RESUMO
To establish the optimal detection of third-generation cephalosporin-resistant Enterobacterales (3GCREB), the performance of four different screening methods has been investigated: stool samples without (A) and with (B) pre-enrichment and rectal swabs without (C) and with (D) pre-enrichment were contrasted. Pre-enrichment approaches (B and D) increased the detection of 3GCREB carriers by 29.4% (20/68 3GCREB carriers only found using pre-enrichment, p < 0.0001) compared to direct plating approaches (A and C). Moreover, the study demonstrates a minor advantage of stool samples in contrast to rectal swabs in both cases (with and without pre-enrichment). Registration number: DRKS00022520, 24 July 2020.
Assuntos
Antibacterianos/farmacologia , Portador Sadio/microbiologia , Cefalosporinas/farmacologia , Farmacorresistência Bacteriana , Enterobacteriaceae/efeitos dos fármacos , Fezes/microbiologia , Reto/microbiologia , Enterobacteriaceae/classificação , Enterobacteriaceae/genética , Enterobacteriaceae/isolamento & purificação , Infecções por Enterobacteriaceae/microbiologia , HumanosRESUMO
PURPOSE: To evaluate the predictive power of arterial injury detected on contrast-enhanced CT (trauma CT (tCT)) imaging obtained prior to selective angiography for treatment of patients with traumatic abdominal and pelvic injuries. MATERIALS AND METHODS: A retrospective chart review was performed of all patients who underwent angiography after undergoing contrast-enhanced CT imaging for the evaluation/treatment of traumatic injuries to the abdomen and pelvis between March 2014 and September 2018. Data collection included demographics, pertinent history and physical findings, CT and angiography findings, treatment information, and outcomes. RESULTS: Eighty-nine (63 males, mean age = 45.8 ± 20.5 years) patients that were found to have 102 traumatic injuries on tCT and subsequently underwent angiography met inclusion criteria for this study. Sixty-four injuries demonstrated evidence of traumatic vascular injury on initial tCT. A negative tCT was able to predict subsequent negative angiography in 83% of cases (negative predictive power = 83%). The ability of tCT to rule out a positive finding on subsequent angiography was also 83% (sensitivity = 83%). The average systolic blood pressure and hemoglobin concentration at the time of tCT were higher in patients who had positive tCT than in patients with negative tCT (p < 0.05 and p < 0.01, respectively). The average time to angiography was greater in patients whom had subsequent negative angiography than the patients who had subsequent positive angiography (p < 0.05). CONCLUSION: Contrast-enhanced CT imaging may be able to help stratify patients who may have subsequent negative angiograms. Hemodynamic factors may affect sensitivity of tCT. Shorter time to angiography may increase the chance of identifying the injury on subsequent angiography.
Assuntos
Traumatismos Abdominais/diagnóstico por imagem , Angiografia , Pelve/irrigação sanguínea , Pelve/lesões , Tomografia Computadorizada por Raios X , Lesões do Sistema Vascular/diagnóstico por imagem , Meios de Contraste , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pelve/diagnóstico por imagem , Valor Preditivo dos Testes , Sensibilidade e EspecificidadeRESUMO
PURPOSE: To investigate the correlation of non-heme iron content in deep gray matter nuclei as a function of age using quantitative susceptibility mapping (QSM) from both whole-structural and regional perspectives. MATERIALS AND METHODS: We studied a group of 174 normal subjects ranging from 20 to 69 years old and measured the magnetic susceptibility of seven subcortical gray matter nuclei. SWI (susceptibility-weighted imaging) phase images were used to generate the susceptibility maps, which were acquired on a 1.5T scanner. The 3D whole-structural measurements were used to determine age-related thresholds, which were applied to calculate the local iron deposition (RII: portion of the structure that contains iron concentration larger than the structure threshold). Age-susceptibility correlation was reported for each measured structure for both the whole-region and two-region (low iron and high iron content regions) analysis. RESULTS: For the local high iron content region, a strong age-susceptibility correlation was found in the caudate nucleus (CN,R = 0.9), putamen (PUT,R = 0.9), red nucleus (RN,R = 0.8), globus pallidus (GP,R = 0.7), substantia nigra (SN,R = 0.5), and pulvinar thalamus (PT,R = 0.5); for the global iron content, a strong age-susceptibility correlation was found in CN(R = 0.6), PUT(R = 0.7), and RN(R = 0.6). Overall, for each structure analyzed in this study, regional analysis showed higher correlation coefficient and higher slope comparing to the whole-region analysis. Further, we found the quantitative conversion factor between magnetic susceptibility and iron concentration to be 1.03 ± 0.03 ppb per µg iron/g wet tissue. CONCLUSION: We conclude that the age-susceptibility correlation can serve as a quantitative magnetic susceptibility baseline as a function of age for monitoring abnormal global and regional iron deposition. A regional analysis has shown a tighter age related behavior, providing a reliable and sensitive reference for what can be considered normal iron content for studies of neurodegenerative diseases. J. Magn. Reson. Imaging 2016;44:59-71.
Assuntos
Envelhecimento/metabolismo , Encéfalo/metabolismo , Substância Cinzenta/metabolismo , Interpretação de Imagem Assistida por Computador/métodos , Ferro/metabolismo , Imageamento por Ressonância Magnética/métodos , Imagem Molecular/métodos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Distribuição TecidualRESUMO
The following publication was cited in the published article, but it was not included in the reference list.
RESUMO
PURPOSE: To evaluate the safety and effectiveness of n-butyl cyanoacrylate (NBCA) for portal vein embolization (PVE) when used to induce contralateral future liver remnant (FLR) hypertrophy in patients undergoing planned hepatic resection for hepatic malignancy. MATERIALS AND METHODS: The PubMed database (including articles indexed by MEDLINE) was searched for articles published from 1970 to 2018 describing patients treated with PVE utilizing NBCA to induce hypertrophy of the FLR prior to contralateral hepatic lobe resection. Demographic data, embolization technique, complications of embolization, resultant FLR hypertrophy, and surgical outcomes were obtained when available. A meta-analysis was performed to determine the cumulative relative hypertrophy rate of the FLR following PVE with NBCA. RESULTS: The literature search yielded 18 relevant articles. Six hundred and seven patients (383 men, 220 women; mean age 60.7 years) with procedures describing PVE utilizing NBCA were reviewed. The most common underlying hepatic malignancies were colorectal metastases (n = 348), followed by cholangiocarcinomas (n = 92), and hepatocellular carcinomas (n = 89). Technical success was reportedly achieved in 603/607 patients, for a success rate of 99.3%. Fixed effects meta-analysis of the relative hypertrophy rate of the FLR among studies resulted in an aggregate rate of 49.4 ± 1.3%. Of the patients who underwent attempted PVE, 461/607 (75.9%) eventually underwent surgical resection. Major complications following PVE occurred in 19 patients (3.13%), while minor complications following PVE occurred in 38 patients (6.26%). CONCLUSIONS: PVE utilizing NBCA to induce hypertrophy of the FLR prior to contralateral lobe resection in the setting of hepatic malignancy is safe and effective. LEVEL OF EVIDENCE: Level IIa-Systematic review of cohort studies.