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1.
PLoS One ; 18(3): e0281727, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36877697

RESUMEN

The purpose of this study is to anatomically evaluate the impact on the patient intra vitam of an endocranial condition on a late 20th century skull housed in the Section of Legal Medicine of the University of Foggia (Foggia, Apulia, Italy). After performing a retrospective diagnosis, the condition is framed in the broader context of studies on this pathology. An anthropological and radiological analysis (X-ray and CT scan imaging) made it possible to confirm the preliminary information and to detail the osteological diagnosis of HFI. In order to assess the impact on the cerebral surface of the endocranial growth a 3D endocast was obtained using the Software OrtogOnBlender. The skull is demonstrated to have belonged to a female senile individual known, from limited documentary evidence, to have suffered from a psychiatric condition during her life. The final diagnosis is hyperostosis frontalis interna (HFI), Type D. Although a direct correlation between the demonstrated intracranial bony growth and the onset of the patient's psychiatric condition is difficult to retrospectively ascertain, the pressure exerted on this female individual's frontal lobe may have contributed to further degenerative behavioural changes in the last years of her life. This case adds to previous knowledge, especially from the palaeopathological literature, on this condition and, for the first time, presents a neuroanatomical approach to assess the global impact of the disease.


Asunto(s)
Hiperostosis Frontal Interna , Radiología , Femenino , Humanos , Estudios Retrospectivos , Hiperostosis Frontal Interna/diagnóstico por imagen , Radiografía , Encéfalo
2.
Front Cardiovasc Med ; 9: 997961, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36312248

RESUMEN

Introduction: In the last two decades, a more aggressive approach has been encouraged to treat patients with acute type A aortic dissection (ATAAD), extending the repair to the aortic arch and proximal descending thoracic aorta with the frozen elephant trunk (FET) implantation. Here, we report our single-centre experience with the FET technique for the systematic treatment of emergency type A aortic dissection. Materials and methods: Between December 2017 and January 2022, 69 consecutive patients were admitted with ATAAD; of those, 66 patients (62.9 ± 10.2 years of age, 81.8% men) underwent emergency hybrid aortic arch and FET repair with the multibranched Thoraflex hybrid graft and were enrolled in the study. Primary endpoints were 30 days- and in-hospital mortality. Secondary endpoints were postoperative morbidity and follow-up survival. To better clarify the impact of age on surgical outcomes, we have divided the study population into two groups: group A for patients <70 years of age (47 patients), and group B for patients ≥70 years (19 patients). Time-to-event analysis has been conducted using the Log-rank test and is displayed with Kaplan-Meier curves. A multiple Cox proportional Hazard model was developed to identify predictors of long-term survival with a stepwise backward/forward selection process. Results: 30-days- and in-hospital mortality were 10.6 and 13.6%, respectively. Stroke occurred in three (4.5%) patients. Two (3.0%) patients experienced spinal cord ischemia. We did not find any statistically significant difference between the two groups in terms of main post-operative outcomes. The multivariable Cox proportional hazard model showed left ventricular ejection fraction (HR: 0.83, 95% CI: 0.79-0.92, p < 0.01), peripheral vascular disease (HR: 15.8, 95% CI: 3.9-62.9, p < 0.01), coronary malperfusion (HR: 0.10, 95% CI: 0.01-0.77, p =0.03), lower limbs malperfusion (HR: 5.1, 95% CI: 1.10-23.4, p = 0.04), and cardiopulmonary bypass time (HR: 1.02, 95% CI: 1-1.04, p = 0.01) as independent predictors of long term mortality. Conclusions: Frozen elephant trunk repair to treat emergency type A aortic dissection appears to be associated with good early and mid-term clinical outcomes even in the elderly.

3.
Cardiovasc Diagn Ther ; 12(4): 516-520, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-36033221

RESUMEN

The frozen elephant trunk (FET) technique is an increasingly common procedure to treat complex extensive aortic disease both in elective and emergency setting. In a contemporary era, several prostheses are available to be used by surgeons performing such procedures, merging the advantages of endovascular and conventional surgery and preparing a more useful landing zone for second-stage downstream endovascular or open repair. Thoraflex hybrid (Terumo Aortic, Scotland) is a largely used hybrid vascular device merging a conventional surgical vascular graft made of gelatin-sealed woven polyester graft with a nitinol self-expanding stent graft. Since its release in 2012, this prosthesis has gained a large consensus, mainly for the plexus version, which allows for single reimplantation of the epiaortic vessels. In the last few years, new devices have come out to offer new specific weapons to be used by the surgical team in different clinical scenarios. In this context, the need of making the supra-aortic vessel debranching easier and more functional to our surgical technique has pushed our demand for a customization of a conventional Thoraflex hybrid. Here we report a modification to its standard design, the concept beyond the "Custom device" and its potential advantages with regards to our peculiar implantation technique and intraoperative cerebral perfusion during circulatory arrest time.

4.
Diagnostics (Basel) ; 12(1)2022 Jan 17.
Artículo en Inglés | MEDLINE | ID: mdl-35054385

RESUMEN

During the last years, post-mortem imaging has gradually been assumed within research in the field of forensic pathology. This role appears to be clearly and simply applied in the trauma field with the use of conventional radiography or Post Mortem Computed Tomography (PMCT). Recently, particular attention was paid to cardiovascular imaging using Post Mortem Magnetic Resonance Imaging (PMMRI). The present experimental study aims to: (i) confirm the efficacy of a Post Mortem Cardiac Resonance Imaging (PMCRI) study protocol for the study of human hearts collected during the autopsy; (ii) apply the defined protocol on subjects who died of "SCD (sudden cardiac death)", to identify alterations that could guide subsequent sampling. Two hearts of healthy subjects (A: male 22 years; B: female 26 years), who died from causes other than SCD were collected and compared to hearts that belonged to SCD individuals (C: male, 47 years old; D: female, 44 years old; E: male; 72 years old). The exams were performed on a 1.5 T scanner (Philips Intera Achieva, Best, the Netherlands) on hearts collected during autopsy and after a 30-day formalin fixation. Two readers analyzed the obtained images blindly and after randomization. From the comparison between the data from imaging and the macroscopic and histological investigations carried out, the present study proved the effectiveness of a PMMRI protocol to study ex-situ hearts. Moreover, it suggested the following semeiology in post-mortem SCD cases: the hyperintense area with indistinct margins in the Short Tau Inversion Recovery (STIR) sequence was linked to edema or area of pathological fibers, whereas the hypointense area in the T2-FFE sequences was linked to fibrosis. PMMRI can provide a valuable benefit to post-mortem investigations, helping to distinctly improve the success rate of histological sampling and investigations, which remains the gold standard in the diagnosis of sudden death.

5.
J Card Surg ; 37(1): 107-114, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34662451

RESUMEN

BACKGROUND AND AIM OF THE STUDY: To report early clinical outcomes of the frozen elephant trunk (FET) technique for the treatment of complex aortic diseases after transition from conventional elephant trunk. METHODS: A single-center, retrospective study of patients who underwent hybrid aortic arch and FET repair for aortic arch and/or proximal descending aortic aneurysms, acute and chronic Stanford type A aortic dissection with arch and/or proximal descending involvement, Stanford type B acute and chronic aortic dissections with retrograde aortic arch involvement. RESULTS: Between December 2017 and May 2020, 70 consecutive patients (62.7 ± 10.6 years, 59 male) were treated: 41 (58.6%) for emergent conditions and 29 (41.4%) for elective. Technical success was 100%. In-hospital mortality was 14.2% (n = 12, 17.1% emergent vs. 10.3% elective, P = NS); 2 (2.9%) major strokes; 1 (1.4%) spinal cord injury. Mean follow-up was 12.5 months (interquartile range, 3.7-22.3). Overall survival at 3, 6, 12, and 24 months was 90% (95% confidence interval [CI], 83.2-97.3), 85.6% (95% CI, 77.7-94.3), 79.1% (95% CI, 69.9-89.5), 75.6% (95% CI, 65.8-86.9) and 73.5% (95% CI, 63.3-85.3). There were no aortic re-interventions and no distal stent graft-induced new entry (dSINE); 5 patients with residual type B dissection underwent TEVAR completion. CONCLUSIONS: In a real-world setting, FET with Thoraflex Hybrid demonstrated feasibility and good clinical outcomes, even in emergent setting. Our implant technique optimize cerebral perfusion reporting good results in terms of neurological complications. Techniques to perfect the procedure and to reduce remaining risks, and consensus on considerations such as standardized cerebral protection need to be reported.


Asunto(s)
Aneurisma de la Aorta Torácica , Disección Aórtica , Implantación de Prótesis Vascular , Disección Aórtica/diagnóstico por imagen , Disección Aórtica/cirugía , Aorta Torácica/diagnóstico por imagen , Aorta Torácica/cirugía , Aneurisma de la Aorta Torácica/cirugía , Prótesis Vascular , Humanos , Masculino , Estudios Retrospectivos
6.
Medicina (Kaunas) ; 57(9)2021 Aug 28.
Artículo en Inglés | MEDLINE | ID: mdl-34577818

RESUMEN

Acute type A aortic dissection (ATAAD) is an indisputable emergency with very poor outcomes without surgical treatment. Although the aortic arch is often involved in the aortic dissection, its optimal management during surgical therapy remains uncertain. A conservative tear-oriented approach has traditionally been adopted, limiting the procedure to the ascending aorta (or hemiarch) replacement. However, dilation of the residual dissected aorta and subsequent rupture may occur, requiring further intervention in the future. In the last two decades, the frozen elephant trunk (FET) technique has become a valid and attractive option to treat aortic disease when the arch and the thoracic aorta are involved, both in elective and in emergency settings. Here, we report a review of the contemporary literature regarding the short- and long-term outcomes of the FET technique in ATAAD repair.


Asunto(s)
Aneurisma de la Aorta Torácica , Disección Aórtica , Implantación de Prótesis Vascular , Enfermedad Aguda , Disección Aórtica/diagnóstico por imagen , Disección Aórtica/cirugía , Aneurisma de la Aorta Torácica/diagnóstico por imagen , Aneurisma de la Aorta Torácica/cirugía , Humanos , Estudios Retrospectivos
7.
Radiol Med ; 126(12): 1609-1618, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34453276

RESUMEN

Phosphaturic mesenchymal tumors (PMTs) are rare mesenchymal neoplasms of soft tissue or bone origin that can give rise to a challenge in diagnostic imaging. These tumors are frequently associated with tumor-induced osteomalacia, also called oncogenic osteomalacia, which is a rare paraneoplastic syndrome characterized by ectopic secretion of fibroblast growth factor 23, a hormone that regulates serum phosphate level. PMTs show polymorphic features on both radiological findings and histological examination, causing problems in diagnosis owing to their similarity with other mesenchymal tumors. Thus, this paper aims to describe radiological aspects of PMTs and suggest an imaging pathway for accurate diagnosis throughout the evidence from the literature review.


Asunto(s)
Diagnóstico por Imagen/métodos , Mesenquimoma/diagnóstico por imagen , Osteomalacia/diagnóstico por imagen , Síndromes Paraneoplásicos/diagnóstico por imagen , Humanos , Mesenquimoma/patología , Osteomalacia/patología , Síndromes Paraneoplásicos/patología
8.
JACC Case Rep ; 3(6): 884-887, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-34317647

RESUMEN

We report a unique case of a Starr-Edwards prosthesis (model 6310, cloth covered) implanted in the mitral position by Christian Barnard that was successfully explanted and replaced after 50 years, the longest period free from valve dysfunction ever reported. Reoperation also included replacement of the native aortic valve combined with tricuspid valve annuloplasty. (Level of Difficulty: Beginner.).

9.
Endocrine ; 74(1): 20-28, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34245432

RESUMEN

Osteoporosis, a disease characterized by low bone mass and alterations of bone microarchitecture, leading to an increased risk for fragility fractures and, eventually, to fracture; is associated with an excess of mortality, a decrease in quality of life, and co-morbidities. Bone mineral density (BMD), measured by dual X-ray absorptiometry (DXA), has been the gold standard for the diagnosis of osteoporosis. Trabecular bone score (TBS), a textural analysis of the lumbar spine DXA images, is an index of bone microarchitecture. TBS has been robustly shown to predict fractures independently of BMD. In this review, while reporting also results on BMD, we mainly focus on the TBS role in the assessment of bone health in endocrine disorders known to be reflected in bone.


Asunto(s)
Osteoporosis , Fracturas Osteoporóticas , Absorciometría de Fotón , Densidad Ósea , Hueso Esponjoso/diagnóstico por imagen , Humanos , Vértebras Lumbares/diagnóstico por imagen , Osteoporosis/diagnóstico por imagen , Fracturas Osteoporóticas/diagnóstico por imagen , Fracturas Osteoporóticas/etiología , Calidad de Vida , Medición de Riesgo
10.
Gen Thorac Cardiovasc Surg ; 69(5): 877-881, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33400196

RESUMEN

Short-term mechanical circulatory support (MCS) devices are designed to provide hemodynamic support for a wide range of clinical conditions such as high-risk cardiac surgery or interventional procedures, post-cardiotomy cardiogenic shock, acute decompensated heart failure. Electrical storm (defined as three or more sustained episodes of ventricular fibrillation-VF- in a 24-h period) is a rare but critical complication following revascularization in patients with ischemic heart disease and it is associated with a very high mortality (80-90%) both during the incident alone and during further observation. Here we report the case of a 38-year-old patient affected by coronary artery disease with moderate to severe left ventricular systolic dysfunction (EF 30-35%) who underwent emergency coronary artery bypass grafting (CABG) complicated by electrical storm and severe haemodynamic instability, successfully managed with a novel approach of biventricular mechanical circulatory support with extracorporeal life support (ECLS) in first instance, subsequently switched to Impella CP and ProtekDuo.


Asunto(s)
Procedimientos Quirúrgicos Cardíacos , Oxigenación por Membrana Extracorpórea , Insuficiencia Cardíaca , Corazón Auxiliar , Adulto , Humanos , Choque Cardiogénico/etiología , Choque Cardiogénico/terapia
11.
J Card Surg ; 36(1): 371-373, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33225461

RESUMEN

Reimplantation of the supra-aortic vessels can be challenging with Thoraflex Hybrid. A device modification made the vessel lengths more appropriate and the position of the neo-vessels in the chest avoided malpositioning and kinking and facilitated sternum closure; this may improve operating times as well as allowing complete and continuous cerebral trivascular perfusion and corrects positioning of the intrathoracic vessels.


Asunto(s)
Aneurisma de la Aorta Torácica , Disección Aórtica , Implantación de Prótesis Vascular , Anastomosis Quirúrgica , Disección Aórtica/cirugía , Aorta Torácica/diagnóstico por imagen , Aorta Torácica/cirugía , Aneurisma de la Aorta Torácica/diagnóstico por imagen , Aneurisma de la Aorta Torácica/cirugía , Prótesis Vascular , Humanos
12.
Aging Clin Exp Res ; 32(7): 1303-1308, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31471889

RESUMEN

INTRODUCTION: The relationship between post-menopausal osteoporosis and obesity has been mainly investigated using bone mineral density (BMD) as marker of bone health. Since BMD does not reflect bone microarchitecture, another analytical tool, the Trabecular Bone Score (TBS), has been recently developed for this purpose. In this study, we intended to investigate the validity of TBS as marker of bone quality in obese post-menopausal women. METHODS AND MATERIALS: Three hundred fifty-two post-menopausal women were consecutively enrolled in the study and underwent anthropometric and dual-energy X-ray absorptiometry (DXA) examination. DXA-based BMD was used to classify subjects into osteoporotic (9%), osteopenic (58%), and controls (33%) categories. As TBS is sometimes sensitive to the effects of increased image noise with higher BMI, a corrected version of the TBS (TBS*) was also used to assess bone microarchitecture quality in this cohort. RESULTS: As expected, BMI was positively and negatively related to total BMD (r = 0.22, p < 0.0001) and TBS (r = - 0.12, p < 0.05), respectively. TBS* was found positively and significantly correlated with femoral neck BMD (r = 0.40, p < 0.001), total hip (r = 0.33, p < 0.001) and lumbar spine BMD (r = 0.50, p < 0.001). CONCLUSION: TBS, once removed the effect of BMI, can serve as a good surrogate maker of bone microarchitecture in obese post-menopausal women in addition to BMD.


Asunto(s)
Densidad Ósea , Hueso Esponjoso/fisiología , Obesidad , Posmenopausia , Absorciometría de Fotón , Adulto , Anciano , Anciano de 80 o más Años , Antropometría , Estudios de Cohortes , Estudios Transversales , Femenino , Humanos , Vértebras Lumbares , Región Lumbosacra , Persona de Mediana Edad , Osteoporosis Posmenopáusica
13.
Magn Reson Imaging Clin N Am ; 27(4): 625-640, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31575397

RESUMEN

The human spine is a highly specialized structure that protects the neuraxis and supports the body during movement, but its complex structure is a challenge for imaging. Radiographs can provide fine bony detail, but lack soft tissue definition and can be complicated by overlying structures. MR imaging allow(s) excellent soft tissue contrast, but some bony abnormalities can be difficult to discern. This makes the 2 modalities highly complementary. In this article, the authors discuss the correlation between radiographic and MR imaging appearances focusing first on disease affecting the vertebral body itself, its surrounding structures, and finally global spinal alignment.


Asunto(s)
Imagen por Resonancia Magnética/métodos , Radiografía/métodos , Enfermedades de la Columna Vertebral/diagnóstico por imagen , Humanos , Columna Vertebral/diagnóstico por imagen
14.
Semin Ultrasound CT MR ; 40(1): 86-93, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30686372

RESUMEN

Postmortem imaging is a fascinating field of forensic radiology that has seen extraordinary growth in the last 10 years. Indeed, if autopsy represents the sole reliable method of determining the definitive cause of death, imaging may provide an efficient guide to supplement conventional autopsy. This is particularly true because of several techniques that are currently available, such as postmortem computed tomography, multiphase postmortem computed tomography angiography, and postmortem magnetic resonance imaging. In this review, we explore the newer imaging techniques in forensic radiology.


Asunto(s)
Autopsia/métodos , Medicina Legal/métodos , Imagen por Resonancia Magnética/métodos , Tomografía Computarizada por Rayos X/métodos , Humanos
15.
Aging Clin Exp Res ; 31(5): 637-644, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30128661

RESUMEN

OBJECTIVES: Bone mineral density (BMD) is associated with muscle mass and quality, but little research has been done on functional muscle-bone unit and back muscle density in patients with lumbar vertebral fracture. This study used the "modified functional muscle-bone unit" concept and measured back muscle density to investigate muscle-bone interaction difference between the fracture and control group. METHODS: This was a case-control study. A total of 52 elderly male patients (mean age 75 years) with lumbar vertebral fracture (cases) and 52 control healthy subjects were enrolled. Cross-sectional area (CSA) and density of paravertebral muscle were measured in quantitative computed tomography (QCT) images to represent the muscle mass, while the bone mineral density measured by QCT was used to represent the bone mass. The modified functional muscle-bone unit was calculated as the value of volumetric BMD divided by muscle area. RESULTS: People with vertebral fractures reported significantly lower values in the cross-sectional area and density of paravertebral muscle compared to control group. In the multivariate analysis, BMD (odds ratio, OR = 0.929; 95% confidence intervals, CIs 0.888-0.971), erector muscle density (OR = 0.698; 95% CI 0.547-0.892), and summated muscle CSA (OR = 0.963; 95% CI 0.93-0.991) were independent protective factors for the presence of a fracture. BMD resulted significantly and moderately associated with cross-sectional area and density of paravertebral muscle (r = 0.329-0.396). CONCLUSIONS: There were significant differences between the modified functional muscle-bone unit and back muscle density between the fracture group and control group in elderly men. Lower BMD, loss of muscle mass and density are associated with increased presence of the lumbar vertebral fracture.


Asunto(s)
Músculos de la Espalda/fisiopatología , Densidad Ósea/fisiología , Vértebras Lumbares/lesiones , Fracturas de la Columna Vertebral/fisiopatología , Anciano , Anciano de 80 o más Años , Músculos de la Espalda/diagnóstico por imagen , Estudios de Casos y Controles , China , Estudios Transversales , Humanos , Vértebras Lumbares/diagnóstico por imagen , Vértebras Lumbares/fisiopatología , Masculino , Oportunidad Relativa , Fracturas de la Columna Vertebral/diagnóstico por imagen , Tomografía Computarizada por Rayos X
16.
Forensic Sci Med Pathol ; 14(3): 377-380, 2018 09.
Artículo en Inglés | MEDLINE | ID: mdl-29926437

RESUMEN

Type 1 neurofibromatosis (NF 1), a rare genetic disease with autosomal dominant transmission, has typical dermatologic manifestations with pathognomonic Lisch nodules, and is rarely known for vascular alterations. Among these, aneurysmal dilatation is the most common form. We report a fatal case of massive hemothorax due to a spontaneous rupture of the left pulmonary artery branch micro-aneurysm in a NF 1 patient. Indeed, spontaneous rupture of these pathologic vessels is very rare in clinical practice and the literature, but, for its potentially life-threatening complications, there is the need for it to be taken into account in differential diagnosis. The origin of bleeding was first confirmed by computed tomography angiography (CTA). The patient's condition worsened suddenly leading to pulmonary hemorrhage and death. A clinical autopsy was required to assess the definitive cause of death.


Asunto(s)
Aneurisma Roto/patología , Hemotórax/etiología , Microaneurisma/patología , Neurofibromatosis 1/complicaciones , Arteria Pulmonar/patología , Aneurisma Roto/diagnóstico por imagen , Resultado Fatal , Femenino , Hemotórax/diagnóstico por imagen , Humanos , Microaneurisma/diagnóstico por imagen , Persona de Mediana Edad , Arteria Pulmonar/diagnóstico por imagen , Rotura Espontánea
17.
Eur Heart J Cardiovasc Imaging ; 18(9): 1049-1056, 2017 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-27742738

RESUMEN

AIMS: To evaluate the relationship between an incremental model including cardiovascular risk factors, carotid disease, and inflammatory biomarkers to predict the presence of obstructive coronary artery disease (CAD). METHODS AND RESULTS: A total of 134 consecutive and asymptomatic intermediate-risk patients (mean age 61 ± 9 years, 52% men) were enrolled. Each subject underwent circulating levels assessment of interleukin (IL)-2r, IL-6, IL-8, IL-10, high-sensitivity C-reactive protein (hs-CRP) and carotid and coronary artery evaluation using carotid ultrasound and coronary computed tomography angiography (CCTA), respectively. Carotid disease was diagnosed in 71 (53%) patients. Obstructive and multi-vessel CAD were found in 50 (37%) and 18 (14%) patients, respectively. Patients in whom CCTA showed multi-vessel CAD had a higher rate of carotid disease (89 vs. 46%, P = 0.001) and increased values of all interleukins when compared with patients without multi-vessel obstructive CAD. The univariate and multivariate analysis showed that male gender, diabetes, carotid disease, and IL-6 were independently associated with obstructive CAD. At receiver operating characteristic curve analysis, the multivariate model (including male gender, carotid disease, IL-6 > 5.9 pg/mL, and diabetes) showed the highest area under the curve for prediction of obstructive CAD, multi-vessel CAD, and high-risk plaque defined as mixed and/or remodelled plaque when compared with all other models (P < 0.001). CONCLUSION: Among asymptomatic intermediate-risk patients, the presence of increased IL6 levels in addition to traditional risk factors (male gender with diabetes) and carotid artery disease predicts higher rates of obstructive CAD and it could be of help to identify which subset of asymptomatic patients could be referred to CCTA for screening.


Asunto(s)
Enfermedades de las Arterias Carótidas/diagnóstico por imagen , Angiografía por Tomografía Computarizada/métodos , Angiografía Coronaria/métodos , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Anciano , Enfermedades Asintomáticas , Enfermedades de las Arterias Carótidas/sangre , Enfermedades de las Arterias Carótidas/epidemiología , Comorbilidad , Intervalos de Confianza , Enfermedad de la Arteria Coronaria/sangre , Enfermedad de la Arteria Coronaria/epidemiología , Femenino , Voluntarios Sanos , Humanos , Incidencia , Mediadores de Inflamación/sangre , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Valor Predictivo de las Pruebas , Curva ROC , Medición de Riesgo
18.
Eur J Radiol ; 85(8): 1461-8, 2016 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-26971404

RESUMEN

Nutritional status is the results of nutrients intake, absorption and utilization, able to influence physiological and pathological conditions. Nutritional status can be measured for individuals with different techniques, such as CT Body Composition, quantitative Magnetic Resonance Imaging, Ultrasound, Dual-Energy X-Ray Absorptiometry and Bioimpendance. Because obesity is becoming a worldwide epidemic, there is an increasing interest in the study of body composition to monitor conditions and delay in development of obesity-related diseases. The emergence of these evidence demonstrates the need of standard assessment of nutritional status based on body weight changes, playing an important role in several clinical setting, such as in quantitative measurement of tissues and their fluctuations in body composition, in survival rate, in pathologic condition and illnesses. Since body mass index has been shown to be an imprecise measurement of fat-free and fat mass, body cell mass and fluids, providing no information if weight changes, consequently there is the need to find a better way to evaluate body composition, in order to assess fat-free and fat mass with weight gain and loss, and during ageing. Monitoring body composition can be very useful for nutritional and medical interventional. This review is focused on the use of Body Composition in Clinical Practice.


Asunto(s)
Tejido Adiposo/diagnóstico por imagen , Composición Corporal , Diagnóstico por Imagen , Estado Nutricional , Obesidad/diagnóstico por imagen , Índice de Masa Corporal , Humanos , Masculino
19.
Tumori ; 93(2): 207-9, 2007.
Artículo en Inglés | MEDLINE | ID: mdl-17557572

RESUMEN

Wernicke's encephalopathy is an acute neuropsychiatric condition due to thiamine deficiency frequently associated with chronic alcohol abuse. We describe 2 cases of patients who experienced acute Wernicke's encephalopathy after allogeneic stem cell transplantation associated with the use of commercial total parental nutrition. Early diagnosis with magnetic resonance imaging and timely treatment with thiamine resulted in rapid resolution of clinical and radiological signs. In conclusion, the prolonged use of commercial total parental nutrition formulas must be supplemented with thiamine in the form of intramuscularly administered multivitamins.


Asunto(s)
Trasplante de Células Madre Hematopoyéticas/efectos adversos , Tiamina/uso terapéutico , Encefalopatía de Wernicke/etiología , Adulto , Suplementos Dietéticos , Humanos , Leucemia/complicaciones , Leucemia/terapia , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Nutrición Parenteral , Deficiencia de Tiamina , Trasplante Homólogo , Encefalopatía de Wernicke/diagnóstico , Encefalopatía de Wernicke/tratamiento farmacológico
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