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1.
Nan Fang Yi Ke Da Xue Xue Bao ; 40(4): 491-498, 2020 Apr 30.
Artigo em Chinês | MEDLINE | ID: mdl-32895133

RESUMO

OBJECTIVE: To establish an algorithm based on 3D convolution neural network to segment the organs at risk (OARs) in the head and neck on CT images. METHODS: We propose an automatic segmentation algorithm of head and neck OARs based on V-Net. To enhance the feature expression ability of the 3D neural network, we combined the squeeze and exception (SE) module with the residual convolution module in V-Net to increase the weight of the features that has greater contributions to the segmentation task. Using a multi-scale strategy, we completed organ segmentation using two cascade models for location and fine segmentation, and the input image was resampled to different resolutions during preprocessing to allow the two models to focus on the extraction of global location information and local detail features respectively. RESULTS: Our experiments on segmentation of 22 OARs in the head and neck indicated that compared with the existing methods, the proposed method achieved better segmentation accuracy and efficiency, and the average segmentation accuracy was improved by 9%. At the same time, the average test time was reduced from 33.82 s to 2.79 s. CONCLUSIONS: The 3D convolution neural network based on multi-scale strategy can effectively and efficiently improve the accuracy of organ segmentation and can be potentially used in clinical setting for segmentation of other organs to improve the efficiency of clinical treatment.


Assuntos
Processamento de Imagem Assistida por Computador , Órgãos em Risco , Cabeça , Humanos , Pescoço , Redes Neurais de Computação , Tomografia Computadorizada por Raios X
2.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 42(4): 491-496, 2020 Aug 30.
Artigo em Chinês | MEDLINE | ID: mdl-32895101

RESUMO

Objective To investigate the value of head and neck CT angiography(CTA)in the evaluation of intraoperative hemorrhage of carotid body tumours. Methods Head and neck CTA images of 36 patients with carotid body tumours confirmed by pathology were retrospectively analyzed.Patients were divided into two groups based on the intraoperative bleeding volume:<500 ml and≥500 ml groups.The patient's age,sex,Shamblin classification,size of the lesion,number of blood supply arteries,course of the disease,plain scan,and enhanced CT value between two groups were compared and analyzed.Logistics regression equation was established based on the CTA parameters with significant differences between the two intraoperative bleeding volume groups,and combined parameter was acquired.The receiver operating characteristic curve was established based on CTA single and combined parameters. Results The bleeding volume during the operation of carotid body tumors was significantly correlated with the age of patients(P=0.019),the maximum diameter of tumours on axial images(P=0.003),the maximum upper and lower diameters(P=0.004),Shamblin classification(P=0.012),and number of blood supply arteries(P<0.001).The area under the receiver operating characteristic curve of the number of feeding arteries,the maximum diameter of axial images,maximum upper and lower diameters,Shamblin classification,and combined parameters were 0.865,0.781,0.806,0.766,and 0.927,respectively.When the optimal critical value was 0.408,the Youden index was 0.794,and the corresponding accuracy,sensitivity,and specificity were 0.919,0.909,and 0.923,respectively. Conclusions Preoperative head and neck CTA can be used to evaluate the intraoperative blood loss.Combined parameters has the best diagnostic performance compared with single parameters.


Assuntos
Tumor do Corpo Carotídeo , Angiografia por Tomografia Computadorizada , Tumor do Corpo Carotídeo/diagnóstico por imagem , Cabeça , Humanos , Pescoço , Estudos Retrospectivos
3.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(4): 415-418, 2020 Aug 01.
Artigo em Chinês | MEDLINE | ID: mdl-32865361

RESUMO

OBJECTIVE: The effects of different tube currents and voltages on image quality and radiation dose were studied to provide a theoretical basis for low-dose cone beam computed tomography (CBCT) scanning in children. METHODS: Different tube currents and voltages were used to scan the incisor area of fresh Bama pig heads by CBCT. The radiation dose was recorded, and image quality was evaluated. RESULTS: As the tube current or voltage decreased, the radiation dose and image quality gradually decreased. The computed tomographic dose index (CTDIvol) of 90 kV, 2.5 mA and 60 kV, 7.0 mA were all 1.7 mGy. The image quality score of the former was higher than that of the latter, and the difference between them was statistically significant (P<0.05). CONCLUSIONS: Low-dose CBCT scanning appears to be able to reduce the necessary tube current during imaging by improving image quality.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Cabeça , Animais , Criança , Estudos de Viabilidade , Humanos , Doses de Radiação , Suínos
4.
Nat Commun ; 11(1): 4228, 2020 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-32839445

RESUMO

Grid and head direction codes represent cognitive spaces for navigation and memory. Pure grid cells generate grid codes that have been assumed to be independent of head direction, whereas conjunctive cells generate grid representations that are tuned to a single head direction. Here, we demonstrate that pure grid cells also encode head direction, but through distinct mechanisms. We show that individual firing fields of pure grid cells are tuned to multiple head directions, with the preferred sets of directions differing between fields. This local directional modulation is not predicted by previous continuous attractor or oscillatory interference models of grid firing but is accounted for by models in which pure grid cells integrate inputs from co-aligned conjunctive cells with firing rates that differ between their fields. We suggest that local directional signals from grid cells may contribute to downstream computations by decorrelating different points of view from the same location.


Assuntos
Potenciais de Ação/fisiologia , Córtex Entorrinal/fisiologia , Células de Grade/fisiologia , Cabeça/fisiologia , Neurônios/fisiologia , Animais , Simulação por Computador , Eletrofisiologia/instrumentação , Eletrofisiologia/métodos , Córtex Entorrinal/citologia , Feminino , Masculino , Camundongos , Modelos Neurológicos , Atividade Motora/fisiologia , Ratos
5.
PLoS One ; 15(7): e0233582, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32735620

RESUMO

The craniofacial developmental disorder Burn-McKeown Syndrome (BMKS) is caused by biallelic variants in the pre-messenger RNA splicing factor gene TXNL4A/DIB1. The majority of affected individuals with BMKS have a 34 base pair deletion in the promoter region of one allele of TXNL4A combined with a loss-of-function variant on the other allele, resulting in reduced TXNL4A expression. However, it is unclear how reduced expression of this ubiquitously expressed spliceosome protein results in craniofacial defects during development. Here we reprogrammed peripheral mononuclear blood cells from a BMKS patient and her unaffected mother into induced pluripotent stem cells (iPSCs) and differentiated the iPSCs into induced neural crest cells (iNCCs), the key cell type required for correct craniofacial development. BMKS patient-derived iPSCs proliferated more slowly than both mother- and unrelated control-derived iPSCs, and RNA-Seq analysis revealed significant differences in gene expression and alternative splicing. Patient iPSCs displayed defective differentiation into iNCCs compared to maternal and unrelated control iPSCs, in particular a delay in undergoing an epithelial-to-mesenchymal transition (EMT). RNA-Seq analysis of differentiated iNCCs revealed widespread gene expression changes and mis-splicing in genes relevant to craniofacial and embryonic development that highlight a dampened response to WNT signalling, the key pathway activated during iNCC differentiation. Furthermore, we identified the mis-splicing of TCF7L2 exon 4, a key gene in the WNT pathway, as a potential cause of the downregulated WNT response in patient cells. Additionally, mis-spliced genes shared common sequence properties such as length, branch point to 3' splice site (BPS-3'SS) distance and splice site strengths, suggesting that splicing of particular subsets of genes is particularly sensitive to changes in TXNL4A expression. Together, these data provide the first insight into how reduced TXNL4A expression in BMKS patients might compromise splicing and NCC function, resulting in defective craniofacial development in the embryo.


Assuntos
Processamento Alternativo , Atresia das Cóanas/patologia , Surdez/congênito , Regulação da Expressão Gênica no Desenvolvimento , Cardiopatias Congênitas/patologia , Células-Tronco Pluripotentes Induzidas/citologia , Modelos Biológicos , Ribonucleoproteína Nuclear Pequena U5/deficiência , Spliceossomos/fisiologia , Apoptose , Diferenciação Celular , Técnicas de Reprogramação Celular , Atresia das Cóanas/genética , Células Clonais , Surdez/genética , Surdez/patologia , Transição Epitelial-Mesenquimal , Éxons/genética , Face/embriologia , Facies , Feminino , Cabeça/embriologia , Cardiopatias Congênitas/genética , Humanos , Crista Neural/citologia , Regiões Promotoras Genéticas/genética , Sítios de Splice de RNA , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Ribonucleoproteína Nuclear Pequena U5/genética , Deleção de Sequência , Proteína 2 Semelhante ao Fator 7 de Transcrição/genética , Via de Sinalização Wnt
6.
Artigo em Russo | MEDLINE | ID: mdl-32678561

RESUMO

Cervical dystonia is one of the most complex movement disorders, in which type A botulinum toxin (BTA) preparations are used. A significant number of types of dystonic installation of the head and neck determines a large number of different muscle patterns, sometimes with outwardly similar manifestations. Objective difficulties in choosing the actual pathological muscle pattern for subsequent injection in some cases determine the low effectiveness of botulinum therapy. Given this situation, it is necessary to adapt the anatomical approach to the correct choice of dystonic muscles in order to improve the results of botulinum therapy of cervical dystonia.


Assuntos
Clostridium botulinum , Torcicolo , Toxinas Botulínicas Tipo A , Cabeça , Humanos , Pescoço
7.
Medicine (Baltimore) ; 99(28): e21178, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32664159

RESUMO

Lumbar and pelvic alignment may have a huge impact on the posture of the spine and other parts. The aim of this study were to compare the spinal curvature of the cervical, thoracic, and lumbar spine and the muscle activity of the cervical erector spinae muscle, upper trapezius muscle, and thoracic erector spinae muscle when sitting at 3 different sloped, seating surfaces. A 10° wedge was used as the seating surface and we compared a forward sloping seat surface, a flat seating surface, and a rear sloping seat surface, in that order. Twenty healthy officers were recruited for this study. The subjects sat on the seat of 3 different slopes and watched a total of 3 videos, 10 minutes each. The rest time was 10 minutes. Subjects were photographed while viewing videos and muscle activity was measured. There were significant differences in cervical, thoracic, lumbar curvatures, and muscle activity in the 3 different sitting positions according to seat tilt (P < .05). Among the 3 slopes, the forward slope decreased forward head posture and cervical erector spinae muscle activity (P < .05). The activity of the cervical erector spinae muscle was 2.67% with a forward sloping seat, 5.45% with a flat sloping seat, and 6.77% with a rear sloping seat, revealing a significant difference (P < .05). This suggests that a forward sloping seat surface was effective in maintaining a neutral alignment of the spine, and this decreased the cervical spine erector muscle activity. Based on this result, equipment and chair development to incline seats forward may improve posture and health, and prevent chronic pain.


Assuntos
Músculos do Dorso/fisiologia , Postura Sentada , Curvaturas da Coluna Vertebral/fisiopatologia , Coluna Vertebral/fisiologia , Adulto , Músculos do Dorso/diagnóstico por imagem , Fenômenos Biomecânicos , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/fisiologia , Feminino , Cabeça , Voluntários Saudáveis , Humanos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/fisiologia , Masculino , Pescoço/diagnóstico por imagem , Pescoço/fisiologia , Pelve/diagnóstico por imagem , Pelve/fisiologia , Curvaturas da Coluna Vertebral/diagnóstico por imagem , Coluna Vertebral/diagnóstico por imagem , Vértebras Torácicas/diagnóstico por imagem , Vértebras Torácicas/fisiologia
8.
Proc Natl Acad Sci U S A ; 117(29): 17269-17277, 2020 07 21.
Artigo em Inglês | MEDLINE | ID: mdl-32611818

RESUMO

Traumatic brain injury (TBI) is the strongest environmental risk factor for the accelerated development of neurodegenerative diseases. There are currently no therapeutics to address this due to lack of insight into mechanisms of injury progression, which are challenging to study in mammalian models. Here, we have developed and extensively characterized a head-specific approach to TBI in Drosophila, a powerful genetic system that shares many conserved genes and pathways with humans. The Drosophila TBI (dTBI) device inflicts mild, moderate, or severe brain trauma by precise compression of the head using a piezoelectric actuator. Head-injured animals display features characteristic of mammalian TBI, including severity-dependent ataxia, life span reduction, and brain degeneration. Severe dTBI is associated with cognitive decline and transient glial dysfunction, and stimulates antioxidant, proteasome, and chaperone activity. Moreover, genetic or environmental augmentation of the stress response protects from severe dTBI-induced brain degeneration and life span deficits. Together, these findings present a tunable, head-specific approach for TBI in Drosophila that recapitulates mammalian injury phenotypes and underscores the ability of the stress response to mitigate TBI-induced brain degeneration.


Assuntos
Lesões Encefálicas Traumáticas/metabolismo , Encéfalo/metabolismo , Drosophila/fisiologia , Neuroglia/metabolismo , Animais , Comportamento Animal , Lesões Encefálicas Traumáticas/diagnóstico por imagem , Lesões Encefálicas Traumáticas/patologia , Modelos Animais de Doenças , Cabeça , Humanos , Masculino , Doenças Neurodegenerativas/metabolismo , Neuroglia/patologia , Estresse Fisiológico
9.
J Craniofac Surg ; 31(6): e630-e633, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32649560

RESUMO

The recent pandemic has led to an unprecedented overload of sanitary systems around the world. Despite that a maxillofacial department is not a frontline specialty in the treatment of coronavirus disease 2019 infections, our department has found itself faced with numerous problems in keeping the care system active and efficient while ensuring safety for patients and healthcare professionals. Massive redistribution of health personnel was needed to improve prevention and personal safety measures. The education and training system has been kept active, giving residents a decisive role in managing the state of emergency response. This article outlines new guidelines for infection prevention: from clinical control, treatment processes, clinical management, protection, and disinfection of healthcare professionals.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Cabeça/cirurgia , Maxila/cirurgia , Pescoço/cirurgia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Guias de Prática Clínica como Assunto , Infecções por Coronavirus/transmissão , Humanos , Pneumonia Viral/transmissão
10.
J Craniofac Surg ; 31(6): e644-e649, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32649566

RESUMO

At the end of December, 2019, a new virus was named severe acute respiratory syndrome coronavirus 2 appeared in Wuhan, China, and the disease caused is called as coronavirus disease 2019 (COVID-19) by World Health Organization, which to date having infected more than 3,588,773 people worldwide, as well as causing 247,503 deaths. A human to human transmission is thought to be predominantly by droplet spread, and direct contact with the patient or contaminated surfaces. This study aims to provide a comprehensive overview as well as to highlight essential evidence-based guidelines for how head and neck surgeon and healthcare providers need to take into consideration during their management of the upper airway during the COVID-19 pandemic safely and effectively to avoid the spread of the virus to the health provider.


Assuntos
Manuseio das Vias Aéreas , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Cabeça/cirurgia , Pescoço/cirurgia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Surtos de Doenças , Humanos , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Cirurgiões
11.
J Appl Behav Anal ; 53(3): 1225-1236, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32686131

RESUMO

Habit reversal training (HRT) has been a mainstay of behavior analysts' repertoire for nearly the last 50 years. HRT has been effective in treating a host of repetitive behavior problems. In the face of the current coronavirus pandemic, HRT has practical public health importance as a possible intervention for reducing hand-to-head behaviors that increase the risk of viral infection. The current paper provides a brief review of HRT for hand-to-head habits that is designed for a broad audience and concludes with practical suggestions, based on HRT, for reducing face-touching behaviors.


Assuntos
Terapia Comportamental , Hábitos , Comportamentos de Risco à Saúde , Infecções por Coronavirus/prevenção & controle , Face , Mãos , Cabeça , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle
12.
Cochrane Database Syst Rev ; 6: CD003959, 2020 06 23.
Artigo em Inglês | MEDLINE | ID: mdl-32573771

RESUMO

BACKGROUND: The ideal quantity of dietary protein for formula-fed low birth weight infants is still a matter of debate. Protein intake must be sufficient to achieve normal growth without leading to negative effects such as acidosis, uremia, and elevated levels of circulating amino acids. OBJECTIVES: To determine whether higher (≥ 3.0 g/kg/d) versus lower (< 3.0 g/kg/d) protein intake during the initial hospital stay of formula-fed preterm infants or low birth weight infants (< 2.5 kilograms) results in improved growth and neurodevelopmental outcomes without evidence of short- or long-term morbidity. Specific objectives were to examine the following comparisons of interventions and to conduct subgroup analyses if possible. 1. Low protein intake if the amount was less than 3.0 g/kg/d. 2. High protein intake if the amount was equal to or greater than 3.0 g/kg/d but less than 4.0 g/kg/d. 3. Very high protein intake if the amount was equal to or greater than 4.0 g/kg/d. SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 8), in the Cochrane Library (August 2, 2019); OVID MEDLINE Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily, and Ovid MEDLINE(R) (to August 2, 2019); MEDLINE via PubMed (to August 2, 2019) for the previous year; and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (to August 2, 2019). We also searched clinical trials databases and the reference lists of retrieved articles for randomized controlled trials (RCTs) and quasi-randomized trials. SELECTION CRITERIA: We included RCTs contrasting levels of formula protein intake as low (< 3.0 g/kg/d), high (≥ 3.0 g/kg/d but < 4.0 g/kg/d), or very high (≥ 4.0 g/kg/d) in formula-fed hospitalized neonates weighing less than 2.5 kilograms. We excluded studies if infants received partial parenteral nutrition during the study period, or if infants were fed formula as a supplement to human milk. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane and the GRADE approach to assess the certainty of evidence. MAIN RESULTS: We identified six eligible trials that enrolled 218 infants through searches updated to August 2, 2019. Five studies compared low (< 3 g/kg/d) versus high (3.0 to 4.0 g/kg/d) protein intake using formulas that kept other nutrients constant. The trials were small (n = 139), and almost all had methodological limitations; the most frequent uncertainty was about attrition. Low-certainty evidence suggests improved weight gain (mean difference [MD] 2.36 g/kg/d, 95% confidence interval [CI] 1.31 to 3.40) and higher nitrogen accretion in infants receiving formula with higher protein content (3.0 to 4.0 g/kg/d) versus lower protein content (< 3 g/kg/d), while other nutrients were kept constant. No significant differences were seen in rates of necrotizing enterocolitis, sepsis, or diarrhea. We are uncertain whether high versus low protein intake affects head growth (MD 0.37 cm/week, 95% CI 0.16 to 0.58; n = 18) and length gain (MD 0.16 cm/week, 95% CI -0.02 to 0.34; n = 48), but sample sizes were small for these comparisons. One study compared high (3.0 to 4.0 g/kg/d) versus very high (≥ 4 g/kg/d) protein intake (average intakes were 3.6 and 4.1 g/kg/d) during and after an initial hospital stay (n = 77). Moderate-certainty evidence shows no significant differences in weight gain or length gain to discharge, term, and 12 weeks corrected age from very high protein intake (4.1 versus 3.6 g/kg/d). Three of the 24 infants receiving very high protein intake developed uremia. AUTHORS' CONCLUSIONS: Higher protein intake (≥ 3.0 g/kg/d but < 4.0 g/kg/d) from formula accelerates weight gain. However, limited information is available regarding the impact of higher formula protein intake on long-term outcomes such as neurodevelopment. Research is needed to investigate the safety and effectiveness of protein intake ≥ 4.0 g/kg/d.


Assuntos
Desenvolvimento Infantil/fisiologia , Proteínas na Dieta/administração & dosagem , Fórmulas Infantis/química , Recém-Nascido de Baixo Peso/crescimento & desenvolvimento , Proteínas na Dieta/efeitos adversos , Cabeça/crescimento & desenvolvimento , Humanos , Recém-Nascido , Criança Pós-Termo , Nitrogênio/metabolismo , Ensaios Clínicos Controlados Aleatórios como Assunto , Ganho de Peso
13.
Br J Oral Maxillofac Surg ; 58(6): 704-707, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32513429

RESUMO

The COVID-19 pandemic has had a dramatic impact on international medicine practice. The propensity for head and neck surgery to generate aerosols needs special consideration over and above simply adopting personal protective equipment. This study sought to interrogate the literature and evaluate whether which additional measures might provide benefit if routinely adopted in minimising viral transmission.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Aerossóis , Cabeça/cirurgia , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional , Pescoço/cirurgia , Equipamento de Proteção Individual
14.
Nature ; 583(7815): 249-252, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32528177

RESUMO

The phylum of annelids is one of the most disparate animal phyla and encompasses ambush predators, suspension feeders and terrestrial earthworms1. The early evolution of annelids remains obscure or controversial2,3, partly owing to discordance between molecular phylogenies and fossils2,4. Annelid fossils from the Cambrian period have morphologies that indicate epibenthic lifestyles, whereas phylogenomics recovers sessile, infaunal and tubicolous taxa as an early diverging grade5. Magelonidae and Oweniidae (Palaeoannelida1) are the sister group of all other annelids but contrast with Cambrian taxa in both lifestyle and gross morphology2,6. Here we describe a new fossil polychaete (bristle worm) from the early Cambrian Canglangpu formation7 that we name Dannychaeta tucolus, which is preserved within delicate, dwelling tubes that were originally organic. The head has a well-defined spade-shaped prostomium with elongated ventrolateral palps. The body has a wide, stout thorax and elongated abdomen with biramous parapodia with parapodial lamellae. This character combination is shared with extant Magelonidae, and phylogenetic analyses recover Dannychaeta within Palaeoannelida. To our knowledge, Dannychaeta is the oldest polychaete that unambiguously belongs to crown annelids, providing a constraint on the tempo of annelid evolution and revealing unrecognized ecological and morphological diversity in ancient annelids.


Assuntos
Fósseis , Filogenia , Poliquetos/classificação , Abdome/anatomia & histologia , Animais , China , Cabeça/anatomia & histologia , Poliquetos/anatomia & histologia
15.
Niger J Clin Pract ; 23(6): 759-763, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32525108

RESUMO

Objective: The aim of this study was to detect the prevalence of soft tissue calcifications in the head and neck using cone beam computed tomography (CBCT) and to determine their clinical importance. Subjects and Methods: Soft tissue calcifications in the head and neck region were retrospectively evaluated in 1557 CBCT images obtained between 2013 and 2015. The findings were categorized as follows: tonsillolith (calcified tonsil), carotid artery calcification (CAC), sialolith (salivary stone), calcified triticeous cartilage (CTC), calcified lymph node (CLN), rhinolith, antrolith, calcification of the superior cornu of the thyroid cartilage (CSCTC), calcified stylohyoid ligaments (CSL), myositis ossifican, osteoma cutis, and intracranial calcification. A Chi-square test was performed for categorical variables. In the 1557 CBCT images, 520 (33.4%) contained had at least one soft tissue calcification in the head and neck region. Results: Tonsilloliths (18.8%) were the most prevalent soft tissue calcification, followed by CTC (5.8%), CAC (4.3%), intracranial calcifications (3.9%), CSL (3.7%), CSCTC (2.1%), osteoma cutis (1%), sialoliths (0.7%), antroliths (0.5%), myositis ossificans (0.4%), rhinoliths, and CLN (0.2%). Conclusion: There was a high prevalence of soft tissue calcifications in the head and neck region on CBCT images. Tonsilloliths were the most common type of calcification. CBCT imaging may aid the diagnosis and assessment of these calcifications.


Assuntos
Calcinose/diagnóstico por imagem , Calcinose/epidemiologia , Tomografia Computadorizada de Feixe Cônico/métodos , Cabeça/diagnóstico por imagem , Pescoço/diagnóstico por imagem , Tonsila Palatina/diagnóstico por imagem , Adulto , Doenças das Artérias Carótidas/diagnóstico por imagem , Doenças das Artérias Carótidas/epidemiologia , Doenças das Cartilagens/diagnóstico por imagem , Doenças das Cartilagens/epidemiologia , Feminino , Humanos , Linfadenopatia/diagnóstico por imagem , Linfadenopatia/epidemiologia , Masculino , Pessoa de Meia-Idade , Doenças Faríngeas/diagnóstico por imagem , Doenças Faríngeas/epidemiologia , Prevalência , Estudos Retrospectivos
16.
Medicine (Baltimore) ; 99(25): e20565, 2020 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-32569180

RESUMO

RATIONALE: Ventriculoperitoneal shunt (VPS) is the most common treatment for idiopathic normal pressure hydrocephalus, a subtype of hydrocephalus characterized by gait disturbance, dementia, and urinary incontinence. However, while the malfunction of VPS is reported at a high rate, the involvement of chronic cholecystitis in shunt malfunction is rare. PATIENT CONCERNS: A 73-year-old woman with idiopathic normal pressure hydrocephalus who received a VPS but subsequently developed chronic cholecystitis. The patient suffered from drowsiness and was unable to walk. Her family found that she presented with poor appetite and was bloated. DIAGNOSES: Chronic cholecystitis was confirmed through abdominal computed tomography, which showed a swollen, and enlarged gallbladder, and flatulence. A head computed tomography scan indicated hydrocephalus with enlarged ventricular system and paraventricular edema. INTERVENTIONS: Laparoscopic cholecystectomy was performed successfully, requiring no further shunt manipulation. OUTCOMES: The patient's memory and cognitive ability were slightly impaired without a positive sign in the abdomen. No catheter or abdominal infection signs were observed during the following 3 months of follow-up. CONCLUSION: To the best of our knowledge, this report is the first to reveal that shunt malfunction may result from chronic cholecystitis, which induced the presently observed intra-abdominal hypertension.


Assuntos
Colecistite/complicações , Falha de Equipamento , Derivação Ventriculoperitoneal/efeitos adversos , Idoso , Colecistectomia Laparoscópica , Colecistite/dietoterapia , Colecistite/cirurgia , Feminino , Cabeça/diagnóstico por imagem , Humanos , Tomografia Computadorizada por Raios X
17.
Eur Arch Otorhinolaryngol ; 277(9): 2647-2648, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32500327

RESUMO

PURPOSE: To propose a way to safely perform endoscopic nasopharyngoscopy in ENT outpatient clinic during the COVID-19 pandemic. METHODS: This manuscript highlights the importance of endoscopy in daily ENT clinical practice, which is a pivotal procedure in the diagnosis of many head and neck pathologies. However, since the beginning of the COVID-19 outbreak, the authors have witnessed a drastic reduction (91%) in the use of endoscopic nasopharyngoscopy at their institutions. In fact, it is considered at risk of contamination for healthcare professionals, as any upper airway manipulation procedure. RESULTS: In the "Back approach to the patient" for endoscopic nasopharyngoscopy, the operator positions himself behind the patient and faces the monitor. The endoscopist, not being positioned in front of the patient, should, therefore, be less exposed to airborne transmission of SARS-CoV-2 virus. CONCLUSION: This simple variation of the physician's position during endoscopic nasopharyngoscopy could potentially reduce the risk of contagion since the operator is not in the trajectory of droplets and/or aerosols.


Assuntos
Infecções por Coronavirus/prevenção & controle , Endoscopia , Nasofaringe/diagnóstico por imagem , Otorrinolaringologistas , Procedimentos Cirúrgicos Otorrinolaringológicos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Aerossóis , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Cabeça , Humanos , Pescoço , Saúde do Trabalhador , Otolaringologia , Pneumonia Viral/epidemiologia
18.
Am J Otolaryngol ; 41(5): 102612, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32574896

RESUMO

OBJECTIVE: The aim of this manuscript is to investigate transversally Ear Nose Throat (ENT) symptoms COVID-19 infection correlated and to study the neurotropism and neuroinvasiveness of the virus in the head-neck district through the investigation of the sense of smell, taste, tearing, salivation and hearing. METHODS: A total of 50 patients with laboratory-confirmed COVID-19 infection were included in our study. For each patient we evaluated the short version of the Questionnaire of Olfactory Disorders-Negative Statements (sQOD-NS), the Summated Xerostomia Inventory-Dutch Version (SXI-DV), The Standardized Patient Evaluation of Eye Dryness (SPEED), Schirmer test I, the Hearing Handicap Inventory For Adults (HHIA) and the Tinnitus Handicap Inventory (THI). All the tests we carried out were performed during the active phase of the symptomatology from COVID-19 (Condition A) and 15 after SARS-COV-2 RT-PCR test negative (Condition B). RESULTS: A total of 46 patients (92%) had olfactory dysfunction related to the infection. The 70% of patients reported gustatory disorders. Cough, fever, headache and asthenia were the most prevalent symptoms. There was a statistically significant difference (p < 0,001) in sQOD-NS, SXI-DV, SPEED, Schirmer test, HHIA and THI between Condition A and Condition B. CONCLUSIONS: In our population there was an alteration of the sense of taste, of the sense of smell, dry eyes and of the oral cavity and an auditory discomfort, symptoms probably linked to the neurotropism of the virus. Furthermore, anosmia, dysgeusia and xerostomia are early symptoms of COVID-19, which can be exploited for an early quarantine and a limitation of viral contagion.


Assuntos
Betacoronavirus/fisiologia , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Transtornos das Sensações/virologia , Tropismo Viral/fisiologia , Cabeça/inervação , Humanos , Pescoço/inervação , Pandemias
19.
Zhonghua Yi Xue Za Zhi ; 100(23): 1789-1794, 2020 Jun 16.
Artigo em Chinês | MEDLINE | ID: mdl-32536124

RESUMO

Objective: To analyze clinical characteristics of intracranial vessel involvement in Takayasu's arteritis (TA). Methods: Retrospectively analyzed 135 hospitalized TA patients' clinical data in Beijing Anzhen Hospital from November 2012 to November 2018. Based on intracranial artery (IA) complicated or not, TA patients were divided into two groups:32 patients within involvement and 103 patients without involvement. The difference in comparison of imaging types, basic data and laboratory test were analyzed. Results: The proportion of TA patients with intracranial vascular involvement was 23.7% (32/135) and the most common site was internal carotid artery (intracranial segment) (59.4%, 19/32). The incidences of hypertension and coronary heart disease were significantly higher in TA patients with intracranial vascular involvement compared with the patients without intracranial involvement (46.9% vs 26.2%, 21.9% vs 6.8%, χ(2)=4.863, 4.460, all P<0.05). The rate of tocilizumab treatment in the intracranial vascular involved group was higher than that in the group without intracranial vascular involvement (40.6% vs 19.4%, χ(2)=5.945, P<0.05). The platelet count in patients with intracranial involvement group was significantly lower than that in patients without intracranial involvement group [(218±55)×10(9)/L vs (272±71)×10(9)/L, t=-3.570, P<0.01], while the hemoglobin [(130±17) vs (121±18) g/L, t=2.363, P<0.05] and triglyceride [1.22(0.75, 1.64) vs 0.92(0.63, 1.21) mmol/L, U=1 017.000, P<0.01] were significantly higher than those without intracranial vascular involvement. Moreover, coronary artery involvement presented more frequently in the intracranial vascular involved group than the group without intracranial vascular involvement (43.8% vs 14.6%, χ(2)=12.331, P<0.01). Logistic regression analysis showed that the incidence of intracranial vascular disease in TA patients with coronary artery involvement was 4 times higher than that in patients without coronary artery lesions (OR=3.965, 95%CI:1.584-9.926, P=0.003). Conclusion: The proportion of intracranial vascular involvement in TA is not rare, TA patients with cardiovascular risk factors should be considered to strengthen imaging examination of intracranial vessels.


Assuntos
Hipertensão , Arterite de Takayasu , Vasos Coronários , Cabeça , Humanos , Estudos Retrospectivos
20.
Nat Commun ; 11(1): 2772, 2020 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-32487986

RESUMO

Vestigial structures are key indicators of evolutionary descent, but the mechanisms underlying their development are poorly understood. This study examines vestigial eye formation in the teleost Astyanax mexicanus, which consists of a sighted surface-dwelling morph and multiple populations of blind cave morphs. Cavefish embryos initially develop eyes, but they subsequently degenerate and become vestigial structures embedded in the head. The mutated genes involved in cavefish vestigial eye formation have not been characterized. Here we identify cystathionine ß-synthase a (cbsa), which encodes the key enzyme of the transsulfuration pathway, as one of the mutated genes responsible for eye degeneration in multiple cavefish populations. The inactivation of cbsa affects eye development by increasing the transsulfuration intermediate homocysteine and inducing defects in optic vasculature, which result in aneurysms and eye hemorrhages. Our findings suggest that localized modifications in the circulatory system may have contributed to the evolution of vestigial eyes in cavefish.


Assuntos
Cistationina beta-Sintase/genética , Cistationina/metabolismo , Olho/embriologia , Olho/metabolismo , Peixes/fisiologia , Animais , Apoptose , Evolução Biológica , Encéfalo/embriologia , Sistema Cardiovascular , Cistationina beta-Sintase/metabolismo , Biologia do Desenvolvimento , Olho/citologia , Olho/crescimento & desenvolvimento , Feminino , Peixes/embriologia , Peixes/genética , Regulação da Expressão Gênica no Desenvolvimento/genética , Técnicas de Silenciamento de Genes , Cabeça , Cristalino/citologia , Cristalino/metabolismo , Masculino , Modelos Animais
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