Correlation of magnetic resonance imaging findings with arthroscopy in the evaluation of rotator cuff pathology

Objective: The purpose of this study was to compare the accuracy of magnetic resonance imaging in clinically diagnosed rotator cuff disease based upon the radiologist’s interpretation with actual intraoperative arthroscopic findings being used as the reference standard in a Kenyan outpatient practice.Design: This was a retrospective cohort study.Setting: The study was carried out at Plaza Advanced Imaging Centre over a period of one year from December 2011 to November 2012.Methods: Using the University of Nairobi and Kenyatta National Hospital Ethics Committee approved protocol medical records of thirty four randomly selected consecutive patients with shoulder pain were evaluated. The records of these patients were reviewed to determine the demographics, radiologists MRI interpretations, and the surgeon’s operative findings.Results: Thirty four (79%) patients out of the targeted sample size of 43 were successfully evaluated with an aim of establishing the accuracy and sensitivity of MRI in the diagnosis of rotator cuff pathology in relation to arthroscopic findings. Twenty one (62%) of the patients were male, while the female patientss were 13 (38%).Conclusions: In the present study the sensitivity of MRI in diagnosing of rotator cuff pathology was low but the specificity was high. This means that MRI missed a number of lesions, but of those that were picked the specificity was high. Given the relatively low sensitivity findings of the study compared to previous studies done elsewhere there is need to have a trained dedicated musculoskeletal radiologist. However, there exists a significant correlation between the diagnoses made under MRI and arthroscopy.Results from this study will serve as a useful guide to orthopaedic surgeons in planning the management pathway for patients with rotator cuff pathology and will also highlight areas in need of improving interpretation skills and imaging protocols for radiologists in the country

Exploiting disorder for perfect focusing

We demonstrate experimentally that disordered scattering can be used to improve, rather than deteriorate, the focusing resolution of a lens. By using wavefront shaping to compensate for scattering, light was focused to a spot as small as one tenth of the diffraction limit of the lens. We show both experimentally and theoretically that it is the scattering medium, rather than the lens, that determines the width of the focus. Despite the disordered propagation of the light, the profile of the focus was always exactly equal to the theoretical best focus that we derived.Comment: 4 pages, 4 figure

Economic burden of disease of uncontrolled acromegalic patients : the acromegaly Italian collaborative study group

Background: Acromegaly is a rare, serious and disabling disease associated with increased mortality if not properly treated. The objective of this study was to estimate indirect and direct costs associated to uncontrolled acromegalic patients in Italy. Methods: a specific questionnaire was developed in order to obtain specific information from the patient perspective and administrated to subsequent patients treated in 17 Italian endocrinology centres. Indirect cost from patients and caregivers perspective were estimated considering the Human Capital Approach while direct cost were evaluated considering the patients perspective. assuming that our sample were representative of the general uncontrolled acromegalic patients. Results: 86 patients were enrolled in the study and complete the questionnaire. Of these 51.16% were employed, 23.26% were unemployed for reasons unrelated to the illness, 8,14% were unemployed due to the illness and 17.44% were inactive. The total costs per patient amounted to about € 3,832 per year, of which 5.1% are mobility costs, while the indirect costs come to € 7.7 million, of which 45.7% is due to illness-related to unemployment. Conclusions: To our knowledge, this study represents the first attempt to quantify the costs of uncontrolled acromegalic patients in Italy

Simulational study of anomalous tracer diffusion in hydrogels

In this article, we analyze different factors that affect the diffusion behavior of small tracer particles (as they are used e.g.in fluorescence correlation spectroscopy (FCS)) in the polymer network of a hydrogel and perform simulations of various simplified models. We observe, that under certain circumstances the attraction of a tracer particle to the polymer network strands might cause subdiffusive behavior on intermediate time scales. In theory, this behavior could be employed to examine the network structure and swelling behavior of weakly crosslinked hydrogels with the help of FCS.Comment: 11 pages, 11 figure

The Hydration Structure at Yttria-Stabilized Cubic Zirconia (110)-Water Interface with Sub-Angstrom Resolution

The interfacial hydration structure of yttria-stabilized cubic zirconia (110) surface in contact with water was determined with ~0.5 Å resolution by high-resolution X-ray reflectivity measurement. The terminal layer shows a reduced electron density compared to the following substrate lattice layers, which indicates there are additional defects generated by metal depletion as well as intrinsic oxygen vacancies, both of which are apparently filled by water species. Above this top surface layer, two additional adsorbed layers are observed forming a characteristic interfacial hydration structure. The first adsorbed layer shows abnormally high density as pure water and likely includes metal species, whereas the second layer consists of pure water. The observed interfacial hydration structure seems responsible for local equilibration of the defective surface in water and eventually regulating the long-term degradation processes. The multitude of water interactions with the zirconia surface results in the complex but highly ordered interfacial structure constituting the reaction front.ope

Intra-anal imiquimod cream against human papillomavirus infection in men who have sex with men living with hiv: A single-arm, open-label pilot study

Men who have sex with men (MSM) living with HIV have a high prevalence and incidence of anal high-risk human papillomavirus (hrHPV) and anal cancer. We conducted an open-label, single-arm pilot study to examine the tolerability of imiquimod cream among MSM aged ≥18 years, living with HIV, who tested positive for anal hrHPV at Melbourne Sexual Health Centre between April 2018 and June 2020. We instructed men to apply 6.25 mg imiquimod intra-anally and peri-anally 3 doses per week for 16 weeks (period 1) and then one dose per week for a further 48 weeks (period 2). Twenty-seven MSM enrolled in period 1 and 24 (86%) applied at least 50% of doses. All men reported adverse events (AEs), including 39.5% grade 1, 39.5% grade 2, and 21% grade 3 AEs on at least one occasion. Eighteen MSM (67%) temporarily stopped using imiquimod during period 1, most commonly due to local AEs (n = 11) such as irritation and itching. Eighteen MSM continued in period 2 and all applied at least 50% of doses with no treatment-limiting AEs reported. Imiquimod 3 doses per week caused local AEs in most men and was not well tolerated. In contrast, once-a-week application was well tolerated over 48-weeks with no treatment-limiting AEs

Absence of diabetic retinopathy in a patient who has had diabetes mellitus for 69 years, and inadequate glycemic control: case presentation

The main risk factors for the development and progression of diabetic retinopathy (DR) are chronic hyperglycemia, disease duration and systemic blood pressure. So far chronic hyperglycemia is the strongest evidence concerning the risk of developing DR. However there are some patients with poor metabolic control who never develop this diabetic complication. We present a case of a 73-year-old woman with type 1 diabetes mellitus, diagnosed 69 years ago. The patient is 73 years old, with no evidence of DR, despite poor glycemic control and several risk factors for DR. This case suggests the presence of a possible protection factor, which could be genetic