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1.
Sci Total Environ ; 891: 164060, 2023 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-37230344

RESUMO

The feeding of wild birds is a popular but often controversial activity. This study explored differences in demographics, attitudes, and normative beliefs between waterbird feeders and non-feeders at an urban wetland residential estate in Melbourne, Australia. An online survey of nearby residents and visitors (n = 206) identified those who have fed waterbirds at least once in the past two years (feeders; 32.4 %) and those who have not (non-feeders). No differences were observed in demographic profile or connection to nature between feeders and non-feeders, but feeders were significantly more likely to believe that waterbird feeding is an acceptable activity. When compared with non-feeders, feeders exhibited different injunctive and descriptive norms relating to waterbird feeding; feeders believed that most people would be relatively happy with them feeding waterbirds in their community, while non-feeders thought that most people would be moderately unhappy. Feeders believed that more than half of the people in their community fed waterbirds (55.5 %), while non-feeders believed that less than half fed birds (36.7 %). These findings suggest that education or behaviour change programs with bird feeding objectives could be enhanced with information about the actual and perceived social norms for this common activity.


Assuntos
Aves , Áreas Alagadas , Animais , Austrália , Demografia , Inquéritos e Questionários
3.
Socioecol Pract Res ; 5(1): 79-92, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36714059

RESUMO

Boundary spanners are individuals able to reach across organizational borders to build relationships and interconnections to help better manage complex problems. What is not clear, however, are the skills that allow boundary spanners to cross diverse scales, sectors, and organizations. To address this gap, we use a qualitative case study approach to examine evidence for how boundary spanning skills are implemented in the context of stakeholder engagement for addressing water challenges in agricultural settings. We employ a hybrid deductive-inductive thematic analysis approach to examine interview data collected with 25 stakeholder participants as well as direct observation of engagement behavior. Interview instruments were designed to elicit responses related to six deductively derived skills of boundary spanning: relationship builder, authentic leadership, trustworthiness, autonomy, perspective-taking, and effective science communication. Our inductive analysis identified evidence for three additional boundary spanning skills. Our study finds that some boundary spanning skills were exhibited more than others, and their frequency of use varied throughout the engagement process, and certain skills were used interchangeably. This research provides guidance on what boundary spanning looks like in action, and thus provides guidance on identifying and enhancing these skills in stakeholder engagement for water resource management.

4.
Environ Manage ; 71(2): 421-431, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36370177

RESUMO

The Western United States is experiencing historic drought, increasing pressure on water management systems. Agricultural production that relies on surface water flows is therefore imperiled, requiring new innovations and partnerships in order to adapt and survive. In Arizona, some agriculture continues to rely on historic, low-tech irrigation infrastructure such as hand-dug open ditches that divert river water to flood fields. These ditch systems are managed through both formal ditch companies and informal associations. To address changing water availability and needs, ditch users regularly "tinker" with water infrastructure, experimenting and making changes beyond the original infrastructure plans. Such changes are informed and driven by local social relationships and realities of the physical infrastructure. These dynamics are critical to understanding the adaptive capacity and flexibility of the water system; however, they are challenging to recognize and record. In this paper, we apply the emerging conceptualization of sociotechnical tinkering to examine the adaptive management of irrigation ditches in the Verde Valley of Arizona. We find evidence that water users frequently tinker with their water delivery and monitoring infrastructure to respond to and anticipate changes in water availability. Viewed through the lens of sociotechnical tinkering, these interactions are understood as the material manifestations of situated practice and actor agency within a water management system. This case study contributes to literature on adaptive environmental management and the hydrosocial cycle.


Assuntos
Meio Ambiente , Água , Água/química , Agricultura , Abastecimento de Água
5.
Socioecol Pract Res ; 4(4): 283-304, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36407755

RESUMO

Participatory approaches to science and decision making, including stakeholder engagement, are increasingly common for managing complex socio-ecological challenges in working landscapes. However, critical questions about stakeholder engagement in this space remain. These include normative, political, and ethical questions concerning who participates, who benefits and loses, what good can be accomplished, and for what, whom, and by who. First, opportunities for addressing justice, equity, diversity, and inclusion interests through engagement, while implied in key conceptual frameworks, remain underexplored in scholarly work and collaborative practice alike. A second line of inquiry relates to research-practice gaps. While both the practice of doing engagement work and scholarly research on the efficacy of engagement is on the rise, there is little concerted interplay among 'on-the-ground' practitioners and scholarly researchers. This means scientific research often misses or ignores insight grounded in practical and experiential knowledge, while practitioners are disconnected from potentially useful scientific research on stakeholder engagement. A third set of questions concerns gaps in empirical understanding of the efficacy of engagement processes and includes inquiry into how different engagement contexts and process features affect a range of behavioral, cognitive, and decision-making outcomes. Because of these gaps, a cohesive and actionable research agenda for stakeholder engagement research and practice in working landscapes remains elusive. In this review article, we present a co-produced research agenda for stakeholder engagement in working landscapes. The co-production process involved professionally facilitated and iterative dialogue among a diverse and international group of over 160 scholars and practitioners through a yearlong virtual workshop series. The resulting research agenda is organized under six cross-cutting themes: (1) Justice, Equity, Diversity, and Inclusion; (2) Ethics; (3) Research and Practice; (4) Context; (5) Process; and (6) Outcomes and Measurement. This research agenda identifies critical research needs and opportunities relevant for researchers, practitioners, and policymakers alike. We argue that addressing these research opportunities is necessary to advance knowledge and practice of stakeholder engagement and to support more just and effective engagement processes in working landscapes. Supplementary Information: The online version contains supplementary material available at 10.1007/s42532-022-00132-8.

6.
J Biomech ; 135: 111015, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35259658

RESUMO

Horizontal jumps are discrete, fast, over-ground movements requiring coordination of the centre of mass (CoM) and base of support and are routinely assessed in sports settings. There is currently no biomechanics-based system to aid in their quick and objective large-scale assessment. We describe a practical system combining a single low-cost depth-sensing camera and point-cloud processing (PCP) to capture whole-body CoM and foot kinematics. Fourteen participants performed 10 single-leg horizontal jumps for distance. Foot displacement, CoM displacement, CoM peak velocity and CoM peak acceleration in the anterior-posterior direction of movement were compared with a reference 15-segment criterion model, captured concurrently using a nine-camera motion capture system (Vicon Motion Systems, UK). Between-system Pearson's correlations were very-large to near-perfect (n = 140; foot displacement = 0.99, CoM displacement = 0.98, CoM peak velocity = 0.97, CoM peak acceleration = 0.79), with mean biases being trivial-small (-0.07 cm [0.12%], 3.8 cm [3.5%], 0.03 m·s-1 [1.6%], 0.42 m·s-2 [7%], respectively) and typical errors being trivial-small for displacement (foot: 0.92 cm [0.8%]; CoM: 3.8 cm [3.4%]) and CoM peak velocity (0.07 m·s-1 [4.3%]), and large for CoM peak acceleration (0.72 m·s-2 [15%]). Limits of agreement were -1.9 to 2.0 cm for foot displacement, -11.3 to 3.6 cm for CoM displacement, -0.17 to 0.12 m·s-1 for CoM peak velocity and -2.28 to 1.43 m·s-2 for CoM peak acceleration. The practical system captured CoM and foot kinematics during horizontal jumps with acceptable precision. Further work to improve estimates of CoM accelerations and different populations are warranted.


Assuntos
Computação em Nuvem , , Aceleração , Fenômenos Biomecânicos , Humanos , Extremidade Inferior
7.
Front Neurosci ; 15: 758427, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34690689

RESUMO

Objective: Intuitive control of conventional prostheses is hampered by their inability to provide the real-time tactile and proprioceptive feedback of natural sensory pathways. The macro-sieve electrode (MSE) is a candidate interface to amputees' truncated peripheral nerves for introducing sensory feedback from external sensors to facilitate prosthetic control. Its unique geometry enables selective control of the complete nerve cross-section by current steering. Unlike previously studied interfaces that target intact nerve, the MSE's implantation requires transection and subsequent regeneration of the target nerve. Therefore, a key determinant of the MSE's suitability for this task is whether it can elicit sensory percepts at low current levels in the face of altered morphology and caliber distribution inherent to axon regeneration. The present in vivo study describes a combined rat sciatic nerve and behavioral model developed to answer this question. Approach: Rats learned a go/no-go detection task using auditory stimuli and then underwent surgery to implant the MSE in the sciatic nerve. After healing, they were trained with monopolar electrical stimuli with one multi-channel and eight single-channel stimulus configurations. Psychometric curves derived by the method of constant stimuli (MCS) were used to calculate 50% detection thresholds and associated psychometric slopes. Thresholds and slopes were calculated at two time points 3 weeks apart. Main Results: For the multi-channel stimulus configuration, the average current required for stimulus detection was 19.37 µA (3.87 nC) per channel. Single-channel thresholds for leads located near the nerve's center were, on average, half those of leads located near the periphery (54.92 µA vs. 110.71 µA, or 10.98 nC vs. 22.14 nC). Longitudinally, 3 of 5 leads' thresholds decreased or remained stable over the 3-week span. The remaining two leads' thresholds increased by 70-74%, possibly due to scarring or device failure. Significance: This work represents an important first step in establishing the MSE's viability as a sensory feedback interface. It further lays the groundwork for future experiments that will extend this model to the study of other devices, stimulus parameters, and task paradigms.

9.
J Sci Med Sport ; 23(9): 866-871, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32061525

RESUMO

OBJECTIVES: This study examined the acute effect of small-sided-game (SSG) and resistance training sequence on neuromuscular, endocrine and mood response over a 24-h (h) period. DESIGN: Repeated measures. METHODS: Fourteen semi-professional soccer players performed SSG-training (4vs4+goalkeepers; 6×7-min, 2-min inter-set recovery) followed by resistance training 2h later (back-squat, Romanian deadlift, barbell-hip-thrust; 4×4 repetitions, 4-min inter-set recovery; 85% 1 rep-max) (SSG+RES), and on a separate week reversed the session order (RES+SSG). Physical demands of SSG's were monitored using global positioning systems (GPS) and ratings of perceived exertion (RPE). Countermovement-jump (CMJ; peak power output; jump height) and brief assessment of mood were collected before (pre), during (0h) and after (+24h) both protocols. Salivary testosterone and cortisol concentrations were obtained at the same time-points but with the inclusion of a measure immediately prior to the second training session (+2h). RESULTS: GPS outputs and RPE were similar between SSG-training during both protocols. Between-protocol comparisons revealed no significant differences at +24h in CMJ performance, mood, and endocrine markers. Testosterone was higher at 0h during RES+SSG in comparison to SSG+RES (moderate-effect; +21.4±26.7pgml-1; p=0.010), yet was similar between protocols by +2h. CONCLUSIONS: The order of SSG and resistance training does not appear to influence the physical demands of SSG's with sufficient recovery between two sessions performed on the same day. Session order did not influence neuromuscular, endocrine or mood responses at +24h, however a favourable testosterone response from the resistance first session may enhance neuromuscular performance in the second session of the day.


Assuntos
Afeto/fisiologia , Desempenho Atlético/fisiologia , Hidrocortisona/metabolismo , Condicionamento Físico Humano/métodos , Treinamento Resistido/métodos , Futebol/fisiologia , Testosterona/metabolismo , Adulto , Sistemas de Informação Geográfica , Voluntários Saudáveis , Humanos , Masculino , Inquéritos e Questionários , Adulto Jovem
10.
J Sci Med Sport ; 23(1): 69-74, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31526664

RESUMO

OBJECTIVES: This study profiled the 24h neuromuscular, endocrine and mood responses to a single versus a double training day in soccer players. DESIGN: Repeated measures. METHODS: Twelve semi-professional soccer players performed small-sided-games (SSG's; 4 vs 4+goalkeepers; 6×7-min, 2-min inter-set recovery) with neuromuscular (peak-power output, PPO; jump height, JH), endocrine (salivary testosterone, cortisol), and mood measures collected before (pre) and after (0h, +24h). The following week, the same SSG protocol was performed with an additional lower body strength training session (back-squat, Romanian deadlift, barbell hip thrust; 4×4 repetitions, 4-min inter-set recovery; 85% 1 rep-max) added at 2h after the SSG's. RESULTS: Between-trial comparisons revealed possible to likely small impairments in PPO (2.5±2.2Wkg-1; 90% Confidence Limits: ±2.2Wkg-1), JH (-1.3; ±2.0cm) and mood (4.6; ±6.1AU) in response to the double versus single sessions at +24h. Likely to very likely small favourable responses occurred following the single session for testosterone (-15.2; ±6.1pgml-1), cortisol (0.072; ±0.034ugdl-1) and testosterone/cortisol ratio (-96.6; ±36.7AU) at +24h compared to the double session trial. CONCLUSIONS: These data highlight that performance of two training sessions within a day resulted in possible to very likely small impairments of neuromuscular performance, mood score and endocrine markers at +24h relative to a single training session day. A strategy of alternating high intensity explosive training days containing multiple sessions with days emphasising submaximal technical/tactical activities may be beneficial for those responsible for the design and delivery of soccer training programs.


Assuntos
Afeto , Desempenho Atlético/fisiologia , Hidrocortisona/análise , Futebol/fisiologia , Testosterona/análise , Atletas , Fadiga , Humanos , Masculino , Condicionamento Físico Humano , Saliva/química , Carga de Trabalho , Adulto Jovem
11.
J Prosthet Dent ; 121(2): 234-236, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30017161

RESUMO

This article describes a technique for measuring the length of the edentulous space to be restored and transferring the same size of the dentate space on the contralateral side to plan for symmetrical definitive restorations for the restorative dentist and orthodontist. The technique involves incorporating 2 archwire locks with hooks on a stainless steel wire that can be easily moved and adjusted to assess the curved space being measured.


Assuntos
Prótese Dentária , Estética Dentária , Arcada Parcialmente Edêntula/reabilitação , Desenho de Aparelho Ortodôntico , Instrumentos Odontológicos , Humanos , Fios Ortodônticos , Aço Inoxidável
12.
J Endod ; 44(12): 1802-1811, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30477666

RESUMO

INTRODUCTION: Regeneration of the pulp-dentin complex is the penultimate goal of regenerative endodontic procedures (REPs). Histological outcomes have demonstrated reparative tissue formation in human teeth extracted post-REPs. However, lack of accurate characterization has precluded identification of the true nature of tissues formed post-REP. METHODS: Here, we present 2 case reports of tooth #29 and #9 treated with REPs and demonstrate their clinical, radiographic, and histological outcomes. RESULTS: Clinical outcomes revealed healing of apical periodontitis in both teeth and re-establishment of vitality responses in tooth #29. Moreover, radiographic assessments using 2D and 3D-volumetric analyses demonstrate considerable increase in root development for both teeth. Further, histological outcomes evaluated using Hematoxylin and Eosin and immunohistochemical staining demonstrates presence of vascular and lymphatic structures as well as immune cell markers indicative of regeneration of an immunocompetent pulp. Lastly, examination of hard tissue deposition shows dentin-like tissue in parts of tooth #29 demonstrating for the first time, regeneration of a pulp-dentin complex post-REP. CONCLUSIONS: Collectively, this is the first study demonstrating recapitulation of several tissues commonly found as part of a pulp-dentin complex in teeth treated with REPs.


Assuntos
Polpa Dentária/fisiologia , Dentina/fisiologia , Periodontite Periapical , Regeneração , Endodontia Regenerativa/métodos , Raiz Dentária/fisiologia , Criança , Polpa Dentária/diagnóstico por imagem , Polpa Dentária/imunologia , Polpa Dentária/inervação , Necrose da Polpa Dentária/terapia , Dentina/diagnóstico por imagem , Dentina/imunologia , Dentina/inervação , Feminino , Humanos , Imageamento Tridimensional , Regeneração Nervosa , Periodontite Periapical/diagnóstico por imagem , Periodontite Periapical/patologia , Periodontite Periapical/fisiopatologia , Periodontite Periapical/terapia , Radiografia Dentária , Raiz Dentária/diagnóstico por imagem , Raiz Dentária/imunologia , Raiz Dentária/inervação , Resultado do Tratamento , Cicatrização
13.
J Esthet Restor Dent ; 30(5): 457-463, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30284754

RESUMO

OBJECTIVE: To compare color change magnitude of an infiltrative resin and a flowable composite resin after immersion in commonly consumed beverages. MATERIALS AND METHODS: Disks (1 × 9 mm) of a flowable composite (Filtek Supreme Ultra Flowable) and a resin-infiltrative product (Icon) were made. Specimens were dark-stored in tap water (24 hours). Baseline color parameters (CIE L*a*b*) were obtained using a colorimeter (Easyshade V4, VITA). Specimens were immersed (dark stored, 37°C, 1 week) in commercial beverages: Kool-Aid, coffee, Coca-Cola, and tap water (control). ΔE00 between final and baseline conditions for each material/beverage combination was determined (N = 10/group). Initial analysis of variance indicated significant impact of major factors/interactions on ΔE00 . Subsequently, t-tests between ΔE00 values of restorative materials within each beverage was performed: alpha 0.05. RESULTS: Kool-Aid produced the greatest color change for flowable composite, with a ΔE00 significantly greater than the infiltrative product. No significant ΔE00 differences were noted between products immersed in coffee, however color parameters causing these differences were not similar. Water or Coca-Cola immersion showed lowest ΔE00 values for both materials, considered visually imperceptible: ΔE00 values <0.8. CONCLUSIONS: Color change potential of infiltrative resin or resin composite was highly dependent on beverage type, with no general trends observed in which material was affected more. CLINICAL SIGNIFICANCE: Staining potential of an infiltrative restorative resin differs from that of a filled, flowable composite material on a beverage-by-beverage basis. The potential for color change seems not related to the presence or absence of fillers in the restorative material.


Assuntos
Resinas Compostas , Estética Dentária , Cor , Materiais Dentários , Teste de Materiais , Coloração e Rotulagem , Propriedades de Superfície
14.
Clin Radiol ; 73(10): 837-838, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30057331
15.
Scand J Med Sci Sports ; 28(2): 658-666, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28544170

RESUMO

We examined the effects of a 12-week program of Nordic hamstring exercises (NHE), administered before or after football training, upon eccentric hamstring strength, muscle activity, and architectural adaptations. Amateur soccer players were randomized into three groups. The control group (CON; n=11) undertook core stability exercises, whereas a periodized NHE program was delivered either before (NHEBEF ; n=10) or after (NHEAFT ; n=14) biweekly training sessions. Outcome measures included peak torque and concomitant normalized peak surface electromyography signals (sEMG) of the biceps femoris (BF) and medial hamstring (MH) muscles during knee flexor maximal eccentric contractions, performed at 30°·s-1 . Ultrasonography was used to determine BF muscle thickness, muscle fiber pennation angle, and fascicle length. Performing the NHE derived likely moderate peak torque increases in both NHEBEF (+11.9%; 90% confidence interval: 3.6%-20.9%) and NHEAFT (+11.6%; 2.6%-21.5%) vs CON. Maximum sEMG increases were moderately greater in the BF of both NHE training groups vs CON. There were likely moderate increases in BF muscle thickness (+0.17 cm; 0.05-0.29 cm) and likely small pennation angle increases (+1.03°; -0.08° to 2.14°) in NHEAFT vs CON and NHEBEF . BF fascicle length increases were likely greater in NHEBEF (+1.58 cm; 0.48-2.68 cm; small effect) vs CON and NHEAFT . A 12-week eccentric hamstring strengthening program increased strength and sEMG to a similar magnitude irrespective of its scheduling relative to the football training session. However, architectural adaptations to support the strength gains differed according to the timing of the injury prevention program.


Assuntos
Traumatismos em Atletas/prevenção & controle , Músculos Isquiossurais/lesões , Condicionamento Físico Humano , Futebol/lesões , Adulto , Eletromiografia , Humanos , Masculino , Força Muscular , Treinamento Resistido , Torque , Adulto Jovem
16.
Br J Surg ; 104(13): 1791-1801, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28990651

RESUMO

BACKGROUND: This study assessed the feasibility of a preoperative high-intensity interval training (HIT) programme in patients awaiting elective abdominal aortic aneurysm repair. METHODS: In this feasibility trial, participants were allocated by minimization to preoperative HIT or usual care. Patients in the HIT group were offered three exercise sessions per week for 4 weeks, and weekly maintenance sessions if surgery was delayed. Feasibility and acceptability outcomes were: rates of screening, eligibility, recruitment, retention, outcome completion, adverse events and adherence to exercise. Data on exercise enjoyment (Physical Activity Enjoyment Scale, PACES), cardiorespiratory fitness (anaerobic threshold and peak oxygen uptake), quality of life, postoperative morbidity and mortality, duration of hospital stay and healthcare utilization were also collected. RESULTS: Twenty-seven patients were allocated to HIT and 26 to usual care (controls). Screening, eligibility, recruitment, retention and outcome completion rates were 100 per cent (556 of 556), 43·2 per cent (240 of 556), 22·1 per cent (53 of 240), 91 per cent (48 of 53) and 79-92 per cent respectively. The overall exercise session attendance rate was 75·8 per cent (276 of 364), and the mean(s.d.) PACES score after the programme was 98(19) ('enjoyable'); however, the intensity of exercise was generally lower than intended. The mean anaerobic threshold after exercise training (adjusted for baseline score and minimization variables) was 11·7 ml per kg per min in the exercise group and 11·4 ml per kg per min in controls (difference 0·3 (95 per cent c.i. -0·4 to 1·1) ml per kg per min). There were trivial-to-small differences in postoperative clinical and patient-reported outcomes between the exercise and control groups. CONCLUSION: Despite the intensity of exercise being generally lower than intended, the findings support the feasibility and acceptability of both preoperative HIT and the trial procedures. A definitive trial is warranted. Registration number: ISRCTN09433624 ( https://www.isrctn.com/).


Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Treinamento Intervalado de Alta Intensidade , Cuidados Pré-Operatórios , Idoso , Limiar Anaeróbio , Aptidão Cardiorrespiratória , Procedimentos Cirúrgicos Eletivos , Estudos de Viabilidade , Feminino , Treinamento Intervalado de Alta Intensidade/economia , Humanos , Masculino , Consumo de Oxigênio , Cooperação do Paciente , Medidas de Resultados Relatados pelo Paciente , Qualidade de Vida , Reino Unido
18.
J Biomech Eng ; 139(8)2017 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-28462423

RESUMO

We have proposed a long-term, noninvasive, nonrestrictive method of delivering and implanting a biosensor within the body via a swallowable implantation capsule robot (ICR). The design and preliminary validation of the ICR's primary subsystem-the sensor deployment system-is discussed and evidence is provided for major design choices. The purpose of the sensor deployment system is to adhere a small biosensor to the mucosa of the intestine long-term, and the modality was inspired by tapeworms and other organisms that employ a strategy of mechanical adhesion to soft tissue via the combined use of hooks or needles and suckers. Testing was performed to refine the design of the suction and needle attachment as well as the sensor ejection features of the ICR. An experiment was conducted in which needle sharpness, needle length, and vacuum volume were varied, and no statistically significant difference was observed. Finally, preliminary testing, coupled with prior work within a live porcine model, provided evidence that this is a promising approach for implanting a biosensor within the small intestine.


Assuntos
Técnicas Biossensoriais/instrumentação , Próteses e Implantes , Robótica/instrumentação , Animais , Cápsulas , Desenho de Equipamento , Suínos
19.
Clin Radiol ; 71(11): 1184-92, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27519974

RESUMO

AIM: To assess safety and accuracy of transvaginal ultrasound (TVUS)-guided biopsy in achieving a diagnosis of peritoneal carcinomatosis (PC). MATERIALS AND METHODS: This was a retrospective study comprising a cohort of 54 consecutive women aged 18-85 years referred from the gynaecological oncology multidisciplinary team meeting (MDTM) who attended for TVUS-guided biopsy procedures in a tertiary oncology centre over a 4-year period (2010-2014). Clinicopathological validation was assessed using online patient records and radiological information systems. An independent oncologist assessed patient outcomes. RESULTS: The procedure was successful in all 19 patients with suspected recurrent malignancy with diagnosis validated against previous histology. Successful histological confirmation was achieved in 31 of 35 patients with suspected PC, which was thereafter validated by histology from subsequent surgery and favourable response to site-specific therapies (n=22). In three patients with suspected PC, the procedure did not result in biopsy as a suitable target could not be identified. Another woman had two false-negative biopsies. Thus overall a site-specific and subtype cancer diagnosis was obtained for 50 women giving an overall patient success rate of 93% (50/54). There were no procedure-related complications. CONCLUSION: TVUS core biopsy is a safe, effective, well-tolerated, and valuable technique in modern oncological management of PC when other diagnostic options are unavailable.


Assuntos
Recidiva Local de Neoplasia/diagnóstico por imagem , Recidiva Local de Neoplasia/patologia , Neoplasias Pélvicas/diagnóstico por imagem , Neoplasias Pélvicas/patologia , Neoplasias Peritoneais/diagnóstico por imagem , Neoplasias Peritoneais/patologia , Ultrassonografia de Intervenção/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Biópsia Guiada por Imagem , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Adulto Jovem
20.
Clin Radiol ; 71(6): 501-6, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27005017

RESUMO

AIM: To analyse the positive rate for cancer on additional abdominopelvic computed tomography (CT) in patients with unprovoked venous thromboembolism (VTE), evaluate the subsequent emergence of a cancer diagnosis in the clinical follow-up period, and identify any possible predictive factors of cancer in this cohort, which may allow better selection of patients for additional imaging. MATERIALS AND METHODS: Consecutive adult patients with VTE were retrospectively identified in two large teaching hospitals between January 2013 and June 2014, including a subset of those with unprovoked VTE. Relevant demographic data were extracted and analysed. All patients had a minimum of 12 months clinicoradiological follow-up. RESULTS: One thousand four hundred and forty-six patients with VTE were deemed eligible, of which 699 (48%) were male; the median age (range) was 66 (16-102) years. The prevalence of pre-existing cancer in these patients was 343/1446 (24%), and 388/1446 (27%) were classified as unprovoked VTE. In 12/1446 (0.8%), cancer was diagnosed synchronously with VTE on the initial imaging investigation. Additional screening imaging was performed in 232/388 (60%) including abdominopelvic CT in 205 (53%) patients with unprovoked VTE. Only five additional cancers were identified, all of these occurring in patients with clinical symptoms suspicious for cancer. None of the additional CT examinations identified any clinically occult cancer in asymptomatic patients, and subsequent mean follow-up of 22 (SD=6) months also failed to reveal any further cancer diagnosis. CONCLUSION: Contrary to the National Institute of Health and Care Excellence (NICE) guidance, the yield of performing additional abdominopelvic CT as a screening tool for occult cancer in asymptomatic patients with unprovoked VTE is negligible. A more selective and clinically-driven assessment of these patients is recommended.


Assuntos
Detecção Precoce de Câncer/métodos , Neoplasias/diagnóstico por imagem , Neoplasias/epidemiologia , Tomografia Computadorizada por Raios X/métodos , Tromboembolia Venosa/diagnóstico por imagem , Tromboembolia Venosa/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Causalidade , Comorbidade , Detecção Precoce de Câncer/estatística & dados numéricos , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Pelve/diagnóstico por imagem , Prognóstico , Radiografia Abdominal/métodos , Radiografia Abdominal/estatística & dados numéricos , Reprodutibilidade dos Testes , Medição de Risco/métodos , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Reino Unido/epidemiologia , Adulto Jovem
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