The evolution of loan volume and non-performing loans under COVID-19 innovations: The Colombian case.

Financial institutions' scale of total and non-performing loans are important figures signaling economic activity and its risk level. COVID-19 created an external shock with overarching effects on the global economy, impacting the credit activity and debtors' ability to repay their obligations. We study how Colombia's loans and non-performing loans market ratios could react to an external shock (absent of any relief measures) by developing a vector autoregressive model with exogenous variables (VARX) with the Central Bank intervention rate as an exogenous variable. We use impulse response functions to simulate the impact of the COVID-19 pandemic on the market of loans and default levels in Colombia. Our results show that the effects remain significant over long periods.

Comparative complete scheme and booster effectiveness of COVID-19 vaccines in preventing SARS-CoV-2 infections with SARS-CoV-2 Omicron (BA.1) and Delta (B.1.617.2) variants: A case-case study based on electronic health records.

Background: Information on vaccine effectiveness in a context of novel variants of concern (VOC) emergence is of key importance to inform public health policies. This study aimed to estimate a measure of comparative vaccine effectiveness between Omicron (BA.1) and Delta (B.1.617.2 and sub-lineages) VOC according to vaccination exposure (primary or booster). Methods: We developed a case-case study using data on RT-PCR SARS-CoV-2-positive cases notified in Portugal during Weeks 49-51, 2021. To obtain measure of comparative vaccine effectiveness, we compared the odds of vaccination in Omicron cases versus Delta using logistic regression adjusted for age group, sex, region, week of diagnosis, and laboratory of origin. Results: Higher odds of vaccination were observed in cases infected by Omicron VOC compared with Delta VOC cases for both complete primary vaccination (odds ratio [OR] = 2.1; 95% confidence interval [CI]: 1.8 to 2.4) and booster dose (OR = 5.2; 95% CI: 3.1 to 8.8), equivalent to reduction of vaccine effectiveness from 44.7% and 92.8%, observed against infection with Delta, to -6.0% (95% CI: 29.2% to 12.7%) and 62.7% (95% CI: 35.7% to 77.9%), observed against infection with Omicron, for complete primary vaccination and booster dose, respectively. Conclusion: Consistent reduction in vaccine-induced protection against infection with Omicron was observed. Complete primary vaccination may not be protective against SARS-CoV-2 infection in regions where Omicron variant is dominant.

Embolización de colaterales portosistémicas espontáneas como tratamiento de la encefalopatía hepática refractaria / Embolization of spontaneous portosystemic shunts as treatment for refractory hepatic encephalopathy

BACKGROUND: Hepatic encephalopathy (HE) is a common complication of cirrhosis associated with a reduced survival. The presence of high-flux spontaneous porto-systemic shunts can induce HE even in patients with preserved liver function. AIM: To evaluate the effect of spontaneous porto-systemic shunt embolization (SPSE) over HE and its long-term evolution. MATERIAL AND METHODS: Retrospective analysis of 11 patients (91% males) with severe HE non-responsive to medical treatment in whom a SPSE was performed. The grade of HE (employing West Haven score), survival, MELD and Child-Pugh score, ammonia levels, degree of disability (employing the modified Rankin scale (mRs)) were evaluated before and at thirty days after procedure. RESULTS: The most common etiology found was non-alcoholic steatohepatitis (63.6%). A reduction of at least two score points of HE was observed in all patients after thirty days. There was a significant reduction on median (IQR) West Haven score from 3 (2-3) at baseline to 1 (0-1) after the procedure (p < 0.01). Twelve months survival was 63.6%. There was a decrease in median ammonia level from 106.5 (79-165) (ug/dL) to 56 (43-61) after SPSE (p = 0.006). The median mRS score before and after the procedure was 3 (3-5) and 1 (1-2.5), respectively (p < 0.01). Conclusions: According to our experience, SPSE is a feasible and effective alternative to improve HE and functionality of patients with refractory EH.

[Embolization of spontaneous portosystemic shunts as treatment for refractory hepatic encephalopathy]. / Embolización de colaterales portosistémicas espontáneas como tratamiento de la encefalopatía hepática refractaria.

BACKGROUND: Hepatic encephalopathy (HE) is a common complication of cirrhosis associated with a reduced survival. The presence of high-flux spontaneous porto-systemic shunts can induce HE even in patients with preserved liver function. AIM: To evaluate the effect of spontaneous porto-systemic shunt embolization (SPSE) over HE and its long-term evolution. MATERIAL AND METHODS: Retrospective analysis of 11 patients (91% males) with severe HE non-responsive to medical treatment in whom a SPSE was performed. The grade of HE (employing West Haven score), survival, MELD and Child-Pugh score, ammonia levels, degree of disability (employing the modified Rankin scale (mRs)) were evaluated before and at thirty days after procedure. RESULTS: The most common etiology found was non-alcoholic steatohepatitis (63.6%). A reduction of at least two score points of HE was observed in all patients after thirty days. There was a significant reduction on median (IQR) West Haven score from 3 (2-3) at baseline to 1 (0-1) after the procedure (p < 0.01). Twelve months survival was 63.6%. There was a decrease in median ammonia level from 106.5 (79-165) (ug/dL) to 56 (43-61) after SPSE (p = 0.006). The median mRS score before and after the procedure was 3 (3-5) and 1 (1-2.5), respectively (p < 0.01). CONCLUSIONS: According to our experience, SPSE is a feasible and effective alternative to improve HE and functionality of patients with refractory EH.

Foraging Behaviour in Magellanic Woodpeckers Is Consistent with a Multi-Scale Assessment of Tree Quality.

Theoretical models predict that animals should make foraging decisions after assessing the quality of available habitat, but most models fail to consider the spatio-temporal scales at which animals perceive habitat availability. We tested three foraging strategies that explain how Magellanic woodpeckers (Campephilus magellanicus) assess the relative quality of trees: 1) Woodpeckers with local knowledge select trees based on the available trees in the immediate vicinity. 2) Woodpeckers lacking local knowledge select trees based on their availability at previously visited locations. 3) Woodpeckers using information from long-term memory select trees based on knowledge about trees available within the entire landscape. We observed foraging woodpeckers and used a Brownian Bridge Movement Model to identify trees available to woodpeckers along foraging routes. Woodpeckers selected trees with a later decay stage than available trees. Selection models indicated that preferences of Magellanic woodpeckers were based on clusters of trees near the most recently visited trees, thus suggesting that woodpeckers use visual cues from neighboring trees. In a second analysis, Cox's proportional hazards models showed that woodpeckers used information consolidated across broader spatial scales to adjust tree residence times. Specifically, woodpeckers spent more time at trees with larger diameters and in a more advanced stage of decay than trees available along their routes. These results suggest that Magellanic woodpeckers make foraging decisions based on the relative quality of trees that they perceive and memorize information at different spatio-temporal scales.

Seguimiento clínico de neonatos con Enterocolitis necrosante / Clinical folow-up in newborn infants with necrotizing enterocolitis

La enterocolitis necrosante (ECN) es la urgencia gastrointestinal más frecuente en lactantes pretérmino. En el Hospital Roosevelt la mortalidad secundaria a la misma fue del 40% en el año 2009. Según literatura internacional, de los pacientes que sobreviven, aproximadamente 25% presentarán secuelas de larga duración como retraso en el neurodesarrollo y desnutrición; sin embargo, en Guatemala no se tienen datos al respecto.

Hepatic encephalopathy in a liver transplant recipient with stable liver function.

Postshunt hepatic encephalopathy after liver transplantation (LT) is an infrequent condition and is commonly associated with portal occlusion or stenosis and the presence of a patent portosystemic shunt. Portal vein stenosis (PVS) or thrombosis (PVT) are uncommon complications after LT. The overall frequency of both complications is reported to be less than 3%. When PVS or PVT develop early after LT, the occlusion of the portal vein can have catastrophic consequences to the graft including acute liver failure and graft loss. Late PVT/PVS are asymptomatic in approximately 50% of the cases and mainly diagnosed by a routine ultrasound. Symptomatic postshunt hepatic encephalopathy (HE) is a very infrequent condition after LT that has been scarcely reported in the literature. We present here the case of a liver recipient with normal graft function who presented with hepatic encephalopathy 3 months after LT with stable liver function but a severe portal stenosis and the presence of a spontaneous portosystemic shunt whose successful endovascular treatment was followed by the complete resolution of the HE.

Embolization of incompetent pelvic veins for the treatment of recurrent varicose veins in lower limbs and pelvic congestion syndrome.

PURPOSE: We present our experience with embolization of incompetent pelvic veins (IPV) in women with recurrence of varicose veins (VV) in lower limbs, as well as symptoms of pelvic congestion syndrome (PCS), after first surgery. In addition, we evaluated the effects of embolization in decreasing the symptoms of VV before surgery as well as its effects on PCS symptoms. MATERIALS AND METHODS: We included 10 women who had consulted a vascular surgeon because of recurrent VV in lower limbs after surgery. All of these patients were included in the study because they also had symptoms of PCS, probably due to IPV. In patients who had confirmed IPV, we performed embolization before a second surgery. VV and PCS were assessed before and at 3 months after embolization (before the second surgery) using a venous clinical severity score (VCSS) and a visual analog pain scale (VAS), respectively. Patients were controlled between 3 and 6 months after embolization. Paired Student t test analysis was used for comparing data before and after embolization. RESULTS: Fifteen vein segments in 10 women were suitable for embolization. There was a significant (p < 0.001) decrease of VCSS after embolization, and recurrence of VV was not detected within a period of 6 months. There was also significant (p < 0.01) relief of chronic pelvic pain related to PCS evaluated using VAS at 3 months after embolization. CONCLUSION: Embolization decreases the risk of VV recurrence after surgery and also improves PCS symptoms in women with VV in lower limbs and IPV.

Natriuretic peptide type-B can be a marker of reperfusion in patients with pulmonary thromboembolism subjected to invasive treatment.

This study was intended to investigate changes in cardiac biomarkers and pulmonary hemodynamic effects of invasive treatment in patients with intermediate-risk (hemodynamic stability with evidence of right ventricle dysfunction and/or myocardial injury) pulmonary embolism. Also, to also evaluate if natriuretic peptide type-B (NT-proBNP) plasma levels are associated with right ventricle function and pulmonary arterial pressures. Interventional study: Fourteen normotensive adult patients with acute and radiologically massive pulmonary embolism plus positive biomarkers and evidences of right ventricle dysfunction underwent invasive pulmonary angiography for invasive treatment consisting on mechanical thrombus fragmentation and catheter-directed intrathrombus thrombolysis. Angiography was repeated after 12-24 h to reevaluate perfusion status. Plasma biomarkers were monitored before and 8-h after intervention. Biomarkers were initially elevated in all patients. Eleven patients (78.6%) exhibited significant angiographic reperfusion. NT-proBNP and mean pulmonary arterial pressure decreased significantly in all of them [3693 (1803, 8862) to 1951 (1309, 7918) pg/ml; P = 0.008) and 40.0 (24.0, 46.0) to 22.0 (14.0, 27.0) mmHg; P = 0.003, respectively]. No significant variation was observed in troponin-T levels. In patients with high-risk pulmonary embolism, NT-proBNP plasma levels experience rapid and significant reduction after successful invasive treatment. In pulmonary embolism, serial measurements of NT-proBNP could be useful as a tracking tool to assess the success or failure of the thrombolytic treatment.

Seudoaneurismas iatrogénicos de arteria femoral: factores de riesgo, prevención y opciones terapéuticas / Iatrogenic femoral artery pseudoaneurysms: factors

Los Seudoaneurimas (SA) iatrogénicos de la arteria femoral, se han vuelto más frecuentes debido al aumento en la complejidad de los procedimientos que requieren introductores cada vez de mayor diámetro, asociado a terapias anticoagulantes y/o antiagregantes de largo plazo. El tratamiento estándar de este tipo de lesiones fue por mucho tiempo la cirugía, sin embargo, han aparecido nuevas opciones menos invasivas, como el seguimiento activo, la compresión guiada bajo ultrasonido o la inyección de trombina bajo visión ecográfica Asimismo, se han estudiado cuales son los factores -ya sea asociados a los pacientes o a las técnicas de punción o hemostasia-, que aumentan las posibilidades de desarrollar SA. Esto ha permitido el desarrollo de dispositivos de tipo "sello arterial" como elementos preventivos. El presente trabajo tiene por objetivo revisar los factores de riesgo asociados al desarrollo de SA, las medidas de prevención -incluido el uso de "sellos arteriales en ciertos pacientes-, así como las opciones terapéuticas disponibles actualmente para el manejo de pacientes con este tipo de lesiones.

Determinaciones de niveles de creatina y lípidos mediante espectroscopia por resonancia magnética en miocardio de pacientes con insuficiencia cardiaca no isquémica / Myocardial lipids and creatine measured by magnetic resonance spectroscopy among patients with heart failure

Background: Heart failure (HF) is characterized, among other features, by the development of alterations in myocardial energy metabolism, involving a decrease in glucose utilization and increased free fatty acid uptake by cardiomyocytes, associated with decreased deposits of high-energy phosphates (creatine phosphate/ creatine transporter). Magnetic resonance (MR) imaging allows a direct and noninvasive assessment of myocardial metabolites. Aim: To measure myocardial creatine and lipids by MR spectroscopy among patients with HF. Material and Methods: Cardiac MR spectroscopy (1.5 Tesla) with Hydrogen antenna and single voxel acquisition was performed in fve patients with non-ischemic heart failure, aged 58 ± 9.7 years, (60 percent males) and 5 healthy volunteers matched for age and sex. We analyzed the signals of creatine (Cr), lipids (L) and water (W) in the interventricular septum, establishing the water/lipid (W/L) and water/creatine (W/Cr) index to normalize the values obtained. Results: Among patients, left ventricular ejection fraction was 32 ± 6.9 percent, 60 percent were in functional capacity II, 60 percent had hypertension and one was diabetic. Spectroscopic curves showed a depletion of total Cr, evidenced by the W/ Cr index, among patients with heart failure, when compared with healthy controls (1.46 ± 1.21 and 5.96 ± 2.25 respectively, p < 0,05). Differences in myocardial lipid content, measured as the W/L index, were not significant (5.06 ± 2.66 and 1.80 ± 1.62 respectively, p = 0.08). Conclusions: Among patients with heart failure of non-ischemic etiology, there is a depletion of creatine levels measured by MR spectroscopy.

Evaluación prospectiva de la venografía mediante angioTC en el diagnóstico de enfermedad tromboembólica / Diagnostic yield of CT pulmonary angiography and venography for thromboembolic disease

Background: CT pulmonary angiography is the diagnostic procedure of choice for non-massive pulmonary embolism. Aim: To assess the diagnostic yield for thromboembolic disease of CT pulmonary angiography and venography using a 64- slice multidetector tomography. Material and Methods: Prospective study of patients with a clinical suspicion of thromboembolic disease, subjected to CT pulmonary angiography and venography. The presence and location of pulmonary thromboembolism, of isolated or concomitant deep venous thrombosis and of other significant radiological findings, were registered. Results: A 64-MDCT scanner was performed to 893 patients and thromboembolic disease was demonstrated in 240. Pulmonary thromboembolism was diagnosed in 218 patients. It was concomitant with deep venous thrombosis in 79 patients (36 percent) and isolated in the rest. Thirty fve of the 218 patients with pulmonary thromboembolism had radiological evidence of right ventricular overload. Twenty two patients (10 percent) had an isolated deep venous thrombosis. In 65 patients with pulmonary thromboembolism (30 percent) a possibly new or old malignant lesion, was observed. Seventy one of 653 patients without evidence of thromboembolic disease had potentially pathological findings on CT. Conclusions: The combined use of CT pulmonary arteriography and venography using a 64 MDCT scanner increases the diagnostic yield of the procedure for thromboembolic disease. It also allows the diagnosis of other related conditions, specially malignant tumors.

New frequency translation technique for FM-CW reflectometry.

In broadband microwave reflectometry, coherent detection is widely used to obtain the phase information and to improve the systems sensitivity, both in diagnostics measuring the electronic density profile and plasma fluctuations. Coherent detection uses a translated version of the probing signal to guarantee a stable intermediate frequency. Here, a novel technique to generate the frequency translation by double frequency conversion is presented and its advantages over the commonly used single frequency conversion techniques employing image rejection mixers are discussed. The results obtained with the new frequency translator modules developed for the three JET FM-CW reflectometers, operating successfully at JET since mid-2009, are presented.

Resonancia magnética cardíaca con perfusión stress: utilidad clínica y relación con coronariografía convencional / Stress perfusion cardiac magnetic resonance imaging: clinical usefulness compared to conventional coronary angiography

Introducción: La resonancia magnética cardiaca (RMC) es una herramienta no invasiva, libre de radiación que permite una evaluación global del corazón. Una de las potencialidades son los estudios de perfusión miocárdica con stress. Objetivo: Presentar nuestra experiencia de RMC con stress (RMCS) su correlación con la coronariografía convencional (CC) y su relación con eventos clínicos. Método: En forma prospectiva se incluyeron en un registro todos los pacientes sometidos a RMCS en nuestro servicio entre Enero 2007 y Abril 2009. Todos los pacientes fueron sometidos a RMCS analizando anatomía, estructura, función global y segmentaria, perfusión stress/reposo y viabilidad miocárdica. Los exámenes fueron realizados en resonadores 1.5 T, en apnea de +/- 10 segundos, con gatilleo ECG retrospectivo y con uso de Gadolinio endovenoso para las fases de perfusión y viabilidad El estudio de stress se realizó con inyección de adenosina ev (140ug/kg/min) tras lo cual se adquirieron las imágenes y comparadas con la fase de reposo. El estudio de viabilidad se realizo a continuación de la fase de reposo. Se consideraron como RMCS positivas aquellas con áreas de hipoperfusión en stress que se recuperaron en reposo. En aquellos pacientes que fueron sometidos a CC dentro de los 3 meses de realizado la RMCS, se realizó correlación entre ambos métodos, considerando presencia y localización de la enfermedad coronaria. Se consideraron significativas las lesiones >70 por ciento de estenosis luminal. Resultados: Incluimos 71 pacientes que fueron estudiados durante el periodo indicado. Las indicaciones para los exámenes fueron: estudio viabilidad e insuficiencia cardiaca (64 por ciento); sospecha de cardiopatía coronaria (36 por ciento). Las características del grupo fueron: Hombres 72 por ciento, Edad 49 +/-7 años; Diabetes 17 por ciento, HTA 13 por ciento, AFCC 15 por ciento, TBQ 20 por ciento. La fracción de eyección promedio fue de 53+/-7 por ciento. El tiempo de examen...

Background: Cardiovascular magnetic resonance (CMR) is a non invasive and non ionizing imaging tool that allows a complete cardiovascular evaluation. One of its advantages is the ability to analyze myocardial perfusion with and without stress. Aim: To show our experience using stress perfusion CMR (SPCMR), its correlation with conventional coronary angiography (CCA) and cardiovascular events. Methods: We retrospectively included in the analysis all patients referred to our institution to undergo a SPCMR since January 2007 to April 2009. In all patients we performed a complete evaluation including anatomic, left ventricular function, adenosine stress perfusion and viability study. All the studies were performed in a 1.5 T scanner and 10 seconds breath-hold. Stress perfusion was performed alter iv adenosine bolus (140 ug/Kg/min). Eight minutes after the stress, the rest phase was performed. Viability analysis was done after the iv injection of gadolinium based contrast (0.15 mMol/ kg). A positive SPCMR was considered in those with mismatch areas between stress and rest phases. In those patients who underwent a CCA, we correlated the SP-CMR findings with the presence and location of stenoses equal or greater than 70 percent as significant. Results: We included 71 patients during the mentioned period. Indication for SPCMR were heart failure and viability study (64 percent); coronary ischemia (36 percent). Main baseline characteristics were: Male 7 percent; age 9 +/-7 years; diabetes 17 percent; hypertension 13 percent; previous family history for CAD 15 percent; and tobacco 20 percent. Mean left ventricular ejection fraction was 53+/-7 percent. Mean time to complete the exam was 50+/-5 minutes. There were not adverse reactions to contrast or adenosine. Thirty one patients (42 percent) underwent CCA. All patients with stenoses greater than 70 percent had a positive SPCMR. Agreement between CCA and SPCMR for ischemia location was 90 percent...

[Diagnostic yield of CT pulmonary angiography and venography for thromboembolic disease]. / Evaluación prospectiva de la venografía mediante angioTC en el diagnóstico de enfermedad tromboembólica.

BACKGROUND: CT pulmonary angiography is the diagnostic procedure of choice for non-massive pulmonary embolism. AIM: To assess the diagnostic yield for thromboembolic disease of CT pulmonary angiography and venography using a 64-slice multidetector tomography. MATERIAL AND METHODS: Prospective study of patients with a clinical suspicion of thromboembolic disease, subjected to CT pulmonary angiography and venography. The presence and location of pulmonary thromboembolism, of isolated or concomitant deep venous thrombosis and of other significant radiological findings, were registered. RESULTS: A 64-MDCT scanner was performed to 893 patients and thromboembolic disease was demonstrated in 240. Pulmonary thromboembolism was diagnosed in 218 patients. It was concomitant with deep venous thrombosis in 79 patients (36%) and isolated in the rest. Thirty five of the 218 patients with pulmonary thromboembolism had radiological evidence of right ventricular overload. Twenty two patients (10%) had an isolated deep venous thrombosis. In 65 patients with pulmonary thromboembolism (30%) a possibly new or old malignant lesion, was observed. Seventy one of 653 patients without evidence of thromboembolic disease had potentially pathological findings on CT. CONCLUSIONS: The combined use of CT pulmonary arteriography and venography using a 64 MDCT scanner increases the diagnostic yield of the procedure for thromboembolic disease. It also allows the diagnosis of other related conditions, specially malignant tumors.

[Myocardial lipids and creatine measured by magnetic resonance spectroscopy among patients with heart failure]. / Determinaciones de niveles de creatina y lípidos mediante espectroscopia por resonancia magnética en miocardio de pacientes con insuficiencia cardiaca no isquémica.

BACKGROUND: Heart failure (HF) is characterized, among other features, by the development of alterations in myocardial energy metabolism, involving a decrease in glucose utilization and increased free fatty acid uptake by cardiomyocytes, associated with decreased deposits of high-energy phosphates (creatine phosphate/creatine transporter). Magnetic resonance (MR) imaging allows a direct and noninvasive assessment of myocardial metabolites. AIM: To measure myocardial creatine and lipids by MR spectroscopy among patients with HF. MATERIAL AND METHODS: Cardiac MR spectroscopy (1.5 Tesla) with Hydrogen antenna and single voxel acquisition was performed in five patients with non-ischemic heart failure, aged 58 ± 9.7 years, (60% males) and 5 healthy volunteers matched for age and sex. We analyzed the signals of creatine (Cr), lipids (L) and water (W) in the interventricular septum, establishing the water/lipid (W/L) and water/creatine (W/Cr) index to normalize the values obtained. RESULTS: Among patients, left ventricular ejection fraction was 32 ± 6.9%, 60% were in functional capacity II, 60% had hypertension and one was diabetic. Spectroscopic curves showed a depletion of total Cr, evidenced by the W/ Cr index, among patients with heart failure, when compared with healthy controls (1.46 ± 1.21 and 5.96 ± 2.25 respectively, p < 0,05). Differences in myocardial lipid content, measured as the W/L index, were not significant (5.06 ± 2.66 and 1.80 ± 1.62 respectively, p = 0.08). CONCLUSIONS: Among patients with heart failure of non-ischemic etiology, there is a depletion of creatine levels measured by MR spectroscopy.

Enhancement of visual perception with use of dynamic cues.

UNLABELLED: Institutional review board approval and signed informed consent were not needed, as medical images included in public databases were used in this study. The purpose of this study was to improve the detection of microcalcifications on mammograms and lung nodules on chest radiographs by using the dynamic cues algorithm and the motion and flickering sensitivity of the human visual system (HVS). Different sets of mammograms from the Mammographic Image Analysis Society database and chest radiographs from the Japanese Society of Radiological Technology database were presented statically, as is standard, and in a video sequence generated with the dynamic cues algorithm. Nine observers were asked to rate the presence of abnormalities with a five-point scale (1, definitely not present; 5, definitely present). The data were analyzed with receiver operating characteristic (ROC) techniques and the Dorfman-Berbaum-Metz method. The video sequence generated with the dynamic cues algorithm increased the rate of detection of microcalcifications by 10.2% (P = .002) compared with that obtained with the standard static method, as measured by the area under the ROC curve. Similar results were obtained for lung nodules, with an increase of 12.3% (P = .0054). The increase in the rate of correct detection did not come just from the image contrast change produced by the algorithm but also from the fact that image frames generated with the dynamic cues algorithm were put together in a video sequence so that the motion sensitivity of the HVS could be used to facilitate the detection of low-contrast objects. SUPPLEMENTAL MATERIAL: http://radiology.rsnajnls.org/cgi/content/full/250/2/551/DC1.

Systematic and routine analysis of radial correlation reflectometry data in JET.

This paper discusses a tool specially developed for the analysis of radial correlation reflectometry data in JET. The tool, which calculates the correlation length and coherent reflection from the raw data, has been designed for offline analysis and to assist diagnostic operators. After being verified in controlled tests using theoretical signals, the tool is validated by means of a study of ITB plasmas in JET.

Utilidad de la tomografía axial computada multicorte de 64 detectores en síndromes coronarios agudos sin supradesnivel del segmento ST / Diagnostic usefulness of 64-slice computed tomography in patients with acute coronary syndromes

Introducción: La Tomografía Axial Computada de Multicorte (TACM) de 64 detectores tiene alta sensibilidady especificidad en la detección de lesiones coronarias obstructivas crónicas. La TACM también sería útil enla evaluación de las características de las placas en pacientes con síndromes coronarios agudos (SCA). Objetivo: Evaluar la utilidad de la TACM en la valoración de placas coronarias complicadas (lesión culpable) en pacientes con SCA sin Supradesnivel del Segmento ST (SDST). Métodos: Se realizó una TACM en 28 pacientes con SCA sin SDST previo a coronariografía estándar (CE).Dos casos se excluyen por imágenes no evaluables. La lesión culpable (LC) fue identificada en la CE por los hallazgos del ECG, alteración de la motilidad segmentaria a la ventriculografía y por la imagen angiográfica de la lesión, mientras que la TACM identificó la LC mediante el ECG y las características de la placa (composición y/o perfil de trombo). Se realizó análisis densitométrico en cortes coronarios transversales en las áreas consideradas de interés a fin de identificar placas blandas (< 50 unidades Hounsfield) y/o perfil de trombo intracoronario. Conjuntamente se realizo un ultrasonido intracoronario (IVUS) en 6 de los 26 casos evaluables por la TACM. El análisis de dichas técnicas fue efectuado por observadores expertos “ciegos” a la técnica alternativa. La correlación entre ambos métodos fue evaluada por coeficiente Kappa Resultados: El grupo quedó compuesto por 16 hombres (61.5%) y 10 mujeres (38.5%), edad promedio de 56.2 +/- 10.1 años, hipertensos 65.4% dislipidémicos 53.8%, tabáquicos 46.2% y diabéticos 19.2%. El dolor torácico tuvo una duración promedio de 56.7 +/- 52.8 min, elevación de troponina 1.1 +/- 2.8 ng/dL y puntaje TIMI 3.0 +/- 1.0. Se objetivó 44 lesiones coronarias significativas (estenosis > 50%) por análisis cuantitativo por CE de las cuales 39 fueron detectadas exitosamente...

Background: sixty four detector Multi-slice computed tomography (MSCT) is highly sensitive and specific to detectchronic obstructive coronary lesions. It has been suggested that MSCT could be useful to assess coronary plaque traits in patients with NST elevation acute coronary syndromes (ACS). Aim: to evaluate the usefulness of MSCT for the characterization of culprit lesions (complicated plaques) in patients with NST elevation ACS. Method: Prior to conventional coronary angiography, MSCT was performed in 28 patients with NST elevation ACS. 2 cases were excluded due to poor images. Culprit lesion was identified by coronary angiography based on ECG and wall motion abnormalities. Plaque characteristics, composition and presence of thrombi, and ECG were used to identified the culprit lesion in MSCT. Densitometric analysis of cross sectional views was used to identify soft plaques (<50 Hounsfield units). Intracoronary ultrasound (IVUS) was performed in 6 of 26 patients with adequate MSCT imaging. Findings of angiography and MSCT were analyzed separately by observers blinded to the alternative diagnostic modality. Correlation between both groups were valuated using kappa coefficient. Results: There were 16 males (61.5%), the mean age was 56.2 +/-10.1 years. Hypertension was present in 65.4%, dyslipidemia in 53.8%, 46.2% were smokers and 19.2% had Diabetes. Chest pain lasted 56.7 +/- 52.8 min, troponin was 1.1 +/-2.8 nG/dL and TIMI flow was 3.0 +/-1.0. Forty four significant coronary lesions (>50% stenosis) were identified by quantitative angiography; 39 of them were correctly identified by MSCT. A culprit lesion was detected in 17 patients (65.3%) and was not seen in 9 (34.6%); MSCT identified a culprit lesion in 16 cases (61.5%) while 8 cases did not show such lesion (30.8%); One case had a segment not amenableto evaluation (coronary angiography did not show...