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Bahloul A, Verger A, Lamash Y, Roth N, Dari D, Marie PY, Imbert L. Ultra-fast whole-body bone tomoscintigraphies achieved with a high-sensitivity 360° CZT camera and a dedicated deep-learning noise reduction algorithm. Eur J Nucl Med Mol Imaging 2024; 51:1215-1220. [PMID: 38082197 DOI: 10.1007/s00259-023-06558-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/01/2023] [Indexed: 03/22/2024]
Abstract
This study aimed to determine whether the whole-body bone Single Photon Emission Computed Tomography (SPECT) recording times of around 10 min, routinely provided by a high-sensitivity 360° cadmium and zinc telluride (CZT) camera, can be further reduced by a deep-learning noise reduction (DLNR) algorithm. METHODS DLNR was applied on whole-body images recorded after the injection of 545 ± 33 MBq of [99mTc]Tc-HDP in 19 patients (14 with bone metastasis) and reconstructed with 100%, 90%, 80%, 70%, 60%, 50%, 40%, and 30% of the original SPECT recording times. RESULTS Irrespective of recording time, DLNR enhanced the contrast-to-noise ratios and slightly decreased the standardized uptake values of bone lesions. Except in one markedly obese patient, the quality of DLNR processed images remained good-to-excellent down to 60% of the recording time, corresponding to around 6 min SPECT-recording. CONCLUSION Ultra-fast SPECT recordings of 6 min can be achieved when DLNR is applied on whole-body bone 360° CZT-SPECT.
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Affiliation(s)
- Achraf Bahloul
- CHRU-Nancy, Department of Nuclear Medicine & Nancyclotep imaging platform, Université de Lorraine, Nancy, France
- INSERM, IADI U1254, Université de Lorraine, Vandoeuvre-lès-Nancy, France
| | - Antoine Verger
- CHRU-Nancy, Department of Nuclear Medicine & Nancyclotep imaging platform, Université de Lorraine, Nancy, France
- INSERM, IADI U1254, Université de Lorraine, Vandoeuvre-lès-Nancy, France
| | | | | | - Diawad Dari
- CHRU-Nancy, Department of Nuclear Medicine & Nancyclotep imaging platform, Université de Lorraine, Nancy, France
| | - Pierre-Yves Marie
- CHRU-Nancy, Department of Nuclear Medicine & Nancyclotep imaging platform, Université de Lorraine, Nancy, France
- INSERM, IADI U1254, Université de Lorraine, Vandoeuvre-lès-Nancy, France
| | - Laetitia Imbert
- CHRU-Nancy, Department of Nuclear Medicine & Nancyclotep imaging platform, Université de Lorraine, Nancy, France.
- INSERM, IADI U1254, Université de Lorraine, Vandoeuvre-lès-Nancy, France.
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Roth N, Goodwin A. Tuning electronic and phonon bands through disorder. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322091926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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Støckler K, Roth N, Grønbech T, Iversen B. Epitaxial intergrowths and local oxide displacements in natural bixbyite. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322095791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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de Souza ACDAH, Harms HJ, Martell L, Bibbo C, Harrington M, Sullivan K, Hainer J, Dorbala S, Blankstein R, Taqueti VR, Foley Kijewski M, Park MA, Meretta A, Breault C, Roth N, Poitrasson-Rivière A, Soman P, Gullberg GT, Di Carli MF. Accuracy and Reproducibility of Myocardial Blood Flow Quantification by Single Photon Emission Computed Tomography Imaging in Patients With Known or Suspected Coronary Artery Disease. Circ Cardiovasc Imaging 2022; 15:e013987. [PMID: 35674051 DOI: 10.1161/circimaging.122.013987] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Single photon emission computed tomography (SPECT) has limited ability to identify multivessel and microvascular coronary artery disease. Gamma cameras with cadmium zinc telluride detectors allow the quantification of absolute myocardial blood flow (MBF) and myocardial flow reserve (MFR). However, evidence of its accuracy is limited, and of its reproducibility is lacking. We aimed to validate 99mTc-sestamibi SPECT MBF and MFR using standard and spline-fitted reconstruction algorithms compared with 13N-ammonia positron emission tomography in a cohort of patients with known or suspected coronary artery disease and to evaluate the reproducibility of this technique. METHODS Accuracy was assessed in 34 participants who underwent dynamic 99mTc-sestamibi SPECT and 13N-ammonia positron emission tomography and reproducibility in 14 participants who underwent 2 99mTc-sestamibi SPECT studies, all within 2 weeks. A rest/pharmacological stress single-day SPECT protocol was performed. SPECT images were reconstructed using a standard ordered subset expectation maximization (OSEM) algorithm with (N=21) and without (N=30) application of spline fitting. SPECT MBF was quantified using a net retention kinetic model' and MFR was derived as the stress/rest MBF ratio. RESULTS SPECT global MBF with splines showed good correlation with 13N-ammonia positron emission tomography (r=0.81, P<0.001) and MFR estimates (r=0.74, P<0.001). Correlations were substantially weaker for standard reconstruction without splines (r=0.61, P<0.001 and r=0.34, P=0.07, for MBF and MFR, respectively). Reproducibility of global MBF estimates with splines in paired SPECT scans was good (r=0.77, P<0.001), while ordered subset expectation maximization without splines led to decreased MBF (r=0.68, P<0.001) and MFR correlations (r=0.33, P=0.3). There were no significant differences in MBF or MFR between the 2 reproducibility scans independently of the reconstruction algorithm (P>0.05 for all). CONCLUSIONS MBF and MFR quantification using 99mTc-sestamibi cadmium zinc telluride SPECT with spatiotemporal spline fitting improved the correlation with 13N-ammonia positron emission tomography flow estimates and test/retest reproducibility. The use of splines may represent an important step toward the standardization of SPECT flow estimation.
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Affiliation(s)
- Ana Carolina do A H de Souza
- Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Boston, MA (A.C.d.A.H.d.S., H.J.H., L.M., C.B., M.H., K.S., J.H., S.D., R.B., V.R.T., M.F., M.-A.P., M.F.D.C.)
| | - Hendrik J Harms
- Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Boston, MA (A.C.d.A.H.d.S., H.J.H., L.M., C.B., M.H., K.S., J.H., S.D., R.B., V.R.T., M.F., M.-A.P., M.F.D.C.)
| | - Laurel Martell
- Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Boston, MA (A.C.d.A.H.d.S., H.J.H., L.M., C.B., M.H., K.S., J.H., S.D., R.B., V.R.T., M.F., M.-A.P., M.F.D.C.)
| | - Courtney Bibbo
- Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Boston, MA (A.C.d.A.H.d.S., H.J.H., L.M., C.B., M.H., K.S., J.H., S.D., R.B., V.R.T., M.F., M.-A.P., M.F.D.C.).,Spectrum Dynamics Medical, Caesarea, Israel (C.B., N.R.)
| | - Meagan Harrington
- Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Boston, MA (A.C.d.A.H.d.S., H.J.H., L.M., C.B., M.H., K.S., J.H., S.D., R.B., V.R.T., M.F., M.-A.P., M.F.D.C.)
| | - Kyle Sullivan
- Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Boston, MA (A.C.d.A.H.d.S., H.J.H., L.M., C.B., M.H., K.S., J.H., S.D., R.B., V.R.T., M.F., M.-A.P., M.F.D.C.)
| | - Jon Hainer
- Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Boston, MA (A.C.d.A.H.d.S., H.J.H., L.M., C.B., M.H., K.S., J.H., S.D., R.B., V.R.T., M.F., M.-A.P., M.F.D.C.)
| | - Sharmila Dorbala
- Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Boston, MA (A.C.d.A.H.d.S., H.J.H., L.M., C.B., M.H., K.S., J.H., S.D., R.B., V.R.T., M.F., M.-A.P., M.F.D.C.)
| | - Ron Blankstein
- Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Boston, MA (A.C.d.A.H.d.S., H.J.H., L.M., C.B., M.H., K.S., J.H., S.D., R.B., V.R.T., M.F., M.-A.P., M.F.D.C.)
| | - Viviany R Taqueti
- Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Boston, MA (A.C.d.A.H.d.S., H.J.H., L.M., C.B., M.H., K.S., J.H., S.D., R.B., V.R.T., M.F., M.-A.P., M.F.D.C.)
| | - Marie Foley Kijewski
- Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Boston, MA (A.C.d.A.H.d.S., H.J.H., L.M., C.B., M.H., K.S., J.H., S.D., R.B., V.R.T., M.F., M.-A.P., M.F.D.C.)
| | - Mi-Ae Park
- Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Boston, MA (A.C.d.A.H.d.S., H.J.H., L.M., C.B., M.H., K.S., J.H., S.D., R.B., V.R.T., M.F., M.-A.P., M.F.D.C.)
| | - Alejandro Meretta
- Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina (A.M.)
| | - Christopher Breault
- Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Boston, MA (A.C.d.A.H.d.S., H.J.H., L.M., C.B., M.H., K.S., J.H., S.D., R.B., V.R.T., M.F., M.-A.P., M.F.D.C.)
| | - Nathaniel Roth
- Spectrum Dynamics Medical, Caesarea, Israel (C.B., N.R.)
| | | | - Prem Soman
- Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA (P.S.)
| | - Grant T Gullberg
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA (G.T.G.)
| | - Marcelo F Di Carli
- Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Boston, MA (A.C.d.A.H.d.S., H.J.H., L.M., C.B., M.H., K.S., J.H., S.D., R.B., V.R.T., M.F., M.-A.P., M.F.D.C.)
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Roth N, Khalil N, Moore-Gillon C, James D, Gilby L, Morgan C. 737 STOOLS FOR STOOLS - COMBINING MEDICAL AND CONSERVATIVE TREATMENTS TO REDUCE CONSTIPATION IN THE ELDERLY INPATIENT POPULATION. Age Ageing 2022. [DOI: 10.1093/ageing/afac034.737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Constipation is a common cause of morbidity in the elderly. Its management is particularly challenging in the inpatient population, where many factors exacerbate constipation. We describe a Quality Improvement Project to reduce the rates of constipation on a female Medicine for the Elderly ward.
Aims
Our aim was to increase bowel chart documentation (nursing and doctor entries) and increase patient frequency of bowel motions to at least once every two days. In particular we focused on conservative measures such as the use of footstools to optimise posture when using commodes and toilets [R Hari Krishnan, Proc Inst Mech Eng H, 2019, 233(4):464–475].
Method
• Weekly monitoring of ward inpatients. • Measurements taken were: days since last bowel motion, laxatives prescribed, bowel chart and ward round documentation, and episodes of diarrhoea over the past week. • One episode of diarrhoea was defined as 3 motions of type 6 or type 7 stool in 24 hours. • A new intervention was introduced every two weeks, over a total of 2 months. Interventions: 1. Recording bowel motions at the daily ‘Board Round’ Multi-Disciplinary Meeting. 2. Ward staff education sessions. 3. Footstools for use with commodes and toilets. 4. High-fibre foods to patients with constipation.
Results
Level of constipation was successfully reduced, with 100% patients moving bowels every 2 days from a baseline of 68%. Ward round and bowel chart documentation improved to 100% and 93.3% respectively (from 41.3% and 33.3%). However, incidence of diarrhoea increased from 0 episodes/week to 8 episodes/week, with laxative prescriptions similarly increased from 50% to 86%.
Conclusion
Constipation improved with our interventions, but at the unintended cost of laxative-associated diarrhoea. Our next steps will be to reduce laxative prescriptions in favour of conservative measures, in order to reduce episodes of loose stool while maintaining our improved constipation rates.
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Affiliation(s)
- N Roth
- Department for Medicine for the Elderly, St. Mary’s Hospital, Imperial College Healthcare NHS Trust
| | - N Khalil
- Department for Medicine for the Elderly, St. Mary’s Hospital, Imperial College Healthcare NHS Trust
| | - C Moore-Gillon
- Department for Medicine for the Elderly, St. Mary’s Hospital, Imperial College Healthcare NHS Trust
| | - D James
- Department for Medicine for the Elderly, St. Mary’s Hospital, Imperial College Healthcare NHS Trust
| | - L Gilby
- Department for Medicine for the Elderly, St. Mary’s Hospital, Imperial College Healthcare NHS Trust
| | - C Morgan
- Department for Medicine for the Elderly, St. Mary’s Hospital, Imperial College Healthcare NHS Trust
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Otaki Y, Manabe O, Miller RJH, Manrique A, Nganoa C, Roth N, Berman DS, Germano G, Slomka PJ, Agostini D. Quantification of myocardial blood flow by CZT-SPECT with motion correction and comparison with 15O-water PET. J Nucl Cardiol 2021; 28:1477-1486. [PMID: 31452085 PMCID: PMC7042031 DOI: 10.1007/s12350-019-01854-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 07/16/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND We compared quantification of MBF and myocardial flow reserve (MFR) with a 99mTc-sestamibi CZT-SPECT to 15O-water PET. METHODS SPECT MBF for thirty patients in the WATERDAY study was re-analyzed by QPET software with motion correction and optimal placement of the arterial input function. 15O-water PET MBF was re-quantified using dedicated software. Inter-operator variability was assessed using repeatability coefficients (RPC). RESULTS Significant correlations were observed between global (r = 0.91, P < 0.001) and regional MBF (r = 0.86, P < 0.001) with SPECT compared to PET. Global MBF (rest 0.95 vs 1.05 ml/min/g, P = 0.07; stress 2.62 vs 2.68 mL/min/g, P = 0.17) and MFR (2.65 vs 2.75, P = 0.86) were similar between SPECT and PET. Rest (0.81 vs 0.98 mL/min/g, P = 0.03) and stress MBF (1.98 vs 2.61 mL/min/g, P = 0.01) in right coronary artery (RCA) were lower with SPECT compared to PET. However, MFR in the RCA territory was similar (2.54 vs 2.77, P = 0.21). The SPECT-PET RPC for global MBFs and MFR were 0.95 mL/min/g and 0.94, with inter-observer RPC of 0.59 mL/min/g and 0.74, respectively. CONCLUSIONS MBF and MFR derived from CZT-SPECT with motion correction and optimal placement of the arterial input function showed good agreement with 15O-water PET, as well as low inter-operator variability.
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Affiliation(s)
- Yuka Otaki
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Osamu Manabe
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Department of Nuclear Medicine, Hokkaido University of Graduate School of Medicine, Sapporo, Japan
| | - Robert J H Miller
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Alain Manrique
- Department of Nuclear Medicine, CHU Cote de Nacre, Normandy University, Caen, France
| | - Catherine Nganoa
- Department of Nuclear Medicine, CHU Cote de Nacre, Normandy University, Caen, France
| | | | - Daniel S Berman
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Guido Germano
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Piotr J Slomka
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Denis Agostini
- Department of Nuclear Medicine, CHU Cote de Nacre, Normandy University, Caen, France
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Da BL, Suchman K, Roth N, Rizvi A, Vincent M, Trindade AJ, Bernstein D, Satapathy SK. Cholestatic liver injury in COVID-19 is a rare and distinct entity and is associated with increased mortality. J Intern Med 2021; 290:470-472. [PMID: 33786906 PMCID: PMC8250628 DOI: 10.1111/joim.13292] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/04/2021] [Accepted: 03/24/2021] [Indexed: 12/11/2022]
Affiliation(s)
- B L Da
- From the, Division of Hepatology, North Shore University Hospital, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Manhasset, NY, USA
| | - K Suchman
- Department of Internal Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Manhasset, NY, USA
| | - N Roth
- From the, Division of Hepatology, North Shore University Hospital, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Manhasset, NY, USA
| | - A Rizvi
- Division of Gastroenterology, Long Island Jewish Medical Center, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, New Hyde Park, NY, USA
| | - M Vincent
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - A J Trindade
- Department of Internal Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Manhasset, NY, USA
| | - D Bernstein
- From the, Division of Hepatology, North Shore University Hospital, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Manhasset, NY, USA
| | - S K Satapathy
- From the, Division of Hepatology, North Shore University Hospital, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, Manhasset, NY, USA
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Stirrup J, Gregg S, Baavour R, Roth N, Breault C, Agostini D, Ernst S, Underwood SR. Hybrid solid-state SPECT/CT left atrial innervation imaging for identification of left atrial ganglionated plexi: Technique and validation in patients with atrial fibrillation. J Nucl Cardiol 2020; 27:1939-1950. [PMID: 30694425 DOI: 10.1007/s12350-018-01535-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 09/19/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND Ablating left atrial (LA) ganglionated plexi (GP), identified invasively by high-frequency stimulation (HFS) during pulmonary vein isolation (PVI), may reduce atrial fibrillation (AF) recurrence. 123I-metaiodobenzylguanidine (123I-mIBG) solid-state SPECT LA innervation imaging (LAII) has the spatial resolution to detect LAGP non-invasively but this has never been demonstrated in clinical practice. METHODS 20 prospective patients with paroxysmal AF scheduled for PVI underwent 123I-mIBG LAII. High-resolution tomograms, reconstructed where possible using cardiorespiratory gating, were co-registered with pre-PVI cardiac CT. Location and reader confidence (1 [low] to 3 [high]) in discrete 123I-mIBG LA uptake areas (DUAs) were recorded and correlated with HFS. RESULTS A total of 73 DUAs were identified, of which 59 (81%) were HFS positive (HFS +). HFS + likelihood increased with reader confidence (92% [score 3]). 64% of HFS-negative DUAs occurred over the lateral and inferior LA. Cardiorespiratory gating reduced the number of DUAs per patient (4 vs 7, P = .001) but improved: HFS + predictive value (76% vs 49%); reader confidence (2 vs 1, P = .02); and inter-observer, intra-observer, and inter-study agreement (κ = 0.84 vs 0.68; 0.82 vs 0.74; 0.64 vs 0.53 respectively). CONCLUSIONS 123I-mIBG SPECT/CT LAII accurately and reproducibly identifies GPs verified by HFS, particularly when reconstructed with cardiorespiratory gating.
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Affiliation(s)
- J Stirrup
- Department of Cardiology, Royal Berkshire Hospital NHS Foundation Trust, Craven Road, Reading, RG1 5AN, United Kingdom.
| | - S Gregg
- Department of Nuclear Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom
| | - R Baavour
- Spectrum Dynamics Medical, Caesarea, Israel
| | - N Roth
- Spectrum Dynamics Medical, Caesarea, Israel
| | - C Breault
- Spectrum Dynamics Medical, Caesarea, Israel
| | - D Agostini
- Department of Nuclear Medicine, CHU Caen and Normandy University EA 4650, Caen, France
| | - S Ernst
- Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom
- Cardiovascular Research Center, Royal Brompton and National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - S R Underwood
- Department of Nuclear Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom
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Agostini D, Roule V, Nganoa C, Roth N, Baavour R, Parienti JJ, Beygui F, Manrique A. First validation of myocardial flow reserve assessed by dynamic 99mTc-sestamibi CZT-SPECT camera: head to head comparison with 15O-water PET and fractional flow reserve in patients with suspected coronary artery disease. The WATERDAY study. Eur J Nucl Med Mol Imaging 2018; 45:1079-1090. [PMID: 29497801 PMCID: PMC5953996 DOI: 10.1007/s00259-018-3958-7] [Citation(s) in RCA: 132] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 01/22/2018] [Indexed: 12/23/2022]
Abstract
PURPOSE We assessed the feasibility of myocardial blood flow (MBF) and flow reserve (MFR) estimation using dynamic SPECT with a novel CZT camera in patients with stable CAD, in comparison with 15O-water PET and fractional flow reserve (FFR). METHODS Thirty patients were prospectively included and underwent FFR measurements in the main coronary arteries (LAD, LCx, RCA). A stenosis ≥50% was considered obstructive and a FFR abnormal if ≤0.8. All patients underwent a dynamic rest/stress 99mTc-sestamibi CZT-SPECT and 15O-water PET for MBF and MFR calculation. Net retention kinetic modeling was applied to SPECT data to estimate global uptake values, and MBF was derived using Leppo correction. Ischemia by PET and CZT-SPECT was considered present if MFR was lower than 2 and 2.1, respectively. RESULTS CZT-SPECT yielded higher stress and rest MBF compared to PET for global and LAD and LCx territories, but not in RCA territory. MFR was similar in global and each vessel territory for both modalities. The sensitivity, specificity, accuracy, positive and negative predictive value of CZT-SPECT were, respectively, 83.3, 95.8, 93.3, 100 and 85.7% for the detection of ischemia and 58.3, 84.6, 81.1, 36.8 and 93% for the detection of hemodynamically significant stenosis (FFR ≤ 0.8). CONCLUSIONS Dynamic 99mTc-sestamibi CZT-SPECT was technically feasible and provided similar MFR compared to 15O-water PET and high diagnostic value for detecting impaired MFR and abnormal FFR in patients with stable CAD.
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Affiliation(s)
- Denis Agostini
- Department of Nuclear Medicine, CHU Caen, CHU Cote de Nacre, Caen, France.
- Normandy University, EA 4650, Caen, France.
| | | | - Catherine Nganoa
- Department of Nuclear Medicine, CHU Caen, CHU Cote de Nacre, Caen, France
| | | | | | | | - Farzin Beygui
- Normandy University, EA 4650, Caen, France
- Department of Cardiology, CHU Caen, Caen, France
| | - Alain Manrique
- Department of Nuclear Medicine, CHU Caen, CHU Cote de Nacre, Caen, France
- Normandy University, EA 4650, Caen, France
- Cyceron PET Center, Caen, France
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Cahn P, Kaplan R, Sax PE, Squires K, Molina JM, Avihingsanon A, Ratanasuwan W, Rojas E, Rassool M, Bloch M, Vandekerckhove L, Ruane P, Yazdanpanah Y, Katlama C, Xu X, Rodgers A, East L, Wenning L, Rawlins S, Homony B, Sklar P, Nguyen BY, Leavitt R, Teppler H, Cahn PE, Cassetti I, Losso M, Bloch MT, Roth N, McMahon J, Moore RJ, Smith D, Clumeck N, Vanderkerckhove L, Vandercam B, Moutschen M, Baril J, Conway B, Smaill F, Smith GHR, Rachlis A, Walmsley SL, Perez C, Wolff M, Lasso MF, Chahin CE, Velez JD, Sussmann O, Reynes J, Katlama C, Yazdanpanah Y, Ferret S, Durant J, Duvivier C, Poizot-Martin I, Ajana F, Rockstroh JK, Faetkanheuer G, Esser S, Jaeger H, Degen O, Bickel M, Bogner J, Arasteh K, Hartl H, Stoehr A, Rojas EM, Arathoon E, Gonzalez LD, Mejia CR, Shahar E, Turner D, Levy I, Sthoeger Z, Elinav H, Gori A, Monforte AD, Di Perri G, Lazzarin A, Rizzardini G, Antinori A, Celesia BM, Maggiolo F, Chow TS, Lee CKC, Azwa RISR, Mustafa M, Oyanguren M, Castillo RA, Hercilla L, Echiverri C, Maltez F, da Cunha JGS, Neves I, Teofilo E, Serrao R, Nagimova F, Khaertynova I, Orlova-Morozova E, Voronin E, Sotnikov V, Yakovlev AA, Zakharova NG, Tsybakova OA, Botes ME, Mohapi L, Kaplan R, Rassool MS, Arribas JR, Gatell JM, Negredo E, Ortega E, Troya J, Berenguer J, Aguirrebengoa K, Antela A, Calmy A, Cavassini M, Rauch A, Stoeckle M, Sheng WH, Lin HH, Tsai HC, Changpradub D, Avihingsanon A, Kiertiburanakul S, Ratanasuwan W, Nelson MR, Clarke A, Ustianowski A, Winston A, Johnson MA, Asmuth DM, Cade J, Gallant JE, Ruane PJ, Kumar PN, Luque AE, Panther L, Tashima KT, Ward D, Berger DS, Dietz CA, Fichtenbaum C, Gupta S, Mullane KM, Novak RM, Sweet DE, Crofoot GE, Hagins DP, Lewis ST, McDonald CK, DeJesus E, Sloan L, Prelutsky DJ, Rondon JC, Henn S, Scarsella AJ, Morales JO, Ramirez, Santiago L, Zorrilla CD, Saag MS, Hsiao CB. Raltegravir 1200 mg once daily versus raltegravir 400 mg twice daily, with tenofovir disoproxil fumarate and emtricitabine, for previously untreated HIV-1 infection: a randomised, double-blind, parallel-group, phase 3, non-inferiority trial. The Lancet HIV 2017; 4:e486-e494. [DOI: 10.1016/s2352-3018(17)30128-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 06/22/2017] [Accepted: 06/23/2017] [Indexed: 12/20/2022]
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Stirrup J, Voss U, Gregg S, Baavour R, Roth N, Breault C, Underwood S, Ernst S. 63123I-mIBG left atrial innervation imaging localises ganglionated plexi verified by high-frequency stimulation during AF ablation and is affected by reader confidence and uptake location. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Stirrup J, Voss U, Gregg S, Baavour R, Roth N, Breault C, Underwood S, Ernst S. P2117Systolic exclusion and respiratory gating of SPECT 123I-mIBG left atrial innervation imaging improves localisation of left atrial ganglionated plexi verified during AF ablation. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ciffroy P, Péry ARR, Roth N. Perspectives for integrating human and environmental exposure assessments. Sci Total Environ 2016; 568:512-521. [PMID: 26672386 DOI: 10.1016/j.scitotenv.2015.11.083] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 11/17/2015] [Accepted: 11/17/2015] [Indexed: 05/25/2023]
Abstract
Integrated Risk Assessment (IRA) has been defined by the EU FP7 HEROIC Coordination action as "the mutual exploitation of Environmental Risk Assessment for Human Health Risk Assessment and vice versa in order to coherently and more efficiently characterize an overall risk to humans and the environment for better informing the risk analysis process" (Wilks et al., 2015). Since exposure assessment and hazard characterization are the pillars of risk assessment, integrating Environmental Exposure assessment (EEA) and Human Exposure assessment (HEA) is a major component of an IRA framework. EEA and HEA typically pursue different targets, protection goals and timeframe. However, human and wildlife species also share the same environment and they similarly inhale air and ingest water and food through often similar overlapping pathways of exposure. Fate models used in EEA and HEA to predict the chemicals distribution among physical and biological media are essentially based on common properties of chemicals, and internal concentration estimations are largely based on inter-species (i.e. biota-to-human) extrapolations. Also, both EEA and HEA are challenged by increasing scientific complexity and resources constraints. Altogether, these points create the need for a better exploitation of all currently existing data, experimental approaches and modeling tools and it is assumed that a more integrated approach of both EEA and HEA may be part of the solution. Based on the outcome of an Expert Workshop on Extrapolations in Integrated Exposure Assessment organized by the HEROIC project in January 2014, this paper identifies perspectives and recommendations to better harmonize and extrapolate exposure assessment data, models and methods between Human Health and Environmental Risk Assessments to support the further development and promotion of the concept of IRA. Ultimately, these recommendations may feed into guidance showing when and how to apply IRA in the regulatory decision-making process for chemicals.
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Affiliation(s)
- P Ciffroy
- Electricité de France (EDF) R&D, National Hydraulic and Environment Laboratory, 6 quai Watier, 78400 Chatou, France
| | - A R R Péry
- AgroParisTech, UMR ECOSYS, 78850 Thiverval-Grignon, France; INRA, UMR ECOSYS, 78850 Thiverval-Grignon, France
| | - N Roth
- Swiss Centre for Applied Human Toxicology (SCAHT) Directorate, Regulatory Toxicology Unit, Missionstrasse 64, 4055 Basel, Switzerland
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Roth N, Ciffroy P. A critical review of frameworks used for evaluating reliability and relevance of (eco)toxicity data: Perspectives for an integrated eco-human decision-making framework. Environ Int 2016; 95:16-29. [PMID: 27480485 DOI: 10.1016/j.envint.2016.07.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 07/16/2016] [Accepted: 07/20/2016] [Indexed: 06/06/2023]
Abstract
Considerable efforts have been invested so far to evaluate and rank the quality and relevance of (eco)toxicity data for their use in regulatory risk assessment to assess chemical hazards. Many frameworks have been developed to improve robustness and transparency in the evaluation of reliability and relevance of individual tests, but these frameworks typically focus on either environmental risk assessment (ERA) or human health risk assessment (HHRA), and there is little cross talk between them. There is a need to develop a common approach that would support a more consistent, transparent and robust evaluation and weighting of the evidence across ERA and HHRA. This paper explores the applicability of existing Data Quality Assessment (DQA) frameworks for integrating environmental toxicity hazard data into human health assessments and vice versa. We performed a comparative analysis of the strengths and weaknesses of eleven frameworks for evaluating reliability and/or relevance of toxicity and ecotoxicity hazard data. We found that a frequent shortcoming is the lack of a clear separation between reliability and relevance criteria. A further gaps and needs analysis revealed that none of the reviewed frameworks satisfy the needs of a common eco-human DQA system. Based on our analysis, some key characteristics, perspectives and recommendations are identified and discussed for building a common DQA system as part of a future integrated eco-human decision-making framework. This work lays the basis for developing a common DQA system to support the further development and promotion of Integrated Risk Assessment.
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Affiliation(s)
- N Roth
- Swiss Centre for Applied Human Toxicology (SCAHT) Directorate, Regulatory Toxicology Unit, Missionsstrasse 64, 4055 Basel, Switzerland.
| | - P Ciffroy
- Electricité de France (EDF) R&D, National Hydraulic and Environment Laboratory, 6 quai Watier, 78400 Chatou, France
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Lee FJ, Monteiro P, Baker D, Bloch M, Roth N, Finlayson R, Moore R, Hoy J, Martinez E, Carr A. Rosuvastatin vs. protease inhibitor switching for hypercholesterolaemia: a randomized trial. HIV Med 2016; 17:605-14. [PMID: 26987376 DOI: 10.1111/hiv.12362] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of the study was to compare the efficacy and safety of rosuvastatin initiation with those of switching of ritonavir-boosted protease inhibitors (PI/rs) in HIV-1-infected adults with hypercholesterolaemia and increased cardiovascular risk scores. METHODS In this open-label, multicentre study, HIV-1-infected adults on PI/r-based therapy with viral load < 50 HIV-1 RNA copies/mL, fasting total cholesterol ≥ 5.5 mmol/L (both for ≥ 6 months) and elevated cardiovascular risk (Framingham score ≥ 8% or diabetes or family history), and not on lipid-lowering therapy, were randomized to open-label rosuvastatin 10 mg/day or to PI/r switching, both with standardized diet/exercise advice. The primary endpoint was change in total cholesterol at week 12 (intention to treat). RESULTS There were 43 participants (23 on rosuvastatin). Baseline characteristics were: mean [± standard deviation (SD)] age 55 (8.5) years, 42 (98%) male, 41 (95%) white race, and mean (± SD) total cholesterol 6.2 (1.2) mmol/L. At enrolment, PI/rs were lopinavir/ritonavir (n = 22; 51%), atazanavir/ritonavir (n = 12; 28%) and darunavir/ritonavir (n = 9; 21%). The commonest PI/r substitutes were raltegravir (n = 9; 45%) and rilpivirine (n = 4; 20%). All participants were adherent through to week 12. Rosuvastatin yielded greater declines than PI/r switching in total (- 21.4% vs. - 8.7%, respectively; P = 0.003) and low-density lipoprotein (- 29.9% vs. - 1.0%, respectively; P < 0.001) cholesterol, but smaller declines in very low-density lipoprotein cholesterol and triglycerides (P < 0.01). Cholesterol lowering was greater in participants on atazanavir/ritonavir or once-daily darunavir/ritonavir (vs. lopinavir/ritonavir). More study drug-related adverse events (mostly grade 1 nausea/diarrhoea; 10 vs. one, respectively; P = 0.001) occurred with PI/r switching than with rosuvastatin. CONCLUSIONS In adults receiving a PI/r, rosuvastatin 10 mg/day for 12 weeks yielded larger decreases in total and low-density lipoprotein cholesterol than PI/r switching, and was better tolerated.
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Affiliation(s)
- F J Lee
- Clinical Research Program, Centre for Applied Medical Research, St Vincent's Hospital, Sydney, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - P Monteiro
- Infectious Diseases Unit, Hospital Cliníc, University of Barcelona, Barcelona, Spain
| | - D Baker
- East Sydney Doctors, Sydney, NSW, Australia
| | - M Bloch
- Holdsworth House Medical Practice, Sydney, NSW, Australia
| | - N Roth
- Prahran Market Clinic, Melbourne, Vic., Australia
| | - R Finlayson
- Taylor Square Private Clinic, Sydney, NSW, Australia
| | - R Moore
- Northside Clinic, Melbourne, Vic., Australia
| | - J Hoy
- Department of Infectious Diseases, The Alfred Hospital & Monash University, Melbourne, Vic., Australia
| | - E Martinez
- Infectious Diseases Unit, Hospital Cliníc, University of Barcelona, Barcelona, Spain
| | - A Carr
- Clinical Research Program, Centre for Applied Medical Research, St Vincent's Hospital, Sydney, NSW, Australia
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de Wit JBF, Murphy DA, Lal L, Audsley JM, Roth N, Moore R, Tee BK, Read T, Wright EJ. O19.2 Pre-exposure prophylaxis and risk compensation: evidence of decreased condom use at three-month follow-up among predominantly gay male participants in the vicprep study. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.183] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Leitinger D, Wilkinson A, Bartnik N, Fairley C, Tee BK, Roth N, Leslie D, El-Hayek C, Hellard M, Stoové M. P11.11 High rates of co-occurring sexually transmissible infections among men who have sex with men attending high-caseload general practice and sexual health services in victoria. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Murphy DA, de Wit JBF, Lal L, Audsley JM, Roth N, Moore R, Tee BK, Read T, Wright E. O19.3 Pills, pleasure and privacy: early experiences of pre-exposure prophylaxis among men in the vicprep study. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Wilks MF, Roth N, Aicher L, Faust M, Papadaki P, Marchis A, Calliera M, Ginebreda A, Andres S, Kühne R, Schüürmann G. White paper on the promotion of an integrated risk assessment concept in European regulatory frameworks for chemicals. Sci Total Environ 2015; 521-522:211-8. [PMID: 25841074 DOI: 10.1016/j.scitotenv.2015.03.065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 03/17/2015] [Accepted: 03/17/2015] [Indexed: 05/22/2023]
Abstract
The vision of a sustainable and safe use of chemicals to protect human health, preserve the environment and maintain the ecosystem requires innovative and more holistic approaches to risk assessment (RA) in order to better inform decision making. Integrated risk assessment (IRA) has been proposed as a solution to current scientific, societal and policy needs. It is defined as the mutual exploitation of environmental risk assessment (ERA) for human health risk assessment (HHRA) and vice versa in order to coherently and more efficiently characterize an overall risk to humans and the environment for better informing the risk analysis process. Extrapolating between species which are relevant for HHRA and ERA requires a detailed understanding of pathways of toxicity/modes of action (MoA) for the various toxicological endpoints. Significant scientific advances, changes in chemical legislation, and increasing environmental consciousness have created a favourable scientific and regulatory environment to develop and promote the concept and vision of IRA. An initial proof of concept is needed to foster the incorporation of IRA approaches into different chemical sectorial regulations and demonstrate their reliability for regulatory purposes. More familiarity and confidence with IRA will ultimately contribute to an overall reduction in in vivo toxicity testing requirements. However, significant progress will only be made if long-term support for MoA-related research is secured. In the short term, further exchange and harmonization of RA terminology, models and methodologies across chemical categories and regulatory agencies will support these efforts. Since societal values, public perceptions and cultural factors are of increasing importance for the acceptance of risk analysis and successful implementation of risk mitigation measures, the integration of socio-economic analysis and socio-behavioural considerations into the risk analysis process may help to produce a more effective risk evaluation and consideration of the risks and benefits associated with the use of chemicals.
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Affiliation(s)
- M F Wilks
- Swiss Centre for Applied Human Toxicology (SCAHT), University of Basel, Switzerland.
| | - N Roth
- Swiss Centre for Applied Human Toxicology (SCAHT), University of Basel, Switzerland
| | - L Aicher
- Swiss Centre for Applied Human Toxicology (SCAHT), University of Basel, Switzerland
| | - M Faust
- Faust & Backhaus Environmental Consulting GbR (F+B), Bremen, Germany
| | - P Papadaki
- Department of Pesticides Control & Phytopharmacy, Benaki Phytopathological Institute (BPI), Athens, Greece
| | - A Marchis
- OPERA Research Center, Catholic University of the Sacred Heart (UCSC), Piacenza, Italy
| | - M Calliera
- Institute of Agricultural and Environmental Chemistry, Catholic University of the Sacred Heart (UCSC), Piacenza, Italy
| | - A Ginebreda
- Institute of Environmental Assessment and Water Research, Spanish Council of Scientific Research (CSIC), Barcelona, Spain
| | - S Andres
- French National Institute for Industrial Environment and Risks (INERIS), Parc Technologique Alata, Verneuil-en-Halatte, France
| | - R Kühne
- UFZ Department of Ecological Chemistry, Helmholtz Centre for Environmental Research, Leipzig, Germany
| | - G Schüürmann
- UFZ Department of Ecological Chemistry, Helmholtz Centre for Environmental Research, Leipzig, Germany; Institute for Organic Chemistry, Technical University Bergakademie Freiberg, Germany
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Kirian RA, Awel S, Eckerskorn N, Fleckenstein H, Wiedorn M, Adriano L, Bajt S, Barthelmess M, Bean R, Beyerlein KR, Chavas LMG, Domaracky M, Heymann M, Horke DA, Knoska J, Metz M, Morgan A, Oberthuer D, Roth N, Sato T, Xavier PL, Yefanov O, Rode AV, Küpper J, Chapman HN. Simple convergent-nozzle aerosol injector for single-particle diffractive imaging with X-ray free-electron lasers. Struct Dyn 2015; 2:041717. [PMID: 26798816 PMCID: PMC4711644 DOI: 10.1063/1.4922648] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 05/18/2015] [Indexed: 05/06/2023]
Abstract
A major challenge in high-resolution x-ray free-electron laser-based coherent diffractive imaging is the development of aerosol injectors that can efficiently deliver particles to the peak intensity of the focused X-ray beam. Here, we consider the use of a simple convergent-orifice nozzle for producing tightly focused beams of particles. Through optical imaging we show that 0.5 μm particles can be focused to a full-width at half maximum diameter of 4.2 μm, and we demonstrate the use of such a nozzle for injecting viruses into a micro-focused soft-X-ray FEL beam.
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Affiliation(s)
| | | | - N Eckerskorn
- Laser Physics Centre, Research School of Physics and Engineering, Australian National University , Canberra, Australia
| | - H Fleckenstein
- Center for Free-Electron Laser Science , DESY, 22607 Hamburg, Germany
| | | | - L Adriano
- Deutsches Elektronen-Synchrotron DESY , 22607 Hamburg, Germany
| | - S Bajt
- Deutsches Elektronen-Synchrotron DESY , 22607 Hamburg, Germany
| | - M Barthelmess
- Center for Free-Electron Laser Science , DESY, 22607 Hamburg, Germany
| | - R Bean
- European XFEL GmbH , 22761 Hamburg, Germany
| | - K R Beyerlein
- Center for Free-Electron Laser Science , DESY, 22607 Hamburg, Germany
| | - L M G Chavas
- Center for Free-Electron Laser Science , DESY, 22607 Hamburg, Germany
| | | | - M Heymann
- Center for Free-Electron Laser Science , DESY, 22607 Hamburg, Germany
| | - D A Horke
- Center for Free-Electron Laser Science , DESY, 22607 Hamburg, Germany
| | | | | | - A Morgan
- Center for Free-Electron Laser Science , DESY, 22607 Hamburg, Germany
| | - D Oberthuer
- Center for Free-Electron Laser Science , DESY, 22607 Hamburg, Germany
| | - N Roth
- Center for Free-Electron Laser Science , DESY, 22607 Hamburg, Germany
| | - T Sato
- Center for Free-Electron Laser Science , DESY, 22607 Hamburg, Germany
| | | | - O Yefanov
- Center for Free-Electron Laser Science , DESY, 22607 Hamburg, Germany
| | - A V Rode
- Laser Physics Centre, Research School of Physics and Engineering, Australian National University , Canberra, Australia
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Roth N, Wohl MP, Rust NC. Invariant representations of targets are enhanced relative to distractors during object search. J Vis 2014. [DOI: 10.1167/14.15.80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Roth N, Wilks M. Neurodevelopmental and neurobehavioural effects of polybrominated and perfluorinated chemicals: A systematic review of the epidemiological literature using a quality assessment scheme. Toxicol Lett 2014; 230:271-81. [DOI: 10.1016/j.toxlet.2014.02.015] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 02/17/2014] [Accepted: 02/18/2014] [Indexed: 11/26/2022]
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Abstract
An reinem n-Decylalkohol, sowie seinen konzentrierten und verdünnten Lösungen in vier unpolaren Flüssigkeiten wurde zwischen 20 und 60°C die komplexe DK bei 9,4,19,5 und 34,8 GHz gemessen. Wenn man die Anteile abtrennt, die das Hauptabsorptionsgebiet bei diesen Frequenzen noch beiträgt, erhält man ein Mikrowellengebiet anomaler Dispersion, das allein von Prozessen mit Kurzzeitrelaxation herrührt. Dazu gehört eine Verteilung von Relaxationszeiten, die in erster Näherung durch zwei diskrete Werte zu beschreiben ist. Die so erhaltenen charakteristischen Daten — Dispersionsstufe, Relaxationszeit und Aktivierungsenergie — werden von sehr verdünnter Lösung, die nur Einzelmoleküle enthält, bis zur reinen Dipolflüssigkeit verfolgt und geben bei der Diskussion Hinweise auf die zugrundeliegenden molekularen Vorgänge. Danach ist die kürzeste Zeitkonstante der Eigenbewegung von polaren Molekülgruppen zuzuordnen, in verdünnter Lösung allein der OH-Gruppe. Die Dipolorientierung mit längerer Relaxationszeit dagegen hat quantitativ alle Kennzeichen, die von der rotatorischen Bewegung ganzer, starrer oder flexibler Moleküle bekannt sind. Zu ihr müssen bei konzentrierten Mischungen aber noch andere Strukturen beitragen als allein Monomere, wie aus dem Relaxationszeitspektrum des Einzelmoleküls in verdünnter Heptanlösung folgt. Bei Benzol treten durch eine spezifische Wechselwirkung mit der OH-Gruppe erhebliche Verschiebungen in der Relaxationszeit-Verteilung auf, die sich noch bei höheren Alkoholkonzentrationen bemerkbar machen.
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Affiliation(s)
- G. Klages
- Physikalisches Institut, Abteilung Mikrowellenphysik, der Universität Mainz
| | - N. Roth
- Physikalisches Institut, Abteilung Mikrowellenphysik, der Universität Mainz
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Lim MSC, Hellard M, El-Hayek C, Cuevas M, Fairley C, Leslie D, Roth N, Tee B, Stoove M. P3.123 Hepatitis C Testing and Incidence in HIV-Positive Men Who Have Sex with Men in Melbourne, Victoria. A Retrospective Cohort Study. Sex Transm Infect 2013. [DOI: 10.1136/sextrans-2013-051184.0582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Ben-Haim S, Murthy VL, Breault C, Allie R, Sitek A, Roth N, Fantony J, Moore SC, Park MA, Kijewski M, Haroon A, Slomka P, Erlandsson K, Baavour R, Zilberstien Y, Bomanji J, Di Carli MF. Quantification of Myocardial Perfusion Reserve Using Dynamic SPECT Imaging in Humans: A Feasibility Study. J Nucl Med 2013; 54:873-9. [PMID: 23578996 DOI: 10.2967/jnumed.112.109652] [Citation(s) in RCA: 170] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
UNLABELLED Myocardial perfusion imaging (MPI) is well established in the diagnosis and workup of patients with known or suspected coronary artery disease (CAD); however, it can underestimate the extent of obstructive CAD. Quantification of myocardial perfusion reserve with PET can assist in the diagnosis of multivessel CAD. We evaluated the feasibility of dynamic tomographic SPECT imaging and quantification of a retention index to describe global and regional myocardial perfusion reserve using a dedicated solid-state cardiac camera. METHODS Ninety-five consecutive patients (64 men and 31 women; median age, 67 y) underwent dynamic SPECT imaging with (99m)Tc-sestamibi at rest and at peak vasodilator stress, followed by standard gated MPI. The dynamic images were reconstructed into 60-70 frames, 3-6 s/frame, using ordered-subsets expectation maximization with 4 iterations and 32 subsets. Factor analysis was used to estimate blood-pool time-activity curves, used as input functions in a 2-compartment kinetic model. K1 values ((99m)Tc-sestamibi uptake) were calculated for the stress and rest images, and K2 values ((99m)Tc-sestamibi washout) were set to zero. Myocardial perfusion reserve (MPR) index was calculated as the ratio of the stress and rest K1 values. Standard MPI was evaluated semiquantitatively, and total perfusion deficit (TPD) of at least 5% was defined as abnormal. RESULTS Global MPR index was higher in patients with normal MPI (n = 51) than in patients with abnormal MPI (1.61 [interquartile range (IQR), 1.33-2.03] vs. 1.27 [IQR, 1.12-1.61], P = 0.0002). By multivariable regression analysis, global MPR index was associated with global stress TPD, age, and smoking. Regional MPR index was associated with the same variables and with regional stress TPD. Sixteen patients undergoing invasive coronary angiography had 20 vessels with stenosis of at least 50%. The MPR index was 1.11 (IQR, 1.01-1.21) versus 1.30 (IQR, 1.12-1.67) in territories supplied by obstructed and nonobstructed arteries, respectively (P = 0.02). MPR index showed a stepwise reduction with increasing extent of obstructive CAD (P = 0.02). CONCLUSION Dynamic tomographic imaging and quantification of a retention index describing global and regional perfusion reserve are feasible using a solid-state camera. Preliminary results show that the MPR index is lower in patients with perfusion defects and in regions supplied by obstructed coronary arteries. Further studies are needed to establish the clinical role of this technique as an aid to semiquantitative analysis of MPI.
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Affiliation(s)
- Simona Ben-Haim
- Institute of Nuclear Medicine, University College London Hospitals, NHS Trust, London, United Kingdom.
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Nakazato R, Berman DS, Hayes SW, Fish M, Padgett R, Xu Y, Lemley M, Baavour R, Roth N, Slomka PJ. Myocardial perfusion imaging with a solid-state camera: simulation of a very low dose imaging protocol. J Nucl Med 2013; 54:373-9. [PMID: 23321457 DOI: 10.2967/jnumed.112.110601] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
UNLABELLED High-sensitivity dedicated cardiac camera systems provide an opportunity to lower the injected doses for SPECT myocardial perfusion imaging (MPI), but the exact limits for lowering doses have not been determined. List-mode data acquisition allows for reconstruction of various fractions of acquired counts, enabling a simulation of gradually lower administered dose. We aimed to determine the feasibility of very low dose MPI by exploring the minimal count level in the myocardium required for accurate MPI. METHODS Seventy-nine patients were studied (mean body mass index, 30.0 ± 6.6; range, 20.2-54.0 kg/m(2)) who underwent 1-d standard-dose (99m)Tc-sestamibi exercise or adenosine rest-stress MPI for clinical indications using a cadmium-zinc-telluride dedicated cardiac camera. The imaging time was 14 min, with averaged 803 ± 200 MBq (21.7 ± 5.4 mCi) of (99m)Tc injected at stress. To simulate clinical scans with a lower dose at that imaging time we reframed the list-mode raw data. Accordingly, 6 stress-equivalent datasets were reconstructed containing various count fractions of the original scan. Automated quantitative perfusion and gated SPECT software was used to quantify total perfusion deficit (TPD) and ejection fraction for all 553 datasets (7 × 79). The minimal acceptable left ventricular region counts were determined on the basis of a previous report with repeatability of same-day, same-injection Anger camera studies. Pearson correlation coefficients and the SD of differences in TPD for all scans were calculated. RESULTS The correlations of quantitative perfusion and function analysis were excellent for both global and regional analysis between original scans and all simulated low-count scans (all r ≥ 0.95, P < 0.0001). The minimal acceptable counts were determined to be 1.0 million for the left ventricular region. At this count level, the SD of differences was 1.7% for TPD and 4.2% for ejection fraction. This count level would correspond to a 92.5-MBq (2.5-mCi) injected dose for the 14-min acquisition or 125.8-MBq (3.4-mCi) injected dose for the 10-min acquisition. CONCLUSION 1.0 million counts appear to be sufficient to produce myocardial images that agree well with 8.0-million-count images on quantitative perfusion and function parameters. With a dedicated cardiac camera, these images can be obtained over 10 min with an effective radiation dose of less than 1 mSv without significant sacrifice of accuracy.
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Affiliation(s)
- Ryo Nakazato
- Department of Imaging and Medicine, and Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA
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Roth N, Städler S, Lemann M, Hösli S, Simon HU, Simon D. Distinct eosinophil cytokine expression patterns in skin diseases - the possible existence of functionally different eosinophil subpopulations. Allergy 2011; 66:1477-86. [PMID: 21884530 DOI: 10.1111/j.1398-9995.2011.02694.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND The function of eosinophils has been attributed to host defense, immunomodulation, and fibrosis. Although eosinophils are found among infiltrating cells in a broad spectrum of skin diseases, their pathogenic role remains uncertain. This study aimed to analyze the cytokine expression by eosinophils in different skin diseases. METHODS Skin specimens from different skin diseases [allergic/reactive, infectious, autoimmune, and tumors/lymphomas (LY)] were stained by antibodies directed to eosinophil cationic protein, cytokines [tumor necrosis factor (TNF)-α, interleukin (IL)-5, IL-6, IL-10, IL-11, IL-13, IL-17, IL-25, IL-33, interferon-γ, transforming growth factor (TGF)-β, and thymic stromal lymphopoietin], eotaxins (CCL11, CCL24, and CCL26), metalloproteinase (MMP)-9 as well as extracellular matrix proteins (tenascin-C and procollagen-3) and then analyzed by laser scanning microscopy. RESULTS The number of eosinophils varied considerably in and between disease groups and did not correlate with the numbers of accompanying inflammatory cells. The expression of IL-5, IL-6, IL-11, TGF-β, CCL24, and MMP-9 by eosinophils significantly differed between disease groups. Eosinophils in tumors/LY predominantly expressed IL-6, TGF-β, and CCL24, but not IL-11. On the other hand, in autoimmune diseases, eosinophils largely contributed to MMP-9 production. IL-5-generating eosinophils were particularly obvious in allergic and infectious diseases. CONCLUSION In skin diseases, eosinophil expresses a broad spectrum of cytokines. The different cytokine expression patterns suggest distinct functional roles of eosinophils in these diseases that might be related to host defense, immunomodulation, fibrosis, and/or tumor development.
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Affiliation(s)
- N Roth
- Department of Dermatology, Inselspital, Bern University Hospital, Switzerland
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Gatter M, Roth N, Safarian C, Nucatola D. Eliminating the routine postoperative surgical abortion visit. Contraception 2011. [DOI: 10.1016/j.contraception.2011.05.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Guy R, Goller JL, Spelman T, El-Hayek C, Gold J, Lim M, Leslie D, Tee BK, Roth N, Anderson J, Fairley CK, Kaldor J, Hellard M. Does the frequency of HIV and STI testing among men who have sex with men in primary care adhere with Australian guidelines? Sex Transm Infect 2010; 86:371-6. [PMID: 20460263 DOI: 10.1136/sti.2009.040972] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Australian guidelines recommend annual testing for HIV and sexually transmitted infections (STIs) for all men who have sex with men (MSM) and 3-6 monthly testing for those at higher risk as defined by behavioural criteria. We assessed HIV/STI re-testing rates among MSM attending primary care clinics. METHODS We conducted a retrospective follow-up of HIV negative MSM tested for HIV or STIs (chlamydia or syphilis) at four primary care clinics in the 9-month period: April to December 2006. Re-testing rates for these infections were calculated over 18 months. Logistic regression was undertaken to identify predictors of guideline adherence. RESULTS Of the MSM requiring annual HIV testing according to the guidelines, the re-testing rates at 1 y were 35% (762/2163). Among the higher risk MSM, 6-monthly HIV re-testing rates were 15% (283/1862). Within the subgroup who reported 11 or more male sexual partners within the past 6 months, HIV re-testing rates within 6 months were 19%. Independent predictors of HIV re-testing within 6 months in higher-risk MSM were reporting 11 or more male sexual partners in the last 6 months (AOR 3.1, 95% CI 1.8 to 4.8); being born overseas (AOR 2.0, 95% CI 1.2 to 3.4); and previous HIV testing more than 12 months earlier (AOR 3.3, 95% CI 1.9 to 5.5). CONCLUSION There is poor adherence to national guidelines that recommend regular re-testing of MSM for STIs, particularly among those at higher risk who require more frequent testing. Clinical strategies are urgently needed to encourage more frequent HIV/STI testing among MSM, especially in the higher risk subgroup.
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Affiliation(s)
- R Guy
- National Centre in HIV Epidemiology and Clinical Research, Sydney, New South Wales, Australia.
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Ben-Haim S, Kacperski K, Hain S, Van Gramberg D, Hutton BF, Erlandsson K, Sharir T, Roth N, Waddington WA, Berman DS, Ell PJ. Simultaneous dual-radionuclide myocardial perfusion imaging with a solid-state dedicated cardiac camera. Eur J Nucl Med Mol Imaging 2010; 37:1710-21. [PMID: 20383705 DOI: 10.1007/s00259-010-1441-1] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2009] [Accepted: 03/08/2010] [Indexed: 11/28/2022]
Abstract
PURPOSE We compared simultaneous dual-radionuclide (DR) stress and rest myocardial perfusion imaging (MPI) with a novel solid-state cardiac camera and a conventional SPECT camera with separate stress and rest acquisitions. METHODS Of 27 consecutive patients recruited, 24 (64.5+/-11.8 years of age, 16 men) were injected with 74 MBq of (201)Tl (rest) and 250 MBq (99m)Tc-MIBI (stress). Conventional MPI acquisition times for stress and rest are 21 min and 16 min, respectively. Rest (201)Tl for 6 min and simultaneous DR 15-min list mode gated scans were performed on a D-SPECT cardiac scanner. In 11 patients DR D-SPECT was performed first and in 13 patients conventional stress (99m)Tc-MIBI SPECT imaging was performed followed by DR D-SPECT. The DR D-SPECT data were processed using a spill-over and scatter correction method. DR D-SPECT images were compared with rest (201)Tl D-SPECT and with conventional SPECT images by visual analysis employing the 17-segment model and a five-point scale (0 normal, 4 absent) to calculate the summed stress and rest scores. Image quality was assessed on a four-point scale (1 poor, 4 very good) and gut activity was assessed on a four-point scale (0 none, 3 high). RESULTS Conventional MPI studies were abnormal at stress in 17 patients and at rest in 9 patients. In the 17 abnormal stress studies DR D-SPECT MPI showed 113 abnormal segments and conventional MPI showed 93 abnormal segments. In the nine abnormal rest studies DR D-SPECT showed 45 abnormal segments and conventional MPI showed 48 abnormal segments. The summed stress and rest scores on conventional SPECT and DR D-SPECT were highly correlated (r=0.9790 and 0.9694, respectively). The summed scores of rest (201)Tl D-SPECT and DR-DSPECT were also highly correlated (r=0.9968, p<0.0001 for all). In six patients stress perfusion defects were significantly larger on stress DR D-SPECT images, and five of these patients were imaged earlier by D-SPECT than by conventional SPECT. CONCLUSION Fast and high-quality simultaneous DR MPI is feasible with D-SPECT in a single imaging session with comparable diagnostic performance and image quality to conventional SPECT and to a separate rest (201)Tl D-SPECT acquisition.
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Affiliation(s)
- Simona Ben-Haim
- Institute of Nuclear Medicine, University College London Hospitals NHS Trust, London, UK.
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Bloch M, Hoy J, Cunningham N, Roth N, Andrianopoulos N, Rayner C, Carr A. Adherence to HIV treatment guidelines for initiation of antiretroviral therapy in Australia. J Int AIDS Soc 2010. [PMCID: PMC3112952 DOI: 10.1186/1758-2652-13-s4-p172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Mueller T, Dieplinger B, Gegenhuber A, Haidinger D, Schmid N, Roth N, Ebner F, Landl M, Poelz W, Haltmayer M. Serum total 8-iso-prostaglandin F2α: A new and independent predictor of peripheral arterial disease. J Vasc Surg 2004; 40:768-73. [PMID: 15472607 DOI: 10.1016/j.jvs.2004.07.044] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Circulating 8-iso-prostaglandin F 2alpha (8-iso-PGF 2alpha ) has been proposed as new indicator of oxidative stress, which is involved in the pathophysiologic changes of atherosclerosis. We proposed to test the hypothesis that 8-iso-PGF 2alpha is an independent predictor of symptomatic peripheral arterial disease (PAD). METHODS A case-control study in 100 patients with symptomatic PAD and 100 control subjects matched for age, sex, and diabetes mellitus was conducted. Smokers and subjects using lipid-lowering drugs were excluded. Serum total 8-iso-PGF 2alpha was quantified with an enzyme immunoassay. RESULTS Median 8-iso-PGF 2alpha was higher in patients with PAD than in control subjects (63 vs 42 pg/mL; P = .001). Logistic regression with hypertension, body mass index, and creatinine, low-density lipoprotein (LDL) cholesterol, triglyceride, high-sensitivity C-reactive protein (hs-CRP), 8-iso-PGF 2alpha , and total homocysteine concentrations as independent variables and case-control status as dependent variable revealed significant odds ratios (OR) for hypertension (OR, 3.74; 95% confidence interval [CI], 1.85-7.53), low-density lipoprotein cholesterol (OR, 1.16, for an increment of 10 mg/dL; 95% CI, 1.07-1.27), high-sensitivity C-reactive protein (OR, 1.02, for an increment of 1 mg/L; 95% CI, 1.00-1.03), and 8-iso-PGF 2alpha (OR, 1.11, for an increment of 10 pg/mL; 95% CI, 1.03-1.20). CONCLUSIONS Serum total 8-iso-PGF 2alpha was an independent predictor of PAD in the population studied. This finding supports the hypothesis that 8-iso-PGF 2alpha is a risk marker for PAD. Our results indicate increased systemic oxidative stress in patients with PAD.
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Affiliation(s)
- T Mueller
- Department of Laboratory Medicine, Konventhospital Barmherize Brueder Linz, Austria.
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Roth N. Jewish and Muslim physicians of 'Ali Ibn Tashufīn. Korot 2001; 10:83-91. [PMID: 11639676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Affiliation(s)
- N Roth
- Department of Hebrew & Semitic Studies, University of Wisconsin, Madison
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Biesinger E, Grabner B, Pawlata H, Phleps G, Poppendieck J, Roth N. [Allergies: deficits in diagnosis and therapy]. HNO 2001; 49:704-5. [PMID: 11593769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- E Biesinger
- Gesellschaft für Allergologie und klinische Immunologie e.V., Hamburg
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Smith D, Hales G, Roth N, Law M, Ray J, Druett J, Mitchell J, Mills G, Doong N, Franklin R. A randomized trial of nelfinavir, ritonavir, or delavirdine in combination with saquinavir-SGC and stavudine in treatment-experienced HIV-1-infected patients. HIV Clin Trials 2001; 2:97-107. [PMID: 11590517 DOI: 10.1310/cfyj-26jf-vvru-7an8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To evaluate the 24-week impact of saquinavir-enhancing antiretroviral therapy on viral replication in patients previously treated with nucleoside analogues with or without prior saquinavir hard-gel capsules (HGC). METHOD Patients were randomized in three groups to receive the following: Group 1-nelfinavir (750 mg tid), saquinavir soft-gel capsule (SGC) (800 mg tid), and stavudine (40 mg bid); Group II-ritonavir (400 mg bid), saquinavir-SGC (400 mg bid), and stavudine (40 mg bid); or Group III-delavirdine (400 mg tid), saquinavir-SGC (800 mg tid), and stavudine (40 mg bid). Viral loads, CD4 count, and safety were assessed over a 24-week period with an additional 6-month follow-up. RESULTS 73 patients received randomized therapy; 14 of whom were SQV naïve, with a median baseline viral load of 3.6 log(10) and a CD4 count of 370 cells/mm(3). By 6 months, the median decreases in plasma viral loads were 0.26, 0.71, and 0.29 log(10) copies/mL for groups I, II, and III, respectively. The median increases in CD4 counts, for groups I, II, and III, were 52, 40, and 69 cells/mm(3) at 6 months, respectively. Changes in viral load and CD4 counts at 6 months and 1 year were not significantly different between the treatment groups. More patients discontinued therapy in the ritonavir arm (35%) for drug intolerance or toxicity compared to either the nelfinavir or delavirdine arms (15% and 5%, respectively). In a multivariate analysis, baseline viral load, younger age, and baseline saquinavir resistance were significantly associated with detectable viral load at 24 weeks. CONCLUSION The use of antiretroviral agents that pharmacokinetically boost saquinavir levels has a modest benefit in saquinavir-experienced patients.
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Affiliation(s)
- D Smith
- Community HIV Research Network, National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, Australia.
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Ben-Hur E, Chan WS, Yim Z, Zuk MM, Dayal V, Roth N, Heldman E, Lazo A, Valeri CR, Horowitz B. Photochemical decontamination of red blood cell concentrates with the silicon phthalocyanine PC 4 and red light. Dev Biol (Basel) 2000; 102:149-55. [PMID: 10794102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Various approaches are being developed for virus inactivation of red blood cell concentrates (RBCC) in order to increase the safety of the blood supply. We have been studying the silicon phthalocyanine Pc 4 for this purpose, a photosensitizer activated with red light. Pc 4 targets the envelope of pathogenic viruses such as HIV. To protect RBC during the process two main approaches are used: (i) inclusion of quenchers of reactive oxygen species produced during the treatment. Tocopherol succinate was found to be most effective for this purpose; (ii) formulation of Pc 4, a lipophilic compound, in liposomes that reduce its binding to RBC but not to viruses. As a light source we used a light emitting diode array emitting at 670-680 nm. An efficient mixing device ensures homogenous light exposure during treatment of intact RBCC. Treatment of 50 ml RBCC with 5 microM Pc 4 and 18 J/cm(2) light results in the inactivation of > or = 5.5 log(10) HIV, > or = 6.3 log(10), VSV and > or = 5 log(10) of PRV and BVDV. The relative sensitivities of these viruses based on the slope of virus kill versus light dose are 1.0, 1.25, 1.5 and 1.9 for HIV, VSV, PRV and BVDV, respectively. To achieve the same level of virus inactivation in 350 ml RBCC, the light dose needed is 40 J/cm(2). HIV actively replicating in CEM cells is as sensitive as cell-free and HIV in latently infected cells is 3-4 times more sensitive. Parasites that can be transmitted by blood transfusion (P. falciparum and T. cruzi) are even more sensitive than viruses. Following treatment, RBCC can be stored for 28 days at 4 degrees C with haemolysis below 1%. Previous studies under less favourable conditions showed that baboon RBC circulated with an acceptable 24 hr recovery and half-life. Genetic toxicological studies of Pc 4 with or without light exposure (mutagenicity in bacteria, mammalian cells in vitro and clastogenicity in vivo) were negative. We conclude that a process using Pc 4 and red light can potentially reduce the risk of transmitting pathogens in RBCC.
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Affiliation(s)
- E Ben-Hur
- V.I. Technologies, Inc. (Vitex), New York, NY 10032, USA
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Hales G, Roth N, Smith D. Possible fatal interaction between protease inhibitors and methamphetamine. Antivir Ther 2000; 5:19. [PMID: 10846588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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Smith D, Goggin L, Meldrum H, Phillips S, Russell D, Bloch M, Bodsworth NJ, Roth N, Law MG. Capturing the paradigm shift in HIV treatment: changing attitudes in the choice of combination antiretroviral drugs by high HIV caseload Australian GPs (1996-1997). AIDS Care 2000; 12:41-7. [PMID: 10716016 DOI: 10.1080/09540120047459] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The use of combination antiretroviral therapy for HIV infection is a rapidly changing field. To assess the impact of recent studies on prescribing patterns, two surveys of 21 high HIV caseload Australian GPs were undertaken in June 1996 and June 1997 to plot changes in the choice of combination antiviral therapy. Of the 17 GPs who responded to the survey in each year, the number of HIV-infected patients seen at their practices were estimated to be 5,061 in 1996 and 5,912 in 1997. In 1996, 40% of their patients were estimated to be on antiretroviral therapy compared to 60% in 1997 (p < 0.05). In 1996, most GPs preferred using dual combination therapy (59%); whereas in 1997, triple combination therapy was preferred (82%). Between 1996 and 1997, there was a significant change by high caseload Australian GPs in the choice of antiretroviral drugs with many combinations being preferred prior to presentation of efficacy data for those combinations, or recommendation through national guidelines.
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Affiliation(s)
- D Smith
- Community HIV Research Network, University of New South Wales, Darlinghurst, Australia.
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Vitale MG, Higgs GB, Liebling MS, Roth N, Roye DP. Superior mesenteric artery syndrome after segmental instrumentation: a biomechanical analysis. Am J Orthop (Belle Mead NJ) 1999; 28:461-7. [PMID: 10470672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Superior mesenteric artery (SMA) syndrome is a rare complication that occurs after correction of scoliosis. A review of the literature suggests that the incidence of this syndrome may be decreasing, as methods for the correction of scoliosis have improved. We present the first report of SMA syndrome that occurred after segmental 'derotational' instrumentation. Computerized axial tomography was helpful in suggesting the diagnosis of this condition. The risk factors and pathophysiology of SMA syndrome are reviewed with respect to the biomechanical effects of casting and Harrington and segmental instrumentation systems on the spine. Attention to the three-dimensional nature of the scoliotic deformity, particularly in the sagittal plane, may help to predict those at risk for the development of this potentially fatal syndrome.
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Affiliation(s)
- M G Vitale
- Department of Orthopedic Surgery, Columbia Presbyterian Medical Center, New York, New York, USA
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Puza S, Roth N, Macones GA, Mennuti MT, Morgan MA. Does cesarean section decrease the incidence of major birth trauma? J Perinatol 1998; 18:9-12. [PMID: 9527937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To determine whether the increase in frequency of cesarean section is associated with a decreased incidence of major birth trauma. STUDY DESIGN A retrospective cohort study was performed evaluating all neonatal cases of major birth trauma from January 1989 to December 1994. Major birth trauma was defined as peripheral plexus or nerve injuries, fractures, or lacerations. The data were grouped into two mutually exclusive periods (January 1989 to December 1990 vs January 1991 to December 1994) in which a significant difference in the cesarean section rate was known. RESULTS Of 17,957 deliveries during the period, 141 cases of birth trauma occurred. One hundred thirty-seven of the 141 medical records were available for review, and 116 were classified as having had major birth trauma and were included in the study. The overall incidence of major birth trauma was 6.5/1000 deliveries. During the two-year period (January 1989 to December 1990), 18.3% of deliveries were by cesarean section and the major birth trauma rate was 8.4/1000 deliveries. During the following 4 years, the cesarean section rate was 22.3% and the major birth trauma rate was 5.3/1000 deliveries. Significant differences in the birth trauma chi(2) = 6.12, p = 0.013) and cesarean section (chi(2) = 40.80, p < 0.001) rates were observed. Controlling for the mode of delivery lessened the association between time period and birth trauma incidence (chi(2)MH = 3.28, p = 0.07). A significant decrease in the occurrence of major birth trauma in neonates delivered by cesarean section in the later period was discovered (relative risk = 0.46, 95% confidence interval 0.22 to 0.97). This decrease appeared to be mediated by a decrease in total lacerations between the periods (chi(2) = 11.76, p < 0.001), because the rates of other types of major birth trauma did not differ in neonates delivered by cesarean section or the vaginal route. CONCLUSIONS With a 4% increase in rate of cesarean section at our institution, a significant decrease in the occurrence of major birth trauma was observed. This finding cannot be explained by a decreased risk of neonatal trauma in patients delivering vaginally, but rather by a decreased risk of neonatal trauma at cesarean section during the latter period.
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Affiliation(s)
- S Puza
- Department of Obstetrics and Gynecology, University of Pennsylvania Medical Center, Philadelphia, USA
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Monn C, Fuchs A, Högger D, Junker M, Kogelschatz D, Roth N, Wanner HU. Particulate matter less than 10 microns (PM10) and fine particles less than 2.5 microns (PM2.5): relationships between indoor, outdoor and personal concentrations. Sci Total Environ 1997; 208:15-21. [PMID: 9496645 DOI: 10.1016/s0048-9697(97)00271-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Among 17 homes in Switzerland, the relationship between indoor and outdoor levels for particulate matter less than 10 microns (PM10), particulate matter less than 2.5 microns (PM2.5) and NO2 was investigated. In 10 homes, the inhabitants also participated in conducting personal measurements. All homes were naturally ventilated. In homes without any indoor sources and where human activity was low, PM10 I/O ratios amounted to approximately 0.7. Of the indoor sources, smoking had the highest influence on I/O ratios (> 1.8). In homes not containing any apparent source, 'human activity' was an important factor accounting for high indoor levels. However, this factor is difficult to quantify. Personal exposure was in most cases higher than the indoor and the corresponding home outdoor levels. For NO2, gas-cooking was found to have the strongest influence on elevated I/O ratios (> 1.2) whilst for other homes, the I/O ratio was less than 1.
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Affiliation(s)
- C Monn
- Swiss Federal Institute of Technology, Institute of Hygiene and Applied Physiology, Zürich, Switzerland.
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Jordan K, Schmidt A, Plotz K, von Specht H, Begall K, Roth N, Scheich H. Auditory event-related potentials in post- and prelingually deaf cochlear implant recipients. Am J Otol 1997; 18:S116-7. [PMID: 9391625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The development of central auditory functions in cochlear implant (CI) patients was studied over six months of rehabilitation. Examinations were performed beginning with the first week after processor calibration, and in monthly follow-up sessions thereafter. The subjects were given a simple auditory perception task (detection of a 400 Hz and a 1450 Hz tone), as well as an oddball-paradigm (detection of one of the tones as a rare deviant). Auditory evoked potentials, reaction time and errors were recorded. Results from five patients, two postlingually deaf and three prelingually deaf CI recipients are shown. Generally, in the auditory evoked potentials of patients a shortening of N100 latency towards those of subjects with normal hearing was seen from month to month. However, in the prelingually deaf patients this effect was weaker and more variable over time. Three CI recipients showed a P300 component in the oddball-paradigm in correlation with their performance. Two prelingually deaf patients failed to show a P300 in the oddball-paradigm. For both components, the N100 and the P300 we found a larger spreading over the skull in the patients compared to a normal hearing person. The results show that from the very first days after initial processor fitting prelingually and postlingually deaf CI recipients may show cortical correlates of stimulus processing and discrimination. For some components of the auditory evoked potentials an initial temporal change but a maintained larger spreading over the skull was seen.
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Affiliation(s)
- K Jordan
- Federal Institute for Neurobiology, Magdeburg, Germany
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Puza S, Roth N, Malee M. Early detection of patients at high risk for gestational diabetes in the early second trimester in patients with significant risk factors. Am J Obstet Gynecol 1997. [DOI: 10.1016/s0002-9378(97)80696-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Robinson CA, Amirthanayagan M, Goodman D, Roth N, Morgan MA. Urinary calcium-creatinine ratios fall from 16–20 to 28–32 weeks in healthy primigravid patients who subsequently develop preeclampsia. Am J Obstet Gynecol 1997. [DOI: 10.1016/s0002-9378(97)80401-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Roth N. The aim of psychoanalytic therapy. Am J Psychother 1996; 50:513-24; discussion 525-7. [PMID: 8968442 DOI: 10.1176/appi.psychotherapy.1996.50.4.513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Abstract
The objective of this study on the glenohumeral joint was to assess the (1) accuracy of clinical diagnosis of osteoarthritis compared with arthroscopic diagnosis, and (2) the ability of biochemical markers in synovial fluid to detect osteoarthritis. Patients (96) were examined clinically and the preoperative diagnosis of osteoarthritis was recorded. At surgery (arthroscopy or arthroplasty), the glenohumeral joint was inspected for signs of osteoarthritis, and the joint osteoarthritis grade (I-IV) was recorded. At surgery, synovial fluid lavage was obtained from the joint, and later analyzed to determine levels of aggrecan components: total sulfated glycosaminoglycan and keratan sulfate epitope, link protein and the chondroitin sulfate epitope recognized by antibody 3B3 (3B3(-)). Compared with arthroscopic diagnosis of osteoarthritis, the results showed that the clinical diagnosis did not wrongly identify joints without osteoarthritis, and was always able to identify joints with advanced (Grade IV) osteoarthritis. Grade II osteoarthritis was rarely identified (10% of the time), and Grade III osteoarthritis was identified 50% of the time. Biochemical assessment of the synovial fluid showed that the catabolic markers (sulfated glycosaminoglycan, keratan sulfate and link protein) were elevated in fluids from joints with moderate (Grade III) and advanced osteoarthritis (Grade IV), and the 3B3(-) epitope was elevated in Grades II, III, and IV. These results show that arthroscopic diagnosis for osteoarthritis, of the glenohumeral joint is particularly useful for early and moderate osteoarthritis, where clinical (nonarthroscopic) diagnosis is poor, and that biochemical analysis of the synovial fluids corresponds well to arthroscopic diagnosis of shoulder osteoarthritis.
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Affiliation(s)
- A Ratcliffe
- Department of Orthopaedic Surgery, Columbia University, New York 10032, NY, USA
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Schmidt A, Darius J, Brosz M, Roth N, Meyer FP, Kroker S, Wien F, Brett B. [The effect of valproic acid monotherapy on behavior and cognitive performance of children with idiopathic generalized epilepsy]. Z Kinder Jugendpsychiatr 1995; 23:161-170. [PMID: 7571875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Valproic acid (VPA) currently plays an important role in the treatment of several different types of epilepsy. Especially in children and adolescents, VPA is used because of a minimum of adverse effects and generally little impact on cognitive and psychomotor functions. However, reports in the literature regarding the influence of VPA on behavior and cognitive performance and on EEG parameters vary widely. We investigated the effect of VPA monotherapy on behavioral components (attention, concentration, inhibitory control), cognitive efficiency (motor reaction time, learning, retention) and evoked potentials in 19 children aged 6 to 14 years with idiopathic generalized epilepsy and compared the results with those of healthy controls matched for age. In addition, we analyzed the serum levels of VPA and some of the VPA metabolites in all of the children with epilepsy immediately before the psychophysiological assessments. Our results show marked differences between the children with epilepsy and the healthy controls in all types of behavior and cognitive performance assessed. Abnormal behavior (disturbances of attention and concentration, impulsive behavior patterns) and significant changes in evoked potentials appear to be correlated with serum levels of VPA and certain VPA metabolites.
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Affiliation(s)
- A Schmidt
- Institut für Neurobiologie, Otto-von-Geuricke-Universität, Magdeburg
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Krause K, Neumann HW, Roth N, Brosz M. [Idiopathic varus gonarthrosis: diminished nociceptive vs. unchanged somatosensory sensitivity]. Z Orthop Ihre Grenzgeb 1995; 133:352-6. [PMID: 7571806 DOI: 10.1055/s-2008-1039807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Neuromuscular control deficits are supposed to contribute to the development of osteoarthritis (OA). Pain measurements were performed to clarify whether nociceptive afferents differ between OA patients and healthy subjects. Thermal pain thresholds were significantly higher in OA subjects as compared to controls, but there was no difference in perceptual thresholds after electrical stimulation. Lateralization, gender, site of OA changes, previous operations, or medication did not affect these findings.
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Affiliation(s)
- K Krause
- Klinik für Orthopädie, Medizinische Fakultät, Universität Magdeburg
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Neumann HW, Roth N, Nebelung W. [Extra-articular pathogenetic factors in arthritis and deformities in old age as exemplified by varus gonarthrosis]. Orthopade 1994; 23:32-7. [PMID: 8134095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Extraarticular, predominantly neuromuscular, factors are thought to contribute to the development of osteoarthritis. With increasing age, changed temporal dynamics of motor reflexes and reduced muscular force may affect the efficacy of neuromuscular protection of the knee joint. In three experimental studies conducted with osteoarthritis patients and healthy controls, no difference was found in monosynaptic reflex times and latencies of somatosensory evoked brain potentials. Muscular force was generally diminished in the patients, with the most prominent reduction during coxal abduction. Osteoarthritis patients had marked nociceptive hyposensitivity, but no difference was seen in fast conduction afferent systems. In an animal study with high locomotion load, interruption of articular afferent nerve fibers led to a precipitation of cartilage degeneration. It is concluded that minor extraarticular functional deficits acting over time, probably support and aggravate the development of osteoarthritic changes.
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Affiliation(s)
- H W Neumann
- Klinik für Orthopädie der Medizinischen Akademie Magdeburg
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