Role of ultrasound, color doppler, elastography and micropure imaging in differentiation between benign and malignant thyroid nodules

Purpose: To evaluate the role of ultrasound elastography, Doppler and micropure imaging in the assessment of thyroid nodules, using the pathological analysis as the reference standard. Patients and methods: A prospective study was carried on all patients referred to radio-diagnosis department at Tanta Cancer Centre between November 2015 and November 2016 for evaluation of undiagnosed thyroid nodules. All patients were examined by B-mode ultrasound, color Doppler, micropure imaging and ultrasound elastography. All thyroid nodules were subjected to fine-needle aspiration biopsy. Results: 90 patients (78 women, 12 men) with 159 incompletely diagnosed thyroid nodules. 24 nodules were malignant and 135 nodules were benign, micro calcification was detected by micropure imaging in 40 nodules (29.6%) in the benign thyroid nodules and in 20 nodules (83.3%) in the malignant thyroid nodules (sensitivity 83.3%, specificity 70.4%, and accuracy 84.9%). Color flow Doppler (type III) with marked intranodular and absent or slight perinodular blood flow, was detected in 19 malignant nodules, with sensitivity 79.2%, specificity 95.6%, and the overall accuracy rate was 88.7%. The predictivity of ultrasound elastographic score measurement has high sensitivity 87.5%, and specificity 91.1%, Strain elastography cutoff value for malignant nodules was 2.7 (Sensitivity 83.3% and specificity 91.1%). Conclusion: Elastography and micropure imaging technique are useful imaging modalities to detect the nature of thyroid nodules. In combination with Doppler and B-mode sonography, they could give a better assessment for undiagnosed thyroid nodules. Keywords: Thyroid nodules, Ultrasound, Micropure, Doppler, Elastograph

Mersaquinone, A New Tetracene Derivative from the Marine-Derived Streptomyces sp. EG1 Exhibiting Activity against Methicillin-Resistant Staphylococcus aureus (MRSA).

New antibiotics are desperately needed to overcome the societal challenges being encountered with methicillin-resistant Staphylococcus aureus (MRSA). In this study, a new tetracene derivative, named Mersaquinone (1), and the known Tetracenomycin D (2), Resistoflavin (3) and Resistomycin (4) have been isolated from the organic extract of the marine Streptomyces sp. EG1. The strain was isolated from a sediment sample collected from the North Coast of the Mediterranean Sea of Egypt. The chemical structure of Mersaquinone (1) was assigned based upon data from a diversity of spectroscopic techniques including HRESIMS, IR, 1D and 2D NMR measurements. Mersaquinone (1) showed antibacterial activity against methicillin-resistant Staphylococcus aureus with a minimum inhibitory concentration of 3.36 μg/mL

International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010-2015: Device-associated module

•We report INICC device-associated module data of 50 countries from 2010-2015.•We collected prospective data from 861,284 patients in 703 ICUs for 3,506,562 days.•DA-HAI rates and bacterial resistance were higher in the INICC ICUs than in CDC-NHSN's.•Device utilization ratio in the INICC ICUs was similar to CDC-NHSN's. Background: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. Methods: During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days. Results: Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the INICC medical-surgical ICUs, the pooled rate of central line-associated bloodstream infection, 4.1 per 1,000 central line-days, was nearly 5-fold higher than the 0.8 per 1,000 central line-days reported from comparable US ICUs, the overall rate of ventilator-associated pneumonia was also higher, 13.1 versus 0.9 per 1,000 ventilator-days, as was the rate of catheter-associated urinary tract infection, 5.07 versus 1.7 per 1,000 catheter-days. From blood cultures samples, frequencies of resistance of Pseudomonas isolates to amikacin (29.87% vs 10%) and to imipenem (44.3% vs 26.1%), and of Klebsiella pneumoniae isolates to ceftazidime (73.2% vs 28.8%) and to imipenem (43.27% vs 12.8%) were also higher in the INICC ICUs compared with CDC-NHSN ICUs. Conclusions: Although DA-HAIs in INICC ICU patients continue to be higher than the rates reported in CDC-NSHN ICUs representing the developed world, we have observed a significant trend toward the reduction of DA-HAI rates in INICC ICUs as shown in each international report. It is INICC's main goal to continue facilitating education, training, and basic and cost-effective tools and resources, such as standardized forms and an online platform, to tackle this problem effectively and systematically