| 1. |
- Schöll, Michael, 1980, et al.
(författare)
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Biomarkers for tau pathology.
- 2019
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Ingår i: Molecular and cellular neurosciences. - : Elsevier BV. - 1095-9327 .- 1044-7431. ; 97, s. 18-33
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Forskningsöversikt (refereegranskat)abstract
- The aggregation of fibrils of hyperphosphorylated and C-terminally truncated microtubule-associated tau protein characterizes 80% of all dementia disorders, the most common neurodegenerative disorders. These so-called tauopathies are hitherto not curable and their diagnosis, especially at early disease stages, has traditionally proven difficult. A keystone in the diagnosis of tauopathies was the development of methods to assess levels of tau protein in vivo in cerebrospinal fluid, which has significantly improved our knowledge about these conditions. Tau proteins have also been measured in blood, but the importance of tau-related changes in blood is still unclear. The recent addition of positron emission tomography ligands to visualize, map and quantify tau pathology has further contributed with information about the temporal and spatial characteristics of tau accumulation in the living brain. Together, the measurement of tau with fluid biomarkers and positron emission tomography constitutes the basis for a highly active field of research. This review describes the current state of biomarkers for tau biomarkers derived from neuroimaging and from the analysis of bodily fluids and their roles in the detection, diagnosis and prognosis of tau-associated neurodegenerative disorders, as well as their associations with neuropathological findings, and aims to provide a perspective on how these biomarkers might be employed prospectively in research and clinical settings.
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| 2. |
- Wisniewski, Karol, et al.
(författare)
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H3 K27M-Altered Diffuse Midline Gliomas : A Review
- 2023
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Ingår i: Indian Journal of Neurosurgery. - : Georg Thieme Verlag KG. - 2277-954X .- 2277-9167. ; 12:02, s. 104-115
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Forskningsöversikt (refereegranskat)abstract
- Diffuse midline glioma H3 K27M-altered is a recently renamed high-grade glioma in the 2021 World Health Organization (WHO) Classification of Central Nervous System Tumors, previously being labelled diffuse midline glioma H3 K27M-mutant in the 2016 update and diffuse intrinsic pontine glioma prior to 2016. After identification of multiple alterations causing H3 K27 hypomethylation, the definition of this tumor subtype was changed. To further characterize this new entity in both the pediatric and adult population, we conducted a review of the current literature, investigating genetic, epidemiological, clinical, radiological, histopathological, treatment and prognostic characteristics, particularly highlighting the differences between adults and children. This tumor is more common in children, and has a poorer prognosis. Additionally, childhood H3 K27-altered gliomas are more common in the brainstem, but more common in the thalamus in adults. Sadly, limited treatment options exist for these tumors, with radiotherapy the only treatment shown to improve overall survival.
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| 3. |
- Friedli, Iris, et al.
(författare)
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Magnetic Resonance Imaging in Clinical Trials of Diabetic Kidney Disease
- 2023
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Ingår i: Journal of Clinical Medicine. - 2077-0383. ; 12:14
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Forskningsöversikt (refereegranskat)abstract
- Chronic kidney disease (CKD) associated with diabetes mellitus (DM) (known as diabetic kidney disease, DKD) is a serious and growing healthcare problem worldwide. In DM patients, DKD is generally diagnosed based on the presence of albuminuria and a reduced glomerular filtration rate. Diagnosis rarely includes an invasive kidney biopsy, although DKD has some characteristic histological features, and kidney fibrosis and nephron loss cause disease progression that eventually ends in kidney failure. Alternative sensitive and reliable non-invasive biomarkers are needed for DKD (and CKD in general) to improve timely diagnosis and aid disease monitoring without the need for a kidney biopsy. Such biomarkers may also serve as endpoints in clinical trials of new treatments. Non-invasive magnetic resonance imaging (MRI), particularly multiparametric MRI, may achieve these goals. In this article, we review emerging data on MRI techniques and their scientific, clinical, and economic value in DKD/CKD for diagnosis, assessment of disease pathogenesis and progression, and as potential biomarkers for clinical trial use that may also increase our understanding of the efficacy and mode(s) of action of potential DKD therapeutic interventions. We also consider how multi-site MRI studies are conducted and the challenges that should be addressed to increase wider application of MRI in DKD.
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| 4. |
- Halgamuge, Malka N., et al.
(författare)
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Comparison Between Two Models for Interactions Between Electric and Magnetic Fields and Proteins in Cell Membranes
- 2009
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Ingår i: Environmental Engineering Science. - : Mary Ann Liebert Inc. - 1092-8758 .- 1557-9018. ; 26:10, s. 1473-1480
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Forskningsöversikt (refereegranskat)abstract
- Investigations on exposure to electromagnetic have generated conflicting results both in epidemiological and laboratory studies, leaving their possible health consequences largely inconclusive. One of the well-reported reasons for the discrepancies is that there is no generally accepted theory to describe the interactions between the very weak electromagnetic fields and the living cells. This work presents a critical evaluation of three theories that describes the effects of weak electromagnetic fields on channel proteins in the cell membrane. The forced ion vibration model appears to explain the opening of ion channel proteins for exposures to low-frequency magnetic fields in the mili-Tesla range. No resonance frequencies or amplitude window effects are predicted in this method. We identify inconsistencies in the forced vibration model and show that the environmental magnetic fields that would be required to elicit opening of channel proteins are much stronger than predicted by the proposers of this model. The Ion Parametric Resonance model predicts a biological response at well-defined resonance frequencies for magnetic fields exceeding about 10 micro-Tesla. The oscillating magnetic field is assumed to act on proteins together with the earth's static magnetic field. This model predicts amplitude windows. We explain how a purely magnetic interaction, where in a two-stage ion magnetic resonance model, the conformation of a protein is changed under the influence of ions attached to its surface, which in turn, changes the function of the protein, can overcome the inherent signal-to-noise problem caused by electric thermal noise. The hydrogen nuclear polarization model predicts a biological response for oscillating magnetic field strengths above 0.1 micro-Tesla. The presence of a static magnetic field is required, and biological effects can be expected for frequencies below a few hundred hertz. All models except the forced vibration model can be applied for amplitude modulated microwaves.
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| 5. |
- Robinson, Yohan, 1977, et al.
(författare)
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Vertebroplasty and kyphoplasty--a systematic review of cement augmentation techniques for osteoporotic vertebral compression fractures compared to standard medical therapy.
- 2012
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Ingår i: Maturitas. - : Elsevier BV. - 1873-4111 .- 0378-5122. ; 72:1, s. 42-9
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Forskningsöversikt (refereegranskat)abstract
- After more than two decades the treatment effect of cement augmentation of osteoporotic vertebral compression fractures (VCF) has now been questioned by two blinded randomised placebo-controlled trials. Thus many practitioners are uncertain on the recommendation for cement augmentation techniques in elderly patients with osteoporotic VCF. This systematic review analyses randomised controlled trials on vertebroplasty and kyphoplasty to provide an overview on the current evidence. From an electronic database research 8 studies could be identified meeting our inclusion criteria of osteoporotic VCF in elderly (age>60 years), treatment with vertebroplasty or kyphoplasty, controlled with placebo or standard medical therapy, quality of life, function, or pain as primary parameter, and randomisation. Only two studies were properly blinded using a sham-operation as control. The other studies were using a non-surgical treatment control group. Further possible bias may be caused by manufacturer involvement in financing of three published RCT. There is level Ib evidence that vertebroplasty is no better than placebo, which is conflicting with the available level IIb evidence that there is a positive short-term effect of cement augmentation compared to standard medical therapy with regard to QoL, function and pain. Kyphoplasty is not superior to vertebroplasty with regard to pain, but with regard to VCF reduction (evidence level IIb). Kyphoplasty is probably not cost-effective (evidence level IIb), and vertebroplasty has not more than short-term cost-effectiveness (evidence level IV). Vertebroplasty and kyphoplasty cannot be recommended as standard treatment for osteoporotic VCF. Ongoing sham-controlled trials may provide further evidence in this regard.
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| 6. |
- Laurell, Louise, 1959, et al.
(författare)
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Imaging in juvenile idiopathic arthritis with a focus on ultrasonography.
- 2013
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Ingår i: Clinical and experimental rheumatology. - 0392-856X .- 1593-098X. ; 31:1, s. 135-48
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Forskningsöversikt (refereegranskat)abstract
- Early therapeutic intervention and use of new highly efficacious treatments have improved the outcome in many patients with juvenile idiopathic arthritis (JIA), but have also led to the need for more precise methods to evaluate disease activity. In adult rheumatology, numerous studies have established the importance of magnetic resonance imaging (MRI) and ultrasonography (US), and MRI is considered the reference standard. Nevertheless, due to differences in disease characteristics and the unique features of the growing skeleton, the findings obtained in adults are not directly applicable to children and adolescents. For paediatric patients, US offers specific advantages over MRI, because it is non-invasive, does not require sedation or general anesthesia (which facilitates repeated examinations for follow-up), is quickly accessible bedside, and is easy to combine with clinical assessment (interactivity). Agitation of the patient is rarely a problem, and hence young children can be seated on a parent's lap or play while being examined, and multiple locations can be assessed during a single session. Furthermore, modern high-frequency US transducers used by experienced US examiners can provide unsurpassed resolution of the superficial musculoskeletal structures in children. US is also the best available technique for imaging guidance of steroid injections. Unfortunately, there are still no validated MRI or US scoring systems for evaluating inflammatory and joint damage abnormalities in JIA, and few US studies have been conducted. Sonographic assessment of disease activity has, however, been proven to be more informative than clinical examination and is also readily available at points of care. This review summarises the literature on imaging in JIA, focusing on US and the important role this technique will play in JIA in the future.
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| 7. |
- Ebrahimi, Sheida, et al.
(författare)
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Application of PET/MRI in Gynecologic Malignancies
- 2024
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Ingår i: Cancers. - : MDPI. - 2072-6694. ; 16:8
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Forskningsöversikt (refereegranskat)abstract
- Simple Summary This article reviews the value of Positron Emission Tomography/Magnetic Resonance Imaging (PET/MRI) in evaluating female pelvic cancers. It also provides a comparative analysis of PET/MRI with other imaging modalities in the context of female pelvic malignancies and outlines their respective strengths and limitations. The aim of this narrative review is to introduce to clinicians up and coming technology and how it may be valuable to their assessment of female pelvic cancers.Abstract The diagnosis, treatment, and management of gynecologic malignancies benefit from both positron emission tomography/computed tomography (PET/CT) and MRI. PET/CT provides important information on the local extent of disease as well as diffuse metastatic involvement. MRI offers soft tissue delineation and loco-regional disease involvement. The combination of these two technologies is key in diagnosis, treatment planning, and evaluating treatment response in gynecological malignancies. This review aims to assess the performance of PET/MRI in gynecologic cancer patients and outlines the technical challenges and clinical advantages of PET/MR systems when specifically applied to gynecologic malignancies.
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| 8. |
- Lindgren Belal, Sarah, et al.
(författare)
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Applications of Artificial Intelligence in PSMA PET/CT for Prostate Cancer Imaging
- 2024
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Ingår i: Seminars in Nuclear Medicine. - 1558-4623 .- 0001-2998. ; 54:1, s. 141-149
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Forskningsöversikt (refereegranskat)abstract
- Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) has emerged as an important imaging technique for prostate cancer. The use of PSMA PET/CT is rapidly increasing, while the number of nuclear medicine physicians and radiologists to interpret these scans is limited. Additionally, there is variability in interpretation among readers. Artificial intelligence techniques, including traditional machine learning and deep learning algorithms, are being used to address these challenges and provide additional insights from the images. The aim of this scoping review was to summarize the available research on the development and applications of AI in PSMA PET/CT for prostate cancer imaging. A systematic literature search was performed in PubMed, Embase and Cinahl according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 26 publications were included in the synthesis. The included studies focus on different aspects of artificial intelligence in PSMA PET/CT, including detection of primary tumor, local recurrence and metastatic lesions, lesion classification, tumor quantification and prediction/prognostication. Several studies show similar performances of artificial intelligence algorithms compared to human interpretation. Few artificial intelligence tools are approved for use in clinical practice. Major limitations include the lack of external validation and prospective design. Demonstrating the clinical impact and utility of artificial intelligence tools is crucial for their adoption in healthcare settings. To take the next step towards a clinically valuable artificial intelligence tool that provides quantitative data, independent validation studies are needed across institutions and equipment to ensure robustness.
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| 9. |
- Fork, Thomas, et al.
(författare)
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Enteroskopikapseln- sväljbart engångsinstrument för videoundersökning av tunntarmen
- 2002
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Ingår i: Läkartidningen. - 0023-7205. ; 99:48, s. 6-4842
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Forskningsöversikt (refereegranskat)abstract
- Since 1,5 years wireless enteroscopy with the GivenM2A-capsule has been tested clinically. Wireless capsule-enteroscopy (WCE) has already contributed significantly to the understanding of patients with obscure intestinal symptoms. Series of occult bleeders show that WCE detects lesions in 60%, whereas enterography only in 15%, and push-enteroscopy in 25%. Lesions detected are angiodysplasia in 55%, ulcerations in 14%, aphtoid lesions and erosions in 11%, tumours in 8%. Active bleeding was seen in 43%. In patients with Crohn’s disease further information on extent of disease and type of lesions is gained, mainly seen as erosions in 64%. WCE in hereditary polyposis disclosed more and bigger lesions, and in celiac enteropathy villous atrophy and scalloping of the mucous membrane is readily identified. Software to locate the capsule in the gastrointestinal tract is recently launched together with a graphic display of capsule track and transit times. Soon displays for motility and pressure will follow. Capsule adaptation for screening for Barrett’s esophagus and colon cancer might come true.
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| 10. |
- Leuzy, Antoine, et al.
(författare)
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Use of amyloid PET across the spectrum of Alzheimer's disease : clinical utility and associated ethical issues
- 2014
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Ingår i: Amyloid. - : Informa UK Limited. - 1350-6129 .- 1744-2818. ; 21:3, s. 143-148
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Forskningsöversikt (refereegranskat)abstract
- Recent advances have made possible the in vivo detection of beta-amyloid (Ab) pathology using positron emission tomography. While the gold standard for amyloid imaging, carbon-11 labeled Pittsburgh compound B is increasingly being replaced by fluorine-18 labeled radiopharmaceuticals, with three already approved for clinical use by US and European regulatory bodies. Appropriate use criteria proposed by an amyloid imaging taskforce convened by the Alzheimer's Association and the Society of Nuclear Medicine and Molecular Imaging recommend restricting use of this technology to the evaluation of patients with mild cognitive impairment or atypical dementia syndromes. While use among asymptomatic individuals is currently viewed as inappropriate due prognostic uncertainty, elevated levels of brain Ab among asymptomatic individuals may represent preclinical Alzheimer's disease. Amyloid imaging is likewise expected to play a role in the design of clinical trials. Though preliminary results suggest amyloid imaging to possess clinical utility and cost-effectiveness, both domains have yet to be assessed systematically. As the field moves toward adoption of a pro-disclosure stance for amyloid imaging findings, it is imperative that a broad range of stakeholders be involved to ensure the appropriateness of emerging policies and protocols.
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