Uvod: Primarni hiperparatireoidizam liječi se kirurški. Opseg i uspješnost operacije ovise o točnosti prepoznavanja lokalizacije patološki promijenjene žlijezde dijagnostičkim pretragama prije ...operacije te o intraoperativnoj potvrdi uklanjanja izvora povišene koncentracije PTH. Materijali i metode: Učinjena je retrospektivna analiza bolesnika s dijagnozom primarnog hiperparatireoidizma liječenih u Klinici za tumore u periodu od 2012. do 2019. Godine. Uključena su 54 bolesnika s dijagnozom primarnog hiperparatireoidizma, jedna bolesnica operirana je dva puta. Raspon normalnih koncentracija intaktnog PTH je 15 – 65 pg/mL, a ukupnog kalcija 2,14 – 2,53 mmol/L. Preoperativna koncentracija PTH mjerena je nakon uvoda u opću anesteziju. Intraoperativna koncentracija PTH mjerena je 15 minuta nakon vađenja žlijezde koju smo smatrali zahvaćenom. Kriterij uspješno učinjene operacije bio je pad koncentracije PTH veći od 50% u odnosu na početnu vrijednost. U slučaju izostanka pada koncentracije PTH, prema odluci kirurga, a ovisno o intraoperativnoj situaciji, operacija je produljena traženjem zahvaćene žlijezde, te ponavljanim mjerenjem. Rezultati: Prosječna koncentracija PTH prije operacije bila je 117,4 (39,6 – 305,4) pg/mL, a ukupnog kalcija 2,75 (2,45 – 3,15) mmol/L. Prosječna koncentracija intraoperativnog PTH bila je 35,6 (8,1 – 198,6) pg/mL. Intraoperativne vrijednosti bile su 67,6% manje u odnosu na preoperativne. Kod 44
bolesnika bilo je dovoljno jedno intraoperativno mjerenje koncentracije PTH, dok je kod 11 bolesnika bilo potrebno više mjerenja. Prosječna koncentracija ukupnog kalcija šest mjeseci nakon operacije bila je 2,39 (1,96 – 2,7) mmol/L. Primjenom intraoperativnog određivanja PTH postignuta je uspješnost operacije kod 53 bolesnika (98,14%). Određivanje intraoperativnog pada koncentracije PTH ima visoku osjetljivost 88,7% i pozitivnu prediktivnu vrijednost 97,9%. Zaključak: Intraoperativna potvrda pada koncentracije PTH povećava uspjeh kirurškog
liječenja primarnog hiperparatireoidizma, posebno u skupini bolesnika s multiglandularnom bolesti. Zaključak je temeljen na skupini bolesnika kod kojih je bilo potrebno više od jednog određivanja intraoperativnog PTH.
25-Hydroxyvitamin D (25-OHD) may have a prognostic value in colorectal cancer (CRC) patients. However, as 25-OHD concentration is strongly impacted by surgery, it is uncertain what is the most ...reliable time-point for 25-OHD assessment, pre- or post-operative. Therefore, we examined 515 CRC patients (AJCC I-III) who underwent surgery. Blood samples were collected either pre-operatively (n = 286; median = 1 day before surgery) or post-operatively (n = 229; median = 8 days). Serum 25-OHD concentration was determined by liquid chromatography-tandem mass spectrometry. Association between 25-OHD and survival was tested in the whole cohort, followed by stratified analyses in pre- and post-operatively sampled. Median 25-OHD in the cohort was 36.7 nmol/L and median follow-up time was 5.9 years. There were no differences between pre- and post-operative cohort in age, sex, 25-OHD, AJCC stage, or localization of tumor. After adjustment, higher 25-OHD (>50 nmol/L) was associated with better overall survival only in post-operative (HR = 0.53; 95% CI: 0.33-0.84; P = 0.006), but not in pre-operative cohort (HR = 1.13; 95% CI: 0.77-1.65; P = 0.53). In conclusion, higher post-operative 25-OHD levels were associated with better survival outcome in CRC patients, while no such association was found for pre-operative levels. Time-point of blood collection should be addressed carefully in future research as it might affect the prognostic value of 25-OHD in CRC.
This study aimed to identify and quantify the clinical significance of the HE4 and ROMA index in patients with an adnexal tumour. We recruited 159 women and the HE4 and CA125 were measured with an ...electrochemiluminescence immunoassay in the sera. We used the Kolmogorov-Smirnov test, Mann-Whitney's test and logistic regression to interpret the data. In the premenopausal group (n = 57), the ROC analysis (with cut-off: 86.1 pmol/L for HE4; 40.7 U/L for CA125 and 21.9% for ROMA) demonstrated the superior prognostic potential of those markers when the higher cut-offs used are compared to producer
s
. The AUC for HE4/CA125/ROMA were 0.846/0.867/0.846, respectively. The HE4/ROMA showed 85.7% sensitivity and 94% specificity. In the postmenopausal group (n = 102), the ROC analysis cut-off values were: 99.8 pmol/L for HE4; 45.8 U/L for CA125 and 38.4% for ROMA. AUC for HE4/CA125/ROMA were 0.928/0.899/0.927, respectively. HE4 had an 86.1% sensitivity at 92.4% specificity, while ROMA showed an 88.9% sensitivity at a 90.9% specificity.
Impact Statement
What is already known on this subject? The incidence of ovarian cancer has been increasing, despite the improvement of diagnostic, operative and therapeutic procedures. As a part of the multiparametric approach, the HE4 and ROMA index improve the diagnostic sensitivity and specificity of CA125 in the detection of ovarian cancer.
What the results of this study add? The evaluation of HE4 and ROMA efficacy in the preoperative stratification was made by logistic regression analysis. The better prognostic potential of ROMA index, in patients with present adnexal mass, was obtained using our higher cut-offs for the ROMA index (21.9% for premenopausal and 38.4% for postmenopausal) in comparison to the producer's (11.7% for premenopausal and 29.9% for postmenopausal). The HE4 and ROMA index had 14.29 +LR, 0.15 -LR, 67% PPV and 97.9% NPV in the premenopausal patients. In the postmenopausal group, the HE4 had 11.37 +LR, 0.15 -LR, 75.6% PPV and 92.4% NPV, the ROMA showed 9.78 +LR, 0.12 -LR, 91.2% PPV and 95.2% NPV.
What the implications are of these findings for clinical practice and/or further research? Application of a higher cut-off for HE4/CA125/ROMA index can significantly reduce the percentage of FP and FN in the preoperative stratification of ovarian cancer and justify speculations about this subject in the future.
To compare the analytical performances of the enzymatic method (EM) and capillary electrophoresis (CE) for hemoglobin A1c (HbA1c) measurement.
Imprecision, carryover, stability, linearity, method ...comparison, and interferences were evaluated for HbA1c via EM (Abbott Laboratories, Inc) and CE (Sebia).
Both methods have shown overall within-laboratory imprecision of less than 3% for International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) units (<2% National Glycohemoglobin Standardization Program NGSP units). Carryover effects were within acceptable criteria. The linearity of both methods has proven to be excellent (R2 = 0.999). Significant proportional and constant difference were found for EM, compared with CE, but were not clinically relevant (<5 mmol/mol; NGSP <0.5%). At the clinically relevant HbA1c concentration, stability observed with both methods was acceptable (bias, <3%). Triglyceride levels of 8.11 mmol per L or greater showed to interfere with EM and fetal hemoglobin (HbF) of 10.6% or greater with CE.
The enzymatic method proved to be comparable to the CE method in analytical performances; however, certain interferences can influence the measurements of each method.
Uvod: Godišnje u Hrvatskoj od kolorektalnog karcinoma oboli oko 3500 bolesnika. Nacionalni program ranog otkrivanja raka debelog crijeva u Hrvatskoj se provodi od 2007. godine. Primarni cilj programa ...je otkrivanje raka debelog crijeva u ranoj fazi bolesti, što bi trebalo smanjiti učestalost i smrtnost od raka debelog crijeva.
Cilj: Utvrditi interes ciljne skupine za sudjelovanje u programu, razloge neodazivanja na program te njihovu ukupnu upućenost u program.
Materijali i metode: Anketiranje 50 pacijenata unutar ciljne skupine programa o njihovom odgovoru i razumijevanju razloga za probir.
Rezultati: Iako 84% sudionika zna za program, stopa odaziva nije bila zadovoljavajuća.
Zaključak: Većina ispitanika koji su bolovali od kolorektalnog karcinoma primili su poziv, ali se nisu odazvali zbog nepostojanja simptoma, što korelira s niskom razinom znanja o kolorektalnom karcinomu.
Uvod: Markeri upale su važni čimbenici u predviđanju poslijeoperacijskog tijeka u kolorektalnoj kirurgiji. Uz leukocite, C reaktivni protein, prokalcitonin i neutrofilno/limfocitni omjer, uvodimo ...mogućnost korištenja broja i trendova nezrelih granulocita u postoperacijskom periodu.
Metode: Zabilježili smo kliničke podatke tri pacijenta koja su imala uredan poslijeopracijski tijek i tri koja su imala dehiscencu anastomoze. Pacijenti su upareni po dobi, spolu, i lokalizaciji karcinoma kolorektuma. Obradili smo podatke o broju nezrelih granulocita koji je integralni dio kompletne krvne slike na analizatoru Sysmex XN 1000, te korelirali podatke sa CRP-om, PCT-om, NLR-om. Najbolje predviđanje smo dobili kada je ustanovljen potencijalni Zagreb score: povećan NLR za više od 75%, tri povećanja % IG zaredom i udvostručenje IG-a and IT-a u tri mjerenja zaredom.
Rezultati i zaključak: Potencijalni Zagreb score je predvidio potrebu za reoperacijom na vrijeme. Ova serija slučajeva je uvela koncept i planiramo retrospektivno, na većem uzorku, testirati izvedivost i preciznost potencijalnog Zagreb scorea.
Many companies recruit employees from different parts of the globe, and faking behavior by potential employees is a ubiquitous phenomenon. It seems that applicants from some countries are more prone ...to faking compared to others, but the reasons for these differences are largely unexplored. This study relates country‐level economic variables to faking behavior in hiring processes. In a cross‐national study across 20 countries, participants (N = 3,839) reported their faking behavior in their last job interview. This study used the random response technique (RRT) to ensure participants’ anonymity and to foster honest answers regarding faking behavior. Results indicate that general economic indicators (gross domestic product per capita GDP and unemployment rate) show negligible correlations with faking across the countries, whereas economic inequality is positively related to the extent of applicant faking to a substantial extent. These findings imply that people are sensitive to inequality within countries and that inequality relates to faking, because inequality might actuate other psychological processes (e.g., envy) which in turn increase the probability for unethical behavior in many forms.
In molecular double-slit experiments, the interference between emitted core electrons of diatomic molecules gives rise to oscillations in the observed electron intensity. Here, we explore this ...behaviour for photoelectrons emitted from CO and N2 by soft X-ray ionization in the molecular frame, and we argue that in addition to the undisturbed emission process, intramolecular scattering can lead to electron interference between the scattered and unscattered wave in two ways: two-centre interference between two spatially coherent emitters and one-centre self-interference. The latter is the signature of a loss of spatial coherence. The spatial scale over which the transition from two-centre to one-centre coherence occurs is the de Broglie wavelength of the scattered photoelectron in units of the bond length. These results highlight the fact that the molecular double slit is based on two independent uncertainty principles, DeltapxDeltax and DeltaEDeltat, the second of which causes ongoing tunnelling between the two centres, even after the collapse of the electron wavefunction in real space. PUBLICATION ABSTRACT
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