RESUMO
Background: This study aims to evaluate the value of computed tomography (CT) in detecting arterial injuries in abdominopelvic trauma compared with digital subtraction angiography (DSA). Methods: A retrospective study was performed on 83 patients (67 men, 16 women with a mean age of 38.2 years) who were hospitalized with abdominopelvic trauma and were diagnosed by CT with arterial injuries including active extravasation (AE), pseudoaneurysm (PA), and arteriovenous fistula (AVF). The findings on the CT images were interpreted and its value as a diagnostic modality was analyzed compared with images taken from patients who underwent DSA from June 2020 to November 2021. Results: A total of 94 arterial lesions were observed on CT (54 AE, 37 PA, and 3 AVF). The sensitivity (Se), specificity (Sp), positive predictive values (PPV), and negative predictive values (NPV) on the arterial phase when diagnosing AE were 88.9%, 90%, 92.3%, and 85.7%, respectively, and 86.1%, 91.4 %, 86.1%, and 91.4%, respectively, when diagnosing PA. On the portal venous phase, the Se, Sp, PPV, NPV for AE were 88.9%, 92.5%, 94.1%, and 86.0%, respectively, and 75%, 91.4%, 84.4%, and 85.5%, respectively, for PA. On the dual phase, the Se, Sp, PPV, and NPV for AE were 92.6%, 90%, 92.6%, and 90%, respectively, 88.9%, 91.4%. 86.5%, and 93%, respectively, for PA, and 75%, 100%, 100%, and 98.9%, respectively for AVF. Conclusions: Our study showed that CT is a useful, non-invasive modality for detecting arterial injuries in abdominopelvic trauma. A dual-phase scan combined with arterial and portal venous phases gives the optimal performance.
Assuntos
Ferimentos não Penetrantes , Adulto , Angiografia Digital , Feminino , Humanos , Masculino , Estudos Retrospectivos , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X/métodos , Ferimentos não Penetrantes/diagnóstico por imagemRESUMO
The optimal design of reserve networks and fisheries closures depends on species occurrence information and knowledge of how anthropogenic impacts interact with the species concerned. However, challenges in surveying mobile and cryptic species over adequate spatial and temporal scales can mask the importance of particular habitats, leading to uncertainty about which areas to protect to optimize conservation efforts. We investigated how telemetry-derived locations can help guide the scale and timing of fisheries closures with the aim of reducing threatened species bycatch. Forty juvenile speartooth sharks (Glyphis glyphis) were monitored over 22 months with implanted acoustic transmitters and an array of hydrophone receivers. Using the decision-support tool Marxan, we formulated a permanent fisheries closure that prioritized areas used more frequently by tagged sharks and considered areas perceived as having high value to fisheries. To explore how the size of the permanent closure compared with an alternative set of time-area closures (i.e., where different areas were closed to fishing at different times of year), we used a cluster analysis to group months that had similar arrangements of selected planning units (informed by shark movements during that month) into 2 time-area closures. Sharks were consistent in their timing and direction of migratory movements, but the number of tagged sharks made a big difference in the placement of the permanent closure; 30 individuals were needed to capture behavioral heterogeneity. The dry-season (May-January) and wet-season (February-April) time-area closures opened 20% and 25% more planning units to fishing, respectively, compared with the permanent closure with boundaries fixed in space and time. Our results show that telemetry has the potential to inform and improve spatial management of mobile species and that the temporal component of tracking data can be incorporated into prioritizations to reduce possible impacts of spatial closures on established fisheries.
Uso de Información de Movimiento Basada en Individuos para Identificar las Prioridades de Conservación Espacial para las Especies Móviles Resumen El diseño óptimo de redes de reservas y los cierres de pesquerías depende de la información sobre la presencia de especies y del conocimiento sobre cómo los impactos antropogénicos interactúan con las especies afectadas. Sin embargo, las dificultades que existen al monitorear especies móviles y crípticas en escalas espaciales y temporales adecuadas pueden enmascarar la importancia de los hábitats particulares, lo que resulta en incertidumbre con respecto a cuáles áreas proteger para optimizar los esfuerzos de conservación. Investigamos cómo las ubicaciones derivadas de la telemetría pueden ayudar a guiar la escala y el momento justo del cierre de las pesquerías con el objetivo de reducir la captura accesoria de especies amenazadas. Se monitorearon 40 tiburones lanza juveniles (Glyphis glyphis) durante 22 meses con transmisores acústicos implantados y una selección de receptores hidrofónicos. Con la herramienta de apoyo para la toma de decisiones Marxan, formulamos un cierre de pesquerías permanente que priorizó las áreas usadas con frecuencia por los tiburones marcados y que consideraba a las áreas percibidas como altamente valiosas para las pesquerías. Para explorar cómo el tamaño del cierre permanente se comparaba con un conjunto de cierres con áreas y tiempos alternativos (es decir, donde las áreas se cerraron a la pesca en diferentes momentos del año) usamos un análisis de clúster para agrupar los meses que tuvieron arreglos similares a las unidades de planeación seleccionadas (informadas por el movimiento de los tiburones durante ese mes) en dos cierres de tiempo-área. Los tiburones fueron consistentes en el tiempo y dirección de sus movimientos migratorios, pero el número de tiburones marcados generó una gran diferencia en la ubicación del cierre permanente; se necesitaron 30 individuos para capturar la heterogeneidad del comportamiento. Los cierres de tiempo-área de la temporada de secas (mayo - enero) y la de lluvias (febrero - abril) abrieron a la pesca un 20% y 25% más de unidades de planeación, respectivamente, en comparación con el cierre permanente con barreras fijas en el tiempo y el espacio. Nuestros resultados muestran que la telemetría tiene el potencial para informar y mejorar el manejo espacial de las especies móviles y que el componente temporal de los datos de rastreo puede ser incorporado a las priorizaciones para reducir los posibles impactos del manejo sobre las pesquerías establecidas.