Discrepancies between clinical diagnoses and autopsy findings

Autopsy examination is considered to be an essential element for medical auditing and teaching. Despite the significant progress in diagnostic procedures, autopsy has not always confirmed the clinical diagnosis. In the present study, we compared the diagnosis recorded on medical charts with reports of 96 autopsies performed at the University Teaching Hospital of the Faculdade de Medicina de Botucatu, Botucatu, SP, Brazil, between 1975 and 1982, and of 156 autopsies performed at the same institution between 1992 and 1996. The clinical diagnosis of the basic cause of death was confirmed at autopsy in 77% of cases. The percent confirmation fell to 60% when the immediate terminal cause of death was considered, and in 25% of cases, the terminal cause was only diagnosed at autopsy. The discrepancies between clinical and autopsy diagnosis were even larger for secondary diagnoses: 50% of them were not suspected upon clinical diagnosis. Among them, we emphasize the diagnosis of venous thromboses (83%), pulmonary embolisms (80%), bronchopneumonias (46%) and neoplasias (38%). Iatrogenic injuries were very frequent, and approximately 90% of them were not described in clinical reports. Our results suggest that highly sensitive and specific diagnostic tests are necessary but cannot substitute the clinical practice for the elaboration of correct diagnoses.

Marginal and Internal Discrepancies Related to Margin Design of Ceramic Crowns Fabricated by a CAD/CAM System

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Potentially malignant epithelial oral lesions: Discrepancies between clinical and histological diagnosis

OBJECTIVE: To evaluate the discrepancy index between the clinical and histological diagnosis and the prevalence of epithelial dysplasia and carcinoma in 45 patients with potentially malignant epithelial oral lesions (PMEL). PATIENTS AND METHODS: We submitted 45 patients with PMEL to clinical examination and obtained a biopsy from each. The results of histological diagnosis were compared to the clinical diagnosis. RESULTS: Clinical diagnosis showed that the most common PMEL was leukoplakia followed by lichen planus and by actinic cheilitis associated with leukoplakia. The most common site was the buccal mucosa. Histological diagnosis revealed that 46.7% of the PMEL were lichen planus. The discrepancy index between clinical and histological diagnosis was 24.4%. The higher discrepancy index occurred among leukoplakias. The prevalence of epithelial dysplasia and carcinoma was 17.8%. CONCLUSIONS: We conclude that all PMEL should be submitted to a microscopic analysis because the discrepancy between clinical and histological diagnosis was present in a quarter of these lesions. Otherwise, the epithelial dysplasia and carcinoma were more frequent in the leukoplakias.

Discrepancies between abstracts presented at international association for dental research annual sessions from 2004 to 2005 and full-text publication

Purpose. The purpose of this study was to evaluate the discrepancies between abstracts presented at the IADR meeting (2004-2005) and their full-text publication. Material and Methods. Abstracts from the Prosthodontic Section of IADR meeting were obtained. The following information was collected: abstract title, number of authors, study design, statistical analysis, outcome, and funding source. PubMed was used to identify the full-text publication of the abstracts. The discrepancies between the abstract and the full-text publication were examined, categorized as major and minor discrepancies, and quantified. The data were collected and analyzed using descriptive analysis. Frequency and percentage of major and minor discrepancies were calculated. Results. A total of 109 (95.6%) articles showed changes from their abstracts. Seventy-four (65.0%) and 105 (92.0%) publications had at least one major and one minor discrepancies, respectively. Minor discrepancies were more prevalent (92.0%) than major discrepancies (65.0%). The most common minor discrepancy was observed in the title (80.7%), and most common major discrepancies were seen in results (48.2%). Conclusion. Minor discrepancies were more prevalent than major discrepancies. The data presented in this study may be useful to establish a more comprehensive structured abstract requirement for future meetings. © 2012 Soni Prasad et al.

Comparação da precisão dos resultados do teste de tetrazolio usando a metodologia alternativa e a tradicional em sementes de soja

The use of tetrazolium testing is recognized in the soybean seed quality control due to the large amount of data which it provides. Although it is considered a quick test, in 1998 an alternative methodology was proposed for the seed preconditioning, which allows 10 hours of time saving in seeds preparation. The objective of this research is to compare the accuracy of the new and the traditional tetrazolium testing. Three soybean seed genotypes were used, Conquista, Garantia and M-soy 8400, all 2000/2001 crop. The seeds were evaluated in relation to germination, evaluated with the traditional (TZt) and the alternative (Tza) tetrazolium test as well as with the accelerated aging performed in two different conditions (45 degrees C 24h(-1) and 45 degrees C 72h(-1)). After aging, the seeds too were submitted to TZt and Tza testing. The experimental design was a randomized blocks, with four replicates the 50 seeds per genotype in every evaluation, with exception only for tetrazolium test, with two replicates. The averages were compared in the Tukey test level of 5% probability. The comparison between the two methodologies in relation to level of vigor (class 1 to 3) and germination potential (class 1 to 5) indicated no statistical discrepancies, for aged non-aged seeds. This, the use of the alternative tetrazolium test is recommend in case a reduced seed preparation time is needed.

Application of ionospheric corrections in the equatorial region for L1 GPS users

In the absence of the selective availability, which was turned off on May 1, 2000, the ionosphere can be the largest source of error in GPS positioning and navigation. Its effects on GPS observable cause a code delays and phase advances. The magnitude of this error is affected by the local time of the day, season, solar cycle, geographical location of the receiver and Earth's magnetic field. As it is well known, the ionosphere is the main drawback for high accuracy positioning, when using single frequency receivers, either for point positioning or relative positioning of medium and long baselines. The ionosphere effects were investigated in the determination of point positioning and relative positioning using single frequency data. A model represented by a Fourier series type was implemented and the parameters were estimated from data collected at the active stations of RBMC (Brazilian Network for Continuous Monitoring of GPS satellites). The data input were the pseudorange observables filtered by the carrier phase. Quality control was implemented in order to analyse the adjustment and to validate the significance of the estimated parameters. Experiments were carried out in the equatorial region, using data collected from dual frequency receivers. In order to validate the model, the estimated values were compared with ground truth. For point and relative positioning of baselines of approximately 100 km, the values of the discrepancies indicated an error reduction better than 80% and 50% respectively, compared to the processing without the ionospheric model. These results give an indication that more research has to be done in order to provide support to the L1 GPS users in the Equatorial region.

Período de mínima atividade solar: melhora no desempenho do posicionamento relativo

In the relative positioning, even considering that part of the errors due to ionosphere is canceled with the double-difference observations, strong ionospheric effects can occur in maximum solar activity period. However, in minimum solar activity period, the ionospheric effects decrease significantly and therefore an improvement of the relative positioning performance takes place. In this paper we aim at showing that improvement for the scientific and GPS community users. So, have been experiments by using GPS data of two stations of the Brazilian Network for Continuous Monitoring of GPS, forming a baseline of 430 km. The processing were use accomplished with interval of two hours, and only L1 carrier data have been used. The analysis of the obtained results has been carried out from the discrepancies between the "true" coordinates and corresponding ones obtained in the processing. In maximum solar activity period the discrepancy value reached 25 m. on the other hand, in minimum solar activity period, the discrepancy value reached 5,5 m. It is important to emphasize that the majority of the discrepancy values didn't exceed 0,50 m, and in some cases only reached 0,10 m. This shows the increase of application possibilities of the relative positioning using single-frequency GPS receivers in minimum solar activity period.

Comparison of different analysis techniques for the determination of muscle onset in individuals with patellofemoral pain syndrome

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Análise crítica do processo de auditoria de sistema de gestão da qualidade no setor aeroespacial

A auditoria de sistema de gestão da qualidade é utilizada pelas organizações para melhorar o seu desempenho por meio de avaliações sistemáticas dos processos. Ao mesmo tempo, a atividade de auditoria vem sendo questionada quanto à sua capacidade de promover essa melhoria. Diante deste cenário, este artigo objetiva analisar fatores que afetam o processo de auditoria de certificação do sistema de gestão da qualidade, de modo a indicar oportunidades de melhoria das auditorias. A pesquisa é delimitada a auditorias no setor aeroespacial, que são orientadas pela NBR 15100. Foi realizada uma survey com auditores experientes nos anos de 2009 e 2010. São identificados fatores como comunicação, seleção da equipe, conhecimento do setor e os resultados mostram a existência de discrepâncias consideráveis entre o nível de importância e de aplicação desses fatores nas organizações auditadas.

Diferenças entre as deduções nas duas edições da crítica da razão pura

Comparação entre as duas versões da dedução kantiana dos conceitos puros do entendimento, a da 1ª edição de 1781 e a de 1787. Focam-se aqui principalmente as discrepâncias referentes à dedução objetiva, isto é, aquela encarregada de demonstrar que as categorias são as condições de possibilidade dos objetos de experiência

A complete dosimetric characterization of two Sr-90-Y-90 dermatologic applicators

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Comparative evaluation of the efficacy of occlusal splints fabricated in centric relation or maximum intercuspation in temporomandibular disorders patients

Fabrication of occlusal splints in centric relation for temporomandibular disorders (TMD) patients is arguable, since this position has been defined for asymptomatic stomatognathic system. Thus, maximum intercuspation might be employed in patients with occlusal stability, eliminating the need for interocclusal records. This study compared occlusal splints fabricated in centric relation and maximum intercuspation in muscle pain reduction of TMD patients. Twenty patients with TMD of myogenous origin and bruxism were divided into 2 groups treated with splints in maximum intercuspation (I) or centric relation (II). Clinical, electrognathographic and electromyographic examinations were performed before and 3 months after therapy. Data were analyzed by the Student's t test. Differences at 5% level of probability were considered statistically significant. There was a remarkable reduction in pain symptomatology, without statistically significant differences (p>0.05) between the groups. There was mandibular repositioning during therapy, as demonstrated by the change in occlusal contacts on the splints. Electrognathographic examination demonstrated a significant increase in maximum left lateral movement for group I and right lateral movement for group II (p<0.05). There were no significant differences (p>0.05) in the electromyographic activities at rest after utilization of both splints. In conclusion, both occlusal splints were effective for pain control and presented similar action. The results suggest that maximum intercuspation may be used for fabrication of occlusal splints in patients with occlusal stability without large discrepancies between centric relation and maximum intercuspation. Moreover, this technique is simpler and less expensive.

A discrepância de tamanho dentário, de Bolton, na oclusão normal e nos diferentes tipos de más oclusões, bem como sua relação com a forma de arco e o posicionamento dentário

Esta pesquisa teve como objetivo geral avaliar a discrepância de tamanho dentário, na oclusão normal e nos diferentes tipos de más oclusões e a sua relação com as medidas que determinam a forma de arco e o posicionamento dentário na região anterior. Para tanto, foram estudados 185 pares de modelos de gesso, divididos em 4 grupos: Grupo 1 (composto por 41 pares com Oclusão Normal, sendo 20 do gênero masculino e 21 do gênero feminino); Grupo 2 (composto por 44 pares com má oclusão de Classe I, divisão 1, sendo 22 do gênero masculino e 22 do gênero feminino); Grupo 3 (composto por 54 pares com má oclusão de Classe II, sendo 28 do gênero masculino e 26 do gênero feminino) e Grupo 4 (composto por 46 pares com Classe III, sendo 23 do gênero masculino e 23 do gênero feminino). Observou-se que não ocorreu dimorfismo sexual entre as discrepâncias de tamanho dentário e os diferentes tipos de oclusão dentária; as proporções estabelecidas por Bolton não se aplicaram ao grupo com Oclusão Normal; na Oclusão Normal, Classe I, Classe II e Classe III, houve um predomínio de excesso dentário total (RAZ12) no arco inferior; na Classe I houve uma igualdade na distribuição de excesso dentário anterior (RAZ6) nos arcos superior e inferior; na Oclusão Normal, Classe II e Classe III, ocorreu um predomínio de excesso dentário anterior (RAZ6) no arco inferior, em relação ao arco superior; os excessos dentários não contribuíram na ocorrência das más oclusões e as discrepâncias total e anterior (RAZ12 e RAZ6) não interferiram diretamente nas larguras e comprimentos dos arcos, bem como no posicionamento dos dentes anteriores.

Sistema de Apoio Ósseo para Mecânica Ortodôntica (SAO®): miniplacas para ancoragem ortodôntica. Parte I: tratamento da mordida aberta

Este trabalho descreve uma nova forma de ancoragem por meio de miniplacas denominada SAO®, Sistema de Apoio Ósseo para Mecânica Ortodôntica. Após a descrição do sistema, protocolos de tratamento para mordidas abertas esqueléticas são apresentados. A aplicação de cantiléveres e alças apoiadas diretamente nos tubos do sistema de ancoragem permite que associações de problemas verticais e sagitais (Classe II e III) sejam tratadas de formas distintas. A aplicação de forças leves e constantes e o controle tridimensional das forças aplicadas são o grande diferencial desse novo sistema.