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1.
BMC Health Serv Res ; 24(1): 1033, 2024 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-39243074

RESUMO

BACKGROUND: The Jordanian healthcare system has evolved over the past decades expanding its services, technological, and educational resources. A comprehensive view of this system is lacking. The objective of this report is to describe the structure of the Jordanian healthcare system, the challenges facing it, and the current and recommended health policies. MATERIALS AND METHODS: This study reviewed the current status of the Jordanian healthcare system. The following parameters were analyzed: health indicators, infrastructure, human resources, insurance system, pharmaceutical expense, health education system, and medical tourism. Data were collected from various relevant official institutions and related published literature. RESULTS: Jordan has a young population with a median age of 23.8 years. Life expectancy is 78.8 years for females and 77.0 years for males. The Jordanian healthcare system is divided into three major categories: (1) Governmental Insurance (i.e., the Ministry of Health (MOH), the Royal Medical Services (RMS) and semi-governmental insurance); (2) Private Insurance; and (3) Refugee Insurance, including the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) and the United Nations High Commissioner for Refugees (NHUR). The Governmental Insurance covers 64.30% of the total population. Health expenditure is 6.37% of the gross domestic product (GDP). Pharmaceutical expenses make up 26.6% of the total national healthcare budget. Human resource assessment shows a high ratio of medical staff per 10.000 inhabitants, especially concerning physicians (31.7), dentists (7.9), and pharmacists (15.1). However, the ratio of nursing staff per 10.000 inhabitants is considered low (37.5). The Hospital bed/1000 population ratio is also relatively low (1.4). Healthcare accreditation is implemented through the Joint Commission International (JCI) accreditation which was achieved by 7 hospitals and by the National Health Care Accreditation Certificate (HCAC) achieved by 17 hospitals and 42 primary healthcare centers. Postgraduate medical education covers almost all medical and surgical fields. Medical tourism is currently well-established. CONCLUSIONS: Assessment of the Jordanian healthcare system shows high ratios of physicians, dentists, and pharmacists but a low ratio of nursing staff per 10.000 inhabitants. The hospital bed/1000 population ratio is also relatively low. Pharmaceutical expenses are significantly high and medical tourism is well-developed.


Assuntos
Atenção à Saúde , Jordânia , Humanos , Atenção à Saúde/organização & administração , Masculino , Feminino , Política de Saúde , Turismo Médico/estatística & dados numéricos , Conflitos Armados , Adulto , Refugiados/estatística & dados numéricos , Seguro Saúde/estatística & dados numéricos
2.
BMC Med Educ ; 23(1): 273, 2023 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-37085824

RESUMO

BACKGROUND: Different variables have been used to predict the academic performance of students in medical schools. The aim of this study was to assess the effect of demographics, admission system, and high-school background on the academic performance of medical students. METHODS: We conducted this longitudinal cohort study on 808 students admitted to the Faculty of. Medicine at the University of Jordan (Amman, Jordan), in the years 2012 and 2013. Admission pathway, and academic performance data were collected and analyzed. RESULTS: A total of 808 students [i.e., 426 (52.7%) females, and 382(47.3%) males] were identified. Admitted students were holding 17 different types of high school degrees, and were accepted through 6 different quota pathways (open competition [National unified admission], underprivileged ["Makrumah"], parallel, children of university staff, international students, and others). Students admitted through the open competition and the underprivileged quota(Makrumah) were more likely to graduate on time and had higher graduation grades while students admitted through the parallel, international and others quota were more likely to fail and had lower graduation grades. Regarding highs school degrees, the students that were more likely to graduate were those with IB and the Jordanian high school degrees. The highest graduation GPA was for IB students followed by SAT, IGCSE as well as Jordanian and Syrian high school degrees respectively. IB, Jordanian, Kuwaiti and IGSC high school grades were significantly correlated with the graduation GPA. CONCLUSIONS: Admission criteria such as type of high school degree and grades as well as admission pathways can predict the likelihood to graduate and the graduation GPA of medical students. Open competition and underprivileged admission pathways as well as IB, IGCSE and Jordanian high school degrees seem to be better predictors of student performance in the medical school.


Assuntos
Desempenho Acadêmico , Estudantes de Medicina , Masculino , Feminino , Criança , Humanos , Faculdades de Medicina , Critérios de Admissão Escolar , Estudos Longitudinais , Avaliação Educacional
3.
BMC Health Serv Res ; 22(1): 1481, 2022 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-36471368

RESUMO

BACKGROUND AND AIM: Fear of coronavirus disease 2019 (COVID-19) and its complications may result in stigmatization of individuals who may carry the virus. This is of special concern to healthcare workers who tolerate additional physical and emotional stress at times of pandemic. The aims of this study are to (1) develop and validate the COVID-19 Stigma Scale (COVISS-HCWs) survey; and (2) investigate the experience of stigma among healthcare workers possibly dealing with COVID-19 patients in five major public hospitals in Damascus, Syria. METHODS: We divided the sample into two parts and then underwent EFA on the first 350 participants, dividing the 14 questions into two dimensions. Furthermore, CFA was conducted on the other 350 participants to confirm how correctly a hypothesized model matched the factor structure by EFA, as described above. Moreover, the coefficient of determination (R2) and item-scale correlations (standardized factor loading) were estimated to establish the acceptability of the final structure of the COVISS-HCWs. Through a cross-sectional study, a convenience sample of 700 healthcare workers participated in a self-administered questionnaire containing a section for demographic variables and another for newly designed COVISS-HCWs. The scale comprises 14 adapted and novel items that measure two subscales: feelings of perceived harm and inferiority, and avoidance. Descriptive statistics, reliability, and validity were evaluated. RESULTS: The 14 COVISS-HCWs items were reduced to 11 items with a high Cronbach's α of 0.909. A significant correlation was observed between the responses to each COVISS-HCWs item and the corresponding subscale, and between each subscale and the overall scale. Feeling stigmatized was reported by 9.86% of the participants. Younger age, low socioeconomic status, and higher intensity of contact with COVID-19 patients significantly correlated with higher stigmatization. CONCLUSIONS: The novel COVISS-HCWs is a reliable and valid tool to evaluate stigma among healthcare workers during the COVID-19 pandemic. The Stigma prevalence among healthcare workers was 9.86%. Therefore, this must be addressed to prevent possible psychosocial and public health repercussions.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , Pandemias/prevenção & controle , Reprodutibilidade dos Testes , Estudos Transversais , Pessoal de Saúde/psicologia
4.
Cancer ; 127(20): 3727-3741, 2021 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-34286864

RESUMO

18 F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is now an integral part of lymphoma staging and management. Because of its greater accuracy compared with CT alone, PET/CT is currently routinely performed for staging and for response assessment at the end of treatment in the vast majority of FDG-avid lymphomas and is the cornerstone of response classification for these lymphomas according to the Lugano classification. Interim PET/CT, typically performed after 2 to 4 of 6 to 8 chemotherapy/chemoimmunotherapy cycles with or without radiation, is commonly performed for prognostication and potential treatment escalation or de-escalation early in the course of therapy, a concept known as response-adapted or risk-adapted treatment. Quantitative PET is an area of growing interest. Metrics, such as the standardized uptake value, changes (Δ) in the standardized uptake value, metabolic tumor volume, and total lesion glycolysis, are being investigated as more reproducible and potentially more accurate predictors of response and prognosis. Despite the progress made in standardizing the use of PET/CT in lymphoma, challenges remain, particularly with respect to its limited positive predictive value, emphasizing the need for more specific molecular probes. This review highlights the most relevant applications of PET/CT in Hodgkin and B-cell non-Hodgkin lymphoma, its strengths and limitations, as well as recent efforts at implementing PET/CT-based metrics as promising tools for precision medicine.


Assuntos
Linfoma não Hodgkin , Linfoma , Fluordesoxiglucose F18 , Humanos , Linfoma/terapia , Linfoma não Hodgkin/terapia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Tomografia por Emissão de Pósitrons , Prognóstico , Carga Tumoral
5.
Eur J Nucl Med Mol Imaging ; 48(9): 2883-2893, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33909086

RESUMO

PURPOSE: To determine whether interim 3'-deoxy-3'-[18F]fluorothymidine (iFLT) PET/CT is a superior predictor of progression-free survival (PFS) compared with interim 18F-fluorodeoxyglucose (iFDG) PET/CT in patients with diffuse large B cell lymphoma (DLBCL) treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) or rituximab, etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin (R-EPOCH). METHODS: Ninety-two prospectively enrolled patients with DLBCL underwent both FLT-PET/CT and FDG-PET/CT 18-24 days after two cycles of R-CHOP/R-EPOCH. Deauville-criteria, PERCIST1.0, standardized uptake value (SUV), total lesion glycolysis (TLG), and metabolic tumor volume were used to interpret iFDG-PET/CT while dichotomous visual interpretation was used to interpret iFLT-PET/CT and the results were compared with the 3- and 5-year PFS. RESULTS: iFLT-PET/CT was negative in 67 (73%) and positive in 25 (27%) patients. iFDG-PET/CT by Deauville criteria was negative (Deauville scores [DS] of 1-3) in 53 (58%) and positive (DS = 4-5) in 39 (42%) patients. Of the 67 iFLT-PET/CT-negative patients, 7 (10.4%) progressed at a median of 14.1 months whereas 14/25 (56.0%) iFLT-PET/CT-positive patients progressed at a median of 7.8 months (P < .0001). Of the 53 Deauville-negative patients, 9 (17.0%) progressed at a median of 14.1 months whereas 12/39 (30.8%) Deauville-positive patients progressed at a median of 5.6 months (P = .11). In multivariate analysis, including iFLT-PET/CT, PERCIST, interim TLG, and interim SUVmax, only iFLT-PET/CT was an independent predictor for 3- and 5-year PFS (P < .0001 and P = .001, respectively). CONCLUSIONS: In patients with DLBCL given R-CHOP/R-EPOCH, iFLT-PET/CT is a superior independent predictor of outcome compared with iFDG-PET/CT.


Assuntos
Linfoma Difuso de Grandes Células B , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Ciclofosfamida/uso terapêutico , Doxorrubicina/uso terapêutico , Fluordesoxiglucose F18 , Humanos , Linfoma Difuso de Grandes Células B/diagnóstico por imagem , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Prednisona/uso terapêutico , Prognóstico , Intervalo Livre de Progressão , Vincristina/uso terapêutico
6.
J Musculoskelet Neuronal Interact ; 21(2): 255-262, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-34059570

RESUMO

OBJECTIVES: To investigate the effect of vagus nerve stimulation (VNS) on the bone mineral density (BMD) in epileptic patients. METHODS: A prospective cohort study was conducted on individuals with refractory seizures who underwent VNS surgery between January 2012 and December 2018. BMD was measured preoperatively and between 6 months and one year after surgery. RESULTS: Twenty-one patients (mean age (±SD)=23.6±12.3 years) were recruited for the implantation of a VNS device. The mean absolute increase in lumbar BMD in the 21 patients was 0.04±0.04 g/cm2 resulting in an overall percent increase from baseline of 4.7±6.1%. BMD increased by an amount ≥ the least significant change (LSC) for the lumbar spine in 13 patients (61.9%). The lumbar Z score also increased in these patients from -1.22±1.15 to -0.88±1.22, P=0.006). Pre and Post VNA femoral BMD was measured in only 11 patients and, of those 3 showed a significant increase in BMD, 1 a significant decrease and 7 no change. CONCLUSION: The implantation of a VNS was associated with an increase in lumbar BMD. This study could lead to a new application for VNS in the treatment of osteoporosis.


Assuntos
Osteoporose , Estimulação do Nervo Vago , Densidade Óssea , Remodelação Óssea , Humanos , Estudos Prospectivos
7.
Pediatr Neurosurg ; 56(1): 35-44, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33596589

RESUMO

INTRODUCTION: There is paucity of data regarding change in arachnoid cyst (AC) volume following surgery. This study aimed at investigating the clinical outcome of ACs and applying 2 volumetric methods for determination of their volume change post microsurgical fenestration. METHODS: Twenty-one ACs in 20 patients that underwent microsurgical fenestration were analyzed using 2 volumetric methods; the modified McDonald equation and the picture archiving and communication (PAC) system-based method. Patients were followed up for 23 ± 40.3 months. RESULTS: The majority of the patients (13 or 65%) were children. Preoperative symptoms in children were mainly seizures and less commonly headache. Of the 20 patients, 12 (60%) had complete resolution of their preoperative symptoms with 8 (40.0%) showing partial improvement. Volumetric studies showed a mean reduction in AC size of 73.7% in children and 64.4% in adults using the PAC system versus 67.9% in children and 70.5% in adults using the modified McDonald equation method. There was no correlation between the percentage decrease in AC volume post surgery and degree of symptom improvement (49.2 ± 34.3% in patients with complete vs. 60.9 ± 40.3% in patients with only partial resolution of symptoms, p = 0.57). DISCUSSION/CONCLUSION: Microsurgical fenestration is an effective approach for ACs with an excellent clinical outcome apparent in the complete or partial improvement of symptoms in all patients. Volumetric estimates of ACs and their change following surgery are feasible using the modified McDonald or PAC system methods. However, there is no correlation between the percentage decrease in AC volume after surgery and degree of clinical improvement.


Assuntos
Cistos Aracnóideos , Adulto , Cistos Aracnóideos/diagnóstico por imagem , Cistos Aracnóideos/cirurgia , Criança , Cefaleia , Humanos , Estudos Retrospectivos , Convulsões , Resultado do Tratamento
8.
Int J Cancer ; 147(9): 2345-2354, 2020 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-32319676

RESUMO

Differentiated thyroid cancer (DTC) is the most common endocrine malignancy with a growing incidence worldwide. The initial conventional management is surgery, followed by consideration of 131 I treatment that includes three options. These are termed remnant ablation (targeting benign thyroid remnant), adjuvant (targeting presumed microscopic DTC) and known disease (targeting macroscopic DTC) treatments. Some experts mostly rely on clinicopathologic assessment for recurrence risk to select patients for the 131 I treatment. Others, in addition, apply radioiodine imaging to guide their treatment planning, termed theranostics (aka theragnostics or radiotheragnostics). In patients with low-risk DTC, remnant ablation rather than adjuvant treatment is generally recommended and, in this setting, the ATA recommends a low 131 I activity. 131 I adjuvant treatment is universally recommended in patients with high-risk DTC (a primary tumor of any size with gross extrathyroidal extension) and is generally recommended in intermediate-risk DTC (primary tumor >4 cm in diameter, locoregional metastases, microscopic extrathyroidal extension, aggressive histology or vascular invasion). The optimal amount of 131 I activity for adjuvant treatment is controversial, but experts reached a consensus that the 131 I activity should be greater than that for remnant ablation. The main obstacles to establishing timely evidence through randomized clinical trials for 131 I therapy include years-to-decades delay in recurrence and low disease-specific mortality. This mini-review is intended to update oncologists on the most recent clinical, pathologic, laboratory and imaging variables, as well as on the current 131 I therapy-related definitions and management paradigms, which should optimally equip them for individualized patient guidance and treatment.


Assuntos
Técnicas de Ablação/métodos , Radioisótopos do Iodo/uso terapêutico , Recidiva Local de Neoplasia/prevenção & controle , Neoplasias da Glândula Tireoide/terapia , Tireoidectomia , Adulto , Intervalo Livre de Doença , Relação Dose-Resposta à Radiação , Humanos , Recidiva Local de Neoplasia/epidemiologia , Seleção de Pacientes , Guias de Prática Clínica como Assunto , Radioterapia (Especialidade)/métodos , Radioterapia (Especialidade)/normas , Dosagem Radioterapêutica/normas , Radioterapia Adjuvante/métodos , Medição de Risco/normas , Glândula Tireoide/patologia , Glândula Tireoide/efeitos da radiação , Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/mortalidade , Neoplasias da Glândula Tireoide/patologia
9.
J Nucl Cardiol ; 27(5): 1596-1606, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-31044401

RESUMO

BACKGROUND: The significance of post-stress reduction in left ventricular ejection fraction (LVEF) in patients with normal perfusion on adenosine stress/rest imaging remains controversial. METHODS: Consecutive patients who underwent 2-day adenosine gated stress/rest 99mTc-sestamibi imaging and had normal perfusion were analyzed. LVEF was quantified at rest and 1 hour post-adenosine. Patients were followed up for hard (cardiac death or nonfatal MI) and soft (coronary revascularization or congestive heart failure) cardiac events for 24.1 ± 11.0 months. RESULTS: Of 560 patients included in the study, 135 (24.1%) had a post-stress reduction in LVEF of ≥ 5%. Rest LVEF (P < 0.001), known history of CAD (P = 0.01) and transient ischemic dilatation ratio (P = 0.02) were independent predictors of LVEF reduction. Event-free survivals were similar in patients with and without ≥ 5% LVEF reduction (P = 0.8). The unadjusted hazard ratio (95% CI) for cardiac events for ≥ 5% LVEF reduction was 1.09 (0.55-2.15), P = 0.81, while the hazard ratio adjusted for known history of CAD, smoking, post-stress LVEF and peak heart rate was 0.87 (0.44-1.75), P = 0.71. CONCLUSIONS: Significant post-adenosine reduction in LVEF occurs in about one-fourth of patients with normal perfusion but does not confer adverse prognosis compared with patients without such reduction.


Assuntos
Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/fisiopatologia , Teste de Esforço , Volume Sistólico/fisiologia , Adenosina , Idoso , Doenças Cardiovasculares/diagnóstico por imagem , Feminino , Humanos , Jordânia , Masculino , Pessoa de Meia-Idade , Imagem de Perfusão do Miocárdio , Revascularização Miocárdica , Prognóstico , Compostos Radiofarmacêuticos , Descanso , Taxa de Sobrevida , Tecnécio Tc 99m Sestamibi , Tomografia Computadorizada de Emissão de Fóton Único
10.
Hell J Nucl Med ; 23(2): 165-172, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32716408

RESUMO

OBJECTIVE: To determine whether a pregnancy-adapted clinical and D-dimer-based algorithm, termed the "YEARS algorithm," can reduce the need for radiological imaging, including lung scintigraphy in pregnant women with suspected pulmonary embolism (PE). PATIENTS AND METHODS: This retrospective study included all pregnant women with suspected PE between January 2014 and September 2019 who have undergone D-dimer testing and radiological imaging (computed tomography pulmonary angiography or lung perfusion scans) at presentation. Three criteria from the YEARS algorithm were assessed: clinical signs of deep vein thrombosis, haemoptysis, and whether PE was clinically considered as the most likely diagnosis. Patients who did not have to undergo imaging per the YEARS algorithm were defined as those with no YEARS criteria and a D-dimer of <1µg/mL (group 1) and those with 1-3 YEARS criteria and a D-dimer of <0.5µg/mL (group 2). Patients who had to undergo imaging were those with no YEARS criteria and a D-dimer ≥1µg/mL (group 3) and those with 1-3 YEARS criteria and a D-dimer ≥0.5µg/mL (group 4). Women with symptoms of deep-vein thrombosis had to undergo Doppler ultrasound: If positive, they were anticoagulated and excluded from this analysis, and if negative, they were evaluated further for the need of imaging based on other YEARS criteria and D-dimer level. RESULTS: Of 117 pregnant women with suspected PE analyzed according to the YEARS algorithm five had confirmed deep-vein thrombosis by Doppler ultrasound, were anticoagulated and excluded from the analysis. Of the remaining 112 women (mean age; 30.4±5.7 years), 50 underwent computed tomography pulmonary angiography (CTPA), 54 lung perfusion or ventilation-perfusion (V/Q) scan and eight both; PE was diagnosed in 7 (6.25%), two by CTPA, two by lung perfusion or V/Q scan and three by both. Thirty-three of the 112 women (29.5%) were in groups 1+2 and could, therefore, have avoided CTPA or lung perfusion scans per the YEARS algorithm. None of those 33 women had PE by CTPA or lung perfusion scans vs. 7/79 patients (8.9%) who required CTPA or lung perfusion scans per the YEARS algorithm. CONCLUSION: The pregnancy-adapted YEARS algorithm can safely rule out PE in about one-third of pregnant women with suspected PE without the need for radiological imaging.


Assuntos
Algoritmos , Angiografia por Tomografia Computadorizada , Complicações na Gravidez/diagnóstico por imagem , Adulto , Feminino , Produtos de Degradação da Fibrina e do Fibrinogênio/metabolismo , Humanos , Processamento de Imagem Assistida por Computador , Gravidez , Embolia Pulmonar/diagnóstico por imagem , Embolia Pulmonar/metabolismo , Estudos Retrospectivos
14.
Radiology ; 280(1): 220-9, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-26854705

RESUMO

Purpose To compare the performance characteristics of interim fluorine 18 ((18)F) fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) (after two cycles of chemotherapy) by using the most prominent standardized interpretive criteria (including International Harmonization Project [IHP] criteria, European Organization for Research and Treatment of Cancer [EORTC] criteria, and PET Response Criteria in Solid Tumors (PERCIST) versus those of interim (18)F fluorothymidine (FLT) PET/CT and simple visual interpretation. Materials and Methods This HIPAA-compliant prospective study was approved by the institutional review boards, and written informed consent was obtained. Patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL) underwent both FLT and FDG PET/CT 18-24 days after two cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone or rituximab, etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin. For FDG PET/CT interpretation, IHP criteria, EORTC criteria, PERCIST, Deauville criteria, standardized uptake value, total lesion glycolysis, and metabolic tumor volume were used. FLT PET/CT images were interpreted with visual assessment by two reviewers in consensus. The interim (after cycle 2) FDG and FLT PET/CT studies were then compared with the end-of-treatment FDG PET/CT studies to determine which interim examination and/or criteria best predicted the result after six cycles of chemotherapy. Results From November 2011 to May 2014, there were 60 potential patients for inclusion, of whom 46 patients (24 men [mean age, 60.9 years ± 13.7; range, 28-78 years] and 22 women [mean age, 57.2 years ± 13.4; range, 25-76 years]) fulfilled the criteria. Thirty-four patients had complete response, and 12 had residual disease at the end of treatment. FLT PET/CT had a significantly higher positive predictive value (PPV) (91%) in predicting residual disease than did any FDG PET/CT interpretation method (42%-46%). No difference in negative predictive value (NPV) was found between FLT PET/CT (94%) and FDG PET/CT (82%-95%), regardless of the interpretive criteria used. FLT PET/CT showed statistically higher (P < .001-.008) or similar NPVs than did FDG PET/CT. Conclusion Early interim FLT PET/CT had a significantly higher PPV than standardized FDG PET/CT-based interpretation for therapeutic response assessment in DLBCL. (©) RSNA, 2016 Online supplemental material is available for this article.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Fluordesoxiglucose F18 , Linfoma Difuso de Grandes Células B/diagnóstico por imagem , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Compostos Radiofarmacêuticos , Adulto , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Critérios de Avaliação de Resposta em Tumores Sólidos , Resultado do Tratamento
16.
J Clin Ultrasound ; 44(8): 474-9, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27120130

RESUMO

PURPOSE: To determine the prevalence of testicular microlithiasis and its correlation with Doppler parameters of testicular arteries and sperm function. METHODS: Reports of 1,200 consecutive scrotal sonographic examinations performed at our hospital were reviewed. Patients diagnosed with testicular microlithiasis were recalled for detailed scrotal sonographic examination, including Doppler sonography and sperm function. The same examinations were performed in an age-matched control group and the findings compared. RESULTS: Testicular microlithiasis was found in 64 cases (5.3%). Doppler sonography showed mean resistance index, Vmax, and Vmin of 61.1 ± 9.3%, 18.2 ± 4.7 cm/s, and 7.7 ± 2.3 cm/s, respectively, in the testicular microlithiasis group versus 62.4 ± 10.4%, 18.4 ± 5.7 cm/s, and 7.3 ± 2.4 cm/s, respectively, in the control group (p = 0.49, 0.84 and 0.35, respectively). Sperm function tests demonstrated sperm count, motility, and normal morphology (normal oval head) of 29.6 ± 20.4 × 10(6) /mL, 35.3 ± 16.2%, and 44.4 ± 12%, respectively, in patients with testicular microlithiasis versus 54.3 ± 22.4 × 10(6) /mL, 50.2% ± 14.4%, and 66.4 ± 11.6% in control subjects (p < 0.02). CONCLUSIONS: Prevalence of testicular microlithiasis of 5.3% in Jordanian patients is similar to what has been reported in the literature. Testicular microlithiasis does not have a significant effect on Doppler parameters of testicular arteries. The apparent impairment of sperm function in patients with testicular microlithiasis warrants further studies. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:474-479, 2016.


Assuntos
Cálculos/diagnóstico por imagem , Cálculos/fisiopatologia , Espermatozoides/fisiologia , Doenças Testiculares/diagnóstico por imagem , Doenças Testiculares/fisiopatologia , Testículo/irrigação sanguínea , Ultrassonografia Doppler , Adolescente , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Testículo/diagnóstico por imagem , Testículo/fisiopatologia , Adulto Jovem
18.
J Clin Densitom ; 17(1): 143-9, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-23499561

RESUMO

The objective of this study was to assess the relative association between body weight, body mass index (BMI), lean mass (LM) and fat mass (FM), and bone mineral density (BMD) in a group of Jordanian postmenopausal women and investigate if this possible association changes with age. A total of 3256 patients had dual-energy X-ray absorptiometry (DXA) scan in the period from January 2009 till January 2012 at the Radiology and Nuclear Medicine Department of Jordan University Hospital. Only 584 women met the selection criteria. Age has been recorded, and patients were divided into subgroups according to age. Body weight and height were measured, and BMI was calculated. Body composition (LM, FM, percentage of android fat, and percentage of gynoid fat) was assessed by DXA. BMD of the lumbar spine (L1-L4) and femoral neck was measured by DXA. Weight, BMI, FM, LM, percentage of android fat, and percentage of gynoid fat were positively correlated to BMD at both lumbar spine and femoral neck. However, this correlation disappeared at the age of 70 yr at lumbar spine and 75 yr at femoral neck. This study suggests that both FM and LM are important determinants of BMD in Jordanian postmenopausal women, and this correlation disappears after the age of 70 yr at lumbar spine and 75 yr at femoral neck.


Assuntos
Adiposidade , Povo Asiático , Peso Corporal , Densidade Óssea , Absorciometria de Fóton , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Colo do Fêmur , Humanos , Jordânia , Vértebras Lombares , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Sexuais
19.
Cureus ; 16(6): e61627, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38966480

RESUMO

Radiation emergencies involving high doses of nuclear radiation pose significant risks from exposure to ionizing radiation in various scenarios. These situations include transportation accidents involving radioactive materials, occupational exposure, nuclear detonations, dirty bombs, and nuclear power plant accidents. In addition to the immediate risks of acute radiation syndrome (ARS) and related diseases, long-term exposure can increase the risk of other health issues such as cardiovascular disease and cancer. Vulnerable populations, including pregnant women and children, face particular concern due to potential impacts on their health and the health of unborn babies. The severity of ARS depends on several factors such as radiation dose, quality, dose rate, exposure uniformity, and individual biological responses. Bioindicators are biological responses or markers that help assess the severity and effects of radiation exposure on an individual. Bioindicators can include physical symptoms such as nausea, vomiting, and diarrhea, or laboratory tests such as changes in blood cell counts and gene expression that can help in assessing and treating exposed individuals. Additionally, early prodromal symptoms such as vomiting, diarrhea, and erythema can provide important clues for diagnosis and treatment. Developing a comprehensive plan for radiation emergencies is vital for safeguarding public health, infrastructure, and the environment. First responders play a critical role in establishing safety perimeters, triage, and coordination with various stakeholders. Education and training are essential for medical personnel and the public. This article provides general recommendations and identifies challenges to effective radiation emergency preparedness and response.

20.
Nucl Med Commun ; 45(7): 550-563, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38646840

RESUMO

2-Deoxy-2-[ 18 F]fluoro- d -glucose PET/computed tomography ([ 18 F]FDG PET/CT) has proven to be a sensitive method for the detection and evaluation of hematologic malignancies, especially lymphoma. The increasing incidence and mortality rates of leukemia have raised significant concerns. Through the utilization of whole-body imaging, [ 18 F]FDG PET/CT provides a thorough assessment of the entire bone marrow, complementing the limited insights provided by biopsy samples. In this regard, [ 18 F]FDG PET/CT has the ability to assess diverse types of leukemia The utilization of [ 18 F]FDG PET/CT has been found to be effective in evaluating leukemia spread beyond the bone marrow, tracking disease relapse, identifying Richter's transformation, and assessing the inflammatory activity associated with acute graft versus host disease. However, its role in various clinical scenarios in leukemia remains unacknowledged. Despite their less common use, some novel PET/CT radiotracers are being researched for potential use in specific scenarios in leukemia patients. Therefore, the objectives of this review are to provide a thorough assessment of the current applications of [ 18 F]FDG PET/CT in the staging and monitoring of leukemia patients, as well as the potential for an expanding role of PET/CT in leukemia patients.


Assuntos
Leucemia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Humanos , Leucemia/diagnóstico por imagem , Fluordesoxiglucose F18
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