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1.
J Clin Immunol ; 44(6): 143, 2024 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-38847936

RESUMO

Despite advancements in genetic and functional studies, the timely diagnosis of common variable immunodeficiency (CVID) remains a significant challenge. This exploratory study was designed to assess the diagnostic performance of a novel panel of biomarkers for CVID, incorporating the sum of κ+λ light chains, soluble B-cell maturation antigen (sBCMA) levels, switched memory B cells (smB) and the VISUAL score. Comparative analyses utilizing logistic regression were performed against established gold-standard tests, specifically antibody responses. Our research encompassed 88 subjects, comprising 27 CVID, 23 selective IgA deficiency (SIgAD), 20 secondary immunodeficiency (SID) patients and 18 healthy controls. We established the diagnostic accuracy of sBCMA and the sum κ+λ, achieving sensitivity (Se) and specificity (Spe) of 89% and 89%, and 90% and 99%, respectively. Importantly, sBCMA showed strong correlations with all evaluated biomarkers (sum κ+λ, smB cell and VISUAL), whereas the sum κ+λ was uniquely independent from smB cells or VISUAL, suggesting its additional diagnostic value. Through a multivariate tree decision model, specific antibody responses and the sum κ+λ emerged as independent, signature biomarkers for CVID, with the model showcasing an area under the curve (AUC) of 0.946, Se 0.85, and Spe 0.95. This tree-decision model promises to enhance diagnostic efficiency for CVID, underscoring the sum κ+λ as a superior CVID classifier and potential diagnostic criterion within the panel.


Assuntos
Biomarcadores , Imunodeficiência de Variável Comum , Humanos , Imunodeficiência de Variável Comum/diagnóstico , Imunodeficiência de Variável Comum/imunologia , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Modelos Logísticos , Adulto Jovem , Adolescente , Idoso , Cadeias kappa de Imunoglobulina/sangue , Cadeias kappa de Imunoglobulina/genética , Sensibilidade e Especificidade , Linfócitos B/imunologia , Cadeias lambda de Imunoglobulina , Células B de Memória/imunologia
2.
Diagnostics (Basel) ; 14(10)2024 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-38786283

RESUMO

(1) Background: Computed tomography (CT) plays a paramount role in the characterization and follow-up of COVID-19. Several score systems have been implemented to properly assess the lung parenchyma involved in patients suffering from SARS-CoV-2 infection, such as the visual quantitative assessment score (VQAS) and software-based quantitative assessment score (SBQAS) to help in managing patients with SARS-CoV-2 infection. This study aims to investigate and compare the diagnostic accuracy of the VQAS and SBQAS with two different types of software based on artificial intelligence (AI) in patients affected by SARS-CoV-2. (2) Methods: This is a retrospective study; a total of 90 patients were enrolled with the following criteria: patients' age more than 18 years old, positive test for COVID-19 and unenhanced chest CT scan obtained between March and June 2021. The VQAS was independently assessed, and the SBQAS was performed with two different artificial intelligence-driven software programs (Icolung and CT-COPD). The Intraclass Correlation Coefficient (ICC) statistical index and Bland-Altman Plot were employed. (3) Results: The agreement scores between radiologists (R1 and R2) for the VQAS of the lung parenchyma involved in the CT images were good (ICC = 0.871). The agreement score between the two software types for the SBQAS was moderate (ICC = 0.584). The accordance between Icolung and the median of the visual evaluations (Median R1-R2) was good (ICC = 0.885). The correspondence between CT-COPD and the median of the VQAS (Median R1-R2) was moderate (ICC = 0.622). (4) Conclusions: This study showed moderate and good agreement upon the VQAS and the SBQAS; enhancing this approach as a valuable tool to manage COVID-19 patients and the combination of AI tools with physician expertise can lead to the most accurate diagnosis and treatment plans for patients.

3.
BMC Med Imaging ; 23(1): 34, 2023 02 22.
Artigo em Inglês | MEDLINE | ID: mdl-36814217

RESUMO

BACKGROUND: Head and neck squamous cell carcinoma (HNSCC) represents the 6th leading cancer worldwide. In most cases, patients present a locally advanced disease at diagnosis and non-surgical curative treatment is considered the standard of care. Nowadays, [18F]FDG PET/CT is a validated tool in post-treatment evaluation, with a high level of evidence. However, to standardize imaging response, several visual scales have been proposed with none of them approved yet. The study's aim is a head-to-head comparison between the diagnostic performance of the Hopkins criteria, the Deauville score, and the new proposed Cuneo score, to establish their prognostic role. Secondly, we investigate the possible value of semiquantitative analysis, evaluating SUVmax and ΔSUVmax of the lymph node with the highest uptake on the restaging PET scan. Moreover, we also considered morphological features using the product of diameters measured on the co-registered CT images to assess the added value of hybrid imaging. METHODS: We performed a retrospective analysis on histologically proven HNSCC patients who underwent baseline and response assessment [18F]FDG PET/CT. Post-treatment scans were reviewed according to Hopkins, Deauville, and Cuneo criteria, assigning a score to the primary tumor site and lymph nodes. A per-patient final score for each scale was chosen, corresponding to the highest score between the two sites. Diagnostic performance was then calculated for each score considering any evidence of locoregional progression in the first 3 months as the gold standard. Survival analysis was performed using the Kaplan-Meier method. SUVmax and its delta, as well as the product of diameters of the lymph node with the highest uptake at post-treatment scan, if present, were calculated. RESULTS: A total of 43 patients were finally included in the study. Sensitivity, specificity, PPV, NPV, and accuracy were 87%, 86%, 76%, 92%, and 86% for the Hopkins score, whereas 93%, 79%, 70%, 96%, and 84% for the Deauville score, respectively. Conversely, the Cuneo score reached the highest specificity and PPV (93% and 78%, respectively) but the lowest sensitivity (47%), NPV (76%), and accuracy (77%). Each scale significantly correlated with PFS and OS. The ROC analysis of the combination of SUVmax and the product of diameters of the highest lymph node on the restaging PET scan reached an AUC of 0.822. The multivariate analysis revealed the Cuneo criteria and the product of diameters as prognostic factors for PFS. CONCLUSIONS: Each visual score statistically correlated with prognosis thus demonstrating the reliability of point-scale criteria in HNSCC. The novel Cuneo score showed the highest specificity, but the lowest sensibility compared to Hopkins and Deauville criteria. Furthermore, the combination of PET data with morphological features could support the evaluation of equivocal cases.


Assuntos
Fluordesoxiglucose F18 , Neoplasias de Cabeça e Pescoço , Humanos , Carcinoma de Células Escamosas de Cabeça e Pescoço , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Estudos Retrospectivos , Reprodutibilidade dos Testes , Compostos Radiofarmacêuticos , Tomografia por Emissão de Pósitrons , Prognóstico
4.
Hepatol Int ; 16(5): 1075-1084, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35789473

RESUMO

BACKGROUND: Hepatic steatosis (HS) can be comprehensively assessed by visually comparing the hepatic and vessel attenuation on unenhanced computed tomography (CT). We aimed to evaluate the reliability and reproducibility of a CT-based visual grading system (VGS) for comprehensive assessment of HS. METHODS: In this retrospective study, a four-point VGS based on the visual comparison of liver and hepatic vessels was validated by six reviewers with diverse clinical experience using the unenhanced CT images of 717 potential liver donors. The diagnostic performance of VGS and quantitative indices (difference and ratio of the hepatic and splenic attenuation) to diagnose HS were evaluated using multi-reader multi-case receiver operating characteristics (ROC) analysis (reference: pathology). The interobserver agreement was assessed using Fleiss κ statistics. RESULTS: Using the VGS, all six reviewers showed areas under the ROC curves (AUROCs) higher than 0.9 for diagnosing total steatosis (TS) ≥ 30%, macrovesicular steatosis (MaS) ≥ 30%, and MaS ≥ 10%. No difference was noted between the AUROCs of the VGS and quantitative indices (p ≥ 0.1). The reviewers showed substantial agreement (Fleiss κ, 0.61). Most discrepancies occurred between the two lowest grades of VGS (81.5%; 233/283), in which most subjects (97.0%; 226/233) had a MaS < 10%. The average-reader sensitivity and specificity of the VGS were 0.80 and 0.94 to detect TS ≥ 30% and 0.93 and 0.81 to detect MaS ≥ 10%. CONCLUSION: VGS was reliable and reproducible in assessing HS. It may be useful as a non-invasive and simple tool for comprehensive HS assessment.


Assuntos
Fígado Gorduroso , Transplante de Fígado , Fígado Gorduroso/diagnóstico , Humanos , Transplante de Fígado/métodos , Doadores Vivos , Variações Dependentes do Observador , Curva ROC , Reprodutibilidade dos Testes , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos
5.
Jpn J Radiol ; 40(3): 279-288, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34586581

RESUMO

PURPOSE: The purposes of this experimental study were to compare the quantitative and qualitative visibility of in-stent restenosis between conventional-resolution CT (CRCT) and ultra-high-resolution CT (U-HRCT) and to investigate the effects of the image reconstruction techniques on the visualization of in-stent restenosis. MATERIALS AND METHODS: A vessel tube with non-calcified plaque in a 3.0-mm stent was scanned by using CRCT and U-HRCT at 4 stent directions (0, 30, 60, and 90 degrees) to the through-plane direction. Hybrid iterative reconstruction (HIR); model-based iterative reconstruction (MBIR); deep-learning-based reconstruction (DLR) were used as reconstruction methods. The lumen size was assessed using the full width at half maximum method, and image quality was visually evaluated using 4-point scale. RESULTS: U-HRCT had the significantly wider lumen sizes and narrower stent strut thickness than CRCT in three types of the reconstruction methods (P < 0.01). The lumen sizes for U-HRCT with 90 degrees were narrower than those with the other angle directions regardless of the reconstruction methods. Visual score was significantly higher for U-HRCT than CRCT (3.2 ± 0.7 vs 2.0 ± 0.4, P < 0.001). CONCLUSIONS: U-HRCT quantitatively and qualitatively provided better visualization of in-stent restenosis compared to CRCT. Image quality of U-HRCT may be affected by stent angle.


Assuntos
Reestenose Coronária , Aprendizado Profundo , Algoritmos , Angiografia Coronária , Reestenose Coronária/diagnóstico por imagem , Humanos , Imagens de Fantasmas , Doses de Radiação , Stents , Tomografia Computadorizada por Raios X/métodos
6.
Diagnostics (Basel) ; 11(1)2021 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-33445645

RESUMO

To investigate the role of diffuse pulmonary ossification (DPO) in disease severity in a population of Idiopathic Pulmonary Fibrosis (IPF) patients. This retrospective study was carried out on 95 IPF patients-44 with DPO on high resolution computed tomography (HRCT) and 51 with no calcifications detected on HRCT. Pulmonary Function Tests (PFTs) acquired nearest to the HRCT were collected. Images were analyzed by two radiologists using a qualitative method, based on HRCT fibrosis visual score, and using a quantitative method, based on histogram-based analysis. The Spearman's rank correlation coefficient was used to measure the strength and direction of the linear relationship between HRCT fibrosis score and PFTs; in addition, Spearman's rank correlation coefficient was used to explore the relationships between HRCT fibrosis score and quantitative index and between quantitative indexes and PFTs. A weak correlation between HRCT fibrosis score and PFTs was proven (r =-0.014 and p = 0.9347 for FVC (Forced Vital Capacity), r = -0.379 and p = 0.0174 for DLCO (Carbon monoxide diffusing capacity)). We found a moderate negative correlation between HRCT fibrosis score and kurtosis (r = -0.448, p = 0.004272) and skewness (r = -0.463, p = 0.003019) and a weak positive correlation with High Attenuation Area (HAA)% (r = 0.362, p = 0.0235). Moreover, a moderate linear correlation between Quantitative Indexes and FVC (r = 0.577, p = 0.000051 for kurtosis and FVC, r = 0.598, p = 0.000023 for skewness and FVC, r = -0.519, p = 0.0000364 for HAA% and FVC) and between quantitative indexes and DLCO (r = 0.469, p = 0.001508 for kurtosis, and DLCO, r = 0.474, p = 0.001309 for skewness and DLCO, r = -0.412, p = 0.005996 for HAA% and DLCO) was revealed. To better investigate the influence of DPO in disease progression, a longitudinal evaluation should be performed.

7.
J Med Imaging Radiat Oncol ; 65(1): 23-37, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33063470

RESUMO

INTRODUCTION: The purpose of this study was to investigate the prognostic utility and reproducibility of a qualitative 5-point 18-fluorodeoxyglucose (FDG)-PET primary visual score (PVS) in patients with oesophageal and gastro-oesophageal junction (GOJ) cancer. METHODS: This was a retrospective review of patients with histologically proven oesophageal or GOJ cancer who received curative intent therapy. Clinical, pathological and imaging data were extracted from electronic medical records. Patients were required to have pre-treatment and post-treatment FDG-PET scans, that were evaluated with a 5-point primary visual score (prePVS, postPVS). The changes in PVS (ΔPVS) were correlated with progression-free survival and overall survival. Interobserver variability was assessed using Cohen's Kappa intraclass correlation and agreement. RESULTS: Sixty-seven patients were retrospectively identified. Two (3%), 36 (54%) and 29 (43%) of the patients had stage I, II and III disease respectively. Twenty-five (37%) patients had squamous cell carcinoma. Thirty-seven (55%) patients proceeded onto surgical resection. postPVS was associated with both PFS (P = 0.013) and OS (P = 0.0002). ΔPVS predicted for PFS (P = 0.002) and OS (P = 0.0003). When thresholds of response were considered, agreement was 80.6% (K = 0.78) and 74.6% (K = 0.69) for postPVS and ΔPVS respectively. CONCLUSION: Qualitative assessment of oesophageal and GOJ cancers utilising FDG-PET is reproducible and may be able to prognosticate outcomes in patients undergoing treatment. Prospective validation is required.


Assuntos
Neoplasias Esofágicas/diagnóstico por imagem , Junção Esofagogástrica/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Neoplasias Gástricas/diagnóstico por imagem , Carcinoma de Células Escamosas , Fluordesoxiglucose F18 , Humanos , Prognóstico , Compostos Radiofarmacêuticos , Reprodutibilidade dos Testes , Estudos Retrospectivos
8.
Radiol Med ; 126(4): 599-607, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33252712

RESUMO

BACKGROUND: Volumetric high-resolution computed tomography (HRCT) of the chest has recently replaced incremental CT in the diagnostic workup of idiopathic pulmonary fibrosis (IPF). Concomitantly, visual and quantitative scores have been proposed for disease extent assessment to ameliorate disease management. PURPOSE: To compare the performance of density histograms (mean lung attenuation, skewness, and kurtosis) and visual scores, along with lung function correlations, in IPF patients submitted to incremental or volumetric thorax HRCT. MATERIAL AND METHODS: Clinical data and CT scans of 89 newly diagnosed and therapy-naive IPF patients were retrospectively evaluated. RESULTS: Forty-six incremental and 43 volumetric CT scans were reviewed. No differences of density histograms and visual scores estimates were found by comparing two HRCT techniques, with an optimal inter-operator agreement (concordance correlation coefficient >0.90 in all instances). Single-breath diffusing lung capacity for carbon monoxide (DLCOsb) was inversely related with the Best score (r = -00.416; p = 0.014), the Kazerooni fibrosis extent (r = -0.481; p = 0.004) and the mean lung attenuation (r = -0.382; p = 0.026), while a positive correlation was observed with skewness (r = 0.583; p = 0.001) and kurtosis (r = 0.543; p = 0.001) in the incremental HRCT sub-group. Similarly, in the volumetric CT sub-cohort, DLCOsb was significantly associated with skewness (r = 0.581; p = 0.007) and kurtosis (r = 0.549; p = 0.018). Correlations with visual scores were not confirmed. Forced vital capacity significantly related to all density indices independently on HRCT technique. CONCLUSIONS: Density histograms and visual scores similarly perform in incremental and volumetric HRCT. Density quantification displays an optimal reproducibility and proves to be superior to visual scoring as more strongly correlated with lung function.


Assuntos
Fibrose Pulmonar Idiopática/diagnóstico por imagem , Tórax/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Idoso , Densitometria , Feminino , Humanos , Fibrose Pulmonar Idiopática/patologia , Fibrose Pulmonar Idiopática/fisiopatologia , Masculino , Pessoa de Meia-Idade , Testes de Função Respiratória , Tomografia Computadorizada por Raios X/métodos
9.
BMC Pulm Med ; 20(1): 242, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32917179

RESUMO

BACKGROUND: Lung cancer is a frequent comorbidity of chronic obstructive pulmonary disease (COPD). However, the local risk of developing lung cancer related to regional emphysema distribution and clinical outcome has not been investigated. Our aim was to evaluate the impact of regional emphysema score (RES) on tumor location and prognosis in non-small cell lung cancer (NSCLC) patients. METHODS: We enrolled 457 patients who underwent curative surgery for NSCLC at seven hospitals at The Catholic University of Korea from 2014 to 2018. Emphysema was visually assessed for each lobe, with the lingula as a separate lobe. Semi-quantitative emphysema scoring was classified as follows: 0 = none, 0.5 = 1 to 10%, 1 = 11 to 25%, 2 = 26 to 50%, 3 = 51 to 75%, and 4 = 76 to 100%. An RES was given to each of the six lung zone: the upper, middle, and lower lobes in the right and left lungs. RESULTS: There were 145 patients in the high RES (≥ 3) group and 312 in the low RES (< 3) group. The mean RES in each lobe with cancer was significantly higher than that in other lobes without cancer (0.51 vs. 0.37, P <  0.001). This group showed significantly shorter disease-free survival (P <  0.001), in addition, presence of COPD, low diffusing capacity of the lung for carbon monoxide (< 80), smoking status, and poor differentiation were more frequent in this group. Also, cancer in a lobe with a higher RES (odds ratio (OR) = 1.56; 95% confidence interval (CI:1.01-2.42; P = 0.04), pathologic stage ≥ III (OR = 2.23; 95% CI: 1.28-3.89; P <  0.001), and poor differentiation (OR = 1.99; 95% CI: 1.22-3.21; P <  0.001) were independent factors for tumor recurrence. CONCLUSIONS: The regional severity of emphysema by visual qualification was associated with the location of lung cancer, and was an independently poor prognostic factor for tumor recurrence in completely resected NSCLC patients.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/complicações , Neoplasias Pulmonares/complicações , Enfisema Pulmonar/complicações , Idoso , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Feminino , Humanos , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Índice de Gravidade de Doença
10.
Braz. arch. biol. technol ; 63(spe): e20190498, 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1142507

RESUMO

Abstract The objective was to undertake the visual evaluation of soil structure in maize and forage grasses intercropping under no-tillage. The experiment was carried out in a rural property located in North Paraná State, Brazil, where there were five parallel areas with the following treatments: maize + Urochloa brizantha cv. Marandu (T1), maize + Urochloa brizantha cv. Piatã (T2), maize + Urochloa brizantha cv. Xaraés (T3), maize + Urochloa ruziziensis (T4), and non-intercropping maize (T5). Seeds of forage grasses were sown in April 5th, 2018 and sampling was carried out in December, 30th, 2018. Samples of 0.10 m width, 0.20 m length, and 0.25 m thickness were collected from five random locations of each experimental area and, for the visual evaluation of soil structural quality, a soil evaluation (VESS) chart was used so that visual scores were attributed to each sample. Treatments 1 and 5 received the highest scores, while treatment 3 had the lowest score and showed good structural quality and great root presence. At the superficial layer, treatment 2 had the lowest score (0.8) among treatments. For the subsuperficial layer, the scores obtained were higher than those found for the superficial layer: T3 had the lowest mean (1.5) and was significantly similar to T4 that presented a mean score of 1.7. Except for T1, which showed a similar score to non-intercropping maize (T5), the forage grasses had better visual scores. The visual evaluation of soil structure indicated that maize and forage grasses intercropping improves soil structural quality.


Assuntos
Humanos , Monitoramento do Solo , Zea mays , Poaceae , Brasil , Modelos Teóricos
11.
Acta Trop ; 199: 105150, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31425672

RESUMO

The point-of-care strip assay for the detection of the schistosome Circulating Cathodic Antigen (POC-CCA) in urine has shown to be a user-friendly and sensitive alternative to stool microscopy for the diagnosis of Schistosoma mansoni infections. However, visual scoring of the test is by definition observer dependent and leads to discussion about the qualitative interpretation, in particular in low intensity infections when test lines tend to be weak. In order to standardise visual scoring, an innovative approach for semi-quantitative interpretation of the POC-CCA cassettes, called G-scores, was developed and evaluated. Urines (n = 110) from a S. mansoni endemic area were used to evaluate this new approach. Test lines of the POC-CCA were visually compared against the G-scores, i.e. a series of artificial cassettes containing inkjet-printed strips of different intensities in order to grade the POC-CCA test line on a scale of 1 to 10. A significant positive correlation (Spearman 0.660, p < 0.001) was observed between G-scores and eggs per gram of faeces. This proof-of-concept study demonstrates the usefulness of the G-scores for standardising the visual scoring of the POC-CCA urine strip assay. Several research groups have already indicated an interest in the G-scores for their field work. Further distribution of the cassettes, in particular when provided in combination with reference standards, will assist the wider schistosomiasis community in dealing with issues like batch-to-batch differences and interpretation of trace readings.


Assuntos
Antígenos de Helmintos/urina , Glicoproteínas/urina , Proteínas de Helminto/urina , Sistemas Automatizados de Assistência Junto ao Leito , Fitas Reagentes , Esquistossomose mansoni/diagnóstico , Animais , Humanos , Sistemas Automatizados de Assistência Junto ao Leito/normas , Schistosoma mansoni/imunologia , Esquistossomose mansoni/urina
12.
J Anim Breed Genet ; 136(2): 118-133, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30592105

RESUMO

The aim of this study was to estimate genetic parameters and identify genomic regions associated with carcass traits obtained by ultrasound and visual scores in Nellore cattle. Data from ~66,000 animals from the National Association of Breeders and Researchers (ANCP) were used. The variance components for backfat thickness, rump fat thickness and Longissimus muscle area (LMA) were estimated considering a linear model whereas a threshold model for body structure (BS), finishing precocity (FP) and musculature (MS) traits. The SNP solutions were estimated using the ssGBLUP approach by considering windows of 10 consecutive SNPs. Regions that accounted for more than 1.0% of the additive genetic variance were used. Genes identified within the significant windows, such as FOXA3, AP2S1, FKRP, NPASI and ATP6V1G1, were found to be related with MS, while OMA1 and FFGY with BS and FP traits. The PLTP, TNNC2 and GPAT2 genes were found in the regions associated with LMA, as well as TKT, FNDC5 and CHRND can strongly be related with fat deposition. Gene enrichment analysis revealed processes that might be directly influenced the organism growth and development. These results should help to better understand the genetic and physiological mechanisms regulating growth and body composition, muscle tissue development and subcutaneous fat expression, and this information might be useful for future genomic studies in Nellore cattle.


Assuntos
Composição Corporal/genética , Cruzamento , Genoma/genética , Genômica , Animais , Bovinos , Músculos Paraespinais/crescimento & desenvolvimento , Fenótipo , Polimorfismo de Nucleotídeo Único/genética , Gordura Subcutânea/crescimento & desenvolvimento
13.
Gait Posture ; 49: 14-18, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27344448

RESUMO

Assessment of gait abnormalities in cerebral palsy (CP) is challenging, and access to instrumented gait analysis is not always feasible. Therefore, many observational gait analysis scales have been devised. This study aimed to evaluate the interobserver reliability, intraobserver reliability, and validity of Edinburgh visual gait score (EVGS). Video of 30 children with spastic CP were reviewed by 7 raters (10 children each in GMFCS levels I, II, and III, age 6-12 years). Three observers had high level of experience in gait analysis (10+ years), two had medium level (2-5 years) and two had no previous experience (orthopedic fellows). Interobserver reliability was evaluated using percentage of complete agreement and kappa values. Criterion validity was evaluated by comparing EVGS scores with 3DGA data taken from the same video visit. Interobserver agreement was 60-90% and Kappa values were 0.18-0.85 for the 17 items in EVGS. Reliability was higher for distal segments (foot/ankle/knee 63-90%; trunk/pelvis/hip 60-76%), with greater experience (high 66-91%, medium 62-90%, no-experience 41-87%), with more EVGS practice (1st 10 videos 52-88%, last 10 videos 64-97%) and when used with higher functioning children (GMFCS I 65-96%, II 58-90%, III 35-65%). Intraobserver agreement was 64-92%. Agreement between EVGS and 3DGA was 52-73%. We believe that having EVGS as part of the standardized gait evaluation is helpful in optimizing the visual scoring. EVGS can be a supportive tool that adds quantitative data instead of only qualitative assessment to a video only gait evaluation.


Assuntos
Paralisia Cerebral/diagnóstico , Transtornos Neurológicos da Marcha/diagnóstico , Marcha/fisiologia , Paralisia Cerebral/complicações , Paralisia Cerebral/fisiopatologia , Criança , Feminino , Transtornos Neurológicos da Marcha/etiologia , Transtornos Neurológicos da Marcha/fisiopatologia , Humanos , Masculino , Curva ROC , Reprodutibilidade dos Testes , Gravação em Vídeo
14.
Skin Res Technol ; 21(2): 201-6, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25130375

RESUMO

BACKGROUND/PURPOSE: Nasolabial lines (NL) and wrinkles of the face are major features of aging. Wrinkles have been studied widely by morphological methods using 3-dimensional (3D) photographic analysis instrument, but NL were evaluated by visual scoring usually. To evaluate NL quantitatively, another method is needed. This study is purposed to find out quantitative method for evaluation of NL. METHOD: One hundred Korean female subjects aged 20 to 60 were recruited in this study. Facial image was taken using light source adjusted VISIA-CR(®) and 3-dimensional wrinkle depth on the NL area was evaluated by Phase shift rapid in vivo measuring of human skin (PRIMOS(®)). The pixel number of NL area and the angle were obtained using processed images. The severity of NL was assessed by visual score. Skin elasticity was measured by Cutometer(®) MPA580. Statistical significance was determined at P < 0.05. RESULT: The optical images obtained by light source adjusted VISIA-CR(®) were easy to distinguish NL and significantly increased age-dependently. And three parameters of elasticity (R2, R5, and R7) on NL area were gradually decreased with age. The Pearson correlation coefficient was -0.756 (P < 0.01) between R7 parameter and ages. Also the pixel number of NL area, angle, wrinkle depth on the NL area (Ra), and visual score were decreased elasticity-dependently. The pixel number of NL area was highly related to Ra (r = 0.567, P < 0.01) and visual score (r = 0.647, P < 0.01). CONCLUSION: This study has shown that NL severity is related to decrease of dermal elasticity and age using quantitative new method by processing optical images.


Assuntos
Dermoscopia/métodos , Interpretação de Imagem Assistida por Computador/métodos , Envelhecimento da Pele/patologia , Envelhecimento da Pele/fisiologia , Adulto , Algoritmos , Módulo de Elasticidade/fisiologia , Feminino , Humanos , Pessoa de Meia-Idade , Nariz/anatomia & histologia , Nariz/fisiologia , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Adulto Jovem
15.
Auris Nasus Larynx ; 40(6): 548-53, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23751774

RESUMO

OBJECTIVE: The Lund-Mackay system (L-M system) is widely used for computed tomography (CT) evaluation of chronic rhinosinusitis (CRS). However, a major drawback of the L-M system is its insufficiency of gradation. To avoid this deficiency, a new staging system proposed by American societies and the Zinreich system were reported as modifications of the L-M system. The aim of this study was to investigate the efficiency of gradation and the accuracy of the visual quantification of these modified staging systems. METHODS: Preoperative CT scanning was performed on 20 adult patients with CRS. A computer workstation was used to measure the volume of each sinus and the volume of inflammatory disease in each sinus. Then the soft tissue density rate (STDR) and objective scores, which were adapted to each system, were calculated. Visual evaluation of the CT images was performed using these systems. The visual score with each staging system and STDR value were evaluated for a correlation, and the rate of agreement was determined between the visual and objective scores obtained with each staging system. RESULTS: The correlation between the visual scores and the STDR values was shown with all staging system including L-M system. The coefficients of correlation between the visual scores and the STDR values with these modified systems were higher than with the L-M system. While the agreement rates with these modified systems were significantly lower than with the L-M system, differences of 2 or greater between the subjective and objective scores were rare. CONCLUSION: We cannot conclude that one of these three staging systems is superior to the other. With this study, the simple grading system such L-M staging score was considered easy and accurate method to use the clinical level. The modified staging systems showed more efficient ability to gradate in evaluating rhinosinusitis inflammation compared with the L-M system and also showed acceptable accuracy.


Assuntos
Sinusite/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Doença Crônica , Diagnóstico por Computador , Humanos
16.
J Forensic Sci ; 58(2): 513-7, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23278272

RESUMO

Protocols for determining postmortem submersion interval (PMSI) have long been problematic for forensic investigators due to the wide variety of factors affecting the rate of decomposition of submerged carrion. Likewise, it has been equally problematic for researchers to develop standardized experimental protocols to monitor underwater decomposition without artificially affecting the decomposition rate. This study compares two experimental protocols: (i) underwater in situ evaluation with photographic documentation utilizing the Heaton et al. total aquatic decomposition (TAD) score and (ii) weighing the carrion before and after submersion. Complete forensic necropsies were performed as a control. Perinatal piglets were used as human analogs. The results of this study indicate that in order to objectively measure decomposition over time, the human analog should be examined at depth using the TAD scoring system rather than utilizing a carrion weight evaluation. The acquired TAD score can be used to calculate an approximate PMSI.


Assuntos
Peso Corporal , Água Doce , Imersão , Fotografação , Mudanças Depois da Morte , Animais , Patologia Legal/métodos , Humanos , Modelos Animais , Suínos
17.
Arq. bras. med. vet. zootec ; 64(2): 443-449, abr. 2012.
Artigo em Português | LILACS | ID: lil-622499

RESUMO

Estimaram-se os componentes de (co)variância e herdabilidade da conformação frigorífica à desmama (CFD), conformação frigorífica ao sobreano (CFS), peso à desmama (PD) e peso ao sobreano (PS) de animais Nelore, e as correlações genéticas entre essas características. Um modelo animal multicaracterística foi proposto para analisar 6.397 informações de peso e escores visuais de conformação frigorífica, obtidas à desmama e ao sobreano. Esse modelo incluiu os efeitos aleatórios genético aditivo direto, genético aditivo materno, ambiente permanente materno e residual, além dos efeitos fixos de grupo contemporâneo e das covariáveis idade da mãe ao parto - para peso e conformação frigorífica à desmama e ao sobreano - e idade do animal à data da avaliação - para conformação frigorífica, à desmama e ao sobreano. As herdabilidades estimadas para CFD, CFS, PD e PS foram, respectivamente, 0,13, 0,25, 0,22 e 0,29. Correlações genéticas positivas e de alta magnitude entre as características de peso e as características de avaliação visual sugerem que a seleção para uma delas pode resultar em resposta indireta na outra. A característica de conformação frigorífica pode ser selecionada em idade mais precoce em razão da correlação genética alta e positiva entre mensurações feitas nas duas idades estudadas.


The aim of this study was to estimate variance components, heritability and genetic correlation for slaughter conformation at weaning (SCW), slaughter conformation at yearling age (SCY), weaning weight (WW) and yearling age weight (YW) of Nellore cattle. A total of 6,397 records of all traits measured at weaning and at yearling age were used in the analysis. A multiple trait animal model which included the direct genetic additive, maternal genetic additive, maternal permanent environmental and residual random effects, as well as the fixed effect of contemporary group and the covariates age at calving (for weight and slaughter conformation at weaning and yearling age) and age at the evaluation time (slaughter conformation at weaning and yearling age) was proposed. The heritability estimates for SCW, SCY, WW and YW were, respectively, 0.13, 0.25, 0.22 and 0.29. Positive and high genetic correlations between body weight traits and visual evaluation traits suggested that direct selection for one trait results in positive indirect response in the remaining trait. Slaughter conformation trait can be selected at earlier age due to the high and positive genetic correlation between conformation scores at different age.

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