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1.
In. Soeiro, Alexandre de Matos; Leal, Tatiana de Carvalho Andreucci Torres; Accorsi, Tarso Augusto Duenhas; Gualandro, Danielle Menosi; Oliveira Junior, Múcio Tavares de; Caramelli, Bruno; Kalil Filho, Roberto. Manual da residência em cardiologia / Manual residence in cardiology. Santana de Parnaíba, Manole, 2 ed; 2022. p.921-927, ilus, tab.
Monography in Portuguese | LILACS | ID: biblio-1353766
3.
Rev. colomb. cardiol ; 28(2): 197-199, mar.-abr. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1341284

ABSTRACT

Al editor: Clásicamente se ha considerado la amiloidosis cardiaca como una afección rara, con un amplio espectro de síntomas que requiere un alto índice de sospecha. Sin embargo, los estudios han demostrado que la amiloidosis cardiaca por transtiretina (TTR) es más común de lo que previamente se creía1,2. Las características clínicas que se han asociado a la amiloidosis cardiaca por TTR son el sexo masculino, la edad avanzada, la hipertrofia concéntrica y la función ventricular izquierda preservada1. Se realizó un análisis descriptivo retrospectivo de las gammagrafías solicitadas en nuestro centro para descartar amiloidosis cardiaca por TTR desde septiembre de 2016 hasta noviembre de 2019. En dicho periodo se realizaron 39 gammagrafías, con una tendencia al alza en los últimos meses. Los objetivos fueron evaluar las gammagrafías solicitadas y conocer el porcentaje de gammagrafías diagnósticas de amiloidosis por TTR, establecer qué características son más frecuentes en los pacientes con amiloidosis por TTR en nuestra población de referencia y analizar las características diferenciales de las distintas posibilidades diagnósticas. Del total de las pruebas, 22 (56.4% de la muestra) mostraron una captación de grado 2-3 de Perugini, diagnóstica de amiloidosis por TTR. De acuerdo con las recomendaciones de diagnóstico no invasivo de amiloidosis cardiaca por TTR3, se descartó la presencia de pico monoclonal. Únicamente se realizó estudio genético a 10 pacientes, en dos de los cuales se detectó una mutación patogénica (Val50Met y variante patogénica c.290C>A en heterocigosis); los ocho restantes no mostraron mutaciones en el estudio molecular del gen TTR.


Subject(s)
Humans , Male , Aged, 80 and over , Amyloidosis , Prealbumin , Radionuclide Imaging , Diagnosis
5.
Article in English | AIM, AIM | ID: biblio-1342407

ABSTRACT

The ingestion of smoked foods has been linked to the development of cancer. Polycyclic aromatic hydrocarbons have been recognized as carcinogenic compounds which contaminate smoked foods; their ingestion has been linked to the development of cancers such as breast cancer. Breast cancer may be evaluated using the nuclear bone scan as an imaging modality. This study reviewed bone scan results of patients with a positive history of consumption of smoked foods who presented at a Nuclear Medicine facility in South-West Nigeria. Our results show a significant association between a positive history of consumption of smoked foods and the presence of advanced breast cancer on the bone scan ((χ2 = 11.190, p = 0.001, df = 2; Crude Odds Ratio (95% CI) = 1.692 (1.242-2.304). Thus, those patients with a history of eating smoked foods have between 50-100% increase in the risk of having abnormal scan findings. In a logistic regression, this association was retained (AOR=0.591 (0.434-0.805). Recommendations are made to address the significance of these findings


Subject(s)
Humans , Polycyclic Aromatic Hydrocarbons , Nuclear Medicine , Breast Neoplasms , Radionuclide Imaging , Food
6.
Article in English | WPRIM | ID: wpr-879947

ABSTRACT

Neuroendocrine tumors are a type of heterogeneous tumors originating from neuroendocrine cells derived from the neural crest,which can secrete a variety of amines and peptide hormones.Based on different molecular biomarkers,histologic types and differentiation degrees,individualized nuclear imaging can provide information for the early diagnosis,clinical staging,treatment guidance,and detection of the recurrence and metastasis of neuroendocrine tumor. In this paper,we review the development and application of nuclear medicine molecular imaging probes such as glucose analogs,somatostatin analogues,amine precursors,hormone analogs and enzyme inhibitors in the diagnosis and treatment of neuroendocrine tumors.


Subject(s)
Diagnostic Imaging , Humans , Molecular Probes , Neoplasm Recurrence, Local , Neuroendocrine Tumors/diagnostic imaging , Radionuclide Imaging
7.
Article in Chinese | WPRIM | ID: wpr-879846

ABSTRACT

OBJECTIVE@#To study the clinical features of vesicoureteral reflux (VUR) in children with neurogenic bladder (NB), and to provide a reference for its early diagnosis and treatment.@*METHODS@#Clinical data were collected from 26 children with NB and urinary tract infection who were admitted to the Department of Pediatric Nephrology from January 2014 to December 2019. According to the presence or absence of VUR, the children were divided into a VUR group with 11 children and a non-VUR group with 15 children. Clinical features were compared between the two groups.@*RESULTS@#Compared with the non-VUR group, the VUR group had a significantly higher proportion of children with non-@*CONCLUSIONS@#When NB children have the clinical manifestations of non-


Subject(s)
Child , Creatinine , Humans , Infant , Radionuclide Imaging , Urinary Bladder, Neurogenic/etiology , Urinary Tract Infections/etiology , Vesico-Ureteral Reflux/diagnostic imaging
8.
Rev. colomb. reumatol ; 27(supl.2): 102-108, oct.-dic. 2020. graf
Article in Spanish | LILACS | ID: biblio-1341345

ABSTRACT

RESUMEN El diagnóstico del síndrome de Sjögren se basa en los criterios del consenso americano y europeo (AECG), sin embargo, en muchas oportunidades no se alcanza a detectar el compromiso glandular o extraglandular. Presentamos la evidencia de la utilidad de la gammagrafía con los análogos de somatostatina radiomarcados como prueba novedosa en el acercamiento diagnóstico al compromiso glandular y extraglandular del síndrome de Sjögren.


ABSTRACT Sjögren syndrome is diagnosed using American European Consensus Group (AECG) criteria, although frequently these criteria are not enough to detect the glandular and extra-glandular compromise. Evidence is presented on the use of whole body somatostatin scintigraphy as a novel probe in the diagnostic approach to the glandular and extra-glandular compromise in Sjögren s syndrome.


Subject(s)
Humans , Somatostatin , Sjogren's Syndrome , Diagnosis , Radionuclide Imaging , Consensus , Molecular Imaging
9.
Arch. cardiol. Méx ; 90(3): 259-265, Jul.-Sep. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1131042

ABSTRACT

Resumen Antecedentes y objetivo: La amiloidosis cardíaca es una entidad que permanece infradiagnosticada, a pesar de los avances recientes en su diagnóstico y tratamiento. El objetivo de este estudio es revisar una serie de casos de amiloidosis cardíaca para describir los principales datos clínicos y los hallazgos en las pruebas de imagen. Materiales y métodos: Estudio retrospectivo de pacientes con diagnóstico principal o secundario de amiloidosis cardíaca en los informes de alta de pacientes hospitalizados en este centro desde 2006 hasta 2016. Se revisaron los datos clínicos de los pacientes, así como las pruebas de imagen (ECG, ecocardiograma, gammagrafía cardíaca, resonancia magnética cardíaca). Se realizó seguimiento de los pacientes hasta enero de 2018. Resultados: Se analiza a 30 pacientes (20 varones) con media de 65 años. Los principales datos ecocardiográficos fueron dilatación biauricular, disfunción diastólica e hipertrofia ventricular izquierda (HVI) en un 97%. Sólo el 6.7% cumplía criterios de HVI en el electrocardiograma. Hasta un 33% tenía disfunción sistólica. Se realizó gammagrafía y resonancia magnética cardíaca en un 33%. La supervivencia a los 12 meses fue de 61%. Conclusión: La presencia de insuficiencia cardíaca, fibrilación auricular o trastornos de conducción junto a datos ecocardiográficos indicativos debe alertar al clínico. Otros datos como disfunción sistólica o sexo femenino no deben disminuir la sospecha. El estudio debe completarse con gammagrafía y resonancia magnética cardíaca, ya que el diagnóstico temprano tiene implicaciones pronósticas y terapéuticas.


Abstract Background and objective: Cardiac amyloidosis is an entity that remains underdiagnostic, despite recent advances in its diagnosis and treatment. The aim of this study is to review a series of diagnosed cases of cardiac amyloidosis to describe the main clinical data and the findings in the imaging tests. Materials and methods: Retrospective study of patients with primary or secondary diagnosis of cardiac amyloidosis in discharge reports of patients hospitalized in our center from 2006 to 2016. The clinical data of the patients were reviewed, as well as the imaging tests (ECG, echocardiogram, cardiac scintigraphy, cardiac magnetic resonance). Patients were followed until January 2018. Results: We analyze 30 patients (20 men) with an average of 65 years. The main echocardiographic data were biatrial dilatation, diastolic dysfunction and left ventricular hypertrophy (LVH) in 97%. Only 6.7% met criteria for LVH in the electrocardiogram. Up to 33% had systolic dysfunction. Scintigraphy and cardiac magnetic resonance were performed in 33%. Survival at 12 months was 61%. Conclusion: The presence of heart failure, atrial fibrillation or conduction disorders with suggestive echocardiographic data should alert the clinician. Other data such as systolic dysfunction or female sex should not decrease the suspicion. The study should be completed with gammagraphy and cardiac magnetic resonance since early diagnosis has prognostic and therapeutic implications.


Subject(s)
Humans , Male , Female , Aged , Heart Diseases/diagnosis , Amyloidosis/diagnosis , Magnetic Resonance Imaging , Echocardiography , Radionuclide Imaging , Retrospective Studies , Follow-Up Studies , Electrocardiography , Heart Diseases/physiopathology , Amyloidosis/physiopathology
10.
Rev. Assoc. Med. Bras. (1992) ; 66(3): 345-352, Mar. 2020. graf
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-1136196

ABSTRACT

SUMMARY Cardiac amyloidosis is an infiltrative disease which requires a high degree of clinical suspicion for appropriate diagnosis. Early diagnosis and the definition of the type of amyloidosis play a key role in the early treatment and prognosis of this disease. In this context, the use of cardiac biomarkers such as troponins and NT-proBNT associated with analysis by multimodality imaging methods like echocardiographic techniques such as strain, nuclear medicine, and cardiovascular resonance imaging have an increasing role in patients with cardiac amyloidosis. This article details the role of non-invasive diagnostic methods in patients with cardiac amyloidosis.


RESUMO A amiloidose cardíaca é uma doença infiltrativa que exige um alto grau de suspeição clínica para o diagnóstico apropriado. O diagnóstico precoce e a definição do subtipo de amiloidose têm um papel fundamental para a terapêutica e prognóstico desta doença. Nesse contexto, o emprego de biomarcadores cardíacos como as troponinas e NT-proBNT associados à análise por métodos de imagem multimodalidade por técnicas ecocardiográficas atuais como o strain, medicina nuclear e a ressonância magnética cardíaca têm papel crescente em pacientes com amiloidose. Este artigo detalha a utilização dos métodos não invasivos para a avaliação de pacientes com amiloidose cardíaca.


Subject(s)
Humans , Amyloidosis/diagnosis , Prognosis , Echocardiography , Magnetic Resonance Spectroscopy , Biomarkers , Radionuclide Imaging , Tomography, X-Ray Computed
13.
Rev. chil. endocrinol. diabetes ; 13(4): 150-153, 2020. ilus
Article in Spanish | LILACS | ID: biblio-1123620

ABSTRACT

Los adenomas hipofisarios ectópicos (EPA) constituyen un reto diagnóstico, dada su escasa prevalencia y variada presentación en la que puede incluirse un síndrome de hipersecreción de hormonas hipofisarias. La clínica suele ser larvada e inespecífica, no presentan ninguna característica radiológica diferencial y el diagnóstico habitualmente es anatomopatológico. Sin embargo, a pesar de ser tumores benignos, pueden presentar un comportamiento agresivo, con invasión ósea y difícil resección completa, por lo que un diagnóstico de sospecha precoz podría resultar en un tratamiento más eficaz y con un menor número de complicaciones. Presentamos el caso de una paciente con un adenoma hipofisario ectópico silente en el seno esfenoidal con inmunohistoquímica positiva para Hormona de crecimiento (GH) y prolactina que presentaba restos tumorales tras la intervención quirúrgica y ha sido manejada con tratamiento médico conservado, con buenos resultados.


Ectopic pituitary adenomas constitute a diagnostic challenge, given their low prevalence and varied presentation in which a pituitary hormone hypersecretion syndrome may be included. Clinical symptoms are usually latent and nonspecific, they have no differential radiological characteristics and the diagnosis is usually anatomopathological. However, despite being benign tumors, they can exhibit aggressive behavior, with bone invasion and difficult complete resection, so a diagnosis of early suspicion could result in more effective treatment and fewer complications. We present the case of a patient with a silent ectopic pituitary adenoma in the sphenoid sinus with positive immunohistochemistry for Growth Hormone (GH) and prolactin who had tumor remnants after surgery and was managed with conservative medical treatment, with good results.


Subject(s)
Humans , Female , Aged , Pituitary Neoplasms/diagnosis , Pituitary Neoplasms/drug therapy , Sphenoid Sinus , Adenoma/diagnosis , Adenoma/drug therapy , Postoperative Period , Prolactin/metabolism , Growth Hormone/metabolism , Immunohistochemistry , Magnetic Resonance Imaging , Radionuclide Imaging , Tomography, X-Ray Computed , Dopamine Agonists/therapeutic use , Cabergoline/therapeutic use
16.
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1291283

ABSTRACT

El trasplante renal es el tratamiento de elección para la enfermedad renal terminal. Pueden presentarse diversas complicaciones médicas y quirúrgicas posteriores, entre ellas las vasculares (trombosis/estenosis de la vena y/o arteria renal) que son poco frecuentes y resultan en la pérdida del injerto. Presentamos el caso de un paciente masculino que al tercer día posterior al trasplante persisten con anuria y elevación de azoados, realizándose renograma con 99m - Tc MAG3 con hallazgos compatibles de trombosis vascular.


Kidney transplantation is the treatment of choice for end-stage renal disease. Various medical and surgical complications can occur later, among them the vascular ones (thrombosis/stenosis of the vein and/or renal artery) that are infrequent and result in the loss of the graft. We present the case of a male patient who persisted with anuria and azoate elevation on the third day after transplantation, performing a renogram with 99m - Tc MAG3 with compatible findings of vascular thrombosis.


Subject(s)
Humans , Male , Adult , Renal Artery/pathology , Renal Veins/pathology , Technetium Tc 99m Mertiatide , Venous Thrombosis/diagnostic imaging , Radionuclide Imaging
17.
Article in Spanish | LILACS, UY-BNMED | ID: biblio-1291282

ABSTRACT

Se presenta el caso de un paciente con antecedente de adenocarcinoma de próstata y diagnóstico de ACV isquémico con transformación hemorrágica. La gammagrafía ósea con Tc-99m MDP complementada con SPECT e imágenes de fusión con TC cerebral simple, realizada a los 15 días, muestra hipercaptación en la región temporal izquierda, correspondiente al ACV en etapa subaguda.


We present the case of a patient with a history of prostate adenocarcinoma with a diagnosis of ischemic stroke with hemorrhagic transformation. Bone scintigraphy with Tc-99m MDP supplemented with SPECT and fusion images with simple cerebral CT, performed at 15 days, shows uptake in the left temporal region, corresponding to stroke in subacute stage


Apresentamos o caso de um paciente com história de adenocarcinoma de próstata com diagnóstico de acidente vascular cerebral isquêmico com transformação hemorrágica. A cintilografia óssea com Tc-99m MDP suplementada com SPECT e imagens de fusão com TC cerebral simple, realizadas aos 15 dias, mostra captação na região temporal esquerda, correspondente ao ACV na fase subaguda


Subject(s)
Humans , Male , Aged, 80 and over , Technetium Tc 99m Medronate , Stroke/diagnostic imaging , Radionuclide Imaging , Tomography, Emission-Computed, Single-Photon
18.
Arq. ciências saúde UNIPAR ; 23(3): 221-226, set-dez. 2019.
Article in Portuguese | LILACS | ID: biblio-1046191

ABSTRACT

A Organização Mundial de Saúde (OMS) aponta as doenças cardiovasculares como a principal causa de morte no mundo, caracterizando um grave problema na saúde pública. Os três tipos de doenças que mais acarretam em óbito são: acidente vascular cerebral, seguido de infarto agudo do miocárdio e outras doenças isquêmicas do coração.Apesar dos avanços terapêuticos das últimas décadas, o infarto ainda apresenta altas taxas de mortalidade. Para as pessoas com doenças cardiovasculares ou com alto risco cardiovascular é fundamental o diagnóstico precoce da doença. A cintilografia de perfusão miocárdica é um método de investigação diagnóstica e prognóstico não invasivo de várias doenças cardiovasculares. Esse exame consiste na administração de um radiofármaco para obtenção de imagens de perfusão cardíaca. Dois traçadores marcados com Tecnécio-99m são amplamente utilizados na clínica, porém, esses dois radiofármacos não atendem aos requisitos de um agente de perfusão ideal, por sofrerem significativa excreção biliar, produzindo artefatos na imagem, o que pode inteferir um diagnóstico preciso, já que a qualidade é comprometida, e prolongando o tempo de obtenção da imagem após a administração do radiotraçador. Para superar essa lacuna, pesquisadores vêm estudando novos complexos catiônicos marcados com o Tecnécio. O objetivo desse artigo é fazer uma revisão, abordando a literatura sobre os radiofármacos que estão sendo estudados, suas vantagens e desvantagens sobre os traçadores já utilizados, e sobre sua potencial utilização na obtenção de imagem de perfusão cardíaca.


The World Health Organization (WHO) acknowledges cardiovascular diseases as the leading cause of death in the world, being regarded as a serious public health issue. The three types of diseases with the greatest mortality are: stroke, followed by acute myocardial infarction (AMI) and other ischemic heart diseases. Despite the therapeutic advances of the last decades, AMI still presents high mortality rates. Early diagnosis is essential for people with cardiovascular diseases or with a high cardiovascular risk. Myocardial perfusion scintigraphy is a method of diagnostic investigation and noninvasive prognosis of various cardiovascular diseases. This examination consists in the administration of a radiopharmaceutical drug to obtain images of cardiac perfusion. Two tracers labeled with Technetium-99m are widely used, however, these two radiopharmaceuticals do not meet the requirements of an ideal perfusion agent, because they have a high liver absorption, producing artifacts in the image, which can disrupt a precise diagnosis, since the quality is compromised, and prolonging the imaging time after administration of the radioisotope. To overcome this gap, researchers have been studying new cationic complexes marked with technetium. The objective of this article is to review the literature on the radiopharmaceuticals being studied, their advantages and disadvantages on the tracers already used, and their potential use in obtaining a cardiac perfusion image.


Subject(s)
Technetium/pharmacokinetics , Radiopharmaceuticals/pharmacokinetics , Myocardial Perfusion Imaging/instrumentation , Radioactive Tracers , Cardiovascular Diseases/diagnostic imaging , Radionuclide Imaging/instrumentation , Technetium Tc 99m Sestamibi/adverse effects , Cardiac Imaging Techniques/instrumentation , Liver/drug effects , Myocardial Infarction/diagnostic imaging
20.
Rev. chil. endocrinol. diabetes ; 12(3): 175-178, jul. 2019. ilus, tab
Article in Spanish | LILACS | ID: biblio-1006639

ABSTRACT

Los nódulos tiroideos suelen ser benignos en más del 95% de los casos y eutiroideos. La probabilidad de cáncer de tiroides en el hipertiroidismo es baja. Al enfrentarse a un nódulo tiroideo la importancia radica en excluir patología maligna, pero se debe mantener el orden en el algoritmo de estudio para evitar un diagnóstico incorrecto y caer en costos innecesarios. Se presenta el caso de una mujer de 23 años de edad con hipertiroidismo que en la ecografía aparece un nódulo tiroideo y adenopatía derecha, ambos con elementos sospechosos de malignidad, por lo que se pide punción de ambas estructuras, y se confirma el carcinoma papilar en el nódulo tiroideo, no así en la adenopatía. En el centellograma se observa un nódulo caliente que coincide con el nódulo maligno. Se realiza biopsia intraoperatoria de la adenopatía sospechosa y resulta ser una metástasis de carcinoma papilar. Se procedió a la tiroidectomía total con vaciamiento ganglionar central y lateral derecho. La anatomía patológica confirmó la presencia del carcinoma papilar clásico con metástasis de la adenopatía sospechosa. Posteriormente se administraron 130 mCi de radioyodo. Se debe considerar que los carcinomas pueden enmascararse ocasionalmente como nódulos «calientes¼ en el centellograma y en este caso, si bien en principio no estaría indicada la punción con aguja fina del nódulo dado que es hipercaptante en el centellograma, la ecografía demuestra elementos sospechosos contundentes de malignidad. En este caso el hilo conductor fue la ecografía y se rompió con el esquema clásico en la solicitud de estudios paraclínicos, obteniendo finalmente la confirmación diagnóstica de un cáncer y se realizó el tratamiento adecuado del mismo.


Thyroid nodules are usually benign in more than 95% of cases and euthyroid. The likelihood of thyroid cancer in hyperthyroidism is low. When dealing with a thyroid nodule the importance lies in excluding malignant pathology, but order must be maintained in the study algorithm to avoid an incorrect diagnosis and to fall into unnecessary costs. We present the case of a 23-year-old woman with hyperthyroidism who presented a thyroid nodule and right adenopathy on ultrasound, both with suspicious elements of malignancy, so puncture of both structures was requested, and papillary carcinoma was confirmed in the thyroid nodule, but not in adenopathy. In the scintigraphy a hot nodule is observed that coincides with the malignant nodule. Intraoperative biopsy of the suspected adenopathy is performed and it turns out to be a metastasis of papillary carcinoma. Total thyroidectomy was performed with central and right lateral lymph node dissection. The pathological anatomy confirmed the presence of classic papillary carcinoma with metastasis of the suspected adenopathy. Subsequently, 130 mCi of radioiodine was administered. It should be considered that carcinomas can occasionally be masked as «hot¼ nodules in the scintigraphy and in this case, although in principle the fine needle puncture of the nodule is not indicated given that it is hypercaptant in the scintigraphy, the ultrasound shows blunt suspicious elements of malignancy. In this case, the common thread was ultrasound and it was broken with the classic scheme in the request for paraclinical studies, finally obtaining the diagnostic confirmation of a cancer and the appropriate treatment was carried out.


Subject(s)
Humans , Female , Young Adult , Thyroid Neoplasms/diagnostic imaging , Carcinoma, Papillary/diagnostic imaging , Thyroid Nodule/diagnostic imaging , Thyroidectomy , Thyroid Neoplasms/surgery , Thyroid Neoplasms/pathology , Carcinoma, Papillary/surgery , Carcinoma, Papillary/pathology , Radionuclide Imaging , Ultrasonography , Thyroid Nodule/surgery , Thyroid Nodule/pathology , Sodium Pertechnetate Tc 99m , Hyperthyroidism
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