Women in Radiology: A perspective from Spain.

INTRODUCTION: There are gender inequalities in all fields, including radiology. Although the situation is improving, the presence of radiologists in leadership positions continues to be a minority. The objective of this article is to analyse the situation of women in the spanish radiology, comparing it with Europe and the United States. MATERIALS AND METHODS: We selected the years 2000-2022 as reference period to make a comparison with feminization data throughout history. In addition, relevant specific data from the just begun 2023 were also included. The variables in which we investigated feminization were the following: medical students, medical graduates, radiology residents and specialists, section chiefs, department chairs, radiology residency programme directors, radiology university professors, presidents of the main radiological entities and societies in Spain, Europe and the United States, recipients of the main awards given by these radiological societies and chief editors of their journals. In order to perform this analysis we conducted an in-depth bibliographic research, we contacted the radiological societies of Spain, Europe and the USA and we carried out a survey in the main Spanish radiology departments. RESULTS: The female presence in radiology decreases as we rise to leadership positions, a situation that is patent in Spain, Europe and the US, comparison that will be analysed in depth throughout the article. In Spanish hospitals in 2021 there were 58.1% female radiology residents, 55% female radiologists, 42.9% female section chiefs and 24.4% female department chairs. In SERAM's history there have been 10% female presidents, 22% female gold medallists and 5% female editors-in-chief. If we analyse data from 2000 to 2023, female presidents reach 32% and female gold medallists 31%. CONCLUSIONS: Although gender inequality is declining, in radiology women continue to be underrepresented in leadership positions. Work must be done in order to build a diverse and inclusive profession that reflects demographic reality.

Paediatric interventional radiology: it's not child's play.

Pediatric interventional radiology is a dynamic and growing subspecialty. The new training pathways in interventional radiology, the maintenance of skills with a small volume of cases or complex procedures, the limited availability of specific pediatric equipment and materials pose significant challenges and opportunities.

Teaching radiology in integrated educational programs.

Radiology is a medical discipline, an area of transversal knowledge integrated into any clinical situation. The optimal training of learning knowledge, skills and aptitudes in Radiology in the Degree in Medicine requires the integration of any imaging modality in the different areas of knowledge; from the basic subjects to any clinical subject of the Degree. This article describes the integration of Radiology teaching into the curriculum throughout the Medicine Degree at the University of Girona (UdG), describing the different radiology teaching activities that are taught. The specific activities of the subject "Radiology" are detailed; through workshops, seminars, practices, interactive computer game; and describing the characteristics of the main teaching methodological activity of the UdG, Problem-Based Learning.

The teaching of Radiology in other university studies.

After the implementation of the European Space for Higher Education, the contents of the Radiology and Physical Medicine Area that were taught in the Medicine Degree have also been incorporated into the new degrees of Dentistry, Nursing, Physiotherapy, Podiatry, and, to a lesser extent, Pharmacy, Occupational Therapy, Logopedia, and Biomedical Engineering As a whole, the basic concepts of radiology and radiological protection are taught in Murcia in 5 different degrees with a total of 52.5 ECTS credits, participating in the training of 1219 students each academic year. This incorporation in the new degrees has tripled the number of subjects in which undergraduate teaching is taught, and doubled both the number of ECTS credits and the number of undergraduate students to whom it directs its training work. Thus, given the possible creation of new university degrees in the near future (Diagnostic Imaging and Radiotherapy Technicians), it would be necessary to involve a greater number of accredited professionals, from different specialties, and to optimize teaching resources (bibliography, material teacher, clinical cases, etc.,) for its usefulness in the different subjects that share similar contents.

La mujer en la radiología española actual: análisis en perspectiva / Women in Radiology: A perspective from Spain

Introducción: Existen desigualdades por razón de género en todos los ámbitos, incluyendo la radiología. Aunque la situación está mejorando, la presencia de radiólogas en puestos de liderazgo continúa siendo minoritaria. El objetivo de este artículo es analizar la situación de la mujer en la radiología española, comparándola con Europa y EE. UU. Materiales y métodos: Seleccionamos como franja de referencia los años 2000-2022 para hacer una comparación con datos de feminización a lo largo de la historia. Además también se incluyeron datos puntuales relevantes del recién comenzado 2023. Las variables en las que investigamos la feminización fueron las siguientes: estudiantes de medicina, médicos graduados, residentes y especialistas en radiodiagnóstico, jefes de sección, jefes de servicio, tutores de residentes de radiodiagnóstico, radiólogos profesores universitarios, presidentes de las principales entidades y sociedades radiológicas de España, Europa y EE. UU., receptores de los principales galardones de dichas sociedades radiológicas y editores jefe de sus revistas. Para ello realizamos una amplia búsqueda bibliográfica, contactamos con las sociedades radiológicas de España, Europa y EE. UU. y realizamos una encuesta a los principales servicios de radiodiagnóstico de España. Resultados: La presencia femenina en radiología va disminuyendo a medida que ascendemos a puestos de liderazgo, situación que se constata tanto en España como en Europa y EE. UU., comparativa que analizaremos en profundidad a lo largo del artículo. En los hospitales españoles en el año 2021 había un 58,1% de mujeres residentes de radiodiagnóstico, 55% de radiólogas, 42,9% de jefas de sección y 24,4% de jefas de servicio. En la historia de la SERAM ha habido un 10% de mujeres presidentas, un 22% de mujeres medallas de oro y un 5% de editoras jefe. Analizando los datos del año 2000 al 2023 el porcentaje de presidentas alcanza el 32% y las mujeres medalla de oro el 31%.(AU)

Introduction: There are gender inequalities in all fields, including radiology. Although the situation is improving, the presence of radiologists in leadership positions continues to be a minority. The objective of this article is to analyze the situation of women in the spanish radiology, comparing it with Europe and the United States. Materials and methods: We selected the years 2000-2022 as reference period to make a comparison with feminization data throughout history. In addition, relevant specific data from the just begun 2023 were also included. The variables in which we investigated feminization were the following: medical students, medical graduates, radiology residents and specialists, section chiefs, department chairs, radiology residency programme directors, radiology university professors, presidents of the main radiological entities and societies in Spain, Europe and the United States, recipients of the main awards given by these radiological societies and chief editors of their journals. In order to perform this analysis we conducted an in-depth bibliographic research, we contacted the radiological societies of Spain, Europe and the USA and we carried out a survey in the main spanish radiology departments. Results: The female presence in radiology decreases as we rise to leadership positions, a situation that is patent in Spain, Europe and the US, comparison that will be analyzed in depth throughout the article. In spanish hospitals in 2021 there were 58.1% female radiology residents, 55% female radiologists, 42.9% female section chiefs and 24.4% female department chairs. In SERAM's history there have been 10% female presidents, 22% female gold medallists and 5% female editors-in-chief. If we analyze data from 2000 to 2023, female presidents reach 32% and female gold medallists 31%.(AU)

Radiología intervencionista en pediatría: no es un juego de niños / Pediatric interventional radiology: It's not a child's play

La radiología intervencionista pediátrica es una subespecialidad dinámica y en crecimiento. Las nuevas vías de formación en radiología intervencionista, el mantenimiento de las competencias con un pequeño volumen de casos o procedimientos complejos, la disponibilidad limitada de equipos y material pediátrico específico, los efectos de la sedación o de la anestesia sobre el neurodesarrollo y la protección radiológica suponen importantes retos y oportunidades.(AU)

Pediatric interventional radiology is a dynamic and growing subspecialty. The new training pathways in interventional radiology, the maintenance of skills with a small volume of cases or complex procedures, the limited availability of specific pediatric equipment and materials, the effects of sedation or anesthesia on neurodevelopment or radiological on neurodevelopment or radiation protection pose significant challenges and opportunities.(AU)

La enseñanza de la radiología en los programas docentes integrados / Teaching Radiology in integrated educational programs

La radiología es una disciplina médica, un área de conocimiento transversal integrada en cualquier situación clínica. El aprendizaje óptimo del conocimiento, habilidades y aptitudes en radiología en el Grado en Medicina requiere la integración de cualquier modalidad de imagen en las distintas áreas del conocimiento: desde las asignaturas básicas hasta cualquier asignatura clínica del grado. El presente artículo describe la integración de la docencia en radiología del plan de estudios en todo el grado de medicina de la Universidad de Girona (UdG), describiendo las distintas actividades docentes de radiología que se imparten en las distintas asignaturas; desde primero a sexto curso. Se detallan las actividades específicas de la asignatura de «radiología», incluyendo talleres, seminarios, prácticas, juego de ordenador interactivo, y describiendo las características de la actividad metodológica docente principal de la UdG, el aprendizaje basado en problemas.(AU)

Radiology is a medical discipline, an area of transversal knowledge integrated into any clinical situation. The optimal training of learning knowledge, skills and aptitudes in Radiology in the Degree in Medicine requires the integration of any imaging modality in the different areas of knowledge; from the basic subjects to any clinical subject of the Degree. This article describes the integration of Radiology teaching into the curriculum throughout the Medicine Degree at the University of Girona (UdG), describing the different radiology teaching activities that are taught. The specific activities of the subject «Radiology» are detailed; through workshops, seminars, practices, interactive computer game; and describing the characteristics of the main teaching methodological activity of the UdG, Problem-Based Learning.(AU)

La enseñanza de la Radiología en otros estudios universitarios / The teaching of Radiology in other university studies

Tras la implantación del Espacio Europeo de Formación Superior, los contenidos del Área de Radiología y Medicina Física que se impartían tradicionalmente en la Licenciatura de Medicina se han incorporado también a los nuevos grados de Odontología, Enfermería, Fisioterapia, Podología y, en menor medida, Farmacia, Terapia Ocupacional, Logopedia, e Ingeniería Biomédica. En su conjunto, los conceptos básicos de radiología y protección radiológica se imparten en Murcia en 5 grados diferentes con un total de 52,5 créditos ECTS, participando en la formación de 1219 alumnos cada curso académico. Esta incorporación en los nuevos grados ha triplicado el número de asignaturas en las que se imparte docencia pregrado, y duplicado tanto el número de créditos ECTS como el número de alumnos de pregrado a los que dirige su labor de formación. Así, ante la posible creación de nuevos grados universitarios en un futuro próximo (Imagen para el Diagnóstico y Técnico en Radioterapia) sería necesaria la implicación de un mayor número de profesionales acreditados, de diferentes especialidades, y que optimicen los recursos docentes (bibliografía, material docente, casos clínicos, etc.) para su utilidad en las diferentes asignaturas que comparten contenidos similares.(AU)

After the implementation of the European Space for Higher Education, the contents of the Radiology and Physical Medicine Area that were taught in the Medicine Degree have also been incorporated into the new degrees of Dentistry, Nursing, Physiotherapy, Podiatry, and, to a lesser extent, Pharmacy, Occupational Therapy, Logopedia, and Biomedical Engineering As a whole, the basic concepts of radiology and radiological protection are taught in Murcia in 5 different degrees with a total of 52.5 ECTS credits, participating in the training of 1,219 students each academic year. This incorporation in the new degrees has tripled the number of subjects in which undergraduate teaching is taught, and doubled both the number of ECTS credits and the number of undergraduate students to whom it directs its training work. Thus, given the possible creation of new university degrees in the near future (Diagnostic Imaging and Radiotherapy Technicians), it would be necessary to involve a greater number of accredited professionals, from different specialties, and to optimize teaching resources (bibliography, material teacher, clinical cases, etc.) for its usefulness in the different subjects that share similar contents.(AU)

Estenosis arterial del injerto renal: evaluación de la incidencia mediante ecografía doppler, factores de riesgo y análisis de las complicaciones que pueden afectar a la supervivencia del injerto / Transplant renal artery stenosis: Study of incidence using doppler ultrasound, risk factors and analysis is effect in graft outcomes

Introducción y objetivos La estenosis de la arteria del injerto renal (EAR) es una complicación vascular del trasplante renal cuya incidencia estimada es del 13%, la cual puede causar hipertensión arterial refractaria, disfunción renal y muerte prematura en los receptores. Métodos Se realizó un estudio retrospectivo que incluyó a todos los pacientes sometidos a trasplante renal entre 2014 y 2020. Los pacientes fueron evaluados mediante ecografía doppler renal sistemática tras el trasplante. Para identificar los factores de riesgo independientes de la estenosis de la arteria renal tras el trasplante, realizamos un análisis multivariante. Resultados Se incluyeron 724 trasplantes renales, el 12% eran de donante vivo y el 88% de donante fallecido. La edad media en los receptores era de 54,8 años y en los donantes era de 53. Se diagnosticó estenosis de la arteria del injerto renal en 70 (10%) receptores, la mayoría durante los primeros 6 meses después de la intervención. El 51% de los pacientes con estenosis de la arteria del injerto renal se manejaron de manera conservadora. El análisis multivariante mostró que la diabetes mellitus, el rechazo del injerto, la resutura arterial y el índice de masa corporal del donante eran factores de riesgo independientes de estenosis de la arteria renal después del trasplante. La supervivencia de los injertos con estenosis de la arteria del injerto renal fue del 98% a los 6 meses y del 95% a los 2 años. Conclusiones El uso sistemático de la ecografía doppler en el período inmediatamente posterior al trasplante permitió diagnosticar un 10% de estenosis de la arteria del injerto renal en nuestra cohorte. A pesar de los factores de riesgo mencionados anteriormente, un seguimiento y tratamiento adecuados podrían reducir el riesgo de pérdida del injerto en pacientes con estenosis de la arteria del injerto renal. (AU)

Introduction and objectives Transplant renal artery stenosis (TRAS) is a vascular complication after kidney transplantation which estimated incidence is 13%. It could cause refractory arterial hypertension, kidney dysfunction and premature death in transplant recipients. Methods We carried out a retrospective study including every patient who underwent renal transplantation between 2014 and 2020. They were evaluated with a systematic post-transplant renal Doppler ultrasound. To identify independent risk factors for transplant renal artery stenosis we performed a multivariate analysis. Results Seven hundred twenty-four kidney transplants were included, 12% were living donors and 88% were deceased donors. The mean age was 54.8 in recipients and 53 in donors. Transplant renal artery stenosis was diagnosed in 70 (10%) recipients, the majority in the first 6 months after surgery. The 51% of patients with transplant renal artery stenosis were managed conservatively. The multivariate analysis showed diabetes mellitus, graft rejection, arterial resuture and donor body mass index as independent risk factors for transplant renal artery stenosis. Survival of the grafts with transplant renal artery stenosis was 98% at 6 months and 95% at two years. Conclusions The systematic performance of Doppler ultrasound in the immediate post-transplant period diagnosed 10% of transplant renal artery stenosis in our cohort. Despite the above risk factors, an adequate monitoring and treatment could avoid the increased risk of graft loss in patients with transplant renal artery stenosis. (AU)

Sarcoma folicular de células dendríticas mediastinal: primer reporte de caso en Costa Rica / Mediastinal Follicular Dendritic Cell Sarcoma: First Case Report in Costa Rica

El sarcoma folicular de células dendríticas (SFCD) es una neoplasia maligna rara derivada de las células dendríticas foliculares. Ha sido clasificado, dadas sus características inmunohistoquímicas, como parte del grupo de los sarcomas, donde representa un porcentaje menor al 1%. Actualmente, existen menos de 1.000 reportes en la literatura a nivel mundial, lo cual plantea una dificultad no sólo diagnóstica, siendo confundido frecuentemente con neoplasias de tipo linfoide; sino también terapéutica al no existir un claro consenso sobre su manejo definitivo. Esta revisión de caso clínico describe el primer caso reportado de SFCD en Costa Rica.

Follicular dendritic cell sarcoma (SFCD) is a rare malignant neoplasm derived from follicular dendritic cells, which has been classified, given its immunohistochemical characteristics, as part of the group of sarcomas, where it represents less than 1%. Currently, there are less than 1000 reports in the literature worldwide, which generates a difficulty not only in diagnosis, being frequently confused with lymphoid type neoplasms; but also, as therapeutic as there is no clear consensus on its definitive management. This clinical case review describes the first reported case of SFCD in Costa Rica.

Electroporación irreversible: ampliando las fronteras de la ablación / Irreversible electroporation: Beyond the limits of tumor ablation

La electroporación irreversible o IRE (irreversible electroporation) es una técnica de ablación tumoral no térmica basada en la aplicación de pulsos eléctricos de alto voltaje entre pares de agujas insertadas alrededor de un tumor. La corriente generada favorece la creación de nanoporos en la membrana plasmática, desencadenando la apoptosis. Por ello, la IRE puede utilizarse de manera segura en localizaciones cercanas a estructuras vasculares delicadas, contraindicadas para el resto de técnicas termoablativas. Actualmente la IRE se emplea con éxito para la ablación de tumores en páncreas, riñón e hígado y, de manera muy extendida, como opción terapéutica focal para el cáncer de próstata. La necesidad de un manejo anestésico específico y la colocación precisa y en paralelo de múltiples agujas implican un alto nivel de complejidad, siendo necesaria una gran experiencia del equipo intervencionista. No obstante, se trata de una técnica muy prometedora con una gran capacidad inmunológica sistémica que puede provocar un efecto a distancia del tumor tratado (efecto abscopal).(AU)

Irreversible electroporation (IRE) is a non-thermal tumor ablation technique. High-voltage electrical pulses are applied between pairs of electrodes inserted around and/or inside a tumor. The generated electric current induces the creation of nanopores in the cell membrane, triggering apoptosis. As a result, IRE can be safely used in areas near delicate vascular structures where other thermal ablation methods are contraindicated. Currently, IRE has demonstrated to be a successful ablation technique for pancreatic, renal, and liver tumors and is widely used as a focal therapeutic option for prostate cancer. The need for specific anesthetic management and accurate parallel placement of multiple electrodes entails a high level of complexity and great expertise from the interventional team is required. Nevertheless, IRE is a very promising technique with a remarkable systemic immunological capability and may impact on distant metastases (abscopal effect).(AU)

Irreversible electroporation: Beyond the limits of tumor ablation.

Irreversible Electroporation (IRE) is a non-thermal tumor ablation technique. High-voltage electrical pulses are applied between pairs of electrodes inserted around and/or inside a tumor. The generated electric current induces the creation of nanopores in the cell membrane, triggering apoptosis. As a result, IRE can be safely used in areas near delicate vascular structures where other thermal ablation methods are contraindicated. Currently, IRE has demonstrated to be a successful ablation technique for pancreatic, renal, and liver tumors and is widely used as a focal therapeutic option for prostate cancer. The need for specific anesthetic management and accurate parallel placement of multiple electrodes entails a high level of complexity and great expertise from the interventional team is required. Nevertheless, IRE is a very promising technique with a remarkable systemic immunological capability and may impact on distant metastases (abscopal effect).

Transplant renal artery stenosis: Study of incidence using doppler ultrasound, risk factors and analysis is effect in graft outcomes.

INTRODUCTION AND OBJECTIVES: Transplant renal artery stenosis (TRAS) is a vascular complication after kidney transplantation which estimated incidence is 13%. It could cause refractory arterial hypertension, kidney dysfunction and premature death in transplant recipients. METHODS: We carried out a retrospective study including every patient who underwent renal transplantation between 2014 and 2020. They were evaluated with a systematic post-transplant renal Doppler ultrasound. To identify independent risk factors for transplant renal artery stenosis we performed a multivariate analysis. RESULTS: Seven hundred twenty-four kidney transplants were included, 12% ​​were living donors and 88% were deceased donors. The mean age was 54.8 in recipients and 53 in donors. Transplant renal artery stenosis was diagnosed in 70 (10%) recipients, the majority in the first 6 months after surgery. 51% of patients with transplant renal artery stenosis were managed conservatively. The multivariate analysis showed diabetes mellitus, graft rejection, arterial resuture and donor body mass index as independent risk factors for transplant renal artery stenosis. Survival of the grafts with transplant renal artery stenosis was 98% at 6 months and 95% at two years. CONCLUSIONS: The systematic performance of Doppler ultrasound in the immediate post-transplant period diagnosed 10% of transplant renal artery stenosis in our cohort. Despite the above risk factors, an adequate monitoring and treatment could avoid the increased risk of graft loss in patients with transplant renal artery stenosis.

Solutions based on three-dimensional technologies for the practice and teaching of biomedical sciences

Introduction: Three-dimensional printing is one of the technologies that promote change at an economic and social level, and one of the fundamental elements of industry 4.0. It has enormous potential for the future of medicine, establishing itself as a new paradigm. Despite its advantages, its use in our environment is incipient. Objective: To design and develop solutions based on three-dimensional technologies for the teaching and practice of biomedical sciences. Materials and methods: A technological development investigation was carried out between the Center for Assisted and Sustainable Manufacturing of the University of Matanzas and Matanzas University of Medical Sciences, between September 2019 and July 2022. The designs and fabrications were made from the acquisition of computed tomography images, or from a surface scanner, which were then processed, converted into Standard Tessellation Language format, printed, and post-processed. Virtual designs were developed using computer-aided design software. Results: Various solutions were developed including prototypes: biomodels for craniosynostosis repair and anatomical figures, custom cranial prosthesis mold, hand prosthesis, O2 line splitters, tissue scaffolds, syringe gun, face shields, breast prosthesis; autologous restoration mold and tissue expander. Conclusions: In all areas of application of this technology in medicine―except the printing of medicines, in the current context―, it is feasible to obtain solutions in the territory of Matanzas. It is therefore imperative that managers and the medical community in general, begin to acquire awareness, knowledge, and experience to ensure the optimal use of this technology.

Introducción: La impresión tridimensional es una de las tecnologías que promueve el cambio a nivel económico y social, y uno de los elementos fundamentales de la industria 4.0. Asimismo, constituye un enorme potencial para el futuro de la medicina, estableciéndose como un nuevo paradigma. A pesar de sus ventajas, su explotación en nuestro medio es incipiente. Objetivos: Diseñar y desarrollar soluciones basadas en tecnologías tridimensionales para la enseñanza y la práctica de las ciencias biomédicas. Materiales y métodos: Se realizó una investigación colaborativa, de desarrollo tecnológico entre el Centro de Fabricación Asistida y Sostenible de la Universidad de Matanzas y la Universidad de Ciencias Médicas de Matanzas, entre septiembre de 2019 y julio de 2022. Los diseños y fabricaciones se realizaron a partir de la adquisición de imágenes de tomografía computarizada, o desde un escáner de superficie, las que luego se procesaron, se convirtieron en formato Standard Tessellation Language, se imprimieron y posprocesaron. Los diseños virtuales se desarrollaron empleando un software de diseño asistido por computadora. Resultados: Se desarrollaron varias soluciones que incluyen varios prototipos: biomodelos para reparación de craneosinostosis y figuras anatómicas, molde de prótesis craneal personalizada, prótesis de mano, divisores de líneas de O2, andamios tisulares, pistola portajeringas, protectores faciales, prótesis de mama, molde para restauración autóloga y expansor tisular. Conclusiones: En todas las áreas de aplicación de esta tecnología en medicina―salvo en la impresión de medicamentos, en el contexto actual―, es factible obtener soluciones en el territorio de Matanzas. Es un imperativo, pues, que directivos y la comunidad médica en general, comiencen a adquirir conciencia, conocimientos y experiencias para garantizar la utilización óptima de esta tecnología.

Radiologia odontológica: percepção e segurança de dentistas de centros de especialidades odontológicas e serviços de apoio diagnóstico públicos / Dental radiology: perception and safety of dentists from dental specialty centers and public diagnostic support services

Objetivo: Avaliar a percepção e segurança dos cirurgiões-dentistas servidores municipais de Porto Alegre - RS que realizam radiografias intrabucais em relação à conteúdos da radiologia odontológica. Materiais e métodos: Todos os 26 dentistas que atuam no Centro de Especialidades Odontológicas e Serviço de Apoio Terapêutico da Secretaria Municipal de Saúde foram convidados a participar de 15 horas do Projeto de Extensão em Radiologia Odontológica da Faculdade de Odontologia da Universidade Federal do Rio Grande do Sul, onde alunos de graduação atendem pacientes encaminhados pelas unidades básicas de saúde. Foi aplicado um questionário online de 19 questões relacionado a sua segurança e rotina na Radiologia. Os dados coletados foram submetidos à análise descritiva. Dez profissionais participaram do projeto, e oito responderam ao questionário (n=8). Resultados: Realização de técnicas e processamentos radiográficos, a maioria dos participantes mostrou-se segura, assim como os aspectos de radioproteção. Relataram maior dificuldade em realizar exames radiográficos em criança, molares e caninos superiores, além de preferirem, o método manual visual de processamento radiográfico. Foi identificada menor compreensão sobre biossegurança e efeitos biológicos determinísticos. Discussão: Conhecer esses servidores, suas rotinas e vivências com a radiologia, permitiu aprimorar o atendimento aos pacientes e a integração da Faculdade ao programa de educação permanente. Observa-se que princípios teóricos, não estão sedimentados o que pode interferir tanto na sua saúde como na do paciente. Conclusão: Os profissionais estudados sentem-se seguros em relação à prática e compreendem suas lacunas de conhecimento sobre efeitos biológicos e biossegurança na área da Radiologia.

Aim: To evaluate the perception and confidence of dental surgeons working in Porto Alegre - RS who perform intraoral radiographs in relation to the contents of dental radiology. Materials and methods: All 26 dentists who work at the Center for Dental Specialties and Therapeutic Support Service of the Municipal Health Department were invited to participate in 15 hours of the Extension Project in Dental Radiology at the School of Dentistry at the Federal University of Rio Grande do Sul, where students Undergraduate courses assist patients referred by basic health units. An online questionnaire of 19 questions related to your safety and routine in Radiology was applied. The collected data were submitted to descriptive analysis. Ten professionals participated in the project, and eight answered the questionnaire (n=8). Results: Performing radiographic techniques and processing, most participants proved to be safe, as well as radioprotection aspects. They reported greater difficulty in performing radiographic examinations in children, molars and upper canines, in addition to preferring the visual manual method of radiographic processing. Less understanding of biosafety and deterministic biological effects was identified. Discussion: Getting to know these public servants, their routines and experiences with radiology, made it possible to improve patient care and integrate the Faculty into the permanent education program. It is observed that theoretical principles are not settled, which can interfere with both your health and that of the patient. Conclusion: The professionals studied feel safe and understand their knowledge gaps such as biological effects and biosafety in the field of Radiology.

Inter-observer agreement on levels of evidence in radiology articles.

Levels of evidence (LE) are established through a hierarchical classification of studies according to their design. At present, there are many heterogeneous LE classifications, and this hampers their applicability. Our study aims to identify which LE classification has the best interobserver concordance for radiology articles. For this purpose, an interobserver agreement analysis were performed on 105 original articles applying two NE scales (Oxford Center of Evidence Based Medicine (OCEBM) y National Health and Medical Research Council (NHMRC)). The inter-rater agreement of the LE assigned after reading the abstracts was good when using the OCEBM scale (K = 0.679), and somewhat lower with the NHMRC (K = 0.577 -moderate-). All differences were statistically significant (P < .000). So, in conclusion, of the two scales analysed (OCEBM and NHMRC), the OCEBM led to the strongest level of inter-rater agreement.

The current situation of Radiology training in medical studies in Spain.

Radiology is now an essential part of Clinical Medicine, but undergraduate training does not reflect its importance in medical practice. In the current course, there are 46 medical schools in our country. According to the information published on the institutional websites, the study plans are very different in terms of the presence of Diagnostic Radiology and the organization of teaching. The estimated number of teaching hours in diagnostic radiology (mean ±â€¯standard deviation) is 61.3 ±â€¯22.2 h (range from 26 h to 137 h). There is a great shortage of clinical university professors, and a generational change is essential. The current situation poses various challenges, including adapting to new teaching methods and technologies and promoting the presence of radiology in medical study plans, paying special attention to hospital practices, the Final Degree Project (FDP) and the Objective Structured Clinical Examination (OSCE).

“Displasia ósea florida: signos imagenológicos reportados en artículos odontológicos publicados entre el 2012 y 2021” / Florid bone dysplasia: imaging signs reported in dental articles published between 2012 and 2021

Introducción: Identificar los signos imagenológicos característicos de la displasia ósea florida reportados en artículos publicados en revistas odontológicas indexadas en la principal fuente de información de salud (Medline) entre el año 2012 al 2021. Materiales y métodos: Se llevó a cabo un estudio observacional, transversal y retrospectivo evaluando las principales revistas odontológicas encontradas en publicaciones entre los años 2012 al 2021 mediante la búsqueda electrónica en la base de datos de Medline vía PubMed, usando los términos (cemento-osseus displasia) AND (radiology), luego se procedió a depurar la muestra siguiendo los criterios de selección estipulados. Resultados: Se evaluó un total de 7 artículos que cumplieron con los criterios de selección en donde se recopiló la información de 363 casos de displasia ósea florida. Encontrándose en promedio esta lesión a los 51.88 años según la edad con predominio en el sexo femenino, en promedio 49.51 frente a 2.34 para el masculino. Según la ubicación de la lesión, los artículos muestran que es más frecuente en mandíbula con un promedio de 28 casos, seguido de ambos maxilares con 23.29 casos y muy raro en la maxila con 0.57 casos. Imagenológicamente los artículos describen lesiones radiolúcidas o hipodensas en promedio 2.29 casos, mixtas 36.57 casos y radiopacas o hiperdensas en promedio 20.29 casos. Conclusiones: De acuerdo a lo descrito en la literatura, la displasia ósea florida suele presentarse con mayor frecuencia en mujeres adultas, a partir de la quinta década de vida, disminuyendo su incidencia de la sexta década en adelante. Su localización más frecuente es en la mandíbula, en segundo lugar, en ambos maxilares y muy raramente solo en la maxila. Imagenológicamente se presentan con mayor incidencia con un patrón mixto. (AU)

Introduction: Identify the characteristic imaging signs of florid bone dysplasia reported in articles published in dental journals indexed in the main source of health information (Medline) between 2012 and 2021. Materials and methods: An observational, cross-sectional and retrospective study was carried out evaluating the main dental journals found in publications between the years 2012 and 2021 through the electronic search in the Medline database via PubMed. Using the terms (cemento-osseus dysplasia) AND (radiology), we then proceeded to refine the sample following the stipulated selection criteria. Results: A total of 7 articles that met the selection criteria were evaluated, where information from 363 cases of florid bone dysplasia was collected. Finding this lesion on average at 51.88 years according to age, with a predominance in the female sex, on average 49.51 compared to 2.34 for the male. Depending on the location of the lesion, the articles show that it is more frequent in the mandible with an average of 28 cases, followed by both maxillae with 23.29 cases and very rare in the maxilla with 0.57 cases. Imagingly, the articles describe radiolucent or hypodense lesions in an average of 2.29 cases, mixed 36.57 cases, and radiopaque or hyperdense lesions in an average of 20.29 cases. Conclusions: According to what has been described in the literature, florid bone dysplasia tends to occur more frequently in adult women, starting in the fifth decade of life, decreasing its incidence from the sixth decade onwards. Its most frequent location is in the mandible, secondly, in both jaws and very rarely only in the maxilla. Imaging, they present with a higher incidence with a mixed pattern. (AU)

Diagnóstico por imagen de las metástasis vertebrales / Imaging diagnosis of vertebral metastasis

La columna vertebral es la tercera ubicación más frecuente para la enfermedad metastásica, después del pulmón y el hígado. Por otra parte, los tumores óseos más recurrentes son las metástasis, siendo la columna su principal lugar de localización. En este trabajo se realiza una revisión de las diferentes técnicas de imagen disponibles, tanto radiológicas como de medicina nuclear, y de la apariencia morfológica de las metástasis de columna en cada una de ellas. La resonancia magnética (RM) es la mejor modalidad de imagen para la detección de metástasis en la columna. Es importante efectuar el diagnóstico diferencial entre fractura vertebral de causa osteoporótica y patológica. La compresión medular es una complicación grave de la enfermedad metastásica y su valoración mediante imagen a través de escalas objetivas es determinante para la estimación de la estabilidad de la columna y, por consiguiente, para establecer el tratamiento. Por último, se comentan brevemente las técnicas de intervencionismo percutáneo.(AU)

The spine is the third most frequent location for metastatic disease, after the lung and liver. On the other hand, the most frequent bone tumors are metastases and the spine is the main location. A review of the different imaging techniques available, both radiological and nuclear medicine, and the morphological appearance of spinal metastases in each of them is performed. Magnetic resonance imaging is the best imaging modality for detection of spinal metastases. It is important to make the differential diagnosis between vertebral fracture of osteoporotic and pathological cause. Spinal cord compression is a serious complication of metastatic disease and its assessment by imaging through objective scales is decisive for estimating spinal stability and therefore establishing treatment. Lastly, percutaneous intervention techniques are briefly discussed.(AU)

[Translated article] Imaging diagnosis of vertebral metastasis / Diagnóstico por imagen de las metástasis vertebrales

La columna vertebral es la tercera ubicación más frecuente para la enfermedad metastásica, después del pulmón y el hígado. Por otra parte, los tumores óseos más recurrentes son las metástasis, siendo la columna su principal lugar de localización. En este trabajo se realiza una revisión de las diferentes técnicas de imagen disponibles, tanto radiológicas como de medicina nuclear, y de la apariencia morfológica de las metástasis de columna en cada una de ellas. La resonancia magnética (RM) es la mejor modalidad de imagen para la detección de metástasis en la columna. Es importante efectuar el diagnóstico diferencial entre fractura vertebral de causa osteoporótica y patológica. La compresión medular es una complicación grave de la enfermedad metastásica y su valoración mediante imagen a través de escalas objetivas es determinante para la estimación de la estabilidad de la columna y, por consiguiente, para establecer el tratamiento. Por último, se comentan brevemente las técnicas de intervencionismo percutáneo.(AU)

The spine is the third most frequent location for metastatic disease, after the lung and liver. On the other hand, the most frequent bone tumors are metastases and the spine is the main location. A review of the different imaging techniques available, both radiological and nuclear medicine, and the morphological appearance of spinal metastases in each of them is performed. Magnetic resonance imaging is the best imaging modality for detection of spinal metastases. It is important to make the differential diagnosis between vertebral fracture of osteoporotic and pathological cause. Spinal cord compression is a serious complication of metastatic disease and its assessment by imaging through objective scales is decisive for estimating spinal stability and therefore establishing treatment. Lastly, percutaneous intervention techniques are briefly discussed.(AU)