ABSTRACT
Objetivo Describir el coeficiente de difusión aparente (CDA) medido mediante resonancia magnética potenciada en difusión (RMD) en una serie de pacientes con traumatismo craneoencefálico (TCE) grave, sus aspectos clínicos y pronósticos y sus posibles implicaciones Diseño Estudio observacional, descriptivo de serie de casos Pacientes e intervenciones Pacientes con TCE grave, ingresados en UCI que no presentan contraindicaciones para traslado y realización de resonancia magnética (RM). Se realizó RM usando un scanner de 1.5 Tesla. Las imágenes potenciadas en difusión se obtuvieron usando una secuencia de pulso eco-planar con las siguientes características: TR 10.000 ms, TE 126,9 ms, valores b 1.000 s/mm2 en las tres direcciones del espacio. Combinando los tres sets de imágenes se obtuvo una imagen isotrópica que constituyó el mapa de los CDA medios. Resultados RMD se realizó en 23 pacientes con TCE grave ingresados en UCI entre 2001 y 2004. Se seleccionaron para su análisis 26 regiones de interés y se recogió el CDA en cada una de ellas. Se observó un incremento en la difusión en las lesiones ocupantes de espacio no evacuadas respecto a otros tipos de lesión y a valores normales. El pronóstico, según la escala de resultados de Glasgow, fue peor en los pacientes con valores de CDA más bajos. Conclusiones Los CDA medios fueron mayores que los valores normales y mayores en las contusiones que en otros tipos de lesión, como expresión de edema extracelular. Los CDA estaban disminuidos en pacientes con mal pronóstico sugiriendo una asociación entre isquemia y pronóstico(AU)
Objective To describe the apparent diffusion coefficient (ADC) in a series of severe traumatic brain injuries, their clinical and outcome features, and possible implications. Design A descriptive, observational case-series study was carried out. Patients and interventions Patients with severe traumatic brain injuries (TBIs) admitted to the ICU were subjected to MRI study using a 1.5 T scanner. Diffusion-weighted images (DWMR) were obtained using the following echo-planar pulse sequence: TR 10000 ms, TE 126.9 ms, with b values 1000 s/mm2 in the three spatial dimensions. Combining the three sets of images, an isotropic image conforming a map of the mean ADCs was obtained. Results DWMR was performed in 23 patients with severe TBI admitted to the ICU between 2001 and 2004. In the MR images we selected 26 regions of interest (ROIs) where ADC was recorded. We observed a clear increase in diffusion in non-treated space-occupying lesions versus other types of injuries and the normal values. A poorer outcome was recorded in patients with lower ADC values. Conclusions Mean ADC in the lesions was greater than the normal values and greater in contusions than in other types of injuries, as an expression of extracellular edema. ADCs were decreased in patients with a poor outcome, suggesting an association between ischemia and the patient prognosis (AU)
Subject(s)
Humans , Diffusion Magnetic Resonance Imaging , Craniocerebral Trauma/diagnosis , Magnetic Resonance Spectroscopy , Brain Edema/diagnosis , Tomography, X-Ray Computed , Sensitivity and Specificity , Echo-Planar ImagingABSTRACT
OBJECTIVE: To describe the apparent diffusion coefficient (ADC) in a series of severe traumatic brain injuries, their clinical and outcome features, and possible implications. DESIGN: A descriptive, observational case-series study was carried out. PATIENTS AND INTERVENTIONS: Patients with severe traumatic brain injuries (TBIs) admitted to the ICU were subjected to MRI study using a 1.5 T scanner. Diffusion-weighted images (DWMR) were obtained using the following echo-planar pulse sequence: TR 10000 ms, TE 126.9 ms, with b values 1000 s/mm2 in the three spatial dimensions. Combining the three sets of images, an isotropic image conforming a map of the mean ADCs was obtained. RESULTS: DWMR was performed in 23 patients with severe TBI admitted to the ICU between 2001 and 2004. In the MR images we selected 26 regions of interest (ROIs) where ADC was recorded. We observed a clear increase in diffusion in non-treated space-occupying lesions versus other types of injuries and the normal values. A poorer outcome was recorded in patients with lower ADC values. CONCLUSIONS: Mean ADC in the lesions was greater than the normal values and greater in contusions than in other types of injuries, as an expression of extracellular edema. ADCs were decreased in patients with a poor outcome, suggesting an association between ischemia and the patient prognosis.
Subject(s)
Brain Injuries/diagnosis , Diffusion Magnetic Resonance Imaging , Adult , Female , Humans , Injury Severity Score , Male , NeuroimagingSubject(s)
Bone Diseases/diagnostic imaging , Eosinophilic Granuloma/diagnostic imaging , Fibula , Child, Preschool , Humans , Male , RadiographyABSTRACT
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Subject(s)
Humans , Female , Adolescent , Encephalomyelitis, Acute Disseminated/chemically induced , Papillomavirus Vaccines/adverse effects , Vaccination/adverse effectsABSTRACT
We present an educational health experience in Sexuality and Family Planning, carried out jointly by health care professionals in a Health Care Center and by teachers at a Job Training School within its area, with three groups of students, mostly adolescents. Four sessions were conducted: Sexual education: sexuality and health. Sexual relations. Family relations. Family planning. Evaluation of the previous sessions. In each session, there was a presentation made by the teacher/expert, after which working groups of 4-5 students were formed. Finally, everyone came together again to discuss their work. In each session, several group techniques were used to motivate a higher degree participation, lower inhibition, and deepen mutual contacts. Results have been positive, both for students and teachers, with an increase in knowledge, a variation in attitudes towards the subject, and because it was something different from everyday studies.
