Validity of diffusion-weighted magnetic resonance imaging in the evaluation of acute pyelonephritis in comparison with contrast-enhanced computed tomography.

PURPOSE: Applications of diffusion-weighted magnetic resonance imaging outside the brain have gained increasing importance in recent years, and recent studies have shown the usage of diffusion-weighted (DW) imaging in diagnosing pyelonephritis based on renal cortical and medullary apparent diffusion coefficient (ADC) values. The aim of this study was to assess the validity of DW magnetic resonance (MR) imaging in comparison with contrast-enhanced computed tomography (CECT) in diagnosing pyelonephritis. MATERIAL AND METHODS: A cross-sectional observational study was conducted for a period of six months in a tertiary hospital in Coimbatore. All patients with clinical and laboratory diagnosis of acute pyelonephritis, who were referred for radiological imaging (CECT), were taken into the study. Out of 112 patients with a clinical and laboratorial diagnosis of acute pyelonephritis (APN), who underwent both DW MR and CECT, diagnosis of APN was made in 100 patients based on CECT, while in 12 cases the investigation (CECT) was negative. Finally, these 100 patients were included in the study. The validity of DW MR imaging in diagnosing APN was assessed by deriving sensitivity, specificity, and positive and negative predictive value in comparison with CECT findings. RESULTS: The validity report of DW MR imaging in the detection of APN showed a very high sensitivity (96-100%) and specificity (86-90%) and very low false positives (6-10%) and negatives (< 5%), and it also showed that in the areas of affected renal parenchyma ADC values were consistently lower compared to unaffected renal parenchyma. CONCLUSION: Based on the generated hypothesis, DW MR imaging of the kidneys seems to be highly sensitive and specific for the detection of focal or diffuse infections within the kidney in comparison with CECT.

BioVeL: a virtual laboratory for data analysis and modelling in biodiversity science and ecology.

BACKGROUND: Making forecasts about biodiversity and giving support to policy relies increasingly on large collections of data held electronically, and on substantial computational capability and capacity to analyse, model, simulate and predict using such data. However, the physically distributed nature of data resources and of expertise in advanced analytical tools creates many challenges for the modern scientist. Across the wider biological sciences, presenting such capabilities on the Internet (as "Web services") and using scientific workflow systems to compose them for particular tasks is a practical way to carry out robust "in silico" science. However, use of this approach in biodiversity science and ecology has thus far been quite limited. RESULTS: BioVeL is a virtual laboratory for data analysis and modelling in biodiversity science and ecology, freely accessible via the Internet. BioVeL includes functions for accessing and analysing data through curated Web services; for performing complex in silico analysis through exposure of R programs, workflows, and batch processing functions; for on-line collaboration through sharing of workflows and workflow runs; for experiment documentation through reproducibility and repeatability; and for computational support via seamless connections to supporting computing infrastructures. We developed and improved more than 60 Web services with significant potential in many different kinds of data analysis and modelling tasks. We composed reusable workflows using these Web services, also incorporating R programs. Deploying these tools into an easy-to-use and accessible 'virtual laboratory', free via the Internet, we applied the workflows in several diverse case studies. We opened the virtual laboratory for public use and through a programme of external engagement we actively encouraged scientists and third party application and tool developers to try out the services and contribute to the activity. CONCLUSIONS: Our work shows we can deliver an operational, scalable and flexible Internet-based virtual laboratory to meet new demands for data processing and analysis in biodiversity science and ecology. In particular, we have successfully integrated existing and popular tools and practices from different scientific disciplines to be used in biodiversity and ecological research.

A meta-analysis of the use of intraoperative cholangiography; time to revisit our approach to cholecystectomy?

BACKGROUND: Despite some evidence of improved survival with intraoperative cholangiography during cholecystectomy, debate has raged about its benefit, in part because of its questionable benefit, time, and resources required to complete. METHODS: An International Prospective Register of Systematic Reviews-registered (ID CRD42018102154) meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using PubMed, Scopus, Web of Science, and Cochrane library from 2003 to 2018 was undertaken including search strategy "intraoperative AND cholangiogra* AND cholecystectomy." Articles scoring ≥ 16 for comparative and ≥ 10 for noncomparative using the Methodological Index for Non-Randomized Studies criteria were included. A dichotomous random effects meta-analysis using the Mantel-Haenszel method performed on Review Manager Version 5.3 was carried out. RESULTS: Of 2,059 articles reviewed, 62 met criteria for final analysis. The mean rate of intraoperative cholangiography was 38.8% (range 1.6%-96.4%).There was greater detection of bile duct stones during cholecystectomy with routine intraoperative cholangiography compared with selective intraoperative cholangiography (odds ratio = 3.28, confidence interval = 2.80-3.86, P value < .001). While bile duct injury during cholecystectomy was less with intraoperative cholangiography (0.39%) than without intraoperative cholangiography (0.43%), it was not statistically significant (odds ratio = 0.88, confidence interval = 0.65-1.19, P value = .41). Readmission following cholecystectomy with intraoperative cholangiography was 3.0% compared to 3.5% without intraoperative cholangiography (odds ratio = 0.91, confidence interval = 0.78-1.06, P value = .23). CONCLUSION: The use of intraoperative cholangiography still has its place in cholecystectomy based on the detection of choledocholithiasis and the potential reduction of unfavorable outcomes associated with common bile duct stones. This meta-analysis, the first to review intraoperative cholangiography use, identified a marked variation in cholangiography use. Retrospective studies limit the ability to critically define association between intraoperative cholangiography use and bile duct injury.

REtrospective Multicenter INdian Study of Derivo Embolization Device (REMIND): Periprocedural Safety / 신경중재치료의학

Purpose@#The treatment of aneurysms with characteristics such as complex morphology, fusiform, blister-like, wide neck, or large size has been revolutionized with the introduction of flow diverters. Though flow diverters have several advantages over coiling, they also have certain important disadvantages such as the lack of immediate protection against rupture, the risk of ischemic stroke, the need for antiplatelet therapy, and long latency for complete effect. The Derivo Embolization Device (DED) is a second-generation self-expanding device that is claimed to be less thrombogenic than conventional devices. We retrospectively evaluated the periprocedural safety and risks associated with the DED across 5 centers in India. @*Materials and Methods@#This is a multicentric, retrospective, observational study of DED, conducted at 5 high volume endovascular therapy centers in India from May 2018 to June 2020. Periprocedural demographic, clinical, and angiographic data were collected from a retrospective review of patient charts. @*Results@#A total of 96 patients, including 56 (58.3%) females, aged between 16–80 years (60±12.7 years) harboring 106 aneurysms were studied. Seven (7.3%) were noted to harbor multiple aneurysms: 6 had 3 aneurysms each, while 1 patient had 5 aneurysms. The following aneurysm characteristics were noted: average size, 9.8±8.2 mm; average neck size, 6.9±8.5 mm; wide-necked (>4 mm), 63 (59.4%); giant (>25 mm), 8 (7.5%); and anterior circulation location, 98 (92.5%). Eighteen (17%) of these were ruptured. Additional balloon angioplasty was performed in 5 (5.2%) patients. Intraprocedural problems were encountered in 3 (3.1%), of which only 1 had clinical implications, the device fish-mouthing with stent thrombosis resulting in a malignant middle cerebral artery territory infarction. The modified Rankin scale at 3 months was worse in 1 patient. @*Conclusion@#DED is a newer generation flow diverter stent with a low periprocedural complication rate.

Wharton's Duct Sialolith of Unusual Size: A Case Report with a Review of the Literature.

There is an increased incidence of submandibular gland duct developing sialoliths. Among them the sialoliths attaining a size of more than 1.5 cms are rare. Here we present a case with an abnormally sized sialolith in Wharton's duct and a review of the literature about the abnormally sized sialoliths and various anatomical and physiological considerations of the duct which contribute to the higher incidence of sialolith in the duct.

A semi-automated workflow for biodiversity data retrieval, cleaning, and quality control.

The compilation and cleaning of data needed for analyses and prediction of species distributions is a time consuming process requiring a solid understanding of data formats and service APIs provided by biodiversity informatics infrastructures. We designed and implemented a Taverna-based Data Refinement Workflow which integrates taxonomic data retrieval, data cleaning, and data selection into a consistent, standards-based, and effective system hiding the complexity of underlying service infrastructures. The workflow can be freely used both locally and through a web-portal which does not require additional software installations by users.

Case of Pseudoaneurysm Mimicking a Soft Tissue Sarcoma: A Diagnostic Pitfall

Pseudoaneurysms represent a pulsating encapsulated hematoma in communication with the lumen of a ruptured vessel. We present a 33-year-old male with a pseudoaneurysm of the profunda femoris artery. At presentation and on further evaluation, he was diagnosed with a possible soft tissue sarcoma of the distal thigh. Catastrophic haemorrhage occurred at the time of a planned, elective open biopsy. This case report emphasises the importance of considering pseudoaneurysm as a crucial differential diagnosis in atypical swellings and scrutinising all suspected soft tissue tumours with a contrast study or a Doppler ultrasound.