Diagnostic precision of image-guided multisampling core needle biopsy of suspected lymphomas in a primary care hospital

We evaluated the diagnostic quality of image-guided multisampling core needle biopsy (CNB) in patients investigated for suspected lymphoma in a primary care hospital. A total of 112 patients were consecutively assessed during a 3-year period. There were 80 lymphoid site biopsies and 32 non-lymphoid site biopsies. Eight to nine cores were obtained from different parts of the biopsy site. Two cores were systematically frozen, allowing for further morphological, immunochemistry and molecular studies. The diagnostic yield of CNB for malignancy was 100%. Only 47% (41/87) of patients with initial suspicion of lymphoma were finally diagnosed with Lymphoma. The diagnostic yield of CNB for lymphoma typing was 98% (62/63), according to the WHO classification. The diagnostic yield of CNB for complete lymphoma subtyping/grading was 86% (54/63). The diagnostic yield of CNB for a definite diagnosis of benignity was only 47% (8/17). In a primary care setting, multisampling CNB is a minimally invasive, and very accurate procedure for confirming malignancy in patients with suspected lymphoma, presenting with superficial/deep-seated, lymphoid/non-lymphoid site targets. With a very high diagnostic yield for lymphoma typing and a high diagnostic yield for complete lymphoma subtyping/grading a therapeutic decision can be taken in most patients

Fluxograma diferencial entre a artrite séptica e sinovite transitória do quadril em crianças Flowchart distinguishing between septic arthritis and transitory synovitis of the hip in children

O diagnóstico diferencial entre a artrite séptica e a sinovite transitória do quadril não é fácil de ser realizado, pois não há um exame que seja simples, nem satisfatoriamente sensível e específico para diferenciá-las. Sendo assim, é muitas vezes utilizada uma propedêutica armada de exames que demanda maior custo e requer melhor infra-estrutura da instituição de saúde. Perante isso, torna-se evidente a necessidade de uma análise multifatorial dos dados clínicos e laboratoriais envolvidos para a proposição de um fluxograma em que se possa racionalizar exames visando a correta abordagem e evitar a indicação de procedimentos, muitas vezes, desnecessários como a ressonância magnética ou mais invasivos como a artrocentese e a própria drenagem cirúrgica. Realizamos uma ampla revisão da literatura nas bases de dados do Pubmed e Cochrane até maio de 2009 em que foi analisada a importância do exame clínico, dos testes laboratoriais e de imagem para a diferenciação entre as duas afecções. Mediante o cruzamento dos dados foi elaborado um fluxograma para o diagnóstico e conduta na criança e no adolescente, com idade de seis meses a dezoito anos, com sintoma de dor no quadril, na suspeita de quadro inflamatório. Nivel de Evidência III, estudos diagnósticos, investigação de um exame para diagnóstico.<br>The distinguishing diagnosis between the septic arthritis and the transitory synovitis of a hip is not easy to be carried through; therefore, there is not a simple, nor sensible and satisfactorily specific examination to differentiate them. Thus, the use of a propedeutic set of examinations becomes necessary to demand greater cost and depend on a bigger infrastructure of the health institution. First of all, the necessity of a multifactorial analysis on a flowchart is evident, so it can rationalize the indication of unnecessary or more invasive procedures as artrocentesis, magnetic resonance and the surgical draining. A revision of literature on the databases of Pubmed and Cochrane until May of 2009 was carried through, and the importance of the clinical examination, laboratorial tests and imaging exams was analyzed. By studies on the data, it was elaborated a flowchart for the diagnosis and the conduction of the management on the patient, between the ages of six months and eighteen years old, with complaint of pain on the hip under suspicion of inflammatory picture. Level of Evidence: Level III, diagnostic studies - investigating a diagnostic test

Patterned magnetic thin films for ultra high density recording

The areal bit density of magnetic disk recording has increased since 1990 60% per year and even in the last years 100%. Extrapolation of these rates leads to recording parameters not likely to be achieved without changes in the present way of storing hard disk data. One of the possible solutions is the development of so-called patterned magnetic media. Such media will also shift the superparamagnetic limit positively in comparison with the present thin film media. Theoretically, a bit density in the order of Tbits/in 2 may be possible by using this so-called discrete magnetic recording scheme. The patterned structures presented in this paper consist of a regular two-dimensional array of single domain dots with large uniaxial magnetic anisotropy and have been prepared from CoNi/Pt multilayers with strong intergranular exchange coupling and large perpendicular magnetic anisotropy. For the preparation of the patterned media, a patterning process based on Laser Interference Lithography method (LIL) and Ion Beam Etching has been developed. This technology provides the possibility to pattern 2-D arrays of submicron dots smaller than the critical size for the transition from multi to single domain. The smallest prepared dot sizes are 60 nm with a center-to-center dot spacing of 200 nm and thickness of 30 nm. The magnetic characterization of these dots showed that they are single domain with reasonable coercivity and good thermal stability. Micromagnetic simulations show that the single domain state is the lowest energy state for dots with a diameter below 75nm, which confirms the experimental observations