Patients with leg ulcers have more vitamin D deficiency. No difference in the ulcer characteristics was noted between those with and without vitamin D deficiency. There was a trend toward a better healing in those with vitamin D reposition.
OBJETIVO: Avaliar a tendência da concentração plasmática e do clearance de procalcitonina (PCT-c) como biomarcadores de prognóstico de pacientes com sepse grave e choque séptico, comparado a um outro marcador precoce de prognóstico representado pelo número de critérios de SIRS no momento do diagnóstico da sepse. MÉTODOS: Estudo de coorte prospectivo observacional onde foram incluídos pacientes com sepse grave e choque séptico. A concentração sérica de procalcitonina foi determinada no momento do diagnóstico da sepse e após 24 e 48 horas. Foram coletados dados demográficos, escore APACHE IV, escore SOFA na chegada, número de critérios de SIRS no momento do diagnóstico, sitio da infecção e resultados microbiológicos. RESULTADOS: Vinte e oito pacientes foram incluídos, 19 clínicos e nove cirúrgicos. Em 13 (46,4%) a fonte da sepse foi pulmonar, em sete abdominal (25,0%), em cinco urinária (17,9%) e de partes moles em três casos (10,7%). Quinze pacientes tinham sepse grave e 13 choque séptico. A mortalidade global foi cinco pacientes (17,9%), três deles com choque séptico. Vinte e oito determinações de PCT foram realizadas no momento do diagnóstico da sepse, 27 após 24 horas e 26 após 48 horas. A concentração inicial não se mostrou expressivamente diferente entre os grupos sobreviventes e não sobreviventes, mas as diferenças entre os dois grupos após 24 e 48 horas alcançaram significância estatística expressiva. Não se observou diferença em relação ao número de critérios de SIRS. O clearance de procalcitonina de 24 horas mostrou-se expressivamente mais elevado no grupo de sobreviventes (-3,0 versus -300,0, p=0,028). Embora o clearance de procalcitonina de 48 horas tenha mostrado resultado mais elevado no grupo de sobreviventes comparado aos não sobreviventes, a diferença não alcançou significância estatística. CONCLUSÃO: Concentrações persistentemente elevadas de procalcitonina no plasma, assim como, redução do PCT-c 24 horas, associaram-se à elevação expressiva da mortalidade de pacientes com sepse grave e choque séptico.
Introduction: Contrast computed tomography and magnetic resonance imaging are widely used due to its image quality and ability to study pancreatic and peripancreatic morphology. The understanding of the various subtypes of the disease and identification of possible complications requires a familiarity with the terminology, which allows effective communication between the different members of the multidisciplinary team. Aim: Demonstrate the terminology and parameters to identify the different classifications and findings of the disease based on the international consensus for acute pancreatitis ( Atlanta Classification 2012). Methods: Search and analysis of articles in the "CAPES Portal de Periódicos with headings "acute pancreatitis" and "Atlanta Review". Results: Were selected 23 articles containing radiological descriptions, management or statistical data related to pathology. Additional statistical data were obtained from Datasus and Population Census 2010. The radiological diagnostic criterion adopted was the Radiology American College system. The "acute pancreatitis - 2012 Rating: Review Atlanta classification and definitions for international consensus" tries to eliminate inconsistency and divergence from the determination of uniformity to the radiological findings, especially the terminology related to fluid collections. More broadly as "pancreatic abscess" and "phlegmon" went into disuse and the evolution of the collection of patient fluids can be described as "acute peripancreatic collections", "acute necrotic collections", "pseudocyst" and "necrosis pancreatic walled or isolated". Conclusion: Computed tomography and magnetic resonance represent the best techniques with sequential images available for diagnosis. Standardization of the terminology is critical and should improve the management of patients with multiple professionals care, risk stratification and adequate treatment.
Introduction:
Among the screening tests for colorectal cancer, colonoscopy is currently
considered the most sensitive and specific technique. However, computed
tomography colonography (CTC), magnetic resonance imaging (MRI), and
transrectal ultrasonography have gained significant ground in the clinical
practice of pre-treatment, screening and, more recently, post-treatment and
surgical evaluation.
Objective:
To demonstrate the high accuracy of CT and MRI for pre and postoperative
colorectal cancer staging.
Methods:
Search and analysis of articles in Pubmed, Scielo, Capes Periodicals and
American College of Radiology with headings “colorectal cancer” and
“colonography”. Weew selected 30 articles that contained radiological
descriptions, management or statistical data related to this type of
neoplasia. The criteria for radiological diagnosis were the American College
of Radiology.
Results
:
The great majority of patients with this subgroup of neoplasia is submitted
to surgical procedures with the objective of cure or relief, except those
with clinical contraindication. CTC colonography is not the most commonly
used technique for screening; however, it is widely used for treatment
planning, assessment of the abdomen for local complications or presence of
metastasis, and post-surgical evaluation. MRI colonography is an alternative
diagnostic method to CT, recommended by the American Society of
Gastrointestinal Endoscopy. Although there are still no major studies on the
use of MRI for screening, the high resolution examination has now shown good
results for the American Joint Committee on Cancer TNM classification.
Conclusion:
MRI and CT represent the best means for colorectal neoplasm staging. The use
of these methods as screening tools becomes beneficial to decrease
complications and discomfort related to colonoscopy.
Souza et al. Souza et al. Souza et al. Souza et al. Souza et al. Expressão citofotométrica do fator de proliferação celular ki-67 no bócio colóide e no carcinoma papilífero da tireóide 105Rev. Col. Bras.
The correlation of liver biopsies with ultrasound B-mode and Doppler of hepatic vein was positive; 2) individuals with liver disease showed alterations in the flow of the right hepatic vein and normal subjects not, being the wave pattern in normal triphasic and in patients with chronic liver disease monophasic or biphasic; 3) Doppler of the right hepatic vein is useful marker for chronic liver disease.
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