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Article in Chinese | WPRIM | ID: wpr-922061


Virtual monochromatic images (VMI) that reconstructed on dual-energy computed tomography (DECT) have further application prospects in radiotherapy, and there is still a lack of clinical dose verification. In this study, GE Revolution CT scanner was used to perform conventional imaging and gemstone spectral imaging on the simulated head and body phantom. The CT images were imported to radiotherapy treatment planning system (TPS), and the same treatment plans were transplanted to compare the CT value and the dose distribution. The results show that the VMI can be imported into TPS for CT value-relative electron density conversion and dose calculation. Compared to conventional images, the VMI varies from 70 to 140 keV, has little difference in dose distribution of 6 MV photon treatment plan.

Electrons , Phantoms, Imaging , Tomography Scanners, X-Ray Computed , Tomography, X-Ray Computed
J. bras. nefrol ; 41(3): 345-355, July-Sept. 2019. tab, graf
Article in English | LILACS | ID: biblio-1040247


ABSTRACT Introduction: There is evidence that aldosterone plays a role in the pathogenesis of vascular calcification. The aim of this study was to evaluate the effect of spironolactone, a mineralocorticoid receptor antagonist, on the progression of coronary calcification (CC) in peritoneal dialysis patients and to identify the factors involved in this progression. Methods: Thirty-three patients with a coronary calcium score (CCS) ≥ 30, detected through multi-detector computed tomography (MDCT) and expressed in Agatston units, were randomly assigned to a group receiving 25mg spironolactone per day for 12 months (spironolactone group) and a control group not receiving this drug. The primary outcome was a percentage change in CCS from baseline to end of the study (relative progression), when a further MDCT was conducted. Patients who had progression of CC were compared with those who did not progress. Results: Sixteen patients, seven in the spironolactone group and nine in the control group, concluded the study. The relative progression of the CCS was similar in both groups, 17.2% and 27.5% in the spironolactone and control groups respectively. Fifty-seven percent of the treated patients and 67% of those in the control group presented progression in the CC scores (p = 0.697). Progressor patients differed from non-progressors because they presented higher levels of calcium and low-density lipoprotein cholesterol and lower levels of albumin. Conclusion: In peritoneal dialysis patients, spironolactone did not attenuate the progression of CC. However, large-scale studies are needed to confirm this observation. Disorders of mineral metabolism and dyslipidemia are involved in the progression of CC.

RESUMO Introdução: Existem evidências de que a aldosterona exerça um papel na patogênese da calcificação vascular. O objetivo deste estudo foi avaliar o efeito da espironolactona, um antagonista do receptor mineralocorticoide, na progressão da calcificação coronariana (CC) de pacientes em diálise peritoneal, e identificar os fatores envolvidos nessa progressão. Métodos: Trinta e três pacientes com escore de cálcio coronariano (ECC) ≥ 30, detectado por tomografia computadorizada com múltiplos detectores (TCMD) e expresso em unidades de Agatston, foram randomizados para um grupo que recebeu 25 mg de espironolactona por dia durante 12 meses (grupo espironolactona) e um grupo controle que não recebeu este medicamento. O desfecho primário foi a mudança percentual do ECC do início para o final do estudo (progressão relativa), quando uma nova TCMD foi realizada. Os pacientes que tiveram progressão de CC foram comparados com aqueles que não progrediram. Resultados: Dezesseis pacientes, sete no grupo espironolactona e nove no grupo controle, concluíram o estudo. A progressão relativa do ECC foi semelhante nos dois grupos, 17,2% e 27,5% nos grupos espironolactona e controle, respectivamente. Cinquenta e sete por cento dos pacientes tratados e 67% daqueles no grupo controle apresentaram progressão nos escores de CC (p = 0,697). Os pacientes progressores diferiram dos não progressores porque apresentaram níveis séricos mais elevados de cálcio e LDL-colesterol e menores níveis de albumina. Conclusão: Em pacientes em diálise peritoneal, a espironolactona não atenuou a progressão da CC. No entanto, estudos em grande escala são necessários para confirmar essa observação. Distúrbios do metabolismo mineral e dislipidemia estão envolvidos na progressão da CC.

Humans , Male , Female , Middle Aged , Aged , Spironolactone/therapeutic use , Peritoneal Dialysis , Disease Progression , Mineralocorticoid Receptor Antagonists/therapeutic use , Vascular Calcification/drug therapy , Vascular Calcification/blood , Spironolactone/administration & dosage , Tomography Scanners, X-Ray Computed , Pilot Projects , Calcium/blood , Prospective Studies , Follow-Up Studies , Treatment Outcome , Mineralocorticoid Receptor Antagonists/administration & dosage , Renal Insufficiency, Chronic/therapy , Lost to Follow-Up , Vascular Calcification/pathology , Vascular Calcification/diagnostic imaging , Serum Albumin, Human/analysis , Cholesterol, LDL/blood
Oncol. (Guayaquil) ; 29(2): 145-152, 30 de Agosto del 2019.
Article in Spanish | LILACS | ID: biblio-1015498


Introducción: Los casos de tiroides ectópica localizados en la base de la lengua son anormalidades congénitas raras y difíciles de diagnosticar. Razón de presentación del caso. Caso Clínico: El caso corresponde a una mujer de 41 años con tiroides en base de la lengua diagnosticada incidentalmente con tomografía computarizada (TC), con antecedentes de hipotiroidismo y cáncer de mama derecha. Al examen físico de cuello no se palpa glándula tiroidea ni se observa masa o protuberancia en cavidad bucal. Por control del cáncer de mama, se solicita tomografía por emisión de positrones (PET) y ecografía de cuello, reportándose captación del radiofármaco en la región cervical anterior y superior de cuello, y ausencia de tejido glandular tiroideo a nivel habitual, respectivamente. Por cuanto, se realiza TC simple y contrastada observándose a nivel de la raíz de la lengua una imagen nodular hipercaptante que mide 23x20x20 mm, bien definida, contornos regulares, no infiltra tejidos adyacentes, impronta luz de la orofaringe, sin individualizar la glándula tiroides a nivel habitual, corroborando así el diagnóstico de tiroides ectópica lingual. Conclusión: El diagnóstico de tiroides ectópica en paciente adulto hipotiroideo es raro, por lo que debe considerarse la realización de TC si al examen físico y ecográfico no es palpable ni observable

Introduction: Cases of ectopic thyroid located at the base of the tongue are rare and difficult to diagnose congenital abnormalities. Reason for presenting the case. Clinical case: The case corresponds to a 41-year-old woman with thyroid based on the tongue diagnosed incidentally with computed tomography (CT), with a history of hypothyroidism and right breast cancer. On the physical examination of the neck, the thyroid gland is not palpated, and no mass or bump is observed in the oral cavity. For breast cancer control, positron emission tomography (PET) and neck ultrasound are requested, radiopharmaceutical uptake is reported in the anterior and upper cervical neck region, and absence of thyroid glandular tissue at the usual level, respectively. As a simple and contrasted CT scan, a hypercapting nodular image measuring 23x20x20 mm, well defined, regular contours is observed at the root of the tongue, does not infiltrate adjacent tissues, oropharynx light imprint, without individualizing the thyroid gland to usual level, thus corroborating the diagnosis of lingual ectopic thyroid. Conclusion: The diagnosis of ectopic thyroid in an adult hypothyroid patient is rare, so CT should be considered if the physical and ultrasound examination is not palpable or observable.

Humans , Tomography Scanners, X-Ray Computed , Lingual Thyroid , Thyroid Dysgenesis , Thyroid Diseases , Chronic Disease , Ecuador
ABCD arq. bras. cir. dig ; 32(3): e1455, 2019. graf
Article in English | LILACS | ID: biblio-1038026


ABSTRACT Background: Pancreaticoduodenectomy is the usual surgical option for curative treatment of periampullary cancer and carries a significant mortality. Arterial anomalies of the celiac axis are not uncommon and might lead to iatrogenic lesions or requiring arterial resection/reconstruction in a pancreatoduodenectomy. Aim: Determine the prevalence of arterial variations having implications in pancreatoduodenectomy. Methods: Celiac trunk and hepatic arterial system anatomy was retrospectively evaluated in 200 abdominal enhanced computed tomography studies. Results: Normal anatomy of hepatic arterial system was found in 87% of cases. An anomalous right hepatic artery was identified in 13% of cases. In 12 cases there was a substitute right hepatic artery arising from superior mesenteric artery and in two cases an accessory right hepatic artery with similar origin. A hepatomesenteric trunk was identified in seven cases and in five there was a right hepatic artery directly from the celiac trunk. All cases of anomalous right hepatic artery had a route was behind the pancreatic head and then, posteriorly and laterally, to the main portal vein before reaching the liver. Conclusions: Hepatic artery variations, such as anomalous right hepatic artery crossing posterior to the portal vein, are frequently seen (13%). These patients, when undergoing pancreatoduodenectomy, may require a change in the surgical approach to achieve an adequate resection. Preoperative imaging can clearly identify such variations and help to achieve a safer pancreatic head dissection with proper surgical planning.

RESUMO Racional: Pancreatoduodenectomia consiste no procedimento cirúrgico usual para tratamento curativo de neoplasias periampulares e apresenta mortalidade significativa. Variações arteriais do tronco celíaco não são incomuns e podem favorecer lesões iatrogênicas ou exigirem realização de ressecção/reconstrução arterial durante pancreatoduodenectomia. Objetivo: Determinar a prevalência de variações arteriais que apresentam implicações durante pancreatoduodenectomia. Métodos: A anatomia do tronco celíaco e sistema arterial hepático foi investigada retrospectivamente em 200 exames tomográficos contrastados do abdome. Resultados: Anatomia normal do sistema arterial hepático foi observada em 87% dos casos. Presença de uma artéria hepática direita anômala foi identificada em 13%. Em 12 casos houve uma artéria hepática direita substituta originária da artéria mesentérica superior, em dois uma artéria hepática direita acessória com origem similar. Tronco hepaticomesentérico foi identificado em sete casos e em cinco houve uma artéria hepática direita originária diretamente do tronco celíaco. Em todos casos de artéria hepática direita anômala seu curso foi por trás da cabeça do pâncreas e com trajeto passando posteriormente ao tronco da veia porta e após percorrendo sua face lateral direita antes de alcançar o fígado. Conclusões: Variações arteriais hepáticas, como artéria hepática direita anômala com trajeto posterior à veia porta, são frequentes (13%). Nestes pacientes, quando submetidos à pancreatoduodenectomia, pode ser necessária alteração na abordagem cirúrgica para ressecção adequada. Exames de imagem pré-operatórios podem claramente identificar estas variações e auxiliar na realização de dissecção segura da cabeça do pâncreas com adequado planejamento cirúrgico.

Humans , Male , Female , Pancreaticoduodenectomy , Hepatic Artery/anatomy & histology , Abdominal Neoplasms/surgery , Celiac Artery/anatomy & histology , Tomography Scanners, X-Ray Computed , Prevalence , Retrospective Studies , Dissection , Anatomic Variation , Hepatic Artery/abnormalities , Hepatic Artery/diagnostic imaging
Rev. cient. Esc. Univ. Cienc. Salud ; 5(2): 48-55, jun.- dic. 2018. ilus
Article in Spanish | LILACS | ID: biblio-999429


El quiste periapical se deriva del epitelio de revestimiento por una proliferación de pequeños residuos epiteliales de Malassez, el presente reporte señala características clínico-patológicas de un quiste periapical y la incorporación del uso de la tomografía computarizada de haz cónico (CBCT) como método de diagnóstico y el procedimiento de biopsia para descartar malignidad. Por lo general, en el protocolo de intervención, el odontólogo no emplea la realización de biopsia ni estudios histopatológicos a lesio-nes que aparentan ser benignas, con base en la literatura y experiencia del caso clíni-co, se pretende que el estudiante de pregra-do, odontólogo general y especialista incor-pore la CBCT y biopsia en el diagnóstico. Paciente femenina de 45 años, acudió a las clínicas estomatológicas de la Carrera de Odontología de la Universidad Nacional Autónoma de Honduras en el Valle de Sula (UNAH-VS). En el exámen intraoral se observó fracturas de coronas fijas de cerá-mica en el incisivo central e incisivo lateral superior izquierdo, presencia de tumefac-ción fluctuante en el rafe palatino medio, dolor a la palpación y presencia de fístula activa. Se realizó una CBCT para elabora-ción del plan de tratamiento; el abordaje clínico fue terapia endodóntica convencio-nal, apicectomía con obturación retrógrada en los dientes involucrados, remoción del quiste, realización de biopsia y estudiosanatomopatológicos que corroboran el diag-nóstico presuntivo de epitelio escamoso típico densamente infiltrado de linfocitos, el corion muestra infiltrados linfoplasmocitarios de un quiste periapical. La paciente evolu-cionó sin complicaciones permaneciendo asintomática; en 12 meses radiografía peria-pical evidenció formación de tejido óseo en el área tratada...(AU)

Humans , Female , Adult , Radicular Cyst/diagnostic imaging , Tomography Scanners, X-Ray Computed , Cone-Beam Computed Tomography , Biopsy/methods
Rev. Círc. Argent. Odontol ; 77(227): 13-17, dic. 2018. ilus, tab
Article in Spanish | LILACS | ID: biblio-1122775


La osteoartrosis es una enfermedad degenerativa que, instalada en la articulación temporomandibular, genera efectos deletéreos en los tejidos blandos y óseos que la constituyen. En los tejidos duros se destaca la aparición de procesos osteolíticos a nivel condilar y de la cavidad glenoidea con cambios morfológicos importantes. Estas modificaciones están íntimamente relacionadas con el debilitamiento y/o destrucción de los tejidos blandos que ocurren previamente. Los síntomas que se presentan con mayor frecuencia en esta afección son la alteración del rango de movimiento, el dolor y, el más característico, la crepitación durante el examen con estetoscopio. La frecuencia de aparición alcanza entre un 8% y un 18%. Las causas para su documentación son variables y están vinculadas al desplazamiento discal, el trauma, hormonales y la inestabilidad oclusal, siendo el aumento de carga (bruxismo) la de mayor significación. El examen imagenológico puede documentar aplanamiento de los componentes óseos, disminución del espacio articular, discontinuidad de las corticales, esclerosis subcondral, osteofitos, quistes subcondrales y cuerpos libres periarticulares. En ocasiones la radiografía panorámica puede ser poco demostrativa para la documentación de esas particularidades; por el contrario, la tomografía computada es un excelente procedimiento diagnóstico. El aporte de la IRM es relevante en la ubicación del disco articular; asimismo, posibilita la observación de colección de fluido en los espacios articulares, generando una señal hiperintensa. Tratamiento: actuar principalmente para disminuir la carga sobre la ATM y,`por lo tanto, concientizar al paciente de la presencia del bruxismo, instalar un dispositivo oclusal miorrelajante (DOM) y suplementar con analgésicos, antiinflamatorios y antiartrósicos. Cuando la OA está asociada al desplazamiento discal, debe indicarse un dispositivo oclusal de desplazamiento anterior mandibular (DODAM) (AU)

Osteoarthrosis is a degenerative disease. When is located in the TMJ produces deleterious effects in its soft and hard tissues, osteolytic processes on condyle and glenoid cavity in the latter, with significant morphological changes, closely related to weakening and destruction of the tissues that had happened previously. Symptoms most frequent are alteration of the range of movement, pain and,the most characterystic, cracking while examination through stethoscope. Its frequency is between 8 and 18%.Causes for its documentation are variable and related to disc displacement, trauma, hormones and occlusal unsteadiness, being de increase of charge (clenching) the most relevant. Imaging can show flattening on osseusparts,, the articular space, discontinuation of cortexes, subchondral sclerosis, osteophytes, subchondral cysts,and loose particular bodies. Sometimes orthopantomograph may be barely demonstrative to document these phenomena, conversely CT is an excellent diagnostic procedure. The contribution of MRI is relevant to locate articular disc, and facilitate visualize fluid collection within the articular spaces, producing a hiperintense signal. Treatment: to act mainly for diminishing charge on the TMJ, so to raise patients conscience of the presence of clenching, install a myorelaxant occlusal device (DOM) and additionally analgesics, antiinflamatories and antiarthrosis When osteoarthrosis is associated with disc displacement and occlusal device for anterior mandibular displacement (DODAM) is suitable(AU)

Humans , Male , Female , Osteoarthritis/pathology , Temporomandibular Joint Disorders/diagnostic imaging , Osteoarthritis/drug therapy , Signs and Symptoms , Bruxism , Magnetic Resonance Imaging , Radiography, Panoramic , Tomography Scanners, X-Ray Computed , Chronic Disease , Chondroitin Sulfates/therapeutic use , Occlusal Splints , Age and Sex Distribution , Analgesics/therapeutic use , Anti-Inflammatory Agents
Rev. méd. Chile ; 146(9): 1070-1073, set. 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-978799


Vasculitic midline destructive lesions can be a complication of cocaine use. We report a 44-year-old man who presented with a two months history of left facial pain associated with ipsilateral facial paralysis and a cheek phlegmon. Magnetic resonance imaging showed broad soft tissue destruction linked to important cranial nerve involvement. Antibiotic and antifungal therapy was started and multiple surgical debridement procedures were performed, with no clinical improvement. Microbiological analysis was negative. Finally, thanks to the histologic findings corresponding to vasculitis and granuloma formation and the history of cocaine abuse, a cocaine induced midline destructive lesion was diagnosed.

Humans , Male , Adult , Nose Diseases/diagnosis , Nose Diseases/chemically induced , Cocaine-Related Disorders/complications , Nasal Septum/drug effects , Magnetic Resonance Imaging , Tomography Scanners, X-Ray Computed , Granulomatosis with Polyangiitis/diagnosis , Nose Diseases/therapy , Diagnosis, Differential , Anti-Bacterial Agents/classification , Anti-Bacterial Agents/therapeutic use
Dental press j. orthod. (Impr.) ; 23(3): 80-93, May-June 2018. graf
Article in English | LILACS | ID: biblio-953026


ABSTRACT Dentofacial deformities usually are surgically treated, and 3D virtual planning has been used to favor accurate outcomes. Cases reported in the present article show that orthognathic surgery carried out to correct facial asymmetries does not comprise only one treatment protocol. 3D virtual planning might be used for surgical planning, but it should also be used to diagnose the deformity, thus allowing for an analysis of the best-recommended possibilities for the orthodontic preparation that suits each individual case.

RESUMO As deformidades dentofaciais são, geralmente, tratadas de forma cirúrgica, e o planejamento virtual 3D tem sido utilizado para aumentar a precisão dos resultados. Os casos exemplificados no presente artigo mostram que a cirurgia ortognática para correção das assimetrias faciais não apresenta um único protocolo de tratamento. O planejamento virtual 3D pode ser adotado para planejar a cirurgia, mas também deve ser utilizado na fase de diagnóstico da deformidade, assim permitindo uma análise das possibilidades mais indicadas para o preparo ortodôntico mais adequado em cada caso.

Humans , Female , Adult , Patient Care Planning , Imaging, Three-Dimensional , Facial Asymmetry/surgery , Facial Asymmetry/diagnostic imaging , Orthognathic Surgical Procedures/methods , Radiography, Panoramic , Tomography Scanners, X-Ray Computed , Dentofacial Deformities/surgery , Dentofacial Deformities/diagnostic imaging
Article in Chinese | WPRIM | ID: wpr-689824


To explore the effect and experience of quality control circle(QCC) in quality control testing for CT scanners, the quality control circle group was set up to determine the theme of quality control circle, and the causes of the failure of the quality control testing for CT scanners were analyzed, then the corresponding corrective measures were formulated and carried out. After the activity of the quality control circle, the qualified rate of CT quality control testing in the second level 2nd Class of public hospitals and private hospitals in Shanghai increased from 40.6% to 86.1%. By conducting quality control circle activities, we found the problems existed in the quality control testing of CT scanners, and put forward many corresponding corrective measures and solutions which finally improved the qualified rate of CT quality control testing.

China , Quality Control , Tomography Scanners, X-Ray Computed , Reference Standards , Tomography, X-Ray Computed
Rev. estomat. salud ; 25(2): 8-9, 20180000.
Article in Spanish | LILACS, COLNAL | ID: biblio-884126


La práctica clínica de la odontología avanzó desde los últimos 20 años, con la inmersión del CAD/CAM (Computer-assisted Design and Manufacturing), reduciendo tanto los pasos para la realización de una corona o prótesis, como mejorando la eficiencia, calidad del tratamiento y por consiguiente, la experiencia percibida por los pacientes. En Estados Unidos se estima que, el 15% de los consultorios practican Odontología Digital, es decir, hacen uso de tecnología CAD/CAM e impresión digital 3D. Además, para el año 2017, se estimó el uso de 19,000 unidades de CAD/CAM en las oficinas dentales de odontólogos americanos, mostrando que, los avances de la tecnología que veíamos muy lejanos, son una realidad, hoy (1,2). A pesar de estas cifras, las universidades han adoptado el entrenamiento en tecnología digital odontológica tímidamente, tal como lo han manifestado, según el entusiasmo por parte de docentes y estudiantes. Esto se ve reflejado en la incipiente publicación de artículos científicos en ésta área. La odontología digital se ha desarrollado en varios campos dentro de la odontología. De hecho, se ha utilizado desde el diagnóstico, planificación del tratamiento, hasta el diseño y elaboración de prótesis y restauraciones. Dentro de las herramientas de la odontología digital, se encuentra el escáner intraoral. Los escáneres han permitido capturar información detallada de las estructuras anatómicas dentales, óseas y tejidos blandos del paciente. Por tanto, es una herramienta útil para el diagnóstico y planificación del tratamiento del paciente. Además, los datos pueden ser transferidos para una impresora 3D, permitiendo obtener modelos de estudios de los pacientes sin necesidad de tomar una impresión en hidrocoloide irreversible (alginato) o en silicona. En el área de Periodoncia, la odontología digital ofrece ventajas para el estudio de los sitios quirúrgicos a operar tanto en procedimientos resectivos como regenerativos. De esta forma, la regeneración ósea guiada, la instalación quirúrgica de implantes dentales, entre otros, son procedimientos que serán realizados con mayor supervisión del clínico, haciendo la cirugía más precisa, predecible y segura para el paciente. Por su parte, la odontología pediátrica y ortopedia maxilar ha sido enriquecida en el diagnóstico de pacientes con labio y paladar fisurado, una vez que se puede evitar el uso de materiales como el hidrocoloide irreversible (alginato), disminuyendo la incomodidad que puede causar para el paciente pediátrico, sobre todo en aquellos pacientes con labio y paladar hendido. De otro lado, la ortodoncia ha utilizado la tecnología digital para personalizar los brackets de los pacientes, permitiendo un mayor control de las fuerzas ortodóncicas y, aumentando la eficacia del movimiento dental. Esto se verá traducido en menor tasa de reabsorción radicular, menor tiempo del tratamiento ortodóncico, entre otras ventajas. Finalmente, la odontología digital puede ser explotada para la educación de los pacientes. De hecho, el éxito del tratamiento no solo depende de los procedimientos realizados por el odontólogo sino también por los cuidados que el paciente tenga después de su atención clínica. Así, el uso de una impresión 3D generada a partir de información obtenida desde un escáner intraoral o una tomografía, permite mostrarle al paciente la relación entre el diagnóstico y el plan de tratamiento elegido. Adicionalmente, el paciente puede ser consciente de la evolución de su cicatrización después de la realización del tratamiento. Con todo esto, aún falta mucho por explorar. La era digital en odontología representa una atractiva línea de investigación, para aquellas personas inquietas que buscan mejorar cada vez más los servicios odontológicos. Así, esperamos comenzar en la Universidad del Valle, un camino, una trayectoria para ser pioneros en la odontología digital.

Humans , Computers , Dentistry , Computer Systems , Computer-Aided Design , Computers, Analog , Radiography, Dental, Digital , Tomography , Tomography Scanners, X-Ray Computed
Rev. Ateneo Argent. Odontol ; 59(2): 7-12, 2018. ilus
Article in Spanish | LILACS | ID: biblio-1051053


Podemos definir "quiste" como una bolsa conectivoepitelial, tapizada en su interior por epitelio y recubierta en su cara externa por tejido conectivo, que encierra un contenido líquido o semisólido. Según su patogénesis, los clasificamos como lesiones de desarrollo o de tipo inflamatorio (1, 17). Tanto los quistes de desarrollo como los inflamatorios se caracterizan por un crecimiento lento y una tendencia expansiva. A pesar de ser entidades con un comportamiento benigno, pueden alcanzar un tamaño considerable si no se diagnostican y se tratan a tiempo (2). El tipo de tratamiento de la lesión está condicionado por múltiples factores como el tamaño de la misma, su localización, su relación con estructuras anatómicas vecinas, la posible afectación de estructuras dentales, entre otras. (3) El objetivo es elegir la modalidad de tratamiento que conlleve el menor riesgo posible de recurrencia, el cuidado, en lo posible, de las estructuras nobles vecinas y, por supuesto, la erradicación de la lesión. (4) Dentro de los tratamientos de los quistes maxilares, podemos mencionar la enucleación total de los mismos o técnica de Parstch II, la marsupialización o técnica de Parstch I y la técnica descompresiva, también llamada técnica de Waldron- Axhausen. El objetivo de este trabajo es el de mostrar un caso clínico donde se realizó la técnica descompresiva para el tratamiento de un quiste inflamatorio en el maxilar inferior en íntimo contacto con el nervio dentario inferior y la basal mandibular (AU)

We can define "cyst" like a connective-epitelial bag, upholstered inside by epithelium and covered on the outside by connective tissue, enclosing a liquid or semisolid contents. According to its pathogenesis, classify them as development or inflammatory (1, 17). Injury both the inflammatory and developing cysts are characterized by slow growth and an expansionary trend. Despite being entities with a benign behavior, they can reach a considerable size if not diagnosed and treated in time. (2) The type of treatment of injury, is determined by multiple factors such as the size, its location, its relationship with neighboring anatomical structures, possible involvement of dental structures, among others. (3) The objective is to choose the modality of treatment involving the least possible risk of recurrence, care, as far as possible, of the neighboring noble structures and of course the elimination of the lesion. (4) Inside of the Maxillary cysts treatments we can mention the enucleation total thereof or technical Parstch II, the marsupialization or technique of Parstch I and the decompression technique, also called Waldron - Axhausen technique. The objective of this work is the show a clinical case where took place the decompression technique for the treatment of inflammatory cyst in the lower jaw in intimate contact with the inferior alveolar nerve and the mandibular basal (AU)

Humans , Male , Adult , Jaw Cysts/surgery , Decompression, Surgical , Tooth Extraction , Biopsy , Jaw Cysts/diagnostic imaging , Tomography Scanners, X-Ray Computed , Follow-Up Studies
Einstein (Säo Paulo) ; 16(3): eAO4090, 2018. tab
Article in English | LILACS | ID: biblio-953177


ABSTRACT Objective: To describe the characteristics of patients diagnosed with tuberculosis and latent tuberculosis infection. Methods: A retrospective study, between 2012 and 2015, with data from patients of Programa Einstein na Comunidade de Paraisópolis. To evaluate possible factors associated with patient's sex and diagnoses of tuberculosis and latent tuberculosis infection, χ2 or Fisher's exact tests were used for qualitative variables, and Mann-Whitney test for quantitative or ordinal qualitative variables. Results: A total of 77 patients were evaluated. Age ranged from 6 months to 13.4 years, with a majority of males (54.5%), aged zero to 4 years (54.5%), diagnosed with latent tuberculosis infection (64.9%), and classified as eutrophic (71.2%). The tuberculin test was positive in 92% and in most cases the values were above 10mm (68.0%). Approximately three-quarters of chest X-ray tests were normal (72.7%). After chest X-ray, computed tomography of thorax was the most ordered exam (29.9%), followed by smear and culture for Mycobacterium tuberculosis in the gastric aspirate (28.6%). The frequencies of altered chest X-ray (70.4% versus 4.0%), computed tomography of thorax requests (55.6% versus 16.0%) and other tests requested (81.5% versus 38.0%) were significantly higher in patients with a diagnosis of tuberculosis, relative to those with latent tuberculosis infection, respectively. Conclusion: In our sample, proportions of altered chest X-ray, and performing computed tomography of thorax and other tests in patients diagnosed with tuberculosis were higher than in those with latent tuberculosis infection.

RESUMO Objetivo: Descrever as características de pacientes com diagnóstico de tuberculose e de infecção latente por tuberculose. Métodos: Estudo retrospectivo, entre os anos de 2012 e 2015, com os dados dos pacientes do ambulatório do Programa Einstein na Comunidade de Paraisópolis. Para se avaliarem possíveis fatores associados ao sexo e aos diagnósticos de tuberculose e infecção latente por tuberculose, foram utilizados os testes χ2 ou exato de Fisher, para variáveis qualitativas, e de Mann-Whitney, para variáveis quantitativas ou qualitativas ordinais. Resultados: Foram avaliados 77 pacientes. A idade variou de 6 meses a 13,4 anos, sendo a maioria do sexo masculino (54,5%), na faixa etária de zero a 4 anos (54,5%), com diagnóstico de infecção latente por tuberculose (64,9%) e categorizada como eutrófica (71,2%). Em 92% dos casos, a prova tuberculínica foi positiva, e a maioria mostrou valores acima de 10mm (68,0%). Cerca de três quartos dos exames de raio X de tórax resultaram normais (72,7%). Depois do raio X de tórax, a tomografia computadorizada de tórax foi o segundo exame mais solicitado (29,9%), seguida da baciloscopia e da cultura do bacilo Mycobacterium tuberculosis no aspirado gástrico (28,6%). As frequências de raio X de tórax alterado (70,4% versus 4,0%), solicitações de tomografia computadorizada de tórax (55,6% versus 16,0%) e outros exames (81,5% versus 38,0%) foram significativamente maiores nos pacientes com diagnóstico de tuberculose, em relação àqueles com infecção latente por tuberculose, respectivamente. Conclusão: Em nossa amostra, as proporções de raio X de tórax alterados e de realização de tomografia computadorizada de tórax e de outros exames nos pacientes com diagnóstico de tuberculose foram maiores em relação àqueles com infecção latente por tuberculose.

Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Tuberculosis, Pulmonary/epidemiology , Latent Tuberculosis/epidemiology , Tuberculosis, Pulmonary/diagnosis , Brazil/epidemiology , Tuberculin Test/statistics & numerical data , Radiography, Thoracic , Tomography Scanners, X-Ray Computed , Retrospective Studies , Sex Distribution , Age Distribution , Statistics, Nonparametric , Latent Tuberculosis/diagnosis , Mycobacterium tuberculosis/isolation & purification
Rev. chil. infectol ; 34(6): 598-602, dic. 2017. graf
Article in Spanish | LILACS | ID: biblio-899765


Resumen La actinomicosis diseminada es muy infrecuente, así como la afección del sistema nervioso central (SNC) asociada, con mortalidad de hasta 28%. Sus manifestaciones pueden ser similares a cuadros infecciosos de otras etiologías, por lo que el conocimiento de la entidad aumenta la sospecha clínica y permite brindar un tratamiento oportuno. Se presenta el caso clínico de un adulto con edema en una extremidad superior como manifestación de una tromboflebitis y una lesión abscedada axilar, en que se confirmó una infección por actinomicetos. Presentó una diseminación hematógena con compromiso de SNC, de evolución fatal.

Actinomycosis is very rare, as well as the central nervous system (CNS) condition associated with it, presenting a mortality up to 28%. Its manifestations could be similar to infectious conditions from other etiologies, thus, having a better understanding of the entity increases clinical suspicion and also it can provide a timely treatment. The clinical case of an adult with edema in an upper extremity is presented as a manifestation of thrombophlebitis and an abscessed axillary lesion, in which actinomycetes infection was confirmed. He presented a haematogenous spread with CNS involvement, with fatal ending.

Humans , Male , Middle Aged , Brain Abscess/microbiology , Brain Abscess/diagnostic imaging , Actinomycosis/microbiology , Actinomycosis/diagnostic imaging , Central Nervous System Bacterial Infections/microbiology , Central Nervous System Bacterial Infections/diagnostic imaging , Biopsy , Brain Abscess/pathology , Actinomyces/isolation & purification , Actinomycosis/pathology , Magnetic Resonance Imaging , Tomography Scanners, X-Ray Computed , Central Nervous System Bacterial Infections/pathology
Rev. bras. cir. cardiovasc ; 32(3): 228-230, May-June 2017. tab, graf
Article in English | LILACS | ID: biblio-897906


Abstract The development of left atrial myxoma after coronary artery bypass graft surgery is a rare entity. A 60-year-old man with previous off-pump coronary artery bypass grafting four years ago with patent coronary grafts was diagnosed with left atrial mass. The patient underwent successful resection of the same through minimally invasive right anterolateral thoracotomy. Histopathology of the atrial mass confirmed the diagnosis of atrial myxoma.

Humans , Male , Middle Aged , Coronary Artery Bypass/adverse effects , Heart Neoplasms/etiology , Heart Neoplasms/pathology , Myxoma/etiology , Myxoma/pathology , Reoperation , Time Factors , Cardiopulmonary Bypass/methods , Tomography Scanners, X-Ray Computed , Treatment Outcome , Sternotomy/methods , Heart Atria/pathology , Heart Neoplasms/surgery , Myxoma/surgery
Braz. oral res. (Online) ; 31: e1, 2017. tab, graf
Article in English | LILACS | ID: biblio-839501


Abstract The objective of this investigation was to compare the accuracy of mandibular measurements using a stabilizer (MS) with gold standard computed tomography (GS) images. Sixty mandibles were studied. Werth TomoScope HV Compact® was used to obtain CT images (GS), and the MS was also used. Analysis of the CT scans was performed using the VG Studio Max software® (Volume Graphics GmbH, Heidelberg, Germany), and MS was used after the proper positioning of the mandible. Descriptive and paired t test measures were used, and a ROC curve was calculated, as well as sensibility and specificity. MedCalc and STATA 13.0® were used (95% level of significance). Bicondylar breadth, bicoronoid breadth and minimum ramus breadth reached the highest concordance correlation coefficients at 0.99 (0.99-1.00), 0.99 (0.99–1.00) and 1.00 (0.99–1.00), respectively. Comparing observers with GS, the lowest accuracy was noted for the maximum mandibular length [0.59 (0.45–0.69), 0.64 (0.51–0.74)], the breadth of the right (0.14 (0.04–0.23), 0.14 (0.004–0.24)) and left mandibular body [0.14 (0.03–0.24), 0.16 (0.05-0.26)], and the right [0.58 (0.45–0.69), 0.63 (0.51–0.73) and left (0.59 (0.45–0.70), 0.59 (0.46–0.69)] mandibular angle. Various measurements exhibited good sensibility for males using MS: maximum mandibular length (78.12), bicondylar breadth (78.12), left mandibular notch breadth (84.37), and the left height of the mandibular body at the mental foramen (75.00). High specificity in discriminating females was observed for the left maximal ramus height (85.19), mandibular length (85.71), bicoronoid breadth (96.43), right height of the mandibular body at the mental foramen (82.19), bimental breadth (78.57), breadth right (92.86) and left (96.43) mandibular body, minimum ramus breadth (89.29), and left mandibular angle (85.71). MS was able to discriminate sexual dimorphism.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Tomography, X-Ray Computed/instrumentation , Tomography Scanners, X-Ray Computed , Sex Characteristics , Mandible/anatomy & histology , Reference Standards , Tomography, X-Ray Computed/methods , Sex Factors , Reproducibility of Results , ROC Curve , Imaging, Three-Dimensional/instrumentation , Equipment Design , Anatomic Variation , Mandible/diagnostic imaging
Arq. bras. oftalmol ; 79(5): 336-338, Sept.-Oct. 2016. graf
Article in English | LILACS | ID: biblio-827966


ABSTRACT We report a case of bilateral acute angle-closure glaucoma in a patient with undiagnosed granulomatosis with polyangiitis (Wegener's). A 59-year-old man presented with a severe headache, ocular pain, blurred vision, shortness of breath, and mild fever. Clinical examination revealed conjunctival chemosis, corneal edema, and shallow anterior chambers. Closed angles were observed bilaterally on gonioscopy. The patient was treated with intravenous mannitol, oral acetazolamide, and anti-glaucomatous eye drops. Over the following two days, his vision improved and intraocular pressures decreased. Subsequently, laser iridotomies were performed bilaterally and the patient attended consultations with our departments of respiratory medicine, nephrology, and rheumatology and was subsequently diagnosed with granulomatosis with polyangiitis. Bilateral acute angle-closure glaucoma is a very rare ocular manifestation of granulomatosis with polyangiitis. The association of this clinical entity with Wegener's granulomatosis remains unknown.

RESUMO Relatamos um caso glaucoma bilateral agudo de ângulo fechado em um paciente sem diagnóstico prévio de granulomatose com poliangeíte (Wegener). Um homem de 59 anos apresentou-se com uma forte dor de cabeça, dor nos olhos, visão turva, dificuldade em respirar e febre baixa. Observamos quemose conjuntival, edema da córnea e câmara anterior rasa. A gonioscopia demonstrou ângulos fechados bilateralmente. Ele foi tratado com manitol intravenoso, acetazolamida oral, olho e colírios antiglaucomatosos. Durante os dois dias seguintes a sua visão melhorou e as pressões intra-oculares diminuíram. A seguir, foram realizadas iridotomias a laser bilateralmente e ele foi referido para os departamentos de doenças pulmonares, nefrologia e reumatologia. Ele foi diagnosticado com poliangeíte granulomatosa. Glaucoma bilateral agudo de ângulo fechado é uma entidade clínica muito rara e sua associação com a granulomatose de Wegener é desconhecida e deve acrescentar-se à lista de manifestações oculares de granulomatose com poliangeíte.

Humans , Male , Middle Aged , Glaucoma, Angle-Closure/etiology , Granulomatosis with Polyangiitis/complications , Time Factors , Radiography, Thoracic , Glaucoma, Angle-Closure/pathology , Glaucoma, Angle-Closure/therapy , Glaucoma, Angle-Closure/diagnostic imaging , Tomography Scanners, X-Ray Computed , Granulomatosis with Polyangiitis/pathology , Granulomatosis with Polyangiitis/diagnostic imaging , Acute Disease , Ultrasonography , Intraocular Pressure
Int. arch. otorhinolaryngol. (Impr.) ; 20(3): 196-201, July-Sept. 2016. tab, graf
Article in English | LILACS | ID: lil-795197


Abstract Introduction Foreign body in airway is a common emergency in ENT practice. As we know, Rigid Bronchoscopy is the method of choice for removing it, although at times it leads to specialists performing unnecessary bronchoscopy, exposing patients to hazards of general anesthesia. Objective The objective of my study is to calculate sensitivity, specificity, positive predictive value, odds ratio from the clinical and radiological signs, comparing with the gold standard, the rigid bronchoscope procedure. Method This is a prospective analytical study designed at University Teaching Hospital and conducted over a period of 18 months, from March 2011 to August 2012. Data collection was broadly classified into three different categories: (1) Symptomatology, such as presence or absence of choking, cyanosis, and difficulty in breathing; (2) Clinical signs, such as the presence or absence of air entry, crackles, and rhonchi 3. Chest X-ray findings were suggestive of a foreign body. Results There were a total of 40 rigid bronchoscopies performed under general anesthesia for the diagnosis and therapeutic reasons. Among 40 patients who underwent rigid bronchoscopy, 32 (80%) were found to have varieties of foreign bodies in their airway while 8 patients (20%) had negative bronchoscopy. The history of choking is the only clinical symptoms which came out to be statistically Significant (p = 0.043) with odds ratio of 5. Conclusion Rigid bronchoscopy is the gold standard technique for diagnosis and procedure of choice to remove FB from airway. Regardless, it still presents a small chance of negative result, especially when there is no history of aspiration. received.

Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Bronchoscopy , Foreign Bodies , Signs and Symptoms , Airway Obstruction , Tomography Scanners, X-Ray Computed