The avian spleen is an important immune organ in birds and its size can be used as an index of immune system responses in different conditions. Based on the lack of knowledge in computed tomography ...of the spleen in chickens, the present study was conducted to assess the inter-and intraobserver reliability in the measurement of the spleen dimensions and attenuation, as well as the feasibility of utilization of these measurements as a predictor of different diseases. For these purposes, the spleens of 47 chickens were included in the study. Two observers measured the dimensions and attenuations of the spleen, which were finally compared with the clinical diagnosis. The results showed an excellent interobserver reliability in the length, width, and height of the spleen (ICC: 0.944, 0.906, and 0.938, retrospectively), and a good interobserver reliability was observed during the evaluation of the average Hounsfield units of the spleen (ICC: 0.818). The intraobserver reliability was excellent in all the measurements (ICC > 0.940). Additionally, no statistical differences were detected in the spleen size and attenuation between the normal and diseased groups. Based on the present results, the computed tomographic measurements of the spleen could not predict the clinical diseases of the chickens; however, the low rates of the inter- and intraobserver variability suggest the reliable utilization of these computed tomographic measurements in routine clinical application and follow-up examinations.
Machine learning (ML) integrated with medical imaging has introduced new perspectives in precision diagnostics of high-grade gliomas, through radiomics and radiogenomics. This has raised hopes for ...characterizing noninvasive and in vivo biomarkers for prediction of patient survival, tumor recurrence, and genomics and therefore encouraging treatments tailored to individualized needs. Characterization of tumor infiltration based on pre-operative multi-parametric magnetic resonance imaging (MP-MRI) scans may allow prediction of the loci of future tumor recurrence and thereby aid in planning the course of treatment for the patients, such as optimizing the extent of resection and the dose and target area of radiation. Imaging signatures of tumor genomics can help in identifying the patients who benefit from certain targeted therapies. Specifying molecular properties of gliomas and prediction of their changes over time and with treatment would allow optimization of treatment. In this article, we provide neuro-oncology, neuropathology, and computational perspectives on the promise of radiomics and radiogenomics for allowing personalized treatments of patients with gliomas and discuss the challenges and limitations of these methods in multi-institutional clinical trials and suggestions to mitigate the issues and the future directions.
Despite advancements in molecular and histopathologic characterization of pediatric low-grade gliomas (pLGGs), there remains significant phenotypic heterogeneity among tumors with similar ...categorizations. We hypothesized that an unsupervised machine learning approach based on radiomic features may reveal distinct pLGG imaging subtypes.
Multi-parametric MR images (T1 pre- and post-contrast, T2, and T2 FLAIR) from 157 patients with pLGGs were collected and 881 quantitative radiomic features were extracted from tumorous region. Clustering was performed using K-means after applying principal component analysis (PCA) for feature dimensionality reduction. Molecular and demographic data was obtained from the PedCBioportal and compared between imaging subtypes.
K-means identified three distinct imaging-based subtypes. Subtypes differed in mutational frequencies of BRAF (p < 0.05) as well as the gene expression of BRAF (p<0.05). It was also found that age (p < 0.05), tumor location (p < 0.01), and tumor histology (p < 0.0001) differed significantly between the imaging subtypes.
In this exploratory work, it was found that clustering of pLGGs based on radiomic features identifies distinct, imaging-based subtypes that correlate with important molecular markers and demographic details. This finding supports the notion that incorporation of radiomic data could augment our ability to better characterize pLGGs.
The present study investigated the expression of cytokines and cellular changes in chickens following vaccination with irradiated avian pathogenic
(APEC) and/or challenge. Four groups of 11-week-old ...pullets, each consisting of 16 birds were kept separately in isolators before they were sham inoculated (N), challenged only (C), vaccinated (V) or vaccinated and challenged (V+C). Vaccination was performed using irradiated APEC applied
aerosol. For challenge, the homologous strain was administered intratracheally. Birds were sacrificed on 3, 7, 14 and 21 days post challenge (dpc) to examine lesions, organ to body weight ratios and bacterial colonization. Lung and spleen were sampled for investigating gene expression of cytokines mediating inflammation by RT-qPCR and changes in the phenotype of subsets of mononuclear cells by flow cytometry. After re-stimulation of immune cells by co-cultivation with the pathogen, APEC-specific IFN-γ producing cells were determined. Challenged only birds showed more severe pathological and histopathological lesions, a higher probability of bacterial re-isolation and higher organ to body weight ratios compared to vaccinated and challenged birds. In the lung, an upregulation of
and
following vaccination and/or challenge at 3 dpc was observed, whereas in the spleen
was elevated. Changes were observed in macrophages and TCR-γδ
cells within 7 dpc in spleen and lung of challenged birds. Furthermore, an increase of CD4
cells in spleen and a rise of Bu-1
cells in lung were present in vaccinated and challenged birds at 3 dpc. APEC re-stimulated lung and spleen mononuclear cells from only challenged pullets showed a significant increase of IFN-γ
CD8α
and IFN-γ
TCR-γδ
cells. Vaccinated and challenged chickens responded with a significant increase of IFN-γ
CD8α
T cells in the lung and IFN-γ
TCR-γδ
cells in the spleen. Re-stimulation of lung mononuclear cells from vaccinated birds resulted in a significant increase of both IFN-γ
CD8α
and IFN-γ
TCR-γδ
cells. In conclusion, vaccination with irradiated APEC caused enhanced pro-inflammatory response as well as the production of APEC-specific IFN-γ-producing γδ and CD8α T cells, which underlines the immunostimulatory effect of the vaccine in the lung. Hence, our study provides insights into the underlying immune mechanisms that account for the defense against APEC.
There is considerable interest in the use of tranexamic acid (TXA) for the control of hemorrhages in trauma patients. Multiple recent studies found that TXA used in the setting of a suspected ...significant hemorrhage in trauma patients significantly reduced mortality. To date, there are no cited studies that specifically address hemorrhage due to solid organ injury (i.e., kidneys, liver, and spleen) and TXA use in humans. Our current research addresses whether TXA is effective in reducing complications and mortality from traumatic hemorrhage in the setting of a specific solid organ injury.
We conducted a retrospective observational cohort study utilizing propensity score matching at Arrowhead Regional Medical Center (ARMC) from February 1, 2009 to February 1, 2019. This study period marks five years prior to and five years after February 1, 2004, which is the date when TXA first started to be used at ARMC in the management of traumatic hemorrhage. We compared for statistical difference between corresponding injury types in the TXA and non-TXA groups.
Before the propensity matching, there were 123 patients who received TXA and 118 patients who did not. After propensity match for age and injury severity score (ISS), 35 patients were included in each group. We found no statistically significant difference between TXA and non-TXA treatment groups in terms of mortality at 24 hours (p-value=0.4945), mortality at 48 hours (p-value=0.4945), and mortality at 28 days (p-value=0.7426). We found no statistically significant difference between the need for interventional radiology intervention at 72 hours (p-value=0.3932), surgical intervention at 72 hours (p-value=0.2123) and possible TXA related complications (p-value=1).
Although prior studies showed that TXA use in the setting of trauma may be beneficial, the specific candidate-selection criteria remain unclear. The results of our study suggest that the benefit from TXA in the setting of the isolated splenic, liver, and or renal injury may be negligible. We believe that this first-of-its-kind study adds to the growing body of knowledge about the utility of TXA and helps guide patient-selection criteria.
Clinical management in neuro-oncology has changed to an integrative approach that incorporates molecular profiles alongside histopathology and imaging findings. While the World Health Organization ...(WHO) guideline recommends the genotyping of informative alterations as a routine clinical practice for central nervous system (CNS) tumors, the acquisition of tumor tissue in the CNS is invasive and not always possible. Liquid biopsy is a non-invasive approach that provides the opportunity to capture the complex molecular heterogeneity of the whole tumor through the detection of circulating tumor biomarkers in body fluids, such as blood or cerebrospinal fluid (CSF). Despite all of the advantages, the low abundance of tumor-derived biomarkers, particularly in CNS tumors, as well as their short half-life has limited the application of liquid biopsy in clinical practice. Thus, it is crucial to identify the factors associated with the presence of these biomarkers and explore possible strategies that can increase the shedding of these tumoral components into biological fluids. In this review, we first describe the clinical applications of liquid biopsy in CNS tumors, including its roles in the early detection of recurrence and monitoring of treatment response. We then discuss the utilization of imaging in identifying the factors that affect the detection of circulating biomarkers as well as how image-guided interventions such as focused ultrasound can help enhance the presence of tumor biomarkers through blood–brain barrier (BBB) disruption.
, formerly known as
, is one member of a group of bacteria referred to as HACEK (
,
,
,
,
) organisms. Infections from any of the HACEK organisms typically lead to very poor outcomes and can be ...difficult to manage, especially when complicated by intracranial hemorrhage (ICH). HACEK organisms can also be difficult to grow on blood cultures, and
is rarely seen, if at all. Traditionally, most laboratories follow an extended incubation protocol of 14 to 21 days to aid the growth of HACEK bacteria. Herein we report a case of infective endocarditis where
resulted on blood culture in three days, in a patient with a right shoulder abscess, complicated by septic embolization leading to ICH. We explore a potential link between the prompt growth of
on blood culture and the presence of the right shoulder abscess.
Remote ischemic preconditioning (RIPC) protects other organs from subsequent lethal ischemic injury, but uncertainty remains. We investigated if RIPC could prevent acute kidney injury (AKI) in ...patients undergoing coronary artery bypass graft (CABG) surgery.
This parallel-group, double-blind, randomized, controlled trial was done on adults undergoing elective or urgent on-pump CABG surgery from 2013 to 2017 in Shiraz, Iran. Patients were allocated to RIPC or control groups through permuted blocking. The patients in the RIPC group received three cycles of 5 min ischemia and 5 min reperfusion in the upper arm after induction of anesthesia. We placed an uninflated cuff on the arm for 30 min in the control group. The study primary endpoint was an incidence of AKI. Secondary endpoints included short-term clinical outcomes. We compared categorical and continuous variables using Pearson χ2 and unpaired t tests, respectively. P<0.05 was considered significant.
of the 180 patients randomized to RIPC (n=90) and control (n=90) groups, 87 patients in the RIPC and 90 patients in the control group were included in the analysis. There was no significant difference in the incidence of AKI between the groups (38 patients 43.7% in the RIPC group and 41 patients 45.6% in the control group; relative risk, 0.96; 95% confidence interval, 0.69 to 1.33; P=0.80). No significant differences were seen regarding secondary endpoints such as postoperative liver function, atrial fibrillation, and inpatient mortality.
RIPC did not reduce the incidence of AKI, neither did it improve short-term clinical outcomes in patients undergoing on-pump CABG surgery.
IRCT2017110537254N1.
PDF
