Avaliação radiológica do refluxo vesico – ureteral em crianças

O Refluxo Vesico – Ureteral (RVU) é uma patologia frequente na idade pediátrica. A detecção precoce de RVU é fundamental na orientação terapêutica, de modo a permitir um crescimento renal adequado e prevenir infecções urinárias recorrentes. A investigação radiológica de RVU baseia-se na ecografia e cistouretrografia miccional seriada (CUMS), sendo este último procedimento, o método de eleição, efectuado sob controlo fluoroscópico. Este trabalho tem como objectivo dar a conhecer o papel CUMS na avaliação de RVU e abordar os parâmetros técnicos de aquisição, posicionamento e critérios de qualidade de imagem.Vesicoureteral reflux (VUR) is a common disease in childhood. Early diagnosis of VUR is fundamental in establishing therapeutic orientations which allow an adequate renal growth and prevent recurrent urinary tract infections. VUR radiologic investigation relies on ultrasound and voiding cystourethrogram (VCUG) procedures, being this last the preferred method, performed under fluoroscopy. The aim of this paper is to show the importance of VCUG in VUR assessment and to discuss technical aspects of this procedure as to acquisition, positioning and image quality criteria

Imaging for radiofrequency ablation

Many solid tumors have a poor response to systemic chemotherapy, local radiotherapy or surgical recession. They are responsible for premature morbidity and decreased patient survival. The radiofrequency ablation is an emerging technique, and is now becoming more widespread throughout the world because it is minimally invasive, image guided, which offers the possibility of an effective and less costly approach. The procedure can be performed percutaneously, guided by several imaging modalities as Ultrasound, Computed Tomography and Magnetic Resonance. This article pretends to demonstrate the state-of-the-art of this technique focusing in the technical aspects and application of radiofrequency ablation.Muitos tumores sólidos têm uma fraca resposta à quimioterapia sistémica, recessão cirúrgica ou radioterapia local. São responsáveis por morbilidade prematura e diminuição da sobrevida dos pacientes. A termoablação por radiofrequência (ARF) é uma técnica emergente, minimamente invasiva, guiada por imagem, que oferece a possibilidade de uma abordagem eficaz e menos dispendiosa. O procedimento pode ser realizado por via percutânea ou cirúrgica, guiado por várias modalidades imagiológicas tais como a Ecografia, Tomografia Computorizada e Ressonância Magnética. O presente artigo pretende demonstrar o estado-da-arte desta técnica, centrando-se em aspectos técnicos e aplicações da ablação por radiofrequência

Prevalência de Osteoporose numa amostra de mulheres Portuguesas

A osteoporose é uma doença crónica e progressiva. O diagnóstico baseia-se na avaliação de densidade mineral óssea (DMO), por absorciometria bifotónica por RX (DXA) e no conceito operacional da Organização Mundial de Saúde (OMS) indicando que a doença acontece para valores de DMO inferiores a 2,5 desvios-padrão do valor médio máximo para mulheres jovens, saudáveis de etnia caucasóide. Existe variabilidade nos valores de pico de massa óssea entre diferentes populações. Este estudo pretende avaliar a prevalência de osteoporose quando utilizada a base de referência do equipamento e quando utilizada a base de dados para score-T construída a partir da amostra.Osteoporosis is a chronic and progressive disease. Its diagnosis is based on the assessment of bone mineral density (BMD) by dual energy X-ray absortiometry (EDXA) and the operational concept of the World Health Organization (WHO) indicating that the disease happens to BMD values less than 2.5 deviations standard of the average maximum for young, healthy Caucasian women. Variability exists in what relates values of peak bone mass between different populations. The purpose of this study is to evaluate and compare osteoporosis prevalence using the equipment reference database against using our sample´s calculated T-scores

Dual source/dual energy-renal applications

Development of Dual Source Computed Tomography (Definition, Siemens Medical Solutions, Erlanger, Germany) allowed advances in temporal resolution, with the addition of a second X-ray source and an array of detectors to the TCM 64 slices. The ability to run exams on Dual Energy, allows greater differentiation of tissues, showing differences between closer attenuation coefficients. In terms of renal applications, the distinction of kidney stones and masses become one of the main advantages of the use of dual-energy technology. This article pretends to demonstrate operating principles of this equipment, as its main renal applications.O desenvolvimento da Tomografia Computorizada Dual Source (TCDS) (Definition, Siemens Medical Solutions, Erlanger, Germany) permitiu avanços na resolução temporal, com a adição de uma segunda fonte de raios X e de uma fileira de detectores à TCM de 64 cortes. A capacidade de executar exames em Energia Dupla, permite uma maior diferenciação dos tecidos, evidenciando diferenças entre coeficientes de atenuação próximos. Relativamente a aplicações renais, a distinção de cálculos renais e massas tornam-se uma das principais vantagens do uso da tecnologia em energia dupla. Este artigo pretende demonstrar princípios de funcionamento do equipamento em questão, assim como as principais aplicações a nível renal

Apparent diffusion coefficient in the analysis of prostate cancer

The multiparametric magnetic resonance imaging (MPMRI) approach, has allowed the diagnostic performance in the detection and characterization of prostate cancer (PCa). Diffusion-weighted imaging (DWI), is an important technique in the MPMRI, that provides qualitative and quantitative biological information regarding water diffusivity in a non-invasive manner. The apparent diffusion coefficient (ADC) measures water mobility and can be quantified from the signal intensity loss between two or more b-values. Different studies reported that ADC values are directly associated with microvessel density and cellularity. One of the main aspects that is in discussion is the b-values that must be used in the DWI sequence in order to compute ADC.info:eu-repo/semantics/publishedVersio

Efeito da eletrolipólise no tecido adiposo abdominal: estudo piloto

O excesso de tecido adiposo abdominal associa-se a distúrbios cardiometabólicos. A microcorrente associada ao exercício físico aeróbio poderá auxiliar na estimulação da lipólise para diminuir a quantidade dessa gordura.info:eu-repo/semantics/publishedVersio

Effects of aerobic exercise associated with abdominal microcurrent: a preliminary study

To analyze the short- and long-term effects of microcurrent used with aerobic exercise on abdominal fat (visceral and subcutaneous). Methods: Forty-two female students from a university population were randomly assigned into five group: intervention group (IG) 1 (n=9), IG2 (n=9), IG3 (n=7), IG4 (n=8), and placebo group (PG) (n=9). An intervention program of 10 sessions encompassing microcurrent and aerobic exercise (performed with a cycloergometer) was applied in all groups, with slightly differences between them. In IG1 and IG2, microcurrent with transcutaneous electrodes was applied, with different frequency values; 30-minute exercise on the cycloergometer was subsequently performed. IG3 used the same protocol as IG1 but with different electrodes (percutaneous), while in IG4 the microcurrent was applied simultaneously with the cycloergometer exercise. Finally, the PG used the IG1 protocol but with the microcurrent device switched off. All groups were evaluated through ultrasound and abdominal perimeter measurement for visceral and subcutaneous abdominal fat assessment; through calipers for skinfolds measurement; through bioimpedance to evaluate weight, fat mass percentage, and muscular mass; and through blood analyses to measure cholesterol, triglyceride, and glucose levels. After intervention sessions, visceral fat decreased significantly in IG1 compared with the PG. Subcutaneous fat was reduced significantly in all groups compared with the PG. After 4 weeks, almost all results were maintained. The addition of microcurrent to aerobic exercise may reduce fat more than does aerobic exercise alone

Gestational Weight Gain and Offspring Bone Mass: Different Associations in Healthy Weight Versus Overweight Women

Weight management strategies during pregnancy reduce child cardiometabolic risk. However, because maternal weight has an overall positive correlation with offspring bone mass, pregnancy weight management could adversely affect child bone health. We aimed to estimate associations between gestational weight gain (GWG) and bone mineralization in the offspring at 7 years of age, and test early pregnancy body mass index (BMI) as an effect modifier. We analyzed prospective data from 2167 mother-child pairs from the Generation XXI birth cohort who underwent whole-body dual-energy X-ray absorptiometry at 7 years of age. GWG was analyzed as a continuous measure and using the Institute of Medicine categories. In the whole sample and for each early pregnancy BMI category (under/normal weight and overweight/obese), relationships between GWG and offspring bone measures (bone mineral content [BMC], bone areal density [aBMD], size-corrected BMC [scBMC], and height) at 7 years were fitted through local polynomial regression and smoothing splines. The magnitude of associations was estimated through linear regression coefficients (95% CIs), crude and adjusted for maternal age, height, educational level, and child gestational age. In under/normal weight mothers, GWG was associated with slightly increased bone measures at 7 years (per 5 kg of GWG, BMC: 0.07 SD [95% CI, 0.01 to 0.12]; aBMD: 0.10 SD [95% CI, 0.05 to 0.15], scBMC: 0.11SD [95% CI, 0.06 to 0.16], and height: 0.05 SD [95% CI, 0.00 to 0.10]), while in overweight/obese mothers no effect of GWG on bone was observed (BMC: 0.02 SD [95% CI, -0.04 to 0.09]; aBMD: 0.02 SD [95% CI, -0.04 to 0.08], scBMC: 0.01 SD [95% CI, -0.06 to 0.08], and height: 0.02 SD [95% CI, -0.04 to 0.08]). Also, no advantageous effect of gaining weight above the Institute of Medicine recommendations was observed in either early pregnancy BMI group. Our results suggest that adherence to Institute of Medicine recommendations for pregnancy weight gain is unlikely to have a negative repercussion on offspring bone health, particularly in women with excess weight in early pregnancy.info:eu-repo/semantics/publishedVersio

Acute effects of physical exercise with microcurrent in the adipose tissue of the abdominal region: A randomized controlled trial

Increased abdominal fat and sedentary lifestyles contribute to cardiovascular disease risk. Low-intensity electrical current (microcurrent) on the abdominal region, associated with physical exercise, appears to be an innovative method to increase the lipolytic rate of abdominal adipocytes, in order to reduce abdominal fat. This study aimed to analyze the acute effects of microcurrent associated with an aerobic exercise program in healthy subjects in lipolysis. A double-blinded, randomized controlled trial was developed and conducted in a higher education school. Eighty-three healthy subjects, aged between 18 and 30 years old and with a 18.5 to 29.9 kg/m2 body mass index were randomly assigned either to an experimental or to a placebo group. Subjects received a trans-abdominal microcurrent stimulation for 40 min with (experimental group) or without (placebo group) electrical current, followed by a single aerobic exercise session (60 min at 45– 55% VO2max intensity). Lipolytic activity (serum glycerol), abdominal fat (waist circumference, abdominal skinfold, ultrasonography), and serum lipid profile (serum triglyceride, total cholesterol, low- density lipoprotein cholesterol and high-density lipoprotein cholesterol) were evaluated in all subjects. Physical activity (International Physical Activity Questionnaire) and dietary intake (food-frequency questionnaire) questionnaires were applied. After the intervention, lipolytic rate was significantly higher (p = 0.003) in the experimental group (mean = 0.15) than in the placebo group (mean = 0.09). Glycerol results showed a statistically significant increase between baseline and after the intervention for both experimental group (p = 0.001) and the placebo group (p = 0.001). Combined use of microcurrent and physical aerobic exercise had an acute effect enhancing lipolytic rate comparing to exercise alone, in young healthy subjects.info:eu-repo/semantics/publishedVersio