Objective
To assess the performance of multiparametric magnetic resonance imaging (MRI) in identifying pathological-index (path-index) lesions, defined as cancer present in the same prostate sextant in two separate surveillance biopsies, in men followed within an active surveillance (AS) programme for low-risk prostate cancer (CaP) with extended follow-up.
Materials and Methods
A total of 50 men, representing >215 person-years of follow-up in an AS programme, who were referred for prostate MRI were randomly chosen to have their images reviewed by a radiologist with expertise in prostate MRI, who was blinded to biopsy results.
Index lesions on MRI were defined as a single suspicious lesion ≥10 mm or >2 lesions in a given prostate sextant. Lesions on MRI were considered suspicious if ≥2 abnormal parameters co-registered anatomically. Path-index lesions were defined as cancer present in a given prostate sextant on two separate biopsy sessions.
Sensitivity and specificity were calculated to test the performance of MRI for identifying path-index lesions.
Clinical and pathological features were compared between men with and without a MRI-index lesion.
Results
A total of 31 path-index and 13 MRI-index lesions were detected in 22 and 10 patients, respectively.
Multiparametric MRI demonstrated excellent specificity and negative predictive value (0.974 and 0.897, respectively) for the detection of path-index lesions. Sensitivity (0.19) and positive predictive value (0.46) were considerably lower.
Patients with an index lesion on MRI were younger and less likely to have met the ‘Epstein’ criteria for very low-risk CaP.
Compared with men without an MRI lesion, a significant increase in biopsy reclassification was noted for men with a MRI lesion (40 vs 12.5%, P = 0.04).
Conclusions
A non-suspicious MRI was highly correlated with a lack of path-index lesions in an AS population.
Multiparametric MRI may be useful in both the selection and monitoring of patients undergoing AS.
Ammonia temperature-programmed desorption (TPD) with water vapor treatment method was applied to
MFI-type ferrisilicate, and theoretical analysis was carried out to determine the acid amount and strength
exactly. At the low iron content where isomorphous substitution of iron into the silicate matrix was predominant,
a quite strong acid site with 150−180 kJ mol-1 adsorption heat of ammonia, which was stronger than that on
aluminosilicate, was observed. The determined acidic property was in good agreement with microcalorimetry.
Therefore, it is concluded that the isomorphous substitution of iron into the MFI structure generates a stronger
acid site than that by aluminum.
Purpose
To identify factors associated with best-corrected visual acuity (BCVA) presentation and two-year outcome in 479 intermediate, posterior, and panuveitic eyes.
Design
Cohort study using randomized controlled trial data
Methods
Multicenter Uveitis Steroid Treatment (MUST) Trial masked BCVA measurements at baseline and 2 years’ follow-up used gold standard methods. Twenty-three clinical centers documented characteristics per protocol, which were evaluated as potential predictive factors for baseline BCVA and two-year change in BCVA.
Results
Baseline factors significantly associated with reduced BCVA included: age ≥50 vs. <50 years; posterior vs. intermediate uveitis; uveitis duration >10 vs. <6 years; anterior chamber (AC) flare > grade 0; cataract; macular thickening; and exudative retinal detachment. Over two years, eyes better than 20/50 and 20/50 or worse at baseline improved, on average, by 1 letter (p=0.52) and 10 letters (p<0.001) respectively. Both treatment groups and all sites of uveitis improved similarly. Factors associated with improved BCVA included resolution of active AC cells, of macular thickening, and cataract surgery in an initially cataractous eye. Factors associated with worsening BCVA included longer duration of uveitis (6–10 or >10 vs. <6 years), incident AC flare, cataract at both baseline and follow-up, pseudophakia at baseline, persistence or incidence of vitreous haze, and incidence of macular thickening.
Conclusions
Intermediate, posterior and panuveitis have a similarly favorable prognosis with both systemic and fluocinolone acetonide implant treatment. Eyes with more prolonged/severe inflammatory damage and/or inflammatory findings initially or during follow-up have a worse visual acuity prognosis. The results indicate the value of implementing best practices in managing inflammation.
The adsorptive properties of carboxymethyl cellulose (CMC) prepared from sugarcane bagasse (SB) for the removal of methylene blue (MB) from aqueous solution was investigated. Two batches of CMC, CTSB-CMC-B1 and CTSB-CMC-B2, were prepared from chlorite treated sugarcane bagasse (CTSB). The prepared CMCs were characterized by FT-IR spectral analysis. Degree of substitution (DS) value of prepared CMCs was estimated. Batch adsorption experiments show that the adsorption of MB on CMCs reaches equilibrium within 30 minutes. The MB adsorption capacity of CTSB-CMC-B1 and CTSB-CMC-B2 were found to be 652.0 and 369.0 mg g −1 , respectively. CMC with the higher DS value (CTSB-CMC-B1) shows higher adsorption capacity than the CMC having lower DS value (CTSB-CMC-B2). The uptake of MB was minimum at pH 2 and gradually increases with the increase of pH. From the desorption studies, it was found that large amount of MB was released in strong acidic (pH 3.0) conditions.
Remission was defined as inactivity of disease off all suppressive medications at all visits spanning at least three consecutive months or at all visits up to the last visit (to avoid censoring patients stopping follow-up after remission). Factors potentially predictive of remission were assessed using Cox regression models. RESULTS: During 1,906 years' aggregate follow-up of 832 affected eyes, remission occurred in 214 (170 of 584 patients). Median time-to-remission of scleritis [ 7.8 years (95% confidence interval [CI]: 5.7, 9.5). More remissions occurred earlier than later during follow-up. Factors predictive of less scleritis remission included scleritis bilaterality (adjusted hazard ratio [aHR] [ 0.46, 95% CI: 0.32-0.65); and diagnosis with any systemic inflammatory disease (aHR [ 0.36, 95% CI: 0.23-0.58), or specifically with Rheumatoid Arthritis (aHR [ 0.22), or Granulomatosis with Polyangiitis (aHR [ 0.08). Statin treatment (aHR [ 1.53, 95% CI: 1.03-2.26) within £90 days was associated with more remission incidence.CONCLUSIONS: Our results suggest scleritis remission occurs more slowly in anterior scleritis than in newly diagnosed anterior uveitis or chronic anterior uveitis, suggesting that attempts at tapering suppressive medications is warranted after long intervals of suppression. Remission is less frequently achieved when systemic inflammatory diseases are present. Confirmatory studies of whether adjunctive statin treatment truly can enhance scleritis remission (as suggested here) are needed. (Am
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.