ABSTRACT
El objetivo de este trabajo fue evaluar el desplazamiento de los puntos craneales: Nasion, Silla, Basion, Porion, Orbitario y Pterigoideo, utilizados como referencia en los análisis cefalométricos de Jarabak y Ricketts durante el crecimiento activo. Se seleccionaron 120 telerradiografías de perfil en formato digital, correspondientes a 60 pacientes con 2 telerradiografías cada uno, tomadas con un intervalo de tiempo mínimo de 1 año (T1 y T2), en donde T1 se encuentra antes o durante el peak de crecimiento según el Estado de Maduración Cervical Vertebral (CVM) I, II ó III de Baccetti y T2 en estadio CVM IV,V,VI (después del peak de crecimiento). Un examinador previamente calibrado, ubicó los puntos analizados y para evaluar su desplazamiento, se realizaron mediciones en T1 y T2 (3 variables para cada punto), usando como referencia 2 planos que no se modifican a partir de los 5 años de edad (LCB y Vert-T). Para determinar el desplazamiento de los puntos, se calculó la variación promedio observada entre T1 y T2 y se realizó la prueba t para muestras pareadas o Wilcoxon (según distribución) para determinar la existencia de diferencias significativas. Además, se comparó la muestra por sexo, CVM inicial y CVM final. Se encontraron variaciones entre T1 y T2 en todas las medidas, aunque sólo en 5 de ellas se encontraron diferencias significativas; no se encontró diferencias al comparar por sexo, CVM inicial y final. Es así como podemos concluir que todos los puntos craneales analizados sufren desplazamiento durante el crecimiento. Los puntos Basion y Orbitario son los que sufren mayor desplazamiento. Es necesario analizar las implicancias de estas variaciones en los resultados obtenidos de los análisis cefalométrico y evaluar la necesidad de utilizar puntos de referencia alternativos.
The objective of this study was to evaluate the displacement of cranial reference points: Nasion, Sella, Basion, Porion, Orbitale and Pterygomaxillary, used in Jarabak and Ricketts cephalometric analysis, during active growth. Hundred and twenty digitalized lateral telerradiographies, corresponding to 60 patients (2 teleradiographies each one), were collected. The radiographies were taken with a minimum interval of one year between them (T1 and T2), where T1 is taken before or during the pubertal growth peack according to the cervical vertebral maturation stages developed by baccetti (CVM) I, II or III and T2 in CVM IV,V,VI (after the growth peak). Then, a previously calibrated examinator marked reference points and cephalometric measurements were taken (2 variables for each landmark). Measurements were made using craniofacial stable structures as references (stable basicranial line and Vertical T). To detect displacement in the landmark positions, t test or Wilcoxon test according to the distribution of each variable, was used to compare the data between T1 and T2. Also, comparisons were made by sex, and by initial and final CVM. All of the variables have variations between T1 y T2, but only 5 have a statistically significant difference. There were no differences between sexes and at initial and final CVM. In conclusion, all of the reference landmarks analyzed had displacement during active growth. Point Basion and Orbitale suffered the largest displacement. It is necessary to analyze the clinical implications of this displacement in order to evaluate the convenience of using alternative reference landmarks.
Subject(s)
Humans , Male , Female , Child , Adolescent , Anatomic Landmarks/anatomy & histology , Cephalometry/methods , Skull/anatomy & histology , Skull/growth & developmentABSTRACT
Background: An increased inflammatory innate response may play a role in pathogenesis of respiratory syncytial virus (RSV) infection. Aim: To quantify pro-inflammatory cytokines (IL-6-IL-8, ÍL-2-P and TNF-a) in nasopharyngeal aspirate (NPA) and plasma, and plasma cortisol in previously healthy infants with RSV bronchiolitis. Patients and Methods: We studied 49 infants aged less than one year of age with RSV bronchiolitis and 25 healthy controls. Severity was defined using a previously described modified score. We quantified interleukins in NPA and plasma by flow cytometry and plasma cortisol by radioimmunoanalysis. Results: Among patients with RSV bronchiolitis, 25 were classified as severe and 24 as moderate or mild. Significantly higher levels ofIL-6 and IL-8 in NPA and plasma and IL-lfi in NPA were found in children classified as severe, when compared to those with moderate or mild disease and controls. There was a positive correlation between IL-6 and cortisol in plasma (r = 0,55; p < 0,0001) and both were correlated with the severity of the disease. Conclusions: RSV bronchiolitis severity was associated with higher levéis of inflammatory interleukins and plasma cortisol.