Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 364
Filtrar
1.
Am Surg ; 86(3): 232-236, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32223803

RESUMO

A modern approach to incisional hernia is oriented toward midline restoration to re-establish abdominal wall physiology and to restore muscular strength. A high-protein diet has been demonstrated to improve muscle function and mass. The aim of this prospective study was to evaluate the effect of a high-protein diet on abdominal muscle remodeling in patients submitted to abdominal wall reconstruction (AWR). Forty-five patients submitted to elective AWR were prospectively divided into two groups depending on pre- and postoperative daily protein assumption: Group A patients were submitted to a standard 2300 kcal diet with 103 g of protein intake (males) and 1800 kcal diet with 80 g of protein intake (females) starting one month before surgery and lasting for three months postoperatively; Group B patients were submitted to the same dietary regimen plus 34 g of purified proteins daily. Patients underwent ultrasound scan preoperatively and three and six months after surgery, to evaluate the widest thickness of the rectus abdominis muscle on the transverse umbilical line. Three patients reporting hernia recurrence were excluded. No significant difference among the two groups in muscle thickness growth after surgery was observed at three months after surgery, even if a favorable trend in Group B was noted (10% vs 19%, P = not significant). At six months after surgery, Group B patients showed a significant difference in muscle thickening (13% vs 32%, P < 0.05 ). The study demonstrates a positive effect of a protein diet on the rectus abdominis muscle thickening after AWR. Further studies are needed.


Assuntos
Abdominoplastia/métodos , Proteínas na Dieta/administração & dosagem , Herniorrafia/métodos , Hérnia Incisional/cirurgia , Cicatrização/fisiologia , Parede Abdominal/diagnóstico por imagem , Parede Abdominal/cirurgia , Idoso , Estudos de Coortes , Procedimentos Cirúrgicos Eletivos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Força Muscular/fisiologia , Complicações Pós-Operatórias/fisiopatologia , Complicações Pós-Operatórias/cirurgia , Estudos Prospectivos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Fatores de Tempo , Resultado do Tratamento , Ultrassonografia Doppler/métodos
2.
Ann R Coll Surg Engl ; 102(5): e102-e104, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32159370

RESUMO

Epigastric hernia involving the falciform ligament is exceptionally rare. Most reported cases are incisional hernia secondary to prior abdominal surgery. We report a case of primary falciform ligament herniation into the epigastric region repaired by the laparoscopic preperitoneal approach. In this case, an accompanying vessel along the herniated falciform ligament was identified. This finding provides a basis for the hypothesis of a perforating vessel piercing the linea alba and thereby creating a weak point for hernia protrusion (Moschowitz theory). The patient had an uneventful recovery and was discharged home on the postoperative day two. A laparoscopic preperitoneal approach is feasible for the repair of primary falciform ligament herniation. The magnified endoscopic view enables surgeons to achieve definite repair without missing occult defects.


Assuntos
Parede Abdominal/patologia , Hérnia Abdominal/cirurgia , Laparoscopia , Ligamentos/patologia , Parede Abdominal/diagnóstico por imagem , Parede Abdominal/cirurgia , Idoso , Feminino , Hérnia Abdominal/diagnóstico , Hérnia Abdominal/patologia , Humanos , Ligamentos/diagnóstico por imagem , Resultado do Tratamento , Ultrassonografia
3.
Bull Cancer ; 107(3): 359-363, 2020 Mar.
Artigo em Francês | MEDLINE | ID: mdl-32008700

RESUMO

The management of desmoid-type fibromatosis has considerably evolved these last years, toward first-line active surveillance then systemic or local symptomatic treatment in case of aggressive tumor. Magnetic resonance imaging is the modality of choice in each of these treatment settings. It needs multiparametric approach taking into account mainly the tumor size, and T2-weighted signal that is correlated with histological composition and clinical behavior. A volumetric approach should be favored for the evaluation of tumor size change. The interest of paramagnetic contrast injection and tumor enhancement requires further investigation.


Assuntos
Fibromatose Agressiva/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Conduta Expectante , Parede Abdominal/diagnóstico por imagem , Parede Abdominal/patologia , Adulto , Meios de Contraste/administração & dosagem , Fibromatose Agressiva/patologia , Fibromatose Agressiva/terapia , Humanos , Pessoa de Meia-Idade , Ombro/diagnóstico por imagem , Carga Tumoral
5.
Orv Hetil ; 160(35): 1395-1402, 2019 Sep.
Artigo em Húngaro | MEDLINE | ID: mdl-31448642

RESUMO

The incidence of endometriosis, including atypical forms of the disease, has been continuously growing, thus increasingly challenging for the imaging specialists as well. We conducted a retrospective study to analyze the results of ultrasound-guided interventions between 2016 and 2018. All interventions were performed in female patients due to uncertain abdominal wall lesions at the University of Szeged, Hungary. The abdominal wall lesions were incidentally detected, one by CT, the others by ultrasound examinations. We identified 12 cases during the study period. The average age of the patients was 59 years (29-79), 8 of them had abdominal surgery in their medical history. The mean diameter of the masses was 34.4 mm (20-49 mm). Since the indication of imaging examinations was the evaluation of a known or suspected malignancy, four patients had undergone an MRI prior to the biopsy. In addition, ultrasound-guided biopsy was not performed in another two patients, and the diagnosis was established by histological examination of the surgically removed specimens. The histological examination revealed malignant primary serous epithelial tumor in one case, metastases in six cases, endometriosis in six patients and abdominal wall abscess was found in one patient. Endometriosis was more frequent in the younger patients. The likelihood of endometriosis as a cause of abdominal wall lesions of younger, premenopausal female patients is rather high, especially with obstetrical or gynaecological operations in the medical history. Ultrasound plays a primary role in the detection and therapy planning of these lesions. Orv Hetil. 2019; 160(35): 1395-1403.


Assuntos
Parede Abdominal/diagnóstico por imagem , Endometriose/diagnóstico por imagem , Parede Abdominal/patologia , Adulto , Idoso , Biópsia , Endometriose/patologia , Feminino , Humanos , Hungria , Pessoa de Meia-Idade , Radiologistas , Estudos Retrospectivos , Ultrassonografia
6.
Cir Cir ; 87(4): 385-389, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31264985

RESUMO

Background: Abdominal wall endometriosis is a rare pathological entity. It presents as a tumor with pain, erythema, which worsens with Valsalva maneuvers. Objective: To show the experience and results in the management of the department of hernias and abdominal wall in a hospital of second level and to present review of the literature. Method: The files of patients treated in the department of hernias and abdominal wall, surgically treated with preoperative clinical and postoperative histopathological diagnosis of abdominal wall endometriosis were taken. The data was described using measures of central tendency and percentages. Results: Twenty-nine patients were identified, with an average age of 32.75 years, 68.9% reported cyclic catamenial pain associated with a tumor in the abdominal wall; a preoperative clinical diagnosis of abdominal wall endometriosis was made in 89.75%. Only one patient was reported with histopathological diagnosis of fibrolipoma. The totality of the patients referred cesarean section as previous surgery. No recurrences were reported. Conclusions: Abdominal wall endometriosis is the presence of ectopic endometrial tissue in any layer of the abdominal wall. Patients with this diagnosis are referred to the general surgeon presenting a tumor, however, the preoperative diagnosis rate is erroneous in most cases. Abdominal wall ultrasound is useful in diagnosis; tomography and magnetic resonance determine the extent of the disease. The treatment must be related to the extension of the disease and its recurrence is associated with the presence of positive margins.


Assuntos
Parede Abdominal , Endometriose/cirurgia , Parede Abdominal/diagnóstico por imagem , Adulto , Cesárea , Dismenorreia/etiologia , Endometriose/complicações , Endometriose/patologia , Feminino , Humanos , Lipoma/complicações , Lipoma/cirurgia , Pessoa de Meia-Idade , Estudos Retrospectivos , Centros de Cuidados de Saúde Secundários , Adulto Jovem
7.
Br J Radiol ; 92(1104): 20180841, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31322915

RESUMO

OBJECTIVE: Pelvic side wall dose in locally advanced cervical carcinoma treated with definitive chemoradiation has been debated. The present study investigated relationship of disease recurrence with dose for the pelvic side wall. It also attempted to identify minimal dose that significantly reduced recurrence. METHODS: Pelvic side wall recurrence at median 24 months was assessed clinically and radiologically across three groups of patients receiving variable pelvic wall doses using no parametrial boost, external beam or interstitial boost, or dose escalated combined external beam with interstitial boost. RESULTS: At 24 months, recurrence occurred in 3/155 boost vs 40/130 no boost patients. (p < 0.0001). Receiver operating characteristic curve analysis demonstrated cut-off pelvic wall dose to be 58.9 Gy (p < 0.0001). Dose escalated combined boost showed no significant benefit compared to single modality parametrial boost (p = 0. 0.553). CONCLUSION: Mean pelvic wall dose of at least 58.9 Gy offers clinically significant benefit in pelvic wall control. Doses recommended by guidelines should be adhered to in the patients' best interests. ADVANCES IN KNOWLEDGE: This preliminary study determined a relationship between recurrence rates and dose to the pelvic side wall and also a cut-off dose that significantly improved pelvic wall control in locally advanced cervical cancer.


Assuntos
Parede Abdominal/efeitos da radiação , Quimiorradioterapia , Recidiva Local de Neoplasia , Neoplasias do Colo do Útero/terapia , Parede Abdominal/diagnóstico por imagem , Adulto , Idoso , Antineoplásicos/administração & dosagem , Braquiterapia/métodos , Cisplatino/administração & dosagem , Fracionamento da Dose de Radiação , Feminino , Humanos , Radioisótopos de Irídio/uso terapêutico , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico por imagem , Recidiva Local de Neoplasia/prevenção & controle , Estadiamento de Neoplasias , Pelve , Curva ROC , Doses de Radiação , Radiossensibilizantes/administração & dosagem , Reirradiação/métodos , Fatores de Tempo , Falha de Tratamento , Neoplasias do Colo do Útero/patologia
8.
Medicina (Kaunas) ; 55(8)2019 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-31357513

RESUMO

Background and objectives: Doppler ultrasound of umbilical and fetal vessels is useful for monitoring fetal well-being, fetal anemia, intrauterine growth retardation, and other perinatal outcomes. The adverse perinatal outcome and circulatory changes can be reflected in fetal Doppler studies. The aim of this study was to evaluate the effect of increased pressure exerted on the maternal abdominal wall during routine ultrasound on the middle cerebral artery (MCA), resistance index (RI), pulsatility index (PI), and peak systolic velocity (PSV). Materials and Methods: A prospective study was conducted, in which we included 40 pregnant women between 24 + 0 and 41 + 3 gestational weeks (GW), with singleton pregnancies, without any associated pathologies, undergoing routine US examination. We recorded the flow velocity waveforms in the MCA, and we measured the RI, PI, PSV, and the applied pressure on to the maternal abdominal wall-needed for a proper evaluation of MCA. We then repeated the same measurements at two different higher pressure levels, at the same time having a proper image of the targeted vessel. Results: We found significant differences for the PI and RI levels with an increase in abdominal pressure (median PI 1.46, 1.58, and 1.92, respectively; median RI 0.74, 0.78, and 0.85, respectively; p < 0.05), for both PI and RI. At the same time, we found no significant differences for PSV in the studied group in relationship with increase in abdominal pressure (median PSV 39.56, 40.10, and 39.70, respectively; p > 0.05). Conclusions: The applied abdominal pressure by the examiner's hand, during routine US scan in pregnancy, can modify the MCA parameters of blood flow resistance (PI and RI) when measured by Doppler US, thus influencing the diagnostic accuracy in a series of pregnancy associated pathologies, such as chronic fetal distress (CFD) or intrauterine growth restriction (IUGR).


Assuntos
Parede Abdominal/fisiologia , Indicadores Básicos de Saúde , Artéria Cerebral Média/fisiologia , Pressão/efeitos adversos , Ultrassonografia Pré-Natal/efeitos adversos , Parede Abdominal/diagnóstico por imagem , Adulto , Análise de Variância , Velocidade do Fluxo Sanguíneo/fisiologia , Feminino , Monitorização Fetal/efeitos adversos , Monitorização Fetal/métodos , Idade Gestacional , Humanos , Gravidez , Estudos Prospectivos , Romênia , Ultrassonografia Pré-Natal/métodos
9.
Plast Reconstr Surg ; 144(2): 197e-204e, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31348338

RESUMO

BACKGROUND: Abdominoplasty is one of the top five most commonly performed cosmetic procedures. Whereas widening of the linea alba is a well-accepted consequence of pregnancy, the changes to the rectus abdominis muscles are less well known and thus unappreciated and undertreated. METHODS: After institutional review board approval, the Northwestern Enterprise Data Warehouse identified nulliparous and multiparous women, aged 18 to 45 years, who underwent abdominal computed tomography between 2000 and the present. Measurements included the width and cross-sectional area of each rectus muscle, width of the linea alba, and circumference of the abdominal cavity at the level of the L3 vertebra. In addition, two case reports addressing these anatomical changes with muscle modification and mesh reinforcement are presented. RESULTS: Sixty women were identified that met our inclusion criteria: 15 nulliparous, 15 after one pregnancy (para 1), 15 after two pregnancies (para 2), and 15 after three or more pregnancies (para ≥ 3). The linea alba was significantly widened after one pregnancy from 1.14 cm to 2.29 cm, but did not significantly widen further with each subsequent pregnancy. The width of each rectus muscle was significantly widened from 6.00 ± 0.60 cm in nulliparous to 6.61 ± 0.58 cm in para 1, significantly widened again to 7.03 ± 0.46 cm in para 2, but not significantly widened after that (6.97 ± 1.00 cm in para 3). CONCLUSIONS: In addition to widening of the linea alba, pregnancy alters the shape of the rectus abdominis muscle. Correction of muscle width during abdominoplasty may be a necessary adjunct to achieve the proper tension in both primary and revision procedures. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.


Assuntos
Abdominoplastia/métodos , Abdominoplastia/estatística & dados numéricos , Reto do Abdome/diagnóstico por imagem , Reto do Abdome/cirurgia , Parede Abdominal/diagnóstico por imagem , Parede Abdominal/cirurgia , Adulto , Estudos de Coortes , Bases de Dados Factuais , Estética , Feminino , Seguimentos , Humanos , Incidência , Pessoa de Meia-Idade , Paridade , Satisfação do Paciente/estatística & dados numéricos , Período Pós-Parto , Gravidez , Estudos Retrospectivos , Medição de Risco , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Estados Unidos , Adulto Jovem
10.
J Surg Oncol ; 120(3): 366-375, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31236956

RESUMO

BACKGROUND: Desmoid tumors are rare locally invasive, benign neoplasms that develop along aponeurotic structures. Current treatment is complicated by associated morbidity and high recurrence rates. METHODS: A retrospective, single-institution review identified 23 patients (age: 16-77) with extra-abdominal desmoid tumors who received CT-guided percutaneous cryoablation as either a first-line (61%) or salvage (39%) treatment in 30 sessions between 2014 and 2018. Median maximal lesion diameter was 69 mm (range: 11-209). Intent was curative in 52% and palliative in 48%. Contrast-enhanced cross-sectional imaging was obtained before and after treatment in addition to routine clinical follow-up. RESULTS: Technical success was achieved in all patients. The median follow-up was 15.4 months (3.5-43.4). Symptomatic improvement was demonstrated in 89% of patients. At 12 months, the average change in viable volume was -80% (range -100% to + 10%) and response by modified response evaluation criteria in solid tumors (mRECIST) was CR 36%, PR 36%, and SD 28% No rapid postablation growth or track seeding was observed. Four patients underwent repeat cryoablation for either residual or recurrent disease. Two patients sustained a major procedural complication consisting of significant neuropraxia. CONCLUSION: Cryoablation for desmoid tumors demonstrates a high degree of symptom improvement and local tumor control on early follow-up imaging with relatively low morbidity.


Assuntos
Criocirurgia/métodos , Fibromatose Agressiva/cirurgia , Parede Abdominal/diagnóstico por imagem , Parede Abdominal/patologia , Parede Abdominal/cirurgia , Adolescente , Adulto , Idoso , Extremidades/diagnóstico por imagem , Extremidades/patologia , Extremidades/cirurgia , Feminino , Fibromatose Agressiva/diagnóstico por imagem , Fibromatose Agressiva/patologia , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Parede Torácica/diagnóstico por imagem , Parede Torácica/patologia , Parede Torácica/cirurgia , Tomografia Computadorizada por Raios X , Adulto Jovem
11.
Comput Methods Programs Biomed ; 175: 103-109, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31104699

RESUMO

BACKGROUND AND OBJECTIVE: The biomechanical analysis of the abdominal wall should take into account muscle activation and related phenomena, such as intra-abdominal pressure variation and abdomen surface deformation. The geometry of abdominal surface and its deformation during contraction have not been extensively characterized, while represent a key issue to be investigated. METHODS: In this work, the antero-lateral abdominal wall surface of ten healthy volunteers in supine position is acquired via laser scanning in relaxed conditions and during abdominal muscles contraction, repeating each acquisition six times. The average relaxed and contracted abdominal surfaces are compared for each subject and displacements measured. RESULTS: Muscular activation induces raising in the region adjacent to linea alba along the posterior-anterior direction and a simultaneous lowering along lateral-medial direction of the abdominal wall sides. Displacements reach a maximum value of 12.5 mm for the involved subjects. The coefficient of variation associated to the abdomen surface measurements in the same configuration (relaxed or contracted) is below 0.75%. Non-parametric Mann-Whitney U test highlights that the differences between relaxed and contracted abdominal wall surfaces are significant (p < 0.01). CONCLUSIONS: Laser scanning is an accurate and reliable method to evaluate surface changes on the abdominal wall during muscular contraction. The results of this experimental activity can be useful to validate numerical models aimed at describing abdominal wall biomechanics.


Assuntos
Músculos Abdominais/diagnóstico por imagem , Parede Abdominal/diagnóstico por imagem , Imageamento Tridimensional/métodos , Contração Muscular , Adulto , Fenômenos Biomecânicos , Feminino , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Propriedades de Superfície
12.
Cir Pediatr ; 32(2): 104-108, 2019 Apr 22.
Artigo em Espanhol | MEDLINE | ID: mdl-31056872

RESUMO

INTRODUCTION: Endodermal sinus tumor is a malignant germ cell tumor that generally involves the gonads. Extra-gonadal localization out of midline organs is rare. We report a case of endodermal sinus tumor in the thoracoabdominal wall. CASE REPORT: We discuss the case of an infant presenting an abdominal mass detected after a fall from his own height. Studies revealed anemia with abundant intraabdominal fluid and elevated alpha-fetoprotein. During surgery, a left thoracoabdominal wall-dependent tumor was identified, with involvement of the diaphragm and the costal cartilage. Complete resection was performed. Pathology report informed of an endodermal sinus tumor. DISCUSSION: Abdominal wall location of endodermal sinus tumor is rare. Pathophysiology has not been completely outlined, however, it is presumed to be a consequence of aberrant migration patterns of the primordial cells. Pre-surgical diagnosis remains a challenge due to the low incidence.


Assuntos
Parede Abdominal , Tumor do Seio Endodérmico/patologia , Parede Torácica , Parede Abdominal/diagnóstico por imagem , Diafragma/cirurgia , Tumor do Seio Endodérmico/diagnóstico por imagem , Tumor do Seio Endodérmico/cirurgia , Humanos , Lactente , Masculino , Costelas/cirurgia , Parede Torácica/diagnóstico por imagem
13.
J Pharm Pharmacol ; 71(8): 1282-1290, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31134628

RESUMO

OBJECTIVES: Rectus sheath blocks are an established option for analgesia following abdominal surgery, but pharmacokinetic data are limited. This study sought to characterise the absorption of lidocaine injectate and the pharmacokinetics of lidocaine after rectus sheath injection. METHODS: Bilateral rectus sheath single-injection blocks were given to 10 patients undergoing general or urological surgery. Afterwards, serial lidocaine serum levels and ultrasound measurements of the rectus sheath injectate reservoir were collected. KEY FINDINGS: Injectate within the rectus sheath was visible with ultrasound up to 12 h after injection. However, the rate of drug absorption exceeded that of injectate disappearance. Peak serum concentration occurred within 30 min with average peak concentrations of 1.65 µg/ml. Lidocaine clearance was lower than reported in young healthy subjects. The body mass index positively correlated with lidocaine terminal phase half-life, and clearance negatively correlated with age. CONCLUSIONS: The study provides the first data describing lidocaine pharmacokinetics after rectus sheath injection. Peak serum concentrations transiently achieved systemic levels associated with pain relief after a single bolus injection. The data from this study could be used to develop a regime using single shot rectus sheath blockade with a bolus of lidocaine followed by infusion using bilateral rectus sheath catheters.


Assuntos
Dor Abdominal/tratamento farmacológico , Parede Abdominal/diagnóstico por imagem , Lidocaína/sangue , Reto do Abdome/efeitos dos fármacos , Adulto , Idoso , Idoso de 80 Anos ou mais , Analgesia/métodos , Anestésicos Locais , Índice de Massa Corporal , Feminino , Voluntários Saudáveis , Humanos , Injeções , Lidocaína/farmacocinética , Masculino , Pessoa de Meia-Idade , Bloqueio Nervoso/métodos , Manejo da Dor/métodos
14.
PLoS One ; 14(4): e0214752, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31022190

RESUMO

Repetitive mechanical load applied to a body part may lead to hypertrophy of its muscles. If a movement requires asymmetric activation of bilateral muscles, this may result in differences in muscle size between the sides. This study aimed to investigate the degree of bilateral differences in the trunk muscle volume of golfers by comparing with non-golfers. Seventeen male right-handed golfers and eleven (nine right- and two left-handed) non-golfers participated. Trunk muscle volume was determined using magnetic resonance imaging, and the degree of asymmetry was calculated as the ratio of trunk muscle volume on the left to trunk muscle volume on the right side in right-handers and vice-versa in left-handers. Golfers had significantly larger lateral abdominal wall (LA) muscle volume than non-golfers: 12.36 ± 1.12 vs. 9.96 ± 0.94 cm3/kg; erector spinae: 9.12 ± 1.16 vs. 7.88 ± 0.84 cm3/kg; psoas major (PM): 6.27 ± 0.88 vs. 5.51 ± 0.98 cm3/kg; rectus abdominis (RA): 4.15 ± 0.54 vs. 3.50 ± 0.64 cm3/kg; and multifidus: 3.61 ± 0.41 vs. 3.05 ± 0.40 cm3/kg (p < 0.05). The degree of bilateral asymmetry of the LA, PM, and RA volume was significantly greater in golfers than in non-golfers (LA: -8.63 ± 7.40% vs. 1.94 ± 2.76%; PM: -9.10 ± 5.25% vs. -0.48 ± 5.96%; RA: 6.36 ± 6.50% vs. -2.12 ± 9.64%, respectively, p < 0.05). Right-handed golfers had greater left LA and PM volume compared to the right (LA: 5.89 ± 0.55 vs. 6.48 ± 0.65 cm3/kg; PM: 3.00 ± 0.42 vs. 3.27 ± 0.47 cm3/kg; p < 0.05) and had greater right RA volume compared to the left (2.15 ± 0.32 vs. 2.00 ± 0.24 cm3/kg, p < 0.05). These findings suggest that skilled, long-term golfers develop large volume and bilateral asymmetry of their trunk muscles.


Assuntos
Músculos Abdominais/fisiologia , Atletas , Músculos Abdominais/diagnóstico por imagem , Parede Abdominal/diagnóstico por imagem , Parede Abdominal/fisiologia , Golfe , Humanos , Imagem por Ressonância Magnética , Masculino , Músculos Psoas/diagnóstico por imagem , Músculos Psoas/fisiologia , Reto do Abdome/diagnóstico por imagem , Reto do Abdome/fisiologia , Adulto Jovem
15.
Ultrasound Med Biol ; 45(5): 1176-1183, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30827707

RESUMO

This study investigated the clinical application value of the automated breast volume scanner (ABVS) in patients with abdominal external hernias. A total of 121 abdominal external hernias from 103 inpatients were examined with both conventional handheld ultrasound (HHUS) and the ABVS before surgery. The rate of detection of abdominal external hernias and the diagnostic accuracy of classifying inguinal hernias using the two modalities were compared between junior and senior sonographers. Additionally, the sonographic appearance of abdominal external hernias with the ABVS system was evaluated. The results revealed that junior sonographers had a higher detection rate with the ABVS (92.6%) than with HHUS (83.5%). For the classification of inguinal hernias, the accuracy of junior sonographers using the ABVS was 89.2%, which was higher than that for the HHUS system (77.6%), but there was no significant difference between HHUS (92.7%) and the ABVS (93.1%) for senior sonographers. Measurement of the hernia orifice size with the ABVS was accurate. In addition, the ABVS could provide coronal images and visually revealed the contents of the hernia, the shape of the hernia orifice and the pathway of herniation, as well as the relationship with adjacent tissues. Therefore, the clinical application value of the ABVS for abdominal external hernias is excellent.


Assuntos
Hérnia Abdominal/diagnóstico por imagem , Interpretação de Imagem Assistida por Computador/métodos , Reconhecimento Automatizado de Padrão/métodos , Ultrassonografia Mamária/instrumentação , Parede Abdominal/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Adulto Jovem
16.
Cancer Biother Radiopharm ; 34(4): 218-223, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30810349

RESUMO

Background: The treatment of abdominal wall metastasis presents a challenge, because resection can be followed by poor healing and external radiotherapy is associated with serious adverse events. This study aimed to evaluate the efficacy and safety of interstitial 125I seed implantation under ultrasound (US) guidance for treating abdominal wall metastasis. Materials and Methods: The cases of 21 patients with 28 abdominal wall metastases who received brachytherapy with 125I seeds at the department from August 2010 to March 2015 were retrospectively reviewed. 125I seeds were implanted in the abdominal wall lesions under US guidance and with the help of a treatment planning system. Follow-up was performed using computed tomography at 1 d and at 3, 6, and 12 months after implantation. The lymphocyte count before the surgery was compared with the 3-month postoperative count. The main indicators observed were changes in tumor size, side effects, and complications. Results: All 21 patients were successfully treated with 125I seed implantation under US guidance. The median follow-up since 125I seed implantation was 15 months (range 6-23 months). The response rates and local tumor control after 3, 6, and 12 months were 78.6% and 89.3%, 64.3% and 85.7%, and 52.4% and 71.4%, respectively. The mean preoperative lymphocyte count was 0.262 ± 0.117 × 109/L, which did not differ significantly from the postoperative count, which was 0.259 ± 0.094 × 109/L (p = 0.122). Procedure-related complications included fever, bleeding, and pain, but all these were Grade 1-2. No severe side effects or complications were noted. Conclusions: Percutaneous interstitial implantation of 125I seeds under US guidance is safe and feasible for abdominal wall metastases. However, its long-term efficacy requires further investigation.


Assuntos
Neoplasias Abdominais/radioterapia , Braquiterapia/métodos , Carcinoma/radioterapia , Radioisótopos do Iodo/administração & dosagem , Lesões por Radiação/epidemiologia , Neoplasias Abdominais/sangue , Neoplasias Abdominais/diagnóstico por imagem , Neoplasias Abdominais/secundário , Parede Abdominal/diagnóstico por imagem , Parede Abdominal/patologia , Parede Abdominal/efeitos da radiação , Adulto , Idoso , Braquiterapia/efeitos adversos , Carcinoma/sangue , Carcinoma/diagnóstico por imagem , Carcinoma/secundário , Estudos de Viabilidade , Feminino , Febre/epidemiologia , Febre/etiologia , Seguimentos , Hemorragia/epidemiologia , Hemorragia/etiologia , Humanos , Radioisótopos do Iodo/efeitos adversos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Dor/epidemiologia , Dor/etiologia , Lesões por Radiação/etiologia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Carga Tumoral/efeitos da radiação , Ultrassonografia de Intervenção/métodos
17.
Ultrasound Q ; 35(1): 30-34, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30724866

RESUMO

OBJECTIVES: The objective of this study is to establish a nomogram of fetal abdominal wall fat thickness in fetuses with known normal neonatal outcomes. METHODS: After IRB approval (HSD-49496), 157 ultrasound examinations in 100 patients, 41 of whom had multiple examinations during the same pregnancy were reviewed. The thickness of the fetal lateral abdominal wall fat Interreader agreement was summarized using the intraclass correlation coefficient (ICC). Fat thickness growth curve equations were estimated to quantify the relationship between fat thickness and gestational age. RESULTS: The abdominal wall fat had an intraclass correlation coefficient of 0.93 (95% confidence interval, 0.90-0.96) for 2 readers. Fat thickness increased in all 41 fetuses with multiple examinations (P < 0.001). Fat thickness increased 0.19 mm per week on average (95% confidence interval, 0.17-0.21 mm; P < 0.001) from an average of 1.7 mm at 22 weeks and 4.3 mm at 36 weeks. CONCLUSIONS: Lateral wall abdominal fat can be reproducibly measured with good inter observer correlation, and fat does increase with increasing gestational age in normal fetuses. We believe the utility of fetal fat is the documentation of its presence as a reassuring finding indicative of normal fetal health, particularly when prior dating is discrepant or not available during the third trimester.


Assuntos
Gordura Abdominal/diagnóstico por imagem , Parede Abdominal/diagnóstico por imagem , Nomogramas , Ultrassonografia Pré-Natal/métodos , Ultrassonografia Pré-Natal/estatística & dados numéricos , Gordura Abdominal/embriologia , Músculos Abdominais/diagnóstico por imagem , Músculos Abdominais/embriologia , Parede Abdominal/embriologia , Adulto , Feminino , Humanos , Gravidez , Terceiro Trimestre da Gravidez
18.
Int J Comput Assist Radiol Surg ; 14(5): 841-850, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30788665

RESUMO

PURPOSE: The aim of this study is to propose a model that simulates patient-specific anatomical changes resulting from pneumoperitoneum, using preoperative data as input. The framework can assist the surgeon through a real-time visualisation and interaction with the model. Such could further facilitate surgical planning preoperatively, by defining a surgical strategy, and intraoperatively to estimate port positions. METHODS: The biomechanical model that simulates pneumoperitoneum was implemented within the GPU-accelerated NVIDIA FleX position-based dynamics framework. Datasets of multiple porcine subjects before and after abdominal insufflation were used to generate, calibrate and validate the model. The feasibility of modelling pneumoperitoneum in human subjects was assessed by comparing distances between specific landmarks from a patient abdominal wall, to the same landmark measurements on the simulated model. RESULTS: The calibration of simulation parameters resulted in a successful estimation of an optimal set parameters. A correspondence between the simulation pressure parameter and the experimental insufflation pressure was determined. The simulation of pneumoperitoneum in a porcine subject resulted in a mean Hausdorff distance error of 5-6 mm. Feasibility of modelling pneumoperitoneum in humans was successfully demonstrated. CONCLUSION: Simulation of pneumoperitoneum provides an accurate subject-specific 3D model of the inflated abdomen, which is a more realistic representation of the intraoperative scenario when compared to preoperative imaging alone. The simulation results in a stable and interactive framework that performs in real time, and supports patient-specific data, which can assist in surgical planning.


Assuntos
Parede Abdominal/cirurgia , Laparoscopia/métodos , Modelos Biológicos , Pneumoperitônio Artificial/métodos , Parede Abdominal/diagnóstico por imagem , Parede Abdominal/fisiopatologia , Animais , Estudos de Viabilidade , Humanos , Imageamento Tridimensional , Insuflação , Pressão , Suínos , Tomografia Computadorizada por Raios X
19.
BMJ Case Rep ; 12(1)2019 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-30696650

RESUMO

We report the case of a 59-year-old Russian man who presented with a painless, slow-growing, epigastric mass. CT revealed a large heterogeneous mass within the omentum infiltrating into adjacent tissues. During diagnostic laparoscopy, the omental mass was noted to be firm, raising the suspicion of malignancy. Surgical en-bloc resection of the mass, including the posterior rectus sheath, transverse colon and small bowel, was performed with primary anastomoses at laparotomy. Histological examination was inconsistent with malignancy and revealed the mass to be actinomycosis, confirmed by microscopy and gram staining. Surgical resection was followed by an 8-week course of penicillin and doxycycline antibiotic therapy. This treatment resulted in full clinical and radiological recovery with no complications. Although the clinical and radiological findings, in this case, were highly suspicious of malignancy, abdominal actinomycosis should be considered a differential diagnosis in patients with infiltrative abdominal masses and mild constitutional symptoms.


Assuntos
Parede Abdominal/microbiologia , Actinomicose/diagnóstico , Colo Transverso/microbiologia , Intestino Delgado/microbiologia , Omento/microbiologia , Doenças Peritoneais/microbiologia , Parede Abdominal/diagnóstico por imagem , Parede Abdominal/cirurgia , Actinomicose/diagnóstico por imagem , Actinomicose/terapia , Amoxicilina/uso terapêutico , Antibacterianos/uso terapêutico , Colo Transverso/diagnóstico por imagem , Colo Transverso/cirurgia , Diagnóstico Diferencial , Doxiciclina/uso terapêutico , Humanos , Intestino Delgado/diagnóstico por imagem , Intestino Delgado/cirurgia , Masculino , Pessoa de Meia-Idade , Omento/diagnóstico por imagem , Omento/cirurgia , Doenças Peritoneais/diagnóstico por imagem , Doenças Peritoneais/terapia , Tomografia Computadorizada por Raios X/métodos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA