Costs and effectiveness of a brief MRI examination of patients with acute knee injury

The aim of this study was to assess the costs and effectiveness of selective short magnetic resonance imaging (MRI) in patients with acute knee injury. A model was developed to evaluate the selective use of MRI in patients with acute knee injury and no fracture on radiography based on the results of a trial in which 208 patients were randomized between radiography only and radiography plus MRI. We analyzed medical (diagnostic and therapeutic) costs, quality of life, duration of diagnostic workup, number of additional diagnostic examinations, time absent from work, and time to convalescence during a 6-month follow-up period. Quality of life was lowest (EuroQol at 6 weeks 0.61 (95% CI 0.54–0.67)); duration of diagnostic workup, absence from work, and time to convalescence were longest; and the number of diagnostic examinations was largest with radiography only. These outcomes were more favorable for both MRI strategies (EuroQol at 6 weeks 0.72 (95% CI 0.67–0.77) for both). Mean total costs were 2,593 euros (95% CI 1,815–3,372) with radiography only, 2,116 euros (95% CI 1,488–2,743) with radiography plus MRI, and 1,973 euros (95% CI 1,401–2,543) with selective MRI. The results suggest that selective use of a short MRI examination saves costs and potentially increases effectiveness in patients with acute knee injury without a fracture on radiography

La plastisphère des eaux continentales.

International audienc

Freshwater Perkinsea: diversity, ecology and genomic information

International audienc

MR imaging field strength: prospective evaluation of the diagnostic accuracy of MR for diagnosis of multiple sclerosis at 0.5 and 1.5 T.

PURPOSE: To compare the diagnostic efficacy of middle-field-strength and high-field-strength magnetic resonance (MR) imaging in diagnosis of multiple sclerosis. MATERIALS AND METHODS: One hundred thirty-two patients with suspected multiple sclerosis underwent MR imaging at 0.5 and 1.5 T. Imaging parameters were identical except for band width optimization at middle field strength. Images were interpreted by radiologists expert in MR imaging who were blinded to diagnosis and field strength. The diagnosis of multiple sclerosis was made by experienced neurologists, and indeterminate cases and patients without clinical evidence of multiple sclerosis were followed up for 6 months to 1 year. RESULTS: There was no difference in accuracy, sensitivity, or specificity between scanners in the diagnosis of multiple sclerosis or white matter disease. Equal numbers of lesions were detected at both field strengths in all parts of the brain. Image quality was always good or adequate at middle field strength. CONCLUSION: Higher field strength does not confer higher accuracy in the diagnosis of multiple sclerosis with current-generation MR imagers

Analysis of metagenomic data reveals common features of halophilic viral communities across continents

Microbial communities from hypersaline ponds, dominated by halophilic archaea, are considered specific of such extreme conditions. The associated viral communities have accordingly been shown to display specific features, such as similar morphologies among different sites. However, little is known about the genetic diversity of these halophilic viral communities across the Earth. Here, we studied viral communities in hypersaline ponds sampled on the coast of Senegal (8-36% of salinity) using metagenomics approach, and compared them with hypersaline viromes from Australia and Spain. The specificity of hyperhalophilic viruses could first be demonstrated at a community scale, salinity being a strong discriminating factor between communities. For the major viral group detected in all samples (Caudovirales), only a limited number of halophilic Caudovirales clades were highlighted. These clades gather viruses from different continents and display consistent genetic composition, indicating that they represent related lineages with a worldwide distribution. Non-tailed hyperhalophilic viruses display a greater rate of gene transfer and recombination, with uncharacterized genes conserved across different kind of viruses and plasmids. Thus, hypersaline viral communities around the world appear to form a genetically consistent community that are likely to harbour new genes coding for enzymes specifically adapted to these environments