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1.
Int. j. med. surg. sci. (Print) ; 8(3): 1-16, sept. 2021. ilus
Article in English | LILACS | ID: biblio-1292541

ABSTRACT

For a long time, any heart-based injury was an off-limits area for surgeons; a patient with a traumatic cardiac injury was doomed to die. Little more than one hundred years have passed since the first surgical correction of a penetrating cardiac injury and there is still a high rate of mortality, despite the medical advances. We present the case of 6 patients with penetrating cardiac injuries that were repaired at a third level hospital of Mexico, alongside relevant findings on the literature about the topic. From 2019 to 2020, an incidence of 6 patients with penetrating cardiac injuries was present; all men aged 30 years or older. The etiology of 4 (67%) patients was stab wounds and 2 (33%) gunshot wounds. Left anterolateral thoracotomy was used on 5 (83%) patients and midline sternotomy on 1 (17%) patient. 2 (33%) injuries on the left ventricle presented along with coronary arteries injuries. Left ventricle and right atrium injuries presented each 50% of mortality. The mortality was of 33%, 1 patient died due to intraoperative complications and another one due to massive cerebral infarction and polyuric syndrome because of diabetes insipidus. There is a long path ahead of the surgical field on this topic and further to be analyzed. An excellent tool for cardiac tamponade diagnosis due to penetrating cardiac injuries is cardiac ultrasound, therefore it should be used on every hemodynamic unstable patient in the context of PCI. Definitively, time is of the essence, and the survival of patients depends on immediate transport to a hospital and an opportune surgical intervention.


Durante mucho tiempo las heridas en el corazón eran un área prohibida para el cirujano. Cualquier persona con herida penetrante cardíaca estaba condenada a morir. Poco más de cien años han transcurrido desde la primera corrección quirúrgica de una herida penetrante cardíaca y sigue habiendo una tasa alta de mortalidad, a pesar de los avances médicos. Se presenta una serie de casos de 6 pacientes con heridas penetrantes cardíacas que fueron reparadas en un hospital de tercer nivel de México, junto con revisión de la literatura. Desde el 2019 al 2020, hubo una incidencia de 6 pacientes con heridas penetrantes cardíacas; todos fueron hombres de 30 años o mayores. La etiología en 4 (67%) casos fueron heridas por arma blanca y 2 (33%) por herida por proyectil de arma de fuego. Se usó el abordaje por toracotomía anterolateral izquierda en 5 (83%) pacientes y esternotomía media en 1 (17%) paciente. Dos (33%) heridas se suscitaron en el ventrículo izquierdo en conjunto con heridas en arterias coronarias. Heridas en el ventrículo izquierdo y atrio derecho presentaron una mortalidad del 50% cada una. La mortalidad total fue de 33%, 1 paciente falleció por complicaciones intraoperatorias y otro más por infarto cerebral masivo y síndrome poliúrico causado por diabetes insípida. Hay un gran camino por recorrer en el ámbito quirúrgico de este tipo de heridas y más por ser analizado. Una herramienta útil para el diagnóstico del taponamiento cardíaco por heridas penetrantes cardíacas es el ultrasonido cardíaco, y, por ende, debe ser usado en todo paciente con inestabilidad hemodinámica en el contexto de una herida penetrante cardíaca. Definitivamente, el tiempo es vida, y la sobrevivencia de estos pacientes depende del transporte inmediato a un hospital y una intervención quirúrgica oportuna.


Subject(s)
Humans , Male , Myocardial Contusions/therapy , Myocardial Contusions/diagnostic imaging , Ultrasonics/methods
2.
Rev. bras. med. esporte ; 27(4): 372-376, Aug. 2021. graf
Article in English | LILACS | ID: biblio-1288601

ABSTRACT

ABSTRACT Objective: By studying the recognition effect of ultrasonic biological image data analysis on muscle group motion function, the evaluation value and significance of ultrasonic biomedical image combination algorithm on muscle group motion function are discussed. Methods: A Gabor filtering algorithm is proposed to smooth the original image. The MVEF algorithm is used to enhance the ultrasonic image and binary further the image again. Using the principle of the Hove transform, the thickness of the muscle is automatically estimated. Results: The square of correlation coefficients of the manual measurement method, Gabor filtering algorithm and MVEF algorithm are 91.3%, 91.3% and 87.8%, respectively. The difference between the manual measurement and the estimation based on the Gabor filtering algorithm is 1.45 ± 0.48mm. The difference between the results of manual measurement and the MVEF algorithm is 1.38 ± 0.56mm. The computation time of the MVEF algorithm and Gabor algorithm are 5 seconds and 0.3 seconds, respectively. Conclusions: The algorithm proposed in this study can effectively measure the muscle thickness, fast, convenient and accurate, and can reflect the contractility of skeletal muscle well, which is of great value for the recognition and evaluation of muscle group movement function. Level of evidence II; Therapeutic studies - investigation of treatment results.


RESUMO Objetivo: Ao estudar o efeito de reconhecimento da análise de dados de imagem biológica ultrassônica na função de movimento do grupo muscular, o valor de avaliação e a importância do algoritmo de combinação de imagem biomédica ultrassônica na função de movimento do grupo muscular são discutidos. Métodos: Um algoritmo de filtragem Gabor é proposto para suavizar a imagem original. O algoritmo MVEF é usado para aprimorar ainda mais a imagem ultrassônica e binar a imagem novamente. Usando o princípio da transformada de H ove, a espessura do músculo é automaticamente estimada. Resultados: O quadrado dos coeficientes de correlação do método de medição manual, algoritmo de filtragem Gabor e algoritmo MVEF são 91,3%, 91,3% e 87,8%, respectivamente. A diferença entre a medição manual e a estimativa baseada no algoritmo de filtragem Gabor é 1,45 ± 0,48 mm. A diferença entre os resultados da medição manual e o algoritmo MVEF é de 1,38 ± 0,56 mm. O tempo de cálculo do algoritmo MVEF e do algoritmo Gabor é de 5 segundos e 0,3 segundos, respectivamente. Conclusões: O algoritmo proposto neste estudo pode medir efetivamente a espessura muscular, de forma rápida, conveniente e precisa, e pode refletir bem a contratilidade do músculo esquelético, o que é de grande valor para o reconhecimento e avaliação da função de movimento do grupo muscular. Nível de evidência II; Estudos terapêuticos- investigação dos resultados do tratamento.


RESUMEN Objetivo: Al estudiar el efecto de reconocimiento del análisis de datos de imágenes biológicas ultrasónicas sobre la función del movimiento del grupo muscular, se discuten el valor de evaluación y la importancia del algoritmo de combinación de imágenes biomédicas ultrasónicas sobre la función del movimiento del grupo muscular. Métodos: Se propone un algoritmo de filtrado de Gabor para suavizar la imagen original. El algoritmo MVEF se utiliza para mejorar aún más la imagen ultrasónica y volver a binar la imagen. Utilizando el principio de la transformada de H ove, el grosor del músculo se estima automáticamente. Resultados: El cuadrado de los coeficientes de correlación del método de medición manual, el algoritmo de filtrado de Gabor y el algoritmo MVEF son 91,3%, 91,3% y 87,8%, respectivamente. La diferencia entre la medición manual y la estimación basada en el algoritmo de filtrado de Gabor es de 1,45 ± 0,48 mm. La diferencia entre los resultados de la medición manual y el algoritmo MVEF es 1,38 ± 0,56 mm. El tiempo de cálculo del algoritmo MVEF y el algoritmo de Gabor son 5 segundos y 0,3 segundos respectivamente. Conclusiones: El algoritmo propuesto en este estudio puede medir eficazmente el grosor muscular, de forma rápida, conveniente y precisa, y puede reflejar bien la contractilidad del músculo esquelético, lo cual es de gran valor para el reconocimiento y evaluación de la función del movimiento de grupos musculares. Nivel de evidencia II; Estudios terapéuticos- investigación de los resultados del tratamiento.


Subject(s)
Humans , Ultrasonics/methods , Algorithms , Muscles/physiopathology , Muscles/diagnostic imaging , Data Analysis
3.
Rev. cuba. med ; 60(1): e1399, tab
Article in Spanish | LILACS, CUMED | ID: biblio-1156554

ABSTRACT

RESUMEN Introducción: El ultrasonido endobronquial lineal con aspiración transbronquial por aguja fina es una técnica novedosa para el diagnóstico de tumores y ganglios mediastínicos e hiliares. Objetivo: Evaluar la eficacia diagnóstica de ultrasonido endobronquial lineal con aspiración transbronquial por aguja fina como método de estudio de lesiones hiliares y mediastinales. Métodos: Se realizó un estudio descriptivo con carácter prospectivo en 49 pacientes a los que se le realizó ultrasonido endobronquial lineal con aspiración transbronquial por aguja fina. Resultados: El diagnóstico se obtuvo mediante la histología y resultaron positivos 48 pacientes, de ellos 45 fueron positivos por el ultrasonido endobronquial lineal con aspiración transbronquial por aguja fina y 4 negativos por este estudio. El resultado global de la investigación mostró una sensibilidad de 93,8 %, especificidad 100 %, valor predictivo positivo de 100 % y predictivo negativo 25 %. De esta manera, el índice de validez de ultrasonido endobronquial lineal con aspiración transbronquial por aguja fina fue de 93,8 %. El número de complicaciones fue mínimo. Conclusiones: El ultrasonido endobronquial lineal con aspiración transbronquial por aguja fina constituye un método diagnóstico eficaz y seguro en el estudio de pacientes que presentan lesiones hiliares y mediastinales con alta sospecha de cáncer de pulmón y a su vez, una alternativa de acceder al mediastino de manera no cruenta para la estadificación ganglionar.


ABSTRACT Introduction: Linear endobronchial ultrasound with transbronchial fine needle aspiration is a novel technique for the diagnosis of tumors and mediastinal and hilar lymph nodes. Objective: To evaluate the diagnostic efficacy of linear endobronchial ultrasound with transbronchial fine needle aspiration as a method of studying hila and mediastinal lesions. Methods: A prospective descriptive study was carried out in 49 patients who underwent linear endobronchial ultrasound with transbronchial fine needle aspiration. Results: The diagnosis was obtained by histology and 48 patients were positive, 45 of them resulted positive by linear endobronchial ultrasound with transbronchial fine needle aspiration and 4 resulted negative by this study. The overall result of the investigation showed a sensitivity of 93.8%, specificity 100%, a positive predictive value of 100% and a negative predictive value of 25%. Thus, the validity index of linear endobronchial ultrasound with transbronchial fine needle aspiration was 93.8%. The number of complications was minimal. Conclusions: Linear endobronchial ultrasound with transbronchial fine needle aspiration is an effective and safe diagnostic method in the study of patients with hilar and mediastinal lesions with high suspicion of lung cancer and, consecutively, it is an alternative to access the mediastinum in a non- invasive approach for lymph node staging.


Subject(s)
Humans , Male , Female , Ultrasonics/methods , Bronchoscopy/methods , Biopsy, Fine-Needle/methods , Epidemiology, Descriptive , Prospective Studies
4.
Rev. cuba. ortop. traumatol ; 34(2): e298, jul.-dic. 2020. tab, ilus
Article in Spanish | LILACS, CUMED | ID: biblio-1156592

ABSTRACT

RESUMEN Introducción: Diferentes estudios relacionan el diagnóstico del ultrasonido de alta resolución con el diagnóstico artroscópico del manguito rotador, ambos métodos son favorables y muestran una alta sensibilidad y especificidad al compararlos. Objetivo: Establecer la eficacia diagnóstica entre los hallazgos ecográficos de alta resolución y el diagnóstico artroscópico de rupturas parciales y completas del manguito rotador. Métodos: Se realizó un estudio analítico transversal con el objetivo de evaluar la eficacia diagnóstica del ultrasonido de alta resolución en pacientes del Hospital Provincial General Docente Dr. Antonio Luaces Iraola, de Ciego de Ávila, con diagnóstico clínico de rupturas parciales y completas del manguito rotador, de enero del 2016 a enero del 2019. El universo estuvo constituido por 62 pacientes con diagnóstico clínico de ruptura del manguito rotador que presentaban indicaciones quirúrgicas, a los que se les indicó un estudio imagenológico con ultrasonido de alta resolución y, con posterioridad, se les realizó la intervención quirúrgica por artroscopia, que fue tomada como criterio de verdad. Resultados: Predominó el sexo masculino, con una edad media menor que los del sexo femenino. Los hallazgos diagnósticos por ambos métodos mostraron concordancia en más de dos tercios de los pacientes que presentaron rupturas parciales y completas del espesor del manguito rotador. La ultrasonografía según el método empleado resultó un medio diagnóstico eficaz para las rupturas parciales y completas del espesor del manguito rotador. Conclusiones: El ultrasonido de alta resolución presentó una adecuada correlación en el diagnóstico de lesiones parciales o completas del manguito rotador, confirmada por artroscopia y es considerado un medio diagnóstico eficaz(AU)


ABSTRACT Introduction: Different studies relate the diagnosis of high-resolution ultrasound with the arthroscopic diagnosis of the rotator cuff. Both methods are favorable and show high sensitivity and specificity when they are compared. Objective: To establish diagnostic efficacy between the findings of high-resolution ultrasound and the arthroscopic diagnosis of partial and complete ruptures of the rotator cuff. Methods: A cross-sectional analytical study was carried out, aimed at evaluating the diagnostic efficacy of high-resolution ultrasound in patients of Dr. Antonio Luaces Iraola Provincial General Teaching Hospital, in Ciego de Ávila, with a clinical diagnosis of partial and complete ruptures of the rotator cuff, from January 2016 to January 2019. The universe consisted of 62 patients with a clinical diagnosis of rotator cuff rupture who presented surgical indications, and who were also indicated for an imaging study with high-resolution ultrasound and, subsequently, performed arthroscopic surgery, taken as a criterion of truth. Results: The male sex predominated, with an average age lower than those corresponding to female sex. The diagnostic findings by both methods showed agreement in more than two thirds of the patients who presented partial and complete ruptures of the rotator cuff's thickness. Ultrasonography, according to the method used, was an effective diagnostic tool for partial and complete ruptures of the rotator cuff's thickness. Conclusions: High-resolution ultrasound showed an adequate correlation in the diagnosis of partial or complete ruptures of rotator cuff, as confirmed by arthroscopy. It is considered an effective diagnostic means(AU)


Subject(s)
Humans , Male , Female , Arthroscopy/methods , Ultrasonics/methods , Rotator Cuff Injuries/surgery , Rotator Cuff Injuries/diagnostic imaging , Cross-Sectional Studies
5.
Rev. cuba. med ; 59(2): e1351, abr.-jun. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1139047

ABSTRACT

Introducción: Las enfermedades cardiovasculares de mayor prevalencia y la hipertensión arterial tienen como sustento la aterosclerosis y la disfunción endotelial. La evaluación no invasiva de aterosclerosis subclínica constituye un complemento para la estratificación del riesgo cardiovascular en la evaluación del paciente hipertenso. Objetivo: Determinar la utilidad del diámetro basal de la arteria braquial en la evaluación del paciente con hipertensión arterial esencial. Método: Se realizó un estudio transversal analítico que incluyó 30 pacientes con hipertensión arterial esencial, a quienes se les realizó ultrasonografía para medir el diámetro basal de la arteria braquial, la vasorreactividad dependiente del endotelio y el grosor íntima media carotídeo, así como se precisó su riesgo cardiovascular, el tiempo de evolución y grado de la hipertensión arterial. Para determinar la asociación entre el diámetro arterial y el resto de las variables se utilizaron pruebas estadísticas como ANOVA de una vía y el coeficiente de correlación de Pearson. Resultados: La disfunción endotelial estuvo presente en 83,3 por ciento de los pacientes estudiados. Tanto el grosor del complejo íntima media carotídeo como la vasorreactividad dependiente del endotelio fueron adecuados marcadores de la enfermedad aterosclerótica. El diámetro basal de la arteria braquial tuvo una correlación inversa con la vasorreactividad dependiente del endotelio, y mostró valores medios esperados en relación a la presencia del tabaquismo, y con los peores grados de la enfermedad hipertensiva y el riesgo cardiovascular. Conclusiones: El diámetro basal de la arteria braquial no mostró la asociación esperada para la evaluación del paciente hipertenso esencial en la población estudiada(AU)


Introduction: The most prevalent cardiovascular diseases and high blood pressure are supported by atherosclerosis and endothelial dysfunction. The non-invasive assessment of subclinical atherosclerosis complements the cardiovascular risk stratification when evaluating hypertensive patients. Objective: To determine the value of the basal diameter of the brachial artery in assessing patients suffering from essential arterial hypertension. Method: An analytical cross-sectional study was carried out in 30 patients with essential arterial hypertension. They underwent ultrasonography to measure the basal diameter of the brachial artery, endothelium-dependent vasoreactivity and carotid mean intima thickness, as well as the cardiovascular risk, time of evolution and degree of arterial hypertension. Statistical tests such as one-way ANOVA and Pearson's correlation coefficient were used to determine the association between arterial diameter and the rest of the variables. Results: Endothelial dysfunction was present in 83.3% of the studied patients. Both the thickness of the carotid media intima complex and endothelium-dependent vasoreactivity were adequate markers for atherosclerotic disease. The basal diameter of the brachial artery had inverse correlation with endothelium-dependent vasoreactivity, and it showed expected mean values in relation to the presence of smoking, and with the worst degrees of hypertensive disease and cardiovascular risk. Conclusions: The basal diameter of the brachial artery did not show the expected association for the evaluation of essential hypertensive patients in the studied population(AU)


Subject(s)
Humans , Male , Female , Ultrasonics/methods , Brachial Artery/growth & development , Essential Hypertension/diagnosis , Patients , Cross-Sectional Studies
7.
Rev. cuba. pediatr ; 92(1): e990, ene.-mar. 2020. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1093749

ABSTRACT

Introducción: El síndrome prune belly es una rara y compleja anomalía congénita y el seudo prune belly es aún más raro y en muchas ocasiones no se diagnostica como tal. Objetivo: Describir un paciente con las características de este síndrome. Presentación del caso: Feto de sexo masculino que en la semana 23 del embarazo el ultrasonido prenatal detectó dilatación pélvica bilateral y se propuso la interrupción del embarazo que no fue aceptada por los padres. Al nacer se observa criptorquidia bilateral, el ultrasonido renal a las 34 horas de nacido confirma dilatación pélvica bilateral severa, se indica profilaxis con cefalexina, y a los cuatro dias de nacido es enviado a consulta de nefrología. Al llegar a consulta se observa la ausencia de testículos en ambas bolsas escrotales y el ultrasonido abdominal a los 16 dias confirma dilatación pélvica renal derecha severa y uréter dilatado en su tercio superior con 6 mm de diámetro y ureteropielocaliectasia severa del lado izquierdo; no se visualiza testículo derecho y el izquierdo en canal inguinal mide 7 × 10 mm. La gammagrafía estática demostró hipocaptación marcada del radiofármaco por el riñón izquierdo y disminución de la función renal relativa y en la uretrocistografía miccional se encontró dilatación vesical y reflujo vesicoureteral con ureterohidronefrosis bilateral. Conclusiones: El seudo síndrome prune belly presenta alteraciones complejas del tracto urinario que son las que establecen el pronóstico en estos casos(AU)


Introduction: Prune belly syndrome is a rare and complex congenital anomaly and the pseudo prune belly is even rarer and often not diagnosed as such. Objective: To describe a patient with the characteristics of this syndrome. Presentation of the case: Male fetus that in the 23rd week of pregnancy it was detected a bilateral pelvic dilatation in the prenatal ultrasound; and it was proposed the termination of pregnancy which was not accepted by the parents. At birth it is observed bilateral cryptorchidism; the renal ultrasound at 34 hours after birth confirmed bilateral severe pelvic dilation, it is indicated prophylaxis with cephalexin, and at four days after birth, the newborn is remitted to the Nephrology consultation. In the consultation it was noticed the absence of scrotal sacs in both testicles and the abdominal ultrasound at 16 days after birth confirmed severe right renal pelvic dilatation and dilated ureter in its upper third with 6 mm of diameter and severe uretero-pielocaliectasy in the left side; it is not visualized the right testicle and the left in the inguinal channel measured 7 × 10 mm. Static scintigraphy showed marked hypocaptation of the radiopharmaceutical by the left kidney and decreased relative renal function, and in the voiding cystourethrogram it was found bladder dilation and vesicoureteral reflux with bilateral ureterohydronephrosis. Conclusions: The pseudo prune belly syndrome presents complex abnormalities of the urinary tract that are those which establish the prognosis in these cases(AU)


Subject(s)
Humans , Male , Infant, Newborn , Prune Belly Syndrome/diagnostic imaging , Ultrasonics/methods , Fetus/abnormalities
8.
Rev. otorrinolaringol. cir. cabeza cuello ; 79(4): 482-492, dic. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1058726

ABSTRACT

RESUMEN En la práctica clínica es habitual el estudio de linfonodos cervicales. La anamnesis y el examen físico orientan la etiología, pero ocasionalmente debemos recurrir a estudios imagenológicos. Esto es muy relevante en contexto de un linfonodo metastásico por un carcinoma escamoso de cabeza y cuello. Para esto podemos utilizar diversas herramientas imagenológicas. El ultrasonido se utiliza para el estudio inicial de una masa cervical en donde clínicamente no queda claro el origen. La tomografía computarizada permite la evaluación de manera global del cuello. Se utiliza ante sospechas o diagnósticos confirmados de carcinoma escamoso de cabeza y cuello. La resonancia magnética tiene utilidad en casos que requieren evaluación de un primario y el cuello, como cánceres de glándulas salivales, base de lengua, lengua oral o piso de boca. El PET-TC es un buen examen a la hora de evaluar un cáncer de cabeza y cuello de primario desconocido y posibles metástasis a distancia, como también cuando se quiere evaluar adenopatías persistentes postratamiento con radioquimioterapia. Tener una evaluación ordenada en el estudio de un linfonodo, por sobre todo con un uso adecuado del recurso imagenológico ayuda a no enlentecer el proceso diagnóstico y dar un diagnóstico y tratamiento más certero.


ABSTRACT In clinical practice, the study of cervical lymph nodes is common. The anamnesis and the physical examination often guide the etiology, however sometimes we have to use images studies. This is very relevant when we are assessing a metastatic lymph node due to head and neck squamous cell carcinoma. Ultrasound is usually used for the initial study of a cervical mass where the physician cannot determine its origin. The computed tomography allows a global evaluation of the neck. It is most often used when there is suspicion or confirmed diagnoses of head and neck squamous cell carcinoma. Magnetic resonance imaging is useful in cases that require evaluation of a primary neoplasm and the neck, such in salivary gland cancers, tongue base cancers, oral tongue or mouth floor tumors. PET-CT is a good test to evaluate head and neck cancers of unknown primary site and possible distant metastases, as well as evaluation of persistent adenopathies after treatment with radiochemotherapy. Having an organized evaluation in the study of a lymph node, with an adequate use of the imaging resource, helps not to hinder the diagnostic process and give an accurate diagnosis and treatment.


Subject(s)
Humans , Head and Neck Neoplasms/diagnostic imaging , Lymph Nodes/anatomy & histology , Lymph Nodes/diagnostic imaging , Ultrasonics/methods , Magnetic Resonance Spectroscopy/methods , Tomography, X-Ray Computed/methods , Lymphadenopathy/diagnostic imaging , Head and Neck Neoplasms
11.
J. vasc. bras ; 17(4): 333-336, out.-dez. 2018. ilus
Article in Portuguese | LILACS | ID: biblio-969174

ABSTRACT

Cerebral ischemia is a very rare and harmful complication of ultrasound-guided foam sclerotherapy for treatment of varicose veins. This case describes a documented cerebrovascular ischemia in Broca's area following ultrasound-guided foam sclerotherapy. Less than one hour after intravenous injection of 10 ml of sclerosing foam, an otherwise healthy woman experienced aphasia without any other signs of neurological changes. When she arrived home, a complete inability to talk was observed. The event was misdiagnosed by another doctor as an allergic reaction. Next morning she came to the office to report the allergic reaction, where an appropriate diagnosis was made. She recovered just two days after the injection, but signs of recent cerebral ischemia were seen in Broca's area on magnetic resonance and transesophageal bubble study echocardiogram revealed a patent foramen ovale. Although rare, we must make great effort to prevent these events instead of treating them


A isquemia cerebral é uma complicação muito rara e perigosa da escleroterapia com espuma guiada por ultrassom no tratamento de varizes. Este caso descreve uma isquemia cerebral da área de Broca após escleroterapia com espuma guiada por ultrassom. Menos de uma hora após injeção de 10 mL de espuma, uma até então saudável mulher apresentou afasia, sem quaisquer outros sinais neurológicos. No caminho para casa, uma completa incapacidade de fala foi observada. Levada ao hospital mais próximo, foi diagnosticada com reação alérgica. Na manhã seguinte, compareceu ao consultório para relatar a reação alérgica, quando um correto diagnóstico foi feito. Ela ficou recuperada dois dias depois do procedimento, mas uma ressonância magnética mostrou sinais de isquemia recente da área de Broca e um ecocardiograma transesofágico mostrou um forame oval patente. Embora raros, devemos concentrar nossos esforços em prevenir tais eventos para que não precisem de tratamento


Subject(s)
Humans , Female , Ultrasonics/methods , Sclerotherapy , Brain Ischemia/complications , Sclerosing Solutions/therapeutic use , Varicose Veins/therapy , Magnetic Resonance Spectroscopy/methods , Echocardiography, Transesophageal/methods , Embolism/complications , Foramen Ovale, Patent
12.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 28(3 (supl)): 345-352, jul.-set. 2018. tab
Article in English, Portuguese | LILACS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-964372

ABSTRACT

As emergências cardiológicas podem causar rápidas e profundas alterações na resposta metabólica e sistêmica. Essas alterações contribuem acentuadamente para a mobilização das reservas corporais que repercutirão no estado nutricional. A avaliação nutricional, ainda que não seja realizada na fase crítica da assistência interdisciplinar, deverá ser realizada o quanto antes, visando a adoção da alimentação adequada e reposição hídrica e de eletrólitos. O uso de ferramentas subjetivas capazes de estimar o risco nutricional global é de fácil aplicação devido a sua praticidade e rapidez. Entre essas destaca-se o Nutritional Risk Score ­ NRS 2002. Sempre que possível, a avaliação nutricional global deve ser complementada pela avaliação nutricional objetiva e pelo uso de marcadores nutricionais bioquímicos, os quais auxiliarão na avaliação mais precisa do estado nutricional do paciente crítico. Essas ferramentas devem ser utilizadas por nutricionistas treinados e os resultados devem ser discutidos pela equipe multidisciplinar de terapia nutricional que decidirá as estratégias mais adequadas para o início da terapia nutricional precoce nos quadros de emergências cardiológicas


Cardiac emergencies can cause rapid and profound changes in the metabolic and systemic response. These changes contribute significantly to the mobilization of body reserves, which will affect nutritional status. Nutritional evaluation, although not performed in the critical phase of interdisciplinary care, should be carried out as early as possible in order to ensure an adequate diet, and water and electrolyte replacement. The use of subjective tools capable of estimating the global nutritional risk is easy to apply due to its effective and rapid application. One such tool is the Nutritional Risk Score ­ NRS 2002. Whenever possible, the global nutritional assessment should be complemented with objective nutritional assessment and the use of biochemical nutritional markers, which will help obtain a more accurate evaluation of the nutritional status of the critically ill patient. These tools should be applied by trained nutritionists, and the results should be discussed by the multidisciplinary nutritional therapy team, which will decide on the most appropriate strategies for the initiation of early nutritional therapy in cardiac emergency situations


Subject(s)
Humans , Male , Female , Adult , Cardiology , Nutrition Assessment , Emergencies , Prognosis , Atrial Fibrillation/complications , Atrial Fibrillation/physiopathology , Cardiovascular Surgical Procedures/adverse effects , Cardiovascular Surgical Procedures/methods , Ultrasonics/methods , Body Mass Index , Anthropometry/methods , Guidelines as Topic/standards , Heart Diseases/surgery , Hospitalization
13.
J. vasc. bras ; 17(3)jul.-set. 2018. ilus
Article in Portuguese | LILACS | ID: biblio-915729

ABSTRACT

A compressão do tronco celíaco pelo ligamento arqueado mediano do diafragma pode causar sintomas inespecíficos como dor abdominal, vômitos e emagrecimento. Existe uma associação comprovada entre estenoses ou oclusões do tronco celíaco e aneurismas da artéria pancreatoduodenal. Nas situações em que essa associação ocorre, a estratégia de tratamento deve ser individualizada. Relatamos o caso de uma paciente com aneurisma de artéria pancreatoduodenal associado à compressão do tronco celíaco pelo ligamento arqueado, manejados, respectivamente, por técnicas endovasculares e laparoscópicas


Compression of the celiac axis by the median arcuate ligament of the diaphragm can cause nonspecific symptoms such as abdominal pain, vomiting, and weight loss. There is a known association between stenosis or occlusion of the celiac trunk and aneurysms of the pancreaticoduodenal artery. Treatment strategies for patients who have this association should be selected on a case-by-case basis. We describe the case of a patient with pancreaticoduodenal artery aneurysm associated with compression of the celiac trunk by the arcuate ligament, which were managed with endovascular and laparoscopic techniques, respectively


Subject(s)
Humans , Male , Female , Aneurysm/physiopathology , Aneurysm/therapy , Celiac Artery/diagnostic imaging , Diaphragm , Endovascular Procedures/methods , Laparoscopy/methods , Median Arcuate Ligament Syndrome/physiopathology , Median Arcuate Ligament Syndrome/therapy , Constriction, Pathologic/complications , Diagnosis, Differential , Diagnostic Imaging/methods , Echocardiography, Doppler/methods , Mesenteric Arteries/diagnostic imaging , Pancreas/physiopathology , Stents , Ultrasonics/methods
14.
Rev. cuba. invest. bioméd ; 37(1): 32-46, ene.-mar. 2018. tab
Article in Spanish | LILACS, CUMED | ID: biblio-991089

ABSTRACT

Fundamento: el cáncer gástrico constituye la segunda causa de muerte por cáncer en el mundo. Objetivo: validar el ultrasonido hidrogástrico en el diagnóstico del cáncer gástrico avanzado. Métodos: el ultrasonido hidrogástrico fue realizado por dos observadores independientes a 100 pacientes, 30 con cáncer gástrico avanzado, confirmados por endoscopia y biopsia; y 70 pacientes sin cáncer gástrico. Resultados: por regresión logística se determinó que el engrosamiento de la pared gástrica fue el único signo con valor como predictor de la presencia de CG. La sensibilidad, especificidad, certeza, valor predictivo positivo y valor predictivo negativo del ultrasonido hidrogástrico fueron de 83,3 por ciento; 90, por ciento; 88,0 por ciento; 78,1 por ciento y 92,6 por ciento respectivamente. Conclusiones: el ultrasonido hidrogástrico es una modalidad diagnostica útil en el diagnóstico del cáncer gástrico avanzado(AU)


Background: gastric cancer still remains one of the most common malignancies worldwide. Objective: to validate the Conventional hydrogastric ultrasound in the diagnosis of the advanced gastric cancer. Methods: the hydrogastric ultrasound was carried out by two independent observers 30 with cancer patients with advanced gastric cancer, confirmed by endoscopy and biopsy; and 70 patients without gastric cancer. Results: for logistical regression it was determined that the thickening of the gastric wall was the only sign with value like predictor of the presence of advancedgastric cancer. The sensibility, specificity, certainty, value positive predictive and value negative predictive of the hydrogastric ultrasound in the diagnosis of gastric cancer were of 83,3 percent; 90;0 percent; 88,0 percent; 78,1 percent y 92,6 percent respectively. Conclusions: the Hydrogastric ultrasound is a diagnostic modality useful in the diagnosis of the advanced gastric cancer(AU)


Subject(s)
Humans , Male , Female , Stomach Neoplasms/diagnostic imaging , Ultrasonics/methods , Abdominal Wall/diagnostic imaging , Validation Study
15.
Braz. oral res. (Online) ; 32: e88, 2018. tab, graf
Article in English | LILACS | ID: biblio-952167

ABSTRACT

Abstract The aim of this study was to evaluate the influence of a novel ultrasonic tip as an auxiliary method for removing filling material from flattened/oval-shaped canals. The null hypothesis tested was that this method does not influence removing the filling material in flattened/oval-shaped canals. Forty-five mandibular incisors were selected and randomly divided into three experimental groups (n = 15) according to different protocols for removing root canal filling material. Group R: Reciproc R25/.08, Group RC: Reciproc R25/.08 + Clearsonic tip, and Group CR: Clearsonic tip + Reciproc R25/.08. The teeth were scanned pre and post-operatively by means of a micro-computed tomography system. Data were analyzed using non-parametric Kruskal-Wallis and Dunn tests (p < 0.05). The percentage of residual root canal filling material between the experimental groups was examined. Statistically significant differences between the experimental groups were found in the root canal. Group R had the highest percentage of residual root canal filling material when compared with Groups RC and CR. The lowest percentage of residual root canal filling material was observed in Group CR. In the apical third of the root canal, statistically significant differences were found between the different protocols. The use of the ClearSonic tip followed by the Reciproc 25/.08 file to remove filling material resulted in the lowest percentage of residuals in the whole root canal and in the apical third.


Subject(s)
Humans , Root Canal Filling Materials , Ultrasonics/instrumentation , Root Canal Preparation/instrumentation , Dental Instruments , Dental Pulp Cavity/anatomy & histology , Reference Values , Ultrasonics/methods , Materials Testing , Reproducibility of Results , Analysis of Variance , Statistics, Nonparametric , Root Canal Preparation/methods , Retreatment , Equipment Design , X-Ray Microtomography , Incisor/anatomy & histology
16.
Braz. J. Pharm. Sci. (Online) ; 54(spe): e01008, 2018. tab, ilus
Article in English | LILACS | ID: biblio-974428

ABSTRACT

Topical drug delivery is an interesting approach to treat skin diseases and to avoid pain and low patient compliance in cases where a systemic delivery is required. However, the stratum corneum, which is the outermost skin layer, strongly protects the body from the entrance of substances, especially those hydrophilic. In this context, different physical methods have been studied to overcome the stratum corneum barrier and facilitate penetration of drugs into or through the skin. Among them, iontophoresis, low-frequency ultrasound and microneedles have been widely employed for transdermal drug delivery. More recently, they are also studied to aid in the treatment of dermatological disorders, such as skin tumors and inflammation. Basically, iontophoresis refers to the movement of charged and non-charged hydrophilic molecules through the skin due to the application of a low constant electric current and the contributions of electromigration and electroosmosis. In low-frequency ultrasound, cavitation is the main mechanism for skin permeabilization that consists on the formation of microbubbles that disorganize the stratum corneum. Microneedles are microprojections, minimally invasive, that can be designed with different lengths, materials and geometry to increase skin permeability. In this review, concepts, mechanisms and applications of these three physical methods will be presented and discussed with focus on their use in dermatological treatments. Moreover, comparative studies using different physical methods will be presented and also some clinical perspectives will be addressed


Subject(s)
Skin , Administration, Topical , Skin Diseases/drug therapy , Ultrasonics/methods , Administration, Cutaneous , Iontophoresis/methods
17.
Int. j. morphol ; 35(4): 1249-1253, Dec. 2017. tab
Article in English | LILACS | ID: biblio-893123

ABSTRACT

SUMMARY: The aim of this research was to determine the difference in Calcaneus quantitative ultrasound (QUS) and body composition according to physical activity in preschool children. We recruited 296 healthy children (112 girls and 184 boys) from different kindergartens in Vojvodina, Serbia. Children were evaluated for body composition. Quantitative ultrasound (QUS) measurements of the heel were performed using the Speed of sound, Broadband Ultrasound Attenuation, Quantitative Ultrasound Index and Estimated bone mineral density for further analysis. Furthermore, children were divided into three groups according to physical activity. Apart from the differences in Body fat % and body mass, there were no significant group differences for BMI, waist circumference and abdominal skinfold (p>0.05). The ANOVA showed significant differences (p<0.05) in all QUS measurements between three different intensities of physical activity. The results show that Body Mass and Body fat % were important predictors that discriminate children according to physical activity. Moreover, the results show that beside BMI and Body fat %, all calcaneus QUS measurements showed differences according to physical activity. In conclusion, our study showed differenses in all calcaneus QUS measurements according to physical activity level.


RESUMEN: El objetivo de esta investigación fue determinar la diferencia entre el ultrasonido cuantitativo (USC) de calcáneo y la composición corporal según la actividad física en niños en edad preescolar. Se estudiaron 296 niños sanos (112 niñas y 184 niños) de diferentes jardines infantiles en Vojvodina, Serbia. Se evaluó la composición corporal de los niños. Las medidas de USC del talón se realizaron utilizando la velocidad del sonido, atenuación de ultrasonido de banda ancha, el índice de ultrasonidos cuantitativos y la densidad mineral ósea estimada para un análisis posterior. Los niños se dividieron en tres grupos según actividad física. Además de las diferencias de porcentaje de grasa corporal y masa corporal, no se observaron diferencias significativas de grupo en el índice de masa corporal (IMC), circunferencia de cintura y el pliegue abdominal (p> 0,05). El test de ANOVA mostró diferencias significativas (p <0,05) en todas las mediciones USC entre tres diferentes intensidades de actividad física. Los resultados muestran que la masa corporal y la grasa corporal fueron indicadores importantes que permiten diferenciar a los niños según la actividad física. Por otra parte, los resultados muestran que además del IMC y el porcentaje de grasa corporal, todas las mediciones de USC del calcáneo mostraron diferencias según el nivel de actividad física. En conclusion, nuestro estudio mostró diferencias en el USC de acuerdo al nivel de actividad física.


Subject(s)
Humans , Male , Female , Child, Preschool , Body Composition , Calcaneus/anatomy & histology , Exercise , Ultrasonics/methods , Analysis of Variance , Body Weight , Bone Density , Calcaneus/diagnostic imaging , Serbia
18.
J. vasc. bras ; 16(4): f:314-l:319, out.-dez. 2017. ilus
Article in Portuguese | LILACS | ID: biblio-880798

ABSTRACT

O trombo venoso flutuante em veia femoral é um tipo de trombo com alto potencial de embolização pulmonar. Entretanto, ainda é controversa a conduta mais apropriada nesses casos. Tratamentos clínicos com anticoagulantes ou fibrinolíticos e trombectomias abertas ou por meio de dispositivos endovasculares vêm sendo empregados ainda sem um critério de indicação bem definido. Apresentamos três casos clínicos de trombos flutuantes em veia femoral, de etiologias distintas, cujos tratamentos e respectivas evoluções serão discutidos


A floating venous thrombus in the femoral vein is a type of thrombus with a high potential for pulmonary embolization. However, the most appropriate management for these cases is still controversial. Clinical treatments, using anticoagulants or fibrinolytics, open thrombectomies, or thrombectomies by means of endovascular devices have all been used, although the criteria for indication of each are not yet defined. We present 3 clinical cases of floating thrombi in femoral veins with different etiologies and discuss their respective treatments and outcomes


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Femoral Vein/surgery , Venous Thrombosis/surgery , Anticoagulants/therapeutic use , Enoxaparin/administration & dosage , Lower Extremity , Pulmonary Embolism , Therapeutics/methods , Thrombectomy/methods , Thrombosis/surgery , Ultrasonics/methods , Warfarin/administration & dosage
19.
J. vasc. bras ; 16(3): f:214-l:219, jul.-set. 2017. tab
Article in English | LILACS | ID: biblio-876994

ABSTRACT

Background: During pregnancy, a number of changes affecting venous blood flow occur in the circulatory system, such as reduced vein wall tension or increased exposure to collagen fibers. These factors may cause blood stagnation, swelling of the legs, or endothelial damage and consequently lead to development of venous disease. Objectives: The aim of this study is to evaluate the effect of special footwear designed to improve blood circulation in the feet on venous blood flow changes observed during advancing phases of pregnancy. Methods: Thirty healthy pregnant women participated in this study at 25, 30, and 35 weeks of gestation. Participants were allocated at random to an experimental group (n = 15) which was provided with the special footwear, or a control group (n = 15). At each data collection session, Doppler measurements of peak systolic blood flow velocity and cross-sectional area of the right popliteal vein were performed using a MySonoU6 ultrasound machine with a linear transducer (Samsung Medison). The differences were compared using Cohen's d test to calculate effect size. Results: With advancing phases of pregnancy, peak systolic velocity in the popliteal vein decreased significantly in the control group, whereas it increased significantly in the experimental group. No significant change in cross-sectional area was observed in any of the groups. Conclusions: Findings in the experimental group demonstrated that wearing the footwear tested may prevent venous blood velocity from reducing during advanced phases of pregnancy. Nevertheless, there is a need for further investigation of the beneficial effect on venous flow of the footwear tested and its application


Contexto: Durante a gravidez, uma série de mudanças que afetam o fluxo venoso ocorrem no sistema circulatório, tais como menor tensão da parede venosa ou aumento da exposição a fibras de colágeno. Esses fatores podem causar estagnação sanguínea, inchaço das pernas ou dano endotelial e, consequentemente, levar ao desenvolvimento de doença venosa. Objetivos: O objetivo deste estudo foi avaliar o efeito do uso de calçados especiais projetados para melhorar a circulação sanguínea dos pés sobre as mudanças no fluxo venoso observadas nas fases avançadas da gravidez. Métodos: Trinta gestantes saudáveis participaram deste estudo às 25, 30 e 35 semanas de gestação. As participantes foram aleatoriamente designadas a um grupo experimental (n = 15) que recebeu calçados especiais, ou um grupo controle (n = 15). A cada sessão de coleta de dados, foram obtidas medidas Doppler do pico de velocidade do fluxo sanguíneo sistólico e da área transversal da veia poplítea direita, utilizando-se um aparelho de ultrassom MySonoU6 com transdutor linear (Samsung Medison). As diferenças foram comparadas utilizando-se o teste d de Cohen para calcular o tamanho do efeito. Resultados: Nas fases avançadas da gravidez, o pico da velocidade sistólica na veia poplítea diminuiu significativamente no grupo controle, porém aumentou significativamente no grupo experimental. Não houve mudanças significativas na área transversal da veia poplítea em nenhum dos grupos. Conclusões: Os achados do grupo experimental demonstraram que o uso dos calçados especiais testados pode evitar que a velocidade do fluxo venoso diminua nas fases avançadas da gravidez. No entanto, mais estudos são necessários para investigar os efeitos benéficos sobre o fluxo venoso do uso dos calçados testados e suas aplicações


Subject(s)
Humans , Female , Pregnancy , Lower Extremity/physiopathology , Pregnancy/physiology , Regional Blood Flow/physiology , Shoes/adverse effects , Cardiovascular System/physiopathology , Control Groups , Echocardiography/methods , Popliteal Vein/physiopathology , Stroke Volume , Ultrasonics/methods
20.
J. vasc. bras ; 16(3): f:220-l:226, jul.-set. 2017. ilus, graf, tab
Article in Portuguese | LILACS | ID: biblio-877004

ABSTRACT

Contexto: Faz-se importante o conhecimento técnico dos ajustes de potência e de densidade de energia linear endovenosa (linear endovenous energy density, LEED) adequados para atingir o objetivo final da termoablação endovenosa (endovenous laser ablation, EVLA). Objetivos: Avaliar a influência de diferentes LEEDs em termos de patência e presença de refluxo, bem como determinar a evolução clínica. Métodos: Foram incluídas 60 veias safenas magnas (VSM). Os pacientes foram randomizados em dois grupos: EVLA com baixa potência (7 W e LEED de 20-40 J/cm) e com alta potência (15 W e LEED de 80-100 J/cm). O acompanhamento com eco-Doppler e escore de severidade clínica venoso (VCSS) foi realizado nos intervalos de 3-5 dias, 30 dias, 180 dias e 1 ano após o procedimento. Resultados: Dezoito pacientes (29 membros) tratados com 7W de potência e 13 pacientes (23 membros) com 15 W completaram o estudo. Não houve diferença significativa considerando idade, tempo de cirurgia e o uso de analgésicos, lateralidade, gênero e presença de comorbidades. O LEED médio foi de 33,54 J/cm no grupo de 7 W e de 88,66 J/cm no de 15 W. Ambos apresentaram melhora no VCSS, redução significativa dos diâmetros da JSF e ausência de diferença significativa quanto ao aumento do comprimento do coto da VSM e de refluxo após o tratamento. Conclusões: A utilização de maior densidade de energia mostrou-se mais efetiva em relação à estabilização do comprimento do coto da VSM e do refluxo em 6 meses. Fazem-se necessários estudos com um período de acompanhamento maior para fundamentar essa hipótese


Background: It is important to acquire technical knowledge about the power and linear endovenous energy density (LEED) settings needed to achieve the ultimate goal of endovenous laser ablation (EVLA). Objectives: To evaluate the influence of different LEEDs in terms of patency and presence of reflux and to determine clinical outcomes. Methods: Sixty great saphenous veins (GSVs) were included. Patients were randomized into 2 groups, low-power EVLA (7 W and LEED of 20-40 J/cm) and high-power EVLA (15 W and LEED of 80-100 J/cm). Patients were followed-up with duplex ultrasound and calculation of venous clinical severity score (VCSS) at 3-5 days, 30 days, 180 days, and 1 year after the procedure. Results: 18 patients (29 limbs) treated with 7 W of laser power and 13 patients (23 limbs) treated with 15 W of laser power completed the study. There was no significant difference regarding age, operating time, use of analgesics, laterality, sex, or presence of comorbidities. Mean LEED was 33.54 J/cm in the 7-W group and 88.66 J/cm in the 15-W group. Both groups exhibited improvements in VCSS and significant reductions in SFJ diameters, and there were no significant difference in increase of length of the GSV stump or rates of reflux after treatment. Conclusions: The higher energy density setting was more effective for stabilizing the length of the GSV stump and was associated with a lower incidence of reflux at 6 months. Further studies with a longer follow-up period are required to substantiate this hypothesis


Subject(s)
Humans , Male , Female , Ablation Techniques/methods , Laser Therapy/methods , Treatment Outcome , Varicose Veins/therapy , Echocardiography, Doppler/methods , Femoral Vein , Lower Extremity , Prospective Studies , Data Interpretation, Statistical , Ultrasonics/methods , Venous Insufficiency/complications
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