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This research examined monthly dengue incidences per barangay (village) in Quezon City, Philippines over a period of six years (2010–2015) to determine the relative significance of environmental variables on dengue prevalence. The data were subjected to correlation analysis, spatial autocorrelation assessment, multiple factor analysis, ordinary least squares (OLS) and spatial regression. Local Indicators of Spatial Autocorrelation (LISA) Moran’s I cluster maps indicate significant (p=0.05, 0.01) High-High clustering and Low-Low clustering in the northern and southern parts of the city, respectively. Monthly total cases indicated increasing trend staring from May/June, peaking at around August/September, and declining afterwards to lower levels in November/December. This corresponds to the typical temporal rainfall pattern. Dengue cases were found to be positively correlated (α=0.05) with Population (R=0.84), Informal_Settlements (IS) (R=0.716), Very_Low_Density_Residential (VLDR) (R=0.512), Open_Spaces (OS) (R=0.339), Mean_Rainfall (RFM) (R=0.637), and Mean Elevation (EM) (R=0.498). Dengue incidence (DI) was negatively correlated with Mean Air Temperature (ATM) (R=−0.3 to 0.5). Based on factor analysis, the dengue incidences were closely related to these variables, though factors F1 and F2 accounted for only 28% of the data variability. Ordinary Least Square (OLS) regression analysis of DI with general land use (LU) classes (e.g., no subclasses in residential areas) identified only IS and OS, explaining 43% of the variability of DI, with IS having twice as much influence on DI compared to OS. When residential subclasses are considered, VLDR was added to the model, slightly increasing R-squared to 0.452. Considering, in addition, EM, RFM, and ATM, the R-squared improved to 0.589, with RFM and EM considered more influential on dengue compared to IS and OS. ATM was however removed due to multicollinearity. The use of Spatial Error regression (SER) and Spatial Lag regression (SLR) produced improved models relative to the OLS model with R-squared of 0.676 and 0.667, respectively. This indicates the importance of spatial dependence. This can be explained by the fact that mosquitos fly over considerably long distances, traversing across the different barangays. The SER model (AIC=1359.89; SE=26.9584) is slightly better than the SLR model (AIC=1366.05; SE= 27.3399).

Aims Microvascular dysfunction in hypertrophic cardiomyopathy (HCM) is predictive of clinical decline, however underlying mechanisms remain unclear. Cardiac diffusion tensor imaging (cDTI) allows in vivo characterization of myocardial microstructure by quantifying mean diffusivity (MD), fractional anisotropy (FA) of diffusion, and secondary eigenvector angle (E2A). In this cardiac magnetic resonance (CMR) study, we examine associations between perfusion and cDTI parameters to understand the sequence of pathophysiology and the interrelation between vascular function and underlying microstructure. Methods and results Twenty HCM patients underwent 3.0T CMR which included: spin-echo cDTI, adenosine stress and rest perfusion mapping, cine-imaging, and late gadolinium enhancement (LGE). Ten controls underwent cDTI. Myocardial perfusion reserve (MPR), MD, FA, E2A, and wall thickness were calculated per segment and further divided into subendocardial (inner 50%) and subepicardial (outer 50%) regions. Segments with wall thickness ≤11 mm, MPR ≥2.2, and no visual LGE were classified as ‘normal’. Compared to controls, ‘normal’ HCM segments had increased MD (1.61 ± 0.09 vs. 1.46 ± 0.07 × 10−3 mm2/s, P = 0.02), increased E2A (60 ± 9° vs. 38 ± 12°, P < 0.001), and decreased FA (0.29 ± 0.04 vs. 0.35 ± 0.02, P = 0.002). Across all HCM segments, subendocardial regions had higher MD and lower MPR than subepicardial (MDendo 1.61 ± 0.08 × 10−3 mm2/s vs. MDepi 1.56 ± 0.18 × 10−3 mm2/s, P = 0.003, MPRendo 1.85 ± 0.83, MPRepi 2.28 ± 0.87, P < 0.0001). Conclusion In HCM patients, even in segments with normal wall thickness, normal perfusion, and no scar, diffusion is more isotropic than in controls, suggesting the presence of underlying cardiomyocyte disarray. Increased E2A suggests the myocardial sheetlets adopt hypercontracted angulation in systole. Increased MD, most notably in the subendocardium, is suggestive of regional remodelling which may explain the reduced subendocardial blood flow.

OBJECTIVE: The identification and management of incidental findings is becoming increasingly problematic, particularly in relation to brachial plexus imaging because the prevalence is unknown. Therefore, we aimed to estimate the prevalence of incidental findings in symptomatic patients undergoing MRI of the brachial plexus. METHODS: This retrospective cohort study included all children and adults who underwent MRI over a 12-year period, in a tertiary care centre in the UK. An incidental finding was any abnormality which was not a direct injury to or disease-process of the brachial plexus. An “incidentaloma” was defined by the need for further investigation or treatment. Multivariable logistic regression was used to estimate the odds ratio (OR) of an “incidentaloma”. To estimate which factors were associated with the incident rate ratio (IRR) of incidental findings, multivariable Poisson regression was used. RESULTS: Overall, 502 scans (72%) reported incidental anomalies. Although the number of MRIs performed per annum increased by 23%, the prevalence of “incidentalomas” remained static (p = 0.766). Musculoskeletal incidental findings were the most prevalent (63%) and when identified, there were a median of 3 incidental anomalies per patient. Overall, 125 (18%) anomalies were “incidentalomas” which required further investigation or treatment. The odds of having further investigation or treatment was strongly related to the frequency of incidental findings [adjusted OR 1.16 (95% CI 1.08, 1.24)] and when a tumour was identified [adjusted OR 2.86 (95% CI 1.81, 4.53)]. The number of incidental findings recorded per scan increased when trainees co-reported with consultants [adjusted IRR 0.36 (95% CI 0.05, 0.67)] and in the presence of a tumour [adjusted IRR 0.39 (95% CI 0.28, 0.49)] CONCLUSIONS: The prevalence of clinically important incidental findings on brachial plexus MRI is lower than organ-specific imaging, but still 18% of scans identified an ‘incidentaloma’ which required further investigation or treatment. ADVANCES IN KNOWLEDGE: This cohort study shows that approximately 1 in 5 symptomatic patients undergoing a brachial plexus MRI had a clinically important incidental findings, which required further investigation or treatment. This information can be used to inform patients consenting to clinical or research imaging.

Diffusion tensor magnetic resonance imaging (DTI) can be used to reconstruct the brachial plexus in 3D via tracts connecting contiguous diffusion tensors with similar primary eigenvector orientations. When creating DTI tractograms, the turning angle of connecting lines (step angle) must be prescribed by the user; however, the literature is lacking detailed geometry of brachial plexus to inform such decisions. Therefore, the spinal cord and brachial plexus of 10 embalmed adult cadavers were exposed bilaterally by posterior dissection. Photographs were taken under standardised conditions and spatially calibrated in MATLAB. The roots of the brachial plexus were traced from the dorsal root entry zone for 5 cm laterally using a 2.5-mm2 Cartesian grid overlay. The trace was composed of points connected by lines, and the turning angle between line segments (the step angle) was resolved. Our data show that the geometry of the roots increased in tortuosity from C5 to T1, with no significant differences between sides. The 1st thoracic root had the most tortuous course, turning through a maximum angle of 56° per 2.5 mm (99% CI 44° to 70°). Significantly higher step angles and greater variability were observed in the medial 2 cm of the roots of the brachial plexus, where the dorsal and ventral rootlets coalesce to form the spinal root. Throughout the brachial plexus, the majority of step angles (>50%) were smaller than 20° and

Purpose\ud \ud Structure-guided total variation is a recently introduced prior that allows reconstruction of images using knowledge of the location and orientation of edges in a reference image. In this work, we demonstrate the advantages of a variant of structure-guided total variation known as directional total variation (DTV), over traditional total variation (TV), in the context of compressed-sensing reconstruction and super-resolution.\ud \ud \ud \ud Methods\ud \ud We compared TV and DTV in retrospectively undersampled ex vivo diffusion tensor imaging and diffusion spectrum imaging data from healthy, sham, and hypertrophic rat hearts.\ud \ud \ud \ud Results\ud \ud In compressed sensing at an undersampling factor of 8, the RMS error of mean diffusivity and fractional anisotropy relative to the fully sampled ground truth were 44% and 20% lower in DTV compared with TV. In super-resolution, these values were 29% and 14%, respectively. Similarly, we observed improvements in helix angle, transverse angle, sheetlet elevation, and sheetlet azimuth. The RMS error of the diffusion kurtosis in the undersampled data relative to the ground truth was uniformly lower (22% on average) with DTV compared to TV.\ud \ud \ud \ud Conclusion\ud \ud Acquiring one fully sampled non-diffusion-weighted image and 10 diffusion-weighted images at 8× undersampling would result in an 80% net reduction in data needed. We demonstrate efficacy of the DTV algorithm over TV in reducing data sampling requirements, which can be translated into higher apparent resolution and potentially shorter scan times. This method would be equally applicable in diffusion MRI applications outside the heart.

Cardiac electrical excitation-propagation is influenced by myocyte orientations (cellular organization). Quantitatively understanding this relationship presents a significant research challenge, especially during arrhythmias in which excitation patterns become complex. Tissue-scale simulations of cardiac electrophysiology, incorporating both dynamic action potential behavior and image-based myocardial architecture, provide an approach to investigate three-dimensional (3D) propagation of excitation waves in the heart. In this study, we aimed to assess the importance of natural variation in myocyte orientations on cardiac arrhythmogenesis using 3D tissue electrophysiology simulations. Three anatomical models (i.e., describing myocyte orientations) of healthy rat ventricles—obtained using diffusion tensor imaging at 100 μm resolution—were registered to a single biventricular geometry (i.e., a single cardiac shape), in which the myocyte orientations could be represented by each of the diffusion tensor imaging data sets or by an idealized rule-based description. The Fenton-Karma cellular excitation model was modified to reproduce rat ventricular action potential duration restitution to create reaction-diffusion cardiac electrophysiology models. Over 250 3D simulations were performed to investigate the effects of myocyte orientations on the following: 1) ventricular activation, 2) location-dependent arrhythmia induction via rapid pacing, and 3) dynamics of re-entry averaged over multiple episodes. It was shown that 1) myocyte orientation differences manifested themselves in local activation times, but the influence on total activation time was small; 2) differences in myocyte orientations could critically affect the inducibility and persistence of arrhythmias for specific stimulus-location/cycle-length combinations; and 3) myocyte orientations alone could be an important determinant of scroll wave break, although no significant differences were observed in averaged arrhythmia dynamics between the four myocyte orientation scenarios considered. Our results show that myocyte orientations are an important determinant of arrhythmia inducibility, persistence, and scroll wave break. These findings suggest that where specificity is desired (for example, when predicting location-dependent, patient-specific arrhythmia inducibility), subject-specific myocyte orientations may be important.

Purpose: Diffusion MRI requires acquisition of multiple diffusion‐weighted images, resulting in long scan times. Here, we investigate combining compressed sensing and a fast imaging sequence to dramatically reduce acquisition times in cardiac diffusion MRI. Methods: Fully sampled and prospectively undersampled diffusion tensor imaging data were acquired in five rat hearts at acceleration factors of between two and six using a fast spin echo (FSE) sequence. Images were reconstructed using a compressed sensing framework, enforcing sparsity by means of decomposition by adaptive dictionaries. A tensor was fit to the reconstructed images and fiber tractography was performed. Results: Acceleration factors of up to six were achieved, with a modest increase in root mean square error of mean apparent diffusion coefficient (ADC), fractional anisotropy (FA), and helix angle. At an acceleration factor of six, mean values of ADC and FA were within 2.5% and 5% of the ground truth, respectively. Marginal differences were observed in the fiber tracts. Conclusion: We developed a new k‐space sampling strategy for acquiring prospectively undersampled diffusion‐weighted data, and validated a novel compressed sensing reconstruction algorithm based on adaptive dictionaries. The k‐space undersampling and FSE acquisition each reduced acquisition times by up to 6× and 8×, respectively, as compared to fully sampled spin echo imaging. Magn Reson Med 76:248–258, 2016.

A model of cardiac microstructure and diffusion MRI is presented, and compared with experimental data from ex vivo rat hearts. The model includes a simplified representation of individual cells, with physiologically correct cell size and orientation, as well as intra- to extracellular volume ratio. Diffusion MRI is simulated using a Monte Carlo model and realistic MRI sequences. The results show good correspondence between the simulated and experimental MRI signals. Similar patterns are observed in the eigenvalues of the diffusion tensor, the mean diffusivity (MD), and the fractional anisotropy (FA). A sensitivity analysis shows that the diffusivity is the dominant influence on all three eigenvalues of the diffusion tensor, the MD, and the FA. The area and aspect ratio of the cell cross-section affect the secondary and tertiary eigenvalues, and hence the FA. Within biological norms, the cell length, volume fraction of cells, and rate of change of helix angle play a relatively small role in influencing tissue diffusion. Results suggest that the model could be used to improve understanding of the relationship between cardiac microstructure and diffusion MRI measurements, as well as in testing and refinement of cardiac diffusion MRI protocols.

Micro-computed tomography systems are widely used for high-resolution, non-destructive analysis of internal microvascular networks. When the scale of the targeted vessel approaches the imaging resolution limit, the level of noise becomes a limiting factor for accurate reconstruction. Denoising algorithms provided by vendors are often suboptimal for enhancing SNR of fine (vessel) features. Furthermore, the performance of existing methods has not been systematically analyzed in the context of final network reconstruction and graph model extraction. This work evaluates several standard and state-of-the-art noise reduction techniques using both in silico and physical phantoms, and ex vivo rat coronary data for their ability to improve vascular network analysis. We compared five noise reduction approaches, including vendor-supplied (Gaussian smoothing), conventional (median filter) and advanced (i.e. wavelet filter with soft thresholding, block-matching collaborative filtering (BM3D), and isotropic and anisotropic total variation denoising) techniques. The latter two methods were chosen for their reported ability to preserve fine details, a prerequisite for a successful microvascular extraction. The full evaluation pipeline included the reconstruction from projection images, denoising, vascular segmentation and graph model extraction to be performed on all simulated and real image data sets. SNR, CNR and 3D NPS were quantified from denoised images, and where the ground truth was known, Sørensen–Dice coefficients, Jaccard index metrics were calculated as measures of segmentation error. The performance of the image denoising algorithms where the ground-truth was available has been assessed by computing the correlation coefficients between the residual images (obtained between the noise-free data and the denoised data) and the first derivative of the noise-free data were computed. Overall, simpler denoising techniques including the median and wavelet filters and the vendor-supplied implementations have been found to perform inadequately for segmentation of fine vessel features, particularly on real images. BM3D technique performed well in most of our tests, however isotropic total variation (ITV) was the optimal choice for noise reduction and feature preservation in real data as shown by the extracted network models. Globally, ITV increased the SNR from 10.2 to 31.7 dB in a Shepp Logan phantom, doubled SNR and CNR values in a scanned physical phantom compared with BM3D, enabled the smallest vessels to be fully recovered in an in silicon phantom and achieved a near-ideal outcome in the rat coronary data.

Purpose Hyperpolarized metabolic imaging has the potential to revolutionize the diagnosis and management of diseases where metabolism is dysregulated, such as heart disease. We investigated the feasibility of imaging rodent myocardial metabolism at high resolution at 7 T. Methods We present here a fly‐back spectral‐spatial radiofrequency pulse that sidestepped maximum gradient strength requirements and enabled high resolution metabolic imaging of the rodent myocardium. A 3D echo‐planar imaging readout followed, with centric ordered z‐phase encoding. The cardiac gated sequence was used to image metabolism in rodents whose metabolic state had been manipulated by being fasted, fed, or fed and given the pyruvate dehydrogenase kinase inhibitor dichloroacetate. Results We imaged hyperpolarized metabolites with a spatial resolution of 2×2×3.8 mm3 and a temporal resolution of 1.8 s in the rat heart at 7 T. Significant differences in myocardial pyruvate dehydrogenase flux were observed between the three groups of animals, concomitant with the known biochemistry. Conclusion The proposed sequence was able to image in vivo metabolism with excellent spatial resolution in the rat heart. The field of view enabled the simultaneous multi‐organ acquisition of metabolic information from the rat, which is of great utility for preclinical research in cardiovascular disease. Magn Reson Med 000:000–000, 2015. © 2015 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Magn Reson Med 75:1515–1524, 2016. © 2015 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance.

Cardiac architecture is fundamental to cardiac function and can be assessed non-invasively with diffusion tensor imaging (DTI). Here, we aimed to overcome technical challenges in ex vivo DTI in order to extract fine anatomical details and to provide novel insights in the 3D structure of the heart. An integrated set of methods was implemented in ex vivo rat hearts, including dynamic receiver gain adjustment, gradient system scaling calibration, prospective adjustment of diffusion gradients, and interleaving of diffusion-weighted and non-diffusion-weighted scans. Together, these methods enhanced SNR and spatial resolution, minimised orientation bias in diffusion-weighting, and reduced temperature variation, enabling detection of tissue structures such as cell alignment in atria, valves and vessels at an unprecedented level of detail. Improved confidence in eigenvector reproducibility enabled tracking of myolaminar structures as a basis for segmentation of functional groups of cardiomyocytes. Ex vivo DTI facilitates acquisition of high quality structural data that complements readily available in vivo cardiac functional and anatomical MRI. The improvements presented here will facilitate next generation virtual models integrating micro-structural and electro-mechanical properties of the heart.

Diffusion in biological tissues is known to be hindered by the structural complexity of the underlying medium. In the heart, improved characterisation on how this complexity influences acquired diffusion weighted signals is key to advancing our interpretation of diffusion magnetic resonance imaging, as well as to propose novel biomarkers to further characterise myocardial microstructure. In this work, we propose stretched Mittag–Leffler signal decay models for the quantification of the anomalous decay observed in acquired diffusion weighted signals. Our results, analysed in ex vivo healthy, fixed rat ventricles, indicate that such a representation suffices to capture the anomalous signal decay observed in the myocardial syncytium. The subdiffusive order of signal decay is shown to encode independent information to that encapsulated by standard diffusion tensor metrics, and thus may provide additional information on tissue microstructure. Moreover, subdiffusion gradients are shown to be indicative of the total structural heterogeneity spanning the left ventricular wall, which includes progressive myolaminae branching and spatially varying densities of perimysial collagen, microvasculature and adipose tissue. The proposed approach may therefore have important implications for the characterisation of tissue microstructure, both in cardiac and other tissue types.

Salmonella Infantis patogena je bakterija čija je prevalencija u porastu u primarnoj proizvodnji, u mesu peradi, ali i u humanim izolatima u više europskih zemalja. Veća pojavnost ove bakterije uočena je u centralnim i istočnim zemljama članicama Europske unije (Rumunjska, Italija, Slovenija, Austrija), a prema izvještaju Europskog centra za sprječavanje i kontrolu bolesti (ECDC) za 2014. god., S. Infantis bila je četvrti najčešći serovar salmonele kod ljudi, dok je najčešći serovar izoliran u jatima brojlera u zemljama EU. Prevalencija S. Infanits u jatima pilića u porastu je od 2011. godine, dok izostaju podaci o prevalenciji u mesu pilića na tržištu Hrvatske. U ovom radu prikazana je pojavnost S. Infantis u uzorcima svježeg i zamrznutog pilećeg mesa na tržištu Republike Hrvatske koji su prikupljeni tijekom 2015. godine. Uzorkovanje je provedeno u okviru nadzora od strane sanitarne inspekcije Ministarstva zdravlja, a uzorci su na anali¬zu slani u županijske zavode za javno zdravstvo. Od ukupno 474 uzoraka pilećeg mesa obuhvaćenih nadzorom, 51 uzorak bio je pozitivan na Salmonella spp., a S. Infantis je bila najčešće izolirani serovar (88,2 %)., Salmonella Infantis are pathogenic bacteria whose prevalence in primary production of poultry meat and human isolates from several European countries is on the rise. According to the report of the European Centre for Disease Prevention and Control (ECDC) published in 2014, a higher incidence of these bacte¬ria was also observed in Central and Eastern European EU Member States (Romania, Italy, Slovenia, Austria). S. Infantis was the fourth most common serovar of Salmonella in humans. The most common serovar in broiler flocks was isolated in the EU. The prevalence of S. Infanits in flocks of chickens was on the rise since 2011. However, the data on its prevalence in chicken meat on the Croatian market is not available. This paper looks at the incidence of S. Infantis in samples of fresh and frozen chicken meat collected on the Croatian market during 2015. The sampling was performed within the framework of Ministry of Health sanitary inspection monitoring, and collected samples were analysed in due county public health institutes. From the total of 474 chicken meat sam¬ples included in monitoring, 51 samples were culture positive for Salmonella spp, while S. Infantis represented the most frequently isolated serovar (88.2 %)., Bei der Salmonella Infantis handelt es sich um eine pathogene Bakterie, deren Prävalenz in der Primärindustrie, im Geflügelfleisch, aber auch in den humanen Isolaten, in mehreren europäischen Ländern eine steigende Tendenz aufweist. Eine größere Prävalenz dieser Bakterie wurde laut Bericht des Europäischen Zentrums für die Prävention und Kontrolle von Krankheiten (ECDC) für 2014 in den zentral- und osteuropäischen EU-Mitgliedsstaaten beobachtet (Rumänien, Italien, Slowenien, Österreich). Die S. Infantis war der vierte häufigste Salmonellen-Serotyp bei Men¬schen, und der am häufigsten in den Broilerstämmen der EU-Länder isolierte Serotyp. Die Prävalenz der S. Infanits in den Hähnchenscharen weist seit 2011 eine steigende Tendenz auf; Angaben über die Prävalenz im Hähnchenfleisch auf dem kroatischen Markt sind ausgeblieben. In dieser Arbeit wurde die Prävalenz der S. Infantis in frischen und gefrorenen in 2015 gesammelten Hähnchenfleischproben auf dem Markt der Repu¬blik Kroatien dargestellt. Die Proben wurden im Rahmen eines Monitorings der Sanitärinspektion des Ministeriums für Gesundheit entnommen und zur Auswertung an regionale Institute für öffentliche Gesundheit geschickt. Von den insgesamt 474 Proben des vom Monitoring erfassten Hähnchenfleischs waren 51 Proben positiv auf die Salmonella spp, wobei die S. Infantis der am häufigsten isolierte Serotyp war (88,2 %)., La Salmonella Infantis è un batterio patogeno la cui prevalenza è in crescita nella produzione primaria, sia nella carne di pollo, sia negli isolati umani in diversi paesi europei. Secondo il rapporto del Centro europeo per la prevenzione ed il controllo delle malattie (ECDC) per il 2014, è stata riscontrata una maggiore manifestazione di questo batterio in alcuni paesi membri dell’Unione europea collocati nell’Europa centro-orientale (Romania, Italia, Slovenia e Austria). Dal rapporto risulta, infatti, che la S. Infantis è il quarto sierotipo più frequentemente isolato tra gli uomini, ed il primo in assoluto tra le batterie di polli da carne (brojler) nei paesi dell’UE. La prevalenza della S. Infantis nelle batterie di polli da carne è in crescita dal 2011, mentre mancano i dati sulla prevalenza nella carne di pollo commercializzata in Croazia. In questo studio viene illustrato il manifestarsi della S. Infantis nei campioni di carne di pollo fresca e congelata commercializzata nella Repubblica di Croazia, prelevati nel corso del 2015. Il campionamento è stato operato nell’ambito dell’attività di monitoring svolta dall’Ispettorato d’igiene e sanità pubblica presso il Ministero della Salute, mentre i campioni sono stati analizzati presso gli istituti regionali di salute pubblica. Su un totale di 474 campioni di carne di pollo compresi nell’attività di monitoraggio, 51 campioni sono risultati positivi alla Salmonella spp, mentre la S. Infantis è stato il sierotipo più frequentemente isolato (88,2%)., Salmonella Infantis es una bacteria patógena cuya prevalencia está creciendo en la producción primaria, en la carne de aves del corral, pero también en los aislantes humanos en muchos países europeos. Mayor aparición de esta bacteria es notada en los países centrales y orientales de los estados miembros de la UE (Rumania, Italia, Eslovenia, Austria), y según el informe del Centro Europeo para la Prevención y Control de Enfermedades (ECDC) para el año 2014. S. Infantis ha sido el cuarto serotipo más frecuente de la salmonella en la gente, mientras que el serotipo más frecuente aislado en averíos de los pollos broiler en los países de la UE. La prevalencia de S. Infanits en averíos de pollos está creciendo desde el año 2011, mientras que están ausentes los datos de la prevalencia en la carne de polluelos en el mercado de Croacia. En esta obra está demostrada la aparición de S. Infantis en especímenes de la carne fresca y congelada en el mercado de la República Croacia que han sido recogidos durante el año 2015. El muestreo es implementado dentro de la monitorización por parte de la inspección sanitaria del Ministerio de Salud, y los especímenes han sido enviados a un análisis a los institutos condales para la salud pública. De los 474 especímenes totales de la carne de pollo abarcada de la monitorización, los 51 especímenes han sido positivos en Salmonella spp, mientras que S. Infantis ha sido el serotipo aislado más frecuente (88,2 %).

Background The size and number of tumors are important prognostic indicators for hepatocellular carcinoma (HCC). However, it is difficult to assess the prognosis for patients with a variable number and size of tumors. By combining these two factors, we investigated the role and prognostic accuracy of total tumor volume (TTV) for HCC. Methods A total of 786 patients undergoing locoregional therapy (transarterial chemoembolization, percutaneous radiofrequency ablation and acetic acid or ethanol injection) for HCC were prospectively evaluated. Results The mean and median TTV was 177 cm3 (range, 0.1-3,591 cm3) and 21 cm3, respectively. Of all, 38%, 29%, 15%, 7% and 11% of patients had TTV of 3, 10-50 cm3, 50-200 cm3, 200-500 cm3 and >500 cm3, respectively. TTV was significantly larger in patients with higher serum α-fetoprotein (AFP) levels or with vascular invasion. The Child-Turcotte-Pugh score, performance status, vascular invasion, AFP level and TTV were significant independent prognostic predictors in the Cox proportional hazards model. After adjustment, patients with TTV 50-200 cm3 (relative risk [RR]: 1.74, p = 0.009), 200-500 cm3 (RR: 2.15, p = 0.006) and >500 cm3 (RR: 3.92, p < 0.001) had a significantly increased mortality risk in comparison to patients with TTV 3. Conclusions TTV is a feasible prognostic predictor across a wide gradient and can be used to predict the mortality risk of HCC. Selecting appropriate cutoffs of TTV may help refine the design of cancer staging system and treatment planning. Future clinical trials of HCC may include this parameter for mortality risk stratification.