Porto Alegre, Brazil
Porto Alegre, Brazil

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Origa R.,Clinica Pediatrica 2 | Danjou F.,Clinica Pediatrica 2 | Cossa S.,Radiology Service | Matta G.,Radiology Service | And 7 more authors.
British Journal of Haematology | Year: 2013

This study aimed to verify the impact of heart magnetic resonance imaging on chelation choices and patient compliance in a single-institution cohort as well as its predictive value for heart failure and arrhythmias. Abnormal cardiac T2* values determined changes in treatment in most subjects. Heart T2* was confirmed to be highly predictive over 1 year for heart failure and arrhythmias. The choice of chelation regimens known to remove heart iron efficiently was not sufficient by itself to influence the risk. Compliance with treatment had a more remarkable role. © 2013 John Wiley & Sons Ltd.


Perez-Carro L.,Hospital Universitario Marques Of Valdecilla And Medical Center Loyalty | Golano P.,University of Barcelona | Golano P.,University of Pittsburgh | Vega J.,Hospital San Cugat Asepeyo | And 3 more authors.
HIP International | Year: 2011

The objective of the study was to describe the normal anatomy of the ligamentum capitis femoris and to determine the neurovascular structures potentially at risk during its reconstruction. Ten cadaveric specimens of the ligamentum capitis femoris (LCF) were dissected and photographed. Magnetic resonance (MR) and Computed tomography (CT) arthrography evaluation of the anatomy of the LCF in 30 hips were performed to measure length of the ligament and to study the proximity of neurovascular structures. The anatomical study showed that the LCF has a pyramidal structure and a banded appearance. The thickness of the medial wall of the acetabulum 3mm superior to the inferior acetabular boundary was found to be 6.7mm (4-9mm) at point 1 (anterior), 4.1mm (3-7mm) at point 2 (central), and 6.5mm (4-9mm) at point 3 (posterior). Central anchors or screws were found to lie within 1.7cm (1.6-1.9cm) of the external iliac vein and artery. Angulation of anchors in the anterior and posterior columns in the axial plane with respect to acetabular fossa floor (the Optimal Angulation Angle or OAA), is safer (0 to 45o the safest optimal angles). The sagittal angulation created by the safe pathway in the anterior and posterior columns with respect to the plane of the facies lunata in this area was also measured and termed the Optimal Angle of Penetration (OAP) with normal values being: 110° (102-123°) for the posterior column and 90° (85-94°) for the anterior column. Our results suggest that reconstruction of the LCF can be safely performed if these guidelines are followed. © 2011 Wichtig Editore.


Barbarroja N.,Hospital Reina Sofia | Perez-Sanchez C.,Hospital Reina Sofia | Ruiz-Limon P.,Hospital Reina Sofia | Castro-Villegas C.,Hospital Reina Sofia | And 11 more authors.
Arteriosclerosis, Thrombosis, and Vascular Biology | Year: 2014

Objective-Previous studies have suggested a relationship between anticyclic citrullinated protein (CCP) levels and development of cardiovascular disease in rheumatoid arthritis (RA). However, a limited number of studies have demonstrated an involvement of anti-CCPs in those processes. This study was aimed to define the specific role of these auto-antibodies in the pro-oxidative, inflammatory, and proatherogenic profile observed in leukocytes from RA patients.Approach and Results-Seventy-five RA patients and 31 healthy donors were enrolled. Carotid intima media thickness was evaluated as atherosclerosis marker. Several procoagulant and inflammatory factors, leukocyte activation, and oxidative stress markers were analyzed in plasma and leukocyte subsets. Anti-CCPs were purified from plasma of RA patients, and in vitro treatment of healthy leukocytes was conducted. High titers of anti-CCPs were associated to altered expression of prothrombotic and inflammatory markers, high oxidative stress, and pathological carotid intima media thickness in RA patients. Notably, gene expression analysis showed that lymphocytes were major players in altered inflammatory profile, monocytes were responsible for the protrombotic and atherogenic status, and neutrophils mainly displayed a prooxidative feature. In vitro treatment with purified anti-CCPs fully recapitulated that pathogenic profile, promoting the activation of leukocytes.Conclusions-Anti-CCPs are key players in the inflammatory and proatherogenic status of RA patients. The effects are specific of the immune cell targeted, promoting overexpression of thrombotic, inflammatory, and pro-oxidative markers in monocytes; pro-oxidative status in neutrophils; and proinflammatory profile in lymphocytes. Targeting these autoantibodies would be an excellent strategy to prevent the development of cardiovascular disease in RA. © 2014 American Heart Association, Inc.


PubMed | CONICET, Radiology Service, National University of La Plata and Ultrasonography Service
Type: Journal Article | Journal: Theriogenology | Year: 2016

The aim of this study was to describe resistance index (RI) and systolic/diastolic ratio (S/D ratio) of uterine and umbilical arteries in an experimental model of abnormal pregnancy in felids. On days 30 to 35 (322.9) after mating, 20 domestic short-hair pregnant queens were randomly assigned to one of the following treatment groups: a treated group (TG; n=8), which received 10mg/kg of aglepristone subcutaneously twice, 24hours apart, and a control nontreated group (CG; n=12). M-mode and Doppler ultrasonographic evaluations were performed at the initiation of the treatment (Day 0) and then every other day during 8days. In both groups, uterine and umbilical arteries were evaluated by Doppler ultrasound, whereas fetal heart rate was assessed by M-mode ultrasound. Resistance index of uterine artery augmented in TG from Day 2 onward, conversely it decreased in CG (P<0.01). On Day 8, RI values were 0.640.05 vs 0.370.01 for TG and CG, respectively. Additionally, S/D ratio of the same artery presented an increase in TG, whereas this ratio diminished in CG (P<0.01). On Day 8, this parameter showed values of 2.980.4 vs 1.620.06 for TG and CG, respectively. Resistance index of umbilical artery remained almost unchanged in TG from Day 6 onward, whereas it progressively decreased in CG throughout the course of the study (P<0.05). On Day 8, RI were 0.890.04 and 0.820.01, for TG and CG, respectively. Furthermore, on Day 8, S/D ratio of umbilical artery progressively diminished in CG but not in TG (P<0.01), being 14.79.1 vs 5.90.3 for TG and CG, respectively. Fetal heart rate was higher in TG than in CG (P<0.05). Group differences in Doppler parameters appeared on Day 2, when the other clinical or ultrasonographic signs were still absent. It is concluded that blood flow of the uterine and umbilical arteries differed between these normal and abnormal gestations predicting an adverse obstetric outcome.


Castiella A.,Mendaro Hospital | Zapata E.,Mendaro Hospital | Alustiza J.M.,Radiology Service
World Journal of Hepatology | Year: 2010

Advances in recent years in the understanding of, and the genetic diagnosis of hereditary hemochromatosis (HH) have changed the approach to iron overload hereditary diseases. The ability to use a radiologic tool (MRI) that accurately provides liver iron concentration determination, and the presence of non-invasive serologic markers for fibrosis prediction (serum ferritin, platelet count, transaminases, etc ), have diminished the need for liver biopsy for diagnosis and prognosis of this disease. Consequently, the role of liver biopsy in iron metabolism disorders is changing. Furthermore, the irruption of transient elastography to assess liver stiffness, and, more recently, the ability to determine liver fibrosis by means of MRI elastography will change this role even more, with a potential drastic decline in hepatic biopsies in years to come. This review will provide a brief summary of the different non-invasive methods available nowadays for diagnosis and prognosis in HH, and point out potential new techniques that could come about in the next years for fibrosis prediction, thus avoiding the need for liver biopsy in a greater number of patients. It is possible that liver biopsy will remain useful for the diagnosis of associateddiseases, where other non-invasive means are not possible, or for those rare cases displaying discrepancies between radiological and biochemical markers. © 2010 Baishideng.


Gich J.,University of Girona | Gich J.,Girona Biomedical Research Institute IDIBGI | Freixanet J.,University of Girona | Garcia R.,University of Girona | And 7 more authors.
Multiple Sclerosis | Year: 2015

Background: MS-Line! was created to provide an effective treatment for cognitive impairment in multiple sclerosis (MS) patients. Objective: To assess the efficacy of MS-Line!. Methods: A randomized, controlled, single-blind, 6-month pilot study. Patients were randomly assigned to an experimental group (cognitive rehabilitation with the programme) or to a control group (no cognitive rehabilitation). Randomization was stratified by cognitive impairment level. Cognitive assessment included: selective reminding test, 10/36 spatial recall test (10/36 SPART), symbol digit modalities test, paced auditory serial addition test, word list generation (WLG), FAS test, subtests of WAIS-III, Boston naming test (BNT), and trail making test (TMT). Results: Forty-three patients (22 in the experimental group, 21 in the control group) were analyzed. Covariance analysis showed significant differences in 10/36 SPART (P=0.0002), 10/36 SPART delayed recall (P=0.0021), WLG (P=0.0123), LNS (P=0.0413), BNT (P=0.0007) and TMT-A (P=0.010) scores between groups. Conclusions: The study showed a significant improvement related to learning and visual memory, executive functions, attention and information processing speed, and naming ability in those patients who received cognitive rehabilitation. The results suggest that MS-Line! is effective in improving cognitive impairment in MS patients. © 2015 The Author(s).


PubMed | Radiology Service, University of Barcelona and University of Girona
Type: Journal Article | Journal: Multiple sclerosis (Houndmills, Basingstoke, England) | Year: 2015

MS-Line! was created to provide an effective treatment for cognitive impairment in multiple sclerosis (MS) patients.To assess the efficacy of MS-Line!.A randomized, controlled, single-blind, 6-month pilot study. Patients were randomly assigned to an experimental group (cognitive rehabilitation with the programme) or to a control group (no cognitive rehabilitation). Randomization was stratified by cognitive impairment level. Cognitive assessment included: selective reminding test, 10/36 spatial recall test (10/36 SPART), symbol digit modalities test, paced auditory serial addition test, word list generation (WLG), FAS test, subtests of WAIS-III, Boston naming test (BNT), and trail making test (TMT).Forty-three patients (22 in the experimental group, 21 in the control group) were analyzed. Covariance analysis showed significant differences in 10/36 SPART (P=0.0002), 10/36 SPART delayed recall (P=0.0021), WLG (P=0.0123), LNS (P=0.0413), BNT (P=0.0007) and TMT-A (P=0.010) scores between groups.The study showed a significant improvement related to learning and visual memory, executive functions, attention and information processing speed, and naming ability in those patients who received cognitive rehabilitation. The results suggest that MS-Line! is effective in improving cognitive impairment in MS patients.


De Mattos V.F.,Federal University of Health Sciences, Porto Alegre | Graziadio C.,Federal University of Health Sciences, Porto Alegre | Machado Rosa R.F.,Federal University of Health Sciences, Porto Alegre | Lenhardt R.,Radiology Service | And 4 more authors.
Pediatric Neurology | Year: 2014

Background Gómez-López-Hernández syndrome is a rare genetic disease characterized by scalp alopecia with trigeminal anesthesia, brachycephaly or turribrachycephaly, midface retrusion, and rhombencephalosynapsis. We report the second case with this condition who presented with consanguineous parents. Patient This boy was evaluated shortly after birth because of suspected craniosynostosis. He was the only son of healthy, consanguineous parents (his maternal grandmother and his paternal great-grandfather were siblings). His examination was notable for turribrachycephaly, prominent forehead, bilateral parietotemporal alopecia, midfacial retrusion, anteverted nostrils, micrognathia, low-set and posteriorly rotated ears, and short neck with redundant skin. Radiographs and tridimensional computed tomography scan of skull revealed lambdoid craniosynostosis. Brain magnetic resonance imaging revealed complete rhombencephalosynapsis, aqueductal stenosis, fused colliculi, abnormal superior cerebellar penducle, mild ventriculomegaly, and dysgenesis of the corpus callosum. Conclusions Since its first description, 34 patients with this condition have been reported. The etiology of Gómez-López-Hernández syndrome is unknown. However, it is noteworthy that the patient in this report presented with a family history of consanguinity because this finding reinforces the possibility of an autosomal-recessive inheritance for this condition. © 2014 Elsevier Inc. All rights reserved.


Nourissat G.,Maussins Group | Radier C.,Radiology Service | Aim F.,Orthopedic Fellow | Lacoste S.,Orthopedic Fellow
Orthopaedics and Traumatology: Surgery and Research | Year: 2014

Purpose: We performed a prospective arthroscopic study to explore the variability of the posterior labrum glenoid insertion. We aimed to classify the insertions and to explore whether these insertions can be identified by pre-operative arthro-CT scan. Patients and methods: From January to December 2011, 86patients were prospectively included in the current study. During arthroscopy, anterior labrum was evaluated and posterior labrum was assessed in 3 different locations: superior, medial, and inferior. For each segment, the labrum was considered normally inserted (directly to the glenoid cartilage), medialized (inserted at the posterior part of the glenoid bone, without direct contact with the cartilage), torn (macroscopic degenerative changes, tears, fragments) or absent (agenesis). Imaging was analyzed segment by segment by an experienced osteoarticular radiologist, using the same classification. Results: Four types of posterior labrum insertions were identified. Type 1, 60% of the cases, corresponded to a posterior labrum totally inserted in the glenoid, with direct contact with the cartilage. Type 2, 20% of the cases, represented medialized insertion of the superior segment. Type 3, 15% of the cases, represented an associated medialization of the superior and medial segment of the posterior labrum. Type 4 is a medialized insertion of the all-posterior labrum. Fifty-six shoulders were used for arthro-CT and arthroscopy correlation: for the superior segment (n=22/56), the sensitivity of arthro-CT to identify an abnormal insertion when the labrum is medialized was 68.18%, specificity 70.59%, positive predictive value (PPV) 60%, and negative predictive value (NPV) 77.42%. For the medial segment (n=16/56), the sensitivity of arthro-CT to identify an abnormal insertion when the labrum is medialized was 81.25%, specificity 57.50%, PPV 43.33% and NPV 88.46%. For the inferior segment (n=5/56), the sensitivity was 100%, specificity 47.60%, PPV 15.63% and NPV 100%. Conclusion: The current study points out the high variability of shoulder posterior labrum glenoid insertion, and thus the risk of misdiagnosis with posterior labral tears, especially in posterior instability and also the risk of considering as labral lesions some non-pathological aspects. Level of evidence: Level III. Anatomic prospective study. © 2014 Elsevier Masson SAS.


Brasseur J.L.,Radiology Service
Journal of Ultrasound | Year: 2012

The . biceps brachii muscle, which inserts proximally onto the scapula and distally onto the forearm, has several tendons with numerous anatomic peculiarities, which render their sonographic examination highly variable. Proximally, the tendon of the short head of the biceps inserts onto the coracoid process and that of the long head on the superior aspect of the glenoid. The distal biceps tendon is bifurcated, and it generally inserts on the radial tuberosity, around which it rolls during pronation/supination. There is a third distal structure, the . Lacertus fibrosus, an aponeurosis that branches off from the medial aspect of the tendon, crossing the median artery and median nerve, and inserting on the superficial aponeurosis of the flexor muscles. The sonographic examination of these tendons focuses on nine separate zones of interest: the glenoid insertion of the long head, its extension to the upper pole of the humeral head, the rotator interval, the reflection to the upper bicipital groove, the bicipital groove, the upper myotendinous junction, the lower myotendinous junction, the distal tendon(s), and the inferior enthesis. Because of their morphological and topographical characteristics, the biceps tendons are subject to a variety of lesions, some of which are frequently misdiagnosed on the basis of clinical findings. Ultrasound plays an important role in detecting and characterizing these lesions. Proper examination of the biceps (the distal portion in particular) is a difficult task that cannot be improvised. © 2011 Elsevier Srl.

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