1) This study aimed to identify thrombus in carotid arteries using high-resolution MRI, comparing a T1-weighted turbo field echo (TFE) technique to a T1-weighted fast spin echo (FSE) technique.
2) MRI of carotid arteries in 11 patients was compared to histology, which served as the gold standard. Both techniques were evaluated by two independent readers.
3) The T1w TFE technique detected thrombus with higher accuracy (reader 1: 93%, reader 2: 82%) than the T1w FSE technique (reader 1: 79%, reader 2: 72%), and had significantly fewer false positive results. The T1w TFE technique can accurately detect throm
We report the case of a 74 year old female who presented with imaging concerning for an intramural hematoma of the ascending aorta. Despite multiple imaging modalities consistent with intramural hematoma, operative findings confirmed a peri-aortic lymphoma or what was once lymphoma.
We report the case of a 74 year old female who presented with imaging concerning for an intramural hematoma of the ascending aorta. Despite multiple imaging modalities consistent with intramural hematoma, operative findings confirmed a peri-aortic lymphoma or what was once lymphoma.
Neuroimaging is the use of various techniques to either directly or indirectly image the structure, function of the nervous system.
Neuroimaging plays a pivotal role in the diagnosis of central nervous system (CNS) disorders.
Main modalities of neuroimaging techniques are CT scan and MRI.
Identified in 1921 by James Ewing
2nd most common bone tumor in children
Ewing’s Sarcoma Family of tumors:
Ewing’s sarcoma (Bone –87%)
Extraosseous Ewing’s sarcoma (8%)
Peripheral PNET(5%)
Askin’s tumor
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
1. IN VIVO MRI OF THROMBI IN
ADVANCED ATHEROSCLEROTIC
CAROTID ARTERY
Vincent Cappendijk1
Kitty Cleutjens1
Sylvia Heeneman1
Geert Willem Schurink1
Rob Welten2
Fons Kessels1
Mat Daemen1
Jos van Engelshoven1
Eline Kooi1
1
University Hospital of Maastricht, Cardiovascular Research
Institute Maastricht (CARIM), 2
Atrium Hospital Heerlen,
Netherlands
2. Background (1)
• Atherosclerosis is a major source of morbidity
and mortality
-61,800,000 Americans have one or more types of
cardiovascular disease (CVD)
-Mortality CVD: 958,775 yearly
-Costs: 329.2 billion Dollar
Source: American Heart Association Website
3. Background
(2)• Plaque composition rather than plaque size
(degree of stenosis) is the predictor of risk on
thrombo-embolic events
• High-resolution multi-contrast MRI can
subjectively detect atherosclerotic plaque
components in vivo1,2
• Thrombus, a component in advanced (high-risk)
lesions is still difficult to detect
1
Yuan et al. Radiology 2001; 221: 285
2
Fayad et al. Circulation Research 2001; 89: 305
4. From low-risk to high-risk
plaque
From fatty streak to ruptured lesion
Berliner et al. Circulation. 1995;91:2488-2496
5. Thrombus detection with MRI
PDw
FSE
T2w
FSE
T1w
FSE
MPRAG
E
Calcified low low low -
Lipid normal /
high
low low -
Fibrous normal /
high
high normal
/high
-
Thrombus normal /
high
variable high high
Yuan et al, Fayad et al, Zhao et al, von Ingersleben et al, Shinnar et al, Moody et al.
6. Aim of the present study
• Identification of thrombus in the carotid artery with
high-resolution MRI and T1w Turbo Field Echo
technique (T1w TFE or MPRAGE)
• Compare this technique with T1w Fast Spin Echo
(FSE)
• Determine the performance and agreement
of two observers for both techniques
7. Subjects & Methods (1)
• 11 symptomatic patients with a carotid stenosis
of more than 70%
• Pre-operative MRI scan (mean 5 +/- 4 days)
• Pathology is gold standard
• High MR signal relative to muscle tissue
= positive test result
8. Subjects & Methods (2)
• MRI slices were matched with the corresponding
histological slices by Reader 1 (bifurcation, ink,
gross morphological features)
╸
╹
9. Subjects & Methods (3)
• Reader 2 scored the same by Reader 1 marked
locations
(unaware of the results of Reader 1)
Histology:
• Gross assignment of major plaque components
(fibrous tissue, lipid core, calcification,
thrombus)
• Only areas with pre-dominantly one of these
tissue types were marked
10. MRI Protocol (1)
Hardware: 1.5 T Philips Intera whole body scanner
(Gyroscan NT, release 8.1)
Small diameter receiver surface coil (47 mm)
11. MRI Protocol (2)
Technique turbo field echo fast spin echo
TR / TE 10.3 / 4.0 ms 570 / 14 ms
(double inversion pulse)
FA 15º 90º
TI 900 ms 255 ms
In-plane resolution 0.39x0.39 mm 0.39x0.39 mm
Acquisitions 6 2
Slices 3 mm 3 mm
Scan time (9 slices) 3 minutes 7 minutes
T1w 3D TFE T1w 2D FSE
15. Results (4)
False positive results
•FSE had far more false positive results than TFE (32 vs 9;
i.e. the different false positives for both readers together)
•The 9 false positives of TFE were all fibrous tissue,
located within the thickened vessel wall but outside the
main plaque area
•Most areas with fibrous tissue were scored correctly
in TFE (20/29)
16. Example of a true positive result
T1w 3D TFE
T1w FSE
Histology: Internal carotid
artery containing thrombus
17. Example of false positive T1w FSE
Carotid bifurcation; The arrows indicate two areas of
histological proved fibrous tissue in the internal and
external carotid artery. These areas have high signal
intensity in FSE, but not in TFE
T1w 3D TFET1w FSE
18. Discussion
• FSE has far more false positive results than TFE
-this might be due to a T2* effect
• The 9 false positives in TFE were all located within
the thickened vessel wall but outside the main
plaque area. However, most areas with histological
tissue were scored correctly in TFE (20/29)
-possibly not only high signal intensity but also
its location determines if its thrombus
19. Conclusions
• Thrombus can be accurately detected with T1w TFE
high-resolution MRI
• FSE performed significantly worse
• Two readers could detect more than 80% of histological
proven thrombi using T1w TFE (Kappa=0.73)