Influence of dental metallic artifact from multislice CT in the assessment of simulated mandibular lesions

OBJECTIVE: This study evaluated the influence of metallic dental artifacts on the accuracy of simulated mandibular lesion detection by using multislice technology. MATERIAL AND METHODS: Fifteen macerated mandibles were used. Perforations were done simulating bone lesions and the mandibles were subjected to axial 16 rows multislice CT images using 0.5 mm of slice thickness with 0.3 mm interval of reconstruction. Metallic dental restorations were done and the mandibles were subjected again to CT in the same protocol. The images were analyzed to detect simulated lesions in the mandibles, verifying the loci number and if there was any cortical perforation exposing medullar bone. The analysis was performed by two independent examiners using e-film software. RESULTS: The samples without artifacts presented better results compared to the gold standard (dried mandible with perforations). In the samples without artifacts, all cortical perforation were identified and 46 loci were detected (of 51) in loci number analysis. Among the samples with artifacts, 12 lesions out of 14 were recognized regarding medullar invasion, and 40 out of 51 concerning loci number. The sensitivity in samples without artifacts was 90% and 100% regarding loci number and medullar invasion, respectively. In samples with artifacts, these values dropped to 78% and 86%, respectively. The presence of metallic restorations affected the sensitivity values of the method, but the difference was not significant (p>0.05). CONCLUSIONS: Although there were differences in the results of samples with and without artifacts, the presence of metallic restoration did not lead to misinterpretation of the final diagnosis. However, the validity of multislice CT imaging in this study was established for detection of simulated mandibular bone lesions.CNPqFAPESPCoordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES

AIDS in adults 50 years of age and over: characteristics, trends and spatial distribution of the risk

OBJECTIVE: to analyze the sociodemographic characteristics, epidemic trend and spatial distribution of the risk of AIDS in adults 50 years of age and over.METHOD: population-based, ecological study, that used secondary data from the Notifiable Disease Information System (Sinan/AIDS) of Paraíba state from the period January 2000 to December 2010.RESULTS: during the study period, 307 cases of AIDS were reported among people 50 years of age or over. There was a predominance of males (205/66, 8%), mixed race, and low education levels. The municipalities with populations above 100 thousand inhabitants reported 58.5% of the cases. There was a progressive increase in cases among women; an increasing trend in the incidence (positive linear correlation); and an advance in the geographical spread of the disease, with expansion to the coastal region and to the interior of the state, reaching municipalities with populations below 30 thousand inhabitants. In some locations the risk of disease was 100 times greater than the relative risk for the state.CONCLUSION: aging, with the feminization and interiorization of the epidemic in adults 50 years of age and over, confirms the need for the induction of affirmative policies targeted toward this age group

3D-CT imaging processing for qualitative and quantitative analysis of maxillofacial cysts and tumors Processamento de imagens em 3D-TC para análise qualitativa e quantitativa de cistos e tumores maxilo-faciais

The objective of this study was to evaluate spiral-computed tomography (3D-CT) images of 20 patients presenting with cysts and tumors in the maxillofacial complex, in order to compare the surface and volume techniques of image rendering. The qualitative and quantitative appraisal indicated that the volume technique allowed a more precise and accurate observation than the surface method. On the average, the measurements obtained by means of the 3D volume-rendering technique were 6.28% higher than those obtained by means of the surface method. The sensitivity of the 3D surface technique was lower than that of the 3D volume technique for all conditions stipulated in the diagnosis and evaluation of lesions. We concluded that the 3D-CT volume rendering technique was more reproducible and sensitive than the 3D-CT surface method, in the diagnosis, treatment planning and evaluation of maxillofacial lesions, especially those with intra-osseous involvement.<br>O presente trabalho consiste em um estudo associativo e comparativo entre as técnicas de superfície e volume para a reconstrução de imagens em três dimensões (3D) utilizando tomografia computadorizada (TC). Foram realizadas tomografias computadorizadas em espiral de 20 pacientes com cistos e tumores do complexo maxilo-facial para análise qualitativa e quantitativa, utilizando métodos de superfície e de volume em 3D. A comparação interexaminadores apresentou erro padrão percentual menos elevado para a técnica de volume (1,94%) que para a técnica de superfície (4,38%), indicando a maior reprodutibilidade do primeiro método. As medidas obtidas pela técnica de volume foram em média 6,28% mais elevadas que as medidas obtidas pela técnica de superfície. A técnica de volume apresentou sensibilidade mais elevada que a técnica de superfície na identificação das lesões do complexo maxilo-facial. A técnica de volume em 3D-TC, utilizando a metodologia da computação gráfica, apresentou maior reprodutibilidade e sensibilidade para o diagnóstico, planejamento e acompanhamento do tratamento, principalmente das lesões com comprometimento intra-ósseo