RESUMEN

This study investigated a quick way to discriminate grape varieties based on their composition in volatile compounds through a SIFT-MS scan coupled with simple chemometrics approaches such as analysis of variance (ANOVA), principal component analysis (PCA) and hierarchical ascendant classification (HAC). The 23 studied grape varieties were distinguishable using O2+, H3O+ and NO+ as reagent ions, and the combination of these three ions. For its ability to ionize most compounds, to efficiently fragment them to generate ions with distinct m/z ratio, and to enhance the differentiation of compounds of similar masses, O2+ reagent ion should be preferentially considered. The use of one single ion rather than three enables to limit the time of analysis and the number of variables to be treated. The technique allowed the distinction of high and low aroma compounds producers as confirmed by headspace solid-phase microextraction followed by gas chromatography-mass spectrometry (HS-SPME/GC-MS) analyses. SIFT-MS is a quick and interesting tool with potential application in various fields of viticulture such as phenotyping of grape varieties or non-targeted studies on the impact of environmental factors or viticultural practices on grape aroma composition.

Asunto(s)

RESUMEN

PURPOSE: We evaluated the association between intravesical prostate protrusion (IPP) and the detection rate of clinically significant prostate cancer (csPCa) on magnetic resonance imaging (MRI)-transrectal ultrasound (TRUS) fusion targeted biopsy (TB). MATERIALS AND METHODS: A total of 538 consecutive men who underwent MRI-TRUS fusion TB and concomitant systematic biopsy were evaluated. IPP on MRI was independently measured by 4 blinded reviewers. The primary outcome was per-lesion detection of csPCa on TB. We assessed the association between IPP and csPCa detection on TB, controlling for age, prostate specific antigen, Prostate Imaging Reporting and Data System® (PI-RADS®) score, prostate volume, targeted cores sampled and previous biopsy experience. RESULTS: A total of 847 PI-RADS 3 or greater lesions were targeted across 570 biopsies. Intra- and interrater reliability for measuring IPP was strong. A total of 81 (14.2%), 127 (22.3%), 237 (41.6%) and 125 (21.9%) men had 0, small, medium and large IPP, respectively. A total of 230, 392 and 196 lesions were PI-RADS 3, 4 and 5, respectively. Of the lesions 198 (34.7%) had csPCa on TB. The overall relationship between IPP size and csPCa found on TB was not significant; however, large IPP is associated with a significantly lower rate of csPCa detection than 0 IPP (p=0.007). Every mm increase in IPP is associated with a 5.6% decrease in the odds of csPCa detection on TB (p=0.004) and a 66.5% decrease in odds of detection in large IPP compared to 0 IPP (p=0.003). CONCLUSIONS: As the size of the IPP and volume increase, there is a decrease in the detection rate of csPCa on MRI-guided TB. These findings may be driven by poor MRI-TRUS co-registration and prostate asymmetry.

Asunto(s)

RESUMEN

OBJECTIVE: To assess the effect of resident involvement on patient and physician satisfaction, we evaluated the outcomes from a private urology group both prior to and after initiation of resident coverage. METHODS: Urologic procedures completed by attending surgeons without residents from October 2010 to December 2011 were compared to the same surgeons working with residents from January 2012 to March 2013. Surgical case times, postoperative complications, readmission rate, length of stay, Press-Ganey consumer assessments, resident and physician self-report of training quality and quality of life were collected. RESULTS: 3316 operative and nonoperative cases were measured.Total 1565 were in preresident periods and 1751 were in postresident periods. With resident coverage, there was an increase in OR times. There was no difference in complications for surgical and nonsurgical cases (P = .2269 and P = 1.000, respectively). There was a statistically significant improvement of readmission rate in nonsurgical patients with resident coverage (P = .0344). Patients' satisfaction scores were higher in every category and they more often reported that they "always" received quality care (78.6 % vs 82.5%) with resident coverage. Resident and faculty perceptions of training, patient care, and satisfaction increased with resident coverage. CONCLUSION: Resident coverage of a private practice urology group resulted in no difference in surgical complications and improvement in readmission rates in nonsurgical patients. It resulted in longer OR times but greater satisfaction of faculty, residents and most important, patients. Our data demonstrate the beneficial effect of resident participation in patient care and provides further justification of residency financial support.

Asunto(s)

RESUMEN

BACKGROUND: Neurotoxoplasmosis is a common opportunistic infection in HIV/AIDS patients. Imaging identification of neurotoxoplasmosis assists in timely treatment. PURPOSE: To delineate the frequency of imaging abnormalities in patients with neurotoxoplasmosis on different MR sequences with a particular focus on SWI, and NCCT. MATERIAL AND METHODS: The PACS database was retroactively searched over a 5-year period for patients with neurotoxoplasmosis who underwent MRI with SWI. Included patients had imaging features of neurotoxoplasmosis based on consensus review by two neuroradiologists, a clinical diagnosis of neurotoxoplasmosis at the time of MRI, and diagnostic confirmation based on positive serum or CSF serology or histopathology; 15 patients were included. The number of abnormal foci with restricted diffusion, increased FLAIR signal, intrinsic T1 hyperintensity, abnormal enhancement (CE-T1WI), and intrinsic hyperdensity on CT were recorded. RESULTS: Intralesional susceptibility signal (ISS) foci on SWI were observed in 93.3% of patients with neurotoxoplasmosis (mean size 5.2 ±â€¯3.8 mm). The average number of ISS foci was 3.9 per patient; 3/15 (20.0%) had a single ISS. Amongst other MR sequences, hyperintense FLAIR foci were the most common abnormalities observed (12.4 lesions/patient), followed by enhancing foci (8.2 lesions/patient), foci of restricted diffusion (7.1 lesions/patient), and intrinsic T1 hyperintense foci (3.4 lesions/patient). Abnormalities were least frequently observed on NCCT: abnormalities were identified in 5/15 (33.3%) patients, at a rate of 0.4 lesions/patient. CONCLUSION: ISS foci are present in the vast majority of neurotoxoplasmosis patients, likely representing hemorrhage. The incidence and frequency of other abnormal foci are highest on FLAIR, and lowest on NCCT.

RESUMEN

The constant improvement of industrial needs to face modern telecommunication challenges leads to the development of novel transducer principles as alternatives to SAW and BAW solutions. The main technological limits of SAW (short-circuit between electrodes) and BAW (precise thickness control) solutions can be overcome by a new kind of transducer based on periodically poled ferroelectric substrate. The approach proposed in this paper exploits a ridge structure combined with a periodically poled transducer (PPT), allowing for the excitation of highly coupled modes unlike previously published results on planar PPTs. High-aspect-ratio ridges showing micrometer dimensions are achieved by dicing PPT plates with a diamond-tipped saw. An adapted metallization is achieved to excite acoustic modes exhibiting electromechanical coupling in excess of 15% with phase velocities up to 10 000 m·s(-1). Theoretical predictions show that these figures may reach values up to 20% and 18 000 m·s(-1), respectively, using an appropriate design.

RESUMEN

BACKGROUND: Methamphetamine (METH) use has increased substantially in the last 10 years and poses a serious health concern, especially for young populations. Drug abuse primarily begins during adolescence, when uninhibited and excessive and drug intake is a common occurrence; thus, understanding the developmental patterns of addiction during this critical period is an essential step in its prevention. In the present study, the effect of age on the vulnerability to METH abuse was examined using a rat model of bingeing (i.e., escalation). METHODS: Adolescent and adult rats were compared during short (ShA, 2-h) and long-access (LgA, 6-h) to METH self-administration. On postnatal (PN) days 23 (adolescents) and 90 (adults), rats were implanted with i.v. catheters and trained to lever press for infusions of METH (0.05mg/kg) during 2-h sessions. Once the rats reached a steady rate of METH self-administration, they were divided into ShA or LgA groups and allowed to self-administer METH for 15 additional days. RESULTS: Results indicated that adolescent rats earned significantly more infusions than adults under the LgA condition, but the age groups did not differ during ShA. Adolescents, but not adults, also significantly increased (i.e., escalated) METH self-administration across the 15 days of testing under the LgA condition. Further analysis indicated excessive responding during infusions in the LgA METH-exposed adolescents compared to the other groups, suggesting elevated impulsivity or motivation for drug. CONCLUSION: These results demonstrate that adolescents are more vulnerable to the escalation of METH than adults during LgA.

Asunto(s)

RESUMEN

AIM: In the presence of coronary artery disease, implantable cardioverter-defibrillators (ICD) are used effectively for treating life-threatening tachyarrhythmias. Continuous monitoring of myocardial ischaemia would provide a new diagnostic option in future ICD generations. METHODS AND RESULTS: In 22 selected patients undergoing coronary angioplasty, percutaneous transluminal coronary angioplasty (PTCA), three electrodes, similar to those used in the ICD, were inserted aiming to create six intra-thoracic ECG (IT-ECG) leads according to Einthoven and Goldberger. In total, 27 PTCA were conducted. The diagnostic efficacy for ischaemia assessment was compared with the surface ECG. The IT-ECG proved to be more sensitive than conventional ECG in early and overall ischaemia assessment. At 30 s of coronary artery occlusion, ischaemic ST-segment alterations (> or =0.25 mV) were present in the IT-ECG 2.3 times more often (23 vs. 10/27 PTCA attempts, P<0.01) and at 90 s 1.4 times more often compared with conventional ECG leads (18 vs. 26/27, P<0.05). Intra-thoracic Einthoven 2 (SVC+RVA vs. ICD-housing) and Goldberger 3 (SVC+ICD-housing vs. RVA) had the highest sensitivity (88/85%). Using > or =4 IT-ECG, ischaemia monitoring was independent of severity and site of origin. IT-ECG signals showed double ST-T signal amplitude (4.19+/-0.6 vs. 2.15+/-0.3 mV, ratio: 1.95, P<0.01) at a QRS/ST amplitude ratio similar in the two ECG techniques. CONCLUSION: This study provides strong evidence that the ICD-based IT 6-lead ECG would provide a new and efficient means of assessing a patient's daily ischaemic burden.

Asunto(s)

RESUMEN

Present-day ICD systems offer the possibility to reconstruct an intrathoracic 6-lead ECG (IT-ECG), using the defibrillator coils in the right ventricle and superior vena cava and the left-laterally positioned ICD as electrodes according to Einthoven and Goldberger. The aim of this study was to assess the feasibility of (1). automated P wave recognition in the IT-ECG without an additional atrial electrode as the basis of AV synchronous ventricular pacing (VDD) and for improved differentiation between supraventricular tachyarrhythmias and, (2). the automated detection of pacing evoked atrial potentials (EAP) in dual chamber ICDs as the basis for atrial "autocapture"pacing systems. In 27 patients during ICD implanation intraoperatively, the IT-ECG was digitally recorded. A recently established algorithm for automatic P wave and EAP detection correctly identified 1663/1672 (99.5%) P waves (oversensing rate 0.6%) and 543/554 (98.0%) EAP (no oversensing). During subthreshold atrial stimulation, 405/412 (98.3%) P waves were correctly identified (oversensing due to pacemaker spikes, n = 421, without subsequent EAP, 1.9%,n = 8). During stimulated ventricular tachycardia in 26/27 patients retrograde P wave or AV dissociation were identified. The 6-lead IT-ECG, easily implementable in ICD systems, is a diagnostic tool providing reliable information about atrial activation, serving as a basis for VDD pacing in single chamber ICD systems, allowing reliable EAP recognition that enables atrial "autocapture"pacing in dual chamber ICDs, and improves the differentiation between supraventricular and ventricular tachycardia.

Asunto(s)