Fracturas osteoporóticas vertebrales en laproyección lateral de tórax / Osteoporotic vertebral fractures in the lateral thorax projection

Objetivo: Este estudio se realizó para determinar el porcentaje de cambios morfológicos,considerados fracturas vertebrales por osteoporosis en la proyección lateral de tórax, depacientes mayores de 50 anos ˜ atendidos por razones médicas distintas a problemas decolumna, en un hospital de tercer nivel.Método: Tres investigadores evaluaron 237 radiografías digitales de tórax de pacientes conuna edad media de 66,86 anos ˜ (rango 50-90), usando de manera secuencial y estandarizadalos métodos Algorithm-Base Qualitative approach (ABQ) y de Genant. Cada evaluador contócon una pantalla de similar resolución y evaluó las radiografías de forma independiente.Resultados: De los casos, 152 fueron del sexo femenino y 85 del masculino. La edad promedio para las fracturas grado 1 (17 casos) fue 72,17 anos ˜ con rango de 60-90(DE 8,96) y para las de grado 2 (6 casos) de 74 anos ˜ con rango de 68-87 anos ˜ (DE 6,72).Conclusiones: El porcentaje de cambios morfológicos considerados fracturas osteoporóticasdorsales fue del 9,7% (23 fracturas), el cual resultó más bajo con respecto a lo reportado en la literatura. La distribución de las lesiones por sexo fue similar en ambos grupos yla concordancia inter e intraobservador, usando los 2 métodos de manera conjunta, fueexcelente...

ObjectiveThis study was performed to determine the percentage of morphological changes considered as vertebral fractures due to osteoporosis in the lateral thorax projection of patients older than 50 years old who were attended for different medical reasons for spine problems in a third level hospital.MethodThree investigators evaluated 237 digital radiographs of the thorax of patients with a median age of 66.86 years (range 50-90) using 2 standardized methods sequentially: the Algorithm-Base Qualitative approach (ABQ) method and the Genant method. Each examiner used a similar resolution screen and evaluated the radiographs independently.ResultsThe cases included 152 females and 85 males. There were 23 fractures where the distribution by Genant method was 10 (6.5%) of grade 1, and only one (0.6%) of grade 2 for a total of 11 (7.2%) in the female group. In the male group there were 7 (8.2%) of grade 1, and 5 (5.8%) of grade 2 fractures, for a total of 12 (14.1%). The total number of grade 1 fractures was 17 (7.17%) and 6 (2.53%) grade 2. The fractures identified by ABQ method were 11 (7.2%) in the female group and 12 (14.1%) in the male group.The interobserver agreement for the 3 evaluators using the Genant method had a Kappa value of 0.88 (Z of 23.59 with p > Z of 0.0) and 0.9237 (Z of 24.63 with p > Z of 0.0) by ABQ method. The agreement for each evaluator respect the consensus of them for each method had a Kappa of 0.929 for the first and second evaluators, and 0.954 for the third. Whilst using the Genant method it was 0.911, 0.886 and 0.907, respectively. Both of them with P < .005.The intraobserver agreement had a Kappa value of 0.83 and 1 for the first evaluator, 0.704 and 0.86 for the second; and, 1 and 1 for the third evaluator for ABQ and Genant methods, respectively, with P < .005.The median age for grade 1 fractures (17 cases) was 72.17 years with range 60-90 (SD of 8.96 years)...

Entendiendo la clasificación de las fracturas toracolumbares por el sistema `AO´ / Understanding the Thoracolumbar Fractures in the AO System

Objetivos: Facilitar la comprensión del sistema AO de clasificación de las fracturas toracolumbares y difundir su uso entre radiólogos. Métodos: Revisión de la literatura en PubMed, usando como términos de búsqueda: ao spine injury classification system, thoracolumbar spine fractures and classifications, computed tomography and thoracolumbar fractures, magnetic resonance and thoracolumbar fractures y thoracolumbar fractures and treatment. En los archivos de IDIME se buscaron imágenes de radiografía convencional, tomografía y resonancia magnética de fracturas del segmento toracolumbar para seleccionar la mayoría de ejemplos ilustrativos de los diferentes grupos de fracturas de la clasificación AO. Resultados: Se seleccionaron 52 artículos y se recopilaron 35 imágenes para ilustrar los diferentes grupos de la clasificación AO. Conclusiones: Aunque no existe una clasificación ideal que cumpla cabalmente los principios de relevancia, fiabilidad y precisión, la clasificación AO hasta la fecha es la que más se acerca. Por lo tanto, el radiólogo debe estar familiarizado con esta clasificiación para aplicarla y mejorar su comunicación con el clínico.

Objectives: The purpose of this review is to ease the understanding of AO classification of thoracic lumbar fractures, and spread its usage throughout radiologists. Methods: Literature revision in PubMed, using the following search items: ao spine injury classification system, thoracolumbar spine fractures and classifications, computed tomography and thoracolumbar fractures, magnetic resonance and thoracolumbar fractures y thoracolumbar fractures and treatment. We searched for conventional radiography, tomography and magnetic resonance images of fractures of the thoracolumbar segment in order to select most illustrative examples of the different fracture groups of AO classification. Results: We selected 52 articles and compiled 35 images to illustrate the different AO classification groups. Conclusions: Even through an ideal classification which fulfills the principles of relevance, reliable and accuracy does not yet exist, the AO classification the closest method to date. Therefore, the radiologist must be familiarized with this classification in order to apply it, as well as improve communication with the doctor.

Aspergilosis pulmonar por tomografía computarizada en el paciente pediátrico / Pulmonary Aspergillus in Pediatric Pa tient by CT

La aspergilosis pulmonar es una micosis con un espectro variable de manifestaciones que dependen del estado inmunológico. El propósito de esta revisión es mostrar las diferentes modalidades de la aspergilosis en los niños, en las que el radiólogo cumple un papel importante, especialmente para la detección temprana de las formas invasivas en inmunosupresión, debido a sus implicaciones pronósticas

Pulmonary aspergillosis is a mycotic disease with many manifestations which depend on the immunological state. The purpose of this article is to show the different forms of aspergillosis in children. The radiologist plays an important role, especially in early detection with the invasive forms of immunosuppression, due to prognostic implications.

Fístula arteriovenosa dural tentorial: presentación de un caso / Tentorial dural arteriovenous fistula: case report

Las fístulas arteriovenosas durales (FAVD ). Son lesiones vasculares de la duramadre generalmente adquiridas, consistentes en conexiones anormales entre las arterias durales con los senos venosos o las venas corticales. El objetivo de este artículo es presentar un caso de fistula dural de localización poco frecuente (en la tienda del cerebelo) en una paciente de 64 años. La tomografía y la resonancia son útiles para el diagnóstico, aunque es la angiografía convencional el examen ideal para caracterizar y planear el tratamiento. La neurorradiología intervencionista desempeña un papel fundamental y actualmente es la primera elección en el manejo de esta patologia.

Natural infection and distribution of triatomines (Hemiptera: Reduviidae) in the state of Querétaro, Mexico.

Chagas disease is present in Mexico but data on the presence of its vectors are not known for all the states. We conducted an epidemiological study to ascertain the presence of bedbugs in 23 communities of seven municipalities in the state of Querétaro, Mexico. Sampling was performed within and outside dwellings, using the technique of one person searching per hour per house. Four triatomine species were found: Triatoma mexicana (94%), Tri. dimidiata (3%), Tri. gerstaeckeri (2%) and Tri. pallidipennis (1%). Triatoma mexicana was found in six of the seven municipalities but has previously been found only in the state of Hidalgo, where it is considered the most important vector species of Trypanosoma cruzi. This is the first time that the presence of Tri. gerstaeckeri or Tri. dimidiata has been reported in the state of Querétaro. Tolimán municipality had the highest entomological indices: infestation index 73%; infection index 34.5%; crowding index 9.2%; density index 6.7%; and colonization index 20.6%. Although the prevalence and colonization indices were low, the infestation and infection indices indicate that different Triatoma species are becoming established in Querétaro. This work represents the first entomological study in this Mexican state and suggests that some triatomine vectors are extraordinarily mobile.