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Souza SPM, Frasson FC, Takahashi MES, Duarte GBO, Castro VP, Pericole FV, Velloso LA, De Souza CA, Lorand-Metze I, Santos AO, Ramos CD. Head-to-head comparison of [ 68Ga]Ga-PSMA-11 and [ 18F]FDG PET/CT in multiple myeloma. Eur J Nucl Med Mol Imaging 2023; 50:2432-2440. [PMID: 36988710 DOI: 10.1007/s00259-023-06214-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023]
Abstract
PURPOSE The aim of this study was to compare [18F]FDG and [68Ga]Ga-PSMA-11 PET/CT image findings in patients with multiple myeloma (MM). METHODS Twenty consecutive patients with symptomatic biopsy-proven MM were submitted to whole body [18F]FDG and [68Ga]Ga-PSMA-11 PET/CT with a time interval of 1-8 days between procedures. All lesions were counted and had their maximum SUV (SUVmax) measured. Intra-class correlation (ICC) was used to assess the agreement between [18F]FDG and [68Ga]Ga-PSMA-11 PET/CT findings. RESULTS A total of 266 lesions were detected in 19/20 patients. [18F]FDG detected 223/266 (84%) lesions in 17 patients and [68Ga]Ga-PSMA-11 190/266 (71%) lesions in 19 patients. Both procedures did not identify any active lesion in 1 patient. Forty-three (16%) lesions were detected only by [68Ga]Ga-PSMA-11 and 76 (29%) only by [18F]FDG. Both tracers identified 147 (55%) lesions. Intralesional mismatch of FDG-PSMA uptake was identified in 25 of these 147 lesions, found in 8 different patients. Different lesions with uptake of only [18F]FDG or [68Ga]Ga-PSMA-11 in the same patient were found in 4 patients. The highest SUVmax of [18F]FDG and [68Ga]Ga-PSMA-11 had a median (min-max) SUVmax of 6.5 (2.0-37.8) and 5.5 (1.7-51.3), respectively. [18F]FDG and [68Ga]Ga-PSMA-11 respectively identified 18 and 19 soft tissue lesions. False-positive [18F]FDG findings had minimal or no uptake of [68Ga]Ga-PSMA-11. Good reliability (ICC ≥ 0.75) was found for number of lesions, number of soft tissue lesions and highest SUVmax in each patient. CONCLUSION [18F]FDG or [68Ga]Ga-PSMA-11 alone can detect most MM lesions. Almost half of the lesions take up only one of the tracers, reflecting increased glycolysis or angiogenesis in specific lesions, and suggesting their possible complementary role in MM. The marked [68Ga]Ga-PSMA-11 uptake in some cases raises the possibility of a theranostic approach in selected patients.
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Affiliation(s)
- Stephan P M Souza
- Division of Nuclear Medicine, School of Medical Sciences University of Campinas (UNICAMP), Campinas, Brazil
| | - Fernanda C Frasson
- Division of Nuclear Medicine, School of Medical Sciences University of Campinas (UNICAMP), Campinas, Brazil
| | | | - Gislaine B O Duarte
- Center of Hematology and Hemotherapy, University of Campinas (UNICAMP), Campinas, Brazil
| | - Vania P Castro
- Division of Nuclear Medicine, School of Medical Sciences University of Campinas (UNICAMP), Campinas, Brazil
| | - Fernando V Pericole
- Center of Hematology and Hemotherapy, University of Campinas (UNICAMP), Campinas, Brazil
| | - Licio A Velloso
- Laboratory of Cell Signaling, Obesity and Comorbidities Research Center, University of Campinas (UNICAMP), Campinas, Brazil
- Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Carmino A De Souza
- Center of Hematology and Hemotherapy, University of Campinas (UNICAMP), Campinas, Brazil
- Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Irene Lorand-Metze
- Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Allan O Santos
- Division of Nuclear Medicine, School of Medical Sciences University of Campinas (UNICAMP), Campinas, Brazil
| | - Celso D Ramos
- Division of Nuclear Medicine, School of Medical Sciences University of Campinas (UNICAMP), Campinas, Brazil.
- Laboratory of Cell Signaling, Obesity and Comorbidities Research Center, University of Campinas (UNICAMP), Campinas, Brazil.
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Minekawa TB, Santos AO, Moraes AG, Sasse A, Silva CA, Lima MT, Camacho M, Lima MC, Etchebehere E. Erratum: Single-center developing country analysis of radium-223 therapy in prostate cancer-preliminary results. Am J Nucl Med Mol Imaging 2023; 13:126. [PMID: 37457327 PMCID: PMC10349289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 05/09/2023] [Indexed: 07/18/2023]
Abstract
[This corrects the article on p. 352 in vol. 11, PMID: 34754606.].
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Affiliation(s)
- Thaís B Minekawa
- Division of Nuclear Medicine of The Department of Radiology, University of Campinas (UNICAMP)Campinas, Brazil
| | - Allan O Santos
- Division of Nuclear Medicine of The Department of Radiology, University of Campinas (UNICAMP)Campinas, Brazil
- Medicina Nuclear de Campinas (grupoMND)Campinas, Brazil
| | | | | | - Cleide A Silva
- Department of Statistics, University of Campinas (UNICAMP)Campinas, Brazil
| | - Marcelo T Lima
- Department of Statistics, University of Campinas (UNICAMP)Campinas, Brazil
| | | | - Mariana C Lima
- Division of Nuclear Medicine of The Department of Radiology, University of Campinas (UNICAMP)Campinas, Brazil
- Medicina Nuclear de Campinas (grupoMND)Campinas, Brazil
| | - Elba Etchebehere
- Division of Nuclear Medicine of The Department of Radiology, University of Campinas (UNICAMP)Campinas, Brazil
- Medicina Nuclear de Campinas (grupoMND)Campinas, Brazil
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3
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Silva Neto JF, Pereira WO, Cavalcante LA, Oliveira Neto JG, Graça MPF, Gavinho SR, Amaral FMB, Santos AO, Sombra ASB, Mendes F, Macêdo AAM. Extraction, Purification and Electrical Characterization of Gross Galactomannan and Purified Galactomannan Obtained from Adenanthera pavonina L. Seeds. Chem Biodivers 2023; 20:e202200888. [PMID: 36703594 DOI: 10.1002/cbdv.202200888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/11/2023] [Indexed: 01/28/2023]
Abstract
Aiming of self-sustainable production, the search for biodegradable and biocompatible materials has brought with it the need to know the physicochemical and dielectric characteristics of polysaccharide-based composite structures, which can be used as important and promising raw materials for biotechnology and electronic industries. Galactomannans are polysaccharides, extracted from seeds and microbiological sources, consisting of mannose and galactose. In this context, this work aimed to extract, purify and characterize by XRD, FTIR and impedance spectroscopy galactomannan obtained from seeds of Adenanthera pavonina L. The purification process was made with ethyl alcohol at concentrations of 70, 80 and 90 %. Polymeric films were prepared by solvent slow evaporation at low temperatures. XRD measurements revealed that Galactomannan from Adenanthera pavonina L., after purification, has a semi-crystalline structure due to the identification of two peaks the first between 5.849° and 6.118° and the second between 20.011° and 20.247°. FTIR spectra showed the functional groups associated with monosaccharides of the galactomannan from Adenanthera pavonina L. seeds, as well as the typical polysaccharide bands and peaks, confirmed by literature data. The impedance results give an increment on the state-of-the-art of this biomaterial by showing the existence of dielectric relaxations, independent of the degree of purification, using the dielectric modulus formalism. The permittivity analysis reveals the presence of water in the structure of the film, whose dipoles contribute to the relatively high value of the dielectric constant. From the results obtained, it can be concluded that purified galactomannan has the potential for possible applications in the electronics industry as a green and eco-friendly dielectric material.
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Affiliation(s)
- J F Silva Neto
- Instituto Federal do Maranhão - Campus Imperatriz, Laboratório de Pesquisa, 65919-050, Imperatriz, Brasil
| | - W O Pereira
- Universidade Federal do Maranhão, CCSST, 65900-410, Imperatriz, Brasil
| | - L A Cavalcante
- Instituto Federal do Maranhão - Campus Imperatriz, Laboratório de Pesquisa, 65919-050, Imperatriz, Brasil
| | - J G Oliveira Neto
- Universidade Federal do Maranhão, CCSST, 65900-410, Imperatriz, Brasil
| | - M P F Graça
- I3N and Physics Department, Aveiro University, 3810-193, Aveiro, Portugal
| | - S R Gavinho
- I3N and Physics Department, Aveiro University, 3810-193, Aveiro, Portugal
| | - F M B Amaral
- Politécnico de Coimbra, ESTeSC, Departamento de Ciências Complementares, DCC, Rua 5 de Outubro - SM Bispo, Apartado 7006, 3046-854 Coimbra, Coimbra, Portugal
| | - A O Santos
- Universidade Federal do Maranhão, CCSST, 65900-410, Imperatriz, Brasil
| | - A S B Sombra
- Universidade Federal do Ceará - Campus Pici, LOCEM-Laboratório de Telecomunicações e Ciência e Engenharia de Materiais, Departamento de Física, Avenida Humberto Monte, s/n - Pici, 60440-593, Fortaleza, Brasil
| | - Fernando Mendes
- Politécnico de Coimbra, ESTeSC, Unidade Cientifico-Pedagógica de Ciências Biomédicas Laboratoriais, UCPCBL, Rua 5 de Outubro - SM Bispo, Apartado 7006, 3046-854 Coimbra, Coimbra, Portugal
| | - A A M Macêdo
- Instituto Federal do Maranhão - Campus Imperatriz, Laboratório de Pesquisa, 65919-050, Imperatriz, Brasil
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Minekawa TB, Santos AO, Moraes AG, Sasse A, Silva CA, Lima MT, Camacho M, Lima MC, Etchebehere E. Single-center developing country analysis of radium-223 therapy in prostate cancer-preliminary results. Am J Nucl Med Mol Imaging 2021; 11:352-362. [PMID: 34754606 PMCID: PMC8569335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/21/2021] [Indexed: 06/13/2023]
Abstract
We reviewed the records of mCRPC patients treated with off-label use of Ra-223. Ra-223 efficiency in this non-study population was correlated to outcome measures overall survival (OS), progression-free survival (PFS), bone event-free survival, bone marrow failure (BMF), and disease-related biomarkers. There were no limits regarding the number of prior hormonal agents or chemotherapy received before or during Ra-223. Exclusion criteria consisted of baseline platelet counts below 50,000/mm3 and/or absolute neutrophil counts below 1,500/mm3. Twenty-eight patients received 130 cycles of Ra-223 between 2017 and 2018. The overall median OS was 15.6 months. However, in patients submitted to 4 or fewer cycles, the median OS was 9.1 months; in contrast, the median OS was 18.5 months in patients submitted to 5 or 6 cycles. There was a significant inverse correlation between the number of cycles and the occurrence of bone events (76.2% of the patients that completed 6 cycles did not present bone events, while 71.4% of the patients that had skeletal-related events were submitted to less than 6 cycles). 82.1% of the patients were submitted to concomitant therapies with no significant side effects. There was also a decrease in ALP and LDH levels throughout treatment. Radium-223 increased OS and decreased bone events, especially when patients were able to complete 5-6 cycles. The proper selection of patients is crucial to improve outcomes.
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Affiliation(s)
- Thaís B Minekawa
- Division of Nuclear Medicine of The Department of Radiology, University of Campinas (UNICAMP)Campinas, Brazil
| | - Allan O Santos
- Division of Nuclear Medicine of The Department of Radiology, University of Campinas (UNICAMP)Campinas, Brazil
- Medicina Nuclear de Campinas (grupoMND)Campinas, Brazil
| | | | | | - Cleide A Silva
- Department of Statistics, University of Campinas (UNICAMP)Campinas, Brazil
| | - Marcelo T Lima
- Department of Statistics, University of Campinas (UNICAMP)Campinas, Brazil
| | | | - Mariana C Lima
- Division of Nuclear Medicine of The Department of Radiology, University of Campinas (UNICAMP)Campinas, Brazil
- Medicina Nuclear de Campinas (grupoMND)Campinas, Brazil
| | - Elba Etchebehere
- Division of Nuclear Medicine of The Department of Radiology, University of Campinas (UNICAMP)Campinas, Brazil
- Medicina Nuclear de Campinas (grupoMND)Campinas, Brazil
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5
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Santos AO, Ricciardi JBS, Pagnano R, Pereira LFM, Sakuma ET, Matsuda MMN, Bernardes ES, Araújo EB, Brunetto SQ, Takahashi MES, Brunetto EM, Zulli R, Ozelo MC, Etchebehere ECSC. Knee radiosynovectomy with 153Sm-hydroxyapatite compared to 90Y-hydroxyapatite: initial results of a prospective trial. Ann Nucl Med 2021; 35:232-240. [PMID: 33389651 DOI: 10.1007/s12149-020-01557-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 11/19/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Radiosynovectomy (RS) with 90Y-hydroxyapatite (90Y-HyA) aims to control knee hemarthrosis in hemophiliac patients to prevent secondary arthropathy. However, knee RS using 153Sm-hydroxyapatite (153Sm-HyA) is considered less suitable due to the lower average soft tissue range and energy of 153Sm for large joints, such as the knees. PURPOSE The objective of this investigation was to assess the efficacy and safety of knee RS with 153Sm-HyA, compared to 90Y-HyA. METHODS Forty patients were prospectively assigned to undergo knee RS with 153Sm-HyA (n = 19) or with 90Y-HyA (n = 21). The frequency of hemarthrosis episodes before and after treatment were compared. RESULTS After six months of knee RS, 153Sm-HyA and 90Y-HyA promoted a similar reduction of hemarthrosis episodes (50% and 66.7%, respectively). However, after 12 months of knee RS, the reduction of hemarthrosis episodes was significantly (p = 0.037) higher using 153Sm-HyA (87.5%) compared to 90Y-HyA (50.0%). This discrepancy was more pronounced (p = 0.002) for 153Sm-HyA compared to 90Y-HyA in adults/adolescents. CONCLUSION Knee radiosynovectomy with 153Sm-HyA is safe, reduces hemarthrosis episodes after 12 months of treatments, especially in adults/adolescents and even with grades III/IV arthropathy, similar to 90Y-HyA. 90Y-HyA seems to promote better hemarthrosis control in small children.
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Affiliation(s)
- Allan O Santos
- Division of Nuclear Medicine of the Department of Radiology, University of Campinas (UNICAMP), Campinas, Brazil.
| | - Janaina B S Ricciardi
- Hemophilia Unit of Hemocentro UNICAMP, University of Campinas (UNICAMP), Campinas, Brazil
| | - Rodrigo Pagnano
- Department of Orthopedics and Traumatology of the Department of Surgery, University of Campinas (UNICAMP), Campinas, Brazil
| | - Luis Fernando M Pereira
- Division of Nuclear Medicine of the Department of Radiology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Emerson T Sakuma
- Division of Ultrasound of the Department of Radiology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Margareth M N Matsuda
- Radiopharmacy Center of the Nuclear and Energy Research Institute (IPEN/CNEN), São Paulo, Brazil
| | - Emerson S Bernardes
- Radiopharmacy Center of the Nuclear and Energy Research Institute (IPEN/CNEN), São Paulo, Brazil
| | - Elaine B Araújo
- Radiopharmacy Center of the Nuclear and Energy Research Institute (IPEN/CNEN), São Paulo, Brazil
| | - Sérgio Q Brunetto
- Center of Biomedical Engineering, University of Campinas, Campinas, Brazil
| | | | - Edna M Brunetto
- Division of Nuclear Medicine of the Department of Radiology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Roberto Zulli
- Hemophilia Unit of Hemocentro UNICAMP, University of Campinas (UNICAMP), Campinas, Brazil
| | - Margareth C Ozelo
- Hemophilia Unit of Hemocentro UNICAMP, University of Campinas (UNICAMP), Campinas, Brazil
| | - Elba C S C Etchebehere
- Division of Nuclear Medicine of the Department of Radiology, University of Campinas (UNICAMP), Campinas, Brazil
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6
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Mosci C, Pericole FV, Oliveira GB, Delamain MT, Takahashi MES, Carvalheira JBC, Etchebehere ECSC, Santos AO, Miranda ECM, Lima MCL, Amorim BJ, de Souza CA, Lorand-Metze I, Ramos CD. 99mTc-sestamibi SPECT/CT and 18F-FDG-PET/CT have similar performance but different imaging patterns in newly diagnosed multiple myeloma. Nucl Med Commun 2020; 41:1081-1088. [PMID: 32732603 PMCID: PMC7497601 DOI: 10.1097/mnm.0000000000001259] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE F-fluorodeoxiglucose (F-FDG)-PET/CT has been widely used to evaluate multiple myeloma. Tc-sestamibi (MIBI) scintigraphy has also been proposed for assessing multiple myeloma, but its use with state-of-the-art single-photon emission computed tomography/computed tomography (SPECT/CT) technology has not been fully evaluated.This study aimed to compare these two imaging modalities in multiple myeloma staging. MATERIALS AND METHODS Sixty-two patients with recently diagnosed multiple myeloma were submitted to whole-body F-FDG-PET/CT and whole-body MIBI scans plus SPECT/CT of the chest and abdomen/pelvis. Number of focal lesions, contiguous soft tissue involvement (CSTI), extramedullary lesions (EMLs) and diffuse bone marrow (BM) involvement were recorded. RESULTS PET/CT was positive in 59 patients (95%) and MIBI SPECT/CT in 58 (93%) (P = 0.69). MIBI detected more diffuse bone marrow involvement than PET/CT (respectively 78 vs. 58% of the patients), while PET/CT demonstrated more focal lesions than MIBI SPECT/CT (81 vs. 54% of the patients) (P = 0.002). PET/CT detected EMLs in four subjects and MIBI in one subject. CSTI was found in 28 (45%) and 23 (37%) patients on PET/CT and MIBI images, respectively (P = 0.36). Three patients with lytic lesions and no FDG uptake were MIBI positive, and two subjects with lytic lesions without MIBI uptake were FDG positive. CONCLUSION MIBI SPECT/CT performs similarly to F-FDG-PET/CT in identifying sites of active disease in multiple myeloma staging. MIBI is more efficient than FDG for detecting the diffuse involvement of bone marrow but less efficient for detecting focal lesions. Some patients presented a 'mismatch' pattern of FDG/MIBI uptake.
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Affiliation(s)
- Camila Mosci
- Department of Radiology, Division of Nuclear Medicine, School of Medical Sciences
| | - Fernando V Pericole
- Hematology and Hemotherapy Center (Hemocentro), University of Campinas (UNICAMP)
| | - Gislaine B Oliveira
- Hematology and Hemotherapy Center (Hemocentro), University of Campinas (UNICAMP)
| | - Marcia T Delamain
- Hematology and Hemotherapy Center (Hemocentro), University of Campinas (UNICAMP)
| | - Maria E S Takahashi
- Gleb Wataghin Physics Institute
- Post-Graduation Program in Internal Medicine, School of Medical Sciences
| | | | | | - Allan O Santos
- Department of Radiology, Division of Nuclear Medicine, School of Medical Sciences
| | - Eliana C M Miranda
- Hematology and Hemotherapy Center (Hemocentro), University of Campinas (UNICAMP)
| | - Mariana C L Lima
- Department of Radiology, Division of Nuclear Medicine, School of Medical Sciences
| | - Barbara J Amorim
- Department of Radiology, Division of Nuclear Medicine, School of Medical Sciences
| | - Carmino A de Souza
- Hematology and Hemotherapy Center (Hemocentro), University of Campinas (UNICAMP)
- Division of Hematology, Department of Internal Medicine, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Irene Lorand-Metze
- Division of Hematology, Department of Internal Medicine, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Celso D Ramos
- Department of Radiology, Division of Nuclear Medicine, School of Medical Sciences
- Post-Graduation Program in Internal Medicine, School of Medical Sciences
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Almeida LS, Santos AO, Martins GH, Eloy L, Lima ML, Etchebehere E. 18F-FDG PET/CT images defined the true extent of a urothelial bladder carcinoma. Urol Case Rep 2020; 33:101289. [PMID: 32528854 PMCID: PMC7276442 DOI: 10.1016/j.eucr.2020.101289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 05/19/2020] [Accepted: 05/20/2020] [Indexed: 11/27/2022] Open
Abstract
A patient was referred, after neoadjuvant chemotherapy, for pre-surgical evaluation of urothelial bladder carcinoma (single lesion). Two thickenings in the left ureter wall identified on the CT scan were equivocal for malignancy. 18F-FDG PET/CT with delayed pelvic images, hyperhydration, and furosemide showed hypermetabolic ureteral metastases and multifocal bladder tumors. There were no lymph nodes or distant metastases. These 18F-FDG PET/CT findings completely altered the surgical treatment. The patient underwent left nephroureterectomy, radical cystoprostatectomy, and lymphadenectomy, followed by a urinary transit reconstruction. Histopathology confirmed multifocal high-grade urothelial carcinoma in the bladder walls and left ureter and benign lymph nodes.
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Affiliation(s)
- L S Almeida
- Division of Nuclear Medicine, Department of Radiology, Campinas State University (UNICAMP), Campinas, Brazil
| | - A O Santos
- Division of Nuclear Medicine, Department of Radiology, Campinas State University (UNICAMP), Campinas, Brazil
| | - G H Martins
- Division of Nuclear Medicine, Department of Radiology, Campinas State University (UNICAMP), Campinas, Brazil
| | - L Eloy
- Department of Pathology, Campinas State University (UNICAMP), Campinas, Brazil
| | - M L Lima
- Division of Urology, Department of Surgery, Campinas State University (UNICAMP), Campinas, Brazil
| | - E Etchebehere
- Division of Nuclear Medicine, Department of Radiology, Campinas State University (UNICAMP), Campinas, Brazil
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Takahashi MES, Mosci C, Souza EM, Brunetto SQ, Etchebehere E, Santos AO, Camacho MR, Miranda E, Lima MCL, Amorim BJ, de Souza C, Pericole FV, Lorand-Metze I, Ramos CD. Proposal for a Quantitative 18F-FDG PET/CT Metabolic Parameter to Assess the Intensity of Bone Involvement in Multiple Myeloma. Sci Rep 2019; 9:16429. [PMID: 31712729 PMCID: PMC6848137 DOI: 10.1038/s41598-019-52740-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 10/21/2019] [Indexed: 12/13/2022] Open
Abstract
Many efforts have been made to standardize the interpretation of 18F-FDG PET/CT in multiple myeloma (MM) with qualitative visual analysis or with quantitative metabolic parameters using various methods for lesion segmentation of PET images. The aim of this study was to propose a quantitative method for bone and bone marrow evaluation of 18F-FDG PET/CT considering the extent and intensity of bone 18F-FDG uptake: Intensity of Bone Involvement (IBI). Whole body 18F-FDG PET/CT of 59 consecutive MM patients were evaluated. Compact bone tissue was segmented in PET images using a global threshold for HU of the registered CT image. A whole skeleton mask was created and the percentage of its volume with 18F-FDG uptake above hepatic uptake was calculated (Percentage of Bone Involvement - PBI). IBI was defined by multiplying PBI by mean SUV above hepatic uptake. IBI was compared with visual analysis performed by two experienced nuclear medicine physicians. IBI calculation was feasible in all images (range:0.00–1.35). Visual analysis categorized PET exams into three groups (negative/mild, moderate and marked bone involvement), that had different ranges of IBI (multi comparison analysis, p < 0.0001). There was an inverse correlation between the patients’ hemoglobin values and IBI (r = −0.248;p = 0.02). IBI score is an objective measure of bone and bone marrow involvement in MM, allowing the categorization of patients in different degrees of aggressiveness of the bone disease. The next step is to validate IBI in a larger group of patients, before and after treatment and in a multicentre setting.
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Affiliation(s)
- Maria E S Takahashi
- School of Medical Sciences, University of Campinas, Campinas, Brazil.,Gleb Wataghin Physics Institute, University of Campinas, Campinas, Brazil
| | - Camila Mosci
- Division of Nuclear Medicine, University of Campinas, Campinas, Brazil
| | - Edna M Souza
- Division of Nuclear Medicine, University of Campinas, Campinas, Brazil.,Center of Biomedical Engineering, University of Campinas, Campinas, Brazil
| | - Sérgio Q Brunetto
- Division of Nuclear Medicine, University of Campinas, Campinas, Brazil.,Center of Biomedical Engineering, University of Campinas, Campinas, Brazil
| | - Elba Etchebehere
- Division of Nuclear Medicine, University of Campinas, Campinas, Brazil
| | - Allan O Santos
- Division of Nuclear Medicine, University of Campinas, Campinas, Brazil
| | - Mariana R Camacho
- School of Medical Sciences, University of Campinas, Campinas, Brazil.,Division of Nuclear Medicine, University of Campinas, Campinas, Brazil
| | - Eliana Miranda
- Center of Hematology and Hemotherapy, University of Campinas, Campinas, Brazil
| | - Mariana C L Lima
- Division of Nuclear Medicine, University of Campinas, Campinas, Brazil
| | - Barbara J Amorim
- Division of Nuclear Medicine, University of Campinas, Campinas, Brazil
| | - Carmino de Souza
- School of Medical Sciences, University of Campinas, Campinas, Brazil.,Center of Hematology and Hemotherapy, University of Campinas, Campinas, Brazil
| | - Fernando V Pericole
- Center of Hematology and Hemotherapy, University of Campinas, Campinas, Brazil
| | - Irene Lorand-Metze
- School of Medical Sciences, University of Campinas, Campinas, Brazil.,Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Celso D Ramos
- School of Medical Sciences, University of Campinas, Campinas, Brazil. .,Division of Nuclear Medicine, University of Campinas, Campinas, Brazil.
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Konert T, Vogel WV, Paez D, Polo A, Fidarova E, Carvalho H, Duarte PS, Zuliani AC, Santos AO, Altuhhova D, Karusoo L, Kapoor R, Sood A, Khader J, Al-Ibraheem A, Numair Y, Abubaker S, Soydal C, Kütük T, Le TA, Canh NX, Bieu BQ, Ha LN, Belderbos JSA, MacManus MP, Thorwarth D, Hanna GG. Introducing FDG PET/CT-guided chemoradiotherapy for stage III NSCLC in low- and middle-income countries: preliminary results from the IAEA PERTAIN trial. Eur J Nucl Med Mol Imaging 2019; 46:2235-2243. [PMID: 31367906 PMCID: PMC6717604 DOI: 10.1007/s00259-019-04421-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 06/30/2019] [Indexed: 12/24/2022]
Abstract
Purpose Patients with stage III non-small-cell lung cancer (NSCLC) treated with chemoradiotherapy (CRT) in low- and middle-income countries (LMIC) continue to have a poor prognosis. It is known that FDG PET/CT improves staging, treatment selection and target volume delineation (TVD), and although its use has grown rapidly, it is still not widely available in LMIC. CRT is often used as sequential treatment, but is known to be more effective when given concurrently. The aim of the PERTAIN study was to assess the impact of introducing FDG PET/CT-guided concurrent CRT, supported by training and quality control (QC), on the overall survival (OS) and progression-free survival (PFS) of patients with stage III NSCLC. Methods The study included patients with stage III NSCLC from nine medical centres in seven countries. A retrospective cohort was managed according to local practices between January 2010 and July 2014, which involved only optional diagnostic FDG PET/CT for staging (not for TVD), followed by sequential or concurrent CRT. A prospective cohort between August 2015 and October 2018 was treated according to the study protocol including FDG PET/CT in treatment position for staging and multimodal TVD followed by concurrent CRT by specialists trained in protocol-specific TVD and with TVD QC. Kaplan–Meier analysis was used to assess OS and PFS in the retrospective and prospective cohorts. Results Guidelines for FDG PET/CT image acquisition and TVD were developed and published. All specialists involved in the PERTAIN study received training between June 2014 and May 2016. The PET/CT scanners used received EARL accreditation. In November 2018 a planned interim analysis was performed including 230 patients in the retrospective cohort with a median follow-up of 14 months and 128 patients in the prospective cohort, of whom 69 had a follow-up of at least 1 year. Using the Kaplan–Meier method, OS was significantly longer in the prospective cohort than in the retrospective cohort (23 vs. 14 months, p = 0.012). In addition, median PFS was significantly longer in the prospective cohort than in the retrospective cohort (17 vs. 11 months, p = 0.012). Conclusion In the PERTAIN study, the preliminary results indicate that introducing FDG PET/CT-guided concurrent CRT for patients with stage III NSCLC in LMIC resulted in a significant improvement in OS and PFS. The final study results based on complete data are expected in 2020. Electronic supplementary material The online version of this article (10.1007/s00259-019-04421-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- T Konert
- Nuclear Medicine Department, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
| | - W V Vogel
- Nuclear Medicine Department, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.,Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - D Paez
- Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - A Polo
- Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - E Fidarova
- Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - H Carvalho
- Department of Radiology and Oncology, Faculty of Medicine, University of São Paulo - Institute of Cancer of Sao Paulo State, São Paulo, Brazil
| | - P S Duarte
- Department of Radiology and Oncology, Faculty of Medicine, University of São Paulo - Institute of Cancer of Sao Paulo State, São Paulo, Brazil
| | - A C Zuliani
- Department of Radiation Oncology and Nuclear Medicine Department, Hospital das Clínicas, Campinas University, Campinas, Brazil
| | - A O Santos
- Department of Radiation Oncology and Nuclear Medicine Department, Hospital das Clínicas, Campinas University, Campinas, Brazil
| | - D Altuhhova
- Department of Radiation Oncology and Radiology Department, North Estonia Medical Center, Tallinn, Estonia
| | - L Karusoo
- Department of Radiation Oncology and Radiology Department, North Estonia Medical Center, Tallinn, Estonia
| | - R Kapoor
- Department of Radiation Oncology and Nuclear Medicine Department, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - A Sood
- Department of Radiation Oncology and Nuclear Medicine Department, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - J Khader
- Department of Radiation Oncology and Nuclear Medicine Department, King Hussein Cancer Center, Amman, Jordan
| | - A Al-Ibraheem
- Department of Radiation Oncology and Nuclear Medicine Department, King Hussein Cancer Center, Amman, Jordan
| | - Y Numair
- Department of Radiation Oncology and Nuclear Medicine Department, Institute of Nuclear Medicine and Oncology, Lahore, Pakistan
| | - S Abubaker
- Department of Radiation Oncology and Nuclear Medicine Department, Institute of Nuclear Medicine and Oncology, Lahore, Pakistan
| | - C Soydal
- Department of Radiation Oncology and Nuclear Medicine Department, Ankara University School of Medicine, Mamak/Ankara, Turkey
| | - T Kütük
- Department of Radiation Oncology and Nuclear Medicine Department, Ankara University School of Medicine, Mamak/Ankara, Turkey
| | - T A Le
- Department of Radiation Oncology and Nuclear Medicine Department, Cho Ray Hospital, University of Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - N X Canh
- Department of Radiation Oncology and Nuclear Medicine Department, Cho Ray Hospital, University of Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - B Q Bieu
- Department of Radiation Oncology and Radiosurgery, Tran Hung Dao Hospital, Hanoi, Vietnam
| | - L N Ha
- Department of Radiation Oncology and Radiosurgery, Tran Hung Dao Hospital, Hanoi, Vietnam
| | - J S A Belderbos
- Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - M P MacManus
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
| | - D Thorwarth
- Section for Biomedical Physics, Department of Radiation Oncology, University Hospital Tübingen, Tübingen, Germany
| | - G G Hanna
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia. .,Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia.
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Farias AM, Appenzeller S, França MC, Martinez AR, Etchebehere EE, Souza TF, Santos AO. Assessment of Bone Mineral Density of Patients with Spinocerebellar Ataxia Type 3. J Mov Disord 2019; 12:43-46. [PMID: 30732432 PMCID: PMC6369376 DOI: 10.14802/jmd.18041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 12/13/2018] [Indexed: 12/19/2022] Open
Abstract
Objective Machado-Joseph disease (MJD) is a spinocerebellar ataxia, and osteoporosis is a multifactor disease that may affect patients with neurologic conditions. The frequency of osteoporosis among MJD patients, however, has not been studied. The purpose of this study is to evaluate bone mineral density (BMD) and identify correlations between clinical factors and frequency of vertebral fractures in patients with MJD. Methods Clinical data, lumbar X-rays and BMD data were obtained in 30 patients with MJD. Results Ten patients (33.3%) showed low BMD in at least one of the sites studied based on Z-scores. The Z-score correlated directly with body mass index, and the femoral neck Z-score was inversely correlated with cytosine-adenine-guanine (CAG) expansion. There was no correlation between BMD and other clinical factors. Forty-three percent of the patients reported previous pathologic fractures. Five patients (16.7%) had at least one fracture detected by lumbar X-ray. Conclusion Low BMD and fractures are frequent among MJD patients, and careful management of BMD may be beneficial for these patients.
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Affiliation(s)
- Aline Ms Farias
- Nuclear Medicine Division, Department of Radiology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Simone Appenzeller
- Rheumatology Division, Department of Internal Medicine, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Marcondes C França
- Department of Neurology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Alberto Rm Martinez
- Department of Neurology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Elba E Etchebehere
- Nuclear Medicine Division, Department of Radiology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Thiago F Souza
- Department of Radiology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Allan O Santos
- Nuclear Medicine Division, Department of Radiology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
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11
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Cabrera RN, Chone CT, Zantut-Wittmann DE, Matos PS, Ferreira DM, Pereira PS, Ribeiro MP, Santos AO, Ramos CD, Crespo AN, Etchebehere EC. The Role of SPECT/CT Lymphoscintigraphy and Radioguided Sentinel Lymph Node Biopsy in Managing Papillary Thyroid Cancer. JAMA Otolaryngol Head Neck Surg 2017; 142:834-41. [PMID: 27366869 DOI: 10.1001/jamaoto.2016.1227] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Single-photon emission computed tomography/computed tomography (SPECT/CT) and radioguided sentinel lymph node biopsy (rSLNB) are techniques that could potentially benefit surgeons and pathologists in the identification of sentinel lymph node (SLN) metastases in patients with papillary thyroid carcinoma (PTC). Evidence suggests that these novel techniques lead to substantial changes in PTC management by reducing understaging and of occult lymph node (LN) metastases and optimizing neck surgery by increasing the necessity of lateral lymphadenectomy and decreasing central lymphadenectomy. OBJECTIVES To correlate the presence of LN metastases in PTC with clinical and pathological features using SPECT/CT and rSLNB. DESIGN, SETTING, AND PARTICIPANTS For this prospective cohort study from June 2010 to November 2013, 42 patients with thyroid nodules suspicious for papillary carcinoma or classified as malignant on cytology examination without suspicion of lymph node metastases by clinical and ultrasound examinations were recruited from a single public medical institution. INTERVENTIONS All 42 patients underwent preoperative lymphoscintigraphy after an ultrasound-guided peritumoral injection of Technetium Tc 99m nanocolloid. Cervical images were acquired with a SPECT/CT scanner 15 minutes after radiotracer injection. Approximately 2 hours after lymphoscintigraphy, the patients were submitted to intraoperative rSLNB using a handheld gamma probe. All SLNs identified were removed alongside with non-SLNs from the same compartment. Papillary thyroid carcinoma, SLNs and non-SLNs were submitted for histopathology and immunohistochemical analyses. RESULTS Of the 42 patients initially enrolled, 37 were included in analysis, including 6 men and 31 women with a mean (range) age of 47 (22-83) years. Overall, T stage was as follows: T1, 23 patients (62.2%); T2, 8 patients (21.6%); and T3, 6 patients (16.2%). Sentinel lymph nodes were identified in 92% of the patients, and among these metastases were present in 17 patients (46%). The SLNs were false-negative in 3 patients. Metastases in the lateral compartment ocurred in 7 patients (18%). There was a significant association between LN metastases and tumor size (odds ratio, 1.06; 95% CI, 1.00-1.13; P = .02), with a Cohen d effect of 0.683 (medium to large effect). Overall, 17 patients (46%) with LN metastases had management changed because they were submitted to higher radioiodine ablation doses and closer clinical surveillance. CONCLUSIONS AND RELEVANCE Radioguided SLNB is able to detect occult cervical lymph node metastases in patients with papillary thyroid carcinoma, and in 7 patients (18%) rSLNB detected lymph node metastases in the lateral compartments. The rSLNB technique lead to management change in 14 patients (37.8%).
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Affiliation(s)
- Raquel Novas Cabrera
- Division of Nuclear Medicine, Campinas State University (UNICAMP), Campinas, Brazil
| | - Carlos T Chone
- Department of Otorhinolaringology, Campinas State University (UNICAMP), Campinas, Brazil
| | - Denise E Zantut-Wittmann
- Division of Endocrinology of the Department of Internal Medicine, Campinas State University (UNICAMP), Campinas, Brazil
| | - Patrcia S Matos
- Department of Pathology, Campinas State University (UNICAMP), Campinas, Brazil
| | - Daniel M Ferreira
- Department of Radiology, Campinas State University (UNICAMP), Campinas, Brazil
| | - Pablo S Pereira
- Department of Otorhinolaringology, Campinas State University (UNICAMP), Campinas, Brazil
| | - Mariana P Ribeiro
- Division of Nuclear Medicine, Campinas State University (UNICAMP), Campinas, Brazil
| | - Allan O Santos
- Division of Nuclear Medicine, Campinas State University (UNICAMP), Campinas, Brazil
| | - Celso D Ramos
- Division of Nuclear Medicine, Campinas State University (UNICAMP), Campinas, Brazil
| | - Agrício N Crespo
- Department of Otorhinolaringology, Campinas State University (UNICAMP), Campinas, Brazil
| | - Elba C Etchebehere
- Division of Nuclear Medicine, Campinas State University (UNICAMP), Campinas, Brazil
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12
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Santos AO, Nuvunga JJ, Silva CP, Pires LPM, Von Pinho RG, Guimarães LJM, Balestre M. Maize hybrid stability in environments under water restriction using mixed models and factor analysis. Genet Mol Res 2017; 16:gmr-16-02-gmr.16029672. [PMID: 28671255 DOI: 10.4238/gmr16029672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
In several crops, the water deficit is perhaps the main limiting factor in the search for high yields. The objective of this study was to evaluate the phenotypic stability of maize hybrids in environments with and without water restriction using the analytical factor (AF) approach. We evaluated 171 maize hybrids in 14 environments, divided into environments with (A1, A2, A3, A4, A5, A6, and A7) and without (A8, A9, A10, A11, A12, A13, and A14) water restriction, over a period of 7 years. Each year, 36 hybrids were evaluated. A square lattice design (6 x 6) was used, with common treatments between years. The characteristics of grain yield (GY), male flowering (MF) and female flowering (FF), plant height (PH), and ear height (EH) were evaluated. Phenotypic adaptability and stability of the hybrids were also verified. Hybrids G66, G99, G86, and G26 were the most stable and showed potential for use in environments with and without water restriction. The AF models showed to be useful for evaluating hybrids over many years, allowing selection of better hybrids with adaptability, specific and general stability, and correlation of hybrids with their production components, in addition to allowing identification of mega-environments that permit stability in the response of the adapted hybrids.
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Affiliation(s)
- A O Santos
- Departamento de Agricultura, Universidade Federal de Lavras, Lavras, MG, Brasil
| | - J J Nuvunga
- Departamento de Estatística, Universidade Federal de Lavras, Lavras, MG, Brasil
| | - C P Silva
- Departamento de Estatística, Universidade Federal de Lavras, Lavras, MG, Brasil
| | - L P M Pires
- Departamento de Agricultura, Universidade Federal de Lavras, Lavras, MG, Brasil
| | - R G Von Pinho
- Departamento de Agricultura, Universidade Federal de Lavras, Lavras, MG, Brasil
| | | | - M Balestre
- Departamento de Estatística, Universidade Federal de Lavras, Lavras, MG, Brasil
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Eisenlohr PV, Tavares JR, Oliveira SL, Santos AO, Valadão MBX, Bilce JM, Roberto RL, Castro HB, Zaratim ECP, Lima SL, Santos AJ, Silva APG, Lima LB, Melo-Santos KS, Figueiredo JDS, Santos LM, Pereira FC, Oliveira JCA, Miguel TB, Serpa AO, Kreutz C, Reis SMA. Thinking better about high-quality science: a look at some ethical flaws and productivity evaluation. BRAZ J BIOL 2015; 74:1009-10. [PMID: 25627616 DOI: 10.1590/1519-6984.17413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 03/11/2014] [Indexed: 11/21/2022] Open
Affiliation(s)
- P V Eisenlohr
- Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Alta Floresta, Alta Floresta, MT, Brasil
| | - J R Tavares
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - S L Oliveira
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - A O Santos
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - M B X Valadão
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - J M Bilce
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - R L Roberto
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - H B Castro
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - E C P Zaratim
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - S L Lima
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - A J Santos
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - A P G Silva
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - L B Lima
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - K S Melo-Santos
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - J D S Figueiredo
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - L M Santos
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - F C Pereira
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - J C A Oliveira
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - T B Miguel
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - A O Serpa
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - C Kreutz
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
| | - S M A Reis
- Programa de Pós-graduação em Ecologia e Conservação, Universidade do Estado de Mato Grosso - UNEMAT, Campus Universitário de Nova Xavantina, Nova Xavantina, MT, Brasil
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Gonçalves EM, Sewaybricker LE, Baptista F, Silva AM, Carvalho WRG, Santos AO, de Mello MP, Lemos-Marini SHV, Guerra G. Performance of phalangeal quantitative ultrasound parameters in the evaluation of reduced bone mineral density assessed by DX in patients with 21 hydroxylase deficiency. Ultrasound Med Biol 2014; 40:1414-1419. [PMID: 24726797 DOI: 10.1016/j.ultrasmedbio.2013.12.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 12/12/2013] [Accepted: 12/29/2013] [Indexed: 06/03/2023]
Abstract
The purpose of this study was to verify the performance of quantitative ultrasound (QUS) parameters of proximal phalanges in the evaluation of reduced bone mineral density (BMD) in patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency (21 OHD). Seventy patients with 21 OHD (41 females and 29 males), aged between 6-27 y were assessed. The QUS measurements, amplitude-dependent speed of sound (AD-SoS), bone transmission time (BTT), and ultrasound bone profile index (UBPI) were obtained using the BMD Sonic device (IGEA, Carpi, Italy) on the last four proximal phalanges in the non-dominant hand. BMD was determined by dual energy X-ray (DXA) across the total body and lumbar spine (LS). Total body and LS BMD were positively correlated to UBPI, BTT and AD-SoS (correlation coefficients ranged from 0.59-0.72, p < 0.001). In contrast, when comparing patients with normal and low (Z-score < -2) BMD, no differences were found in the QUS parameters. Furthermore, UBPI, BTT and AD-SoS measurements were not effective for diagnosing patients with reduced BMD by receiver operator characteristic curve parameters. Although the AD-SoS, BTT and UBPI showed significant correlations with the data obtained by DXA, they were not effective for diagnosing reduced bone mass in patients with 21 OHD.
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Affiliation(s)
- Ezequiel M Gonçalves
- Growth and Development Lab-Center for Investigation in Pediatrics (CIPED), Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil.
| | - Leticia E Sewaybricker
- Growth and Development Lab-Center for Investigation in Pediatrics (CIPED), Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil; Pediatric Endocrinology Unit, Pediatrics Department, Faculty of Medical Sciences, State University of Campinas, Campinas, SP, Brazil; PhD Student Program in Child and Adolescent Health
| | - Fatima Baptista
- Exercise and Health Laboratory, CIPER, Fac Motricidade Humana, Univ Lisboa, Cruz-Quebrada, Portugal
| | - Analiza M Silva
- Exercise and Health Laboratory, CIPER, Fac Motricidade Humana, Univ Lisboa, Cruz-Quebrada, Portugal
| | - Wellington R G Carvalho
- Growth and Development Lab-Center for Investigation in Pediatrics (CIPED), Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil; Physical Education Department, Center of Health and Biology Sciences, Federal University of Maranhão, São Luis, MA, Brazil
| | - Allan O Santos
- Nuclear Medicine Division, Clinical Hospital, University of Campinas, Campinas, SP, Brazil
| | - Maricilda P de Mello
- Center of Molecular Biology and Genetic Engineering, University of Campinas, Campinas, SP, Brazil
| | - Sofia H V Lemos-Marini
- Pediatric Endocrinology Unit, Pediatrics Department, Faculty of Medical Sciences, State University of Campinas, Campinas, SP, Brazil
| | - Gil Guerra
- Growth and Development Lab-Center for Investigation in Pediatrics (CIPED), Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil; Pediatric Endocrinology Unit, Pediatrics Department, Faculty of Medical Sciences, State University of Campinas, Campinas, SP, Brazil
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Etchebehere ECSC, Santos AO, Matos PS, Assumpção LVM, Lima MCVL, Lima MCL, Ward LS. Is thyroid stunning clinically relevant? A retrospective analysis of 208 patients. ACTA ACUST UNITED AC 2014; 58:292-300. [PMID: 24863093 DOI: 10.1590/0004-2730000002989] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 12/06/2013] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Current guidelines have advised against the performance of (131)I-iodide diagnostic whole body scintigraphy (dxWBS) to minimize the occurrence of stunning, and to guarantee the efficiency of radioiodine therapy (RIT). The aim of the study was to evaluate the impact of stunning on the efficacy of RIT and disease outcome. SUBJECTS AND METHODS This retrospective analysis included 208 patients with differentiated thyroid cancer managed according to a same protocol and followed up for 12-159 months (mean 30 ± 69 months). Patients received RIT in doses ranging from 3,700 to 11,100 MBq (100 mCi to 300 mCi). Post-RIT-whole body scintigraphy images were performed 10 days after RIT in all patients. In addition, images were also performed 24-48 hours after therapy in 22 patients. Outcome was classified as no evidence of disease (NED), stable disease (SD) and progressive disease (PD). RESULTS Thyroid stunning occurred in 40 patients (19.2%), including 26 patients with NED and 14 patients with SD. A multivariate analysis showed no association between disease outcome and the occurrence of stunning (p = 0.3476). CONCLUSION The efficacy of RIT and disease outcome do not seem to be related to thyroid stunning.
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Affiliation(s)
- Elba C S C Etchebehere
- Division of Nuclear Medicine of the Department of Radiology, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Allan O Santos
- Division of Nuclear Medicine of the Department of Radiology, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Patrícia S Matos
- Department of Pathology, School of Medical Sciences, Unicamp, Campinas, SP, Brazil
| | - Lígia V M Assumpção
- Division of Endocrinology of the Department of Internal Medicine, School of Medical Sciences, Unicamp, Campinas, SP, Brazil
| | - Maria Cecília V L Lima
- Division of Nuclear Medicine of the Department of Radiology, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Mariana C L Lima
- Division of Nuclear Medicine of the Department of Radiology, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Laura S Ward
- Laboratory of Molecular Cancer Genetics, School of Medical Sciences, Unicamp, Campinas, SP, Brazil
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Deus-Silva L, Bonilha L, Damasceno BP, Costa ALF, Yasuda CL, Costa FF, Santos AO, Etchebehere ECSC, Oquendo-Nogueira R, Fockink R, de Freitas CF, Camargo EE, Li LM, Cendes F, Saad ST. Brain Perfusion Impairment in Neurologically Asymptomatic Adult Patients with Sickle-Cell Disease Shown by Voxel-Based Analysis of SPECT Images. Front Neurol 2013; 4:207. [PMID: 24391625 PMCID: PMC3869238 DOI: 10.3389/fneur.2013.00207] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2013] [Accepted: 12/08/2013] [Indexed: 11/13/2022] Open
Abstract
Cerebrovascular lesions are frequently observed in patients with sickle-cell disease (SCD) and these structural lesions are preceded by insidious perfusion deficits. Our aim was to investigate the presence of brain perfusion deficits in neurologically asymptomatic SCD patients, especially affecting microvessels. For this study, 42 SCD patients [33 sickle-cell anemia (HbSS), 6 sickle hemoglobin C disease (HbSC), and 3 sickle β-thalassemia disease (HbSβ)] with mean hematocrit of 25.1 (±4.85; 15.6–38.5) underwent brain perfusion single photon emission computerized tomography (SPECT) using the tracer 99mTc-ECD. Images from SCD patients were compared to images of a healthy control group (29 females and 20 males, mean age 31 ± 8; range 25–49 years). Images underwent voxel-wise comparison of regional tracer uptake using paired t-test to estimate the probability of each voxel to have an increased or decreased tracer uptake. When compared to controls, SCD patients exhibited significantly reduced tracer uptake in basal ganglia and thalami, the anterior frontal region and the watershed region of the temporo-parietal-occipital transition (p < 0.05). Our study showed that neurologically asymptomatic adult SCD patients exhibit a pattern of reduced 99mTc-ECD tracer uptake demonstrated by SPECT. Early diagnosis of this cerebral vasculopathy has prognostic implications and can be determinant in considering therapeutic alternatives to avoid increasing brain lesion load and progressive disability.
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Affiliation(s)
| | - Leonardo Bonilha
- Division of Neurology, Department of Neurosciences, Medical University of South Carolina , Charleston, SC , USA
| | | | - Andre L F Costa
- Department of Neurology, University of Campinas , Campinas , Brazil ; Department of Orthodontics, City University of São Paulo , São Paulo , Brazil
| | | | - Fernando F Costa
- Hematology and Hemotherapy Center, University of Campinas , Campinas , Brazil
| | - Allan O Santos
- Division of Nuclear Medicine, Department of Radiology, University of Campinas , Campinas , Brazil
| | - Elba C S C Etchebehere
- Division of Nuclear Medicine, Department of Radiology, University of Campinas , Campinas , Brazil
| | - Regis Oquendo-Nogueira
- Division of Nuclear Medicine, Department of Radiology, University of Campinas , Campinas , Brazil
| | - Renata Fockink
- Division of Nuclear Medicine, Department of Radiology, University of Campinas , Campinas , Brazil
| | | | - Edwaldo E Camargo
- Division of Nuclear Medicine, Department of Radiology, University of Campinas , Campinas , Brazil
| | - Li M Li
- Department of Neurology, University of Campinas , Campinas , Brazil
| | - Fernando Cendes
- Department of Neurology, University of Campinas , Campinas , Brazil
| | - Sara T Saad
- Hematology and Hemotherapy Center, University of Campinas , Campinas , Brazil
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Bortot DC, Amorim BJ, Oki GC, Gapski SB, Santos AO, Lima MCL, Etchebehere ECSC, Barboza MF, Mengatti J, Ramos CD. 18F-Fluoride PET/CT is highly effective for excluding bone metastases even in patients with equivocal bone scintigraphy. Eur J Nucl Med Mol Imaging 2012; 39:1730-6. [DOI: 10.1007/s00259-012-2195-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Accepted: 07/13/2012] [Indexed: 10/28/2022]
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Gonçalves EM, Silva AM, Matias CN, Lemos-Marini SHV, Santos AO, Guerra-Júnior G. Estimation of percent body fat based on anthropometric measurements in children and adolescents with congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Clin Nutr 2012; 32:45-50. [PMID: 22647418 DOI: 10.1016/j.clnu.2012.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Revised: 05/01/2012] [Accepted: 05/07/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND & AIM Congenital adrenal hyperplasia due to 21-hydroxylase deficiency is associated with a high risk for obesity. Anthropometric measures are simple and inexpensive methods to assess body fat. However, the accuracy of alternative methods in these patients is unknown. This study aim to develop and evaluate the accuracy of predictive anthropometric equations in the estimation of percent body fat in individuals with congenital adrenal hyperplasia due to 21-hydroxylase deficiency. METHODS A total of 31 female and 22 male patients, aged 7-20 years, were evaluated. Dual-energy X-ray absorptiometry was used as the reference method for body fat, and anthropometric measurements were performed. RESULTS Three new predictive equations showed similar results: Equation (1) (R² = 0.85; SEE = 2.89%), Equation (2) (R² = 0.86; SEE = 2.82%), and Equation (3) (R² = 0.86; SEE = 2.81%). Internal cross-validation procedures showed a high R² (range, 0.84-0.85) and low SEE (<3%). The limits of agreement ranged from -5.6% to 5.6% and no trend was observed. CONCLUSION In children and adolescents with congenital adrenal hyperplasia due to 21-hydroxylase deficiency, three new predictive equations were validated for the estimation of percent body fat, with dual-energy X-ray absorptiometry as the reference method.
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Affiliation(s)
- Ezequiel M Gonçalves
- Growth and Body Composition Laboratory, Center for Investigation in Pediatrics (CIPED), Faculty of Medical Sciences (FCM), State University of Campinas (UNICAMP), Campinas, SP, Brazil.
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Brenzan MA, Santos AO, Nakamura CV, Filho BPD, Ueda-Nakamura T, Young MCM, Côrrea AG, Júnior JA, Morgado-Díaz JA, Cortez DAG. Effects of (-) mammea A/BB isolated from Calophyllum brasiliense leaves and derivatives on mitochondrial membrane of Leishmania amazonensis. Phytomedicine 2012; 19:223-230. [PMID: 22285848 DOI: 10.1016/j.phymed.2011.10.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Revised: 08/30/2011] [Accepted: 10/14/2011] [Indexed: 05/31/2023]
Abstract
We have previously demonstrated antileishmanial activity on Leishmania amazonensis of the natural (1-2), synthetic (7) and derivatives of coumarin (-) mammea A/BB (3-6) isolated from the dichloromethane extract of Calophyllum brasiliense leaves. The aim of the present study was to evaluate morphological and ultrastructural alterations in Leishmania amazonensis induced by these compounds. In promastigote forms, all seven compounds produced significant morphological and ultrastructural alterations, as revealed by scanning and transmission electron microscopy. The compound 5,7-dihydroxy-8-(2-methylbutanoyl)-6-(3-methylbutyl)-4-phenyl-chroman-2-one (3), the most active antileishmanial with LD₅₀ of 0.9 μM), induced cell shrinkage and a rounded appearance of the cells. Parasites incubated in the presence of compound (3) showed ultrastructural changes, such as the appearance of mitochondrial swelling with a reduction in the density of the mitochondrial matrix and the presence of vesicles inside the mitochondrion, indicating damage and significant change in this organelle; abnormal chromatin condensation, alterations in the nuclear envelope, intense atypical cytoplasmic vacuolization, and the appearance of autophagic vacuoles were also observed. In addition, the compound (3) may be acting to depolarize the mitochondrial membrane potential of the cells, leading to death of the parasite.
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Affiliation(s)
- M A Brenzan
- Pós-doutoranda em Ciências Farmacêuticas, Departamento de Farmácia e Farmacologia, Universidade Estadual de Maringá, Av. Colombo 5790, 87020-900 Maringá, PR, Brazil
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Martins-Filho R, Ward LS, Amorim BJ, Santos AO, Lima MCLD, Ramos CD, Matos PS, Assumpção LVM, Camargo EE, Etchebehere ECSC. Cumulative doses of radioiodine in the treatment of differentiated thyroid carcinoma: knowing when to stop. ACTA ACUST UNITED AC 2011; 54:807-12. [PMID: 21340173 DOI: 10.1590/s0004-27302010000900006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2010] [Accepted: 11/03/2010] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Evaluate the efficacy of cumulative doses (CDs) of 131I-iodide therapy (RIT) in differentiated thyroid cancer (DTC). SUBJECTS AND METHODS The probability of progressive disease according to CDs was evaluated in patients < 45 years old and > 45 years old and correlated to tumor-node-metastasis (TNM), thyroglobulin values, histological types and variants, age, and zduration of the disease. RESULTS At the end of a follow-up period of 69 ± 56 months, 85 out of 150 DTC patients submitted to fixed doses RIT had no evidence of disease, 47 had stable disease and 18 had progressive disease. Higher CDs were used in the more aggressive variants (p < 0.0001), higher TNM stages (p < 0.0001), and follicular carcinomas (p = 0.0034). Probability of disease progression was higher with CDs > 600 mCi in patients > 45 years old and with CDs > 800 mCi in patients < 45 years. CONCLUSION Although some patients may still respond to high CDs, the impact of further RIT should be carefully evaluated and other treatment strategies may be warranted.
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Affiliation(s)
- Raul Martins-Filho
- Division of Nuclear Medicine, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, São Paulo, SP, Brazil
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Santos AO, Pereira JP, Pedroso de Lima MC, Simões S, Moreira JN. In vitro modulation of Bcl-2 levels in small cell lung cancer cells: effects on cell viability. Braz J Med Biol Res 2010; 43:1001-9. [PMID: 20922271 DOI: 10.1590/s0100-879x2010007500099] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2010] [Accepted: 09/13/2010] [Indexed: 11/22/2022] Open
Abstract
Small cell lung cancer (SCLC) is an aggressive disease, representing 15% of all cases of lung cancer, has high metastatic potential and low prognosis that urgently demands the development of novel therapeutic approaches. One of the proposed approaches has been the down-regulation of BCL2, with poorly clarified and controversial therapeutic value regarding SCLC. The use of anti-BCL2 small interfering RNA (siRNA) in SCLC has never been reported. The aim of the present study was to select and test the in vitro efficacy of anti-BCL2 siRNA sequences against the protein and mRNA levels of SCLC cells, and their effects on cytotoxicity and chemosensitization. Two anti-BCL2 siRNAs and the anti-BCL2 G3139 oligodeoxynucleotide (ODN) were evaluated in SCLC cells by the simultaneous determination of Bcl-2 and viability using a flow cytometry method recently developed by us in addition to Western blot, real-time reverse-transcription PCR, and cell growth after single and combined treatment with cisplatin. In contrast to previous reports about the use of ODN, a heterogeneous and up to 80% sequence-specific Bcl-2 protein knockdown was observed in the SW2, H2171 and H69 SCLC cell lines, although without significant sequence-specific reduction of cell viability, cell growth, or sensitization to cisplatin. Our results question previous data generated with antisense ODN and supporting the present concept of the therapeutic interest in BCL2 silencing per se in SCLC, and support the growing notion of the necessity of a multitargeting molecular approach for the treatment of cancer.
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Paiva V, Garcia J, Rios LF, Santos AO, Terto V, Munõz-Laboy M. Religious communities and HIV prevention: an intervention study using a human rights-based approach. Glob Public Health 2010; 5:280-94. [PMID: 20373192 DOI: 10.1080/17441691003677421] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Religious communities have been a challenge to HIV prevention globally. Focusing on the acceptability component of the right to health, this intervention study examined how local Catholic, Evangelical and Afro-Brazilian religious communities can collaborate to foster young people's sexual health and ensure their access to comprehensive HIV prevention in their communities in Brazil. This article describes the process of a three-stage sexual health promotion and HIV prevention initiative that used a multicultural human rights approach to intervention. Methods included 27 in-depth interviews with religious authorities on sexuality, AIDS prevention and human rights training of 18 young people as research-agents, who surveyed 177 youth on the same issues using self-administered questionnaires. The results, analysed using a rights-based perspective on health and the vulnerability framework, were discussed in daylong interfaith workshops. Emblematic of the collaborative process, workshops are the focus of the analysis. Our findings suggest that this human rights framework is effective in increasing inter-religious tolerance and in providing a collective understanding of the sexuality and prevention needs of youth from different religious communities, and also serves as a platform for the expansion of state AIDS programmes based on laical principles.
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Affiliation(s)
- V Paiva
- a Universidade de São Paulo , São Paulo , Brazil
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Lima MCL, de Lima ML, Pepe CFV, Etchebehere ECSC, Santos AO, Amorim BJ, Camargo EE, Ferreira U, Palma PCR, Ramos CD. Technetium-99m-L,L-ethylenedicysteine is more effective than technetium-99m diethylenetriamine penta-acetic acid for excluding obstruction in patients with pyelocalicinal dilation. Urology 2010; 76:283-8. [PMID: 20206974 DOI: 10.1016/j.urology.2009.12.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2009] [Revised: 12/18/2009] [Accepted: 12/20/2009] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To evaluate the utility of diuretic dynamic renal scintigraphy (DDRS) with technetium-99m-L,L-ethylenedicysteine ((99m)Tc-EC) in patients with indeterminate or possible false-positive results for urinary obstruction by technetium-99m diethylenetriamine penta-acetic acid ((99m)Tc-DTPA) DDRS. METHODS A total of 92 patients (63 male; mean age, 16.6 +/- 21.25 years) were studied, with a total of 103 kidneys presenting indeterminate (20/103) or possible false-positive results for obstruction attributable to reduced renal function or severe kidney dilation (83/103) by (99m)Tc-DTPA DDRS (<60% of radiopharmaceutical excreted in 20 minutes-half-time clearance [T(1/2)] >15 minutes). Patients were reimaged after intravenous injection of (99m)Tc-EC, with dynamic images before and after furosemide administration using the same acquisition parameters applied in the previous (99m)Tc-DTPA study. Time interval between (99m)Tc-DTPA and (99m)Tc-EC renograms was 2-64 days. The percentage of excreted material 20 minutes after furosemide was calculated using both radiopharmaceuticals, and were statistically compared using the paired samples t test. RESULTS The excretion after furosemide injection was 25.3% +/- 18.2% for (99m)Tc-DTPA and 41.2% +/- 26.1% for (99m)Tc-EC, with a statistically significant difference between both radiopharmaceuticals (P <.0001). Using (99m)Tc-EC obstruction was excluded in 36 of 103 kidneys, which excreted >60%. A total of 10 of 83 kidneys (12.0%) with an obstructive pattern by (99m)Tc-DTPA study turned out to be indeterminate by (99m)Tc-EC DDRS. There was an agreement between (99m)Tc-EC and (99m)Tc-DTPA studies in 54 of 83 kidneys with obstructive (65.1%) and in 3 of 20 (15.0%) with indeterminate patterns. CONCLUSIONS (99m)Tc-EC was more effective than (99m)Tc-DTPA for excluding obstruction, presenting less false-positive and indeterminate results. (99m)Tc-EC can substitute (99m)Tc-DTPA to evaluate patients with urinary tract dilation.
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Affiliation(s)
- Mariana C L Lima
- Division of Nuclear Medicine, Department of Radiology, State University of Campinas, Campinas, São Paulo, Brazil.
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Sanches A, Etchebehere ECSC, Mazzali M, Filho GA, Lima MCL, Santos AO, Ramos CD, Cardinalli I, Billis A, Camargo EE. The accuracy of (99m)Tc-DTPA scintigraphy in the evaluation of acute renal graft complications. Int Braz J Urol 2009; 29:507-16. [PMID: 15748304 DOI: 10.1590/s1677-55382003000600005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2003] [Accepted: 11/14/2003] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Renal scintigraphy has been used for many years in the evaluation of renal transplants and can help in the diagnosis of graft complications, leading to prompt clinical management and preventing further deterioration of renal function. The purpose of this study was to evaluate the overall accuracy of renal scintigraphy with (99m)Tc-DTPA in the diagnosis of acute renal graft complications. MATERIALS AND METHODS Seventy-six scintigraphic studies performed in 55 patients (ages ranging from 6 to 65 years), were reviewed. Scintigraphy results were compared to biopsies performed within 5 days of imaging. (99m)Tc-DTPA study was performed within a mean time of 19 days after kidney transplants. Dynamic images were performed in the anterior position of the abdomen and pelvis every 2 seconds for 80 seconds (flow phase) and every 15 seconds for 30 minutes (functional phase), after an intravenous injection of 370 MBq (10 mCi) of (99m)Tc-DTPA. RESULTS The scintigraphic results were concordant with the biopsies in 86% of the cases studied. The sensitivities of renal scintigraphy for detection of acute tubular necrosis (ATN), acute rejection (AR) and cortical necrosis (CN) were 98%, 87% and 100%, respectively. Specificities and accuracies for detection of ATN, AR and CN were 89%, 86% and 100%, and 95%, 87% and 100%, respectively. CONCLUSION Renal scintigraphy with (99m)Tc-DTPA showed a good overall accuracy in the detection of acute renal graft complications. It can be used as a reliable tool in the routine evaluation of these patients.
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Affiliation(s)
- Adelina Sanches
- Division of Nuclear Medicine, Department of Radiology, Campinas State University, UNICAMP, Campinas, São Paulo, Brazil
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Monteiro CMC, Izar MCO, Pinheiro LFM, Oliveira L, Santos AO, Fischer SCPM, Paola AAV, Carvalho ACC, Fonseca FAH. A 005 Early Effects of Lipid Lowering Treatment in Subjects with Metabolic Syndrome and Acute Coronary Syndromes. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71668-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Monteiro CMC, Izar MCO, Pinheiro LFM, Brandão SAB, Oliveira L, Fischer SCPM, Santos AO, Paola AAV, Carvalho ACC, Fonseca FAH. A 003 Highly Sensitive C-reactive Protein and the Framingham Risk Score are Independently Related to the Severity of Coronary Disease in Patients with Metabolic Syndrome. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71666-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Monteiro CMC, Izar MCO, Pinheiro LFM, Brandão SAB, Oliveira L, Fischer SCPM, Santos AO, Carvalho ACC, Paola AAV, Fonseca FAH. L 002 Early Glucometabolic Profile in Patients with Acute Coronary Syndromes and Metabolic Syndrome. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71768-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Santos AO, Fonseca FAH, Fischer SCPM, Monteiro CMC, Brandão SAB, Monteiro AM, Sanches EMR, Gidlund MA, Figueiredo A, Carvalho ACC, Izar MCO. I 002 High Circulating Autoantibodies Against Human Oxidized LDL are Related to Stable and Lower Titers to Unstable Clinical Situation. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71756-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Medeiros CCM, de Lemos-Marini SHV, Filho MB, Camargo EE, Santos AO, Magna LA, Guerra-Júnior G, Baptista MTM, Maciel-Guerra AT. Turner's syndrome and subclinical autoimmune thyroid disease: a two-year follow-up study. J Pediatr Endocrinol Metab 2009; 22:109-18. [PMID: 19449668 DOI: 10.1515/jpem.2009.22.2.109] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Although autoimmune thyroid disease (AITD) is frequent in Turner's syndrome (TS), followup studies are scant, and there are none regarding subclinical thyroiditis. We investigated thyroid function and morphology in 17 patients with TS (mean age 14.6 years) with transient and asymptomatic variations of TSH and/or thyroid hormones. Our 2-year follow-up included measurements of TSH, free T4, T3 and TPO and Tg antibodies, ultrasound (US) (first and last evaluations) and scintigraphy (first evaluation). Thyroid volume was evaluated relative to the patients' stature. Fourteen had abnormal hormones, including four with hypothyroidism and one with hyperthyroidism, ten had positive antibodies, and all had abnormalities on US; uptake was normal in 14/16. Abnormal hormones were independent of antibodies, number of US findings, age, time of disease and volume. At the end of the follow-up, antibodies were associated with a high number of abnormal US features, particularly heterogeneous texture. Our results indicate that recurring thyroid hormone variations in TS are due to chronic AITD.
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Affiliation(s)
- Carla C M Medeiros
- Pediatric Endocrinology Service, Department of Pediatrics, Faculty of Medical Sciences, State University of Campinas, Brazil
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Fischer SCPM, Santos AO, Monteiro AM, Sanches EMR, Brandão SAB, Helfenstein T, Monteiro CMC, Gidlund MA, Izar MCO, Fonseca FAH. H 009 ACE-INHIBITORS AND DIURETICS REDUCE TITERS OF ANTIBODIES ANTI-OXLDL IN HYPERTENSIVE PATIENTS. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71912-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Santos AO, Fischer SCPM, Monteiro CMC, Monteiro AM, Sanches EMR, Helfenstein T, Brandão SAB, Gidlund MA, Fonseca FAH, Izar MCO. L 015 LOW TITERS OF HUMAN ANTIOXIDIZED LDL AUTOANTIBODIES ARE ASSOCIATED WITH UNSTABLE CORONARY DISEASE. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71959-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Fonseca FAH, Monteiro CMC, Santos AO, Fischer SCPM, Alves SIPMN, Gidlund MA, Figueiredo A, Izar MCO. L 053 CHARACTERIZATION OF OXIDIZED LDL BY THE Z-SCAN TECHNIQUE IN PATIENTS WITH METABOLIC SYNDROME AFTER AN ACUTE CORONARY EVENT. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71997-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Helfenstein T, Ihara SSM, Santos AO, Relvas WGM, Souza DRS, Scartezini M, Han SW, Fonseca MIH, Pinto LDESA, Fonseca FAH, Izar MCO. D 003 CAN GENETIC MARKERS PREDICT CORONARY RISK IN TYPE 2 DIABETES OVER AND ABOVE CLASSIC RISK FACTORS? ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71894-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Anjos DA, Etchebehere ECSC, Ramos CD, Santos AO, Albertotti C, Camargo EE. 18F-FDG PET/CT Delayed Images After Diuretic for Restaging Invasive Bladder Cancer. J Nucl Med 2007; 48:764-70. [PMID: 17475965 DOI: 10.2967/jnumed.106.036350] [Citation(s) in RCA: 131] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED PET with (18)F-FDG has been considered of limited value for detection of bladder cancer because of the urinary excretion of the tracer. The purpose of this study was to investigate the role of PET/CT in the detection and restaging of bladder cancer using furosemide and oral hydration to remove the excreted (18)F-FDG from the bladder. METHODS Seventeen patients with bladder cancer (11 without cystectomy, 6 with total cystectomy and urinary diversion) underwent (18)F-FDG PET/CT from head to the upper thighs 60 min after the intravenous injection of 370 MBq of (18)F-FDG. Additional pelvic images were acquired 1 h after the intravenous injection of furosemide and oral hydration. PET/CT findings were confirmed by MRI, cystoscopy, or biopsy. RESULTS PET/CT was able to detect bladder lesions in 6 of 11 patients who had not undergone cystectomy. These images changed the PET/CT final reading in 7 patients: Recurrent bladder lesions were detected in 6 patients, pelvic lymph node metastases in 2 patients, and prostate metastasis in 1. This technique overcame the difficulties posed by the urinary excretion of (18)F-FDG. Hypermetabolic lesions could be easily detected by PET and precisely localized in the bladder wall, pelvic lymph nodes, or prostate by CT. Seven of 17 patients (41%) were upstaged only after delayed pelvic images. CONCLUSION Detection of locally recurrent or residual bladder tumors can be dramatically improved using (18)F-FDG PET/CT with delayed images after a diuretic and oral hydration.
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Affiliation(s)
- Dalton A Anjos
- Division of Nuclear Medicine and PET/CT, Sírio-Libanês Hospital, São Paulo, Brazil
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Ramos CD, Massumoto CM, Rosa MF, Mazo-Ruiz MF, Mitteldorf C, Etchebehere EC, Santos AO, Lima MC, Cerri GG, Camargo EE. Focal Bone Marrow Involvement in Multicentric Castleman Disease Demonstrated By FDG PET/CT. Clin Nucl Med 2007; 32:295-6. [PMID: 17413577 DOI: 10.1097/01.rlu.0000257288.11595.32] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Celso Dario Ramos
- State University of Campinas, Rua Murici, 207, Campinas, Sao Paulo, Brazil.
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Medeiros CCM, Lemos-Marini SHVD, Brícola Filho M, Camargo EE, Santos AO, Magna LA, Guerra Júnior G, Baptista MTM, Maciel-Guerra AT. [Evidences for subclinic chronic autoimmune thyroid disease in girls with Turner Syndrome]. Arq Bras Endocrinol Metabol 2007; 51:401-9. [PMID: 17546238 DOI: 10.1590/s0004-27302007000300007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2005] [Accepted: 11/10/2006] [Indexed: 05/15/2023]
Abstract
Patients with Turner syndrome (TS) frequently exhibit transient, recurrent and asymptomatic variations of TSH and/or thyroid hormones (TH). This work was carried out to evaluate thyroid function and structure in patients with TS who had had such variations in hormone concentrations. Our sample comprised 24 patients, 17 less than 20-years old. Evaluation included serum levels of TSH, free T4, total T3, TPO and Tg autoantibodies, thyroid ultrasound (US) and scintigraphy with 99mTc-pertechnetate. Thirteen patients had abnormal TSH and/or TH levels; 23 exhibited US features compatible with chronic thyroid disorder, particularly thyromegaly (established according to volume expected for stature) and heterogeneous echogenicity. Uptake was normal in 21 cases and tracer distribution was homogeneous in 22. The finding of abnormal hormone concentrations was independent of age, length of time since the first similar finding, thyroid autoantibodies, number of abnormalities at US and abnormal scintigraphic findings. Patients aged more than 20 years had higher frequency of thyroid antibodies and heterogeneous echogenicity, and thyroid volume was significantly correlated to length of time since detection of the first hormone variation, indicating progressive thyroid disease. These results suggest that subclinical thyroid dysfunction in TS is due to chronic autoimmune thyroid disease.
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Affiliation(s)
- Carla C M Medeiros
- Serviço de Endocrinologia Pediátrica, Departamento de Pediatria e Centro de Investigação em Pediatria, Faculdade de Ciências Médicas, UNICAMP, Campinas, SP
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Barros FB, Lima CSP, Santos AO, Mazo-Ruiz MFC, Lima MCL, Etchebehere ECSC, Costa FF, Saad STO, Camargo EE, Ramos CD. 51Cr-EDTA measurements of the glomerular filtration rate in patients with sickle cell anaemia and minor renal damage. Nucl Med Commun 2007; 27:959-62. [PMID: 17088681 DOI: 10.1097/01.mnm.0000243373.03636.6e] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Creatinine clearance has been reported to be inaccurate for the estimation of glomerular filtration rate (GFR) in patients with sickle cell anaemia (SCA). Inulin clearance, the reference method for GFR estimation, is impractical for routine use in these patients, and 51Cr-EDTA measurements of the GFR have been rarely reported in this disease. METHODS In order to obtain reference 51Cr-EDTA values in this disease, we studied 70 patients (40 females; 13-59 years of age, mean: 31.6 years) with homozygous SCA, normal serum creatinine and urinary albumin excretion < or =200 microg x min(-1). All patients were submitted to single-injection 51Cr-EDTA GFR, urinary albumin and haematocrit measurements. 51Cr-EDTA clearances were calculated in different age groups (<20, 20-29, 30-39, 40-49 and >50 years). RESULTS The mean GFR (+/-standard deviation) obtained for the 70 patients was 111.5+/-23.1 ml x min(-1). Analysis of variance for evaluation of the possible interaction effect between 51Cr-EDTA clearance and sex, age, urinary albumin and haematocrit demonstrated patient age as the only factor influencing 51Cr-EDTA clearance (P < 0.001). The Spearman correlation coefficient showed a significant relationship between 51Cr-EDTA clearance and patient age (r = -0.44, P = 0.0001), but not between 51Cr-EDTA and urinary albumin (r = -0.17, P = 0.1546) or haematocrit (r = 0.079, P = 0.5121). The group aged 20-29 years presented the highest 51Cr-EDTA clearance mean value (126.7+/-20.4 ml x min(-1)), with a progressive reduction in the older groups. CONCLUSION Young adults with homozygous SCA, normal serum creatinine and micro-albuminuria or normo-albuminuria present supranormal 51Cr-EDTA GFR values. These values rapidly decrease after 30 years of age. We did not find association between urinary albumin and GFR in these patients.
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Affiliation(s)
- Fabiana B Barros
- Nuclear Medicine Division, Department of Radiology, State University of Campinas, Brazil
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Anjos DA, Etchebehere ECSC, Santos AO, Lima MCL, Ramos CD, Paula RB, Camargo EE. Normal values of [99mTc]pertechnetate uptake and excretion fraction by major salivary glands. Nucl Med Commun 2006; 27:395-403. [PMID: 16531928 DOI: 10.1097/01.mnm.0000202864.52046.b1] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The assessment of the functional status of the salivary glands has been used in the scintigraphic evaluation of xerostomia. Several quantitative methods derived from standard dynamic scintigraphy have been suggested. However, the indices proposed are quite variable and unlikely to be useful in clinical practice. The objectives of this study were to obtain reference values of major salivary glands uptake and excretion fraction in healthy subjects and to obtain normal ratios of Tc-pertechnetate uptake by the major salivary glands in comparison to the thyroid gland uptake. The standardization of these values has the purpose of making this evaluation faster and more objective. Fifty volunteers without clinical evidence of xerostomia or thyroid disease underwent static salivary glands scintigraphy with Tc-pertechnetate. Static images were obtained at 20 minutes and then at 3 minutes after oral stimulation with lemon juice. Percent uptake, excretion fraction and salivary gland to thyroid ratio rates were calculated for the parotid and the submandibular glands. The mean of the uptake values at 20 minutes for the right and left parotid glands were respectively 0.31% and 0.26%, and for the submandibular glands 0.15%. The excretion fraction of the tracer after the lemon juice stimulation was 70% for the parotids glands, 50% for the right and 49% for the left submandibular glands. The mean+/-SD salivary gland to thyroid count ratio was 0.79+/-0.45 for the right parotid, 0.78+/-0.5 for the left parotid, 0.67+/-0.33 and 0.66+/-0.34 for the right and left submandibular glands, respectively. Salivary glands scintigraphy with uptake and excretion fraction calculation is an easy to perform, non-invasive and objective method to investigate salivary glands function. These findings help the nuclear physician to interpret salivary gland scintigraphy more objectively, even in patients with thyroid gland dysfunction in whom Tc-pertechnetate thyroid uptake may be abnormal.
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Affiliation(s)
- Dalton A Anjos
- Division of Nuclear Medicine, Department of Radiology, Campinas State University (UNICAMP), Campinas, Brazil.
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Zantut-Wittmann DE, Ramos CD, Santos AO, Lima MMO, Panzan AD, Facuri FVO, Etchebehere ECSC, Lima MCL, Tambascia MA, Camargo EE. High pre-therapy [99mTc]pertechnetate thyroid uptake, thyroid size and thyrostatic drugs: predictive factors of failure in [131I]iodide therapy in Graves' disease. Nucl Med Commun 2005; 26:957-63. [PMID: 16208172 DOI: 10.1097/01.mnm.0000183795.59097.42] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVE Several factors may interfere with the success rate of radioiodine therapy (RIT) in Graves' disease. Our aim was to evaluate, retrospectively, some of these factors in the outcome of RIT. METHODS Patient gender, age at diagnosis, ophthalmopathy, disease duration, thyroid size, drug used as clinical treatment, thionamide withdrawal period during RIT preparation, FT4, TSH and [99mTc]pertechnetate thyroid uptake prior to RIT were studied as potential interference factors for RIT success. Eighty-two Graves' disease patients were submitted to RIT after thionamide treatment failure. Prior to RIT, 67 patients were receiving methimazole and 15 propylthiouracil. Thirty-three patients received thionamides during RIT; in 49 patients the medication was withdrawn for 2-30 days. [99mTc]pertechnetate thyroid uptake was determined before RIT. Fixed doses of 370 MBq of [131I]iodide were administered to all patients. RESULTS Eleven patients became euthyroid; 40 became hypothyroid and 31 remained hyperthyroid. There was no association between outcome and age at diagnosis, gender, ophthalmopathy, pre-RIT FT4, TSH, antithyroid antibodies or thyrostatic drug. Multiple logistic regression showed higher probability of treatment success in patients with thyroid mass <53 g (odds ratio (OR)=8.9), with pre-RIT thyroid uptake <12.5% (OR=4.1) and in patients who withdrew thionamide before RIT (OR=4.9). CONCLUSIONS Fixed doses of 370 MBq of radioiodine seem to be practical and effective for treating Graves' disease patients with [99mTc]pertechnetate uptake <12.5% and thyroid mass <53 g. This treatment is clearly not recommended for patients with large goitre. In contrast to what could be expected, patients with a high pre-RIT thyroid uptake presented a higher rate of RIT failure.
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Affiliation(s)
- Denise E Zantut-Wittmann
- Endocrinology Division, Department of Internal Medicine, State University of Campinas-Campinas, São Paulo, Brazil.
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Santos AO, Zantut-Wittmann DE, Nogueira RO, Etchebehere ECSC, Lima MCL, Tambascia MA, Camargo EE, Ramos CD. 99mTc-sestamibi thyroid uptake in euthyroid individuals and in patients with autoimmune thyroid disease. Eur J Nucl Med Mol Imaging 2005; 32:702-7. [PMID: 15703932 DOI: 10.1007/s00259-004-1728-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2004] [Accepted: 11/08/2004] [Indexed: 11/30/2022]
Abstract
PURPOSE We investigated the biokinetics of (99m)Tc-sestamibi in the thyroid of euthyroid volunteers (EVs) and in patients with autoimmune thyroid diseases and determined the best time interval between (99m)Tc-sestamibi injection and calculation of uptake. METHODS Forty EVs, 30 patients with Graves' disease (GD), 15 patients with atrophic Hashimoto's thyroiditis (AHT) and 15 patients with hypertrophic Hashimoto's thyroiditis (HHT) underwent (99m)Tc-sestamibi thyroid scintigraphy. Dynamic images were acquired for 20 min, and static images were obtained 20 min, 60 min and 120 min post injection. Five-, 20-, 60- and 120-min uptake, time to maximal uptake (T(max)) and T(1/2) of tracer clearance were calculated. Thyroid hormones and antibodies were measured. (99m)Tc-pertechnetate uptake was investigated in GD patients. RESULTS T(max) was approximately 5 min in all four groups. The mean T(1/2) value for EVs was similar to the GD value and lower than the HHT and AHT values. The mean (+/-SD) 5-min uptake was 0.13% (+/-0.05%) for EVs. The 5-min uptake in GD was higher than that in EVs(P<0.001) and correlated with free thyroxine (r=0.54) and with (99m)Tc-pertechnetate uptake (r=0.68). Uptake in HHT was higher than that in AHT (P=0.0003) and EVs (P=0.002). Uptake in AHT was lower than uptake in EVs (P=0.0001). CONCLUSION Five minutes is the optimal time interval between (99m)Tc-sestamibi injection and calculation of thyroid uptake. Five-minute uptake differentiates euthyroid individuals from GD patients. There is a high correlation between (99m)Tc-sestamibi and (99m)Tc-pertechnetate uptake in GD. The reduced (99m)Tc-sestamibi uptake in AHT patients is probably due to glandular destruction and fibrosis. Inflammatory infiltrate and high mitochondrial density in thyrocytes possibly explain the increased uptake in GD and HHT.
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Affiliation(s)
- Allan O Santos
- Division of Nuclear Medicine, Department of Radiology, School of Medical Sciences, Campinas State University, Campinas, Brazil
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Lima CSP, Bottini PV, Garlipp CR, Santos AO, Costa FF, Saad STO. Accuracy of the urinary albumin to creatinine ratio as a predictor of albuminuria in adults with sickle cell disease. J Clin Pathol 2002; 55:973-5. [PMID: 12461072 PMCID: PMC1769834 DOI: 10.1136/jcp.55.12.973] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM To test the usefulness of a random urine specimen albumin to creatinine ratio (A/C) in predicting 12 hour urinary albumin excretion (12UA) in patients with sickle cell disease. METHODS 12UA and A/C were measured in nocturnal urine collections and random morning urine samples, respectively, of 72 patients with sickle cell disease. RESULTS The correlation of A/C values with 12UA values did not provide support for the use of random urine specimens for predicting urinary albumin excretion (UAE) in these patients. However, values of A/C >/= 0.45 and < 0.45 were indicative of raised and normal UAE, respectively. The sensitivity, specificity, and accuracy of the test were 100.0%, 87.2%, and 91.7%, respectively. CONCLUSIONS This method cannot be recommended for predicting 12UA in patients with sickle cell disease, but it is useful for selecting patients who should collect 12 hour urine for the estimation of UAE.
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Affiliation(s)
- C S P Lima
- Haematology and Haemotherapy Centre, Faculty of Medical Sciences, State University of Campinas, Campinas, São Paulo, Brazil.
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Etchebehere EC, Cendes F, Lopes-Cendes I, Pereira JA, Lima MC, Sansana CR, Silva CA, Camargo MF, Santos AO, Ramos CD, Camargo EE. Brain single-photon emission computed tomography and magnetic resonance imaging in Machado-Joseph disease. Arch Neurol 2001; 58:1257-63. [PMID: 11493166 DOI: 10.1001/archneur.58.8.1257] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Machado-Joseph disease (MJD) is one of the most frequently encountered spinocerebellar ataxias. However, few reports on brain single-photon emission computed tomographic (SPECT) imaging (BSI) with hexylmethylpropylene amineoxine labled with technetium Tc 99m and magnetic resonance imaging (MRI) have been performed for the evaluation of patients with MJD. OBJECTIVES To investigate possible abnormalities with BSI and MRI in patients with MJD and to correlate these findings with the duration of symptoms; cerebellar, extrapyramidal, and pyramidal syndromes; and the molecular characteristics of the MJD mutation. PATIENTS AND METHODS Twelve patients (8 males and 4 females [mean age, 39 years]) with genetically proven MJD were studied. The patients underwent BSI and MRI on the same day. Brain SPECT imaging was performed after an intravenous injection of 99mTc-hexylmethylpropylene amineoxine. The transaxial, coronal, and sagittal BSIs obtained were submitted to visual and semiquantitative analyses. Magnetic resonance imaging was obtained in a 2-T system with coronal, sagittal, transaxial, and 3-dimensional (volumetric) acquisitions. The volumes of the cerebellar hemispheres and vermis were calculated. Control groups for BSI (22 female and 20 male subjects [mean age, 33 years]) and MRI (13 female and 4 male subjects [mean age, 32.2 years]) were included for comparison. RESULTS Correlation was observed between the perfusion abnormalities identified by visual analysis in the BSI with the structural abnormalities observed on MRI in the parietal lobes and vermis. Brain SPECT imaging identified (by visual analysis) more perfusion abnormalities in the inferior portion of the frontal lobes, mesial and lateral portions of the temporal lobes, basal ganglia, and cerebellar hemispheres. Magnetic resonance imaging identified more abnormalities in the pons and superior portions of the frontal lobes. Olivary atrophy was identified by MRI. Semiquantitative analysis showed a statistically significant difference of perfusion in the inferior and superior portions of the frontal lobes, lateral portion of the temporal lobes, parietal lobes, left basal ganglia, cerebellar hemispheres, and vermis when compared with the control group. A significant difference was noted between the vermis and cerebellar volumes on MRI when compared with the control group. A significant relationship was observed between the perfusion of the left parietal lobe (P =.05) and extrapyramidal syndrome. There was a tendency toward an inverse relationship between the duration of symptoms and the perfusion of the cerebellar hemispheres (rho = -0.37; P =.24) and volume of the vermis (rho = -0.30; P =.34); between the length of the expanded (CAG)n repeat and the perfusion of the left parietal lobe (rho = -0.32; P =.36), vermis (rho = -0.28; P =.43), and pons (rho = -0.28; P =.42). A direct association was observed between the length of the expanded (CAG)n repeat and the perfusion of the lateral portion of the right temporal lobe (rho = 0.67; P =.03). CONCLUSIONS Brain SPECT imaging and MRI were capable of identifying subclinical abnormalities in individuals with MJD. These findings may be helpful for a better understanding of the pathophysiology of this disease.
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Affiliation(s)
- E C Etchebehere
- Department of Radiology, Campinas State University, UNICAMP, Caixa Postal 6142, 13081-970 Campinas, Brazil.
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Teixeira AB, Sá de Camargo Etchebehere EC, Santos AO, Lima MC, Ramos CD, Camargo EE. Scintigraphic findings of dysplasia epiphysealis hemimelica: a case report. Clin Nucl Med 2001; 26:162. [PMID: 11201484 DOI: 10.1097/00003072-200102000-00022] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- A B Teixeira
- Department of Radiology, Campinas State University, Brazil
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Etchebehere EC, Caron M, Pereira JA, Lima MC, Santos AO, Ramos CD, Barros FB, Sanches A, Santos-Jesus R, Belangero W, Camargo EE. Activation of the growth plates on three-phase bone scintigraphy: the explanation for the overgrowth of fractured femurs. Eur J Nucl Med 2001; 28:72-80. [PMID: 11202455 DOI: 10.1007/s002590000395] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Children with an uncomplicated femoral fracture, treated with superimposition of fragments and intentional shortening, usually develop overgrowth of the fractured femur and the ipsilateral tibia which may compensate for the initial shortening and enable the limb in question to reach a length similar to that on the normal side. The overgrowth is evaluated clinically and by scanography. The increased metabolic activity of the growth plates that support this overgrowth has not been documented by any laboratory method. In order to evaluate the metabolic activity of the growth plates, 18 patients (11 males, seven females; mean age 6.1 years) with fractures of the femur were studied at three different time intervals (2-5 months, 6-12 months and 18-24 months). Three-phase bone scintigraphy was performed in all patients. Ten children (five males, five females; mean age 7.5 years) who had had bone imaging for other reasons were used as the control group. Visual analysis of the flow and equilibrium phases was performed for the distal femoral and proximal tibial growth plates. Visual and semi-quantitative analyses of the delayed images were performed for the distal femoral and proximal and distal tibial growth plates. Semi-quantitative analyses yielded the following activity ratios: (a) the distal femoral growth plate of the fractured femur to the contralateral one (FR); (b) the proximal growth plate of the tibia on the side of the fractured femur to the contralateral one (TpR); (c) the distal growth plate of the tibia on the side of the fractured femur to the contralateral one (TdR); and (d) in the control group, the distal growth plates of both femora (FCG) and the proximal (TCGp) and distal (TCGd) growth plates of the tibiae. Visual analysis of the blood flow, equilibrium and delayed images showed increased activity in the distal femoral growth plates during the first and second time intervals, but not during the third. No significant activity changes were found in the proximal and distal tibial growth plates during any of the phases analysed. The mean and standard deviation for FR in the three time intervals were: FRI=1.22+/-0.27, FRII=1.17+/-0.16 and FRIII=1.09+/-0.20. FR values were significantly higher than in the control group (FCG=0.99+/-0.03) (P=0.033). The mean and standard deviation for TpR in the three time intervals were: TpRI=1.08+/-0.18, TpRII=0.94+/-0.09 and TpRIII=0.96+/-0.20. TpR values were not significantly different from those in the control group (TCGp=1.00+/-0.05). However, TpRI was significantly higher than TpRII (P=0.043). The mean and standard deviation for TdR in the three time intervals were: TdRI=1.10+/-0.41, TdRII=1.05+/-0.15 and TdRIII=1.13+/-0.36. TdR values were not significantly higher than in the control group (TCGd=1.00+/-0.04) (P=0.777). These results support the concept that three-phase bone imaging is able to quantify and determine that activation occurs in the distal femoral and proximal tibial growth plates of fractured femora. This phenomenon may explain the overgrowth observed in this injured bone structure.
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Abstract
A 47-year-old woman with adenocarcinoma of the right breast had bone scintigraphy with Tc-99m MDP. Bone imaging did not show any metastases. However, a large area of increased tracer uptake was seen extending from the abdomen to the pelvis. Abdominal ultrasound revealed a large solid and heterogeneous mass, measuring 18 x 11 x 14.3 cm, that originated in an empty uterus. A biopsy of the surgical specimen showed a leiomyoma of the uterus.
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Affiliation(s)
- A B Teixeira
- Department of Radiology, Campinas State University, Brazil
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Teixeira AB, Etchebehere EC, Lima MC, Santos AO, Pires BC, Valença JT, Ramos CD, Camargo EE. Gallium-67 imaging in a patient with paracoccidioidomycosis: a case report. Rev Inst Med Trop Sao Paulo 2000; 42:167-70. [PMID: 10887378 DOI: 10.1590/s0036-46652000000300011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A 26 year-old female was admitted with abdominal pain, fever and weight loss. The clinical and laboratory investigations led to the diagnosis of paracoccidioidomycosis. Gallium-67 whole body images correlated well with the clinical course of the disease and with the patient's prognosis.
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Affiliation(s)
- A B Teixeira
- Division of Nuclear Medicine, Department of Pathology, Department of Radiology, Campinas State University, Campinas, Brazil
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Pin CA, Grigolon MV, Etchebehere EC, Santos AO, Lima MC, Ramos CD, Camargo EE. Detection of synchronous carcinomas of the colon with F-18 fluorodeoxyglucose: a case report. Clin Nucl Med 2000; 25:370-1. [PMID: 10795698 DOI: 10.1097/00003072-200005000-00011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Colon and rectal carcinomas are common in North America and Northwestern Europe. In South America, the risk of this disease is not as great. Adenocarcinomas are the most common types of tumors, and they occur mainly in the descending colon, sigmoid, and rectum. A patient with a possible right colon carcinoma was examined using F-18 FDG.
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Affiliation(s)
- C A Pin
- Department of Radiology, Campinas State University, Brazil.
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Etchebehere EC, Lima MC, Passos W, Maciel Júnior JA, Santos AO, Ramos CD, Camargo EE. Brain SPECT imaging in Huntington's disease before and after therapy with olanzapine. Case report. Arq Neuropsiquiatr 1999; 57:863-6. [PMID: 10751925 DOI: 10.1590/s0004-282x1999000500021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Olanzapine, an atypical antipsychotic drug, was administered to a patient with Huntington's disease (HD) with marked choreiform movements. Brain SPECT with 99mTc-HMPAO was performed before and after treatment. Brain SPECT imaging has been performed in patients with HD in order to determine the status of basal ganglia perfusion. The use of brain SPECT with 99mTc-HMPAO before and after treatment in patients with HD has not been yet reported. The marked hypoperfusion of the basal ganglia on brain SPECT performed before therapy with olanzapine improved significantly after treatment.
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Affiliation(s)
- E C Etchebehere
- Department of Radiology, Faculdade de Ciências Médicas (FCM) da Universidade Estadual de Campinas (UNICAMP), Brazil.
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