Search Results for: L'imaging nella urolitiasi

This update discusses new risk stratification criteria, refinement of cardiovascular imaging, and updated medical management.

Colonoscopy is the gold standard for detecting and resecting adenomas and early-stage cancers to reduce colorectal cancer (CRC) incidence and mortality rates. This study aimed to confirm the superiority of texture and color enhancement imaging (TXI) over white light imaging (WLI) in detecting colorectal lesions.

Ductal carcinoma in situ (DCIS) is defined as “a neoplastic proliferation of cells within the ductal-lobular structures of the breast that has not penetrated the myoepithelial basement membrane interface.” DCIS is considered to be a nonobligate precursor to invasive cancer, such that the purpose of therapy is primarily to avoid the occurrence of invasive cancer. To achieve this end, DCIS has historically been treated in the same way as invasive breast cancer: surgery, often followed by radiation and antiestrogen therapy (if the DCIS is hormone receptor positive). Advances in mammography and the increasing use of magnetic resonance imaging for breast cancer screening have led to the detection of smaller, low-risk lesions. Growing evidence suggests that low-risk DCIS is unlikely to develop into invasive cancer, leading to a question of whether DCIS can be managed with active surveillance alone, thereby avoiding treatment-associated morbidity.

Introduction
Treating attention disorders is one of the hottest studies in the field of rehabilitation medicine. Stroke leads to the destruction of the functional network of the cerebral cortex and impairs the cognitive function of patients. Improvement of attention plays a pivotal role in the rehabilitation of patients who have had a stroke. Repetitive transcranial magnetic stimulation has achieved relatively positive efficacy in rehabilitation applications for patients who have had a stroke; however, its optimal parameters and mechanism of action regarding poststroke attention deficits are still elusive. Therefore, this will be an in-depth study exploring the mechanisms of high-frequency transcranial magnetic stimulation on cerebral functional connectivity in patients with poststroke attentional dysfunction.

Methods and analysis
This single-centre randomised controlled trial will involve 120 patients who have had a stroke. They will be randomly allocated to either a high-frequency transcranial magnetic stimulation group or a control group (sham stimulation group). The intervention will take place 5 days a week for 2 weeks. The primary outcome will be a comparison between and within the two groups from baseline to 2 weeks before and after the intervention, and will be based on quantitative electroencephalography to explore the connectivity of brain networks and to assess the efficacy of high-frequency transcranial magnetic stimulation on attentional functioning after stroke. Functional near-infrared spectroscopy imaging, a range of neuropsychological scales, activities of daily living, motor function scores and biological indicators will be used as secondary outcome indicators.

Ethics and dissemination
This study has been approved by the Ethics Committee of the First Hospital of Shanxi Medical University (NO. KYLL-2023–264 and NO.KYXZ-2024–005). All participants will sign the informed consent form. Findings will be published in peer-reviewed journals and presented at conferences.

Trial registration number
ChiCTR2400082383.

Introduction
The majority of all patients with systemic sclerosis (SSc) experience hand function impairment. The exact cause for this impairment is yet unknown. As impaired hand function hugely impacts daily functioning and quality of life, there is a high unmet need for effective treatments. With the availability of new imaging modalities, biomarkers and laboratory techniques, opportunities arise to increase insights into the factors contributing to hand function impairment. The objective of this study is to identify risk factors and underlying mechanisms leading to hand function impairment in SSc.

Methods and analysis
This is a longitudinal observational multicentre study in patients with very early diagnosis of systemic sclerosis and SSc under care of the Department of Rheumatology and Clinical Immunology of the University Medical Centre Utrecht (UMCU), St Antonius Hospital Nieuwegein, UMC Groningen (UMCG), Leiden UMC (LUMC), Radboudumc or Royal Free Hospital (RFH) London. Patients will be followed for 2 years. Medical history, clinical status, nailfold capillaroscopy, skin assessments, serum biomarker analysis, ultrasound, elastography and MRI will be performed, and results related to hand function measurements will be analysed.

Ethics and dissemination
This study was approved by the Medical Research Ethics Committee NedMec (MREC NedMec) in the Netherlands and by HRA and Health and Care Research Wales in the UK. Results will be published in scientific journals and presented at scientific congresses and patient meetings.

Trial registration number
NCT06133244.

Protocol version
V1.3 6-06-2024.

Introduction
SARS-CoV-2 disease (COVID-19) has had an enormous health and economic impact globally. Although primarily a respiratory illness, multi-organ involvement is common in COVID-19, with evidence of vascular-mediated damage in the heart, liver, kidneys and brain in a substantial proportion of patients following moderate-to-severe infection. The pathophysiology and long-term clinical implications of multi-organ injury remain to be fully elucidated. Age, gender, ethnicity, frailty and deprivation are key determinants of infection severity, and both morbidity and mortality appear higher in patients with underlying comorbidities such as ischaemic heart disease, hypertension and diabetes. Our aim is to gain mechanistic insights into the pathophysiology of multiorgan dysfunction in people with COVID-19 and maximise the impact of national COVID-19 studies with a comparison group of COVID-negative controls.

Methods and analysis
COmorbidities and Sociodemographic factors on Multiorgan Injury following COVID-19 (COSMIC) is a prospective, multicentre UK study which will recruit 200 subjects without clinical evidence of prior COVID-19 and perform extensive phenotyping with multiorgan imaging, biobank serum storage, functional assessment and patient reported outcome measures, providing a robust control population to facilitate current work and serve as an invaluable bioresource for future observational studies.

Ethics and dissemination
Approved by the National Research Ethics Service Committee East Midlands (REC reference 19/EM/0295). Results will be disseminated via peer-reviewed journals and scientific meetings.

Trial registration number
COSMIC is registered as an extension of C-MORE (Capturing Multi-ORgan Effects of COVID-19) on ClinicalTrials.gov (NCT04510025).

Introduction
The rapid growth in popularity of e-cigarettes over the past decade has prompted concerns about their impact on long-term respiratory health. Small airway injury is suspected to be a direct consequence of e-cigarette use and may be quantifiable by novel structural and functional diagnostic modalities.

Methods and analysis
In a multicentre observational longitudinal study, participants will be enrolled in either an adolescent (ages ≥12 and

Introduction
Health systems are under pressure as one in five Canadians have no regular place for primary care, with many experiencing substantial travel times and delays in accessing care. In the context of these urgent needs, platforms for virtual care offer immediate access to care in ‘walk-in’ style format, with limited continuity for ongoing health needs or coordination with other health services. We refer to these services as episodic virtual care (EVC), to distinguish them from virtual services offered in longitudinal primary care. The governments of Nova Scotia (NS) and New Brunswick (NB) both offer publicly funded EVC and offer a unique opportunity for research.
The overarching goal of this work is to learn from the implementation of EVC in NS and NB to understand experiences and system impacts, including
What are patient perceptions and experiences of EVC and how do these differ by patient characteristics?

What are the characteristics of patients who use EVC and of clinicians who deliver it?

What are the system impacts of EVC?

Methods and analysis
We will use a cross-sectional survey conducted through an online questionnaire to explore patient perceptions and experiences with EVC. We will also examine how these differ based on the type of care needed, age, gender, residence (urban or rural), immigration and language preference. We will use linked administrative data and quasi-experimental analysis to assess the impacts of EVC on visits to community-based primary care (including in-person walk-in clinics), emergency department visits, prescriptions and referrals for other health services like laboratory testing, imaging and consulting specialist physicians.

Ethics and dissemination
This proposal has been reviewed and received approval from the Nova Scotia Health Research Ethics Board. Findings will identify the impacts and trade-offs in the deployment of EVC, which will inform primary care planning. In addition to traditional academic publications and information provided to primary care patients/the public, this study will inform decision-makers across multiple jurisdictions as they contend with the challenge of meeting patients’ immediate care needs for access to primary care, while seeking to improve coordination and integration of systems as a whole.

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

Introduction
Postpartum lumbopelvic pain (LPP) is a prevalent condition among women following childbirth. Due to the importance of respiratory muscles in lumbopelvic stability, and the changes they undergo during pregnancy, this study aims to assess the effects of motor control training and breathing exercises on pain, disability and core muscle activity in women suffering from LPP after childbirth.

Methods and analysis
52 women with postpartum LPP will participate in this two-parallel-armed, superiority randomised controlled trial, comprising 24 treatment sessions. The intervention group consists of motor control training and breathing exercises, and the control group includes motor control training. The diaphragm excursion, pelvic floor and abdominal muscle activity, pain and disability will be evaluated using ultrasound imaging, visual analogue scale and Oswestry Disability Index, before and after the intervention, respectively.

Ethics and dissemination
Ethical approval was obtained from the human research ethics committee of the Iran University of Medical Sciences (IR.IUMS.REC.1403.017). The study results will be submitted to a relevant journal and conferences.

Trial registration number
This clinical trial has been registered in the Iranian Registry of Clinical Trials on 21 May 2024 (registration number: IRCT20180916041051N2).

Stroke, Ahead of Print.

Muhler P, AkuamoaBoateng D, Rosenbrock J, et al. Cost–utility analysis of MR imaging-guided transurethral ultrasound ablation for the treatment of low- to intermediate-risk localised prostate cancer. BMJ Open 2025;15:e088495. doi:10.1136/bmjopen-2024–0 88 495 This article has been corrected since it was published online. Page 1 ‘BACKGROUND […] Among all prostate cancer patients, those with low or favourable intermediate risk of prostate cancer who have a low risk of tumour & page 2 ‘[…] To evaluate the clinical and economic long-term consequences of applying MR-TULSA in low or favourable intermediate-risk prostate cancer in Germany’ We found inconsistencies in punctuation: Please correct them into ‘low- and favourable intermediate-risk (of) prostate cancer. Page 5: ‘Table 2 Cost calculation […] Salvage ADT withleuprorelinn for 2 years’ The typing mistake mentioned above, needs to be corrected in ‘with leuprorelin for 2 years’ Page 5: ‘Table 2 Cost calculation […] RARP, radical prostatectomy’ Please correct to ‘RARP, robot-assisted…

Circulation, Ahead of Print. BACKGROUND:Catheter ablation of ventricular arrhythmias, one of the most rapidly growing procedures in cardiac electrophysiology, is associated with magnetic resonance imaging–detected brain lesions in more than half of cases. Although a retrograde aortic approach is conventional, modern tools enable entry through a transseptal approach that may avoid embolization of debris from the arterial system. We sought to test the hypothesis that a transseptal puncture would mitigate brain injury compared with a retrograde aortic approach.METHODS:The TRAVERSE trial (Transseptal Versus Retrograde Aortic Ventricular Entry to Reduce Systemic Emboli) was a multicenter randomized controlled comparative effectiveness trial. Patients with left ventricular arrhythmias undergoing catheter ablation procedures were randomly assigned to a transseptal puncture approach compared (1:1) with a retrograde aortic approach. The primary outcome was the presence of an acute brain lesion detected by magnetic resonance imaging. Secondary outcomes included clinically manifest complications, procedural efficacy, and 6-month neurocognitive assessments.RESULTS:Among the 62 patients randomly assigned to a retrograde aortic approach with postoperative brain magnetic resonance imaging, 28 (45%) exhibited an acute brain lesion compared with 19 of the 69 (28%) of those randomized to a transseptal puncture (P=0.036). No differences in clinically manifest complications or procedural efficacy were observed. More patients in the retrograde aortic arm were categorized as having a high likelihood of cognitive impairment at 6 months (33% compared with 19% of those in the transseptal arm), but substantial loss to follow-up was present.CONCLUSIONS:Among patients undergoing left ventricular catheter ablation procedures, a transseptal approach reduced the risk of acute brain lesions by nearly half compared with a retrograde aortic approach without sacrificing safety or efficacy. Given a likely embolic pathogenesis, the brain magnetic resonance imaging findings may reflect a propensity to other organ damage; these findings may extend to other procedures requiring left ventricular entry.REGISTRATION:URL:https://www.clinicaltrials.gov; Unique identifier: NCT03946072

Objective
To investigate the relationship between eosinophil (EOS) and CT imaging, we quantitatively evaluated the bronchial wall thickening, emphysema index (EI) and pulmonary vascular parameters in patients with chronic obstructive pulmonary disease (COPD) based on different EOS levels.

Design
Retrospective observational study.

Setting
A tertiary hospital in China.

Participants
448 patients with COPD from January 2020 to January 2023.

Main outcome measures
Laboratory data, chest CT and pulmonary function based on different EOS levels: