Confiabilidade inter e intraexaminadores nas mensurações angulares por fotogrametria digital e goniometria

INTRODUÇÃO: A utilização da fotogrametria computadorizada em prol da goniometria, ou vice-versa, na prática clínica ainda necessita de fundamentações consistentes. OBJETIVOS: Os objetivos deste estudo foram: verificar a confiabilidade inter e intraexaminadores avaliadores na quantificação das medidas angulares obtidas a partir da fotogrametria computadorizada e a goniometria e determinar a confiabilidade paralela entre esses dois diferentes instrumentos de avaliação. MATERIAIS E MÉTODOS: 26 voluntários e 4 examinadores foram utilizados no estudo. A coleta foi realizada em 4 etapas sequenciais: demarcação dos pontos anatômicos de referência, mensuração e registro dos valores goniométricos, captação da imagem do voluntário com os marcadores fixados no corpo e avaliação do registro fotográfico no programa ImageJ. RESULTADOS: O goniômetro é um instrumento confiável na maioria das evidências, porém, a confiabilidade das medições depende principalmente da uniformização dos procedimentos. Considerações metodológicas relativas ao estabelecimento de confiabilidade e padronização da colocação dos marcadores se fazem necessárias, de modo a oferecer opções de avaliação ainda mais confiáveis para a prática clínica. CONCLUSÃO: Ambos os instrumentos são confiáveis e aceitáveis, porém, mais evidências ainda são necessárias para suportar a utilização desses instrumentos, pois poucos pesquisadores têm utilizado o mesmo desenho de estudo, e a comparação dos resultados entre eles muitas vezes são difíceis.

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.

Análise comparativa de métodos de avaliação da composição corporal em homens sadios e em pacientes com doença pulmonar obstrutiva crônica: antropometria, impedância bioelétrica e absortiometria de raios-X de dupla energia

The aim of this study was to examine the agreement between the results of body fat (BF and BF%), fat-free mass (FFM) and FFM index (FFMI= FFM/height2) as estimated by skinfold anthropometry (ANT), bioelectrical impedance (BIA) and dual-energy X-ray absorptiometry (DXA) in two groups of men (> or = 50 y), one comprising healthy individuals (n=23) and the other, patients with chronic obstructive pulmonary disease (COPD) (n=24). Comparisons between body composition techniques were done by repeated measures ANOVA; the Bland & Altman procedure was used to analyse agreement. RESULTS AND CONCLUSIONS: 1) comparison between healthy and COPD groups showed significant differences between all studied variables; 2) in the healthy group, values for BF, BF%, FFM and FFMI were not significantly different when BIA or ANT was compared to DXA; however, in COPD, values for BF and BF% were significantly higher and for FFM and FFMI significantly lower when BIA was compared to DXA; in contrast, no differences were shown between values for these variables when ANT was compared with DXA; 3) Bland & Altman test, in both groups, showed no agreement between BIA and DXA and between ANT and DXA; it was also shown that body fat was overestimated and fat free mass underestimated by BIA in relation to DXA.

Cross-cultural differences for three visual memory tasks in Brazilian children

Norms for three visual memory tasks, including Corsi's block tapping test and the BEM 144 complex figures and visual recognition, were developed for neuropsychological assessment in Brazilian children. The tasks were measured in 127 children ages 7 to 10 years from rural and urban areas of the States of São Paulo and Minas Gerais. Analysis indicated age-related but not sex-related differences. A cross-cultural effect was observed in relation to copying and recall of Complex pictures. Different performances between rural and urban children were noted. © Perceptual and Motor Skills 2005.

Estudo comparativo da pressão arterial sistêmica obtida por dois métodos distintos

As arterial hypertension can be diagnosed by different methods, among which are the traditional auscultatory instrument and the automated oscillometric monitor, the aim of this study was to compare the performance of these instruments, to evaluate the reliability of the digital oscillometer. The sample consisted of 40 patients under dental treatment, whose blood pressure measurements were recorded. The measurements of systolic and diastolic blood pressures were evaluated in terms of their intraclass correlation coefficients (r). For systolic blood pressure, an excellent level of agreement was found between the instruments, with r=0.93, and for diastolic blood pressure, there was a good level of agreement (r=0.75). It was concluded, from the excellent agreement for systolic blood pressure, that the oscillometric monitor can be recommended for the monitoring of the variations of that pressure in the same individual, while the good agreement obtained in the determination of the diastolic blood pressure indicates that the oscillometric method is reliable. However, new studies need to be carried out for a better understanding of the disagreements that can occur in the diastolic pressure results.

Reprodutibilidade de medidas antropométricas estáticas de graduandos de odontologia e de mochos odontológicos

Objective: To evaluate the intraexaminer reproducibility of static anthropometric measurements of undergraduate dental students as well as the characteristics and regulating measurements of the dental stools used by them. Methods: Forty volunteers and 6 types of dental stools were evaluated. For the anthropometric measurements the employed equipments were: an adapted office chair, aflexible measuring tape with two adapted rods, a metallic device with a 90 degree central angle, string, a 35 x 24 cm rectangular wooden board, isolating tape and crepe tape. In order to standardize the position of the adapted office chair and the volunteers' feet, the floor was marked with the isolating and crepe tapes. A string was attached to the waist of each volunteer to mark the area corresponding to the kidney region making it possible to measure the seat-renal region area. The examined anthropometric measurements were height, trunkcephalic heigh, sacral-popliteal distance (OK?), hip width, popliteal height and the seat-renal region height. The evaluated characteristics of the dental stools relative to the seat were depth, horizontal width and minimum/maximum height. The back of the dental stool was evaluated as for the minimum/ maximum height adjustment. The anthropometric and dental stool measurements were obtained by a single examiner at two moments with a 1-week interval between the evaluations. Intra-class correlation coefficient (ρ) was used to estimate the intraexaminer reproducibility. Results: Excellent reproducibility was observed for all anthropometric measurements obtained (ρ=0.99) as well as for all dental stools evaluated (ρ=0.99). Conclusion: The method used to obtain the anthropometric and dental stools measurements was reproducible and can be used reliably.

An Integrative Genomic and Transcriptomic Analysis Reveals Potential Targets Associated with Cell Proliferation in Uterine Leiomyomas

Background: Uterine Leiomyomas (ULs) are the most common benign tumours affecting women of reproductive age. ULs represent a major problem in public health, as they are the main indication for hysterectomy. Approximately 40-50% of ULs have non-random cytogenetic abnormalities, and half of ULs may have copy number alterations (CNAs). Gene expression microarrays studies have demonstrated that cell proliferation genes act in response to growth factors and steroids. However, only a few genes mapping to CNAs regions were found to be associated with ULs. Methodology: We applied an integrative analysis using genomic and transcriptomic data to identify the pathways and molecular markers associated with ULs. Fifty-one fresh frozen specimens were evaluated by array CGH (JISTIC) and gene expression microarrays (SAM). The CONEXIC algorithm was applied to integrate the data. Principal Findings: The integrated analysis identified the top 30 significant genes (P<0.01), which comprised genes associated with cancer, whereas the protein-protein interaction analysis indicated a strong association between FANCA and BRCA1. Functional in silico analysis revealed target molecules for drugs involved in cell proliferation, including FGFR1 and IGFBP5. Transcriptional and protein analyses showed that FGFR1 (P = 0.006 and P<0.01, respectively) and IGFBP5 (P = 0.0002 and P = 0.006, respectively) were up-regulated in the tumours when compared with the adjacent normal myometrium. Conclusions: The integrative genomic and transcriptomic approach indicated that FGFR1 and IGFBP5 amplification, as well as the consequent up-regulation of the protein products, plays an important role in the aetiology of ULs and thus provides data for potential drug therapies development to target genes associated with cellular proliferation in ULs. © 2013 Cirilo et al.

Estudo da reprodutibilidade do diagnóstico de microinfiltração marginal

Pós-graduação em Ciências Odontológicas - FOAR

Reprodutibilidade diagnóstica das imagens radiográficas panorâmicas convencional e digitalizada invertida na detecção do teto do canal da mandíbula e do forame mentual

Pós-graduação em Odontologia - FOAR

Imagem por ressonância magnética das articulações temporomandibulares: avaliação da confiabilidade e da validade

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Laboratory testes with quality data in Dentistry

In laboratory tests, just following the manufacturer’s instructions of materials or equipments may not be enough to obtain reliable data. Thus, intra and inter-examiners studies may be required. The aim of this study was to illustrate the application of the Intraclass Correlation Coefficient (r) in a study related to the color changing and hardness of composite resin conducted by two examiners. The color and hardness of 10 specimens of composite resin were evaluated by a colorimetric spectrophotometer and hardness tester, respectively, at two different times. Two trained examiners performed two measurements with an interval of one week. Specimens were stored in artificial saliva at 37±1ºC for 7 days. The Intraclass Correlation was used for analysis of intra and inter-examiner reproducibility. The intra-examiner reproducibility was 0.79, 0.44 and 0.76 for L, a and b color coordinates for the examiner 1 and 0.84, 0.23, 0.21 for examiner 2. For hardness, r-values were 0.00 and 0.23 for the examiner 1 and 2, respectively, showing unsatisfactory agreement on color and hardness evaluation for both examiners. It was noted that only the observation of protocol for use of equipment and examiners training were not sufficient to collect reliable information. Thus, adjustments in the experimental protocol were made and devices were produced to standardize the measurements. The reproducibility study was performed again. For examiner 1, values as 0.90, 0.59 and 0.79 were verified for L, a and b coordinates and, for examiner 2 were obtained values of 0.90, 0.75, 0.95. In relation to hardness, r-values of 0.75 and 0.71 were obtained for examiners 1 and 2, respectively. The inter-examiner reproducibility was 0.86, 0.87, 0.91 for L, a and b coordinates and 0.79 for hardness. It was concluded that intra and inter-examiner calibration is essential for obtaining quality measurements in laboratory tests.

Confiabilidade do teste de identificação de transtornos devido ao uso de álcool (AUDIT) em adolescentes

The objective of this study was to estimate the reliability of the alcohol use disorders identification test (AUDIT) applied to adolescents. Evaluations were performed with 141 students of ages ranging from 14 to 17 years (14.93±0.62). The internal consistency of the instrument was estimated by Cronbach’s alpha coefficient and its reproducibility by weighted Kappa statistics by score and by a reliability interval of 95%. The AUDIT presented excellent internal consistency (α=0.80, rinter-item=0.29). Most questions present reproducibility ranked as “good”. It is concluded that the AUDIT is a reliable instrument to survey information about alcohol use in adolescents.

Biometry and fetal weight estimation by two-dimensional and three-dimensional ultrasonography: an intraobserver and interobserver reliability and agreement study

Objective To evaluate and compare the intraobserver and interobserver reliability and agreement for the biparietal diameter (BPD), abdominal circumference (AC), femur length (FL) and estimated fetal weight (EFW) obtained by two-dimensional ultrasound (2D-US) and three-dimensional ultrasound (3D-US). Methods Singleton pregnant women between 24 and 40 weeks were invited to participate in this study. They were examined using 2D-US in a blinded manner, twice by one observer, intercalated by a scan by a second observer, to determine BPD, AC and FL. In each of the three examinations, three 3D-US datasets (head, abdomen and thigh) were acquired for measurements of the same parameters. We determined EFW using Hadlock's formula. Systematic errors between 3D-US and 2D-US were examined using the paired t-test. Reliability and agreement were assessed by intraclass correlation coefficients (ICCs), limits of agreement (LoA), SD of differences and proportion of differences below arbitrary points. Results We evaluated 102 singleton pregnancies. No significant systematic error between 2D-US and 3D-US was observed. The ICC values were higher for 3D-US in both intra- and interobserver evaluations; however, only for FL was there no overlap in the 95% CI. The LoA values were wider for 2D-US, suggesting that random errors were smaller when using 3D-US. Additionally, we observed that the SD values determined from 3D-US differences were smaller than those obtained for 2D-US. Higher proportions of differences were below the arbitrarily defined cut-off points when using 3D-US. Conclusion 3D-US improved the reliability and agreement of fetal measurements and EFW compared with 2D-US.