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1.
Rev. colomb. anestesiol ; 49(4): e400, Oct.-Dec. 2021. graf
Article in English | LILACS, COLNAL | ID: biblio-1341243

ABSTRACT

The accompanying images demonstrate giant pulmonary artery aneurysms in a patient with idiopathic pulmonary arterial hypertension (Image 1). In addition to the main pulmonary artery, both the left and right pulmonary arteries are aneurysmal and are compressing the lung parenchyma (Image 2).


Las imágenes adjuntas muestran aneurismas gigantes de la arteria pulmonar en un paciente con hipertensión arterial pulmonar idiopática (Imagen 1). Además de la arteria pulmonar principal, tanto la arteria pulmonar izquierda como la derecha son aneurismáticas y están comprimiendo el parénquima pulmonar (Imagen 2).


Subject(s)
Humans , Pulmonary Artery , Radiology , Aneurysm , Familial Primary Pulmonary Hypertension , Parenchymal Tissue , Heart Defects, Congenital
2.
Edumecentro ; 13(4): 274-287, 2021.
Article in Spanish | LILACS | ID: biblio-1345962

ABSTRACT

RESUMEN Introducción: la enfermedad por SARS-Cov-2 refuerza la importancia del uso de las nuevas tecnologías de la información y las comunicaciones en función del desarrollo e implementación de sistemas de inteligencia artificial que favorecen el diagnóstico. Objetivo: describir la posibilidad del uso de la inteligencia artificial como una herramienta en la imagenología para los pacientes positivos a la COVID-19. Métodos: se realizó una revisión de fuentes bibliográficas en Infomed, SciELO, PubMed y Google Académico, comprendidas en los años 2015 al 2020 con el uso de palabras claves: coronavirus, COVID-19, neumonía, radiografía e inteligencia artificial. Se seleccionaron 28 documentos por su pertinencia en el estudio. Desarrollo: la creación de sistemas de inteligencia artificial que ayuden al diagnóstico médico requiere un enfoque interprofesional de la ciencia y constituye una de las líneas de trabajo en Cuba durante la pandemia. Una condición indispensable para la introducción de la inteligencia artificial en el diagnóstico radiológico es la capacitación que deben recibir los médicos para interactuar con ella, a través de un proceso formativo que incluya una evaluación y explicación de la calidad de los datos asociada tanto al aprendizaje como a las nuevas predicciones. Conclusiones: la utilización de inteligencia artificial mejorará el rendimiento del radiólogo para distinguir la COVID-19; la integración de estas tecnologías en el flujo de trabajo clínico de rutina puede ayudar a los radiólogos a diagnosticar con precisión.


ABSTRACT Introduction: SARS-Cov-2 disease reinforces the importance of the use of new information and communication technologies based on the development and implementation of artificial intelligence systems that favor diagnosis. Objective: to describe the possibility of using artificial intelligence as a tool in imaging for COVID-19 positive patients. Methods: a review of bibliographic sources was carried out in Infomed, SciELO, PubMed and Google Scholar, from 2015 to 2020 with the use of keywords: coronavirus, COVID-19, pneumonia, radiography and artificial intelligence. 28 documents were selected for their relevance in the study. Development: the creation of artificial intelligence systems that help medical diagnosis requires an interprofessional approach to science and constitutes one of the lines of work in Cuba during the pandemic. An essential condition for the introduction of artificial intelligence in radiological diagnosis is the training that doctors must receive to interact with it, through a training process that includes an evaluation and explanation of the quality of the data associated with both learning and to new predictions. Conclusions: the use of artificial intelligence will improve the radiologist's performance to distinguish COVID-19; integrating these technologies into routine clinical workflow can help radiologists diagnose accurately.


Subject(s)
Radiology , Artificial Intelligence , Coronavirus Infections , Imaging, Three-Dimensional
3.
Rev. bras. ortop ; 56(6): 790-795, Nov.-Dec. 2021. graf
Article in English | LILACS | ID: biblio-1357137

ABSTRACT

Abstract Objective The present study aimed to evaluate and compare the total surgical procedure time and intraoperative X-ray exposure during different techniques for fixation of transtrochanteric fractures of the femur in elderly patients, using extramedullary and intramedullary methods based on cephalic traction screws. Methods The Orthopedics and Traumatology Service from our hospital evaluated 107 patients with transtrochanteric fractures, including 34 males and 73 females, with age ranging from 61 to 101 years old. Fracture fixation was performed with a dynamic hip system (DHS) in 21 patients, a standard proximal femoral nail (PFN) in 55 subjects, and a standard gamma nail in 31 patients. All procedures were performed by the same surgeon and his team of nursing assistants, along with the same radiology technician using the same image intensifier. Total surgery time (in minutes) and X-ray emission (in centigrays [cGy]) were evaluated. Results Transtrochanteric fracture fixation with PFN provides a significantly shorter surgical time (p = 0.013) in comparison to the 2 other techniques. Intraoperative exposure to X-rays was significantly lower when using DHS (p = 0.015) as a fixation method when compared with gamma nail and PFN. Conclusion Although PFN resulted in the shortest surgical time, DHS was associated with the lowest X-ray exposure levels within the studied sample.


Resumo Objetivo Avaliar e comparar o tempo total do procedimento cirúrgico e a exposição ao raio X no intraoperatório em diferentes técnicas de fixação das fraturas transtrocanterianas do fêmur em pacientes idosos, utilizando técnicas extramedulares e intramedulares baseadas em parafuso de tração cefálico. Métodos Foram avaliados no serviço de ortopedia e traumatologia do nosso hospital 107 pacientes com fraturas transtrocanterianas, sendo 34 do sexo masculino e 73 do sexo feminino, com idade mínima de 61 anos e máxima de 101 anos. As fraturas fixadas, utilizando a técnica com dynamic hip system (DHS, na sigla em inglês) somaram 21 pacientes; em 55 pacientes, foi utilizado o proximal femur nail (PFN, na sigla em inglês) standard; e em 31 idosos, foi optado pelo uso do gama nail standard. Todos os procedimentos foram realizados pelo mesmo cirurgião acompanhado de sua equipe de auxiliares de enfermagem, assim como pelo mesmo técnico de radiologia manuseando o mesmo intensificador de imagens. Foram avaliados o tempo total da cirurgia (em minutos) e a emissão de raios X medida em centigrays. Resultados A fixação das fraturas transtrocanterianas com PFN proporciona um menor tempo cirúrgico com uma diferença estatística significativa (p =0,013), quando comparada com as demais técnicas utilizadas entre os grupos envolvidos. Foi observada, também, uma menor exposição intraoperatória aos raios X (p =0,015), a qual foi estatisticamente relevante quando utilizado o DHS como método de fixação comparado com o gama nail e o PFN. Conclusão Apesar do PFN ter o menor tempo de cirurgia, a técnica do DHS se mostrou com menores níveis de exposição dentro da amostra estudada.


Subject(s)
Radiology , Surgical Procedures, Operative , X-Rays , Internal Fixators , Femoral Fractures , Operative Time , Neoplasms
4.
Article in Spanish | LILACS | ID: biblio-1353440

ABSTRACT

ABSTRACT: Introduction: According to the world health organization, injuries represent more than 20% of health problems in the world. Head trauma and the absence of neurosurgery and radiology services in less populated areas make it difficult to assess and manage patients with brain injury. Objective: To describe the clinical findings and benefits derived from the implementation of teleradiology in neurotrauma in areas of difficult geographic access. Materials and methods: A systematic search was carried out in Pubmed, Scopus, Ebsco host, Sciencedirect, and Embase, with the thesauri "Teleradiology" and "Craniocerebral Trauma". Results: The decision to intervene in a patient with brain trauma and the period of time until surgery are essential for the clinical outcome. Those centers that use teleradiology require transfers to specialized hospitals, for which portable technological devices contribute to the response time of neurosurgery care. Conclusion: Teleradiology has a positive impact on patients with traumatic brain injury in geographical areas of difficult access, facilitating communication with specialists; providing timely care and optimizing transfers to high complexity centers.


RESUMEN: Introducción: Según la organización mundial de la saludlos traumatismos representan más del 20% de los pro-blemas en salud en el mundo. El trauma craneoencefálico y la ausencia de servicios de neurocirugía y radiología en zonas menos pobladas dificultan la valoración y manejo de pacientes con lesión cerebral. Objetivo: Describir los hallazgos clínicos y beneficios derivados de la implementación de la telerradiología en neurotrauma en áreas de difícil acceso geográfico. Materiales y métodos: Se realizó una búsqueda sistemática en Pubmed, Scopus, Ebsco host, Sciencedirect, y Embase, con los tesauros "Teleradiology" y "Craniocerebral Trauma". Resultados: La decisi-ón de intervenir a un paciente con traumatismo cerebral y el periodo de tiempo hasta la cirugía son fundamentales para el desenlace clínico. Aquellos centros que usan la telerradiología, precisan los traslados a los hospitales espe-cializados, por lo cual los dispositivos tecnológicos portátiles contribuyen en el tiempo de respuesta de la atención en neurocirugía. Conclusión: La telerradiología impacta positivamente en pacientes con trauma craneoencefálico en zonas geográficas de difícil acceso, facilitando la comunicación con especialistas; brindando atención oportuna y optimizando los traslados a centros de alta complejidad. (AU)


Subject(s)
Radiology , Brain Injuries , Teleradiology , Brain Injuries, Traumatic , Craniocerebral Trauma
5.
Rev. colomb. cir ; 36(4): 703-708, 20210000. fig
Article in Spanish | LILACS | ID: biblio-1291259

ABSTRACT

Introducción. Los tumores desmoides o fibromatosis agresiva corresponden a neoplasias mesenquimales poco frecuentes. Son tumores localmente agresivos que ocurren especialmente en jóvenes, no desarrollan metástasis a distancia, pero se asocian con invasión locorregional y alta tasa de recurrencia después de la resección. Su etiología es desconocida, pero se ha asociado al síndrome de Gardner, trauma, embarazo, estados hiperestrogénicos y puerperio. El objetivo de este artículo fue hacer una revisión sobre el tema a propósito de un caso clínico. Caso clínico. Se presenta el caso de una paciente puérpera con progresivo y rápido aumento del volumen abdominal. Se realizó una tomografía computarizada de abdomen y pelvis que confirmó la presencia de una masa intraperitoneal bien definida. La paciente fue operada con escisión de la masa y confirmación histológica de tumor desmoide a partir de la muestra de patología. Discusión. Los tumores desmoides tienen una incidencia de 2 a 4 casos por millón de habitantes por año, con leve predominio en el sexo femenino y representan menos del 3 % de los tumores de partes blandas. Aunque el tumor se puede ubicar a nivel intraabdominal o en la pared, la ubicación más común es en las extremidades. Conclusiones. La sospecha y detección del tumor desmoide es fundamental, así como su adecuado estudio, para determinar el tratamiento quirúrgico como fue realizado en este caso


Introduction. Desmoid tumors or aggressive fibromatosis correspond to rare mesenchymal neoplasms. They are locally aggressive tumors that occur especially in young people, they do not develop distant metastases, but are associated with locoregional invasion and a high recurrence rate after resection. Its etiology is unknown, but it has been associated with Gardner syndrome, trauma, pregnancy, hyperestrogenic states, and puerperium. The objective of this article was to review the topic based on a clinical case. Clinical case. The case of a puerperal patient with progressive and rapid increase in abdominal volume is presented. An abdominal and pelvic CT scan was performed, which confirmed the presence of a well-defined intraperitoneal mass. The patient underwent surgery with excision of the mass and histological confirmation of a desmoid tumor from the pathology sample. Discussion. Desmoid tumors have an incidence of 2 to 4 cases per million inhabitants per year, with a slight predominance in females, and represent less than 3% of soft tissue tumors. Although the tumor can be located intra-abdominal or in the wall, the most common location is in the extremities. Conclusions. The suspicion and detection of the desmoid tumor is essential, as well as its adequate study to determine the surgical treatment as it was done in this case


Subject(s)
Humans , Gardner Syndrome , Fibromatosis, Aggressive , Postpartum Period , Radiology , General Surgery , Fibroma, Desmoplastic
7.
Rev. colomb. anestesiol ; 49(2): e700, Apr.-June 2021. graf
Article in English | LILACS, COLNAL | ID: biblio-1251505

ABSTRACT

Cervical kyphoscoliosis is an uncommon spinal deformity. Kyphosis or outward curvature of cervical-spine (Image A) has led to a fixed flexion state resulting in suspension of patient's head in the air while lying on the imaging table. Additionally, dextroscoliosis or rightward convexity of the cervical vertebral axis has resulted in a persistent leftward head tilt (Image B). Head and neck radiation and trauma can lead to cervical kyphoscoliosis. In addition to the cosmetic deformity, patients present with myelopathic sensorimotor symptoms such as weakness and tingling of upper extremities. The Poisson effect states that flexion of the spine lengthens and stretches the spinal canal, reduces its area and narrows its lumen. This causes spinal cord impingement and myelopathy.


La cifoescoliosis cervical es una deformidad de la columna vertebral poco frecuente. La cifosis o la curvatura hacia fuera de la columna cervical (imagen A) ha dado lugar a un estado de flexión fija que provoca la suspensión de la cabeza del paciente en el aire mientras está tumbado en la mesa de diagnóstico por imagen. Además, la dextroscoliosis o convexidad hacia la derecha del eje vertebral cervical ha dado lugar a una inclinación persistente de la cabeza hacia la izquierda (Imagen B). La radiación de cabeza y cuello y los traumatismos pueden provocar cifoescoliosis cervical. Además de la deformidad estética, los pacientes presentan síntomas sensoriomotores mielopáticos como debilidad y hormigueo en las extremidades superiores. El efecto Poisson establece que la flexión de la columna vertebral alarga y estira el canal espinal, reduce su área y estrecha su lumen. Esto provoca el pinzamiento de la médula espinal y la mielopatía.


Subject(s)
Humans , Spinal Cord Diseases , Spine , Congenital Abnormalities , Paresthesia , Radiology , Spinal Canal , Cervical Vertebrae , Neck
10.
Rev. argent. radiol ; 85(2): 41-45, abr. 2021. graf
Article in Spanish | LILACS, BINACIS | ID: biblio-1288198

ABSTRACT

Resumen La pancreatitis aguda es una patología inflamatoria del páncreas que se caracteriza por dolor abdominal y elevación de los niveles séricos de amilasa. Desde el punto de vista imagenológico, se la estudia con tomografía computada (TC), siendo esa la modalidad de elección para evaluar la extensión y la localización de las complicaciones. Según la gravedad, el tiempo de evolución y la extensión, hay distintos tipos de complicaciones y una variedad de hallazgos en TC.


Abstract Acute pancreatitis is an inflammatory pathology of the pancreas characterized by abdominal pain and elevated levels of serum amylase. In radiology, it is studied with computed tomography (CT), which is the preferred method to evaluate the extent and location of complications. Depending on the severity, time of evolution, and extent, there are different types of complications and a variety of findings on the CT scan.


Subject(s)
Pancreas , Pancreatitis , Tomography , Pathology , Radiology , Time , Abdominal Pain , Lifting , Serum , Selection of the Waste Treatment Site , Gravitation , Amylases , Methods
11.
Rev. argent. radiol ; 85(2): 33-40, abr. 2021. tab, graf
Article in Spanish | LILACS, BINACIS | ID: biblio-1288197

ABSTRACT

Resumen Objetivo: Evaluar la diferencia del trazado cefalométrico manual con el digital en radiografías laterales de cráneo. Materiales y métodos: Inicialmente se realizó un piloto para calibrar al investigador principal, en donde se analizaron 10 radiografías pertenecientes a cinco pacientes del Servicio de Radiología del Centro Odontológico de nuestra institución para evaluar la concordancia entre los dos evaluadores y establecer el tamaño de la muestra. Finalmente, se analizaron 78 radiografías cefalométricas de 39 pacientes, en las que se realizó el trazado cefalométrico de Steiner manual y digital. Esas radiografías se analizaron en una escala 1:1 y posteriormente se evaluó la diferencia de las mediciones mediante el análisis univariado, se determinó en mediana e intervalo intercuartil por separado. En el análisis bivariado, se aplicó la prueba de signo de rangos de Wilcoxon y muestras pareadas para determinar la diferencia de las mediciones cefalométricas de Steiner entre el tipo del análisis cefalométrico. El nivel de significancia se fijó en p < 0,05 y confiabilidad al 95%, respectivamente. Resultados: No hubo diferencia significativa en la mayoría de las mediciones hechas de manera manual y digital, siendo el ángulo interincisal la única medición angular en la cual hubo diferencia significativa al obtener un resultado de p = 0,002. Mientras tanto, en las mediciones lineales, la única medición en la que hubo diferencia significativa fue en el segmento incisivo inferior - NB con p = 0,005. Conclusión: No se encuentran diferencias significativas entre el trazado cefalométrico manual y el digital. No obstante, es importante tener en cuenta que la muestra o población evaluada es reducida para definir conclusiones.


Abstract Objective: To evaluate the difference of the manual cephalometric tracing with the digital tracing on lateral cranial radiographs. Materials and Methods: Initially, a pilot study was carried out to calibrate the principal investigator, where 10 radiographs belonging to 5 patients of the Radiology Service of the Dental Center, were analyzed to evaluate the intraclass concordance between the two evaluators. To establish the size of the sample, finally, 78 cephalometric radiographs of 39 patients were analyzed, in which the manual and digital Steiner cephalometric tracing was performed. These radiographs were analyzed on a 1: 1 scale and then the difference of the measurements was evaluated using the univariate analysis, which was determined in the median and interquartile range, separately. In the bivariate analysis, the Wilcoxon rank sign test and paired samples were applied to determine the difference of Steiner's cephalometric measurements between the cephalometric analysis type. The level of significance was set at p < 0.05 and 95% reliability, respectively. Results: There was no significant difference in most of the measurements made manually and digitally. The interincisal angle the only angular measurement in which there was a significant difference when obtaining a result of p = 0.002, while, in the linear measurements, the only measurement in which there was significant difference was in the lower incisor segment - NB with p = 0.005. Conclusion: There is no significant difference between manual and digital cephalometric tracing, nevertheless it is important to keep in mind that the simple or population evaluated is reduced to define conclusions.


Subject(s)
Humans , Adolescent , Adult , Middle Aged , Cephalometry , Radiography, Dental, Digital , Patients , Population , Radiology , Research Personnel , Skull , Measurements, Methods and Theories , Radiography, Dental , Pilot Projects , Organizations , Sample Size , Materials , Incisor , Methods
12.
Rev. colomb. anestesiol ; 49(1): e302, Jan.-Mar. 2021. graf
Article in English | LILACS, COLNAL | ID: biblio-1149796

ABSTRACT

Acuphagia, the practice of inappropriate consumption of non-nutritive sharp metallic substances, is a rare form of pica and can lead to devastating consequences.1 Panel A demonstrates an ingested serrated knife in the right upper abdominal quadrant (Image 1). Panel B exhibits distended bowel loops, pneumatosis intestinalis and pneumoperitoneum on radiological imaging (Image 2).


La acuphagia, la práctica del consumo inadecuado de sustancias metálicas cortantes no nutritivas, es una forma rara de pica y puede tener consecuencias devastadoras. 1 El panel A muestra un cuchillo dentado ingerido en el cuadrante abdominal superior derecho ( Imagen 1). El panel B muestra asas intestinales distendidas, neumatosis intestinal y neumoperitoneo en las imágenes radiológicas ( Imagen 2 ).


Subject(s)
Humans , Radiography , Metallic Wastes , Radiology , Foreign Bodies/diagnostic imaging
13.
Rev. chil. ortop. traumatol ; 62(1): 27-33, mar. 2021. ilus, tab
Article in Spanish | LILACS | ID: biblio-1342658

ABSTRACT

INTRODUCCIÓN: Una de las complicaciones de la osteosíntesis retrógrada del escafoides es la protrusión del tornillo en la articulación radiocarpiana, dada la limitada visualización intraoperatoria del polo proximal del escafoides con las proyecciones tradicionales. OBJETIVO: Evaluar la capacidad de una nueva proyección radiológica, la proyección "tangencial del escafoides dorsal", o TED, para identificar tornillos prominentes radiocarpianos durante la osteosíntesis retrógrada del escafoides con tornillos canulados. MATERIALES Y MÉTODOS: Estudio cadavérico en muñecas frescas congeladas. Se introdujo en el escafoides un tornillo canulado con técnica retrógrada estándar. La proyección TED fue evaluada en 5 muñecas, con angulaciones del antebrazo de 15°, 30° y 45° para definir la mejor visualización del polo proximal del escafoides y del tornillo. Se comparó la capacidad para identificar la prominencia del tornillo en el polo proximal de la proyección TED de 30° con 5 proyecciones tradicionales de escafoides en 9 muñecas. El tornillo se posicionó a nivel de la superficie del escafoides, y luego se avanzó a intervalos de 0,5 mm bajo visualización directa por artrotomía dorsal. Tras cada intervalo, se repitieron todas las proyecciones para determinar su capacidad de detectar tornillos prominentes en el escafoides. RESULTADOS: La mejor visualización del polo proximal del escafoides se logró con la proyección TED de 30°. Al comparar la proyección TED de 30° y las tradicionales, con la TED se logró identificar tornillos prominentes a 0,8 mm promedio, seguida por la proyección posteroanterior con cubitalización y extensión a 1.3 mm (p » 0.014), con una alta precisión y correlación interobservador de estas proyecciones. CONCLUSIÓN: La proyección TED demostró ser la más sensible para detectar tornillos prominentes en la articulación radiocarpiana. Su uso rutinario podría evitar complicaciones durante la osteosíntesis.


INTRODUCTION: One of the complications of the retrograde percutaneous scaphoid fixation is the protrusion of the screw in the radiocarpal joint due to the limited intraoperative visualization of the proximal pole of the scaphoid with the traditional radiographic views. OBJETIVE: To evaluate the sensitivity of a novel radiographic view (the skyline scaphoid view, SSV) to detect screws protruding in the radiocarpal joint during the retrograde fixation of the scaphoid. MATERIALS AND METHODS: We studied nine cadaverous fresh frozen wrists. A retrograde cannulated screw was inserted in the scaphoid. To validate the SSV, 5 wrists were studied, comparing 3 forearm angulations (15°, 30° and 45°) to get the best visualization of the proximal pole and screw. We compared the ability to identify the protrusion of the screw in the proximal pole of the 30° SSV with that of 5 standard scaphoid radiographic views in 9 wrists. The screw was positioned at the level of the surface of the scaphoid, and was sequentially protruded in 0.5 mm increments, with direct visualization of its tip through a dorsal capsulotomy. After each increment, all views were repeated to determine if they were able to detect screws projecting from the scaphoid. RESULTS: The best visualization of the proximal pole of the scaphoid was found with the 30° SSV. In the comparison of the 30° SSV and the standard views, with the SSV we were able to identify the protrusion of the screws at an average of 0.8 mm, followed by the posterior-anterior view with ulnar deviation and extension at 1.3 mm (p » 0.014), with high precision and interobserver agreement regarding these views. CONCLUSION: The SSV was the most sensitive view to detect protruding screws in the proximal pole of the scaphoid. Its routine use could avoid complications during osteosynthesis.


Subject(s)
Humans , Wrist Joint/diagnostic imaging , Bone Screws/adverse effects , Scaphoid Bone/diagnostic imaging , Fracture Fixation, Internal/adverse effects , Radiology/methods , Wrist Joint/surgery , Cadaver , Observer Variation , Scaphoid Bone/surgery , Fracture Fixation, Internal/instrumentation
14.
Rev. cient. odontol ; 9(1): e045, ene.-mar. 2021. tab
Article in Spanish | LIPECS, LILACS, LIPECS | ID: biblio-1254251

ABSTRACT

Los sistemas de conductos radiculares presentan una variada conformación morfológica para cada grupo de piezas dentarias. Diversos autores han presentado en diferentes clasificaciones su conformación anatómica y sus variantes. Tenemos los conductos principales, colaterales, laterales, secundario, accesorio, interconducto, recurrente, delta apical y cavo interradicular. La radiología actual aún no permite la visualización de todas estas estructuras; sin embargo, el uso adecuado de las técnicas imagenológicas, junto con el empleo de nuevos equipos 3D por ajustes de parámetros de adquisición con adecuados software y algoritmos, permite una precisión mayor en las imágenes lo que favorece la observación de finos detalles útiles para el diagnóstico y abordaje de los tratamientos endodónticos. El objetivo de este artículo es realizar una revisión de la literatura para identificar nuevos conceptos y herramientas imagenológicas útiles para obtener mejores diagnósticos. (AU)


Root canal systems present a varied morphological conformation for each group of teeth. Several authors have described the anatomical conformation and its variants in different classifications, including the main, collateral, lateral, secondary, accessory, interduct, recurrent, apical delta and interradicular cavus canals. Currently, radiology still does not allow visualization of all these structures. However, proper use of imaging techniques together with the use of new 3D equipment for adjustments of acquisition parameters with adequate software and algorithms allows greater image precision, facilitating diagnosis and the planning of the most adequate approach for endodontic treatments. The objective of this article was to conduct a review of the literature to identify new concepts and useful imaging tools for better diagnoses. (AU)


Subject(s)
Humans , Radiology , Dental Pulp Cavity/diagnostic imaging , Endodontics , Cone-Beam Computed Tomography
15.
Ethiop. Med. j ; 59(4): 289-295, 2021.
Article in English | AIM, AIM | ID: biblio-1341997

ABSTRACT

Introduction: The spread of coronavirus disease 2019 (COVID-19) pandemic disrupted the personal and profes-sional lives of many throughout the world. To mitigate the spread of the virus, Addis Ababa University introduced an online teaching/learning method which minimized the physical engagement of faculty members and residents. Online teaching is a major shift in the history of the country's oldest and largest university. Objectives: This study aimed to investigate how trainees managed to cope up with the sudden changes in the teach-ing/learning system, and assess the ensuing satisfaction with the new method of teaching/learning. Methods: Descriptive research design was implemented and analysis of variance (ANOVA) and T-tests were used to test hypotheses. Analysis of data collected from 58 radiology residents found that, the residents appreciated the participatory nature of the newly introduced online learning method. Results: The results showed that residents have accepted the new teaching/learning method and are satisfied with it. Furthermore, tests of hypotheses revealed that there is no significant difference in level of satisfaction between female and male residents as well as throughout the three years of radiology residency training. Conclusion: The new method of teaching/learning has a positive acceptance among trainees and there was high level of satisfaction with the new method. Poor internet network, reduced in-person mentoring, failure to make engaging discussions due to large number of participants were the common challenges to online teaching in the setting.


Subject(s)
Humans , Female , Pregnancy , Radiology , Teaching , Teleworking , COVID-19 , Perception
16.
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
17.
Article in Portuguese | LILACS | ID: biblio-1179869

ABSTRACT

Anatomia e Radiologia são disciplinas amplamente presentes nas grades curriculares de cursos da área da saúde. A interseção entre a Anatomia Radiológica e as tecnologias recentes, como plataformas de ensino interativo, caracteriza-se como uma tendência a ser seguida na esfera educacional, sendo as implicações desse processo ainda não muito debatidas. O Departamento de Anatomia da Universidade Federal de Juiz de Fora iniciou o desenvolvimento de um atlas de anatomia vascular radiológica, o qual apresenta versões impressa e interativa. Possui imagens de angiotomografias computadorizadas feitas em aparelhos multislice de 16 a 128 canais, sendo as imagens de arquivo pessoal dos organizadores. O atlas promove a identificação das estruturas vasculares em questão e propicia a integração do conhecimento adquirido em salas de aula com a visualização de exames de imagem complementares rotineiros. A indiscutível presença de exames de imagem adicionais na rotina dos profissionais da saúde atuais faz com que seja válida a estratégia de integração entre o método tradicional de ensino e as práticas ativas de aprendizagem, as quais vêm ganhando destaque recentemente, devido a sua efetividade na fixação de conhecimentos.


Anatomy and Radiology are subjects widely present in health courses at universities. The intersection between Radiological Anatomy and recent technologies, such as interactive teaching platforms, is characterized as a tendency to be followed in the educational sphere, and the implications of this process are not much debated. The Department of Anatomy of Juiz de Fora Federal University has begun the development of an atlas of radiological vascular anatomy, which features printed and interactived versions. It presents computed tomography images taken on multislice devices from 16 to 128 channels, and the images are from the personal authors' archives. The Radiologic Vascular Atlas provides the identification of vascular structures in study and makes easier the integration of knowledge acquired in classrooms with the visualization of routine complementary imaging exams. The indisputable presence of complementary imaging examinations in the routine of current health professionals makes valid the strategy of integration between the traditional teaching method and active learning practices, which have recently gained prominence, due to its effectiveness in setting knowledge.


Subject(s)
Radiology , Anatomy , Technology, Radiologic , Education, Medical
18.
Rev. bras. educ. méd ; 45(1): e007, 2021. tab
Article in English | LILACS | ID: biblio-1155923

ABSTRACT

Abstract: Introduction: The development of clinical reasoning to diagnose diseases and order ancillary tests, such as radiology imaging, is based on history-taking and physical examination skills, which are developed during the semiology course. Objective: We aimed to evaluate the results of the innovative integration of two courses in the medical curriculum at our institution: Medical Semiology and Clinical Radiology. Methods: The sample consisted of 184 fifth-semester medical students attending the two courses simultaneously. Extra-class semiology-radiology sessions based on theoretical and practical topics integrating radiological images and semiological signs were conducted, and the results were assessed by applying a semi-structured questionnaire to the participants, in which all 18 items were rated on a scale from 0 (worst) to 10 (best). The normality hypothesis in score distribution was verified by the Kolmogorov-Smirnov test and the Shapiro-Wilk test. The distribution of the 18 scores were summarized by descriptive statistics and compared by Friedman's test, with post-hoc test in pairwise comparisons adjusted by Bonferroni test. Correlations between the scores were determined by Spearman's Rank Correlation Coefficients. Results: The overall mean score for the semiology-radiology sessions was high (8.55). Students were satisfied with the selection of clinical cases (8.46) and found that the semiology-radiology sessions contributed to the development of their clinical reasoning (8.58). Conclusion: Medical schools are facing new challenges in medical education. The innovative concept of Radiology-Semiology integrated teaching modality affects the students' self-perception ability to interpret radiological images and might be an educational strategy trend.


Resumo: Introdução: O desenvolvimento do raciocínio clínico para diagnosticar doenças e solicitar exames complementares, como os radiológicos, baseia-se na história e no exame físico, desenvolvidos durante o curso de Semiologia. Objetivo: Nosso objetivo foi avaliar os resultados da integração inovadora de duas disciplinas no currículo médico em nossa instituição: Semiologia Médica e Radiologia Clínica. Métodos: A amostra foi composta por 184 estudantes de Medicina do quinto semestre que participaram das duas disciplinas simultaneamente. Realizaram-se sessões extraclasse de semiologia e radiologia, baseadas em tópicos teóricos e práticos, integrando imagens radiológicas com sinais semiológicos. Avaliaram-se os resultados por meio da aplicação de um questionário semiestruturado aos participantes, no qual todos os 18 itens foram classificados em uma escala de 0 (pior) a 10 (melhor). A hipótese de normalidade na distribuição dos escores foi verificada pelos testes de Kolmorov-Smirnov e Shapiro-Wilk. As 18 distribuições de pontuação foram resumidas por estatística descritiva e comparadas pelo teste de Friedman, com teste post hoc em comparações pareadas ajustadas por Bonferroni. As correlações entre as pontuações foram determinadas pelos coeficientes de correlação de classificação de Spearman. Resultados: O escore médio geral para as sessões de semiologia e radiologia foi alto (8,55). Os estudantes ficaram satisfeitos com a seleção de casos clínicos (8,46) e descobriram que as sessões de semiologia-radiologia contribuíram para o desenvolvimento de seu raciocínio clínico (8,58). Conclusão: As escolas médicas enfrentam novos desafios na educação médica. O conceito inovador da modalidade de ensino integrado de radiologia-semiologia afeta a capacidade de autopercepção dos alunos para interpretar imagens radiológicas e pode ser uma tendência de estratégia educacional.


Subject(s)
Humans , Radiology/education , Clinical Diagnosis/education , Education, Medical/methods , Schools, Medical , Surveys and Questionnaires , Curriculum
19.
J. bras. pneumol ; 47(5): e20200595, 2021. graf
Article in English | LILACS | ID: biblio-1346404

ABSTRACT

ABSTRACT Effective communication among members of medical teams is an important factor for early and appropriate diagnosis. The terminology used in radiology reports appears in this context as an important link between radiologists and other members of the medical team. Therefore, heterogeneity in the use of terms in reports is an important but little discussed issue. This article is the result of an extensive review of nomenclature in thoracic radiology, including for the first time terms used in X-rays, CT, and MRI, conducted by radiologists from Brazil and Portugal. The objective of this review of medical terminology was to create a standardized language for medical professionals and multidisciplinary teams.


RESUMO A comunicação eficiente entre a equipe médica é um fator importante no diagnóstico e tratamento precoce e adequado dos pacientes. A terminologia utilizada em relatórios de exames radiológicos aparece nesse contexto como um elo importante entre radiologistas e os demais integrantes da equipe médica. Portanto, a heterogeneidade no uso de termos em relatórios é importante mas ainda pouco discutida. Este artigo é resultado de uma extensa revisão da nomenclatura radiológica em radiologia torácica, englobando pela primeira vez termos utilizados em vários métodos (radiografia, TC e RM), desenvolvida por radiologistas brasileiros e portugueses. O objetivo desta revisão da terminologia médica foi criar uma linguagem padronizada para os profissionais médicos e as equipes multidisciplinares.


Subject(s)
Humans , Radiology , Language , Portugal , Brazil , Consensus
20.
Rev. colomb. reumatol ; 27(supl.1): 146-169, Oct.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1341330

ABSTRACT

ABSTRACT Background: Systemic sclerosis (SSc) is an immune-mediated disease characterized by small vessel vasculopathy and fibroblast dysfunction that leads to increased production of extracellular matrix. Interstitial lung disease represents one of the most common complications, by affecting almost 70% of patients with SSc. Objective: To evaluate the effectiveness of the pharmacological treatments available for systemic sclerosis-associated interstitial lung disease (SSc-ILD) based on pulmonary function tests and radiologic findings. Materials and methods: A systematic literature review and meta-analysis were conducted. A thorough literature search was made in EMBASE, PUBMED, and Cochrane CENTRAL to collect studies published between January 2015 and July 31 of 2019. The primary outcomes were forced vital capacity (FVC), diffusion capacity of carbon monoxide (DLCO), and high-resolution computed tomography findings (HR-CT). Studies using medications for the treatment of SSc-ILD including cyclophosphamide (CYC), mycophenolate mofetil (MMF), nintedanib, pirfenidone, or rituximab (RTX) were included. Effect measures were calculated based on available data, and a meta-analysis was made with these results. Results: We found a total of 312 studies. 49 studies were selected for full-text assessment after reading the abstracts. Finally, 14 studies were selected to be included in the final review. 2 meta-analyses, 8 clinical trials, 3 retrospective cohorts, and one nested case-control study were identified. The available evidence supports the use of CYC and MMF as the best options for the treatment of SSc-ILD, with MMF being the preferred option based on a better safety profile. Other medications such as RTX, pirfenidone, and nintedanib show potential as alternatives to CYC. The overall quality of evidence available is adequate based on generally well-designed studies. Meta-analysis was done by assessing >5% or >10% decrease of FVC when comparing pharmacological agents vs. placebo. Results show that the use of pharmacological agents is negatively associated with the worsening of FVC. However, high heterogeneity limits the number of studies used during quantitative analysis, affecting the overall results. Conclusions: Immunosuppressive therapies remain as the cornerstone of treatment of SSc-ILD, as most evidence show improvement or slow progression of pulmonary function tests by using them, especially CYC and MMF. However, more evidence is required regarding the use of alternative pharmacological agents, in search of an improvement in the quality of life of these patients.


RESUMEN Antecedentes: La esclerosis sistémica (ES) es una enfermedad mediada por el sistema inmunitario, caracterizada por vasculopatía de pequeños vasos y disfunción de los fibroblastos, que da lugar a una mayor producción de matriz extracelular. La enfermedad pulmonar intersticial representa una de las complicaciones más comunes, ya que afecta a cerca del 70% de los pacientes con ES. Objetivo: Evaluar la efectividad de los tratamientos farmacológicos disponibles para la enfermedad pulmonar intersticial asociada a la esclerosis sistémica (EPI-ES) basándonos en las pruebas de función pulmonar y los hallazgos radiológicos. Materiales y métodos: Se llevó a cabo una revisión sistemática de la literatura y un metaanálisis. Se hizo una búsqueda exhaustiva de literatura en EMBASE, MEDLINE PubMed y Cochrane (CENTRAL) con el fin de recopilar los estudios publicados entre enero de 2015 y el 31 de julio de 2019. Los resultados primarios fueron la capacidad vital forzada (CVF), la capacidad de difusión del monóxido de carbono (diffusing capacity of the lungs for carbon monoxide, DLCO), y los hallazgos de la tomografía computarizada de alta resolución (TCAR). Se incluyeron los estudios que utilizaron medicamentos para el tratamiento de la EPI-ES, incluyendo ciclofosfamida (CYC), micofenolato de mofetilo (MMF), nintedanib, pirfenidona o rituximab (RTX). Las medidas de efecto se calcularon con base en los datos disponibles, y se hizo un metaanálisis con estos resultados. Resultados: Encontramos un total de 312 estudios. Después de leer los resúmenes, se seleccionaron 49 estudios para la evaluación del texto completo. Finalmente, se seleccionaron 14 estudios para incluirlos en la revisión final. Se identificaron dos metaanálisis, ocho ensayos clínicos, tres cohortes retrospectivas y un estudio de casos y controles anidado. La evidencia disponible respalda el uso de CYC y MMF como las mejores opciones para el tratamiento de la EPI-ES, siendo el MMF la opción preferida basada en un mejor perfil de seguridad. Otros medicamentos como RTX, pirfenidona y nintedanib muestran potencial como alternativas a la CYC. La calidad global de la evidencia disponible es adecuada ya que parte de estudios por lo general bien diseñados. El metaanálisis se realizó evaluando una disminución > 5% o > 10% de la CVF al comparar los agentes farmacológicos vs. placebo. Los resultados muestran que el uso de agentes farmacológicos se asocia negativamente con el empeoramiento de la CVF. Sin embargo, la alta heterogeneidad limita el número de estudios utilizados durante el análisis cuantitativo, afectando los resultados generales. Conclusiones: Las terapias inmunosupresoras, especialmente la CYC y el MMF, siguen siendo la piedra angular del tratamiento de la EPI-ES, ya que la mayoría de la evidencia muestra una mejoría o una progresión lenta de las pruebas de función pulmonar al usarlas. Sin embargo, se requiere más evidencia con respecto al uso de agentes farmacológicos alternativos, en busca de una mejora de la calidad de vida de estos pacientes.


Subject(s)
Humans , Scleroderma, Systemic , Therapeutics , Lung Diseases, Interstitial , Radiology , Immune System
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