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Aging; Aorta; Calcification Envelliment; Aorta; Calcificació Envejecimiento; Aorta; Calcificación Magnetic resonance imaging and computed tomography allow the characterization of arterial state and function with high confidence and thus play a key role in the understanding of arterial aging and its translation into the clinic. Decades of research into the development of innovative imaging sequences and image analysis techniques have led to the identification of a large number of potential biomarkers, some bringing improvement in basic science, others in clinical practice. Nonetheless, the complexity of some of these biomarkers and the image analysis techniques required for their computation hamper their widespread use. In this narrative review, current biomarkers related to aging of the aorta, their founding principles, the sequence, and postprocessing required, and their predictive values for cardiovascular events are summarized. For each biomarker a summary of reference values and reproducibility studies and limitations is provided. The present review, developed in the COST Action VascAgeNet, aims to guide clinicians and technical researchers in the critical understanding of the possibilities offered by these advanced imaging modalities for studying the state and function of the aorta, and their possible clinically relevant relationships with aging. This article is based upon work from COST Action CA18216 VascAgeNet, supported by COST (European Cooperation in Science and Technology, www.cost.eu). A. Guala has received funding from Spanish Ministry of Science, Innovation and Universities (IJC2018‐037349‐I) and from “la Caixa” Foundation (LCF/BQ/PR22/11920008). S. Piskin has received funding from the European Research Executive Agency, Marie‐Sklodowska Curie Actions‐Global Individual Fellowship (101038096), and from Istinye University, Scientific Research Projects project (2019B1). P. Wohlfahrt's work was supported by the Ministry of Health of the Czech Republic, grant no. NV 19‐09‐00125. J. Alastruey was supported by the British Heart Foundation under Grant PG/15/104/31913, the Wellcome Engineering and Physical Sciences Research Council Centre for Medical Engineering at King's College London under Grant WT 203148/Z/16/Z, and the UK Department of Health through the National Institute for Health Research Cardiovascular MedTech Co‐Operative at Guy's and St Thomas' National Health Service Foundation Trust under grant MIC‐2016‐019.

Resumo Contexto A veia safena interna é a principal veia superficial do membro inferior, sendo também a mais utilizada para cirurgias de enxerto arterial para revascularização de membros inferiores. O conhecimento prévio da qualidade da veia pode orientar a mudança da estratégia terapêutica, evitando cirurgias fadadas ao insucesso. Observou- se, com frequência, a discrepância entre achados intraoperatórios e exames de imagem. Objetivos Avaliar e comparar o calibre da veia safena interna através de dois métodos de imagem [ultrassonografia (USG) dúplex e angiotomografia computadorizada (angio TC)] e do padrão-ouro (medida no intraoperatório). Métodos Tratou-se de estudo prospectivo observacional. Os dados coletados foram obtidos dos procedimentos médicos de rotina realizados pela equipe de Cirurgia Vascular. Resultados Foram avaliados 41 pacientes, seguidos clinicamente por 12 meses, sendo 27 (65,8%) do sexo masculino, com média de idade de 65,37 anos. Dezenove (46,3%) pacientes foram submetidos a enxerto fêmoro-poplíteo, e 22 (53,7%) a enxertos distais. Os diâmetros da veia safena foram em média 16,4% menores na TC e 33,8% menores na USG, quando medidos em decúbito dorsal no pré-operatório, comparados ao diâmetro externo após dilatação hidrostática no intraoperatório. Não houve diferença estatística das medidas da cirurgia quando se comparou sexo, peso e altura. Conclusões A avaliação do calibre da veia safena foi subestimada pelos exames de USG e TC pré-operatórias com o paciente em decúbito dorsal, em relação à medida intraoperatória. Em pacientes em programação de enxerto para revascularização, a escolha do conduto deve levar esse dado em consideração para que não ocorra exclusão precipitada do uso da veia safena no planejamento. Abstract Background The great saphenous vein is the major superficial vein of the lower limb, and also the most often used as arterial graft material for lower limb revascularization. Prior knowledge of the quality of the vein can guide choice of therapeutic strategy, avoiding surgery that is doomed to failure. Discrepancies between intraoperative findings of the quality of the great saphenous vein and imaging tests are also frequently observed. Objectives To evaluate the diameter of the great saphenous vein using two imaging methods (Duplex Ultrasound and Computed Tomography) and the gold-standard (intraoperative direct measurement of the vein), comparing the results. Methods Prospective, observational study of data obtained during routine medical procedures performed by the Vascular Surgery team. Results 41 patients were evaluated, with a 12-month follow-up. 27 (65.85%) were male and mean age was 65.37 years. 19 (46.34%) patients had femoropopliteal grafts and 22 (53.66%) had distal grafts. Preoperative saphenous vein internal diameters measured with the patient supine were on average 16.4% smaller on CT and 33.8% smaller on US than the external diameters measured after intraoperative hydrostatic dilatation. There were no statistical differences in measurements when sex, weight, and height were considered. Conclusions Saphenous vein diameters were underestimated by preoperative US and CT scans when compared to intraoperative measurements. Thus, in patients undergoing graft planning for revascularization, the choice of conduit should take this data into consideration, so that use of the saphenous vein is not ruled out unnecessarily during planning.

BACKGROUND: The preoperative nutritional state has prognostic postoperative value. Tomographic density and area of psoas muscle are validated tools for assessing nutritional status. There are few reports assessing the utility of staging tomography in gastric cancer patients in this field. AIMS: This study aimed to determine the influence of sarcopenia, measured by a preoperative staging computed tomography scan, on postoperative morbimortality and long-term survival in patients operated on for gastric cancer with curative intent. METHODS: This retrospective study was conducted from 2007 to 2013. The definition of radiological sarcopenia was by measurement of cross-sectional area and density of psoas muscle at the L3 (third lumbar vertebra) level in an axial cut of an abdominopelvic computed tomography scan (in the selection without intravascular contrast media). The software used was OsirixX version 10.0.2, with the tool “propagate segmentation”, and all muscle seen in the image was manually adjusted. RESULTS: We included 70 patients, 77% men, with a mean cross-sectional in L3 of 16.6 cm2 (standard deviation+6.1) and mean density of psoas muscle in L3 of 36.1 mean muscle density (standard deviation+7.1). Advanced cancers were 86, 28.6% had signet-ring cells, 78.6% required a total gastrectomy, postoperative surgical morbidity and mortality were 22.8 and 2.8%, respectively, and overall 5-year long-term survival was 57.1%. In the multivariate analysis, cross-sectional area failed to predict surgical morbidity (p=0.4) and 5-year long-term survival (p=0.34), while density of psoas muscle was able to predict anastomotic fistulas (p=0.009; OR 0.86; 95%CI 0.76–0.96) and 5-year long-term survival (p=0.04; OR 2.9; 95%CI 1.04–8.15). CONCLUSIONS: Tomographic diagnosis of sarcopenia from density of psoas muscle can predict anastomotic fistulas and long-term survival in gastric cancer patients treated with curative intent. RESUMO RACIONAL: O estado nutricional pré-operatório tem valor prognóstico pós-operatório. A densidade tomográfica e a área do músculo psoas é uma ferramenta validada para o estado nutricional. Existem poucos estudos avaliando a utilidade da tomografia de estadiamento em pacientes com câncer gástrico neste campo. OBJETIVOS: Determinar a influência da sarcopenia, medida por tomografia computadorizada de estadiamento pré-operatório, na morbimortalidade pós-operatória e sobrevida em longo prazo em pacientes operados de câncer gástrico com intenção curativa. MÉTODOS: Estudo retrospectivo de 2007 a 2013. A definição de sarcopenia radiológica foi pela medida da área (PA) e densidade do músculo psoas (PD) a nível de L3 (Terceira vertebra lombar), em um corte axial de tomografia computadorizada abdominopélvica (na seleção sem meio de contraste intravascular). O Software utilizado foi o OsirixX v 10.0.2, com a ferramenta “propagar segmentação”, ajustando manualmente todos os músculos vistos na imagem. RESULTADOS: Foram incluídos 70 pacientes, 77% homens, PA média em L3: 16,6 cm2 (desvio padrão+6,1), PD média em L3: 36,1 mean muscle density (desvio padrão+7,1). Os cânceres avançados foram de 86, 28,6% tinham células em anel de sinete, 78,6% necessitaram de gastrectomia total, a morbidade e mortalidade cirúrgica pós-operatória foi de 22,8 e 2,8%, respectivamente, a sobrevida global de 5 anos a longo prazo (SV5) foi de 57,1%. Na análise multivariada, PA falhou em prever morbidade cirúrgica (p=0,4) e sobrevida global de 5 anos (p=0,34), enquanto PD foi capaz de prever fístulas anastomóticas (p=0,009; OR 0,86; IC95% 0,76–0,96) e SV5 (p=0,04; OR 2,9; IC95% 1,04–8,15). CONCLUSÕES: O diagnóstico tomográfico de sarcopenia por desvio padrão é capaz de predizer fístulas anastomóticas e sobrevida a longo prazo em pacientes com câncer gástrico tratados com intenção curativa.

Objective: To evaluate the morphometry of the pelvis to determine the safe trajectory for the insertion of the S2-iliac screw, and to correlate it with studies reported in the literature for other populations. Method: The computed tomography (CT) pelvic exams of 36 Brazilian patients without congenital malformations, tumors, pelvic ring fractures or dysplasias were selected from the database of a radiological clinic. To define the ideal trajectory of the S2-iliac screw, the following variables were measured: 1- maximum sacroiliac screw length; 2- thickness of the iliac dipole for planning the choice of screw dimensions (length and diameter); 3 - distance between the insertion point of the iliac S2 screw and the posterior sacral cortex; 4 - angulation for insertion of the screw in the mediolateral direction, representing the angle formed between the “iliac line” and the anatomical sagittal plane; 5- Angulation for insertion of the screw in the craniocaudal direction. The Pearson's chi squared and student's t tests were used for statistical analysis. Results: The sample consisted of 36 patients, 50% (18/36) of whom were women. The mean age was 63.7 years, ranging from 23 to 96 years. All the pelvic morphometric variables analyzed presented values similar to those described in the literature for other populations. Conclusion: Prior evaluation of the tomography exams was important for preoperative planning, and there was a statistically significant difference between the sexes only in relation to the variables left craniocaudal and length of the left internal table. Level of evidence III; Observational cross-sectional study. RESUMO Objetivo: Avaliar a morfometria da pelve para determinar a trajetória de segurança de introdução do parafuso S2-ilíaco e correlacionar com estudos relatados na literatura para outras populações. Métodos: A partir do banco de dados de uma clínica radiológica, foram selecionados 36 exames de tomografia computadorizada (TC) da pelve de pacientes brasileiros sem achados de malformações congênitas, tumorações, fraturas do anel pélvico ou displasias. Para definição da trajetória ideal do parafuso S2-ilíaco foram mensuradas as seguintes variáveis: 1 - comprimento máximo do parafuso sacro-ilíaco; 2 - espessura da díploe ilíaca para planejar a escolha das dimensões do parafuso (comprimento e diâmetro); 3 - distância entre o ponto de inserção do parafuso S2-ilíaco e a cortical posterior do sacro; 4 - angulação para inserção do parafuso no sentido médio-lateral, representando o ângulo formado entre a “reta ilíaca” e o plano sagital anatômico; 5 - angulação para inserção do parafuso no sentido craniocaudal. Para análise estatística foram usados os testes Qui-quadrado de Pearson e t de Student. Resultados: A amostra foi constituída de 36 pacientes, sendo 50% (18/36) mulheres. A média de idade foi de 63,7 anos, variando de 23 a 96 anos. Todas as variáveis morfométricas pélvicas analisadas apresentaram valores semelhantes aos descritos na literatura para outras populações. Conclusões: A avaliação prévia dos exames de tomografia foi importante para o planejamento pré-operatório, assim como a diferença estatisticamente significante entre os sexos somente com relação às variáveis craniocaudal esquerda e comprimento da tábua interna esquerda. Nível de evidência III; Estudo observacional de corte transversal. RESUMEN Objetivo: Evaluar la morfometría de la pelvis para determinar la trayectoria de seguridad de introducción del tornillo S2-ilíaco y correlacionarla con estudios relatados en la literatura para otras poblaciones. Método: A partir de la base de datos de una clínica radiológica, se seleccionaron 36 exámenes de tomografía computarizada (TC) de la pelvis de pacientes brasileños sin hallazgos de malformaciones congénitas, tumores, fracturas del anillo pélvico o displasias. Para definir la trayectoria ideal del tornillo S2-ilíaco, se midieron las siguientes variables: 1- longitud máxima del tornillo sacro-ilíaco; 2- espesor del díploe ilíaco: para planificar la elección de las dimensiones del tornillo (longitud y diámetro); 3- distancia entre el punto de inserción del tornillo S2ilíaco y la cortical posterior del sacro; 4- angulación para inserción del tornillo en el sentido medio-lateral, que representa el ángulo formado entre la “recta ilíaca” y el plano sagital anatómico; 5- angulación para inserción del tornillo en el sentido craneocaudal. Para el análisis estadístico se utilizaron las pruebas Chi-cuadrado de Pearson y t de Student. Resultados: La muestra fue constituida de 36 pacientes, siendo 50% (18/36) mujeres. La edad promedio fue de 63,7 años, variando de 23 a 96 años. Todas las variables morfométricas pélvicas analizadas presentaron valores similares a los descritos en la literatura para otras poblaciones. Conclusiones: Fue importante la evaluación previa de los exámenes de tomografía para la planificación preoperatoria; así como la diferencia estadísticamente significativa entre géneros sólo en relación a las variables craneocaudal izquierda y longitud de la tabla interna izquierda. Nivel de evidencia III; Estudio observacional de corte transversal.

ilustraciones, fotografías Propósito: Desarrollar un método computacional basado en Deep Learning (DL) para detectar automáticamente biomarcadores de oclusiones de venas retinianas en imágenes adquiridas por angiografía por tomografía de coherencia óptica (OCT-A) Diseño: Desarrollo de algoritmo para detectar biomarcadores de oclusiones de venas retinianas utilizando datos retrospectivos. (Texto tomado de la fuente) Purpose: To develop a computational method based on Deep Learning (DL) to automatically detect biomarkers of retinal vein occlusions in images acquired by optical coherence tomography angiography (OCT- A) Design: Algorithm development for detect biomarkers of retinal vein occlusions using retrospective data. Participants: Images of the superficial, deep, en face, choriocapillaris and outer retina to choriocapillaris (ORCC) layers obtained from 254 patients attended in an Ophthalmology Clinic were used to train and test an artificial intelligence (AI) model. Methods: The OCT-A scans were manually annotated with four biomarkers (BMs): disruption of the perifoveal capillary plexus, non-perfusion areas (NPAs), vascular tortuosity and cystoid spaces. Segmentation and identification were subsequently provided to build and training the DL model using Deep Convolutional Neural Networks (DNN) Main Outcome Measures: detection rate and jaccard index Results: The detection rate of the model for disruption of the perifoveal capillary plexus, non-perfusion areas (NPAs), vascular tortuosity and cystoid spaces were 93%, 92%, 91% and 84% respectively. The Jaccard index values were 0.85, 0.77, 0.72 and 0.73 respectively Conclusion: The proposed DL model may id Especialidades Médicas Especialista en Oftalmología

Programa Oficial de Doctorado en Ciencias de la Salud. 5007V01 [Resumen] Introducción y objetivos: Actualmente existen diferentes estrategias para la detección del síndrome coronario agudo (SCA) en una unidad de dolor torácico. Nuestro objetivo es comparar el ecocardiograma de estrés (EcoE) y la tomografía computarizada multidetector (TCMD) en este escenario. Métodos: Se aleatorizó a 203 pacientes con al menos 1 factor de riesgo cardiovascular y con electrocardiograma y troponinas normales a EcoE (103) o a TCMD (100). El objetivo primario era un combinado de eventos graves (muerte e infarto de miocardio no mortal), revascularizaciones y readmisiones. El objetivo secundario fue el coste. Resultados: Se realizaron 61 coronariografías, 34 (33%) en el grupo EcoE y 27 (27%) en el grupo TCMD (p = 0,15). Se confirmó SCA en 53 pacientes (el 88 y el 85%; p = 0,35). No hubo diferencias significativas en el objetivo primario (el 42 y el 41%; p = 0,91) ni en el número de eventos graves entre grupos (el 5 y el 7%; p = 0,42). El coste medio en la sala de urgencias fue menor en el grupo con EcoE negativo comparado con el grupo con TCMD negativa (557 y 706 euros; p = 0,02), aunque no se encontraron diferencias significativas con respecto al coste total. Conclusiones: No se encontraron diferencias significativas en cuanto a eficacia y seguridad entre el EcoE y la TCMD en el cribado del dolor torácico agudo en pacientes con probabilidad baja-intermedia de SCA. El coste medio en la sala de urgencias fue significativamente menor en el subgrupo EcoE negativo. [Resumo] Introducción e obxetivos: Actualmente existen diferentes estratexias para a detección do síndrome coronario agudo (SCA) nunha unidade de dor torácica. O noxo obxetivo é comparar o ecocardiograma de estrés (EcoE) e a tomografía computarizada multidetector (TCMD) neste escenario. Métodos: Aleatorizáronse a 203 pacientes con ao menos 1 factor de risco cardiovascular e con electrocardiograma e troponinas normais a EcoE (103) ou a TCMD (100). O obxetivo primario era un combinado de eventos graves (muerte e infarto de miocardio no mortal), revascularizacións y readmisións. O obxetivo secundario foi o custo. Resultados: Realizáronse 61 coronariografías, 34 (33%) no grupo EcoE e 27 (27%) no grupo TCMD (p = 0,15). Confirmouse SCA en 53 pacientes (88% e 85%; p = 0,35). Non houbo diferencias significativas no obxetivo primario (42% e 41%; p = 0,91) nin no número de eventos graves entre grupos (5% e 7%; p = 0,42). O custo medio na sala de urxencias foi menor no grupo con EcoE negativo comparado co grupo con TCMD negativa (557 y 706 euros; p = 0,02), aínda que non se encontraron diferencias significativas con respecto o custo total. Conclusións: Non se encontraron diferencias significativas en canto a eficacia e seguridade entre o EcoE e a TCMD no cribado de dor torácica aguda en pacientes con probabilidade baixa-intermedia de SCA. O custo medio na sala de urxencias foi significativamente menor no subgrupo con EcoE negativo. [Abstract] Introduction and objectives: This study aimed to compare stress echocardiography (SE) and multidetector computed tomography (MCT) in patients admitted to a chest pain unit to detect acute coronary syndrome (ACS). Methods: A total of 203 patients with ≥1 cardiovascular risk factor, no ischemic electrocardiogram changes and negative biomarkers were randomized to SE (n = 103) or MTC (n = 100). The primary endpoint was a combination of hard events (death and nonfatal myocardial infarction), revascularizations, and readmissions during follow-up. The secondary endpoint was the cost of the two strategies. Results: Invasive angiography was performed in 61 patients, 34 (33%) in the SE group and in 27 (27%) in the MCT group, P = .15). A final diagnosis of ACS was made in 53 patients (88% vs 85%, P = .35). There were no significant differences between groups in the primary endpoint (42% vs 41%, P = .91), or in hard events (5% vs 7%, P = .42). There were no significant differences in overall cost, but costs were lower in patients with negative SE than in those with negative MCT (557 vs 706 euro; P=.02). Conclusions: No significant differences were found in efficacy and safety for the stratification of patients with a low to moderate probability of ACS admitted to a chest pain unit. The cost of the two strategies was similar, but cost was significantly lower for SE on comparison of negative studies.

[EN] All through modern history, prostheses have been used by people of all ages to regain a sense of wholeness. From the time of the early Egyptians, who fashioned a wooden toe so that a noblewoman could keep on wearing sandals as per their tradition, to the late 20th century, when the first bionic prosthetic arm was created, prostheses have proven to be as much about function as identity. A series of more advanced, functional, and comfortable prostheses have followed suit since then, but the development of the electronics present in most commercially available units can be said to have plateaued significantly in the last decade. These prostheses usually force the users to choose from a list of pre-programmed gestures before being able to recreate them. This does not only hinder their ability to react swiftly to unexpected events, but it is also impractical for everyday use. This project addresses the design of a portable, fully contained, low-power acquisition device that makes use of machine learning algorithms to allow for the control of hand prostheses in real-time. To achieve this, a technique known as EIT, or Electrical Impedance Tomography will be used in lieu of the more primitive EMG (electromyography), the standard nowadays. Due to the complexity of the project, the scope of this TFG will be limited to the design of the electronics, the programming of the embedded system, and the training and usage of machine learning algorithms. That is, the design and control of the prosthesis will not be covered. EIT is a non-invasive, medical imaging technique that relies on the electrical properties of a given body and a series of surface measurements to infer its internal anatomic structure via the use of active current injection. This data will be used, in conjunction with a neural network classifier to automatically determine the gesture that the user intends to make. The proposed method has proven to be more robust and less prone to external interferences than EMG due to its active nature and configurability. Therefore, the suggested technique might be used as a viable replacement for EMG in the future., [ES] A lo largo de la historia moderna, las prótesis han sido utilizadas por personas de todas las edades para recuperar la sensación de totalidad. Desde la época de los primeros egipcios, los cuales fabricaron un dedo de madera para que una mujer noble pudiera seguir llevando sandalias según marcaba su tradición, hasta finales del siglo XX, cuando se creó el primer brazo protésico biónico, las prótesis han demostrado ser tanto funcionales como identitarias. Desde entonces, prótesis más avanzadas, funcionales y cómodas se han desarrollado, pero puede decirse que el desarrollo de la electrónica presente en la mayoría de las unidades disponibles en el mercado se ha estancado de forma significativa en la última década. Estas prótesis suelen obligar a los usuarios a elegir entre una lista de gestos preprogramados antes de poder recrearlos. Esto no solo ralentiza la capacidad de reacción de los usuarios ante acontecimientos inesperados, sino que además resulta poco práctico para el uso diario. Este proyecto aborda el diseño de un dispositivo de adquisición portátil, autónomo y de bajo consumo que utiliza algoritmos de aprendizaje automático para permitir el control de prótesis de mano en tiempo real. Para ello, se utilizará una técnica conocida como EIT, o Tomografía por Impedancia Eléctrica, en lugar de la más primitiva EMG (electromiografía), el estándar actual. Debido a la complejidad del proyecto, el alcance de este TFG se limitará al diseño de la electrónica, la programación del sistema embebido, y el entrenamiento y uso de algoritmos de aprendizaje automático. Es decir, no se cubrirá ni el diseño ni el control de la prótesis. La EIT es una técnica de imagen médica no invasiva que se basa en las propiedades eléctricas de un cuerpo determinado y en una serie de mediciones superficiales para inferir su estructura anatómica interna mediante el uso de inyección de corriente activa. Estos datos se utilizarán, junto con un clasificador de red neuronal, para determinar automáticamente el gesto que el usuario pretende realizar. El método propuesto ha demostrado ser más robusto y menos propenso a las interferencias externas que la EMG debido a su naturaleza activa y a su capacidad de configuración. Por lo tanto, la técnica sugerida podría utilizarse como un sustituto viable de la EMG en el futuro.

This article addresses the issue of the influence of imaging tests on the prognosis of heart failure. The objective of this review is to verify the main predictors on echocardiography, computed tomography and magnetic resonance imaging that are related to the prognosis of heart failure (HF). This is an integrative review of the scientific literature from publications from 2011 to 2021. The PUBMED, SCIELO and LILACS databases were chosen, using search terms identified in the Health Sciences Descriptors (DeCS). The main predictors of prognosis reported in the publications include: left ventricular ejection fraction (50% of articles), ventricular volume (40% of articles), cardiac chamber filling pressure (30% of articles), detection etiology (50% of the articles) and the presence of fibrosis (40% of the articles), of valvular alterations (30% of the articles), and of pulmonary alterations (30% of the articles). It is concluded that imaging tests provide information capable of predicting the prognosis of patients with HF and that the different imaging modalities contribute to improving data accuracy, prognosis and, consequently, the proper management and promotion of the quality of life of the person with heart failure. Este artículo aborda el tema de la influencia de las pruebas de imagen en el pronóstico de la insuficiencia cardiaca. El objetivo de esta revisión es verificar los principales predictores de ecocardiografía, tomografía computarizada y resonancia magnética que se relacionan con el pronóstico de la insuficiencia cardíaca (IC). Se trata de una revisión integradora de la literatura científica a partir de publicaciones de 2011 a 2021. Se escogieron las bases de datos PUBMED, SCIELO y LILACS, utilizando términos de búsqueda identificados en los Descriptores de Ciencias de la Salud (DeCS). Los principales predictores de pronóstico informados en las publicaciones incluyen: fracción de eyección del ventrículo izquierdo (50% de los artículos), volumen ventricular (40% de los artículos), presión de llenado de las cámaras cardíacas (30% de los artículos), etiología de detección (50% de los artículos) y la presencia de fibrosis (40% de los artículos), de alteraciones valvulares (30% de los artículos) y de alteraciones pulmonares (30% de los artículos). Se concluye que las pruebas de imagen brindan información capaz de predecir el pronóstico de los pacientes con IC y que las diferentes modalidades de imagen contribuyen a mejorar la precisión de los datos, el pronóstico y, en consecuencia, el manejo adecuado y la promoción de la calidad de vida de la persona con insuficiencia cardiaca. Esse artigo aborda a temática da influência dos exames de imagem no prognóstico da insuficiência cardíaca. O objetivo desta revisão é constatar os principais preditores no ecocardiograma, na tomografia computadorizada e na ressonância magnética que possuem relação com o prognóstico da insuficiência cardíaca (IC). Trata-se de uma revisão integrativa da literatura científica a partir de publicações de 2011 a 2021. Foram escolhidas as bases de dados PUBMED, SCIELO e LILACS, usando termos de busca identificados nos Descritores em Ciências da Saúde (DeCS). Os principais preditores do prognóstico relatados nas publicações incluem: a fração de ejeção do ventrículo esquerdo (50% dos artigos), o volume ventricular (40% dos artigos), a pressão de enchimento das câmaras cardíacas (30% dos artigos), a detecção da etiologia (50% dos artigos) e a presença de fibrose (40 % dos artigos), de alterações valvares (30% dos artigos), e de alterações pulmonares (30% dos artigos). Conclui-se que os exames de imagem fornecem informações capazes de predizer o prognóstico dos portadores de IC e que as diferentes modalidades de imagem contribuem na melhora da precisão dos dados, no prognóstico e por consequência, no manejo adequado e promoção da qualidade de vida da pessoa com insuficiência cardíaca.

El uso de la Tomografía Computarizada de Haz Cónico (CBCT) ha sido ampliamente relevante en el campo de la Endodoncia, pues además de que permite la visualización en los diferentes cortes (axial, coronal y sagital), facilita la emisión de diagnósticos más precisos como fracturas radiculares y/o coronales, reabsorciones radiculares, periodontitis apical en estadios iniciales, perforaciones, planificación de cirugías endodónticas, entre otros. Objetivo: Determinar la sensibilidad y especificidad de la CBCT en la detección de fractura vertical mediante la revisión sistemática. Métodos: Se realizó una revisión sistemática, en la cual se tuvieron en cuenta estudios realizados entre los años 2012 a 2022. Se utilizaron las bases de datos Pubmed y Springer, incluyendo artículos en inglés y español disponibles en forma completa. Se utilizaron artículos relacionados con Efectividad y sensibilidad de la CBCT en los hallazgos de fractura vertical. Resultados: En esta revisión se identificaron 176 documentos. Luego de revisar los títulos, resúmenes y palabras clave, se descartaron 78, pues no trataban sobre Efectividad y Sensibilidad de la CBCT o estaban duplicados. De estos se descargaron 108 artículos para ser examinados con mayor profundidad por medio de la lectura del texto completo, de los cuales se descartaron 87 debido a que no eran estudios in vivo, in vitro o por no estar dentro del rango de año de publicación establecido. Finalmente, el número de artículos de texto completo evaluados para su elegibilidad fueron 21. Conclusiones: El uso de CBCT en el diagnóstico de fractura vertical es una herramienta útil, pero se debe tener conocimiento de la configuración del equipo para poder ser lo más preciso posible, utilizar tamaños de voxel menores a 2 micras, para evitar la pérdida de sensibilidad y especificidad. The use of Cone Beam Computed Tomography (CBCT) has been very relevant in the field of Endodontics, since in addition to allowing visualization in different cuts (axial, coronal and sagittal), it facilitates the issuance of more precise diagnoses such as root and/or crown fractures, root resorptions, apical periodontitis in early stages, perforations, endodontic surgery planning, among others. Objective: To determine the sensitivity and specificity of CBCT in the detection of vertical fracture through systematic review. Methods: A systematic review was carried out, in which studies carried out between the years 2012 and 2022 were taken into account. The Pubmed and Springer databases were used, including articles in English and Spanish available in full. Articles related to the Effectiveness and Sensitivity of CBCT in the findings of vertical fracture were used. Results: In this review, 176 documents were identified. After reviewing the titles, abstracts and keywords, 78 were discarded, since they were not analyzed on the Effectiveness and Sensitivity of the CBCT or they were duplicated. Of these articles, 108 were downloaded to be examined in greater depth by reading the full text, of which 87 were discarded because they were not in vivo or in vitro studies or because they were not within the established publication year range. . Finally, the number of full-text articles evaluated for eligibility was 21. Conclusions: The use of CBCT in the diagnosis of vertical fracture is a useful tool, but knowledge of the equipment configuration must be known in order to be as accurate as possible. , use a voxel size smaller than 2 microns, to avoid loss of sensitivity and specificity. Especialista en Endodoncia http://www.ustabuca.edu.co/ustabmanga/presentacion Especialización

Objective: Measure the diameter and thickness of the C6 and C7 pedicles using computed tomography, to analyze the security of the act surgery and the difference between males and females. Methods: This is a retrospective study. Two hundred computerized tomography scans of the cervical spine, one hundred male and one hundred female, from the Hospital Santa Teresa Radiology sector were evaluated. The pedicle thickness was measured in the axial plane, and the height was measured in sagittal slices. The student’s t-test was used to compare differences between the sexes, and a p-value lower than 0.05 was considered significant. Results: The mean age of the individuals included in the sample was 35±9 years. The mean height of the C6 and C7 pedicles were 7.1±0.9 mm and 7.8±0.9 mm, respectively. The mean thickness of the C6 and C7 pedicles were 5.2±0.7 mm and 5.9±0.8 mm, respectively. The statistical test showed that the values were significantly lower for female patients. Conclusions: The present study demonstrated parameters that can be used and can be the rule for preoperative planning of transpedicular cervical fixation surgeries, both in C6 and C7. As it is a procedure that can cause iatrogenic damage to important structures, the screw size must be chosen with care in pre-operative planning to avoid vessel rupture or damage to adjacent nerves. Level of Evidence III; retrospective study. RESUMO Objetivo: Mensurar o diâmetro e a espessura do pedículo de C6 e C7 por meio de tomografia computadorizada para analisar a segurança no ato cirúrgico e a diferença entre o sexo masculino e feminino. Métodos: Trata-se de um estudo retrospectivo. Foram avaliadas 200 tomografias computadorizadas da coluna cervical, sendo 100 do sexo masculino e 100 do sexo feminino, provenientes do setor de Radiologia do Hospital Santa Teresa. Foram inclusos exames de pacientes acima de 18 anos e menores que 70 anos. A espessura do pedículo foi mensurada no plano axial e a altura foi mensurada em cortes sagitais. O teste t de Student foi utilizado para comparar diferenças entre os sexos, e um valor de p menor que 0,05 foi considerado significante. Resultados: A média de idade dos indivíduos incluídos na amostra foi de 35±9 anos. Em geral, a média da altura dos pedículos de C6 e C7 foram de 7,1±0,9 mm e 7,8±0,9 mm, respectivamente. A média da espessura dos pedículos de C6 e C7 foram de 5,2±0,7 mm e 5,9±0,8 mm, respectivamente. Os valores foram significativamente menores para pacientes do sexo feminino. Conclusões: O presente trabalho demonstrou parâmetros que podem ser utilizados para o planejamento préoperatório de cirurgias de fixação transpedicular cervical, tanto em C6 quanto em C7. Como é um procedimento que pode acarretar lesão iatrogênica em estruturas importantes, o tamanho do parafuso deve ser escolhido com cautela, dentro de um planejamento minucioso pré-operatório de modo à evitar ruptura de vasos ou lesões em nervos adjacentes. Nível de evidência III; Estudo retrospectivo. RESUMEN Objetivo: Medir el diámetro y grosor del pedículo C6 y C7 mediante tomografía computarizada para analizar la seguridad en el procedimiento quirúrgico y la diferencia entre hombres y mujeres. Métodos: Este es un estudio retrospectivo. Se evaluaron un total de 200 tomografías computarizadas de columna cervical, 100 del sexo masculino y 100 del femenino, del sector de Radiología del Hospital Santa Teresa. Se incluyeron exámenes de pacientes mayores de 18 años y menores de 70 años. El grosor del pedículo se midió en el plano axial y la altura en cortes sagitales. Se utilizó la prueba de la t de Student para comparar las diferencias entre sexos, y se consideró significativo un valor de p inferior a 0,05. Resultados: La edad media de los individuos incluidos en la muestra fue de 35±9 años. En general, la altura media de los pedículos C6 y C7 fue de 7,1±0,9 mm y 7,8±0,9 mm, respectivamente. El grosor medio de los pedículos de C6 y C7 fue de 5,2±0,7 mm y 5,9±0,8 mm, respectivamente. Los valores fueron significativamente más bajos para las pacientes femeninas. Conclusiones: El presente estudio demostró parámetros que pueden ser utilizados para la planificación preoperatoria de cirugías de fijación cervical transpedicular, tanto en C6 como en C7. Al ser un procedimiento que puede causar lesiones iatrogénicas en estructuras importantes, el tamaño del tornillo debe elegirse cuidadosamente, dentro de una minuciosa planificación preoperatoria para evitar la ruptura de vasos o daño de nervios adyacentes. Nivel de Evidencia III; Estudio retrospectivo.

Introducción: los dientes anteroinferiores permanentes han sido considerados como dientes unirradiculares y con un solo conducto a partir de la cámara pulpar hasta el foramen apical. Una de las primordiales causas que llevan al fracaso en el procedimiento endodóntico de los dientes anteroinferiores, es el desconocimiento acerca de la anatomía delsistema de conductosradiculares (SCR) y sus variaciones. Objetivo: determinar la prevalencia, de acuerdo con la configuración Vertucci, de la anatomía del sistema de conductos radiculares en dientes anteroinferiores permanentes evaluados mediante CBCT en una población colombiana. Materiales y métodos: Según los criterios de inclusión y exclusión establecidos fueron seleccionados 677 dientes anteroinferiores que hicieron parte de la muestra, se utilizaron tomografías computarizadas CBCT como ayuda diagnostica para observar la configuración Vertucci desde una vista sagital, se evaluaron 4 variables cualitativas: clasificación Vertucci, sexo, tipo de diente, número de conductos y se realizaron pruebas estadísticas Chi2 y exacta de Fisher. Resultados: de acuerdo al análisis realizado de las 140 CBCT, 80(56%) correspondieron a mujeres siendo así la mayoría de la población y según la configuración Vertucci la tipo I fue la clasificación más frecuente con 553 (81,7%) en dientes anteroinferiores, quedando segundo lugar la tipo III con 88 (13%).Conclusiones: la prevalencia de la configuración Vertucci por diente quedó de la siguiente manera; para la tipo I el canino inferior derecho con 19,7%(109) , para el tipo II canino inferior izquierdo 30%, tipo IV el incisivo lateral izquierdo 25%, tipo V incisivos centrales y laterales 20%, tipo VI 66.7%, tipo VII 57.1% Introduction: Permanent anteroinferior teeth have been considered as uniradicular teeth with a single canal from the pulp chamber to the apical foramen. One of the main causes that lead to failure in the endodontic procedure of anteroinferior teeth is the lack of knowledge about the anatomy of the root canal system (RCS) and its variations. Objective: To determine the prevalence, according to the Vertucci configuration, of the anatomy of the root canal system in permanent anteroinferior teeth evaluated by CBCT in a Colombian population. Materials and methods: According to the established inclusion criteria 677 anteroinferior teeth were selected as part of the sample, CBCT computerized tomography was used as a diagnostic aid to observe the Vertucci configuration from a sagittal view, 4 qualitative variables were evaluated: Vertucci classification, sex, type of tooth, number of canals and Chi2 and Fisher's exact statistical tests were carried out. Results: 140 topographies were selected, of which 80 (56%) corresponded to women being the majority of the population. According to the Vertucci configuration with the tooth, type I was determined as the most frequent classification with 53 (81.7%) in anteroinferior teeth, with type III in second place with 88 (13%). Conclusions: According to the topographies it was possible to establish the prevalence of the Vertucci configuration, whose classification was as follows: the right lower canine with 19.7%(109) , for type II the left lower canine 30%, type IV the left lateral incisor 25.0%, type V central and lateral incisors 20%, type VI 66.7%, type VII 57.1%. Odontólogo http://www.ustabuca.edu.co/ustabmanga/presentacion Pregrado

Introducción: La mejora de la resolución y precisión de las imágenes facilita la visualización de las estructuras anatómicas, como consecuencia a los avances tecnológicos como la CBCT. La reconstrucción de imágenes 3D y su incorporación en la práctica clínica han permitido un adecuado diagnóstico, consecuentemente una mejor elaboración de planes de tratamiento. Objetivo: Evaluar los niveles de conocimiento y la actitud sobre CBCT en los estudiantes y docentes de posgrado de la Universidad Santo Tomás. Materiales y métodos: Mediante un estudio observacional, descriptivo de corte transversal se evaluaron los estudiantes y docentes de posgrado de la USTA, utilizando un cuestionario compuesto por 3 categorías: sociodemográficas, nivel de conocimiento y actitudes. El cuestionario constaba de 22 preguntas, en donde el número de aciertos clasificó el conocimiento en: bueno, regular y malo; la actitud se clasificó en: positiva, indiferentes y sin opinión, con la finalidad de evaluar el nivel de conocimiento y actitud frente a la CBCT de los participantes. La variable de salida fue determinada por los conocimientos y actitudes respecto a la CBCT. Los resultados fueron analizados mediante la aplicación de test exacto de Fisher estableciendo un alfa de 5%. Resultados: Se analizaron los datos obtenidos por 88 encuestados. Se encontró que el 86,4% de los participantes utilizaban CBCT en su práctica clínica. Sin embargo, el 57% de los participantes que usan CBCT tienen un conocimiento malo y el 29% un conocimiento regular. No se evidenciaron diferencias estadísticas significativas entre las variables, con excepción de la interacción entre las actitudes y la especialidad. Conclusiones: Se evidenció que los profesionales a pesar de presentar un conocimiento malo y una actitud indiferente acerca de la CBCT ha incrementado su uso actualmente, lo cual demuestra la necesidad de incorporar seminarios que resaltan la importancia de esta ayuda diagnóstica en la práctica odontológica. Introduction: The improvement of image resolution and accuracy facilitates the visualization of anatomical structures, as a consequence to technological advances such as CBCT. The reconstruction of 3D images and their incorporation in clinical practice have allowed an adequate diagnosis, consequently a better elaboration of treatment plans. Objective: To evaluate the levels of knowledge and attitude about CBCT in postgraduate students and teachers of the Universidad Santo Tomás. Materials and methods: Through an observational, descriptive, cross-sectional study, graduate students and teachers of the USTA were evaluated using a questionnaire composed of 3 categories: sociodemographic, level of knowledge and attitudes. The questionnaire consisted of 22 questions, where the number of correct answers classified the knowledge into: good, fair and poor; the attitude was classified into: positive, indifferent and no opinion, with the purpose of evaluating the level of knowledge and attitude towards CBCT of the participants. The output variable was determined by knowledge and attitudes regarding CBCT. The results were analyzed by applying Fisher's exact test, establishing an alpha of 5%. Results: The data obtained by 88 respondents were analyzed. It was found that 86.4% of the participants used CBCT in their clinical practice. However, 57% of the participants using CBCT had poor knowledge and 29% had fair knowledge. No significant statistical differences were evident between variables, with the exception of the interaction between attitudes and specialty. Conclusions: It was evidenced that the professionals despite presenting poor knowledge and an indifferent attitude about CBCT have increased its use currently, which demonstrates the need to incorporate seminars that highlight the importance of this diagnostic aid in dental practice. Odontólogo http://www.ustabuca.edu.co/ustabmanga/presentacion Pregrado

El siguiente trabajo consiste en una revisión bibliográfica cuyo objetivo es determinar la utilidad clínica de la tomografía de perfusión cerebral en pacientes adultos con diagnóstico de evento cerebral vascular, así como detallar las distintas variantes que se pueden establecer en su protocolo de realización para optimizar la fiabilidad diagnóstica del mismo y someter al paciente a la menor cantidad de dosis de radiación y medio de contraste posible. The following work is a literature review with the goal of outlining the clinical utility of computed tomography perfusion of the brain in adult patients with the diagnosis of stroke, and specifying the multiple variants which can be incorporated in its protocol to optimize the diagnostic precision of the study, while submitting the patient to the lowest radiation dose and contrast media volume attainable. UCR::Vicerrectoría de Investigación::Sistema de Estudios de Posgrado::Salud::Especialidad en Radiología e Imágenes Médicas

Upon infection, viruses hijack the cell machinery and remodel host cell structures to utilize them for viral proliferation. Since viruses are about a thousand times smaller than their host cells, imaging virus-host interactions at high spatial resolution is like looking for a needle in a haystack. Scouting gross cellular changes with fluorescent microscopy is only possible for well-established viruses, where fluorescent tagging is developed. Soft X-ray tomography (SXT) offers 3D imaging of entire cells without the need for chemical fixation or labeling. Here, we use full-rotation SXT to visualize entire human B cells infected by the herpes simplex virus 1 (HSV-1). We have mapped the temporospatial remodeling of cells during the infection and observed changes in cellular structures, such as the presence of cytoplasmic stress granules and multivesicular structures, formation of nuclear virus-induced dense bodies, and aggregates of capsids. Our results demonstrate the power of SXT imaging for scouting virus-induced changes in infected cells and understanding the orchestration of virus-host remodeling quantitatively.

Los algoritmos de Machine Learning (ML) han impulsado aplicaciones en distintas áreas de investigación. En este trabajo, se evalúa modelos de ML para estimación del tiempo de evolución del Accidente cerebrovascular isquémico (ACVi) mediante caracterización radiómica de imágenes de Tomografía Computarizada (TC) y características clínicas. Estos registros se encuentran almacenados en el Sistema de Información Radiológica del departamento de Radiología de la Fundación Valle de Lili, y son adecuados para construir una base de datos con 2819 muestras obtenidas de los registros de 74 pacientes. La recolección de imágenes e información clínica del paciente se realizó de forma manual. Se organizaron características clínicas; de la evaluación realizada al paciente y radiómicas; extraidas de las imágenes de TC en un conjunto de datos. Se implementaron técnicas de clasificación para la estimación entre dos clases: clase 1; tiempo trascurrido desde el inicio del ACVi menor o igual a 4,5 horas y clase 2; mayor a 4,5 horas. El mejor clasificador fue Gradient Boosting con exactitud de 99,1%, precisión de 100%, sensibilidad de 98,3%, especificidad de 100%, puntaje F1 de 99,1% e índice kappa de 98,3%. Finalmente, se implementaron técnicas de regresión que buscan estimar el tiempo transcurrido en un rango definido por cada una de las clases. El mejor regresor para la clase 1 fue Bosque aleatorio con MAE de 5,735 y RMSE de 18,855, mientras que, para la clase 2, fue Árbol de decisión con MAE de 9,905 y RMSE de 90,961. Machine learning (ML) algorithms have driven applications in different research areas. In this work, ML models are evaluated to estimate the time of evolution of a stroke through radiomic characterization of computerized tomography (CT) images and clinical characteristics. These records are stored in the Radiological Information System of the Radiology Department of the Fundación Valle de Lili, and are suitable for building a database with 2,819 samples obtained from the records of 74 patients. The collection of images and clinical information of the patient was carried out manually. Characteristics clinical; of the evaluation carried out on the patient and radiomics; extracted from the CT images were organized in a data set. Classification techniques were implemented for the estimation between two classes: class 1, the time elapsed since the start of the ACVi less than or equal to 4.5 hours, and class 2, greater than 4.5 hours. The best classifier was Gradient Boosting with an accuracy of 99.1%, precision of 100%, sensitivity of 98.3%, specificity of 100%, F1 score of 99.1%, and kappa index of 98.3%. Finally, regression techniques were implemented to estimate the time elapsed in a range defined by each class. The best regressor for class 1 was Random Forest with MAE of 5,735 and RMSE of 18,855, while for class 2, it was Decision Tree with MAE of 9,905 and RMSE of 90,961. Pasantía institucional (Ingeniero Biomédico)-- Universidad Autónoma de Occidente, 2022 Pregrado Ingeniero(a) Biomédico(a)

Optical coherence tomography (OCT) has revolutionized ophthalmology over the past two decades. Comparable success in other medical and non-medical fields is still prevented by the high cost of OCT. Despite the benefit of OCT for other applications like dermatology, dentistry, and many industrial applications has been demonstrated, a poor cost/performance ratio compared to existing technologies is hindering its commercial success in these areas. The main cost driver of swept source OCT (SS-OCT) devices is the laser. We have identified a light source commonly used in telecom and consumer applications, which costs several magnitudes less than conventional swept sources and thereby enables low cost SS-OCT devices. We have developed a prototype of a SS-OCT system using this low cost source and MEMS scanners.

La tomografía computarizada es el estudio Gold standard para complementar a la endoscopia en el estudio de patologías laríngeas. Por lo tanto, se debe tener conocimiento de la anatomía normal de la laringe. En el presente trabajo se analizaron 26 tomografías de pacientes que acudieron al Servicio de Imágenes del Hospital de Clínicas sin patología laríngea. Se lograron identificar las características anatómicas radiológicas de la laringe buscadas en cada una de ellas. Siendo las características buscadas: Calcificación cartílagos laríngeos, Altura cartílago tiroideo, Distancia tiro-aritenoidea, Distancia interaritenoidea, Altura y diámetro del espacio preepiglótico.

Objective: Our aim was to describe the foot alignment in National Football League (NFL) players with different symptomatic foot and ankle pathologies using weightbearing cone-beam computed tomography (WBCBCT), comparing them to normally aligned feet as control group. Methods: 41 feet (36 active NFL players) were assessed using WBCBCT and compared to 20 normally aligned controls from a normal population. Measurements included: Foot and Ankle Offset (FAO); Calcaneal Offset (CO); Hindfoot Alignment Angle (HAA); angle between inferior and superior facets of the talus (Inftal-Suptal); angle between inferior facet of the talus and the horizontal/floor (Inftal-Hor); Forefoot Arch Angle (FAA); navicular- and medial cuneiform-to-floor distance. Results: NFL athletes showed a neutrally aligned hindfoot when compared to controls (FAO: 1% vs 0.5%; CO: 2.3 mm vs 0.8 mm; HAA: 2.9° vs 0.8° in two groups, with all p > 0.05) and a normal morphology of the subtalar joint (no difference in Inftal-Suptal and Inftal-Hor angles). Conversely, in athletes we found a decreased medial longitudinal arch (FAA: 15° vs 18.3°, p = 0.03) with smaller navicular (38.2 mm vs 42.2 mm, p = 0.03) and medial cuneiform (27 mm vs 31.3 mm, p = 0.01) mean distances to the floor when compared to controls. Conclusion: In our series, NFL players presented a lower medial longitudinal arch than controls but a neutrally aligned hindfoot. WBCBCT may help shed light on anatomical risk factors for injuries in professional players. Level of Evidence III, Retrospective comparative study. RESUMO Objetivo: Descrever o alinhamento do pé em jogadores da National Football League (NFL) com diferentes patologias sintomáticas do pé e tornozelo usando a tomografia computadorizada de feixe cônico com suporte de peso (weightbearing cone-beam computed tomography - WBCBCT), e comparar as medidas a grupo controle de voluntários com pés de alinhamento normal. Métodos: Quarenta pés (36 jogadores ativos da NFL) foram avaliados usando WBCBCT e comparados com 20 controles da população normal. As medidas incluíram: Offset do pé e tornozelo(FAO); Calcâneo Offset (CO); ângulo de alinhamento do retropé (HAA); ângulo entre as facetas inferior e superior do tálus (Inftal-Suptal); ângulo entre a faceta inferior do tálus e o solo (Inftal-Hor); ângulo do arco do antepé (FAA); distância navicular/solo e cuneiforme medial/solo. Resultados: Atletas da NFL mostraram retropé com alinhamento neutro quando comparados aos controles (FAO: 1% vs. 0,5%; CO:2,3mm vs. 0,8 mm; HAA: 2,9° vs. 0,8°, com todos p > 0,05) e morfologia normal da articulação subtalar (sem diferença nos ângulos Inftal-Suptal e Inftal-Hor). Por outro lado, observamos nos atletas profissionais um arco longitudinal medial diminuído (FAA: 15° vs. 18,3°,p=0,03) com distâncias médias do navicular/solo (38,2 mm vs. 42,2 mm, p = 0,03) e do cuneiforme medial/solo (27 mm vs. 31,3 mm, p = 0,01) menores quando comparados ao grupo controle. Conclusão: Em nossa série, os jogadores da NFL apresentaram um arco longitudinal medial diminuído em relação aos controles, mas um retropé neutro. WBCBCT pode ajudar a esclarecer os fatores de risco anatômicos para lesões em jogadores profissionais de elite. Nível de Evidência III, Estudo retrospectivo comparativo.

Introduction: Basketball sports will effect on the morphology and structure of the hand bones and joints. Objective: The article selected nine professional basketball players (basketball group) and 11 non-basketball players (control group) in the provincial youth team. A 64-row spiral computed tomography scan was used to scan the wrist and three-dimensional reconstruction. The volume of each carpal bone and the computed tomography value (bone density) were measured. Methods: To explore the influence of basketball sports on the hand bones and joints’ morphological structure, the paper analyzes the structural characteristics of the computed tomography images of young male basketball players’ wrist bones. Results: Compared with the carpal bones in the control group, the volume of the right navicular bone and the small polygonal bone, the left-hand navicular bone, the large triangular bone, and the small polygonal bone in the basketball group increased significantly (P

Mycoplasma pneumoniae is a frequent cause of upper and lower respiratory tract infections in children and young adults, accounting for up to 40% of community-acquired pneumonia cases. The diagnosis of community-acquired pneumonia is primarily clinical. Chest radiography is the gold standard for confirmation, but it is not routinely recommended. In severe cases, tomographic imaging is necessary. The objective of this work is to present the case of a patient with pneumonia caused by Mycoplasma pneumoniae acquired in the community who was treated at the Hospital de Cienfuegos. This is a 51-year-old man of white skin color, of urban origin, without toxic habits, with a personal pathological history of arterial hypertension for three years, with regular treatment; Type 2 diabetes mellitus, with glycemic control through diet, in addition to a referred history of venous insufficiency, which was admitted to the hospital for the diagnosis of atypical pneumonia. It progressed towards severity, but the proper use and interpretation of the clinical and imaging elements allowed the diagnosis of community-acquired pneumonia due to Mycoplasma pneumoniae to be reached. Adequate medical care and recovery of the patient was achieved.

Resumen Introducción. En Colombia el cáncer gástrico representa un problema de salud pública teniendo en cuenta su alta incidencia y sus elevadas tasas de mortalidad. Cerca del 15 % de los pacientes sufren una pérdida significativa de peso, lo que se asocia con un incremento en la morbilidad y mortalidad. Método. Se realizó un estudio de corte transversal, con el objetivo de determinar la presencia de sarcopenia a través de la medición del índice del psoas por tomografía computarizada y su asociación con morbimortalidad postoperatoria temprana en pacientes con cáncer gástrico. Se incluyeron los pacientes con cáncer gástrico admitidos entre el 1° de enero de 2014 y el 31 de agosto de 2019 en el Hospital Militar Central, en Bogotá, D.C., Colombia. Se hizo un análisis descriptivo, un análisis bivariado y un análisis de regresión logística univariado para determinar la asociación de sarcopenia y complicaciones a 30 días. Todos los análisis fueron realizados en R®. Resultados. Se estudiaron 70 pacientes, encontrando una frecuencia de sarcopenia de 54,3 % (n=38), edad media de 69 años (RIC 54 - 74), mayor proporción de hombres 68,6 % (n=48), siendo menor en el grupo de sarcopenia 55,3 % (n=21), índice de psoas de 0,63 mm (RIC 0,55 - 0,7), mortalidad 2,9 % (n=2) y asociación de sarcopenia con desenlaces a 30 días (OR 1,2; IC95% 0,59 - 2,4). Discusión. Se encontraron resultados similares a los informados en la literatura mundial, con una mortalidad inferior al 3 %. En este estudio, la sarcopenia no se asoció con la aparición de complicaciones a 30 días. Abstract Introduction. Gastric cancer represents a public health problem in Colombia considering its high incidence and high mortality rates. About 15% of patients suffer a significant weight loss, which is associated with an increase in morbidity and mortality. Method. A cross-sectional study was carried out in order to determine the presence of sarcopenia by measuring the psoas index by computed tomography and its association with early postoperative morbidity and mortality in patients with gastric cancer. Gastric cancer patients admitted between January 1, 2014 and August 31, 2019 at Hospital Militar Central, in Bogotá, D.C., Colombia were included. Descriptive analysis, bivariate analysis, and univariate logistic regression analysis were performed to determine the association of sarcopenia and complications at 30 days. All analyzes were performed in R®. Results. Seventy patients were studied, finding a frequency of sarcopenia of 54.3% (n=38), mean age of 69 years (IQR 54-74), higher proportion of men 68.6% (n=48), being lower in sarcopenia group 55.3% (n=21), psoas index of 0.63 mm (IQR 0.55 - 0.7), mortality 2.9% (n=2) and no association of sarcopenia with outcomes a 30 days (OR 1.2; 95% CI 0.59 - 2.4). Discussion. Similar results were found to those reported in the world literature, with a mortality of less than 3%. In this study, sarcopenia was not associated with the development of complications at 30 days.

Introducción: la causa de dolor abdominal mayormente relacionada a cirugía es la apendicitis; su diagnóstico se ve afectado por las variaciones anatómicas del apéndice vermiforme, debido a que es el órgano abdominal con mayores variaciones en cuanto a su posición y relación con otros órganos. Objetivo: determinar las características del apéndice cecal normal en tomografías computarizadas, incluidas la longitud, el diámetro, el grosor de la pared, y la ubicación de la base y de la punta apendicular. Métodos: se estudiaron tomografías computarizadas abdominales con imágenes del protocolo de exploración UroCT para identificar la localización de la base y la punta, y medir longitud, ancho y diámetro del apéndice cecal. La ubicación de la punta se categorizó como anterior o posterior y se subdividió en: pélvica, retrocecal/retrocólica, postileal, paracólica, subcecal, subhepática o línea media. La localización de la base apendicular se definió en tres planos en relación con la válvula ileocecal: antero-posterior, medial-lateral o superior-inferior. Resultados: fueron incluidas tomografías abdominales de 83 pacientes en las que se determinaron las características generales del apéndice cecal: se observó una longitud media de 78 mm (DE = 23,41) y diámetro medio de 6,55 mm (DE= 1,77). Las bases tuvieron con mayor frecuencia una localización inferior posterior, lateral y medial a la válvula ileocecal, las puntas estuvieron más frecuentemente localizadas en la cavidad pélvica, seguidas de localizaciones retrocecal y paracecal. Conclusión: la localización de la base del apéndice se correlaciona con lo descrito en estudios previos. No existe correlación entre la ubicación de la punta y la longitud del apéndice, esto significa que, incluso si el apéndice es largo, no se asocia con una ubicación de la punta más alejada de la válvula ileocecal.

Introdução: A tomografia computadorizada de feixe cônico (TCFC) auxilia a investigação de processos patológicos na Odontopediatria, sendo fundamental na estratégia do tratamento cirúrgico. Objetivo: Relatar o caso clínico de uma criança com ameloblastoma abordando o uso da TCFC no diagnóstico e plano de tratamento. Relato de caso: Trata-se do relato do caso clínico de uma paciente de 11 anos de idade diagnosticada com ameloblastoma. A criança foi encaminhada para a equipe de Cirurgia e Traumatologia Bucomaxilofacial das Obras Sociais Irmã Dulce, com dor e edema no lado esquerdo da face. Ao exame intraoral, observou-se dentição mista com higiene bucal satisfatória, bem como oclusão dentária classe I. A radiografia panorâmica evidenciou a presença de imagem radiolúcida com margens bem definidas, unilocular, associada a coroa do dente 37, com deslocamento dessa unidade em direção ao 36. Além disso, foi possível perceber o deslocamento da unidade 38 para a incisura mandibular. Na análise da TCFC, observou-se a expansão das corticais ósseas com afilamento e perfuração, evidenciando o caráter agressivo da lesão de extensão 30,0 x 26,0 x 57,85 mm. O diagnóstico de ameloblastoma do tipo plexiforme foi elucidado pelo exame anatomopatológico. Conclusão: A partir dessa análise proporcionada pela tomografia, foi possível constatar o caráter agressivo da lesão e o comprometimento dos tecidos ósseos circundantes e dentes adjacentes, orientando com precisão o plano de tratamento cirúrgico. O diagnóstico precoce e o conhecimento sobre a extensão das lesões são importantes para que haja um tratamento adequado e melhor prognóstico.

Odontomas are benign odontogenic tumors, and are divided into two types, compound and complex. The composite type is made up of multiple calcified structures, similar to miniature teeth. The complex type, on the other hand, consists of a mineralized mass, with no anatomical similarity to a tooth. Its most accepted etiology is related to trauma, infection or stress at the site of formation. To report a clinical case of composite odontoma removal in the maxilla. A male patient sought the dental clinic of Faculdade Verde Norte, with an indication for removal of an odontoma. Clinical examination revealed a slight bulging in the vestibular region of teeth 11 and 12. Computed tomography of the region was requested, where the location of the odontoma was confirmed, and due to the proximity to adjacent teeth and because it was a tumor of odontogenic origin, removal was chosen. After direct access to the odontoma, the entire fragment was surgically removed, where the procedure was performed without any complications. Surgical removal is the recommended treatment for both complex and composite odontomas, using the principles of extraction of impacted teeth. They are located in areas of difficult access and larger ones may present greater difficulty in their removal. The proposed treatment was effective and computed tomography is a complementary exam of great value in the diagnosis and surgical planning, due to its high resolution and precision. Odontomas son tumores odontogénicos benignos, y se dividen en dos tipos, compuestos y complejos. El tipo compuesto se compone de múltiples estructuras calcificadas, similares a los dientes en miniatura. El tipo complejo, por su parte, consiste en una masa mineralizada, sin similitud anatómica con un diente, su etiología más aceptada está relacionada con trauma, infección o estrés en el sitio de formación. Reportar un caso clínico de remoción de odontoma compuesto en maxilar. Un paciente del sexo masculino acudió a la clínica odontológica de la Faculdade Verde Norte, con indicación de remoción de un odontoma. Al examen clínico se evidenció un ligero abombamiento en la región vestibular de los dientes 11 y 12. Se solicitó tomografía computarizada de la región, donde se confirmó la ubicación del odontoma, y ??por la proximidad a los dientes adyacentes y por tratarse de un tumor de origen odontogénico , se optó por la eliminación. Luego del acceso directo al odontoma, se procedió a la extirpación quirúrgica de todo el fragmento, donde se realizó el procedimiento sin complicaciones. La extracción quirúrgica es el tratamiento recomendado tanto para odontomas complejos como compuestos, utilizando los principios de extracción de dientes impactados. Se ubican en zonas de difícil acceso y las de mayor tamaño pueden presentar mayor dificultad en su remoción. El tratamiento propuesto fue efectivo y la tomografía computarizada es un examen complementario de gran valor en el diagnóstico y planificación quirúrgica, por su alta resolución y precisión. Odontomas são tumores odontogênicos benignos, e são divididos em dois tipos, composto e complexo. O tipo composto é constituído por múltiplas estruturas calcificadas, semelhantes a dentes em miniatura. Já o tipo complexo constitui-se de uma massa mineralizada, sem semelhança anatômica com dente Sua etiologia mais aceita está relacionada a trauma, infecção ou estresse no local de formação. O objetivo deste trabalho foi relatar um caso clínico de remoção de odontoma composto em maxila. Paciente do sexo masculino procurou a clínica odontológica da Faculdade Verde Norte, com indicação de remoção de um odontoma. Ao exame clínico observou-se discreto abaulamento na região vestibular dos dentes 11 e 12. Foi solicitada tomografia computadorizada da região, onde se confirmou a localização do odontoma, e devido à proximidade com dentes adjacentes e por se tratar de um tumor de origem odontogênica, optou-se pela remoção. Após o acesso direto ao odontoma, foi realizada remoção cirúrgica de todo fragmento, onde o procedimento foi realizado sem nenhuma complicação. A remoção cirúrgica é o tratamento recomendado tanto para os odontomas complexos e compostos, utilizando os princípios de extração de dentes inclusos. São localizados em áreas de difícil acesso e de maior porte podem vir apresentar uma maior dificuldade em sua remoção. O tratamento proposto foi eficaz e a tomografia computadorizada é um exame complementar de grande valia no diagnóstico e no planejamento cirúrgico, devido à alta resolução e precisão.

Purpose: To determine normal corneal tomographic parameters in children and adolescents without corneal disease or atopy diagnosis. Methods: This descriptive cross-sectional study evaluated patients aged 8-16 years who underwent a complete slit-lamp biomicroscopic examination and tomographic corneal evaluation by a dual Scheimpflug analyzer, excluding those with ocular disease (including allergic conjunctivitis) or a positive prick test for systemic atopies. Results: A total of 170 patients were evaluated, and 34 patients (68 eyes) were analyzed once the exclusion criteria were applied. The sample’s mean age was 10.76 ± 2.31 years; with 19 (55.9%) men and 15 (44.1%) women. The mean keratometry in the flat meridian (Kflat), steep meridian (Ksteep), and maximum (Kmax) were 42.37 ± 1.63D, 43.53 ± 1.65D, and 43.90 ± 1.73D, respectively. The mean values for corneal asphericity (ε2) and thinnest point were 0.28 ± 0.11 and 550.20 ± 37.90 μm, respectively. The inferior-superior asymmetry ratio (I-S) and coma were 0.74 ±0.59D and 0.28 ± 0.12D, respectively. Conclusion: The knowledge of normal corneal tomographic parameters and their variation in children and adolescents without corneal disease or atopy may be useful for diagnosing keratoconus and initiating early disease treatment. RESUMO Objetivo: Identificar parâmetros tomográficos de normalidade em córneas de crianças e adolescentes sem a presença de atopias sistêmicas e alergias oculares. Métodos: Este estudo descritivo transversal avaliou pacientes com idade entre 8 e 16 anos que foram submetidos a exame biomicroscópico completo por lâmpada de fenda e avaliação tomográfica da córnea por tomógrafo dual Scheimpflug, excluindo pacientes com doença ocular (incluindo conjuntivite alérgica) ou prick test positivo para atopias sistêmicas. Resultados: Cento e setenta pacientes foram avaliados e após cumpridos os critérios de exclusão, 34 (68 olhos) foram analisados. A média etária da amostra foi 10,76 ± 2,31 anos; 19 (55,9%) eram meninos e 15 (44,1%) meninas. A média da ceratometria em dioptrias (D) no meridiano mais plano (Kflat), mais curvo (Ksteep) e máxima (Kmax) foram 42,37 ± 1,63D, 43,53 ± 1,65D e 43,90 ± 1,73D, respectivamente. Os valores médios da asfericidade corneana (ε2) e do ponto mais fino da córnea foram 0,28 ± 0,11 e 550,20 ± 37,90 micras (μm). A assimetria corneana inferior-superior (I-S) e coma foi em média 0,74 ± 0,59D e 0,28 ± 0,12D, respectivamente. Conclusão: O conhecimento dos valores médios e sua variação de parâmetros tomográficos da córnea em crianças e adolescentes sem atopias sistêmicas ou alergias oculares pode ser útil para o diagnóstico precoce do ceratocone e o seu tratamento em estágio inicial.

If the integrals of a one-form over all lines meeting a small open set vanish and the form is closed in this set, then the one-form is exact in the whole Euclidean space. We obtain a unique continuation result for the normal operator of the X-ray transform of one-forms, and this leads to one of our two proofs of the partial data result. Our proofs apply to compactly supported covector-valued distributions., Comment: 15 pages, 1 figure. Final version

La informació és el recurs més valuós mundialment [1], i és possible trobar-la a tot arreu. En el cas de les imatges mèdiques, la informació significa no només imatges de giga píxels, sinó que també inclou metadades i mesures quantitatives [2]. DICOM (Digital Imaging and Communications in Medicine) és una clara font d’informació, ja que es tracta del Standard per emmagatzemar i transmetre imatges mèdiques [2] i la informació relacionada [3]; això significa que conté dades d’imatges sense processar i metadades relacionades amb els procediments que es donen a terme amb l’adquisició i curació de la imatge [2]. Una de les dades més rellevants que es poden trobar en un arxiu DICOM són els paràmetres de dosi de radiació. Actualment, ni les Directives Europees ni les Regulacions Espanyoles estableixen límits en la dosi de radiació per a pacients sota processos de diagnòstic ni tractament. Està científicament demostrat que les radiacions ionitzants tenen efectes nocius en la salut humana [4], i per això s’han de prendre mesures com abans possible. Aquestes accions comencen per poder quantificar la radiació rebuda pel pacient en diferents estudis al llarg del temps, cosa que es pot fer fent ús d’una taula de metadades DICOM. Aquest projecte fa èmfasi en l’anàlisi de les metadades generades per Tomografia Computeritzada per comprovar la qualitat de la informació i veure si és possible estimar la quantitat dosimètrica que té en compte la sensibilitat biològica del teixit irradiat i reflecteix el risc d’una exposició no uniforme de cos sencer: la Dosi Efectiva [5]. Finalment, amb aquesta avaluació, és possible definir passos futurs per al desenvolupament d’una eina digital capaç d’analitzar dades relacionades amb radiació i controlar el risc de la ionització per a qualsevol tipus d’examinació mèdica. La información es el recurso más valioso mundialmente [1], y es posible encontrarla en todas partes. En el caso de las imágenes médicas, la información significa no solo imágenes de giga píxeles, sino que también incluye metadatos y medidas cuantitativas [2]. DICOM (Digital Imaging and Communications in Medicine) es una clara fuente de información, ya que se trata del estándar para almacenar y transmitir imágenes médicas [2] e información relacionada [3]; esto significa que contiene datos de imágenes sin procesar y metadatos relacionados con los procedimientos que se llevan a cabo durante la adquisición y curación de la imagen [2]. Uno de los datos más relevantes que se puede encontrar en un archivo DICOM son los parámetros de dosis de radiación. Actualmente, ni las Directivas Europeas ni Regulaciones Españolas establecen límites en la dosis de radiación para pacientes ante procesos de diagnóstico ni tratamiento. Está científicamente comprobado que las radiaciones ionizantes tienen efectos nocivos en la salud humana [4], por lo que se tienen que tomar medidas lo antes posible. Estas acciones empiezan con poder cuantificar la radiación recibida por el paciente en diferentes estudios a lo largo del tiempo, lo cual se puede conseguir haciendo uso de una tabla de metadatos DICOM. Este proyecto hace énfasis en el análisis de los metadatos generados por Tomografía Computarizada para comprobar la calidad de la información y ver si es posible estimar una cantidad dosimétrica que tiene en cuenta la sensibilidad biológica del tejido irradiado y refleja el riesgo de una exposición no uniforme de cuerpo completo: la Dosis Efectiva [5]. Finalmente, con esta evaluación, es posible definir pasos futuros para el desarrollo de una herramienta digital capaz de analizar datos relacionados con la radiación y controlar el riesgo de dicha ionización para cualquier tipo de examinación médica. Data is the world’s most valuable resource [1], and it is possible to find data everywhere. In medical images, data covers not only gigapixel images, but also metadata and quantitative measurements [2]. DICOM (Digital Imaging and Communications in Medicine) is a clear source of medical data, since it is the current standard for storing and transmitting medical images [2] and related information [3]; this means it contains raw data imaging and all metadata related to the procedures of image acquisition and curation [2]. Some of the most relevant information found on DICOM files relies on radiation dose parameters. In the current defined Directives and Regulations, no limits on the radiation dose are stipulated for patients undergoing diagnostic nor treatment procedures. There is proof that ionizing radiation has direct implications in human health [4], which is why measures need to be taken as soon as possible. These actions start with being able to quantify the radiation received by a patient in studies over time, which can be done by means of a DICOM dataset of metadata. The main focus of this project is to analyze Computerized Tomography (CT) scans generated metadata in order to check the quality of the data and then be able to estimate a dosimetric quantity that takes into account the biological sensitivity of the irradiated tissue and reflects the risk of a non-uniform whole-body exposure: the Effective Dose [5]. Finally, with this evaluation, it is possible to define the future steps for the development of a digital tool to analyze radiation-related data and risk control of ionizing radiation expanded for all type of medical examinations.

Endodontics is a branch of dentistry, which consists of treating the dental pulp, being important to make a correct diagnosis, collecting all the signs and symptoms. The upper first premolars present anatomical variations and there are probably failures during said therapy due to ignorance of it. According to several studies carried out through radiographs, diaphanizations and computed tomography, the upper first premolars can present three roots and three canals which vary from 0.5 to 6%, this anatomical variant being infrequent. To perform root canal treatment of a maxillary first premolar with 3 canals with the help of computed tomography. An 18-year-old male patient attends the FOUCE clinic for root canal treatment. When performing the intraoral exploration of the right maxillary first premolar, it showed coronal loss, negative thermal tests and positive to the vertical percussion test, in periapical radiography unusual anatomy is shown, computed tomography is performed locating 3 ducts: mesio-vestibular duct, disto-vestibular duct and palatine. Subsequently, the bio-chemo-mechanical preparation was carried out with manual protapper files, final irrigation protocol, thus ending with the obturation with the lateral technique. Thanks to the 3D image of the tomography, the mesio-vestibular, disto-vestibular, and palatal ducts will be detected, preventing a possible perforation due to the morphological complexity of this dental organ. Computed tomography is a test used for anatomical variations of dental organs, avoiding mistakes in the diagnosis and location of canals. La endodoncia es una rama de la odontología que consiste en realizar un tratamiento a la pulpa dental. Es importante realizar un correcto diagnóstico. Los primeros premolares superiores presentan variaciones anatómicas no muy comunes y probablemente ellas lleven al fracaso del tratamiento. De acuerdo a varios estudios realizados a través de radiografías, diafanizaciones y tomografías computarizadas, los primeros premolares superiores pueden presentar tres raíces y tres conductos los cuales varían de 0,5 a 6%, siendo poco frecuente esta variante anatómica. Realizar el tratamiento de conductos de un primer premolar superior con tres conductos con la ayuda de la tomografía computarizada. Paciente masculino de 18 años, acude a la clínica de la FOUCE para tratamiento de conductos. Al realizar la exploración intraoral del primer premolar maxilar derecho mostró pérdida coronal, pruebas térmicas negativo y positivo a la prueba de percusión vertical, en radiografía periapical se muestra anatomía inusual, se realiza tomografía computarizada localizando tres conductos: conducto mesiovestibular, distovestibular y palatino. Posteriormente se realizó la preparación bio-quimio-mecánica con limas protapper manuales, protocolo de irrigación final terminando así con la obturación con técnica lateral. La imagen 3D de la tomografía logró localizar el conducto mesiovestibular, distovestibular y palatino, impidiendo una posible perforación de este órgano dentario. La tomografía computarizada es un examen utilizado para observar variaciones anatómicas de órganos dentales, evitando cometer errores en el diagnóstico y localización de conductos.

Introducció: La síndrome de Cushing és un trastorn hormonal causat per l'exposició d'altes concentracions de cortisol al cos del pacient, tenint una incidència d'origen endogen de 2 a 4 casos per milió d'habitants/any [2]. Entre un 19 a 50% dels pacients que el pateixen també pateixen osteoporosi [2]. Actualment, per mitjà de mètodes no invasius i fent ús d'imatges diagnòstiques, plataformes i programaris especialitzats es poden analitzar les propietats mecàniques dels ossos. Mètodes: Mitjançant els programes MATLAB, FEBio i GIBBON s'efectua l'anàlisi d'elements finits seguint una sèrie de passes Primer, el procés de segmentació es duu a terme amb imatges DICOM. Seguit a això i per mitjà d'un Image Segmentation Widget es genera el contorn del fèmur. Com a tercer pas, s'obtindran tant la malla superficial com la malla volumètrica amb elements tetraèdrics. Finalment, i amb l'ajuda de models de simulació es realitza la interpolació. D’altra banda, s’implementa un codi sobre MATLAB que compara el valor obtingut del mòdul de Young d’interpolació lineal amb el mètode de dimensió fractal. Resultats: Es realitza l’estudi de models de pacients sans i amb Síndrome de Cushing mitjançant la propietat mecànica que determina la càrrega externa per deformar el fèmur. S'aplica el criteri de tensió de von Mises i es comparen els pacients. També s'efectua una anàlisi quantitativa entre la distribució del mòdul de Young amb interpolació lineal i dimensió fractal. Conclusions: En conclusió, la zona cortical del fèmur en pacients amb síndrome de Cushing és més propensa a deformar-se segons l’anàlisi obtinguda al mòdul de Young. Segons el criteri de Von Mises la tensió màxima augmenta si s’aplica una forca inclinada a la superfície del cap del fèmur. El mètode de dimensió fractal i interpolació lineal proveeixen resultats molt semblants Introducción: El síndrome de Cushing es un trastorno hormonal causado por la exposición de altas concentraciones de cortisol en el cuerpo del paciente, teniendo una incidencia de origen endógeno de 2 a 4 casos por millón de habitantes/año [2]. Entre un 19 a 50% de los pacientes que lo padecen también sufren de osteoporosis [2]. Actualmente, por medio de métodos no invasivos y haciendo uso de imágenes diagnósticas, plataformas y softwares especializados se puede analizar las propiedades mecánicas de los huesos. Métodos: Mediante los programas MATLAB, FEBio y GIBBON se efectúa el análisis de elementos finitos siguiendo una serie de pasos Primero, el proceso de segmentación se lleva a cabo con imágenes DICOM. Seguido a esto y por medio de un Image Segmentation Widget se genera el contorno del fémur. Como tercer paso, se obtendrán tanto la malla superficial como la malla volumétrica con elementos tetraédricos. Por último, y con la ayuda de modelos de simulación se realiza la interpolación. Por otra parte, se implementa un código sobre MATLAB que compara el valor obtenido del módulo de Young de interpolación lineal con el método de dimensión fractal. Resultados: Se realiza el estudio de modelos de pacientes sanos y con Síndrome de Cushing mediante la propiedad mecánica que determina la carga externa para deformar el fémur. Se aplica el criterio de tensión de von Mises y se comparan los pacientes. También se efectúa un análisis cuantitativo entre la distribución del módulo de Young con interpolación lineal y dimensión fractal. Conclusiones: En conclusión, la zona cortical del fémur en pacientes con síndrome de Cushing es más propensa a deformarse según el análisis obtenido en el módulo de Young. Según el criterio de Von Mises la tensión máxima aumenta si se aplica una fuerza inclinada en la superficie de la cabeza del fémur. El método de dimensión fractal e interpolación lineal proveen resultados muy similares. Introduction: Cushing's syndrome is a hormonal disorder caused by exposure to high concentrations of cortisol in the patient's body, with an endogenous incidence of 2 to 4 cases per million inhabitants/year [2]. Between 19 to 50% of patients who suffer from it also suffer from osteoporosis [2]. Currently, through non-invasive methods and using diagnostic images, specialized platforms and software, the mechanical properties of bones can be analyzed. Methods: Using the MATLAB, FEBio and GIBBON programs, the finite element analysis is carried out following a series of steps First, the segmentation process is carried out with DICOM images. Following this and by means of an Image Segmentation Widget, the outline of the femur is generated. As a third step, both the surface mesh and the volumetric mesh with tetrahedral elements will be obtained. Finally, and with the help of simulation models, the interpolation is performed. On the other hand, a code is implemented on MATLAB that compares the value obtained from Young's modulus of linear interpolation with the fractal dimension method. Outcomes: For the analysis of results, the bone symmetry is initially projected as a linear elastic isotrope. The study of models of healthy patients and those with Cushing's Syndrome is carried out through the mechanical property that determines the external load to deform the femur. The von Mises stress criterion is applied and the patients are compared. A quantitative analysis between the Young's modulus distribution with linear interpolation and fractal dimension is also performed. Conclusions: In conclusion, the cortical area of the femur in patients with Cushing’s Syndrome is more prone to deformation according to the analysis obtained in Young’s modulus. According to Von Mise’s criterion, the maximum stress increases if an inclined force is applied to the surface of the head of the femur. The fractal dimension method and linear interpolation provide very similar results.

OBJECTIVE: The aim of the present study was to establish the tomographic limit of lung overdistention in normal individuals as well as to assess positive end-expiratorypressure-induced overdistention and alveolar recruitment in patients with acute lung injury.MATERIALS AND METHODS: Lung distention was first determined in six healthy volunteers in whom computed tomographic sections were obtained at functionalresidual capacity and total lung capacity with a positive airway pressure of 30 cmH2O. Tomographic scans at zero end-expiratory pressure and positive end-expiratorypressure were performed in six patients with acute lung injury. Computed tomographies were performed from the apex to the diaphragm and lung volumes were quantified by the analysis of the density histograms.RESULTS: Analysis of the density histograms in healthy volunteers was monophasic with a peak at -791 ± 12 Housenfield units. In total lung capacity, lung volumeincreased by 79 ± 35% and the peak of lung density decreased to -886 ±26 Housenfield units. More than 70% of the increase in lung volume was located below-900 Housenfield units, suggesting that this value can be considered as the threshold separating normal aeration from overdistention. In patients with acute lung injury, atzero end-expiratory pressure the distribution of density histograms was either monophasic (n=3) or biphasic (n=3), with mean density of -319 ± 34 Housenfieldunits. With positive end-expiratory pressure application, lung volume increased by 47 ± 19%, while lung density decreased to -538 ± Housenfield units. Positive endexpiratory pressure induced a mean alveolar recruitment of 238 ±320 ml.CONCLUSIONS: The limit of overdistention in healthy individuals was -900 Housenfield units. This threshold can be used in patients with acute lung injury fordifferentiating alveolar recruitment from lung overdistention., OBJETIVO: O objetivo do presente estudo foi determinar o limite tomográfico da hiperdistensão pulmonar em indivíduos normais, bem como avaliar o recrutamentoe a hiperdistensão pulmonares induzidos pela pressão expiratória final positiva em pacientes com lesão pulmonar aguda.MATERIAIS E MÉTODOS: Inicialmente, o limite da hiperdistensão pulmonar foi determinado em seis voluntários sadios, nos quais tomografias computadorizadas espiraladas de tórax foram obtidas em capacidade residual funcional e em capacidadepulmonar total mais pressão positiva de 30 cm H2O. Posteriormente, foram avaliados seis pacientes com lesão pulmonar aguda nos quais as tomografias foram obtidas em zero de pressão expiratória final positiva e em pressão expiratória final positiva. As tomografias computadorizadas foram realizadas do ápex ao diafragma, e os volumes pulmonares quantificados por análise dos histogramas de densidade.RESULTADOS: A análise dos histogramas de densidade em voluntários sadios em capacidade residual funcional mostrou histogramas monofásicos, com um pico em-791 + 12 UH. Em capacidade pulmonar total, o volume pulmonar aumentou em 79 + 35% e o pico das densidades pulmonares caiu para -886 + 26 UH. Mais de 70% do aumento no volume pulmonar foi localizado abaixo de -900 UH, sugerindo que este valor possa ser definido como o limite da hiperdistensão. Os pacientes com lesão pulmonar aguda mostraram em zero de pressão expiratória final positiva uma distribuição monofásica (n=3) ou bifásica (n=3), com densidades pulmonares médias situadas em 319 + 34 UH. Com a aplicação de pressão expiratória final positiva, ovolume pulmonar aumentou em 47 + 19%, enquanto que as densidades pulmonares caíram para -538 + 171 UH. Pressão expiratória final positiva induziu um recrutamento alveolar de 320 + 160 ml e uma hiperdistensão de 238 + 320 ml.CONCLUSÕES: O limite de hiperdistensão em voluntários sadios foi de -900 UH. Este limite pode ser usado em pacientes com lesão pulmonar aguda para diferenciarrecrutamento alveolar de hiperdistensão pressão expiratória final positiva induzidos.

Lo studio degli ioni ed elettroni veloci è fondamentale per il successo della prossima generazione di tokamak di grande dimensione, come ITER, che mirano a dimostrare la possibilità di produrre energia attraverso la fusione termonucleare. Siano essi accelerati dal riscaldamento ausiliario o nati da reazioni di fusione, gli ioni possono raggiungere energie nell’ordine dei MeV. Questa energia viene poi trasmessa al plasma attraverso collisioni, aumentandone l’energia media e il rateo delle reazioni di fusione. È quindi cruciale migliorare il confinamento degli ioni veloci e sviluppare schemi di riscaldamento efficienti. Gli elettroni, invece, possono raggiungere velocità relativistiche se accelerati da campi elettrici induttivi generati durante disruzioni di plasma. Questi elettroni runaway rappresentano una minaccia per l'integrità strutturale dei tokamak di grandi dimensioni e necessitano di essere mitigati. Questa tesi tratta di metodi di deconvoluzione applicati alla ricostruzione della distribuzione delle particelle veloci a partire dall’emissione di radiazione nel range di energia del MeV. La deconvoluzione è stata declinata in due modi: unfolding della distribuzione di velocità degli elettroni runaway a partire dalla loro radiazione di bremsstrahlung, e tomografia della distribuzione di densità di ioni veloci o elettroni runaway a partire dalla misura dei loro profili di emissione fatta con linee di vista multiple. Questi algoritmi sono stati implementati in una libreria Python open source. Quattro algoritmi per l’unfolding sono stati implementati: singular value decomposition, maximum likelihood - expectation maximization, regolarizzazione di Tikhonov and di Poisson. La matrice di probabilità necessaria per svolgere queste inversioni è stata calcolata usando il codice GENESIS per stimare la probabilità di emettere fotoni di bremsstrahlung, e il codice MCNP per calcolare la funzione di risposta del detector. Queste funzioni di risposta sono state calcolate per tutte le diagnostiche hard X-ray installate nei tokamak Joint European Torus ed ASDEX Upgrade. I quattro metodi sono stati comparati su spettri sintetici e sperimentali, questi ultimi misurati ad ASDEX Upgrade. Maximum likelihood - expectation maximization si è dimostrato il più accurato sia nella ricostruzione della distribuzione in energia degli elettroni runaway, sia nel calcolo della loro energia media e massima. È stata inoltre studiato l’effetto del taglio a basse energie applicato ai dati sperimentali e il numero minimo di conteggi nello spettro necessario per svolgere una ricostruzione. In vista di una futura ricostruzione in 2D della distribuzione delle velocità degli elettroni runaway, sono state calcolate le matrici di probabilità come funzioni dell’energia e del pitch degli elettroni per tutte le diagnostiche hard X-ray installate a JET. I risultati sono presentati col formalismo delle weight-function, che permette di studiare la sensitività del detector a elettroni con energia e pitch differenti. Le matrici riportate mostrano un picco di sensitività per particelle aventi pitch-angolo uguale all’angolo racchiuso tra linea di vista del detector e il campo magnetico. Fast particles, both electrons and ions, play an important role for the success of the next generation of large tokamak devices, such as ITER, that will prove the feasibility of magnetically confined thermonuclear fusion as an energy source. Ions accelerated by external heating or born in fusion reactions can reach energies in the MeV range. Their primary role is to sustain the plasma temperature and the fusion reaction rate, thus lots of efforts have been put into the development of efficient heating schemes and in the improvement of their confinement. On the other hand, during fast terminations of plasma pulses on tokamaks, electrons can accelerate to relativistic velocities, entering the runaway regime. Runaway electrons have enough energy to seriously damage the plasma facing components of large tokamaks, thus mitigation techniques are under study in view of ITER operations. This thesis focuses on the implementation of deconvolution techniques for the reconstruction of the fast particles distributions from their emission in the MeV energy range. The problem was approached from two different perspectives: the unfolding of the runaway electrons velocity-space distribution from spectroscopic measurements of their bremsstrahlung emission, and the tomographic reconstruction of the density distribution of both fast ions and runaway electrons from the integrated measurement of their emission performed with multiple lines of sight. These algorithms were implemented in an open source Python library. Four deconvolution algorithms were implemented for the unfolding of runaway electrons energy distribution: singular value decomposition, maximum likelihood - expectation maximization, Tikhonov regularization and Poissonian regularization. The transfer matrix necessary for this inversion was calculated using the GENESIS code for estimating the probability of bremsstrahlung emission and the MCNP code for computing the detector response function. The detector response function was calculated for all the hard X-rays diagnostics systems installed at the Joint European Torus and ASDEX Upgrade tokamaks. The performance of the four methods wes then compared over both synthetic and experimental spectra, the latter being measured at ASDEX Upgrade. Maximum likelihood - expectation maximization was found to be the most accurate in the reconstruction of both the runaway electrons energy distribution and their average and maximum energies. The robustness of the four methods against experimental limitations, such as low-energy cut and low statistics, was also investigated. In the path towards the generalization of these unfolding algorithms to the reconstruction of the runaway electrons 2D velocity-space distribution, the transfer matrices in energy and pitch were calculated for all the hard X-ray diagnostics installed at JET. The weight-function formalism was adopted, which allows studying the sensitivity of the detectors to different energy and pitch regions. The matrices showed a sensitivity peak in the pitch axis which is determined by the angle between the line of sight and the magnetic field. Finally, the gamma camera upgrade installed at the Joint European Torus, with its 10 by 9 lines of sight that observe a poloidal section of the tokamak from two perpendicular projections, allows reconstructing the spatial distribution of fast particles. A tomographic algorithm that makes use of smoothing along the magnetic field lines was implemented. This tomography was first applied to recent three-ion radio frequency heating experiments in D-3He mixed plasmas, during which the gamma camera was able to detect the 16.4 MeV γ-rays from 3He(D,γ)5Li reactions. The spatial distribution of the α-particles born in 3He(D,p)4He reactions was reconstructed and the results were used to validate TRANSP simulations. The tomographic algorithm was also applied to the reconstruction of the runaway electrons spatial profiles during plasma disruptions.

Objective: To investigate the correlation of HRCT findings with pulmonary metabolic activity in the corresponding regions using 18F-FDG PET/CT and inflammatory markers in patients with systemic sclerosis (SSc)-associated interstitial lung disease (ILD). Methods: This was a cross-sectional study involving 23 adult patients with SSc-associated ILD without other connective tissue diseases. The study also involved 18F-FDG PET/CT, HRCT, determination of serum chemokine levels, clinical data, and pulmonary function testing. Results: In this cohort of patients with long-term disease (disease duration, 11.8 ± 8.7 years), a nonspecific interstitial pneumonia pattern was found in 19 (82.6%). Honeycombing areas had higher median standardized uptake values (1.95; p = 0.85). Serum levels of soluble tumor necrosis factor receptor 1, soluble tumor necrosis factor receptor 2, C-C motif chemokine ligand 2 (CCL2), and C-X-C motif chemokine ligand 10 were higher in SSc patients than in controls. Serum levels of CCL2-a marker of fibroblast activity-were correlated with pure ground-glass opacity (GGO) areas on HRCT scans (p = 0.007). 18F-FDG PET/CT showed significant metabolic activity for all HRCT patterns. The correlation between serum CCL2 levels and GGO on HRCT scans suggests a central role of fibroblasts in these areas, adding new information towards the understanding of the mechanisms surrounding cellular and molecular elements and their expression on HRCT scans in patients with SSc-associated ILD. Conclusions: 18F-FDG PET/CT appears to be unable to differentiate the intensity of metabolic activity across HRCT patterns in chronic SSc patients. The association between CCL2 and GGO might be related to fibroblast activity in these areas; however, upregulated CCL2 expression in the lung tissue of SSc patients should be investigated in order to gain a better understanding of this association. RESUMO Objetivo: Investigar a correlação entre achados de TCAR e a atividade metabólica pulmonar nas regiões correspondentes por meio de PET/TC com 18F-FDG e marcadores inflamatórios em pacientes com doença pulmonar intersticial (DPI) associada à esclerose sistêmica (ES). Métodos: Estudo transversal envolvendo 23 pacientes adultos com DPI associada à ES sem outras doenças do tecido conjuntivo. O estudo também envolveu PET/TC com 18F-FDG, TCAR, dosagem sérica de quimiocinas, dados clínicos e testes de função pulmonar. Resultados: Nessa coorte de pacientes com doença de longa duração (11,8 ± 8,7 anos), 19 (82,6%) apresentaram o padrão de pneumonia intersticial não específica. A mediana dos valores padronizados de captação foi maior nas áreas de faveolamento (1,95; p = 0,85). Os níveis séricos de soluble tumor necrosis factor receptor 1, soluble tumor necrosis factor receptor 2, C-C motif chemokine ligand 2 (CCL2) e C-X-C motif chemokine ligand 10 foram maiores nos pacientes com ES que nos controles. Os níveis séricos de CCL2 - um marcador de atividade fibroblástica - correlacionaram-se com áreas de opacidade em vidro fosco (OVF) pura na TCAR (p = 0,007). A PET/TC com 18F-FDG mostrou atividade metabólica significativa para todos os padrões de TCAR. A correlação entre níveis séricos de CCL2 e OVF na TCAR sugere que os fibroblastos desempenham um papel fundamental nessas áreas, acrescentando novas informações para a compreensão dos mecanismos que envolvem elementos celulares e moleculares e sua expressão na TCAR em pacientes com DPI associada à ES. Conclusões: A PET/TC com 18F-FDG aparentemente não consegue diferenciar a intensidade da atividade metabólica nos diferentes padrões de TCAR em pacientes com ES crônica. A associação entre CCL2 e OVF pode estar relacionada à atividade fibroblástica nessas áreas; entretanto, a expressão suprarregulada de CCL2 no tecido pulmonar de pacientes com ES deve ser investigada para que se compreenda melhor essa associação.

In this study, we aimed to identify factors associated with performing dental imaging examinations in public health services. Brazilian data at the municipal level (n = 5,564) in two time periods, P0 (2005–2007) and P1 (2014–2016), were collated from health information systems. The increase in the municipal rates of intraoral and extraoral radiographic imaging procedures was the outcome. Changes in the use of clinical procedures and the rates of dentists and equipment were the main predictors. Multiple logistic regression analysis was performed to estimate the adjusted odds ratio (OR). Approximately 35.3% of the Brazilian municipalities increased the dental radiography equipment rate, 9.9% increased the fan-beam computed tomography (CT) equipment rate, and 5.9% increased the magnetic resonance imaging (MRI) equipment rate. In addition, 31.8% increased the periapical/interproximal radiography rate, 10.5% increased the CT rate, and 4.4% increased the MRI rate. Increases in the dental radiography, CT, and MRI rates were associated with higher chances of periapical/interproximal images (OR = 1.90, p < 0.01), face and neck images (OR =1 5.3, p < 0.01), and MR images (OR = 18.1, p < 0.01), respectively. Municipalities that increased the rates of endodontists increased the rates of periapical/interproximal (OR = 2.50, p < 0.01) and occlusal (OR = 1.60, p < 0.01) imaging procedures, and those that increased the rates of radiologists also increased the rates of occlusal (OR = 2.00, p < 0.01) and panoramic (OR = 1.70, p < 0.01) imaging procedures. The implementation of a secondary dental care center, Centro de Especialidades Odontológicas (CEO) was associated with an increase in the chances of performing periapical/interproximal and panoramic radiographic procedures in 1.5 and occlusal radiographic examinations in 2.0. The rates of dentists, equipment, specialized dental centers, and specific dental procedures were associated with the increased use of imaging procedures in dentistry in the Brazilian public health system.

Abdominal wall (AW) hernias are a common problem faced by general surgeons. With an essentially clinical diagnosis, abdominal hernias have been considered a simple problem to be repaired. However, long-term follow-up of patients has shown disappointing results, both in terms of complications and recurrence. In this context, preoperative planning with control of comorbidities and full knowledge of the hernia and its anatomical relationships with the AW has gained increasing attention. Computed tomography (CT) appears to be the best option to determine the precise size and location of abdominal hernias, presence of rectus diastase and/or associated muscle atrophy, as well as the proportion of the hernia in relation to the AW itself. This information might help the surgeon to choose the best surgical technique (open vs MIS), positioning and fixation of the meshes, and eventual need for application of botulinum toxin, preoperative pneumoperitoneum or component separation techniques. Despite the relevance of the findings, they are rarely described in CT scans as radiologists are not used to report findings of the AW as well as to know what information is really needed. For these reasons, we gathered a group of surgeons and radiologists to establish which information about the AW is important in a CT. Finally, a structured report is proposed to facilitate the description of the findings and their interpretation. RESUMO Hérnias da parede abdominal são um problema bastante comum enfrentado pelo cirurgiões gerais. De diagnóstico essencialmente clínico, as hérnias abdominais durante muito tempo têm sido consideradas um problema de simples reparo. Entretanto, o acompanhamento de longo prazo dos pacientes têm demonstrado resultados desapontadores, tanto em termos de complicações quanto risco de recidiva da hérnia. Neste contexto, o planejamento pré-operatório com controle de comorbidades e pleno conhecimento da hérnia e suas relações anatômicas com a parede abdominal têm ganho cada vez mais atenção. A tomografia de abdome parece ser a melhor opção para determinar o tamanho e localização precisos das hérnias abdominais, presença de diastase de músculo reto e/ou atrofia da parede associada, assim como proporção da hérnia em relação a parede abdominal. Essas informações podem auxiliar o cirurgião na escolha da melhor técnica cirúrgica (aberta vs. MIS), posicionamento e fixação das telas, e eventual necessidade de aplicação de toxina botulínica, pneumoperitônio pré-operatório ou técnicas de separação de componentes. Apesar da relevância dos achados, eles são raramente descritos em exames de tomografia uma vez que os radiologistas não estão acostumados a olhar para a parede abdominal assim como não sabem quais as informações são realmente necessárias. Por estes motivos, nós reunimos um grupo de cirurgiões e radiologistas visando estabelecer quais são as informações da parede abdominal mais importantes em um exame de tomografia assim como propor um laudo estruturado para facilitar a descrição dos achados e sua interpretação.

La calcificación parcial o total de la pulpa es un hallazgo común en diferentes tipos de dientes, y es a menudo asociado con la caries dental, lesiones traumáticas, y diversas condiciones sistémicas. Esto ha generado una problemática para el dentista debido a que la localización del conducto radicular por la obliteración parcial o total. Diversos estudios realizados han sugerido el uso de la endodoncia guiada confeccionada usando una tomografía computarizada para la confección de un molde tridimensional que permita acceder al conducto. Por todo los mencionado anteriormente, el objetivo de esta revisión es realizar un análisis bibliográfico sobre el uso de acceso guiado por tomografía computarizada en dientes anteriores calcificados. Se realizó una revisión de la literatura en el metabuscador PUBMED, realizando dos búsquedas con distintas combinaciones de términos MESH. Se incluyeron tantos estudios clínicos sobre calcificación de dientes anteriores y la confección de guías quirúrgicas con la ayuda de tomografías computarizadas. Se eliminaron los duplicados y se realizó filtro por título y resumen. Finalmente, se realizó la revisión de los artículos completos obteniendo un total de 30 estudios de los cuales 20 fueron seleccionados para el análisis de resultados. La totalidad de los estudios incluidos en esta revisión concluyen que desde la perspectiva clínica, el acceso guiado proporciona al operador una técnica más predecible y confiable que mejora los resultados tanto a corto como a largo plazo porque permite accesos más conservadores, preservando así la estructura dentaria. Partial or total calcification of the pulp is a common finding in different types of teeth, and is often associated with dental caries, traumatic injuries, and various systemic conditions. This has generated a problem for the dentist due to the location of the root canal by partial or total obliteration. Various studies have suggested the use of guided endodontics made using computed tomography for the making of a three-dimensional mold that allows access to the canal. For all of the above, the objective of this review is to carry out a bibliographic analysis on the use of computed tomography-guided access in calcified anterior teeth. A review of the literature was carried out in the PUBMED metasearch engine, performing two searches with different combinations of MESH terms. So many clinical studies on calcification of anterior teeth and the making of surgical guides with the help of CT scans are included. Duplicates were removed and filtering by title and abstract was performed. Finally, the review of the complete articles was carried out, obtaining a total of 30 studies, of which 20 were selected for the analysis of results. All the studies included in this review conclude that From a clinical perspective, guided access provides the operator with a more predictable and reliable technique that improves both short-term and long-term results because it allows more conservative access, thus preserving the structure dental. Trabajo académico

Objetivo. Analizar las tomografías computarizadas de haz cónico (CBCT), de sujetos con diferente biotipo facial y diferente patrón esquelético para comparar el volumen de la vía aérea orofaríngea. Métodos. El estudio fue de carácter descriptivo y transversal. La muestra estuvo formada por 55 tomografías cone beam pertenecientes a sujetos de 15 a 43 años. Las tomografías se agruparon según el biotipo facial, el patrón esquelético y por grupos etarios (15 - 20, 21 - 29, y 30 - 43 años). Se crearon cefalogramas virtuales para hallar el índice de Vert y el ángulo ANB. Los datos fueron analizados mediante las pruebas estadísticas: U de Mann-Whitney, ANOVA y Kruskal-Wallis. Resultados. No se encontró una diferencia estadísticamente significativa entre el volumen orofaríngeo y el biotipo facial, ni entre el volumen orofaríngeo y el patrón esquelético. Se observó que los volúmenes más bajos fueron registrados en sujetos con patrón esquelético clase II (=8,70±3,60 cm3) y en sujetos con biotipo braquifacial (=8,87±2,96 cm3). No hubo diferencia significativa entre el volumen y el sexo de los sujetos (p>0,05). El grupo de 15 a 20 años presentó el mayor volumen orofaríngeo (=11,16±5,64 cm3). Adicionalmente, se registró una correlación negativa entre el volumen orofaríngeo y el ángulo ANB (r=-0,31, p=0,02). Conclusiones. El volumen orofaríngeo según el biotipo facial y el patrón esquelético no presenta una variación significativa para la muestra analizada. Además, el volumen orofaríngeo no varía de acuerdo al sexo, y es mayor entre los 15 y 20 años.

Computerized Tomography (CT) and, more recently, Magnetic Resonance Imaging (MRI) have become the state-of-the art techniques for morpho-volumetric analysis of abdominal cavities. Due to its constant motility, the colon is an organ difficult to analyze. Unfortunately, CT’s radiative nature makes it only indicated for patients with important disorders. Lately, acquisition techniques that rely on the use of MRI have matured enough to enable the analysis of colon data. This allows gathering data of patients with- out preparation (i.e. administration of drugs or contrast agents), and incorporating data of patients with non life-threatening diseases and healthy subjects to databases. In this paper we present an end-to-end framework that comprises all the steps to extract colon content and morphology data coupled with a web-based visualization tool that facilitates the visual exploration of such data. We also introduce the set of tools for the extraction of morphological data, and a detailed description of a specifically-designed interactive tool that facilitates a visual comparison of numerical variables within a set of patients, as well as a detailed inspection of an individual. Our prototype was evaluated by domain experts, which showed that our visual approach may reduce the costly process of colon data analysis. As a result, physicians have been able to get new insights on the effects of diets, and also to obtain a better understanding on the motility of the colon. This project has been supported by the project TIN2017-88515-C2-1-R (GEN3DLIVE), from the Spanish Ministerio de Economía y Competitividad with FEDER (EU) funds.

Viral pneumonia is the main cause of respiratory system infections in the community and they usually regress spontaneously. Coronavirus is part of a family of viruses that cause infections in humans and certain animals. The current outbreak that originated in Wuhan city in Hubei Province, China, is due to a new strain called SARS Covid 2, never described in humans before .The diagnostic test is real-time PCR. Imaging studies are being a key role in the management of patients with covid infection 19.This article aims to point out the aspects of interest for x rays and tomography diagnosis in these patients, point out the semantics used and to mention some important considerations from scientific societies.

International audience; Background: There have been reports of procoagulant activity in patients with COVID-19. Whether there is an association between pulmonary embolism (PE) and COVID-19 in the emergency department (ED) is unknown. The aim of this study was to assess whether COVID-19 is associated with PE in ED patients who underwent a computed tomographic pulmonary angiogram (CTPA).Methods: A retrospective study in 26 EDs from six countries. ED patients in whom a CTPA was performed for suspected PE during a 2-month period covering the pandemic peak. The primary endpoint was the occurrence of a PE on CTPA. COVID-19 was diagnosed in the ED either on CT or reverse transcriptase-polymerase chain reaction. A multivariable binary logistic regression was built to adjust with other variables known to be associated with PE. A sensitivity analysis was performed in patients included during the pandemic period.Results: A total of 3,358 patients were included, of whom 105 were excluded because COVID-19 status was unknown, leaving 3,253 for analysis. Among them, 974 (30%) were diagnosed with COVID-19. Mean (±SD) age was 61 (±19) years and 52% were women. A PE was diagnosed on CTPA in 500 patients (15%). The risk of PE was similar between COVID-19 patients and others (15% in both groups). In the multivariable binary logistic regression model, COVID-19 was not associated with higher risk of PE (adjusted odds ratio = 0.98, 95% confidence interval = 0.76 to 1.26). There was no association when limited to patients in the pandemic period.Conclusion: In ED patients who underwent CTPA for suspected PE, COVID-19 was not associated with an increased probability of PE diagnosis. These results were also valid when limited to the pandemic period. However, these results may not apply to patients with suspected COVID-19 in general.

RESUMEN: La correcta identificación del canal mandibular es esencial cuando se pretende realizar procedimientos quirúrgicos del sector posterior o incluso odontología clínica. La tomografía computarizada de haz cónico (CBCT) utiliza diferentes planos para la evaluación de este. Para conocer las variaciones anatómicas del canal mandibular se lleva a cabo un estudio en 100 adultos mayores de 30 años, donde la ubicación, la forma y la orientación se estudia mediante la tomografía computarizada de haz cónico. Así, el principal objetivo de nuestro estudio es conocer la variabilidad y tipo de presentación del canal bífido en el Canal mandibular en pacientes dentados o parcialmente edéntulos adultos mayores de 30 años.

A descriptive and exploratory study was carried out with the aim of proposing and validating an open protocol for making 3D impressions of stereolithographic models, which is available to professionals in the area of Dentistry. Nine operators (senior students of the Dentistry degree), without previous experience in the use of software and hardware for 3D printing, divided into two groups were trained through theoretical and practical sessions. The A worked with three helical tomographies (TAC) and the B with three cone beam computed tomography (CBCT), all in DICOM format, converted to STL files. In total, 99 bone structures corresponding to 33 jaws, 33 axis and 33 facial masses-skull bases were analyzed, and a total of 33 jaws were printed in PLA (polylactic acid filament). At the end of the study, no statistically significant difference was found in the implementation of the proposed protocol between the operators, the measurements of the pieces printed by each of them, the gold standard, the TAC and the CBCT, with which not only validated the protocol, but it was possible to determine the resources necessary to carry out this type of 3D printing. Se realizó un estudio descriptivo y exploratorio con el objetivo de proponer y validar un protocolo abierto para hacer impresiones 3D de modelos estereolitográficos, que esté a disposición de profesionales en el área de la Odontología. Se capacitó mediante sesiones teórico prácticas, a nueve personas operadoras (estudiantes de último año de la carrera de Odontología), sin previa experiencia en el uso de software y hardware para impresión 3D, divididos en dos grupos; el A trabajó con tres tomografías helicoidales (TAC) y el B con tres Tomografías Computarizadas de Haz Cónico (CBCT), todas en formato DICOM, convertidas en archivos STL. En total se aplicó el protocolo en 99 estructuras óseas correspondientes a 33 mandíbulas, 33 axis y 33 macizos faciales-bases de cráneo, y se imprimieron un total de 33 mandíbulas en filamento PLA (ácido poliláctico). Al finalizar el estudio, no se encontró diferencia estadísticamente significativa en la implementación del protocolo propuesto entre los operadores, las mediciones de las piezas impresas por cada uno de ellos, el patrón de oro, la TAC y el CBCT, con lo cual no solo se validó el protocolo, sino que se logró determinar los recursos necesarios para realizar este tipo de impresiones 3D.

Objectives. The aim of this study is to assess the utility of optical coherence tomography (OCT) in patients with exercise-related acute coronary syndrome (ACS) presenting with inconclusive angiographic findings. Background. Regular physical activity reduces the incidence of cardiovascular events. Nevertheless, the risk of ACS or sudden cardiac death (SCD) increases during sport. In adults older than 35 years, exercise-related ACS or SCD is associated with plaque rupture, but not infrequently patients present ambiguous angiographic findings. Methods. Between September 2015 and January 2020, patients admitted for ACS or SCD triggered by physical exertion and with coronary stenosis ≤50% were included in this prospective observational study. OCT was performed on the artery deemed to be responsible of the event. Results. Ten patients were enrolled, predominantly men (80%) of middle age (51 years old, IQR 41–63) with low cardiovascular risk burden. Cycling was the most frequent (50%) exercise-related trigger, 8 patients were regular sport practitioners, and 7 had the clinical event during strenuous exertion. Five patients presented with non-ST-elevation ACS, two with ST-elevation ACS, and three with SCD. Angiographic analysis showed nonsignificant stenosis in all patients (42% stenosis, IQR 36–46). OCT identified the etiology of the event in 9 patients (4 plaque erosion, 3 plaque rupture, 1 eruptive calcific nodule, and 1 coronary dissection). Treatment was adjusted according to OCT findings. Conclusions. OCT is a valuable technique to identify the etiology of exercise-related ACS or SCD in patients with nonobstructive coronary arteries and, as a result, may lead to a more specific treatment.

Introducción: Estudio piloto que determina el diagnóstico de sarcopenia mediante tomografía computarizada (TC) a nivel de la tercera vértebra cervical (C3) y dinamometría en pacientes con cáncer de cabeza y cuello. Comparación de la masa magra (MM) determinada mediante TC con técnicas clásicas de antropometría y dinamometría.Material y métodos: Se analizó la MM y el tejido adiposo mediante TC a nivel de C3 en 37 pacientes oncológicos mediante Unidades Hounsfield (UH). Posteriormente, se calculó el índice musculoesquelético (IME) y se determinó la fuerza prensora de mano para la determinación de sarcopenia. Por último, se comparó el IME mediante técnicas de valoración antropométrica clásica y dinamometría. Resultados: El 59,46% de los pacientes presentaron un IME (cm2/m2) disminuido, el 64,86% dinapenia, el 54,05% sarcopenia, el 32,43% sarcopenia dentro del sobrepeso y obesidad. Por otro lado, la media de la masa grasa intermuscular fue 6,69 (3,8) cm2, y la masa grasa intramuscular 2,06 (1,11) cm2. Además, se encontró una asociación estadísticamente significativa entre la fuerza tanto en la mano fuerte (estimado = 0,412, IC95% [0,219; 0,605], p-valor

espanolLa fractura de instrumental rotatorio es una complicacion transoperatoria rara en cirugia de terceros molares, cuando pasa desapercibida, su diagnostico como cuerpo extrano suele ser un hallazgo radiografico y su extraccion requiere una valoracion minuciosa. Se presenta el caso clinico de un paciente femenino de 21 anos, que acude al servicio de Cirugia de la Facultad de Odontologia de la Universidad Central del Ecuador (FOUCE), referida por el hallazgo radiografico de un cuerpo extrano en la mandibula posterior izquierda, en la historia refiere la extraccion de terceros molares inferiores hace 5 anos; sin signos clinicos al examen intraoral, en el estudio radiografico se observo la presencia de una sombra radiopaca en la parte distal del organo dental #37, se confirma en la tomografia como imagen compatible con una fresa fraccionada entre la parte activa y pasiva. El diagnostico fue alojamiento intraoseo de cuerpo extrano dividido en 2 fragmentos. El tratamiento consistio en la exeresis de la parte pasiva de la fresa, se decidio no extraer la parte activa localizada debajo del paquete vasculonervioso, por riesgo de lesion del nervio dentario inferior. En el posoperatorio se realizaron controles clinicos, radiograficos y tomograficos, no se evidenciaron complicaciones, la paciente se ha mantenido asintomatica y estable. EnglishRotating instrument fracture is a rare trans-operation complication in third molar surgery. When it goes unnoticed, its diagnosis as a foreign body is usually a radiographic finding and its extraction requires careful evaluation. A clinical case of a 21-year-old female patient is presented, who comes to the Surgery service of the Faculty of Dentistry of the Central University of Ecuador (FOUCE), referred by the radiographic finding of a foreign body in the left posterior jaw, the history refers to the extraction of lower third molars 5 years ago; without clinical signs on intraoral examination, in the radiographic study the presence of a radiopaque shadow was observed in the distal part of dental organ # 37, confirmed on tomography as an image compatible with a fractional drill between the active and passive parts. The diagnosis was of an intra-osseous foreign body placed and divided into 2 fragments. The treatment consisted of the excision of the passive part of the drill; it was decided not to extract the active part located below the nervous-vascular package, due to the risk of injury to the lower dental nerve. In the post-operation period, clinical, radiographic and tomographic controls were performed, no complications were observed, the patient remained asymptomatic and stable.

Agradecimentos: The authors would like to thank the Nuclear and Energy Research Institute (IPEN-CNEN), São Paulo, Brazil, for supplying the radiopharmaceuticals used in the present project (IPEN/UNICAMP agreement No. 01342000458/2017-15). The authors are grateful for the financial support from FAPESP (Fundação de Amparo à Pesquisa do Estado de São Paulo), grant numbers 2009/54065-0 and 2018/00654-4 Abstract: Purpose: Quantifications in nuclear medicine are occasionally limited by the lack of standardization for defining volumes of interest (VOIs) on functional images. In the present article, we propose the use of computed tomography (CT)-based skeletal segmentation to determine anatomically the VOI in order to calculate quantitative parameters of fluorine 18 fluorodeoxyglucose (F-18-FDG) PET/CT images from patients with multiple myeloma. Methods: We evaluated 101 whole-body F-18-FDG PET/CTs of 58 patients with multiple myeloma. An initial subjective visual analysis of the PET images was used to classify the bone involvement as negative/mild, moderate, or marked. Then, a fully automated CT-based segmentation of the skeleton was performed on PET images. The maximum, mean, and SD of the standardized uptake values (SUVmax, SUVmean, and SDSUV) were calculated for bone tissue and compared with the visual analysis. Results: Forty-five (44.5%), 32 (31.7%), and 24 (23.8%) PET images were, respectively, classified as negative/mild, moderate, or marked bone involvement. All quantitative parameters were significantly related to the visual assessment of bone involvement. This association was stronger for the SUVmean [odds ratio (OR): 10.52 (95% confidence interval (CI), 5.68-19.48); P < 0.0001] and for the SDSUV [OR: 5.58 (95% CI, 3.31-9.42); P < 0.001) than for the SUVmax [OR: 1.01 (95% CI, 1.003-1.022); P = 0.003]. Conclusion: CT-based skeletal segmentation allows for automated and therefore reproducible calculation of PET quantitative parameters of bone involvement in patients with multiple myeloma. Using this method, the SUVmean and its respective SD correlated better with the visual analysis of F-18-FDG PET images than SUVmax. Its value in staging and evaluating therapy response needs to be evaluated FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP Fechado

Introducción. La tomografía corporal (TC) total en la evaluación de pacientes con trauma grave, puede ser una herramienta eficaz y segura para decidir entre un tratamiento quirúrgico y uno no quirúrgico, pero aún no son claras las implicaciones diagnósticas y los riesgos asociados con esta técnica. Métodos. Se incluyeron pacientes mayores de 15 años con trauma grave que fueron sometidos a TC total. Se evaluaron la seguridad, la efectividad y la eficiencia por medio de los parámetros de incidencia de nefropatía inducida por los medios de contraste, dosis total de radiación por paciente, proporción de casos en los que la TC total cambió el manejo, y el retraso en el diagnóstico. Resultados. Se incluyeron 263 pacientes, 83 % sufrieron trauma cerrado y 17 % sufrieron trauma penetrante. La gravedad de la lesión fue mayor en estos últimos y, sin embargo, el trauma cerrado con inestabilidad hemodinámica se presentó con mayores grados de choque. El 65 % de los pacientes recibió tratamiento selectivo no operatorio. Entre los subgrupos, no hubo diferencias significativas en el tiempo entre el ingreso a la sala de urgencias y la toma de la TC total (p=0,96) y, en la mayoría de los casos, el tiempo entre la práctica de la TC total y el diagnóstico de presencia o ausencia de heridas fue menor de 25 minutos. La mediana de radiación total estuvo por debajo de 20 mSv en todos los grupos. No hubo diferencias significativas en la mortalidad (p=0,17). Conclusión. La TC total es una herramienta segura y eficiente para decidir entre un tratamiento quirúrgico y uno no quirúrgico en los casos de trauma grave, independientemente del mecanismo de la lesión o la estabilidad hemodinámica al ingreso.