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Contribui??o da densidade do PSA para predizer o cancer da próstata em pacientes com valores de PSA entre 2,6 e 10,0 ng/ml
Castro, Hugo Alexandre Sócrates de;Iared, Wagner;Shigueoka, David Carlos;Mouro, José Eduardo;Ajzen, Sérgio;
Radiologia Brasileira , 2011, DOI: 10.1590/S0100-39842011000400003
Abstract: objective: to study the profile of patients with psa level between 2.6 and 10.0 ng/ml and submitted to prostate biopsy, determining possible patterns that might lead to a reduction of unnecessary biopsies. materials and methods: in the period from 2007 to 2009, a cross-sectional study was developed with 1,282 patients with psa levels between 2.6 and 10.0 ng/ml, and submitted to prostate biopsy. results: cancer prevalence was 28.6%. on average, the patients with positive biopsies were older, with higher psa levels and density, and smaller prostate volume as compared with the patients with negative biopsies. in the analysis of psa density, the cancer patients averaged 0.31 ng/ml/cc, while patients with negative results averaged 0.10 ng/ml/cc. utilizing a cutoff value of 0.15 ng/ml/cc for psa density as a cancer positiveness criterion, the authors obtained sensitivity of 74% and specificity of 70%. the cutoff value should be reduced to increase the sensitivity. with a cutoff value of 0.09 ng/ml/cc, sensitivity reached 84% (ci 95%: 80-87%), and specificity, 75% (ci 95%: 72-78%). conclusion: the systematic use of psa density as an indicator to proceed with the investigation of a patient with biopsy could substantially reduce the amount of unnecessary procedures.
Avalia??o do angulo ano-retal por meio de defecograma em voluntárias assintomáticas nulíparas e multíparas
Santos, José Eduardo Mouro;D'Ippolito, Giuseppe;Leme, Lígia Maria;Sa?udo, Adriana;Shigueoka, David Carlos;Szejnfeld, Jacob;
Radiologia Brasileira , 2003, DOI: 10.1590/S0100-39842003000400007
Abstract: objective: we developed a protocol to compare the measurements of the anorectal angle in nulliparous and multiparous asymptomatic volunteers in three different situations. subjects and methods: defecograms were carried out in 30 women (15 nulliparous and 15 multiparous) from may, 1997 to december, 1998. after rectal administration of texturized barium contrast media, lateral radiographic views of the rectum were obtained at rest, during contraction of the puborectal muscle and during defecation. a repeated measures model was used for the statistical analysis. results: there were no significant differences between the mean anorectal angles of nulliparous and multiparous volunteers. measurements were as follows: 92.9° at rest, 78.8° during the contraction of the puborectal muscle and 117.9° during defecation for the nulliparous volunteers; 94.3° at rest, 79.7° during the contraction of the puborectal muscle and 121.4° during defecation for the multiparous volunteers. a significant difference was observed between the anorectal angle measurements at rest, during contraction of the puborectal muscle and during defecation. conclusion: there were no significant differences between the anorectal angle measurements of the two groups of volunteers examined.
Avalia??o do volume de fluxo portal em pacientes esquistossomóticos: estudo comparativo entre ressonancia magnética e ultrassom Doppler
Le?o, Alberto Ribeiro de Souza;Sales, Danilo Moulin;Santos, José Eduardo Mouro;Nakano, Edson;Shigueoka, David Carlos;D'Ippolito, Giuseppe;
Radiologia Brasileira , 2010, DOI: 10.1590/S0100-39842010000600005
Abstract: objective: to evaluate the agreement between doppler ultrasonography and magnetic resonance imaging as well as the interobserver reproducibility of both methods in the measurement of portal blood flow in schistosomal patients. materials and methods: a cross-sectional, observational, self-paired study evaluated 21 patients with schistosomiasis mansoni submitted to measurement of portal blood flow with phase-contrast magnetic resonance imaging and doppler ultrasonography. results: a poor intermethod agreement was observed (intraclass correlation coefficient: 34.5% [ci 95%]). on the other hand, the interobserver reproducibility was excellent in the evaluation by magnetic resonance imaging (intraclass correlation coefficient: 99.2% [ci 95%] / pearson's correlation coefficient: 99.2% / portal blood flow = 0.806) and by doppler ultrasonography (intraclass correlation coefficient: 80.6 to 93.0% [ci 95%] / pearson's correlation coefficient: 81.6% to 92.7% / portal blood flow = 0.954, 0.758 and 0.749). conclusion: there is a poor intermethod agreement in the measurement of portal blood flow. nevertheless, contrast-phase magnetic resonance imaging and doppler ultrasonography demonstrated to be reproducible methods presenting excellent interobserver agreement in the quantification of portal blood flow in patients with hepatosplenic schistosomiasis-related portal hypertension
Mensura??o do volume de fluxo portal em pacientes esquistossomóticos: avalia??o da reprodutibilidade do ultra-som Doppler
Le?o, Alberto Ribeiro de Souza;Santos, José Eduardo Mouro;Moulin, Danilo Sales;Shigueoka, David Carlos;Colleoni, Ramiro;D'Ippolito, Giuseppe;
Radiologia Brasileira , 2008, DOI: 10.1590/S0100-39842008000500007
Abstract: objective: to evaluate the reproducibility of doppler ultrasonography in the measurement of portal blood flow volume in schistosomal patients. materials and methodos: prospective, transversal, observational and self-paired study evaluating 21 patients with hepatosplenic schistosomiasis submitted to doppler ultrasonography performed by three independent observers for measurement of portal blood flow. pairwise interobserver agreement was calculated by means of the intraclass correlation coefficient, paired t-test and pearson's correlation coefficient. results: interobserver agreement was excellent. intraclass correlation ranged from 80.6% to 93.0% (ic at 95% [65.3% ; 95.8%]), with the pearson's correlation coefficient ranging between 81.6% and 92.7% with no statistically significant interobserver difference regarding the mean portal blood flow volume measured by doppler ultrasonography (p = 0.954 / 0.758 / 0.749). conclusion: doppler ultrasonography has demonstrated to be a reliable method for measuring the portal blood flow volume in patients with portal hypertension secondary to schistosomiasis, with a good interobserver agreement.
Avalia??o da fun??o ventricular esquerda pela sequência de ressonancia magnética sem apneia e com múltiplas excita??es
Nakano, Edson Minoru;Shigueoka, David Carlos;Szarf, Gilberto;Pinetti, Rogério Zaia;Santos, José Eduardo Mouro;Szejnfeld, Denis;Barbieri, Ant?nio;
Radiologia Brasileira , 2009, DOI: 10.1590/S0100-39842009000500006
Abstract: objective: to evaluate the efficacy of free-breathing magnetic resonance sequence with three excitations in the determination of ventricular volumes and masses in individuals without breathholding. materials and methods: left ventricular volumes and masses determined in 32 healthy volunteers through two cine magnetic resonance imaging sequences were compared: the first sequence, traditionally utilized and considered as a standard, performed under apnea, with a single excitation, and the second one, with free-breathing and three excitations. three observers at different levels of experience evaluated the agreement and reproducibility. intraclass correlation coefficient, paired t-test, bland-altman plots and sign test were utilized for statistical analysis. results: according to the two most experienced observers, intraclass correlation coefficients were > 0.913, the paired t-test demonstrated p values > 0.05, bland-altman plots had differences randomly distributed around zero and the sign test descriptive levels were > 0.05. conclusion: the sequence evaluated presents an excellent agreement and reproducibility as compared with the standard sequence, and can be utilized in patients with respiratory limitations.
Correla??o interobservador das altera??es morfológicas das vias biliares em pacientes com esquistossomose mansoni pela colangiorressonancia magnética
Sales, Danilo Moulin;Santos, José Eduardo Mouro dos;Shigueoka, David Carlos;Le?o, Alberto Ribeiro de Souza;Colleoni Neto, Ramiro;Borges, Durval Rosa;D'Ippolito, Giuseppe;Szejnfeld, Jacob;
Radiologia Brasileira , 2009, DOI: 10.1590/S0100-39842009000500004
Abstract: objective: to describe changes of the biliary tree demonstrated by magnetic resonance cholangiography (mrc) in patients with the hepatosplenic presentation of schistosomiasis mansoni, and evaluating the interobserver agreement in the detection of schistosomal cholangiopathy. materials and methods: prospective, cross-sectional study involving 24 patients with hepatosplenic schistosomiasis and 6 healthy patients (control group) submitted to biliary tree evaluation by mrc. the following changes of the biliary tree were considered: distortion, thinning, stenosis, dilation and irregularity. the interobserver agreement in the detection of biliary tree changes was calculated with the mcnemar's test and the kappa index of agreement (κ). results: the interobserver agreement in the detection of distortion and thinning of the biliary tree was almost perfect (κ = 0.867; confidence interval [ci] 95% [0.512-1.0] and κ = 0.865; ci 95% [0.51-1.0], respectively). there was a substantial agreement for stenosis (κ = 0.78; ci 95% [0.424-1.0]), moderate agreement for dilation (κ = 0.595; ci 95% [0.247-0.942]) and mild agreement for thinning (κ = 0.229; ci 95% [0.095-0.552]). conclusion: in a decreasing order of frequency, the changes of the biliary tree were observed: distortion, thinning, stenosis, dilation and irregularity. the interobserver agreement for signs of schistosomal cholangiopathy was almost perfect for distortion and thinning, and substantial for stenosis.
Reprodutibilidade da classifica??o ultra-sonográfica de Niamey na avalia??o da fibrose periportal na esquistossomose mans?nica
Santos, Germana Titonelli;Sales, Danilo Moulin;Le?o, Alberto Ribeiro de Souza;Santos, José Eduardo Mouro;Aguiar, Luciane Aparecida Kopke de;Brant, Paulo Eugênio;Shigueoka, David Carlos;Colleoni Neto, Ramiro;D'Ippolito, Giuseppe;
Radiologia Brasileira , 2007, DOI: 10.1590/S0100-39842007000600005
Abstract: objective: to determine the intra- and interobserver agreement in the classification of periportal fibrosis, according to the criteria defined at the niamey workshop of 1996. materials and methods: a prospective, observational and transverse study was developed in the period between february, 2005 and march, 2006, in 30 schistosomal patients with no other hepatic findings associated, submitted to abdominal ultrasound. ultrasonographic studies were independently performed and reviewed by two radiologists at three different moments: the dynamic examination itself (first moment), 30 and 90 days later (second and third moments), by means of the images review performed in a workstation. intra- and interobserver agreement was evaluated by means of the kappa test. results: intraobserver agreement was 0.43 for the first, and 0.57 for the second observer. interobserver agreement as regards the dynamic examination and images review was respectively 0.46 and 0.71. conclusion: ultrasonography demonstrated moderate to substantial reproducibility in the classification of periportal fibrosis according to the niamey criteria.
Avalia??o da concordancia entre ressonancia magnética de ultra-sonografia na classifica??o de fibrose periportal em esquitossomóticos, segundo a classifica??o de Niamey
Scortegagna Junior, Eduardo;Le?o, Alberto Ribeiro de Souza;Santos, José Eduardo Mouro;Sales, Danilo Moulin;Shigueoka, David Carlos;Aguiar, Luciane Aparecida Kopke de;Brant, Paulo Eugênio;Colleoni Neto, Ramiro;Borges, Durval Rosa;D'Ippolito, Giuseppe;
Radiologia Brasileira , 2007, DOI: 10.1590/S0100-39842007000500005
Abstract: objective: to evaluate the reproducibility of magnetic resonance imaging and the agreement between ultrasound and magnetic resonance imaging in the classification of periportal fibrosis in patients with schistosomiasis based on niamey's qualitative criteria. materials and methods: a prospective, double-blinded study was conducted between february 2005 and june 2006 with 20 patients (10 men and 10 women, with ages ranging between 24 and 60 years, mean age 42.7 years) diagnosed with schistosomiasis mansoni. both ultrasound and magnetic resonance images were independently evaluated by two experienced observers. interobserver agreement was evaluated for findings of periportal fibrosis on magnetic resonance images and in a comparison between magnetic resonance and ultrasound images. results: the analysis of magnetic resonance images showed total interobserver agreement in 14 patients (70%). the comparison between ultrasound and magnetic resonance imaging showed agreement between images in only six cases (30%) by observer 1, and in eight cases (40%) by observer 2. conclusion: magnetic resonance imaging presents a good reproducibility in the evaluation of periportal fibrosis in later stages of schistosomiasis, however, the correlation between magnetic resonance imaging and ultrasound is poor.
Electroestimula??o e Exercita??o Aeróbia em cicloergómetro: Metodologias por superimposi??o e sua influência sobre o Vo2máx.
?ngelo,Rui; Mouro,Paulo; Carvalho,Alberto; Carvalho,Carlos;
Motricidade , 2007,
Abstract: the main purpose of our study was to test the direct effect of using combined electrical muscle stimulation with endurance cycling exercises over the maximal oxygen intake factor. we used a sample of 12 subjects, subsequently split into to different groups of 6. all subjects were participants in a four week, four times per week, 50 minute cycling training protocol. one group was also subjected to a simultaneous electrical muscle stimulation protocol on three of the training sessions. to assess maximal aerobic power output we used a maximal cycle-ergometer test with step by step load increases. our results demonstrated that the muscle stimulation assisted group revealed a statistically significant vo2máx increase, as well as a higher physical fitness development when comparing within group heart rate evolution. however, between group difference was not significant. we may thus conclude that combined training methodologies may contribute to a faster and more effective goal achievement when regarding vo2máx variables.
Integra??o de três conceitos: fun??o executiva, memória de trabalho e aprendizado
Mouro Junior, Carlos Alberto;Melo, Luciene Bandeira Rodrigues;
Psicologia: Teoria e Pesquisa , 2011, DOI: 10.1590/S0102-37722011000300006
Abstract: this article discusses the concept of executive function as a temporal integration process, involving tasks like preparatory adaptation, inhibitory control and working memory. next, baddeley's multicomponent model for working memory is criticized and a new classification of executive function is proposed which incorporates both the model of fuster as well as that of baddeley. finally, this paper revisits the neurobiological concept of learning and suggests an approach to appraise the learning deficits that take into account the executive function as the cornerstone of the cognitive process.
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