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Introduction: The complexity of the vocal phenomenon hinders the therapist's ability to quickly and effectively monitor the achievements obtained by the patient through vocal intervention. The assessment of therapeutic progress relies on the therapist's capability to utilize valid, reliable, and meaningful outcome criteria. Aim: Develop a conceptual framework of outcome criteria to be used in the treatment plans designed by speech-language pathologists for patients with vocal complaints. Methodology: Qualitative, conceptual, and model-type research in which a critical review is conducted through a non-probabilistic theoretical sampling of the theoretical models of therapy treatment plans, the outcome criteria involved and their relevance to voice intervention. Building upon this, a taxonomy of outcome criteria is proposed for verifying therapeutic progress in voice therapy. Results: A conceptual outcome criteria framework is proposed. This model incorporates quantitative, qualitative, and mixed criteria to monitor the diverse aspects of vocal function in the context of voice intervention. Conclusion: The model provides a precise guide to assess the results achieved by the patient in vocal intervention through treatment goals.
Introducción: La complejidad del fenómeno vocal dificulta que el/la terapeuta monitoree de manera rápida y eficaz los logros obtenidos por el/la usuario/a mediante la intervención fonoaudiológica. La evaluación del avance terapéutico depende de la habilidad del/la terapeuta para emplear criterios de medición válidos, confiables y significativos. Objetivo: Desarrollar un modelo teórico de criterios de logro para su consideración en la formulación de los objetivos operacionales en las planificaciones terapéuticas que emplean los profesionales fonoaudiólogos en la atención de usuarios/as que presentan queja vocal. Metodología: Investigación cualitativa, de tipo conceptual y modélica, en la que se lleva a cabo una revisión crítica de la literatura a través de un muestreo teórico no probabilístico de los modelos teóricos propuestos para la formulación y medición de objetivos en el contexto terapéutico y sus alcances respecto de la intervención vocal. A partir de ello, se propone una taxonomía de criterios de logro para la verificación del avance terapéutico. Resultados: Se propone una taxonomía organizada en torno a criterios de logro cuantitativos, cualitativos y mixtos, los que son propuestos para el monitoreo de diversos aspectos de la función vocal en el contexto de la intervención fonoaudiológica. Conclusión: El modelo proporciona una guía precisa para evaluar de manera efectiva el progreso y los resultados alcanzados por el/la usuario/a en el abordaje fonoaudiológico vocal a través de los objetivos operacionales planteados para la intervención.
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ABSTRACT Introduction: Superposing 3D models is an imminent need. However, current methods rely on marking multiple points on the maxilla and mandible, which could increase point marking and overlapping errors. Objective: This study aimed at developing a method for superimposing 3D models of the maxillary and mandibular arches with Autodesk Inventor® engineering software, using a single universal coordinate system (UCS) point superposition. Methods: A total of 104 STL (stereolithography) models of the maxillary and mandibular arches exported from My iTero® platform were retrospectively selected, in which T0 and T1 were the initial and refinement periods, respectively (n=26 per group). The X, Y, and Z coordinates associated with a single point in each arch were inserted into the models with SlicerCMF® software for model orientation. The arch models with UCS registration were transferred to Autodesk Inventor® for superimposition and to measure tooth movements performed during Invisalign® treatment. Arch expansion, intrusion and rotation were analyzed by two examiners. The statistics were performed using intraclass correlation coefficients (ICC), Dahlberg's formula, and t-test (p<0.05). Results: A reliable method of superimposing 3D digital models using a single UCS point in the maxilla and mandible was developed. ICC showed excellent intra- and inter-examiner correlation (ICC>0.90). A systematic error was not found concerning linear and angular measurements (<1mm and <1.5°, respectively). Digital dental movements could be analyzed, including arch expansion, dental intrusion, and tooth rotation. Conclusions: The developed method was proven reliable and reproducible for superimposing 3D models of the maxillary and mandibular arches by using UCS system.
RESUMO Introdução: A sobreposição de modelos 3D é uma necessidade iminente. No entanto, os métodos atuais dependem da marcação de múltiplos pontos na maxila e na mandíbula, o que pode aumentar a incorporação de erros no processo de sobreposição. Objetivo: O objetivo desse estudo foi desenvolver um método para sobrepor modelos 3D das arcadas superior e inferior utilizando o software de engenharia Autodesk Inventor®, por meio da marcação de um único ponto em cada arcada, usando o sistema de coordenadas universal (UCS). Métodos: No total, 104 modelos STL das arcadas superior e inferior exportados da plataforma My iTero® foram selecionados retrospectivamente, onde T0 foi o período inicial e T1, o de refinamento (n=26 por grupo). As coordenadas X, Y e Z associadas a um único ponto em cada arcada foram inseridas nos modelos usando o software SlicerCMF®. Os modelos com os pontos UCS demarcados foram transferidos para o software Autodesk Inventor® para realizar a sobreposição e medir os movimentos dentários realizados durante o tratamento com Invisalign®. Os movimentos de expansão, intrusão e rotação foram analisados por dois examinadores. A análise estatística foi realizada usando os coeficientes de correlação intra-classe (ICC), fórmula de Dahlberg e teste t (p<0,05). Resultados: Foi desenvolvido um método confiável de sobreposição de modelos digitais 3D usando um único ponto UCS na maxila e mandíbula. O ICC apresentou excelente correlação intra e inter-avaliadores (ICC>0,90). Não foi encontrado erro sistemático nas medidas lineares e angulares (<1mm e <1,5°, respectivamente). Os movimentos dentários puderam ser analisados por meio do método proposto, incluindo expansão da arcada, intrusão e rotação dentária. Conclusão: O método desenvolvido provou ser confiável e reprodutível para sobreposição de modelos 3D das arcadas superior e inferior usando o sistema UCS com marcação de ponto único.
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BACKGROUND: When designing a treatment in orthodontics, especially for children and teenagers, it is crucial to be aware of the changes that occur throughout facial growth because the rate and direction of growth can greatly affect the necessity of using different treatment mechanics. This paper presents a Bayesian network approach for facial biotype classification to classify patients' biotypes into Dolichofacial (long and narrow face), Brachyfacial (short and wide face), and an intermediate kind called Mesofacial, we develop a novel learning technique for tree augmented Naive Bayes (TAN) for this purpose. RESULTS: The proposed method, on average, outperformed all the other models based on accuracy, precision, recall, [Formula: see text], and kappa, for the particular dataset analyzed. Moreover, the proposed method presented the lowest dispersion, making this model more stable and robust against different runs. CONCLUSIONS: The proposed method obtained high accuracy values compared to other competitive classifiers. When analyzing a resulting Bayesian network, many of the interactions shown in the network had an orthodontic interpretation. For orthodontists, the Bayesian network classifier can be a helpful decision-making tool.
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Algoritmos , Concienciación , Niño , Adolescente , Humanos , Teorema de BayesRESUMEN
PURPOSE/OBJECTIVE(S): Standardized simulation training geared towards interstitial brachytherapy (IS BT) for gynecologic malignancies is lacking in radiation oncology resident education. We developed and implemented a curriculum for IS BT training with (1) lecture on equipment, workflow, and guidelines, (2) hands-on ultrasound-guided IS BT workshop, and (3) treatment planning workshop. METHODS AND MATERIAL: The cost in materials of each phantom was approximately $66. After a lecture, two alternating workshops were performed. The first session consisted of a hands-on ultrasound-guided IS BT workshop with one resident imaging the phantom with a transabdominal ultrasound probe and the other resident implanting the phantom with needles. A second session consisted of a hands-on treatment planning workshop using BrachyVision and an l-Q spreadsheet with the following objectives: coverage goal, meeting D2cc constraints, and minimizing V200. The primary outcome was improvement in knowledge assessed with Likert-style questions and objective knowledge-based questions (KBQs). RESULTS: Four of the seven medical residents that participated in this curriculum had prior IS BT experience. Residents reported significantly improved knowledge regarding gynecologic IS BT equipment and procedure, evaluating gynecologic anatomy using ultrasound, CT simulation, contouring, and plan review (overall median pre-session subjective score 2 (1) -(3) versus post-session score 4 (3) -(4, p < 0.01). Residents demonstrated improvement in answering KBQs correctly from 44% correct at baseline to 88% after completion of the curriculum (p < 0.01). All residents "Agree" and "Strongly Agree" the session was an effective learning experience. CONCLUSIONS: Residents participating in phantom training with an ultrasound curriculum and a treatment planning session is effective for improving knowledge and skills in IS BT for radiation oncology residents.
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Braquiterapia , Internado y Residencia , Entrenamiento Simulado , Braquiterapia/métodos , Competencia Clínica , Curriculum , Femenino , HumanosRESUMEN
OBJECTIVES: To evaluate the relationship between the tomographic sagittal root position (SRP) of maxillary anterior teeth and periodontal phenotype (PP). MATERIAL AND METHODS: Seventy volunteers (420 teeth) were evaluated. Clinical and photographic exams included the evaluation of gingival phenotype (GP) by transparency of the periodontal probe, keratinized tissue width (KTW), gingival architecture, tooth shape, and papilla height (PH). Soft tissue tomographic scan (ST-CBCT) measurements included the SRP classification, GP, gingival thickness in the tissue zone (GT-TZ) and in the bone zone (GT-BZ), buccal bone thickness (BBT), and the distances from the gingival margin and from cementoenamel junction to the buccal bone crest (GM-BBC and CEJ-BBC). Kruskal-Wallis test and a linear regression analysis model were used. RESULTS: The frequency of SRP over the 420 teeth was 65.2% (class I), 9.3% (class II), 0.7% (class III), and 24.8% (class IV). Linear regression analysis showed that SRP is related to PP (p < 0.05). Significantly different measurements of PP parameters were found in SRP classes. The higher and lower GT and BBT were found in classes II and I, respectively. Class IV presented the highest KTW, PH, CEJ-BBC, and GM-BBC. Central incisors (CI) classes I and II were most frequently square-shaped, while 89% of CI Class IV were triangular-shaped. CONCLUSION: The SRP of maxillary anterior teeth is related to periodontal phenotype. CLINICAL RELEVANCE: Clinical and ST-CBCT individual analysis of PP and SRP may be helpful for an esthetic and functional treatment plan based on soft and hard tissue thickness and tooth positioning.
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Incisivo , Maxilar , Tomografía Computarizada de Haz Cónico , Estética Dental , Humanos , Incisivo/diagnóstico por imagen , Maxilar/diagnóstico por imagen , Fenotipo , Raíz del DienteRESUMEN
INTRODUCTION: The aim of this study was to evaluate the influence of different superimposition methods on the accuracy and predictability of conventional and virtual diagnostic setups. MATERIALS AND METHODS: Ten finished cases were used to make a conventional setup and a virtual setup. Second molars were not moved in the two setup situations to allow a reference for superimposition. Conventional and virtual setups were superimposed and compared by second molar registration and the whole surface best fit method (WSBF). Conventional and virtual setups were compared to the posttreatment models with WSBF and palatal rugae best fit (PRBF). Anterior, intermediate, and posterior regions of the dental arches were compared. The paired t-test was used to compare the mean differences between conventional and virtual setups, posttreatment models and both conventional and virtual setups by the WSBF method, and between maxillary posttreatment and virtual setup models using the WSBF and PRBF methods. RESULTS: Conventional and virtual setups differed depending on the two superimposition methods used. Superimposition of the posttreatment models and both setups using WSBF presented no statistically significant differences. There were statistically significant differences between posttreatment and virtual setup models using WSBF and PRBF superimposition methods. CONCLUSIONS: The model superimposition method influenced the assessment of accuracy and predictability of setup models. There were statistically significant differences between the maxillary posttreatment and virtual setup models using the WSBF and the PRBF superimposition methods. It is important to establish stable structures to evaluate the accuracy and predictability of setup models.
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Imagenología Tridimensional , Modelos Dentales , Maxilar/diagnóstico por imagen , Diente Molar/diagnóstico por imagen , Hueso PaladarRESUMEN
PURPOSE: Peer review has been proposed as a strategy to ensure patient safety and plan quality in radiation oncology. Despite its potential benefits, barriers commonly exist to its optimal implementation in daily clinical routine. Our purpose is to analyze peer-review process at our institution. METHODS AND MATERIALS: Based on our group peer-review process, we quantified the rate of plan changes, time and resources needed for this process. Prospectively, data on cases presented at our institutional peer-review conference attended by physicians, resident physicians and physicists were collected. Items such as time to present per case, type of patient (adult or pediatric), treatment intent, dose, aimed technique, disease location and receipt of previous radiation were gathered. Cases were then analyzed to determine the rate of major change, minor change and plan rejection after presentation as well as the median time per session. RESULTS: Over a period of 4 weeks, 148 cases were reviewed. Median of attendants was six physicians, three in-training-physicians and one physicist. Median time per session was 38 (4-72) minutes. 59.5% of cases presented in 1-4 min, 32.4% in 5-9 min and 8.1% in ≥ 10 min. 79.1% of cases were accepted without changes, 11.5% with minor changes, 6% with major changes and 3.4% were rejected with indication of new presentation. Most frequent reason of change was contouring corrections (53.8%) followed by dose or fractionation (26.9%). CONCLUSION: Everyday group consensus peer review is an efficient manner to recollect clinical and technical data of cases presented to ensure quality radiation care before initiation of treatment as well as ensuring department quality in a feedback team environment. This model is feasible within the normal operation of every radiation oncology Department.
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Revisión por Expertos de la Atención de Salud/métodos , Oncología por Radiación/normas , Factores de Edad , Consenso , Conferencias de Consenso como Asunto , Estudios de Factibilidad , Humanos , Neoplasias/diagnóstico por imagen , Neoplasias/patología , Neoplasias/radioterapia , Órganos en Riesgo , Oncología por Radiación/estadística & datos numéricos , Factores de TiempoRESUMEN
PURPOSE: An accurate assessment of out-of-field dose is necessary to estimate the risk of second cancer after radiotherapy and the damage to the organs at risk surrounding the planning target volume. Although treatment planning systems (TPSs) calculate dose distributions outside the treatment field, little is known about the accuracy of these calculations. The aim of this work is to thoroughly compare the out-of-field dose distributions given by two algorithms implemented in the Monaco TPS, with measurements and full Monte Carlo simulations. METHODS: Out-of-field dose distributions predicted by the collapsed cone convolution (CCC) and Monte Carlo (MCMonaco ) algorithms, built into the commercially available Monaco version 5.11 TPS, are compared with measurements carried out on an Elekta Axesse linear accelerator. For the measurements, ion chambers, thermoluminescent dosimeters, and EBT3 film are used. The BEAMnrc code, built on the EGSnrc system, is used to create a model of the Elekta Axesse with the Agility collimation system, and the space phase file generated is scored by DOSXYZnrc to generate the dose distributions (MCEGSnrc ). Three different irradiation scenarios are considered: (a) a 10 × 10 cm2 field, (b) an IMRT prostate plan, and (c) a three-field lung plan. Monaco's calculations, experimental measurements, and Monte Carlo simulations are carried out in water and/or in an ICRP110 phantom. RESULTS: For the 10 × 10 cm2 field case, CCC underestimated the dose, compared to ion chamber measurements, by 13% (differences relative to the algorithm) on average between the 5% and the ≈2% isodoses. MCMonaco underestimated the dose only from approximately the 2% isodose for this case. Qualitatively similar results were observed for the studied IMRT case when compared to film dosimetry. For the three-field lung plan, dose underestimations of up to ≈90% for MCMonaco and ≈60% for CCC, relative to MCEGSnrc simulations, were observed in mean dose to organs located beyond the 2% isodose. CONCLUSIONS: This work shows that Monaco underestimates out-of-field doses in almost all the cases considered. Thus, it does not describe dose distribution beyond the border of the field accurately. This is in agreement with previously published works reporting similar results for other TPSs. Analytical models for out-of-field dose assessment, MC simulations or experimental measurements may be an adequate alternative for this purpose.
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Aceleradores de Partículas , Planificación de la Radioterapia Asistida por Computador , Algoritmos , Método de Montecarlo , Fantasmas de Imagen , Radiometría , Dosificación RadioterapéuticaRESUMEN
OBJECTIVE: The aim of this study was to compare the accuracy and reliability of measurements performed using two different software programs on digital models generated using two types of plaster model scanners (a laser scanner and a computed tomography [CT] scanner). METHODS: Thirty plaster models were scanned with a 3Shape laser scanner and with a Flash CT scanner. Two examiners performed measurements on plaster models by using digital calipers and on digital models by using Ortho Analyzer (3Shape) and Digimodel® (OrthoProof) software programs. Forty-two measurements, including tooth diameter, crown height, overjet, overbite, intercanine and intermolar distances, and sagittal relationship, were obtained. RESULTS: Statistically significant differences were not found between the plaster and digital model measurements (ANOVA); however, some discrepancies were clinically relevant. Plaster and digital model measurements made using the two scanning methods showed high intraclass coefficient correlation values and acceptable 95% limits of agreement in the Bland-Altman analysis. The software used did not influence the accuracy of measurements. CONCLUSIONS: Digital models generated from plaster casts by using laser and CT scanning and measured using two different software programs are accurate, and the measurements are reliable. Therefore, both fabrication methods and software could be used interchangeably.
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Radiation acts not only through cell death but has also angiogenic, immunomodulatory and bystander effects. The realization of its systemic implications has led to extensive research on the combination of radiotherapy with systemic treatments, including immunotherapy and antiangiogenic agents. Parameters such as dose, fractionation and sequencing of treatments are key determinants of the outcome. However, recent high-quality research indicates that these are not the only radiation therapy parameters that influence its systemic effect. To effectively integrate systemic agents with radiation therapy, these new aspects of radiation therapy planning will have to be taken into consideration in future clinical trials. Our aim is to review these new treatment planning parameters that can influence the balance between contradicting effects of radiation therapy so as to enhance the therapeutic ratio.
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Planificación de la Radioterapia Asistida por Computador/métodos , Efecto Espectador/efectos de la radiación , Daño del ADN , Fraccionamiento de la Dosis de Radiación , Humanos , Inmunomodulación , Ganglios Linfáticos/efectos de la radiación , Especies Reactivas de Oxígeno/metabolismoRESUMEN
PURPOSE: Noninvasive thermometry during magnetic nanoparticle hyperthermia (MNH) remains a challenge. Our pilot study proposes a methodology to determine the noninvasive intratumoral thermal dose during MNH in the subcutaneous tumor model. METHODS: Two groups of Ehrlich bearing-mice with solid and subcutaneous carcinoma, a control group (n = 6), and a MNH treated group (n = 4) were investigated. Histopathology was used to evaluate the percentage of non-viable lesions in the tumor. MNH was performed at 301 kHz and 17.5 kA.m-1, using a multifunctional nanocarrier. Surface temperature measurements were obtained using an infrared camera, where an ROI with 750 pixels was used for comparison with computer simulations. Realistic simulations of the bioheat equation were obtained by combining histopathology intratumoral lesion information and surface temperature agreement of at least 50% of the pixel's temperature data calculated and measured at the surface. RESULTS: One animal of the MNH group showed tumor recurrence, while two others showed complete tumor remission (monitored for 585 days). Sensitivity analysis of the simulation parameters indicated low tumor blood perfusion. Numerical simulations indicated, for the animals with complete remission, an irreversible tissue injury of 91 ± 5% and 100%, while the one with recurrence had a lower value, 56 ± 7%. The computer simulations also revealed the in vivo heat efficiency of the nanocarrier. CONCLUSION: A new methodology for determining noninvasively the three-dimensional intratumoral thermal dose during MNH was developed. The method demonstrates the potential for predicting the long-term preclinical outcome of animals treated with MNH.
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Hipertermia Inducida , Nanopartículas de Magnetita , Animales , Simulación por Computador , Hipertermia , Ratones , Recurrencia Local de Neoplasia , Proyectos Piloto , TemperaturaRESUMEN
INTRODUCTION: This case report presents the successful multidisciplinary treatment of a maxillary lateral incisor with a deep and narrow recession involving the root apex associated with pulpal necrosis. The tooth initially considered with a hopeless prognosis, was treated with a combined periodontal plastic, regenerative, and endodontic surgical procedure. CASE PRESENTATION: A recently reported technique, the laterally stretched (LAST) flap with a connective tissue graft (CTG) technique for root coverage, was combined with enamel matrix derivative (EMD) for periodontal regeneration of the periapical lesion, that complemented an apicoectomy with retrograde sealing. The 6-year follow-up evidenced root coverage (RC) of 91.6% and increased keratinized tissue. Clinical and radiographic evaluation showed resolution of the periapical process. CONCLUSIONS: A severe gingival recession with endodontic involvement can be repaired if adequate control of the endodontic infection is obtained. The LAST flap, originally described for lower anterior teeth, was used successfully in a maxillary tooth, under extreme circumstances.
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Tejido Conectivo , Proteínas del Esmalte Dental , Recesión Gingival , Gingivoplastia , Tejido Conectivo/trasplante , Recesión Gingival/cirugía , Humanos , PlásticosRESUMEN
Accurate light dosimery is critical to ensure consistent outcome for pleural photodynamic therapy (pPDT). Ellipsoid shaped cavities with different sizes surrounded by turbid medium are used to simulate the intracavity lung geometry. An isotropic light source is introduced and surrounded by turbid media. Direct measurements of light fluence rate were compared to Monte Carlo simulated values on the surface of the cavities for various optical properties. The primary component of the light was determined by measurements performed in air in the same geometry. The scattered component was found by submerging the air-filled cavity in scattering media (Intralipid) and absorbent media (ink). The light source was located centrally with the azimuthal angle, but placed in two locations (vertically centered and 2 cm below the center) for measurements. Light fluence rate was measured using isotropic detectors placed at various angles on the ellipsoid surface. The measurements and simulations show that the scattered dose is uniform along the surface of the intracavity ellipsoid geometries in turbid media. One can express the light fluence rate empirically as Ï =4S/As *Rd/(1 - Rd), where Rd is the diffuse reflectance, As is the surface area, and S is the source power. The measurements agree with this empirical formula to within an uncertainty of 10% for the range of optical properties studied. GPU voxel-based Monte-Carlo simulation is performed to compare with measured results. This empirical formula can be applied to arbitrary geometries, such as the pleural or intraperitoneal cavity.
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PURPOSE: To develop a computer-based method for automating the repositioning of jaw segments in the skull during three-dimensional virtual treatment planning of orthognathic surgery. The method speeds up the planning phase of the orthognathic procedure, releasing surgeons from laborious and time-consuming tasks. MATERIALS AND METHODS: The method finds the optimal positions for the maxilla, mandibular body, and bony chin in the skull. Minimization of cephalometric differences between measured and standard values is considered. Cone-beam computed tomographic images acquired from four preoperative patients with skeletal malocclusion were used for evaluating the method. RESULTS: Dentofacial problems of the four patients were rectified, including skeletal malocclusion, facial asymmetry, and jaw discrepancies. CONCLUSIONS: The results show that the method is potentially able to be used in routine clinical practice as support for treatment-planning decisions in orthognathic surgery.
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Tomografía Computarizada de Haz Cónico , Imagenología Tridimensional , Procedimientos Quirúrgicos Ortognáticos/métodos , Cirugía Asistida por Computador/métodos , Cefalometría/métodos , Asimetría Facial/diagnóstico por imagen , Asimetría Facial/cirugía , Humanos , Maxilares/anatomía & histología , Maxilares/diagnóstico por imagenRESUMEN
AIM: To evaluate the clinical effects of different dosages of metronidazole (MTZ) and durations of MTZ + amoxicillin (AMX) in the treatment of generalized chronic periodontitis (GChP). MATERIAL AND METHODS: Subjects with severe GChP were randomly assigned to receive scaling and root planing (SRP)-only, or combined with 250 or 400 mg of MTZ + AMX (500 mg) thrice a day (TID), for 7 or 14 days. Subjects were monitored for 1 year. RESULTS: One hundred and nine subjects were enrolled. At 1 year, 61.9% and 63.6% of the subjects receiving AMX + 250 or 400 mg of MTZ for 14 days, respectively, reached the clinical endpoint for treatment (≤4 sites with probing depth ≥5 mm), against 31.8% of those taking 250 or 400 mg of MTZ for 7 days (p < .05) and 13.6% of those receiving SRP-only (p < .05). Fourteen days of MTZ + AMX was the only significant predictor of subjects reaching the clinical endpoint at 1 year (OR, 5.26; 95% CI, 2.3-12.1, p = .0000). The frequency of adverse events did not differ among treatment groups (p > .05). CONCLUSION: The adjunctive use of 400 or 250 mg of MTZ plus 500 mg of AMX/TID/14 days offers statistically significant and clinically relevant benefits over those achieved with SRP alone in the treatment of severe GChP. The added benefits of the 7-days regimen in this population were less evident. (ClinicalTrials.gov NCT02735395).
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Antibacterianos/uso terapéutico , Periodontitis Crónica/terapia , Amoxicilina/uso terapéutico , Periodontitis Crónica/tratamiento farmacológico , Periodontitis Crónica/microbiología , Terapia Combinada , Raspado Dental , Método Doble Ciego , Femenino , Humanos , Masculino , Metronidazol/uso terapéutico , Persona de Mediana Edad , Índice Periodontal , Estudios Prospectivos , Aplanamiento de la Raíz , Resultado del TratamientoRESUMEN
O objetivo deste trabalho é relatar um caso clínico de implante imediato pós-exodontia na região anterior da maxila. O caso apresentado seguiu o seguinte protocolo de tratamento clínico: diagnóstico da necessidade de exodontia, sondagem óssea; cirurgia reversa em modelo de gesso para a confecção de um pilar de zircônia e uma restauração provisória, exodontia; instalação do implante; enxerto ósseo aloplástico; instalação do pilar de zircônia e da restauração provisória. Após seis meses foi realizada a moldagem do pilar preparado para a confecção da restauração definitiva. Os resultados obtidos preencheram os requisitos estéticos, funcionais e biológicos em função dos corretos diagnósticos, planejamento e execução do caso.
The aim of this work is to present a clinical case of immediate implant in a fresh extraction socket in the maxillary anterior region. The case was treated following the subsequent clinical treatment protocol: diagnosis of dental extraction necessity; reverse surgery in a cast model for the fabrication of a zirconia abutment and a temporary restoration; tooth extraction; alloplastic bone graft; implant placement; installation of the zirconia abutment and the temporary restoration. After a 6-month healing period, an impression of the prepared abutment was done for the production of the definitive restoration. The results met the aesthetic, functional and biological requirements due to the correct diagnosis, planning and execution of the case.
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O objetivo deste estudo foi relatar um caso clínico no qual foi utilizado o sistema KEA-TECH, para planejamento e confecção do guia tomográfi co/cirúrgico na colocação de implante cone-morse com carga imediata. Foi proposta ao paciente (sexo masculino, 69 anos), com fratura radicular do elemento 11, a utilização da coroa natural remanescente como elemento provisório imediato. Pôde-se concluir que o planejamento adequado garante sucesso na reabilitação com implantes em áreas estéticas. Além disso, a utilização do sistema KEA-TECH proporciona facilidade e rapidez nos procedimentos clínicos.
The aim of this study was to report a clinical case where the KEA-TECH system was used to plan the tomographic/surgical guide and place a morse cone implant for immediate loading. The male, 69 years-old patient presented a root fracture at tooth 11, and his natural crown was used as a provisional immediate restoration. It was demonstrated that the adequate planning guarantees the success of implant rehabilitation in esthetic areas. Besides, the use of the KEA-TECH system allows for an easier and speed procedure at the daily clinics.
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Humanos , Masculino , Anciano , Implantación Dental/métodos , Carga Inmediata del Implante Dental , Planificación de Atención al Paciente , Prótesis e Implantes , Cirugía Asistida por ComputadorRESUMEN
Radiotherapy is one of the main approaches to cure prostate cancer, and its success depends on the accuracy of dose planning. A complicating factor is the presence of a metallic prosthesis in the femur and pelvis, which is becoming more common in elderly populations. The goal of this work was to perform dose measurements to check the accuracy of radiotherapy treatment planning under these complicated conditions. To accomplish this, a scale phantom of an adult pelvic region was used with alanine dosimeters inserted in the prostate region. This phantom was irradiated according to the planned treatment under the following three conditions: with two metallic prostheses in the region of the femur head, with only one prosthesis, and without any prostheses. The combined relative standard uncertainty of dose measurement by electron spin resonance (ESR)/alanine was 5.05%, whereas the combined relative standard uncertainty of the applied dose was 3.35%, resulting in a combined relative standard uncertainty of the whole process of 6.06%. The ESR dosimetry indicated that there was no difference (P>0.05, ANOVA) in dosage between the planned dose and treatments. The results are in the range of the planned dose, within the combined relative uncertainty, demonstrating that the treatment-planning system compensates for the effects caused by the presence of femur and hip metal prostheses.
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Adulto , Humanos , Masculino , Citocinas/sangre , Infecciones por VIH/sangre , Linfoma Relacionado con SIDA/sangre , Linfoma de Células B/sangre , Linfoma de Células B/virología , Biomarcadores de Tumor/sangre , Bisexualidad , Estudios de Casos y Controles , Infecciones por VIH/inmunología , Homosexualidad , Inflamación/sangre , Inflamación/inmunología , Inflamación/virología , Activación de Linfocitos , Linfoma Relacionado con SIDA/inmunología , Linfoma de Células B/inmunología , Análisis MultivarianteRESUMEN
The goal of this study was to develop and improve an infrared (IR) navigation system to deliver light dose uniformly during intracavitory PDT by tracking the movement of the light source and providing real-time feedback on the light fluence rate on the entire cavity surface area. In the current intrapleural PDT protocol, several detectors placed in selected locations in the pleural cavity monitor the light doses. To improve the delivery of light dose uniformity, an IR camera system is used to track the motion of the light source as well as the surface contour of the pleural cavity. Monte-Carlo simulation is used to improve the calculation algorithm for the effect of light that undergoes multiple scattering along the surface in addition to an improvement of the direct light calculation using an improved model that accounts for the anisotropy of the light from the light source.
RESUMEN
La asociación entre trastornos psicopatológicos y variables de funcionamiento psicosocial ha sido documentada, pero son escasos los estudios que evalúan su impacto sobre la eficacia de los tratamientos psicológicos. El objetivo de este estudio fue evaluar la organización vital de 78 pacientes de un servicio de atención psicológica y examinar la relación con variables clínicas y con el éxito del tratamiento. Esta organización se evaluó mediante una escala confeccionada ad hoc para este estudio. El área de pareja resultó la menos organizada frente a la familiar y personal, con las mayores puntuaciones. La organización vital se relacionó de forma significativa con distintos ejes del DSM-IV-TR. Se confirmó que pacientes con baja organización vital requieren un mayor número de objetivos terapéuticos.
The association between psychological disorders and psychosocial functioning variables has been previously documented, but relatively few studies have examined the impact of these variables on psychological treatment outcomes. The aim of this study was to assess the life functioning of 78 patients from a psychological service centre, and to examine its relationship with clinical variables and treatment success. Life functioning was evaluated with a scale elaborated ad hoc for this study. The partner area of functioning was the most impaired while family and personal areas obtained the highest functioning scores. Patient's life functioning was significantly associated with several axis of DSM-IV-TR. It was confirmed that patients with poorer life functioning required a greater number of treatment objectives.