Development of a Semaphore of Anemia: Screening Method Based on Photographic Images of the Ungueal Bed Using a Digital Camera.

Anemia is a disease present worldwide. High prevalence of anemia (43%) is found in the child population and its main long-term effect (slow cognitive development) can remain even if the disease has disappeared. One of the main reasons for the high prevalence of anemia in Peru is the poor screening coverage during the growth of the child due to the parents' fear of infringing pain on their children. We take advantage that anemia produces pallor in the hands, fingers and ungueal bed to develop a semaphore for this disease. This screening tool uses photographic images of the patient's ungueal bed to determine if they have a high, medium or low possibility of having anemia. Sixty people participated in the study and 6 photographic images for each participant's right hand were captured. The images were processed to extract regions of interest from each of the fingernails. Datasets were generated and a neural network was used to predict the risk of anemia. Initial results show that the proposed semaphore of anemia reaches a sensitivity of 0.79 and specificity of 0.91. These results indicate that the semaphore of anemia may be used as a screening method to reduce the number of blood tests and the time of evaluation from 15 minutes (rapid test with portable hemoglobinometer) to 1 minute.

Métodos de diagnóstico y tratamiento actuales de la osteoartritis de la articulación temporomandibular: una revisión de la literatura / Current diagnostic methods and treatment of tmporomandibular joint osteoarthritis: a review of the literature

Este artículo involucra una revisión de los factores etiológicos asociados a la osteoartritis (OA) de la articulación temporomandibular (ATM), así como los hallazgos imagenológicos, los cuales son indispensables para el diagnóstico y la determinación de la etapa de evolución de esta patología. Además, se discuten los métodos de tratamiento invasivos y no invasivos. Los objetivos del presente artículo fueron describir los métodos de diagnóstico y tratamiento más actuales y eficientes para la osteoartritis de la articulación temporomandibular, y determinar la existencia de la correlación clínica e imagenológica en las diferentes etapas de esta patología. A partir de una revisión de la literatura, se encontró que el método de diagnóstico más relevante para la OA de la ATM es la tomografía computarizada de haz cónico (TCHC), por sus múltiples ventajas. El método de tratamiento más eficiente durante la etapa sintomatológica de la enfermedad es la artrocentesis sinergizada con ácido hialurónico o plasma rico en plaquetas. Cabe resaltar que no se encontraron correlaciones directas suficientes entre los cambios óseos y la sintomatología clínica de la OA de ATM empleando la TCHC. (AU)

The objectives of this article were to describe the most current and efficient diagnostic and treatment methods for osteoarthritis of the temporomandibular joint (TMJ) and to determine the correlation of clinical and imaging in the different stages of this pathology. We review the etiological factors associated with osteoarthritis (OA) of the TMJ as well as the imaging findings, which are essential for the diagnosis and determination of the stage of evolution of this pathology. In addition, invasive and noninvasive treatment methods are discussed. Based on review of the literature, the most relevant diagnostic method for OA of the TMJ is conic beam computed tomography (CBCT), due to its multiple advantages. The most efficient treatment method during the symptomatic stage of the disease is arthrocentesis synergized with hyaluronic acid or plateletrich plasma. It was of note that no direct correlation was found between bone changes and the clinical symptomatology of TMJ OA using CBCT. (AU)

[Thin layer agar represents a cost-effective alternative for the rapid diagnosis of multi-drug resistant tuberculosis]. / Agar de capa delgada: Una opción costo-efectiva para el diagnóstico rápido de tuberculosis multirresistente.

OBJECTIVE: Using cost-benefit analysis for comparing the thin-layer agar culture method to the standard multiple proportion method used in diagnosing multidrug-resistant tuberculosis (MDR TB). METHODS: A cost-benefit evaluation of two diagnostic tests was made at the Corporación para Investigaciones Biológicas (CIB) in Medellín, Colombia. RESULTS: 100 patients were evaluated; 10.8% rifampicin resistance and 14.3% isoniazid resistance were found. A computer-based decision tree model was used for cost-effectiveness analysis (Treeage Pro); the thin-layer agar culture method was most cost-effective, having 100% sensitivity, specificity and predictive values for detecting rifampicin and isoniazid resistance. The multiple proportion method value was calculated as being US$ 71 having an average 49 day report time compared to US$ 18 and 14 days for the thin-layer agar culture method. DISCUSSION: New technologies have been developed for diagnosing tuberculosis which are apparently faster and more effective; their operating characteristics must be evaluated as must their effectiveness in terms of cost-benefit. The present study established that using thin-layer agar culture was cheaper, equally effective and could provide results more quickly than the traditional method. This implies that a patient could receive MDR TB treatment more quickly.

Agar de capa delgada: Una opción costo-efectiva para el diagnóstico rápido de tuberculosis multirresistente / Thin layer agar represents a cost-effective alternative for the rapid diagnosis of multi-drug resistant tuberculosis

Objetivo Realizar un análisis de costo efectividad comparando el método de cultivo en agar de capa delgada y el método estándar de proporciones múltiples, utilizados en el diagnóstico de Tuberculosis Multi-drogorresistente (TB MDR). Métodos Estudio de evaluación económica en el cual se evalúan los costos y la efectividad de dos pruebas diagnósticas, ejecutado en la Corporación para Investigaciones Biológicas-CIB en Medellín, Colombia. Resultados Se evaluaron 100 pacientes, encontrando una prevalencia de resistencia a la Rifampicina de 10,8 % y resistencia a Isoniazida de 14,3 %. Se presenta un análisis en términos de costo-efectividad mediante el diseño de un árbol de decisiones (Treeage Pro ®), resultando ser la prueba basada en cultivo en agar de capa delgada más costo-efectiva; con valores de sensibilidad, especificidad y predictivos del 100 % para detectar resistencia a Rifampicina e Isoniazida. El valor del método de las proporciones múltiples fue calculado en US$ 71, con una media de tiempo para ser reportado de 49 días versus US$ 18 y 14 días respectivamente para el cultivo en agar de capa delgada. Discusión Se han desarrollado nuevas tecnologías para el diagnóstico de Tuberculosis, aparentemente más rápidas y efectivas, que deben ser evaluadas no solo en sus características operativas, sino también en términos de costo-efectividad. El presente estudio establece que el empleo de la capa delgada es menos costoso, igualmente efectivo, y puede aportar resultados más rápidamente; cuando se compara con el método tradicional. Esto implica, entre otros aspectos, que el paciente pueda recibir más oportunamente el tratamiento dirigido para TB MDR.

Objective Using cost-benefit analysis for comparing the thin-layer agar culture method to the standard multiple proportion method used in diagnosing multidrug-resistant tuberculosis (MDR TB). Methods A cost-benefit evaluation of two diagnostic tests was made at the Corporación para Investigaciones Biológicas (CIB) in Medellín, Colombia. Results 100 patients were evaluated; 10.8 % rifampicin resistance and 14.3 % isoniazid resistance were found. A computer-based decision tree model was used for cost-effectiveness analysis (Treeage Pro); the thin-layer agar culture method was most cost-effective, having 100 % sensitivity, specificity and predictive values for detecting rifampicin and isoniazid resistance. The multiple proportion method value was calculated as being US$ 71 having an average 49 day report time compared to US$ 18 and 14 days for the thin-layer agar culture method. Discussion New technologies have been developed for diagnosing tuberculosis which are apparently faster and more effective; their operating characteristics must be evaluated as must their effectiveness in terms of cost-benefit. The present study established that using thin-layer agar culture was cheaper, equally effective and could provide results more quickly than the traditional method. This implies that a patient could receive MDR TB treatment more quickly.