ABSTRACT
OBJECTIVE: To show the role of magnetic resonance imaging in the early diagnosis of ankylosing spondylitis and discuss its possible usefulness in evaluating the response to treatment. MATERIAL AND METHODS: We describe the findings on magnetic resonance images using STIR and contrast-enhanced T1-weighted sequences in 13 patients diagnosed with ankylosing spondylitis receiving adalimumab treatment. Magnetic resonance images were acquired at baseline and after six months. We describe the findings obtained and the results of the quantitative analysis of vertebral affection (using the ASspiMRI-a score), and sacroiliac and hip joint affection. RESULTS: Inflammatory effects were demonstrated in 12 patients as signal hyperintensity in STIR sequences and as contrast enhancement in T1-weighted sequences. After treatment, 12 patients showed decreased ASspiMRI-a score and less affection in the sacroiliac and hip joints. No changes were observed in the remaining patient. Two patients showed posterior vertebral element involvement and disc involvement was seen in three. CONCLUSIONS: MRI opens up new possibilities for the management of patients with ankylosing spondylitis. On the one hand, it enables early diagnosis, saving the patient years of trial treatments and saving the healthcare system the cost of multiple diagnostic tests to try to explain the symptoms these patients present. On the other hand, it enables the rapid, objective evaluation of the response to therapy, thus making it possible to step up to a new, more aggressive therapy quickly and avoid treatments that are not very effective.
Subject(s)
Magnetic Resonance Imaging , Spondylitis, Ankylosing/diagnosis , Adult , Female , Follow-Up Studies , Humans , Male , Middle Aged , Spondylitis, Ankylosing/drug therapyABSTRACT
Objetivo. Mostrar el papel de la resonancia magnética en el diagnóstico precoz de la espondilitis anquilosante y su posible utilidad en la valoración de la respuesta al tratamiento.Material y métodos. Se describen los hallazgos en resonancia magnética (secuencias STIR y T1 con contraste paramagnético) en 13 pacientes diagnosticados de espondilitis anquilosante que reciben tratamiento con adalimumab. Se realiza una resonancia magnética basal al comienzo del estudio y otra a los seis meses, describiendo los hallazgos obtenidos y valorando cuantitativamente la afectación vertebral (con el sistema de puntuación ASspiMRI-a), la afectación sacroilíaca y de la articulación coxofemoral.Resultados. La afectación inflamatoria se demostró en 12 pacientes en forma de hiperintensidad de señal en STIR y captación de contraste en secuencias T1. Tras la administración del tratamiento 12 pacientes mostraron una disminución de la puntuación ASspiMRIa, y una menor afectación en ASI y coxofemorales. En el paciente restante la puntuación no se modificó. Dos pacientes presentaban afectación de elementos posteriores vertebrales y en tres pacientes se apreció afectación discal.Conclusiones. La resonancia magnética abre nuevas posibilidades para el manejo de los pacientes con espondilitis anquilosante. Por un lado, permite el diagnóstico precoz, ahorrando al paciente años de tratamientos de prueba y ahorrando al sistema sanitario el coste de múltiples pruebas diagnósticas para intentar explicar los síntomas que presentan dichos enfermos. Por otro lado, permite una valoración rápida y objetiva de la respuesta al tratamiento, por lo que el paso a un nuevo escalón terapéutico más agresivo se podrá realizar con mayor celeridad, evitando tratamientos poco efectivos
Objective. To show the role of magnetic resonance imaging in the early diagnosis of ankylosing spondylitis and discuss its possible usefulness in evaluating the response to treatment.Material and methods. We describe the findings on magnetic resonance images using STIR and contrast-enhanced T1-weighted sequences in 13 patients diagnosed with ankylosing spondylitis receiving adalimumabtreatment. Magnetic resonance images were acquired at baseline and after six months. We describe the findings obtained and the results of the quantitative analysis of vertebral affection (using the ASspiMRI-a score), and sacroiliac and hip joint affection.Results. Inflammatory effects were demonstrated in 12 patients as signal hyperintensity in STIR sequences and as contrast enhancement in T1-weighted sequences. After treatment, 12 patients showed decreasedASspiMRI-a score and less affection in the sacroiliac and hip joints. No changes were observed in the remaining patient. Two patients showed posterior vertebral element involvement and disc involvementwas seen in three.Conclusions. MRI opens up new possibilities for the management of patients with ankylosing spondylitis. On the one hand, it enables early diagnosis, saving the patient years of trial treatments and saving the healthcare system the cost of multiple diagnostic tests to try to explain the symptoms these patients present. On the other hand, it enables the rapid, objective evaluation of the response to therapy, thus making it possible to step up to a new, more aggressive therapy quickly and avoid treatments that are not very effective
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Magnetic Resonance Imaging , Spondylitis, Ankylosing/diagnosis , Spondylitis, Ankylosing/drug therapy , Follow-Up StudiesABSTRACT
This is the first iconographic taxonomic database intended as an everyday tool for the practising taxonomist, that allows access to the original drawings used to describe species. We demonstrate the system with water mites (Acari, Parasitengona, Hydrachnidia) but it may be used with any other plant or animal group. Query by genus or species leads to the original drawings and any additional images associated to that particular name. At present, the database includes images from more than 4,000 species (around 38,000 illustrations) and is easily expandable. Copyright does not allow the database to be used in an open WWW context, but it can be an extremely useful tool in private taxonomic applications.
Subject(s)
Classification/methods , Databases, Factual , Mites/classification , Animals , PhotographyABSTRACT
INTRODUCTION: Acute hepatic failure (AHF) is an uncommon entity but with high mortality. Liver transplantation has improved prognosis but is an aggressive treatment with high risk. Currently, there are no accurate criteria to differentiate between irreversible AHF and the possibility of hepatic regeneration. The aim of this study is to review the clinical characteristics indicating transplantation and the outcome of AHF in patients at our institution. PATIENTS AND METHOD: Descriptive and retrospective study of cases of AHF at our institution in the last 3 years. RESULTS: Eleven patients were studied. Mortality was lower in transplant recipients (23%; 2 out of 8) than in non-transplanted patients (67%; 2 out 3). Hepatic regeneration occurred in one patient. Overall mortality was 36% with a perioperative mortality of 13%. CONCLUSION: The indication of hepatic transplantation in patients with a poor prognosis, early stage acute liver failure, and a low grade of encephalopathy, and prior to the development of multiorgan failure could improve the results of transplantation and reduce perioperative mortality.
Subject(s)
Liver Failure, Acute/mortality , Liver Failure, Acute/surgery , Liver Transplantation , Adult , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
Microscopes offer a limited depth of focus which precludes the observation of a complete image of a three-dimensional (3D) object in a single view. Investigations, by a variety of researchers, have led to the development of extended depth of focus algorithms for serial optical slices of microscopic 3D objects in recent years. However, to date, no quantitative comparison of the different algorithms has been performed, generally leaving the evaluation to the subjective qualitative appreciation of the observer. In this paper we use three different tests for extended depth of focus algorithm evaluation and test 10 different algorithms, some of them have been adapted (by us) for a series of optical slices. However, the main contribution of the paper is a new improved algorithm for computing the extended depth of focus.
Subject(s)
Algorithms , Microscopy/methods , Animals , Image Processing, Computer-Assisted/methods , Mites/anatomy & histologyABSTRACT
Split notochord syndrome has been described in several previous case reports; however, we recently treated two patients with a previous undescribed variant of this syndrome. A 2,800 g male baby was admitted to the neonatal patients room with a non covered mass on the lumbo-sacral region, and a portion of intestine, with meconium being passed attached to it the legs were equine-varus and the anus was absent. Radiographs were consistent with a double spine defect (lumbar and sacral split notochord), and the patient was taken to the operating room for closure. A 2,600 g male baby was first seen in other hospital, and was admitted with a circular defect in the mid-line of the lumbosacral region. This defect was conformed by knee, leg, ankle and fingers. Radiographs showed bony structures consistent with incomplete lower extremity. During surgery, the skin overlying the mass was excised, showing a wide spine defect including stomach, duodenum, jejunum, ileum and colon, covered by a peritoneal membrane; there was not communication between this structure and the normal digestive tract.
