Are PET and PET/CT useful in pediatrics?

The value of PET in the evaluation of various disease states, particularly in oncology, has been well documented. Compared with its widespread application in adults, clinical use of PET in pediatrics is limited. Concerns of radiation exposure to the child, as well as lack of studies evaluating the diagnostic benefit of PET/CT in children, are a contributing factor. This study was conducted to review the usefulness of PET and PET/CT in the evaluation of pediatric patients and to identify unique FDG physiologic distribution in the sample population. All pediatric patients referred for PET scan from March 2002 - September 2010 were included in the study. The indication for referral was predominantly oncology-related (93.5%). Of the 85 patients included, PET/CT was able to detect new sites of metastases in 5 patients and help resolve equivocal CT findings in 12 patients. Of six patients presenting with seizures, PET successfully localized hypometabolic areas in the brain in all cases, as probable seizures foci. Physiologic distribution of F18-fluorodeoxyglucose (FDG)was noted in the thymus, adenoids/tonsils, laryngeal area and supraclavicular brown fat. PET/CT is useful in selective pediatric cases. Its value in effectively evaluating pediatric malignancies allows for early initiation of appropriate treatment and discourages unnecessary diagnostics and treatments for benign lesions. Physiologic uptake unique to children should be considered to avoid misinterpretations, reduce unnecessary treatments and follow-ups as well as provide an overall improvement in patient care.

Laboratory environment effects on the reproduction and mortality of adult screwworm (Diptera: Calliphoridae)

The New World screwworm, Cochliomyia hominivorax Coquerel, is mass reared for screwworm eradication initiatives that use the sterile insect technique. New methods for rearing have helped to reduce the cost of the eradication program. We examined the effect and interaction of three temperatures (24.5, 29.5 and 34.5°C), two diets (2 percent spray-dried blood plus 0.05 percent vitamins and corn syrup carrageenan) and three population densities (300, 400, and 500 flies/cage) on egg production, egg hatch, number of observable fertilized eggs, mortality (male and female) and ovarian development. The three population densities did not affect any of the parameters monitored. Using the protein diet increased egg production at all temperatures. Diet did not affect egg hatch or female mortality. Male mortality was significantly greater when fed the protein diet and reared at 24.5°C and 34.5°C. Egg hatch was significantly less when the flies were reared at 34.5°C. When exposed to high temperatures (37°C and 40°C) egg production, egg hatch, fertility and mortality were adversely affected. At the higher temperatures, yolk did not adequately form during oogenesis. When compared to the normal rearing photoperiod (12 L: 12 D), short photoperiod (1 L: 23 D) increased egg production, egg hatch and fertility but lowered mortality.

A mosca-da-bicheira, Cochliomyia hominivorax Coquerel, é criada em escala massal com o objetivo de fornecer insetos para programas para sua erradicação, através da técnica do inseto estéril. Novos métodos de criação têm auxiliado na redução dos custos desses programas de erradicação. Nós examinamos o efeito e a interação de três temperaturas (24,5, 29,5 e 34,5°C), duas dietas (carboidrato e carboidrato + proteína) e três densidades populacionais (300, 400 e 500 moscas/gaiola), na fecundidade eclosão de larvas, número de ovos fertilizados, mortalidade (macho e fêmea) e desenvolvimento dos ovários. As três densidades populacionais não afetaram nenhum dos parâmetros avaliados. O uso da dieta protéica aumentou a produção de ovos em todas as temperaturas testadas. O tipo de dieta não afetou a eclosão de larvas e mortalidade de fêmeas. A mortalidade dos machos foi significativamente maior quando alimentados com a dieta protéica e criados a 24,5°C e 34,5°C. A eclosão de larvas foi significativamente menor quando as moscas foram criadas a 34,5°C. Nas temperaturas mais elevadas (37°C e 40°C), a produção de ovos, eclosão de larvas, fertilidade e mortalidade foram afetadas desfavoravelmente. Ainda nessas mesmas temperaturas, durante a oogênese, não houve a formação adequada do estoque de alimento para os embriões. O fotoperíodo curto (1L: 23E) propiciou maior produção de ovos, eclosão de larvas e fertilidade, e diminuiu a mortalidade quando comparado ao fotoperíodo padrão em criações (12L: 12E).

Sensibilidad, especificidad, valores predictivos y exactitud del examen digital rectal, la endoscopia del tracto urinario bajo, el flujo, la presion miccional y la resistencia uretral en el diagnostico de la obstruccion secundaria al crecimiento prostatico / Sensibility, specify. predictive value and exactness of techniques in diagnosis of secundary obstruction at prostatic increase

El valor de los métodos diagnósticos de la obstrucción en el tracto urinario bajo (TUB) debida a la hiperplasia benigna de la próstata (HBP), se midió investigando la sensibilidad, especificidad, los valores predictivos y exactitud de los métodos de diagnóstico corrientemente practicados para tal patología, aplicados a un grupo masculino, mayores de 40 años que consultaron por prostatismo en la unidad de Urología del Hospital San Ignacio de Santafé de Bogotá. Se evaluaron un total de 95 pacientes, a quienes se les practicó un examen digital del recto (EDR), endoscopia del TUB y valoración urodinámica de los siguientes parámetros: flujo máximo libre, patrónde curva de flujo urinario, presión miccional y resistencia ureteral. Del grupo total de pacientes se excluyeron 7 porque no cumplieron los criterios de inclusión, los 88 restantes fueron divididos en 2 grupos, el de los obstruidos y no obstruidos, de acuerdo, a la capacidad diagnóstica de las pruebas anteriormente mencionadas. Una vez analizados los datos observamos que la medición del patrón de la curva de flujo y el flujo máximo libre, obtuvieron la mayor validez epidemiológica, para diagnosticar objetivamente la obstrucción significativa del TUB y creemos que en ausencia de enfermedad miopática o neurológica del detrusor son dos pruebas seguras y objetivas para diagnosticar tempranamente a los individuos que padecen tal enfermedad y recomendarles algún procedimiento de desobstrucción. La valoración de la información anatómica obtenida con el EDR y la endoscopia de TUB tienen indudable valor para conocer las características macroscópicas de la arquitectura glandular, pero aportaron muy poco al conocimiento del estado funcional en la unidad vesicouretral