Abbreviated Biparametric Prostate MR Imaging in Men with Elevated Prostate-specific Antigen

Purpose: To determine the diagnostic accuracy for clinically significant prostate cancer achieved with abbreviated biparametric prostate magnetic resonance (MR) imaging in comparison with full multiparametric contrast material-enhanced prostate MR imaging in men with elevated prostatespecific antigen (PSA) and negative transrectal ultrasonography (US)guided biopsy findings; to determine the significant cancer detection rate of biparametric versus full multiparametric contrast-enhanced MR imaging and between-reader agreement for interpretation of biparametric MR imaging. Materials and Methods: In this institutional review board-approved retrospective review of prospectively acquired data, men with PSA greater than or equal to 3 ng/mL after negative transrectal US-guided biopsy findings underwent state-of-the-art, full multiparametric contrast-enhanced MR imaging at 3.0-T including high-spatial-resolution structural imaging in several planes, diffusion-weighted imaging at 0, 800, 1000, and 1400 mm(2)/ sec, and dynamic contrast-enhanced MR imaging, obtained without endorectal coil within 34 minutes 19 seconds. One of four radiologists with different levels of expertise (1-9 years) first reviewed only a fraction of the full multiparametric contrast-enhanced MR images, consisting of single-plane (axial) structural imaging (T2-weighted turbo spin-echo and diffusion-weighted imaging), acquired within 8 minutes 45 seconds (referred to as biparametric MR imaging), and established a diagnosis according to the Prostate Imaging Reporting and Data System (PI-RADS) version 2; only thereafter, the remaining full multiparametric contrast-enhanced MR images were read. Men with PI-RADS categories 3-5 underwent MR-guided targeted biopsy. Men with PI-RADS categories 1-2 remained in urologic follow-up for at least 2 years, with rebiopsy (transrectal US-guided or transperineal saturation) where appropriate. McNemar test was used to compare diagnostic accuracies. To investigate between-reader agreement, biparametric MR images of 100 patients were read independently by all three radiologists. Results: A total of 542 men, aged 64.8 years 6 8.2 (median PSA, 7 ng/mL), were included. Biparametric MR imaging helped detect clinically significant prostate cancer in 138 men. Full multiparametric contrastenhanced MR imaging allowed detection of one additional clinically significant prostate cancer (a stage pT2a, intermediate-risk cancer with a Gleason score of 3+ 4) and caused 11 additional false-positive diagnoses. Diagnostic accuracy for detection of clinically significant cancer of biparametric MR imaging (89.1%, 483 of 542) was similar to that of full multiparametric contrast-enhanced MR imaging (87.2%, 473 of 542). Between-reader agreement of biparametric MR imaging interpretation was substantial (k = 0.81). Conclusion: Biparametric MR imaging allows detection of clinically significant prostate cancer missed by transrectal US-guided biopsy. Biparametric prostate MR imaging takes less than 9 minutes examination time, works without contrast agent injection, and offers a diagnostic accuracy and cancer detection rate that are equivalent to those of conventional full multiparametric contrast-enhanced MR imaging protocols. (C) RSNA, 201

Factors associated to cases of Brazilian Spotted Fever, Minas Gerais, 1995- 2002

ABSTRACT. Calic S.B., Rocha C.M.B.M, Bruhn F.R.P., Barros R.A. & Leite R.C. [Factors associated to cases of Brazilian Spotted Fever, Minas Gerais, 1995- 2002.] Fatores associados aos casos de Febre Maculosa Brasileira frente aos suspeitos não confirmados, Minas Gerais, 1995 a 2002. Revista Brasileira de Medicina Veterinária, 37(3):239-244, 2015. Instituto Otávio Magalhães, Fundação Ezequiel Dias, Rua Conde Pereira Carneiro, 80, Gameleira, Belo Horizonte, MG 30510- 010, Brasil. E-mail: [email protected] The aim of this study was to evaluate factors and symptoms associated with confirmed cases of FMB in Minas Gerais. For this, was conducted a retrospective study using epidemiological records received by the Central Laboratory (LACEN) of MG in the period 1995-2002. Cases were suspected patients after clinical and epidemiological assessment for BSF and seropositive for Rickettsia ricketsii (IFAT 1:64) in at least one serum sample. As negative suspects were those that have no seroconversion in two consecutive samples to BSF. After adjustment of multiple logistic regression analysis, only the occurrence of rash and seizures were associated with symptoms FMB. Using analysis of main components symptoms that characterized the cases were: rash, convulsions and coma. Moreover cases have a high relation with hospitalization and lack of similar cases. The FMB in Minas Gerais is a serious disease and need early diagnosis

Epidemiologia de micoses, pitiose e micotoxicoses em equinos no sudeste do Rio Grande do Sul

RESUMO: Descrevem-se os aspectos epidemiológicos das doenças causadas por fungos e oomicetos na população de equinos na região sudeste do Rio Grande do Sul, estabelecendo as taxas epidemiológicas, suas causas e sua importância sanitária na região. Foi realizada a epidemiologia descritiva por meio do cálculo da incidência das doenças encontradas ao longo dos anos e verificada a existência de associação entre a ocorrência dessas enfermidades e o sexo, a raça e a estação do ano. Entre os anos de 1978 e 2014 a pitiose teve prevalência de 49,71% (86/173), as micotoxicoses 30,05% (52/173), sendo 45 casos de leucoencefalomalácia e sete de ergotismo. As micoses tiveram prevalência de 19,65% (34/173), sendo as dermatofitoses as mais prevalentes com 58,82% (20/34) dos casos. As espécies de dermatófitos mais frequentemente isoladas foram Trichophyton mentagrophytes 60% (12/20), Trichophyton equinum 25% (5/20) e Microsporum gypseum, Microsporum canis e Trichophyton verrucosum ambos responsáveis por 5% (1/20) das infecções. Rinosporidiose foi diagnosticada em 35,29% (12/34) dos casos. Micoses uterinas causadas por Candida albicans e Cryptococcus laurentii foram observadas em 5,88% (2/34) dos casos. Alergia por Cladosporium sp. teve um registro. De acordo com as incidências calculadas entre 1990 e 2014 a pitiose teve incidência mediana (IM) 2,98 e distância interquartil (DI) =3,82, as fêmeas tiveram chance 4,18 vezes maiores de desenvolver a doença, a enfermidade ocorre independente das estações climáticas. A leucoencefalomalácia teve IM=0,0; DI 1,00 e equinos machos tiveram 3,4 vezes mais chance de desenvolver a doença que fêmeas, no inverno a possibilidade de ocorrência dessa enfermidade foi seis vezes maior. O ergotismo teve IM = 0,00; DI = 0,000, rinosporidiose IM=0,00; DI=0,088 e dermatofitose IM=0,00; DI=0,935. A pitiose foi mais prevalente entre as doenças encontradas, podendo ser considerada endêmica na região. Considera-se que a magnitude das doenças possa ser ainda maior dentro do rebanho equino, uma vez que as doenças descritas não são de notificação obrigatória e algumas são bem conhecidas por veterinários e proprietários, que muitas vezes não fazem a confirmação laboratorial do diagnóstico