Livio Nanni

Computerized tomography findings in Fahr's syndrome

We analyzed computerized tomography (CT) findings in six patients with Fahrs syndrome. They presented calcifications in basal ganglia, dentate nucleus, subcortical region and semioval center, due to alteration in calcium metabolism or due to senile relative hypoxemic state. The image pattern was not strictly related with etiology, although some differences in dystrophic senile calcifications (the only one present in semioval center and absent in subcortical region). CT is an easy exam, has maximum sensitivity and allows diagnosis, contributing to early treatment of many etiologies of Fahrs syndrome.

Postmenopausal Women With Osteoporosis and Musculoskeletal Status: A Comparative Cross-Sectional Study

Background With increased life expectancy of the worlds population that has taken place in recent decades, there has been growth in the incidence of illnesses of the most advanced ages, including osteoporosis. However, changes in musculoskeletal disorders are not yet so clear. This study proposes to evaluate musculoskeletal alterations in osteoporotic postmenopausal women and healthy and correlate with bone mineral density of the lumbar spine. Methods Randomized, examiner-blinded, comparative cross-sectional study was designed with two groups of women attending the Menopause Clinic in the UNICAMP, 30 women with osteoporosis, while 33 women without osteoporosis comprised the second group. Diagnosis of the presence or absence of osteoporosis was based on bone densitometry performed on the lumbar spine. Volunteers were interviewed and underwent a physical examination with the same examiner, including the muscle strength and amplitude of movement of back flexion and extension, angles of thoracic kyphosis and lumbar lordosis, as well as static and dynamic balance. Results Mean back flexors and extensors strength was significantly lower in women with osteoporosis (P < 0.01). Flexion spinal range of motion was similar in both groups (P = 0.91). However, movement amplitude of spine extension was 20.5o in women with osteoporosis and 28.4o in women without osteoporosis. Thoracic kyphosis angles from T1 to T4 (P < 0.01) and lumbar lordosis angles (P = 0.02) were greater in women with osteoporosis. Seventy-three point three percent of women with osteoporosis and 78.8% of women without osteoporosis had good reply to static balance. Women in both groups had poor results to dynamic balance. No significant differences were observed in static or dynamic balance between women with and without osteoporosis. Vertebral fractures were present in 20% of women with osteoporosis and absent in women without osteoporosis. Conclusions Women with osteoporosis in the study population had poorer musculoskeletal status than women without osteoporosis. Further studies are necessary to evaluate whether correction of these alterations would be related to preventing falls and reducing fracture risk. Keywords Balance; Kyphosis; Mobility; Muscle strength; Osteoporosis; Postmenopausal

Determinação radiológica do índice e do tamanho craniano por mensuração dos diâmetros cranianos em uma população infantil brasileira

OBJETIVO: Realizar as medidas dos diâmetros cranianos obtidos por metodo radiologico e elaborar, por meio delas, o indice e o tamanho craniano, para comparar com as medidas dos diâmetros e os indices propostos por alguns trabalhos da literatura, principalmente os do estudo de Haas. MATERIAIS E METODOS: Foram avaliados 732 pacientes sem doencas cranianas, medidos seus diâmetros cranianos e, posteriormente, formulados o indice e o tamanho craniano, que mostram as diferentes fases do crescimento do crânio, pelas medidas de tabua interna a tabua interna. RESULTADOS: O estudo comparativo das medias dos diâmetros, por medidas de tabuas internas, mostrou aumento do crescimento francamente progressivo no primeiro ano de vida para ambos os sexos e aumento menor a partir do segundo ano de vida. As medias globais dos diâmetros nao apresentaram diferenca significativa entre os sexos feminino e masculino. CONCLUSAO: O indice e o tamanho craniano sao bons indicadores do crescimento craniano, principalmente nos quatro primeiros anos de vida, quando o crescimento aumenta vertiginosamente no primeiro ano e, posteriormente, ocorre aumento moderado ate os quatro anos de idade. Apos esta idade, ocorre um leve e estavel aumento e seu valor estatistico diminui. Nao houve diferenca estatisticamente significante, no crescimento, para ambos os sexos. Recomenda-se o uso dos valores medios dos diâmetros para ambos os sexos e sugere-se o uso do indice craniano, ate os quatro anos de idade, e o tamanho craniano, apos os quatro anos, sendo ideal para o acompanhamento do crescimento do crânio.

O papel das variantes anatômicas do complexo ostiomeatal na rinossinusite crônica

A tomografia computadorizada constitui, hoje, o metodo de escolha para a avaliacao dos seios paranasais e fossas nasais e de suas variacoes anatomicas. Postula-se que essas variacoes possam obstruir as vias de drenagem de muco, predispondo a rinossinusite cronica. Contudo, esse conceito e ainda controverso e a simples presenca da variacao anatomica nao estabelece necessariamente a etiologia da rinossinusite. Dos tres subtipos de concha media bolhosa, a variante bulbosa e a unica que parece ter forte associacao com a geracao de sintomas. As dimensoes da variacao e a sua associacao com a obliteracao das vias de drenagem do complexo ostiomeatal parecem ser tambem muito importantes. Sinais tomograficos de doenca sinusal do mesmo lado da variacao anatomica reforcam a possibilidade de que esta interfira com o processo de drenagem de muco. A tomografia computadorizada permite estudo detalhado das variacoes anatomicas e e metodo indispensavel na determinacao da conduta e no planejamento de estrategias cirurgicas. A analise tomografica deve basear-se na identificacao das variacoes, definicao de suas dimensoes e sua associacao com obliteracao dos ostios de drenagem e alteracoes tomograficas sinusais ipsilaterais.

Aumento da transparência pulmonar na infância: ensaio iconográfico

Thoracic asymmetries characterized by increased radiolucency of the lungs are important causes of morbidity in infants and children. Evaluation of affected patients frequently requires multiple imaging methods to diagnose the abnormality and to plan the surgical correction. The authors review and illustrate the characteristics of both common and rare thoracic asymmetries with emphasis on the radiological findings. The usefulness of different imaging methods in the diagnosis and treatment of these conditions is evaluated. The differential diagnosis as well the pitfalls and diagnostic difficulties are also discussed.