Ultrasound semiautomatic versus manual estimation of carotid intima-media thickness : reproducibility and cardiovascular risk stratification

Aims: Carotid intima-media thickness (CIMT) is used increasingly as an imaging biomarker of cardiovascular risk (CVR). Our aim was to compare semiautomatic CIMT (sCIMT) versus manual CIMT (mCIMT) for reproducibility and prediction of CVR. Materials and methods: Two independent readers measured sCIMT and mCIMT on previously acquired images of the right common carotid artery of 200 consecutive patients. Measurements were performed twice, four weeks apart; sCIMT was reported along with an image quality index (IQI) provided by the software. CVR stratification was compared for thresholds established by mCIMT studies, adapted for sCIMT according to a regression model. Results: sCIMT (median 0.67 mm, interquartile range [IQR] 0.57\u20120.76 mm) was significantly lower (p<0.001) than mCIMT (median 0.76 mm, IQR 0.63\u20120.84 mm; \u3c1=0.832, p<0.001, slope 0.714, intercept 0.124). Overall, intra-reader reproducibility was 76% for sCIMT and 83% for mCIMT (p=0.002), inter-reader reproducibility 75% and 76%, respectively (p=0.316). In 129 cases with IQI 650.65, reproducibility was significantly higher (p 640.004) for sCIMT than for mCIMT (intra-reader 85% versus 83%, inter-reader 80% versus 77%,). The agreement between sCIMT and mCIMT for CVR stratification was fair both overall (\u3ba=0.270) and for IQI 650.65 (\u3ba=0.345), crude concordance being 79% and 88%, respectively. Conclusions: Reproducibility of sCIMT was not higher than mCIMT overall but sCIMT was significantly more reproducible than mCIMT for high-IQI cases. sCIMT cannot be used for CVR stratification due to fair concordance with mCIMT, even for high IQI. More research is required to improve image quality and define sCIMT-based thresholds for stratification of CVR

Breast arterial calcifications as a biomarker of cardiovascular risk: radiologists' awareness, reporting, and action : a survey among the EUSOBI members

Objectives: To investigate the knowledge of radiologists on breast arterial calcifications (BAC) and attitude about BAC reporting, communication to women, and subsequent action. Methods: An online survey was offered to EUSOBI members, with 17 questions focused on demographics, level of experience, clinical setting, awareness of BAC association with cardiovascular risk, mammographic reporting, modality of BAC assessment, and action habits. Descriptive statistics were used. Results: Among 1084 EUSOBI members, 378 (34.9%) responded to the survey, 361/378 (95.5%) radiologists, 263 females (69.6%), 112 males (29.6%), and 3 (0.8%) who did not specify their gender. Of 378 respondents, 305 (80.7%) declared to be aware of BAC meaning in terms of cardiovascular risk and 234 (61.9%) to routinely include BAC in mammogram reports, when detected. Excluding one inconsistent answer, simple annotation of BAC presence was declared by 151/233 (64.8%), distinction between low versus extensive BAC burden by 59/233 (25.3%), and usage of an ordinal scale by 22/233 (9.5%) and of a cardinal scale by 1/233 (0.4%). Among these 233 radiologists reporting BAC, 106 (45.5%) declared to orally inform the woman and, in case of severe BAC burden, 103 (44.2%) to investigate cardiovascular history, and 92 (39.5%) to refer the woman to a cardiologist. Conclusion: Among EUSOBI respondents, over 80% declared to be aware of BAC cardiovascular meaning and over 60% to include BAC in the report. Qualitative BAC assessment predominates. About 40% of respondents who report on BAC, in the case of severe BAC burden, investigate cardiovascular history and/or refer the woman to a cardiologist

A NEW CASE OF LOUSE-BORNE RELAPSING FEVER IN SICILY: CASE REPORT AND MINI REVIEW

Body lice transport B. recurrentis from man to man and humans are the only host. The presence of lice in Italy and an increasing number of cases in migrants can contribute to the onset of autochthonous cases. In this paper, we report a new case of Louse-borne Relapsing Fever (LBRF) diagnosed among migrants in Sicily exactly one year after the first case was recorded. We reviewed all cases reported in Europe from February 2016 until now. Our study identified two new cases of LBRF in migrants arrived in Europe: one who came from Somalia and one from Mali. Here we report data on a new case in Sicily. The number of migrants and refugees to transit in Sicily has increased, and this has led to the introduction of infectious diseases. Therefore, in our opinion it is essential to upgrade control of the sanitation conditions of migrants