Risk stratification of suspicious lesions (BI-RADS category 4) can be satisfactorily performed with DCE-MRI and slightly improved when DWI is introduced.

Objective:To test the use of diffusion-weighted imaging (DWI) in stratifying suspicious breast lesions (BI-RADS 4), correlating them with histopathology. We also investigated the performance of DWI related to the main enhancement patterns (mass and non-mass) and tested its reproducibility.Materials and Methods:Seventy-six patients presented 92 lesions during the sampling period. Two independent examiners reviewed magnetic resonance imaging studies, described the lesions, and determined the apparent diffusion coefficient (ADC) values. Differences among benign, indeterminate- to high-risk, and malignant findings, in terms of the ADCs, were assessed by analysis of variance. Using receiver operating characteristic (ROC) curves, we compared the performance of ADC values in masses and non-mass lesions, and tested the reproducibility of measurements by determining the coefficient of variation and smallest real difference.Results:Among the 92 lesions evaluated, the histopathology showed that 37 were benign, 11 were indeterminate- to high-risk, and 44 were malignant. The mean ADC differed significantly among those histopathological groups, the value obtained for the malignant lesions (1.10 × 10-3 mm2/s) being significantly lower than that obtained for the other groups (p < 0.001). ROC curves demonstrated that DWI performed better when applied to masses than when applied to non-mass lesions (area under the curve, 0.88 vs. 0.67). Reproducibility was good (coefficient of variation, 7.03%; and smallest real difference, ± 0.242 × 10-3 mm2/s).Conclusion:DWI can differentiate between malignant and nonmalignant (benign or indeterminate- to high-risk) lesions, showing better performance for masses. Nevertheless, stratification based on histopathological criteria that are more refined has yet to be achieved.

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RESUMO Objetivo: Investigar se valores de coeficiente de difusão aparente (ADC) podem discriminar carcinomas ductais in situ (CDIS) de carcinomas invasivos e testar o ganho incremental de modelo combinando tais medidas ao padrão principal de realce (nódulo versus realce não nodular) do estudo contrastado dinâmico (ECD

Os meios de contraste iodado (MCI) são compostos que contém o iodo como elemento radiopaco que quando introduzido no organismo, por diferentes vias, permitem aumentar a sensibilidade e a especificidade das imagens radiográficas. Uma tentativa de atenuar e/ou prevenir os sinais e sintomas apresentados pelos pacientes destaca-se o uso da pré-medicação como prática em pacientes alérgicos ao contraste iodado. O presente estudo tem como objetivo demonstrar as atribuições do enfermeiro em relação ao uso da pré-medicação como forma de prevenção de reações adversas ao contraste iodado. A metodologia adotada foi uma revisão integrativa de caráter exploratório e do tipo descritivo, a fim de compreender as principais características, da participação do enfermeiro no processo do uso do contraste iodado. O estudo configurou-se num período de um ano utilizando as bases de dados científicos LILACS, SCIELO, MEDLINE, BDENF e PUBMED, extraindo periódicos publicados nos últimos onze anos disponíveis na íntegra em português e inglês. Como conclusão o uso da combinação de anti-histamínicos com corticosteróides é a base da profilaxia as reações adversas relacionadas ao MCI.

A ressonância magnética cardíaca é um método diagnóstico que fornece informação morfofuncional em uma vasta gama de patologias do sistema cardiovascular. Por ser um exame complexo, de várias fases, torna-se relevante o papel da enfermagem na ressonância magnética cardíaca. O presente estudo tem como objetivo demonstrar as atribuições da equipe de enfermagem nos exames de ressonância magnética cardíaca como forma de garantir uma assistência específica e segura ao paciente. A metodologia utilizada foi uma revisão integrativa de caráter exploratório e do tipo descritivo utilizando as bases de dados científicos LILACS, SCIELO, MEDLINE, BDENF e PUBMED, extraindo periódicos publicados recentemente disponíveis na íntegra em português e inglês. Como conclusão o enfermeiro desempenha um papel fundamental em garantir a qualidade da assistência e a segurança do paciente em todos os aspectos relacionados ao exame de ressonância magnética cardiovascular.

Any interruption in the continuity of the skin, whether to a greater or lesser extent, is considered a wound and can be classified as acute or chronic. In Brazil and several parts of the world, the chronic wound is seen as a barrier to public health because, in addition to raising the cost for the health service, the patient is susceptible to numerous losses in quality of life, which can have social impacts, economic and psychological. For this reason, the investigation of alternative and low-cost technologies for the treatment of wounds is imperative. The study aimed to describe the use of 10% papain gel in the treatment of wounds arising from amputation processes, characterize the sociodemographic profile of individuals and trace the clinical profile of the patients involved in the study. For this, a pilot study was carried out in a Health Unit in the city of Campos dos Goytacazes/RJ, which works in welcoming patients with chronic wounds of different etiologies. The sample consisted of two individuals, of both sexes, with chronic wounds resulting from recent amputation processes in the lower limbs, treated with a 10% papain gel between April 19 and June 21, 2021. In clinical development, is considered the treatment of wounds with 10% papain gel and measurement of wound area using ImageJ software. Statistical analysis of data was performed using SPSS version 23 software. The sociodemographic results obtained showed that 100% of the sample was composed of patients of economically active age (±51.5 years), both living in areas far from the location where they undergo the treatment of the lesions (±28.5 km), requiring of great displacement to change dressings, which can hinder access to the Health Service. As for the characterization of the clinical profile, 100% of the sample had hypertension and diabetes undergoing treatment for both pathologies, with recent surgical amputation (less than 6 months) at the wound site. Regarding wound healing, patient A showed a reduction in wound area (cm2) of 37.54%, and patient B of 40.53%. Treatment with 10% papain gel was presented as a viable and low-cost alternative compared to the usual coverage offered by the public sector, representing an effective savings of 42% when comparing therapies with similar results. It is suggested that further studies be carried out to expand the scope of evaluation of the alternative therapy proposed by this study.