Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 73
Filtrar
1.
Nanotechnology ; 34(32)2023 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-37163999

RESUMO

The microwave detection capability of GaN-based asymmetric planar nanodiodes (so-called Self-Switching Diode, SSD, due to its non-linearity) has been characterized in a wide temperature range, from 70 K up to 300 K. At low temperature, microwave measurements reveal an enhancement of the responsivity at frequencies below 1 GHz, which, together with a pronounced hysteresis in the DC curves, indicate a significant influence of the surface states. This leads to a significant variability and non-repeatability which needs to be reduced since it degrades the accuracy of the detection. For this sake, the RF characterization was repeated after applying a positive/negative voltage able to fill/empty the surface states in order to have a well-established preconditioned state. As a consequence of the positive pre-soak bias, a significant enhancement of the measured responsivity, with a × 10 increase at low temperature. The RF detection measurements after such preconditioning contains a time dependence induced by the slow discharge mechanism of the traps, so that the improved responsivity remains even after 100s of seconds. On the other hand, a negative voltage pre-soak benefits the discharge process, thus suppressing the low frequency dispersion and the important variability of the detection without the pre-conditioning step. We also show that the relation between the voltage and current responsivities in each case allows to explain the impact of the surface charges in terms of the device impedance.

2.
Appl Opt ; 62(6): 1483-1491, 2023 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-36821308

RESUMO

The simultaneous surface and internal measurements from a chemically modified cortical bovine bone suffering a plastic range deformation are presented. Since the bone is an anisotropic structure, its mechanical response could be modified if its organic or inorganic phases change. The latter could result in high plastic deformations, where the interferometrical signal from an optical analysis is easily de-correlated. In this work, digital holography interferometry (DHI) and Fourier domain optical coherence tomography (FD-OCT) are used to analyze the plastic range deformation of the bone under compression. The simultaneous use of these two optical methods gives information even when one of them de-correlates. The surface results retrieved with DHI show the high anisotropy of the bone as a continuously increasing displacement field map. Meanwhile, the internal information obtained with FD-OCT records larger deformations at different depths. Due to the optical phase, it is possible to complement the measurements of these two methods during the plastic deformation.

3.
Rev Esp Anestesiol Reanim (Engl Ed) ; 69(8): 502-505, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36088271

RESUMO

Effective management and control of peri- and postoperative pain in hip surgery is essential in order to minimize the use of opioids and their adverse effects. Effective regional analgesia for hip pain is made particularly challenging by the complex innervation of the hip joint. Standard regional techniques can be associated with complications, including incomplete anesthesia, hypotension, or lower limb weakness. We present the case of a 5-year-old girl with a history of infantile cerebral palsy who underwent bilateral varus derotation osteotomy and adductor tenotomy due to paralytic dislocation. She received bilateral PENG block and femoral cutaneous nerve block-a simple technique that covers all the nerves involved in the sensory innervation of the joint capsule without the need for multiple injections.


Assuntos
Analgesia , Bloqueio Nervoso , Analgésicos Opioides , Criança , Pré-Escolar , Feminino , Humanos , Bloqueio Nervoso/métodos , Manejo da Dor/métodos , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/prevenção & controle
4.
Appl Opt ; 61(5): B225-B236, 2022 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-35201144

RESUMO

Dennis Gabor's seminal idea of a simple all-optical setup aimed at reconstructing the object wavefront stored on a photographic plate gave birth a little over seven decades ago to the field of holography. In 1971 Gabor obtained the Nobel Prize in Physics for this invention. Still, the road in the early days after his two first papers on the subject was one full of obstacles, so his scientific and engineering contemporaries put his idea to rest for more than 10 years, until the invention of the laser. This fact made his holographic concept take off to new and unsuspected applications. This invited review paper is a homage to Dennis Gabor's 50th anniversary of his Nobel Prize accolade. For this purpose, the review departs from the typical common route, i.e., those written following a timeline fashion, and instead is written with the intent to cover only a few of the holography applications in optics while scanning the electromagnetic spectrum. In doing this, the authors are aware that other invited papers for this special issue will tackle other subjects not dealt with in this review non-timeline paper.

5.
Spectrochim Acta A Mol Biomol Spectrosc ; 272: 121001, 2022 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-35158137

RESUMO

The polarization state of the excitation light used in two Raman systems was controlled to study its effect in the unpolarized Raman spectra of unstructured samples. Both systems work in different regions of the electromagnetic spectrum (NIR and visible). Four polarization states (linear, linear at 45° and 90°, and circular) were used to excite liquid samples (ethanol, acetone, and their mixture). The results show that the Raman peaks intensities' ratio varies according to the polarization state of the excitation light. Peaks related to functional groups and C-H stretching modes increase their intensity when circular polarization (CP) is applied. The latter may help to study liquid mixtures with low concentrations. Different polarizing light states give a more detailed spectroscopic analysis since it gathers more structural information of the samples tested in this work with an undefined structure.


Assuntos
Análise Espectral Raman , Análise Espectral Raman/métodos
6.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-34538664

RESUMO

Effective management and control of peri- and postoperative pain in hip surgery is essential in order to minimize the use of opioids and their adverse effects. Effective regional analgesia for hip pain is made particularly challenging by the complex innervation of the hip joint. Standard regional techniques can be associated with complications, including incomplete anesthesia, hypotension, or lower limb weakness. We present the case of a 5-year-old girl with a history of infantile cerebral palsy who underwent bilateral varus derotation osteotomy and adductor tenotomy due to paralytic dislocation. She received bilateral PENG block and femoral cutaneous nerve block - a simple technique that covers all the nerves involved in the sensory innervation of the joint capsule without the need for multiple injections.

7.
Appl Opt ; 60(18): 5376-5381, 2021 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-34263775

RESUMO

A collimated transmission beam interferometer is used to measure the water motion provoked by the fish swimming through it. An indirect measurement of the fish motion impact in the water contained in a home-type aquarium is detected. Measurements of the whole aquarium are possible due to a large diameter collimated laser beam in the interferometer's object arm. This beam goes through the aquarium, and any perturbation inside it deflects the collimated beam. The interferometer detects a phase difference, i.e., the beam through the disturbed water undergoes different optical paths. This optical phase change was first demonstrated by means of a simple test using spherical steel marbles placed in a cuvette. For this, the small water movements for a single steel marble are detected with the acquired optical phase. Next, the aquarium optical phase results show water movements according to the fishes' size and swimming speed. It is worth mentioning that no additives were added to the aquarium's fresh water during the tests, so the water was crystal clear.


Assuntos
Carpa Dourada/fisiologia , Holografia/métodos , Interferometria/métodos , Poecilia/fisiologia , Natação/fisiologia , Água/metabolismo , Animais , Desenho de Equipamento
8.
Appl Opt ; 60(19): 5623-5628, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34263854

RESUMO

A digital holographic interferometer using a collimated beam in transmission mode to illuminate a flow coming from a diffusion flame is presented. The optical system proposes an indirect visualization of the flow to avoid saturation at the sensor. It can detect the intensity signal as a classical schlieren technique and the phase changes due to the presence of the flow. It is possible to retrieve a pseudo-3D flow's view and different gradient maps using the optical phase. According to the knife edge's position, these gradients could be observed in classical schlieren one at a time, but the proposed system could retrieve them all with a single image hologram. As proof of principle, a flame's flow is simultaneously observed with the optical system and a Z-type schlieren set up. A comparison of the visualized flows at different stages of the flame is presented and discussed. A temperature profile is obtained and validated with a thermocouple's point thermal measurements taking the resulting optical phase. Results from both optical techniques show a good agreement.

9.
BJOG ; 128(5): 908-915, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33187026

RESUMO

OBJECTIVE: To demonstrate that delayed cord clamping (DCC) is safe in mothers with confirmed SARS-CoV-2 infection. DESIGN, SETTING AND PARTICIPANTS: Prospective observational study involving epidemiological information from 403 pregnant women with SARS-CoV-2 between 1 March and 31 May 2020. Data were collected from 70 centres that participate in the Spanish Registry of COVID-19. METHODS: Patients' information was collected from their medical chart. MAIN OUTCOMES AND MEASURES: The rate of perinatal transmission of SARS-CoV-2 and development of the infection in neonates within 14 days postpartum. RESULTS: The early cord clamping (ECC) group consisted of 231 infants (57.3%) and the DCC group consisted of 172 infants (42.7%). Five positive newborns (1.7% of total tests performed) were identified with the nasopharyngeal PCR tests performed in the first 12 hours postpartum, two from the ECC group (1.7%) and three from the DCC group (3.6%). No significant differences between groups were found regarding neonatal tests for SARS-CoV-2. No confirmed cases of vertical transmission were detected. The percentage of mothers who made skin-to-skin contact within the first 24 hours after delivery was significantly higher in the DCC group (84.3% versus 45.9%). Breastfeeding in the immediate postpartum period was also significantly higher in the DCC group (77.3% versus 50.2%). CONCLUSIONS: The results of our study show no differences in perinatal outcomes when performing ECC or DCC, and skin-to-skin contact, or breastfeeding. TWEETABLE ABSTRACT: This study demonstrates that delayed cord clamping is safe in mothers with confirmed SARS-CoV-2 infection.


Assuntos
COVID-19 , Constrição , Parto Obstétrico , Transmissão Vertical de Doenças Infecciosas , Complicações Infecciosas na Gravidez , SARS-CoV-2/isolamento & purificação , Cordão Umbilical/cirurgia , Adulto , Aleitamento Materno/métodos , Aleitamento Materno/estatística & dados numéricos , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/transmissão , Parto Obstétrico/métodos , Parto Obstétrico/estatística & dados numéricos , Feminino , Humanos , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Transmissão Vertical de Doenças Infecciosas/estatística & dados numéricos , Método Canguru/métodos , Método Canguru/estatística & dados numéricos , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/prevenção & controle , Resultado da Gravidez/epidemiologia , Espanha/epidemiologia , Tempo para o Tratamento
10.
Nanotechnology ; 31(40): 405204, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-32544891

RESUMO

The zero-bias microwave detection capability of self-switching diodes (SSDs) based on AlGaN/GaN is analyzed in a wide temperature range, from 10 K to 300 K. The measured responsivity shows an anomalous enhancement at low temperature, while the detected voltage exhibits a roll-off in frequency, which can be attributed to the presence of surface and bulk traps. To gain a deep insight into this behavior, a systematic DC and AC characterization of the diodes has been carried out in the mentioned temperature range. DC results confirm the existence of traps and AC measurements allow us to identify their properties. In particular, impedance studies enable to distinguish two types of traps: at the lateral surfaces of the channel, with a wide spread of relaxation times, and in the bulk.

11.
RMD Open ; 6(1)2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32371431

RESUMO

OBJECTIVE: To compare improvement in pain and physical function for patients treated with baricitinib, adalimumab, tocilizumab and tofacitinib monotherapy from randomised, methotrexate (MTX)-controlled trials in conventional synthetic disease-modifying antirheumatic drugs (csDMARDs)/biologic (bDMARD)-naïve RA patients using matching-adjusted indirect comparisons (MAICs). METHODS: Data were from Phase III trials on patients receiving monotherapy baricitinib, tocilizumab, adalimumab, tofacitinib or MTX. Pain was assessed using a visual analogue scale (0-100 mm) and physical function using the Health Assessment Questionnaire-Disability Index (HAQ-DI). An MAIC based on treatment-arm matching, an MAIC with study-level matching and Bucher's method without matching compared change in outcomes between therapies. Matching variables included age, gender, baseline disease activity and baseline value of outcome measure. RESULTS: With all methods, greater improvements were observed in pain and HAQ-DI at 6 months for baricitinib compared with adalimumab and tocilizumab (p<0.05). Differences in treatment effects (TEs) favouring baricitinib for pain VAS for treatment-arm matching, study-level matching and Bucher's method, respectively, were -12, -12 and -12 for baricitinib versus adalimumab and -7, -7 and -9 for baricitinib versus tocilizumab; the difference in TEs for HAQ-DI was -0.28, -0.28 and -0.30 for adalimumab and -0.23, -0.23 and -0.26 for tocilizumab. For baricitinib versus tofacitinib, no statistically significant differences for pain improvement were observed except with one of the three methods (Bucher method) and none for HAQ-DI. CONCLUSIONS: Results suggest greater pain reduction and improved physical function for baricitinib monotherapy compared with tocilizumab and adalimumab monotherapy. No statistically significant differences in pain reduction and improved physical function were observed between baricitinib and tofacitinib with the MAIC analyses.


Assuntos
Antirreumáticos/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Produtos Biológicos/uso terapêutico , Metotrexato/uso terapêutico , Dor/tratamento farmacológico , Adalimumab , Anticorpos Monoclonais Humanizados , Artrite Reumatoide/complicações , Azetidinas , Ensaios Clínicos Fase III como Assunto , Avaliação da Deficiência , Humanos , Metanálise em Rede , Medição da Dor , Piperidinas , Purinas , Pirazóis , Pirimidinas , Ensaios Clínicos Controlados Aleatórios como Assunto , Sulfonamidas , Resultado do Tratamento
12.
Rev Esp Quimioter ; 32 Suppl 2: 1-9, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31475801

RESUMO

The IX Course of Antimicrobials and Infectious Diseases update included a review of the main issues in clinical microbiology, epidemiology and clinical aspects for a current approach of infectious pathology. The present introduction summarizes about the most important meetings related to infectious diseases during 2018 (ECCMID, IAS, ASM and ID Week). In addition, the course provides a practical information to focus on nosocomial infection models, with immunosuppressed patients or complex multidrug-resistant pathogens. The closing lecture of this year reviewed the infection during donation process.


Assuntos
Infecções , Infectologia/tendências , Anti-Infecciosos/farmacologia , Anti-Infecciosos/uso terapêutico , Doenças Transmissíveis , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/prevenção & controle , Humanos , Hospedeiro Imunocomprometido
13.
Appl Microbiol Biotechnol ; 103(15): 5975-5991, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31187209

RESUMO

Orange peel waste (OPW) (peels, pulp and seeds) is an underutilised residue coming from the orange juice industry. Its classical applications are cattle feeding and composting, while they cannot ensure a total use of OPW, so landfilling is also common practice. On the other side, OPW is very rich in sugars, polysaccharides, essential oils and polyphenols, so there is a vast literature focused on the development and optimization of technologies and processes to several products from OPW. In this review, papers on OPW-based bioprocesses are visited, discovering a wide landscape that goes from the composting and biogas processes on detoxified OPW (deoiled) to bioprocesses to bioethanol, chemicals, flavours and polymers. All these processes are prone to integration within the 2nd-generation biorefinery framework.


Assuntos
Fatores Biológicos/isolamento & purificação , Fatores Biológicos/metabolismo , Biotecnologia/métodos , Citrus sinensis/química , Resíduos Industriais , Compostagem/métodos , Eliminação de Resíduos/métodos
14.
Appl Microbiol Biotechnol ; 102(24): 10511-10521, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30324487

RESUMO

In this study, the effect of several organic nitrogen sources (namely peptone, meat extract-ME, yeast extract-YE, and corn steep liquor-CSL) on D-lactic acid production by Lactobacillus delbrueckii ssp. delbrueckii has been studied. While lactic acid bacteria (LAB) are well-known for their complex nutritional requirements, organic nitrogen source-related cost can be as high as 38% of total operational costs (OPEX), being its nature and concentration critical factors in the growth and productivity of the selected strain. Corn steep liquor (CSL) has been chosen for its adequacy, on the grounds of the D-lactic acid yield, productivity, and its cost per kilogram of product. Finally, orange peel waste hydrolysate supplemented with 37 g/l CSL has been employed for D-lactic acid production, reaching a final yield of 88% and a productivity of 2.35 g/l h. CSL cost has been estimated at 90.78$/ton of D-lactate.


Assuntos
Biotecnologia/métodos , Citrus sinensis , Ácido Láctico/biossíntese , Lactobacillus delbrueckii/metabolismo , Nitrogênio/metabolismo , Biotecnologia/economia , Custos e Análise de Custo , Resíduos Industriais , Peptonas/metabolismo , Leveduras/química , Leveduras/metabolismo
15.
Rev Esp Quimioter ; 31 Suppl 1: 1-8, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30209913

RESUMO

VIII Updating Course of Antimicrobials and Infectious Diseases has reviewed useful microbiological, epidemiological and clinical aspects for a current approach of infectious pathology. Present manuscript summarizes a chronicle about the main infection related meetings during 2017 (ECCMID, IAS, ASM and ID Week). In addition, the course proposed a practical approach for understanding different type of pathogens and our selected topics this year were the epidemiology of bacterial nosocomial infection, a practical approach to Clostridium difficile infection patients, a two year selection of the top ten papers about fungal infection and an update in fungal biofilms. Finally, proffesors made a practical approach by main clinical syndromes like sepsis, infections in oncohematological patients, CNS infections in immunosuppressed patients and reviewed the top ten papers in transplant infectious diseases and infection control during the last two years.


Assuntos
Anti-Infecciosos/uso terapêutico , Doenças Transmissíveis/tratamento farmacológico , Doenças Transmissíveis/microbiologia , Humanos
16.
Opt Lett ; 43(4): 871-874, 2018 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-29444015

RESUMO

An optical setup that does not need in-line alignment of the object illumination and camera sensor, or requires a reflection mirror after the sample, is introduced to observe the optical phase in a heating liquid. This system uses an out-of-plane transmission digital holographic interferometer that uniformly adds speckle to the image holograms by means of a neutral phase screen. The way in which the liquid is illuminated allows having a variable magnification of the observed area of the sample. As a proof of principle, a thermal time-dependent distribution experiment is presented, whose resulting optical phase readily depicts the temperature-time-varying distribution in the liquid.

17.
Clin Exp Immunol ; 190(3): 372-383, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-28800164

RESUMO

Serum levels of B cell-activating factor (BAFF) rise following rituximab (RTX) therapy in patients with rheumatoid arthritis (RA). Initiation of naive B cell return to the periphery and autoreactive B cell expansion leading to relapse after RTX may therefore be linked to interactions between BAFF and BAFF-binding receptors (BBR). Relationships between serum BAFF and BBR expression [(BAFFR, calcium signal modulating cyclophilic ligand interactor (TACI) and B cell maturation antigen (BCMA)] were determined on B cell subsets, defined using immunoglobulin (Ig)D/CD38. Twenty pre-RTX and 18 RA patients relapsing after B cell depletion were included. Results were analysed with respect to timing of relapse up to 7 months after peripheral B cell return (≥ 5 B cells/µl) and to serum BAFF levels. After B cell return, B cell populations from relapsing patients had significantly lower BAFFR+ expression compared to HC and pre-RTX patients. The percentage of BAFFR+ B cells increased with time after B cell return and was correlated inversely with serum BAFF levels. BAFFR expression remained reduced. The percentage of TACI+ memory B cells were lower in RA patients after RTX compared with healthy controls (HC). BCMA expression (% and expression) did not differ between patients and HC. Relapse following B cell return appeared largely independent of the percentage of BAFFR+ or percentage of BCMA+ B cells or serum BAFF levels. The lower percentage of TACI+ memory B cells may reduce inhibitory signalling for B cell differentiation. In patients relapsing at longer periods after B cell return, recovery of the B cell pool was more complete, suggesting that selection or expansion of autoreactive B cells may be needed to precipitate relapse.


Assuntos
Artrite Reumatoide , Receptor do Fator Ativador de Células B , Subpopulações de Linfócitos B , Regulação da Expressão Gênica , Memória Imunológica , Rituximab/administração & dosagem , Artrite Reumatoide/sangue , Artrite Reumatoide/tratamento farmacológico , Artrite Reumatoide/imunologia , Artrite Reumatoide/patologia , Fator Ativador de Células B/sangue , Fator Ativador de Células B/imunologia , Receptor do Fator Ativador de Células B/sangue , Receptor do Fator Ativador de Células B/imunologia , Antígeno de Maturação de Linfócitos B/sangue , Antígeno de Maturação de Linfócitos B/imunologia , Subpopulações de Linfócitos B/imunologia , Subpopulações de Linfócitos B/metabolismo , Subpopulações de Linfócitos B/patologia , Regulação da Expressão Gênica/efeitos dos fármacos , Regulação da Expressão Gênica/imunologia , Memória Imunológica/efeitos dos fármacos , Memória Imunológica/imunologia , Proteína Transmembrana Ativadora e Interagente do CAML/sangue , Proteína Transmembrana Ativadora e Interagente do CAML/imunologia
18.
Appl Opt ; 56(13): F179-F188, 2017 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-28463314

RESUMO

A bone's fracture could be produced by an excessive, repetitive, or sudden load. A regular medical practice to heal it is to fix it in two possible ways: external immobilization, using a ferule, or an internal fixation, using a prosthetic device commonly attached to the bone by means of surgical screws. The bone's volume loss due to this drilling modifies its structure either in the presence or absence of a fracture. To observe the bone's surface behavior caused by the drilling effects, a digital holographic interferometer is used to analyze the displacement surface's variations in nonfractured post-mortem porcine femoral bones. Several nondrilled post-mortem bones are compressed and compared to a set of post-mortem bones with a different number of cortical drillings. During each compression test, a series of digital interferometric holograms were recorded using a high-speed CMOS camera. The results are presented as pseudo 3D mesh displacement maps for comparisons in the physiological range of load (30 and 50 lbs) and beyond (100, 200, and 400 lbs). The high resolution of the optical phase gives a better understanding about the bone's microstructural modifications. Finally, a relationship between compression load and bone volume loss due to the drilling was observed. The results prove that digital holographic interferometry is a viable technique to study the conditions that avoid the surgical screw from loosening in medical procedures of this kind.


Assuntos
Parafusos Ósseos/efeitos adversos , Osso Cortical/lesões , Fêmur/lesões , Holografia/instrumentação , Imageamento Tridimensional/métodos , Animais , Osso Cortical/química , Consolidação da Fratura/fisiologia , Interferometria , Suínos , Suporte de Carga
19.
Lupus ; 25(8): 797-804, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27252255

RESUMO

The second meeting for the International Consensus on Antinuclear antibody (ANA) Pattern (ICAP) was held on 22 September 2015, one day prior to the opening of the 12th Dresden Symposium on Autoantibodies in Dresden, Germany. The ultimate goal of ICAP is to promote harmonization and understanding of autoantibody nomenclature, and thereby optimizing ANA usage in patient care. The newly developed ICAP website www.ANApatterns.org was introduced to the more than 50 participants. This was followed by several presentations and discussions focusing on key issues including the two-tier classification of ANA patterns into competent-level versus expert-level, the consideration of how to report composite versus mixed ANA patterns, and the necessity for developing a consensus on how ANA results should be reported. The need to establish on-line training modules to help users gain competency in identifying ANA patterns was discussed as a future addition to the website. To advance the ICAP goal of promoting wider international participation, it was agreed that there should be a consolidated plan to translate consensus documents into other languages by recruiting help from members of the respective communities.


Assuntos
Anticorpos Antinucleares/sangue , Doenças Autoimunes/diagnóstico , Programas de Rastreamento/normas , Conferências de Consenso como Assunto , Alemanha , Humanos , Guias de Prática Clínica como Assunto
20.
Radiologia ; 58 Suppl 2: 119-28, 2016 May.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-27091551

RESUMO

Child abuse or nonaccidental trauma is a major problem worldwide; in Spain, there are about 12,000 victims per year. The detection of specific lesions or findings that are incongruent with the reported mechanism of trauma mean that radiologists are often the physician responsible for sounding the alarm in cases of abuse. The triad consisting of subdural hematoma, metaphyseal fracture, and posterior rib fractures is very characteristic of the battered child syndrome. The finding of acute and chronic lesions in the same patient is highly specific for nonaccidental trauma. Fractures of long bones in patients who have yet begun to walk should also alert to possible child abuse. Lesions that are highly specific for abuse, such as classic metaphyseal fractures or posterior rib fractures, can be difficult to demonstrate radiographically and are usually clinically occult. The American College of Radiology (ACR) protocols recommend obtaining three separate X-rays of each upper and lower limb. It is important to use X-ray systems that give high resolution images with low kilovoltage (50-70 kvp) and appropriate milliamperage. A skeletal survey consisting of a series of images collimated to each body region is recommended for all children under the age of two years in whom abuse is suspected. A follow-up skeletal survey about two weeks after the initial survey is useful for detecting new fractures and for assessing the consolidation of others, which helps in dating the lesions. Head injuries are the leading cause of death in abused children. Although computed tomography is the first neuroimaging technique in nonaccidental trauma, magnetic resonance imaging of the head can better characterize the lesions seen on computed tomography and can help to estimate the age of the lesions.


Assuntos
Maus-Tratos Infantis/diagnóstico , Papel do Médico , Radiologia , Ferimentos e Lesões/diagnóstico por imagem , Criança , Pré-Escolar , Protocolos Clínicos , Traumatismos Craniocerebrais/diagnóstico por imagem , Diagnóstico Diferencial , Fraturas Ósseas/diagnóstico por imagem , Humanos , Lactente
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA