Hypovitaminosis D in recent onset rheumatoid arthritis is predictive of reduced response to treatment and increased disease activity: a 12 month follow-up study.

BACKGROUND: Vitamin D displays immunomodulatory activities and has been proposed as a potential player in the pathogenesis of rheumatoid arthritis (RA). A negative association between serum 25(OH) vitamin D levels and RA activity was demonstrated but longitudinal studies investigating the role of vitamin D levels in predicting RA activity and response to treatment are lacking. Therefore, this study was designed to test the hypothesis of an association between serum 25(OH) vitamin D levels at RA diagnosis and disease activity evaluated by clinimetric, laboratory and ultrasound (US) parameters and to detect the prevalence of remission and response to treatment after 12 months follow-up. METHODS: This is a longitudinal, retrospective study on data obtained from thirty-seven patients with early RA treatment-naïve. Serum inflammatory markers, auto-antibodies and 25(OH) vitamin D levels were obtained at baseline. Hypovitaminosis D was diagnosed for 25(OH) vitamin D levels < 20 ng/ml. Tender joint count (TJCs), swollen joint count (SJCs), Visual Analog Scales (VAS), Disease Activity Score (DAS) 28 score were assessed at baseline and 12 months after diagnosis. Joints synovitis and power-Doppler were evaluated at baseline and 12 months later. RESULTS: At baseline mean 25(OH) vitamin D levels were 24.4 ± 11.9 ng/ml; 35% of study subjects had hypovitaminosis D which strongly associated with higher RA activity and lower prevalence of remission and response to treatment (all p-values < 0.001). The percentage of patients not presenting a reduction of the US synovitis score after 12 months from diagnosis was significantly higher among patients with hypovitaminosis D than in those with normal serum 25(OH) vitamin D at baseline. CONCLUSIONS: In patients with early RA and basal hypovitaminosis D after 12 months follow-up reduction of disease activity and percentage of remission and response to treatment were significantly lower than those observed in patients with normal vitamin D levels. These results provide further support to the immunomodulatory action of vitamin D in RA and suggest a role of basal vitamin D status in the prediction of disease evolution. Vitamin D measurement and possibly vitamin D supplementation should be considered an additional option in the management of early RA patients

Chest CT Features of COVID-19 in Rome, Italy

Background The standard for diagnosis of SARS-CoV-2 virus is reverse transcription polymerase chain reaction (RT-PCR) test, but chest CT may play a complimentary role in the early detection of COVID-19 pneumonia. Purpose To investigate CT features of patients with COVID-19 in Rome, Italy, and to compare the accuracy of CT with RT-PCR. Methods In this prospective study from March 4, 2020, until March 19, 2020, consecutive patients with suspected COVID-19 infection and respiratory symptoms were enrolled. Exclusion criteria were: chest CT with contrast medium performed for vascular indications, patients who refused chest CT or hospitalization, and severe CT motion artifact. All patients underwent RT-PCR and chest CT. Diagnostic performance of CT was calculated using RT-PCR as reference. Chest CT features were calculated in a subgroup of RT-PCR-positive and CT-positive patients. CT features of hospitalized patients and patient in home isolation were compared by using Pearson chi squared test. Results Our study population comprised 158 consecutive study participants (83 male and 75 female, mean age 57 y ±17). Fever was observed in 97/158 (61%), cough in 88/158 (56%), dyspnea in 52/158 (33%), lymphocytopenia in 95/158 (60%), increased C-reactive protein level in 139/158 (88%), and elevated lactate dehydrogenase in 128/158 (81%) study participants. Sensitivity, specificity, and accuracy of CT were 97% (60/62)[95% IC, 88-99%], 56% (54/96)[95% IC,45-66%] and 72% (114/158)[95% IC 64-78%], respectively. In the subgroup of RT-PCR-positive and CT-positive patients, ground-glass opacities (GGO) were present in 58/58 (100%), multilobe and posterior involvement were both present in 54/58 (93%), bilateral pneumonia in 53/58 (91%), and subsegmental vessel enlargement (&gt; 3 mm) in 52/58 (89%) of study participants. Conclusion The typical pattern of COVID-19 pneumonia in Rome, Italy, was peripherally ground-glass opacities with multilobe and posterior involvement, bilateral distribution, and subsegmental vessel enlargement (&gt; 3 mm). Chest CT sensitivity was high (97%) but with lower specificity (56%)

Radiomics analysis in gastrointestinal imaging: a narrative review

Background and Objective: To present an overview of radiomics radiological applications in major gastrointestinal oncological non-oncologic diseases, such as colorectal cancer, pancreatic cancer, gastro- oesophageal cancer, gastrointestinal stromal tumor (GIST), hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), and non-oncologic diseases, such as liver fibrosis, nonalcoholic steatohepatitis, and inflammatory bowel disease. Methods: A search of PubMed databases was performed for the terms “radiomic”, “radiomics”, “liver”, “small bowel”, “colon”, “GI tract”, and “gastrointestinal imaging” for English articles published between January 2013 and July 2022. A narrative review was undertaken to summarize literature pertaining to application of radiomics in major oncological and non-oncological gastrointestinal diseases. The strengths and limitation of radiomics, as well as advantages and major limitations and providing considerations for future development of radiomics were discussed. Key Content and Findings: Radiomics consists in extracting and analyzing a vast amount of quantitative features from medical datasets, Radiomics refers to the extraction and analysis of large amounts of quantitative features from medical images. The extraction of these data, integrated with clinical data, allows the construction of descriptive and predictive models that can build disease-specific radiomic signatures. Texture analysis has emerged as one of the most important biomarkers able to assess tumor heterogeneity and can provide microscopic image information that cannot be identified with the naked eye by radiologists. Conclusions: Radiomics and texture analysis are currently under active investigation in several institutions worldwide, this approach is being tested in a multitude of anatomical areas and diseases, with the final aim to exploit personalized medicine in diagnosis, treatment planning, and prediction of outcomes. Despite promising initial results, the implementation of radiomics is still hampered by some limitations related to the lack of standardization and validation of image acquisition protocols, feature segmentation, data extraction, processing, and analysi

Updates on Quantitative MRI of Diffuse Liver Disease. A Narrative Review

Diffuse liver diseases are highly prevalent conditions around the world, including pathological liver changes that occur when hepatocytes are damaged and liver function declines, often leading to a chronic condition. In the last years, Magnetic Resonance Imaging (MRI) is reaching an important role in the study of diffuse liver diseases moving from qualitative to quantitative assessment of liver parenchyma. In fact, this can allow noninvasive accurate and standardized assessment of diffuse liver diseases and can represent a concrete alternative to biopsy which represents the current reference standard. MRI approach already tested for other pathologies include diffusion-weighted imaging (DWI) and radiomics, able to quantify different aspects of diffuse liver disease. New emerging MRI quantitative methods include MR elastography (MRE) for the quantification of the hepatic stiffness in cirrhotic patients, dedicated gradient multiecho sequences for the assessment of hepatic fat storage, and iron overload. Thus, the aim of this review is to give an overview of the technical principles and clinical application of new quantitative MRI techniques for the evaluation of diffuse liver disease

Artificial intelligence based image quality enhancement in liver MRI. a quantitative and qualitative evaluation

Purpose To compare liver MRI with AIR Recon Deep Learning (TM)(ARDL) algorithm applied and turned-off (NON-DL) with conventional high-resolution acquisition (NAiVE) sequences, in terms of quantitative and qualitative image analysis and scanning time. Material and methods This prospective study included fifty consecutive volunteers (31 female, mean age 55.5 +/- 20 years) from September to November 2021. 1.5 T MRI was performed and included three sets of images: axial single-shot fast spin-echo (SSFSE) T2 images, diffusion-weighted images(DWI) and apparent diffusion coefficient(ADC) maps acquired with both ARDL and NAiVE protocol; the NON-DL images, were also assessed. Two radiologists in consensus drew fixed regions of interest in liver parenchyma to calculate signal-to-noise-ratio (SNR) and contrast to-noise-ratio (CNR). Subjective image quality was assessed by two other radiologists independently with a five-point Likert scale. Acquisition time was recorded. Results SSFSE T2 objective analysis showed higher SNR and CNR for ARDL vs NAiVE, ARDL vs NON-DL(all P &lt; 0.013). Regarding DWI, no differences were found for SNR with ARDL vs NAiVE and, ARDL vs NON-DL (all P &gt; 0.2517).CNR was higher for ARDL vs NON-DL(P = 0.0170), whereas no differences were found between ARDL and NAiVE(P = 1). No differences were observed for all three comparisons, in terms of SNR and CNR, for ADC maps (all P &gt; 0.32). Qualitative analysis for all sequences showed better overall image quality for ARDL with lower truncation artifacts, higher sharpness and contrast (all P &lt; 0.0070) with excellent inter-rater agreement (k &gt;= 0.8143). Acquisition time was lower in ARDL sequences compared to NAiVE (SSFSE T2 = 19.08 +/- 2.5 s vs. 24.1 +/- 2 s and DWI = 207.3 +/- 54 s vs. 513.6 +/- 98.6 s, all P &lt; 0.0001). Conclusion ARDL applied on upper abdomen showed overall better image quality and reduced scanning time compared with NAiVE protocol

Deep learning image reconstruction algorithm. impact on image quality in coronary computed tomography angiography

PurposeTo perform a comprehensive intraindividual objective and subjective image quality evaluation of coronary CT angiography (CCTA) reconstructed with deep learning image reconstruction (DLIR) and to assess correlation with routinely applied hybrid iterative reconstruction algorithm (ASiR-V).Material and methodsFifty-one patients (29 males) undergoing clinically indicated CCTA from April to December 2021 were prospectively enrolled. Fourteen datasets were reconstructed for each patient: three DLIR strength levels (DLIR_L, DLIR_M, and DLIR_H), ASiR-V from 10% to 100% in 10%-increment, and filtered back-projection (FBP). Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) determined objective image quality. Subjective image quality was assessed with a 4-point Likert scale. Concordance between reconstruction algorithms was assessed by Pearson correlation coefficient.ResultsDLIR algorithm did not impact vascular attenuation (P &gt;= 0.374). DLIR_H showed the lowest noise, comparable with ASiR-V 100% (P = 1) and significantly lower than other reconstructions (P &lt;= 0.021).DLIR_H achieved the highest objective quality, with SNR and CNR comparable to ASiR-V 100% (P = 0.139 and 0.075, respectively). DLIR_M obtained comparable objective image quality with ASiR-V 80% and 90% (P &gt;= 0.281), while achieved the highest subjective image quality (4, IQR: 4-4; P &lt;= 0.001). DLIR and ASiR-V datasets returned a very strong correlation in the assessment of CAD (r = 0.874, P = 0.001).ConclusionDLIR_M significantly improves CCTA image quality and has very strong correlation with routinely applied ASiR-V 50% dataset in the diagnosis of CAD

Caracterización de la producción porcina familiar en los partidos de Gral Belgrano, Magdalena y Cañuelas: fortalecimiento de la producción porcina familiar

La Facultad de Ciencias Veterinarias de la Universidad Nacional de la Plata (UNLP) participa activamente en procesos locales de desarrollo territorial en diferentes áreas con instituciones locales. A partir de estos proyectos se revela la importancia de la producción porcina en los productores familiares y surge, por parte de los alumnos y docentes la facultad y de la Facultad Ciencias Agrarias y Forestales UNLP y las instituciones locales, la necesidad de intervenir y participar en este sector productivo, tradicionalmente relegado, de gran importancia en nuestro país (Campagna, 2005). El objetivo es contribuir al fortalecimiento de la producción sustentable, a través de la caracterización de la producción porcina familiar en los partidos de General Belgrano, Cañuelas y Magdalena para una posterior implementación de actividades para mejorarla.Eje: Educación y formación para el desarrollo ruralUniversidad Nacional de La Plat

Adrenal lesions: a review of imaging

Adrenal lesions are frequently incidentally diagnosed during investigations for other clinical conditions. Despite being usually benign, nonfunctioning, and silent, they can occasionally cause discomfort or be responsible for various clinical conditions due to hormonal dysregulation; therefore, their characterization is of paramount importance for establishing the best therapeutic strategy. Imaging techniques such as ultrasound, computed tomography, magnetic resonance, and PET-TC, providing anatomical and functional information, play a central role in the diagnostic workup, allowing clinicians and surgeons to choose the optimal lesion management. This review aims at providing an overview of the most encountered adrenal lesions, both benign and malignant, including describing their imaging characteristics

Proyecto de extension multiactoral en los partidos de Gral Belgrano, Magdalena y Cañuelas: fortalecimiento de la producción porcina familiar

El proyecto consiste en convocar y conformar una mesa multiactoral de instituciones y organizaciones que diseñe y ejecute un plan de acción de apoyo a los productores familiares de cerdos, en el marco de procesos locales de desarrollo territorial en zonas rurales de General Belgrano, Cañuelas y Magdalena. A partir de un diagnóstico previo, la Facultad se ha involucrado como un participante más de estos procesos y surgió la necesidad de ampliar la participación en áreas temáticas y sectores más vulnerables. El proyecto contribuye a fortalecer la producción sustentable, a través de la identificación de problemas e implementación de actividades. Se realizará un relevamiento sanitario de los planteles, junto con talleres participativos con productores, lo que permitirá obtener un diagnóstico de situación que oriente las diferentes instancias de trabajo. En la medida en que se identifiquen demandas, se abordarán acciones para el fortalecimiento organizativo de los productores y estrategias de comercialización. Acorde a la inadecuada información y formación de técnicos en producción porcina familiar, se hace imperioso avanzar en la misma.Educación, Formación y Desarrollo Rural.Universidad Nacional de La Plat

Proyecto de extension multiactoral en los partidos de Gral Belgrano, Magdalena y Cañuelas: fortalecimiento de la producción porcina familiar

El proyecto consiste en convocar y conformar una mesa multiactoral de instituciones y organizaciones que diseñe y ejecute un plan de acción de apoyo a los productores familiares de cerdos, en el marco de procesos locales de desarrollo territorial en zonas rurales de General Belgrano, Cañuelas y Magdalena. A partir de un diagnóstico previo, la Facultad se ha involucrado como un participante más de estos procesos y surgió la necesidad de ampliar la participación en áreas temáticas y sectores más vulnerables. El proyecto contribuye a fortalecer la producción sustentable, a través de la identificación de problemas e implementación de actividades. Se realizará un relevamiento sanitario de los planteles, junto con talleres participativos con productores, lo que permitirá obtener un diagnóstico de situación que oriente las diferentes instancias de trabajo. En la medida en que se identifiquen demandas, se abordarán acciones para el fortalecimiento organizativo de los productores y estrategias de comercialización. Acorde a la inadecuada información y formación de técnicos en producción porcina familiar, se hace imperioso avanzar en la misma.Educación, Formación y Desarrollo Rural.Universidad Nacional de La Plat