Different aspects of hyperacute cerebral ischemia are depicted at DW and HW imaging before infarction is depicted at conventional MR or CT. These techniques may improve stroke diagnosis and may contribute to advances in treatment.

ZIKV is potentially sexually transmitted and persists in male genital secretions for a prolonged period after symptom onset. PROSPERO systematic review registration number CRD42016041475.

Sporotrichosis is a fungal infection of man and animals caused by Sporothrix complex. It usually presents as a lymphocutaneous form, but disseminated disease may occur. Given the paucity of data about HIV/AIDS and sporotrichosis co-infection, a systematic review of reported cases of HIV-associated sporotrichosis found via Pubmed (1984-2013) was done. A total of 39 papers were included, and 58 patients' data analyzed. Thirty-three (56.9 %) cases were from Brazil and 18 (31 %) from the USA. Patients' mean age was 37.8 ± 10.4 years; males predominated (84.5 %). The median CD4(+) cell count was 97 cells/mm(3). The most common clinical forms were disseminated and disseminated cutaneous with 33 (56.9 %) and 10 (17.5 %) patients, respectively. There was a correlation between CD4(+) count and clinical categories (p = 0.002). Mortality was 30 % and there was a correlation between central nervous system involvement and death (p < 0.001).

DENV fever is the febrile illness most frequently reported, reflecting its importance, while chikungunya and zika viruses present increasing trends since their emergence in the region. Studies with systematic and harmonized approaches for detection of multiple pathogens are needed and would probably reveal a higher burden of neglected pathogens such as Rickettsia spp. and arenaviruses. The lack of point-of-care tests and harmonized approach limits the care provided by health professionals and the efficacy of surveillance for AFI in the region.

ABSTRACT. Pulmonary embolism (PE) is the third most common acute cardiovascular disease after myocardial infarction and stroke, and results in thousands of deaths each year. Improvements in MRI accuracy are ongoing with the use of parallel imaging for angiography techniques and pulmonary perfusion. This, associated with other potential advantages of MRI (e.g. a radiation free method and better safety profile of MR contrast media), reinforces its use. The aim of this paper is to perform a pictorial review of the principal findings of MRI in acute PE. Acute PE can manifest itself as complete arterial occlusion and the affected artery may be enlarged. We report the main vascular and parenchymal signs, and an overview of current literature regarding accuracy, limitations and technical aspects is provided. Diagnostic strategies for pulmonary embolism (PE) have evolved over the last few decades with the development of new diagnostic methods. Initially, the time required for an MR examination and the lack of MR-compatible monitoring devices hindered the broad clinical acceptance of this method. Recently, significant technical developments in pulmonary MR angiography have occurred. Improvements include the use of parallel imaging, view-sharing, time-resolved echo-shared angiography [1, 2] and pulmonary perfusion. These techniques have shortened the acquisition time of MR angiography, improved spatial resolution and made it less susceptible to motion artefacts. In addition to classical MR angiography, other sequence types have been developed for more rapid acquisition of images and additional functional information.The increased use of multidetector CT (MDCT) scanning has raised concerns about overall radiation exposure to the population, and has emphasised the need in the radiology community for optimised scanning protocols [3]. MRI does not require ionising radiation, or iodated contrast media, and is associated with less renal impairment than MDCT. Thus, MRI appears to be the ideal imaging modality for use in ruling out PE.The aim of this paper is to provide a pictorial review of MRI in PE diagnosis, and assess its accuracy through a review of the literature. MRI techniqueThe proposed MRI protocol for PE diagnosis consists of real-time MR, MR perfusion imaging and MR angiography [3]. This basic evaluation protocol can be easily extended to match individual demands like the assessment of right and/or left ventricular function or the visualisation of the abdominal/pelvic and lower limb veins. The examination protocol first addresses fast overview sequences that ensure short examination times for use with patients in critical condition. Subsequently, the protocol presents a more comprehensive evaluation of the pulmonary arteries, for use with patients with less serious conditions ( Table 1). The total time of acquisition is therefore dependent on the depth of the evaluation and lasts anywhere between 3 and 20 min. The achieved diagnostic accuracy is, at each step, balanced against the patient's condition (30-50 s for tra...

BackgroundLittle is studied about complications related to probiotic ingestion. This study proposes to present a synthesis and critical evaluation of the reports and series of cases on the infectious complications related to the ingestion of probiotics, which can raise awareness for the prescribing and use of probiotics for certain groups of patients.MethodsSystematic review of reports and series of cases researched in the PubMed, SciELO and Scopus databases published until August 2018. The references of the articles were investigated manually for the search of cross references. SPSS version 23.0 was used for descriptive statistics and univariate analysis.ResultsWe found 60 case reports and 7 case series, making up a total of 93 patients. Fungemia was the most common infectious complications with 35 (37.6%) cases. The genus Saccharomyces was the most frequent with 47 (50.6%) cases, followed by Lactobacillus, Bifidobacterium, Bacillus, Pedioccocus and Escherichia with 26 (27.9%), 12 (12.8%), 5 (5.4%), 2 (2.2%) and 1 (1.1%) case, respectively. Adults over 60 years of age, Clostridium difficile colitis, antibiotic use and Saccharomyces infections were associated with overall mortality. HIV infections, immunosuppressive drugs, solid organ transplantation, deep intravenous lines, enteral or parenteral nutrition were not associated with death.ConclusionThe use of probiotics cannot be considered risk-free and should be carefully evaluated for some patient groups.Trial registration CRD42016042289 Electronic supplementary materialThe online version of this article (10.1186/s12906-018-2394-3) contains supplementary material, which is available to authorized users.

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Compared with contrast-enhanced CT, unenhanced MR sequences demonstrate good accuracy and no differences in the mortality rates in 1 year were detected.