Automated inversion time selection for black-blood late gadolinium enhancement cardiac imaging in clinical practice.

OBJECTIVE: To simplify black-blood late gadolinium enhancement (BL-LGE) cardiac imaging in clinical practice using an image-based algorithm for automated inversion time (TI) selection. MATERIALS AND METHODS: The algorithm selects from BL-LGE TI scout images, the TI corresponding to the image with the highest number of sub-threshold pixels within a region of interest (ROI) encompassing the blood-pool and myocardium. The threshold value corresponds to the most recurrent pixel intensity of all scout images within the ROI. ROI dimensions were optimized in 40 patients' scans. The algorithm was validated retrospectively (80 patients) versus two experts and tested prospectively (5 patients) on a 1.5 T clinical scanner. RESULTS: Automated TI selection took ~ 40 ms per dataset (manual: ~ 17 s). Fleiss' kappa coefficient for automated-manual, intra-observer and inter-observer agreements were [Formula: see text]= 0.73, [Formula: see text] = 0.70 and [Formula: see text] = 0.63, respectively. The agreement between the algorithm and any expert was better than the agreement between the two experts or between two selections of one expert. DISCUSSION: Thanks to its good performance and simplicity of implementation, the proposed algorithm is a good candidate for automated BL-LGE imaging in clinical practice.

[Analysis of circumstances of occurrence of contrast media in imaging services]. / Analyse des circonstances de survenue des extravasations de produits de contraste en imagerie.

INTRODUCTION: To prevent extravasations in medical imaging, analyses of organizational and professional circumstances of the occurrence of extravasations have been conducted in the Bordeaux University Hospital (BUH). METHOD: Two parallel studies were conducted: (i) clinical practice evaluation (CPE) including practice analysis groups and development of indicator of extravasation occurrence; (ii) Case-control study analyzing the factors associated with the occurrence of extravasations. Cases were constituted with consecutive series of patients with extravasation occurred in the BUH; controls were constituted of series of patients managed in medical imaging in the BUH without any extravasation. Statistical analysis included univariate and multivariate regression logistic models. RESULTS: CPE identified the following circumstances: patient' characteristics (female gender, low blood vessels) and professional situations (lack of check of: peripheral veinous access, contrast media temperature, injection process and lack of matching between injection amount and veinous access diameter). In the case-control analysis, patients' gender and catheter placement in medical imaging were significantly associated with the occurrence of extravasations. Guidelines have been drafted allowing the decrease of extravasation incidence. CONCLUSION: Adherence to guidelines of contrast media preparation and injection process is very important to prevent extravasation and improve patient safety.

Assessment of myocardial injuries in ischaemic and non-ischaemic cardiomyopathies using magnetic resonance T1-rho mapping.

AIMS: To identify clinical correlates of myocardial T1ρ and to examine how myocardial T1ρ values change under various clinical scenarios. METHODS AND RESULTS: A total of 66 patients (26% female, median age 57 years [Q1-Q3, 44-65 years]) with known structural heart disease and 44 controls (50% female, median age 47 years [28-57 years]) underwent cardiac magnetic resonance imaging at 1.5 T, including T1ρ mapping, T2 mapping, native T1 mapping, late gadolinium enhancement, and extracellular volume (ECV) imaging. In controls, T1ρ positively related with T2 (P = 0.038) and increased from basal to apical levels (P < 0.001). As compared with controls and remote myocardium, T1ρ significantly increased in all patients' sub-groups and all types of myocardial injuries: acute and chronic injuries, focal and diffuse tissue abnormalities, as well as ischaemic and non-ischaemic aetiologies (P < 0.05). T1ρ was independently associated with T2 in patients with acute injuries (P = 0.004) and with native T1 and ECV in patients with chronic injuries (P < 0.05). Myocardial T1ρ mapping demonstrated good intra- and inter-observer reproducibility (intraclass correlation coefficient = 0.86 and 0.83, respectively). CONCLUSION: Myocardial T1ρ mapping appears to be reproducible and equally sensitive to acute and chronic myocardial injuries, whether of ischaemic or non-ischaemic origins. It may thus be a contrast-agent-free biomarker for gaining new and quantitative insight into myocardial structural disorders. These findings highlight the need for further studies through prospective and randomized trials.

Impairments in learning and memory performances associated with nicotinic receptor expression in the honeybee Apis mellifera after exposure to a sublethal dose of sulfoxaflor.

Sulfoxaflor is a new insecticide which acts on the nicotinic acetylcholine receptor (nAChRs) in a similar way to neonicotinoids. However, sufloxaflor (SFX) is thought to act in a different manner and is thus proposed as an alternative in crop protection. The goal of this study is to evaluate the toxicity of SFX and its sublethal effect on the honeybee Apis mellifera after acute exposure. In toxicological assay studies, the LD50 value and sublethal dose (corresponding to the NOEL: no observed effect level) were 96 and 15 ng/bee, respectively. Using the proboscis extension response paradigm, we found that an SFX dose of 15 ng/bee significantly impairs learning and memory retrieval when applied 12 h before conditioning or 24 h after olfactory conditioning. SFX had no effect on honeybee olfactory performance when exposure happened after the conditioning. Relative quantitative PCR experiments performed on the six nicotinic acetylcholine receptor subunits demonstrated that they are differently expressed in the honeybee brain after SFX exposure, whether before or after conditioning. We found that intoxicated bees with learning defects showed a strong expression of the Amelß1 subunit. They displayed overexpression of Amelα9 and Amelß2, and down-regulation of Amelα1, Amelα3 and Amelα7 subunits. These results demonstrated for the first time that a sublethal dose of SFX could affect honeybee learning and memory performance and modulate the expression of specific nAChR subunits in the brain.

Optimized Computed Tomography Acquisition Protocol for Ethanol Infusion Into the Vein of Marshall.

OBJECTIVES: This study sought to introduce a computed tomography (CT) protocol for optimal planning of vein of Marshall (VOM) catheterization. BACKGROUND: Ethanol infusion into the VOM (Et-VOM) is increasingly used in atrial fibrillation ablation. METHODS: Preprocedural CT was performed with either a conventional (conv-CT; n = 132) or an optimized CT protocol (VOM-CT; n = 126) designed for obtaining on a single image both left atrial and coronary sinus (CS) enhancement. The detection rate and anatomical features of the CT-derived VOM were analyzed and the utility of VOM-CT protocol was assessed by comparing the procedural data. RESULTS: VOM was detected in 35% in conv-CT versus 63% in VOM-CT (P < 0.001). The VOM-CT protocol did not impair the assessment of left atrial anatomy and appendage patency. In VOM-CT, the detection of the VOM was related to body mass index and width of epicardial space on posterior wall. Mean distance between CS ostium and VOM was 36 ± 7 mm. Mean VOM diameter was 1.6 ± 0.3 mm. On the CS circumference, the VOM emerged superiorly in 68% and postero-superiorly in 32%. Ethanol infusion into the VOM was attempted in 165 patients (77 conv-CT, 70 VOM-CT, and 18 without-CT). After registration in CARTO, the VOM segmented on CT matched its location on venography in all cases. As compared with conv-CT and without-CT, procedures guided by VOM-CT showed significantly shorter radiation time, shorter procedure time, lower amount of the contrast medium, and fewer contrast injections to obtain VOM catheterization. CONCLUSIONS: The proposed CT protocol allows for improved visualization of the VOM, translating into easier VOM catheterization.

Human exposure to banned pesticides reported to the French Poison Control Centers: 2012-2016.

In 2008, 30 active substances from plant protection products were banned from marketing in France. Nevertheless, the French Poison Control Centers continue to see cases of poisoning caused by these active substances that are no longer approved. The aim of this study was to describe the characteristics of the reported cases in mainland France and in overseas French territories, over the period 2012-2016. A total of 408 cases of human exposure were reported during the study period. The most commonly reported substances were dichlorvos (24.8%, n = 108), paraquat (23.8%, n = 97), aldicarb (14.7%, n = 60), diuron (9.6%, n = 39), dinocap (5.1%, n = 21), methomyl (4.2%, n = 17), carbofuran (3.9%, n = 16), anthraquinone (2.9%, n = 12) and carbendazim (2.7%, n = 11). The number of cases of intoxication dropped sharply between 2012 (n = 119) and 2016 (n = 47), except in the overseas French territories. Among the 72 serious cases (severe or life-threatening or with a fatal outcome), the most common substances involved were paraquat (n = 34), aldicarb (n = 24) and carbofuran (n = 7). This study suggests persistent use of carbamate insecticides, the existence of illegal imports of dichlorvos or paraquat-based products, and the use of certain banned fungicides in the professional agricultural sector. Information and collection campaigns are therefore essential after the withdrawal of marketing authorization for the plant protection products.

European outbreak of atypical myopathy in the autumn 2009.

BACKGROUND: Atypical myopathy is an acute, severe rhabdomyolysis occurring in grazing horses. In the beginning of October 2009, a new outbreak occurred in several European countries. Geographic, demographic and clinical data of the reported cases in the month October 2009 are described. KEY FINDINGS: The survival rate in this outbreak was 25%. The most frequently observed clinical signs were congested mucous membranes, dyspnea, tachycardia, depression, weakness, stiffness, recumbency, trembling, sweating, and myoglobinuria. Nonsurvivors were significantly more likely to be recumbent than survivors. Prognostic factors, symptomatic treatment, and preventive measures are discussed. SIGNIFICANCE: Differences were encountered during the described outbreak of atypical myopathy in October 2009 compared with previous outbreaks reported. Equine practitioners should be aware that previous epidemiological studies have shown that after a high prevalence in the autumn, new cases are likely to occur in the following spring.