Abdominal tuberculosis: a radiological review with emphasis on computed tomography and magnetic resonance imaging findings

AbstractTuberculosis is a disease whose incidence has increased principally as a consequence of HIV infection and use of immunosuppressive drugs. The abdomen is the most common site of extrapulmonary tuberculosis. It may be confused with several different conditions such as inflammatory bowel disease, cancer and other infectious diseases. Delay in the diagnosis may result in significantly increased morbidity, and therefore an early recognition of the condition is essential for proper treatment. In the present essay, cases with confirmed diagnosis of abdominal tuberculosis were assessed by means of computed tomography and magnetic resonance imaging, demonstrating the involvement of different organs and systems, and presentations which frequently lead radiologists to a diagnostic dilemma. A brief literature review was focused on imaging findings and their respective prevalence.

Análisis del error de medición y variabilidad interespecífica morfométrica de Fourier en M2 de primates Hominoidea

Los análisis de Fourier permiten caracterizar el contorno del diente y obtener una serie de parámetros para un posterior análisis multivariante. Sin embargo, la gran complejidad que presentan algunas formas obliga a determinar el error de medición intrínseco que se produce. El objetivo de este trabajo es aplicar y validar los análisis de Fourier en el estudio de la forma dental del segundo molar inferior (M2) de cuatro especies de primates Hominoidea para explorar la variabilidad morfométrica interespecífica, así como determinar el error de medición a un nivel intra e interobservador. El contorno de la superficie oclusal del diente fue definido digitalmente y con las funciones derivadas del análisis de Fourier se realizaron Análisis Discriminantes y Test de Mantel (correlaciones de Pearson) para determinar las diferencias de forma a partir de las mediciones tomadas. Los resultados indican que el análisis de Fourier muestra la variabilidad de forma en dientes molares en especies de primates Hominoidea. Adicionalmente, los altos niveles de correlación a nivel intra (r>0,9) como interobservador (r>0,7) sugieren que la descripción morfométrica del diente a partir de métodos de Fourier realizados por diferentes observadores puede ser agrupada para posteriores análisis.

Caracterización morfológica del M2 de Primates Hominoidea a partir de análisis de Fourier

Los análisis de Fourier permiten caracterizar el contorno del diente a partir de un número determinado de puntos y extraer una serie de parámetros para un posterior análisis multivariante. No obstante, la gran complejidad que presentan algunas conformaciones, obliga a comprobar cuántos puntos son necesarios para una correcta representación de ésta. El objetivo de este trabajo es aplicar y validar los análisis de Fourier (Polar y Elíptico) en el estudio de la forma dental a partir de diferentes puntos de contorno y explorar la variabilidad morfométrica en diferentes géneros. Se obtuvieron fotografías digitales de la superfi cie oclusal en segundos molares inferiores (M2s) de 4 especies de Primates (Hylobates moloch, Gorilla beringei graueri, Pongo pygmaeus pygmaeus y Pan troglodytes schweirfurthii) y se defi nió su contorno con 30, 40, 60, 80, 100 y 120 puntos y su representación formal a 10 armónicos. El análisis de la variabilidad morfométrica se realizó mediante la aplicación de Análisis Discriminantes y un NP-MANOVA a partir de matrices de distancias para determinar la variabilidad y porcentajes de clasifi cacióncorrecta, a nivel metodológico y taxonómico. Los resultados indicaron que los análisis de forma con series de Fourier permiten analizar la variabilidad morfométrica de M2s en géneros de Hominoidea, con independencia del número de puntos de contorno (30 a 120). Los porcentajes de clasifi cación son más variables e inferiores con el uso de la serie Polar (≈60-90) que con la Elíptica (75-100%). Un número entre 60-100 puntos de contorno mediante el método elíptico garantiza una descripción correcta de la forma del diente.

Tamaño dental, desgaste oclusal y microestriación en primates Hominoidea

El patrón de microestriación dentaria depende no solo de la composición de los alimentos ingeridos, sino también de la presencia en ellos de polvo, cenizas u otras partículas abrasivas de origen externo, generalmente incorporadas al alimento durante su preparación. El presente estudio analiza cómo se ve afectado el patrón de microestriación de la superficie vestibular de los dientes por factores independientes a la estructura y composición alimentaria, como son el tamaño de la pieza dentaria y el desgaste oclusal de la misma. Se han analizado moldes dentarios obtenidos de ejemplares originales de colecciones osteológicas de molares de primates Hominoideos, en los que se ha medido el patrón de microestriación dentaria de todos los individuos, así como el tamaño dental (área oclusal total- AOT) y el desgaste oclusal (porcentaje de exposición de dentina- PED) mediante técnicas semiautomáticas de análisis cuantitativo. Los resultados obtenidos indican que el tamaño dentario y el grado de desgaste oclusal de los molares analizados no están correlacionados con el patrón de microdesgaste dental de sus superficies vestibulares. Ello sugiere que las actividades masticatorias asociadas con las superficies oclusales de los molares no están directamente relacionadas con la capacidad abrasiva del alimento, sino con utilización de la superficie occlusal de la dentición en actividades que no repercuten en el patrón de microestriación de las superficies vestibulares de los dientes.

Age-Related Tooth Wear Differs between Forest and Savanna Primates

Tooth wear in primates is caused by aging and ecological factors. However, comparative data that would allow us to delineate the contribution of each of these factors are lacking. Here, we contrast age-dependent molar tooth wear by scoring percent of dentine exposure (PDE) in two wild African primate populations from Gabonese forest and Kenyan savanna habitats. We found that forest-dwelling mandrills exhibited significantly higher PDE with age than savanna yellow baboons. Mandrills mainly feed on large tough food items, such as hard-shell fruits, and inhabit an ecosystem with a high presence of mineral quartz. By contrast, baboons consume large amounts of exogenous grit that adheres to underground storage organs but the proportion of quartz in the soils where baboons live is low. Our results support the hypothesis that not only age but also physical food properties and soil composition, particularly quartz richness, are factors that significantly impact tooth wear. We further propose that the accelerated dental wear in mandrills resulting in flatter molars with old age may represent an adaptation to process hard food items present in their environment.

Readjustment of abdominal computed tomography protocols in a university hospital: impact on radiation dose

AbstractObjective:To assess the reduction of estimated radiation dose in abdominal computed tomography following the implementation of new scan protocols on the basis of clinical suspicion and of adjusted images acquisition parameters.Materials and Methods:Retrospective and prospective review of reports on radiation dose from abdominal CT scans performed three months before (group A – 551 studies) and three months after (group B – 788 studies) implementation of new scan protocols proposed as a function of clinical indications. Also, the images acquisition parameters were adjusted to reduce the radiation dose at each scan phase. The groups were compared for mean number of acquisition phases, mean CTDIvol per phase, mean DLP per phase, and mean DLP per scan.Results:A significant reduction was observed for group B as regards all the analyzed aspects, as follows: 33.9%, 25.0%, 27.0% and 52.5%, respectively for number of acquisition phases, CTDIvol per phase, DLP per phase and DLP per scan (p < 0.001).Conclusion:The rational use of abdominal computed tomography scan phases based on the clinical suspicion in conjunction with the adjusted images acquisition parameters allows for a 50% reduction in the radiation dose from abdominal computed tomography scans.

Prevalence and sonographic changes compatible with fatty liver disease in patients referred for abdominal ultrasound examination in Aracaju, SE

Abstract Objective: To estimate the prevalence and evaluate sonographic findings compatible with changes consistent with hepatic steatosis in patients referred for abdominal ultrasonography at four reference centers in Aracaju, SE, Brazil. Materials and Methods: Prospective, descriptive survey, with analytical and quantitative approach, comprising abdominal ultrasonography scans performed with a convex, dynamic 3.75 MHz transducer. Liver dimensions and parenchymal echotexture were evaluated, classifying hepatic steatosis into grades (1, 2 or 3). The SPSS® 22.0 software was used for statistical analysis, adopting p < 0.05 as significance level. Results: A total of 800 individuals (561 women and 239 men) were evaluated. The prevalence of steatosis was 29.1%, and the male patients were most affected, presenting with more advanced grades of disease (p = 0.021), as follows: 119 grade 1 (51.0%); 94 grade 2 (40.4%); and 20 grade 3 (8.6%). The median age patients' was 46 years. Conclusion: In the present study sample, the prevalence of hepatic steatosis was high, particularly in the male patients. Ultrasonography is suggested as a first choice for the diagnosis of this condition, considering its wide availability, low cost and absence of side effects or risks to the patient.

The "Abdominal Circulatory Pump": An Auxiliary Heart during Exercise?

Apart from its role as a flow generator for ventilation the diaphragm has a circulatory role. The cyclical abdominal pressure variations from its contractions cause swings in venous return from the splanchnic venous circulation. During exercise the action of the abdominal muscles may enhance this circulatory function of the diaphragm. Eleven healthy subjects (25 ± 7 year, 70 ± 11 kg, 1.78 ± 0.1 m, 3 F) performed plantar flexion exercise at ~4 METs. Changes in body volume (ΔVb) and trunk volume (ΔVtr) were measured simultaneously by double body plethysmography. Volume of blood shifts between trunk and extremities (Vbs) was determined non-invasively as ΔVtr-ΔVb. Three types of breathing were studied: spontaneous (SE), rib cage (RCE, voluntary emphasized inspiratory rib cage breathing), and abdominal (ABE, voluntary active abdominal expiration breathing). During SE and RCE blood was displaced from the extremities into the trunk (on average 0.16 ± 0.33 L and 0.48 ± 0.55 L, p < 0.05 SE vs. RCE), while during ABE it was displaced from the trunk to the extremities (0.22 ± 0.20 L p < 0.001, p < 0.05 RCE and SE vs. ABE respectively). At baseline, Vbs swings (maximum to minimum amplitude) were bimodal and averaged 0.13 ± 0.08 L. During exercise, Vbs swings consistently increased (0.42 ± 0.34 L, 0.40 ± 0.26 L, 0.46 ± 0.21 L, for SE, RCE and ABE respectively, all p < 0.01 vs. baseline). It follows that during leg exercise significant bi-directional blood shifting occurs between the trunk and the extremities. The dynamics and partitioning of these blood shifts strongly depend on the relative predominance of the action of the diaphragm, the rib cage and the abdominal muscles. Depending on the partitioning between respiratory muscles for the act of breathing, the distribution of blood between trunk and extremities can vary by up to 1 L. We conclude that during exercise the abdominal muscles and the diaphragm might play a role of an "auxiliary heart."

Composição química da glândula abdominal da fêmea da mariposa Castnia licus (Drury) (Lepidoptera:Castniidae): possíveis feromônios e precursores

The hexane and methanolic extracts from pheromonal glands of Castnia licus (Drury) virgin females have been studied. Analyses by gas chromatography and mass spectrometry allowed us to determine the major constituents present in the hexane extract as n-alkanes C21 to C30, (Z)-9-hexadecenoic acid (C16), and (Z)-9-octadecenoic acid (C18) and hexadecanoic acid (C16). Aldehyds, alkenes and acetates were also detected in low concentrations in the extracts. Female pheromone glands were analysed for pheromone precursors using the methanolic extract. In addition to the compounds methyl hexadecanoate and methyl (Z)-9-octadecenoate, the glandular tissue contains a homologous series of methyl esters from C12 to C24. The hexane extract of the female abdomenal glands elicited activity from males in a behavioural bioassay.

Morfología comparada de la escápula de primates humanos y no humanos mediante morfometría geométrica. Estudio preliminar.

Este trabajo estudia la morfología comparada de la escápula de primates humanos y no humanos mediante morfometría geométrica. Se han utilizado 62 omóplatos de individuos adultos de sexo desconocido (22 humanos actuales, 1 Neandertal y 39 primates no humanos), procedentes de las colecciones de las Universidades UAB, UB y del Museo de Ciencias Naturales de Barcelona. Cada escápula se fotografió ortogonalmente y se cuantificó su morfología mediante el uso de puntos anatómicos de referencia (12 para la cara posterior y 13 para la anterior). Después de evaluar la fiabilidad de las mediciones mediante un test de distancias euclídeas, se analizó la diversidad de este hueso en las diferentes especies de primates mediante un Análisis de Componentes Principales (ACP). Los resultados mostraron clara separación morfológica entre primates cuadrúpedos y no cuadrúpedos (suspensores, saltadores y bípedos). En este último conjunto los humanos se separan netamente del resto. En los primates cuadrúpedos predomina la dimensión horizontal (mayor anchura y menor altura), mientras que en los no cuadrúpedos se da la tendencia contraria (menor anchura y mayor altura). La espina escapular queda situada en posición más horizontal enprimates cuadrúpedos respecto a los no cuadrúpedos, aunque en el género Homo, esta inclinación está atenuada. La escápula analizada de Neandertal, si bien es más robusta y con menor inclinación de la espina escapular que la de los humanos actuales, se agrupa bien con éstos. Nuestros resultados muestran el potencial de la metodología utilizada para el estudio de la morfología escapular de Homo y demás géneros de primates.

Percutaneous access versus standard femoral exposure for endovascular abdominal aortic aneurysm repair: a randomized, controlled trial

The treatment of abdominal aortic aneurysm (AAA) has shifted from the exposure of the aorta artery in an open repair technique to a small groin cut in an endovascular repair. Recently, a percutaneous access for endovascular repair has appeared. This new technique aims to minimize the complications of the common femoral artery exposure, the patient discomfort and the length of hospitalizationObjectives: To compare the proportion of discharged patients within the first 48 postoperative hours of two common femoral artery accesses for endovascular repair of AAA: the open exposure technique and the percutaneous technique. Secondary objectives include to evaluate the total procedure time, the femoral access complications, the need for extra analgesia and the patient satisfaction and groin discomfort of the two techniquesDesign: Randomized controlled trial conducted between 2014 and 2017Participants: Patients diagnosed with abdominal aortic aneurysm with elective endovascular repair indication

Quality of Abdominal Surgical Nursing Care

The study evaluates the quality of abdominal surgical nursing care. The data were collected from patients (n=1208) having undergone abdominal surgical operations on their last day of hospitalization and nurses (n=218) working in the same wards. Three instruments originally created in Finland and adapted to the Lithuanian context were used: (1) Good Nursing Care Scale for patients and nurses (GNCS-P, GNCS-N), (2) Nurse Competence Scale (NCS), and (3) Nurse Empowerment Scale (NES). Patient and nurses’ perceptions of the quality of nursing care were evaluated. In addition, nurses’ perceptions of their competence and empowerment were evaluated. The patient and nurses' perceptions of the quality of abdominal surgical nursing care were positive, with more criticism in the nurses’ perceptions. Both patients and nurses gave the lowest evaluation to the quality in the progress of nursing care and the co-operation with significant others. The nurses gave the highest evaluation to the self-assessed level of their competence and the frequency of using competences in practice, with the highest assessment given to situation management and their role at work and the lowest to teaching-coaching and ensuring quality. The nurse perceptions of their empowerment were positive in the qualities and performance of an empowered nurse and empowerment promoting factors, with the highest evaluation in moral principles and sociability and the lowest evaluation in the future-orientedness and expertise. The empowerment-impeding factors were evaluated as negative. The perceptions of the quality of nursing care of both patients and nurses had significant correlations with patient and nurse satisfaction and nurse job independence. The nurse perceptions of their competence and empowerment correlated with their education, the type of the nurse license, completed courses of development of their knowledge and skills, nurse job independence, and nurse satisfaction. The nurse perceptions of the quality of nursing care had a positive correlation with their perceptions of competence and empowerment. Generally, the quality of nursing care was evaluated as high and had correlations with the patients' demographic and satisfaction factors and with the nurse demographic, work-related, and satisfaction factors. The study produced the knowledge that the quality in co-operation with significant others and the progress of nursing process, surgical nurse competence in teaching-coaching, and future-orientedness of surgical nurse empowerment need to be improved in order to develop the quality of abdominal surgical nursing care. The knowledge may be used to offer better services for abdominal surgical patients and increase their satisfaction with nursing care, as well as to increase nurses' satisfaction with work and independence at work. The study suggests implications for clinical practice and management, nursing education, and nursing research.

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.

Tratamento cirúrgico das distrofias da parede abdominal no adulto

Os autores apresentam um estudo retrospectivo de 79 pacientes portadores de distrofias abdominais acompanhadas ou não de hérnias, operados no período compreendido entre 01/06/94 a 31/12/96. A idade média foi de 46 anos. A hérnia incisional isoladamente e o abdome distrófico (em avental) foram o principal objetivo do estudo. Enfatizam a importância da dermolipectomia abdominal para a completa recuperação do paciente bem como demonstram facilitar o manuseio técnico das hérnias. A técnica da transposição peritônio-aponeurótica longitudinal bilateral (técnica de Lázaro da Silva) foi utilizada para as grandes hérnias incisionais. É uma técnica já consagrada, que consta de três planos de suturas sem superposição dos mesmos. Sua recidiva em cinco anos de seguimento tem sido em tomo de 5% segundo estudos do próprio autor. A grande vantagem técnica é que, usando o saco herniário (quanto maior e mais espesso, melhor) como fechamento e reforço do anel, evita-se o uso de prótese com todos os inconvenientes da mesma (fístulas, rejeições etc.) Uma variante desta técnica, para as hérnias com anel herniário de até 10cm, é proposta pelos autores, e consiste no fechamento do anel e reforço da sutura com o saco herniário, em jaquetão. A vantagem seria a facilidade de execução e diminuição do tempo operatório, além de evitar dissecções extensas das camadas aponeuróticas. Quando o anel herniário alcançar 10cm e existir ligeira tensão, deve-se realizar incisão relaxadora na aponeurose anterior dos retos e recobrir a superfície cruenta com o próprio saco herniário que deverá estar íntegro. Esta técnica ainda requer maior observação clínica. É feita a revisão dos resultados dos procedimentos realizados isoladamente e acompanhados com dermolipectomia abdominal: 63 pacientes (81,66%) evoluíram sem complicações, cinco recidivas (6,3%); um caso de hematoma extenso (1,26%); dois casos de abscesso de parede em operações sem dermolipectomia (2,5%); uma necrose de linha média+embolia pulmonar (1,26%); e um óbito por embolia pulmonar (1,26%).