This paper presents a brief review of risk studies in Geography since the beginning of the 20th century, from approaches focused on physical-natural components or social aspects, to perspectives that incorporate a systemic approach seeking to understand and explain risk issues at a spatial level. The systemic approach considers principles of interaction between multiple variables and a dynamic organization of processes, as part of a new formulation of the scientific vision of the world. From this perspective, the Complex Systems Theory (CST) is presented as the appropriate conceptual-analytical framework for risk studies in Geography. Finally, the analysis and geographic information integration capabilities of Geographic Information Systems (GIS) based on spatial analysis are explained, which position it as a fundamental conceptual and methodological tool in risk analysis from a systemic approach.
A systemic and synthetic review of the anatomy of the temporomandibular joint in magnetic resonance imaging was developed for its evaluation. The temporomandibular joint is an anatomical structure composed of bones, muscles, ligaments and an articular disc that allows important physiological movements, such as mandibular opening, closing, protrusion, retrusion and lateralization. Magnetic resonance imaging is an imaging technique that does not use ionizing radiation and is more specific for the evaluation and interpretation of soft tissues, due to its high resolution, so it has an important role in the diagnosis of various maxillofacial pathologies, which is why the dentist should have knowledge of the structures and functions of the temporomandibular joint through magnetic resonance imaging. The review demonstrates the importance of magnetic resonance imaging in the study of the anatomy of the temporomandibular joint, in addition to mentioning the advantages provided by this imaging technique such as its good detail of the soft tissues in its different sequences and the non-use of ionizing radiation to obtain its images.
Introduction: the presence of anti-CCP is an important prognostic tool for rheumatoid arthritis (RA), but its relationship with the activity of the disease and functional capacity is still being investigated. Objectives: to study the relationship between anti-CCP and the indices of disease activity, functional capacity and structural damage, by means of conventional radiography (CR) and magnetic resonance imaging (MRI), in stabilized RA. Methods: cross-sectional study of RA patients with one to 10 years of disease. The participants were subjected to clinical evaluation with anti-CCP screening. Disease activity was assessed by means of the Clinical Disease Activity Index (CDAI) and functional capacity by means of the Health Assessment Questionnaire (HAQ). CR was analyzed by the Sharp van der Heijde index (SmvH) and MRI by the Rheumatoid Arthritis Magnetic Resonance Image Scoring System (RAMRIS). Results: 56 patients were evaluated, with median (IIq) of 55 (47.5–60.0) years, 50 (89.3%) were female among whom 37 (66.1%) were positive for anti-CCP. The median (IIq) of CDAI, HAQ, SmvH and RAMRIS were 14.75 (5.42–24.97), 1.06 (0.28–1.75), 2 (0–8) and 15 (7–35), respectively. There was no association between anti-CCP and CDAI, HAQ, SmvH and RAMRIS. Conclusion: our results did not establish the association of anti-CCP with the severity of the disease. So far, we cannot corroborate the anti-CCP as a prognostic tool in RA established.
Introduction: Stenoses in the path of arteriovenous fistulas (AVF) for hemodialysis are a very prevalent problem and there is long experience in their treatment by percutaneous angioplasty (PTA). These procedures, however, involve non-negligible equipment requirements, exposure to radiation and intravenous contrast that are not beneficial for the patient and make their performance more complex. This study reviews our initial experience with Doppler ultrasound-guided angioplasty. Methods: Prospective cohort of patients with native AVF dysfunction due to significant venous stenosis treated by Doppler echo-guided PTA. AVF puncture, lesion catheterization, balloon localization and inflation, and outcome verification were performed under ultrasound guidance. Only one fistulography was performed before and another one after dilatation. As a control, the cases performed during the same period by the usual angiographic method were also collected. Results: Between February 2015 and September 2018, 51 PTAs were performed on native AVF, of which 27 were echogenic (mean age, 65.3 years; 63% male). The technical success rate was 96%. In 26% of cases, PTA was repeated due to residual stenosis after angiographic imaging. There were 7.3% periprocedural complications. 92% of the AVFs were punctured at 24 hours. Primary patency at 1 month, 6 months and 1 year was 100%, 64.8% and 43.6%, and assisted patency was 100%, 87.2% and 74.8%. There were no significant differences in immediate or late results with respect to angiographically guided AVF angioplasty. Conclusions: AVF-PTA can be performed safely and effectively guided by Doppler ultrasound, which simplifies the logistics required for its performance, although we still need to improve the capacity for early verification of the result with this imaging technique.
Introduction: In Colombia, the last oral health study showed that about 70% of the population has partial edentulism while 5.2% will have lost all their teeth between the age of 65 and 79. Rehabilitation with implants is an increasingly used option, which requires clinical and radiographic follow-up. Panoramic radiography is a low-cost option, in which it is possible to observe areas of bone loss, mesiodistal angulation of the implant, relationship with anatomical structures and lesions suggestive of peri-implantitis. Reports and analysis of relevant data on radiographic findings associated with dental implants are required to determine the risk factors for their success in patients who use them. Objective: To determine the prevalence and characterize the findings associated with osseointegration implants in panoramic radiographs. Methods: A descriptive cross-sectional observational study was carried out with 10,000 digital panoramic radiographs selected by convenience from radiological centers in the city of Bogota, Colombia, of which 543 corresponded to the sample analyzed for the presence of implants. The following were evaluated for each implant: location, position, angulation and distances to adjacent structures, using the Clínicalview® program (Orthopantomograph OP200D, Instrumentarium, USA). Results: The frequency of radiographs with implants was 5.43% with a total of 1,791 implants, with an average of 3.2 per radiograph. They were found in greater proportion in the upper jaw with a supracrestal location and an angulation of 10.3 degrees. 32% had implant/tooth or implant/implant distances that were less than optimal. 40.9% were restored and 1.2% showed lesions compatible with periimplantitis. Conclusions: A high percentage of the implants reviewed have a risk factor that affects their long-term viability, either due to angulation, supracrestal or crestal position, proximity to teeth or other implants, or because they are not restorable.
Imaging technology plays a key role in guiding endovascular treatment of aortic aneurysm, especially in the complex thoracoabdominal aorta. The combination of high quality images with a sterile and functional environment in the surgical suite can reduce contrast and radiation exposure for both patient and operator, in addition to better outcomes. This presentation aims to describe the current use of this technique, combining angiotomography and intraoperative cone beam computed tomography, image “fusion” and intravascular ultrasound, to guide procedures and thus improve the intraoperative success rate and reduce the need for reoperation. On the other hand, a procedure is described to create customized 3D templates with the high-definition images of the patient’s arterial anatomy, which serve as specific guides for making fenestrated stents in the operating room. These customized fenestration templates could expand the number of patients with complex aneurysms treated minimally invasively.
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