ABSTRACT
Conventional mammography has been used for decades for breast cancer screening. Its limitations are well known and are partly related to the fact that with conventional imaging, the three-dimensional volume of the breast is imaged and presented in a two-dimensional format, which leads to low sensitivity in detecting some cancers and high false-positive recall rates. Digital breast tomosynthesis consists in the acquisition of several low dose images from slightly different angles which are then sent to a computer that uses the data to generate 3-D images, providing breast images which are virtually free from superimposition. This is in particular important in cases of high mammographic density to differentiate real masses and architectural distortions from the overlying parenchyma. Digital breast tomosynthesis has shown decreased false-positive callback rates and increased rates of cancer detection, resulting in increased sensitivity and specificity, without a significant increase in the radiation dose.
Subject(s)
Female , Humans , Breast Neoplasms/diagnostic imaging , Mammography/methodsABSTRACT
La fístula cutánea dental es una patología de difícil diagnóstico. Se presenta como una lesión supurativa crónica e indolora, cuya localización no siempre guarda relación con la pieza dental afectada. Su diagnóstico requiere un alto índice de sospecha, que habitualmente se confirma con radiografía. Se presentan seis casos que se manifestaron con lesiones de larga evolución, con supuración intermitente y apariencia clínica variable. A todos se les realizó ecografía de partes blandas para demostrar el trayecto fistuloso. Para determinar la localización del foco osteomielítico, a dos pacientes se les solicitó además una tomografía axial computada y a otros dos una radiografía periapical. La mayoría de las fístulas tuvo su origen en la arcada dental inferior.
Odontogenic cutaneous sinus tract is a condition difficult to diagnose. It appears as a painless, chronic suppurative lesion, with a location not always related to the affected tooth. Its diagnosis requires a high index of suspicion, usually confirmed by radiography. We report six cases, all of them presenting with long lasting lesions, with intermittent drainage and variable clinical appearance. An ultrasonography was done in every patient, in order to demonstrate the sinus tract. To determine the location of the osteomyelitic focus, in two patients a computed tomography was done, and in other two a periapical radiography. Most sinus tracts were originated in the lower dental arch.
Subject(s)
Humans , Male , Adult , Female , Aged , Aged, 80 and over , Periapical Abscess/complications , Cutaneous Fistula/diagnosis , Cutaneous Fistula/etiologyABSTRACT
Introducción: Los psicoestimulantes son medicamentos de primera línea en el tratamiento del síndrome por déficit atencional (TDA). Su indicación en menores varía según edad y sexo. Existen pocos datos a nivel nacional de frecuencia de uso de psicoestimulantes en niños y no hay datos en nuestra región. Objetivo: Estudiar la frecuencia de uso de psicoestimulantes en escolares de primero a sexto básico en Talca y los factores asociados a su uso. Material y Método: Estudio de corte de alumnos entre primero y sexto básico provenientes de establecimientos educacionales del radio urbano de Talca, estratificados según nivel socioeconómico. Se obtuvo lista con sexo y edad de los alumnos desde la dirección de cada establecimiento. La información acerca de la prescripción de psicoestimulantes fue proporcionada por el profesor jefe o encargado de educación diferencial. Resultados: De una muestra de 2.905 niños, el 1,76 por ciento utilizaba psicoestimulantes, 0,96 por ciento, metilfenidato y 0,76 por ciento, anfetaminas. La probabilidad de consumo de psicoestimulantes fue mayor en varones (OR = 5,8; 95 por ciento, IC: 2,6-13,2), alumnos de cuarto básico (OR = 2,3; 95 por ciento, IC: 1,26-4,15) y de 11 años de edad (OR = 2,4; 95 por ciento, IC: 1,35-4,43). En el nivel socioeconómico alto se registró el mayor consumo de metilfenidato (p = 0,0495) y en el medio bajo la mayor utilización de anfetaminas (p = 0,0014). Discusión: La frecuencia de uso de psicoestimulantes en Talca es baja en relación a la encontrada en otras regiones del país. La frecuencia y tipo de fármaco utilizado en el tratamiento del TDA, se asocia con la edad, el sexo y el nivel socioeconómico de los alumnos.
Background: Stimulant drugs are frequently prescribed in the treatment of Attention-Deficit/ Hyperactivity Disorder (ADHD) in children. Drug prescription is associated with children's age and gender. Chile has few reports of Stimulant drugs prescription and there are no records in our region. Objective: To evaluate the prevalence of Stimulant drugs intake in schoolchildren from first to sixth grade in Talca. Material and Methods: A cross-sectional study in schoolchildren attending first to sixth grade at urban schools in Talca was performed. The schools were stratified according to socioeconomic status. A list with sex and age of the children was obtained from the headmaster of each school. The information about stimulant drugs prescription was provided by the class teacher or the person in charge of special education. Results: We studied 2,905 children, 1.76 percent of them were under stimulant drugs, 0.96 percent took methylphenidate and 0.76 percent took dexamphetamine. Administration of ADHD drugs was higher in boys than in girls (OR = 5.8; 95 percent IC: 1.35-4.43), in fourth grade students (OR = 2.3; 95 percent, IC: 1.26-4.15) and in 11-year-old children (OR = 2,4; 95 percent, IC: 1,35-4,43). Intake of methylphenidate was higher in the highest socioeconomic status (p = 0.0496), while the highest intake of dexamphetamine was found in the lowest socioeconomic status (p = 0.0014). Discussion: The use of stimulant drugs medication is low in Talca compared to national records. The prescription of these drugs is related to the age, sex of the students while the kind of drug prescribed was related to the socioeconomic status of the child.