The role of T2-weighted fast-spin-echo imaging in the diagnosis of meniscal tears

The objective of this study was to compare the accuracy of T2-weighted fast-spin-echo (FSE) and intermediate-weighted spin-echo (SE) MR imaging in the detection of meniscal tears. Seventy-six patients (152 menisci) who had arthroscopic surgery after MR imaging of the knee were studied. MR imaging included intermediate-weighted SE and T2-weighted FSE sequences. The use of intermediate-weighted conventional SE images, T2-weighted FSE images, and a combination of both sequences were evaluated in the detection of meniscal tears. T2-weighted FSE imaging was slightly less accurate than intermediate-weighted SE imaging in the diagnosis of meniscal tears. Interpretation of the menisci using both intermediate-weighted SE and T2-weighted FSE imaging did not improve the accuracy over intermediate-weighted imaging evaluated in isolation.     

The influence of cardiac diastole on weaning from mechanical ventilation.

Hemodynamic changes occur during weaning from mechanical ventilation, especially after disconnection from positive pressure ventilation. Their importance has been insufficiently studied, although some refer to their role in weaning. The authors studied the hemodynamic implications after ventilator disconnection, using echocardiography. They found isovolumetric relaxation time to be a good predictor of successful weaning, proving the importance of the diastole changes with the hemodynamic adaptation in the transition to negative pressure ventilation.     

Current Status of Ecotoxicological Studies of Bats in Brazil

Bulletin of Environmental Contamination and Toxicology - Bats are sensitive to contaminants generated by agricultural activities, mining, and urbanization. In this review, we update the status of...     

Outcome Measures of Adjustable Transobturator Male System with Pre-attached Scrotal Port for Male Stress Urinary Incontinence After Radical Prostatectomy: A Prospective Study

Introduction

The objective of this study was to report outcome measures with third-generation pre-attached scrotal port adjustable transobturator male system (ATOMS) for male stress urinary incontinence (SUI) after radical prostatectomy.

Methods

A prospective open study was conducted on consecutive patients. Evaluation included cough test, urethroscopy, filling and voiding cystometry, 24-h pad count and pad test, patient-reported outcomes (ICIQ-SF, IIQ-7, PGI, GRA, and VAS), complications according to the Clavien–Dindo system, operative results, number of adjustments, and filling of the system.

Results

Thirty-four patients with median pad test 510 (170–1225) ml were operated on. Preoperative SUI was mild (5.9%), moderate (17.6%), and severe (76.5%). At median 18.5 (12–26) months follow-up distribution of SUI was none (85.3%), mild (8.8%), and moderate (5.9%). Median intraoperative filling was 14 (8–17) ml, number of adjustments 1 (0–5), and total filling 17.5 (11–33.5) ml. At 3 months, median ICIQ-SF (p = 0.0001) and IIQ-7 (p < 0.0001) decreased. At 12 months, 24-h pad count and pad test decreased (both p < 0.0001), residual volume slightly increased (p = 0.018), PGI-I was 1 (1–3), GRA 6 (3–6), and 97% were satisfied with treatment. Continence (p = 0.016) and satisfaction (p = 0.09) were worse in irradiated patients. Median operative time was 67 (35–120) min, hospital stay 1 (1–3) days, and VAS for pain on postoperative day 1 was 0 (0–2). Complications presented in 14.7% (8.8% grade I and 5.9% grade III).

Conclusion

Treatment of severe male SUI after radical prostatectomy with pre-attached scrotal port ATOMS is safe and very effective in the short term. A positive cough test before implant and intraoperative overfilling of the system may optimize patient selection and results.

     

New perspectives on CKD-induced dyslipidemia

Introduction: Chronic kidney disease (CKD) is a world-wide health concern associated with a significantly higher cardiovascular morbidity and mortality. One of the principal cardiovascular risk factors is the lipid profile. CKD patients have a more frequent and progressive atheromatous disease that cannot be explained by the classical lipid parameters used in the daily clinical practice.

Areas covered: The current review summarizes prevailing knowledge on the role of lipids in atheromathosis in CKD patients, including an overview of lipoprotein metabolism highlighting the CKD-induced alterations. Moreover, to obtain information beyond traditional lipid parameters, new state-of-the-art technologies such as lipoprotein subfraction profiling and lipidomics are also reviewed. Finally, we analyse the potential of new lipoprotein subclasses as therapeutic targets in CKD.

Expert opinion: The CKD-induced lipid profile has specific features distinct from the general population. Besides quantitative alterations, renal patients have a plethora of qualitative lipid alterations that cannot be detected by routine determinations and are responsible for the excess of cardiovascular risk. New parameters, such as lipoprotein particle number and size, together with new biomarkers obtained by lipidomics will personalize the management of these patients. Therefore, nephrologists need to be aware of new insights into lipoprotein metabolism to improve cardiovascular risk assessment.     

An in-depth analysis shows a hidden atherogenic lipoprotein profile in non-diabetic chronic kidney disease patients

Background: Chronic kidney disease (CKD) is an independent risk factor for atherosclerotic disease. We hypothesized that CKD promotes a proatherogenic lipid profile modifying lipoprotein composition and particle number.

Methods: Cross-sectional study in 395 non-diabetic individuals (209 CKD patients and 186 controls) without statin therapy. Conventional lipid determinations were combined with advanced lipoprotein profiling by nuclear magnetic resonance, and their discrimination ability was assessed by machine learning.

Results: CKD patients showed an increase of very-low-density (VLDL) particles and a reduction of LDL particle size. Cholesterol and triglyceride content of VLDLs and intermediate-density (IDL) particles increased. However, low-density (LDL) and high-density (HDL) lipoproteins gained triglycerides and lost cholesterol. Total-Cholesterol, HDL-Cholesterol, LDL-Cholesterol, non-HDL-Cholesterol and Proprotein convertase subtilisin-kexin type (PCSK9) were negatively associated with CKD stages, whereas triglycerides, lipoprotein(a), remnant cholesterol, and the PCSK9/LDL-Cholesterol ratio were positively associated. PCSK9 was positively associated with total-Cholesterol, LDL-Cholesterol, LDL-triglycerides, LDL particle number, IDL-Cholesterol, and remnant cholesterol. Machine learning analysis by random forest revealed that new parameters have a higher discrimination ability to classify patients into the CKD group, compared to traditional parameters alone: area under the ROC curve (95% CI), .789 (.711, .853) vs .687 (.611, .755).

Conclusions: non-diabetic CKD patients have a hidden proatherogenic lipoprotein profile.     

Mitomicina C endovesical y fibrosis pulmonar

The Mitomycin C is a chemotherapeutic agent used in several types of carcinomas. In the superficial vesical carcinoma comes using since more than a quarter century in the form of endovesical instillations.It is a drug relatively safe, although there have been described adverse effects related to its systemic administration as myelosuppression, anaemia, kidney toxicity and less frequently pulmonary fibrosis.In this article we presented the case of a patient who suffers a respiratory illness compatible with interstitial lung disease that develops a respiratory severe insufficiency finishing with the death, after the administration of endovesical mitomycin C, being this adverse effect exceptional for this route of administration.     

Immunohistochemical analysis of BRAF V600E mutation in ameloblastomas

Clinical Oral Investigations - This study aimed to investigate the presence of BRAF V600E mutation in mandible ameloblastomas by correlating clinical and imaging data on the cases studied....