Casuistry of radiographic examinations of wild animals in the southern region of the state of Rio Grande do Sul, Brazil, from 2017 to 2020 / [Casuística dos exames radiográficos de animais silvestres na região Sul do Rio Grande do Sul entre 2017-2020]

A radiologia é uma importante ferramenta complementar para o diagnóstico de diversas afecções em diferentes espécies. O uso de exames complementares na medicina de animais silvestres, em especial o exame de imagem, traz inúmeras informações acerca do paciente. Este trabalho apresenta os dados obtidos por meio de um levantamento dos exames radiográficos realizados em animais silvestres entre os anos de 2017 e 2020, no Laboratório de Diagnóstico de Imagem e Cardiologia (LADIC), do Hospital de Clínicas Veterinárias da Universidade Federal de Pelotas (HCV/UFPel). Ao todo, foram avaliados 464 prontuários, sendo 293 (63,1%) de aves, 135 (29,1%) de mamíferos e 36 (7,8%) de répteis. As alterações mais encontradas nos exames radiológicos foram fratura de membros torácicos para as duas primeiras classes, e pneumonia para a última.(AU)

Caracterización de estudios por imágenes realizados en niños sanos en un centro de atención ambulatoria: percepciones, creencias y expectativas de sus padres / Characterizing imaging studies in healthy pediatric patients in an ambulatory center: parental perceptions, beliefs and expectations

Introducción: los estudios por imágenes (EPI) son de gran ayuda para el diagnóstico clínico, pero su uso irracional puede ocasionar daños. Objetivos: relevar las percepciones y expectativas sobre estudios por imágenes pediátricos en un grupo de padres de niños sanos. Evaluar los datos obtenidos en relación con el registro de EPI solicitados por Guardia durante el mismo período. Materiales y métodos: estudio exploratorio, descriptivo, cuali-cuantitativo mediante una encuesta en una muestra por conveniencia en un centro pediátrico ambulatorio, a lo largo de dos meses. Análisis retrospectivo de solicitud de EPI en el registro informatizado de historias clínicas de Guardia durante el mismo período. Resultados: respondieron 243 padres. El 93,4% refirió conocer métodos de EPI (la radiografía[Rx] fue el más conocido). Se había realizado al menos un EPI al 83,4% de los niños en los últimos doce meses. El estudio fue explicado en forma clara en el 96,4% de los casos. Un 47,7% de los padres refirieron conocer las consecuencias del uso repetitivo de EPI. El 81,6% acordó con que "ante cualquier traumatismo se debe realizar Rx para descartar fractura". Más del 60% consideró que debe realizarse Rx de tórax a todo niño con tos sin fiebre o con fiebre de más de dos días y 55% solicitarían Rx de senos paranasales si el niño elimina mocos verdes. El 49,8% opinó que los médicos piden EPI de menos (por falta de recursos, para trabajar menos o para ahorrar dinero). Durante el período estudiado se solicitó una radiografía al 5% de los pacientes que consultaron por Guardia; no se encontró justificación para solicitar el estudio en el 29% de los casos. Conclusión: un gran porcentaje de padres conoce los EPI; sin embargo, desconocen los riesgos asociados a su uso. Existen errores de concepto que generan expectativas desmedidas con respecto a la indicación de Rx. Se informó un exceso en las solicitudes de EPI por Guardia. Los padres consideran que los médicos solicitan EPI de menos. (AU)

Introduction: ediatric radiologic exams (PRE) are of great value for clinicians. It's over or misuse can lead to irreparable damage that can be prevented. Objective: to describe perceptions and expectations for the use of PRE among healthy children`s parents in an ambulatory center. To analyze these results in relation to the report of PRE performed in the emergency room during the same period. Methods: observational, cross sectional, quali- quantitative study using a survey on a convenience sample conducted in an outpatient pediatric center over a two months period. Retrospective analysis of medical records to evaluate PRE requested on the ER during the 2 months of the study. Results: 243 parents completed the survey. 93,4% were familiar with PRE (X-rays being the most popular among them). 83,4% of children in our sample had at least one PRE in the past 12 months. The need and utility of the study had been explained to the parents clearly in 96,4% of cases. 47,7% of parents knew about the side effects associated with repetitive use of PRE. 81,6% agreed with the statement "in the event that a child should suffer any trauma, an X-Ray should be performed to look for fractures". Over 60% think a chest X ray has to be obtained if the child has fever for over 48 hours and 55% would expect an X ray to be performed whenever a child has green nasal discharge. 49,8% respondents think that doctors order less than necessary (for lack of resources, unwillingness to work in or to save money). The analysis of clinical reports showed that X-Rays were performed to 5% of children at the emergency clinic. Among them, we found no reason for the study in 29% of the cases. Conclusion: we found that parents were very familiar with PRE, however less than half our sample knew of the potential risks related to their use. There are considerable misconceptions among parents regarding X-Ray use. Parents considered that doctors order too little PRE. (AU)

Pediatric cardiac catheterization procedure with dexmedetomidine sedation: Radiographic airway patency assessment.

Aims: The aim of the study was to measure airway patency objectively during dexmedetomidine sedation under radiographic guidance in spontaneously breathing pediatric patients scheduled for cardiac catheterization procedures. Subjects and Methods: Thirty‑five patients in the age group 5–10 years scheduled for cardiac catheterization procedures were enrolled. All study patients were given loading dose of dexmedetomidine at 1 μg/kg/min for 10 min and then maintenance dose of 1.5 μg/kg/h. Radiographic airway patency was assessed at the start of infusion (0 min) and after 30 min. Antero‑posterior (AP) diameters were measured manually at the nasopharyngeal and retroglossal levels. Dynamic change in airway between inspiration and expiration was considered a measure of airway collapsibility. Patients were monitored for hemodynamics, recovery time and complications. Statistical Analysis: Student paired t‑test was used for data analysis. P < 0.05 was considered significant. Results: Minimum and maximum AP diameters were compared at 0 and 30 min. Nasopharyngeal level showed significant reduction in the minimum (6.27 ± 1.09 vs. 4.26 ± 1.03, P < 0.0001) and maximum (6.51 ± 1.14 vs. 5.99 ± 1.03, P < 0.0001) diameters. Similarly retroglossal level showed significant reduction in the minimum (6.98 ± 1.09 vs. 5.27 ± 1.15, P < 0.0001) and maximum (7.49 ± 1.22 vs. 6.92 ± 1.12, P < 0.0003) diameters. The degree of collapsibility was greater at 30 min than baseline (P < 0.0001). There was a significant decrease in heart rate (P < 0.0001), and the average recovery time was 39.86 ± 12.22 min. Conclusion: Even though airway patency was maintained in all children sedated with dexmedetomidine, there were significant reductions in the upper airway dimensions measured, so all precautions to manage the airway failure should be taken.

Traumatismo nasal con arpón de pesca / Nasal trauma caused by fishing harpoon

Paciente masculino de 60 años de edad con trauma nasal accidental, producido por un arpón de pesca que penetra a través de la fosa nasal izquierda. Este fue atendido de urgencia y se le removió el arpón mediante una rinoscopia anterior. El paciente evolucionó de forma satisfactoria y no hubo afectación de gravedad ni secuelas. Los traumatismos en el macizo facial y craneoencefálico, producidos por armas diferentes a las de fuego, son poco frecuentes. El tipo de lesión presentada es algo excepcional y no existen informes similares en la literatura.

A sixty-year old male patient, who suffered nasal trauma caused by a fishing harpoon that penetrated his left nasal cavity. He was immediately assisted to remove the hapoon by performing anterior rhinoscopy. He recovered satisfactorily and there were no side effects or sequelae. The facial and cranioencephalic traumas caused by weapons different from firearms are rare. The type of lesion presented in this article is unique and there is no similar reports found in literature.

The Profile of Indications for Radiography in the Neonatal Intensive Care Unit at Universitas Academic Hospital; Bloemfontein

Introduction. Radiography is a key diagnostic tool in paediatric care. A pro-active approach (including the use of radiography) is required to ensure effective management of these patients. Taking into account the widely documented harmful effects of ionising radiation and the small organ masses of neonates; the number of radiographs that neonates receive during hospital admission is of particular concern. A reduction in radiation exposure tailored to specific indications would be advantageous. The aim of this study was therefore to establish a profile of indications for radiographs in the Neonatal Intensive Care Unit at Universitas Academic Hospital; Bloemfontein; South Africa.Methods. A retrospective; descriptive study was conducted over a 1-month period (8 September - 8 October 2010). Information was obtained from the online Medi-Tech system used to request radiographs.Results. A total of 469 radiographs were performed on 51 neonates. Twenty-seven male and 24 female neonates received 226 (48.2) and 243 (51.8) radiographs; respectively. The radiographs were classified into routine (91.9) and urgent (8.1). Chest radiographs were requested most frequently (59.5). The most commonly recorded indication was prematurity (37.1); followed by respiratory-related indications (28.5). The highest number of radiographs performed on a single neonate was 46. Conclusions. All radiographs were requested online; supporting the validity of the study with regard to the number of radiographs performed and their respective indications. A representative profile of indications was successfully obtained; which can assist with the implementation of further research on the stratification of radiation exposure according to indications for radiographs

Digital radiograph of the middle phalanx of the third finger (MP3) region as a tool for skeletal maturity assessment.

Objective: To evaluate the reliability of the digital radiograph of the middle phalanx of the third finger (MP3) in skeletal maturity assessment Study Design: Fifty children (24 girls and 26 boys) belonging to the circumpubertal age-group were selected for the study. Two radiographs - lateral cephalogram and digital radiograph of the MP3 region - were taken in each child. Age assessment was based on the changes in shape of the cervical vertebrae and the epiphysis of the middle phalanx of the third finger of the left hand. The radiographs were assessed by three examiners. The inter- and intraexaminer variability were determined by the Wilcoxon rank sign test and the Kruskal-Wallis test and were found to be nonsignificant. Examiner 3 showed the best intraexaminer agreement and was selected to evaluate the radiographs for the entire study. Results: The correlation determined between the MP3 stages and cervical vertebrae maturity index (CVMI) stages, the peak-wise distribution of the MP3 stages, and the correlation between the MP3 stages and the chronological age were found to be highly significant. Conclusions: Digital radiograph of the MP3 region is definitely a simple, reliable, cost-effective, and time-saving technique for the assessment of skeletal maturity.

Pneumonias na enfermaria de pediatria do Hospital Nossa Senhora da Conceição, em Tubarão – SC / Pneumonia in Pediatrics Nursery in a Hospital in South Brazil

Objetivos: Verificar os procedimentos realizados para obtenção do diagnóstico e tratamento da criançainternada com pneumonia e conhecer o seu perfil epidemiológico.Métodos: Foi realizado um estudo transversal, observacional,que incluiu 100 crianças, com idade entre 01 mês e 14 anos, com diagnóstico de pneumonia adquiridana comunidade, internadas na enfermaria de pediatria do Hospital Nossa Senhora da Conceição, no períodode março a outubro de 2007.Resultados: Foi encontrada uma média de idade de2,3 anos, predominando o gênero masculino em 59%. Observou-se que o padrão de radiografia de tórax prevalente foi consolidação em 60%, seguido pelo infiltrado intersticial em 32% e padrão misto em 10%. Não houve significância estatística na comparação de dados do RX de tórax com o hemograma. A hemocultura foi realizada em 5% dos pacientes, havendo positividade em apenas1 caso. Os antibióticos mais realizados para tratamento ambulatorial antes da internação e tratamento hospitalarforam amoxicilina e penicilina cristalina respectivamente. Dentre as crianças avaliadas apenas 7% haviam realizadovacina antipneumocócica. Conclusões: As crianças com RX de tórax alteradofizeram uso de antibioticoterapia hospitalar havendo dificuldade em identificar a etiologia da pneumonia. Poucas crianças avaliadas possuíam vacinação contra o pneumococo, refletindo a necessidade de inclusão dasvacinas antipneumocócicas no calendário vacinal brasileiro,alcançando uma redução nas taxas de morbi/mortalidade por pneumonia adquirida na comunidade.

To verify the procedures made to obtaindiagnose and treatment of the inpatient child with pneumonia and know its epidemiologic profile. Methods: An observational transverse study wasdone, which included a hundred children from 1 month to 14 years old with Community Acquired Pneumonia, inthe pediatrics nursery of the Nossa Senhora da Conceição Hospital, from March to October in 2007. Results: A 2,3 years old average was found, with amale majority of 59%. It was noticed the chest X-ray pattern prevalent was consolidation in 60%, followed byinterstitial infiltrates in 32% and the mixed pattern in 10%. There was not any notable statistics on the comparisonof the chest X-ray data with the white blood cell count. Blood culture was effectuated in 5% of patients, and itwas found positive result at only one case. The antibio tics frequently used for the ambulatory and hospitalartreatment were amoxicillin and penicillin respectively. Among the evaluated children just 7% have taken thepneumococcal vaccine. Conclusions: Children with altered chest X-ray weretreated by antibiotic therapy. There was difficulty in identify the aetiology of pneumonia. Few of the evaluatedchildren took the pneumococcal vaccine, which reflects the necessity to include in the Brazilian vaccination calendarthese vaccines to accomplish some reduction on the mortality rates caused by Community Acquired Pneumonia.

Endoscopic assessment of effacement of balloon waist during pneumatic dilatation of primary achalasia cardia under topical anesthesia

Balloon dilatation of Primary Achalasia Cardia [PAC] is usually performed under antegrade endoscopic guidance, with conscious sedation. The main goats of this prospective study were to assess the safety and efficacy of pneumatic dilatation without conscious sedation and to determine the endoscopic signs of effacement of the balloon "waist". Pneumatic dilatation was successfully performed as outdoor procedure without conscious sedation in patients [n= 25; mean age 42.56 years] with endoscopic and radiologic diagnosis of PAC. Immediate relief of symptoms was observed in 23 [92%] cases. Effacement of the balloon "waist" under endoscopic vision was appreciated in all cases in the present study. Common complications of pneumatic dilatation were chest pain in all [100%] subjects and mild local bleeding in 17 [68%] patients. There was no cancellation of procedure. Re-dilatation was required in 2 [8%] cases. The duration of follow-up was from 6 weeks to 23 months. Pneumatic dilatation of PAC can be safely performed as same day procedure, without conscious sedation. Obliteration of the balloon "waist" can be readily determined by antegrade "endoscopic assessment of stretch on the lower oesophageal sphincter [EASL]"

[Prediction of maxillary canine impaction with panoramic radiographs]

The incidence of maxillary canine impaction is between 1% and 3% populations. Determining whether impaction will occur and timing the treatment modalities that are affected by impacted canine [s] are paramount for a successful out come, panoramic radiograph to identify canine impaction; not only is economical but treatment result will be more desirable. The aim of this investigation was to develop a reliable method for predictors of maxillary canine impaction on a panoramic radiograph. Sixty - four panoramic radiographs of mixed dentition patients were inspected to belong to two groups of patient with impacted and not impacted canines. 88 were found with no impaction and 40 with impacted canines. For predicting canine impaction panoramic radiographs were inspected for two indices: 1- The erupted lateral tooth were divided to fourfold zone from 4 to 1 sectors in mesiodistal dimension; therefore identified the unerupted permanent canines cusp tip location related to the erupted permanent lateral. 2-The internal angle between the long axis of the unerupted canine and a horizontal line between superior points of condyles was measured. The data were analyzed by descriptive statistics and logistic regression. All of not impacted teeth were found in sector I and II. [69.3% in sector I and 30.7% were placed in sector II]. 17.5% of impacted teeth were in sector I, 42.5% in sector II, 27.5% in sector Ill and 12.5% were placed in sector IV. Furthermore the mean angle for non impacted teeth was 74.72' and for impacted teeth was 67.12'. The location of canine cusp tip in panoramic radiograph is the most important factor in predicting probable impaction, but often, the angle of canine is not worth

[ maxillary second molar with two palatal roots: Case report]

The knowledge about the anatomic variation pulp cavity, specially in multi-rooted teeth, is an important factor for diagnosis and successful endodontic treatment. Root canal treatment of 4-rooted maxillary second molars has been described in only a limited number of case reports. The purpose of this case report was to illustrate and describe the endodontic treatment of a 4-rooted maxillary second molar. A 20-year-old female with no history of systemic disease was referred for treatment of her upper left second molar tooth. The diagnostic radiographies revealed root anomalies. After access cavity preparation, presence of four orifices in the pulp chamber was confirmed; each of them related to a distinct root. Root canal therapy was performed completely in all four roots. This case report indicates that the clinicians must be aware of anatomic variations during the diagnostic and treatment phases of maxillary molars, and proper root canal treatment should be performed respecting the presence of challenges in pulp space anatomy

survey of annual effective and genetically significant dose from conventional X-ray examinations in 10 counties Khorasan province-Iran

A study has been conducted to assess two useful radiation protection indices, the annual per-capita effective dose equivalent [AED] andthe genetically significant dose [GSD], from conventional diagnostic radiography in 10 counties with more than 1,886,000 inhabitants in Khorasan province in Iran. The health centre authorities of Khorasan province were asked to record data of their patients [sex, age, weight and height] who had undergone radiography during one month starting October 2002, with the radiography specifications [kVp, mAs, FSD, field size] and conditions of the X-ray machines [filtration, model and performance]. Based on the gonad absorbed dose level, the radiography data were first divided into 5 groups. Then, the average gonad and effective dose of the radiography groups were estimated using ODS-60 software, and finally, GSD and AED of each county were calculated. Average number of radiography per thousand inhabitant was 34.5 in this study, which varied from 9.4 [Kashmar] to 109.4 [Ferdos]. Number of X-ray units per 1000 population was 0.008. The GSD and AED of inhabitants in 10 counties in Khorasan province is 0.012 and 0.014 mGy/y/person respectively. The GSD and AED of 10 counties in Khorasan province were much lower than those in most of other countries, which would have been due to lower number of X-ray units and examinations per 1000 inhabitants. Although this would reduce the risk of radiation absorbed dose from medical diagnostic, but it also showed need to improve and expand the health care facility and services in those cities

Evaluation of uterine involution using radio-opaque markers during the postpartum period in Makuii ewes

After completion of the third stage of parturition and expulsion of the placenta, the uterus starts to involute until it reaches to normal size. The rate of uterine involution after parturition was studied in 6 healthy Makuii ewes. During second month of pregnancy the genital tract was exteriorized through a posterior midline laparatomy under general anesthesia and then four non-toxic split shots with different sizes were sutured on the serosal wall of the uterine body and horns. After parturition, the distance between markers was measured by sequential radiography. The mean length of the uterine body declined until 28 days after lambing but statistically maximum reduction was seen at about 14 days after parturition [P<0.05]. Also, the mean diameter of gravid and non-gravid horn rapidly declined until 14 days postpartum [P<0.05] but reduction countinued until 42 days postpartum [P>0.05]. The difference between the mean diameter of the gravid and non-gravid horn was not significant between days 14-42 [because of relatively small reduction in size]. There as a high correlation between the measurements taken at the time of laparotomy and determined by radiography [4 days after surgery] for the mean length of uterine body [r = 0.89], the mean gravid horn diameter [r = 0.91] and non-gravid horn diameter [r = 0.79]. In conclusion, after final statistical analysis of sequential radiographic views by using a repeated measurement analysis of variance, involution of the uterus in Makuii ewes was completed about 28 days postpartum for the uterine body and about 14 days for both the gravid and non-gravid horn. Radio-opaque marker is a useful method to study changes of the uterine size after parturition in live ewes

Receiver Operating Characteristic (ROC) Curve: Practical Review for Radiologists

The receiver operating characteristic (ROC) curve, which is defined as a plot of test sensitivity as the y coordinate versus its 1-specificity or false positive rate (FPR) as the x coordinate, is an effective method of evaluating the performance of diagnostic tests. The purpose of this article is to provide a nonmathematical introduction to ROC analysis. Important concepts involved in the correct use and interpretation of this analysis, such as smooth and empirical ROC curves, parametric and nonparametric methods, the area under the ROC curve and its 95% confidence interval, the sensitivity at a particular FPR, and the use of a partial area under the ROC curve are discussed. Various considerations concerning the collection of data in radiological ROC studies are briefly discussed. An introduction to the software frequently used for performing ROC analyses is also presented.

Artropatía por depósito de cristales de dihidrato de pirofosfato de calcio / Calcium pyrophosfate dihydrate crystal deposition disease: review

Los autores estudiaron las características radiológicas en 67 pacientes con artropatía por depósito de cristales de dihidrato de pirofosfato de calcio encontrados en un total de 2.565 pacientes con articulaciones dolorosas no traumáticas; 2 por ciento de los casos presentaron artropatía por pirofosfato. La radiología convencional fue generalmente diagnóstica en todos los casos cuando se analizaron signos específicos para diferenciar la artropatía por pitofosfato de otras artropatías como la osteoartritis, considerando: a) condocalcinosis (94 por ciento), b) articulación no afectada usualmente en la osteoartritis primaria (22 por ciento) y c) compartimientos no comúnmente comprometidos en la osteoartritis (29 por ciento). Todos los pacientes presentaron además signos de artropatía degenerativa

Avaliaçäo do funcionamento do serviço de radiodiagnóstico do Hospital Universitário Clementino Fraga Filho - Universidade Federal do Rio de Janeiro

Resumo: Visando a implantaçäo de um Programa de Garantia de Qualidade (PGQ) no Serviço de Radiodiagnóstico (SR) do Hospital Universitário Clementino Braga Filho da Universidade Federal do Rio de Janeiro, foi feita uma avaliaçäo preliminar das condiçöes de funcionamento deste Serviço. O trabalho realizado abrangeu tanto aspectos técnicos relacionados ao funcionamento dos equipamentos de raio X e os acessórios em uso no Serviço, quanto os aspectos administrativos e de gerência do SR. Para este levantamento foram feitos Testes de Controle de Qualidade e pesquisa diversas para avaliaçäo do funcionamento gerencial do SR. Os resultados obtidos indicaram ser oportuna e benéfica a implantaçäo de um PGQ visando a reduçäo dos custos operacionais, melhoria da qualidade da imagem e reduçäo das doses nos pacientes

Reconocimiento de la osteoporosis mediante estudios radiológicos simples / Osteoporosis recognition through plain X-ray studies

Se realizó un estudio sobre las causas y frecuencias de osteoporosis en la población femenina de 40 a 60 años de edad a través de estudios radiológicos simples, en 222 pacientes, de las cuales 53 (23.8 por ciento) pertenecen a rango de edad de 40 a 45 años, 87 (39.1 por ciento) de 46 a 50 años, 51 (22.9 por ciento( de 51 a 55 años y 31 (13.9 por ciento) de 56 a 60 años, la edad promedio fue de 50 años. A todas las pacientes se les aplicó un interrogatorio previamente y Singh en radiografías simples AP de mano y AP de cadera respectivamante. Encontramos que el factor predisponente más frecuente fue la falta de ejercicio físico, hallado en el 83.4 por ciento de la población estudiada; otro factor fue la dieta inadecuada con carencia de calcio en los alimentos, que fue constante en un 65.76 por ciento de la población; y la menopausia que se halló en el 56.30 por ciento de las pacientes. La medición del índice de Singh reveló que el 13.96 por ciento de las 222 pacientes cuentan con una osteopenia severa, el 80.62 por ciento presentan datos de osteopenia y tan sólo el 5.4 por ciento se encuentran con un índice normal. En cuanto al índice de Nordin reveló que el 13.0 por ciento de la población total obtuvo un índice desfavorable de espesor cortical. En conclusión, la osteoporosis es una patología que debería ser más previsible que tratable, ya que los factores que la condicionan pueden ser modificados fácilmente siempre y cuando la paciente no cuente con patología de tipo endocrinológico. La utilidad de los estudios radiológicos simples para la medición de los índices de Nordin y Singh radica en la aplicación que se raliza de éstos para descartar padecimientos de tipo osteomuscular que ocasiona dolor y para poder identificar datos de osteopenia para el consecuente manejo y/o investigación de la patología del paciente