Perfil clínico e incidência de eventos cardiovasculares em 36 meses em pacientes com Minoca: registro de 126 pacientes em um hospital terciário de cardiologia / Clinical profile and incidence of cardiovascular events at 36 months in patients with Minoca: registry of 126 patients in a tertiary cardiology hospital

INTRODUÇÃO: Em 5% a 6% dos IAM não são observadas lesões obstrutivas maiores que 50%, sendo estes classificados como MINOCA (Infarto do Miocárdio com Artérias Coronárias não Obstrutivas). Estudos maiores de longo prazo demonstraram que o prognóstico desses pacientes não é benigno com risco aumentado de morte e novos eventos cardiovasculares. MÉTODOS: Nesta coorte de centro único, todos os pacientes que preencheram os critérios diagnósticos para MINOCA com (1) IAM (2) ausência de estenose coronária ≥ 50% na artéria relacionada ao infarto e (3) nenhuma outra causa específica clinicamente evidente entre março de 2000 e junho de 2022 foram incluídos com um acompanhamento médio de 30 (9,5-67,3) meses. As características da amostra foram descritas em frequências e valores medianos (p25%-p75%). A incidência de um novo evento cardiovascular (CV) em 36 meses após a MINOCA foi estimada pelo método de Kaplan-Meier e o teste de log-rank aplicado para comparar os grupos, acompanhado de intervalos de confiança de 95% e alfa de 5% (R 3,6,1 para MacOS). RESULTADOS: Dos 126 pacientes, 57,1% eram mulheres com cerca de 50 anos de idade (42,0-57,8). 20,6% tinham diabetes, 47,6% dislipidemia, 60,3% hipertensão e 20% IAM prévio. A apresentação clínica predominante foi IAMSSST (55,6%) e 7 pacientes tiveram um episódio de morte súbita abortada durante a internação. 38,1% dos pacientes não tiveram uma etiologia identificada. O mecanismo fisiopatológico mais prevalente foi ruptura da placa < 50% (16,7%), seguido de tromboembolismo (13,5%) e dissecção espontânea de coronária (13,5%). Apenas 3,2% realizaram tomografia de coerência óptica (OCT) ou ultrassom intravascular (IVUS). Nenhum teste provocativo foi realizado. 44,4% realizaram ressonância magnética cardíaca (RMC), com mediana de tempo para realização de 180,0 (60,0-707,5) dias após o evento. Em relação à medicação prescrita na alta hospitalar, 79,4% tiveram betabloqueador e IECA/BRA prescritos, 14,3% iniciaram anticoagulação e apenas 34,1% receberam dupla antiagregação plaquetária (DAP). A incidência do desfecho composto (morte CV, novo IAM, AVC e internação CV) em 36 meses foi de 15% (IC95% 8,9%-24,6%). A incidência de novo IAM foi de 6,3% (N=8), de AVC 2,4% (N=3), de hospitalização CV 17,5% (N=22) e apenas um óbito. CONCLUSÃO: Chama a atenção o risco do desfecho primário em 36 meses. Notavelmente, a maior parte da incidência foi atribuída à hospitalização CV. Um número importante de pacientes recebeu alta sem etiologia conhecida para sua apresentação clínica e, consequentemente, sem tratamento individualizado.

Impact of gingivitis on oral health-related quality of life in 12-year-old schoolchildren of Quito, Ecuador.

PURPOSE: Evaluate the impact of gingivitis on oral health-related quality of life (OHRQoL) amongst 12-year-old schoolchildren from Quito, Ecuador. METHODS: We evaluated 998 school children using the Community Periodontal Index for gingival bleeding and calculus. OHRQoL was assessed with the Child Perceptions Questionnaire 11-14 (CPQ11-14) questionnaire. RESULTS: Of the 998 schoolchildren, 93% had gingival bleeding and 73% had dental calculus. Schoolchildren with more than one sextant with gingival bleeding had 1.18 times higher mean CPQ11-14 (RR 1.18, 95% CI 1.11-1.27) than those with none or just one affected sextant. Male schoolchildren presented a 15% lower mean Child Perceptions Questionnaire (CPQ) (RT 0.85; 95% CI 0.76-0.96). Children whose parents had incomplete secondary education had a 15% lower mean CPQ (RT 0.85; 95% CI 0.77-0.94). Bleeding in more than one sextant was significantly associated with worse quality of life in the emotional well-being (RT 1.40, 95% CI 1.03-1.90) and social well-being domains (RT 1.76, 95% CI 1.32-2.34). CONCLUSION: Gingival bleeding negatively impacted the OHRQoL of 12-year-old Ecuadorian schoolchildren living in Quito.

Avaliação de dor torácica na unidade de emergência ­ é possível associar os escores de risco cardiovascualr (TIMI, HEART E GRACE) e a presença de placa obstrutiva na angiotomografia de coronárias? / Assessment of chest pain in the emergency unit ­ is it possible to associate cardiovascular risk scores (TIMI, HEART AND GRACE) and the presence of obstructive plaque on coronary computed tomography angiography?

INTRODUÇÃO: Estima-se que quatro milhões de pacientes sejam atendidos anualmente em serviços de emergência do Brasil com a queixa de dor torácica, dos quais apenas 10% serão diagnosticados com síndrome coronariana aguda. Nesse contexto, escores de risco cardiovascular, como TIMI, HEART e GRACE, são utilizados como ferramenta para avaliar a possibilidade de doença arterial coronária (DAC). Inicialmente validados para estimar risco de eventos cardíacos intra-hospitalares, a sua associação com a presença de placa obstrutiva é pouco conhecida. OBJETIVO: Correlacionar os achados na Angiotomografia de Coronárias (Angio-TC) e os escores de risco cardiovascular, nos pacientes atendidos com dor torácica no pronto-socorro de hospital terciário. METODOLOGIA: Estudo observacional retrospectivo, baseado na análise de prontuários, no período de janeiro de 2019 a dezembro de 2021. Foram incluídos pacientes atendidos em pronto-atendimento de hospital terciário com a queixa principal de dor torácica aguda com valores de troponina negativos e ECG sem achados isquêmicos, submetidos a Angio-TC. Lesões coronárias ateroscleróticas foram quantificadas quanto à proporção de estenose luminal, sendo consideradas significativas aquelas com estenose ≥ 50% da luz do vaso em ≥ 1 artéria epicárdica relevante. RESULTADOS: Foram avaliados 350 pacientes com idade média de 52,6±11,9 anos, sendo 50% mulheres (Tabela 1). Desses pacientes, 72 (20,6%) apresentaram lesão aterosclerótica significativa em Angio-TC. Sexo masculino (OR: 1,87; IC 95%: 1,08 ­ 3,26), idade > 52 anos (OR: 2,85; CI 95%: 1,6 ­ 5,07), diagnóstico de Diabetes Mellitus (OR 2,17; IC 95%: 1,12 ­ 4,2) e relato de angina típica (OR 2,17; IC 95%: 1,12 ­ 4,2) estiveram associados de forma independente à presença de placa obstrutiva. Mais de 90% dos pacientes com lesão significativa na Angio-TC, apresentavam escore GRACE e TIMI de baixo risco. O escore HEART < 4 foi calculado em 23,6% dos pacientes com placa obstrutiva (Figura 1). CONCLUSÕES: A avaliação baseada em características clínicas e nos escores de risco cardiovascular de forma isolada não se mostrou suficiente para excluir de forma segura o diagnóstico de doença arterial coronária. Dessa forma, a Angio-TC é ferramenta complementar importante para o diagnóstico de coronariopatia nos pacientes com dor torácica aguda, possibilitando o início precoce de terapêutica adequada para a prevenção de novos eventos cardiovasculares.

Technical analysis in Tsuri-goshi through three complementary observational analysis.

The aim of this article is to identify the factors involved in learning judo based on an observational study of technical errors and their relationships. The analysis was carried out using a combination of a self-generated observational instrument (OI-JUDO-TG) and a recording instrument (developed with the Lince software) using a sample of 78 novice students. In addition, descriptive statistics and sequential analysis with polar coordinates and T-Patterns were obtained using the Hoisan and Theme software program. The implementation of the various analytical methods optimizes the knowledge of performance and the concretion of feedback, like the process of communication between the teacher and the student, that which will activate new neuronal connections in learning. The results confirmed that the most frequent chain of errors during the performance of the technique were as follows: (1) the lack of an initial imbalance, the incorrect placement of the feet, the head and (2) the head after the tsukuri of the technique, as well as the absence of load of the body during this phase and the lack of balance of the performer when finishing the projection. At the initiation of judo, analytical methods are not applied, but the personal experience or the immediate feedback from the teacher is applied. It proposes a new analytical method to learn the technical errors and the different ways to implement their correction. Through the observational analysis generated, intense relationships between the detected errors have been demonstrated, determining the presence of the ones that causes the occurrence of the others.

Addition of a Second Metal (Co) to Molybdenum Carbide: Effect of the Doping Route.

Molybdenum carbide is an interesting and versatile material, which has important applications in the metal matrix industry as a reinforcement material, as well as in the catalytic field. Though many papers suggest different methodologies for adding cobalt to the carbide structure aiming either to increase catalytic activity or enhancing mechanical proprieties such as ductility, etc. no straightforward evaluation is available. In the present paper two doping methodologies were studied: via solid state mixture of powders and via wet impregnation. Ammonium molybdate [(NH4)2MoO4] and cobalt nitrate [Co(NO3)2·6H2O] were used as starting materials and the doping process was carried out before carburization reaction. Those materials were characterized by FT-IR, SEM, XRF and XRD. The carbo-reduction products' were evaluated on XRD and XRF basis. Doped precursors' evaluation showed that the wet impregnated doped materials presented smaller particle sizes, were more homogeneous and retained more cobalt than the solid state doped ones. However, final products' assessment indicated that the solid state methodology was able to retain a greater dopant percentage according to XRF evaluation, and XRD data indicated a more intrinsic addition of the dopant to the carbide structure. In addition, no significant changes on particle size could be attributed to any of the methodologies, both producing Mo2C of approximately 30 nm.

Efficacy of local phytotherapy in the nonsurgical treatment of periodontal disease: A systematic review.

Herbal drugs are commonly used in the treatment of several diseases, including periodontitis. So far, no systematic review had evaluated the evidence regarding the efficacy of these agents in the treatment of periodontal disease. Therefore, the purpose of this review was to evaluate the effect of local application of phytotherapic agents as adjuncts to scaling and root planing (SRP), compared to SRP alone, on clinical parameters of chronic periodontal patients. Only randomized controlled trials of at least 3 months follow-up, of SRP alone in association with local phytotherapic agents were included. MEDLINE (PubMed), Google Scholar and LILACS databases were searched for articles published up to October 2016. Random-effects meta-analyses were conducted for clinical attachment level and probing pocket depth (PPD) change after treatment. Of 1861 papers potentially relevant, 7 were included. All studies showed that periodontal treatment in association with local phytotherapic delivery promotes a significant PPD reduction and the majority of them showed clinical attachment level gain. The local use of phytotherapy as an adjunct to SRP may promote additional benefits in PPD reduction and clinical attachment level gain. However, these results must be interpreted with caution due to the small sample size, high risk of bias and heterogeneity of the studies.

Detection of a chemical cue from the host seaweed Laurencia dendroidea by the associated mollusc Aplysia brasiliana.

Chemical cues from sessile hosts can attract mobile and associated organisms and they are also impotant to maintain associations and overall biodiversity, but the identity and molecular structures of these chemicals have been little explored in the marine environment. Secondary metabolites are recognized as possible chemical mediators in the association between species of Laurencia and Aplysia, but the identity of the compounds has not been established. Here, for the first time, we experimentally verify that the sesquiterpene (+)-elatol, a compound produced by the red seaweed Laurencia dendroidea, is a chemical cue attracting the associated sea hare Aplysia brasiliana. In addition to revealing the nature of the chemical mediation between these two species, we provide evidence of a chemical cue that allows young individuals of A. brasiliana to live in association with L. dendroidea. This study highlights the importance of chemical cues in Laurencia-Aplysia association.

Radiographic evaluation of cardiac silhouette using vertebral heart size method in squirrel monkey (Saimiri sciureus).

BACKGROUND: The Saimiri sciureus represents a valuable resource for biomedical research, due to its large number on primate centers and similarity to human anatomy and physiology. The aim of this study was to apply the method proposed by Buchanan & Bücheler in healthy squirrel monkeys (S. sciureus) and determine by radiographic examination, the average value of the vertebral heart size (VHS) for the specie. METHOD: Laterolateral left (LLL), laterolateral right (LLR), ventrodorsal (VD), and dorsoventral (DV) projections were used for radiographic examinations to evaluate the heart silhouette of S. sciureus. RESULTS: There was no statistical difference between the projections LLL and LLR, or VD and DV, and between males and females, so measurements in the four radiographic projections were not performed. CONCLUSION: The values obtained in VHS of S. sciureus showed up species specific.

Lead migration from toys by anodic stripping voltammetry using a bismuth film electrode.

Metals may be released from toys via saliva during mouthing, via sweat during dermal contact, or via gastric and intestinal fluids after partial or whole ingestion. In this study, we determined the lead migration from toys bought on the Portuguese market for children below 3 years of age. The lead migration was performed according to the European Committee for Standardization EN 71-3, which proposes a 2-hour migration test that simulates human gastric conditions. The voltammetric determination of migrated lead was performed by anodic stripping voltammetry (ASV) at a bismuth film electrode (BiFE). For all the analyzed toys, the values of migrated lead did not exceed the limits imposed by the European Committee for Standardization EN 71-3 (90 mg kg-1) and by the EU Directive 2009/48/EC (13.5 mg kg-1) on the safety of toys.

Evaluation of the presence of Echinococcus granulosus sensu lato in the environment and in hosts in a region endemic for hydatidosis in the province of Chubut (Argentina).

In the province of Chubut (Argentina), hydatidosis is an endemic disease. This province has had a program for control of this disease since 1984. The aim of the present study was to evaluate the presence of Echinococcus granulosus sensu lato in the environment and hosts in a region characterized as endemic and inhabited by indigenous people whose sustenance economy is based on the extensive rearing of sheep. To this end, we carried out an observational, descriptive and transversal study. Sheep sera, water samples, soil samples and canine fecal matter collected from the environment and adult specimens of E. granulosus s.l. were analyzed for strain studies by genotyping. Also there were analyzed serum samples of resident persons to detect E. granulosus antibodies. The frequency of sera positive for hydatidosis was 17.5% in lambs and 28.57% in sheep older than one year of age. The frequency of canine echinococcosis was 25%, and the strain found corresponded to E. granulosus s.l. G1. Samples of canine fecal matter showed presence of taeniid eggs and three of the samples were positive for the coproantigen. The results indicate the circulation of the G1 strain and its presence in the environment under the dry climate conditions of Patagonia. These findings provide useful information for the evaluation of the effectiveness of control actions that may be implemented in a region endemic for hydatidosis.

[Low-grade gliomas: review of 10 years]. / Gliomas de bajo grado: revisión de 10 años.

INTRODUCTION: Central nervous system (CNS) tumors are the most common solid tumors in children. Among these, the low-grade gliomas are the most common type, accounting for up to 30-50% of them. PATIENTS AND METHODS: A retrospective analysis was carried out on the epidemiology, clinical characteristics, tumor location, histology, treatment, outcome and long-term sequelae of 111 patients diagnosed with low-grade glioma in the Niño Jesús Children's Hospital of Madrid from January 2002 to December 2011. RESULTS: Of the 111 patients, there were 57 boys and 54 girls. The mean age was 7.26 years (range, 2 months - 19 years). The most common symptoms of presentation were headache (27%) and vomiting (19%). The most common locations were the cerebral hemispheres (38%), followed by the brainstem (27.4%), and cerebellum (18.5%). Histological examination was performed in 89 patients (80.18%). Pilocytic astrocytoma was the most common histological type. Diagnostic biopsy was performed in 20 patients (22.5%), partial resection in 38 patients (42.7%), and total resection in 31 patients (34.8%). Sixteen patients received chemotherapy (14%), and eighteen patients received radiotherapy (16%). Overall survival was 88.3%. Long term hearing, visual and endocrine sequelae were note in 1, 5, and 4 patients, respectively. CONCLUSIONS: The most common histological type is pilocytic astrocytoma. Overall survival was 88.3%. Only 9% of patients had some kind or auditory, visual or endocrine sequelae.

Ofloxacin determination in urine, serum and pharmaceuticals using an automatic flow potentiometric system.

An automatic system was developed to determine ofloxacin in biological fluids and pharmaceutical formulations. Drug detection was carried out by a potentiometric membrane sensor based on [bis(trifluoromethyl)phenyl]borate as molecular-recognition material. The tubular shaped detector system was solidly attached to the manifold, creating a high-throughput stable setup (50 samples per hour) appropriate for routine antibiotic assessment. Under the optimized flow conditions, the sensor displayed a mean detection limit of 1 × 10(-5) M, a linear response over the concentrations of 2 × 10(-5) to 5 × 10(-3) M (slope of 57.4 mV decade(-1)) and a wide working pH range (2.1 - 6.6). The procedure was successfully applied to ofloxacin analysis in pharmaceuticals (relative deviation lower than 6%) and biological fluids at levels usually found after drug administration of clinical doses (recoveries between 91 and 106%). No significant interference from common excipients found in commercial formulations and inorganic ions usually present in biological fluids was noticed.

Análise tecidual e celular das brânquias de Oreochromis niloticus L. tratadas com extrato etanólico bruto e frações das folhas da pitanga (Eugenia uniflora L. ) - Myrtaceae / Tissue and cell analysis of Oreochromis niloticus L. gill treated with crude ethanol extract and fractions from pitanga (Eugenia uniflora L. ) leaves Myrtaceae

Eugenia uniflora L. (Myrtaceae) é uma planta que ocorre no bioma Cerrado e é utilizada popularmente no tratamento de diarréias, inflamações, hiperglicemia e hipertensão. Estudos prévios revelaram atividade antimicrobiana da E. uniflora in vitro. Tendo em vista o uso popular, este trabalho objetivou avaliar as possíveis atividades celulares e teciduais sistêmicas do extrato bruto e das frações das folhas dessa planta em brânquias de Oreochromis niloticus L. (tilápia nilótica). Para isso, o extrato etanólico e as frações das folhas dessa planta foram administrados no peixe, por via oral, adicionadas à ração. Após um período de 24 horas, os peixes foram sacrificados e o segundo arco branquial de cada peixe foi dissecado, fixado em formalina neutra, desidratado, incluído em parafina e cortado. Nas análises histológicas, utilizaram-se tricômico de Masson e hematoxilina e eosina (HE). Pelas análises qualitativas na microscopia de luz, concluiu-se que o extrato etanólico bruto e as frações das folhas da E. uniflora apresentaram efeito sistêmico nas tilápias nilóticas atingindo as brânquias. As ações tóxicas como destacamento e descamação do epitélio respiratório e hiperplasia das células do epitélio interlamelar, foram mais pronunciadas nas tilápias que ingeriram maiores concentrações. Este trabalho colaborou para identificar o efeito vasodilatador dessa planta, e contribuiu para estabelecer a tilápia nilótica como sistema-modelo para testes com princípios ativos de plantas. Espera-se, com esses testes, viabilizar o uso de plantas como medicamentos para tratamentos de peixes, a manutenção da saúde de animais em cultivo intensivo e extensivo, a partir do qual se possibilite emprego alternativo aos medicamentos sintéticos.

Eugenia uniflora L. (Myrtaceae) is a plant found in the Cerrado biome and traditionally used in the treatment of diarrheas, inflammations, hyperglycemia and hypertension. Previous studies have revealed in vitro antimicrobial activity of E. uniflora. Considering its popular use, this study aimed to assess possible systemic cellular and tissue activities of the crude extract and the fractions from the leaves of this plant on Oreochromis niloticus L. (Nile tilapia) gill. Thus, ethanol extract and fractions from the leaves of this plant were orally administered to the fish in their rations. After 24 hours, the fish were sacrificed and the second gill arch of each fish was dissected, fixed in neutral formalin, dehydrated, embedded in paraffin and sectioned. Masson's trichome and hematoxylin and eosin (HE) were used in the histological analyses. Qualitative analyses using a light microscope led to the conclusion that the crude ethanol extract and the fractions from E. uniflora leaves presented systemic effect on Nile tilapias, affecting the gills. Toxic actions such as respiratory epithelium detachment and lifting, and hyperplasia of interlamellar epithelial cells were more pronounced in the tilapias that ingested higher concentrations. This study helped to identify the vasodilator effect of this plant and contributed to the definition of the Nile tilapia as a model system for testing plant active principles. These tests are expected to make feasible not only the use of plants as fish medication but also the maintenance of the health of animals in intensive and extensive cultures through the possible use of alternatives to synthetic medication.

Sequential injection kinetic flow assay for monitoring glycerol in a sugar fermentation process by Saccharomyces cerevisiae.

A sequential injection system to monitor glycerol in a Saccharomyces cerevisiae fermentation process was developed. The method relies on the rate of formation of nicotinamide adenine dinucleotide in its reduced form (NADH, measured spectrophotometrically at 340 nm) from the reaction of glycerol with NAD(+) cofactor, catalysed by the enzyme glycerol dehydrogenase present in solution. This procedure enables the determination of glycerol between 0.046 and 0.46 g/l, (corresponding to yeast fermentation samples with concentrations up to 50 g/l) with good repeatability (relative standard deviation for n = 10 lower than 2.2% for three different samples) at a sampling frequency of 25/h. The detection and quantification limits using a miniaturised spectrophotometer were 0.13 and 0.44 mM, respectively. Reagent consumption was of 0.45 mumol NAD(+) and 1.8 microg enzyme per assay, and the waste production was 2.8 ml per determination. Results obtained for samples were in agreement with those obtained with a high-performance liquid chromatography method.

Manifestaciones de la afasia en gallego. Datos preliminares de pacientes bilingües gallego-castellano / Manifestations of aphasia in Galician. Preliminary finding from Galician-Spanish bilingual patients

Se presentan datos de un estudio preliminar sobre las manifestaciones de la afasia en gallego, una lenguahablada principalmente en el noroeste deEspaña. Participaron 17 pacientes afásicos bilingüesque hablaban gallego y castellano, evaluados con elTest de afasia en bilingües (BAT). Se analizó (testde Wilcoxon) el rendimiento en fluidez en el lenguajeespontáneo, comprensión de órdenes complejas,fonología (discriminación auditiva verbal yrepetición de palabras), léxico (decisión léxica),morfología (morfología derivacional y opuestosmorfológicos) y sintaxis (comprensión sintáctica,juicios de gramaticalidad, corrección en construcciónde oraciones y sentido en la construcción deoraciones) comparando especialmente el rendimientoen oraciones activas positivas, pasivas,negativas, oraciones con pronombres clíticos y oracionescon topicalización del sujeto y del objeto.Los resultados indicaron que el rendimiento entodos los subtest del BAT era similar para ambaslenguas. En fonología se producían parafasias fonémicaspero respetando las reglas fonotácticas delgallego. En sintaxis las oraciones que peor se comprendían,en relación a las activas estándar, fueronlas negativas, las oraciones con topicalización delobjeto y las que llevaban pronombres clíticos. Sediscuten estos resultados en relación a las principalesteorías del agramatismo(AU)

We present data from a preliminary study of manifestationsof aphasia in Galician, a language thatis spoken mainly in Galicia, N.W. of Spain. 17aphasic patients who are bilingual in Spanish(Castilian) and Galician participated in the studyand they were evaluated by the Bilingual AphasiaTest (BAT). Wilcoxon tests were carried out onfluency in spontaneous speech, comprehension ofcomplex commands, phonology (Verbal AuditoryDiscrimination and Repetition of Words), lexicon(Lexical Decision), morphology (Derivational Morphologyand Morphological Opposites) and syntax(Syntactic Comprehension, Grammaticality Judgments,Sentence Construction Correctness andSentence Construction Sense). Special attentionwas paid to the difficulties in understanding sentenceswith clitic pronouns, passives, negativesand topicalized subjects or objects. Results showeda similar performance on all the BAT subtests forthe two languages. In phonology the phonemicparaphasias that were produced respected the phonotacticrules of Galician. In syntax the sentencetypes that were worst understood relative to standardactive sentences were negative, the sentenceswith topicalized objects and those with cliticpronouns. These findings are discussed in relationto the main theories of agrammatism(AU)

[Automatic detection of pulmonary nodules on computed tomography: a preliminary study]. / Detección automática de nódulos pulmonares en tomografía computarizada.Un estudio preliminar.

OBJECTIVES: Recent years have seen growing interest in the development of algorithms for computer-assisted diagnosis (CAD) for the detection of pulmonary nodules on both plain-film radiographs and computed tomography (CT) studies. The purpose of CAD algorithms in this context is to alert radiologists to suspicious radioopacities that might represent cancer in the images. We are developing a CAD system for the detection of pulmonary nodules on helical CT images. MATERIAL AND METHODS: We collected cases of patients with pulmonary nodules examined with helical CT. A total of 64 nodules, including both calcified and noncalcified lesions, ranging from 3 to 30 mm in diameter were included in the study. Studies were acquired on one 4-slice and one 64-slice CT scanners. Three chest radiologists at two institutions interpreted the studies to determine whether pulmonary nodules were present. We calculated the sensitivity and the number of false positives per image to evaluate the CAD system. RESULTS: We have developed and evaluated an algorithm for the automatic detection of pulmonary nodules on CT images. For a sensitivity of 76%, the false-positive rate was 1.3 per image. CONCLUSIONS: Our preliminary results suggest that the system might be useful for radiologists in the detection of pulmonary nodules on helical CT images.

Detección automática de nódulos pulmonares en tomografía computarizada. Un estudio preliminar / Automatic detection of pulmonary nodules on computed tomography: a preliminary study

Objetivos. Durante estos últimos años ha habido un interés creciente en el desarrollo de algoritmos de diagnóstico asistido por ordenador (CAD) aplicados a la detección de nódulos pulmonares, tanto en radiografías como en tomografía computarizada (TC); su propósito consistiría en llamar la atención del radiólogo indicando radioopacidades sospechosas que podrían representar cáncer en las imágenes. Nosotros estamos desarrollando un sistema CAD dedicado a la detección de nódulos pulmonares en imágenes de TC helicoidal. Material y métodos. Se han recogido casos de TC helicoidal de pacientes con nódulos pulmonares. Se incluyeron en el estudio 64 nódulos, calcificados y no calcificados, con diámetros entre 3-30 mm. Para la obtención de los casos se han utilizado dos equipos de TC de 4 y 64 cortes, respectivamente. Los casos positivos para nódulo pulmonar se determinaron mediante interpretación del estudio por tres radiólogos de tórax, de dos instituciones diferentes. Para evaluar el sistema de detección se calcularon la sensibilidad y el número de falsos positivos por imagen. Resultados. Se ha desarrollado un algoritmo de detección automática de nódulos pulmonares en TC y se ha realizado una evaluación preliminar del mismo. Para una sensibilidad del 76% se obtuvo una tasa de 1,3 falsos positivos por imagen. Conclusiones. Los resultados obtenidos, aunque son preliminares, sugieren que el sistema podría ser de ayuda para los radiólogos en la detección de nódulos pulmonares en TC helicoidal (AU)

Recent years have seen growing interest in the development of algorithms for computer-assisted diagnosis (CAD) for the detection of pulmonary nodules on both plain-film radiographs and computed tomography (CT) studies. The purpose of CAD algorithms in this context is to alert radiologists to suspicious radioopacities that might represent cancer in the images. We are developing a CAD system for the detection of pulmonary nodules on helical CT images. Material and methods. We collected cases of patients with pulmonary nodules examined with helical CT. A total of 64 nodules, including both calcified and noncalcified lesions, ranging from 3 to 30 mm in diameter were included in the study. Studies were acquired on one 4-slice and one 64-slice CT scanners. Three chest radiologists at two institutions interpreted the studies to determine whether pulmonary nodules were present. We calculated the sensitivity and the number of false positives per image to evaluate the CAD system. Results. We have developed and evaluated an algorithm for the automatic detection of pulmonary nodules on CT images. For a sensitivity of 76%, the false-positive rate was 1.3 per image. Conclusions. Our preliminary results suggest that the system might be useful for radiologists in the detection of pulmonary nodules on helical CT images (AU)