Cardiovascular Magnetic Resonance Versus Histopathologic Study for Diagnosis of Benign and Malignant Cardiac Tumours: A Systematic Review and Meta-Analysis

Sandra Nóbrega,Catarina Martins da Costa,Ana Filipa Amador,Sofia Justo,Elisabete Martins 한국심초음파학회 2023 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.31 No.4

BACKGROUND: The gold standard for diagnosis of cardiac tumours is histopathological examination. Cardiovascular magnetic resonance (CMR) is a valuable non-invasive, radiation-free tool for identifying and characterizing cardiac tumours. Our aim is to understand CMR diagnosis of cardiac tumours by distinguishing benign vs. malignant tumours compared to the gold standard. METHODS: A systematic search was performed in the PubMed, Web of Science, and Scopus databases up to December 2022, and the results were reviewed by 2 independent investigators. Studies reporting CMR diagnosis were included in a meta-analysis, and pooled measures were obtained. The risk of bias was assessed using the Quality Assessment Tools from the National Institutes of Health. RESULTS: A total of 2,321 results was obtained; 10 studies were eligible, including one identified by citation search. Eight studies were included in the meta-analysis, which presented a pooled sensitivity of 93% and specificity of 94%, a diagnostic odds ratio of 185, and an area under the curve of 0.98 for CMR diagnosis of benign vs. malignant tumours. Additionally, 4 studies evaluated whether CMR diagnosis of cardiac tumours matched specific histopathological subtypes, with 73.6% achieving the correct diagnosis. CONCLUSIONS: To the best of our knowledge, this is the first published systematic review on CMR diagnosis of cardiac tumours. Compared to histopathological results, the ability to discriminate benign from malignant tumours was good but not outstanding. However, significant heterogeneity may have had an impact on our findings.

Pharmacological Treatment of Acute Unilateral Vestibulopathy: A Review

Sousa Francisco Alves de,Alves Clara Serdoura,Pinto Ana Nóbrega,Meireles Luís,Rego Ângela Reis 대한청각학회 2024 Journal of Audiology & Otology Vol.28 No.1

There have been few investigations on the epidemiology, etiology, and medical management of acute unilateral vestibulopathy (AUV). Short-term pharmaceutical resolutions include vestibular symptomatic suppressants, anti-emetics, and some cause-based therapies. Anticholinergics, phenothiazines, antihistamines, antidopaminergics, benzodiazepines, and calcium channel antagonists are examples of vestibular suppressants. Some of these medications may show their effects through multiple mechanisms. In contrast, N-acetyl-L-leucine, Ginkgo biloba, and betahistine improve central vestibular compensation. Currently, AUV pathophysiology is poorly understood. Diverse hypotheses have previously been identified which have brought about some causal treatments presently used. According to some publications, acute administration of anti-inflammatory medications may have a deleterious impact on both post-lesional functional recovery and endogenous adaptive plasticity processes. Thus, some authors do not recommend the use of corticosteroids in AUV. Antivirals are even more contentious in the context of AUV treatment. Although vascular theories have been presented, no verified investigations employing anti-clotting or vasodilator medications have been conducted. There are no standardized treatment protocols for AUV to date, and the pharmacological treatment of AUV is still questionable. This review addresses the most current developments and controversies in AUV medical treatment.

Sedoanalgesia With Midazolam and Fentanyl Citrate Controls Probe Pain During Prostate Biopsy by Transrectal Ultrasound

Fábio Hissachi Tsuji,Renato Caretta Chambó,Aparecido Donizeti Agostinho,José Carlos Souza Trindade Filho,Carlos Márcio Nóbrega de Jesus 대한비뇨의학회 2014 Investigative and Clinical Urology Vol.55 No.2

Purpose: To assess the pain intensity of patients administered midazolam and fentanylcitrate before undergoing transrectal ultrasound-guided prostate biopsy. Materials and Methods: This was a study in patients with different indications for prostatebiopsy in whom 5 mg of midazolam and 50 μg of fentanyl citrate was administeredintravenously 3 minutes before the procedure. After biopsy, pain was assessed by useof a visual analogue scale (VAS) in three stages: VAS 1, during probe introduction; VAS2, during needle penetration into prostate tissue; and VAS 3, in the weeks followingthe exam. Pain intensity at these different times was tested with stratification by age,race, education, prostate volume, rebiopsy, and anxiety before biopsy. Pain was rankedaccording to the following scores: 0 (no pain), 1–3 (mild pain), 4–7 (moderate pain), and8–10 (severe pain). Statistical analysis was performed by using Kruskal-Wallis andWilcoxon two-tailed tests with a significance of 5%. Results: Pain intensity was not influenced by any risk factors. The mean VAS 1 scorewas 1.95±1.98, the mean VAS 2 score was 2.73±2.55, and the mean VAS 3 score was0.3±0.9, showing greater pain at the time of needle penetration than in other situations(VAS 2>VAS 1>VAS 3, p=0.0013, p=0.0001, respectively). Seventy-five percent of patientsreported a VAS pain scale of less than 3.1 or mild pain. Conclusions: Intravenous sedation and analgesia with midazolam and fentanyl citrateis a good method for reducing pain caused by prostate biopsy, even during probeinsertion.

What Is the Ideal Core Number for Ultrasound-Guided Prostate Biopsy?

Renato Caretta Chambó,Fábio Hissachi Tsuji,Flávio de Oliveira Lima,Hamilto Akihissa Yamamoto,Carlos Márcio Nóbrega de Jesus 대한비뇨의학회 2014 Investigative and Clinical Urology Vol.55 No.11

Purpose: We evaluated the utility of 10-, 12-, and 16-core prostate biopsies for detectingprostate cancer (PCa) and correlated the results with prostate-specific antigen (PSA)levels, prostate volumes, Gleason scores, and detection rates of high-grade prostaticintraepithelial neoplasia (HGPIN) and atypical small acinar proliferation (ASAP). Materials and Methods: A prospective controlled study was conducted in 354 consecutivepatients with various indications for prostate biopsy. Sixteen-core biopsy specimenswere obtained from 351 patients. The first 10-core biopsy specimens were obtainedbilaterally from the base, middle third, apex, medial, and latero-lateral regions. Afterward, six additional punctures were performed bilaterally in the areas more lateralto the base, middle third, and apex regions, yielding a total of 16-core biopsyspecimens. The detection rate of carcinoma in the initial 10-core specimens was comparedwith that in the 12- and 16-core specimens. Results: No significant differences in the cancer detection rate were found between thethree biopsy protocols. PCa was found in 102 patients (29.06%) using the 10-core protocol,in 99 patients (28.21%) using the 12-core protocol, and in 107 patients (30.48%) usingthe 16-core protocol (p=0.798). The 10-, 12-, and 16-core protocols were comparedwith stratified PSA levels, stratified prostate volumes, Gleason scores, and detectionrates of HGPIN and ASAP; no significant differences were found. Conclusions: Cancer positivity with the 10-core protocol was not significantly differentfrom that with the 12- and 16-core protocols, which indicates that the 10-core protocolis acceptable for performing a first biopsy.

Does the Agaricus blazei Murill Mushroom Have Properties That Affect the Immune System? An Integrative Review

Cristiane Urcina Joanna Oliveira Lima,Cláudio Olavo de Almeida Cordova,Otávio de Tolêdo Nóbrega,Silvana Schwerz Funghetto,Margô Gomes de Oliveira Karnikowski 한국식품영양과학회 2011 Journal of medicinal food Vol.14 No.1

There has been a significant increase in the use of mushrooms for therapeutic and medicinal purposes, in particular, use of the species Agaricus blazei Murrill, a basidiomycota of Brazilian origin. The objective of this study was to identify scientific evidence regarding the influence of A. blazei Murrill on the immune system. We undertook an integrative review of indexed publications published between 2000 and 2009, using the following question as a guideline: “What evidence can be found in the literature regarding the influence of A. blazei Murrill on the immune system?” Fourteen studies verified that there is in vitro and in vivo research demonstrating this mushroom's influence on the immune system. All research was characterized as evidence level 7 (preclinical study [animals/in vitro]). The research shows that A. blazei Murrill functions through bioactive compounds via mechanisms that are not yet entirely clear, although it has been shown that they promote action on the innate and adaptive immunological response, activation of the complement system, and synthesis of pro- and anti-inflammatory cytokines and even aid in diapedesis. Despite broad scientific evidence demonstrating relevant immunomodulatory properties of A. blazei Murrill, randomized clinical trials with human subjects are still needed in order for the mushroom to be put into clinical practice.