Potential of artificial intelligence to generate health research reports of decayed, missed and restored teeth / Potencial de la inteligencia artificial para generar informes de investigación sanitaria sobre dientes cariados, perdidos y restaurados

Abstract This study aims to indicate the potential of artificial intelligence (AI) in epidemiological reports of decayed, missed and restored teeth. As a proof of concept our study model used panoramic x-ray images and an AI algorithm for tooth numbering, detection of the caries and restorations with accuracy over 80% for such diagnostic tasks. The output came as the number of decayed, missed and restored teeth according to patient's age and the DMFT index (number of decayed, missing, and filled teeth) which varied from 3.6 (up to 20 years old) to 20.4 (+60 years old). Thus, it is suggested that AI is a promising method to automate health data collection through the analysis of x-rays.

Resumen Este estudio tiene como objetivo indicar el potencial de la inteligencia artificial (IA) en los informes epidemiológicos de dientes cariados, perdidos y restaurados. Como prueba de concepto, nuestro modelo de estudio utilizó imágenes panorámicas de rayos X y un algoritmo de inteligencia artificial para la numeración de dientes, la detección de caries y las restauraciones con una precisión superior al 80 % para dichas tareas de diagnóstico. El resultado fue el número de dientes cariados, perdidos y restaurados según la edad del paciente y el índice CPOD (número de dientes cariados, perdidos y obturados) que varió de 3,6 (hasta 20 años) a 20,4 (+60 años). Por tanto, se sugiere que la IA es un método prometedor para automatizar la recopilación de datos de salud mediante el análisis de rayos X.

Diagnostic approach to a rare case of anaplastic meningioma with osteosarcomatous differentiation and associated bone alterations

Anaplastic meningioma with osteosarcomatous differentiation is a very rare finding. We herewith present squash cytology, histopathology and immunohistochemistry findings of this rare case with systematic approach to diagnosis. A 38-year-old female presented with complaints of headache, vomiting, seizure with loss of consciousness and left side weakness. Radiologically, there was a heterogeneous hyperintense likely extra axial densely calcified solid lesion measuring approximately 4.2�1�5 cm along right high frontal convexity compressing the adjacent brain parenchyma. Histology sections revealed fibro collagenous tissue, devitalized bone, multiple vascular spaces lined by fibrous septa with giant cells, along with spindle cell and round proliferation at one end with vague whorl formation. High mitosis, (>20/10 hpf) along with malignant lacy osteoid closely abutting the highly pleomorphic cells were indicative of a malignant spindle cell neoplasm with osteosarcomatous differentiation. Systematic approach, immunohistochemistry with involvement of all the specialities involved led to the correct diagnosis and management of patient.

Role of multidetector computed tomography and magnetic resonance imaging in evaluation of buccal mucosal neoplasms

Background: Buccal mucosa cancers are increasingly common among younger individuals, primarily due to tobacco usage. Accurate staging is essential for effective treatment planning. This study evaluates the role of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) in assessing buccal mucosa neoplasms. Methods: This prospective study included 25 patients from Great Eastern medical school and hospital over a 12-month period. All patients underwent initial clinical examination followed by CT and MRI scans. CT scans were conducted using a GE 16-slice MDCT scanner, and MRI scans were performed with a 1.5-T unit. Imaging results were correlated with histopathological findings. The TNM classification system was used for disease staging. Results: CT and MRI demonstrated high sensitivity (98%) in detecting bone erosion and invasion into the infratemporal fossa. MDCT effectively identified the extent of bone involvement, while MRI provided detailed soft tissue contrast, aiding in the evaluation of surgical outcomes. Imaging accurately identified key features impacting staging and treatment, including involvement of the retromolar trigone, tongue, masticator space, bones, neurovascular bundles, lymph nodes, and distant metastases. Conclusions: MDCT and MRI are non-invasive, cost-effective tools critical for the staging and management of buccal mucosa cancer. Early and accurate imaging significantly improves treatment planning and prognostication. Both modalities play complementary roles in assessing disease extent and guiding clinical decisions.

Trauma craneoencefálico moderado y severo en un hospital del suroccidente de Colombia: factores clínico-radiológicos relacionados con la mortalidad / Moderate and severe traumatic brain injury in a hospital in southwest Colombia: Clinical radiological factors related to mortality

Resumen Introducción: El trauma craneoencefálico es una patología con altos índices de mortalidad, por lo que es de gran relevancia identificar los factores que inciden en ella. Materiales y métodos: Se elaboró un estudio analítico entre los años 2020 y 2021, donde se incluyeron pacientes con trauma craneoencefálico moderado y severo, se caracterizaron las variables más relacionadas con el pronóstico, como aspectos demográficos, clínicos y radiológicos, y se analizó la asociación entre la mortalidad y estas variables. Resultados: La mortalidad hospitalaria fue del 22,8 %, encontrando como variables relacionadas la frecuencia respiratoria, la anisocoria, el reflejo pupilar y la atención en unidad de cuidados intensivos (UCI), y como factor relacionado con supervivencia, el número de días de estancia hospitalaria. Discusión: La mortalidad por trauma craneoencefálico es más elevada en países de ingresos medianos y bajos, posiblemente en relación con una mayor cantidad de accidentes de tránsito y un acceso limitado a tratamientos. Los factores asociados en el estudio se respaldan con estudios previos y se subraya la importancia de las alteraciones pupilares en la evaluación del paciente. Conclusiones: Es fundamental un examen físico completo desde el momento del ingreso, pues hallar taquipnea, anisocoria, ausencia del reflejo pupilar o signos de choque, puede dictar el pronóstico. Aunque la literatura global se centra en la caracterización del TCE, este estudio subraya la necesidad de una mayor investigación sobre factores que permitan predecir cursos hospitalarios tórpidos con desenlaces fatales.

Abstract Introduction: Traumatic brain injury is a disease with high mortality rates, so it is highly relevant to identify the factors that affect it. Materials and methods: An analytical study was prepared between 2020 and 2021, which included patients with moderate and severe head trauma, characterized the variables most related to prognosis, such as demographic, clinical, and radiological aspects, and analyzed the association between mortality and these variables. Results: Hospital mortality was 22.8%, finding as conditions related to mortality the respiratory rate, anisocoria, pupillary reflex, ICU care and as a factor related to survival, the number of days of hospital stay. Discussion: Mortality due to traumatic brain injury is higher in low- and middle-income countries, possibly due to a higher incidence of traffic accidents and limited access to treatment. The factors identified in this study are consistent with previous research, emphasizing the importance of pupillary abnormalities in patient assessment. Conclusions: A comprehensive physical examination from the time of admission is crucial, as the presence of tachypnea, anisocoria, absence of pupillary reflex, or signs of shock can dictate prognosis. While global literature primarily focuses on characterizing traumatic brain injuries, this study underscores the need for further research on factors predicting protracted hospital courses with fatal outcomes.

Prevalence of the Fabella and Determination of the Fabella Index / Prevalencia de la Fabela y Determinación del Índice Fabelar

SUMMARY: The fabella is a bony anatomical variable, which in humans is located posterior to the lateral condyle of the femur, in the tendinous portion of the lateral head of the gastrocnemius muscle. Its prevalence rate has been reported in different populations, ranging from 3% to 86%. This study aimed to create an index that classifies the fabella according to its dimensions, determine the prevalence of the fabella in the Colombian population, and identify possible differences according to the fabella index (FI), sex, age, laterality, and degree of fabellar degeneration. A retrospective study used 93 lateral knee radiographs belonging to Colombian individuals. A fabella index was established to classify fabellae into longifabellar, medifabellar, and equifabellar, and radiological classification was used to identify the degree of fabellar degeneration (DFD). The prevalence of fabella was 36.30 %, and this variant was associated with the individual's sex, with male subjects having 2.66 times the probability of presenting fabella. A higher prevalence of medifabellar fabellae (57.60 %) was observed, followed by longifabellar (24.20 %) and equifabellar (18.20 %). There was a positive and moderate correlation between the DFD and age. We consider that larger fabellae can cause entrapment of the common fibular nerve, compression of the popliteal artery, and tear of the medial meniscus, so the FI becomes relevant in clinical practice, providing information on the type of fabella and its associated pathological manifestations. This study introduces a novel fabella index and investigates the frequency of fabella in the Colombian population. The findings of this study will serve as a reference for future research and contribute to the field of knee orthopedics and surgery in this population.

La fabela es una variable anatómica ósea, que en humanos se localiza posterior al cóndilo lateral del fémur, en la porción tendinosa de la cabeza lateral del músculo gastrocnemio. Su tasa de prevalencia se ha reportado en diferentes poblaciones, cuyos valores oscilan entre 3 % y 86 %. El objetivo de este estudio fue crear un índice que clasifique la fabela según sus dimensiones, determinar la prevalencia de la fabela en población colombiana, así como identificar posibles diferencias en función del índice fabelar, sexo, edad, lateralidad y grado de degeneración de la fabela. Se desarrolló un estudio retrospectivo en el que se dio uso a 93 radiografías laterales de rodilla, pertenecientes a individuos colombianos. Se estableció un índice fabelar que clasificó las fabelas en longifabelares, medifabelares y equifabelares, además utilizamos la clasificación radiológica para identificar los grados de degeneración fabelar (GDF). La prevalencia de la fabela fue del 36,30 %, se encontró asociación de esta variante al sexo del individuo, siendo los hombres quienes tuvieron 2,66 veces más probabilidades de presentar la fabela. Se observó mayor prevalencia de fabelas tipo medifabelar 57,60 %, seguido de tipo longifabelar 24,20 % y equifabelar 18,20 %. Hubo correlación positiva y moderada entre la edad y el grado de degeneración fabelar. Consideramos que las fabelas con mayores dimensiones podrían causar atrapamiento del nervio fibular común, compresión de la arteria poplítea y desgarro del menisco medial, por lo que el índice fabelar adquiere relevancia en la práctica clínica, al dar información del tipo de fabela y sus manifestaciones patológicas asociadas. El presente estudió es el primero en proponer un índice fabelar y la frecuencia de la fabela en población colombiana, por lo que servirá de referencia para futuras investigaciones, además de brindar un aporte al área traumatológica y quirúrgica de la rodilla en esta población.

Aspectos genéticos e imagenológicos de la enfermedad quística renal en pediatría: serie de casos / Genetic and radiological aspects of pediatric renal cystic disease: A case series

Las enfermedades quísticas renales son condiciones frecuentes cuya etiología puede ser muy heterogénea, por lo que se requiere un adecuado abordaje para su diagnóstico y manejo. El objetivo de este trabajo fue ilustrar parte del espectro de la enfermedad renal quística por medio de casos clínicos manejados en la Fundación Valle del Lili. Se describen 11 casos clínicos que incluyen enfermedades como displasia multiquística renal, enfermedad poliquística renal autosómica dominante y autosómica recesiva, entre otras. Las enfermedades quísticas renales varían en su presentación clínica, historia natural, hallazgos imagenológicos, bases genéticas y fisiopatológicas, por consiguiente, el enfoque diagnóstico y el manejo integral se debe realizar de forma individualizada y con un abordaje multidisciplinario.

Renal cystic diseases are common conditions whose etiology can be highly heterogeneous. They require a correct approach for adequate diagnosis and management. We aimed to illustrate part of the spectrum of renal cystic diseases through some clinical cases managed in our service. We describe 11 clinical cases including clinical entities such as renal multicystic dysplasia, and autosomal dominant and autosomal recessive polycystic renal disease, among other pathologies. Renal cystic diseases are heterogeneous in their clinical presentation, natural history, radiological findings, and genetic and pathophysiological basis. An integral clinical approach is needed to get a clear etiological diagnosis and offer adequate individualized care and follow-up for patients.

Evaluation of the root morphology of mandibular first premolars using cone-beam computed tomography in a peruvian population / Evaluación de la morfología radicular de primeros premolares mandibulares mediante tomografía computarizada de haz cónico en una población peruana

Introduction: The morphology of the root canal of the first premolars is not always the same and therefore a good knowledge of its dental anatomy is essential. Aim: To assess the morphology of roots and root canals of mandibular first premolars in a Peruvian population using cone-beam computed tomography (CBCT). Materials and Methods: This was a descriptive cross-sec-tional study. A total of 370 mandibular first premolars fulfilling the inclusion criteria were evaluated using CBCT, and the number of roots and root canals, the Vertucci's classification of root canal configuration, age, sex and side of the tooth were registered. Results: One and two roots were presented in 96.2% (n=356) and 3.8% (n=14), respectively, of the mandibular first premolars analyzed, and one canal was present in 67.6% (n=250) and two canals in 32.2% (n=119). A type I root canal configuration was found in 67.6% (n=250) of the cases followed by type V with 26.2% (n=97). A statistically significant association was found between the number of roots and canals (p<0.001) and age also had a significant influence on this variable (p=0.0043). Conclusions: The presence of one canal in mandibular first premolars is the most frequent, although there is a considerable prevalence of two in the population studied. The number of roots is associated with the number of canals, with age having a significant influence on these variables.

Introducción: La morfología del canal radicular de los primeros premolares no siempre es la misma y por ello es fundamental un buen conocimiento de su anatomía dental. Objetivo: Evaluar la morfología de las raíces y conductos radiculares de primeros premolares mandibulares en una población peruana mediante tomografía computarizada de haz cónico. Materiales y Métodos: Este fue un estudio transversal descriptivo. Se evaluaron mediante tomografías un total de 370 primeros premolares mandibulares que cumplían con los criterios de inclusión, y se registró el número de raíces y conductos radiculares, la clasificación de Vertucci de la configuración radicular, la edad, el sexo y el lado del diente. Se realizaron las pruebas de chi-cuadrado y una regresión logística binaria (p<0,05). Resultado: Se presentó una y dos raíces en el 96,2% (n=356) y 3,8% (n=14), respectivamente, de los primeros premolares mandibulares analizados, y un canal estuvo presente en el 67,6% (n=250) y dos canales en el 32,2% (n=119). Se encontró una configuración del conducto radicular tipo I en el 67,6% (n=250) de los casos seguido del tipo V con un 26,2% (n=97). Se encontró una asociación estadísticamente significativa entre el número de raíces y conductos (p<0.001) y la edad también influyó significativamente en esta variable (p=0.0043). Conclusión: La presencia de 1 canal en primeros premolares mandibulares es la más frecuente, aunque existe una prevalencia considerable de 2 en la población estudiada. El número de raíces está asociado al número de canales, teniendo la edad una influencia significativa en estas variables.

Asociación entre Calcificaciones del Complejo Estilohioideo y Síntomas Clínicos en Pacientes Atendidos en el Centro de Salud de la Universidad San Sebastián, Sede Santiago, Chile

Hoy en día es común recibir pacientes en la clínica odontológica relatando dolor uni o bilateral en la zona lateral de la cara, más específicamente en la zona de las ramas mandibulares. Este dolor puede ser muchas veces de origen dental, muscular masticatorio, de las articulaciones temporomandibulares, o incluso tonsilar. Debido a que las anteriores son patologías más frecuentes, muchas veces el clínico no considera que la causa de estos dolores podría estar asociada al síndrome de Eagle. Esta investigación se fundamentó en la necesidad de utilizar las radiografías panorámicas como herramienta para asociar dolores que no remiten a tratamientos convencionales a calcificaciones del complejo estilohioideo, muchas veces hallazgos radiográficos que no son comúnmente tomados en consideración por el clínico. El objetivo del estudio fue eterminar la asociación entre calcificaciones del complejo estilohioideo en radiografías panorámicas y sintomatología clínica dolorosa en pacientes del centro de salud de la Universidad San Sebastián, sede Santiago, Chile. Se realizó un estudio correlacional, analítico y retrospectivo en el Centro de Salud de la Universidad San Sebastián. Se tomó una muestra aleatoria de 815 radiografías y fichas clínicas asociadas, en las cuáles se analizó la presencia, tipo y ubicación de calcificaciones del complejo estilohioideo, así como, si los pacientes relataron sintomatología dolorosa asociable al Síndrome de Eagle. Posteriormente se realizó un análisis descriptivo, exploratorio e inferencial de asociación entre variables. El porcentaje de pacientes que presentó calcificaciones del complejo estilohioideo alcanzó un 85,4%, siendo la mayoría de tipo elongado (70,98%), seguida del tipo segmentado (26,72%) y muy por debajo el tipo pseudoarticulado (2,3%). Con respecto a la prevalencia de sintomatología la gran mayoría de los pacientes no presentó (96,32%), sin verse diferencias según sexo o edad. Por último, al realizar el análisis de asociación el valor de X 2 calculado fue de 3,171, menor al valor de X2 crítico tabulado de 3,841. Al obtener un X2 calculado menor a un X2 crítico tabulado se demostró que no existe una asociación entre la presencia de calcificaciones del complejo estilohioideo y sintomatología clínica asociada. Además, las prevalencias de calcificaciones y sus tipos no variaron según la edad o género, lo que no nos permitió establecer una relación causal entre las variables.

Nowadays it is very common to receive patients in the dental clinic reporting unilateral or bilateral pain in the lateral area of the face, more specifically in the mandibular rami area. The origin of this pain can often be dental, muscular, from the temporomandibular joint or even tonsillar. Because the named pathologies are more frequent, many times the clinician does not consider that the cause of this pain could be associated with Eagle syndrome. This research was based on the need to use panoramic radiographs as a tool to associate pain that does not refer to conventional treatments with calcifications of the stylohyoid complex, many times radiographic findings that are not commonly considered by the clinician. This correlational cross analytical study was carried out at San Sebastián University Health Center. A random sample of 815 radiographs and associated clinical records was taken, in which the presence, type and location of calcifications of the stylohyoid complex were analyzed, as well as whether the patients reported painful symptoms associated with Eagle syndrome. Subsequently, a descriptive, exploratory, and inferential analysis of association between variables was conducted. The percentage of patients who presented calcifications of the stylohyoid complex reached 85.4%, being the majority the elongated type (70.98%), followed by the segmented type (26.72%) and far below the pseudoarticulated type (2.3%). Regarding the prevalence of symptoms, the vast majority of patients did not present (96.32%), without seeing differences according to gender or age. Finally, when performing the association analysis, the calculated X2 value was 3.171, lower than the critical tabulated X2 value of 3.841. Obtaining a calculated X2 lower than a critical tabulated X2 showed that there is no association between the presence of calcifications of the stylohyoid complex and associated clinical symptoms. In addition, the prevalence of calcifications and their types did not vary according to age or gender, which did not allow us to establish a causal relationship between the variables.

Relationship between the Volume of the Upper Airways and the Mandibular Angle Analyzed in Computed Tomography Scans / Relação do Volume das Vias Aéreas Superiores com o Ângulo Mandibular Analisadas em Tomografias Computadorizadas

Several variables can influence the treatment and outcome of orthognathic surgery, one of which is the angle of the mandibular ramus. The objective of this study is to analyze the upper airways (UA) of patients prior to orthognathic surgery, using cone-beam computed tomography (CBCT) and to correlate their volume with the angle of the mandibular ramus. DICOM (Digital Image Communication in Medicine) images of a radiology clinic were used, with a survey of 124 full face CBCT scans, from 2015 to 2018, and the measurement of the total volume in mm³ through software. To obtain the values of the angle of the mandibular ramus, images obtained from medical reports were used, through morphological evaluation. The values were tabulated and subsequently statistical analysis was performed using the ANOVA test to assess the differences between the mean airway volumes (mm³) according to gender, age and mandibular ramus angle. However, the angle of the ramus did not influence the volume of the UA, but a greater average of UA volume was observed in male individuals and in individuals over 34 years of age. There is no evidence that it is possible to measure or predict the volume of the UA by evaluating the angle of the mandibular ramus. (AU)

Diversas as variáveis podem influenciar no tratamento e resultado de uma cirurgia ortognática, uma delas é o ângulo do ramo mandibular. O objetivo deste trabalho é analisar as vias aéreas superiores (VAS) de pacientes previamente à cirurgia ortognática, por meio de tomografia computadorizada de feixe cônico (TCFC) e correlacionar o seu volume com o ângulo do ramo mandibular. Foram utilizadas imagens DICOM (Comunicação de Imagens Digitais em Medicina) de uma clínica radiológica, com o levantamento de 124 exames de TCFC de face total, do ano de 2015 até 2018 e feita a mensuração do volume total em mm³ através de um software. Para a obtenção dos valores do ângulo do ramo mandibular foram utilizadas imagens obtidas através dos laudos médicos, mediante avaliação morfológica. Os valores foram tabulados e posteriormente feita a análise estatística com o teste ANOVA para avaliar as diferenças entre as médias de volume das vias aéreas (mm³) de acordo com o gênero, a idade e o ângulo do ramo mandibular. Contudo, o ângulo do ramo não influenciou no volume das VAS, mas uma maior média de volume de VAS foi observada nos indivíduos do gênero masculino e nos indivíduos acima de 34 anos. Não há evidências de que se é possível mensurar ou ter previsibilidade do volume de VAS, avaliando o ângulo do ramo mandibular. (AU)

La profesora Raquel Pérez González y el signo de la muela de cangrejo / Professor Raquel Pérez González and crab claw sign

La Dra. Raquel Pérez González, más conocida entre colegas, alumnos y compañeros de trabajo por "la profe Raquel", obtuvo el título de Medicina en el año 1976. Comenzó por vía directa la residencia de Radiología y obtuvo el título de especialista de primer grado en 1979. Se convirtió así, el Hospital Militar Central "Dr. Carlos J. Finlay", en la cuna de su formación profesional y en años posteriores, en la casa que la vio crecer, especialmente como maestra de numerosas generaciones de radiólogos e imagenólogos. Hoy reposan en el jardín del Departamento de Imagenología, parte de sus cenizas, custodiadas por el amor que fue capaz de cultivar. En el 2016, una paciente femenina de 60 años de edad, acudió a la consulta de gastroenterología, con dolor abdominal difuso. La radiografía de abdomen simple, anteroposterior, en posición acostado mostró, una imagen en "muela de cangrejo", visible al tomar el aire dentro del hemicolon transverso izquierdo, como contraste, el cual bordea por ese lado parcialmente, una opacidad de partes blandas, que se extiende desde el mesogastrio, hasta la fosa ilíaca derecha, donde se observa el signo del menisco. Los estudios de imágenes realizados, evidenciaron signos radiológicos típicos de invaginación por causa tumoral maligna. En varias ocasiones, la profesora Raquel utilizó la imagen de este caso, como pregunta en exámenes de promoción de residentes. La publicación de este caso constituye un homenaje a quien será siempre un paradigma de docente.

Dr. Raquel Pérez González, better known among colleagues, students and co-workers as "professor Raquel", obtained her degree in Medicine in 1976. She began her Radiology residency directly and obtained the title of first-class specialist degree in 1979. Thus, the Central Military Hospital "Dr. Carlos J. Finlay" is the cradle of her professional training and in later years, in her home where she saw her grow up, especially as a teacher to numerous generations of radiologists and imaging scientists. Today, part of her ashes rest in the garden of the Imaging Department, guarded by the love that she was able to cultivate. In 2016, a 60-year-old female patient attended the gastroenterology clinic with diffuse abdominal pain. The simple, anteroposterior abdominal x-ray, in the lying position, showed a "crab claw" image, visible when breathing into the left transverse hemicolon, as contrast, which partially borders on that side, a soft tissue opacity, which extends from the mesogastrium to the right iliac fossa, where the meniscus sign is observed. The imaging studies performed showed typical radiological signs of invagination due to malignant tumor. On several occasions, Professor Raquel used the image of this case as a question in resident promotion exams. The publication of this case constitutes a tribute to someone who will always be a paradigm of a teacher.

Orthopedic sports injuries: advanced imaging modalities, return-to-play criteria, and injury prevention

Orthopaedic sports injuries encompass a wide range of musculoskeletal conditions resulting from the physical demands of athletic activities. These injuries can vary from acute, such as sprains and fractures, to chronic overuse syndromes like tendinopathies. Prevalent due to the global enthusiasm for sports, they affect bones, muscles, tendons, ligaments, and joints. The etiology of these injuries is multifactorial, stemming from biomechanical stressors, training methods, genetics, and environmental conditions. Advanced imaging modalities like magnetic resonance imaging and Computed tomography have revolutionized the assessment and diagnosis of these injuries, aiding in treatment decisions and return-to-play criteria. Injury prevention is paramount and involves understanding intrinsic (athlete-related) and extrinsic (environmental) risk factors. Strategies include pre-participation screening, strength and conditioning programs, biomechanical analysis, neuromuscular training, proper equipment use, rule changes, education, and creating a safety-conscious culture. Effective prevention reduces the burden of these injuries. Treatment strategies range from conservative approaches to surgery, depending on the type and severity of the injury. Emerging trends in sports medicine, including biologic therapies and telemedicine, offer promising avenues for improved diagnosis and recovery. The holistic approach to orthopaedic sports injuries encompasses prevention, diagnosis, and treatment, ensuring athletes' well-being and longevity in their chosen sports.

Efficacy and radiology evaluation of pulpotomy in mature permanent teeth / 北京大学学报(医学版)

Objective:To observe the clinical efficacy of pulpotomy in patients of different ages and to explore the occurrence and characteristics of pulpal calcification.Methods:A total of 77 patients who underwent pulpotomy for mature permanent premolars and molars with caries-derived pulp exposure in the Department of General Dentistry,Peking University School and Hospital of Stomatology from October 2019 to August 2022 were selected.Pulpotomies were performed in a single visit using iRoot BP Plus bioceramic material as pulp capping agent.The patients were divided into three groups according to age:25 cases in the adolescent group(11-20 years old)with a mean age of(15.88±2.19)years;27 cases in the middle-aged group(21-50 years old)with a mean age of(34.59±8.67)years;and 25 cases in the elder-aged group(51-83 years old)with a mean age of(63.84±7.40)years.The patients were reviewed 1 year after the operation to evaluate the clinical efficacy and to record the formation of calcified bridge,thickness of calcified bridge,and pulp calcification index(PCI).Results:There was no statisti-cally significant difference between the three groups in terms of gender,dentition,and tooth position(P＞0.05).The 1-year postoperative follow-up rate was 85.71％(66/77),including 88.00％(22/25)in the adolescent group,85.19％(23/27)in the middle-aged group,and 84.00％(21/25)in the elder-aged group.The 1-year follow-up clinical success rates of the three groups were 95.45％(21/22),91.30％(21/23),and 95.24％(20/21),respectively,with no statistically significant difference(P＞0.05).Among the clinical success cases,calcified bridges appeared in 12 cases(57.14％,12/21)in the adolescent group,8 cases(38.10％,8/21)in the middle-aged group,and 3 cases(15.00％,3/20)in the elder-aged group,with statistically significant differences(x2=7.810,P=0.020＜0.05).The difference was statistically significant(F=4.434,P=0.020＜0.05)when comparing the thickness of calcified bridges among the three groups.Calcified bridge thickness was negatively corre-lated with age(r=-0.516,P＜0.05).The changes in pulpal calcification index ΔPCI were 0.67±0.58,0.43±0.51,and 0.25±0.52,respectively,with statistically significant differences among the three groups(F=3.404,P=0.040＜0.05).Conclusion:Pulpotomy for caries-derived pulp exposure in elderly patients could also achieve a high success rate.The incidence of calcified bri-dges after pulpotomy and the acceleration of pulpal calcification were age-related.The adolescent group was more likely to form calcified bridges and also showed more pronounced accelerated root canal calcifi-cation.

Digital intervention:current status of the integration of digital medicine with interventional radiology / 介入放射学杂志

As a cross-field discipline,digital intervention integrates digital technology with interventional therapeutic methods.In the clinical practice of interventional radiology,the digital medicine,through using the basic tools such as electronic health records,artificial intelligence,wearable devices,remote monitoring,etc.,has been deeply integrated into the advanced imaging technology,interventional surgery planning,image-guided procedure,navigation equipment,interventional surgery robot,3D printing,remote medical education and training,and other aspects of the clinical work,which greatly optimizes the diagnostic and therapeutic processes and improves the efficiency and precision of medical services.At the same time,digital intervention also brings challenges related to data security and privacy security in medical services.Therefore,more attention should be paid to the balance between the technology and the medical ethics when planning for the future development direction of digital intervention so as to make sure that digital intervention can be continuously and safely developed.(J Intervent Radiol,2024,32:1-6)

Transarterial infusion chemotherapy combined with lipiodol chemoembolization for the treatment of advanced colorectal cancer / 介入放射学杂志

Objective To discuss the clinical safety,feasibility and efficacy of transcatheter arterial infusion chemotherapy(TAI)combined with lipiodol chemoembolization in the treatment of advanced colorectal cancer(CRC).Methods The clinical data of 37 patients with advanced CRC,who received TAI combined with lipiodol chemoembolization at the First Affiliated Hospital of Zhengzhou University of China between June 2016 and December 2022,were retrospectively analyzed.The clinical efficacy was evaluated,the progression-free survival(PFS)and the serious complications were recorded.Results A total of 55 times of TAI combined with lipiodol chemoembolization procedures were successfully accomplished in the 37 patients.The mean used amount of lipiodol emulsion was 2.9 mL(0.8-10 mL).No serious complications such as bleeding and intestinal perforation occurred.The median follow-up time was 24 months(range of 3-48 months).The postoperative one-month,3-month,6-month and 12-month objective remission rates(ORR)were 67.6%(25/37),67.6%(25/37),64.9%(24/37)and 56.8%(21/37)respectively,and the postoperative one-month,3-month,6-month and 12-month disease control rates(DCR)were 91.9%(34/37),91.9%(34/37),89.2%(33/37)and 81.1%(30/37)respectively.The median PFS was 16 months(range of 2-47 months).As of the last follow-up,22 patients survived and 15 patients died of terminal stage of tumor.Conclusion Preliminary results of this study indicate that TAI combined with lipiodol chemoembolization is clinically safe and effective for advanced CRC,and it provide a new therapeutic method for patients with advanced CRC.

Construction of evaluation index system and theory-skill-humanity model for core competence of radiation specialist nurses / 中国实用护理杂志

Objective:To construct of evaluation index system and theory-skill-humanity (TSH) model for core competence of radiation specialist nurses, to provide reference for clinical training of radiation specialist nurses.Methods:In January 2023, the draft of the evaluation index system of core competence for radiation specialist nurses was development by literature reviews and semi-structured interviews; from February to March 2023, 20 experts were consulted with 2 rounds of Delphi consultations to determine the index system and determine indicator weights based on the importance assigned by experts to each indicator.Results:Among 20 experts, 17 were female and 3 were male, aged 35-65 (46.48 ± 8.19) years old. The effective recovery rate of the questionnaires was 100.0% (20/20) and 95.0% (19/20) in the first and second round, respectively. The authority coefficient of the experts was 0.937 in the second round, the Kendall coefficients of concordance in the first-level indexes, second-level indexes and third-level indexes were 0.448, 0.407, 0.464, respectively, the difference was statistically significant ( χ2 = 53.60, 148.81, 58.18, all P<0.001). The final evaluation index system of the core competence of radiation specialist nurses included 3 first-level indicators, 11 second-level indicators and 56 third-level indicators. Conclusions:The evaluation index system of the core competence of radiation specialist nurses constructed based on TSH model in the present study has certain feasibility and practicality, which can be used as the basis for the training and evaluation of radiation specialized nurses.

Establishment of a rat femoral nonunion model by intramedullary fixation / 中国组织工程研究

BACKGROUND:Establishing an objective and standard animal model of bone nonunion is essential for experimental studies and treatment of nonunion. OBJECTIVE:To establish an objective animal model for experimental studies of nonunion. METHODS:Specific pathogen-free male Wistar rats were selected and prepared by cutting off a 5 mm bone defect in the middle femur,peeling off a large periosteum and removing bone marrow.Animal models were fixed with a 1.2 mm Kirschner wire.At 1,4 and 8 weeks,bone nonunion was observed by gross specimen observation,X-ray examination and histopathological examination. RESULTS AND CONCLUSION:The gross specimen,X-ray film and histopathological examination showed that there was no callus formation in the bone defect area,the broken end was filled with fiber tissue,and the bone callus was rare or even invisible.To conclude,the rat model of nonunion can be successfully established by osteotomy of the middle femur,large periosteum peeling and bone marrow removal.This modeling method is simple,reliable and effective.

Analysis of the trend of radiological diagnostic examination frequency and the related influencing factors / 中华放射医学与防护杂志

Objective:To investigate the trend of radiological diagnostic examination frequency and the related influencing factors in a general hospital in recent four years.Methods:The hospital information system and the radiology information system were used to collect the information on the numbers of the outpatients, the emergency patients, and the inpatients and the radiology examination information from 2019 to 2022. The examination frequency and proportion of various imaging equipment were counted by using the perspective table of data, and the examination items and the proportion of the radiological diagnostic examinations were calculated. The positive rates of the radiological examinations were measured from 2019 to 2022. The gender and age distribution of the patients were analyzed. Spearman correlation analysis was used to analyze the relationships between the numbers of the patients undergoing radiological examinations and the numbers of the outpatients, emergency patients and the inpatients.Results:The annual frequency of radiological diagnostic examinations from 2019 to 2022 were 307 306, 245 418, 317 250 and 325 625, respectively, with a total of 1 195 599. Among them, the proportions of CT, X-rays, bedside X-rays, bone density, gastrointestinal imaging and mammography were 59.74%, 38.04%, 1.39%, 0.42%, 0.21% and 0.19%, respectively. In each year, the proportion of CT in all radiological diagnostic examinations was 49.58%, 63.40%, 60.40% and 65.20%, respectively. The frequency of emergency CT and emergency chest CT was correlated with the number of emergency patients( r =0.63, 0.61, P<0.05), and the frequency of non-emergency CT was correlated with the number of outpatients and inpatients ( r =0.61, 0.66, P<0.05). The positive rates of the CT examinations were higher than 80% except the lowest of 79.95% in 2021. Conclusions:Radiological examinations especially CT examinations have increased significantly, and played an important role in the diagnosis of diseases. However, attention should be paid to the Justification of the CT examinations. Timely statistical analysis of radiological examination information can provide data supports and references for scientific management of radiological examinations.

Application of Monte Carlo simulation in radiation dose estimation and optimization for diagnostic radiology / 中华放射医学与防护杂志

The increasing frequency of radiographic diagnostic imaging and the cumulative dose to the public from radiation has raised widespread concerns. However, accurate measurement of the radiation dose received by the human body is difficult to achieve. Monte Carlo simulation, as a numerical computational method guided by probability statistics theory, has been applied to various dose assessments, imaging optimizations, and radiation protection in radiographic diagnostic imaging. We provide a comprehensive review of the principles of the Monte Carlo method, the modelling process of Monte Carlo simulation and the progress of its application to diagnostic radiological dose estimation.

Achievements and prospects in endovascular treatment of aortic aneurysms / 中华普通外科杂志

In recent years, endovascular treatment has emerged as the preferred approach for aortic aneurysms. From an anatomical perspective, the current focus of research remains on the reconstruction of iliac artery branches, multiple branches of visceral arteries, and branches of the aortic arch. Substantial clinical evidence has been accumulated in these areas. Simultaneously, future research is expected to explore the reconstruction of the aortic root involving coronary arteries openings and the inhibition of small arterial aneurysm progression through pharmacological means. This article aims to provide a review of significant research data in recent years related to the treatment of aortic aneurysms, offering insights and prospects for future research directions.