Internal Lesions Research Articles

Comparison of the clinical value of transcranial Doppler ultrasound and computed tomography angiography for diagnosing ischemic cerebrovascular disease.

ObjectiveTo compare the clinical value of transcranial Doppler (TCD) ultrasound and computed tomography angiography (CTA) for diagnosing ischemic cerebrovascular disease.MethodsA retrospective clinical study was conducted in 142 patients with ischemic cerebrovascular disease who were initially diagnosed by digital subtraction angiography. Under the single-blind condition, the patients were diagnosed by using TCD ultrasound and CTA independently. The accuracy of these two methods was compared.ResultsThe accuracy of diagnosing bilateral middle cerebral artery, bilateral vertebral artery and bilateral internal carotid artery lesions with a TCD examination was significantly higher than that with a CTA examination. There were no significant differences in the accuracy of diagnosing bilateral anterior cerebral artery, bilateral posterior cerebral artery or basilar artery lesions between TCD ultrasound and CTA. The accuracy of diagnosing all cerebral arterial ischemic lesions was significantly higher with a TCD examination (87.39%) than with a CTA examination (69.75%). The accuracy of diagnosing all cerebral arteries that cause ischemic encephalopathy (cerebrovascular + cervical blood vessels) was significantly higher with a TCD examination (88.03%) than with a CTA examination (69.01%).ConclusionsTCD ultrasound has several advantages over CTA. Therefore, TCD ultrasound is better for diagnosing ischemic encephalopathy than CTA.

Impact of Single Versus Multiple Stent Selection for Treatment of Solitary Lesions During Carotid Artery Stenting

Carotid artery stenting (CAS) via either transfemoral or transcarotid (transcarotid artery revascularization) approaches has emerged as a safe and feasible option for patients with high anatomic and/or physiologic risks for conventional carotid endarterectomy. We studied the differences in outcomes for patients receiving single vs multiple stents for the treatment of isolated internal carotid artery lesions.

First Report of Fusarium falciforme (FSSC 3 + 4) Causing Rot of Industrial Hemp (Cannabis sativa) in California.

Industrial hemp (Cannabis sativa) is a newly legal crop in California that is grown for cannabidiol oil, fiber and seed. In August 2019, whole plant decline and root rot were observed affecting <5% of plants in two industrial fields in Fresno County, CA. Symptoms included chlorotic, collapsed foliage, stem vascular discoloration, and root rot with abundant mycelial growth. Stem and root segments (1-2 cm) from three to five diseased plants were agitated in 0.1% tween-20 and soaked in 70% ethanol for 30 s and 1% NaOCl for 2 min. After incubating for 5 to 7 days on 1:10 potato dextrose agar (PDA) amended with tetracycline, Fusarium selective medium (FSM), and PARP (pimaricin + ampicillin + rifampicin + pentachloronitrobenzene [PCNB] agar) medium, white to pale cream aerial mycelium emerged from tissue of all plants on PDA and FSM but not PARP. Isolates cultured on 0.1% potassium chloride agar formed heads of microconidia on long monophialides consistent with the Fusarium solani species complex (FSSC) (Leslie and Summerell 2008). To obtain pure cultures of two isolates (CS529 and CS530), a single-hyphal tip was excised and grown on PDA. DNA was extracted from actively growing mycelium (PrepMan Ultra kit). The translation elongation factor gene (EF-1α) was amplified via PCR using EF1/EF2 primers (O'Donnell et al. 1998). Sequences of the two isolates were identical and deposited under accession number MW892973 in GenBank. The 599 bp sequence was 99.33% identical to FSSC 3 + 4 (Fusarium falciforme) accessions FD_01443_EF-1a based on FUSARIUM-ID BLAST analysis. To evaluate pathogenicity, stems of hemp plants (cv. 'Berry Blossom'; n=8 plants per isolate) were wounded by penetrating the epidermis in an area about 0.5-cm square by 1-mm deep and 8-inches above the soil line. A 0.5 cm-diameter plug of 7-day old F. falciforme-colonized PDA was placed against the wound. Inoculation sites were loosely wrapped with parafilm for 2 days. A negative control consisted of a sterile PDA plug (n=3). Treatments were arranged in a completely randomized design in a greenhouse. The experiment was conducted once, due to regulatory restrictions at campus facilities. At 61 days post-inoculation, external stem lesions were significantly larger in diameter (P < 0.05; Tukey's HSD) in plants inoculated with CS529 (8 ± 1 mm) compared to the control (2 ± 0 mm), and larger but not significant for CS530 (6 ± 1 mm). Internal stem lesions (i.e., rot in stele) were observed in plants inoculated with CS529 (9 ± 3 mm); stem rot was very minor in plants treated with CS530 (1 ± 1 mm) and nonexistent for control plants. No other disease symptoms were observed. F. falciforme was isolated from stems of CS529- and C530-inoculated plants. Sequences of re-isolates matched 100% with accession MW892973. These results suggest that F. falciforme causes rot in hemp in California. These studies specifically confirm stem rot abilities; field observations of root rot indicate root rotting abilities, but further tests are needed for confirmation. This is the first report of F. falciforme causing disease in industrial hemp. FSSC was described as causing foot rot in hemp in Italy (Sorrentino et al. 2019), but these isolates belonged to phylogenetic species 5 (F. solani) not F. falciforme. In addition, F. falciforme was reported as causing root rot in hydroponically grown cannabis (Punja and Rodriguez 2018). These studies provide the foundation for development of management tools for hemp disease.

Effect of the Combined Treatments with LC2017 and Trichoderma atroviride Strain I-1237 on Disease Development and Defense Responses in Vines Infected by Lasiodiplodia theobromae

Grapevine trunk diseases constitute one of the major problems for viticulture worldwide, with Botryosphaeria dieback considered as one of the most important of these diseases. In this work, we aimed to (i) evaluate the effect of the combination of two products, Esquive® (a Trichoderma-based product) and LC2017 (a low-copper-based product), in the control of Lasiodiplodia theobromae, by evaluating the internal lesion length caused by inoculation of this pathogen on greenhouse kept grapevines of cvs Cabernet Sauvignon and Touriga Nacional and, (ii) investigating their elicitor effect on plant defense responses, through the analysis of the expression of a set of genes. The pathogen was always re-isolated from the infected tissues and was able to cause wood discoloration. Touriga Nacional exhibited longer lesions than Cabernet Sauvignon, and the application of both products did not appear to reduce lesion length when compared to LC2017 applied alone. The elicitor effect of LC2017 on plant defense was confirmed by gene expression analysis, and no significant differences were found between plants treated with LC2017 and with both products. Moreover, a specific response related to the cultivar was verified, but this apparently unique interaction between product, cultivar and pathogen remains to be further investigated.

Infection of a Free-Living Wild Boar (Sus scrofa) with a Bacterium from the Mycobacterium kansasii Complex.

Simple SummaryMycobacteriosis is a collective term for diseases caused by nontuberculous mycobacteria. Wild animals are a frequent source of mycobacteria infection in farm animals and humans; therefore, it is important to monitor the presence of these pathogens in free-living mammals. We isolated bacterium belonging to Mycobacterium kansasii complex from a submandibular lymph node obtained from a wild boar. This mycobacterium is a common cause of severe human lung diseases and is rarely responsible for animal diseases; therefore, its presence in the wild animal population is of great concern. The animal was apparently healthy, and we did not find any internal organ lesions despite the abundant growth of tissue-isolated bacteria on media. Thanks to our research, the specificity of wild boar mycobacteriosis caused by MKC will be better known.The most numerous group of bacteria in the genus Mycobacterium is the nontuberculous mycobacteria. Currently, over 200 species of bacteria have been classified as belonging to this group, of which approximately 30 are pathogenic to humans and animals. Mycobacterium kansasii complex numbers among these pathogenic species. The submandibular lymph nodes of a wild boar shot by a hunter were examined in order to confirm or exclude infection with bacteria of the genus Mycobacterium. In culture, a bacterial isolate was obtained after 12 days of incubation on Petragnani and Stonebrink media. A multiplex PCR clearly indicated that the isolate was a nontuberculous mycobacterium. The results of species identification attempts via both molecular biology methods and mass spectrometry confirmed that the isolated strain belonged to MKC. The described case of a wild boar infection with MKC is the first documented case in Poland and only the second in Europe, and in confirming the presence of this pathogen among free-living animals, this report implies that MKC is of great concern. Our research elucidates some specifics of wild boar mycobacteriosis and may be used to instill awareness in the public of the dangers of dressing hunt prey or consuming its meat in ignorance of safe procedures, which can contribute to the transmission of the pathogen to humans.

Managing argatroban in heparin-induced thrombocytopenia: Aretrospective analysis of 729 treatment days in 32 patients with confirmed heparin-induced thrombocytopenia.

Managing argatroban in heparin-induced thrombocytopenia: Aretrospective analysis of 729 treatment days in 32 patients with confirmed heparin-induced thrombocytopenia.

Differential assessment of frontally-mediated behaviors between self- and informant-report in patients with obsessive-compulsive disorder following gamma ventral capsulotomy

Obsessive-Compulsive Disorder (OCD) is a debilitating disorder causing marked distress and functional impairment. While advances in behavioral and pharmacotherapies have been effective for a majority of patients with OCD, 10–30% remain treatment refractory and severely impaired. For a subset of treatment-resistant individuals with the most severe and disabling (intractable) illness, gamma ventral capsulotomy (GVC) appears effective in reducing OCD symptoms and functional impairment. However, the effects of the ventral internal capsule lesion via GVC surgery on executive function in everyday life have been minimally investigated. Examining behavioral outcomes of GVC also provides a rare opportunity to probe the functional importance of the ventral prefrontal-subcortical connections of the internal capsule white matter tract in a relatively homogenous sample of patients with comparable white matter lesions. The present study investigated changes in frontally-mediated behaviors, measured by the Frontal Systems Behavior Scale (FrSBe), following GVC in 45 individuals with severe and otherwise intractable OCD, as rated by patients themselves and family members. Linear mixed effects models revealed a significant improvement in patient self-ratings on the FrSBe after surgery, while family ratings did not significantly change. Interestingly, improvement on the FrSBe for both self and family raters was significantly correlated with improvement in OCD symptomatology post-surgery, as measured by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). At the group level, we found no evidence of decline in frontally-mediated behaviors assessed by the FrSBe as a result of focal white matter disconnection via GVC. However, we cannot rule out the possibility that placebo effects or compromised patient self-awareness or insight contributed to the significant improvement in self ratings. Our measures may also have limited sensitivity to more selective impairments that could result from a small lesion to the ventral internal capsule. The present study demonstrates the need for detailed investigation of cognitive and behavioral changes as important factors when considering GVC as a viable treatment option for patients with refractory OCD.

Imaging in joint-preserving hip surgery

Instabilität und Impingement stellen die Hauptpathomechanismen dar, die bereits bei jungen Patienten durch erhöhten mechanischen Stress zu chondrolabralen Schäden, schmerzhafter Bewegungseinschränkung und frühzeitiger Coxarthrose führen können. Ziele der gelenkerhaltenden Chirurgie an der Hüfte sind die Korrektur der knöchernen Deformitäten und chondrolabraler Schäden sowie die Wiederherstellung der Gelenkfunktion. Voraussetzung dafür ist die Identifikation der ursächlichen Pathologien an der Hüfte, welche zudem in Kombination auftreten können. Die dezidierte Röntgen- und Magnetresonanzbildgebung der knöchernen Morphologie und der degenerativen Gelenkbinnenläsionen liefern einen essenziellen Beitrag für die Behandlungsindikation und die Behandlungsplanung. Der vorliegende Artikel soll einen kurzen Überblick über die Hüftdeformitäten mit deren Prävalenz, Pathomechanismus und indizierter Therapie sowie detaillierte Empfehlungen über die spezifische radiologische Abklärung geben.

Characterization, pathogenicity, and fungicide sensitivity of Alternaria isolates associated with preharvest fruit drop in California citrus

Alternaria rot has been recently described as an emerging fungal disease of citrus causing significant damage in California groves. A survey was conducted to determine latent infections on fruits, twigs, and leaves and investigate their seasonal patterns during 2019 and 2020. On fruits, latent infections were more associated with the stem end than with the stylar end, except during spring when a significantly high percentage of flowers (86%) had latent infections. Latent infections on twigs varied markedly between years (28% in 2019 and 9.5% in 2020), while Alternaria spp. were also recovered from citrus leaves. Alternaria isolates collected during the survey were identified based on multigene sequence analysis, confirming that Alternaria alternata and Alternaria arborescens are the two species associated with infections of citrus fruits. Of the 23 isolates, 19 were identified as A. alternata and demonstrated the dominance of this species over A. arborescens. Isolates representing populations of these two species were selected as representative isolates for physiological and morphological studies. A. alternata and A. arborescens showed similar conidial dimensions but differed in the number of conidia produced. Growth rates demonstrated that A. alternata grows faster than A. arborescens at all the temperatures evaluated, except at 25 and 35 °C. The growth patterns were similar for both species. The sporulation rate of the Alternaria isolates was influenced differently by temperature. This parameter also influenced conidial germination and appressorium formation, and no significant differences were observed between Alternaria species. Pathogenicity and aggressiveness tests on detached fruit demonstrated the ability of A. alternata and A. arborescens to cause internal lesions and produce fruit drop in the orchards with no quantitative differences between them (disease severity indexes of 58 and 68%, respectively). The fungicide sensitivity tests showed that DMI fungicides are the most effective fungicides in reducing mycelial growth. The SDHI fungicides had intermediate activity against the mycelial growth but also suppressed spore germination. The spore germination assay suggested that some of the isolates included in this study might have some level of resistance to QoI and SDHI fungicides. The findings of this study provide new information about the pathogens associated with the excessive fruit drop recently observed in some California citrus groves.

Examination of teeth in Lower and Upper Jaw Fracture Lines of Children Aged &lt;12 Years Admitted to Bahonar Hospital, Kerman, Iran

Background and Aim: The most concern about children with head and face trauma is the effects of the trauma and the treatment on their growth considering the possibility that the teeth in different stages of evolution that are adjacent to the fracture line, have different prognosis in growth and deformity. The present study examines the situation of the teeth around fracture lines in order to check the effects of the trauma on the mentioned teeth. Methods and Materials: Complete information of 28 under 12 years old patients with jaw fracture that were admitted in the Bahonar hospital from 2010 until 2016, was extracted from files and Teeth adjacent to fracture line were clinically evaluated. Panoramic graphs that were taken instantly after the surgery and in the next 6 to 24 months period were inspected. The information examined in the panoramic graphs contained the level of internal and external erosion pathological lesion, and growth rate of teeth adjacent to the fracture line. Ethical Considerations: This article was ethically approved by ethical committee of Kerman University of Medical Sciences (ethical code: IR.KMU.REC.1396.1398). Result: 60/7 percent of the fractures were occurred in the lower jaw which in 67/9 percent of the times were treated by internal fixation and 10/7 were treated by Open Fracture Reduction. 89/3 percent of cases were free of pathological lesion. In 78/6 percent of cases change in color and in 71/4 percent of cases dental necrosis was not observed. 82/1 percent of the teeth had reached full growth. Conclusion: Most of the teeth adjacent to the fracture line had reached full growth and lacked pathological, color change, root deformation and loose teeth problems and there was no Difference in Open Fracture Reduction and internal fixation.

Acute Carotid Artery Stenting Versus Balloon Angioplasty for Tandem Occlusions: A Systematic Review and Meta-Analysis.

BackgroundDespite thrombectomy having become the standard of care for large‐vessel occlusion strokes, acute endovascular management in tandem occlusions, especially of the cervical internal carotid artery lesion, remains uncertain. We aimed to compare efficacy and safety of acute carotid artery stenting to balloon angioplasty alone on treating the cervical lesion in tandem occlusions. Similarly, we aimed to explore those outcomes’ associations with technique approaches and use of thrombolysis.Methods and ResultsWe performed a systematic review and meta‐analysis to compare functional outcomes (modified Rankin Scale), reperfusion, and symptomatic intracranial hemorrhage and 3‐month mortality. We explored the association of first approach (anterograde/retrograde) and use of thrombolysis with those outcomes as well. Two independent reviewers performed the screening, data extraction, and quality assessment. A random‐effects model was used for analysis. Thirty‐four studies were included in our systematic review and 9 in the meta‐analysis. Acute carotid artery stenting was associated with higher odds of modified Rankin Scale score ≤2 (odds ratio [OR], 1.95 [95% CI, 1.24–3.05]) and successful reperfusion (OR, 1.89 [95% CI, 1.26–2.83]), with no differences in mortality or symptomatic intracranial hemorrhage rates. Moreover, a retrograde approach was significantly associated with modified Rankin Scale score ≤2 (OR, 1.72 [95% CI, 1.05–2.83]), and no differences were found on thrombolysis status.ConclusionsCarotid artery stenting and a retrograde approach had higher odds of successful reperfusion and good functional outcomes at 3 months than balloon angioplasty and an anterograde approach, respectively, in patients with tandem occlusions. A randomized controlled trial comparing these techniques with structured antithrombotic regimens and safety outcomes will offer definitive guidance in the optimal management of this complex disease.

Pathogenicity Testing of Fungal Isolates Associated with Olive Trunk Diseases in South Africa.

A recent olive trunk disease survey performed in the Western Cape Province, South Africa, identified several fungi associated with olive trunk disease symptoms, including species of Basidiomycota, Botryosphaeriaceae, Coniochaetaceae, Calosphaeriaceae, Diaporthaceae, Diatrypaceae, Phaeomoniellaceae, Phaeosphaeriaceae, Symbiotaphrinaceae, Togniniaceae, and Valsaceae. Many of the species recovered had not yet been reported from olive trees; therefore, the aim of this study was to determine their pathogenicity toward this host. Pathogenicity tests were first conducted on detached shoots to select virulent isolates, which were then used in field trials. During field trials, 2-year-old olive branches of 15-year-old trees were inoculated by inserting colonized agar plugs into artificially wounded tissue. Measurements were made of the internal lesions after 8 months. In total, 58 isolates were selected for the field trials. Species that formed lesions significantly larger than the control could be considered as olive trunk pathogens. These included Biscogniauxia rosacearum, Celerioriella umnquma, Coniochaeta velutina, Coniothyrium ferrarisianum, isolates of the Cytospora pruinosa complex, Didymocyrtis banksiae, Diaporthe foeniculina, Eutypa lata, Fomitiporella viticola, Neofusicoccum stellenboschiana, Neofusicoccum vitifusiforme, Neophaeomoniella niveniae, Phaeoacremonium africanum, Phaeoacremonium minimum, Phaeoacremonium oleae, Phaeoacremonium parasiticum, Phaeoacremonium prunicola, Phaeoacremonium scolyti, Phaeoacremonium spadicum, Pleurostoma richardsiae, Pseudophaeomoniella globosa, Punctularia atropurpurascens, Vredendaliella oleae, an undescribed Cytospora sp., Geosmithia sp., two undescribed Neofusicoccum spp., and four Xenocylindrosporium spp. Pseudophaeomoniella globosa can be regarded as one of the main olive trunk pathogens in South Africa because of its high incidence from olive trunk disease symptoms in established orchards and its high virulence in pathogenicity trials.

Malignancy in three medieval Polish osteological collections

This paper presents the archaeological skeletal remains of four adult females presenting with cranial lesions typical of malignant neoplastic disease. The four cases were sourced from three medieval Polish skeletal assemblages: Milicz (12–13th century), Pawłów Trzebnicki (15–16th century), and Gródek nad Bugiem (13–15th century). The observed pathological skeletal changes were evaluated with a comprehensive macroscopic analysis of the skeleton, and radiography of the affected bones. The observed osteolytic lesions were largely limited to the crania and were multiple and varied in size; further internal lesions were revealed with radiography. Three cases were differentially diagnosed as highly consistent with metastatic carcinoma, and the fourth case was differentially diagnosed as typical of multiple myeloma. This report adds to the scant number of palaeopathological examples of malignant neoplasms in Poland and it discusses the possible impact of cancer on medieval lives, as well as possible factors in the occurrence of malignant neoplasms in medieval Poland.

Computational Simulation of Breast Tissue with Lesion Characterized by a Thermal Gradient Oriented to Anomalies Smaller than 1 cm of Diameter.

In this work, the computational simulation of thermal gradients related to internal lesions according to the phenomenon of pathological angiogenesis is proposed, this is based on the finite element method, and using a three¬dimensional geometric model adjusted to suit the real female anatomy. The simulation of the thermal distribution was based on the bioheating equation; it was carried out using the COMSOL Multiphysics® software. As a result, the simulation of both internal and superficial thermal distributions associated to lesions smaller than 1 cm and located inside the simulated breast tissue were obtained. An increase in temperature on the surface of the breast of 0.1 ° C was observed for a lesion of 5 mm in diameter and 15 mm in deep. A qualitative validation of the model was carried out by contrasting the simulation of anomalies of 10 mm in diameter at different depths (10, 15 and 20 mm) proposed in the literature, with the simulation of the model proposed here, obtaining the same behavior for the three cases.Clinical Relevance- The 3D computational tool adjusted to suit the anatomy of the real female breast allows obtaining the temperature distribution inside and on the surface of the tissue in healthy cases and with abnormalities associated with temperature elevations. It is an important characteristic of the model when the behavior of the parameters inside the tissue needs to be analyzed.

A complete check-up of European eel after eight years of restocking in an upland river: Trends in growth, lipid content, sex ratio and health status

By combining field research and careful laboratory analysis of samples over the course of an eight-year study, we met the challenge of assessing the life history traits and health status of eels restocked in freshwater ecosystems. We found that restocked eels exhibited good growth performance; moreover, the stocks were female-dominated, showed a good Fulton's condition factor (K) and lipid stores and had high survival probability estimated using the best model of Jolly-Seber stock assessment method for open populations. A necropsy revealed the absence of internal lesions. A swim bladder examination revealed the absence of the parasite Anguillicola crassus. Polymerase chain reaction (PCR) analyses revealed an increase of Anguillid herpesvirus-1 (AngHV-1) prevalence throughout the study. Most positive subjects expressed viral loads compatible with a latent infection and correlated positively with K. All restocked eels were contaminated by at least one of the organic pollutant congeners studied, but the pollution loads corresponded to the lowest range of pollutant concentrations reported in the available literature for European eels and did not exceed the maximum residue and contaminant limits in food and feed of several national and international regulations. Pollutant loads were negatively correlated with K, lipid content and eel density for polychlorinated biphenyls PCB 138, 153 and 180 and K for pesticides p.p’-DDE, p.p’-DDD, p.p’-DDT and PBDE47. This study highlights the potential role played by upland aquatic ecosystems in enhancing riverine silver eel production from the perspective of species conservation. To be successful, restocking must be accompanied by improved ecosystem quality and migration routes for eels in inland freshwaters. We also provide some recommendations for future research to improve the management of restocking programmes.

Comparison of Diagnostic Accuracy of Conventional and Photo Stimulable- Phosphor Periapical Radiography in Internal Root Resorption Lesions

Background and Objectives Internal Root Resorption (IRR) occurs in pulpchamber and canals of the tooth and results in desolation of around dentin. Regarding to important role of early diagnosis of IRR in prognose and treatment plan of the teeth and also limitations of intraoral technics in early detecting of these lesions, in this study we evaluated the accuracy of PSP in diagnosis of these lesions. Subjects and Methods We split 70 single root premolar teeth mesiodistalyand made artificial IRR in 35 teeth. The rest of them used as control group PSP and Conventional radiography captured from all teeth. IRR existence or not was considered in PSP and Conventionalradiographies of each tooth. Results PSP has complete agreement in all cases with reality but Conventional radiography in some cases particularly in 1/3 apical lesions of the root has moderate accuracy with reality and its results diden’t have considerable differences with reality. Conclusion Regarding to this study, has higher accuracy for PSP than Conventional radiography in detecting Internal root resorption lesions particularly in apical sites.

Acute ischemic stroke with cervical internal carotid artery steno-occlusive lesion: multicenter analysis of endovascular approaches

BackgroundOcclusion of the internal carotid artery (ICA), whether isolated or in the setting of a tandem lesion (TL) have a poor response to treatment with intravenous thrombolysis. Previous studies ​​have demonstrated the superiority of mechanical thrombectomy in the treatment of acute ischemic stroke (AIS) following large vessel occlusion, compared to standard intravenous fibrinolysis. The aim of our study was to describe endovascular treatment (EVT) in AIS due to isolated ICA occlusion or TL.MethodsWe assessed the association between 90-day outcome and clinical, demographic, imaging, and procedure data in 51 consecutive patients with acute isolated ICA occlusion or TL who underwent EVT. We evaluated baseline NIHSS and mRS, ASPECTS, type of occlusion, stent placement, use of stent retrievers and/or thromboaspiration, duration of the procedure, mTICI, postprocedural therapy and complications.ResultsA favorable 90-day outcome (mRS 0–2) was achieved in 34 patients (67 %) and was significantly associated with the use of dual antiplatelet therapy after the procedure (p = 0.008), shorter procedure duration (p = 0.031), TICI 2b-3 (p < 0.001) and lack of post-procedural hemorrhagic transformation (p = 0.001). Four patients did not survive, resulting in a mortality rate of 8 %.ConclusionsOur study has shown that EVT in the treatment of AIS due to ICA occlusion is safe, and effective in determining a good functional outcome. ICA stenting led to good angiographic results and therapy with a glycoprotein IIb / IIIa inhibitor immediately after stent release did not result in a greater risk of hemorrhage. The use of post-procedural dual antiplatelet therapy was associated with favorable outcome, without a significant increase in hemorrhagic transformation.

Francisella noatunensis subsp. orientalis outbreak in Nile tilapia juveniles cultivated in net cages in the Araguari river basin, Brazil

The aims at identifying and describing the occurrence ofanatomopathological and histopathological changes in Nile tilapia juveniles, naturally infected with Francisella noatunensis subsp. orientalis (Fno). The Nile tilapias of this study were cultivated in net cages in the region of the Araguari River basin, Minas Gerais, Brazil, and due to a mortality rate ranging from 40 to 60%, 64 fish samples were collected and sent for examination in the laboratory. At necropsy, granuloma-like nodules were observed in the spleen 59/64(92.2%), kidney 24/64 (37.5%), and liver 09/64 (14.1%). Fno was detected in 98% (49/50) of the samples by PCR. Upon analysis, astrong correlation was observed between external and internal lesions, since granulomatous lesions present in the spleen and kidney of the same animal simultaneously were also accompanied by skin ulcers, suggesting that the cutaneous lesion is related to the presence of Fno in tilapia and can be used as an indication for early diagnosis. Thus, the high prevalence of Fno observed in this research study allows characterizing an outbreak in the region. It is noteworthy that especially regarding the consumption of tilapia meat, although there are zoonotic species in the Francisella group, the zoonotic potential of Fno is not yet known and should be further studied.

Preclinical mouse model of optical coherence tomography for subcortical brain imaging without dissection.

The purpose of this study was to investigate the feasibility of using optical coherence tomography (OCT) to identify internal brain lesions, specifically intracerebral hemorrhage, without dissection. Mice with artificially injected brain hematomas were used to test the OCT system, and the recorded images were compared with microscopic images of the same mouse brains after hematoxylin and eosin staining. The intracranial structures surrounding the hematomas were clearly visualized by the OCT system without dissection. These images reflect the ability of OCT to determine the extent of a lesion in several planes. OCT is a useful technology, and these findings could be used as a starting point for future research in intraoperative imaging.

P–326 Presence of adenomyosis at MRI in endometriosis women negatively affect live birth chances in IVF cycles

Abstract Study question What is the impact of adenomyosis and its magnetic resonance imaging (MRI) characteristics on live birth rate (LBR) in endometriosis-affected women undergoing in-vitro fertilization (IVF) treatment? Summary answer Among women undergoing IVF, the presence of adenomyosis at MRI, and especially T2 high signal-intensity spots within the myometrium have a negative impact on LBR. What is known already: Adenomyosis is a frequent gynecologic disease. With the development of imaging technics for the diagnosis (notably MRI), several adenomyosis phenotypes have been described and fertility issues seem variable according to the lesions characteristics. Moreover, on IVF outcomes, controversial results have been found in studies assessing the impact of adenomyosis. What make the impact-assessment of adenomyosis on fertility issues even more difficult is the frequent association with endometriosis, another known risk factor of infertility. Some data suggested that adenomyosis could worsen IVF prognostics, however there is no clear consensus about the impact of the adenomyosis on IVF outcomes in endometriosis affected-women. Study design, size, duration This was an observational study including phenotyped endometriosis patients, aged between 18 to 42 years, who underwent IVF/intra-cytoplasmic sperm injection (ICSI) treatment in a tertiary care center, from June 2015 through July 2018.Only women who had performed a pelvic MRI during the pre-therapeutic ART work-up, were retained for this study. The MRI data were interpreted by radiologists who had expertise in gynaecological MRI. Participants/materials, setting, methods A continuous series of 202 endometriosis affected women was included. The women were followed until four ART cycles had been completed, until delivery or until discontinuation of treatment before the completion of four cycles. The primary outcome was the delivery of one or more live infant(s) after up to four IVF/ICSI cycles. Patients and MRI characteristics were compared between women who gave a live birth and those without live birth. Main results and the role of chance The mean age of the included population was 32.5 ±3.7 years. 90.1% (182/202) had deep infiltrating endometriosis whereas only 5.4% (11/202) and 4.5% (9/202) had respectively isolated ovarian endometriosis (OMA) and superficial peritoneal endometriosis (SUP). The presence of adenomyosis (internal and/or external lesions) was found in 71.8% (145/202) of included women. The cumulative live birth rate was 57.4% (116/202). Women that gave birth (‘live birth +’) were significantly younger, (33.3±4.1 vs 32.0±3.3 p = 0.026) and had significant better ovarian reserve parameters (AMH, AFC). The presence of adenomyosis (internal and/or external lesions) (76/116 (65.5%) versus 69/86 (80.2%), p = 0.022) and the presence of T2 high-signal intensity myometrial spots (27/116 (23.3%) and 37/86 (43.0%), p = 0.003) were significantly less frequently found in the group of women ‘Live birth +’. After multivariate analysis, the presence of adenomyosis (OR: 0.48 95% CI (0.29–0.99) p = 0.048) and the presence of T2 high-signal intensity myometrial spots (OR: 0.43 95% CI (0.22–0.86) p = 0.018) were independently found to be associated with a decrease in cumulative chances of live birth. Limitations, reasons for caution The inclusion of patients from our referral center could constitute a possible selection bias, as those women may have suffered from particularly severe forms of adenomyosis ± endometriosis. Wider implications of the findings: In women presenting endometriosis, the practitioner should perform an appropriate imaging work-up searching for adenomyosis, to identify prognostic factors and to plan the strategy of patient management in the setting of ART. Trial registration number NA