Quantitative Breast Density in Contrast-Enhanced Mammography

Contrast-enhanced mammography (CEM) demonstrates a potential role in personalized screening models, in particular for women at increased risk and women with dense breasts. In this study, volumetric breast density (VBD) measured in CEM images was compared with VBD obtained from digital mammography (DM) or tomosynthesis (DBT) images. A total of 150 women who underwent CEM between March 2019 and December 2020, having at least a DM/DBT study performed before/after CEM, were included. Low-energy CEM (LE-CEM) and DM/DBT images were processed with automatic software to obtain the VBD. VBDs from the paired datasets were compared by Wilcoxon tests. A multivariate regression model was applied to analyze the relationship between VBD differences and multiple independent variables certainly or potentially affecting VBD. Median VBD was comparable for LE-CEM and DM/DBT (12.73% vs. 12.39%), not evidencing any statistically significant difference (p = 0.5855). VBD differences between LE-CEM and DM were associated with significant differences of glandular volume, breast thickness, compression force and pressure, contact area, and nipple-to-posterior-edge distance, i.e., variables reflecting differences in breast positioning (coefficient of determination 0.6023; multiple correlation coefficient 0.7761). Volumetric breast density was obtained from low-energy contrast-enhanced spectral mammography and was not significantly different from volumetric breast density measured from standard mammograms.

Download Full-text

Quantitative breast density in Contrast-Enhanced Mammography

10.21203/rs.3.rs-400818/v1 ◽

2021 ◽

Author(s):

Gisella Gennaro ◽

Melissa L. Hill ◽

Elisabetta Bezzon ◽

Francesca Caumo

Keyword(s):

Breast Cancer ◽

Breast Density ◽

Breast Imaging ◽

High Energy ◽

Multiple Correlation Coefficient ◽

Low Energy ◽

Wilcoxon Test ◽

Coefficient Of Determination ◽

Contrast Enhanced ◽

Significant Difference

Abstract Background: Breast density is an independent risk factor for breast cancer, and cancer detection in mammography is reduced in dense breasts. Quantitative tools are available to measure breast density from digital mammography (DM) or tomosynthesis (DBT). Contrast-enhanced mammography (CEM) is an emerging breast imaging technique, consisting of the acquisition of an image pair (low-energy, LE, and high-energy, HE) for each mammography view. LE-CEM images have been demonstrated to be visually equivalent to a standard mammogram, thereby, CEM examinations do not require additional mammography to complete the clinical information. In this study, volumetric breast density (VBD) measured in LE-CEM was compared with VBD obtained from DM/DBT images.Methods: Between Mar 2019 and Dec 2020 222 women were enrolled in a prospective clinical trial aiming to compare clinical performance of CEM with breast MRI in a population of women at intermediate and high risk for breast cancer. In this observational cohort study, 150 women enrolled in this trial having at least a DM/DBT study performed before/after CEM were selected. CEM and previous/subsequent DM/DBT images were processed by an automatic algorithm to calculate VBD for each view. VBD from LE-CEM and DM/DBT views were compared using a paired Wilcoxon test. P < 0.05 was considered indicative of a statistically significant difference. A multivariate regression model was applied to analyze the relationship between paired VBD differences and multiple independent variables certainly or potentially affecting VBD.Results: Mean age of women included in this study was 51.0±8.4 years. Median VBD was comparable for LE-CEM and previous/subsequent DM/DBT (12.73% vs. 12.39%), not evidencing any statistically significant difference (P = 0.5855). VBD differences between LE-CEM and DM were associated to significant differences of glandular volume, breast thickness, compression force and pressure, contact area, and nipple-to-posterior-edge distance i.e. variables reflecting differences in breast positioning (coefficient of determination 0.6023; multiple correlation coefficient 0.7761).Conclusions: Volumetric breast density can be obtained from low-energy contrast-enhanced spectral mammography and is not significantly different from volumetric breast density measured from standard mammograms.

Download Full-text

Relationship between benzodiazepine prescription, aggressive behavior, and behavioral disinhibition: a retrospective study in a Swiss prison

Harm Reduction Journal ◽

10.1186/s12954-021-00504-5 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Stéphanie Baggio ◽

Vladan Starcevic ◽

Patrick Heller ◽

Karen Brändle ◽

Irina Franke ◽

...

Keyword(s):

Propensity Score ◽

Aggressive Behavior ◽

Propensity Score Matching ◽

Potential Role ◽

Behavioral Disinhibition ◽

Increased Risk ◽

Benzodiazepine Use ◽

Logistic Regressions ◽

Relationship Of ◽

The Relationship

Abstract Background Benzodiazepines are commonly prescribed in prisons amidst the controversies surrounding their potential role in causing behavioral disinhibition and aggressive behavior and their association with use and trafficking of illicit and addictive substances. The present study aimed to (1) ascertain the relationship between benzodiazepine prescription (including their dosage and duration of use) and aggressive behavior and behavioral disinhibition in prison and (2) investigate whether there was an association between benzodiazepine prescription, (including their dosage and duration of use) and using and trafficking illicit and addictive substances during imprisonment. Methods Data were extracted from the electronic database of an “open” Swiss prison (n = 1206, 1379 measures) over a 5-year period (2010–2015). Measures included benzodiazepine prescription, duration of benzodiazepine use and mean dosage, and punishable behaviors (physical and verbal aggression, disinhibited but not directly aggressive behaviors, property damage or theft, substance-related offenses, and rule transgression). We assessed the relationship between benzodiazepine prescription and punishable behaviors after propensity score matching. Logistic regressions were also used to test the relationship of benzodiazepine use duration and dosage with punishable behaviors among participants who received benzodiazepines. Results After propensity score matching, benzodiazepine prescription was not significantly associated with any punishable behavior. Among detained persons who took benzodiazepines, there was no significant association of dosage and duration of use with offenses involving illicit or addictive substance use or trafficking. Conclusions Our study did not empirically support the occurrence of increased aggressive or disinhibited behaviors or increased risk of substance abuse in detained persons who received benzodiazepines in prison. This suggests a need to reconsider restrictions in prescribing benzodiazepines in the prison setting.

Download Full-text

How Does Frailty Factor Into Mortality Risk Assessment of a Middle-Aged and Geriatric Trauma Population?

Geriatric Orthopaedic Surgery & Rehabilitation ◽

10.1177/2151458517735202 ◽

2017 ◽

Vol 8 (4) ◽

pp. 225-230 ◽

Cited By ~ 18

Author(s):

Sanjit R. Konda ◽

Ariana Lott ◽

Hesham Saleh ◽

Sebastian Schubl ◽

Jeffrey Chan ◽

...

Keyword(s):

Mortality Risk ◽

Functional Independence ◽

High Energy ◽

Low Energy ◽

Geriatric Trauma ◽

Inpatient Mortality ◽

Middle Aged ◽

Trauma Population ◽

Increased Risk ◽

Significant Difference

Introduction: Frailty in elderly trauma populations has been correlated with an increased risk of morbidity and mortality. The Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA) is a validated mortality risk score that evaluates 4 major physiologic criteria: age, comorbidities, vital signs, and anatomic injuries. The aim of this study was to investigate whether the addition of additional frailty variables to the STTGMA tool would improve risk stratification of a middle-aged and elderly trauma population. Methods: A total of 1486 patients aged 55 years and older who met the American College of Surgeons Tier 1 to 3 criteria and/or who had orthopedic or neurosurgical traumatic consultations in the emergency department between September 2014 and September 2016 were included. The STTGMAORIGINAL and STTGMAFRAILTY scores were calculated. Additional “frailty variables” included preinjury assistive device use (disability), independent ambulatory status (functional independence), and albumin level (nutrition). The ability of the STTGMAORIGINAL and the STTGMAFRAILTY models to predict inpatient mortality was compared using area under the receiver operating characteristic curves (AUROCs). Results: There were 23 high-energy inpatient mortalities (4.7%) and 20 low-energy inpatient mortalities (2.0%). When the STTGMAORIGINAL model was used, the AUROC in the high-energy and low-energy cohorts was 0.926 and 0.896, respectively. The AUROC for STTGMAFRAILTY for the high-energy and low-energy cohorts was 0.905 and 0.937, respectively. There was no significant difference in predictive capacity for inpatient mortality between STTGMAORIGINAL and STTGMAFRAILTY for both the high-energy and low-energy cohorts. Conclusion: The original STTGMA tool accounts for important frailty factors including cognition and general health status. These variables combined with other major physiologic variables such as age and anatomic injuries appear to be sufficient to adequately and accurately quantify inpatient mortality risk. The addition of other common frailty factors that account for does not enhance the STTGMA tool’s predictive capabilities.

Download Full-text

Relationship of Migraine and Body Mass Index (BMI)

Journal of Enam Medical College ◽

10.3329/jemc.v6i2.27762 ◽

2016 ◽

Vol 6 (2) ◽

pp. 80-87

Author(s):

Mohammed Momenuzzaman Khan ◽

Md Nazmul Huda ◽

Manabendra Bhattacharjee ◽

Md Jalal Uddin ◽

Mustofa Kamal Uddin Khan

Keyword(s):

Social Life ◽

Overweight And Obesity ◽

Control Group ◽

P Value ◽

Case Group ◽

Increased Risk ◽

Significant Difference ◽

Associated Symptoms ◽

Migraine Group ◽

The Relationship

Background: Migraine is an important cause of headache and headache-related disabilities. It increases loss of working time, causes inability to carry out daily activities and disruption of family and social life. The pathophysiology of migraine is still poorly understood. On the other hand, the prevalence of obesity is constantly increasing worldwide. The consequence of overweight and obesity includes increased risk of diabetes mellitus, dyslipidemia, hypertension, cardiovascular disease and cancer.Objectives: This study was performed to assess the relationship between BMI and migraine by finding out the relationship between migraine frequency and duration in different BMI groups, comparing the socio-demographic variables in migraine and non-migraine patients and to find out the migraine related co-morbidities.Materials and Methods: This observational case-control study was conducted on 100 subjects aged 1250 years in the Neurology Outpatient Department, Mymensingh Medical College Hospital, Mymensingh in the period of January 2011 to December 2012. Out of total subjects fifty migraine patients were selected as cases and fifty nonmigraineurs as controls. Subjects were then categorized in three groups based on BMI: <23, 23 to 25 and >25. Collected data were compiled and appropriate analyses were done by using computer based software, Statistical Package for Social Sciences (SPSS) version 16.0. For statistical analysis one way ANOVA tests were done for comparing means of quantitative data and Chi-square tests were done for qualitative data. A p value <0.05 was considered statistically significant.Results: In this study, majority (>95%) of the study subjects were between 10 and 35 years of age. Mean age of case group was found 25.55 ± 5.87 and that of control was 25.53 ± 4.22 years. Case group contained 10 (20%) males and 40 (80%) females whereas control group had 14 (28%) males and 36 (72%) females. Number of female cases and controls were higher than that of male. In control group 30 (60%) were unmarried and 20 (40%) were married. There was no significant difference in the financial condition between case and control groups. Students and housewives occupied the largest number of study subjects who were unemployed. Regarding residence, rural and urban patients were equal in case group and in control group 29 (58%) were urban and 21 (42%) rural. Mean duration of headache was 8.9 ± 7.5, 5.8 ± 6.7, 9.6 ± 14.3 years in different BMI groups (<23, 2325, >25 respectively) in case group and 4.6 ± 5.3, 4.4 ± 3.4, 3.4 ± 1.4 years in control group respectively. There was significant difference in quality of headache. In migrainous group 58.6% in BMI <23, 30% in BMI 2325, 36.4% in BMI >25 noted their headache as throbbing, in contrast most of the nonmigrainous described them as dull in nature. Mean frequency of headache per month was significantly higher in migraine group compared to non-migraine group (p=0.02). Regarding associated symptoms, nausea, vomiting, photophobia and phonophobia were observed significantly higher in migraine patients in BMI <23 group. Odd ratios (ORs) for vomiting, photophobia and phonophobia with 95% confidence interval (CI) were 23.385 (2.75297.739), 16.500 (3.060 88.971) and 13.000 (2.92257.846) respectively. Smoking was found significantly higher in nonmigrainous group than migraine group in case of BMI <23.Conclusion: From the result of present study it can be concluded that there is statistically no significant relation of BMI with frequency of headache, but some relationship were observed for associated symptoms of migraine with low BMI.J Enam Med Col 2016; 6(2): 80-87

Download Full-text

COVID-19-associated healthcare worker depression: An increasingly common condition

Praxis of Otorhinolaryngology ◽

10.5606/kbbu.2021.23855 ◽

2021 ◽

Vol 9 (3) ◽

pp. 93-97

Author(s):

Kemal Koray Bal

Keyword(s):

Healthcare Workers ◽

Depressive Mood ◽

Clinical Psychologist ◽

Sufficient Information ◽

Increased Risk ◽

Significant Difference ◽

Group 2 ◽

Work Done ◽

The Relationship ◽

Group 1

OBJECTIVE: This study aimed to evaluate the mood of the employees of the ear-nose-throat (ENT) department with the Beck Depression Inventory (BDI) during the coronavirus disease 2019 (COVID-19) pandemic and determine the relationship between the mood and the quality and quantity of the work done. METHODS: A total of 62 healthcare workers (24 males, 38 females; mean age: 34.3±1.1 years; range 24 to 52 years) of our ENT clinic, who have been actively managing COVID-19 patients since April 2020, were included in the study. Those in the study were classified into two groups as nurses (Group 1) and doctors (Group 2). Group 1 consisted of 33 (53.2%) nurses, and Group 2 consisted of 29 (46.8%) doctors. The participants were assessed with a questionnaire by a clinical psychologist, and BDI was conducted to evaluate depressive mood in these individuals. RESULTS: A statistically significant difference was found between the groups in thinking they have sufficient knowledge on COVID-19, and the employees in Group 2 were more of the opinion that they did not have sufficient information (p=0.002). A statistically significant difference was found between the groups in terms of their viewpoint on the precautions against COVID-19 (p=0.001). Group 2 was more inclined to think that the precautions taken were inadequate (p=0.001). There was no statistically significant difference between the groups in terms of BDI severity, age, and BDI score (p=0.252, p=0.137, p=0.053, respectively). CONCLUSION: Employees of high-risk departments such as ENT may be more prone to a depressed mood. The increased risk of contamination in correlation with the work done can lead to increased BDI scores and depressive mood disorder.

Download Full-text

Surgical Aspects of Recurrent Inguinal Hernia in Adults

The American Surgeon ◽

10.1177/000313481608201120 ◽

2016 ◽

Vol 82 (11) ◽

pp. 1063-1067 ◽

Cited By ~ 5

Author(s):

Sang Su Lee ◽

Hyuk Jae Jung ◽

Byung Soo Park ◽

Gyung Mo Son ◽

Yong Hoon Cho

Keyword(s):

Inguinal Hernia ◽

Primary Repair ◽

Recurrent Hernia ◽

Recurrent Inguinal Hernia ◽

Inguinal Herniorrhaphy ◽

Increased Risk ◽

Significant Difference ◽

Surgical Aspects ◽

The Relationship

Surgeons occasionally encounter a case of recurrent hernia in adult patients after the primary repair, and these cases are challenging to manage appropriately. This study was conducted to describe the clinical nature of recurrent inguinal hernia, compare the results of management, and identify the relationship between the specific risk factors and the occurrence of recurrent hernia. Retrospectively reviewed 58 patients who underwent the inguinal herniorrhaphy for recurrent hernia in a single institution. Analyzed clinical characteristics of recurrent hernia and tried to verify the relationship between smoking, obesity, and occurrence of recurrent hernia. Recurrent inguinal hernia was 13.5 per cent of all hernia repairs in the study period. Most of the recurrence was the first event (74.1%) and showed an interval to recurrence with a mean duration of 40.7 months. There was no significant difference in procedure time, development of postoperative complications, and duration of hospital stay according to the procedure. Compromise of smoker and overweight was significantly higher in the recurrent group (P < 0.05). Surgeons should be aware of the increased risk for recurrence in adult inguinal hernia patients when they smoke or are overweight (body mass index ≥ 25 kg/m2), also it needs to follow-up during the adequate period.

Download Full-text

Do African American Men Have Lower Survival From Prostate Cancer Compared With White Men? A Meta-analysis

American Journal of Men s Health ◽

10.1177/1557988309353934 ◽

2010 ◽

Vol 4 (3) ◽

pp. 189-206 ◽

Cited By ~ 16

Author(s):

Gayathri Sridhar ◽

Saba W. Masho ◽

Tilahun Adera ◽

Viswanathan Ramakrishnan ◽

John D. Roberts

Keyword(s):

Prostate Cancer ◽

African American ◽

Racial Differences ◽

African American Men ◽

Meta Analysis ◽

White Men ◽

Cancer Specific Survival ◽

Increased Risk ◽

Significant Difference ◽

The Relationship

Prostate cancer is the second leading cause of cancer-related mortality in men. This meta-analysis was conducted to investigate the relationship between race and survival from prostate cancer. A systematic review of articles published from 1968 to 2007 assessing survival from prostate cancer was conducted. Analysis of unadjusted studies reported that African American men have an increased risk of all-cause mortality (hazard ratio [HR] = 1.47, 95% confidence interval [CI] = 1.31-1.65, p < .001). However, examination of adjusted studies identified no difference (HR = 1.07, 95% CI = 0.94-1.22, p = .308). No statistically significant difference was observed in prostate cancer—specific survival in both analyses using unadjusted (HR = 1.11, 95% CI = 0.94-1.31, p = .209) and adjusted studies (HR = 1.15, 95% CI = 0.95-1.41, p = .157). This meta-analysis concludes that there are no racial differences in the overall and prostate cancer—specific survival between African American and White men.

Download Full-text

Galectin-3 and acute heart failure: genetic polymorphisms, plasma level, myocardial fibrosis and 1-year outcomes

Biomarkers in Medicine ◽

10.2217/bmm-2020-0269 ◽

2020 ◽

Vol 14 (11) ◽

pp. 943-954

Author(s):

Hao Fu ◽

Shaoping Nie ◽

Ping Luo ◽

Yang Ruan ◽

Zichuan Zhang ◽

...

Keyword(s):

Heart Failure ◽

Acute Heart Failure ◽

Myocardial Fibrosis ◽

Nucleotide Polymorphisms ◽

Single Nucleotide ◽

Increased Risk ◽

Significant Difference ◽

Galectin 3 ◽

The Relationship

Aim: This study sought to investigate the relationship between galectin-3 (Gal-3), myocardial fibrosis (MF) and outcomes in acute heart failure. Materials & methods: The single-nucleotide polymorphisms (SNPs) of LGALS3 at rs4644 and rs4652, plasma Gal-3 level, MF and major adverse events (MAEs) were obtained. Results: There was no significant difference in MAEs when categorizing patients by the LGALS3 SNPs at rs4644 and rs4652. The circulating Gal-3 was related to the degree of MF (p < 0.001). Plasma Gal-3 level and MF can predict an increased risk of MAEs (p < 0.001, p = 0.023, respectively). Conclusion: Not the SNPs of LGALS3 but Gal-3 and MF can predict MAEs in acute heart failure at 1 year of follow-up.

Download Full-text

Abstract 14886: Outcome of Early Surgery in Active Infective Endocarditis in Terms of Intraoperative Valve Culture

Circulation ◽

10.1161/circ.142.suppl_3.14886 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Kota Suzuki ◽

Daisuke Yoshioka ◽

Koichi Toda ◽

Shigeru Miyagawa ◽

Satoshi Kainuma ◽

...

Keyword(s):

Infective Endocarditis ◽

Hazard Analysis ◽

Early Surgery ◽

Term Outcome ◽

Active Infective Endocarditis ◽

Reactive Protein ◽

Increased Risk ◽

Significant Difference ◽

The Relationship

Introduction: In recent years, the benefit of early surgery in active infective endocarditis (IE) has been reported. The drawback of early surgery is the risk that residual bacteria in the operative field may cause IE recurrence. Little is known regarding the relationship between intraoperative valve culture and recurrence. In the present study, we investigated the value of early surgery for IE based on the results of valve cultures. Hypothesis: Positive intraoperative valve cultures in early surgery are associated with recurrence. Methods: Between 2009 and 2017, 585 patients underwent valve surgery for definitive left-sided active IE at 14 affiliated hospitals. Early surgery was defined as surgery within 14 days from diagnosis, and patients with unknown valve culture results were excluded. We analyzed the short and mid-term outcome in patients with early surgery (n=228). These 228 patients were compared in two groups: positive (Group P, n=106) and negative (Group N, n=122) valve cultures. The primary outcome was all-cause mortality. Secondary outcomes were recurrence of IE. Mean follow-up time was 2.5±2.8 years. Results: Patients in group P had a significantly higher inflammatory response on preoperative blood tests (White blood cell count: 10.4 (8.3-14.5) vs. 8.2 (6.0-12.7) х10 3 /μl, p=0.005, C-reactive protein: 7.3 (3.8-11.0) vs. 3.8 (2.1-6.8) mg/dl, p<0.001). Patients in group P also had a significantly shorter duration from diagnosis to surgery (2 (1-4) vs. 4 (1-9) days, p<0.001). There was no significant difference in in-hospital mortality between the two groups (13/106 (12%) vs. 11/122 (9%), p=0.43). The overall survival rate at 1 and 5 years was 83% and 69% in group P, 82% and 75% in group N, respectively (p=0.85). The rate of freedom from the recurrence of endocarditis at 1 and 5 years postoperatively was 97% and 82% in group P, and 98% and 92% in group N, respectively (p=0.02). In Cox's hazard analysis, positive valve culture was a risk factor for IE recurrence in multivariate analysis (hazard ratio, 3.39; 95% confidence interval, 1.07 to 10.67; p=0.037). Conclusions: Positive valve culture cases in early surgery for active IE have a significantly increased risk of recurrence compared with valve culture-negative cases and require careful management.

Download Full-text

Lack of Significant Association between Plasma/Serum miR-221 Expression and Poor Survival of Carcinoma: A Meta-Analysis

The Scientific World JOURNAL ◽

10.1155/2013/394030 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Min-hua Rong ◽

Yi-wu Dang ◽

Gang Chen

Keyword(s):

Potential Role ◽

Meta Analysis ◽

Cochrane Library ◽

Poor Survival ◽

Poor Overall Survival ◽

Altered Expression ◽

Precise Estimation ◽

Hazard Ratios ◽

Significant Difference ◽

The Relationship

Background. MicroRNAs (miRNAs) exhibit altered expression levels in cancers, and they may play a potential role as diagnostic and prognostic biomarkers of cancers. The aim of this meta-analysis was to summarize recent advances in miR-221 involvement in a variety of carcinomas and derive a more precise estimation of the relationship between circulating miR-221 level and survival of cancer patients.Methods. We searched online PubMed, EMBASE, and Cochrane Library up to August 2013 to identify relevant studies. Data were collected from studies comparing survival in patients with various carcinomas with higher miR-221 expression to those with lower levels. Pooled hazard ratios (HRs) of miR-221 for survival were calculated.Results. There were 4 studies included in the meta-analysis. The results of meta-analysis suggested that no significant difference in poor overall survival between miR-221 high and low groups (OR = 0.94, 95%, CI = 0.47–1.87,Z=0.17, andP=0.863).Conclusions. The current meta-analysis showed the equivalence of high and low plasma/serum miR-221 expression for carcinomas in terms of survival.

Download Full-text