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1.
PLoS One ; 16(12): e0261447, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34919595

RESUMO

BACKGROUND: Defining reference intervals in experimental animal models plays a crucial role in pre-clinical studies. The hepatic parameters in healthy animals provide useful information about type and extension of hepatic damage. However, in the majority of the cases, to obtain them require an invasive techniques. Our study combines these determinations with dynamic functional test and imaging techniques to implement a non-invasive protocol for liver evaluation. The aim of the study was to determine reference intervals for hepatic function, perfusion and parenchyma attenuation with analytical and biochemical blood parameters, indocyanine green, ultrasound and computed tomography in six healthy SD rats. METHODS: Six males healthy SD rats were followed for 4 weeks. To determine hepatic function, perfusion and parenchyma attenuation analytical and biochemical blood parameters, indocyanine green, ultrasound and computed tomography were studied. Results were expressed as Means ± standard error of mean (SEM). The significance of differences was calculated by using student t-test, p < 0.05 was considered statistically significant. RESULTS: Indocyanine green clearance 5 and 10 minutes after its injection was 80.12% and 96.59%, respectively. Approximate rate of decay during the first 5 minutes after injection was 38% per minute. Hepatic perfusion evaluation with the high-frequency ultrasound was related to cardiovascular hemodynamic and renal perfusion. Portal area, hepatic artery resistance index, hepatic artery and portal peak systolic velocity and average between hepatic artery and porta was 3.41 ± 0.62 mm2, 0.57 ± 0.04 mm2/s, 693.24±102.53 mm2/s, 150.72 ± 17.80 mm2/s and 4.82 ± 0.96 mm2/s, respectively. Heart rate, cardiac output, left renal artery diammetre and renal blood flow were 331.01 ± 22.22 bpm, 75.58 ± 8.72 mL/min, 0.88 ± 0.04 mm2 and 13.65 ± 1.95 mm2/s. CT-scan hepatic average volume for each rat were 21.08±3.32, 17.57±2.76, 14.87±2.83 and 13.67±2.45 cm3 with an average attenuation coefficient of 113.51±18.08, 129,19±7.18, 141,47±1.95 y 151,67±1.2 HU. CONCLUSION: Indocyanine green and high-frequency ultrasound could be used in rats as a suitable marker of liver function. Computed tomography, through the study of raw data, help to characterize liver parenchyma, and could be a potential tool for early detection of liver parenchymal alterations and linear follow-up of patients. Further studies in rats with liver disease are necessary to verify the usefulness of these parameters.


Assuntos
Verde de Indocianina/metabolismo , Testes de Função Hepática/métodos , Fígado/metabolismo , Tecido Parenquimatoso/metabolismo , Animais , Masculino , Modelos Animais , Ratos , Ratos Sprague-Dawley , Valores de Referência , Tomografia Computadorizada por Raios X , Ultrassonografia
2.
Rev. colomb. anestesiol ; 49(4): e400, Oct.-Dec. 2021. graf
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1341243

RESUMO

The accompanying images demonstrate giant pulmonary artery aneurysms in a patient with idiopathic pulmonary arterial hypertension (Image 1). In addition to the main pulmonary artery, both the left and right pulmonary arteries are aneurysmal and are compressing the lung parenchyma (Image 2).


Las imágenes adjuntas muestran aneurismas gigantes de la arteria pulmonar en un paciente con hipertensión arterial pulmonar idiopática (Imagen 1). Además de la arteria pulmonar principal, tanto la arteria pulmonar izquierda como la derecha son aneurismáticas y están comprimiendo el parénquima pulmonar (Imagen 2).


Assuntos
Humanos , Artéria Pulmonar , Radiologia , Aneurisma , Hipertensão Pulmonar Primária Familiar , Tecido Parenquimatoso , Cardiopatias Congênitas
3.
Vet Res ; 52(1): 132, 2021 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-34663465

RESUMO

The study aim was to determine the expression of genes potentially related to chronic mastitis at the mRNA and protein levels, viz. chemokine C-C motif receptor 1 (CCR1), C-C motif chemokine ligand 2 (CCL2), C-C motif chemokine ligand 5 (CXCL5), tumor necrosis factor α (TNFα), interleukin 1ß (IL-1ß), interleukin 6 (IL-6), interleukin 8 (IL-8), interleukin 18 (IL-18), in bovine mammary gland parenchyma. The study examines the differences in expression of selected genes between cows with chronic mastitis caused by coagulase-positive (CoPS) or coagulase-negative staphylococci (CoNS) and those with healthy udders (H). Samples were collected from the udder quarters from 40 Polish Holstein-Friesian cows; 54 of these samples were chosen for analysis based on microbiological analysis of milk taken two days before slaughter. They were categorized into three groups: CoPS (N = 27), CoNS (N = 14) and H (N = 13). The RNA expression was analyzed by RT-qPCR and protein concentration by ELISA. No differences in the mRNA levels of seven genes (TNFα, IL-18, CCR1, IL-1ß, CCL2, IL-8, IL-6) and four proteins (TNFα, IL-18, CCR1, IL-1ß) were identified between the CoPS and H groups. Higher transcript levels of CXCL5 (p ≤ 0.05) gene were noted in CoPS than in H. Compared to H, higher concentrations of IL-8 and CXCL5 (p ≤ 0.05) were observed in CoPS (0.05 < p < 0.1) and CCL2 (0.05 < p < 0.1) in CoNS, while lower levels of Il-6 were found in CoPS. This may suggest that during chronic mastitis the organism stops producing pro-inflammatory cytokines, probably to protect the host tissues against their damage during prolonged infection.


Assuntos
Doenças dos Bovinos/metabolismo , Citocinas/genética , Expressão Gênica , Glândulas Mamárias Animais/metabolismo , Tecido Parenquimatoso/metabolismo , Infecções Estafilocócicas/veterinária , Animais , Bovinos , Doenças dos Bovinos/microbiologia , Doença Crônica/veterinária , Citocinas/metabolismo , Feminino , Infecções Estafilocócicas/metabolismo , Infecções Estafilocócicas/microbiologia , Staphylococcus/fisiologia
4.
Med Sci Monit ; 27: e929617, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33647007

RESUMO

BACKGROUND Renal parenchymal damage and scarring usually is associated with urinary tract infection (UTI), whereas the impact of vesicoureteral reflux (VUR) on the kidneys is unclear. We aimed to compare kidneys with all grades of VUR (grades Io-V) and those without VUR by using direct radionuclide cystography, voiding cystourethrography, and findings from 99mTc-DMSA scintigraphy (DMSA scan). MATERIAL AND METHODS The present analysis included 253 renal ureteral units (RUU) from 129 children with VUR and recurrent UTI and children with a single febrile UTI associated with abnormal ultrasonographic findings. The 6 grades of VUR (Io, I, II, III, IV, and V) and 35 RUUs without VUR were divided into 4 groups: 1. Non-dilated VUR (grades Io-II); 2. Mildly dilated VUR (grade III); 3. Dilated VUR (grades IV-V); and 4. The control group. RESULTS DMSA scanning showed significant differences between the groups with non-dilated VUR, grade III VUR, grades IV-V VUR, and the control group in kidney width (χ²=30.5; P<0.001); position and shape (χ²=30.6; P<0.001); intensity of activity (χ²=38.1; P<0.001); distribution of activity (χ²=34.5; P<0.001); and existence of scars (χ²=16; P<0.001). The probability of abnormalities on DMSA scans increased with the VUR grade. However, inside the groups of dilated and non-dilated VUR we found no significant statistical differences between those characteristics. CONCLUSIONS Our results indicate that kidneys without VUR or with non-dilated lateral VUR and dilated VUR on the contralateral side represent 2 different categories of parenchymal changes.


Assuntos
Rim/patologia , Refluxo Vesicoureteral/diagnóstico por imagem , Criança , Pré-Escolar , Cicatriz/diagnóstico por imagem , Cicatriz/metabolismo , Cicatriz/patologia , Feminino , Humanos , Lactente , Recém-Nascido , Rim/diagnóstico por imagem , Rim/metabolismo , Masculino , Tecido Parenquimatoso/diagnóstico por imagem , Tecido Parenquimatoso/metabolismo , Tecido Parenquimatoso/patologia , Cintilografia , Compostos Radiofarmacêuticos , Ácido Dimercaptossuccínico Tecnécio Tc 99m , Ureter/diagnóstico por imagem , Ureter/patologia , Infecções Urinárias/diagnóstico por imagem , Infecções Urinárias/metabolismo , Infecções Urinárias/patologia , Micção/fisiologia , Refluxo Vesicoureteral/metabolismo , Refluxo Vesicoureteral/patologia
6.
PLoS One ; 16(3): e0246582, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33690730

RESUMO

PURPOSE: To evaluate the discrimination of parenchymal lesions between COVID-19 and other atypical pneumonia (AP) by using only radiomics features. METHODS: In this retrospective study, 301 pneumonic lesions (150 ground-glass opacity [GGO], 52 crazy paving [CP], 99 consolidation) obtained from nonenhanced thorax CT scans of 74 AP (46 male and 28 female; 48.25±13.67 years) and 60 COVID-19 (39 male and 21 female; 48.01±20.38 years) patients were segmented manually by two independent radiologists, and Location, Size, Shape, and First- and Second-order radiomics features were calculated. RESULTS: Multiple parameters showed significant differences between AP and COVID-19-related GGOs and consolidations, although only the Range parameter was significantly different for CPs. Models developed by using the Bayesian information criterion (BIC) for the whole group of GGO and consolidation lesions predicted COVID-19 consolidation and AP GGO lesions with low accuracy (46.1% and 60.8%, respectively). Thus, instead of subjective classification, lesions were reclassified according to their skewness into positive skewness group (PSG, 78 AP and 71 COVID-19 lesions) and negative skewness group (NSG, 56 AP and 44 COVID-19 lesions), and group-specific models were created. The best AUC, accuracy, sensitivity, and specificity were respectively 0.774, 75.8%, 74.6%, and 76.9% among the PSG models and 0.907, 83%, 79.5%, and 85.7% for the NSG models. The best PSG model was also better at predicting NSG lesions smaller than 3 mL. Using an algorithm, 80% of COVID-19 and 81.1% of AP patients were correctly predicted. CONCLUSION: During periods of increasing AP, radiomics parameters may provide valuable data for the differential diagnosis of COVID-19.


Assuntos
COVID-19/diagnóstico por imagem , Pneumonia por Mycoplasma/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Teorema de Bayes , COVID-19/patologia , Estudos Transversais , Diagnóstico Diferencial , Progressão da Doença , Feminino , Humanos , Pulmão/patologia , Doenças Pulmonares Intersticiais/patologia , Masculino , Pessoa de Meia-Idade , Micoses/patologia , Tecido Parenquimatoso/diagnóstico por imagem , Pneumonia por Mycoplasma/patologia , Estudos Retrospectivos , SARS-CoV-2/patogenicidade , Tórax , Tomografia Computadorizada de Emissão/métodos
7.
Langenbecks Arch Surg ; 406(7): 2201-2215, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33740114

RESUMO

BACKGROUND: Liver surgery and transplantation currently represent the only curative treatment options for primary and secondary hepatic malignancies. Despite the ability of the liver to regenerate after tissue loss, 25-30% future liver remnant is considered the minimum requirement to prevent serious risk for post-hepatectomy liver failure. PURPOSE: The aim of this review is to depict the various interventions for liver parenchyma augmentation-assisting surgery enabling extended liver resections. The article summarizes one- and two-stage procedures with a focus on hypertrophy- and corresponding resection rates. CONCLUSIONS: To induce liver parenchymal augmentation prior to hepatectomy, most techniques rely on portal vein occlusion, but more recently inclusion of parenchymal splitting, hepatic vein occlusion, and partial liver transplantation has extended the technical armamentarium. Safely accomplishing major and ultimately total hepatectomy by these techniques requires integration into a meaningful oncological concept. The advent of highly effective chemotherapeutic regimen in the neo-adjuvant, interstage, and adjuvant setting has underlined an aggressive surgical approach in the given setting to convert formerly "palliative" disease into a curative and sometimes in a "chronic" disease.


Assuntos
Neoplasias Hepáticas , Regeneração Hepática , Transplante de Fígado , Hepatectomia , Humanos , Ligadura , Fígado/cirurgia , Neoplasias Hepáticas/cirurgia , Tecido Parenquimatoso , Veia Porta , Resultado do Tratamento
8.
Braz. J. Vet. Pathol. ; 14(1): 40-45, mar. 2021. ilus
Artigo em Inglês | VETINDEX | ID: vti-31198

RESUMO

Fourteen, 31-week-old Lohmann white layers from a flock of 30,000 chickens had a history of apathy, and a drop in egg production. Clinical signs were observed in approximately 40% of the flock, and lasted for three months. Fourteen hens were euthanized for post-mortem examinations. Macroscopic findings included marked atrophy and loss of renal lobes along with compensatory renal hypertrophy of the contralateral lobe. Ureters were markedly dilated and filled with mucus and/or with molded white to yellow-grey uroliths that obliterated the lumen. At histopathology, the uroliths inside ureters and tubules were composed of concentrically arranged mineralized concretions, as well as urates associated with heterophilic infiltrations and epithelial hyperplasia. Renal parenchyma adjacent to obstructed ureters was compressed with tubules replaced by fibrous tissue. Multifocal interstitial lymphocytic nephritis, proteinuria and membranoproliferative glomerulonephritis were also found. Heterophilic and caseous ureteritis associated with numerous Gram-positive coccoid bacteria occurred in three chickens. Immunohistochemistry for avian coronavirus was negative. This negative result along with the case history indicated that water restriction was the most likely cause of mortality. This condition resulted in significant economic loss for this farmer.(AU)


Assuntos
Animais , Urolitíase/patologia , Rim , Galinhas/anatomia & histologia , Tecido Parenquimatoso
9.
Clin Chest Med ; 42(1): 101-112, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33541604

RESUMO

Although the diagnosis of pulmonary hypertension requires invasive testing, imaging serves an important role in the screening, classification, and monitoring of patients with pulmonary vascular disease (PVD). The development of advanced imaging techniques has led to improvements in the understanding of disease pathophysiology, noninvasive assessment of hemodynamics, and stratification of patient risk. This article discusses the current role of advanced imaging and the emerging novel techniques for visualizing the lung parenchyma, mediastinum, and heart in PVD.


Assuntos
Diagnóstico por Imagem/métodos , Coração/diagnóstico por imagem , Pneumopatias/diagnóstico , Pulmão/diagnóstico por imagem , Mediastino/diagnóstico por imagem , Tecido Parenquimatoso/diagnóstico por imagem , Doenças Vasculares/diagnóstico por imagem , Diagnóstico por Imagem/instrumentação , Humanos
10.
Arch Virol ; 166(4): 1071-1081, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33533976

RESUMO

Elimination of hepatitis C virus (HCV) may fail, leading to a non-response outcome because of inappropriate testing for viral RNA in peripheral blood mononuclear cells (PBMCs). Sequelae of HCV genotype 4 therapy with sofosbuvir and daclatasvir ± ribavirin were assessed in our study at the 12th week after end of treatment (EOT) by screening for viral genomic RNA in serum and PBMCs with correlation to hepatic parenchymal changes. We recruited 102 out of 2165 patients who had received sofosbuvir/daclatasvir, either alone (n = 1573) or together with ribavirin (n = 592). Subjects were classified into three groups based on testing by single-step reverse transcription PCR: group I, HCV negative in both serum and PBMCs (n = 25); group II, HCV positive in PBMCs only (n = 52); and group III, HCV positive in both serum and PBMCs (n = 25). Groups I and II (n = 77) were selected out of 2102 (every 27th subject), while group III (n = 25) were selected from every second or third serologic relapse (n = 63). The pre-sampling population (n = 2165) showed sustained virologic response (SVR) in 33.21%; serologic relapse in 2.91%; HCV RNA only in PBMCs (66.79%) compared to serologic relapses and potential cure (P < 0.0001); higher serologic (38 out of 63, P = 0.03210) and cellular (36 out of 52, P = 0.0002) relapses in dual therapy than in triple therapy. The post-sampling population (n = 102) showed more HCV relapses in dual (50 out of 60) than in triple (27 out of 42) therapy (P = 0.0351); increased HCV antisense RNA strand in relapses compared to positive-sense strands alone (P < 0.001); and significant SVR events in undetectable (15 out of 31) compared to early (10 out of 55, P = 0.0058) and cirrhotic liver tissue changes (0 out of 16, P = 0.0006). In summary, HCV treatment with sofosbuvir/daclatasvir is followed by higher rates of serologic and intracellular viral RNA relapse than treatment with sofosbuvir/daclatasvir plus ribavirin. Cellular and serum viral RNA relapses are accompanied by HCV-induced hepatic pathology. An increased SVR with no detectable liver tissue changes was observed after triple therapy due to elimination of HCV RNA from PBMCs.


Assuntos
Antivirais/uso terapêutico , Hepacivirus/efeitos dos fármacos , Hepatite C Crônica/tratamento farmacológico , RNA Viral/efeitos dos fármacos , Ribavirina/uso terapêutico , Adulto , Carbamatos/uso terapêutico , Quimioterapia Combinada , Feminino , Hepacivirus/genética , Hepatite C Crônica/patologia , Hepatite C Crônica/virologia , Humanos , Imidazóis/uso terapêutico , Leucócitos Mononucleares/efeitos dos fármacos , Leucócitos Mononucleares/virologia , Fígado/efeitos dos fármacos , Fígado/patologia , Masculino , Pessoa de Meia-Idade , Tecido Parenquimatoso/efeitos dos fármacos , Tecido Parenquimatoso/patologia , Pirrolidinas/uso terapêutico , RNA Viral/análise , Prevenção Secundária , Sofosbuvir/uso terapêutico , Resultado do Tratamento , Valina/análogos & derivados , Valina/uso terapêutico
11.
Sci Rep ; 11(1): 1710, 2021 01 18.
Artigo em Inglês | MEDLINE | ID: mdl-33462259

RESUMO

Colorectal cancer and other cancers often metastasize to the liver in later stages of the disease, contributing significantly to patient death. While the biomechanical properties of the liver parenchyma (normal liver tissue) are known to affect tumor cell behavior in primary and metastatic tumors, the role of these properties in driving or inhibiting metastatic inception remains poorly understood, as are the longer-term multicellular dynamics. This study adopts a multi-model approach to study the dynamics of tumor-parenchyma biomechanical interactions during metastatic seeding and growth. We employ a detailed poroviscoelastic model of a liver lobule to study how micrometastases disrupt flow and pressure on short time scales. Results from short-time simulations in detailed single hepatic lobules motivate constitutive relations and biological hypotheses for a minimal agent-based model of metastatic growth in centimeter-scale tissue over months-long time scales. After a parameter space investigation, we find that the balance of basic tumor-parenchyma biomechanical interactions on shorter time scales (adhesion, repulsion, and elastic tissue deformation over minutes) and longer time scales (plastic tissue relaxation over hours) can explain a broad range of behaviors of micrometastases, without the need for complex molecular-scale signaling. These interactions may arrest the growth of micrometastases in a dormant state and prevent newly arriving cancer cells from establishing successful metastatic foci. Moreover, the simulations indicate ways in which dormant tumors could "reawaken" after changes in parenchymal tissue mechanical properties, as may arise during aging or following acute liver illness or injury. We conclude that the proposed modeling approach yields insight into the role of tumor-parenchyma biomechanics in promoting liver metastatic growth, and advances the longer term goal of identifying conditions to clinically arrest and reverse the course of late-stage cancer.


Assuntos
Neoplasias Hepáticas/patologia , Modelos Biológicos , Neoplasias Colorretais/patologia , Humanos , Neoplasias Hepáticas/secundário , Invasividade Neoplásica , Tecido Parenquimatoso/patologia
12.
Biomaterials ; 269: 120611, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33385685

RESUMO

Bioprinting is an emergent technology that has already demonstrated the capacity to create complex and/or vascularized multicellular structures with defined and organized architectures, in a reproducible and high throughput way. Here, we present the implementation of a complex liver model by the development of a three-dimensional extrusion bioprinting process, including parameters for matrix polymerization of methacrylated gelatin, using two hepatic cell lines, Huh7 and HepaRG. The printed structures exhibited long-term viability (28 days), proliferative ability, a relevant hepatocyte phenotype and functions equivalent to or better than those of their 2D counterparts using standard DMSO treatment. This work served as a basis for the bioprinting of complex multicellular models associating the hepatic parenchymal cells, HepaRG, with stellate cells (LX-2) and endothelial cells (HUVECs), able of colonizing the surface of the structure and thus recreating a pseudo endothelial barrier. When bioprinted in 3D monocultures, LX-2 expression was modulated by TGFß-1 toward the induction of myofibroblastic genes such as ACTA2 and COL1A1. In 3D multicellular bioprinted structures comprising HepaRG, LX-2 and endothelial cells, we evidenced fibrillar collagen deposition, which is never observed in monocultures of either HepaRG or LX-2 alone. These observations indicate that a precise control of cellular communication is required to recapitulate key steps of fibrogenesis. Bioprinted 3D co-cultures therefore open up new perspectives in studying the molecular and cellular basis of fibrosis development and provide better access to potential inducers and inhibitors of collagen expression and deposition.


Assuntos
Bioimpressão , Fígado/citologia , Impressão Tridimensional , Engenharia Tecidual , Técnicas de Cultura de Células , Linhagem Celular , Células Endoteliais , Gelatina , Células Estreladas do Fígado , Humanos , Tecido Parenquimatoso/citologia , Tecidos Suporte
13.
MAGMA ; 34(4): 487-497, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33502667

RESUMO

OBJECTIVES: To investigate the effect of compressed SENSE (CS), an acceleration technique combining parallel imaging and compressed sensing, on potential bias and precision of brain volumetry and evaluate it in the context of normative brain volumetry. MATERIALS AND METHODS: In total, 171 scans from scan-rescan experiments on three healthy subjects were analyzed. Each subject received 3D-T1-weighted brain MRI scans at increasing degrees of acceleration (CS-factor = 1/4/8/12/16/20/32). Single-scan acquisition times ranged from 00:41 min (CS-factor = 32) to 21:52 min (CS-factor = 1). Brain segmentation and volumetry was performed using two different software tools: md.brain, a proprietary software based on voxel-based morphometry, and FreeSurfer, an open-source software based on surface-based morphometry. Four sub-volumes were analyzed: brain parenchyma (BP), total gray matter, total white matter, and cerebrospinal fluid (CSF). Coefficient of variation (CoV) of the repeated measurements as a measure of intra-subject reliability was calculated. Intraclass correlation coefficient (ICC) with regard to increasing CS-factor was calculated as another measure of reliability. Noise-to-contrast ratio as a measure of image quality was calculated for each dataset to analyze the association between acceleration factor, noise and volumetric brain measurements. RESULTS: For all sub-volumes, there is a systematic bias proportional to the CS-factor which is dependent on the utilized software and subvolume. Measured volumes deviated significantly from the reference standard (CS-factor = 1), e.g. ranging from 1 to 13% for BP. The CS-induced systematic bias is driven by increased image noise. Except for CSF, reliability of brain volumetry remains high, demonstrated by low CoV (< 1% for CS-factor up to 20) and good to excellent ICC for CS-factor up to 12. CONCLUSION: CS-acceleration has a systematic biasing effect on volumetric brain measurements.


Assuntos
Aceleração , Encéfalo/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Adulto , Líquido Cefalorraquidiano/diagnóstico por imagem , Feminino , Substância Cinzenta/diagnóstico por imagem , Voluntários Saudáveis , Humanos , Processamento de Imagem Assistida por Computador , Imageamento Tridimensional , Imageamento por Ressonância Magnética/normas , Masculino , Neuroimagem , Tecido Parenquimatoso/diagnóstico por imagem , Reprodutibilidade dos Testes , Substância Branca/diagnóstico por imagem
14.
Sci Rep ; 11(1): 2042, 2021 01 21.
Artigo em Inglês | MEDLINE | ID: mdl-33479430

RESUMO

Acute traumatic intraparenchymal hematoma (tICH) expansion is a devastating neurological complication that is associated with poor outcome after cerebral contusion. This study aimed to develop and validate a novel noncontrast computed tomography (CT) (NCCT) multihematoma fuzzy sign to predict acute tICH expansion. In this multicenter, prospective cohort study, multihematoma fuzzy signs on baseline CT were found in 212 (43.89%) of total 482 patients. Patients with the multihematoma fuzzy sign had a higher frequency of tICH expansion than those without (90.79% (138) vs. 46.71% (71)). The presence of multihematoma fuzzy sign was associated with increased risk for acute tICH expansion in entire cohort (odds ratio [OR]: 16.15; 95% confidence interval (CI) 8.85-29.47; P < 0.001) and in the cohort after propensity-score matching (OR: 9.37; 95% CI 4.52-19.43; P < 0.001). Receiver operating characteristic analysis indicated a better discriminative ability of the presence of multihematoma fuzzy sign for acute tICH expansion (AUC = 0.79; 95% CI 0.76-0.83), as was also observed in an external validation cohort (AUC = 0.76; 95% CI 0.67-0.84). The novel NCCT marker of multihematoma fuzzy sign could be easily identified on baseline CT and is an easy-to-use predictive tool for tICH expansion in the early stage of cerebral contusion.


Assuntos
Lesões Encefálicas Traumáticas/diagnóstico , Hemorragia Cerebral/diagnóstico , Hematoma/diagnóstico , Tecido Parenquimatoso/diagnóstico por imagem , Adolescente , Adulto , Idoso , Lesões Encefálicas Traumáticas/diagnóstico por imagem , Lesões Encefálicas Traumáticas/patologia , Hemorragia Cerebral/diagnóstico por imagem , Hemorragia Cerebral/patologia , Estudos de Coortes , Angiografia por Tomografia Computadorizada , Hematoma/diagnóstico por imagem , Hematoma/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Tecido Parenquimatoso/patologia , Fatores de Risco , Tomografia Computadorizada por Raios X , Adulto Jovem
15.
Dig Dis Sci ; 66(7): 2362-2367, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-32776270

RESUMO

BACKGROUND: The presence of necrotic collection in acute necrotizing pancreatitis (ANP) at intra-abdominal sites other than the retroperitoneum has not been systematically studied. AIM: To investigate unusual sites of necrotic collections at computed tomography (CT) and to evaluate association with pancreatic necrosis and clinical outcomes. METHODS: This retrospective study comprised of consecutive patients with ANP evaluated between January 2018 and March 2019. Based on CT findings, patients were divided into two groups: collections at unusual sites (small bowel mesentery, mesocolon, omentum, subcapsular collections along liver and spleen, pelvis, anterior abdominal wall, and inguinoscrotal regions) and collections at usual retroperitoneal locations (lesser sac, gastrosplenic location, anterior and posterior pararenal spaces, and paracolic gutters). The differences in CT findings and clinical outcomes (need for drainage, length of hospitalization, intensive care unit admission, surgery, and death) between the two groups were evaluated. RESULTS: A total of 75 patients with ANP were evaluated. There were 25 (33.3%) patients with collections in unusual locations. These included mesentery (n = 17), splenic subcapsular location (n = 7), omentum (n = 6), hepatic subcapsular location (n = 4), anterior abdominal wall (n = 3), pelvis (n = 2), and inguinoscrotal location (n = 1). Compared to patients with collections at usual locations (n = 50), there were no differences in the CT findings except complete parenchymal necrosis (32% vs. 0%, P = .001). There were no statistically significant differences in the clinical outcomes between the two groups. CONCLUSIONS: Mesenteric collections are frequent in ANP. The other non-retroperitoneal sites are infrequently involved. There is no association between unusual sites of collection and clinical outcomes.


Assuntos
Necrose/patologia , Pancreatite Necrosante Aguda/patologia , Tecido Parenquimatoso/patologia , Adulto , Feminino , Humanos , Masculino , Pâncreas/patologia , Estudos Retrospectivos
16.
AJR Am J Roentgenol ; 216(2): 340-348, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32755162

RESUMO

OBJECTIVE. The purpose of this study was to determine the relationship between background parenchymal enhancement (BPE) on contrast-enhanced mammography (CEM) and breast tissue density, menstrual status, endocrine therapy, and risk factors for breast cancer and also to evaluate interreader agreement on classification of BPE on CEM. MATERIALS AND METHODS. Five subspecialty-trained breast radiologists independently and blindly graded tissue density (with fatty tissue and scattered fibroglandular tissue classified as nondense tissue and with heterogeneously dense and extremely dense classified as dense tissue) and BPE (with minimal or mild BPE categorized as low BPE and moderate or marked BPE categorized as high BPE) on CEM examinations performed from 2014 to 2018. Electronic medical charts were reviewed for information on menstrual status, endocrine therapy, history of breast surgery, and other risk factors for breast cancer. Comparisons were performed using the Kruskal-Wallis test, Mann-Whitney test, and Spearman rank correlation. Interreader agreement was estimated using the Fleiss kappa test. RESULTS. A total of 202 patients (mean [± SD] age, 54 ± 10 years; range, 25-84 years) underwent CEM. Tissue density was categorized as fatty in two patients (1%), scattered fibroglandular in 67 patients (33%), heterogeneously dense in 117 patients (58%), and extremely dense in 16 patients (8%). Among the 202 patients, BPE was minimal in 77 (38%), mild in 80 (40%), moderate in 31 (15%), and marked in 14 (7%). Dense breasts, younger age, premenopausal status, no history of endocrine therapy, and no history of breast cancer were significantly associated with high BPE. Among premenopausal patients, no association was found between BPE and time from last menstrual period to CEM. Overall interreader agreement on BPE was moderate (κ = 0.41; 95% CI, 0.40-0.42). Interreader agreement on tissue density was substantial (κ = 0.67; 95% CI, 0.66-0.69). CONCLUSION. Women with dense breasts, premenopausal status, and younger age are more likely to have greater BPE. Targeting CEM to the last menstrual period is not indicated.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Meios de Contraste , Mamografia , Tecido Parenquimatoso/diagnóstico por imagem , Intensificação de Imagem Radiográfica , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Densidade da Mama , Feminino , Humanos , Imageamento por Ressonância Magnética , Menopausa , Pessoa de Meia-Idade , Variações Dependentes do Observador , Estudos Retrospectivos
17.
AJR Am J Roentgenol ; 216(5): 1193-1204, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-32755210

RESUMO

BACKGROUND. Background parenchymal uptake (BPU) on molecular breast imaging (MBI) was identified in a case-control study as a breast cancer risk factor beyond mammographic density. To our knowledge, this finding has not yet been confirmed in a cohort study. OBJECTIVE. The objectives of this study were to examine the association of BPU with breast cancer and to estimate the absolute risk and discriminatory accuracy of BPU in a cohort study. METHODS. A retrospective cohort was established that included women without a history of breast cancer who underwent MBI from 2004 to 2015. Radiologists who were blinded to future breast cancer diagnoses assessed BPU on baseline MBI examinations as low (photopenic or minimal) or elevated (mild, moderate, or marked). Associations of BPU with breast cancer were estimated using multivariable Cox proportional hazards models of the time to diagnosis. The 5-year absolute risk was calculated for study subgroups. The discriminatory accuracy of BPU was also assessed. RESULTS. Among 2992 women (mean age, 56.3 years; SD, 10.6 years) who underwent MBI, breast cancer events occurred in 144 women (median follow-up, 7.3 years). Median time to diagnosis after MBI was 4.2 years (range, 0.5-11.6 years). Elevated BPU was associated with a greater breast cancer risk (hazard ratio [HR], 2.39; 95% CI, 1.68-3.41; p ≤ .001). This association remained in postmenopausal women (HR, 3.50; 95% CI, 2.31-5.31; p < .001) but was not significant in premenopausal women (HR, 1.29; 95% CI, 0.72-2.32; p = .39). The 5-year absolute risk of breast cancer was 4.3% (95% CI, 2.9-5.7%) for women with elevated BPU versus 2.5% (95% CI, 1.8-3.1%) for those with low BPU. Postmenopausal women with dense breasts and elevated BPU had a 5-year absolute risk of 8.1% (95% CI, 4.3-11.8%) versus 2.8% (1.8-3.8%) for those with low BPU. Among postmenopausal women, discriminatory accuracy for invasive cancer was improved with the addition of BPU versus use of the Gail risk score alone (C statistic, 65.1 vs 59.1; p = .04) or use of the Breast Cancer Surveillance Consortium risk score alone (C statistic, 66.4 vs 60.4; p = .04). CONCLUSION. BPU on MBI is an independent risk factor for breast cancer, with the strongest association observed among postmenopausal women with dense breasts. In postmenopausal women, BPU provides incremental discrimination in predicting breast cancer when combined with either the Gail model or the Breast Cancer Surveillance Consortium model. CLINICAL IMPACT. Observation of elevated BPU on MBI may identify a subset of women with dense breasts who would benefit most from supplemental screening or preventive options.


Assuntos
Densidade da Mama , Neoplasias da Mama/diagnóstico por imagem , Mamografia/métodos , Imagem Molecular/métodos , Tecido Parenquimatoso/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Mama/diagnóstico por imagem , Estudos de Coortes , Feminino , Humanos , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos
19.
Br J Radiol ; 94(1119): 20200630, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33035073

RESUMO

OBJECTIVES: To conduct a systematic review of evidences about the relationship between background parenchymal enhancement (BPE) of the contralateral healthy breast and breast cancer: its association with clinicopathological breast cancer characteristics, its potential as predictive and prognostic biomarker and the biological linkage between BPE and breast cancer. METHODS: A computerized literature search using PubMed and Google Scholar was performed up to June 2020. Two authors independently conducted search, screening, quality assessment, and extraction of data from the eligible studies. Studies were assessed for quality and risk of bias using the revised Quality Assessment of Diagnostic Accuracy Studies tool. RESULTS: Of the 476 articles identified, 22 articles met the inclusion criteria. No significant association was found between BPE and invasiveness, histological cancer type, T- and N-stage, multifocality, lymphatic and vascular invasion and histological tumour grade while the association between BPE and molecular subtypes is still unclear. As predictive biomarker, a greater decrease in BPE during and after neoadjuvant chemotherapy was associated with pathological complete response. Results about the role of BPE as prognostic factor were inconsistent. An association between high BPE and microvessel density, CD34 and VEGF (histological markers of vascularization and angiogenesis) was found. CONCLUSIONS: BPE of the contralateral breast is associated with breast cancer in several aspects, therefore it has been proposed as a tool to refine breast cancer decision-making process. ADVANCES IN KNOWLEDGE: Additional researches with standardized BPE assessment are needed to translate this emerging biomarker into clinical practice in the era of personalized medicine.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Meios de Contraste , Aumento da Imagem/métodos , Imageamento por Ressonância Magnética/métodos , Biomarcadores , Mama/diagnóstico por imagem , Feminino , Humanos , Tecido Parenquimatoso/diagnóstico por imagem
20.
Int Urol Nephrol ; 53(3): 455-463, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33006090

RESUMO

OBJECTIVES: Surgical removal of completely endophytic renal tumors has presented great technical difficulties for surgeons. In this study, we aim to introduce the role and use of intraoperative ultrasound (IOUS) performed in robotic-assisted renal partial nephrectomy (RAPN) for endophytic renal tumors. METHODS: We retrospectively assessed the demographics data and surgical outcomes of 58 consecutive endophytic renal tumor patients who were all attributed 3 points for the 'E' domain of the RENAL nephrometry score or 3 points for the exophytic rate of the PADUA score between October 2016 and September 2018. 38 patients who had undergone RAPN with IOUS were grouped. RAPN was carried out in another 20 patients without IOUS and these 20 patients were also grouped. RESULTS: Patients in IOUS-guided group had significantly lower estimated blood loss (P < 0.001), shorter warm ischemia time (P = 0.010) and improved MIC (Margin, ischemia, and complications) rate (P = 0.026) and Pentafecta achievement (P = 0.016) compared to non IOUS-guided group. In multivariate logistic regression analysis, RAPN with IOUS was an independent predictor of MIC achievement (odds ratio 3.595; confidence interval 1.023-12.633; P = 0.046). Surface-intermediate-base (SIB) margin score was lower for IOUS-guided group vs non IOUS-guided group (P = 0.029). CONCLUSION: RAPN for completely endophytic renal tumors is a feasible procedure in terms of complication rates, oncologic and functional outcomes. A robotic ultrasound probe operated by console surgeon generates a favorable perioperative outcomes and surgical margin rates after RAPN.


Assuntos
Neoplasias Renais/patologia , Neoplasias Renais/cirurgia , Nefrectomia/métodos , Tecido Parenquimatoso , Procedimentos Cirúrgicos Robóticos , Cirurgia Assistida por Computador , Ultrassonografia de Intervenção/métodos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
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