What Are We Missing? False-Negative Cancers at Multiparametric MR Imaging of the Prostate.

Purpose To characterize clinically important prostate cancers missed at multiparametric (MP) magnetic resonance (MR) imaging. Materials and Methods The local institutional review board approved this HIPAA-compliant retrospective single-center study, which included 100 consecutive patients who had undergone MP MR imaging and subsequent radical prostatectomy. A genitourinary pathologist blinded to MP MR findings outlined prostate cancers on whole-mount pathology slices. Two readers correlated mapped lesions with reports of prospectively read MP MR images. Readers were blinded to histopathology results during prospective reading. At histopathologic examination, 80 clinically unimportant lesions (<5 mm; Gleason score, 3+3) were excluded. The same two readers, who were not blinded to histopathologic findings, retrospectively reviewed cancers missed at MP MR imaging and assigned a Prostate Imaging Reporting and Data System (PI-RADS) version 2 score to better understand false-negative lesion characteristics. Descriptive statistics were used to define patient characteristics, including age, prostate-specific antigen (PSA) level, PSA density, race, digital rectal examination results, and biopsy results before MR imaging. Student t test was used to determine any demographic differences between patients with false-negative MP MR imaging findings and those with correct prospective identification of all lesions. Results Of the 162 lesions, 136 (84%) were correctly identified with MP MR imaging. Size of eight lesions was underestimated. Among the 26 (16%) lesions missed at MP MR imaging, Gleason score was 3+4 in 17 (65%), 4+3 in one (4%), 4+4 in seven (27%), and 4+5 in one (4%). Retrospective PI-RADS version 2 scores were assigned (PI-RADS 1, n = 8; PI-RADS 2, n = 7; PI-RADS 3, n = 6; and PI-RADS 4, n = 5). On a per-patient basis, MP MR imaging depicted clinically important prostate cancer in 99 of 100 patients. At least one clinically important tumor was missed in 26 (26%) patients, and lesion size was underestimated in eight (8%). Conclusion Clinically important lesions can be missed or their size can be underestimated at MP MR imaging. Of missed lesions, 58% were not seen or were characterized as benign findings at second-look analysis. Recognition of the limitations of MP MR imaging is important, and new approaches to reduce this false-negative rate are needed. © RSNA, 2017 Online supplemental material is available for this article.

Whey protein-based coatings on frozen Atlantic salmon (Salmo salar): Influence of the plasticiser and the moment of coating on quality preservation.

The effects of different whey protein concentrate coating formulations (with or without glycerol or sorbitol in two proportions) on frozen Atlantic salmon quality parameters were evaluated. The influence of the moment of coating application (before or after freezing) was also studied. The coating application after freezing increased the thaw yield, decreased the drip loss, and modified colour parameters of frozen and thawed fillets, in comparison with application before freezing. The moment of coating also influenced the colour of cooked fish fillets. The type of plasticiser affects the colour of thawed and cooked samples, but not the colour of frozen samples. The protein coatings delayed lipid oxidation of salmon fillets, providing better protection against it than water glazing, and this effect was more pronounced when glycerol instead of sorbitol was used in the coating formulation. WPC+glycerol (1:1) coating was the best for frozen Atlantic salmon protection. The sensory properties of salmon fillets were not modified by the use of this coating.

[Nursing care in the neurosurgical patient]. / Cuidados de enfermería en el paiente neuroquirúrgico.

The Neurosurgery patient is the one who has been undergone to surgery in the brain or in the peripheral nervous system, and might suffer complications during per operative period. They are patients who require attention in areas specialized in critical health care and who will need advanced monitorization, due to it is a high risk postoperative. It is in this point, in the one in which the nurse develops a function of vital importance in the health care, through the constant and specialized attention, to get the best quality of health care. The nurse should be able to evaluate, prevent, control and identify risk situations, avoiding complications and helping patient recovery