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BACKGROUND: The categorical approach to diagnosing mental disorders has been criticized for a number of reasons (e.g., high rates of comorbidity; larger number of diagnostic categories and combination). Diverse alternatives have been proposed using a hybrid or totally dimensional perspective. Despite the evidence supporting use of the Multidimensional Emotional Disorders Inventory (MEDI) for assessing the transdiagnostic dimensions of Emotional Disorders using a dimensional-categorical hybrid approach, no data exist on Spanish clinical samples. The present study explores the validity and reliability of the 49-item MEDI in a clinical sample and provides data for its use. METHODS: A total of 280 outpatients with emotional disorders attended in different Spanish public Mental Health Units in Spain filled out all questionnaires during the assessment phase and the MEDI again one week after. The instruments used evaluate four main constructs: personality, mood, anxiety and avoidance. RESULTS: The nine original factors were confirmed and showed adequate reliability (α: 0.66-0.91) and stability (r = 0.76-0.87). No differences in mean scores by sex were presented in any subscale (p ≥ .07). The MEDI subscales correlated significantly with the scales of each of the selected constructs (0.45 < r < 0.76). LIMITATIONS: The main limitations of this study were the limited sample size and not being able to count on MEDI scores post-transdiagnostic intervention. CONCLUSIONS: The MEDI demonstrates adequate reliability and validity. It allows to assess diverse symptoms efficiently, thus being of interest for clinical studies and practice.
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Transtornos de Ansiedade , Transtornos do Humor , Humanos , Reprodutibilidade dos Testes , Transtornos do Humor/diagnóstico , Transtornos de Ansiedade/psicologia , Ansiedade/psicologia , Inquéritos e Questionários , PsicometriaRESUMO
INTRODUCTION: Several socioeconomic population factors have been related to the aetiology of Legg-Calve-Perthes disease (LCPD), such as its higher incidence in the urban population, living on the periphery of urban centres or residing at a certain latitude with respect to the world equator. The incidence in some other countries is known but the incidence of the process in our environment is unknown an important fact to allocate the social and health resources necessary for the treatment of the disease. Therefore, the aim of the present study is to determine the incidence of LCPD in Health Area 2 of Madrid. MATERIAL AND METHODS: The incidence of LCPD is analysed in Healthcare Area 2 of Madrid because it is the Mediterranean area that has been scarcely studied. It is an area with very low geographic mobility, a medium-low socioeconomic level, and mostly composed of workers in companies in the secondary and tertiary sectors. The data were obtained from the hospital databases of Area 2 between the years 1994 and 2010. The inclusion criteria were the presence of LCPD and the territorial distribution of the population in Area 2 of Madrid. CONCLUSIONS: The incidence of LCPD in this Mediterranean population of an industrial area was 1.59 cases/year and 100,000 inhabitants, close to that found in populations of similar latitudes, but nevertheless it is an industrial area and socioeconomic level similar to United Kingdom populations with a much higher incidence.
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The utility of cancer whole genome and transcriptome sequencing (cWGTS) in oncology is increasingly recognized. However, implementation of cWGTS is challenged by the need to deliver results within clinically relevant timeframes, concerns about assay sensitivity, reporting and prioritization of findings. In a prospective research study we develop a workflow that reports comprehensive cWGTS results in 9 days. Comparison of cWGTS to diagnostic panel assays demonstrates the potential of cWGTS to capture all clinically reported mutations with comparable sensitivity in a single workflow. Benchmarking identifies a minimum of 80× as optimal depth for clinical WGS sequencing. Integration of germline, somatic DNA and RNA-seq data enable data-driven variant prioritization and reporting, with oncogenic findings reported in 54% more patients than standard of care. These results establish key technical considerations for the implementation of cWGTS as an integrated test in clinical oncology.
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Perfilação da Expressão Gênica , Neoplasias , Criança , Estudos de Viabilidade , Perfilação da Expressão Gênica/métodos , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Humanos , Neoplasias/diagnóstico , Neoplasias/genética , Estudos Prospectivos , Transcriptoma/genética , Sequenciamento Completo do Genoma/métodos , Adulto JovemRESUMO
Lead-210 from natural atmospheric fallout is widely used in multidisciplinary studies to date recent sediments. Some of the 210Pb-based dating models can produce historical records of sediment accumulation rates (SAR) and initial activity concentrations (A0). The former have been profusely used to track past changes in the sedimentary conditions. Both physical magnitudes are differently affected by model errors (those arising for the partial or null accomplishment of some model assumptions). This work is aimed at assessing the effects on SAR and A0 of model errors in the CRS, CS, PLUM and TERESA dating models, due to random variability in 210Pb fluxes, which is a usual sedimentary condition. Synthetic cores are used as virtual laboratories for this goal. Independently of the model choice, SARs are largely affected by model errors, resulting in some large and spurious deviations from the true values. This questions their general use for tracking past environmental changes. A0 are less sensitive to model errors and their trends of change with time may reflect real changes in sedimentary conditions, as it is shown with some real cores from varved sediments.
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Monitoramento de Radiação , Poluentes Radioativos da Água , Monitoramento Ambiental , Sedimentos Geológicos , Chumbo , Radioisótopos de Chumbo/análise , Poluentes Radioativos da Água/análiseRESUMO
Understanding the behaviour of particulate matter and chemicals at the sediment-water interface (SWI) is of interest in environmental studies and risk assessments. These processes are still poorly understood, and this work aims to gain relevant insights by using a kinetic reactive transport model. It merges early diagenetic processes and box models for the uptake kinetics. Numerical solutions have been found for synthetic scenarios and for studying real cases from the literature (210Pb and Chernobyl fallout radionuclides in Lake Sniardwy, Poland, and 7Be in sediments from Tema Harbour, Ghana). The study identifies a series of factors that dynamically interact to govern the final fate of tracers in the SWI region, leading to a wide diversity of behaviours. When a term of eddy diffusivity is included in the upper regions of the pore fluid, which seems feasible for some energetic scenarios, it is possible to explain the observed large penetration depths for Cs and Be, while high particle-reactive elements are retained in thinner sediment layers. Desorption from the sediment occurs through the pore fluid as diffusive fluxes. Transient depth profiles of tracer concentrations can last from months up to a year, and they can show subsurface maxima at positions unrelated with the accretion rate. In the application cases, the model explained a wide set of observational data that was beyond the capabilities of other approaches involving physical mixing of solids and equilibrium kd. This modelling study could provide useful guidance for future research works.
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Poluentes Ambientais , Monitoramento de Radiação , Cinética , Radioisótopos , ÁguaRESUMO
BACKGROUND: This study aimed to synthesize the evidence of the effect of practicing Tai Chi on oxidative stress markers (OxSM). METHODS: This systematic review and meta-analysis was conducting using the MEDLINE, Cochrane Library, ScienceDirect, Scopus, Epistemonikos, Lilacs, and Ovid databases to identify randomized (RCT) and non-randomized (NRCT) clinical trials that evaluated the Tai Chi effect on OxSM compared to sedentary behavior, walking or yoga. Pooled mean differences (MDs) with 95% confidence intervals (95%CI) were estimated using the inverse variance method to determine the effect of Tai Chi on OxSM. PROSPERO register: CRD42019138362. RESULTS: Five RCT and five NRCT were included. Compared to sedentary behavior, regular Tai Chi practice increases the levels of the enzymes superoxide dismutase (MD = 34.97 U/mL, (95%CI, 9.45 to 60.48), 344 participants) and catalase (MD = 15.63 U/mL, (95%CI, 4.05 to 27.22), 110 participants), as well as reducing the levels of lipoperoxides (MD = -0.02 µmol/L, (95%CI, -0.04 to -0.00), 234 participants). For comparisons with walking or yoga, only one study per activity was identified comparing the effect on OxSM. CONCLUSIONS: Regular Tai Chi practice increases the levels of superoxide dismutase and catalase, as well as reducing the levels of lipoperoxides. More studies are necessary to determine the effect of Tai Chi on OxSM when compared to other physical activities.
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Meditação , Tai Chi Chuan , Humanos , Estresse Oxidativo , Qualidade de Vida , CaminhadaRESUMO
INTRODUCTION: Perthes disease often produces a congruent nonspherical coxa. The most widely accepted cause is initial bone collapse, but some authors refer to physeal injury as the cause of this deformity. We analyze this elliptical process in cases of congruent nonspherical Perthes. METHODS: Retrospective case-control study of 49 unilateral class III-IV Perthes cases that were not operated on. Results were compared with 49 healthy contralateral hips. The following radiological variables were determined both in AP and lateral projection, and at 4 points in time of the disease: ovalization index (OI), arthrotrochanteric distance, intraphysial angle, physeal narrowing, presence of double epiphyseal reosification nucleus, physeal length and Reimers index. RESULTS: The initial OI was 1.7 in the early reosification phase and final OI was 2.07 at physeal closure. The OI in the control cases was invariably 1.4. There was a direct relation between a high index and the initial appearance of a double epiphyseal ossification nucleus, asymmetric physeal effacement and the increase of the intraphyseal angle in both radiographic projections. CONCLUSIONS: The elliptical process of the femoral head occurs progressively throughout the disease and not only during bone collapse. It starts in the reosification phase and ends when growth stops. The initial risk signs found were the appearance of the double nucleus of reosification, the progressive angulation of the physis and the progressive increase in the rate of ovalization.
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MOTIVATION: There is an increasing amount of transcriptomic and genomic data available for planarians with the advent of both traditional and single-cell RNA sequencing technologies. Therefore, exploring, visualizing and making sense of all these data in order to understand planarian regeneration and development can be challenging. RESULTS: In this work, we present PlanExp, a web-application to explore and visualize gene expression data from different RNA-seq experiments (both traditional and single-cell RNA-seq) for the planaria Schmidtea mediterranea. PlanExp provides tools for creating different interactive plots, such as heatmaps, scatterplots, etc. and links them with the current sequence annotations both at the genome and the transcript level thanks to its integration with the PlanNET web application. PlanExp also provides a full gene/protein network editor, a prediction of genetic interactions from single-cell RNA-seq data, and a network expression mapper that will help researchers to close the gap between systems biology and planarian regeneration. AVAILABILITY AND IMPLEMENTATION: PlanExp is freely available at https://compgen.bio.ub.edu/PlanNET/planexp. The source code is available at https://compgen.bio.ub.edu/PlanNET/downloads. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.
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Planárias/genética , Animais , RNA-Seq , Análise de Sequência de RNA , Software , Sequenciamento do ExomaRESUMO
MOTIVATION: Protein-protein interactions (PPIs) are very important to build models for understanding many biological processes. Although several databases hold many of these interactions, exploring them, selecting those relevant for a given subject and contextualizing them can be a difficult task for researchers. Extracting PPIs directly from the scientific literature can be very helpful for providing such context, as the sentences describing these interactions may give insights to researchers in helpful ways. RESULTS: We have developed PPaxe, a python module and a web application that allows users to extract PPIs and protein occurrence from a given set of PubMed and PubMedCentral articles. It presents the results of the analysis in different ways to help researchers export, filter and analyze the results easily. AVAILABILITY AND IMPLEMENTATION: PPaxe web demo is freely available at https://compgen.bio.ub.edu/PPaxe. All the software can be downloaded from https://compgen.bio.ub.edu/PPaxe/download, including a command-line version and docker containers for an easy installation. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.
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Software , Bases de Dados Factuais , Proteínas , PubMed , PublicaçõesRESUMO
The Sancho Reservoir (SW Spain) was built in 1962, about the time of maximum 137Cs fallout, and it has been affected by acid mine drainage (AMD) particularly since the mining cease in 2001. This is a unique scenario for studying the radiogeochronological fingerprints in AMD-affected sediments deposited over the former flood plain. A sediment core sampled in 2011 was analysed for bulk density, 137Cs, 239Pu, 240Pu, 210Pb, 226Ra, 228Ra, 234Th (238U) and 40K, and studied with various radiometric dating models. Bulk density revealed unsteady compaction and likely depositional events. The activity concentrations of 226Ra, 228Ra, 234Th (238U) and 40K were uniform down-core, but declining overall in the upper 0-25cm, revealing changes in provenance except for 238U, which increased in the top 10cm likely due to its supply by AMD. The AMD fingerprint was also found in the 239+240Pu/137Cs activity ratio, which increased in the top sediment layers. The 137Cs and 239+240Pu profiles show well defined peaks at the same depth, with inventories being about four times higher than the expected integrated atmospheric deposition in the area. The unsupported 210Pb (210Pbexc) showed a complex non-monotonic profile interrupted at several sections, particularly around the 137Cs peak. The whole dataset cannot be interpreted in terms of continuous sedimentation processes. Based upon correlated features in the bulk density and 210Pbexc profiles, a series of depositional events (likely linked to peaks in the rainfall records) have been identified in the core. These events date back to the period comprised since the construction of the dam until its increase in height in 1972, which likely displaced upstream the main depositional area of riverine loads, as inferred from sediment trap data. The CRS (with a reference date) and (a piecewise) CIC models have been used for complementing and discussing the chronology.
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Motivation: Planarians are emerging as a model organism to study regeneration in animals. However, the little available data of protein-protein interactions hinders the advances in understanding the mechanisms underlying its regenerating capabilities. Results: We have developed a protocol to predict protein-protein interactions using sequence homology data and a reference Human interactome. This methodology was applied on 11 Schmidtea mediterranea transcriptomic sequence datasets. Then, using Neo4j as our database manager, we developed PlanNET, a web application to explore the multiplicity of networks and the associated sequence annotations. By mapping RNA-seq expression experiments onto the predicted networks, and allowing a transcript-centric exploration of the planarian interactome, we provide researchers with a useful tool to analyse possible pathways and to design new experiments, as well as a reproducible methodology to predict, store, and explore protein interaction networks for non-model organisms. Availability and implementation: The web application PlanNET is available at https://compgen.bio.ub.edu/PlanNET. The source code used is available at https://compgen.bio.ub.edu/PlanNET/downloads. Contact: jabril@ub.edu. Supplementary information: Supplementary data are available at Bioinformatics online.
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Perfilação da Expressão Gênica/métodos , Planárias/genética , Mapas de Interação de Proteínas , Regeneração , Software , Animais , Humanos , Internet , Planárias/fisiologia , Análise de Sequência de RNA/métodosRESUMO
The application of next-generation sequencing (NGS) techniques for the identification of viruses present in urban sewage has not been fully explored. This is partially due to a lack of reliable and sensitive protocols for studying viral diversity and to the highly complex analysis required for NGS data processing. One important step towards this goal is finding methods that can efficiently concentrate viruses from sewage samples. Here the application of a virus concentration method based on skimmed milk organic flocculation (SMF) using 10L of sewage collected in different seasons enabled the detection of many viruses. However, some viruses, such as human adenoviruses, could not always be detected using metagenomics, even when quantitative PCR (qPCR) assessments were positive. A targeted metagenomic assay for adenoviruses was conducted and 59.41% of the obtained reads were assigned to murine adenoviruses. However, up to 20 different human adenoviruses (HAdV) were detected by this targeted assay being the most abundant HAdV-41 (29.24%) and HAdV-51 (1.63%). To improve metagenomics' sensitivity, two different protocols for virus concentration were comparatively analysed: an ultracentrifugation protocol and a lower-volume SMF protocol. The sewage virome contained 41 viral families, including pathogenic viral species from families Caliciviridae, Adenoviridae, Astroviridae, Picornaviridae, Polyomaviridae, Papillomaviridae and Hepeviridae. The contribution of urine to sewage metavirome seems to be restricted to a few specific DNA viral families, including the polyomavirus and papillomavirus species. In experimental infections with sewage in a rhesus macaque model, infective human hepatitis E and JC polyomavirus were identified. Urban raw sewage consists of the excreta of thousands of inhabitants; therefore, it is a representative sample for epidemiological surveillance purposes. The knowledge of the metavirome is of significance to public health, highlighting the presence of viral strains that are circulating within a population while acting as a complex matrix for viral discovery.
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Metagenômica , Vigilância em Saúde Pública , Esgotos/virologia , Vírus/isolamento & purificação , Animais , Humanos , Macaca mulatta , Espanha , Vírus/genéticaRESUMO
Hepatitis is a general term meaning inflammation of the liver, which can be caused by a variety of viruses. However, a substantial number of cases remain with unknown aetiology. We analysed the serum of patients with clinical signs of hepatitis using a metagenomics approach to characterize their viral species composition. Four pools of patients with hepatitis without identified aetiological agents were evaluated. Additionally, one pool of patients with hepatitis E (HEV) and pools of healthy volunteers were included as controls. A high diversity of anelloviruses, including novel sequences, was found in pools from patients with hepatitis of unknown aetiology. Moreover, viruses recently associated with gastroenteritis as sapovirus GV.2 and astrovirus VA3 were also detected only in those pools. Besides, most of the HEV genome was recovered from the HEV pool. Finally, GB virus C and human endogenous retrovirus were found in the HEV and healthy pools. Our study provides an overview of the virome in serum from hepatitis patients suggesting a potential role of these viruses not previously described in cases of hepatitis. However, further epidemiologic studies are necessary to confirm their contribution to the development of hepatitis.
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Anelloviridae/isolamento & purificação , Hepatite Viral Humana/virologia , Mamastrovirus/isolamento & purificação , Sapovirus/isolamento & purificação , Viremia/sangue , Doença Aguda , Anelloviridae/classificação , Estudos de Casos e Controles , Hepatite Viral Humana/sangue , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Mamastrovirus/classificação , Filogenia , Viremia/classificaçãoRESUMO
The Volta and Pra estuaries (Ghana, West Africa) are dynamical sedimentary systems whose natural equilibrium is being affected by anthropogenic activities. This paper reports depth-distributions of 210Pb, 226Ra, 234Th, 40K, 228Ra and 137Cs for two sediment cores from these estuaries. Bulk densities were not steady-state and well correlated with 40K (p < 0.00005). Unsupported 210Pb profiles were incomplete, non-monotonic and showed large fluctuations. The assumptions involved in the common 210Pb-based dating models were not meet in these dynamical scenarios, and the use of 137Cs as a time-marker is difficult in Equatorial and South-Hemisphere countries due to its low fallout rates. Chronologies have been solved with the new 210Pb-based TERESA model, which operates with varying but statistically correlated fluxes and sediment accumulation rates (SAR). The core from the Volta reflects the conditions prevailing after the construction of the Akosombo Dam, with a mean SAR of 1.05 ± 0.03 g cm-2·y-1, while a higher value of 2.73 ± 0.06 g cm-2·y-1 was found in the Pra, affected by intense gold mining activities along its course. Radiological and radioecological assessments have been conducted by applying the UNSCEAR protocols and the ERICA model, respectively. The measured radionuclide concentrations do not pose any significant risk for the environment and human health.
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Monitoramento de Radiação , Datação Radiométrica , Poluentes Radioativos da Água/análise , Radioisótopos de Césio/análise , Estuários , Sedimentos Geológicos , Gana , Radioisótopos de Chumbo/análise , MineraçãoRESUMO
Microbial food-borne diseases are still frequently reported despite the implementation of microbial quality legislation to improve food safety. Among all the microbial agents, viruses are the most important causative agents of food-borne outbreaks. The development and application of a new generation of sequencing techniques to test for viral contaminants in fresh produce is an unexplored field that allows for the study of the viral populations that might be transmitted by the fecal-oral route through the consumption of contaminated food. To advance this promising field, parsley was planted and grown under controlled conditions and irrigated using contaminated river water. Viruses polluting the irrigation water and the parsley leaves were studied by using metagenomics. To address possible contamination due to sample manipulation, library preparation, and other sources, parsley plants irrigated with nutritive solution were used as a negative control. In parallel, viruses present in the river water used for plant irrigation were analyzed using the same methodology. It was possible to assign viral taxons from 2.4 to 74.88% of the total reads sequenced depending on the sample. Most of the viral reads detected in the river water were related to the plant viral families Tymoviridae (66.13%) and Virgaviridae (14.45%) and the phage viral families Myoviridae (5.70%), Siphoviridae (5.06%), and Microviridae (2.89%). Less than 1% of the viral reads were related to viral families that infect humans, including members of the Adenoviridae, Reoviridae, Picornaviridae and Astroviridae families. On the surface of the parsley plants, most of the viral reads that were detected were assigned to the Dicistroviridae family (41.52%). Sequences related to important viral pathogens, such as the hepatitis E virus, several picornaviruses from species A and B as well as human sapoviruses and GIV noroviruses were detected. The high diversity of viral sequences found in the parsley plants suggests that irrigation on fecally-tainted food may have a role in the transmission of a wide diversity of viral families. This finding reinforces the idea that the best way to avoid food-borne viral diseases is to introduce good field irrigation and production practices. New strains have been identified that are related to the Picornaviridae and distantly related to the Hepeviridae family. However, the detection of a viral genome alone does not necessarily indicate there is a risk of infection or disease development. Thus, further investigation is crucial for correlating the detection of viral metagenomes in samples with the risk of infection. There is also an urgent need to develop new methods to improve the sensitivity of current Next Generation Sequencing (NGS) techniques in the food safety area.
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Vírus de DNA/classificação , Vírus de DNA/isolamento & purificação , Contaminação de Alimentos/análise , Doenças Transmitidas por Alimentos/virologia , Petroselinum/virologia , Vírus de RNA/classificação , Vírus de RNA/isolamento & purificação , Poluição da Água/análise , Surtos de Doenças , Fezes/virologia , Alimentos/virologia , Inocuidade dos Alimentos , Genoma Viral/genética , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Metagenoma/genética , Metagenômica , Vírus de RNA/genética , Rios/virologiaRESUMO
INTRODUCTION: Guillain-Barre syndrome is classically defined as a symmetrical ascending acute polyradiculoneuropathy, although there are atypical variants that make diagnosis difficult. CASE REPORTS: The medical data of six patients in our hospital area are collected during the first quarter of 2013. Lumbar punctures, imaging, neurophysiological studies, ganglioside antibodies and serologies have been proposed in all cases. We focus on the atypical features as late hyporeflexia, increased frequency of asymmetry and distal paresis and initial fever. From a neurophysiological point of view, all patients presented sensorimotor axonal forms. The most consistent datas in early studies is the F wave's alteration. A Miller Fisher variant associated with faciocervicobraquial paresis and cerebral reversible vasoconstriction syndrome has been detected. A bilateral brachial paresis and lumbar polyradiculopathy in the context of influenza A infection is other interesting case. The saltatory variant with cranial nerve involvement and lower limbs paresis has been demonstrated in one patient. Bands in cerebrospinal fluid are positive in three cases and anti-ganglioside antibodies in one patient. The syndrome of inappropriate secretion of antidiuretic hormone may explain some of the hyponatremias registered. The first line of treatment are inmunoglobulins in all patients. Plasmapheresis exchanges has been used as an additional therapy in four cases. CONCLUSIONS: These clusters of six axonal cases with atypical clinical features justifies the need for knowledge of these variants in order to achieve an early treatment. Late hyporeflexia and brachialfaciocervico, saltatory and lumbar forms should be considered in the spectrum of Guillain-Barre syndrome. The etiological study should rule out a lots of pathogens as influenza A.
TITLE: Agrupacion de casos de sindrome de Guillain-Barre atipico: es necesario redefinir los criterios diagnosticos y los protocolos microbiologicos?Introduccion. El sindrome de Guillain-Barre se define clasicamente como una polirradiculopatia aguda simetrica ascendente, si bien existen variantes atipicas que dificultan el diagnostico. Casos clinicos. Se recogen las historias clinicas de seis pacientes de nuestra area hospitalaria durante el primer trimestre de 2013. Se han realizado punciones lumbares, electroneurograma-electromiograma y analiticas con autoinmunidad en todos los casos. El conjunto de la muestra destaca por la presencia de caracteristicas atipicas, como hiporreflexia tardia, mayor frecuencia de asimetria y afectacion distal, asi como fiebre inicial. Desde el punto de vista neurofisiologico, todos los pacientes presentan formas axonales de tipo sensitivomotoras y las alteraciones de la onda F son el dato mas precoz. Se identifica una variante de sindrome de Miller Fisher asociada a paresia faciocervicobraquial y sindrome de vasoconstriccion cerebral reversible. Otro caso auna las variantes de paresia braquial bilateral y polirradiculopatia lumbar en el contexto de infeccion aguda por influenza A. La variante saltatoria ha sido demostrada en otro paciente. Todos los pacientes han recibido tratamiento con inmunoglobulinas, y en dos de ellos se sumo la plasmaferesis como terapia adicional. Conclusiones. La agrupacion de seis casos axonales con caracteristicas clinicas atipicas justifica la necesidad del conocimiento de estas variantes para lograr un diagnostico y un tratamiento precoz. La hiporreflexia tardia y las formas faciocervicobraquiales, saltatorias y lumbares deben considerarse dentro del espectro del sindrome de Guillain-Barre. El estudio etiologico debe incluir el cribado de numerosos patogenos, entre los que debe incluirse el virus influenza A.
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Síndrome de Guillain-Barré/diagnóstico , Adulto , Idoso , Autoanticorpos/sangue , Análise por Conglomerados , Eletroencefalografia , Eletromiografia , Feminino , Gangliosídeos/imunologia , Síndrome de Guillain-Barré/metabolismo , Síndrome de Guillain-Barré/fisiopatologia , Síndrome de Guillain-Barré/virologia , Humanos , Vírus da Influenza A , Influenza Humana/complicações , Masculino , Pessoa de Meia-Idade , Síndrome de Miller Fisher/diagnóstico , Condução Nervosa , Reflexo Anormal , Avaliação de Sintomas , VasoconstriçãoRESUMO
BACKGROUND: The presence of liver fibrosis is the common denominator in numerous chronic liver diseases that can progress to fibrosis and hepatocellular carcinoma. Most important, with respect to frequency, are viral hepatitis and non-alcoholic fatty liver disease, the prevalence of which is increasing in epidemic proportions. Liver biopsy, albeit imperfect, continues to be the criterion standard, but in many clinical situations tends to be replaced with noninvasive imaging methods. OBJECTIVES: The aim of the present article was to describe our imaging department experience with magnetic resonance elastography and to analyze and discuss recently published results in gastroenterology, hepatology, and radiology from other authors in the literature, complemented with a PubMed search covering the last 10 years. RESULTS AND CONCLUSIONS: Magnetic resonance elastography is an efficacious, noninvasive method with results that are concordant with liver biopsy. It is superior to ultrasound elastography because it evaluates a much greater volume of hepatic tissue and shows the often heterogeneous lesion distribution. The greatest advantage of the magnetic resonance protocol described is the fact that it quantifies fibrosis, fat content, and iron content in the same 25min examination specifically directed for that purpose, resulting in a favorable cost-benefit ratio for the patient and/or institution.