RESUMO
Radiologic knowledge of different fracture patterns involving the shoulder girdle is an important tool to generate clinically relevant reports, identify concomitant injuries, guide management decisions, and predict and minimize complications, such as nonunion, osteoarthritis, osteonecrosis, and hardware failure. Complex unstable injuries like scapulothoracic dissociation can also occur because of shoulder girdle trauma. Management options may vary from conservative to surgical, depending on the fracture type and patient factors. Injuries around the shoulder girdle can involve the glenohumeral articulation, scapula, superior shoulder suspensory complex, acromioclavicular joints, and scapulothoracic articulation.
Assuntos
Articulação Acromioclavicular , Lesões do Ombro , Articulação do Ombro , Humanos , Articulação Acromioclavicular/lesões , Escápula/lesões , OmbroRESUMO
Medications usage has become a significant part of contemporary life. Many studies indicate that there is an excessive use and a considerable waste of medicines. This descriptive study aims at identifying the most used medicines in Saudi Arabia from 2010 to 2015 according to the statistics of specialized companies in the field. Comparison of the most commonly used drugs with those in the United States aims at clarifying similarities and differences. The results showed that the use of antibiotics and analgesics still accounted for the bulk, followed by proton pump inhibitors and anti-diabetics respectively, then anti-hyperlipidemic agents and erectile dysfunction treatments. The causes of this overuse vary according to the studies concerned between the self-medications and the over-prescription of the medication and the failure of the diagnostic and treatment procedures (malpractice). The recommendations are the strict application of prescribed and non-prescribed dispensing systems and the further establishment and application of national guides in the diagnosis and treatment of communicable diseases. The repetition of such studies is useful in reviewing health policies and regulations related to health practice in general and pharmacological policies in particular.
RESUMO
BACKGROUND: Coronary artery calcification (CAC) can be visually estimated on computed tomography (CT) attenuation correction (CTAC) of positron emission tomography (PET). The visual estimation of CAC from CTAC scans performed for PET/CT is comparable to the standard CAC score scan. Myocardial perfusion imaging (MPI) with single-photon emission CT (SPECT) is commonly performed for risk stratification before oncologic surgery. OBJECTIVE: We investigated the value of visual estimation of CAC from CTAC of PET/CT as well as other factors such as coronary artery disease (CAD) risk factors and type of cancer as predictors of MPI ischemia. METHODS: Retrospectively, we identified 268 patients who underwent PET/CT and MPI for preoperative cardiac evaluation. Visual estimation of CAC was performed and classified into four categories. RESULTS: The results of visual CAC were as follows: 47.8% - zero CAC, 32.8% - mild CAC, 14.2% - moderate CAC, and 5.2% - severe CAC. The majority of patients (85.8%) had normal MPI, whereas 14.2% were abnormal. There was a strong association between ischemia on MPI and CAC seen on CTAC (P < 0.01), dyslipidemia (P < 0.01), family history of CAD (P < 0.05), smoking (P < 0.01), and type of malignancy (P < 0.01). CONCLUSION: A strong association exists between visual estimation of CAC on CTAC and MPI. Zero is highly associated with normal MPI, but moderate-to-severe CAC is associated with abnormal MPI, in addition smoking, dyslipidemia, and certain cancer are associated with ischemic MPI; subsequently, preoperative cardiac testing is warranted in these subsets of patients.
RESUMO
Our case involved a 1-year-old female with multiple admissions for chest infections. Given her family history and high clinical suspicion, a diagnosis of Griscelli syndrome and hemophagocytic lymphohistiocytosis was made. Her work-up included a brain MRI, which revealed diffuse volume loss and corpus callosum hypogenesis associated with a diffuse simplified pattern of the sulci and gyri compatible with lissencephaly. We describe hypogenesis of the corpus callosum and lissencephaly for the first time in this syndrome.