Leiomiomas ano-retais: descrição de dois casos com características anatômicas diferentes e revisão da literatura

Gastrointestinal mesenchymal tumors comprise a rare group of gastrointestinal tract wall tumors that have long been a source of confusion and controversy, especially in terms of pathological classification, preoperative diagnosis, management strategies, and prognosis. This report describes the clinical manifestations and management of 2 rectal leiomyomas and reviews the pertinent literature. Case 1: A 44-year-old woman was admitted reporting a nodule in the right para-anal region for the previous 2 years. At proctological examination, a 4-cm diameter fibrous mass situated in the para-anal region that produced an arch under the smooth muscle on the right rectal wall just above the anorectal ring was noted. Computed tomography and magnetic resonance imaging of the abdomen and pelvis showed the lesion and detected no other abnormalities. Surgical treatment consisted of wide local resection of the tumor through a para-anal incision, with no attempts to perform lymphadenectomy. Case 2: A 40-year-old male patient was admitted reporting constant anal pain for 4 months. He presented a 3-cm submucosal nodule at the anterior rectal wall just above the dentate line. After 2 inconclusive preoperative biopsies, transanal resection of the tumor was performed. Histological analysis of the specimen showed a benign leiomyoma. A review of the literature is presented, emphasizing some clinical and therapeutic aspects of this unusual rectal tumor.Os tumores mesenquimais gastrointestinais constituem um grupo raro de neoplasias que têm sido fonte de confusão e controvérsia, especialmente quanto à classificação patológica, diagnóstico pré-operatório, manuseio e prognóstico. O presente artigo descreve as manifestações clínicas e o tratamento de dois pacientes com leiomioma retal e revê a literatura pertinente. Caso 1: Uma mulher de 44 anos foi admitida referindo um nódulo na região paranal direita nos últimos 2 anos. Ao exame físico notou-se uma massa fibrosa de 4 centímetros de diâmetro situada na região paranal que produzia um discreto abaulamento na musculatura lisa da parede retal, logo acima do anel ano-retal. As imagens de tomografia computadorizada e ressonância magnética do abdômen e pelve confirmaram a lesão e não detectaram outras anormalidades. O tratamento cirúrgico consistiu de ressecção alargada do tumor através de uma incisão paranal, sem se realizar linfadenectomia. Caso 2: Outro paciente com 40 anos foi admitido com história de dor anal constante há 4 meses. Este homem apresentava nódulo submucoso de 3 cm na parede retal anterior, logo acima da linha pectínea. Após duas biópsias inconclusivas, realizou-se a ressecção transanal do tumor. A análise histológica do espécime demonstrou tratar-se de um leiomioma benigno. Uma breve revisão da literatura é apresentada, enfatizando alguns aspectos clínicos e terapêuticos deste tumor retal pouco comum

Estimativa de Parâmetros Biofísicos de Povoamentos de Eucalyptus Através de Dados SAREstimation of Biophysical Parameters in the Eucalyptus Stands by SAR Data

O objetivo deste trabalho foi estabelecer as relações entre os parâmetros dendométricos de florestas e a resposta da radiometria e da interferometria obtidas por sensores SAR (Synthetic Aperture Radar), utilizando técnicas de regressão multivariada. Uma área de povoamento de Eucalyptus grandis, com 6,1 anos de plantio, foi selecionada para estudo. Os resultados indicaram que o volume das parcelas foi altamente correlacionado com o logaritmo da altura interferométrica (LogHint) obtida pela diferença entre os modelos interferométricos nas bandas X e P, enquanto que o DAP (Diâmetro à Altura do Peito) apresentou melhor relação com a combinação da coerência interferométrica na banda PVV (CohPVV) e o LogHint. A altura comercial da vegetação, similarmente ao DAP, foi melhor explicada com a combinação da CohPvv e o LogHint. Os resultados obtidos demonstraram que, devido ao povoamento ser constituído de indivíduos cuja estrutura era predominantemente cilíndrica de orientação vertical, houve uma maior interação com a polarização VV. Os resultados indicaram também que a resposta radiométrica na banda P, de maior comprimento de onda, não foi tão eficaz quanto a interferometria (CohPvv e o LogHint) para estimativa dos parâmetros dendométricos estudados, obtendo índices de determinação de 84 a 88% em relação ao inventário florestal das áreas.Abstract The main goal of this paper was to establish the relationship between the forest dendrometric parameters and the interferometric and radiometric image response, obtained from a SAR sensor (Synthetic Aperture Radar), using multivariable regression techniques. A 6.1-year-old Eucalyptus grandis stand area was selected for this study. The results pointed out that the stand volume was highly correlated with the interferometric height logarithm (LogHint), obtained by the difference between interferometric models in X and P bands, whereas the DBH presented better relationship with the combination of VV coherence (CohPvv) and the LogHint. The commercial vegetation height, similar to the DBH, was better explained by the combination of CohPvv and LogHint. The results showed that due to the fact that the population of individuals whose structure was predominantly cylindrical and vertically oriented, caused a higher interaction with the vertical polarization. The higher wavelength P band radiometry efficacy wasn’t as good as the interferometry (CohPvv and LogHint) to estimate the dendometric parameters studied, which obtained 84 to 88% of determination coefficient in relation to the area forest inventory

ANALYSIS OF THE TARGET DECOMPOSITION TECHNIQUE ATTRIBUTES AND POLARIMETRIC RATIOS TO DISCRIMINATE LAND USE AND LAND COVER CLASSES OF THE TAPAJÓS REGION

This study aims to analyze the capability of the target decomposition techniques and the polarimetric ratios applied to the ALOS/PALSAR-2 satellite polarimetric images to discriminate the land use and land cover classes in the Tapajós National Forest region, Pará State. Three full polarimetric ALOS/PALSAR-2, level 1 single look complex scenes were selected to generate the coherence and the covariance matrices to derive the Cloude-Pottier and the Freeman-Durden target decomposition attributes. From the radiometrically calibrated PALSAR-2 images, we generated the backscatter coefficients, the cross polarized ratio (RC; HV/HH), the parallel polarized ratio (RP; VV/HH) and the Radar Forest Degradation Index (RFDI). The images resulting from these polarimetric attributes were processed by the Maximum Likelihood (MAXVER) classifier coupled with the Iterated Conditional Modes (ICM) contextual algorithm. We found that the classifications derived from the target decomposition attributes, mainly from the CloudePottier technique, with a Kappa index of 0.75, presented a significant higher performance than those derived from the RC ratio, RP ratio, and RFDI

AVALIAÇÃO DO POTENCIAL DA INTERFEROMETRIA SAR PARA O MAPEAMENTO ALTIMÉTRICO DE ÁREAS REFLORESTADAS POR EUCALYPTUS SP.

Este trabalho tem como objetivo avaliar a qualidade altimétrica dos modelos de elevação (MDE) gerados através da interferometria SAR (Synthetic Aperture Radar) nas bandas X e P, em diferentes polarizações em áreas florestadas. Este estudo foi realizado no município de Pindamonhangaba/SP, em uma área caracterizada por reflorestamento de Eucalyptus saligna de 6 anos de idade, cujo inventario florestal e levantamento topográfico foram realizados no mesmo período do aerolevantamento. Verificou-se que nesta área florestada o modelo de elevação da superfície do dossel empregando a interferometria na banda X, gerou produtos cartográficos de precisão inferior a esperada, com desvio padrão na ordem 2,7 metros. A utilização de um modelo de  regressão, que combinou a coerência interferométrica e o MDE, compensou os erros de medida da altura da vegetação, melhorando a qualidade do produto cartográfico para desvio padrão da ordem de 1,4 metro atingindo a resolução altimétrica desejada. Os modelos de elevação do terreno na banda P, polarização HH, em áreas florestadas apresentaram similaridade com os dados do levantamento topográfico, com desvio padrão na ordem de 1,97 metro, devido à maior penetração do  feixe do radar na floresta de  Eucalyptus e conseqüentemente uma maior interação com o solo do que com as árvores. O modelo de elevação do solo na banda X em áreas de pasto apresentou um desvio padrão de 0,6 metro, cuja escala de mapeamento foi compatível com a resolução empregada, enquanto que os modelos de  elevação na banda P apresentaram um valor de desvio padrão de 6 a 20 metros conforme a polarização,  devido ao espalhamento especular, causando uma baixa relação sinal/ruído

Land use/land cover characterization in Amazonia using COSMO-SkyMed multitemporal images

The use of radar imagery is an alternative source of information to support the monitoring of the Amazon region, since the optical images have imaging limitations in tropical areas due to the occurrence of clouds. Therefore, the goal of this study is to analyze the radar images in X-band multi-temporal polarized obtained by COSMO-SkyMed satellite (COnstellation of small Satellites for Mediterranean basin Observation), in the intensity mode, isolated and/or combined with textural information, to thematic characterization of land use/land cover in the Humaitá, Amazonas State region. The methodology used includes: analysis of the dual images obtained during two subsequent acquisitions, in order to explore the potential of the dataset as a quad-pol intensity; extraction of textural attributes from the co-occurrence matrix (Gray Level Co-occurrence Matrix) and subsequent contextual classification; statistical assessment of the thematic performance of the intensity and textural images, isolated and in polarized groups. Within the results achieved, the group formed only by the intensity images presented a better performance if compared to those containing the textural attributes. In this discrimination, the classes involved were forest, alluvial forest, reforestation, savannah, pasture and burned areas, yielding 66% overall accuracy and a Kappa value of 0.55. The results showed that X band images, from COSMO-SkyMed, StripMap mode (Ping-Pong), multi-polarized, presents a moderate potential to characterize and monitor the dynamics of land use/land land cover in the Brazilian Amazon.A utilização de imagens de radar é fonte alternativa de informações para subsidiar o monitoramento da região amazônica, visto que as imagens ópticas têm limitações de imageamento em zonas tropicais face a ocorrência de nuvens. Por conseguinte este trabalho teve como objetivo analisar a capacidade das imagens-radar de banda X multitemporais e polarizadas obtidas pelo satélite COSMO-SkyMed (COnstellation of small Satellites for Mediterranean basin Observation), no modo intensidade, isoladamente e agregados às informações texturais, na caracterização temática de uso e cobertura da terra no município de Humaitá/AM. A metodologia empregada consistiu daanálise das imagens duais obtidas em duas aquisições subsequentes, de forma a explorar a potencialidade do conjunto de dados na forma quad-pol intensidade; extração dos atributos texturais a partir da matriz de coocorrência (Gray Level Co-occurrence Matrix) e posterior classificação contextual; avaliação estatística de desempenho temático das imagens intensidade e texturais, isoladas e em grupos polarizados. Dentre os vários resultados alcançados, foi verificado que o grupo formado somente pelas imagens intensidade apresentou o melhor desempenho, comparado àqueles contendo os atributos texturais. Nesta separabilidade, estavam envolvidas as classes de floresta, floresta aluvial, reflorestamento, savana, pasto e queimada, obtendo-se 66% de acurácia total e valor Kappa de 0,55. Os resultados mostraram que as imagens de banda X do COSMO-SkyMed, modo StripMap (Ping-Pong), multipolarizadas, têm potencial moderado para a caracterização e monitoramento da dinâmica de uso e cobertura da terra na Amazônia brasileira

Caracterização de uso e cobertura da terra na Amazônia utilizando imagens duais multitemporais do COSMO-SkyMed

The use of radar imagery is an alternative source of information to support the monitoring of the Amazon region, since the optical images have imaging limitations in tropical areas due to the occurrence of clouds. Therefore, the goal of this study is to analyze the radar images in X-band multi-temporal polarized obtained by COSMO-SkyMed satellite (COnstellation of small Satellites for Mediterranean basin Observation), in the intensity mode, isolated and/or combined with textural information, to thematic characterization of land use/land cover in the Humaitá, Amazonas State region. The methodology used includes: analysis of the dual images obtained during two subsequent acquisitions, in order to explore the potential of the dataset as a quad-pol intensity; extraction of textural attributes from the co-occurrence matrix (Gray Level Co-occurrence Matrix) and subsequent contextual classification; statistical assessment of the thematic performance of the intensity and textural images, isolated and in polarized groups. Within the results achieved, the group formed only by the intensity images presented a better performance if compared to those containing the textural attributes. In this discrimination, the classes involved were forest, alluvial forest, reforestation, savannah, pasture and burned areas, yielding 66% overall accuracy and a Kappa value of 0.55. The results showed that X band images, from COSMO-SkyMed, StripMap mode (Ping-Pong), multi-polarized, presents a moderate potential to characterize and monitor the dynamics of land use/land land cover in the Brazilian Amazon.A utilização de imagens de radar é fonte alternativa de informações para subsidiar o monitoramento da região amazônica, visto que as imagens ópticas têm limitações de imageamento em zonas tropicais face a ocorrência de nuvens. Por conseguinte este trabalho teve como objetivo analisar a capacidade das imagens-radar de banda X multitemporais e polarizadas obtidas pelo satélite COSMO-SkyMed (COnstellation of small Satellites for Mediterranean basin Observation), no modo intensidade, isoladamente e agregados às informações texturais, na caracterização temática de uso e cobertura da terra no município de Humaitá/AM. A metodologia empregada consistiu daanálise das imagens duais obtidas em duas aquisições subsequentes, de forma a explorar a potencialidade do conjunto de dados na forma quad-pol intensidade; extração dos atributos texturais a partir da matriz de coocorrência (Gray Level Co-occurrence Matrix) e posterior classificação contextual; avaliação estatística de desempenho temático das imagens intensidade e texturais, isoladas e em grupos polarizados. Dentre os vários resultados alcançados, foi verificado que o grupo formado somente pelas imagens intensidade apresentou o melhor desempenho, comparado àqueles contendo os atributos texturais. Nesta separabilidade, estavam envolvidas as classes de floresta, floresta aluvial, reflorestamento, savana, pasto e queimada, obtendo-se 66% de acurácia total e valor Kappa de 0,55. Os resultados mostraram que as imagens de banda X do COSMO-SkyMed, modo StripMap (Ping-Pong), multipolarizadas, têm potencial moderado para a caracterização e monitoramento da dinâmica de uso e cobertura da terra na Amazônia brasileira

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

SAR data for the analysis of forest features: current Brazilian experiences

This article presents some applications of airborne polarimetric and/or interferometric microwave data to improve the knowledge of forest structures. Three airborne SAR (Synthetic Aperture Radar) experiments were done in the Amazon tropical forest: (a) to study the spatial distribution of very large trees (VLTs) in the primary forest using local maximum filtering and a series of Markov processes; (b) to model the estimation of biomass variations in primary and secondary forests; (c) to analyze the retrieval of timber volume over selective logging areas. Another experiment (d) was to investigate the relation among SAR data and the volumetric configuration in stands of Eucalyptus sp. done by an airborne SAR imaging mission in SE-Brazil. To perform the objectives (b), (c) and (d) we carry out regression techniques, using variables got from multipolarimetric and/or interferometric SAR attributes and biophysical parameters from the forest cover. All data from the experiments were calibrated radiometrically to extract information during digital processing, besides an exhaustive field survey which was done simultaneously to SAR imaging, to know the physiognomy/structure of forest typology and to support the models produced for each case. The results of this series of experiments show advances at the techniques to treat SAR data, focusing on models of stand architecture and forest stock density. This will be helpful to increase the regional inventory and surveying procedures of forest conversion in the Brazilian territory in the near future

Removal of Ionospheric Effects from Sigma Naught Images of the ALOS/PALSAR-2 Satellite

The monitoring of forest degradation in the Amazon through radar remote sensing methodologies has increased intensely in recent years. Synthetic aperture radar (SAR) sensors that operate in L-band have an interesting response for land use and land cover (LULC) as well as for aboveground biomass (AGB). Depending on the magnetic and solar activities and seasonality, plasma bubbles in the ionosphere appear in the equatorial and tropical regions; these factors can cause stripes across SAR images, which disturb the interpretation and the classification. Our article shows a methodology to filter these stripes using Fourier fast transform (FFT), in which a stop-band filter removes this noise. In order to make this possible, we used Environment for Visualizing Images (ENVI), Sentinel Application Platform (SNAP), and Interactive Data Language (IDL). The final filtered scenes were classified by random forest (RF), and the results of this classification showed superior performance compared to the original scenes, showing this methodology can help to recover historic series of L-band images