Assessment of 3-T MRI using susceptibility-weighted imaging to detect and evaluate intra- or periarticular blood metabolites and meniscal tears of the knee

Purpose: The purpose of this study was to assess the suitability of susceptibility-weighted imaging (SWI) sequences using the 3T MRI-unit for assessment of potential intraarticular pathologies in patients with acute and chronic torsion trauma of the knee joint. Material and methods: Sixty-three patients with subacute and chronic rotary knee joint trauma of either the left or right knee were studied using an Achieva MRI 3T device (Philips, Amsterdam, Netherlands). Ground truth was set by two expert radiologists with seven and 10 years of experience in musculoskeletal imaging. Readings were performed separately for meniscus and joint space including synovia, ligaments, and periarticular soft tissue. Haemorrhage was defined as any lesion that was either T1 or SWI positive, without proton density (PD)-hypointensity (calcification). A lesion was defined as any pathology/variant with any signal positivity of either T1, PD, or SWI. Results: A total of 63 patients were included (F : M = 22 : 41). The median age of the cohort was 29 years (range 13 to 71 years). Thirty-nine patients showed a meniscal tear, and only three of them (7.7%) demonstrated a meniscal haemorrhage. A total of 18 patients suffered from a periarticular injury, and 16 patients (88.9%) demonstrated a concomitant periarticular haemorrhage. Conclusions: These data suggest that SWI can be used for the diagnosis of intra- or periarticular blood metabolites because their potential have an impact on mechanical conflict with the surface of the knee joints, in particular the cartilage and their effect on malacic lesions, but it performs poorly in the detection of meniscal pathologies

Influence of Lung Reconstruction Algorithms on Interstitial Lung Pattern Recognition on CT.

BACKGROUND  Despite current recommendations, there is no recent scientific study comparing the influence of CT reconstruction kernels on lung pattern recognition in interstitial lung disease (ILD). PURPOSE  To evaluate the sensitivity of lung (i70) and soft (i30) CT kernel algorithms for the diagnosis of ILD patterns. MATERIALS AND METHODS  We retrospectively extracted between 15-25 pattern annotations per case (1 annotation = 15 slices of 1 mm) from 23 subjects resulting in 408 annotation stacks per lung kernel and soft kernel reconstructions. Two subspecialized chest radiologists defined the ground truth in consensus. 4 residents, 2 fellows, and 2 general consultants in radiology with 3 to 13 years of experience in chest imaging performed a blinded readout. In order to account for data clustering, a generalized linear mixed model (GLMM) with random intercept for reader and nested for patient and image and a kernel/experience interaction term was used to analyze the results. RESULTS  The results of the GLMM indicated, that the odds of correct pattern recognition is 12 % lower with lung kernel compared to soft kernel; however, this was not statistically significant (OR 0.88; 95%-CI, 0.73-1.06; p = 0.187). Furthermore, the consultants' odds of correct pattern recognition was 78 % higher than the residents' odds, although this finding did not reach statistical significance either (OR 1.78; 95%-CI, 0.62-5.06; p = 0.283). There was no significant interaction between the two fixed terms kernel and experience. Intra-rater agreement between lung and soft kernel was substantial (κ = 0.63 ± 0.19). The mean inter-rater agreement for lung/soft kernel was κ = 0.37 ± 0.17/κ = 0.38 ± 0.17. CONCLUSION  There is no significant difference between lung and soft kernel reconstructed CT images for the correct pattern recognition in ILD. There are non-significant trends indicating that the use of soft kernels and a higher level of experience lead to a higher probability of correct pattern identification. KEY POINTS   · There is no significant difference between lung and soft kernel reconstructed CT images for the correct pattern recognition in interstitial lung disease.. · There are even non-significant tendencies that the use of soft kernels lead to a higher probability of correct pattern identification.. · These results challenge the current recommendations and the routinely performed separate lung kernel reconstructions for lung parenchyma analysis.. CITATION FORMAT · Klaus JB, Christodoulidis S, Peters AA et al. Influence of Lung Reconstruction Algorithms on Interstitial Lung Pattern Recognition on CT. Fortschr Röntgenstr 2022; DOI: 10.1055/a-1901-7814

Guidance for the Management of Patients with Vascular Disease or Cardiovascular Risk Factors and COVID-19: Position Paper from VAS-European Independent Foundation in Angiology/Vascular Medicine .

COVID-19 is also manifested with hypercoagulability, pulmonary intravascular coagulation, microangiopathy, and venous thromboembolism (VTE) or arterial thrombosis. Predisposing risk factors to severe COVID-19 are male sex, underlying cardiovascular disease, or cardiovascular risk factors including noncontrolled diabetes mellitus or arterial hypertension, obesity, and advanced age. The VAS-European Independent Foundation in Angiology/Vascular Medicine draws attention to patients with vascular disease (VD) and presents an integral strategy for the management of patients with VD or cardiovascular risk factors (VD-CVR) and COVID-19. VAS recommends (1) a COVID-19-oriented primary health care network for patients with VD-CVR for identification of patients with VD-CVR in the community and patients' education for disease symptoms, use of eHealth technology, adherence to the antithrombotic and vascular regulating treatments, and (2) close medical follow-up for efficacious control of VD progression and prompt application of physical and social distancing measures in case of new epidemic waves. For patients with VD-CVR who receive home treatment for COVID-19, VAS recommends assessment for (1) disease worsening risk and prioritized hospitalization of those at high risk and (2) VTE risk assessment and thromboprophylaxis with rivaroxaban, betrixaban, or low-molecular-weight heparin (LMWH) for those at high risk. For hospitalized patients with VD-CVR and COVID-19, VAS recommends (1) routine thromboprophylaxis with weight-adjusted intermediate doses of LMWH (unless contraindication); (2) LMWH as the drug of choice over unfractionated heparin or direct oral anticoagulants for the treatment of VTE or hypercoagulability; (3) careful evaluation of the risk for disease worsening and prompt application of targeted antiviral or convalescence treatments; (4) monitoring of D-dimer for optimization of the antithrombotic treatment; and (5) evaluation of the risk of VTE before hospital discharge using the IMPROVE-D-dimer score and prolonged post-discharge thromboprophylaxis with rivaroxaban, betrixaban, or LMWH

Functionalisation of PLLA nanofiber scaffolds using a possible cooperative effect between collagen type I and BMP-2: impact on growth and osteogenic differentiation of human mesenchymal stem cells

Mesenchymal stem cell differentiation of osteoblasts is triggered by a series of signaling processes including integrin and bone morphogenetic protein (BMP), which therefore act in a cooperative manner. The aim of this study was to analyze whether these processes can be remodeled in an artificial poly-(l)-lactide acid (PLLA) based nanofiber scaffold. Matrices composed of PLLA-collagen type I or BMP-2 incorporated PLLA-collagen type I were seeded with human mesenchymal stem cells (hMSC) and cultivated over a period of 22 days, either under growth or osteoinductive conditions. During the course of culture, gene expression of alkaline phosphatase (ALP), osteocalcin (OC) and collagen I (COL-I) as well as Smad5 and focal adhesion kinase (FAK), two signal transduction molecules involved in BMP-2 or integrin signaling were analyzed. Furthermore, calcium and collagen I deposition, as well as cell densities and proliferation, were determined using fluorescence microscopy. The incorporation of BMP-2 into PLLA-collagen type I nanofibers resulted in a decrease in diameter as well as pore sizes of the scaffold. Mesenchymal stem cells showed better adherence and a reduced proliferation on BMP-containing scaffolds. This was accompanied by an increase in gene expression of ALP, OC and COL-I. Furthermore the presence of BMP-2 resulted in an upregulation of FAK, while collagen had an impact on the gene expression of Smad5. Therefore these different strategies can be combined in order to enhance the osteoblast differentiation of hMSC on PLLA based nanofiber scaffold. By doing this, different signal transduction pathways seem to be up regulated

Riverside, Illinois reconstruction within the historic landscape

Master of ScienceLandscape ArchitectureUniversity of Michiganhttp://deepblue.lib.umich.edu/bitstream/2027.42/114810/1/39015003271890.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/114810/2/39015003271890.pd

Causes and circumstances of formation traumatic body injuries in majorettes

Mażoretka to tancerka, która prezentuje dwa style – baton i pom-pom, tańcząc według określonych zasad. Wymaga to od tańczącej umiejętności manualnych, gracji i dobrego opanowania techniki tańca. Mażoretki występują na pokazach estradowych i paradach ulicznych, na których prezentują układy choreograficzne, taneczno-marszowe do muzyki orkiestr dętych, żonglując i podrzucając przy tym pałeczki mażoretkowe. Aktywność ruchowa, którą wykonują mażoretki, kwalifikuje się do dyscyplin sportowych o zwiększonym ryzyku wystąpienia obrażeń ciała. Badaniami, przeprowadzonymi w okresie od 2014 do połowy roku 2016, objęto 23 mażoretki Klubu Sportowego Azaria z terenu województwa śląskiego czynnie trenujące i startujące w zawodach. Posłużono się ankietą zawierającą 15 pytań o charakterze jednorazowego sondażu diagnostycznego na próbie ważonej. Na podstawie uzyskanych odpowiedzi dokonano oceny najczęstszych przyczyn urazowych obrażeń ciała, ich lokalizacji oraz okoliczności powstawania obrażeń w związku z podejmowaną aktywnością sportową i używaniem pałeczek mażoretkowych. Analiza otrzymanych wyników wykazała, że najczęstszymi przyczynami urazowych obrażeń ciała mażoretek była niedostateczna rozgrzewka (52,1%) oraz brak wyleczenia poprzednio doznanych urazów (21,7%). Najczęściej urazy dotyczyły kończyn dolnych (35,5%), głowy (34,2%) oraz kończyn górnych (30,2%). Najczęściej do urazów dochodziło podczas treningów (47,8%) oraz w czasie zawodów (30,4%).Majorette is the dancer who presents two styles – baton and pom-pom, dancing according to definite principles. It requires from dancer the manual acquirements, grace and the good command of a technique of dance. The majorettes step out on stage demonstrations and the street parades, at which they present choreographic, dance-marching arrangements, to the music of brass bands, juggling and throwing up the majorettes baton at the same time. Motorial activity executed by the majorettes qualifies to the sport disciplines, with enlarged risk of appearance of body injuries. In this study, performed in a period since 2014 to half of 2016 year, 23 majorettes of Sport Club from the terrain of Silesian province actively training and starting in the competitions were involved. The questionnaire including 15 questions forming single diagnostic test on weigh sample was applied. On the basis of obtained answers, the analysis of most frequent causes of traumatic body injuries, their location, as well as the circumstances of appearance of injuries related to undertaken sport activity and the usage of majorette batons was performed. The analysis of obtained results showed, that the most frequent causes of traumatic injuries of the body in majorettes was the insufficient warming up (52,1%), as well as the lack of recovery of previously experienced injuries (21,7%). The most frequent injuries regarded bottom limbs (35,5%), head (34,2 %), as well as upper limbs (30,2%). Most often injuries occurred during trainings (47,8%), as well as during competitions (30,4%). Most often cause of traumatic injuries of the body in majorettes, regarding mainly bottom limbs and head, are incorrectly conducted warming up, especially during the training in the period of preparation for the contests, and also the lack of complete recovery of previously experienced injuries, that promotes the recurrence of body injuries

Zarazenia grzybicze u pacjentow hospitalizowanych na Oddziale Intensywnej Terapii

Over the last years, systemic fungal infections have dramatically increased in hospitalized patients. The Candida is the main pathogen caused nosocomial fungal infections. The aim of the study: The aim was to analyze frequency of occurrence of the yeast-like fungi in different biological materials isolated from the patients of an Intensive Care Unit of the University Hospital of Lodz in the period of 2000-2003. Material and methods: 123 strains of fungi were analyzed with the use of API 20 C AUX® test (bioMarieux). Results: Among all the investigated Candida strains C. albicans accounted for 52.0%. Samples from respiratory system and urine most often contained the strains of C. albicans (56.3 and 60.5%, respectively); blood samples contained C. parapsilosis (44.8%). In patients who were untreated by bacterial antibiotics C. albicans was the most frequent species, whereas in patients who were ordered bacterial antibiotics it was C. parapsilosis that dominated. Conclusions: (1) Candida is the most frequent cause of fungal infections in patients hospitalized in an intensive care unit. (2) C. parapsilosis is the main pathogen caused bloodstream infections. This species is also more frequent in patients who were ordered antibacterial antibiotics over five days. (3). Species other than C. albicans become more and more frequent and dangerous