Da prescrição radiográfica: uma análise em medicina bucal

A redução da dose de radiação ao paciente é aceita em Radiologia Odontológica, com a finalidade de diminuir os riscos associados ao exame radiográfico. Para atingir este objetivo, além do avanço tecnológico ocorrido nas últimas décadas, devemos considerar a importância do Critério de Seleção para o paciente e da prescrição radiográfica na indicação correta do tipo de radiografia necessária para cada um deles. O objetivo deste trabalho foi avaliar a prescrição radiográfica de pacientes atendidos pelo Serviço de Medicina Bucal da Faculdade de Odontologia de Araraquara - UNESP durante o período de 1989 a 1993. Selecionamos 396 prontuários que constituiu a totalidade dos que continham exames radiográficos. Para a análise da prescrição radiográfica, consideramos as informações obtidas da ficha clínica e da interpretação das radiografias, utilizando os Critérios de Seleção e a análise de decisão clínica. Os resultados demonstraram um alto índice de pacientes com prescrição incorreta (44,0%); tendo em 24,7% dos pacientes ocorrido mais de uma radiografia prescrita incorretamente. Com relação ao tipo de técnica com prescrição incorreta, em 31,6% dos pacientes foi realizada a radiografia panorâmica, vindo a seguir a oclusal (28,7%), outro (17,2%) e a associação da panorâmica e oclusal (12,6%). Pacientes portadores de doenças e alterações de tecido mole tiveram a mais alta freqüência de prescrições incorretas, seguidos pelos portadores de doenças das glândulas salivares (13,5%) (incluindo os tumores); outros (10,1%); distúrbios da A.T.M. (9,0%); inflamação e infecção dos maxilares (6,8%); tumores benignos (5,6%) e tumores malignos (5,6%). Em 62,9% dos pacientes, o exame radiográfico contribuiu para o diagnóstico e tratamento. A alta porcentagem de prescrição incorreta encontrada evidencia a necessidade de... (Resumo completo, clicar acesso eletrônico abaixo).

Avaliação da instabilidade atlanto-axial em indivíduos com síndrome de Down por meio de radiografias da coluna cervical

O objetivo nesta pesquisa consiste em fazer um trabalho de prevenção junto às instituições APAE (Associação de Pais e Amigos de Excepcionais) e ASIN (Associação de síndrome de Down), ambas de São José dos Campos e ASPAD (Associação de Pais e Amigos de síndrome de Down) de Jacareí, orientando e avaliando sobre a presença ou não da instabilidade atlanto-axial (IAA), assim como verificar a prevalência dessa anormalidade nesses indivíduos. Foram convidados a participar do projeto todos os indivíduos das três instituições de assistência à SD, tendo formado uma amostra com 68 indivíduos, com idades entre 2 a 34 anos, sendo 39 do sexo masculino e 29 do feminino. Foram realizadas radiografias da coluna cervical nas posições de extensão, flexão e neutra, para as quais todos os responsáveis assinaram termo de consentimento. A verificação da IAA foi feita pela análise da distância atlanto-odontóide (DAO), utilizando o programa Radiocef, com uma ferramenta criada para isso. A DAO foi analisada nas três incidências, e era considerada a presença de IAA desde que o indivíduo apresentasse valores ?4,5mm em pelo menos uma dessas posições. Após a realização dos testes estatísticos e análise dos resultados, concluímos que a prevalência de IAA foi de 22,1% dos indivíduos, com valores DAO entre 4,5 e 8,83mm, tendo sido mais prevalente nos indivíduos do sexo masculino do que feminino, assim como nas crianças do que nos jovens e adultos. Foi possível verificar também que, a posição de flexão apresentou maior prevalência de IAA, mas que ela não deve sobrepor às posições de extensão e neutra, pois pode omitir casos ausentes em flexão, mas presentes nas outras posições. Dessa forma, foi realizado o trabalho de prevenção com a avaliação da IAA por meio da realização dos exames radiográficos em que os laudos... (Resumo completo, clicar acesso eletrônico abaixo)

Achados radiográficos e ultrassonográficos em equinos com doença do navicular

The distal sesamoid bone, also known as navicular bone, is located inside the hoof, palmar (thoracic limbs) or plantar (pelvic limbs) to distal interphalangeal joint. Its extremities are fixed by collateral medial and lateral sesamoidean ligament and distal impar sesamoidean ligament. Navicular disease diagnostic is made through a thorough clinical exam, nerve blocks and imaging exams. Even though imaging exams are not conclusive, they are essential to evaluate the extension of soft tissue lesions. Radiographic projections used to evaluate navicular bone are lateromedial (LM); dorsoproximal-palmaro/plantarodistal oblíqua (D30Pr-PaDiO); dorsoproximal-palmaro/plantarodistal oblíqua (D60Pr-PaDiO) e a palmaro/plantaroproximal-palmaro/plantarodistal oblíqua (PaPr-PaDiO). This exam allows to identify number and shape alterations of synovial invaginations on the distal (foramem nutricio) in the distal margin of distal sesamoid, osteophytes, enthesophytes and periarticular lesions. There are four ultrasonographic accesses described in literature to evaluate podotroclear apparatus, they are: palmar or plantar distal do the pastern, through the heel bulbs, through coronary band and transcuneal. These images allow a beeter the evaluation of soft tissue next to the distal sesamoid, because it is more sensitive than radiographic exam to evaluate acute lesions in soft tissues and perioesteum

Desenvolvimento de algoritmos para a avaliação quantitativa de imagens de fantomas mamográficos

There are many advantages when using a phantom for the evaluation of the mammographic images, one of them is to test the visibility of the distribution of objects that constitute it, and then, set the best image in order to obtain a diagnostic medical insurance, trying to reach the best risk - benefit ratio for the patient. Typically, the quality of the mammographic image is performed by subjective and quantitative assessments. This study developed algorithms that can quantitatively evaluate digital images (DICOM), obtained from mammographic phantom consisting of test objects. The results were adjusted by the response of the subjective evaluation performed by experts in radiology. This procedure aims to create an independence of the experts in radiology in daily tests of quality control in routine clinical diagnostic radiology

Controle de qualidade em equipamentos mamográficos

Nowadays the mammography is the most effective way of revealing early breast cancer. The image in this kind of exam is gotten trough a x-ray sheaf of low energy, however, the suitable visualization of the interesting structures by the radiologist is not always possible due several factors that appears since the mamma composition until the equipments limitation. The regulation 453/98 sets quality control tests and limits of acceptation that guarantee a good development of the mammographys. The purpose of this study is the 3D principle ( Diagnostic, Dose and Dollar), that means, an improved diagnosis, a dose reduction in the patient and a cost decrease for the Institution. In this study was made the quality control tests set by the Regulation in two mammography equipments from Hospital das Clínicas da Faculdade de Medicina de Botucatu (HCFMB - UNESP). The results reached in this research were used in the renovation process of quality stamp in mammography granted by Colégio Brasileiro de Radiologia (CBR) to the diagnosis by image from the HCFMB – UNESP

Doença do trato inferior (DITUI) em felinos doméstico

Lower urinary tract disease (LUTD) is a multifactorial disease, wich may be caused by uroliths and calculations, bacterial and viral infections and anatomical abnormalities, among others. The disease can also be of unknown origin in wich case it is called intersticial cystitis. Knowing that the disease may have many causes, it is necessary to know the exact etiology and the best method of diagnosis, to establish specific therapeutic measures for each case. The diagnostic methods most commonly used are: urinalysis, radiography and ultrassonography, but the blood count and biochemistry can be used, trying to assess the overall status of the animal. The terapy used depends on the causative agent of disease, wich may include changes in supply until emergency treatment, azotemia in cats with post-renal. The present study aims to present a complete study of a disease, addressing it’s etiology, diagnosis and treatment, with particular attention to first item

Subluxação atlantoaxial canina

The atlantoaxial subluxation or luxation is an instability of this articulation that produces excessive flexion of this joint causing the cranial aspect of the axis to rotate dorsally into the vertebral channel with subsequent spinal cord compression. This disorder is most commonly found in young small breed dogs. The diagnosis of this disease is done by survey radiographs, where there is a larger distance between the atlas dorsal arch and the axis spinal process characterize the atlantoaxial subluxation. Surgical stabilization is the treatment of choice and multiple implants show the best results to stabilize the atlantoaxial joint. The main complications are sudden death or implant failure. The sudden death happens because of cardiorespiratory arrest and it is most likely caused by brainstem iatrogenic trauma. However, a larger study comparing different surgical stabilization techniques should be performed to evaluate relative success rates in dogs that have the same initial neurologic status

Estudo de parâmetros radiométricos e legislação sobre radioproteção em equipamentos de radiodiagnóstico

O uso de radiações ionizantes (R.I.), nas mais variadas atividades tem aumentado nas últimas décadas. Com o avanço tecnológico, novos e sofisticados equipamentos emissores de R.I. tem surgido no cenário nacional, o que torna imperativo a difusão do conhecimento sobre os conceitos de proteção radiológica junto à comunidade em geral, e neste sentido, o curso de física médica desenvolve um importante papel, quer seja no aspecto informativo quanto formativo de cidadãos e profissionais críticos e politicamente corretos, que possam contribuir com as Políticas Públicos dos órgãos normatizadores e fiscalizadores das atividades de vigilância sanitária. Conforme a legislação atual (Resolução SS-625 de 14/12/1994, da Secretaria de Estado da Saúde, e Portaria 453 de 01/06/1998 da Vigilância Sanitária do Ministério da Saúde), todos os serviços que utilizam radiações ionizantes devem realizar testes de avaliação dos parâmetros radiométricos dos equipamentos emissores de R.I., sendo exigidos as medidas de Levantamento Radiométrico das instalações, o Teste de Radiação de Fuga do cabeçote emissor e a implementação de Programa de Garantia de Qualidade dos equipamentos e dos procedimentos radiológicos. Este procedimento tem como objetivo principal a obtenção de imagens radiográficas com qualidade e a segurança de pacientes e profissionais, evitando a exposição desnecessária à radiação de pacientes e profissionais. A correta realização de procedimentos radiológicos além de reduzir a dose nos pacientes também promove significativa diminuição nos custos, por não haver necessidade da repetição dos exames. No Brasil, conforme dados da Secretaria de Atenção à Saúde SAS/MS, atualmente existem instalados 4.469 mamógrafos, 25.930 aparelhos de raios-x médicos, 39.438 aparelhos de raios-x odontológicos e...(Resumo completo, clicar acesso eletrônico abaixo)

Mensuração das dimensões cardíacas pelo método VHS (Vertebral Heart Size) em cães

It is imortant to be able to evaluate the cardiact size . In 1995, was proposed by Buchanan and Bücheler a new way to measure the dimensions of the cardiac silhouette. This study aims to gather several studies of the cardiac dimensions by VHS method in the right lateral recumbency of of different breeds of dogs in a single work, facilitating the assess to information. Deep chest breeds have a smaller mean VHS value than the barrel chest breeds, showing that there is a variation of the VHS values acoording to the thoracic conformation of each breed, which indicates that there is a need to recognize the specific VHS values according to the breed standard to not to interpret the cardiac measurement in a wrong way through not compatible reference values for the animal. There is the individual variation that should be taken into accont at the time of measurement. The VHS is a helper method to a radiographic evaluation of the heart, and the ultrasonography remains the gold standard for the evaluation of the cardiac chambers and other changes of the heart

Necrose Asséptica da cabeça do fêmur

Legg-Calvé-Perthes disease is a non-inflammatory aseptic necrosis of the head of the femur that is found in both young animals and humans before the gap in the femur head closes. In the fields of both human and veterinary medicine the cause of this condition is not known for certain. Various factors have been put forward in the literature as being responsible for the incidence of this condition such as: abnormalities in coagulation, changes in blood flow in the arteries, a septic obstruction in the draining of the epiphysis or the upper parts of the femur, trauma, growth cycle, hyperactivity in a child, genetic influences and dietary factors. Case histories in dogs show that the first stages of the condition progress slowly but that limping or putting weight on the limb worsens at 6 to 8 weeks. Some owners talk about a sharp onset in clinical lameness. Other clinical symptoms may include irritability, loss of appetite and knawing at the hair surrounding the affected hip. In the course of physical examination manipulating the hip joint will cause pain to the animal. The advanced stages of the disease may result in restricted amplitude of movement, muscular atrophy and fracturing. In humans the clinical signs are similar, although progression of the disease is slower so that it can be diagnosed at an earlier stage. In veterinary medicine the diagnosis is, in the main, based on case history, clinical symptoms, physical examination and certain related procedures such as radiography. The various diagnoses include physical trauma and dislocation of the medial patella. In human medicine many people have been correctly diagnosed. Whatsmore, there is a range of related procedures that are virtually not available to veterinary medicine such as magnetic nuclear resonance, that show up necroses with great clarity before radiography and cintilography do, and is considered... (Complete abstract click electronic access below)

Comparação entre metodologias de controle de qualidade em mamografia digital

The best way to detect breast cancer is by screening mammography. The mammography equipments are dedicated and require a rigorous quality control in order to have a good quality image and to early detect this disease. The digital equipment is relatively new in the market and there isn’t a national rule for quality control for several types of digital detectors. This study has proposed to compare two different tests manuals for quality control provided by the manufacturers of digital mammography equipments, and also compare them to the “European guidelines for quality assurance in breast cancer screening and diagnosis “(2006). The studied equipments were: Senographe 2000D from General Electric (GE) and the Hologic Selenia Lorad. Both were digital mammography equipments, the GE unit presents an indirect digital system and the other presents a direct digital system. Physical parameters of the image have been studied, such as spatial resolution, contrast resolution, noise, signal-tonoise ratio, contrast-to-noise ratio and modulation transfer function. After that, a study of the importance of quality control and the requirement to implement a Quality Assurance Program has been done. One data collection was done to compare those manual, it was done by checking which tests are indicated and the minimum frequency which they should be conducted in accordance with each manufacturer. The tests were performed by different methodologies and the results were compared. The examined tests were: the breast entrance skin dose, mean glandular dose, contrast-to-noise ratio, signal-to-noise ratio, automatic exposure control and automatic control of density, modulation transfer function, equipment resolution, homogeneity and ghost

Síntese e caracterização de ferritas de manganês e zinco visando aplicação como agente de contraste em diagnóstico médico

This work aims to synthesize the manganese and zinc ferrite, by the polymeric precursor method, in order to obtain materials with appropriate characteristics for the application in medical diagnosis techniques. The manganese and zinc ferrite powders with the composition of Mn(1-x)ZnxFe2O4, where x=0,23, were prepared and calcined in air at different times and temperatures. The X-ray diffraction (XRD) data show that the sample calcined at 400°C crystallize as ferrite (monophase), but in an inverted spinel structure (high content of iron occupying manganese tetrahedral site and manganese occupying the iron octahedral site). The samples calcined at temperatures between 600°C and 900°C shows the secondary phase of hematite and the sample calcined at 1100oC shows to be monophase in ferrite with normal spinel structure. The monophase powders of ferrite showed a reduction in the surface area and an increasing in the pore size for higher calcination temperatures. The magnetic analysis show that the sample calcined at 400°C presents satisfactory magnetization at room temperature, however, it behaves as diamagnetic material at low temperatures (10K). The powder containing hematite, without the partial substitution of iron ions by manganese, showed to have low transition temperature, and consequently low magnetization at room temperature. The hematite, when partially substituted, provides materials with irregular magnetization at the saturation region. The powder calcined at 1100°C shows high magnetization either at room temperature or low temperature (10K)

Tomografia por Biosusceptometria de Corrente Alternada (tBAC): desenvolvimento, caracterização, implementação

The Biosusceptometry AC (BAC) is a research tool that has been extensively explored by the group Biomagnetism IBB-UNESP for monitoring of the gastrointestinal tract, its response to a known drug or in vivo performance of solid dosage forms. During this period the BAC, which has the characteristics of high sensitivity and low cost, has been developed primarily for recording signals contraction of activity and traffic human gastrointestinal tract. With the possibility of producing images with this instrumentation, it was possible to evaluate different situations in vitro and in vivo for physiological studies and pharmaceuticals. Considering the good performance of this system to produce planar images, the first aim of the BAC system tomography (TBAC) was to evaluate the system performance of BAC to produce tomographic images of phantoms ferromagnetic for a single channel system. All these applications were only possible because of their sensitivity to materials of high magnetic suscepitibility as ferrite, which allow to produce an electrical signal proportional to the variation of the magnetic flux generated by the presence of magnetic marker next to a first-order gradiometer. Measuring this variation at various points was possible to generate planar images that recently came to be produced in systems with multiple detectors, said multi-channels. From planar images, also producing tomographic images of simulators BAC bars in a system of 13 channels using only the center channel, with good results when applied to simple objects as one and two bars. When testing the resolution of the system with more elaborate forms the quality and resolution of images reconstructed is not satisfactory, which would be solved by increasing the spatial sampling rate and hence the acquisition time. The present system works with an acquisition time of about five hours. Whereas this system will be applied for in vivo experiments, the acquisition time became a ...

Otimização de procedimentos de controle de qualidade em equipamentos radiográficos convencionais do Instituto de Eletrotécnica e Energia - USP

Radiography is currently an important method of diagnosis, both medical, dental and veterinary. The image in this type of survey is obtained using an X-ray beam, where the radiologist can possibly view structures of interest. It isn't always possible to get the desired images due to various factors, such as equipment limitations. The Administrative Law 453/98, the State Resolution SS 625/94, and other standards require testing and quality control acceptance limits that guarantee a good performance of the equipment for the security and quality of care, giving service users greater effectiveness in exams. This study were performed in the accompaniment of testing procedures for quality control established by Administrative Law 453/98 in several X-ray equipment to make a comparison and optimization in the descriptions of the procedures used by the Institute for Electrical Energy and the University of São Paulo (IEE / USP / SP).The optimization of the procedures were performed with the aid of a current literature, the Resolution 453/98, State Resolution SS 625/94 and other international standards. On this basis it was possible to observe the importance of regular monitoring of tests for an update, following the technological development of instruments used in the service

Análise da densidade óssea de rádio-ulna de cães SRD utilizando o método de imersão

Imaging diagnosis is a medical specialty that uses imaging techniques to perform diagnosis. In diagnostic imaging various methods are used such as direct absorption of photons - SPA and DPA, radiographic photometry, the dual-energy radiographic absorptiometry - DEXA, ultrasound, magnetic resonance imaging, computed tomography and optical densitometry in radiographic image. The dog can be considered one of the most widely used animals in the study of bone diseases and searching for a reliable diagnosis, although not an ideal model for the study of osteoporosis, because these animals tend not to develop a decrease in bone mineral density. The objective of this study was to analyze bone density in mongrel dogs from the determination of the variation of density along the radio-ulna bone and also the mean value related to gender, weight and age of individuals. The density analysis carried out showed that for this data set, there is a significant difference in the case of gender and age of the animal and may generalize according to these variables. The only significant difference was found in the weight, which increases bone mass is related to weight gain through the growth of the animal