Theoretical Compartment Modeling of DCE-MRI Data Based on the Transport across Physiological Barriers in the Brain

Neurological disorders represent major causes of lost years of healthy life and mortality worldwide. Development of their quantitative interdisciplinary in vivo evaluation is required. Compartment modeling (CM) of brain data acquired in vivo using magnetic resonance imaging techniques with clinically available contrast agents can be performed to quantitatively assess brain perfusion. Transport of 1H spins in water molecules across physiological compartmental brain barriers in three different pools was mathematically modeled and theoretically evaluated in this paper and the corresponding theoretical compartment modeling of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) data was analyzed. The pools considered were blood, tissue, and cerebrospinal fluid (CSF). The blood and CSF data were mathematically modeled assuming continuous flow of the 1H spins in these pools. Tissue data was modeled using three CMs. Results in this paper show that transport across physiological brain barriers such as the blood to brain barrier, the extracellular space to the intracellular space barrier, or the blood to CSF barrier can be evaluated quantitatively. Statistical evaluations of this quantitative information may be performed to assess tissue perfusion, barriers' integrity, and CSF flow in vivo in the normal or disease-affected brain or to assess response to therapy

Bilateral orbital lymphoma: A diagnostic odyssey through surreal clinical and imaging features plus therapeutic implications

The paper aim was to present a case of bilateral, advanced, orbital lymphoma diagnosed in a middle aged man who was admitted in a clinical condition which almost defied reality. The entire orbito-facial region was replaced by massive ulcero-necrotic masses which completely distorted the normal anatomy, giving an alien-like resemblance of an otherwise ordinary man. The patient was submitted to several imaging examinations (head and whole body computer tomography, head MRI, laterocervical ultrasound and elastography) and surgical biopsy. The final diagnosis was stage IVB diffuse large B-cell lymphoma (DLBCL). Currently the patient is undergoing chemotherapy with astonishing response (clinically visible tumoral shrinkage).The differential diagnosis of orbital masses may be extensive, starting from inflammatory conditions, such as cellulitis, pseudotumor, sarcoidosis and finishing with metastases from lung, renal or breast cancers. However, considering the substantial tumor volume in this case and imaging aspects, lymphomatous origin was the first diagnostic verified and ultimately confirmed.The peculiarities of the case do not reside in the final diagnosis, for DLBCL is the most common form of non-Hodgkin lymphoma in middle aged men, but its debut or spread to orbits is rare, usually unilateral and diagnosed in less advanced stage

Predictors of outcome in infant and toddlers functional or behavioral disorders after a brief parent–infant psychotherapy

The efficacy of parent–child psychotherapies is widely recognized today. There are, however, less data on predictive factors for outcome in infants and toddlers and their parents. The aim of this study was to highlight predictive factors for outcome after a brief psychotherapy in a population of 49 infants and toddlers aged 3–30 months presenting functional or behavioral disorders. Two assessments were performed, the first before treatment and the second a month after the end of the therapy. These assessments included an evaluation of the child’s symptoms, and of depressive or anxiety symptoms in the parents. The assessments after therapy show complete or partial improvement in the child’s symptoms for nearly three quarters, and a decrease in the number of anxious and depressive mothers, and also in the number of depressive fathers. Three independent factors appear as predictive of unfavorable outcome for the child: frequency and intensity of behavioral problems and fears, and the absence of the father at more than two-thirds of consultations. The outcome for the mother is associated solely with her anxiety score at the start of the therapy. This study underlines the particular difficulties involved in the treatment of infants and toddlers presenting behavioral disturbances and emotional difficulties, and the value of involving the father in treatment

O psicólogo como facilitador da interação familiar no ambiente de cuidados intensivos neonatais

Neste artigo, apresentaremos a atenção com o processo interativo entre o bebê e sua família como uma das prioridades do psicólogo numa unidade de tratamento intensivo neonatal. Inicialmente, iremos caracterizar o ambiente de uma UTI neonatal e, em seguida, discutir o momento evolutivo da família a partir das experiências ocorridas durante a gestação e daquelas provocadas pelo parto antecipado ou de risco. Compreendendo esses dois aspectos - o ambiente e o momento em que se encontram os diferentes personagens familiares - discutiremos as possibilidades de cuidados que o psicólogo pode oferecer, privilegiando a saúde através de vias facilitadoras da interação familiar