Impacto de la mecatrónica en la medicina / Impact of mechatronic in medicine

Se efectuó una revisión bibliográfica para determinar el impacto de la mecatrónica en el sector de la salud. Se valoró el desarrollo de esta desde la visión de diferentes investigadores, lo cual ha permitido su inserción en dicho sector. También se comprobó que la robótica y el procesamiento digital de imágenes y señales tienen mayor incidencia en la medicina. Asimismo, se hizo un análisis de la mecatrónica aplicada a esta ciencia, el cual demostró que las áreas quirúrgica y terapéutica son las más favorecidas y se nutren de técnicas innovadoras, que resultan más fiables y menos invasivas para el paciente

A literature review was carried out to determine the impact of mechatronic in the health sector. Its development was evaluated from the point of view of different investigators, which has allowed its insertion in this sector. It was also proven that robotics and digital processing of images and signs have higher incidence in medicine. Also, an analysis of mechatronic applied to this science was carried out, which demonstrated that the surgical and therapeutical areas are the most favored and receive nourishment through innovative techniques that are more reliable and less invasive for the patient

Accuracy of five electronic foramen locators with different operating systems: an ex vivo study

Objective: The aim of this study was to evaluate, ex vivo, the precision of five electronic root canal length measurement devices (ERCLMDs) with different operating systems: the Root ZX, Mini Apex Locator, Propex II, iPex, and RomiApex A-15, and the possible influence of the positioning of the instrument tips short of the apical foramen. Material and Methods: Forty-two mandibular bicuspids had their real canal lengths (RL) previously determined. Electronic measurements were performed 1.0 mm short of the apical foramen (-1.0), followed by measurements at the apical foramen (0.0). The data resulting from the comparison of the ERCLMD measurements and the RL were evaluated by the Wilcoxon and Friedman tests at a significance level of 5%. Results: Considering the measurements performed at 0.0 and -1.0, the precision rates for the ERCLMDs were: 73.5% and 47.1% (Root ZX), 73.5% and 55.9% (Mini Apex Locator), 67.6% and 41.1% (Propex II), 61.7% and 44.1% (iPex), and 79.4% and 44.1% (RomiApex A-15), respectively, considering ±0.5 mm of tolerance. Regarding the mean discrepancies, no differences were observed at 0.0; however, in the measurements at -1.0, the iPex, a multi-frequency ERCLMD, had significantly more discrepant readings short of the apical foramen than the other devices, except for the Propex II, which had intermediate results. When the ERCLMDs measurements at -1.0 were compared with those at 0.0, the Propex II, iPex and RomiApex A-15 presented significantly higher discrepancies in their readings. Conclusions: Under the conditions of the present study, all the ERCLMDs provided acceptable measurements at the 0.0 position. However, at the -1.0 position, the ERCLMDs had a lower precision, with statistically significant differences for the Propex II, iPex, and RomiApex A-15.

A dinâmica inovativa do subsistema de base mecânica, eletrônica e de materiais / The innovative dynamic of the mechanics, electronics and materials subsystem / La dinámica innovadora del subsistema de base mecánica, electrónica y de materiales

O subsistema de base mecânica, eletrônica e de materiais, um dos subsistemas do complexo produtivo da saúde, reúne diferentes atividades, usualmente agregadas na designada indústria de equipamentos e materiais médico-hospitalares e odontológicos, uma área estratégica para a saúde por representar uma fonte contínua de mudanças nas práticas assistenciais. Além de exercer influência na prestação de serviços de saúde, possui potencial de promover o adensamento do sistema nacional de inovação e de ampliar a competitividade da indústria como um todo, dado que articula tecnologias portadoras de futuro. Apesar do crescimento significativo dessa indústria no Brasil nos últimos anos, esses equipamentos e materiais têm apresentado um crescente déficit na balança comercial. Essa incompatibilidade entre as necessidades nacionais de saúde e a base produtiva e inovativa da indústria aponta fragilidades estruturais do subsistema. Utilizando o arcabouço da economia política, o objetivo do artigo foi discutir o desenvolvimento dessa indústria no Brasil e seus desafios.

The mechanics, electronics and materials subsystem, one of the subsystems of the health care productive complex, encompasses different activities, usually clustered in what is called the medical, hospital and dental equipment and materials industry. This is a strategic area for health care, since it represents a continuous source of changes in care practices, and influences the provision of health care services. It has, moreover, potential for promoting the progress of Brazil's system of innovation and for increasing the competitiveness of the industry as a whole, given that it articulates future technologies. Despite the significant growth of this industry in Brazil in recent years, such equipment and materials have been presenting a growing deficit in the balance of trade. This incompatibility between national health care needs and the productive and innovative basis of the industry points to structural fragilities in the system. Using the framework of political economy, the article aims to discuss the development of this industry in Brazil and its challenges.

OBJETIVO: El subsistema de base mecánica, electrónica y de materiales, uno de los subsistemas del complejo productivo de la salud, reúne diferentes actividades, usualmente agregadas en la designada industria de equipos y materiales médico-hospitalarios y odontológicos, un área estratégica para la salud por representar una fuente continua de cambios en las prácticas asistenciales. Además de ejercer influencia en la prestación de servicios de salud, posee potencial de promover la saturación del sistema nacional de innovación y de ampliar la competitividad de la industria como un todo, dado que articula tecnologías portadoras de futuro. A pesar del crecimiento significativo de esta industria en Brasil en los últimos años, los equipos y materiales han presentado un creciente déficit en la balanza comercial. Esta incompatibilidad entre las necesidades nacionales de salud y la base productiva e innovadora de la industria señalan fragilidades estructurales del subsistema. Utilizando el armazón de la economía política, el objetivo del artículo fue discutir el desarrollo de ésta industria en Brasil y sus desafíos.

In vivo accuracy of conventional and digital radiographic methods in confirming root canal working length determination by Root ZX

OBJECTIVES: To compare, in vivo, the accuracy of conventional and digital radiographic methods in determining root canal working length. MATERIAL AND METHODS: Twenty-five maxillary incisor or canine teeth from 22 patients were used in this study. Considering the preoperative radiographs as the baseline, a 25 K file was inserted into the root canal to the point where the Root ZX electronic apex locator indicated the APEX measurement in the screen. From this measurement, 1 mm was subtracted for positioning the file. The radiographic measurements were made using a digital sensor (Digora 1.51) or conventional type-E films, size 2, following the paralleling technique, to determine the distance of the file tip and the radiographic apex. RESULTS: The Student "t" test indicated mean distances of 1.11 mm to conventional and 1.20 mm for the digital method and indicated a significant statistical difference (p<0.05). CONCLUSIONS: The conventional radiographic method was found to be superior to the digital one in determining the working length of the root canal.

Effect of pre-flaring and file size on the accuracy of two electronic apex locators

OBJECTIVE: This ex vivo study evaluated the effect of pre-flaring and file size on the accuracy of the Root ZX and Novapex electronic apex locators (EALs). MATERIAL AND METHODS: The actual working length (WL) was set 1 mm short of the apical foramen in the palatal root canals of 24 extracted maxillary molars. The teeth were embedded in an alginate mold, and two examiners performed the electronic measurements using #10, #15, and #20 K-files. The files were inserted into the root canals until the "0.0" or "APEX" signals were observed on the LED or display screens for the Novapex and Root ZX, respectively, retracting to the 1.0 mark. The measurements were repeated after the preflaring using the S1 and SX Pro-Taper instruments. Two measurements were performed for each condition and the means were used. Intra-class correlation coefficients (ICCs) were calculated to verify the intra- and inter-examiner agreement. The mean differences between the WL and electronic length values were analyzed by the three-way ANOVA test (p<0.05). RESULTS: ICCs were high (>0.8) and the results demonstrated a similar accuracy for both EALs (p>0.05). Statistically significant accurate measurements were verified in the pre-flared canals, except for the Novapex using a #20 K-file. CONCLUSIONS: The tested EALs showed acceptable accuracy, whereas the pre-flaring procedure revealed a more significant effect than the used file size.

An in vivo comparative evaluation to determine the accuracy of working length between radiographic and electronic apex locators.

Background: An in vivo comparative evaluation to determine the accuracy of working length between radiographic and electronic apex locators. Aim: The study was aimed at evaluating the accuracy of electronic apex locator, to determine the working length of root canal, and to compare it with the radiographic method of working length determination. Materials and Methods: A total of 20 teeth selected for the study had to go for extraction because of periodontal or orthodontic reasons. Access cavity was prepared and the clinical estimated working length (CEWL) was determined with 10-25 no. K-file. A radiograph was then taken for determining the radiographic estimated working length (REWL). For electronic measurement of root canal, a 10 no. K-file was advanced toward the apex until it reached a 0.5 mm short of apex as shown by the apex locator. After fixing the file with a light cured composite, the tooth was extracted, the tooth surface was then longitudinally grounded using straight fissure diamond bur until the root canal and the tip of the file were visible. The distance of file from the minor constriction was measured with help of stereomicroscope. Statistical analysis : The chi-square test was used for statistical analysis for this study. Results: The chi-square test where χ2 = 21.034 with P = 0.000 indicated that a significant difference exists among the groups. The electronic method showed highest number of cases with the working length at the minor constrictor. Conclusion: The electronic method for determining the working length of root canal was found to be more accurate than the radiographic method.

Influence of pulp condition on the accuracy of an electronic foramen locator in posterior teeth: an in vivo study

The aim of this study was to assess, in vivo, the accuracy of the NovApex® electronic foramen locator in determining working length (WL) in vital and necrotic posterior teeth. The NovApex®was used in 144 canals: 35 teeth with vital pulps (68 canals) and 42 teeth with necrotic pulps (76 canals). WL was measured with the NovApex® locator and confirmed using the radiographic method. Differences between electronic and radiographic measurements ranging between 0.0 and 0.4 millimeters were classified as acceptable; differences equal to or greater than 0.5 millimeter were considered unacceptable. Pearson's chi-square test was used to assess the influence of pulp condition on the accuracy of NovApex®(a = 0.05). Regardless of pulp condition, differences between electronic and radiographic WL measurements were acceptable in 73.61% of the canals. No statistically significant differences in accuracy were observed when comparing vital and necrotic canals (p > 0.05). There were 38 unacceptable measurements. In none of these cases was the file tip located beyond the radiographic apex; in 32, it was located short of the NovApex® measurement. Pulp condition had no significant effect on the accuracy of NovApex®.

Ex vivo accuracy of three electronic apex locators using different apical file sizes

This study evaluated the accuracy of three electronic apex locators (Root ZX, Novapex, and Justy II) in root canal length determinations using different apical file sizes, considering the apical constriction (AC) and the major foramen (MF) as anatomic references. The diameter of the apical foramina of 40 single-rooted teeth was determined by direct visual measurement and the master apical file was established. Electronic measurements were then performed using 3 instruments: the selected master apical file (adjusted file), one size smaller (intermediate file), and two sizes smaller (misfit file). The distances from the tip of files fixed in the canals to the MF and to the AC were measured digitally. Precision at AC and at MF for the misfit, intermediate and adjusted apical files was as follows: 80%/88%/83% and 78%/83%/95% (Root ZX); 80%/85%/80% and 68%/73%/73% (Novapex); and 78%/80%/78% and 65%/78%/70% (Justy II). Considering the mean discrepancies, statistically significant differences were found only for the adjusted file at MF, with Root ZX presenting the best results at MF. The chi-square test showed significant differences between the acceptable measurements at AC and at MF for the Justy II and Novapex (± 0.5 mm) regardless of file adjustment. Under the conditions of the present study, all devices provided acceptable electronic measurements regardless of file adjustment, except for Root ZX which had its performance improved significantly when the precisely fit apical file was used. Justy II and Novapex provided electronic measurements nearest to the AC.

Este estudo avaliou a precisão de três localizadores eletrônicos foraminais (Root ZX, Novapex e Justy II) nas determinações de odontometria utilizando limas com diferentes padrões de ajuste, considerando-se a constrição apical (CA) e do forame principal (FA) como referências anatômicas. O diâmetro dos forames apicais de 40 dentes unirradiculados foi previamente determinado por visualização direta e a lima compatível com o forame apical foi estabelecida. Medições eletrônicas foram realizadas utilizando 3 instrumentos diferentes: lima compatível com o forame apical (lima ajustada), lima um tamanho menor (lima intermediária), e lima dois tamanhos menores (lima desajustada). As distâncias da ponta dos instrumentos ao FA e a CA foram determinadas em software específico. A precisão na CA e no FA para os instrumentos desajustado, intermediário e ajustado foram: 80% / 88% / 83% e 78% / 83% / 95% (Root ZX); 80% / 85% / 80% e 68% / 73% / 73% (Novapex), e 78% / 80% / 78% e 65% / 78% / 70% (Justy II). Considerando os erros médios oferecidos pelos aparelhos, foi encontrada diferença estatística apenas nas determinações realizadas com os instrumentos adaptados tendo como referência o FA onde o Root ZX ofereceu os melhores resultados. O teste qui-quadrado apresentou diferenças significantes entre as determinações consideradas aceitáveis para a CA e o FA tanto para o Justy II quanto para o Novapex (± 0,5 mm), independente do ajuste do instrumento. Nas condições do presente estudo todos os dispositivos ofereceram medições aceitáveis independentemente do ajuste dos instrumentos; exceção feita apenas ao Root ZX, que teve seu desempenho melhorado quando uma lima ajustada foi utilizada. Os aparelhos Justy II e Novapex ofereceram determinações mais próximas à CA.

Development of Micro/Nano Devices for Cancer Diagnosis / 대한소화기학회지

In order to rapidly detect and analyze the presence of a target ligand of interests in environmental or industrial fluids as well as biological samples, numerous test systems have been designed and developed, which have been based on the combination of a test reagent and absorbing paper or membrane. The main limitations of these conventional devices are the difficulty of quantitative or semi-quantitative detection and poor detection limit (around nanogram/ml range detection capability). In this paper, new approaches and research trends which use nano/MEMS (micro electro mechanical systems) technology is introduced, which has a concept of fast, precise, and massive diagnosis and analysis of target molecules using very small amount of samples.

Accuracy of electronic apex locator in length determination in the presence of different irrigants: An in vitro study.

Determining the root canal length accurately had been a challenge in endodontics. Introduction of apex locators have definitely served as an effective adjuvant to radiographs. This in vitro study had attempted to compare the effectiveness of electronic apex locator in the presence of various canal contents. Comparison of the length determined by apex locators with the radiographic length was also made. The results of the study had shown that the length of root canals can be accurately made irrespective of the canal contents.

Assessment of the efficacy of an indigeniously developed pulse oximeter dental sensor holder for pulp vitality testing.

Current routine methods of assessment of pulp vitality rely on stimulation of nerve fibres and give no direct indication of blood flow within the pulp. Pulse oximeter is a proven, atraumatic method of measuring vascular status, by evaluating oxygen saturation. This study explores the use of customized dental pulse oximeter sensor holder to assess pulpal vascular oxygen saturation in permanent teeth. Pulse oximeter readily differentiated between known vital and nonvital teeth. Vital teeth consistently provided oxygen saturation values that were lower than the values recorded on the patient's fingers. Pulse oximeter is an accurate, atraumatic clinical alternative to the present electrical and thermal methods of assessing pulp vitality in teeth.

Disfunción craneomandibular: integración de la instrumentación bioelectrónica en su diagnóstico y terapéutica / Cranio-mandibular dysfunction: integration of bio-electronic instruments for diagnosis and therapy

El odontólogo recibe frecuentemente la consulta de pacientes con diagnóstico de disfunción craneomandibular, disfunción temporomandibular o simplemente pacientes de ATM (SIC), cuyos síntomas podrían ser el resultado de una o múltiples entidades concomitantes que requieren un diagnóstico específico y diferencial. El dolor en el área de la articulación temporomandibular (A.T.M.) puede deberse a uno o una combinación de diversos síndromes clínicos: capsulitis crónica, artritis reumatoidea, patologías musculoesqueléticas, afecciones miogénicas, Síndrome de Ernest, neuralgia occipital menor que irradia allí y otras enfermedades sistémicas. Por otra parte, el cuadro de disfunción craneomandibular (D.C.M.) -que es su nombre correcto- suele ser tratado como sinónimo de bruxismo -actividad parafuncional que se produce como consecuencia de un aumento del tono muscular fundamentalmente de músculos maseteros, temporales y pterigoideos internos-, lo cual es un error, si bien ambas entidades pueden coexistir. El presente artículo tiene como objetivos: a) utilizando instrumentación bioelectrónica, hacer una revisión y actualización sobre la fisiopatología, el cuadro clínico, los diagnósticos diferenciales, el concepto de sistema estomatognático" y el abordaje diagnóstico, pronóstico y terapéutico de la D.C.M. desde la concepción de la odontología neuromuscular y b) resaltar la importancia de un tratamiento interdisciplinario entre odontólogos, médicos expertos en medicina del dolor y otras especialidades médicas para un eficaz diagnóstico y tratamiento de nuestros pacientes; como la D.C.M. es una patología de origen multifactorial, su detección y terapéutica oportuna requiere de toda la artillería que tenemos a nuestra disposición.

Um novo conceito para um antigo instrumento: espátula corneana flexível / A new concept for an old instrument: flexivel corneal scrapping spatula

Os autores descrevem um novo métodopara produzir um instrumento para colheita de material de córnea. Tal instrumento pode ser manufaturado com uma cânula ou agulha fina. O material é moldado de forma plana como auxílio de laminador, ou de um martelo e placa de metal. Lixa fina é utilizada para arredondar as bordas e a ponta é ligeiramente dobrada. Um cabo pode ser adicionado de modo a facilitar a manipulaçäo do instrumento, que pode ser reutilizado após lavagem e esterilizaçäo local na pontal do metal, ou por óxido de etileno

La microelectrónica en la medicina y la cirugía / Microelectronics in medicine and surgery

Cualquier rama de la ciencia enfrenta problema para definir los límites de sus legítimas actividades. Pero la microelectrónica y la Medicina son dos ciencias que trabajan juntas en el desarrollo de muchas especialidades médicas. Particularmente la cirugía es un campo especial para estos conocimientos y día con día crecen los avances gracias a la investigación bioelectrónica en muchos campos. Ahora es posible hacer manos "biónicas", marcapasos, estimuladores de callo óseo y diversos aparatos electrónicos que vienen a mejorar o restablecer la salud perdida. Nuevos materiales microelectrónicos ofrecen la posibilidad de mejorar equipos o instrumentos para enfermos discapacitados y las diferentes imagenologías, como especialidad, son el mejor ejemplo para entender como la cooperación médica, electrónica y de la ingeniería de computación, pueden resolver problemas médicos diversos

Metodologia para avaliaçäo da interferência eletromagnética conduzida em equipamentos eletrônicos utilizados em procedimentos cirurgicos / Methodology for evaluation of the electromagnetic interference conducted in eletronic equipament utilized in surgical procedures

O relato de intercorrências associadas à utilização de equipamentos eletro-médicos em procedimentos cirúrgicos, tem levado ao desenvolvimento de metodologias para avaliação destas intercorrências, as quais podem originar-se devido as interferências eletromagnéticas conduzidas. Este trabalho propõe uma metodologia de avaliação para este tipo de interferência

Abstract - The Electrosurgical-related injuries have started up the development of methodologies that allow to investigate them. Electromagnetic interference has been appointed as one of the causes of these injuries. This work describes one methodology to evaluate this kind of interference

Aplicaciones de ingeniería electrónica en cardiología / Application of electronic engineering in cardiology

La medicina en general y muy en especial la cardiología, han sentido el impacto directo de las nuevas posibilidades abiertas por el concepto "integración en muy alta escala" (VSLI), que integra microcomputadores, memorias RAM de gran tamaño y otros. Los autores analizan aplicaciones importantes del desarrollo ingenieril electrónico en el campo de la cardiología, como son los marcapasos inteligentes, los desfibriladores automáticos implantables, el monitoreo electrocardiográfico Holter y procesamiento de información clínica obtenida en el test de esfuerzo