Navegando por Palavras-chave "Ultrassonography"

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    Caracterização tecidual e fenotípica in vivo da placa aterosclerótica em pacientes com infarto agudo do miocárdio: análise pelo ultrassom intravascular utilizando o mapeamento tecidual iMAP®
    (Universidade Federal de São Paulo (UNIFESP), 2016-11-11) Souza, Cristiano Freitas de [UNIFESP]; Carvalho, Antonio Carlos de Camargo [UNIFESP]; http://lattes.cnpq.br/6569055379421505; http://lattes.cnpq.br/2847246252774147; Universidade Federal de São Paulo (UNIFESP)
    Background: There is limited data on plaque tissue characterization and phenotype classification using radiofrequency iMAP-IVUS?. Methods: In the iWonder study patients presenting with non-ST-elevation myocardial infarction (STEMI) or STEMI underwent 3-vessel grayscale IVUS and iMAP-IVUS? tissue characterization prior to percutaneous intervention. In total, 385 lesions from 100 patients were divided into culprit (n=100) and non-culprit (n=285) lesions. Lesion phenotype was classified in a hierarchical fashion into: (1) TCFA (thin-cap fibroatheroma ? at least 1 frame with >30° of necrotic core [NC] abutting to the lumen); (2) ThCFA (NC >10%, confluent dense calcium [DC] >10%, well-defined fibrous cap); (3) PIT (pathological intimal thickening ? mainly fibrofatty tissue, <10% confluent NC); (4) fibrotic plaque (mainly fibrous tissue, <10% confluent NC, <10% confluent DC) and (5) fibrocalcific plaque (mainly fibrous tissue, >10% confluent DC and <10% confluent NC). Results: Culprit lesions had smaller minimum lumen area with greater plaque burden compared to non-culprit lesions. Volumetric analysis showed that culprit lesions had longer length and larger vessel and plaque volumes compared to non-culprit lesions. iMAP-IVUS? revealed that culprit lesions presented more NC and fibrofatty volume, both at lesion level and at the minimum lumen area (MLA) site (all p<0.001). Any fibroatheroma was more frequently identified in the culprit lesions compared to non-culprit lesions (93% vs. 78.9%, p=0.001). Also, a TCFA was more prevalent within culprit vs. non-culprit lesions (39.0% vs. 19.0%, p<0.001) anywhere within the lesion as well as at the MLA site (18.0% vs. 9.5%, p=0.07). Conclusion: Three-vessel radiofrequency iMAP-IVUS? study demonstrated a greater plaque burden and higher prevalence of any fibroatheroma as well as TCFAs in culprit vs non-culprit lesions in patients presenting with STEMI or non-STEMI and undergoing percutaneous intervention.
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    Considerações sobre eficiência administrativa relacionado aos exames de ultra-sonografia, tomografia computadorizada e ressonância magnética nas afecções orbitárias
    (Sociedade Brasileira de Oftalmologia, 2007-12-01) Watanabe, Magno [UNIFESP]; Morais, Carlos Augusto De; Couto Júnior, Abelardo De Souza; Universidade Federal de São Paulo (UNIFESP); Instituto Benjamin Constant Setor de Ultra-sonografia; Instituto Benjamin Constant; Faculdade de Medicina de Valença; Instituto Benjamin Constant Setor de Plástica Ocular e Órbita; Pontifícia Universidade Católica
    PURPOSES:This study focuses the orbital exams of ultrassononography (US), computed tomography (CT) and magnetic resonance imaging (MRI), and has the following purposes: Collecting the paid amounts by Sistema Único de Saúde (SUS), Associação Médica Brasileira (AMB) and private clinic tables. Reviewing the advantages and disadvantages of the referred diagnostic tests. Suggesting administrative efficiency measures related to these tests in the orbit. METHODS: The costs were achieved based on the amounts paid by SUS, brazilian medical insurance companies and private clinics in Rio de Janeiro City. Bibliographic research of the advantages and disadvantages of these tests. RESULTS: Amounts of these tests in reais (R$): US: 9,05 SUS / 81,77 AMB 90 / 57,01 AMB/CIEFAS 93 / 102,00 AMB/LPM 99 / 158,33 private clinics. CT 86,76 SUS / 193,70 AMB90 / 196,30 AMB/CIEFAS 93 / 204,12 AMB/LPM 99 / 255,33 private clinics MRI: 268,75 SUS / 475,80 AMB 90 and AMB/CIEFAS 93 / 472,50 AMB/LPM 99 / 563,33 private clinics. The advantages and disadvantages of these tests were described according to the literature review. CONCLUSION: Knowing the tests costs and its advantages and disadvantages are important strategies to improve efficiency in diagnostic imaging. It was also concluded the need of new clinical studies that includes economic evaluation of cost-effectiveness in US, CT and MRI exams in orbital diseases which allow the development of clinical practice guidelines or clinical protocols to be applied in medical and administrative decision making.
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    Contribuição do exame de imagem para avaliação de pacientes com deficiência de alfa-galactosidase A
    (Universidade Federal de São Paulo (UNIFESP), 2018-06-28) Neves, Rodrigo Fernandes de Carvalho Azambuja [UNIFESP]; Kirsztajn, Gianna Mastroianni [UNIFESP]; http://lattes.cnpq.br/5744106277657588; http://lattes.cnpq.br/2080021675766046
    Introduction: Alpha-galactosidase A (α-GalA) deficiency is more commonly referred to as Fabry's disease. It is a rare, recessive, X-linked disease caused by mutations in the gene encoding the lysosomalα-GalA enzyme, which affects glycosphingolipid metabolism, as a result of deficient activity of this enzyme, leading to the progressive accumulation of its substrate in plasma and various types of cells, including kidney cells. Renal impairment in such disease is known as well as its progressive nature, but there are still many gaps in relation to the nature of the renal involvement and the manner, moment and intensity with which the different compartments are affected. There are few descriptions directed to the presence, frequency and type of renal cysts found in this disease, motivating the accomplishment of the present study. Objectives: In patients of both genders with α-GalA deficiency, establish: frequency of the occurrence of renal cysts and their characteristics; possible association between these findings and theFabry's disease genotype. Patients and Methods: We compared consecutive patients with Fabry's diseaseand patients with glomerulopathiestreated at UNIFESP, using abdomen ultrasonography, with an active search for cystic formations and detailed evaluation of the kidneys, as well as of demographic, clinical and laboratory data. Results: Individuals with Fabry’s disease and patients with different glomerulopathies with varying glomerular filtration rates were compared. We observed that the groups evaluated were statistically similar, regarding age, gender, glomerular filtration rate estimated by the CKD-EPI formula and stages of chronic kidney disease. When we evaluated the sonographic findings, parapelvic cysts were more frequent in patients with Fabry's disease and this difference was statistically significant in each separate kidney and in both kidneys as well. There was no difference between the group with Fabry's disease and that with other glomerulopathies in relation to the frequency of cortical cysts or other characteristics of the ultrasound examination. The frequency of parapelvic cysts in patients with Fabry's disease and other glomerulopathies was 40.5% vs. 8.9% (and parapelvic associated with cortical cysts was52.4% vs. 10.7%). The finding of parapyelic cysts was not related to the occurrence of Fabry's diseasedefining mutations. Conclusions: In patients with Fabry's disease at different stages of renal involvement, the detection of parapelvic cysts was statistically more frequent than in patients with glomerulopathies and comparable glomerular filtration. This finding may be a further evidence of Fabry's disease in patients with renal disease of undefined etiology when patientsarereferredtoultrasoundexaminationin the investigation of a renal disease, in particular in cases of familial nephropathy.
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    Estudo iWONDER (Imaging WhOle vessel coroNary tree with intravascular ultrasounD and iMap® in patiEnts with acute myocaRdial infarction): racional e desenho do estudo
    (Sociedade Brasileira de Hemodinâmica e Cardiologia Intervencionista - SBHCI, 2012-06-01) Souza, Cristiano Freitas de [UNIFESP]; Alves, Claudia Maria Rodrigues [UNIFESP]; Carvalho, Antonio Carlos [UNIFESP]; Bonfim, Alexandre Vidal [UNIFESP]; Silva, Erlon Oliveira de Abreu [UNIFESP]; Pereira Júnior, Edilberto Castilho [UNIFESP]; Falcão, Felipe José de Andrade [UNIFESP]; Lanaro, Eduardo [UNIFESP]; Barbosa, Adriano Henrique Pereira [UNIFESP]; Souza, José Augusto Marcondes de [UNIFESP]; Sousa, José Marconi A. [UNIFESP]; Souza, Rodrigo Almeida [UNIFESP]; Rigla, Juan; Caixeta, Adriano [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Boston Scientific Setor de Imagem em Cardiologia Intervencionista; Hospital Israelita Albert Einstein
    BACKGROUND: Intravascular ultrasound (IVUS) provides a sensitive and reproducible measurement of coronary artery dimensions, atherosclerotic plaque, and arterial lumen. Advances in IVUS technology now allow the characterization of the composition and morphology of atherosclerotic plaques. Although previous studies have reported data using IVUS radiofrequency analysis, the use of a new modality (iMap®, Boston Scientific, Santa Clara, USA) of atherosclerotic plaque characterization is very little known. Our objective is to analyze the morphological, phenotypic and tissue characteristics of culprit and non-culprit atherosclerotic plaques determined by angiography in patients undergoing coronary angiography due to acute myocardial infarction (AMI). METHODS: Prospective, cross-sectional, single center study (Hospital São Paulo - Escola Paulista de Medicina - Universidade Federal de São Paulo (UNIFESP)/UNIFESP, São Paulo, SP, Brazil). Fifty patients will be selected for ultrasound analysis according to the following inclusion criteria: age < 75 years, non-ST-segment elevation AMI or recent ST-segment elevation AMI, with or without previous fribrinolytic agents. CONCLUSIONS: The present study is aimed at obtaining morphological, phenotypic and tissue characteristics of the atherosclerotic plate using an imaging modality not extensively evaluated in patients with AMI.
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    Ultrassonografia versus eletroneuromiografia para o diagnóstico de fasciculação na esclerose lateral amiotrófica: revisão sistemática e metanálise
    (Universidade Federal de São Paulo (UNIFESP), 2018-06-28) Duarte, Marcio Luis [UNIFESP]; Silva, Maria Stella Peccin da [UNIFESP]; http://lattes.cnpq.br/0428199048138850; http://lattes.cnpq.br/1842227342641417; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Fasciculations are rapid, random, fine, flickering, or vermicular twitching movements of a group of muscle fibres innervated by a single motor unit – is almost obligatory among patients with amyotrophic lateral sclerosis which is the most common motor neuron disease in adults on the planet – and can be diagnosed by clinical evaluation, by electromyography (EMG) or by ultrasonography (US). There is uncertainty as to which of the diagnostic methods is best in the evaluation of fasciculations. Objective: To determine the diagnostic accuracy of the US and EMG for the diagnosis of fasciculation and to compare its detection rates. Determine which of these two diagnostic methods is best for the diagnosis of fasciculation, as well as which is the best muscle to be evaluated in each method. Methodology: We searched the electronic databases Cochrane Library, MEDLINE, EMBASE and LILACS from 12/01/2016 to 12/12/2017, as well as the reference lists of the included studies and the main revisions on the subject, for studies evaluating the diagnostic accuracy and detection rates of the US and EMG for the diagnosis of fasciculation, independently of the status of the publication and the language, selecting 10 studies at the end of the QUADAS 2 and RTI item bank methodological quality evaluation. Results: It was observed that the US, both 10 seconds and 30 seconds, had a detection rate higher than EMG in all muscles evaluated, as well as patients, with emphasis on the 30second evaluation of the brachial biceps muscle – 88% – and tibialis anterior muscle – 82%. The EMG, in these muscles, had a detection rate of 61% and 47%, respectively. The evaluation of the detection rate by patients did not present a significant difference between the US of 10 and 30 seconds – 92% and 93% respectively. The accuracy of the US of 10 seconds in the muscles is of 70%, whereas in the patients it is of 85%. In the US of 30 seconds, the accuracy in the patients is of 82%. The accuracy of the EMG was not possible because the studies that evaluated it did not perform the evaluation with the control group. Conclusion: The US presented detection rates superior to EMG, independently of the time of its evaluation and of the evaluated muscles, being, therefore, a better diagnostic method for the evaluation of the fasciculation.