Alexandra Maria Vieira Monteiro

Abdominal adiposity, insulin and bone quality in young male rats fed a high-fat diet containing soybean or canola oil

OBJECTIVES: A low ratio of omega-6/omega-3 polyunsaturated fatty acids is associated with healthy bone properties. However, fatty diets can induce obesity. Our objective was to evaluate intra-abdominal adiposity, insulin, and bone growth in rats fed a high-fat diet containing low ratios of omega-6/omega-3 provided in canola oil. METHODS: After weaning, rats were grouped and fed either a control diet (7S), a high-fat diet containing soybean oil (19S) or a high-fat diet of canola oil (19C) until they were 60 days old. Differences were considered to be significant if p<0.05. RESULTS: After 60 days, the 19S and 19C groups showed more energy intake, body density growth and intra-abdominal fat mass. However, the 19S group had a higher area (200%) and a lower number (44%) of adipocytes, while the 7S and 19C groups did not differ. The serum concentrations of glucose and insulin and the insulin resistance index were significantly increased in the 19C group (15%, 56%, and 78%, respectively) compared to the 7S group. Bone measurements of the 19S and 19C groups showed a higher femur mass (25%) and a higher lumbar vertebrae mass (11%) and length (5%). Computed tomography analysis revealed more radiodensity in the proximal femoral epiphysis and lumbar vertebrae of 19C group compared to the 7S and 19S groups. CONCLUSIONS: Our results suggest that the amount and source of fat used in the diet after weaning increase body growth and fat depots and affect insulin resistance and, consequently, bone health.

Videoconferências: sistematização e experiências em telemedicina

Telemedicine refers to the delivery of health care services over a distance. Videoconference is one of the different modalities of telemedicine, allowing real-time interaction. The present study is aimed at describing videoconference systems in a simplified way, focusing on their application in telemedicine. Videoconference involves the necessity of equipment for audio and video capture and reproduction, besides a communication link for connection with similar equipment through ISDN (integrated services digital network) or IP (internet protocol). Video and audio quality is essential for the success of a videoconference. Experiments using videoconferencing equipment in radiology and other fields of medicine are a reality at international level. In Brazil, reports account for some isolated initiatives in this field, most of them involving universities networks. Besides its remarkable impact on costs of medical care delivery for the population, videoconference represents an invaluable tool for physicians in their education and knowledge updating.

Telemedicine and Pediatric Radiology: A New Environment for Training, Learning, and Interactive Discussions

OBJECTIVE To report the experience of the Brazilian Program of Pediatric Teleradiology in combining teleconferencing and a virtual learning environment for services integration, collaborative research, and continuing education in pediatric radiology. MATERIALS AND METHODS We performed virtual meetings from March 2005 to October 2010 on pediatric radiology-related themes, using a combination of videoconferences and Web conferences, which were recorded and made available in an open-source software (Moodle) for reuse. RESULTS We performed 58 virtual sessions: 29 anatomical-clinical-radiological sessions, 28 on upgrading themes, and 1 virtual symposium. The average of connected points was 12 by videoconference and 39 by Web conference, and of 450 participants per event. At the time of this writing, 318 physicians and students are registered in the virtual learning environment, with a total of 14,678 accesses. CONCLUSIONS Telemedicine is being included in pediatric radiology practice, as a means for distance education, training, and continuing integration between groups.

Digitalização de filmes radiográficos com costura de imagens

OBJECTIVE: To propose a reproducible, user friendly and low cost method for digitization of radiographic films of all the standard sizes, focusing efforts on chest X-ray films. MATERIALS AND METHODS: The focus on low cost have dictated the use of an A4 scanner with transparency adapter, as well as an optimized image stitching software that takes advantage of the scanner geometry and constant capture area, besides the knowledge of the standard X-ray film sizes. RESULTS: The end result of the proposed method is a high resolution image with good contrast and no perceptible stitching artifacts. CONCLUSION: The proposed digitization method with an A4 scanner allows reproducibility, excellent image quality and high degree of certainty in the identification of lesions.

Is there any influence of breastfeeding on the cerebral blood flow? A review of 256 healthy newborns

OBJECTIVE: To investigate whether breastfeeding influence the cerebral blood-flow velocity. MATERIALS AND METHODS: The present study included 256 healthy term neonates, all of them with appropriate weight for gestational age, 50.8% being female. Pulsatility index, resistance index and mean velocity were measured during breastfeeding or resting in the anterior cerebral artery, in the left middle cerebral artery, and in the right middle cerebral artery of the neonates between their first 10 and 48 hours of life. The data were analyzed by means of a paired t-test, Briegers f-test for analysis of variance and linear regression, with p < 0.01 being accepted as statistically significant. RESULTS: Mean resistance index decreased as the mean velocity increased significantly during breastfeeding. Pulsatility index values decreased as much as the resistance index, but in the right middle cerebral artery it was not statistically significant. CONCLUSION: Breastfeeding influences the cerebral blood flow velocities.

Diagnóstico por imagem e aspectos clínicos da trombose venosa cerebral em recém-natos a termo sem dano cerebral: revisão em 10 anos

OBJECTIVE: To describe and compare imaging methods and clinical findings of cerebral venous thrombosis in four full-term neonates without brain damage, admitted to a neonatal intensive care unit. MATERIALS AND METHODS: Ten-year review of four cases diagnosed with cerebral venous thrombosis by transfontanellar ultrasonography associated with Doppler fluxometry and confirmed by magnetic resonance imaging/magnetic resonance angiography in correlation with clinical findings and neurological progression. RESULTS: Ultrasonography presented normal results in 75% of cases and magnetic resonance imaging in 100%. Doppler fluxometry and magnetic resonance angiography were abnormal in 100% of cases. Hypoxia (100%) and early seizures (100%) were predominant among clinical findings with evoked potential changes in 50% of cases. In the assessment of the neurodevelopment all the areas remained within normality parameters up to the conclusion of the present study. CONCLUSION: Ultrasonography in association with Doppler can identify changes related to cerebral venous thrombosis and should be complemented with magnetic resonance imaging that is the gold standard for diagnosis in these cases.

Relação entre índice de resistência obtido pela ultra-sonografia Doppler transfortanela e o neurodesenvolvimento até o primeiro ano de vida em recém-nascidos a termo com encefalopatia hipóxico-isquêmica leve e moderada

OBJECTIVE To evaluate the relation between the resistance index (RI) obtained by transfontanellar Doppler ultrasonography, and the neurodevelopment until one year of life, at term newborns with mild or moderate hypoxic-ischaemic encephalopathy due to intrapartum asphyxia. METHOD 20 term newborns, with mild or moderate hypoxic-ischemic encephalopathy, high values of resistance index in the first exam, and without cerebral morfologic abnormalities or other diseases. They were submitted to serial bimonthly transfontanellar Doppler ultrasonography, from the seventh day of life on, and monthly clinical neurodevelopment assessment until one year of life. RESULTS There was a progressive normalization of RI values until the last examination. In five cases there were clinical neurologic normalization in the neonatal period after the first Doppler exam. Fifteen infants presented neurologic abnormalities, with normalization after the second trimester of life. CONCLUSION There was a relation between the normal RI values with the normalization of the clinical assessment.

Association between cardiovascular risk factors and carotid intima-media thickness in prepubertal Brazilian children

Abstract Background: Early exposure to cardiovascular risk factors creates a chronic inflammatory state that could damage the endothelium followed by thickening of the carotid intima-media. Objective: To investigate the association of cardiovascular risk factors and thickening of the carotid intima. Subjects/Methods: Media in prepubertal children. In this cross-sectional study, carotid intima-media thickness (cIMT) and cardiovascular risk factors were assessed in 129 prepubertal children aged from 5 to 10 year. Association was assessed by simple and multivariate logistic regression analyses. Results: In simple logistic regression analyses, body mass index (BMI) z-score, waist circumference, and systolic blood pressure (SBP) were positively associated with increased left, right, and average cIMT, whereas diastolic blood pressure was positively associated only with increased left and average cIMT (p<0.05). In multivariate logistic regression analyses increased left cIMT was positively associated to BMI z-score and SBP, and increased average cIMT was only positively associated to SBP (p<0.05). Conclusions: BMI z-score and SBP were the strongest risk factors for increased cIMT.

A medicina de bolso

mHealth, ou “medicina movel”, e um tema, em geral, associado no cotidiano mais diretamente ao uso de aparelhos celulares ou tablets. Uma tendencia universal de convergencia de todas as informacoes e imagens dos pacientes, bancos de dados como fonte de informacao, redes sociais academicas, suporte remoto especializado e afins, como apoio a pratica do medico e ao ensino da medicina. Alem, e claro, da possibilidade de acesso, pelos pacientes, aos seus laudos, exames e agendamentos. No entanto, outras tecnologias de baixo custo podem ser utilizadas, como o Raspberry Pi, um computador do tamanho de um cartao de credito desenvolvido no Reino Unido pela Fundacao Raspberry Pi (1) . Este projeto teve como base facilitar e estimular o ensino da ciencia da computacao para criancas naquele pais, uma ciencia que estuda tecnicas, metodos e instrumentos computacionais, que automatiza processos e desenvolve solucoes baseadas no uso do processamento diRadiol Bras. 2014 Mar/Abr;47(2):IX mHealth, or mobile health is a term associated with the daily practice of medicine and public health supported by mobile devices such as cell phones and tablets. It is an universal trend of convergence of all patients’ information and images, data banks as source of information, academic social networks, specialized remote support systems and alike, as a support to the medical practice and to the teaching of medicine. Additionally there is the possibility of access by patients to their reports, tests results and schedules. However, other low-cost technologies are available, such as Raspberry Pi, a credit-card-sized computer developed in the United Kingdom by the Raspberry Pi Foundation. Such project was aimed at facilitating and encouraging the teaching of computer sciences for children in that country, and involving the study of computer techniques, methods and tools, processes automation and development of solutions based on the use of digital processing. The suc-

Worldwide Pediatric Radiology Network (RADPED) in Brazil: growth of telemedicine and the global exchange of knowledge

The Worldwide Pediatric Radiology Network (RADPED) was created in Brazil in May 2006 by a pioneering initiative of scientific–technical cooperation among three universities in three Brazilian states. Since then, with support from the Brazilian federal government and in cooperation with Brazilian universities, the network has been expanded to include Brazilian university hospitals (Brazilian Telemedicine University Network) and basic health units located in remote areas (Telehealth Brazil Networks Program). For communicating on this network, Web conferencing and video conferencing are both used, expanding the coverage and allowing all remote participants to interact via chat or via audio and image. For remote participation no specific equipment is required and the minimum demanded speed is 256 kbps. The combination of Web and video conferencing is achieved through the capture of the audio (using the sound board) and video codec (using a capture card), which are sent to a workstation and distributed to the points connected to the Web conference. Since its inception 82 monthly teleconferences have been held interspersing discussion of clinical cases, anatomical and clinical sessions and lessons updates, and virtual seminars on thematic issues including childhood urinary dysfunction, liver transplantation and imaging in oncology. All virtual meetings have been recorded and are available for reuse in the virtual learning environment of the Telehealth Center at Rio de Janeiro State University, Brazil [1]. The target audience consists of graduate students in medicine, medical residents, general physicians, radiologists and pediatric radiologists. For foreign speakers, translation is performed to facilitate the exchange of ideas among all groups. Each tele-session includes about 575 participants at 38 sites connected simultaneously in several countries (Fig. 1). Telemedicine is changing paradigms for continuing education. Concerning pediatric radiology, in particular, telemedicine extends the breadth of knowledge in an area exclusively practiced by very few professionals. Telemedicine eliminates geographical barriers and increases the interactivity among the groups. We encourage doctors of all Portuguese-speaking countries to participate in this network, radiologists and non-radiologists,