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1.
Medicine (Baltimore) ; 99(41): e22633, 2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33031323

RESUMO

RATIONALE: Leiomyomatosis peritonealis disseminata (LPD) is a rare benign lesion primarily consisting of smooth muscle cells, which mostly affects premenopausal females. Here, we reported 3 females with LPD (age, 40-48 years) admitted for pelvic masses. PATIENT CONCERNS: All 3 LPD cases received laparoscopic uterine fibroid morcellation at 3, 8, and 14 years ago, respectively. Two cases were admitted for pelvic masses. One case was admitted for recurrent fibroids with pollakiuria. DIAGNOSES: LPD was considered in 2 cases preoperation according to imaging examination, and one of them received ultrasound-guided biopsy of the lesion in the right lobe of the liver. One case was considered as recurrent fibroids preoperation. After surgery, all cases were pathologically diagnosed as LPD consisting of benign smooth muscle cells. INTERVENTIONS: A total abdominal hysterectomy, salpingo-oophorectomy, and debulking was performed for all 3 cases. Intraoperative exploration revealed that the fibroids distributed in the mesentery (3 cases), broad ligament (1 case), omentum (1 case), liver (1 case), and rectus abdominis (1 case). OUTCOMES: No recurrence was found during postoperative following-up (5-12 months). LESIONS: Preoperative diagnosis of LPD is presented as a challenge due to unspecific clinical manifestations. Its diagnosis mainly depends on histopathologic evaluation. Surgery still is the primary treatment for LPD. For patients without reproductive desire, total abdominal hysterectomy, salpingo-oophorectomy, and debulking can be performed, and the affected tissue should be removed as much as possible based on the risk assessment.


Assuntos
Cavidade Abdominal/patologia , Leiomiomatose/patologia , Pelve/patologia , Cavidade Abdominal/diagnóstico por imagem , Adulto , Feminino , Humanos , Laparoscopia/efeitos adversos , Leiomiomatose/diagnóstico por imagem , Leiomiomatose/etiologia , Pessoa de Meia-Idade , Morcelação/efeitos adversos , Pelve/diagnóstico por imagem , Complicações Pós-Operatórias/etiologia , Ultrassonografia
3.
Am J Vet Res ; 81(11): 899-903, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33107753

RESUMO

OBJECTIVE: To determine the degree of histomorphometric damage in dorsal colon and pelvic flexure biopsy specimens (DCBSs and PFBSs, respectively) obtained from horses with large colon volvulus (LCV) and assess the accuracy of predicting short-term outcome for those horses on the basis of DCBS or PFBS characteristics. ANIMALS: 18 horses with ≥ 360° LCV that underwent large colon resection. PROCEDURES: During surgery, biopsy specimens from the dorsal colon resection site and the pelvic flexure (when available) were collected from each horse. Interstitial-to-crypt (I:C) ratio (ratio of the lamina propria space occupied by the interstitium to that occupied by crypts), hemorrhage within the lamina propria (mucosal hemorrhage score [MHS] from 0 to 4), and percentage losses of glandular and luminal epithelium were determined in paired biopsy specimens and compared to determine optimal cutoff values for calculating the accuracy of DCBS and PFBS characteristics to predict short-term outcome (survival or nonsurvival after recovery from surgery). RESULTS: Paired biopsy specimens were obtained from 17 of the 18 horses. The I:C ratio and percentage glandular epithelial loss differed between DCBSs and PFBSs. For DCBSs, an I:C ratio ≥ 0.9 and MHS ≥ 3 each predicted patient nonsurvival with 77.8% accuracy. For PFBSs, an I:C ratio ≥ I and MHS ≥ 3 predicted patient nonsurvival with 70.6% and 82.4% accuracy, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Although different, histomorphometric measurements for either DCBSs or PFBSs could be used to accurately predict short-term outcome for horses with LCV that underwent large colon resection, and arguably PFBSs are easier to collect.


Assuntos
Doenças dos Cavalos , Volvo Intestinal , Animais , Biópsia/veterinária , Colo/cirurgia , Doenças dos Cavalos/cirurgia , Cavalos , Volvo Intestinal/cirurgia , Volvo Intestinal/veterinária , Pelve
4.
J Postgrad Med ; 66(4): 215-217, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33109783

RESUMO

Once purely the domain of knee surgery, the use of computer-navigated techniques in total hip arthroplasty (THA) is becoming progressively more commonplace. As with the adoption of any new technology-assisted approach, the uptake of navigated THA utilization has heralded a new suite of technique-specific potential complications. One such example - not usually seen with conventional instrumented THA - pertains to complications related to the insertion and use of fixed pelvic array trackers. This case report describes the unusual circumstance of retained local bony debris generated through application of self-drilling, self-tapping iliac crest pins (for rigid navigation tracker placement) being mis-interpreted on advanced imaging - at a hospital site remote from the index surgery - as an aggressive, early-stage, chondrosarcomatous lesion. This case highlights the critical importance of both a general awareness of common imaging findings after navigated THA surgery (whereby tracker pins have been employed) and the value of 'hands on' clinical assessment of patients to allow correlation with suspicious imaging findings.


Assuntos
Artroplastia de Quadril/efeitos adversos , Pinos Ortopédicos/efeitos adversos , Articulação do Quadril/cirurgia , Pelve/cirurgia , Fraturas Periprotéticas/diagnóstico por imagem , Cirurgia Assistida por Computador/instrumentação , Idoso de 80 Anos ou mais , Artroplastia de Quadril/instrumentação , Feminino , Humanos , Imageamento Tridimensional , Pelve/diagnóstico por imagem , Complicações Pós-Operatórias , Cirurgia Assistida por Computador/métodos , Tomografia Computadorizada por Raios X , Resultado do Tratamento
5.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1364-1367, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018242

RESUMO

The anterior pelvic plane (APP) defined by both iliac spines and the pubic symphysis, is essential in total hip arthroplasty (THA) for the orientation of the prosthetic cup. However, the APP is nowadays still difficult to determine in computer assisted orthopedic surgery (CAOS). We propose to use a statistical shape model (SSM) of the pelvis to estimate the APP from ipsilateral anatomical landmarks, more easily accessible during surgery in computer assisted THA with the patient in lateral decubitus position. A SSM of the pelvis has been built from 40 male pelvises. Various ipsilateral anatomical landmarks have been extracted from these data and used to deform the SSM. Fitting the SSM to several combinations of these landmarks, we were able to reconstruct the pelvis with an accuracy between 2.8mm and 4.4mm, and estimate the APP inclination with an angular error between 1.3° and 2.8°, depending on the landmarks fitted. Results are promising and show that the APP could be acquired during the intervention from ipsilateral landmarks only.


Assuntos
Artroplastia de Quadril , Cirurgia Assistida por Computador , Humanos , Masculino , Modelos Estatísticos , Orientação Espacial , Pelve/diagnóstico por imagem
6.
Rev Med Suisse ; 16(712): 2042-2045, 2020 Oct 28.
Artigo em Francês | MEDLINE | ID: mdl-33112517

RESUMO

Pelvic congestion syndrome is an underdiagnosed disease, defined as chronic pelvic pain lasting more than 6 months, associated with pelvic varicose veins in premenopausal women. Diagnose is based on imagery after exclusion of other causes of pelvic pains. Echography is first line diagnostic modality. Conservative treatment is often insufficient and pelvic veins embolization is required to improve symptoms.


Assuntos
Embolização Terapêutica , Dor Pélvica/complicações , Dor Pélvica/diagnóstico , Varizes/complicações , Feminino , Humanos , Dor Pélvica/terapia , Pelve/diagnóstico por imagem , Síndrome , Resultado do Tratamento , Varizes/diagnóstico , Varizes/terapia
7.
Orthopade ; 49(10): 870-876, 2020 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-32926204

RESUMO

Spinal alignment changes with age and degeneration. Different compensatory mechanisms of the spine are necessary to preserve spinal balance. The capacity of compensation of the spine decreases with age. Thus, the pelvis and the lower limbs become involved in the compensatory mechanism. Concomitant osteoarthritis of the hip could impair this capacity. The biomechanical principles of compensation are described with respect to planning reconstructive hip and spine surgery.


Assuntos
Pelve/cirurgia , Coluna Vertebral/cirurgia , Cirurgiões , Humanos , Extremidade Inferior , Radiografia
8.
Orthopade ; 49(10): 849-859, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32944784

RESUMO

The field of musculoskeletal diagnostics and personalized medicine has undergone a revolutionary transformation due to a deeper understanding of skeletal biomechanics and due to technological advancements. Analogous to this transformation, our understanding of spinopelvic conditions has experienced a paradigm shift in terms of both static and dynamic changes in spinopelvic pathologies and enabled a more accurate delineation of the drivers of disability. The purpose of this review is to describe the standard and state of the art of preoperative diagnostic and planning methods for common spinopelvic pathologies and to discuss both the added clinical value and limitations. The rationale is to accelerate the accurate and timely diagnosis and as well as the efficient and safe preoperative workflow.


Assuntos
Pelve/diagnóstico por imagem , Coluna Vertebral/diagnóstico por imagem , Humanos , Pelve/patologia , Período Pré-Operatório , Coluna Vertebral/patologia
9.
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
10.
J Sports Sci ; 38(19): 2200-2207, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32921248

RESUMO

The aims of this study were (a) to describe the kinematics underlying the phenomenon of the knee of the swing leg passing medially in front of the athlete during the single push (SP) phase of the block sprint start, and (b) to determine the relationships between block phase pelvis range of motion (RoM), 1st step width and block phase performance. Three-dimensional kinematic data (250 Hz) were collected from eleven competitive sprinters (100 m PB: 11.17 ± 0.41) performing maximal effort block starts. The joint angles of the rear hip with respect to the pelvis and the pelvis segment angles with respect to the laboratory coordinate system were calculated during the block start phase to the end of the 1st stance. A combination of pelvis list and rotation (not hip adduction) was coupled with the thigh of the swing leg moving medially during the SP phase. A very high positive correlation was found between pelvic list RoM and 1st step width (r = 0.799, p = 0.003). No other significant correlations were found. Attempting to reduce pelvic RoM or changing frontal and transverse plane hip joint angles to minimise medial thigh motion is unlikely to lead to an improvement to performance.


Assuntos
Articulação do Joelho/fisiologia , Pelve/fisiologia , Corrida/fisiologia , Aceleração , Fenômenos Biomecânicos , Feminino , Análise da Marcha , Articulação do Quadril/fisiologia , Humanos , Masculino , Postura/fisiologia , Amplitude de Movimento Articular , Coxa da Perna/fisiologia , Estudos de Tempo e Movimento , Adulto Jovem
11.
J Sports Med Phys Fitness ; 60(8): 1072-1080, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32955833

RESUMO

BACKGROUND: This study aims at describing and comparing each other male and female soccer players kicking instep a stationary ball. The different measures we collected by the 3D motion capture system Movit G1 and the High-Speed Camera (240 fps) were considered as dependent variables, whereas the gender was considered as the independent one. METHODS: Twenty soccer well trained non-professional players: 10 men (age: 25.3±6.5 yrs; height 1.80±0.07 m; body mass 76.9±13.2 kg) and 10 women (age: 19±3.34 yrs; height 1.64±0.07 m; body mass 58.2±7.2 kg) volunteered to participate in the study. RESULTS: Gender differences were found, with a statistical significance (P<0.05) or interesting magnitude (Cohen d>0.5). The most relevant ones were the differences in hip extension of the kicking leg when the foot of the supporting one touches the ground, just before the impact on the ball (independent sample t-Test; P=0.03; Cohen d=1.64) and the speed of the ball, reached immediately after kicking (P<0.001;d=1.23). CONCLUSIONS: These results, together with the greater pelvic acceleration shown by men compared to women, highlight the need to develop a gender-differentiated training model, in order to customize the kicking technique in women and to reduce the likelihood, currently higher than for men, of kicking related injuries.


Assuntos
Extremidade Inferior/fisiologia , Futebol/fisiologia , Aceleração , Adulto , Fenômenos Biomecânicos , Feminino , Pé/fisiologia , Quadril/fisiologia , Humanos , Joelho/fisiologia , Masculino , Pelve/fisiologia , Caracteres Sexuais , Fatores Sexuais , Estudos de Tempo e Movimento , Adulto Jovem
12.
J Sports Med Phys Fitness ; 60(8): 1128-1136, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32955839

RESUMO

BACKGROUND: Little is known about the changes in biomechanical risk factors for an anterior cruciate ligament (ACL) injury after participation in a pelvic and core strength training (PCST) program in female team players. METHODS: This is a randomized controlled trial for which a total of 29 female soccer players were recruited from a soccer club and split into two groups, namely, experimental group (EG, N.=18; mean [SD] age, 17.8 [2.0 years], weight 64.0 [6.6] kg and height 1.7 [0.0] m) and control group (control, N.=11; mean [SD] age, 16.2 [1.2] years, weight 61.6 [7.3] kg and height 1.7 [0.0] m). The EG participated in an in-season 8-week PCST program (twice/week). Participants in the CG performed their normal training without additional pelvic and core strengthening. Pre- and postintervention knee frontal plane projection angle (FPPA), hip, knee and ankle peak flexion angles and jump height were collected during bilateral and unilateral drop jumps. RESULTS: PCST significantly reduced FPPA at dynamic landing, in both dominant (-7.1º) and non-dominant lower extremities (-8º). Further, this training significantly increased the peak hip (24.4º) and knee flexion angles (14.94º), but not the peak ankle dorsiflexion angle (P>0.05) which, significantly decreased in the CG (-3.5º). Following the intervention, EG significantly increased measures obtained for both bilateral (2.84 cm) and unilateral jumps (1.33 cm for the dominant leg and 1.22 cm for the non-dominant leg) (P<0.05), not so for CG (P<0.05). CONCLUSIONS: PCST resulted in improvements on ACL injury risk factors and vertical drop jump performance, suggesting that strengthening this body part warrants not only injury prevention, but increases jumping performance.


Assuntos
Lesões do Ligamento Cruzado Anterior/prevenção & controle , Força Muscular/fisiologia , Pelve/fisiologia , Treinamento de Resistência/métodos , Futebol/lesões , Futebol/fisiologia , Adolescente , Tornozelo/fisiologia , Fenômenos Biomecânicos , Feminino , Quadril/fisiologia , Humanos , Lactente , Joelho/fisiologia , Fatores de Risco
13.
Bone Joint J ; 102-B(10): 1311-1318, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32993337

RESUMO

AIMS: Morphological abnormalities are present in patients with developmental dysplasia of the hip (DDH). We studied and compared the pelvic anatomy and morphology between the affected hemipelvis with the unaffected side in patients with unilateral Crowe type IV DDH using 3D imaging and analysis. METHODS: A total of 20 patients with unilateral Crowe-IV DDH were included in the study. The contralateral side was considered normal in all patients. A coordinate system based on the sacral base (SB) in a reconstructed pelvic model was established. The pelvic orientations (tilt, rotation, and obliquity) of the affected side were assessed by establishing a virtual anterior pelvic plane (APP). The bilateral coordinates of the anterior superior iliac spine (ASIS) and the centres of hip rotation were established, and parameters concerning size and volume were compared for both sides of the pelvis. RESULTS: The ASIS on the dislocated side was located inferiorly and anteriorly compared to the healthy side (coordinates on the y-axis and z-axis; p = 0.001; p = 0.031). The centre of hip rotation on the dislocated side was located inferiorly and medially compared to the healthy side (coordinates on the x-axis and the y-axis; p < 0.001; p = 0.003). The affected hemipelvis tilted anteriorly in the sagittal plane (mean 8.05° (SD 3.57°)), anteriorly rotated in the transverse plane (mean 3.31° (SD 1.41°)), and tilted obliquely and caudally in the coronal plane (mean 2.04° (SD 0.81°)) relative to the healthy hemipelvis. The affected hemipelvis was significantly smaller in the length, width, height, and volume than the healthy counterpart. (p = 0.014; p = 0.009; p = 0.035; p = 0.002). CONCLUSION: Asymmetric abnormalities were identified on the affected hemipelvis in patients with the unilateral Crowe-IV DDH using 3D imaging techniques. Improved understanding of the morphological changes may influence the positioning of the acetabular component at THA. Acetabular component malpositioning errors caused by anterior tilt of the affected hemi pelvis and the abnormal position of the affected side centre of rotation should be considered by orthopaedic surgeons when undertaking THA in patients with Crowe-IV DDH. Cite this article: Bone Joint J 2020;102-B(10):1311-1318.


Assuntos
Luxação Congênita de Quadril/diagnóstico por imagem , Imageamento Tridimensional , Pelve/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
14.
Hinyokika Kiyo ; 66(9): 283-287, 2020 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-32993271

RESUMO

Sixty eight patients had robot-assisted radical prostatectomy (RARP) from January 2016 to April 2017 with estimated blood loss of less than 500 ml. We compared the postoperative complication rates and the length of hospital stay between 34 of these patients who had pelvic drain placement (PD group), and the remaining 34 patients who had no drain placement (ND group). The approach was intraperitoneal in 25 patients in each group. The PD and ND groups were comparable for age (69.5 vs 70 yrs, P=0.459), clinical Gleason Score (6/7/≧8) 2/17/15 vs 3/8/23 (P=0.077), clinical stage (1c/2/3) 3/25/6 vs 1/25/8 (p=0. 539), operative time (311 vs 309 min, P=0.868), and estimated blood loss (p=0.166). The PD group had significantly higher median PSA level than the ND group (8.01 vs 6.25 ng/ml, P=0.023). Incidence of 30- day overall complications in the PD group (35 events) was lower than that in the ND group (38 events). All complications were classified as Clavien Dindo grade I. The postoperative hospital stay was 8 days in the PD group and 7 days in the ND group, showing no prolongation in the ND group. Pelvic drainage may be omitted after RARP without increasing postoperative complications or prolonging the hospital stay.


Assuntos
Neoplasias da Próstata/cirurgia , Robótica , Drenagem , Humanos , Masculino , Pelve/cirurgia , Prostatectomia
15.
Zhongguo Gu Shang ; 33(9): 862-6, 2020 Sep 25.
Artigo em Chinês | MEDLINE | ID: mdl-32959576

RESUMO

OBJECTIVE: To analyze the characteristics of lumbar spine-pelvic structure in degenerative lumbar spondylolisthesis and its significance in degenerative lumbar spondylolisthesis(DLS). METHODS: The clinical data of 45 patients with simple degenerative L4, 5-segment lumbar spondylolisthesis (spondylolisthesis group) admitted from April 2015 to January 2017 were retrospectively analyzed, which were compared with 50 healthy people with complete physical examination data in the same period(control group). Statistical analysis of the lumbar spine-pelvic structure parameters of the subjects through imaging data was performed to analyze the characteristics of the spine-pelvis of DLS patients. The degenerative characteristicsof intervertebral disc and articular process joint were observed in degenerative lumbar spondylolisthesis. Use Spearson to analyze the correlation between observation items. RESULTS: The facet joint angle, lumbar lordosis angle (LL), pelvic incidence angle(PI), pelvic tilt angle (PT), sacral slope angle (SS) in spondylolisthesis group of L4, 5-segment were (36.5±11.2)°, (44.2±7.3)°, (66.5±11.6)°, ( 22.2±10.0)°, (33.4±11.3)°, respectively, while in control group were (44.4±8.2)°, (36.7±8.5)°, (55.4± 13.2)°, (14.4±7.0)°, (42.3±13.1)°. PI, LL, PT of spondylolisthesis group were obviously larger than that of control group (P< 0.05), the facet joint angle and SS of spondylolisthesis group were smaller than that of control group(P<0.05). The correlation analysis showed that PI value was related to the PT and SS in two group. The degree of degeneration of intervertebral disc was related to the degree of spondylolisthesis. The degree of degeneration of L3-S1 intervertebral disc and L4, 5 facet jointin spondylolisthesis group was more serious (P <0.05). CONCLUSION: Lumbar spinal pelvic structure of degenerative lumbar spondylolisthesis has undergone significant changes. Lumbar lordosis and pelvic dumping phenomenon in the mechanism of lumbar degeneration plays an important role. Lumbar facet joint degeneration and lumbar intervertebral disc degeneration are mutually promoted, and lumbar spondylolisthesis aggravates intervertebral disc and facet joint degeneration.


Assuntos
Degeneração do Disco Intervertebral , Espondilolistese , Humanos , Vértebras Lombares , Região Lombossacral , Pelve , Estudos Retrospectivos
16.
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
17.
Leg Med (Tokyo) ; 47: 101771, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32795933

RESUMO

The classification performance of the statistical methods binary logistic regression (BLR), multinomial and penalized multinomial logistic regression (MLR, pMLR), linear discriminant analysis (LDA), and the machine learning algorithms naïve Bayes classification (NBC), decision trees (DT), random forest (RF), artificial neural networks (ANN), support vector machines (linear, polynomial or radial) (SVM), multivariate adaptive regression splines (MARS), and extreme gradient boosting (XGB) is examined in skeletal sex/ancestry estimation. The datasets used to test the performance of these methods were obtained from a documented human skeletal collection, Athens Collection, and the Howells Craniometric data set. For their implementation, an R package has been written to search for the optimum tuning parameters under cross-validation and perform sex/ancestry classification. It was found that the classification performance may vary significantly depending on the problem. From the methods tested, LDA and the machine learning technique of linear SVM exhibit the best performance, with high prediction accuracy and relatively low bias in most of the tests. ANN and pMLR can generally be considered to give satisfactory predictions, whereas NBC when using metric traits and DT are the worst of the classification methods examined. The possibility of making the models developed via the machine learning algorithms applicable to other assemblages without the use of a training sample is also discussed.


Assuntos
Algoritmos , Grupos de Populações Continentais/classificação , Aprendizado de Máquina , Restos Mortais , Análise Discriminante , Feminino , Antropologia Forense/métodos , Humanos , Masculino , Pelve , Determinação do Sexo pelo Esqueleto/métodos , Crânio , Máquina de Vetores de Suporte
18.
J Vasc Interv Radiol ; 31(10): 1560-1569, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32855049

RESUMO

PURPOSE: The purpose of this study was to determine the efficacy and safety of embolization treatment in pelvic venous disorders in women refluxing in the ovarian and or internal iliac veins in women with chronic pelvic pain. MATERIALS AND METHODS: A retrospective study conducted from January 2000 to June 2017 in 617 patients diagnosed with pelvic venous disorders (PeVDs) with a mean age of 43.2 ± 7.2 years were treated using an embolization procedure. A total of 520 were included, and 97 patients were excluded. The main inclusion criteria were PeVD symptoms for more than 6 months and transvaginal Doppler ultrasonography (TV-DUS) diagnosis of varicose veins in the pelvis with a diameter greater than 6 mm. The main objective was to embolize the 4 main pelvic venous plexi (ovarian and internal iliac veins) whenever possible. Follow-up was performed using clinical symptoms (visual analog scale) and TV-DUS at 1, 3, 6, and 12 months and then every year up to 5 years. RESULTS: The technical success (embolization of the 4 main pelvic veins) was achieved in 84.4% of the patients. The average follow-up was 58.7 ± 5.7 months. The visual analog scale was improved from 7.63 ± 0.9 points pretreatment to 0.91 ± 1.5 at 5 years. A total of 26 patients (5%) presented with symptom recurrence and pelvic varicose veins. There were 57 minor complications (10.9%) and 11 major complications (2.1%), with 7 cases (1.34%) of device migration to the lung. CONCLUSIONS: The embolization of pelvic varicose veins is a safe and effective procedure. The selection of the embolic agents and the number of veins needed to be treated.


Assuntos
Dor Crônica/prevenção & controle , Embolização Terapêutica , Ovário/irrigação sanguínea , Dor Pélvica/prevenção & controle , Pelve/irrigação sanguínea , Varizes/terapia , Veias , Adulto , Dor Crônica/diagnóstico , Dor Crônica/etiologia , Embolização Terapêutica/efeitos adversos , Embolização Terapêutica/instrumentação , Feminino , Humanos , Pessoa de Meia-Idade , Dor Pélvica/diagnóstico , Dor Pélvica/etiologia , Recidiva , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento , Varizes/diagnóstico por imagem , Veias/diagnóstico por imagem
19.
Br J Radiol ; 93(1114): 20200565, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-32783630

RESUMO

OBJECTIVES: To investigate via computer simulation, an optimised tube voltage (kVp) range for caesium iodide (CsI)-based digital radiography (DR) of the abdomen, pelvis and lumbar spine. METHODS: Software capable of simulating abdomen, pelvis and spine radiographs was used. Five evaluators graded clinical image criteria in images of 20 patients at tube voltages ranging from 60 to 120 kVp in 10 kVp increments. These criteria were scored blindly against the same patient reconstructed at a specific reference kVp. Linear mixed effects analysis was used to evaluate image scores for each criterion and test for statistical significance. RESULTS: Score was dependent on tube voltage and image criteria; both were statistically significant. All criteria for all anatomies scored very poorly at 60 kVp. Scores for abdomen, pelvis and spine imaging peaked at 70, 70 and 100 kVp, respectively, but other kVp values were not significantly poorer. CONCLUSIONS: Results indicate optimum tube voltages of 70 kVp for abdomen and pelvis (with an optimum range 70-120 kVp), and 100 kVp (optimum range 80-120 kVp) for lumbar spine. ADVANCES IN KNOWLEDGE: There are no recommendations for optimised tube voltage parameters for DR abdomen, pelvis or lumbar spine imaging. This study has investigated and recommended an optimal tube voltage range.


Assuntos
Abdome/diagnóstico por imagem , Pelve/diagnóstico por imagem , Intensificação de Imagem Radiográfica/métodos , Coluna Vertebral/diagnóstico por imagem , Algoritmos , Césio , Simulação por Computador , Humanos , Iodetos , Imagens de Fantasmas , Interpretação de Imagem Radiográfica Assistida por Computador , Software
20.
Zhonghua Wei Chang Wai Ke Za Zhi ; 23(5): 472-479, 2020 May 25.
Artigo em Chinês | MEDLINE | ID: mdl-32842427

RESUMO

Objective: To evaluate the factors affecting the degree of radical resection and the prognosis of patients with locally recurrent rectal cancer (LRRC). Methods: A retrospective case-control study was performed. Clinical data of 111 patients with LRRC undergoing operation at the General Surgery Department of Peking University First Hospital from January 2009 to August 2019 were analyzed retrospectively. The "Peking University First Hospital F typing" was performed according to the preoperative images of the pelvic involvement. The pelvis was assigned into four directions: the front wall, lateral sides of the pelvic wall and the sacrum. According to the degree of pelvic wall involvement, F typing included F0 type (no involvement of the pelvic wall, the cancer only involved the adjacent organs or invaded conteriorly the urinary tract, genital organs or small intestine), F1 type (cancer involved the pelvic wall in one direction, such as the sacrum, or one side of the pelvic wall), F2 type (cancer involved the pelvic wall in two directions) and F3 type (cancer involved the pelvic wall in three directions). Case inclusion criteria: (1) LRRC was confirmed by imaging and pathological examination of samples (puncture or endoscopic biopsy); (2) complete clinical and follow-up data; (3) informed consent of patient. Those with dysfunction of heart, lung, etc., intolerance of operation, F3 type indicated by image, and distant metastasis were excluded. The degree of radical resection was evaluated according to the postoperative pathological results. Patients were followed up every 12 months and related examinations were arranged. The univariate analysis of radical resection was performed by χ(2) test, and the multivariate analysis was performed by logistic methods. The survival rate was calculated by Kaplan-Meier method and the survival curve was drawn. The survival rate was compared by log-rank test. Cox proportional hazards model was used to analyze the factors affecting the prognosis of patients with LRRC. Results: A total of 111 patients were included in this study. Of 111 patients, 59 were male and 52 were female; recurrent age of 36 cases was ≥ 65 years old; CEA level of 48 cases was ≥15 µg/L. According to the "Peking University First Hospital F typing", 70 cases were F0 type, 38 F1 type and 3 F2 type. Surgical procedures were abdominoperineal resection (n=28), posterior pelvic exenteration (n=32), and total pelvic exenteration (n=51, including 1 case of TPE combined with sacrectomy). According to the postoperative pathological results, R0, R1 and R2 resections were 83, 20 and 8 cases, respectively. Univariate analysis showed that the degree of radical resection was associated with the secondary surgical procedure, F typing and lymph node metastasis (all P<0.05). Multivariate analysis showed that F typing (F1-F2) was an independent risk factor for non- R0 resection (OR=37.256, 95%CI:8.572 to 161.912, P<0.001). The morbidity of operative complications was 22.5% (25/111); the perioperative mortality was 1.8% (2/111); the local recurrence rate after the second operation was 37.8% (42/111). The 3- and 5-year overall survival rates were 41.2% and 21.9% respectively. The 3-year survival rates of patients with and without postoperative chemotherapy were 52.7% and 32.4% respectively (P=0.005). The 3-year survival rates of patients with lower (<15 µg/L) and higher CEA level (≥15 µg/L) were 52.9% and 24.3% respectively (P<0.001). The 3-year survival rates of patients with R0, R1 and R2 resection were 49.8%, 21.3% and 8.5% respectively (P=0.002). The 3-year survival rates of patients with F0, F1 and F2 type were 52.7%, 22.0% and 0 respectively (P<0.001). Cox analysis confirmed that the degree of radical resection (HR=2.088, 95%CI:1.095 to 3.979, P=0.025), the CEA level before the secondary operation (HR=1.857, 95%CI:1.157 to 2.980, P=0.010) and postoperative chemotherapy (HR=1.826, 95%CI:1.137 to 2.934, P=0.013) were independent factors affecting the prognosis. Conclusions: The indication of LRRC surgical treatments must be strictly limited. Evaluation of the fixation site to the pelvic wall is helpful for improving the rate of R0 resection. Lower preoperative CEA level, radical resection and postoperative chemotherapy are protective factors of prolonged overall survival time of patients with LRRC.


Assuntos
Recidiva Local de Neoplasia/cirurgia , Neoplasias Retais/cirurgia , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/patologia , Pelve/cirurgia , Prognóstico , Neoplasias Retais/mortalidade , Neoplasias Retais/patologia , Estudos Retrospectivos , Fatores de Risco , Sacro/cirurgia
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