Dice-and-fill single element octagon transducers for next generation 3D USCT

At the Karlsruhe Institue of Technology (KIT), a 3D-Ultrasound Computer Tomography (3D-USCT) medical imaging system for early breast cancer detection is currently developed. With the next generation of 3D-USCT 2.5, the current region of interest (ROI) of 10 x 10 x 10 cm³ shall be increased to 20 x 20 x 20 cm³ to allow reliable imaging results also for bigger female breasts. Therefore, the opening angle (OA) of the future transducers should be increased to approx. 60° at 3 dB while other characteristics such as bandwidth (BW) and resonance frequency should be preserved or even improved. Based on the current dice-andfill approach in transducer production, optimization is performed on piezoelectric sensor geometry and size, type and structure of matching and backing layer and interconnection technology of the several parts of the transducer

Neuroimmune and inflammatory signals in complex disorders of the central nervous system

An extensive microglial-astrocyte-monocyte-neuronal cross talk seems to be crucial for normal brain function, development, and recovery. However, under certain conditions neuroinflammatory interactions between brain cells and neuroimmune cells influence disease outcome and brain pathology. Microglial cells express a range of functional states with dynamically pleomorphic profiles from a surveilling status of synaptic transmission to an active player in major events of development such as synaptic elimination, regeneration, and repair. Also, inflammation mediates a series of neurotoxic roles in neuropsychiatric conditions and neurodegenerative diseases. The present review discusses data on the involvement of neuroinflammatory conditions that alter neuroimmune interactions in four different pathologies. In the first section of this review, we discuss the ability of the early developing brain to respond to a focal lesion with a rapid compensatory plasticity of intact axons and the role of microglial activation and proinflammatory cytokines in brain repair. In the second section, we present data of neuroinflammation and neurodegenerative disorders and discuss the role of reactive astrocytes in motor neuron toxicity and the progression of amyotrophic lateral sclerosis. In the third section, we discuss major depressive disorders as the consequence of dysfunctional interactions between neural and immune signals that result in increased peripheral immune responses and increase proinflammatory cytokines. In the last section, we discuss autism spectrum disorders and altered brain circuitries that emerge from abnormal long-term responses of innate inflammatory cytokines and microglial phenotypic dysfunctions.Fil: Liberman, Ana Clara. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigación en Biomedicina de Buenos Aires - Instituto Partner de la Sociedad Max Planck; ArgentinaFil: Trias, Emiliano. Instituto Pasteur de Montevideo; UruguayFil: Da Silva Chagas, Luana. Universidade Federal Fluminense; BrasilFil: Trindade, Pablo. No especifíca;Fil: Dos Santos Pereira, Marissol. Fundación Oswaldo Cruz; Brasil. Universidade Federal do Rio de Janeiro; BrasilFil: Refojo, Damian. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigación en Biomedicina de Buenos Aires - Instituto Partner de la Sociedad Max Planck; ArgentinaFil: Hedin Pereira, Cecilia. Universidade Federal do Rio de Janeiro; Brasil. Fundación Oswaldo Cruz; BrasilFil: Serfaty, Claudio A.. Universidade Federal Fluminense; Brasi

Combination of High Prevalence Sign/Symptom Pairs: An Approach to the Diagnosis of Cushing’s Syndrome

Most of the clinical features of Cushing’s syndrome (CS) are nonspecific and could be present in obesity, particularly when this condition is associated with metabolic syndrome. Our objective was to evaluate the frequency of clinical manifestations and changes in general laboratory tests, in patients with confirmed endogenous CS, to identify diagnostic dyads. We evaluated in each patient the rate of coexistence of 2 elements either: symptoms, clinical signs, or laboratory alteration. The prevalence of a combined pair of clinical features or dyad in over 30% of the cases, was considered clinically significant. Fourteen dyads were identified as clinically relevant. Facies + buffalo hump; facies + eosinopenia; buffalo hump + supraclavicular fat pads and facies + supraclavicular fat pads, were present in over 50% of cases. Facies + muscular atrophy; centripetal fat distribution + muscular atrophy and facies + striae were present in 42–49%. Hirsutism/acne + eosinopenia; buffalo hump + eosinopenia; muscular atrophy+ eosinopenia; eosinopenia + accelerated weight gain; buffalo hump + muscular atrophy; hirsutism/acne + muscular atrophy and hirsutism/acne + supraclavicular fat pads, were observed in 33–38% of patients. Its application will facilitate the correct diagnosis of CS

Enfermedad tiroidea subclínica: revisión y enfoque clínico

La enfermedad tiroidea subclínica (ETS) es una condición asintomática de alta prevalencia que incluye el hipertiroidismo subclínico (HiperSC) y el hipotiroidismo subclínico (HipoSC). Ambas formas no tienen síntomas ni signos específicos y solamente pueden ser detectados mediante exámenes hormonales. Las causas más frecuentes de HiperSC son la enfermedad de Graves y el bocio multinodular. De HipoSC la causa más frecuente es la tiroiditis crónica autoinmune (enfermedad de Hashimoto). El criterio diagnóstico para HiperSC es TSH sérica de ≤0.4 mU/L y valores normales deT4 total o libre. El criterio diagnóstico para HipoSC es TSH sérica de 4.5-10mU/L junto con valores normales de T4 total o libre. Ambas se consideran más severas cuando los valores de TSH se alejan del valor normal: 10mU/L en HipoSC. En la ETS las alteraciones cardiovasculares son frecuentes, pero de distinta índole, así en el HiperSC hay mayor riesgo de arritmias supraventriculares mientras en el HipoSC hay un riesgo aumentado de dislipidemia y ateroesclerosis. En este artículo se analizan los aspectos diagnósticos de la ETS, sus complicaciones y se propone un plan de manejo desde una perspectiva clínica

Prevalencia e incidencia de los principales trastornos endocrinos y metabólicos

Se presentan los datos de prevalencia e incidencia reportados de los principales trastornos endocrinos y metabólicos, obtenidos principalmente de trabajos epidemiológicos publicados en la literatura nacional e internacional. Se constata que los trabajos epidemiológicos en este campo son escasos, tanto a nivel nacional como internacional. En Chile se obtuvieron estadísticas de la Revista Médica de Chile, Revista Chilena de Pediatría, Encuesta Nacional de Salud (2009-2010). Los datos se entregan con sus principales referencias y se discuten algunas de sus implicancias desde una perspectiva clínica no especializada. La prevalencia de varios trastornos endocrinos y metabólicos parece estar aumentando. Sin embargo, es probable que este incremento sea debido a los avances en las técnicas de laboratorio e imágenes. El objetivo de esta revisión es entregar al médico clínico una información estadística básica para el manejo de pacientes con trastornos endocrinos y metabólicos

Marcadores de recambio óseo en mujeres postmenopáusicas: utilidad clínica

Bone metabolism is a dynamic process, which includes formation and resorption. Osteoblast and osteoclast are responsible of replacing 20% of bone each year. Bone Markers are fragments of bone matrix; these peptides are released in the process of formation and resorption, later accumulated in body compartments (bone and blood) and finally excreted in the urine, reflecting bone dynamic. The international Federation of Osteoporosis and the International Federation of Laboratory and Clinical Chemistry recommend the use of these two markers (one representing bone formation and the other bone resorption) to evaluate bone turnover, especially in high-risk groups such as postmenopausal women. The collagen C-terminal telopeptide or carboxi-terminal collagen crosslinking (CTX) is one of the most used, among different bone markers. This is a blood biomarker that can be measured to assess bone turnover; this marker increases when the bone resorption is accelerated. On the other hand, osteocalcin (a non-collagen protein) is a bone formation marker, which has been widely studied and can be measured in venous blood during bone formation. Both markers are important for monitoring anti-resorptive therapy, and they have been validated to predict fracture risk complementing densitometry in osteoporosis diagnosis. Main disadvantages are variability of the laboratory techniques and lack of information about normal reference values in different populations. Therefore it is necessary to establish normal reference values for each population before its incorporation as a clinical tool