Prognostic Value of Cardiac MRI and FDG PET in Cardiac Sarcoidosis: A Systematic Review and Meta-Analysis.

Background There is no consensus regarding the relative prognostic value of cardiac MRI and fluorodeoxyglucose (FDG) PET in cardiac sarcoidosis. Purpose To perform a systematic review and meta-analysis of the prognostic value of cardiac MRI and FDG PET for major adverse cardiac events (MACE) in cardiac sarcoidosis. Materials and Methods In this systematic review, MEDLINE, Ovid Epub, CENTRAL, Embase, Emcare, and Scopus were searched from inception until January 2022. Studies that evaluated the prognostic value of cardiac MRI or FDG PET in adults with cardiac sarcoidosis were included. The primary outcome of MACE was assessed as a composite including death, ventricular arrhythmia, and heart failure hospitalization. Summary metrics were obtained using random-effects meta-analysis. Meta-regression was used to assess covariates. Risk of bias was assessed using the Quality in Prognostic Studies, or QUIPS, tool. Results Thirty-seven studies were included (3489 patients with mean follow-up of 3.1 years ± 1.5 [SD]); 29 studies evaluated MRI (2931 patients) and 17 evaluated FDG PET (1243 patients). Five studies directly compared MRI and PET in the same patients (276 patients). Left ventricular late gadolinium enhancement (LGE) at MRI and FDG uptake at PET were both predictive of MACE (odds ratio [OR], 8.0 [95% CI: 4.3, 15.0] [P < .001] and 2.1 [95% CI: 1.4, 3.2] [P < .001], respectively). At meta-regression, results varied by modality (P = .006). LGE (OR, 10.4 [95% CI: 3.5, 30.5]; P < .001) was also predictive of MACE when restricted to studies with direct comparison, whereas FDG uptake (OR, 1.9 [95% CI: 0.82, 4.4]; P = .13) was not. Right ventricular LGE and FDG uptake were also associated with MACE (OR, 13.1 [95% CI: 5.2, 33] [P < .001] and 4.1 [95% CI: 1.9, 8.9] [P < .001], respectively). Thirty-two studies were at risk for bias. Conclusion Left and right ventricular late gadolinium enhancement at cardiac MRI and fluorodeoxyglucose uptake at PET were predictive of major adverse cardiac events in cardiac sarcoidosis. Limitations include few studies with direct comparison and risk of bias. Systematic review registration no. CRD42021214776 (PROSPERO) © RSNA, 2023 Supplemental material is available for this article.

Clinical utility of technetium-99m-labelled leukocyte scan in diagnosis of vascular infections.

INTRODUCTION: The diagnosis of vascular graft infections and infected aneurysms via conventional methods such as computed tomography (CT) and ultrasound (US) can often be challenging. Nuclear medicine imaging techniques can detect infection in these difficult cases. We aim to evaluate the diagnostic value of technetium-99m-labelled leukocyte scans in diagnosing vascular graft infections in our centre. METHODS: There were 164 patient-scans identified over a 16-year period. The electronic clinical records, laboratory findings and radiology of these patients were reviewed. An adapted case definition of infection was defined using the criteria proposed by the Management of Aortic Graft Infection Collaboration. There were 43 patients identified to have vascular indications and had sufficient information to be divided into infected and non-infected groups. Imaging and reports of the leucocyte scans in these patients were analysed to calculate specificity and sensitivity. RESULTS: Overall sensitivity of leucocyte scans to detect vascular infection was 78.1% and specificity of 81.8% with a positive likelihood ratio of 4.30 and negative likelihood ratio of 0.27. Two false positives in patients with aortic grafts; one patient possibly had concurrent gastrointestinal infection and continued antibiotic treatment. The other patient had persistent uptake around an endoleak and was treated with lifelong antibiotics for aortic vascular graft infection on the basis of the leucocyte scan; no other clinical or laboratory evidence was found to fulfil the case definition of the vascular graft infection. CONCLUSION: Technetium-99m-labelled leukocyte scan can be a useful adjuvant test in diagnosing suspected vascular infections in this uncommon presentation.

Varicella zoster virus: a rare cause of acute pancreatitis in an immunocompetent child.

A 15-year-old girl with a diagnosis of varicella zoster virus (VZV) presented to hospital with severe abdominal pain. This patient was immunocompetent and found to have acute pancreatitis in association with VZV. She responded well to intravenous acyclovir and supportive treatment. A review of the literature for the management of pancreatitis associated with VZV suggests treatment with acyclovir, as it appears to reduce hospital stay and symptoms. The exact benefit is yet to be quantified. Importantly, this diagnosis should be considered in children who have VZV associated with abdominal pain.

Initial interaction of the P22 phage with the Salmonella typhimurium surface.

OBJECTIVES: The goals of these studies were to characterize the interaction of the P22 phage particle with the Salmonella cell surface and to determine the phage elements involved in this interaction by mutational analysis. BACKGROUND: The phage P22 has been characterized extensively. The gene and protein for the phage P22 tailspike, which is the phage adsorption organelle, have been intensively studied. The kinetics of the interaction of the tailspike protein with the cell surface has been studied in detail, surprisingly no mutational analysis has ever been reported that has defined these components and their interaction between themselves and the cell surface. The main and perhaps only component needed for this cell surface interaction is the tailspike protein. METHODS: Adsorption to the cell surface has been measured in the wild type phage and in mutant derivatives, isolated in this study. Phage mutants have been isolated after hydroxylamine mutagenesis. RESULTS: The adsorption of P22 to the cell surface is a temperature-independent event. Forty putative phage adsorption mutants have been isolated. A sample of them have been further analyzed. These divide the adsorption process into at least two stages. One stage contains mutants that absorb with essential wild type phage kinetics to the cell surface while the other stage with delayed adsorption kinetics. CONCLUSIONS: The interaction of the phage P22 with the Salmonella cell surface has been shown to be a complicated one which is temperature-independent and multi-stage. Mutants isolated in this study may help dissect this process even further.

Primeros auxilios en el nivel comunitario / First aid at the community level

La publicación está conformada por ocho temas, desde las conceptualizaciones hacia las indicaciones del qué hacer o cómo actuar en diversas circunstancias de riesgo o peligro, producto de un accidente o situación específica. El desarrollo de estos temas, permitirá el tránsito dialéctico desde la teoría a la práctica, combinando ambos aspectos para lograr un aprendizaje significativo en la materia.

Vigilancia, prevención y control de enfermedades zoonóticas y metaxénicas selectas / Surveillance, prevention and control of selected zoonotic and metaxenic diseases

La publicación aborda como primer tema las enfermedades metaxénicas que afectan a la población como el Dengue, Chikungunya, Malaria y Leishmaniasis; se revisan sus normas y procedimientos técnicos en la obtención de muestra. COmo segundo tema las Enfermedades Zoonóticas, se dará a conocer las principales que pueden ser trasmitidas por los animales a los seres humanos, como Peste, rabia, hidatidosis, cisticercosis, fasciolosis y leptospirosis; así también se revisan las normas y procedimientos técnicos. Y como tercer tema la Bioseguridad, se da a conocer el conjunto de medidas preventivas, destinadas a proteger la salud y seguridad del personal, durante su trabajo en los laboratorios donde se manipulan productos biológicos y químicos para la obtención de muestras, y para los procesos de vigilancia, prevención y control, que incluyen además, el reconocimiento de zonas de riesgo, la identificación de focos de rabia, peste y otras enfermedades zoonóticas (leptospirosis); la vacunación canina según norma técnica, y los registros de Información de enfermedades zoonóticas que puede manejar el capacitado en salud pública.

Initial interaction of the P22 phage with the Salmonella typhimurium surface

OBJECTIVES: The goals of these studies were to characterize the interaction of the P22 phage particle with the Salmonella cell surface and to determine the phage elements involved in this interaction by mutational analysis. BACKGROUND: The phage P22 has been characterized extensively. The gene and protein for the phage P22 tailspike, which is the phage adsorption organelle, have been intensively studied. The kinetics of the interaction of the tailspike protein with the cell surface has been studied in detail, surprisingly no mutational analysis has ever been reported that has defined these components and their interaction between themselves and the cell surface. The main and perhaps only component needed for this cell surface interaction is the tailspike protein. METHODS: Adsorption to the cell surface has been measured in the wild type phage and in mutant derivatives, isolated in this study. Phage mutants have been isolated after hydroxylamine mutagenesis. RESULTS: The adsorption of P22 to the cell surface is a temperature-independent event. Forty putative phage adsorption mutants have been isolated. A sample of them have been further analyzed. These divide the adsorption process into at least two stages. One stage contains mutants that absorb with essential wild type phage kinetics to the cell surface while the other stage with delayed adsorption kinetics. CONCLUSIONS: The interaction of the phage P22 with the Salmonella cell surface has been shown to be a complicated one which is temperature-independent and multi-stage. Mutants isolated in this study may help dissect this process even further