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Background Ultrasonographic evaluation of thyroid nodules is challenging due to their high frequency and low malignancy rate. The risk stratification system developed by the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) focuses on addressing the primary contemporary objectives for these lesions, aiming to decrease unnecessary biopsies while maintaining a similar specificity compared with other risk stratification systems. Generally, when indicative of malignancy by ultrasound findings, the next best step in management is an evaluation by fine needle aspiration biopsy (FNAB) and cytological analysis with The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) results that determine further evaluation requirements, actions that are based on the risk of malignancy (ROM) of the assigned category, which could include surgical intervention. Objectives To validate and analyze the individual impact of each ultrasonographic finding indicative of malignancy in the ACR TI-RADS guidelines based on their respective correlation with results obtained by TBSRTC. Materials and method Reports for 212 thyroid ultrasound-guided FNABs from 2018 to 2020 were assessed. Only 117 had both ACR TI-RADS and TBSRTC reports available and were analyzed. Nodules were divided into two groups: ROM < 5% (Bethesda 1, 2; n = 58), and ROM > 5% (Bethesda 3, 4, 5, 6; n = 59). Statistical analysis was performed using the x2 test and bivariate logistic regression model for each characteristic included in ACR TI-RADS. Results Individual ultrasound characteristics with a more pronounced distribution towards the Bethesda > 5% malignancy group were: solid or almost completely solid composition (n=53, 62.3%), very hypoechoic echogenicity (n=3, 75%), wider-than-tall shape (n=50, 50.5%), lobulated or irregular margin (n=23, 65.7%), punctate echogenic foci (n=18, 72%), and thyroid isthmus location (n=6, 75%). Statistically significant individual ultrasonographic characteristics indicative of malignancy included solid or almost completely solid (p = 0.005), very hypoechoic echogenicity (p = 0.046), margin lobulated or irregular (p = 0.031), and punctate echogenic foci (p = 0.015). No significant association was found in the taller-than-wide shape for differentiating malignant from benign lesions (p = 0.969). Conclusions Specific ultrasound characteristics identified in the ACR TI-RADS system demonstrate a stronger correlation with an increased risk of malignancy when compared with cytologic evaluation results. These characteristics include a solid composition, lobulated or irregular margins, punctate echogenic foci, and very hypoechoic echogenicity. Our findings revealed that the scale points for the taller-than-wide characteristic do not adequately represent its true influence on the risk of malignancy.
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Oats are known for their nutritional value and also for their beneficial properties on human health, such as the reduction of cholesterol levels and risk of coronary heart disease; they are an important export product for Chile. During the last decade (2010-2022) over 90% of the oat cultivated area in Chile has been covered with Avena sativa L. cv. Supernova INIA. This lack of genetic diversity in a context of climate change could limit the long-term possibility of growing oats in Chile. The present study is a phenotypic and genetic analysis of 132 oat cultivars and pure lines of diverse origin that can be considered as potential breeding material. The germplasm was evaluated for 28 traits and analyzed with 14 SSR markers. The effects of genotypes on phenotype were significant over all traits (P ≤ 0.05). Most traits exhibited moderate to high broad-sense heritability with exceptions such as yield (H2 = 0.27) and hulls staining (H2 = 0.32). Significant undesirable correlations between traits were generally of small biological importance, which is auspicious for achieving breeding objectives. Some of the heritability data and correlations provided here have not been previously reported. The overall phenotypic diversity was high (H' = 0.68 ± 0.18). The germplasm was grouped into three phenotypic clusters, differing in their qualities for breeding. Twenty-six genotypes outperforming Supernova INIA were identified for breeding of conventional food-oats. The genetic diversity of the germplasm was moderate on average (He = 0.58 ± 0.03), varying between 0.32 (AM22) and 0.77 (AME178). Two genetic subpopulations supported by the Structure algorithm exhibited a genetic distance of 0.24, showing low divergence of the germplasm. The diversity and phenotypic values found in this collection of oat genotypes are promising with respect to obtaining genetic gain in the short term in breeding programs. However, the similar genetic diversity, higher phenotypic diversity, and better phenotypic performance of the germplasm created in Chile compared to foreign germplasm suggest that germplasm harboring new genetic diversity will be key to favor yield and quality in new oat cultivars in the long term.
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Resumen ANTECEDENTES: En Obstetricia, las imágenes en espejo son artefactos ecográficos infrecuentes que, potencialmente, pueden confundirse con embarazos heterotópicos y propiciar errores diagnósticos e intervenciones iatrógenas. Estas imágenes ficticias se generan por la existencia de una superficie reflectora como, por ejemplo, el intestino distendido o la vejiga repleta. CASO CLÍNICO: Paciente de 39 años, con embarazo por fertilización in vitro, que asiste a evaluación ecográfica del primer trimestre. En la ecografía de rutina a las 11 semanas se observó una imagen en espejo y en la resonancia magnética: útero gestante con una estructura retrouterina hipoecoica, sin feto en el interior. La imagen ecográfica en espejo volvió a reproducirse en el tercer trimestre. El embarazo llegó a término y finalizó por vía abdominal, sin que pudieran demostrarse las estructuras que se advirtieron en la resonancia magnética. CONCLUSIONES: Las imágenes en espejo se han reportado en ultrasonidos de diversas localizaciones pero pocos en la Obstetricia. Todo hizo suponer que la superficie reflectora fue la estructura hipoecoica retrouterina observada, transitoriamente, en la resonancia magnética.
Abstract BACKGROUND: In obstetrics, ultrasonic artifactual mirror images are infrequent, but potentially dangerous since they can be mistakenly interpreted as heterotopic pregnancies, precluding diagnostic errors and iatrogenic interventions. These images require a reflection surface such as dilated bowl or plenty bladder to be generated. OBJECTIVE: We report a first trimester scan ghost twin, diagnosed since first trimester of pregnancy. CLINICAL CASE: 39-year-old patient, with pregnancy due to in vitro fertilization, who attends ultrasound evaluation of the first trimester. Routine ultrasound at 11 weeks showed a mirror image and magnetic resonance imaging: a pregnant uterus with a hypoechoic retrouterine structure, with no fetus inside. The ultrasound mirror image reproduced again in the third trimester. The pregnancy came to an end and ended by abdominal route, without being able to demonstrate the structures that were noticed on the MRI. CONCLUSION: Very few reports of obstetric ultrasound mirror images have been reported. We hypothesize that the transient retrouterine hypoecogenic structure observed by MRI was the reflective surface that create the ghost twin image.
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O objetivo deste estudo foi conhecer o que pesam os pais de diferentes níveis econômicos sobre a idade ideal para a primeira consulta odontológica dos filhos, bem como o motivo de sua realização. A coleta de dados foi através de questionários e os resultados obtidos de 327 pais de escolares com idade entre seis e dez anos, na cidade de Pitangui - MG, foram analisados estatisticamente através do Programa EPI-INFO 6.02, ao nível de confiança de 95 por cento. As famílias foram agrupadas em economicamente favorecidas (Grupo I) e desfavorecidas (Grupo II). Constatou-se que houve diferença estatisticamente significante (p<0,0010) entre os dois grupos para a indicação da idade ideal da primeira consulta odontológica, sendo 61,2 por cento das respostas corretas dadas pelo Grupo I. Quanto à idade efetiva da primeira consulta, observou-se que apenas 7,6 por cento dos pesquisadores relataram que esta visita ocorreu com até um ano de idade. Houve diferença estatisticamente significante entre os dois grupos (p<0,0010), onde 76,7 por cento das respostas foram dadas pelo Gupo I e 23,3 por cento pelo Grupo II. Em relação ao motivo para a primeira consulta, a maior parte dos pesquisados concorda ser a prevenção, sendo 61,5 por cento das respostas dadas pelo Grupo I e 38,5 por cento pelo Grupo II, mas observou-se que a cárie dentária foi a principal responsável para que a primeira consulta odontológica se efetivasse. Conclui-se, então, que famílias de um nível econômico mais privilegiado demonstraram reconhecer a idade ideal e motivo correto para levar seus filhos ao dentista pela primeira vez. Embora esta prática não tenha sido vivenciada pelas mesmas
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Recolección de Datos , Odontología Pediátrica , Clase SocialRESUMEN
A anestesia local é um importante recurso a ser utilizado no tratamento odontológico de todos os pacientes. No entanto, existe grande controvérsia em torno de qual anestésico deve ser escolhido no atendimento ambulatorial às gestantes. Conseqüentemente, muitos dentistas se apresentam apreensivos quando da utililizaçäo do anestésico local nestas pacientes, chegando inclusive a postergar o tratamento emergencial erroneamente para depois do parto. Este trabalho, baseado na literatura científica disponível, discute sobre o uso do anestésico local em tratamentos odontológicos no período da gravidez, bem como as principais consideraçöes que levam à eleiçäo da soluçäo anestésica mais apropriada