ABSTRACT
O odontoma é o mais comum tumor odontogênico, definido como malformação benigna, geralmente descoberto na segunda década de vida, durante a investigação de erupção tardia de dentes adjacentes ou retenção prolongada de dentes decíduos. O odontoma é subdividido em composto e complexo. O Odontoma classificado como Composto é constituído por um conjunto de estruturas similares a dentes, de formas e tamanhos diversos, cercados por uma área delgada radiolúcida. Já o Odontoma Complexo se assemelha a uma massa calcificada que apresenta a mesma radiopacidade do tecido dentário, também cercado por uma área delgada radiolúcida. Ocasionalmente, esses dois aspectos podem ser vistos em uma mesma lesão. Frequentemente os odontomas podem provocar um aumento de volume ósseo local devido ao seu desenvolvimento. O diagnóstico é feito através de exames radiográficos de rotina e quando necessário pode-se também lançar mão de Radiografias Panorâmicas e Tomografia Computadorizada Cone Beam com o intuito de verificar sua extensão, as malformações e alterações de erupção causadas aos dentes adjacentes, assim como a classificação do tumor. Este relato de caso apresenta um Odontoma Composto-Complexo em um paciente de 13 anos, do sexo masculino, atendido em 2016 na Clínica de Diagnóstico Bucal II da Universidade Federal Fluminense, que apresentou elementos dentários 22 e 23 impactados, retenção prolongada do elemento 63 e aumento de volume na região anterior do lado esquerdo da maxila. Para obtenção do diagnóstico foram realizadas: Radiografias Periapicais, Radiografia Panorâmica e Tomografia Computadorizada Cone Beam. O objetivo deste trabalho foi elucidar as formas de diagnóstico por imagem que foram utilizadas neste caso clínico e quais as vantagens de cada exame.
Odontomas are the most common type of odontogenic tumors, defined as a benign malformation, usually diagnosed in the second decade of life, during the investigation of late adjacent teeth eruption or a delay in exfoliation of deciduous teeth. They are divided into two types: compound and complex. The odontoma classified as compound is composed of multiple small tooth-like structures, in several shapes and sizes, surrounded by a thin radiolucent rim. On the other hand, complex odontomas resemble a mass of calcified tissue that presents the same dental tissue radiopacity, also surrounded by a thin radiolucent rim. Occasionally, both aspects can be seen in the same lesion. Often, odontomas can cause a local increase in bone volume due to their development. The diagnosis is made through routine radiographic examination and, when it is necessary, it is possible to make use of panoramic radiographies and cone beam computed tomography with the purpose of verifying its extension, malformations and erupted alterations caused to the adjacent teeth, as well as the tumor classification. This case report presents a Compound-Complex Odontoma in a 13-year-old male patient, treated in 2016 at the Oral Diagnosis Clinic II of the Federal Fluminense University. He presented impacted teeth 22 and 23, delayed eruption of tooth 63 and volume increase in the left anterior maxilla site. Aiming the patient's diagnosis, the following exams were necessary: periapical radiographies, panoramic radiography, cone beam computed tomography. The aim of this paper is to explain the different image diagnostic tools which were used in this clinical study and what are the advantages of each exam.
Subject(s)
Humans , Male , Adolescent , Tooth, Impacted , X-Rays , Diagnostic Imaging , Radiography, Panoramic , Odontoma , Cone-Beam Computed TomographyABSTRACT
OBJECTIVE@#To compare the clinical effects of pulpotomy with two kinds of calcium silicate materials, and to evaluate the formation of dentin bridge and pulp calcification after pulpotomy of adult permanent teeth.@*METHODS@#Patients who visited the General Department of Peking University School and Hospital of Stomatology from November 2017 to September 2019 and planned for pulpotomy on permanent premolars and molars with carious exposed pulp were selected. They were randomly divided into two groups. Bioceramic putty material iRoot BP (iRoot group, n=22) and mineral trioxide aggregate MTA (MTA group, n=21) were used as pulp capping agents, respectively. The patients were recalled after one year and two years. The clinical efficacy, dentin bridge index (DBI) and pulp calcification index (PCI) were recorded. Blinding method was used for the patients and evaluators.@*RESULTS@#There was no significant difference in gender, mean age, dentition and tooth position between the two groups (P>0.05). Seven cases were lost during the first year (4 cases in iRoot group and 3 cases in MTA group). In the iRoot group, 1 case had transient sensitivity at the time of 1-year follow-up. The cure rate of the two groups was 100% at the time of 2-year follow-up. The proportion of dentin bridge formation was 38.9% one year after operation, 55.6% two years after operation. The proportion of partial or even complete disappearance of root canal image was 5.6% before operation, 38.9% and 55.6% one and two years after operation, respectively. The difference was statistically significant by rank sum test (P < 0.05). There was no significant difference in dentin bridge formation and pulp calcification between the two groups (P < 0.05). DBI and PCI after operation was as the same as those before operation (44.4% cases of DBI and 25% cases of PCI) or gradually increased (55.6% cases of DBI and 75% cases of PCI). Spearman's nonparametric correlation analysis showed that age was positively correlated with preoperative pulp calcification index (PCI0, P < 0.05), but not with the dentin bridge index (DBI1, DBI2), pulp calcification index (PCI1, PCI2) and the degree of change (DBI2 vs. DBI1, PCI1 vs. PCI0, PCI2 vs. PCI0) 1-year and 2-year after operation (P>0.05).@*CONCLUSION@#According to this study, good clinical effects were obtained within 2-year after pulpotomy of adult permanent teeth with MTA and iRoot. In some cases, the root canal system had a tendency of calcification aggravation, and there was no statistical difference in the development of this trend between the two groups.
Subject(s)
Humans , Adult , Pulpotomy/methods , X-Rays , Calcium Compounds/therapeutic use , Dentition, Permanent , Molar/surgery , Treatment Outcome , Silicates/therapeutic use , Aluminum Compounds/therapeutic use , Oxides , Drug Combinations , Dental Pulp CappingABSTRACT
OBJECTIVE@#To investigate the difference in sensitivity between X-ray and three-dimensional reconstruction of computed tomography (3D-CT) for the diagnosis of distal fibular avulsion fracture, and the radiographic presentation of the ossicle.@*METHODS@#From January to October 2018, 92 patients with distal fibular avulsion fracture were visited for surgical treatment in Department of Sports Medicine, Peking University Third Hospital, and 60 cases were finally enrolled according to the inclusion and exclusion criteria. Intraoperative detection was regarded as the gold standard, and the diagnostic sensitivity of preoperative ankle X-ray and 3D-CT for the distal fibular avulsion fractures was statistically determined. The ossicle maximum diameter as well as the degree of its displacement were also measured. On 3D-CT, the distance from the ossicle center point to the anterior fibular tuberosity (a), the distance to the fibular tip (b), and the a/b value was used to present the ossicle displacement.@*RESULTS@#Among the 60 patients, 36 and the 52 patients were correctly detected by X-ray and 3D-CT, respectively, and the sensitivities was 60.0% and 86.7%, respectively (P=0.004). The mean diameter of the ossicle on X-ray and 3D-CT was (9.2±3.9) mm and (10.5±3.2) mm, respectively. The mean distance from the ossicle center to the anterior fibular tuberosity (a) was (17.5±3.6) mm and the mean distance to the fibular tip (b) was (17.4±4.8) mm, with mean a/b values of 1.1±0.7. The intraclass correlation coefficients (ICC) for each measurement ranged from 0.891-0.998 with a high degree of consistency.@*CONCLUSION@#Compared with X-ray, 3D-CT has higher sensitivity in diagnosing distal fibular avulsion fractures, can help clinicians evaluate ossicle's location and choose surgical methods, and is recommended to be performed in patients with suspected distal fibula avulsion fractures in clinical practice.
Subject(s)
Humans , Fibula/surgery , Fractures, Avulsion , Ankle , X-Rays , Imaging, Three-Dimensional , Ankle Fractures , Ankle Joint , Tomography, X-Ray ComputedABSTRACT
OBJECTIVE@#To analyze the malfunction and maintenance process of Carestream digital X-ray machine DRX-NOVA for reference.@*METHODS@#The fault of Carestream digital X-ray machine DRX-NOVA in 2011-2021 was summarized, the fault types were classified, and the maintenance process was summarized.@*RESULTS@#Fault types can be divided into three categories, each of which has its own characteristics and specific solutions.@*CONCLUSIONS@#It is necessary to master the principle of equipment to repair all kinds of equipment failures. Repair the machine should be careful, comprehensive consideration of the cause of the failure. To correctly understand and analyze the operation of the machine under normal conditions, we can accurately analyze the cause of failure, so that we can really solve the problem.
Subject(s)
X-Rays , Radiography , Radiographic Image Enhancement , Equipment FailureABSTRACT
OBJECTIVE@#To investigate the status of depression and social anxiety in children and adolescents, and to analyze the association between body fat distribution and depression, social anxiety in children and adolescents.@*METHODS@#A total of 1 412 children aged 7 to 18 years in Beijing were included by stratified cluster random sampling method. Body fat distribution, including total body fat percentage (total BF%), Android BF%, Gynoid BF% and Android-to-Gynoid fat ratio (AOI), were obtained by dual-energy X-ray absorption method. Depression and social anxiety were evaluated by Children Depression Inventory and Social Anxiety Scale for Children. Multivariate linear regression and restricted cubic spline analysis were used to estimate the linear and non-linear correlation between body fat distribution and depression and social anxiety.@*RESULTS@#13.1% and 31.1% of the children and adolescents had depressive symptoms and social anxiety symptoms respectively, and the detection rate of depression and social anxiety in the boys and young groups was significantly lower than those in the girls and old groups. There was no significant linear correlation between total BF%, Android BF%, Gynoid BF%, AOI and depression and social anxiety in the children and adolescents. However, total BF% and Gynoid BF% had significant nonlinear correlation with depression, showing an inverted U-shaped curve relationship with the tangent points of 26.8% and 30.9%, respectively. In terms of the nonlinear association of total BF%, Android BF%, Gynoid BF% and AOI with depression and social anxiety, the change trends of the boys and girls, low age group and high age group were consistent. The overall anxiety risk HR of body fat distribution in the boys was significantly higher than that in the girls, and the risk HR of depression and social anxiety were significantly higher in the high age group than those in the low age group.@*CONCLUSION@#There was no significant linear correlation between body fat distribution and depression and social anxiety in children and adolescents. Total BF% and depression showed an inverted U-shaped curve, mainly manifested in Gynoid BF%, and this trend was consistent in different genders and different age groups. Maintaining children and adolescents' body fat distribution at an appropriate level is the future direction of the prevention and control of depression and social anxiety in children and adolescents.
Subject(s)
Humans , Female , Child , Male , Adolescent , Cross-Sectional Studies , X-Rays , Depression/epidemiology , Absorptiometry, Photon/methods , Body Mass Index , Body Fat Distribution , Anxiety/epidemiology , Adipose Tissue , Body CompositionABSTRACT
Precise segmentation of lung field is a crucial step in chest radiographic computer-aided diagnosis system. With the development of deep learning, fully convolutional network based models for lung field segmentation have achieved great effect but are poor at accurate identification of the boundary and preserving lung field consistency. To solve this problem, this paper proposed a lung segmentation algorithm based on non-local attention and multi-task learning. Firstly, an encoder-decoder convolutional network based on residual connection was used to extract multi-scale context and predict the boundary of lung. Secondly, a non-local attention mechanism to capture the long-range dependencies between pixels in the boundary regions and global context was proposed to enrich feature of inconsistent region. Thirdly, a multi-task learning to predict lung field based on the enriched feature was conducted. Finally, experiments to evaluate this algorithm were performed on JSRT and Montgomery dataset. The maximum improvement of Dice coefficient and accuracy were 1.99% and 2.27%, respectively, comparing with other representative algorithms. Results show that by enhancing the attention of boundary, this algorithm can improve the accuracy and reduce false segmentation.
Subject(s)
X-Rays , Algorithms , Diagnosis, Computer-Assisted , Thorax/diagnostic imaging , Lung/diagnostic imaging , Image Processing, Computer-AssistedABSTRACT
OBJECTIVE@#To explore the feasibility and accuracy of ultrasound volume navigation (UVN) combined with X-ray fluoroscopy-guided percutaneous pedicle screw implantation through a prospective randomized controlled study.@*METHODS@#Patients with thoracic and lumbar vertebral fractures scheduled for percutaneous pedicle screw fixation between January 2022 and January 2023 were enrolled. Among them, 60 patients met the selection criteria and were included in the study. There were 28 males and 32 females, with an average age of 49.5 years (range, 29-60 years). The cause of injury included 20 cases of traffic accidents, 21 cases of falls, 17 cases of slips, and 2 cases of heavy object impact. The interval from injury to hospital admission ranged from 1 to 5 days (mean, 1.57 days). The fracture located at T 12 in 15 cases, L 1 in 20 cases, L 2 in 19 cases, and L 3 in 6 cases. The study used each patient as their own control, randomly guiding pedicle screw implantation using UVN combined with X-ray fluoroscopy on one side of the vertebral body and the adjacent segment (trial group), while the other side was implanted under X-ray fluoroscopy (control group). A total of 4 screws and 2 rods were implanted in each patient. The implantation time and fluoroscopy frequency during implantation of each screw, angle deviation and distance deviation between actual and preoperative planned trajectory by imaging examination, and the occurrence of zygapophysial joint invasion were recorded.@*RESULTS@#In terms of screw implantation time, fluoroscopy frequency, angle deviation, distance deviation, and incidence of zygapophysial joint invasion, the trial group showed superior results compared to the control group, and the differences were significant ( P<0.05).@*CONCLUSION@#UVN combined with X-ray fluoroscopy-guided percutaneous pedicle screw implantation can yreduce screw implantation time, adjust dynamically, reduce operational difficulty, and reduce radiation damage.
Subject(s)
Male , Female , Humans , Middle Aged , Pedicle Screws , Prospective Studies , X-Rays , Surgery, Computer-Assisted/methods , Spinal Fusion/methods , Fluoroscopy/methods , Lumbar Vertebrae/injuriesABSTRACT
Objetivo. Apontar para a forma como a sonda nasoenteral serve a várias finalidades, entre as quais estão a própria alimentação enteral, a administração de drogas, como meio de contraste ou carvão ativado, para fins de aspiração do conteúdo do estômago para descomprimir o estômago de fluido, ar ou sangue, para reduzir o risco de vômito ou aspiração e para outros fins. Método: Revisão de literatura, descritiva exploratória, escolhidas, pois descreve, discute e analisa de forma ampla a literatura publicada sobre o tema, sob o ponto de vista teórico ou contextual a respeito da relevância do diagnóstico por imagem radiológica nestes casos. Resultados: Deve-se garantir a segurança do paciente, para isso é essencial confirmar que a sonda foi introduzida de maneira correta e está no devido local (estômago ou parte do intestino), uma vez que a sonda pode inadvertidamente ter sido inserida nos pulmões, o que pode passar desapercebido em pacientes de alto risco. Conclusão: Deve-se usar a sonda naso/oro para terapia nutricional, além de se prevenir eventos adversos para que o processo seja efetivo.
Objective. Point out how the nasoenteral tube serves various purposes, among which are enteral feeding itself, administration of drugs such as contrast medium or activated charcoal, for the purpose of aspiration of stomach contents to decompress the stomach of fluid, air or blood, to reduce the risk of vomiting or aspiration, and for other purposes. Method: Literature review, descriptive and exploratory, chosen because it describes, discusses and analyzes widely the published literature on the subject, from a theoretical or contextual point of view regarding the relevance of radiological imaging diagnosis in these cases. Results: Patient safety must be ensured, for this it is essential to confirm that the tube has been inserted correctly and is in the right place (stomach or part of the intestine), since the tube may have been inadvertently inserted into the lungs, which may go unnoticed in high-risk patients. Conclusion: The naso/oro tube should be used for nutritional therapy, in addition to preventing adverse events for the process to be effective
Objetivo. Señalar cómo la sonda nasoenteral sirve para varios fines, entre los que se encuentran la alimentación enteral en sí, la administración de fármacos como medio de contraste o carbón activado, con el fin de aspirar el contenido del estómago para descomprimir el estómago de líquido, aire o sangre, para reducir la riesgo de vómito o aspiración, y para otros fines. Método: Revisión bibliográfica, descriptiva y exploratoria, elegida porque describe, discute y analiza ampliamente la literatura publicada sobre el tema, desde un punto de vista teórico o contextual respecto a la relevancia del diagnóstico por imágenes radiológicas en estos casos. Resultados: Se debe garantizar la seguridad del paciente, para ello es fundamental confirmar que la sonda se ha insertado correctamente y está en el lugar correcto (estómago o parte del intestino), ya que la sonda puede haber sido introducida inadvertidamente en los pulmones, que puede pasar desapercibido en pacientes de alto riesgo. Conclusión: La sonda naso/oro debe ser utilizada para la terapia nutricional, además de prevenir eventos adversos para que el proceso sea efectivo.
Subject(s)
X-Rays , Enteral Nutrition , Nutrition TherapyABSTRACT
Abstract Solid dispersions (SDs) of ursolic acid (UA) were developed using polyvinylpyrrolidone K30 (PVP K30) in combination with non-ionic surfactants, such as D-α-tocopherol polyethylene glycol 1000 succinate (TPGS) or poloxamer 407 (P407) with the aim of enhancing solubility and in vitro release of the UA. SDs were investigated using a 24 full factorial design, subsequently the selected formulations were characterized for water solubility, X-ray diffractometry (XRD), differential scanning calorimetry (DSC), particle diameter, scanning electron microscopy, drug content, physical-chemical stability and in vitro release profile. SDs showed higher UA water-solubility than physical mixtures (PMs), which was attributed by transition of the drug from crystalline to amorphous or molecular state in the SDs, as indicated by XRD and DSC analyses. SD1 (with P407) and SD2 (with TPGS) were chosen for further investigation because they had higher drug load. SD1 proved to be more stable than SD2, revealing that P407 contributed to ensure the stability of the UA. Furthermore, SD1 and SD2 increased UA release by diffusion and swelling-controlled transport, following the Weibull model. Thus, solid dispersions obtained with PVP k-30 and P407 proved to be advantageous to enhance aqueous solubility and stability of UA.
Subject(s)
Polyethylene Glycols/administration & dosage , Solubility , Poloxamer/adverse effects , Diffusion , X-Rays/adverse effects , In Vitro Techniques , Calorimetry, Differential Scanning/methods , Pharmaceutical Preparations/analysis , Microscopy, Electron, Scanning/methodsABSTRACT
ABSTRACT Objective: Evaluate the radiographic results of patients with cerebral palsy and Lonstein and Akbarnia type II scoliosis who underwent intraoperative halofemoral traction (IFAT) and correction with a 3rd provisional nail. Methods: Retrospective case series study. Were evaluated preoperative (PRE), traction (TR), immediate (POI), and late (POT) total spine radiographs. Were verified the angular value of the main curve (COBB), pelvic obliquity (OP), trunk balance in the coronal plane (CSVA), vertical sagittal alignment (SVA), curve flexibility, and percentage of correction in the final PO. Friedam and Wilcoxon tests were performed (p<0.05). Results: Twenty-one patients were included in the study, with a mean age of 16 (±4.13). There was a statistical difference when comparing COBB PRE with TRACTION to POI and POT (p=0.0001), OP in PRE with TRACTION, and between PRE and POT (p=0.0001). There was a statistical difference in coronal (CSVA) and sagittal (SVA) balance concerning PRE and POT. The percentage of correction for the main curve was 55.75% (± 11.11), and for the O P, 64.86% (± 18.04). Conclusion: The correction technique using the 3rd provisional nail technique and intraoperative traction presents a correction power of 55.75% of the proximal curve and 64% of the pelvic obliquity. In addition, it is easy to assemble, has a short surgical time, and causes little loss of correction during follow-up. Level of Evidence III B; I study a series of retrospective cases.
Resumo: Objetivo: Avaliar os resultados radiográficos de pacientes com paralisia cerebral e escoliose tipo II de Lonstein e Akbarnia submetidos à tração halo-femoral intra-operatória (THFI) e correção com 3ª haste provisória. Métodos: Estudo série de casos retrospectivo. Foram avaliadas radiografias de coluna total pré-operatórias (PRÉ), sob tração (TR), pós-operatória imediata (POI) e tardia (POT). Verificou-se valor angular da curva principal (COBB), obliquidade pélvica (OP), equilíbrio do tronco no plano coronal (CSVA), alinhamento sagital vertical (SVA), flexibilidade da curva e percentual de correção no PO final. Foram realizados os testes de Friedam e Wilcoxon (p<0,05). Resultados: Vinte e um pacientes foram incluídos no estudo, com idade média de 16 (±4,13) anos. Houve diferença estatística quando se comparou: COBB PRÉ com TRAÇÃO em relação ao POI e POT (p=0,0001), OP no PRÉ com TRAÇÃO e entre o PRÉ e POT (p=0,0001). Houve diferença estatística em relação ao equilíbrio coronal (CSVA) e sagital (SVA) em relação ao PRE e POT. O percentual de correção da curva principal foi de 55,75% (± 11,11) e da OP de 64,86% (± 18,04). Conclusão: A técnica de correção utilizando a técnica da 3° haste provisória e tração intra-operatória apresenta poder de correção de 55,75% da curva proximal e 64% da obliquidade pélvica. Além disso, apresenta facilidade de montagem, tempo cirúrgico pequeno e pouca perda de correção ao longo do seguimento. Nível de Evidência III B; Estudo de série de casos retrospectivos.
Resumen: Objetivo: Evaluar los resultados radiográficos de pacientes con parálisis cerebral y escoliosis tipo II de Lonstein y Akbarnia a quienes se les realizó tracción halofemoral intraoperatoria (THFI) y corrección con una tercera barra provisoria. Métodos: Estudio retrospectivo de serie de casos. Se evaluaron radiografías totales de columna preoperatorias (PRE), de tracción (TR), post-operatorias inmediatas (POI) y tardías (POT). Se verificó el valor angular de la curva principal (COBB), la oblicuidad pélvica (OP), el equilibrio del tronco en el plano coronal (CSVA), la alineación sagital vertical (SVA), la flexibilidad de la curva y el porcentaje de corrección en el PO final. Se realizaron las pruebas de Friedam y Wilcoxon (p<0,05). Resultados: Se incluyeron en el estudio 21 pacientes, con una edad media de 16 (±4,13) años. Hubo diferencia estadística al comparar: COBB PRE con TRACCIÓN en relación a POI y POT (p=0,0001), OP en PRE con TRACCIÓN y entre PRE y POT (p=0,0001). Hubo diferencia estadística en relación al equilibrio coronal (CSVA) y sagital (SVA) en relación a PRE y POT. El porcentaje de corrección para la curva principal fue del 55,75% (± 11,11) y para la OP del 64,86% (± 18,04). Conclusión: La técnica de corrección mediante la técnica de la tercera barra provisoria y tracción intraoperatoria presenta un poder de corrección del 55,75% de la curva proximal y del 64% de la oblicuidad pélvica. Además, es de fácil montaje, tiene un tiempo quirúrgico corto y poca pérdida de corrección durante el seguimiento. Nivel de evidencia III B; Estudio una serie de casos retrospectivos.
Subject(s)
Humans , Adolescent , Kyphosis , Spine , X-RaysABSTRACT
Abstract Introduction: Adolescent idiopathic scoliosis (AIS) is the most common and severe spinal deformity, which affects children and adolescents in the stage of neuromotor development and skeletal maturity of the sagittal curvatures of the spine. The literature presents several radiation-free instruments to assess and monitor the progression of scoliotic curvature angles in the AIS. However, the reliability and validity of the inclinometer at different stages of growth in relation to X-ray parameters has not been understood to date. Objective: To evaluate the reliability of the inclinometer and its validity with the X-ray exam on the sagittal parameters of the spine in the early and late growth stages of adolescents with AIS. Methods: A cross-sectional study was conducted with 39 adolescents with AIS who were divided into two groups: the initial growth phase (10-13 years) and the late growth phase (14-18 years). The evaluated sagittal parameters of the spine were the angle of the thoracic kyphosis and the angle of the lumbar lordosis, both measured by the X-ray image examination and the inclinometer. Results: The inclinometer showed excellent inter- and intra-examiner reliability for the different growth phases, early and late, with a strong association with the X-ray (gold standard; r = 0.84; p = 0.308 and r = 0.75; p = 0.517). The angle of lumbar lordosis was different between the inclinometer and X-ray instruments in the early and late stages of growth (p < 0.001), with moderate reliability and a less significant correlation with the gold standard of radiography (r = 0.38; p = 0.001 and r = 0.49; p = 0.024). Conclusion: The inclinometer showed excellent reliability and validity for the sagittal parameter of thoracic kyphosis in the early and late stages of growth. The angle of lumbar lordosis measured by inclinometer proved to be of moderate reliability and weak validity when considering the phases of skeletal growth, showing it to be an inefficient instrument for monitoring the lumbar scoliotic curvature for AIS.
Resumen Introducción: La escoliosis idiopática del adolescente (EIA) es la deformidad espinal más común y severa, que afecta a niños y adolescentes en la etapa de desarrollo neuromotor y madurez esquelética de las curvaturas sagitales de la columna. La literatura presenta varios instrumentos libres de radiación para evaluar y monitorear la progresión de los ángulos de curvatura escolióticos en el AIS. Sin embargo, hasta la fecha no se ha entendido la fiabilidad y validez del inclinómetro en diferentes etapas de crecimiento en relación con los parámetros de rayos X. Objectivo: Evaluar la confiabilidad del inclinómetro y su validez con el examen de rayos X sobre los parámetros sagitales de la columna vertebral en las etapas de crecimiento temprano y tardío de adolescentes con EIA. Materiales y métodos: Se realizó un estudio transversal con 39 adolescentes con EIA que se dividieron en dos grupos: la fase de crecimiento inicial (10-13 años) y la fase de crecimiento tardío (14-18 años). Los parámetros sagitales de la columna evaluados fueron el ángulo de la cifosis torácica y el ángulo de la lordosis lumbar, ambos medidos por el examen de imagen de rayos X y el inclinómetro. Resultados: El inclinómetro mostró una excelente confiabilidad inter e intraexaminador para las diferentes fases de crecimiento, temprana y tardía, con una fuerte asociación con la radiografía (estándar de oro; r = 0.84; p = 0.308 y r = 0.75; p = 0,517). El ángulo de lordosis lumbar fue diferente entre el inclinómetro y los instrumentos de rayos X en las etapas tempranas y tardías del crecimiento (p < 0,001), con confiabilidad moderada y una correlación menos significativa con el estándar de oro de la radiografía (r = 0,38; p = 0,001 y r = 0,49; p = 0,024). Conclusión: El inclinómetro mostró excelente confiabilidad y validez para el parámetro sagital de cifosis torácica en etapas tempranas y tardías de crecimiento. El ángulo de lordosis lumbar medido por inclinómetro demostró ser de confiabilidad moderada y validez débil al considerar las fases de crecimiento esquelético, mostrándose como un instrumento ineficiente para monitorear la curvatura escoliótica lumbar para EIA.
Subject(s)
Humans , Adolescent , Adult , Scoliosis/diagnosis , X-Rays , Growth and DevelopmentABSTRACT
Abstract Objective The present study aims to understand the perceptions of orthopedists and traumatologists regarding the risk of exposure to ionizing radiation in fluoroscopy procedures. Methods An objective, structured, self-administered questionnaire with sociodemographic, professional, and occupational variables was developed, available through an invitation sent to orthopedist physicians whose contacts were made publicly available. Results A total of 141 questionnaires were answered and analyzed. Most respondents (99%) use fluoroscopy in their surgeries, and only 34.8% of the participants feel safe with the use of the equipment. It was observed that the knowledge about ionizing radiation is inadequate, because 22.6% of the participants are unaware of the type of radiation emitted in fluoroscopy and its biological effects. In addition, 52% of the participants did not know or do not understand the principles of radiological protection and their relationship with surgical practices. Conclusion We concluded that the radiological protection of most orthopedists in surgical procedures is inadequate, and initial and continued training programs of professionals are necessary, bringing health benefits to orthopedists and their patients.
Resumo Objetivo Este estudo visa compreender as percepções dos médicos ortopedistas e traumatologistas em relação ao risco da exposição à radiação ionizante nos procedimentos de fluoroscopia. Métodos Desenvolveu-se um questionário objetivo, estruturado, autoaplicável e com variáveis sociodemográficas, profissionais e ocupacionais, disponibilizado através de convite enviado a médicos ortopedistas cujos contatos estavam disponibilizados publicamente. Resultados Foram respondidos e analisados 141 questionários. A maioria dos respondentes (99%) utilizam a fluoroscopia em suas cirurgias, e apenas 34,8% dos participantes se sentem seguros com o uso do equipamento. Observou-se que o conhecimento sobre radiação ionizante é inadequado, pois 22,6% dos respondentes desconhecem o tipo de radiação emitida na fluoroscopia e seus efeitos biológicos. Além disso, 52% dos respondentes não conhecem ou não compreendem os princípios de proteção radiológica e suas relações com as práticas cirúrgicas. Conclusão Conclui-se que a proteção radiológica da maioria dos ortopedistas nos procedimentos cirúrgicos é inadequada e são necessários programas de formação inicial e continuada dos profissionais, trazendo benefícios para a saúde dos ortopedistas e de seus pacientes.
Subject(s)
Humans , Radiation, Ionizing , X-Rays , Surveys and Questionnaires , Risk Assessment , Radiation ExposureABSTRACT
Las intoxicaciones medicamentosas son un motivo de consulta frecuente en pediatría, además de una de las principales causas externas de mortalidad en adolescentes. El diagnóstico y tratamiento tempranos son fundamentales para el manejo adecuado de estos casos. Se presenta una niña de 13 años que, luego de ingerir un fármaco desconocido, muestra decaimiento y manifestaciones clínicas gastrointestinales. Por sospecha de intoxicación con hierro y la imposibilidad de determinar los niveles de sideremia de manera urgente, se realiza radiografía de abdomen, que confirma el diagnóstico y permite el tratamiento adecuado de la paciente. En este caso, se destaca la utilidad de la radiología para el diagnóstico en la sospecha de intoxicación con hierro, gracias a la radiopacidad de sus sales
Drug intoxication is a common reason for pediatric emergency department (ED) visits and one of the leading causes of death among teenagers. Early diagnosis and treatment are essential for a proper management of these patients. We present a 13-year-old girl attended at the ED showing excessive sleepiness and gastrointestinal symptoms after taking an unknown drug. Due to suspected iron overdose and the impossibility of measuring urgent iron levels, an abdominal X-ray was performed, which confirmed the diagnosis. We highlight the utility of radiology in the diagnosis of iron poisoning, which is possible due to its radiopacity.
Subject(s)
Humans , Female , Adolescent , Emergency Service, Hospital , Iron , Poisoning , X-RaysABSTRACT
Background@#COVID-19 is diagnosed via Real Time Reverse Transcription Polymerase Chain Reaction (RT-PCR), with plain chest CT and chest x-ray as adjuncts. In the Philippines, chest x-ray is used as initial screening in assessing potential COVID-19 cases, with plain chest CT scan not routinely used due to higher cost and decreased availability.@*Objective@#This study determined the validity of chest x-ray and plain chest CT as initial screening tools for admitted COVID-19 patients from March 1 to November 30, 2020, at San Lazaro Hospital, comparing these with RT-PCR testing for COVID-19 as initial basis for considering a patient as a possible case of COVID-19.@*Methods@#This was a cross-sectional study of radiographic literature of admitted COVID-19 patients from March 1 to November 30, 2020, at San Lazaro Hospital, all with confirmatory RT-PCR, chest X-rays, and plain chest CTs. Baseline chest x-rays, with initial plain chest CT results, were compared with RT-PCR results. A tally was made, noting radiographic findings on both Chest X-ray and Plain Chest CT most frequently seen among patients with corresponding positive real time RT-PCR results.@*Results@#Chest X-rays done < 2 days from admission revealed involvement of both lungs, with infiltrates located centrally and peripherally, with major predilection for both lower lobes. Plain chest CT was similar, with ground glass opacities as the most common finding, consolidation second. Chest x-ray had a sensitivity of 88.11%, plain chest CT 94.71%. Sensitivity of combined chest x-ray and plain chest CT was 86.78%. Specificity and predictive value were not computed due to non-inclusion of admitted patients with COVID negative RT-PCR swab.@*Conclusion@#Chest X-ray and plain chest CT are useful modalities with high sensitivity in screening patients with fever, cough, and colds on admission. However, initial chest x-ray and plain chest CT scan results do not translate into a prognosis without context of initial diagnostics and management done during confinement.
Subject(s)
COVID-19 , X-Rays , COVID-19 TestingABSTRACT
OBJECTIVE@#To investigate the short-term clinical effect of lumbar nerve root canal injection under X-ray angiography in the treatment of sciatica.@*METHODS@#The clincal data of 78 patients with sciatica underwent lumbar nerve root canal injection under X-ray angiography from December 2017 to February 2020 was retrospectively analyzed. Including 31 males and 47 females, aged from 22 to 88 years old with a median of 65 years. There were 55 cases of lumbar disc herniation and 23 cases of lumbar spinal stenosis, the course of disease ranged from 1 to 8 weeks with a median of 3 weeks. There were 71 cases of single segment disc herniation or stenosis, including L3,4 of 5 cases, L4,5 of 61 cases, L5S1 of 5 cases, and 7 cases of multisegment herniation or stenosis. The pain visual analogue scale (VAS) was recorded and Macnab was used to evaluate the clinical effect.@*RESULTS@#All patients completed standardized treatment without serious adverse reactions. VAS were (3.21±0.76) scores immediately after treatment, (2.89±0.33) scores 1 hour after treatment, (1.80±0.27) scores 6 hours after treatment, (1.10±0.20) scores 24 hours after treatment, (2.53±0.35) scores 1 week after treatment and (4.27±0.36) scores 1 month after treatment. There were significant differences in VAS between before treatment(7.83±0.56) and each time period after treatment(P<0.05). According to Macnab low back pain evaluation standard, 42 cases were effective, 34 cases were markedly effective and 2 cases were ineffective within 24 hours after treatment, with an effective rate of 97.4%;38 cases were effective, 25 cases were markedly effective, 15 cases were ineffective within one week after treatment, the effective rate was 80.0%;32 cases were effective, 22 cases were markedly effective, 24 cases were ineffective within one month after treatment, the effective rate was 69.2%.@*CONCLUSION@#The short-term clinical effect of nerve root canal injection under X-ray radiography in the treatment of sciatica is good and it is an effective method to relieve sciatica.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Angiography , Dental Pulp Cavity , Intervertebral Disc Displacement/diagnostic imaging , Lumbar Vertebrae/diagnostic imaging , Retrospective Studies , Sciatica/drug therapy , Treatment Outcome , X-RaysABSTRACT
Abstract The objective of the present investigation was to design, optimize and characterize the gastro retentive floating levofloxacin tablets and perform in-vivo evaluation using radiographic imaging. The floating tablets were prepared by using polymers i.e hydroxy propyl methyl cellulose (HPMC-K4M) and carbopol-940 individually and in combination by nonaquous granulation method. All the Formulations were evaluated for swelling index (S.I), floating behavior and in-vitro drug release kinetics. The compatibility study of levofloxacin with other polymers was investigated by FTIR, DSC, TGA and XRD. Results from FTIR and DSC revealed no chemical interaction amongst the formulation components. The optimized formulation (F11) showed floating lag time (FLT), total floating time (TFT) swelling index (S.I) of 60 sec, >16h and approximately 75 %, respectively. Moreover, F11 showed zero order levofloxacin release in simulated gastric fluid over the period of 6 h. X-ray studies showed that total buoyancy time was able to delay the gastric emptying of levofloxacin floating tablets in rabbits for more than 4 hours. In conclusion the optimized formulation (F11) can be used for the sustained delivery of levofloxacin for the treatment of peptic ulcer.
Subject(s)
Drug Liberation , Peptic Ulcer/classification , Tablets/pharmacology , X-Rays/adverse effects , In Vitro Techniques/instrumentation , Spectroscopy, Fourier Transform Infrared , Drug Compounding/instrumentation , Process Optimization/analysis , Levofloxacin/analysis , Gastric Emptying/drug effectsABSTRACT
El objetivo de este trabajo es referir, a través de un reporte de caso clínico, a una paciente de sexo femenino de 9 años que sufrió una caída de su propia altura en el colegio. Inicialmente, la paciente acudió a urgencias en su ciudad natal, en la que al examen clínico se objetivó un traumatismo dentario en los dientes 11 y 21 y el diente 11 sufrió una luxación extrusiva leve, siendo reposicionada por el odontólogo que le brindó la primera atención. El examen radiográfico reveló una fractura radicular horizontal en el tercio medio de los dos incisivos centrales superiores. Los dientes fueron ferulizados con resina compuesta en los dientes proximales involucrados en el trauma. Posteriormente, la paciente fue remitida a la consulta de odontopediatría de la FOA-Unesp, donde recibió atención clínica y radiográfica por un período de diez años. No fue necesaria la intervención endodóntica en ambos dientes incisivos centrales, y los procesos de cicatrización se dieron de dos maneras diferentes. Cicatrización del diente 11 por interposición de hueso y tejido conectivo, y cicatrización del diente 21 por interposición de tejido conectivo. Después de diez años, los dientes se presentaban sin signos o síntomas significativos que requirieran una intervención invasiva. Se concluye que en un mismo paciente ocurren diferentes procesos de cicatrización en dientes muy próximos entre sí y que la cooperación del paciente en cuanto a cuidados, higiene bucal y asistencia a las citas de retorno, puede ser determinante para el éxito del tratamiento
The objective of this case report is to present a 9-year-old female patient who suffered horizontal root fracture in the middle third of the two upper central permanent incisors. The teeth were splinted with composite resin in the proximal teeth involved in the trauma. After, the patient was referred to the pediatric dentistry clinic, where she received clinical and radiographic care for a period of ten years. Endodontic intervention was not necessary on both central incisors teeth. Tooth 11 healing by interposition of bone and connective tissue, and teeth 21 healing by interposition of connective tissue. After ten years, the teeth presented without any significant signs or symptoms requiring an invasive intervention. It is concluded that the patient's cooperation regarding care, oral hygiene and attendance at the return appointments, can be decisive for the success of the treatment
O objetivo deste trabalho é referir-se, por meio de um relato de caso clínico, sobre um paciente de 9 anos de idade, sexo feminino, que sofreu queda da própria altura na escola. A paciente recebeu atendimento em sua cidade de origem, em que ao exame clínico foi observado traumatismo dentário sobre os dentes 11 e 21 e o dente 11 sofreu suave luxação extrusiva sendo reposicionado pelo cirurgião dentista que prestou os primeiros atendimentos. Ao exame radiográfico foi constatada fratura radicular horizontal de terço médio nos dois elementos dentários. Foi realizada a contenção dos dentes com resina composta nas proximais dos dentes envolvidos no trauma. A paciente foi encaminhada para a clínica de Odontopediatria da FOA-Unesp onde recebeu atendimento clínico e radiográfico por um período de dez anos, sem que a mesma apresentasse sinais ou sintomas significativos que necessitasse de uma intervenção invasiva. Dessa forma, infere-se que uma correta atuação no primeiro atendimento e a proservação do caso, pode ser determinante para o sucesso do tratamento, assim como a colaboração do paciente quanto aos cuidados, higienização bucal e comparecimento nas consultas de retorno
Subject(s)
Humans , Female , Child , Tooth Injuries , Attention , X-Rays , Patient Compliance , Joint Dislocations , Fractures, BoneABSTRACT
Abstract Passiflora nitida Kunth, an Amazonian Passiflora species, is little studied, although the specie's high biological potential. Herein the plant's pharmacognostic characterization, extract production, antioxidant potential evaluation, and application of this extract in cosmetic products is reported. The physical chemical parameters analyzed were particle size by sieve analysis, loss through drying, extractive yield, total ash content, laser granulometry, specific surface area and pore diameter (SBET), differential scanning calorimetry, thermogravimetry (TG), and wave dispersive X-Ray fluorescence (WDXRF). Total phenol/flavonoid content, LC-MS/MS analysis, DPPH and ABTS antioxidant radical assays, cytotoxicity, melanin, and tyrosinase inhibition in melanocytes test provided evidence to determine the content of the major constituent. P. nitida dry extract provided a fine powder with mesopores determined by SBET, with the TG curve showing five stages of mass loss. The antioxidant potential ranged between 23.5-31.5 mgâmL-1 and tyrosinase inhibition between 400-654 µgâmL-1. The species presented an antimelanogenic effect and an inhibitory activity of cellular tyrosinase (26.6%) at 25 µg/mL. The LC-MS/MS analysis of the spray-dried extract displayed the main and minor phenolic compounds constituting this sample. The results indicate that P. nitida extract has promising features for the development of cosmetic formulations
Subject(s)
Plant Extracts/analysis , Plant Leaves/adverse effects , Cosmetics/classification , Passiflora/classification , Thermogravimetry/methods , X-Rays/adverse effects , Calorimetry, Differential Scanning/methods , Monophenol Monooxygenase/antagonists & inhibitors , Phenolic Compounds , Melanins , Antioxidants/adverse effectsABSTRACT
Se estima que en 2019 murieron alrededor de 1,4 millones de personas infectadas por tuberculosis, gran parte de ellos en países en desarrollo. Si la tuberculosis se hubiera diagnosticado oportunamente se habría evitado la muerte de las personas infectadas. Uno de los métodos de detección de tuberculosis más relevante es el análisis de radiografías del tórax; sin embargo, contar con profesionales altamente capacitados para el diagnóstico de la tuberculosis en todos los centros de salud es imposible en los países emergentes, este es uno de los principales motivos de que este método no sea ampliamente usado. En las últimas décadas las redes neuronales han tenido un papel muy relevante en la solución de problemas de la sociedad y en especial en el sector salud. Se ha empleado tres algoritmos de aprendizaje profundo reconocidos en el desarrollo de visión computacional que son VGG19, MobileNet e InceptionV3, se ha logrado obtener resultados muy auspiciosos para la detección de la tuberculosis. Caso especial ha sido MobileNet que ha destacado entre las demás, dando resultados importantes en las diferentes métricas de evaluación empleadas. Además, MobileNet cuenta con una arquitectura menos compleja y los pesos obtenidos después del entrenamiento son muy menores en comparación de los otros dos algoritmos. Se concluye que MobileNet es el algoritmo de Deep Learning más eficiente a comparación de VGG19 e InceptionV3, cuenta con mejor precisión para la detección de la tuberculosis y; el costo computación y tiempo de procesamiento es significativamente menor.
It is estimated that around 1.4 million people infected with tuberculosis died in 2019, most of them in developing countries. If tuberculosis had been diagnosed in time, the death of infected people would have been prevented. One of the most relevant tuberculosis detection methods is the analysis of chest radiographs; However, having highly trained professionals for the diagnosis of tuberculosis in all health centers is impossible in emerging countries, this is one of the main reasons why this method is not widely used. In recent decades, neural networks have played a very relevant role in solving problems in society and especially in the health sector. Three recognized Deep Learning algorithms have been used in the development of computational vision that are VGG19, MobileNet and InceptionV3, it has been possible to obtain very auspicious results for the detection of tuberculosis. MobileNet has been a special case, which has stood out among the others, giving important results in the different evaluation metrics used. In addition, MobileNet has a less complex architecture and the weights obtained after training are very less compared to the other two algorithms. It is concluded that MobileNet is the most efficient Deep Learning algorithm compared to VGG19 and InceptionV3, it has better precision for the detection of tuberculosis and the computational cost and processing time is significantly lower.
Estima-se que cerca de 1,4 milhão de pessoas infectadas com tuberculose morreram em 2019, a maioria delas em países em desenvolvimento. Se a tuberculose tivesse sido diagnosticada a tempo, a morte de pessoas infectadas teria sido evitada. Um dos métodos de detecção de tuberculose mais relevantes é a análise de radiografias de tórax; No entanto, ter profissionais altamente capacitados para o diagnóstico da tuberculose em todos os centros de saúde é impossível nos países emergentes, esse é um dos principais motivos pelo qual esse método não é amplamente utilizado. Nas últimas décadas, as redes neurais têm desempenhado um papel muito relevante na resolução de problemas na sociedade e principalmente no setor da saúde. Três algoritmos de aprendizado profundo reconhecidos foram usados no desenvolvimento da visão computacional que são VGG19, MobileNet e InceptionV3, sendo possível obter resultados muito auspiciosos para a detecção da tuberculose. A MobileNet tem sido um caso especial, que tem se destacado entre os demais, apresentando resultados importantes nas diferentes métricas de avaliação utilizadas. Além disso, o MobileNet possui uma arquitetura menos complexa e os pesos obtidos após o treinamento são muito menores em comparação com os outros dois algoritmos. Conclui-se que o MobileNet é o algoritmo de aprendizado profundo mais eficiente em comparação ao VGG19 e ao InceptionV3, possui melhor precisão para detecção de tuberculose e; o custo de computação e o tempo de processamento são significativamente menores.