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Background and purpose SARS-CoV-2 causes multiorgan disease due to altered coagulability and microangiopathy. Patients may have an increased risk of cerebrovascular accidents (CVA). Our objective was to analyze clinical and neuroimaging characteristics of patients with ischemic CVA during the pandemic peak in our region, in order to identify atypical presentations. Methods We performed a cross-sectional analysis of patients admitted under code-stroke protocol to our center with a final diagnosis of ischemic brain infarction. We analyzed the main imaging and demographic characteristics and reviewed neuroimaging for atypical presentations. Results One-hundred patients with confirmed ischemic CVA were included. Nineteen had positive polymerase chain reaction testing for SARS-CoV-2 on admission. These patients had a lower prevalence of proximal arterial occlusion on imaging, higher in-hospital mortality, and worse baseline disability. No differences were identified in affected vascular territory, volume of infarction, initial CT stroke score, prevalence of hemorrhagic transformation, gender, age, cardiovascular risk factors, time to admission, symptom severity on entry, or decision to treat with thrombolysis or mechanical thrombectomy. Prevalence of COVID-19 in our code-stroke sample was higher than that for our province during this time period. Conclusion The COVID-19 group had more in-hospital mortality, less proximal arterial occlusion on CT or MR angiography, and lower baseline modified Rankin Scale score. We suggest a possibly higher proportion of microangiopathic involvement or undetected distal large-vessel occlusion in the COVID-19 stroke group. Excess mortality was explained by severe respiratory failure. Otherwise, stroke patients with COVID-19 did not differ demographically or clinically from those without the illness.

The purpose of this study was to evaluate whether single-voxel 1H MRS could add useful information to conventional MRI in the preoperative characterisation of the type and grade of brain tumours. MRI and MRS examinations from a prospective cohort of 40 consecutive patients were analysed double blind by radiologists and spectroscopists before the histological diagnosis was known. The spectroscopists had only the MR spectra, whereas the radiologists had both the MR images and basic clinical details (age, sex and presenting symptoms). Then, the radiologists and spectroscopists exchanged their predictions and re-evaluated their initial opinions, taking into account the new evidence. Spectroscopists used four different systems of analysis for 1H MRS data, and the efficacy of each of these methods was also evaluated. Information extracted from 1H MRS significantly improved the radiologists' MRI-based characterisation of grade IV tumours (glioblastomas, metastases, medulloblastomas and lymphomas) in the cohort [area under the curve (AUC) in the MRI re-evaluation 0.93 versus AUC in the MRI evaluation 0.85], and also of the less malignant glial tumours (AUC in the MRI re-evaluation 0.93 versus AUC in the MRI evaluation 0.81). One of the MRS analysis systems used, the INTERPRET (International Network for Pattern Recognition of Tumours Using Magnetic Resonance) decision support system, outperformed the others, as well as being better than the MRI evaluation for the characterisation of grade III astrocytomas. Thus, preoperative MRS data improve the radiologists' performance in diagnosing grade IV tumours and, for those of grade II–III, MRS data help them to recognise the glial lineage. Even in cases in which their diagnoses were not improved, the provision of MRS data to the radiologists had no negative influence on their predictions. Copyright © 2011 John Wiley & Sons, Ltd.

Despite considerable literature on the functional anatomy of the hominoid upper limb, there are no quantitative approaches relating to bone design and the resulting muscular-activity enhancement. The purpose of this study is to quantitatively analyze the relationship between the rotational efficiency of the pronator teres muscle and the design of the skeletal structures on which it acts. Using conventional scan images of a human forearm for three rotational positions, this study develops an original biomechanical model that defines rotational efficiency as a mathematical function expressing a geometrical relationship between the origin and insertion muscular sites. The results show that this parameter varies throughout the entire pronation range, being maximal when the forearm lies around its functional position. Moreover, the rotational-efficiency formula allows us to demonstrate, by several simulation conditions, that an improvement in pronation efficiency is derived from a large shaft radius curvature, a large humeral medial epicondyle, and a more proximal pronator teres radial attachment. The fact that forearm pronation efficiency can be inferred, even quantified, throughout the entire rotational range, by applying the biomechanical model developed here allows us to undertake anatomical approaches in the field of Evolutionary Anthropology, to interpret more precisely how skeletal design is related to upper-limb function in extant and fossil primate taxa.