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Preventive Medicine Reports Dec 2020We assess whether the cross-sectional associations between moderate-vigorous physical activity (MVPA) and CVD risk factors are modified by various stress types. Complete...
We assess whether the cross-sectional associations between moderate-vigorous physical activity (MVPA) and CVD risk factors are modified by various stress types. Complete baseline data from 4,000 participants, ages 18-74 years, of the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study (HCHS/SOL SCAS) were analyzed using complex survey design methods. Accelerometer-measured MVPA was assessed continuously (average minutes per day). CVD risk factors assessed were diabetes, hypercholesterolemia, hypertension, and obesity. Stress was assessed using the Chronic Burden Scale for chronic stress, Traumatic Stress Schedule for traumatic stress, and the Perceived Stress Scale for perceived stress. Poisson regression models estimated prevalence ratios of CVD risk factors. The interaction was evaluated by cross-product terms with p <0.10. There was a significant interaction between chronic stress and MVPA among those with prevalent diabetes (p = 0.09). Among those reporting low chronic stress, higher MVPA was associated with a low prevalence of diabetes, however among those reporting high chronic stress, the prevalence of diabetes remained high even with higher MVPA. We did not observe interactions between chronic stress and MVPA for the remaining CVD risk factors, or interactions between traumatic stress or perceived stress and MVPA. This study provides initial evidence on the role of chronic stress on the association between MVPA and diabetes for Hispanic/Latino adults. Mostly, however, chronic stress, traumatic stress, and perceived stress did not modify the associations between MVPA and CVD risk factors for Hispanic/Latino adults.
PubMed: 32995142
DOI: 10.1016/j.pmedr.2020.101190 -
Acta Ophthalmologica Scandinavica Dec 2005Schwannoma is rarely encountered as an intraocular tumor arising from uveal tract. We describe a case of choroidal schwannoma.
PURPOSE
Schwannoma is rarely encountered as an intraocular tumor arising from uveal tract. We describe a case of choroidal schwannoma.
METHODS
A 74-year-old woman presented with rapidly decreasing visual acuity and proptosis for 2 months. To further delineate the tumor, she underwent enucleation of the eyeball. The tumor was examined by light microscopy, electron microscopy and immunohistochemical study.
RESULTS
Microscopically, the tumor was composed of a mixture of cellular solid component (Antoni A) and loose myxoid component (Antoni B). Immunohistochemical study revealed a positive reaction for S-100 protein. Ultrastructurally, the tumor cells showed prominent, continuous basal lamina.
CONCLUSIONS
We enucleated the eyeball with a clinical diagnosis of choroidal amelanotic melanoma, but the tumor was finally diagnosed as schwannoma. We think that currently available ancillary studies are still little value in definitely differentiating schwannoma from other choroidal tumors.
Topics: Aged; Choroid Neoplasms; Diagnosis, Differential; Eye Enucleation; Female; Humans; Magnetic Resonance Imaging; Neurilemmoma; Ultrasonography; Visual Acuity
PubMed: 16396657
DOI: 10.1111/j.1600-0420.2005.00517.x -
Antioxidants & Redox Signaling Feb 2019Proline catabolism refers to the 4-electron oxidation of proline to glutamate catalyzed by the enzymes proline dehydrogenase (PRODH) and l-glutamate γ-semialdehyde... (Review)
Review
SIGNIFICANCE
Proline catabolism refers to the 4-electron oxidation of proline to glutamate catalyzed by the enzymes proline dehydrogenase (PRODH) and l-glutamate γ-semialdehyde dehydrogenase (GSALDH, or ALDH4A1). These enzymes and the intermediate metabolites of the pathway have been implicated in tumor growth and suppression, metastasis, hyperprolinemia metabolic disorders, schizophrenia susceptibility, life span extension, and pathogen virulence and survival. In some bacteria, PRODH and GSALDH are combined into a bifunctional enzyme known as proline utilization A (PutA). PutAs are not only virulence factors in some pathogenic bacteria but also fascinating systems for studying the coordination of metabolic enzymes via substrate channeling. Recent Advances: The past decade has seen an explosion of structural data for proline catabolic enzymes. This review surveys these structures, emphasizing protein folds, substrate recognition, oligomerization, kinetic mechanisms, and substrate channeling in PutA.
CRITICAL ISSUES
Major unsolved structural targets include eukaryotic PRODH, the complex between monofunctional PRODH and monofunctional GSALDH, and the largest of all PutAs, trifunctional PutA. The structural basis of PutA-membrane association is poorly understood. Fundamental aspects of substrate channeling in PutA remain unknown, such as the identity of the channeled intermediate, how the tunnel system is activated, and the roles of ancillary tunnels.
FUTURE DIRECTIONS
New approaches are needed to study the molecular and in vivo mechanisms of substrate channeling. With the discovery of the proline cycle driving tumor growth and metastasis, the development of inhibitors of proline metabolic enzymes has emerged as an exciting new direction. Structural biology will be important in these endeavors.
Topics: Animals; Biocatalysis; Humans; Models, Molecular; Molecular Structure; Proline; Proline Oxidase
PubMed: 28990412
DOI: 10.1089/ars.2017.7374 -
Journal of the American Society of... 2022Patient safety and quality improvement initiatives are integral parts of every cytopathology laboratory. The need to revisit our approaches to patient safety are... (Review)
Review
Patient safety and quality improvement initiatives are integral parts of every cytopathology laboratory. The need to revisit our approaches to patient safety are essential in light of the expanding test menu, ancillary studies, comprehensive diagnostic reports, and emergence of new technologies for augmenting cytologic diagnosis. Our interview with Drs. Yael Heher, Adam Seegmiller, and Paul VanderLaan explores recent developments that have shaped their perspectives in patient safety, test usage, and laboratory quality. The practical strategies presented provide tools for enhanced patient safety and improved outcomes in a new era of ancillary and molecular testing and standardized reporting in the cytopathology laboratory.
Topics: Humans; Laboratories; Patient Safety; Quality Improvement
PubMed: 34996748
DOI: 10.1016/j.jasc.2021.12.001 -
Nature Nanotechnology Nov 2021Nanoparticles are often engineered as a scaffolding system to combine targeting, imaging and/or therapeutic moieties into a unitary agent. However, mostly overlooked,... (Review)
Review
Nanoparticles are often engineered as a scaffolding system to combine targeting, imaging and/or therapeutic moieties into a unitary agent. However, mostly overlooked, the nanomaterial itself interacts with biological systems exclusive of application-specific particle functionalization. This nanoparticle biointerface has been found to elicit specific biological effects, which we term 'ancillary effects'. In this Review, we describe the current state of knowledge of nanobiology gleaned from existing studies of ancillary effects with the objectives to describe the potential of nanoparticles to modulate biological effects independently of any engineered function; evaluate how these effects might be relevant for nanomedicine design and functional considerations, particularly how they might be useful to inform clinical decision-making; identify potential clinical harm that arises from adverse nanoparticle interactions with biology; and, finally, highlight the current lack of knowledge in this area as both a barrier and an incentive to the further development of nanomedicine.
Topics: Clinical Decision-Making; Humans; Nanomedicine; Nanoparticles; Nanostructures; Systems Biology
PubMed: 34759355
DOI: 10.1038/s41565-021-01017-9 -
La Radiologia Medica Apr 2022In December 2019, a new coronavirus, SARS-COV-2, caused a cluster of cases of pneumonia in China, and rapidly spread across the globe. It was declared a pandemic by the... (Review)
Review
In December 2019, a new coronavirus, SARS-COV-2, caused a cluster of cases of pneumonia in China, and rapidly spread across the globe. It was declared a pandemic by the World Health Organization on March 11th, 2020. Virtual autopsy by post-mortem CT (PMCT) and its ancillary techniques are currently applied in post-mortem examinations as minimally or non-invasive techniques with promising results. In this narrative review, we speculate on the potentials of PMCT and its ancillary techniques, as a viable investigation technique for analysis of suspected or confirmed SARS-COV-2 deaths. An online literature search was performed by using three prefix search terms (postmortem, post-mortem, post mortem) individually combined with the suffix radiology, imaging, computed tomography, CT and with the search terms 'SARS-CoV-2' and 'COVID-19' to identify papers about PMCT and its ancillary techniques in SARS-COV-2 positive cadavers. PMCT findings suggestive for pulmonary COVID-19 in deceased positive SARS-COV-2 infection are reported in the literature. PMCT ancillary techniques were never applied in such cases. PMCT imaging of the lungs has been proposed as a pre-autopsy screening method for SARS-COV-2 infection. Further studies are needed to ascertain the value of PMCT in determining COVID-19 as the cause of death without autopsy histopathological confirmation. We advocate the application of PMCT techniques in the study of ascertained or suspected SARS-COV-2 infected deceased individuals as a screening technique and as a method of post-mortem investigation, to augment the numbers of case examined and significantly reducing infection risk for the operators.
Topics: Autopsy; COVID-19; Humans; Pandemics; SARS-CoV-2; Tomography, X-Ray Computed
PubMed: 35226246
DOI: 10.1007/s11547-022-01457-w -
Canadian Journal of Anaesthesia =... Apr 2023We performed a systematic review and meta-analysis to determine the diagnostic test accuracy of ancillary investigations for declaration of death by neurologic criteria... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
We performed a systematic review and meta-analysis to determine the diagnostic test accuracy of ancillary investigations for declaration of death by neurologic criteria (DNC) in infants and children.
SOURCE
We searched MEDLINE, EMBASE, Web of Science, and Cochrane databases from their inception to June 2021 for relevant randomized controlled trials, observational studies, and abstracts published in the last three years. We identified relevant studies using Preferred Reporting Items for Systematic Reviews and Meta-Analysis methodology and a two-stage review. We assessed the risk of bias using the QUADAS-2 tool, and applied Grading of Recommendations Assessment, Development, and Evaluation methodology to determine the certainty of evidence. A fixed-effects model was used to meta-analyze pooled sensitivity and specificity data for each ancillary investigation with at least two studies.
PRINCIPAL FINDINGS
Thirty-nine eligible manuscripts assessing 18 unique ancillary investigations (n = 866) were identified. The sensitivity and specificity ranged from 0.00 to 1.00 and 0.50 to 1.00, respectively. The quality of evidence was low to very low for all ancillary investigations, with the exception of radionuclide dynamic flow studies for which it was graded as moderate. Radionuclide scintigraphy using the lipophilic radiopharmaceutical Tc-hexamethylpropyleneamine oxime (HMPAO) with or without tomographic imaging were the most accurate ancillary investigations with a combined sensitivity of 0.99 (95% highest density interval [HDI], 0.89 to 1.00) and specificity of 0.97 (95% HDI, 0.65 to 1.00).
CONCLUSION
The ancillary investigation for DNC in infants and children with the greatest accuracy appears to be radionuclide scintigraphy using HMPAO with or without tomographic imaging; however, the certainty of the evidence is low. Nonimaging modalities performed at the bedside require further investigation.
STUDY REGISTRATION
PROSPERO (CRD42021278788); registered 16 October 2021.
Topics: Humans; Child; Infant; Bias; Sensitivity and Specificity
PubMed: 37131035
DOI: 10.1007/s12630-023-02418-1 -
Journal of Pediatric Intensive Care Dec 2017When confounding variables exist that inhibit the ability to diagnose brain death clinically in pediatric patients, ancillary tests may provide additional information... (Review)
Review
When confounding variables exist that inhibit the ability to diagnose brain death clinically in pediatric patients, ancillary tests may provide additional information for the practitioner in evaluating for the presence or absence of brain death. Multiple options exist but differ in availability, ease of administration, cost, safety profile, and reliability to accurately diagnose brain death. An important desirable quality of an ancillary test is eliminating false positives, which imply brain death when brain death is in fact not present. More commonly available ancillary studies include electroencephalograms, brain angiography through various modalities, brain stem auditory evoked potentials, and transcranial Doppler ultrasound. At this time, there is not an ancillary test with 100% reliability in diagnosing brain death that can replace the clinical brain death exam. Therefore, practitioners need to understand the strengths and limitations of the ancillary studies available at their hospital.
PubMed: 31073456
DOI: 10.1055/s-0037-1604015 -
JAMA Network Open Oct 2021Many insurers waived cost sharing for COVID-19 hospitalizations during 2020. Nonetheless, patients may have been billed if their plans did not implement waivers or if...
IMPORTANCE
Many insurers waived cost sharing for COVID-19 hospitalizations during 2020. Nonetheless, patients may have been billed if their plans did not implement waivers or if waivers did not capture all hospitalization-related care. Assessment of out-of-pocket spending for COVID-19 hospitalizations in 2020 may show the financial burden that patients may experience if insurers allow waivers to expire, as many chose to do during 2021.
OBJECTIVE
To estimate out-of-pocket spending for COVID-19 hospitalizations in the US in 2020.
DESIGN, SETTING, AND PARTICIPANTS
This cross-sectional study used data from the IQVIA PharMetrics Plus for Academics Database, a national claims database representing 7.7 million privately insured patients and 1.0 million Medicare Advantage patients, regarding COVID-19 hospitalizations for privately insured and Medicare Advantage patients from March to September 2020.
MAIN OUTCOMES AND MEASURES
Mean total out-of-pocket spending, defined as the sum of out-of-pocket spending for facility services billed by hospitals (eg, accommodation charges) and professional and ancillary services billed by clinicians and ancillary providers (eg, clinician inpatient evaluation and management, ambulance transport).
RESULTS
Analyses included 4075 hospitalizations; 2091 (51.3%) were for male patients, and the mean (SD) age of patients was 66.8 (14.8) years. Of these hospitalizations, 1377 (33.8%) were for privately insured patients. Out-of-pocket spending for facility services, professional and ancillary services, or both was reported for 981 of 1377 hospitalizations for privately insured patients (71.2%) and 1324 of 2968 hospitalizations for Medicare Advantage patients (49.1%). Among these hospitalizations, mean (SD) total out-of-pocket spending was $788 ($1411) for privately insured patients and $277 ($363) for Medicare Advantage patients. In contrast, out-of-pocket spending for facility services was reported for 63 hospitalizations for privately insured patients (4.6%) and 36 hospitalizations for Medicare Advantage patients (1.3%). Among these hospitalizations, mean (SD) total out-of-pocket spending was $3840 ($3186) for privately insured patients and $1536 ($1402) for Medicare Advantage patients. Total out-of-pocket spending exceeded $4000 for 2.5% of privately insured hospitalizations compared with 0.2% of Medicare Advantage hospitalizations.
CONCLUSIONS AND RELEVANCE
In this cross-sectional study, few patients hospitalized for COVID-19 in 2020 were billed for facility services provided by hospitals, suggesting that most were covered by insurers with cost-sharing waivers. However, many patients were billed for professional and ancillary services, suggesting that insurer cost-sharing waivers may not have covered all hospitalization-related care. High cost sharing for patients who were billed by facility services suggests that out-of-pocket spending may be substantial for patients whose insurers have allowed waivers to expire.
Topics: Aged; Aged, 80 and over; COVID-19; Cost Sharing; Cross-Sectional Studies; Databases, Factual; Female; Health Expenditures; Hospitalization; Humans; Male; Middle Aged; Pandemics; SARS-CoV-2
PubMed: 34661662
DOI: 10.1001/jamanetworkopen.2021.29894 -
CytoJournal 2021Many types of elective ancillary tests may be required to support the cytopathologic interpretations. Most of these tests can be performed on cell-blocks of different... (Review)
Review
Many types of elective ancillary tests may be required to support the cytopathologic interpretations. Most of these tests can be performed on cell-blocks of different cytology specimens. The cell-block sections can be used for almost any special stains including various and for including fungi, Pneumocystis jirovecii (carinii), and various organisms including acid-fast organisms similar to the surgical biopsy specimens. Similarly, in addition to , different can be performed on cell-blocks. Molecular tests broadly can be divided into two main types and .
PubMed: 33880127
DOI: 10.25259/Cytojournal_3_2021