Carlsonkappel5396

leeding and cardiogenic shock. Our findings are consistent with, and add external validity to, recent randomised trials.Background Targeted ultrasound (US) can be performed to characterize and potentially biopsy areas of enhancement detected on contrast-enhanced mammography (CEM). Objective To determine the utility of targeted US in predicting malignancy of indeterminate or suspicious enhancement on CEM. Methods 1000 consecutive CEM examinations with a same-day targeted breast US performed at our institution between October 2013 and May 2018 were retrospectively reviewed. All cases with indeterminate or suspicious enhancement detected on CEM that underwent US evaluation were included. Palpable or symptomatic lesions, those with suspicious findings on low-energy mammographic views or on another imaging modality, and those with less than 1-year follow-up were excluded. Medical records, imaging, and pathology were reviewed. Histopathology and follow-up imaging served as reference standards for biopsied and unbiopsied lesions, respectively. Associations between pathologic diagnosis, presence of an US correlate, and lesion charactet and can serve as targets for US-guided biopsy in the present absence of a commercially available CEM-biopsy system.Hepatic arterial infusion (HAI) of chemotherapy is a locoregional treatment strategy for hepatic malignancy involving placement of a surgically implanted pump or percutaneous port-catheter device into a branch of the hepatic artery. HAI has been used for metastatic colorectal cancer for decades but has recently attracted new attention due to its potential impact on survival, when combined with systemic therapy, in patients presenting with unresectable hepatic disease. Although various HAI device related complications have been described, little attention has been given to their appearance on imaging. Radiologists are uniquely positioned to identify these complications given that patients receiving HAI therapy typically undergo frequent imaging and may have complications that are delayed or clinically unsuspected. This article therefore reviews the multimodality imaging considerations of surgically implanted HAI devices. The role of imaging in routine perioperative assessment, including the normal postoperative appearance of the device, is described. The imaging findings of potential complications, including pump pocket complications, catheter or arterial complications, and toxic or ischemic complications, are presented, with a focus on CT. Familiarity with the device and its complications will aid radiologists in playing an important role in the management of patients undergoing HAI therapy.Background Ultrasound (US)-guided percutaneous pleural needle biopsy (PCPNB) is widely used to evaluate pleural lesions, though has variable diagnostic accuracy. Objective To assess the diagnostic yield of US-guided PCPNB for small (≤ 2 cm) pleural lesions and the impact of CT and US morphologic and technical factors. Materials and Methods 103 patients (73 men, 30 women; age, 60.8±13.3 years) who underwent US-guided PCPNB of a small pleural lesion by a single experienced operator from July 2013 to December 2019 were retrospectively analyzed. Final diagnosis was established via histopathological results, including from repeat US-guided and CT-guided biopsies, as well as imaging and clinical follow-up. Pleural morphology and thickness were assessed on CT and US, and needle pathway length throughout the pleura was measured on US. Accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. The association between diagnostic yield with imaging and techn length (p=0.035) were independent predictors of diagnostic yield. Retinoid Receptor agonist Conclusion US-guided PCPNB has excellent diagnostic accuracy for small pleural lesions; imaging characteristics influence this accuracy. Clinical impact US-guided PCPNB is highly likely to be diagnostic for small pleural lesions with nodular morphology on CT or US, or with pleural thickness ≥4.5 mm.

Obesity is a known risk factor for knee osteoarthritis (OA). Diabetes has been associated with progression of OA and metformin is the first-line treatment in type 2 diabetes. The effect of the body mass index (BMI) and metformin on the expression of certain matrix genes in human chondrocytes is unclear. The purpose of this study was to investigate the effect of BMI and metformin on the expression of matrix genes in primary human chondrocytes.

Adult female patients undergoing knee arthroplasty for end-stage OA were enrolled. Primary chondrocytes were cultivated and stimulated with metformin. Matrix gene expression was analyzed using polymerase chain reaction. Clinical data were used in multivariable regression models to assess the influence of BMI and metformin stimulation on gene expression.

A total of 14 patients were analyzed. BMI was a predictor of increased expression in ADAMTS5 (β = -0.11,

= 0.03). Metformin slightly reduced expression in ADAMTS5 (β = 0.34,

= 0.04), HIF-1a (β = 0.39,

= 0.0s correlated with increased MMP1 expression, indicating a destructive process.Aim Breast cancer is a leading cause of cancer among women. Because guidelines on screening for breast cancer for certain ages are controversial, many experts advocate the use of shared decision making (SDM) using validated decision aids (DAs). Recent studies have concluded that DAs are beneficial; however, the results have great heterogeneity. Therefore, further studies are needed to improve understanding of these tools. Objective This systematic review and meta-analysis aimed to investigate the impact of using web-based DAs in women aged 50 years and below facing the decision to be screened for breast cancer in comparison with usual care. Methods PubMed, Web of Science, Embase and the Cochrane CENTRAL databases were searched up to February 2020 for studies assessing web-based DAs for women making a breast cancer screening decision and reported quality of decision-making outcomes. Using a random-effects model or a fixed-effects model, meta-analyses were conducted pooling results using mean differences (MD), standardized mean differences (SMD) and relative risks (RR).