ABSTRACT This study aimed to quantify the participation of male master swimmers during ten seasons (2008/2009 – 2018/2019) in the national master swimmers and predict the results for the 2020/2021 season in the events of 50 100, 200 and 400 m freestyle. Eight age groups were considered, namely, A to H with a total of 5,368 participants, in the four events analysed 50, 100, 200 and 400 m freestyle. The best time of each race was recorded in the selected age groups that took place in the last decade of the National Summer Championship, through the specific website “Swimrakings” (https://www.swimrankings.net/). The resulting equation for the calculation was y= (–) ax2 – bx + c, y being the rate of increase or decrease in swimming performance and the x variation depending on the year of events that one intends to estimate for 2021, x= 13. The results showed an increase in the number of participations in middle age groups (35-49 years) and a prediction of improvements in the results of 21 events for all the swimming races studied. In conclusion, we can verify that prediction becomes essential for the definition of new objectives and evolutionary trends in swimming.

Resumo 21. O pâncreas é o órgão abdominal mais frequentemente envolvido na fibrose quística, sendo a lipomatose a anomalia pancreática mais comum nestes doentes. Apresentamos um caso clínico e respetivo estudo imagiológico de um jovem adulto com fibrose quística e infiltração adiposa completa do pâncreas.

Abstract 16. The pancreas is the abdominal organ most frequently affected in cystic fibrosis and pancreatic lipomatosis is the most common abnormality seen in these patients. We present a case and images of a young male patient with cystic fibrosis and associated complete adipose replacement of the pancreas.

Introdução: A cápsula de patência (CP) é geralmente realizada para avaliar a patência do intestino delgado, previamente à realização de cápsula endoscópica (VCE), em doentes com doença de Crohn (DC) diagnosticada. Notavelmente, a taxa de retenção da CP nos doentes com DC é significativamente superior à taxa global de retenção de VCE. Os autores pretendem avaliar a patência do intestino delgado e determinar a localização precisa das CP retidas nos doentes com DC, determinar a taxa de falsos positivos da avaliação com RFIT scanner, bem como avaliar possíveis fatores associados. Métodos: Estudo prospetivo de um centro único, incluindo doentes com DC com indicação clínica para VCE. A PillCam® CP foi realizada em todos os doentes para avaliar a patência do intestino delgado. Nos doentes com deteção positiva da CP através de um radiofrequency identification tag (RFID) scanner, 30 horas após a ingestãofoi realizada uma tomografia computadorizada abdominal (TC) de forma a determinar a localização precisa da cápsula. Resultados: Foram incluídos 54 doentes. A taxa de retenção da CP 30h, na avaliação com RFIT scanner, após a ingestão foi de 20% (11). Estes doentes foram então submetidos a TC abdominal, que detetou a CP no intestino delgado apenas em 5 (9%) doentes. Níveis mais elevados de PCR, doença penetrante e história de cirurgia abdominal foram associados com aumento do risco de retenção da CP (p = 0,007, p = 0,011 e p = 0,033, respetivamente). Na análise multivariada, houve uma associação independente entre retenção da cápsula do intestino delgado e níveis de PCR > 5 mg/dL (OR = 15,5; p = 0,03). Conclusões: A taxa de retenção da CP no intestino delgado (9%) foi consideravelmente menor do que a previamente reportada. Estes resultados mostram que, com este protocolo, os casos falso positivos do RFIT scanner ou radiografia abdominal simples podem ser evitados. Isso pode contribuir para uma aplicação mais extensa da VCE sem o risco de retenção do intestino delgado.

Background and Purpose: Patency capsule (PC) examination is usually performed - previously to capsule endoscopy - to evaluate small-bowel patency in patients with established Crohn’s disease (CD). The reported PC retention rate is significantly higher than expected. Our aims were to assess small-bowel patency, to determine the precise location of the retained PC in patients with CD, and to determine the false positive rate of evaluation with a radiofrequency identification tag (RFIT) scanner. Methods: This is a prospective single-center study including CD patients with clinical indication for small-bowel capsule endoscopy. PillCam® PC examination was performed on all patients to assess smallbowel patency. On all patients with a positive identification of the PC using an RFIT scanner, 30 h after ingestion, an abdominal CT was performed in order to identify its precise location. Results: Fifty-four patients were included. The PC retention rate, according to evaluation with the RFIT scanner, was 20% (in 11 patients) 30 h after ingestion. These patients were then submitted to abdominal CT, which revealed that there was small-bowel retention in 5 cases (9%). Higher CRP levels, penetrating disease, and a history of abdominal surgery were associated with an increased risk of PC retention (p = 0.007, p = 0.011, and p = 0.033, respectively). On multivariate analysis, there was an independent association between small-bowel PC retention and CRP levels > 5 mg/dL (OR = 15.5; p = 0.03). Discussion: The small-bowel PC retention rate (9%) was considerably lower than those found in previous reports. Our results show that, with this protocol, the false-positive cases of RFIT scans or plain abdominal Xrays may be avoided. This may contribute to more extensive application of capsule endoscopy without the risk of smallbowel retention.

RESUMO OBJETIVO: Avaliar o impacto que a distribuição do enfisema tem na gravidade clínica e funcional em pacientes com DPOC. MÉTODOS: A distribuição do enfisema foi analisada em pacientes com DPOC, que foram classificados de acordo com um sistema de classificação visual de cinco pontos a partir de achados de TC de tórax. Avaliou-se a influência do tipo de distribuição do enfisema na apresentação funcional e clínica da DPOC. Hipoxemia após o teste da caminhada de seis minutos (TC6) foi também avaliada e a distância percorrida (DTC6) foi determinada. RESULTADOS: Foram incluídos 86 pacientes. A média de idade foi de 65,2 ± 12,2 anos, 91,9% eram homens, e todos menos um eram fumantes (média de carga tabágica, 62,7 ± 38,4 anos-maço). A distribuição do enfisema foi categorizada como obviamente predominante no pulmão superior (tipo 1), em 36,0% dos pacientes; levemente predominante no pulmão superior (tipo 2), em 25,6%; homogêneo entre o pulmão superior e inferior (tipo 3), em 16,3%; e levemente predominante no pulmão inferior (tipo 4), em 22,1%. A distribuição do enfisema do tipo 2 foi associada a menores valores de VEF1, CVF, relação VEF1/CVF e DLCO. Em comparação com os pacientes do tipo 1, os do tipo 4 apresentaram maior probabilidade de ter VEF1 < 65% do previsto (OR = 6,91, IC95%: 1,43-33,45; p = 0,016), DTC6 < 350 m (OR = 6,36, IC95%: 1,26-32,18; p = 0,025),e hipoxemia após o TC6 (OR = 32,66, IC95%: 3,26-326,84; p = 0,003). Os pacientes do tipo 3 tiveram uma relação VR/CPT maior, embora sem diferença significativa. CONCLUSÕES: A gravidade da DPOC parece ser maior nos pacientes do tipo 4, e os do tipo 3 tendem a apresentar maior hiperinsuflação. A distribuição do enfisema pode ter um impacto importante nos parâmetros funcionais e deve ser considerada na avaliação de pacientes com DPOC.

ABSTRACT OBJECTIVE: To evaluate the impact that the distribution of emphysema has on clinical and functional severity in patients with COPD. METHODS: The distribution of the emphysema was analyzed in COPD patients, who were classified according to a 5-point visual classification system of lung CT findings. We assessed the influence of emphysema distribution type on the clinical and functional presentation of COPD. We also evaluated hypoxemia after the six-minute walk test (6MWT) and determined the six-minute walk distance (6MWD). RESULTS: Eighty-six patients were included. The mean age was 65.2 ± 12.2 years, 91.9% were male, and all but one were smokers (mean smoking history, 62.7 ± 38.4 pack-years). The emphysema distribution was categorized as obviously upper lung-predominant (type 1), in 36.0% of the patients; slightly upper lung-predominant (type 2), in 25.6%; homogeneous between the upper and lower lung (type 3), in 16.3%; and slightly lower lung-predominant (type 4), in 22.1%. Type 2 emphysema distribution was associated with lower FEV1, FVC, FEV1/FVC ratio, and DLCO. In comparison with the type 1 patients, the type 4 patients were more likely to have an FEV1 < 65% of the predicted value (OR = 6.91, 95% CI: 1.43-33.45; p = 0.016), a 6MWD < 350 m (OR = 6.36, 95% CI: 1.26-32.18; p = 0.025), and post-6MWT hypoxemia (OR = 32.66, 95% CI: 3.26-326.84; p = 0.003). The type 3 patients had a higher RV/TLC ratio, although the difference was not significant. CONCLUSIONS: The severity of COPD appears to be greater in type 4 patients, and type 3 patients tend to have greater hyperinflation. The distribution of emphysema could have a major impact on functional parameters and should be considered in the evaluation of COPD patients.

PURPOSE: To retrospectively determine the accuracy of T2-weighted endorectal MR imaging in the detection of prostate cancer after external beam radiation therapy and to investigate the relationship between imaging accuracy and time since therapy. MATERIAL AND METHODS: Institutional review board approval was obtained and the study was HIPPA compliant. We identified 59 patients who underwent 1.5 Tesla endorectal MR imaging of the prostate between 1999 and 2006 after definitive external beam radiation therapy for biopsy-proven prostate cancer. Two readers recorded the presence or absence of tumor on T2-weighted images. Logistic regression and Fisher’s exact tests for 2x2 tables were used to determine the accuracy of imaging and investigate if accuracy differed between those imaged within 3 years of therapy (n = 25) and those imaged more than 3 years after therapy (n = 34). Transrectal biopsy was used as the standard of reference for the presence or absence of recurrent cancer. RESULTS: Thirty-four of 59 patients (58%) had recurrent prostate cancer detected on biopsy. The overall accuracy of T2-weighted MR imaging in the detection cancer after external beam radiation therapy was 63% (37/59) for reader 1 and 71% for reader 2 (42/59). For both readers, logistic regression showed no difference in accuracy between those imaged within 3 years of therapy and those imaged more than 3 years after therapy (p = 0.86 for reader 1 and 0.44 for reader 2). CONCLUSION: T2-weighted endorectal MR imaging has low accuracy in the detection of prostate cancer after external beam radiation therapy, irrespective of the time since therapy.