ABSTRACT
In this work we assessed the association between the whole skeletal mean standardized uptake value (SUV) measured on 18F-NaF PET/CT studies and the overall survival (OS) of bone metastatic breast cancer patients. Methods: We retrospectively analyzed 176 patients with breast cancer and bone metastatic disease who performed 18F-NaF PET/CT studies. The outcomes of the patients (dead or alive) were established based on the last information available on their files. The mean and maximum SUVs were measured in a whole skeletal volume of interest (wsVOI). The wsVOI was defined based on the CT component of the PET/CT study using Hounsfield Units thresholds. The wsVOI was then applied on the 18F-NaF PET image. Univariate analyses were performed to assess the association of the SUVs with OS. We also analyzed the association of the age of the patients, the presence of visceral metastatic disease, histological subtypes, presence of hormone receptors, human epidermal growth factor receptor 2 expression and the creatinine, CA15-3 and alkaline phosphatase (ALP) levels with OS. The variables statistically significant in the univariate analyses were included in a multivariate cox regression survival analysis. Results: In the univariate analyses there were associations of the mean and maximum whole skeletal SUVs, estrogen receptor status and the CA15-3 and ALP levels with OS. In the multivariate analysis, all the variables that were statistically significant in the univariate analysis but the CA15-3 were associated with OS. Conclusion: In patients with bone metastatic breast cancer, the whole skeletal mean SUV is an independent predictor of overall survival.
ABSTRACT
Slow-growing intraventricular masses are sometimes imaging findings in asymptomatic patients. The neuroimaging characteristics frequently help making the correct diagnosis and the treatment decision. Subependymomas usually present as single lesions poorly vascularized, without invasion into adjacent brain parenchyma or cerebrospinal fluid dissemination. Ependymoma is considered the main differential diagnosis. We report two cases of this tumour who share the unusual location: The temporal horns. The lack of enhancement (or heterogeneous when present) and advanced neuroimaging techniques can be very useful in differentiating them from other lesions.
ABSTRACT
OBJECTIVE: To evaluate the prevalence of exclusive lower extremity metastases, specifically in the femur and below the knee, observed at (18)F-NaF PET/CT. MATERIALS AND METHODS: One thousand consecutive PET/CT studies were retrospectively evaluated for the presence of exclusive uptake in lower extremities suggesting metastatic involvement. The presumptive diagnoses based on such uptakes were subsequently obtained by evaluation of other imaging studies. RESULTS: No exclusive uptake suggestive of metastasis below the femur was observed in the present series. Exclusive uptake was observed in the proximal femur with a presumptive diagnosis of metastasis in two patients. CONCLUSION: The prevalence of exclusive metastasis below the femur is low and scanning from head to knees is appropriate in most cases.
OBJETIVO: Avaliar a prevalência de metástases exclusivas em membros inferiores, subdivididas em lesões femorais e abaixo dos joelhos, em exames de PET/TC com 18F-NaF. MATERIAIS E MÉTODOS: Mil exames consecutivos foram retrospectivamente avaliados para a presença de captações exclusivas em membros inferiores sugestivas de comprometimento metastático. Os diagnósticos presuntivos dessas captações foram posteriormente obtidos pela avaliação de outros exames realizados. RESULTADOS: Não foram observadas captações exclusivas sugestivas de metástases abaixo dos fêmures na nossa casuística. Foi observada captação exclusiva no terço superior do fêmur com diagnóstico de metástase em dois pacientes. CONCLUSÃO: A prevalência de metástase exclusiva abaixo dos fêmures é baixa e a realização do exame da cabeça até os joelhos é adequada na maioria dos casos.
ABSTRACT
Abstract Objective: To evaluate the prevalence of exclusive lower extremity metastases, specifically in the femur and below the knee, observed at 18F-NaF PET/CT. Materials and Methods: One thousand consecutive PET/CT studies were retrospectively evaluated for the presence of exclusive uptake in lower extremities suggesting metastatic involvement. The presumptive diagnoses based on such uptakes were subsequently obtained by evaluation of other imaging studies. Results: No exclusive uptake suggestive of metastasis below the femur was observed in the present series. Exclusive uptake was observed in the proximal femur with a presumptive diagnosis of metastasis in two patients. Conclusion: The prevalence of exclusive metastasis below the femur is low and scanning from head to knees is appropriate in most cases. .
Resumo Objetivo: Avaliar a prevalência de metástases exclusivas em membros inferiores, subdivididas em lesões femorais e abaixo dos joelhos, em exames de PET/TC com 18F-NaF. Materiais e Métodos: Mil exames consecutivos foram retrospectivamente avaliados para a presença de captações exclusivas em membros inferiores sugestivas de comprometimento metastático. Os diagnósticos presuntivos dessas captações foram posteriormente obtidos pela avaliação de outros exames realizados. Resultados: Não foram observadas captações exclusivas sugestivas de metástases abaixo dos fêmures na nossa casuística. Foi observada captação exclusiva no terço superior do fêmur com diagnóstico de metástase em dois pacientes. Conclusão: A prevalência de metástase exclusiva abaixo dos fêmures é baixa e a realização do exame da cabeça até os joelhos é adequada na maioria dos casos. .
ABSTRACT
The emergence of resistance-associated mutations to the antiretroviral agents and the genetic variability of HIV-1 impose challenges to therapeutic success. We report the results of genotype testing assays performed between 2002 and 2006 in 240 antiretroviral-experienced patients followed up in an HIV reference center in Brazil. Drug resistance mutations and viral subtypes were assessed through the algorithms from the Brazilian Genotyping Network (RENAGENO-Brazil) and from Stanford University. Mutation 184VI was the most prevalent (70%) and the thymidine analogue mutations that appeared most frequently were 215FY, 41L, 67N, and 210W, in this order. Among nonnucleoside reverse transcriptase inhibitor mutations, 103NS (32.5%) stood out. HIV subtype B was identified in 184 patients (76.7%). A significant increasing trend in the prevalence of non-B subtypes was observed during the study period (p=0.004). The main differences in prevalence of mutations among HIV-1 subtypes were related to viral protease, with 20MRI, 36I, and 89IMT more prevalent among non-B subtypes, and 84V, 10FR, 63P, 71LTV, and 77I more common in subtype B (p<0.05). Most mutations to etravirine had a prevalence lower than 10%, but at least one mutation to this drug was observed in 45% of the patients. In only 11 patients (4.6%) three mutations to etravirine were verified. Regional surveillance of the resistance profile and HIV-1 subtypes is crucial in the context of public health, to prevent the transmission of resistant strains and to guide the introduction of new drugs in a specific population.
Subject(s)
Anti-HIV Agents/therapeutic use , Drug Resistance, Viral , HIV Infections/epidemiology , HIV Infections/virology , HIV-1/genetics , Mutation, Missense , Adult , Aged , Brazil/epidemiology , Female , Genotype , HIV Infections/drug therapy , HIV-1/classification , HIV-1/isolation & purification , Humans , Male , Middle Aged , PrevalenceABSTRACT
A parada cardíaca durante a gravidez apresenta altos índices de mortalidade maternae fetal que variam conforme a etiologia. Felizmente, sua ocorrência é pouco comum,sendo o número de casos estimados de um para 30.000 gestações. Segundo estudosepidemiológicos em mortalidade materna, as maiores causas de morte devido a paradacardiorrespiratória (PCR) são: tromboembolismo venoso, síndromes hipertensivasda gravidez, sepse, embolismo pelo fluido amniótico, hemorragia, trauma, causasiatrogênicas e doenças cardíacas congênitas ou adquiridas. Independentemente dacausa, uma intervenção deve ser adotada precocemente para otimizar as chances desobrevivência da mãe e/ou do feto. Dentre essas intervenções, destacam-se o suportebásico e avançado de vida, a cesariana perimortem e a cesariana postmortem, queserão abordadas neste artigo.
Cardiac arrest during pregnancy has high rates of maternal and fetal mortality, whichvary according to the etiology. Fortunately, its occurrence is uncommon, and the estimatednumber of cases is 1 for each 30,000 pregnancies5. According to epidemiologicalstudies on maternal mortality, the major causes of death due to cardiopulmonary arrestare: venous thromboembolism, hypertensive disorders of pregnancy, sepsis, pulmonaryembolism by amniotic fluid, hemorrhage, trauma, iatrogenic causes and congenital or acquiredheart conditions. Whatever the cause is, intervention must be done early, in orderto maximize the chances of survival of the mother and/or fetus. Among these interventions,the basic and advanced life support, and the perimortem and postmortem cesareansection modalities will be discussed in this review.
Subject(s)
Humans , Female , Pregnancy , Pregnancy Complications, Cardiovascular , Cardiopulmonary Resuscitation , Cesarean Section , Advanced Cardiac Life SupportABSTRACT
O hímen imperfurado (HI) é a causa congênita mais comum de obstrução do fluxo genital no sexo feminino. Embora seja detectável em todas as faixas etárias pela inspeção da genitália externa, o HI é um diagnóstico que muitas vezes passa despercebido. Relatamos o caso de uma adolescente virgem, com desenvolvimento normal de caracteres sexuais secundários, ausência de menarca, que apresentou um quadro clínico de abdome agudo secundário à hematocolpo por hímen imperfurado.
Imperforate hymen is the most common congenital cause of genital flow obstruction in females. Although it is noticeable in all ages by the inspection of external genitalia, imperforate hymen is commonly misdiagnosed. We present a case in which a virgo intacta adolescent, with normal secondary sexual characters, without menarche, that evolved to acute abdomen and hematocolpus due to imperforate hymen.
