Aplicação da norma DICOM em Medicina Dentária

ResumoA norma DICOM (Digital Imaging and Communications in Medicine) é formada por um conjunto de regras que permite a interoperabilidade de imagens, isto é, o intercâmbio de imagens médicas e dos respetivos dados associados, independentemente do fabricante dos equipamentos utilizados na aquisição e na observação dessas mesmas imagens. De modo a obter informação acerca desta norma, realizou-se uma pesquisa na Medline® (http://www.ncbi.nlm.nih.gov/pubmed/), utilizando como palavras-chave «DICOM» e «Dentistry»’, combinadas com o operador boleano «AND». A pesquisa realizada teve como limites: artigos publicados em «Dental Journals», em língua Inglesa, entre 1990 e 2011. De acordo com as várias publicações encontradas na pesquisa, verificou-se que uma das principais vantagens da existência deste padrão de referência era o facto de assegurar a disponibilidade de toda esta informação médica por tempo indefinido, sem perda de qualidade das imagens originais, qualquer que fosse o equipamento que pudesse vir a ser utilizado para o seu armazenamento e visualização no futuro.AbstractThe DICOM standard (Digital Imaging and Communications in Medicine) is formed by a set of standards that allows interoperability of images, i.e. the exchange of medical images and associated data, regardless of manufacturer of equipment used in the acquisition and observation of these same images. In order to obtain some information about this standard, we did a bibliographic research in Medline, using “DICOM” and “Dentistry” as keywords, combined by the boolean operator “AND”. This research had as limits: articles published in Dental Journals, which were written in English, between 1990 and 2011. According to the obtained results, we could observe that one of its main advantages was that it ensured the availability of all this medical information indefinitely, without loss of original picture quality, whatever the equipment that was used for storage and display in the future

Protective effects of aerobic exercise on acute lung injury induced by LPS in mice

Abstract\ud \ud \ud \ud Introduction\ud \ud The regular practice of physical exercise has been associated with beneficial effects on various pulmonary conditions. We investigated the mechanisms involved in the protective effect of exercise in a model of lipopolysaccharide (LPS)-induced acute lung injury (ALI).\ud \ud \ud \ud Methods\ud \ud Mice were divided into four groups: Control (CTR), Exercise (Exe), LPS, and Exercise + LPS (Exe + LPS). Exercised mice were trained using low intensity daily exercise for five weeks. LPS and Exe + LPS mice received 200 µg of LPS intratracheally 48 hours after the last physical test. We measured exhaled nitric oxide (eNO); respiratory mechanics; neutrophil density in lung tissue; protein leakage; bronchoalveolar lavage fluid (BALF) cell counts; cytokine levels in BALF, plasma and lung tissue; antioxidant activity in lung tissue; and tissue expression of glucocorticoid receptors (Gre).\ud \ud \ud \ud Results\ud \ud LPS instillation resulted in increased eNO, neutrophils in BALF and tissue, pulmonary resistance and elastance, protein leakage, TNF-alpha in lung tissue, plasma levels of IL-6 and IL-10, and IL-1beta, IL-6 and KC levels in BALF compared to CTR (P ≤0.02). Aerobic exercise resulted in decreases in eNO levels, neutrophil density and TNF-alpha expression in lung tissue, pulmonary resistance and elastance, and increased the levels of IL-6, IL-10, superoxide dismutase (SOD-2) and Gre in lung tissue and IL-1beta in BALF compared to the LPS group (P ≤0.04).\ud \ud \ud \ud Conclusions\ud \ud Aerobic exercise plays important roles in protecting the lungs from the inflammatory effects of LPS-induced ALI. The effects of exercise are mainly mediated by the expression of anti-inflammatory cytokines and antioxidants, suggesting that exercise can modulate the inflammatory-anti-inflammatory and the oxidative-antioxidative balance in the early phase of ALI.CTRG receives a fellowship from Coordenação de Aperfeiçoamento Pessoal de Nível Superior (CAPES). MD receives an individual research grant from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq). The study was supported by the Laboratórios de Investigação Médica-LIMs 05 e 20 do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (LIMHC-FMUSP)

Influence of lateral cephalometric radiography in orthodontic diagnosis and treatment planning

Objective: To evaluate the impact of additional lateral cephalometric radiography in orthodontic diagnosis and treatment planning. Materials and Methods: Forty-three patients seeking orthodontic treatment, and for whom pretreatment diagnostic records were available, were randomly selected. Ten qualified orthodontists were involved in this study. The patients' records included three photographs of the angle trimmed dental casts, digital lateral cephalometric and panoramic radiographs, and standard clinical photographs comprising seven intra- and four extraoral pictures. Records were evaluated in two sessions. At the first session, orthodontists evaluated records without lateral cephalometric radiography (LCR). In the second session, the same information was presented, but with LCR. Between the two sessions the order in which the cases were presented was altered to avoid bias. Results: The percentage of agreement between sessions was lower for diagnosis than for treatment planning. Concerning skeletal classification, the least experienced orthodontist was the least consistent (28%), while the more experienced orthodontist was the more reliable (67%). In terms of treatment modalities, in general there was an agreement of 64%. The most frequent modifications in treatment modalities were seen in Class II malocclusion patients. Conclusions: The results of our study suggest that the majority of Portuguese orthodontists judge that LCR is important to producing a treatment plan. Despite that, it does not seem to have an influence on orthodontic treatment planning.status: publishe

Masseter muscle measurement performed by ultrasound: a systematic review

The aim of this study was to systematically review the existing scientific literature and evidence about (a) the validation of masseter muscle ultrasonography for accurate assessment of muscle thickness and (b) the reproducibility of masseter muscle thickness measures. An electronic literature search was conducted using determined keywords on specific databases. Preliminary search revealed 298 articles listed in Medline, Scopus and Web of Science. 60 duplicates were rejected, leaving 238 articles for review. After reading titles and abstracts, 31 articles remained. 23 articles were assessed for eligibility. These articles were categorized as follows: thickness, cross-section, volume and the length of the masseter muscle measured by ultrasonography. It is possible to verify the thickness of the masseter muscle in males and females in relaxation (10-15 and 9-13 mm, respectively) and contraction (14-19 and 12-15 mm, respectively). A similar tendency can also be evidenced in other measurements. Many studies evaluate masseter muscle dimensions to relate it to cephalometric analysis as such to evaluate morphological variations. It can be concluded that ultrasound is a reliable clinical tool for masseter muscle measurements, yet there is a need for standardization of methods and parameters to be recorded.status: publishe

Cephalometric landmark variability among orthodontists and dentomaxillofacial radiologists: a comparative study

The aim this study was to compare the accuracy of orthodontists and dentomaxillofacial radiologists in identifying 17 commonly used cephalometric landmarks, and to determine the extent of variability associated with each of those landmarks.status: publishe