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AIM: To identify the relationship between the violence-prevention climate and workplace happiness in hospitals. The secondary objective is to adapt a valid and reliable scale to a different culture in healthcare settings. BACKGROUND: Healthcare settings are not immune to the harmful effects of violence, which can exacerbate existing challenges such as staff shortages. In the midst of these challenges, organizational efforts to ensure the safety of health workers are critical. These efforts can contribute positively to workers' happiness or well-being. METHOD: Using a cross-sectional design with 400 healthcare professionals from five hospitals in Trabzon, Turkey, data collection involved the Violence-Prevention Climate Scale and Workplace Happiness Scale. Confirmatory factor analysis was conducted to test the Turkish validity and reliability of the scale, and the consistency coefficient was calculated. RESULTS: The findings revealed that, on average, employees exhibited high levels of violence-prevention climate ( x ¯ ${{\bar{\rm x}}}$ = 4.22) and moderate levels of workplace happiness ( x ¯ ${{\bar{\rm x}}}$ = 3.70). Subsequently, correlation analysis unveiled a statistically significant association between the dimensions of violence-prevention climate and workplace happiness (p < 0.05, r = 0.392). It was observed that those who experienced violence and did not feel safe in the workplace had lower levels of happiness. DISCUSSION: The instances of healthcare workers being exposed to violence identified in the study largely align with previous theories related to both individual and organizational effects. CONCLUSION: Violence-prevention climate affects the safety and workplace happiness of workers. IMPLICATIONS FOR NURSING AND/OR HEALTH POLICY: Employees expect their managers to seriously consider all reports of violence. In this context, creating a violence-prevention climate would be a good start. According to WHO 2030 targets, in an environment where there is a significant shortage of healthcare personnel, especially nurses, ensuring that existing employees work in a safer and happier environment will make a positive contribution to healthcare systems.
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Background and Purpose: This study was conducted in line with the request of the senior management of a hospital. The objective of the current research is to identify managerial problems through the relationship between health employees' perceptions of organizational justice, trust in the manager and the organization, and job satisfaction; develop a solution proposal over the relationships between these variables and motivation variables; and present a model proposal (BUY Model) as a result. Methods: The study sample is comprised of 673 employees. The study data were collected online using a questionnaire consisting of five scales. The data were analyzed by descriptive statistical methods, correlation analysis, and regression analysis. Results: The findings obtained from the study showed that the participants' perceptions of organizational justice, trust in the manager and the organization, job satisfaction and motivation were generally at a moderate level. The study also determined that trust in the manager and the organization had a partial mediation effect on the effect of organizational justice on job satisfaction and the variables of trust in the organization, organizational justice, and trust in the manager, respectively, and especially, the job satisfaction variable also affected motivation. Conclusion: The BUY model was developed to identify problems related to the management of healthcare human resources and solve these problems. Considering the importance of the concepts of job satisfaction and motivation in terms of employee performance, health service quality, and patient satisfaction, it is thought that the developed model will benefit managers of health institutions in increasing the job satisfaction and motivation levels of health employees.
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Satisfação no Emprego , Humanos , Turquia , Adulto , Feminino , Masculino , Inquéritos e Questionários , Pessoa de Meia-Idade , Modelos OrganizacionaisRESUMO
Background: There is evidence that telemedicine can be used safely, easily, and cost-effectively in primary health care services. This study aims to determine family physicians' opinions regarding the potential advantages, disadvantages, and usage areas of telemedicine in primary health care services. Methods: This study was designed with a qualitative case study. The Standards for Reporting Qualitative Research (SRQR) checklist was followed throughout the research process. Interviews were conducted with family physicians working in a provincial center using snowball sampling in the study. MaxQDA 20 software was used for analysis process, and themes and subthemes were identified through a deductive-reflective thematic analysis method. The family physicians who participated in the study are between 29 and 56. In addition, family medicine specialists, general practitioners, and academic department heads were included in the study. Family physicians are evenly distributed in terms of gender and professional experience. Results: All interviewed family physicians stated that they had not received professional or technical training in delivering telemedicine. It was observed that family physicians had different perspectives on telemedicine in primary care. The data obtained in the study were analyzed under the main themes of the advantages, disadvantages, and services that can be provided in primary telemedicine. Physicians have different views on telemedicine, including negative, undecided, and positive opinions. Conclusion: It is understood that many services could be delivered remotely if the scope, procedures, and processes of the services to be provided are determined with guidelines. It is recommended that family physicians receive professional and technical training in telemedicine.
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Atitude do Pessoal de Saúde , Médicos de Família , Atenção Primária à Saúde , Pesquisa Qualitativa , Telemedicina , Humanos , Feminino , Masculino , Adulto , Atenção Primária à Saúde/organização & administração , Pessoa de Meia-Idade , Entrevistas como AssuntoRESUMO
PURPOSE: In some primary immunodeficiency (PID) patients, especially in the subgroup with common variable immunodeficiency (CVID), radiosensitivity is a concern and avoidance of repeated radiation exposure has been recommended. To investigate the use of lung Magnetic resonance imaging (MRI) instead of Computed Tomography (CT) for the diagnosis and follow-up of various lesions in the lung parenchyma and airways, especially in PID patients in whom x-ray exposure should be limited. METHODS: The study enrolled 23 patients with PID who underwent thorax CT within the last 3 months and/or who will undergo initial radiological assessment. Lung MRI was performed in all patients to compare the pulmonary findings with CT images. RESULTS: MRI performance was weaker at detecting bronchiectasis extension, and a low concordance was found between MRI and CT in the assessment of the number of bronchial generations. CT better identified peripheral airway abnormalities, while CT and MRI gave similar results for detecting the presence and extension of consolidation, bullae, mucus plugging, bronchial wall thickening, bronchiectasis severity and nodules. CONCLUSIONS: Despite the low spatial resolution, higher cost, and low availability, we suggest MRI as a possible radiation-free alternative to CT in selected patients with PID.
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Bronquiectasia/diagnóstico , Síndromes de Imunodeficiência/diagnóstico , Pulmão/diagnóstico por imagem , Imageamento por Ressonância Magnética , Adulto , Bronquiectasia/complicações , Feminino , Humanos , Síndromes de Imunodeficiência/complicações , Pulmão/patologia , Masculino , Pessoa de Meia-Idade , Muco/metabolismo , Radiação , Tolerância a Radiação , Cintilografia , Tomografia Computadorizada por Raios X , Adulto JovemRESUMO
INTRODUCTION: We evaluate the diagnostic performance of strain elastography to differentiate renal cell carcinoma (RCC) from angiomyolipoma (AML). METHODS: Strain elastography was performed in 65 patients (mean age 55.5 years; range: 32-81) who had renal lesions (24 AMLs and 41 RCCs) prospectively. Lesions were classified according to lesion size and histological subtypes. The strain ratios of the RCCs and AMLs were evaluated by a radiologist. The area under the curve and the cut-off point were used to assess diagnostic performance. Sensitivity, specificity, and positive and negative predictive values were obtained. RESULTS: In assessing the mean strain ratio, we divided the groups in 3 according to size: (1) <20-mm lesions; (2) 20- to 40-mm lesions; and (3) >40-mm lesions; the respective mean strain ratios were: 1.5 ± 0.5 (range: 0.06-5.92), 2.8 ± 0.4 (range: 0.17-9.92), 2.7 ± 0.3 (range: 0.08-6.15). When RCCs and AMLs were compared, there was a statistically significant difference in the strain ratio among the 3 groups divided per lesion size (p < 0.01). For the strain ratio, the mean ± standard deviation was 1.1 ± 0.1 for AMLs and 3.4 ± 0.3 for RCCs (p < 0.01). When lesion subtypes were compared, there was a statistically significant difference in the strain ratio between the AML and clear cell RCC (p < 0.01). CONCLUSIONS: For assessing renal lesions, strain elastography and strain ratio values may be useful in differentiating RCCs from AMLs.
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OBJECTIVE: Plasma interleukin-18 (IL-18) has been reported to be associated with homeostasis model assessment of insulin resistance (HOMA-IR). It also has been described as one of the factors that, in addition to insulin resistance, may also contribute to atherosclerosis. Parameters of systemic inflammation are also significantly associated with circulating IL-18. Our objective was to investigate whether IL-18 is associated with insulin resistance and atherosclerosis in patients with rheumatoid arthritis (RA) in which accelerated atherogenesis develops. MATERIAL AND METHODS: Fifty-one female RA patients and 30 female controls were enrolled in the study; 31 of them were without disease-modifying antirheumatic drug (DMARD) treatment and had a relatively short disease duration. Disease activity was assessed by Disease Activity Score (DAS) 28 index. HOMA-IR method was used to detect insulin resistance. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), fasting plasma glucose (FPG), insulin, tumor necrosis factor alpha (TNF-α), and IL-18 levels were evaluated. Also, carotid intima-media thickness (cIMT) was measured. RESULTS: There were no differences between patients and the control group according to age, sex, and body mass index. ESR, CRP, insulin, FPG, HOMA-IR, TNF-α, IL-18 levels, and cIMT measurements were significantly high in the patient group. HOMA-IR and cIMT measurements were similar and high in both the DMARD and non-DMARD patient groups. HOMA-IR correlated with TNF-α (r=0.308, p=0.028), but no correlation was found between IL-18 and HOMA-IR. However, IL-18 was correlated positively with cIMT (r= 0.318, p=0.028) and negatively with BMI (r=-0.360, p=0.01). CONCLUSION: IL-18 is associated with atherosclerosis in RA patients. However, no significant relation was found with insulin resistance. IL-18 may be a marker for early evaluation of atherosclerosis in RA patients.
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OBJECTIVES: The aim of this study was to compare the upper extremity musculoskeletal complications in the patients who had been receiving hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD). MATERIAL AND METHODS: The patients who had been receiving HD (n=17) or CAPD (n=15) were included to the study. The age, gender, duration of dialysis were recorded. The physical findings related to musculoskeletal system in the upper extremity were researched. The cervical, shoulder, hand standard radiographies and shoulder magnetic resonance imaging were investigated. RESULTS: The mean duration of HD and CAPD were 53.60 ± 36.03 and 49.17 ± 33.14 months, respectively (p=0.720). Only 6.3% of the CAPD group had signs of carpal tunnel syndrome (CTS). There were not any differences in the frequency of cervical destructive spondyloarthropathy, decreased height of vertebral corpus in the examination of cervical radiography (p=0.579) and also in the frequency of erosions in the humeral head and bones of hand, cyst in the clavicula, erosive osteoarthropathy and osteoporosis detected in the bones of hands (p> 0.005). In the examination of shoulder MR imaging, 80% of the HD group and 47.1% of the CAPD group had supraspinatus tendinitis (p=0.059). The frequency of subscapularis, biceps and infraspinatus tendinitis were not different in HD and CAPD groups (p> 0.05). CONCLUSION: The musculoskeletal system complications of the upper extremity were common in the patients undergoing dialysis therapy. The most common complications were osteoporosis of the hand region and supraspinatus tendinitis. LEVEL OF EVIDENCE: Prospective, Level 2b.
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Diálise Peritoneal Ambulatorial Contínua/efeitos adversos , Diálise Renal/efeitos adversos , Extremidade Superior/fisiopatologia , Ossos da Extremidade Superior/fisiopatologia , Síndrome do Túnel Carpal/fisiopatologia , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/fisiopatologia , Estudos Transversais , Humanos , Falência Renal Crônica/fisiopatologia , Falência Renal Crônica/terapia , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Osteoporose/fisiopatologia , Dor/fisiopatologia , Exame Físico , Estudos Prospectivos , Radiografia , Amplitude de Movimento Articular/fisiologia , Síndrome de Colisão do Ombro/patologia , Síndrome de Colisão do Ombro/fisiopatologia , Espondiloartropatias/fisiopatologia , Tendinopatia/patologia , Tendinopatia/fisiopatologiaRESUMO
We suspected that the multi-bullous parenchymal disease of our patient could be related to Caroli disease (CD) because he had no pulmonary pathology before the diagnosis of CD. The CD associated with bilateral multiple bullous emphysema may be an unknown component.
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Doença de Caroli/complicações , Enfisema/complicações , Adulto , Enfisema/diagnóstico por imagem , Humanos , Pulmão/diagnóstico por imagem , Masculino , Radiografia , Testes de Função Respiratória , Índice de Gravidade de DoençaRESUMO
PURPOSE: Heart-type fatty acid binding protein (H-FABP) is a sensitive marker of myocardial injury and predictor of worse prognosis in patients with pulmonary embolism (PE). Assessment of right ventricular dysfunction and pulmonary artery obstruction index (PAOI) with computed tomography (CT) has been reported as a predictor of mortality in PE. Therefore, we aimed to assess the correlation between H-FABP and CT angiographic PAOI in PE patients at intermediate risk. MATERIALS AND METHODS: Sixty-one patients (28 males; mean age, 62 ± 17 years) with diagnosis of PE were included in this study. CT was performed in all patients, and the following parameters were evaluated: right ventricle/left ventricle ratio (RV/LV), pulmonary artery axial diameter, superior vena cava axial diameter, and PAOI determined with Qanadli score. Blood samples were assessed for H-FABP and troponin levels. Patients were followed for 30 days after discharge. RESULTS: Mean PAOI was 57 ± 18%. Eleven patients died during the follow-up period due to PE (18% mortality rate). H-FABP was positive in 21 patients (35%). There was no difference in CT parameters between patients with positive H-FABP and negative H-FABP. In addition, CT parameters were similar between patients who survived and those who did not. RV/LV ratio correlated with PAOI score. Among the biomarkers, troponin levels correlated with both RV/LV ratio and PAOI. H-FABP was an independent predictor of mortality. PAOI and RV/LV ratio did not predict 30-day mortality. CONCLUSION: Although H-FABP positivity confers a bad prognosis on PE patients at intermediate risk, PAOI did not predict mortality in this group.
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Arteriopatias Oclusivas/diagnóstico por imagem , Arteriopatias Oclusivas/mortalidade , Proteínas de Ligação a Ácido Graxo/sangue , Embolia Pulmonar/sangue , Embolia Pulmonar/mortalidade , Arteriopatias Oclusivas/sangue , Biomarcadores/sangue , Feminino , Seguimentos , Coração/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Artéria Pulmonar/diagnóstico por imagem , Risco , Análise de Sobrevida , Tomografia Computadorizada por Raios X/métodos , Disfunção Ventricular Direita/sangue , Disfunção Ventricular Direita/diagnóstico por imagem , Disfunção Ventricular Direita/mortalidadeRESUMO
Availability and utilization of computed tomography angiography has been increasing recently. We aimed to assess the effectiveness of low amount of contrast media and low kV value in order to reduce possible side effects of contrast media and to provide optimization of kV value in the evaluation of the carotid artery with multi-detector computed tomography angiography. Forty one patients were randomized into two groups. Contrast media was administered at a dose of 1 ml/kg in group A patients and of 0.5 ml/kg in group B patients. kV value of 120 in group A and 100 in group B were chosen. Bolus tracking technique was used. Attenuation values of certain arterial segments were measured, and values over 200 HU were considered as significant. North American Symptomatic Carotid Endartherectomy Trial criteria were utilized in the evaluation of stenosis. Image quality in arterial segments of all cases was found to be sufficient for diagnosis. Arterial attenuation values were found to be higher in group B than group A. When compared separately in all arterial segments, there was no statistically significant difference between the groups. For stenosis, 615 arterial segments were evaluated. Moderate stenosis in eight segments and severe stenosis in three segments were identified in group A. Occlusion in three segments, severe stenosis in three segments, and moderate stenosis in 25 segments were detected in group B. Better image quality can be obtained, and the amount of contrast media can be reduced using low kV technique in carotid artery multi-detector computed tomography angiography examination.
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Angiografia/métodos , Artérias Carótidas/diagnóstico por imagem , Doenças das Artérias Carótidas/diagnóstico por imagem , Meios de Contraste/administração & dosagem , Iohexol/análogos & derivados , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Relação Dose-Resposta a Droga , Relação Dose-Resposta à Radiação , Feminino , Humanos , Iohexol/administração & dosagem , Masculino , Pessoa de Meia-Idade , Doses de Radiação , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
The aim of this study was to investigate the clinical, radiographic, and magnetic resonance imaging (MRI) findings of temporomandibular joint (TMJ) and masticatory muscles in rheumatoid arthritis (RA) patients. Twenty-eight RA patients and 29 healthy subjects were participated in the study. The patient underwent clinical and laboratory investigation. DAS28 scores were calculated. Lateral panoramic radiography was performed to evaluate condylar erosion and condylar movement. Craniofacial MRI was performed to evaluate TMJ and masseter, medial and lateral pterygoid muscles' thickness, and cross-sectional area. It was found that the mean maximal interincisal distance, range of lateral, retrusive (P < 0.05) and protrusive motion were all lesser in RA group. Lateral panoramic radiography revealed a distinct erosion in 10.7% (3/28) and restricted condylar movement in 53.6% (15/28) of RA patients. Two RA patients demonstrating marked condylar erosion in lateral panoramic radiographs were RF negative and had DAS28 scores 3.41 and 4.61. MRI findings revealed condylar erosion and effusion in one RA patient and atrophic changes of masticatory muscles in another patient. There was no statistical significance between RA and healthy groups for the thickness and cross-sectional areas of the masticatory muscles. RA group revealed a strong linear relationship for the right and left muscle thickness and cross-sectional areas in regression analysis. TMJ symptoms are frequent findings and thought to be affected from mean disease duration in RA. Laboratory findings should be considered for disease activity-related TMJ involvement. RA patients did not present muscular atrophy or hypertrophy.
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Artrite Reumatoide/diagnóstico , Imageamento por Ressonância Magnética , Músculos da Mastigação/patologia , Articulação Temporomandibular/patologia , Adulto , Artrite Reumatoide/diagnóstico por imagem , Artrite Reumatoide/patologia , Artrite Reumatoide/fisiopatologia , Fenômenos Biomecânicos , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Feminino , Humanos , Masculino , Mastigação , Músculos da Mastigação/fisiopatologia , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Radiografia , Análise de Regressão , Articulação Temporomandibular/diagnóstico por imagem , Articulação Temporomandibular/fisiopatologia , TurquiaRESUMO
UNLABELLED: Firstly, we aimed to determine the effectiveness of various treatment modalities using ultrasonography (US), and secondly, we aimed to assess the correlations between the ultrasonographic findings and electrophysiological tests, symptom severity, functional status and physical findings. 74 hands of 47 patients with carpal tunnel syndrome (CTS) were randomly treated by applying wrist splinting alone in the neutral position (23 hands), phonophoresis with corticosteroid (PCS) (28 hands) and phonophoresis with non-steroid anti-inflamatory drug (PNSAI) (23 hands). The cross-sectional area (CSA) of the median nerve (MN) was determined by ultrasound on the initial and at the 3 months after treatment. MN conduction studies were performed on the initial visit and 3 months after treatment. The patients completed the Boston symptom severity questionnaire. For clinical evaluation, we used Phalen's and Tinel's signs. We could find reduction in CSA of MN in PCS group (P < 0.001). The CSA of MN was inversely correlated with motor sensory and median nerve conduction velocity (NCV) (r = 0.421, r = 0.213, respectively). Statistically significant correlations were not detected between ultrasonographic parameters and clinical evaluation parameters (P > 0.05) and also between ultrasonographic parameters and BQ scores (P > 0.05). Although there was some improvement in clinical parameters, ultrasonographic parameters did not change in P-NSAI group. CONCLUSION: The most effective treatment modality was P-CS according to ultrasonographic and other findings. Although there were inverse correlations between the CSA of MN and sensory and motor MN conduction velocity, no relationship was found between symptom severity, functional status and US findings or electrophysiological studies.
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Síndrome do Túnel Carpal/diagnóstico por imagem , Síndrome do Túnel Carpal/terapia , Nervo Mediano/diagnóstico por imagem , Manejo da Dor , Adulto , Anti-Inflamatórios não Esteroides/administração & dosagem , Valerato de Betametasona/administração & dosagem , Síndrome do Túnel Carpal/fisiopatologia , Diclofenaco/administração & dosagem , Diclofenaco/análogos & derivados , Eletrodiagnóstico , Feminino , Glucocorticoides/administração & dosagem , Humanos , Masculino , Nervo Mediano/fisiopatologia , Pessoa de Meia-Idade , Condução Nervosa , Exame Neurológico , Manejo da Dor/métodos , Medição da Dor , Fonoforese , Valor Preditivo dos Testes , Recuperação de Função Fisiológica , Índice de Gravidade de Doença , Contenções , Inquéritos e Questionários , Fatores de Tempo , Resultado do Tratamento , Turquia , UltrassonografiaRESUMO
Carotico-jugular fistulae are known complications of gunshot injuries and stab wounds, but they can be iatrogenic. Untreated, these lesions may lead to heart failure, endocarditis, or cerebral embolization. We present the computerized tomography (CT)-angiographic view and its value in the treatment strategy in carotico-jugular fistula. A 35-year-old male was referred in the second hour of a ballistic injury to the right side of the neck. Physical examination revealed hematoma, exit hole and thrill on the right sternocleidomastoid muscle. Diagnosis was confirmed with Doppler ultrasound and CT angiography. Surgical interposition with 6 mm polytetrafluoroethylene for the carotid artery and with 12 mm Dacron for the internal jugular vein was performed. The fistulous tract was ligated. In the postoperative sixth month, Doppler ultrasound was normal and the patient was on antiaggregant therapy and healthy.
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Fístula Arteriovenosa/etiologia , Doenças das Artérias Carótidas/etiologia , Veias Jugulares/anormalidades , Lesões do Pescoço/complicações , Músculos do Pescoço/lesões , Ferimentos por Arma de Fogo/complicações , Adulto , Angiografia , Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/cirurgia , Doenças das Artérias Carótidas/diagnóstico por imagem , Doenças das Artérias Carótidas/cirurgia , Hematoma/etiologia , Humanos , Veias Jugulares/cirurgia , Masculino , Lesões do Pescoço/diagnóstico por imagem , Resultado do Tratamento , Ultrassonografia Doppler , Ferimentos por Arma de Fogo/diagnóstico por imagemRESUMO
BACKGROUND: Superficial venous insufficiency is a common problem associated with varicose veins. Endovenous laser ablation (EVLA) and concomitant ultrasound (US)-guided foam sclerotherapy are recent treatment methods alternative to surgery in the treatment of superficial venous insufficiency. PURPOSE: To compare the effectiveness of EVLA and concomitant US-guided foam sclerotherapy prospectively in two different subgroups of the disease (isolated truncal vs. truncal with perforating vein insufficiency). MATERIAL AND METHODS: The study was approved by the institutional review board. Fifty-five patients with symptomatic saphenous vein insufficiency and varicose veins were included in the study. Seventy-three EVLA and concomitant foam sclerotherapy were performed for 60 lower extremities. To determine the severity of the venous disease, Venous Clinical Severity Score (VCSS) and Visual Analogue Scale (VAS) were carried out before and 6 months after the treatment. Patients were followed up clinically and with Doppler ultrasonography for 6 months after the procedures. RESULTS: At the sixth month of the follow-up; the total occlusion rate for the saphenous veins was 98.64% (72/73), and re-canalization rate was 1.36% (1/73). The total occlusion rate for the perforating veins was 75% (18/24), re-canalization rate was 25% (6/24). There was no notable major complication. VCSS and VAS scores were decreased significantly following the treatment (p < 0.05). The patients who had isolated saphenous vein insufficiency (Group I: 36/60) and those who had saphenous and perforating vein reflux (Group II: 24/60) were compared. VAS scores were more prominently decreased after the treatment in the isolated saphenous vein insufficiency group (p < 0.05). VCSS were also decreased more prominently in Group I when compared to Group II. CONCLUSION: EVLA and concomitant US-guided foam sclerotherapy are effective, safe, and minimally invasive treatment options, yielding good cosmetic and clinical results in both isolated truncal and truncal with perforating vein insufficiency groups. However, clinical results and satisfaction of the patients were remarkably superior in cases with isolated truncal vein insufficiency compared to truncal and perforating vein insufficiency.
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Terapia a Laser/métodos , Escleroterapia/métodos , Ultrassonografia de Intervenção , Varizes/diagnóstico por imagem , Varizes/terapia , Insuficiência Venosa/diagnóstico por imagem , Insuficiência Venosa/terapia , Adolescente , Adulto , Idoso , Feminino , Humanos , Perna (Membro)/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Retratamento , Veia Safena , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Resultado do Tratamento , Varizes/complicações , Insuficiência Venosa/complicaçõesRESUMO
PURPOSE: To investigate the effect of combined intravitreal triamcinolone and ocular photodynamic therapy on retinal and choroidal hemodynamics in age-related macular degeneration. METHODS: Intravitreal triamcinolone (4 mg, 0.1 cc) and photodynamic therapy with verteporfin were applied to 48 eyes of 33 subjects (25 male and 8 female; mean age: 68.9 years) with subfoveal choroidal neovascular membrane secondary to age-related macular degeneration. Patients were assessed for ocular hemodynamic parameters with color Doppler imaging 24 hr before and 1 week, 1 month, and 3 months after a single-dose administration of combined intravitreal triamcinolone and photodynamic therapy. RESULTS: Throughout the study period, no significant difference in resistance index, peak systolic velocity, or end diastolic velocity existed in the ophthalmic artery (P = 0.58, P = 0.18, and P = 0.19, respectively), the posterior ciliary arteries (P = 0.73, P = 0.19, and P = 0.34, respectively), or the central retinal artery (P = 0.09, P = 0.32, and P = 0.47, respectively). CONCLUSION: Combined intravitreal triamcinolone and photodynamic therapy was not associated with any alteration in ocular blood flow or flow velocity over 3 months in eyes with age-related macular degeneration.
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Glucocorticoides/uso terapêutico , Degeneração Macular/tratamento farmacológico , Degeneração Macular/fisiopatologia , Fotoquimioterapia , Triancinolona Acetonida/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Velocidade do Fluxo Sanguíneo/efeitos dos fármacos , Neovascularização de Coroide/tratamento farmacológico , Neovascularização de Coroide/fisiopatologia , Artérias Ciliares/efeitos dos fármacos , Artérias Ciliares/fisiologia , Terapia Combinada , Feminino , Humanos , Injeções Intravítreas , Masculino , Pessoa de Meia-Idade , Artéria Oftálmica/efeitos dos fármacos , Artéria Oftálmica/fisiologia , Fármacos Fotossensibilizantes/uso terapêutico , Porfirinas/uso terapêutico , Fluxo Sanguíneo Regional/efeitos dos fármacos , Artéria Retiniana/efeitos dos fármacos , Artéria Retiniana/fisiologia , Ultrassonografia Doppler em Cores , Verteporfina , Acuidade VisualRESUMO
Muscle herniation is a focal protrusion of muscle tissue through a defect in the deep fascial layer. Anterior tibial muscle is the most commonly affected muscle of the lower extremities because its fascia is the most vulnerable to trauma. Clinically it is characterized by asymptomatic or painful, skin-coloured, soft, subcutaneous nodules of various size depending on the position. The diagnosis is usually made clinically based on its typical manifestations, but ultrasonographic examination is useful for detecting the fascial defect and excluding other conditions caused by soft tissue tumours such as lipomas, angiolipomas, fibromas, schwannomas or varicosities. Although this entity is not rare, it has been less well documented in the dermatological literature. We report a case of bilateral tibialis anterior muscle herniation mimicking a soft tissue tumour in a young amateur football player.
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Hérnia/diagnóstico , Músculo Esquelético , Doenças Musculares/diagnóstico , Neoplasias de Tecidos Moles/diagnóstico , Adolescente , Traumatismos em Atletas/complicações , Diagnóstico Diferencial , Hérnia/etiologia , Hérnia/terapia , Humanos , Masculino , Músculo Esquelético/lesões , Doenças Musculares/etiologia , Doenças Musculares/terapia , Futebol/lesões , Resultado do TratamentoRESUMO
Jacob disease is a rare condition consisting of pseudo joint formation between enlarged mandibular coronoid process and the inner surface of the zygoma. We report a 16-years-old male patient with Jacob disease who presented with restricted mouth opening and swelling of the right zygoma. In this report, clinical, radiological, and histopathological findings of the Jacob disease and its surgical approach are discussed.
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We report a case of hepatobiliary fascioliasis presenting with unusual radiological findings that have not been reported previously. Imaging studies revealed hepatic cystic pouches communicating with intrahepatic bile ducts. Snail-like, oval shaped and conglomerated echogenic particles with no acoustic shadowing, suggesting F. hepatica, were detected in these cystic pouches. In addition, secondary sclerosing cholangitis developed after fascioliasis.
Assuntos
Doenças dos Ductos Biliares/diagnóstico por imagem , Fasciolíase/diagnóstico por imagem , Adulto , Anti-Helmínticos/uso terapêutico , Benzimidazóis/uso terapêutico , Doenças dos Ductos Biliares/parasitologia , Ductos Biliares Intra-Hepáticos/diagnóstico por imagem , Ductos Biliares Intra-Hepáticos/parasitologia , Colangite Esclerosante/complicações , Colangite Esclerosante/diagnóstico por imagem , Colangite Esclerosante/cirurgia , Coledocostomia , Meios de Contraste , Cistos/complicações , Diagnóstico Diferencial , Fasciolíase/complicações , Fasciolíase/tratamento farmacológico , Feminino , Seguimentos , Humanos , Fígado/diagnóstico por imagem , Fígado/parasitologia , Intensificação de Imagem Radiográfica , Tomografia Computadorizada por Raios X , Triclabendazol , UltrassonografiaRESUMO
Neurofibromatosis (NF) is a genetic disorder of the nervous system that primarily affects the development and growth of neural cell tissues. This disorder is characterized by the development of various tumors, including neurofibromas, neuroniomas, malignant and benign peripheral nerve sheath tumors, and meningiomas. Accompanying skin changes and bone deformities are also common in NF. However, genitourinary involvement in NF is a rare condition, and penile enlargement has been reported only in a few males with plexiform NF. We report a 6-year-old boy with chronic renal failure associated with plexiform neurofibromas of the bladder and prostatic urethra which led to urinary obstruction and macrogenitalia due to genitourinary NF.