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3.
Mol Imaging Biol ; 24(3): 394-403, 2022 06.
Article in English | MEDLINE | ID: mdl-34611766

ABSTRACT

PROPOSE: This study aims to explore the use of the Centiloid (CL) method in amyloid-ß PET quantification to evaluate distinct cognitive aging stages, investigating subjects' mismatch classification using different cut-points for amyloid-ß positivity. PROCEDURES: The CL equation was applied in four groups of individuals: SuperAgers (SA), healthy age-matched controls (AC), healthy middle-aged controls (MC), and Alzheimer's disease (AD). The amyloid-ß burden was calculated and compared between groups and quantitative variables. Three different cut-points (Jack CR, Wiste HJ, Weigand SD, et al., Alzheimer's Dement 13:205-216, 2017; Salvadó G, Molinuevo JL, Brugulat-Serrat A, et al., Alzheimer's Res Ther 11:27, 2019; and Amadoru S, Doré V, McLean CA, et al., Alzheimer's Res Ther 12:22, 2020) were applied in CL values to differentiate the earliest abnormal pathophysiological accumulation of Aß and the established Aß pathology. RESULTS: The AD group exhibited a significantly increased Aß burden compared to the MC, but not AC groups. Both healthy control (MC and AC) groups were not significantly different. Visually, the SA group showed a diverse distribution of CL values compared with MC; however, the difference was not significant. The CL values have a moderate and significant relationship between Aß visual read, RAVLT DR and MMSE. Depending on the cut-point used, 10 CL, 19 CL, or 30 CL, 7.5% of our individuals had a different classification in the Aß positivity. For the AC group, we obtained about 40 to 60% of the individuals classified as positive. CONCLUSION: SuperAgers exhibited a similar Aß load to AC and MC, differing in cognitive performance. Independently of cut-point used (10 CL, 19 CL, or 30 CL), three SA individuals were classified as Aß positive, showing the duality between the individual's clinics and the biological definition of Alzheimer's. Different cut-points lead to Aß positivity classification mismatch in individuals, and an extra care is needed for individuals who have a CL value between 10 and 30 CL.


Subject(s)
Alzheimer Disease , Cognitive Aging , Alzheimer Disease/diagnostic imaging , Alzheimer Disease/pathology , Amyloid beta-Peptides , Aniline Compounds , Humans , Middle Aged , Positron-Emission Tomography/methods
4.
J Alzheimers Dis ; 81(4): 1419-1428, 2021.
Article in English | MEDLINE | ID: mdl-33935091

ABSTRACT

BACKGROUND: Individuals at 80 years of age or above with exceptional memory are considered SuperAgers (SA), an operationalized definition of successful cognitive aging. SA showed increased thickness and altered functional connectivity in the anterior cingulate cortex as a neurobiological signature. However, their metabolic alterations are yet to be uncovered. OBJECTIVE: Herein, a metabolic (FDG-PET), amyloid (PIB-PET), and functional (fMRI) analysis of SA were conducted. METHODS: Ten SA, ten age-matched older adults (C80), and ten cognitively normal middle-aged (C50) adults underwent cognitive testing and multimodal neuroimaging examinations. Anterior and posterior regions of the cingulate cortex and hippocampal areas were primarily examined, then subregions of anterior cingulate were segregated. RESULTS: The SA group showed increased metabolic activity in the left and right subgenual anterior cingulate cortex (sACC, p < 0.005 corrected, bilateral) and bilateral hippocampi (right: p < 0.0005 and left: p < 0.005, both corrected) as compared to that in the C80 group. Amyloid deposition was above threshold in 30% of SA and C80 (p > 0.05). The SA group also presented decreased connectivity between right sACC and posterior cingulate (p < 0.005, corrected) as compared to that of the C80 group. CONCLUSION: These results support the key role of sACC and hippocampus in SA, even in the presence of amyloid deposition. It also suggests that sACC may be used as a potential biomarker in older adults for exceptional memory ability. Further longitudinal studies measuring metabolic biomarkers may help elucidate the interaction between these areas in the cognitive aging process.


Subject(s)
Amyloid beta-Peptides/metabolism , Cognitive Aging/psychology , Glucose/metabolism , Gyrus Cinguli/metabolism , Hippocampus/metabolism , Aged , Aged, 80 and over , Female , Gyrus Cinguli/diagnostic imaging , Hippocampus/diagnostic imaging , Humans , Magnetic Resonance Imaging , Male , Neuropsychological Tests , Positron-Emission Tomography
5.
Rev Assoc Med Bras (1992) ; 65(4): 509-517, 2019 May 02.
Article in English | MEDLINE | ID: mdl-31066802

ABSTRACT

The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standardize procedures to assist the reasoning and decision-making of doctors. The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient.


Subject(s)
Fluorodeoxyglucose F18 , Neoplasm Recurrence, Local/diagnostic imaging , Ovarian Neoplasms/diagnostic imaging , Positron Emission Tomography Computed Tomography/methods , Radiopharmaceuticals , Brazil , Clinical Decision-Making , Female , Humans , Reproducibility of Results , Sensitivity and Specificity
6.
Rev. Assoc. Med. Bras. (1992) ; 65(4): 509-517, Apr. 2019. tab, graf
Article in English | LILACS | ID: biblio-1003064

ABSTRACT

The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standardize procedures to assist the reasoning and decision-making of doctors. The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient.


Subject(s)
Humans , Female , Ovarian Neoplasms/diagnostic imaging , Radiopharmaceuticals , Fluorodeoxyglucose F18 , Positron Emission Tomography Computed Tomography/methods , Neoplasm Recurrence, Local/diagnostic imaging , Brazil , Reproducibility of Results , Sensitivity and Specificity , Clinical Decision-Making
7.
Rev. méd. Minas Gerais ; 25(3)julho a setembro.
Article in Portuguese | LILACS-Express | LILACS | ID: lil-763943

ABSTRACT

Objetivo: identificar os achados radiológicos da salpingite ístmica nodosa (SIN) a partir da histerossalpingografia e avaliar o local de comprometimento e sua repercussão na infertilidade. Métodos: em estudo retrospectivo foram revistos 2.800 protocolos, realizadas entre janeiro de 1987 e janeiro de 1997, em pacientes com história clínica de infertilidade feminina, tendo quatro com diagnóstico radiológico de SIN, sendo analisados etnia, idade, estado civil, queixa clínica atual, antecedentes clínicos, local e o lado do comprometimento. Resultados: entre as quatro pacientes com SIN, três eram melanodérmicas e uma caucasiana, com idade média de 35 anos na época do diagnóstico, duas solteiras, uma casada e uma divorciada. As queixas de infertilidade secundária estavampresentes em três pacientes com antecedentes de gravidez tubária prévia e outro de infertilidade primária, sem antecedentes de gravidez. Nas quatro pacientes com SIN, a porção tubária acometida foi a ístmica cornual, tubário bilateral em três e unilateral em uma. Em relação à peritonização, uma apresentava prova de Cotté positiva bilateral, duas com obstrução completa bilateral e uma com Cotté positiva em uma das tubas.Conclusão: SIN é mais frequente em pacientes melanodérmicas, na faixa etária média de 35 anos, com história clínica de infertilidade, de gravidez tubária inicial e recorrente e consequente obstrução tubária caracterizada por lesão na porção ístmica cornual da tuba uterina, geralmente de comprometimento bilateral.


Objective: to identify the radiological findings of salpingitis isthmica nodosa (SIN) through hysterosalpingography and evaluate the site of involvement and its impact on infertility. Methods: 2,800 protocols were reviewed in a retrospective study between January of 1987 and January of 1997, in patients with a clinical history of female infertility; four of them with a radiological diagnosis of SIN. Ethnicity, age, marital status, current clinical complaints, medical history, location, and side of involvement were analyzed. Results: among the four patients with SIN, three were dark-skin, and one was Caucasian, with an average age of 35 years at diagnosis, two single, one married, and one divorcee. Three patients presented complaints of secondary infertility with previous tubal pregnancy history, and another with primary infertility without pregnancy history. In the four patients with SIN, the tubal portion affected was the cornual isthmian, bilateral tubal in three, and unilateral in one. Regarding peritonization, one showed positive bilateral Cotte proof, two with complete bilateral obstruction, and one with positive Cotte in one of the tubes. Conclusion: SIN is more common in dark-skin patients, in the mean age of 35 years, with a clinical history of infertility, with initial and recurrent tubal pregnancy, and subsequent tubal obstruction characterized by lesion in the Isthmian cornual portion of the fallopian tube, usually with bilateral involvement.

8.
Rev. méd. Minas Gerais ; 24(4): 474-477, out.-dez. 2014.
Article in Portuguese | LILACS-Express | LILACS | ID: lil-749270

ABSTRACT

Objetivo: demonstrar os achados da salpingite ístmica nodosa (SIN) por meio da histerossalpingografia e avaliar o local de comprometimento e sua repercussão na infertilidade feminina. Paciente e Métodos: em estudo retrospectivo foram revistas 2.800 histerossalpingografias realizadas entre janeiro de 1987 e janeiro de 2007 em pacientes com história clínica de infertilidade feminina. Destas, quatro pacientes apresentavam diagnóstico radiológico de SIN, sendo analisados seus principais aspectos radiográficos, como também os locais de comprometimento e suas repercussões na infertilidade. Resultados: das quatro pacientes em que foi encontrada a doença estudada a partir da investigação histerossalpingográfica da infertilidade, três tinham antecedentes de gravidez tubária, todas com comprometimento ístmico cornual, sendo três delas de comprometimento bilateral e uma unilateral. Uma delas apresentava prova de Cotté positiva bilateral, duas com prova de Cotté negativa bilateral e uma com tuba direita positiva e esquerda negativa. Conclusão: o diagnóstico da SIN é feito com base na histerossalpingografia, caracterizada pelo acúmulo do meio de contraste na parede tubária, distribuída na porção ístmica cornual ou ampolar, uni ou bilateralmente, acompanhado de história clínica de infertilidade, gravidez tubária, abortamento espontâneo e obstrução tubária.


Objective: to demonstrate the findings of isthmian nodosa salpingitis (SIN) through histero-salpingography and evaluate the site of involvement and its impact on female infertility. Patients and Methods: a total of 2,800 histero-salpingographies were reviewed in a retrospective study between January of 1987 and January of 2007 in patients with a clinical history of female infertility. Of these, four patients presented radiological diagnosisof SIN; their main radiographic aspects, sites of involvement, and impact on infertility were analyzed. Results: out of the four patients in which the studied disease was found through the histero-salpingography infertility research, three had a history of tubal pregnancy, all with cornual isthmian involvement; bilateral in three of them and unilateral in one. One of them showed evidence of positive bilateral Cotté, two showed evidence ofnegative bilateral Cotté, and one bilateral with right positive tubal and left negative tubal. Conclusion: the diagnosis of SIN is achieved based on histero-salpingography, characterized by the accumulation of contrast medium on the tubal wall, distributed in the cornual or ampolar isthmian portion, uni- or bilaterally, and accompanied by clinical history ofinfertility, tubal pregnancy, spontaneous abortion, and tubal obstruction.

9.
Rev. méd. Minas Gerais ; 23(3)jul.-set. 2013.
Article in Portuguese, English | LILACS | ID: lil-702900

ABSTRACT

Objetivo: caracterizar clínica e pela ultrassonografia (US) a hipertensão portal idiopática. Pacientes e métodos: foram avaliados, retrospectivamente, por US com doppler colorido, 60 pacientes com diagnóstico clínico de hepatopatia crônica e hipertensão portal, de janeiro de 1996 a janeiro de 2006, em clínica privada, encontrando dois casosde hipertensão portal idiopática. Comentários: em jovens com esplenomegalia, hematêmese recorrente, anemia, ascite, funções hepáticas normais e hipertensão portal sem evidência de cirrose, foram observados à US fígado de tamanho usual, textura heterogênea e superfície lisa, ausência de deformidades das ramificações das veias portais intra-hepáticas, espessamento da parede da veia porta maior ou igual a 3 mm e estreitamento abrupto das veias portais secundárias intra-hepáticas acompanhado de esplenomegalia.


Objective: to characterize idiopathic portal hypertension clinically and by ultrasound (US). Patients and methods: 60 patients with clinical diagnosis of chronic liver disease and portal hypertension were retrospectively assessed by color Doppler US, from January 1996 to January 2006, in a privately owned clinic. Two cases of idiopathic portal hypertension were found. Comments: in young patients with splenomegaly, recurring hematemesis, anemia, ascites, normal liver function and portal hypertension without evidence of cirrhosis, US revealed livers of usual size, heterogeneous texture and flat surface, without deformities in the branches of the intra-hepatic portal veins. The portal vein walls were also thickened starting at 3 mm and marked by an abrupt narrowing of the secondary intra-hepatic portal veins, accompanied by splenomegaly.


Subject(s)
Humans , Male , Female , Adult , Liver Diseases/pathology , Hypertension, Portal , Biopsy , Retrospective Studies , Ultrasonography, Doppler, Color
10.
Rev. méd. Minas Gerais ; 23(1)jan.-mar. 2013.
Article in Portuguese, English | LILACS | ID: lil-702862

ABSTRACT

Objetivo: este trabalho analisa as alterações ultrassonográficas que caracterizam a síndrome de Cruveilhier-Baumgarten (SCB), com suas alterações clínicas. A SCB caracteriza-se pela veia paraumbilical proeminente, com dilatação das veias superficiais da parede abdominal de aspecto radiado provenientes do umbigo dos pacientes com hepatopatia crônica e hipertensão portal. Casuística e métodos: em avaliação ultrassonográfica de 60 pacientes com diagnóstico de hepatopatia crônica com hipertensão portal foram encontrados quatro casos com a SCB em que foi realizado o estudo por meio do doppler colorido. Resultados: todos os pacientes avaliados eram do gênero masculino, estavam na terceira década de vida, tinham história de esplenomegalia, varizes na parede abdominal e eram portadores de esquistossomose e aspecto histopatológico de cirrose micronodular. Foram analisados também dois pacientes com varizes do esôfago sem clinica de hematêmese. Ultrassonograficamente, todos os pacientes tinham sinais de hepatopatia crônica com esplenomegalia, com fluxo hepatopetal em todos os segmentos da veia porta e fluxo hepatofugal nas veias que deixam o fígado (veia paraumbilical no ligamento falciforme e nas veias superficiais da parede abdominal anterior). Conclusão: a SCB caracteriza-se pela associação de sinais de hepatopatia crônica com esplenomegalia, veias paraumbilicais com aumento de calibre (hipertensão porta) e com fluxo para as veias superficiais da parede abdominal, que se acham dilatadas na região umbilical e com sopro à ausculta pelo ultrassom e ao exame físico.


Objective: The purpose of this paper is to analyze the sonographic changes that characterize the Cruveilhier-Baumgarten syndrome and its clinical charactheristics. Cruveilhier- Baumgartem syndrome is characterized by a prominent paraumbilical vein, with dilatated superficial veins of the abdominal wall radiating from the umbilicus of patients with chronic liver disease and portal hypertension. Patients and methods: In a sonographic evaluation of 60 patients diagnosed with chronic liver disease with portal hypertension we found 4 cases of Cruveilhier-Baumgarten syndrome, which we studied with color doppler sonography.Results: All patients were male, in their third decade of life, with a clinical history of splenomegaly and varicose abdominal wall veins. Patients had schistosomiasis and micronodular cirrhosis on hystopathological examination. We also evaluated two patients with esophageal varices without hemathemesis. All patients had ultrasound signs of splenomegaly and chronic liver disease, with hepatopetal flow in all segments of the portal vein and hepatofugal flow in the efferent veins of the liver (paraumbilical vein in the falciform ligament and the anterior abdominal wall surface veins). Conclusion: CBS is charactherized by the associationof signs of chronic liver damage with splenomegaly, distention of paraumbilical veins (portal hypertension) and blood flow towards the superficial abdominal wall veins, which are dilated in the umbilical region, associated with an audible bruit in both clinical and sonographic examination.


Subject(s)
Humans , Liver Diseases/complications , Hypertension, Portal , Liver Cirrhosis , Splenomegaly , Ultrasonography, Doppler, Color
11.
Radiol. bras ; 40(3): 217-219, maio-jun. 2007. ilus
Article in Portuguese | LILACS | ID: lil-458045

ABSTRACT

Relata-se um caso de um paciente do sexo masculino, de 29 anos de idade, que na tentativa de auto-extermínio injetou 2 ml de mercúrio industrial no antebraço esquerdo. O estudo radiológico mostrou várias esferas metálicas no subcutâneo da fossa olecraniana e ao longo das veias do braço esquerdo, com disseminação para pulmões, coração, fígado, baço e encéfalo.


A case of a male, 29-year-old patient who, in a suicide attempt, has self-administered a 2 ml injection of metallic mercury into his left arm is reported. Radiological studies have shown the presence of several metallic spheres in the subcutaneous tissue of the olecranal fossa and along the veins of the left arm, with dissemination to lungs, heart, liver, spleen and brain.


Subject(s)
Humans , Male , Adult , Embolectomy , Mercury Poisoning/diagnosis , Mercury Poisoning , Mercury/administration & dosage , Injections, Subcutaneous , Suicide, Attempted
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