The MRI features of placental adhesion disorder – a pictorial review

Placental adhesion disorder (PAD) comprises placenta accreta, increta and percreta lesions, these are classified according to the depth of uterine invasion. Although PAD is considered a rare condition, its incidence has increased 10 fold in the last 50 years. Ultrasound is the primary imaging modality for assessment of the placenta, and in the majority of cases it is sufficient for diagnosis, however when ultrasound findings are suspicious or inconclusive, MRI is recommended as an adjunct imaging technique. Numerous MRI features of PAD have been described, including dark intra-placental bands, disorganised intra-placental vascularity and abnormal uterine bulging. This pictorial review describes and illustrates these characteristics and discusses their implications in planning delivery. In addition we present a series of ‘pitfall’ cases to aid the interpreting radiologist and discuss management of PAD. PAD is a clinical and diagnostic challenge that is encountered with increasing frequency requiring a cohesive multidisciplinary approach to its management

Testicular microlithiasis imaging and follow-up: guidelines of the ESUR scrotal imaging subcommittee

The subcommittee on scrotal imaging, appointed by the board of the European Society of Urogenital Radiology (ESUR), have produced guidelines on imaging and follow-up in testicular microlithiasis (TML)

Sonography of Scrotal Wall Lesions and Correlation With Other Modalities

The scrotal wall may be involved in a variety of pathologic processes. Such lesions may rise primarily from the layers of the scrotum or may be due to a process arising from scrotal content. Imaging is not needed in most cases, but it may be useful for making such differentiations and for evaluation of possible involvement of the testes and epididymides in cases of primary wall abnormalities. This pictorial essay will show the imaging findings observed in a variety of pathologic conditions affecting the scrotal wall, both common and unusual ones, with an emphasis on clinically relevant findings and features that lead to a specific diagnosis

Fludarabine, cytarabine, granulocyte colony-stimulating factor, and idarubicin with gemtuzumab ozogamicin improves event-free survival in younger patients with newly diagnosed aml and overall survival in patients with npm1 and flt3 mutations

Purpose To determine the optimal induction chemotherapy regimen for younger adults with newly diagnosed AML without known adverse risk cytogenetics. Patients and Methods One thousand thirty-three patients were randomly assigned to intensified (fludarabine, cytarabine, granulocyte colony-stimulating factor, and idarubicin [FLAG-Ida]) or standard (daunorubicin and Ara-C [DA]) induction chemotherapy, with one or two doses of gemtuzumab ozogamicin (GO). The primary end point was overall survival (OS). Results There was no difference in remission rate after two courses between FLAG-Ida + GO and DA + GO (complete remission [CR] + CR with incomplete hematologic recovery 93% v 91%) or in day 60 mortality (4.3% v 4.6%). There was no difference in OS (66% v 63%; P = .41); however, the risk of relapse was lower with FLAG-Ida + GO (24% v 41%; P < .001) and 3-year event-free survival was higher (57% v 45%; P < .001). In patients with an NPM1 mutation (30%), 3-year OS was significantly higher with FLAG-Ida + GO (82% v 64%; P = .005). NPM1 measurable residual disease (MRD) clearance was also greater, with 88% versus 77% becoming MRD-negative in peripheral blood after cycle 2 (P = .02). Three-year OS was also higher in patients with a FLT3 mutation (64% v 54%; P = .047). Fewer transplants were performed in patients receiving FLAG-Ida + GO (238 v 278; P = .02). There was no difference in outcome according to the number of GO doses, although NPM1 MRD clearance was higher with two doses in the DA arm. Patients with core binding factor AML treated with DA and one dose of GO had a 3-year OS of 96% with no survival benefit from FLAG-Ida + GO. Conclusion Overall, FLAG-Ida + GO significantly reduced relapse without improving OS. However, exploratory analyses show that patients with NPM1 and FLT3 mutations had substantial improvements in OS. By contrast, in patients with core binding factor AML, outcomes were excellent with DA + GO with no FLAG-Ida benefit

Valoración del cultivo de tilapia nilótica (Oreochromis niloticus) en agua salobre a diferentes densidades de siembra en estanques camaroneros, como alternativa de producción en la zona de Puerto Morazán, Chinandega, durante el período de agosto 2006-enero 2007

Estudio en el cual se valora el cultivo de tilapia nilótico en agua salobre en estanques camaroneros de la zona Granja Escuela CIDEA-UCA, como una alternativa de producción para la zona se estimaron los factores físico-químicos de la calidad del agua, se determinó la densidad de siembra más favorable y se estableció la rentabilidad económica del cultivo

Testicular microlithiasis imaging and follow-up: guidelines of the ESUR scrotal imaging subcommittee

Objectives: The subcommittee on scrotal imaging, appointed by the board of the European Society of Urogenital Radiology (ESUR), have produced guidelines on imaging and follow-up in testicular microlithiasis (TML).Methods: The authors and a superintendent university librarian independently performed a computer-assisted literature search of medical databases: MEDLINE and EMBASE. A further parallel literature search was made for the genetic conditions Klinefelter\ue2\u80\u99s syndrome and McCune-Albright syndrome.Results: Proposed guidelines are: follow-up is not advised in patients with isolated TML in the absence of risk factors (see Key Points below); annual ultrasound (US) is advised for patients with risk factors, up to the age of 55; if TML is found with a testicular mass, urgent referral to a specialist centre is advised.Conclusion: Consensus opinion of the scrotal subcommittee of the ESUR is that the presence of TML alone in the absence of other risk factors is not an indication for regular scrotal US, further US screening or biopsy. US is recommended in the follow-up of patients at risk, where risk factors other than microlithiasis are present. Risk factors are discussed and the literature and recommended guidelines are presented in this article.Key Points: \ue2\u80\ua2 Follow up advised only in patients with TML and additional risk factors.\ue2\u80\ua2 Annual US advised for patients with risk factors up to age 55.\ue2\u80\ua2 If TML is found with testicular mass, urgent specialist referral advised.\ue2\u80\ua2 Risk factors \ue2\u80\u93 personal/ family history of GCT, maldescent, orchidopexy, testicular atrophy