Navegando por Assunto "Tomografia computadorizada"

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Análise comparativa do padrão tomográfico pulmonar na infecção pelas variantes B.1.1.7 e P.1 do vírus SARS-COV-2
(Centro Universitário do Estado do Pará, 2022) Savino, Beatriz Amaral Costa; Mafra, Eduarda Gabriel; Paes, Andréa Luzia Vaz; Bichara, Cléa Nazaré Carneiro; http://lattes.cnpq.br/2161704040280760; http://lattes.cnpq.br/4364540186589331
Introduction: The SARS-CoV-2 virus quickly spread globally and acquired pandemic status in March 2020, posing a major threat to public health. Since then, it has suffered several genetic mutations, which culminated in multiple waves of disease transmission. Computed tomography (CT) of the chest may be a diagnostic alternative complementary to RT-PCR, to assess pulmonary involvement and assist in the therapeutic approach. Objective: To analyze lung tomographic patterns in the COVID-19 epidemic curves in 2020 and 2021 caused by the B.1.1.7 and P.1 variants of the SARS-CoV-2 virus. Methodology: A cross-sectional, descriptive, analytical and retrospective study was carried out through the evaluation of 360 CT scans of the chest, in a Reference Radiology Service, including patients with COVID-19 in two epidemic periods in an area of the Brazilian Amazon, characterized by lineages B.1.1.7 (Alpha) from April – September 2020 and P.1 (Gamma) from October 2020 – March 2021. Expert Consensus criteria of the Radiological Society of North America (RSNA) were used. In patients older than 18 years of age, of both sexes, the pattern and degree of pulmonary involvement, distribution of lesions, affected segments and other findings on tomography were evaluated. Results: The proportions of patients of different genders (p=0.289) or different age groups (p=0.314) did not vary significantly between periods. In the first period, 70.6% had pulmonary involvement between 10-25% and in the second period only 43.3%. All individuals had ground-glass lesions and the presence of thickening of the interlobular septa was significantly observed in the first epidemic curve (81.9%) (p=0.002). Conclusion: There was a prevalence of women and individuals aged between 45-60 years. 100% of the individuals presented ground-glass lesions and the typical pattern of involvement prevailed in both analyses. The Alpha variant, predominant in the first epidemic curve, presented a higher degree of pulmonary involvement in relation to the Gamma variant, predominant in the second epidemic curve.
Avaliação do teste de impulso cefálico clínico (HIT-c) realizado por examinadores com diferentes níveis de experiência
(Centro Universitário do Estado do Pará, 2020) Tuma, Sarah Maués; Cal, Renato Valerio Rodrigues; http://lattes.cnpq.br/9362044691690331
Introduction: The Clinical Head Impulse Test (c-HIT) identifies the vestibular function and uses that information to help diferentiating pathologies of central origin from those of peripheral origin in the emergency room. However, this test is underused due to the difficulty of interpretation. Objective: Express the current level of experience of the examiners in carrying out the c-HIT and using the findings to make the exam (examinor’s dependente) more acurate. Methodology: This is an accurate, prospective, double-blind study for examiners and patients, for which a data collection form was prepared, containing the evaluation for c-HIT for the three levels of examiners and the comparation with the results of the Video Head Impulse Test (v-HIT). Patients who failed to perform the test or did not accept to participate the research were excluded. Results: Fifty-seven patients met the inclusion and exclusion criteria. Thirtyeight participants (66.8%) were female and nineteen male (33.3%). The primary diagnosis was of Menière’s diseas with fourteen patients. There was significant agreement between the diferent levels of examiners, with a weak agreement (kappa between 0 and 0.2) between residentes level 1 and 2. And a slight agreement (kappa between 0.2 and 0.4) between level 3 and levels 1 and 2. There was a decrease in sensitivity (level 1 and 2: 86,7% and level 3: 60%), na increase in specificity (level 1: 57.1%, level 2: 78.6% and level 3 : 81%) and increased accuracy (level 1: 64.9%, level 2: 80.7 %% and level 3: 75.4%). Conclusion: It was concluded that the level of experience directly influences the interpretation of the HIT-c result. Accuracy was low for the level 1 examiner, increased for level 2 examiner and remained high for the level 3 examiner. In addition, the sensitivity was inversely proportional to the examiner’s level of experience and the specificity was directly proporcional.
Estudo guiado por imagem da anatomia suína como ferramenta para pesquisa e treinamento de procedimentos urológicos
(Centro Universitário do Estado do Pará, 2020) Smit, Jacob Hindrik Antunes; Góes Junior, Adenauer Marinho de Oliveira; Leonardi, Eduardo Piotto; http://lattes.cnpq.br/6939444550426302; http://lattes.cnpq.br/4029653381282393
Purpose: To describe the anatomy of the swine’s urinary system using computed tomography and to discuss the role of this animal as an experimental model for urological procedures. Methods: Three male Landrace pigs underwent computed tomography and the anatomy of the urinary system and renal circulation was analyzed and described. Results: In all animals, 2 kidneys, 2 ureters and one bladder were identified. Each kidney presented a single renal artery vascularization, with a mean diameter on the right of 4.45mm and 5.31mm on the left (p<0.0001), and single renal vein drainage, with a mean diameter on the right of 5.78mm and 5.82mm on the left (p=0.0336). The average renal length was 9.85cm on the right and 10.30cm on the left (p<0.0001). The average renal volume was 113.70cm3 on the right and 109.70cm3 on the left (p<0.0001). The average length of the ureter was 19.78cm on the right and 22.08cm on the left (p<0.0001). The average bladder volume was 423.70cm3. Conclusions: The data obtained show similarities with human anatomy, suggesting the viability of the swine model for planning pre-clinical trials, basic research, refinement in experimental surgery and surgical training for urological procedures.
Influência do sexo e da idade sobre o diâmetro da cava inferior e implicações para o implante de filtros de veia cava
(Centro Universitário do Estado do Pará, 2021) Franco, Ana Carolina Corrêa; Franco, Angra Vanessa da Silva; Franco, Reinaldo Sérgio Monteiro; Góes Junior, Adenauer Marinho de Oliveira; http://lattes.cnpq.br/4029653381282393; http://lattes.cnpq.br/2607797387599708
Context: Measuring the venous diameter and choosing a compatible vena cava filter are essential to reduce the risk of complications resulting from the implantation of these devices, however, there is little information on how the diameter of the inferior vena cava varies with sex and age. Objective: To determine the influence of patients gender and age on the inferior vena cava diameter and the suitability of the different filter models available. Methods: Retrospective analytical study based on computed tomography images. The diameter of the inferior vena cava was measured at 3 points (above the confluence of the common iliac veins, below the renal veins and midway between these points) using the Arya® and Carestream PACS® software. The results were classified according to sex and age groups (19-40, 41-50, 51-60, 61-70, 71- 80 and 81-92 years). Results: CT scans of 417 patients were analyzed: 245 women and 172 men. The diameters at the mid and caudal points were statistically smaller (p<0.05) in older women than in younger women. Similar results were seen in men. The venous diameters at the cranial and caudal points were statistically greater in men than in women among patients aged between 51 and 70 years (p<0.05). Conclusions: The diameter of the inferior vena cava tends to decrease with advancing age in both sexes and the rate of change in diameter is similar between men and women.
Perfil clínico e epidemiológico dos pacientes portadores de doenças intersticiais pulmonares em um Centro De Especialidades Médicas em Belém-PA
(Centro Universitário do Estado do Pará, 2022) Sarmento, Matheus Alonso de Souza; Silva, Paulo André Dias da; Monteiro, José Tadeu Colares; http://lattes.cnpq.br/7627103187307808
Objective: To characterize the epidemiological profile associated with the clinical repercussions of patients diagnosed with interstitial pulmonary disease who are being accompanied by the Center of Medical Specialties of the Centro Universitário do Estado do Pará (CEMEC-CESUPA) in Belém do Pará, to thru it contribute as a source for other papers. Methodology: The study developed is cross-sectional, descriptive and observational with quantitative and qualitative, descriptive and analytical approach, with data collection in the medical records of patients older than 18 years treated at the Center of Medical Specialties of the Centro Universitário do Estado do Pará (CEMEC-CESUPA) conducted from January 2018 to June 2022. Results: 74 patients were included. The majority (51 or 68.9%) were female and 23 (31.1%) were male. More than half (42 or 56.8%) were aged 60 years or older. 36.5% of the individuals had final diagnosis of idiopathic pulmonary fibrosis, 22 (29.7%) had hypersensitivity pneumopathy, 10 (13.5%) had pneumopathy secondary to rheumatoid arthritis. Regarding the exposure of patients with IPD, it was identified that 15 individuals (20.3%) had exposure to birds and 11 (14.9%) had exposure to mold. As for the symptoms presented, most (68 or 91.9%) had dyspnea, (57 or 77%) had a cough, and 45 or 60.8% had Velcro crackles. Among the tomographic alterations, most (58 or 78.4%) had ground glass, (57 or 77.0%) had septal thickening, (45 or 60.8%) bronchiectasis and (43 or 58.1%) had fibrosis. Regarding the main drugs used in the treatment of patients diagnosed with IPD, it was found that prednisone corresponds to 55.4%, nintedanib 21.6%, acetylcysteine 14.9% and azathioprine 13.5%. Conclusion: This study contributed with important clinical and epidemiological information for the creation of a clinical profile of patients, in addition to expanding the knowledge about their tomographic changes and the main therapies used in the treatment of interstitial lung diseases.
Principais aspectos clínicos e radiológicos pulmonares em pacientes portadores de artrite reumatóide em um Centro de Especialidades Médicas em Belém-PA
(Centro Universitário do Estado do Pará, 2019) Castro, Erick Garcia; Fernandes, Marina Assis da Escóssia; Monteiro, José Tadeu Colares; Ohashi, Claudia Barros; http://lattes.cnpq.br/0889116450004563; http://lattes.cnpq.br/7627103187307808
Objective: To analyze the main repercussions pulmonary, clinical and radiological, in patients diagnosed with rheumatoid arthritis who are being monitored by the Center for Medical Specialties of the Pará State University Center (CEMEC-CESUPA), and from there serve as a source for secondary studies. Methods: The study is cross-sectional, descriptive and observational with quantitative and qualitative descriptive and analytical approach, with data collection in the medical records of patients treated at the Center of Medical Specialties of the University Center of the State of Pará (CESUPA), in the period between january 2014 to december 2018. Results: 156 patients with rheumatoid arthritis were analyzed. The age group and the most affected sex were, respectively, patients older than 60 years and female. Regarding smoking, 53.8% non-smokers, 37.2% former smokers and 9% smokers. Regarding the performance or not of laboratory tests, it was found that 56.4% of the patients performed PPD, 83.3% of the DAS 28 was calculated and 99.4% of the rheumatoid factor. Among the pulmonary symptoms present in 40 patients (24.5%), the most common was dyspnea, followed by chest pain and cough. Regarding the imaging exams, it was concluded that 85.3% had documented in the medical records the description of chest radiography or computed tomography or magnetic resonance, among them, 30.8% presented alteration in the exam. The main documented radiological alteration was the acinar pattern present in 75.0% of patients with alteration, followed by interstitial pattern (66.7%), pulmonary nodule (27.1), pleural pattern (10.4%) and others. Conclusion: It is necessary to perform the analysis of all patients with rheumatoid arthritis, with special attention to pulmonary repercussions due to the significant appearance of clinical and / or radiological alterations in these patients.