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Encefalitis Antirreceptor N-Metil-D-Aspartato , COVID-19 , Encefalitis Antirreceptor N-Metil-D-Aspartato/complicaciones , Encefalitis Antirreceptor N-Metil-D-Aspartato/diagnóstico por imagen , COVID-19/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética/métodos , Tomografía de Emisión de Positrones/métodos , SARS-CoV-2Asunto(s)
Enfermedad de Castleman , Linfoma de Células B Grandes Difuso , Enfermedad de Castleman/diagnóstico por imagen , Células Dendríticas Foliculares/patología , Fluorodesoxiglucosa F18 , Estudios de Seguimiento , Humanos , Linfoma de Células B Grandes Difuso/diagnóstico por imagen , Linfoma de Células B Grandes Difuso/patología , Tomografía Computarizada por Tomografía de Emisión de PositronesRESUMEN
El estudio gated-SPECT de perfusión miocárdica es una técnica utilizada e indicada para la valoración de los pacientes con un diagnóstico no claro de cardiopatía isquémica. El estudio gated-SPECT de reposo precoz en fase aguda tiene una alta sensibilidad y alto valor predictivo negativo para descartar enfermedad coronaria. Presentamos el caso de una paciente ingresada para el estudio de dolor torácico, a la que se le realizó un estudio de perfusión miocárdica de esfuerzo-reposo, cuyo resultado podría haber sido equívoco debido al estado clínico de la paciente durante la inyección del radiofármaco (AU)
Gated-SPECT myocardial perfusion imaging is a widely used technique indicated for assessment of patients with no clear diagnosis of ischemic heart disease. Early rest gated-SPECT myocardial perfusion study in patients with acute chest pain has high sensitivity and high negative predictive value for ruling out coronary disease. We report a case of a patient admitted for the study of her chest pain. She underwent a myocardial perfusion stress-rest whose interpretation could have been equivocal due to the clinical status of the patient during the injection of the radiotracer (AU)
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Humanos , Femenino , Anciano , Tomografía Computarizada por Emisión de Fotón Único Sincronizada Cardíaca/métodos , Tecnecio Tc 99m Sestamibi , Isquemia Miocárdica , Electrocardiografía , Dolor en el PechoRESUMEN
Gated-SPECT myocardial perfusion imaging is a widely used technique indicated for assessment of patients with no clear diagnosis of ischemic heart disease. Early rest gated-SPECT myocardial perfusion study in patients with acute chest pain has high sensitivity and high negative predictive value for ruling out coronary disease. We report a case of a patient admitted for the study of her chest pain. She underwent a myocardial perfusion stress-rest whose interpretation could have been equivocal due to the clinical status of the patient during the injection of the radiotracer.
Asunto(s)
Tomografía Computarizada por Emisión de Fotón Único Sincronizada Cardíaca/métodos , Dolor en el Pecho/diagnóstico por imagen , Isquemia Miocárdica/diagnóstico por imagen , Imagen de Perfusión Miocárdica/métodos , Anciano , Cateterismo Cardíaco , Diabetes Mellitus Tipo 2/complicaciones , Electrocardiografía , Prueba de Esfuerzo , Reacciones Falso Negativas , Femenino , Humanos , Hipertrigliceridemia/complicaciones , Radiofármacos , Tecnecio Tc 99m SestamibiRESUMEN
BACKGROUND: Subungual melanoma (SUM) is a rare entity, comprising approximately 0·7-3·5% of all melanoma subtypes. SUM histopathologically belongs to the acral lentiginous pathological subtype of malignant melanoma. Its diagnosis is helped by dermoscopy but pathological examination of doubtful cases is required. Classical management of SUM is based on radical surgery, namely distal phalanx amputation. Conservative treatment with nonamputative wide excision of the nail unit followed by a skin graft has been insufficiently reported in the medical literature even though it is performed in many centres. OBJECTIVES: To report a series of patients with in situ or minimally invasive SUM treated by conservative surgery, to investigate the postoperative evolution and to evaluate the outcome with a review of the literature. METHODS: We performed a retrospective extraction study from our melanoma register of all patients with in situ and minimally invasive SUM treated with conservative surgery in the University Hospital Department of Dermatology, Lyon, France from 2004 to 2009. The patient demographics, disease presentation, delay to diagnosis, histopathology and postoperative evolution were reviewed. RESULTS: Seven cases of SUM treated as such were identified in our melanoma database. All cases had a clinical presentation of melanonychia striata. The mean delay to diagnosis was 2years. Surgical excision of the entire nail unit with a 5-10mm safety margin without bone resection followed by full-thickness skin graft taken from the arm was performed in all cases. No recurrence was observed with a mean follow-up of 45months. Functional results were found satisfactory by all patients and their referring physicians. Sixty-two other cases have been found in the literature and are also discussed. CONCLUSIONS: Conservative surgical management in patients with in situ or minimally invasive SUM is a procedure with good cosmetic and functional outcome and, in our cases as well as in the literature, the prognosis is not changed.
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Melanoma/cirugía , Enfermedades de la Uña/cirugía , Neoplasias Cutáneas/cirugía , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trasplante de Piel/métodos , Colgajos QuirúrgicosAsunto(s)
Nevo Pigmentado/patología , Neoplasias Cutáneas/patología , Adolescente , Mama , Femenino , HumanosRESUMEN
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No disponible
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Humanos , Femenino , Persona de Mediana Edad , Diálisis Peritoneal/efectos adversos , Derrame Pleural/etiología , Derrame PleuralAsunto(s)
Anomalías Múltiples/diagnóstico por imagen , Albúminas/farmacocinética , Aorta/diagnóstico por imagen , Fístula Arterio-Arterial/diagnóstico por imagen , Pulmón/irrigación sanguínea , Angiografía por Resonancia Magnética , Radiofármacos/farmacocinética , Tetralogía de Fallot/cirugía , Relación Ventilacion-Perfusión , Adolescente , Aorta/anomalías , Fístula Arterio-Arterial/congénito , Circulación Colateral , Humanos , Masculino , CintigrafíaRESUMEN
OBJECTIVE: To study the influence of the 18F-FDG radioactive concentration and the usual greatest storage time of the radiopharmaceutical at the Radiopharmacy Unit (RU) over its radiochemical purity. MATERIAL AND METHODS: Thirty 18F-FDG preparations coming from different batches were studied. The radiochemical purity was determined at the RU by means of TLC to saline-diluted (1:10) and undiluted samples of each preparation, in the early 30 minutes since its arrival and 5 hours later. The radiochemical purity of the original 18F-FDG was determined at the PET radiopharmaceutical producer Laboratory (PETL) by means of HPLC in the early hour since the 18F-FDG dispensing. RESULTS: The increase of 18F-Fluoride found in the (5 h-30 min) period was significantly greater in the samples without diluting than in the diluted ones (p < 0.0001). We found a significant correlation between the percent of this increase of 18F-Fluoride (y) and the radioactive concentration of the 18F-FDG (x): y = 0.00061x + 0.1759 (R2 = 0.198; p < 0.0005). The percent of 18F-Fluoride determined at the RU was significantly higher than the percent of 18F-Fluoride determined at the PETL (p < 0.0001). A significant correlation between the differences of the percent of 18F-Fluoride determined by TLC and HPLC (y) and the radioactive concentration (x) was found: y = 0.0139x + 0.3146 (R2 = 0.196; p = 0.016). A significant correlation among the differences of percent 18F-Fluoride determined by TLC and HPLC ([%F] RU - [%F] PETL), the radioactive concentration (RC) and the time since the radiopharmaceutical dispensing (t) was found: [%F] RU - [%F] PETL = 0.01159*RC (mCi/mL) + 0.250*t (h) - 0.01903 (R2 = 0.226; p < 0.014). CONCLUSIONS: The stability of the 18F-FDG preparations with time increases when diminishing its concentration. We recommended the dilution of these preparations with physiological saline solution.
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Fluorodesoxiglucosa F18/química , Acetilación , Cromatografía Líquida de Alta Presión , Estabilidad de Medicamentos , Almacenaje de Medicamentos , Radioisótopos de Flúor/análisis , Radiactividad , Factores de TiempoRESUMEN
Objetivo. Determinar la influencia de la concentración radiactiva de la 2-[ 18F]-fluoro-2-desoxi-D-glucosa ( 18F-FDG) y el tiempo de almacenamiento máximo habitual del radiofármaco en la Unidad de Radiofarmacia (UR) sobre su pureza radioquímica. Material y métodos. Se estudiaron 30 preparaciones de 18F-FDG procedentes de lotes diferentes. Se determinó la pureza radioquímica en la UR dentro de los 30 minutos siguientes a su recepción y a las 5 horas mediante cromatografía en capa fina (TLC) a las muestras diluidas con suero salino fisiológico (1:10) y sin diluir. La pureza radioquímica también se determinó en el Laboratorio de radiofármacos PET (LPET) dentro de la primera hora posterior a su dispensación por cromatografía líquida a alta presión (HPLC). Resultados. El aumento de porcentaje de 18F-Fluoruro a las 5 horas fue significativamente mayor en las muestras sin diluir que en las diluidas (p < 0,0001), encontrándose una correlación significativa entre el aumento de porcentaje de 18F-Fluoruro con el tiempo (y) respecto a la concentración radiactiva (x): y = 0,0061x + 0,1759 (R 2 = 0,1977; p < 0,0005). El porcentaje de 18F-Fluoruro determinado en la UR fue significativamente mayor que el determinado en el LPET (p < 0,0001), obteniéndose una correlación significativa entre el aumento de porcentaje de 18F-Fluoruro (y) y la concentración radiactiva (x): y = 0,0139x + 0,3146 (R 2 = 0,196; p = 0,016). Se obtuvo una correlación significativa entre este aumento ([ %F] UR [ %F] LPET), la concentración radiactiva (CR) y el tiempo desde la dispensación (t): [ %F] UR [ %F] LPET = 0,01159*CR (mCi/ml) + 0,250*t (h) 0,01903 (R 2 = 0,226; p = 0,014). Conclusiones. La estabilidad de las preparaciones de 18F-FDG aumenta al disminuir su concentración. Aconsejamos la dilución de estas preparaciones con solución salina fisiológica
Objective. To study the influence of the 18F-FDG radioactive concentration and the usual greatest storage time of the radiopharmaceutical at the Radiopharmacy Unit (RU) over its radiochemical purity. Material and methods. Thirty 18F-FDG preparations coming from different batches were studied. The radiochemical purity was determined at the RU by means of TLC to saline-diluted (1:10) and undiluted samples of each preparation, in the early 30 minutes since its arrival and 5 hours later. The radiochemical purity of the original 18F-FDG was determined at the PET radiopharmaceutical producer Laboratory (PETL) by means of HPLC in the early hour since the 18F-FDG dispensing. Results. The increase of 18F-Fluoride found in the (5 h-30 min) period was significantly greater in the samples without diluting than in the diluted ones (p < 0,0001). We found a significant correlation between the percent of this increase of 18F-Fluoride (y) and the radioactive concentration of the 18F-FDG (x): y = 0,00061x + 0,1759 (R 2 = 0,198; p < 0,0005). The percent of 18F-Fluoride determined at the RU was significantly higher than the percent of 18F-Fluoride determined at the PETL (p < 0,0001). A significant correlation between the differences of the percent of 18F-Fluoride determined by TLC and HPLC (y) and the radioactive concentration (x) was found: y = 0,0139x + 0,3146 (R 2 = 0,196; p = 0,016). A significant correlation among the differences of percent 18F-Fluoride determined by TLC and HPLC ([ %F] RU [ %F] PETL), the radioactive concentration (RC) and the time since the radiopharmaceutical dispensing (t) was found: [ %F] RU [ %F] PETL = 0,01159*RC (mCi/mL) + 0,250*t (h) 0,01903 (R 2 = 0,226; p < 0,014). Conclusions. The stability of the 18F-FDG preparations with time increases when diminishing its concentration. We recommended the dilution of these preparations with physiological saline solution