Dentonwu1606
To assess the outcomes through systematic review and meta-analysis of multi-parametric magnetic resonance imaging (mpMRI) of the prostate in biopsy naïve men.
Systemic review and meta-analysis was performed to assess the performance of mpMRI on prostate cancer (PCa) detection at the time of biopsy. We used standard methods for performing a meta-analysis evaluating a diagnostic test and reported the pooled sensitivity and specificity, and the positive and negative likelihood ratios (LR) for mpMRI in the detection of any and clinically significant prostate cancer (csPCa).
A total of 10 studies comprising 2486 patients were analyzed. Overall, if biopsies would have been performed only in men with an mpMRI suspicious for malignancy between 7.4% and 58.5% of the biopsies could have been avoided, but 2.3%-36% of any PCa and 0%-30.8% of csPCa would have been missed. The sensitivity, specificity, positive LR, and negative LR ofmpMRIfor any PCa detection were 0.86 (95% confidence interval [CI], 0.78-0.91), 0.67 (95% CI, 0.40-0.86), 2.6 (95% CI, 1.2-5.5), and 0.2 (95% CI, 0.12-0.32), respectively. The AUC for any PCa detection was 0.84 (95% CI, 0.75-0.90). The pooled sensitivity, specificity, positive LR, and negative LR ofmpMRIfor csPCa detection was 0.94 (95% CI, 0.83-0.98), 0.54 (95% CI, 0.42-0.65), 2 (95% CI, 1.5-2.7), and 0.1 (95% CI, 0.02-0.35), respectively. The AUC for csPCa detection was 0.94 (95% CI, 0.65-1).
This study provides summary estimates indicating that mpMRI can accurately detect prostate cancer and help avoid unnecessary biopsies in this population.
This study provides summary estimates indicating that mpMRI can accurately detect prostate cancer and help avoid unnecessary biopsies in this population.Sacbrood virus (SBV) is one of the most damaging viruses in honey bee colonies. Genetic differences among sacbrood viruses detected in honey bees in different locales have been reported in previous studies. The aim of this study was to construct phylogenetic trees based on the structural polyprotein and non-structural RNA dependent RNA polymerase gene regions and to make a molecular characterization of the Tur/Bur/Sac01 and Tur/Bur/Sac02 strains identified in Apis mellifera in Turkey. As a result of the study, the tree based on the structural polyprotein region separated into four lineages Tur/Bur/Sac01 and Tur/Bur/Sac02 were in the same branch as the Turkish sacbrood virus strains identified in previous studies and formed the Turkish clade. Strains isolated from adjacent geographical areas were in the same clade in this tree. The phylogenetic tree based on the non-structural RNA dependent RNA polymerase gene region divides into two main branches, reflecting host affiliation Apis cerana and A. mellifera. Strains formed clusters based on their geographic distribution and host affiliation. The Tur/Bur/Sac01 and Tur/Bur/Sac02 strains formed a separate cluster among the European strains. Sacbrood viruses from Turkey were genetically different from SBV strains detected in other countries and in A. cerana.
Catheter ablation is recommended for symptomatic WPW-syndrome. Commonly perceived low recurrence rates were challenged recently. We sought to identify patient strata at increased risk.
Of 12,566 patients enrolled at 52 German Ablation Registry sites from 2007 to 2010, 789 were treated for WPW-syndrome. Patients were included for symptomatic palpitations and tachycardia documentation. Follow-up duration was one year. Overall complications were defined as serious, access-related, and ablation-related. We adjudicated WPW-recurrence for re-ablation during follow-up. Risk strata included admission for repeat ablation at registry entry; accessory pathway localization; antiarrhythmic medical treatment before the ablation.
WPW-syndrome patients were 42.8±16.2years on average; 39.9% were women. A majority of 95.9% was symptomatic; in 84.4%, a tachycardia was documented. Seventy-six (9.6%) patients presented for repeat procedures. Accessory pathways were located in the left atrium (71.4%), right atrium (21.1%), sngs may help improving peri-procedural patient management and information.
The MRI-assessed tumor regression grade (mrTRG) is limited due to its subjectivity and poor consistency on pathological tumor regression grade (pTRG). selleck kinase inhibitor A new MRI criterion was established to predict the prognosis of locally advanced rectal cancer (LARC).
The new MRI criterion magnetic resonance imaging tumor response score (mrTRS) was based on the retrospective sample of 214 LARC patients (unpublished data). Subsequently, 878 LARC patients were enrolled for a prospective, multicenter study. Baseline and postoperative MRI were obtained, and imaging features were measured by collecting the pathological, clinical and follow-up data. Kaplan-Meier method with log-rank estimate and multivariate cox regression model was used to determine the prognosis of mrTRS in LARC patients with neoadjuvant chemoradiotherapy (NACRT). The predictive capability of 3-year prognosis between mrTRS and mrTRG was determined by time-dependent ROC curves.
The results demonstrated that mrTRS acted as an independent predictor of survival outcomes. mrTRS stratified by good and moderate responders showed significantly lower risk of death (HR=0.04, 95%CI 0.01-0.31; HR=0.35, 95%CI 0.23-0.52), distant metastasis (HR=0.25, 95%CI 0.13-0.52; HR=0.42, 95%CI 0.30-0.58), and local recurrence when compared with poor responders(HR=0.01 95%CI 0.23-0.52;HR=0.38, 95%CI 0.16-0.90). In contrast, no significant difference was observed among mrTRG stratified groups. Excellent and substantial interobserver agreement for mrTRS and mrTRG evaluation was observed (κ=0.92 and 0.62), respectively.
mrTRS can serve as an effective predictor for assessing tumor regression grade in LARC patients with NACRT.
mrTRS can serve as an effective predictor for assessing tumor regression grade in LARC patients with NACRT.
Radiation-related heart disease (RRHD) can occur many decades after thoracic radiotherapy for Hodgkin lymphoma (HL) or childhood cancer (CC). To quantify the likely risk of RRHD for patients treated today, dose-response relationships derived from patients treated in previous decades are used. Publications presenting these dose-response relationships usually include estimates of uncertainties in the risks but ignore the effect of uncertainties in the reconstructed cardiac doses.
We assessed the systematic and random uncertainties in the reconstructed doses for published dose-response relationships for RRHD risk in survivors of HL or CC. Using the same reconstruction methods as were used in the original publications, we reconstructed mean heart doses and, wherever possible, mean left-ventricular doses for an independent case-series of test patients. These patients had known, CT-based, cardiac doses which were compared with the reconstructed doses to estimate the magnitude of the uncertainties and their effect on the dose-response relationships.