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1.
Praxis (Bern 1994) ; 111(16): 927-938, 2022 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-36475363

RESUMO

Physiotherapeutic Scar Therapy for Large Scars Abstract. Deep dermal defects can result from burns, necrotizing fasciitis, and severe soft tissue trauma. Physiological scar restriction during wound healing becomes increasingly relevant in proportion to the area affected. It is massively restrictive for the general mobility of patients. External mechanical influences (activity or immobilization in everyday life) can cause pronounced scar strands and adhesions to form. Overloading ends in a renewed inflammatory reaction and thus in further restriction. Adequate mechanical stimuli can positively influence the scar tissue. The current state of research does not allow a direct transfer to the clinical treatment of large-area scars. However, the continuous clinical implementation of study results regarding the mechanosensitivity of isolated fibroblasts and the constant adaptation of manual techniques have resulted in an evidence-based foundation for manual scar therapy. Early manual treatment in combination with appropriate compression therapy is important.

2.
BMJ Case Rep ; 12(9)2019 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-31519721

RESUMO

Antisynthetase syndrome is a rare autoimmune disease and represents a distinct entity within the idiopathic inflammatory myopathies. Its variable systemic manifestations are composed of myositis, interstitial lung disease, non-erosive arthritis, fever, Raynaud's phenomenon, hyperkeratotic skin changes and the presence of antibodies against aminoacyl-transfer-RNA-synthetases. Interstitial lung disease is the major determinant of morbidity and mortality. The role of lung biopsy remains controversial but it might be considered on an individual basis and may provide information regarding prognosis and treatment response. An integrated clinical, radiological and pathological approach to interstitial lung disease has to be emphasised. Due to the rarity of the disease, no standardised treatment guidelines for antisynthetase syndrome exist. We discuss a patient with anti-Jo1-autoantibody antisynthetase syndrome with proximal myositis and severe, rapid onset, interstitial lung disease with a histopathological pattern of organising pneumonia on surgical lung biopsy and good response to early combined immunosuppressive treatment with corticosteroids, mycophenolate mofetil and rituximab.


Assuntos
Terapia Combinada/métodos , Doenças Pulmonares Intersticiais/tratamento farmacológico , Ácido Micofenólico/uso terapêutico , Miosite/tratamento farmacológico , Pneumonia/patologia , Administração Intravenosa , Corticosteroides/administração & dosagem , Corticosteroides/uso terapêutico , Aminoacil-tRNA Sintetases/imunologia , Autoanticorpos , Inibidores Enzimáticos/uso terapêutico , Feminino , Humanos , Fatores Imunológicos/uso terapêutico , Imunossupressores/uso terapêutico , Pulmão/patologia , Doenças Pulmonares Intersticiais/diagnóstico por imagem , Doenças Pulmonares Intersticiais/imunologia , Doenças Pulmonares Intersticiais/patologia , Pessoa de Meia-Idade , Miosite/imunologia , Miosite/patologia , Pneumonia/etiologia , Rituximab/uso terapêutico , Índice de Gravidade de Doença , Resultado do Tratamento
4.
Eur J Nucl Med Mol Imaging ; 34(1): 11-9, 2007 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-16896667

RESUMO

PURPOSE: To evaluate the use of CT attenuation maps, generated from coronary calcium scoring (CCS) scans at in- and expiration with a 64-slice CT scanner, for attenuation correction (AC) of myocardial perfusion SPECT images. METHODS: Thirty-two consecutive patients underwent( 99m)Tc-tetrofosmin gated adenosine stress/rest SPECT scan on an Infinia Hawkeye SPECT-CT device (GE Medical Systems) followed by CCS and CT angiography on a 64-slice CT. AC of the iteratively reconstructed images was performed with AC maps obtained: (a) from the "Hawkeye" low-resolution X-ray CT facility attached to the Infinia camera (IRAC); (b) from the CCS scan acquired on a 64-slice CT scanner during maximal inspiration (AC(INSP)) and (c) during normal expiration (AC(EXP)). Automatically determined uptake values of stress scans (QPS, Cedars Medical Sinai) from AC(INSP) and AC(EXP) were compared with IRAC. Agatston score (AS) values using AC(INSP)versus AC(EXP) were also compared. RESULTS: AC(INSP) and AC(EXP) resulted in identical findings versus IRAC by visual analysis. A good correlation for uptake values between IRAC and AC(INSP) was found (apex, r=0.92; anterior, r=0.85; septal, r=0.91; lateral, r=0.86; inferior, r=0.90; all p<0.0001). The correlation was even closer between IRAC and AC(EXP) (apex, r=0.97; anterior, r=0.91; septal, r=0.94; lateral, r=0.92; inferior, r=0.97; all p<0.0001). The mean AS during inspiration (319+/-737) and expiration(317+/-778) was comparable (p=NS). CONCLUSION: Attenuation maps from CCS allow accurate AC of SPECT MPI images. AC(EXP) proved superior to AC(INSP), suggesting that in hybrid scans CCS may be performed during normal expiration to allow its additional use for AC of SPECT MPI.


Assuntos
Artefatos , Calcinose/diagnóstico , Doença da Artéria Coronariana/diagnóstico , Aumento da Imagem/métodos , Interpretação de Imagem Assistida por Computador/métodos , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Tomografia Computadorizada Espiral/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Tomografia Computadorizada Espiral/instrumentação
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