Adriano Tachibana - Academia.edu (original) (raw)

Papers by Adriano Tachibana

Nutrition in Clinical Practice, 2022

Aim: The incidence of most hematologic malignancies increases with age. Hematopoietic stem cell t... more Aim: The incidence of most hematologic malignancies increases with age. Hematopoietic stem cell transplantation (HSCT) provides a potentially life-prolonging or curative option for many patients in this scenario. Limited data is available on muscle mass and density assessed from CT-images on outcomes after HSCT. We aimed to evaluate the influence of body composition on morbidity and mortality in older adults undergoing (HSCT). Methods: Retrospective longitudinal study conducted with 50 patients ≥ 60 years undergoing HSCT at Hospital Israelita Albert Einstein, São Paulo. Body composition was assessed by chest computed tomography and treatment related mortality, graft versus host disease, neutrophil grafting, and overall survival were analyzed.Results: 148 HSCT patients were evaluated, 50 patients were eligible: 60% with autologous and 40% with allogeneic transplantation. Body mass index in patients was (female: 26.9 ± 4.7 kg/m2; 30.1± 4.9 kg/m2) - autologous and (female: 24.3 ± 5.15 kg/m2; male: 26.4 ± 2.0 kg/m2) - allogeneic. In autologous transplant group, we found a positive association between age and death risk with an increase of 63.5% in this risk (p=0.006) and also Karnofsky performance scale with decrease of 11.9% in death risk (p<0.001). A negative association between muscle radiodensity and death risk was observed in allogeneic transplantation patients with risk decrease of 20.1% (p = 0.032). We found a positive association between T4 muscle area and radiodensity with risk of acute graft versus host disease (p= 0.028). Conclusion: In population studied, body composition assessed by chest tomography showed the importance of radiodensity for better prognosis.

Clinics, 2021

This study aimed to determine the prevalence of signs of impending rupture (SIR) in asymptomatic ... more This study aimed to determine the prevalence of signs of impending rupture (SIR) in asymptomatic patients with abdominal aortic and iliac artery aneurysms, and to evaluate whether these signs were associated with rupture in asymptomatic patients. METHODS: This was a retrospective study of patients with abdominal aortic and iliac artery aneurysms identified on computed tomography (CT) over a 10-year period in a single center. The CT scans were reviewed by two reviewers, and patients with SIR were assigned to one of three groups: (1) early symptomatic (ES), (2) late symptomatic (LS), and (3) always asymptomatic (AA). The four main SIR described in the literature were investigated: 1) crescent sign, 2) focal wall discontinuity of circumferential calcifications, 3) aortic bulges or blebs, and 4) aortic draping. RESULTS: From a total of 759 aortic and iliac aneurysm reports on 2226 CT scans, we identified 41 patients with at least one SIR, and a prevalence of 4.14% in asymptomatic patients. Focal wall discontinuity of circumferential calcifications was the most common sign, and it was present in 46.3% of these patients (19/41); among these, 26 were repaired (ES: 9, LS: 2, AA: 15). Eleven asymptomatic patients underwent follow-up CT. The aneurysm increased in size in 6 of the 11 (54.5%) patients, and three ruptured (all with discontinuity of calcifications), one of which had no increase in diameter. CONCLUSIONS: The presence of focal wall discontinuity of circumferential calcifications was the most common SIR. There was a prevalence of all signs in less than 5% of asymptomatic patients. In unrepaired patients, the signs could be observed on follow-up CT scans with an increase in aneurysm size, indicating that the presence of SIR alone in the absence of other clinical factors or aneurysm characteristics is an insufficient indication for surgery.

The Lancet, 2022

Background Patients hospitalised with COVID-19 are at risk for thrombotic events after discharge;... more Background Patients hospitalised with COVID-19 are at risk for thrombotic events after discharge; the role of extended thromboprophylaxis in this population is unknown. Methods In this open-label, multicentre, randomised trial conducted at 14 centres in Brazil, patients hospitalised with COVID-19 at increased risk for venous thromboembolism (International Medical Prevention Registry on Venous Thromboembolism [IMPROVE] venous thromboembolism [VTE] score of ≥4 or 2–3 with a D-dimer >500 ng/mL) were randomly assigned (1:1) to receive, at hospital discharge, rivaroxaban 10 mg/day or no anticoagulation for 35 days. The primary efficacy outcome in an intention-to-treat analysis was a composite of symptomatic or fatal venous thromboembolism, asymptomatic venous thromboembolism on bilateral lower-limb venous ultrasound and CT pulmonary angiogram, symptomatic arterial thromboembolism, and cardiovascular death at day 35. Adjudication was blinded. The primary safety outcome was major bleeding. The primary and safety analyses were carried out in the intention-to-treat population. This trial is registered at ClinicalTrials.gov, NCT04662684. Findings From Oct 8, 2020, to June 29, 2021, 997 patients were screened. Of these patients, 677 did not meet eligibility criteria; the remaining 320 patients were enrolled and randomly assigned to receive rivaroxaban (n=160 [50%]) or no anticoagulation (n=160 [50%]). All patients received thromboprophylaxis with standard doses of heparin during hospitalisation. 165 (52%) patients were in the intensive care unit while hospitalised. 197 (62%) patients had an IMPROVE score of 2–3 and elevated D-dimer levels and 121 (38%) had a score of 4 or more. Two patients (one in each group) were lost to follow-up due to withdrawal of consent and not included in the intention-to-treat primary analysis. The primary efficacy outcome occurred in five (3%) of 159 patients assigned to rivaroxaban and 15 (9%) of 159 patients assigned to no anticoagulation (relative risk 0·33, 95% CI 0·12–0·90; p=0·0293). No major bleeding occurred in either study group. Allergic reactions occurred in two (1%) patients in the rivaroxaban group. Interpretation In patients at high risk discharged after hospitalisation due to COVID-19, thromboprophylaxis with rivaroxaban 10 mg/day for 35 days improved clinical outcomes compared with no extended thromboprophylaxis. Funding Bayer.

Einstein (São Paulo), 2020

Radiology departments were forced to make significant changes in their routine during the coronav... more Radiology departments were forced to make significant changes in their routine during the coronavirus disease 2019 pandemic, to prevent further transmission of the coronavirus and optimize medical care as well. In this article, we describe our Radiology Department's policies in a private hospital for coronavirus disease 2019 preparedness focusing on quality and safety for the patient submitted to imaging tests, the healthcare team involved in the exams, the requesting physician, and for other patients and hospital environment.

Intermittent claudication is frequently associated with atherosclerotic disease, but differential... more Intermittent claudication is frequently associated with atherosclerotic disease, but differential diagnosis must be sought in patients with no traditional risk factors. Cystic adventitial disease, of unknown etiology, most frequently affects the popliteal artery, and occasionally presents as intermittent claudication. We report a case of this disease and the surgical treatment, and discuss some aspects related to etiopathogenesis, diagnosis and treatment of this condition.

Clinical and Applied Thrombosis/Hemostasis, 2016

Background: Distal deep venous thrombosis (DVT) accounts for approximately half of all the cases ... more Background: Distal deep venous thrombosis (DVT) accounts for approximately half of all the cases of lower limb thrombosis. The impact and management of this condition is still controversial. This study aims to evaluate the incidence of pulmonary embolism (PE) in patients with distal DVT in comparison to proximal DVT and evaluate the correlation between DVT and PE extension. Methods: 100 patients with acute lower limb DVT diagnosed with whole leg Doppler ultrasound from January 2006 to December 2014 were retrospectively analyzed. Active investigation for PE was carried out in all patients using multislice computed tomography angiography. Classification of DVT and PE was based on the proximal extension of the thrombus. Results: The overall incidence of PE in our sample patients was 72%. In the subgroup analysis, incidence of PE was equal in both the proximal and distal DVT groups (77%, p > 0.99). PE was detected in 43% of the patients with isolated calf vein thrombosis (ICVT). No s...

Clinics (São Paulo, Brazil), 2015

The purpose of this study was to evaluate the effectiveness of contrast-enhanced ultrasound with ... more The purpose of this study was to evaluate the effectiveness of contrast-enhanced ultrasound with a second-generation contrast agent in distinguishing between occlusion and pseudo-occlusion of the cervical internal carotid artery, comparing it with that of conventional Doppler ultrasound and the gold standard, computed tomography angiography. Between June 2006 and June 2012, we screened 72 symptomatic vascular surgery outpatients at a public hospital. Among those patients, 78 cervical internal carotid arteries were previously classified as occluded by Doppler ultrasound (without contrast). The patients were examined again with Doppler ultrasound, as well as with contrast-enhanced ultrasound and computed tomography angiography. The diagnosis was based on the presence or absence of flow. Among the 78 cervical internal carotid arteries identified as occluded by Doppler ultrasound, occlusion was confirmed by computed tomography angiography in only 57 (73.1%), compared with 59 (77.5%) for...

Arquivos brasileiros de cardiologia, 2014

Os anúncios veiculados nesta edição são de exclusiva responsabilidade dos anunciantes, assim co... more Os anúncios veiculados nesta edição são de exclusiva responsabilidade dos anunciantes, assim como os conceitos emitidos em artigos assinados são de

Ultrasound in Medicine & Biology, 2009

The significant diadynamic criterias with multivariate Logistic regression analysis were selected... more The significant diadynamic criterias with multivariate Logistic regression analysis were selected in order to establish the multivariate predictive model for diagnosis of early EP. Results: The multivariate analysis indicated that the final predictive model included three factors as follow: whether the endometrial thickness was more than 9mm, whether the endometrial pattern was type A, and whether the endometrial spiral arteriae were detected by TV-PDU. The area under the ROC curve of the TV-PDU multivariate predictive model was 0.980. The accuracy of diagnosis was high, when the RI value was 0.65 and predictive regression diagnosis ratio was more than 0.50. The coincidence rate was 94.5%, when this model was used to diagnose early EP. Conclusion: We conclude that the multivariate regressive predictive model established in this study has significant clinical value in the differential diagnosis of early EP of PUL.

Ultrasound in Medicine & Biology, 2009

Objective: To evaluate the feasibility of diagnosing breast cancer by ultrasound with computer-ai... more Objective: To evaluate the feasibility of diagnosing breast cancer by ultrasound with computer-aided detection system (CAD). Materials and Methods: A total of 99 patients with 100 lesions were included in this study(mean age, 51years; range, 27-75). Of 100 lesions, 64 breast cancer and 36 benign lesions confirmed by pathology. All patients underwent conventional ultrasound examination and ultrasound examination with B-CAD system in sequence in the same day by two doctors, and accuracy of the diagnosis was calculated and compare the accuracy of B-CAD system in diagnosing the breast cancer of different size. Results: There was no significant difference in diagnosis accuracy of breast cancer by ultrasound with and without B-CAD system. The diagnosis accuracy of breast cancer increased 44% with B-CAD system when the lesions were less than 1cm in diameter and there was a significant difference compared to conventional ultrasound without B-CAD system(pϽ0.05). However, there was no significant difference when the lesions were more than 1cm in diameter with and without B-CAD system(pϾ0.05). Conclusions: The detection rate of breast cancer can be significantly improved with B-CAD system when the lesion is less than 1cm in diameter.

Journal of Vascular and Interventional Radiology, 2002

Einstein (São Paulo), 2010

Adnexial torsion is an unusual event, but a major cause of abdominal pain in women. It is often a... more Adnexial torsion is an unusual event, but a major cause of abdominal pain in women. It is often associated with ovarian tumor or cyst, but can occur in normal ovaries, especially in children. The twisting of adnexial structures may involve the ovary or tube, but frequently affects both. In most cases, it is unilateral, with slight predilection for the right side. In imaging findings, increased ovarian volume and adnexial masses are observed, with reduced or absent vascularization. In cases of undiagnosed or untreated complete twist, hemorrhagic necrosis may occur leading to complications; in that, peritonitis is the most frequent. Early diagnosis helps preventing irreversible damage with conservative treatment, thereby saving the ovary. Limitations in performing physical examination, possible inconclusive results in ultrasound and exposure to radiation in computed tomography makes magnetic resonance imaging a valuable tool in emergency assessment of gynecological diseases. The objec...

Vasa

Summary: Background: Chronic liver disease (CLD) patients are at greater risk for developing sple... more Summary: Background: Chronic liver disease (CLD) patients are at greater risk for developing splenic artery aneurysm (SAA). Treatment for aneurysms > 2.5 cm in this population is considered. However, the procedure might be challenging in CLD patients, and complications may interfere in liver transplantation. We, therefore, sought to estimate the prevalence, growth rate and complications of SAA in patients with CLD. As secondary objective, we sought to evaluate whether those features differ in pre and post transplantation follow-up and among aneurysms with diameters greater or less than 2.5 cm at diagnosis. Patients and methods: We searched for the terms “SAA” and “CLD” on CT or MRI reports from January 2009 to December 2016. Patients with single examination or less than 6 months follow-up were excluded. Results: Fifty nine out of 2050 CLD patients presented SAA (prevalence of 2.9%). Fifteen patients were excluded (due to exclusion criteria). Forty-four CLD patients (mean age 55.9...

Circulation Journal

Background: The goal of this study was to assess the degree of the left common iliac vein (LCIV) ... more Background: The goal of this study was to assess the degree of the left common iliac vein (LCIV) compression by the right common iliac artery (RCIA) on magnetic resonance imaging (MRI), and verify differences in compression measurements in end-inspiration, end-expiration, supine, and prone decubitus between patients with and without symptoms in the lower limbs. Methods and Results: A total of 82 consecutive participants provided informed consent and underwent pelvic MRI for different clinical indications other than vascular-related disorders. The participants answered a questionnaire about venous disease in the lower limbs and history of previous deep vein thrombosis. This study measured the area and diameter of the LCIV at the site of the crossing with the RCIA and in the uncompressed caudal LCIV segment. Statistical analysis was performed to compare the degree of LCIV compression by the RCIA and verify differences in compression measurements. A total of 71 participants were included; 46.6% were in group A and did not experience signs and symptoms in lower limbs and 53.6% were in group B and answered at least one question with a positive answer. It was observed that there was a statistically significant difference between groups for end-expiration. No statistically significant differences were observed for all other measurements. Conclusions: A substantial percentage of the asymptomatic and symptomatic population showed compression of the LCIV, suggesting there are no clear relationships between stenosis and non-specific symptomatology in the general population.

Blood

Introduction: It is well established that the loss of muscle mass is the biggest change that occu... more Introduction: It is well established that the loss of muscle mass is the biggest change that occurs with aging and may lead to decline of muscle strength and functionality. In 1989, Irwin Rosenberg proposed the term "sarcopenia" to describe this decline in muscle mass is related to aging. Patients with hematologic malignancies are usually well nourished before undergoing the hematopoietic stem cell transplantation (HSCT). However, changes in body composition after HSCT have been the subject of studies. After HSCT, complications such as infections and graft-versus-host disease (GVHD) might affect the weight and body composition. Immunosuppressive therapy and corticosteroids also alter skeletal muscle metabolism. Thus, treatment and complications after HSCT exert large negative effects on lean muscle mass, especially in elderly patients. Objective: The aim of this study is to determine whether measures of body composition predict outcomes after HSCT within the context of an ...

Journal of Magnetic Resonance Imaging

Radiologia Brasileira

Objective: To evaluate the correlation of morphological criteria of the cecal appendix using comp... more Objective: To evaluate the correlation of morphological criteria of the cecal appendix using computed tomography (CT) and the possible risk of developing acute appendicitis. Materials and Methods: Cases were defined as patients with surgically confirmed acute appendicitis who had undergone CT at least twice: at diagnosis and at least one month prior. Controls were defined as emergency patients with abdominal pain who had undergone abdominal CT that excluded acute appendicitis and had also undergone CT at least one month before. Results: 100 cases and 100 controls were selected for inclusion in the final analysis. Comparisons between the cases and controls revealed the following: mean transverse diameter of 0.6 cm (range, 0.4-1.0 cm) versus 0.6 cm (range, 0.6-0.8 cm; p = 0.37); mean length of 6.6 cm (range, 3.5-9.7 cm) versus 6.6 cm (range, 4.5-8.3 cm; p = 0.87); mean angle of 100° (range, 23-178°) versus 86° (range, 43-160°; p = 0.01); vertical descending orientation in 56% versus 4...

Nutrition in Clinical Practice, 2022

Aim: The incidence of most hematologic malignancies increases with age. Hematopoietic stem cell t... more Aim: The incidence of most hematologic malignancies increases with age. Hematopoietic stem cell transplantation (HSCT) provides a potentially life-prolonging or curative option for many patients in this scenario. Limited data is available on muscle mass and density assessed from CT-images on outcomes after HSCT. We aimed to evaluate the influence of body composition on morbidity and mortality in older adults undergoing (HSCT). Methods: Retrospective longitudinal study conducted with 50 patients ≥ 60 years undergoing HSCT at Hospital Israelita Albert Einstein, São Paulo. Body composition was assessed by chest computed tomography and treatment related mortality, graft versus host disease, neutrophil grafting, and overall survival were analyzed.Results: 148 HSCT patients were evaluated, 50 patients were eligible: 60% with autologous and 40% with allogeneic transplantation. Body mass index in patients was (female: 26.9 ± 4.7 kg/m2; 30.1± 4.9 kg/m2) - autologous and (female: 24.3 ± 5.15 kg/m2; male: 26.4 ± 2.0 kg/m2) - allogeneic. In autologous transplant group, we found a positive association between age and death risk with an increase of 63.5% in this risk (p=0.006) and also Karnofsky performance scale with decrease of 11.9% in death risk (p<0.001). A negative association between muscle radiodensity and death risk was observed in allogeneic transplantation patients with risk decrease of 20.1% (p = 0.032). We found a positive association between T4 muscle area and radiodensity with risk of acute graft versus host disease (p= 0.028). Conclusion: In population studied, body composition assessed by chest tomography showed the importance of radiodensity for better prognosis.

Clinics, 2021

This study aimed to determine the prevalence of signs of impending rupture (SIR) in asymptomatic ... more This study aimed to determine the prevalence of signs of impending rupture (SIR) in asymptomatic patients with abdominal aortic and iliac artery aneurysms, and to evaluate whether these signs were associated with rupture in asymptomatic patients. METHODS: This was a retrospective study of patients with abdominal aortic and iliac artery aneurysms identified on computed tomography (CT) over a 10-year period in a single center. The CT scans were reviewed by two reviewers, and patients with SIR were assigned to one of three groups: (1) early symptomatic (ES), (2) late symptomatic (LS), and (3) always asymptomatic (AA). The four main SIR described in the literature were investigated: 1) crescent sign, 2) focal wall discontinuity of circumferential calcifications, 3) aortic bulges or blebs, and 4) aortic draping. RESULTS: From a total of 759 aortic and iliac aneurysm reports on 2226 CT scans, we identified 41 patients with at least one SIR, and a prevalence of 4.14% in asymptomatic patients. Focal wall discontinuity of circumferential calcifications was the most common sign, and it was present in 46.3% of these patients (19/41); among these, 26 were repaired (ES: 9, LS: 2, AA: 15). Eleven asymptomatic patients underwent follow-up CT. The aneurysm increased in size in 6 of the 11 (54.5%) patients, and three ruptured (all with discontinuity of calcifications), one of which had no increase in diameter. CONCLUSIONS: The presence of focal wall discontinuity of circumferential calcifications was the most common SIR. There was a prevalence of all signs in less than 5% of asymptomatic patients. In unrepaired patients, the signs could be observed on follow-up CT scans with an increase in aneurysm size, indicating that the presence of SIR alone in the absence of other clinical factors or aneurysm characteristics is an insufficient indication for surgery.

The Lancet, 2022

Background Patients hospitalised with COVID-19 are at risk for thrombotic events after discharge;... more Background Patients hospitalised with COVID-19 are at risk for thrombotic events after discharge; the role of extended thromboprophylaxis in this population is unknown. Methods In this open-label, multicentre, randomised trial conducted at 14 centres in Brazil, patients hospitalised with COVID-19 at increased risk for venous thromboembolism (International Medical Prevention Registry on Venous Thromboembolism [IMPROVE] venous thromboembolism [VTE] score of ≥4 or 2–3 with a D-dimer >500 ng/mL) were randomly assigned (1:1) to receive, at hospital discharge, rivaroxaban 10 mg/day or no anticoagulation for 35 days. The primary efficacy outcome in an intention-to-treat analysis was a composite of symptomatic or fatal venous thromboembolism, asymptomatic venous thromboembolism on bilateral lower-limb venous ultrasound and CT pulmonary angiogram, symptomatic arterial thromboembolism, and cardiovascular death at day 35. Adjudication was blinded. The primary safety outcome was major bleeding. The primary and safety analyses were carried out in the intention-to-treat population. This trial is registered at ClinicalTrials.gov, NCT04662684. Findings From Oct 8, 2020, to June 29, 2021, 997 patients were screened. Of these patients, 677 did not meet eligibility criteria; the remaining 320 patients were enrolled and randomly assigned to receive rivaroxaban (n=160 [50%]) or no anticoagulation (n=160 [50%]). All patients received thromboprophylaxis with standard doses of heparin during hospitalisation. 165 (52%) patients were in the intensive care unit while hospitalised. 197 (62%) patients had an IMPROVE score of 2–3 and elevated D-dimer levels and 121 (38%) had a score of 4 or more. Two patients (one in each group) were lost to follow-up due to withdrawal of consent and not included in the intention-to-treat primary analysis. The primary efficacy outcome occurred in five (3%) of 159 patients assigned to rivaroxaban and 15 (9%) of 159 patients assigned to no anticoagulation (relative risk 0·33, 95% CI 0·12–0·90; p=0·0293). No major bleeding occurred in either study group. Allergic reactions occurred in two (1%) patients in the rivaroxaban group. Interpretation In patients at high risk discharged after hospitalisation due to COVID-19, thromboprophylaxis with rivaroxaban 10 mg/day for 35 days improved clinical outcomes compared with no extended thromboprophylaxis. Funding Bayer.

Einstein (São Paulo), 2020

Radiology departments were forced to make significant changes in their routine during the coronav... more Radiology departments were forced to make significant changes in their routine during the coronavirus disease 2019 pandemic, to prevent further transmission of the coronavirus and optimize medical care as well. In this article, we describe our Radiology Department's policies in a private hospital for coronavirus disease 2019 preparedness focusing on quality and safety for the patient submitted to imaging tests, the healthcare team involved in the exams, the requesting physician, and for other patients and hospital environment.

Intermittent claudication is frequently associated with atherosclerotic disease, but differential... more Intermittent claudication is frequently associated with atherosclerotic disease, but differential diagnosis must be sought in patients with no traditional risk factors. Cystic adventitial disease, of unknown etiology, most frequently affects the popliteal artery, and occasionally presents as intermittent claudication. We report a case of this disease and the surgical treatment, and discuss some aspects related to etiopathogenesis, diagnosis and treatment of this condition.

Clinical and Applied Thrombosis/Hemostasis, 2016

Background: Distal deep venous thrombosis (DVT) accounts for approximately half of all the cases ... more Background: Distal deep venous thrombosis (DVT) accounts for approximately half of all the cases of lower limb thrombosis. The impact and management of this condition is still controversial. This study aims to evaluate the incidence of pulmonary embolism (PE) in patients with distal DVT in comparison to proximal DVT and evaluate the correlation between DVT and PE extension. Methods: 100 patients with acute lower limb DVT diagnosed with whole leg Doppler ultrasound from January 2006 to December 2014 were retrospectively analyzed. Active investigation for PE was carried out in all patients using multislice computed tomography angiography. Classification of DVT and PE was based on the proximal extension of the thrombus. Results: The overall incidence of PE in our sample patients was 72%. In the subgroup analysis, incidence of PE was equal in both the proximal and distal DVT groups (77%, p > 0.99). PE was detected in 43% of the patients with isolated calf vein thrombosis (ICVT). No s...

Clinics (São Paulo, Brazil), 2015

The purpose of this study was to evaluate the effectiveness of contrast-enhanced ultrasound with ... more The purpose of this study was to evaluate the effectiveness of contrast-enhanced ultrasound with a second-generation contrast agent in distinguishing between occlusion and pseudo-occlusion of the cervical internal carotid artery, comparing it with that of conventional Doppler ultrasound and the gold standard, computed tomography angiography. Between June 2006 and June 2012, we screened 72 symptomatic vascular surgery outpatients at a public hospital. Among those patients, 78 cervical internal carotid arteries were previously classified as occluded by Doppler ultrasound (without contrast). The patients were examined again with Doppler ultrasound, as well as with contrast-enhanced ultrasound and computed tomography angiography. The diagnosis was based on the presence or absence of flow. Among the 78 cervical internal carotid arteries identified as occluded by Doppler ultrasound, occlusion was confirmed by computed tomography angiography in only 57 (73.1%), compared with 59 (77.5%) for...

Arquivos brasileiros de cardiologia, 2014

Os anúncios veiculados nesta edição são de exclusiva responsabilidade dos anunciantes, assim co... more Os anúncios veiculados nesta edição são de exclusiva responsabilidade dos anunciantes, assim como os conceitos emitidos em artigos assinados são de

Ultrasound in Medicine & Biology, 2009

The significant diadynamic criterias with multivariate Logistic regression analysis were selected... more The significant diadynamic criterias with multivariate Logistic regression analysis were selected in order to establish the multivariate predictive model for diagnosis of early EP. Results: The multivariate analysis indicated that the final predictive model included three factors as follow: whether the endometrial thickness was more than 9mm, whether the endometrial pattern was type A, and whether the endometrial spiral arteriae were detected by TV-PDU. The area under the ROC curve of the TV-PDU multivariate predictive model was 0.980. The accuracy of diagnosis was high, when the RI value was 0.65 and predictive regression diagnosis ratio was more than 0.50. The coincidence rate was 94.5%, when this model was used to diagnose early EP. Conclusion: We conclude that the multivariate regressive predictive model established in this study has significant clinical value in the differential diagnosis of early EP of PUL.

Ultrasound in Medicine & Biology, 2009

Objective: To evaluate the feasibility of diagnosing breast cancer by ultrasound with computer-ai... more Objective: To evaluate the feasibility of diagnosing breast cancer by ultrasound with computer-aided detection system (CAD). Materials and Methods: A total of 99 patients with 100 lesions were included in this study(mean age, 51years; range, 27-75). Of 100 lesions, 64 breast cancer and 36 benign lesions confirmed by pathology. All patients underwent conventional ultrasound examination and ultrasound examination with B-CAD system in sequence in the same day by two doctors, and accuracy of the diagnosis was calculated and compare the accuracy of B-CAD system in diagnosing the breast cancer of different size. Results: There was no significant difference in diagnosis accuracy of breast cancer by ultrasound with and without B-CAD system. The diagnosis accuracy of breast cancer increased 44% with B-CAD system when the lesions were less than 1cm in diameter and there was a significant difference compared to conventional ultrasound without B-CAD system(pϽ0.05). However, there was no significant difference when the lesions were more than 1cm in diameter with and without B-CAD system(pϾ0.05). Conclusions: The detection rate of breast cancer can be significantly improved with B-CAD system when the lesion is less than 1cm in diameter.

Journal of Vascular and Interventional Radiology, 2002

Einstein (São Paulo), 2010

Adnexial torsion is an unusual event, but a major cause of abdominal pain in women. It is often a... more Adnexial torsion is an unusual event, but a major cause of abdominal pain in women. It is often associated with ovarian tumor or cyst, but can occur in normal ovaries, especially in children. The twisting of adnexial structures may involve the ovary or tube, but frequently affects both. In most cases, it is unilateral, with slight predilection for the right side. In imaging findings, increased ovarian volume and adnexial masses are observed, with reduced or absent vascularization. In cases of undiagnosed or untreated complete twist, hemorrhagic necrosis may occur leading to complications; in that, peritonitis is the most frequent. Early diagnosis helps preventing irreversible damage with conservative treatment, thereby saving the ovary. Limitations in performing physical examination, possible inconclusive results in ultrasound and exposure to radiation in computed tomography makes magnetic resonance imaging a valuable tool in emergency assessment of gynecological diseases. The objec...

Vasa

Summary: Background: Chronic liver disease (CLD) patients are at greater risk for developing sple... more Summary: Background: Chronic liver disease (CLD) patients are at greater risk for developing splenic artery aneurysm (SAA). Treatment for aneurysms > 2.5 cm in this population is considered. However, the procedure might be challenging in CLD patients, and complications may interfere in liver transplantation. We, therefore, sought to estimate the prevalence, growth rate and complications of SAA in patients with CLD. As secondary objective, we sought to evaluate whether those features differ in pre and post transplantation follow-up and among aneurysms with diameters greater or less than 2.5 cm at diagnosis. Patients and methods: We searched for the terms “SAA” and “CLD” on CT or MRI reports from January 2009 to December 2016. Patients with single examination or less than 6 months follow-up were excluded. Results: Fifty nine out of 2050 CLD patients presented SAA (prevalence of 2.9%). Fifteen patients were excluded (due to exclusion criteria). Forty-four CLD patients (mean age 55.9...

Circulation Journal

Background: The goal of this study was to assess the degree of the left common iliac vein (LCIV) ... more Background: The goal of this study was to assess the degree of the left common iliac vein (LCIV) compression by the right common iliac artery (RCIA) on magnetic resonance imaging (MRI), and verify differences in compression measurements in end-inspiration, end-expiration, supine, and prone decubitus between patients with and without symptoms in the lower limbs. Methods and Results: A total of 82 consecutive participants provided informed consent and underwent pelvic MRI for different clinical indications other than vascular-related disorders. The participants answered a questionnaire about venous disease in the lower limbs and history of previous deep vein thrombosis. This study measured the area and diameter of the LCIV at the site of the crossing with the RCIA and in the uncompressed caudal LCIV segment. Statistical analysis was performed to compare the degree of LCIV compression by the RCIA and verify differences in compression measurements. A total of 71 participants were included; 46.6% were in group A and did not experience signs and symptoms in lower limbs and 53.6% were in group B and answered at least one question with a positive answer. It was observed that there was a statistically significant difference between groups for end-expiration. No statistically significant differences were observed for all other measurements. Conclusions: A substantial percentage of the asymptomatic and symptomatic population showed compression of the LCIV, suggesting there are no clear relationships between stenosis and non-specific symptomatology in the general population.

Blood

Introduction: It is well established that the loss of muscle mass is the biggest change that occu... more Introduction: It is well established that the loss of muscle mass is the biggest change that occurs with aging and may lead to decline of muscle strength and functionality. In 1989, Irwin Rosenberg proposed the term "sarcopenia" to describe this decline in muscle mass is related to aging. Patients with hematologic malignancies are usually well nourished before undergoing the hematopoietic stem cell transplantation (HSCT). However, changes in body composition after HSCT have been the subject of studies. After HSCT, complications such as infections and graft-versus-host disease (GVHD) might affect the weight and body composition. Immunosuppressive therapy and corticosteroids also alter skeletal muscle metabolism. Thus, treatment and complications after HSCT exert large negative effects on lean muscle mass, especially in elderly patients. Objective: The aim of this study is to determine whether measures of body composition predict outcomes after HSCT within the context of an ...

Journal of Magnetic Resonance Imaging

Radiologia Brasileira

Objective: To evaluate the correlation of morphological criteria of the cecal appendix using comp... more Objective: To evaluate the correlation of morphological criteria of the cecal appendix using computed tomography (CT) and the possible risk of developing acute appendicitis. Materials and Methods: Cases were defined as patients with surgically confirmed acute appendicitis who had undergone CT at least twice: at diagnosis and at least one month prior. Controls were defined as emergency patients with abdominal pain who had undergone abdominal CT that excluded acute appendicitis and had also undergone CT at least one month before. Results: 100 cases and 100 controls were selected for inclusion in the final analysis. Comparisons between the cases and controls revealed the following: mean transverse diameter of 0.6 cm (range, 0.4-1.0 cm) versus 0.6 cm (range, 0.6-0.8 cm; p = 0.37); mean length of 6.6 cm (range, 3.5-9.7 cm) versus 6.6 cm (range, 4.5-8.3 cm; p = 0.87); mean angle of 100° (range, 23-178°) versus 86° (range, 43-160°; p = 0.01); vertical descending orientation in 56% versus 4...