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1.
Int. j. med. surg. sci. (Print) ; 8(3): 1-16, sept. 2021. ilus
Article in English | LILACS | ID: biblio-1292541

ABSTRACT

For a long time, any heart-based injury was an off-limits area for surgeons; a patient with a traumatic cardiac injury was doomed to die. Little more than one hundred years have passed since the first surgical correction of a penetrating cardiac injury and there is still a high rate of mortality, despite the medical advances. We present the case of 6 patients with penetrating cardiac injuries that were repaired at a third level hospital of Mexico, alongside relevant findings on the literature about the topic. From 2019 to 2020, an incidence of 6 patients with penetrating cardiac injuries was present; all men aged 30 years or older. The etiology of 4 (67%) patients was stab wounds and 2 (33%) gunshot wounds. Left anterolateral thoracotomy was used on 5 (83%) patients and midline sternotomy on 1 (17%) patient. 2 (33%) injuries on the left ventricle presented along with coronary arteries injuries. Left ventricle and right atrium injuries presented each 50% of mortality. The mortality was of 33%, 1 patient died due to intraoperative complications and another one due to massive cerebral infarction and polyuric syndrome because of diabetes insipidus. There is a long path ahead of the surgical field on this topic and further to be analyzed. An excellent tool for cardiac tamponade diagnosis due to penetrating cardiac injuries is cardiac ultrasound, therefore it should be used on every hemodynamic unstable patient in the context of PCI. Definitively, time is of the essence, and the survival of patients depends on immediate transport to a hospital and an opportune surgical intervention.


Durante mucho tiempo las heridas en el corazón eran un área prohibida para el cirujano. Cualquier persona con herida penetrante cardíaca estaba condenada a morir. Poco más de cien años han transcurrido desde la primera corrección quirúrgica de una herida penetrante cardíaca y sigue habiendo una tasa alta de mortalidad, a pesar de los avances médicos. Se presenta una serie de casos de 6 pacientes con heridas penetrantes cardíacas que fueron reparadas en un hospital de tercer nivel de México, junto con revisión de la literatura. Desde el 2019 al 2020, hubo una incidencia de 6 pacientes con heridas penetrantes cardíacas; todos fueron hombres de 30 años o mayores. La etiología en 4 (67%) casos fueron heridas por arma blanca y 2 (33%) por herida por proyectil de arma de fuego. Se usó el abordaje por toracotomía anterolateral izquierda en 5 (83%) pacientes y esternotomía media en 1 (17%) paciente. Dos (33%) heridas se suscitaron en el ventrículo izquierdo en conjunto con heridas en arterias coronarias. Heridas en el ventrículo izquierdo y atrio derecho presentaron una mortalidad del 50% cada una. La mortalidad total fue de 33%, 1 paciente falleció por complicaciones intraoperatorias y otro más por infarto cerebral masivo y síndrome poliúrico causado por diabetes insípida. Hay un gran camino por recorrer en el ámbito quirúrgico de este tipo de heridas y más por ser analizado. Una herramienta útil para el diagnóstico del taponamiento cardíaco por heridas penetrantes cardíacas es el ultrasonido cardíaco, y, por ende, debe ser usado en todo paciente con inestabilidad hemodinámica en el contexto de una herida penetrante cardíaca. Definitivamente, el tiempo es vida, y la sobrevivencia de estos pacientes depende del transporte inmediato a un hospital y una intervención quirúrgica oportuna.


Subject(s)
Humans , Male , Myocardial Contusions/therapy , Myocardial Contusions/diagnostic imaging , Ultrasonics/methods
2.
Rev. bras. med. esporte ; 27(4): 372-376, Aug. 2021. graf
Article in English | LILACS | ID: biblio-1288601

ABSTRACT

ABSTRACT Objective: By studying the recognition effect of ultrasonic biological image data analysis on muscle group motion function, the evaluation value and significance of ultrasonic biomedical image combination algorithm on muscle group motion function are discussed. Methods: A Gabor filtering algorithm is proposed to smooth the original image. The MVEF algorithm is used to enhance the ultrasonic image and binary further the image again. Using the principle of the Hove transform, the thickness of the muscle is automatically estimated. Results: The square of correlation coefficients of the manual measurement method, Gabor filtering algorithm and MVEF algorithm are 91.3%, 91.3% and 87.8%, respectively. The difference between the manual measurement and the estimation based on the Gabor filtering algorithm is 1.45 ± 0.48mm. The difference between the results of manual measurement and the MVEF algorithm is 1.38 ± 0.56mm. The computation time of the MVEF algorithm and Gabor algorithm are 5 seconds and 0.3 seconds, respectively. Conclusions: The algorithm proposed in this study can effectively measure the muscle thickness, fast, convenient and accurate, and can reflect the contractility of skeletal muscle well, which is of great value for the recognition and evaluation of muscle group movement function. Level of evidence II; Therapeutic studies - investigation of treatment results.


RESUMO Objetivo: Ao estudar o efeito de reconhecimento da análise de dados de imagem biológica ultrassônica na função de movimento do grupo muscular, o valor de avaliação e a importância do algoritmo de combinação de imagem biomédica ultrassônica na função de movimento do grupo muscular são discutidos. Métodos: Um algoritmo de filtragem Gabor é proposto para suavizar a imagem original. O algoritmo MVEF é usado para aprimorar ainda mais a imagem ultrassônica e binar a imagem novamente. Usando o princípio da transformada de H ove, a espessura do músculo é automaticamente estimada. Resultados: O quadrado dos coeficientes de correlação do método de medição manual, algoritmo de filtragem Gabor e algoritmo MVEF são 91,3%, 91,3% e 87,8%, respectivamente. A diferença entre a medição manual e a estimativa baseada no algoritmo de filtragem Gabor é 1,45 ± 0,48 mm. A diferença entre os resultados da medição manual e o algoritmo MVEF é de 1,38 ± 0,56 mm. O tempo de cálculo do algoritmo MVEF e do algoritmo Gabor é de 5 segundos e 0,3 segundos, respectivamente. Conclusões: O algoritmo proposto neste estudo pode medir efetivamente a espessura muscular, de forma rápida, conveniente e precisa, e pode refletir bem a contratilidade do músculo esquelético, o que é de grande valor para o reconhecimento e avaliação da função de movimento do grupo muscular. Nível de evidência II; Estudos terapêuticos- investigação dos resultados do tratamento.


RESUMEN Objetivo: Al estudiar el efecto de reconocimiento del análisis de datos de imágenes biológicas ultrasónicas sobre la función del movimiento del grupo muscular, se discuten el valor de evaluación y la importancia del algoritmo de combinación de imágenes biomédicas ultrasónicas sobre la función del movimiento del grupo muscular. Métodos: Se propone un algoritmo de filtrado de Gabor para suavizar la imagen original. El algoritmo MVEF se utiliza para mejorar aún más la imagen ultrasónica y volver a binar la imagen. Utilizando el principio de la transformada de H ove, el grosor del músculo se estima automáticamente. Resultados: El cuadrado de los coeficientes de correlación del método de medición manual, el algoritmo de filtrado de Gabor y el algoritmo MVEF son 91,3%, 91,3% y 87,8%, respectivamente. La diferencia entre la medición manual y la estimación basada en el algoritmo de filtrado de Gabor es de 1,45 ± 0,48 mm. La diferencia entre los resultados de la medición manual y el algoritmo MVEF es 1,38 ± 0,56 mm. El tiempo de cálculo del algoritmo MVEF y el algoritmo de Gabor son 5 segundos y 0,3 segundos respectivamente. Conclusiones: El algoritmo propuesto en este estudio puede medir eficazmente el grosor muscular, de forma rápida, conveniente y precisa, y puede reflejar bien la contractilidad del músculo esquelético, lo cual es de gran valor para el reconocimiento y evaluación de la función del movimiento de grupos musculares. Nivel de evidencia II; Estudios terapéuticos- investigación de los resultados del tratamiento.


Subject(s)
Humans , Ultrasonics/methods , Algorithms , Muscles/physiopathology , Muscles/diagnostic imaging , Data Analysis
3.
Rev. venez. cir. ortop. traumatol ; 53(1): 20-26, jun. 2021. ilus
Article in Spanish | LILACS, LIVECS | ID: biblio-1252895

ABSTRACT

Cuando fracasa el tratamiento conservador en el Estadio I de Disfunción del Tendón Tibial posterior (DTTP), se debe indicar sinovectomía y debridamiento del tendón. En este estudio evaluamos la evolución con 8 años mínimo de seguimiento, de los pacientes con esta patología tratados vía tenoscópica. Este es un estudio retrospectivo de pacientes operados entre el año 2008 y el año 2011. En ese período de tiempo se intervinieron 11 pacientes con esta patología. Sólo 9 de los 11 pacientes operados pudieron ser evaluados. 7 pacientes mejoraron su sintomatología según el VAS y no progresaron a estadio II. En 3 pacientes se evidenció lesión tendinosa durante la tendoscopía y ameritaron reparación a cielo abierto. La sinovectomía tendoscópica del TTP es un procedimiento quirúrgico efectivo para tratar a los pacientes con DTTP Estadio I, rebeldes a tratamiento conservador(AU)


When conservative treatment fails for Stage I Posterior Tibial tendon dysfunction (PTTD), synovectomy and tendon debridement is indicated. In this study we evaluate tendoscopic treatment results for this pathology with a minimum of 8 years follow up. This is a retrospective study of patients after tendoscopic surgery performed between 2008 and 2011. 9 of the 11 patients were available for evaluation. 7 improved their symptoms according to VAS scale, and did not progress to stage II. In 3 patients tendon tear was visualized during tendoscopy and needed open repair. PTT tendoscopy is an effective surgical treatment to treat Stage I PTTD, failing to conservative treatment(AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Flatfoot , Magnetic Resonance Spectroscopy , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Posterior Tibial Tendon Dysfunction/pathology , Tendinopathy , Synovectomy , Ultrasonics , Cryotherapy , Diagnostic Techniques and Procedures , Debridement
5.
Rev. cuba. med ; 60(1): e1399, tab
Article in Spanish | LILACS, CUMED | ID: biblio-1156554

ABSTRACT

RESUMEN Introducción: El ultrasonido endobronquial lineal con aspiración transbronquial por aguja fina es una técnica novedosa para el diagnóstico de tumores y ganglios mediastínicos e hiliares. Objetivo: Evaluar la eficacia diagnóstica de ultrasonido endobronquial lineal con aspiración transbronquial por aguja fina como método de estudio de lesiones hiliares y mediastinales. Métodos: Se realizó un estudio descriptivo con carácter prospectivo en 49 pacientes a los que se le realizó ultrasonido endobronquial lineal con aspiración transbronquial por aguja fina. Resultados: El diagnóstico se obtuvo mediante la histología y resultaron positivos 48 pacientes, de ellos 45 fueron positivos por el ultrasonido endobronquial lineal con aspiración transbronquial por aguja fina y 4 negativos por este estudio. El resultado global de la investigación mostró una sensibilidad de 93,8 %, especificidad 100 %, valor predictivo positivo de 100 % y predictivo negativo 25 %. De esta manera, el índice de validez de ultrasonido endobronquial lineal con aspiración transbronquial por aguja fina fue de 93,8 %. El número de complicaciones fue mínimo. Conclusiones: El ultrasonido endobronquial lineal con aspiración transbronquial por aguja fina constituye un método diagnóstico eficaz y seguro en el estudio de pacientes que presentan lesiones hiliares y mediastinales con alta sospecha de cáncer de pulmón y a su vez, una alternativa de acceder al mediastino de manera no cruenta para la estadificación ganglionar.


ABSTRACT Introduction: Linear endobronchial ultrasound with transbronchial fine needle aspiration is a novel technique for the diagnosis of tumors and mediastinal and hilar lymph nodes. Objective: To evaluate the diagnostic efficacy of linear endobronchial ultrasound with transbronchial fine needle aspiration as a method of studying hila and mediastinal lesions. Methods: A prospective descriptive study was carried out in 49 patients who underwent linear endobronchial ultrasound with transbronchial fine needle aspiration. Results: The diagnosis was obtained by histology and 48 patients were positive, 45 of them resulted positive by linear endobronchial ultrasound with transbronchial fine needle aspiration and 4 resulted negative by this study. The overall result of the investigation showed a sensitivity of 93.8%, specificity 100%, a positive predictive value of 100% and a negative predictive value of 25%. Thus, the validity index of linear endobronchial ultrasound with transbronchial fine needle aspiration was 93.8%. The number of complications was minimal. Conclusions: Linear endobronchial ultrasound with transbronchial fine needle aspiration is an effective and safe diagnostic method in the study of patients with hilar and mediastinal lesions with high suspicion of lung cancer and, consecutively, it is an alternative to access the mediastinum in a non- invasive approach for lymph node staging.


Subject(s)
Humans , Male , Female , Ultrasonics/methods , Bronchoscopy/methods , Biopsy, Fine-Needle/methods , Epidemiology, Descriptive , Prospective Studies
6.
Pesqui. vet. bras ; 41: e06598, 2021. tab, graf
Article in English | ID: biblio-1340345

ABSTRACT

Objective was to evaluate the accuracy of elastography in the differentiation between normal and cataract lenses One hundred forty-five eyes of 98 dogs were divided into groups according to cataract stage. Forty-twoeyes were submitted to phacoemulsification. Biometric parameters, echogenicity and echotexture patterns of the anterior, posterior and vitreous chambers, lens and retina-choroid-sclera complexes were evaluated by ocular ultrasound in modes A and B. Deformability, and color (blue color = indicated less rigid structures, color red = more rigid structures) of the lenses were evaluated by the elastogram. The shear wave velocity (SWV; m/s) was calculated in three regions of the lens, both in the cortex and in the nucleus. The SWV of nucleus was statistically different between the normal lenses and with cataracts, and between the stages of cataract (P<0.001). Healthy lenses and incipient cataracts had a more rigid nucleus. Mature cataracts presented lowest nuclear rigidity (P<0.001). On cortical region the SWV was significantly higher (P<0.01) in intumescent and incipient cataracts. SWV less than 2.67m/s indicates cataract with a sensitivity of 72% and specificity of 94%. Values lower than 2.23m/s suggest mature cataract, with sensitivity of 71% and specificity of 76%. SWV greater than 2.66 m/s are associated with normal lenses or incipient cataract, presenting sensitivity of 94% and specificity of 84%. Qualitative method allowed differentiation between healthy and affected lenses and the classification of evolutionary stages. There was a correlation between the degree of stiffness of lens in cortical and nuclear regions (p=00165, r=0.37) and between the balanced saline solution quantitative and surgical time (P<0.01, r=0.73). Degree of stiffness of lens did not correlate with parameters of phacoemulsification. Elastographic proved feasible for evaluating the lens of dogs, characterizing the types of cataracts, and demonstrating increased stiffness of the diseased lenses.(AU)


O objetivo foi avaliar a precisão da elastografia na diferenciação entre lentes normais e de catarata. Cento e quarenta e cinco olhos de 98 cães foram divididos em grupos de acordo com o estágio de maturação da catarata. Quarenta e dois olhos foram submetidos à facoemulsificação. Parâmetros biométricos, ecogenicidade e padrões de ecotextura das câmaras anterior, posterior e vítrea, lente e complexos retina-coróide-esclera foram avaliados por ultrassonografia ocular nos modos A e B. A deformabilidade e a coloração (cor azul = indicou estruturas menos rígidas, cor vermelha = estruturas mais rígidas) das lentes foram avaliadas pelo elastograma. A velocidade da onda de cisalhamento (SWV; m/s) foi calculada em três regiões da lente, tanto no córtex quanto no núcleo. A SWV do núcleo foi estatisticamente diferente entre as lentes normais e com catarata e entre os estágios da catarata (P<0,001). Lentes saudáveis e cataratas incipientes tinham um núcleo mais rígido. Cataratas maduras apresentaram menor rigidez nuclear (P<0,001). Na região cortical, a SWV foi significativamente maior (P<0,01) nas cataratas intumescentes e incipientes. Uma SWV menor que 2,67m/s indica catarata com sensibilidade de 72% e especificidade de 94%. Valores inferiores a 2,23m/s sugerem catarata madura, com sensibilidade de 71% e especificidade de 76%. Uma SWV superior a 2,66m/s está associada à catarata normal ou incipiente, apresentando sensibilidade de 94% e especificidade de 84%. O método qualitativo permitiu a diferenciação entre lentes normais de olhos saudáveis e afetadas e a classificação dos estágios evolutivos. A elastografia se mostrara uma ferramenta viável para avaliar as lentes de cães, caracterizando os tipos de catarata e demonstrando maior rigidez das lentes doentes.(AU)


Subject(s)
Male , Dogs , Cataract/veterinary , Dogs , Elasticity Imaging Techniques/veterinary , Ultrasonics , Phacoemulsification
7.
Braz. dent. sci ; 24(3): 1-8, 2021. ilus
Article in English | LILACS, BBO | ID: biblio-1282062

ABSTRACT

Objective: To evaluate the effect of scaling procedures using different ultrasonic tips on the surface roughness, color stability and bacterial accumulation of lithium disilicate ceramic. Material and Methods: Scaling procedure was carried out using ultrasonic scaler (Satalec, Acteon, North America) with stainless-steel tip (US), titanium tip (UT) and plastic tip (UP), on disc shaped lithium disilicate samples cemented into a cavity prepared onto the labial surface of freshly extracted bovine teeth (10 samples per group). The samples were stored in coffee solution in an incubator at 37°C for 12 days, which is equivalent to 1 year of coffee consumption. The surface roughness was measured before and after the scaling procedure using a profilometer and atomic force microscopy. The color parameters were measured before and after scaling and staining procedures using VITA Easyshade Advance 4.0 according to the CIE L*a*b* color order system. The samples were then incubated with Streptococcus mutans (S. mutans) suspension. After incubation, the plates with 30 to 300 typical colonies of S. mutans were counted in a colony counter and mean values of colony forming units were obtained (CFU/mL). Results:The titanium scaling tip showed a statistically significant higher mean values of change in surface roughness ΔRa and bacterial count than the plastic scaling tip. Color changes (ΔE) were not a statistically significant among the groups. The results showed a statistically significant positive (direct) correlation between surface roughness and color change (p = 0.012) and also between surface roughness and bacterial count (p = 0.00). Conclusion: Within the limitations of this study, titanium scaling instruments cause irreversible surface alterations of lithium disilcate ceramics which was in direct correlation to the color changes and bacterial accumulation; therefore, dentists should proceed with caution when scaling lithium disilicate surfaces. The findings of the current study may indicate the need for instruments or equipment that can remove plaque and calculus without causing surface damage (AU)


Introdução: Avaliar o efeito de procedimentos de raspagem com diferentes pontas de ultrassom na rugosidade superficial, estabilidade de cor e acúmulo bacteriano em cerâmica de dissilicato de lítio. Material e Métodos: O procedimento de raspagem foi realizado usando um aparelho de ultrassom (Satalec, Acteon, América do Norte) com ponta de aço inoxidável (US), ponta de titânio (UT) e ponta de plástico (UP), em amostras de dissilicato de lítio em forma de disco cimentadas em uma cavidade preparada na superfície vestibular de dentes bovinos recém-extraídos (10 amostras por grupo). As amostras foram armazenadas em solução de café em incubadora a 37 ° C por 12 dias, o que equivale a 1 ano de consumo de café. A rugosidade da superfície foi medida antes e após o procedimento de raspagem usando um perfilômetro e um microscópio de força atômica. Os parâmetros de cor foram medidos antes e depois dos procedimentos de raspagem e armazenagem no café usando VITA Easyshade Advance 4.0 de acordo com o sistema de ordem de cores CIE L*a*b*. As amostras foram incubadas com suspensão de Streptococcus mutans (S. mutans). Após a incubação, as placas com 30 a 300 colônias típicas de S. mutans foram contadas em contador de colônias e obtidos os valores médios das unidades formadoras de colônias (UFC / mL). Resultados: A ponta de titânio mostrou valores estatisticamente maiores de mudança na rugosidade da superfície ΔRa e contagem de bactérias do que a ponta de raspagem de plástico. A mudança de cor (ΔE) não foi estatisticamente significativa entre os grupos. Os resultados mostraram uma correlação positiva (direta) estatisticamente significativa entre rugosidade superficial e alteração de cor (p = 0,012) e também entre rugosidade superficial e contagem bacteriana (p = 0,00). Conclusão: Dentro das limitações deste estudo, os instrumentos de raspagem de titânio causam alterações irreversíveis na superfície das cerâmicas de dissilicato de lítio que estão em correlação direta com as mudanças de cor e o acúmulo de bactérias. Portanto, os dentistas devem proceder com cautela ao realizar raspagem em superfícies de dissilicato de lítio. Os resultados deste estudo podem indicar a necessidade de instrumentos ou equipamentos que possam remover a placa e cálculo sem causar danos à superfície. (AU)


Subject(s)
Surface Properties , Ultrasonics , Bacterial Adhesion , Dental Scaling , Color
8.
Braz. oral res. (Online) ; 35: e003, 2021. tab, graf
Article in English | LILACS, BBO | ID: biblio-1132743

ABSTRACT

Abstract: The present study investigated the intracanal decontamination and apical extrusion of bacteria and debris from root canals instrumented with rotary and reciprocating systems (ProDesign Logic or ProDesign R), with different file diameters and using conventional syringe irrigation (CSI) or passive ultrasonic irrigation (PUI). Eighty extracted mandibular premolars were contaminated with Enterococcus faecalis and randomly assigned to eight experimental groups according to the root canal instrumentation and irrigation technique employed (n = 10): G1: Prodesign Logic 25.06; G2: Prodesign R 25.06; G3 and G4 were instrumented with the same single-file systems, respectively, using 35.05 diameters and CSI. G5, G6, G7, and G8 were instrumented like the previous groups, but with PUI. Apically extruded debris during instrumentation was collected into pre-weighed microtubes. The weight of the empty microtube was subtracted from the final weight to establish the amount of extruded debris. Bacteria from root canals and extruded debris were collected for a microbiological evaluation of colony forming units (CFU/mL). For statistical analyses, the Mann-Whitney and Kruskal-Wallis followed by the Dunn's tests were used (α = 0.05). All instruments caused extrusion of debris. For irrigation techniques, PUI promoted greater debris and bacterial extrusion (p < 0.05). The CFU/mL count indicated that the instrumentation of the experimental groups were equally effective in the decontamination of the root canal (p > 0.05). The systems tested (regarding file diameter and kinematics) were associated with similar amounts of apically extruded debris and root canal decontamination. PUI was associated with greater debris and bacterial extrusion.


Subject(s)
Humans , Root Canal Preparation , Tooth Apex , Ultrasonics , Biomechanical Phenomena , Decontamination , Dental Pulp Cavity
9.
Article in Chinese | WPRIM | ID: wpr-877670

ABSTRACT

OBJECTIVE@#To explore the impacts on weight reduction effect treated with acupoint thread embedding therapy at different tissue levels under ultrasonic guidance.@*METHODS@#A total of 70 patients with overweight or obesity were randomized into a shallow-tissue thread embedding group (35 cases, 5 cases dropped off) and a deep-tissue thread embedding group (35 cases, 4 cases dropped off). Under ultrasonic guidance, the thread was embedded in the shallow tissue level and the deep tissue level respectively. The acupoints were Zhongwan (CV 12), Xiawan (CV 10), Shuifen (CV 9), Zhongji (CV 3), etc. The thread embedding therapy was exerted once every 2 weeks, totally for 3 times. Before and 2 weeks after treatment, body mass, body mass index (BMI), waist circumference and hip circumference were recorded in the patients of the two groups separately. After each treatment, the number and the property of blood vessels under each acupoint were detected by ultrasound. Besides, the needling sensation and the intensity were scored and the adverse events were observed after thread embedding therapy.@*RESULTS@#After treatment, the reduction range of body mass, BMI and waist circumference in the deep-tissue thread embedding group were larger than those in the shallow-tissue thread embedding group successively (@*CONCLUSION@#The deep-tissue thread embedding therapy achieves the stronger


Subject(s)
Acupuncture Points , Acupuncture Therapy , Body Mass Index , Catgut , Humans , Ultrasonics , Weight Loss
10.
Rev. méd. Maule ; 36(2): 68-73, dic. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1344690

ABSTRACT

Popliteal artery aneurysms is the most frequent peripheral aneurysm, predominantly affects men over 60 years of age and has a high morbidity associated to his complications, among which are ischemic complication, which can often end in amputation of the limb. Less frequent complications such as neuropathic and venous complications, particularly deep vein thrombosis, are equally relevant. Case presentation: Patient with an aneurysm of the popliteal artery complicated by thrombosis of the adjacent popliteal vein. Color Doppler ultrasound plays a fundamental role in the diagnosis.


Subject(s)
Humans , Popliteal Artery/surgery , Popliteal Artery/diagnostic imaging , Venous Thrombosis/etiology , Ultrasonics , Bone Neoplasms/complications , Echocardiography, Doppler , Osteochondroma/complications , Aneurysm
11.
Rev. colomb. anestesiol ; 48(4): e204, Oct.-Dec. 2020. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-1144315

ABSTRACT

Abstract Introduction: The use of ultrasound in regional anesthesia has become a standard technique to improve nerve block accuracy and reduce associated complications. The literature reports a good correlation between the distance from the skin to the dura mater or the ligamentum flavum measured on ultrasound and the conventional technique of "loss of resistance". Latin American populations have not been included in the studies conducted so far but, because of differences in physical build, it is important to determine whether this correlation is maintained in the various populations. This paper offers new information about the role of ultrasound in determining the distance to the ligamentum flavum and recognizing the proximity of the dura mater to avoid accidental puncture of this structure in Latin American populations. Objective: To determine correlation and concordance in estimating the distance from the skin to the epidural space between the loss of resistance technique and ultrasound measurement. Methodology: Observational study conducted in 52 pediatric patients who received general anesthesia plus epidural analgesia for acute perioperative pain management between July 2014 and November 2015 to assess correlation and concordance between loss of resistance and ultrasound measurement of distance to the epidural space. Results: There is a correlation between distances measured using the two techniques, which appears to be higher as patient age increases. As for concordance, the study found that 0.43 cm should be added to the ultrasound measurement to achieve agreement with the distance obtained using the loss of resistance technique; however, the interval between the two measurements is 1.15 cm. Conclusions: A correlation was found between the measurement taken from the skin to the epidural space using ultrasound and the measurement obtained with the traditional needle puncture and loss of resistance technique. Although concordance was not as expected and the distance measured with ultrasound may be smaller than the real measurement with the needle, ultrasound offers good guidance regarding proximity to the epidural space.


Resumen Introducción: El uso del ultrasonido en la anestesia regional se ha convertido en una técnica estándar para mejorar la precisión de los bloqueos nerviosos y disminuir las complicaciones relacionadas con dicha anestesia. La literatura informa que hay una buena correlación entre la distancia entre la duramadre o el ligamento amarillo y la piel según el ultrasonido y la técnica convencional de "pérdida de resistencia". Los estudios realizados hasta ahora no han incluido población latinoamericana y, debido a las diferencias en la contextura física, es importante determinar si esta correlación se mantiene en varias poblaciones. Con este trabajo se aporta nueva información sobre la utilidad del ultrasonido para determinar la distancia al ligamento amarillo y advertir la cercanía de la duramadre con el fin de evitar la punción accidental de esta estructura en población latina. Objetivo: Determinar la correlación y concordancia en la estimación de la distancia de la piel al espacio epidural entre la técnica de pérdida de resistencia y la medición por ultrasonido. Metodología: Se llevó a cabo un estudio observacional en 52 pacientes pediátricos, que recibieron anestesia general más analgesia epidural para manejo del dolor agudo perioperatorio entre julio de 2014 y noviembre de 2015. Se evaluó la correlación y la concordancia de la distancia medida al espacio epidural entre la técnica de pérdida de resistencia y la distancia por ultrasonido. Resultados: Existe una correlación entre la distancia obtenida mediante las dos técnicas de medición que parece aumentar a medida que aumenta la edad de los pacientes. En cuanto a la concordancia se encontró que a la medida tomada por ultrasonido se le debería sumar 0,43 cm para que concuerde con la distancia tomada por pérdida de resistencia; no obstante, el intervalo entre ambas medidas es de 1,15 cm. Conclusiones: Encontramos una correlación entre la medida tomada desde la piel hasta el espacio epidural por ultrasonido y la tomada por la técnica tradicional de punción con aguja y pérdida de resistencia. Aunque la concordancia que hallamos no fue la esperada, y la medición del ultrasonido puede ser menor a la medición real encontrada con la aguja, es una buena guía para advertir la cercanía del espacio epidural.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Analgesia, Epidural , Pediatrics , Skin , Ultrasonics , Ultrasonography , Epidural Space , Anesthesia, General , Nerve Block
12.
Rev. cuba. ortop. traumatol ; 34(2): e298, jul.-dic. 2020. tab, ilus
Article in Spanish | LILACS, CUMED | ID: biblio-1156592

ABSTRACT

RESUMEN Introducción: Diferentes estudios relacionan el diagnóstico del ultrasonido de alta resolución con el diagnóstico artroscópico del manguito rotador, ambos métodos son favorables y muestran una alta sensibilidad y especificidad al compararlos. Objetivo: Establecer la eficacia diagnóstica entre los hallazgos ecográficos de alta resolución y el diagnóstico artroscópico de rupturas parciales y completas del manguito rotador. Métodos: Se realizó un estudio analítico transversal con el objetivo de evaluar la eficacia diagnóstica del ultrasonido de alta resolución en pacientes del Hospital Provincial General Docente Dr. Antonio Luaces Iraola, de Ciego de Ávila, con diagnóstico clínico de rupturas parciales y completas del manguito rotador, de enero del 2016 a enero del 2019. El universo estuvo constituido por 62 pacientes con diagnóstico clínico de ruptura del manguito rotador que presentaban indicaciones quirúrgicas, a los que se les indicó un estudio imagenológico con ultrasonido de alta resolución y, con posterioridad, se les realizó la intervención quirúrgica por artroscopia, que fue tomada como criterio de verdad. Resultados: Predominó el sexo masculino, con una edad media menor que los del sexo femenino. Los hallazgos diagnósticos por ambos métodos mostraron concordancia en más de dos tercios de los pacientes que presentaron rupturas parciales y completas del espesor del manguito rotador. La ultrasonografía según el método empleado resultó un medio diagnóstico eficaz para las rupturas parciales y completas del espesor del manguito rotador. Conclusiones: El ultrasonido de alta resolución presentó una adecuada correlación en el diagnóstico de lesiones parciales o completas del manguito rotador, confirmada por artroscopia y es considerado un medio diagnóstico eficaz(AU)


ABSTRACT Introduction: Different studies relate the diagnosis of high-resolution ultrasound with the arthroscopic diagnosis of the rotator cuff. Both methods are favorable and show high sensitivity and specificity when they are compared. Objective: To establish diagnostic efficacy between the findings of high-resolution ultrasound and the arthroscopic diagnosis of partial and complete ruptures of the rotator cuff. Methods: A cross-sectional analytical study was carried out, aimed at evaluating the diagnostic efficacy of high-resolution ultrasound in patients of Dr. Antonio Luaces Iraola Provincial General Teaching Hospital, in Ciego de Ávila, with a clinical diagnosis of partial and complete ruptures of the rotator cuff, from January 2016 to January 2019. The universe consisted of 62 patients with a clinical diagnosis of rotator cuff rupture who presented surgical indications, and who were also indicated for an imaging study with high-resolution ultrasound and, subsequently, performed arthroscopic surgery, taken as a criterion of truth. Results: The male sex predominated, with an average age lower than those corresponding to female sex. The diagnostic findings by both methods showed agreement in more than two thirds of the patients who presented partial and complete ruptures of the rotator cuff's thickness. Ultrasonography, according to the method used, was an effective diagnostic tool for partial and complete ruptures of the rotator cuff's thickness. Conclusions: High-resolution ultrasound showed an adequate correlation in the diagnosis of partial or complete ruptures of rotator cuff, as confirmed by arthroscopy. It is considered an effective diagnostic means(AU)


Subject(s)
Humans , Male , Female , Arthroscopy/methods , Ultrasonics/methods , Rotator Cuff Injuries/surgery , Rotator Cuff Injuries/diagnostic imaging , Cross-Sectional Studies
14.
Dent. press endod ; 10(2): 10-19, maio-ago.2020. Ilus
Article in English | LILACS | ID: biblio-1344302

ABSTRACT

Os canais radiculares, quando não tratados, podem ter um impacto direto na previsibilidade do tratamento endodôntico. Hoje, já se sabe que o canal mesiovestibular 2 (MV2) é o mais esquecido sem tratamento durante a terapia endodôntica e, quando isso acontece, a probabilidade de aparecimento de doença inflamatória na região periapical é de 4,5 a 6,5 vezes maior do que em dentes que tiveram todos os canais tratados. Sendo assim, o clínico deve conhecer informações importantes relacionadas às complexidades anatômicas que dificultam o acesso e exploração desse canal, bem como conhecer manobras que facilitam o seu tratamento, uma vez que localizar e negociar o MV2 sempre foi um grande desafio. O objetivo do presente estudo é mostrar os principais obstáculos enfrentados para localizar e tratar o canal MV2, e orientar como essas dificuldades podem ser superadas no dia a dia da clínica endodôntica (AU).


When not treated, root canals may affect the predictability of endodontic treatments directly. The second mesiobuccal root canal (2MB) is the canal most often missed and left untreated during endodontic treatments. The probability of inflammatory disease in the periapical region in these cases is 4.5 to 6.5 times greater than in teeth that have all canals treated. Therefore, clinical dentists should know the anatomical complexities that may complicate root canal access and exploration. As 2MB detection and negotiation are a great challenge, they should also be familiar with the procedures that facilitate treatment. This study describes the main obstacles to the location and treatment of the 2MB canal and discusses how these obstacles may be overcome in routine endodontic practice (AU).


Subject(s)
Cuspid , Dentists , Endodontics , Therapeutics , Ultrasonics
15.
Rev. chil. radiol ; 26(2): 46-51, jun. 2020. graf
Article in Spanish | LILACS | ID: biblio-1126193

ABSTRACT

Resumen: La llegada de la pandemia COVID-19 originada por el virus SARS-CoV-2 ha requerido de una rápida respuesta de múltiples especialidades médicas, incluída la Imagenología. El Ultrasonido pulmonar es una técnica que previamente ha demostrado utilidad en otras patologías pulmonares, la cual ofrece alta disponibilidad, bajo costo, ausencia de radiaciones ionizantes y la posibilidad de evaluar al paciente in situ. En algunos de los países afectados más temprana e intensamente por la pandemia, como China e Italia, se ha utilizado como estudio imagenológico complementario para evaluación y seguimiento de los pacientes afectados por esta patología. Para obtener un resultado satisfactorio es necesario seleccionar el equipamiento, protección, desinfección y protocolo adecuados. Los hallazgos ecográficos descritos hasta el momento en la literatura son de carácter inespecífico, pero su combinación y distribución anatómica en un contexto clínico y epidemiológico compatible, los hacen sugerentes de esta enfermedad y permiten evaluar en forma seriada la evolución del cuadro. La literatura disponible es incipiente y es necesaria la generación de más evidencia para cuantificar adecuadamente el aporte de esta modalidad de estudio en los pacientes con COVID-19.


Abstract: The arrival of the COVID-19 pandemic originated by the SARS-CoV-2 virus has required a quick response by multiple medical specialties, including Imaging. Lung Ultrasound is an exam that has previously demonstrated its utility in other lung diseases, with high availability, low cost, absence of ionizing radiation and the possibility to have a bed-side assessment. In some of the countries that experienced earlier and more intense effects of the pandemic, as China and Italy, it has been used as an imaging modality for evaluation and follow-up for COVID-19 patients. In order to achieve a satisfactory result, adequate equipment, protection, disinfection and protocol must be chosen. The US findings described so far in the literature are nonspecific, but their combination and anatomical distribution in a compatible clinical and epidemiologic context, made them highly suggestive of this disease and allow for a serial follow-up. The current literature is scarce and more evidence is needed to truly estimate the usefulness of this imaging modality in the evaluation of COVID-19 patients.


Subject(s)
Humans , Pneumonia, Viral/diagnostic imaging , Ultrasonics , Coronavirus Infections/diagnostic imaging , Lung/diagnostic imaging , Pandemics
16.
Rev. chil. radiol ; 26(2): 52-61, jun. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1126194

ABSTRACT

Resumen: La tendinopatía cálcica es causada por el depósito patológico de cristales de hidroxiapatita de calcio en los tendones y es una causa común de dolor en las articulaciones. Afecta más frecuentemente al hombro y la cadera, con hallazgos característicos en imágenes; sin embargo, cualquier tendón puede estar involucrado. Ocasionalmente, la tendinopatía cálcica puede simular patología agresiva, como infección o neoplasia, especialmente en RM. Fisiotpatológicamente, las calcificaciones provendrían de una diferenciación anormal de las células madre del tendón, que comienzan a producir calcio, aunque todavía no es del todo claro. Los radiólogos deben estar familiarizados con los hallazgos de las imágenes para distinguir la tendinopatía cálcica de procesos más agresivos. La aspiración y lavado guiado bajo ecografía es una técnica útil realizada por el radiólogo para el tratamiento de casos sintomáticos. La familiaridad con estos procedimientos y su apariencia en imágenes es un aspecto importante en el manejo de esta enfermedad. El propósito de esta revisión es analizar la etiopatogenia de la tendinopatía cálcica, la evaluación con imágenes en los sitios de presentación más comunes y también en los menos frecuentes, así como el papel que desempeña la ecografía en el tratamiento de la patología.


Abstract: Calcific tendinitis is caused by abnormal deposition of calcium hydroxyapatite crystals in tendons and is a common cause of joint pain. The disease typically affects the shoulder and hip, with characteristic imaging findings; however, any tendon can be involved. Occasionally, calcific tendinitis can mimic aggressive disorders, such as infection and neoplasm, especially on MRI. Apparently, the calcifications come from an abnormal differentiation of the tendon stem cells, which begin to produce calcium. Radiologists should be familiar with the imaging findings to distinguish calcific tendinitis from more aggressive processes. Image-guided percutaneous needle aspiration is a useful technique performed by the radiologist for the treatment of symptomatic cases. Being familiar with these processes and their imaging appearance is an important aspect in the management of this common disease. The purpose of this review is to analyze the pathogenesis of calcium tendinopathy, the evaluation of images in both the most common and less frequent presentation sites, as well as the role played by ultrasound in the treatment of pathology.


Subject(s)
Humans , Calcinosis/etiology , Calcinosis/diagnostic imaging , Rotator Cuff/diagnostic imaging , Tendinopathy/etiology , Tendinopathy/diagnostic imaging , Ultrasonics , Calcinosis/classification , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Tendinopathy/classification
18.
Braz. J. Vet. Res. Anim. Sci. (Online) ; 57(2): e166204, mai. 2020. ilus, graf
Article in English | ID: biblio-1122176

ABSTRACT

Medical management of abdominal abscesses in horses requires prolonged antibiotic therapy and presents varied success rates. A 6-year-old male horse with a history of colic and multiple abdominal punctures to relieve gas was attended. At admission, tachycardia, tachypnea, hyperthermia, mucosal congestion, dehydration, and rigid gait were observed. The association of physical examination, laboratory and ultrasonographic findings allowed the diagnoses of peritonitis and abdominal abscess. Supporting treatment plus broad spectrum antibiotic therapy was performed: daily intraperitoneal ceftriaxone (25 mg/kg, 7 days); daily intravenous gentamicin (6.6 mg/kg, 7 days); per os metronidazole three times a day (15 mg/kg 12 days), followed by the same dose twice a day (15 mg/kg 33 days), totaling 45 days of treatment. Plasma fibrinogen and ultrasonographic examination were the most effective tools to evaluate abscess evolution. There was normalization of the physical examination 24 h after beginning the treatment, consecutive regression of the nucleated cell count in the peritoneal fluid, and regression of plasma fibrinogen and size of the abscess. On the 10th treatment day, the animal was discharged from the hospital, maintaining oral therapy with metronidazole every 12 h (15 mg / kg). When the animal returned on the 30th day, an abscess size regression was observed. However, there was no resolution, and therapy with metronidazole was maintained. On the 45th day of treatment, a new hospital evaluation was performed, where the abscess resolved, and metronidazole was suspended. It is highlighted that the therapeutic association used in the treatment of abdominal infection and abscess resulted in a rapid clinical response.(AU)


O tratamento conservativo dos abscessos abdominais em equinos requer antibioticoterapia prolongada e apresenta variadas taxas de sucesso. Foi atendido um cavalo de seis anos de idade, com histórico de cólica e múltiplas punções abdominais por agulha para esvaziamento de gás. Na admissão, foram observados taquicardia, taquipnéia, hipertermia, congestão mucosa, desidratação e marcha rígida. A associação do exame físico, achados laboratoriais e ultrassonográficos permitiu o diagnóstico de peritonite e abscesso abdominal. Foi realizado tratamento suporte e antibioticoterapia de amplo espectro: ceftriaxona intraperitoneal diária (25 mg/kg, 7 dias); gentamicina intravenosa diária (6,6 mg/kg, 7 dias); metronidazol oral três vezes ao dia (15 mg/kg, 12 dias), seguido de mesma dose duas vezes ao dia, por mais 33 dias, totalizando 45 dias de tratamento. O fibrinogênio plasmático e o exame ultrassonográfico foram os recursos mais eficazes para a avaliação da evolução do abscesso. Após 24 horas do início do tratamento foi constatada a normalização do exame fisico, regressão progressiva da contagem de células nucleadas no líquido peritoneal, do fibrinogênio plasmático e do tamanho do abscesso. No 10° dia de tratamento o animal recebeu alta hospitalar, mantendo-se a terapia oral com metronidazol a cada 12 horas (15 mg/Kg). Em retorno, ao 30° dia, observou-se regressão do tamanho do abscesso, entretanto, não houve resolução, tendo sido mantida a terapia com metronidazol. No 45º dia de tratamento, realizou-se nova avaliação hospitalar, onde foi observada a resolução do abscesso e a admnistração do metronidazol foi suspensa. Destaca-se, que a associação terapêutica utilizada no tratamento de infecção abdominal e abscesso resultou em rápida resposta clínica.(AU)


Subject(s)
Animals , Peritonitis/veterinary , Ceftriaxone/administration & dosage , Gentamicins/administration & dosage , Abdominal Abscess/veterinary , Horses , Metronidazole/administration & dosage , Ultrasonics , Fibrinogen , Injections, Intraperitoneal/veterinary
19.
Dent. press endod ; 10(1): 43-48, Jan-Apr2020.
Article in English | LILACS | ID: biblio-1344213

ABSTRACT

Avaliar o efeito da ativação ultrassônica e do veículo do MTA no pH dentinário em dentes com reabsorção radicular externa simulada. Métodos: Uma cavidade foi preparada na superfície radicular de 46 dentes bovinos, as quais foram seladas com MTA preparado com 100% de água destilada (DW) ou com 80% DW e 20% de propilenoglicol (PG). Os dentes foram divididos em quatro grupos (n = 10), de acordo com o veículo e o protocolo de ativação ultrassônica utilizado durante a inserção do material (ativação ou sem ativação). O grupo controle (n = 6) foi deixado sem selamento. O pH foi mensurado após 15, 30 e 60 dias de imersão. Resultados: A ativação com ultrassom não alterou significativamente o pH (p>0,05). Os cimentos manipulados utilizando DW + PG apresentaram maior pH aos 15 dias, em relação ao MTA manipulado com DW (p<0,05). Conclusão: A associação de 80% de água destilada com 20% de propilenoglicol aumentou o pH dentinário, o que é positivo para o reparo de reabsorções radiculares (AU).


The aim of this study was to evaluate the effect of ultrasonic activation and MTA vehicle on dentinal pH in simulated external root resorptions. So, a cavity was prepared in the root of forty-six bovine teeth. They were filled with MTA mixed with 100% distilled water (DW) or MTA mixed with 80% DW and 20% propylene glycol (PG). Teeth were divided into four groups (n = 10), according to the vehicle (DW or PG) and ultrasonic protocol used for material insertion (activated or not). Control group (n = 6) was unfilled. The pH was assessed after 15, 30 and 60 days of immersion. As results of all that, activation with ultrasound did not significantly alter the pH (p > 0.05). The cements were mixed with either DW or DW + PG, with the later association presenting higher pH at 15 days of assessment than the former (p < 0.05). Thereby, it can be concluded that mixing MTA with 80% DW and 20% PG increased the dentinal pH, which is positive for root resorption repair (AU).


Subject(s)
Animals , Cattle , Root Resorption , Ultrasonics , Biocompatible Materials , Propylene Glycol
20.
Dent. press endod ; 10(1): 62-67, Jan-Apr2020. Ilus
Article in English | LILACS | ID: biblio-1344283

ABSTRACT

Alterações morfológicas podem influenciar adversamente o sucesso do tratamento endodôntico. O incisivo lateral superior caracteriza-se pela presença de um canal e uma única raiz. A interpretação cuidadosa das radiografias, associada a recursos de iluminação e ampliação, é de extrema importância para detecção de variações anatômicas. Objetivo: O objetivo do presente relato de caso foi descrever o retratamento endodôntico não usual de um incisivo lateral superior com duas raízes. Relato de caso: O microscópio operatório foi de fundamental importância para a realização do novo tratamento. Para remoção do material obturador, foram utilizados solvente, limas manuais e pontas de ultrassom, reinstrumentação com limas manuais tipo K de aço inoxidável e obturação com guta-percha e cimento Pulp Canal Sealer, por meio da técnica de termoplastificação. Conclusão: O prognóstico favorável foi confirmado após acompanhamento de 216 meses (AU).


Morphological changes in teeth may adversely affect the success of endodontic treatment. The upper lateral incisors are characterized by the presence of a canal and a single root. Several studies have reported variations in the number of roots and canals. A careful interpretation of radiographs under enhanced illumination and magnification is of extreme importance for detecting these anatomic variations. this report aimed to describe a clinical case of unusual endodontic retreatment of an upper lateral incisor with two roots. The operative microscopy played a fundamental role in accomplishing the new treatment. The procedure involved the use of solvents, manual files, and ultrasonic tips to remove the obturator, and instrumentation of root canals with stainless steel type K manual files. Root canals were obturated with gutta-percha and Pulp Canal Sealer cement using the thermoplastic technique. A favorable prognosis was confirmed after a follow-up of 216 months (AU).


Subject(s)
Humans , Female , Aged , Ultrasonics , Retreatment , Endodontics , Lifting , Gutta-Percha , Anatomy , Microscopy
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