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Hypohydration may be associated with vascular diseases, poor prognosis and worse outcomes in stroke. The underlying mechanisms have not yet been completely investigated, although some studies suggested potential associations with brain perfusion and collaterals status. Despite the potentially different mechanisms promoting serum or urine biomarkers of hypohydration, few studies have investigated both markers separately. A prospective descriptive study was conducted in stroke patients admitted to a stroke unit 15 and “underhydrated” (UND) if urine osmolality was >500 mOsm/kg. CTP images were processed to calculate core, penumbra, their mismatch and total hypoperfused volume. Forty-six patients were included and were grouped according to hydration status. Despite no different NIHSS at baseline, at CTP HYP was independently associated with core-penumbra mismatch (β: −0.157, 95% CI: −0.305 to −0.009; p =.04), while UND was independently associated with the total hypoperfused volume (β: 31.502, 95% CI: 8.522‒54.481; p =.01). Using CTP imaging, this study proposes a physiological insight of some possible mechanisms associated with the better outcomes observed in acute stroke patients when properly hydrated. These results suggest different associations between hydration status and CTP parameters depending on serum or urine biomarkers in the hyper-acute phase and encourage the association between hydration status and stroke characteristics.

Purpose Antisynthetase syndrome (ASS) is a rare systemic autoimmune condition associated to the presence of anti-aminoacyl-tRNA synthetase antibodies. Interstitial lung disease (ILD) is the most prevalent manifestation of ASS and is a major determinant of morbidity and mortality. The aim of this study was to describe the radiological characteristics of patients with ASS-associated-ILD in our institution. Materials and methods Medical records from 2014 to 2020 were retrospectively reviewed and patients with a diagnosis of ASS and evidence of ILD on HRCT were included. HRCT images were reviewed by two thoracic radiologists in consensus. Five HRCT patterns were defined: cellular non-specific interstitial pneumonia (NSIP), organizing pneumonia (OP), mixed NSIP/OP pattern, acute interstitial pneumonia (AIP) pattern and fibrotic pattern. Descriptive statistics was calculated for all variables. Results Twenty-two patients with ASS who met inclusion criteria were included. The disease presented with the typical triad of ASS in 45% of patients, 55% had ILD only at the onset. Cellular NSIP was present in 27% of patients, OP in 23%, mixed NSIP/OP in 9%, AIP in 18% and a fibrotic pattern in 23%. Conclusion HRCT findings in ASS-associated ILD are often non-specific; nevertheless, it is important to consider this diagnosis, especially in patients presenting with acute onset of symptoms.

Background: The purpose of this study was to evaluate High-Resolution CT (HRCT) findings in SARS-CoV-2-related ARDS survivors treated with prolonged low-dose methylprednisolone after hospital discharge. Methods: A total of 44 consecutive patients (M: 32, F: 12, average age: 64), hospitalised in our department from April to September 2020 for SARS-CoV-2-related ARDS, who had a postdischarge CT scan, were enrolled into this retrospective study. We reviewed the electronic medical charts to collect laboratory, clinical, and demographic data. The CT findings were evaluated and classified according to lung segmental distribution. The imaging findings were correlated with spirometry results and included ground glass opacities (GGOs), consolidations, reticulations, bronchiectasis/bronchiolectasis, linear bands, and loss of pulmonary volume. Results: Alterations in the pulmonary parenchyma were observed in 97.7% of patients at HRCT (median time lapse between ARDS diagnosis and HRCT: 2.8 months, range 0.9 to 6.7). The most common findings were linear bands (84%), followed by GGOs (75%), reticulations (34%), bronchiolectasis (32%), consolidations (30%), bronchiectasis (30%) and volume loss (25%). They had a symmetric distribution, and both lower lobes were the most affected areas. Conclusions: A reticular pattern with a posterior distribution was observed 3 months after discharge from severe COVID-19 pneumonia, and this differs from previously described postCOVID-19 fibrotic-like changes. We hypothesized that the systematic use of prolonged low-dose of corticosteroid could be the main reason of this different CT scan appearance.

Coronavirus disease 2019 (COVID-19) is mostly perceived as a respiratory disease. However, there is increasing evidence of patients showing gastrointestinal symptoms, with increasing rates of presentation according to the severity of the disease. In a few cases, the abdominal involvement of COVID-19 resulted in spontaneous bowel perforation. Here, we present in detail the first case of rectal perforation in a patient with COVID-19.

Purpose of Review: This paper is aimed at describing the main malignant hematolymphoid disorders and their most frequent imaging appearance. Recent Findings: Hematological malignancies are a heterogeneous group of neoplasms, including leukemia, lymphoma, and multiple myeloma that may involve the bone marrow as a primary or metastatic disease. Imaging has a pivotal role in the assessment of bone involvement, staging, and evaluation of treatment response and detection of complications. Summary: Radiologist should be aware of most frequent findings of hematological malignant diseases, in order to perform an earlier diagnosis as well as assess an adequate clinical-therapeutic pathway.

Objective: Advanced neuroimaging has proved to be pivotal in the management of acute ischemic stroke. The use of CT perfusion (CTP) core and penumbra parameters to predict the outcome in wake-up stroke (WUS) patients in everyday clinical scenarios has not yet been investigated. The aim of our study was to investigate the predictive power of CTP parameters on functional and morphological outcomes in WUS patients treated with recombinant tissue plasminogen activator (rTPA). Approach: We analyzed clinical data and processed CTP images of 83 consecutive WUS patients treated with rTPA. The predictive power of whole-brain CTP features and of the clinical stroke-related parameters to predict the National Institutes of Health Stroke Scale (NIHSS) score at the seventh day and ischemic lesion volume outcome was investigated by means of multivariate regression analysis as well as least absolute shrinkage and selection operator (LASSO) modeling. Main results: Multivariate analysis showed that CTP core volume (β = 0.403, p = 0.000), NIHSS at admission (β = 0.323, p = 0.005) and Alberta Stroke Program Early CT (ASPECT) score (β = -0.224, p = 0.012) predict NIHSS at 7 days, while total hypoperfused volume (β = 0.542, p = 0.000) and core volume on CTP (β =0.441, p = 0.000) predict infarct lesion volume at follow-up CT. The LASSO modeling approach confirmed the significant predictive power of CTP core volume, total hypoperfused CTP volume, NIHSS at baseline and ASPECT score, producing a sparse model with adequate reliability (the root mean square error on a previously unseen testing dataset was 3.68). Significance: Our findings highlight the importance of CT multimodal imaging features for decision-making and prediction in the hyperacute phase of WUS. The predictive model supports the hypothesis that an irreversible necrotic core rather than the extent of the penumbra is the main prognostic factor in WUS patients treated with rTPA.

Introduction Ground-glass nodules may be the expression of benign conditions, pre-invasive lesions or malignancies. The aim of our study was to evaluate the capability of chest digital tomosynthesis (DTS) in detecting pulmonary ground-glass opacities (GGOs). Methods An anthropomorphic chest phantom and synthetic nodules were used to simulate pulmonary ground-glass nodules. The nodules were positioned in 3 different regions (apex, hilum and basal); then the phantom was scanned by multi-detector CT (MDCT) and DTS. For each set (nodule-free phantom, nodule in apical zone, nodule in hilar zone, nodule in basal zone) seven different scans (n = 28) were performed varying the following technical parameters: Cu-filter (0.1–0.3 mm), dose rateo (10–25) and X-ray tube voltage (105–125 kVp). Two radiologists in consensus evaluated the DTS images and provided in agreement a visual score: 1 for unidentifiable nodules, 2 for poorly identifiable nodules, 3 for nodules identifiable with fair certainty, 4 for nodules identifiable with absolute certainty. Results Increasing the dose rateo from 10 to 15, GGOs located in the apex and in the basal zone were better identified (from a score = 2 to a score = 3). GGOs located in the hilar zone were not visible even with a higher dose rate. Intermediate density GGOs had a good visibility score (score = 3) and it did not improve by varying technical parameters. A progressive increase of voltage (from 105 kVp to 125 kVp) did not provide a better nodule visibility. Conclusion DTS with optimized technical parameters can identify GGOs, in particular those with a diameter greater than 10 mm. Implications for practice DTS could have a role in the follow-up of patients with known GGOs identified in lung apex or base region.

Item does not contain fulltext Breast computed tomography (BCT) is an emerging application of X-ray tomography in radiological practice. A few clinical prototypes are under evaluation in hospitals and new systems are under development aiming at improving spatial and contrast resolution and reducing delivered dose. At the same time, synchrotron-radiation phase-contrast mammography has been demonstrated to offer substantial advantages when compared with conventional mammography. At Elettra, the Italian synchrotron radiation facility, a clinical program of phase-contrast BCT based on the free-space propagation approach is under development. In this paper, full-volume breast samples imaged with a beam energy of 32 keV delivering a mean glandular dose of 5 mGy are presented. The whole acquisition setup mimics a clinical study in order to evaluate its feasibility in terms of acquisition time and image quality. Acquisitions are performed using a high-resolution CdTe photon-counting detector and the projection data are processed via a phase-retrieval algorithm. Tomographic reconstructions are compared with conventional mammographic images acquired prior to surgery and with histologic examinations. Results indicate that BCT with monochromatic beam and free-space propagation phase-contrast imaging provide relevant three-dimensional insights of breast morphology at clinically acceptable doses and scan times.

Aims: Lake Louise Criteria (LLC) are time-dependent and some acute myocarditis (AM) with preserved left ventricular ejection fraction (LVEF) could be missed, due to the limited accessibility of Cardiac Magnetic Resonance (CMR). We aimed to assess the potential value of cardiac strain measured by feature tracking (FT) imaging in this population. Methods and results: Eighty-three patients with clinically suspected AM and normal LVEF were divided into 39 “confirmed AM” (positive LLC) and 44 “suspected AM” (negative LLC). An age and gender-matched sample of 42 normal subjects underwent CMR. In all groups, FT-derived biventricular strains and STE- global longitudinal strain (GLS) were assessed, being regularly measurable. Strain values < 5th percentile of the control group were considered abnormal. “Suspected” and “confirmed” AM were similar, except for medium time of CMR evaluation (5.2 vs 1 months from presentation, respectively; p = 0.004). Compared to healthy controls, both “suspected” and “confirmed” AM showed significantly impaired strain values. LV-global circumferential strain (GCS), right ventricular GCS and LV-GLS were abnormal in 15.4% and 15.9%, 20.5% and 15.9%, 7.7% and 9.1% in “confirmed” and “suspected” AM, respectively. STE analysis confirmed the results on LV-GLS, however a weak correlation emerged between STE and CMR-FT LV-GLS (p = 0.08). Conclusions: Compared to STE, CMR-FT analysis provided a more comprehensive and complementary biventricular strain evaluation that resulted similar in “confirmed” and “suspected” AM with normal LVEF. Conversely, mostly biventricular GCS was significantly reduced in up to 20% of patients, compared to healthy controls.

A Phase-Contrast breast CT facility based on a high-resolution CdTe photon-counting detector is under development at Elettra, the Italian Synchrotron Radiation (SR) facility in Trieste. The CT system exploits propagation-based phasecontrast imaging and phase-retrieval algorithm. The voxel size is 57×57×50 μm3 and the delivered MGDs, about 5 mGy, are comparable with clinical breast CT systems. In the present contribution, the comparisons between histological breast cancers and full breast CT images are presented from samples of breast mastectomy. The high resolution of the breast CT images and low noise due to the phase contrast allow a very fine matching between X-ray CT and histology at acceptable delivered doses.

Erectile dysfunction (ED) is defined as the persistent inability to achieve and/or maintain an erection for a satisfactory sexual activity. It is secondary to several organic, psychogenic, and combined causes, and represents a serious health dilemma affecting both men and their partners. The diagnostic approach to erectile dysfunction has significantly changed in the last years with the advent of phosphodiesterase-5 (PDE5) inhibitors, and with the recognition that surgical treatment of both arterial insufficiency and penile venous leak have poor long-term clinical outcomes. Although imaging modalities have diminished in importance, differentiating among causes of erectile dysfunction remains mandatory in good medical practice, and ultrasound (US) still remains the cornerstone of the diagnostic workup. US provides an objective, minimally invasive evaluation of penile hemodynamics. Moreover, it provides an excellent depiction of the penile anatomy and of its changes in pathological conditions such as in patients with Peyronie’s disease, priapism, and posttraumatic erectile dysfunction.

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A quantitative characterization of the soft tissues composing the human breast is achieved by means of a monochromatic CT phase-contrast imaging system, through accurate measurements of their attenuation coefficients within the energy range of interest for breast CT clinical examinations. Quantitative measurements of linear attenuation coefficients are performed on tomographic reconstructions of surgical samples, using monochromatic x-ray beams from a synchrotron source and a free space propagation setup. An online calibration is performed on the obtained reconstructions, in order to reassess the validity of the standard calibration procedure of the CT scanner. Three types of healthy tissues (adipose, glandular, and skin) and malignant tumors, when present, are considered from each sample. The measured attenuation coefficients are in very good agreement with the outcomes of similar studies available in the literature, although they span an energy range that was mostly neglected in the previous studies. No globally significant differences are observed between healthy and malignant dense tissues, although the number of considered samples does not appear sufficient to address the issue of a quantitative differentiation of tumors. The study assesses the viability of the proposed methodology for the measurement of linear attenuation coefficients, and provides a denser sampling of attenuation data in the energy range useful to breast CT.

Introduction & Objectives: To analyze our 10-year experience with Cryoablation (CA) ofSmall Renal Masses (SRM), and present the Trifecta Outcomes in these cohort of patients, by studying three topics: recurrence free survival (RFS) rate, functional kidney preservation, and complications free-recovery. Secondary outcome was evaluated the predictor factors of RFS. Materials & Methods: We retrospectively analyzed 181 patients who underwent 191 percutaneous or laparoscopic CAfor SRMs from 2007 and 2018 in 2 institutions. Data were collected and populations were divided into 2 equally groups in relation to the diameter (group 1: ≤20 mm - 82 CA; group 2: >20 mm - 109 CA). We defined RFS as the absence of imaging evidence of local disease recurrence during follow-up. Renal function preservation was defined as a percentage ratio of postoperative eGFR to preoperative eGFR. Complications were graded using the Clavien system. Cumulative incidence curves were generated for both groups and differences were analyzed using an appropriate test for competing risks (i.e. taking into account death without recurrence as a competing risk). The Cox proportional cause-specific model was used to determine factors associated with RFS. Trifecta was defined as cases with: no complications, no recurrence and 3 is 1.57% (2 IIIa and 1 IIIb). PADUA score (p=0.049) and number of cryoprobes (p20 mm (hazard ratio, 3.40; 95% confidence interval, 1.18-9.86; p=0.024) were predictors of recurrence. Trifecta positive treatments at 24 months: 66.67% vs 62.90% (p=0.701). Conclusions: More than half of our patients did achieve the trifecta outcome, making CA a reliable treatment for patients not suitable for surgery. Masses ≤20 mm could be treated with a low risk of complication and recurrence, for masses >20 mm we recommend to discuss each patient in a multidisciplinary meeting.

Renal colic indicates a type of abdominal pain due to urinary tract obstruction, commonly caused by urinary stones. The classic presentation of renal colic is the sudden onset of severe loin pain, but depending on the site of obstruction, the pain will radiate to the flank, groin, and testes or labia majora. Unfortunately, symptoms due to many other abdominal diseases could be indistinguishable from renal colic, and therefore emergency imaging in patients with suspected renal colic is necessary to rule out other clinical conditions, either renal diseases or gynecologic, gastrointestinal, pancreatic, hepatobiliary, vascular, and musculoskeletal conditions. In this setting, imaging is required to allow rapid diagnosis, to guide patient management, and to evaluate active treatment complications.

Headache is a very common clinical feature in daily practice. Most patients are affected by the so-called primary headache and do not require neuroimaging as the diagnosis is based on the history and clinical data. In patients noncompliant to therapy, with abnormal neurological examination or worsening of symptoms, imaging is useful. Imaging is especially mandatory to rule out underlying causes of headache.

Introduction & Objectives: The Bosniak classification of renal cysts is commonly used by urologists and radiologists as an effective way to assess and evaluate cystic renal masses and decide clinical management. Although this classification scheme is based on computed tomographic (CT) criteria, the same approach may provide a useful framework for evaluation with magnetic resonance (MR) imaging and contrast-enhanced ultrasonography (CEUS). The aim of this study was to compare CT, MRI, and CEUS in characterization of complex renal cysts in the same series of patients. Materials & Methods: The records of patients having complex renal cysts evaluated with CT, MRI, and CEUS within a 6-months interval were considered. Inclusion criteria were at least an unenhanced and a contrast enhanced nephrographic acquisition at CT, at least T2-weighted, T1-weighted and contrast enhanced scans at MRI, and digital cine-clips available for review at CEUS. Images and clips were retrospectively evaluated by 2 blind independent readers to assigned a Bosniak score for the different techniques. This process yielded a total of 36 patients who met the inclusion criteria. ROC curve analysis was employed to assess the overall confidence for diagnosis of benign vs. malignant lesions. Reference procedure was surgery, or follow-up >3years. Results: Inter-reader agreement in assigning Bosniak score was good or very good (K values for CT, MRI, and CEUS 0.75, 0.86 and 0.79, respectively). When surgical vs. non-surgical lesions were considered, CT, MRI, and CEUS scores were equivalent in 83% of cases for reader1, and in 78% of cases for reader2. ROC curve analysis showed similar diagnostic performance for the 3 techniques (reader1 AUC=0.89, 0.96, 0.93 for and CT, MRI, CEUS, respectively; reader2 AUC=0.92, 0.98, 0.88, respectively). Conclusions: Although differences exist, CEUS, CT, and MRI are basically equivalent in characterization the majority of complex renal cysts. Concordance rates were approximately 80% with weighted good to very good k values. Differences can be useful to differentiate benign from malignant lesions in equivocal cases.

Idiopathic pulmonary fibrosis (IPF) is a chronic, pulmonary-limited, interstitial lung disease with a poor prognosis. This condition is characterized by different clinical scenarios, ranging from the most typical slow and progressive deterioration of symptoms to a rapid and abrupt decline of lung function. Rapid worsening of clinical course is due to superimposed complications and comorbidities that can develop in IPF patients, with a higher incidence rate compared to the general population. These conditions may require a different management of the patient and a therapy adjustment, and thus it is fundamental to recognize them. High Resolution Computed Tomography (HRCT) is sensitive, but not specific, in detecting these complications, and can evaluate the presence of radiological variations when previous examinations are available; it recognizes ground glass opacities or consolidation that can be related to a large spectrum of comorbidities, such as infection, lung cancer, or acute exacerbation. To reach the final diagnosis, a multidisciplinary discussion is required, particularly when the clinical context is related to imaging findings.

Submitted by Leticia Schettini (leticia@ufrrj.br) on 2022-02-21T18:35:23Z No. of bitstreams: 1 2018 - Viviane Arno di Palma.pdf: 5271423 bytes, checksum: 995c43098b804c5c61eff80c60444605 (MD5) Made available in DSpace on 2022-02-21T18:35:24Z (GMT). No. of bitstreams: 1 2018 - Viviane Arno di Palma.pdf: 5271423 bytes, checksum: 995c43098b804c5c61eff80c60444605 (MD5) Previous issue date: 2018-05-25 CAPES The present research approaches the server?s conceptions concerning Quality of life at work (QWL) and its influence on their professional dopted practices in daily work environment. In this approach, the UFRRJ physical structure conditions of Serop?dica campus available for the employees to develop their professional activities, were examined. The motivation for this research was given by the Division of Attention of the Health of the Worker of the UFRRJ (DAST) perception about servants? sickness due to musculoskeletal disorders characteristic of occupational illnesses that seemed to be related to the working conditions in their routine. Faced with this situation of sickness and working conditions, the present research is theoretically based on the activity ergonomics perspective, which addresses the gaps between prescribed and actual work. In view of a possible interaction between physical structure working factors (ergonomics), health risks, physical and psychological stress, ergonomic practices, satisfaction and QWL at work, the present applied research asked: How do the servers? adopted ergonomics practices influence their QWL conception? For this, this research focused on how the servers have experienced their physical working situation and the ergonomic practices they adopted. Accordingly, the researched servers developed their own QVT conception. Field data were collected through documentary research and semi-structured interviews with fifteen servers from three sectors. In this qualitative study the interview transcripts were phenomenographically analyzed, emerging five individual?s conceptions regarding the phenomenon of how the ergonomic practices adopted influence their conceptions of QLW, namely: (i) physical structure factors, (ii) Health risk, (iii) Physical and psychological stress, (iv) Adopted ergonomic practices and, (v) Satisfaction at work. The research evidenced that both negative and positive ergonomic experiences at work develop and support their conceptions. It emphasizes the conception (iv) Ergonomic practices adopted, revealing how the employees act or react to bypass the negative experiences present in their work context and thus, (v) Satisfaction at work. The study revealed that ergonomics may have an extended approach beyond physical ergonomics thus, it is suggested that the ergonomic perspective be contemplated in the planning of the goals of an organization, as it provides improvements in the QLW, such as lower rate of work sickness. It was also explained in this research how the experiences of the individuals in the labor context generates their own conceptions about the QLW, which effectively guide in the practices they adopt in the daily life of their work. Therefore, as practical implications, it is recommended to establish goals for QSL management at this HEI Higher Education Institution and that the ergonomics of the activity be considered in the Institutional Development Plan - IDP, with the objective of favoring QLW and the quality of the services provided by this institution. For that, it is necessary to consider the experiences perceived by the servants as revealing their conceptions about the QLW, in the goals of improvement of the QLW in the institution. A presente pesquisa aborda as concep??es dos servidores sobre Qualidade de vida no trabalho (QVT) ? sua influ?ncia nas pr?ticas profissionais adotadas no quotidiano do ambiente f?sico de trabalho. Nessa abordagem foram examinadas as condi??es de estrutura f?sica da UFRRJ, no campus de Serop?dica, dispon?veis para os servidores desenvolverem suas atividades profissionais. A motiva??o para esta pesquisa foi dada por se perceber na rotina da Divis?o de Aten??o da Sa?de do Trabalhador da UFRRJ (DAST), o adoecimento de servidores por patologias do tecido osteomuscular com car?ter de doen?as ocupacionais que parecem ter rela??o com as condi??es de trabalho. Diante desta situa??o, do adoecimento e das condi??es de trabalho, a pesquisa se apoia teoricamente na ergonomia da atividade, que aborda os gaps entre o trabalho prescrito e real. Em vista de uma poss?vel intera??o entre Fatores da estrutura f?sica para o trabalho (ergonomia), Riscos ? sa?de, Estresse f?sico e psicol?gico, Pr?ticas de ergonomia, Satisfa??o e QVT no trabalho, a presente pesquisa aplicada indagou: Como as pr?ticas de ergonomia adotadas influenciam a concep??o de QVT dos servidores? Para tanto esta pesquisa focou em como os servidores t?m vivenciado a situa??o ergon?mica e as pr?ticas profissionais por eles adotadas. E assim, os servidores pesquisados desenvolveram sua pr?pria concep??o sobre QVT. Os dados de campo foram coletados mediante pesquisa documental e entrevista semiestruturada com quinze servidores de tr?s setores. Nesta pesquisa qualitativa de abordagem fenomenogr?fica das transcri??es das entrevistas analisadas emergiram cinco concep??es dos indiv?duos acerca do fen?meno de como as pr?ticas de ergonomia adotadas influenciam as suas concep??es de QVT, a saber: (i) Fatores da estrutura f?sica, (ii) Risco a sa?de, (iii) Estresse f?sico e psicol?gico, (iv) Pr?ticas ergon?micas adotadas e (v) Satisfa??o no trabalho. A pesquisa evidenciou que vivencias ergon?micas tanto negativas como positivas no trabalho decorrem em concep??es. Destaca-se a concep??o (iv) Pr?ticas ergon?micas adotadas, revelando a forma como os servidores agem ou reagem para contornar a vivencias negativas presentes no seu contexto laboral e assim, alcan?arem (v) Satisfa??o no trabalho. O estudo revelou que ergonomia pode ter uma abordagem ampliada al?m da ergonomia f?sica e se sugere que a perspectiva ergon?mica seja contemplada no planejamento das metas de uma organiza??o, pois propicia melhorias na QVT, tais como menor ?ndice de adoecimentos pelo trabalho. Tamb?m se explicitou nesta pesquisa como as vivencias dos indiv?duos no contexto laboral gera as pr?prias concep??es sobre a QVT, as quais efetivamente orientam nas pr?ticas que adotam no quotidiano de seu trabalho. Logo, como implica??es pr?ticas, recomenda-se estabelecer metas para gest?o da QVT dessa IFES e que a ergonomia da atividade seja considerada no Plano de Desenvolvimento InstitucionalPDI, com o objetivo de se favorecer a QVT e a qualidade dos servi?os prestados por esta institui??o. Para tanto, cabe considerar as vivencias percebidas pelos servidores como reveladoras de suas concep??es sobre a QVT, nas metas de melhoria da QVT na institui??o.

Submitted by Jorge Silva (jorgelmsilva@ufrrj.br) on 2022-02-17T09:43:03Z No. of bitstreams: 1 2018 - Carolina Souza Nogueira.pdf: 5252382 bytes, checksum: 4bd60fc6fb6ad79ed835d84aa089caaa (MD5) Made available in DSpace on 2022-02-17T09:43:03Z (GMT). No. of bitstreams: 1 2018 - Carolina Souza Nogueira.pdf: 5252382 bytes, checksum: 4bd60fc6fb6ad79ed835d84aa089caaa (MD5) Previous issue date: 2018-05-25 The relations between health and work are recognized and focus of studies and applications in contemporary society since the mid-twentieth century, and work is now considered a social determinant of health. The physical and psychosocial quality of work environments in organizations reflects and reflected in their workers whose mutual influence is in increasing transformation with the modernization of work processes. At this juncture, it is up to managers intermediating relationships in the workplace, to show competence in the act of managing. Given this context, we seek to analyze the managerial skills practiced and their influence on the psychosocial health of workers from the Federal Rural University of Rio de Janeiro - UFRRJ, a Federal Institution of Higher Education - IFES. To this end, an applied qualitative research based on interpretative and phenomenographic basis was configured as a unique case study. Data collection in the field included documentary research, natural participant observation and semi-structured individual interviews with 18 servants, institute directors, department heads and technicaladministrative staff (all staffed at the institute directorates' offices), all working at the Serop?dica Campus from UFRRJ. The revelations of the interviewees about their experiences in their work environments classified into descriptive categories of 1st, 2nd and 3rd order, resulted in four conceptions about the phenomenon, that is, the "how" and "what" means working with the manager. Conception 1 - Being in acute illness; Conception 2 - Being in chronic illness; Conception 3 - Being in rehabilitation; Conception 4 - Being healthy. These developed conceptions inseparably interrelate work, the daily work experience of the worker and his work context and effectively guide the practices as they result from the work experience. We identified a continuum of (in) managerial competencies practiced in this IFES and implications for work forms and processes, in solving daily challenges and problems, interpersonal relationships, organizational structuring and physical and human maintenance in the workplace. It is concluded that the managerial actions affect the workers mutually in their psychosocial health, either positively or negatively, (not) triggering illness of individuals and (not) compromising the work activities. The predominance of negative feelings among workers with a more negative than positive influence on the psychosocial health of the servants was explained by the managerial (in) competences attributed to the experiences reported by the subjects of this research. The study provides support to senior management to develop programs and training courses and development of managerial skills relevant to the reality of the organization examined, required to confer quality of life at work, necessary for quality work. As rela??es entre sa?de e trabalho s?o reconhecidas e foco de estudos e aplica??es na sociedade contempor?nea desde meados do s?culo XX, se passando a considerar o trabalho um determinante social de sa?de. A qualidade f?sica e psicossocial dos ambientes de trabalho nas organiza??es ? reflexo e se reflete em seus trabalhadores cuja influ?ncia m?tua encontra-se em crescente transforma??o junto ?s moderniza??es dos processos de trabalho. Nesta conjuntura, cabe aos gestores intermediando as rela??es nos ambientes de trabalho, evidenciar compet?ncia no ato de gerenciar. Diante desse contexto, busca-se analisar as compet?ncias gerenciais praticadas e sua influ?ncia na sa?de psicossocial dos trabalhadores da Universidade Federal Rural do Rio de Janeiro - UFRRJ, uma Institui??o Federal de Ensino Superior ? IFES. Para tanto, foi realizada pesquisa qualitativa aplicada de base interpretativista e fenomenogr?fica configurada como um estudo de caso ?nico. A coleta de dados no campo abrangeu pesquisa documental, observa??o participante natural e entrevista individual semiestruturada junto a 18 servidores, diretores de institutos, chefes de departamentos e t?cnico-administrativos (lotados nas secretarias das dire??es dos institutos), todos em exerc?cio no Campus de Serop?dica da UFRRJ. As revela??es dos entrevistados sobre suas experi?ncias vividas nos seus ambientes de trabalho classificadas em categorias descritivas de 1?, 2? e 3? ordem, resultaram em quatro concep??es sobre o fen?meno, ou seja, o "como" e "o que" significa trabalhar com o gestor, a saber: Concep??o 1 ? Estar em adoecimento agudo; Concep??o 2 ? Estar em adoecimento cr?nico; Concep??o 3 ? Estar em reabilita??o; Concep??o 4 ? Estar saud?vel. Essas concep??es desenvolvidas inter-relacionam indissociavelmente o trabalho, a viv?ncia cotidiana do trabalhador e seu contexto laboral e, orientam efetivamente as pr?ticas por decorrerem da viv?ncia laboral. Identificou-se um continuum de (in) compet?ncias gerenciais praticadas nesta IFES e implica??es nas formas e processos de trabalho, na resolu??o dos desafios e problemas cotidianos, nas rela??es interpessoais, na estrutura??o organizacional e na manuten??o f?sica e humana no ?mbito laboral. Conclui-se que, as a??es gerenciais repercutem nos trabalhadores mutuamente na sua sa?de psicossocial, seja de forma positiva ou negativa, (n?o) desencadeando adoecimento dos indiv?duos e (n?o) comprometendo as atividades laborais. Explicitou-se predom?nio de sentimentos negativos entre os trabalhadores de influ?ncia mais negativa que positiva sobre a sa?de psicossocial dos servidores pelas (in) compet?ncias gerenciais atribu?das mediante as vivencias relatadas pelos sujeitos desta pesquisa. O estudo fornece subs?dio ? administra??o superior para elabora??o de programas e cursos de capacita??o e desenvolvimento de compet?ncias gerenciais pertinentes ? realidade da organiza??o examinada, requeridas para conferir qualidade de vida no trabalho, necess?ria a um trabalho de qualidade.

Urinary tract infection (UTI) is the most common bacterial infection. It accounts for 8.6 million visits in the ambulatory care setting in the United States. Women are at higher risk for UTI, with a self-reported annual incidence of 12%, and by the age of 32, half of them have suffered at least one UTI. Moreover UTI recurrence is high. Luckily acute pyelonephritis is much less common than cystitis, with a peak annual incidence of 25 cases per 10,000 women 15–34 years of age [1]. Infection is initiated when potential pathogens migrate from the bowel lumen to urethra and ascend to the kidneys. Accurate differentiation between uncomplicated UTI (episodes of acute cystitis and pyelonephritis in healthy premenopausal, non-pregnant woman, with no history suggesting abnormalities of urinary tract) and complicated UTI (all the other cases) is mandatory. Imaging helps in disease detection, definition its extent, reveal predisposing conditions and complications. Ultrasound is iexpensive, immediate, painless, widely available and radiation-free, so it should represents he first line imaging modality in the majority of patients. However uncomplicated UTI usually do not require imaging for diagnosis and treatment.

Contrary to upper urinary tract infections (UTI), which affect almost exclusively the kidneys, lower UTI are a more complex entity, affecting several different portions of the genitourinary tract. They consist of a wide spectrum of manifestations, ranging from acute cystitis, which is the most common infection of all the urinary tract counting 0.70 episodes per person-year in young women and 0.07 episodes per person-year in postmenopausal women, to infrequent entities as schistosomiasis or life threatening disease such as Fournier’s gangrene. Enteric flora organisms like Escherichia Coli, Klebsiella Pneumoniae and Enterococcus species are the cause of disease in the vast majority of patients. The role of imaging techniques is strictly related to the severity of presentation varying between either end of possibilities: not required and mandatory. Ultrasound (US) is the technique of choice in most cases, however plain film and computer tomography (CT) may help the diagnostic workup in selected cases demonstrating peculiar findings.

Submitted by Sandra Pereira (srpereira@ufrrj.br) on 2021-04-29T13:00:13Z No. of bitstreams: 1 2017 - Laice de Souza Scotelano.pdf: 3304182 bytes, checksum: fb9bcae925b1d7f8e317b656760665e7 (MD5) Made available in DSpace on 2021-04-29T13:00:13Z (GMT). No. of bitstreams: 1 2017 - Laice de Souza Scotelano.pdf: 3304182 bytes, checksum: fb9bcae925b1d7f8e317b656760665e7 (MD5) Previous issue date: 2017-07-14 The development of projects focused on the environmental area can reduce the impacts generated. However, it is necessary that standardized practices be created so that these projects are excellent in their results. In this way, this work aims to develop a model that helps university management in the implementation of a recyclable waste management program for CEFET / RJ Campus Petr?polis based on the concepts of project management (PMI) to comply with Decree 5.940 / 2006 instituted by the Federal Government by CEFET-RJ Campus Petr?polis. For this, a descriptive interventionary research was carried out through the use of an action research, counting on 4 (four) phases. The main results are that the intuitions, each in its stage of compliance with the decree, have similar challenges as: the logistics of directing this waste, the search for the best way to communicate these actions and the main, the cultural variable; that project management presents gaps when applied in an educational environment and in the environmental area and that despite this, a model of waste management was successfully implemented so that Decree 5.940 / 2006 was fulfilled by the institution researched . Finally, it can be seen that this model may be applicable in other educational institutions that are willing to work towards environmental sustainability. O desenvolvimento de projetos voltados para a ?rea ambiental pode reduzir os impactos gerados. Todavia, ? necess?rio que pr?ticas padronizadas sejam criadas para que esses projetos sejam excelentes em seus resultados. Desta forma, este trabalho tem por objetivo desenvolver um modelo que auxilie a gest?o universit?ria na implanta??o de um programa de gerenciamento de res?duos recicl?veis para CEFET/RJ Campus Petr?polis baseado nos conceitos de gest?o de projetos (PMI) para o cumprimento do Decreto 5.940/2006 institu?do pelo Governo Federal por parte do CEFET-RJ Campus Petr?polis. Para tanto se realizou uma pesquisa descritiva de cunho intervencionista por meio da utiliza??o de uma pesquisa-a??o, contando com 4 (quatro) fases. Como principais resultados t?m que as intui??es, cada uma na sua etapa de cumprimento do decreto, contam com desafios semelhantes como: a log?stica do direcionamento destes res?duos, a busca da melhor forma de comunica??o destas a??es e a principal, a vari?vel cultural; que a gest?o de projetos apresenta lacunas quando de sua aplica??o em um ambiente educacional e na ?rea de meio ambiente e que, apesar disso, um modelo de gerenciamento de res?duos foi implantado com ?xito de forma que o Decreto 5.940/2006 fosse cumprido pela institui??o pesquisada. Por fim, percebe-se que esse modelo pode ser aplic?vel em outras institui??es de ensino que estejam dispostas a trabalharem no sentido da sustentabilidade ambiental.

PURPOSE: This study compared the role of multislice computed tomography coronary angiography (MSCT-CA) and stress electrocardiography (ECG) in the diagnostic workup of patients with chronic chest pain. MATERIALS AND METHODS: MSCT-CA was performed in 43 patients (31 men, 12 women, mean age 58.8+/-7.7 years) with stable angina after a routine diagnostic workup involving stress ECG and conventional CA. The following inclusion criteria were adopted: sinus rhythm and ability to hold breath for 12 s. Beta-blockers were administered in patients with heart rate>or=70 beats/minute. In order to identify or exclude patients with significant stenoses (>or=50% lumen), we determined posttest likelihood ratios of stress test and MSCT-CA separately and of MSCT-CA performed after the stress test. RESULTS: The pretest probability of significant coronary artery disease (CAD) was 74%. Positive and negative likelihood ratios were 2.3 [95% confidence interval (CI) 1.0-5.3] and 0.3 (95% CI: 0.2-0.7) for the stress test and 10.0 (95% CI: 1.8-78.4) and 0.0 (95% CI: 0.0-infinity) for MSCT-CA, respectively. MSCT-CA increased the posttest probability of significant CAD after a negative stress test from 50% to 86% and after a positive stress test from 88% to 100%. MSCT-CA correctly detected all patients without CAD. CONCLUSIONS: Noninvasive MSCT-CA is a potentially useful tool in the diagnostic workup of patients with stable angina owing to its capability to detect or exclude significant CAD.

Introduction The first clinical trial of phase-contrast mammography with monochromatic beam was performed at Elettra, the Italian Synchrotron Radiation facility. A lower Mean Glandular Dose (MGD) and a higher specificity were achieved compared to the digital mammography for the patient cohort (more than 70). Purpose The SYRMA-CT project (SYnchrotron Radiation for MAmmography – Computed Tomography) aims to perform the first clinical trial of phase-sensitive breast CT with monochromatic beam. High image quality and low dose are expected according to the results of the first mammography trial. Materials and methods A large area CdTe single photon counting detector (PIXIRAD-8) is used. Phase-retrieval algorithm are applied, thus exploiting propagation based phase-contrast imaging (PPCI). The dose system of the beamline has been calibrated to match the energy requirement up to 40 keV. Due to the peculiar irradiation modality, ad hoc Monte Carlo simulations and experimental measurements were performed for dose evaluation. Results Images of surgical samples included in large test objects (up to 12 cm diameter) were acquired at 38 keV in clinical compatible dose conditions (MGD ∼5 mGy). Phase-retrieval pre-processing was applied improving the CNR of the high-resolution images with (120 μm) 3 voxel size. Conclusion The upgrade of the mammographic facility of the Elettra laboratory towards a new clinical trial is going on. Image quality and dose assessment indicate its feasibility with monochromatic beam. This clinical trial will allow the evaluation of PPCI breast CT in optimal conditions and will give indication for the translation to the hospital of phase-sensitive techniques. Disclosure Nothing to declare.

The aim of this study was to assess the feasibility of three-dimensional (3D) reconstructions and quantitative analysis of the volume of each component of the lung with cystic fibrosis (CF).Twenty-two patients with CF (mean age 17+/-8 years) were included in the study. The patients underwent an unenhanced single-slice spiral computed tomography (CT) chest scan with the following parameters: collimation 3 mm, table feed 6 mm x rot(-1), reconstruction interval 1 mm, soft tissue reconstruction kernel. Four image data sets were obtained: native axial slices, cine-mode display, virtual bronchographic volume-rendered images with algorithm for tissue transition display and virtual endoluminal views. The lungs were segmented manually from the hilum to the visceral pleura on the axial images, and the entire lung volume was calculated. A histogram was generated representing the fractional volume of tissues, the density of which was within a preset range. A curve was then obtained from the histogram.Native axial images and cine-mode display allowed complete evaluation of lung volumes. Virtual bronchography allowed a better assessment of the distribution of bronchiectasis. Virtual bronchoscopy was limited by the fact that it visualised only the surface, without differentiating mucus from the bronchial wall. Manual segmentation and generation of density-volume curves required 41+/-7 min for each lung. Three curve patterns were identified depending on disease severity.Volume-density analysis of lungs with CF is feasible. Its main advantage is that image analysis is not analogical, as the assessment is not performed using scoring systems or similar ordinal scales. This technique cannot differentiate acute from chronic findings, and the predictive value of the curve should be assessed.

Magnetic resonance (MR) urography has become an integral part of the recently emerging advances that involve clinical uroradiology. MR urography has received a relatively lower attention than multidetector CT (MDCT) urography, being hampered by the low spatial resolution which is crucial for calyceal evaluation and by the requirement of updated MR units. However, excellent contrast resolution and lack of ionizing radiation make MR urography a technique to be considered for noninvasively evaluating the entire urinary tract, especially when ionizing radiation is to be avoided, such as in pediatric or pregnant patients.

Objective: The aim of this study was to design, deliver and evaluate an e-learning teaching programme for post-graduate radiodiagnostics training that would involve various post-graduate schools throughout Italy. Materials and methods: All of the Directors of Italian post-graduate schools of radiodiagnostics were sent an e-mail on 27 September 2010 informing them of our willingness to set up an e-learning project for the academic year 2010-2011 in the form of single-subject teaching seminars. The proposed subjects were the semeiotics of the various organs and apparatuses in the context of "Urgent/Emergency Pathology". After having received registrations, a calendar of lessons was planned to be held between 10 November 2010 and 12 October 2011. The validity of the project was tested by means of a multiple-choice questionnaire covering the technical and didactic quality of the entire project, to be completed by the students. Results: Fifty-one percent of the universities in Italy participated in the project: Trieste, Udine, Verona, Milan-Bicocca, Novara, Varese, Genoa, Sassari, Rome Campus, the Catholic University of Rome, Chieti, Foggia, Catania, Modena, Florence, Palermo, Bologna, Pavia, Parma and Ferrara. The lessons were attended by a total of 10,261 post-graduate medical students, for an average of 513.1 students per lesson. Seventy percent of the students judged the didactic content "excellent", 25% "good", and 5% "satisfactory"; none said it was unsatisfactory. In terms of visual quality (particularly the details of the radiological images proposed in the form of slides and/or video clips), 73% judged it "excellent", 20% "good", 6% "satisfactory", and 1% "poor". The audio quality was judged "excellent" by 71%, "good" by 22%, "satisfactory" by 6% and "poor" by 1%. In relation to judgement of audio and video quality, it has to be underlined that this was greatly affected by the hardware/software configuration and the band speed and technology of the Internet connection. Conclusions: Technological evolution is overcoming all barriers, and technology is also having a positive impact on the approach to teaching. Our multicentre teaching experience merits the following considerations: the quality of the teaching product was certified by the students' judgements of its didactic content and the quality of reception; the economic cost of the teaching had a minimal impact on the post-graduate schools ((sic) 18 per lesson). In terms of breaking down national barriers, it is to be hoped that the coordination and integration of diagnostic imaging e-learning projects, with the participation of post-graduate schools in different European countries, can be developed not only in a spirit of "cultural sharing" and the exchange of teaching experiences. (C) 2012 Elsevier Ireland Ltd. All rights reserved.

PURPOSE: The aim of our work was to design, implement and evaluate an e-learning programme in favour of trainee radiologists enrolled at the many specialty schools located throughout Italy, in the spirit of "sharing culture". MATERIALS AND METHODS: Once a common educational programme and time slot had been identified and planned, the programme was delivered via Internet-based video conferencing once a week for 2-h lectures. Each lecture was followed by interaction between the teaching staff and trainees at the individual sites. The universities involved were Trieste, Udine, Verona, Milano Bicocca, Novara, Varese, Genova, Sassari, Rome "Campus", Rome "Cattolica", Chieti, Foggia, Catania, Modena and Firenze. The University of Rome "Cattolica" participated in the project with two locations: Rome "Policlinico Gemelli" and Rome "Cattolica Campus of Campobasso". RESULTS: Eighteen lectures were conducted, for a total of 36 h. "Transient" connection interruption occurred 13 times for a total of 33 min over 2,160 min of lessons. Video quality and, in particular, details of radiological images shown in slides or moving pictures, were rated as very good by 71% of trainees, good by 24% and satisfactory by 4.5%; no one gave a rating of unsatisfactory. CONCLUSIONS: Based on our experience, whereas e-learning in radiology has become established and compulsory, there is the need for legislation that on the one hand protects online teaching activity and on the other allows study and continuing medical education (CME) credits to be recognised.

At the SYnchrotron Radiation for MEdical Physics (SYRMEP) beamline of Elettra Synchrotron Light Laboratory in Trieste (Italy), an extensive research program in bio-medical imaging has been developed since 1997. The core program carried out by the SYRMEP collaboration concerns the use of Synchrotron Radiation (SR) for clinical mammography with the aim of improving the diagnostic performance of the conventional technique. The first protocol with patients, started in 2006 has been completed at the end of 2009 and the data analysis is now in progress. Regarding applications different from clinical imaging, synchrotron X-ray computed microtomography (micro-CT) is the most used technique, both in absorption and phase contrast. A new software tool, Pore3D, has been developed to perform a quantitative morphological analysis on the reconstructed slices and to access textural information of the sample under study.

BACKGROUND: We describe different possible enhancement patterns in liver hemangiomas with atypical appearance on baseline ultrasound after microbubble-based contrast agent injection. METHODS: From a series of 253 consecutive lesions that were indeterminate on baseline ultrasound and then scanned after injection of air-filled microbubble contrast agent, 65 focal liver lesions were retrospectively selected on the basis of a diagnosis of liver hemangioma on multiphase contrast-enhanced computed tomography (n = 23), magnetic resonance imaging (n = 27), or histology (n = 15). Each lesion was scanned during arterial phase (30 s after microbubble injection) and late phase (5 min after injection). On-site sonologists performed retrospective assessment of contrast-enhancement patterns by consensus. RESULTS: Centripetal fill-in preceded (n = 50) or not preceded (n = 3) by peripheral nodular/rim-like enhancement was the prevalently observed contrast-enhancement pattern, equivalent to the typical enhancement pattern of liver hemangiomas on contrast-enhanced computed tomography or magnetic resonance imaging. In the remaining lesions, additional enhancement patterns (diffuse contrast enhancement with rapid fill-in and a late hyper-isoechoic appearance, n = 6; peripheral nodular enhancement with a late hypoechoic appearance, n = 3; or persistent heterogeneous and hyperechoic appearance, n = 3) were observed. CONCLUSION: Different contrast-enhancement patterns are possible in atypical liver hemangiomas after microbubble injection. Typical centripetal fill-in is the prevalent pattern and its evidence allows diagnosis.

Nowadays, the surgical treatment of male-to-female transsexuals is not rare, but few studies have reported on postoperative results. The aim of this study was to determine the role of magnetic resonance imaging (MRI) in the evaluation of the results of sex reassignment surgery (SRS) in male-to-female transsexual patients. Ten such patients (median age 28 years, range 21-47), who had undergone SRS using an inversion of combined penile and scrotal skin flaps for vaginoplasty, were examined with MRI after the operation. Turbo spin-echo T2-weighted and spin-echo T1-weighted images were obtained on sagittal, coronal, and axial planes with a 1.5 T superconducting magnet. The images were acquired on the sagittal, coronal and axial planes, by using TSE T2 weighted and SG T1 weighted images. MRI was performed within 2 weeks after the operation in six patients and after 1 year in the other four. In all cases, the images were obtained with and without an inflatable silicon vaginal tutor. The average neovaginal depth was 7.9 cm (range 6-10 cm). In four patients, MRI showed the presence of cavernosal rests, and in two there were remnants of the corpus spongiosus. In another patient, an abnormal anterior inclination of the neovagina was present. The average distance of the recto-vaginal septum was 4 mm (range 3-6 mm). No major complications were noted. Our study allowed not only a detailed assessment of the pelvic anatomy after genital reconfiguration, but also provided valuable information on possible complications.

Background: We investigated the value of magnetic resonance imaging (MRI) in the evaluation of sex-reassignment surgery in male-to-female transsexual patients. Methods: Ten male-to-female transsexual patients who underwent sex-reassignment surgery with inversion of combined penile and scrotal skin flaps for vaginoplasty were examined after surgery with MRI. Turbo spin-echo T2-weighted and spin-echo T1-weighted images were obtained in sagittal, coronal, and axial planes with a 1.5-T superconductive magnet. Images were acquired with and without an inflatable silicon vaginal tutor. The following parameters were evaluated: neovaginal depth, neovaginal inclination in the sagittal plane, presence of remnants of the corpus spongiosum and corpora cavernosa, and thickness of the rectovaginal septum. Results: The average neovaginal depth was 7.9 cm (range 5–10 cm). The neovagina had a correct oblique inclination in the sagittal plane in four patients, no inclination in five, and an incorrect inclination in one. In seven patients, MRI showed remnants of the corpora cavernosa and/or of the corpus spongiosum; in three patients, no remnants were detected. The average thickness of the rectovaginal septum was 4 mm (range 3– 6 mm). Conclusion: MRI allows a detailed assessment of the pelvic anatomy after genital reconfiguration and provides information that can help the surgeon to adopt the most correct surgical approach.

Aims: Tissue transglutaminase (tTG) was recently identified as the major autoantigen in coeliac disease. The aim of this multicentre study was to evaluate the impact of a new immunoenzymatic assay for the detection of IgA anti-tGT antibodies. Methods: Seventy four Italian and French clinical laboratories participated in this study; anti-tTG IgA with an enzyme linked immunosorbent assay (ELISA) method using guinea pig liver extract as the coating antigen, anti-endomysium IgA autoantibodies (EMA), and total serum IgA were determined in 7948 patients, 1162 of whom had coeliac disease (737 untreated cases and 425 on a gluten free diet). A proportion of the sera were then sent to a reference laboratory for anti-tTG retesting with an ELISA method using recombinant human tTG antigen. Results: Seven thousand four hundred and fifty eight (93.8%) sera were EMA/antiguinea pig tTG concordant (positive or negative); 490 (6.2%) were non-concordant. The sensitivity of EMA and antiguinea pig tTG in the 737 untreated patients with coeliac disease was 92.1% and 94.8%, respectively, and the specificity was 99.8% and 99.2%, respectively. Retesting of the discordant sera showed that of the 162 sera classified as EMA negative/antiguinea pig tTG positive, only 49 were positive for human recombinant anti-tTG, and that 39 of these were also EMA positive. Furthermore, of the 36 sera classified as EMA positive/antiguinea pig tTG negative, only two were confirmed as EMA positive. Conclusions: The antiguinea pig tTG assay is more sensitive but less specific than EMA, whereas the antihuman recombinant tTG assay is far more specific and just as sensitive as antiguinea pig tTG. Testing for EMA presents considerable interpretative problems and is difficult to standardise.