Targeted metabolomic profiling as a tool for diagnostics of patients with non-small-cell lung cancer.

Lung cancer is referred to as the second most common cancer worldwide and is mainly associated with complex diagnostics and the absence of personalized therapy. Metabolomics may provide significant insights into the improvement of lung cancer diagnostics through identification of the specific biomarkers or biomarker panels that characterize the pathological state of the patient. We performed targeted metabolomic profiling of plasma samples from individuals with non-small cell lung cancer (NSLC, n = 100) and individuals without any cancer or chronic pathologies (n = 100) to identify the relationship between plasma endogenous metabolites and NSLC by means of modern comprehensive bioinformatics tools, including univariate analysis, multivariate analysis, partial correlation network analysis and machine learning. Through the comparison of metabolomic profiles of patients with NSCLC and noncancer individuals, we identified significant alterations in the concentration levels of metabolites mainly related to tryptophan metabolism, the TCA cycle, the urea cycle and lipid metabolism. Additionally, partial correlation network analysis revealed new ratios of the metabolites that significantly distinguished the considered groups of participants. Using the identified significantly altered metabolites and their ratios, we developed a machine learning classification model with an ROC AUC value equal to 0.96. The developed machine learning lung cancer model may serve as a prototype of the approach for the in-time diagnostics of lung cancer that in the future may be introduced in routine clinical use. Overall, we have demonstrated that the combination of metabolomics and up-to-date bioinformatics can be used as a potential tool for proper diagnostics of patients with NSCLC.

COVID-Induced Hyperthyroidism in a 30-Year-Old Female: A Case Study.

Thyroiditis should be in the differential for hyperthyroidism when thyroid-stimulating hormone (TSH) is suppressed and T3/T4 levels are elevated. Suspicion of hyperthyroidism is further increased when the patient can exhibit symptoms such as weight loss, anxiety, feeling feverish, tremors, shaking, and sweating. Hyperthyroidism is generally classified as being overt or subclinical. In the following case, the patient had overt hyperthyroidism which is considered more severe than subclinical hyperthyroidism. Coronavirus disease is not typically associated with thyroiditis; however, in this case, the patient's disorder was accidentally found on her blood results which were originally taken due to her coronavirus disease 2019 (COVID-19) diagnosis.  In this case study, we present a 30-year-old female patient, with suspicions of COVID-19-induced hyperthyroidism found incidentally on her blood panel. An original diagnosis of thyroiditis was made prior to the visualization of increased release of thyroid hormone. A sonogram was done, and a follow-up blood panel was ordered, confirming the patient's diagnosis of hyperthyroidism post COVID-19 recovery.

Ovarian Fibroma Presents As Uterine Leiomyoma in a 61-Year-Old Female: A Case Study.

Uterine leiomyoma should be considered when a female patient reports symptoms of abdominal pressure and abnormal vaginal bleeding. However, the symptoms of a uterine leiomyoma are vast and overlap with other possible diseases that are difficult to distinguish even with imaging studies. This is why it is important for physicians and healthcare providers to keep an open mind and have a broad differential diagnosis.  In this case study, we present a 61-year-old postmenopausal female patient who presented to the emergency department with complaints of pelvic and abdominal pain, as well as vomiting and diarrhea. She was admitted for observation. A complete blood count (CBC), comprehensive metabolic panel (CMP), and urinalysis revealed no abnormalities; a pelvic ultrasound and CT scan reported possible adnexal torsion. The patient remained stable and the pain had subsided when she was seen the next morning by her gynecologist (GYN) who discharged her to follow-up in the office. Subsequent examinations that aided in the diagnosis included, but were not limited to pelvic and transvaginal ultrasounds, an abdominal and pelvic CT, and a pelvic MRI. In this case, the MRI revealed an 11-cm mass that could represent a torsioned pedunculated necrotic fibroid originating from the uterus. Radiology recommended surgical removal. Upon removal and review of the pathology of the mass, it was revealed to be a torsioned, partially necrotic fibroma that had originated from the ovary and not from the uterus, as imaging had originally suggested.

Target Metabolome Profiling-Based Machine Learning as a Diagnostic Approach for Cardiovascular Diseases in Adults.

Metabolomics is a promising technology for the application of translational medicine to cardiovascular risk. Here, we applied a liquid chromatography/tandem mass spectrometry approach to explore the associations between plasma concentrations of amino acids, methylarginines, acylcarnitines, and tryptophan catabolism metabolites and cardiometabolic risk factors in patients diagnosed with arterial hypertension (HTA) (n = 61), coronary artery disease (CAD) (n = 48), and non-cardiovascular disease (CVD) individuals (n = 27). In total, almost all significantly different acylcarnitines, amino acids, methylarginines, and intermediates of the kynurenic and indolic tryptophan conversion pathways presented increased (p < 0.05) in concentration levels during the progression of CVD, indicating an association of inflammation, mitochondrial imbalance, and oxidative stress with early stages of CVD. Additionally, the random forest algorithm was found to have the highest prediction power in multiclass and binary classification patients with CAD, HTA, and non-CVD individuals and globally between CVD and non-CVD individuals (accuracy equal to 0.80 and 0.91, respectively). Thus, the present study provided a complex approach for the risk stratification of patients with CAD, patients with HTA, and non-CVD individuals using targeted metabolomics profiling.

Análisis psicométrico de versiones cortas del Big Five Inventory en universitarios mexicanos / Psychometric analysis of short versions of the Big Five Inventory in Mexican college students / Análise psicométrica de versões curtas do Big Five Inventory em universitários mexicanos

La personalidad es uno de los constructos centrales de la psicología, no obstante, las escalas extensas pueden dificultar su inclusión en diversos estudios. En este sentido, el objetivo de este estudio fue verificar si las dos versiones breves del Big Five Inventory (BFI, 15p y BFI-10p) presentan evidencias de validez y de confiabilidad en una muestra de 451 estudiantes universitarios mexicanos (57,2% mujeres; Medad = 20,84). El BFI-15p y el BFI-10p fueron analizados mediante un modelo exploratorio de ecuaciones estructurales (método de estimativa, y rotación geomin), y se encontró que el BFI-15p tenía un índice de ajuste satisfactorio y estructura interna coherente, así como asociaciones significativas con una breve medida de inteligencia emocional. Además, los coeficientes y puntuaciones de confiabilidad del constructo fueron adecuados. Se concluye que el BFI-15p presenta propiedades psicométricas satisfactorias para su uso en estudiantes universitarios.(AU)

A personalidade é um dos construtos centrais da psicologia, no entanto, as escalas extensas podem dificultar a sua inclusão em diversos estudos. Nesse sentido, o objetivo do presente estudo foi verificar se as duas versões breves do Big Five Inventory (BFI-15p e BFI-10p) apresentam evidências de validade e de confiabilidade numa amostra de 451 estudantes universitários mexicanos (57.2% mulheres; Midade = 20.84). O BFI-15p e o BFI-10p foram analisados por meio de um modelo exploratório de equações estruturais (método de estimativa WLSMV e rotação Geomin), e verificou-se que o BFI-15p apresentava índice de ajuste satisfatório e estrutura interna coerente, assim como associações significativas com uma breve medida de inteligência emocional. Além disso, os coeficientes e pontuações de confiabilidade do construto foram adequados. Conclui-se que o BFI-15p apresenta propriedades psicométricas satisfatórias para o uso em estudantes universitários.(AU)

Personality is one of the central constructs of psychology, however, its extensive scales can hinder its inclusion in various studies. Therefore, the aim of this study was to verify whether the two short versions of the Big Five Inventory (BFI-15p and BFI-10p) present evidence of validity and reliability in a sample of 451 Mexican university students. (57.2% women; Mage = 20.84). The BFI-15p and BFI-10p were analyzed through exploratory structural equation modeling (WLSMV estimation method and geomin rotation), and it was found that the BFI-15p presented a satisfactory fit index and a coherent internal structure, as well as significant associations with a brief measure of emotional intelligence. The construct reliability coefficients and scores were also adequate. It was concluded that the BFI-15p presents satisfactory psychometric properties for use with university students.(AU)

Impact of perioperative management of glycemia in severely obese diabetic patients undergoing gastric bypass surgery.

BACKGROUND: Roux-en-Y gastric bypass (RYGB) surgery is associated with rapid postsurgical improvement in glycemic control in patients with type 2 diabetes mellitus (T2 DM). However, there is little outcome-based evidence to guide the glycemic management of this patient group preoperatively. OBJECTIVES: We conducted 2 pilot studies randomizing patients to assess the impact of intensive glucose management pre- and post-RYGB on clinical outcomes after surgery. SETTING: University hospital. METHODS: In the GLUCOSURG-pre randomized controlled trial (RCT), 34 obese T2 DM patients with glycated hemoglobin (HbA1 c) ≥8.5% (69 mmol/mol) undergoing RYGB were randomly assigned to receive either glucose optimization or no optimization 3 months preoperatively. In the GLUCOSURG-post RCT, 35 obese T2 DM patients on insulin were randomly assigned to either intensive or conservative glucose management up to 2 weeks post- RYGB. HbA1c at 1 year post-RYGB was the primary outcome. RESULTS: In GLUCOSURG-pre, the HbA1 c at 1 year postsurgery was -3.0% (51.9 mmol/mol) in the optimized and -4.0% (45.4 mmol/mol) in the nonoptimized groups (P = .06). In GLUCOSURG-post, there were no significant differences in HbA1 c at 1 year postsurgery between the intensive and conservative groups [-2.4% (44.3 mmol/mol)] versus [-2.3% (44.3 mmol/mol), P = .73)]. CONCLUSIONS: Our pilot studies suggested that neither intensive management of glycemia in the 3 months pre- RYGB, nor the first 2 weeks post-RYGB resulted in better glycemic control one year after surgery. RYGB has substantial effects on glucose control, and additional intensive glucose-lowering interventions do not confer clinical benefits compared to conservative approaches.

Comparison of costs of home and facility-based basic obstetric care in rural Bangladesh.

This study compared the costs of providing antenatal, delivery and postnatal care in the home and in a basic obstetric facility in rural Bangladesh. The average costs were estimated by interviewing midwives and from institutional records. The main determinants of cost in each setting were also assessed. The cost of basic obstetric care in the home and in a facility was very similar, although care in the home was cheaper. Deliveries in the home took more time but this was offset by the capital costs associated with facility-based care. As use-rates increase, deliveries in a facility will become cheaper. Antenatal and postnatal care was much cheaper to provide in the facility than in the home. Facility-based delivery care is likely to be a cheaper and more feasible method for the care provider as demand rises. In settings where skilled attendance rates are very low, home-based care will be cheaper.