Congruencia entre modelos dentales impresos 3D y el archivo digital de origen: estudio in vitro comparativo de 5 impresoras 3D / Congruence between 3D printed dental models and the original digital file: comparative in vitro study of 5 3D printers

Este trabajo tuvo como objetivo conocer la fiabilidad de la impresora 3D (i3D) aditiva por Matriz de Proceso Digital de Luz (MDLP) Hellbot modelo Apolo®, a través de verificar la congruencia dimensional entre las mallas de modelos impresos (MMi) y su correspondiente archivo digital de origen (MMo), obtenido del software de planificación ortodontica Orchestrate 3D® (O3D). Para determinar su uso en odontología y sus posibilidades clínicas, fue comparada entre cinco i3D de manufactura aditiva, dos DLP, dos por estereolitografía (SLA) y una por Depósito de Material Fundido (FDM). La elección de las cinco i3D se fundamentó en su valor de mercado, intentando abarcar la mayor diversidad argentina disponible. Veinte modelos fueron impresos con cada i3D y escaneados con Escáner Intraoral (IOS) Carestream modelo 3600® (Cs3600). Las 120 MMi fueron importadas dentro del programa de ingeniería inversa Geomagic® Control X® (Cx) para su análisis 3D, consistiendo en la superposición de MMo con cada una de las MMi. Luego, una evaluación cualitativa de la desviación entre la MMi y MMo fue realizada. Un análisis estadístico cuidadoso fue realizado obteniendo como resultado comparaciones en 3d y 2d. Las coincidencias metrológicas en la superposición tridimensional permitieron un análisis exhaustivo y fácilmente reconocible a través de mapas colorimétricos. En el análisis bidimensional se plantearon planos referenciados dentariamente desde la MMo, para hacer coincidir las mediciones desde el mismo punto de partida dentaria. Los resultados fueron satisfactorios y muy alentadores. Las probabilidades de obtener rangos de variabilidad equivalentes a +/- 50µm fueron de un 40,35 % y de +/- 100µm un 71,04 %. Por lo tanto, te- niendo en cuenta las exigencias de congruencia dimensional clínicas de precisión y exactitud a las cuales es sometida nuestra profesión odontológica, se evitan problemas clínicos arrastrados por los errores dimensionales en la manufactura (Cam) (AU)

The objective of this study was to determine the reliability of the Hellbot Apollo® model additive 3D printer (i3D) by Matrix Digital Light Processing (MDLP) by verifying the dimensional congruence between the printed model meshes (MMi) and their corresponding digital source file (MMo), obtained from the Orchestrate 3D® (O3D) orthodontic planning software. A comparison was made between five i3D of additive manufacturing, two DLP, two by stereolithography (SLA), and one by Fused Material Deposition (FDM), to determine its use in dentistry and its clinical possibilities. The choice of the five i3D was based on their market value, trying to cover most of the Argentinean diversity available. Twenty models were printed with each i3D and scanned with Carestream Intraoral Scanner (IOS) model 3600® (Cs3600). The 120 MMi were imported into the reverse engineering program Geomagic® Control X® (Cx) for 3D analysis, consisting of overlaying MMo with each MMi. Then, a qualitative evaluation of the deviation between MMi and MMo. Also, a careful statistical analysis was performed, resulting in 3d and 2d comparisons. Metrological coincidences in three-dimensional overlay allowed a comprehensive and easily recognizable analysis through colorimetric maps. In the two-dimensional analysis, dentally referenced planes were proposed from the MMo, to match the measurements from the same dental starting point. The results were satisfactory and very encouraging. The probabilities of obtaining ranges of variability equivalent to +/- 50µm were 40.35 % and +/- 100µm 71.04 %. Therefore, considering the demands of clinical dimensional congruence, precision, and accuracy to which our dental profession it is subjected, clinical problems caused by dimensional errors in manufacturing (Cam) are avoided (AU)

Analysis of biolo artificial neural network in prediction of aerobic exercise index based on algorithm / Análise de rede neural artificial na predição do índice de exercício aeróbio baseada em algorítimo / Análisis de red neuronal artificial en la predicción del índice de ejercicio aeróbico

ABSTRACT Objective: To study the relationship between aerobic activity and cardiac autonomic nerve activity by artificial neural network algorithm and biological image fusion; because of the artificial neural network model (ANN) problems, biological image processing technology is introduced based on ANN. Methods: An Ann under biological image intelligence algorithm is proposed, a classifier suitable for electrocardiograph (ECG) screening is designed, and an ECG signal screening system is successfully established. Moreover, the data set of normal recovered ECG signals of the subjects during the experimental period is constructed, and a classifier is used to extract the characteristic data of a normal ECG signal during the experimental period. Results: The changes in resting heart rate and other physical health indicators are analyzed by combining resting physiological indicators, namely heart rate, body weight, body mass index and body fat rate. The results show that the self-designed classifier can efficiently process the ECG images, and long-term regular activities can improve the physical conditions of most people. Most subjects' body weight and body fat rate decrease with the extension of experiment time, and the resting heart rate decreases relatively. Conclusions: Certain indicators can be used to predict a person's dynamic physical health, which indicates that the experimental research of index prediction in this research has a good effect, which not only extends the application of artificial neural network but also lays a foundation for the research and implementation of ECG intelligent testing wearable devices. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Objetivo: Com o objetivo de estudar a relação entre atividade aeróbia e atividade nervosa autonômica cardíaca por algoritmo de rede neural artificial e fusão biológica de imagens, tendo em vista os problemas existentes no modelo de rede neural artificial (RNA), é introduzida a tecnologia de processamento biológico de imagens com base em ANN. Métodos: um algoritmo de inteligência biológica de imagem Ann é proposto, um classificador adequado para triagem eletrocardiográfica (ECG) é projetado e um sistema de triagem de sinal de ECG é estabelecido com sucesso. Além disso, o conjunto de dados de sinais de ECG normais recuperados dos sujeitos durante o período experimental é construído e um classificador é usado para extrair os dados característicos de um sinal de ECG normal durante o período experimental. Resultados: As alterações na frequência cardíaca em repouso e outros indicadores de saúde física são analisadas pela combinação de indicadores fisiológicos de repouso, a saber, frequência cardíaca, peso corporal, índice de massa corporal e índice de gordura corporal. Os resultados mostram que o classificador autodesenhado pode processar com eficiência as imagens de ECG, e as atividades regulares de longo prazo podem melhorar as condições físicas da maioria das pessoas. O peso corporal e a taxa de gordura corporal da maioria dos indivíduos diminuem com a extensão do tempo do experimento, e a freqüência cardíaca em repouso diminui relativamente. Conclusões: Certos indicadores podem ser usados para prever a saúde física dinâmica de uma pessoa, o que indica que a pesquisa experimental de predição de índice nesta pesquisa tem um bom efeito, que não apenas estende a aplicação da rede neural artificial, mas também estabelece uma base para a pesquisa e implementação de dispositivos vestíveis de teste inteligente de ECG. Nível de evidência II; Estudos terapêuticos- investigação dos resultados do tratamento.

RESUMEN Objetivo: Para estudiar la relación entre la actividad aeróbica y la actividad del nervio autónomo cardíaco mediante el algoritmo de red neuronal artificial y la fusión de imágenes biológicas, ante los problemas existentes en el modelo de red neuronal artificial (ANN), se introduce la tecnología de procesamiento de imágenes biológicas basada en ANA. Métodos: Se propone un algoritmo de inteligencia de imagen biológica de Ann, se diseña un clasificador adecuado para el cribado electrocardiógrafo (ECG) y se establece con éxito un sistema de cribado de señales de ECG. Además, se construye el conjunto de datos de las señales de ECG recuperadas normales de los sujetos durante el período experimental, y se utiliza un clasificador para extraer los datos característicos de una señal de ECG normal durante el período experimental. Resultados: Los cambios en la frecuencia cardíaca en reposo y otros indicadores de salud física se analizan combinando indicadores fisiológicos en reposo, a saber, frecuencia cardíaca, peso corporal, índice de masa corporal y tasa de grasa corporal. Los resultados muestran que el clasificador de diseño propio puede procesar de manera eficiente las imágenes de ECG, y las actividades regulares a largo plazo pueden mejorar las condiciones físicas de la mayoría de las personas. El peso corporal y la tasa de grasa corporal de la mayoría de los sujetos disminuyen con la extensión del tiempo del experimento, y la frecuencia cardíaca en reposo disminuye relativamente. Conclusiones: Ciertos indicadores pueden usarse para predecir la salud física dinámica de una persona, lo que indica que la investigación experimental de predicción de índices en esta investigación tiene un buen efecto, lo que no solo extiende la aplicación de la red neuronal artificial sino que también sienta las bases para la investigación. e implementación de dispositivos portátiles de prueba inteligente de ECG. Nivel de evidencia II; Estudios terapéuticos- investigación de los resultados del tratamiento.

Ortodoncia Digital. Sistema de Alineación Mediante Placas Transparentes: caso clínico / Digital orthodontics. Alignment system using transparent plates: a clinical case

El tratamiento ortodóncico permite rehabilitar la función como también la estética facial y de la sonrisa. En muchos casos, esto puede realizarse sin la utilización de brackets. Las placas alineadoras realizan movimientos en las arcadas dentarias y las posibilidades y los resultados obtenidos cada vez son mejores. La utilización del sistema de alineación con placas permite que muchos pacientes, que no están dispuestos a utilizar brackets, encuentren una respuesta a sus problemas de oclusión (AU)

Análisis de concordancia entre trazado cefalométrico manual y cefalométrico digital con programa Nemoceph / Analysis of concordance between manual cephalometric and digital cephalometric tracing with Nemoceph program

La importancia del análisis cefalométrico dentro del diagnóstico en ortodoncia ha ido incrementando a través de los años, por ello, el interés de comparar la confiabilidad de los sistemas digitales con el trazado manual convencional. Objetivo: Definir el grado de concordancia entre los resultados de trazado cefalométrico manual y con Nemoceph. Material y métodos: Se utilizaron ocho medidas lineales y angulares del análisis cefalométrico de Steiner. Se realizó un estudio transversal, correlacional, en el cual se analizaron 70 radiografías laterales de cráneo digitales. Los resultados se dividieron en dos grupos, trazado manual y trazado cefalométrico con Nemoceph, los cuales fueron evaluados con un índice de correlación intraclase. Conclusión: Se reportó un grado de correlación intraclase mayor a 0.75, estableciendo que el sistema digital exhibe la misma precisión del manual, con algunas ventajas convenientes a la época (AU)

The importance taken by the cephalometric analysis within the orthodontic diagnosis has been increasing over the years, for that reason the interest of comparing the reliability of the digital systems with the conventional manual tracing. Objective: To define the degree of concordance between the results of manual cephalometric tracing and with Nemoceph. Material and methods: Eight linear and angular measurements of Steiner's cephalometric analysis were used. A crosssectional, correlational study was conducted in which 70 digital skull lateral radiographs were analyzed. The results were divided into two groups; manual tracing and cephalometric tracing with Nemoceph, which were evaluated with an intraclass correlation index. Conclusion: a correlation degree greater than 0.75 was reported. Establishing that the digital system exhibits the same precision of the manual, with some advantages suited to the age (AU)

Intra- and interobserver reliability of a modified distraction test based on digital images to assess lower eyelid horizontal tension / Confiabilidade intra e interobservador do teste de tração modificado para avaliar a tensão da pálpebra inferior baseado em imagens digitais

ABSTRACT Purpose: Inferior eyelid laxity is classically evaluated using "snap-back" and "distraction" tests. This study aimed to assess the reproducibility of the technique used to indirectly quantify the horizontal tension in the lower eyelids using digital image processing. Methods: This longitudinal study was conducted to assess the reproducibility of a new technique that quantifies the horizontal tension in the lower eyelid. The study was conducted at the Hospital das Clínicas of Porto Alegre. The protocol was established by two trained ophthalmologist examiners, allowing intra- and interobserver agreement analyses. Image acquisition was done in two stages: the first image was captured with the eyelid in primary gaze position and the second with the eyelid in traction position. All images and measurements were processed using Image J 1.33m software from the National Institute of Health. The Bland-Altman method, intraclass correlation coefficients, concordance correlation coefficients, and technical measurement error were used to evaluate reproducibility. Results: The study participants comprised healthy individuals with no ophthalmologic pathologies. The measurements obtained in the neutral position showed a slightly higher agreement than those obtained in the traction position. The mean difference between the measurements performed in the traction position was 0.028 ± 0.7 mm and 0.014 ± 0.9 mm in the intra- and interobserver analyses, respectively. The Bland-Altman method demonstrated adequate confidence limits for both measurements. Correlation coefficients for measurements varied between 0.87 [95% confidence interval (CI) 0.68-0.95] and 0.91 (95% CI 0.77-0.97) in the neutral position and between 0.72 (95% CI 0.37-0.89) and 0.76 (95% CI 0.4-0.91) in the traction position. Conclusion: A high intra- and interobserver concordance was observed in the studied method to quantify lower eyelid tension. The proposed method is simple and easily reproducible, and to the best our knowledge, this is the first method that quantifies lower eyelid horizontal tension on the basis of digital image processing. This modified distraction test might be useful in studies quantifying lower eyelid horizontal tension.

RESUMO Objetivo: A frouxidão palpebral inferior é avaliada classicamente por meio de testes de "snap-back" e "distraction test". O objetivo deste estudo foi avaliar a reprodutibilidade da técnica utilizada para quantificar indiretamente a tensão horizontal nas pálpebras inferiores através do processamento digital de imagens. Métodos: Este estudo longitudinal foi realizado para avaliar a reprodutibilidade de uma nova técnica que quantifica a tensão horizontal na pálpebra inferior. O estudo foi realizado no Hospital das Clínicas de Porto Alegre. O protocolo foi estabelecido por dois examinadores oftalmologistas treinados, permitindo análises de concordância intra e interavaliador. A aquisição de imagens foi feita em duas etapas: a primeira imagem foi capturada com a pálpebra na posição primária do olhar e a segunda com pálpebra tracionada. Todas as imagens e medições foram processadas usando o software Image J 1.33m do National Institute of Health. O método de Bland-Altman, os coeficientes de correlação intraclasses, os coeficientes de correlação de concordância e o erro técnico da medida foram utilizados para avaliar a reprodutibilidade. Resultados: Os participantes do estudo foram indivíduos saudáveis e sem patologias oftalmológicas. As medidas obtidas na posição neutra mostraram concordância levemente maior do que as obtidas na posição tracionada. A diferença média entre as medidas realizadas na posição tracionada foi de 0,028 ± 0,7mm e 0,014 ± 0,9mm nas análises intra e interobservadores, respectivamente. O método de Bland-Altman demonstrou limites de confiança adequados para ambas as medidas. Os coeficientes de correlação para as medidas variaram entre 0,87 [intervalo de confiança de 95% (IC) 0,68-0,95) e 0,91 (IC 95% 0,77-0,97) na posição neutra e entre 0,72 (IC 95% 0,37-0,89) e 0,76 (IC 95% 0,46-0,91) na posição tracionada. Conclusão: Observou-se elevada concordância intra e interobservador no método estudado para quantificar a tensão palpebral inferior. O método proposto é simples e facilmente reproduzível, e, do melhor modo possível, este é o primeiro método que quantifica a tensão horizontal da pálpebra inferior com base no processamento digital de imagens. Este teste de distração modificado pode ser útil em estudos que quantifiquem a tensão horizontal da pálpebra inferior.

Color-based segmentation vs. stereology: a simple comparison between two semi-automated methods of image analysis for the quantification of collagen / Segmentación basada en colores vs. estereología: una comparación simple entre dos métodos semiautomáticos de análisis de imágenes para la cuantificación del colágeno

Image processing techniques are being widely developed for helping specialists in analysis of histological images and its application is especially useful in obtaining numerical data for the realization of the subsequent statistical analysis. The use of these methods makes the histological analysis of experts more objective and less time-consuming. In this paper we evaluate how well the quantitative methods - color-based image segmentation and stereology - agree on average, and how well they agree for the individuals when they are used to quantify type I and III collagen. Digital images of sections of Salmo salar jaws (5 µm, SiriusRed staining) were analyzed. Collagen quantification was performed by two methods in the same group of images: i) Color Based-Segmentation (K-means algorithm; pixel cluster; ImageJ32 v1.51p) and ii) Stereology (VV; M36; STEPanizer Stereological Tools). They were evaluated 200 images per group. The difference between groups and concordance was analyzed using t-Student (p<0.05) and Blant Altman Comparison Method, respectively. The data analysis of average and individual assessments showed that there is concordance between two methods. In conclusion, stereology and color-based image segmentation are powerful tools which quantify collagen in histological sections.

Las técnicas de procesamiento de imágenes han sido ampliamente desarrolladas para ayudar a los especialistas en el análisis de imágenes histológicas y su aplicación es especialmente útil para obtener datos numéricos para la realización del posterior análisis estadístico. El uso de estos métodos hace que el análisis histológico realizado por expertos sea más objetivo. En este estudio evaluamos qué tan bien coinciden o concuerdan en promedio y entre evaluaciones individuales los métodos cuantitativos "segmentación basada en color" y la "estereología" cuando son utilizados para cuantificar el colágeno tipo I y III. Se analizó imágenes digitales de tejido mandibular de Salmo salar (5 µm, tinción SiriusRed). La cuantificación del colágeno se realizó mediante dos métodos en el mismo grupo de imágenes: i) Segmentación basada en color (algoritmo K-mean, cluster de píxeles, ImageJ32 v1.51p) y ii) Estereología (VV; M36; STEPanizer Stereological Tools). Fueron evaluados 200 imágenes por grupo. Se analizó la diferencia de medias y concordancia entre métodos mediante t-Students (p>0,05) y el Método de Comparación de Blant-Altman. El análisis de los datos de las evaluaciones promedio e individuales demostró que hay concordancia entre los dos métodos. En conclusión, la estereología y la segmentación de imágenes basadas en color son poderosas herramientas útiles para cuantificar colágeno en secciones histológicas.

Uso de digitalizador e impressora doméstica em 3 dimensões em rinoplastia / Domestic three-dimensional scanner and printer in patients undergoing rhinoplasty

Os princípios para uma rinoplastia bem-sucedida incluem consulta e planejamento pré-operatório e uma análise clínica abrangente que defina as metas da cirurgia. Mais recentemente, a digitalização e a impressão doméstica em 3 dimensões tornaram-se disponíveis. O objetivo deste estudo é descrever um método de digitalização em 3 dimensões e de impressão doméstica da anatomia real do paciente para ser usada como ajuda intraoperatória. Nós apresentamos uma forma de uso desta tecnologia no transoperatório, auxiliando o cirurgião a comparar os resultados obtidos após suas manobras, verificar a sua adesão ao plano cirúrgico previamente estabelecido e melhorar a sua tomada de decisão durante a cirurgia. Em conclusão, a aplicação da impressão doméstica em 3 dimensões demonstra um efeito positivo sobre o tratamento de alterações estéticas do nariz.

The principles for a successful rhinoplasty include preoperative consultation and planning, as well as a comprehensive clinical analysis and defining rhinoplasty goals. Three-dimensional domestic scanning and printing have recently become available. We sought to objectively describe this method as an intraoperative aid in patients' anatomy. This method can be used trans-operatively to help surgeons compare the results of his or her technique, check adherence to the surgical plan, and improve his or her surgical decision-making. We found that the application of 3-dimensional printing had a positive effect on the treatment of patients with aesthetic nose disorders.

Unsupervised identification of malaria parasites using computer vision

Malaria in human is a serious and fatal tropical disease. This disease results from Anopheles mosquitoes that are infected by Plasmodium species. The clinical diagnosis of malaria based on the history, symptoms and clinical findings must always be confirmed by laboratory diagnosis. Laboratory diagnosis of malaria involves identification of malaria parasite or its antigen / products in the blood of the patient. Manual diagnosis of malaria parasite by the pathologists has proven to become cumbersome. Therefore, there is a need of automatic, efficient and accurate identification of malaria parasite. In this paper, we proposed a computer vision based approach to identify the malaria parasite from light microscopy images. This research deals with the challenges involved in the automatic detection of malaria parasite tissues. Our proposed method is based on the pixel-based approach. We used K-means clustering [unsupervised approach] for the segmentation to identify malaria parasite tissues

Tomografías para endodoncia: qué solicitar y cómo interpretar / Tomography in endodontics: what to ask for and how to interpret

La práctica endodóntica requiere el respaldo de imágenes de manera permanente, tanto para el diagnóstico como durante las distintas etapas del tratamiento. Desde siempre, estas imágenes han sido radiográficas. Con el advenimiento de las tomografías, se incluyó la visión de la tercera dimensión y se logró despejar interferencias gracias a la incorporación de cortes sectorizados. Sin embargo, estos estudios implican el uso de radiaciones ionizantes y de aparatología de alto costo. Con el tiempo, los estudios tomográficos han evolucionado; permiten obtener imágenes más fieles, isométricas, con mejor definición ymenos dosis de radiación para los pacientes. El presente trabajo tiene como objetivo brindar información clara a los colegas que deseen incorporar estas nuevas tecnologías en su práctica cotidiana. Para ello, se describen las diferencias entre los distintos sistemas, la manera en que deben ser evaluados por el profesional y los límites de su aplicación...

Acute respiratory distress syndrome due to Clostridium difficile colitis: a case report and review of the literature / Síndrome de distress respiratorio agudo debido a colitis por Clostridium difficile: reporte de caso y revisión de la literatura

Clostridium difficile is a major cause of antibiotic-associated diarrhea. We report a patient with complicated Clostridium difficile infection (CDI) who developed rapidly progressive acute respiratory distress syndrome (ARDS), for which CDI was the only identifiable source. CDI should be considered in the differential diagnosis for anyone with diarrhea who presents ARDS, especially in high-risk groups such as the elderly, hospitalized patients, or those who have had a history of CDI.

El Clostridium difficile es una de las causas más frecuentes de diarreas asociadas a antibióticos. Reportamos un paciente con infección por Clostridium difficile complicada (CDI) que desarrolló rápida y progresivamente un síndrome de distress respiratorio agudo (ARDS), del cual el CDI fue la fuente única identificable. El CDI debe considerarse en el diagnóstico diferencial de cualquier persona con diarrea que presenta ARDS, especialmente en los grupos de alto riesgo como los ancianos, pacientes hospitalizados o aquellos que han tenido historia precia de DCI.

Efectividad del ejercicio físico en la fatiga de pacientes con cáncer durante el tratamiento activo: revisión sistemática y metaanálisis / Effectiveness of physical exercise on fatigue in cancer patients during active treatment: a systematic review and meta-analysis / Eficácia do exercício físico na fadiga dos pacientes com câncer durante o tratamento ativo: revisão sistemática e meta-análise

El objetivo del estudio fue determinar la efectividad del ejercicio físico en la fatiga de pacientes con cáncer durante el tratamiento activo. Las bases de datos de PubMed Central, EMBASE y OVID fueron consultadas hasta abril de 2014 para identificar ensayos clínicos aleatorizados, que evaluaran el efecto del ejercicio en la fatiga de pacientes con cáncer sometidos a tratamiento activo. Once estudios (n = 1.407) fueron incluidos. La quimioterapia fue el tratamiento más común (n = 1.028). Los estudios tuvieron bajo riesgo de sesgo y alta calidad metodológica. Las estimaciones de efecto mostraron que el ejercicio físico mejoró significativamente la fatiga (SMD = -3,0; IC95%: -5,21; -0,80), p < 0,0001. Se encontraron efectos similares para el entrenamiento de resistencia (SMD = -4,5; IC95%: -7,24; -1,82), p = 0,001. Se encontraron mejoras significativas en pacientes con cáncer de mama y de próstata (p < 0,05). El ejercicio es una intervención segura y eficaz en el control de la fatiga en pacientes sometidos a tratamiento activo.

This study aimed to determine the effectiveness of physical exercise in decreasing fatigue in cancer patients during active treatment. The PubMed Central, EMBASE, and OVID databases were consulted up to April 2014 to identify randomized clinical trials that evaluated the effect of exercise on fatigue in cancer patients undergoing active treatment. Eleven studies (n = 1,407) were included. Chemotherapy was the most common form of treatment (n = 1,028). The studies showed a low risk of bias and high methodological quality. Effect estimates showed that physical exercise significantly improved fatigue (SMD = -3.0; 95%CI: -5.21; -0.80), p < 0.0001. Similar effects were found for resistance training (SMD = -4.5; 95%CI: -7.24; -1.82), p = 0.001. Significant improvements were found in breast and prostate cancer patients (p < 0.05). Exercise is a safe and effective intervention in the management fatigue in cancer patients undergoing active treatment.

O objetivo foi determinar a efetividade do exercício físico sobre a fadiga em pacientes com câncer durante o tratamento ativo. As bases de dados PubMed Central, EMBASE e OVID foram consultadas até abril de 2014 para identificar ensaios clínicos randomizados que avaliaram o efeito do exercício sobre a fadiga em pacientes com câncer em tratamento ativo. Onze estudos (n = 1.407) foram incluídos. A quimioterapia foi o tratamento mais comum (n = 1.028). Os estudos tiveram baixo risco de viés e alta qualidade metodológica. As estimativas de efeito mostraram que o exercício melhorou significativamente a fadiga (DMP = -3,0; IC95%: -5,21; -0,80), p < 0,0001. Efeitos semelhantes sobre o treinamento de resistência (DMP = -4,5; IC95%: -7,24; -1,82), p = 0,001 foram encontrados. O exercício físico é uma intervenção segura e eficaz contra a fadiga em pacientes submetidos ao tratamento ativo.

Fasting does not induce gastric emptying in rats

PURPOSE: To evaluate the effect of fasting on gastric emptying in mice. METHODS: Twenty-eight mice were distributed into three study groups: a normal group (N=4): normal standard animals; a total fasting group (N=12): subjected to food and water deprivation and a partial fasting group (N=12): subjected to food deprivation only. The fasting groups were subdivided into three subgroups of four animals each, according to the date of euthanasia: 24, 48 and 72 hours. Was analyzed: the gastric volume, degree of the gastric wall distention and the presence of food debris in gastrointestinal tract. RESULTS: The mean gastric volume was 1601 mm3in the normal group, 847 mm3in total fasting group and 997 mm3in partial fasting group. There was difference between the fasting groups in any analyzed period (p<0.05). Regarding the presence of food debris in the gastrointestinal tract and the degree of distension of the stomach, there was no difference between the groups that underwent total or partial fasting (p>0.05). CONCLUSION: Total fasting or only-solids deprivation does not induce gastric emptying in mice. .

Análise quantitativa da ecogenicidade testicular pela técnica do histograma de ovinos da baixada ocidental maranhense / Quantitative analysis of testicular echogenicity by technical histogram in sheep of the western lowland region of Maranhão, Brazil

A ultrassonografia é um método de diagnóstico por imagem que permite a avaliação de diferentes órgãos e estruturas corpóreas de maneira não invasiva. No entanto, a avaliação subjetiva das imagens caracteriza um dos grandes entraves na utilização desta técnica de diagnóstico, havendo necessidade de mecanismos que minimizem a subjetividade do exame e a divergência na interpretação dos achados ultrassonográficos. Desta forma este trabalho objetivou caracterizar a ecogenicidade do parênquima e mediastino testicular de ovinos utilizando a técnica do histograma escala-cinza. Foram utilizados 30 animais divididos em três grupos de acordo com a faixa etária (FE): de três a seis meses (FE1), sete a 12 meses (FE2), 13 a 18 meses (FE3) e realizadas varreduras testiculares nos planos frontal, sagital e transversal, elaborando ao final um histograma a partir das imagens ultrassonográficas. Observou-se que tanto a ecogenicidade do parênquima quanto a do mediastino testicular aumentaram gradativamente com a progressão das idades dos animais, com média e desvio-padrão de 95,00±19,05 e 94,35±18,82 para a ecogenicidade do parênquima do antímero direito e esquerdo, respectivamente, e 127,95±12,97 para o mediastino direito e 126,59±11,78 para o esquerdo. A técnica do histograma escala-cinza demonstrou ser um método eficiente na determinação da ecogenicidade testicular, possibilitando o estabelecimento de padrões de normalidade que venham a auxiliar pesquisas futuras no monitoramento do desenvolvimento testicular bem como na detecção de patologias. Para a regimes exclusivos de criação extensiva, como na baixada maranhense, representa ferramenta valiosa para sua utilização em projetos sociais do Estado que atendem a agricultura familiar.

Ultrasound is a diagnostic imaging method that allows a no invasive evaluation of different organs and body structures. However, the personal evaluation of images is one of the major hampers in using this technique. In order to reduce this drawback, it is necessary to find out tools that can help diminish the divergence in the interpretation of sonographic findings. Therefore, this study aimed to identify features of the parenchyma's and mediastinum's testis of sheep echogenicity using the technique of gray scale histogram. 30 animals were divided into three groups according to age (FE): three to six months (FE1), seven to 12 months (FE2), 13 to 18 months (FE3). The testicular scans were performed in the frontal, sagital and transverse views, and the gray scale histograms were analyzed. It was observed that such parenchymal as the mediastinum testis echogenicity gradually increased with the aging of the animals, with mean and standard deviation of 95.00±19.05 and 94.35±18.82 for the echogenicity parenchyma of the right and left antimere, respectively, and 127.95±12.97 to 126.59±11.78, for the right and the left mediastinum. The technique of gray scale histogram was an efficient method for determination of testicular echogenicity, enabling the establishment of normal standards that may assist future research in monitoring testicular development as well as for detecting pathologies. For exclusive regimes of extensive farming, as the western lowland region of Maranhão, is a valuable tool for use in social projects of the State to attend the family farm.

Multiparametric magnetic resonance imaging for prostate cancer: A review and update for urologists

Recently, imaging of prostate cancer has greatly advanced since the introduction of multiparametric magnetic resonance imaging (mpMRI). mpMRI consists of T2-weighted sequences combined with several functional sequences including diffusion-weighted imaging, dynamic contrast-enhanced imaging, and/or magnetic resonance spectroscopy imaging. Interest has been growing in mpMRI because no single MRI sequence adequately detects and characterizes prostate cancer. During the last decade, the role of mpMRI has been expanded in prostate cancer detection, staging, and targeting or guiding prostate biopsy. Recently, mpMRI has been used to assess prostate cancer aggressiveness and to identify anteriorly located tumors before and during active surveillance. Moreover, recent studies have reported that mpMRI is a reliable imaging modality for detecting local recurrence after radical prostatectomy or external beam radiation therapy. In this regard, some urologic clinical practice guidelines recommended the use of mpMRI in the diagnosis and management of prostate cancer. Because mpMRI is the evolving reference standard imaging modality for prostate cancer, urologists should acquire cutting-edge knowledge about mpMRI. In this article, we review the literature on the use of mpMRI in urologic practice and provide a brief description of techniques. More specifically, we state the role of mpMRI in prostate biopsy, active surveillance, high-risk prostate cancer, and detection of recurrence after radical prostatectomy.

Reproducibility of Apparent Diffusion Coefficient Measurements in Malignant Breast Masses

This study aimed to evaluate the reproducibility of apparent diffusion coefficient (ADC) measurements in malignant breast masses, and to determine the influence of mammographic parenchymal density on this reproducibility. Sixty-six patients with magnetic resonance findings of the mass were included. Two breast radiologists measured the ADC of the malignant breast mass and the same area on the contralateral normal breast in each patient twice. The effects of mammographic parenchymal density, histology, and lesion size on reproducibility were also assessed. There was no significant difference in the mean ADC between repeated measurements in malignant breast masses and normal breast tissue. The overall reproducibility of ADC measurements was good in both. The 95% limits of agreement for repeated ADCs were approximately 30.2%-33.4% of the mean. ADC measurements in malignant breast masses were highly reproducible irrespective of mass size, histologic subtype, or coexistence of microcalcifications; however, the measurements tended to be less reproducible in malignant breast masses with extremely dense parenchymal backgrounds. ADC measurements in malignant breast masses are highly reproducible; however, mammographic parenchymal density can potentially influence this reproducibility.

Treatment Response Evaluation of Breast Cancer after Neoadjuvant Chemotherapy and Usefulness of the Imaging Parameters of MRI and PET/CT

This study was aimed to evaluate the ability of imaging parameters measured on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), diffusion-weighted MRI (DWI) and positron emission tomography/computed tomography (PET/CT) to serve as response markers in breast cancer after neoadjuvant chemotherapy (NAC). In 20 patients with breast cancer, DCE-MRI and DWI using a 3 T scanner and PET/CT were performed before and after NAC. DCE-MRI was analyzed using an automatic computer-aided detection program (MR-CAD). The response imaging parameters were compared with the pathologic response. The areas under the curve (AUCs) for DCE-MRI using MR-CAD analysis, DWI and PET/CT were 0.77, 0.59 and 0.76, respectively. The combination of all parameters measured by MR-CAD showed the highest diagnostic performance and accuracy (AUC = 0.77, accuracy = 90%). The combined use of the parameters of PET/CT with DCE-MRI or DWI showed a trend toward improved specificity and negative predictive value (100%, 100%, accuracy = 87.5%). The use of DCE-MRI using MR-CAD parameters indicated better diagnostic performance in predicting the final pathological response compared with DWI and PET/CT, although no statistically significant difference was observed. The combined use of PET/CT with DCE-MRI or DWI may improve the specificity for predicting a pathological response.

Evaluation of low-dose dual energy computed tomography for in vivo assessment of renal/ureteric calculus composition

PURPOSE: This study aimed to assess the accuracy of low-dose dual-energy computed tomography (DECT) in predicting the composition of urinary calculi. MATERIALS AND METHODS: A total of 52 patients with urinary calculi were scanned with a 128-slice dual-source DECT scanner by use of a low-dose protocol. Dual-energy (DE) ratio, weighted average Hounsfield unit (HU) of calculi, radiation dose, and image noise levels were recorded. Two radiologists independently rated study quality. Stone composition was assessed after extraction by Fourier transform infrared spectroscopy (FTIRS). Analysis of variance was used to determine if the differences in HU values and DE ratios between the various calculus groups were significant. Threshold cutoff values to classify the calculi into separate groups were identified by receiver operating characteristic curve analysis. RESULTS: A total of 137 calculi were detected. FTIRS analysis differentiated the calculi into five groups: uric acid (n=17), struvite (n=3), calcium oxalate monohydrate and dihydrate (COM-COD, n=84), calcium oxalate monohydrate (COM, n=28), and carbonate apatite (n=5). The HU value could differentiate only uric acid calculi from calcified calculi (p80% sensitivity and specificity to differentiate them. The DE ratio could not differentiate COM from COM-COD calculi. No study was rated poor in quality by either of the observers. The mean radiation dose was 1.8 mSv. CONCLUSIONS: Low-dose DECT accurately predicts urinary calculus composition in vivo while simultaneously reducing radiation exposure without compromising study quality.

Relationship of Liver Stiffness and Controlled Attenuation Parameter Measured by Transient Elastography with Diabetes Mellitus in Patients with Chronic Liver Disease

High prevalence of diabetes mellitus in patients with liver cirrhosis has been reported in many studies. The aim of our study was to evaluate the relationship of hepatic fibrosis and steatosis assessed by transient elastography with diabetes in patients with chronic liver disease. The study population consisted of 979 chronic liver disease patients. Liver fibrosis and steatosis were assessed by liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) on transient elastography. Diabetes was diagnosed in 165 (16.9%) of 979 patients. The prevalence of diabetes had significant difference among the etiologies of chronic liver disease. Higher degrees of liver fibrosis and steatosis, assessed by LSM and CAP score, showed higher prevalence of diabetes (F0/1 [14%], F2/3 [18%], F4 [31%], P50 yr (OR, 1.52; P=0.046). The degree of hepatic fibrosis but not steatosis assessed by transient elastography has significant relationship with the prevalence of diabetes in patients with chronic liver disease.

Relationship of Liver Stiffness and Controlled Attenuation Parameter Measured by Transient Elastography with Diabetes Mellitus in Patients with Chronic Liver Disease

High prevalence of diabetes mellitus in patients with liver cirrhosis has been reported in many studies. The aim of our study was to evaluate the relationship of hepatic fibrosis and steatosis assessed by transient elastography with diabetes in patients with chronic liver disease. The study population consisted of 979 chronic liver disease patients. Liver fibrosis and steatosis were assessed by liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) on transient elastography. Diabetes was diagnosed in 165 (16.9%) of 979 patients. The prevalence of diabetes had significant difference among the etiologies of chronic liver disease. Higher degrees of liver fibrosis and steatosis, assessed by LSM and CAP score, showed higher prevalence of diabetes (F0/1 [14%], F2/3 [18%], F4 [31%], P50 yr (OR, 1.52; P=0.046). The degree of hepatic fibrosis but not steatosis assessed by transient elastography has significant relationship with the prevalence of diabetes in patients with chronic liver disease.