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1.
Rev. Assoc. Med. Bras. (1992, Impr.) ; Rev. Assoc. Med. Bras. (1992, Impr.);70(2): e20231001, 2024. tab, graf
文章 在 英语 | LILACS-Express | LILACS | ID: biblio-1535081

摘要

SUMMARY OBJECTIVE: The objective of this study was to investigate whether the measurement of mean optic nerve sheath diameter in patients with transient ischemic attack could be used to distinguish between control groups, the acute ischemic stroke group, and subgroups within the acute ischemic stroke category. METHODS: Retrospectively, the mean optic nerve sheath diameters of patients aged 18 years and older belonging to control, transient ischemic attack, acute ischemic stroke, and subgroups within the acute ischemic stroke category were measured with initial computed tomography conducted in the emergency department. RESULTS: Out of the 773 patients included in the study, 318 (41.1%) were in the control group, 77 (10%) had transient ischemic attack, and 378 (49%) were categorized as stroke patients. The average mean optic nerve sheath diameter was significantly higher in both the stroke and transient ischemic attack groups compared with the control group (p<0.001 for both comparisons). Furthermore, the mean optic nerve sheath diameter in the stroke subgroups was significantly higher than in both the transient ischemic attack and control groups (p<0.001 for all comparisons). In transient ischemic attack patients, the mean optic nerve sheath diameter showed a significant ability to predict transient ischemic attack (AUC=0.913, p<0.001), with a calculated optimal cutoff value of 4.72, sensitivity of 94.8%, and specificity of 73.9%. CONCLUSION: The mean optic nerve sheath diameter of patients in the transient ischemic attack group was lower compared with those in the stroke subgroups but higher compared with the control group.

2.
Braz. j. otorhinolaryngol. (Impr.) ; Braz. j. otorhinolaryngol. (Impr.);90(2): 101382, 2024. tab, graf
文章 在 英语 | LILACS-Express | LILACS | ID: biblio-1557339

摘要

Abstract Objective To find out if motion sickness susceptibility (MSS) of vestibular migraine (VM) patients and migraine only (MO) patients can be reliably detected with a single simple question: "Can you read while travelling in a car without getting motion sick?". Method Ninety-two definite VM and 58 MO patients and 74 healthy control (HC) subjects were asked about their MSS and about being able to read while riding in a car without becoming motion sick. A Motion Sickness Susceptibility Questionnaire (MSSQ-Short) including childhood (MSA), adulthood (MSB) and total (MST) parts was also administered to all participants. ROC curves of MSSQ-Short were prepared for "not being able to read in a car" as the gold standard. Results Mean MSA scores were significantly higher in both VM and MO patients than in HCs (p< 0.001), but their scores were not significantly different (p= 0.171). Mean MSB and MST scores were significantly higher in VM than in MO patients (p< 0.001) and both VM and MO patients had significantly higher scores than HCs (p< 0.001). MSA scores were significantly higher than MSB scores in MO patients (p< 0.001). All sections of the questionnaire were associated with high area-under-curve values for MSS detected by the question about being able to read in a car without becoming motion sick. Conclusion We propose that all migraine patients could have the same level of MSS in childhood but MO patients are able to compensate over years, but VM patients are not. A quick way to determine MSS is to ask about the ability to read without becoming motion sickness while riding a car.

3.
Rev. Assoc. Med. Bras. (1992, Impr.) ; Rev. Assoc. Med. Bras. (1992, Impr.);70(4): e20231521, 2024. tab
文章 在 英语 | LILACS-Express | LILACS | ID: biblio-1558904

摘要

SUMMARY OBJECTIVE: This study aimed to investigate the value of miR-29a-3p, miR-27a, miR126-3p, miR-146a-5p, miR-625-3p, miR-130a, miR-32, miR-218, miR-131, and miR5196 in the diagnosis of axial spondyloarthritis and to determine whether there is a difference in miRNA expression levels between radiographic axial spondyloarthritis and non-radiographic axial spondyloarthritis, as well as the relationship between miRNA expression levels, disease activity, and uveitis history. METHODS: This study included 50 patients with axial spondyloarthritis (25 with radiographic axial spondyloarthritis and 25 with non-radiographic axial spondyloarthritis) and 25 healthy individuals. The fold change of miRNA expression for each miRNA was calculated using the 2-ΔΔCt method. RESULTS: The expression of all miRNAs except miR-130a was downregulated in axial spondyloarthritis patients (miR-27a: fold regulation: −11.21, p<0.001; miR-29a-3p: fold regulation: −2.63, p<0.001; miR-32: fold regulation: −2.94, p=0.002; miR-126-3p: fold regulation −10.94, p<0.001; miR-132: fold regulation: −2.18, p<0.001; miR-146-5p: fold regulation: −9.78, p<0.001; miR-218: fold regulation: −2.65, p<0.001; miR-625-3p: fold regulation: −2.01, p=0.001; miR-5196-3p: fold regulation: −7.04, p<0.001). The expression levels of these miRNAs did not differ significantly between non-radiographic axial spondyloarthritis and radiographic axial spondyloarthritis patients (p>0.05 for all). CONCLUSION: Particularly, miR-27a, miR-126-3p, miR-146-5p, and miR-5196-3p were found to be substantially downregulated in both non-radiographic axial spondyloarthritis and radiographic axial spondyloarthritis patients, suggesting their potential as diagnostic biomarkers for axial spondyloarthritis.

4.
Rev. Assoc. Med. Bras. (1992, Impr.) ; Rev. Assoc. Med. Bras. (1992, Impr.);69(1): 112-118, Jan. 2023. tab, graf
文章 在 英语 | LILACS-Express | LILACS | ID: biblio-1422578

摘要

SUMMARY OBJECTIVE: Pathological destruction of insulin signaling molecules such as insulin receptor substrate, especially due to the increase in suppressors of cytokine signaling molecules, has been demonstrated in experimental diabetes. The contribution of suppressors of cytokine signaling proteins to the development of insulin resistance and the effects of antidiabetic drugs and exercise on suppressors of cytokine signaling proteins are not clearly known. METHODS: A total of 48 Wistar albino adult male rats were divided into six groups: control group, obese group with diabetes, obese diabetic rats treated with metformin, obese diabetic rats treated with pioglitazone, obese diabetic rats treated with exenatide, and obese diabetic rats with applied exercise program. Immunohistochemical staining was performed in both the liver and adipose tissue. RESULTS: There was a statistically significant decrease in suppressors of cytokine signaling-1, a decrease in suppressors of cytokine signaling-3, an increase in insulin receptor substrate-1, and a decrease in immunohistochemical staining in the obese group treated with metformin and exenatide compared to the obese group without treatment in the liver tissue (p<0.05). A statistically significant decrease in immunohistochemical staining of suppressors of cytokine signaling-1 and suppressors of cytokine signaling-3 was found in the obese group receiving exercise therapy compared to the obese group without treatment in visceral adipose tissue (p<0.05). Likewise, no significant immunohistochemistry staining was seen in diabetic obese groups. CONCLUSION: Metformin or exenatide treatment could prevent the degradation of insulin receptor substrate-1 protein by reducing the effect of suppressors of cytokine signaling-1 and suppressors of cytokine signaling-3 proteins, especially in the liver tissue. In addition, exercise can play a role as a complementary therapy by reducing suppressors of cytokine signaling-1 and suppressors of cytokine signaling-3 proteins in visceral adipose tissue.

5.
Arq. neuropsiquiatr ; Arq. neuropsiquiatr;80(9): 935-943, Sept. 2022. tab, graf
文章 在 英语 | LILACS-Express | LILACS | ID: biblio-1420238

摘要

Abstract Background Parkinson disease (PD) is a progressive condition that causes disorders in movement and balance. Objective To evaluate the effectiveness of static posturography-assisted biofeedback exercises in PD-related balance disorder. Methods We screened 83 patients, 48 of whom were enrolled, and 41 completed the study. The sample was randomized into two groups, one submitted to static posturography-assisted biofeedback exercises and the other, to a conventional exercise program. The patients in the biofeedback group (n =20) performed biofeedback exercises in addition to conventional balance exercises. Those in the conventional exercise group (n = 21) performed classic balance exercises. Both groups were treated for 20 minutes per session 3 times a week for 6 weeks. The patients were evaluated using the Hoehn and Yahr Scale, the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), the Berg Balance Scale (BBS), the Tinetti Gait and Balance Assessment (TGBA), the Timed Up and GoTest (TUG), the Tandem Stance Test (TST), a Turkish version of the Stanford Health Assessment Questionnaire (HAQ), and the Beck Depression Inventory (BDI) before and at the end of the treatment. Results No statistically significant differences were observed between the two groups in terms of the MDS-UPDRS, BBS, TGBA, TST, TUG, HAQ, or BDI measurements before and after the treatment (p > 0.05). Conclusions Improved balance parameters were observed following balance training in the patients with PD, although static posturography-assisted biofeedback exercises appeared to provide no additional benefit. However, larger, randomized controlled trials are needed to investigate their effectiveness.


Resumo Antecedentes A doença de Parkinson (DP) é uma doença degenerativa que causa alterações no movimento e no equilíbrio. Objetivo Avaliar a eficácia dos exercícios com biorretroalimentação assistidos por posturografia estática na alterações do equilíbrio derivadas da DP. Métodos Selecionamos 83 pacientes, 48 dos quais foram incluídos, e 41 completaram o estudo. A amostra foi randomizada e dividida em dois grupos, um submetido a exercícios com biorretroalimentação assistidos por posturografia estática, e outro submetido a um programa de exercícios convencional. Os pacientes do grupo de biorretroalimentação (n = 20) fizeram exercícios com biorretroalimentação e exercícios convencionais de equilíbrio. E o grupo dos exercícios convencionais (n = 21), fez exercícios clássicos de equilíbrio. Ambos os grupos receberam tratamento durante 20 minutos por sessão, 3 vezes por semana, por 6 semanas. Os pacientes foram avaliados antes e depois do tratamento pela Escala de Hoehn e Yahr, Escala Unificada de Avaliação da Doença de Parkinson (EUADP) da Movement Disorder Society (MDS), a Escala de Equilíbrio Berg (EEB), Avaliação de Equilíbrio e Marcha Tinetti (AEMT), oTeste Timed Up and Go (TUG), o Teste de Apoio Tandem (TAT), a versão em turco do Questionário de Avaliação de Saúde (QAS) de Stanford, e o Inventário de Depressão de Beck (IDB). Resultados Não se observaram diferenças estatisticamente significativas entre os dois grupos quanto às mediçõesdo EUADP, EEB, AEMT, TAT, TUG, QAS ou IDB realizadas antes e depois do tratamento (p > 0.05). Conclusões Verificou-se uma melhoria dos parâmetros de equilíbrio após os exercícios de equilíbrio nos pacientes com DP, apesar de não ter sido detectado sem nenhum benefício adicional aparente dos exercícios com retroalimentação assistidos por posturografia estática. Contudo, é necessário efetuar ensaios maiores, randomizados e controlados para estudar a sua eficácia.

6.
Arq. bras. oftalmol ; Arq. bras. oftalmol;85(1): 19-24, Jan.-Feb. 2022. tab, graf
文章 在 英语 | LILACS-Express | LILACS | ID: biblio-1350095

摘要

ABSTRACT Purpose: The aim of this study was to compare the effects of topical cyclosporine 0.1% and bevacizumab on experimentally induced corneal neovascularization in a rat model. Methods: A total of 30 adult Sprague-Dawley rats were used in this experimental study. The central cornea of the rats was cauterized chemically. The rats were randomly enrolled into three groups as follows: Group 1 received bevacizumab 1%, Group 2 received cyclosporine 0.1%, and Group 3 received isotonic saline twice a day for 28 days. Slit-lamp examination of all rats was performed at the 3rd and 28th day. The rats were then sacrificed, and the corneas were excised. The number of blood vessels, state of inflammation, and collagen formation were evaluated histopathologically in the corneal sections. Results: Corneal opacity and edema grades were significantly lower in Group 2 than in Group 3 (p=0.04 and 0.00, respectively). In the histopathological examination, Group 2 demonstrated significantly lesser number of blood vessels than Group 3 (p=0.001). Regarding collagen formation, Group 2 exhibited more regular collagen formation than Groups 1 and 3 (p=0.03). Inflammation grades were significantly lower in Groups 1 and 2 than in Group 3 (p=0.014 and 0.001, respectively). Conclusion: Topical bevacizumab is effective in inhibiting newly formed corneal neovascularization. The topical cyclosporine 0.1% treatment appears to be more effective than the topical bevacizumab treatment.


RESUMO Objetivo: Comparar os efeitos da ciclosporina tópica 0,1% e do bevacizumabe na neovascularização da córnea produzida experimentalmente em um modelo com ratos. Métodos: Trinta ratos Sprague-Dawley adultos foram usados neste estudo experimental. A córnea central dos ratos foi cauterizada quimicamente. Os ratos foram distribuídos aleatoriamente em três grupos. O grupo 1 recebeu bevacizumabe a 1%, o grupo 2 recebeu ciclosporina tópica a 0,1% e o grupo 3 recebeu solução salina isotônica duas vezes ao dia durante 28 dias. O exame de lâmpada de fenda de todos os ratos foi realizado no terceiro e no vigésimo oitavo dias. Os ratos foram então sacrificados e as córneas excisadas. Nos cortes da córnea, o número de vasos sanguíneos, o estado de inflamação e a formação de colágeno foram avaliados em uma análise anatomopatológica. Resultados: No Grupo 2, os graus de opacidade e de edema da córnea foram significativamente menores que no Grupo 3 (p=0,04 e 0,00, respectivamente). No exame histopatológico, o Grupo 2 apresentou um número significativamente menor de vasos sanguíneos do que o Grupo 3 (p=0,001). Em relação à avaliação da formação de colágeno, esta mostrou-se mais regular no Grupo 2 que no Grupo 1 e no Grupo 3 (p=0,03). Os graus de inflamação foram significativamente menores no Grupo 1 e no Grupo 2 em comparação com o Grupo 3 (p=0,014 e 0,001, respectivamente). Conclusão: O bevacizumabe tópico é eficaz na inibição da neovascularização da córnea recém-formada. O tratamento tópico com ciclosporina a 0,1% parece ser mais eficaz em comparação ao tratamento tópico com bevacizumabe.

7.
Braz. j. otorhinolaryngol. (Impr.) ; Braz. j. otorhinolaryngol. (Impr.);86(1): 30-37, Jan.-Feb. 2020. tab, graf
文章 在 英语 | LILACS | ID: biblio-1089360

摘要

Abstract Introduction Ototoxicity is a health problem appearing after powerful treatments in serious health conditions. It is sometimes inevitable when treatment of the serious disease is required. Cisplatin is an antineoplastic agent which was investigated previously to reveal increased nitrogen and reactive oxygen radicals that damages hair cells, resulting in ototoxicity. N-acetylcysteine, previously shown to decrease ototoxicity caused by different agents, is known to be a powerful in vitro antioxidant. Probably N-acetylcysteine, in addition to its antioxidant effect, blocks a cascade where reactive oxygen species result in apoptosis in the cochlea. Objectives The possible preventive effect of N-acetylcysteine in cisplatin ototoxicity was studied with auditory brain stem responses, otoacoustic emissions, and histopathological investigation of the cochlea in a scanning electron microscopy. Methods This study was conducted on 21 Wistar Albino rats in four groups. 1 mL/kg/day three times in total intraperitoneal (i.p.) Saline (n = 5), 500 mg/kg/day i.p. three times in total N-acetylcysteine (n = 5), i.p. 15 mg/kg cisplatin alone (single dose) (n = 5) and i.p. 15 mg/kg cisplatin plus 500 mg/kg/day N-acetylcysteine (n = 6) were administered. The rats were anesthetized to study the hearing tests before and after the experiment. The rats were sacrificed to investigate the cochleas by scanning electron microscopy. Results Auditory brain stem responses and otoacoustic emissions values were attenuated in the cisplatin group. The group that received N-acetylcysteine in addition to cisplatin had better auditory brain stem responses thresholds and otoacoustic emissions. The samples obtained from the cisplatin group showed surface irregularities, degeneration areas, and total or partial severe stereocilia losses. The changes were milder in the cisplatin + N-acetylcysteine group. Conclusion Cisplatin ototoxicity can be detected by auditory brain stem responses and otoacoustic emissions testing in rats. N-acetylcysteine may protect the cochlear cells from histopathological changes. We concluded that N-acetylcysteine given 4 h after cisplatin injection has a potential otoprotective effect against cisplatin ototoxicity. which suggests it could be used in clinical trials.


Resumo Introdução A ototoxicidade é um problema que pode ocorrer após certos tipos de tratamentos para condições graves de saúde. Às vezes é inevitável quando o tratamento da doença é necessário. A cisplatina é um agente antineoplásico cujo uso em pesquisas anteriores demonstrou aumentar os radicais livres de nitrogênio e espécies reativas de oxigênio que danificam as células ciliadas e resultam em ototoxicidade. Por outro lado, a N-acetilcisteína, que já demonstrou diminuir a ototoxicidade causada por diferentes agentes, é conhecida por ser um potente antioxidante in vitro. Provavelmente a N-acetilcisteína, além de seu efeito antioxidante, bloqueia uma cascata onde espécies reativas de oxigênio resultam em apoptose na cóclea. Objetivos Estudar o possível efeito preventivo da N-acetilcisteína na ototoxicidade por cisplatina por meio de potencial evocado auditivo de tronco encefálico, emissões otoacústicas e investigação histopatológica da cóclea por microscopia eletrônica de varredura. Método Este estudo foi realizado em 21 ratos albinos Wistar, separados em quatro grupos. Foram administrados: 1 mL/kg/dia intraperitoneal (i.p.) de solução salina (n = 5), três vezes no total; 500 mg/kg/dia i.p. de N-acetilcisteína (n = 5), três vezes no total; 15 mg/kg i.p. (dose única) somente de cisplatina (n = 5) e 15 mg/kg i.p. de cisplatina e 500 mg/kg/dia i.p. de N-acetilcisteína (n = 6). Os ratos foram anestesiados para estudo dos testes auditivos antes e depois do experimento. Os ratos foram sacrificados para investigação da cóclea por microscopia eletrônica de varredura. Resultados Os potenciais evocados auditivos de tronco encefálico e os valores das emissões otoacústicas estavam atenuados no grupo cisplatina. O grupo que recebeu N-acetilcisteína além da cisplatina apresentou melhores limiares de respostas auditivas do tronco encefálico e emissões otoacústicas. As amostras obtidas do grupo cisplatina apresentaram irregularidades de superfície, áreas de degeneração, com perdas graves totais ou parciais de estereocílios. As alterações foram mais leves no grupo cisplatina + N-acetilcisteína. Conclusão A ototoxicidade por cisplatina pode ser detectada por meio de potenciais evocados auditivos de tronco encefálico e pelo teste de emissões otoacústicas em ratos. A N-acetilcisteína pode proteger as células cocleares contra alterações histopatológicas. Concluímos que a N-acetilcisteína administrada 4 horas após a injeção de cisplatina tem potencial efeito otoprotetor contra a ototoxicidade por cisplatina e pode ser utilizada em ensaios clínicos.


Subject(s)
Animals , Male , Acetylcysteine/administration & dosage , Cisplatin/adverse effects , Protective Agents/administration & dosage , Ototoxicity/etiology , Antineoplastic Agents/adverse effects , Antioxidants/administration & dosage , Acetylcysteine/pharmacology , Microscopy, Electron, Scanning , Evoked Potentials, Auditory, Brain Stem , Rats, Wistar , Cochlea/pathology , Apoptosis , Hair Cells, Auditory, Outer/drug effects , Hair Cells, Auditory, Outer/pathology , Protective Agents/pharmacology , Disease Models, Animal , Stereocilia/drug effects , Stereocilia/pathology , Ototoxicity/prevention & control , Hearing Tests , Antioxidants/pharmacology
8.
Rev. bras. cir. cardiovasc ; Rev. bras. cir. cardiovasc;34(4): 436-443, July-Aug. 2019. tab, graf
文章 在 英语 | LILACS | ID: biblio-1020487

摘要

Abstract Objective: To investigate the effect of continuous lung ventilation with low tidal volume on oxidation parameters, such as thiol/disulphide homeostasis and albumin-adjusted ischemia-modified albumin (AAIMA), during cardiopulmonary bypass (CBP) in coronary artery bypass grafting (CABG). Methods: Seventy-four patients who underwent elective CABG with CPB were included in the study. Blood samples were taken in the preoperative period, 10 minutes after CPB, and six and 24 hours postoperatively. Patients were assigned to the continuous ventilation group (Group 1, n=37) and the non-ventilated group (Group 2, n=37). The clinical characteristics, thiol/disulphide homeostasis, ischemia-modified albumin (IMA), and AAIMA levels of the patients were compared. Results: A significant difference was found between the groups regarding native thiol, total thiol, and IMA levels at the postoperative 24th hour (P=0.030, P=0.031, and P=0.004, respectively). There was no difference between the groups in terms of AAIMA. AAIMA levels returned to preoperative levels in Groups 1 and 2, at the 6th and 24th postoperative hours, respectively. Length of hospital stay was significantly shorter in Group 1 (P<0.001) than in Group 2. Conclusion: Continuous ventilation during CPB caused an increase in native and total thiol levels, an earlier return of AAIMA levels, and shorter hospital stay. Continuous ventilation may reduce the negative effects of CPB on myocardium (Table 2, Figure 1, and Reference 31).


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Respiration, Artificial , Sulfhydryl Compounds/blood , Serum Albumin/analysis , Cardiopulmonary Bypass/adverse effects , Disulfides/blood , Postoperative Complications/prevention & control , Biomarkers/blood , Cardiopulmonary Bypass/methods , Coronary Artery Bypass , Double-Blind Method , Prospective Studies , Lung Injury/etiology , Serum Albumin, Human , Homeostasis/physiology , Antioxidants
9.
Arq. bras. oftalmol ; Arq. bras. oftalmol;78(4): 255-256, July-Aug. 2015. ilus
文章 在 英语 | LILACS | ID: lil-759263

摘要

ABSTRACTWe report a case of primary acquired corneal melanosis without atypia associated with corneal haze in a patient with a history of limbal malignant melanoma and the effect of mitomycin-C. A 75-year-old woman with a history of limbal malignant melanoma presented with loss of vision in right eye. Corneal examination showed a patchy melanotic pigmentation with a central haze. Topical mitomycin-C improved visual acuity and corneal haze. However, the pigmented lesions persisted, and they were removed with alcohol corneal epitheliectomy. Histopathological examination demonstrated primary acquired melanosis without atypia. The lesions were successfully removed, and there were no recurrences during the follow-up period of 36 months. The association of conjunctival and corneal melanosis without atypia is a rare condition. In addition, co-existence of central corneal haze and melanosis may decrease visual acuity. Topical mitomycin-C and alcohol corneal epitheliectomy can be useful treatments in this condition.


RESUMORelatar um caso de melanose adquirida primária de córnea sem atipia, associado a haze corneano em um paciente com história de melanoma maligno de limbo e o efeito da mitomicina-C. Uma mulher de 75 anos de idade, com história de melanoma maligno do limbo apresentado com diminuição de visão no olho direito. O exame de córnea mostrou uma pigmentação melânica irregular com um haze central. O uso de mitomicina-C tópica levou à melhora da acuidade visual e da opacidade corneana. No entanto, as lesões pigmentadas persistiram e foram removidas com epiteliectomia associada ao álcool. O exame histopatológico demonstrou melanose adquirida primária sem atipia. As lesões foram removidas com êxito, e não houve recidiva durante o período de acompanhamento de 36 meses. A associação melanose sem atipia da conjuntiva e da córnea é uma condição rara. Além disso, a coexistência de haze corneano central e melanose pode diminuir a acuidade visual. O uso de mitomicina-C tópica e epiteliectomia corneana auxiliada pelo álcool podem ser tratamentos úteis nessa situação.


Subject(s)
Aged , Female , Humans , Antibiotics, Antineoplastic/therapeutic use , Corneal Diseases/drug therapy , Melanosis/drug therapy , Mitomycin/therapeutic use , Combined Modality Therapy , Conjunctival Neoplasms/complications , Corneal Diseases/etiology , Follow-Up Studies , Melanoma/complications , Melanosis/etiology , Treatment Outcome , Visual Acuity
10.
Rev. bras. cir. cardiovasc ; Rev. bras. cir. cardiovasc;28(4): 498-503, out.-dez. 2013. ilus, tab
文章 在 英语 | LILACS | ID: lil-703118

摘要

OBJECTIVE: Since twenty-four-hour imaging by Tl-201 myocardial perfusion scintigraphy has been introduced as an effective additional procedure, the aim of this study was to compare this method's result with only rest redistribution procedure in the diagnosis of myocardial viability. METHODS: Thirty patients (Seven female, 23 male; mean: 59.8 ± 10.7, 55.8-63.8 years old) with diagnosis of coronary artery disease were involved in this study. All patients had anamnesis of previous myocardial infarction and/or total occlusion of any main artery in the coronary angiography. Myocardial perfusion scintigraphy with Tl-201 with rest four hour (early) redistribution and 24 hour delayed redistribution protocol were performed to all of the patients. The images were evaluated according to 17 segment basis by an experienced nuclear medicine physician and improvement of a segment by visual interpretation was considered as viable myocardial tissue. RESULTS: Viability was found at 52 segments in the early redistribution images and additional 18 segments in the 24 hour delayed redistribution images on segment basis in the evaluation of 510 segments of 30 patients. On per patient basis, among the 26 patients who had viable tissue, 14 (54%) had additional improvement in 24 hour delayed images. Three (12%) patients had viable tissue in only 24 hour delayed images. CONCLUSION: Delayed imaging in Tl-201 MPS is a necessary application for the evaluation of viable tissue according to considerable number of patients with additional improvement in 24 hour images in our study, which is restricted to the patients with myocardial infarct.


OBJETIVO: Dado que a cintilografia Tl -201 24 horas de imagens por perfusão miocárdica foi introduzida como um procedimento adicional efetivo, assim, o objetivo deste estudo foi comparar os resultados deste método com o procedimento único de redistribuição no diagnóstico de viabilidade miocárdica. MÉTODOS: Trinta pacientes (Sete mulheres, 23 homens, média: 59,8 ± 10,7, 55,8-63,8 anos) com diagnóstico de doença arterial coronariana foram avaliados neste estudo. Todos os pacientes tinham anamnese de infarto do miocárdio e/ou oclusão total de uma artéria principal na cinecoronariografia. Cintilografia de perfusão miocárdica com protocolo de Tl-201 em repouso, redistribuição quatro horas (início) e redistribuição tardia 24 horas foi realizada em todos os pacientes. As imagens foram avaliadas de acordo com a base de 17 segmentos por um médico com experiência em medicina nuclear e melhoria de um segmento por interpretação visual foi considerado como tecido miocárdico viável. RESULTADOS: A viabilidade foi encontrada em 52 segmentos de redistribuição das imagens iniciais e 18 segmentos adicionais nas imagens de redistribuição tardias de 24 horas baseadas em segmento, na avaliação de 510 segmentos de 30 pacientes. Em termos de pacientes, entre os 26 pacientes que tinham tecido viável, 14 (54%) apresentaram melhora adicional em imagens tardias de 24 horas. Três (12%) pacientes tiveram tecido viável apenas em imagens tardias de 24 horas. CONCLUSÃO: A imagem tardia em TL- 201 MPS é uma aplicação necessária para a avaliação do tecido viável de acordo com o número considerável de pacientes com melhora adicional em imagens de 24 horas em nosso estudo, o qual é restrito aos pacientes com infarto do miocárdio.


Subject(s)
Female , Humans , Male , Middle Aged , Coronary Artery Disease , Myocardial Perfusion Imaging/methods , Thallium Radioisotopes , Coronary Artery Disease/physiopathology , Heart , Myocardial Infarction/physiopathology , Reproducibility of Results , Time Factors , Tissue Survival , Tomography, Emission-Computed, Single-Photon
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