Health-Related Quality of Life in patients with hepatitis C in double and triple therapy

Abstract OBJECTIVE Comparing Health-Related Quality of Life (HRQoL) scores in patients with chronic hepatitis C undergoing double and triple antiviral therapy and analyzing possible factors related to HRQoL. METHOD HRQoL was assessed using the Short Form 36 and Chronic Liver Disease Questionnaire, which were applied at baseline and at weeks 4, 12 and 16 of treatment to 32 patients divided into two groups: double therapy with pegylated interferon (IFN-PEG) and ribavirin, and triple therapy with PEG-IFN, ribavirin and telaprevir. RESULTS The reduction of HRQoL was greater in patients receiving triple therapy compared to those treated with two drugs, the most critical time is at 12 weeks in both groups. After removal of telaprevir, the triple therapy group significantly improved their HRQoL scores. Anxiety and depression before treatment, employment status and race are significantly related to diminished HRQoL. CONCLUSION Patients undergoing double and triple therapy have diminished HRQoL indexes, but the addition of telaprevir chooses a more significant decrease.

Graduating 4th year radiology residents' perception of optimal imaging modalities for neoplasm and trauma: a pilot study from four U.S. universities

OBJECTIVE: Our purpose was to assess 4th year radiology residents' perception of the optimal imaging modality to investigate neoplasm and trauma. MATERIALS AND METHODS: Twenty-seven 4th year radiology residents from four residency programs were surveyed. They were asked about the best imaging modality to evaluate the brain and spine, lungs, abdomen, and the musculoskeletal system. Imaging modalities available were MRI, CT, ultrasound, PET, and X-ray. All findings were compared to the ACR appropriateness criteria. RESULTS: MRI was chosen as the best imaging modality to evaluate brain, spine, abdominal, and musculoskeletal neoplasm in 96.3%, 100%, 70.4%, and 63% of residents, respectively. CT was chosen by 88.9% to evaluate neoplasm of the lung. Optimal imaging modality to evaluate trauma was CT for brain injuries (100%), spine (92.6%), lung (96.3%), abdomen (92.6%), and major musculoskeletal trauma (74.1%); MRI was chosen for sports injury (96.3%). There was agreement with ACR appropriateness criteria. CONCLUSION: Residents' perception of the best imaging modalities for neoplasm and trauma concurred with the appropriateness criteria by the ACR.

Posterior migration of lumbar disc herniation - imaging dilemma due to contrast contraindication: a case report

Disc herniation with posterior epidural migration is a rare and often symptomatic entity. Multiple are the natural barriers that prevent this pattern of migration. Enhanced magnetic resonance imaging is the diagnostic modality of choice in these cases. The diagnostic dilemma in this case was the contraindication to the use of contrast since the patient was known to have chronic renal failure.

Sonography of the iliotibial band: spectrum of findings

Iliotibial band lesions constitute a potential source of discomfort and are frequently confounded with other conditions which cause pain on the lateral aspect of the hip, thigh and knee. Ultrasonography is usually regarded as a first-line imaging modality in the assessment of such conditions because of its excellent diagnostic accuracy, low cost and wide availability. The correct identification of the structure involved in the production of symptoms leads to an appropriate management and to a higher probability of resolution of the clinical complaint. The present article is aimed at reviewing the different sonographic presentations of iliotibial band syndromes.

Effects of iodinated contrast agent, xylocaine and gadolinium concentration on the signal emitted in magnetic resonance arthrography: a samples study

Objective:To investigate the effects of dilution of paramagnetic contrast agent with iodinated contrast and xylocaine on the signal intensity during magnetic resonance arthrography, and to improve the paramagnetic contrast agent concentration utilized in this imaging modality.Materials and Methods:Samples specially prepared for the study with three different concentrations of paramagnetic contrast agent diluted in saline, iodinated contrast agent and xylocaine were imaged with fast spin echo T1-weighted sequences with fat saturation. The samples were placed into flasks and graphical analysis of the signal intensity was performed as a function of the paramagnetic contrast concentration.Results:As compared with samples of equal concentrations diluted only with saline, the authors have observed an average signal intensity decrease of 20.67% for iodinated contrast agent, and of 28.34% for xylocaine. However, the increased gadolinium concentration in the samples caused decrease in signal intensity with all the dilutions.Conclusion:Minimizing the use of iodinated contrast media and xylocaine and/or the use of a gadolinium concentration of 2.5 mmol/L diluted in saline will improve the sensitivity of magnetic resonance arthrography.

Chest magnetic resonance imaging: a protocol suggestion

Abstract In the recent years, with the development of ultrafast sequences, magnetic resonance imaging (MRI) has been established as a valuable diagnostic modality in body imaging. Because of improvements in speed and image quality, MRI is now ready for routine clinical use also in the study of pulmonary diseases. The main advantage of MRI of the lungs is its unique combination of morphological and functional assessment in a single imaging session. In this article, the authors review most technical aspects and suggest a protocol for performing chest MRI. The authors also describe the three major clinical indications for MRI of the lungs: staging of lung tumors; evaluation of pulmonary vascular diseases; and investigation of pulmonary abnormalities in patients who should not be exposed to radiation.

Terapia fotodinâmica: princípios, potencial de aplicação e perspectivas

Photodynamic Therapy (PDT) has been designated as a promising new modality in the treatment of cancer and other diseases since the early 1980s. It has been used with success for the treatment of a variety of tumours, and attempts are being made to extend this treatment modality to other clinical conditions (as example, the inactivation of viruses in blood and blood components). This can be partly attributed to the very attractive basic concept of PDT: the combination of a photosensitizing drug and light, which are relatively harmless by themselves but combined (in the presence of oxygen) ultimately cause more or less selective tumour destruction.

Terapia fotodinâmica: aspectos farmacológicos, aplicações e avanços recentes no desenvolvimento de medicamentos

Photodynamic Therapy (PDT) is a clinical procedure, which utilize a photosensitive compound and light. This is a new modality of treatment for cancer, aged related macular degenerescence (AMD), psoriasis, arthritis, arterial restenosis, etc which exhibits efficiency, less traumatic effects, low recovery time and few co-lateral effects. The first officially approved drug for PDT by the Food and Drug Administration (EUA) is Photofrinâ, which is applied for cancer. A new generation drug for PDT, Visudyneâ was recently approved to treat AMD; its photoactive compound is BPDMA, a benzoporphyrin mono-acid derivative (chlorin-type molecule). A concise history, technical information and some drugs for PDT are reported.

CASOS INVESTIGATIVOS E A RELAÇÃO COM O SABER: TRAJETÓRIA E PROCESSO DE APRENDIZAGEM DE ESTUDANTES DO ENSINO SUPERIOR NO TOCANTINS

In light of the theory of relationship with know of Bernard Charlot, aiming to understand the unique stories of the subject through a positive lecture, i.e., understanding the reality and the way the subjects read and interpret the world, this article attempts identify how higher education students solve an investigative case and learn the scientific knowledge using this theory. For this, we used narrative as a discourse genre to collect the data of 34 students who participated in the small group activities. After content analysis, the results showed that all groups of students solve the case in a similar way and in three stages, prevailing relations with know with the world, with others and with yourself. However, even if the resolution is similar, chemical learning differs between different groups and differs between the scientific content present in the case. From these results it is possible to identify the effectiveness of learning depends on the epistemic and identity relationships with know of each subject (relationship with yourself) because to learn the student must enter into an intellectual activity (investigative case), stay on it and develop the relationships with known necessary to master the normativity (chemical language).

Love and rationality: on some possible rational effects of love

In this paper I defend the idea that rather than disrupting rationality, as the common-sense conception has done it, love may actually help us to develop rational ways of thinking and acting. I make the case for romantic or erotic love, since this is the kind of love that is more frequently associated with irrationality in acting and thinking. I argue that this kind of love may make us develop epistemic and practical forms of rationality. Based on an analysis of its characteristic action tendencies, I argue that love may help us to develop an instrumental form of rationality in determining the best means to achieve the object of love. It may also narrow down the number of practical considerations that may help us to achieve our goals. Finally, love may generate rational ways of belief-formation by framing the parameters taken into account in perception and attention, and by bringing into light only a small portion of the epistemic information available. Love may make us perceive reality more acutely.

Necessary truth and proof

What makes necessary truths true? I argue that all truth supervenes on how things are, and that necessary truths are no exception. What makes them true are proofs. But if so, the notion of proof needs to be generalized to include verification-transcendent proofs, proofs whose correctness exceeds our ability to verify it. It is incumbent on me, therefore, to show that arguments, such as Dummett's, that verification-truth is not compatible with the theory of meaning, are mistaken. The answer is that what we can conceive and construct far outstrips our actual abilities. I conclude by proposing a proof-theoretic account of modality, rejecting a claim of Armstrong's that modality can reside in non-modal truthmakers.

The relativity of evaluative sentences: disagreeing over disagreement

Evaluative sentences (moral judgments, expressions of taste, epistemic modals) are relative to the speaker's standards. Lately, a phenomenon has challenged the traditional explanation of this relativity: whenever two speakers disagree over them they contradict each other without being at fault. Hence, it is thought that the correction of the assertions involved must be relative to an unprivileged standard not necessarily the speaker's. I will claim instead that so far, neither this nor any other proposal has provided an explanation of the phenomenon. I will point out several problems presented by them and I will hint to how this phenomenon could be explained by making minor adjustments to our semantic theory.

The mathematics of McTaggart's paradox

Mc Taggart's celebrated proof of the unreality of time is a chain of implications whose final step asserts that the A-series (i.e. the classification of events as past, present or future) is intrinsically contradictory. This is widely believed to be the heart of the argument, and it is where most attempted refutations have been addressed; yet, it is also the only part of the proof which may be generalised to other contexts, since none of the notions involved in it is specifically temporal. In fact, as I show in the first part of the paper, McTaggart's refutation of the A-series can be easily interpreted in mathematical terms; subsequently, in order to strengthen my claim, I apply the same framework by analogy to the cases of space, modality, and personal identity. Therefore, either McTaggart's proof as a whole may be extended to each of these notions, or it must embed some distinctly temporal element in one of the steps leading up to the contradiction of the A-series. I conclude by suggesting where this element might lay, and by hinting at what I believe to be the true logical fallacy of the proof.

A puzzle for philosophers

In the paper I tackle a puzzle by Goldberg (2009) that challenges all of us as philosophers. There are three plausible thesis, separately defensible, that together seem to lead to a contradiction: 1) Reliability is a necessary condition for epistemic justification. 2) On contested matters in philosophy, philosophers are not reliable. 3) At least some philosophical theses regarding contested matters in philosophy are epistemically justified. In this paper I will assess the status of the puzzle and attempt to solve it. In the first section, I'll present the puzzle with a little more detail. Secondly, I'll provide some general arguments to show that the alleged puzzle is not a legitimate one. Finally, in section 3, I will argue that even assuming that the puzzle can be coherently formulated, Goldberg's arguments in favor of premise (2) are either unsound or too limited in their scope in order to represent a significant or interesting problem for philosophers.

A videolaparoscopia no diagnóstico e tratamento do schwannoma abdominal

The authors present two patients with solid tumours (benign Schwannoma), which were found during abdominal ultra-sonography. One of them was located adjacent to the hepatic artery, near its origin at the celiac axis. In the second case the tumor was found in the diafragm. Both of them were well limited and non-invasive (benign characteristics). The removal -for diagnosis and treatment - was done using videolaparoscopy. They emphasize the huge advantages of this new diagnostic and therapeutical modality.