Novel Classification of Acromegaly in Accordance with Immunohistochemical Subtypes: Is There Really a Clinical Relevance?

2021 ◽  
Author(s):  
Gamze Akkus ◽  
Fulya Odabaş ◽  
Sinan Sözütok ◽  
Murat Sert ◽  
Numan Emre Ak ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Clinical Outcomes ◽  
Pituitary Tumors ◽  
University Hospital ◽  
Proliferation Index ◽  
Ki 67 ◽  
Age And Gender ◽  
Remission Rates ◽  
And Gender ◽  
Group 1

AbstractAccording to the recent studies, immunohistochemical subtypes of growth hormone (GH) secreting adenomas have been considered as a predictive factor in determining the clinical outcomes including biochemical, radiologic, and endocrine remission. In a 20 year-of time period, acromegaly patients who were treated and followed at the Endocrinology Department of our University Hospital were screened for the study. Of total 98 patients, 65 patients who had been operated by transsphenoidal surgery and having postoperative specimens were included. Postoperative specimens of the surgery of the patients were classified into 3 groups based on the histochemical characteristics (densely, sparsely, and mixed). Parasellar extensions of pituitary tumors were classified into the five grades according to Knosp classification. The patients were investigated and evaluated for postoperative clinical progress, remission rates, comorbidities regarding with the histopathological patterns. Of total 65 patients, 31 were classified as densely granulated (group 1), 32 were classified as sparsely granulated (group 2), and 2 patients were assessed as mixed granulated (group 3). There was no difference between groups for age and gender. Pre-treatment of adenoma size in all groups was correlated with each other and the frequency of macroadenoma (1 vs. 2, 77.4 vs. 84.3%) was higher in two groups. Although mean initial GH levels in group 1 was higher than the other groups (p=0.03), IGF1 levels (age and gender matched) were similar in each group. Adenomas in all groups demonstrated noninvasive radiological characteristics (Knosp grade 0–1–2). Ki-67 proliferation index of both groups (64.5 vs. 50%) was predominantly 1%. With a similar follow-up period, the endocrine remission rates (GH<1 μg/l) in groups were 64 vs. 69%, respectively. In conclusion, classification according to immunohistochemical subtypes of growth hormone secreting adenomas may not be a qualified parameter to evaluate patients with patterns of aggressiveness, clinical outcomes, or treatment response.

scholarly journals Influence of Gender on Cardiac and Encephalic Inflammation in the Elderly with Cysticercosis: A Case Control Study

2012 ◽  
Vol 2012 ◽  
pp. 1-6
Author(s):  
Camila Lourencini Cavellani ◽  
Rosana Rosa Miranda Corrêa ◽  
Mara Lúcia Fonseca Ferraz ◽  
Laura Penna Rocha ◽  
Ana Carolina Guimarães Faleiros ◽  
...  
Keyword(s):  
Inflammatory Infiltrate ◽  
Case Control Study ◽  
The Elderly ◽  
Brain Parenchyma ◽  
Elderly Group ◽  
University Hospital ◽  
Evolutionary Stage ◽  
Age And Gender ◽  
And Gender ◽  
Control Study

Background. The present study explores the influence of the host’s age and gender upon the inflammatory infiltrate. We aimed to quantify the inflammatory infiltrate caused by cysticercosis, which is related to aging, in the heart and in the encephalon.Methods. 75 autopsy protocols with cysticercosis diagnosis from department of pathology at a university hospital from 1970 to 2008 were reviewed. Two groups were formed: elderly with cysticercosis and nonelderly with cysticercosis. We used KS-300 (Kontron-Zeiss) software for morphometric analysis of the inflammation.Results.The elderly had an average of3.1±2.5cysticerci, whereas the non-elderly had2.7±3.8parasites. The non-elderly group with cysticercosis had significantly more inflammation, both cardiac and encephalic, than the elderly group. The elderly females with cysticercosis had more cardiac and encephalic inflammation.Conclusions. In this study, we showed that the non-elderly had significantly more cardiac and encephalic inflammation than the elderly, and that such inflammatory infiltrate decreases with age and depends upon the evolutionary stage of the cysticercus. Furthermore, there are differences concerning gender in the intensity of the inflammatory response due to cysticerci in the heart and brain parenchyma during senescence. Even during this period, women continue to have a more intense response to the parasitosis.

Reference interval by the indirect approach of serum thyrotropin (TSH) in a Mediterranean adult population and the association with age and gender

2019 ◽  
Vol 57 (10) ◽  
pp. 1587-1594 ◽  
Author(s):  
Bruna Lo Sasso ◽  
Matteo Vidali ◽  
Concetta Scazzone ◽  
Luisa Agnello ◽  
Marcello Ciaccio
Keyword(s):  
Healthy Subjects ◽  
Indirect Method ◽  
Adult Population ◽  
Reference Interval ◽  
University Hospital ◽  
Thyroid Peroxidase ◽  
Free Triiodothyronine ◽  
Age And Gender ◽  
And Gender ◽  
Effect Of Age

Abstract Background The serum concentration of thyrotropin (TSH) represents a first-line test in diagnostic algorithms. The estimation of TSH reference intervals (RIs) is still a matter of debate due to the high prevalence of subclinical disease making difficult the definition of truly healthy subjects. The aim of this study was to estimate TSH RIs in healthy subjects and to evaluate the effect of age and gender on TSH concentration. Methods Forty-four thousand one hundred and fifty-six TSH data were collected between July 2012 and April 2018 at the Department of Laboratory Medicine, University-Hospital, Palermo. Common and sex-specific RIs were estimated by Arzideh’s indirect method after exclusion of individuals younger than 15 years, subjects with repeated TSH tests and with abnormal free thyroxine (fT4), free triiodothyronine (fT3) or anti-thyroid-peroxidase antibodies. The combined effect of age and gender on TSH values was evaluated. Results RIs estimated in the selected individuals (n = 22602) were, respectively, 0.18–3.54 mIU/L (general), 0.19–3.23 mIU/L (men) and 0.18–3.94 mIU/L (women). Women showed significantly higher median TSH than men (1.46 vs. 1.39 mIU/L; p < 0.0001). Both in men and in women, median TSH decreased along with age; however, although up to 60 years in both men and women showed similar values, afterwards women showed constantly higher TSH than men. Accordingly, statistical analysis showed a significant interaction between gender and age (p = 0.001), suggesting that the effect of age on TSH is different between genders. Conclusions Our findings suggest that the indirect method, with appropriate cleaning of data, could be useful to define TSH RIs.

Growth hormone binding protein and growth hormone availability in acromegalic patients treated with long-acting octreotide (Sandostatin-LAR)

1997 ◽  
Vol 136 (1) ◽  
pp. 61-66 ◽  
Author(s):  
Sanne Fisker ◽  
Andreas Kaal ◽  
Marcella Montini ◽  
Alberto Pedroncelli ◽  
Giorgio Pagani ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Binding Protein ◽  
Hormone Binding ◽  
Age And Gender ◽  
Growth Hormone Binding Protein ◽  
Igf I ◽  
Octreotide Treatment ◽  
Hormone Binding Protein ◽  
And Gender ◽  
Long Acting

Abstract Objective: In the medical treatment of acromegaly different factors are influencial; among these the impact on growth hormone binding protein (GHBP) has not been clarified. Design: Twenty acromegalic patients and nineteen age- and gender-matched normal subjects participated in this study. The patients were treated for 21 months with depot long-acting microsphere-enclosed octreotide (Sandostatin-LAR). Previously, all the patients were treated s.c. with octreotide t.i.d. After a 2-week wash-out period (baseline) the patients received the first i.m. injection of the long-acting octreotide. The first two injections were administered at 60-day intervals; thereafter the injections were at 28-day intervals. Methods: The levels of GHBP, complexed GHBP, growth hormone (GH) and insulin-like growth factor-I (IGF-I) were determined in fasting serum samples. Results: In the 2-week wash-out period GHBP levels decreased from 1·13 ± 0·17 to 0·92 ± 0·15 nmol/l (P < 0·05). During the 21-months treatment, GHBP increased again to 1·10 ± 0·16 nmol/l. In the age- and gender-matched control group GHBP levels were significantly higher at all times (1·95 ± 0·21 nmol/l, P(all) < 0·02). Mean levels of 8-h GH decreased from 12·6 ± 2·58 μg/l at baseline to 1·97 ± 0·20 μg/l after 21 months of treatment (P < 0·05). Mean 8-h GH levels were unchanged during long-acting octreotide treatment compared with levels during s.c. treatment (1·97 ± 0·20 μg/l and 1·90 ± 0·20 μg/l respectively). In fasting blood samples GH-complexed GHBP ranged from 13·8 ± 2·4% (9 months) to 25·4 ± 4·5% (baseline) of total GHBP. Serum IGF-I increased from 367 ± 45 to 764 ± 80 μg/l (P < 0·05) during the 2-week wash-out period and decreased to 290 ± 35 μg/l (P < 0·05) after 21 months of treatment with long-acting octreotide. IGF-I levels after 21 months were significantly lower than during s.c. octreotide treatment (P < 0·05). Conclusion: Serum GHBP levels are similar during treatment with long-acting octreotide as compared with regular octreotide. Furthermore, significant changes in GHBP can occur within 2 weeks. Finally, in addition to the lowering effect on GH levels, the induced increase in GHBP levels may imply a further advantage in octreotide treatment of acromegaly, circulating GH bound to GHBP may less readily reach the tissues. European Journal of Endocrinology 136 61–66

scholarly journals Interatrial block as electrocardiographic predictive sign for atrial fibrillation in patients hospitalized in Internal Medicine Departments

2019 ◽  
Vol 13 (2) ◽  
pp. 103-108 ◽  
Author(s):  
Gianpaolo Bragagni ◽  
Chiu Hua Chen ◽  
Federico Lari ◽  
Gaetano Magenta
Keyword(s):  
Internal Medicine ◽  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Clinical Features ◽  
P Wave ◽  
Age And Gender ◽  
Interatrial Block ◽  
Group 2 ◽  
And Gender ◽  
Group 1

This study evaluated the correlation between interatrial block (IAB) and atrial fibrillation (AF) among patients admitted to our Internal Medicine Unit: 110 (group 1) were identified with electrocardiograms both in sinus rhythm and AF, and 123 (group 2) constantly in sinus rhythm. In both groups we analyzed: the presence of partial (P≥120 msec) or advanced (P>120 msec and biphasic in D2, D3, aVF) IAB, and the main electrocardiographic and clinical features. Age and gender between the two groups were similar. IAB was present in 89/110 (80.91%) in group 1 and 26/123 (21.13%) in group 2 (P=<0.01); partial in 50/110 (45.45%) and 19/123 (15.7%) in group 1 and 2 respectively (P<0.01), advanced in 39/110 (35.45%) and 7/123 (5.69%) (P<0.019). The correlation between IAB and AF was significant (P<0.001); 36 (65.4%) patients out of 55 with atrial echo dilatation had IAB and 14 (25.4%) had deep terminal negativity of P-wave in V1 (DTNPV1) >0.1 mV (P<0.01). IAB represents a reliable predictor of AF; moreover, the sensitivity of the IAB in detecting atrial dilatation is higher than the DTNPV1 >0.1 mV.

Nasal Carriage ofStaphylococcus aureusAmong Patients Receiving Allergen-Injection Immunotherapy: Associated Factors and Quantitative Nasal Cultures

2001 ◽  
Vol 22 (12) ◽  
pp. 741-745 ◽  
Author(s):  
Stefano Bassetti ◽  
Donnie P. Dunagan ◽  
Ralph B. D'Agostino ◽  
Robert J. Sherertz
Keyword(s):  
Atopic Dermatitis ◽  
Independent Predictor ◽  
Statistical Significance ◽  
Nasal Carriage ◽  
University Hospital ◽  
Carriage Rate ◽  
Age And Gender ◽  
Desensitization Therapy ◽  
Second Year ◽  
And Gender

AbstractObjective:To compare the prevalence of nasalStaphylococcus aureuscarriage among outpatients receiving allergen-injection immunotherapy with the prevalence among healthy controls and to determine predictors of nasalS aureuscarriage.Design:Survey.Setting:Allergy clinic of a university hospital.Participants:A volunteer sample consisting of 45 outpatients undergoing desensitization therapy and 84 first- and second-year medical students.Results:The nasalS aureuscarriage rate was significantly higher among patients (46.7%) than among students (26.2%;P=.019). In a multivariate model adjusted for age and gender, the presence of atopic dermatitis or eczema was the only independent predictor of nasal Saureuscarriage (odds ratio [OR], 4.4; 95% confidence interval [CI95], 1.2-16.0;P=.02). The only other participant characteristic associated with nasalS aureuscarriage was immunotherapy with allergen injections (OR, 1.98; CI95, 0.7-6.0), but this association did not reach statistical significance (P=.23). The probability of nasalS aureuscarriage was 88.9% for patients receiving allergen injections and having atopic dermatitis or eczema, and 36.1% for patients receiving allergen injections without atopic dermatitis or eczema.Conclusions:Patients undergoing desensitization have a higher nasal carriage rate ofS aureus.However, factors other than the regular use of needles, and in particular abnormalities related to the atopic constitution of these patients, may predispose this population forS aureuscarriage.

scholarly journals COVID-19 Clinical Profile in Latin American Migrants Living in Spain: Does the Geographical Origin Matter?

2021 ◽  
Vol 10 (22) ◽  
pp. 5213
Author(s):  
Abiu Sempere ◽  
Fernando Salvador ◽  
Arnau Monforte ◽  
Júlia Sampol ◽  
Juan Espinosa-Pereiro ◽  
...  
Keyword(s):  
Latin America ◽  
Latin American ◽  
Geographical Origin ◽  
Vital Signs ◽  
Hospitalized Patients ◽  
University Hospital ◽  
Retrospective Case ◽  
Age And Gender ◽  
And Gender ◽  
Control Study

The aim of this study was to describe and compare the clinical characteristics of hospitalized patients with COVID-19 pneumonia according to their geographical origin. This is a retrospective case-control study of hospitalized patients with confirmed COVID-19 pneumonia treated at Vall d’Hebron University Hospital (Barcelona) during the first wave of the pandemic. Cases were defined as patients born in Latin America and controls were randomly selected among Spanish patients matched by age and gender. Demographic and clinical variables were collected, including comorbidities, symptoms, vital signs and analytical parameters, intensive care unit admission and outcome at 28 days after admission. Overall, 1080 hospitalized patients were registered: 774 (71.6%) from Spain, 142 (13.1%) from Latin America and the rest from other countries. Patients from Latin America were considered as cases and 558 Spanish patients were randomly selected as controls. Latin American patients had a higher proportion of anosmia, rhinorrhea and odynophagia, as well as higher mean levels of platelets and lower mean levels of ferritin than Spanish patients. No differences were found in oxygen requirement and mortality at 28 days after admission, but there was a higher proportion of ICU admissions (28.2% vs. 20.2%, p = 0.0310). An increased proportion of ICU admissions were found in patients from Latin America compared with native Spanish patients when adjusted by age and gender, with no significant differences in in-hospital mortality.

scholarly journals The Utility of the Callosal/Supratentorial-Supracallosal Area Ratio to Evaluate Corpus Callosum Morphometry in Children

2020 ◽  
Author(s):  
Mehmet Öztürk ◽  
Emine Uysal ◽  
Halil İbrahim Duran ◽  
Zuhal İnce Bayramoğlu ◽  
Abidin Kılınçer
Keyword(s):  
Corpus Callosum ◽  
Sagittal Plane ◽  
Pediatric Population ◽  
Age Group ◽  
Age And Gender ◽  
Mean Values ◽  
Group 3 ◽  
Group 2 ◽  
And Gender ◽  
Group 1

Objective: To perform morphometric analysis of corpus callosum (CC) by using callosal area (CA), supratentorial-supracallosal area (SSA) and CA/SSA parameters in a healthy pediatric population and to investigate changes according to age and gender. Method: Method: This retrospective study included a total of 313 children (154 boys, 159 girls) aged between 3-17 years. The cases were divided into three groups according to age: 3-6 years (Group 1) (pre-school), 7-12 years (Group 2) (preadolescent) and 13-17 years (Group 3) (adolescent). CA and SSA were measured on the mid-sagittal plane on T1-weighted images. CA/ SSA index was calculated. Differences in age, CA, SSA, and ratio parameters among the gender groups were compared using the Mann-Whitney U or the t-test. Results: Median values of CA (p= 0.002), mean values of SSA (p=0.001) and CA/SSA ratios (p= 0.04) were significantly higher in boys compared to girls. The median CA and mean CA/SSA ratios in Group 3 were significantly higher than Groups 1 and 2 (p= 0.001). Mean CA/SSA ratio values of boys and girls in Age Group 3 were significantly higher than Group 1 (p= 0.001) and significantly higher than Age Group 2 in girls. There were highly significant positive correlations of age with CA (p=0.001, r=0.47), SSA (p=0.028, r=0.12) and CA/SSA ratio (p=0.001, r=042). There was a highly significant and positive correlation between CA and SSA (p=0.001, r=0.25) and CA/SSA ratio (p=0.001, r=0.87). Conclusion: CA, SSA, and CA/ SSA ratio values in children are affected by age and gender. These parameters can be used as reference values for the diagnosis of congenital and acquired pathologies affecting the corpus callosum.

Clinicopathological significance of CD47 expression in hepatocellular carcinoma

2020 ◽  
pp. jclinpath-2020-206611
Author(s):  
Hyunsung Kim ◽  
Seongsik Bang ◽  
Seungyun Jee ◽  
Seung Sam Paik ◽  
Kiseok Jang
Keyword(s):  
Hepatocellular Carcinoma ◽  
Clinical Outcomes ◽  
Adjuvant Treatment ◽  
Clinical Investigation ◽  
Tumour Cells ◽  
Proliferation Index ◽  
Recurrence Free Survival ◽  
Ki 67 ◽  
Free Survival ◽  
Preclinical Trials

AimsCD47 is upregulated on the surface of various tumour cells, and it is known to inhibit the phagocytosis of tumour cells by macrophages. Immunotherapy that targets CD47 has demonstrated success in preclinical trials and is now under clinical investigation for both solid and haematological malignancies. However, data regarding CD47 expression in hepatocellular carcinoma (HCC) tissue and its correlation with clinical outcomes in patients with HCC remain limited. Here, we investigated the clinicopathological features associated with CD47 expression in HCC.MethodsCD47 expression was evaluated by immunohistochemistry in tissue microarray sections containing 166 HCC tissues. CD47 expression was considered positive if 10% or more tumour cells were stained.ResultsCD47 expression was observed in 36 (21.7%) of 166 HCC tissues and was significantly associated with frequent large vessel invasion, advanced American Joint Committee on Cancer stage and higher Ki-67 proliferation index. In the survival analyses, CD47 expression was not associated with recurrence-free survival or overall survival in total patients with HCC. However, in patients who received surgical resection without any adjuvant treatment, CD47 expression was associated with shorter recurrence-free survival.ConclusionsCD47 expression was significantly associated with adverse pathological features and poor clinical outcomes in patients with HCC who did not receive adjuvant treatment.

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