Baseline chest computed tomography as standard of care in high-risk hematology patients

Baseline chest computed tomography (BCT) in high-risk hematology patients allows for the early diagnosis of invasive pulmonary aspergillosis (IPA). The distribution of BCT implementation in hematology departments and impact on outcome is unknown. A web-based questionnaire was designed. International scientific bodies were invited. The estimated numbers of annually treated hematology patients, chest imaging timepoints and techniques, IPA rates, and follow-up imaging were assessed. In total, 142 physicians from 43 countries participated. The specialties included infectious diseases (n = 69; 49%), hematology (n = 68; 48%), and others (n = 41; 29%). BCT was performed in 57% (n = 54) of 92 hospitals. Upon the diagnosis of malignancy or admission, 48% and 24% performed BCT, respectively, and X-ray was performed in 48% and 69%, respectively. BCT was more often used in hematopoietic cell transplantation and in relapsed acute leukemia. European centers performed BCT in 59% and non-European centers in 53%. Median estimated IPA rate was 8% and did not differ between BCT (9%; IQR 5-15%) and non-BCT centers (7%; IQR 5-10%) (p = 0.69). Follow-up computed tomography (CT) for IPA was performed in 98% (n = 90) of centers. In high-risk hematology patients, baseline CT is becoming a standard-of-care. Chest X-ray, while inferior, is still widely used. Randomized, controlled trials are needed to investigate the impact of BCT on patient outcome

Ensaios mecânicos de um sistema de fixação pedicular com barra transversal Mechanical assay of a pedicular fixation system with transversal rod

Foi realizado estudo biomecânico de um protótipo de sistema de fixação vertebral que utiliza o pedículo vertebral como ponto de ancoragem dos implantes, associado a hastes que conectam transversalmente os parafusos pediculares. De modo diferente dos sistemas convencionais, nos quais os parafusos são conectados no sentido longitudinal, no sistema desenvolvido as hastes são conectadas transversalmente aos parafusos. Foram realizados ensaios mecânicos (flexo-compressão, flexão lateral e torção) utilizando-se corpos de prova de madeira em máquina universal de testes, com a finalidade de comparar a resistência desse sistema de fixação com o sistema convencionalmente utilizado. Os testes biomecânicos mostraram que o sistema desenvolvido apresentou menor resistência nos ensaios mecânicos realizados, quando comparado com o sistema de fixação convencional.<br>A biomechanical study of a spine fixation prototype was performed. This system uses vertebral pedicle as anchor point of the implants in association with transversally connecting rods. This is different form the usual systems where longitudinally placed rods connect the pedicular screws. Mechanical assays were performed (flexo-compression, lateral flexion, torsion) using probe wood pieces in an universal testing machine, aiming to compare the resistance of this system of fixation to the conventionally used ones. Biomechanical tests showed that the system was less resistant to the mechanical assays when compared to conventional systems

Mesoarchean melting and Neoarchean to Paleoproterozoic metasomatism during the formation of the cratonic mantle keel beneath West Greenland

Highly siderophile element (HSE) concentration and 187Os/188Os isotopic heterogeneity has been observed on various scales in the Earth’s mantle. Interaction of residual mantle peridotite with infiltrating melts has been suggested to overprint primary bulk rock HSE signatures originating from partial melting, contributing to the heterogeneity seen in the global peridotite database. Here we present a detailed study of harzburgitic xenolith 474527 from the Kangerlussuaq suite, West Greenland, coupling the Re–Os isotope geochemistry with petrography of both base metal sulfides (BMS) and silicates to assess the impact of overprint induced by melt-rock reaction on the Re–Os isotope system. Garnet harzburgite sample 474527 shows considerable heterogeneity in the composition of its major phases, most notably olivine and Cr-rich garnet, suggesting formation through multiple stages of partial melting and subsequent metasomatic events. The major BMS phases show a fairly homogeneous pentlandite-rich composition typical for BMS formed via metasomatic reaction, whereas the 187Os/188Os compositions determined for 17 of these BMS are extremely heterogeneous ranging between 0.1037 and 0.1981. Analyses by LA-ICP-MS reveal at least two populations of BMS grains characterized by contrasting HSE patterns. One type of pattern is strongly enriched in the more compatible HSE Os, Ir, and Ru over the typically incompatible Pt, Pd, and Re, while the other type shows moderate enrichment of the more incompatible HSE and has overall lower compatible HSE/incompatible HSE composition. The small-scale heterogeneity observed in these BMS highlights the need for caution when utilizing the Re–Os system to date mantle events, as even depleted harzburgite samples such as 474527 are likely to have experienced a complex history of metasomatic overprinting, with uncertain effects on the HSE