Myocardial infarct size quantification by MR imaging early after coronary artery occlusion in dogs

The feasibility of using magnetic resonance (MR) imaging to estimate myocardial infarct size was explored in an in vitro model using only the inherent differences in contrast between infarcted and noninfarcted myocardium. Eight dogs underwent coronary occlusion; their hearts were removed 6 hours later. Estimates of T2 for normal and infarcted myocardium were derived from MR images. Infarct size was quantified anatomically using triphenyltetrazolium-chloride (TTC) staining and compared with MR estimates. The T2 values derived from the images clearly discriminated between infarcted (126 +/- 22 msec) and normal myocardium (88 +/- 10 msec, P less than .05), providing images with good contrast between normal and infarcted myocardium. Comparable differences in T2 values were also noted from spectrometric determinations. Estimates of infarct size by MR imaging compared well with TTC estimates (r = 0.98) over a wide range of infarct sizes from 3% to 29% of the left ventricular mass. These results suggest the potential for in vivo quantification of infarct size based on the inherent contrast difference between infarcted and normal myocardium.     

Heterogeneity of glomerular size in normal donor kidneys: impact of race

Glomerular size has been the subject of many studies and, in a number of settings, has a direct association with the development of glomerular sclerosis. However, the normal distribution of glomerular size has not been thoroughly evaluated in the general population in the United States. To address this issue, we analyzed the baseline biopsy specimens of 103 human donor kidneys to determine the maximal planar area (MPA) of the glomerular tuft in a heterogeneous human population. The MPA of each glomerulus was determined by measurement of sections through the vascular pole and/or origin of the proximal tubule, and was determined on each section by two methods: point counting and computer planimetry. There was very high agreement between these two methods. Multivariate analysis was used to identify significant correlates with MPA. Overall, younger donors had smaller glomeruli (P < 0.0001). Black donors had a larger MPA (23.4+/-8.6 mm2 x 10(-3)) than white donors (17.9+/-6.7 mm2 x 10(-3); P < 0.001), independent of donor age. MPA was not significantly different between genders. This heterogeneity in glomerular size may confound clinical studies if not recognized and may help explain differences in glomerular structure and function in response to injurious processes.     

DIFFICULTIES AND DILEMMAS IN THE MANAGEMENT OF CONGENITAL ANOMALIES IN TWIN PREGNANCY

Both the incidence of twin pregnancy and the demand for prenatal diagnosis are increasing. Unfortunately, biochemical screening and ultrasound scanning are less reliable for prenatal diagnosis in twin pregnancies than in singletons. Amniocentesis and chorionic villous biopsy are usually diagnostic in singleton pregnancies but may be marred by sampling errors in twin gestations. Where a congenital anomaly has been diagnosed in a twin pregnancy, difficult decisions may have to be made, especially if one twin is unaffected. In these cases, special skills are required to ensure that adequate information, psychological support and optimal medical care are provided.     

People with vascular ulcers in outpatient nursing care: a study of sociodemographic and clinical variables

The aim of this study was to analyze the sociodemographic and clinical characteristics of people with vascular ulcers and to investigate the association between these variables. This cross-sectional, observational clinical study was conducted in outpatient clinics from February to August 2009. Interview, clinical exam, Pressure Ulcer Scale Healing and photographic registry of the wounds were performed. Forty-two individuals participated who were, on average, 60 (± 12) years old, 73.8% males, with single wounds (66.7%) resulting from alterations in venous circulation (90.5%). Their wounds had lasted for up to one year (55.5%). There was an association between the PUSH score (p=0.019) and depth of wound (p=0.027) with currently performing occupational activity, as well as between history of tobacco use and gender (p=0.049). The sociodemographic characteristics that were observed were similar to the others, except for being male, which indicates the need for more studies in the population in Goiania, Brazil.     

History of the scientific field of Food and Nutrition in Public Health in Brazil

This paper aims to trace the history of the scientific field of Food and Nutrition in Public Health in Brazil (FNPH), trying to describe the contexts that allowed the construction, consolidation and redefinition of the field, to identify the Brazilian scientists who contributed to this process and address the scientific concepts or paradigms that guided the actions of these scientists. As methodological criteria of analysis three cross sections corresponding to contexts of history in this field were established: the first one covers the period from 1930 to 1963, the second one between 1964 and 1984 and the third one considers the period from 1985 to 2010. We conclude that the field of FNPH assumed the current configuration from the mid-1970's, within the so-called Brazilian health movement, whose main ideas were the achievement of health reform and the construction of the Unified Health System. We reaffirm the importance of multidisciplinary character and the premise of the important role of the field of FNPH in ensuring the human right to healthy food, a component of the set of conditions necessary for health promotion, disease prevention, surveillance and health recovery and improvement of quality of life for all Brazilians.     

Pushing the limits of liver surgery for colorectal liver metastases:Current state and future directions

Liver surgery for the treatment of colorectal liver metastases is the standard treatment in a dynamic surgical field with many variables that should be considered in a curative intent scenario. Hepatectomy for colorectal liver metastases has undergone constant changes over the last 30 years, including indications until the need for rescue procedures of recurrent and advanced diseases as well as minimally invasive surgery. These advancements in liver surgery have not only resulted from overall improvements in the surgical field but have also resulted from a better understanding of the biological behavior of the disease, liver regeneration, and homeostasis during and after surgery.Improvements in anesthesiology, intensive care medicine, radiology, and surgical devices have correlated with further advancements of hepatectomies. Moreover,changes are still forthcoming, and both fields of augmented reality and artificial intelligence will likely have future contributions in this field in regard to both diagnoses and the planning of procedures. The aim of this editorial is to emphasize several aspects that have contributed to the paradigm shifts in colorectal liver metastases surgery over the last three decades as well as to discuss the factors concerning patient selection and the technical aspects of liver surgery. Finally, this editorial will highlight the promising new features of this surgery for diagnoses and treatments in this field.