CONTEXT AND OBJECTIVE: Computed tomography (CT) guided biopsy is widely accepted as effective and safe for diagnosis in many settings. Accuracy depends on target organ and needle type. Cutting needles present advantages over fine needles. This study presents experience from CT guided biopsies performed at an oncology center. DESIGN AND SETTING: Retrospective study at Hospital do Câncer A. C. Camargo, São Paulo. METHODS: 1,300 consecutive CT guided biopsies performed between July 1994 and February 2000 were analyzed. Nodules or masses were suspected as primary malignancy in 845 cases (65%) or metastatic lesion in 455 (35%). 628 lesions were thoracic, 281 abdominal, 208 retroperitoneal, 134 musculoskeletal and 49 head/neck. All biopsies were performed by one radiologist or under his supervision: 765 (59%) with 22-gauge fine-needle/aspiration technique and 535 (41%) with automated 16 or 18-gauge cutting-needle biopsy. RESULTS: Adequate samples were obtained in 70-92% of fine-needle and 93-100% of cutting-needle biopsies. The specific diagnosis rates were 54-67% for fine-needle and 82-100% for cutting-needle biopsies, according to biopsy site. For any site, sample adequacy and specific diagnosis rate were always better for cutting-needle biopsy. Among 530 lung biopsies, there were 84 pneumothorax (16%) and two hemothorax (0.3%) cases, with thoracic drainage in 24 (4.9%). Among abdominal and retroperitoneal biopsies, there were two cases of major bleeding and one of peritonitis. CONCLUSION: Both types of needle showed satisfactory results, but cutting-needle biopsy should be used when specific diagnosis is desired without greater incidence of complications.

The maintenance of high cognitive performance in old age has increasinglybecome a public health interest due to associations between cognition,well-being, longevity, and autonomy. The objective of the researchis to investigate cognitive, physical, and psychological trajectories ofneurotypical older adults (NOAs) and high performing older adults(HPOAs). An exploratory study to investigate 21 NOAs and six HPOAs(mean age 71, SD = ± 3.59), followed up for one year. The older adultswere submitted to physical fitness, quality of life, anxiety, depression,RAVLT, ACE-R, and Stroop tests, being assessed at three moments:baseline, six months after the cognitive (MEMO) or stimulation (Stimullus)interventions, and six months after the multimodal interventions, whichcould be physical or psychopedagogical interventions (health educationlectures). Nonparametric statistical tests (Mann-Whitney and Wilcoxon)were performed with p≤0.05. The results demonstrated that the cognitivemeasures were good predictors of cognitive performance and we observedpositive correlations between cognitive and mood measures. The olderadults with high performance had a lower prevalence of depressivesymptoms. There were gains in global cognitive performance, mood, and inphysical fitness variables associated with multimodal interventions, evidentin the neurotypical group

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Objetivo: relatar o diagnóstico e tratamento de um caso atípico de Displasia de Trevor, caracterizada pelo crescimento osteocondral no aspecto medial ou lateral de uma ou mais epífises. Método: relato de um caso atendido em serviço de reabilitação ortopédica. Resultado: criança do sexo masculino, 3 anos, apresentando ao exame físico, nodulação no joelho esquerdo; exames de imagem de lesão nodular com ossificação irregular, 2,1 x 1,5 cm, adjacente à região epifisária do fêmur. Conclusão: Tratamento pela excisão cirúrgica com bom resultado. Ressonância magnética foi adequada para medir a massa cartilaginosa não ossificada, a extensão do envolvimento epifisário e o aspecto da epífise.