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1.
Eur J Radiol ; 165: 110921, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37336037

RESUMO

PURPOSE: To evaluate whether the Prostate Imaging Quality (PI-QUAL) score impacts prostate cancer (PCa) staging on MRI. The secondary goal was to test inter-reader agreement among radiologists experienced in prostate imaging. METHOD: A retrospective, single-center study with patients who underwent 3 Tesla prostate MRI scans and were submitted to radical prostatectomy (RP) between January 2018 and November 2021 and were eligible for our study. Extraprostatic extension (EPE) data were collected from original MR reports (EPEm) and pathological reports of RP specimens (EPEp). Three expert prostate radiologists (ESUR/ESUI criteria R1, R2, R3) independently evaluated all MRI exams according to PI-QUAL score for image quality (1 to 5; 1: poor, 5: excellent), blinded to original imaging reports and clinical data. We studied the diagnostic performance of MRI using pooled data from PI-QUAL scores (≤3 vs. ≥4). We also performed univariate and multivariate analyses to assess the PI-QUAL score impact on local PCa staging. Cohen's K and Tau-b Kendall tests were used to assess the inter-reader agreement for PI-QUAL score, T2WI, DWI, and DCE. RESULTS: Our final cohort included 146 patients, of which 27.4% presented EPE on pathology. We observed no impact of imaging quality on accuracy for EPE prediction: AUC of 0.750 (95% CI 0.26-1) for PI-QUAL ≤ 3 and 0.705 (95% CI 0.618-0.793) for PI-QUAL ≥ 4. The multivariate analysis demonstrated a correlation of EPEm (OR 3.25, p 0.001) and ISUP grade group (OR 1.89, p 0.012) to predict EPEp. The inter-reader agreement was moderate to substantial (0.539 for R1-R2, 0.522 for R2-R3, and 0.694 for R1-R3). CONCLUSION: Our clinical impact evaluation showed no direct correlation between MRI quality by PI-QUAL score and accuracy in detecting EPE in patients undergoing RP. Additionally, we had moderate to a substantial inter-reader agreement for the PI-QUAL score.


Assuntos
Próstata , Neoplasias da Próstata , Masculino , Humanos , Próstata/diagnóstico por imagem , Próstata/patologia , Estudos Retrospectivos , Imageamento por Ressonância Magnética/métodos , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/cirurgia , Neoplasias da Próstata/patologia , Prostatectomia/métodos
2.
Ann Vasc Surg ; 93: 71-78, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36805426

RESUMO

BACKGROUND: Most studies on focusing on the prevalence of vascular anomalies are either aimed to determine the individual occurrence of a specific type among known bearers of abnormalities or propose an estimation of prevalence for the general population by extrapolating from the paediatric population. In this scenario, we intended to assess the profile of vascular anomalies in a group of patients subjected to imaging studies, throughout a long period of time, to evaluate the frequency of abnormal findings in a consecutive, nonselected population. METHODS: This is a retrospective review of 996,569 computed tomography and magnetic resonance studies between 2009 and 2019. Findings were grouped as vascular tumours (hemangiomas; vascular tumours), cavernomas, and vascular malformations. Positive findings were evaluated with regard to patients' demographic characteristics and anatomic distribution and the subset of vascular malformations was also evaluated with regard to size, classification in accordance to flow pattern, and Hamburg Classification. RESULTS: Eighteen thousand four hundred thirty positive examinations were evaluated (mean age, 55.82 ± 15.43 years; 8,188 men). Vascular anomalies were present in 18.49 per 1,000 examinations (17.41 hemangiomas; 0.69 cavernomas and 0.39 vascular malformations per 1,000 examinations). Hemangiomas and cavernomas were homogeneous in anatomic location between sexes throughout the age groups. Complex malformations were heterogeneous in anatomic distribution between the sexes in each age group, with intracranial findings decreasing for female patients in older groups. CONCLUSIONS: Vascular anomalies were found in 18.49 per 1,000 examinations. Hemangiomas and cavernomas were homogenously distributed, whereas complex malformations displayed a heterogeneous anatomic distribution pattern between sexes in each age group.


Assuntos
Hemangioma Cavernoso , Hemangioma , Malformações Vasculares , Neoplasias Vasculares , Criança , Masculino , Humanos , Adulto , Feminino , Idoso , Pessoa de Meia-Idade , Incidência , Resultado do Tratamento , Malformações Vasculares/diagnóstico por imagem , Malformações Vasculares/epidemiologia
3.
Sci Data ; 9(1): 487, 2022 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-35948551

RESUMO

Chest radiographs allow for the meticulous examination of a patient's chest but demands specialized training for proper interpretation. Automated analysis of medical imaging has become increasingly accessible with the advent of machine learning (ML) algorithms. Large labeled datasets are key elements for training and validation of these ML solutions. In this paper we describe the Brazilian labeled chest x-ray dataset, BRAX: an automatically labeled dataset designed to assist researchers in the validation of ML models. The dataset contains 24,959 chest radiography studies from patients presenting to a large general Brazilian hospital. A total of 40,967 images are available in the BRAX dataset. All images have been verified by trained radiologists and de-identified to protect patient privacy. Fourteen labels were derived from free-text radiology reports written in Brazilian Portuguese using Natural Language Processing.


Assuntos
Algoritmos , Processamento de Linguagem Natural , Radiografia Torácica , Brasil , Humanos , Raios X
4.
Appl Psychophysiol Biofeedback ; 47(2): 85-94, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35006474

RESUMO

To evaluate the heart rate response, emotion and changes in anxiety and anger levels after exposure to unpleasant pictures from the International Assessment Pictures System (IAPS) compared with neutral picture exposure in healthy individuals. Forty participants (23 women) visited the laboratory on two occasions. State anger and state anxiety levels were evaluated pre- and post-visualization of a set of IAPS pictures and heart rate was monitored during exposure. Two different picture sets were utilized-one with neutral pictures (that served as the control) and the other with unpleasant pictures. State anxiety and state anger were higher in post-unpleasant session for women than before (p < 0.001). For men, only state anxiety was higher in the post-unpleasant session (p < 0.001). State anxiety (p = 0.004) and state anger (p < 0.001) post-unpleasant session was higher for women than in men. The pleasure and dominance domains were lower in the unpleasant session for both men and women (p < 0.001), and the arousal domain was higher for both men and women (p < 0.001) than in the neutral session. In the unpleasant session, arousal was higher (p = 0.004), and dominance was lower (p < 0.001) among women than among men, but no difference in pleasure was found (p > 0.05). For women, average heart rate was higher on unpleasant session, compared to neutral (p = 0.01), but not for men (p > 0.05). Women are more sensitive and react strongly to unpleasant picture exposure. The IAPS unpleasant session was not able to induce anger levels in men.


Assuntos
Nível de Alerta , Emoções , Ira , Ansiedade , Nível de Alerta/fisiologia , Emoções/fisiologia , Feminino , Frequência Cardíaca , Humanos , Masculino
5.
Front Plant Sci ; 12: 749533, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34868135

RESUMO

The detection of spatial variability in field trials has great potential for accelerating plant breeding progress due to the possibility of better controlling non-genetic variation. Therefore, we aimed to evaluate a digital soil mapping approach and a high-density soil sampling procedure for identifying and adjusting spatial dependence in the early sugarcane breeding stage. Two experiments were conducted in regions with different soil classifications. High-density sampling of soil physical and chemical properties was performed in a regular grid to investigate the structure of spatial variability. Soil apparent electrical conductivity (ECa) was measured in both experimental areas with an EM38-MK2® sensor. In addition, principal component analysis (PCA) was employed to reduce the dimensionality of the physical and chemical soil data sets. After conducting the PCA and obtaining different thematic maps, we determined each experimental plot's exact position within the field. Tons of cane per hectare (TCH) data for each experiment were obtained and analyzed using mixed linear models. When environmental covariates were considered, a previous forward model selection step was applied to incorporate the variables. The PCA based on high-density soil sampling data captured part of the total variability in the data for Experimental Area 1 and was suggested to be an efficient index to be incorporated as a covariate in the statistical model, reducing the experimental error (residual variation coefficient, CVe). When incorporated into the different statistical models, the ECa information increased the selection accuracy of the experimental genotypes. Therefore, we demonstrate that the genetic parameter increased when both approaches (spatial analysis and environmental covariates) were employed.

7.
Rev. Assoc. Méd. Rio Gd. do Sul ; 65(2): 01022105, Abr. - Jun. 2021.
Artigo em Português | LILACS | ID: biblio-1367459

RESUMO

RESUMO Introdução: A cirurgia de confecção de ostomia é um procedimento corriqueiro que envolve diversos fatores ambientais, psicossociais e técnicos. Porém este procedimento gera limitações na vida do paciente, seja ele permanente ou temporário. Objetivo: Descrever o perfil epidemiológico dos pacientes que realizaram ostomias no Hospital Nossa Senhora da Conceição de Tubarão-SC e associar com suas comorbidades de acordo com o Índice de Comorbidades de Charlson (ICC). Métodos: Estudo de corte transversal descritivo, incluiu 79 pacientes ostomizados durante o período de 2008 a 2018. Resultados: Houve maior prevalência do sexo masculino (60,8%), a principal causa foi neoplasia de cólon (41,8%), as complicações tardias mais frequentes foram hérnia (21,5%), prolapso (17,7%) e fistula (15,2%). A pontuação do ICC foi a mais elevada (maior gravidade) nos pacientes com neoplasia de cólon. Os pacientes do sexo masculino apresentaram oito vezes mais risco de prolapso e três vezes mais risco de hérnia. Pacientes com ostomia permanente apresentaram ICC mais elevado que os de temporária. Conclusão: Estratégias de prevenção e avaliação das comorbidades são fundamentais para o seguimento de pacientes ostomizados. PALAVRA-CHAVE: Estomia, colostomia, ileostomia, comorbidade


ABSTRACT Introduction: Ostomy surgery is a common procedure that involves several environmental, psychosocial and technical factors. However, this procedure generates limitations in the patient's life, whether it is permanent or temporary. Objective: To describe the epidemiological profile of patients who underwent ostomies at the Hospital Nossa Senhora da Conceição in Tubarão-SC and associate it with their comorbidities according to the Charlson Comorbidity Index (CCI). Methods: A descriptive cross-sectional study included 79 ostomy patients from 2008 to 2018. Results: There was a higher prevalence of males (60.8%), the main cause was colon cancer (41.8%), the more frequent late complications were hernia (21.5%), prolapse (17.7%) and fistula (15.2%). The CCI score was the highest (greater severity) in patients with colon cancer. Male patients had an eight-fold higher risk of prolapse and three-fold higher risk of of hernia. Patients with permanent ostomy had higher CCI than temporary ones. Conclusion: Strategies of prevention and assessment of comorbidities are essential for the follow-up of ostomy patients. KEYWORDS: Ostomy, colostomy, ileostomy, comorbidity


Assuntos
Humanos , Estomia , Colostomia , Ileostomia , Comorbidade
8.
Einstein (Sao Paulo) ; 19: eRW5772, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33729289

RESUMO

Ground-glass opacity is a very frequent and unspecified finding in chest computed tomography. Therefore, it admits a wide range of differential diagnoses in the acute context, from viral pneumonias such as influenza virus, coronavirus disease 2019 and cytomegalovirus and even non-infectious lesions, such as vaping, pulmonary infarction, alveolar hemorrhage and pulmonary edema. For this diagnostic differentiation, ground glass must be correlated with other findings in imaging tests, with laboratory tests and with the patients' clinical condition. In the context of a pandemic, it is extremely important to remember the other pathologies with similar findings to coronavirus disease 2019 in the imaging exams.


Assuntos
COVID-19/diagnóstico por imagem , Pneumopatias/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Infecções por Citomegalovirus/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Influenza Humana/diagnóstico por imagem , Pneumonia Viral/classificação , Tomografia Computadorizada por Raios X
9.
Einstein (Säo Paulo) ; 19: eRW5772, 2021. graf
Artigo em Inglês | LILACS | ID: biblio-1154099

RESUMO

ABSTRACT Ground-glass opacity is a very frequent and unspecified finding in chest computed tomography. Therefore, it admits a wide range of differential diagnoses in the acute context, from viral pneumonias such as influenza virus, coronavirus disease 2019 and cytomegalovirus and even non-infectious lesions, such as vaping, pulmonary infarction, alveolar hemorrhage and pulmonary edema. For this diagnostic differentiation, ground glass must be correlated with other findings in imaging tests, with laboratory tests and with the patients' clinical condition. In the context of a pandemic, it is extremely important to remember the other pathologies with similar findings to coronavirus disease 2019 in the imaging exams.


RESUMO A opacidade em vidro fosco é uma alteração muito frequente e pouco específica na tomografia computadorizada de tórax. Ela admite grande leque de diagnósticos diferenciais no contexto agudo, desde pneumonias virais, como as causadas pelo vírus influenza, pela doença do coronavírus 2019 e pelo citomegalovírus, até mesmo lesões de origem não infecciosa, como vaping , infarto pulmonar, hemorragia alveolar e edema pulmonar. Para essa diferenciação diagnóstica, deve-se correlacionar o vidro fosco com os demais achados nos exames de imagem, exames laboratoriais e quadro clínico do paciente. É de suma importância, no contexto de pandemia, recordar as demais patologias com os achados semelhantes aos da doença do coronavírus 2019 nos exames de imagem.


Assuntos
Humanos , Pneumonia Viral/diagnóstico por imagem , COVID-19/diagnóstico por imagem , Pneumopatias/diagnóstico por imagem , Pneumonia Viral/classificação , Tomografia Computadorizada por Raios X , Infecções por Citomegalovirus/diagnóstico por imagem , Diagnóstico Diferencial , Influenza Humana/diagnóstico por imagem
10.
Rev.Soc. Bras. Clín. Med. ; 19(4): 238-241, 2021.
Artigo em Português | LILACS | ID: biblio-1401228

RESUMO

Objetivo: Avaliar a incidência e a evolução da Covid-19 em indivíduos com diagnóstico prévio de doença renal crônica estágio 5D e também comparar diabéticos e não diabéticos. Métodos: Foi analisada a mortalidade por Covid-19 em pacientes com doença renal crônica estágio 5D sem diabetes e no subgrupo de pacientes diabéticos. A comparação da idade média entre diabéticos e não diabéticos e pacientes que morreram e sobreviventes foi realizada por meio do teste t de Student para amostras independentes. A proporção de óbitos entre diabéticos e não diabéticos foi calculada pelo teste do qui-quadrado de Pearson. Resultados: A pro- porção de óbitos entre pacientes diabéticos e não diabéticos com doença renal crônica estágio 5D foi significativamente diferente (p=0,0245; razão de chance de 5,03; IC95% 1,26-21,84). A idade média foi de 55,0±15,6, e 15 pacientes (35,7%) eram diabéticos e significativamente mais velhos que os não diabéticos (p=0,0233). Não foi observada diferença na proporção de diabéticos entre homens e mulheres (p=0,5758) e nem na idade média entre diabéticos e não diabéticos (p=0,1829). Conclusão: A mortalidade por Covid-19 em pacientes com doença renal crônica estágio 5D é significativamente maior do que na população em geral, e este estudo mostrou diabetes mellitus e idade como fatores de risco adicionais para mortalidade nesta população.


Objective: To evaluate the incidence and progression of Covid-19 in individuals previously diagnosed with stage 5 chronic kidney disease and compare diabetic and nondiabetic indi- viduals. Methods: Covid-19 mortality in nondiabetic 5 chronic kidney disease patients and in the subgroup of diabetic patients was analyzed. The average age comparison between diabetic and nondiabetic patients and those who died and survived was performed using Student t test for independent samples. The proportion of deaths between diabetics and nondiabetics was calculated using Pearson's Chi-squared test. Results: The proportion of deaths between diabetic and nondiabetic 5 chronic kid- ney disease patients was significantly different (p=0.0245), odds ratio of 5.03 (95%CI= 1.26-21.84). The average age was 55.0±15.6, and 15 patients (35.7%) were diabetic and significantly older than nondiabetic (p=0.0233). No difference was observed in the proportion of diabetics between men and women (p=0.5758) or in the average age between diabetics and nondiabetics (p=0.1829). Conclusion: Covid-19 mortality in 5 chronic kidney disease patients is significantly higher than in general popula- tion and this study has shown diabetes mellitus and age as ad- ditional risk factors for mortality in this population.


Assuntos
Humanos , Diabetes Mellitus , Insuficiência Renal Crônica , COVID-19/mortalidade , Fatores de Risco , Fatores Etários , Diálise
11.
Einstein (Sao Paulo) ; 18: eRC5831, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33084795

RESUMO

The COVID-19 became a pandemic in early 2020. It was found, at first, that the main manifestations of this new virus occur through respiratory and constitutional symptoms. Therefore, chest tomography was elected as the best imaging test to assess the extent of pulmonary involvement and as a good prognostic predictor for the disease. However, as new studies were produced, the gastrointestinal involvement of COVID-19 becomes more evident, with reports from patients who manifested mainly or only gastrointestinal symptoms in the course of the disease. Thus, in some cases, the initial investigation is carried out at the emergency department with an abdominal computed tomography. We report a case series of ten patients who came to the emergency department of our institution with a chief gastrointestinal complaint, and were initially submitted to an abdominal computed tomography as the first investigation. Although most of the patients did not have significant changes in the abdominal images, most reported patients had pulmonary findings visualized at the lung bases, which were later designated as typical COVID-19 pulmonary findings on chest computed tomography. Only one patient had atypical COVID-19 lung changes on chest computed tomography. All patients had a positive real-time polymerase chain reaction for COVID-19. It is imperative to alert radiologists, especially abdominal radiologists, with the possibility of COVID-19 isolated gastrointestinal symptoms. Besides, it must become a habit to radiologists to assess the pulmonary basis on abdominal scans, a site commonly affected by the new coronavirus.


Assuntos
Dor Abdominal/diagnóstico por imagem , Infecções por Coronavirus/diagnóstico , Coronavirus/isolamento & purificação , Pulmão/diagnóstico por imagem , Pneumonia Viral/diagnóstico , Tomografia Computadorizada por Raios X/métodos , Dor Abdominal/etiologia , Betacoronavirus , COVID-19 , Teste para COVID-19 , Técnicas de Laboratório Clínico , Coronavirus/genética , Humanos , Pandemias , Reação em Cadeia da Polimerase em Tempo Real , SARS-CoV-2
12.
Zootaxa ; 4819(2): zootaxa.4819.2.3, 2020 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-33055659

RESUMO

Brachycephalus bufonoides was described as a "variety" of B. ephippium based on two specimens which 90 years later was considered full species. Besides its brief original description, nothing else is known for this species. Herein we report the rediscovery of the pumpkin-toadlet Brachycephalus bufonoides from Nova Friburgo, State of Rio de Janeiro, the second most populous area within the Atlantic Forest in Brazil. A detailed osteological description of this species was also provided, including skull, hyolaryngeal skeleton and postcranium skeleton. The laryngeal skeleton of Brachycephalus genus was depicted for the first time. We conducted a molecular phylogenetic analysis of Brachycephalus using DNA sequences comprising two fragments of mitochondrial gene (16S). Both analysis with Bayesian inference and maximum parsimony supported the recognition of B. bufonoides as an exclusive lineage, allocated within the B. ephippium species group in B. vertebralis lineage. We improved the diagnosis and variation of the species, including more collected specimens, coloration in vivo and advertisement call description. Compared with its congeners, B. bufonoides has skin on head and dorsum with dermal hyperossification; skull with hyperossification of postorbital crests; a pair of hyperossified bulges about equidistant between postorbital crests; fourth presacral vertebra with transverse process hyperossified, ornamented and sacral diapophyses hyperossified, which can be seen externally (lineage of B. vertebralis sensu Condez et al. 2020); presence of dermal ossification as separated bulges of each vertebrae; general background color orange with different intensities of dark orange blotches on dorsum, including bordering of sacral region; absence of osteoderms and presence of warts on the dorsolateral surface of body; medium body size (SVL of adults: 12.0-14.5 mm for males and 14.7-16.3 mm for females; Table 1); rough dorsum; advertisement calls with 13 to 17 pulses; presence of pulse period modulation; and advertisement calls with notes longer than 0.2 s (0.22 to 0.31 s). Herein an important contribution for the taxonomy and systematics of this genus is provided, including a large amount of novel information for B. bufonoides from different sources (i.e., molecular, morphological variation, bioacoustic), allowing it to be included in future studies of species delimitation and relationships within Brachycephalus. Also, the discovery of this species reiterates the importance of Nova Friburgo for the conservation of the Atlantic Forest biodiversity.


Assuntos
Acústica , Anuros , Animais , Teorema de Bayes , Feminino , Masculino , Filogenia
14.
Molecules ; 25(19)2020 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-33023070

RESUMO

The jabuticaba is a native Brazilian fruit that has aroused worldwide interest in terms of its nutritional composition and biological activity. However, research on the profile of volatile compounds (VOCs) emitted by these fruits is rare. This study presents the first identification of VOCs from four jabuticaba species. The aim of the study was to characterize the aromatic profile of the following species: 'Sabará' (Plinia jaboticaba), 'Escarlate' (Plinia phitrantha × Plinia cauliflora), 'Otto Andersen' (Plinia cauliflora), and 'Esalq' (Plinia phitrantha). The analysis was performed by headspace solid-phase microextraction combined with gas chromatography/mass spectrometry (SPME-GC-MS). Multivariate analysis techniques applying the partial least squares-discriminant analysis (PLS-DA) and heatmap were used to compare the results. Fruit quality parameters were determined in terms of fresh mass (g), skin color, soluble solids, and titratable acidity. A total of 117 VOCs was identified including terpenoids, esters, alcohols, aldehydes, alkanes, ketones, and carboxylic acids, with 36 VOCs common to all four species. Terpenes were the majority for all jabuticabas with smaller contributions from other volatile classes, especially ß-cubebene, ß-elemene, and D-limonene for the 'Otto Andersen' jabuticaba.


Assuntos
Fenômenos Químicos , Myrtaceae/química , Compostos Orgânicos Voláteis/análise , Odorantes/análise , Análise de Componente Principal
17.
Einstein (Sao Paulo) ; 18: eRW5741, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32578687

RESUMO

The disease caused by the new coronavirus, or COVID-19, has been recently described and became a health issue worldwide. Its diagnosis of certainty is given by polymerase chain reaction. High-resolution computed tomography, however, is useful in the current context of pandemic, especially for the most severe cases, in assessing disease extent, possible differential diagnoses and searching complications. In patients with suspected clinical symptoms and typical imaging findings, in which there is still no laboratory test result, or polymerase chain reaction is not available, the role of this test is still discussed. In addition, it is important to note that part of the patients present false-negative laboratory tests, especially in initial cases, which can delay isolation, favoring the spread of the disease. Thus, knowledge about the COVID-19 and its imaging manifestations is extremely relevant for all physicians involved in the patient care, clinicians or radiologists.


Assuntos
Infecções por Coronavirus/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Tórax/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Betacoronavirus , COVID-19 , Diagnóstico Diferencial , Humanos , Linfadenopatia/diagnóstico por imagem , Pandemias , Derrame Pleural/diagnóstico por imagem , SARS-CoV-2
19.
Einstein (Säo Paulo) ; 18: eRC5831, 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1133760

RESUMO

ABSTRACT The COVID-19 became a pandemic in early 2020. It was found, at first, that the main manifestations of this new virus occur through respiratory and constitutional symptoms. Therefore, chest tomography was elected as the best imaging test to assess the extent of pulmonary involvement and as a good prognostic predictor for the disease. However, as new studies were produced, the gastrointestinal involvement of COVID-19 becomes more evident, with reports from patients who manifested mainly or only gastrointestinal symptoms in the course of the disease. Thus, in some cases, the initial investigation is carried out at the emergency department with an abdominal computed tomography. We report a case series of ten patients who came to the emergency department of our institution with a chief gastrointestinal complaint, and were initially submitted to an abdominal computed tomography as the first investigation. Although most of the patients did not have significant changes in the abdominal images, most reported patients had pulmonary findings visualized at the lung bases, which were later designated as typical COVID-19 pulmonary findings on chest computed tomography. Only one patient had atypical COVID-19 lung changes on chest computed tomography. All patients had a positive real-time polymerase chain reaction for COVID-19. It is imperative to alert radiologists, especially abdominal radiologists, with the possibility of COVID-19 isolated gastrointestinal symptoms. Besides, it must become a habit to radiologists to assess the pulmonary basis on abdominal scans, a site commonly affected by the new coronavirus.


RESUMO A COVID-19 foi declarada uma pandemia no início de 2020. Constatou-se, inicialmente, que as principais manifestações desse novo vírus ocorrem por meio de sintomas respiratórios e constitucionais. A tomografia do tórax foi eleita o exame de imagem para avaliar a extensão do comprometimento pulmonar e como um fator preditivo do prognóstico para a doença. No entanto, à medida que novos estudos são produzidos, o envolvimento gastrointestinal da COVID-19 torna-se mais evidente, com relatos de pacientes que manifestaram principalmente ou apenas sintomas gastrointestinais no decorrer da doença. Em alguns casos, a investigação inicial é realizada no pronto-socorro, com tomografia computadorizada do abdome. Relatamos uma série de casos de dez pacientes que compareceram ao serviço de emergência da instituição com uma queixa principal gastrointestinal e foram submetidos inicialmente a uma tomografia computadorizada de abdome como primeira investigação. Embora a maioria dos pacientes não tenha apresentado alterações significativas nas imagens abdominais, eles apresentaram achados pulmonares visualizados nas bases pulmonares, que depois foram caracterizadas como achados pulmonares típicos de COVID-19 nas tomografias de tórax subsequentes. Apenas um paciente apresentou achados atípicos para COVID-19 na tomografia. Todos os pacientes tiveram reação em cadeia da polimerase em tempo real positiva para o novo coronavírus. É muito importante alertar os radiologistas, principalmente os radiologistas abdominais, da possibilidade de sintomas gastrointestinais isolados no contexto da COVID-19. Além disso, deve ser um hábito para todos os radiologistas avaliar as bases pulmonares nas tomografias de abdome, local comumente afetado pela COVID-19.


Assuntos
Humanos , Pneumonia Viral/diagnóstico , Tomografia Computadorizada por Raios X/métodos , Dor Abdominal/diagnóstico por imagem , Infecções por Coronavirus/diagnóstico , Coronavirus/isolamento & purificação , Pulmão/diagnóstico por imagem , Dor Abdominal/etiologia , Coronavirus/genética , Técnicas de Laboratório Clínico , Pandemias , Reação em Cadeia da Polimerase em Tempo Real , Betacoronavirus , Teste para COVID-19 , SARS-CoV-2 , COVID-19
20.
Einstein (Säo Paulo) ; 18: eRW5741, 2020. graf
Artigo em Inglês | LILACS | ID: biblio-1133785

RESUMO

ABSTRACT The disease caused by the new coronavirus, or COVID-19, has been recently described and became a health issue worldwide. Its diagnosis of certainty is given by polymerase chain reaction. High-resolution computed tomography, however, is useful in the current context of pandemic, especially for the most severe cases, in assessing disease extent, possible differential diagnoses and searching complications. In patients with suspected clinical symptoms and typical imaging findings, in which there is still no laboratory test result, or polymerase chain reaction is not available, the role of this test is still discussed. In addition, it is important to note that part of the patients present false-negative laboratory tests, especially in initial cases, which can delay isolation, favoring the spread of the disease. Thus, knowledge about the COVID-19 and its imaging manifestations is extremely relevant for all physicians involved in the patient care, clinicians or radiologists.


RESUMO A doença causada pelo novo coronavírus, ou COVID-19, foi descrita recentemente e tornou-se uma questão de saúde mundial. Seu diagnóstico de certeza é dado pela reação em cadeia da polimerase. A tomografia computadorizada de alta resolução, entretanto, mostra-se útil no contexto atual de pandemia, especialmente nos casos mais graves, na avaliação da extensão da doença, em possíveis diagnósticos diferenciais e na pesquisa de complicações. Em pacientes com quadro clínico suspeito e achados de imagem típicos, nos quais ainda não há resultado laboratorial ou a reação em cadeia da polimerase não se encontra disponível, ainda se discute o papel desse exame. Importante ressaltar que parte dos pacientes apresenta exames laboratoriais falsos-negativos, notadamente em casos iniciais, o que pode retardar medidas de isolamento, favorecendo a propagação da doença. Dessa forma, o conhecimento da COVID-19 e de suas manifestações nos exames de imagem é de extrema importância para os médicos envolvidos no atendimento, sejam clínicos ou radiologistas.


Assuntos
Humanos , Pneumonia Viral/diagnóstico por imagem , Tórax/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Infecções por Coronavirus/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Derrame Pleural/diagnóstico por imagem , Diagnóstico Diferencial , Pandemias , Linfadenopatia/diagnóstico por imagem , Betacoronavirus , SARS-CoV-2 , COVID-19
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