Pre-operative apparent diffusion coefficient values and tumour region volumes as prognostic biomarkers in glioblastoma: correlation and progression-free survival analyses
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01.12.2019 |
Durand-Muñoz C.
Flores-Alvarez E.
Moreno-Jimenez S.
Roldan-Valadez E.
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Insights into Imaging |
10.1186/s13244-019-0724-8 |
0 |
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© 2019, The Author(s). Objectives: Glioblastoma (GB) contains diverse histologic regions. Apparent diffusion coefficient (ADC) values are surrogates for the degree of number of cells within the tumour regions. Because an assessment of ADC values and volumes within tumour sub-compartments of GB is missing in the literature, we aimed to evaluate these associations. Methods: A retrospective cohort of 48 patients with GB underwent segmentation to calculate tumour region volumes (in cubic centimetre) and ADC values in tumour regions: normal tissue, enhancing tumour, proximal oedema, distal oedema, and necrosis. Correlation, Kaplan-Meier, and Cox hazard regression analyses were performed. Results: We found a statistically significant difference among ADC values for tumour regions: F (4, 220) = 166.71 and p ≤.001 and tumour region volumes (necrosis, enhancing tumour, peritumoural oedema): F (2, 141) = 136.3 and p ≤.001. Post hoc comparisons indicated that the only significantly different mean score was the peritumoural volume in oedema region (p <.001). We observed a positive significant correlation between ADC of distal oedema and peritumoural volume, r =.418, df = 34, and p =.011. Cox proportional hazards regression analysis considering only tumour region volumes provided an almost significant model: − 2 log-likelihood = 146.066, χ 2 (4) = 9.303, and p =.054 with a trend towards significance of the hazard function: p =.067 and HR = 1.077 for the non-enhancing tumour volume. Conclusions: ADC values together with volumes of oedema region might have a role as predictors of progression-free survival (PFS) in patients with GB; we recommend a routine MRI assessment with the calculation of these biomarkers in GB.
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Disc hernia regression as a natural course of discogenic lumbosacral radiculopathy
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01.10.2018 |
Ivanova M.
Parfenov V.
Isaikin A.
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Zhurnal Nevrologii i Psihiatrii imeni S.S. Korsakova |
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© 2018, Media Sphera Publishing Group. All rights reserved. Disc herniation with radiculopathy is a common cause of severe back pain leading to significant disability and a decrease in patients’ quality of life. The authors report a case of 38-year-old female patient with radiculopathy of the first sacral root due to a large (11 mm) sequestered disc herniation between the fifth lumbar and the first sacral vertebrae. Conservative treatment with flu-oroscopically-guided epidural steroid injection provided a significant clinical improvement, the patient was able to return to normal daily and professional activity in a short time. MRI in 9 months showed the regression of disc herniation. Possible predictors and timing of disc herniation regression are discussed, as well as the proposed mechanisms, the main one of which is considered to be immune-mediated lysis.
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Conservative treatment for patients with discogenic lumbosacral radiculopathy: Results of a prospective follow-up
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01.01.2018 |
Ivanova M.
Parfenov V.
Isaikin A.
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Nevrologiya, Neiropsikhiatriya, Psikhosomatika |
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1 |
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© Ima-Press Publishing House. All rights reserved. Surgical treatment as accelerated functional recovery for discogenic radiculopathy has been proven to have advantages over medical treatment, the efficiency of which remains debatable. Objective: to investigate the efficiency of combination conservative treatment in patients with discogenic lumbosacral radiculopathy. Patients and methods. Thirty patients (12 men and 18 women; mean age, 39.5±2.2 years) with discogenic lumbosacral radiculopathy confirmed by magnetic resonance imaging were followed up. All the patients underwent combination conservative treatment (epidural glucocorticoid administration, analgesic therapy, and motor mode correction). They were surveyed using questionnaires (numeric pain rating scale (NPRS), Oswestry disability index, Hospital Anxiety and Depression Scale, the 12-Item Short Form (SF-12) of Quality of Life (QoL) Questionnaire on admission to the clinic, at 7-14 days after treatment (pain intensity and functional status), and in the long-term period (at 3, 6 and 12 months) after discharge. At baseline, the patients were severely disabled due to pain syndrome. The average Oswestry index was 57.9±3.7%, the back and leg pain intensity scores were 6.5±0.6 and 6.9±0.5, respectively, as evidenced by NPRC. The majority of patients were found to have the combined musculoskeletal sources of pain, such as a myofascial component in 56.7% and sacroiliac joint dysfunction in 43.3%. In these cases, nonsteroidal anti-inflammatory drugs and muscle relaxants were additionally used. Results. The conservative treatment resulted in a statistically significant clinical improvement with a preserved positive effect in the long term: at 1 year, the average Oswestry index was equal to 16.6±3.9%, the back and leg pain intensity scores were 1.7±0.5 and 1.6±0.5, respectively, as shown by NPRC (p<0.001 vs baseline). Within a year, only one female patient required surgical treatment; regression of large extrusions and sequesters, the average initial size of which reached 11.1 mm, was observed in 9 cases. Conclusion. The findings reflect the efficiency of conservative treatment and the expediency of detecting mixed musculoskeletal disorders and their correction in discogenic radiculopathy.
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Prediction of activity and severity of endocrine ophthalmopathy by multidimensional linear regression modeling
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01.01.2018 |
Lihvantseva V.
Afanasev M.
Rudenko E.
Karaulov A.
Afanasev S.
Korosteleva E.
Vygodin V.
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Vestnik Oftalmologii |
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© 2018 Media Sfera. All rights reserved. Endocrine ophthalmopathy (EOP) is a severe chronic autoimmune disease associated with autoimmune thyroid pathology that leads to loss of sight, cosmetic defects and quality of life decrease. EOP is difficult to give prognosis for due to various factors affecting its course and outcome. Purpose - to develop a reliable and precise prognosis method for EOP activity and severity based on personalized combination of risk factors in specific patients by multidimensional linear regression modeling. Material and methods. A group of 139 patients (278 orbits) with newly diagnosed EOP associated with toxic diffuse goiter was observed during 1 year by an ophthalmologist and an endocrinologist; patient examination interval was 6 months. More than 250 indices were dynamically analyzed in the course of the study. Linear regression analysis was chosen as the research method; it allowed detection of linear dependencies between dependent and explanatory variables. Results. More than 600 various linear regression equations were derived that enabled prediction of EOP onset risk and development timeline, estimation of activity and/or severity of the disease, duration of active period in specific patients for the immediate and long-term outcome. From the derived models, the most reliable and safest for practical application were picked out. The present study introduces nine optimized models that can be used for patient follow-up since day one. Conclusion. The onset risk, progression and outcome of the disease can be determined by a combination of factors revealed in the study.
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Classification (Agonist/antagonist) and regression “structure-activity” models of drug interaction with 5-HT6
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01.01.2018 |
Raevsky O.
Grigorev V.
Yarkov A.
Polianczyk D.
Tarasov V.
Bovina E.
Bryzhakina E.
Dearden J.
Avila-Rodriguez M.
Aliev G.
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Central Nervous System Agents in Medicinal Chemistry |
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© 2018 Bentham Science Publishers. Introduction: One promising target for novel psychotropic drugs is the 5-HT6 receptor, G-Protein-Coupled Receptor (GPCR) family, displaying seven transmembrane domains. There is considerable interest in how both 5-HT6 receptor agonist and antagonist compounds can have marked procognitive effects. Methods: An exact structure of the 5-HT6 receptor is not available, so application of powerful methods of (Q)SAR and molecular modelling, which play an essential role in modern drug design, are currently limited to structure-based homology models. The present study is devoted to a detailed QSAR analysis of 61 drugs (26 agonists and 35 antagonists) acting on the 5-HT6 receptor (rattus norvegicus and homo sapiens). Five classification methods were used: k-Nearest Neighbors (k-NN), Logistic Regression (LG), Linear Discriminant Analysis (LDA), Random Forest (RF), and Support Vector Machine (SVM). Multiple Regression Analysis (MRA) was involved also for regression analysis. Spectra of Inter Atomic Interactions (SIAI) were applied in the search for ligand centres interacting with the 5-HT6 receptor. Results & Conclusion: SAR and QSAR models based on the use of HYBOT, MOLTRA, VolSurf+, and SYBYL programs, and having cross-validated coefficients of determination of at least 0.80, show a predominant influence of H-bond acceptor ability and hydrophobicity on the type of ligand activity and degree of inhibition.
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