Clinical Application of the New Prostate Imaging for Recurrence Reporting (PI-RR) Score Proposed to Evaluate the Local Recurrence of Prostate Cancer after Radical Prostatectomy

Simple Summary The aim of the new Prostate Imaging for Recurrence Reporting (PI-RR) is a standardization in reporting to assess the likelihood of relapse after radical prostatectomy. Our study documented an excellent inter-observer agreement in recurrence reporting when using the PI-RR score, demonstrating a wide reproducibility, thus supporting the wide use of the PI-RR score in the clinical practice. The diagnostic accuracy was 68.4%, with the detection rate influenced by the PSA values. Overall, the PI-RR score globally showed a higher detection rate than PET/CT scans for local recurrence. Background: We investigated the diagnostic accuracy of the new Prostate Imaging for Recurrence Reporting (PI-RR) score and its inter-observer variability. Secondly, we compared the detection rate of PI-RR and PET and analyzed the correlation between Prostate Specific Antigen (PSA) levels and the PI-RR score. Methods: We included in the analysis 134 patients submitted to multiparametric magnetic resonance imaging for suspected local recurrence. The images were independently reviewed by two radiologists, assigning a value from 1 to 5 to the PI-RR score. Inter-observer agreement and diagnostic accuracy of the PI-RR score (compared to histopathological data, available for 19 patients) were calculated. The detection rate was compared to those of choline PET/CT (46 patients) and PSMA PET/CT (22 patients). The distribution of the PSA values in relation to the PI-RR scores was also analyzed. Results: The accuracy of the PI-RR score was 68.4%. The reporting agreement was excellent (K = 0.884, p < 0.001). The PI-RR showed a higher detection rate than choline PET/CT (69.6% versus 19.6%) and PSMA PET-CT (59.1% versus 22.7%). The analysis of the PSA distribution documented an increase in the PI-RR score as the PSA value increased. Conclusion: The excellent reproducibility of the PI-RR score supports its wide use in the clinical practice to standardize recurrence reporting. The detection rate of PI-RR was superior to that of PET, but was linked to the PSA level

Healthcare-associated respiratory infections in intensive care unit can be reduced by a hand hygiene program: A multicenter study

Purpose: Healthcare-associated respiratory tract infections are common and markedly affecting the quality of life and mortality, as well as increasing costs for health systems due to prolonged hospitalisation. This study aimed to assess the change in both level and trend of respiratory tract infections after a specific hand hygiene program for intensive care unit (ICU) staff. Materials and methods: The infection data collection was carried out from January 2013 to August 2014. The hand hygiene program started in December 2013. To analyse the change in level and trend of infections after the intervention, the Interrupted Time Series method was used. Chi-square test was used to compare the incidence of respiratory tract infections before and after the intervention. Results: A total of 825 patients were hospitalised in three Italian ICUs. The infection level was significantly decreased by 36.3 infections per 1000 device-days after the intervention. The infection trend was also decreased of about 1 infection per month. Conclusions: After the hand hygiene program a decreased level of infection was found. Continuous performance feedback should be provided to promote a long-term adherence to the guidelines. Organisational and individual risk factors must be individuated and correctly managed to increase quality of practice

Diagnostic Accuracy of North America Expert Consensus Statement on Reporting CT Findings in Patients Suspected of Having COVID-19 Infection: An Italian Single-Center Experience

Purpose: To evaluate the diagnostic accuracy of the four standardized categories for CT reporting proposed by the Radiological Society of North America (RSNA) to support a faster triage compared with real-time reverse-transcription polymerase chain reaction (RTPCR), which is the reference standard for suspected coronavirus disease 2019 (COVID-19), but has long reporting time (6\u201348 hours). Materials and Methods: A retrospective analysis of 569 thin-section CT examinations performed for patients suspected of having COVID-19 from February 27 to March 27, 2020 (peak of infection in Italy) was conducted. The imaging pattern was classified according to the statement by the RSNA as \u201ctypical,\u201d \u201cindeterminate,\u201d \u201catypical,\u201d and \u201cnegative\u201d and compared with RT-PCR for 460 patients. Interobserver variability in reporting between a senior and a junior radiologist was evaluated. Use of the vascular enlargement sign in indeterminate cases was also assessed. Results: The diagnosis of COVID-19 was made in 45.9% (211/460) of patients. The \u201ctypical\u201d pattern (n = 172) showed a sensitivity of 71.6%, a specificity of 91.6%, and a positive predictive value of 87.8% for COVID-19. The \u201catypical\u201d (n = 67) and \u201cnegative\u201d (n =123) pattern demonstrated a positive predictive value of 89.6% and 86.2% for non\u2013COVID-19, respectively. The \u201cindeterminate\u201d (n = 98) pattern was nonspecific, but vascular enlargement was most frequently found in patients with COVID-19 (86.1%; P , .001). Interobserver agreement was good for the \u201ctypical\u201d and \u201cnegative\u201d pattern and fair for \u201cindeterminate\u201d and \u201catypical\u201d (k = 0.5; P =.002). Conclusion: In an epidemic setting, the application of the four categories proposed by the RSNA provides a standardized diagnostic hypothesis, strongly linked to the RT-PCR results for the \u201ctypical,\u201d \u201catypical,\u201d and \u201cnegative\u201d pattern. In the \u201cindeterminate\u201d pattern, the analysis of the vascular enlargement sign could facilitate the interpretation of imaging features

Asthma in patients admitted to emergency department for COVID-19: prevalence and risk of hospitalization

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