Imaging the postoperative patient: long-term complications of gastrointestinal surgery

The objectives of this review are (1) to become acquainted with the long-term complications of surgery of the gastrointestinal tract, and (2) to appreciate the appropriate use of imaging in the assessment of long-term complications

Usefulness of Perfusion CT to Assess Response to Neoadjuvant Combined Chemoradiotherapy in Patients with Locally Advanced Rectal Cancer

RATIONALE AND OBJECTIVES: To prospectively evaluate perfusion computed tomography (CT) for assessment of changes in tumor vascularity after chemoradiation therapy (CRT) in locally advanced rectal cancer and to analyze the correlation between baseline perfusion parameters and tumor response. MATERIALS AND METHODS: Twenty patients with rectal cancer underwent baseline perfusion CT before CRT, and in 11 an examination after CRT was also performed. For each tumor, blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability-surface area product (PS) were quantified. The Mann-Whitney U test compared baseline perfusion parameters of responders and nonresponders and pre- and post-CRT measurements were compared by the Wilcoxon signed-rank test (P < .05 statistically significant for both tests). RESULTS: Baseline BF was significantly lower (P = .013) and MTT was significantly higher (P = .006) in responders. Both were able to discriminate responders from nonresponders with a sensitivity of 80% and 100% and a specificity of 73.3% and 86.7%, respectively, for BF and MTT. Baseline BV and PS were not significantly different in responders and nonresponders. Perfusion parameters changed significantly in post-CRT scans compared to baseline: BF (P = .003), BV (P = .003), and PS (P = .008) decreased, whereas MTT increased (P = .006). CONCLUSION: Baseline BF and MTT can discriminate patients with a favorable response from those that fail to respond to CRT, potentially selecting high-risk patients with resistant tumors that may benefit from an aggressive preoperative treatment approach

Congenital cystic lesions of the biliary tree

OBJECTIVE: The purpose of this essay is to illustrate the imaging findings of congenital cystic lesions of the biliary tract. CONCLUSION: Congenital cystic lesions of the biliary tract include ductal plate malformations and choledochal cysts and can be recognized with characteristic imaging findings and basic knowledge of the embryologic development of the biliary tree

Usefulness of Liver and Spleen Acoustic Radiation Force Impulse (ARFI) for the evaluation of cirrhotic patients

Objective: To evaluate the correlation between ARFI and Child-Pugh classification. Secondary Aims: 1) To compare ARFI values (hepatic, splenic and spleno-hepatic index) from cirrhotic to normal population; 2) To correlate biochemical parameters of liver function and ARFI. Materials and Methods: 58 cirrhotic patients (referenced to US for surveillance or to clarify any hepatic decompensation) were included in this prospective study, as well as 38 healthy subjects who underwent ultrasonography for other reasons than hepatic evaluation. All had ARFI liver and spleen evaluation on ACUSON S2000 ARFI equipment. The best cut-off liver and spleen values for the diagnosis of cirrhosis in comparison to the normal subjects were determined using SPSS® v20. Results: Mean liver ARFI values in controls and cirrhotic patients were respectively 1.18 ± 0.22 m/s and 2.93 ± 0.50 m/s. The ROC curve demonstrated an AUC 0.998 and the best cut-off was 1.89. Mean spleen ARFI values in controls and cirrhotic patients were respectively 2.60 ± 0.42 m/s and 3.03 ± 0.71. The ROC curve demonstrated an AUC 0.766 and the best cut-off was 2.73 m/s. The splenohepatic index showed a worse AUC than ARFI liver. A weak correlation was found between the ARFI liver and Child-Pugh. We found no statistically significant differences for spleen ARFI values and Child-Pugh. We found a statistically significant correlation between liver ARFI and bilirubin, ALKP, GGT, AST and AST/ALT ratio; and with spleen ARFI and ALKP and AST/ALT ratio. Conclusion: We showed that there is a tendency of higher levels of liver ARFI values for higher Child-Pugh classification suggesting a definite trend for higher values with more severe disease

Organizing pneumonia due to actinomycosis: an undescribed association

Organizing pneumonia is a pathologic entity characterized by intra-alveolar buds of granulation tissue that can extend to the bronchiolar lumen. It is a non-specific finding reflecting a pattern of pulmonary response to aggression that can be cryptogenic or associated with several causes. Pulmonary actinomycosis is a rare infectious disease, of bacterial aetiology, and of difficult diagnosis. This disease usually causes non-specific respiratory symptoms and radiological findings, and the treatment is based on the use of antibiotics. The authors describe a clinical case of a 53-year-old male smoker (50 pack years), initially seen for complaints of right-sided chest pain and sub-febrile temperature. Imaging studies revealed a mass in the inferior right lobe and enlarged mediastinal lymph nodes. Empirical treatment with antibiotics caused partial and temporary improvement. Transthoracic biopsy revealed a pattern of organizing pneumonia with giant multinucleated cell granulomas. Repeat imaging studies revealed an enlargement of the pulmonary mass and therefore a right inferior lobectomy was performed. The pathologic study revealed a histological pattern of organizing pneumonia surrounding inflammatory bronchiectasis with a large number of Actinomyces colonies. To our knowledge there is presently no report in the literature of organizing pneumonia associated with Actinomyces infection

A novel approach in glioblastoma multiforme drug discovery: Perturbation studies in vitro

Despite impressive advances in drug discovery methods, predicting cellular response to anticancer drugs remains challenging. In glioblastoma multiforme, this fact is even marked as many promising drugs were followed by disappointment. As a result, the aim of this study is to clarify the effects of inhibition of 3-phosphoinositide-dependent protein kinase-1 (PDK1) in glioblastoma multiforme, while exploring how the focus on potency might ignore the potential impact of variation in other pharmacological parameters. The evaluation of the induced drug perturbation in glioblastoma cancer cells and a multiparametric characterization dose-response of two PDK1 inhibitors were performed. Singular analysis of potency would lead to the conclusion that FC100 compound would be the most promising to treat glioblastoma multiforme. However, exploring other pharmacological parameters shows the opposite giving more information about the cell response. The study shows that potency should not be the critical factor in developing new drugs as our most potent compound lacks growth inhibition effect. So, the evaluation of promising drugs during the drug discovery phase needs to be re-evaluated and multiparametric dose-response analysis might be a useful approach to compare drugs and potentially better characterization of both drug and disease profiles

Prevalence of antibodies to a new histo-blood system: the FORS system

In 1987, three unrelated English families were reported with a putative blood subgroup called Apae. Swedish researchers later found evidence leading to abolishment of the Apae subgroup and establishment instead of the FORS blood group system (System 31 - ISBT, 2012). It is important to know the prevalence of antibodies in order to make the best decisions in transfusion medicine. Cells expressing the Forssman saccharide, such as sheep erythrocytes, are needed to detect the anti-Forssman antibody. The aim of this study was to define the prevalence of human anti-Forssman antibody.info:eu-repo/semantics/publishedVersio

O conhecimento matemático dos estudantes no início da Licenciatura em Educação Básica: um projeto envolvendo três Escolas superiores de educação

O novo modelo de formação inicial (Decreto-Lei 43/2007) exige que os futuros professores do 1.º e 2.º ciclos do ensino básico e os futuros educadores de infância façam pelo menos 30 ECTS de formação em Matemática na Licenciatura em Educação Básica (LEB), mas a forma e o conteúdo desta formação é da responsabilidade de cada instituição, que define as unidades curriculares, o seu conteúdo e a forma como são lecionadas. Sabe-se que, para além do conteúdo, a forma como o professor aprende tem uma forte influência na forma como vai ensinar. Assim, todos estes aspetos precisam de ser discutidos, tendo por base a investigação já realizada em Portugal e noutros países. Partindo da assunção de que o conhecimento do professor constitui um fator decisivo na interpretação e implementação do currículo e da necessidade de uma discussão alargada de qual deverá ser o conteúdo da formação em Matemática na LEB, as Escolas Superiores de Educação de Lisboa, de Viana do Castelo e de Viseu iniciaram um projeto de investigação que tem como principal objetivo compreender de que modo a formação inicial contribui para o desenvolvimento do conhecimento do professor em Matemática e em Ensino da Matemática e como pode este ser promovido. Uma das questões que o projeto visa investigar é que conhecimento de conteúdo matemático têm os estudantes quando iniciam o curso da LEB. Para caracterizar o conhecimento matemático dos estudantes da LEB, à entrada no curso, foi elaborado um teste diagnóstico, que foi aplicado nas três Escolas Superiores de Educação, em outubro de 2011, a todos os alunos a iniciar o 1.º ano, num total de 268: 143 em Lisboa, 51 em Viseu e 74 em Viana do Castelo. Neste artigo é apresentada uma análise dos principais resultados deste teste bem como as questões e dilemas que aqueles resultados nos colocam

Dental pulp stem cells and Bonelike® for bone regeneration in ovine model

Development of synthetic bone substitutes has arisen as a major research interest in the need to find an alternative to autologous bone grafts. Using an ovine model, the present pre-clinical study presents a synthetic bone graft (Bonelike®) in combination with a cellular system as an alternative for the regeneration of non-critical defects. The association of biomaterials and cell-based therapies is a promising strategy for bone tissue engineering. Mesenchymal stem cells (MSCs) from human dental pulp have demonstrated both in vitro and in vivo to interact with diverse biomaterial systems and promote mineral deposition, aiming at the reconstruction of osseous defects. Moreover, these cells can be found and isolated from many species. Non-critical bone defects were treated with Bonelike® with or without MSCs obtained from the human dental pulp. Results showed that Bonelike® and MSCs treated defects showed improved bone regeneration compared with the defects treated with Bonelike® alone. Also, it was observed that the biomaterial matrix was reabsorbed and gradually replaced by new bone during the healing process. We therefore propose this combination as an efficient binomial strategy that promotes bone growth and vascularization in non-critical bone defects.This research was supported by Programa Operacional Regional do Norte (ON.2 – O Novo Norte), QREN, FEDER with the project ‘iBone Therapies: Terapias inovadoras para a regeneração óssea’, ref. NORTE-01-0247-FEDER-003262, and by the programme COMPETE – Programa Operacional Factores de Competitividade, Projects PEst-OE/AGR/UI0211/2011 and PEst-C/EME/UI0285/2013 funding from FCT. This research was also supported by Programa Operacional Competitividade e Internacionalizac¸~ao (P2020), Fundos Europeus Estruturais e de Investimento (FEEI) and FCT with the project ‘BioMate—A novel bio-manufacturing system to produce bioactive scaffolds for tissue engineering’ with reference PTDC/EMS-SIS/7032/2014 and by COMPETE 2020, from ANI—Projectos ID&T Empresas em Copromoção Programas Operacionais POCI, by the project ‘insitu.Biomas - Reinvent biomanufacturing systems by using an usability approach for in situ clinic temporary implants fabrication’ with the reference POCI-01-0247-FEDER-017771. The research was also supported by the research project ‘BEPIM III –Microdispositivos me´dicos com capacidades osteintegradoras por micoPIM’, with the reference POCI-01-0247-FEDER-017935, from Fundo Europeu de Desenvolvimento Regional (FEDER), by the Programa Operacional da Competitividade & Internacionalização. Ana Rita Caseiro (SFRH/BD/101174/2014) acknowledges FCT, for financial support