Vascular access in hemodialysis is one of the pillars of success of the program. Therefore, efforts should be directed firstly to achieve the greatest number of vascular accesses of the arteriovenous fistula type, and secondly to reduce complications related to access cannulation in order to functionally preserve the access. Several strategies have been described to improve this last aspect; this article describes the use of ultrasound to improve the probability of successful cannulation in cases considered difficult by the nursing team.
Cardiovascular imaging analysis is a useful tool for the diagnosis, treatment and monitoring of cardiovascular diseases. Imaging techniques allow non-invasive quantitative assessment of cardiac function, providing morphological, functional and dynamic information. Recent technological advances in ultrasound have made it possible to improve the quality of patient treatment, thanks to the use of modern image processing and analysis techniques. However, the acquisition of these dynamic three-dimensional (3D) images leads to the production of large volumes of data to process, from which cardiac structures must be extracted and analyzed during the cardiac cycle. Extraction, three-dimensional visualization, and qualification tools are currently used within the clinical routine, but unfortunately require significant interaction with the physician. These elements justify the development of new efficient and robust algorithms for structure extraction and cardiac motion estimation from three-dimensional images. As a result, making available to clinicians new means to accurately assess cardiac anatomy and function from three-dimensional images represents a definite advance in the investigation of a complete description of the heart from a single examination. The aim of this article is to show what advances have been made in 3D cardiac imaging by ultrasound and additionally to observe which areas have been studied under this imaging modality.
The present work shows an application of the Chan-Vese algorithm for the semi-automatic segmentation of anatomical structures of interest (lungs and lung tumor) in 4DCT images of the thorax, as well as their three-dimensional reconstruction. The segmentation and reconstruction were performed on 10 CT images, which make up an inspiration-expiration cycle. The maximum displacement was calculated for the case of the lung tumor using the reconstructions of the onset of inspiration, the onset of expiration, and the voxel information. The proposed method achieves appropriate segmentation of the studied structures regardless of their size and shape. The three-dimensional reconstruction allows us to visualize the dynamics of the structures of interest throughout the respiratory cycle. In the future, it is expected to have more evidence of the good performance of the proposed method and to have the feedback of the clinical expert, since the knowledge of the characteristics of anatomical structures, such as their dimension and spatial position, helps in the planning of Radiotherapy (RT) treatments, optimizing the radiation dose to cancer cells and minimizing it in healthy organs. Therefore, the information found in this work may be of interest for the planning of RT treatments.
The human brain has been described as a complex system. Its study by means of neurophysiological signals has revealed the presence of linear and nonlinear interactions. In this context, entropy metrics have been used to uncover brain behavior in the presence and absence of neurological disturbances. Entropy mapping is of great interest for the study of progressive neurodegenerative diseases such as Alzheimer’s disease. The aim of this study was to characterize the dynamics of brain oscillations in such disease by means of entropy and amplitude of low frequency oscillations from Bold signals of the default network and the executive control network in Alzheimer’s patients and healthy individuals, using a database extracted from the Open Access Imaging Studies series. The results revealed higher discriminative power of entropy by permutations compared to low-frequency fluctuation amplitude and fractional amplitude of low-frequency fluctuations. Increased entropy by permutations was obtained in regions of the default network and the executive control network in patients. The posterior cingulate cortex and the precuneus showed differential characteristics when assessing entropy by permutations in both groups. There were no findings when correlating metrics with clinical scales. The results demonstrated that entropy by permutations allows characterizing brain function in Alzheimer’s patients, and also reveals information about nonlinear interactions complementary to the characteristics obtained by calculating the amplitude of low frequency oscillations.
Introduction: the presence of anti-CCP is an important prognostic tool for rheumatoid arthritis (RA), but its relationship with the activity of the disease and functional capacity is still being investigated. Objectives: to study the relationship between anti-CCP and the indices of disease activity, functional capacity and structural damage, by means of conventional radiography (CR) and magnetic resonance imaging (MRI), in stabilized RA. Methods: cross-sectional study of RA patients with one to 10 years of disease. The participants were subjected to clinical evaluation with anti-CCP screening. Disease activity was assessed by means of the Clinical Disease Activity Index (CDAI) and functional capacity by means of the Health Assessment Questionnaire (HAQ). CR was analyzed by the Sharp van der Heijde index (SmvH) and MRI by the Rheumatoid Arthritis Magnetic Resonance Image Scoring System (RAMRIS). Results: 56 patients were evaluated, with median (IIq) of 55 (47.5–60.0) years, 50 (89.3%) were female among whom 37 (66.1%) were positive for anti-CCP. The median (IIq) of CDAI, HAQ, SmvH and RAMRIS were 14.75 (5.42–24.97), 1.06 (0.28–1.75), 2 (0–8) and 15 (7–35), respectively. There was no association between anti-CCP and CDAI, HAQ, SmvH and RAMRIS. Conclusion: our results did not establish the association of anti-CCP with the severity of the disease. So far, we cannot corroborate the anti-CCP as a prognostic tool in RA established.
The optimized methodology and results of the new characterization in terms of dose and image quality of the X-ray system used in the main pediatric hemodynamics service in Chile are presented. In addition, scattered dose rate values at the operator’s eye level are reported for all acquisition modes available in different thicknesses of absorbent media and angiography. The characterization was performed according to the European DIMOND and SENTINEL protocols adapted to pediatric procedures. The air kerma at the entrance surface (ESAK) was measured and the image quality parameters signal-to-noise ratio (SNR) and a figure of merit (FOM) were calculated. The scattered dose rate was measured in personal dose equivalent units. The ESAK for fluoroscopic modes ranged from 0.2 to 35.6 μGy/image when passing from 4 to 20 cm of polymethyl methacrylate (PMMA). For the cine mode, these values ranged from 2.8 to 160.1 μGy/image. The values of the image quality parameters showed a correct system configuration, although abnormal values were observed in the medium fluoroscopic mode. As for the scattered dose rate at the level of the cardiologist’s eyes, the highest value is PMMA with a thickness of 20 cm, where the cine mode reached 9.41 mSv·h-1. The differences found from previous evaluations can be explained by the deterioration of the system and the change of one of the X-ray tubes.
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