Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 50
Filter
Add more filters

Publication year range
1.
Microsc Microanal ; 29(3): 938-952, 2023 Jun 09.
Article in English | MEDLINE | ID: mdl-37749697

ABSTRACT

In this study, a methodology for assessing the thickness of titanium nitride (TiN) coatings by energy dispersive X-ray spectroscopy (EDS) in the scanning electron microscope is explored. A standardless method is applied, where the film thickness (th) is related to the microscope accelerating voltage (V0), the type of substrate and the ratio between the more intense peaks in the EDS spectrum, arising from both the substrate and the coating (afterwards called the I-ratio, IR). Three different substrates covered with TiN were studied, namely, silicon, glass, and stainless steel. Monte Carlo simulations enabled to state an analytic equation, which allows assessing the coating thickness as follows:th=thcr⋅exp[-ßIR1/n]where IR = Iksubstrate/Ikcoating, thcr (critical thickness) is the largest coating thickness, which is assessable at a fixed V0, ß is a multiplication factor, and n is an exponent, where thcr, ß and n are assessable from V0 and substrate type. Interpolation via the equation presented, using reference thicknesses, allowed thickness predictions with around 80% of datapoints differing less than around 2% from the reference value. A procedure for detecting variations as low as 1.0% in coating thickness regarding the nominal thickness is presented.

2.
Pain Manag Nurs ; 24(4): 436-441, 2023 08.
Article in English | MEDLINE | ID: mdl-36890094

ABSTRACT

BACKGROUND: Somatic symptom disorder is described as excessive thoughts, feelings, or behaviors related to physical symptoms. The presence of somatic symptoms has been associated with depression, alexithymia, and the presence of chronic pain. Individuals with somatic symptom disorder are frequent attenders of primary health care services. AIM: We focused on investigating if the presence of psychological symptoms, alexithymia, or pain could be risk factors for somatic symptoms in a secondary health care service. METHODS: A cross-sectional and observational study. A total of 136 Mexican individuals who regularly attend a secondary health care service were recruited. The Visual Analogue Scale for Pain Assessment, the Symptom Checklist 90, and the Patient Health Questionnaire-15 were applied. RESULTS: Of all the participants, 45.2% showed somatic symptoms. We observed that these individuals more frequently presented with complaints of pain (χ2 = 18.4, p < .001), as well as more severe (t = -4.6, p < .001), and prolonged (χ2 = 4.9, p = 0.02). They also exhibited higher severity in all psychological dimensions assessed (p < .001). Finally, cardiovascular disease (t = 2.52, p = .01), pain intensity (t = 2.94, p = .005), and SCL-90 depression (t = 7.58, p < .001) were associated with somatic symptoms. CONCLUSIONS: In this study, we observed a high frequency of somatic symptoms in outpatients attending secondary health care services. They may be accompanied by comorbid cardiovascular conditions, higher pain intensity, and other mental health-related symptoms, which may aggravate the general clinical picture presented by the patient seeking health care. The presence and severity of somatization should be taken into consideration in the first and second level health care services for an early mental state evaluation and treatment of these outpatients to have a better clinical assessment and health outcome.


Subject(s)
Chronic Pain , Medically Unexplained Symptoms , Humans , Adult , Chronic Pain/complications , Chronic Pain/epidemiology , Depression/complications , Depression/therapy , Outpatients , Cross-Sectional Studies , Delivery of Health Care
3.
J Stroke Cerebrovasc Dis ; 32(6): 107138, 2023 Jun.
Article in English | MEDLINE | ID: mdl-37087772

ABSTRACT

OBJECTIVE: The purpose of this study was to evaluate the impact of COVID-19 pandemic public health restrictions on our drip and ship mechanical thrombectomy program in Santiago Chile. MATERIALS AND METHODS: This was a retrospective analysis of a prospectively collected database comparing two cohorts, one during a two-year period before COVID-19 and the second during the two years of the pandemic at our metropolitan stroke program. RESULTS: A total of 100 patients were included in the pre COVID-19 cohort (cohort 1) and 121 in the COVID-19 cohort (cohort 2). There was a significant difference between cohorts, with older patients, different occlusion sites and higher door to arterial puncture time during the COVID-19 period. A non-significant trend for worse 90-day outcomes and higher mortality was present in cohort 2. There were no statistical differences in safety treatment parameters. CONCLUSIONS: COVID-19 pandemic has had a measurable impact on our mechanical thrombectomy program. Results showed similarities to other reported Latin American series, where less robust health systems could adapt less efficiently compared to developed countries. After two years of public health restrictions, there were changes in the treatment population characteristics, delay in some internal management metrics and a non-significant trend to worse 90-day outcomes and higher mortality.


Subject(s)
Brain Ischemia , COVID-19 , Stroke , Humans , Post-Acute COVID-19 Syndrome , Brain Ischemia/therapy , Thrombectomy/adverse effects , Thrombectomy/methods , Retrospective Studies , COVID-19/epidemiology , Pandemics , Public Health , Treatment Outcome , Stroke/diagnosis , Stroke/therapy , Stroke/epidemiology
4.
J Stroke Cerebrovasc Dis ; 31(6): 106470, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35398625

ABSTRACT

OBJECTIVE: To present a rare cause of recurrent posterior embolic strokes originating from a partially thrombosed pseudoaneurysm of a shoulder artery after arthroscopy. MATERIALS AND METHODS: The clinical history, complementary studies and follow-up were reviewed. RESULTS: The patient was successfully embolized and presented no new ischemic episodes at the 3-month follow-up visit. CONCLUSIONS: Shoulder artery pseudoaneurysm should be considered as an unusual source of posterior embolic strokes.


Subject(s)
Aneurysm, False , Embolic Stroke , Embolism , Embolization, Therapeutic , Stroke , Aneurysm, False/complications , Aneurysm, False/diagnostic imaging , Arteries , Cerebral Infarction/complications , Embolism/complications , Embolism/diagnostic imaging , Embolization, Therapeutic/adverse effects , Humans , Stroke/diagnostic imaging , Stroke/etiology , Stroke/therapy
5.
Can Assoc Radiol J ; 73(3): 557-567, 2022 Aug.
Article in English | MEDLINE | ID: mdl-35044276

ABSTRACT

Increased intracranial pressure is the most common cause of papilledema. Multiple etiologies such as cerebral edema, hydrocephalus, space occupying lesions, infection, and idiopathic intracranial hypertension among others should be considered. Imaging plays a critical role in the detection of pathologies that can cause papilledema. MRI with contrast and CE-MRV, in particular, are key for the diagnosis of idiopathic intracranial hypertension. This review will focus in common and infrequent causes of papilledema, the role of imaging in patients with papilledema as well as its potential mimickers.


Subject(s)
Papilledema , Pseudotumor Cerebri , Diagnosis, Differential , Humans , Magnetic Resonance Imaging/adverse effects , Papilledema/diagnostic imaging , Papilledema/etiology , Pseudotumor Cerebri/complications , Pseudotumor Cerebri/diagnostic imaging
6.
Int J Psychiatry Med ; 56(3): 177-188, 2021 May.
Article in English | MEDLINE | ID: mdl-33327844

ABSTRACT

INTRODUCTION: Alexithymia is the difficulty in identifying and describing feelings. Several studies have suggested that chronic pain can be linked to alexithymia. The aims of this study were to determine the presence of alexithymia in a sample of Mexican individuals who attended public health services, to assess if alexithymia is higher in medically ill individuals with pain than in those without pain, and to determine which alexithymia dimensions are more affected by the presence of pain. METHODS: Demographic and clinical features were evaluated in 250 Mexican outpatients of the General Hospital of Comalcalco, Tabasco. Pain was evaluated using the Visual Analogue Scale for Pain Assessment (VAS-P) and alexithymia was evaluated using the Toronto Alexithymia Scale (TAS-20). RESULTS: 38.8% of the sample was identified with probable/definite alexithymia and up to 61.2% of individuals were currently experiencing pain. Individuals with pain exhibited higher scores in the TAS-20 dimensions: difficulty describing feelings (p = 0.02), difficulty identifying feelings (p < 0.001) and higher total TAS-20 score (p < 0.001). Also, Probable/definite alexithymia was more frequently reported in individuals with pain (49% vs. 21.6%, p < 0.001). CONCLUSIONS: Our results show that a large proportion of individuals who attend public health services in a Mexican population present pain. We also identified that pain could be associated with alexithymia, in particular with a difficulty in describing and identifying feelings. An early identification and treatment of alexithymia could help in reducing the clinical burden of chronic pain in Mexican outpatients.


Subject(s)
Affective Symptoms , Chronic Pain , Affective Symptoms/diagnosis , Affective Symptoms/epidemiology , Chronic Pain/epidemiology , Emotions , Humans , Outpatients
7.
Clin Otolaryngol ; 46(4): 775-781, 2021 Jul.
Article in English | MEDLINE | ID: mdl-33548105

ABSTRACT

OBJECTIVE: To describe a group of patients with suspected acute invasive fungal rhinosinusitis (AIFRS) diagnosis, and identify factors associated with a greater risk of presenting this disease. DESIGN: Non-concurrent cohort study. SETTING: A single-centre non-concurrent follow-up of patients with suspected AIFRS between August 2015 and July 2018. PARTICIPANTS: 50 inpatients referred due to suspected AIFRS at Hospital Clínico Universidad Católica based on the association of a predisposing factor (neutropenia/immunodeficiency/poorly controlled diabetes) with fever of unknown origin. MAIN OUTCOME MEASURE: The primary outcome was AIFRS diagnosis, defined as a concordant tissue biopsy. RESULTS: Acute invasive fungal rhinosinusitis was confirmed in 18% (9/50) of the evaluated patients. AIFRS was significantly associated with a positive galactomannan (P = .04), and a paranasal sinus MRI with lack of contrast enhancement (LoCE) (P = .04) orbit compromise (P = .03) or global extrasinusal extension (P = .04). LoCE and extrasinusal extension in the paranasal sinus/brain MRI were risk factors for AIFRS (OR 16; CI 1.2-210.6 and OR 12.75; CI 1.3-128.8, respectively). Conversely, a nasal endoscopy showing healthy mucosa was identified as a protective factor for AIFRS (OR 0.06; CI 0.007-0.57). CONCLUSIONS: In patients with suspected AIFRS, we identified laboratory and radiologic variables associated with the disease, which may help for a more accurate diagnostic algorithm and approach in this population.


Subject(s)
Invasive Fungal Infections/diagnosis , Rhinitis/microbiology , Sinusitis/microbiology , Acute Disease , Adult , Biopsy , Diagnosis, Differential , Endoscopy , Female , Humans , Immunocompromised Host , Magnetic Resonance Imaging , Male , Risk Factors
8.
BMC Neurol ; 20(1): 173, 2020 May 07.
Article in English | MEDLINE | ID: mdl-32380977

ABSTRACT

BACKGROUND: Multiple sclerosis (MS) is a chronic immune mediated disease and the progressive phase appears to have significant neurodegenerative mechanisms. The classification of the course of progressive MS (PMS) has been re-organized into categories of active vs. not active inflammatory disease and the presence vs. absence of gradual disease progression. Clinical trial experience to date in PMS with anti-inflammatory medications has shown limited effect. Andrographolide is a new class of anti-inflammatory agent, that has been proposed as a potential drug for autoimmune disorders, including MS. In the present trial, we perform an exploratory pilot study on the efficacy and safety of andrographolide (AP) compared to placebo in not active PMS. METHODS: A pilot clinical trial using 140 mg oral AP or placebo twice daily for 24 months in patients with not active primary or secondary progressive MS was conducted. The primary efficacy endpoint was the mean percentage brain volume change (mPBVC). Secondary efficacy endpoints included 3-month confirmed disability progression (3-CDP) and mean EDSS change. RESULTS: Forty-four patients were randomized: 23 were assigned to the AP group, and 21 were assigned to the placebo group. The median baseline EDSS of both groups was 6.0. Annualized mPBVC was - 0.679% for the AP group and - 1.069% for the placebo group (mean difference: -0.39; 95% CI [- 0.836-0.055], p = 0.08, relative reduction: 36.5%). In the AP group, 30% had 3-CDP compared to 41% in the placebo group (HR: 0.596; 95% CI [0.200-1.777], p = 0.06). The mean EDSS change was - 0.025 in the AP group and + 0.352 in the placebo group (mean difference: 0.63, p = 0.042). Adverse events related to AP were mild rash and dysgeusia. CONCLUSIONS: AP was well tolerated and showed a potential effect in reducing brain atrophy and disability progression, that need to be further evaluated in a larger clinical trial. TRIAL REGISTRATION: ClinicalTrials.gov NCT02273635 retrospectively registered on October 24th, 2014.


Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Brain/drug effects , Diterpenes/therapeutic use , Multiple Sclerosis, Chronic Progressive/drug therapy , Aged , Andrographis , Anti-Inflammatory Agents, Non-Steroidal/pharmacology , Brain/diagnostic imaging , Disease Progression , Diterpenes/pharmacology , Double-Blind Method , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Multiple Sclerosis , Phytotherapy , Pilot Projects , Prospective Studies
9.
Arch Psychiatr Nurs ; 34(3): 159-163, 2020 06.
Article in English | MEDLINE | ID: mdl-32513466

ABSTRACT

The aim of the present study was to evaluate the attitude toward suicide prevention in medicine and nursing students attending University in south Mexico, considering their family and personal history of suicide. Demographic features and self-reported personal and family history of suicide were evaluated in 355 Mexican students at the Health Sciences School. Their views toward suicide prevention was assessed using the Attitude Toward Suicide Prevention scale. Comparisons between medicine and nursing students were performed, as well as between had or had-not previous personal or family history of suicide. Our results support that nursing students showed the most negative attitude toward suicide prevention. Therefore, training programs and strategies encouraging a better attitude in suicide prevention are necessary to be implemented. It is also necessary to consider cultural, ethnic and family backgrounds of the students/of the population when developing new strategies.


Subject(s)
Attitude , Students, Medical , Students, Nursing , Suicide Prevention , Adult , Female , Humans , Male , Mexico , Self Report , Students, Medical/psychology , Students, Medical/statistics & numerical data , Students, Nursing/psychology , Students, Nursing/statistics & numerical data , Surveys and Questionnaires/statistics & numerical data , Universities , Young Adult
10.
Rev Med Chil ; 148(12): 1796-1805, 2020 Dec.
Article in Spanish | MEDLINE | ID: mdl-33844746

ABSTRACT

Hypopituitarism after moderate or severe traumatic brain injury (TBI) is usually underdiagnosed and therefore undertreated. Its course can be divided in an acute phase during the first 14 days after TBI with 50 to 80% risk of hypopituitarism, and a chronic phase, beginning three months after the event, with a prevalence of hypopituitarism that ranges from 2 to 70%. Its pathophysiology has been addressed in several studies, suggesting that a vascular injury to the pituitary tissue is the most important mechanism during the acute phase, and an autoimmune one during chronic stages. In the acute phase, there are difficulties to correctly interpret pituitary axes. Hence, we propose a simple and cost-effective algorithm to detect and treat a potential hypothalamic-pituitary-adrenal axis impairment and alterations of sodium homeostasis, both of which can be life-threatening. In the chronic phase, post-concussion syndrome is the most important differential diagnosis. Given the high prevalence of hypopituitarism, we suggest that all pituitary axes should be assessed in all patients with moderate to severe TBI, between 3 to 6 months after the event, and then repeated at 12 months after trauma by a specialized team in pituitary disease.


Subject(s)
Brain Injuries, Traumatic , Hypopituitarism , Pituitary Diseases , Brain Injuries, Traumatic/complications , Humans , Hypopituitarism/diagnosis , Hypopituitarism/etiology , Hypothalamo-Hypophyseal System , Pituitary-Adrenal System
11.
Biomed Instrum Technol ; 54(1): 37-43, 2020.
Article in English | MEDLINE | ID: mdl-31961742

ABSTRACT

Hydrophilic polymer coatings on intravascular devices lower friction between the device and vasculature, thereby reducing trauma during interventional procedures. Polymer coating embolism-the detachment and downstream embolism of polymer particles-has been reported as an iatrogenic complication of coated interventional devices affecting the vasculature and various organs. The Food and Drug Administration (FDA) acknowledges this complication and continues to work with stakeholders to close gaps in performance testing and standards related to polymer coating integrity. Recent innovations within interventional technologies have led to development of new hydrophilic-coated devices with expanded indications for use. The 2018 FDA draft guidance for intravascular guidewires expands the application of particulate generation testing to most devices and recommends labeling changes to increase industry awareness. This article highlights current procedural trends where the phenomenon of polymer coating embolism may be more prevalent. It describes the mechanisms of polymer separation, reported clinical sequelae, and risk factors for relevant indications. These procedural trends and associated risk factors articulate the need for particulate testing and support the FDA's draft guidance recommendations for performance testing of applied coatings. If standardized, particulate assessments may allow characterization and comparisons of coating integrity among devices from various manufacturers, and are an important foundation for setting particulate limits. As hydrophilic coatings enable endovascular treatment for a range of patient populations, setting particulate limits or finding alternative solutions without compromise to device function may be essential. Particulate testing is relevant to physicians, regulators, and manufacturers for the purposes of product development and quality improvement of interventional devices.


Subject(s)
Embolism , Coated Materials, Biocompatible , Humans , Hydrophobic and Hydrophilic Interactions , Polymers , United States , United States Food and Drug Administration
12.
Mult Scler ; 23(13): 1791-1795, 2017 Nov.
Article in English | MEDLINE | ID: mdl-28397579

ABSTRACT

Secondary paroxysmal dyskinesias (SPDs) are short, episodic, and recurrent movement disorders, classically related to multiple sclerosis (MS). Carbamazepine is effective, but with risk of adverse reactions. We identified 7 patients with SPD among 457 MS patients (1.53%). SPD occurred in face ( n = 1), leg ( n = 2), or arm +leg ( n = 4) several times during the day. Magnetic resonance imaging (MRI) showed new or enhancing lesions in thalamus ( n = 1), mesencephalic tegmentum ( n = 1), and cerebellar peduncles ( n = 5). Patients were treated with clonazepam and then acetazolamide ( n = 1), acetazolamide ( n = 5), or levetiracetam ( n = 1) with response within hours (acetazolamide) to days (levetiracetam). No recurrences or adverse events were reported after a median follow-up of 33 months.


Subject(s)
Anticonvulsants/pharmacology , Cerebellum/diagnostic imaging , Dyskinesias , Dystonia , Multiple Sclerosis , Tegmentum Mesencephali/diagnostic imaging , Thalamus/diagnostic imaging , Acetazolamide/pharmacology , Adult , Anticonvulsants/administration & dosage , Clonazepam/pharmacology , Dyskinesias/diagnostic imaging , Dyskinesias/drug therapy , Dyskinesias/etiology , Dyskinesias/physiopathology , Dystonia/diagnostic imaging , Dystonia/drug therapy , Dystonia/etiology , Dystonia/physiopathology , Female , Follow-Up Studies , Humans , Levetiracetam , Magnetic Resonance Imaging , Male , Multiple Sclerosis/complications , Multiple Sclerosis/diagnostic imaging , Multiple Sclerosis/physiopathology , Piracetam/analogs & derivatives , Piracetam/pharmacology , Treatment Outcome
13.
Eur Spine J ; 25(9): 2728-33, 2016 09.
Article in English | MEDLINE | ID: mdl-26879918

ABSTRACT

PURPOSE: Grading inter-vertebral disc degeneration (IDD) is important in the evaluation of many degenerative conditions, including patients with low back pain. Magnetic resonance imaging (MRI) is considered the best imaging instrument to evaluate IDD. The Pfirrmann classification is commonly used to grade IDD; the authors describing this classification showed an adequate agreement using it; however, there has been a paucity of independent agreement studies using this grading system. The aim of this study was to perform an independent inter- and intra-observer agreement study using the Pfirrmann classification. METHODS: T2-weighted sagittal images of 79 patients consecutively studied with lumbar spine MRI were classified using the Pfirrmann grading system by six evaluators (three spine surgeons and three radiologists). After a 6-week interval, the 79 cases were presented to the same evaluators in a random sequence for repeat evaluation. The intra-class correlation coefficient (ICC) and the weighted kappa (wκ) were used to determine the inter- and intra-observer agreement. RESULTS: The inter-observer agreement was excellent, with an ICC = 0.94 (0.93-0.95) and wκ = 0.83 (0.74-0.91). There were no differences between spine surgeons and radiologists. Likewise, there were no differences in agreement evaluating the different lumbar discs. Most differences among observers were only of one grade. Intra-observer agreement was also excellent with ICC = 0.86 (0.83-0.89) and wκ = 0.89 (0.85-0.93). CONCLUSIONS: In this independent study, the Pfirrmann classification demonstrated an adequate agreement among different observers and by the same observer on separate occasions. Furthermore, it allows communication between radiologists and spine surgeons.


Subject(s)
Intervertebral Disc Degeneration , Intervertebral Disc , Lumbar Vertebrae , Female , Humans , Intervertebral Disc/diagnostic imaging , Intervertebral Disc/pathology , Intervertebral Disc Degeneration/classification , Intervertebral Disc Degeneration/diagnostic imaging , Intervertebral Disc Degeneration/pathology , Lumbar Vertebrae/diagnostic imaging , Lumbar Vertebrae/pathology , Magnetic Resonance Imaging/methods , Male , Middle Aged , Observer Variation , Reproducibility of Results
14.
AJNR Am J Neuroradiol ; 45(5): 612-617, 2024 05 09.
Article in English | MEDLINE | ID: mdl-38637025

ABSTRACT

BACKGROUND AND PURPOSE: Transvenous embolization has emerged as a novel technique for treating selected brain AVMs with high reported occlusion rates. However, it requires anatomic and technical skills to be successful and to ensure patient safety. Therefore, training and testing are essential for preparing clinicians to perform these procedures. Our aim was to develop and test a novel, patient-specific brain AVM in vitro model for transvenous embolization by using 3D printing technology. MATERIALS AND METHODS: We developed a brain AVM in vitro model based on real patient data by using stereolithography resin 3D printing. We created a closed pulsed circuit with flow passing from the arterial side to the venous side, and we tested the effect of mean arterial pressure on retrograde nidal filling with contrast injections. Transvenous embolization simulations were conducted for each of the 12 identical models divided into 2 groups (2×6). This involved the use of an ethylene-vinyl alcohol liquid embolic agent injected through microcatheters either without or with a coil in the vein (groups 1 and 2, respectively). RESULTS: Retrograde contrast advance to nidus was directly related to lower mean arterial pressure. Transvenous embolization tests with a liquid embolic agent adequately reproduced the usual embolization plug and push technique. We found no differences between the 2 group conditions, and additional venous coil neither increased nidus penetration nor reduced injection time in the model (57.6 versus 61.2% nidus occlusion rate, respectively). CONCLUSIONS: We were able to develop and test a functional in vitro brain AVM model for transvenous embolization by using 3D printing to emulate its conditions and characteristics. Better contrast penetration was achieved with less mean arterial pressure, and no embolization advantage was found by adding coil to the vein in this model.


Subject(s)
Embolization, Therapeutic , Intracranial Arteriovenous Malformations , Printing, Three-Dimensional , Humans , Embolization, Therapeutic/methods , Intracranial Arteriovenous Malformations/therapy , Intracranial Arteriovenous Malformations/diagnostic imaging , Models, Anatomic
15.
Interv Neuroradiol ; : 15910199231184605, 2023 Jun 22.
Article in English | MEDLINE | ID: mdl-37350047

ABSTRACT

BACKGROUND: Brain arteriovenous malformations (bAVM) are complex vascular diseases. Several models have been used to simulate endovascular treatments; thus in vitro models have not been widely employed because it has been difficult to recreate realistic phantoms of this disease. OBJECTIVE: To describe the development and evaluate the preliminary experience of a novel bAVM in vitro model for endovascular embolization using millifluidic three-dimensional (3D) printing technology. METHODS: We designed a bAVM phantom starting from simple to more complex designs, composed of a nidus, feeding arteries and draining vein. We recreate the design by using millifluidic technology with stereolithography 3D printing. Structural and functional tests were performed using angiographic images and computer flow dynamics. Treatment simulations with ethylene vinyl alcohol were tested using two different microcatheter position techniques. A Likert-scale questionnaire was applied to perform a qualitative evaluation of the model. RESULTS: We developed a realistic model of a bAVM with hollow channels. The structural evaluation showed a high precision of the 3D printing process. Embolization tests with the liquid agent gave similar sensations and material behaviour as in vivo cases. There were no significant differences between microcatheter position techniques, thus we observed a trend for better nidus filling with a deeper in-nidus position technique. CONCLUSIONS: We were able to create and test a novel bAVM in vitro model with stereolithography 3D printing in resin. It showed a high capacity for simulating endovascular embolization characteristics, with an excellent user experience. It could be potentially used for training and testing of bAVM embolizations.

16.
Neuroimaging Clin N Am ; 33(3): 407-422, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37356859

ABSTRACT

Most intradural tumors are located within the intradural extramedullary compartment, and the most common tumors are schwannomas and meningiomas. Other less common neoplasms include neurofibroma, solitary fibrous tumor, myxopapillary ependymoma, lymphoma, metastatic leptomeningeal disease, malignant peripheral nerve sheath tumor, and paraganglioma. Patients usually present with gait ataxia, radicular pain, and motor and sensory deficits due to chronic compressive myelopathy or radiculopathy. MRI is the modality of choice for detecting and evaluating intradural extramedullary spinal tumors. This imaging technique helps narrow the differential diagnosis and therefore decide treatment.


Subject(s)
Meningeal Neoplasms , Spinal Cord Neoplasms , Spinal Neoplasms , Humans , Spinal Cord Neoplasms/diagnostic imaging , Spinal Cord Neoplasms/pathology , Syndrome , Spinal Neoplasms/pathology , Magnetic Resonance Imaging/methods , Meningeal Neoplasms/pathology
17.
Mult Scler Relat Disord ; 69: 104442, 2023 Jan.
Article in English | MEDLINE | ID: mdl-36521387

ABSTRACT

BACKGROUND: Anti-Myelin Oligodendrocyte Glycoprotein (MOG) Antibody Associated Disease (MOGAD) is an emerging disorder recognized as a clinical entity distinct from Multiple Sclerosis and Aquaporin-4-positive Neuromyelitis Optica Spectrum Disorders (NMOSD-AQP4+), and its phenotypic spectrum continues to expand. Most information about its clinical course has emerged from retrospective studies, and treatment response both in acute and chronic-relapsing disease is still limited. We aimed to describe the clinical and paraclinical characteristics of monophasic and relapsing, paediatric and adult patients with MOGAD under regular clinical care in Chile, highlighting some challenging cases that are far from being considered benign. METHODS: Observational, retrospective, and prospective longitudinal multicentre study including patients with positive serum MOG-IgG assessed by cell-based assay. RESULTS: We include 35 patients, 71% women, median age at onset 30 years (range 1-68), 23% had paediatric onset, with a median disease-duration 24 months (range 12-348). In the whole cohort, the most frequent symptoms at onset were isolated optic neuritis (ON) (34%) and myelitis (22%). Encephalitis with seizures or encephalomyelitis was the most common presentation in paediatric-onset patients 75% (n = 6), compared to 11% (n = 3) of the adult-onset patients (p < 0.001). A relapsing course was observed in 34%, these patients were younger (25 vs. 34 years, p = 0.004) and with a longer disease duration (64 vs. 6 months, p = 0.004) compared to monophasic patients. Two patients developed encephalitis with seizures/status epilepticus, with concomitant positive CSF anti-NMDAR-IgG. Chronic immunotherapy was ever prescribed in 77%, the most frequent was rituximab (35%). Relapses under chronic immunotherapy occurred in 5/27 patients (18.5%), two of them under rituximab, one paediatric patient who started combined therapy with monthly IVIG and one adult patient that switched to satralizumab plus mycophenolate. The median EDSS at the last follow-up was 1.5 (range 0-6.0). CONCLUSION: In Chile, patients with MOGAD exhibit a wide spectrum of clinical presentations at disease onset and during relapses. Close monitoring is needed, particularly in younger patients with short follow-up periods.


Subject(s)
Encephalitis , Neuromyelitis Optica , Female , Male , Humans , Retrospective Studies , Prospective Studies , Rituximab , Chile/epidemiology , Myelin-Oligodendrocyte Glycoprotein , Aquaporin 4 , Seizures , Autoantibodies , Immunoglobulin G , Oligodendroglia
18.
Nurs Rep ; 13(4): 1388-1398, 2023 Oct 07.
Article in English | MEDLINE | ID: mdl-37873823

ABSTRACT

(1) Background: health care workers, particularly nurses, have been regularly assaulted during the COVID-19 pandemic. Purpose: to evaluate the prevalence and location of assaults against nursing personnel in Latin America, and to determine predictor factors for aggression against nurses. (2) Methods: A cross-sectional online survey was answered by 374 nurses working in health care during the COVID-19 pandemic. The aggression against nurses was estimated using the Victimization Scale. (3) Results: A total of 288 nurses were included in this study. The victimization scale showed that 52.1% of nurses have suffered aggression by the general population during the COVID-19 pandemic. Males were more likely to be attacked than females (p < 0.05). Additionally, males were attacked more frequently on public transport (x2 = 6.72, p = 0.01). The home neighborhood and markets were other locations with a higher risk of being assaulted (OR: 3.39, CI: 1.53-7.50). (4) Conclusions: Our results indicate that nurses in Latin America who work during the COVID-19 pandemic and social isolation have been frequently assaulted by the general public. Males are more frequently attacked than females and the main places of aggression are public transportation, their home neighborhood and supermarkets. Implications for nursing practice: it is necessary to create and implement protocols and guidelines to support nursing personnel during the COVID-19 pandemic. This study was retrospectively registered at the Juarez Autonomous University of Tabasco (103/CIPDACS/2020) on the (08/2020).

19.
Abdom Imaging ; 37(1): 83-90, 2012 Feb.
Article in English | MEDLINE | ID: mdl-21681494

ABSTRACT

Portal biliopathy (PB) is a disorder characterized by biliary ductal and gallbladder wall abnormalities seen in patients with extrahepatic portal vein obstruction. These abnormalities consist mainly of bile duct compression and tethering, stenoses, fibrotic strictures and dilatation of both extrahepatic and intrahepatic bile ducts, as well as gallbladder varices. In this pictorial essay, we describe the imaging findings of PB, which allow differentiation of this entity from other diseases that may have similar imaging findings including cholangiocarcinoma, extrinsic compression of the bile duct caused by metastatic adenopathy or sclerosing cholangitis.


Subject(s)
Bile Duct Diseases/diagnosis , Hypertension, Portal/complications , Bile Duct Diseases/etiology , Bile Ducts/diagnostic imaging , Cholangiography , Humans , Magnetic Resonance Imaging , Multidetector Computed Tomography , Portal Vein/diagnostic imaging , Tomography, X-Ray Computed , Ultrasonography, Doppler, Color
20.
Schizophr Bull ; 48(2): 485-494, 2022 03 01.
Article in English | MEDLINE | ID: mdl-34931688

ABSTRACT

22q11.2 deletion syndrome (22q11.2DS) is a genetic neurodevelopmental disorder that represents one of the greatest known risk factors for psychosis. Previous studies in psychotic subjects without the deletion have identified a dopaminergic dysfunction in striatal regions, and dysconnectivity of striatocortical systems, as an important mechanism in the emergence of psychosis. Here, we used resting-state functional MRI to examine striatocortical functional connectivity in 22q11.2DS patients. We used a 2 × 2 factorial design including 125 subjects (55 healthy controls, 28 22q11.2DS patients without a history of psychosis, 10 22q11.2DS patients with a history of psychosis, and 32 subjects with a history of psychosis without the deletion), allowing us to identify network effects related to the deletion and to the presence of psychosis. In line with previous results from psychotic patients without 22q11.2DS, we found that there was a dorsal to ventral gradient of hypo- to hyperstriatocortical connectivity related to psychosis across both patient groups. The 22q11.2DS was additionally associated with abnormal functional connectivity in ventral striatocortical networks, with no significant differences identified in the dorsal system. Abnormalities in the ventral striatocortical system observed in these individuals with high genetic risk to psychosis may thus reflect a marker of illness risk.


Subject(s)
DiGeorge Syndrome/complications , Ventral Striatum/physiopathology , Adolescent , DiGeorge Syndrome/physiopathology , Female , Humans , Magnetic Resonance Imaging/methods , Magnetic Resonance Imaging/statistics & numerical data , Male , Mental Status and Dementia Tests/statistics & numerical data , Ventral Striatum/anatomy & histology , Young Adult
SELECTION OF CITATIONS
SEARCH DETAIL