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1.
Einstein (Säo Paulo) ; 15(4): 465-469, Oct.-Dec. 2017. tab
Artigo em Inglês | LILACS | ID: biblio-891424

RESUMO

ABSTRACT Objective: To analyze the quality and quantity of data in the questionnaires and in request forms for magnetic resonance imaging. Methods: This retrospective study was conducted with data from 300 medical records. The research used the following data from the questionnaires: patient age, reason for the magnetic resonance imaging, reason for placing the breast implant, report of any signs or symptoms, time elapsed since surgery to place the current breast implant, replacement implant surgery, chemotherapy, and/or radiation therapy treatments. From the magnetic resonance imaging request forms, information about the breast implant, the implant placement surgery, patient clinical information and ordering physician specialty were verified. Results: The mean age of patients was 48.8 years, and the mean time elapsed since breast implant surgery was 5 years. A total of 60% of women in the sample were submitted to aesthetic surgery, while 23.7% were submitted to chemotherapy and/or radiation therapy. In the request forms, 23.7% of physicians added some piece of information about the patient, whereas 2.3% of them informed the type of implant and 5.2% informed about the surgery. Conclusion: The amount of information in the magnetic resonance imaging request forms is very limited, and this may hinder quality of radiological reports. Institutional and technological measures should be implemented to encourage the requesting physicians and radiologists to share information.


RESUMO Objetivo: Analisar a qualidade e a quantidade de dados que constam nos questionários e nas requisições médicas de exame de ressonância magnética. Métodos: Estudo retrospectivo com 300 prontuários de pacientes. Dos questionários, foram utilizados os seguintes dados: idade, razão para a realização do exame, motivo para a colocação da prótese, referência a sinal ou sintoma, tempo decorrido desde a cirurgia de implante da prótese atual, se a cirurgia foi de troca da prótese, e se foi submetida à radioterapia ou à quimioterapia. Das requisições médicas do exame, foram utilizadas informações sobre prótese mamária, cirurgia de colocação do implante, dados clínico da paciente e especialidade do médico requisitante. Resultados: A média da idade das pacientes foi de 48,8 anos, e o tempo decorrido desde a colocação do implante foi de 5 anos, na média. Foram submetidas à cirurgia estética 60% das mulheres da amostra, e 23,7% tinham sido submetidas à quimioterapia e/ou radioterapia. Na requisição médica, 23,7% dos médicos inseriram algum dado, sendo que 2,3% informaram o tipo de implante e 5,2% sobre a cirurgia realizada. Conclusão: A quantidade de informações contidas nas requisições médicas foi baixa, o que pode comprometer a qualidade do laudo radiológico. Medidas institucionais e tecnológicas deveriam ser adotadas para estimular o intercâmbio de informações entre o médico solicitante e o médico radiologista.


Assuntos
Humanos , Feminino , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Encaminhamento e Consulta/estatística & dados numéricos , Imageamento por Ressonância Magnética/estatística & dados numéricos , Inquéritos e Questionários , Implantes de Mama/efeitos adversos , Silicones/efeitos adversos , Fatores de Tempo , Prontuários Médicos/normas , Estudos Retrospectivos , Sistemas de Registro de Ordens Médicas , Pessoa de Meia-Idade
3.
Rev. bras. neurol ; 52(1): 18-20, jan.-mar. 2016. ilus
Artigo em Português | LILACS | ID: lil-779350

RESUMO

A neuroartropatia de Charcot é uma das complicações da siringomielia, podendo ocasionar deformidades osteoarticulares e incapacidade funcional, com comprometimento das atividades da vida diária. Relatamos um caso de paciente com neuroartropatia de Charcot do ombro associada a siringomielia e malformação de Arnold-Chiari tipo I, acompanhado no Instituto Nacional de Traumatologia e Orto-pedia do Rio de Janeiro, RJ, Brasil.


Charcot neuroartropathy is one of the complications of syringomyelia and can lead to joint deformity and disability, affecting patients in activities of daily living. We report a case of a patient with shoulder Charcot neuroarthropathy associated with syringomyelia and Arnold-Chiari malformation type I, from the National Institute of Traumatology and Orthopedics of Rio de Janeiro, RJ, Brazil.


Assuntos
Humanos , Pessoa de Meia-Idade , Malformação de Arnold-Chiari/diagnóstico , Artropatia Neurogênica/etiologia , Siringomielia/complicações , Siringomielia/diagnóstico , Dor de Ombro/etiologia , Articulação do Ombro/diagnóstico por imagem , Imageamento por Ressonância Magnética/estatística & dados numéricos , Vértebras Cervicais/diagnóstico por imagem , Exame Neurológico/métodos
4.
Audiol., Commun. res ; 20(2): 167-174, Apr-Jun/2015. graf
Artigo em Português | LILACS | ID: lil-751335

RESUMO

Objetivo Avaliar a viabilidade e segurança da ressonância magnética funcional para a avaliação de áreas corticais envolvidas na deglutição. Estratégia de pesquisa Conduziu-se uma busca entre abril de 2003 e abril de 2013, usando as palavras chave “functional magnetic resonance imaging” or “fMRI” and “dysphagia” e “functional magnetic resonance imaging” or “fMRI” and “swallowing” na base de dados PubMed. Critérios de seleção Os estudos foram revisados por análise de seus títulos e abstracts e os critérios de inclusão utilizados foram: pesquisas envolvendo seres humanos, utilização de exames neurofuncionais, referência à função de deglutição, análise de população adulta e/ou idosa, relação com patologias neurológicas. Resultados A estratégia de busca resultou em 1167 citações, das quais apenas 35 preencheram os critérios de elegibilidade. Conclusão A ressonância magnética funcional foi considerada segura e viável para a avaliação de áreas corticais envolvidas na deglutição. Entretanto, os relatos de utilização de ressonâcia magnética funcional diferiram entre os estudos revisados e houve variabilidade na metodologia utilizada, dificultando as comparações. .


Purpose Evaluate the feasibility and safety of functional magnetic resonance imaging (fMRI) for the evaluation of cortical areas involved in swallowing. Research strategy The search was conducted from April 2003 to April 2013, using the keywords “functional magnetic resonance imaging” or “fMRI” and “dysphagia” and “functional magnetic resonance imaging” or “fMRI” and “swallowing” in “PubMed” database. Selection criteria Studies were reviewed by analyzing their titles and abstracts with the following inclusion criteria: research involving human subjects, use of neurofunctional tests, reference to swallowing function, adult and/or elderly population analysis and association with neurological disorders. Results the search strategy resulted in 1167 citations, from which only 35 met the eligibility criteria. Conclusion the functional magnetic resonance imaging was considered safe and feasible for evaluating cortical areas involved in swallowing. However, the reports of functional magnetic resonance usage differed between the reviewed studies and the variability in the methodology used, made meaningful comparisons difficult. .


Assuntos
Humanos , Córtex Cerebral/diagnóstico por imagem , Deglutição , Transtornos de Deglutição/diagnóstico por imagem , Imageamento por Ressonância Magnética/estatística & dados numéricos , Técnicas de Diagnóstico Neurológico , Neuroimagem
5.
Rev. bras. neurol ; 51(1): 18-20, jan.-mar. 2015. ilus, tab
Artigo em Português | LILACS | ID: lil-749261

RESUMO

O diagnóstico diferencial das ataxias é complexo e a determinação etiológica um desafio. Quando se inicia após os 50 anos de idade, mesmo após extensa investigação, eventualmente não se estabelece a etiologia, podendo tratar-se de ataxia cerebelar idiopática de início tardio (ILOCA), uma das formas de ataxia esporádica neurodegenerativa. Relatamos o caso de uma mulher com quadro de ataxia e sinais piramidais com evolução de 14 anos, cuja causa, mesmo após extensa investigação, não foi possível de se identificar. Citamos, ainda, os diagnósticos diferenciais, assim como o estabelecido para a paciente em questão: ILOCA-plus , por causa da presença de sinais piramidais associados à ataxia.


The differential diagnosis of ataxia is complex and determining etiology is a diagnostic challenge. In some patients even after extensive investigation no etiology is determined and these cases could be classified as idiopathic late onset cerebellar ataxia (ILOCA), a cause of sporadic neurodegenerative ataxia. We report a case of a female patient with progressive ataxia (14 years of evolution) with pyramidal signs that even after extensive research has not been possible to determine the cause. We discuss the differential diagnosis and the diagnosis established for the patient: ILOCA-plus, due to presence of pyramidal signs associated with ataxia.


Assuntos
Humanos , Feminino , Idoso , Degenerações Espinocerebelares/diagnóstico , Ataxia Cerebelar/diagnóstico , Progressão da Doença , Doenças Neurodegenerativas , Crânio/diagnóstico por imagem , Imageamento por Ressonância Magnética/estatística & dados numéricos , Diagnóstico Diferencial
6.
Acta cir. bras ; 30(3): 199-203, 03/2015. graf
Artigo em Inglês | LILACS | ID: lil-741042

RESUMO

PURPOSE: To evaluate the effects of the dipeptide L-alanyl-glutamine (L-Ala-Gln) as a preconditioning agent to potentially promote reduction in the intensity of lesion or induction of resilience in rats subjected to global cerebral ischemia/reperfusion (I/R) injury. METHODS: Thirty-six male Wistar rats weighing 280-300g were randomly assigned to six groups (n=6). Groups Sham 1h and 24h were treated with saline and spared of further interventions. The remaining groups were submitted to clamping of the common carotid arteries for 30 minutes (ischemia) and treated with saline (SS) or L-Ala-Gln. Brain reperfusion was allowed for 1or 24 h. L-Ala-Gln was administered intravenously (0.75g/kg) 30 minutes before sham procedure or induction of global brain I/R injury. Brain edema and red neuron counting were determined. Results were expressed as Mean±SD for normal results and Median±Percentile for non parametric data. Significance was established at p<0.05. RESULTS: Global I/R injury promoted an increase in brain edema at 24 h after reperfusion, whereas preconditioning with L-Ala-Gln induced no change in edema. On the other hand, L-Ala-Gln preconditioning decreased significantly red neurons counting both at 1h and 24h post reperfusion (p<0.05). CONCLUSION: There was a significant preconditioning effect with L-Ala-Gln decreasing cell death (red neurons counting) at early (1h) and late reperfusion (24h) in the cerebral tissue. .


Assuntos
Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Calicreínas/sangue , Imageamento por Ressonância Magnética/estatística & dados numéricos , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Neoplasias da Próstata/diagnóstico , Biomarcadores Tumorais/sangue , Reações Falso-Negativas , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
7.
Ciênc. Saúde Colet. (Impr.) ; 20(2): 515-524, fev. 2015. tab, graf
Artigo em Português | LILACS | ID: lil-742222

RESUMO

O presente estudo identificou as características demográficas dos indivíduos e assistenciais do tratamento odontológico sob sedação e/ou anestesia geral em ambiente hospitalar no SUS-MG. Foram avaliadas todas as Autorizações de Internações Hospitalares (AIH) para o procedimento Tratamento Odontológico para Pacientes com Necessidades Especiais, de julho de 2011 a junho de 2012. Foram mensuradas variáveis demográficas e assistenciais dos atendimentos. Foram calculadas as taxas de internações por 10.000 habitantes e a cobertura assistencial realizada no estado de Minas Gerais e em cada uma das Regiões Ampliadas de Saúde. A análise descritiva das variáveis foi feita por meio de cálculo da frequência e medidas de tendência central e variabilidade. Foram avaliadas todas as 1.063 AIH pagas no período estudado, que representaram uma taxa de 0,54 internações por 10.000 habitantes. A maioria dos indivíduos era adulta, do sexo masculino, com diagnóstico de transtornos mentais ou comportamentais e residente em 27,7% dos municípios de Minas Gerais. Os procedimentos foram realizados em 39 municípios e a cobertura assistencial foi igual a 1,58%. O estudo revelou um perfil clássico do paciente atendido. Dificuldades em se estabelecer uma rede de atenção à saúde bucal foram identificadas.


This study identified the demographic characteristics of individuals and dental treatment care under sedation/general anesthesia in a hospital environment in the Unified Health System in the State of Minas Gerais (SUS-MG). All Hospitalization Authorizations (AIHs) for Dental Treatment for Patients with Special Needs procedures were evaluated between July 2011 and June 2012. Demographic and health care variables for treatment were also assessed. Hospitalization rates per 10,000 inhabitants, and health care coverage provided in the state of Minas Gerais and in each of the Broader Health Regions were calculated. Descriptive analysis of data was carried out by calculating the central trend and variability frequency and measurements. All 1,063 AIHs paid during the study period were evaluated, which is equivalent to a rate of 0.54 hospitalizations per 10,000 individuals. The majority of the patients were adult, male, diagnosed with mental or behavioral disorders and resident in 27.7% of the municipalities in Minas Gerais. The procedures were performed in 39 municipalities and the care coverage was equal to 1.58%. The study reveals a classic demographic and clinical profile of patient attendance. Difficulties in establishing a network of dental care were identified.


Assuntos
Humanos , Biofísica , Causalidade , Interpretação Estatística de Dados , Modelos Neurológicos , Modelos Estatísticos , Teorema de Bayes , Mapeamento Encefálico/métodos , Mapeamento Encefálico/estatística & dados numéricos , Eletroencefalografia/estatística & dados numéricos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética/estatística & dados numéricos , Magnetoencefalografia , Reprodutibilidade dos Testes
8.
Rev. cuba. ortop. traumatol ; 28(2): 181-192, jul.-dic. 2014. ilus, tab
Artigo em Espanhol | LILACS, CUMED | ID: lil-740946

RESUMO

INTRODUCCIÓN: se realizó el trasplante de células madre en siete pacientes diagnosticados con enfermedad degenerativa de un solo disco intervertebral. OBJETIVO: evaluar la seguridad del proceder y la tolerancia a las células trasplantadas. MÉTODOS: las células fueron extraídas de medula ósea del propio paciente, aisladas por el método de Ficoll-Hypaque e implantadas en los discos seleccionados como grados II y III de la clasificación de Pfirrmann por imágenes de resonancia. Se evaluaron los resultados al año del injerto. RESULTADOS: no se registraron eventos adversos importantes derivados del procedimiento ni del injerto de células. Con la utilización del índice de Oswestry se evaluaron los resultados clínicos como beneficiosos, así como la posible mejoría en las imágenes de resonancia magnética antes y un año después. CONCLUSIÓN: los resultados demuestran que las células madre obtenidas de médula ósea del propio paciente pueden ser trasplantadas de manera segura, con excelente tolerancia y sin complicaciones usando el método descrito.


INTRODUCTION: stem cell transplant was performed in seven patients diagnosed with degenerative one intervertebral disc. OBJECTIVE: evaluate the safety and tolerance of the procedure to transplanted cells. METHODS: cells were extracted from the patient's own bone marrow. They were isolated by the Ficoll-Hypaque method and they were implemented in discs selected as grades II and III according to Pfirrmann classification resonance imaging. Graft outcomes were evaluated one year later. RESULTS: no significant adverse events were recorded from the procedure or graft cells. By using the Oswestry index, clinical outcomes were evaluated as beneficial, as well as the possible improvement in images from magnetic resonance imaging before and a year later. CONCLUSION: these results show that stem cells derived from the patient's own bone marrow can be safely transplanted with excellent tolerance and no complications using the method described.


INTRODUCTION: une greffe de cellules souches a été réalisée chez sept patients diagnostiqués de maladie dégénérative sur un seul disque intervertébral. OBJECTIF: le but de cette étude est d'évaluer cette procédure et la tolérance aux cellules transplantées. MÉTHODES: les cellules proviennent de la moelle osseuse du patient lui-même, isolées par la méthode de Ficoll-Hypaque et implantées au niveau des disques en grade II et III selon classification RM de Pfirrmann. Les résultats ont été évalués un an après la transplantation. RÉSULTATS: il n'y a pas eu de complications importantes au cours de l'opération ni de la greffe de cellules. Au moyen de l'indice d'Oswestry, les résultats cliniques ont été classifiés de bons ; une amélioration potentielle des images par RM a été aussi remarquée avant et après un an. CONCLUSIONS: les résultats montrent que les cellules souches prélevées de la moelle osseuse du propre patient peuvent être transplantées de manière sure, avec une tolérance excellente, et sans complications, en utilisant la méthode décrite.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Imageamento por Ressonância Magnética/estatística & dados numéricos , Transplante de Medula Óssea/efeitos adversos , Transplante de Células-Tronco/efeitos adversos , Degeneração do Disco Intervertebral/diagnóstico , Estudos Prospectivos
9.
Rev. cuba. med. mil ; 43(3): 352-369, jul.-set. 2014. Ilus
Artigo em Espanhol | LILACS, CUMED | ID: lil-731007

RESUMO

Los tumores del epidídimo son infrecuentes y la mayoría benignos, por lo que muchos no se informan en la literatura médica. En ocasiones, llegar al diagnóstico histológico de certeza, implica realizar múltiples exámenes al paciente y un reto al desempeño del médico. En el presente trabajo se hace un recuento anatómo-fisiológico del epidídimo, así como la actualización del tema de los tumores de dicho órgano, en lo referente al diagnóstico y tratamiento. Se efectuó una búsqueda bibliográfica, en las bases de datos de Hinari, PubMed, MEDLINE y en el motor de búsquedas de Google, en el periodo de 2009 a 2013. Se emplearon los términos del MeSH: tumores paratesticulares, tumores intraescrotales y tumores del epidídimo, en idioma español e inglés. También se revisaron libros de consulta y revistas especializadas. Se confirma el valor del interrogatorio y del examen físico minucioso, para establecer el diagnóstico topográfico y diferencial de estos tumores. Aunque el ultrasonido es el estudio imagenológico de elección para su valoración inicial, muchas veces no es concluyente, por lo que resulta necesario obtener imágenes por resonancia magnética nuclear para lograr información adicional. Cuando el cuadro clínico y los hallazgos de las imágenes suponen un tumor benigno, la citología aspirativa con aguja fina es una opción fiable para clasificarlos en benignos o malignos. No obstante, si esta no es definitoria, se recurre a la biopsia por congelación transoperatoria, la cual se obtiene mediante inguinotomía, y así se evita orquiectomías radicales innecesarias. Los tratamientos adyuvantes, para los tumores malignos, son muy particularizados según la edad del paciente, el tipo histológico y el estadio.


Epididymus tumors are rare and the majority of them are benign, so there is not much information about them in the medical literature. Reaching the final histological diagnosis implies multiple testing and represents a challenge for the physician's performance. The present paper made an anatomical and physiological review of the epididymus as well as provided updating on the tumors affecting this organ in terms of diagnosis and treatment. Literature search was made in databases Hinari, PubMed, Medline and in Goggle from 2009 to 2013. The MeSH terms were paratesticular tumors, intrascrotal tumors and epididymal tumors in Spanish and English. Reference books and specialized journals were also reviewed. This paper confirmed the value of questioning and of the detailed physical exam in order to set the topographic and differential diagnosis of these tumors. Although ultrasound is the imaging study of choice for initial assessment, it is often inconclusive; therefore, it is necessary to obtain nuclear magnetic resonance images so as to have additional information. When the clinical picture and the findings from images may indicate a benign tumor, then fine needle aspiration cytology is a reliable option to make the final classification. Nevertheless, if this technique is not conclusive, then there is the biopsy through transoperative freezing, which is taken with inguinotomy, thus avoiding unnecessary radical orchiectomies. The adjuvant treatments for malignant tumors are very customized since they depend on the patient's age, the histological type and the tumor staging.


Assuntos
Humanos , Imageamento por Ressonância Magnética/estatística & dados numéricos , Quimioterapia Adjuvante/efeitos adversos , Biópsia por Agulha Fina/métodos , Epididimo/lesões , Doenças dos Genitais Masculinos/diagnóstico , Neoplasias/patologia
10.
Rev. bras. neurol ; 50(4): 83-87, out.-dez. 2014. graf, tab
Artigo em Português | LILACS | ID: lil-737169

RESUMO

Este estudo destaca os recursos em neurologia, neurologistas eequipamentos de diagnóstico por meio de imagem, segundo os estadosbrasileiros e sua distribuição populacional. Há grandes desigualdadesentre as regiões. A informação apresentada pode ser útil para o planejamento em saúde e para os especialistas atuais ou futuros. Os resultados deste estudo sugerem a necessidade de aumento substancial dos serviços de neurologia em alguns locais do Brasil, mas de modo geral o atendimento neurológico parece ter indicadores satisfatórios. Entretanto, o material apresentado é apenas uma primeira abordagem da situação real, sendo necessário obter informações mais completas e precisas, em estudos futuros.


This study highlights neurological resources, mainly neurologists and diagnostic imaging equipment, according to the Brazilian states and their population distribution. There is great inequality between regions. The presented information may be useful for health planning and for current or future specialists. The results of this study suggest the need for substantial increase in neurology services in some locations of Brazil, but in general, neurological care seems to have satisfactory indicators. However, the presented material is only a first approach of the real situation, being necessary to acquire more complete and accurate information, in future studies.


Assuntos
Humanos , Faculdades de Medicina/estatística & dados numéricos , Tecnologia Biomédica , Educação Médica Continuada , Neurologia/educação , Neurologia/estatística & dados numéricos , Brasil , Imageamento por Ressonância Magnética/estatística & dados numéricos , Tomografia Computadorizada por Raios X/estatística & dados numéricos
11.
Journal of the Egyptian Society of Parasitology. 2014; 44 (1): 55-70
em Inglês | IMEMR | ID: emr-154429

RESUMO

Helminth parasitic infections of the central nervous system [CNS] occur worldwide with high prevalence in tropical and subtropical countries. Clinical evaluation of patients is mandatory, and it is convenient to group the clinical manifestations into syndromes: for example space-occupying lesions, meningitis, and encephalitis. The history should focus on residence or travel to endemic areas, diet, activities, inter-current medical conditions, and associated clinical clues. Direct parasitological diagnosis can be reached by cerebrospinal fluid and cerebral tissue examination either by microscopy, culture, or immunological techniques. Immunodiagnosis by detection of parasite antibodies or antigens in serum could provide indirect evidence of parasitic infections. In addition, various imaging and radiological techniques e.g., computed tomography [CT] scan and magnetic resonance imaging [MRI] complement the diagnostic work-up of CNS diseases. Finally, the helminthic CNS infections of global impact, such as schistosomiasis, neurotoxocariasis, Strongyloides infection, neurotrichinosis, neurocysticercosis, and echinococcosis will be briefly discussed as regards the principal clinical and diagnostic features


Assuntos
Humanos , Masculino , Feminino , Cisticercose/complicações , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Imageamento por Ressonância Magnética/estatística & dados numéricos
12.
Journal of the Egyptian Society of Parasitology. 2014; 44 (1): 131-140
em Inglês | IMEMR | ID: emr-154435

RESUMO

Echinococcosis is a major parasitic zoonosis of public health importance worldwide. This is particularly true in sheep-raising countries including Egypt. Therefore, it is very important to identify the significant risk factors of the diseases by reviewing studies done in the region in the past decade to help policy makers design appropriate control strategies


Assuntos
Humanos , Masculino , Feminino , Animais , Zoonoses/microbiologia , Ovinos/parasitologia , Fatores de Risco , Criança/diagnóstico por imagem , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Imageamento por Ressonância Magnética/estatística & dados numéricos
13.
Indian J Med Sci ; 2011 May; 65(5) 193-202
Artigo em Inglês | IMSEAR | ID: sea-145610

RESUMO

Context: Imaging techniques are commonly used by emergency physicians in a febrile comatose patient. Their utility requires judicious use of the available resources. In this study, we have compared the efficacy of cranial imaging techniques in adult patients with acute febrile encephalopathy. Materials and Methods: This prospective observational study enrolled 101 patients presenting to the emergency with fever of less than 15 days duration and altered sensorium. All the patients were subjected to routine investigations, detailed cerebrospinal fluid analysis, computerized tomograms (noncontrast followed by contrast enhanced), and magnetic resonance imaging of the brain. Final diagnosis was reached after considering the clinical, biochemical findings, imaging results, and response to therapy. The positive yield of radiological investigations was compared against the final diagnosis. Results: The patients were divided into three groups. Forty-eight had evidence of meningoencephalitis, 22 patients had pyogenic meningitis, and 20 were combined together in other group. In 12 patients, a definitive diagnosis could not be made. Only 37% patients were detected to have abnormal computerized tomograms and the most common abnormality was diffuse edema, which failed to point to an etiological diagnosis. Magnetic resonance imaging was abnormal in 62.75% cases and was able to suggest an etiological diagnosis in 100% cases of cerebral venous thrombosis, tubercular meningitis, 95% cases of meningoencephalitis, and 45% patients with meningitis. Conclusions: We can conclude that magnetic resonance imaging provides better information than computerized tomography in adult patients with acute febrile encephalopathy.


Assuntos
Adulto , Coma , Encefalite Viral/diagnóstico , Encefalite Viral/etiologia , Febre/diagnóstico , Febre/etiologia , Humanos , Imageamento por Ressonância Magnética/estatística & dados numéricos , Meningite/diagnóstico , Meningite/etiologia , Meningoencefalite/diagnóstico , Meningoencefalite/etiologia , Pacientes , Tomografia Computadorizada por Raios X/estatística & dados numéricos
14.
Indian J Cancer ; 2011 Apr-Jun; 48(2): 181-186
Artigo em Inglês | IMSEAR | ID: sea-144449

RESUMO

Background: FDG-PET is recommended as an investigation in unknown primary tumors, but its definitive role and cost effectiveness are yet to be established. Aims: dditional value of FDG-PET over conventional imaging in unknown primary tumors with cervical metastasis. Setting and Design: Retrospective study in a tertiary level oncology centre. Materials and Methods: A total of 112 patients were divided into three groups; 53 with conventional modalities (either computed tomography or magnetic resonance imaging) (group I), 59 with FDG-PET (group II), and group III (subgroup of group II) with both (40 patients). Statistical Analysis: Sensitivity and specificity of both conventional modality and PET were calculated. Association between neck nodes and distant metastasis was analysed using multivariate logistic regression analysis. Results: Sensitivity and specificity for conventional modalities was 92.3% and 50% and sensitivity and specificity of FDG-PET was 92.8% and 71.4%, respectively. FDG-PET detected metastasis in 52.54% of patients. Multivariate logistic regression analysis showed statistically significant association between distant metastasis and multiplicity of nodes (N2b, N2c) (P = 0.007). Among all patients with low neck nodes in group II, FDG-PET detected primaries in 12 patients, 9 of which were infraclavicular (75%). FDG-PET added information to conventional imaging in 32.5% of patients and influenced an overall change in management in 38.9% of patients. Conclusions: FDG-PET is a valuable tool influencing change of management in unknown primary with cervical metastasis. It is recommended especially in the presence of low or multiple neck nodes in view of high incidence of infraclavicular primary and distant metastasis, respectively.


Assuntos
Adulto , Idoso , Feminino , Fluordesoxiglucose F18/diagnóstico , Neoplasias de Cabeça e Pescoço/secundário , Humanos , Imageamento por Ressonância Magnética/estatística & dados numéricos , Masculino , Prontuários Médicos , Pessoa de Meia-Idade , Neoplasias Primárias Desconhecidas/patologia , Tomografia por Emissão de Pósitrons/estatística & dados numéricos , Prognóstico , Compostos Radiofarmacêuticos/diagnóstico , Estudos Retrospectivos , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X/estatística & dados numéricos
15.
Yonsei Medical Journal ; : 727-733, 2011.
Artigo em Inglês | WPRIM | ID: wpr-155391

RESUMO

PURPOSE: No precise data are available showing how magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) can be applied to diagnosis for the first attack of a suspected cerebrovascular disease in Korea. The purpose of this study was to evaluate the application level of MRI and MRA as diagnostic tools and the related factors to the use of these techniques. MATERIALS AND METHODS: This study used the health benefit claim data of 89,890 patients who were hospitalized for the first time due to suspected cerebrovascular disease in 2007 without having visited medical institutions as an outpatient or inpatient from 2003 to 2006. RESULTS: Of the 89,890 cases, 28.4% took both MRI and MRA, 10.7% took only MRI and 6.9% took only MRA. The related factors identified in the multivariate logistic regression analysis were gender, type of insurance, type of medical institution, type of department, duration of hospitalization, and type of disease. CONCLUSION: This study showed that the application level of MRI and MRA as diagnostic measures for the first attack of a suspected cerebrovascular diseases varied depending on several factors. It is necessary to study more accurate levels of computerized tomography (CT), computerized tomography angiography (CTA), MRI or MRA as measures to diagnose a first attack of suspected cerebrovascular disease.


Assuntos
Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Angiografia Cerebral , Transtornos Cerebrovasculares/diagnóstico , Angiografia por Ressonância Magnética/estatística & dados numéricos , Imageamento por Ressonância Magnética/estatística & dados numéricos , Razão de Chances , República da Coreia , Tomografia Computadorizada por Raios X
16.
New Egyptian Journal of Medicine [The]. 2010; 42 (Supp. 2): 23-29
em Inglês | IMEMR | ID: emr-166037

RESUMO

Serum C-reactive protein [CRP] concentration issensitive marker of underlying systemic inflammation. Patientsunder continuous hemodialysis have an activated inflammatoryresponse, evidenced by increased serum CRP levels especiallyin patients with cerebral stroke. The study was performed toevaluate serum levels of CRP as inflammatory markers inpatients with stroke under continuous hemodialysis. The study was included 33 patients with chronicrenal failure under continuous hemodialysis divided into twogroups. Group I included 23 patients with acute stroke. Group II [control group] included 10 patients without stroke. All patientswere subjected to complete history and clinical examinationwith special emphasis to history of co-morbid conditions,hypertension, diabetes mellitus and cardiovascular disease.Serum creatinine, urea, CBC, albumin, lipid profile, calcium,fasting and post prandial blood sugar, sodium, potassium, serumuric acid, phosphorus, C-reactive protein and other investigationwere evaluated. In addition axial CT or MRI was performed atadmission and after 72 hours. The following parameterswere significantly higher in groupe I when compared to group II;ages [t=3.5. p< 0.01], CRP [t=7.1, p<0.001], serum creatinine [tett, p<0.0] and blood urea [t=4.3, p<0.01], while serumlevels of Hb% and serum calcium were significantly lower ingroup I when compared to group II [t=3.1, p<0.01 and t=2.2,p<0.05 respectively]. On the hand no significant differences inthe other studied parameters between two groups. Serum levelsof CRP were positively correlated with INR [r=520, p<0.05] and negatively correlated with serum calcium [r=0.580, p<0.05] and serum albumin [r=-540, p<0.05]. On the other hand nosignificant correlations were found between CRP and otherstudied parameters. According to ROC curve between group Iand II in CRP the cutoff were greater than 12 with sensitivity,specificity, Positive Perdictive Value and Negative PredictiveValue were 100% by accuracy 100%. Elevatedserum CRP could be a predictor of cerebrovascular stroke indialysis patients. Therefore, regular determination of serumCRP may be helpful to detect early signs of tissue damage andasymptomatic inflammation in these patients


Assuntos
Humanos , Masculino , Feminino , Proteína C-Reativa/biossíntese , Infarto Cerebral/sangue , Infarto Cerebral/complicações , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Imageamento por Ressonância Magnética/estatística & dados numéricos , Falência Renal Crônica/sangue , Testes de Função Renal/estatística & dados numéricos , Hospitais Universitários
17.
New Egyptian Journal of Medicine [The]. 2010; 42 (Supp. 4): 15-37
em Inglês | IMEMR | ID: emr-166046

RESUMO

Despite decades of experience in the topics of clubfoot considerable 1 uncertainty remains, regarding its treatment and long term results. Surgical release of talocalcaneal interosseous ligament [TCIL] possesses a controversial issue, as many thought that it has early and remote drawbacks effect as avascular necrosis of the talus and hindfoot overcorrection. This is a retrospective study of 60 idiopathic clubfeet in 43 patients were treated by posteromedial surgical approach since 14 years ago. There were 38 male patients [88.4%] and 5 were females [11.6%] . The affected side was [left =11; right= 15; bilateral = 34 feet]. The preoperative deformity was very severe in 36 feet [60%] and severe in 24 [40%] by using the Simon scale . Preoperatively the feet were divided randomly into 2 equal groups [A] and [B][30 feet each]. All the feet were treated by means of soft tissue release via posteromedial approach at mean age 9 months range [3-24 months]. In group [A] feet, the talocalcaneal interosseous ligament [TCIL] was released, where in group [B] the ligament was left intact. At mean follow-up period of 12.5 years range [11-14 years] the late follow result was satisfactory in [96.6%] in group A and [90%] in group B feet. This shows increasing of their late satisfactory percentage than their early follow up assessment. When the late total mean of both clinical and radiological scores were investigated, group [A] still graded excellent results while group [B] graded as good. The group [A] feet showed more satisfactory and statistically significant improvement of the talocalcaneal index, anteroposterior, lateral talocalcaneal and lateral calcaneus-first metatarsal angles when compared with group B elements. This was reflected clinically as it shows more better hindfoot correction with the surgical release of the TCIL .This without any evidence of significant clinical overcorrection. Magnetic resonance imaging[MRI] was performed early five months after surgery to assess talar avascular necrosis and talo-calcanio-navicular alignment .ThiV


Assuntos
Humanos , Masculino , Feminino , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Imageamento por Ressonância Magnética/estatística & dados numéricos , Estudos Retrospectivos , Seguimentos , Resultado do Tratamento
18.
New Egyptian Journal of Medicine [The]. 2010; 42 (Supp. 1): 66-77
em Inglês | IMEMR | ID: emr-166058

RESUMO

Congenital clubfoot is a variable three dimensional complex system of chondroosseous and joints deformity. Its treatment possess a controversial issue since dates of Hippocrates. In clubfoot surgery many complications as stiffness, overcorrection, talar avascular necrosis and subsequently poor functional results were postulated by many as a sequlae to simultaneous complete subtalar release . This is a prospective study of 33 patients with 40 idiopathic clubfeet. There were 28 males [84.8%] and 5 were female [15.2%] patients.The affected sides were [left =11; right= 15; bilateral = 14 feet]. The feet were divided randomly into 2 equal groups [A and B][20 feet each]. The initial deformity was very severe in 32 feet and severe in 8 by using the Simon scale and allocated equally in both groups. All the feet were treated at a mean age of 8 months by means of posteromedial surgical soft tissue release. In addition selective medial capsular release of the subtalar joint with release of talocalcaneal interosseous ligament was done in group [A] feet where it was left intact in group [B]. At a mean follow-up period of 26 months range [24-30], the total satisfactory results were [85%]. In both groups the result was [90%] satisfactory in group [A] and [85%] in group [B] feet . When their mean overall clinical and radiological scores were investigated and comparing their satisfactory results together, group [A] feet showed statistically significant improvement of clinical and radiological parameters than those of group [B]. This was reflected clinically on better hindfoot alignment with the release of the TCIL in group [A] feet. Neither any evidence of overcorrection nor talar avascular necrosis was detected either clinically or radiologically by conventional x-ray as well as by MRI of all the studied feet in both groups. Posteromedial surgical approach with release of TCIL proved to be a good contribution in the treatment of severe and relapsing clubfeet, which gave significantly better hindfoot alignment without aforementioned serious complication


Assuntos
Humanos , Masculino , Feminino , Pé Torto Equinovaro/complicações , Osteonecrose/terapia , Imageamento por Ressonância Magnética/estatística & dados numéricos , Seguimentos
19.
Iranian Journal of Pediatrics. 2009; 19 (1): 69-74
em Inglês | IMEMR | ID: emr-91421

RESUMO

Reversible posterior leukoencephalopathy syndrome [RPLE] is an increasingly recognized disorder, most commonly associated with immunosuppressive and cytotoxic agent, malignant hypertension and toxemia of pregnancy. Neurological symptoms are headache, mental and visual disturbance, and seizures. Brain MRI findings are symmetrical bilateral hyper intense areas of occipital and parietal lobes in T2-weighted magnetic resonance [MR] images. This finding is reversible with prompt successful treatment which may take days to weeks for full reversal. We observed a case of status epilepticus which occurred 32 days after liver transplantation in a patient on regimen consisting of Tacrolimus [FK 506]. He had no history of neurologic disease or metabolic abnormalities. Typical findings of RPLE were present on brain MRI. The recurrence of seizures terminated after a few hours with adding Na-valproate to Phenytoin, Phenobarbital and Midazolam. The radiological finding of brain MRI gradually diminished after several weeks. A physician should be alert of seizures during early post transplant period of liver transplantation. He should bear in mind the diagnosis of RPLE and consider discontinuation of immunosuppressive drugs


Assuntos
Humanos , Masculino , Síndrome da Leucoencefalopatia Posterior/etiologia , Síndrome da Leucoencefalopatia Posterior/complicações , Síndrome da Leucoencefalopatia Posterior/diagnóstico por imagem , Estado Epiléptico/tratamento farmacológico , Estado Epiléptico/etiologia , Estado Epiléptico/diagnóstico por imagem , Transplante de Fígado/efeitos adversos , Imunossupressores/efeitos adversos , Imunossupressores , Imageamento por Ressonância Magnética/estatística & dados numéricos , Tacrolimo/efeitos adversos , Tacrolimo , Ácido Valproico , Midazolam , Fenitoína , Fenobarbital
20.
Medical Journal of Cairo University [The]. 2007; 75 (2 Supp.): 231-238
em Inglês | IMEMR | ID: emr-145664

RESUMO

To determine the efficacy and toxicity of accelerated concomitant boost radiotherapy [RT] plus concurrent cisplatin in patients with muscle invasive bladder cancer. Sixty four patients with muscle invading transitional cell bladder cancer were entered into a protocol of transurethral resection of the bladder tumor [TURBT] followed by concurrent cisplatin [10mg/m[2] thrice weekly] and accelerated concomitant boost radiotherapy. The whole pelvis was treated by l.8Gy conventional daily fractions up to a total dose of 45Gy. A concomitant boost limited to the bladder was delivered as a second daily fraction [1.4Gy] during the last 3 weeks up to a total dose of 66Gy. The patients were evaluated for local control, toxicity and survival. All but two patients completed the radiotherapy protocol. Fifty eight patients received the full doses of cisplatin. Grade 3 acute urinary toxicity was observed in 10 patients [15.6%]. Also, 6 patients [9.4%] presented with acute grade 3 bowel toxicity. Eight patients [12.6%] experienced late grade 3 toxicity [4 with bladder and 4 with bowel toxicity]. The 3-year actuarial local control, distant disease control and overall survival rates were 60% [95% CI, 50.1-69.3], 65.6% [95% CI, 53.7%-74.3%], and 37.5% [95% CI, 26.1%-45.9%] respectively. The results of our protocol of acclerated concomitant boost radiotherapy with concurrent cisplatin, as regard locoregional control and overall survival, did not appear to be improved in comparison with other studies combining cisplatin and standard conventional fractionation, moreover the observed toxicity was higher


Assuntos
Humanos , Cisplatino , Radiossensibilizantes , Granulócitos , Plaquetas , Testes de Função Hepática , Cistoscopia/métodos , Imageamento por Ressonância Magnética/estatística & dados numéricos , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Seguimentos
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