Amyloidosis is a systemic disorder produced by the deposition of insoluble protein fibrils that fold and deposit in the myocardium. Patients with amyloidosis and cardiac involvement have higher mortality than patients without cardiac involvement. The two most prevalent forms of amyloidosis associated with cardiac involvement are AL amyloidosis, due to the deposition of immunoglobulin light chains, and ATTR amyloidosis, due to the deposition of the transthyretin (TTR) protein in mutated or senile form. This article aims to review the different cardiac imaging modalities (echocardiography, cardiac magnetic resonance imaging, nuclear medicine and tomography) that allow to determine the severity of cardiac involvement in patients with amyloidosis, the type of amyloidosis and its prognosis. Finally, we suggest a diagnostic algorithm to determine cardiac involvement in amyloidosis adapted to locally available diagnostic tools, with a practical and clinical approach.
In the present research work, we investigated the use of the image intensifier in the extraction of radiopaque foreign bodies in traumatology. First of all, it is necessary to clarify that this method constitutes an essential component of practically generalized use, in which low current level radiation is used, that is, fluoroscopic radiation, so that it can be applied for a considerably longer time than that of the longest radiographic exposure. This tool works with a tube intended for this purpose, which is known as fluoroscopy. The radiations from the tube pass through the patient and reach the serigraph, on which the image intensifier or fluoroscopic screen is mounted. In the latter case, this is where the chain ends, since it is on this screen that the image is formed and where the physician directly observes the region to be studied. It is also necessary to define that a foreign body is any element foreign to the body that enters it, either through the skin or through any natural orifice such as the eyes, nose, throat, preventing its normal functioning. It was possible to obtain as a result that the advantages of fluoroscopic navigation are the reduction of surgical time and the amount of irradiation, which goes from about 140 seconds without navigation to only 8 seconds, which is a substantial difference. Among the conclusions, it was possible to highlight that in the case of a radiopaque object, it is essential to have an image intensifier for localization of the foreign body during surgery; while in the case of a radiolucent foreign body, it is more advisable to locate it through the clinic, since these tend to form granulomas.
Currently there is a great acceptance in medicine and dentistry that clinical practice should be “evidence-based” as much as possible. That is why multiple works have been published aimed at decreasing radiation doses in the different types of imaging modalities used in dentistry, since the greater effect of radiation, especially in children, forces us to take necessary measures to rationalize its use, especially with Cone Beam computed tomography (CBCT), the method that provides the highest doses in dentistry. This review was written using such an approach with the purpose of rationalizing the radiation dose in our patients. In order to formulate recommendations that contribute to the optimization of the use of ionizing radiation in dentistry, the SEDENTEXCT project team compiled and analyzed relevant publications in the literature, guidelines that have demonstrated their efficiency in the past, thus helping to see with different perspectives the dose received by patients, and with this, it is recommended taking into account this document so as to prescribe more adequately the complementary examinations that we use on a daily basis.
Background: Multiple sclerosis is often a longitudinal disease continuum with an initial relapsing-remitting phase (RRMS) and later secondary progression (SPMS). Most currently approved therapies are not sufficiently effective in SPMS. Early detection of SPMS conversion is therefore critical for therapy selection. Important decision-making tools may include testing of partial cognitive performance and magnetic resonance imaging (MRI). Aim of the work: To demonstrate the importance of cognitive testing and MRI for the prediction and detection of SPMS conversion. Elaboration of strategies for follow-up and therapy management in practice, especially in outpatient care. Material and methods: Review based on an unsystematic literature search. Results: Standardized cognitive testing can be helpful for early SPMS diagnosis and facilitate progression assessment. Annual use of sensitive screening tests such as Symbol Digit Modalities Test (SDMT) and Brief Visual Memory Test-Revised (BVMT-R) or the Brief International Cognitive Assessment for MS (BICAMS) test battery is recommended. Persistent inflammatory activity on MRI in the first three years of disease and the presence of cortical lesions are predictive of SPMS conversion. Standardized MRI monitoring for features of progressive MS can support clinically and neurocognitively based suspicion of SPMS. Discussion: Interdisciplinary care of MS patients by clinically skilled neurologists, supported by neuropsychological testing and MRI, has a high value for SPMS prediction and diagnosis. The latter allows early conversion to appropriate therapies, as SPMS requires different interventions than RRMS. After drug switching, clinical, neuropsychological, and imaging vigilance allows stringent monitoring for neuroinflammatory and degenerative activity as well as treatment complications.
The suspicion of mediastinal alterations, always includes in its initial study, the chest radiography. The identification of mediastinal alterations in the X-ray is a priority. The knowledge of the mediastinal references and the identification of their alterations allows the suspicion of a pathology specific to each of the mediastinal spaces. When the semiology of mediastinal lesions, their location and the three most frequent pathologies are taken into account, the possibility of having an etiological diagnosis increases[1]. This is a review article based on a detailed literature search, in which radiological mediastinal references are studied, with emphasis on the epidemiological data of each one of them.
Introduction: Given the heterogeneous nature and inherent complexity of forensic medical expertise, the expert (medical professional or related areas) must make the best use of the technical and technological tools at his disposal. Imaging, referring to the set of techniques that allow obtaining images of the human body for clinical or scientific purposes, in any of its techniques, is a powerful support tool for establishing facts or technical evidence in the legal field. Objective: To analyze the use of magnetic resonance and computed tomography in postmortem diagnosis. Methodology: information was searched in the databases PubMed, Science Direct, Springer Journal and in the search engine Google Scholar, using the terms “X-Ray Computed Tomography”, “Magnetic Resonance Spectroscopy”, “Autopsy” and “Forensic Medicine” published in the period 2008–2015. Results: MRI is useful for the detailed study of soft tissues and organs, while computed tomography allows the identification of fractures, calcifications, implants and trauma. Conclusions: In the reports found in the literature search, regarding the use of nuclear magnetic resonance and computed tomography in postmortem cases, named by the genesis of the trauma, correlation was found between the use of imaging and the correct expert diagnosis at autopsy.
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