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1.
Artigo em Português | LILACS, BNUY, UY-BNMED | ID: biblio-1568769

RESUMO

Apesar de não muito frequente, nos últimos 20 anos, houve um aumento significativo dos relatos sobre rotura do peitoral maior, normalmente associadas à prática de atividade física em que ocorre contração intensa e/ou uso de cargas pesadas exercendo resistência sobre o músculo. Neste relato de caso temos um paciente de 51 anos referindo dor no tórax à direita e no braço direito há 3 dias após tentar consertar o guidão da moto. Apresentava assimetria dos peitorais, perda de força do membro superior direito, dificuldade de movimentação e hematoma. A ressonância magnética demonstrou rotura completa da junção miotendínea do peitoral maior, com tendinopatia com fissuras insercionais e intrasubstanciais infraespinhal e tendinopatia com rotura parcial do tendão subescapular. Foi indicado por médico ortopedista o acompanhamento com o uso de medicação analgésica.


Although not very common, in the last 20 years, there has been a significant increase in reports of rupture of the pectoralis major, normally associated with the practice of physical activity in which intense contraction occurs and/or the use of heavy loads exerting resistance on the muscle. In this case report we have a 51-year-old patient reporting pain in his right chest and right arm for 3 days after trying to fix his motorcycle's handlebars. He had asymmetry of the pectorals, loss of strength in the right upper limb, difficulty moving and hematoma. Magnetic resonance imaging demonstrated complete rupture of the myotendinous junction of the pectoralis major, with tendinopathy with insertional and intrasubstantial infraspinatus fissures and tendinopathy with partial rupture of the subscapularis tendon. An orthopedic doctor recommended follow-up with the use of analgesic medication.


Aunque no es muy común, en los últimos 20 años se ha observado un aumento significativo en los reportes de rotura del pectoral mayor, normalmente asociado a la práctica de actividad física en la que se produce una contracción intensa y/o al uso de cargas pesadas ejerciendo resistencia sobre el mismo. el músculo. En este caso clínico tenemos un paciente de 51 años que refiere dolor en el pecho derecho y en el brazo derecho durante 3 días después de intentar arreglar el manillar de su motocicleta. Presentó asimetría de pectorales, pérdida de fuerza en miembro superior derecho, dificultad de movimiento y hematoma. La resonancia magnética demostró rotura completa de la unión miotendinosa del pectoral mayor, con tendinopatía con fisuras de inserción e intrasustancial del infraespinoso y tendinopatía con rotura parcial del tendón subescapular. Un médico ortopédico recomendó seguimiento con el uso de medicación analgésica.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Músculos Peitorais/lesões , Músculos Peitorais/diagnóstico por imagem , Extremidade Superior/lesões , Extremidade Superior/diagnóstico por imagem , Junção Miotendínea/lesões , Junção Miotendínea/diagnóstico por imagem
2.
Gen Comp Endocrinol ; 357: 114599, 2024 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-39128814

RESUMO

Knowledge on hormonal regulation of reproductive cycles in viperid snakes is still incipient, especially when it comes to females and tropical species. There is an urgent need to understand the reproduction of venomous snakes to improve assisted reproduction techniques and optimize the maintenance of these animals in captivity. With this in mind, we monitored Northern pit viper females year-round throughout different seasons via serum levels of progesterone (P4) and estradiol (E2) in conjunction with ultrasound examinations. Ovarian follicles were classified according to their size and stage of vitellogenesis in F-I and F-II (non-vitellogenic phase) or in F-III and F-IV (vitellogenic phase). During autumn and winter, five adult males were rotated among these females for reproductive pairing, which resulted in 17 copulations and 2 pregnancies in the first year and 12 copulations and 5 pregnancies in the second year. Then, we assessed changes in P4 and E2 levels according to seasons, predominant ovarian structures and the presence of embryos or eggs in the oviduct. Our findings showed high levels of E2 when a greater number of vitellogenic follicles were detected, indicating a possible influence of E2 on vitellogenesis and higher levels of P4 whenever eggs and embryos were visualized in the oviduct, implying its role in maintaining pregnancy. Descriptive analysis of the vipers' ovarian cycles revealed a greater number of vitellogenic follicles during winter, probably as a result of increases in E2; whereas pregnancies occurred predominantly in spring, under the influence of P4. The use of ultrasound images, as a minimally invasive methodology, associated with serum steroid levels has proven to be an efficient approach in the reproductive monitoring of Northern pit vipers in vivo. In addition, these data suggest that female pit vipers under human care display a seasonal reproductive cycle, despite earlier studies involving captive males of the species indicating a lack of seasonality in sperm production and quality.


Assuntos
Estradiol , Progesterona , Ultrassonografia , Animais , Feminino , Progesterona/sangue , Estradiol/sangue , Estações do Ano , Masculino , Bothrops , Ovário/diagnóstico por imagem , Ovário/metabolismo , Folículo Ovariano/diagnóstico por imagem , Folículo Ovariano/metabolismo , Genitália Feminina/diagnóstico por imagem , Bothrops atrox
3.
Alzheimers Dement ; 2024 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-39136296

RESUMO

BACKGROUND: Education influences brain health and dementia. However, its impact across regions, specifically Latin America (LA) and the United States (US), is unknown. METHODS: A total of 1412 participants comprising controls, patients with Alzheimer's disease (AD), and frontotemporal lobar degeneration (FTLD) from LA and the US were included. We studied the association of education with brain volume and functional connectivity while controlling for imaging quality and variability, age, sex, total intracranial volume (TIV), and recording type. RESULTS: Education influenced brain measures, explaining 24%-98% of the geographical differences. The educational disparities between LA and the US were associated with gray matter volume and connectivity variations, especially in LA and AD patients. Education emerged as a critical factor in classifying aging and dementia across regions. DISCUSSION: The results underscore the impact of education on brain structure and function in LA, highlighting the importance of incorporating educational factors into diagnosing, care, and prevention, and emphasizing the need for global diversity in research. HIGHLIGHTS: Lower education was linked to reduced brain volume and connectivity in healthy controls (HCs), Alzheimer's disease (AD), and frontotemporal lobar degeneration (FTLD). Latin American cohorts have lower educational levels compared to the those in the United States. Educational disparities majorly drive brain health differences between regions. Educational differences were significant in both conditions, but more in AD than FTLD. Education stands as a critical factor in classifying aging and dementia across regions.

4.
Biosens Bioelectron ; 264: 116638, 2024 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-39153261

RESUMO

Fluorophore chemistry is at the forefront of bioimaging, revolutionizing the visualization of biological processes with unparalleled precision. From the serendipitous discovery of mauveine in 1856 to cutting-edge fluorophore engineering, this field has undergone transformative evolution. Today, the synergy of chemistry, biology, and imaging technologies has produced diverse, specialized fluorophores that enhance brightness, photostability, and targeting capabilities. This review delves into the history and innovation of fluorescent probes, showcasing their pivotal role in advancing our understanding of cellular dynamics and disease mechanisms. We highlight groundbreaking molecules and their applications, envisioning future breakthroughs that promise to redefine biomedical research and diagnostics.


Assuntos
Técnicas Biossensoriais , Corantes Fluorescentes , Corantes Fluorescentes/química , Humanos , Técnicas Biossensoriais/métodos , Animais , Imagem Óptica/métodos
5.
J Med Phys ; 49(2): 189-202, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39131437

RESUMO

Purpose: This paper explores different machine learning (ML) algorithms for analyzing diffusion nuclear magnetic resonance imaging (dMRI) models when analytical fitting shows restrictions. It reviews various ML techniques for dMRI analysis and evaluates their performance on different b-values range datasets, comparing them with analytical methods. Materials and Methods: After standard fitting for reference, four sets of diffusion-weighted nuclear magnetic resonance images were used to train/test various ML algorithms for prediction of diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), and kurtosis (K). ML classification algorithms, including extra-tree classifier (ETC), logistic regression, C-support vector, extra-gradient boost, and multilayer perceptron (MLP), were used to determine the existence of diffusion parameters (D, D*, f, and K) within single voxels. Regression algorithms, including linear regression, polynomial regression, ridge, lasso, random forest (RF), elastic-net, and support-vector machines, were used to estimate the value of the diffusion parameters. Performance was evaluated using accuracy (ACC), area under the curve (AUC) tests, and cross-validation root mean square error (RMSECV). Computational timing was also assessed. Results: ETC and MLP were the best classifiers, with 94.1% and 91.7%, respectively, for the ACC test and 98.7% and 96.3% for the AUC test. For parameter estimation, RF algorithm yielded the most accurate results The RMSECV percentages were: 8.39% for D, 3.57% for D*, 4.52% for f, and 3.53% for K. After the training phase, the ML methods demonstrated a substantial decrease in computational time, being approximately 232 times faster than the conventional methods. Conclusions: The findings suggest that ML algorithms can enhance the efficiency of dMRI model analysis and offer new perspectives on the microstructural and functional organization of biological tissues. This paper also discusses the limitations and future directions of ML-based dMRI analysis.

6.
Neuroophthalmology ; 48(5): 348-351, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39145323

RESUMO

Arachnoid cysts (ACs) are cerebrospinal fluid collections between the two layers of the normal arachnoid membrane. Although they are often asymptomatic with a stationary course, eventual complications may occur. Herein, we report the case of a 9-year-old boy who developed bilateral papilloedema secondary to spontaneous rupture of an AC in the left middle cranial fossa. Although the papilloedema worsened during follow-up, his visual field remained bilaterally stable, supporting the expectant management and obviating the potential morbidity associated with neurosurgical intervention. This case report highlights the importance of a multidisciplinary approach to patients with secondary intracranial hypertension, including serial ophthalmological examinations, which provide a useful guide to surgical decision-making.

7.
Radiol Case Rep ; 19(10): 4151-4157, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39101025

RESUMO

Intraventricular neurocytoma is a low incidence central nervous system tumor. It predominantly affects young adults with no apparent gender predilection. The main symptoms include headache, nausea and vomiting. These result from hydrocephalus due to the obstruction of cerebrospinal fluid flow. On diagnostic imaging, neurocytoma can be suspected by some features, such as peripheral cysts, lobulated contours and septa that bridge the ventricular wall, giving a "scalloped" appearance. There are other characteristics, but they are less specific for the diagnosis. The atypical variant of neurocytoma is even rarer and leads to a worst prognosis. Atypical neurocytomas develop higher proliferative potential identified by the Ki-67 biomarker and higher recurrence rate. There are few studies about the imaging characteristics of atypical neurocytomas. At this point, there are no reliable distinctive features to differentiate atypical neurocytomas, especially due to their low incidence. We present the case of a 20-year-old female patient with symptoms of intracraneal hypertension. CT and MRI of the brain revealed a mass occupying the body of the left lateral ventricle, adjacent to the foramen of Monro. The mass was primarily solid with discrete peripheral cyst and a few scalloped areas. It also showed signs of supratentorial obstructive hydrocephalus. The tumor was partially removed because of bleeding and compromise of vascular structures. Immunohistochemistry revealed positive synaptophysin, elevated Ki-67 (7%), increased number of blood vessels and moderate nuclear atypia. After surgery, the patient persisted with signs of intracranial hypertension, not improving with clinical management and requiring aggressive surgical procedures. While rare, atypical neurocytoma requires a better characterization, especially through imaging, to optimize immediate management and explore new therapeutic options.

8.
Radiol Med ; 2024 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-39106024

RESUMO

PURPOSE: There is an unmet clinical need for non-invasive imaging biomarkers that could replace liver biopsy in the management of patients with autoimmune hepatitis (AIH). In this study, we sought to evaluate the diagnostic accuracy of a simple uncorrected, non-contrast T1 mapping for detecting fibrosis and inflammation in AIH patients using histopathology as a reference standard. MATERIAL AND METHODS: Over 3 years, 33 patients with AIH were prospectively studied using a multiparametric liver MRI protocol which included T1 mapping. Biopsies were performed up to 3 months before imaging, and a standardized histopathological score for fibrosis (F0-F4) and inflammatory activity (PPA0-4) was used as a reference. Statistical analysis included independent t test, Mann-Whitney U-test, and ROC (receiver operating characteristic) analysis. RESULTS: T1 mapping values were significantly higher in patients with advanced fibrosis (F0-2 vs. F3-4; p < 0.015), significant fibrosis (F0-1 vs. F2-4; p < 0.005), and significant inflammatory activity (PPA 0-1 vs. PPA 2-4 p = 0.048). Moreover, the technique demonstrated a good diagnostic performance in detecting significant (AUC 0.856) and advanced fibrosis (AUC 0.835), as well as significant inflammatory activity (AUC 0.763). CONCLUSION: A rapid, simple, uncorrected, non-contrast T1 mapping sequence showed satisfactory diagnostic performance in comparison with histopathology for detecting significant tissue inflammation and fibrosis in AIH patients, being a potential non-invasive imaging biomarker for monitoring disease activity in such individuals.

9.
Skin Appendage Disord ; 10(4): 312-320, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39108555

RESUMO

Introduction: 3D biomodels represent a cutting-edge advancement in medical imaging technology. The incorporation of 3D technologies in dermatology through the acquisition of onychological images, 3D reconstruction, and development of customized equipment to assist in surgeries demonstrated reduction in operating times and improved surgical outcomes. Additionally, the use of 3D printing in surgical simulation provided a safe environment for training and education. This article explores the application of 3D biomodels in dermatology, focusing on three clinical cases involving nail tumors. Case Presentation: In case 1, a glomus tumor was visualized in 3D, guiding the creation of a personalized surgical device. The minimally invasive surgery, facilitated by the biomodel, resulted in successful tumor removal. Case 2, featuring a subungual keratoacanthoma, utilized 3D biomodels for conservative surgery planning, anatomical comprehension, and patient communication. Case 3 involved a longitudinal groove, where biomodels aided in precise lesion localization and surgical planning. Conclusion: The integration of virtual and physical anatomical biomodels proves valuable in surgical dermatology, contributing to enhanced treatment quality, patient safety, and medical education.

10.
Int Braz J Urol ; 50(5): 595-604, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39106115

RESUMO

PURPOSE: To validate the Barcelona magnetic resonance imaging predictive model (BCN-MRI PM) in men with pre-biopsy multiparametric MRI (mpMRI) reported with the Prostate Imaging Reporting and Data System (PI-RADS) v2.1, followed by transrectal and transperineal prostate biopsies. MATERIALS AND METHODS: Prospective analysis of 3,264 men with PSA >3.0 ng/mL and/or abnormal digital rectal examination who were referred to ten participant centers in the csPCa early detection program of Catalonia (Spain), between 2021 and 2023. MpMRI was reported with the PI-RADS v2.1, and 2- to 4-core MRI-transrectal ultrasound (TRUS) fusion-targeted biopsy of suspected lesions and/or 12-core systematic biopsy were conducted. 2,295 (70.3%) individuals were referred to six centers for transrectal prostate biopsies, while 969 (39.7%) were referred to four centers for transperineal prostate biopsies. CsPCa was classified whenever the International Society of Urologic Pathology grade group was 2 or higher. RESULTS: CsPCa was detected in 41% of transrectal prostate biopsies and in 45.9% of transperineal prostate biopsies (p < 0.016). Both BCN-MRI PM calibration curves were within the ideal correlation between predicted and observed csPCa. Areas under the curve and 95% confidence intervals were 0.847 (0.830-0.857) and 0.830 (0.823-0.855), respectively (p = 0.346). Specificities corresponding to 95% sensitivity were 37.6 and 36.8%, respectively (p = 0.387). The Net benefit of the BCN-MRI PM was similar with both biopsy methods. CONCLUSIONS: The BCN-MRI PM has been successfully validated when mpMRI was reported with the PI-RADS v2.1 and prostate biopsies were conducted via the transrectal and transperineal route.


Assuntos
Biópsia Guiada por Imagem , Imageamento por Ressonância Magnética Multiparamétrica , Próstata , Neoplasias da Próstata , Humanos , Masculino , Neoplasias da Próstata/patologia , Neoplasias da Próstata/diagnóstico por imagem , Estudos Prospectivos , Biópsia Guiada por Imagem/métodos , Imageamento por Ressonância Magnética Multiparamétrica/métodos , Idoso , Pessoa de Meia-Idade , Próstata/patologia , Próstata/diagnóstico por imagem , Períneo/diagnóstico por imagem , Períneo/patologia , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Imageamento por Ressonância Magnética/métodos
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