Particular imaging features and customized thermal ablation treatment for intramedullary osteoid osteoma in pediatric patients.

OBJECTIVE: To report on the particular imaging features and high success rate of cold mode radio-frequency thermal ablation (RFTA) as the treatment of choice for intramedullary osteoid osteoma. MATERIALS AND METHODS: The study population consisted of 51 patients (39 males, 12 females; mean age 7.2 years; 11 patients under 6 years of age, including 7 males and 4 females) who underwent RFTA for osteoid osteoma and were retrospectively observed. The affected sites were the tibia (n = 22, 43%), femur (n = 13, 25%), pelvis (n = 5, 10%), anklebone (n = 3, 6%), humerus (n = 2, 4%), sacrum (n = 2, 4%), heel, radium, patella ,and rib (n = 1, 2%), respectively. Three patients had tibial intramedullary osteoid osteoma (14% of the tibial lesions, 6% of all cases). Cold mode RFTA was performed for these three patients to obtain a large ablation area without positioning two probes. The noncooled mode was used to treat cortical and subperiosteal lesions. RESULTS: Following RFTA, all patients were pain-free and in good clinical condition. In the intramedullary osteoid osteoma group, no recurrences were observed during the 24-month follow-up period, but one patient, who was affected by cortical osteoid osteoma, required two RFTA treatments to heal completely. CONCLUSION: Children less than 6 years of age with recurrent nocturnal pain and limb swelling should be investigated for intramedullary osteoid osteoma. Once confirmed, CT-guided RFTA should be the first treatment for intramedullary osteoid osteomas because of the high success rate and reduced invasivity, especially with cold mode RFTA. The outcome is related to the disappearance of pain, and the efficacy may be checked shortly after treatment with MR imaging to evaluate the absence of lesion in the ablation area.

Toxicity of silver nanoparticles to Chlamydomonas reinhardtii.

Silver nanoparticles (AgNP) are likely to enter the aquatic environment because of their multiple uses. We have examined the short-term toxicity of AgNP and ionic silver (Ag+) to photosynthesis in Chlamydomonas reinhardtii using fluorometry. AgNP ranged in size from 10 to 200 nm with most particles around 25 nm. As determined by DGT (diffusive gradients in thin films), by ion-selective electrode, and by centrifugal ulrafiltration, about 1% of the AgNP was present as Ag+ ions. Based on total Ag concentration, toxicity was 18 times higher for AgNO3 than for AgNP (in terms of EC50). However, when compared as a function of the Ag+ concentration,toxicity of AgNP appeared to be much higher than that of AgNO3. The ionic Ag+ measured in the AgNP suspensions could not fully explain the observed toxicity. Cysteine, a strong Ag+ ligand, abolished the inhibitory effects on photosynthesis of both AgNP and Ag+. Together, the results indicate that the interaction of these particles with algae influences the toxicity of AgNP, which is mediated by Ag+. Particles contributed to the toxicity as a source of Ag+ which is formed in presence of algae.

Late enhancement detected by cardiac magnetic resonance imaging in acute myocarditis mimicking acute myocardial infarction: location patterns and lack of correlation with systolic function.

OBJECTIVE: Clinical recognition of acute myocarditis is difficult. Late enhancement (LE) detected by magnetic resonance imaging appears to be a valuable tool for evaluating and monitoring inflammatory myocardial diseases. However, patterns of myocardial enhancement and its correlation with systolic function are not yet well defined. The aim of this study was to assess the extent and location of LE during the acute phase of active myocarditis mimicking acute myocardial infarction and at follow-up, in order to correlate LE with systolic function and to monitor disease progression. METHODS: Magnetic resonance imaging was performed in 13 patients with clinical symptoms and signs of acute myocarditis. RESULTS: All patients showed LE, which was located in the lateral free wall in 11 (85%) patients, at the basal level in eight (61%), at the mid level in nine (69%), and at the distal level in 10 (77%). Moreover, six (46%) patients showed LE in the posterior and inferior wall (P = 0.099 versus lateral wall), four (31%) patients in the septum and inferior wall (P = 0.017 versus lateral wall) and three (23%) patients in the anterior wall (P = 0.006 versus lateral wall). Left ventricular ejection fraction was 0.50 +/- 10 and it was severely reduced only in one patient (0.20). Conversely, in the remaining patients, left ventricular ejection fraction was preserved (> or =0.45) (P < 0.001). Multifocal LE was detected in eight (61%) patients, whereas pericardial effusion was observed only in two (15%) patients (P = 0.002). Twelve patients showed ST-segment elevation and chest pain, as it occurs in acute myocardial infarction, whereas one patient showed non-ST-segment elevation with dyspnoea, as it occurs in non-ST-elevation myocardial infarction. The mean follow-up duration was 4 +/- 12 months, and follow-up was complete for all but one patient who died. LE extent decreased in 11 (92%) patients, whereas new areas of LE were detected in one (8%) patient (P < 0.001). CONCLUSIONS: Contrast enhancement is a frequent finding in the clinical setting of suspected myocarditis and is associated with active and/or persistent myocardial inflammation. Myocarditis detected by magnetic resonance imaging predominantly occurs in the lateral free wall and very rarely affects systolic function.

Gerenciamento de projetos de tecnologia da informação

Este livro aborda dois temas atuais: o gerenciamento de projetos e a realização de projetos de Tecnologia da Informação. Nesta nova edição, todos os capítulos foram revisados e ampliados, estudos de casos de sucesso de projetos de tecnologia da informação e de governança corporativa, como Petrobras, Siemens Brasil, Ford e Way Brasil TV foram incluídos.Além disso, você encontrará: Novos temas como: o que é tecnologia da informação, os papéis da TI para os setores da empresa, a TI e a economia digital, pressões comerciais e suporte da TI, planejamento de TI, método de priorização de projetos de TI, Governança de TI, ITIL, COBIT, Sarbanes-Oxley, Seis Sigma, gestão de riscos, normas internacionais para a gestão de serviços de tecnologia da informação e segurança da informação; Apresentação da Metodologia de Gerenciamento de Projetos UPMM, baseada no Enfoque Kerzner para Excelência em Gerenciamento de Projetos; Introdução ao gerenciamento de projetos: conceito de projeto e suas características, ciclo de vida, grupos de processos, os stakeholders, os tipos de estruturas organizacionais, influência das organizações, principais habilidades do gerente de projetos, influências socioeconômicas e ambientais e uma viagem no túnel do tempo desde Gênesis até meados do século XX para compreender a evolução das modernas técnicas de gerenciamento de projetos; Peculiariadades dos projetos de TI sob a ótica das nove áreas do conhecimento; Informações sobre novas associações profissionais e certificações de reconhecimento internacional para os gerentes de projetos: PMI, ABGP, AACE, ISACA, PRMIA, IEEE Computer Society, ASQ, SHRM e CompTIA. Questões para as certificações da ISACA, AACE e ASQ no CD que acompanha o livro; Apresentação de aplicativos para gerenciamento de projetos...