Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 32.623
Filtrar
1.
J Korean Med Sci ; 35(43): e391, 2020 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-33169560

RESUMO

Since mid-April 2020, cases of multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 that mimics Kawasaki disease (KD) have been reported in Europe and North America. However, no cases have been reported in Korea. We describe an 11-year old boy with fever, abdominal pain, and diarrhea who developed hypotension requiring inotropes in intensive care unit. His blood test revealed elevated inflammatory markers, thrombocytopenia, hypoalbuminemia, and coagulopathy. Afterward, he developed signs of KD such as conjunctival injection, strawberry tongue, cracked lip, and coronary artery dilatation, and parenchymal consolidation without respiratory symptoms. Microbiological tests were all negative including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription polymerase chain reaction. However, serum immunoglobulin G against SARS-CoV-2 was positive in repeated tests using enzyme-linked immunosorbent assay and fluorescent immunoassay. He was recovered well after intravenous immunoglobulin administration and discharged without complication on hospital day 13. We report the first Korean child who met all the criteria of MIS-C with features of incomplete KD or KD shock syndrome.


Assuntos
Infecções por Coronavirus/patologia , Pneumonia Viral/patologia , Síndrome de Resposta Inflamatória Sistêmica/diagnóstico , Abdome/diagnóstico por imagem , Anticorpos Antivirais/sangue , Betacoronavirus/genética , Betacoronavirus/imunologia , Criança , Infecções por Coronavirus/complicações , Infecções por Coronavirus/virologia , Humanos , Imunoglobulinas Intravenosas/administração & dosagem , Masculino , Síndrome de Linfonodos Mucocutâneos/patologia , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/virologia , Síndrome de Resposta Inflamatória Sistêmica/complicações , Tórax/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Ultrassonografia
2.
No Shinkei Geka ; 48(11): 1021-1027, 2020 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-33199659

RESUMO

We reported 10 cases of lumbo-peritoneal(L-P)shunt placement using the lateral approach without repositioning. Each patient was placed in a left lateral position under general anesthesia and fixed so that the spine did not rotate. The skin incision on the flank was made at the height of the L4 vertebral body, 4 cm in the left-right direction and 3cm in front of the vertebral body. The external oblique, internal oblique, and transverse abdominal muscles were dissected to reach the peritoneum and confirm that the intestinal tract was peristaltic below the peritoneum. The peritoneum was lifted with hooked tweezers in order to separate them from the intestinal tract, and the peritoneum was incised with a scalpel to reach the peritoneal cavity. Using a finger and a shunt passer, the ventral catheter was guided between the muscle layers. Preoperative abdominal CT showed that all 10 kidneys in this case series were cephalic from the predicted approach route. The ascending colons of three patients were partially in contact with the predicted approach route. During surgery, a ventral catheter could be inserted in all 10 cases. Postoperative abdominal CT showed no intraperitoneal hemorrhage or invasion into the retroperitoneal cavity of the ventral catheter. During the follow-up period, no invasion into the abdominal wall or infection was observed. The average operation time was 52.2 minutes. In order to avoid invasion into the retroperitoneal cavity, a surgical incision was performed without complications by incising the outer side of the lower abdomen and approaching via the external oblique aponeurosis.


Assuntos
Cateteres de Demora , Cavidade Peritoneal , Abdome , Humanos , Instrumentos Cirúrgicos , Derivação Ventriculoperitoneal
3.
Rev Med Suisse ; 16(712): 2026-2030, 2020 Oct 28.
Artigo em Francês | MEDLINE | ID: mdl-33112514

RESUMO

Vaginal cerclage can be used to treat cervical incompetence, thus reducing the risk of an unfavourable outcome. However, in some cases, it can be ineffective. One of the challenges for the gynaecologist-obstetrician is how to deal with a subsequent pregnancy after a failure of vaginal cerclage. The recently published MAVRIC study shows that performing abdominal cerclage prior or at the beginning of pregnancy reduces the rate of late miscarriage and premature delivery compared to vaginal cerclage. This implies a birth by caesarean section, and therefore a second surgery for the woman. However, it remains to determine the best surgical technique for abdominal cerclage. In the MAVIRC study, cerclage was done by laparotomy. It shall be elucidated whether this technique is superior to laparoscopy.


Assuntos
Abdome/cirurgia , Cerclagem Cervical , Incompetência do Colo do Útero/cirurgia , Vagina/cirurgia , Aborto Espontâneo/prevenção & controle , Cesárea , Feminino , Humanos , Laparoscopia , Laparotomia , Gravidez , Nascimento Prematuro/prevenção & controle
4.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1624-1628, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018306

RESUMO

Abdominal fat quantification is critical since multiple vital organs are located within this region. Although computed tomography (CT) is a highly sensitive modality to segment body fat, it involves ionizing radiations which makes magnetic resonance imaging (MRI) a preferable alternative for this purpose. Additionally, the superior soft tissue contrast in MRI could lead to more accurate results. Yet, it is highly labor intensive to segment fat in MRI scans. In this study, we propose an algorithm based on deep learning technique(s) to automatically quantify fat tissue from MR images through a cross modality adaptation. Our method does not require supervised labeling of MR scans, instead, we utilize a cycle generative adversarial network (C-GAN) to construct a pipeline that transforms the existing MR scans into their equivalent synthetic CT (s-CT) images where fat segmentation is relatively easier due to the descriptive nature of HU (hounsfield unit) in CT images. The fat segmentation results for MRI scans were evaluated by expert radiologist. Qualitative evaluation of our segmentation results shows average success score of 3.80/5 and 4.54/5 for visceral and subcutaneous fat segmentation in MR images*.


Assuntos
Abdome , Cavidade Abdominal , Abdome/diagnóstico por imagem , Tecido Adiposo/diagnóstico por imagem , Imagem por Ressonância Magnética , Tomografia Computadorizada por Raios X
5.
Zootaxa ; 4763(1): zootaxa.4763.1.7, 2020 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-33056881

RESUMO

A new genus and species of Hawaiian sabellid polychaete, Euchonoides moeone n. gen. et n. sp. is described. This new species has consistently been one of the most abundant polychaetes collected in Mamala Bay, Hawaii, reaching densities of 141,046 ind. m-2 and representing up to 30.6% of all polychaetes collected in that region. The species has a small body (~2 mm length) with a reduced number of abdominal chaetigers (8-10), and is distinguished by the presence of the following features: 1) three pairs of radioles; 2) radiolar skeleton with two longitudinal rows of cells from radiole base to third proximal pair of pinnules, remainder of each radiole skeleton with single rows of cells; 3) pinnules unpaired, alternating (snowflake arrangement); 4) thoracic uncini acicular with a large tooth above the main fang followed by a series of small ones; 5) thoracic chaetiger 3 enlarged; 6) a wide belt on third abdominal chaetiger; and 7) a pre-pygidial depression composed of three chaetigers, with lateral wings, among a combination of several others features. Histological sections have shown that the abdominal belt seems to be a clitellum-like structure where oogenesis takes place. The new genus is compared with other plesiomorphic genera sharing similar morphological features. Patterns of abundance of the new species are presented for the past 27 years in Mamala Bay.


Assuntos
Poliquetos , Abdome , Animais , Hawaii
6.
Rozhl Chir ; 99(7): 326-328, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32972152

RESUMO

INTRODUCTION: We present the case of a female patient with anterior primary perineal hernia. CASE REPORT: Our 63-year-old obese patient presented with recurrent “inguinal hernia“ at the Hernia Centre of Liberec. However, she was diagnosed with perineal hernia and was indicated for hernioplasty. Combined abdominal and perineal approach was used. One year has elapsed from the surgery and the patient shows no signs of recurrence. CONCLUSION: Primary perineal hernia is a challenge for every herniologist. We managed the case using a combined approach with the use of two meshes.


Assuntos
Hérnia Abdominal/diagnóstico por imagem , Hérnia Abdominal/cirurgia , Telas Cirúrgicas , Abdome , Feminino , Hérnia/diagnóstico por imagem , Herniorrafia , Humanos , Pessoa de Meia-Idade , Períneo/cirurgia
8.
Clin Imaging ; 67: 226-236, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32871427

RESUMO

PURPOSE: Digital radiography has the potential to improve the practice of radiography but it also has the potential to significantly increase patient doses. Considering rapidly growing digital radiography in many centers, concerns rise about increasing the collective dose of the human population and following health effects. This study aimed to estimate organ and effective doses and calculate the lifetime attributable risk (LAR) of cancer incidence and mortality in digital radiography procedures in Iran. METHODS: Organ and effective doses of 12 routine digital radiography examinations including the skull, cervical spine, chest, thoracic spine, lumbar spine, pelvic and abdomen were estimated using PCXMC software based on Monte Carlo simulation method. Then, LARs of cancer incidence and mortality were estimated using the BEIR VII method. RESULTS: Organ doses ranged from 0.01 to a maximum of 2.5 mGy while effective doses ranged from 0.01 to 0.7 mSv. Radiation risk showed dependence on the X-ray examination type and the patient's sex and age. In skull and cervical X-rays, the thyroid; in the chest and thoracic spine X-rays, the lung, and breast; and in the lumbar spine, pelvic and abdominal X-rays, the colon and bladder had the highest LAR of cancer incidence and mortality. Furthermore, younger patients and also females were at higher radiation risk. CONCLUSION: The lifetime attributable risk of cancer incidence and mortality due to radiation exposure is not trivial. Therefore efforts should be made to reduce patient doses while maintaining image quality.


Assuntos
Neoplasias Induzidas por Radiação/epidemiologia , Abdome , Mama , Feminino , Humanos , Incidência , Masculino , Método de Monte Carlo , Pescoço , Neoplasias Induzidas por Radiação/etiologia , Pelve , Doses de Radiação , Intensificação de Imagem Radiográfica , Radiografia , Fatores de Risco , Software , Coluna Vertebral , Tórax
9.
PLoS Genet ; 16(8): e1008976, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32866141

RESUMO

Neural circuitry for mating and reproduction resides within the terminal segments of central nervous system (CNS) which express Hox paralogous group 9-13 (in vertebrates) or Abdominal-B (Abd-B) in Drosophila. Terminal neuroblasts (NBs) in A8-A10 segments of Drosophila larval CNS are subdivided into two groups based on expression of transcription factor Doublesex (Dsx). While the sex specific fate of Dsx-positive NBs is well investigated, the fate of Dsx-negative NBs is not known so far. Our studies with Dsx-negative NBs suggests that these cells, like their abdominal counterparts (in A3-A7 segments) use Hox, Grainyhead (Grh) and Notch to undergo cell death during larval development. This cell death also happens by transcriptionally activating RHG family of apoptotic genes through a common apoptotic enhancer in early to mid L3 stages. However, unlike abdominal NBs (in A3-A7 segments) which use increasing levels of resident Hox factor Abdominal-A (Abd-A) as an apoptosis trigger, Dsx-negative NBs (in A8-A10 segments) keep the levels of resident Hox factor Abd-B constant. These cells instead utilize increasing levels of the temporal transcription factor Grh and a rise in Notch activity to gain apoptotic competence. Biochemical and in vivo analysis suggest that Abdominal-A and Grh binding motifs in the common apoptotic enhancer also function as Abdominal-B and Grh binding motifs and maintains the enhancer activity in A8-A10 NBs. Finally, the deletion of this enhancer by the CRISPR-Cas9 method blocks the apoptosis of Dsx-negative NBs. These results highlight the fact that Hox dependent NB apoptosis in abdominal and terminal regions utilizes common molecular players (Hox, Grh and Notch), but seems to have evolved different molecular strategies to pattern CNS.


Assuntos
Apoptose/genética , Proteínas de Ligação a DNA/genética , Proteínas de Drosophila/genética , Receptores Notch/genética , Fatores de Transcrição/genética , Abdome/crescimento & desenvolvimento , Animais , Sistema Nervoso Central/crescimento & desenvolvimento , Drosophila melanogaster/genética , Drosophila melanogaster/crescimento & desenvolvimento , Feminino , Regulação da Expressão Gênica no Desenvolvimento/genética , Larva/genética , Larva/crescimento & desenvolvimento , Masculino , Células-Tronco Neurais/metabolismo , Sequências Reguladoras de Ácido Nucleico/genética
10.
BMC Bioinformatics ; 21(Suppl 13): 382, 2020 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-32938394

RESUMO

BACKGROUND: Introducing deep learning approach to medical images has rendered a large amount of un-decoded information into usage in clinical research. But mostly, it has been focusing on the performance of the prediction modeling for disease-related entity, but not on the clinical implication of the feature itself. Here we analyzed liver imaging features of abdominal CT images collected from 2019 patients with stage I - III colorectal cancer (CRC) using convolutional neural network (CNN) to elucidate its clinical implication in oncological perspectives. RESULTS: CNN generated imaging features from the liver parenchyma. Dimension reduction was done for the features by principal component analysis. We designed multiple prediction models for 5-year metachronous liver metastasis (5YLM) using combinations of clinical variables (age, sex, T stage, N stage) and top principal components (PCs), with logistic regression classification. The model using "1st PC (PC1) + clinical information" had the highest performance (mean AUC = 0.747) to predict 5YLM, compared to the model with clinical features alone (mean AUC = 0.709). The PC1 was independently associated with 5YLM in multivariate analysis (beta = - 3.831, P < 0.001). For the 5-year mortality rate, PC1 did not contribute to an improvement to the model with clinical features alone. For the PC1, Kaplan-Meier plots showed a significant difference between PC1 low vs. high group. The 5YLM-free survival of low PC1 was 89.6% and the high PC1 was 95.9%. In addition, PC1 had a significant correlation with sex, body mass index, alcohol consumption, and fatty liver status. CONCLUSION: The imaging features combined with clinical information improved the performance compared to the standardized prediction model using only clinical information. The liver imaging features generated by CNN may have the potential to predict liver metastasis. These results suggest that even though there were no liver metastasis during the primary colectomy, the features of liver imaging can impose characteristics that could be predictive for metachronous liver metastasis.


Assuntos
Abdome/diagnóstico por imagem , Neoplasias Colorretais/secundário , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/diagnóstico por imagem , Redes Neurais de Computação , Tomografia Computadorizada por Raios X/métodos , Neoplasias Colorretais/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Período Pré-Operatório
11.
PLoS One ; 15(9): e0231431, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32881876

RESUMO

OBJECTIVE: To compare the radiation dose and the objective and subjective image quality of 80 kVp and 80/150 kVp with tin filter (80/Sn150 kVp) computed tomography (CT) in oncology patients. METHODS: One-hundred-and-forty-five consecutive oncology patients who underwent third-generation dual-source dual-energy CT of the abdomen for evaluation of malignant visceral, peritoneal, extraperitoneal, and bone tumor were retrospectively recruited. Two radiologists independently reviewed each observation in 80 kVp CT and 80/Sn150 kVp CT. Modified line-density profile of the tumor and contrast-to-noise ratio (CNR) were measured. Diagnostic confidence, lesion conspicuity, and subjective image quality were calculated and compared between image sets. The effective dose and size-specific dose estimate (SSDE) were calculated in the image sets. RESULTS: Modified line-density profile analysis revealed higher attenuation differences between the tumor and normal tissue in 80 kVp CT than in 80/Sn150 kVp CT (127 vs. 107, P = 0.05). The 80 kVp CT showed increased CNR in the liver (8.0 vs. 7.6) and the aorta (18.9 vs. 16.3) than the 80/Sn150 kVp CT. The 80 kVp CT yielded higher enhancement of organs (4.9 ± 0.2 vs. 4.7 ± 0.4, P<0.001) and lesion conspicuity (4.9 ± 0.3 vs. 4.8 ± 0.5, P = 0.035) than the 80/Sn150 kVp CT; overall image quality and confidence index were comparable. The effective dose was reduced by 45.2% with 80 kVp CT (2.3 mSv ± 0.9) compared to 80/Sn150 kVp CT (4.1 mSv ± 1.5). The SSDE was 7.4 ± 3.8 mGy on 80/Sn150 kVp CT and 4.1 ± 2.2 mGy on 80 kVp CT. CONCLUSIONS: The 80 kVp CT reduced the radiation dose by 45.2% in oncology patients while showing comparable or superior image quality to that of 80/Sn150 kVp CT for abdominal tumor evaluation.


Assuntos
Neoplasias/diagnóstico por imagem , Doses de Radiação , Intensificação de Imagem Radiográfica/instrumentação , Estanho , Tomografia Computadorizada por Raios X/instrumentação , Abdome/diagnóstico por imagem , Idoso , Algoritmos , Meios de Contraste/administração & dosagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pelve/diagnóstico por imagem , Intensificação de Imagem Radiográfica/métodos , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos
12.
Sud Med Ekspert ; 63(5): 8-12, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32930527

RESUMO

The features of a gunshot injury arising in the presence of body armor on the injured person are considered. The purpose of the work is to reveal the mechanisms of damage formation during non-penetration of an armored composition, during its penetration, as well as during external or internal rebound. The characteristic of damages arising with this is given. It was shown that injuries due to non-penetration of body armor are characterized mainly by local closed injuries, not only of integumentary soft tissues, but also of internal organs in the projection of impact of a wounding projectile. With through penetration of body armor, the severity and volume of gunshot damage increase due to the introduction of fragments of bullets, fragments of armored panels and pieces of equipment into the wound channel. Rebounding of elements of dismantled bullets from the outer or inner surface of the body armor can cause severe gunshot damage to both the wearer of body armor and other persons. Knowledge of the mechanisms of formation and morphological features of injuries that occur when using body armor are prerequisites for a full forensic medical assessment of the investigated incident.


Assuntos
Ferimentos por Arma de Fogo , Abdome , Balística Forense , Humanos
13.
Emerg Med Clin North Am ; 38(4): 891-901, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32981624

RESUMO

Evaluating and treating traumatic cardiac arrest remains a challenge to the emergency medicine provider. Guidelines have established criteria for patients who can benefit from treatment and resuscitation versus those who will likely not survive. Patient factors that predict survival are penetrating injury, signs of life with emergency medical services or on arrival to the Emergency Department, short length of prehospital cardiopulmonary resuscitation, cardiac motion on ultrasound, pediatric patients, and those with reversible causes including pericardial tamponade and tension pneumothorax. Newer technologies such as resuscitative endovascular balloon occlusion of the aorta, selective aortic arch perfusion, and extracorporeal membrane oxygenation may improve outcomes, but remain primarily investigational.


Assuntos
Parada Cardíaca/terapia , Ferimentos e Lesões/complicações , Abdome/diagnóstico por imagem , Aorta , Oclusão com Balão , Serviço Hospitalar de Emergência , Oxigenação por Membrana Extracorpórea , Coração/diagnóstico por imagem , Parada Cardíaca/etiologia , Humanos , Guias de Prática Clínica como Assunto , Ressuscitação , Ordens quanto à Conduta (Ética Médica) , Toracotomia , Ultrassonografia
14.
An Sist Sanit Navar ; 43(2): 251-254, 2020 Aug 31.
Artigo em Espanhol | MEDLINE | ID: mdl-32865189

RESUMO

Infection caused by SARS-CoV-2 (COVID-19) is associated with an increased risk of thromboembolic disease. So-me authors recommend anticoagulation at therapeutic doses for, at least, the most severely ill patients; this practice is not free of risks, which is why only thromboembolic prophylaxis is recommended by other consensuses. In the case of previously anticoagulated patients, changing the oral anticoagulant for a low molecular weight heparin (LMWH) is generally recommended. We present the cases of two patients admitted due to COVID-19, without serious clinical data, in whom anticoagulation (acenocoumarol and rivaroxaban, respectively) was replaced by LMWH at therapeutic doses, both presenting abdominal bleeding. This type of bleeding is an infrequent complication in anticoagulated patients, but the concurrence of two cases in a short period of time in the context of the COVID-19 pandemic leads us to consider that there is not yet any clear evidence on therapeutic anticoagulation in SARS-CoV-2 infection.


Assuntos
Anticoagulantes/efeitos adversos , Betacoronavirus , Infecções por Coronavirus/complicações , Hematoma/induzido quimicamente , Pneumonia Viral/complicações , Tromboembolia Venosa/prevenção & controle , Tromboembolia Venosa/virologia , Abdome , Acenocumarol/efeitos adversos , Acenocumarol/uso terapêutico , Idoso de 80 Anos ou mais , Anticoagulantes/uso terapêutico , Feminino , Hematoma/diagnóstico , Heparina de Baixo Peso Molecular/efeitos adversos , Heparina de Baixo Peso Molecular/uso terapêutico , Humanos , Pandemias , Rivaroxabana/efeitos adversos , Rivaroxabana/uso terapêutico , Tromboembolia Venosa/tratamento farmacológico
15.
Korean J Gastroenterol ; 76(3): 164-166, 2020 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-32969365

RESUMO

The World Health Organization has declared novel coronavirus disease 2019 (COVID-19) a global public health emergency. Although respiratory symptoms predominate in COVID-19, thrombosis can occur in patients with COVID-19. This paper reports a case of an 82-year-old female with a prior medical history of hypertension, diabetes presenting with fever and cough, and was diagnosed with COVID-19. The patient subsequently developed progressively worsening of abdominal distention, tenderness, and underwent emergent laparotomy. She was found to have a gangrenous colon. This case adds to the limited literature regarding the extrapulmonary complications of COVID-19.


Assuntos
Colite/diagnóstico , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Trombose Venosa/diagnóstico , Abdome/diagnóstico por imagem , Abdome/cirurgia , Doença Aguda , Idoso de 80 Anos ou mais , Anticoagulantes/uso terapêutico , Betacoronavirus/isolamento & purificação , Colite/patologia , Infecções por Coronavirus/complicações , Infecções por Coronavirus/virologia , Feminino , Heparina/uso terapêutico , Humanos , Laparotomia , Necrose , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/virologia , Tomografia Computadorizada por Raios X , Trombose Venosa/complicações , Trombose Venosa/tratamento farmacológico
16.
Anticancer Res ; 40(10): 5939-5947, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32988926

RESUMO

Background/Aim: There is an increasing demand for preserving the fertility of young women impacted with early-stage cervical cancer. The aim of this study is to evaluate the oncological and reproductive outcomes of abdominal radical trachelectomy (ART). Patients and Methods: We retrospectively reviewed patients with FIGO stageIA2-IB1 cervical cancer who underwent ART from 2007 to 2018. We also compared the oncological prognosis between the patients who underwent ART and radical hysterectomy (RH). Results: A total of 42 patients underwent ART. During median follow-up 62.5 months, there were 4 (9.5%) recurrences and 1 (2.4%) death. As for tumors ≤2 cm, the 5-year recurrence-free survival (RFS) rate and overall survival (OS) rate for patients who underwent ART was similar to those who underwent RH (89.8% vs. 92.7%, p=0.42 and 97.3% vs. 95.0%, p=0.44, respectively). Nineteen patients attempted to conceive and seven of them were successful. There was one case of a first-trimester miscarriage, two cases of preterm delivery, three cases of full-term delivery and one ongoing pregnancy. Conclusion: ART could be a feasible alternative to RH for patients with tumors ≤2 cm with comparable oncological outcome.


Assuntos
Abdome/cirurgia , Recidiva Local de Neoplasia/cirurgia , Traquelectomia/efeitos adversos , Neoplasias do Colo do Útero/cirurgia , Abdome/fisiopatologia , Adulto , Idoso , Feminino , Fertilidade/fisiologia , Humanos , Histerectomia/efeitos adversos , Recém-Nascido , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/fisiopatologia , Estadiamento de Neoplasias , Gravidez , Estudos Retrospectivos , Resultado do Tratamento , Neoplasias do Colo do Útero/fisiopatologia
17.
PLoS One ; 15(9): e0238582, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32966278

RESUMO

OBJECTIVE: To compare "virtual" unenhanced (VUE) computed tomography (CT) images, reconstructed from rapid kVp-switching dual-energy computed tomography (DECT), to "true" unenhanced CT images (TUE), in clinical abdominal imaging. The ability to replace TUE with VUE images would have many clinical and operational advantages. METHODS: VUE and TUE images of 60 DECT datasets acquired for standard-of-care CT of pancreatic cancer were retrospectively reviewed and compared, both quantitatively and qualitatively. Comparisons included quantitative evaluation of CT numbers (Hounsfield Units, HU) measured in 8 different tissues, and 6 qualitative image characteristics relevant to abdominal imaging, rated by 3 experienced radiologists. The observed quantitative and qualitative VUE and TUE differences were compared against boundaries of clinically relevant equivalent thresholds to assess their equivalency, using modified paired t-tests and Bayesian hierarchical modeling. RESULTS: Quantitatively, in tissues containing high concentrations of calcium or iodine, CT numbers measured in VUE images were significantly different from those in TUE images. CT numbers in VUE images were significantly lower than TUE images when calcium was present (e.g. in the spine, 73.1 HU lower, p < 0.0001); and significantly higher when iodine was present (e.g. in renal cortex, 12.9 HU higher, p < 0.0001). Qualitatively, VUE image ratings showed significantly inferior depiction of liver parenchyma compared to TUE images, and significantly more cortico-medullary differentiation in the kidney. CONCLUSIONS: Significant differences in VUE images compared to TUE images may limit their application and ability to replace TUE images in diagnostic abdominal CT imaging.


Assuntos
Abdome/diagnóstico por imagem , Neoplasias Pancreáticas/diagnóstico por imagem , Imagem Radiográfica a Partir de Emissão de Duplo Fóton/métodos , Tomografia Computadorizada por Raios X/métodos , Feminino , Humanos , Masculino , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Estudos Retrospectivos
18.
Khirurgiia (Mosk) ; (7): 6-11, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32736457

RESUMO

OBJECTIVE: To analyze morbidity and factors affecting mortality in emergency abdominal surgery in the Russian Federation. MATERIAL AND METHODS: The study included patients with acute abdominal diseases aged 18 years and older. All patients were hospitalized in emergency surgical care departments of 3.194 state healthcare institutions in 84 regions of the Russian Federation in 2018. Morbidity, surgical activity and mortality were analyzed. RESULTS: There were 680.337 cases of hospitalization in emergency surgical department, morbidity rate was 582 cases per 100 000. The most common emergency surgical diseases were acute appendicitis (142.3 cases per 100 000), acute cholecystitis (139.0 cases per 100 000) and acute pancreatitis (131.2 cases per 100 000). Surgery was performed in 399.051 (58.7%) patients. In-hospital mortality rate was 2.4% (16 051 cases). CONCLUSION: There are certain factors affecting mortality rate in acute abdominal diseases. The leading problems in organizing emergency surgical care in Russia are insufficient equipment of rural and small municipal surgical hospitals, different staffing with surgeons in rural areas and large cities and late hospitalization of patients.


Assuntos
Assistência à Saúde/estatística & dados numéricos , Doenças do Sistema Digestório/epidemiologia , Doenças do Sistema Digestório/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório/estatística & dados numéricos , Abdome/cirurgia , Doença Aguda/epidemiologia , Doença Aguda/mortalidade , Doença Aguda/terapia , Adolescente , Adulto , Assistência à Saúde/organização & administração , Assistência à Saúde/normas , Doenças do Sistema Digestório/mortalidade , Procedimentos Cirúrgicos do Sistema Digestório/mortalidade , Emergências/epidemiologia , Mortalidade Hospitalar , Hospitalização/estatística & dados numéricos , Humanos , Morbidade , População Rural/estatística & dados numéricos , Federação Russa/epidemiologia , Adulto Jovem
19.
Medicine (Baltimore) ; 99(30): e21337, 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32791732

RESUMO

This study aim is to enhance the understanding, diagnosis and treatment of desmoplastic small round cell tumor (DSRCT) and to determine what factors can affect survival of the disease in China.We report here 8 patients with DSRCT in our center who received a variety of treatment methods. By reviewing the literature published from Chinese database (CNKI, WANGFAN, VIP, CBM, CMCC) in 2000 to 2015 with the terms of "dsrct", "desmoplastic" and "small round-cell tumor",104 eligible cases of DSRCT(including 8 cases in our hospital) were retrospectively analyzed.Among the 104 patients, Median age was 24 years with a range of 15 to 54 years. The main primary tumor site was the abdomen and/or pelvis in 92/104 patients (88.5%). Only 25% of patients had localized disease. Most of the patients had received adjuvant chemotherapy (87.5%) and 76.9% patients had not experienced adjuvant radiotherapy. One-fourth of the patients underwent grossly complete surgical resection, and 33.7% and 41.3% patients received no surgery and incomplete surgical resection, respectively. Median overall survival for all patients was 26 months (95% CI: 20.29-31.71). Multivariate analysis revealed that Metastatic status (HR: 2.327, 95% CI: 1.136-4.768, P = .021), Surgical patterns (HR: 0.673, 95% CI: 0.487-0.928, P = .016), and Adjuvant chemotherapy (HR: 0.337, 95% CI: 0.167-0.678, P = .002) were significant independent prognostic factors for longer overall survival. It was noteworthy that CD99 were significantly associated with OS (P = .002).Here, we identified the prognostic factors which may facilitate risk-adapted treatments for this rare DSRCT group, which should be further investigated.


Assuntos
Abdome/patologia , Tumor Desmoplásico de Pequenas Células Redondas/patologia , Tumor Desmoplásico de Pequenas Células Redondas/terapia , Pelve/patologia , Procedimentos Cirúrgicos Operatórios/tendências , Antígeno 12E7/metabolismo , Adulto , Quimioterapia Adjuvante , China/epidemiologia , Terapia Combinada , Tumor Desmoplásico de Pequenas Células Redondas/metabolismo , Tumor Desmoplásico de Pequenas Células Redondas/mortalidade , Humanos , Prognóstico , Radioterapia Adjuvante , Estudos Retrospectivos , Análise de Sobrevida
20.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 32(7): 792-796, 2020 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-32788011

RESUMO

OBJECTIVE: To study the clinical characteristics of patients with severe abdominal infection and the epidemiological characteristics of pathogenic bacteria in a hospital, to provide a basis for rational use of antibiotics and reduce the drug resistance rate of pathogens. METHODS: A retrospective analysis was performed on 237 patients with abdominal disease as the primary disease admitted to the surgical intensive care unit (ICU) of the First Affiliated Hospital of Guangxi Medical University from January 1st, 2017 to December 31st, 2019. They were divided into two groups according to whether abdominal infection occurred or not. The clinical features of patients in both groups were analyzed, including gender, age, acute physiology and chronic health evaluation II (APACHE II) score, chronic underlying diseases, primary abdominal site, abdominal trauma or bleeding, multiple organ dysfunction syndrome (MODS) involving organs and surgical treatment. At the same time, the bacterial origin, bacterial distribution and antibiotics sensitivity test results of patients with abdominal infection were recorded. RESULTS: Abdominal infection occurred in 141 of the 237 patients and did not occur in the remaining 96 patients. There were no statistically significant differences between the abdominal infection group and the non-abdominal infection group in terms of gender, age, chronic underlying diseases, etiology and trauma. The APACHE II score in the abdominal infection group was obviously higher than that of the non-abdominal infection group (24.0±8.1 vs. 17.1±5.8, P < 0.01). Incidences of abdominal bleeding, MODS involving four or more organs, surgery and the times of surgery ≥ 3 in the abdominal infection group were significantly higher than those in the non-abdominal infection group (36.2% vs. 17.7%, 20.6% vs. 1.0%, 84.4% vs. 21.9%, 9.3% vs. 0%, all P < 0.05). Among the 141 patients with abdominal infection, 107 obtained positive microbial culture results, and a total of 133 pathogenic strains were detected, including 115 strains of bacteria (86.5%) and 18 strains of fungi (13.5%). The main source of bacteria was abdominal drainage (46.1% of non-bloody specimens and 13.9% of bloody specimens). Among the 115 bacteria, Gram-negative (G-) bacteria were the most common (72.2%) and Gram-positive (G+) bacteria accounted for 27.8%. Escherichia coli and Acinetobacter baumannii were the top two G- bacteria (40.9% and 13.9%, respectively), and enterococcus faecalis accounted for the largest proportion of G+ bacteria (7.8%). The pathogenic bacteria of abdominal infection were sensitive to tigacycline. CONCLUSIONS: The patients with abdominal infection in our hospital had high APACHE II score, more organs failure and were easily complicated with intraperitoneal hemorrhage and required surgical intervention and even repeated surgery. The pathogenic bacteria in patients with abdominal infection in ICU were mainly G- bacteria, and the rate of multi-drug resistance of Acinetobacter baumannii was high. Empirical anti-infective treatment should be started as soon as possible according to the microbial spectrum of the region until the pathogenic bacteria results are obtained. Broad-spectrum antimicrobial therapy and combined antimicrobial therapy are recommended for the healthcare acquired abdominal infection in hospital.


Assuntos
Abdome/microbiologia , Infecções/epidemiologia , Unidades de Terapia Intensiva , Bactérias , China/epidemiologia , Cuidados Críticos , Humanos , Estudos Retrospectivos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA