Definiendo la necesidad de especialistas y gammacámaras en medicina nuclear / Defining the need of specialists and gammacameras in nuclear medicine

The aim of this work was to establish the relationship between the number of gammacameras, nuclear medicine specialists and the number of inhabitants in different countries, including Chile. Information was obtained from the International Atomic Energy Agency, Britannic and Canadian Nuclear Medicine Societies, Pan-American Health Organization and American College of Nuclear Physicians. Industrialized countries have approximately 1 specialist and 0.5-3.3 gammacameras per 100,000 inhabitants. The respective figures in Chile are 0.25 and 0.25. Due to the unequal distribution of resources in Chile, the specialists and gammacameras rate in the Metropolitan area is 0.6, some regions or communities do not have these resources and in other communities the rate can raise up to nine. Compared to industrialized countries, Chile lacks nuclear medicine specialists and gammacameras and these resources are unevently distributed

Hipertensión arterial renovascular: rol del cintigrama renal en su detección y en la predicción de la respuesta clínica a la revascularización / Renovascular arterial hypertension: role of renal scintigraphy on it detection and on the prediction of clinical response to revascularization

The most frequently used non invasive tests in the diagnosis of renovascular hypertension are the measurement of peripheral blood renin before and after captopril administration, intravenous pyelogram, renal Doppler examination and radionuclide renography without and with angiotensin converting enzyme inhibitor administration. Measurement of renal vein renin levels and renal angiography are invasive tests commonly used. The latter allows an anatomical disgnosis of renal veins stenosis but does not give information about pressure to revascularization. Radionuclide renography has become the most useful non invasive diagnostic test, with a sensitivity and specificity of 83-94 and 85-97 percent respectively. It also predicts clinical response to revascularization and is useful for follow up after surgery or angioplasty. It also had good results in patients with renal failure, bilateral stenosis or stenosis in a solitary kidney and in transplantated patients

Evaluación de masa ósea en fractura de cadera cuantificando columna lumbar y cadera contralateral con densitometría ósea / Evaluation of bone mass in hip fracture, quantifying lumbar bone marrow and contralateral hip with bone densitometry

Hip fracture is frecuent in postmenopausal women with osteoporosis. The aim of this work was to assess bone mass in women with hip fracture and compare it with that of normal women. Bone densities of lumbar spine (considering areas with and without spondylosis), female neck, greater trochanter and unfractures hip Ward's triangle were measured with a double beam isotopic densitometer. Thirty one women aged 58-95 years old were studied and compared with normal women studied at the same laboratory. Bone densities in fractures and normal women were 0.82ñ0.16 and 0.85ñ0.05 g/cm2 in lumbar spine respectively (NS), 0.74ñ0.15 and 0.85ñ0.05 g/cm2 in lumbar spine without spondylosis respectively (p<0.001), 0.60ñ0.11 and 0.65ñ0.08 g/cm2 in femoral neck respectively (NS), 0.49ñ0.09 and 0.52ñ0.09 g/cm2 in greater trochanter respectively (p<0.001) and 0.48ñ0.12 and 0.52ñ0.09 g/cm2 in Ward's triangle respectively (NS). It is concluded that the larger differences in bone density between women with and without hip fracture are observed in the greater trochanter

Evaluación de revascularización coronaria: comparación entre perfusión con Tc99m sestamibi-dipiridamol gatillado y ecografía-amrinona como predictores de viabilidad / Assessment of coronary revascularization: comparison between perfussion with Tc99m sestamibi-dipyridamol spect and echography-amrinone as predictors of viability

We studied left ventricular perfusion and motility in 37 patients with coronary artery disease and disturbances of parietal motility, aged 57 ñ 9 years old, before and after revascularization. Perfusion was assessed with dipyridamole-Tc99m SPECT and motility was assessed with 2 dimentional echocardiography with amrinone. Myocardial segments were defined as normal, viable or necrotic in both studies. Eighteen subjects were subjected to angioplasty and 19 to coronary bypass surgery. Submitted SPECT and echography were repeated 64 ñ 15 and 69 ñ 23 days after revascularization respectively. The concordance between SPECT and echocardiographic prerevascularization diagnosis was 60.1 percent. Eighty one percent of segment considered viable with SPECT and 71 percent thus considered with echocardiography improved after revascularization. Likewise, 50 percent of segments considered necrotic with SPECT and 68 percent of segment thus considered with echocardiography did not improve. It is concluded that althought there is a good concordance between both methods, they have limitations on the study of myocardial viability and should be considered as second choice