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1.
Medisan ; 25(3)2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1287298

ABSTRACT

Introducción: El método clínico por sí solo no es definitivo para diagnosticar una enfermedad cerebrovascular, por lo que es importante el uso de medios de diagnóstico imagenológicos como la tomografía axial computarizada, que permite investigar los aspectos morfológicos y funcionales del cerebro. Objetivo: Describir las características clínicas y tomográficas de pacientes con infarto cerebral. Métodos: Se efectuó un estudio descriptivo y transversal de 269 pacientes con infarto cerebral, atendidos en el Hospital Provincial Docente Clinicoquirúrgico Saturnino Lora Torres de Santiago de Cuba, desde enero hasta diciembre de 2019. Resultados: Predominaron el sexo masculino (54,6 %), el grupo etario de 70-79 años, las afectaciones motoras (76,5 %), la alteración de la conciencia (51,3 %) y el trastorno del lenguaje (50,5 %). En 38 pacientes los resultados de la tomografía fueron negativos antes de las 24 horas de evolución y 64,0 % se consideraron mejorados con secuelas. Conclusiones: La tomografía antes de las 24 horas demuestra una baja positividad y los hallazgos evolucionan con el tiempo, aunque es posible reconocer varios signos precoces de ictus agudo en menos de 4-6 horas.


Introduction: The clinical method by itself is not definitive to diagnose a cerebrovascular disease, reason why the use of imaging diagnostic means, as the computerized axial tomography is important, as it allows to investigate the morphological and functional aspects of the brain. Objective: To describe the clinical and tomographic characteristics of patients with complete stroke. Methods: A descriptive and cross-sectional study of 269 patients with complete stroke, assisted in Saturnino Lora Torres Teaching Clinical Surgical Provincial Hospital was carried out in Santiago de Cuba, from January to December, 2019. Results: There was a prevalence of the male sex (54.6 %), 70-79 age group, motor disorders (76.5 %), alteration of the conscience (51.3 %) and language disorder (50.5 %). In 38 patients the results of the tomography were negative before the 24 hours of clinical course and 64.0 % were better with aftereffects of the disease. Conclusions: Tomography before the 24 hours demonstrates a low positivity and findings have a favorable clinical course as time goes by, although it is possible to recognize several early signs of acute ictus in less than 4-6 hours.


Subject(s)
Brain Diseases , Cerebral Infarction/diagnostic imaging , Brain Ischemia/diagnostic imaging , Tomography, Spiral Computed
2.
Rev. Assoc. Med. Bras. (1992) ; 66(1): 74-80, Jan. 2020. tab, graf
Article in English | LILACS | ID: biblio-1091899

ABSTRACT

SUMMARY OBJECTIVE This study aims to investigate the application value of magnetic resonance (MR) hydrography of the inner ear in cochlear implantation. METHODS 146 patients were enrolled. MR hydrography and spiral CT examinations for the intracranial auditory canal were performed before surgery, and all imaging results were statistically analyzed in order to explore the application value of MR hydrography of the inner ear in cochlear implantation. RESULTS 146 patients (292 ears) were examined. Among these patients, 13 were diagnosed with abnormal vestibular aqueducts (20 ears) by MR hydrography, while five were diagnosed with this disease by CT; 15 patients were diagnosed with inner ear malformation (19 ears) by MR hydrography, while 11 were diagnosed by CT (four were misdiagnosed); five patients were diagnosed with internal acoustic canal stenosis (eight ears) by MR hydrography, while two were diagnosed by CT (three were misdiagnosed); and four patients were diagnosed with cochlear fibrosis (five ears) by MR hydrography, while four were diagnosed by CT (four ears). The correct rate of diagnosis was 77.40% (113/146) based on CT, while the rate was 93.84% (137/146) based on MR hydrography. CONCLUSIONS MR hydrography imaging technique can be applied to the preoperative evaluation of cochlear implantation, providing accurate and reliable anatomic information on the inner membranous labyrinth and nerves in the internal acoustic canal and an accurate basis for the diagnosis of cochlear fibrosis and nerve development. This has a guiding significance for the selection of treatment schemes.


RESUMO OBJETIVO Este estudo visa investigar o valor da aplicação da hidrografia por ressonância magnética (RM) do ouvido interno no implante coclear. MÉTODOS Cento e quarenta e seis pacientes foram inscritos. Os exames da hidrografia por RM e do CT espiral para o canal auditivo intracraniano foram executados antes da cirurgia, e todos os resultados da imagem foram analisados estatisticamente, a fim de explorar o valor da aplicação da hidrografia por RM do ouvido interno no implante coclear. RESULTADOS Centro e quarenta e seis pacientes (292 ouvidos) foram examinados. Dentre esses pacientes, 13 foram diagnosticados com aquedutos vestibulares anormais (20 ouvidos) pela hidrografia por RM, enquanto cinco pacientes foram diagnosticados com esta doença pelo CT; 15 pacientes foram diagnosticados com malformação do ouvido interno (19 ouvidos) pela hidrografia por RM, enquanto 11 pacientes foram diagnosticados por CT (quatro foram diagnosticados erroneamente); cinco pacientes foram diagnosticados com estenose de canal acústico interno (oito ouvidos) pela hidrografia por RM, enquanto dois pacientes foram diagnosticados por CT (três foram diagnosticados erroneamente); e quatro pacientes foram diagnosticados com fibrose coclear (cinco ouvidos) pela hidrografia por RM, enquanto quatro foram diagnosticados por CT (quatro ouvidos). A taxa correta de diagnóstico foi de 77,40% (113/146) com base no CT, enquanto a taxa foi de 93,84% (137/146) com base na hidrografia por RM. CONCLUSÕES A técnica de imagem da hidrografia por RM pode ser aplicada à avaliação pré-operatória do implante coclear, que pode fornecer informações anatômicas precisas e confiáveis sobre o labirinto membranoso interno e os nervos no canal acústico interno, além de uma base exata para o diagnóstico da fibrose coclear e do desenvolvimento do nervo. Isso tem um significado orientador para a seleção de esquemas de tratamento.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Young Adult , Magnetic Resonance Imaging/methods , Cochlear Implantation/methods , Ear, Inner/diagnostic imaging , Reference Values , Reproducibility of Results , Tomography, Spiral Computed/methods , Preoperative Period , Hearing Loss, Sensorineural/surgery , Hearing Loss, Sensorineural/diagnostic imaging , Ear, Inner/surgery , Labyrinth Diseases/surgery , Labyrinth Diseases/diagnostic imaging , Middle Aged
3.
Braz. dent. sci ; 23(2): 1-8, 2020. ilus
Article in English | LILACS, BBO | ID: biblio-1095886

ABSTRACT

Objective: This work aims to use new spectroscopic and radiographic methods to study the dental hard tissue erosion and abfraction, as these lesions are actually quite difficult to be diagnosed in clinical practice. Material and Methods: This in vivo study was conducted on 60 patients with early erosion and 60 patients with abfraction at the cervical area by means of laser-induced fluorescence (LIF) and multilayer spiral computed tomography (MSCT). Results: In comparative dental hard tissues studies LIF spectra from intact and affected areas, it was noted multidirectional fluorescence intensity dependence between areas affected by abfraction and intact areas. MSCT technique allowed assessing the degree of damaged areas, especially at deeper stages. Conclusion: Although LIF and MSCT methods presented limitations, it was shown their effectiveness in the diagnosis of abfraction and erosion by detecting changes in the morphological structure as well as in the chemical and mineral composition of affected dental hard tissues. So LIF and MSCT methods can be successfully used in order to develop new medical devices which will provide most accurate clinical diagnose of different stages of dental erosion and abfraction.(AU)


Objetivo: Este trabalho tem como objetivo utilizar novos métodos espectroscópicos e radiográficos para estudar a erosão e a abração do tecido duro dentário, pois essas lesões são realmente bastante difíceis de serem diagnosticadas na prática clínica. Material e Métodos: Este estudo in vivo foi realizado em 120 pacientes com erosão e abração precoces na área cervical por meio de fluorescência induzida por laser (LIF) e tomografia computadorizada em espiral multicamada (MSCT). Resultados: Em estudos comparativos espectros de LIF, de tecidos duros dentais intactos e afetados, observouse dependência da intensidade da fluorescência multidirecional entre as áreas afetadas pela abração e as áreas intactas. A técnica MSCT permitiu avaliar o grau de áreas danificadas, principalmente em estágios mais profundos. Conclusão: Embora os métodos LIF e MSCT tenham apresentado limitações, foi demonstrada sua eficácia no diagnóstico de abração e erosão, detectando alterações na estrutura morfológica e na composição química e mineral dos tecidos duros afetados. Portanto, os métodos LIF e MSCT podem ser utilizados com sucesso, a fim de desenvolver novos dispositivos médicos que fornecerão um diagnóstico clínico mais preciso de diferentes estágios de erosão e abração dentária.(AU)


Subject(s)
Humans , Spectrometry, Fluorescence , Tooth Erosion , Tooth Demineralization , Tomography, Spiral Computed
4.
São Paulo; s.n; 20200000. 71 p.
Thesis in Portuguese | LILACS, BBO | ID: biblio-1119590

ABSTRACT

Entre os principais exames de imagem para se avaliar a articulação temporomandibular (ATM) destaca-se a ressonância magnética (RM) e a tomografia computadorizada espiral (TC). Por meio destes exames pode-se observar estruturas ósseas e tecidos moles para detectar alterações patológicas na ATM. A RM e a TC podem apresentar certas limitações na resolução espacial e a variação de contraste das estruturas anatômicas da ATM, assim como também a presença de artefatos podem implicar em problemas na qualidade da imagem e uma análise imprecisa. Atualmente, na Radiologia, se utiliza diferentes tipos de filtros de realce oferecidos pelos softwares de imagem beneficiando o diagnóstico. Neste estudo avaliamos a utilização de dois tipos de filtros (filtro Sharpen 3x3 ou F1 e filtro Sharpen 5x5 ou F2) pertencentes ao software Osirix MD para a observação de três alterações patológicas na cabeça da mandíbula: aplainamento, erosão e osteófito. Foram analisadas 77 ATMs em RM e TC. A avaliação da repetibilidade e reprodutibilidade dos examinadores foi realizada através de GEE (Genelarized Estimating Equations), e a comparação entre os filtros e entre as técnicas foi realizada através do teste Qui-Quadrado. Os resultados mostraram que a aplicação dos filtros melhoraram a qualidade de imagem na RM (F2>F1>SF), mas na TC só a aplicação do F1 melhorou a qualidade da imagem (F1>SF>F2).


Subject(s)
Temporomandibular Joint , Image Processing, Computer-Assisted , Magnetic Resonance Spectroscopy , Tomography, Spiral Computed
5.
Rev. ADM ; 76(6): 336-342, nov.-dic. 2019. ilus
Article in Spanish | LILACS | ID: biblio-1087527

ABSTRACT

Los tumores de las glándulas salivales constituyen alrededor de 5% de las neoplasias de cabeza y cuello. El adenoma pleomorfo es el tumor benigno más frecuente de las glándulas salivales, representa aproximadamente 60% de todas las neoplasias salivales, está compuesto fundamentalmente por una proliferación de células mioepiteliales y por un amplio espectro de componentes de tejido epitelial y mesenquimal, rodeado por una nítida cápsula fibrosa. Alrededor de 80% de los adenomas pleomorfos aparecen en la parótida, 10% en la glándula submandibular y 10% en las glándulas salivales menores de la cavidad oral. La edad media de presentación es a los 46 años, pero la edad oscila entre la tercera y la quinta década de la vida. No obstante, ha sido encontrado en individuos de todas las edades, presentando una ligera predilección por el sexo femenino. Respecto a su sitio de origen, el adenoma pleomorfo es asintomático, de crecimiento lento y consistencia firme. La tomografía axial computarizada (TAC) y la resonancia magnética nuclear (RMN) son de gran utilidad para evaluar la extensión de la lesión, así como el compromiso de estructuras importantes. La biopsia por aspiración con aguja fina (BAAF) es un método útil para el diagnóstico de este tipo de neoplasias. El tratamiento de este tipo de lesiones consiste en la remoción quirúrgica de la tumoración junto con la glándula afectada. Menos de 1% de los casos de adenomas pleomorfos sufren transformación maligna, especialmente los que han presentado múltiples recidivas (AU)


The tumors of the salivary glands constitute about 5% of the neoplasms of the head and neck. The pleomorphic adenoma is the most frequent benign tumor of the salivary glands, represents approximately 60% of all salivary neoplasms, is composed mainly of a proliferation of myoepithelial cells and a wide spectrum of components of epithelial and mesenchymal tissue, surrounded by a sharp fibrous capsule. About 80% of pleomorphic adenomas appear in the parotid, 10% in the submandibular gland and 10% in the minor salivary glands of the oral cavity. The average age of presentation is 46 years, but age ranges between the third and fifth decade of life. However, it has been found in individuals of all ages, presenting a slight female predilection. Regarding its site of origin, the pleomorphic adenoma is asymptomatic, slow growing and firm consistency. Computed tomography (CT) and nuclear magnetic resonance (NMR) are very useful to evaluate the extent of the injury as well as the commitment of important structures. Fine needle aspiration biopsy (FNAB) is a useful method for the diagnosis of this type of neoplasm. The treatment of this type of injuries consists in the surgical removal of the tumor together with the affected gland. Less than 1% of cases of pleomorphic adenomas suffer malignant transformation, especially those that have presented multiple recurrences (AU)


Subject(s)
Humans , Male , Middle Aged , Submandibular Gland/pathology , Adenoma, Pleomorphic , Magnetic Resonance Imaging , Histological Techniques , Adenoma, Pleomorphic/diagnostic imaging , Oral Surgical Procedures , Tomography, Spiral Computed , Biopsy, Fine-Needle , Age and Sex Distribution
6.
Rev. medica electron ; 41(2): 368-381, mar.-abr. 2019. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1004274

ABSTRACT

RESUMEN Introducción: el traumatismo encefalocraneano es una causa frecuente de mortalidad y morbilidad. Según datos epidemiológicos aporta la mayor cantidad de fallecidos en menores de 45 años a nivel mundial. Objetivo: caracterizar el trauma craneoencefálico desde el punto de vista clínico-quirúrgico, neuroimagenológico y por neuromonitorización en los pacientes investigados. Materiales y métodos: estudio observacional, descriptivo, transversal, en el Servicio de Neurocirugía del Hospital Provincial Clínico Quirúrgico Docente José Ramón López Tabrane y Comandante Faustino Pérez Hernández, de Matanzas, durante el periodo comprendido entre enero del 2016 a enero del 2018. Resultados: predominó el sexo masculino con el 71,7% de los casos, la mayor prevalencia estuvo en edades inferiores a 48 años con el 80,1 %. La mayor cantidad presentaba un traumatismo encefalocraneano leve con el 56% de los casos seguido del traumatismo encefalocraneano moderado y severo con el 29% y 15% de los casos respectivamente. Predominaron las fracturas lineales (45,8%), seguido de las contusiones sin efecto de masa y los hematomas subdurales con el 24,2% y 23,3%. La mayoría de los pacientes presentó una escala de Marshall II con el 40,8%. Las cifras de presión intracraneal entre de 20-40 mmHg se presentó con mayor frecuencia (44,4 %). Conclusiones: la mitad de los pacientes neuromonitorizados presentaron una saturación del golfo de la vena yugular dentro de parámetros normales con el 50%. La operación más practicada fue la evacuación de hematomas subdurales con el 29,4%.


ABSTRACT Introduction: the encephalocranial trauma (ECT) is a frequent cause of mortality and morbidity. According to epidemiological data, it causes the highest number of deaths in people aged less than 45 years worldwide. Objective: to characterize the encephalocranial trauma from the clinical-surgical, neuroimaging and neuromonitoring point of view in the studied patients. Materials and methods: observational, descriptive, cross-sectional study carried out in the Neurosurgery Service of the Provincial Teaching Surgical Clinical Hospitals "Jose Ramon Lopez Tabrane" and "Comandante Faustino Perez Hernandez", of Matanzas, during the period from January 2016 to January 2018. Results: male sex predominated with 71.7% of the cases; the highest prevalence was in ages below 48 years with 80.1%. Most of them presented a mild encephalocranial trauma with 56% of the cases followed by moderate and severe encephalocranial trauma with 29% and 15% of the cases respectively. Linear fractures predominated (45.8%), followed by contusions without mass effect and subdural hematomas with 24.2% and 23.3%. Most of patients presented a Marshall II scale with 40.8%. The intracranial pressure between 20-40 mmHg occurred more frequently (44.4%). Conclusions: half of the neuromonitored patients presented jugular vein gulf saturation within normal parameters with 50%. The most practiced operation was the evacuation of subdural hematomas with 29.4%.


Subject(s)
Humans , Neurosurgical Procedures , Tomography, Spiral Computed , Craniocerebral Trauma/surgery , Craniocerebral Trauma/classification , Craniocerebral Trauma/mortality , Craniocerebral Trauma/epidemiology , Craniocerebral Trauma/diagnostic imaging , Epidemiology, Descriptive , Cross-Sectional Studies , Observational Study , Craniocerebral Trauma/diagnosis
8.
Rev. medica electron ; 41(2): 555-563, mar.-abr. 2019. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1004288

ABSTRACT

RESUMEN Los quistes epidermoides constituyen el 1 % de los tumores intracraneales y el 7 % de los del ángulo pontocerebeloso. Los colesteatomas son lesiones benignas que se originan de restos de tejidos epitelial ectodérmicos que quedan en el sistema nervioso central, al cerrarse el tubo neural entre la tercera y quinta semana de gestación. Se trata de un paciente remitido de la Consulta de Neurooftalmología con crisis de cefalea y toma de los pares craneales III, IV, V, rama oftálmica desde hace 2 semanas. Se le realizaron estudios imagenológicos donde se constató un tumor hipodenso en región silviana frontotemporal izquierdo. Se interpretó como un quiste arcnoideo. Se le aplicó un bordaje pterional transilviano con apoyo neuroendoscópico y para sorpresa del equipo quirúrgico se abordó un tumor perlado solido identificado macroscópicamente como un colesteatoma silviano. Se resecó la totalidad del tumor cerebral.


ABSTRACT Epidermal inclusion cysts constitute 1% of the intracranial tumors and 7% of the cerebellopontine angle ones.Cholesteatoma are benign lesions originated from the remains of ectodermic epithelial tissues remaining in the central nervous system when the neural tube closes between the third and fifth week of pregnancy. The case deals with a patient remitted from the Neurophthalmologic Consultation with migraine crisis and lesion on the III, IV, V cranial nerves, ophthalmologic branch, for two weeks. Image studies were carried out, showing a hypo dense tumor in the left silvian frontotemporal region. It was taken as an arachnoid cyst. A pterional trans-silvian approach with neuroendoscopic support was applied, and the surgical team was surprised when they found a solid pearly tumor that was macroscopically identified as a silvian cholesteatoma. The cerebral tumor was totally resected.


Subject(s)
Humans , Male , Aged , Cholesteatoma/surgery , Cholesteatoma/diagnosis , Neurosurgical Procedures , Craniotomy/methods , Neuroendoscopy , Epidermal Cyst/surgery , Epidermal Cyst/diagnosis , Blepharoptosis/diagnosis , Magnetic Resonance Imaging , Exotropia/diagnosis , Tomography, Spiral Computed
9.
Article in English | WPRIM | ID: wpr-765659

ABSTRACT

OBJECTIVE: Fatty liver is associated with insulin resistance-related diseases, such as dyslipidemia, obesity, and type 2 diabetes. The aim of this study was to evaluate the association of dyslipidemia with fatty liver and assess the differences in these associations according to the degree of hepatic steatosis. METHODS: A total of 2,462 subjects (1,679 men and 783 women) who underwent a comprehensive health check-up (including abdominal computed tomography) from January 2010 to December 2013 were enrolled at Samsung Changwon Hospital Healthcare Center. The liver attenuation index (LAI), defined as the difference between mean hepatic and splenic attenuation, was used to assess the degree of hepatic steatosis. An LAI below 5 Hounsfield units was defined as fatty liver. RESULTS: We found that 32.2% of the study subjects had fatty liver. Serum low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG), and fasting blood glucose concentrations and glycated hemoglobin (HbA1c percentage) were significant greater in the fatty liver group compared with the non-fatty liver group, while serum high-density lipoprotein cholesterol (HDL-C) was significantly lower in the fatty liver group. Subjects with fatty liver had 1.7-fold greater risk of dyslipidemia than those without fatty liver after adjusting for age, sex, body mass index (BMI), and HbA1c. When individuals with fatty liver were analyzed by tertiles of LAI values, LDL-C, TG, fasting glucose, BMI, and HbA1c concentrations increased while HDL-C decreased with decreasing LAI tertiles. Compared with LAI tertile 3, the risk for dyslipidemia significantly increased with adjusted odds ratios of 1.42, and 1.81 in tertiles 2 and 1, respectively. CONCLUSION: Fatty liver was significantly associated with dyslipidemia and this association varied according to the degree of hepatic steatosis.


Subject(s)
Blood Glucose , Body Mass Index , Cholesterol , Delivery of Health Care , Dyslipidemias , Fasting , Fatty Liver , Glucose , Glycated Hemoglobin A , Humans , Insulin , Korea , Lipoproteins , Liver , Male , Obesity , Odds Ratio , Tomography, Spiral Computed , Triglycerides
10.
Article in Chinese | WPRIM | ID: wpr-813022

ABSTRACT

To analyze the incidence and imaging characteristics of pulmonary nodules in a unit staff.
 Methods: Low-dose spiral CT (LDCT) scan were performed in 1 372 staffs ≥45 years old in a certain unit during the physical examination. The clinical and imaging data were collected to analyze the detection rate, imaging characteristics, and postoperative pathological conditions of pulmonary nodules.
 Results: The total detection rate for pulmonary nodules was 30.39% (417/1 372). The detected nodules were mainly single (227 cases), solid (343 cases), 0.05). Compared with the Lung-RADS category 3 nodules, the proportions of nodules in subsolid state, with irregular shape, lobulation sign, and vascular penetration in the Lung-RADS category 4 were increased (all P<0.05). Among them, 11 patients received surgical therapy, including 10 women. Postoperative pathology confirmed lung adenocarcinoma in 9 patients (2.16%), including 8 women, all non-smokers.
 Conclusion: The nodules in subsolid state with vascular penetration, irregular shape and lobulation sign tend to be malignant. Lung cancer screening with low-dose spiral CT in female non-smokers should be emphasized.


Subject(s)
Early Detection of Cancer , Female , Humans , Lung Neoplasms , Diagnostic Imaging , Male , Middle Aged , Tomography, Spiral Computed , Tomography, X-Ray Computed
11.
Medisan ; 22(9)nov.-dic. 2018. tab
Article in Spanish | LILACS | ID: biblio-976169

ABSTRACT

Se realizó un estudio observacional, descriptivo y transversal de 61 pacientes con diagnóstico confirmado de cáncer de pulmón, atendidos en el Servicio de Radiología del Hospital General Docente Dr Juan Bruno Zayas Alfonso de Santiago de Cuba durante 2015, con vistas a caracterizarles según variables de interés. Los resultados se organizaron en distribuciones de frecuencias y se confeccionaron tablas de una y dos entradas para establecer algunas relaciones entre variables. En la serie predominaron el sexo masculino (55,7 por ciento), el grupo etario de 60-69 años (39,3 por ciento), el antecedente de bronquitis crónica en ambos sexos (75,4 por ciento), la tos como síntoma principal (63,9 por ciento), la localización periférica (78,7 por ciento) y el adenocarcinoma como tipo histológico (57,4 por ciento), entre otros. Al momento del diagnóstico el mayor número de afectados se encontraba en etapas avanzadas de la enfermedad, por lo que se recomienda implementar estudios a todos aquellos con riesgo de padecerla.


An observational, descriptive and cross-sectional study of 61 patients with confirmed diagnosis of lung cancer, assisted in the Radiology Service of Dr Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba was carried out during 2015, with the aim of characterizing them according to variables of interest. The results were organized in distributions of frequencies and charts of one and two entrances were made to establish some relationships among variables. In the series, the male sex (55.7 percent), the age group 60-69 years (39.3 percent), history of chronic bronchitis in both sexes (75.4 percent), cough as main symptom (63.9 percent), outlying localization (78.7 percent) and the adenocarcinoma as histological type (57.4 percent) prevailed, among others. At the moment of the diagnosis the greatest number affected patients was in advanced stages of the disease, so that it is recommended to implement studies to all those with risk of suffering it.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Lung Neoplasms/physiopathology , Lung Neoplasms/epidemiology , Lung Neoplasms/diagnostic imaging , Tomography, Spiral Computed/methods , Lung Neoplasms
12.
Rev. cuba. med. mil ; 47(4)oct.-dic. 2018. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-985545

ABSTRACT

Los traumatismos oculares representan la principal causa de pérdida de la agudeza visual en individuos jóvenes y se sitúa entre las causas de ceguera en el mundo. Pueden tener un efecto devastador sobre el globo ocular; es el tipo de traumatismo más severo en esta zona, con un pobre pronóstico visual para el paciente. Constituye un accidente grave, que en muchas ocasiones conlleva a la enucleación. Se presentan tres pacientes con rotura del globo ocular, con la conducta terapéutica, seguimiento y resultados visuales en cada caso, para mostrar a la comunidad médica, la complejidad y particularidades de este traumatismo(AU)


Ocular traumatisms represent the principal cause of loss of vision in young people and they are among the causes of blindness in the world. Trauma can result in a wide spectrum of tissue lesions of the globe and it can has devastating effect on the eyeball, since it is the most severe type of trauma in this area, with a poor visual prognosis for the patient. It is a serious accident, which often leads to nucleation as result of a bruised intense trauma. This is the report of three patients with rupture of the ocular globe with the therapeutic behavior, follow-up and visual results in each case, to show the medical community, the complexity and particularities of this traumatism(AU)


Subject(s)
Humans , Male , Female , Adult , Aged , Vitrectomy/methods , Eye Enucleation/methods , Eye Injuries, Penetrating/surgery , Tomography, Spiral Computed/methods , Vitreoretinopathy, Proliferative/drug therapy
13.
Int. j. morphol ; 36(3): 871-876, Sept. 2018. tab, graf
Article in English | LILACS | ID: biblio-954200

ABSTRACT

The nerve entry points (NEPs) cannot yet be accurately localized for the treatment of thigh adductor muscles spasticity in chemical neurolysis. The aim of this study was to identify the location and depth of the NEPs of thigh adductor muscles by spiral computed tomography (CT) and bony landmarks. Forty lower limbs of twenty adult cadavers were dissected in supine position. A curved line on skin surface from the tip of greater trochanter of femur to the center of pubic tubercle was designated as the horizontal reference line (H). Another curved line from the tip of great trochanter to the lateral epicondyle of femur was designated as the longitudinal reference line (L). Following dissection, the NEPs were labeled with barium sulfate, and their body surface projection points (P) were determined by spiral CT. Projection of NEP in the opposite direction was designated as P'. The percentage location of the intersections (PH and PL) of P with the H and L and the percentage depth of NEPs were determined with the Syngo system. The PH for the NEP of pectineus, gracilis, adductor longus, adductor brevis and adductor magnus muscles branch were located at 76.41±0.71 %, 93.85±2.07 %, 92.05±2.15 %, 80.75±1.20 % and 88.08±1.09 % of the H, respectively. The PLwere at 1.64±0.04 %, 29.89±1.90 %, 16.06±1.32 %, 11.66±0.11 % and 22.94±0.90 % of the L, respectively. The depth of NEP from P points were at 17.52±0.52 %, 38.38±2.75 %, 20.88±0.79 %, 20.35±0.82 % and 39.52±0.67 % of PP', respectively. These results help to carry out more precise localization of the NEPs. It should provide a novel anatomical guide for improving the efficacy and efficiency of chemical neurolysis in treating thigh adductor muscle spasticity.


Aún no se pueden localizar con precisión los puntos de entrada del nervio (PEN) para el tratamiento de la espasticidad de los músculos aductores del muslo a través de la neurólisis química. El objetivo de este estudio fue identificar la ubicación y la profundidad de los PEN de los músculos aductores del muslo mediante tomografía computarizada espiral (TC) y puntos de referencia óseos. Se disecaron loa miembros inferiores de 20 cadáveres adultos en posición supina. Se trazó una línea curva en la superficie de la piel desdeel ápice del trocánter mayor del fémur hasta el centro del tubérculo púbico y se designó como línea de referencia horizontal (H). Otra línea curva desde el ápice del trocánter mayor hasta el epicóndilo lateral del fémur se designó como línea de referencia longitudinal (L). Después de la disección, los PEN se marcaron con sulfato de bario y sus puntos de proyección de la superficie del cuerpo (P) se determinaron mediante TC helicoidal. La proyección de PEN en la dirección opuesta se designó como P '. El porcentaje de ubicación de las intersecciones (PH y PL) de P con H y L y la profundidad porcentual de los PEN se determinaron con el sistema Syngo. Los PH para los PEN de los músculos pectineus, gracilis, adductor longus, aductor brevis y rama aductora del músculo aductor magnus se localizaron en 76,41±0,71 %, 93,85±2,07 %, 92,05±2,15 %, 80,75±1,20 % y 88,08±1,09 % de H, respectivamente. Los PL estuvieron en 1,64±0,04 %, 29,89±1,90 %, 16,06±1,32 %, 11,66±0,11 % y 22,94±0,90 % de la L, respectivamente. La profundidad de PEN de P puntos fue de 17,52±0,52 %, 38,38±2,75 %, 20,88±0,79 %, 20,35±0,82 % y 39,52±0,67 % de PP ', respectivamente. Estos resultados ayudan a realizar una localización más precisa de los PEN. Se debe proponer una nueva guía anatómica para mejorar la eficacia y la eficiencia de la neurólisis química en el tratamiento de la espasticidad del músculo aductor del muslo.


Subject(s)
Thigh/innervation , Thigh/diagnostic imaging , Muscle, Skeletal/innervation , Muscle, Skeletal/diagnostic imaging , Cadaver , Tomography, Spiral Computed , Anatomic Landmarks
14.
Rev. cuba. med. mil ; 47(3): 1-6, jul.-set. 2018. ilus
Article in Spanish | LILACS | ID: biblio-985539

ABSTRACT

El pseudoaneurisma cardíaco es una entidad poco frecuente, que se produce cuando existe una rotura incompleta de la pared del corazón y el pericardio sella dicha rotura. Se desarrolla una neocavidad comunicada con la cavidad ventricular por un orificio estrecho. El objetivo del presente trabajo es reportar un caso de pseudoaneurisma ventricular izquierdo, entidad muy poco frecuente. Se presenta un paciente masculino de 69 años, con antecedentes de infarto del miocardio tres años previos al ingreso, que acude al cuerpo de guardia por dolor torácico y disnea. Se le realiza radiografía de tórax, vista póstero-anterior, donde se observa imagen radiopaca con tendencia nodular que borra el contorno cardiaco izquierdo, se complementa con ecografía transtorácica y tomografía helicoidal computarizada, se visualiza una imagen sacular por adición en la pared lateral del ventrículo izquierdo, con trombo mural en su interior, que comunicaba con este a través de cuello estrecho. Se llegó a la conclusión de que se trataba de un pseudoaneurisma ventricular izquierdo. Esta es una entidad que presenta una alta mortalidad, por lo que es necesario realizar un diagnóstico oportuno, a fin de tomar la conducta adecuada para prevenir las complicaciones(AU)


The cardiac pseudoaneurysm is a rare entity, which occurs when there is an incomplete rupture of the heart wall and the pericardium seals the rupture. A neocavity develops communicating with the ventricular cavity through a narrow orifice. The objective of this study is to report a rare case of left ventricular pseudoaneurysm. We present a 69-year-old male patient with a history of myocardial infarction three years prior to admission. The patient goes to the emergency room for chest pain and dyspnea. He underwent chest X-rays for rear-anterior view showing a radiopaque image with nodular tendency that erases the left cardiac line. Transthoracic ultrasound and computerized helical tomography are used to complement the examination. A saccular image is shown by adding to the lateral wall of the left ventricle with wall thrombus inside, a communicating narrow neck. It was concluded that it was a left ventricular pseudoaneurysm. This is an entity that presents high mortality, so it is necessary to make timely diagnosis, in order to take the appropriate medical behavior for preventing complications(AU)


Subject(s)
Humans , Male , Aged , Carotid Artery Injuries/diagnostic imaging , Tomography, Spiral Computed/methods , Myocardial Infarction/etiology
15.
Rev. odontol. Univ. Cid. São Paulo (Online) ; 30(1): 47-53, jan.-mar. 2018. ilus., tab.
Article in Portuguese | LILACS, BBO | ID: biblio-965201

ABSTRACT

O ducto nasolacrimal é um canal que tem início na porção medial anterior do assoalho da órbita e que deságua na cavidade nasal, no meato inferior. Por meio desse ducto a lágrima é recolhida e drenada da órbita para a cavidade nasal. A obstrução do ducto nasolacrimal pode apresentar diferentes etiologias, podendo ser doenças ou alterações anatômicas. Alterações no padrão de normalidade da relação entre o ducto nasolacrimal e o septo podem favorecer a obstrução do ducto. Com isso, faz-se necessário avaliar a distância normal entre o septo nasal e o ducto nasolacrimal, por meio de tomografia computadorizada de modo a conhecermos o padrão de distância comumente encontrado e analisar alterações desse padrão e a contribuição do desvio que possam levar à perda da saúde nessa região. Neste trabalho, foi utilizada uma amostra contendo 51 exames de tomografia computadorizada helicoidal da face, de ambos os gêneros, sendo 22 homens (43,13%), faixa etária entre 18 e 96 anos, e 29 mulheres (56,87%), faixa etária entre 20 e 73 anos. A análise das imagens foi feita em duas alturas, sendo a primeira ao nível da órbita e a segunda ao nível da raiz da concha nasal inferior e, então, foram mensurados, pelo programa Microdicon®, o comprimento e a largura do canal nasolacrimal e sua distância ao septo nasal. Em seguida, sofreram tratamento estatístico com técnicas não paramétricas. Devido ao desvio de septo das amostras, as distâncias entre o ducto nasolacrimal e o septo nas duas alturas apresentaram discrepância entre os valores. E a largura na altura da concha nasal inferior também apresentou discrepância, entretanto o valor de p foi 0,51, sugerindo que o resultado seja consequência do acaso. Com isso, não obtivemos resultados que possam correlacionar as dimensões do canal nasolacrimal com a direção do desvio do septo e a obstrução do ducto.


The nasolacrimal duct is a canal that begins in the anterior medial portion of the floor of the orbit and drains into the nasal cavity in the inferior meatus. Through this duct the tear is collected and drained from the orbit into the nasal cavity. The obstruction of the nasolacrimal duct may present different etiologies, including diseases and anatomical alterations. Changes in the normality of the relationship between the nasolacrimal duct and the septum may favor the duct obstruction. Thus, it is necessary to evaluate the normal distance between the nasal septum and the nasolacrimal duct by means of computerized tomography in order to know the distance pattern commonly found and to analyze changes in this pattern and the contribution of the deviation that could lead to health loss in this region. In this study, a sample containing 51 helicoidal computerized tomography (CT) examinations of both genders was used: 22 men (43.13%), aged between 18 and 96 years old, and 29 women (56.87%), aged between 20 and 73 years old. The images were analyzed at two different heights, the first at orbit level and the second at the root level of the inferior turbinate, and then, measured by the Microdicon® program, the length and width of the nasolacrimal canal and its distance to the nasal septum. Afterwards, they underwent statistical treatment with non-parametric techniques. Due to the septal deviation of the samples, the distances between the nasolacrimal duct and the septum at both heights presented a discrepancy between the values. And the width at the height of the inferior turbinate also presented a discrepancy, however the p value was 0.51, suggesting that the result is a consequence of chance. With this, we did not obtain results that could correlate the dimensions of the lacrimonasal canal with the direction of the septal deviation and the duct obstruction.


Subject(s)
Tomography, Spiral Computed , Nasal Septum , Nasolacrimal Duct
16.
Rev. odontol. Univ. Cid. São Paulo (Online) ; 30(1): 54-63, jan.-mar. 2018. ilus.
Article in Portuguese | LILACS, BBO | ID: biblio-965206

ABSTRACT

A órbita é uma escavação óssea no crânio, que tem função de apoio e proteção ao bulbo do olho, seus vasos e nervos. Ela é uma pirâmide óssea composta por 7 ossos que compõem quatro paredes: um teto, uma base, parede lateral e medial; são eles o osso esfenoidal, etmoide, maxila, palatino, placa orbital do osso frontal, zigomático e lacrimal. O nervo óptico é composto pelas células ganglionares da retina e comunica o globo ocular ao cérebro. Pode ser dividido em 4 partes que possuem comprimentos diferentes, num total de 50mm, divididos em partes intraocular, intraorbital, intracanalicular e intracraniano. Tanto a órbita quanto o nervo óptico devem estar dentro dos parâmetros anatômicos de normalidade e qualquer alteração nesse padrão é uma possível causa de perda ou diminuição da acuidade visual. Uma dessas possíveis causas da diminuição da acuidade poderia ser uma anormalidade anatômica dos ossos orbitais, causando uma diminuição ou distorção do espaço orbital. Outra hipótese pode ser uma desproporção entre as dimensões do nervo óptico e o forame óptico, causando uma compressão e consequente lesão nervosa, ou até mesmo a existência de uma desproporção entre a cavidade orbital e os diâmetros do nervo óptico. Para compreender a relação entre a perda da acuidade visual e as alterações anatômicas citadas é essencial estabelecer o padrão de normalidade da órbita e do nervo óptico e suas dimensões. Para o tipo de análise proposta, a tomografia computadorizada helicoidal pode fornecer esses padrões de normalidade. Com esse intuito, foram observados 50 exames em cortes axiais representando a cavidade orbital, o canal óptico e o nervo óptico que foram identificados e mensurados pelo programa OsiriX. O comprimento da cavidade da órbita apontou para o lado direito, média de 39,40mm e, lado esquerdo, média de 38,40mm. O comprimento da parte intraorbital do nervo óptico para o olho direito, média 23,90mm e o olho esquerdo, média de 23,60mm. O diâmetro do canal óptico do lado direito alcançou um valor médio de 4,900mm e do lado esquerdo obteve uma média de 4,290mm. Por meio da análise do presente estudo foi possível estabelecer valores numéricos para o padrão de normalidade, permitindo investigações causais posteriores.


The orbit is a bone digging in the skull, which has a supporting and protective function to the eye bulb, its vessels and nerves. It is a bone pyramid composed of 7 bones that consists of four walls: a ceiling, a base, lateral and medial wall. They are the sphenoid bone, ethmoid, maxilla, palatine, orbital plaque of the frontal bone, zygomatic and lacrimal. The optic nerve is composed of the ganglion cells of the retina, and they communicate the ocular globe to the cortex. It can be divided into 4 parts that present different lengths, being a total of 50mm, divided into intraocular, intraorbital, intracanalicular and intracranial parts. Both the orbit and the optic nerve must be within the anatomical parameters of normality, and any change in this pattern is a possible cause of loss or decrease of visual acuity. One of these possible causes of decreased acuity could be an anatomical abnormality of the orbital bones, causing a decrease or distortion of the orbital space. Another hypothesis may be a disproportion between the dimensions of the optic nerve and the optic foramen, causing a compression and consequent nerve damage, or even the existence of a disproportion between the orbital cavity and the diameters of the optic nerve. To understand the relationship between loss of visual acuity and the anatomical changes cited, it is essential to establish the normality of the orbit and optic nerve and its dimensions. For analysis proposed, helical computerized tomography can provide these normality patterns. For this purpose, 50 exams were performed on axial sections representing the orbital cavity, optic canal and optic nerve that were identified and measured by the OsiriX program. The cavity length of the orbit was to the right side, mean of 39.40mm and left side: mean of 38.40mm. The length of the intraorbital portion of the optic nerve to the right eye, mean 23.90mm and the left eye, mean of 23.60mm. The diameter of the optical channel on the right side reached an average value of 4.900mm and the left side obtained an average of 4.290mm. Through the analysis of the present study it was possible to establish numerical values for the normality pattern allowing further causal investigations.


Subject(s)
Optic Nerve , Tomography, Spiral Computed , Orbit
17.
Article in Korean | WPRIM | ID: wpr-714799

ABSTRACT

OBJECTIVE: This study examined the efficacy of the computed tomography (CT) findings in the emergency department (ED) in predicting the clinical course and severity of acute pyelonephritis (APN). METHODS: This retrospective clinical study included APN patients in the ED. All participants diagnosed with APN had undergone a radiocontrast-enhanced CT evaluation. The radiocontrast-enhanced CT findings of APN revealed the typical findings, such as hypoperfusion on the kidney, extra-renal parenchymal findings, and renal abscess formation. The patients were classified into five groups based on the CT findings. The clinical parameters analyzed were the white blood cell (WBC) count, C-reactive protein (CRP) level, quick sepsis-related organ failure-assessment (qSOFA) score, need for vasopressor, length of stay, and admission to the intensive care unit (ICU). The relationships between the clinical parameters and the five groups based on the APN CT findings were assessed. RESULTS: Among the 264 patients, there were 225 female patients and the mean age of all patients was 57.9±20.5 years: group 1 (n=31), present renal abscess with APN; group 2 (n=118), both typical and extra-renal parenchymal findings; group 3 (n=49), only typical finding; group 4 (n=32), only extra-renal parenchymal findings; and group 5 (n=34), no APN finding on CT. The length of stay increased from groups 5 to 1. The WBC count and CRP level were worsen from groups 4 to 1, except for group 5. Statistically significant trends, such as the WBC count, CRP level and length of stay correlated with each group were observed (P < 0.001, P < 0.001, and P < 0.001). Statistically significant trends in ICU admission, use of vasopressor, and qSOFA score were also observed (P=0.022, P=0.003, and P < 0.001). CONCLUSION: The specific CT findings of APN might be helpful for predicting the clinical severity and prognosis.


Subject(s)
Abscess , C-Reactive Protein , Clinical Study , Emergencies , Emergency Service, Hospital , Female , Humans , Intensive Care Units , Kidney , Length of Stay , Leukocytes , Prognosis , Pyelonephritis , Retrospective Studies , Tomography, Spiral Computed
18.
Article in Chinese | WPRIM | ID: wpr-776375

ABSTRACT

BACKGROUND@#Lung cancer is the leading cause of cancer-related death in China. The results from a randomized controlled trial using annual low-dose computed tomography (LDCT) in specific high-risk groups demonstrated a 20% reduction in lung cancer mortality. The aim of tihs study is to establish the China National lung cancer screening guidelines for clinical practice.@*METHODS@#The China lung cancer early detection and treatment expert group (CLCEDTEG) established the China National Lung Cancer Screening Guideline with multidisciplinary representation including 4 thoracic surgeons, 4 thoracic radiologists, 2 medical oncologists, 2 pulmonologists, 2 pathologist, and 2 epidemiologist. Members have engaged in interdisciplinary collaborations regarding lung cancer screening and clinical care of patients with at risk for lung cancer. The expert group reviewed the literature, including screening trials in the United States and Europe and China, and discussed local best clinical practices in the China. A consensus-based guidelines, China National Lung Cancer Screening Guideline (CNLCSG), was recommended by CLCEDTEG appointed by the National Health and Family Planning Commission, based on results of the National Lung Screening Trial, systematic review of evidence related to LDCT screening, and protocol of lung cancer screening program conducted in rural China.@*RESULTS@#Annual lung cancer screening with LDCT is recommended for high risk individuals aged 50-74 years who have at least a 20 pack-year smoking history and who currently smoke or have quit within the past five years. Individualized decision making should be conducted before LDCT screening. LDCT screening also represents an opportunity to educate patients as to the health risks of smoking; thus, education should be integrated into the screening process in order to assist smoking cessation.@*CONCLUSIONS@#A lung cancer screening guideline is recommended for the high-risk population in China. Additional research , including LDCT combined with biomarkers, is needed to optimize the approach to low-dose CT screening in the future.


Subject(s)
Aged , China , Epidemiology , Early Detection of Cancer , Female , Humans , Lung Neoplasms , Diagnostic Imaging , Epidemiology , Male , Mass Screening , Middle Aged , Patient Selection , Practice Guidelines as Topic , Radiation Dosage , Risk , Rural Population , Tomography, Spiral Computed
19.
Int. braz. j. urol ; 43(4): 671-678, July-Aug. 2017. tab, graf
Article in English | LILACS | ID: biblio-892870

ABSTRACT

ABSTRACT Objectives Laparoscopic donor nephrectomy is now a commonly performed procedure in most of renal transplantation centers. However, the suitability of laparoscopy for donors with abnormal venous anatomy is still a subject of debate. Materials and methods Between August 2007 and August 2014, 243 laparoscopic donor nephrectomies were performed in our institution. All donors were evaluated with preoperative three-dimensional spiral computed tomography (CT) angiography Thirteen (5.35%) donors had a left renal vein anomaly. A retrospective analysis was performed to collect donor and recipient demographics and perioperative data. Results Four donors had a type I retroaortic vein, seven had type II retroaortic vein and a circumaortic vein was seen in three donors. The mean operative time was 114±11 minutes and mean warm ischemia time was 202±12 seconds. The mean blood loss was 52.7±18.4mL and no donor required blood transfusion. Mean recipient creatinine at the time of discharge was 1.15±0.18mg/dL, and creatinine at six months and one year follow-up was 1.12±0.13mg/dL and 1.2±0.14mg/dL, respectively. There were no significant differences in operative time, blood loss, warm ischemia time, donor hospital stay or recipient creatinine at 6 months follow-up, following laparoscopic donor nephrectomy in patients with or without left renal vein anomalies. Conclusion Preoperative delineation of venous anatomy using CT angiography is as important as arterial anatomy. Laparoscopic donor nephrectomy is safe and feasible in patients with retroaortic or circumaortic renal vein with good recipient outcome.


Subject(s)
Humans , Male , Female , Adult , Renal Veins/diagnostic imaging , Kidney Transplantation/methods , Tissue and Organ Harvesting/methods , Kidney/blood supply , Nephrectomy/methods , Renal Veins/abnormalities , Retrospective Studies , Treatment Outcome , Laparoscopy/methods , Living Donors , Creatinine/blood , Tomography, Spiral Computed , Warm Ischemia , Operative Time , Middle Aged , Nephrectomy/adverse effects
20.
Rev. chil. neurocir ; 43(1): 53-58, July 2017. ilus
Article in Spanish | LILACS | ID: biblio-869779

ABSTRACT

A pesar del desarrollo de las técnicas quirúrgicas de base de cráneo, los meningiomas petroclivales constituyen un reto para el neurocirujano debido a su localización y relación con estructuras neurológicas y vasculares críticas. Se reportan 2 pacientes con diagnóstico de meningioma petroclival que recibieron tratamiento por etapas incluyendo derivación ventrículo peritoneal asistida por endoscopia para la hidrocefalia, abordaje endonasal endoscópico (AEE) extendido al ápex petroso, keyhole subtemporal y retromastoideo con remoción de la lesión. La evolución fue satisfactoria. Se concluyó que los abordajes endoscópicos y por etapas constituyen una excelente opción en el tratamiento de los meningiomas petroclivales.


In spite of the development of the skull base surgery techniques, petroclival meningiomas are a challenge for neurosurgeon due to their localization and relationship with neurovascular structures. Those are two patient with diagnostic of petroclival meningioma whom received treatment step by step included ventricle peritoneal shunt with endoscopic guide for hydrocephalus, extended endonasal approach to petrous apex, subtemporal and retrosigmoid keyhole. The endoscopic approach is an excellent option in the treatment of petroclival meningioma.


Subject(s)
Humans , Male , Adult , Middle Aged , Nasal Cavity/surgery , Natural Orifice Endoscopic Surgery/methods , Endoscopy/methods , Petrous Bone/pathology , Meningioma/surgery , Meningioma/diagnostic imaging , Ventriculoperitoneal Shunt , Brain Neoplasms , Skull Base/surgery , Hydrocephalus, Normal Pressure , Hypertension , Magnetic Resonance Imaging/methods , Osteotomy/methods , Paresis , Radiosurgery/methods , Tomography, Spiral Computed/methods
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