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3.
Rev. Assoc. Med. Bras. (1992) ; 66(9): 1180-1186, Sept. 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1136360

ABSTRACT

SUMMARY INTRODUCTION: The vascular evaluation of the erectile function through Color Duplex-Doppler Ultrasound (CDDU) of the penis can benefit the therapeutic decision-making process. Unfortunately, there is no standard procedure for CDDU conduction, a fact that results in high result-interpretation variability. OBJECTIVE: The aims of this review are to promote greater standardization during CDDU of the penis and discuss the fundamental principles for its accurate conduction. METHODS: CDDU is initially conducted with the penis in the flaccid state; the whole penis must be assessed (images at B mode) with a high-frequency linear transducer (7.5-18 MHz). Intracavernous injection of vasodilating agents (prostaglandin E1, papaverine, phentolamine) is performed to induce a rigid erection. Serial measurements at different times should be taken during the CDDU session and penile rigidity must be assessed in each evaluation. RESULTS: It is important to monitor the erection response after the vasoactive agent (hardness scale), and scanning during the best-quality erection should be contemplated. Manual self-stimulation, audiovisual sexual stimulation (AVSS), and vasoactive agent re-dosing protocols must be taken into account to reduce the influence of psychogenic factors and to help the patient to get the hardest erection possible. Such measurements contribute to the maximal relaxation of the erectile tissue, so the hemodynamic parameters are not underestimated. CONCLUSIONS: CDDU is a relevant specialized tool to assess patients with erectile dysfunction; therefore, this guideline will help to standardize and establish uniformity in its conduction and interpretation, taking into consideration the complexity and heterogeneity of CDDU evaluations of the penis.


RESUMO INTRODUÇÃO: A avaliação vascular da função erétil por meio da ultrassonografia com Doppler colorido do pênis (UDCP) pode trazer benefícios na tomada de decisão. Infelizmente, a falta de padronização na condução de UDCP resulta em alta variabilidade do exame, além de poder comprometer a interpretação dos resultados. OBJETIVO: Os objetivos desta revisão são promover uma maior padronização durante o UDCP e discutir os princípios fundamentais para sua correta condução e interpretação. MÉTODOS: O UDCP é conduzido inicialmente com o pênis no estado flácido; todo o pênis deve ser avaliado (imagens no modo B) com um transdutor linear de alta frequência (7,5-18 MHz). A injeção intracavernosa de agentes vasodilatadores (prostaglandina E1, papaverina, fentolamina) é realizada para induzir uma ereção rígida. Medições seriais em momentos diferentes podem ser realizadas durante a sessão da UDCP e a rigidez peniana deve ser estimada em cada avaliação. RESULTADOS: É importante monitorar a resposta da ereção após o agente vasoativo (escala de rigidez), bem como realizar avaliação hemodinâmica durante a ereção de melhor qualidade. Os protocolos de estimulação sexual manual e audiovisual (AVSS) e redosagem de agente vasoativo devem ser levados em consideração para reduzir a influência de fatores psicogênicos e ajudar o paciente a obter a ereção mais rígida possível. Tais medidas contribuem para o relaxamento máximo do tecido erétil, de modo que os parâmetros hemodinâmicos não são subestimados. CONCLUSÕES: O UDCP é uma ferramenta especializada relevante para avaliar pacientes com disfunção erétil; portanto, esta diretriz ajudará a padronizar e estabelecer uniformidade em sua condução e interpretação, se considerarmos a complexidade e a heterogeneidade das avaliações do pênis por UDCP


Subject(s)
Humans , Male , Penis , Penile Erection , Ultrasonography, Doppler, Color , Hemodynamics , Erectile Dysfunction
4.
Arq. bras. med. vet. zootec. (Online) ; 72(4): 1137-1144, July-Aug. 2020. tab, ilus
Article in Portuguese | ID: biblio-1131517

ABSTRACT

Utilizaram-se quatro garanhões nos meses de janeiro, abril, julho e outubro de 2016, em dois protocolos, em que: GI (n=4; 5mL de solução salina, i.v.) e GII (n=4; 5000UI de hCG, i.v.) e subdividiram-se esses protocolos em ciclos (C1 e C2), seguindo o esquema crossover, sendo: CI=animais 1 (GI) e 2 (GII), avaliados nos dias D1, D3 e D5, e animais 3 (GI) e 4 (GII), em D2, D4 e D6; CII= animais 1 (GII) e 2 (GI), em D1, D3, D5, e animais 3 (GII) e 4 (GI), em D2, D4 e D6. Realizou-se o tratamento em D1 e D2 de cada ciclo e a ultrassonografia testicular no modo color Doppler e Doppler espectral, uma hora antes de cada coleta de sêmen e imediatamente após. Avaliou-se: número de reflexo de Flehmen, de montas sem ereção, início da monta, tempo de reação à ereção e total da monta e análises de qualidade seminal. Estatisticamente foram utilizados os testes de qui-quadrado e ANOVA. Não houve diferenças estatísticas (P>0,05) entre os parâmetros analisados. Concluiu-se que uma única dose de 5000UI de hCG em garanhões não causou alterações significativas nos parâmetros avaliados em diferentes estações do ano.(AU)


Four stallions were used in January, April, July and October 2016 in two protocols: GI (n=4; 5ml saline, iv) and GII (n=4; 5000 hCG, iv), and these protocols were subdivided into cycles (C1 and C2) following the cross over scheme, as follows: CI=animal 1 (GI) and 2 (GII) evaluated on days D1, D3 and D5 and animal 3 (GI) and 4 (GII) at D 2, D 4 and D 6; CII=animal 1 (GII) and 2 (GI) at D1, D3, D5 and animal 3 (GII) and 4 (GI) at D2, D4 and D6. Treatment was performed on D1 and D2 of each cycle and testicular ultrasound in color Doppler and spectral Doppler mode, one hour before each semen collection and immediately after. We evaluated: Flehmen's reflex number, mounts without erection, start of the mount, reaction time to erection and total mount and seminal quality analyzes. Statistically, the Chi-square and ANOVA tests were used. There were no statistical differences (P>0.05) between the analyzed parameters. It was concluded that a single dose of 5000IU hCG in stallions did not cause significant changes in the parameters evaluated in different seasons of the year.(AU)


Subject(s)
Animals , Male , Testis/diagnostic imaging , Chorionic Gonadotropin/administration & dosage , Horses/physiology , Seasons , Ultrasonography, Doppler, Color/veterinary
5.
Rev. Assoc. Med. Bras. (1992) ; 66(1): 31-35, Jan. 2020. tab, graf
Article in English | LILACS | ID: biblio-1091903

ABSTRACT

SUMMARY Homozygous familial hypercholesterolemia is a rarely agentic disorder of the lipoprotein metabolism intimately related to premature atherosclerotic cardiovascular disease that can lead to high disability and mortality. Homozygous familial hypercholesterolemia typically affects not only the aortic root, compromising the coronary ostia, but also affects other territories such as the carotid, descending aorta, and renal arteries. Multi-contrast high-resolution magnetic resonance imaging (MRI) provides a validated and useful method to characterize carotid artery atherosclerotic plaques quantitatively. However, very few studies have been done on assessing plaque composition in patients with Homozygous familial hypercholesterolemia using high-resolution MRI. This report is to evaluate the value of MRI in accessing carotid artery disease in patients with Homozygous familial hypercholesterolemia. We describe a 28-year-old patient from Beijing, China, who presented to the Neurology Clinic with intermittent blurred vision of the right eye, headache, nausea, and vomiting for eight years without obvious causes. Familial hypercholesterolemia was suspected based on medical history and laboratory examination. Carotid Doppler ultrasound showed bilateral common carotid artery, internal carotid artery, and external carotid artery wall thickening with hyperechoic signals. Subsequently, high-resolution multi-contrast MRI of the carotid showed calcification with hypo-intense areas located at the middle layer of the plaque, with moderate stenosis. The plaque located at the right bifurcation of the common carotid artery extended to the internal carotid artery, causing lumen stenosis close to occlusion. The patient was treated with right carotid artery endarterectomy. At a 6-month follow-up, there had been no recurrence of the patient's symptoms.


RESUMO A hipercolesterolemia familiar homozigótica, uma doença patogênica rara do metabolismo da lipoproteína intimamente relacionada com a doença cardiovascular aterosclerótica prematura, pode conduzir a uma elevada deficiência e mortalidade. A hipercolesterolemia familiar homozigótica afeta tipicamente não só a raiz aórtica, comprometendo os óstios coronários, mas também outros territórios, como a carótida, a aorta descendente e as artérias renais. Imagens de ressonância magnética multicontraste de alta resolução (RM) fornecem um método validado e útil para caracterizar quantitativamente as placas de aterosclerose da artéria carótida. No entanto, muito poucos estudos foram feitos sobre a avaliação da composição da placa em doentes com hipercolesterolemia familiar homozigótica utilizando ressonância magnética de alta resolução. Este trabalho deve avaliar o valor da ressonância magnética no acesso à doença da artéria carótida em doentes com hipercolesterolemia familiar homozigótica. Descrevemos um paciente de 28 anos de Pequim, China, que se apresentou à clínica neurológica com visão turva intermitente do olho direito, dor de cabeça, náuseas e vômitos por oito anos sem causas aparentes. Suspeitava-se de hipercolesterolemia familiar com base no histórico médico e no exame laboratorial. O ultrassom Doppler carotídeo mostrou uma artéria carótida bilateral comum, artéria carótida interna e parede da carótida externa espessando-se com sinais hiperecoicos. Posteriormente, a ressonância multicontraste de alta resolução da carótida mostrou calcificação com áreas hipointensas localizadas na camada média da placa, com estenose moderada. A placa localizada na bifurcação direita da artéria carótida comum estendia-se até a artéria carótida interna, causando estenose do lúmen próxima à oclusão. O paciente foi tratado com endarterectomia da artéria carótida direita. Em seis meses de acompanhamento, não houve recorrência dos sintomas do paciente.


Subject(s)
Humans , Female , Adult , Thrombosis/diagnostic imaging , Coronary Artery Disease/diagnostic imaging , Magnetic Resonance Imaging/methods , Carotid Stenosis/diagnostic imaging , Plaque, Atherosclerotic/diagnostic imaging , Hyperlipoproteinemia Type II/diagnostic imaging , Carotid Artery, External/pathology , Carotid Artery, External/diagnostic imaging , Carotid Artery, Internal/pathology , Carotid Artery, Internal/diagnostic imaging , Ultrasonography, Doppler, Color/methods , Plaque, Atherosclerotic/pathology , Carotid Intima-Media Thickness , Computed Tomography Angiography/methods
7.
Rev. Col. Bras. Cir ; 47: e20202481, 2020. tab, graf
Article in English | LILACS | ID: biblio-1136536

ABSTRACT

ABSTRACT Endovascular treatment for femoropopliteal arterial disease has made revascularization procedures less invasive, but the self-expanding stents used can suffer great wear in arteries with extreme mobility. Objective: to evaluate the prevalence of fractures in stents implanted in the femoropopliteal segment, to identify predisposing factors and consequences on arterial patency. Method: between March and June 2019, thirty patients previously operated for femoropopliteal obstruction underwent stent X-rays in anteroposterior and lateral views to detect fractures and Doppler to analyze arterial patency. Results: we observed 12 cases with fractures (33.3%): 1 type I (2.8%), 3 type II (8.3%), 5 type III (13.9%), 3 type IV (8.3%) and no type V. According to the TASC II we had 1 in group B (8.3%), 6 in group C (50%) and 5 in group D (41.6%) p <0.004. The number of stents per limb was 3.1 (± 1.3) in cases of fracture versus 2.3 (± 1.3) in cases without fracture (p = 0.08). The extension was 274.17mm (± 100.94) in cases of fracture and 230.83mm (± 135.44) in cases without fracture (p = 0.29). On Doppler we had: 17 patients (47.2%) without stenosis, 9 patients (25%) with stenosis> 50% and 10 patients (27.8%) with occlusion (p = 0.37). There was no correlation between fracture and arterial obstruction (p = 0.33). Conclusion: stent fractures are a frequent finding in the femoropopliteal area (33.3%), being more prevalent in cases of more advanced disease (C and D). There was no association between the finding of fracture and arterial obstruction.


RESUMO Os tratamentos endovasculares para a doença arterial obstrutiva fêmoro-poplítea tornaram os procedimentos de revascularização menos invasivos, porém os stents metálicos autoexpansíveis utilizados podem sofrer grande desgaste em artérias com extrema mobilidade. Objetivo: avaliar a prevalência de fraturas em stents implantados no segmento fêmoro-poplíteo, identificar fatores predisponentes e possíveis consequências sobre a patência arterial. Métodos: entre março a junho de 2019, trinta pacientes previamente operados por obstrução fêmoro-poplítea realizaram RX dos stents em incidências ântero-posterior e perfil para detectar fraturas e eco Doppler para analisar a patência arterial. Resultados: observamos 12 casos com fraturas (33,3%): 1 do tipo I (2,8%), 3 do tipo II (8,3%), 5 do tipo III (13,9%), 3 do tipo IV (8,3%) e nenhuma tipo V. Segundo a classificação TASC II, tivemos 1 no grupo B (8,3%), 6 no grupo C (50%) e 5 no grupo D (41,6%) p<0,004. O número de stents por membro foi de 3,1 (±1,3) nos casos de fratura contra 2,3 (±1,3) nos casos sem fratura (p = 0,08). A extensão tratada foi 274,17mm (±100,94) nos casos de fratura e 230,83mm (±135,44) nos casos sem fratura (p=0,29). No Doppler tivemos: 17 pacientes (47,2%) sem estenose, 9 pacientes (25%) com estenose>50% e 10 pacientes (27,8%) com oclusão (p=0,37). Não houve correlação entre fratura e obstrução arterial (p=0,33). Conclusão: as fraturas de stents são um achado frequente no setor fêmoro-poplíteo (33,3%) sendo mais prevalentes nos casos de doença mais avançada TASC II C e D. Não houve associação entre o achado de fratura e obstrução arterial.


Subject(s)
Humans , Popliteal Artery , Prosthesis Failure , Stents , Peripheral Vascular Diseases/therapy , Ultrasonography, Doppler, Color/methods , Peripheral Arterial Disease , Endovascular Procedures/methods , Prosthesis Design , Vascular Patency , Prevalence , Retrospective Studies , Risk Factors , Treatment Outcome , Peripheral Vascular Diseases/diagnostic imaging , Leg/blood supply
8.
Arq. bras. med. vet. zootec. (Online) ; 71(6): 1909-1916, Nov.-Dec. 2019. ilus
Article in English | ID: biblio-1055110

ABSTRACT

The study evaluated sonographic and serologic exams performed for early (20 to 30d) diagnosis of pregnancy. One hundred-twenty (n= 120) bovine recipients were synchronized (estrous=D0) and timed embryo transferred (TET, D7) with fresh in vitro produced embryos. In the first trial (n= 46), diagnosis of pregnancy was performed on day 20 (D20) by detecting CL blood flow (BF) and by Pregnancy-Associated Glycoproteins (PAGs) serology. In the second trial (n= 30), pregnancy diagnosis was performed on D25 by ultrasound visualization of uterine contents and by PAGs serology. In the last trial, PAG's serology was performed on D30. Ultrasonographic detection of the uterine contents and embryo viability performed on D30 (DG30) was considered the gold standard. The PROC FREQ procedure was used to test the agreement between diagnostic methods. On D20, the Doppler ultrasonography of the CL had showed high sensitivity (100%), but only moderate specificity (53.3%). On the same day, serologic diagnostic had no agreement (k= -0.08, P< 0.46) with the gold standard, with very low sensitivity (6.3%). However, the sensitivity of the serologic exam increased dramatically (from 6.3 to 100%) from D20 to D25, and it contributed to detect false negatives from the ultrasound diagnosis, improving the overall accuracy from 90% to 96.7%.(AU)


O estudo foi planejado para correlacionar exames ultrassonográficos e sorológicos realizados para o diagnóstico precoce (20 a 30d) de gestação. Cento e vinte (n= 120) receptoras bovinas foram sincronizadas (estro=D0), e embriões frescos produzidos in vitro foram transferidos em tempo fixo (TETF, D7). No experimento 1 (n= 46), o diagnóstico de gestação foi realizado no D20, pela detecção do fluxo sanguíneo do CL e pela sorologia de glicoproteínas associadas à gestação (PAGs). No experimento 2 (n= 30), a detecção da gestação foi realizada por meio da visualização do conteúdo do útero e também pela sorologia para PAGs. No experimento 3, a sorologia para PAGs foi realizada no D30. Em todos os experimentos, a visualização ultrassonográfica da vesícula e da viabilidade embrionária, realizada no D30, foi considerada padrão-ouro. O procedimento PROC FREQ testou o nível de concordância dos métodos diagnósticos. No D20, o diagnóstico baseado na vascularização do CL mostrou alta sensibilidade (100%) e apenas moderada especificidade (53,3%). Nesse mesmo dia, o diagnóstico sorológico não apresentou concordância (k=-0,08, P<0,46) com o padrão-ouro, além de baixa sensibilidade (6,3%). No entanto, a sensibilidade do exame sorológico aumentou drasticamente (6,3 para 100%) do D20 para o D25, contribuindo para detectar falsos negativos diagnosticados pela ultrassonografia, melhorando a acurácia (90 para 96,7%).(AU)


Subject(s)
Animals , Female , Pregnancy , Cattle , Pregnancy, Animal/blood , Serologic Tests/veterinary , Glycoproteins/analysis , Ultrasonography, Doppler, Color/veterinary , Embryo Transfer/veterinary
9.
Int. braz. j. urol ; 45(4): 847-850, July-Aug. 2019. graf
Article in English | LILACS | ID: biblio-1040058

ABSTRACT

ABSTRACT Testicular germ cell tumor is the most common cancer in 20-to 35-years-old men. There are known risk factors such as undescended testicle(s) and history of testicular cancer. Most lesions are germ cell tumors with two main subtypes: seminomas and non-seminomatous germ cell tumors.


Subject(s)
Humans , Male , Adult , Retroperitoneal Neoplasms/pathology , Retroperitoneal Neoplasms/diagnostic imaging , Testicular Neoplasms/pathology , Testicular Neoplasms/diagnostic imaging , Neoplasms, Germ Cell and Embryonal/pathology , Neoplasms, Germ Cell and Embryonal/diagnostic imaging , Retroperitoneal Neoplasms/surgery , Testicular Neoplasms/surgery , Biopsy , Orchiectomy/methods , Tomography, X-Ray Computed , Neoplasms, Germ Cell and Embryonal/surgery , Ultrasonography, Doppler, Color , Tumor Burden , Middle Aged
10.
An. bras. dermatol ; 94(4): 473-475, July-Aug. 2019. graf
Article in English | LILACS | ID: biblio-1038301

ABSTRACT

Abstract: Atrophoderma of Pasini and Pierini is a skin disorder affecting dermal collagen and is clinically characterized by well-defined plaques of depressed skin. Histopathological changes are subtle, and in most cases, the diagnosis requires a comparative study with healthy skin from the same anatomical site. High frequency ultrasound is a useful imaging method for diagnosis of atrophic skin changes. A case is presented in which ultrasound can support the clinical and the histopathological diagnosis of atrophoderma of Pasini and Pierini.


Subject(s)
Humans , Female , Adult , Skin Diseases/pathology , Skin Diseases/diagnostic imaging , Ultrasonography, Doppler, Color/methods , Dermis/pathology , Dermis/diagnostic imaging , Atrophy/pathology , Atrophy/diagnostic imaging , Biopsy , Early Diagnosis
11.
Arq. bras. med. vet. zootec. (Online) ; 71(3): 863-868, May-June 2019. ilus
Article in English | ID: biblio-1011319

ABSTRACT

Portosystemic shunt (PSS) is an anomalous vascular connection between the portal venous system and the systemic circulation. These deviations connect the main portal vein (PV) or some portal branches to the vena cava (VC) or, less commonly, to the azygos vein (AV). The purpose of this case report was to describe the diagnosis of PSS in a dog classified as porto-azygos. This diagnosis is considered uncommon compared to other portosystemic shunts using ultrasonography and portography. The subject was a male dog, Yorkshire, 8 months old, presented neurological signs characterized by head press, ataxia, tremors and episodes of temporary blindness and deafness. Ultrasonographic examination revealed a dilated and curved anomalous vessel with approximately 0.6cm of diameter and turbulent flow seen through pulsed and color Doppler, and segmental dilation of the azygos vein. The portography revealed enhancement by iodinated contrast in the jejunal vein, the portal vein and an anomalous vessel flowing towards the azygos vein in the craniodorsal region of the abdomen. The PSS was surgically corrected with an ameroid constrictor. Ultrasonography and portography were effective at detecting and characterizing the portoazygos shunt despite some limitations.(AU)


Shunt portossistêmico (SPS) é uma comunicação vascular anômala entre o sistema venoso portal e a circulação sistêmica. Esses desvios comunicam a VP ou alguma de suas tributárias à veia cava ou, menos comumente, à veia ázigos (VA). O objetivo do presente estudo foi descrever o diagnóstico, por meio de ultrassonografia e portografia, de um caso de shunt extra-hepático em cão, classificado como portoázigos e considerado incomum quando comparado aos demais tipos de desvio portossistêmico. Um cão, macho, raça Yorkshire, oito meses de idade, chegou ao Hospital Veterinário da Universidade Federal de Minas Gerais apresentando sinais neurológicos, caracterizados por andar apoiando a cabeça na parede, ataxia, tremores, episódios de cegueira e surdez. Ao exame ultrassonográfico, observou-se vaso anômalo calibroso e tortuoso de aproximadamente 0,6cm de diâmetro e fluxo turbulento ao Doppler pulsado e colorido, bem como dilatação segmentar da VA. A portografia revelou realce de contraste iodado em veia jejunal, porta e vaso anômalo (shunt) seguindo em direção à VA em região dorsal do abdômen. Foi realizada a correção cirúrgica do SPS por meio de anel ameroide. A ultrassonografia e a portografia foram eficientes na detecção e caracterização do shunt portoázigos, mesmo que com algumas limitações.(AU)


Subject(s)
Animals , Male , Dogs , Portasystemic Shunt, Surgical/veterinary , Dog Diseases/diagnostic imaging , Portography/veterinary , Ultrasonography, Doppler, Color/veterinary
12.
Int. j. morphol ; 37(2): 752-756, June 2019. graf
Article in English | LILACS | ID: biblio-1002289

ABSTRACT

In the prenatal period, the three types of connections between the portal sinus and main portal vein have been published in the literature: T, X and H-shaped. The T type is the most frequent in the literature, and the aim of our study is to define the percentage of the connection types during the prenatal period in our population. In this prospective study, 237 women between 20 and 38 weeks of pregnancy without a foetal anomaly or pregnancy-related complications were included, and the precordial veins of the foetuses were examined using a wide-band color Doppler technique. The types of connections were determined by two specialists according to the shape of the colour coded vessels in Doppler examinations. The criteria of Czubalski & Aleksandrowicz (2000) were used. All of the connection types in patients were confirmed using video clips and were stored in the picture archiving and communication system. In 237 patients, the types of connection were determined by the first specialist as 189 foetuses (79.7 %) with the X-shaped or side-to-side connection, 16 foetuses (6.8 %) with the T-shaped or end-to-side type and 32 foetuses (13.5 %) with the H-shaped or parallel-coursed vessels connected with a short segment. The most common types of connections between the portal sinus and main portal vein in foetuses are X shaped or side-to-side, which is contrary to previous studies.


En el período prenatal, se han publicado en la literatura los tres tipos de conexiones entre el seno portal y la vena porta principal: en forma de T, X y H. El tipo T es el más frecuente, y el objetivo de nuestro estudio fue definir el porcentaje de tipos de conexión durante el período prenatal en nuestra población. En este estudio prospectivo, se incluyeron 237 mujeres entre 20 y 38 semanas de embarazo, sin anomalías fetales o complicaciones relacionadas con el embarazo, y se examinaron las venas precordiales de los fetos utilizando una técnica Doppler de banda ancha. Los tipos de conexiones fueron determinados por dos especialistas según la forma de los vasos codificados por color en los exámenes Doppler. Se utilizaron los criterios del estudio de Czubalski & Aleksandrowicz. Todos los tipos de conexión en los pacientes se confirmaron mediante videoclips y se almacenaron en el sistema de comunicación y en archivo de imágenes. En 237 pacientes, el primer especialista determinó en 189 fetos (79,7 %) la conexión en forma de X o de lado a lado; en 16 fetos (6,8 %) la forma de T o Tipo de extremo a lado; y en 32 fetos (13,5 %) los vasos en forma de H o paralelos, conectados con un segmento corto. Los tipos más comunes de conexiones entre el seno portal y la vena porta principal en los fetos son en forma de X o de lado a lado, lo que es contrario a estudios anteriores.


Subject(s)
Humans , Male , Female , Pregnancy , Adolescent , Adult , Portal Vein/anatomy & histology , Umbilical Veins/anatomy & histology , Fetus/blood supply , Portal Vein/embryology , Portal Vein/diagnostic imaging , Umbilical Veins/embryology , Umbilical Veins/diagnostic imaging , Prospective Studies , Ultrasonography, Doppler, Color , Anatomic Variation
13.
Arch. endocrinol. metab. (Online) ; 63(3): 288-292, May-June 2019. tab, graf
Article in English | LILACS | ID: biblio-1011161

ABSTRACT

ABSTRACT Objective: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age. The renal resistive index (RRI) is a measure of renal arterial resistance to blood flow. The aim of this study was to investigate the renal resistive index levels of patients with PCOS. Subjects and methods: A total of 216 women were included in this cross-sectional study. The study group consisted of 109 patients with PCOS, and the control group consisted of 107 healthy subjects. The RRI of all subjects was measured using renal Doppler ultrasonography. Results: The patients with PCOS had higher RRI levels in comparison to the healthy subjects (0.64 ± 0.06 vs. 0.57 ± 0.06, p < 0.001). The RRI levels of the patients with PCOS were correlated with systolic blood pressure (p = 0.004, r = 0.268) and with homeostasis model assessment of insulin resistance (HOMA-IR) (p = 0.02, r = 0.216). Conclusion: In this study, we observed higher RRI levels in patients with PCOS. High RRI levels may be an indicator of cardiovascular and/or cardiovascular-associated diseases in patients with PCOS.


Subject(s)
Humans , Male , Female , Adult , Polycystic Ovary Syndrome/physiopathology , Kidney/physiopathology , Blood Pressure , Insulin Resistance , Cross-Sectional Studies , Ultrasonography, Doppler, Color , Kidney/diagnostic imaging
14.
Rev. argent. radiol ; 83(1): 34-41, mar. 2019. ilus, graf, tab
Article in Spanish | LILACS | ID: biblio-1003288

ABSTRACT

Los ataques cerebrovasculares (ACV), representan un problema mayor en salud y son una causa importante de discapacidad en todo el mundo. La estenosis u oclusión carotídea aterosclerótica causa alrededor del 20% de las isquemias cerebrovasculares.¹ Los ACV en los enfermos con estenosis carotídea se producen, en la mayoría de los casos, por la aparición de embolismos distales de trombo formado en la placa, oclusión trombótica aguda debido a rotura de la placa, o bien secundarios a las alteraciones hemodinámicas atribuibles a la estenosis, la cual produce disminución de la perfusión cerebral por el hipoflujo, en casos de estenosis críticas o suboclusivas. El tratamiento de la patología carotídea ha evolucionado de forma considerable a lo largo de los últimos años. Existen dos tratamientos invasivos para la estenosis carotídea significativa, que consisten en el abordaje quirúrgico con endarterectomía o tratamiento por vía percutánea con angioplastia y colocación de stent. En nuestra institución se realizaron, en el periodo comprendido entre marzo de 2013 y junio de 2017, aproximadamente 100 angioplastias carotídeas con colocación de stent. Todas fueron valoradas con ecografía Doppler color (EDC) al mes, a los seis meses y al año (en casos no complicados). En esta revisión bibliográfica es nuestra intención desarrollar las indicaciones, aplicaciones, hallazgos normales y patológicos en el examen de EDC en la evaluación de un paciente con stent carotídeo.


Acute stroke represents a major problem in health and is a major cause of disability worldwide. Atherosclerotic carotid stenosis or occlusion causes around 20% of cerebrovascular ischemias.¹ Stroke in patients with carotid stenosis occurs, in most cases, due to embolisms of thrombus formed in the plaque, acute thrombotic occlusion due to rupture of the plaque, or secondary to hemodynamic alterations, attributable to stenosis, which produces decreased cerebral perfusion by low flow, in cases of critical or sub occlusive stenosis. The treatment of carotid disease has evolved considerably over recent years. There are two invasive treatments for significant carotid stenosis, which consist of the surgical approach with endarterectomy or percutaneous treatment with angioplasty and stenting. In our institution, in the period between March 2013 and June 2017, ~100 carotid angioplasties with stent placement were performed. All were assessed with color Doppler ultrasound (DUS) at month, six months and one year (in non complicated cases). In this literature review it is our intention to develop the indications, applications, normal and pathological findings in the DUS examination in the evaluation of a patient with carotid stent.


Subject(s)
Humans , Carotid Stenosis/diagnostic imaging , Ultrasonography, Doppler, Color/methods , Stents , Carotid Stenosis/drug therapy , Angioplasty , Stroke/complications
15.
Int. j. odontostomatol. (Print) ; 13(1): 75-81, mar. 2019. graf
Article in English | LILACS | ID: biblio-990068

ABSTRACT

ABSTRACT: Carotid stenosis usually results from the accumulation of atherosclerotic plaque in the carotid artery wall and is an important risk factor for ischemic cerebral vascular accident (CVA). This study describes the importance of diagnostic imaging exams used in dentistry for the early identification of atheroma plaques in the extracranial and intracranial internal carotid artery. A male patient was referred to a radiology clinic to perform panoramic radiography (PR) and a cone beam computed tomography (CBCT) to develop treatment plan options. In the PR and CBCT a radiopaque image, suggestive of atheroma in the extracranial internal carotid artery, was observed on the right side. The diagnosis was confirmed by color DOPPLER ultrasonography. In the CBCT, the presence of calcifications in the intracranial internal carotid artery was also observed. Diagnostic imaging exams used in dentistry allow the identification of asymptomatic individuals, facilitating early intervention and consequent reduction in the risk of ischemic CVA.


RESUMEN: La estenosis carotídea generalmente es consecuencia de la acumulación de placa aterosclerótica en la pared de la arteria carótida y es un factor de riesgo importante para el accidente cerebral vascular (ACV) isquémico. Este estudio describe la importancia de los exámenes de diagnóstico por imágenes utilizados en odontología para la identificación precoz de placas de ateroma en la arteria carótida interna, a nivel extracraneal e intracraneal. Un paciente masculino fue remitido a una clínica de radiología para realizar una radiografía panorámica (RP) y tomografía computarizada de haz cónico (TCHC) para analizar opciones de tratamiento. En el RP y TCHC se observó una imagen radiopaca, sugestiva de ateroma en la arteria carótida, extracraneal, en el lado derecho. El diagnóstico fue confirmado por ultrasonido DOPPLER color carotídeo. En el TCHC, también se observó la presencia de calcificaciones en la arteria carótida interna, intracraneal. Los exámenes de imagenología diagnóstica utilizados en odontología permiten la identificación de individuos asintomáticos, lo que facilita la intervención temprana y la consiguiente reducción en el riesgo de ACV isquémico.


Subject(s)
Humans , Male , Aged , Radiography, Panoramic , Carotid Arteries/diagnostic imaging , Cone-Beam Computed Tomography , Plaque, Atherosclerotic/diagnostic imaging , Ultrasonography, Doppler, Color , Stroke/prevention & control , Early Diagnosis
16.
Chinese Medical Journal ; (24): 405-410, 2019.
Article in English | WPRIM | ID: wpr-774818

ABSTRACT

BACKGROUND@#The precise pathophysiology of venous erectile dysfunction (VED) was still unclear. Dynamic infusion cavernosometry and cavernosography (DICC) was the gold standard approach for the diagnoses of VED. However, a standard operative procedure of DICC was needed and it was unclear whether DICC could show promise in accurate assessment and treatment of VED. The aim of this study was to establish an optimized operation process of DICC and evaluate the efficacy of DICC in the diagnoses and therapy of VED.@*METHODS@#One hundred and forty-seven VED patients identified by the color doppler duplex ultrasonography (CDDU) were included. Then the method of DICC was adopted to assess the severity of VED and all patients were divided into 4 groups, including (1) non-VED; (2) mild VED; (3) moderate VED and (4) severe VED. All patients received the treatment of psychotherapy. Drug therapy, the intervention embolism of corpus cavernosum and the implantation of penile prosthesis were applied if psychotherapy was ineffective for patients. The international index of erectile function (IIEF-5) scores of patients were collected and compared before and after treatment.@*RESULTS@#IIEF-5 score of non-VED group after psychotherapy (19.35 ± 3.59) and drug therapy (23.31 ± 0.75) was higher than that before psychotherapy (15.30 ± 2.72, t = -4.31, P  0.05). IIEF-5 score of severe VED group was increased under the treatment of implantation of penile prosthesis (23.25 ± 0.71) compared with that before treatment (8.00 ± 0.39, t = -53.25, P < 0.05).@*CONCLUSION@#DICC was a valid diagnostic tool that could identify patients with VED. And DICC had great effect on the diagnosis and individual therapy for patients with VED in varying degrees. Moreover, the manipulation of DICC needed uniform standards.


Subject(s)
Adult , Embolization, Therapeutic , Humans , Impotence, Vasculogenic , Diagnosis , Therapeutics , Male , Middle Aged , Penis , Diagnostic Imaging , Ultrasonography, Doppler, Color , Veins
17.
Intestinal Research ; : 227-236, 2019.
Article in English | WPRIM | ID: wpr-764136

ABSTRACT

BACKGROUND/AIMS: Consistently defining disease activity remains a critical challenge in the follow-up of patients with Crohn's disease (CD). We investigated the potential applicability of abdominal ultrasonography with color Doppler (USCD) analysis for the detection of morphological alterations and inflammatory activity in CD. METHODS: Forty-three patients with CD ileitis/ileocolitis were evaluated using USCD analysis with measurements obtained on the terminal ileum and right colon. Sonographic parameters included wall thickening, stricture, hyperemia, presence of intra-abdominal mass, and fistulas. Patients were evaluated for the clinical activity (Harvey-Bradshaw Index [HBI]), fecal calprotectin (FC) and C-reactive protein (CRP). The USCD performance was assessed using magnetic resonance enterography (MRE) as a criterion standard. RESULTS: Most measurements obtained with USCD matched the data generated with MRE; however, the agreement improved in clinically active patients where sensitivity, positive predictive value, and accuracy were >80%, considering wall thickening and hyperemia. Complications such as intestinal wall thickening, stricture formation, and hyperemia, were detected in the USCD analysis with moderate agreement with MRE. The best agreement with the USCD analysis was obtained in regard to FC, where the sensitivity, positive predictive value, and accuracy were >70%. The overall performance of USCD was superior to that of HBI, FC and CRP levels, particularly when considering thickening, stricture, and hyperemia parameters. CONCLUSIONS: USCD represents a practical noninvasive and low-cost tool for evaluating patients with ileal or ileocolonic disease, particularly in clinically active CD. Therefore, USCD might become a useful asset in the follow-up of patients with CD.


Subject(s)
C-Reactive Protein , Colon , Constriction, Pathologic , Crohn Disease , Fistula , Follow-Up Studies , Humans , Hyperemia , Ileitis , Ileum , Leukocyte L1 Antigen Complex , Magnetic Resonance Imaging , Ultrasonography , Ultrasonography, Doppler, Color
18.
Einstein (Säo Paulo) ; 17(2): eAO4526, 2019. tab, graf
Article in English | LILACS | ID: biblio-1001911

ABSTRACT

ABSTRACT Objective: To compare the use of the radiofrequency thermoablation of the saphenous vein with the ligation technique, and complete removal of the saphenous vein, from the saphenofemoral junction to the ankle. Methods: A total of 49 patients with chronic venous disease in the Comprehensive Classification System for Chronic Venous Disorders (CEAP) classes 2 to 4 for clinical signs, etiology, anatomic distribution and pathophysiology, were assessed at baseline, after 4 weeks, and after 1 year. The parameters assessed were complications, period of absence from activities, Venous Clinical Severity Score (VCSS) and quality of life scores according to Aberdeen Varicose Veins Questionnaire (AVVQ). They were re-examined 1 and 3 years after treatment to evaluate recurrence rates. Results: The success rate per limb (p=0.540), VCSS (p=0.636), AVVQ (p=0.163), and clinical complications were similar in the two treatment groups. Nevertheless, the radiofrequency thermoablation group had significant shorter length of hospital stay (0.69±0.47) and absence from activities (8.62±4.53), p<000.1. Conclusion: Patients submitted to radiofrequency thermoablation had an occlusion rate, clinical recurrence and improvement in quality of life comparable to removal of the saphenous vein. However, these patients spent less time hospitalized and away from their daily activities during recovering.


RESUMO Objetivo: Comparar o uso da termoablação por radiofrequência da veia safena com a técnica de ligação e retirada completa da veia safena da junção safeno-femoral ao tornozelo. Métodos: Foram avaliados 49 pacientes com doença venosa crônica nas categorias 2 a 4 (Comprehensive Classification System for Chronic Venous Disorders − CEAP) para classificação clínica, etiológica, anatômica e fisiopatológica, no início do estudo, 4 semanas e 1 ano após o procedimento. Os parâmetros analisados foram complicações, período de ausência de atividades,(Venous Clinical Severity) Score revisado (R-VCSS) e escore de qualidade de vida de acordo com o Aberdeen Varicose Veins Questionnaire(AVVQ). Os pacientes foram reexaminados 1 e 3 anos após o tratamento, para avaliar as taxas de recorrência. Resultados: As taxas de sucesso por membro (p=0,540), VCSS (p=0,636), AVVQ (p=0,163) e complicações clínicas foram semelhantes nos dois grupos. No entanto, o grupo termoablação por radiofrequência teve períodos de internação significativamente mais curtos (0,69±0,47) e ausência de atividades (8,62±4,53), com p<000,1. Conclusão: Pacientes submetidos à termoablação por radiofrequência apresentaram taxa de oclusão, recidiva clínica e melhora da qualidade de vida comparáveis à retirada completa da veia safena. No entanto, esses pacientes passaram menos tempo internados e ausentes de suas atividades diárias durante a recuperação.


Subject(s)
Middle Aged , Saphenous Vein/surgery , Vascular Diseases/surgery , Radiofrequency Ablation/methods , Postoperative Period , Quality of Life , Recurrence , Saphenous Vein/diagnostic imaging , Time Factors , Vascular Diseases/diagnostic imaging , Severity of Illness Index , Chronic Disease , Prospective Studies , Follow-Up Studies , Treatment Outcome , Ultrasonography, Doppler, Color , Absenteeism , Length of Stay , Ligation/methods
19.
Article in English | WPRIM | ID: wpr-719276

ABSTRACT

BACKGROUND/AIMS: The strategy of access care at out center involves the use of ultrasound (USG) in case of physical examination (PE) abnormality. USG determines the need of angiography. This study investigated the possible association between the need for percutaneous transluminal angioplasty (PTA) and hemodynamic parameters of USG. The study also assessed the effects of this monitoring strategy on outcomes in comparison with a historical control. METHODS: A retrospective study of the medical records of 127 patients (65 PTA, 62 non-PTA) was conducted. Data were analyzed using logistic regression analysis and receiver operating characteristic curve. Fistula outcomes and intervention rates were calculated and compared with 100 historic controls. RESULTS: Logistic regression analysis showed that brachial artery flow volume (FV) 0.63 was independently associated with the need for PTA. This monitoring strategy showed an a reduction in thromboses (0.02 ± 0.11 events/arteriovenous fistula [AVF]-year vs. 0.07 ± 0.23 events/AVF-year, p = 0.046), reduction in central venous catheter placement (0.01 ± 0.05 events/AVF-year vs. 0.06 ± 0.22 events/AVF-year, p = 0.010), reduction in access loss (0.02 ± 0.13 events/AVF-year vs. 0.19 ± 0.34 events/AVF-year, p = 0.015), and increase in access selective repair (0.49 ± 0.66 events/AVF-year vs. 0.21 ± 0.69 events/AVF-year, p = 0.003), compared to historic control. CONCLUSIONS: There was significant stenosis if brachial artery FV was 0.63 for PE abnormality. These parameters should be used as markers for assessing PTA risk in hemodialysis patients. Addition of USG to determine the need of angiography after detection of PE abnormality leads to decreases in access thrombosis, catheter placement, and access loss despite increasing access intervention rates compared to clinical monitoring.


Subject(s)
Angiography , Angioplasty , Brachial Artery , Catheters , Central Venous Catheters , Constriction, Pathologic , Fistula , Hemodynamics , Humans , Logistic Models , Medical Records , Physical Examination , Renal Dialysis , Retrospective Studies , ROC Curve , Thrombosis , Ultrasonography , Ultrasonography, Doppler, Color
20.
Rev. bras. cir. cardiovasc ; 33(6): 567-572, Nov.-Dec. 2018. tab, graf
Article in English | LILACS | ID: biblio-977470

ABSTRACT

Abstract Introduction: In this study we try to observe the fate of the left internal thoracic artery grafts that were bypassed to left anterior descending artery with moderate stenosis identified with fractional flow reserve (FFR) technique. Doppler ultrasonography was chosen as a noninvasive screening method. Methods: A total of 30 patients who underwent coronary artery bypass grafting depending on results of the fractional flow reserve between January 2007 and January 2012, were subjected to transthoracic color Doppler ultrasonographic evaluation irrespective of the presence of symptoms, and the presence of a systolic-diastolic flow pattern was investigated using the supraclavicular approach. Results: The left internal thoracic artery graft was found to be functional in 63.3% of patients within a mean period of 35.1±19.7 months between coronary bypass and color Doppler ultrasonography. This period was found to be 29.4±19.6 months in the functional graft group, and 44.7±16.6 months in the dysfunctional graft group (P=0.046). Preoperative complaints of angina were reported to fall from 88.9% to 16.7% in the functional graft group, when compared to the postoperative period (P<0.001), but fell from 90.9% to 36.4% in the dysfunctional graft group (P=0.034). Conclusion: Functional left internal thoracic artery graft rates of the study population were found to be lower than the studies reported in the literature.


Subject(s)
Humans , Male , Female , Middle Aged , Thoracic Arteries/transplantation , Coronary Stenosis/surgery , Coronary Stenosis/diagnostic imaging , Internal Mammary-Coronary Artery Anastomosis/methods , Myocardial Revascularization/methods , Time Factors , Severity of Illness Index , Cross-Sectional Studies , Treatment Outcome , Ultrasonography, Doppler, Color , Graft Survival
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