Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 6.965
Filter
1.
Rev. colomb. cir ; 37(1): 49-59, 20211217. tab, fig
Article in Spanish | LILACS | ID: biblio-1355295

ABSTRACT

Introducción. El cáncer de pulmón es la primera causa de mortalidad por cáncer a nivel mundial, lo que hace que sea considerado un problema de salud pública. Existen diferentes hallazgos imagenológicos que hacen sospechar la presencia de cáncer de pulmón, uno de los cuales son los nódulos pulmonares; sin embargo, estos también pueden verse en entidades benignas.Métodos. Se incluyeron 66 pacientes con biopsia de nódulo pulmonar en la Clínica Reina Sofía, en la ciudad de Bogotá, D.C., Colombia, entre el 1° de marzo del 2017 y el 28 de febrero del 2020. Se analizaron las características demográficas de los pacientes, las características morfológicas e histopatológicas de los nódulos pulmonares y la correlación entre sus características imagenológicas e histopatológicas. Resultados. El 69,2 % de los nódulos estudiados tenían etiología maligna, de estos el 55,5 % era de origen metástasico y el 44,5 % eran neoplasias primarias de pulmón, con patrón sólido en el 70,6 % de los casos. El patrón histológico más frecuente fue adenocarcinoma. Respecto a las características radiológicas, en su mayoría los nódulos malignos medían de 1 a 2 cm, de morfología lisa y distribución múltiple, localizados en lóbulos superiores. Conclusiones. La caracterización de los nódulos pulmonares brinda información relevante que orienta sobre los diagnósticos más frecuentes en nuestro medio, cuando se estudian nódulos sospechosos encontrados incidentalmente o en el seguimiento de otro tumor. Como el nódulo es la manifestación del cáncer temprano del pulmón, establecer programas de tamización que permitan el diagnóstico oportuno, es hoy día una imperiosa necesidad, para reducir la mortalidad.


Introduction. Lung cancer is the leading cause of cancer mortality worldwide, which makes it a public health problem. There are different imaging findings that suggest the presence of lung cancer, one of which is pulmonary nodules; however, these can also be seen in benign entities. Methods. A total of 66 patients with pulmonary nodule biopsy at Clínica Reina Sofía, in the city of Bogotá D.C. were included between March 1, 2017 and February 28, 2020. The demographic characteristics of the patients, the morphologic and histopathologic characteristics of the pulmonary nodules and their correlation with their pathological diagnosis were analyzed.Results. 69.2% of the nodules studied had malignant etiology, of these 55.5% were of metastatic origin, and 44.5% were primary lung neoplasms, with a solid pattern in 70.6% of the cases. The most frequent histological pattern was adenocarcinoma. Regarding the radiological characteristics, most of the malignant nodules measure 1 to 2 cm, of smooth morphology and had multiple distribution, located in the upper lobes. Conclusions. The characterization of pulmonary nodules provides relevant information that guides the most fre-quent diagnoses in our setting, when suspicious nodules found incidentally or in the follow-up of another tumor are studied. As the nodule is the manifestation of early lung cancer, establishing screening programs that allow timely diagnosis is an urgent need to reduce mortality.


Subject(s)
Humans , Solitary Pulmonary Nodule , Lung Neoplasms , Pathology , Biopsy, Needle , Diagnostic Imaging , Diagnosis
2.
Braz. j. oral sci ; 20: e219912, jan.-dez. 2021. ilus
Article in English | LILACS, BBO | ID: biblio-1254429

ABSTRACT

Aim: Evaluation of the reliability of 3D computed tomography (3D-CT) in the diagnosis of mandibular fractures. Methods: A cross-sectional, quantitative and qualitative study was carried out, through the application of a questionnaire for 70 professionals in the area of Oral and Maxillofacial Surgery and Radiology. 3D-CT images of mandibular fractures were delivered to the interviewees along with a questionnaire. Participants answered about the number of traces, the region and the type of fracture. The correct diagnosis, that is, the expected answer, was based on the reports of a specialist in oral and maxillofacial radiology after viewing the images in the axial, sagittal and coronal sections. The resulting data from the interviewees was compared with the expected answer and then, the data was analyzed statistically. Results: In the sample 56.9% were between 22 and 30 years old, 52.8% were oral and maxillofacial surgeons (OMF), 34.7% were residents in OMF surgery and 12.5% OMF radiologists. Each professional answered 15 questions (related to five patients) and 50.8% of the total of these was answered correctly. Specialists in Oral and Maxillofacial Surgery and Traumatology correctly answered 53.9%. Interviewees with experience between 6 and 10 years correctly answered 58.2%. In identifying fracture traces, 46.1% of the questions were answered correctly. In terms of location, 5.6% of interviewees answered wrongly while 14.2% answered wrongly regarding classification. Conclusion: 3D computed tomography did not prove to be a reliable image for diagnosing mandibular fractures when used alone. This made necessary an association with axial, sagittal and coronal tomographic sections


Subject(s)
Humans , Male , Female , Diagnostic Imaging , Tomography, X-Ray Computed , Surveys and Questionnaires , Imaging, Three-Dimensional , Mandibular Fractures
3.
Rev. cuba. pediatr ; 93(3): e1510, 2021.
Article in Spanish | LILACS, CUMED | ID: biblio-1347545

ABSTRACT

La ingestión de un cuerpo extraño es un tipo de lesión no intencionada muy frecuente en la infancia, particularmente en lactantes mayores de 6 meses y preescolares. El propósito deseado con la publicación de esta guía es contar con herramientas actualizadas en el diagnóstico y tratamiento de esta afección que permitan sistematizar la conducta y mejorar la calidad de la asistencia médica. Dentro de los cuerpos extraños más frecuentes tenemos: monedas, imanes, baterías, juguetes pequeños, plásticos, joyas, botones, huesos e impactaciones alimentarias en los niños mayores. La sintomatología varía según la naturaleza del cuerpo extraño, el lugar donde se impacte, que casi siempre es en las estrecheces anatómicas o adquiridas del tubo digestivo o por la presencia de complicaciones. Para confirmar el diagnóstico son necesarios diferentes estudios imagenológicos y endoscópicos, estos últimos con un valor terapéutico. El tratamiento depende de factores como la edad, el tiempo de ingerido, la localización, la presencia de complicaciones, la naturaleza del cuerpo extraño, su número y el potencial lacerante, tóxico o corrosivo. En la mayoría de los casos los cuerpos extraños son expulsados de forma espontánea y tienen un pronóstico favorable, pero queda un grupo de pacientes donde es necesario un tratamiento quirúrgico. Después de realizar una búsqueda de revisiones sistemáticas de calidad y tomando en cuenta la experiencia del Servicio de Cirugía Pediátrica de Matanzas en el tratamiento de estos pacientes se elaboró esta guía que fue discutida y aprobada en el IV Simposio Nacional de Cirugía Pediátrica. La publicación de esta guía permitiría a los servicios de Cirugía Pediátrica emplearla como referencia y aplicarla en sus propias instituciones con el consecuente beneficio para los pacientes(AU)


Ingestion of a foreign body is a very common type of unintentional injury in childhood, particularly in infants older than 6 months and preschoolers. The desired purpose with the publication of this guideline is to have up-to-date tools in the diagnosis and treatment of this condition that allow to systematize the behavior and improve the quality of medical care. Within the most frequent foreign bodies we have: coins, magnets, batteries, small toys, plastics, jewelry, buttons, bones and food impactations in older children. Symptomatology varies depending on the nature of the foreign body, the place where it impacted, which is almost always in anatomical or acquired narrowness of the digestive tract, or by the presence of complications. To confirm the diagnosis, different imaging and endoscopic studies are necessary, the latter with a therapeutic value. Treatment depends on factors such as age, ingestion time, location, presence of complications, the nature of the foreign body, the amount and the lacerating, toxic or corrosive potential. In most cases foreign bodies are expelled spontaneously and have a favorable prognosis, but there is a group of patients left for whom surgical treatment is necessary. After conducting a search for quality systematic reviews and taking into account the experience of Matanzas province's Pediatric Surgery Service in the treatment of these patients, this guideline was created and it was discussed and approved at the IV National Symposium of Pediatric Surgery. The publication of this guideline would allow Pediatric Surgery services to use it as a reference and apply it in their own institutions with the consequent benefit for patients(AU)


Subject(s)
Humans , Infant , Child, Preschool , Diagnostic Imaging/methods , Practice Guideline , Gastrointestinal Tract/injuries , Foreign Bodies/therapy , Medical Care
4.
Rev. Ciênc. Méd. Biol. (Impr.) ; 20(2): 240-244, set 29, 2021. fig, tab
Article in Portuguese | LILACS | ID: biblio-1354433

ABSTRACT

Introdução: a detecção da reabsorção da raiz dentária é realizada por meio de exames de imagens, pois frequentemente não apresenta sinal e sintoma clínicos. Dentre os exames de imagem disponíveis, o exame radiográfico periapical, é indicado para diagnóstico, prognóstico e acompanhamento da reabsorção radicular. Objetivo: o estudo tem como objetivo investigar a relação de diferentes resoluções espaciais com o diagnóstico de reabsorção radicular. Metodologia: foram realizados desgastes simulando reabsorção externa no terço apical e vestibular de 15 (quinze) incisivos inferiores, radiografados em crânio seco, antes e depois do desgaste. A técnica radiográfica foi realizada utilizando o sistema VistaScan (Durr Dental, Bietigheim-Bissingen, Germany), aparelho CS 2200 (Carestream Dental LLC, Atlanta-GA, USA) usando tempo de exposição de 0,15 segundos e escaneadas sob diferentes protocolos de resolução espacial, a saber, 20 pares de linhas por milímetro (pl/mm) e 40 pl/mm. Posteriormente dois avaliadores experientes fizeram análises das referidas imagens sem conhecimento prévio da resolução de escaneamento. Resultados: 75% das radiografias realizadas com 20 pl/mm foram classificadas como excelentes pelos avaliadores, contra 33% com 40 pl/mm, estatisticamente significativa. Discussão: ao avaliar a reabsorção radicular, obteve-se uma acurácia diagnóstica igual para os dois protocolos sem distinção, estatisticamente significativa, entre localização ou profundidade. Conclusão: tendo em vista que para os examinadores imagens com 20 pl/mm foram satisfatórias, com percentual de qualidade maior quando comparado a imagens obtidas com 40 pl/ mm, este estudo indica o emprego de imagens com 20 pl/mm para avaliação inicial de suspeita de reabsorções nas raízes dentárias.


Introduction: the detection of tooth root resorption is carried out by means of imaging tests, as it often does not present a clinical sign and symptom. Among the imaging tests available, the periapical radiographic examination is indicated for diagnosis, prognosis and monitoring of root resorption. Objective: the study aims to investigate the relationship of different spatial resolutions in the diagnosis of root resorption. Methods: Artificial external root resorptions were simulated using burs by drilling to the entire depth in different locations at the apical and buccal thirds of 15 (fifteen) lower incisors were worn, radiographed on a dry skull, before and after wear. The radiographic technique was performed using the VistaScan system (Durr Dental, Bietigheim-Bissingen, Germany), CS 2200 device (Carestream Dental LLC, Atlanta-GA, USA) using an exposure time of 0.15 seconds and scanned under different resolutions protocols, namely, 20 pairs of lines per millimeters (pl/mm) and 40 pl/mm. Subsequently, two experienced evaluators performed analyzes of these images without prior knowledge of the scanning resolution. Results: seventy-five percent of the radiographs taken at 20 pl/mm were rated as excellent by the evaluators, against 33% at 40 pl/mm, a statistically significant difference. Discussion: When assessing root resorption, a similar diagnostic accuracy was obtained for the two protocols without a statistically significant distinction between location or depth. Conclusions: Considering that for examiners images with 20 pl/mm were satisfactory, with a percentage of quality greater than 40 pl/mm, this study indicates the use of 20 pl/mm for initial evaluation of suspected root resorption.


Subject(s)
Humans , Root Resorption , Tooth Root , Diagnostic Imaging , Radiography, Dental, Digital , Research , Dimensional Measurement Accuracy , Incisor
5.
Rev. bras. ortop ; 56(4): 411-418, July-Aug. 2021. tab, graf
Article in English | LILACS | ID: biblio-1341164

ABSTRACT

Abstract Bone and soft tissue sarcomas consist of a heterogeneous group of malignant tumors of mesenchymal origin that can affect patients from any age. The precise staging of these lesions determines the best therapeutic strategies and prognosis estimates. Two staging systems are the most frequently used: the system proposed by the University of Florida group, led by Dr. William F. Enneking (1980) and adopted by the Musculoskeletal Tumor Society (MSTS), and the system developed by the American Joint Committee on Cancer (AJCC) (1977), currently in its 8th edition (2017). This paper updates the reader on the staging of bone and soft tissue sarcomas affecting the musculoskeletal system.


Resumo Os sarcomas ósseos e das partes moles consistem em grupo heterogêneo de neoplasias malignas de origem mesenquimal que podem ocorrer em qualquer faixa etária. O estadiamento preciso destas lesões determina as melhores estratégias terapêuticas e estimativas de prognóstico. Dois sistemas de estadiamento são os mais frequentemente empregados no manejo destas neoplasias: o sistema proposto pelo grupo da Universidade da Flórida, liderado pelo Dr. William F. Enneking (1980), adotado pela Musculoskeletal Tumor Society (MSTS) e o sistema desenvolvido pela American Joint Committee on Cancer (AJCC) (1977) que se encontra em sua 8a edição (2017). O presente artigo busca atualizar o leitor a respeito do estadiamento dos sarcomas ósseos e das partes moles que acometem o sistema musculoesquelético.


Subject(s)
Humans , Pathology, Surgical , Sarcoma , Diagnostic Imaging , Neoplasms, Bone Tissue , Neoplasm Staging , Neoplasms, Connective Tissue
7.
Rev. Assoc. Méd. Rio Gd. do Sul ; 65(2): 01022105, Abr. - Jun. 2021.
Article in Portuguese | LILACS | ID: biblio-1367818

ABSTRACT

RESUMO Linfomas primários cardíacos, cujo tipo histológico mais comum é o difuso de grandes células B, são tumores raros, mas de elevada mortalidade, em parte devido ao seu diagnóstico tardio e à agressividade de seu tratamento. Apresentam manifestações clínicas constitucionais e relacionadas ao efeito direto de massa sobre o miocárdio. Vários métodos de diagnóstico por imagem apresentam elevada sensibilidade e especificidade, apesar da dificuldade do estudo de estruturas em movimento. O prognóstico desses tumores depende diretamente do seu diagnóstico precoce e do seu tratamento como uma doença sistêmica. PALAVRAS-CHAVE: Linfoma, doenças cardiovasculares, diagnóstico por imagem


ABSTRACT Primary cardiac lymphomas, whose most common histological type is the diffuse of large B cells, are rare tumors, but with high mortality, in part due to their late diagnosis and aggressive treatment. They present constitutional clinical manifestations and are related to the direct mass effect on the myocardium. Several diagnostic imaging methods have high sensitivity and specificity, despite the difficulty of studying structures in motion. The prognosis of these tumors directly depends on their early diagnosis and their treatment as a systemic disease. KEYWORDS:. Lymphoma, cardiovascular diseases, diagnostic imaging


Subject(s)
Humans , Diagnostic Imaging , Cardiovascular Diseases , Lymphoma
8.
Odontol. Clín.-Cient ; 20(2): 58-64, abr.-maio 2021. tab
Article in Portuguese | LILACS, BBO | ID: biblio-1369051

ABSTRACT

O exame clínico, a sondagem periodontal e a radiografia são os três principais métodos de avaliação de saúde oral usados pelo cirurgião-dentista. Com isso, foi elaborado uma Revisão de Literatura com pesquisa no banco de dados da PubMed, Wiley Online Library e Google Acadêmico, com lapso temporal de 1998 a 2021, com o objetivo de avaliar a aplicação da TCO como possível método auxiliar no diagnóstico de doença periodontal. A partir de 1998, a TCO passa a ser estudada como possível método de diagnóstico não invasivo na Odontologia. Entre os benefícios referentes à Periodontia, tem sido relatado: a possibilidade de visualizar estruturas importantes do periodonto, fazer sondagem periodontal, diferenciar fenótipo gengival, detectar presença de cálculo supra e subgengival, além da observação de microestrutura e vascularização gengival, auxiliando no diagnóstico e acompanhamento do tratamento periodontal. Portando, a TCO é uma tecnologia emergente de bio-imagem que gera imagens estruturais bi e tridimensionais em alta resolução dos tecidos duros e moles do periodonto. Entretanto, mais estudos são necessários para superar as limitações da técnica e desenvolver sistemas de baixo custo para impulsionar seu uso em ambiente clínico... (AU)


Physical examination, periodontal probing and radiography are the three main methods of assessing oral health used by the dentist. Thereby, a Literature review was prepared based on research in the database of PubMed, Wiley Online Library and Google Academic, with time lapse from 1998 to 2021, with the objective of evaluating the application of OCT as a possible auxiliary method in the diagnosis of periodontal disease. Since 1998, the OCT has been studied as a possible non-invasive diagnostic method in Dentistry. Among the benefits related to Periodontics, it has been reported: the possibility of viewing important structures of the periodontium, periodontal probing, differentiating gingival phenotype, detecting the presence of supra and subgingival calculus, in addition to the observation of gingival microstructure and vascularization, helping in the diagnosis and monitoring of periodontal treatment. Therefore, the OCT is an emerging bio-imaging technology that generates high resolution bi and three-dimensional structural images of the hard and soft tissues of the periodontium. However, further studies are needed to overcome the limitations of the technique and develop low-cost systems to boost its use in a clinical setting... (AU)


Subject(s)
Humans , Periodontics , Diagnostic Imaging , Dentistry , Tomography, Optical Coherence , Periodontal Diseases , Physical Examination , Oral Health , Dentists , Diagnosis, Oral
9.
Rev. Hosp. Ital. B. Aires (2004) ; 41(1): 15-20, mar. 2021. graf, tab
Article in Spanish | LILACS | ID: biblio-1178270

ABSTRACT

Introducción: los estudios por imágenes (EPI) son de gran ayuda para el diagnóstico clínico, pero su uso irracional puede ocasionar daños. Objetivos: relevar las percepciones y expectativas sobre estudios por imágenes pediátricos en un grupo de padres de niños sanos. Evaluar los datos obtenidos en relación con el registro de EPI solicitados por Guardia durante el mismo período. Materiales y métodos: estudio exploratorio, descriptivo, cuali-cuantitativo mediante una encuesta en una muestra por conveniencia en un centro pediátrico ambulatorio, a lo largo de dos meses. Análisis retrospectivo de solicitud de EPI en el registro informatizado de historias clínicas de Guardia durante el mismo período. Resultados: respondieron 243 padres. El 93,4% refirió conocer métodos de EPI (la radiografía[Rx] fue el más conocido). Se había realizado al menos un EPI al 83,4% de los niños en los últimos doce meses. El estudio fue explicado en forma clara en el 96,4% de los casos. Un 47,7% de los padres refirieron conocer las consecuencias del uso repetitivo de EPI. El 81,6% acordó con que "ante cualquier traumatismo se debe realizar Rx para descartar fractura". Más del 60% consideró que debe realizarse Rx de tórax a todo niño con tos sin fiebre o con fiebre de más de dos días y 55% solicitarían Rx de senos paranasales si el niño elimina mocos verdes. El 49,8% opinó que los médicos piden EPI de menos (por falta de recursos, para trabajar menos o para ahorrar dinero). Durante el período estudiado se solicitó una radiografía al 5% de los pacientes que consultaron por Guardia; no se encontró justificación para solicitar el estudio en el 29% de los casos. Conclusión: un gran porcentaje de padres conoce los EPI; sin embargo, desconocen los riesgos asociados a su uso. Existen errores de concepto que generan expectativas desmedidas con respecto a la indicación de Rx. Se informó un exceso en las solicitudes de EPI por Guardia. Los padres consideran que los médicos solicitan EPI de menos. (AU)


Introduction: ediatric radiologic exams (PRE) are of great value for clinicians. It's over or misuse can lead to irreparable damage that can be prevented. Objective: to describe perceptions and expectations for the use of PRE among healthy children`s parents in an ambulatory center. To analyze these results in relation to the report of PRE performed in the emergency room during the same period. Methods: observational, cross sectional, quali- quantitative study using a survey on a convenience sample conducted in an outpatient pediatric center over a two months period. Retrospective analysis of medical records to evaluate PRE requested on the ER during the 2 months of the study. Results: 243 parents completed the survey. 93,4% were familiar with PRE (X-rays being the most popular among them). 83,4% of children in our sample had at least one PRE in the past 12 months. The need and utility of the study had been explained to the parents clearly in 96,4% of cases. 47,7% of parents knew about the side effects associated with repetitive use of PRE. 81,6% agreed with the statement "in the event that a child should suffer any trauma, an X-Ray should be performed to look for fractures". Over 60% think a chest X ray has to be obtained if the child has fever for over 48 hours and 55% would expect an X ray to be performed whenever a child has green nasal discharge. 49,8% respondents think that doctors order less than necessary (for lack of resources, unwillingness to work in or to save money). The analysis of clinical reports showed that X-Rays were performed to 5% of children at the emergency clinic. Among them, we found no reason for the study in 29% of the cases. Conclusion: we found that parents were very familiar with PRE, however less than half our sample knew of the potential risks related to their use. There are considerable misconceptions among parents regarding X-Ray use. Parents considered that doctors order too little PRE. (AU)


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Pediatrics/statistics & numerical data , Diagnostic Imaging/statistics & numerical data , Argentina , Radiation Injuries/etiology , Radiation, Ionizing , X-Rays , Diagnostic Imaging/adverse effects , Radiography/statistics & numerical data , Risk , Surveys and Questionnaires , Retrospective Studies
10.
Biomédica (Bogotá) ; 41(1): 52-64, ene.-mar. 2021. tab
Article in Spanish | LILACS | ID: biblio-1249058

ABSTRACT

Resumen | Introducción. La calidad de la mamografía está directamente relacionada con la capacidad para detectar anormalidades y, por ello, es necesario el control de calidad en los centros de imágenes diagnósticas. Objetivo. Evaluar la calidad de la imagen, la lectura y el servicio de mamografía de algunos centros de imágenes diagnósticas en Manizales, Colombia. Materiales y métodos. Cuatro centros participaron de forma voluntaria y bajo acuerdos de confidencialidad en el estudio. De las 520 mujeres atendidas en ellos, a 318 se les hicieron mamografías. A partir de una inspección visual del servicio, se evaluaron la infraestructura, la tecnología y el personal de la unidad. Un radiólogo experto en lectura e interpretación clínica de imágenes mamarias evaluó la calidad de la imagen y la de su lectura. El análisis estadístico se hizo utilizando un anova y determinando el índice kappa y el porcentaje de desacuerdo. Resultados. Se encontró falta de calidad de las imágenes obtenidas, principalmente, por presencia de artificios en el 75 % de ellas, e identificación y rotulación deficientes; además, en la toma de la proyección oblicua medio-lateral, se encontró falta de visualización del ángulo inframamario. El grado de concordancia en el reporte BI-RADS fue bajo en los cuatro centros, con diferencias importantes en el informe y la descripción de los hallazgos. Conclusión. Los centros de imágenes diagnósticas evaluados están habilitados para el funcionamiento, pero se encontraron deficiencias importantes en la calidad de las imágenes y en su lectura, lo que pone de manifiesto la necesidad de establecer estándares de calidad y mejorar los aspectos que se puedan mejorar.


Abstract | Introduction: Mammography quality is directly related to the ability to detect an abnormality and, therefore, quality control is necessary for diagnostic imaging centers. Objective: To evaluate image quality, reading, and mammography service in some diagnostic imaging centers in Manizales, Colombia. Materials and methods: Four diagnostic imaging centers participated voluntarily in the study under confidentiality agreements. Out of 520 women attending the centers, 318 had a mammography. The infrastructure, technology, and human resources of each unit were evaluated based on visual inspections. A radiologist expert in reading and clinical interpretation of mammary images evaluated the quality of the image and the reading. We made the statistical analysis using anova, the kappa index, and the percentage of disagreement. Results: We found images of diminished quality mainly due to the presence of artifacts in 75 % of those evaluated, as well as non-compliance with identification criteria and image labeling. There were difficulties in taking the lateral median oblique projection given the absence of the inframammary. The level of agreement in the BI-RADS reporting was low in the four centers with important differences in the report and description of findings. Conclusion: The city's diagnostic centers under evaluation are authorized for their operation. However, there are important deficiencies in image quality and reading, which highlights the need to seek quality standards starting from those aspects that can be improved upon.


Subject(s)
Mammography , Quality Assurance, Health Care , Biomedical Engineering , Diagnostic Imaging , Quality Management , Maintenance and Engineering, Hospital
11.
CorSalud ; 13(1): 100-103, 2021. graf
Article in Spanish | LILACS | ID: biblio-1345926

ABSTRACT

RESUMEN La disección de la aorta abdominal tiene una baja incidencia, se produce a partir de una laceración, desgarro o rotura intimal, con la consecuente separación longitudinal de las capas de la pared y la aparición de una falsa luz con flujo en su interior. Se presenta el caso de un hombre de 67 años de edad con antecedentes de hipertensión arterial, sin tratamiento regular, que acudió al cuerpo de guardia del Hospital Salvador Allende (La Habana, Cuba) por presentar dolor abdominal con irradiación a fosa ilíaca izquierda y espalda, de una semana de duración, que no aliviaba con los analgésicos habituales. Se le realizó ultrasonido abdominal y se encontró una dilatación aneurismática de la aorta abdominal, con signos de disección hacia la ilíaca derecha; por lo que se realizó angiotomografía que confirmó el diagnóstico. Se realizó baipás aorto-ilíaco con fenestración en aorta abdominal y anastomosis término-terminal en ambas arterias ilíacas.


ABSTRACT Abdominal aortic dissection has a low incidence. It may happen when a small tear or rupture occurs in the tunica intima, dividing the wall layers and forming a false channel, or lumen with blood flow inside. We present the case of a 67-year-old man with a history of high blood pressure, with no regular treatment, who sought care at the Hospital Salvador Allende (Havana, Cuba) as he presented with a week-long abdominal pain radiating to the left iliac fossa and back, which was not relieved by the usual analgesics. An abdominal ultrasound was performed which found an aneurysmal dilatation of the abdominal aorta, with signs of dissection towards the right iliac artery; therefore, computed tomography angiography (CTA) was performed and the diagnosis was confirmed. He underwent aorto-iliac bypass with abdominal-aortic-fenestration and end-to-end anastomosis in both iliac arteries.


Subject(s)
Aorta, Abdominal , Diagnostic Imaging , Tomography, X-Ray Computed , Dissection , Aneurysm, Dissecting
12.
Medicina (B.Aires) ; 81(1): 103-106, mar. 2021. graf
Article in Spanish | LILACS | ID: biblio-1287248

ABSTRACT

Resumen La incidencia de Tb osteoarticular es mucho menor que la pulmonar, representando 1-2% de los casos de Tuberculosis (Tb) y el 10% de los casos de Tb extrapulmonar, por lo que usualmente no es considerada para el diagnóstico diferencial de pacientes con enfermedad articular. Su diagnóstico es difícil y se basa en hallazgos clínicos, radiológicos, bacteriológicos e histológicos. Las lesiones extrapulmonares son paucibacilares y las muestras, en la mayoría de los casos, difíciles de obtener, por lo que el diagnóstico a menudo es simplemente presuntivo. La tuberculosis articular en etapas tempranas, presenta manifestaciones clínicas e imagenológicas inespecíficas. Esto puede facilitar la progresión de la enfermedad local, generando lesiones osteoarticulares graves y, finalmente, la destrucción articular. Se presenta el caso de una paciente de 60 años, intervenida quirúrgicamente por presentar manifestaciones clínicas e imagenológicas compatibles con una ruptura del manguito rotador, y cuya evolución tórpida posoperatoria, llevó al diagnóstico bacteriológico de tuberculosis de húmero proximal.


Abstract The incidence of osteoarticular TB is much lower than that of the lung, representing 1-2% of TB cases and 10% of extrapulmonary TB cases, so it is often not considered for the differential diagnosis of patients with joint disease. Its diagnosis is difficult and is based on clinical, radiological, bacteriological and histological findings. Extrapulmonary lesions are paucibacillary and specimens, in most cases, difficult to obtain, so the diagnosis is often simply presumptive. Joint tuberculosis in early stages presents nonspecific clinical and imaging manifestations. This can lead to the progression of the local disease, generating severe osteoarticular lesions and, finally, joint destruction. We present the case of a 60-year-old patient who underwent surgery due to clinical and imaging manifestations compatible with a rotator cuff tear, and whose torpid postoperative evolution led to the bacteriological diagnosis of proximal humerus tuberculosis.


Subject(s)
Humans , Middle Aged , Tuberculosis , Humerus , Diagnostic Imaging , Rotator Cuff
13.
CorSalud ; 13(1): 95-99, 2021. graf
Article in Spanish | LILACS | ID: biblio-1345925

ABSTRACT

RESUMEN El tratamiento de las enfermedades de la aorta torácica con la implantación percutánea de stent se viene realizando desde su aplicación, por primera vez, a principios del siglo XX. Se presenta un paciente de 79 años de edad que fue llevado a urgencias con intenso dolor de espalda posterior a un accidente automovilístico, a quien se le realizó tomografía computarizada y se le diagnosticó una disección aórtica tipo III de DeBakey. Se le implantó un stent endovascular autoexpandible de nitinol (Talent Stent Graft, Medtronic) en la aorta descendente, donde comenzaba el segmento disecado. Este procedimiento es un método eficaz para prevenir la isquemia de órganos y la ruptura vascular en las enfermedades traumáticas de la aorta. Es menos invasivo, tiene menos complicaciones que el tratamiento quirúrgico, y es efectivo para restituir el flujo sanguíneo de forma rápida y segura.


ABSTRACT The applications of thoracic aorta pathologies with a stent graft percutaneously have been performed for the first time since the beginning of the 20th century. Computed tomography was performed on a 79-year-old patient who was brought to the emergency room due to an in-vehicle traffic accident with severe back pain, and DeBakey type III aortic dissection was determined. An endovascular self-expanding nitinol stent (Talent Stent Graft, Medtronic) was implanted in the descending aorta where the dissected segment begins. Stent graft implantation is an effective method in preventing organ ischemia and rupture in traumatic aortic pathologies. This procedure is less invasive and has less complication than surgical approach. It is effective in providing blood flow quickly and safely.


Subject(s)
Diagnostic Imaging , Self Expandable Metallic Stents , Aneurysm, Dissecting
15.
Bol. méd. postgrado ; 37(1): 68-72, Ene-Jun 2021. ilus
Article in Spanish | LILACS, LIVECS | ID: biblio-1147883

ABSTRACT

Según datos de la OMS, la tuberculosis es una de las diez primeras causas de muerte en el mundo y es la primera causa de muerte por un agente infeccioso único. La incidencia de la tuberculosis ha disminuido por término medio un 1,5% anual desde el año 2000 sin embargo el impacto de la pandemia por el SARS-CoV-2 pudiera retardar el diagnóstico y tratamiento de nuevos casos de TB. Se presenta el caso de un paciente masculino de 26 años de edad quien consulta por presentar fiebre de predominio vespertino, pérdida de peso y disfonía de 6 meses de evolución. Los BK y cultivos de esputo seriados resultaron negativos. Es referido al Servicio de Otorrinolaringología y Cirugía Facial del Hospital Universitario Dr. Luis Gómez López donde se realiza una nasofibrolaringoscopía evidenciándose epiglotis con superficie de aspecto irregular que se extiende hasta aritenoides y zona interaritenoidea y bandas ventriculares edematizadas que no permiten visualizar repliegues vocales. Se realiza microcirugía laríngea para toma de biopsia reportando el estudio histopatológico proliferación de vasos neoformados, espacios intervasculares ocupados por macrófagos y linfocitos, presencia de múltiples lesiones nodulares formadas por macrófagos epiteloides rodeados por un halo de linfocitos y numerosas células gigantes de Langerhans. Se realiza el diagnóstico de tuberculosis laríngea y se inicia tratamiento antituberculoso(AU)


According to the WHO, tuberculosis represents one of the top ten causes of death worldwide and is the number one cause of death from a single infectious agent. The incidence of tuberculosis has decreased an average of 1.5% annually since the year 2000, however the impact of the SARS-CoV-2 pandemic could delay the diagnosis and treatment of new cases of TB. We report the case of a 26-year-old male who consulted for fever, weight loss and dysphonia with a duration of 6 months. BK and sputum cultures were negative for M. tuberculosis. The patient is referred to the Otorhinolaryngology and Facial Surgery Clinic of the Dr. Luis Gomez Lopez University Hospital where a nasofibrolaryngoscopy is performed showing an epiglottis with an irregular surface that extends to the arytenoids and interarytenoid zone and edematous ventricular bands that do not allow visualization of vocal folds. Laryngeal microsurgery is performed to obtain a biopsy sample. Histopathology reveals proliferation of newly formed vessels, intervascular spaces occupied by macrophages and lymphocytes, presence of multiple nodular lesions formed by epithelloid macrophages surrounded by a halo of lymphocytes and numerous giant Langerhans cells. Diagnosis of laryngeal tuberculosis is made and antituberculous treatment is initiated(AU)


Subject(s)
Humans , Male , Adult , Signs and Symptoms , Diagnostic Imaging , Tuberculosis, Laryngeal/mortality , Tuberculosis, Laryngeal/drug therapy , Dysphonia , Fever
16.
Rev. colomb. cir ; 36(1): 155-160, 20210000. fig
Article in Spanish | LILACS | ID: biblio-1150543

ABSTRACT

Introducción. El objetivo de este artículo fue reportar el caso de un paciente con antecedente de enfisema bulloso bilateral que le ocasionó un neumotórax persistente de difícil tratamiento. Caso clínico. Se trata de un paciente de 50 años de edad con diagnóstico de neumotórax asociado con un enfisema bulloso bilateral, en quien estaba contraindicado el tratamiento quirúrgico. El cuadro clínico comenzó con dolor en el hemitórax derecho y disnea, que se fue intensificando hasta el punto de no tolerar el decúbito. En la radiografía de tórax se observó colapso del pulmón derecho con múltiples bulas en ambos pulmones, por lo que se practicó una pleurotomía mínima alta derecha. La evolución del paciente no fue favorable por persistir el neumotórax, lo cual llevó al uso de un tratamiento alternativo. Discusión. En los pacientes con neumotórax persistente por enfisema bulloso bilateral sin indicación quirúrgica, el talco es una alternativa menos invasiva para lograr una sínfisis pleural con buenos resultados, método cuya utilidad se demuestra


Introduction. The aim of this report was to present the case of a patient with a history of bilateral bullous emphysema that causes a persistent pneumothorax that was difficult to treat. Clinical case. This is a 50-year-old patient diagnosed with pneumothorax associated with bilateral bullous emphysema, in whom surgical treatment being contraindicated. The clinical picture began with pain in the right hemithorax and dyspnea, which intensified to the point of not tolerating decubitus. In the chest X-ray, collapse of the right lung was observed with multiple bullae in both lungs, therefore a right upper minimum pleurotomy was performed. The patient's evolution was not favorable due to persisting pneumothorax, which led to the use of an alternative treatment. Discussion. In patients with persistent pneumothorax due to bilateral bullous emphysema without surgical indication, talc is a less invasive alternative to achieve a pleural symphysis with good results, a method whose utility is demonstrated


Subject(s)
Humans , Pneumothorax , Diagnostic Imaging , Thoracic Surgery, Video-Assisted , Lung Diseases
17.
Rev. méd. Minas Gerais ; 31: 31408, 2021.
Article in Portuguese | LILACS | ID: biblio-1291383

ABSTRACT

A mastite é uma patologia relativamente frequente na mulher que amamenta. Surge maioritariamente nas primeiras seis semanas após o parto (prevalência entre 75-95% antes do bebé completar os três meses de vida), podendo, contudo, ocorrer ao longo de todo o período da amamentação. Apresenta-se clinicamente com mastalgia, eritema e edema mamário, linfonodomegalia axilar, febre, calafrios, mal-estar e prostração. Entretanto, o quadro clínico completo pode não estar presente em todos os casos. A técnica incorreta de amamentação provoca as microlesões mamáriasque são fatores associados à mastite, inicialmente, e esta quando não recebe tratamento adequado pode evoluirpara os abscessos mamários, que são caracterizados clinicamente por nodulação palpável ou não, flutuante, parcialmente circunscrita, geralmente no quadrante superior lateral da mama afetada. O microrganismo mais envolvido é o Staphylococcus aureus. O diagnóstico diferencial envolve principalmente outras causas não infecciosas de mastite, por exemplo a granulomatosa com reação a corpo estranho (piercing, implantes de silicone) e também malignidade. A ultrassonografia é um método bastante útil na investigação inicial daqueles quadros com suspeita de desenvolvimento de tal complicação e possibilita de maneira segura o tratamento minimamente invasivo e a obtenção de amostra para analise laboratorial. Isto permite a escolha de antibioticoterapia direcionada para os microorganismos causadores.


Mastitis is a relatively common condition in breastfeeding women. It appears mostly in the first six weeks after delivery (prevalence between 75-95% before the baby is three months old), however, it can occur throughout the entire period of breastfeeding. It may present clinically with mastalgia, erythema and breast edema, axillary lymph node enlargement, fever, chills, malaise and prostration. However, the complete clinical picture may not be present in all cases. The incorrect breastfeeding technique causes breast microlesions which are factors associated with mastitis, initially, and when it does not receive adequate treatment it can evolve for breast abscesses, which are characterized clinically by palpable or not, floating, partially circumscribed nodulation, usually in the upper lateral quadrant of the affected breast. The most involved microorganism is Staphylococcus aureus. The differential diagnosis mainly involves other non-infectious causes of mastitis, for example granulomatous with a foreign body reaction (piercing, silicone implants) and also malignancy. Ultrasonography is a very useful method in the initial investigation of those conditions suspected of developing such a complication, and it safely allows minimally invasive treatment and obtaining a sample for laboratory analysis. This allows the choice of antibiotic therapy directed at the causative microorganisms.


Subject(s)
Humans , Female , Adult , Silicones , Breast Implants , Mastitis , Staphylococcus aureus , Wounds and Injuries , Breast Feeding , Diagnostic Imaging , Ultrasonography, Mammary , Infections , Inflammation , Anti-Bacterial Agents/therapeutic use
18.
Rev. Fac. Odontol. (B.Aires) ; 36(82): 49-55, 2021. ilus, tab
Article in Spanish | LILACS | ID: biblio-1291932

ABSTRACT

Objetivos: Mensurar los niveles de radiación de fuga y dispersión emanada a través de los blindajes y estructuras plomadas del tubo de rayos X de la unidad dental portátil NOMAD, controlando la retrodispersión con el uso del escudo protector de acrílico plomado adaptado en el extremo final del tubo localizador plomado. Se midieron las tasas de exposición dispersadas mediante un detector tipo Geiger-Müller y una cámara de ionización con respuesta en el rango de energías aportadas en diagnóstico por imágenes para la medición de la exposición directa y determinación posterior de las dosis. Se utilizó un fantomas diseñado para diagnóstico odontológico, sopesando la radiación en diferentes angulaciones de operación del equipo NOMAD, simulando los gestos posturales de odontólogos, radiólogos y sujetos a identificar. Se controlaron las tasas de exposición para determinar los valores de las dosis aportadas en las zonas significativas corporales más radiosensibles del operador del equipo. Se obtuvo como resultado que la retrodispersión en el cristalino del ojo del operador fue significativamente menor cuando el fantomas estaba acostado, mientras que a nivel de gónadas resultó más baja con el cuerpo sentado. La tasa de dosis máxima de radiación dispersa que impactó en los operadores fue de 350.8 micro Sieverts por hora (uSv/h) en la zona de gónadas, por cada radiografía tomada sin el uso del delantal de goma plomada, reduciéndose a 4.38 micro Sieverts por hora (uSv/h) al utilizarlo (AU)


Subject(s)
Humans , Male , Female , Radiography, Dental/methods , Technology, Dental , Dental Equipment , Forensic Dentistry , Patients , Argentina , Radiation Dosage , Radiation Protection , Scattering, Radiation , Diagnostic Imaging/methods , Victims Identification , Radiation Exposure Control , Equipment Design
19.
Rev. Fundac. Juan Jose Carraro ; 24(44): 32-39, 2021. ilus
Article in Spanish | LILACS | ID: biblio-1223346

ABSTRACT

Los quistes odontogénicos se dividen en dos grupos principales de acuerdo a la patogénesis de la entidad. Uno de esos grupos incluye a los quistes radiculares de origen inflamatorio. Nuestra situación es una paciente de sexo femenino que a causa de un molar superior con tratamiento endodóntico la patología quística invadió la cavidad sinusal comprometiendo las estructuras vecinas y al realizar la exodoncia se generó una comunicación bucosinusal con infección de esa entidad patológica. El diagnostico de certeza se confirmó a través de la biopsia previa, y se la intervino bajo anestesia general para la extirpación total de la patología quística (AU)


Subject(s)
Humans , Female , Adult , Odontogenic Cysts/surgery , Odontogenic Cysts/diagnostic imaging , Oroantral Fistula/etiology , Argentina , Surgical Flaps , Tooth Extraction , Biopsy/methods , Diagnostic Imaging , Decompression, Surgical , Oral Surgical Procedures , Dental Service, Hospital
20.
Rev. bras. educ. méd ; 45(3): e160, 2021. tab, graf
Article in Portuguese | LILACS | ID: biblio-1288309

ABSTRACT

Resumo: Introdução: A educação médica baseada em competências tem despertado interesse nas últimas décadas. A avaliação do educando constitui um de seus pilares centrais, devendo ser contínua, fundamentada em critérios claros e eminentemente formativa, sempre provendo feedback. A sistematização dos métodos de avaliação envolve variáveis como confiabilidade, validade, aceitabilidade, impacto educacional e custo. Na radiologia, a literatura carece de instrumentos específicos de avaliação, especialmente em programas de residência médica no Brasil. Objetivo: Este estudo teve como objetivos elaborar e implementar um instrumento avaliativo com caráter formativo para o Programa de Residência Médica em Radiologia e Diagnóstico por Imagem (PRM-RDI) do Hospital Universitário Onofre Lopes da Universidade Federal do Rio Grande do Norte (Huol-UFRN), que englobe competências específicas e crie oportunidades para feedback nos cenários de prática. Método: Trata-se de um estudo de abordagem descritiva, exploratória e de intervenção, com três etapas. As duas primeiras consistiram em oficinas com médicos residentes e preceptores: uma para conceituação e compreensão da avaliação por competências e de técnicas de feedback, e outra para construção coletiva de um instrumento avaliativo adequado à radiologia, definindo as competências mais importantes a serem avaliadas. Na terceira etapa, os pesquisadores acompanharam a aplicação inicial do instrumento pelos preceptores. Resultado: As duas oficinas tiveram participação de três pesquisadores, 16 preceptores e cinco residentes. O instrumento de avaliação resultante contém inicialmente um cabeçalho para preenchimento de dados do residente e do avaliador, do local e exame realizado. Há ainda sete competências que devem ser avaliadas em relação ao esperado para o nível do residente e uma escala para conceito geral da avaliação, seguida de campos para comentários do preceptor e do residente. O instrumento foi aplicado 33 vezes nos cenários de prática, num período de seis meses. Conclusão: A realização de oficinas de capacitação para os preceptores, com a introdução de uma nova cultura de avaliação, foi fundamental para a construção e experiência inicial na aplicação do instrumento no referido programa. O instrumento apresentou viabilidade, baixo custo e teve boa aceitabilidade entre preceptores e residentes, servindo como marco inicial na busca por uma avaliação sistematizada na residência médica na área de radiologia.


Abstract: Introduction: There has been a growing interest in competency-based medical education over the past few decades. Student assessment is one of its central pillars, and should be continuous, based on clear and eminently formative criteria, and provide constant feedback. The systematization of assessment methods involves variables such as reliability, validity, acceptability, educational impact and cost. In Radiology, the literature lacks specific assessment instruments, especially in Medical Residency Programs in Brazil. Objective: Our aim was to develop and implement an assessment tool with a formative character for the Radiology program of the Onofre Lopes University Hospital of the Federal University of Rio Grande do Norte, which encompasses specific skills and creates opportunities for feedback in practice scenarios. Method: The study has a descriptive, exploratory and interventionist approach, divided into three stages. The first two consisted of workshops with residents and preceptors, one to conceptualize and understand competency assessment and feedback techniques, and the other to collectively build an assessment tool appropriate for Radiology, defining the most important competencies to be assessed. In the third stage, the researchers monitored how the instrument was initially applied by the preceptors. Result: Both workshops were attended by the three researchers, sixteen preceptors and five residents. The resulting assessment instrument contains a header for resident and evaluator data, location and examination performed. Next, seven competencies that should be assessed in relation to what is expected for the resident's level, and an overall scale of the evaluation, followed by fields for comments by the preceptor and the resident. The instrument was applied 33 times in practice scenarios, over a six-month period. Conclusion: The execution of training workshops for preceptors, with the introduction of a new culture of assessment, was fundamental for the construction and initial experience in the application of the assessment tool in that program. This tool was found to be feasible, low cost and had good acceptability among preceptors and residents, serving as a starting point in the search for a systematic assessment in the Radiology residency program.


Subject(s)
Humans , Radiology/education , Diagnostic Imaging , Surveys and Questionnaires , Internship and Residency , Clinical Competence , Competency-Based Education , Educational Measurement
SELECTION OF CITATIONS
SEARCH DETAIL