Fluoroscopia por tomografia computadorizada - biópsia percutânea guiada de nódulos pulmonares ≤ 10 mm: análise retrospectiva de procedimentos realizados no período de pandemia de COVID-19

Resumo Objetivo: Avaliar o desempenho diagnóstico da biópsia pulmonar percutânea transtorácica (BPPT) guiada por fluoroscopia associada a tomografia computadorizada (FTC) em nódulos pulmonares ≤ 10 mm no período de pandemia de COVID-19. Materiais e Métodos: No período de 1º de janeiro de 2020 a 30 de abril de 2022, 359 BPPTs guiadas por FTC foram realizadas em um centro terciário de radiologia intervencionista. As lesões pulmonares mediam entre 2 mm e 108 mm. Dessas 359 BPPTs, 27 (7,5%) foram realizadas com agulha 18G em nódulos de 2 mm a 10 mm. Resultados: Das 27 BPPTs realizadas nos nódulos ≤ 10 mm, quatro lesões tinham dimensões menores que 5 mm e 23 lesões mediam entre 5 e 10 mm. Sensibilidade e acurácia diagnóstica das BPPTs guiadas por FTC foram de 100% e 92,3%, respectivamente. A dose média de radiação ionizante para os pacientes durante o procedimento de BPPT guiada por FTC foi de 581,33 mGy*cm, variando de 303 a 1129 mGy*cm. A média de tempo dos procedimentos de biópsia foi de 6,6 minutos, variando de 2 a 12 minutos. Nas 27 BPPTs, nenhuma complicação maior foi descrita. Conclusão: A BBPT guiada por FTC resultou em alto rendimento diagnóstico e baixas taxas de complicações.

Computed tomography fluoroscopy-guided percutaneous biopsy of pulmonary nodules ≤ 10 mm: retrospective analysis of procedures performed during the COVID-19 pandemic

Objective

To evaluate the diagnostic performance of computed tomography (CT) fluoroscopy-guided percutaneous transthoracic needle biopsy (PTNB) in pulmonary nodules ≤ 10 mm during the coronavirus disease 2019 pandemic.

Materials and Methods

Between January 1, 2020 and April 30, 2022, a total of 359 CT fluoroscopy-guided PTNBs were performed at an interventional radiology center. Lung lesions measured between 2 mm and 108 mm. Of the 359 PTNBs, 27 (7.5%) were performed with an 18G core needle on nodules ≤ 10 mm in diameter.

Results

Among the 27 biopsies performed on nodules ≤ 10 mm, the lesions measured < 5 mm in four and 5-10 mm in 23. The sensitivity and overall diagnostic accuracy of PTNB were 100% and 92.3%, respectively. The mean dose of ionizing radiation during PTNB was 581.33 mGy*cm (range, 303-1,129 mGy*cm), and the mean biopsy procedure time was 6.6 min (range, 2-12 min). There were no major postprocedural complications.

Conclusion

CT fluoroscopy-guided PTNB appears to provide a high diagnostic yield with low complication rates.

The effect of platelet-rich plasma on the repair of muscle injuries in rats

Objective

The need for therapeutic options for muscle injuries, which are increasingly frequent among sports practitioners, was the motivation for this experimental study, which had the aim of evaluating the histological effects of platelet-rich plasma (PRP) on repairs to muscle tissues of rats.

Methods

PRP was obtained by means of double centrifugation of blood from five animals. In 30 rats, an injury was produced in the middle third of the belly of the gastrocnemius muscle of each hind limb. These injuries did not receive any treatment in six rats (12 legs). In 24 rats, 0.9% physiological serum was injected into the injury in the left leg and PRP into the injury in the right leg. Samples from the treated and untreated tissue were evaluated histologically 7 and 21 days after the procedures.

Results

The quantity of collagen in the injuries treated with PRP was significantly lower than that in the other injuries, in the evaluation made 7 days after the procedure, but it became equal to the other groups in the evaluation done on the 21st day. There was a significant increase (p < 0.001) in the quantity of collagen from the 7th to the 21st day in the injuries treated with PRP, but this was not seen in the injuries treated using other methods. The inflammatory process was shown to be more intense in the injuries treated with PRP than in the injuries of the other treatment groups, in the evaluation done 7 days after the procedure. However, the morphological aspects of these injuries were seen to be similar to those of the untreated injuries, 21 days after the procedure.

Conclusion

PRP promoted complete tissue restitution between the 7th and 21st days in experimental muscle injuries.

[Insufficient loss of weight and/or absence of DM2 remission after Roux-en-Y gastric bypass: factors that may influence the unsatisfactory results]

BACKGROUND

Roux-en-Y gastric by-pass is considered one of the most effective treatments for maintaining long-term weight loss. However, it is associated to failures manifested by the inability to maintain weight loss, weight gain or poor glycemic control.

OBJECTIVE

Study the possible factors that influence weight loss failure and/or DM2 remission.

METHODS

Case-control study of 159 patients submitted to gastric by-pass two or more years postoperatively. Twenty-four individuals with unsatisfactory weight loss and/or DM2 remission were selected as cases and 24 with satisfactory weight loss and/or absence of DM2 remission as controls, matched for age and postoperative time.

RESULTS

Of the 24 cases and controls evaluated, the percentage weight gain was 19.32% and 8.68%, percentage DM2 remission 26.6% and 87.5% and percentage DM2 recurrence 6.6% and 0.0%, respectively. Cases and controls exhibited mean maximum preoperative BMI of 53.50±12.24 kg/m2 and 48.77±5.19 kg/m2, respectively. These values were statistically significant in terms of poor weight management or failed surgery.

CONCLUSION

Patients with elevated initial maximum BMI (≥ 50kg/m2) displayed higher weight loss failure rates. Food intolerance and socioeconomic differences are considered factors in weight gain.

Obesidade em pacientes candidatos a cirurgia bariátrica

OBJETIVO: Estudar a obesidade grau III ou grave, identificando o perfil demográfico, clínico e as doenças de maior ocorrência, em pacientes atendidos na consulta de enfermagem, candidatos a cirurgia bariátrica do Núcleo do Hospital Universitário da Universidade Federal de Mato Grosso do Sul. MÉTODOS: Trata-se de um estudo descritivo, com análise dos registros em 252 prontuários dos pacientes atendidos no Programa de Cirurgia Bariátrica do Núcleo do Hospital Universitário da Universidade Federal de Mato Grosso do Sul, entre 2004 a 2007. RESULTADOS: A prevalência crescente de sobrepeso e obesidade está associada a doenças crônicas relacionadas à dieta (comorbidades). Dos 252 pacientes atendidos 80,15% eram do sexo feminino; a média da idade foi de 36,07±10,16 anos; quanto à etnia 86,53% eram brancos, 8,57% pardos e 4,90% negros; houve predomínio das comorbidades: hipertensão arterial (63,49%), dispnéia (55,56%), varizes de membros inferiores (45,63%) e depressão (36,51%). CONCLUSÃO: observa-se que a doença de maior ocorrência na obesidade é a hipertensão arterial, devendo o paciente ser acompanhado por uma equipe multidisciplinar.