scholarly journals Recovery of Male Hypogonadism Following Successful Treatment of Prolactinoma: The Experience of an Integrated Health Network

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A632-A633
Author(s):  
Mihail Voica ◽  
Maryam Tetlay ◽  
Diane V Thompson ◽  
Farhad Hasan
Keyword(s):  
Tumor Size ◽  
Reference Range ◽  
Small Sample Size ◽  
Small Sample ◽  
Serum Prolactin ◽  
Male Hypogonadism ◽  
Adult Males ◽  
Baseline Serum ◽  
Health Network ◽  
Male Patients

Abstract Background: Hypogonadism is the most prevalent deficiency in male patients with prolactinomas (PrL). The recovery rates of hypogonadism (HGo) following treatment of PrL is variable and can be as high as 62%. In this study we aimed to identify predictors of HGo recovery in mean with PrL. We hypothesized that younger and leaner men and smaller tumor size predict HGo recovery after successful PrL treatment. We also hypothesized that higher baseline serum T predicts HGo recovery. Methods: We conducted a retrospective review of the electronic medical records of adult males with a diagnosis of hyperprolactinemia or PrL who were treated at Allegheny Health Network (Pittsburgh, PA) between January 1, 2016 and December 31, 2019. Serum prolactin and testosterone (T) levels, and pituitary tumor size (microadenoma <10mm, macroadenoma 10-39mm, or giant adenoma ≥ 40 mm) on MRI scan at diagnosis and up to 2 years follow up were analyzed. HGo was defined as serum T below reference range at diagnosis. HGo recovery was defined as total T in the reference range within 2 years from PrL treatment onset in the absence of T replacement. Results: We screened 215 male patients who met initial search criteria. Of the 37 subjects who met eligibility criteria, 26 had HGo while 11 had normal serum T (Fig 1). Mean age of men with HGo was 44.6 ± 13.7 years (range 21 – 64). Median serum prolactin at diagnosis was 283.5 ng/mL (range 31-14,830), and mean serum T was 167.07 ± 61.12 ng/dL. Median tumor (max) diameter was 17.5 mm (range 4-81mm). Of the included 26 patients 20 (77%) achieved normal prolactin with therapy after a median of 5 months. Only 10 of the 26 men with HGo (38.5%) attained recovery of HGo following treatment of PrL, and the mean time to recovery was 8.8 ± 6.9 months. HGo recovery was predictably more common in persons with microadenoma (n=6) while none of patients with giant Prl achieved HGo recovery. Baseline serum prolactin and T levels and baseline tumor size predicted subsequent HGo recovery, while age did not. Baseline serum prolactin was lower in men whose HGo recovered (median = 105 ng/mL, IQR = 202) than in men who did not (median = 931 ng/mL, IQR = 3714); p = 0.014. Baseline serum T was higher in men who attained HGo recovery (173.2 ± 59.6) than in men who failed to do so (103.1 ± 85.9); p = 0.03. Mean tumor size was significantly smaller in men who attained HGo recovery (max diam: 9.8 ± 5.5 mm) than in men who did not (31.8 ± 20.3 mm); p = .003. There were no statistically significant differences between men categorized by remission status with respect to age (p = .367) nor weight at the time of diagnosis (p = .591). Conclusion: In this retrospective study of 26 males with PrL and low T at presentation, 38.5% achieved HGo recovery. Lower baseline serum prolactin, smaller tumor size and higher baseline T predicted recovery of HGo, while presenting age and weight did not. This study was limited by its retrospective nature and small sample size.

scholarly journals Mitochondrial DNA Content Varies with Pathological Characteristics of Breast Cancer

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Ren-Kui Bai ◽  
Julia Chang ◽  
Kun-Tu Yeh ◽  
Mary Ann Lou ◽  
Jyh-Feng Lu ◽  
...  
Keyword(s):  
Mitochondrial Dna ◽  
Tumor Size ◽  
Small Sample Size ◽  
Small Sample ◽  
Coding Region ◽  
Normal Tissues ◽  
Pathological Characteristics ◽  
Loop Region ◽  
Tumor Tissues ◽  
Grade Ii

Changes in mitochondrial DNA (mtDNA) content in cancers have been reported with controversial results, probably due to small sample size and variable pathological conditions. In this study, mtDNA content in 302 breast tumor/surrounding normal tissue pairs were evaluated and correlated with the clinico-pathological characteristics of tumors. Overall, mtDNA content in tumor tissues is significantly lower than that in the surrounding normal tissues,P<0.00001. MtDNA content in tumor tissues decreased with increasing tumor size. However, when the tumor is very large (>50 cm3), mtDNA content started to increase. Similarly, mtDNA content decreased from grades 0 and I to grade II tumors, but increased from grade II to grade III tumors. Tumors with somatic mtDNA alterations in coding region have significantly higher mtDNA content than tumors without somatic mtDNA alterations (P<0.001). Tumors with somatic mtDNA alterations in the D-Loop region have significantly lower mtDNA content (P<0.001). Patients with both low and high mtDNA content in tumor tissue have significantly higher hazard of death than patients with median levels of mtDNA content. mtDNA content in tumor tissues change with tumor size, grade, and ER/PR status; significant deviation from the median level of mtDNA content is associated with poor survival.

The Relationship Between Body Mass and Survival of Wintering Canvasbacks

The Auk ◽  
1986 ◽  
Vol 103 (3) ◽  
pp. 506-514 ◽  
Author(s):  
G. M. Haramis ◽  
J. D. Nichols ◽  
K. H. Pollock ◽  
J. E. Hines
Keyword(s):  
Body Mass ◽  
Survival Probability ◽  
Alternative Explanation ◽  
Small Sample Size ◽  
Small Sample ◽  
Cold Weather ◽  
Early Winter ◽  
Adult Males ◽  
Annual Survival ◽  
Survival Probabilities

Abstract Mass and recapture histories of 6,000 Canvasbacks (Aythya valisineria) banded in upper Chesapeake Bay were used to test two hypotheses: (1) early-winter body mass is associated with the probability of surviving the winter, and (2) early-winter body mass is associated with annual survival probability. Data were analyzed by a binary regression method that treated mass as a continuous variable and estimated parameters to describe a general relationship between body mass and survival probability. Results for adult males, which provided our largest data sets, presented strong evidence that birds with high relative early-winter masses had both greater overwinter and annual survival probabilities. Results of overwinter analyses necessarily are qualified by the alternative explanation of mass-dependent emigration, i.e. the possibility that lighter birds move south in response to cold weather and leave only heavy birds for recapture. Such a phenomenon remains to be documented. Results concerning annual survival probabilities are not vulnerable to this alternative explanation because of the strong fidelity of Canvasbacks at the banding site. Because of small sample size, data were inadequate to permit mass/survival inferences for adult females. Sample sizes were adequate for young Canvasbacks, but the results were less consistent than for adult males. Although early-winter body mass was associated positively with overwinter as well as annual survival for young Canvasbacks in some years, we suspect that the lack of established wintering patterns among these birds may underlie the less consistent result.

Industrial and Agricultural Chemicals

PEDIATRICS ◽  
1974 ◽  
Vol 53 (5) ◽  
pp. 843-844
Author(s):  
S. Hope Sandifer
Keyword(s):  
South Carolina ◽  
Environmental Protection Agency ◽  
Small Sample Size ◽  
The United States ◽  
Small Sample ◽  
Adult Males ◽  
Community Studies ◽  
Water Supplies ◽  
Intermittent Exposure ◽  
High Concentrations

The alert practitioner should know the types of pollution created by agriculture and industry in his area. In agriculture, two important pollutants are nitrates and pesticides (which include insecticides, herbicides, fungicides, rodenticides, and defoliants). Pediatricians are well aware of methemoglobmnemia due to excessive nitrates in water. Nitrates in water supplies are of increasing concern because of runoff from feed lots and incremental use of fertilizers. Tolerance levels of nitrate in municipal water supplies are established, and pediatricians should insist that these standards be enforced in their community. With regard to pesticides, the Environmental Protection Agency has funded 13 community studies throughout the United States. The purpose is to monitor the health of pesticide workers compared with suitable controls. To date no significant health effects have been demonstrated. Most studies have been made on adult males because of their occupational exposure to pesticides. The groups under surveillance include workers who manufacture pesticides, pest-control operators who spray daily, and farmers who have intermittent exposure to high concentrations of pesticides. We are seeking the effects, if any, in the most heavily exposed persons before trying to determine the effects of smaller doses. This approach suffers the problem of small sample size (several thousand instead of hundreds of thousands of exposed persons). Our studies and those of others have shown that DDT in the sera of blacks is about two to three times that of whites.1-3 We had assumed that this difference was due to environmental exposure, but recent studies in Charleston, South Carolina, have suggested a genetic factor.

Abstract 13623: Predicting Acute Kidney Injury Using Biomarkers of Renal Injury Following Cardiac Arrest

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Rahul D Pawar ◽  
Lara L Roessler ◽  
Mahmoud S Issa ◽  
Anne V Grossestreuer ◽  
Mathias Johan J Holmberg ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cardiac Arrest ◽  
Serum Creatinine ◽  
Cystatin C ◽  
Small Sample Size ◽  
Kidney Injury ◽  
Primary Outcome Measure ◽  
Small Sample ◽  
Stage Iii ◽  
Baseline Serum

Aim: Acute kidney injury (AKI) after cardiac arrest (CA) is common and associated with worse outcomes. We aimed to evaluate the performance of kidney specific biomarkers including kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL) and cystatin-C in predicting AKI post-CA as compared to serum creatinine. Methods: Patients with kidney specific biomarkers collected as part of randomized trials conducted in adult post-CA populations (NCT02260258, NCT01319110) were included. Patients with Kidney Disease Improving Global Outcome (KDIGO) stage III AKI immediately after enrollment and patients not enrolled at the coordinating center were excluded. Creatinine, KIM-1, NGAL and cystatin-C were measured immediately before enrollment. The primary outcome measure was KDIGO stage III AKI in the first 7-days after enrollment. We determined the association and discrimination of renal biomarkers with relation to KDIGO stage III AKI. Results: Of 63 patients included, 12 (19.1%) developed stage III AKI and 40 (63.5%) died prior to hospital discharge. As compared to patients who did not develop stage III AKI, those who developed stage III AKI had higher baseline serum creatinine (1.75 [IQR:1.3, 2.75] vs 1.3 [1.1, 1.7], p=0.04), higher NGAL (879 [IQR: 442,1194] vs 234 [IQR: 163, 482], p<0.001) and higher cystatin-C (2567 [IQR: 1222,3835] vs 1248 [IQR: 808,1691], p=0.01). There was no difference in KIM-1 (-1.70 [IQR: -2.79, -0.40] vs -1.87 [IQR: -2.70, -1.27], p=0.57). Of the various biomarkers, NGAL measured early after return of spontaneous circulation had the highest discrimination for the future development of stage III AKI [AUROC 0.81 (95%CI:0.69-0.93)] as compared to creatinine [AUROC 0.69 (95%CI: 0.51-0.87)], and cystatin-C [AUROC 0.74 (95%CI:0.57-0.90)] though the difference in AUROC was not significant (p>0.05 for all comparisons). KIM-1 had lowest discrimination [AUROC 0.55 (95%CI:0.34-0.76)]. Conclusion: In post-CA patients enrolled in the two clinical trials, NGAL measured early after CA had the highest discrimination for the development of stage III AKI though the discrimination was not significant compared to creatinine possibly due to small sample size.

Serum biomarkers as predictors of clinical outcome after cetuximab-based therapy in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN)

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 6035-6035
Author(s):  
R. L. Ferris ◽  
T. Feinstein ◽  
J. Grandis ◽  
R. Johnson ◽  
B. Branstetter ◽  
...  
Keyword(s):  
Growth Factors ◽  
Multiple Testing ◽  
Small Sample Size ◽  
Locally Advanced ◽  
Stage Iv ◽  
Complete Response ◽  
Serum Biomarkers ◽  
Small Sample ◽  
P Value ◽  
Baseline Serum

6035 Background: We correlated a panel of serum cytokines and growth factors with antitumor activity in patients (pts) with locally advanced SCCHN treated with cetuximab-based therapy. We have shown that similar biomarkers may be promising for the early detection of SCCHN (Linkov, Can Epi Biomarkers 2007). Methods: We used multi-analyte biomarker profiling for measurement of multiple serum biomarkers (Luminex Corp., Austin, TX). 39 pts with stage III-IVB SCCHN were treated with cisplatin, docetaxel, and cetuximab (TPE) for 3 cycles followed by radiotherapy, cisplatin, and cetuximab (XPE) and then maintenance cetuximab (Argiris, ASCO 2008, A6002). 31 cytokines and growth factors were measured before and after 3 cycles (9 weeks) of induction TPE. Clinical results were correlated with biomarkers, including 23 pts with PET response. Results: 31 pts had baseline biomarkers and 25 paired samples, pre- and post-TPE. Median follow-up was 22 months. Median age 54 years (21–74); male: 27; stage IV: 29; primary site: oropharynx, 16; larynx, 4; hypopharynx, 3, nasopharynx, 3; oral cavity, 3; and unknown, 2. Eight analytes changed significantly after induction. Adjusting p values for false discovery, the following analytes retain a p <0.05: MCP1c, IP-10, Leptin, IL-5, Eotaxin, IL-6, GCSF, CXCL5. In 23 pts with PET response assessment, low vascular endothelial growth factor (VEGF) levels or low IL-6 levels at baseline may be associated with complete response: 4/5 pts with low baseline VEGF (<20.9 pg/ml) had a complete response by PET vs 1/18 pts with high baseline VEGF. Of 31 pts, 9 have progressed. Among tests of association of the 31 analytes and progression-free survival (PFS), VEGF was the only one with a raw p value <.05 (p = .027), although the adjusted p value was not significant. A decrease in VEGF with treatment had a weak but not statistically significant association with longer PFS. Conclusions: Baseline serum biomarkers and in particular, VEGF and IL-6, were identified as potentially useful predictive markers of cetuximab-based therapy. Due to the small sample size and multiple testing, these biomarkers need to be validated in a larger study in SCCHN specifically powered for biomarker associations. No significant financial relationships to disclose.

scholarly journals Usefulness of Ki-67, Mitoses, and Tumor Size for Predicting Metastasis in Carcinoid Tumors of the Lung: A Study of 48 Cases at a Tertiary Care Centre in Canada

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
M. G. Joseph ◽  
A. Shibani ◽  
N. Panjwani ◽  
A. Arab ◽  
J. Shepherd ◽  
...  
Keyword(s):  
Tumor Size ◽  
Small Sample Size ◽  
Tertiary Care ◽  
Small Sample ◽  
Carcinoid Tumors ◽  
Computer Assisted ◽  
Tertiary Care Centre ◽  
Ki 67 ◽  
Computer Assisted Image ◽  
The Mean

Background. Evaluation of Ki-67 index in lung carcinoid tumors (LCTs) has been of interest in order to identify high risk subsets. Our objectives are (1) to evaluate the usefulness of Ki-67 index, mitoses, and tumor size in predicting metastasis and (2) to compare the Manual Conventional Method (MCM) and the Computer Assisted Image Analysis Method (CIAM) for Ki-67 calculation. Methods. We studied 48 patients with LCTs from two academic centres in Canada. For Ki-67 calculation, digital images of 5000 cells were counted using an image processing software and 2000 cells by MCM. Mitoses/10 HPF was counted. Results. We had 37 typical carcinoids (TCs) and 11 atypical carcinoids (ACs). 7/48 patients developed metastasis. There was a positive relationship between metastasis and carcinoid type (P=0.039) and metastasis and mitoses (≥2) (P=0.017). Although not statistically significant, the mean Ki-67 index for ACs was higher than for TCs (0.95% versus 0.72%, CIAM, P=0.299). Similarly, although not statistically significant, the mean Ki-67 index for metastatic group (MG) was higher than for nonmetastatic group (NMG) (1.01% versus 0.71% by CIAM, P=0.281). However when Ki-67 index data was categorized at various levels, there is suggestion of a useful cutoff (≥0.50%) to predict metastasis (P=0.106, CIAM). A significantly higher proportion of patients with mitosis ≥2 and Ki-67 index ≥0.50% had metastasis (P=0.033) compared to other patients. Similarly patients with tumor size ≥3 cm and Ki-67 ≥0.50% had a greater percentage of metastases than others (P=0.039). Although there was a strong correlation between two (MCM versus CIAM) counting methods (r=0.929, P=0.001), overall the calculated Ki-67 index was slightly higher by MCM (range 0 to 6.4, mean 1.5) compared to CIAM (range 0 to 2.9, mean 0.75). Conclusion. This study confirms that mitoses ≥2 is a powerful predictor of metastasis in LCTs. Although this is a small sample size, there is suggestion that analysis of Ki-67 index along with mitoses and tumor size may be a useful adjunct for predicting metastasis in LCTs.

scholarly journals Lek-associated movement of a putative Ebolavirus reservoir, the Hammer-headed fruit bat (Hypsignathus monstrosus), in northern Republic of Congo

2019 ◽  
Author(s):  
Sarah H. Olson ◽  
Gerard Bounga ◽  
Alain Ondzie ◽  
Trent Bushmaker ◽  
Stephanie N. Seifert ◽  
...  
Keyword(s):  
Small Sample Size ◽  
Small Sample ◽  
Congo Basin ◽  
Gps Tracking ◽  
Molecular Testing ◽  
Radio Tracking ◽  
Adult Males ◽  
Fruit Bats ◽  
Republic Of Congo ◽  
Fruit Bat

AbstractThe biology and ecology of Africa’s largest fruit bat remains largely understudied and enigmatic despite at least two highly unusual attributes. The acoustic lek mating behavior of the hammer-headed bat (Hypsignathus monstrosus) in the Congo basin was first described in the 1970s. Then in the 2000s, molecular testing implicated this species and other fruit bats as potential reservoir hosts for Ebola virus and it was one of only two fruit bat species epidemiologically linked to the 2008 Luebo, Democratic Republic of Congo, Ebola outbreak. Here we share findings from the first pilot study of hammer-headed bat movement using GPS tracking and accelerometry units and a small preceding radio-tracking trial at an apparent lekking site. The radio-tracking revealed adult males had high rates of nightly visitation to the site compared to females (only one visit) and that two of six females day-roosted ∼100 m west of Libonga, the nearest village that is ∼1.6 km southwest. Four months later, in mid-April 2018, five individual bats, comprised of four males and one female, were tracked from two to 306 days, collecting from 67 to 1022 GPS locations. As measured by mean distance to the site and proportion of nightly GPS locations within 1 km of the site (percent visitation), the males were much more closely associated with the site (mean distance 1.4 km; 51% visitation), than the female (mean 5.5 km; 2.2% visitation). Despite the small sample size, our tracking evidence supports our original characterization of the site as a lek, and the lek itself is much more central to male than female movement. Moreover, our pilot demonstrates the technical feasibility of executing future studies on hammer-headed bats that will help fill problematic knowledge gaps about zoonotic spillover risks and the conservation needs of fruit bats across the continent.

Probing the ultrastructure of the mitotic and meiotic spindle in eggs: An expeditious approach based on semi-thin (0.25 μm) serial sections

1983 ◽  
Vol 41 ◽  
pp. 552-555
Author(s):  
Conly L. Rieder ◽  
S. Bowser ◽  
R. Nowogrodzki ◽  
K. Ross ◽  
G. Sluder
Keyword(s):  
Small Sample Size ◽  
Small Sample ◽  
Meiotic Spindle ◽  
Serial Sections ◽  
Mitotic Apparatus ◽  
Thin Sections ◽  
Cell Cycles ◽  
Ultrastructural Studies

Eggs have long been a favorite material for studying the mechanism of karyokinesis in-vivo and in-vitro. They can be obtained in great numbers and, when fertilized, divide synchronously over many cell cycles. However, they are not considered to be a practical system for ultrastructural studies on the mitotic apparatus (MA) for several reasons, the most obvious of which is that sectioning them is a formidable task: over 1000 ultra-thin sections need to be cut from a single 80-100 μm diameter egg and of these sections only a small percentage will contain the area or structure of interest. Thus it is difficult and time consuming to obtain reliable ultrastructural data concerning the MA of eggs; and when it is obtained it is necessarily based on a small sample size.We have recently developed a procedure which will facilitate many studies concerned with the ultrastructure of the MA in eggs. It is based on the availability of biological HVEM's and on the observation that 0.25 μm thick serial sections can be screened at high resolution for content (after mounting on slot grids and staining with uranyl and lead) by phase contrast light microscopy (LM; Figs 1-2).

Validating the Factor Structure of the Stigma of Suicide Scale–Short Form Spanish Version Among Healthcare Students

Crisis ◽  
2020 ◽  
pp. 1-5
Author(s):  
Ruthmarie Hernández-Torres ◽  
Paola Carminelli-Corretjer ◽  
Nelmit Tollinchi-Natali ◽  
Ernesto Rosario-Hernández ◽  
Yovanska Duarté-Vélez ◽  
...  
Keyword(s):  
Factor Structure ◽  
Structural Equation ◽  
Short Form ◽  
Small Sample Size ◽  
Small Sample ◽  
Spanish Version ◽  
Equation Modeling ◽  
Cross Sectional ◽  
Healthcare Students ◽  
Spanish Speaking

Abstract. Background: Suicide is a leading cause of death among Spanish-speaking individuals. Suicide stigma can be a risk factor for suicide. A widely used measure is the Stigma of Suicide Scale-Short Form (SOSS-SF; Batterham, Calear, & Christensen, 2013 ). Although the SOSS-SF has established psychometric properties and factor structure in other languages and cultural contexts, no evidence is available from Spanish-speaking populations. Aim: This study aims to validate a Spanish translation of the SOSS-SF among a sample of Spanish-speaking healthcare students ( N = 277). Method: We implemented a cross-sectional design with quantitative techniques. Results: Following a structural equation modeling approach, a confirmatory factor analysis (CFA) supported the three-factor model proposed by Batterham and colleagues (2013) . Limitations: The study was limited by the small sample size and recruitment by availability. Conclusion: Findings suggest that the Spanish version of the SOSS-SF is a valid and reliable tool with which to examine suicide stigma among Spanish-speaking populations.

An Initial Investigation of Suicide Attempt Disclosures Among US Veterans

Crisis ◽  
2020 ◽  
pp. 1-7
Author(s):  
Brooke A. Ammerman ◽  
Sarah P. Carter ◽  
Heather M. Gebhardt ◽  
Jonathan Buchholz ◽  
Mark A. Reger
Keyword(s):  
Suicide Attempt ◽  
Mental Health Professionals ◽  
Help Seeking ◽  
Psychiatric Treatment ◽  
Small Sample Size ◽  
Romantic Partners ◽  
Small Sample ◽  
Professional Care ◽  
Patient Disclosure ◽  
Previous Suicide Attempt

Abstract. Background: Patient disclosure of prior suicidal behaviors is critical for effectively managing suicide risk; however, many attempts go undisclosed. Aims: The current study explored how responses following a suicide attempt disclosure may relate to help-seeking outcomes. Method: Participants included 37 veterans with a previous suicide attempt receiving inpatient psychiatric treatment. Veterans reported on their most and least helpful experiences disclosing their suicide attempt to others. Results: Veterans disclosed their suicide attempt to approximately eight individuals. Mental health professionals were the most cited recipient of their most helpful disclosure; romantic partners were the most common recipient of their least helpful disclosures. Positive reactions within the context of the least helpful disclosure experience were positively associated with a sense of connection with the disclosure recipient. Positive reactions within the most helpful disclosure experience were positively associated with the likelihood of future disclosure. No reactions were associated with having sought professional care or likelihood of seeking professional care. Limitations: The results are considered preliminary due to the small sample size. Conclusion: Findings suggest that while positive reactions may influence suicide attempt disclosure experiences broadly, additional research is needed to clarify factors that drive the decision to disclose a suicide attempt to a professional.

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