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1.
Artigo em Chinês | MEDLINE | ID: mdl-33040513

RESUMO

A 6 year-old boy, who complained right neck abscesses and X-ray showed left pyriform fistula, was diagnosed as bilateral pyriform sinus fistulas. For bilateral pyriform sinus fistulas, endoscopic CO2laser cauterization should be the first treatment choice.


Assuntos
Fístula , Seio Piriforme , Cauterização , Criança , Fístula/cirurgia , Humanos , Masculino , Pescoço , Estudos Retrospectivos
2.
Praxis (Bern 1994) ; 109(13): 1033-1034, 2020.
Artigo em Alemão | MEDLINE | ID: mdl-33050808

RESUMO

CME Answers: Crowned Dens Syndrome - the Chameleon of Neck Pain Abstract. Crowned Dens Syndrome (CDS) is a rare, under-diagnosed differential diagnosis of acute neck pain. Diagnosis is a challenge in clinical practice due to the similarity of symptoms to other diseases. Knowing this differential diagnosis of acute neck pain, unnecessary examinations and expensive therapy attempts can be avoided with a targeted approach. With this article we would like to sensitize colleagues accordingly.


Assuntos
Cervicalgia , Tomografia Computadorizada por Raios X , Diagnóstico Diferencial , Humanos , Pescoço , Cervicalgia/diagnóstico por imagem , Cervicalgia/etiologia , Síndrome
4.
Tokai J Exp Clin Med ; 45(3): 108-112, 2020 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-32901896

RESUMO

A 33G, 12-mm needle broke and entered the soft tissue in a 60-year old man. Panoramic X-ray imaging and cone-beam computed tomography (CT), which we performed a few hours after the breakage, revealed the needle in the soft tissue of the lower right mandibular molar. We immediately made an incision in the buccal gingiva of the lower right mandibular molar under local anesthesia and attempted to remove the needle but could not locate it. Thereafter, we adopted a watch-and-wait approach, as the patient had no subjective symptoms. Nine months later, we confirmed via CT that the needle had migrated subcutaneously to the right side of the neck. Two months later, we identified its location using C-arm fluoroscopy and removed it under general anesthesia. This report is a rare case and we are the first to document the subcutaneous migration of a fractured needle.


Assuntos
Corpos Estranhos , Migração de Corpo Estranho/diagnóstico , Migração de Corpo Estranho/cirurgia , Gengiva , Mandíbula , Pescoço , Agulhas/efeitos adversos , Anestesia Dentária , Anestesia Local , Tomografia Computadorizada de Feixe Cônico , Fluoroscopia , Humanos , Masculino , Pessoa de Meia-Idade
5.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 42(4): 491-496, 2020 Aug 30.
Artigo em Chinês | MEDLINE | ID: mdl-32895101

RESUMO

Objective To investigate the value of head and neck CT angiography(CTA)in the evaluation of intraoperative hemorrhage of carotid body tumours. Methods Head and neck CTA images of 36 patients with carotid body tumours confirmed by pathology were retrospectively analyzed.Patients were divided into two groups based on the intraoperative bleeding volume:<500 ml and≥500 ml groups.The patient's age,sex,Shamblin classification,size of the lesion,number of blood supply arteries,course of the disease,plain scan,and enhanced CT value between two groups were compared and analyzed.Logistics regression equation was established based on the CTA parameters with significant differences between the two intraoperative bleeding volume groups,and combined parameter was acquired.The receiver operating characteristic curve was established based on CTA single and combined parameters. Results The bleeding volume during the operation of carotid body tumors was significantly correlated with the age of patients(P=0.019),the maximum diameter of tumours on axial images(P=0.003),the maximum upper and lower diameters(P=0.004),Shamblin classification(P=0.012),and number of blood supply arteries(P<0.001).The area under the receiver operating characteristic curve of the number of feeding arteries,the maximum diameter of axial images,maximum upper and lower diameters,Shamblin classification,and combined parameters were 0.865,0.781,0.806,0.766,and 0.927,respectively.When the optimal critical value was 0.408,the Youden index was 0.794,and the corresponding accuracy,sensitivity,and specificity were 0.919,0.909,and 0.923,respectively. Conclusions Preoperative head and neck CTA can be used to evaluate the intraoperative blood loss.Combined parameters has the best diagnostic performance compared with single parameters.


Assuntos
Tumor do Corpo Carotídeo , Angiografia por Tomografia Computadorizada , Tumor do Corpo Carotídeo/diagnóstico por imagem , Cabeça , Humanos , Pescoço , Estudos Retrospectivos
6.
Rev Col Bras Cir ; 47: e20202524, 2020 Sep 04.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32901705

RESUMO

OBJECTIVE: to identify predictive factors for lethality and complications of deep fascial space infections of the neck (DFSIN), establishing an early and aggressive treatment in the neck before the progression to descending mediastinitis. METHODS: we retrospectively analyzed 133 cases of DFSIN treated at Discipline of Head and Neck Surgery of the Medicine School of Santa Casa de Misericórdia de São Paulo. We accessed demographic characteristics, associated diseases, clinical presentation, laboratorial tests, length of hospital stay, number of involved anatomic neck spaces, intra-operative and microbiology findings. We analyzed these data using logistic regression to predict DFSIN lethality and life threatening complications (mediastinitis, septic shock, pneumonia, pleural empyema, skin necrosis). RESULTS: lethality and complication ratios were 9% and 50.3%, respectively. The logistic regression model showed that patients with septic shock were more likely to have progression to death (p < 0.001) and, the presence of more than two involved neck spaces (p < 0.001) and older individuals (p = 0.017) were more likely to have complicated deep neck infections. Descending necrotizing mediatinitis increased the lethality ratio by 50%, and was associated to necrotizing fasciitis (p=0.012) and pleural empyema (p<0.001). CONCLUSION: septic shock is a lethal predictive factor and age as well as more than two involved neck spaces are the predictive factors for complications. Necrotizing fasciitis is an important factor for complications and death. Therefore, its surgical treatment must be more aggressive. Descending mediastinitis has a high lethal rate and the successful treatment is based on early diagnosis and aggressive surgical approach.


Assuntos
Fasciite Necrosante/mortalidade , Infecções , Pescoço , Adulto , Empiema Pleural , Fáscia , Humanos , Infecções/complicações , Infecções/etiologia , Pessoa de Meia-Idade , Estudos Retrospectivos
7.
Facial Plast Surg ; 36(4): 395-403, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32866977

RESUMO

Over the history of facial rejuvenation surgery there has been a progressive assimilation of knowledge about the anatomy of neck structures that are central to the manifestations of the aging neck. These advances in knowledge have been accompanied by the innovation and introduction of several surgical techniques to restore the neck to a more youthful appearance. The rejuvenation of the aging neck frequently incorporates a consideration and execution of accepted methods to restore the platysma muscles to a more aesthetic form. Lasting and dependable surgical techniques remain somewhat elusive and late failures in the neck continue to be a frustration for both patients and surgeons.In this manuscript, the author reviews some of the more enduring and innovative methods to manage the platysma in facelifting and cites the rationale and limitations of the various techniques. The concept of the restoration of an effective platysma "sling" in the upper neck to eliminate platysma bands and recreate a defined jawline is highlighted. A framework of patient evaluation and decision making is presented, and a suggested individualized application of accepted surgical maneuvers is suggested.


Assuntos
Ritidoplastia , Estética Dentária , Humanos , Pescoço/cirurgia , Músculos do Pescoço/cirurgia , Rejuvenescimento
8.
Facial Plast Surg ; 36(4): 416-429, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32866979

RESUMO

South America is a vast territory; its people were made from all parts of the world. The miscegenation made a unique population comprised of Indian, Asian, Caucasian, African, Mestizo, Mulatto, and Zambo. The South American patients tend to have a wider face with a skin-soft tissue envelope (S-STE) that is thicker, heavier, and has less elasticity than the Caucasian patient. Upper eyelids may hood easily. In the same way, malar eminences and round face look are more prominent. The chin can be a little retracted. With aging, the S-STE tends to sag more, making nasolabial folds and jowl area more prominent, and redundant neck skin will appear loose and heavy. Facelift is popular in South American patients. They have peculiar characteristics like heavy dark sebaceous skin which lead to peculiarities in face lifting. It is usually a procedure designed to rejuvenate all thirds of the face. In the forehead, skin excision in temporal incisions is usually necessary. Midface subperiosteal lift is a possibility for heavy skin patients who need great improvement in the center of the face. The neck lift is almost indispensable to the rejuvenation of the lower third. Extended superficial muscular aponeurotic system or deep plane dissection is commonly performed so the soft tissues of the midface, the jowls, and the neck can be lifted to reestablish their youthful relationship with the underlying skeleton.


Assuntos
Ritidoplastia , Testa/cirurgia , Humanos , Pescoço , Rejuvenescimento , Zigoma
9.
Facial Plast Surg ; 36(4): 430-446, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32866980

RESUMO

Energy-based facelifting techniques are a relatively new genre of surgery. In this approach, the energy-based device-whether laser, radiofrequency plasma, or ultrasound-can be used in the superficial plane to elevate skin flaps before performing more traditional facelift techniques involving the superficial musculoaponeurotic system (SMAS) or platysma. The initial reports of utilizing fiber lasers as surgical tools date back to approximately 2007 and initial lipolasers were used to elevate facial skin flaps. The other energy-based devices were also tested. The author has probably the largest series of energy-based facial rejuvenation procedures, having performed over 3,000 of these procedures. The advantages of laser-assisted rhytidectomy include hemostasis, facilitated dissection in areas hard to elevate conventionally such as nasolabial folds or distal neck and the remodeling and tightening of tissue that results from the activation of the wound healing cascade of neocollagenesis and wound contraction. The author currently has a preference for energy device used during rhytidectomy and it is a high frequency ultrasound energy delivered by a five-ring 2.9- and 3.7-mm probe. The use of the ultrasound dissector in both superficial and deep procedures is highlighted in this article with emphasis on its use for deep cervicoplasty and subplatysmal procedures as well as sub-SMAS elevations of the facial deep plane.


Assuntos
Ritidoplastia , Sistema Musculoaponeurótico Superficial/cirurgia , Dissecação , Pescoço/cirurgia , Rejuvenescimento
10.
Facial Plast Surg ; 36(4): 462-477, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32866983

RESUMO

All surgical and minimally invasive procedures carry a risk of complications. It is imperative that the facial plastic surgeon and his/her staff are well educated in recognizing and managing all the possible problems that could arise. They must also be ready and able to deal with and correct any problem. The patient undergoing surgery or a procedure also needs to be informed of all possible sequelae and complications. Sequelae will happen after almost all procedures. These include soreness, swelling, bruising, and so on. If the patients understand that these are to be expected, they will be less likely to be overly concerned about them. They also must be educated about all the possible complications. They should be told that while complications are very rare, they could nevertheless happen. If a problem should arise, the surgeon and his/her staff should correct it and see that the patient receives the best care possible. This article examines the complications that could occur after rejuvenation surgery and minimally invasive procedures of the lower face and neck, what measures can be undertaken to reduce the risks, and how to recognize and manage them.


Assuntos
Rejuvenescimento , Ritidoplastia , Face , Feminino , Humanos , Masculino , Pescoço
11.
N Z Med J ; 133(1520): 50-60, 2020 08 21.
Artigo em Inglês | MEDLINE | ID: mdl-32994593

RESUMO

AIM: Therapeutic lymphadenectomy remains the gold standard for surgical management of clinically evident regional cervical disease for cutaneous malignancy. However, international consensus on adequate lymphadenectomy is lacking. Attempts have been made to establish quality measures; suggested benchmarks for minimum and average nodal yield, as well as recurrence and complication rates have been quoted. We aim to compare our key performance indicators to those benchmarks published in the literature. METHODS: This is a retrospective observational study conducted with prospectively maintained data, over an 11-year period (2007-2018). RESULTS: Of 91 cervical lymphadenectomies included, mean nodal yield for ≤3 and ≥4 dissection levels were 19.7 and 38.7 respectively. We observed a combined locoregional recurrence rate of 25%. Subgroup analysis for melanoma (60) and cSCC (28) revealing regional nodal recurrence of 15% and 11%, respectively. We observed a 38.5% complication rate; however, less than 5.5% was considered grade IIIb/IIIb(d) [Clavein-Dindo]. Median follow-up of 19.3 months, five-year survivial rate of 38% and 32% for melanoma and cSCC, respectively. CONCLUSION: Our data indicates that we are meeting quality measures, set by higher volume centres. We believe that any surgeon with subspecialty training in head and neck surgery can meet quality measures with regards to cervical lymphadenopathy for cutaneous malignancy.


Assuntos
Excisão de Linfonodo/métodos , Linfonodos/cirurgia , Pescoço/patologia , Neoplasias Cutâneas/patologia , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/patologia , Feminino , Seguimentos , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Metástase Linfática/patologia , Masculino , Melanoma/patologia , Pessoa de Meia-Idade , Gradação de Tumores/métodos , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/patologia , Nova Zelândia/epidemiologia , Guias de Prática Clínica como Assunto , Indicadores de Qualidade em Assistência à Saúde , Estudos Retrospectivos , Neoplasias Cutâneas/secundário , Cirurgiões/educação , Taxa de Sobrevida
12.
Nat Commun ; 11(1): 4829, 2020 09 24.
Artigo em Inglês | MEDLINE | ID: mdl-32973154

RESUMO

The computed tomography angiography (CTA) postprocessing manually recognized by technologists is extremely labor intensive and error prone. We propose an artificial intelligence reconstruction system supported by an optimized physiological anatomical-based 3D convolutional neural network that can automatically achieve CTA reconstruction in healthcare services. This system is trained and tested with 18,766 head and neck CTA scans from 5 tertiary hospitals in China collected between June 2017 and November 2018. The overall reconstruction accuracy of the independent testing dataset is 0.931. It is clinically applicable due to its consistency with manually processed images, which achieves a qualification rate of 92.1%. This system reduces the time consumed from 14.22 ± 3.64 min to 4.94 ± 0.36 min, the number of clicks from 115.87 ± 25.9 to 4 and the labor force from 3 to 1 technologist after five months application. Thus, the system facilitates clinical workflows and provides an opportunity for clinical technologists to improve humanistic patient care.


Assuntos
Angiografia/métodos , Vasos Sanguíneos/diagnóstico por imagem , Cabeça/diagnóstico por imagem , Processamento de Imagem Assistida por Computador/métodos , Imageamento Tridimensional/métodos , Pescoço/diagnóstico por imagem , Rede Nervosa/diagnóstico por imagem , Idoso , Osso e Ossos/diagnóstico por imagem , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
13.
Nan Fang Yi Ke Da Xue Xue Bao ; 40(4): 491-498, 2020 Apr 30.
Artigo em Chinês | MEDLINE | ID: mdl-32895133

RESUMO

OBJECTIVE: To establish an algorithm based on 3D convolution neural network to segment the organs at risk (OARs) in the head and neck on CT images. METHODS: We propose an automatic segmentation algorithm of head and neck OARs based on V-Net. To enhance the feature expression ability of the 3D neural network, we combined the squeeze and exception (SE) module with the residual convolution module in V-Net to increase the weight of the features that has greater contributions to the segmentation task. Using a multi-scale strategy, we completed organ segmentation using two cascade models for location and fine segmentation, and the input image was resampled to different resolutions during preprocessing to allow the two models to focus on the extraction of global location information and local detail features respectively. RESULTS: Our experiments on segmentation of 22 OARs in the head and neck indicated that compared with the existing methods, the proposed method achieved better segmentation accuracy and efficiency, and the average segmentation accuracy was improved by 9%. At the same time, the average test time was reduced from 33.82 s to 2.79 s. CONCLUSIONS: The 3D convolution neural network based on multi-scale strategy can effectively and efficiently improve the accuracy of organ segmentation and can be potentially used in clinical setting for segmentation of other organs to improve the efficiency of clinical treatment.


Assuntos
Processamento de Imagem Assistida por Computador , Órgãos em Risco , Cabeça , Humanos , Pescoço , Redes Neurais de Computação , Tomografia Computadorizada por Raios X
14.
Georgian Med News ; (304-305): 91-95, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32965256

RESUMO

The aim of the study is to determine the clinical and laboratory characteristics of acute lymphadenitis in children.; The study was performed using retrograde analysis of diagnosis and treatment of 158 children with acute lymphadenides of nonspecific and specific etiology, different localization (submandibular, cervical, axillary, inguinal and other peripheral localization) who were treated at the inpatient department in the pediatric surgery of MHCF "Local oncologic dispensary of Kramatorsk" from 2015 to 2019. Among the inpatient children there were 86 (54.4%) boys and 72 (45.6%) girls. The age of the patients ranged from 2 months to 18 years. The average age of the patients was 5.8±0.61 years. The surgical procedures were performed in 131 patients (82.9%) while the non-specific nature of the inflammatory process was confirmed in 102 patients (77.9%) taking into account the clinical course of the disease and the results of microbiological analysis. A specific inflammatory process was found out in 29 patients (22.1%). It was clinically detected that 18 children (13.7%) had BCG-lymphadenitis (confirmed by histological examination) and 11 patients (8.4%) had benign lymphoreticulosis (felinosis) among them.; Due to the use of shear wave elastography 62.9% of the children were able to avoid any surgery, extra puncture and they were treated conservatively.


Assuntos
Doença da Arranhadura de Gato , Linfadenite/diagnóstico , Doença Aguda , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Pacientes Internados , Masculino , Pescoço/diagnóstico por imagem , Estudos Retrospectivos
15.
Clin Imaging ; 67: 198-206, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32866821

RESUMO

Nuclear protein of the testis (NUT) carcinoma (NC) (formerly known as NUT midline carcinoma) is an aggressive pleomorphic squamous cell carcinoma with a dismal prognosis. Primary NC tumors are commonly located in the chest or head and neck regions. Imaging plays an indispensable role in the staging, management, treatment response assessment, and surveillance of NC. Primary pulmonary NC usually presents as a large mass with lymphadenopathy and pleural involvement. Primary head and neck NC presents as a large expansile necrotic mass in the sinonasal region with locoregional destruction and occasional cervical lymph node involvement. These imaging features are relatively non-specific but are consistent among patients. Currently, there are no standardized guidelines for the treatment of NC. Because of its rarity, paucity of reports in the medical literature, and the lack of awareness among radiologists, NUT carcinoma (NC) has been largely underdiagnosed and misdiagnosed. Clinical aggressive features and pleomorphic/undifferentiated squamous cell carcinoma should prompt genetic evaluation for NUT translocation to diagnose NC. In this article, we discuss NC's clinicopathologic and imaging features and treatment options, including emerging new treatments.


Assuntos
Carcinoma de Células Escamosas/diagnóstico por imagem , Neoplasias Testiculares/diagnóstico por imagem , Testículo/diagnóstico por imagem , Adulto , Carcinoma de Células Escamosas/patologia , Feminino , Neoplasias de Cabeça e Pescoço , Humanos , Neoplasias Pulmonares/genética , Masculino , Pescoço/patologia , Proteínas Nucleares/genética , Proteínas Nucleares/metabolismo
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.
Zhonghua Yi Xue Za Zhi ; 100(29): 2258-2262, 2020 Aug 04.
Artigo em Chinês | MEDLINE | ID: mdl-32746594

RESUMO

Objective: To investigate the value of contrast-enhanced ultrasound (CEUS) in the diagnosis of benign and malignant lateral cervical lymph nodes. Methods: One hundred and fifteen cases of suspected lymph nodes disease, 60 males, 55 females, between November 2018 and June 2019 from clinic and inpatient in Fujian Cancer Hospital were collected. Routine ultrasound and CEUS were performed in 115 cases of lateral cervical lymph nodes. All cases underwent ultrasound-guided biopsy, and were divided into two groups of benign and malignant lymph nodes according to pathological results. The differences between the two groups were analyzed and statistically analyzed. The rate and frequency were used to qualitatively describe the ultrasound performance and observed lymph node morphology between the two groups of routine ultrasound and CEUS. The sensitivity, specificity, accuracy, negative predictive value and positive predictive value were used to evaluate the efficacy of routine ultrasound and CEUS. Results: There were 37 cases of benign lymph nodes and 78 cases of malignant lymph nodes. In benign lymph nodes, 51.4% (19/37) showed uniform high enhancement, and 48.6% (18/37) showed uneven or circular enhancement with clear boundaries and no focal enhancement area. In malignant lymph nodes, 94.9% (74/78) showed uneven enhancement, and only 5.1% (4/78) showed uniform enhancement. The difference of ultrasonic contrast medium uniformities in differentiating benign from malignant was statistically significant (P<0.001). The sensitivity, accuracy, negative predictive value and positive predictive value of routine ultrasound to differentiate benign and malignant lymph nodes were 64.1%, 65.2%, 47.2%, and 66.7%, respectively, while the corresponding values of CEUS were 93.6%, 75.7%, 73.7% and 83.9%. Conclusion: CEUS may provide a valuable basis for the differential diagnosis of benign and malignant lateral cervical lymph nodes.


Assuntos
Linfonodos , Pescoço , Meios de Contraste , Diagnóstico Diferencial , Feminino , Humanos , Metástase Linfática , Masculino , Sensibilidade e Especificidade , Ultrassonografia
18.
Praxis (Bern 1994) ; 109(10): 763-770, 2020 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-32752966

RESUMO

CME Sonography 92: Nodes on the Neck Abstract. Nodules on the neck can be discovered accidentally when looking in the mirror, or due to pain that may be acute or gradual. The clinical examination is helpful to estimate the localization or to assign the nodule to a specific organ and assess its consistency and mobility. A sonography is very helpful in most cases as there are typical findings related to the thyroid gland, findings based on lymph nodes, changes in the tonsils, vessels and salivary glands. In some cases, the ultrasound must be supplemented by fine needle puncture.


Assuntos
Linfonodos , Pescoço , Neoplasias da Glândula Tireoide , Linfonodos/diagnóstico por imagem , Glândula Tireoide , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Ultrassonografia
19.
Braz J Med Biol Res ; 53(10): e9815, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32813851

RESUMO

Body fat distribution predicts cardiovascular events better than body-mass index (BMI). Waist circumference (WC) and neck circumference (NC) are inexpensive anthropometric measurements. We aimed to present the conditional distribution of WC and NC values according to BMI, stratified by age and sex, from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline data. We analyzed 15,085 ELSA-Brasil participants with complete data. We used spline quantile regression models, stratified by sex and age, to estimate the NC and WC quantiles according to BMI. To test a putative association between age and median NC or WC values, we built sex-specific median regression models using both BMI and age as explanatory variables. We present estimated 25th, 50th, 75th, and 90th percentiles for NC and WC values, according to BMI, age, and sex. Predicted interquartile intervals for NC values varied from 1.6 to 3.8 cm and, for WC values, from 5.1 to 10.3 cm. Median NC was not associated with age in men (P=0.11) nor in women (P=0.79). However, median WC increased with advancing age in both sexes (P<0.001 for both). There was significant dispersion in WC and NC values for a given BMI and age strata for both men and women. WC, but not NC values, were associated with increasing age. The smaller influence of advancing age on the relationship between BMI and NC (compared to WC) values may be useful in longitudinal studies.


Assuntos
Pescoço , Adulto , Idoso , Índice de Massa Corporal , Brasil , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Fatores de Risco , Circunferência da Cintura
20.
Wiad Lek ; 73(4): 674-678, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32731695

RESUMO

OBJECTIVE: The aim of this study were to assess clinical (cutaneous allodynia) and neurophysiological (R2 nBR component) markers of the nociceptive trigeminal-cervical pathway sensitization in the abdominally obese patients with episodic (EM) and chronic migraine (CM). PATIENTS AND METHODS: Materials and methods: It had been recorded nBR within interictal period in 79 migraineurs with EM and CM who had abdominal obesity (AO) and normal body weight (NBW). RESULTS: Results: Patients with EM and AO had significantly lower pain thresholds than patients with EM and NBW - 0,55 (0,34-0,63) µV vs 0,70 (0,59-1,03) µV. The mean latency of R2 nBR component was significantly decreased in patients who had EM and AO (36,59 (31,95-42,41) ms) compared to patients who had EM and NBW(46,75 (42,93-52,34) ms). It had been revealed significant increasing of the mean amplitude of the component R2 nBR in patients who had EM and AO (158 (115-197) µV) compared to patients who had EM and NBW (124 (76-144) µV). In patients who had CM and AO, it had been found direct positive correlation between the amplitude of R2 nBR and severity of cutaneous allodynia - τ=0,4 (p=0,03), as well as found negative correlation between the latency of R2 nBR and severity of cutaneous allodynia - τ=-0,44 (p=0,02) within the interictal period of migraine. CONCLUSION: Conclusions: Neurophysiological findings may indirectly indicate faster migraine chronification in patients with EM and AO.


Assuntos
Transtornos de Enxaqueca , Obesidade Abdominal , Piscadela , Humanos , Pescoço
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