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1.
Arq. bras. cardiol ; 116(3): 404-412, Mar. 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1248885

ABSTRACT

Resumo Fundamentos: Os mecanismos subjacentes pelos quais a doença cardíaca reumática (DCR) levam à disfunção valvar grave não são totalmente compreendidos. Objetivo: O presente estudo avaliou as alterações histopatológicas nas valvas mitrais (VM) buscando uma associação entre o padrão de disfunção valvar predominante e os achados histopatológicos. Métodos: Em 40 pacientes submetidos à troca da VM devido a DCR e em 20 controles submetidos a transplante cardíaco, foram analisados os aspectos histológicos da VM excisada. Dados clínicos e ecocardiográficos também foram coletados. As análises histológicas foram realizadas usando coloração com hematoxilina-eosina. Determinou-se inflamação, fibrose, neoangiogênese, calcificação e metaplasia adiposa. Valores de p<0,05 foram considerados estatisticamente significativos. Resultados: A idade média dos pacientes com DCR foi de 53±13 anos, sendo 36 (90%) do sexo feminino, enquanto a idade média dos controles foi de 50±12 anos, semelhante aos casos, sendo a maioria do sexo masculino (70%). O endocárdio valvar reumático apresentou espessura maior que os controles (1,3±0,5 mm versus 0,90±0,4 mm, p=0,003, respectivamente), e infiltrado inflamatório mais intenso no endocárdio (78% versus 36%; p=0,004), com predominância de células mononucleares. Ocorreu fibrose moderada a acentuada mais frequentemente em válvulas reumáticas do que em válvulas controle (100% vs. 29%; p<0,001). Ocorreu calcificação em 35% das valvas reumáticas, principalmente entre as valvas estenóticas, associada à área valvar mitral (p=0,003). Conclusões: Apesar do intenso grau de fibrose, o processo inflamatório permanece ativo na valva mitral reumática, mesmo em doença tardia com disfunção valvar. A calcificação predominou em valvas estenóticas e em pacientes com disfunção ventricular direita.


Abstract Background: The underlying mechanisms by which rheumatic heart disease (RHD) lead to severe valve dysfunction are not completely understood. Objective: The present study evaluated the histopathological changes in mitral valves (MV) seeking an association between the pattern of predominant valvular dysfunction and histopathological findings. Methods: In 40 patients who underwent MV replacement due to RHD, and in 20 controls that underwent heart transplant, histological aspects of the excised MV were analyzed. Clinical and echocardiographic data were also collected. Histological analyses were performed using hematoxylin-eosin staining. Inflammation, fibrosis, neoangiogenesis, calcification and adipose metaplasia were determined. A p value<0.05 was considered to be statistically significant. Results: The mean age of RHD patients was 53±13 years, 36 (90%) were female, whereas the mean age of controls was 50±12 years, similar to the cases, with the majority of males (70%). The rheumatic valve endocardium presented greater thickness than the controls (1.3±0.5 mm versus 0.90±0.4 mm, p=0.003, respectively), and a more intense inflammatory infiltrate in the endocardium (78% versus 36%; p=0.004), with predominance of mononuclear cells. Moderate to marked fibrosis occurred more frequently in rheumatic valves than in control valves (100% vs. 29%; p<0.001). Calcification occurred in 35% of rheumatic valves, especially among stenotic valves, which was associated with the mitral valve area (p=0.003). Conclusions: Despite intense degree of fibrosis, the inflammatory process remains active in the rheumatic mitral valve, even at late disease with valve dysfunction. Calcification predominated in stenotic valves and in patients with right ventricular dysfunction.


Subject(s)
Humans , Male , Female , Adult , Aged , Rheumatic Heart Disease/diagnostic imaging , Calcinosis/diagnostic imaging , Mitral Valve Insufficiency , Mitral Valve Stenosis/diagnostic imaging , Middle Aged , Mitral Valve/diagnostic imaging
2.
Rev. chil. endocrinol. diabetes ; 14(3): 115-117, 2021. ilus
Article in Spanish | LILACS | ID: biblio-1293385

ABSTRACT

La ecografía tiroidea es la principal herramienta diagnóstica en el manejo de los nódulos tiroideos, siendo la presencia de microcalcificaciones un signo de malignidad. Sin embargo, existen escasas publicaciones acerca de la presencia de microcalcificaciones en ausencia de nódulo identificable y su asociación con cáncer de tiroides. Presentamos un caso de una mujer de 26 años, que, tras hallazgo incidental de bocio, se describe en ecografía un tiroides con alteración difusa de su ecogenicidad e imágenes compatibles con microcalcificaciones sin claro nódulo definido en su polo inferior. Tras realización de punción aspiración con aguja fina de la lesión con resultado Bethesda categoría 5, se decide realizar tiroidectomía total, presentando estudio histológico con diagnóstico de carcinoma papilar de tiroides variante clásica con metástasis ganglionares p(T1bN1a). Tras una revisión sistemática, los estudios hasta hoy publicados sugieren que la presencia de microcalcificaciones aisladas sin nódulo identificable debe considerarse un importante factor de riesgo de cáncer de tiroides, especialmente en gente joven, y en aquellas asentadas sobre una tiroiditis de Hashimoto. Por ende, resulta imperativo mantener una alta sospecha ante el hallazgo de este tipo de lesiones, recomendando una valoración exhaustiva de las mismas con la realización de una punción aspiración con aguja fina a todas las lesiones con dichas características.


Thyroid ultrasound is the main diagnostic tool in the management of thyroid nodules, with the presence of microcalcifications being a sign of malignancy. However, there are few publications about the presence of microcalcifications in the absence of an identifiable nodule and its association with thyroid cancer. We present a case of a 26-year-old woman who, after an incidental finding of goiter, a thyroid with diffuse echogenicity alteration and images compatible with microcalcifications without a clear nodule defined in the lower pole of the lobe is described on the ultrasound. After performing a fine needle aspiration of the lesion resulting in a Bethesda category 5, a total thyroidectomy was performed, presenting in the histological study a diagnosis of a classic variant of a papillary thyroid carcinoma with lymph node metastases p (T1bN1a). After a systematic review, the studies previously published suggest that the presence of isolated microcalcifications without an identifiable nodule should be considered an important risk factor for thyroid cancer, especially in young people, and in those with a concomitant Hashimoto's thyroiditis. Therefore, it is imperative to maintain a high suspicion of the discovery of this type of lesion, recommending an exhaustive assessment of them with the performance of a fine needle aspiration to all lesions with these features.


Subject(s)
Humans , Female , Adult , Calcinosis/diagnostic imaging , Thyroid Neoplasms/diagnostic imaging , Carcinoma/diagnostic imaging , Thyroid Nodule/diagnostic imaging , Thyroidectomy , Calcinosis/surgery , Calcinosis/pathology , Thyroid Neoplasms/surgery , Thyroid Neoplasms/pathology , Carcinoma/surgery , Carcinoma/pathology , Ultrasonography , Thyroid Nodule/surgery , Thyroid Nodule/pathology , Biopsy, Fine-Needle
3.
Article in Chinese | WPRIM | ID: wpr-921558

ABSTRACT

Objective To explore the roles of conventional ultrasound and contrast-enhanced ultrasound in distinguishing between benign and malignant thyroid nodules with calcification. Methods A total of 102 solid thyroid nodules with calcification in 76 patients were evaluated by conventional ultrasound alone and conventional ultrasound combined with contrast-enhanced ultrasound.The features obtained through conventional ultrasound alone and that combined with contrast-enhanced ultrasound were scored,and the diagnostic performance of the two methods was analyzed based on the final pathological results. Results The distribution of microcalcification(


Subject(s)
Calcinosis/diagnostic imaging , Contrast Media , Diagnosis, Differential , Humans , Sensitivity and Specificity , Thyroid Neoplasms , Thyroid Nodule/diagnostic imaging , Ultrasonography
4.
Article in Chinese | WPRIM | ID: wpr-879274

ABSTRACT

In order to overcome the shortcomings of high false positive rate and poor generalization in the detection of microcalcification clusters regions, this paper proposes a method combining discriminative deep belief networks (DDBNs) to automatically and quickly locate the regions of microcalcification clusters in mammograms. Firstly, the breast region was extracted and enhanced, and the enhanced breast region was segmented to overlapped sub-blocks. Then the sub-block was subjected to wavelet filtering. After that, DDBNs model for breast sub-block feature extraction and classification was constructed, and the pre-trained DDBNs was converted to deep neural networks (DNN) using a softmax classifier, and the network is fine-tuned by back propagation. Finally, the undetected mammogram was inputted to complete the location of suspicious lesions. By experimentally verifying 105 mammograms with microcalcifications from the Digital Database for Screening Mammography (DDSM), the method obtained a true positive rate of 99.45% and a false positive rate of 1.89%, and it only took about 16 s to detect a 2 888 × 4 680 image. The experimental results showed that the algorithm of this paper effectively reduced the false positive rate while ensuring a high positive rate. The detection of calcification clusters was highly consistent with expert marks, which provides a new research idea for the automatic detection of microcalcification clusters area in mammograms.


Subject(s)
Algorithms , Breast Neoplasms/diagnostic imaging , Calcinosis/diagnostic imaging , Early Detection of Cancer , Humans , Mammography , Neural Networks, Computer
5.
Rev. urug. cardiol ; 36(3): e203, 2021. ilus, tab
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1366959

ABSTRACT

Introducción: la degeneración valvular protésica es un problema clínico; los métodos de imagen convencionales permiten diagnosticarla en las últimas etapas. La tomografía por emisión de positrones (PET) con 18Ffluoruro puede detectar de manera precoz la degeneración subclínica. Objetivo: correlacionar parámetros de deterioro estructural protésico por PET con parámetros hemodinámicos ecocardiográficos al año de la sustitución valvular aórtica (SVA) por bioprótesis porcina. Métodos: estudio prospectivo ad hoc de un ensayo clínico. Se reclutaron pacientes sometidos a SVA por bioprótesis porcina en dos centros nacionales entre el 01/01/2019 y el 13/02/2020. Se realizaron controles clínicos y ecocardiográficos. Se seleccionaron aleatoriamente 19 sujetos a los que se les realizó PET 18Ffluoruro de sodio con angiotomografía al año de la SVA. Se midió la captación del trazador en la válvula (SUVavV) y aurícula derecha (SUVavA), calculando el índice SUVavV/SUVavA, que se comparó con los gradientes ecocardiográficos medio y máximo al año, mediante análisis de correlación de Spearman. Resultados: de 140 sujetos sometidos a SVA se realizó PET a 19, a los 16,3 meses (15,9-16,9) luego de la SVA. La mediana del índice SUVavV/SUVavA fue de 1,17 (1,11-1,27). Se encontró una correlación negativa moderada entre la captación de 18Ffluoruro y el gradiente medio (coeficiente de correlación -0,516, p = 0,028) y máximo (coeficiente -0,589, p = 0,010) al año. Conclusiones: en el seguimiento de los pacientes en los que se le realizó una sustitución valvular aórtica con bioprótesis, encontramos valores bajos de captación en el PET y gradientes ecocardiográficos normales con una correlación negativa moderada entre estos hallazgos


Introduction: prosthetic valve degeneration is a relevant clinical disorder; conventional imaging methods allow diagnosis in the later stages. 18Ffluoride positron emission tomography (PET) can detect subclinical degeneration earlier. Objective: correlate parameters of prosthetic structural deterioration by PET with echocardiographic hemodynamic parameters one year after aortic valve replacement (AVR) by porcine bioprosthesis. Methods: prospective ad hoc study of a clinical trial. Patients undergoing AVR by porcine bioprosthesis were recruited in two national centers between 01/01/2019 and 02/13/2020. Clinical and echocardiographic controls were carried out. 19 subjects were randomly selected and underwent 18Fsodium fluoride PET with CT angiography one year after AVR. Tracer uptake in the valve (SUVavV) and right atrium (SUVavA) was measured, creating the SUVavV/SUVavA index, which was compared with the mean and maximum gradients at one year, using Spearman's correlation analysis. Results: of a total of 140 subjects, PET was performed on 19 at 16.3 months (15.9-16.9) after the AVR. The median SUVavV/SUVavA ratio was 1.17 (1.11-1.27). A moderate negative correlation was found between. 18Ffluoride uptake and the mean gradient (correlation coefficient -0.516, p = 0.028) and maximum (coefficient of -0.589, p = 0.010) at one year. Conclusions: we found low uptake values in PET, echocardiographic gradients in normal range and no positive correlation between both parameters. It is the first national report with these imaging techniques


Introdução: a degeneração da válvula protética é um problema clínico; os métodos convencionais de imagem permitem o diagnóstico nas fases posteriores. A tomografia por emissão de pósitrons (PET) com fluoreto18F pode detectar a degeneração subclínica precocemente. Objetivo: correlacionar parâmetros de deterioração estrutural protética por PET com parâmetros hemodinâmicos ecocardiográficos após um ano da troca valvar aórtica (SVA) por bioprótese suína. Métodos: estudo ad hoc prospectivo de um ensaio clínico. Pacientes submetidos a SVA por bioprótese suína foram recrutados em dois centros nacionais entre 01/01/2019 e 13/02/2020. Foram realizados controles clínicos e ecocardiográficos. 19 indivíduos foram selecionados aleatoriamente que foram submetidos a PET com fluoreto de sódio 18F com angiotomografia um ano após AVS. A captação do traçador na válvula (SUVavV) e átrio direito (SUVavA) foi medida, criando o índice SUVavV/SUVavA, que foi comparado com os gradientes médio e máximo em um ano, usando a análise de correlação de Spearman. Resultados: de um total de 140 indivíduos submetidos a SVA, PET foi realizado em 19, em 16,3 meses (15,9-16,9) após a SVA. A proporção média de SUVavV/SUVavA foi de 1,17 (1,11-1,27). Uma correlação negativa moderada foi encontrada entre a captação de fluoreto18F e o gradiente médio (coeficiente de correlação -0,516, p = 0,028) e máximo (coeficiente de -0,589, p = 0,010) em um ano. Conclusões: encontramos valores baixos de captação na PET, gradientes ecocardiográficos dentro da normalidade, sem correlação positiva entre os dois parâmetros. É o primeiro trabalho nacional com essas técnicas de imagem


Subject(s)
Humans , Male , Female , Aged , Aortic Valve , Sodium Fluoride/administration & dosage , Bioprosthesis , Prosthesis Failure , Calcinosis/diagnostic imaging , Heart Valve Prosthesis , Echocardiography , Prospective Studies , Follow-Up Studies , Positron-Emission Tomography
6.
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1142107

ABSTRACT

La tendinitis calcificante del músculo largo del cuello es una patología subdiagnsoticada, de baja frecuencia, autolimitada. Se presenta clínicamente como una de las causas de odinofagia en la consulta médica. Se produce debido al depósito de cristales de hidroxiapatita en espacio retrofaríngeo, desencadenándose una respuesta inflamatoria local. En la TMLC el principal diagnóstico diferencial es el absceso retrofaríngeo, ya que puede presentarse clínicamente con odinofagia, disfagia , disminución de la movilidad del cuello y cervicalgia. En nuestro trabajo se analiza un caso clínico sobre dicha patología, en un hombre de 45 años; realizando un análisis de la sintomatología, diagnóstico y tratamiento de esta entidad.


Calcific tendinitis of the long neck muscle is an underdiagnosed, low frequency, self-limited pathology. It is clinically presented as one of the causes of odynophagia in the medical consultation. It occurs due to the deposit of hydroxyapatite crystals in the retropharyngeal space, triggering a local inflammatory response. On This patholgy, the main differential diagnosis is retropharyngeal abscess, since it can present clinically with odynophagia, dysphagia, decreased mobility of the neck, and neck pain. In our work, a clinical case of this pathology is analyzed, in a 45-year-old man; performing an analysis of the symptoms, diagnosis and treatment of this entity.


A tendinite calcificante do músculo longo do pescoço é uma patologia subdiagnsoticada, de baixa frequência, autolimitada. Apresenta-se clinicamente como uma das causas de odinofagia na consulta médica. Ocorre devido ao depósito de cristais de hidroxiapatita em espaço retrofaríngeo, desencadeando-se uma resposta inflamatória local. Na TMLC o principal diagnóstico diferencial é o abscesso retrofaríngeo, já que pode apresentar-se clinicamente com odinofagia, disfagia , diminuição da mobilidade do pescoço e cervicalgia. Em nosso trabalho analisa-se um caso clínico sobre essa patologia, em um homem de 45 anos; realizando uma análise da sintomatologia, diagnóstico e tratamento desta entidade.


Subject(s)
Humans , Male , Middle Aged , Cervical Atlas/pathology , Axis, Cervical Vertebra/pathology , Calcinosis/diagnostic imaging , Tendinopathy/drug therapy , Tendinopathy/diagnostic imaging , Neck Muscles/pathology , Deglutition Disorders/etiology , Neck Pain/etiology , Diagnosis, Differential , Analgesics/therapeutic use
7.
Int. j. morphol ; 38(6): 1560-1565, Dec. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1134478

ABSTRACT

RESUMEN: Aunque la radiografía panorámica no es una prueba de diagnóstico inicial para detectar la aterosclerosis carotídea, no podemos ignorar su valor al ver estas lesiones como hallazgos incidentales que pueden ser grandes aliados en el diagnóstico temprano y la prevención de eventos vasculares graves. El objetivo de este estudio fue evaluar la prevalencia de calcificaciones en la bifurcación de la arteria carótida en las radiografías panorámicas de rutina como principio diagnóstico, así como su relación con los factores de riesgo cardiovascular en individuos brasileños. Se analizaron 449 exámenes de radiografía panorámica de la base de datos del Departamento de Radiología de la Facultad de Odontología de Piracicaba, UNICAMP, São Paulo, Brasil. Después de obtener mediciones de la presión arterial e información sobre el tabaquismo y las enfermedades sistémicas, fue buscado en la radiografía panorámica la presencia o ausencia de la masa radiopaca en las regiones de las vértebras cervicales C3-C4. En el caso de una imagen sugestiva de ateroma, se realizó una radiografía anteroposterior para confirmar el diagnóstico. Aplicamos la prueba estadística de Chi-cuadrado con distribución normal y muestras independientes y aleatorias con un intervalo de confianza del 95 %. La confirmación de calcificaciones carotideas se produjo en el 8,5 % de la población de estudio (38 casos). No encontramos ninguna relación entre la presencia de calcificaciones con el tabaquismo, con el sexo o con datos previos de antecedentes familiares. Sin embargo 49,1 % de los casos estaban por encima de sesenta años y tenía asociación significativa con la hipertensión (P = 0,006). El mayor riesgo se presenta en pacientes ancianos hipertensos y, por lo tanto, hacemos hincapié en la importancia de una observación minuciosa de las radiografías panorámicas en la búsqueda de cualquier alteración de la anatomía normal y si es así, proceder con la derivación lo antes posible para un diagnóstico concluyente por parte de un especialista, pudiendo así ayudar en la prevención de episodios vasculares graves.


SUMMARY: Although panoramic radiography is not an initial diagnostic test for detecting carotid atherosclerosis, we cannot ignore its value in viewing these lesions as incidental findings that can be great allies in early diagnosis and prevention of serious vascular events. The aim was to evaluate the prevalence of calcifications in the bifurcation of the carotid artery on routine panoramic radiographs as a diagnostic principle, as well as its relationship with cardiovascular risk factors in Brazilians. We analyzed 449 panoramic radiography exams from the database of the Department of Radiology of the Faculty of Dentistry of Piracicaba, UNICAMP, São Paulo, Brazil. After obtaining blood pressure measurements and information on smoking and systemic diseases, the researcher observed on the panoramic radiograph, the presence or absence of the radiopaque mass in the regions of the cervical vertebrae C3-C4. In the case of a suggestive image of atheroma, an anteroposterior radiography was performed to confirm the diagnosis. The Chi-square test of normal distribution for independent and random samples with a 95 % confidence interval was applied to the data. Confirmation of carotid calcifications occurred in 8.5 % of the study population (38 cases). We did not find any relationship between the presence of calcifications with smoking, sex or previous family history. However, 49.1 % of cases occurred above sixty years old and there was a significant relationship with hypertension (P = 0.006). The greatest risk was presented in elderly and hypertensive patients, so we highlight the importance of a thorough observation by the dentist of panoramic radiographs to detect any alteration of the normal anatomy and in the positive case, proceed with the referral as soon as possible for a conclusive diagnosis by a specialist, being able to thus assist in the prevention of severe vascular episodes.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Cardiovascular Diseases/epidemiology , Carotid Arteries/pathology , Carotid Artery Diseases/epidemiology , Carotid Artery Diseases/diagnostic imaging , Brazil/epidemiology , Calcinosis/diagnostic imaging , Radiography, Panoramic , Cardiovascular Diseases/etiology , Carotid Arteries/diagnostic imaging , Carotid Artery Diseases/complications , Chi-Square Distribution , Confidence Intervals , Prevalence , Retrospective Studies , Risk Factors , Atherosclerosis/diagnostic imaging , Hypertension
8.
J. oral res. (Impresa) ; 9(6): 457-465, dic. 31, 2020. ilus, tab
Article in English | LILACS | ID: biblio-1178939

ABSTRACT

Soft tissue calcifications can indicate the presence of more serious, potentially life-threatening pathologies. Therefore, their study can lead to an early diagnosis of those conditions that have not yet become clinically apparent. Main objective: To determine the prevalence of calcifications in soft tissues of the head and neck in cone beam computed tomography images obtained from the Oral and Maxillofacial Radiology Service at Universidad Andrés Bello (UNAB), Viña del Mar, Chile. Material and Methods: Retrospective, cross-sectional, quantitative study. A total of 288 images of cone beam computed tomography (CBCT) were used. Images were obtained at random from the database of the Oral and Maxillofacial Radiology Service at UNAB, Viña Del Mar, between 2014 and 2019. Results: A prevalence of 59.72% of soft tissue calcifications was obtained. The most prevalent were: tonsilloliths and calcified stylohyoid ligament, accounting for 30.65% and 45.56%, respectively. Conclusion: A high prevalence of soft tissue calcifications was found in a population that has not been studied previously; therefore, it is important that the dentist perform a detailed analysis of the cone beam computed tomography.


Introducción: Las calcificaciones en tejidos blandos pueden indicar patologías más graves, que incluso pueden comprometer la vida. Por lo tanto, investigarlas puede conducir a un diagnóstico temprano de aquellas que aún no se han manifestado clínicamente. Objetivo principal: determinar la prevalencia de calcificaciones en tejidos blandos de cabeza y cuello en tomografía computarizada de haz cónico del Servicio de Radiología Oral y Maxilofacial de la UNAB, Viña del Mar, Chile. Material y Métodos: Estudio retrospectivo, transversal, cuantitativo. Se utilizaron 288 volúmenes de tomografía computarizada de haz cónico (CBCT, por las iniciales en inglés de Cone Beam Computed Tomography), obtenidas al azar, de la base de datos del Servicio de Radiología Oral y Maxilofacial de la Universidad Andrés Bello (UNAB), Viña del Mar entre 2014 y 2019. Resultados: Se obtuvo una prevalencia de 59.72% de calcificaciones en tejidos blandos. Las más prevalentes fueron: tonsilolitos, con un 30,65% y ligamento estilohioídeo calcificado, con un 45,56%. Conclusión: Se encontró una alta prevalencia de calcificaciones en tejidos blandos en una población que no ha sido estudiada previamente, por ello es importante que el odontólogo realice un análisis detallado de la tomografía computarizada de haz cónico.


Subject(s)
Humans , Male , Female , Calcinosis/diagnostic imaging , Cone-Beam Computed Tomography/methods , Head/diagnostic imaging , Neck/diagnostic imaging , Palatine Tonsil/diagnostic imaging , Calcinosis/epidemiology , Chile , Prevalence , Retrospective Studies , Ligaments
9.
Medicina (B.Aires) ; 80(6): 707-709, dic. 2020. graf
Article in Spanish | LILACS | ID: biblio-1250298

ABSTRACT

Resumen Varón de 33 años con antecedentes de convulsiones febriles y discapacidad intelectual moderada grave, inició a los 2 años convulsiones tanto focales como generalizadas atónicas diarias, que ocasionaron traumas faciales. Debido a la farmacorresistencia se implantó un estimulador del nervio vago, con respuesta parcial al mismo. Durante su seguimiento, se hizo diagnóstico de enfermedad celíaca. Al realizar una tomografía de encéfalo se evidenciaron calcificaciones piriformes occipitales bilaterales, estableciéndose el diagnostico de enfermedad celiaca, epilepsia y calcificaciones cerebrales. Se le indicó dieta libre de gluten y continuar el tratamiento farmacológico, logrando de esta manera una reducción de las crisis.


Abstract A 33-year-old man with a history of febrile seizures and moderate-severe intellectual disability began, at 2 years, both focal and generalized daily atonic seizures, which caused facial trauma. Due to drug resistance, a vagus nerve stimulator was implanted, with partial response to it. During his follow-up, he was diagnosed with celiac disease. When performing a brain tomography, bilateral occipital pyriform calcifications were evidenced, establishing the diagnosis of celiac disease, epilepsy and cerebral calcifications. A gluten-free diet was indicated and pharmacological treatment continued, thus achieving a reduction in seizures.


Subject(s)
Humans , Male , Adult , Brain Diseases , Calcinosis/diagnostic imaging , Celiac Disease/complications , Epilepsy , Electroencephalography
11.
Rev. bras. cir. cardiovasc ; 35(5): 844-846, Sept.-Oct. 2020. tab, graf
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-1137318

ABSTRACT

Abstract Submitral left ventricular aneurysm is a rare cardiac pathology with very few cases reported in the literature. These are nonischemic aneurysms mostly reported from Africa. Patients with submitral aneurysm exhibit varied clinical manifestations. We report a case of calcified submitral aneurysm and its successful surgical management through a transaneurysmal approach.


Subject(s)
Humans , Male , Middle Aged , Heart Aneurysm/surgery , Heart Aneurysm/diagnostic imaging , Heart Ventricles/surgery , Heart Ventricles/diagnostic imaging , Pericardium/transplantation , Calcinosis/diagnostic imaging , Echocardiography , Tomography, X-Ray Computed , Cardiac Surgical Procedures/methods
12.
Rev. bras. oftalmol ; 79(5): 336-339, set.-out. 2020. tab, graf
Article in English | LILACS | ID: biblio-1137986

ABSTRACT

Abstract Sclerochoroidal calcifications (SC) are a rare and benign ocular condition characterized by yellow-white irregular subretinal lesions usually found in the supero-temporal arcade of the midperipheral fundus in middle-aged elderly men. We present a clinical case of a 79- year-old patient who during a fundus examination presented raised whitish nodules in the supero-temporal arcade in the right eye. After performing optical coherence tomography, ultrasound, ocular computed tomography and laboratory analysis, she was diagnosed with idiopathic sclerochoroidal calcifications The pathogenesis of sclerochoroidal calcifications remains unclear but systemic conditions should be discarded. It is important to distinguish sclerochoroidal calcifications from other conditions such as tumors.


Resumo Calcificações esclerocoroidais (SC) são uma condição ocular rara e benigna caracterizada por lesões sub-retinianas irregulares amarelo-brancas, geralmente encontradas na arcada superotemporal do fundo médio-periférico em homens idosos de meia-idade. Apresentamos um caso clínico de uma paciente de 79 anos que durante exame de fundo apresentou nódulos esbranquiçados elevados na arcada superotemporal do olho direito. Após realizar tomografia de coerência óptica, ultra-sonografia, tomografia computadorizada ocular e análise laboratorial, ela foi diagnosticada com calcificações esclerocoroidais idiopáticas A patogênese das calcificações esclerocoroidais permanece incerta, mas as condições sistêmicas devem ser descartadas. É importante distinguir calcificações esclerocoroidais de outras condições, como tumores.


Subject(s)
Humans , Female , Aged , Calcinosis/diagnostic imaging , Scleral Diseases/diagnostic imaging , Choroid Diseases/diagnostic imaging , Tomography, X-Ray Computed/methods , Ultrasonography/methods , Clinical Laboratory Techniques/methods , Tomography, Optical Coherence/methods , Diagnosis, Differential , Metabolic Diseases
13.
Rev. chil. cardiol ; 39(2): 159-164, ago. 2020. graf
Article in Spanish | LILACS | ID: biblio-1138529

ABSTRACT

Abstract A 68-year-old man previously subjected to radiotherapy had a prior aortic valve replacement due de radiation induced calcification of the aortic valve. Presently the patient developed severe calcification of the mitral valve ring leading to critical mitral valve stenosis. A supra annular implantation of an On X Conform valve was successfully achieved. The clinical course was uneventful, and the echocardiographic evaluation demonstrated a normal function of the valve. Different alternatives for the surgical management of this complication are discussed.


Subject(s)
Humans , Male , Aged , Calcinosis/complications , Heart Valve Prosthesis , Heart Valve Prosthesis Implantation , Mitral Valve Stenosis/surgery , Mitral Valve Stenosis/complications , Calcinosis/surgery , Calcinosis/diagnostic imaging , Echocardiography , Fluoroscopy , Mitral Valve Annuloplasty , Mitral Valve Stenosis/diagnostic imaging
14.
Rev. chil. radiol ; 26(2): 52-61, jun. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1126194

ABSTRACT

Resumen: La tendinopatía cálcica es causada por el depósito patológico de cristales de hidroxiapatita de calcio en los tendones y es una causa común de dolor en las articulaciones. Afecta más frecuentemente al hombro y la cadera, con hallazgos característicos en imágenes; sin embargo, cualquier tendón puede estar involucrado. Ocasionalmente, la tendinopatía cálcica puede simular patología agresiva, como infección o neoplasia, especialmente en RM. Fisiotpatológicamente, las calcificaciones provendrían de una diferenciación anormal de las células madre del tendón, que comienzan a producir calcio, aunque todavía no es del todo claro. Los radiólogos deben estar familiarizados con los hallazgos de las imágenes para distinguir la tendinopatía cálcica de procesos más agresivos. La aspiración y lavado guiado bajo ecografía es una técnica útil realizada por el radiólogo para el tratamiento de casos sintomáticos. La familiaridad con estos procedimientos y su apariencia en imágenes es un aspecto importante en el manejo de esta enfermedad. El propósito de esta revisión es analizar la etiopatogenia de la tendinopatía cálcica, la evaluación con imágenes en los sitios de presentación más comunes y también en los menos frecuentes, así como el papel que desempeña la ecografía en el tratamiento de la patología.


Abstract: Calcific tendinitis is caused by abnormal deposition of calcium hydroxyapatite crystals in tendons and is a common cause of joint pain. The disease typically affects the shoulder and hip, with characteristic imaging findings; however, any tendon can be involved. Occasionally, calcific tendinitis can mimic aggressive disorders, such as infection and neoplasm, especially on MRI. Apparently, the calcifications come from an abnormal differentiation of the tendon stem cells, which begin to produce calcium. Radiologists should be familiar with the imaging findings to distinguish calcific tendinitis from more aggressive processes. Image-guided percutaneous needle aspiration is a useful technique performed by the radiologist for the treatment of symptomatic cases. Being familiar with these processes and their imaging appearance is an important aspect in the management of this common disease. The purpose of this review is to analyze the pathogenesis of calcium tendinopathy, the evaluation of images in both the most common and less frequent presentation sites, as well as the role played by ultrasound in the treatment of pathology.


Subject(s)
Humans , Calcinosis/etiology , Calcinosis/diagnostic imaging , Rotator Cuff/diagnostic imaging , Tendinopathy/etiology , Tendinopathy/diagnostic imaging , Ultrasonics , Calcinosis/classification , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Tendinopathy/classification
15.
Actual. osteol ; 16(1): 77-82, Ene - abr. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1140152

ABSTRACT

Introducción. El hipoparatiroidismo es una enfermedad caracterizada por la ausencia o concentraciones inadecuadamente bajas de hormona paratiroidea (PTH), que conduce a hipocalcemia, hiperfosfatemia y excreción fraccional elevada de calcio en la orina. Las calcificaciones del sistema nervioso central son un hallazgo frecuente en estos pacientes. Caso clínico. Mujer de 56 años con antecedente de hipotiroidismo, que ingresó por un cuadro de 6 días de evolución caracterizado por astenia, parestesias periorales y movimientos anormales de manos y pies. Las pruebas de laboratorio demostraron hipocalcemia, hiperfosfatemia y niveles bajos de hormona paratiroidea. Se realizó una tomografía computarizada de cráneo que mostró áreas bilaterales y simétricas de calcificaciones en hemisferios cerebelosos, ganglios basales y corona radiata. No se evidenciaron trastornos en el metabolismo del cobre y hierro. Se estableció el diagnóstico del síndrome de Fahr secundario a hipoparatiroidismo y se inició tratamiento con suplementos de calcio y vitamina D con evolución satisfactoria. Discusión. El síndrome de Fahr es un trastorno neurológico caracterizado por el depósito anormal de calcio en áreas del cerebro que controlan la actividad motora. Se asocia a varias enfermedades, especialmente, hipoparatiroidismo. La suplementación con calcio y vitamina D con el objetivo de normalizar los niveles plasmáticos de estos cationes es el tratamiento convencional. (AU)


Introduction. Hypoparathyroidism is a disease characterized by absence or inappropriately low concentrations of circulating parathyroid hormone, leading to hypocalcaemia, hyperphosphataemia and elevated fractional excretion of calcium in the urine. Central nervous system calcifications are a common finding in these patients. Case report. 56-year-old woman with a history of hypothyroidism who was admitted for a 6-day course of illness characterized by asthenia, perioral paresthesias, and abnormal movements of the hands and feet. Laboratory tests showed hypocalcemia, hyperphosphatemia, and low parathyroid hormone levels. A cranial computed tomography was performed. It showed bilateral and symmetrical areas of calcifications in the cerebellar hemispheres, basal ganglia, and radiata crown. No disorders of copper or iron metabolism were evident. The diagnosis of Fahr syndrome secondary to hypoparathyroidism was established and treatment with calcium and vitamin D supplements was started with satisfactory evolution. Discussion. Fahr's syndrome is a neurological disorder associated with abnormal calcium deposition in areas of the brain that control motor activity. It is associated with various diseases, especially hypoparathyroidism. The conventional treatment is supplementation with calcium and vitamin D, with the aim of normalizing their plasma levels. (AU)


Subject(s)
Humans , Female , Middle Aged , Calcinosis/diagnostic imaging , Hypoparathyroidism/diagnosis , Nervous System Diseases/diagnostic imaging , Parathyroid Hormone/blood , Calcinosis/complications , Calcinosis/drug therapy , Calcitriol/administration & dosage , Calcium Carbonate/administration & dosage , Calcium Gluconate/administration & dosage , Calcium/administration & dosage , Hyperphosphatemia/blood , Hypocalcemia/blood , Hypoparathyroidism/etiology , Hypoparathyroidism/drug therapy , Nervous System Diseases/complications , Nervous System Diseases/drug therapy
17.
J. oral res. (Impresa) ; 8(6): 510-516, dic. 28, 2019. tab
Article in English | LILACS | ID: biblio-1224615

ABSTRACT

Background: Carotid artery calcification (CAC) is one of risk factors of cardiovascular disorders (CVDs). Digital panoramic radiographs can detect it. Aim of the study: This study aimed to determine the prevalence of CAC detected by digital panoramic radiographs in a sample of Yemeni dental patients. Materials and Methods: An observational and analytical cross-sectional study was used to investigate a convenience sample of 443 patients. These patients were interviewed face-to-face for their socio-demographic information and their medical background regarding CVDs and associated risk factors. The researchers for detection of CAC assessed the digital panoramic radiographs. Results: High income and middle-aged patients were risk factors of CVDs significantly associated with increased incidence of CAC (42 patients (9.5%) and 32 patients (7.2%), respectively). Patients with a previous medical consultation, previous medications and family history of CVDs revealed a significant higher prevalence of CAC (p=0.001). Conclusion: There was an increased prevalence of CAC detected on digital panoramic radiographs, as a risk factor of CVDs. CAC was more common in females than males.


Antecedentes: La calcificación de la arteria carótida (CAC) es uno de los factores de riesgo de enfermedades cardiovasculares (ECV). La CAC puede ser detectada por radiografías panorámicas digitales. Objetivo del estudio: Este estudio tuvo como objetivo determinar la prevalencia de CAC detectada por radiografías panorámicas digitales en una muestra de pacientes dentales yemeníes. Materiales y métodos: Se utilizó un estudio transversal observacional y analítico para investigar una muestra de conveniencia de 443 pacientes. Estos pacientes fueron entrevistados en persona para obtener su información sociodemográfica y sus antecedentes médicos con respecto a las ECV y los factores de riesgo asociados. Los investigadores evaluaron las radiografías panorámicas digitales para detectar CAC. Resultados: Los pacientes de ingresos altos y de mediana edad fueron factores de riesgo de ECV significativamente asociados con una mayor incidencia de CAC (42 pacientes (9,5%) y 32 pacientes (7,2%), respectivamente). Los pacientes con una consulta médica previa, medicamentos previos y antecedentes familiares de ECV revelaron una prevalencia significativamente mayor de CAC (p=0.001). Conclusión: Hubo una mayor prevalencia de CAC detectada en radiografías panorámicas digitales como factor de riesgo de ECV, y CAC fue más común en mujeres que en hombres.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Cardiovascular Diseases/complications , Carotid Artery, Common/diagnostic imaging , Yemen , Calcinosis/diagnostic imaging , Radiography, Panoramic , Carotid Arteries , Prevalence , Cross-Sectional Studies , Carotid Stenosis
19.
Rev. cuba. reumatol ; 21(2): e60, mayo.-ago. 2019.
Article in Spanish | LILACS, CUMED | ID: biblio-1093819

ABSTRACT

Introducción: La búsqueda bibliográfica realizada estableció una problemática a atender: la escasez de estudios de caso de dermatomiositis juvenil, por lo que la presente investigación pretende arrojar luz sobre esta patología, poco reflejada en la literatura médica. Nótese, además, que la sistematización puede servir de reservorio bibliográfico para estudios de posgrados de especialistas médicos. Dermatomiositis juvenil. Sistematización de casos: sistematizar y comparar 10 casos de dermatomiositis juvenil, publicados en las principales revistas médicas en cuanto a la edad del paciente, antecedentes de salud, cuadro clínico, resultados de complementarios, diagnóstico diferencial, manejo. Dermatomiositis juvenil. Sistematización de casos: hasta un 30 por ciento de los pacientes con dermatomiositis juvenil puede presentar calcinosis, especialmente en puntos de presión como codos, rodillas, dedos y glúteos. La calcinosis puede estar presente en el momento del diagnóstico, pero corrientemente se establece luego de 1 a 3 años y puede provocar la aparición de úlceras cutáneas, mengua de los rangos articulares, dolor e inflamación local. Alrededor del 10 por ciento de los pacientes con dermatomiositis juvenil puede presentar úlceras cutáneas. El estudio de su evolución suele anunciar un curso severo de la enfermedad con debilidad constante, calcinosis extensa y mala respuesta al tratamiento. Conclusiones: resulta importante sistematizar los estudios relacionados con casos de alteraciones dermatológicas de la dermatomiositis juvenil, ya que la enfermedad constituye una manifestación notable, tanto como marcador de actividad como de su daño derivado. Así también, pueden coadyuvar a lograr una percepción estadística más clara de la tasa de morbilidad y su consecuente relación con los pronósticos(AU)


Introduction: Literature search established a problem to be addressed: the scarcity of case studies of juvenile dermatomyositis, which is why this research aims to shed light on this pathology, little reflected in the medical literature. Note also that systematization can serve as a bibliographic reservoir for postgraduate studies of medical specialists. Dermatomiositis juvenil. Sistematización de casos: to systematize and compare 10 cases of juvenile dermatomyositis, published in the main medical journals regarding patient's age, health history, clinical picture, complementary results, differential diagnosis, management. Dermatomiositis juvenil. Sistematización de casos: up to 30 percent of patients with juvenile dermatomyositis can present calcinosis, especially in pressure points such as elbows, knees, fingers and buttocks. Calcinosis may be present at the time of diagnosis but is usually established after 1 to 3 years and may cause the appearance of skin ulcers, decreased joint ranges, pain and local inflammation. About 10 percent of patients with juvenile dermatomyositis may have skin ulcers. The study of its evolution usually announces a severe course of the disease with constant weakness, extensive calcinosis and poor response to treatment. Conclusions: it is important to systematize the studies related to cases of dermatological alterations of juvenile dermatomyositis, since the disease constitutes a remarkable manifestation, both as a marker of activity and of its derived damage. Likewise, they can help to achieve a clearer statistical perception of the morbidity rate and its consequent relationship with prognosis(AU)


Subject(s)
Humans , Skin Ulcer/etiology , Calcinosis/diagnostic imaging , Dermatomyositis/diagnosis , Diagnosis, Differential , Joints/injuries , Dermatomyositis/epidemiology
20.
Rev. bras. ginecol. obstet ; 41(1): 59-61, Jan. 2019. graf
Article in English | LILACS | ID: biblio-1003522

ABSTRACT

Abstract Lithopedion (lithos = rock and paidion = child) is a rare condition that only occurs in 1.5 to 1.8% of extrauterine pregnancies and in 0.00045% of all pregnancies. It consists of an ectopic pregnancy in which the fetus dies but cannot be reabsorbed by the mother's body, which then coats it in a calcium-rich substance.We present the case of a 77-year-old woman with an incidental diagnosis of a lithopedion, which had been retained in her left pelvis for presumably 40 years.


Subject(s)
Humans , Female , Aged , Calcinosis/diagnostic imaging , Fetus/diagnostic imaging , Incidental Findings
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