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Background: Sufficient tumor collection has become of utmost importance in therapeutic experimental protocols. Rapid on‐site evaluation (ROSE) ensures adequate sampling for quantification of biomarkers, molecular analyses, and other ancillary studies. The objectives of this study were to evaluate the role of ROSE in trial‐associated fine‐needle aspiration (FNA) and to analyze predictors of adequacy and cumulative survival from in‐house FNA cases used in clinical trials. Methods: Clinical trial FNA biopsies performed at a large academic institution were analyzed over 10 months using a comprehensive chart review of the electronic medical records. SPSS version 28 was used for statistical analysis. Results: Three hundred twenty‐five FNAs were collected for 57 clinical trials. In total, 225 individual patients had an average of 1.4 FNA procedures each as a result of a multidepartmental collaborative effort. ROSE was performed for all patients, and adequacy was evaluated by cytotechnologists. Seventy‐eight percent of samples were considered adequate, 14% were considered less than optimal, and 8% were considered inadequate, with the latter two categories designated together as less than adequate. The imaging modalities were mainly ultrasound‐guided (n = 267; 82%) and computed tomography‐guided (n = 58; 18%). There was a statistically significant association between adequate sampling and ultrasound‐guided biopsies (83%) compared with computed tomography‐guided biopsies (59%; p <.01). The effect of body mass index (BMI) on mortality was also a significant finding. The authors observed a survival benefit in patients who had elevated BMIs (range, 25.0–34.9 kg/m2) compared with those who were underweight (BMI, <18.5 kg/m2) or class III obese (BMI, >35.0 kg/m2; p <.01). Therefore, the best predictors of adequacy and mortality were imaging modality and BMI, respectively. Conclusions: Ultrasound‐guided modalities are recommended for obtaining adequate FNA sampling for clinical trials. In addition, patients with cancer who had slightly elevated BMIs (25.0–34.0 kg/m2) had increased overall survival in this cohort. The role of rapid on‐site evaluation in trial‐associated fine‐needle aspiration (FNA) biopsies was evaluated, and predictors of adequacy and cumulative survival were analyzed from in‐house FNA clinical trial cases. Ultrasound‐guided modalities are recommended for obtaining adequate FNA sampling in clinical trials, and a slightly elevated body mass index (range, 25–34 kg/m2) in patients with cancer was correlated with increased overall survival. [ABSTRACT FROM AUTHOR]

Background: Human papillomavirus‐associated oropharynx squamous cell carcinoma (HPV‐OPSCC) has no known pre‐malignant lesion. While vaccination offers future primary prevention, there is current interest in secondary prevention. The feasibility of clinical evaluation of individuals at increased risk for HPV‐OPSCC is unclear. Methods: Individuals with risk factors for HPV‐OPSCC were enrolled in a prospective study (MOUTH). Participants positive for biomarkers associated with HPV‐OPSCC were eligible for a clinical evaluation which comprised a head and neck examination and imaging with ultrasound and/or magnetic resonance imaging (MRI). This study was designed to evaluate feasibility of clinical evaluation in a screening study. Results: Three hundred and eighty‐four participants were eligible for clinical evaluation. Of the 384, 204 (53%) completed a head and neck examination or imaging. Of these, 66 (32%) completed MRI (n = 51) and/or ultrasound (n = 64) studies. Conclusions: Clinical evaluations, including head and neck examination and imaging, are feasible in the context of a screening study for HPV‐OPSCC. [ABSTRACT FROM AUTHOR]

The aim of the present study is to assess the impact of smoking dose and duration on the distribution of risk factor(s) in patients with RAP and CP, and the impact of genetic testing on the distribution of risk factor(s) in patients with idiopathic RAP and CP. All adult patients with RAP and CP referred to a multidisciplinary pancreatitis clinic between 2010 and 2017 were evaluated. Risk factors included alcohol and smoking, hypertriglyceridemia, biliary, and other etiologies. Genetic testing was only pursued in patients with idiopathic RAP or CP. Among the 1770 patients evaluated, 167 had RAP and 303 had CP. After genetic testing and smoking, the most common risk factors for RAP and CP were pathogenic variant(s) (23%) and the combination of alcohol and smoking (23%), respectively. Genetic testing and smoking assessment decreased the proportion of patients with alcoholic RAP from 17% to 5%, alcoholic CP from 33% to 10%, idiopathic RAP from 49% to 12%, and idiopathic CP from 54% to 14%. Pathogenic CFTR variants were the most common variant in patients with RAP (51%) and CP (43%). Among the 68 patients with pancreas divisum, other risk factor(s) were identified in 72%. Genetic testing and a detailed assessment of smoking dose and duration reduce the proportion of patients with alcoholic and idiopathic pancreatitis. Other risk factor(s) for pancreatitis are found in the majority of patients with pancreas divisum further questioning its role as an independent risk factor. Approximately 30% of patients with pancreatitis have no clear risk factor(s) and are categorized as having an idiopathic etiology. Pathogenic variant(s) as well as smoking dose and duration are well-established risk factors for recurrent acute and chronic pancreatitis but are not widely recognized or incorporated into clinical practice. Genetic testing and a detailed assessment of smoking dose and duration reduced the proportion of patients with alcoholic and idiopathic acute recurrent and chronic pancreatitis. Approximately three-fourths of patients with pancreas divisum have a risk factor for pancreatitis. [ABSTRACT FROM AUTHOR]

Background and Objective: Grip strength is one of the important] parameters in hand muscle function that can be negatively affected by vibration. This study aimed to determine the effect of sport intervention on the grip strength of workers exposed to hand-arm vibration. Materials and Methods: This descriptive-interventional study was conducted on the workers (n=41) of one of the metal industries in Isfahan, Iran. The required data were collected through the completion of demographic questionnaires, measurement of hand-arm vibration acceleration based on ISO 5349, and assessment of grip strength with a Jamar dynamometer. The intervention of hand sports movement was performed for 8 weeks. The gathered data were analyzed in SPSS-21 software. Results: The grip strength of the workers was significant before and after exposure to vibration (P<0.001). The mean scores of workers' grip strength were obtained at 42.16±3.8 and 39.55±3.97 kg force before working with the vibrating tool and after the end of the work shift and finishing working with the vibrating tool, respectively. The difference between grip strength before and after the intervention of hand sports movements was significant (P<0.001). Conclusion: The results of this study showed that vibration reduced the grip strength of workers; while performing the intervention of hand sports movements was effective in improving the workers' grip strength. Therefore, sports movements could effectively and efficiently improve the grip strength of workers exposed to vibration. [ABSTRACT FROM AUTHOR]

Acute interstitial nephritis (AIN) is known as a common cause of acute kidney injury, found in 15% to 27% of kidney biopsies. Drug-induced AIN is currently the most common cause of AIN. The most common medications causing AIN are antibiotics and nonsteroidal anti-inflammatory drugs. We describe a case of Citrullus colocynthis (herbal remedy for diabetes mellitus and weight reduction) that induced AIN. A 31-year-old woman with major thalassemia, diabetes mellitus, and hepatitis C infection was admitted because of flank pain and unexpected increase in serum creatinine level. She had been using Citrullus colocynthis for 3 months. Kidney biopsy results suggested AIN. She did not respond to steroid therapy and underwent hemodialysis. We suggest the use of Citrullus colocynthis as a herbal medicine with extreme caution. [ABSTRACT FROM AUTHOR]

The Canadian Cervical Spine Rule, a clinical decision-making tool for patients post-trauma is often interpreted as recommending cervical spine computed tomography in patients ≥ 65 years old, who sustain a dangerous mechanism of injury, and/or have extremity paresthesias. We retrospectively reviewed 6 years' of emergency department cervical spine computed tomography reports to determine fracture rates in patients ≥ 65, symptomatic or not, who did and did not have a dangerous mechanism. Of those ≥ 65 years old, 240/13925 (1.72%) patients had cervical spine fractures. The fracture rate in asymptomatic patients ≥ 65 was 0.27%. The fracture rate in asymptomatic patients ≥ 65, who did not have a dangerous mechanism of injury was 0.15%. The rate of unstable fractures requiring surgery was 0.007%. The findings suggest that the algorithm to scan asymptomatic patients ≥ 65, and/or those ≥ 65 without a dangerous injury mechanism, should be revisited for appropriateness and overall value.ABBREVIATIONS: CCR = The Canadian Cervical Spine Rule; CSCT = cervical spine computed tomography; ED = emergency department; EMR = electronic medical record; MVC = motor vehicle collision., (© 2024 by American Journal of Neuroradiology.)

Purpose: The purpose of this study was to develop a radiomics-based algorithm to identify small pancreatic neuroendocrine tumors (PanNETs) on CT and evaluate its robustness across manual and automated segmentations, exploring the feasibility of automated screening., Materials and Methods: Patients with pathologically confirmed T1 stage PanNETs and healthy controls undergoing dual-phase CT imaging were retrospectively identified. Manual segmentation of pancreas and tumors was performed, then automated pancreatic segmentations were generated using a pretrained neural network. A total of 1223 radiomics features were independently extracted from both segmentation volumes, in the arterial and venous phases separately. Ten final features were selected to train classifiers to identify PanNETs and controls. The cohort was divided into training and testing sets, and performance of classifiers was assessed using area under the receiver operator characteristic curve (AUC), specificity and sensitivity, and compared against two radiologists blinded to the diagnoses., Results: A total of 135 patients with 142 PanNETs, and 135 healthy controls were included. There were 168 women and 102 men, with a mean age of 55.4 ± 11.6 (standard deviation) years (range: 20-85 years). Median PanNET size was 1.3 cm (Q1, 1.0; Q3, 1.5; range: 0.5-1.9). The arterial phase LightGBM model achieved the best performance in the test set, with 90 % sensitivity (95 % confidence interval [CI]: 80-98), 76 % specificity (95 % CI: 62-88) and an AUC of 0.87 (95 % CI: 0.79-0.94). Using features from the automated segmentations, this model achieved an AUC of 0.86 (95 % CI: 0.79-0.93). In comparison, the two radiologists achieved a mean 50 % sensitivity and 100 % specificity using arterial phase CT images., Conclusion: Radiomics features identify small PanNETs, with stable performance when extracted using automated segmentations. These models demonstrate high sensitivity, complementing the high specificity of radiologists, and could serve as opportunistic screeners., Competing Interests: Declaration of competing interest Dr. Elliot K. Fishman discloses the following relationships: Siemens Medical Systems, research grant support, and HIP Graphics, co-founder. The other authors have no competing interests or disclosures to declare., (Copyright © 2024 Société française de radiologie. Published by Elsevier Masson SAS. All rights reserved.)

Background: Cervical spine computed tomography (CSCT) scans are frequently performed in older emergency department (ED) trauma patients based on the 65-year-old high-risk criterion of the Canadian Cervical Spine Rule (CCR). We sought to determine the positivity rate of CSCT scans in symptomatic and asymptomatic patients to assess the current applicability of age in the CCR., Methods: We reviewed CSCT ED reports from two institutional hospitals from 2018 to 2023. The primary variable was age; however, we also recorded fracture types and sites and type of treatments. Patients were separated into symptomatic and asymptomatic cohorts. We used a Fisher's exact test to compare variables between the asymptomatic and symptomatic groups and chi-square tests for comparison between age groups., Results: Of 9455 CSCTs performed in patients ≥ 65 years, 192 (2.0%) fractures were identified (113 females); 28 (0.30%) were in asymptomatic patients. The rates of fractures (1.6%) and asymptomatic fractures (0.18%) were lowest in the 65- to 70-year age group. There were no distinguishing features as to the level or part of the vertebra fractured or surgical treatment rate between asymptomatic and symptomatic patients., Conclusions: Cervical spine fractures in posttrauma patients ≥ 65 years are uncommon, with the lowest incidence in those 65 to 70 years old. Excluding asymptomatic individuals aged 65-70 from routine CSCT presents a minimal risk of missed fractures (0.18%). This prompts consideration for refining age-based screening and integrating shared decision making into the clinical protocol for this demographic, reflecting the low incidence of fractures and the changing health profile of the aging population., (© 2024 Society for Academic Emergency Medicine.)