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Isr Med Assoc J ; 23(1): 43-47, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33443342


BACKGROUND: The sonographic assessment of estimated fetal weight (EFW) is essential for identification of fetuses in weight extremes and aids in peripartum management. However, there are inconsistent reports regarding EFW accuracy. OBJECTIVES: To examine maternal and fetal determinants associated with unreliable EFW. METHODS: A retrospective case-control study was conducted at a single, tertiary medical center between 2011 and 2019. All term, singleton deliveries with a sonographic EFW within 2 weeks of delivery were included. Unreliable EFW was defined as > 500 grams discordance between it and the actual birth weight. We allocated the study cohort into two groups: unreliable EFW (cases) and accurate EFW (controls). RESULTS: Overall, 41,261 deliveries met inclusion criteria. Of these, 1721 (4.17%) had unreliable EFW. The factors positively associated with unreliable EFW included body mass index > 30 kg/m2, weight gain > 20 kg, higher amniotic fluid index, pregestational diabetes, gestational age > 410/7, and birth weight ≥ 4000 grams. On multiple regression analysis, pregestational diabetes (odds ratio [OR] 2.22, 95% confidence interval [95%CI] 1.56-3.17, P < 0.001) and a higher birth weight (OR 1.91, 95%CI 1.79-2.04, P < 0.001) were independently associated with unreliable EFW. On analysis of different weight categories, pregestational diabetes was associated with unreliable EFW only among birth weights ≥ 3500 grams (OR 3.28, 95%CI 1.98-5.44, P< 0.001) and ≥ 4000 grams (OR 4.27, 95%CI 2.31-7.90, P < 0.001). CONCLUSIONS: Pregestational diabetes and increased birth weight are independent risk factors for unreliable EFW and should be considered when planning delivery management.

Peso al Nacer , Peso Fetal , Atención Prenatal/métodos , Ultrasonografía Prenatal , Adulto , Diabetes Mellitus/epidemiología , Precisión de la Medición Dimensional , Femenino , Edad Gestacional , Humanos , Valor Predictivo de las Pruebas , Embarazo , Tercer Trimestre del Embarazo , Pronóstico , Factores de Riesgo , Ultrasonografía Prenatal/métodos , Ultrasonografía Prenatal/normas
Braz. dent. sci ; 24(1): 1-13, 2021. tab, ilus
Artículo en Inglés | LILACS, BBO - Odontología | ID: biblio-1145439


Objective: The purpose of this study is to evaluate the influence of the type of scanner and scanning direction on the accuracy of the final cast. Material and Methods: A partial master cast was used as a reference. A total of 128 scans were obtained and divided into two groups: the conventional method and the digital method. The digital group was divided into three groups: TRIOS 3, Omnicam and CS 3600. Each of these groups was subdivided according to the scanning direction, and each scan was overlaid on the digital reference cast to measure the trueness and precision of the procedures. Results: The overall precision values for the type of impression were 59.89 ± 13.08 µm for conventional and 13.42 ± 4.28 µm for digital; the values for trueness were 49.37 ± 19.13 µm for conventional and 53.53 ± 4.97 µm for digital; the scanning direction trueness values were 53.05 ± 4.36 µm for continuous and 54.03 ± 5.52 µm for segmented; and the precision values were 14.18 ± 4.67 µm for continuous and 12.67 ± 3.75 µm for segmented (p> 0.05). For the scanner type, the trueness values were 50.06 ± 2.65 µm for Trios 3, 57.45 ± 4.63 µm for Omnicam, and 52.57 ± 4.65 µm for Carestream; and those for precision were 11.7 ± 2.07 µm for Trios 3, 10.09 ± 2.24 µm for Omnicam, and 18.49 ± 2.42 µm for Carestream (p <0.05). Conclusions: The digital impression method is the most favorable method regarding precision; in terms of trueness, there are no differences between the types of impressions. (AU)

Objetivo: O objetivo deste estudo é avaliar a influência do tipo de técnica de moldagem, tipo de escâner intraoral e direção do escaneamento na precisão do modelo final. Material e Métodos: Um modelo parcial mestre foi usado como referência. Um total de 128 escaneamentos foi obtido e dividido em dois grupos: o método convencional (n = 32) e o método digital (n = 96). O grupo digital foi dividido em três grupos: TRIOS 3 (n = 32), Omnicam (n = 32) e CS 3600 (n = 32). Cada um desses grupos foi subdividido de acordo com a direção do escaneamento (n = 16), e cada escaneamento foi sobreposto ao modelo de referência digital para medir a veracidade e precisão dos procedimentos. Resultados: Os valores gerais de precisão para o tipo de impressão foram 59,89 ± 13,08 µm para convencional e 13,42 ± 4,28 µm para digital; os valores de veracidade foram 49,37 ± 19,13 µm para convencional e 53,53 ± 4,97 µm para digital; os valores de veracidade para a direção de digitalização foram 53,05 ± 4,36 µm para contínua e 54,03 ± 5,52 µm para segmentada; e os valores de precisão foram 14,18 ± 4,67 µm para contínua e 12,67 ± 3,75 µm para segmentada (p> 0,05). Para o tipo de scanner, os valores de veracidade foram 50,06 ± 2,65 µm para Trios 3, 57,45 ± 4,63 µm para Omnicam e 52,57 ± 4,65 µm para Carestream; e os de precisão foram 11,7 ± 2,07 µm para Trios 3, 10,09 ± 2,24 µm para Omnicam e 18,49 ± 2,42 µm para Carestream (p <0,05). Conclusões: O método de moldagem digital é o método mais favorável em relação à precisão; em termos de veracidade, não há diferenças entre os tipos de impressão (AU)

Técnica de Impresión Dental , Precisión de la Medición Dimensional , Exactitud de los Datos
Medicine (Baltimore) ; 99(46): e23110, 2020 Nov 13.
Artículo en Inglés | MEDLINE | ID: mdl-33181678


Multilocular cystic renal neoplasm of low malignant potential (MCRNLMP) might be benefited from nephron-sparing surgery. Contrast-enhanced computed tomography is used for the diagnosis of MCRNLMP but contrast-enhanced ultrasound has lack of nephrotoxicity and several advantages over contrast-enhanced computed tomography and contrast-enhanced magnetic resonance. The purpose of the study was to compare diagnostic parameters of preoperative contrast-enhanced ultrasound against contrast-enhanced computed tomography for the detection of MCRNLMP in patients who faced curative surgery for complex cystic renal mass.Data regarding contrast-enhanced ultrasound, contrast-enhanced computed tomography, and clinicopathological results of 219 patients who underwent curative surgery for complex cystic renal mass (Bosniak classification III or IV) were retrospectively collected and analyzed. Bosniak classification for imaging modality and the 2016 WHO criteria for clinic pathology were used for detection of MCRNLMP.Contrast-enhanced ultrasound, contrast-enhanced computed tomography, and clinicopathology were detected 68, 66, and 67 as a MCRNLMP respectively. Contrast-enhanced ultrasound and contrast-enhanced computed tomography had 30.37% and 29.27% sensitivities for the detection of MCRNLMP. While 60% and 50% specificities respectively. Bosniak classification III (P = .045) and lower mean Hounsfield unit (P = .049) were associated with the prevalence of MCRNLMP. Contrast-enhanced computed tomography was detected 6 and 7, while contrast-enhanced ultrasound detected 3 and 2 complex cystic renal mass as false positive and false negative MCRNLMP respectively. A contrast-enhanced ultrasound had 0.011 to 1.0 diagnostic confidence and contrast-enhanced computed tomography had 0.045 to 0.983 diagnostic confidence for decision making of nephron-sparing surgeries.Contrast-enhanced ultrasound may have better visualization of MCRNLMP than contrast-enhanced computed tomography.Level of Evidence: III.

Carcinoma de Células Renales , Aumento de la Imagen/métodos , Neoplasias Renales , Riñón/diagnóstico por imagen , Compuestos Organometálicos/farmacología , Fosfolípidos/farmacología , Hexafluoruro de Azufre/farmacología , Tomografía Computarizada por Rayos X/métodos , Ultrasonografía/métodos , Carcinoma de Células Renales/diagnóstico , Carcinoma de Células Renales/cirugía , Toma de Decisiones Clínicas , Investigación sobre la Eficacia Comparativa , Medios de Contraste/farmacología , Precisión de la Medición Dimensional , Femenino , Humanos , Neoplasias Renales/diagnóstico , Neoplasias Renales/cirugía , Masculino , Persona de Mediana Edad , Nefrectomía/métodos , Tratamientos Conservadores del Órgano/métodos
Medicine (Baltimore) ; 99(46): e23111, 2020 Nov 13.
Artículo en Inglés | MEDLINE | ID: mdl-33181679


To compare distant visual acuity (DVA) and near visual acuity (NVA) in amblyopia and evaluate if NVA can be used to diagnose amblyopia.A retrospective study was performed on 73 patients diagnosed with amblyopia based on DVA, by measuring their NVA and comparing the DVA and NVA. The NVA was measured by Snellen chart at 30 cm and the DVA was measured by Dr Hahn vision test chart at 5m. The patients' age, type of amblyopia, spherical equivalent, the difference between spherical equivalent and the fellow eye spherical equivalent spherical, and prism diopter (PD) were evaluated and their relationship with the difference between the DVA and NVA was analyzed.The NVA was significantly better than the DVA in amblyopia (P = .000). The difference between the DVA and NVA was not significantly related to the type of amblyopia (P = .600) or the patients' age(P = .351). Also, the difference between the DVA and NVA was not significantly affected by the spherical equivalent (P = .425) or the difference between spherical equivalent and the fellow eye spherical equivalent (P = .212) in anisometropia amblyopia, and also not by the PD (P = .882) in strabismus amblyopia.In amblyopes, the NVA was better than the DVA before amblyopia treatment. The difference between the DVA and NVA was not affected by age, type of amblyopia, spherical equivalent, the difference between spherical equivalent and the fellow eye spherical equivalent spherical, or PD. Therefore, it should be taken into consideration that NVA could underestimate the severity of amblyopia and affect the accuracy at diagnosing amblyopia.

Ambliopía , Anisometropía/complicaciones , Estrabismo/complicaciones , Agudeza Visual , Ambliopía/diagnóstico , Ambliopía/etiología , Anisometropía/fisiopatología , Niño , Técnicas de Diagnóstico Oftalmológico/clasificación , Técnicas de Diagnóstico Oftalmológico/normas , Precisión de la Medición Dimensional , Diagnóstico Precoz , Femenino , Humanos , Masculino , Índice de Severidad de la Enfermedad , Estrabismo/fisiopatología
Medicine (Baltimore) ; 99(46): e23161, 2020 Nov 13.
Artículo en Inglés | MEDLINE | ID: mdl-33181689


BACKGROUND: To investigate the accuracy of screening tests for gestational diabetes mellitus (GDM) in Southeast Asian pregnant women. METHODS: We searched PubMed (MEDLINE), Web of Science, Cochrane Library,, Google Scholar, and Google for relevant articles published in English up to November 2018 using search terms related to GDM, screening tests for GDM and diagnostic performance. The studies were independently screened and selected by both authors. The methodological quality of the included studies was independently assessed by quality assessment of diagnostic accuracy studies 2. A hierarchical summary receiver operating characteristic (HSROC) model was created to estimate the HSROC curve. The summary sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were calculated in a meta-analysis using bivariate random-effects model. RESULTS: A total of 19 studies were included in which the 100 g oral glucose tolerance test (OGTT) and 75 g OGTT were the two common reference standards for diagnosis of GDM. Most points of diagnostic performance in the HSROC 50 g GCT curve compared with the 100 g OGTT reference standard were clustered in the upper left-hand quadrant. The pooled sensitivity and specificity of the 50 g GCT were 79% (95% confidence interval [CI] 64%-89%) and 74% (95% CI 59%-85%), respectively. For the 75 g OGTT reference standard, the non-fasting 2-hour plasma glucose showed quite similar sensitivity the 50 g GCT compared with the 100 g OGTT reference standard. The pooled sensitivities and specificities of the fasting plasma glucose and hemoglobin A1c were 81% (95% CI 76%-86%) and 70% (95% CI 67%-72%), and 80% (95% CI 66%-90%) and 69% (95% CI 58%-78%), respectively. CONCLUSION: Our findings indicate that the 50 g GCT using the threshold of 140 mg/dL is a good screening test for identifying GDM at 24 to 28 weeks' gestational age for both high-risk and universal screening strategies in Southeast Asian countries. The non-fasting 2-hour PG, fasting plasma glucose or hemoglobin A1c are alternative choices for screening.

Diabetes Gestacional , Prueba de Tolerancia a la Glucosa/métodos , Tamizaje Masivo , Asia Sudoriental/epidemiología , Diabetes Gestacional/sangre , Diabetes Gestacional/diagnóstico , Diabetes Gestacional/epidemiología , Precisión de la Medición Dimensional , Femenino , Humanos , Tamizaje Masivo/métodos , Tamizaje Masivo/normas , Embarazo
Acta Odontol Latinoam ; 33(1): 22-26, 2020 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-32621595


Cone Beam Computed Tomography (CBCT) has modified the perspective of dentistry images, providing manipulable threedimensional images with a 1:1 patient:image ratio. Treatments and diagnosis are modified or corroborated by CBCT; however, its accuracy in thin structures such as cortical bone has been subjected to critical review. The aim of this study is to correlate the measurement of vestibular alveolar bone height using direct measurements and measurements performed with cone-beam tomographic images with standard (SD) voxel resolution. Thirty incisor and premolar teeth of patients undergoing open curettage were measured with a high-precision caliper and with Cone Beam Computed Tomography (CBCT) at an SD resolution of 0.16 mm voxels in a 3D Orthophos XG Sirona scanner. Intra-observer evaluation was performed using the intraclass correlation coefficient (ICC). Direct measurements and CBCT measurements were correlated using Pearson correlation (PCC). The mean difference between indirect and direct measurements was 3.15 mm. Paired t test and Pearson Correlation coefficient determined that all measurements differed statistically from each other with p<0.05. With the CT scanner and protocol used in this study, CBCT images do not enable accurate evaluation of vestibular alveolar bone height.

Proceso Alveolar/diagnóstico por imagen , Diente Premolar/diagnóstico por imagen , Tomografía Computarizada de Haz Cónico/normas , Incisivo/diagnóstico por imagen , Proceso Alveolar/anatomía & histología , Diente Premolar/anatomía & histología , Tomografía Computarizada de Haz Cónico/métodos , Precisión de la Medición Dimensional , Humanos , Incisivo/anatomía & histología , Reproducibilidad de los Resultados
J Interv Cardiol ; 2020: 4817239, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32581660


Objectives: We aimed to assess the quality of optical frequency domain imaging (OFDI) of the left main (LM) arterial wall and describe and analyse potential artefacts in this setting. Background: OFDI is increasingly used to assess ambiguous lesions and optimize LM percutaneous coronary intervention. However, its ability to provide artefact-free high-quality images of coronary ostia and large segments such as the LM remains uncertain. Methods: We included 42 consecutive patients who underwent OFDI, including LM imaging. Each OFDI frame was subdivided into four quadrants and analysed. The number of quadrants with artifacts was calculated within the proximal, mid, and distal LM and the first 5 mm of the left anterior descending artery (LAD) and/or left circumflex artery (LCX). Results: The quadrants analysis showed an overall artifact rate of 8.9%, mostly out-of-field (45.1%) or residual blood (44.7%) artefacts. Most artifacts were located in the proximal LM (18.6%) with a stepwise reduction of artifact rates towards distal segments (mid LM 5.8%; distal LM 3.6%, ostial LAD 2.6%, and ostial LCX 0%; p < 0.001). While 20 (48.8%) patients had angiographically visible plaques, OFDI showed plaques in 32 patients (76.2%; p=0.007). Conclusion: OFDI can accurately evaluate the LM and detect and assess angiographically unvisualized atherosclerotic plaques providing accurate assessment of >90% of the quadrants of the LM and the ostia of its bifurcation branches. However, artifacts mainly located in the proximal LM and decreasing distally in a stepwise fashion should be considered in the interpretation of OFDI in this setting.

Enfermedad de la Arteria Coronaria/diagnóstico , Vasos Coronarios , Placa Aterosclerótica/diagnóstico por imagen , Tomografía de Coherencia Óptica/métodos , Angiografía Coronaria/métodos , Enfermedad de la Arteria Coronaria/cirugía , Vasos Coronarios/diagnóstico por imagen , Vasos Coronarios/patología , Precisión de la Medición Dimensional , Femenino , Humanos , Masculino , Persona de Mediana Edad , Selección de Paciente , Intervención Coronaria Percutánea/métodos , Pronóstico
Clin Pharmacol Ther ; 108(5): 1090-1097, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-32588427


Association between Hydroxychloroquine (HCQ) and Azithromycin (AZT) is under evaluation for patients with lower respiratory tract infection (LRTI) caused by the Severe Acute Respiratory Syndrome (SARS-CoV-2). Both drugs have a known torsadogenic potential, but sparse data are available concerning QT prolongation induced by this association. Our objective was to assess for COVID-19 LRTI variations of QT interval under HCQ/AZT in patients hospitalized, and to compare manual versus automated QT measurements. Before therapy initiation, a baseline 12 lead-ECG was electronically sent to our cardiology department for automated and manual QT analysis (Bazett and Fridericia's correction), repeated 2 days after initiation. According to our institutional protocol (Pasteur University Hospital), HCQ/AZT was initiated only if baseline QTc ≤ 480ms and potassium level> 4.0 mmol/L. From March 24th to April 20th 2020, 73 patients were included (mean age 62 ± 14 years, male 67%). Two patients out of 73 (2.7%) were not eligible for drug initiation (QTc ≥ 500 ms). Baseline average automated QTc was 415 ± 29 ms and lengthened to 438 ± 40 ms after 48 hours of combined therapy. The treatment had to be stopped because of significant QTc prolongation in two out of 71 patients (2.8%). No drug-induced life-threatening arrhythmia, nor death was observed. Automated QTc measurements revealed accurate in comparison with manual QTc measurements. In this specific population of inpatients with COVID-19 LRTI, HCQ/AZT could not be initiated or had to be interrupted in less than 6% of the cases.

Azitromicina , Infecciones por Coronavirus , Monitoreo de Drogas , Electrocardiografía/métodos , Hidroxicloroquina , Síndrome de QT Prolongado , Pandemias , Neumonía Viral/tratamiento farmacológico , Antiinfecciosos/administración & dosificación , Antiinfecciosos/efectos adversos , Antiinfecciosos/farmacocinética , Azitromicina/administración & dosificación , Azitromicina/efectos adversos , Azitromicina/farmacocinética , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/fisiopatología , Precisión de la Medición Dimensional , Monitoreo de Drogas/instrumentación , Monitoreo de Drogas/métodos , Monitoreo de Drogas/normas , Femenino , Humanos , Hidroxicloroquina/administración & dosificación , Hidroxicloroquina/efectos adversos , Hidroxicloroquina/farmacocinética , Síndrome de QT Prolongado/inducido químicamente , Síndrome de QT Prolongado/diagnóstico , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Neumonía Viral/diagnóstico , Neumonía Viral/fisiopatología , Torsades de Pointes/inducido químicamente , Torsades de Pointes/prevención & control
Rev. cuba. estomatol ; 57(2): e2366, abr.-jun. 2020.
Artículo en Portugués | LILACS, CUMED | ID: biblio-1126508


RESUMO Introdução: O escâner intraoral é um aparelho que surge como alternativa aos métodos convencionais de moldagem utilizando a técnica de impressão digital. O meio acadêmico vem realizando diversos estudos para avaliar a real efetividade da tecnologia e sua aplicabilidade clínica. Objetivo: Analisar resultados obtidos em estudos sobre escâneres intraorais na área de implantodontia quanto ao tipo de escâneres e acurácia, tempo de trabalho e preferência do operador e do paciente. Métodos: Foram realizadas buscas de artigos nas bases de dados "Pubmed" e "SciELO" utilizando os seguintes descritores: «intraoral AND scanner AND implant¼, «digital AND scanner AND implant¼ e «digital AND impression AND implant¼ em inglês, português e espanhol respectivamente. Os critérios de inclusão foram: artigos de avaliação clínica (in vivo) ou laboratorial (in vitro) que avaliassem o uso da técnica de escaneamento intra-oral para impressão digital de implantes com acesso integral, escritos em português, inglês ou espanhol e publicados a partir de 2013. Análise e integração da informação: Foram encontrados 158 artigos. Após a análise e seleção, 35 artigos foram incluídos, sendo 28 laboratoriais e 7 clínicos. Apesar de limitações na padronização dos estudos, percebemos o potencial e a viabilidade da técnica digital, com resultados clínicos e de acurácia favoráveis e vantagens como redução do tempo e etapas de trabalho, comunicação dinâmica com os laboratórios, preferência de pacientes e estudantes de odontologia e facilidade de incorporação por profissionais já experientes. Conclusões: Estudos laboratoriais indicam que, além de vantagens quanto ao uso de materiais de moldagem, comunicação com os laboratórios e facilidade de manipulação, a técnica digital pode alcançar resultados superiores aos da técnica convencional, assim, a técnica se mostra promissora para a área de implantodontia sendo necessário, contudo, estudos futuros, especialmente in vivo, para avaliar a consistência dos resultados clínicos(AU)

RESUMEN Introducción: El escáner intrabucal es un aparato que surge como una alternativa frente a los métodos convencionales de moldeo, y el medio académico viene realizando diversos estudios para evaluar la real efectividad de esta tecnología y su aplicabilidad clínica. Objetivo: Analizar resultados obtenidos en estudios sobre escáneres intrabucales en el área de implantología en cuanto a los tipos de escáneres y la exactitud, tiempo de trabajo y preferencia del operador y del paciente. Métodos: Se realizaron búsquedas en las bases de datos "PubMed" y "SciELO" utilizando los siguientes descriptores: "intraoral AND scanner AND implant", "digital AND scanner AND implant" and "digital AND impression AND implant" en inglés, portugués y español, respectivamente. Los criterios de inclusión fueron: artículos clínicos o de laboratorio para evaluar el uso de la técnica de escaneamiento digital de los implantes, con acceso completo al artículo, escrito en portugués, inglés o español y publicados desde 2013. Análisis e integración de la información: Se encontraron 158 artículos. Después del análisis y selección, 35 artículos fueron incluidos, siendo 28 de laboratorio y 7 clínicos. A pesar de las limitaciones en la estandarización de los estudios, percibimos el potencial y la viabilidad de la técnica digital, con resultados clínicos y de precisión favorables y ventajas como reducción del tiempo y etapas de trabajo, comunicación dinámica con los laboratorios, preferencia de pacientes y estudiantes de odontología y facilidad de incorporación de profesionales experimentados. Conclusiones: Los estudios de laboratorio indican que, además de ventajas en cuanto al uso de materiales de moldeo, comunicación con los laboratorios y facilidad de manipulación, la técnica digital puede alcanzar resultados superiores a los de la técnica convencional, por lo que el uso de escáneres intrabucales se muestra prometedor para el área de implantología siendo necesario, sin embargo, estudios futuros, especialmente in vivo, para evaluar la consistencia de los resultados clínicos(AU)

ABSTRACT Introduction: Intraoral scanners are devices that emerged as an alternative to conventional impression methods. A variety of studies have been conducted to evaluate the actual effectiveness of this technology and its clinical applicability. Objective: Analyze the results obtained by studies about intraoral scanners in the area of implantology in terms of types, accuracy, working time, and operator and patient preference. Methods: A search was conducted in the databases PubMed and SciELO using the following descriptors: "intraoral AND scanner AND implant", "digital AND scanner AND implant" and "digital AND impression AND implant" in English, Portuguese and Spanish. The inclusion criteria were the following: clinical or laboratory papers evaluating the use of digital implant scanning technique, full access to the paper, written in Portuguese, English or Spanish and published as of the year 2013. Data analysis and integration: Of the 158 papers obtained and analyzed, 35 were selected: 28 laboratory and 7 clinical. Despite the limitations in the standardization of the studies, we perceive the potential and viability of the digital technique, with favorable clinical and accuracy results, as well as advantages such as a reduction in work time and stages, dynamic communication with laboratories, preference by patients and dental students and ease of technical incorporation by experienced dentists. Conclusions: Laboratory studies indicate that, in addition to the advantages concerning the use of impression materials, communication with laboratories and ease of manipulation, the digital technique may achieve better results than conventional impression techniques. The use of intraoral scanners is therefore a promising technique for the area of ​​implantology. However, further studies shouldbe conducted, especially in vivo, to evaluate the consistency of the clinical results obtained(AU)

Humanos , Procesamiento de Señales Asistido por Computador , Implantes Dentales/tendencias , Literatura de Revisión como Asunto , Bases de Datos Bibliográficas , Precisión de la Medición Dimensional
PLoS One ; 15(5): e0233395, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32421740


OBJECTIVES: Tape measurement is a commonly used method in the clinical assessment of lymphedema. However, few studies have assessed the precision and reliability of tape measurement in assessing head and neck lymphedema. This study aimed to evaluate the reliability and precision of using tape measurement, performed by different evaluators, for the assessment of head and neck lymphedema. METHODS: This study was conducted at a tertiary care cancer hospital. Between January and December 2019, 50 patients with head and neck cancers and 50 normal subjects were enrolled. Each subject was examined using tape measurements for 7 point-to-point distances of facial landmarks, 3 circumferences of the neck (upper, middle, and lower), and 2 circumferences of the face (vertical and oblique) by 3 random examiners. Test precision and reliability were assessed with the within-subject standard deviation (Sw) and intra-class correlation coefficient (ICC), respectively. RESULTS: Overall, the standard deviation of the tape measurements varied in the range of 4.6 mm to 18.3 mm. The measurement of distance between the tragus and mouth angle (Sw: 4.6 mm) yielded the highest precision, but the reliability (ICC: 0.66) was moderate. The reliabilities of neck circumference measurements (ICC: 0.90-0.95) were good to excellent, but the precisions (Sw: 8.3-12.3 mm) were lower than those of point-to-point facial measurements (Sw: 4.6-8.8 mm). CONCLUSIONS: The different methods of tape measurements varied in precision and reliability. Thus, clinicians should not rely on a single measurement when evaluating head and neck lymphedema.

Antropometría/métodos , Pesos y Medidas Corporales/métodos , Linfedema/patología , Adulto , Antropometría/instrumentación , Pesos y Medidas Corporales/instrumentación , Pesos y Medidas Corporales/normas , Precisión de la Medición Dimensional , Femenino , Cabeza/patología , Humanos , Linfedema/diagnóstico , Masculino , Persona de Mediana Edad , Cuello/patología , Reproducibilidad de los Resultados
Nutr. hosp ; 37(2): 243-250, mar.-abr. 2020. tab, graf
Artículo en Inglés | IBECS | ID: ibc-190587


NTRODUCTION: in emergencies or in situations involving critically ill patients, an accurate calculation of body weight is essential to ensure adequate medical care. Generally, simple techniques are used to determine weight. AIM: to evaluate the weight estimation methods Advanced Paediatric Life Support (APLS) Update, Luscombe and Owens, Best Guess, and the Broselow tape, comparing measured weight with the weight estimated by each method in hospitalized Brazilian children and adolescents. METHODS: an observational study in which anthropometric data were collected from patients of 0-14 years of age between August 2016 and January 2017. The paired t-test was used to compare the patients' measured weight with their estimated weight. The accuracy of each method was analyzed using Bland-Altman plots and Lin's concordance correlation coefficient. RESULTS: the sample consisted of 446 patients. Most of the patients were male (58.1%), of 1-5 years of age (43%) and well nourished (85%). For those under 12 months of age, the APLS Update and Best Guess methods performed best, with the difference in means of measured weight and estimated weight being 0.4 kg (p = 0.183) and -0.2 kg (p = 0.140), respectively. In the 1-5 years of age group only the APLS Update yielded satisfactory results (0.2 kg; p = 0.200). The best agreement with measured weight, according to the Bland-Altman plots and Lin's coefficient, was found for the Broselow tape (CC = 0.96). CONCLUSION: of the estimation methods evaluated the Broselow tape was the most accurate one. Further studies are required to adapt this method for use in the Brazilian population, thus ensuring its appropriate application in this country

INTRODUCCIÓN: en las emergencias o en las situaciones que involucran a pacientes críticamente enfermos, el cálculo preciso del peso corporal es esencial para garantizar una atención médica adecuada. En general se utilizan técnicas simples para determinar el peso. OBJETIVO: evaluar los métodos de estimación del peso Advanced Paediatric Life Support (APLS) Update, Luscombe y Owens, Best Guess y la cinta Broselow, comparando el peso medido con el peso estimado por cada método en los pacientes hospitalizados. MÉTODOS: estudio observacional en el que se recopilaron datos antropométricos de pacientes de 0 a 14 años de edad entre agosto de 2016 y enero de 2017. Se utilizó la prueba t pareada para comparar el peso medido de los pacientes con su peso estimado. La precisión de cada método se analizó mediante gráficos de Bland-Altman y el coeficiente de correlación de concordancia de Lin. RESULTADOS: la muestra estuvo constituida por 446 pacientes. La mayoría eran varones (58,1 %) de 1 a 5 años (43 %) y bien nutridos (85 %). Para los menores de 12 meses de edad, los métodos APLS Update y Best Guess obtuvieron los mejores resultados, siendo la diferencia entre las medias de peso medido y peso estimado de 0,4 kg (p = 0,183) y -0,2 kg (p = 0,140), respectivamente. En el grupo de 1 a 5 años, solo el método APLS Update arrojó resultados satisfactorios (0,2 kg; p = 0,200). El mejor acuerdo con el peso medido, según las gráficas de Bland-Altman y el coeficiente de Lin, se encontró al utilizar la cinta Broselow (CC = 0,96). CONCLUSIÓN: de los métodos de estimación evaluados, la cinta Broselow fue la más precisa. Se requieren estudios adicionales para adaptar este método para su uso en la población brasileña

Humanos , Lactante , Preescolar , Niño , Adolescente , Peso Corporal , Niño Hospitalizado , Adolescente Hospitalizado , Estatura , Antropometría/instrumentación , Brasil , Pesos y Medidas Corporales , Precisión de la Medición Dimensional
Cien Saude Colet ; 25(3): 1073-1082, 2020 Mar.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-32159675


The main objectives were to analyse the validity and accuracy of Body Mass Index (BMI) and Waist Circumference (WC) to evaluate obesity by excess of body fat in older adults and to identify more adequate cut-off points for this age group. The recommended cut-off points for BMI (25, 27 or 30 kg/m2) and WC (≥ 102 cm for men and ≥ 88 cm for women or ≥ 90cm for men and ≥ 80 cm for women) were compared to the total body densitometry. BF was defined by a value higher than the 90th percentile. Out of the 132 participants, 61% were women and aged between 60 and 91 years. The recommended cut-off points of BMI ≥ 25kg/m2 and BMI ≥ 27 kg/m2 showed similar performances. BMI ≥ 30 kg/m2 showed high specificity but low sensitivity to identify BF in men and better performance in women. Conventional WC cut-off points showed low sensitivity and specificity. Based on our analyses, new cut-off points for BMI (25 kg/m2 for men and 26.6 kg/m2 for women) and WC (98.8 cm for men and 77.8cm for women) were proposed. The new cut-off points showed sensitivity and specificity values > 74% and accuracy > 76%. The areas under the curve (ROC) were > 0.86. The new BMI and WC cut-off points proposed in the present study for the diagnosis of obesity in older adults showed the best levels of sensitivity and specificity for this age group.

Índice de Masa Corporal , Precisión de la Medición Dimensional , Obesidad , Circunferencia de la Cintura , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad/epidemiología , Valor Predictivo de las Pruebas , Sensibilidad y Especificidad
Jt Dis Relat Surg ; 31(1): 28-33, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32160490


OBJECTIVES: This study aims to investigate the usability and reliability of our new axis in a three-dimensional modelling work and demonstrate if it is a reproducible method for anteversion measurement that sufficiently correlates with other computed tomography (CT)-derived gold standards including trans- epicondylar axis (TEA) and posterior condylar axis (PCA). PATIENTS AND METHODS: Three-dimensional solid models were derived from left femoral CT data of 100 participants (50 males, 50 females; mean age 57 years; range, 21 to 86). The newly proposed popliteal surface axis (PSA) was compared with TEA and PCA in terms of anteversion measurement on these solid models. RESULTS: Popliteal surface axis was found as a reproducible reference axis in our study as it could be measured in 99% of our sample. The mean value of PSA based anteversion was (-) 1.8° which was 10.7° and 4.4° for PCA and TEA, respectively. Popliteal surface axis was perfectly correlated with PCA and TEA for anteversion measurements (p<0.001, r=0.92 for both). CONCLUSION: Our findings suggest that the newly defined PSA may be used as an alternative method for determination of anteversion.

Fémur/diagnóstico por imagen , Imagenología Tridimensional/métodos , Articulación de la Rodilla/diagnóstico por imagen , Precisión de la Medición Dimensional , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valores de Referencia , Reproducibilidad de los Resultados , Tomografía Computarizada por Rayos X/métodos
Ciênc. Saúde Colet ; 25(3): 1073-1082, mar. 2020. tab, graf
Artículo en Portugués | LILACS | ID: biblio-1089475


Resumo O objetivo deste estudo foi analisar a validade e a acurácia do Índice de Massa Corporal (IMC) e da Circunferência da Cintura (CC) na avaliação de obesidade avaliada pelo excesso de gordura corporal (GC) e propor pontos de corte mais adequados para idosos. Os pontos propostos da literatura IMC (25,27 ou 30 kg/m2) e CC (≥ 102 cm-homens e ≥ 88 cm-mulheres ou ≥ 90 cm-homens e ≥ 80 cm-mulheres) foram avaliados conforme densitometria corporal total. A elevada GC foi definida por percentil > 90. Dos 132 idosos, 60,6% eram mulheres de 60-91 anos. Os pontos de corte recomendados de IMC ≥ 25 e ≥ 27kg/m2 apresentaram desempenhos similares, sendo que o IMC ≥ 30kg/m2 apresentou alta especificidade e baixa sensibilidade no sexo masculino e melhor desempenho para GC nas mulheres. Os pontos de corte convencionais de CC não apresentaram boa sensibilidade/especificidade. Foram propostos novos pontos de corte para IMC (masculino-25 kg/m2; feminino-26,6 kg/m2) e CC (masculino-98,8 cm; feminino-77,8 cm). Estes valores demonstraram sensibilidade e especificidade > 74% e acurácia > 76%. As áreas sob a curva foram > 0,86. O presente estudo propõe a utilização de pontos de corte mais acurados para diagnóstico de obesidade/GC em idosos, sendo para homens IMC 25kg/m2 e CC de 98,8cm e para mulheres IMC de 26,6kg/m2 e CC de 77,8cm, com melhores níveis de sensibilidade e especificidade.

Abstract The main objectives were to analyse the validity and accuracy of Body Mass Index (BMI) and Waist Circumference (WC) to evaluate obesity by excess of body fat in older adults and to identify more adequate cut-off points for this age group. The recommended cut-off points for BMI (25, 27 or 30 kg/m2) and WC (≥ 102 cm for men and ≥ 88 cm for women or ≥ 90cm for men and ≥ 80 cm for women) were compared to the total body densitometry. BF was defined by a value higher than the 90th percentile. Out of the 132 participants, 61% were women and aged between 60 and 91 years. The recommended cut-off points of BMI ≥ 25kg/m2 and BMI ≥ 27 kg/m2 showed similar performances. BMI ≥ 30 kg/m2 showed high specificity but low sensitivity to identify BF in men and better performance in women. Conventional WC cut-off points showed low sensitivity and specificity. Based on our analyses, new cut-off points for BMI (25 kg/m2 for men and 26.6 kg/m2 for women) and WC (98.8 cm for men and 77.8cm for women) were proposed. The new cut-off points showed sensitivity and specificity values > 74% and accuracy > 76%. The areas under the curve (ROC) were > 0.86. The new BMI and WC cut-off points proposed in the present study for the diagnosis of obesity in older adults showed the best levels of sensitivity and specificity for this age group.

Humanos , Masculino , Femenino , Anciano , Anciano de 80 o más Años , Índice de Masa Corporal , Circunferencia de la Cintura , Precisión de la Medición Dimensional , Valor Predictivo de las Pruebas , Sensibilidad y Especificidad , Persona de Mediana Edad , Obesidad/epidemiología
Einstein (Sao Paulo) ; 18: eAO4662, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-32022105


OBJECTIVE: To assess accuracy of multiparametric magnetic resonance of the prostate to estimate gland volume, comparing the results with transrectal ultrasound and surgical specimen. METHODS: A retrospective study of 85 patients who underwent multiparametric magnetic resonance and transrectal ultrasound (for fusion image-guided biopsy) before radical prostatectomy. Prostate measurements were obtained from magnetic resonance axial and sagittal T2-weighted images and ultrasound; the prostate volume was determined using the ellipsoid formula. The results were compared with the surgical specimen weight. Maximum interval between multiparametric magnetic resonance imaging, transrectal ultrasound, and prostatectomy was 6 months. RESULTS: The prostate volume measured by multiparametric magnetic resonance imaging was 18-157cm3 (mean of 49.9cm3) and by transrectal ultrasound, 22-165cm3 (mean of 54.9cm3); the surgical specimen weight was 20-154g (mean of 48.6g), with no statistical differences. Based on the values obtained from imaging examinations, the prostate volume obtained was very close to the real prostatic weight, and the measures by multiparametric magnetic resonance were slightly more precise. CONCLUSION: Prostate volume measured by multiparametric magnetic resonance imaging and transrectal ultrasound showed similar values, and excellent agreement with real prostate weight of the surgical specimens. Prostate volume measured by magnetic resonance has been increasingly used in the clinical practice, and its value enables appropriate therapeutic planning and control of patients.

Imágenes de Resonancia Magnética Multiparamétrica/métodos , Próstata/anatomía & histología , Neoplasias de la Próstata/diagnóstico por imagen , Ultrasonografía/métodos , Adulto , Anciano , Anciano de 80 o más Años , Precisión de la Medición Dimensional , Humanos , Biopsia Guiada por Imagen/métodos , Masculino , Persona de Mediana Edad , Tamaño de los Órganos , Próstata/diagnóstico por imagen , Prostatectomía , Neoplasias de la Próstata/patología , Estudios Retrospectivos
Arch Dis Child ; 105(5): 428-432, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-31836636


BACKGROUND AND OBJECTIVE: The Zika virus outbreak has drawn attention to microcephaly, whose definition is based on head circumference measuring below a percentile or number of SDs below the mean. The objective of this analysis was to assess how differences in measurement precision might affect prevalence and trends of microcephaly. METHODS: Data from all births in Uruguay during 2010-2015 were obtained from the Perinatal Information System. The prevalence of births with microcephaly was calculated based on head circumference measurement at birth applying the INTERGROWTH-21st standards for sex and gestational age, and compared by method of ascertaining gestational age. RESULTS: Rounding and digit preference was observed: 74% of head circumference measurements were reported as a whole centimetre value. The prevalence of births varied substantially by the criterion used to define microcephaly (<3 SD, <2 SD, <3rd percentile for gestational age) and could be halved or doubled based on adding or subtracting a half-centimetre from all reported head circumference measurements. If 4 days were added to gestational age calculations, rather than using completed gestational weeks (without days) for gestational age reporting, the prevalence was 1.7-2 times higher. DISCUSSION: Rounding in measurement of head circumference and reporting preferences of gestational age may have contributed to a lower prevalence of microcephaly than expected in this population. Differences in head circumference measurement protocols and gestational age dating have the potential to affect the prevalence of babies reported with microcephaly, and this limitation should be acknowledged when interpreting head circumference data collected for surveillance.

Cefalometría , Precisión de la Medición Dimensional , Microcefalia/diagnóstico , Microcefalia/epidemiología , Humanos , Recién Nacido , Microcefalia/virología , Prevalencia , Uruguay/epidemiología , Infección por el Virus Zika/complicaciones
J Perinatol ; 40(4): 595-599, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-31558806


OBJECTIVE: To develop a nasal-tragus length (NTL)-based table for estimating the endotracheal tube (ETT) insertion depth. STUDY DESIGN: A prospective study of 110 Thai neonates was conducted in a NICU in Bangkok, Thailand. The correlation between the optimal insertion depth (Opt-Depth) and NTL was determined, and then an NTL-based table for estimating ETT depth was developed. The accuracy of using various methods in estimating ETT depth was compared. RESULTS: A strong correlation between Opt-Depth and NTL was found (r = 0.897, p < 0.001). There was no significant difference between ETT depth estimated by the NTL-based table and Opt-Depth [mean difference (95% CI) -0.75 (-12.11 to 10.61) mm, p = 0.22]. The accuracies of using NTL + 1, NTL-based, GA-based, and BW-based tables for estimating ETT depth were 32.7%, 55.5%, 61.8%, and 52.7%, respectively. CONCLUSION: Our NTL-based table for estimating the ETT depth had an acceptable accuracy while using "NTL + 1" resulted in overestimating ETT depth.

Oído Externo , Cara/anatomía & histología , Intubación Intratraqueal/métodos , Nariz , Precisión de la Medición Dimensional , Femenino , Edad Gestacional , Humanos , Recién Nacido , Recien Nacido Prematuro , Unidades de Cuidado Intensivo Neonatal , Masculino , Variaciones Dependientes del Observador , Estudios Prospectivos , Radiografía , Tailandia , Tráquea/anatomía & histología , Tráquea/diagnóstico por imagen
Rev. latinoam. enferm. (Online) ; 28: e3299, 2020. tab, graf
Artículo en Inglés | LILACS, BDENF - Enfermería | ID: biblio-1126959


Objective: to evaluate the use of the 2D-FlexRuler as a facilitating tool for the early calculation of the predictive scar factor of chronic wounds. Method: a descriptive study with a quantitative, experimental, longitudinal and prospective approach. The sample consisted of 22 outpatients. 32 chronic wounds were analyzed. The wound edges were identified and drawn on the 2D-FlexRuler. The calculations of the areas of chronic wounds were obtained by manual, traditional methods, by software and Matlab algorithm. These areas were compared with each other to determine the efficiency of the proposed ruler in relation to traditional methods. Results: the calculation of the wound area by the traditional method and Kundin's coefficient show average errors greater than 40%. The manual estimation of the area with the 2D-FlexRuler is more accurate in relation to traditional measurement methods, which were considered quantitatively disqualified. When compared with the reference method, for example, the Klonk software, the data obtained by 2D-FlexRuler resulted in an error of less than 1.0%. Conclusion: the 2D-FlexRuler is a reliable metric platform for obtaining the anatomical limits of chronic wounds. It facilitated the calculation of the wound area under monitoring and allowed to obtain the scar predictive factor of chronic wounds with precocity in two weeks.

Objetivo: avaliar o uso da régua 2D-FlexRuler como ferramenta facilitadora para o cálculo precoce do fator preditivo cicatricial de feridas crônicas. Método: estudo descritivo com abordagem quantitativa, experimental, longitudinal e prospectiva. A amostra foi de 22 pacientes ambulatoriais. Foram analisadas 32 feridas crônicas. As bordas das feridas foram identificadas e desenhadas na 2D-FlexRuler. Os cálculos das áreas das feridas crônicas foram obtidos pelos métodos manuais, tradicionais, por softwares e algoritmo Matlab. Essas áreas foram comparadas entre si para determinar a eficiência da régua proposta em relação aos métodos tradicionais. Resultados: o cálculo da área da ferida pelo método tradicional e coeficiente de Kundin demonstram erros médios maiores do que 40%. A estimativa manual da área com a 2D-FlexRuler é mais exata em relação aos métodos tradicionais de medição, os quais foram considerados quantitativamente desqualificados. Quando comparada com o método de referência, i.e., o software Klonk, os dados obtidos pela 2D-FlexRuler resultaram em um erro menor que 1,0%. Conclusão: a régua 2D-FlexRuler é uma plataforma métrica confiável para a obtenção dos limites anatômicos de feridas crônicas. Facilitou o cálculo da área da ferida sob monitoramento e permitiu obter o fator preditivo cicatricial de feridas crônicas com precocidade em duas semanas.

Objetivo: evaluar el uso de la regla 2D-FlexRuler como herramienta facilitadora para el cálculo temprano del factor predictivo de cicatrices en heridas crónicas. Método: estudio descriptivo con enfoque cuantitativo, experimental, longitudinal y prospectivo. La muestra consistió en 22 pacientes ambulatorios. Se analizaron 32 heridas crónicas. Los bordes de la herida fueron identificados y dibujados en 2D-FlexRuler. Los cálculos de las áreas de heridas crónicas se obtuvieron por métodos manuales, tradicionales, por software y algoritmo Matlab. Estas áreas se compararon entre sí para determinar la eficiencia de la regla propuesta en relación con los métodos tradicionales. Resultados: el cálculo del área de la herida por el método tradicional y el coeficiente de Kundin muestran errores promedio superiores al 40%. La estimación manual del área con 2D-FlexRuler es más precisa en relación con los métodos de medición tradicionales, que se consideraron descalificados cuantitativamente. Al ser comparados con el método de referencia, es decir, el software Klonk, los datos obtenidos por 2D-FlexRuler arrojaron un error de menos del 1,0%. Conclusión: la regla 2D-FlexRuler es una plataforma métrica confiable para obtener los límites anatómicos de las heridas crónicas. Facilitó el cálculo del área de la herida bajo monitoreo y permitió obtener el factor predictivo de cicatriz de heridas crónicas con precocidad en dos semanas.

Pesos y Medidas , Cicatrización de Heridas , Heridas y Traumatismos , Programas Informáticos , Cicatriz , Precisión de la Medición Dimensional , Herida Quirúrgica , Metronidazol