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1.
Respirar (Ciudad Autón. B. Aires) ; 16(2): 193-197, Junio 2024.
Article in Spanish | LILACS, UNISALUD, BINACIS | ID: biblio-1556266

ABSTRACT

Introducción: La tuberculosis (TB) extrapulmonar es la afectación de cualquier órgano, sin compromiso pulmonar demostrado, como consecuencia de la diseminación hematógena/linfática del bacilo de Koch. Presentación de caso: Paciente en puerperio inmediato cursando cuadro clínico de gonalgia que se estudió con resonancia magnética que mostró lesión endomedular en región distal del fémur izquierdo. Se estudió con tomografía de tórax, abdomen y pelvis que evidenciaron otras lesiones a nivel esplénico, sin compromiso hepático ni pulmonar. Se realizó punción diagnóstica femoral con evidencia de granulomas con necrosis central. Se interpretó tuberculosis extrapulmonar y se inició tratamiento antifímico con mejora sintomática. Discusión: La TB extrapulmonar puede impactar a nivel de pleura, ganglios linfáticos, vías urinarias, sistema osteoarticular, sistema nervioso central y abdomen. En el embarazo, la prevalencia de TB extrapulmonar es baja. Conclusión: La TB femoral y esplénica concomitante en pacientes embarazadas es un hallazgo infrecuente por lo que su análisis resulta de gran importancia. Arribar al diagnóstico requiere un elevado índice de sospecha. El retraso diagnóstico conlleva a un aumento de la morbimortalidad


Introduction: Extrapulmonary tuberculosis (TB) is the involvement of any organ, without demonstrated pulmonary involvement, as a consequence of the hematogenous/lymphatic dissemination of the Koch bacillus. Case presentation: Patient in the immediate postpartum period with clinical symptoms of gonalgia that was studied with magnetic resonance imaging showing intramedullary lesion in the distal region of the left femur. A CT scan of the chest, abdomen and pelvis showed other lesions at the splenic level, without liver or lung involvement. A femoral diagnostic puncture was performed with evidence of granulomas with central necrosis. Extrapulmonary tuberculosis was interpreted and antifimic treatment was started with symptomatic improvement. Discussion: Extrapulmonary TB can impact the pleura, lymph nodes, urinary tract, osteoarticular system, central nervous system and abdomen. During pregnancy, the prevalence of extrapulmonary TB is low. Conclusion: Concomitant femoral and splenic TB in pregnant patients is a rare finding, which is why its analysis is of great importance. Arriving at a diagnosis requires a high index of suspicion. Delayed diagnosis leads to an increase in morbidity and mortalit


Subject(s)
Humans , Female , Adult , Pregnancy , Tuberculosis, Extrapulmonary/diagnosis , Mycobacterium tuberculosis , Argentina , Pleura , Splenomegaly , Biopsy , Diagnostic Imaging , Arthralgia , Diagnosis, Differential , Knee Joint/pathology
2.
J. nurs. health ; 14(2): 1425789, jun. 2024.
Article in Portuguese | LILACS, BDENF | ID: biblio-1560702

ABSTRACT

Objetivo:analisar a percepção de profissionais de enfermagem sobre a comunicação entre equipes na transferência de cuidados de pacientes para a realização de exames de imagem. Método:pesquisa exploratório-descritiva, qualitativa, realizada com 43 profissionais de enfermagem de um complexo hospitalar de Porto Alegre, entre junho e agosto de 2021. Os dados foram coletados por entrevista semiestruturada e utilizou-se Análise de Conteúdo de Minayo. Resultados:emergiram três temas: como ocorre o processo de comunicação para a transferência do paciente internado ao setor de exames; as potencialidades e fragilidades deste processo e ferramentas para qualificar a comunicação. O enfermeiro atua como articulador da comunicação, que ora ocorre utilizando ferramentase com etapas verbais/telefônicas. O sistema de notas de transferência, a dupla checagem e o readbackpossuem falhas, por não serem oficializados nem específicos. Conclusões:os profissionais consideram a comunicação verbal como a maior fragilidade e sugerem ferramentas formais para torná-la efetiva.


Objective:to analyze the perception of nursing professionals regarding communication between teams in the transfer of patient care for imaging examinations. Method:exploratory-descriptive research, qualitative, conducted with 43 nursing professionals from a hospital complex in Porto Alegre, between June and August 2021. Data were collected through semi-structured interviews and analyzed using Minayo's Content Analysis. Results: three themes emerged: how the communication process occurs for the transfer of the hospitalized patient to the examination department; the strengths and weaknesses of this process; and tools to enhance communication. The nurse acts as a communication facilitator, sometimes using tools and verbal/phone methods. The transfer note system, double-checking, and read-back have flaws because they are not formalized nor specific. Conclusions: professionals consider verbal communication the major weakness and suggest formal tools to make it more effective


Objetivo: analizar la percepción de profesionales de enfermería sobre la comunicación entre equipos al momento de transferir la atención al paciente para la realización de exámenes de imagen.Método: investigación realizada con 43 profesionales de enfermería de un complejo hospitalario de Porto Alegre, entre junio y agosto de 2021. Entrevistas semiestructuradas ocurrieron y se utilizó el análisis de contenido. Resultados: surgieron tres temas: cómo ocurre el proceso de comunicación para la transferencia delpaciente hospitalizado al departamento de exámenes; las potencialidades y debilidades de este proceso y las herramientas para cualificar la comunicación. El enfermero actúa como articulador de la comunicación, que en ocasiones ocurre mediante herramientasy pasos verbales/telefónicos. El sistema de notas de transferencia, la doble verificación y la relectura tienen fallas, pues no son oficiales ni específicos. Conclusiones: los profesionales consideran la comunicación verbal como la mayor debilidad y sugieren herramientas formales para hacerla efectiva.


Subject(s)
Health Communication , Diagnostic Imaging , Nursing , Patient Safety , Transitional Care
3.
Respirar (Ciudad Autón. B. Aires) ; 16(1): 85-92, Marzo 2024.
Article in Spanish | LILACS, UNISALUD, BINACIS | ID: biblio-1551285

ABSTRACT

El sarcoma folicular de células dendríticas (SFCD) es una neoplasia maligna rara derivada de las células dendríticas foliculares. Ha sido clasificado, dadas sus características inmunohistoquímicas, como parte del grupo de los sarcomas, donde representa un porcentaje menor al 1%. Actualmente, existen menos de 1.000 reportes en la literatura a nivel mundial, lo cual plantea una dificultad no sólo diagnóstica, siendo confundido frecuentemente con neoplasias de tipo linfoide; sino también terapéutica al no existir un claro consenso sobre su manejo definitivo. Esta revisión de caso clínico describe el primer caso reportado de SFCD en Costa Rica.


Follicular dendritic cell sarcoma (SFCD) is a rare malignant neoplasm derived from follicular dendritic cells, which has been classified, given its immunohistochemical characteristics, as part of the group of sarcomas, where it represents less than 1%. Currently, there are less than 1000 reports in the literature worldwide, which generates a difficulty not only in diagnosis, being frequently confused with lymphoid type neoplasms; but also, as therapeutic as there is no clear consensus on its definitive management. This clinical case review describes the first reported case of SFCD in Costa Rica.


Subject(s)
Humans , Female , Adult , Asthma/diagnosis , Cough/diagnosis , Dendritic Cell Sarcoma, Follicular/diagnosis , Mediastinal Neoplasms/diagnosis , Obesity/diagnosis , Biopsy , Case Reports , Diagnostic Imaging , Immunohistochemistry , Thoracotomy , Costa Rica
4.
São Paulo; s.n; 20240301. 113 p.
Thesis in Portuguese | LILACS, BBO | ID: biblio-1537496

ABSTRACT

A Periodontite Apical (PA), por ser comumente assintomática, é considerada um achado radiográfico, frequentemente encontrada em pacientes que efetuam radiografias para início ou durante tratamentos odontológicos. Entretanto, tais radiografias apresentam limitações para identificar a real extensão e destruição óssea causada pela lesão. Por isso, é indicada a realização de Tomografia Computadorizada de Feixe Cônico (TCFC). O presente estudo tem como propósito avaliar a prevalência das PA, correlacioná-las de acordo com a idade, sexo, local afetado na estrutura óssea e classificá-las de acordo como parâmetro do índice do complexo apical apresentadas em uma amostra de brasileiros, através de imagens de TCFC do banco de dados do Laboratório de Análises e Processamento de Imagens (LAPI) da Faculdade de Odontologia da Universidade de São Paulo (FOUSP). Foram analisadas 250 TCFC, utilizando o software Ondemand 3D Dental. A PA mostrou-se com prevalência maior no sexo feminino (64,53%). Em relação à localização, 232 dentes possuiam PA na maxila sendo que 140 apresentavam tratamento endodôntico satisfatório (60,34%). Na mandíbula, 96 dentes com PA, 68 apresentavam tratamento endodôntico satisfatório (70,83%). O dente mais acometido na maxila foi o 16 e na mandíbula o 46. Na comparação por sexo e condições de dentes da maxila e mandíbula, houve diferença significativa do índice R0 do dente 17, e na presença de PA no dente 25. Na mandíbula houve diferenças significativas na ausência de tratamento endodôntico do dente 42, presença de PA e índices SRD. Na análise feita por faixas etárias, não houveram diferenças significantes estatisticamente. Concluiu-se que a TCFC proporciona precisão de diagnóstico e mensurações, além de oferecer maior segurança ao cirurgião dentista.


Subject(s)
Periapical Periodontitis , Diagnostic Imaging , Cone-Beam Computed Tomography
6.
São Paulo; s.n; 20240301. 70 p.
Thesis in Portuguese | LILACS, BBO | ID: biblio-1532839

ABSTRACT

Objetivo: Esta revisão sistemática investigou se a precisão dos escaneamentos intraorais e modelos 3D com diferentes escâneres e softwares, é suficiente para os clínicos aceitarem e implementarem as novas tecnologias como critério de diagnóstico e planejamentos dos tratamentos. Material e métodos: Protocolo PROSPERO número CRD42020218151. Duas revisoras realizaram uma pesquisa avançada de banco de dados eletrônico, sem restrição de idioma ou data, no MEDLINE/PubMed; Embase; BVS/LILACS; Scopus; Cochrane Library; Google Scholar e Web of Science até janeiro de 2021. Os estudos foram escolhidos por título e resumo para triagem, de acordo com os seguintes critérios de inclusão: Estudos Clínicos in vivo e in vitro (pacientes, modelos de gesso de pacientes e manequins simulando bocas humanas) com os diferentes softwares e técnicas de escaneamento intraoral comparando a acurácia, fidelidade e/ou precisão como desfecho dos escaneamentos intraorais, dos modelos virtuais em 3D com modelos de gesso; com um mínimo de 5 pacientes escaneados sem limite de idade ou gênero; texto completo acessível; nos estudos de coorte, transversais e caso-controle. Após a leitura do texto completo os artigos foram excluídos de acordo com os seguintes critérios: 1) estudos com menos de 5 pacientes; 2) estudos em animais; 3) revisão sistemática, descrição de técnica, intervenções, protocolos; 4) escaneamentos por Ressonância Magnética ou Tomografia computadorizada; 5) estudos em que não foram utilizados scanners intraorais. Resultados. Dos 4410 estudos inicialmente identificados, 16 preencheram os critérios de inclusão. O guia PRISMA foi utilizado para redação da revisão e a ferramenta ROBINS-1 da Cochrane foi utilizada para análise de viés. Os estudos incluídos na sua maioria mostraram diferenças estatisticamente significativas entre os resultados das moldagens convencionais e digitais, porém também demonstraram que as diferenças não têm significância clínica. Conclusões: Esta revisão sistemática permitiu levantar dados que demonstraram que os escaneamentos intraorais não são superiores às moldagens convencionais, mas de acurácia equivalente com confiabilidade para o uso das imagens digitais conseguidas por escaneamento intraoral e dos modelos digitais provenientes destes escaneamentos.


Subject(s)
Diagnostic Imaging , Models, Dental , Dimensional Measurement Accuracy , Imaging, Three-Dimensional
7.
São Paulo; s.n; 20240222. 79 p.
Thesis in Portuguese | LILACS, BBO | ID: biblio-1531870

ABSTRACT

Objetivo: O objetivo deste estudo foi realizar uma revisão sistemática (RS) e metanálise para avaliar a acurácia de exames de imagem para o diagnóstico de defeitos ósseos peri-implantares em implantes de titânio (Ti) e dióxido de zircônia (ZrO2). Material e método: Seis bancos de dados online foram pesquisados. Todos os estudos selecionados foram submetidos a critérios de inclusão e exclusão. Os estudos incluídos na RS foram submetidos a avaliação de viés e aplicabilidade por meio da ferramenta QUADAS-2 e metanálise de efeito aleatório. As curvas sumárias de características de operação do receptor (sROC) foram construídas para comparar o efeito das diferenças metodológicas em relação às variáveis de cada grupo. Resultados: A estratégia de busca resultou em 719 artigos, seguindo os critérios de elegibilidade, títulos e resumos foram lidos e 61 estudos foram selecionados para leitura na íntegra, 24 dos 61 estudos foram incluídos nesta RS. A tomografia computadorizada de feixe cônico (TCFC) apresentou dados suficientes para análise quantitativa (metanálise) em implantes de ZrO2 e Ti. A metanálise revelou altos níveis de inconsistência no último grupo. Em relação às curvas sROC, a área sob a curva (AUC) foi maior para o grupo Ti global (AUC = 0,79) do que para o ZrO2 global (AUC = 0,69), mas sem diferença estatisticamente significativa entre elas. A comparação de AUCs de deiscências e defeitos de fenestração em implantes de Ti (AUC de deiscência em Ti = 0,73 e AUC de fenestração em Ti = 0,87) resultou em uma diferença estatisticamente significativa. Conclusão: A acurácia diagnóstica da TCFC na avaliação de defeitos ósseos peri-implantares ao comparar os implantes de Ti e ZrO2 foi semelhante, e o defeito de fenestração foi diagnosticado com mais precisão do que a deiscência nos implantes de Ti. Os dados coletados para analisar quantitativamente o desempenho diagnóstico de defeitos ósseos peri-implantares dos métodos de imagem RP, PAN, IRM e TC em implantes de Ti e ZrO2 não foram suficientes. Número do protocolo PROSPERO: CRD42020149678.


Subject(s)
Diagnostic Imaging , Dental Implants , Cone-Beam Computed Tomography
8.
Rev. colomb. cir ; 39(1): 70-84, 20240102. tab, fig
Article in Spanish | LILACS | ID: biblio-1526809

ABSTRACT

Introducción. La evaluación de la movilidad de las cuerdas vocales en cirugía de tiroides y paratiroides hace parte de la adecuada valoración integral. Aunque la laringoscopia directa es prueba de referencia, su uso real no es rutinario por lo que se propone la ecografía translaríngea como alternativa de evaluación. Métodos. Estudio prospectivo de evaluación de una prueba diagnóstica de la movilidad de las cuerdas vocales pre y posoperatoria, comparando la ecografía translaríngea con la video laringoscopia, en pacientes con cirugía de tiroides y paratiroides, de febrero 1° a noviembre 30 de 2022. Se describieron las variables usando frecuencias absolutas y relativas. En el análisis univariado se calcularon Chi cuadrado y T de Student y en el bivariado, regresión logística binaria. La agudeza diagnóstica se determinó con sensibilidad, especificidad y valores predictivos; se consideró la significancia estadística con p < 0,05. Resultados. Se incluyeron 267 pacientes, 219 mujeres y 48 hombres; 196 pacientes (73,4%) tenían malignidad. Se encontró en el preoperatorio, sensibilidad 100 %, especificidad 99,6 %, VPP 83,3 %, VPN 100 %, odds de probabilidad positiva 83 % y Odds de probabilidad negativa 0,004 %. En el posoperatorio, sensibilidad 82,8 %, especificidad 99,2 %, VPP 92,3 % VPN 97,9 %, odds de probabilidad positiva 92 % y odds de probabilidad negativa 0,2 %. Conclusiones. La ecografía translaríngea en nuestro medio tiene alta agudeza diagnóstica. Podría ser usada en el abordaje inicial de la evaluación de la movilidad de las cuerdas vocales y reemplazar la laringoscopia directa, dejando ésta para cuando la visualización ecográfica no sea adecuada, o en casos de afectación o sospecha de invasión, para su confirmación.


Introduction. The evaluation of the mobility of the vocal cords in thyroid and parathyroid surgery is part of the adequate comprehensive assessment. Altough, direct laryngoscopy is the gold standard, its real use is not routine, so translaryngeal ultrasound approach is proposed as an alternative. Methods. A prospective diagnostic test study was carried out to evaluate the translaryngeal ultrasound compared with video laryngoscopy in visualizing vocal mobility in patients with thyroid and parathyroid surgery from February 1 to November 30, 2022. Patients were described using absolute and relative frequencies. Univariate statistical analysis with Chi-square and Student's t tests. T. Bivariate analysis using binary logistic regression. Diagnostic acuity was calculated with sensitivity, specificity, PPV, NPV. Statistical significance with p< 0.05, 95% confidence interval. Results. 267 patients undergoing thyroid or parathyroid surgery were included, 219 women and 48 men. Malignant: thyroid neoplasm 196 patients (73.4%). The findings were for the preoperative period, 100% sensitivity, 99.6% specificity, PPV 83.33%, NPV 100%, 83% positive probability odds, and 0.004% negative probability odds. For the postoperative period, 82.8% sensitivity, 99.2% specificity, 92.3% PPV, 97.9% NPV, 92% positive probability odds, and 0.2% negative probability odds were found.Conclusions. Translaryngeal ultrasound in our series has high diagnostic acuity. It could be used as the initial approach to evaluate vocal mobility and might replace direct laryngoscopy, leaving it when its visualization is not adequate or in cases of involvement or suspected invasion for confirmation.


Subject(s)
Humans , Thyroid Diseases , Vocal Cords , Diagnostic Imaging , Thyroid Gland , Ultrasonography , Larynx
9.
Acta Medica Philippina ; : 1-8, 2024.
Article in English | WPRIM | ID: wpr-1013409

ABSTRACT

Background and Objectives@#The Philippines faces challenges in the screening of tuberculosis (TB), one of them being the shortage in the health workforce who are skilled and allowed to screen TB. Deep learning neural networks (DLNNs) have shown potential in the TB screening process utilizing chest radiographs (CXRs). However, local studies on AIbased TB screening are limited. This study evaluated qXR3.0 technology's diagnostic performance for TB screening in Filipino adults aged 15 and older. Specifically, we evaluated the specificity and sensitivity of qXR3.0 compared to radiologists' impressions and determined whether it meets the World Health Organization (WHO) standards.@*Methods@#A prospective cohort design was used to perform a study on comparing screening and diagnostic accuracies of qXR3.0 and two radiologist gradings in accordance with the Standards for Reporting Diagnostic Accuracy (STARD). Subjects from two clinics in Metro Manila which had qXR 3.0 seeking consultation at the time of study were invited to participate to have CXRs and sputum collected. Radiologists' and qXR3.0 readings and impressions were compared with respect to the reference standard Xpert MTB/RiF assay. Diagnostic accuracy measures were calculated. @*Results@#With 82 participants, qXR3.0 demonstrated 100% sensitivity and 72.7% specificity with respect to the reference standard. There was a strong agreement between qXR3.0 and radiologists' readings as exhibited by the 0.7895 (between qXR 3.0 and CXRs read by at least one radiologist), 0.9362 (qXR 3.0 and CXRs read by both radiologists), and 0.9403 (qXR 3.0 and CXRs read as not suggestive of TB by at least one radiologist) concordance indices. @*Conclusions@#qXR3.0 demonstrated high sensitivity to identify presence of TB among patients, and meets the WHO standard of at least 70% specificity for detecting true TB infection. This shows an immense potential for the tool to supplement the shortage of radiologists for TB screening in the country. Future research directions may consider larger sample sizes to confirm these findings and explore the economic value of mainstream adoption of qXR 3.0 for TB screening.


Subject(s)
Tuberculosis , Diagnostic Imaging , Deep Learning
10.
Braz. j. oral sci ; 23: e242840, 2024. ilus
Article in English | LILACS, BBO | ID: biblio-1553448

ABSTRACT

Aim: To evaluate the influence of notebook computers screens and undergraduate level of dental students in the radiographic detection of carious lesions. Methods: Bitewing digital radiographs were presented to 3rd and 5th year dental students in three different notebooks computers: Notebook 1 with anti-glare screen (1366×768 pixels), Notebook 2 without anti-glare screen (1366×768 pixels), and Notebook 3 with anti-glare screen (1920×1080 pixels). A reference standard based on a consensus analysis was set by three senior professors of Oral Radiology and Cariology. Sensitivity, specificity and accuracy values were measured and submitted to two-way ANOVA at a significance level of 5%. Results: Notebook 2 provided significantly lower sensitivity values (Mean 56.5% ± 2.94) than notebook 3 (71.1% ± 2.82) (p = 0.002). We found no statistically significant differences between the two undergraduate years (p > 0.05). Conclusion: The anti-glare screen of notebook computers screens can influence the radiographic detection of carious lesions, but the undergraduate level of dental students does not influence this diagnostic task


Subject(s)
Students, Dental , Computers , Diagnostic Imaging , Radiography, Dental, Digital , Dental Caries
11.
Respirar (Ciudad Autón. B. Aires) ; 15(4): 285-290, Diciembre 2023.
Article in Spanish | LILACS, UNISALUD, BINACIS | ID: biblio-1518706

ABSTRACT

Presentamos el caso de un niño de 12 años que consultó por hemoptisis, sin otros sín- tomas asociados. Se realizó radiografía de tórax (patológica), laboratorio con aumen- to moderado de reactantes de fase aguda, PPD (negativa), esputos x 3 con bacilosco- pias negativas y tomografía de tórax con contraste i.v. que mostró imágenes de árbol en brote en todos los lóbulos y una imagen de dilatación vascular de una rama de la ar- teria pulmonar en lóbulo superior izquierdo. Se plantearon diagnósticos diferenciales: malformación vascular primaria o lesión secundaria a infección. La angiografía digital permitió confirmar el pseudoaneurisma y embolizarlo. Luego de 17 días, 2/3 cultivos de esputo fueron positivos para Mycobacterium tuberculosis. El niño realizó tratamiento antituberculoso con drogas de primera línea con evolución clínica favorable. Este caso resalta la importancia de considerar el pseudoaneurisma de Rasmussen en- tre las posibles complicaciones de un paciente con tuberculosis y hemoptisis recurren- te o masiva.


We present the case of a 12-year-old boy admitted to the hospital due to hemoptysis without other symptoms. We performed a Thorax X-Ray (pathological), laboratory with elevated acute phase reactants, TST (negative), sputum x 3 with negative smear and computed tomography angiography showing a tree-in-bud pattern in all lobes, and di-latation of a brunch of the pulmonary artery in the upper left lobe. We considered pri-mary vascular anomaly or lesion due to infection as a differential diagnosis. The patient underwent digital angiography and therapeutic embolization of this pseudoaneurysm. After seventeen days, 2/3 of the sputum cultures were positive for Mycobacterium tu-berculosis. The patient received standard anti-TB therapy with favorable evolution. This case highlights the importance of considering complications such as Rasmussen's pseudoaneurysm in patients with pulmonary tuberculosis and recurrent or massive hemoptysis.


Subject(s)
Humans , Male , Child , Tuberculosis, Pulmonary/diagnosis , Aneurysm, False/complications , Hemoptysis/diagnosis , Mycobacterium tuberculosis , Bronchoscopy , Tuberculin Test , Diagnostic Imaging , Angiography, Digital Subtraction , Embolization, Therapeutic , Antitubercular Agents/therapeutic use
13.
Rev. argent. coloproctología ; 34(3): 22-26, sept. 2023. ilus
Article in Spanish | LILACS | ID: biblio-1552478

ABSTRACT

Un plastrón apendicular es una masa apendicular palpable que contiene el apéndice inflamado, vísceras adyacentes y el omento mayor, asociado a o no a la presencia de pus. El manejo del plastrón apendicular abscedado es controvertido. Cuando hay signos de sepsis asociados, la indicación es una intervención quirúrgica de urgencia, de lo contrario puede optarse por un tratamiento conservador. La utilización de drenaje percutáneo tiene una alta tasa de efectividad, aunque la tasa de neoplasias no detectadas presenta un porcentaje no despreciable, especialmente en los pacientes mayores de 40 años. El objetivo de esta presentación es comunicar una paciente de 65 años con diagnóstico presuntivo de plastrón apendicular abscedado quien luego del fracaso de los drenajes percutáneos fue sometida a una laparotomía exploratoria y hemicolectomía derecha. El diagnóstico histopatológico fue de adenocarcinoma mucinoso del apéndice. (AU)


A palpable inflammatory appendiceal mass may contain the inflamed appendix, adjacent viscera, and the greater omentum, associated or not with the presence of pus. The management of an inflammatory appendiceal mass is controversial. When there are associated signs of sepsis, the indication is emergency surgery, otherwise, you can opt for a conservative treatment. The use of percutaneous drainage has a high rate of effectiveness, although the rate of undetected neoplasia is not negligible, especially in patients older than 40 years. We present the case of a 65-year-old female patient with a presumptive diagnosis of an appendiceal mass with abscess, who underwent exploratory laparotomy and right hemicolectomy after percutaneous drainage failure. The histopathological diagnosis was mucinous adenocarcinoma of the appendix. (AU)


Subject(s)
Humans , Female , Aged , Appendiceal Neoplasms/pathology , Appendicitis/surgery , Appendicitis/diagnosis , Appendectomy , Diagnostic Imaging , Colectomy , Adenocarcinoma, Mucinous , Abdominal Abscess
14.
Femina ; 51(8): 497-501, 20230830. ilus
Article in Portuguese | LILACS | ID: biblio-1512463

ABSTRACT

O presente estudo tem como objetivo relatar o caso de uma paciente com malformação arteriovenosa uterina, efetivamente tratada com embolização seletiva e com fertilidade preservada. A malformação arteriovenosa uterina é uma alteração vascular rara até então pouco descrita na literatura. A paciente do sexo feminino apresentou quadro de sangramento uterino anormal, com início 30 dias após um abortamento, sem realização de curetagem, de uma gestação resultante de fertilização in vitro. Foram, então, realizados exames de imagem, que levaram ao diagnóstico de malformação arteriovenosa uterina. O tratamento de escolha foi a embolização arterial seletiva, com resolução do caso. Após sete meses, nova fertilização in vitro foi realizada, encontrando-se na 36a semana de gestação. São necessários mais estudos sobre essa malformação a fim de que sejam estabelecidos os métodos mais eficazes para o manejo de casos futuros, especialmente quando há desejo de gestar.


The present study aims to report the case of a patient with uterine arteriovenous malformation, effectively treated with selective embolization and with preserved fertility. Uterine arteriovenous malformation is a rare vascular disorder that has so far been rarely described in the literature. Female patient presented with abnormal uterine bleeding, starting 30 days after an abortion without subsequent curettage, of a pregnancy resulting from in vitro fertilization. Imaging tests were then performed that led to the diagnosis of uterine arteriovenous malformation. The treatment of choice was selective arterial embolization, with successful results. After seven months, a new in vitro fertilization was performed, being in the 36th week of pregnancy. Further studies on this pathology are needed in order to establish the most effective methods for the management of future cases, especially when there is a desire to become pregnant.


Subject(s)
Humans , Female , Pregnancy , Adult , Arteriovenous Malformations/drug therapy , Arteriovenous Malformations/diagnostic imaging , Uterine Hemorrhage/drug therapy , Uterus/diagnostic imaging , Case Reports , Diagnostic Imaging , Women's Health , Endometritis/drug therapy , Uterine Artery Embolization/instrumentation , Adenomyosis/drug therapy , Gynecology , Infertility, Female/complications , Obstetrics
15.
Rev. bras. ortop ; 58(2): 179-190, Mar.-Apr. 2023. tab, graf
Article in English | LILACS | ID: biblio-1449801

ABSTRACT

Abstract The evolution in imaging evaluation of musculoskeletal sarcomas contributed to a significant improvement in the prognosis and survival of patients with these neoplasms. The precise characterization of these lesions, using the most appropriate imaging modalities to each clinical condition presented, is of paramount importance in the design of the therapeutic approach to be instituted, with a direct impact on clinical outcomes. The present article seeks to update the reader regarding imaging methodologies in the context of local and systemic evaluation of bone sarcomas and soft tissues.


Resumo A evolução na avaliação por imagens dos sarcomas musculoesqueléticos contribuiu para melhora significativa no prognóstico e na sobrevida dos portadores destas neoplasias. A caracterização precisa destas lesões, mediante utilização das modalidades de imagem mais adequadas a cada condição clínica apresentada, é de suma importância no delineamento da abordagem terapêutica a ser instituída, com impacto direto sobre os desfechos clínicos. O presente artigo busca atualizar o leitor a propósito das metodologias de imagem no contexto da avaliação local e sistêmica dos sarcomas ósseos e das partes moles.


Subject(s)
Humans , Sarcoma/radiotherapy , Diagnostic Imaging , Neoplasms, Bone Tissue/diagnosis , Multimodal Imaging
16.
Braz. j. oral sci ; 22: e237798, Jan.-Dec. 2023. il
Article in English | LILACS, BBO | ID: biblio-1434019

ABSTRACT

Aim: To evaluate the prevalence of soft tissue calcifications in orofacial region and their panoramic radiographic characteristics using digital panoramic radiographs among patients reporting to a tertiary dental hospital. Methods: 1,578 digital panoramic radiographs were retrieved from the archives and scrutinized for the presence of calcifications. Soft tissue calcifications were recorded according to age, gender, site (left or right). Data were analysed using Chi-square and Fisher's exact test using SPSS software and a p < 0.05 was considered statistically significant. Results: Among the total number of radiographs, calcified carotid artery (34.3%), calcified stylohyoid ligament (21%), tonsillolith (10.3%), phlebolith (17.6%), antrolith (6.3%), sialolith (5.9%), rhinolith (2.5%) and calcified lymph nodes (1.9%) were identified. The most commonly observed calcifications were calcification of carotid artery and stylohyoid ligament and the least commonly observed calcifications were rhinolith and calcified lymph node. A statistically significant association of the presence of calcifications of carotid artery and stylohyoid ligament on the left and right side was observed in females and tonsillolith on the right side in males (p-value < 0.05). Considering the gender and age group, the occurrence of antrolith among males and rhinolith among females of young-adult population, tonsillolith among the males, calcified carotid artery and stylohyoid ligament among the females of middle-aged population was found to be significant. Conclusion: Soft tissue calcifications are often encountered in dental panoramic radiographs. Our study revealed that the soft tissue calcifications in orofacial region were more common in women and were found to be increased above 40 years of age


Subject(s)
Humans , Male , Female , Prune Belly Syndrome , Calcinosis/epidemiology , Diagnostic Imaging , Radiography, Panoramic , Plaque, Atherosclerotic
17.
São Paulo; s.n; 2023. 69 p. ilus, tab.
Thesis in Portuguese | LILACS, Inca | ID: biblio-1434417

ABSTRACT

INTRODUÇÃO: Em menos de duas décadas, a imunoterapia consolidou-se como um dos pilares do tratamento do câncer. Apesar da sua potencial elevada eficácia e resposta duradoura, a proporção de pacientes que apresentam resposta objetiva é relativamente baixa e existem poucos biomarcadores para selecionar os pacientes com maior potencial de resposta. OBJETIVO: Nossa hipótese era de que era possível avaliar globalmente o sistema imune do paciente através da mensuração por imagem do timo e do baço e usar essas métricas como fator prognóstico e preditivo de resposta a bloqueadores de checkpoint. RESULTADOS: Os principais resultados foram: 1) As medidas tímicas não se correlacionam com a sobrevida em pacientes tratados com imunoterapia; 2) Há aumento do volume esplênico após o uso de imunoterapia na maior parte dos pacientes, mas o grau de aumento não se correlaciona com resposta à terapia; 3) Maior volume esplênico está associado a pior sobrevida livre de progressão em pacientes com melanoma tratados com imunoterapia, mas essa correlação não pôde ser replicada em outros tipos tumorais. CONCLUSÃO: a espessura tímica não se correlaciona com desfechos clínicos em pacientes oncológicos tratados com imunoterapia. Menor volume esplênico antes de iniciar imunoterapia está relacionada a melhor prognóstico em pacientes com melanoma, mas não em outros tipos tumorais.


INTRODUCTION: In less than two decades, immunotherapy has established itself as one of the pillars of cancer treatment. Despite its potentially high efficacy and long-lasting response, the proportion of patients who have an objective response is relatively low and there are few biomarkers to select patients with the greatest response potential. OBJECTIVE: Our hypothesis was that it was possible to assess the patient's immune system globally by measuring the thymus and spleen by imaging and using these metrics as a prognostic and predictive factor of response to immune checkpoint inhibitors. RESULTS: The main results were: 1) Thymic measurements do not correlate with survival in patients treated with immunotherapy; 2) There is an increase in splenic volume after the use of immunotherapy in most patients, but the degree of increase does not correlate with response to therapy; 3) Greater splenic volume is associated with worse progression free survival in patients with melanoma treated with immunotherapy, but this correlation could not be replicated in other tumor types. CONCLUSION: thymic thickness does not correlate with clinical outcomes in cancer patients treated with immunotherapy. Smaller splenic volume before starting immunotherapy is associated with better prognosis in patients with melanoma, but not other tumor types


Subject(s)
Humans , Male , Female , Splenomegaly , Diagnostic Imaging , Immunotherapy , Spleen , Thymus Gland , Biomarkers , Immune System , Neoplasms/therapy
18.
Chinese Journal of Medical Instrumentation ; (6): 272-277, 2023.
Article in Chinese | WPRIM | ID: wpr-982227

ABSTRACT

OBJECTIVE@#In order to solve the technical problems, clinical researchers face the process of medical imaging analysis such as data labeling, feature extraction and algorithm selection, a medical imaging oriented multi-disease research platform based on radiomics and machine learning technology was designed and constructed.@*METHODS@#Five aspects including data acquisition, data management, data analysis, modeling and data management were considered. This platform provides comprehensive functions such as data retrieve and data annotation, image feature extraction and dimension reduction, machine learning model running, results validation, visual analysis and automatic generation of analysis reports, thus an integrated solution for the whole process of radiomics analysis has been generated.@*RESULTS@#Clinical researchers can use this platform for the whole process of radiomics and machine learning analysis for medical images, and quickly produce research results.@*CONCLUSIONS@#This platform greatly shortens the time for medical image analysis research, decreasing the work difficulty of clinical researchers, as well as significantly promoting their working efficiency.


Subject(s)
Machine Learning , Diagnostic Imaging , Algorithms , Radiography
19.
Chinese Journal of Medical Instrumentation ; (6): 74-79, 2023.
Article in Chinese | WPRIM | ID: wpr-971307

ABSTRACT

As imaging technology develops rapidly, dynamic and static guided technology is widely used in many medical fields now. In order to improve the success rate, reduce surgical complications and improve future prognosis, domestic and foreign experts have introduced digital navigation technology into apical surgery. With the help of digital navigation technology, apical lesions can be easily located and the scope of osteotomy can be limited, which can make the surgery be completed accurately, especially in complex clinical cases. This study overviews the clinical use and research progress of dynamic and static guided technology in apical surgery, summarizes the advantages and disadvantages of this technique as well as looks forward to its future.


Subject(s)
Technology , Endodontics , Diagnostic Imaging
20.
Chinese Journal of Lung Cancer ; (12): 31-37, 2023.
Article in Chinese | WPRIM | ID: wpr-971176

ABSTRACT

Non-small cell lung cancer (NSCLC) can be detected with enlarged lymph nodes on imaging, but their benignity and malignancy are difficult to determine directly, making it difficult to stage the tumor and design radiotherapy target volumes. The clinical diagnosis of malignant lymph nodes is often based on the short diameter of lymph nodes ≥1 cm or the maximum standard uptake value ≥2.5, but the sensitivity and specificity of these criteria are too low to meet the clinical needs. In recent years, many advances have been made in diagnosing benign and malignant lymph nodes using other imaging parameters, and with the development of radiomics, deep learning and other technologies, models of mining the image information of enlarged lymph node regions further improve the diagnostic accuracy. The purpose of this paper is to review recent advances in imaging-based diagnosis of benign and malignant enlarged lymph nodes in NSCLC for more accurate and noninvasive assessment of lymph node status in clinical practice.
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Subject(s)
Humans , Carcinoma, Non-Small-Cell Lung/pathology , Diagnostic Imaging , Lung Neoplasms/pathology , Lymph Nodes/pathology , Sensitivity and Specificity
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