RESUMEN
Balloon pulmonary angioplasty (BPA) has recently been elevated as a class I recommendation for the treatment of inoperable or residual chronic thromboembolic pulmonary hypertension (CTEPH). Proper patient selection, procedural safety, and post-procedural evaluation are crucial in the management of these patients, with imaging work-up playing a pivotal role. Understanding the diagnostic and therapeutic imaging algorithms of CTEPH, the imaging features of patients amenable to BPA, all imaging findings observed during and immediately after the procedure and the changes observed during the follow-up is crucial for all interventional radiologists involved in the care of patients with CTEPH. This article illustrates the imaging work-up of patients with CTEPH amenable to BPA, the imaging findings observed before, during and after BPA, and provides a detailed description of all imaging modalities available for CTEPH evaluation.
Asunto(s)
Angioplastia de Balón , Hipertensión Pulmonar , Embolia Pulmonar , Humanos , Hipertensión Pulmonar/diagnóstico por imagen , Hipertensión Pulmonar/terapia , Embolia Pulmonar/diagnóstico por imagen , Embolia Pulmonar/terapia , Embolia Pulmonar/complicaciones , Enfermedad Crónica , Arteria Pulmonar/diagnóstico por imagenRESUMEN
BACKGROUND: Gliosarcoma (GS) is a rare primary high-grade brain neoplasm with a poor prognosis and challenging surgical resection. Although it is now considered a morphologic variant of IDH-wildtype glioblastoma (World Health Organization Classification of Tumours 2021), GS may display peculiarities that hamper both surgical and oncological management. METHODS: In this retrospective study, we searched our registry for histologically confirmed GS patients between 2006 and 2020. Cases were reviewed for clinical information, pathologic characteristics, imaging findings, management, and outcome. RESULTS: 21 patients with histologically confirmed GS were identified with a median age of 62 years. Twelve were men and 9 women. The temporal lobe was the most common location (9 patients, 42.9%). Nineteen patients underwent surgical resection, and only 4 (19%) demonstrated gross total resection on postsurgical MRI, with an overall median survival of 7 months (range, 0.5-37). Diagnostic MRI demonstrated heterogenous lesions with necrotic-cystic areas and a ring-enhancement pattern. Only 1 case of extracranial extension was seen in our sample, and no patient showed distant metastases. CONCLUSIONS: The rarity of primary GS and the absence of specific therapeutic guidelines represent a significant clinical challenge. Our study provides a comprehensive analysis of clinical and neuroimaging characteristics in a real-world patient cohort and compares our findings with the available literature.
RESUMEN
Background: the learning styles are cognitive, emotional, and psychological characteristics, which function as relatively stable indicators of how teachers and students perceive, interact, and respond to their learning environments. Knowing students' styles allows teachers to have tools to improve medical education. Our objective was to identify learning styles in pediatric residents and professors from a pediatric hospital. Methods: a learning styles questionnaire was applied to residents and theirs professors; data was analyzed in SPSS 12 software. Results: the dominant learning style in pediatric residents was reflexive and for professors was theoretical. There wasn't any difference between sexes or between medical or surgical specialities. There was more correlation between professors and residents when there was an increase in training time. Conclusions: the learning styles between professors and residents are different, especially at the beginning of the medical specialty courses; that's why it is necessary to realize a confrontation between the students' learning styles and teaching methods used by professors to improve significant learning. To know learning styles gives residents an important alternative to find a better study strategy.
Introducción: los estilos de aprendizaje son indicadores de cómo los docentes y los alumnos perciben, interaccionan y responden a sus ambientes de aprendizaje. El objetivo de esta investigación fue identificar los estilos de aprendizaje de residentes de pediatría y de especialidades de rama pediátricas y sus profesores. Métodos: estudio transversal, comparativo y analítico realizado en un hospital de pediatría. Se aplicó el cuestionario de Honey-Alonso. El resultado se obtuvo con la suma del número de reactivos positivos para cada estilo de aprendizaje y el resultado se verificó de acuerdo con los baremos de interpretación para estudiantes de la carrera de medicina. En cada encuesta se realizó el diagrama complementario para identificar el estilo de aprendizaje preferente. Resultados: el estilo de aprendizaje predominante en los residentes fue el reflexivo y en sus profesores, el teórico, sin diferencias significativas según sexo, especialidad y si esta era médica o quirúrgica. Hubo mayor correlación entre los estilos de profesores y residentes conforme se incrementaba el tiempo de entrenamiento. Conclusiones: se requiere confrontar los estilos de aprendizaje de los estudiantes y los métodos de enseñanza empleados por sus profesores, con la finalidad de favorecer un aprendizaje significativo.