scholarly journals Risk of recurrence after antiepileptic withdrawal: Was it a good decision or not?

2021 ◽  
Author(s):  
Ozlem Yayici Koken ◽  
Ayse Aksoy ◽  
Ozge Kucur ◽  
Mehpare Kafali
Keyword(s):  
Roc Analysis ◽  
Operating Characteristic ◽  
Age At Onset ◽  
Recurrence Risk ◽  
Idiopathic Epilepsy ◽  
Good Decision ◽  
Generalized Epilepsy ◽  
Electroencephalogram Eeg ◽  
Recurrence Group ◽  
Homogenous Population

Background: The aim of this study was to identify the demographic-clinical variables affecting idiopathic epilepsy (IE) [called genetic generalized epilepsy (GGE)] recurrence and determine cut-off values that can be used in pediatric neurology practice for children with IE/GGE. Methods: A total of 250 children and adolescents with IE/GGE were included and retrospectively evaluated. The patients’ hospital records were examined in order to identify possible electro-clinical features affecting epilepsy recurrence. Results: The overall rate of recurrence in the patients was 46%; the age at onset of seizures in recurrence group was lower (P = 0.040) and the age at last seizure was higher in the recurrence group (P < 0.001) than that in the non-recurrence group. Other factors found to be related to recurrence were the shorter duration of the seizure-free period (P = 0.030), shorter interval between the last seizure and antiepileptic drug (AED) withdrawal (P = 0.003), shorter duration of AED withdrawal (P = 0.005), and the existence of abnormalities on sleep electroencephalogram (EEG) during AED withdrawal (P = 0.010) and at the 6th month of withdrawal (P < 0.001). According to receiver operating characteristic (ROC) analysis, the risk of IE recurrence was higher in children who were younger than 3.6 years old (sensitivity: 65.6%, specificity: 62.7%), children with a seizure-free period that was shorter than 35.5 months (sensitivity: 89.6%, specificity: 32.8%), and children whose drug withdrawal period was shorter than 4.5 months (sensitivity: 56.3%, specificity: 71.6%). Conclusion: This study defined some electro-clinical factors that could guide clinicians when deciding to withdraw AEDs with regard to recurrence risk after evaluating a homogenous population of children with a diagnosis of IE/GGE.

scholarly journals Fully Automated Colorimetric Analysis of the Optic Nerve Aided by Deep Learning and Its Association with Perimetry and OCT for the Study of Glaucoma

2021 ◽  
Vol 10 (15) ◽  
pp. 3231
Author(s):  
Marta Gonzalez-Hernandez ◽  
Daniel Gonzalez-Hernandez ◽  
Daniel Perez-Barbudo ◽  
Paloma Rodriguez-Esteve ◽  
Nisamar Betancor-Caro ◽  
...  
Keyword(s):  
Distribution Function ◽  
Deep Learning ◽  
Optic Nerve ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Learning Models ◽  
Colorimetric Analysis ◽  
Cirrus Oct ◽  
And Function ◽  
Usual Pattern

Background: Laguna-ONhE is an application for the colorimetric analysis of optic nerve images, which topographically assesses the cup and the presence of haemoglobin. Its latest version has been fully automated with five deep learning models. In this paper, perimetry in combination with Laguna-ONhE or Cirrus-OCT was evaluated. Methods: The morphology and perfusion estimated by Laguna ONhE were compiled into a “Globin Distribution Function” (GDF). Visual field irregularity was measured with the usual pattern standard deviation (PSD) and the threshold coefficient of variation (TCV), which analyses its harmony without taking into account age-corrected values. In total, 477 normal eyes, 235 confirmed, and 98 suspected glaucoma cases were examined with Cirrus-OCT and different fundus cameras and perimeters. Results: The best Receiver Operating Characteristic (ROC) analysis results for confirmed and suspected glaucoma were obtained with the combination of GDF and TCV (AUC: 0.995 and 0.935, respectively. Sensitivities: 94.5% and 45.9%, respectively, for 99% specificity). The best combination of OCT and perimetry was obtained with the vertical cup/disc ratio and PSD (AUC: 0.988 and 0.847, respectively. Sensitivities: 84.7% and 18.4%, respectively, for 99% specificity). Conclusion: Using Laguna ONhE, morphology, perfusion, and function can be mutually enhanced with the methods described for the purpose of glaucoma assessment, providing early sensitivity.

scholarly journals Quantitative Assessment of the Echogenicity of a Breast Tumor Predicts the Response to Neoadjuvant Chemotherapy

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3546
Author(s):  
Katarzyna Sylwia Dobruch-Sobczak ◽  
Hanna Piotrzkowska-Wróblewska ◽  
Piotr Karwat ◽  
Ziemowit Klimonda ◽  
Ewa Markiewicz-Grodzicka ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Treatment Response ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Quantitative Measure ◽  
Malignant Cell ◽  
Breast Cancer Patients ◽  
The Third ◽  
Leibler Divergence

The aim of the study was to improve monitoring the treatment response in breast cancer patients undergoing neoadjuvant chemotherapy (NAC). The IRB approved this prospective study. Ultrasound examinations were performed prior to treatment and 7 days after four consecutive NAC cycles. Residual malignant cell (RMC) measurement at surgery was the standard of reference. Alteration in B-mode ultrasound (tumor echogenicity and volume) and the Kullback-Leibler divergence (kld), as a quantitative measure of amplitude difference, were used. Correlations of these parameters with RMC were assessed and Receiver Operating Characteristic curve (ROC) analysis was performed. Thirty-nine patients (mean age 57 y.) with 50 tumors were included. There was a significant correlation between RMC and changes in quantitative parameters (KLD) after the second, third and fourth course of NAC, and alteration in echogenicity after the third and fourth course. Multivariate analysis of the echogenicity and KLD after the third NAC course revealed a sensitivity of 91%, specificity of 92%, PPV = 77%, NPV = 97%, accuracy = 91%, and AUC of 0.92 for non-responding tumors (RMC ≥ 70%). In conclusion, monitoring the echogenicity and KLD parameters made it possible to accurately predict the treatment response from the second course of NAC.

scholarly journals Urinary Metabolomics Study of Patients with Bicuspid Aortic Valve Disease

Molecules ◽  
2021 ◽  
Vol 26 (14) ◽  
pp. 4220
Author(s):  
Massimo Chessa ◽  
Mario Panebianco ◽  
Sara Corbu ◽  
Milena Lussu ◽  
Angelica Dessì ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Metabolic Pathways ◽  
Congenital Heart ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Molecular Fingerprint ◽  
Metabolomics Study ◽  
Cardiovascular Anomalies ◽  
Potential Use

Bicuspid aortic valve (BAV) is the most common congenital heart defect responsible for valvular and aortic complications in affected patients. Causes and mechanisms of this pathology are still elusive and thus the lack of early detection biomarkers leads to challenges in its diagnosis and prevention of associated cardiovascular anomalies. The aim of this study was to explore the potential use of urine Nuclear Magnetic Resonance (NMR) metabolomics to evaluate a molecular fingerprint of BAV. Both multivariate and univariate statistical analyses were performed to compare the urinary metabolome of 20 patients with BAV with that of 24 matched controls. Orthogonal partial least squared discriminant analysis (OPLS-DA) showed statistically significant discrimination between cases and controls, suggesting seven metabolites (3-hydroxybutyrate, alanine, betaine, creatine, glycine, hippurate, and taurine) as potential biomarkers. Among these, glycine, hippurate and taurine individually displayed medium sensitivity and specificity by receiver operating characteristic (ROC) analysis. Pathway analysis indicated two metabolic pathways likely perturbed in BAV subjects. Possible contributions of gut microbiota activity and energy imbalance are also discussed. These results constitute encouraging preliminary findings in favor of the use of urine-based metabolomics for early diagnosis of BAV.

scholarly journals The Impact of Idiopathic Generalized Epilepsy on Executive Functions

2021 ◽  
pp. 097275312096875
Author(s):  
Haritha Koganti ◽  
Shasthara Paneyala ◽  
Harsha Sundaramurthy ◽  
Nemichandra SC ◽  
Rithvik S Kashyap ◽  
...  
Keyword(s):  
Executive Functions ◽  
Executive Dysfunction ◽  
Cross Sectional Study ◽  
Idiopathic Epilepsy ◽  
Idiopathic Generalized Epilepsy ◽  
Word Fluency ◽  
Cross Sectional ◽  
Generalized Epilepsy ◽  
Multiple Domains ◽  
The Impact

Background: Idiopathic generalized epilepsy is defined as seizures with a possible hereditary predisposition without an underlying cause or structural pathology. Assessment of executive dysfunction in idiopathic generalized epilepsies based on standard Indian battery is not available in the literature. Aims and Objectives: To assess specific executive functions affected in patients with idiopathic epilepsy and their association with various variables. Materials and Methods: Type of observational cross-sectional study, where clinical profile of all idiopathic epilepsy patients attending the neurology OPD was studied and their executive higher mental functions were assessed using the NIMHANS battery. Results: A total of 75 idiopathic generalized epilepsy patients were included in the study. Executive functions that were commonly found abnormal in our study were word fluency ( P ≤ .001), category fluency ( P < .001), verbal n-back ( P < .001), Tower of London ( p < 0.01), and Stroop test ( P < 0.01). Executive functions showed a significant correlation with age at symptom onset, duration of epilepsy, and in those with uncontrolled seizures. Conclusion: Patients of idiopathic generalized epilepsy according to the present study were found to have significant executive dysfunction in multiple domains. This necessitates the screening for executive dysfunctions, which if detected should prompt the clinician to initiate cognitive retraining.

scholarly journals Type 2 diabetes is more predictable in women than men by multiple anthropometric and biochemical measures

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tangying Li ◽  
Huibiao Quan ◽  
Huachuan Zhang ◽  
Leweihua Lin ◽  
Lu Lin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Diastolic Blood Pressure ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Regression Coefficient ◽  
Regression Coefficients ◽  
Sexually Dimorphic ◽  
Fasting Insulin

AbstractMen and women are sexually dimorphic but whether common anthropometric and biochemical parameters predict type 2 diabetes (T2D) in different ways has not been well studied. Here we recruit 1579 participants in Hainan Province, China, and group them by sex. We compared the prediction power of common parameters of T2D in two sexes by association, regression, and Receiver Operating Characteristic (ROC) analysis. HbA1c is associated with FPG stronger in women than in men and the regression coefficient is higher, consistent with higher prediction power for T2D. Age, waist circumference, BMI, systolic and diastolic blood pressure, triglyceride levels, total cholesterol, LDL, HDL, fasting insulin, and proinsulin levels all predict T2D better in women. Except for diastolic blood pressure, all parameters associate or tend to associate with FPG stronger in women than in men. Except for diastolic blood pressure and fasting proinsulin, all parameters associate or tend to associate with HbA1c stronger in women than in men. Except for fasting proinsulin and HDL, the regression coefficients of all parameters with FPG and HbA1c were higher in women than in men. Together, by the above anthropometric and biochemical measures, T2D is more readily predicted in women than men, suggesting the importance of sex-based subgroup analysis in T2D research.

scholarly journals Arginase 1 (Arg1) as an Up-Regulated Gene in COVID-19 Patients: A Promising Marker in COVID-19 Immunopathy

2021 ◽  
Vol 10 (5) ◽  
pp. 1051 ◽  
Author(s):  
Afshin Derakhshani ◽  
Nima Hemmat ◽  
Zahra Asadzadeh ◽  
Moslem Ghaseminia ◽  
Mahdi Abdoli Shadbad ◽  
...  
Keyword(s):  
Immune Responses ◽  
Whole Blood ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Rna Extraction ◽  
Diagnostic Value ◽  
Healthy Individuals ◽  
Cdna Synthesis ◽  
Arginase 1 ◽  
Global Pandemic

Background: The coronavirus disease 2019 (COVID-19) outbreak, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been declared a global pandemic. It is well-established that SARS-CoV-2 infection can lead to dysregulated immune responses. Arginase-1 (Arg1), which has a pivotal role in immune cells, can be expressed in most of the myeloid cells, e.g., neutrophils and macrophages. Arg1 has been associated with the suppression of antiviral immune responses. Methods: Whole blood was taken from 21 COVID-19 patients and 21 healthy individuals, and after RNA extraction and complementary DNA (cDNA) synthesis, gene expression of Arg1 was measured by real-time PCR. Results: The qPCR results showed that the expression of Arg1 was significantly increased in COVID-19 patients compared to healthy individuals (p < 0.01). The relative expression analysis demonstrated there were approximately 2.3 times increased Arg1 expression in the whole blood of COVID-19 patients. Furthermore, the receiver operating characteristic (ROC) analysis showed a considerable diagnostic value for Arg1 expression in COVID-19 (p = 0.0002 and AUC = 0.8401). Conclusion: Arg1 might be a promising marker in the pathogenesis of the disease, and it could be a valuable diagnostic tool.

scholarly journals The Responses of VIP Neurons Are Sufficiently Sensitive to Support Heading Judgments

2010 ◽  
Vol 103 (4) ◽  
pp. 1865-1873 ◽  
Author(s):  
Tao Zhang ◽  
Kenneth H. Britten
Keyword(s):  
Optic Flow ◽  
Discrimination Task ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Macaque Monkey ◽  
Pursuit Eye Movements ◽  
Behavioral Thresholds ◽  
Heading Direction ◽  
Ventral Intraparietal Area ◽  
Self Motion

The ventral intraparietal area (VIP) of the macaque monkey is thought to be involved in judging heading direction based on optic flow. We recorded neuronal discharges in VIP while monkeys were performing a two-alternative, forced-choice heading discrimination task to relate quantitatively the activity of VIP neurons to monkeys' perceptual choices. Most VIP neurons were responsive to simulated heading stimuli and were tuned such that their responses changed across a range of forward trajectories. Using receiver operating characteristic (ROC) analysis, we found that most VIP neurons were less sensitive to small heading changes than was the monkey, although a minority of neurons were equally sensitive. Pursuit eye movements modestly yet significantly increased both neuronal and behavioral thresholds by approximately the same amount. Our results support the view that VIP activity is involved in self-motion judgments.

scholarly journals Determining when impairment constitutes incapacity for informed consent in schizophrenia research

2007 ◽  
Vol 191 (1) ◽  
pp. 38-43 ◽  
Author(s):  
Scott Y. H. Kim ◽  
Paul S. Appelbaum ◽  
Jeffrey Swan ◽  
T. Scott Stroup ◽  
Joseph P. McEvoy ◽  
...  
Keyword(s):  
Roc Analysis ◽  
Operating Characteristic ◽  
Assessment Tool ◽  
Ethics Committees ◽  
Competence Assessment ◽  
Evidence Based ◽  
Research Ethics Committees ◽  
Predictive Values ◽  
Risks And Benefits ◽  
Capacity Determination

BackgroundAlthough people with schizophrenia display impaired abilities for consent, it is not known how much impairment constitutes incapacity.AimsTo assess a method for determining the categorical capacity status of potential participants in schizophrenia research.MethodExpert-judgement validation of capacity thresholds on the sub-scales of the MacArthur Competence Assessment Tool – Clinical Research (MacCAT–CR) was evaluated using receiver operating characteristic (ROC) analysis in 91 people with severe mental illness and 40 controls.ResultsThe ROC areas under the curve for the understanding, appreciation and reasoning sub-scales of the MacCAT–CR were 0.94 (95% CI 0.88–0.99), 0.85 (95% CI 0.76–0.94) and 0.80 (95% CI 0.70–0.90). These findings yielded negative and positive predictive values of incapacity that can guide the practice of investigators and research ethics committees.ConclusionsBy performing such validation studies for a few categories of research with varying risks and benefits, it might be possible to create evidence-based capacity determination guidelines for most schizophrenia research.

The potential value of a pictorial atlas for aid in the visual diagnosis of 123I FP-CIT SPECT scans

2009 ◽  
Vol 48 (04) ◽  
pp. 173-178 ◽  
Author(s):  
H. Ham ◽  
A. Dobbeleir ◽  
P. Santens ◽  
Y. D'Asseler ◽  
I. Goethals
Keyword(s):  
Diagnostic Accuracy ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Interobserver Variability ◽  
Area Under The Curve ◽  
Visual Assessment ◽  
Added Value ◽  
Related Disorder ◽  
Visual Diagnosis ◽  
Spect Images

SummaryThe aim of our study was to evaluate the value of a pictorial atlas of 123I FP-CIT SPECT images for aid in the visual diagnosis. Patients, materials, methods: Sixty patients, of whom 20 were clinically diagnosed as ‘non-parkinsonian’ and 40 as having Parkinson's disease or any related disorder, were included in the study. An atlas consisting of 12 123I FP-CIT SPECT images was constructed first. Validity of the atlas was investigated by performing a receiver operating characteristic (ROC) analysis with the clinical diagnosis as the gold standard. The remaining 48 SPECT images were visually assessed twice by 5 observers, first with and secondly without consulting the atlas, or vice versa. The added value of the atlas was investigated by comparing the diagnostic accuracy and the interobserver variability for both methods. Results: ROC analysis performed on the atlas yielded an area under the curve of 1 for a threshold discriminating between clinically non-parkinsonian and parkinsonian patients that was situated between image 4 and 5 of the atlas. For the diagnostic accuracy, we found that the area under the ROC curve was systematically higher if observers had access to the atlas compared to when they had not (Wilcoxon's test, p<0.05). Also, the interobserver variability was significantly lower when observers used the atlas when compared to when they did not (p = 0.05). Conclusion: Diagnostic accuracy was significantly higher and interobserver variability significantly lower if observers had access to the atlas compared to when they had not. Hence, having a pictorial atlas available may facilitate the visual assessment of 123I FP-CIT SPECT scans.

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