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Objective To analyze the correlations of the expressions of miR-4500 and nerve growth factor(NGF)in breast cancer patients with preoperative magnetic resonance(MR)signs.Methods A total of 105 patients with breast cancer admitted to our hospital were selected,the mRNA expression levels of miR-4500 and NGF in breast cancer tissues and adjacent tissues of patients were detected by qRT-PCR,and the positive expression rates of NGF in breast cancer tissues and adjacent tissues were determined by immunohistochemistry method.The correlations of the expressions of miR-4500 and NGF in breast cancer tissues with clinicopathological features and MR signs of patients were analyzed.The targeting relationship between miR-4500 and NGF was predicted by the bioinformatics website,and the correla-tion between the expressions of the two was analyzed.Results Compared with the adjacent tissues,the expression level of miR-4500 in breast cancer tissue decreased(P<0.05),while the level of NGF mRNA and the positive expression rate of NGF increased(P<0.05).There was no significant difference in age,pathological type,tumor classification,parenchymal background,apparent diffusion coefficient or enhancement curve among different expressions of miR-4500 and NGF(P>0.05).The histological grade,lymph node metastasis,tumor diameter,tumor morphology,ring-like enhancement,and peritu-moral brain edema were related to the expressions of miR-4500 and NGF(P<0.05).The bioinformatics website prediction showed that miR-4500 and NGF had binding sites,and the expressions of miR-4500 and NGF mRNA in breast cancer tissues were negatively correlated(r=-0.576,P<0.05).Conclusion The expression of miR-4500 in breast cancer tissue is low,and the expression of NGF is high,which are correlated with the preoperative MR signs in patients,providing a molecu-lar basis for MR signs.
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【Objective】 To explore the causal relationship between education level and pancreatitis risk through Mendelian randomization. 【Methods】 A two-sample Mendelian randomization analysis was conducted using genome-wide association study (GWAS) summary data. The GWAS data for education level and pancreatitis were obtained from SSGAC database and the FinnGen database (version R9). Causal relationship between education level and pancreatitis was explored using the inverse variance weighted (IVW), MR-Egger, and weighted median methods. Heterogeneity and directional pleiotropy were evaluated using Cochran’s Q test and funnel plots. 【Results】 Totally 604 SNPs associated with education level were included. The results provided evidence that there was negative relationship between education level and pancreatitis risk. For acute pancreatitis, OR=0.52, 95% CI: 0.44-0.62, P=2.43×10-14 while for chronic pancreatitis, OR=0.51, 95% CI: 0.41-0.64, P=7.20×10-9. Results from MR-Egger and weighted median analyses obtained the same results. The results of sensitivity analysis indicated that this study did not violate the basic assumptions of Mendelian randomization. 【Conclusion】 There is a causal relationship between education level and the occurrence of pancreatitis. The educational level is negatively correlated with the risk of pancreatitis.
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BACKGROUND:As the incidence of spinal cord injury increases with the years and axon regeneration after spinal cord injury was very difficult.How to promote the recovery from spinal cord injury and improve the transplantation efficiency of stem cells and other therapeutic cells after spinal cord injury has been the focus of clinical and scientific research. OBJECTIVE:To establish the efficient transplantation and replacement of mouse spinal cord microglia in the spinal cord injury model. METHODS:CX3CR1 creER-/+::LSL-BDNF-/+-tdTomato mice,CX3CR1+/GFP mice,β-actin GFP mice and C57 BL/6J wild-type mice at 8-10 weeks of age were selected.According to the requirements of the experiment,they were randomly divided into six groups.(1)Sham operation group:eight C57 BL/6J wild-type mice were used when only the lamina was removed without injury.(2)Spinal cord contusion injury group:eight C57 BL/6J wild-type mice were used.(3)Spinal cord crush injury group:eight C57 BL/6J wild-type mice were used.(4)Conjoined symbiotic spinal cord strike injury group:β-actin GFP mice with green fluorescent blood were surgically stitched together with C57 BL/6J wild-type mice,using eight β-actin GFP mice and eight C57 BL/6J wild-type mice.(5)Mr BMT-X Ray group(using PLX5622 to eliminate the spinal microglia and bone marrow transplantation with X-ray radiation):Bone marrow cells from four CX3CR1 creER-/+::LSL-BDNF-/+-tdTomato mice were extracted and transplanted into eight C57 BL/6J wild-type mice for spinal cord injury modeling.(6)Mr BMT-Busulfan group(using PLX5622 to eliminate the spinal microglia and bone marrow transplantation with Busulfan):Bone marrow cells from four CX3CR1+/GFP mice were transplanted into eight C57 BL/6J wild-type mice.The percentage of cell transplantation replacement in this group was observed,and the spinal cord injury model was not established in this group.The sham operation group,spinal cord contusion injury group and spinal cord crush injury group were sampled by perfusion on day 14 after spinal cord injury.The conjoined symbiotic spinal cord strike injury group was sampled by perfusion on day 7 after spinal cord injury.Mr BMT-X Ray group was sampled by perfusion on day 28 after spinal cord injury.Mr BMT-Busulfan group was sampled by perfusion on day 28 after transplantation.The sampling site was a 1.2 cm long spinal cord with the T10 segment as the center.In the Mr BMT-X Ray group and Mr BMT-Busulfan group,additional mouse brain tissue was retained to see if it would lead to brain transplantation and replacement.The number and proportion of transplanted and replaced cells in the damaged area were measured using transgenic mice,symbiosis and immunofluorescence. RESULTS AND CONCLUSION:Compared with the traditional peripheral blood transplantation(9.8%)of mice in the conjoined symbiotic spinal cord strike injury group,the new transplantation methods,Mr BMT-X Ray and Mr BMT-Busulfan,could greatly improve the proportion of spinal microglia transplantation and replacement,which could reach 84.8%and 95.6%,respectively.The difference was significant(P<0.05).The results showed that Mr BMT-X Ray and Mr BMT-Busulfan could achieve efficient replacement of spinal microglia cells,and could improve the problems of low cell transplantation efficiency,few survival numbers and unclear differentiation of the traditional cell transplantation methods.In addition,Mr BMT-X Ray can only replace the microglia in the spinal cord,while Mr BMT-Busulfan could avoid brain inflammation and injury caused by X-ray radiation transplantation.
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The challenge of knowing the events surrounding the modern origins of the different specialties of Chilean medicine should be of interest to the specialists of these specialties. Thus, in the case of surgery, fortunately in Chile there are testimonial documents, which reviewed and analyzed can suggest this question, mentioning the one who today is considered the world father of modern surgery, whose important surgical teachings were delivered to Chilean disciples who introduced it in our country. In the context of the War of the Pacific, in the year 1879, a "blood hospital" was built in Santiago, donated by Domingo Matte, a Chilean politician, to receive the many war wounded who were transported from the north. It was Dr. Manuel Barros Borgoño, a young surgeon recently graduated from the Faculty of Medicine in Paris, with a degree revalidated in Chile, who in 1880 took charge of this hospital, and together with his team, began to apply his experience in listerian methods learned in Paris from his teacher Dr. Just Lucas Champonniere. Just Lucas Champonniere, giving beginning to the Chilean antiseptic surgery, managing to reduce the mortality of surgeries to 3%, compared to 80% of other Chilean hospitals that refused to change, and continued with the use of sponge soaked in cerato (lard).
Subject(s)
Humans , History, 16th Century , History, 19th Century , General Surgery/history , Antisepsis/methods , General Surgery/methods , Chile , Hospitals/history摘要
Background : The aim of this study is to determine the distribution and nature of Cranial MRI findings in eclamptic patients, and to correlate them with clinical and laboratory data. Materials and Methods : This study was conducted in the Department of Obstetrics and Gynecology in Sri Ramachandra Institute of Higher Education and Research. A total number of 35 Eclamptic patients were included in this study and they were analyzed retrospectively. Laboratory parameters, Blood Pressure and Cranial MRI was performed for all and the same were analyzed statistically. Results : Out of 35 Eclamptic patients, MR Imaging was normal in 6 patients. Among the 29 patients with abnormal MRI, Cortical-subcortical Lesion, appeared iso/hypo-intense in T-1 weighted images and hyper intense in T-2 weighted images. In most of the patients, occipital lobe was involved followed by involvement of other lobes such as Parietal, Frontal, Temporal, Basal Ganglia and Cerebellum. When patients with and without positive MRI findings were compared regarding clinical features such as Headache, Blurred Vision, Nausea and Vomiting, Epigastric Pain, Loss of Consciousness, Reduced Urine Output there was no statistically significant difference between the two groups. Similarly, there was no statistical difference in mean arterial pressures between MRI positive and MRI negative patients (p=0.218) however, it was found that those with MR imaging positive features had a higher Blood Pressure than those with MRI negative findings. Among the laboratory parameters, in the patients with abnormal MRI findings Fibrinogen was found to be significantly low than those with normal MRI findings (p=0.0002).
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@#Objective To analyze the safety of children of different ages vaccinated with measles,mumps and rubella combined attenuated live vaccine(MMR in brief)/measles and rubella combined attenuated live vaccine(MR in brief)in Jilin Province from 2015 to 2022.Methods The actual vaccination data of MMR and MR from January 1,2015 to December 31,2022 were collected through the Jilin information management system for immunization programming,and all AEFI case information reported after vaccination with MMR and MR in this period was collected through the national adverse event following immunization(AEFI) monitoring and reporting system.The incidence rates of AEFI reports were compared among8-month-old children vaccinated with the first dose of MMR(MMR 8 group) and MR(MR8 group),18-month-old children vaccinated with the first dose of MMR(vaccinated with MR at 8 months old,MMR18-1 group) and the second dose of MMR(vaccinated with the first dose of MMR at 8 months old,MMR18-2 group) to preliminarily evaluate the safety of children vaccinated with MMR and MR at different ages.Results The reported incidence of AEFI in MMR8,MR8,MMR18-1 and MMR18-2 groups were 374.41/100 000,350.81/100 000,101.70/100 000 and 104.91/100 000,respectively,with significant difference among the four groups(χ~2=1 145.47,P=0.00);There was no significant difference between MMR8 and MR8,as well as MMR18-1 and MMR18-2 groups(χ~2=3.780 and 0.194,respectively,each P> 0.05);There were significant differences between MMR8 and MMR18-1,MMR8 and MMR18-2,as well as MR8 and MMR18-1groups(χ~2=920.440,412.110 and 1 021.120,respectively,each P=0.00).Most of the adverse reactions were general reactions,mainly fever,local redness and induration;A few were abnormal reactions,which were mainly allergic reactions(rash,papules,urticaria,etc.).Only one case of coincidence was reported in MMR8 group,and no psychogenic reaction,vaccine quality accident and vaccination accident occurred.All AEFI turned out to be improved or cured.Conclusion The differences of AEFI reported incidence of 8-month-old children vaccinated with MMR and MR were all small,and the difference of AEFI reported incidence of 18-month-old children vaccinated with the second dose of MMR was small regardless of the initial vaccination with MMR or MR.It is safe to use MMR instead of MR for the first vaccination in8-month-old children.
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Objective To explore the effect of endoscopic hemostasis combined with octreotide on hemodynamics and clinical outcome of patients with acute upper gastrointestinal bleeding.Methods From January 2019 to June 2022,80 patients with acute upper gastrointestinal bleeding in Xinyu Yinhe Hospital of Jiangxi Province,and according to random number table method,40 cases each in the control group and 40 cases in the observation group.The control group was treated with conventional endoscopic,while the observation group was treated with octreotide on this basis.The clinical efficacy,high sensitivity C-reactive protein(hs-CRP),cortisol(Cor)levels and hemodynamic changes[cardiac output(CO),heart rate(HR),mean arterial pressure(MAP)]were compared between the two groups.Results The total effective rate of the observation group was significantly higher(P<0.05).After treatment,hs-CRP and Cor levels in 2 groups were lower than before,and hs-CRP and Cor levels in observation group were significantly lower(P<0.05).After treatment,the levels of CO,HR and MAP in the two groups were decreased,and the levels of CO,HR and MAP in the observation group were significantly lower(P<0.05).Conclusion Endoscopic hemostasis combined with octreotide can promote the hemodynamic indexes of patients with acute upper gastrointestinal bleeding to return to normal,improve the levels of hs-CRP and Cor,and improve clinical efficacy.
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Objective:To explore the application of magnetic resonance(MR)quantitative analysis technique of fat in analyzing the relationships between liver fat fraction(LFF)and pancreatic fat fraction(PFF)and the severity of nonalcoholic fatty liver disease(NAFLD),and between them and liver function.Methods:A total of 185 patients who received MR whole-liver mDIXON sequence scan were selected,and their LFF and PFF were measured.They were divided into NAFLD group(160 cases)and control group(25 cases)according to the fat fraction(FF)of liver.The body mass index(BMI),alanine aminotransferase(ALT),triglycerides(TG),fasting blood glucose(FBG),low-density lipoprotein(LDL-c),high-density lipoprotein(HDL-c),LFF and PFF between two groups were compared.Spearman analysis method was adopted to analyze the correlation between LFF and various indicators,and between PFF and various indicators.Logistic regression analysis was used to analyze the influencing factors of NAFLD severity.Results:In 160 patients of NAFLD group,72 cases were mild degree(LFF WAS 5.1%-14.0%),and 76 cases were moderate degree(LFF was 14.1%-28.0%),and 12 cases were severe degree(LFF>28.0%).There were significant differences in LFF,PFF and BMI between NAFLD group and control group(tLFF=17.259,tPFF=9.058,tBMI=7.430,P<0.05),and the differences of ALT,TG,FBG,LDL-c and HDL-c between two groups also were significant(t=6.591,t=3.957,t=3.267,t=2.112,t=-3.727,P<0.05),respectively.There were significant differences in LFF,PFF,BMI,ALT,TG,FBG,LDL-c and HDL-c among mild group,moderate group and severe group of patients(F=21.944,F=16.391,F=5.872,F=30.240,F=3.984,F=3.863,F=3.398,F=1.214,P<0.05),respectively.BMI,ALT,TG and FBG appeared positive correlation with LFF and PFF of NAFLD patients(r=0.31,r=0.52,r=0.33,r=0.35,r=0.30,r=0.36,r=0.27,r=0.29,P<0.05),and HDL-c appeared negative correlation with them(r=-0.16,r=-0.3,P<0.05),respectively.Multivariate Logistic regression analysis showed that HDL-c was an independent protective factor of the severity of NAFLD(OR=0.004,P<0.05),and LFF,PFF,BMI,ALT,TG,LDL were independent risk factors of the severity of NAFLD(OR=2.252,OR=1.988,OR=1.404,OR=1.196,OR=1.025,OR=5.150,P<0.05),respectively.Conclusion:LFF and PFF are closely related to the severity of NAFLD and the indicators of liver function,and the increases of LFF and PFF are independent risk factors of the aggravation of NAFLD.The MR quantitative analyses of LFF and PFF values have a certain guiding significance in clinical monitoring for NAFLD severity and liver function.
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Objective:To explore the configuration conditions and type-selections of positron emission tomography/computed tomography(PET/CT)and positron emission tomography/magnetic resonance(PET/MR)system under the national new policies during the 14th Five-Year Plan period,so as to provide references for configuration and type-selection of PET/CT and PET/MR equipment of medical institutions.Methods:According to the management polices of relevant configurations of PET/CT and PET/MR,which included configuration licensing,use management and configuration plan,and which were issued by China 14th Five-Year Plan,as well as the development trend and characteristics of PET/CT and PET/MR new techniques,the configuration conditions and type-selection plan of PET/CT and PET/MR equipment were analyzed.Results:Under the new polices during national 14th Five-Year Plan,medical institutions should configure PET/CT and PET/MR depended on the condition of institutions,personnel condition,work basis,the supporting facilities and other conditions,and should select the type of PET/CT and PET/MR which can meet the requirements of medical institutions depended on the technique parameters and performance indicators of PET/CT and PET/MR.Conclusions:Since the 14th Five-Year Plan,there were significant changes in the new policies related to the configurations of PET/CT and PET/MR compared to previous policies.The medical institutions should apply configurations and use PET/CT and PET/MR as new requirement,and configure the PET/CT and PET/MR equipment and conduct type-selection of them as various requirements of each institution.
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@#This systematic review was conducted to evaluate the image quality performance when implementing computed tomography data (CTAC) or magnetic resonance data for attenuation correction (MRAC) on positron emission tomography (PET) images. The CTAC and MRAC were performed on image from PET/CT and PET/MR scanners, respectively. The systematic review was done based on Preferred Reporting Items for Systematic Reviews (PRISMA). In this study, twelve articles were included from six databases. The image performance was evaluated by overall image quality, contrast, spatial resolution, detectability, standardised uptake value (SUV) and acquisition time. Data was shown as mean ± standard deviation and compared between CTAC and MRAC images to determine which attenuation correction method provides better image quality. Results found that PET-CTAC and PET-MRAC have similar image performance in overall image quality (p=0.93), detectabilty (p=0.84), SUVmean (p=0.84) and SUVmax (p=0.81). Meanwhile, PET-CTAC acquisition time is significantly faster than PET-MRAC by approximately two fold (p <0.05). There were no statistical analyses performed for image contrast, spatial resolution and contrast-noise-ratio due to the insufficient data. In conclusion, although PET/CT is faster than PET/MRI procedure, images yielded from CTAC and MRAC are equivalent to each other. Due to the variation of linear attenuation coefficient for each type of tissue, future review of image quality comparison can be done focusing on specific tissue or region such as soft tissue, bone and lungs to reflect the real impact of CTAC and MRAC on PET image.
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Facing the increasingly severe energy shortage and environmental pollution, electrocatalytic processes using electroactive microorganisms provide a new alternative for achieving environmental-friendly production. Because of its unique respiratory mode and electron transfer ability, Shewanella oneidensis MR-1 has been widely used in the fields of microbial fuel cell, bioelectrosynthesis of value-added chemicals, metal waste treatment and environmental remediation system. The electrochemically active biofilm of S. oneidensis MR-1 is an excellent carrier for transferring the electrons of the electroactive microorganisms. The formation of electrochemically active biofilm is a dynamic and complex process, which is affected by many factors, such as electrode materials, culture conditions, strains and their metabolism. The electrochemically active biofilm plays a very important role in enhancing bacterial environmental stress resistance, improving nutrient uptake and electron transfer efficiency. This paper reviewed the formation process, influencing factors and applications of S. oneidensis MR-1 biofilm in bio-energy, bioremediation and biosensing, with the aim to facilitate and expand its further application.
Subject(s)
Bioelectric Energy Sources/microbiology , Biofilms , Electrodes , Electron Transport , Shewanella/metabolism摘要
In situ and real-time monitoring of responsive drug release is critical for the assessment of pharmacodynamics in chemotherapy. In this study, a novel pH-responsive nanosystem is proposed for real-time monitoring of drug release and chemo-phototherapy by surface-enhanced Raman spectroscopy (SERS). The Fe3O4@Au@Ag nanoparticles (NPs) deposited graphene oxide (GO) nanocomposites with a high SERS activity and stability are synthesized and labeled with a Raman reporter 4-mercaptophenylboronic acid (4-MPBA) to form SERS probes (GO-Fe3O4@Au@Ag-MPBA). Furthermore, doxorubicin (DOX) is attached to SERS probes through a pH-responsive linker boronic ester (GO-Fe3O4@Au@Ag-MPBA-DOX), accompanying the 4-MPBA signal change in SERS. After the entry into tumor, the breakage of boronic ester in the acidic environment gives rise to the release of DOX and the recovery of 4-MPBA SERS signal. Thus, the DOX dynamic release can be monitored by the real-time changes of 4-MPBA SERS spectra. Additionally, the strong T2 magnetic resonance (MR) signal and NIR photothermal transduction efficiency of the nanocomposites make it available for MR imaging and photothermal therapy (PTT). Altogether, this GO-Fe3O4@Au@Ag-MPBA-DOX can simultaneously fulfill the synergistic combination of cancer cell targeting, pH-sensitive drug release, SERS-traceable detection and MR imaging, endowing it great potential for SERS/MR imaging-guided efficient chemo-phototherapy on cancer treatment.
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OBJECTIVE@#To analysis and determine MR signs of Harris score ARCO stages 2-4 in osteonecrosis of femoral head (ONFH).@*METHODS@#Thirty-four patients with ONFH of ARCO stages 2 to 4 who underwent routine MR, T2 mapping, 3D-SPACE sequence examination and Harris score were retrospectively collected from January 2019 to June 2020, and 3 patients were excluded, and 31 patients were finally included, including 23 males and 8 females, aged from 18 to 62 years old with an average of(40.0±10.8) years old. Among them 21 patients with bilateral femoral head necrosis, totally 52 cases, including 17 with ARCO stage 2 patients, 24 ARCO stage 3, and 11 ARCO stage 4. MR imaging signs (femoral head collapse depth, ONFH index, bone marrow edema, hyperplasia, grade and T2 value of cartilage injury, and joint effusion) were scored and measured on the picture archiving and communication system (PACS) workstation, and the cartilage quantitative parameter T2 value was calculated and measured on Siemens postprocessing workstation. Pearson correlation analysis was used to evaluate the correlation between various MR signs and Harris score, and then multiple linear regression analysis was used to examine impact of MR signs on Harris hip score.@*RESULTS@#Femoral head collapse depth(r=-0.563, P=0.000), grade of cartilage injury(r=-0.500, P=0.000), and joint effusion (r=-0.535, P=0.000) were negatively correlated with Harris score by Pearson correlation analysis. Multiple linear regression analysis showed that joint effusion(β=-6.198, P=0.001) and femoral head collapse depth(β=-4.085, P=0.014) had a significant negative impact on Harris hip score.@*CONCLUSION@#Femoral head collapse depth and joint effusion both had significant negative relationship with Harris hip score. It is recommended to routinely evaluate femoral head collapse depth and joint effusion quantitatively and gradedly, so as to efficiently and accurately assist clinical diagnosis and treatment.
Subject(s)
Male , Female , Humans , Adolescent , Young Adult , Adult , Middle Aged , Femur Head Necrosis/diagnostic imaging , Retrospective Studies , Femur Head/diagnostic imaging , Bone Transplantation/methods , Magnetic Resonance Imaging , Treatment Outcome摘要
@#Headaches are a common presentation in the emergency department (ED). Even though not all are potentially serious, some such as subarachnoid hemorrhage (SAH) can be more dangerous than others. SAH is a medical emergency with an almost 50% mortality rate. It is crucial not to miss the diagnosis of SAH, as a missed or delayed diagnosis can be severely detrimental. It classically presents as thunderclap headache, a severe, sudden-onset headache. There are various approaches in diagnosing or excluding SAH, which is classically done by performing a computed tomography (CT) scan followed by a lumbar puncture (LP). But with the improved sensitivity of more modern diagnostic tools, more physicians are in support of changing this classical teaching. The aim of this case report is to review the advantages and disadvantages of LP in diagnosing SAH, along with other diagnostic tools commonly used.
Subject(s)
Subarachnoid Hemorrhage , Spinal Puncture , Cerebrospinal Fluid摘要
Radiotherapy (RT) is the primary local treatment modality for brain metastases, which are common secondary malignancies. Image-guidance system such as cone beam computed tomography (CBCT) may be not applicable to adaptive radiotherapy (ART), as well as hypofractionated RT in brain metastases, because it cannot clearly show the shrinkage and deformation of intracranial tumors, and the peritumoral edema changes in a real-time manner. Magnetic resonance (MR) image has high spatial resolution and soft tissue contrast and no radiation dose burden compared with CBCT. MR-guided adaptive radiotherapy (MR-gART) allows real-time tracking of deformation and position changes of the intracranial tumors, and enables online planning reconstruction during the treatment process. MR-gART could deliver high dose irradiation to the tumors while reducing the radiation dose of important organs at risk around, which contributes to achieving precision RT. In this work, the application of MR-gART in brain metastases was reviewed.
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Takayasu Arteritis (TA) is classified as a large vessel vasculitis, it primarily affects aorta and principal branches. The clinical presentation in pediatric patients is odd and there a few literature about it. The case is about a feminine patient hospitalized after birth with diagnosis of patent ductus arterious (PDA), abnormal widening of the descending aorta, aneurysm of the aortic arch. It is kept under close surveillance for 5 years, with imaging improvement in treatment with methotrexate and immunoglobulin, however she presented relapses on two occasions where the caliber decreased in descending aorta and left iliac artery. We can conclude that Identifying AT findings is important for early diagnosis, medical management, and proper monitoring specifically in pediatric patients where little literature is available.
La arteritis de Takayasu (AT) se clasifica como una vasculitis de grandes vasos desarrollándose sobre todo en aorta y ramas principales. Su presentación en pacientes pediátricos es rara y existe muy poca información en la literatura. Se trata de una paciente femenina hospitalizada al nacimiento, a quien se diagnostica ductus arterioso persistente (DAP), dilatación de aorta descendente y aneurisma de arco aórtico. Se mantiene bajo vigilancia estrecha durante cinco arios, con mejoría imagenológica en tratamiento a base metrotexato e inmunoglobulina, sin embargo, presenta recaídas en dos ocasiones, donde se observa disminución del calibre de aorta descendente y arteria iliaca izquierda. Se puede concluir que el identificar los hallazgos de la AT es importante para realizar un diagnóstico temprano, manejo médico oportuno y vigilancia adecuada, en específico en pacientes pediátricos, de quienes se tiene poca información en la literatura.
Subject(s)
Humans , Female , Infant, Newborn , Vascular Diseases , Vasculitis , Cardiovascular Diseases , Takayasu Arteritis摘要
RESUMO Objetivo: Descrever o IMPACTO-MR, um estudo brasileiro de plataforma nacional em unidades de terapia intensiva focado no impacto das infecções por bactérias multirresistentes relacionadas à assistência à saúde. Métodos: Descrevemos a plataforma IMPACTO-MR, seu desenvolvimento, critérios para seleção das unidades de terapia intensiva, caracterização da coleta de dados, objetivos e projetos de pesquisa futuros a serem realizados na plataforma. Resultados: Os dados principais foram coletados por meio do Epimed Monitor System® e consistiram em dados demográficos, dados de comorbidades, estado funcional, escores clínicos, diagnóstico de internação e diagnósticos secundários, dados laboratoriais, clínicos e microbiológicos e suporte de órgãos durante a internação na unidade de terapia intensiva, entre outros. De outubro de 2019 a dezembro de 2020, 33.983 pacientes de 51 unidades de terapia intensiva foram incluídos no banco de dados principal. Conclusão: A plataforma IMPACTO-MR é um banco de dados clínico brasileiro de unidades de terapia intensiva focado na pesquisa do impacto das infecções por bactérias multirresistentes relacionadas à assistência à saúde. Essa plataforma fornece dados para o desenvolvimento e pesquisa de unidades de terapia intensiva individuais e ensaios clínicos observacionais e prospectivos multicêntricos.
ABSTRACT Objective: To describe the IMPACTO-MR, a Brazilian nationwide intensive care unit platform study focused on the impact of health care-associated infections due to multidrug-resistant bacteria. Methods: We described the IMPACTO-MR platform, its development, criteria for intensive care unit selection, characterization of core data collection, objectives, and future research projects to be held within the platform. Results: The core data were collected using the Epimed Monitor System® and consisted of demographic data, comorbidity data, functional status, clinical scores, admission diagnosis and secondary diagnoses, laboratory, clinical, and microbiological data, and organ support during intensive care unit stay, among others. From October 2019 to December 2020, 33,983 patients from 51 intensive care units were included in the core database. Conclusion: The IMPACTO-MR platform is a nationwide Brazilian intensive care unit clinical database focused on researching the impact of health care-associated infections due to multidrug-resistant bacteria. This platform provides data for individual intensive care unit development and research and multicenter observational and prospective trials.
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Background: Accurate quantitative evaluation of MR severity remains challenging because limited scan plane orientation of 2D echocardiography does not provide direct measurement of the regurgitant lesion. Three-dimensional echocardiography, which has become a clinically established technique, has been shown to provide useful information for flow quantification and so has the potential to address the major drawbacks of 2D-based approaches. Objectives: To assess the reliability of PISA measurement using real-time 3D color trans-thoracic echocardiographic imaging in clinical practice and to compare its derived EROA, regurgitant volume (Rvol) and regurgitant fraction with that obtained by 2D trans thoracic PISA. Patients and Methods: This cross-sectional study, included 30 patients with at least moderate functional MR came for evaluation on clinical basis indications at Al-Hussein and Bab El-Shaareya University Hospitals during the period from November 2020 to July 2021. Two- and three-dimensional echocardiography was done to asses MR and calculate vena contract width, 2D PISA and derived EORA and regurgitant volume. Also, calculation of 3D EROA using PISA method by 3D probe. Results: There was a significant positive correlation between 2D EPISA and 3D EROA using PISA method and EROA, p value was 0.0001. With higher values for 3D EROA using PISA method when compared with 2D PISA in different degrees of MR as summarized in “the mean value of EROA by 2D PISA in moderate MR was 0.25 ±0.042 cm2, while it was 0.32±0.059 cm2 by 3D EROA using PISA method. While the mean value of EROA by 2D PISA in severe MR was 0.58 ±0.14 cm2, and it was 0.47 ±0.049 cm2 by 3D EROA”. Also showed significant difference in different direction of MR jets especially in eccentric jet as shown by the mean value of EROA by 2D PISA in central MR was 0.41±0.19 cm2, while it was 0.41±0.87 cm2 by 3D method. While the mean value of EROA by 2D PISA in eccentric MR was 0.53 ±0.21 cm2, and it was 0.44 ±0.096 cm2 by 3D EROA using PISA method. Conclusion: The use of 3D EROA using PISA method and simple calculation of a mean systolic regurgitation orifice area proved to be superior to 2D measures (VC, 2D-PISA) for distinguishing moderate from severe MR, evaluation, classification and grading of MR in a routine clinical cardiology setting. 3D EROA reduces assumptions and seemingly improves diagnostic value as compared with 2D-PISA
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Adaptive radiation therapy (ART) has been proposed as a method to account for changes in head and neck cancer and normal tissues to enhance the therapeutic ratios. Online magnetic resonance-guided radiotherapy (MRgRT) using hybrid MR-Linac systems is a novel innovative application in ART for head and neck cancer. The concept of MR-Linac systems is the ability to acquire MR images for ART and also online imaging during treatment delivery. Daily ART allows to improve the targeting accuracy while avoiding organs at risk for head and neck cancer. Although an increasing number of studies related to clinical application and technical aspect of MRgRT in head and neck cancer have been published, MRgRT for ART of head and neck cancer remains in its infancy. The purpose of this article is to summarize and discuss the rationale, clinical implementation, and prospect of this promising adaptive radiotherapy modality for treating head and neck cancer.
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Radiotherapy is one of the most important components of cancer treatment. Image-guided radiotherapy (IGRT) is the mainstream tool in the precision radiation oncology. Magnetic resonance (MR) accelerator can perform MRI for tumors during radiotherapy, deliver real-time tracing and monitoring of tumors and thus realize the MRI-guided adaptive radiotherapy. Here, the latest research status and clinical application of MR accelerator in lung cancer were reviewed.