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Two satellites are currently monitoring surface soil moisture (SM) using L-band observations: SMOS (Soil Moisture and Ocean Salinity), a joint ESA (European Space Agency), CNES (Centre national d'études spatiales), and CDTI (the Spanish government agency with responsibility for space) satellite launched on November 2, 2009 and SMAP (Soil Moisture Active Passive), a National Aeronautics and Space Administration (NASA) satellite successfully launched in January 2015. In this study, we used a multilinear regression approach to retrieve SM from SMAP data to create a global dataset of SM, which is consistent with SM data retrieved from SMOS. This was achieved by calibrating coefficients of the regression model using the CATDS (Centre Aval de Traitement des Données) SMOS Level 3 SM and the horizontally and vertically polarized brightness temperatures (TB) at 40° incidence angle, over the 2013 - 2014 period. Next, this model was applied to SMAP L3 TB data from Apr 2015 to Jul 2016. The retrieved SM from SMAP (referred to here as SMAP_Reg) was compared to: (i) the operational SMAP L3 SM (SMAP_SCA), retrieved using the baseline Single Channel retrieval Algorithm (SCA); and (ii) the operational SMOSL3 SM, derived from the multiangular inversion of the L-MEB model (L-MEB algorithm) (SMOSL3). This inter-comparison was made against in situ soil moisture measurements from more than 400 sites spread over the globe, which are used here as a reference soil moisture dataset. The in situ observations were obtained from the International Soil Moisture Network (ISMN; https://ismn.geo.tuwien.ac.at/) in North of America (PBO_H2O, SCAN, SNOTEL, iRON, and USCRN), in Australia (Oznet), Africa (DAHRA), and in Europe (REMEDHUS, SMOSMANIA, FMI, and RSMN). The agreement was analyzed in terms of four classical statistical criteria: Root Mean Squared Error (RMSE), Bias, Unbiased RMSE (UnbRMSE), and correlation coefficient (R). Results of the comparison of these various products with in situ observations show that the performance of both SMAP products i.e. SMAP_SCA and SMAP_Reg is similar and marginally better to that of the SMOSL3 product particularly over the PBO_H2O, SCAN, and USCRN sites. However, SMOSL3 SM was closer to the in situ observations over the DAHRA and Oznet sites. We found that the correlation between all three datasets and in situ measurements is best (R > 0.80) over the Oznet sites and worst (R = 0.58) over the SNOTEL sites for SMAP_SCA and over the DAHRA and SMOSMANIA sites (R= 0.51 and R= 0.45 for SMAP_Reg and SMOSL3, respectively). The Bias values showed that all products are generally dry, except over RSMN, DAHRA, and Oznet (and FMI for SMAP_SCA). Finally, our analysis provided interesting insights that can be useful to improve the consistency between SMAP and SMOS datasets.
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A 26-year-old male presented with a mild confusion and hemianopsia after traumatic brain injury. Cerebral CT-scan revealed a 62.5 cm(3) left occipital extradural haematoma (EDH). Although conventional neurosurgical management would have been to evacuate the haematoma, a conservative strategy was preferred, and the patient made a total recovery.
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Cavidades Cranianas/lesões , Hematoma Epidural Craniano/terapia , Adulto , Lesões Encefálicas/complicações , Gerenciamento Clínico , Escala de Coma de Glasgow , Hematoma Epidural Craniano/etiologia , Humanos , Masculino , Lobo Occipital/patologia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
The CAMCATT-AI4GEO extensive field experiment took place in Toulouse, a city in the southwest of France, from 14th to 25th June 2021 (with complementary measurements performed on the 6 September 2021). Its main objective was the acquisition of a new reference dataset on an urban site to support the development and validation of data products from the future thermal infrared (TIR) satellite missions such as TRISHNA (CNES/ISRO), LSTM (ESA) and SBG (NASA). With their high spatial (between 30-60m) and temporal (2-3 days) resolutions, the future TIR satellite data will allow a better investigation of the urban climate at the neighbourhood scale. However, in order to validate the future products of these missions such as LST, air temperature, comfort index and Urban Heat Island (UHI), there is a need to accurately characterise the organisation of the city in terms of 3D geometry, spectral optical properties and both land surface temperature and emissivity (LST and LSE) at several scales. In this context, the CAMCATT-AI4GEO field campaign provides a set of airborne VISNIR-SWIR (Visible Near InfraRed - ShortWave InfraRed) hyperspectral imagery, multispectral thermal infrared (TIR) imagery and 3D LiDAR acquisitions, together with a variety of ground data collected, for some of them, simultaneously to the flight. The ground dataset includes surface reflectance measured spectrally with ASD spectroradiometers and in six spectral bands spreading from shortwave to thermal infrared and for two viewing angles with a SOC410-DHR handheld reflectometer. It is completed with LST and LSE retrieved from thermal infrared radiance acquired in six spectral bands with CIMEL radiometers. It also includes meteorological data coming from four radio soundings (one of which was taken during the flight), data routinely collected at the Blagnac airport reference station as well as air temperature and humidity acquired using instrumented cars following two different itineraries. In addition, a link is provided to access the data routinely collected by the network of weather stations set up by Toulouse Metropole in the city and its surroundings. This data paper describes this new reference urban dataset which can be useful for many applications such as calibration/validation of at-surface radiance, LST and LSE data products as well as higher level products such as air temperature or comfort index. It also provides valuable opportunities for other applications in urban climate studies, such as supporting the validation of microclimate models.
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The contribution of scattered neutrons is inevitable in neutron calibration facilities. This contribution complicates the measurements of neutron radiation, therefore, it should be estimated to correct the response of neutron probe instruments. In the present work, Monte Carlo simulation was performed for a neutron calibration bunker using the MCNP-4C code. This simulation aimed to calculate the contribution ratio of scattered neutrons to the neutron field. To simulate the neutron field, 241Am-Be neutron source defined in the ISO 8529-1 was used. The results of the simulation reported in this work were found to be consistent with those found experimentally in previous work. Additionally, the distribution of both the ambient dose equivalent rate and the contribution ratio of scattered neutrons in the bunker were mapped using this simulation.
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Amerício , Nêutrons , Amerício/análise , Calibragem , Simulação por Computador , Método de Monte Carlo , Doses de Radiação , Radiometria/métodosRESUMO
PURPOSE: The purpose of this work is to report mid- to long-term clinical results, recurrence rates and instability following surgery to repair anterior dislocation of the shoulder by the remplissage technique. METHODS: This was a retrospective case series at a single center with patients with anterior shoulder instability that received surgery using the remplissage technique. Rowe questionnaire, instability complaints, recurrence episodes and return to sport were analyzed. RESULTS: Of all patients screened, 21 (92.3%) were enrolled and only 2 patients were lost to follow-up. The mean age of the patients at the time of surgery was 27.8y.o., and the mean number of dislocations before surgery was 3.2 episodes. The follow-up average was 83.8 months (range 28-126). No case of postoperative infection was observed. Two patients (9.5%) had recurrent shoulder instability and required reintervention after 18 and 48 months. The average final Rowe score was 92.9 (range 75-100). All patients that played sports before surgery returned to the sport, and 73.7% of them returned to the same activity level. CONCLUSION: The remplissage technique applied to repair anterior shoulder dislocation with humeral bone loss presents good results regarding clinical scores, shoulder stability and acceptable rates of return to sports, even in a mid- to long-term follow-up. LEVEL OF EVIDENCE: IV.
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Lesões de Bankart , Instabilidade Articular , Luxação do Ombro , Articulação do Ombro , Artroscopia , Seguimentos , Humanos , Instabilidade Articular/cirurgia , Recidiva , Estudos Retrospectivos , Ombro , Luxação do Ombro/diagnóstico por imagem , Luxação do Ombro/cirurgiaRESUMO
Estimation of radiation intake and internal dose can be carried out through direct or indirect measurements during routine or special monitoring program. In case of Iodine-131 contamination, direct measurements, such as thyroid counting, are fast and efficient to give quick results. Generally, the calculation method implements suitable values for known parameters whereas default values are used if no information is available. However, in view to avoid significant discrepancies, IDEAS guidelines put in route a comprehensive method to evaluate the monitoring data for one and different types of monitoring. This article deals with a case of internal contamination of a worker who inhaled aerosols containing 131I during the production of radiopharmaceuticals. The interpretation of data obtained was done by following IDEAS guidelines.
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Aerossóis , Radioisótopos do Iodo/análise , Exposição Ocupacional/análise , Doses de Radiação , Monitoramento de Radiação/métodos , Compostos Radiofarmacêuticos/análise , Glândula Tireoide/efeitos da radiação , Humanos , Proteção Radiológica/métodos , SíriaRESUMO
Understanding the socioecology of domestic dog populations is essential for effective disease control, especially canine rabies. In Morocco, since 1986, the control efforts and plans put in place by the government have failed to eradicate this disease; this is because the management of the canine population was not taken into account during the establishment of these plans. It is against the background that this study was designed to estimate the dog population and determine its socioecological characteristics, as well as investigate the attitude of the inhabitants towards the dogs. A stratified random sampling was conducted using a structured questionnaire from May to December 2016. A total of 1931 households were interviewed, comprising 27.4% in urban areas and 72.6% in rural areas. A total of 3719 dogs were counted alongside a human population of 11302 for a dog : human ratio of 1 : 2.42 in rural areas and 1 : 46.58 in urban areas. The majority of dogs (92%) in rural areas were not vaccinated against rabies. In urban areas, about 88.5% were vaccinated against rabies. In addition, 78.5% of dogs in rural areas were free roaming, with more than 53% of births being abandoned by their owners, resulting in a large stray and feral dog population and increasing the potential for continued transmission of rabies virus. There was strong association between breed and rabies vaccination (p<0.05) and confinement with body condition score.
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Murine models are useful for targeted radiotherapy pre-clinical experiments. These models can help to assess the potential interest of new radiopharmaceuticals. In this study, we developed a voxel-based mouse for dosimetric estimates. A female nude mouse (30 g) was frozen and cut into slices. High-resolution digital photographs were taken directly on the frozen block after each section. Images were segmented manually. Monoenergetic photon or electron sources were simulated using the MCNP4c2 Monte Carlo code for each source organ, in order to give tables of S-factors (in Gy Bq-1 s-1) for all target organs. Results obtained from monoenergetic particles were then used to generate S-factors for several radionuclides of potential interest in targeted radiotherapy. Thirteen source and 25 target regions were considered in this study. For each source region, 16 photon and 16 electron energies were simulated. Absorbed fractions, specific absorbed fractions and S-factors were calculated for 16 radionuclides of interest for targeted radiotherapy. The results obtained generally agree well with data published previously. For electron energies ranging from 0.1 to 2.5 MeV, the self-absorbed fraction varies from 0.98 to 0.376 for the liver, and from 0.89 to 0.04 for the thyroid. Electrons cannot be considered as 'non-penetrating' radiation for energies above 0.5 MeV for mouse organs. This observation can be generalized to radionuclides: for example, the beta self-absorbed fraction for the thyroid was 0.616 for I-131; absorbed fractions for Y-90 for left kidney-to-left kidney and for left kidney-to-spleen were 0.486 and 0.058, respectively. Our voxel-based mouse allowed us to generate a dosimetric database for use in preclinical targeted radiotherapy experiments.
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Rim/efeitos da radiação , Método de Monte Carlo , Radioisótopos/farmacocinética , Radiometria/métodos , Baço/efeitos da radiação , Glândula Tireoide/efeitos da radiação , Animais , Carga Corporal (Radioterapia) , Transferência Linear de Energia , Camundongos , Camundongos Nus , Eficiência Biológica Relativa , Processamento de Sinais Assistido por Computador , Contagem Corporal TotalRESUMO
Dosimetric studies are necessary for all patients treated with targeted radiotherapy. In order to attain the precision required, we have developed Oedipe, a dosimetric tool based on the MCNPX Monte Carlo code. The anatomy of each patient is considered in the form of a voxel-based geometry created using computed tomography (CT) images or magnetic resonance imaging (MRI). Oedipe enables dosimetry studies to be carried out at the voxel scale. Validation of the results obtained by comparison with existing methods is complex because there are multiple sources of variation: calculation methods (different Monte Carlo codes, point kernel), patient representations (model or specific) and geometry definitions (mathematical or voxel-based). In this paper, we validate Oedipe by taking each of these parameters into account independently. Monte Carlo methodology requires long calculation times, particularly in the case of voxel-based geometries, and this is one of the limits of personalized dosimetric methods. However, our results show that the use of voxel-based geometry as opposed to a mathematically defined geometry decreases the calculation time two-fold, due to an optimization of the MCNPX2.5e code. It is therefore possible to envisage the use of Oedipe for personalized dosimetry in the clinical context of targeted radiotherapy.
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Radiometria/métodos , Radioterapia/métodos , Simulação por Computador , Estudos de Avaliação como Assunto , Humanos , Imageamento por Ressonância Magnética , Modelos Anatômicos , Modelos Estatísticos , Modelos Teóricos , Método de Monte Carlo , Imagens de Fantasmas , Fótons , Planejamento da Radioterapia Assistida por Computador , Reprodutibilidade dos Testes , SoftwareRESUMO
Personal monitoring programs for workers handling radioactive materials are influenced by numerous factors as the measurements of radioactivity in tissues or/and in excreta can be carried out using different techniques. This paper summaries the basic procedures needed for accurate and fast measurement of different radionuclides like (235)U, (234)U, (238)U, (226)Ra, (210)Po, (131)I, (99m)Tc, (134)Cs, (137)Cs, (57)Co, (58)Co, and (60)Co. Overviews of in vitro and in vivo monitoring methods are provided as well as methods used to calculate detection limits and internal radiation dose. For the radionuclides of interest, in vivo and in vitro detection limits were converted into committed effective doses to evaluate the applicability and limitations of the systems used at the laboratory. The results proved that the systems' sensitivity is suitable for use in routine monitoring of workers subject to risk of internal exposure from such radionuclides. Consequently, monitoring programs suggested by the Syrian internal dosimetry laboratory are suitable to detect committed effective doses even below 1mSv in most cases.
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Exposição Ocupacional/análise , Exposição à Radiação/análise , Monitoramento de Radiação/métodos , Radioisótopos/análise , Partículas alfa , Raios gama , Humanos , Limite de Detecção , Imagens de Fantasmas , Doses de Radiação , Monitoramento de Radiação/instrumentação , Monitoramento de Radiação/estatística & dados numéricos , Radioisótopos/urina , Síria , Glândula Tireoide/efeitos da radiaçãoRESUMO
One hundred patients with "mild" depressive states, variously referred to as "situational," "reactive," or "neurotic," were studied. During a three- to four-year prospective follow-up, 4% had developed bipolar I, 14% bipolar II, and 22% unipolar disorders with predominantly favorable social outcome. Most of the remainder were suffering from nonaffective disorders; in this group, intermittent depressive symptomatology followed a protacted course (paralleling the underlying disorder) with generally unfavorable outcome. Irrespective of diagnostic subtype, a "characterological" component occurring in 24% of the total sample appeared to predict unfavorable prognosis, including three suicides. The diagnostic usage of the concept of neurotic depression may no longer be clinically meaningful, since it lacks sufficient phenomenological characterization and refers to a heterogeneous group of disorders. The data suggest the merits of a biaxial approach to the nosology of depressive disorders whereby phenomenologically based affective diagnoses are qualified as to the presence or absence of character disorder.
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Transtornos de Adaptação/diagnóstico , Transtorno Bipolar/diagnóstico , Adolescente , Adulto , Transtornos Psicóticos Afetivos/diagnóstico , Idoso , Caráter , Feminino , Seguimentos , Hospitais Psiquiátricos , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos da Personalidade/diagnóstico , Prognóstico , Transtornos Psicofisiológicos/diagnóstico , Esquizofrenia/diagnóstico , Ajustamento SocialRESUMO
AIM: The objective of the present study was to determine oxygen uptake (VO(2)) and percentage of maximum oxygen uptake (%VO2max) in obese and non-obese adolescents during various activities in standardised conditions, and the corresponding %VO2max in free-living conditions. METHODS: Twenty-seven obese and 50 non-obese adolescents aged 12 to 16 years participated in this study. Body composition was assessed by bioelectrical impedance analysis and dual energy X-ray absorptiometry (DXA), VO2max by treadmill tests, VO2 corresponding to various activities by whole body calorimetry, and time and % VO2max corresponding to various activities in free-living conditions using the heart-rate recording method and a physical activity diary. RESULTS: VO2max (l/min) was 27.4% higher in obese than in non-obese subjects (p<0.001), but not significantly different after adjustment for fat-free mass (FFM). In the whole body calorimeters, with the same activity program, % VO2max corresponding to sleep and sedentary activities were lower in obese than in non-obese girls (-15.1% and -12.3%, p<0.05), but not significantly different between obese and non-obese boys. However, walking at 4-5-6 km/h corresponded to 47-59% and 71% of VO2max, respectively, in obese, and 34-41% and 48% of VO2max in non-obese subjects (p<0.001). In free-living conditions, moderate physical activities and sports corresponded to 52% vs 35%, and 39% vs 51% of VO2max, respectively, in obese and non-obese adolescents. CONCLUSIONS: In standardised conditions %VO2max did not correspond to the same type of physical activity in obese compared to non-obese adolescents. Consequently, % VO2max is inadequate for comparing the types of physical activities of obese and non-obese adolescents in free-living conditions.
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Atividade Motora/fisiologia , Obesidade/fisiopatologia , Consumo de Oxigênio/fisiologia , Absorciometria de Fóton , Adolescente , Análise de Variância , Composição Corporal , Criança , Impedância Elétrica , Metabolismo Energético , Feminino , Frequência Cardíaca/fisiologia , Humanos , MasculinoRESUMO
The aim of the present study was to compare total daily and circadian variations of energy expenditure (EE) in 21 prepubescent 10-y-old children (12 boys and 9 girls) and 18 23-y-old adults (9 men and 9 women) under the same conditions by using two large calorimetric chambers. The volunteers followed similar activity programs with four periods of exercise on a cyclergometer. Total daily and sleeping EE adjusted for differences in fat-free mass (FFM) and age were significantly higher in children than in adults by 35% and 27%, respectively (P < 0.001). EE during sleep decreased by 2% per hour in both age groups. Heart rate was significantly higher in girls than in boys. The energy cost of cycling, adjusted for differences in FFM and external mechanical power, was not significantly different in children and adults. The differences in EE between children and adults may partly result from a higher proportion of internal organs in the FFM.
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Envelhecimento/fisiologia , Ritmo Circadiano/fisiologia , Metabolismo Energético/fisiologia , Adulto , Composição Corporal/fisiologia , Índice de Massa Corporal , Calorimetria Indireta , Criança , Feminino , Humanos , Masculino , Esforço Físico/fisiologia , Descanso/fisiologia , Sono/fisiologia , Fatores de TempoRESUMO
BACKGROUND: Adolescence is characterized by rapid anatomic, physiologic, and behavioral alterations expected to induce changes in metabolic rate. OBJECTIVE: The aim of the present study was to investigate variations in daily energy expenditure (DEE) and its main components during adolescence and to quantify their significant determinants. DESIGN: Eighty-three children and adolescents (44 boys and 39 girls aged 10-16 y) participated in this cross-sectional study. Tanner stages ranged from 1 to 5. Body composition was assessed by both the skinfold-thickness method and bioimpedance analysis. Energy expenditure (EE) was determined continuously over 24 h by using 2 whole-body calorimeters. The subjects followed a standardized activity program that included four 15-min periods of exercise on a cycle ergometer. RESULTS: Body composition, DEE, sleeping EE (SEE), resting EE, and EE during meals, miscellaneous activities, and physical exercise varied significantly with sex and stage of puberty. The DEE of boys and girls averaged 8.22 and 7.60 MJ in prepubertal children, 11.35 and 9.10 MJ in pubertal children, and 11.73 and 9.68 MJ in postpubertal adolescents, respectively. The significant determinants of DEE and SEE, respectively, were fat-free mass (r2 = 0.842 and 0.826), sex (r2 = 0.017 and 0.022), and season (r2 = 0.021 and 0.011). Stage of puberty and fat mass were not significant factors. DEE and SEE adjusted for fat-free mass were on average 5% higher in boys than in girls and 6% higher in spring than in autumn. CONCLUSIONS: The DEE of adolescents measured under standardized conditions varied with sex, body composition, and season, but not with stage of puberty. These variables could be predicted accurately from fat-free mass, sex, and season.
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Adolescente/fisiologia , Metabolismo Energético , Puberdade/metabolismo , Composição Corporal , Calorimetria Indireta , Criança , Estudos Transversais , Exercício Físico , Feminino , França , Humanos , Masculino , Análise de Regressão , Estações do Ano , Caracteres Sexuais , Dobras Cutâneas , SonoRESUMO
The aim of the study was to validate the heart rate (HR) recording method against whole body indirect calorimetry in prepubertal children. Nineteen 10.5-yr-old healthy children (10 boys, 9 girls) participated in this study. HR and energy expenditure (EE) were recorded through laboratory tests. Individual relationships between HR and EE were computed (equation established in laboratory). Several models were tested and validated from 24-h measurements of EE and HR by whole body indirect calorimetry. The best fit was obtained with individual polynomial relationships. Mean differences between predicted (equation established in laboratory) and measured total daily EE averaged 7.6 +/- 20.1%. The causes of the differences and the means of improving the accuracy of the prediction equation are discussed.
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Metabolismo Energético/fisiologia , Frequência Cardíaca/fisiologia , Calorimetria Indireta , Criança , Feminino , Humanos , Masculino , Reprodutibilidade dos TestesRESUMO
OBJECTIVE: Three-dimensional computed tomographic angiography (CTA) is a recently developed imaging modality. We demonstrate the value of this noninvasive method in replacing digital subtraction angiography (DSA) in the detection of aneurysms of the circle of Willis in patients with subarachnoid hemorrhage admitted to our institution. METHODS: A helical acquisition was performed for computed tomographic scans obtained for 120 patients with a 1 mm per second table speed and a 1-mm collimation, 1:1 pitch. Axial source images were transferred on a console Advantage Windows workstation (General Electric, Milwaukee, WI) and CTA was obtained using maximum intensity projection reconstruction. All patients had undergone DSA of the circle of Willis (80 patients preoperatively and 40 postoperatively). RESULTS: A total of 129 aneurysms were detected in 107 patients. Three-dimensional CTA disclosed nothing abnormal in 13 patients. Ninety-two patients sustained one aneurysm, 10 patients sustained two, 3 patients sustained three, and 2 patients sustained four. All results were confirmed by DSA. In two cases, aneurysms of the middle cerebral artery were defected by CTA but not by DSA. When using angiographic views, the aneurysm was always masked by a branch of the middle cerebral artery. CONCLUSION: The sensitivity of three-dimensional CTA is comparable with that of DSA, and its specificity is 100%. Because CTA is simple, quick, noninvasive, and reliable, we think that it can eventually replace DSA.
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Aneurisma Roto/diagnóstico por imagem , Angiografia Cerebral/instrumentação , Processamento de Imagem Assistida por Computador/instrumentação , Aneurisma Intracraniano/diagnóstico por imagem , Hemorragia Subaracnóidea/diagnóstico por imagem , Tomografia Computadorizada por Raios X/instrumentação , Adulto , Idoso , Aneurisma Roto/cirurgia , Angiografia Digital/instrumentação , Círculo Arterial do Cérebro/diagnóstico por imagem , Círculo Arterial do Cérebro/cirurgia , Feminino , Humanos , Aneurisma Intracraniano/cirurgia , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Hemorragia Subaracnóidea/cirurgiaRESUMO
OBJECT: In this study the authors sought to estimate the frequency, seriousness, and delay of rebleeding in a homogeneous series of 20 patients whom they treated between May 1987 and May 1997 for arteriovenous fistulas (AVFs) that were revealed by intracranial hemorrhage (ICH). The natural history of intracranial dural AVFs remains obscure. In many studies attempts have been made to evaluate the risk of spontaneous hemorrhage, especially as a function of the pattern of venous drainage: a higher occurrence of bleeding was reported in AVFs with retrograde cortical venous drainage, with an overall estimated rate of 1.8% per year in the largest series in the literature. However, very few studies have been designed to establish the risk of rebleeding, an omission that the authors seek to remedy. METHODS: Presenting symptoms in the 20 patients (17 men and three women, mean age 54 years) were acute headache in 12 patients (60%), acute neurological deficit in eight (40%), loss of consciousness in five (25%), and generalized seizures in one (5%). Results of the clinical examination were normal in five patients and demonstrated a neurological deficit in 12 and coma in three. Computerized tomography scanning revealed intracranial bleeding in all cases (15 intraparenchymal hematomas, three subarachnoid hemorrhages, and two subdural hematomas). A diagnosis of AVF was made with the aid of angiographic studies in 19 patients, whereas it was a perioperative discovery in the remaining patient. There were 12 Type III and eight Type IV AVFs according to the revised classification of Djindjian and Merland, which meant that all AVFs in this study had retrograde cortical venous drainage. The mean duration between the first hemorrhage and treatment was 20 days. Seven patients (35%) presented with acute worsening during this delay due to radiologically proven early rebleeding. Treatment consisted of surgery alone in 10 patients, combined embolization and surgery in eight, embolization only in one, and stereotactic radiosurgery in one. Three patients died, one worsened, and in 16 (80%) neurological status improved, with 15 of 16 AVFs totally occluded on repeated angiographic studies (median follow up 10 months). CONCLUSIONS: The authors found that AVFs with retrograde cortical venous drainage present a high risk of early rebleeding (35% within 2 weeks after the first hemorrhage), with graver consequences than the first hemorrhage. They therefore advocate complete and early treatment in all cases of AVF with cortical venous drainage revealed by an ICH.
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Fístula Arteriovenosa/complicações , Hemorragia Cerebral/etiologia , Dura-Máter/irrigação sanguínea , Malformações Arteriovenosas Intracranianas/complicações , Adulto , Idoso , Fístula Arteriovenosa/classificação , Fístula Arteriovenosa/cirurgia , Fístula Arteriovenosa/terapia , Angiografia Cerebral , Hemorragia Cerebral/diagnóstico por imagem , Veias Cerebrais/anormalidades , Veias Cerebrais/diagnóstico por imagem , Coma/etiologia , Terapia Combinada , Embolização Terapêutica , Feminino , Seguimentos , Cefaleia/etiologia , Hematoma/diagnóstico por imagem , Hematoma/etiologia , Hematoma Subdural/diagnóstico por imagem , Hematoma Subdural/etiologia , Humanos , Malformações Arteriovenosas Intracranianas/classificação , Malformações Arteriovenosas Intracranianas/cirurgia , Malformações Arteriovenosas Intracranianas/terapia , Masculino , Pessoa de Meia-Idade , Radiocirurgia , Recidiva , Convulsões/etiologia , Hemorragia Subaracnóidea/diagnóstico por imagem , Hemorragia Subaracnóidea/etiologia , Taxa de Sobrevida , Tomografia Computadorizada por Raios X , Inconsciência/etiologiaRESUMO
OBJECT: The goal of this study was to determine the somatotopical structure-function relationships of the primary motor cortex in individual patients by using functional magnetic resonance (fMR) imaging. This was done to assess whether there is a displacement of functional areas compared with anatomical landmarks in patients harboring brain tumors close to the central region, and to validate these findings with intraoperative cortical stimulation. METHODS: One hundred twenty hemispheres in 60 patients were studied by obtaining blood oxygen level-dependent fMR images in patients while they performed movements of the foot, hand, and face on both sides. There was a good correspondence between anatomical landmarks in the deep portion of the central sulcus on axial slices and the somatotopical organization of primary motor areas. Pixels activated during hand movements were centered on a small characteristic digitation; those activated during movements in the face and foot areas were located in the lower portion of the central sulcus (lateral to the hand area) and around the termination of the central sulcus, respectively. In diseased hemispheres, signal-intensity changes were still observed in the projection of the expected anatomical area. The fMR imaging data mapped intraoperative electrical stimulation in 92% of positive sites. CONCLUSIONS: There was a high correspondence between the somatotopical anatomy and function in the central sulcus, which was similar in normal and diseased hemispheres. The fMR imaging and electrical stimulation data were highly concordant. These findings may enable the neurosurgeon to locate primary motor areas more easily during surgery.
Assuntos
Neoplasias Encefálicas/fisiopatologia , Estimulação Elétrica , Imageamento por Ressonância Magnética , Monitorização Intraoperatória , Córtex Motor/fisiopatologia , Adulto , Idoso , Astrocitoma/patologia , Astrocitoma/fisiopatologia , Astrocitoma/cirurgia , Mapeamento Encefálico , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/cirurgia , Face/fisiologia , Pé/fisiologia , Mãos/fisiologia , Humanos , Processamento de Imagem Assistida por Computador , Pessoa de Meia-Idade , Atividade Motora/fisiologia , Córtex Motor/patologia , Oligodendroglioma/patologia , Oligodendroglioma/fisiopatologia , Oligodendroglioma/cirurgia , Oxigênio/sangue , Estudos RetrospectivosRESUMO
BACKGROUND: Energy intake at breakfast affects the performance of creativity tests, memory recall and voluntary physical endurance in children before lunch, and food craving during the whole day. OBJECTIVES: To assess the adequacy of breakfast energy supply (BES) and energy expenditure (EE) in adolescents during a schoolday without or with 2 h of physical education lesson (PEL) in the morning. DESIGN: Sixty adolescents (four groups of 14-16 boys and girls aged 12-16 y) participated in a cross-sectional study. Activity patterns and EE were determined by whole-body calorimetry during 36 h and in free-living conditions during 5 days using both a diary and the validated heart rate recording method. BES was determined by weighing individual foods. The pyloric energy flow was assessed using a model of fractional stomach emptying. RESULTS: BES averaged 24.9% (s.d.=6.1) of daily EE in the four groups of subjects. It covered the mean morning EE on a schoolday without PEL, but not in a schoolday with 2 h of PEL in any group. When PEL took place from 8-10 am the cumulative EE exceeded the cumulative pyloric energy flow after 105-150 min, that is during the PEL session, and the energy deficit increased until lunch. With a light breakfast (BES-1 s.d.) energy deficiency happened after 90 min. CONCLUSION: The results stress the need for a heavy breakfast for children and adolescents on the days with PEL in the morning, and a carbohydrate rich snack at 10 am to improve attention, memory and willing participation in physical activities.
Assuntos
Ritmo Circadiano/fisiologia , Ingestão de Energia/fisiologia , Metabolismo Energético/fisiologia , Comportamento Alimentar/fisiologia , Atividade Motora/fisiologia , Adolescente , Análise de Variância , Calorimetria , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Fatores de TempoRESUMO
BACKGROUND: Changes in lifestyle and increases in sedentary activities during recent decades have been shown to contribute to the prevalence of overweight in adolescents. OBJECTIVES: To determine the inter-individual variability and the day-to-day variations in daily energy expenditure (DEE) and activity pattern, and the energy costs and EE of the various activities of adolescents in free-living conditions. DESIGN: Sixty adolescents (four groups of 14-16 boys or girls aged 12-16 y) participated in this cross-sectional study during spring or autumn. Activity patterns and EE were determined during five consecutive days, using both a diary and the heart rate recording method validated by whole-body calorimetry and laboratory tests. RESULTS: Mean DEE increased significantly with age in boys, but not in girls. However, the physical activity level did not vary significantly with sex and age. Mean DEE was significantly higher in spring than in autumn in the 12.6-y-old subjects. It was also 21% higher during the free days than during the schooldays in the active subjects, but 7% lower in the sedentary subjects. The energy cost of 22 activities was determined. Time and energy devoted to moderate and sport activities exhibited great inter-individual variability. They were lower in girls than in boys and decreased with age. The increase in EE resulting from moderate and sport activities instead of sedentary activities ranged from 0.2 to 2.7 MJ/day over the week. CONCLUSION: The great variability in DEE of adolescents resulted mainly from differences in the nature, duration and intensity of physical activities during the free days.