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Bratislava, Slovakia

Raneta O.,Comenius University | Ondrus D.,Comenius University | Bella V.,St Elisabeth Cancer Institute
Klinicka Onkologie | Year: 2012

Backgrounds: Breast cancer presents a serious medical and social problem worldwide. Early detection is key to effective breast cancer treatment. Therefore, scientists are consistently looking for new diagnostic techniques that would be more efficient, easy to use and safe for the patient. The main task of this study was to evaluate the feasibility of a novel low-cost non-invasive technique called electrical impedance tomography (EIT) and to determine whether EIT can qualitatively supplement the existing traditional imaging techniques in the process of breast cancer diagnostics. Patients and Methods: Randomly selected patients with mammographic and/or sonographic abnormalities were involved into the study. In total, 808 patients aged 18-94 (mean 54) years participated in the survey. Exclusion criteria involved previous breast surgery, breast core biopsy or fine needle aspiration within the last 1 and 3 months, respectively. Furthermore, patients with implanted electrically powered devices (cardioverter, pacemaker) and patients previously treated by chemo-radiotherapy were also excluded. The EIT examination was performed using the electrical impedance computer mammograph MEIK developed by the Institute of Radio Engineering and Electronics, Russian Academy of Sciences. Results: The following results were obtained: sensitivity of EIT was 87%, X-ray mammography (MMG) 89% and ultrasonography (USG) 91%; specificity of EIT was 85%, MMG 91% and USG 84%. Negative predictive value (NPV) of all three modalities showed nearly equal values, with slight advantage of the USG. MMG had the highest positive predictive (PPV) value (83%), EIT had the lowest (63%). Sensitivity increased to 96% and 98%, respectively, when combinations EIT + MMG and EIT + USG were used. The specificity increased to 79% for EIT + MMG and 71% for EIT + USG. EIT + MMG and EIT + USG NPV remained the same. PPV was 65% and 58%, respectively for the EIT + MMG and EIT + USG combination. Conclusion: Our study findings are comparable to those of other similar studies. Although the EIT is a promising method and deserves close attention of specialists, it cannot replace MMG and/or USG examination as it does not provide information on structural changes to the breast. It can, however, provide very useful additional information about metabolic processes in the body. But in order to show its full potential some improvements should be held. Source

Steno A.,Comenius University | Bocko J.,R.O.S.A. | Rychly B.,R.O.S.A. | Chorvath M.,St Elisabeth Cancer Institute | And 4 more authors.
Acta Neurochirurgica | Year: 2014

Background: The postoperative biological behavior of nonfunctioning pituitary adenomas (NFPAs) is variable. Some residual NFPAs are stable long-term, others grow, and some recur despite complete removal. The usual histological markers of tumor aggressiveness are often similar between recurring, regrowing, and stable tumors, and therefore are not reliable as prognostic parameters. In this study, the clinical utility of proliferation indices (labeling index, Li) based on immunohistochemistry targeted at antigens Ki-67 and High-mobility group A1 (HMGA-1) for prediction of NFPA prognosis was investigated. Methods: Fifty patients with NFPAs were investigated. In each patient, Ki-67 and HMGA-1 Li were evaluated. Based on postoperative magnetic resonance images, patients were classified as tumor-free (18 patients), or harboring a residual tumor (32 patients). The latter group was further subdivided into groups with stable tumor remnants (11 patients) or progressive tumor remnants (21 patients). Results: The median follow-up period was 8 years. No significant relationship between HMGA-1 Li and residual tumor growth was found. Growing residual tumors showed a trend towards higher Ki-67 Li compared with stable ones (p = 0.104). All tumor remnants with Ki-67 Li above 2.2 % were growing. The relationship between residual tumor growth and Ki-67 Li exceeding the cutoff value of 2.2 % was significant (p = 0.01 in univariate, p = 0.044 in multivariate analysis). Conclusions: The prognostic significance of the HMGA-1 antigen was not confirmed. In contrast, the Ki-67 Li provides useful and valuable information for the postoperative management of NFPAs. In residual adenomas with a Ki-67 Li above 2.2 %, regrowth should be expected, and these tumors may require shorter intervals of follow-up magnetic resonance imaging (MRI) and/or early adjuvant therapy. Future larger studies are needed to confirm the results of this study. © 2014 Springer-Verlag Wien. Source

Racek J.,Charles University | Sindberg C.D.,Pharma Nord Research | Moesgaard S.,Pharma Nord Research | Mainz J.,R.O.S.A. | And 3 more authors.
Biological Trace Element Research | Year: 2013

Chromium is required for a normal insulin function, and low levels have been linked with insulin resistance. The aim of this study was to follow the effect of chromium supplementation on fasting plasma glucose (FPG), glycated haemoglobin (HbA1c) and serum lipids in patients with type 2 diabetes mellitus (DM2) on insulin therapy. Eleven randomly selected patients with DM2 on insulin therapy were supplemented with a daily dose of 100 μg chromium yeast for the first supplementation period of 2 weeks. In the second supplementation period, the chromium dose was doubled and continued for the next 6 weeks. The third phase was a 6-week washout period. After each period, the levels of FPG and HbA1c were compared with the corresponding values at the end of the previous period. Serum triglycerides, total HDL and LDL cholesterol values after supplementation were compared with the baseline values. FPG decreased significantly after the first period of chromium supplementation (p < 0.001), and a tendency to a further reduction was observed after the second supplementation period. Similarly, HbA1c decreased significantly in both periods (p < 0.02 and p < 0.002, respectively). Eight weeks after withdrawal of chromium supplementation, both FPG and HbA 1c levels returned to their pre-intervention values. The serum lipid concentrations were not significantly influenced by chromium supplementation. Chromium supplementation could be beneficial in patients with DM2 treated with insulin, most likely due to lowered insulin resistance leading to improved glucose tolerance. This finding needs to be confirmed in a larger study. © 2013 Springer Science+Business Media New York. Source

Spanik S.,Comenius University | Spanikova B.,St Elisabeth Cancer Institute
Bratislava Medical Journal | Year: 2010

Purpose: Recent data indicate that women with breast cancer receiving aromatase inhibitors (AIs) are at increase risk of osteoporosis. Patients and methods: We evaluated 263 patients in our study, 42 receiving AI (22 - Arimidex, 20 - Femara), 69 selective estrogen receptor modulater (SERM - Tamoxifen), in 72 the therapy with SERM was changed for AI and 80 were in follow-up without hormonal therapy. We measured BMD by whole-body densitometer Hologic explorer. BMD of proximal femur and L spine was measured and evaluated and in case of degenerative changes also the region of distal forearm. We evaluated T-score. 43. Results: 35 % of the patients had decline of BMD to T-score of osteoporosis and only 13.31 % of patients had normal bone density. 53.13 % of the treated patients had BMD level of osteoporosis versus 40.2 % of untreated patients or patients treated for less than one year. 3.13 % of treated patients had normal BMD versus 16.58 % of untreated patients (p=0.015). Conclusions: We confirm the influence of adjuvant AI therapy on decline of BMD in early breast cancer patients in our study. The bone loss was statistically significant in patients whose therapy lasted at least one year (Fig. 6, Ref. 20). Full Text (Free, PDF) www.bmj.sk. Source

Raneta O.,Comenius University | Bella V.,St Elisabeth Cancer Institute | Bellova L.,St Elisabeth Cancer Institute | Zamecnikova E.,St Elisabeth Cancer Institute
Neoplasma | Year: 2013

Our study involved 870 eligible women with suspected pathological breast lesion discovered by mammography (MMG) or ultrasound examination (USG) which were recommended to pass histological examination to verify the diagnosis. All patients included in our study were divided into two age groups: the 1st group - patients older than 40 years (total of 724 patients), the 2nd group - patients younger than 40 years (total of 146 patients). The purpose of our study was to analyze the possibilities of electrical impedance tomography (EIT) implementation to the differential diagnosis of pathologic lesions of the breast either solely, or in a combination with MMG/USG. The following results were obtained: in the 1st group the average specificity of MMG was 79.5%; when added EIT the average specificity decreased to 72.8%. The sensitivity of MMG, by contrast, increased from 87.8% when using it as an independent method to 94.5% when added EIT. In the 2nd group the average specificity of USG was 90.2%; when added EIT the average specificity decreased to 86.4%. Similarly, as in the 1st group the sensitivity of USG increased from 86.7% when using it as an independent method to 93.3% when added EIT. Analysis of false-negative results of electrical impedance tomography depending on the stage of the process has shown that as the earlier stage of the disease and as the smaller is the dimensions of the tumor, the higher is the number of falsenegative results. In addition, we observed the dependence of the false-negative results of the tumor grade. The results of our study show that the use of EIT in addition to MMG/USG can improve the sensitivity of these methods and to increase the rate of early detection of breast cancer with minimal economic costs and highly qualified staff time expenditures. Source

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