Cuerpo extraño intraorbitario extraído mediante abordaje pterional extradural / Intraorbial foreign body removed by extradural pterional approach

RESUMEN Paciente femenina de 9 años de edad, remitida al Hospital Pediátrico Universitario de Holguín "Octavio de la Concepción de la Pedraja", con el diagnóstico presuntivo de celulitis orbitaria izquierda. Se recoge el antecedente de trauma ocular ipsilateral con objeto de madera hacía un año, por lo que presentó como secuela disminución de la agudeza visual del ojo izquierdo. Al examen oftalmológico presentaba edema y secreciones purulentas a través de trayecto fistuloso en el párpado inferior. Se le realiza ecografía, tomografía computarizada e imagen por resonancia magnética de cráneo y órbitas, con sospecha de cuerpo extraño vegetal. Se decide realizar abordaje pterional extradural, y se logra la extracción de fragmento de madera. Cursa con tratamiento antibiótico con desaparición de las secreciones a las 48 horas del posoperatorio. La evolución ha sido favorable. Los traumas oculares son frecuentes, pero la presencia de cuerpos extraños intraorbitarios son eventos raros que desencadenan un proceso inflamatorio local, cuya magnitud estará en relación con la naturaleza de este. Los estudios imagenológicos son un elemento indispensable para el diagnóstico y la planificación quirúrgica(AU)

ABSTRACT A 9-year-old female patient is referred to Octavio de la Concepción de la Pedraja Children's University Hospital in Holguín with a presumptive diagnosis of left orbital cellulitis. The patient has an antecedent of ipsilateral ocular trauma by a wooden object one year before, which resulted in visual acuity reduction in the left eye. Ophthalmological examination revealed edema and purulent secretion along a fistulous tract in the lower eyelid. Suspicion of the presence of a plant foreign body leads to performance of echography, computed tomography and magnetic resonance imaging of the brain and orbits. It is decided to apply an extradural pterional approach and a wooden fragment is extracted. Antibiotic therapy is indicated and secretion disappears 48 hours after surgery. The patient's evolution has been favorable. Eye trauma is common, but the presence of intraorbital foreign bodies is a rare event that triggers a local inflammatory process whose magnitude will depend on its nature. Imaging studies are indispensable for diagnosis and surgical planning(AU)

A preliminary study on establishment of AI-assisted remote imaging diagnosis system for major infectious diseases / 中华医学科研管理杂志

Objective@#In response to the outbreak of severe infectious diseases such as new coronavirus pneumonia, an artificial intelligence based image diagnosis system is established to improve the efficiency of disease diagnosis, reduce the burden of front-line doctors, and improve the medical resource allocation.@*Methods@#Using the deep convolution neural network and regional prevention and control auxiliary information system, the image data and other information of the confirmed patients were analyzed and processed comprehensively.@*Results@#A set of AI based medical image auxiliary data processing system is proposed. Combined with multimodal medical data collaborative diagnosis, it can effectively and accurately segment the diseased areas in patients' lung CT images, and generate standardized reports. Relying on the multi-center collaborative diagnosis and treatment platform, the system can introduce multi-expert remote consultation mechanism to improve the diagnosis quality of severe patients.@*Conclusions@#By segmenting pathological regions, generating standardized reports and introducing multicenter mechanism, the system can help to optimize the medical resources allocation and improve the utilization of these resources.

Iniquidade socioeconómica na distribuição de equipamentos de imagem na saúde pública brasileira / Socioeconomic Inequity in the Distribution of Imagery Equipment in the Brazilian Public Healthcare / Inequidad socioeconómica en el reparto de equipos de imagen en la salud pública brasileña

Resumo: Estudo de caráter observacional, transversal, descritivo, com abordagem quantitativa, com o objetivo de avaliar as implicações bioéticas decorrentes da iniquidade socioeconômica em relação à distribuição de equipamentos de imagem na saúde pública brasileira. Foi encontrado resultado significante quando relacionado o número de equipamentos de diagnósticos por 100.000 habitantes e a porcentagem da população com renda inferior a meio salário-mínimo. Apenas dois estados ofereceram ótimas ofertas de equipamentos por imagem na rede do sistema público de saúde e baixos índices de extrema pobreza. Na perspectiva bioética, a má distribuição de equipamentos de diagnóstico por imagem pode ser vista como uma iniquidade gerada pela gestão pública.

Abstract: This observational, crosscutting, descriptive study with a quantitative approach has the goal to assess the bioethical implications arising from the socioeconomic inequities regarding the distribution of imagery equipment in the Brazilian public health system. A significant result was found when making the ratio of diagnose equipment to 100.000 inhabitants and the percentage of population with income below the minimum wage. Only two states were found to provide optimum imagery equipment offers in the public health network and low poverty indexes. From the bioethics perspective, a bad distribution of diagnosis equipment can be seen as inequity generated by the public administration.

Resumen: El estudio de carácter observacional, transversal, descriptivo, con enfoque cuantitativo, tiene por objetivo evaluar las implicaciones bioéticas derivadas de la inequidad socioeconómica en relación con el reparto de equipos de imagen en la salud pública brasileña. Se encontró un resultado significativo cuando se relacionó el número de equipos de diagnóstico por 100.000 habitantes y el porcentaje de la población con renta inferior medio salario mínimo. Solo dos estados ofrecieron óptimas ofertas de equipos por imagen en la red del sistema público de salud y bajos índices de extrema pobreza. Desde la perspectiva bioética, la mala distribución de equipos de diagnóstico por imagen puede ser vista como una iniquidad generada por la gestión pública.

Malignant perineal tumors in dogs: the contribution of computed tomography for staging and surgical planning / Tumores perineais malignos em cães: contribuição da tomografia computadorizada para estadiamento e planejamento cirúrgico

The contribution of computed tomography for staging and surgical planning of malignant perineal tumors in dogs is discussed. Five dogs diagnosed with malignant perineal neoplasms underwent to computed tomography (CT) examination. The CT image enabled investigation of cleavage planes between neoplastic lesions and adjacent structures such as the rectum, anus, vagina, urethra and perineal muscles. Accurate assessment regional lymph nodes and adjacent bone structures was also possible. All tumors evaluated in this region presented heterogeneous appearance in pre and postcontrast CT images, but only the anal sac adenocarcinomas presented lymphadenopathy. Computed tomography proved to be a valuable tool for tumor staging and determination of lesion extension and invasion of adjacent tissues, providing significant contributions to clinical and surgical therapeutic planning.(AU)

A contribuição da tomografia computadorizada para estadiamento e planejamento cirúrgico de tumores perineais malignos em cães é discutida. Cinco cães diagnosticados com neoplasias perineais malignas foram submetidos ao exame de tomografia computadorizada (CT). A imagem por TC permitiu a investigação de planos de clivagem entre as lesões neoplásicas e estruturas adjacentes, como o reto, o ânus, a vagina, a uretra e os músculos perineais. A avaliação precisa dos linfonodos regionais e estruturas ósseas adjacentes também foi possível. Todos os tumores avaliados nesta região apresentaram aspecto heterogêneo nas imagens de TC pré e pós-contraste, mas apenas os adenocarcinomas de saco anal apresentaram linfonodopatia. A tomografia computadorizada mostrou ser uma ferramenta valiosa para o estadiamento da neoplasia, determinação da extensão da lesão e invasão de tecidos adjacentes, proporcionando contribuições significativas para o planejamento terapêutico clínico e cirúrgico.(AU)

Neurotoxoplasmose em pacientes imunocomprometidos e a relevância do diagnóstico por imagem / Neurotoxoplasmosis in immunocompromised patients and the relevance of image diagnosis

Introdução: a toxoplasmose é causada por um protozoário intracelular obrigatório, o Toxoplasma gondii. Felídeos, como gatos domésticos, são hospedeiros definitivos enquanto o homem é hospedeiro intermediário. Normalmente a infecção por T. gondii é assintomática e benigna, mas em indivíduos imunocomprometidos como portadores da AIDS, pode ocorrer reativação da doença crônica. Como o HIV apresenta neurotropismo, a neurotoxoplasmose é a causa predominante de distúrbios neurológicos nesses pacientes. As manifestações clínicas, principalmente os achados em exames de imagem específicos como a tomografia e a ressonância magnética do crânio, constituem a melhor forma de diagnóstico. Objetivo: neste contexto, analisou-se neste estudo a relevância do diagnóstico por imagem na neurotoxoplasmose em pacientes HIV positivos. Método: foi realizada uma revisão sistemática da literatura científica em bases de dados como: Bireme, Scielo, Medline, Google Acadêmico e Pudmed para os seguintes descritores: Diagnóstico por imagem, Neurotoxoplasmose, Sorodiagnóstico da AIDS, Ressonância Magnética e Tomografia Computadorizada. Foram incluídos na seleção artigos, teses, dissertações, atlas, livros, sites e guias em Português e em Inglês, publicados entre os anos de 1977 a 2015. Resultados e discussão: observou-se que dentre os exames de imagem mais utilizados, destacam-se a tomografia computadorizada (TC) com meio de contraste e a ressonância magnética (RM) de encéfalo, que costumam evidenciar múltiplas lesões com hipossinal, com reforço do contraste, envolvendo gânglios da base e córtex cerebral. Conclusão: o desenvolvimento de novas técnicas e critérios de diagnóstico é imprescindível para a exclusão de outras doenças do SNC, principalmente o linfoma e leucoencefalopatia multifocal progressiva, que podem ser confundidas nas imagens, principalmente no caso de lesão única.

Introduction: toxoplasmosis is caused by a mandatory intracellular protozoan, Toxoplasma gondii. Domestic cats are definitive hosts while humans are intermediate. Usually T. gondii infection is asymptomatic and benign, but in immunocompromised individuals as AIDS patients, reactivation of chronic disease may occur. As HIV presents neurotropism, neurotoxoplasmosis is the predominant cause of neurological disorders in these patients. The clinical manifestations, especially the ones found in specific image exams such as tomography and magnetic resonance of the skull are the best form of diagnosis. Objective: in this context, it was analyzed the relevance of image diagnosis in the neurotoxoplasmosis in HIVpositive patients. Methods: it was made a systematic review of the scientific literature in databases such as: Bireme, Scielo, Medline, Google Scholar and Pudmed, for the following descriptors: Image Diagnosis, Neurotoxoplasmosis, AIDS Serodiagnostic, Magnetic Resonance and Computed Tomography. It was included in the selection: articles, theses, dissertations, atlases, books, websites and guides in Portuguese and English, published between 1977 and 2015. Results and discussion: it was observed that among the most commonly used image exams, Computed tomography (CT) was highlighted with contrast medium and magnetic resonance image (MRI) of the encephalon, which usually show multiple hypersignal lesions with contrast medium enhancement, involving basal ganglia and cerebral cortex. Conclusion: the development of new techniques and diagnostic criteria is essential for the exclusion of other CNS diseases, especially lymphoma and progressive multifocal leukoencephalopathy, which can be misunderstood in the images, especially in the case of a single lesion.

New mode for remote image diagnosis / 医疗卫生装备

Objective To explore a new mode for remote image diagnosis and to study the development direction of remote image diagnosis in China.Methods The problems and countermeasures of remote image diagnosis in China were pointed out with considerations on its development in foreign countries and China as well as China's national medicine development plan.The present situation and problems of remote image diagnosis were summarized,and some countermeasures were put forward accordingly.Results Internet+ was involved in the upgrade of remote image diagnosis to realize optimized distribution of qualified medical resources,graded medical service,high convenience of the patient as well as high efficient of the doctor and hospital.Conclusion The new mode solves the problems in the existing remote image diagnosis,benefits multi aspects regarding to medical service,and contributes to national medical reformation and medical service transformation.

New mode for remote image diagnosis / 医疗卫生装备

Objective To explore a new mode for remote image diagnosis and to study the development direction of remote image diagnosis in China.Methods The problems and countermeasures of remote image diagnosis in China were pointed out with considerations on its development in foreign countries and China as well as China's national medicine development plan.The present situation and problems of remote image diagnosis were summarized,and some countermeasures were put forward accordingly.Results Internet+ was involved in the upgrade of remote image diagnosis to realize optimized distribution of qualified medical resources,graded medical service,high convenience of the patient as well as high efficient of the doctor and hospital.Conclusion The new mode solves the problems in the existing remote image diagnosis,benefits multi aspects regarding to medical service,and contributes to national medical reformation and medical service transformation.

Avaliação em 3D da cabeça da mandíbula em crianças portadoras de mordida cruzada posterior unilateral por meio de tomografia computadorizada de feixe cônico / 3D evaluation of the condyle in children with unilateral posterior cross bite using Cone Beam Computed Tomography

Durante o desenvolvimento da oclusão, a instalação de maloclusões podem resultar em desarmonias dento faciais de natureza e severidade diversas, podendo provocar alterações no desenvolvimento crânio facial, dentre as estruturas envolvidas as Articulações Temporo Mandibulares (ATM), podem sofrer alguma influência, dessa forma a avaliação desta região, no aspecto morfológico e funcional, constituí tema de interesse, sempre que levados em conta os aspectos funcionais da oclusão. A relação entre a forma e a função, tanto das cabeças da mandíbula, bem como o contorno da fossa mandibular com as maloclusões ainda é controversa e não está compreendida por completo, porém a literatura sobre o assunto, demonstra correlação entre a instalação de maloclusões e modificações neste sistema, mesmo que algumas alterações não sejam de ordem estatística e em amostras de indivíduos em tenra idade, as mesmas podem comprometer o desenvolvimento adequado em indivíduos adultos ou mesmo adultos jovens...

During the development of occlusion, malocclusions installation may result in disharmony dento facial nature and various severity, can cause changes in craniofacial development, among the structures involved in the temporomandibular joints mandibular (ATM), may suffer some influence, thus the evaluation of this region, the morphological and functional aspect, constitutes topic of interest, when taken into account the functional aspects of occlusion. The relationship between form and function, both the heads of the jaw, as well as the outline of the mandibular fossa with malocclusion remains controversial and is not fully understood, but the literature on the subject shows correlation between the installation of malocclusions and modifications to this system, even if some changes are not of statistical order and samples from individuals at an early age, they can compromise the proper development in adults and even young adults. With the intent of this study was to evaluate the heads of the jaw as the volume and surface of the right and left sides, crossed and uncrossed, the selected sample of 20 subjects with unilateral posterior cross bite, aged from 06 to 09 years old, using computed tomography cone beam, images obtained by a device model i-Cat, being used in reformatting and manipulation of images the computer program - NemoCeph 3D® version 11.5...

Investigation on the imaging features and value of multilayer spiral CT in diagnosis of pulmonary embolism / 中国医学装备

Objective:To investigate the diagnostic valuation of multilayer spiral CT pulmonary angiography in pulmonary embolism. Methods:A retrospective analysis 22 cases of pulmonary embolism were performed by 16 slice spiral CT diagnosis, The volume data of all cases were reconstructed for image post-processing with multi-plane reconstruction, maximum intensity projection and volume rendering. Results: Pulmonary embolism in patients with 22 cases, pulmonary artery and its branches remobilization of 22 cases were demonstrated well by MSCTA. Conclusion:The 16 slice spiral CT in the diagnosis of pulmonary embolism in a safe, rapid, high sensitivity, reliable diagnosis advantages, has been used as first choice of imaging diagnosis of pulmonary embolism diagnosis methods. It is worthy of wide clinical application.

Efeitos da parede de levedura em dieta úmida na microbiota fecal, na produção de gás e na morfologia intestinal de gatos adultos / Effects of the yeast cell wall in a moist diet in fecal microbial, gas production and intestinal morphology of adult cats

O objetivo deste estudo é avaliar os efeitos do extrato de levedura (EPL) em dietas úmidas sobre a microbiota fecal, a produção de gás e a morfologia intestinal de gatos adultos. Foram utilizados 20 gatos adultos, de ambos os sexos, distribuídos ao acaso em quatro tratamentos: 1) dieta comercial úmida (controle); 2) controle + 0,2% de extrato de levedura em matéria seca; 3) controle + 0,4%; e 4) controle + 0,6%. Foram realizadas a microbiologia fecal, a avaliação da morfologia intestinal por meio de exames radiográficos, ultrassonográficos e de colonoscopia, bem como a biópsia para histologia intestinal. Não foram observadas diferenças significativas (p>0,05) para contagem de bactérias do ácido lático e de clostrídio sulfito redutor, área de gás em alças intestinais (avaliação radiográfica), espessura da parede do cólon (ultrassonografia intestinal) e contagem de colonócitos/células caliciformes (histologia). Por meio da colonoscopia, notaram-se alterações em características de mucosa em animais submetidos ao tratamento 4. Conclui-se que a adição de até 0,6% de EPL não teve efeito sobre os parâmetros avaliados, mas novos estudos são necessários para compreender os mecanismos de ação e os efeitos desse aditivo para gatos domésticos.

The aim of this study is to evaluate the effects of yeast extract (EPL) in the moist diet on the fecal microbiotal, gas production and intestinal morphology of adult cats. Twenty adult cats from both sexes were randomly assigned to four treatments: 1) moist commercial diet (control); 2) control + 0,2% yeast extract dry matter; 3) control + 0,4%; and 4) control + 0,6%. Fecal microbiology and intestinal morphology were performed by radiographic, ultrasound, colonoscopy and intestinal biopsy exams for histology. There were no significant differences (P>0,05) for lactic acid bacteria counts and clostridium-reductor, gas area in the bowel (radiographic), wall thickness of the colon (ultrasound) and colonocytes count/globet cells (histology). Through colonoscopy, changes in characteristics of the intestinal mucosa in animals receiving treatment 4 were noticed. It is concluded that the addition of up to 0.6% EPL had no effect on the parameters evaluated, but further studies are needed to understand the action mechanisms and additive effects for domestic cats.

Image diagnosis of AIDS related toxoplasma encephalitis in AIDS patients / 中国艾滋病性病

Objective To assess the diagnostic value of CT and MRI findings of toxoplasma encephalitis among AIDS patients.Methods CT and MRI findings of toxoplasma encephalitis were retrospectively studied in 17 AIDS cases.Results The lesions were bilateral and multiple,involving basal nuclei in 12 cases,thalamus in 3 cases,bilateral cerebral hemispheres near corticomedullary junction in 1 case,and cerebellum and brain stem in 1 case.The lesions showed weak hypodensity on CT,and long T 1 and long T2 signal intensity on MRI,with marked peripheral edema effect.After contrast administration,the small ring or twist and target enhancement was seen in 12 cases,large ring enhancement-in 1 case.multiple focus in 15 cases and single focus in 2 cases;MRI was more sensitive in detecting a largest number of cerebral lesions than CT.Conclusion More small ring and twist,nodular,target enhancement are highly suggestive of toxoplasma encephalitis in the basal nuclei.Both CT and MRI are effective in diagnosing toxoplasma encephalitis,but MRI imaging without and with gadolinium is more sensitive than CT in the detection of toxoplasma encephalitis;MRI imaging may reveal a greater number of lesion when it is positive and so the detection rate of MRI is higher than that of CT.

Image Diagnosis of Bone Destruction with Soft-tissue Tumor in Sacrum (An Analysis of 26 Cases) / 实用放射学杂志

Objective To analyze the image diagnosis and differential diagnosis of bone destruction with soft-tissue tumor in sacrum.Methods 26 cases patient proved by surgically and pathologically were retrospectively reviewed, including chordoma (n=8) , giant cell tumor (n=5), tuberculosis(n=5),metastatic cancer(n=3), sarcoma(n=2), and malignant neurofibroma, osteomyelitis, eosinophilic granuloma in one each.Results All cases image manifested as different kinds of bone destruction and soft-tissue tumor in sacrum , pelvis organ were moved.Conclusion A reliable diagnosis can be made by the shape a bone destruction , location characterization of soft-tissue tumor and the age.

Imaging Diagnosis of Lumbar Spinal Canal Stenosis Caused byLumbar Posterior Marginal Intraosseous Cartilaginous Node / 实用放射学杂志

Objective To summarize the image diagnosis and treatnent of lumar spinal canal stenosis caused by lumbar posterior marginal intraosseous cartilaginous node(LPMN)and discuss its ralated pathogenic factors.Methods 16 cases of lumbar spinal canal stenosis caused by LPMN undergone susgical treatmeut from 1989 to 1999 were reviewed.Results The typical imaging findings included:(1)a defect in the posterior superior margin of the affected vertebral body,with sclerotic margin;(2)posterior to the defect,a bony fragment was seen protruding into the spinal canal;(3)compression of the dural sac and nerve root.Conclusion Imaging examniation can provide reliable evidence for diagnosis of lumbar spinal canal stenosis caused by lumbar posterior marginal intraosseous cartilagous node and is help planning treatment protocol.

Image Diagnosis and Differential Diagnosis of Nonossifying Fibroma / 实用放射学杂志

Objective To study image findings of nonossifying fibroma.Methods The pathological and image findings fo 22 cases of nonossifying fibromas proved by operation were analysed.There were 12 cases of male and 10 cases female,with age ranging from 10 to 35 years(mean age 17 years).X-ray plain films were obtained in all 22 cases,CT images in 7 cases,and MRI in 2 cases.Results The tumors were located in long bone in 19 cases,in which 14 cases were located in metaphyses,2 cases in diaphyses and 2 cases in bone end,and 4 cases in irregular bone,which was seen in clavicle,rib,illum and maxilla respectively.The tumor maximum diamneter ranged from 2 to 6.5 cm,with mean diameter of 3.2 cm,and the ratio of longitudinal to transverse diameter was 2.51.The tumors were round,oral or mild lobular in 17 cases.The tumors were showed sclerotic borders in 20 cases,and no sclerotic border in 2 cases(clavicle and rib).Septum was demonstrated in 19 cases.Bone expasion was showed in one case.Conclusion If a tumor is located in cortex or marrow of long or irregular bone which is showed a welldefined lytic lesion with sclerotic rim,the diagnosis of nonossifying fibroma will be considered.