Genotyping of Brucella isolates from animals and humans by Multiple-Locus Variable-number Tandem Repeat Analysis (MLVA).

This study investigates country-wide genotype variations through the genotyping of Brucella strains isolated from domestic ruminants and humans. The Brucella spp. isolated from samples taken from animals and humans were first identified as B. abortus and B. melitensis by real-time PCR, and the MLVA-16 approach was then used for the genotyping of the identified isolates. For the study, 416 Brucella spp. were isolated from aborted fetus samples examined between 2018 and 2021, and 74 Brucella spp. from infected humans. Of the 74 human isolates analyzed, 1.3% were identified as B. abortus and 98.7% (73/74) as B. melitensis. The MLVA-16 typing method revealed 30 clonal groups for B. abortus and 37 clonal groups for B. melitensis from which the dominant genotypes and similarities with human isolates in Türkiye were determined.

Extraprostatic extension in multiparametric MRI; Is presurgical detection possible?

INTRODUCTION: Extraprostatic extension (EPE) is one of the important factors affecting the prognosis of prostate cancer (PCa). Therefore, preoperative evaluation of the presence of EPE is essential in multiparametric magnetic resonance imaging (mpMRI) examination. However, for the evaluation of mpMRI, objective criteria are needed to detect EPE, especially microscopic EPE. AIM: To evaluate the efficacy of 1.5T MRI using lesion length (LL) and tumor-capsule contact length (TCL) in detecting EPE in PCa. METHODS: A total of 110 patients who underwent radical prostatectomy due to PCa were enrolled. Preoperative MR images were evaluated retrospectively by two independent observers who did not know the histopathological results. The observers evaluated LL and TCL. The radiological findings, including lesion location, were verified using histopathological mapping. RESULTS: Multiparametric MRI examination of the prostate demonstrated low sensitivity (Observer 1; 40.4% and Observer 2; 40.4%) but high specificity (Observer 1; 96.6% and Observer 2; 84.5%), with significant differences for detecting EPE (Observer 1, P < 0.0001; Observer 2, P = 0.003). The increased PI-RADS score correlated positively with the increased EPE rate (P < 0.0001 for both observers). The mean LL and TCL values were statistically significantly higher in patients with EPE than in patients without EPE. The TCL was a significant parameter for EPE, with high sensitivity and low for both observers. For both observes the cutoff value of LL for EPE was 14.5 mm, and the cutoff value of TCL for EPE was 9.5 mm. Histopathological LL value (28 ± 12,3 mm) was higher than radiological LLs (Observer 1; 22,14 ± 10,15 mm and Observer 2; 19,06 ± 8,61). CONCLUSION: The results revealed that 1.5T MRI demonstrated low sensitivity and high specificity in detecting EPE. The LL and TCL may be indirectly beneficial in detecting EPE. Considering the radiological underestimation of LL may be helpful before PCa surgery.

Strain and shearwave sonoelastographic findings of quadriceps tendon in patients with chronic kidney disease. Are they reliable?

AIM: In this study, we aimed to compare the strain (SE) and shear wave elastography (SWE) findings of the quadriceps tendons (QT) of the patients with chronic kidney disease (CKD) and healthy volunteers (HV), and estimate the reliability of the evaluations. MATERIALS AND METHODS: Twenty-nine HV and twenty-seven patients with CKD were enrolled. All sonoelastographic examinations were performed separately by two observers. The QT thickness (QTT), SWE, and SE findings including the tissue elastic modulus (EM), shear wave velocity (SWV), and the elasticity patterns were obtained and compared. Interobserver agreement was evaluated to test the reliability of the findings. RESULTS: The QT in CKD patients is thinner than HV (p = 0.001 for both observers). The elasticity patterns of QT were mostly intermediate stiffness for both observers (p < 0.05 for both observers). The mean EM values in the patient group were significantly higher than HV for both observers (p < 0.05 for both observers). The mean SWVs were significantly higher in the patient group (p < 0.05 for both observers). SWV showed weak, significant, and negative correlations with the hemodialysis (HD) duration (p < 0.05 for both observers). The interobserver agreements were moderate to excellent for QTT, EM, SWS, and SE patterns (p < 0.01 for all parameters). CONCLUSION: QTT and its elasticity are decreased in patients with CKD. The QTT and SE patterns may be the choice to determine the elasticity in CKD patients with good reliability values rather than SWE. But, there is still debate on the reliability of sonoelastographic findings, to ensure standardization of the factors affecting reliability, they should be well understood.

Takayasu Arteritis Presenting as Renovascular Hypertension and Renal Failure in a Patient with Factor VII Deficiency.

A 23-year-old female patient with factor VII (FVII) deficiency was admitted with severe hypertension and renal failure. Brachial arterial pressures were 230/120 and 220/115 mm/Hg on the right and left arms, respectively. There was no blood pressure difference between the arms. Renal artery Doppler ultrasonography revealed bilateral severe renal artery stenosis (RAS). Contrast-enhanced magnetic resonance imaging angiography (CE-MRA) revealed severe mural irregularities, contrast enhancement in the aorta and its branches, and long-segment stenosis starting in the abdominal aorta and extending into the proximal renal arteries. The diagnosis of Takayasu arteritis (TA) complicated by RAS in a patient with FVII deficiency was established. This is the first case of concomitant TA and factor VII deficiency in the literature. In conclusion, TA complicated with RAS should be kept in mind in the etiology of secondary hypertension, even when there is no blood pressure difference between the arms in patients. CE-MRA is an accurate, sensitive, and safe imaging method for diagnosing vasculitis, even in the early phases of the disease, and should be considered for evaluating the activity and response to treatment in patients with TA.

Shear Wave and Strain Elastographic Features of the Brachial Plexus in Healthy Adults: Reliability of the Findings-a Pilot Study.

OBJECTIVES: To determine the sonoelastographic findings for the normal brachial plexus via shear wave elastography (SWE) and strain elastography (SE) and the reliability of the measurements. METHODS: Thirty-nine healthy adult volunteers were included in the study. The brachial plexus was evaluated with SWE and SE at the interscalene region by 2 observers separately, and the observers were unaware of each other's outcomes. The elastic modulus (kilopascals), shear wave velocity (SWV, meters per second), and strain ratio were obtained. Elasticity patterns on SE were assessed as hard, intermediate, and soft. An intraclass correlation coefficient analysis was performed for determining the reliability of sonoelastographic findings. The correlation of sonoelastographic features with age and sex was investigated. RESULTS: The volunteers included 13 men and 26 women. The mean age of the participants ± SD was 36.2 ± 7.8 (range, 25-56) years. The mean elasticity modulus values of the brachial plexus for observers 1 and 2 were 17.03 (95% confidence interval [CI], 15.03, 19.03) and 13.83 (95% CI, 12.23, 15.43) kPa, respectively; the SWVs were 2.24 (95% CI, 2.12, 2.36) and 2.04 (95% CI, 1.93, 2.15) m/s; and the strain ratios were 1.20 (95% CI, 1.18, 1.25) 1.38 (95% CI, 1.22, 1.54). The elasticity pattern was mostly intermediate stiffness for both observers (n = 72 [92.3%]; n = 75 [96.1%]). The intraclass correlation coefficient was poor to moderate and statistically significant for the elastic modulus, SWV, and elasticity pattern (P < .05 for all parameters). The sonoelastographic characteristics of the brachial plexus had no correlation with age or sex. CONCLUSIONS: The reliability and reproducibility of sonoelastography of the brachial plexus are low, and the appropriateness of this technique in this manner is controversial.