Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 255
Filtrar
1.
BMC Public Health ; 23(1): 57, 2023 01 09.
Artigo em Inglês | MEDLINE | ID: mdl-36624461

RESUMO

BACKGROUND: Young workers (aged 15-24 years) experience higher rates of job-related injury compared with workers aged 25-44 years in the United States. Young workers may have limited or no prior work experience or safety training, which can contribute to their injury risk. In 2018, Alaska had the second highest work-related fatality rate and 14th highest non-fatal injury rate in the United States. This study aimed to characterize nonfatal and fatal occupational injuries among young workers in Alaska. METHODS: To describe injury patterns among Alaska young workers from 2014-2018, we used data from four datasets: Alaska Workers' Compensation, Alaska Occupational Injury Surveillance System, Alaska Trauma Registry, and Alaska Fishermen's Fund. The datasets were merged two at a time and filtered by the worker characteristics (e.g., age and sex) and incident characteristics (e.g., date of injury). Duplicates were then manually identified between the datasets using the variables above. The injury narrative and Occupational Injury and Illness Classification System codes were used last to verify true duplicates. Descriptive analyses were performed after the duplicates were merged. RESULTS: During the 5-year study period 2014-2018, young workers experienced 20 fatal and 12,886 nonfatal injuries. Residents of Alaska comprised 85% of nonfatal and 70% of fatal injuries. The top three major occupation groups with the highest number of injuries were production (1,391, 14%), food preparation (1,225, 12%), and transportation/material moving (1,166, 11%). The most common events leading to injuries were struck by object or equipment (2,027, 21%), overexertion involving outside sources (1,385, 14%), and struck against object or equipment (905, 9%). The most common nature of injuries were sprains/strains/tears (3,024, 29%), cuts/lacerations (1,955, 19%), and bruises/contusions (1,592, 15%). CONCLUSION: Although progress has been made in reducing worker injuries, Alaskan young workers still experience injuries and fatalities frequently. Based on findings, there is a clear need for employers, researchers, public health professionals, parents, and young workers to prioritize young worker safety through an integrated approach, from education and training to adequate workplace supervision and support.


Assuntos
Traumatismos Ocupacionais , Ferimentos e Lesões , Humanos , Estados Unidos , Traumatismos Ocupacionais/epidemiologia , Alaska/epidemiologia , Sistemas de Dados , Acidentes de Trabalho , Local de Trabalho , Indenização aos Trabalhadores , Ferimentos e Lesões/epidemiologia
2.
Expert Rev Vaccines ; 22(1): 161-179, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36576068

RESUMO

INTRODUCTION: The introduction of effective human papillomavirus (HPV) vaccination, screening, and treatment programs has led the World Health Organization to call for the global elimination of cervical cancer. Assessing progress toward this goal is supported through monitoring vaccination coverage and its impact. AREAS COVERED: We performed a targeted review to assess the characteristics of HPV-related data systems from seven high-income countries (HICs) that represented varied approaches, including Australia, Canada, France, Italy, Scotland, Sweden, and the United States (US). Included data systems focused on preventive and early detection measures: HPV vaccination and cervical screening programs, as well as HPV-related disease outcomes. Differences were observed in approach to development of data systems, along with variation in geographical scope and methods of data collection. EXPERT OPINION: A challenge exists in how to best follow-up the ongoing global-scale elimination efforts in a comprehensive manner. These sources provide a wealth of information regarding the strengths and limitations of, and notable variation among, current data systems used in HICs. This review can inform improvements to existing prevention programs and the implementation of new programs in other countries, and thus support optimization of cervical cancer prevention policy.


Assuntos
Infecções por Papillomavirus , Vacinas contra Papillomavirus , Neoplasias do Colo do Útero , Feminino , Humanos , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/prevenção & controle , Neoplasias do Colo do Útero/diagnóstico , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/prevenção & controle , Vacinação/métodos , Detecção Precoce de Câncer/métodos , Sistemas de Dados , Países Desenvolvidos
4.
S Afr Med J ; 112(10): 819-827, 2022 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-36472333

RESUMO

BACKGROUND: An essential part of providing high-quality patient care and a means of efficiently conducting research studies relies upon high-quality routinely collected medical information. OBJECTIVES: To describe the registers, paper records and databases used in a sample of primary healthcare clinics in South Africa (SA) with the view to conduct an impact evaluation using routine data. METHODS: Between October 2015 and December 2015, we collected information on the presence, quality and completeness of registers, clinical stationery and databases at 24 public health facilities in SA. We describe each register and type of clinical stationery we encountered, their primary uses, and the quality of completion. We also mapped the ideal flow of data through a site to better understand how its data collection works. RESULTS: We identified 13 registers (9 standard, 4 non-standard), 5 types of stationery and 4 databases as sources of medical information within a site. Not all clinics used all the standardised registers, and in those that did, registers were kept in various degrees of completeness: a common problem was inconsistent recording of folder numbers. The quality of patient stationery was generally high, with only the chronic patient record being considered of varied quality. The TIER.Net database had high-quality information on key variables, but national identification (ID) number was incompletely captured (42% complete). Very few evaluation sites used electronic data collection systems for conditions other than HIV/AIDS. CONCLUSION: Registers, databases and clinical stationery were not implemented or completed consistently across the 24 evaluation sites. For those considering using routinely collected data for research and evaluation purposes, we would recommend a thorough review of clinic data collection systems for both quality and completeness before considering them to be a reliable data source.


Assuntos
Instituições de Assistência Ambulatorial , Sistemas de Dados , Humanos , África do Sul/epidemiologia , Coleta de Dados , Atenção Primária à Saúde
5.
Molecules ; 27(20)2022 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-36296457

RESUMO

The mechanism of reaction in isobutane/2-butene alkylation systems is extremely complicated, accompanied by numerous side reactions. Therefore, a comprehensive understanding of the reaction pathways in this system is essential for an in-depth discussion of the reaction mechanism and for improving the selectivity of the major products (clean fuel blend components). The alkylation of isobutane/2-butene was studied using a self-made intermittent reaction device with a metering, cooling, reaction, vacuum and analysis system. The alkylates were qualitatively and quantitatively analyzed using a capillary gas chromatography-mass spectrometry-data system (CGC-MS-DS) and capillary gas chromatography with flame ionization detection (CCGC-FID), respectively, and the precision and recovery of the quantitative analytical methods were verified. The results showed that the relative standard deviation (RSD) of the standard sample was below 0.78%, and the recoveries were from 98.53% to 102.85%. Under the specified reaction conditions, 79 volatile substances were identified from the alkylates, and the selectivity of C8 and trimethylpentanes (TMPs) reached 63.63% and 53.81%, respectively. The changes of the main chemical components in the alkylation reaction with time were tracked and analyzed, based on which reaction pathways were determined, and a complex reaction network containing the main products' and the by-products' generation pathway was constructed.


Assuntos
Butanos , Sistemas de Dados , Cromatografia Gasosa-Espectrometria de Massas/métodos , Ionização de Chama , Alquilação
6.
Front Endocrinol (Lausanne) ; 13: 938961, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36157473

RESUMO

Background: Chinese thyroid imaging reports and data systems (C-TIRADS) is a novel malignancy risk stratification used for thyroid nodule diagnosis and guiding thyroid fine needle aspiration (FNA). In this review, we aim to assess the performance of C-TIRADS in malignancy risk stratification of thyroid nodules. Methods: PubMed, Medline, Web of Science, Embase, CNKI, and Wanfang databases were searched until 1 April 2022. Original articles reporting data about C-TIRADS and setting FNA or histology as reference standards were included. C-TIRADS 4A, 4B, and 4C were set as thresholds, respectively, to obtain pooled sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR-), diagnostic odds ratio (DOR), and the area under the curve (AUC). Integrated nested Laplace approximation was used for Bayesian bivariate meta-analysis of diagnostic tests. Results: Sixteen studies were included, evaluating 11,506 thyroid nodules. The rate of malignancy in each risk classification is comparable with that in C-TIRADS. C-TIRADS 4B appeared to have better diagnostic performance than C-TIRADS 4A and 4C. The pooled sensitivity, specificity, LR+, LR-, and DOR of C-TI-RADS 4B were 0.94 (95% CI: 0.89-0.97), 0.70 (95% CI: 0.60-0.79), 3.20 (95% CI: 2.28-4.39), 0.09 (95% CI: 0.05-0.15), and 33.71 (95% CI: 25.51-42.40), respectively. The area under the summary ROC curve was 0.94 (95% CI: 0.90-0.96). Conclusion: C-TIRADS performed well in malignancy risk stratification of thyroid nodules. C-TIRADS 4B showed strong evidence of detecting malignancy.


Assuntos
Nódulo da Glândula Tireoide , Teorema de Bayes , Sistemas de Dados , Humanos , Medição de Risco/métodos , Nódulo da Glândula Tireoide/diagnóstico por imagem , Ultrassonografia/métodos
7.
Big Data ; 10(S1): S3-S8, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-36070506

RESUMO

The growing centering of equity in health has elevated a conversation about how those interests should translate within the systems and sectors that influence health. In particular, the public health data system has been relatively limited in capturing the drivers and consequences of health inequity as well as the varying dimensions of equity. This article examines what it means to use equity as a guiding principle throughout the components and functions of a modern public health data system. As with other articles in this supplement, this article builds from a literature review, environmental scan, and deliberations from the National Commission to Transform Public Health Data Systems to summarize current gaps to integrate equity throughout the system. It outlines opportunities for the technology and data science sectors specifically to engage given the access that these sectors have to information that would illuminate and frame the nuances and impacts of health inequity.


Assuntos
Sistemas de Dados , Saúde Pública , Política de Saúde
8.
Big Data ; 10(S1): S9-S14, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-36070507

RESUMO

The public is inundated with data, both in where data are ubiquitously collected and in how organizations are using data to drive public sector and commercial decisions. The public health data system is no exception to this flood of data, both in growing data volume and variety. However, what are collected and analyzed about the health status of the nation, how particular data and measures are prioritized for parsimony, and how those data provide a signal for where to invest to address health inequities are in dire need of a reboot. As with other articles in this supplement, this article builds from a literature review, an environmental scan, and deliberations from the National Commission to Transform Public Health Data Systems. The article summarizes what data should be included and identifies where the technology and data sectors can contribute to fill current gaps to measure equity, positive health, and well-being.


Assuntos
Sistemas de Dados , Saúde Pública
9.
Int J Cancer ; 151(12): 2229-2243, 2022 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-36095154

RESUMO

Current risk stratification systems for thyroid nodules suffer from low specificity and high biopsy rates. Recently, machine learning (ML) is introduced to assist thyroid nodule diagnosis but lacks interpretability. Here, we developed and validated ML models on 3965 thyroid nodules, as compared to the American College of Radiology Thyroid Imaging, Reporting and Data System (ACR TI-RADS). Subsequently, a SHapley Additive exPlanation (SHAP) algorithm was leveraged to interpret the results of the best-performing ML model. Clinical characteristics including thyroid-function tests were collected from medical records. Five ACR TI-RADS ultrasonography (US) categories plus nodule size were assessed by experienced radiologists. Random forest (RF), support vector machine (SVM) and extreme gradient boosting (XGBoost) were used to build US-only and US-clinical ML models. The ML models and ACR TI-RADS were compared in terms of diagnostic performance and unnecessary biopsy rate. Among the ML models, the US-only RF model (hereafter, Thy-Wise) achieved the optimal performance. Compared to ACR TI-RADS, Thy-Wise showed higher accuracy (82.4% vs 74.8% for the internal validation; 82.1% vs 73.4% for external validation) and specificity (78.7% vs 68.3% for internal validation; 78.5% vs 66.9% for external validation) while maintaining sensitivity (91.7% vs 91.2% for internal validation; 91.9% vs 91.1% for external validation), as well as reduced unnecessary biopsies (15.3% vs 32.3% for internal validation; 15.7% vs 47.3% for external validation). The SHAP-based interpretation of Thy-Wise enables clinicians to better understand the reasoning behind the diagnosis, which may facilitate the clinical translation of this model.


Assuntos
Nódulo da Glândula Tireoide , Humanos , Nódulo da Glândula Tireoide/diagnóstico por imagem , Estudos Retrospectivos , Sistemas de Dados , Aprendizado de Máquina
10.
Diagn Interv Radiol ; 28(5): 396-402, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35997477

RESUMO

PURPOSE We aimed to investigate the accuracy of Vesical Imaging - Reporting and Data System (VI-RADS) in the detection of muscle-invasive bladder cancer (MIBC) and to determine which factors affect the results of this scoring system. METHODS A prospective data analysis of 80 patients who were detected to have bladder tumor was performed between March 2019 and October 2020. VI-RADS scoring was used to determine the probability of muscle invasion. The scores were compared with pathological results to evaluate the accuracy of the VI-RADS scoring system. Interobserver agreement was assessed by VI-RADS scoring of 20 randomly chosen patients by a different experienced radiologist. RESULTS Using the VI-RADS scoring system, the sensitivity, specificity, positive predictive value, and negative predictive value of multiparametric magnetic resonance imaging (mpMRI) were 87.5%, 87.5%, 63.6%, and 96.6%, respectively. The interobserver agreement expressed as the interclass correlation coefficient (ICC) was 0.72 (95% CI: 0.44-0.84, P < .001). In addition, the flat appearance of the tumor was an important factor affecting the accuracy of the VI-RADS score (odds ratio: 5.3 [95% CI: 1.1-27.0] and relative risk: 1.87 [95% CI: 1.24-2.82]). CONCLUSION The mpMRI, used in conjunction with VI-RADS, has proven to be an effective imaging method for detecting muscle invasion in cases of bladder cancer. VI-RADS scoring system can distinguish whether there is a muscle-invasive and non-muscle invasive bladder cancer with acceptable accuracy. In addition, the flat appearance of the tumor is an important entity that can affect the accuracy of the VI-RADS scoring system.


Assuntos
Imageamento por Ressonância Magnética Multiparamétrica , Neoplasias da Bexiga Urinária , Sistemas de Dados , Humanos , Imageamento por Ressonância Magnética/métodos , Valor Preditivo dos Testes , Estudos Prospectivos , Neoplasias da Bexiga Urinária/diagnóstico por imagem , Neoplasias da Bexiga Urinária/patologia
12.
AJR Am J Roentgenol ; 219(6): 916-927, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35856453

RESUMO

The Ovarian-Adnexal Reporting and Data System (O-RADS) ultrasound (US) risk stratification and management system was first published by the American College of Radiology in 2020. It provides standardized terminology for evaluation of ovarian and adnexal masses, aids risk stratification, and provides management guidelines for different categories of lesions. This system has been validated by subsequent research and found to be a useful diagnostic and management tool. However, as noted in the system's governing concepts, in some clinical scenarios, such as patients with acute symptoms or with a history of ovarian malignancy, O-RADS US does not apply, or the system's standard management may be adjusted. Additional scenarios, such as an adnexal mass in pregnancy, present challenges in the application of O-RADS US to assist diagnosis and management. The purpose of this article is to highlight 10 clinical scenarios in which O-RADS US version 1 may not apply, may be difficult to apply, or may require modified management. Additional scenarios in which O-RADS US can be appropriately applied are also described.


Assuntos
Doenças dos Anexos , Neoplasias Ovarianas , Feminino , Humanos , Ultrassonografia , Sistemas de Dados , Neoplasias Ovarianas/diagnóstico por imagem , Neoplasias Ovarianas/patologia , Extremidades
13.
Curr Opin Urol ; 32(5): 536-544, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-35849696

RESUMO

PURPOSE OF REVIEW: To conduct a nonsystematic review of the existing literature to investigate the role of Magnetic Resonance Imaging (MRI) in urothelial carcinomas (UCs). RECENT FINDINGS: Imaging is becoming progressively more crucial in local and distant staging of UCs, especially in cases of bladder cancer (BCa). The primary objective of imaging in patients with BCa is to detect lesions and distinguish T1 from T2 stages, since the treatment varies significantly. SUMMARY: The applicability of MRI in the management of UCs has been investigated, particularly focusing on the new evidence on multiparametric MRI (mpMRI) of the bladder and Vesical Imaging-Reporting And Data System score for the description of BCa and discussing the possible utility of MRI for upper tract urothelial carcinomas . Imaging modalities, in particular CT and MRI, are essential tools for the local and distant staging of UCs. MpMRI of the bladder and VI-RADS score accurately define the risk of muscle invasiveness, promoting tailored therapeutic planning. Moreover, mpMRI has also been included in patients' follow-up and in the assessment of response to systematic therapy. MRI utility and possible application in upper tract urothelial carcinomas cases are yet to be discovered.


Assuntos
Carcinoma de Células de Transição , Imageamento por Ressonância Magnética Multiparamétrica , Neoplasias da Bexiga Urinária , Carcinoma de Células de Transição/diagnóstico por imagem , Sistemas de Dados , Humanos , Imageamento por Ressonância Magnética/métodos , Neoplasias da Bexiga Urinária/diagnóstico por imagem , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/terapia
14.
Liver Int ; 42(10): 2131-2144, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35808845

RESUMO

Hepatocellular carcinoma (HCC) is the fourth most lethal malignancy with an increasing incidence worldwide. Management of HCC has followed several clinical staging systems that rely on tumour morphologic characteristics and clinical variables. However, these algorithms are unlikely to profile the full landscape of tumour aggressiveness and allow accurate prognosis stratification. Noninvasive imaging biomarkers on computed tomography (CT) or magnetic resonance imaging (MRI) exhibit a promising prospect to refine the prognostication of HCC. The Liver Imaging Reporting and Data System (LI-RADS) is a comprehensive system for standardizing the terminology, techniques, interpretation, reporting and data collection of liver imaging. At present, it has been widely accepted as an effective diagnostic system for HCC in at-risk patients. Emerging data have provided new insights into the potential of CT/MRI LI-RADS in HCC prognostication, which may help refine the prognostic paradigm of HCC that promises to direct individualized management and improve patient outcomes. Therefore, this review aims to summarize several prognostic imaging features at CT/MRI for patients with HCC; the available evidence regarding the use of LI-RDAS for evaluation of tumour biology and clinical outcomes, pitfalls of current literature, and future directions for LI-RADS in the management of HCC.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Carcinoma Hepatocelular/patologia , Meios de Contraste , Sistemas de Dados , Humanos , Neoplasias Hepáticas/patologia , Imageamento por Ressonância Magnética , Prognóstico , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos
15.
J Comput Assist Tomogr ; 46(4): 530-544, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35723651

RESUMO

Although cystoscopic biopsy is the standard of care for initial diagnosis and local staging of bladder cancer, radiologic imaging plays a major role in identifying local invasion, nodal status, distant metastasis, and posttreatment surveillance. Recent development of the Vesical Imaging-Reporting and Data System for interpretation of multiparametric magnetic resonance imaging of the bladder has expanded the role diagnostic imaging in the management of bladder cancer. This article reviews multimodality imaging appearances, staging, and differential diagnosis of bladder cancer.


Assuntos
Neoplasias da Bexiga Urinária , Sistemas de Dados , Humanos , Imageamento por Ressonância Magnética/métodos , Estadiamento de Neoplasias , Radiografia , Neoplasias da Bexiga Urinária/diagnóstico por imagem , Neoplasias da Bexiga Urinária/patologia
16.
Radiology ; 304(3): 593-599, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35670714

RESUMO

Background The Vesical Imaging Reporting and Data System (VI-RADS) based on multiparametric MRI scans standardizes preoperative bladder cancer staging. However, limitations have been reported for VI-RADS, particularly for ureteral orifice tumors. Purpose To investigate the diagnostic performance and interobserver agreement of VI-RADS in evaluating muscle invasion for bladder tumors located at the ureteral orifice. Materials and Methods In this retrospective study, patients with histopathologically confirmed bladder cancer occurring at the ureteral orifice from January 2012 to November 2021 were analyzed. Two blinded radiologists independently scored multiparametric MRI scans according to VI-RADS. Interobserver agreement of the VI-RADS scores was evaluated with weighted κ analysis. Receiver operating characteristic curve analysis was used to evaluate the diagnostic performance of the VI-RADS scores in the prediction of muscle invasion. Results A total of 78 patients (mean age, 67 years ± 7 [SD]; age range, 46-90 years; 67 men) were included in the final analysis: 25 with non-muscle-invasive bladder cancer and 53 with muscle-invasive bladder cancer (MIBCa). At consensus reading, one (1%) case was scored as VI-RADS 1, 27 cases (35%) were scored as VI-RADS 2, six (8%) were scored as VI-RADS 3, 10 (13%) were scored as VI-RADS 4, and 34 (44%) were scored as VI-RADS 5. On comparison of the VI-RADS score with histopathologic findings, it was confirmed that the presence of muscle invasion was 0% (zero of one) for VI-RADS 1, 15% (four of 27) for VI-RADS 2, 83% (five of six) for VI-RADS 3, 100% (10 of 10) for VI-RADS 4, and 100% (34 of 34) for VI-RADS 5. The area under the receiver operating characteristic curve of VI-RADS in the detection of MIBCa was 0.96 (95% CI: 0.92, 1.00). Conclusion The Vesical Imaging Reporting and Data System could be used to accurately predict muscle invasion for bladder tumors occurring at the ureteral orifice. © RSNA, 2022 Online supplemental material is available for this article.


Assuntos
Imageamento por Ressonância Magnética Multiparamétrica , Neoplasias da Bexiga Urinária , Idoso , Idoso de 80 Anos ou mais , Sistemas de Dados , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Bexiga Urinária , Neoplasias da Bexiga Urinária/diagnóstico por imagem , Neoplasias da Bexiga Urinária/patologia
17.
Wiad Lek ; 75(5 pt 2): 1384-1389, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35758462

RESUMO

OBJECTIVE: The aim: To present the assumptions and to show the usefulness of Vesical Imaging-Reporting and Data System (VI-RADS) based on multiparametric magnetic resonance imaging (mpMRI) in the diagnostic pathway management of patients with a bladder cancer. PATIENTS AND METHODS: Materials and methods: The review is based on available literature from last 10 years from PubMed database and the Przeglad Urologiczny journal focusing on articles on VI-RADS. Overall, 18 articles were included. Presented magnetic resonance images come from the examinations of the patients who were diagnosed with bladder cancer from 2019 to 2021 at Department of Diagnostic Imaging in University Clinical Hospital in Opole, Poland. CONCLUSION: Conclusions: The newly developed Vesical Imaging-Reporting and Data System has a potential to play a significant role in staging of the bladder cancer as a non-invasive, comprehensive, and effective diagnostic tool providing accurate information for differentiation non-muscle-invasive bladder cancer (NMIBC) from muscle-invasive bladder cancer (MIBC). However more prospective studies should be conducted to validate this system in clinical practice.


Assuntos
Neoplasias da Bexiga Urinária , Sistemas de Dados , Humanos , Imageamento por Ressonância Magnética/métodos , Estadiamento de Neoplasias , Estudos Prospectivos , Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/diagnóstico por imagem
18.
Eur Radiol ; 32(11): 7513-7521, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35554648

RESUMO

OBJECTIVES: To develop a modified Vesical Imaging Reporting and Data System (VI-RADS) without dynamic contrast-enhanced imaging (DCEI), termed "non-contrast-enhanced VI-RADS (NCE-VI-RADS)", and to assess the additive impact of denoising deep learning reconstruction (dDLR) on NCE-VI-RADS. METHODS: From January 2019 through December 2020, 163 participants who underwent high-gradient 3-T MRI of the bladder were prospectively enrolled. In total, 108 participants with pathologically confirmed bladder cancer by transurethral resection were analyzed. Tumors were evaluated based on VI-RADS (scores 1-5) by two readers independently: an experienced radiologist (reader 1) and a senior radiology resident (reader 2). Conventional VI-RADS assessment included all three imaging types (T2-weighted imaging [T2WI], diffusion-weighted imaging [DWI], and dynamic contrast-enhanced imaging [DCEI]). Also evaluated were NCE-VI-RADS comprising only non-contrast-enhanced imaging types (T2WI and DWI), and "NCE-VI-RADS with dDLR" comprising T2WI processed with dDLR and DWI. All systems were assessed using receiver-operating characteristic curve analysis and simple and/or weighted κ statistics. RESULTS: Muscle invasion was identified in 23/108 participants (21%). Area under the curve (AUC) values for diagnosing muscle invasion were as follows: conventional VI-RADS, 0.94 and 0.91; NCE-VI-RADS, 0.93 and 0.91; and "NCE-VI-RADS with dDLR", 0.96 and 0.93, for readers 1 and 2, respectively. Simple κ statistics indicated substantial agreement for NCE-VI-RADS and almost perfect agreement for conventional VI-RADS and "NCE-VI-RADS with dDLR" between the two readers. CONCLUSION: NCE-VI-RADS achieved predictive accuracy for muscle invasion comparable to that of conventional VI-RADS. Additional use of dDLR improved the diagnostic accuracy of NCE-VI-RADS. KEY POINTS: • Non-contrast-enhanced Vesical Imaging Reporting and Data System (NCE-VI-RADS) was developed to avoid risk related to gadolinium-based contrast agent administration. • NCE-VI-RADS had predictive accuracy for muscle invasion comparable to that of conventional VI-RADS. • The additional use of denoising deep learning reconstruction (dDLR) might further improve the diagnostic accuracy of NCE-VI-RADS.


Assuntos
Sistemas de Dados , Neoplasias da Bexiga Urinária , Humanos , Bexiga Urinária/diagnóstico por imagem , Bexiga Urinária/patologia , Estudos Prospectivos , Estudos Retrospectivos , Imageamento por Ressonância Magnética/métodos , Neoplasias da Bexiga Urinária/diagnóstico por imagem , Neoplasias da Bexiga Urinária/patologia , Campos Magnéticos
19.
Soins ; 67(863): 26-31, 2022 Mar.
Artigo em Francês | MEDLINE | ID: mdl-35551781

RESUMO

The year 2020, originally dedicated to nurses by the World Health Organization (WHO), took an unexpected turn with the occurrence of the Covid-19 pandemic. However, the state of the art of nursing around the world was able to be published based on data collected in 2019. The findings of this report were used in the work of the 74th World Health Assembly in 2021 and led to the development of a new WHO global strategy to promote nursing in the health field.


Assuntos
COVID-19 , Enfermeiras e Enfermeiros , COVID-19/epidemiologia , Sistemas de Dados , Humanos , Liderança , Pandemias , Organização Mundial da Saúde
20.
Clin Nucl Med ; 47(8): e529-e539, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35543633

RESUMO

PURPOSE: 68 Gallium-labeled prostate-specific membrane antigen-11 (PSMA) PET/CT is the new reference to identify relapse during biochemical recurrence of prostate cancer (PCa). However, this method lacks specificity for bone foci. This study aimed to report the prevalence of PCa bone metastases and to assess the diagnostic performances of PSMA reporting and data systems (RADS), clinical, biological, and imaging features for identification. PATIENTS AND METHODS: A multicentric retrospective cohort of consecutive patients with biochemical recurrence after local treatment was analyzed. Clinical and biological features at initial staging and during recurrence were retrieved from medical reports. The metastatic status of each bone uptake on PSMA PET/CT was determined according to histopathology, comparisons with concomitant and previous conventional imaging, prostate-specific antigen kinetic, and follow-up. Two nuclear medicine physicians assessed PSMA-RADS, anatomic location, radiological patterns, SUV max , and the presence of other molecular lesions. Univariate and multivariate analyses were conducted to identify independent predictors of PCa metastases. RESULTS: In the eligible population, 98/298 patients (32.9%) showed bone uptake on PSMA PET/CT. In patients with a final diagnosis, 28/81 lesions (34.6%) were metastases. PSMA-RADS-4 or 5 showed sensitivity of 79%, specificity of 94%, and accuracy of 89%. PSMA-RADS had a significantly higher area under the receiver operating characteristic curve than the initial reading in clinical practice (0.91 vs 0.83, P = 0.0074). Initial Gleason score ≥8, age ≤71 years at recurrence, and SUV max >6.21 were independent predictors of PCa metastases in multivariate logistic regression ( P = 0.0314, 0.0179, and 0.0003, respectively). CONCLUSIONS: Most bone uptakes at PSMA PET/CT were benign lesions. PSMA-RADS, patients and tumor characteristics, and SUV max could help identify PCa bone metastases.


Assuntos
Neoplasias Ósseas , Neoplasias da Próstata , Idoso , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/secundário , Sistemas de Dados , Ácido Edético , Radioisótopos de Gálio , Humanos , Masculino , Recidiva Local de Neoplasia/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologia , Estudos Retrospectivos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...