Malignancy risk of indeterminate mammographic calcification in symptomatic breast clinics

2021 ◽  
pp. postgradmedj-2021-140835
Author(s):  
Gaurav J Bansal ◽  
Lauren Emanuel ◽  
Sesha Kanagasabai
Keyword(s):  
Breast Biopsy ◽  
Linear Regression Analysis ◽  
Regional Distribution ◽  
Study Cohort ◽  
Malignancy Risk ◽  
Breast Malignancy ◽  
Potential Risk Factors ◽  
The Mean ◽  
Multiple Clusters ◽  
Symptomatic Breast

BackgroundTo explore the potential risk factors predicting malignancy in patients with indeterminate incidental mammographic microcalcification and to evaluate the short-term risk of developing malignancy.MethodsBetween January 2011 and December 2015, one hundred and fifty (150) consecutive patients with indeterminate mammographic microcalcifications who had undergone stereotactic biopsy were evaluated. Clinical and mammographic features were recorded and compared with histopathological biopsy results. In patients with malignancy, postsurgical findings and surgical upgrade, if any, were recorded. Linear regression analysis (SPSS V.25) was used to evaluate significant variables predicting malignancy. OR with 95% CIs was calculated for all variables. All patients were followed up for a maximum of 10 years. The mean age of the patients was 52 years (range 33–79 years).ResultsThere were a total of 55 (37%) malignant results in this study cohort. Age was an independent predictor of breast malignancy with an OR (95% CI) of 1.10 (1.03 to 1.16). Mammographic microcalcification size, pleomorphic morphology, multiple clusters and linear/segmental distribution were significantly associated with malignancy with OR (CI) of 1.03 (1.002 to 1.06), 6.06 (2.24 to 16.66), 6.35 (1.44 to 27.90) and 4.66 (1.07 to 20.19). The regional distribution of microcalcification had an OR of 3.09 (0.92 to 10.3), but this was not statistically significant. Patients with previous breast biopsies had a lower risk of breast malignancy than patients with no prior biopsy (p=0.034).ConclusionMultiple clusters, linear/segmental distribution, pleomorphic morphology, size of mammographic microcalcifications and increasing age were independent predictors of malignancy. Having a previous breast biopsy did not increase malignancy risk.

The Aging Parotid Gland: A Longitudinal Volumetric Study and Implications for Treatment

2020 ◽  
Author(s):  
Jacob I Tower ◽  
Tareq Sawan ◽  
Neil A Gordon ◽  
Boris Paskhover
Keyword(s):  
Regression Analysis ◽  
Linear Regression ◽  
Parotid Gland ◽  
Multiple Linear Regression ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Ct Scans ◽  
Study Cohort ◽  
Gland Volume ◽  
The Mean

Abstract Background The parotid gland accounts for significant soft tissue volume in the face and is therefore of central relevance to facial and neck rejuvenation. Objectives To determine how parotid gland volume is predicted by age and other factors. Methods We conducted a retrospective longitudinal study of patients with multiple computed tomography (CT) scans of the neck performed at least 7 years apart. Parotid gland volumes were measured and multiple linear regression analysis was performed to model the relations between age, BMI and parotid volume. Results The study cohort comprised 70 patients. The mean (SD) ages at initial and final imaging time points were 47.5 (12.6) and 58.8 (12.2) years old, with an average of 11.3 years elapsed between CT scans. The mean (SD) parotid gland volume increased from 28.7 (10.0) cc to 32.2 (10.7) cc over the average 11.3 year period (P = 0.03). However, the results of the multiple linear regression analysis show that when controlling for body mass index (BMI) and sex, age alone does not predict parotid volume (P = 0.29). BMI was directly correlated with gland volume (P < 0.01). An increase of 1.0 kg/m 2 in BMI predicted an increase in parotid volume by 1.1 cc. Male sex was also associated with significantly greater parotid volume. Conclusions Mean parotid volume increased over time but these gains were driven by increases in BMI and not age alone. These findings are highly relevant to the treatment of the aging face and neck.

Analysis of Clinical, Imaging, and Pathologic Features of 36 Patients with Primary Intraspinal Primitive Neuroectodermal Tumors: A Case Series and Literature Review

2021 ◽  
Author(s):  
Xuefeng Wei ◽  
Xu Zhang ◽  
Zimu Song ◽  
Feng Wang
Keyword(s):  
Literature Review ◽  
Single Case ◽  
Case Reports ◽  
Case Series ◽  
Subtotal Resection ◽  
Study Cohort ◽  
Primitive Neuroectodermal Tumors ◽  
Pathologic Features ◽  
Neuroectodermal Tumors ◽  
The Mean

Abstract Background and Study Aims Primary intraspinal primitive neuroectodermal tumors (PNETs) account for ∼0.4% of all intraspinal tumors, but information about these tumors in the medical literature is limited to single case reports. We report four cases of primary intraspinal PNETs and present a systematic literature review of the reported cases. Materials and Methods We retrospectively reviewed and analyzed the clinical data of 4 patients with primary intraspinal PNETs who underwent neurosurgical treatment at our clinic between January 2013 and January 2020, and of 32 cases reported in the literature. Results The female-to-male ratio was 2.6:1. The mean patient age was 21.42 ± 15.76 years (range: 1–60 years), and patients <36 years of age accounted for 83.30% of the study cohort. Progressive limb weakness and numbness were the chief symptoms (accounting for ∼55.6%). The mean complaint duration was 0.89 ± 0.66 months for males and 2.72 ± 3.82 months for females (p = 0.028). Epidural (41.7%) was the most common site, and thoracic (47.3%) was the most frequent location. Most PNETs were peripheral, and magnetic resonance imaging (MRI) appearance was isointense or mildly hypointense on T1-weighted images and hyperintense on T2-weighted images. Homogeneous contrast enhancement was observed. The 1-year survival rate of patients who underwent chemoradiation after total or subtotal lesion resection was better compared with patients who did not undergo chemotherapy, radiotherapy, or total or subtotal resection. The modality of treatment was associated with survival time (p = 0.007). Conclusion Primary intraspinal PNETs mainly occur in young people with a female preponderance. In patients with a rapid loss of lower limb muscle strength and large intraspinal lesions on MRI, PNETs should be considered. Surgical resection and adjuvant radio chemotherapy are key prognostic factors.

scholarly journals Happiness, quality of working life, and job satisfaction among nurses working in emergency departments in Iran

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Somayeh Javanmardnejad ◽  
Razieh Bandari ◽  
Majideh Heravi-Karimooi ◽  
Nahid Rejeh ◽  
Hamid Sharif Nia ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Emergency Departments ◽  
Economic Status ◽  
Linear Regression Analysis ◽  
Working Life ◽  
Least Square ◽  
Life Questionnaire ◽  
Quality Of Working Life ◽  
The Mean

Abstract Background Nurses have a vital role in the healthcare system. One of the basic steps to increase their happiness is to recognize factors such as job satisfaction and quality of working life. Therefore, the goal of the present study was to examine the relationship between happiness and quality of working life and job satisfaction among nursing personnel. Methods This descriptive study was carried out on 270 hospital nurses who worked in emergency departments in Iran. Nurses were recruited through the census method. Data collection instruments included the Oxford Happiness Inventory (OHI), the Quality of Work Life Questionnaire (QWL), and the Job Satisfaction Questionnaire (JSQ). Data were explored using descriptive statistics, and stepwise multiple linear regression analysis. Results The mean age of participants was 30.1 ± 6.26 years. The mean happiness score was 38.5 ± 16.22, the mean Quality of Working Life (QWL) score was 84.3 ± 17.62, and the mean job satisfaction score was found to be 45.5 ± 13.57); corresponding to moderate levels of attributes. The results obtained from the ordinary least-square (OLS) regression indicated that happiness significantly was associated with economic status and satisfaction with closure (R2: 0.38). Conclusion Overall the current study found that nurses who work in emergency departments did not feel happy. Additionally, the findings suggest that their happiness were associated with their economic status, and closure over their duties.

The impact of legs fat mass and legs lean fat mass on thigh circumference according cardiovascular risk: a population-based study

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
M Chlabicz ◽  
M Paniczko ◽  
J Jamolkowski ◽  
P Sowa ◽  
M Lapinska ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Regression Analysis ◽  
Linear Regression ◽  
Muscle Tissue ◽  
Fat Mass ◽  
Linear Regression Analysis ◽  
Population Based ◽  
Thigh Circumference ◽  
Tissue Model ◽  
The Mean

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Medical University of Bialystok, Poland Introduction A low thigh circumference is associated with an increased risk of high blood pressure, diabetes, cardiovascular diseases, and total mortality. Objectives The aim of the study was to investigate the relationship between the thigh circumference and cardiovascular (CV) risk classes, and to assess what type of tissue, adipose tissue or muscle tissue affects the thigh circumference. Methods The longitudinal, population-based, Polish study was conducted in 2017-2020. A total of 931 individuals aged 20-79 were analyzed. Pol-SCORE system was used to assess the 10-year risk of fatal CV based on the following risk factors: age, gender, smoking, systolic blood pressure, and total cholesterol for individuals aged 40-70.  Then, CV risk classes were assessed using the 2019 ESC/EAS guidelines. The measurement of thigh circumference were performed directly below the gluteal fold of the thigh. Both thighs were measured and the mean value was calculated as the final thigh circumference. Body composition was assessed using Dual Energy X-ray Absorptiometry (DEXA). Results The mean age was 49.1 ± 15.5 years and 43.2% male. The mean thigh circumference was 58.2 ± 5.9 cm, the mean legs fat mass was 7.7 ± 2.8kg, and the mean legs lean mass was 16.9 ± 4.0kg. Lower thigh circumference was associated with higher CV risk classes in univariate linear regression analysis (β -0.516, p = 0.002), as well adjusted by age and sex (β -0.839, p = 0.008), adjusted by age, sex, BMI (β -0.886, p &lt;0.001), and age, sex, WHR (β -0.988, p &lt;0.001). In linear regression analysis legs adipose tissue and muscle tissue were related to the thigh circumference independently of CV risk classes (Model 1) and Pol-SCORE value (Model 2). However, fatty tissue (Model 1: β 0.746, p &lt; 0.001; Model 2: β 0.749, p &lt; 0.001) affects the thigh circumference more than the muscle tissue (Model 1: β 0.479, p &lt; 0.001; Model 2: β 0.442, p &lt; 0.001) (Fig. 1). Conclusion Smaller thigh circumference was associated with higher CV risk classes. Thigh circumference was more influenced by adipose tissue than by muscle tissue, regardless of the Pol-SCORE  or CV risk classes. Table 1. Variable Model 1 Model 2 Beta p R2 Beta p R2 Legs fat mass 0.746 &lt;0.001 0.785 0.749 &lt;0.001 0.760 Legs lean mass 0.479 &lt;0.001 0.785 0.442 &lt;0.001 0.760 Model 1: adjusted for Cardiovascular risk classesModel 2: adjusted for Pol-SCOREResults of the linear regression analysis thigh circumference in the general population Abstract Figure 1.

scholarly journals Outcomes of Local Bone Graft and Fixation of Proximal Pole Scaphoid Nascent Nonunions and Nonunions

2020 ◽  
Vol 09 (03) ◽  
pp. 203-208
Author(s):  
Kristin E. Shoji ◽  
F. Joseph Simeone ◽  
Sezai Ozkan ◽  
Chaitanya S. Mudgal
Keyword(s):  
Bone Graft ◽  
Common Mechanism ◽  
Study Cohort ◽  
Proximal Pole ◽  
Scaphoid Fractures ◽  
Local Bone ◽  
Case Series Study ◽  
Increased Risk ◽  
Surgical Fixation ◽  
The Mean

Abstract Background Fractures of the proximal pole of the scaphoid have an increased risk of nonunion due to its tenuous blood supply. The optimal treatment of proximal pole scaphoid nonunions remains controversial. Objectives To review a single surgeon's experience with proximal pole scaphoid nascent nonunions (delayed unions) and nonunions that underwent surgical fixation with a cannulated headless compression screw and local autologous bone graft from the distal radius. Patients and Methods After obtaining Institutional Review Board approval, the electronic medical record of one tertiary care center was queried for patients with the diagnosis of “proximal pole scaphoid fractures” who underwent surgical fixation by a single surgeon over an 11-year period (2006–2017). Fifteen patients met initial query criteria; upon review of records, four patients were excluded due to the acute nature of the fracture, and one was excluded as surgical fixation included a vascularized bone graft. Results The final study cohort consisted of 10 patients with a total of 10 proximal pole scaphoid nonunions. Almost all of the patients in this study were male (9/10 [90%]), and sporting activities were the most common mechanism of injury (8/10 [80%]). Volumetric measurements of the scaphoid fractures on computed tomography (CT) revealed that the mean total volume of the scaphoid was 2.4 ± 0.48 cm3 and the mean volume of the proximal pole fragment was 0.38 ± 0.15 cm3. Postoperative CT scans were performed at a mean of 12.4 weeks (range: 8–16 weeks), with seven (7/10 [70%]) showing signs of complete union and three (3/10 [30%]) demonstrating partial union. None of the patients required additional procedures and there were no complications. Conclusions Our results suggest that proximal pole scaphoid fractures with delayed union and nonunion treated with surgical fixation and autologous local bone graft heal without the need for more complex vascularized procedures. The volume of the proximal pole fragment did not correlate with increased risk of ongoing nonunion after the index procedure. Level of Evidence This is a Level IV, case series study.

Cadmium concentrations in kidneys of sheep and cattle in Western Australia. 1. Regional distribution

1994 ◽  
Vol 45 (4) ◽  
pp. 851 ◽  
Author(s):  
PW Morcombe ◽  
DS Petterson ◽  
HG Masters ◽  
PJ Ross ◽  
JR Edwards
Keyword(s):  
Western Australia ◽  
Geometric Mean ◽  
Regional Distribution ◽  
Adult Cattle ◽  
Agricultural Region ◽  
Wet Weight ◽  
The Mean ◽  
Winter Annual ◽  
Rate Of Accumulation ◽  
Cattle And Sheep

A sample of 4973 kidneys from sheep stratified by age and shire of origin within the Agricultural Region of Western Australia, was analysed for cadmium (Cd) content during the period August 1989 to April 1991. The geometric mean Cd concentration in the kidney of hogget ewes was 0.9 mg/kg, in 4-tooth ewes 1.47 mg/kg and in adult ewes 3.34 mg/kg on a wet weight basis. The mean Cd concentrations of either ewe or hogget flocks from different Divisions of the Agricultural Region did not differ from each other. The annual increase in Cd concentration of kidney from hogget sheep was estimated to be 0-65 mg/kg. The rate of accumulation of Cd in kidney from cattle and sheep grazing the same properties was similar. Kidneys from a sample of 354 adult cattle from the Kimberley Region and 483 aged sheep from the Pastoral Region, both areas of unimproved rangelands, had geometric mean Cd concentrations of 0.15 mg/kg and 0-31 mg/kg respectively. A higher Cd concentration in flocks from the divisions adjacent to the Agricultural Region may have resulted from the establishment of some volunteer species of winter annual pastures in the rangeland.

Non-invasive determination of the systolic peak-to-peak gradient in children with aortic stenosis: validation of a mathematical model

2000 ◽  
Vol 10 (2) ◽  
pp. 115-119 ◽  
Author(s):  
Valter C. Lima ◽  
Evan Zahn ◽  
Christine Houde ◽  
Jeffrey Smallhorn ◽  
Robert M. Freedom ◽  
...  
Keyword(s):  
Mathematical Model ◽  
Pulse Pressure ◽  
Linear Regression Analysis ◽  
Systolic Pressure ◽  
Pressure Gradients ◽  
Non Invasive ◽  
The Mean ◽  
Congenital Aortic Valvar Stenosis ◽  
Peak Gradient

AbstractDoppler derived systolic pressure gradients have become widely applied as noninvasively obtained estimates of the severity of aortic valvar stenosis. There is little correlation, however, between the Doppler derived peak instantaneous gradient and the peak-to-peak gradient obtained at catheterisation, the latter being the most applied variable to determine severity in children. The purpose of this study was to validate a mathematical model based on data from catheterisation which estimates the peak-to-peak gradient from variables which can be obtained by noninvasive means (Doppler derived mean gradient and pulse pressure), according to the formula: peak-to-peak systolic gradient=6.02+1.49*(mean gradient)−0.44*(pulse pressure). Simultaneous cardiac catheterization and Doppler studies were performed on 10 patients with congenital aortic valvar stenosis. Correlations between the gradients measured at catheter measured, and those derived by Doppler, were performed using linear regression analysis. The mean gradients correlated well (y=0.67 × + 11.11, r=0.87, SEE=6 mm Hg, p=0.001). The gradients predicted by the formula also correlated well with the peak-to-peak gradients measured at catheter (y=0.66 × + 14.44, r=0.84, SEE=9 mm Hg, p=O.002). The data support the application of the model, allowing noninvasive prediction of the peak-to-peak gradient across the aortic valvar stenosis.

How landscape and climate affect the spatial variability of the Italian rainfall extremes? Some initial clues based on I2-RED

2021 ◽  
Author(s):  
Paola Mazzoglio ◽  
Ilaria Butera ◽  
Pierluigi Claps
Keyword(s):  
Spatial Variability ◽  
Linear Regression Analysis ◽  
Alpine Region ◽  
Annual Rainfall ◽  
Mean Values ◽  
Rainfall Extremes ◽  
Geomorphological Parameters ◽  
The Mean ◽  
The Relationship ◽  
Italian Territory

&lt;p&gt;The intensity and the spatial distribution of precipitation depths are known to be highly dependent on relief and geomorphological parameters. Complex environments like mountainous regions are prone to intense and frequent precipitation events, especially if located near the coastline. Although the link between the mean annual rainfall and geomorphological parameters has received substantial attention, few literature studies investigate the relationship between the sub-daily maximum annual rainfall depth and geographical or morphological landscape features.&lt;br&gt;In this study, the mean of the rainfall extremes in Italy, recently revised in the so-called I&lt;sup&gt;2&lt;/sup&gt;-RED dataset, are investigated in their spatial variability in comparison with some landscape and also some broad climatic characteristics. The database includes all sub-daily rainfall extremes recorded in Italy from 1916 until 2019 and this analysis considers their mean values (from 1 to 24 hours) in stations with at least 10 years of records, involving more than 3700 stations.&lt;br&gt;The geo-morpho-climatic factors considered range from latitude, longitude and minimum distance from the coastline on the geographic side, to elevation, slope, openness and obstruction morphological indices, and also include an often-neglected robust climatological information, as the local mean annual rainfall.&lt;br&gt;Obtained results highlight that the relationship between the annual maximum rainfall depths and the hydro-geomorphological parameters is not univocal over the entire Italian territory and over different time intervals. Considering the whole of Italy, the highest correlation is reached between the mean values of the 24-hours records and the mean annual precipitation (correlation coefficient greater than 0.75). This predominance remains also in sub-areas of the Italian territory (i.e., the Alpine region, the Apennines or the coastal areas) but correlation decreases as the time interval decreases, except for the Alpine region (0.73 for the 1-hour maximum). The other geomorphological parameters seem to act in conjunction, making it difficult to evaluate, with a simple linear regression analysis, their impact. As an example, the absolute value of the correlation coefficient between the elevation and the 1-hour extremes is greater than 0.35 for the Italian and the Alpine regions, while for the 24-hours interval it is greater than 0.35 over the coastal areas.&lt;br&gt;To further investigate the spatial variability of the relationship between rainfall and elevation, a spatial linear regression analysis has been undertaken. Local linear relationships have been fitted in circles centered on any of the 0.5-km size pixels in Italy, with 1 to 30 km radius and at least 5 stations included. Results indicate the need of more comprehensive terrain analysis to better understand the causes of local increasing or decreasing relations, poorly described in the available literature.&lt;/p&gt;

Reduced oxygenation but not fibrosis defined by functional magnetic resonance imaging predicts the long-term progression of chronic kidney disease

2018 ◽  
Vol 35 (6) ◽  
pp. 964-970 ◽  
Author(s):  
Kei Sugiyama ◽  
Tsutomu Inoue ◽  
Eito Kozawa ◽  
Masahiro Ishikawa ◽  
Akira Shimada ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Chronic Kidney Disease ◽  
Regression Analysis ◽  
Linear Regression Analysis ◽  
Resonance Imaging ◽  
Bold Mri ◽  
Adc Values ◽  
The Mean ◽  
Rate Of Decline ◽  
Observation Period

Abstract Background Although chronic hypoxia and fibrosis may be a key to the progression of chronic kidney disease (CKD), a noninvasive means of measuring these variables is not yet available. Here, using blood oxygen level–dependent (BOLD) and diffusion-weighted (DW) magnetic resonance imaging (MRI), we assessed changes in renal tissue oxygenation and fibrosis, respectively, and evaluated their correlation with prognosis for renal function. Methods The study was conducted under a single-center, longitudinal, retrospective observational design. We examined the prognostic significance of T2* values of BOLD-MRI and apparent diffusion coefficient (ADC) values on DW-MRI and other clinical parameters. The rate of decline in estimated glomerular filtration rate (eGFR) was calculated by linear regression analysis using changes in eGFR during the observation period. Results A total of 91 patients were enrolled, with a mean age of 55.8 ± 15.6 years. Among patients, 51 (56.0%) were males and 38 (41.8%) had diabetes mellitus. The mean eGFR was 49.2 ± 28.9 mL/min/1.73 m2 and the mean observation period was 5.13 years. ADC values of DW-MRI but not T2* values of BOLD-MRI were well correlated with eGFR at the initial time point. The mean annual rate of decline in eGFR during the 5-year observation period was −1.92 ± 3.00 mL/min/1.73 m2. On multiple linear regression analysis, the rate of decline in eGFR was significantly correlated with eGFR at the start point, period average amount of proteinuria and T2* values, but not with ADC values (t = 2.980, P = 0.004). Conclusions Reduced oxygenation as determined by low T2* values on BOLD-MRI is a clinically useful marker of CKD progression.

Pyridoxine Deficiency After Solid Organ Transplant

2017 ◽  
Vol 27 (3) ◽  
pp. 251-256
Author(s):  
Summer Van Arsdale ◽  
Sarah E. Yost ◽  
Chiu-Hsieh Hsu ◽  
Mary Meer ◽  
Shari Schoentag ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Solid Organ Transplantation ◽  
Organ Transplant ◽  
Multivariate Logistic Regression Analysis ◽  
Study Cohort ◽  
Solid Organ ◽  
Immune Functions ◽  
Pyridoxine Deficiency ◽  
The Mean ◽  
Low Levels

Objective: Pyridoxine is 1 of 8 B vitamins that assist in a variety of essential functions including immune functions. The purpose of this study was to assess the risk factors associated with low pyridoxine levels in solid organ transplantation recipients. Design: The study cohort was divided into 2 groups: (a) patients with normal pyridoxine levels or (b) patients with low pyridoxine levels. Dietary evaluation and clinical characteristics of all patients, rejection episodes, and immunosuppression were collected. Simple descriptive statistics were used to analyze the overall cohort. Results: Of the 48 patients, 29 (60%) in the study cohort were identified to have low pyridoxine levels. The mean interval between transplantation and pyridoxine level check was 910 days (standard deviation [SD] 456). The mean weight at the time of dietary consultation was 80 kg (SD 20.7). More patients in the deficient group received thymoglobulin for rejection treatment (56% vs 0%; P = .01) and were thymoglobulin recipients (78% vs 10%; odds ratio [OR] = 31.5; 95% confidence interval [CI], 2.35-422.30; P < .01). A strong correlation was identified between thymoglobulin treatment for induction and a low level of pyridoxine (correlation coefficient R = 0.6, P = .004) and between thymoglobulin treatment for rejection and a low pyridoxine level (correlation coefficient R = 0.5, P = .05). Based on multivariate logistic regression analysis, only thymoglobulin treatment (induction or rejection treatment) was significantly associated with low pyridoxine levels (OR = 19.5, 95% CI, 1.01-375.24; P < .05). Conclusions: Low levels of pyridoxine appear to be relatively common, and thymoglobulin treatments are associated with low pyridoxine levels. Prospective studies are needed to confirm and valuate the significance of these findings.

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