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Background: Postsurgical spinal infections are a severe complication and a challenge to the neurosurgeon due to their complex management. Revision surgeries and the removal of hardware are usually necessary. Recently, advances in nuclear medicine have made it possible to employ radiotracers to identify infections. The radiolabeled antimicrobial peptide technetium-99m-ubiquicidin (99mTc-UBI) (29-41) has been demonstrated to detect bacterial infections. UBI 29-41 is a peptide sequence with selective binding to the anionic cell membrane of bacteria, which has recently been used to differentiate between infection and inflammation. Here, we describe the clinical utility of 99mTc-UBI 29-41 single-photon emission computed tomography-computed tomography (SPECT-CT) in a patient suspected of a postoperative infection. Case description: A 54-year-old male who presented with conus medullaris syndrome secondary to T12 spondylodiscitis and multiple abscess collections was initially managed with debridement, corpectomy, and minimally invasive lateral instrumentation. The patient developed postsurgical empyema near the surgical site. The image study avoided the need for a second surgery and hardware removal. Conclusion: The use of 99mTc-UBI 29-41 SPECT-CT served as a tool to avoid a second invasive procedure; instead, conservative management with antibiotics was performed with an effective outcome after two weeks. This radiotracer has utility in cases in which infection is suspected, but the location is not entirely clear, and information is needed to guide the therapeutic approach.
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Background Early treatment of intracranial lesions in the emergency department is crucial, but it can be challenging to differentiate between them. This differentiation is essential because the treatment of each type of lesion is different. Cerebral computed tomography perfusion (CTP) imaging can help visualize the vascularity of brain lesions and provide absolute quantification of physiological parameters. Compared to magnetic resonance imaging, CTP has several advantages, such as simplicity, wide availability, and reproducibility. Purpose This study aimed to assess the effectiveness of Hounsfield units (HU) in measuring the density of hypercellular lesions and the ability of CTP to quantify hemodynamics in distinguishing intracranial space-occupying lesions. Methods A retrospective study was conducted from March 2016 to March 2022. All patients underwent CTP and CT scans, and relative cerebral blood volume (rCBV) and HU were obtained for intracranial lesions. Results We included a total of 244 patients in our study. This group consisted of 87 (35.7%) individuals with glioblastomas (GBs), 48 (19.7%) with primary central nervous system lymphoma (PCNSL), 45 (18.4%) with metastases (METs), and 64 (26.2) with abscesses. Our study showed that the HUs for METs were higher than those for GB (S 57.4% and E 88.5%). In addition, rCBV values for PCNSL and abscesses were lower than those for GB and METs. The HU in PCNSL was higher than those in abscesses (S 94.1% and E 96.6%). Conclusion PCT parameters provide valuable information for diagnosing brain lesions. A comprehensive assessment improves accuracy. Combining rCBV and HU enhances diagnostic accuracy, making it a valuable tool for distinguishing between lesions. PCT's widespread availability allows for the use of both anatomical and functional information with high spatial resolution for diagnosing and managing brain tumor patients.
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PURPOSE: To compare the effectiveness of resistance power training (RPT, training with the individualized load and repetitions that maximize power output) and cycling power training (CPT, short sprint training) in professional cyclists. METHODS: The participants (20 [2] y, peak oxygen uptake 78.0 [4.4] mL·kg-1·min-1) were randomly assigned to perform CPT (n = 8) or RPT (n = 10) in addition to their usual training regime for 7 weeks (2 sessions/wk). The training loads were continuously registered using the session rating of perceived exertion. The outcomes included endurance performance (8-min time trial and incremental test), as well as measures of muscle strength/power (1-repetition maximum and mean maximum propulsive power on the squat, hip thrust, and lunge exercises) and body composition (assessed by dual-energy X-ray absorptiometry). RESULTS: No between-group differences were found for training loads or for any outcome (P > .05). Both interventions resulted in increased time-trial performance, as well as in improvements in other endurance-related outcomes (ie, ventilatory threshold, respiratory compensation point; P < .05). A significant or quasi-significant increase (P = .068 and .047 for CPT and RPT, respectively) in bone mineral content was observed after both interventions. A significant reduction in fat mass (P = .017), along with a trend (P = .059) toward a reduced body mass, was observed after RPT, but not CPT (P = .076 for the group × time interaction effect). Significant benefits (P < .05) were also observed for most strength-related outcomes after RPT, but not CPT. CONCLUSION: CPT and RPT are both effective strategies for the improvement of endurance performance and bone health in professional cyclists, although the latter tends to result in greater improvements in body composition and muscle strength/power.