Ιατρικά Άρθρα: 03/19/18

Δευτέρα 19 Μαρτίου 2018

Editorial Board

Publication date: August 2018
Source:Journal of Environmental Radioactivity, Volume 188

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Enrichment of naturally occurring radionuclides and trace elements in Yatagan and Yenikoy coal-fired thermal power plants, Turkey

Publication date: August 2018
Source:Journal of Environmental Radioactivity, Volume 188
Author(s): Banu Ozden, Erkan Guler, Taavi Vaasma, Maria Horvath, Madis Kiisk, Tibor Kovacs
Coal, residues and waste produced by the combustion of the coal contain naturally occurring radionuclides such as ²³⁸U, ²²⁶Ra, ²¹⁰Pb, ²³²Th and ⁴⁰K and trace elements such as Cd, Cr, Pb, Ni and Zn. In this work, coal and its combustion residues collected from Yatagan and Yenikoy coal fired thermal power plants (CPPs) in Turkey were studied to determine the concentrations of natural radionuclides and trace elements, and their enrichments factors to better understand the radionuclide concentration processes within the combustion system. In addition, the utilization of coal fly ash as a secondary raw material in building industry was also studied in terms of radiological aspects. Fly ash samples were taken at different stages along the emission control system of the thermal power plants. Activity concentrations of naturally occurring radionuclides were determined with Canberra Broad Energy Germanium (BEGe) detector BE3830-P and ORTEC Soloist PIPS type semiconductor detector. The particle size distribution and trace elements contents were determined in various ash fractions by the laser scattering particle size distribution analyzer and inductively coupled plasma (ICP-OES). From the obtained data, natural radionuclides tend to condense on fly ash with and the activity concentrations increase as the temperature drop in CPPs. Measured ²¹⁰Pb and ²¹⁰Po concentration varied between 186 ± 20–1153 ± 44 Bq kg⁻¹, and 56 ± 5–1174 ± 45 Bq kg⁻¹, respectively. The highest ²¹⁰Pb and ²¹⁰Po activity concentrations were determined in fly ash taken from the temporary storage point as 1153 ± 44 Bq kg⁻¹ and 1174 ± 45 Bq kg⁻¹, respectively. There were significant differences in the activity concentrations of some natural radionuclide and trace elements (Pb and Zn) contents in ash fractions among the sampling point inside both of the plants (ANOVA, p < 0.001). Coal and ash sample analysis showed an increase activity concentration and enrichment factors towards the electrostatic precipitators for both of the power plants. The enrichment factors for Zn follow a similar trend as Pb, increasing in value towards the end of the emission control system. The calculated activity indexes were above 1.0 value for both of the power plants, assuming the utilization of fly ash at 100%. It can be concluded that the reuse of fly ash as a secondary raw material may not be hazardous depending on the percentage of utilization of ash.

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Assessment of dose rate to terrestrial biota in the area around coal fired power plant applying ERICA tool and RESRAD BIOTA code

Publication date: August 2018
Source:Journal of Environmental Radioactivity, Volume 188
Author(s): Mirjana Ćujić, Snežana Dragović
This paper presents the environmental radiation risk assessment based on two software program approaches ERICA Tool (version 1.2) and RESRAD BIOTA (version 1.5) to estimate dose rates to terrestrial biota in the area around the largest coal fired power plant in Serbia. For dose rate assessment software's default reference animals and plants and the best estimated values of activity concentrations of ²³⁸U, ²³⁴U, ²³⁴Th, ²³²Th, ²³⁰Th, ²²⁶Ra, ²¹⁰Pb, ²¹⁰Po, ¹³⁷Cs in soil were used. Both approaches revealed the highest contribution to the internal dose rate due to ²²⁶Ra and ²¹⁰Po, while ¹³⁷Cs contributed the most to the external dose rate. In the investigated area total dose rate to biota derived using ERICA Tool ranged from 0.3 to 14.4 μGy h⁻¹. The natural radionuclides exhibited significantly higher contribution to the total dose rate than the artificial one. In the investigated area, only dose rate for lichens and bryophytes exceeded ERICA Tool screening value of total dose rate of 10 μGy h⁻¹ suggested as confident that environmental risks are negligible. The assessed total dose rates for reference animals and plants using RESRAD BIOTA were found to be 7 and 3 μGy h⁻¹, respectively. In RESRAD BIOTA - Level 3, 10 species (Lumbricus terrestris, Rana lessonae, Sciurus vulgaris, Anas platyrhynchos, Lepus europaeus, Vulpes vulpes, Capreolus capreolus, Suss crofa, Quercu srobur, Tilia spp.) representative for the study area were modeled. Among them the highest total dose rate (4.5 μGy h⁻¹) was obtained for large mammals. Differences in the predicted dose rates to biota using the two software programs are the consequence of the difference in the values of transfer parameters used to calculate activity concentrations in biota. Doses of ionizing radiation estimated in this study will not exhibit deterministic effects at the population level. Thus, the obtained results indicate no significant radiation impact of coal fired power plant operation on terrestrial biota. This paper confirms the use ERICA Tool and RESRAD BIOTA softwares as flexible and effective means of radiation impact assessment.

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Non-point source pollution of glyphosate and AMPA in a rural basin from the southeast Pampas, Argentina

Abstract

We measured the occurrence and seasonal variations of glyphosate and its metabolite, aminomethylphosphonic acid (AMPA), in different environmental compartments within the limits of an agricultural basin. This topic is of high relevance since glyphosate is the most applied pesticide in agricultural systems worldwide. We were able to quantify the seasonal variations of glyphosate that result mainly from endo-drift inputs, that is, from direct spraying either onto genetically modified (GM) crops (i.e., soybean and maize) or onto weeds in no-till practices. We found that both glyphosate and AMPA accumulate in soil, but the metabolite accumulates to a greater extent due to its higher persistence. Knowing that glyphosate and AMPA were present in soils (> 93% of detection for both compounds), we aimed to study the dispersion to other environmental compartments (surface water, stream sediments, and groundwater), in order to establish the degree of non-point source pollution. Also, we assessed the relationship between the water-table depth and glyphosate and AMPA levels in groundwater. All of the studied compartments had variable levels of glyphosate and AMPA. The highest frequency of detections was found in the stream sediments samples (glyphosate 95%, AMPA 100%), followed by surface water (glyphosate 28%, AMPA 50%) and then groundwater (glyphosate 24%, AMPA 33%). Despite glyphosate being considered a molecule with low vertical mobility in soils, we found that its detection in groundwater was strongly associated with the month where glyphosate concentration in soil was the highest. However, we did not find a direct relation between groundwater table depth and glyphosate or AMPA detections. This is the first simultaneous study of glyphosate and AMPA seasonal variations in soil, groundwater, surface water, and sediments within a rural basin.

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n-Phase micromechanical framework for the conductivity and elastic modulus of particulate composites: Design to microencapsulated phase change materials (MPCMs)-cementitious composites

Publication date: 5 May 2018
Source:Materials & Design, Volume 145
Author(s): Wenxiang Xu, Mingkun Jia, Zhigang Zhu, Mingjun Liu, Dong Lei, Xiaofan Gou
The smart design of microencapsulated phase change materials (MPCMs) in cementitious composites requires an explicit understanding of effects of soft microcapsule particles, stiff aggregates and their surrounding weak interfaces on the physico-mechanical properties of particulate composites. This paper devises a n-phase micromechanical framework to predict the effective thermal conductivity and elastic modulus of multicomponent particulate composites that consist in stiff and soft anisotropic-shaped inclusions, their surrounding weak interfaces and matrix. In this micromechanical model, the volume fraction of weak interfaces treated as the interphase model is quantified and incorporated into the n-phase differential effective medium model. It is found that the structural configuration of interfaces has a significant effect on the effective physico-mechanical properties of particulate composites. The micromechanical model leads to predictions of the effective conductivity and elastic modulus of multicomponent particulate composites to a good accuracy by comparing with available experimental data for regular concrete, quartz mortar and MPCMs-cementitious composites. By utilizing the micromechanical model, the authors further develop a theoretical design rule for the robust overall performance of MPCMs-cementitious composites with the better thermal resistance and elastic modulus. These results can also be used to design other multiphase particulate composites and porous media with the cherry-pit structure.

Graphical abstract

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Design of sustainable porous materials based on 3D-structured silica exoskeletons, Diatomite: Chemico-physical and functional properties

Publication date: 5 May 2018
Source:Materials & Design, Volume 145
Author(s): B. Galzerano, I. Capasso, L. Verdolotti, M. Lavorgna, P. Vollaro, D. Caputo, S. Iannace, B. Liguori
3D-structured silica exoskeletons-diatomite was used as reactive inorganic ingredient, with and without metakaolin to produce sustainable multifunctional diatomite-based geopolymeric foams. Suitable amount of Silicon powder and vegetable surfactant were used as foaming agents, while polysilicate solution was used as reactive crosslinker. The resulting porous materials, characterized by hierarchical porosity ranging from macro to nano-scale, were fabricated at 40°C for 24h and characterized by means of chemical and morphological investigations, contact angle, thermal and acoustic properties and fire reaction. The presence of diatomite in the produced foams provides an increase of thermal inertia, and the thermal insulation performance firstly due to the intrinsically low thermal conductivity of diatomite and also because silicon and vegetable surfactant are able to promote the formation of a co-continuous mesoporous structure. Furthermore, the created morphological structure provides a good acoustic absorption coefficient in a wide range of frequency. Finally, due to their hydrophilicity/oleophobicity character, diatomite-based geopolymeric foams could, potentially, be proposed as oil/water separation membranes.

Graphical abstract

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Buckling optimization of Kagome lattice cores with free-form trusses

Publication date: 5 May 2018
Source:Materials & Design, Volume 145
Author(s): Lei Zhang, Stefanie Feih, Stephen Daynes, Yiqiang Wang, Michael Yu Wang, Jun Wei, Wen Feng Lu
Lightweight lattice structures are an important class of cellular structures with high potentials for multi-functional applications. Considering load-bearing requirements, truss buckling is one of the main failure mechanisms for low density and slender lattice structures. Critical buckling loads can be increased by modifying the profile of a truss. In this paper, we present a shape design method to optimize the critical buckling loads for lattice cores with free-form trusses. The free-form truss is represented by Fourier series and implicit surfaces, having smooth truss diameter variations and truss joints. The optimized truss profile is obtained by solving a parametric shape optimization problem with Fourier series coefficients as design variables. The method is used for designing optimized 1D columns and 3D Kagome lattice cores for sandwich panels. The numerical results predict 26.8% and 20.4% improvements of the critical buckling loads for 1D columns and 3D Kagome lattice cores compared to their uniform counterparts of the same mass, respectively. The optimized structures include complex smooth and curved geometries that are well suited for additive manufacturing because of the greater design freedom. Finally, the initial and optimized lattice cores are additively manufactured and tested. The experimental results validate the effectiveness of the proposed method.

Graphical abstract

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Functional properties of silicone/ethanol soft-actuator composites

Publication date: 5 May 2018
Source:Materials & Design, Volume 145
Author(s): Aslan Miriyev, Gabriela Caires, Hod Lipson
In the present work, we assess functional properties of silicone/ethanol elastomer composites, recently suggested by us as a novel approach to soft actuation. Our approach allows replacement of massive actuation solutions by self-contained composite material, thus making its detailed characterization extremely important. Here, we describe the composite actuation mechanism using microstructural, thermal and compositional analysis of the material comprising of 0–20vol% ethanol. As a part of our investigation, we also performed mechanical testing aimed at determining the optimal composition, force and strain characteristics for soft actuation. Specifically, we examined the material performance in different soft actuation scenarios pertinent to the soft robotics applications, namely unidirectional piston-like actuator, and radially expanding McKibben artificial muscle. The results were compared in terms of the maximal force and strain developed in the linear portion of the force/time and strain/time scale. The effects of sample size and internal temperature on the mechanical properties of the material were also investigated. Based on the characterization findings, we formulated operational recommendations for utilizing the composites as soft actuators, and drew directions for the further research.

Graphical abstract

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Drop-weight impact characteristics of additively manufactured sandwich structures with different cellular designs

Publication date: 5 May 2018
Source:Materials & Design, Volume 145
Author(s): Amer Beharic, Rafael Rodriguez Egui, Li Yang
In the design of sandwich panels with cellular cores for energy absorption, the geometrical effect of the cellular core design has not been investigated in details previously. In this work three cellular core designs, including re-entrant auxetic, octet-truss, and BCC lattice, were experimentally investigated for their performance under low-energy impact as sandwich structures. Samples with different cellular core designs were fabricated by laser sintering additive manufacturing process using Nylon 12 as material, and evaluated by drop weight testing under multiple strikes and at two levels of elevated temperatures (93°C and 121°C). It was found that beside relative densities, the geometrical design of the cellular cores could also significantly influence the impact energy absorption performance of the sandwich structures. It was also found that the impact energy absorption of the cellular structures investigated in this study does not have a significant correlation with either the quasi-static mechanical properties or the temperature. In addition, the auxetic cellular structure exhibits optimal overall energy absorption performance compared to both the octet-truss and the BCC lattice.

Graphical abstract

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Adhesion force measured by atomic force microscopy for direct carbon fiber-epoxy interfacial characterization

Publication date: 5 May 2018
Source:Materials & Design, Volume 145
Author(s): Nan Zheng, Jinmei He, Jiefeng Gao, Yudong Huang, Flemming Besenbacher, Mingdong Dong
Adhesion force measurement by Atomic force microscopy (AFM) is used to investigate the interfacial interaction of the carbon fiber (CF)/epoxy composite for the first time. The epoxy functionalized AFM tip and three types of carbon fibers with different surface chemistry and morphologies were used in this study. Results show that the Bis (3-aminophenyl) phenyl phosphine oxide (BAPPO) modified CF possesses a much larger adhesion force (72.7 nN) than the as-received and de-sized CF (22.5 nN and 17.9 nN, respectively) due to formation of the chemical bonding between the BAPPO modified CF and the epoxy functionalized tip. Single fiber microbond test demonstrates that the interfacial shear strength (IFSS) of BAPPO modified CF/EP composite is 15% and 22% larger than that of as-received and de-sized CF/EP, respectively. This nanoscale manipulation by AFM provides a new avenue to measure the interfacial adhesion between the CF and epoxy at the molecular level.

Graphical abstract

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Influence of composition and crystal structure on the fracture toughness of NbCo2 Laves phase studied by micro-cantilever bending tests

Publication date: 5 May 2018
Source:Materials & Design, Volume 145
Author(s): W. Luo, C. Kirchlechner, X. Fang, S. Brinckmann, G. Dehm, F. Stein
Cubic and hexagonal NbCo2 Laves phases are known to have composition dependent hardness and yield strength. However, it is unknown whether this dependence is also reflected in their fracture toughness values. In order to elucidate the fracture behavior, single-crystalline micro-cantilevers of the cubic and hexagonal NbCo2 Laves phases having different compositions were fabricated in the diffusion layers grown by the diffusion couple technique. Micro-cantilever bending tests were performed to study the composition- and crystal-structure-dependence of the fracture toughness. To exclude the influence of micro-cantilever geometry, pentagonal and rectangular beams were tested and found to result in the same fracture toughness value. The present results reveal that neither a change of the crystal structure nor a change in chemical composition has a significant influence on the fracture toughness of NbCo2 Laves phase.

Graphical abstract

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Formation of highly porous NiCo2S4 discs with enhanced pseudocapacitive properties through sequential ion-exchange

Publication date: 5 May 2018
Source:Materials & Design, Volume 145
Author(s): Xing Yu, Mengyi Wang, Annie Gagnoud, Yves Fautrelle, Zhongming Ren, Xi Li
In this work, we have developed a sequential chemically topotactic transformation strategy to fabricate highly porous thin NiCo2S4 discs with complex crisscross pore channels through sequential in situ ion-exchange. Starting from Co3O4 discs prepared by direct pyrolysis of solid Co-glycolate discs, complex porous Co3S4 and NiCo2S4 discs are obtained after the sequential ion-exchange reactions with S²⁻ and Ni²⁺ ions, respectively. Physicochemical and electrochemical investigations demonstrate that the as-derived NiCo2S4 discs with high electrical conductivity, ion-diffusion-derived large accessible surface area and pore volume present attractive pseudocapacitive properties including remarkably high capacitivity (908Fg⁻¹ at 3Ag⁻¹), good rate capability (610Fg⁻¹ at 20Ag⁻¹) and outstanding electrochemical stability with a capacitance retention of 82% after continuous cycling for 5000cycles. Furthermore, a hybrid device using the NiCo2S4 discs and carbon-based composite as positive and negative electrodes, respectively, delivers a high energy density of 42.7Whkg⁻¹ at a power density of 375Wkg⁻¹, suggesting that the NiCo2S4 discs could be a powerful electrode platform for advanced supercapacitors.

Graphical abstract

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Editorial Board

Publication date: 5 May 2018
Source:Materials & Design, Volume 145

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Mechanical properties and deformation behavior of additively manufactured lattice structures of stainless steel

Publication date: 5 May 2018
Source:Materials & Design, Volume 145
Author(s): Patrick Köhnen, Christian Haase, Jan Bültmann, Stephan Ziegler, Johannes Henrich Schleifenbaum, Wolfgang Bleck
In this work, we used the powder bed fusion selective laser melting (SLM) technique to build two different lattice structures, i.e. of type f2cc,z and hollow spherical, to investigate their plastic deformation behavior during tension, compression and cyclic testing. The stainless steel AISI 316L/1.4404 was used as model alloy for lattice structures that exhibited a relative density of 33% compared to bulk samples and a part density of 2.623 g/cm³. Using optical microscopy, SEM, EDS, DIC analyses as well as tension, compression and fatigue testing, microstructures and mechanical properties of the two types of lattice structures were compared with annealed counterparts, SLM-produced bulk and reference specimens of the same chemical composition. It was found that the f2cc,z lattice structures deformed by stretch, whereas the hollow spherical lattice structures presented a bending dominated deformation mode. Consequently, f2cc,z lattice specimens revealed higher energy absorption capacity and were capable of bearing higher loads. In addition, the f2cc,z samples showed comparable specific energy absorption with respect to bulk reference samples. The plastic deformation behavior of the different lattice structures has been assessed by considering geometrical and microstructural aspects. Implications on usability and potential improvements were also discussed.

Graphical abstract

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3D cellular metamaterials with planar anti-chiral topology

Publication date: 5 May 2018
Source:Materials & Design, Volume 145
Author(s): Hamid Ebrahimi, Davood Mousanezhad, Hamid Nayeb-Hashemi, Julian Norato, Ashkan Vaziri
We constructed a new class of three-dimensional cellular metamaterials by connecting planar structure with anti-chiral topology. This was achieved by introducing a unique node design for connecting planar materials to enable constructing a three-dimensional architecture. This node design is based on linking the circular elements of the anti-chiral topology using oblique load-bearing ligaments. As the planar structure is subjected to loading, the circular elements rotate and the ligaments undergo bending, resulting in out-of-plane deformation of the three-dimensional cellular metamaterials. The node design, and specifically the ligaments' revolution angle govern the behavior of cellular metamaterials. This was demonstrated by designing cellular metamaterials with a wide range of positive and negative Poisson's ratio in the out-of-plane direction.

Graphical abstract

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Wu-Tou Decoction Inhibits Angiogenesis in Experimental Arthritis by Targeting VEGFR2 Signaling Pathway

Rejuvenation Research, Ahead of Print.

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Effective phthalocyanines mediated photodynamic therapy with doxorubicin or methotrexate combination therapy at sub-micromolar concentrations in vitro

Publication date: June 2018
Source:Photodiagnosis and Photodynamic Therapy, Volume 22
Author(s): Safdar Ali, Saleh Muhammad, Ahmat Khurshid, Masroor Ikram, Muhammad Maqsood, Carl Fisher, Judy Cathcart, Lothar Lilge
To improve a cancer patient's quality of life, short treatment duration resulting in rapid tumour removal while sparing normal tissue are highly desirable. Photodynamic therapy (PDT) commonly applied in a single treatment, while often effective can be limited at low photosensitizer or light doses. Combination therapies can overcome the efficacy limitations while not increasing treatment-associated morbidity. Here the efficacy of combination therapy comprised of doxorubicin (DOX) or methotrexate (MTX) with Photosens mediated PDT was investigated in three cell lines in vitro, employing multiple incubation sequences. Photosense is a mixture of aluminium phthalocyanines with different sulfonation. The results demonstrated higher synergistic effects when DOX or MTX-mediated chemotherapy preceded PDT light activation by 24 h. MTX is marginally more cytotoxic than DOX, when combined with Photosens (AlPcS2-4) mediated PDT. While MTX and DOX exposure prior to AlPcS2-4 incubation may enhance mitochondrial localisation photosensitizer, the simultaneous targeting of DNA, proteins, and lipids of the combination therapies leads to the observed high cytotoxicity at sub μM drug doses. Keywords: Photodynamic Therapy, Chemotherapy, Cancer, Combination therapy

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Chlorin Nanoparticles for Tissue Diagnostics and Photodynamic Therapy

Publication date: Available online 19 March 2018
Source:Photodiagnosis and Photodynamic Therapy
Author(s): Claudia Scalfi-Happ, Zhenxin Zhu, Susanna Graefe, Arno Wiehe, Anastasia Ryabova, Victor Loschenov, Rainer Wittig, Rudolf W. Steiner
BackgroundOrganic crystalline nanoparticles (NPs) are not fluorescent due to the crystalline structure of the flat molecules organized in layers. In earlier experiments with Aluminum Phthalocyanine (AlPc)-derived NPs, the preferential uptake and dissolution by macrophages was demonstrated [3]. Therefore, inflamed tissue or cancer tissue with accumulated macrophages may exhibit specific fluorescence in contrast to healthy tissue which does not fluoresce. The present study addresses the photobiological effects of NP generated from Temoporfin (mTHPC), a clinically utilized photosensitizer belonging to the chlorin family.MethodsIn-vitro investigations addressing uptake, dissolution and phototoxicity of mTHPC NP vs. the liposomal mTHPC formulation Foslip were performed using J774A.1 macrophages and L929 fibroblasts. For total NP uptake analysis, the cells were lysed, the nanoparticles dissolved and the fluorescence quantified. The intracellular molecular dissolution was measured by flow cytometry. Fluorescence microscopy served for controlling intracellular localization of the dissolved fluorescing molecules. Reaction mechanisms after PDT (mitochondrial activity, apoptosis) were analyzed using fluorescent markers in cell-based assays and flow cytometry.ResultsOrganic crystalline NP of different size were produced from mTHPC raw material. NP were internalized more efficiently in J774A.1 macrophages when compared to L929 fibroblasts, whereas uptake and fluorescence of Foslip was similar between the cell lines. NP dissolution correlated with internalization levels for larger particles in the range of 200-500 nm. Smaller particles (45 nm in diameter) were taken up at high levels in macrophages, but were not dissolved efficiently, resulting in comparatively low intracellular fluorescence. Whereas Foslip was predominantly localized in membranes, NP-mediated fluorescence also co-localized with acidic vesicles, suggesting endocytosis / phagocytosis as a major uptake mechanism. In macrophages, phototoxicity of NPs was stronger than in fibroblasts, even exceeding Foslip when administered in identical amounts. In both cell lines, phototoxicity correlated with mitochondrial depolarization and enhanced activation of caspase 3.ConclusionsDue to their preferential uptake / dissolution in macrophages, mTHPC NP may have potential for the diagnosis and photodynamic treatment of macrophage-associated disorders such as inflammation and cancer.

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A Comparison of Neuroradiology and Pediatric Radiology Job Boards

Publication date: Available online 19 March 2018
Source:Current Problems in Diagnostic Radiology
Author(s): Cory M Pfeifer

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Variability in the Use of Simulation for Procedural Training in Radiology Residency: Opportunities for Improvement

Publication date: Available online 19 March 2018
Source:Current Problems in Diagnostic Radiology
Author(s): Shanna A. Matalon, Sona A. Chikarmane, Eren D. Yeh, Stacy E. Smith, William W. Mayo-Smith, Catherine S. Giess
ObjectiveIncreased attention to quality and safety has led to a re-evaluation of the classic apprenticeship model for procedural training. Many have proposed simulation as a supplementary teaching tool. The purpose of this study was to assess radiology resident exposure to procedural training and procedural simulation.Materials and MethodsAn IRB-exempt online survey was distributed to current radiology residents in the United States by e-mail. Survey results were summarized using frequency and percentages. Chi-square tests were used for statistical analysis where appropriate.Results353 current residents completed the survey. Thirty-seven percent (n=129/353) of respondents had never used procedure simulation. Of the residents who had used simulation, most did not do so until after having already performed procedures on patients (59%, n=132/223). The presence of a dedicated simulation center was reported by over half of residents (56%, n=196/353) and was associated with prior simulation experience (P=.007). Residents who had not had procedural simulation were somewhat likely or highly likely (3 and 4 on a 4-point Likert-scale) to participate if it were available (81%, n=104/129). Simulation training was associated with higher comfort levels in performing procedures (P<.001).ConclusionsAlthough procedural simulation training is associated with higher comfort levels when performing procedures, there is variable use in radiology resident training and its use is not currently optimized. Given the increased emphasis on patient safety, these results suggest the need to increase procedural simulation use during residency, including an earlier introduction to simulation prior to patient exposure.

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The Nine Habits of Highly Effective Radiologists

Publication date: Available online 19 March 2018
Source:Current Problems in Diagnostic Radiology
Author(s): Timothy Alves, Monica Kalume-Brigido, Corrie Yablon, Puneet Bhargava, David Fessell
Stephen R. Covey′s landmark work in the field of effectiveness and professional development delineated first seven, then ultimately eight, habits of highly effective people with applicability to all professions.¹ This article describes the eight habits in specific relation to the radiologist, and proposes a ninth habit to help one bring a positive and centered approach during the journey to effectiveness and beyond.

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Lomentospora prolificans vertebral osteomyelitis with spinal epidural abscess in an immunocompetent woman: Case report and literature review

Publication date: Available online 19 March 2018
Source:Medical Mycology Case Reports
Author(s): Walaiporn Wangchinda, Piriyaporn Chongtrakool, Jantima Tanboon, Anupop Jitmuang
Lomentospora prolificans is a rare cause of vertebral osteomyelitis. We report a case of L. prolificans thoracic vertebral osteomyelitis with spinal epidural abscess in a patient without apparent immunodeficiency. Clinical manifestations and radiographic findings could not distinguish from other etiologic agents. Treatment is also challenging because L. prolificans is usually resistant to antifungal agents. The patient underwent surgical debridement and has been receiving a prolonged combination of antifungal therapy to prevent an infection relapse.

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A case of pulmonary cryptococcoma due to Cryptococcus gattii in the United Kingdom

Publication date: Available online 19 March 2018
Source:Medical Mycology Case Reports
Author(s): Isabel Rodriguez-Goncer, Felix Bongomin, Helen M. Doran, Lily Novak-Frazer, Rikesh Masania, Caroline B. Moore, Malcolm D. Richardson
We report a case of Cryptococcus gattii infection in the UK in a 76-year-old woman on biologic therapy for intra-abdominal non-Hodgkin lymphoma. An incidental nodular lung lesion was found on a chest imaging and histology, culture and molecular mycology studies of the lobectomy specimen revealed the presence of C. gattii.

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Near-fatal mucormycosis post-double lung transplant presenting as uncontrolled upper gastrointestinal haemorrhage

Publication date: Available online 19 March 2018
Source:Medical Mycology Case Reports
Author(s): Ciara O'Connor, Ciaran Farrell, Aurelie Fabre, Donna Eaton, Karen Redmond, David G McSharry, John B Conneely, Conor J Shields, Jim J Egan, Margaret M Hannan
Invasive fungal infections in immunosuppressed transplant patients are associated with significant morbidity and mortality. We present a case of splenic mucormycosis post-double lung transplant, presenting as uncontrolled near-fatal upper gastrointestinal haemorrhage, to remind clinicians of the need to consider pre-transplant invasive fungal infection risk factors if an unexpected fungal infection arises in the post-transplant period. This case also highlights the valuable contribution of molecular technology for fungal identification but also the need for clinical correlation.

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The Use of Hormonal Antiandrogen Therapy in Female Patients with Acne: A 10-Year Retrospective Study

Abstract

Background

Little is known about how dermatologists prescribe hormonal antiandrogen acne treatment (HAAT).

Objective

The aim of this study was to investigate dermatologists' HAAT-prescribing habits and HAAT's impact on systemic antibiotic use in women with acne.

Methods

We performed a retrospective study at an academic medical center of female patients receiving HAAT (combined oral contraceptive [COC], spironolactone) for acne from January 2005 to October 2015. Data from a control group of female acne patients who never received HAAT were also collected.

Results

A total of 672 female patients received HAAT. Out of all systemic medications for acne, antibiotics were used as first-line treatment in 39% of patients, COCs in 12%, and spironolactone in 21%. Mean antibiotic durations in patients who initiated HAAT for the first time at the study site (250.4 days) were significantly longer than in patients who received HAAT prior to presentation and continued HAAT at the study site (192.0 days) (p = 0.021). A statistically significant inverse association was found between HAAT use and mean antibiotic duration (p = 0.016).

Conclusions

HAAT is not typically used as a first-line systemic therapy in women with acne. HAAT usage is associated with shorter cumulative antibiotic durations and early HAAT initiation can decrease systemic antibiotic use in acne treatment.

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Editorial Board

Publication date: March–April 2018
Source:Aggression and Violent Behavior, Volume 39

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Repeatability of n-octanol/water partition coefficient values between liquid chromatography measurement methods

Abstract

The n-octanol/water partition coefficient (K_OW) is a physical/chemical property that is extensively used for regulatory and environmental risk and exposure assessments. The K_OW value can estimate various chemical properties such as water solubility, bioavailability, and toxicity using quantitative structure-activity relationships which demands an accurate knowledge of this property. The present investigation aims to compare outcomes of three commonly cited methods of K_OW measurement in the literature for six hydrophobic chemicals with insecticidal functions as well as highly volatile petroleum constituents. This measurement has been difficult to obtain for the selected pyrethroid insecticides, cypermethrin, and bifenthrin and is a novel measurement for the latter: polycyclic aromatic sulfur heterocycles, dibenzothiophene (DBT), and three of its alkyl derivatives except for DBT. The K_OW values were obtained using two liquid chromatographic methods with isocratic and gradient programming, and the slow-stirring method following OECD 117 and 123 guidelines, respectively. The mean log K_OW values of bifenthrin, cypermethrin, DBT, methyl-DBT, dimethyl-DBT, and diethyl-DBT were 8.4 ± 0.1, 6.0 ± 0.3, 4.8 ± 0.0, 5.4 ± 0.1, 6.0 ± 0.1, and 6.8 ± 0.0 using the HPLC method with gradient programing. The K_OW values were significantly reproducible within a method, however, not between the methods. Results suggest assessing a chemical's property and environmental risk and exposure solely based on the K_OW value should be practiced with caution.

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How disturbances and management practices affect bird communities in a Carpathian river ecosystem?

Publication date: April 2018
Source:Acta Oecologica, Volume 88
Author(s): Jozef Lacko, Ján Topercer, Marek Súľovský
We studied how interactions between disturbances, succession, human alterations and other habitat and landscape attributes affect bird community patterns in a lower reach of a large West Carpathian river Váh with complex disturbance and alteration histories. Breeding-bird communities, their habitats (54 variables) and surrounding landscapes (11 metrics) were sampled using standardized point counts with limited distances at 40 riparian sites divided among two transects along a 12.9 km river stretch. The most frequent and abundant birds were generalists typically associated with forest edge habitats, such as Parus major, Sylvia atricapilla, Fringilla coelebs, Oriolus oriolus, Phylloscopus collybita, Sturnus vulgaris, Turdus merula and Luscinia megarhynchos. Abundances show significant increase at the lower transect responding apparently to greater size and heterogeneity of riparian habitats and more abundant food supply linked to more diverse and intense human influences in a suburban zone. Both indirect (NMDS) and direct ordination (CCA) revealed remarkably large number of evenly important factors underlying riparian bird-habitat interactions. It suggests considerable environmental heterogeneity and complexity of these interactions as a likely outcome of long and complex disturbance and alteration histories of the area. Yet structure and relative importance of first two gradients (longitudinal and lateral linkages) remains simple and stable, complying well with predictions of river continuum concept and stream ecosystem theory. Of the nine statistically significant variables most strongly correlated with first two CCA axes, percentages of Helianthus tuberosus, footpaths, fields, Calystegia sepium and steep banks uphold our hypotheses predicting significant effects of invasive species, visitor disturbances, agricultural land use and unaltered river banks/bed on bird community composition and structure. A small but significant contribution of patch size standard deviation within a 150 m radius to the CCA model provides the sole evidence for a hypothesized effect of adjacent terrestrial landscapes on riparian bird communities over different scales of patch size variability. Percentages of fields, invasive species and vertical banks along with average tree diameter were also the most productive predictors across our generalized linear models of riparian bird species diversity, evenness and abundance. Adopting an integrated river basin management, maintaining or restoring both longitudinal and lateral connectivity, taking advantage of natural processes and traditional management practices to maintain or restore riverine biodiversity can be recommended by our data in support of more systematic and evidence-based decision-making.

http://ift.tt/2poVga3

Seal carrion is a predictable resource for coastal ecosystems

Publication date: April 2018
Source:Acta Oecologica, Volume 88
Author(s): Maria-Martina Quaggiotto, Philip S. Barton, Christopher D. Morris, Simon E.W. Moss, Patrick P. Pomeroy, Dominic J. McCafferty, David M. Bailey
The timing, magnitude, and spatial distribution of resource inputs can have large effects on dependent organisms. Few studies have examined the predictability of such resources and no standard ecological measure of predictability exists. We examined the potential predictability of carrion resources provided by one of the UK's largest grey seal (Halichoerus grypus) colonies, on the Isle of May, Scotland. We used aerial (11 years) and ground surveys (3 years) to quantify the variability in time, space, quantity (kg), and quality (MJ) of seal carrion during the seal pupping season. We then compared the potential predictability of seal carrion to other periodic changes in food availability in nature. An average of 6893 kg of carrion ∙yr⁻¹ corresponding to 110.5 × 10³ MJ yr⁻¹ was released for potential scavengers as placentae and dead animals. A fifth of the total biomass from dead seals was consumed by the end of the pupping season, mostly by avian scavengers. The spatial distribution of carcasses was similar across years, and 28% of the area containing >10 carcasses ha⁻¹ was shared among all years. Relative standard errors (RSE) in space, time, quantity, and quality of carrion were all below 34%. This is similar to other allochthonous-dependent ecosystems, such as those affected by migratory salmon, and indicates high predictability of seal carrion as a resource. Our study illustrates how to quantify predictability in carrion, which is of general relevance to ecosystems that are dependent on this resource. We also highlight the importance of carrion to marine coastal ecosystems, where it sustains avian scavengers thus affecting ecosystem structure and function.

http://ift.tt/2IAOt5X

Managing complex trauma injuries in the elderly: a case report of a free flap and circular frame in a 95-year old patient with an open IIIB tibial fracture

Abstract

In an ageing population, increasing numbers of patients over the age of 70 are sustaining severe trauma. These patients require careful multidisciplinary team (MDT) management with careful consideration of existing co-morbidities, as such their treatment should be individually tailored. We present the case of a patient believed to be the oldest documented patient treated in a trauma setting with free flap and circular frame fixation to an open tibial fracture. A 95-year-old male presented to the Level 1 Major Trauma Centre (MTC) with multiple injuries after a pedestrian vs car incident. His injury severity score (ISS) was 22. For treatment of his open tibial fracture, he required soft tissue coverage with a free anterolateral thigh (ALT) flap, and circular frame application. Microsurgery was performed after consultation with the MDT and was uneventful. The circular frame was removed after 10 months and the patient went on to regain pre-injury mobility. Use of free tissue transfer in elderly patients is well documented in the elective setting, but less so in trauma. This case demonstrates that careful patient selection, attention to detail and MDT working can result in an excellent outcome for the patient. The challenges faced in treating this patient will be described in detail.

Level of Evidence: Level V, therapeutic study.

http://ift.tt/2FNDd8u

Editorial Board

Publication date: April 2018
Source:Peptides, Volume 102

http://ift.tt/2poogiG

Endoreplication: The Good, the Bad, and the Ugly

Publication date: Available online 19 March 2018
Source:Trends in Cell Biology
Author(s): Zhiqiang Shu, Sarayu Row, Wu-Min Deng
To battle adverse internal and external conditions and maintain homeostasis, diploid organisms employ various cellular processes, such as proliferation and apoptosis. In some tissues, an alternative mechanism, endoreplication, is employed toward similar goals. Endoreplication is an evolutionarily conserved cell cycle program during which cells replicate their genomes without division, resulting in polyploid cells. Importantly, endoreplication is reported to be indispensable for normal development and organ formation across various organisms, from fungi to humans. In recent years, more attention has been drawn to delineating its connections to wound healing and tumorigenesis. In this Review, we discuss mechanisms of endoreplication and polyploidization, their essential and positive roles in normal development and tissue homeostasis, and the relationship between polyploidy and cancer.

http://ift.tt/2pq7Ntz

Cardiovascular Complications in Pregnancy: It Is Time for Action.

Author: Graves, Cornelia R. MD; Davis, Stacy F. MD

Page: 1213-1215

http://ift.tt/2IClC19

Class Effect for Sodium Glucose-Cotransporter-2 Inhibitors in Cardiovascular Outcomes: Implications for the Cardiovascular Disease Specialist.

Author: Bethel, M. Angelyn MD; McMurray, John J.V. MD

Page: 1218-1220

http://ift.tt/2IE9a0u

Perioperative Myocardial Injury After Noncardiac Surgery: Incidence, Mortality, and Characterization.

Author: Puelacher, Christian MD, PhD; Lurati Buse, Giovanna MD, MSc; Seeberger, Daniela MD; Sazgary, Lorraine MD; Marbot, Stella MD; Lampart, Andreas MD; Espinola, Jaqueline MD; Kindler, Christoph MD Prof; Hammerer, Angelika MD; Seeberger, Esther DAS; Strebel, Ivo MSc; Wildi, Karin MD; Twerenbold, Raphael MD; du Fay de Lavallaz, Jeanne MD; Steiner, Luzius MD Prof; Gurke, Lorenz MD Prof; Breidthardt, Tobias MD; Rentsch, Katharina PhD Prof; Buser, Andreas MD; Gualandro, Danielle M. MD, PhD; Osswald, Stefan MD Prof; Mueller, Christian MD; for the BASEL-PMI Investigators; Seeberger, Manfred; Christ-Crain, Mirjam; Cuculi, Florim; Badertscher, Patrick; Nestelberger, Thomas; Wussler, Desiree; Flores, Dayana; Boeddinghaus, Jasper; Sabti, Zaid; Gimenez, Maria Rubini; Kozhuharov, Nikola; Shrestha, Samyut; Kloos, Wanda; Lohrmann, Jens; Reichlin, Tobias; Freese, Michael; Meissner, Kathrin; Kaiser, Christoph; Buser, Andreas

Page: 1221-1232

http://ift.tt/2poPCET

High-Sensitivity Troponin in Noncardiac Surgery: Pandora's Box or Opportunity for Precision Perioperative Care?.

Author: Mandawat, Aditya MD; Newby, L. Kristin MD, MHS

Page: 1233-1235

http://ift.tt/2IE1Ulm

Long-Term Outcomes in Patients With Type 2 Myocardial Infarction and Myocardial Injury.

Author: Chapman, Andrew R. MD; Shah, Anoop S.V. MD, PhD; Lee, Kuan Ken MD; Anand, Atul MD; Francis, Oliver MD; Adamson, Philip MD; McAllister, David A. MD; Strachan, Fiona E. PhD; Newby, David E. MD, PhD; Mills, Nicholas L. MD, PhD

Page: 1236-1245

http://ift.tt/2poMDvS

Obesity, Hypertension, and Dyslipidemia in Childhood Are Key Modifiable Antecedents of Adult Cardiovascular Disease: A Call to Action.

Author: Turer, Christy B. MD, MHS; Brady, Tammy M. MD, PhD; de Ferranti, Sarah D. MD, MPH

Page: 1256-1259

http://ift.tt/2punUqn

PCSK9 Variants, Low-Density Lipoprotein Cholesterol, and Neurocognitive Impairment: Reasons for Geographic and Racial Differences in Stroke Study (REGARDS).

Author: Mefford, Matthew T. MS; Rosenson, Robert S. MD; Cushman, Mary MD; Farkouh, Michael E. MD, MSc; McClure, Leslie A. PhD; Wadley, Virginia G. PhD; Irvin, Marguerite R. PhD; Bittner, Vera MD, MSPH; Safford, Monika M. MD; Somaratne, Ransi MD; Monda, Keri L. PhD; Muntner, Paul PhD; Levitan, Emily B. ScD

Page: 1260-1269

http://ift.tt/2ICY0t8

Application of Large-Scale Aptamer-Based Proteomic Profiling to Planned Myocardial Infarctions.

Author: Jacob, Jaison PhD *,; Ngo, Debby MD *,,; Finkel, Nancy MS; Pitts, Rebecca MS; Gleim, Scott PhD; Benson, Mark D. MD, PhD; Keyes, Michelle J. PhD; Farrell, Laurie A. RN; Morgan, Thomas MD; Jennings, Lori L. PhD +,; Gerszten, Robert E. MD +,,

Page: 1270-1277

http://ift.tt/2pqr6TO

Venous Thromboembolism Quality Measures Fail to Accurately Measure Quality.

Author: Lau, Brandyn D. MPH, CPH; Streiff, Michael B. MD; Pronovost, Peter J. MD, PhD; Haut, Elliott R. MD, PhD

Page: 1278-1284

http://ift.tt/2ICg1HX

From the Literature.

Author: Hampton, Tracy

Page: 1285-1286

http://ift.tt/2pq7oY5

Ventricular Tachycardia and Electrocardiographic ST-Segment-Elevation Myocardial Infarction Without Coronary Artery Disease.

Author: Zauner, Christina A. MD; Holshouser, J. Warren MD; Littmann, Laszlo MD, PhD

Page: 1287-1289

http://ift.tt/2ICfUfv

Association of Genetic Variation in Coronary Artery Disease-Related Loci With the Risk of Heart Failure With Preserved Versus Reduced Ejection Fraction.

Author: Andersson, Charlotte MD, PhD; Lyass, Asya PhD; Lin, Honghuang PhD; Kober, Lars MD, DSc; Larson, Martin G. DSc; Vasan, Ramachandran S. MD

Page: 1290-1292

http://ift.tt/2poQ5Xy

Letter by Zhu et al Regarding Article, "Aortic Wall Inflammation Predicts Abdominal Aortic Aneurysm Expansion, Rupture, and Need for Surgical Repair".

Author: Zhu, Chengcheng PhD; Saloner, David PhD; Hope, Michael D. MD

Page: 1293-1294

http://ift.tt/2IE1U4Q

Response to Letter Regarding Article, "Aortic Wall Inflammation Predicts Abdominal Aortic Aneurysm Expansion, Rupture, and Need for Surgical Repair".

Author: Forsythe, Rachael O. MD; Syed, Maaz MD; Newby, David E. MD, PhD; On Behalf of the MA3RS Investigators

Page: 1295-1296

http://ift.tt/2poQ5H2

Letter by Lewis et al Regarding Article, "Effect of Intensive Blood Pressure Lowering on Left Ventricular Hypertrophy in Patients With Hypertension: SPRINT (Systolic Blood Pressure Intervention Trial)".

Author: Lewis, Gavin A. MBChB; Schelbert, Erik B. MD, MS; Miller, Christopher A. MBChB, PhD

Page: 1297-1298

http://ift.tt/2IAHEBn

Letter by Jin-shan and Xue-bin Regarding Article, "Effect of Intensive Blood Pressure Lowering on Left Ventricular Hypertrophy in Patients With Hypertension: SPRINT (Systolic Blood Pressure Intervention Trial)".

Author: Jin-shan, He MD; Xue-bin, Li MD

Page: 1299

http://ift.tt/2poPqWb

Response by Soliman et al to Letters Regarding Article, "Effect of Intensive Blood Pressure Lowering on Left Ventricular Hypertrophy in Patients With Hypertension: SPRINT (Systolic Blood Pressure Intervention Trial)".

Author: Soliman, Elsayed Z. MD, MSc, MS; Ambrosius, Walter T. PhD; Lewis, Cora E. MD, MSPH

Page: 1300-1301

http://ift.tt/2ICfhCF

Radiotherapy induced cavernomas in adult cancer patients

Publication date: Available online 19 March 2018
Source:Radiotherapy and Oncology
Author(s): Bernardo Cacho-Díaz, Karen Salmerón-Moreno, Nydia Lorenzana-Mendoza, Armando Reyes, Sergio I. Valdés-Ferrer, Gabriela Gómez-Ahumada, Gervith Reyes-Soto, Ángel Herrera-Gómez
Cerebral Cavernomas (CC) are vascular malformations located in the Central Nervous System (CNS) characterized by endothelium-lined vascular channels without parenchyma between them, whose main risk is hemorrhage. The aim of this study is to report adult cancer patients that developed CC after radiotherapy (RT) to the CNS during oncological surveillance.

http://ift.tt/2DFNBZO

Deltamethrin-induced nuclear erythrocyte alteration and damage to the gills and liver of Colossoma macropomum

Abstract

Deltamethrin is one of the most commonly used pyrethroids in the world, and it has a high toxic potential, mainly on aquatic organism. Thus, the purpose of this study was to evaluate LC₅₀ values of deltamethrin on tambaqui (Colossoma macropomum) fingerlings and to investigate genotoxic effects and histopathological responses. Fish were exposed to different concentrations of deltamethrin (0, 6.16 × 10⁻³; 6.44 × 10⁻²; 1.34 × 10⁻¹, and 1.93 × 10⁻¹ mg L⁻¹) for 96 h. In addition, a genotoxicity analysis was carried out on peripheral blood erythrocytes and histopathological changes were classified by the severity degree of damage and organ functioning. The 96 h LC₅₀ value for tambaqui was estimated at 5.56 × 10⁻² mg L⁻¹ using a static test system. Nuclear abnormalities in exposed fish included micronuclei, blebbed, notched, 8-shaped, and binucleated nuclei forms. Deltamethrin significantly induced a notched nucleus compared to other abnormalities. A histopathological examination showed hepatic lesions and gill damage. Deltamethrin was found to be highly toxic; it induced genotoxicity and caused liver and gill inflammation in tambaqui.

http://ift.tt/2prHoM1

The transition from HLA-I positive to HLA-I negative primary tumors: the road to escape from T-cell responses

Publication date: April 2018
Source:Current Opinion in Immunology, Volume 51
Author(s): Natalia Aptsiauri, Francisco Ruiz-Cabello, Federico Garrido
MHC/HLA class I loss in cancer is one of the main mechanisms of tumor immune escape from T-cell recognition and destruction. Tumor infiltration by T lymphocytes (TILs) and by other immune cells was first described many years ago, but has never been directly and clearly linked to the destruction of HLA-I positive and selection of HLA-I negative tumor cells. The degree and the pattern of lymphocyte infiltration in a tumor nest may depend on antigenicity and the developmental stages of the tumors. In addition, it is becoming evident that HLA-I expression and tumor infiltration have a direct correlation with tumor tissue reorganization. We observed that at early stages (permissive Phase I) tumors are heterogeneous, with both HLA-I positive and HLA-negative cancer cells, and are infiltrated by TILs and M1 macrophages as a part of an active anti-tumor Th1 response. At later stages (encapsulated Phase II), tumor nests are mostly HLA-I negative with immune cells residing in the peri-tumoral stroma, which forms a granuloma-like encapsulated tissue structure. All these tumor characteristics, including tumor HLA-I expression pattern, have an important clinical prognostic value and should be closely and routinely investigated in different types of cancer by immunologists and by pathologists. In this review we summarize our current viewpoint about the alterations in HLA-I expression in cancer and discuss how, when and why tumor HLA-I losses occur. We also provide evidence for the negative impact of tumor HLA-I loss in current cancer immunotherapies, with the focus on reversible ('soft') and irreversible ('hard') HLA-I defects.

http://ift.tt/2FWgNxR

Lung Cancer Biopsies

Publication date: Available online 7 March 2018
Source:Radiologic Clinics of North America
Author(s): Amita Sharma, Jo-Anne O. Shepard

Teaser

Image-guided percutaneous transthoracic needle biopsy (PTNB) is a well-established and minimally invasive technique for evaluating pulmonary nodules. Implementation of a national lung screening program and increased use of chest computed tomography have contributed to the frequent identification of indeterminate pulmonary nodules that may require tissue sampling. The advent of biomarker-driven lung cancer therapy has led to increased use of repeat PTNB after diagnosis. Percutaneous insertion of markers for preoperative localization of small nodules can aid in minimally invasive surgery and radiation treatment planning. This article discusses PTNB, patient selection, and biopsy technique, including minimizing and managing complications.

http://ift.tt/2FLJ3XH

Missed Lung Cancer

Publication date: Available online 7 March 2018
Source:Radiologic Clinics of North America
Author(s): Rydhwana Hossain, Carol C. Wu, Patricia M. de Groot, Brett W. Carter, Matthew D. Gilman, Gerald F. Abbott

Teaser

The chest radiograph is one of the most commonly used imaging studies and is the modality of choice for initial evaluation of many common clinical scenarios. Over the last two decades, chest computed tomography has been increasingly used for a wide variety of indications, including respiratory illnesses, trauma, oncologic staging, and more recently lung cancer screening. Diagnostic radiologists should be familiar with the common causes of missed lung cancers on imaging studies in order to avoid detection and interpretation errors. Failure to detect these lesions can potentially have serious implications for both patients as well as the interpreting radiologist.

http://ift.tt/2u3kTT9

MR Imaging of the Prostate

Publication date: March 2018
Source:Radiologic Clinics of North America, Volume 56, Issue 2
Author(s): Aytekin Oto

http://ift.tt/2FNJDED

Copyright

Publication date: March 2018
Source:Radiologic Clinics of North America, Volume 56, Issue 2

http://ift.tt/2u1bifH

Staging Lung Cancer

Publication date: Available online 7 March 2018
Source:Radiologic Clinics of North America
Author(s): Girish S. Shroff, Chitra Viswanathan, Brett W. Carter, Marcelo F. Benveniste, Mylene T. Truong, Bradley S. Sabloff

Teaser

The updated eighth edition of the tumor, node, metastasis (TNM) classification for lung cancer includes revisions to T and M descriptors. In terms of the M descriptor, the classification of intrathoracic metastatic disease as M1a is unchanged from TNM-7. Extrathoracic metastatic disease, which was classified as M1b in TNM-7, is now subdivided into M1b (single metastasis, single organ) and M1c (multiple metastases in one or multiple organs) descriptors. In this article, the rationale for changes in the M descriptors, the utility of preoperative staging with PET/computed tomography, and the treatment options available for patients with oligometastatic disease are discussed.

http://ift.tt/2FPKRPx

Contributors

Publication date: March 2018
Source:Radiologic Clinics of North America, Volume 56, Issue 2

http://ift.tt/2u1bgo5

Publication date: March 2018
Source:Radiologic Clinics of North America, Volume 56, Issue 2

http://ift.tt/2FPKKDB

CME Accreditation Page

Publication date: March 2018
Source:Radiologic Clinics of North America, Volume 56, Issue 2

http://ift.tt/2u1x1UG

Forthcoming Issues

Publication date: March 2018
Source:Radiologic Clinics of North America, Volume 56, Issue 2

http://ift.tt/2FKCYuR

Atemwegsmanagement – der schwierige Atemweg beim thoraxchirurgischen Patienten

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 187-197
DOI: 10.1055/s-0043-114679

Das Management des schwierigen Atemwegs bei thoraxchirurgischen Patienten ist in den gültigen Leitlinien kaum abgebildet und stellt insbesondere in der Thoraxanästhesie mit der notwendigen Seitentrennung der Atemwege durch einen Doppellumentubus oder Bronchusblocker eine Herausforderung dar. Die Definition des schwierigen Atemwegs mit erschwerter Maskenbeatmung, Laryngoskopie oder endotrachealer Intubation wird überwiegend durch Veränderungen der Anatomie der oberen Atemwege (schwieriger oberer Atemweg) charakterisiert. Pathologische Veränderungen in der tracheobronchialen Anatomie, die die Platzierung des Doppellumentubus oder anderer Atemwegshilfen erschweren (schwieriger unterer Atemweg; schwierige Seitentrennung), sind in die Definition miteinzubeziehen. Der vorliegende Artikel beschreibt die Identifikation von Risikopatienten, Techniken, Empfehlungen und Algorithmen für das Management bei erwartet und unerwartet schwierigem Atemweg. Darüber hinaus gibt er einen Überblick über die Auswahl verschiedener Verfahren und Hilfsmittel zur Seitentrennung der Lungen zur Etablierung einer Ein-Lungen-Ventilation.
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