Notes

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This study aimed to investigate if preoperative assessments of multiparametric magnetic resonance imaging (mpMRI) and Magnetic resonance imaging /ultrasound (MRI/US) fusion-guided prostate biopsy could be used to guide focal therapy for prostate cancer.

A total of 101 prostate cancer patients undergoing radical prostatectomy were included. Preoperative findings included mpMRI and MRI/US fusion-guided prostate biopsy, while postoperative whole mount pathology was based on surgical specimen.

Of the 101 patients preoperatively diagnosed with a unilateral tumor, postoperative whole mount pathology showed 73.27% were bilateral tumors, and 71.62% of bilateral lesions were clinically significant. Comparison between preoperative and postoperative findings, the correct rate of preoperative mpMRI on the lesion side (left or right) was only 20.79%. As for the Gleason score, the correct rate of preoperative MRI/US fusion-guided prostate pathology was 67.33%. Judging from postoperative whole mount pathology, 47.52% of patients had a unilateral clinically significant tumor, which is an indication for focal therapy.

Preoperative examinations of mpMRI and MRI/US fusion-guided prostate biopsy cannot be used to guide focal therapy for prostate cancer.
Preoperative examinations of mpMRI and MRI/US fusion-guided prostate biopsy cannot be used to guide focal therapy for prostate cancer.
Practice guidelines recommend early consideration for palliative care for patients with advanced malignancies, and there has been limited research regarding the use of palliative care for patients with advanced bladder cancer. Our aim is to describe the rate and determinants of the use of palliative care consultation for patients treated with radical cystectomy at our institution.

A retrospective review was performed to identify patients who underwent cystectomy for bladder cancer between September 2014 and June 2019 at our institution. Our primary outcome was receipt of palliative care, defined as receiving a palliative care consult. We tested for associations between factors and our outcome of interest, and then estimated the impact on various determinants of palliative care use by fitting a multivariable logistic regression model.

Over the study period, 294 patients underwent radical cystectomy. Of those patients, 29 (9.9%) received palliative care. Mean time from surgery to palliative care consult wr consideration of palliative care referrals.
Primary hazelnut allergy is a common cause of anaphylaxis in children, as compared to birch-pollen associated hazelnut allergy. Population-based data on hazelnut and concomitant birch-pollen allergy in children are lacking. We aimed to investigate the prevalence of primary and pollen-associated hazelnut allergy and sensitization profiles in school-aged children in Berlin, Germany.

1570 newborn children were recruited in Berlin in 2005-2009. The school-age follow-up (2014-2017) was based on a standardized web-based parental questionnaire and clinical evaluation by a physician including skin prick tests, allergen specific immunoglobulin E serum tests and placebo-controlled double-blind oral food challenges, if indicated.

1004 children (63.9% response) participated in the school-age follow-up assessment (52.1% male). For 1.9% (n=19, 95%-confidence interval 1.1%-2.9%) of children their parents reported hazelnut-allergic symptoms, for half of these to roasted hazelnut indicating primary hazelnut allergy. Symlnut and birch-pollen.
Anxiety is an emotional reaction often experienced by patients who undergo Positron Emission Tomography/Computed Tomography (PET/CT) with 18F-2-fluoro-2-deoxy-d-glucose (
F-FDG). This systematic review aimed to summarise the evidence currently available considering the anxiety experienced by adult oncological patients concerning pre and post
F-FDG PET/CT examination and the factors contributing to anxiety.

A systematic review search of CINAHL, PsycINFO, PubMed, Scopus and Web Science databases and other manual search sources, was conducted from November to February 2021. The research included articles published from January 2000 to December 2020. It included quantitative studies, which analysed the anxiety experienced by oncological patients who had undergone
F-FDG PET/CT.

Ten articles met the inclusion criteria for this systematic review. The studies selected were published between 2011 and 2020 and carried out in five countries. Anxiety experienced by patients was evaluated at the various stages of the
F-FDG PET/CT, eight studies assessed it in the pre-examination, seven studies in the post-examination and five studies at both times. Four main anxiety factors were found patients' clinical situation, first-time patients' examination, scan procedure, and patients concern with the examination result.

Moderate to high levels of anxiety are present in most of the patients who undergo the examination. This review also highlights several factors related to the anxiety levels through different procedure moments.

The results of this research will allow health professionals to adjust non-pharmacological strategies to decrease anxiety levels in oncological patients undergoing
F-FDG PET/CT.
The results of this research will allow health professionals to adjust non-pharmacological strategies to decrease anxiety levels in oncological patients undergoing 18F-FDG PET/CT.
Prior research identified possible interstitial pulmonary fluid, concerning for early high altitude pulmonary edema (HAPE), in a large percentage of trekkers above 3000 m using a comprehensive 28-view pulmonary ultrasound protocol. These trekkers had no clinical symptoms of HAPE despite these ultrasound findings. The more common 4-view lung ultrasound protocol (LUP) is accurate in rapidly detecting interstitial edema during resource-rich care. The objective of this study was to evaluate whether the 4-view LUP detects interstitial fluid in trekkers ascending to Everest Base Camp.

Serial 4-view LUP was performed on 15 healthy trekkers during a 9-d ascent from Kathmandu to Everest Base Camp. see more Ascent protocols complied with Wilderness Medical Society guidelines for staged ascent. A 4-view LUP was performed in accordance with the published 2012 international consensus protocols on lung ultrasound. Symptom assessment and 4-view LUP were obtained at 6 waypoints along the staged ascent. A 4-view LUP was positive for interstitial edema if ≥3 B-lines were detected in 2 ultrasound windows.

A single participant had evidence of interstitial lung fluid at 5380 m as defined by the 4-view LUP. There was no evidence of interstitial fluid in any participant below 5380 m. One participant was evacuated for acute altitude sickness at 4000 m but showed no preceding sonographic evidence of interstitial fluid.

In this small study, sonographic detection of interstitial fluid, suggestive of early HAPE, was not identified by the 4-view LUP protocol.
In this small study, sonographic detection of interstitial fluid, suggestive of early HAPE, was not identified by the 4-view LUP protocol.
To develop and validate a nomogram for differentiating second primary lung cancers (SPLCs) from pulmonary metastases (PMs).

A total of 261 lesions from 253 eligible patients were included in this study. Among them, 195 lesions (87 SPLCs and 108 PMs) were used in the training cohort to establish the diagnostic model. Twenty-one clinical or imaging features were used to derive the model. Sixty-six lesions (32 SPLCs and 34 PMs) were included in the validation set.

After analysis, age, lesion distribution, type of lesion, air bronchogram, contour, spiculation, and vessel convergence sign were considered to be significant variables for distinguishing SPLCs from PMs. Subsequently, these variables were selected to establish a nomogram. The model showed good distinction in the training set (area under the curve=0.97) and the validation set (area under the curve=0.92).

This study found that the nomogram calculated from clinical and radiological characteristics could accurately classify SPLCs and PMs.
This study found that the nomogram calculated from clinical and radiological characteristics could accurately classify SPLCs and PMs.
We aimed to develop and validate a multimodality radiomics model for the preoperative prediction of nonfunctional pancreatic neuroendocrine tumor (NF-pNET) grade (G).

This retrospective study assessed 123 patients with surgically resected, pathologically confirmed NF-pNETs who underwent multidetector computed tomography and MRI scans between December 2012 and May 2020. Radiomic features were extracted from multidetector computed tomography and MRI. Wilcoxon rank-sum test and Max-Relevance and Min-Redundancy tests were used to select the features. The linear discriminative analysis (LDA) was used to construct the four models including a clinical model, MRI radiomics model, computed tomography radiomics model, and mixed radiomics model. The performance of the models was assessed using a training cohort (82 patients) and a validation cohort (41 patients), and decision curve analysis was applied for clinical use.

We successfully constructed 4 models to predict the tumor grade of NF- pNETs. Model 4 combined 6 features of T2-weighted imaging radiomics features and 1 arterial-phase computed tomography radiomics feature, and showed better discrimination in the training cohort (AUC=0.92) and validation cohort (AUC=0.85) relative to the other models. In the decision curves, if the threshold probability was 0.07-0.87, the use of the radiomics score to distinguish NF-pNET G1 and G2/3 offered more benefit than did the use of a "treat all patients" or a "treat none" scheme in the training cohort of the MRI radiomics model.

The LDA classifier combining multimodality images may be a valuable noninvasive tool for distinguishing NF-pNET grades and avoid unnecessary surgery.
The LDA classifier combining multimodality images may be a valuable noninvasive tool for distinguishing NF-pNET grades and avoid unnecessary surgery.
This study aimed to investigate the feasibility, safety, and efficiency rates of the bleb coiling technique for the treatment of acute ruptured wide-neck bifurcation aneurysm (WBNAs) by comparing it with device-assisted coiling.

Patients with ruptured WNBAs who underwent endovascular treatment (EVT) were reviewed. The study sample was divided into five groups according to treatment type bleb coiling, single catheter coiling, balloon-assisted coiling (BAC), neck remodeling mesh-assisted coiling, and stent-assisted coiling (SAC). The feasibility, safety, efficiency and complication rates of the bleb coiling technique were compared with each group.

This study included 109 patients with ruptured WNBAs. Bleb coiling was performed in 24 blebs of 20 WNBAs. The mean time interval between initial and complementary treatment in the bleb coiling group was 12.53± 5 .27 weeks (min-max 4-23 weeks). No rebleeding occurred during this interval time, and no mortality or new permanent neurologic deficit caused by the bleb coiling technique was noted. The bleb coiling technique had a lower complication rate than other techniques (p <0.05).

The bleb coiling strategy led to favourable clinical outcomes with low complication rates and it can be considered as an alternative treatment option at acute phase of SAH in the endovascular treatment of ruptured WBNAs with coilable-bleb.
The bleb coiling strategy led to favourable clinical outcomes with low complication rates and it can be considered as an alternative treatment option at acute phase of SAH in the endovascular treatment of ruptured WBNAs with coilable-bleb.
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