43 research outputs found
Potential impact of body composition analysis by dual-energy x-ray absorptiometry on clinical decision making
No full textPotential impact of body composition analysis by dual-energy x-ray absorptiometry on clinical decision making
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The Role of ultrasonography in the evaluation of visceral fat: analysis of technical and methodological issues
No full textObjective: Sonography is one of the most suitable tools for the evaluation of abdominal adiposity and the differential assessment of subcutaneous and visceral fat. Its accuracy has been validated by several studies. However, the reliability of sonography in the evaluation of abdominal adiposity remains a matter of debate, with values of inter- and intraoperator reproducibility varying significantly, depending on studies. This could result from different methodologic and technical variables; nevertheless, studies evaluating the influence of technical issues on sonographic measurement accuracy and reliability are almost completely missing. Our goal was to analyze how much patient breathing, abdominal distension, and the use of different equipment could modify the values of abdominal adiposity evaluated by sonography and to identify and to describe the technical protocol with the highest inter- and intraoperator reliability.
Materials and Methods: We prospectively enrolled 30 patients (15 women, 15 men; mean age ± SD, 32.7 ± 4.2 years old; body mass index, 25.6 ± 2.1 kg/m2) divided into three groups of 10 patients (five women and five men). Seven main parameters representative of subcutaneous and visceral fat were independently measured by two expert radiologists. Patients of group A underwent sonography before and 45 min after a standardized lunch. Patients of group B underwent sonography during inspiration and 30 min later during expiration. Patients of group C were analyzed with two ultrasound machines of different generations. Data collected with different conditions were compared (?, ?2, Student t test). The Lin correlation coefficient (p) was used to assess reliability.
Results: Intraabdominal fat and aortomesenteric thickness, two visceral fat indexes, showed important variations in group A and group B, (mean ?, 24.3% ± 22.9% and 28.5% ± 38.45%, respectively), with relevant statistical significance (p < 0.0001 and < 0.005). No significant variation was observed in group C, notwithstanding the large technologic gap between the two machines. Reliability was good to excellent for all considered indexes (p range, 0.75–0.98) and in all conditions, even if slightly better values were observed for intraabdominal fat during expiration and without abdominal distension (groups A and B).
Conclusion: Our study results indicate a need for standardization of the methods used for the sonographic evaluation of abdominal adiposity. Our data showed that changes in the methods used could lead to a variation of up to 20% of values commonly taken as markers of visceral fat, leading to an unacceptable lack of reliability in sonographic measurements of abdominal adiposity
Vertebral Fractures of Unknown Origin: Role of Computed Tomography-Guided Biopsy.
No full textBackground:
We performed a retrospective evaluation of histological and imaging results of patients submitted to computed tomography (CT)-guided biopsy for vertebral fractures (VFs) of unknown etiology to evaluate the pathological causes of fractures and also to observe the diagnostic results of imaging studies available.
Methods:
We retrospectively reviewed all the CT-guided vertebral biopsies performed in our institution in the last 2 years, selecting patients with VF of unknown etiology. We reviewed clinical records, imaging studies, and histological examination results. We compared diagnostic performance of the 2 most sensitive imaging modalities for detection of malignancy on the collapsed vertebral body: magnetic resonance imaging (MRI) and positron emission tomography-CT (PET-CT). Anatomopathological results have been considered the gold standard to assess the diagnostic performance of imaging studies. Age stratification has been performed to understand the distribution of different anatomopathological diagnoses in age groups.
Results:
Among 282 CT-guided vertebral biopsies, 36 (12.8%) have been performed to diagnose the etiology of VF of unknown origin. In 26/32 (81.3%), the vertebral biopsy was diagnostic: 8 osteopenia, 6 multiple myelomas, 4 osteomyelitis, 2 eosinophilic granuloma, 3 metastases, 1 mastocytosis, 1 Paget's disease, and 1 dysmielopoiesis. In 6 cases, the anatomopathological diagnosis was normal bone structure, most likely excluding malignancy. There were no statistically significance differences between MRI and PET-CT results (P = 1.0000).
Conclusions:
Multiple myeloma and osteopenia represent the most frequent causes of this condition in adult patients, while eosinophilic granuloma and osteomyelitis in pediatric patients. Computed tomography-guided biopsy permits one to reach diagnosis in most of cases. Both PET and MRI could be insufficient to discriminate benign from malignant causes of fractures. Computed tomography-guided biopsy is needed when the etiology of fracture remains unclea
Vertebral fracture assessment and morphometry by new dual-energy X-ray absorptiometry equipments: accuracy, reproducibility and time consumption
No full textLa valutazione ecografica dell’adiposità addominale: analisi dei parametri tecnici di esecuzione e della strumentazione.
No full textAssociation of dopamine transporter and monoamine oxidase molecular polymorphisms with sudden infant death syndrome and stillbirth : new insights into the serotonin hypothesis
No full textRecent findings demonstrated the role of neurotransmitters in the aetiopathogenesis of sudden unexpected deaths in infancy. Although genes involved in serotonin metabolism have been proposed as risk factors for sudden infant death syndrome (SIDS), the contribution of additional neurotransmitters and genes different from the serotonin transporter (SLC6A4, 5-HTT) has not been investigated. Considering the common metabolic pathway and synergism between dopamine and serotonin, the role of dopamine transporter (SLC6A3, DAT) and monoamine oxidase A (MAOA) genes in SIDS and stillbirth (sudden intrauterine unexplained death, SIUD) was investigated. Genotypes and allelic frequencies of DAT and MAOA were determined in 20 SIDS and five stillbirth cases and compared with 150 controls. No association was found between DAT polymorphisms and SIDS either at genotype (P = 0.64) or allelic (P = 0.86) level; however, a highly significant association was found between MAOA genotypes (P = 0.047) and alleles (P = 0.002) regulating different expression patterns (3R/3R vs 3.5R/3.5R + 4R/4R) in SIDS + SIUD and controls. Analysis of combined 5-HTTLPR (serotonin transporter linked polymorphic region)/MAOA genotypes revealed that frequency of L/L-4R/4R genotype combination was eightfold higher in SIDS + SIUD than in controls (P < 0.001). Findings are discussed considering the metabolic association among DAT, 5-HTT and MAOA with special emphasis on the linked action of 5-HTT/MAOA in regulating serotonin metabolism of SIDS and SIUD infants
Effects of Pleistocene to Holocene seismicity on the landforms and fluvial-lacustrine sequences of the Ixtlahuaca paleobasin, and their possible relation with the Acambay graben: Implications for the seismic hazard assessment of Central Mexico
No full textWe mapped Plio-Pleistocene lake deposits in the Ixtlahuaca paleobasin in Central Mexico, located 51 km south of the Acambay Graben and 69 km west of Mexico City. Within the Acambay basin, Pleistocene to Holocene lake sediments record primary and secondary 25 environmental effects of strong local earthquakes as a consequence of Quaternary activity of the major normal border faults. Likewise, the Ixtlahuaca paleobasin has been controlled mainly by the Quaternary evolution of the Perales and Ixtlahuaca faults, even if there is no record of local historical earthquakes, and therefore the area has not been considered as potentially seismic. However, the application of the ESI 2007 Scale to deformation structures as effects of seismic events on the geological-natural environment in the Tierras Blancas - San Bartolo Lanzados basins and San Pedro El Alto, within the Acambay graben, and its comparison with seismites identified in the Ixtlahuaca paleobasin, show that past earthquakes similar to the Mw 6.5 to 7 surface faulting events generated by the main faults of the Acambay graben have also occurred in the Ixtlahuaca area
