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The perforation rate was 24.6%. Only 36 patients (19.7%) received a CT scan. The follow-up rate after 30days achieved 69%, including no patients with missed appendicitis. The sensitivity and specificity of the diagnostic pathway was 100% and 96.6%, respectively. The potential saving in costs can be as much as 19.8 million €/100,000 cases presenting with the suspicion of appendicitis.

The risk-stratified diagnostic algorithm yields a high diagnostic accuracy for patients with suspicion of appendicitis. Its implementation can safely reduce the NAR, simultaneously minimizing the use of CT scans and optimizing healthcare-related costs in the treatment of acute appendicitis.

ClinicalTrials.gov Identifier NCT02627781 (December 2015).

ClinicalTrials.gov Identifier NCT02627781 (December 2015).Crude oil exploration activities affect the surrounding vegetation. The present investigation deals with the study of phytosociology and biochemical profiles of the herbaceous community in the active and abandoned oil drilling sites of crude oil-explored area. For comparison, a similar investigation was also carried out in control sites where oil exploration activities were not evident. At first, a phytosociological investigation was carried out and based on the results obtained antioxidant enzyme profiles of dominant herbs were studied to understand their defense mechanism to crude oil-associated stress. A total of 69 plant species belonging to 20 families were recorded in the studied sites and the family Cyperaceae was the most dominant in the crude oil-contaminated sites. The results revealed that the plants growing near the oil-explored-contaminated sites exhibit a higher level of DPPH and H2O2 radical scavenging activities as compared to control plant samples. For DPPH assay, the lowest IC50 value was exhibited by Cyperus rotundus which was recorded to be 31.49 and 55.31 respectively for the samples of contaminated and control sites. Again, in the case of H2O2 scavenging activity assay, Parthenium hysterophorus showed the lowest IC50 values of 27.48 and 63.07 for the samples of contaminated and control sites respectively. As a whole, the findings confirm the superior defense mechanism of some dominant herbs of the contaminated sites that include Torenia flava, Croton bonplandianus, Eclipta alba, Cyperus rotundus, Cyperus brevifolius, and Parthenium hysterophorus and their suitability for use in phytomanagement practices.

To assess the incidence and clinical characteristics of acute kidney injury (AKI) and identify the associated risk factors for AKI in children with type 1 diabetes mellitus (T1DM) and diabetic ketoacidosis (DKA).

This was a retrospective study performed over 15 y in a single Korean center. find more Children aged ≤18-y-old with T1DM and DKA were enrolled and divided into 2 groups according to the presence of AKI.

This study included 90 episodes of DKA in 58 children with T1DM. AKI occurred in a total of 70 hospitalizations (77.8%) of 44 children 18 (20.0%) with stage 1 AKI, 39 (43.3%) with stage 2 AKI, and 13 (14.4%) with stage 3 AKI. The number of AKI decreased to 28 (47.4%) and 13 (28.3%) after 12h and 24h of admission, respectively. The white blood cell count (P = 0.001) and anion gap levels (P = 0.025) were significantly higher and serum bicarbonate level (P = 0.004) was lower in the AKI group. Logistic regression analysis revealed that a longer duration of TIDM and high anion gap were independent predictors of developing severe AKI in pediatric DKA with T1DM (odds ratio, 1.225, P = 0.013; odds ratio, 1.130, P = 0.038).

AKI frequently occurred in TIDM children with DKA. Longer duration of TIDM and elevated anion gap are associated with occurrence of severe AKI.

AKI frequently occurred in TIDM children with DKA. Longer duration of TIDM and elevated anion gap are associated with occurrence of severe AKI.

To ascertain the utility of the new pan Indian 2015 IAP references in rural South Indian children and the ability of new IAP charts to recognise children with abnormal cardiometabolic risk factors in 10 to 16 y age group.

Among school health camps conducted at two centres of Tamil Nadu- rural Vellore and rural Erode- height, weight, waist circumference, blood pressure, triceps skin-fold thickness and body fat percentage were measured by trained pediatricians and Z-scores calculated. The anthropometric measures were studied as per IAP 2015 references and compared to other national and international references. Their utility in identification of malnutrition and cardiometabolic risk ascertained.

A total of 420 children (210 from Erode and 210 from Vellore) in the age group of 10 to 16 y were included in the study. New IAP references recognized more short stature (4.2 vs. 3%), wasting (11 vs. 1.5%) and overweight (14.2 vs. 13.2%) children compared to old IAP charts. The Z-scores of anthropometric measures as per New IAP 2015 references had significant correlation with old IAP and other international data (p < 0.05). It was noted that new IAP charts could detect 83.3%, old IAP chart50% and WHO 83.3% of subjects with malnutrition. New IAP charts could detect 70.3% cardiometabolic risk associated with over nutrition compared to old IAP (57.4%) and WHO (51.8%).

There is a significant prevalence of both under nutrition and overweight in rural setting. IAP 2015 reference is useful to diagnose children with under nutrition and overweight including abnormal cardiometabolic risk.

There is a significant prevalence of both under nutrition and overweight in rural setting. IAP 2015 reference is useful to diagnose children with under nutrition and overweight including abnormal cardiometabolic risk.MicroRNAs (miRNA) are small noncoding sequences that control apoptosis, proliferation, and neuroinflammatory pathways in microglia cells. The expression of distinct miRNAs is altered after ischemia in the brain. Only minor information is available about the biogenesis and maturation of miRNAs after ischemia. We aimed at examining the impact of oxygen-glucose deprivation (OGD) and hydrogen peroxide (H2O2)-induced stress on the expression of miRNA regulating proteins such as DROSHA, DGCR8, XPO5, DICER, TARBP2, and AGO2 in the cultured human microglial cell line HMC-3 (human microglial cell line clone 3). OGD duration of 2.5 h or H2O2 stimulation at a concentration of 100 μM for 24 h resulted in a marked increase of the hypoxia sensor hypoxia-inducible factor1-α in HMC-3 cells. These treatments also led to an upregulation of DROSHA, DICER1, and AGO2 detected by semiquantitative real-time PCR (qrtPCR). XPO5 and TARBP2 were only upregulated after stimulation with H2O2, while DGCR8 responded only to OGD. We found elevated DICER1, DROSHA, and AGO2 protein levels by western blot and immunohistochemistry staining. Interestingly, the latter also exposed a colocalization of AGO2 with stress granules (G3BP1) after OGD. Our data indicate that DICER, DROSHA, and AGO2 are induced in microglial cells under hypoxia-like conditions. It might be speculated that their inductions might increase the miRNA synthesis rate. Future studies should investigate this correlation to determine which miRNAs are preferably expressed by microglia cells after ischemia and which functions they could exert.The original version of this article, published on 24 September 2020, unfortunately contained a mistake.

To explore whether multiple 3D computed tomography texture analysis (3D-CTTA) parameters can predict the therapeutic effects of holmium YAG laser lithotripsy (LL) on ureteral calculi.

The files from 94 patients (102 stones) with proximal ureteral calculi treated only by LL at a single institution were retrospectively retrieved from January 2016 to March 2019. According to intra-operative observations and postoperative reexamination, samples were divided into a completely crushed and a non-crushed group. Preoperative non-contrast-enhanced computed tomography (NCCT) images obtained by multiple CT scanners were imported to MaZda software for 3D texture analysis (TA). The CT-derived value of each target stone was measured, and 15 TA parameters were extracted by delineating volumes of interest (VOIs). Receiver operating characteristic (ROC) curves were drawn to determine the optimal critical value of each parameter based on the Youden index, and univariable and multivariable logistic regression analyses determtion of CTTA and the CT-derived value can be used as a preoperative quantitative reference.

• Computed tomography texture analysis (CTTA) may be helpful in selecting suitable laser lithotripsy (LL) patients. • 3D-CTTA better predicts stone fragility than commonly used methods (such as the CT-derived value). • The combination of CTTA and the CT-derived value can be used as a preoperative quantitative reference.

Due to the increased risk of antenatal brain lesions, we offer a third-trimester magnetic resonance imaging (MRI) scan to all patients who underwent an in utero intervention for twin-twin transfusion syndrome (TTTS). However, the usefulness of such a policy has not been demonstrated yet. Therefore, we determined the prevalence of antenatal brain lesions detected on third-trimester MRI and the proportion of lesions detected exclusively on MRI.

We conducted a retrospective cohort study of monochorionic diamniotic twin pregnancies complicated by TTTS that underwent laser coagulation of the vascular anastomoses or fetal reduction by umbilical cord occlusion between 2010 and 2017. We reviewed the third-trimester MRI findings and compared those with the prenatal ultrasonography.

Of the 141 patients treated with laser coagulation and 17 managed by cord occlusion, 112/141 (79%) and 15/17 (88%) patients reached 28weeks. Of those, 69/112 (62%) and 11/15 (73%) underwent an MRI between 28 and 32weeks. After laser csfusion syndrome (TTTS) do not prevent the occurrence of antenatal brain lesions. • Fetal magnetic resonance imaging (MRI) has high accuracy in detecting anomalies of cortical development and can be a useful adjunct to ultrasonography in diagnosing certain brain abnormalities. • After laser coagulation of the anastomoses for TTTS, third-trimester MRI diagnosed a brain lesion that was not detected earlier on ultrasound scan in 6% of pregnancies.As the access of radiology practices to dual-energy CT (DECT) has increased worldwide, seamless integration into clinical workflows and optimized use of this technology are desirable. In this article, we provide basic concepts of commercially available DECT hardware implementations, discuss financial and logistical aspects, provide tips for protocol building and image routing strategies, and review radiation dose considerations to establish a DECT service line in abdominal imaging. KEY POINTS • Tube-based and detector-based DECT implementations with varying features and strengths are available on the imaging market. • Thorough assessment of financial and logistical aspects is key to successful implementation of a DECT service line. • Optimized protocol building and image routing strategies are of critical importance for effective use and seamless inception of DECT in routine clinical workflows.