Cuantificación absoluta de la captación miocárdica de 99mTc-DPD en pacientes con amiloidosis cardiaca por depósitos de transtiretina (ATTR) / Absolute quantification of myocardial uptake of 99mTc-DPD in patients with cardiac amyloidosis due to transthyretin deposits (ATTR)

Objetivo Determinar la contribución diagnóstica de la cuantificación absoluta del depósito miocárdico de 99mTc-DPD en pacientes con amiloidosis cardiaca por depósitos de transtiretina (ATTR). Materiales y métodos Se realizó SPECT/TC a 41 pacientes con resultado gammagráfico positivo para amiloidosis cardiaca ATTR. Se dividió a los pacientes en dos grupos (grados2 y3 de Perugini) y se calcularon los SUVmax a nivel del hueso y de ambos ventrículos y el porcentaje de dosis calculado en estas áreas. Se empleó la prueba t de Student para comparar resultados y se calculó el área bajo la curva (AUC) para evaluar la eficacia diferencial y establecer unos puntos de corte discriminatorios entre ambos grupos de pacientes. Resultados Se observaron diferencias estadísticamente significativas en todas las variables a estudio, a excepción del SUVmax hueso. Las diferencias con mayor potencia estadística se observaron en las variables SUVmaxVD y el porcentaje de dosis en ambos ventrículos (p<0,001). El punto de corte obtenido para la variable SUVmaxVI fue de 8,620 (sensibilidad del 87,9% y especificidad del 100%; AUC: 0,966), mientras que el de la variable SUVmaxVD fue de 6,195 (sensibilidad del 81,8% y especificidad del 100%; AUC: 0,955). Conclusiones La cuantificación absoluta de la captación miocárdica de 99mTc-DPD en las imágenes SPECT/TC de pacientes con sospecha de amiloidosis cardiaca por depósitos de transtiretina supone una nueva herramienta diagnóstica que permite una adecuada clasificación de los pacientes, acorde a la escala de gradación visual de Perugini (AU)

Purpose To determine the diagnostic contribution of the absolute quantification of the myocardial deposit of 99mTc-DPD in patients with cardiac amyloidosis due to transthyretin deposits (ATTR). Materials and methods SPECT/CT was performed on 41 patients with positive scintigraphic results for ATTR cardiac amyloidosis. The patients were divided into two groups (Perugini grades2 and3) and the SUVmax at the level of the bone and both ventricles and the percentage of dose calculated in these areas were calculated. Student's t-test was used to compare results and the area under the curve (AUC) was calculated to assess differential efficacy and establish discriminatory cut-off points between both groups of patients. Results Statistically significant differences were observed in all the study variables, with the exception of SUVmax bone. The differences with the greatest statistical power were observed in the variables SUVmaxRV and the percentage of dose in both ventricles (P<.001). The cut-off point obtained for the variable SUVmaxLV was 8.620 (sensitivity 87.9% and specificity 100%; AUC: 0.966), while that of the variable SUVmaxRV was 6.195 (sensitivity 81.8% and specificity 100%; AUC: 0.955). Conclusions The absolute quantification of myocardial uptake of 99mTc-DPD in the SPECT/CT images of patients with suspected cardiac amyloidosis due to transthyretin deposits represents a new diagnostic tool that allows an adequate classification of patients, according to the visual grading scale of Perugini (AU)

[Increasing decayed, missing and filled teeth index among school children in Loja, Spain]. / Incremento del índice de dientes permanentes cariados, perdidos por caries y obturados, entre escolares de Loja, España.

OBJECTIVE: To identify the clinical, socioeconomic, dietary, and hygienic predictors of the increasing Decayed, Missing, and Filled Teeth (DMFT) index, in a cohort of school children in Loja, Granada, Spain, during a three-year period (1994-1997). MATERIAL AND METHODS: A retrospective cohort study was conducted in 812 students to measure the DMFT index, using the methods recommended by the World Health Organization. Statistical analysis was conducted using logistic regression models. RESULTS: During the study period, the DMFT index increased from 1.86 to 4.5 for the study cohort as a whole, and from 3.71 to 4.47 among twelve-year olds. The DMFT at mid-period was associated to an increase in the final DMFT. The relative risk for attending school no. 3 was 0.69 (95% CI 0.60-0.8) vs. school no. 4, and 0.78 (95% CI 0.67-0.90) vs. school no. 5. CONCLUSIONS: The final model showed that the DMFT at mid-period was a risk factor for an increase in the DMFT index and that attending school number 3 was a protective factor.