Biventricular Reference Values by Body Surface Area, Age, and Gender in a Large Cohort of Well‐Treated Thalassemia Major Patients Without Heart Damage Using a Multiparametric CMR Approach

2020 ◽  
Vol 53 (1) ◽  
pp. 61-70 ◽  
Author(s):  
Antonella Meloni ◽  
Riccardo Righi ◽  
Massimiliano Missere ◽  
Stefania Renne ◽  
Nicolò Schicchi ◽  
...  
Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 5293-5293
Author(s):  
Antonella Meloni ◽  
Giovanni Aquaro ◽  
Lamia Ait-Ali ◽  
Saveria Campisi ◽  
Domenico Giuseppe D'Ascola ◽  
...  

Abstract Abstract 5293 Introduction. Cardiovascular Magnetic Resonance (CMR) has provided the opportunity to quantify right ventricular (RV) parameters with excellent reproducibility and accuracy. The role of the RV is gaining ground in thalassemia major (TM) patients and this population could experience different “normal” RV values due to chronic anemia and eventually pre-existing iron burdens. The aim of this study was to establish the ranges for normal RV volumes, mass and ejection fraction (EF) normalized to the influence of body surface area (BSA), age and sex from CMR in a large cohort of well-treated TM patients without myocardial iron overload. Methods. Among the 923 TM patients enrolled in the Myocardial Iron Overload (MIOT) network who underwent CMR for the assessment of cardiac iron overload, function and fibrosis, we selected 142 patients with no known risk factors or history of cardiac disease, normal electrocardiogram, no myocardial iron overload (all the cardiac segments with a normal T2* value) and no myocardial fibrosis. All patients had been regularly transfused and chelated since early childhood. Moreover, we studied 71 healthy subjects matched for age and sex. RV function parameters were quantitatively evaluated in a standard way by SSFP cine images using MASS® software. RV end-diastolic volume (EDV), end-systolic volume (ESV) and stroke volume (SV) were normalized by body surface area (EDVI, ESVI, SVI). Results. The table shows the comparison of the CMR parameters with differentiation for sex and age in TM patients and healthy subjects and the cut-off of normality defined as mean – 2 standard deviation (SD). TM patients showed significantly lower BSA than the controls (P<0.0001). TM males (except age group 14–20 yrs) showed significantly higher RV EF compared to controls. In TM patients all LV volumes indexes were significantly larger in males than in females (P<0.0001 in all age groups). The EF was not different between the sexes. In males as well as in females the RV volumes were no significant different among the age groups, while in males the EF was significant different (P=0.004). Conclusion. In a large cohort of well-treated TM patients males showed significantly higher RV EF compared to controls. Due to the influence of BSA, sex and age, appropriate “normal” reference ranges normalized to these variables should be used to avoid misdiagnosis of cardiomyopathy in the clinical arena in TM patients. Disclosures: No relevant conflicts of interest to declare.


BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Usman Arshad ◽  
Max Taubert ◽  
Tamina Seeger-Nukpezah ◽  
Sami Ullah ◽  
Kirsten C. Spindeldreier ◽  
...  

Abstract Background The aim of this study was to identify sources of variability including patient gender and body surface area (BSA) in pharmacokinetic (PK) exposure for high-dose methotrexate (MTX) continuous infusion in a large cohort of patients with hematological and solid malignancies. Methods We conducted a retrospective PK analysis of MTX plasma concentration data from hematological/oncological patients treated at the University Hospital of Cologne between 2005 and 2018. Nonlinear mixed effects modeling was performed. Covariate data on patient demographics and clinical chemistry parameters was incorporated to assess relationships with PK parameters. Simulations were conducted to compare exposure and probability of target attainment (PTA) under BSA adjusted, flat and stratified dosing regimens. Results Plasma concentration over time data (2182 measurements) from therapeutic drug monitoring from 229 patients was available. PK of MTX were best described by a three-compartment model. Values for clearance (CL) of 4.33 [2.95–5.92] L h− 1 and central volume of distribution of 4.29 [1.81–7.33] L were estimated. An inter-occasion variability of 23.1% (coefficient of variation) and an inter-individual variability of 29.7% were associated to CL, which was 16 [7–25] % lower in women. Serum creatinine, patient age, sex and BSA were significantly related to CL of MTX. Simulations suggested that differences in PTA between flat and BSA-based dosing were marginal, with stratified dosing performing best overall. Conclusion A dosing scheme with doses stratified across BSA quartiles is suggested to optimize target exposure attainment. Influence of patient sex on CL of MTX is present but small in magnitude.


1970 ◽  
Vol 32 (2) ◽  
pp. 36-43 ◽  
Author(s):  
P Kayastha ◽  
S Paudel ◽  
DM Shrestha ◽  
RJ Ghimire ◽  
S Pradhan

Introduction: The purpose of this study was to establish reference ranges of total thyroid volume among clinically euthyroid Nepalese population using Ultrasonography and correlate this volume with age, sex, individual’s built and geographic location. Methods: This was a prospective cross sectional study involving 485 clinically euthyroid individuals. B - mode Ultrasonography was used to measure the total thyroid volume by combining the volume of both the lobes obtained by using formula for prolate ellipsoid. Age specific reference values for thyroid volume were obtained and Pearson correlation test was used to see the relationship with various factors. Results: Among 485 individuals between 1 to 83 years of age, 221(45.57%) were males and 264(54.43%) were females. Maximum [354 individuals (72.99%)] were from hilly region and minimum [16 individual (3.30%)] were from Himalayan region. Mean thyroid volume was 6.629 ± 2.5025 ml. In general, thyroid volume was found to be more in older individuals than in young age group. There was no significant difference of thyroid volume between males and females. Thyroid volume best correlated with body surface area (r=0.444, p<0.0001). The volume had a positive correlation with weight (r=0.443, p<0.0001), body mass index (r=0.371, p<0.0001) and height (r=0.320, p<0.0001) of the individual. Conclusions: This study estimated the reference range of total thyroid volume for Nepalese population. These ranges are significantly lower than the WHO/ICCIDD thyroid volume references and reference values obtained in various other countries. Total thyroid volume best correlated with Body surface area. Keywords: Body surface area; clinically euthyroid; total thyroid volume; ultrasonography DOI: http://dx.doi.org/10.3126/joim.v32i2.4944 Journal of Institute of Medicine, August, 2010; 32: 36-43


1987 ◽  
Vol 1 (1) ◽  
pp. 3-10 ◽  
Author(s):  
Julius M. Gardin ◽  
Mary K. Rohan ◽  
Dennis M. Davidson ◽  
Ali Dabestani ◽  
Mark Sklansky ◽  
...  

2020 ◽  
Author(s):  
Yanli Liu ◽  
Jiashuo Wang ◽  
Shan Zhong

Abstract Background: Difficult tracheal intubation is a common problem encountered by anesthesiologists in the clinic. This study was conducted to assess the difficulty of tracheal intubation in infants with Pierre Robin syndrome (PRS) by incorporating computed tomography (CT) to guide airway management for anesthesia. Methods: In this retrospective study, we analyzed case-level clinical data and CT images of 96 infants with PRS. First, a clinically experienced physician labeled CT images, after which the color space conversion, binarization, contour acquisition, and area calculation processing were performed on the annotated files. Finally, the correlation coefficient between the seven clinical factors and tracheal intubation difficulty, as well as the differences in each risk factor under tracheal intubation difficulty were calculated. Results: The absolute value of the correlation coefficient between the throat area and tracheal intubation difficulty was 0.54; the observed difference was statistically significant. Body surface area, weight, and gender also showed significant difference under tracheal intubation difficulty. Conclusions: There is a significant correlation between throat area and tracheal intubation difficulty in infants with PRS. Body surface area, weight and gender may have an impact on tracheal intubation difficulty in infants with PRS.


Author(s):  
Niek H. Prakken ◽  
Birgitta K. Velthuis ◽  
Arco J. Teske ◽  
Arend Mosterd ◽  
Willem P. Mali ◽  
...  

2021 ◽  
Vol 12 ◽  
Author(s):  
Yingying Wang ◽  
Xiaolian Dong ◽  
Chaowei Fu ◽  
Meifang Su ◽  
Feng Jiang ◽  
...  

BackgroundThyroid volume (Tvol) is associated with many factors, but the current reference values for Tvol in children with sufficient iodine intake are inappropriate and need to be updated. Moderate changes in thyroid morphology and accentuated increases in body fat percentage occur during puberty as an adaption of the body and sexual development occurs. This study aimed to evaluate the influences of physical growth on Tvol and propose an easily applicable method for conducting Tvol assessments in pubertal girls with sufficient iodine intake.MethodsA cohort study was conducted on 481 pubertal girls in East China from 2017 to 2019. B-ultrasound was used to assess Tvol. Multiple linear regression models were used to estimate the associations of Tvol enlargement (dTvol) with changes in height (dH), weight (dW), waist circumference (dW), body mass index (dBMI), and body surface area (dBSA). Thyroid volume indexes (TVIs), including height thyroid volume index (HVI), weight and height thyroid volume index (WHVI), body mass index thyroid index (BMIV), and body surface area thyroid index (BSAV), were calculated to explore an appropriate method for Tvol assessments by Spearman correlation analyses.ResultsTvol, height, weight, BMI, and BSA increased significantly from baseline to follow-up (P&lt;0.001). The associations between dTvol and physical growth were only observed in the 13 to 14-year-old group. dH, dW,dBMI, and dBSA were positively related to dTvol, with the maximum β of 5.74 (95%CI: 2.54 to 8.94) on dBSA, while dWC was negatively related to dTvol (β= -0.05, 95%CI: -0.08 to -0.03). Both dHVI and dBSAV were not associated with dH, dW, dBMI, or dBSA in both age groups (P&gt;0.05).ConclusionsThyroid volume was associated with physical growth in pubertal girls in East China, both age and anthropometric measurements must be comprehensively considered to establish the reference values for Tvol. HVI, and BSAV may be better indicators for Tvol assessments in pubertal girls.


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