Thiago Costa

Comparison of MB Fraction of Creatine Kinase Mass and Troponin I Serum Levels With Necropsy Findings in Acute Myocardial Infarction

Serum levels of troponin and heart-related fraction of creatine kinase (CK-MB) mass are used as diagnostic and prognostic criteria in myocardial infarction, but the relation between those levels and the necropsy-determined size of necrosis has not been tested in human beings. In this retrospective study, 1-cm-thick transverse sections of the ventricles were cut from the base to the apex in the necropsy hearts of 27 patients aged 47 to 86 years (mean 66, median 69; 19 men). Total and necrotic areas were measured using a computer-linked image analysis system. The weights of the necrotic areas were also calculated. The correlations of the areas and weights of necrotic myocardium with the highest serum values of CK-MB mass and troponin I, which had been quantified during life by chemiluminescence immunoassays, were verified by Pearsons test; results were considered significant at p<or=0.05. Significant correlations were detected between CK-MB mass peak and infarct size (r=0.63, p<0.01) and weight (r=0.69, p<0.01) and between CK-MB mass and highest troponin level (r=0.73, p<0.01); however, the correlations between highest troponin level and myocardial infarct size (r=0.31, p=0.11) and weight (r=0.35, p=0.07) were small and nonsignificant. In conclusion, despite the well-established role of serum levels of troponin as a diagnostic tool for myocardial infarction, their highest values showed poor correlations with the extent of infarct. In contrast, the highest serum level of CK-MB mass was well correlated with myocardial infarct size.

Parastomal and Lateral Defects

Parastomal hernia is an intention hernia per se. It is supposed to permit a benign functionality for one dislodged bowel. The surgeon must consider all details to perform the procedure; it should be strategically planned and well completed (Sugarbaker, Surg Gynecol Obstet 169(1):75–77, 1989). Many hidden predisposing complication factors can be presented at the moment of a colostomy (Mylonakis et al., Colorectal Dis 3(5):334–337, 2001). This scenario is challenging when a parastomal hernia develops. The same analogy can be made for lateral defects that occur through drain incisions, closed stoma locations, surgical incisions, or others.

Non-specific Perceptual Organization Deficits After Traumatic Brain Injury.

Traumatic Brain Injury (TBI) is a prevalent condition and there is limited visual perception research of this population. Here, we investigated perceptual organization changes in 15 closed head TBI outpatients (and age-matched controls) with diffuse axonal injury only (a fundamental clinical manifestation of TBI) and no other known comorbidities. Patients had normal or corrected visual acuity and differed in the time since the lesion (between 4 and 9 months). Perceptual organization was measured with the Leuven Perceptual Organization Screening Test (L-POST), a coherent motion task (CM) and the Leuven Embedded Figures Test (L-EFT). These tests were chosen to screen for deficits in different aspects of perceptual organization (L-POST), to evaluate local and global processing (L-EFT) and grouping in a dynamic set of stimuli (CM). TBI was significantly impaired compared to controls in all measures for both reaction time and accuracy, except for CM thresholds (p=0.23). Repeated measures ANOVA showed that the TBI group was similarly affected in all aspects of the L-EFT (open vs. closed figures, different number of continued elements shared by figure and ground). TBI was also similarly affected in all perceptual factors of the L-POST (perceptual grouping, figure-ground segmentation, parts in wholes, and shape discrimination). No significant correlations were found between scores and time since lesion, except for CM (rs=-0.65), which might explain the lack of group-level differences in CM. The only scores significantly correlated to IQ were L-EFT reaction times (rs=-0.58) and parts in wholes L-POST factor (rs=0.62). These findings demonstrate that perceptual organization is diffusely affected in TBI and this effect has no substantial correlations with IQ. As many of the neuropsychological tests used to measure different cognitive functions involve some level of visual discrimination and perceptual organization demands, these results must be taken into account in the general neuropsychological evaluation of TBI patients. Meeting abstract presented at VSS 2015.