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1.
Leuk Res ; 76: 53-57, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30572266

RESUMO

INTRODUCTION: Transfusion-dependent anemia and iron overload are associatedwith reduced survival in myelodysplastic syndrome (MDS). This cross-sectional study aimed to evaluate the prevalence of hepatic and cardiac overload in patients with MDS as measured by T2* magnetic resonance imaging (MRI), and its correlation with survival. METHODS: MDS or chronic myelomonocytic leukemia patients had iron overload evaluated by T2* MRI. HIO was considered when hepatic iron concentration ≥ 2 g/mg. Cardiac iron overload was considered with a T2*-value < 20 ms. RESULTS: Among 71 patients analyzed, median hepatic iron concentration was 3.9 g/mg (range 0.9-16 g/mg), and 68%of patients had hepatic iron overload. Patients with hepatic iron overload had higher mean ferritin levels (1182 ng/mL versus 185 ng/mL, p < 0.0001), transferrin saturation (76% versus 34%, p < 0.0001) and lower survival rates. Median cardiac T2*value was 42 ms (range 19.7-70.1 ms), and only one patienthad a T2* value indicative of cardiac iron overload. CONCLUSIONS: Hepatic iron overload is found in two thirds of patients, even in cases without laboratory signs of iron overload. Hepatic iron overload by T2* MRI is associated with a decreased risk of survival in patients with MDS.


Assuntos
Sobrecarga de Ferro/diagnóstico , Sobrecarga de Ferro/etiologia , Fígado/diagnóstico por imagem , Fígado/patologia , Imageamento por Ressonância Magnética , Síndromes Mielodisplásicas/complicações , Miocárdio/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Transformação Celular Neoplásica , Estudos Transversais , Feminino , Humanos , Incidência , Sobrecarga de Ferro/epidemiologia , Sobrecarga de Ferro/metabolismo , Fígado/metabolismo , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Síndromes Mielodisplásicas/diagnóstico , Síndromes Mielodisplásicas/mortalidade , Miocárdio/metabolismo , Prevalência , Avaliação de Sintomas , Adulto Jovem
2.
Eur J Endocrinol ; 177(1): 93-102, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28432270

RESUMO

BACKGROUND: The presence of virilizing signs associated with high serum androgen levels in postmenopausal women is rare. Virilizing ovarian tumors (VOTs) and ovarian stromal hyperthecosis (OH) are the most common etiologies in virilized postmenopausal women. The differential diagnosis between these two conditions is often difficult. OBJECTIVE: To evaluate the contribution of clinical features, hormonal profiles and radiological studies to the differential diagnosis of VOT and OH. DESIGN: A retrospective study. SETTING: A tertiary center. MAIN OUTCOME MEASURES: Clinical data, hormonal status (T, E2, LH and FSH), pelvic images (transvaginal sonography and MRI) and anatomopathology were reviewed. PATIENTS: Thirty-four postmenopausal women with a diagnosis of VOT (13 women) and OH (21 women) were evaluated retrospectively. RESULTS: Clinical signs of hyperandrogenism were more prevalent in the VOT group than the OH group. Although the VOT group showed higher T and E2 levels and lower gonadotropin levels than the OH group, a great overlap occurred among the hormone levels. A pelvic MRI provided an accurate differentiation of these two conditions. CONCLUSION: In this group of patients, the main features contributing to the differential diagnosis of VOT and OH were serum levels of testosterone and gonadotropins and the presence of an ovarian nodule identified on the MRI. Although the association of clinical, hormonal and radiological features contributes to the differential diagnosis of these two conditions, histopathological analysis remains the gold standard for the diagnosis of ovarian hyperandrogenism in postmenopausal women.


Assuntos
Estradiol/sangue , Hiperandrogenismo/etiologia , Neoplasias Ovarianas/diagnóstico por imagem , Ovário/diagnóstico por imagem , Lesões Pré-Cancerosas/diagnóstico por imagem , Testosterona/sangue , Regulação para Cima , Idoso , Estudos de Coortes , Diagnóstico Diferencial , Regulação para Baixo , Feminino , Hormônio Foliculoestimulante Humano/sangue , Seguimentos , Humanos , Hiperandrogenismo/epidemiologia , Hiperplasia/sangue , Hiperplasia/diagnóstico por imagem , Hiperplasia/patologia , Hiperplasia/fisiopatologia , Hormônio Luteinizante/sangue , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Tamanho do Órgão , Neoplasias Ovarianas/sangue , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/fisiopatologia , Ovário/patologia , Pós-Menopausa , Lesões Pré-Cancerosas/sangue , Lesões Pré-Cancerosas/patologia , Lesões Pré-Cancerosas/fisiopatologia , Prevalência , Estudos Retrospectivos , Tumor da Célula Tecal/sangue , Tumor da Célula Tecal/diagnóstico por imagem , Tumor da Célula Tecal/patologia , Tumor da Célula Tecal/fisiopatologia , Carga Tumoral , Ultrassonografia
3.
Abdom Imaging ; 36(2): 126-9, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20473666

RESUMO

Referrals for bariatric surgery have currently increased due to the need for more effective interventions in the management of severely obese patients. The Roux-en-Y gastric bypass is currently one of the preferred procedures, and internal hernias are the main causes of late postoperative complication. Petersen's hernia is a less common finding in most published papers compared to transmesocolic hernia, however, it seems to be increasing in incidence (in our service, eight cases which have been tomographic diagnosed in 2 years, were confirmed by laparoscopic surgery). The clinical findings are not specific, usually with abdominal pain, associated or not with abdominal distention and vomiting. In this context, imaging exams have an important role in the early diagnosis and surgery of this condition, with multislice computed tomography being the most accurate method. The aim of this pictorial essay is to the demonstrate the main CT findings associated with Petersen's hernia in patients who underwent Roux-en-Y gastric bypass.


Assuntos
Derivação Gástrica/métodos , Hérnia/diagnóstico por imagem , Hérnia/etiologia , Obesidade Mórbida/cirurgia , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/etiologia , Tomografia Computadorizada por Raios X , Humanos , Cavidade Peritoneal , Radiografia Abdominal
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