Planar Lymphoscintigraphy for sentinel lymph node mapping in dogs with mast cell tumor: a pilot study.

The histopathological assessment of the first node receiving lymphatic drainage from a tumor – defined as Sentinel Lymph Node (SLN) – is essential to determine stage, therapy and outcome in oncological patients. Both in human and veterinary medicine, lymphoscintigraphy is a recognized procedure for SLN detection (Mariani et al., 2004; Tuohy et al., 2009; Beer et al., 2017). In this study, we want to determine the most suitable pre-operative planar lymphoscintigraphy protocol for SLN mapping in dogs with mast cell tumor (MCT). We selected 5 dogs diagnosed with cutaneous MTC, with clinically negative lymph nodes and no distant metastasis, undergoing surgical tumor removal, and we obtained owner’s written consent. Planar lymphoscintigraphy was performed in patients under general anesthesia, after subcutaneous peritumoral injection of different doses of technetium-99m (Tc-99m) labelled colloid diluted reaching a 0.5 ml volume (Worley, 2014). The MegaBecquerel value (MBq) of the syringe was measured before and after the injection. Dynamic images (1 frame/second for 60 seconds) were taken at the moment of the injection, 3 and 8 minutes after the injection. Ventrodorsal (VD) and lateral (L) static images (120 seconds/frame) were taken until the identification of SLN had been made. If needed, the injection site was masked with a 2-mm lead foil. Results are showed in Table 1. In patient 1, the SLN was not identify, probably due to a superimposition with the injection site. During the study, we increased the injected MBq dose, in order to better visualize lymphatic path and SLN (Balogh et al., 2002). In fact, the number of static images needed to identify SLN have been reduced from 8,7 to 6. Masking the injection site proved to be useful for a better visualization of SLN. Dynamic images showed to be unnecessary for the SLN identification. For further studies, we suggest the injection of minimum 23,5 MBq Tc-99m activity and the acquisition of VD and L static images with and without masking the injection site

Circulating MicroRNAs in Elderly Type 2 Diabetic Patients

The circulating microRNAs (miRNAs) associated with type 2 diabetes (T2D) in elderly patients are still being defined. To identify novel miRNA biomarker candidates for monitoring responses to sitagliptin in such patients, we prospectively studied 40 T2D patients (age > 65) with HbA1c levels of 7.5–9.0% on metformin. After collection of baseline blood samples (t0), the dipeptidyl peptidase-IV (DPP-IV) inhibitor (DPP-IVi) sitagliptin was added to the metformin regimen, and patients were followed for 15 months. Patients with HbA1c0.5% after 3 and 15 months of therapy were classified as “responders” (group R, n = 34); all others were classified as “nonresponders” (group NR, n = 6). Circulating miRNA profiling was performed on plasma collected in each group before and after 15 months of therapy (t0 and t15). Intra- and intergroup comparison of miRNA profiles pinpointed three miRNAs that correlated with responses to sitagliptin: miR-378, which is a candidate biomarker of resistance to this DPP-IVi, and miR-126-3p and miR-223, which are associated with positive responses to the drug. The translational implications are as immediate as evident, with the possibility to develop noninvasive diagnostic tools to predict drug response and development of chronic complications

Take a picture! The role of visual methods in understanding psychiatric patient's everyday life

Understanding the patient's experience of mental illness can foster better support for this population and greater partnership with healthcare professionals. This study aims to explore the application of visual methods in the psychiatric field and, in particular, the experience of people suffering from psychotic disorders because it is still an open question that has not been only partially empirically examined

Ultrasound-guided removal of soft tissue foreign bodies in companion animals: A case series

Foreign bodies (FBs) retained in the subcutaneous tissues are a common reason for medical consultation. In small animals, FBs usually consist of vegetal materials, especially grass awns. Failure to remove the FBs is likely to give rise to acute or late complications. The surgical removal of the FBs can be invasive, costly and technically challenging. Ultrasound has become a mainstay in the detection of FBs and it can be used to guide the extraction of the FBs with a minimally invasive technique. This study describes the detection and extraction of soft-tissue FBs in small animals. One hundred-sixty-two patients, presenting at two veterinary clinics with suspected FBs retained in the soft tissues of various body districts, were considered. Once an ultrasound diagnosis was established, the ultrasound-guided removal of the FB was performed. A high-frequency linear transducer, a skin disinfection, sedation or anaesthesia was used when needed and a scalpel and some Hartmann forceps were also used. One hundred-eighty-two FBs were successfully removed in all the patients. In six cases, the FB was identified during a second ultrasonographic examination, after recurrence of the fistula. No complications were reported after the procedure. The extraction of the FB was performed in an echographic suite in 138 cases and in a surgery room with surgical intervention in 24 cases. In the latter situation, the surgical minimally invasive dissection of tissues under ultrasound guidance was performed before the removal of the FB. In conclusion, the ultrasound-guided removal of the FBs retained in the superficial soft tissue can be considered a good alternative to surgery. However, failure to remove a FB does not preclude the removal by traditional surgery

Thyroid involvement in hepatitis C - associated mixed cryoglobulinemia

The prevalence and clinical features of thyroid involvement in patients with hepatitis C virus-associated mixed cryoglobulinemia (MC+HCV) have been reviewed

HW-Flow: A Multi-Abstraction Level HW-CNN Codesign Pruning Methodology

Convolutional neural networks (CNNs) have produced unprecedented accuracy for many computer vision problems in the recent past. In power and compute-constrained embedded platforms, deploying modern CNNs can present many challenges. Most CNN architectures do not run in real-time due to the high number of computational operations involved during the inference phase. This emphasizes the role of CNN optimization techniques in early design space exploration. To estimate their efficacy in satisfying the target constraints, existing techniques are either hardware (HW) agnostic, pseudo-HW-aware by considering parameter and operation counts, or HW-aware through inflexible hardware-in-the-loop (HIL) setups. In this work, we introduce HW-Flow, a framework for optimizing and exploring CNN models based on three levels of hardware abstraction: Coarse, Mid and Fine. Through these levels, CNN design and optimization can be iteratively refined towards efficient execution on the target hardware platform. We present HW-Flow in the context of CNN pruning by augmenting a reinforcement learning agent with key metrics to understand the influence of its pruning actions on the inference hardware. With 2× reduction in energy and latency, we prune ResNet56, ResNet50, and DeepLabv3 with minimal accuracy degradation on the CIFAR-10, ImageNet, and CityScapes datasets, respectively

PATIENTS WITH MIXED CRYOGLOBULINEMIA AND HCV INFECTION, IN PRESENCE OR ABSENCE OF AUTOIMMUNE THYROIDITIS, HAVE HIGH SERUM LEVELS OF (CXC MOTIF) LIGAND (CXCL)9 AND CXCL11 CHEMOKINES

No data are present in the literature regarding chemokine (CXC motif) ligand (CXCL)9 and CXCL11 circulating levels in cryoglobulinemia associated with hepatitis C (MC+HCV), in presence/absence of autoimmune thyroiditis (AT). Serum CXCL9 and CXCL11 have been measured in 38 MC+HCV patients without AT (MCo), 38 MC+HCV patients with AT (MC+AT), and in matched controls without (control 1) or with thyroiditis (control 2). Serum CXCL9 and CXCL11 were significantly higher: in control 2 than control 1 (p<0.05); in MCo than control 1 and control 2 (p<0.001, for both); in MC+AT than control 1 and control 2 (p<0.0001, for both), and than MCo (p=0.01, for both). Our study demonstrates markedly high serum levels of CXCL9 and CXCL11 in patients with MC+HCV compared to healthy controls; in MC+HCV patients increased CXCL9 and CXCL11 levels were significantly associated with the presence of AT. Moreover, a strong relation between circulating CXCL9 and CXCL11 in MC+HCV has been shown

factors underlying the development of chronic temporal lobe epilepsy in autoimmune encephalitis

Abstract Purpose Limbic encephalitis (LE) is an autoimmune condition characterized by amnestic syndrome, psychiatric features and seizures. Early diagnosis and prompt treatment are crucial to avoid long-term sequelae, including psycho-cognitive deficits and persisting seizures. The aim of our study was to analyze the characteristics of 33 LE patients in order to identify possible prognostic factors associated with the development of chronic epilepsy. Methods This is a retrospective cohort study including adult patients diagnosed with LE in the period 2010–2017 and followed up for ≥12 months. Demographics, seizure semiology, EEG pattern, MRI features, CSF/serum findings were reviewed. Results All 33 LE patients (19 M/14F, mean age 61.2 years) presented seizures. Thirty subjects had memory deficits; 22 presented behavioural/mood disorders. Serum and/or CSF auto-antibodies were detected in 12 patients. In 31 subjects brain MRI at onset showed typical alterations involving temporal lobes. All patients received immunotherapy. At follow-up, 13/33 had developed chronic epilepsy; predisposing factors included delay in diagnosis (p = .009), low seizure frequency at onset (p = .02), absence of amnestic syndrome (p = .02) and absence/rarity of inter-ictal epileptic discharges on EEG (p = .06). Conclusions LE with paucisymptomatic electro-clinical presentation seemed to be associated to chronic epilepsy more than LE presenting with definite and severe "limbic syndrome"