Evaluation of temporal bone pneumatization using panoramic radiography and cone beam computed tomography / Avaliação da pneumatização do osso temporal por meio de radiografia panorâmica e tomografia computadorizada de feixe cônico

Aim: To evaluate the presence and characteristics of pneumatizations in the roof of the mandibular fossa and articular eminence by panoramic radiography and cone beam computed tomography (CBCT).Methods: This study analyzed CBCT images of the temporomandibular joint of 705 patients, In 60 exams, it was possible to compare tomographic with panoramic images. For cases where pneumatization was present, laterality and pattern of manifestation were considered. A chi-square test was used to compare the differences between CBCT and panoramic radiography in the diagnosis of pneumatization. Results: Descriptive analysis revealed a sample profile that was predominantly female (75.9%), with a mean age of 42.6 years (± 17.4). The presence of pneumatizations in the roof of the mandibular fossa and articular eminence in CBCT images was identified in 330 (46.8%) and 154 (21.8%) exams, respectively, and the most frequent pneumatization pattern was the multilocular type in both locations. Bilateral pneumatization was more prevalent in the roof of the mandibular fossa. Considering the analysis of 60 pairs of exams, in panoramic radiography, pneumatizations in the roof of the mandibular fossa and articular eminence were identified in 22 (36.7%) and 12 (20.0%) examinations, respectively. Regarding CBCT images, pneumatizations in the roof of the mandibular fossa was observed in 24 (40.0%) exams, while articular eminence was found in 14 (23.3%) images. There were no statistically significant differences between the proportion of pneumatization identified by panoramic radiography and CBCT (p > 0.05). Conclusion: This study suggests that panoramic radiography may be an imaging method used to evaluate pneumatization in the temporomandibular joint region.

Objetivos: Avaliar a presença e as características da pneumatização no teto da fossa mandibular e eminência articular por meio de radiografias panorâmicas (RP) e tomografias computadorizadas de feixe cônico (TCFC). Métodos: Foram analisadas imagens tomográficas da ATM de 705 pacientes, sendo que 60 desses pacientes também possuíam RP. Para todos os casos foram avaliadas a presença, a lateralidade e o padrão de manifestação da pneumatização. O teste qui-quadrado foi empregado para comparar os resultados obtidos a partir das RP e das TCFC no que tange o diagnóstico das pneumatizações. Resultados: A análise descritiva revelou uma amostra predominantemente feminina (75,9%) com uma média de idade de 42,6 anos (± 17,4). A pneumatização no teto da fossa mandibular e eminência articular foi evidenciada em 330 (46,8%) e 154 (21,8%) imagens de TCFC, respectivamente, e o padrão de pneumatização mais frequente foi o multilocular em ambas as regiões. A pneumatização bilateral foi mais prevalente no teto da fossa mandibular. Considerando a análise dos 60 pares de exames, nas radiografias panorâmicas as pneumatizações no teto da fossa mandibular e eminência articular foram identificadas em 22 (36,7%) e 12 (20,0%) exames, respectivamente. Em relação às imagens tomográficas, a presença desse achado no teto da fossa foi observada em 24 (40,0%) exames e na eminência articular em 14 (23,3%). Não houve diferença com significância estatística entre a proporção de pneumatização identificada em RP e TCFC (p > 0,05). Conclusão: Os resultados obtidos sugerem que a radiografia panorâmica pode ser um método de diagnóstico por imagem empregado para avaliação de pneumatizações na região da ATM.

Hemoperitoneum secondary to mesenteric laceration after abdominal trauma - Case report.

Mesenteric laceration is an uncommon cause of hemoperitoneum, with nonspecific signs and symptoms and frequently is camouflaged by the signs of other traumatic lesions. There is a high risk to go unnoticed increasing morbidity and mortality. We report a case of a 43-year-old man, who was involved in a motorcycle accident, with thoraco-abdomino-pelvic trauma, but without evidence of intra-abdominal lesions on exams, with exception of hemoperitoneum. Due to hemodynamic instability, it was performed an exploratory laparotomy. Intraoperative findings were mesenteric lacerations affecting a small bowel segment. This case demonstrates that a high index of suspicion is necessary to diagnose and treat lesions like mesenteric laceration, not visible early on imaging but potentially fatal, with high risk of complications.

Photodynamic Therapy With Propolis: Antibacterial Effects on Staphylococcus aureus, Streptococcus mutans and Escherichia coli Analysed by Atomic Force Microscopy.

Introduction: Photodynamic therapy (PDT) is a process that uses a light source (e.g. laser), oxygen molecules and a photosensitizing agent. PDT aims to act against pathogens, including those resistant to antimicrobials. The association of PDT with natural drugs, such as Propolis, has not been widely studied. Methods: Therefore, this study aimed to evaluate the antimicrobial effect of PDT in vitro by using Propolis as a photosensitizing agent. For this purpose, the dry Propolis extract was used as a photosensitizer and a low-power laser (Photon Laser III model) was irradiated onto the microwells for 90 seconds. Gram-positive and Gram-negative bacterial strains were used in the tests at a concentration of 5 × 105 CFU/mL. Initially, the antibacterial activity of the photosensitizers without laser action was determined by using a serial microdilution method before the experiment with a laser. After the incubation of the plates in a bacteriological oven, resazurin (0.1%) was added and the minimum inhibitory concentration (MIC) was determined. Alterations in the morphology of the bacteria were analysed by using atomic force microscopy (AFM). Results: Bacteria were sensitive to Propolis with MICs ranging from 13.75 to 0.85 mg/mL, but no susceptibility was observed for methylene blue without laser application. A change was observed for MIC values of Propolis against Staphylococcus aureus after irradiation, which decreased from 1.71 mg/mL to 0.85 mg/mL. However, this behaviour was not observed in Escherichia coli, the only gram-negative strain used. In addition, AFM images revealed alterations in the size of one of the bacteria tested. Conclusion: The Propolis is more active against gram-positive bacteria and PDT improved its activity against one of the strains tested.

Case series of Fournier's gangrene: Affected body surface area - The underestimated prognostic factor.

OBJECTIVES: Identifying the factors affecting the outcome of patients with Fournier's Gangrene and assaying the accuracy of the Fournier Gangrene Severity Index (FGIS), the Uludag score (UdS), affected Body Surface Area (BSA) and the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) model as prognostic tools. MATERIALS AND METHODS: Retrospective study involving all patients with Fournier's gangrene treated in our Hospital between January 2008 and December 2015. The epidemiological, clinical, biochemical and management data of these patients was obtained and analyzed. RESULTS: The series includes 19 patients, 14 male and 5 female, with a median age of 70 (62; 78,5) years. The mortality rate was 21%. From the data analyzed, only the affected BSA (BSA>3.25%) was associated with mortality (p = 0.016). None of the established scores (FGSI; UdS; LRINEC) proved to be a useful tool for predicting mortality. The combination of affected BSA and FSGI (FGSI≥9 or BSA>3.25%), (p = 0.004) and the combination of the affected BSA and the LRINEC model (LRICEC≥8 and BSA>3.25%), (p = 0.004) led to a major improvement in these scores. CONCLUSIONS: Affected BSA is a useful prognostic factor in Fournier's gangrene. The existing prognostic scores can be improved with the introduction of this factor.