Diagnostic value of qualitative and strain ratio elastography in the differential diagnosis of non-palpable testicular lesions

The purpose of this study was to evaluate prospectively the accuracy of qualitative and strain ratio elastography (SE) in the differential diagnosis of non-palpable testicular lesions. The local review board approved the protocol and all patients gave their consent. One hundred and six patients with non-palpable testicular lesions were consecutively enrolled. Baseline ultrasonography (US) and SE were correlated with clinical and histological features and ROC curves developed for diagnostic accuracy. The non-palpable lesions were all ≤1.5 cm; 37/106 (34.9%) were malignant, 38 (35.9%) were benign, and 31 (29.2%) were non-neoplastic. Independent risk factors for malignancy were as follows: size (OR 17.788; p = 0.002), microlithiasis (OR 17.673, p < 0.001), intralesional vascularization (OR 9.207, p = 0.006), and hypoechogenicity (OR, 11.509, p = 0.036). Baseline US had 89.2% sensitivity (95% CI 74.6-97.0) and 85.5% specificity (95% CI 75.0-92.8) in identifying malignancies, and 94.6% sensitivity (95% CI 86.9-98.5) and 87.1% specificity (95% CI 70.2-96.4) in discriminating neoplasms from non-neoplastic lesions. An elasticity score (ES) of 3 out of 3 (ES3, maximum hardness) was recorded in 30/37 (81.1%) malignant lesions (p < 0.001). An intermediate score of 2 (ES2) was recorded in 19/38 (36.8%) benign neoplastic lesions and in 22/31 (71%) non-neoplastic lesions (p = 0.005 and p = 0.001 vs. malignancies). None of the non-neoplastic lesions scored ES3. Logistic regression analysis revealed a significant association between ES3 and malignancy (χ2 = 42.212, p < 0.001). ES1 and ES2 were predictors of benignity (p < 0.01). Overall, SE was 81.8% sensitive (95% CI 64.8-92.0) and 79.1% specific (95% CI 68.3-88.4) in identifying malignancies, and 58.6% sensitive (95% CI 46.7-69.9) and 100% specific (95% CI 88.8-100) in discriminating non-neoplastic lesions. Strain ratio measurement did not improve the accuracy of qualitative elastography. Strain ratio measurement offers no improvement over elastographic qualitative assessment of testicular lesions; testicular SE may support conventional US in identifying non-neoplastic lesions when findings are controversial, but its added value in clinical practice remains to be proven

Characterization of circulating blood dendritic cell subsets DC123+ (lymphoid) and DC11C+ (myeloid) in prostate adenocarcinoma patients

PURPOSE. We verified whether prostate adenocarcinoma produces specific modifications in DC subsets count. METHODS. Twenty-one untreated prostate adenocarcinomas were divided on the basis of clinical stage in localized and metastatic disease. As control we used a population of 18 healthy male subjects. For DCs enumeration, peripheral blood (PB) samples were obtained in all cases. A single-platform flow cytometric assay based on Tru-COUNT was used for the enumeration of the two DCs subsets, myeloid (mDCs) and plasmacytoid (pDCs). RESULTS. We showed a statistically significant reduction in pDCs count in prostate cancer population when compared to healthy controls (P = 0.002). Comparing each clinical stage with healthy controls, significant differences were found between controls and the metastatic group in both pDCs and mDCs (P = 0.005 and P = 0.023 respectively) but not between controls and the localized group (P = 0.055 and P = 0.829 respectively). CONCLUSIONS. We showed that DCs count in PB is significantly affected by prostate adenocarcinoma progression in a metastatic disease. © 2006 Wiley-Liss, Inc

Diabetic cardiomiopathy progression is triggered by miR122-5p and involves extracellular matrix: a 5-year prospective study

The purpose of this study was to follow the long-term progression of diabetic cardiomyopathy by combining cardiac magnetic resonance (CMR) and molecular analysis

Osteossarcoma apendicular em um felino

Tumores ósseos primários são raros em felinos, afetando gatos adultos ou idosos e com predileção pelo esqueleto apendicular. Nesta espécie, o índice de desenvolvimento de metástases é baixo e a amputação é um método eficaz de tratamento. A proposta deste trabalho é relatar um caso de osteossarcoma apendicular em um felino, sem raça definida, fêmea, de 16 anos de idade, apresentando aumento de volume na porção distal do úmero do membro anterior direito. Ao exame físico, o paciente apresentava claudicação e encontrava-se ativo e em bom estado nutricional. Foi solicitado hemograma completo, perfil bioquímico e avaliação radiológica do tórax e do membro afetado. Os valores de fosfatase alcalina (FA) e uréia encontravam-se aumentados. Os exames radiográficos indicaram imagem sugestiva de tumor ósseo, com presença de lise e perda da continuidade óssea do membro e as radiografia s torácicas não a presentara mi magens compatíveis com metástase s pul monares.O paciente foi es tabiliza do e encaminha do para o centro cirú rg ico par a realizaç ão de escapulectomia e posterior te ra pia comc arbopl atina. O animal demonstrou boa recuperação pós-cirúrgica e leve toxicidade re lacionada à quimiotera pia com linfopenia e emese

Uso do 5-Fluorouracil associado à cirurgia como terapêutica para o carcinoma de células escamosas em cães

O carcinoma de células escamosas ou carcinoma epidermóide é uma neoplasia maligna de origem epidérmica. O 5-fluorouracil é um agente antineoplásico comumente administrado pela via parenteral, também sendo descrito seu uso tópico em humanos. Este trabalho relata dois casos de carcinoma de células escamosas em cães que apresentavam nódulos na região abdominal ventral. Em ambos os casos, os animais foram submetidos à quimioterapia antineoplásica neoadjuvante com 5-fluorouracil, para reduzir o tamanho dos nódulos e facilitar a exérese dos mesmos. Em um dos pacientes, utilizou-se 5-fluorouracil pomada como tratamento local e, em outro, foi feita a administração por via endovenosa. Em ambos os casos, ocorreu remissão parcial dos tumores, a qual viabilizou a realização da cirurgia com maiores margens de segurança. Este estudo demonstra que o uso de 5-fluorouracil em cães é um procedimento seguro, devendo ser considerado em casos de tumores avançados, nos quais a cirurgia imediata não é possível

Schemi di semeiotica urologica

Nel capitolo vengono analizzati in dettaglio ed in modo organico i principi della semeiotica applicata alla patologie urologich