Usefulness of Single Photon Emission Computed Tomography/Computed Tomography Fusion-Hybrid Imaging to Evaluate Coronary Artery Disorders in Patients with a History of Kawasaki Disease

Brazilian Guideline for Exercise Testing in Children and Adolescents - 2024

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Emerging role of computed tomography coronary angiography in evaluation of children with Kawasaki disease

Coronary artery abnormalities are the most important complications in children with Kawasaki disease (KD). Two-dimensional transthoracic echocardiography currently is the standard of care for initial evaluation and follow-up of children with KD. However, it has inherent limitations with regard to evaluation of mid and distal coronary arteries and, left circumflex artery and the poor acoustic window in older children often makes evaluation difficult in this age group. Catheter angiography (CA) is invasive, has high radiation exposure and fails to demonstrate abnormalities beyond lumen. The limitations of echocardiography and CA necessitate the use of an imaging modality that overcomes these problems. In recent years advances in computed tomography technology have enabled explicit evaluation of coronary arteries along their entire course including major branches with optimal and acceptable radiation exposure in children. Computed tomography coronary angiography (CTCA) can be performed during acute as well as convalescent phases of KD. It is likely that CTCA may soon be considered the reference standard imaging modality for evaluation of coronary arteries in children with KD.

131I-labeled and DOX-loaded multifunctional nanoliposomes for radiotherapy and chemotherapy in brain gliomas

The codelivery of different therapeutics is a promising option because of its synergetic effects of drugs. In this study, a new combination therapy that used the doxorubicin-loaded and ¹³¹I-labeled nanoliposomes (¹³¹I-DOX-NL) was proposed to delay tumor growth of gliomas, which are characterized by significant mortality and morbidity. ¹³¹I-DOX-NL was constructed based on bovine serum albumin (BSA)-tailor made hydrophobic maleimide-functionalized poly(ε-caprolactone) (PCL) (Fig. 1) and was evaluated by cellular viability in vitro and by U87 xenograft models in vivo. Compared with using ¹³¹I-NL or DOX-NL alone, our experimental results show that ¹³¹I-DOX-NL exhibits similar high cellular uptake but enhanced efficacy to cure gliomas because of its codelivery of ¹³¹I and DOX. In the U87 mouse tumor models, the combination therapy resulted in higher survival rates of mice and smaller tumor sizes than monotherapy did alone. In conclusion, multifunctional nanoliposome ¹³¹I-DOX-NL is a good candidate for the codelivery of ¹³¹I-mediated radiotherapy and DOX-mediated chemotherapy due to its ability to inhibit U87 cell proliferation and tumor growth. ¹³¹I-DOX-NL can be used as a promising effective therapy for malignant gliomas and deserves further investigation.