Detection of Polyps via Shape and Appearance Modeling

Presented at the MICCAI 2008 Workshop on Computational and Visualization Challenges in the New Era of Virtual Colonoscopy, September 6, 2008, New York, USA.This paper describes a CAD system for the detection of colorectal polyps in CT. It is based on stochastic shape and appearance modeling of structures of the colon and rectum, in contrast to the data-driven approaches more commonly found in the literature it derives predictive stochastic models for the features used for classification. The method makes extensive use of medical domain knowledge in the design of the models and in the setting of their parameters. The proposed approach was successfully tested on challenging datasets acquired under a protocol with little colonic preparation; such protocol reduces patient discomfort and potentially improves compliance

Mortalidade infantil por causas no Estado de São Paulo (Brasil) em 1983: análise sob a perspectiva das causas múltiplas de morte

An analysis of child mortality by causes was made on the basis of classification by multiple causes of death. For this archives containing records of child deaths in the State of S.Paulo (Brazil) for 1983 were used. The underlying cause and the associated causes, according to various clustering types, were, among other variables, retrieved from each record. Two types of cases with clearly determined characteristics were detected: those occurring predominantly during the neonatal period with the morbid process involving almost exclusively diseases in the Perinatal chapter (Chapter XV of the International Classification of Diseases, 9th Revision), and those occurring after the neonatal period with their morbid process showing a significant presence of intestinal infections, septicemia, malnutrition, dehydration and bronchopneumonia. An analysis of M/B ratios, between the number of mentions of each cause and the number recorded as the underlying cause, shows the importance of the study by multiple causes of death in order to avoid the underestimation of the incidence of some diseases that represent more frequently a terminal phase of the morbid process, and are thus mentioned mainly as associated causes. The study of the association of the main causes of death, using a measure of association called "Yule's Q", revealed that the respiratory diseases of the newborn as well as the specific infections of the perinatal period are intimately linked to immaturity and prematurity. It revealed, at the same time, the existence of a complex interrelationship between the 5 most frequent causes in the post-neonatal period, since one of them always occurs significantly associated with at least one of the others in the same group.Objetivou-se apresentar a mortalidade infantil por causas no Estado de São Paulo, Brasil, com base nos dados de 1983 obtidos a partir da classificação por causas múltiplas de morte, disponíveis desde a implantação do Sistema de Classificação Automática de Causas de Morte. Detectaram-se dois tipos de casos bem definidos: os óbitos ocorridos predominantemente no período neonatal, e cujo processo mórbido envolve quase que exclusivamente as afecções pertencentes ao Capítulo das Perinatais da Classificação Internacional de Doenças; e os óbitos ocorridos principalmente no período pós-neonatal, em cujo processo mórbido aparecem mencionadas significativamente as infecções intestinais, a septicemia, a desnutrição, a desidratação e a broncopneumonia. O estudo da associação entre as principais causas de morte mostrou, por um lado, a imaturidade e a prematuridade fortemente relacionadas com as afecções respiratórias do recém-nascido e com as infecções específicas do período perinatal; e por outro lado, um complexo inter-relacionamento entre as outras cinco causas mencionadas

Effects of ischemic preconditioning and cilostazol on muscle ischemia-reperfusion injury in rats

PURPOSE: To evaluate effects of ischemic preconditioning and Cilostazol on muscle ischemia-reperfusion injury.METHODS: Male Wistar rats were submitted to muscle ischemic and reperfusion injury (4h of the left common iliac artery occlusion followed by 1h of reperfusion). Five experimental groups were constituted: Control group (n=4); Ischemia-Reperfusion (IR, n=5); Ischemic preconditioning group (IP, n=6); Ischemia-Reperfusion group treated with cilostazol (IRCi, n=6) and Ischemic preconditioning group treated with cilostazol (IPCi, n=6). At the end, left gracile muscle was removed and embedded in paraffin. Histopathology, neutrophil infiltration, myocyte necrosis and edema were analyzed.RESULTS: When compared with the control group, IR group showed increased neutrophil infiltration, severe necrosis and edema. There was significant difference between myocytes necrosis of IR group and IP group. There was no difference between the histopathological changes between IP, IRCi and IPCi groups.CONCLUSIONS: the model of IR caused severe muscle injury in the rat hind limb and ischemic preconditioning has a protective effect, reducing myocyte necrosis, however, treatment with cilostazol and also the association between cilostazol and preconditioning has no protective effect on the skeletal muscle subjected to ischemia and reperfusion injury.Universidade Federal de São Paulo, Dept Surg, Surg Tech Lab, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Surg, Surg Tech Lab, São Paulo, BrazilWeb of Scienc

Effect of hyperbaric oxygen therapy combined with autologous platelet concentrate applied in rabbit fibula fraction healing

OBJECTIVES: The purpose is to study the effects of hyperbaric oxygen therapy and autologous platelet concentrates in healing the fibula bone of rabbits after induced fractures. METHODS: A total of 128 male New Zealand albino rabbits, between 6-8 months old, were subjected to a total osteotomy of the proximal portion of the right fibula. After surgery, the animals were divided into four groups (n = 32 each): control group, in which animals were subjected to osteotomy; autologous platelet concentrate group, in which animals were subjected to osteotomy and autologous platelet concentrate applied at the fracture site; hyperbaric oxygen group, in which animals were subjected to osteotomy and 9 consecutive daily hyperbaric oxygen therapy sessions; and autologous platelet concentrate and hyperbaric oxygen group, in which animals were subjected to osteotomy, autologous platelet concentrate applied at the fracture site, and 9 consecutive daily hyperbaric oxygen therapy sessions. Each group was divided into 4 subgroups according to a pre-determined euthanasia time points: 2, 4, 6, and 8 weeks postoperative. After euthanasia at a specific time point, the fibula containing the osseous callus was prepared histologically and stained with hematoxylin and eosin or picrosirius red. RESULTS: Autologous platelet concentrates and hyperbaric oxygen therapy, applied together or separately, increased the rate of bone healing compared with the control group. CONCLUSION: Hyperbaric oxygen therapy and autologous platelet concentrate combined increased the rate of bone healing in this experimental model.Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)Universidade Federal do Vale do Sao Francisco Colegiado de MedicinaUniversidade Federal de São Paulo (UNIFESP) Departamento de CirurgiaUniversidade Federal do Vale do Sao Francisco Colegiado de Medicina VeterinariaSociedade Brasileira de Traumatologia Esportiva e ArtroscopiaUNIFESP, Depto. de Cirurgia104698SciEL

Remote ischemic preconditioning and tacrolimus in the fetal small bowel transplant in mice

PURPOSE: To evaluate the effect of remote ischemic preconditioning (IPC-R) in the fetal small bowel transplantation model. METHODS: Two groups were constituted: The Isogenic transplant (ISO, C57BL/6 mice, n=24) and the allogenic transplant (ALO, BALB/c mice, n=24). In each group, the animals were distributed with and without IPC-R. It was obtained the following subgroups: Tx, IPC-R, Fk, IPC-Fk, in both strains. Intestinal grafts were stained with hematoxylin and eosin and immunohistochemically. RESULTS: The graft development evaluation in ISO group showed that IPC-R reduced the development compared with ISO-Tx (5.2+/-0.4 vs 9.0+/-0.8) and IPC-R-Fk increased the graft development compared with IPC-R (11.2+/-0.7 and 10.2+/-0.8). In ALO group, IPC-Fk increased the development compared with ALO-Tx and ALO with IPC-R (6.0+/-0.8, 9.0+/-1.2, 0.0+/-0.0, 0.5+/-0.3). The PCNA expression was increased in ISO group treated with Fk and IPC-R compared to other groups (12.2+/-0.8 vs Tx: 8.8+/-0.9, IPC-R: 8.0+/-0.4 and Fk: 9.0+/-0.6). The graft rejection was lower in groups treated with IPC-R (-18%), Fk (-68%) or both (-61%) compared with ALO-Tx. CONCLUSION: Remote ischemic preconditioning showed benefic effect even associate with Tacrolimus on the development and acute rejection of the fetal small bowel graft in the Isogenic and Allogenic transplants.Univ Fed Sao Paulo UNIFESP, Sch Med, Operat Tech & Expt Surg Div, Sao Paulo, SP, BrazilUniv Sao Paulo, Fac Med, Lab Emergency Med LIM 51, Sao Paulo, BrazilUniv Fed Vale Sao Francisco UNIVASF, Sch Med, Petrolina, PE, BrazilFMUSP, Surg Physiopathol Lab LIM 62, Sao Paulo, SP, BrazilOperative Technique and Experimental Surgery Division, Medical School, Universidade Federal de São Paulo (UNIFESP), BrazilWeb of Scienc

Effect of hyperbaric oxygen therapy combined with autologous platelet concentrate applied in rabbit fibula fraction healing

OBJECTIVES: The purpose is to study the effects of hyperbaric oxygen therapy and autologous platelet concentrates in healing the fibula bone of rabbits after induced fractures. METHODS: A total of 128 male New Zealand albino rabbits, between 6-8 months old, were subjected to a total osteotomy of the proximal portion of the right fibula. After surgery, the animals were divided into four groups (n = 32 each): control group, in which animals were subjected to osteotomy; autologous platelet concentrate group, in which animals were subjected to osteotomy and autologous platelet concentrate applied at the fracture site; hyperbaric oxygen group, in which animals were subjected to osteotomy and 9 consecutive daily hyperbaric oxygen therapy sessions; and autologous platelet concentrate and hyperbaric oxygen group, in which animals were subjected to osteotomy, autologous platelet concentrate applied at the fracture site, and 9 consecutive daily hyperbaric oxygen therapy sessions. Each group was divided into 4 subgroups according to a pre-determined euthanasia time points: 2, 4, 6, and 8 weeks postoperative. After euthanasia at a specific time point, the fibula containing the osseous callus was prepared histologically and stained with hematoxylin and eosin or picrosirius red. RESULTS: Autologous platelet concentrates and hyperbaric oxygen therapy, applied together or separately, increased the rate of bone healing compared with the control group. CONCLUSION: Hyperbaric oxygen therapy and autologous platelet concentrate combined increased the rate of bone healing in this experimental model

Diagnosis approach of liver metastases from colorectal cancer

A metástase hepática de câncer de colo e reto, uma doença cada vez mais comume potencialmente agressiva, é discutida em âmbito internacional quanto à adequação da suaabordagem investigativa. Nesta revisão, este aspecto foi discutido tendo como parâmetros:custo, disponibilidade, sensibilidade, especificidade, uso de radiação e confiabilidade dométodo. A principal ideia é revisar, a partir de experiências adquiridas em diversos serviços desaúde, os principais métodos diagnósticos disponíveis para a detecção das lesões metastáticasno fígado originárias de câncer colorretal, discutindo em que situações eles devem ser utilizadose principalmente levando em conta a realidade do sistema médico hospitalar brasileiroThe liver metastasis of cancer of the colon and rectum, a disease increasinglycommon and potentially aggressive, is discussed at the international level about the adequacyof its investigative approach. In this review, this parameter was analysed with the cost, availability,sensitivity, specificity, use of radiation and reliability of the method. The main idea is toreview, from experiences in various health services, the main diagnostic methods availablefor the detection of metastatic lesions in the liver unique for colorectal cancer, discussing situationsin which they should be used and especially taking into to the reality of the Brazilianhospital medical syste

EDUCANDO COM DEFICIÊNCIA INTELECTUAL NO CONTEXTO DA EDUCAÇÃO INCLUSIVA: UMA ANÁLISE DO TRABALHO DIDÁTICO.

Em meio às inquietações relacionadas à presença do educando com deficiência intelectual no ensino comum é que emergiu a presente pesquisa. O estudo ganha concretude tendo em vista a organização do trabalho didático na sala de aula do ensino comum que tem alunos com deficiência intelectual em processo de escolarização, mais especificamente no quarto ano do Ensino Fundamental. Como objetivo geral pretendeu-se analisar de que maneira se organiza o trabalho didático nas classes do quarto ano do ensino fundamental

Hiperfluxo portal na forma hepatosplênica da esquistossomose mansônica

PURPOSE: The purpose of this study was to assess portal hemodynamics in patients with portal hypertension due to hepatosplenic schistosomiasis as well as to assess the contribution of splanchnic hyperflow to the pathophysiology of the portal hypertension. METHODS: Sixteen patients with schistosomal portal hypertension and previous history of upper digestive bleeding due to esophageal varices rupture underwent elective esophagogastric devascularization and splenectomy and were prospectively studied. All patients underwent intraoperative invasive hemodynamic portal monitoring with a 4F-thermodilution catheter. The intraoperative portal hemodynamic assessment was conducted after laparotomy (initial) and after esophagogastric devascularization (final). RESULTS: The initial portal pressure was elevated (mean 28.5 ± 4.5 mm Hg), and a significant drop of 25% was observed at the end of the surgery (21.9 ± 4.9 mm Hg). The initial portal flow was elevated (mean 1766.9 ± 686.6 mL/min). A significant fall (42%) occurred at the end of the surgical procedure (1025.62 ± 338.7 mL/min). Fourteen patients (87.5%) presented a portal flow of more than 1200 mL/min, and in 5 cases, values greater than 2000 mL/min were observed. CONCLUSIONS: Esophagogastric devascularization and splenectomy promote a significant reduction of the elevated portal pressure and flow in schistosomal portal hypertension. These data favor the hypothesis of portal hyperflow in the physiopathology of portal hypertension of schistosomiasis.OBJETIVOS: o objetivo do presente estudo é estudar a hemodinâmica portal em pacientes com hipertensão portal secundária a forma hepatoesplênica da esquistossomose e avaliar a contribuição do hiperfluxo esplênico na sua fisiopatologia CASUÍSTICA E MÉTODOS: Foram estudados prospectivamente 16 pacientes portadores de hipertensão portal secundária à forma hepatoesplênica da esquistossomose mansônica com indicação de tratamento cirúrgico. Todos foram submetidos a avaliação hemodinâmica portal com cateter de termodiluição 4F antes e após a realização de desvascularização esofago-gástrica com esplenectomia. RESULTADOS: Na avaliação intra-operatória inicial observou-se pressão (28,5 + 4,5 mmHg ) e fluxo (1750,59 ± 668,14 ml/min) portais iniciais bem acima dos valores considerados normais. Houve queda significante de 25% na pressão (21,65 ± 5,55 mmHg ) e de 42% no fluxo (1011,18 ± 332,73 ml/min) ao término da cirurgia. Quatorze pacientes (87.5%) apresentavam fluxo portal superior a 1200 ml/min e, em 5 casos, valores superiores a 2000 ml/min foram observados. CONCLUSÕES: A pressão e o fluxo portais estão aumentados na hipertensão portal esquistossomótica. A desvascularização esofago-gástrica com esplenectomia reduz significativamente tanto a pressão quanto o fluxo portais. Estes dados favorecem a hipótese do hiperfluxo esplâncnico (esplênico e mesentérico) na fisiopatologia da hipertensão portal na esquistossomose forma hepatoesplênica