Imaging in abdominal trauma

A presente revisão objetiva descrever os recentes avanços tecnológicos dos métodos de diagnóstico por imagem e sua atual aplicabilidade no manuseio dos pacientes com trauma abdominal, bem como as principais apresentações pelos métodos de imagem dos diversos órgãos envolvidos.In this update review, we describe recents improvements of diagnostic imaging and their role in practical assistance of abdominal trauma. We also analyze abdominal injury as well as its main radiological features

Arboviral Etiologies of Acute Febrile Illnesses in Western South America, 2000–2007

Over recent decades, the variety and quantity of diseases caused by viruses transmitted to humans by mosquitoes and other arthropods (also known as arboviruses) have increased around the world. One difficulty in studying these diseases is the fact that the symptoms are often non-descript, with patients reporting such symptoms as low-grade fever and headache. Our goal in this study was to use laboratory tests to determine the causes of such non-descript illnesses in sites in four countries in South America, focusing on arboviruses. We established a surveillance network in 13 locations in Ecuador, Peru, Bolivia, and Paraguay, where patient samples were collected and then sent to a central laboratory for testing. Between May 2000 and December 2007, blood serum samples were collected from more than 20,000 participants with fever, and recent arbovirus infection was detected for nearly one third of them. The most common viruses were dengue viruses (genera Flavivirus). We also detected infection by viruses from other genera, including Alphavirus and Orthobunyavirus. This data is important for understanding how such viruses might emerge as significant human pathogens

Reverse Microfracture of the Hip Acetabulum: A Technique for the Wave Lesion

The long-term efficacy of the treatment of chondral lesions is very important to prevent hip osteoarthritis. Microfracture, autologous chondrocyte transplantation, and direct chondral repair, among others, are techniques that have shown good results in some cases. We propose a technique to treat wave lesions through reverse microfracture, with bubble decompression and adherence of the natural scar from the detached cartilage

Genomic Profiling of Rare Undifferentiated Sarcomatoid Subtypes of Pancreatic Carcinomas: In Search of Therapeutic Targets

The highly aggressive undifferentiated sarcomatoid carcinoma (USC) subtype of pancreatic ductal adenocarcinoma (PDAC) remains poorly characterized because of its rarity. Previous case reports suggest that immune checkpoint inhibitors could be a promising treatment strategy, but the prevalence of established predictive biomarkers of response is largely unknown. The objective of this study was to leverage comprehensive genomic profiling of USC PDAC tumors to determine the prevalence of biomarkers associated with potential response to targeted therapies. USC tumors (n = 20) underwent central pathology review by a board-certified gastrointestinal pathologist to confirm the diagnosis. These samples were compared with non-USC PDAC tumors (N = 5,562). Retrospective analysis of DNA and RNA next-generation sequencing data was performed. USC PDACs were more frequently PD-L1+ by immunohistochemistry than non-USC PDAC (63% 16%, respectively, < .001). Furthermore, USC PDAC had an increase in neutrophils (8.99% 5.55%, = .005) and dendritic cells (1.08% 0.00%, = 0.022) and an increased expression of (4.6% 1.3%, = 0.001), (2.0% 0.8%, = 0.060), and (45.9% 21.7%, = 0.107) than non-USC PDAC. Similar to non-USC PDAC, was the most commonly mutated gene (86% 90%, respectively, = 1). To our knowledge, this work represents the largest molecular analysis of USC tumors to date and showed an increased expression of immune checkpoint genes in USC tumors. These findings provide evidence for further investigation into immune checkpoint inhibitors in USC tumors

Effect of enzyme replacement therapy with alglucosidase alfa (Myozyme (R)) in 12 patients with advanced late-onset Pompe disease

International audienceThe efficacy of enzyme replacement therapy (ERT) in patients at an advanced stage of Pompe disease has only been addressed in a few studies. Our objective was to assess the long term effects of ERT in a cohort of patients with severe Pompe disease.We identified patients from the French Pompe Registry with severe respiratory failure and permanent wheelchair use (assisted walk for a few meters was allowed) when starting ERT. Patients' medical records were collected and reviewed and respiratory and motor functions, before ERT initiation and upon last evaluation were compared.Twelve patients (7 males) were identified. Median age at symptom onset was 24years [IQR=15.5; 36.0]. At baseline ventilation was invasive in 11 patients and noninvasive in one, with a median ventilation time of 24h [IQR=21.88; 24.00] (min 20; max 24). ERT was initiated at a median age of 52.5years [IQR=35.75; 66.50]. Median treatment duration was 55months [IQR=39.5; 81.0]. During observational period no adverse reaction to ERT was recorded, five patients (41.67%) died, three decreased their ventilation time by 30, 60 and 90min and two increased their assisted walking distance, by 80 and 20m.Some patients at a very advanced stage of Pompe disease may show a mild benefit from ERT, in terms of increased time of autonomous ventilation and of enlarged distance in assisted walk. ERT can be initiated in these patients in order to retain their current level of independence and ability to perform daily life activities

Publisher’s Note: Observing gravitational-wave transient GW150914 with minimal assumptions [Phys. Rev. D 93, 122004 (2016)]

The gravitational-wave signal GW150914 was first identified on September 14, 2015, by searches forshort-duration gravitational-wave transients. These searches identify time-correlated transients in multipledetectors with minimal assumptions about the signal morphology, allowing them to be sensitive togravitational waves emitted by a wide range of sources including binary black hole mergers. Over theobservational period from September 12 to October 20, 2015, these transient searches were sensitive tobinary black hole mergers similar to GW150914 to an average distance of∼600Mpc. In this paper, wedescribe the analyses that first detected GW150914 as well as the parameter estimation and waveformreconstruction techniques that initially identified GW150914 as the merger of two black holes. We find thatthe reconstructed waveform is consistent with the signal from a binary black hole merger with a chirp massof∼30M⊙and a total mass before merger of∼70M⊙in the detector fram