ABSTRACT Purpose: To evaluate the presence of congenital hypertrophy of the retinal pigment epithelium in a large family affected by familial adenomatous polyposis and identify the causative mutation in the adenomatous polyposis coli gene. Thus, we aimed to determine the significance of congenital hypertrophy of the retinal pigment epithelium as a phenotypic marker of the disease. Methods: A family consisting of 95 individuals was evaluated. Among these, 45 individuals were randomly selected by convenience sampling method to undergo ophthalmological evaluation. A funduscopic exam, including slit lamp and indirect ophthalmoscopy, were performed in the selected patients. In those with retinal lesions, a retinography was obtained. The adenomatous polyposis coli gene was sequenced in one affected family member to identify the pathogenic mutation. Once the variant was identified, six undiagnosed family members were tested for the mutation via capillary electrophoresis sequencing. Results: Congenital hypertrophy of the retinal pigment epithelium was observed in 13 (28.9%) of the 45 individuals evaluated. Of these, nine patients were confirmed to have familial adenomatous polyposis (via colonoscopy or molecular testing). However, four patients had not been investigated. Of the 32 (71.1%) family members without the lesion, 14 did not have familial adenomatous polyposis and 18 were yet to be evaluated. The lesions were bilaterally present and exhibited a peculiar fish-tail shape in all the evaluated individuals. Adenomatous polyposis coli gene sequencing revealed a pathogenic variant c.4031del. (Ser1344*), in heterozygosity (49.27%), in exon 16. Conclusions: The study findings confirmed the significance of congenital hypertrophy of the retinal pigment epithelium as a phenotypic marker for familial adenomatous polyposis. Furthermore, it is an effective first-line screening method for at risk family members of such patients. The novel mutation identified in our study participants, which is yet to be described in the literature, causes an aggressive form of the disease. Purpose Thus disease Methods 9 these 4 evaluation exam ophthalmoscopy obtained Results 1 28.9% 289 28 (28.9% testing. testing . testing) However investigated 3 71.1% 711 71 (71.1% lesion fishtail fish tail c4031del cdel c 4031del del c.4031del Ser1344*, Ser1344 Ser Ser1344* , (Ser1344*) 49.27%, 4927 49.27% 49 27 (49.27%) 16 Conclusions Furthermore firstline first line participants literature 28.9 2 (28.9 71.1 7 (71.1 Ser134 (Ser1344* 492 49.27 (49.27% 28. (28. 71. (71. Ser13 (Ser1344 49.2 (49.27 (28 (71 Ser1 (Ser134 49. (49.2 (2 (7 (Ser13 (49. ( (Ser1 (49 (Ser (4

ABSTRACT Purpose: This study aimed to evaluate the total macular thickness as well as the thickness of the inner and outer retinal layers in patients with Parkinson’s disease. It also aimed to verify the correlation of these parameters with motor symptoms and cognitive function. Methods: A total of 46 eyes of 23 patients with Parkinson’s disease and 40 eyes of 20 healthy controls were included in the study. The patients’ cognitive, functional, and nonmotor symptoms were evaluated using the Katz Index of Independence and Pfeffer’s Activities of Daily Living, Mini-Mental State Examination, Frontal Assessment Battery, Schwab and England Staging Scales, and Movement Disorders Society Nonmotor Symptoms Scale. The macular thickness measurements obtained via total, inner, and outer optical coherence tomography were recorded. Furthermore, the correlation of the parameters of optical coherence tomography with cognitive, functional, and nonmotor symptoms was assessed. Results: The scores of the Katz Index of Independence and Pfeffer’s Activities of Daily Living as well as the Movement Disorders Society Nonmotor Symptoms Scale were significantly lower in patients with Parkinson’s disease than in healthy controls. Moreover, the former had greater total macular thickness. The temporal and inferior outer sectors were significantly greater for the ganglion cell complex thickness in patients. A significant correlation was observed between the total macular thickness and the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale, Parte III (MDS-UPDRS-III) values. Contrarily, there was a negative correlation between the outer macular thickness and the MDS-UPDRS-III values. Meanwhile, the total macular thickness and ganglion cell complex thickness were significantly correlated with the scores of the Mini-Mental State Examination, Schwab and England Staging Scale, Frontal Assessment Battery, and Katz Index of Independence and Pfeffer’s Activities of Daily Living. In addition, the Schwab and England scale was correlated with the outer macular thickness. Conclusion: The total and inner macular thicknesses at the temporal and inferior outer sectors were greater in patients with Parkinson’s disease than in the control group. These findings indicate that macular thickness may be greater in those with Parkinson’s disease, particularly when associated with mild motor symptoms. In addition, the parameters of the total, inner, and outer optical coherence tomography were significantly associated with motor and nonmotor symptoms as well as cognitive function impairment. Purpose Parkinsons Parkinson s Methods 4 2 functional Pfeffers Pfeffer MiniMental Mini Mental Examination Battery Scales recorded Furthermore assessed Results Moreover SocietyUnified Unified MDSUPDRSIII MDS UPDRS (MDS-UPDRS-III values Contrarily Meanwhile addition Conclusion group impairment

ABSTRACT Purpose: This study aimed to characterize retinitis pigmentosa associated with the eyes shut homolog gene, which causes hereditary retinal degeneration. Methods: The anatomical and functional findings of retinitis pigmentosa in patients with variants of the eyes shut homolog gene were characterized and compared using multimodal imaging and genetic analysis of the variants. Clinical data such as visual acuity, lens status, and refraction were obtained from medical records. Patients underwent an ophthalmic examination, including static visual field, microperimetry, optical coherence tomography, fundus autofluorescence, and fundus photography. Results: Twenty-two patients were included in the study. Several anatomical and functional characteristics of retinitis pigmentosa-eyes shut homolog were identified, including the presence of cataracts, cystoid macular edema, epiretinal membrane, and a tubular visual field. Genetic results revealed 26 distinct variants in the cohort, with 7 novel variants not previously documented or reported in the scientific literature or databases. Conclusion: The findings demonstrate that eyes shut homolog-retinitis pigmentosa manifests in specific patterns, starting in adolescence with mild progression and advancing with age. The integration of multimodal imaging and genetic analysis has provided a detailed understanding of the anatomical and functional features of retinitis pigmentosa-eyes shut homolog. Seven novel variants of the eyes shut homolog gene have been identified. These findings enhance the understanding of eyes shut homolog-related retinitis pigmentosa characteristics of by detailing the spectrum of mutations in this gene within the Brazilian population. Purpose degeneration Methods acuity status records examination field microperimetry tomography autofluorescence photography Results Twentytwo Twenty two pigmentosaeyes identified cataracts edema membrane 2 cohort databases Conclusion homologretinitis patterns age homologrelated related population

RESUMO: A osteologia desempenha um papel indispensável para o conhecimento dos padrões de normalidade das diversas espécies, sendo a base para o entendimento zoológico. Mazama nana é bastante conhecido no Brasil, porém descrições morfológicas básicas acerca da espécie são escassas, enquanto Subulo gouazoubira, revalidação atual de Mazama gouazoubira, também é incidente no Brasil e, atualmente, tem sido alvo de diversos estudos filogenéticos. Nesse escopo, no presente estudo, foram preparadas, osteologicamente, 19 cabeças de cervídeos (16 Subulo gouazoubira e três Mazama nana) e, em seguida, tomografias computadorizadas (TCs) foram realizadas a fim de aprimorar as formas de avaliação de acidentes ósseos, além de estruturas internas e forames mediante técnicas de reconstrução em três dimensões (3D) devido a difícil visibilidade em peças intactas. Posteriormente, realizou-se um comparativo entre as reconstruções, fotografias digitais e secções tomográficas transversais do crânio, o qual possibilitou a visualização de peculiaridades e exclusividades anatômicas, como a presença da fenestra nasolacrimomaxilar, detalhamento dos seios paranasais e arquitetura de ossos finos, além do formato exclusivo dos ossos cranianos, em comparação a outras espécies, que apresentam um fenótipo único e genuíno. RESUMO espécies zoológico escassas atualmente filogenéticos escopo estudo preparadas osteologicamente 1 16 (1 seguida TCs (TCs ósseos 3D D (3D intactas Posteriormente realizouse realizou se reconstruções crânio anatômicas nasolacrimomaxilar finos cranianos genuíno (

ABSTRACT: Osteology plays an indispensable role in understanding the normal patterns of different species, serving as the foundation for zoological understanding. Mazama nana is well-known in Brazil; however, basic morphological descriptions of the species are scarce, while Subulo gouazoubira, currently revalidated as Mazama gouazoubira, is also prevalent in Brazil and has recently been the subject of various phylogenetic studies. In this respect, in the present study, 19 cervid heads (16 Subulo gouazoubira and three Mazama nana) were osteologically prepared. Next, computed tomographies (CTs) were performed to enhance the assessment of bone accidents, as well as internal structures and foramina through three-dimensional (3D) reconstruction techniques due to the difficult visibility in intact specimens. A comparison was then made between the reconstructions, digital photographs, and CT cross-sections of the skull, which enabled the visualization of anatomical peculiarities and exclusivities, such as nasolacrimal-maxillary fenestra, paranasal sinuses, and thin bone architecture, as well as the unique shape of cranial bones, compared to other species that exhibit a unique and genuine phenotype. ABSTRACT wellknown known however scarce studies respect study 1 16 (1 prepared Next CTs (CTs accidents threedimensional dimensional 3D D (3D specimens reconstructions photographs crosssections cross sections skull exclusivities nasolacrimalmaxillary nasolacrimal maxillary fenestra sinuses architecture bones phenotype (

ABSTRACT Purpose: To compare the outcomes of intravitreal dexamethasone implant used as either an adjuvant or a switching therapy for diabetic macular edema in patients with poor anatomic response after three consecutive monthly injections of ranibizumab. Methods: This retrospective study included patients with diabetic macular edema who received three consecutive doses of ranibizumab as initial therapy and demonstrated poor response. A single dose of intravitreal de xamethasone implant was administered to these patients. The patients were divided into two groups according to the treatment modalities: the adjuvant therapy group, consisting of patients who continued treatment with ranibizumab injection after receiving intravitreal dexamethasone implant, and the switch therapy group, consisting of patients who were switched from ranibizumab treatment to intravitreal dexamethasone implant as needed. The main outcome measurements were best corrected visual acuity and central retinal thickness at baseline and at 3, 6, 9, and 12 months of follow-up. Results: In this study that included 64 eyes of 64 patients, the best corrected visual acuity and central retinal thickness values did not significantly differ between the groups at baseline and at 6 months of follow-up (p>0.05). However, at 12 months, the best corrected visual acuity values in the adjuvant and switch therapy groups were 0.46 and 0.35 LogMAR, respectively (p=0.012), and the central retinal thickness values were 344.8 and 270.9, respectively (p=0.007). Conclusions: In a real-world setting, it seems more reasonable to use intravitreal dexamethasone implant as a switch therapy rather than an adjuvant therapy for diabetic macula edema refractory to ranibizumab despite three consecutive monthly injections of ranibizumab. Patients switched to intravitreal dexamethasone implant were found to have better anatomic and visual outcomes at 12 months than those who continued ranibizumab therapy despite their less-than-optimal responses. Purpose Methods modalities group needed 3 9 1 followup. followup follow up. up Results p>0.05. p005 p p>0.05 . 0 05 (p>0.05) However 046 46 0.4 035 35 0.3 LogMAR p=0.012, p0012 p=0.012 , 012 (p=0.012) 3448 344 8 344. 2709 270 270.9 p=0.007. p0007 p=0.007 007 (p=0.007) Conclusions realworld real world setting lessthanoptimal less optimal responses p00 p>0.0 (p>0.05 04 4 0. 03 p001 p=0.01 01 (p=0.012 34 27 270. p000 p=0.00 00 (p=0.007 p0 p>0. (p>0.0 p=0.0 (p=0.01 2 (p=0.00 p>0 (p>0. p=0. (p=0.0 p> (p>0 p=0 (p=0. (p> p= (p=0 (p (p=

ABSTRACT Purpose: This study aimed to evaluate the morphometric and volumetric dimensions of the lacrimal gland in patients with inactive thyroid eye disease and compare them with the values reported in the literature. Methods: This case series evaluated consecutive patients with inactive thyroid eye disease treated at a tertiary eye hospital from 2015 to 2020. The patients’ baseline demographics and clinical characteristics were obtained. The axial and coronal length, width, and volume of the lacrimal gland were measured on computed tomography scan images, and the results were statistically analyzed. Results: A total of 21 patients (42 orbits) with inactive thyroid eye disease were evaluated. Their mean age was 49.0 ± 14.6 years, and 12 (57.1%) of them were men. The main complaint was dryness, and the majority of the patients had good vision and mild proptosis. The mean axial length and width of the lacrimal gland were 19.3 ± 3.9 mm and 7.5 ± 2.1 mm, respectively; coronal length and width, 20.4 ± 4.5 mm and 7.5 ± 2.1 mm, respectively; and lacrimal gland volume, 0.825 ± 0.326 mm3. Age, sex, or laterality were not found to be determinants of lacrimal gland enlargement. Conclusion: Patients with thyroid eye disease have enlarged lacrimal gland even in the nonactive phase of the disease multifactorial aspects influence the lacrimal gland in thyroid eye disease, making it difficult to establish a clear correlation with predisposing factors. Further studies are warranted to better understand the association between thyroid eye disease and the lacrimal gland. Purpose literature Methods 201 2020 obtained images analyzed Results 2 42 (4 orbits 490 49 0 49. 146 14 6 14. years 1 57.1% 571 57 (57.1% men dryness proptosis 193 19 3 19. 39 9 3. 75 7 5 7. 2. respectively 204 20 4 20. 45 4. 0825 825 0.82 0326 326 0.32 mm3 Age sex enlargement Conclusion factors 202 ( 57.1 (57.1 082 82 0.8 032 32 0.3 57. (57. 08 8 0. 03 (57 (5

RESUMO: O objetivo deste trabalho foi descrever mapas corneanos e imagens tomográficas do segmento anterior de gatos jovens sem raça definida e compará-los com aqueles descritos em humanos. Foram analisados os exames de 13 gatos sem raça definida (25 olhos) com idade entre 18 e 48 meses. Os seguintes mapas fornecidos pelo Galilei G4 foram analisados qualitativamente: curvatura axial e instantânea, paquimetria, poder total da córnea e elevação “best fit sphere” (BFS) e “best fit toric asphere” (BFTA). Além disso, foram analisados valores de curvaturas axiais e instantâneas anterior e posterior, potência total da córnea e paquimetria, além de imagens tomográficas do segmento anterior. Os mapas topográficos descrevem a região central da córnea dos gatos. Os mapas de curvatura axial anterior e posterior eram uniformemente planos. O mapa instantâneo da curvatura anterior era asférico. Um anel em formato semelhante a um donut foi observado no mapa de curvatura instantânea posterior. Nenhum padrão foi observado nos mapas de elevação. Os mapas de potência total da córnea tenderam à monofocalidade e 11 mapas apresentaram um triângulo multifocal regressivo na região inferior. O mapa de paquimetria foi uniforme e a paquimetria entre as zonas corneanas não diferiu estatisticamente. A câmara anterior era profunda com amplo ângulo que se estreita próximo à periferia; as superfícies anterior e posterior da córnea e a superfície anterior do cristalino tendiam a ser paralelas. Os mapas corneanos e as imagens tomográficas do segmento anterior de gatos jovens sem raça definida diferiram daqueles descritos em humanos. Foi observado o centro da córnea do gato mais plano esférico, uniformemente espesso e com tendência à monofocalidade. As superfícies anterior e posterior da córnea e a superfície anterior do cristalino tenderam a ser paralelas. RESUMO comparálos compará los humanos 1 25 (2 olhos 4 meses G qualitativamente best sphere BFS (BFS asphere BFTA. BFTA . (BFTA) disso planos asférico inferior estatisticamente periferia paralelas esférico 2 ( (BFTA

ABSTRACT: This research described corneal maps and anterior-segment tomographic images of young mixed breed cats and compared them to those described in humans. The exams of 13 mixed-breed cats (25 eyes) aged between 18 and 48 months were analyzed. The following maps provided by the Galilei G4 were analyzed qualitatively: axial and instantaneous curvature, pachymetry, total corneal power and best fit sphere (BFS) and best fit toric asphere (BFTA) elevation. Furthermore, anterior and posterior axial and instantaneous curvatures, total corneal power and pachymetry values were analyzed in addition to anterior segment tomography images. The topography maps described the central region of the cats’ cornea. Anterior and posterior axial curvature maps were uniformly flat. Instantaneous anterior curvature map was aspheric. A ring in a shape similar to a donut was observed in the posterior instantaneous curvature map. No patterns were observed in the elevation maps. Total corneal power maps tended to monofocality and eleven maps presented a regressive multifocal triangle in the inferior region. The pachymetry map was uniform and pachymetry among the corneal zones did not differ statistically. The anterior chamber was deep with a wide angle that narrows close to the periphery; the anterior and posterior corneal surfaces and the anterior surface of the lens tended to be parallel. Young mixed breed cats’ corneal maps and anterior segment tomographic images differed from those described in humans. The center of the cat’s cornea was flatter, spherical, uniformly thick and tended to monofocality. Anterior and posterior corneal surfaces and the anterior surface of the lens tended to be parallel. ABSTRACT anteriorsegment humans 1 mixedbreed 25 (2 eyes 4 G qualitatively BFS (BFS BFTA (BFTA Furthermore curvatures flat aspheric statistically periphery parallel cat s flatter spherical 2 (

ABSTRACT Introduction: Bronchial asthma is a chronic inflammatory disease of the airways with a prevalence of approximately 7% in the Portuguese population, affecting individuals of all ages. Occupational asthma accounts for 5% to 20% of late-onset asthma cases and is often associated with exposure to chemical irritants or other agents in the workplace. Early diagnosis and intervention, including the removal of the causal agent, are essential for improving prognosis. This case report describes the development of occupational asthma in a woman with prolonged exposure to irritant products in her work as a domestic worker. This case report aims to highlight the importance of early diagnosis and the use of personal protective equipment in the prevention of occupational asthma and its’ biopsychosocial implications. Clinical Case: A 62-year-old woman, a domestic worker since the age of 13, with a medical history of allergic rhinitis, depressive disorder, osteoporosis, and prior surgery for an epigastric hernia, presented for consultation. Pulmonary nodules were identified in the right lung during a computed tomography (CT) scan. The patient denied the presence of respiratory symptoms. However, during the pneumology consultation, she described chest tightness upon exertion and in environments with strong smells over the past six years, symptoms that she didn't appreciate before. Respiratory function tests revealed mild bronchial hyperreactivity, confirmed through a methacholine challenge test. Based on these findings and the patient’s occupational history, a diagnosis of non-IgE-mediated asthma was established. The patient began treatment with inhaled fluticasone/vilanterol. Due to her profession, which involved daily exposure to irritant products, a suspicion of occupational disease was reported. In the following years, the patient experienced worsening respiratory and depressive symptoms, leading to her resignation and an unsuccessful attempt at early retirement. She was referred for social support due to financial difficulties resulting from her inability to return to work. Discussion/Conclusion: This case describes a case of non-IgE-mediated asthma in a domestic worker and highlights the importance of personal protective equipment (PPE) in workplaces with exposure to respiratory irritants. The use of PPE could have prevented the development of occupational asthma by mitigating the harmful effects of prolonged exposure to cleaning products. The prognosis for occupational asthma is generally poor, with avoidance of exposure being the primary method of control, as pharmacological treatments have limited impact when exposure persists. This case also illustrates the biopsychosocial consequences of occupational disease, with negative effects on the patient’s quality of life and financial independence, underscoring the importance of a multidisciplinary approach to managing such cases.

RESUMO Introdução: A asma brônquica é uma doença inflamatória crónica das vias aéreas com prevalência de cerca de 7% na população portuguesa, afetando indivíduos de todas as idades. A asma ocupacional representa entre 5% e 20% dos casos de asma de início tardio e está frequentemente associada à exposição a irritantes químicos ou outros agentes no local de trabalho. O diagnóstico precoce e a intervenção, incluindo a remoção do agente causal, são fundamentais para melhorar o prognóstico. Este caso clínico descreve o desenvolvimento de asma ocupacional numa mulher com longa exposição a produtos irritantes no exercício da sua profissão como trabalhadora do serviço doméstico. Com o presente relato de caso pretende-se destacar a importância do diagnóstico precoce e da utilização de equipamentos de proteção individual na prevenção da asma ocupacional, bem como as consequentes implicações biopsicossociais. Caso Clínico: Apresenta-se o caso de uma mulher de 62 anos, trabalhadora do serviço doméstico desde os treze anos, com antecedentes de rinite alérgica, perturbação depressiva, osteoporose e cirurgia a uma hérnia epigástrica. Após a realização de uma tomografia computorizada pulmonar, foram identificados nódulos no pulmão direito. A paciente não referiu sintomatologia respiratória relevante. No entanto, durante a consulta de pneumologia, referiu sensação de opressão torácica com o esforço e em ambientes com cheiros intensos nos últimos seis anos, sintomas que desvalorizava até então. As provas de função respiratória revelaram hiperreatividade brônquica ligeira, confirmada através de uma prova de broncoconstrição com metacolina. Com base nesses achados e na história ocupacional, foi assumido o diagnóstico de asma não IgE mediada. A paciente iniciou tratamento com terapêutica inalatória com fluticasona/vilanterol. Devido à sua profissão, que envolvia exposição diária a produtos irritantes, foi notificada a suspeita de doença profissional. Nos anos seguintes, a paciente apresentou agravamento da sintomatologia respiratória e, consequentemente, depressiva, o que conduziu ao seu despedimento e tentativa de reforma antecipada, que foi indeferida. A paciente foi referenciada para apoio social devido às dificuldades económicas resultantes da incapacidade para retomar a atividade laboral. Discussão/Conclusão: Este caso clínico descreve um quadro de asma não IgE mediada numa trabalhadora do serviço doméstico e evidencia a importância da proteção individual em ambientes de trabalho com exposição a agentes irritantes respiratórios. A utilização de Equipamentos de Proteção Individual (EPIs) poderia ter prevenido o desenvolvimento da asma ocupacional, mitigando os efeitos nocivos da exposição prolongada a produtos de limpeza. O prognóstico da asma ocupacional é geralmente mau, sendo a evicção da exposição o principal método de controlo, uma vez que os tratamentos farmacológicos têm impacto limitado quando a exposição persiste. Este caso ilustra também as consequências biopsicossociais da doença ocupacional, com efeitos negativos sobre a qualidade de vida e independência financeira da utente, sublinhando a importância da abordagem multidisciplinar para a sua gestão.

Abstract Coronary computed tomography angiography (angio-CT or CCTA) allows the coronary arteries and the rest of the heart to be analyzed, and depending on the protocol used, the anatomy, physiology and function can be evaluated. Its main indication is the characterization of atheromatous involvement of the coronary arteries. New technologies have made it possible to add physiological information to stenosis, which optimizes patient management. The ability to analyze the anatomy of the rest of the heart and its function makes it a very useful examination in the evaluation of other pathologies. The purpose of this article is to describe the current indications of the study.

Resumen La angiografía coronaria por tomografía computada (cardio-TC o angio-TC coronaria) permite analizar las arterias coronarias y el resto del corazón, y dependiendo del protocolo utilizado se pueden evaluar la anatomía, la fisiología y la función. Su principal indicación es la caracterización del compromiso ateromatoso de las arterias coronarias. Las nuevas tecnologías han permitido agregar información fisiológica a la estenosis, lo que optimiza el manejo de los pacientes. La capacidad de analizar la anatomía del resto del corazón y su función la convierten en un examen muy útil en la evaluación de otras patologías. El presente artículo tiene por objetivo describir las indicaciones actuales del estudio.

Abstract Introduction: The limited availability of data in Chile on the use of diagnostic images (DI) poses a challenge in the efficient management of resources. Objective: To quantify and characterize the use of DI in hospitalized subjects in Chile for 1 year. Method: Descriptive population based study on the use of DI in Chile during 2019 in hospitalized subjects using an official national database recorded with the diagnosis-related groups (DRG) system. Demographic variables related to hospitalization and derived from the DRG were analyzed. Results: 55.5% of hospital events involved at least one DI (n = 466,306). The most used imaging technique was radiography/X-ray (36.4%), followed by computed tomography (35%). The Magallanes and Aysén regions exhibited the highest DI rates. Hospitalized patients who required some DI had an average of days of hospitalization and mortality rate that were 3.4 and 5.5 times greater than those who did not require DI (p < 0.01). Conclusions: There are important geographical differences in the use of DI in Chile. Our description will facilitate future studies that delve deeper and explore access or socioeconomic differences.

Resumen Introducción: La escasa disponibilidad de datos en Chile sobre el uso de imágenes diagnósticas (ID) plantea un desafío en la gestión eficiente de recursos. Objetivo: Cuantificar y caracterizar el uso de ID en sujetos hospitalizados en Chile durante 1 año. Método: Estudio poblacional descriptivo sobre el uso de ID en Chile durante el año 2019 en sujetos hospitalizados utilizando una base de datos nacional oficial consignada con la herramienta de grupos relacionados a diagnósticos (GRD). Se analizaron variables demográficas, relativas a la hospitalización y derivadas de los GRD. Resultados: El 55,5% de los eventos hospitalarios involucró al menos una ID (n = 466.306). La modalidad de imagen más utilizada fue la radiografía (36,4%), seguida por la tomografía computada (35%). Las regiones de Magallanes y Aysén exhibieron las tasas de ID más altas. Los pacientes hospitalizados que requirieron alguna ID obtuvieron unos promedios de días de hospitalización y letalidad 3,4 y 5,5 veces mayores que los que no requirieron ID (p < 0,01). Conclusiones: Existen importantes diferencias geográficas en la utilización de ID en Chile. Nuestra descripción facilitará la realización de futuros estudios que profundicen y exploren las diferencias en el acceso o socioeconómicas.

Abstract In the diagnosis of diffuse interstitial lung diseases, the gold standard is multidisciplinary evaluation. This means a clinical, radiological and histopathological consensus. The ideal is to have an experienced team of specialists, mainly in cases that present difficulty in definitive diagnosis, without categorical characteristics of a specific pathology. High-resolution computed tomography is the imaging test of choice that contributes to the definitive diagnosis. The purpose of this article is to analyze the imaging patterns of idiopathic fibrotic diseases: usual interstitial pneumonia, idiopathic pulmonary fibrosis, combined pulmonary fibrosis and emphysema, non-specific interstitial pneumonia and pleuroparenchymal fibroelastosis. Initially we will also analyze the interstitial lung abnormality. Finally, we will refer to the growing use of artificial intelligence in the evaluation and progression of diffuse lung diseases, and to the application of a recently developed technique, photon counting computed tomography.

Resumen En el diagnóstico de las enfermedades pulmonares intersticiales difusas, el método de referencia es la evaluación multidisciplinaria. Esto significa un consenso clínico, radiológico e histopatológico. Lo ideal es contar con un equipo experimentado de especialistas, principalmente en casos que presentan dificultad en el diagnóstico definitivo, sin características categóricas de una patología específica. La tomografía computada de alta resolución es la prueba de imagen de elección que contribuye en el diagnóstico definitivo. El propósito de este artículo es analizar los patrones imagenológicos de las enfermedades idiopáticas fibróticas: fibrosis pulmonar usual o idiopática, fibrosis pulmonar y enfisema combinados, fibrosis pulmonar no específica y fibroelastosis pleuroparenquimatosa. Analizaremos además al inicio la anormalidad pulmonar intersticial. Finalmente, haremos referencia al creciente uso de la inteligencia artificial en la evaluación y la progresión de las enfermedades pulmonares difusas, y a la aplicación de una técnica de desarrollo reciente, la tomografía computada con conteo de fotones.

Abstract Advances in the diagnosis and treatment of multiple myeloma have led to the modification of diagnostic criteria and initiation of therapy, incorporating myeloma-defining events into the CRAB criteria. Imaging has evolved from radiographic study to whole-body techniques, including low-dose computed tomography (LDCT), 18F-fluorodeoxyglucose positron emission tomography (PET/CT), and whole-body magnetic resonance imaging (MRI), being an important part of the evaluation of myeloma precursors, the staging of the disease and the evaluation of treatment response. LDCT has greater sensitivity in the detection of bone lesions compared to the radiographic study, MRI has the greatest sensitivity in the evaluation of bone marrow infiltration and PET/CT is the method of choice in the evaluation of treatment response. The radiologist must know the morphological characteristics of the lesions originating from myeloma in the different techniques and recognize the advantages and disadvantages of the different types of study.

Resumen Los avances en el diagnóstico y el tratamiento del mieloma múltiple han llevado a la modificación de los criterios diagnósticos y de inicio de terapia, incorporándose a los criterios CRAB los eventos definitorios de mieloma. Las imágenes han evolucionado desde el estudio radiográfico hasta las modalidades de cuerpo completo, incluyendo la tomografía computada de baja dosis (TCBD), la tomografía computada por emisión de positrones (PET/CT) con 18F-fluorodesoxiglucosa y la resonancia magnética (RM) de cuerpo completo, siendo parte importante de la evaluación de los precursores del mieloma, de la estadificación de la enfermedad y de la evaluación de la respuesta a tratamiento. La TCBD posee mayor sensibilidad en la detección de lesiones óseas en comparación con el estudio radiográfico, la RM la mayor sensibilidad en la evaluación de la infiltración de la médula ósea y la PET/CT es la modalidad de elección en la valoración de la respuesta al tratamiento. El radiólogo debe conocer las características morfológicas de las lesiones originadas del mieloma en las distintas modalidades y reconocer las ventajas y desventajas de los diferentes tipos de estudio.

RESUMEN Introducción: Las luxaciones traumáticas de codo posteromediales asociadas a fracturas de cóndilo externo constituyen una lesión poco común dentro de la patología ortopédica. Pueden pasar desapercibidas si no se tiene la sospecha clínica, y la falla en el diagnóstico y tratamiento pueden derivar en un mal pronóstico funcional para el miembro lesionado. Metodología: Entre el año 2020 y 2022 identificamos 3 pacientes pediátricos con luxación posteromedial de codo asociado a fractura del cóndilo externo. Los tres pacientes presentaron fractura de cóndilo externo tipo 2 de la clasificación de Milch. Todos los pacientes fueron tratados de manera quirúrgica. Tuvieron un seguimiento de 2 años, salvo en uno de ellos, el cual fue de 18 meses. Se realizó un seguimiento clínico y radiológico para la evaluación de la lesión, al tiempo que se aplicó el cuestionario DASH a los 3 pacientes. Resultados: Se obtuvieron excelentes resultados en 2 de los pacientes y buen resultado en uno de ellos dado por una pérdida de la extensión de 15 grados. Aunque todos tuvieron un buen resultado en el cuestionario funcional DASH adaptado. Conclusión: La luxación de codo asociado a la fractura de cóndilo externo es una lesión poco común. Es necesario realizar un diagnóstico precoz a través de un correcto estudio de la lesión, ya sea con radiografías, artrografía, tomografía o resonancia magnética. Se pueden lograr buenos resultados siempre que se realice un correcto tratamiento de la misma con un exhaustivo control evolutivo.

ABSTRACT Introduction: Traumatic posteromedial elbow dislocations associated with external condyle fractures constitute a rare injury in orthopedic pathology. They can go unnoticed if there is no clinical suspicion, and failure in diagnosis and treatment can lead to a poor functional prognosis for the injured limb. Methods: Between 2020 and 2022, we identified 3 pediatric patients with posteromedial elbow dislocation associated with an external condyle fracture. The three patients presented type 2 external condyle fracture of the Milch classification. All patients were treated surgically. A 2-year follow-up was carried out, except in one of them. A clinical and radiological follow-up was performed to evaluate the injury. The DASH questionnaire was administered to the 3 patients. Results: Excellent results were obtained in 2 of the patients and a good result in one of them due to a loss of extension of 15 degrees. Although everyone had a good DASH functional questionnaire. Conclusion: Elbow dislocation associated with lateral condyle fracture is a rare injury. It is necessary to make an early diagnosis through a correct study of the injury, whether with x-rays, arthrography, tomography or magnetic resonance imaging. Good results can be achieved as long as correct treatment is carried out with exhaustive evolutionary control.

RESUMO Introdução: As luxações póstero-mediais traumáticas do cotovelo associadas a fraturas do côndilo externo constituem uma lesão rara na patologia ortopédica. Podem passar despercebidos se não houver suspeita clínica, e a falha no diagnóstico e tratamento pode levar a um mau prognóstico funcional para o membro lesado. Metodologia: Entre 2020 e 2022 identificamos 3 pacientes pediátricos com luxação posteromedial do cotovelo associada a fratura do côndilo externo. Os três pacientes apresentavam fratura de côndilo externo tipo 2 da classificação de Milch. Todos os pacientes foram tratados cirurgicamente. Tiveram seguimento de 2 anos, exceto em um deles, que foi de 18 meses. Foi realizado acompanhamento clínico e radiológico para avaliação da lesão e aplicado o questionário DASH nos três pacientes. Resultados: Excelentes resultados foram obtidos em 2 dos pacientes e bom resultado em um deles devido à perda de extensão de 15 graus. Embora todos tenham obtido bom resultado no questionário funcional DASH adaptado. Conclusão: A luxação do cotovelo associada à fratura do côndilo externo é uma lesão rara. É necessário fazer um diagnóstico precoce através de um estudo correto da lesão, seja com radiografias, artrografia, tomografia ou ressonância magnética. Bons resultados podem ser alcançados desde que realizado um tratamento correto e com exaustivo controle evolutivo.

ABSTRACT Sarcoidosis is a chronic inflammatory disease characterized by the prevalence of noncaseating granulomas that can affect multiple organs. We present the case of a 35-year-old male, with no previously known pathologies, a bricklayer, from an urban area. The patient presents a 4-month history that begins with dyspnea and dry cough, as well as a feverish feeling and weight loss. The simple chest tomography showed parahilar condensations and multiple solid nodular and micronodular lesions with a clear predominance in the upper lobes. Histopathology reports non-caseating granulomas in the lung tissue sample. Treatment with systemic corticosteroids was instituted with notable improvement in respiratory symptoms.

RESUMEN La sarcoidosis es una enfermedad inflamatoria crónica caracterizada por la prevalencia de granulomas no caseosos que puede afectar múltiples órganos. Presentamos el caso de un varón de 35 años de edad, sin patologías conocidas previamente, albañil, procedente de zona urbana. Presenta un cuadro de 4 meses de evolución que inicia con disnea y tos seca, además de sensación febril y pérdida de peso. En la tomografía de tórax simple se visual condensaciones parahiliares y múltiples lesiones nodulares y micronodulares sólidas con claro predominio en lóbulos superiores. La histopatología informa granulomas no caseosos en la muestra de tejido pulmonar. Se instaura tratamiento con corticoides sistémicos con notable mejoría de los síntomas respiratorios.

ABSTRACT Purpose: Vacuum-assisted mini-percutaneous nephrolithotomy (vmPCNL) is being increasingly adopted due to its faster operating times and lower incidence of postoperative infectious complications (IC), however, studies have been limited by small sample sizes. We hypothesize that vmPCNL is an efficacious treatment for renal stone disease with acceptable stone-free rates (SFR) and low incidence of IC. The objectives of this study were to measure SFR three months after surgery, determine the factors influencing SFR, and determine the rates of postoperative IC after vmPCNL. Materials and Methods: Seven hundred and sixty seven patients underwent vmPCNL for the treatment of renal stones > 20 mm at a single institution. Patients underwent postoperative computed tomography at three months to assess SFR. Postoperative fever and SIRS/Sepsis were recorded for individual patients. Multivariate logistics regression was performed to assess predictors of SFR. Results: The SFR was found to be 73.7% at three months. Stone burden (OR 0.39, 95% CI [0.33-0.46]) and age (OR 1.03, 95% CI [1.01-1.04]) emerged as statistically significant predictors of SFR on multivariate analysis. 5.5% of patients experienced postoperative fever, while 2.9% experienced SIRS/Sepsis. Conclusions: This is the largest continuous cohort of patients to undergo vmPCNL for stone disease and demonstrates that vmPCNL is safe and efficacious, with an SFR of 74% at three months. The incidence of postoperative fever and SIRS/Sepsis is 5.5% and 2.9% respectively. Further randomized studies with large sample sizes are required to ascertain the rates of these complications in comparison to conventional approaches. Purpose Vacuumassisted Vacuum assisted minipercutaneous mini percutaneous (vmPCNL IC, , (IC) however stonefree free (SFR surgery Methods 2 institution SIRSSepsis SIRS Sepsis Results 737 73 7 73.7 OR 039 0 39 0.39 95 0.330.46 033046 0.33 0.46 33 46 [0.33-0.46] 103 1 03 1.03 1.011.04 101104 1.01 1.04 01 04 [1.01-1.04] analysis 55 5 5.5 29 9 2.9 Conclusions 74 respectively approaches (IC 73. 3 0.3 330 0.330.4 03304 033 046 0.4 4 [0.33-0.46 10 1.0 011 1.011.0 10110 101 104 [1.01-1.04 5. 2. 0. 0.330. 0330 [0.33-0.4 1. 1.011. 1011 [1.01-1.0 0.330 [0.33-0. 1.011 [1.01-1. [0.33-0 [1.01-1 [0.33- [1.01- [0.33 [1.01 [0.3 [1.0 [0. [1. [0 [1 [