RESUMO
Due to the high intensity and MHz repetition rate of photon pulses generated by the European X-ray Free-Electron Laser, the heat load on silicon crystal monochromators can become large and prevent ideal transmission in Bragg diffraction geometry due to crystal deformation. Here, we present experimental data illustrating how heat load affects the performance of a cryogenically cooled monochromator under such conditions. The measurements are in good agreement with a depth-uniform model of X-ray dynamical diffraction taking beam absorption and heat deformation of the crystals into account.
RESUMO
BACKGROUND AND OBJECTIVES: According to current guidelines, oral antihistamines are the first-line treatment for chronic spontaneous urticaria (CSU). Up-dosing antihistamines to 4-fold the licensed dose is recommended if control is not achieved. Such indications are based mainly on expert opinion. Objectives: To critically review and analyze clinical evidence on the efficacy and safety of higher-than-licensed dosage of second-generation oral antihistamines in the treatment of CSU. MATERIAL AND METHODS: A systematic literature review was performed following a sensitive search strategy. All articles published in PubMed, EMBASE, and the Cochrane Library between 1961 and October 2018 were examined. Publications with CSU patients prescribed secondgeneration antihistamines in monotherapy compared with placebo, licensed dosages, and/or higher dosages were included. Articles were evaluated by peer reviewers. Quality was evaluated using the Jadad and Oxford scores. RESULTS: We identified 337 articles, of which 14 were included in the final evaluation (fexofenadine, 6; cetirizine, 2; levocetirizine and desloratadine, 1; levocetirizine, 1; rupatadine, 2; ebastine, 1; and bilastine, 1). Only 5 studies were placebo-controlled. The number of patients included ranged from 20 to 439. The observation lapse was ≤16 weeks. High fexofenadine doses produced a significant dosedependent response and controlled urticaria in most patients. Cetirizine, levocetirizine, rupatadine, and bilastine were more effective in up-dosing. The most frequent adverse events were headache and drowsiness. CONCLUSION: The low quality and heterogeneity of the articles reviewed made it impossible to reach robust conclusions and reveal the need for large-scale randomized clinical trials.
Assuntos
Antialérgicos/uso terapêutico , Urticária Crônica/tratamento farmacológico , Antagonistas não Sedativos dos Receptores H1 da Histamina/uso terapêutico , Administração Oral , Animais , Ensaios Clínicos como Assunto , Cálculos da Dosagem de Medicamento , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Humanos , Resultado do TratamentoRESUMO
Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated gastrointestinal food hypersensitivity usually due to cow's milk or soy. Recent researches show that fish is 1 of the most important triggers of FPIES in the Mediterranean countries. Due to the risk of multiple-food FPIES, avoiding foods in the same category or that often occur together may be reasonable. The aim of this study was to evaluate the evolution and follow-up of FPIES related to fish over a period of 20 years. We describe the clinical features of our population, discuss different approaches to oral food challenges, and analyze the possibility of introducing the culprit fish or other nonrelated fish to avoid unnecessary restricted diets.
Assuntos
Enterocolite/imunologia , Peixes , Hipersensibilidade Alimentar/imunologia , Animais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Estudos RetrospectivosRESUMO
OBJECTIVE: The impact of endogenous immunoglobulin isotypes on the prognosis of patients with severe sepsis has not been sufficiently explored. The aim of this study was to evaluate the association between immunoglobulin levels in plasma and survival in patients with this condition. DESIGN AND PATIENTS: A prospective multicentre cohort study was conducted. A total of 172 adult patients admitted to the intensive care unit (ICU) with severe sepsis or septic shock were recruited. Patients were classified based on deciles of immunoglobulin concentrations at diagnosis of sepsis. Categorical variables were created and tested for their association with survival during hospitalization in the ICU. RESULTS: Overall, 42 patients died in the ICU during the study. Kaplan-Meier analysis showed that immunoglobulin concentrations below 300 mg dL(-1) for IgG1, 35 mg dL(-1) for IgM and 150 mg dL(-1) for IgA were associated with shorter survival times. Multivariate regression analysis showed that IgG1 < 300 mg dL(-1) was a risk factor for mortality [odds ratio (OR) 2.50, 95% confidence interval (CI) 1.04-6.03; P = 0.042]. The combined presence of IgG1, IgM and IgA levels below the described thresholds had a synergistic impact on mortality risk (OR 5.27, 95% CI 1.41-19.69; P = 0.013). A similar effect was observed for combined low levels of IgG1 and IgA (OR 4.10, 95% CI 1.28-13.12; P = 0.018) and also of IgG1 and IgM (OR 3.10. 95% CI 1.13-8.49; P = 0.028). CONCLUSIONS: The combined presence of low levels of the endogenous immunoglobulins IgG1, IgM and IgA in plasma is associated with reduced survival in patients with severe sepsis or septic shock. Assessment of the concentrations of these immunoglobulins could improve the results of treatment with exogenous immunoglobulins in patients with sepsis.
Assuntos
Imunoglobulina A/sangue , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Sepse/imunologia , Sepse/mortalidade , Idoso , Feminino , Humanos , Hospedeiro Imunocomprometido , Unidades de Terapia Intensiva , Estimativa de Kaplan-Meier , Masculino , Prognóstico , Estudos Prospectivos , Análise de Regressão , Choque Séptico/imunologia , Choque Séptico/mortalidadeAssuntos
Adjuvantes Imunológicos/uso terapêutico , Anafilaxia/tratamento farmacológico , Antialérgicos/uso terapêutico , Antineoplásicos/efeitos adversos , Dessensibilização Imunológica/efeitos adversos , Omalizumab/uso terapêutico , Oxaliplatina/efeitos adversos , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/patologia , Neoplasias do Colo/tratamento farmacológico , Neoplasias do Colo/patologia , Feminino , Humanos , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/secundário , Pessoa de Meia-Idade , Neoplasias Peritoneais/tratamento farmacológico , Neoplasias Peritoneais/secundário , Resultado do TratamentoRESUMO
The application of PET/CT with radiopharmaceuticals targeting PSMA is significantly transforming the diagnostic and therapeutic strategies of patients with prostate cancer. In Spain, the availability and access to positron-emitting radiopharmaceuticals targeting Prostate-Specific Membrane Antigen (PSMA) have significantly changed in recent months. These changes are affecting their use in diagnostic procedures. As a result, its use within diagnostic protocols for patients with prostate cancer is undergoing significant modifications. In this collective and cooperative document, the authors have selected the most robust evidence accumulated to date to generate a clinical guide to achieve appropriate use of this technology. A format that presents the most frequent clinical situations and the patient profiles in which PSMA PET/CT plays a significant role or will do so in the immediate future has been chosen. It should be taken into account that regulatory restrictions mediate the current indications for its use in Spain, as well as its current cost and the production capacity of radiopharmaceuticals. The guideline presents a review of the established methodology for optimized imaging with each of the radiopharmaceutical variants targeting PSMA and recommendations for structured and accurate reporting of metabolic findings in combination with CT.
RESUMO
INTRODUCTION: Huntington´s disease (HD) is a rare neurodegenerative disorder. Reliable information about nutritional status, especially body composition from individuals with HD is critical for clinical care and research. The ease of application and portability of multiple frequencies bioelectrical impedance analysis (mfBIA) make it an attractive tool for measuring body composition, but its accuracy in HD is unknown. AIM: To evaluate the accuracy of mfBIA vs. Dual X-ray absorptiometry (DEXA) in HD. PATIENTS AND METHODS: Cross-sectional, observational, and single-center study. HD severity was measured using motor subscale of the unified Huntington´s disease rating scale (m-UHDRS) and the total functional capacity (TFC). Body composition was measured in terms of fat-free mass (FFM), fat mass (FM), fat-free mass index (FFMI), and fat mass index (FMI). Using Bland-Altman plots, we analyzed reliability between DEXA and mfBIA using the Intraclass Correlation Coefficient with 95% confidence intervals (CI) and bias estimates for all. RESULTS: We included 16 patients with HD, 7 men, and 9 women, median age of 58.5 (32;68) years, TFC: 10 (3;13), and m-UHDRS: 31 (7;85). The reliability between mfBIA and DEXA were high for FFMI in men: 0.88 (95% CI 0.17-0.98), and women: 0.90 (95% CI 0.61- 0.98); for FMI, men: 0.97 (95% CI 0.83-0.99), and women: 0.91 (95% CI 0.68-0.98). Compared to DEXA, mfBIA slightly overestimated FFM, FM, FMI and FFMI in men and underestimated FFMI in women. CONCLUSIONS: mfBIA is an easy-to-use, safe, non-invasive, accurate method for measuring body composition and nutritional status in patients with mild-moderate HD.
TITLE: Cómo estimar la composición corporal en la enfermedad de Huntington. Estudio transversal y observacional con bioimpedancia de múltiples frecuencias.Introducción. La enfermedad de Huntington (EH) es un trastorno raro neurodegenerativo. La información fiable del estado nutricional, especialmente de la composición corporal, es crítica en clínica y en investigación. La facilidad de aplicación y portabilidad del análisis de la bioimpedancia de múltiples frecuencias (mfBIA) la convierten en una herramienta atractiva para medirla, pero se desconoce su precisión en la EH. Objetivo. Evaluar la precisión del mfBIA frente a la absorciometría dual de rayos X (DEXA) en la EH. Pacientes y métodos. Estudio transversal, observacional y unicéntrico. La EH se midió con la subescala motora de la escala unificada de valoración de la EH y con la capacidad funcional total. La composición corporal se valoró según la masa libre de grasa (MLG), la masa grasa (MG), el índice de masa libre de grasa (IMLG) y el índice de masa grasa (IMG). Se utilizó el coeficiente de correlación intraclase con intervalos de confianza al 95% y estimaciones de sesgo mediante gráficos de Bland-Altman. Resultados. Se incluyó a 16 pacientes, siete hombres y nueve mujeres, con edad media de 58,5 (32-68) años, capacidad funcional total de 10 (3-13) y escala unificada de valoración de la EH de 31 (7-85). La fiabilidad era alta entre el mfBIA y la DEXA para el IMLG en hombres, 0,88 (intervalo de confianza al 95%: 0,17-0,98), y mujeres, 0,9 (intervalo de confianza al 95%: 0,61-0,98); y para el IMG en hombres, 0,97 (intervalo de confianza al 95%: 0,83-0,99), y mujeres, 0,91 (intervalo de confianza al 95%: 0,68-0,98). El mfBIA sobreestimó ligeramente la MLG, la MG, el IMG y el IMLG en los hombres, pero subestimó el IMLG en las mujeres. Conclusiones. El mfBIA es un método fácil de usar, seguro, no invasivo y preciso para medir la composición corporal y el estado nutricional en pacientes con EH leve-moderada.
Assuntos
Doença de Huntington , Idoso , Feminino , Humanos , Masculino , Absorciometria de Fóton/métodos , Composição Corporal , Índice de Massa Corporal , Estudos Transversais , Impedância Elétrica , Doença de Huntington/diagnóstico , Reprodutibilidade dos Testes , Adulto , Pessoa de Meia-IdadeRESUMO
Hydrogen molecules dissociate on clean W(110) surfaces. This reaction is progressively inhibited as the tungsten surface is precovered with oxygen. We use density functional theory and ab initio molecular dynamics to rationalize, at the atomic scale, the influence of the adsorbed O atoms on the H2 dissociation process. The reaction probability is calculated for kinetic energies below 300 meV and different O nominal coverages. We show that the adsorbed O atoms act as repulsive centers that modulate the dynamics of the impinging H2 molecules by closing dissociation pathways. In agreement with existing experimental information, H2 dissociation is absent for an O coverage of half a monolayer. The results show that the influence of O adsorbates on the dissociation dynamics on W(110) goes much beyond the blocking of possible H adsorption sites. Adsorbed O atoms create a sort of chemical shield at the surface that prevents further approach and dissociation of the H2 molecules.
RESUMO
The objective of this guide is to provide to nuclear medicine physicians a tool based on scientific evidence and prepared by consensus of experts, to perform the 18F-DCFPyL PET/CT procedure with safely and efficiently for patients with prostate cancer who present PSMA overexpression. For them, some recommendations will be established for 18F-DCFPyL PET/CT examination: reconstruction parameters, presentation of the images and their interpretation. The possible false positives of the procedure will be analysed, how to interpret them and how to avoid them. Finally, all exploration should lead to the preparation of a report that answers the clinician's question. For this, it is recommended to prepare a structured report that includes the PROMISE criteria as well as the classification of the findings according to PSMA-RADS parameters.
Assuntos
Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Neoplasias da Próstata , Masculino , Humanos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Lisina , Ureia , Neoplasias da Próstata/diagnóstico por imagemRESUMO
OBJECTIVE: To determine the therapeutic effectiveness and safety of transarterial radioembolization (TARE) with Yttrium-90 in patients with colorectal cancer (CRC) liver metastases and to evaluate the prognostic value of different biomarkers. MATERIAL AND METHODS: This prospective longitudinal study enrolled consecutive patients with CRC liver metastases treated with TARE between November 2015 and june 2020. The therapeutic response at three and six months (RECIST1.1 criteria) and the relationship of biomarkers with therapeutic response, by calculating objective tumor response rates (ORR) and disease control (DCR), and overall survival (OS) and progression-free (PFS). RESULTS: Thirty TAREs were performed in 23 patients (mean age, 61.61⯱â¯9.13 years; 56.5% male). At three months, the objective response rate (ORR) was 16.7% and the disease control rate (DCR) 53.3%. At six months, the disease progressed in 80%. The ORR and DCR were significantly associated with age at diagnosis (Pâ¯=â¯0.047), previous bevacizumab treatment (Pâ¯=â¯0.008), pre-TARE haemoglobin (Pâ¯=â¯0.008), NLR (Pâ¯=â¯0.040), pre-TARE albumin (Pâ¯=â¯0.012), pre-TARE ALT (Pâ¯=â¯0.023) and tumour-absorbed doseâ¯>â¯115 Gy (Pâ¯=â¯0.033). Median overall survival (OS) was 12 months (95% CI, 4.75-19.25 months) and median progression-free survival (PFS) 3 months (95% CI, 2.41-3.59). OS was significantly associated with primary tumour resection (Pâ¯=â¯0.019), KRAS mutation (HR: 5.15; Pâ¯=â¯0.024), pre-TARE haemoglobin (HR: 0.50; pâ¯=â¯0.009), pre-TARE NLR (HR: 1.65; Pâ¯=â¯0.005) and PLR (HR: 1.01; Pâ¯=â¯0.042). CONCLUSION: TARE prognosis and therapeutic response were predicted by different biomarkers, ranging from biochemical parameters to tumour dosimetrics.
Assuntos
Neoplasias do Colo , Neoplasias Hepáticas , Idoso , Biomarcadores , Feminino , Humanos , Neoplasias Hepáticas/secundário , Estudos Longitudinais , Masculino , Microesferas , Pessoa de Meia-Idade , Estudos Prospectivos , Compostos Radiofarmacêuticos/uso terapêutico , Estudos Retrospectivos , Radioisótopos de ÍtrioRESUMO
OBJETIVE: To determine the therapeutic effectiveness and safety of transarterial radioembolization (TARE) with Yttrium-90 in patients with colorectal cancer (CRC) liver metastases and to evaluate the prognostic value of different biomarkers. MATERIAL AND METHODS: This prospective longitudinal study enrolled consecutive patients with CRC liver metastases treated with TARE between November 2015 and june 2020. The therapeutic response at three and six months (RECIST1.1 criteria) and the relationship of biomarkers with therapeutic response, by calculating objective tumor response rates (ORR) and disease control (DCR), and overall survival (OS) and progression-free (PFS). RESULTS: Thirty TAREs were performed in 23 patients (mean age, 61,61±9,13 years; 56,5% male). At three months, the objective response rate (ORR) was 16,7% and the disease control rate (DCR) 53,3%. At six months, the disease progressed in 80%. The ORR and DCR were significantly associated with age at diagnosis (P=.047), previous bevacizumab treatment (P=.008), pre-TARE haemoglobin (P=.008), NLR (P=.040), pre-TARE albumin (P=.012), pre-TARE ALT (P=.023) and tumour-absorbed dose>115Gy (P=.033). Median overall survival (OS) was 12 months (95% CI, 4.75-19.25 months) and median progression-free survival (PFS) 3 months (95% CI, 2.41-3.59). OS was significantly associated with primary tumour resection (P=.019), KRAS mutation (HR: 5.15; P=.024), pre-TARE haemoglobin (HR: .50; p=.009), pre-TARE NLR (HR: 1.65; P=.005) and PLR (HR: 1.01; P=.042). CONCLUSION: TARE prognosis and therapeutic response were predicted by different biomarkers, ranging from biochemical parameters to tumour dosimetrics.
RESUMO
Perivascular epithelioid tumors (PEComas) are a rare group of mesenchymal neoplasms with an unpredictable natural history and uncertain malignant potential. Uterine involvement and their association with tuberous sclerosis are typical for these tumors. We present a case of a 40-year old patient who was incidentally diagnosed of a uterine PEComa and serial studies of PET-CT with FDG were performed for staging and therapeutic response assessment. FDG PET-CT proved to be a valuable tool for detecting unsuspected pulmonary metastases and defining the reassessment of the patient after chemotherapy. The findings suggest that since this is a rare tumor, which does not always have benign behaviour, PET-CT may be a useful diagnostic imaging procedure for staging and clinical monitoring of patients who suffer this type of tumors.
Assuntos
Neoplasias do Endométrio/diagnóstico por imagem , Estrogênios , Radioisótopos de Flúor , Fluordesoxiglucose F18 , Neoplasias Pulmonares/secundário , Neoplasias Hormônio-Dependentes/diagnóstico por imagem , Neoplasias de Células Epitelioides Perivasculares/diagnóstico por imagem , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Tomografia Computadorizada por Raios X , Adulto , Angiofibroma/diagnóstico por imagem , Angiofibroma/genética , Quimioterapia Adjuvante , Terapia Combinada , Neoplasias do Endométrio/patologia , Neoplasias do Endométrio/cirurgia , Neoplasias Faciais/genética , Feminino , Humanos , Histerectomia , Achados Incidentais , Neoplasias Renais/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Hormônio-Dependentes/tratamento farmacológico , Neoplasias Hormônio-Dependentes/secundário , Neoplasias Hormônio-Dependentes/cirurgia , Neoplasias Primárias Múltiplas/diagnóstico por imagem , Neoplasias de Células Epitelioides Perivasculares/tratamento farmacológico , Neoplasias de Células Epitelioides Perivasculares/secundário , Neoplasias de Células Epitelioides Perivasculares/cirurgia , Esclerose Tuberosa/diagnóstico por imagem , Esclerose Tuberosa/genéticaRESUMO
The combination of positron emission tomography (PET) and computed tomography (CT) in a single device (PET/CT) offers a powerful diagnostic tool that opens up new horizons for imaging diagnosis. In order to correctly interpret PET/CT studies, knowledge of the biodistribution of 18F-fluorodeoxyglucose (FDG), the physiological variants as well as the pitfalls, including artefacts, which may be found, is necessary. We report four cases performed during the follow-up diagnostic context of an oncology study performed with 18F-FDG-PET/CT. In every case, this study showed focal uptake in the lung parenchyma in the PET study with no structural lesions being found on the CT scan. Radiotracer extravasation in three of these patients and a recent change in the injection protocol used suggest that an artefact was responsible for these discrepancies.
Assuntos
Artefatos , Endotélio Vascular/lesões , Extravasamento de Materiais Terapêuticos e Diagnósticos/diagnóstico por imagem , Radioisótopos de Flúor , Fluordesoxiglucose F18 , Injeções Intravenosas/efeitos adversos , Neoplasias Pulmonares/secundário , Pulmão/diagnóstico por imagem , Tomografia por Emissão de Pósitrons , Embolia Pulmonar/diagnóstico por imagem , Compostos Radiofarmacêuticos , Adulto , Idoso , Hiperplasia do Linfonodo Gigante/diagnóstico por imagem , Diagnóstico Diferencial , Reações Falso-Positivas , Radioisótopos de Flúor/administração & dosagem , Radioisótopos de Flúor/farmacocinética , Fluordesoxiglucose F18/administração & dosagem , Fluordesoxiglucose F18/farmacocinética , Humanos , Injeções Intravenosas/instrumentação , Injeções Intravenosas/métodos , Pulmão/irrigação sanguínea , Neoplasias Pulmonares/diagnóstico por imagem , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Embolia Pulmonar/etiologia , Compostos Radiofarmacêuticos/administração & dosagem , Compostos Radiofarmacêuticos/farmacocinética , Nódulo Pulmonar Solitário/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Paralisia das Pregas Vocais/diagnóstico por imagemRESUMO
Leiomyomas are benign tumors derived from smooth muscle tissue that rarely present outside the uterus. These tumors do not usually show FDG uptake. We present the case of a patient with hypertension refractory to treatment and a lesion arising from inferior vena cava, that shows intense FDG uptake in PET/CT scan, suggestive of paraganglioma, with a final histological diagnosis of leiomyoma.
Assuntos
Fluordesoxiglucose F18 , Leiomioma/diagnóstico por imagem , Paraganglioma/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Compostos Radiofarmacêuticos , Neoplasias Vasculares/diagnóstico por imagem , Veia Cava Inferior/diagnóstico por imagem , 3-Iodobenzilguanidina , Diagnóstico Diferencial , Fluordesoxiglucose F18/farmacocinética , Humanos , Hipertensão , Leiomioma/metabolismo , Masculino , Pessoa de Meia-Idade , Compostos Radiofarmacêuticos/farmacocinética , Neoplasias Vasculares/metabolismo , Veia Cava Inferior/metabolismoRESUMO
OBJECTIVE: Co-circulation of the two Influenza B lineages hinders forecast of strain to include in trivalent vaccine. Autonomous Communities such as Cantabria continue without supplying tetravalent vaccine. The aim of this study was to analyse epidemiological characteristics of influenza type B in Cantabria (2019-2020 season) as well as to establish the predominant lineage and its relation to the recommended vaccine. METHODS: Retrospective study whereby flu diagnosis and lineage analysis were determined by RT-PCR. RESULTS: All samples belonged to the Victoria lineage. Most prevalent viral co-infection was due to SARS-CoV-2. The population affected by influenza B was mainly paediatric and non-vaccinated patients more frequently required hospital admittance. CONCLUSIONS: Influenza type B has a higher incidence in the paediatric population and type A affects more the adult population. Only 28.8% of patients with Influenza B that presented with some underlying condition or risk factor were vaccinated. This shows the need to increase coverage with tetravalent vaccines in order to reduce the burden of disease associated with the Influenza B virus.
Assuntos
COVID-19/epidemiologia , Vírus da Influenza B , Influenza Humana/epidemiologia , Pandemias , SARS-CoV-2 , Adulto , COVID-19/virologia , Distribuição de Qui-Quadrado , Criança , Coinfecção/epidemiologia , Coinfecção/virologia , Epidemias , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Influenza Humana/virologia , Masculino , Estudos Retrospectivos , Estações do Ano , Espanha/epidemiologia , Estatísticas não ParamétricasRESUMO
The Granada group in BNCT research is currently performing studies on: nuclear and radiobiological data for BNCT, new boron compounds and a new design for a neutron source for BNCT and other applications, including the production of medical radioisotopes. All these activities are described in this report.
Assuntos
Terapia por Captura de Nêutron de Boro/métodos , Aceleradores de Partículas , Humanos , Método de Monte Carlo , NêutronsRESUMO
Gallbladder cancer is the most common biliary tract neoplasm. It generally affects the elderly, who are usually clinically asymptomatic. When symptoms appear, they suggest the presence of complications locally or due to tumour progression. Late diagnosis of the disease indicates a poor prognosis for these patients. Surgery is the only treatment with curative intent, but it is only possible in the early stages. Diagnostic imaging of this type of tumour is usually performed with ultrasonography, computed tomography or magnetic resonance cholangiography. Positron emission tomography (PET) with fluorodeoxyglucose (FDG) with dedicated scanners or hybrid PET-CT scans are new diagnostic tools which could help in the pre-surgical diagnosis of these tumours. We present three cases to illustrate the usefulness of PET-FDG in the pre-surgical staging of gallbladder cancer.
Assuntos
Adenocarcinoma/diagnóstico por imagem , Radioisótopos de Flúor , Fluordesoxiglucose F18 , Neoplasias da Vesícula Biliar/diagnóstico por imagem , Estadiamento de Neoplasias/métodos , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Adenocarcinoma/complicações , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Idoso , Antineoplásicos/uso terapêutico , Neoplasias da Mama , Colecistectomia , Colelitíase/complicações , Terapia Combinada , Desoxicitidina/análogos & derivados , Desoxicitidina/uso terapêutico , Feminino , Neoplasias da Vesícula Biliar/complicações , Neoplasias da Vesícula Biliar/tratamento farmacológico , Neoplasias da Vesícula Biliar/patologia , Neoplasias da Vesícula Biliar/cirurgia , Humanos , Fígado/diagnóstico por imagem , Fígado/patologia , Invasividade Neoplásica/diagnóstico por imagem , Segunda Neoplasia Primária/diagnóstico por imagem , Cuidados Pré-Operatórios , GencitabinaRESUMO
Desmoid tumours are uncommon benign tumours but with aggressive behaviour, resulting from the proliferation of well-differentiated fibroblasts. Clinically, they present as a painless firm soft tissue mass. They can be solitary or multiple and have potential infiltrative capacity. When planning treatment, it is important to assess the correct tumour extent to permit curative radical surgery minimizing possible local recurrence. Different imaging techniques help to characterise these tumours. At present, magnetic resonance is the tool of choice for studying these tumours. The role of nuclear medicine techniques, such as bone scintigraphy, or more recently FDG-PET, has not been defined in the evaluation of these neoplasms. We present the case of a patient with a desmoid tumour of the abdominal-chest wall and we review the related literature.
Assuntos
Neoplasias Abdominais/diagnóstico por imagem , Parede Abdominal/diagnóstico por imagem , Neoplasias Ósseas/diagnóstico por imagem , Fibromatose Agressiva/diagnóstico por imagem , Radioisótopos de Flúor , Fluordesoxiglucose F18 , Neoplasias Musculares/diagnóstico por imagem , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Reto do Abdome/diagnóstico por imagem , Costelas/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Parede Abdominal/patologia , Adulto , Neoplasias Ósseas/patologia , Neoplasias Ósseas/cirurgia , Fibromatose Agressiva/patologia , Fibromatose Agressiva/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Neoplasias Musculares/patologia , Neoplasias Musculares/cirurgia , Invasividade Neoplásica , Reto do Abdome/patologia , Parede Torácica/diagnóstico por imagem , Parede Torácica/patologiaRESUMO
When elementary reactive processes occur at such low energies that only a few states of reactants and/or products are available, quantum effects strongly manifest and the standard description of the dynamics within the classical framework fails. We show here, for H2 scattering on Pd(111), that by pseudoquantizing in the spirit of Bohr the relevant final actions of the system, along with adequately treating the diffraction-mediated trapping of the incoming wave, classical simulations achieve an unprecedented agreement with state-of-the-art quantum dynamics calculations.