Inter-rater agreement and reliability of thoracic ultrasonographic findings in feedlot calves, with or without naturally occurring bronchopneumonia.

BACKGROUND: Thoracic ultrasonography (TUS) can be used to assess the extent and severity of lung lesions associated with bronchopneumonia (BP) in feedlot cattle. HYPOTHESIS/OBJECTIVES: To assess inter-rater agreement and reliability of TUS findings in feedlot cattle, with or without naturally occurring BP. ANIMALS: Feedlot steers with (n = 210) or without (n = 107) clinical signs of BP that were assessed by TUS in a previous case-control study. METHODS: A random sample of 50 TUS videos (16-s duration) were scored by 6 raters with various levels of TUS expertise. Lung consolidation, comet tail artifacts, pleural irregularity and effusion were scored. Inter-rater agreement was assessed using raw percentage of agreement (Pa), Cohen's and Fleiss' Kappa (κ), and Gwet agreement coefficient (AC1). Intra-class correlation (ICC) was determined for variables with continuous measurements (mixed factorial design). RESULTS: Median (interquartile range [IQR]) Pa were 0.84 (0.80-0.89), 0.82 (0.80-0.87), 0.62 (0.53-0.67), and 0.82 (0.75-0.86) for presence of lung consolidation, comet tails, pleural irregularity, and pleural effusion, respectively. For the same lesions, Fleiss κ (95% confidence intervals [CI]) were 0.67 (0.49-0.86), 0.56 (0.33-0.80), 0.20 (-0.05 to 0.44), and 0.36 (0.10-0.61), respectively. AC1 were 0.68 (0.51-0.86), 0.73 (0.58-0.89), 0.21 (-0.01 to 0.44), and 0.71 (0.51-0.92), respectively. Moderate reliability was found among raters for all quantitative variables (ICC ranged from 0.52 to 0.70). CONCLUSIONS AND CLINICAL IMPORTANCE: Inter-rater agreement was good for presence of lung consolidation, comet tails and pleural effusion (based on Pa and AC1) but was slight to poor for pleural irregularity.

In-utero coxsackievirus B4 infection of the mouse thymus.

Type B coxsackievirus (CV-B) infections are involved frequently in the triggering of several autoimmune diseases such as myocarditis, dilated cardiomyopathy, pericarditis, pancreatitis, type 1 diabetes, encephalitis, thyroiditis or Sjögren's syndrome. Serological and virological evidence suggests that maternal infections during pregnancy can play a role in the appearance of these diseases in offspring. The current study aims to explore the effect of an in-utero CV-B infection on the fetal thymus, the central site for programming immunological self-tolerance. In this perspective, female Swiss albino mice were inoculated intraperitoneally or orally with the diabetogenic CV-B4 E2 strain at gestational days 10 or 17. Offspring were killed at different post-inoculation times, and their thymuses were analysed for evidence of infection and alterations in thymic T cell subsets. In-utero CV-B infection of the thymus was demonstrated during the course of vertical transmission, as attested by viral RNA and infectious virus detection in most analysed samples. No histopathological changes were evident. Thymic T cells were not depleted, despite being positive for viral RNA. As evidenced by flow cytometry analysis, CV-B infection of the fetal thymus induced significant changes of thymic T cell populations, particularly with maternal inoculation at gestational day 10. Altogether, these findings suggest that CV-B infection of the fetal thymus may play an important role in the genesis of autoimmune diseases.

[Bronchioloalveolar carcinoma: an exceptional cause of diffuse lung disease in a patient with acute myeloid leukemia]. / Le carcinome bronchiolo-alvéolaire, une cause exceptionnelle de pneumopathie infiltrante diffuse au cours d'une leucémie aiguë myéloïde.

INTRODUCTION: Bronchiolo-alveolar carcinoma is a primary pulmonary adenocarcinoma developing in the terminal respiratory unit. CASE REPORT: An 84-year-old non-smoker woman with a history of untreated acute myeloid leukaemia was referred to the intensive care unit for pneumonia and acute respiratory failure. The patient reported dyspnoea and a productive cough for 3 months, treated by antibiotics and steroids without improvement. Thoracic CT-scan showed alveolar condensations and multiple nodular lesions. All microbiological samples were negative and the evolution was fatal within 72 hours despite empirical antibiotic therapy and noninvasive ventilation. Post-mortem lung biopsies gave a diagnosis of mucinous and non-mucinous bronchiolo-alveolar carcinoma with typical lepidic growth pattern of tumor cells and discrete septal thickening but no fibrosis, inflammation or local invasion. CONCLUSION: Bronchiolo-alveolar carcinoma is an alternative diagnosis in alveolar condensations associated with pulmonary nodules even in a patient with immunosupression. Early diagnosis allows effective treatment in some cases.

[Liver calcifications in adults: the KUB stars are too frequently neglected in the CT era]. / Calcifications hépatiques de l'adulte: les stars de l'ASP trop souvent négligées à l'ère du scanner.

Liver calcifications have been extensively described on plain radiographs, either from KUB or angiography examinations. On the other hand, their characteristics are seldom reported on cross-sectional imaging: they are frequently considered as non-specific compared to multiple other imaging features. However, clinical practice demonstrates that in specific situations (such as parasitic infections and calcified metastases), the presence of calcifications may be a determining factor in avoiding misdiagnosis with potential deleterious effects to the patient. Both CT and US can detect a large number of "benign" calcifications without associated focal lesion and knowledge of their imaging features is useful to avoid unnecessary additional imaging work-up. A review of the literature and a series of 100 cases of liver calcifications on CT are presented to review the imaging features of calcified liver lesions and isolated liver calcifications without associated focal lesion.