MRI radiomics for the prediction of recurrence in patients with clinically non-functioning pituitary macroadenomas.

Twelve to 66% of patients with clinically non-functioning pituitary adenoma (NFPA) experience tumor recurrence 1-5 years after the first surgery. Nevertheless, there is still no recurrence prediction factor concisely established and reproduced in the literature for NFPA management. The present study evaluates the prognostic value of MRI Radiomics features combined with machine learning models to assess recurrence after the first surgery in patients with clinically non-functioning pituitary adenomas (NFPA). We carried out a retrospective study on 27 patients with NFPA, 10 patients having experienced tumor recurrence after the first surgery and 17 who did not. Preoperative 3D T1 contrast-enhanced MR images of patients were used to extract up to 255 Radiomics features from two and three-dimensional segmented regions. Additionally, gender, age at first surgery, and the presence of remnant tumor tissue were investigated to find the correlation with NFPA recurrence. Conventional statistics tests were used to evaluate whether the outcome patient groups (stable and recurrent) were different considering each feature individually. Additionally, five well-known machine-learning algorithms were used in combination with Radiomic features to classify recurrent and stable lesions. We found statistical evidence (p < 0.02) for 6 two-dimensional and 13 three-dimensional radiomic features. We achieved accuracies of up to 96.3% for 3D-feature based models and up to 92.6% accuracies for 2D-feature based models. 3D-feature based models achieved better performances using considerably fewer features when compared to 2D-feature based models. We concluded that Radiomics have the potential of NFPA recurrence prediction after the first surgery. Three-dimensional Radiomics have superior discrimination power to predict NFPA recurrence than two-dimensional radiomic features. Finally, the combination of Radiomics with machine-learning algorithms can offer computational models capable of non-invasive, unbiased, and quick assessment that might improve the prediction of NFPA recurrence.

Imbalance of Steroid Hormones in Hamsters Infected with Schistosoma mansoni.

OBJECTIVE: Schistosomiasis is a debilitating disease that affects 200 million people worldwide. Schistosoma haematobium and Schistosoma mansoni are the major causative agents of this disease. Cancer-association and infertility-association in Schistosoma haematobium infection have already been described and it is known that the parasite produces a catechol-estrogen molecule that induces a hormonal imbalance in the host. METHODS: In order to better understand the relation of hormonal imbalance in experimental Schistosoma mansoni infection, we investigated a serum panel of steroid hormones in Schistosoma mansoni infected hamsters. RESULTS: We found a decrease in the serum levels of Estradiol (E2), Testosterone and Progesterone in infected females and an increase of Testosterone and a decrease in Progesterone in infected males in comparison with controls. CONCLUSION: These results indicate that S. mansoni alters the levels of steroid hormones in infected males and females and it will increase the repertoire of data about the host-parasite molecular interplay and its relation with the endocrine system.

Intravoxel incoherent motion MRI in neurological and cerebrovascular diseases.

Intravoxel Incoherent Motion (IVIM) is a recently rediscovered noninvasive magnetic resonance imaging (MRI) method based on diffusion-weighted imaging. It enables the separation of the intravoxel signal into diffusion due to Brownian motion and perfusion-related contributions and provides important information on microperfusion in the tissue and therefore it is a promising tool for applications in neurological and neurovascular diseases. This review focuses on the basic principles and outputs of IVIM and details it major applications in the brain, such as stroke, tumor, and cerebral small vessel disease. A bi-exponential model that considers two different compartments, namely capillaries, and medium-sized vessels, has been frequently used for the description of the IVIM signal and may be important in those clinical applications cited before. Moreover, the combination of IVIM and arterial spin labeling MRI enables the estimation of water permeability across the blood-brain barrier (BBB), suggesting a potential imaging biomarker for disrupted-BBB diseases.

Zika Virus Meningoencephalitis in an Immunocompromised Patient.

The World Health Organization considers the Zika virus (ZIKV) outbreak in the Americas a global public health emergency. The neurologic complications due to ZIKV infection comprise microcephaly, meningoencephalitis, and Guillain-Barré syndrome. We describe a fatal case of an adult patient receiving an immunosuppressive regimen following heart transplant. The patient was admitted with acute neurologic impairment and experienced progressive hemodynamic instability and mental deterioration that finally culminated in death. At autopsy, a pseudotumoral form of ZIKV meningoencephalitis was confirmed. Zika virus infection was documented by reverse trancriptase-polymerase chain reaction, immunohistochemistry, and immunofluorescence and electron microscopy of the brain parenchyma and cerebral spinal fluid. The sequencing of the viral genome in this patient confirmed a Brazilian ZIKV strain. In this case, central nervous system involvement and ZIKV propagation to other organs in a disseminated pattern is quite similar to that observed in other fatal Flaviviridae viral infections.

Using network dynamic fMRI for detection of epileptogenic foci.

BACKGROUND: Epilepsy is one of the most prevalent neurological disorders. It remains medically intractable for about one-third of patients with focal epilepsy, for whom precise localization of the epileptogenic zone responsible for seizure initiation may be critical for successful surgery. Existing fMRI literature points to widespread network disturbances in functional connectivity. Per previous scalp and intracranial EEG studies and consistent with excessive local synchronization during interictal discharges, we hypothesized that, relative to same regions in healthy controls, epileptogenic foci would exhibit less chaotic dynamics, identifiable via entropic analyses of resting state fMRI time series. METHODS: In order to first validate this hypothesis on a cohort of patients with known ground truth, here we test individuals with well-defined epileptogenic foci (left mesial temporal lobe epilepsy). We analyzed voxel-wise resting-state fMRI time-series using the autocorrelation function (ACF), an entropic measure of regulation and feedback, and performed follow-up seed-to-voxel functional connectivity analysis. Disruptions in connectivity of the region exhibiting abnormal dynamics were examined in relation to duration of epilepsy and patients' cognitive performance using a delayed verbal memory recall task. RESULTS: ACF analysis revealed constrained (less chaotic) functional dynamics in left temporal lobe epilepsy patients, primarily localized to ipsilateral temporal pole, proximal to presumed focal points. Autocorrelation decay rates differentiated, with 100 % accuracy, between patients and healthy controls on a subject-by-subject basis within a leave-one-subject out classification framework. Regions identified via ACF analysis formed a less efficient network in patients, as compared to controls. Constrained dynamics were linked with locally increased and long-range decreased connectivity that, in turn, correlated significantly with impaired memory (local left temporal connectivity) and epilepsy duration (left temporal - posterior cingulate cortex connectivity). CONCLUSIONS: Our current results suggest that data driven functional MRI methods that target network dynamics hold promise in providing clinically valuable tools for identification of epileptic regions.

Trigeminal neuralgia as the sole symptom of pancreatic cancer.

Trigeminal neuralgia (TN) is a condition characterized by brief electric shock-like pains in the topography of the trigeminal nerve. The most common cause of this disorder is the compression of the trigeminal nerve root by tortuous or aberrant vessels. In this report, we describe a patient who presented due to paroxysmal and excruciating facial pain that was found to be secondary to pancreatic cancer.

Dehydromonocrotaline inhibits mitochondrial complex I. A potential mechanism accounting for hepatotoxicity of monocrotaline.

Monocrotaline is a pyrrolizidine alkaloid present in plants of the Crotalaria species, which causes cytotoxicity and genotoxicity, including hepatotoxicity in animals and humans. It is metabolized by cytochrome P-450 in the liver to the alkylating agent dehydromonocrotaline. We evaluated the effects of monocrotaline and its metabolite on respiration, membrane potential and ATP levels in isolated rat liver mitochondria, and on respiratory chain complex I NADH oxidase activity in submitochondrial particles. Dehydromonocrotaline, but not the parent compound, showed a concentration-dependent inhibition of glutamate/malate-supported state 3 respiration (respiratory chain complex I), but did not affect succinate-supported respiration (complex II). Only dehydromonocrotaline dissipated mitochondrial membrane potential, depleted ATP, and inhibited complex I NADH oxidase activity (IC50=62.06 microM) through a non-competitive type of inhibition (K(I)=8.1 microM). Therefore, dehydromonocrotaline is an inhibitor of the activity of respiratory chain complex I NADH oxidase, an action potentially accounting for the well-documented monocrotaline's hepatotoxicity to animals and humans. The mechanism probably involves change of the complex I conformation resulting from modification of cysteine thiol groups by the metabolite.

Protective effect of topical formulations containing quercetin against UVB-induced oxidative stress in hairless mice.

UV radiation-induced skin damages may result in pre-cancerous and cancerous skin lesions, and acceleration of skin aging. It involves an imbalance of the endogenous antioxidant system that leads to the increase of free radical levels and inflammation. Therefore, antioxidant supplementation might inhibit such imbalance. In this regard, quercetin is a promising drug, this plant derived lipophilic flavonoid presents the higher antioxidant activity among flavonoids and multiple antioxidant mechanisms. Thus, the present study investigated the possible beneficial effects of topical formulations containing quercetin to inhibit UVB irradiation-induced oxidative damages. Quercetin was administered on the dorsal skin of hairless mice using two formulations, formulation 1 (non-ionic emulsion with high lipid content) and formulation 2 (anionic emulsion with low lipid content). The UVB irradiation (0.31-3.69 J/cm(2)) induced a dose-dependent increase in the myeloperoxidase (MPO) activity (4-2708%) and depletion of reduced glutathione (GSH) (22-68%) in the skin of hairless mice after 6h. These results demonstrated that the UVB doses are not excessive, and additionally, they are lower than the doses used in other similar studies. Proteinases secretion/activity, detected by the qualitative sodium dodecyl sulphate polyacrylamide gel electrophoresis substrate-embedded enzymography (zymography), was also enhanced in the same manner as MPO activity using the UVB dose of 1.23J /cm(2). Formulations 1 and 2 inhibited the MPO activity increase (62% and 59%, respectively), GSH depletion (119% and 53%, respectively) and proteinases secretion/activity. To our knowledge, this is the first study to demonstrate the effectiveness of topical formulations containing quercetin to inhibit the UVB irradiation-induced skin damages. Thus, these data suggest the possible usefulness of topical formulations containing quercetin to prevent UVB radiation skin damages.