IMPACT OF COVID-19 ON THYROID FUNCTION: EVIDENCE FROM IRAN.

Context: We assessed the association between the severity of COVID-19 and the thyroid function, and the relationship of thyroid hormones with inflammatory markers in COVID-19 patients. Subjects and methods: This observational study contained 95 COVID-19 patients. The covariates of interest included the thyroid-stimulating hormone (TSH) and the total form of thyroid hormones thyroxine and triiodothyronine. Furthermore, the inflammatory markers including C-reactive protein, erythrocyte sedimentation rate, lactate dehydrogenase (LDH), and lymphocyte were measured. To analyze the data, the t-test, the nonparametric test for comparing the medians, and the Spearman correlation were used. Results: The median (interquartile range) of ages was equal to 53 (41-66) years old, including 54 men (56.8%). As the severity of COVID-19 progressed from moderate to severe, increasing, though non-significant, trends of thyroid dysfunction were observed, the most remarkable for TSH. The only significant association between thyroid hormones and inflammatory markers was a Spearman correlation of -0.28 between TSH and LDH. Moreover, a direct association was found between the severity of COVID-19 and the LDH levels (p-value<0.001). Conclusions: A direct relation between the severity of COVID-19 and the LDH level and a reverse association between the LDH level and the thyroid hormone, TSH was obtained.

Factores pronósticos de eficacia y seguridad que afectan a la supervivencia global de los pacientes con cáncer de próstata metastásico sometidos a tratamiento con [177Lu]Lu-PSMA-617: estudio en un único centro / Efficacy, safety and prognostic factors affecting overall survival among metastatic prostate cancer patients undergoing treatment with 177Lu-PSMA-617: A single center study

Objetivo: Determinación de los factores pronósticos de eficacia y seguridad que afectan a la supervivencia global (SG) entre los pacientes con cáncer de próstata metastásico que han sido sometidos a terapia con radioligandos (RLT) con PSMA. Método: Estudio retrospectivo, desde noviembre del año 2016 a diciembre del año 2019, se incluyeron 43 pacientes con cáncer de próstata metastásico, con una media de edad de 71 años (entre 51 y 88 años), los cuales habían recibido varias líneas de tratamiento previas (el 90,7%, primera línea de la terapia de privación de andrógenos [ADT], el 53,5% en la segunda línea ADT y el 58,1% en docetaxel). Los ciclos del tratamiento con RLT se repetían cada 8 semanas (entre 6 y 12 semanas). Con el fin de evaluar la respuesta bioquímica tras cada ciclo, los niveles del antígeno específico prostático (PSA) se medían y se analizaban de acuerdo con los criterios del Equipo de Trabajo del Cáncer de Próstata 3 (PCWG3). Los eventos adversos posibles tras la terapia fueron retrospectivamente clasificados de acuerdo con los Criterios de Toxicidad Común para Eventos Adversos (CTCAE) v.5. Para identificar los factores asociados con SG se utilizaron las curvas de Kaplan-Meier, y los análisis de regresión de riesgos proporcionales de Cox. Resultados: Fueron administrados un total de 112 ciclos de RLT con una mediana de 3 ciclos (entre 1 y 6) y una actividad administrada mediana por ciclo de 6,29GBq (entre 4,45 y 7,7). Se observó una disminución en la PSA en el 65,1% de los pacientes, la mayor disminución en la PSA, de ≥50 y ≥90%, se obtuvo en los 39,5 y 23,3% de los pacientes, respectivamente. El mayor grado de anemia (grado III) y trombocitopenia ocurrió en el 11,6 y 7% de los pacientes, respectivamente. La mediana de SG y mediana de supervivencia libre de progresión fueron 52 y 20 semanas, respectivamente. En los análisis univariantes, la hemoglobina basal (AU)

Background: Determining the efficacy, safety, and prognostic factors affecting overall survival (OS) among metastatic prostate cancer patients undergoing PSMA-targeted radioligand therapy (PRLT). Method: In this retrospective study, from November 2016 and December 2019, 43 heavily pretreated (90.7% on 1st line androgen deprivation therapy (ADT), 53.5% on 2nd line ADT, 58.1% on docetaxel) metastatic prostate cancer patients with median age of 71 years (range: 51-88 years) were enrolled. Treatment cycles were repeated every 8 weeks (range: 6-12 weeks). To evaluate the biochemical response after each cycle, prostate specific antigen (PSA) levels were measured and analyzed according to the Prostate Cancer Working Group 3 (PCWG3) criteria cutoffs. Possible adverse events after therapy were retrospectively classified according to the Common Toxicity Criteria for Adverse Events (CTCAE) v.5.0. Kaplan-Meier and multivariable Cox proportional hazard regression analyses were used to identify factors associated with OS. Results: A total of 112 cycles of PRLT with a median of 3 cycles (range: 1-6) and median administered activity per cycle of 6.29 GBq (range: 4.45-7.7 GBq) were used. PSA decline was observed in 65.1% of patients, and best PSA decline of ≥50% and ≥90% were achieved in 39.5% and 23.3% of patients, respectively. Major (grade III) anemia and thrombocytopenia occurred in 11.6% and 7% of patients, respectively. Median OS and median PSA progression-free survival were 52 and 20 weeks, respectively. In univariate analysis, baseline hemoglobin <11.2 g/dL, baseline platelets count ≥327,000/μL, PSA decline <20.94% after first cycle of therapy, Eastern Cooperative Oncology Group (ECOG) >2, baseline PSA ≥115 ng/ml, cumulative dose of 177Lu-PSMA <12.95 GBq, initial alkaline phosphatase ≥196.5 U/L, initial lactate dehydrogenase ≥380 U/L and superscan pattern in bone scintigraphy were associated with worse OS (AU)

Impact of partial coherence on the apparent optical transfer function derived from the response to amplitude edges.

We present an investigation of the impact of partial coherence on optical imaging systems with the focus on whole slide imaging (WSI) systems for digital pathology. The investigation is based on the analysis of the edge response of the optical system, which gives rise to an apparent optical transfer function (OTF) that can be linked to two elementary complex functions Q and U. The function Q is directly related to the transmission cross coefficient (TCC) and can be identified with the performance function first introduced by Kintner and Sillitto. The function U depends on the TCC in a more involved way. When there are no aberrations the Q-function corresponds to the real part of the apparent OTF and the U function to the imaginary part of the apparent OTF. Close to the incoherent limit the effect of the U function is a mere shift of the edge compared to the fully incoherent case. We propose a new expression for the dependence of the depth of focus (DOF) on spatial frequency and on the partial coherence factor σ, and validate it by simulation. Partial coherence effects are investigated experimentally on a WSI system with a compact LED-based Köhler illumination unit with variable condenser NA. This unit incorporates a top hat diffuser for providing a reasonably uniform illumination field, with variations below 10% across the imaged field of view. The measurements of the apparent through-focus OTF derived from edges on a custom resolution chart for different σ were substantially in agreement with the simulations. Finding an optimal value for σ is not straightforward as lateral resolution and the level of edge ringing improve with increasing σ, whereas edge contrast and DOF improve with decreasing σ. We assess that the trade-off for the particular application of WSI systems for digital pathology is optimized for a σ value in the range of 0.55-0.75.

Optical quality assessment of whole slide imaging systems for digital pathology.

Whole Slide Imaging (WSI) systems are high-throughput automated microscopes for digital pathology applications. We present a method for testing and monitoring the optical quality of WSI-systems using a measurement of the through-focus Optical Transfer Function (OTF) obtained from the edge response of a custom made resolution target, composed of sagittal and tangential edges. This enables quantitative analysis of a number of primary aberrations. The curvature of the best focus as a function of spatial frequency is indicative for spherical aberration, the argument of the OTF quantifies for coma, and the best focus as a function of field position for sagittal and tangential edges allows assessment of astigmatism and field curvature. The statistical error in the determined aberrations is typically below 20 mλ. We use the method to compare different tube lens designs and to study the effect of objective lens aging. The results are in good agreement with direct measurement of aberrations based on Shack-Hartmann wavefront sensing with a typical error ranging from 10 mλ to 40 mλ.

Effect of Ramadan fasting on glycemic control in patients with Type 2 diabetes.

BACKGROUND: Although Muslim patients with Type 2 diabetes may be exempt from fasting during Ramadan for medical reasons, a high proportion of them fast. AIM: To investigate the association between Ramadan fasting and glycemic control in patients with Type 2 diabetes. SUBJECTS AND METHODS: A prospective cohort clinical trial was designed. Eighty-eight patients with Type 2 diabetes (45 male, 43 female, age 51±10 yr) who opted to fast for at least 10 days during the month of Ramadan were recruited. Fasting blood samples were taken at the beginning and end of Ramadan, and 1 month after Ramadan, to assess fasting blood glucose (FBG), fasting insulin, full blood count, glycated hemoglobin (HbA(1c)) and fasting lipid profile. Insulin resistance was estimated using the homeostatic model assessment. Anthropometrics and blood pressure were also measured. RESULTS: There was a significant deterioration in FBG and HbA(1c) (p=0.002 and p≤0.001, respectively) and significant improvements in HDL and LDL cholesterol and body mass index after Ramadan (p<0.001). Interestingly, HbA(1c) showed a reduction 1 month after Ramadan (9.4±2% at the end of Ramadan vs 8.4±2.5% 1 month after Ramadan; p<0.001). CONCLUSION: Results from this study showed that fasting during Ramadan deteriorated the glycemic control in Type 2 diabetes patients. This was more evident in patients using oral hypoglycemic medication than diet- controlled patients. However, Ramadan fasting had small positive effects on lipid profile and body weight.

TU-E-217BCD-03: Characterization of Anatomical Noise in Mammography, Tomosynthesis and Breast CT.

PURPOSE: The role of breast density in cancer detection has been well characterized, and newer modalities such as breast tomosynthesis and breast CT (bCT) were developed to improve cancer detection in the dense breast by reducing anatomical complexity. Anatomical noise was characterized on a small cohort of patient images and compared across digital mammography, tomosynthesis, and bCT images. METHODS AND MATERIALS: An IRB-approved and HIPPA-compliant clinical study was performed on women undergoing breast biopsy, and mammography, tomosynthesis, and bCT were performed on both breasts immediately prior to biopsy. A total of 23 women participated in this study, and the unaffected breast (no lesion) was evaluated. A total of 1000 regions of interest were sampled on each image data set, and the 2D noise power spectrum (NPS) was evaluated. This was radially averaged to produce a 1D NPS, and the NPS was fit to a power law: ln{NPS(f)} = alpha+betaxln(f), over an anatomically-relevant range of spatial frequencies. The slope, beta, was averaged across patients and compared between modalities and projections. RESULTS: The value of beta was determined for bCT data sets, and they were 1.75 (0.424), 1.83 (0.352), and 1.79 (0.397), for the coronal, sagittal and axial views, respectively. For tomosynthesis, beta was 3.06 (0.361) and 3.10 (0.315) for the CC and MLO views, respectively. For mammography, these values were 3.17 (0.226) and 3.30 (0.236), for the CC and MLO views, respectively. The values of beta for breast CT were significantly different than those for tomosynthesis and mammography (p<0.001, all 12 comparisons). CONCLUSIONS: The results of this investigation demonstrate that the anatomical complexity of the breast, as characterized by the parameter beta, is statistically similar between mammography and tomosynthesis, a somewhat surprising finding. The breast CT image data, however, demonstrate a statistically-significant reduction in beta across all projections. Funded in part by Hologic Corporation and by a grant from the National Institute of Biomedical Imaging and Bioengineering, EB002138.

Fascial interposition technique for vasectomy: is it justified?

PURPOSE: To assess the feasibility of the fascial interposition (FI) technique to improve the results of non-scalpel vasectomy (NSV) through a cost-effective modification. PATIENTS AND METHODS: The outcome of the FI technique for NSV in 954 consecutive candidates treated by two surgeons was evaluated retrospectively. 726 (76%) of the clients had undergone NSV with FI (FI group) and for the other 228 (24%) NSV by simple ligation and excision (LE) without FI (NFI group) was performed. Demographic data, operative time and complications as well as vasectomy failures were analyzed between the two groups. RESULTS: The two groups were age-matched and there were no significant differences between the two procedures regarding operative complications and operative time. 13 cases of vasectomy failures (5.7%) were detected after 3 months of follow-up, all in the NFI group. No vasectomy failure was recognized in the FI group. CONCLUSION: Combined use of FI with simple LE could be considered a simple effective method for NSV with a high success rate that allows the NSV to remain as a reliable option for contraception.

IL-1 beta increases abundance and activity of the negative transcriptional regulator yin yang-1 (YY1) in neonatal rat cardiac myocytes.

Current research from both clinical and basic science perspectives indicates that cytokines play an important role in the genesis of cardiovascular pathology. Specifically, levels of cytokines such as interleukin-1 (IL-1), tumor necrosis factor- alpha (TNF- alpha), and interleukin-6 (IL-6) have been found to be elevated in both acute myocardial injury as well as situations of chronic dysfunction. Further, therapies directed primarily at interfering with cytokine action have suggested that such an immunomodulatory approach may be beneficial in some of these circumstances of myocardial injury. We recently reported that IL-1 beta induces a hypertrophic state in cultured neonatal rat cardiac myocytes that differs from other well described hypertrophic phenotypes in terms of myocardial gene expression (such as skeletal alpha -actin, sACT), an effect that appeared to co-localize with that of the negative regulator yin yang-1 (YY1).(1)In the present study, we further localize the area in the sACT promoter responsible for the IL-1 effect. These investigations indicate that sequences in and around the third upstream serum response element (SRE3) bind YY1 and are required for IL-1 beta mediated repression. This element is also capable of transferring both IL-1 beta and YY1-mediated transcriptional repression to a heterologous promoter. In support of an IL-1 beta induced post-translational modification of YY1 that results in an increase in DNA-binding activity,(32)P-labeling experiments reveal an increase in phosphorylated YY1 in IL-1 beta treated cells and phosphatase-treated myocyte nuclear proteins lose their ability to bind to the YY1 site. In summary, these results provide evidence that sequences within the SRE3 of the skeletal actin promoter represent an IL-1 beta response element and suggest that IL-1 beta activates the negative transcription factor YY1 by both transcriptional and post-transcriptional mechanisms.