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Measurement Alone (measurement + alone)
Selected AbstractsIdentification of Osteopenic Women at High Risk of Fracture: The OFELY Study,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 10 2005Elisabeth Sornay-Rendu MD Abstract About one-half of women with incident fractures have BMD above the WHO diagnostic threshold of osteoporosis. In the OFELY study, low BMD, increased markers of bone turnover, and prior fracture could be used to identify, within osteopenic women, those at high risk of fracture. Introduction: Recent data suggest that about one-half of women with incident fractures have BMD above the World Health Organization (WHO) diagnostic threshold of osteoporosis (T score , ,2.5). We aimed to identify, within osteopenic women, those at high risk of fracture. Materials and Methods: In the 671 postmenopausal women (mean age: 62 years) belonging to the Os des Femmes de Lyon (OFELY) population-based prospective cohort, we measured at baseline BMD by DXA at the spine and total hip, bone turnover markers (BTM) and clinical risk factors for osteoporosis. All fragility vertebral or nonvertebral fractures, confirmed by radiographs, were assessed during a median follow-up of 9.1 years (IQ: 2.3). Results: 158 incident fractures were recorded in 116 women: 8% in normal, 48% in osteopenic, and 44% in osteoporotic women. Among osteopenic women, low BMD (,2.5 < T score , ,2.0) was associated with an increased fracture risk with an age-adjusted hazard ratio (HR) of 2.5 (1.3-4.6). In addition, age, prior fracture, and high BTM,but not other risk factors,were independently associated with an increased fracture risk with an age-adjusted HR of 2.2 (1.2-4.3) for prior fractures and 2.2 (1.4-3.8) for bone alkaline phosphatase (BALP) in the highest quartile. In the whole group of osteopenic women, a large majority of incident fractures occurred in those with a low BMD, prior fractures, or BALP in the highest quartile, with an age-adjusted HR of 5.3 (2.3-11.8). The 10-year probability of fracture in osteopenic women was 26% if at least one predictor was present, contrasting with 6% in those without any of the three risk factors. Conclusions: In postmenopausal women with osteopenia, low BMD, increased BTM, and prior fracture are associated with an increased risk of fracture in the subsequent 10 years. Their assessment may play an important role in identifying women at high risk of fracture who could not be adequately detected by BMD measurement alone and who may benefit from a therapeutic intervention. [source] Imaging biomarkers of cardiovascular diseaseJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 3 2010Jinnan Wang PhD Abstract Cardiovascular disease (CVD) is a leading cause of morbidity and mortality worldwide. Current clinical techniques that rely on stenosis measurement alone appear to be insufficient for risk prediction in atherosclerosis patients. Many novel imaging methods have been developed to study atherosclerosis progression and to identify new features that can predict future clinical risk. MRI of atherosclerotic vessel walls is one such method. It has the ability to noninvasively evaluate multiple biomarkers of the disease such as luminal stenosis, plaque burden, tissue composition and plaque activity. In addition, the accuracy of in vivo MRI has been validated against histology with high reproducibility, thus paving the way for application to epidemiological studies of disease pathogenesis and, by serial MRI, in monitoring the efficacy of therapeutic intervention. In this review, we describe the various MR techniques used to evaluate aspects of plaque progression, discuss imaging-based measurements (imaging biomarkers), and also detail their validation. The application of plaque MRI in clinical trials as well as emerging imaging techniques used to evaluate plaque compositional features and biological activities are also discussed. J. Magn. Reson. Imaging 2010;32:502,515. © 2010 Wiley-Liss, Inc. [source] Modified TEI Index: A Promising Parameter in Essential Hypertension?ECHOCARDIOGRAPHY, Issue 4 2005Nurgül Keser M.D. Purpose: Modified TEI index is pointed to be more effective in the evaluation of global cardiac functions compared to systolic and diastolic measurements alone. We planned to determine its applicability in hypertension and relation with left ventricular mass index (LVMI). Methods: We studied 48 patients with mild/moderate hypertension and normal coronary angiograms. In total 22 patients (12 men, 10 women, mean age: 55 ± 6) with normal LVMI were studied in group I, 26 patients (12 men, 14 women, mean age: 57 ± 7) with increased LVMI in group II, and 20 patients (10 men, 10 women, mean age: 53 ± 7) with normal blood pressure as a control group. Standard 2D, Doppler, and mitral annulus pulse wave tissue Doppler were used for all measurements. Modified TEI index was calculated as diastolic time interval measured from end of Am wave to origin of Em (a,) minus systolic Sm duration (b,) divided by b(a,,b,/b,). Results: Modified TEI index was significantly higher in both groups than normal group and in group II than in group I. (Control group: 0.33 ± 0.05, group I: 0.51 ± 0.17, group II: 0.68 ± 0.16, P< 0.0001). Conclusion: Modified TEI index, a marker of left ventricular systolic and diastolic functions, is impaired in hypertensives before hypertrophy develops and impairment is more prominent in hypertrophy. Therefore, (1) modified TEI index in hypertensives is a safe, feasible, and sensitive index for evaluation of global ventricular functions. (2) Evaluation of hypertensives with this index periodically may guide interventions directed toward saving systolic and diastolic functions. (3) Modified TEI index is gaining importance as a complementary parameter to standard Doppler or in cases where standard Doppler has its limitations. [source] Extensive Sampling Changes T-Staging of Infiltrating Lobular Carcinoma of Breast: A Comparative Study of Gross versus Microscopic Tumor SizesTHE BREAST JOURNAL, Issue 6 2006Neda A. Moatamed MD Abstract:, Infiltrating lobular carcinoma represents 7,10% of all invasive breast cancers. The greatest diameter of the tumors in the surgical specimens is required for an accurate T-staging. Tumors with dimension of zero cm, >0 to ,2 cm, >2 to ,5 cm, and >5 cm are staged as T0, T1, T2, and T3, respectively. A retrospective study on the specimens was performed on the specimens of 74 cases with infiltrating lobular carcinoma at the UCLA Medical Center from 2003 to 2005. The patients' ages ranged from 38 to 95 years. Specimens were from lumpectomy and mastectomy procedures on 36 and 38 patients, respectively. The specimens were divided in four groups according to the gross T-stages. Microscopic measurement of the tumors was carried out within each of the four groups for restaging purposes. Resizing of tumors was performed by marking the microscopic tumor extensions and compiling the measurements. In group 1, all 26 gross T0 tumors changed to T1 (69%), T2 (19%), and T3 (12%) after microscopic restaging. In group 2, 50% of the 26 gross T1 tumors became T2 (35%) and T3 (15%). In group 3, 9 (50%) of the T2 tumors changed to T3 microscopically. All 7 specimens (100%) in group 4 remained as T3. The results show that the gross measurements alone may underestimate 40,50% of the tumor T-stages. Therefore, the T-stages of the tumors with a gross size of 5 cm or less may change by microscopic resizing after an extensive sampling of the specimen. [source] | ||||||||||