RESUMO
Apparent resistant hypertension (aTRH) is a significant public health issue. Once low adherence to antihypertensive treatment has been ruled out and true resistant hypertension is diagnosed, aldosterone-direct-renin-ratio (ADRR) aids in the screening of an aldosterone-producing adenoma (APA) and primary aldosteronism (PA). Once PA and other secondary causes have been ruled out, the values of aldosterone and renin allow patients to be classified into phenotypes such as low renin hypertension (LRH), Liddle's-like (LLph), and primary hyperaldosteronism (PAph). These classifications could aid in the treatment decision-making process. However, optimal cut-off points for these classifications remain uncertain. This study aims to assess the prevalence of these phenotypes and the behavior of different cut-offs of the ADRR in an Afro-Colombian population with apparent resistant hypertension, as well to describe their sodium consumption. Afro-descendant individuals 18 years of age or older, diagnosed with resistant hypertension and attending to a primary care center in Colombia were recruited as volunteers. As part of the study, their plasma renin concentration (PRC) and plasma aldosterone concentration (PAC) were measured. The phenotypes were categorized into three groups based on multiple cut-off points from different authors: low renin and low aldosterone phenotype (LLph), low renin and high aldosterone phenotype (PAph), and high renin and high aldosterone phenotype, referred to as the renal phenotype (Rph). The prevalence of ADRR values exceeding the cut-off and phenotypes were calculated. A linear regression model was derived to assess the effect of sodium consumption with PAC, PRC and ADRR. A total of 88 patients with aTRH were included. Adherence to at least 3 antihypertensive medications was 62.5%. The median age was 56 years (IQR 48-60), 44% were female, and 20% had diabetes. The study found that the prevalence of ADRR values exceeding the cut-off ranged from 4.5 to 23%, while low-renin hypertension (LRH) varied from 15 to 74%, Rph was found in approximately 30 to 34% of patients, PAph in 30 to 51%, and the LLph in 15 to 41%, respectively, depending on the specific cut-off value by different authors. Notably, sodium consumption was associated with lower aldosterone (ß - 0.15, 95% CI [- 0.27, - 0.03]) and renin concentrations (ß - 0.75, 95% CI [- 1.5, - 0.02]), but ADRR showed no significant association with sodium consumption. There were no significant differences in prevalences between the groups taking < 3 vs ≥ 3 antihypertensive medications. Altered aldosterone-direct-renin-ratio, low renin hypertension, Liddle's-like, and primary hyperaldosteronism are prevalent phenotypes in patients within Afro-Colombian patients with apparent treatment-Resistant hypertension.
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Aldosterona , Anti-Hipertensivos , Hipertensão , Fenótipo , Renina , Humanos , Renina/sangue , Aldosterona/sangue , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Hipertensão/sangue , Feminino , Pessoa de Meia-Idade , Masculino , Adulto , Anti-Hipertensivos/uso terapêutico , Hiperaldosteronismo/sangue , Hiperaldosteronismo/diagnóstico , Hiperaldosteronismo/tratamento farmacológico , Hiperaldosteronismo/epidemiologia , População Negra , Idoso , Resistência a MedicamentosRESUMO
Introducción: El quiste odontogénico calcificante (QOC) es un quiste odontogénico raro de los maxilares, que en un gran número de casos se asociaa otras patologías. Debido a esto, la presentación clínica e imagenológica puede variar. El objetivo del presente trabajo fue determinar las características clínicas e imagenológicas del QOC intraóseo, sin asociación a otras patologías, publicadas en reportes de casos.Material y métodos:Se realizó una búsqueda en PubMed, Scopus, Epistemonikos y Web of Science, de reportes de casos de QOC intraóseo, sin asociación a otras patologías, que tuvieran exámenes imagenológicos y diagnóstico histopatológico.Resultados:Se incluyeron 20 artículos, con 21 casos clínicos. El QOC sepresentó principalmente en la segunda década de vida, sexo masculino y zona posterior mandibular. El aumento de volumen estuvo presente en la mayoría de los casos. El dolor, alteraciones de mucosa y movilidad dentaria se observaron en un menor porcentaje. Radiográficamente se observó una lesión de densidad mixta, unilocular, de límites definidos y regulares, con expansión de corticales. La perforación, desplazamiento dentario y reabsorción radicular fueron poco comunes. El tamaño fue principalmente mayor a 3cm.Conclusiones:La información clínica e imagenológica fue escasa en todos los artículos incluidos. La mayoría de las características que no coinciden con lo reportado por la literatura podrían tener su explicación en el hecho de que los casos publicados suelen ser atípicos.En la presenterevisión se encontraron características del QOC diferentes a las reportadas, que son relevantes para el diagnóstico diferencial.(AU)
Introduction: Calcifying odontogenic cyst (COC) is a rare odontogenic cyst of the jaws, which in many cases is associated with other pathologies and can generate differences in terms of clinical and imaging presentation. The aim of this article was to determinate the clinical and imaging characteristics of intraosseous COC, without association to other pathologies, published in case reports.Material and methods:A search in PubMed, Scopus, Epistemonikos and Web of Science was performed, for case reports of intraosseous COC, without association to other pathologies, which had imaging examinations and histopathological diagnosis.Results:20 articles were included, with 21 clinical cases. COC was found to occur mainly in the second decade of life, male sex, and mandibular posterior area. Swelling was present in most cases. Pain, mucosal alterations, and dental mobility were observed in a lower percentage. Radiographically, a mixed density lesion, unilocular, with defined and regular limits, which generates cortical expansion was observed. Perforation, tooth displacement and root resorption were uncommon. The size was mainly larger than 3cm.Conclusion:Clinical and imaging information was found to be scarce in all articles included in this review. Most of the characteristics that did not coincide with what is reported by the literature could be explained by the fact that published cases are usually atypical. In this review, different COC characteristics than those previously reported were found, which are relevant for differential diagnosis.(AU)
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Humanos , Masculino , Feminino , Odontologia , Cisto Odontogênico Calcificante/diagnóstico , Cisto Odontogênico Calcificante/patologiaRESUMO
Introducción: El fibroma osificante (FO) y la displasia fibrosa (DF) tienen características imagenológicas e histopatológicas similares que dificultan el diagnóstico diferencial. El propósito de la presente revisión narrativa es analizar las características clínicas, epidemiológicas e imagenológicas del FO y la DF, y evaluar la relación entre las características imagenológicas y las variantes histopatológicas del FO, en reportes y series de casos publicados.Materiales y métodos:Se realizó una búsqueda de reportes y series de casos de FO y DF entre 2017-2021 en PubMed, Scopus y Web of Science. Los casos debían tener suficiente información clínica, epidemiológica, histopatológica e imagenológica.Resultados:Se incluyeron 23 artículos con 25 lesiones: 17 FO y 8 DF. El tiempo de evolución de DF es más prolongado que FO. FO se ubica con mayor tendencia en complejo osteomeatal en comparación con DF. Sólo FO presentó alteraciones en piel, radiolucidez/hipodensidad periférica, perforación ósea y rizalisis externa, además, tuvo mayor tendencia al avance a espacios anatómicos adyacentes y a generar asimetría facial y/o craneal. FO psammomatoide y FO trabecular comparten patrones imagenológicos y tienen límites definidos corticalizados. FO convencional tuvo mayor tendencia a perforar corticales. DF puede tener límites mal definidos y definidos corticalizados. El FO mostró características imagenológicas de mayor agresividad que la DF.Conclusiones:La histología e imagenología por sí solas no son decisivas en el diagnóstico de FO y DF. Es imprescindible considerar conjuntamente clínica, imagenología e histopatología, enfatizando en las características que orienten el diagnóstico diferencial.(AU)
Introduction: Ossifying fibroma (OF) and fibrous dysplasia (FD) have similar imaging and histopathological characteristics, which make differential diagnosis difficult. The aim of this narrative review was to analyze the clinical, epidemiological and imaging characteristics of OF and FD, as well as to evaluate the relationship between imaging characteristics and histopathologic variants of OF, in reports and case series published.Materials and methods:A search of reports and case series of OF and FD between 2017-2021 in PubMed, Scopus and Web of Science was performed. The cases had to have enough clinical, epidemiological, histopathological and imaging information.Results:23 articles with 25 lesions were included: 17 OF and 8 FD. FD had a longer time of evolution than OF. OF is more likely to be in osteomeatal complex compared to FD. Only OF had skin alterations, peripheral radiolucency/hypodensity, bone perforation and external root resorption, in addition, it had a greater tendency to advance to adjacent anatomical spaces and generate facial and/or cranial asymmetry. Psammomatoid OF and trabecular OF share imaging patterns and have defined and corticated margins. Conventional OF had a greater tendency to cortical perforation. DF can have ill-defined and defined and corticated margins. OF has imaging characteristics of greater aggressiveness than FD.Conclusion:Histology and imaging alone are not decisive in OF and FD diagnosis. It is essential to consider clinical, imaging and histopathological evaluations as a whole, emphasizing in the characteristics that guide the differential diagnosis.(AU)
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Humanos , Masculino , Feminino , Displasia Fibrosa Craniofacial , Cementoma/diagnóstico , Fibroma Ossificante , Diagnóstico Diferencial , Fibroma Ossificante/epidemiologia , Odontologia , Maxila/lesões , Medicina BucalRESUMO
Introducción: El quiste óseo simple (QOS) es un pseudoquiste intraóseo, de etiología desconocida que representa el 1% de los quistes maxilares. Radiográficamente se observa una imagen radiolúcida de bordes bien definidos, irregulares o festoneados. Su tratamiento consiste en la exploración quirúrgica y curetaje de paredes óseas. En pocas ocasiones se ha descrito resolución espontánea. El propósito de este documento es presentar un caso de QOS de resolución espontánea y realizar una revisión de literatura.Reporte de caso:Mujer de 12 años consulta para evaluación odontológica de rutina. En radiografía panorámica se observa lesión radiolúcida entre raíces de dientes 4.4 y 4.5, de límites bien definidos corticalizados. Se complementó con tomografía computarizada de haz cónico, donde se observó adelgazamiento de tablas óseas. Se realizó un diagnóstico presuntivo de QOS. Se controló a los 3 y 3,5 años observándose hueso de leve mayor densidad que el hueso circundante.Materiales y métodos:Se realizó una revisión de literatura sobre QOS de resolución espontánea en PubMed, Scopus y Web of Science, relacionando los términos libres simple bone cyst spontaneous resolution jaws y sus variantes.Resultados:Se encontraron 13 casos de QOS de resolución espontánea. Las características clínicas y radiográficas de los casos coinciden con la literatura. El 54% de los casos tuvo resolución espontánea en un periodo menor o igual a 5 años.Conclusión:En el presente caso se realizó el seguimiento radiográfico del paciente, demostrando que controlar en el tiempo puede considerarse como tratamiento, ya que la lesión podría resolverse espontáneamente.(AU)
Introduction: Simple bone cyst (SBC) is an intraosseous pseudocyst, of unknown etiology, which represents 1% of maxillary cysts. Radiographically, a radiolucent image with well-defined, irregular or scalloped edges is observed. Treatment consists of surgical exploration and curettage of bone walls. Spontaneous resolution has rarely been described. The purpose of this paper is to present a case of spontaneous resolution of SBC and perform a literature review.Case Report:A 12-year-old woman attends to a routine dental evaluation. Panoramic radiography shows a radiolucent image between roots of teeth 4.4 and 4.5, of well-defined corticated borders. It was complemented with cone-beam computed tomography examination, where thinning of cortical bone was observed. A presumptive diagnosis of SBC was performed. Controls at 3 and 3,5 years were performed and bone of slightly higher density than the surrounding bone was observed.Materials and methods:A literature review on SBC of spontaneous resolution was performed in PubMed, Scopus and Web of Science, relating the free terms simple bone cyst spontaneous resolution jaws and their variants.Results:13 cases of spontaneous resolution of SBC were found. The clinical and radiographic characteristics of the cases coincide with the literature. 54% of cases had spontaneous resolution in a period of 5 years or less.Conclusion:In the case presented, radiographic follow-up of the patient was performed, demonstrating that following-up can be considered as treatment, since the lesion could resolve spontaneously.(AU)
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Humanos , Feminino , Criança , Cistos Ósseos/classificação , Cistos Ósseos/diagnóstico , Cistos Maxilomandibulares , Radiografia Panorâmica , Odontologia , Medicina Bucal , Pacientes Internados , Exame Físico , OdontopediatriaRESUMO
Introducción: El osteosarcoma y el condrosarcoma son lesiones óseas malignas, ubicadas con mayor frecuencia en las extremidades y con menor frecuencia en el territorio craneofacial. No se ha reportado características imagenológicas concretas que diferencien ambas patologías en el territorio craneofacial. El propósito de la presente revisión narrativa es analizar las características epidemiológicas e imagenológicas del osteosarcoma craneofacial (OSCF) y condrosarcoma craneofacial (CSCF).Materiales y métodos:Se analizó la información publicada del OSCF y CSCF entre los años 2011-2021, con un enfoque en el análisis imagenológico.Resultados:El OSCF y CSCF no tienen preferencia clara por sexo. Mientras el OSCF se ubica en huesos de origen membranoso y preferencia entre la tercera y cuarta década de vida, el CSCF se ubica en zonas de origen endocondral y preferencia entre la tercera y sexta década de vida. En el OSCF, se han observado tres patrones de presentación imagenológicos: esclerótico, lítico y mixto, a diferencia del CSCF, en que se ha observado solo el patrón de presentación lítico. Ambas patologías tienen límites infiltrantes. El estudio imagenológico se realiza con tomografía computarizada, resonancia magnética, gammagrafía ósea, tomografía computarizada de fotón único y por emisión de positrones. En ambas patologías es más frecuente la recidiva local que la metástasis.Conclusiones:El OSCF y CSCF tienen características clínicas, epidemiológicas diferentes e imagenológicas similares. Establecer diferencias entre ellas es esencial para una correcta presunción diagnóstica.(AU)
Introduction: Osteosarcoma and chondrosarcoma are malignant lesions which locate most frequently in extremities and less frequently in craniofacial territory. Concrete imaging features in craniofacial territory that identify each pathology have not been reported. The aim of the present narrative review is to analyze the epidemiological and imaging features of the craniofacial osteosarcoma (CFOS) and craniofacial chondrosarcoma (CFCS).Materials and methods:We analyzed the information on CFOS and CFCS published between 2011 and 2021, focused on imaging analysis.Results:CFOS and CFCS do not show sex preference. Whilst CFOS is usually located in bones of membranous origin and is commonly discovered between the third and fourth decade of life, CFCS is usually located in areas of endochondral origin and commonly appears between the third and sixth decade of life. Three radiological presentation patterns are observed in CFOS: sclerotic, lytic and mixed, unlike the CFCS, where only the lytic pattern has been observed. Both pathologies have infiltrated margins. The imaging study is performed with computed tomography, magnetic resonance imaging, bone scintigraphy, single-photon computed tomography and positron emission tomography, among others. Local recurrence is more common than metastasis in both pathologies.Conclusion:CFOS and CFCS have different clinical and epidemiological features but similar imaging features. Stablishing differences between both pathologies is essential to achieve a correct presumptive diagnosis.(AU)
Assuntos
Humanos , Masculino , Feminino , Osteossarcoma/diagnóstico por imagem , Osteossarcoma/epidemiologia , Condrossarcoma/diagnóstico por imagem , Condrossarcoma/epidemiologia , Espectroscopia de Ressonância Magnética , Tomografia Computadorizada por Raios X , Odontologia , Medicina Bucal , Medicina NuclearRESUMO
Introducción: El quiste odontogénico glandular (QOG) tiene una diversidad de características epidemiológicas, clínicas e imagenológicas. El propósito de la presente revisión fue analizarla epidemiología, clínica, imagenología junto con la agresividad, tratamiento, seguimiento y recidiva de QOG en la literatura actual. Materiales y métodos: Se realizó una búsqueda sistemática de casos clínicos de QOG publicados entre 2012-2022 en PubMed, Web of Science y Science Direct que tuvieran información epidemiológica, clínica e imagenológica junto a su confirmación histopatológica a través de descripción e imágenes. Resultados: Se incluyeron 27 artículos con 30QOG. Los QOG se presentaron entre los 7 y 78 años. Su tiempo de evolución promedio fue de un año. Se observaron mayoritariamente en región posterior de mandíbula y sin sintomatología. Mayoritariamente fueron radiolúcidos, uniloculares, con bordes definidos y corticalizados y presentaron expansión ósea. Presentaron características agresivas como gran tamaño, perforación ósea y los dientes involucrados tendieron a tenerespacio periodontal infiltrado, desplazamiento y rizálisis. La mayoría de los QOG se trataron con enucleación y no recidivaron. Conclusiones: Se observaron QOG con características que difieren de la literatura clásica en edad, tiempo de evolución, sintomatología, patrón imagenológico, presentación bilateral y ubicación. La imagenología del QOG tiene un comportamiento por lo general, agresivo. En tanto, su agresividad estuvo asociada con su mayor tamaño, borramiento y/o infiltración cortical, perforación ósea, espacio periodontal infiltrado, rizalisis externa y al compromiso de estructuras anatómicas adyacentes. Teniendo en cuenta estas características, los tratamientos de descompresión y exéresis, junto a seguimientos menores a 5 años podrían recidivar. (AU)
Introduction: Glandular odontogenic cyst (GOC) has a diversity of epidemiological, clinical and imaging characteristics. The purpose of this review was to analyze the epidemiology, clinic, and imaging, along with aggressiveness, treatment, follow-up, and recurrence of GOC in the current literature. Materials and methods: A systematic search for clinical cases of GOC published between 2012-2022 was conducted in PubMed, Web of Science and Science Direct. Epidemiological, clinical and imaging information, along with their histopathological confirmation through description and images had to be present in the articles. Results: 27 articles with 30 GOC were included. GOC was found to be present between 7 and 78 years. Its average evolution time was one year. They were observed mostly in the posterior mandible and were asymptomatic. They were mostly radiolucent, unilocular, with defined and corticated borders and presented bone expansion. They presented aggressive characteristics such as larger size, bone perforation and the teeth involved tended to have infiltrated periodontal space, displacement and root resorption. GOC were mostly treated with enucleation and did not present recurrence. Conclusions: GOC was observed with atypical characteristics, which differ from classical literature in terms of age, time of evolution, symptomatology, imaging pattern, bilateral presentation and location. Imaging of QOG generally has an aggressive behavior. Its aggressiveness was associated with its larger size, cortical effacement and/or infiltration, bone perforation, infiltrated periodontal space, root resorption, and involvement of adjacent anatomical structures. Considering the characteristics mentioned above, decompression and excision treatments, together with follow-up of less than 5 years, could lead to recurrence. (AU)
Assuntos
Humanos , Cisto Odontogênico Calcificante , Diagnóstico por Imagem , Prática Profissional , Maxila , Mandíbula , OdontólogosRESUMO
Introducción: Debido al riesgo que conlleva la exposición a radiación ionizante, se han establecido los principios de protección radiológica, con el propósito de regular las actividades que involucran su uso. Uno de estos principios es la justificación de los exámenes, es decir, la indicación del examen cuando exista la posibilidad de que éste entregue información en beneficio del paciente. Esto implica que dicho examen se evalúe en cuanto a su rendimiento, de manera que exista evidencia que indique su capacidad de entregar la información necesaria para la indicación específica del paciente. Revisión: Para evaluar el rendimiento de los exámenes imagenológicos, con el fin de orientar su uso como herramienta diagnóstica en las distintas indicaciones odontológicas, se ha usado el modelo de Eficacia Diagnóstica descrito por Fryback y Thornbury en 1991.En odontología, el uso de la tomografía computarizada de haz cónico (TCHC) ha aumentado debido a sus ventajas como herramienta diagnóstica. Aún así, son pocas las investigaciones en altos niveles del modelo de Eficacia Diagnóstica -más relacionados con características aplicables al paciente--y muchas las investigaciones en bajos niveles -más relacionado con calidad técnica y de exactitud diagnóstica-. Conclusiones: La evidencia del rendimiento de la TCHC en bajos niveles puede generar una idea equivoca sobre sus indicaciones, dando la impresión de que cuenta con respaldo científico suficiente que justifica su uso. Es necesaria investigación enfocada en el beneficio de los pacientes con el uso de TCHC para las distintas indicaciones en odontología. (AU)
Introduction: Due to the risk of exposure to ionizing radiation, principles of radiation protection have been established, with the aimto regulate activities that involve the use of ionizing radiation. The principle of justification means that the indication of the exam must be associated to the possibility of providing information for the benefit of the patient. The indication of an exam that results in a benefit for the patient entails the evaluation of the exam in terms of its performance. This evaluation should demonstrate the exam has ability to deliver the necessary information for the specific need of the patient. Review: The Diagnostic Efficacy model, described by Fryback and Thornbury in 1991, is used to evaluate the performance of imaging tests, in order to guide its use as a diagnostic tool in different dental indications. In dentistry, the use of TCHC has increased due to the advantages as a diagnostic tool. Still, there are few investigations at high levels of the Diagnostic Efficacy model - related to characteristics that involve the patient - and many investigations at low levels - more related to technical quality and diagnostic accuracy. Conclusions: Evidence of the performance of CBCT at low levels generates a misunderstanding about its use, giving the impression that CBCT has sufficient scientific support to justify its use. Currently, the evaluation of the performance of the TCHC has focused on evaluating the lowest levels of this model, the image quality and the diagnostic precision, although evidence at this level remains limited. Research focusing on the benefit of patients with the use of CBCT for the different indications in dentistry is needed. (AU)
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Humanos , Eficácia/métodos , Tomografia Computadorizada de Feixe Cônico , Odontologia/métodos , Diagnóstico Bucal/métodos , Estudo de Prova de Conceito , Odontologia/tendências , Diagnóstico por Imagem/métodosRESUMO
Introduction: Physical and non-physical processes that occur in nature may influence biological processes, such as dissemination of infectious diseases. However, such processes may be hard to detect when they are complex systems. Because complexity is a dynamic and non-linear interaction among numerous elements and structural levels in which specific effects are not necessarily linked to any one specific element, cause-effect connections are rarely or poorly observed. Methods: To test this hypothesis, the complex and dynamic properties of geo-biological data were explored with high-resolution epidemiological data collected in the 2001 Uruguayan foot-and-mouth disease (FMD) epizootic that mainly affected cattle. County-level data on cases, farm density, road density, river density, and the ratio of road (or river) length/county perimeter were analyzed with an open-ended procedure that identified geographical clustering in the first 11 epidemic weeks. Two questions were asked: (i) do geo-referenced epidemiologic data display complex properties? and (ii) can such properties facilitate or prevent disease dissemination? Results: Emergent patterns were detected when complex data structures were analyzed, which were not observed when variables were assessed individually. Complex properties-including data circularity-were demonstrated. The emergent patterns helped identify 11 counties as 'disseminators' or 'facilitators' (F) and 264 counties as 'barriers' (B) of epidemic spread. In the early epidemic phase, F and B counties differed in terms of road density and FMD case density. Focusing on non-biological, geographical data, a second analysis indicated that complex relationships may identify B-like counties even before epidemics occur. Discussion: Geographical barriers and/or promoters of disease dispersal may precede the introduction of emerging pathogens. If corroborated, the analysis of geo-referenced complexity may support anticipatory epidemiological policies.
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Woodchip bioreactors have gained popularity in many countries as a conservation practice for reducing nitrate load to freshwater. However, current methods for assessing their performance may be inadequate when nitrate removal rates (RR) are determined from low-frequency (e.g., weekly) concurrent sampling at the inlet and outlet. We hypothesised that high-frequency monitoring data at multiple locations can help improve the accuracy of quantifying nitrate removal performance, enhance the understanding of processes occurring within a bioreactor, and therefore improve the design practice for bioreactors. Accordingly, the objectives of this study were to compare RRs calculated using high- and low-frequency sampling and assess the spatiotemporal variability of the nitrate removal within a bioreactor to unravel the processes occurring within a bioreactor. For two drainage seasons, we monitored nitrate concentrations at 21 locations on an hourly or two-hourly basis within a pilot-scale woodchip bioreactor in Tatuanui, New Zealand. A novel method was developed to account for the variable lag time between entry and exit of a parcel of sampled drainage water. Our results showed that this method not only enabled lag time to be accounted for but also helped quantify volumetric inefficiencies (e.g., dead zone) within the bioreactor. The average RR calculated using this method was significantly higher than the average RR calculated using conventional low-frequency methods. The average RRs of each of the quarter sections within the bioreactor were found to be different. 1-D transport modelling confirmed the effect of nitrate loading on the removal process as nitrate reduction followed Michaelis-Menten (MM) kinetics. These results demonstrate that high-frequency temporal and spatial monitoring of nitrate concentrations in the field allows improved description of bioreactor performance and better understanding of processes occurring within woodchip bioreactors. Thus, insights gained from this study can be used to optimise the design of future field bioreactors.
Assuntos
Desnitrificação , Nitratos , Nitratos/análise , Reatores Biológicos , Nova ZelândiaRESUMO
Introducción: La mayoría de las calcificaciones en la región de cabeza y cuello son asintomáticas, generalmente detectadas como hallazgos incidentales en estudios imagenológicos. Se han reportado calcificaciones previamente en el rodete tubárico, sin embargo, no hay reportes del hallazgo incidental de una gran calcificación asintomática en el rodete tubárico con seguimiento de 11 años. Objetivo: El propósito del presente artículo es reportar el hallazgo incidental en una radiografía panorámica, de una gran calcificación en el rodete tubárico y discutir sus posibles diagnósticos. Presentación del caso: Mujer de 43 años, sin historia clínica personal ni antecedentes familiares relevantes asiste a una clínica dental privada, para su evaluación antes de un tratamiento dental integral. Se encontró una gran calcificación asintomática en la trompa auditiva, específicamente en el rodete tubárico, como hallazgo incidental en una radiografía panorámica. El presente reporte muestra el enfoque de toma de decisiones para su diagnóstico diferencial. Basado en las imágenes y su comportamiento clínico, es posible que esta lesión corresponda a un tonsilolito o la unión de varios tonsilolitos en el rodete tubárico. No se realizó ningún tratamiento quirúrgico. En su lugar, se ha realizado un seguimiento imagenológico de 11 años. Teniendo en cuenta la evolución del caso, se espera que la lesión se mantenga estable, sin embargo, debe continuar su seguimiento para evaluar sus características clínicas y radiográficas en el tiempo. Conclusiones: La radiografía panorámica permite observar la superposición de estructuras anatómicas externas al territorio maxilofacial. Por lo tanto, es esencial que los radiólogos maxilofaciales tengan conocimiento adecuado del territorio evaluado, para detectar alteraciones como la reportada. (AU)
Introduction: Most of calcifications in head and neck region are asymptomatic and are usually detected as incidental findings in imaging studies. Calcifications have previously been reported in the torus tubarius, however, there are no reports of the incidental finding of a large, asymptomatic calcification located in the torus tubarius that include an 11-years follow-up. Objective: The purpose of the present article is to report the incidental finding in a panoramic radiography, of a large calcification at the previously described location and discuss its presumptive diagnoses. Case presentation: A 43-year-old female patient, with neither personal medical history nor relevant family history attended a private dental clinic, for evaluation prior to the start of a comprehensive dental treatment. A large, asymptomatic calcification in the auditory tube, specifically in thetorus tubarius, was found as incidental finding in a panoramic radiography. The approach for its differential diagnosis decision making is shown. Based on imaging and clinical behavior, it is possible that this lesion corresponds to a tonsilolith, or the coalescence of several tonsiloliths formed in the torus tubarius. No surgical treatment was carried out. A 11-yearsclinical an imaging follow-up has been performed instead. Considering the evolution of this case, it is expected that this lesion will remain stable, however, the status of the patient must be followed-up to assess its clinical and radiographic characteristics. Conclusions: Panoramic radiograph allows clinicians to observe the superimposition of anatomical structures which are external to the maxillofacial territory. Therefore, it is essential that dental radiologists have an appropriate knowledge of the territory being evaluated. (AU)
Assuntos
Humanos , Feminino , Adulto , Tuba Auditiva , Achados Incidentais , Radiografia Panorâmica , CalcinoseRESUMO
Introducción: El quiste óseo aneurismático (QOA) tiene una diversidad de características clínicase imagenológicas. Existe poca información respecto a la posible relación entre algunas de estas características y los patrones histopatológicos del QOA. El propósito de la presente revisión fue analizar la clínica, epidemiología e imagenología de casos de QOA, y determinar qué características podrían tener relación con algún tipo de patrón histopatológico del QOA en el territorio craneofacial. Materiales y métodos:Se realizó una búsqueda de casos de QOA en el territorio craneofacial publicados desde el año 2000, en PubMed, Scopus y Web of Science, mediante la búsqueda ("Aneurysmal bone cyst") AND ("Skull" OR "Jaw" OR "Mandible" OR "Maxilla"). Los casos debían tener información histopatológica, clínica, epidemiológica e imagenológica. Revisión: Se incluyó 40 artículos con 41 lesiones, siendo 34 de patrón clásico y 7 de patrón mixto-sólido (M-S). El patrón M-S se presentó mayoritariamente sin dolor y en el sexo masculino, mientras que el patrón clásico con dolor asociado y en el sexo femenino. Respecto a la imagenología, el patrón M-S se presentó sin límites definidos-corticalizados y generó perforación ósea con mayor frecuencia que el patrón clásico. Conclusiones: Los patrones histopatológicos del QOA tienen características clínicas, epidemiológicas e imagenológicas similares. Sin embargo, difieren en sexo, dolor asociado, límites definidos corticalizados y perforación ósea, lo que permitiría orientar al diagnóstico hacia un patrón histopatológico. (AU)
Introduction: The aneurysmal bone cyst (ABC) has a variety of clinical and imaging characteristics. There is little information regarding the possible relationship between some of these characteristics and its histopathological patterns. The aim of this review was to analyze the clinical, epidemiology and imaging characteristics of ABC cases, and determine what characteristics might be related to some type of histopathological pattern of ABC in the craniofacial territory. Materials and methods: A search was conducted for ABC cases in the craniofacial territory published since 2000, on PubMed, Scopus and Web of Science, by searching ("Aneurysmal bone cyst") AND ("Skull" OR "Jaw" OR "Mandible" OR "Maxilla"). Cases had to have histopathological, clinical, epidemiological, and imaging information. Review: 40 articles with 41 ABC lesions were included, with 34 being classic pattern and 7 mixed-solid (M-S). The M-S pattern was mostly painless and in males, while the classic pattern, with associated pain was mostly in females. Regarding imaging, the M-S pattern was without defined-corticated limits and with bone perforation more frequently than the classic pattern. Conclusions: Histopathological patterns of ABC have similar clinical, epidemiological and imaging characteristics. However, they differ in sex, associated pain, defined-corticated limits and bone perforation, which would allow the diagnosis to be directed towards a specific histopathological pattern. (AU)
Assuntos
Humanos , Cistos Ósseos Aneurismáticos/epidemiologia , Cistos Ósseos Aneurismáticos/patologia , Cistos Ósseos Aneurismáticos/diagnóstico por imagemRESUMO
Excessive use of insecticides has led to resistance of some pathogenic organisms (nematodes, bacteria and fungi), environmental contamination, and the presence of hazardous residues. Therefore, the aim of the present study was to evaluate synthetic metabolites derived from previous studies with edible mushrooms against the soybean weevil Rhyssomatus nigerrimus Fahraeus (Curculonidae) because of the relevance of pest control in an economically important crop. Furthermore, this is one of the first studies where edible fungal molecules are evaluated for the control of these insects. Initially, two in vitro tests (toxic effect and immersion) were evaluated against R. nigerrimus. In these tests, sensitivity and viability were determined in the 2% Tween control in water. For these two tests, the synthetic metabolites pentadecanoic acid (PNA), palmitic acid (PMA), stearic acid (STA), linoleic acid (LNA), ß-sitosterol (ßT) were evaluated individually as well as in combinations, "the fraction of standards (E1)". Based on the results obtained, the dip test was selected to evaluate the mixtures of two standards (1. PMA + ßT, 2. PMA + PNA, 3. PMA + LNA, 4. PMA + STA, 5. STA + ßT, 6. STA + PNA, 7. STA + LNA, 8. PNA + ßT, 9. PNA + LNA, 10. LNA + ßT), three (1. PNA + ßT + LNA, 2. PNA + ßT + STA, 3. STA + LNA + PNA and 4. STA + LNA + ßT) and four (PNA, ßT, LNA and STA). The results showed that the mixture of three standards caused a higher percentage of mortality relative to the control group: l. PNA + ßT + LNA and 2. PNA + ßT + STA with 54.44 and 48% mortality of R. nigerrimus insects exposed for 15 days. These results show the importance of evaluating mixtures of molecules against R. nigerrimus.
Assuntos
Agaricales , Inseticidas , Ácidos Nucleicos Peptídicos , Gorgulhos , Animais , Ácidos Nucleicos Peptídicos/química , Ácidos Nucleicos Peptídicos/metabolismo , Inseticidas/farmacologia , Agaricales/metabolismo , Gorgulhos/metabolismo , Ácido Linoleico , Ácido Palmítico , Polissorbatos , ÁguaRESUMO
Introducción: Inteligencia artificial (IA) es la automatización de actividades vinculadas con procesos de pensamiento humano. En ortodoncia se han desarrollado sistemas que asistidos por IA pueden tomar decisiones terapéuticas y realizar análisis. No existe un compendio actualizado sobre el uso de IA en ortodoncia. Objetivos: Describir los usos de IA en ortodoncia de acuerdo con la literatura actual. Metodología: Se realizó una revisión narrativa en las bases Medline y SciELO mediante la búsqueda: (orthodont*) AND (machine learning OR deep learning OR artificial intelligence OR neural network). Resultados: Se obtuvieron 19 artículos que mostraron que IA se ha desarrollado en cinco áreas: 1) Cefalometría asistida por IA, donde la localización de puntos y análisis cefalométricos mostraron una precisión igual a ortodoncistas. 2) Localización de dientes no erupcionados en CBCT, con resultados similares entre IA y ortodoncistas. 3) Determinación de edad y maduración ósea de forma más eficiente apoyada por IA, que por métodos convencionales, 4) Análisis facial, donde la IA permite una evaluación objetiva del atractivo facial, con aplicaciones en diagnóstico y planificación quirúrgica. 5) Decisiones terapéuticas con IA, para determinar la necesidad de exodoncias y dientes que serán extraídos. Discusión: La IA se está incorporando aceleradamente en ortodoncia, por lo que debe conocerse conceptos y posibilidades que brinda. (AU)Conclusiones:Un número creciente de artículos sobre usos de IA en ortodoncia muestran resultados similares con IA a los obtenidos por especialistas. Sin embargo, la evidencia aún es poca y principalmente experimental, por lo que la IA debiera usarse cautelosamente en ortodoncia.
Introduction: Artificial Intelligence (AI) is the automation of activities related to human thought processes. In orthodontics, systems have been developed which, assisted by AI, can make therapeutic decisions and perform analyses. There is no updated compendium on the use of AI in orthodontics. Objectives: To describe the uses of AI in orthodontics according to the current literature. Methodology: A narrative review was performed in the Medline and SciELO bases by means of the following search: (orthodont*) AND (machine learning OR deep learning OR artificial intelligence OR neural network). Results: 19 articles were obtained, showing that AI has been developed in four areas: 1) IA assisted cephalometry, where localization of cephalometric points and cephalometric analysis showed equal accuracy than orthodontists. 2) Unerupted tooth localization with CBCT, with similar results between AI and orthodontists. 3) Determination of skeletal age, which is more efficient with AI than with conventional methods. 4) Facial analysis, where AI allows an objective evaluation of facial attractiveness with applications in diagnosis and surgical planning. 5) Therapeutic decisions with AI, to determine the need for exodontia and teeth to be extracted. Discussion: AI is being incorporated rapidly in orthodontics, so we must know concepts and possibilities that it gives us in orthodontics. Conclusions: An increasing number of articles refer to the uses of AI in orthodontics, with similar results to those obtained by specialists. However, the evidence is still scarce and mainly experimental, so AI should still be used with caution in orthodontics. (AU)
Assuntos
Humanos , Inteligência Artificial , Ortodontia , CefalometriaRESUMO
Introducción: La tomografía computarizada de haz cónico (CBCT, del inglés Cone-Beam Computed Tomography) se ha masificado en odontología, incluyendo ortodoncia. Organismos internacionales proponen guías para la indicación de CBCT en odontología. Hasta la fecha no existen publicaciones que recopilen y analicen las guías actuales de uso de CBCT en ortodoncia. El propósito de la presente revisión narrativa es analizar las indicaciones de CBCT en ortodoncia en revisiones sistemáticas y guías actuales de organismos internacionales. Materiales y métodos: Se realizó una búsqueda principal en PubMed, Web of Science y Scopus. Para la búsqueda complementaria se usaron las listas de referencias de los artículos incluidos a texto completo obtenidos de la búsqueda principal y sitios web oficiales de instituciones guías de uso de CBCT en ortodoncia. Los criterios de inclusión correspondieron a guías, y revisiones sistemáticas sobre el uso de CBCT en ortodoncias no incluidas en las referencias de las guías, en idioma inglés. Resultados: Se encontraron 7 guías y 1 revisión sistemática. La CBCT no se recomienda para uso rutinario ni como examen imagenológico inicial en ortodoncia. Sus usos son en su mayoría para casos particulares, en que la radiografía convencional no aporta información suficiente para un correcto diagnóstico y posterior tratamiento. Conclusión: Las organizaciones internacionales concuerdan que la CBCT en ortodoncia se justifica solo cuando beneficia al paciente. La CBCT es una herramienta diagnóstica confiable en casos donde la evaluación en tres dimensiones es obligatoria para tomar la decisión terapéutica más adecuada. Aún falta nueva evidencia en esta área, la que debe considerar los principios de protección radiológica de optimización y justificación. (AU)
Introduction: Cone-beam computed tomography (CBCT) has been popularized in dentistry, including orthodontics. International organizations have published guidelines for the use of CBCT in dentistry. To date, there are no publications that compile and analyze the current guidelines for the use of CBCT in orthodontics. The aim of this narrative review is to analyze the indications for CBCT in orthodontics both in systematic reviews and current guidelines from international organizations. Materials and methods: A main search was conducted in PubMed, Web of Science, and Scopus. For the complementary search, the reference lists of the articles included in full text obtained from the main search and official websites of institutions with guidelines for the use of CBCT in orthodontics, were used. The inclusion criteria corresponded to guides on the use of CBCT in orthodontics, and systematic reviews not included in the references of the guides, in English. Review: Seven guidelines and one systematic review were found. CBCT is not recommended for routine use or as an initial imaging examination in orthodontics. The uses are mostly for particular cases, in which conventional radiography does not provide the information for a correct diagnosis and subsequent treatment. Conclusions: There is a consensus among international organizations regarding the use of CBCT in orthodontics, justifying its use only when it provides a benefit to the patient. CBCT is a reliable diagnostic tool in cases where three-dimensional evaluation is mandatory to take the most appropriate therapeutic decision. New evidence is still lacking in this area, which must consider the principles of optimization and exam justification. (AU)
Assuntos
Humanos , Tomografia Computadorizada de Feixe Cônico , Ortodontia , Guias como AssuntoRESUMO
Introducción: Evaluar la maduración de la sutura palatina mediana (SPM) es importante en ortodoncia y ortopedia dentofacial, para decidir el tipo de tratamiento para expansión palatina, en pacientes con compresión maxilar. Angelieri et al. el 2013, proponen un método de evaluación de maduración de la SPM con tomografía computarizada de haz cónico. No se encontraron publicaciones que analicen artículos que describen y aplican el método de Angelieri. El propósito de esta revisión es analizar el método de Angelieri, describiendo usos, ventajas y desventajas. Revisión: El método de Angelieri clasifica la maduración de la SPM en 5 etapas (A-E). Su uso complementa a estudios con radiografías convencionales cuando éstas indican que el paciente está en etapas circumpuberales y post peak puberal. La identificación de la etapa de maduración de la SPM permite determinar las alternativas de tratamiento -ortopédico o con enfoque quirúrgico-, de acuerdo a si la SPM está sin osificación o con osificación parcial/total, respectivamente. Algunas ventajas del método de Angelieri son ser un método no invasivo, y reproducible tras una adecuada formación. Una de sus desventajas es la falta de un gold standard que compruebe que la morfología imagenológica de la SPM propuesta por los autores no es solo teórica. Conclusiones: El método de Angelieri es útil para evaluar la maduración de la SPM, previa calibración. No existe acuerdo en que el método de Angelieri sea predictor de éxito del tratamiento para expansión palatina. Se requiere mayor investigación acerca de la contribución de este método para su uso clínico. (AU)
Introduction: Assessing the maturity of the midpalatal suture (MPS) is important in orthodontics and dentofacial orthopedics, to decide the type of treatment for palatal expansion, in patients with maxillary compression. Angelieri et al. in 2013, proposed a method for evaluating the maturation of MPS with cone-beam computed tomography. No publications were found which analyze articles describing and applying the Angelieri's method. The purpose of this review is to analyze the Angelieri's method, describing its uses, advantages and disadvantages.Review: Angelieri's method classifies MPS maturation into 5 stages (A-E). Its use complements studies with conventional bi-dimensional radiographs, when they indicate the patient is in circumpubertal and post-peak pubertal stages. The identification of the stage of maturation of MPS allows to determine the treatment alternatives -orthopedic or with a surgical approach-according to whether MPS is without ossification or with partial/total ossification, respectively. Some advantages of the Angelieri's method are being a non-invasive method, and reproducible after adequate training. One of its disadvantages is the lack of a gold standard that proves the imaging morphology of MPS proposed by the authors is not only theoretical.Conclusions: Angelieri's method is useful to evaluate the maturation of MPS, after calibration. There is no agreement that Angelieri's method is a predictor of treatment success for palatal expansion. Further research is required on the contribution of this method to its clinical use. (AU)
Assuntos
Humanos , Suturas , Técnica de Expansão Palatina , Tomografia Computadorizada de Feixe Cônico , Suturas Cranianas , OsteogêneseRESUMO
Introducción: El fibroma osificante (FO) y el fibroma cemento osificante (FCO) son patologías distintas, que hasta el 2017 se consideraban como una. A la fecha no se han comparado las características del FO y el FCO. La presente revisión tuvo como objetivo analizar características clínicas, epidemiológicas e imagenológicas del FO y FCO en los casos publicados. Materiales y métodos: Se realizó una búsqueda de casos clínicos de FO y FCOpublicados desde el año 2015 en PubMed, Scopus y Web of Science, mediante la estrategia de búsqueda ("Ossifying Fibroma" OR "Cemento Ossifying Fibroma") AND (Craniofacial OR Jaws). Los casos debían presentar información clínica, imagenológica e histológica suficientes para confirmar su diagnóstico, patrón histológico y comparar sus características. Revisión: Se incluyeron 32 artículos, con 32 casos y 34 lesiones, siendo 6 FCO y 28 FO. Los FO y FCO se diferencian por su edad y ubicación: mientras los FCO se presentan en edades adultas, exclusivamente en los maxilares y en relación con tejidos dentarios, los FO lo hacen principalmente en niños y jóvenes, y en cualquier hueso. Los FO y FCO tienen las mismas características imagenológicas: son lesiones uniloculares o multiloculares, con distintos grados de radiodensidad, límites definidos y una radiolucidez periférica. Sin embargo, los casos de FO trabecular pueden no presentar esta radiolucidez periférica. Conclusión: Los FO y FCO son patologías, clínica y epidemiológicamente similares, y con las mismas características imagenológicas. Por lo que establecer diferencias histológicas es esencial para un correcto diagnóstico. (AU)
Introduction: Ossifying fibroma (OF) and cemento ossifying fibroma (COF) are different pathologies, which until 2017 where considered as one. To date, the features of OF y COF have not been compared. This aim of this review was to analyze clinical, epidemiological and imaging features of OF and COF in published case reports. Materials and methods: A search of clinical cases of OF and COF published since 2015 was performed on PubMed, Scopus and Web of Science, using the search strategy ("Ossifying Fibroma" OR "Cemento Ossifying Fibroma") AND (Craniofacial OR Jaws). The cases had to haveenough clinical, imaging and histological information to confirm their clinical diagnosis, histological pattern and compare their features. Review: 32 articles were included, with 32 cases and 34 lesions, being 28 OF and 6 COF. OF and COF differ by age and location: while COF occur in adult ages, exclusively in the jaws and in relation to dental tissues, OF occur mainly in children and young people, and in any bone. OF and COF have the same imaging characteristics: they are unilocular or multilocular lesions, with different degrees of radiodensity, defined limits and a peripheral radiolucent area. However, cases of trabecular OF may not present this peripheral radiolucent area. Conclusions: OF and COF are similar pathologies clinically and epidemiologically, with the same imaging characteristics. So, establishing histological differences is essential for an accurate diagnosis. (AU)
Assuntos
Humanos , Cementoma/epidemiologia , Fibroma Ossificante/epidemiologia , Cementoma/história , Fibroma Ossificante/história , Cementoma/diagnóstico , Fibroma Ossificante/diagnósticoRESUMO
The increase in children obesity worldwide has been of particular concern in recent decades. Environmental factors have been proposed as contributors to obesity, and there is a growing concern over obesogens, environmental chemicals with potential obesity-related endocrine-disrupting properties. In this regard, bisphenol A (BPA) and its analogues are suspected to have obesogenic properties. Current document report on the activities of the fellow, undertaken during the fourth, 2020-2021 cycle of the EU-FORA programme at the University of Granada, Institute of Nutrition and Food Science, in Spain. The work programme offered by the hosting site was related to the extrapolation of bisphenols exposure following the determination of these compounds in food frequently consumed by children and in their biological samples. The fellow has participated in the recruitment of the study population in the health centres. In addition, she has participated in the collection of the children biological samples, anthropometric measurements and dietary surveys and in the optimisation of the laboratory methodology for the extraction of bisphenols in biological samples. All these activities also provided the fellow an opportunity to develop her data science related skills, which will benefit her professional development. In addition, the fellow gained an overview of various topics related to food safety risk assessment by attending the EU-FORA dedicated training modules.
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Introducción: Una de las dificultades de los tratamientos endodónticos son las variaciones anatómicas de las raíces y sistema de canales radiculares. Existe poca información sobre prevalencia y distribución espacial de estas variaciones en casos reportados con CBCT (del inglés Cone-Beam Computed Tomography). El propósito de la presente revisión fue analizar las variaciones anatómicas en primer y segundo molar permanente mandibular con tratamiento endodóntico evaluadas con CBCT. Materiales y métodos: Se seleccionaron artículos con casos de tratamiento endodóntico en primer o segundo molar permanente mandibular. Se determinaron el número, distribución espacial de variaciones anatómicas radiculares y canales. Además, el número y tipo de alteraciones de forma. Resultados: La mayor prevalencia del número y distribución espacial de raíces en primer molar fue de tres raíces [1M (mesial), 2D (distal)] con un 76,5% y cuatro raíces (2M, 2D) con un 55,6% en segundo molar. La mayor prevalencia del número y distribución de canales radiculares para el primer y segundo molar fue de cuatro canales: 1mesiovestibular, 1mesiolingual, 1distovestibular y 1distolingual, con un 30% y 90,9% de los casos seleccionados respectivamente. La distribución de alteraciones de forma fue de 8,7% para geminación y de 2,1% para taurodontismo. Conclusiones: La variación anatómica de raíces del primer y segundo molar inferior permanente con más frecuencia fue de tres y cuatro respectivamente. La variación anatómica de canales con más frecuencia fue de cuatro: 2M y 2D. El número de alteraciones de forma fueron poco frecuentes, presentando geminaciones y taurodontismo, solo en segundos molares.
Introduction: One of the difficulties of endodontic treatments is the anatomical variations of the roots and the root canal system. There is little information on the prevalence and spatial distribution of these variations in cases reported with CBCT (Cone-Beam Computed Tomography). The purpose of this review was to analyze the anatomical variations in the mandibular first and second permanent molars with endodontic treatment evaluated with CBCT. Materials and methods: Articles with cases of endodontic treatment in the first or second permanent mandibular molar were selected. The number, spatial distribution of anatomical variations of roots and canals were determined. The number and type of shape alterations were also determined. Results: The highest prevalence regarding number and spatial distribution of root in the first molar was three roots (1M (mesial), 2D (distal)) with 76.5% and four roots (2M, 2D) with 55.6% in second molar. The highest prevalence regarding number and distribution of root canals for the first and second molars was four channels: 1 mesiobuccal, 1 mesiolingual, 1 distobuccal and 1 distolingual, with 30% and 90.9% of the cases selected, respectively. The distribution of shape alterations was 8.7% for gemination and 2.1% for taurodontism. Conclusions: The anatomical variation of roots of the first and second permanent lower molars with the most frequency was three and four respectively. The most frequent anatomic variation of channels was four: 2M and 2D. The number of shape alterations were less frequent, presenting geminations and taurodontism, only in second molars.
Assuntos
Humanos , Ciências da Saúde , Endodontia , Dente Molar , Tomografia Computadorizada de Feixe Cônico/instrumentação , Tomografia Computadorizada de Feixe Cônico/métodosRESUMO
Introducción: Los equipos radiográficos dentales portátiles (ERDP) son dispositivos transportables e inalámbricos cuyo uso se ha masificado. No se encontró revisiones de la literatura recientes que analicen comprehensivamente los ERPD. El propósito del presente artículo es analizar la información actual sobre componentes, características técnicas, forma de uso y recomendaciones de protección radiológica de los ERDP. Materiales y métodos: Se realizó una revisión de la literatura sobre ERDP de la última década en Scopus, PubMed y Web of Science, relacionando el término libre handheld dental X-ray y sus variantes a través del término booleano OR. Revisión: Los ERDP se diferencian de los equipos radiográficos fijos en que tienen una batería recargable y un blindaje externo de retrodispersión. Además, el miliamperaje es menor en ERDP, por lo que los tiempos de exposición son mayores. La forma de uso del ERDP para disminuir el riesgo de exposición a radiaciones ionizantes del operador es sostenerlo a la distancia de un antebrazo del cuerpo manteniendo la emisión del rayo central paralela al piso. Se describen recomendaciones asociadas a protección radiológica para el uso de los ERDP para proteger al paciente, operador y población general de los potenciales riesgos de las radiaciones ionizantes. Conclusión: La amplia variedad de ERPD y su distinta forma de uso, implica un potencial mayor riesgo de exposición a radiación al operador. Los ERDP no debieran considerarse un reemplazo de los equipos radiográficos fijos y su uso debería restringirse a situaciones en que sea imposible el uso equipos radiográficos fijos. (AU)
Introduction: Handheld dental X-ray equipment (HDXE) are portable and wireless devices whose use has become massive. No recent reviews of literature that comprehensively analyze HDXE were found. The aim of the present article was to analyze the current information available on components, technical features, way of use and recommendations on radiological protection of HDXE. Materials and methods: A review of published literature on HDXE in the last decade was made in Scopus, PubMed and Web of Science relating the free term handheld dental X-ray and its variants through the Boolean term OR. Review: HDXE differ from wall-mounted X-ray equipment in that they have a rechargeable battery and external backscatter shielding. Furthermore, milliamperage is lower in HDXE and because of this, exposure times are longer. The way to use HDXE to reduce risk of exposure to ionizing radiation to the operator is to hold it at a forearm distance of the body, keeping the central beam emission parallel to the floor. There are radiological protection recommendations for the use of HDXE that seek to protect the patient, operator and general population from the potential risks of ionizing radiation. Conclusions: The wide variety of HDXE and its different form of use implies a potential greater risk of exposure to radiation to the operator. HDXE should not be considered as a replacement for wall-mounted equipment and their use should be restricted to situations where wall-mounted equipment is impossible to use. (AU)
Assuntos
Humanos , Raios X , Radiografia Dentária/instrumentação , Proteção Radiológica , Equipamentos e ProvisõesRESUMO
Introducción: El manejo de radiación ionizante en odontología sin conocimiento óptimo y actualizado en protección radiológica, puede aumentar el riesgo de efectos adversos por radiación para pacientes y personal ocupacionalmente expuesto (POE). Si bien existen investigaciones sobre el conocimiento en protección radiológica en odontología (PRO), no se encontró artículos que evalúen los resultados de las investigaciones sobre este tema. El propósito de la presente revisión fue evaluar el conocimiento en PRO reportado en investigaciones en la literatura. Materiales y métodos: En la búsqueda principal se usó las bases de datos PubMed, Web of Knowledge y Scopus. Se empleó los términos MeSH: Radiation Protection, Knowledge, Awareness y Dentist en combinación con los operadores booleanos AND y OR. En la búsqueda complementaria, se usaron las listas de referencias de los artículos incluidos en la búsqueda principal. Resultados: Se encontró un nivel de conocimiento en PRO mayoritariamente medio-bajo en protección radiológica al paciente (63,7%), protección radiológica al POE (71,4%), efectos adversos por radiación (81,8%) y especificaciones técnicas del equipo radiográfico (83,3%). El nivel de conocimiento fue mayoritariamente bajo (66,7%) para normativa en protección radiológica. Conclusiones: La falta de conocimiento en PRO puede llevar a actuar inseguramente, y los pacientes podrían recibir dosis de radiación más altas de las requeridas. Además, el POE puede estar recibiendo dosis de radiación más altas que las permitidas. Se necesita conocer las medidas de PRO para minimizar el riesgo biológico de exposición a los rayos X. (AU)
Introduction: The management of ionizing radiation in dentistry without optimal and updated knowledge in radiological protection, may increase the risk of adverse effects of radiation to patients and occupationally exposed personnel (OEP). While there is research on knowledge in radiation protection in dentistry (RPD), articles evaluating the results of the investigations on this topic were not found. The purpose of the present narrative review was to evaluate the knowledge in RPD reported in research in the literature. Materials and methods: PubMed, Web of Knowledge and Scopus databases were used in the main search. The MeSH terms Radiation Protection, Knowledge, Awareness and Dentist were used in combination with the Boolean operators AND and OR. The search strategy was adapted for each database. In the complementary search, the reference lists of the articles included in the main search were used. Results: Mostly a medium-low level of knowledge in RPD was found regarding radiation protection of patients (63.7%), radiation protection of OEP (71.4%), adverse effects of radiation (81.8%) and technical specifications of radiographic equipment (83.3%). Mostly a low level of knowledge was found regarding radiation protection regulations (66.7%). Conclusions: The lack of knowledge in RPD may lead to acting in an insecure way, and patients may be receiving higher radiation doses than required. Moreover, OEP may receive higher doses of radiation than permitted. It is necessary to know the RPD measures to minimize the biological risk of exposure to X-rays. (AU)