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1.
FEMINA ; 51(5): 292-296, 20230530.
Article in Portuguese | LILACS | ID: biblio-1512407

ABSTRACT

PONTOS-CHAVE • A incidência de câncer durante a gestação tem aumentado devido à tendência das mulheres em postergar a gravidez. O câncer de colo de útero é a terceira neoplasia mais comumente diagnosticada durante o período gestacional. • O rastreamento e o diagnóstico devem se dar como nas pacientes não gestantes; a citologia oncótica cervical é o exame obrigatório do pré-natal, e a colposcopia com biópsia pode ser realizada em qualquer período da gestação. • A gestação complicada pelo diagnóstico de um câncer deve sempre ser conduzida em centro de referência e por equipe multidisciplinar. • A interrupção da gestação em situações específicas, para tratamento-padrão, é respaldada por lei. • A quimioterapia neoadjuvante é uma alternativa segura de tratamento durante a gestação, para permitir alcançar a maturidade fetal. Apresenta altas taxas de resposta, sendo relatada progressão neoplásica durante a gestação em apenas 2,9% dos casos. O risco de malformações fetais decorrentes da quimioterapia é semelhante ao da população geral. Contudo, a quimioterapia está associada a restrição de crescimento intraútero, baixo peso ao nascer e mielotoxicidade neonatal. • Na ausência de progressão de doença, deve-se levar a gestação até o termo.


Subject(s)
Humans , Female , Pregnancy , Pregnancy , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/prevention & control , Women's Health , Pregnancy Complications, Neoplastic/prevention & control , Prenatal Diagnosis , Thorax/diagnostic imaging , Congenital Abnormalities/embryology , Bone Marrow/abnormalities , Infant, Low Birth Weight , Colposcopy/methods , Conization/methods , Neoadjuvant Therapy/adverse effects , Fetal Growth Retardation , Watchful Waiting/methods , Trachelectomy/methods , Abdomen/diagnostic imaging
2.
Rev. cuba. pediatr ; 952023. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-1515283

ABSTRACT

Introducción: Los neumatoceles y las bulas pulmonares son lesiones que se observan en los niños casi siempre asociadas a neumonías infecciosas, aunque sus causas pueden ser diversas. La importancia clínica de estos procesos radica en el peligro de crecimiento progresivo, que puede comprometer las funciones respiratoria y cardiovascular. Objetivo: Describir las experiencias derivadas del proceso de diagnóstico por imágenes y del tratamiento invasivo de casos atendidos. Presentación de los casos: Desde finales de 2021 y durante un período de un año, se atendieron, en la unidad de cuidados intensivos pediátricos del Hospital Pediátrico Universitario de Cienfuegos, cinco niños con neumonías extensas, que desarrollaron bulas de gran tamaño varios días después del tratamiento antimicrobiano adecuado. Estas necesitaron drenaje y aspiración percutáneos debido a su magnitud y a la presencia de síntomas cardiovasculares. Conclusiones: Las bulas que aparecieron como complicación de la neumonía en el niño pueden presentarse con una frecuencia no despreciable, y hay que mantenerse atentos a su evolución, porque, a diferencia de los neumatoceles, pueden crecer progresivamente y comprometer las funciones respiratoria y cardiovascular. El drenaje percutáneo y aspiración continua por cinco días resultó un método seguro y eficaz para tratar estos procesos(AU)


Introduction: Pneumoatoceles and pulmonary bullae are lesions that are observed in children almost always associated with infectious pneumonia, although their causes may be diverse. The clinical importance of these processes lies in the danger of progressive growth, which can compromise respiratory and cardiovascular functions. Objective: To describe the experiences derived from the imaging process and the invasive treatment of treated cases. Presentation of the cases: Since the end of 2021 and for a period of one year, five children with extensive pneumonia were treated in the pediatric intensive care unit of the University Pediatric Hospital of Cienfuegos, who developed large bullae several days after appropriate antimicrobial treatment. The bullae required percutaneous drainage and aspiration due to their magnitude and the presence of cardiovascular symptoms. Conclusions: The bulla that appeared as a complication of pneumonia in the child can occur with a not negligible frequency, and it is necessary to be attentive to their evolution, because, unlike pneumoatoceles, can grow progressively and compromise respiratory and cardiovascular functions. Percutaneous drainage and continuous aspiration for five days was a safe and effective method to treat these processes(AU)


Subject(s)
Male , Female , Infant , Child, Preschool , Child , Pleural Effusion/drug therapy , Pneumonia/complications , Pneumonia/diagnostic imaging , Asthenia/etiology , Tachycardia/complications , Residence Characteristics , Blister/etiology , Back Pain , Cough , Thoracentesis/methods , COVID-19 , Thorax/diagnostic imaging , Ceftriaxone/therapeutic use , Vancomycin/therapeutic use , Drainage/instrumentation , Levofloxacin/therapeutic use , Anemia
3.
Rev. méd. Maule ; 37(1): 14-23, jun. 2022. ilus
Article in Spanish | LILACS | ID: biblio-1395909

ABSTRACT

Introduction: Boerhaave syndrome is a spontaneous rupture of the esophageal wall caused by a sudden increase in intraesophageal pressure. It represents an incidence of approximately 15% of all esophageal perforations, which do not exceed 3.1 per 1 million inhabitants per year. Objectives: To communicate the clinical presentation and management of patients with this syndrome, as well as to reveal the different options available in our service for its treatment. Methods: Search in the statistical data of the regional Hospital of Talca for patients with a diagnosis of Boerhaave syndrome. Five patients were found. Information was obtained from their clinical records and is presented as a clinical case report with a descriptive analysis of their management. Results: Of the 5 clinical cases presented, a classic clinical presentation can be observed, most of the patients presented with vomiting that later evolved with thoracic and/or epigastric pain, associated with imaging studies suggesting esophageal perforation. Management was surgical in 100% of the cases, applying different techniques described in the literature. Discussion and Conclusion: Boerhaave syndrome is a medical-surgical emergency that requires timely management. In spite of the variety of management and the consequences of each one of them, all the patients had an evolution that allowed them to preserve their lives until nowadays. Keeping a high index of suspicion and choosing the best management will have an impact on morbidity and mortality.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Thorax/diagnostic imaging , Esophageal Diseases , Mediastinal Diseases/surgery , Radiography, Thoracic , Tomography, X-Ray Computed , Retrospective Studies , Endoscopy, Digestive System , Esophagectomy/methods , Delayed Diagnosis , Tertiary Care Centers/statistics & numerical data
4.
ABC., imagem cardiovasc ; 35(3): eabc331, 2022. ilus, tab
Article in Portuguese | LILACS | ID: biblio-1411428

ABSTRACT

Introdução: A esclerose sistêmica (ES) é uma doença autoimune do tecido conjuntivo que cursa com fibrose e disfunção microvascular. O envolvimento dos órgãos viscerais, incluindo os pulmões e o coração, é a principal causa de óbito na ES. Nesse contexto, analisamos a relação entre os parâmetros ventriculares direitos (VD) pela ecocardiografia com Doppler tecidual e o acometimento pulmonar em pacientes com ES. Métodos: Os pacientes que preencheram os Critérios de Classificação da ES de 2013 foram submetidos à ecocardiografia com Doppler tecidual para avaliação da função sistólica (fração de ejeção) ventricular esquerda (VE), enquanto a função sistólica do VD foi avaliada por meio da fração de variação de área do VD (fractional area change ­ FAC), velocidade (sistólica) do Doppler tecidual, índice de desempenho miocárdico (IDM) e excursão sistólica do plano anular tricúspide (TAPSE). A pressão sistólica pulmonar foi estimada por insuficiência tricúspide. A tomografia computadorizada de alta resolução (TCAR) de tórax avaliou a presença de fibrose pulmonar. De acordo com os resultados da TCAR, os pacientes foram divididos em 2 subgrupos: Grupo I, incluindo pacientes com fibrose pulmonar (n=26), e Grupo II sem fibrose (n=17). Resultados: Entre os 43 pacientes com ES, a maioria era do sexo feminino (86%) com idade de 51±12 anos. Todos os pacientes apresentavam função ventricular sistólica normal, avaliada pela FEVE>55% e FAC VD>35%. Não houve diferença significativa em termos de idade ou duração da doença para os grupos. Exceto pela diminuição das velocidades do Doppler tecidual em pacientes com fibrose pulmonar, todos os índices de desempenho do VD foram semelhantes. Conclusão: Em pacientes com ES e fibrose pulmonar, o Doppler tecidual identifica acometimento miocárdico longitudinal precoce do VD, apesar do desempenho sistólico radial preservado do VD.(AU)


Introduction: Systemic sclerosis (SSc) is an autoimmune tissue connective disease that courses with fibrosis and microvascular dysfunction. Involvement of the visceral organs, including the lungs and heart, is the main cause of death among patients with SSc. In this context, here we analyzed the relationship between right ventricle (RV) parameters assessed by tissue Doppler echocardiography and lung involvement in patients with SSc. Methods: Patients fulfilling the 2013 SSc Classification Criteria underwent tissue Doppler echocardiography for the assessment of left ventricular (LV) systolic function (ejection fraction) and RV fractional area change (FAC), tissue Doppler s' (systolic) velocity, myocardial performance index, and tricuspid annular plane systolic excursion for the assessment of RV systolic function. Pulmonary systolic pressure was estimated using tricuspid regurgitation. Chest high-resolution computed tomography was used to evaluate the presence of pulmonary fibrosis. The patients were divided into two subgroups accordingly: Group I, patients with pulmonary fibrosis (n=26); and Group II, those without fibrosis (n=17). Results: Among the 43 patients with SSc, most were female (86%), and the mean age was 51 ± 12 years. All patients had normal systolic ventricular function as evidenced by an LV ejection fraction > 55% and an RV FAC > 35%. No significant intergroup difference was noted in age or disease duration. Except for a decreased tissue Doppler s' velocity in patients with lung fibrosis, all indexes of RV performance were similar. Conclusion: In patients with SSc and pulmonary fibrosis, tissue Doppler identified early RV longitudinal myocardial involvement despite preserved RV radial systolic performance.(AU)


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Pulmonary Fibrosis/complications , Scleroderma, Systemic/diagnosis , Ventricular Function, Right , Lung Diseases, Interstitial/diagnosis , Thorax/diagnostic imaging , Tricuspid Valve Insufficiency/complications , Echocardiography, Doppler/methods , Tomography, X-Ray Computed/methods
5.
Vet. zootec ; 29: 1-11, 2022. ilus
Article in Portuguese | LILACS, VETINDEX | ID: biblio-1400538

ABSTRACT

O fibrossarcoma é uma neoplasia mesenquimal maligna originada dos fibroblastos que localiza-se especificamente em tecido cutâneo, subcutâneo e cavidade oral. A ressecção cirúrgica do tumor com margem de segurança é conhecida como a principal forma de tratamento. A principal forma de metástase é a via hematógena, atingindo pulmões, e menos comum em linfonodos regionais. A análise histopatológica é o exame diagnóstico de eleição para definição do tipo de tumor e sua graduação. Os exames de imagem são fundamentais no estadiamento das neoplasias e planejamento cirúrgico. A ultrassonografia e radiografia são os métodos mais utilizados e oferecem um grande apoio a oncologia médica veterinária. O exame radiográfico possibilita o achado de neoformações ósseas ou demais alterações como o aumento de volume de tecidos moles, infiltração gordurosa, e cavitações com gás ou fluído. O exame ultrassonográfico permite o conhecimento sobre a ecotextura, organização, e localização da lesão em tecidos moles. Em três gatos com fibrosssarcoma em membro torácico, foram realizadas radiografia e ultrassonografia específica da lesão. Os achados radiográficos foram aumento de volume, radiopacidade dos tecidos moles, sem acometimento ósseo. Os achados ultrassonográficos foram lesões de ecotextura grosseira, altamente heterogêneas. Os exames citológicos e histopatológicos revelaram tratar-se de fibrossarcoma. O presente relato tem como objetivo descrever os achados radiográficos e ultrassonográficos de fibrossarcoma em membro torácico de três gatos.


Fibrosarcoma is a malignant mesenchymal neoplasm originating from fibroblasts, which is specifically located in the skin tissue, subcutaneous tissue and oral cavity. Surgical resection of the tumor with a safety margin is known as the main form of treatment. The main form of metastasis is the hematogenous route, reaching the lungs, and less common in regional lymph nodes. histopathological analysis is the diagnostic test of choice for defining the type of tumor and its graduation. Imaging exams are essential in the staging of neoplasms and surgical planning. Ultrasonography and radiography are the most used methods and offer great support to veterinary medical oncology. The radiographic exam allows the finding of bone neoformations or other alterations such as the increase in soft tissue volume, fatty infiltration, and cavitations with gas or fluid. The ultrasound examination allows knowledge about the echotexture, organization, and location of the soft tissue lesion. Three cats with fibrosarcoma in the thoracic limb underwent lesion-specific radiography and ultrasound. The radiographic findings of fibrosarcomas were increased soft tissue radiopacity volume, without bone involvement. And the ultrasonographic findings were gross echotexture lesions, highly heterogeneous. Cytological and histopathological examinations were performed for definitive diagnosis. The present report aims to describe the radiographic and ultrasonographic findings of fibrosarcoma in the thoracic limb of three cats.


RESUMEN El fibrosarcoma es una neoplasia mesenquimatosa maligna que se origina a partir de fibroblastos, que se localiza específicamente en el tejido cutáneo, tejido subcutáneo y cavidad oral. La resección quirúrgica del tumor con un margen de seguridad se conoce como la forma principal de tratamiento. La principal forma de metástasis es la vía hematógena, que llega a los pulmones y es menos común en los ganglios linfáticos regionales. El análisis histopatológico es la prueba diagnóstica de elección para definir el tipo de tumor y su graduación. Los exámenes por imágenes son esenciales en la estadificación de las neoplasias y la planificación quirúrgica. La ecografía y la radiografía son los métodos más utilizados y ofrecen un gran apoyo a la oncología médica veterinaria. El examen radiográfico permite encontrar neoformaciones óseas u otras alteraciones como aumento de volumen de tejidos blandos, infiltración grasa y cavitaciones con gas o líquido. El examen ecográfico permite conocer la ecotextura, organización y ubicación de la lesión de tejidos blandos. A tres gatos con fibrosarcoma en la extremidad torácica se les realizó una radiografía y una ecografía específicas de la lesión. Los hallazgos radiográficos de los fibrosarcomas fueron un aumento del volumen de radiopacidad de los tejidos blandos, sin afectación ósea. Y los hallazgos ecográficos fueron lesiones macroscópicas de ecotextura, muy heterogéneas. Se realizaron exámenes citológicos e histopatológicos para el diagnóstico definitivo. El presente informe tiene como objetivo describir los hallazgos radiográficos y ecográficos del fibrosarcoma en la extremidad torácica de tres gatos.


Subject(s)
Animals , Cats , Thorax/diagnostic imaging , Fibrosarcoma/veterinary , Fibrosarcoma/diagnostic imaging , Radiography, Thoracic/veterinary , Ultrasonography/veterinary
6.
Rev. cir. (Impr.) ; 73(6): 758-762, dic. 2021. ilus, tab
Article in Spanish | LILACS | ID: biblio-1388897

ABSTRACT

Resumen Objetivo: Describir características demográficas y tratamiento quirúrgico realizado a pacientes con fractura de esternón (FE) en los últimos 5 años. Materiales y Método: Estudio descriptivo retrospectivo de pacientes operados por fractura esternal entre enero de 2015 y enero de 2020. Se analizaron edad, sexo, antecedentes mórbidos, hemodinamia de ingreso, mecanismo causal, características de lesión esternal, lesiones asociadas, indicación quirúrgica y complicaciones. Resultados: Durante el período ingresaron a nuestro hospital 9 pacientes (7 hombres) de 21 a 91 años. Todos fueron operados. La mayoría ingresó con hemodinamia estable. El mecanismo fue siempre traumático. Las indicaciones quirúrgicas fueron: dolor intratable, alteración de la mecánica ventilatoria, tórax volante, deformidad y ayuda en la rehabilitación de un trauma raquimedular. Discusión: La FE es una patología infrecuente, siendo aún más escasa su resolución quirúrgica reportada a nivel mundial. Conclusiones: Presentamos el primer reporte de una serie de casos de FE operada en Chile. La osteosíntesis esternal permite el manejo de la FE con buenos resultados funcionales con baja tasa de morbilidad. Los resultados obtenidos son comparables a los observados en la literatura internacional.


Aim: To describe demographic characteristics and surgical treatment carried out on patients with a sternal fracture (SF) in the last 5 years. Materials and Method: Retrospective descriptive study of patients operated on for SF between January 2015 and January 2020. We analyzed age, sex, morbid history, hemodynamics on admission, causal mechanism and characteristics of sternal injury, associated injuries, surgical indication and complications. Results: During the period, 9 patients were admitted to our hospital (7 men) from 21 to 91 years old. All were operated. Most were admitted with stable hemodynamics. The mechanism was always traumatic. The surgical indications were: intractable pain, alteration of ventilatory mechanics, flail chest, deformity and aid in the rehabilitation of spinal cord trauma. Discussion: SF is an infrequent pathology, its surgical resolution reported worldwide being even scarce. Conclusions: We present the first report of a series of cases of SF operated in Chile. Sternal osteosynthesis allows the management of EF with good functional results with a low morbidity rate. The results obtained are comparable to those observed in the international literature.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Sternum/surgery , Sternum/diagnostic imaging , Fractures, Bone/diagnostic imaging , Thorax/diagnostic imaging , Radiography, Thoracic , Demography , Epidemiology, Descriptive , Retrospective Studies
10.
Medisan ; 25(3)2021. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-1287309

ABSTRACT

La actual pandemia de COVID-19 ha afectado múltiples sectores económicos y sociales a escala mundial, con especial afectación sobre el sector de la salud, ya que constituye un reto adicional para la atención primaria, dada la marcada escasez de recursos. La infección por SARS-CoV-2 ocasiona morbilidad y mortalidad crecientes, por lo que el diagnóstico mediante imágenes es una herramienta imprescindible en la práctica clínica; sin embargo, el acceso limitado a algunos medios como la tomografía axial computarizada en diferentes niveles de atención, justifica el uso de la radiografía de tórax como una opción costo-efectiva y accesible en muchas regiones. En el presente artículo se exponen los hallazgos asociados a procesos infecciosos virales sugestivos de infección por el nuevo coronavirus y una serie de escalas de clasificación que buscan estandarizar la lectura e interpretación radiográfica por parte del personal médico.


The pandemic of COVID-19 has affected multiple economic and social sectors worldwide, with special effects on the health sector, since it constitutes an additional challenge for the primary health care, given the marked lack of resources. The infection due to SARS-CoV-2 causes increasing morbidity and mortality, reason why the diagnosis by means of images is an indispensable tool in the clinical practice; however, the limited access to some means as the computerized axial tomography in different levels of care, justifies the use of the thorax x-ray as a cost-effective and accessible option in many regions. Findings associated with suggestive viral infectious processes of infection due to the new coronavirus and a series of classification scales that seek to standardize reading and radiographic interpretation by the medical staff are exposed in this work.


Subject(s)
Primary Health Care , Thorax/diagnostic imaging , COVID-19 , Radiography , Coronavirus , SARS-CoV-2
11.
Rev. chil. reumatol ; 37(1): 18-22, 2021. tab
Article in Spanish | LILACS | ID: biblio-1400374

ABSTRACT

El síndrome de activación macrofágica (SAM) presenta criterios clínicos y de laboratorio establecidos. Presentamos el caso de un adolescente varón con debut de Lupus eritematoso generalizado pediátrico grave, donde su manifestación principal fue un SAM y el receptor de interleucina 2 soluble en suero (IL-2rs) o CD25 soluble (CD25s) aumentado resultó clave en la confirmación diagnóstica, en el tratamiento y pronóstico de su enfermedad. Sin embargo, este receptor de citocinas no se mide habitualmente en la práctica clínica.


Macrophage activation syndrome (MAS) presents established clinical and laboratory criteria. We present the case of a male adolescent with the onset of severe pediatric systemic Lupus erythematosus, manifested mainly by MAS and how a laboratory marker, serum soluble interleukin-2 receptor (IL-2rs) or altered soluble CD25(CD25s), played a key role in treatment and prognosis of the disease. However, this cytokine receptor is rarely measured in clinical practice.


Subject(s)
Humans , Male , Child , Lymphohistiocytosis, Hemophagocytic/diagnosis , Lymphohistiocytosis, Hemophagocytic/therapy , Macrophage Activation Syndrome/diagnosis , Macrophage Activation Syndrome/therapy , Thorax/diagnostic imaging , Radiography, Thoracic/methods , Receptors, Interleukin-2 , Macrophage Activation Syndrome/pathology , Lupus Erythematosus, Systemic
12.
Environmental Health and Preventive Medicine ; : 35-35, 2021.
Article in English | WPRIM | ID: wpr-880353

ABSTRACT

BACKGROUND@#Body mass-independent parameters might be more appropriate for assessing cardiometabolic abnormalities than weight-dependent indices in Asians who have relatively high visceral adiposity but low body fat. Dual-energy X-ray absorptiometry (DXA)-measured trunk-to-peripheral fat ratio is one such body mass-independent index. However, there are no reports on relationships between DXA-measured regional fat ratio and cardiometabolic risk factors targeting elderly Asian men.@*METHODS@#We analyzed cross-sectional data of 597 elderly men who participated in the baseline survey of the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) study, a community-based single-center prospective cohort study conducted in Japan. Whole-body fat and regional fat were measured with a DXA scanner. Trunk-to-appendicular fat ratio (TAR) was calculated as trunk fat divided by appendicular fat (sum of arm and leg fat), and trunk-to-leg fat ratio (TLR) as trunk fat divided by leg fat.@*RESULTS@#Both TAR and TLR in the group of men who used ≥ 1 medication for hypertension, dyslipidemia, or diabetes ("user group"; N = 347) were significantly larger than those who did not use such medication ("non-user group"; N = 250) (P < 0.05). After adjusting for potential confounding factors including whole-body fat, both TAR and TLR were significantly associated with low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglyceride, fasting serum insulin, and the insulin resistance index in the non-user group and non-overweight men in the non-user group (N = 199).@*CONCLUSION@#The trunk-to-peripheral fat ratio was associated with cardiometabolic risk factors independently of whole-body fat mass. Parameters of the fat ratio may be useful for assessing cardiometabolic risk factors, particularly in underweight to normal-weight populations.


Subject(s)
Aged , Aged, 80 and over , Humans , Male , Absorptiometry, Photon , Adiposity/physiology , Biomarkers/metabolism , Cardiometabolic Risk Factors , Cross-Sectional Studies , Intra-Abdominal Fat/diagnostic imaging , Japan , Osteoporosis/etiology , Prospective Studies , Risk Assessment , Risk Factors , Thorax/diagnostic imaging
13.
An. bras. dermatol ; 95(6): 751-753, Nov.-Dec. 2020. graf
Article in English | LILACS, ColecionaSUS | ID: biblio-1142116

ABSTRACT

Abstract Paget's disease is a rare disorder of the nipple and/or the areola that is characterized by an erythematosquamous lesion and is often associated with in situ or invasive breast carcinoma. The authors present an atypical, exuberant case that had evolved over eight years, emphasizing the importance of early diagnosis.


Subject(s)
Humans , Breast Neoplasms/diagnosis , Paget's Disease, Mammary , Thorax/diagnostic imaging , Ulcer , Nipples
14.
Rev. méd. Maule ; 35(1): 25-46, oct. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1366390

ABSTRACT

In December 2019, an epidemic of cases with unexplained lower respiratory infections detected in Wuhan, China was first reported to the WHO China Office. The respiratory picture presents in various ways, from asymptomatic or paucisymptomatic forms, to clinical conditions characterized by respiratory failure that require mechanical ventilation and support in the ICU, with multi-organ and systemic manifestations in terms of sepsis, septic shock and multiple organ dysfunction syndromes. The etiological agent was identified as a virus belonging to the coronavirus family (CoV) with a high contagion capacity that determined its rapid spread, triggering a pandemic with high morbidity and mortality. This review attempts to address the basics of this disease.


Subject(s)
Humans , Pneumonia, Viral/physiopathology , COVID-19/etiology , COVID-19/transmission , Asthma , Thorax/diagnostic imaging , Tomography, X-Ray Computed , Clinical Diagnosis , Sepsis , Diagnostic Techniques and Procedures , Pulmonary Disease, Chronic Obstructive , Diagnosis, Differential , SARS-CoV-2 , COVID-19/diagnosis , COVID-19/physiopathology , COVID-19/prevention & control , COVID-19/therapy , COVID-19/epidemiology
15.
Int. j. morphol ; 38(5): 1258-1265, oct. 2020. tab, graf
Article in English | LILACS | ID: biblio-1134434

ABSTRACT

SUMMARY: The aim of this exploratory design science research (DSR) study was to design a computer-based teaching simulation tool (CBTST) for training medical imaging (MI) students in chest pattern recognition. A DSR methodology used in the design of the CBTST entailed the following phases: 1) awareness of the problem (proposal design); 2) suggestion; 3) development; 4) evaluation; and 5) conclusion. The CBTST was designed using Microsoft Visual Studio which operates on the Structured Query Language server. The designed CBTST was evaluated using the System Usability Scale (SUS) and MI educators. The designed CBTST evaluation yielded an average score of 70.1 which exceeded the score of 68 which is generally accepted to indicate that the CBTST has good usability. The CBTST proved to be an authentic tool that is user-friendly and allows communication and feedback between the educator and the students. It is envisaged that the implementation of this tool will enhance the future training of MI students in pattern recognition while contributing immensely to the current development of the use of computer-based simulation.


RESUMEN: El objetivo de este estudio de investigación en ciencias de diseño (DSR) fue desarrollar una herramienta de simulación de enseñanza basada en computadora (CBTST) para capacitar a los estudiantes en el reconocimiento de patrones de tórax a través de la imagenología médica. Una metodología DSR utilizada en el diseño del CBTST implicaba las siguientes fases: 1) conciencia del problema (diseño de la propuesta); 2) sugerencia; 3) desarrollo; 4) evaluación; y 5) conclusión. El CBTST se diseñó con Microsoft Visual Studio, que opera en el servidor de Structured Query Language. El CBTST diseñado se evaluó utilizando la escala de usabilidad del sistema (SUS) y educadores de IM. La evaluación CBTST diseñada arrojó un puntaje promedio de 70,1 que excedió el puntaje de 68 que generalmente se acepta para indicar que el CBTST tiene buena usabilidad. El CBTST demostró ser una herramienta auténtica, fácil de usar y que permite la comunicación y la retroalimentación entre el educador y los estudiantes. Se prevé que la implementación de esta herramienta mejorará la formación futura de los estudiantes de IM en el reconocimiento de patrones y contribuirá de manera importante al desarrollo actual del uso de la simulación basada en computadora.


Subject(s)
Humans , Thorax/diagnostic imaging , Computer Simulation , Pattern Recognition, Automated , Computer-Assisted Instruction/methods , Education, Medical/methods , Aptitude , Software , Education, Medical, Undergraduate , Educational Measurement , Simulation Training/methods , Anatomy/education
16.
Rev. Soc. Bras. Clín. Méd ; 18(3): 165-170, mar 2020.
Article in Portuguese | LILACS | ID: biblio-1361515

ABSTRACT

Este relato teve como objetivo apresentar um caso de hepatotoxicidade colestática induzida por azatioprina em portadora da síndrome de Vogt-Koyanagi-Harada. À admissão, apresentava icterícia +3/+4, acolia fecal e colúria, além de aumento de marcadores hepáticos, sendo compatível com síndrome colestática, cuja etiologia foi confirmada após exclusão de outras causas possíveis e retirada da azatioprina. A paciente evoluiu, após 1 semana de retirada do fármaco, com diurese livre de coloração menos escura e evacuação presente, sem acolia. Além disso, houve melhora nos exames que precederam a alta hospitalar


This report aimed at presenting a case of azathioprine-induced cholestatic hepatotoxicity in a patient with Vogt-Koyanagi-Harada syndrome. On admission, she presented with jaundice +3/+4, acholic feces, and choluria, as well as increased hepatic markers, all consistent with cholestatic syndrome, the etiology of which was confirmed after other possible causes were ruled out and azathioprine was discontinued. After 1 week of the drug discontinuation, the patient progressed with free diuresis of lighter color and defecation, with no acholia. In addition, tests performed before discharge were improved.


Subject(s)
Humans , Female , Middle Aged , Azathioprine/toxicity , Azathioprine/therapeutic use , Uveomeningoencephalitic Syndrome/drug therapy , Chemical and Drug Induced Liver Injury/diagnosis , Immunosuppressive Agents/toxicity , Immunosuppressive Agents/therapeutic use , Sinusitis/drug therapy , Azathioprine/adverse effects , Thorax/diagnostic imaging , Radiography , Cholestasis, Intrahepatic/diagnosis , Cholestasis, Intrahepatic/blood , Ultrasonography , Pneumonia, Bacterial/drug therapy , Chemical and Drug Induced Liver Injury/blood , Goiter, Nodular/diagnostic imaging , Immunosuppressive Agents/adverse effects , Anti-Bacterial Agents/therapeutic use
17.
Brasília, DF; OPAS; 11 Jun. 2020. 42 p. ilus. (OPAS-W/BRA/COVID-19/20-079).
Non-conventional in Portuguese | BIGG, LILACS | ID: biblio-1147331

ABSTRACT

Desde sua identificação na China em dezembro de 2019, o novo coronavírus responsável pela COVID-19 evoluiu rapidamente para uma pandemia. A COVID-19 se manifesta com sintomas respiratórios inespecíficos de gravidade variável e pode exigir suporte respiratório avançado. Atualmente, o diagnóstico de COVID- 19 é confirmado por testes laboratoriais através da identificação de RNA viral na reação em cadeia da polimerase com transcriptase reversa (RT-PCR). Os exames de imagem de tórax foram considerados como parte da investigação diagnóstica de pacientes com suspeita ou probabilidade de COVID-19, nos lugares em que a RT-PCR não está disponível ou em que os resultados demoram ou são inicialmente negativos na presença de sintomas sugestivos de COVID-19. Os exames de imagem também foram considerados na complementação da avaliação clínica e dos parâmetros laboratoriais no tratamento de pacientes já diagnosticados com COVID-19. Antes de iniciar o desenvolvimento deste guia, vários estados-membros solicitaram um parecer da OMS sobre o papel dos exames de imagem do tórax em pacientes com suspeita ou confirmação de COVID-19. Uma revisão das práticas de exames de imagem em pacientes com suspeita ou confirmação de COVID-19 em todo o mundo encontrou grandes variações. Isso motivou o desenvolvimento de diretrizes globais sobre o uso de exames de imagem de tórax para apoiar os estados membros na resposta à pandemia da COVID-19. Este guia de aconselhamento rápido examina as evidências e faz recomendações para o uso de exames de imagem do tórax em pacientes agudos com suspeita, probabilidade ou confirmação de COVID-19, incluindo radiografia de tórax, tomografia computadorizada (TC) e ultrassonografia pulmonar. Destina-se a ser um guia prático para os profissionais de saúde envolvidos na evolução da atenção à COVID-19, desde o momento de chegada a um estabelecimento de saúde até a alta hospitalar. A orientação é relevante para pacientes com diferentes níveis de gravidade da doença, desde indivíduos assintomáticos a pacientes críticos...


Subject(s)
Humans , Pneumonia, Viral/diagnostic imaging , Thorax/diagnostic imaging , Coronavirus Infections/diagnostic imaging , RNA, Viral/isolation & purification , Reverse Transcriptase Polymerase Chain Reaction/standards , Betacoronavirus/isolation & purification
18.
Rev. argent. cir ; 112(1): 51-54, mar. 2020. ilus
Article in English, Spanish | LILACS | ID: biblio-1125781

ABSTRACT

El schwannoma es un tumor neurogénico que se presenta más frecuentemente en el ángulo costovertebral del mediastino posterior, pero también en otras localizaciones dentro del tórax. Habitualmente suele ser una masa única, encapsulada, bien definida, con un tamaño aproximado 2 a 10 cm. Presentamos el caso de un paciente de 66 años, derivado a nuestro hospital por una masa de 13 cm localizada en el hemitórax inferior izquierdo. Se realizó una biopsia, y la resonancia magnética corroboró el diagnóstico de un tumor mediastínico gigante de la vaina neural. Se procedió a su resección completa sin complicaciones.


Schwannomas are neurogenic tumors, commonly located in the costovertebral angle of the posterior mediastinum, but with many intrathoracic locations. They usually present as a solitary, well-circumscribed and encapsulated mass with a size between 2 and 10 cm. We report a case of a 66-year-old male, referred to our hospital for a mass located at the left lower hemithorax with 13 cm in size. A percutaneous biopsy was performed, and magnetic resonance imaging confirmed the diagnosis of a resectable giant mediastinal nerve sheath tumor. Surgery was performed without complications.


Subject(s)
Humans , Male , Aged , Lung Neoplasms/pathology , Neurilemmoma/diagnostic imaging , Thorax/diagnostic imaging , Thoracotomy , Magnetic Resonance Spectroscopy/methods , Positron-Emission Tomography/methods , Electrocardiography
19.
Einstein (Säo Paulo) ; 18: eRW5741, 2020. graf
Article in English | LILACS | ID: biblio-1133785

ABSTRACT

ABSTRACT The disease caused by the new coronavirus, or COVID-19, has been recently described and became a health issue worldwide. Its diagnosis of certainty is given by polymerase chain reaction. High-resolution computed tomography, however, is useful in the current context of pandemic, especially for the most severe cases, in assessing disease extent, possible differential diagnoses and searching complications. In patients with suspected clinical symptoms and typical imaging findings, in which there is still no laboratory test result, or polymerase chain reaction is not available, the role of this test is still discussed. In addition, it is important to note that part of the patients present false-negative laboratory tests, especially in initial cases, which can delay isolation, favoring the spread of the disease. Thus, knowledge about the COVID-19 and its imaging manifestations is extremely relevant for all physicians involved in the patient care, clinicians or radiologists.


RESUMO A doença causada pelo novo coronavírus, ou COVID-19, foi descrita recentemente e tornou-se uma questão de saúde mundial. Seu diagnóstico de certeza é dado pela reação em cadeia da polimerase. A tomografia computadorizada de alta resolução, entretanto, mostra-se útil no contexto atual de pandemia, especialmente nos casos mais graves, na avaliação da extensão da doença, em possíveis diagnósticos diferenciais e na pesquisa de complicações. Em pacientes com quadro clínico suspeito e achados de imagem típicos, nos quais ainda não há resultado laboratorial ou a reação em cadeia da polimerase não se encontra disponível, ainda se discute o papel desse exame. Importante ressaltar que parte dos pacientes apresenta exames laboratoriais falsos-negativos, notadamente em casos iniciais, o que pode retardar medidas de isolamento, favorecendo a propagação da doença. Dessa forma, o conhecimento da COVID-19 e de suas manifestações nos exames de imagem é de extrema importância para os médicos envolvidos no atendimento, sejam clínicos ou radiologistas.


Subject(s)
Humans , Pneumonia, Viral/diagnostic imaging , Thorax/diagnostic imaging , Tomography, X-Ray Computed , Coronavirus Infections/diagnostic imaging , Lung/diagnostic imaging , Pleural Effusion/diagnostic imaging , Diagnosis, Differential , Pandemics , Lymphadenopathy/diagnostic imaging , Betacoronavirus , SARS-CoV-2 , COVID-19
20.
Rev. chil. anest ; 49(1): 65-78, 2020. ilus
Article in Spanish | LILACS | ID: biblio-1510337

ABSTRACT

Truncal blocks have recently been positioned as an alternative to neuraxial analgesia. The injection of local anesthetics in interfascial planes was initially guided by anatomical landmarks, to later evolve towards a more selective administration when guided by ultrasound. Successful execution of truncal blocks requires detailed knowledge of the chest and abdominal walls anatomy. The same logic allows us to understand its potential benefits concerning perioperative analgesia, as well as its limitations and therapeutic margins. Secondary to a growing interest in less invasive techniques and analgesic techniques with a more favorable risk-benefit profile, the available evidence in this field is in continuous development. Thus, in the present review, the technical aspects of these blocks will be evaluated, emphasizing the sonoanatomy, and assessing the best evidence to support the use of each technique.


Los bloqueos de tronco se han posicionado recientemente como una alternativa frente a la analgesia neuroaxial. La inyección de anestésicos locales en planos interfasciales inicialmente fue guiado por referencias anatómicas, para posteriormente evolucionar hacia una administración más selectiva al ser guiada por el ultrasonido. La ejecución exitosa de los bloqueos de tronco requiere un conocimiento detallado de la anatomía de las paredes del tórax y abdomen. Esta misma lógica nos permite entender sus potenciales beneficios en relación con la analgesia perioperatoria, como también sus limitaciones y margen terapéutico. La evidencia disponible está en continuo desarrollo, dado el creciente interés que concitan técnicas menos invasivas y con un perfil de riesgo-beneficio potencialmente más favorable. En la presente revisión se evaluarán los aspectos técnicos de cada bloqueo, poniendo énfasis en la sonoanatomía, y evaluando la mejor evidencia que sustente el uso de cada técnica.


Subject(s)
Humans , Thorax/innervation , Abdominal Wall/innervation , Anesthesia, Local/methods , Nerve Block/methods , Thorax/diagnostic imaging , Ultrasonics , Abdominal Wall/diagnostic imaging , Fascia , Anesthesia, Conduction/methods
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