Fetal heart segmentation in a virtual reality environment.

This study presents the initial results of a pilot project using the Elucis Virtual Reality (VR) platform for fetal heart segmentation. Twelve fetal heart cases, ranging in gestational age from 24 to 30 weeks, including various cardiac conditions, were reconstructed using 3D models facilitated by the Elucis platform's integration of automated algorithms and manual adjustments. The models, which were evaluated by four experts in virtual and 3D printed formats, were of high quality and offered improved visuospatial visualization and detailed anatomical insights. This research highlights the potential of VR technology to improve prenatal diagnosis and planning for complex cardiac conditions, suggesting significant implications for continuing medical education and clinical practice in fetal cardiology.

Is there a role for magnetic resonance imaging in cesarean scar pregnancy after the first trimester?

Magnetic resonance imaging (MRI) can provide additional information in cases of cesarean scar pregnancy beyond the first trimester. MRI and 3D reconstructions can demonstrate the relationships between the uterus, cervix, bladder, and placenta, improving the spatial perspective of the pelvic anatomy in cases requiring surgical management. MRI and 3D reconstructions can also provide more comprehensive images for parental counseling, virtual and face-to-face multidisciplinary team discussion, and medical record storage.

Prenatal diagnosis of closed gastroschisis: What to expect in the most severe form of gastroschisis? Case report and literature review.

Closed gastroschisis (CG) and vanishing gastroschisis (VG) are the most severe forms of evolution of the malformation. In this case, a fetus presented with gastroschisis at 13 weeks, and the gastroschisis was not visualized at 22 weeks of gestation. Distal ileum, cecum, and ascending colon atresia were diagnosed at surgery, and the child is fully enteral-fed at 5 months of age. In a literature review of 43 cases of prenatal diagnosis of CS-VG, intrauterine death occurred in 4.5% of cases. 79.6% of the cases underwent surgical treatment. Of these cases, 20% of cases died due to complications of treatment, 26% were still under treatment and 54% are alive with enteral feeding. In 77% of the cases, the closure of the umbilical ring occurred after 26 weeks of gestation and the absence of prenatal diagnosis of CG-VG during pregnancy has a risk of 71% of death.

Prenatal diagnosis of Pallister-Hall syndrome: ultrasound, magnetic resonance imaging, and three-dimensional reconstructions of phenotypical findings.

Pallister - Hall syndrome is a rare malformation that involves the presence of a suprasellar hamartoma and associated malformations. Prenatal diagnosis is also rare, and few cases have been reported using magnetic resonance imaging (MRI). A 35-year-old G5P2A2 woman at the 35th week of gestation was referred to our service. Fetal MRI showed an isointense image in the suprasellar region, pushing the brainstem up and backward, and compressing the vermis and cerebellum on T2-weighted images. On T1-weighted images, the hypointense signal of the tumor was similar to that of the brain parenchyma. Ultrasound images showed a suprasellar mass, which was more echogenic than the normal cerebral parenchyma, posteriorly pushing the brain stem, with involvement of the vermis of the tumor and compression of the posterior fossa. Three-dimensional reconstruction using MRI scan data showed a space view of the tumor and its relationships with the other brain tissues allowing better understanding by parents and multidisciplinary team.

Fetal giant liver hemangioma: Ultrasound, magnetic resonance imaging, three-dimensional reconstruction findings and perinatal outcomes of two cases.

In this case report, we present two cases of fetal liver giant hemangioma assessed using ultrasound, magnetic resonance imaging and three-dimensional reconstructions with their respective postnatal outcomes.

In vitro enamel surface roughness analysis of 4 methods for removal of remaining orthodontic adhesive after bracket debonding.

OBJECTIVES: To perform an in vitro qualitative and quantitative evaluation of the enamel surface (by scanning electronic microscopy [SEM] and measuring polishing time and roughness analysis, respectively) among four methods to remove remaining orthodontic adhesive after bracket debonding. MATERIALS AND METHODS: Forty-one human premolars were randomly divided into four groups (n = 10) according to the adhesive remnant removal method and one tooth was used as control: Group 1 (G1): Enhance (Dentsply, Milford, USA); Group 2 (G2): Fiberglass (TDV, Pomerode, Brazil); Group 3 (G3): DU10CA-Ortho (Dian Fong Industrial, Shenzhen, China); Group 4 (G4): Sof-Lex Pop-On (3M ESPE, Seefeld, Germany). Roughness was measured before bonding and after complete removal of the remaining adhesive (Ra2). SEM analysis was performed on one sample of each group after adhesive removal and polishing. The time required for adhesive remnant removal and polishing was measured in all groups. Analysis of variance and Tukey post hoc for pairwise comparison was applied to compare polishing times among groups and analysis of covariance was used to compare Ra2 means. RESULTS: Comparison between groups show that G4 presented the lowest Ra2 mean (0.43 µm)c followed by G3 (0.71 µm)ac, G1 (1.06 µm)ab, and G2 (1.21 µm)b - different letters, statistically different at P ≤ 0,05. In addition, Fiberglass was more time-consuming for adhesive remnant removal than other methods (P ≤ .05). SEM analysis showed that some enamel damage occurred for all methods. CONCLUSIONS: All methods were able to remove the remaining adhesive and polish the enamel. The DU10CA-Ortho and Sof-Lex methods promoted better polishing of the enamel surface and exhibited a similar time-consuming process.

Prenatal diagnosis of rhabdoid tumor: Ultrasound, magnetic resonance imaging, 3D reconstruction and review of the literature.

Extrarenal tumors are rare malignant tumors and generally are lethal when diagnosed during the pregnancy. Some reports described this condition, using ultrasound. In this report, we describe the prenatal characteristics of an extrarenal rhabdoid tumor, evaluated by ultrasound, magnetic resonance imaging (MRI), and three-dimensional (3D) reconstructions. This report describes the longest period between prenatal diagnosis and delivery of a fetus affected by extrarenal tumor, compares the imaging technologies used during and after the pregnancy and discuss the results of the prenatal study compared to the postnatal images, an important information for parental counseling.

Virtual segmentation of three-dimensional ultrasound images of morphological structures of an ex vivo ectopic pregnancy inside a fallopian tube.

Ex vivo ultrasound (US) of human tissues has been used for decades on the study of the acoustic physical aspects of the US, to the study of the morphology of the organs. Using three-dimensional (3D) US, we demonstrate the possibilities to study surgical specimens from gynecological conditions. 3D images of the surgical specimen were collected and virtually segmented according to the contrast of its images, providing a 3D image of the ectopic pregnancy and its effects on the fallopian tube.

Maternal-fetal physical model: image fusion obtained by white light scanner and magnetic resonance imaging.

BACKGROUND: Physical fetal models developed from three-dimensional (3D) ultrasound or magnetic resonance imaging (MRI) scan data may be used for medical education purposes, for parental counseling/multidisciplinary team management and to improve the maternal-fetal attachment (MFA) in blind pregnant women. PURPOSE: We proposed a new technique to create a maternal-fetal physical model by using MRI scan data to improve the MFA. METHODS: For the construction of the maternal-fetal physical model, two different processes were used. For the internal part of the maternal-fetal physical model, we used the segmentation and the 3D reconstruction made from the MRI scan data, and for the outside, we performed 3D scanning by using a white light scanner. After obtaining the 3D models, we used a registration tool to position them in alignment. CONCLUSION: Maternal-fetal physical models improve the MFA by using both tactile and visual sensations of the pregnant woman and her fetus.

Placenta accreta: Virtual reality from 3D images of magnetic resonance imaging.

Image from a fragment of the video of virtual reality model evaluating a case of placenta accreta spectrum and placental invasion. In this image, the placenta (purple) goes through the uterus and reaches the bladder muscle and mucosa (pink).

Fatores relacionados aos sintomas depressivos em pessoas idosas com diabetes mellitus / Factors related to depressive symptoms in older adults with diabetes mellitus / Factores relacionados con síntomas depresivos en ancianos con diabetes mellitus

RESUMO Objetivo: identificar os fatores relacionados aos sintomas depressivos em pessoas idosas com diabetes mellitus. Método: pesquisa transversal, com abordagem quantitativa e realizada com a participação de 144 pessoas idosas cadastradas em 72 Unidades Saúde da Família do município de João Pessoa, Paraíba, Brasil. Os dados foram coletados no período de setembro a dezembro de 2019, utilizando instrumento para a obtenção de dados referentes ao perfil sociodemográfico e clínico e a Escala de Depressão Geriátrica mediante estatística descritiva e inferencial. Resultados: observou-se que 75,7% dos idosos com diabetes não tinham sintomas depressivos. Foi evidenciada associação significativa entre a sintomatologia depressiva e as variáveis renda pessoal (p=0,044), tipo de renda (p=0,020), dislipidemia (p=0,038), complicações do diabetes (p=0,045) e a retinopatia (p=0,033). Conclusão: os fatores sociais, de saúde e relacionados ao diabetes podem influenciar negativamente a condição psíquica da pessoa idosa e favorecer o surgimento de sintomas depressivos.

ABSTRACT Objective: to identify the factors related to depressive symptoms in older adults with Diabetes Mellitus. Method: a cross-sectional study with a quantitative approach conducted with 144 older adults registered in 72 Family Health units from the municipality of João Pessoa, Paraíba, Brazil. The data were collected from September to December 2019, using an instrument to obtain information referring to the sociodemographic and clinical profile and the Geriatric Depression Scale by means of descriptive and inferential statistics. Results: it was observed that 75.7% of the diabetic older adults did not present depressive symptoms. There was a significant association between depressive symptoms and the following variables: personal income (p=0.044), type of income (p=0.020), dyslipidemia (p=0.038), diabetes complications (p=0.045) and retinopathy (p=0.033). Conclusion: the social and health factors, as well as those related to diabetes, can exert negative influences on older adults' psychological state and favor the onset of depressive symptoms.

RESUMEN Objetivo: identificar los factores relacionados con síntomas depresivos en ancianos con Diabetes Mellitus. Método: investigación transversal, de enfoque cuantitativo y realizada con la participación de 144 adultos mayores registrados en 72 unidades de Salud de la Familia del municipio de João Pessoa, Paraíba, Brasil. Los datos se recolectaron entre septiembre y diciembre de 2019, utilizando un instrumento para obtener datos sobre el perfil sociodemográfico y clínico y la Escala de Depresión Geriátrica mediante estadística descriptiva e inferencial. Resultados: se observó que el 75,7% de los ancianos que padecían diabetes no tenían síntomas depresivos. Se registró una asociación significativa entre los síntomas depresivos y las variables ingresos personales (p=0,044), tipo de ingresos (p=0,020), dislipidemia (p=0,038), complicaciones de la diabetes (p=0,045) y retinopatía (p=0,033). Conclusión: los factores sociales, de salud y relacionados con la diabetes pueden ejercer influencias negativas sobre el estado psicológico de los ancianos y favorece la aparición de síntomas depresivos.

Antenatal Diagnosis of Parapagus Conjoined Twins: 3D Virtual and 3D Physical Models.

Conjoined twins (CTs) are a rare complication from monochorionic and monoamniotic twin pregnancies. We describe the use of 3D technologies, including 3D virtual and 3D physical models on prenatal evaluation of one parapagus CT. A 16-year-old G1P0 woman was referred for fetal magnetic resonance imaging (MRI) anatomical evaluation of a CT at 28 weeks of gestation. 3D images of the fetal surface were generated by the software during the examination for spatial comprehension of the relationship between the fetal parts. The pair of CTs died at the 32nd week of gestation, a few hours after cesarean section. 3D technologies are an important tool for parental counseling and preparation of the multidisciplinary care team for delivery and neonatal assistance and possible surgical planning for postnatal separation in CTs cases.

Gêmeos unidos (GUs) são uma complicação rara de gestações gemelares monocoriônicas e monoamnióticas. Descrevemos o uso de tecnologias 3D, incluindo modelos 3D virtuais e físicos, na avaliação pré-natal de GU parapagus. Mulher de 16 anos, G1P0, foi encaminhada para avaliação anatômica por ressonância magnética (RM) fetal de GU com 28 semanas de gestação. Imagens 3D da superfície fetal foram geradas pelo software durante o exame para compreensão espacial da relação entre as partes fetais. O par de GUs morreu na 32ª semana de gestação, poucas horas após a cesariana. As tecnologias 3D são uma importante ferramenta de aconselhamento dos pais e de preparação da equipe multiprofissional para o parto e a assistência neonatal, além de possível planejamento cirúrgico para separação pós-natal em casos de GUs.