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OBJECTIVE: This scoping review aimed to identify and describe the available evidence on the effect of magnifying devices (loupe or microscope) on the performance of restorative dental preparations. MATERIALS AND METHODS: This study was conducted according to the PRISMA-ScR guidelines for scoping reviews and registered on the INPLASY database. An electronic search was performed in four databases and Grey literature for articles published until November 2023. Eligibility criteria were determined using the PICOS strategy and comprised studies that evaluated the performance of magnification devices for restorative dental preparations. A bibliographic mapping of the evidence was conducted. RESULTS: Sixteen studies met the inclusion criteria. Most of the studies (n = 12) compared the performance of dental preparations using magnification loupes vs. no magnification. The magnification for loupes and microscopes ranged from 2.5x to 4.0x and 6.4x to 10x, respectively. The use of magnifying loupes improved the performance of restorative preparations in 66.6% of the evaluated studies. However, when the magnifications were compared, the greater magnification provided by microscopes did not improve preparation performance compared to magnification loupes. Regarding the place of publication, the American continent concentrates the most significant number of evidence. CONCLUSIONS: Although evidence for magnification improving the performance of dental preparations has increased over the last decade, basically only in vitro studies (most of which have taken place in the Americas) have been reported in the literature. The evidence suggests that magnification significantly improves restorative preparation performance when compared to non-magnification. However, higher magnifications (e.g., microscopes) do not appear to improve tooth preparation performance compared with lower magnification devices (e.g., magnification loupes). CLINICAL RELEVANCE: Available evidence supports that using magnification can improve the performance of restored tooth preparations. However, high magnifications have no advantages over lower magnifications.
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Lentes , Humanos , Microscopia/instrumentação , Restauração Dentária Permanente/métodos , Preparo da Cavidade Dentária/métodosRESUMO
Objectives: This study aimed to assess the effects of different magnification systems on the angular deviations of the neck and trunk and the muscle activities of the upper back and neck during preclinical cavity preparation. Methods: This was an experimental laboratory study, with the angular deviations from the neutral positions of the neck and trunk and the activities of the bilateral upper back (the descending and ascending trapezius) and neck (sternocleidomastoid) muscles as the dependent variables. The independent variables were the different magnification systems used (Simple, Galilean, and Keplerian loupes, with direct vision as the control) and prepared teeth (teeth 16, 26, 36, and 46). A dental mannequin phantom head with artificial resin teeth was used, and Class I cavity preparations for composite resin were performed on teeth 16, 26, 36, and 46 using a 1012 round diamond bur at low speed. To analyze the angular deviations, the postures adopted during the procedure were recorded using a tripod-mounted camera positioned to provide a lateral view of the operator. A trained researcher measured the angular deviations using the software entitled "Software for Postural Assessment"-SAPO (version 0.69). Bilateral muscle activity was assessed using surface electromyography. Descriptive statistical analysis was performed, and after verifying the assumptions of normality and homoscedasticity, two-way analysis of variance and the Tukey and Games-Howell post-hoc tests were used to compare the data (α=0.05). Results: The angular deviation from the neutral position of the neck was found to be significantly higher during cavity preparations performed with the naked eye and the Simple loupe, irrespective of the prepared tooth. With regard to tooth location, the angular deviation of the neck was significantly greater during cavity preparation on teeth 16 and 26, and the angular deviation of the trunk was significantly greater during cavity preparation on tooth 26, regardless of the magnification system used. There were significant differences in right sternocleidomastoid muscle activity between the Simple, Galilean, and Keplerian loupes, with activity being the lowest for the Galilean loupe (p = 0.008). There were no significant differences in left sternocleidomastoid muscle activity between the loupes, regardless of the prepared tooth (p = 0.077). The activities of the bilateral descending trapezius and the right ascending trapezius muscles were significantly lower when the Galilean loupe was used (p < 0.010). Conclusion: These results suggest that the Galilean loupe resulted in lower muscle activity in the neck and back regions and that the Galilean and Keplerian loupes resulted in less angular deviations of the neck and trunk during cavity preparation.
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Eletromiografia , Manequins , Músculos do Pescoço , Humanos , Músculos do Pescoço/fisiologia , Postura/fisiologia , Pescoço , Tronco/fisiologia , MasculinoRESUMO
INTRODUCTION: Accurate assessment of invasion depth of early rectal neoplasms is essential for optimal therapy. We aimed to compare three-dimensional endorectal ultrasound (3D-ERUS) with magnification chromoendoscopy (MCE) regarding their accuracy in assessing parietal invasion depth (T). METHODS: Patients with middle and distal rectum neoplasms were prospectively included. Two providers blinded to each other's assessment performed 3D-ERUS and MCE, respectively. The T stage assessed through ERUS was compared to the MCE evaluation. The results were compared to the surgical specimen anatomopathological report. Sensitivity, specificity, accuracy, positive (PPV), and negative (NPV) predictive values were calculated for the T stage and for the final therapy (local excision or radical surgery). RESULTS: In 8 years, 70 patients were enrolled, and all underwent both exams. MCE and ERUS showed an accuracy of 94.3% and 85.7%, sensitivity of 83.7 and 93.3%, specificity of 96.4 and 83.6%, PPV of 86.7 and 60.9%, and NPV of 96.4 and 97.9%, respectively. Kappa for T stage assessed through ERUS was 0.64 and 0.83 for MCE. CONCLUSION: MCE and 3D-ERUS had good diagnostic performance, but the endoscopic method had higher accuracy. Both methods reliably assessed lesion extension, circumferential involvement, and distance from the anal verge.
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Endossonografia , Neoplasias Retais , Humanos , Endossonografia/métodos , Estadiamento de Neoplasias , Neoplasias Retais/patologia , Ultrassonografia/métodos , Canal AnalRESUMO
Information on pollutant trophodynamics can be crucial for public health, as contaminated food consumption may lead to deleterious effects. This study was performed in Puruzinho Lake, a remote body of water in the Brazilian Amazon from which a riparian human population obtains an important part of its animal protein intake. Samples from 92 individuals, comprising 13 species and four trophic guilds (iliophagous, planktivorous, omnivorous, and piscivorous fish) were analysed for the determination of trace elements (Fe, Cr, Mn, Ni, Zn, Ca, Sr, Cd, Sn, Tl and Pb) and methylmercury concentrations. Samples from the same individuals had already been analysed for stable isotope (SI) measurements (δ13C and δ15N) in a previous investigation and the SI data have been statistically treated with those generated in this study for the evaluation of trophic dynamics of contaminants. Methylmercury was the only analyte that biomagnified, presenting TMF values of 4.65 and 4.55 for total and resident ichthyofauna, respectively. Trace elements presented either trophic dilution or independence from the trophic position, constituting a behaviour that was coherent with that found in the scientific literature. The similarity between Ni behaviour through the trophic web to that of essential elements contributes to the discussion on the essentiality of this metal to fish. Considering the Non-cancer Risk Assessment, the calculated Target Hazard Quotient (THQ) values were higher than 1.0 for all analysed individuals for methylmercury, as well as for only one individual for nickel. No other analyte rendered THQ values higher than 1.0.
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OBJECTIVES: To assess the distortion of high-density materials using two CBCT devices presenting convex triangular and cylindrical fields of view (FOVs). METHODS AND MATERIALS: Four high-density cylinders were individually placed in a polymethylmethacrylate phantom. 192 CBCT scans were acquired using the convex triangular and cylindrical FOVs of Veraviewepocs® R100 (R100) and Veraview® X800 (X800) devices. Using HorosTM's software, two oral radiologists determined the cylinders' horizontal and vertical dimensional alterations. Nine oral radiologists subjectively identified each cylinder's axial shape distortion. Statistical analysis comprised Multiway ANOVA (α = 5%), and the Kruskal-Wallis test. RESULTS: The distortion in the axial plane was greater in the convex triangular FOVs for both devices in almost all the materials (p < 0.05). The evaluators subjectively identified a shape distortion in both FOVs for R100 device (p < 0.001), while no distortion was identified for X800 device (p = 0.620). A vertical magnification of all materials was observed in both FOVs for both devices (p < 0.05). No differences among vertical regions (p = 0.988) nor FOVs (p = 0.544) were found for the R100 device, while all materials showed higher magnification in all regions in the cylindrical FOV (p < 0.001) of the X800 device. CONCLUSIONS: The convex triangular FOV influenced the axial distortion of the high-density materials in both devices. A vertical magnification was observed in both FOVs of both devices, but it was greater in the cylindrical FOV of the X800 device.
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Tomografia Computadorizada de Feixe Cônico , Humanos , Tomografia Computadorizada de Feixe Cônico/métodos , Imagens de FantasmasRESUMO
The aim was to evaluate the effectiveness of clinical methods in identifying the presence of second mesiobuccal canal in maxillary first molars. The influence of age and experience with microscopy was also assessed. Sixty six teeth were selected and the mesiobuccal canal was confirmed in all of the samples by Cone-Beam Computed Tomography. After endodontic cavity access, teeth were evaluated through direct visual; dental loupe and operating microscope. None of the methods was successful in finding the mesiobuccal canal in all samples. Professionals <40, the magnification did not influence the location. Professionals >40, the magnification significantly influenced the location. In the direct vision, professionals >40 years located fewer canals than those <40 years of age with experience. In conclusion, these preliminary findings showed that when the microscope was used, the professionals with experience, regardless of age, found a higher number of canals. The use of the microscope was significant for professionals >40 years.
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Maxila , Raiz Dentária , Maxila/diagnóstico por imagem , Cavidade Pulpar/diagnóstico por imagem , Dente Molar/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico/métodosRESUMO
Introdução: Imagem endoscópica aprimorada permite o diagnóstico diferencial das lesões colorretais em tempo real através do estudo da microvasculatura. Objetivo: Revisar o uso do Blue Laser Imaging (BLI) na análise do padrão dos capilares para o diagnóstico diferencial entre lesões neoplásicas e não neoplásicas. Métodos: Esta é revisão integrativa da literatura que colheu informações publicadas em plataformas virtuais em português e inglês. A busca para leitura e análise foi realizada nas plataformas SciELO Scientific Electronic Library Online, Google Scholar, Pubmed e Scopus. Os descritores retirados do DeCS/MESH foram: "Blue laser imaging. Endoscopia. Cromoendoscopia, Pólipos colorretais. Magnificação" e seus correspondentes em inglês "Blue laser imaging. Image-enhanced endoscopy. Chromoendoscopy. Colorectal polyps. Magnification" com busca AND ou OR, considerando o título e/ou resumo. Foram incluídos somente os que tivessem maior correlação ao tema, e neles foi baseada a revisão com leitura, na íntegra, dos textos. Resultados: Ao final resultaram 22 artigos que compuseram esta revisão. Conclusão: BLI associada à magnificação mostrou bons resultados no diagnóstico histológico preditivo em tempo real para as lesões de cólon e reto.
Introduction: Improved endoscopic imaging allows the differential diagnosis of colorectal lesions in real time through the study of the microvasculature. Objective: To review the use of Blue Laser Imaging (BLI) in analyzing the capillary patern for the differential diagnosis between neoplastic and nonneoplastic lesions. Methods: This is an integrative review of the literature that collected information published on virtual platforms in Portuguese and English. The search for reading and analysis was carried out on the SciELO Scientific Electronic Library Online, Google Scholar, Pubmed and Scopus platforms. The descriptors taken from DeCS/MESH were: "Blue laser imaging. Endoscopy. Chromoendoscopy, Colorectal polyps. Magnification" and its English counterparts "Blue laser imaging. Image-enhanced endoscopy. Chromoendoscopy. Colorectal polyps. Magnification" with AND or OR search, considering the title and/or abstract. Only those that had the greatest correlation to the topic were included, and the review was based on them, with reading, in full, of the texts. Results: In the end, 22 articles resulted that made up this review. Conclusion: BLI associated with magnification showed good results in real-time predictive histological diagnosis for colon and rectal lesions.
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Humanos , Neoplasias do ColoRESUMO
Objective To evaluate the accuracy and differences between 2 types of metallic markers, sphere, and coin, for radiographic calibration in the preoperative planning of hip arthroplasty. Methods Four spherical metallic markers and four coins, both 25 mm in diameter, were placed on the greater trochanter, pubic symphysis, between the thighs, and on the table of the exam, for radiographic examination of the hip in 33 patients with hip prosthesis. The prosthesis head was used for calibration and two examiners measured the markers' image diameters, and the results were analyzed statistically. Results In the greater trochanter, the sphere and the coin were not visualized in 19 radiographs (57.6%). Between the thighs, the coin marker was not visualized in 13 radiographs (39.4%). In the greater trochanter, the 25-mm accuracy of the coin and the sphere was, respectively, between 57.1 and 63.3% and between 64.3 and 92.9%. The coin between the thighs reached 25-mm accuracy in between 50 and 60% of cases. Over the exam table, the coin and sphere markers reached, respectively, the mean diameters of 22.91 mm and 23 mm, the lowest coefficient of variation, the lowest confidence interval, and the easiest positioning. There was statistical difference between the evaluations of the markers (coin vs. sphere) in all positions ( p < 0.032), except for the exam table position ( p = 0.083). Conclusions The coin between the thighs is the best marker for radiographic calibration in the preoperative planning of hip arthroplasty, and we suggest the use of another coin on the exam table for comparison, considering the 8% reduction in relation to its real size.
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Abstract Objective To evaluate the accuracy and differences between 2 types of metallic markers, sphere, and coin, for radiographic calibration in the preoperative planning of hip arthroplasty. Methods Four spherical metallic markers and four coins, both 25 mm in diameter, were placed on the greater trochanter, pubic symphysis, between the thighs, and on the table of the exam, for radiographic examination of the hip in 33 patients with hip prosthesis. The prosthesis head was used for calibration and two examiners measured the markers' image diameters, and the results were analyzed statistically. Results In the greater trochanter, the sphere and the coin were not visualized in 19 radiographs (57.6%). Between the thighs, the coin marker was not visualized in 13 radiographs (39.4%). In the greater trochanter, the 25-mm accuracy of the coin and the sphere was, respectively, between 57.1 and 63.3% and between 64.3 and 92.9%. The coin between the thighs reached 25-mm accuracy in between 50 and 60% of cases. Over the exam table, the coin and sphere markers reached, respectively, the mean diameters of 22.91 mm and 23 mm, the lowest coefficient of variation, the lowest confidence interval, and the easiest positioning. There was statistical difference between the evaluations of the markers (coin vs. sphere) in all positions (p< 0.032), except for the exam table position (p= 0.083). Conclusions The coin between the thighs is the best marker for radiographic calibration in the preoperative planning of hip arthroplasty, and we suggest the use of another coin on the exam table for comparison, considering the 8% reduction in relation to its real size.
Resumo Objetivo Avaliar a precisão e as diferenças entre 2 tipos de marcadores metálicos, esfera e moeda, para calibração radiográfica no planejamento pré-operatório da artroplastia de quadril. Métodos Quatro marcadores metálicos esféricos e quatro moedas, ambas de 25 mm de diâmetro, foram colocadas em trocânter maior, sínfise púbica, entre as coxas e a mesa do exame, para exame radiográfico do quadril em 33 pacientes com prótese de quadril. A cabeça da prótese foi utilizada para calibração e dois examinadores mediram os diâmetros da imagem dos marcadores, e os resultados foram analisados estatisticamente. Resultados No trocânter maior, a esfera e a moeda não foram visualizadas em 19 radiografias (57,6%). Entre as coxas, o marcador de moeda não foi visualizado em 13 radiografias (39,4%). No trocânter maior, a precisão de 25 mm da moeda e da esfera foi, respectivamente, entre 57,1 e 63,3% e entre 64,3 e 92,9%. A moeda entre as coxas atingiu 25 mm de precisão entre 50 e 60%. Sobre a mesa de exame, os marcadores de moeda e esfera atingiram, respectivamente, diâmetros médios de 22,91 mm e 23 mm, o menor coeficiente de variação, o menor intervalo de confiança e o posicionamento mais fácil. Houve diferença estatística entre as avaliações dos marcadores (moeda vs. esfera) em todas as posições (p< 0,032), com exceção da posição na mesa de exame (p= 0,083). Conclusões A moeda entre as coxas é o melhor marcador para calibração radiográfica no planejamento pré-operatório da artroplastia de quadril, e sugerimos o uso de outra moeda na mesa de exame para comparação, considerando os 8% de redução em relação ao seu tamanho real.
Assuntos
Humanos , Masculino , Feminino , Pelve/diagnóstico por imagem , Ampliação Radiográfica , Estudos Retrospectivos , Artroplastia de Quadril , Prótese de QuadrilRESUMO
RESUMEN: Esta revisión sobre magnificación en periodoncia presenta la evidencia disponible sobre el tema. Dentro de este trabajo se incluyen: principios y prestaciones de la magnificación, ventajas y desventajas de los diferentes sistemas, características de los instrumentos de microcirugía, ergonomía, trastornos músculo esqueletales, resultados clínicos, cicatrización, percepción de los pacientes y habilidades clínicas necesarias. El objetivo del trabajo fue comprender el funcionamiento de la magnificación, comparar la microcirugía (cirugía con magnificación) vs macro cirugía (cirugía sin magnificación) en función de la ergonomía, la cicatrización y los resultados clínicos. Comparar las ventajas y desventajas de las lupas vs microscopio y conocer las habilidades necesarias para su utilización. Se realizó una búsqueda bibliográfica manual, las bases consultadas fueron: PubMed, Biblioteca Cochrane, EMBASE, Scopus, Science Direct, SciELO. La búsqueda fue sin límites temporales o de idiomas. Se incluyeron investigaciones, revisiones bibliográficas y metaanálisis, también se realizó rastreo de citas. Se recabaron un total de 251 artículos de los cuales se seleccionaron 43 para la revisión. Los artículos fueron revisados por los autores y aceptados por consenso para su discusión. En conclusión trabajar con magnificación aporta ventajas en todos los aspectos estudiados en esta revisión y en la percepción de los pacientes. Si se comparan las lupas con el microscopio, éste ultimo es mejor en cuanto a ergonomía, iluminación, posibilidades de documentación y mayor aumento. Incorporar la magnificación requiere entrenamiento, esta revisión expone los fundamentos por los cuales dicho esfuerzo se traduce en beneficios mayores.
ABSTRACT: This review on magnification in periodontics presents the available evidence on the subject, comprising principles and benefits of magnification, advantages and disadvantages of different systems, characteristics of the instruments in microsurgery, ergonomics, musculoskeletal disorders, clinical results, healing, perception of patients and necessary clinical skills. Objective: to understand the operation of magnification, to compare microsurgery (surgery with magnification) vs macro surgery (surgery without magnification) based on ergonomics, healing, and clinical results. Compare the advantages and disadvantages of loupes vs microscope and know the skills necessary to use them. Material and Method: a manual bibliographic search was carried out, the databases consulted were: PubMed, Cochrane Library, EMBASE, Scopus, Science Direct, SciELO. The search was without time or language limits. Research, literature reviews, and meta-analysis were included, and citation tracking was also done. Results: a total of 251 articles were collected, of which 43 were selected for the review. The articles were reviewed by the authors and accepted by consensus for discussion. Conclusion: working with magnification provides advantages in all the aspects studied in this review and in the perception of the patients. If the magnifying glasses are compared with the microscope, the latter is better in terms of ergonomics, lighting, documentation possibilities and higher magnification. Incorporating magnification requires training, this review expound the justification for which such effort translates into greater benefits.
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Introduction: Body piercings consist of small holes made with a needle in different parts of the skin or body to introduce a jewel or decorative element. In the oral cavity, most piercings are placed in the tongue. However, some complications may occur, and surgical techniques must be used for their removal. These complications present a certain degree of difficulty due to their position and may challenge the ability of the clinician to access the specific anatomical location. The different imaging techniques, from simple radiography to intraoperative techniques such as image intensifiers, have become an extremely useful tool for locating an object in the three dimensions of space, allowing safe location and extraction. Objective: The aim of this study is to report the case of a complication of a body piercing in the oral cavity and how the use of imaging was decisive for surgical planning and for the quick and effective resolution of the case. Material and Methods: A 14-year-old female patient came looking for treatment. Her mother reported the onset of the condition after the insertion of a needle-like metallic object while performing an artistic perforation in the lingual region. Since the girl was unable to extract the object, she sought medical advice at the Carlos Arvelo Military Hospital in Caracas, Venezuela. Subsequently, an imaging study was performed by means of a Computed Tomography to locate the metallic object. It was observed that the foreign body had migrated to the floor of the mouth/sublingual region, requiring the area to be surgically approached. It was also decided to use an intraoperative image intensifier. The removal of the object was performed satisfactorily. Conclusion: The extraction of foreign bodies placed in the lingual and sublingual region represents a challenge for the clinician due to the number of important anatomical structures that pass through that area. This makes clinicians plan their surgical removal using pre- and intraoperative imaging, to find a less traumatic location, reduce surgical time as well as the risk of damaging adjacent anatomical structures.
Introducción: Los body piercings consisten en producir perforaciones con una aguja en diferentes localizaciones de la piel con el fin de introducir una joya o elemento decorativo a través del agujero producido previamente. En la cavidad oral, la lengua es el sitio de mayor elección; sin embargo, en ciertas ocasiones suelen presentarse ciertas complicaciones, por lo cual se debe recurrir a técnicas quirúrgicas para su remoción presentando cierto grado de dificultad para su localización y la capacidad del clínico para acceder al espacio anatómico. Las diferentes técnicas imagenológicas desde una radiografía simple hasta técnicas intraoperatorias como los intensificadores de imágenes se han convertido en una herramienta sumamente útil para la ubicación de un objeto en las tres dimensiones del espacio, permitiendo una localización y extracción segura para el clínico y el paciente. Objetivo: El propósito de este trabajo es reportar un caso de una complicación de esta práctica en la región bucal y cómo el uso de la imagenología fue determinante para la planificación quirúrgica y la resolución del caso de manera rápida y efectiva. Material y Métodos: Se presenta a consulta una paciente femenina de 14 años de edad, quien madre refiere inicio de enfermedad actual posterior a introducirse objeto metálico tipo aguja de compás con la finalidad de realizar perforación artística en región lingual, al no poder extraer dicho objeto, acude a evaluación en el Hospital Militar Carlos arvelo de Caracas; posterior se realiza estudio imagenológico tipo Tomografía Computarizada para la ubicación del objeto metálico donde se observa que el cuerpo extraño habría migrado hacia el piso de boca/región sublingual, teniendo la necesidad de abordar quirúrgicamente la zona y elegir el uso de intensificador de imagen transoperatorio para retiro del mismo el cual se dio de manera satisfactoria. Conclusión: Los cuerpos extraños desplazados a la región lingual y sublingual representan un desafío para el clínico al momento de extraerlos, esto se debe a la cantidad de estructuras anatómicas importantes que pasan por dicha zona, lo que hace que el clínico opte en su planificación quirúrgica por el uso de imagenología pre y transoperatoria obteniendo así una localización menos traumática, menor tiempo operatorio y menor riesgo de lesión de estructuras anatómicas adyacentes.
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Humanos , Feminino , Adolescente , Língua/cirurgia , Tomografia Computadorizada por Raios X , Corpos Estranhos/diagnóstico por imagem , Soalho Bucal/diagnóstico por imagem , Radiografia , Piercing Corporal , Soalho Bucal/cirurgiaRESUMO
Objectives: To determine the effect of different levels of Galilean loupe magnification on working posture as measured by compliance with ergonomic posture positions, angular deviation from the neutral position of the neck, and muscle activation in the neck and upper back region during simulated clinical conditions. Methods: An experimental laboratory study was performed in which the dependent variables were compliance with ergonomic posture requirements while performing simulated restorative procedures in Restorative Dentistry, angular deviation from the neutral position of the neck, and muscle activation in the neck and upper back. The independent variable was the level of Galilean loupe magnification, which was tested at four levels (naked eye, 2.5× magnification, 3.0× magnification, and 3.5× magnification). The cavity preparations and Class I composite resin restorations were performed on artificial first molars on a mannequin in a dental chair. The Compliance Assessment of Dental Ergonomic Posture Requirements (CADEP) was used for the postural analysis; as was an analysis of the angular deviation from the neutral position of the neck and surface electromyography. Working posture was recorded on video over the course of the procedure. Participants were filmed from three different angles. The Compliance Assessment of Dental Ergonomic Posture Requirements (CADEP) assessed compliance with ergonomic posture requirements. A locally produced posture assessment software analyzed angular deviation. Surface electromyography bilaterally assessed activation of the sternocleidomastoid, descending trapezius and ascending trapezius muscles. Two-factor analysis of variance (ANOVA) and either Tukey's post-hoc test or the Games-Howell post-hoc test were performed (α = 0.05). Results: During the cavity preparations and restorations, the use of Galilean loupes at all magnifications positively influenced working posture as measured by participants' compliance with ergonomic posture positions (p < 0.01) and neck angulation (p < 0.01); the use of these loupes did not affect muscle activation in the regions evaluated (p > 0.05). Conclusion: The use of Galilean loupes had a positive effect on dental students' working posture during the restoration procedures performed.
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Lentes , Estudantes de Odontologia , Humanos , Postura , Olho Artificial , OdontologiaRESUMO
Biomagnification of trace elements is increasingly evident in aquatic ecosystems. In this review we investigate the drivers of biomagnification of mercury (Hg), arsenic (As) and selenium (Se) in aquatic food webs. Despite Hg, As and Se biomagnify in food webs, the biomagnification potential of Hg is much higher than that of As and Se. The slope of trophic increase of Hg is consistent between temperate (0.20), tropical (0.22) and Arctic (0.22) ecosystems. Se exerts a mitigating role against Hg toxicity but desired maximum and minimum concentrations are unknown. Environmental (e.g. latitude, temperature and physicochemical characteristics) and ecological factors (e.g. trophic structure composition and food zone) can substantially influence the biomagnification process these metal (oids). Besides the level of bioaccumulated concentration, biomagnification depends on the biology, ecology and physiology of the organisms that play a key role in this process. However, it may be necessary to determine strictly biological, physiological and environmental factors that could modulate the concentrations of As and Se in particular. The information presented here should provide clues for research that include under-researched variables. Finally, we suggest that biomagnification be incorporated into environmental management policies, mainly in risk assessment, monitoring and environmental protection methods.
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Arsênio , Mercúrio , Selênio , Poluentes Químicos da Água , Animais , Bioacumulação , Ecossistema , Monitoramento Ambiental , Peixes , Cadeia Alimentar , Mercúrio/análise , Selênio/análise , Poluentes Químicos da Água/análiseRESUMO
TESE-ICSI (testicular sperm extraction associated with intracytoplasmic sperm injection) represents a technique to attain pregnancy in couples with non-obstructive azoospermia (NOA) and other unlikely situations. Because of the poor pregnancy outcomes obtained by this procedure, we need new sperm selection techniques to improve the livebirth rate of NOA patients. Here we describe a successful micro TESE-ICSI cycle performed with sperm selected through high magnification and polarized light microscopy in a couple with two previous ICSI failures.
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Azoospermia , Injeções de Esperma Intracitoplásmicas , Azoospermia/diagnóstico , Azoospermia/terapia , Feminino , Humanos , Masculino , Gravidez , Estudos Retrospectivos , Recuperação Espermática , EspermatozoidesRESUMO
La microendodoncia involucra la visualización a través de un microscopio operatorio de todas las fases del tratamiento de conductos y procedimientos de cirugía apical y correctiva por parte del endodoncista. Existe sobrada evidencia acerca de las mejoras que puede aportar la magnificación al tratamiento; la literatura demuestra que la capacidad del operador mejora si su visión del campo gana claridad y precisión, ambos recursos pueden ser proporcionados por el microscopio operatorio, aunado a que posibilita diagnósticos más certeros junto con mejoras en el pronóstico, lo que permite evitar posibles complicaciones. La calidad de los tratamientos endodóncicos involucra infinidad de factores, cada uno relevante en sí mismo pero, en determinados casos, el microscopio puede significar la diferencia entre un tratamiento exitoso o un fracaso clínico. En la actualidad, se ha convertido en un tema de lo más relevante, por lo que el objetivo del presente trabajo es revisar la literatura con el fin de ayudar al entendimiento basado en evidencia científica de los criterios que determinan la relevancia del uso del microscopio en el ámbito endodóncico (AU)
Microendodontics involves the visualization through an operating microscope of all phases of root canal treatment and apical and corrective surgery procedures by the endodontist. There is plenty of evidence about the improvements that magnification can provide, the literature shows that the operator's ability improves if his vision of the field gains clarity and precision, both resources can be provided by the operating microscope, added to the fact that it enables more accurate diagnoses together with improvements in the prognosis allowing to avoid possible complications. The quality of endodontic treatments involves countless factors, each relevant in itself, but in certain cases the microscope can mean the difference between a successful treatment or a clinical failure. At present, it has become a very relevant topic, so the objective of this work is to review the literature in order to help understand the criteria that determine the relevance of the use of the microscope in the endodontic field based on scientific evidence (AU)
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Humanos , Tratamento do Canal Radicular/tendências , Aumento da Imagem/instrumentação , Microscopia/métodos , Doenças Periapicais/diagnóstico , Prognóstico , Resultado do Tratamento , Instrumentos Odontológicos , Doenças da Polpa Dentária/diagnósticoRESUMO
OBJECTIVES: This study observed the effect of different magnification systems on working posture and neck angulation during cavity preparation procedures according to operator's experience. METHODS: This was a laboratory study. The response variables were the neck angulation and the working posture adopted during Class I cavity preparations (N = 640) that were performed under four conditions (unaided visualization, simple loupe, Galilean loupe and Keplerian loupe). Working postures were recorded and evaluated by the Compliance Assessment of Dental Ergonomic Posture Requirements (CADEP). The two-factor ANOVA and Games-Howell post-hoc test were performed (α = 0.05). RESULTS: For all treated teeth it was observed higher posture scores and lowest neck angulations while using the Galilean and Keplerian loupes (p < 0.01). No correlations were found between operator's experience and working posture (p = 0.71-0.88). CONCLUSION: It can be concluded that Galilean and Keplerian loupes helped operators to maintain an ergonomic posture and lower neck angulations for all teeth and the operator's experience provided better ergonomic posture for the mandibular teeth.
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This study assessed the concentration, bioconcentration, and bioaccumulation of As, Cd, Co, Cr, Cu, Mg, Mn, Ni, Pb, and Zn in juvenile fishes (Acestrorynchus pantaneiro, Brycon orbygnianus, Cyphocharax voga, Megaleporinus obtusidens, Odontesthes bonariensis, Pimelodus maculatus, Prochilodus lineatus, Salminus brasiliensis, and Schizodon borelli) in the Lower Paraná River (Argentina), the most extensive floodplain from the Plata Basin. The floodplain is crucial for the reproduction and growth of various species such as P. lineatus, M. obtusidens, and S. brasiliensis, which complete their life cycle in this environment. In total, 90 individuals were sampled for nitrogen stable isotope, and trace element analysis in muscle tissue, water, and sediment was analyzed. The results show that all the studied species bioaccumulate Cr, Mg, Ni, and Zn. In particular, B. orbygnianus and P. maculatus presented the highest bioaccumulation factor for Cr. A biodilution of Co through the food chain was observed. No positive correlation was found between element concentration and trophic level, but we observed significant differences between trophic guilds (herbivorous, omnivorous, and carnivorous). Our findings suggest that feeding habits determine trace element concentrations. To establish differential behavior between different species within the aquatic web further studies are necessary, particularly in the floodplain of the Paraná, which is a crucial nursery area for most commercially important fishes from the Plata Basin. Graphical abstract.
Assuntos
Metais Pesados , Oligoelementos , Poluentes Químicos da Água , Animais , Argentina , Bioacumulação , Ecossistema , Monitoramento Ambiental , Peixes , Humanos , Metais Pesados/análise , Rios , Poluentes Químicos da Água/análiseRESUMO
OBJECTIVE: Fenestrated-branched endovascular aneurysm repair (F/B-EVAR) is a complex procedure that generates high radiation doses. Magnification aids in vessel cannulation but increases radiation. The aim of the study was to compare radiation doses to patients and operating room staff from two fluoroscopy techniques, standard magnification vs dual fluoroscopy with live-image digital zooming during F/B-EVAR. METHODS: An observational, prospective, single-center study of F/B-EVAR procedures using Philips Allura XperFD20 equipment (Philips Healthcare, Amsterdam, The Netherlands) was performed during a 42-month period. Intravascular ultrasound, three-dimensional fusion, and extreme collimation were used in all procedures. Intraoperative live-image processing was performed with two imaging systems: standard magnification in 123 patients (81%) and dual fluoroscopy with live-image digital zooming in 28 patients (18%). In the latter, the live "processed" zoomed images are displayed on examination displays and live images are displayed on reference displays. The reference air kerma was collected for each case and represents patient dose. Operating staff personal dosimetry was collected using the DoseAware system (Philips Healthcare). Patient and staff radiation doses were compared using nonparametric tests. RESULTS: Mean age was 71.6 ± 11.4 years. The median body mass index was 27 kg/m2 (interquartile range [IQR], 24.4-30.6 kg/m2) and was the same for both groups. Procedures performed with dual fluoroscopy with digital zooming demonstrated significantly lower median patient (1382 mGy [IQR, 999-2045 mGy] vs 2458 mGy [IQR, 1706-3767 mGy]; P < .01) and primary operator radiation doses (101 µSv [IQR, 34-235 µSv] vs 266 µSv [IQR, 104-583 µSv]; P < .01) compared with standard magnification. Similar significantly reduced radiation doses were recorded for first assistant, scrub nurse, and anesthesia staff in procedures performed with dual fluoroscopy. According to device design, procedures performed with four-fenestration/branch devices generated higher operator radiation doses (262 µSv [IQR, 116.5-572 µSv] vs 171 µSv [IQR, 44-325 µSv]; P < .01) compared with procedures with three or fewer fenestration/branches. Among the most complex design (four-vessel), operator radiation dose was significantly lower with digital zooming compared with standard magnification (128.5 µSv [IQR, 70.5-296 µSv] vs 309 µSv [IQR, 150-611 µSv]; P = .01). CONCLUSIONS: Current radiation doses to patients and operating personnel are within acceptable limits; however, dual fluoroscopy with live-image digital zooming results in dramatically lower radiation doses compared with the standard image processing with dose-dependent magnification. Operator radiation doses were reduced in half during procedures performed with more complex device designs when digital zooming was used.
Assuntos
Aneurisma Aórtico/cirurgia , Implante de Prótese Vascular , Procedimentos Endovasculares , Exposição Ocupacional/prevenção & controle , Exposição à Radiação/prevenção & controle , Ampliação Radiográfica , Radiografia Intervencionista , Idoso , Idoso de 80 Anos ou mais , Aneurisma Aórtico/diagnóstico por imagem , Prótese Vascular , Implante de Prótese Vascular/efeitos adversos , Implante de Prótese Vascular/instrumentação , Procedimentos Endovasculares/efeitos adversos , Procedimentos Endovasculares/instrumentação , Feminino , Fluoroscopia , Humanos , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/efeitos adversos , Saúde Ocupacional , Segurança do Paciente , Estudos Prospectivos , Exposição à Radiação/efeitos adversos , Ampliação Radiográfica/efeitos adversos , Radiografia Intervencionista/efeitos adversos , Medição de Risco , Fatores de RiscoRESUMO
Purpose: We describe subtle macular changes that were detected by high-magnification color fundus imaging in infants with congenital Zika syndrome. Methods: This series included 4 infants (age: 1.4 ± 0.1 years [range, 1.3-1.5 years]) who were serologically confirmed with congenital Zika syndrome, examined under anesthesia, and underwent fundus examination and color fundus documentation. The fundus images were captured using 130° and 80° field lenses. Fluorescein angiography confirmed macular lesions. Results: Wide-angle color fundus images detected unilateral retinal findings in all 4 infants. Chorioretinal atrophy was identified in 2 eyes (25%) of 2 infants (50%) and pigment mottling in 3 eyes (37.5%) of 2 infants (50%). High-magnification imaging revealed subtle macular changes in the contralateral eyes of the 4 infants that were confirmed by fluorescein angiography imaging. Conclusions: High-magnification fundus imaging can be effective and reliable in revealing and documenting subtle structural changes in the macula of infants with congenital Zika syndrome.
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Background Neuroendoscopy is gaining popularity and is reaching new realms. Young neurosurgeons are exploring the various possibilities associated with the use of neuroendoscopy. Neuroendoscopy in excision of parenchymal brain tumors is less explored, and young neurosurgeons should be aware of the realities. The present article is an approach to put forward the difficulties faced by a young neurosurgeon and the lessons learnt. Objective To report the experience of surgical excision of parenchymal brain tumors, in selected cases, using pure endoscopic approach and to discuss its feasibility, technical benefits, risks and comparison with conventional microscopic excision. Method Eight patients of variable age group with parenchymal brain tumors were operated upon by a single surgeon and followed up for a period varying from6months to 2 years. Data regarding operating time, illumination, clarity of the field, size of craniotomy, blood loss and course of recovery was evaluated. All of the tumors were resected using rigid high definition zero and 30° endoscope. Results Out of eight cases, seven had lesions in the supratentorial and one in the infratentorial location. The age group ranged from 27 to 74 years old. Near to gross total resection was achieved in all except two cases. All of the patients recovered well without any significant morbidity or mortality. Hospital stay was reduced by 1 day on average. Conclusion Excision of parenchymal brain tumors via pure endoscopic method is a safe and efficient procedure. Although there is an initial period of learning curve, it is not steep for those already practicing neuroendoscopy, but the approach has its advantages.