Cerebral single-photon emission computed tomography (SPECT) is a sensitive technique for the detection of central nervous system (CNS) involvement in systemic lupus erythematosus (SLE). The objective was to determine whether a relationship exists between cerebral hypoperfusion as detected by cerebral SPECT, cumulative tissue damage and the clinical activity of SLE. Cerebral technetium-99m-L,L-ethyl cysteinate dimer (99mTc-ECD) SPECT was performed in two groups of patients: 10 women with SLE (Group A) who had no previous history of major neuropsychiatric (NPS) manifestations and no minor NPS symptoms in the last six months, and 57 unselected women with SLE (Group B). In the same week that SPECT was performed, the SLE disease activity index (SLEDAI), SLICC/ACR damage index, native anti-DNA antibodies (ELISA) and erythrocyte sedimentation rate (ESR) were determined. In Group A, cerebral SPECT showed moderate or severe hypoperfusion (abnormal SPECT) in five patients without NPS symptoms, unrelated to age (mean 24.8 versus 27.8 years) or disease duration (mean 6.8 versus 9 years). Patients with significant cerebral hypoperfusion had greater clinical disease activity (mean SLEDAI 13.6 versus 7.6) (SLEDAI> 7 in 5/5 versus 1/5; Fisher: 0.023; OR: 33; 95% CI: 2.3-469.8) and ESR (mean 43.6 versus 9.8; P < 0.05). In Group B, the mean age of the 57 unselected women with SLE was 37 years (SD 6.3) and the mean duration of the disease was 9.7 years (SD 6.3). Cerebral SPECT revealed normal perfusion or mild hypoperfusion (normal SPECT) in 30 patients (52.6%), and moderate or severe hypoperfusion in 27 (47.4%). Hypoperfusion was unrelated to age, duration of SLE or concentrations of anti-DNA antibodies and C3 and C4 fractions. Patients with significant cerebral hypoperfusion had more active clinical disease (mean SLEDAI 13.92; SD 8.44 versus 4.56; SD 4.15) (Mann-Whitney, P < 0.005), more cumulative tissue damage (mean SLICC 2.66; SD 2.84 versus 1.03; SD 1.51) (Mann-Whitney, P = 0.035), and higher ESR values (mean 28.7; SD 22.5 versus 17.7; SD 13.3) (Mann-Whitney, P = 0.023) than patients with normal SPECT studies. Significant cerebral hypoperfusion was related both to NPS manifestations present at the time of the study (17 of 27, 63% versus 3 of 30, 10%) (OR: 15.3) and cumulative manifestations (19 of 27, 70.4% versus 8 of 30, 26.7%) (OR: 6.5), whether mild (OR: 5.5) or severe (OR: 8.2). In conclusion, cerebral hypoperfusion detected by SPECT in patients with SLE is related to clinical activity (SLEDAI), cumulative tissue damage (SLICC) and concomitant or previous NPS manifestations.
RADIOPACITY OF CALCIUM HYDROXIDE CEMENT COMPARED WITH HUMAN TOOTH STRUCTURE
RADIOPACIDADE DO CIMENTO DE HIDRÓXIDO DE CÁLCIO COMPARADA A DAS ESTRUTURAS DENTAIS HUMANASims. All materials added to teeth should present an adequate radiopacity to allow the detection of secondary caries. Usually, in extensive cavities, base materials like calcium hydroxide cement are used for the purpose of protecting the pulp. In an attempt to improve the efficiency of radiographic detection of this material, this study aimed to determine the radiopacity of three calcium hydroxide cements and to compare the radiopacity of these materials with dentin and enamel. Methods. Radiographs were taken of 1-mm thick specimens of three calcium hydroxide cements: Hydro-C, Dycal and Life, an aluminium stepwedge, a lead foil, and one 1-mm thick human tooth slice. Densitometric measurements were obtained after radiographic processing. The radiopacity values of the calcium hydroxide cements, dentin and enamel were expressed in terms of the equivalent thickness of aluminium. Results. The analysis of variance indicated statistically significant difference only for Life, which presented the lowest radiopacity when compared to the other cements. However, all cements and enamel possessed a radiopacity equivalent to 2mm Al, while dentin presented a radiopacity equivalent to 1mm Al. Conclusion. All tested cements presented a similar radiopacity to that of enamel and they meet the ISO 4049 specifications. Uniterms: Radiopacity; Calcium hydroxide cement; Enamel; Dentin.bjetivos. Todos os materiais adicionados aos dentes deveriam apresentar uma adequada radiopacidade para permitir a detecção de cáries secundárias. Geralmente em cavidades extensas, materiais de base, como o cimento de hidróxido de cálcio, são usados com a função de proteger a polpa. Na tentativa de melhorar a eficiência na detecção radiográfica deste material, este estudo foi realizado com o objetivo de determinar a radiopacidade de três cimentos de hidróxido de cálcio e comparar a radiopacidade destes materiais com a da dentina e do esmalte. Materiais e Método. Foram radiografados corpos de prova de 1 mm de espessura de três cimentos de hidróxido de cálcio: Hydro-C, Dycal e Life, uma escala de densidade de alumínio, uma lâmina de chumbo e um corte de dente humano de 1 mm de espessura. As densidades ópticas foram obtidas após o processamento radiográfico. Os valores de radiopacidade dos cimentos de hidróxido de cálcio, dentina e esmalte foram expressos em espessuras equivalentes de alumínio. Resultados. A análise de variância indicou diferença estatisticamente significativa apenas para o cimento Life que apresentou a menor radiopacidade quando comparado aos outros cimentos. Entretanto, todos os cimentos e o esmalte possuíram uma radiopacidade equivalente a 2 mm de Al, enquanto a dentina apresentava radiopacidade equivalente a 1 mm de Al. Conclusão. Todos os cimentos testados apresentaram radiopacidades semelhantes à do esmalte, estando de acordo com as especificações da ISO 4049. Unitermos: Ra...
Objective:The aim of this study was to determine the differences between the skeletal ages estimated by TW2 and TW3 methods through their RUS and Carpal systems.Material and Methods:A sample of two hundred and forty hand and wrist radiographs of male and female Brazilian children aged 84-199 months was evaluated by five observers. The Dunnet test was performed for statistical analysis.Results:Results showed higher skeletal ages estimated by TW2RUS than TW3RUS and Carpal for both genders. For girls a statistically significant difference (p<0.05) was observed between TW2RUS and TW3RUS over the entire age range. For boys this difference was observed from 108 months onwards. In general RUS skeletal ages were higher than the chronological age and Carpal skeletal ages for both genders. The overestimation of chronological age was smaller for TW3RUS than for TW2RUS, and this last system showed a statistically significant difference regarding chronological age over the entire age range for girls, whereas for boys this difference was seen from 132 months onwards. For girls TW3 RUS and Carpal showed a significant difference regarding chronological age in the oldest age groups; in boys TW3RUS did not show a significant difference regarding chronological age. For Carpal, these results were more variable.Conclusion:It seems reasonable to recommend the use of the TW3 system for the studied Brazilian population.
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