bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcome After Combined Pelvic and Femoral Osteotomies in Patients with Legg-Calvé-Perthes Disease
Authors: Mosow N. , Vettorazzi E. , Breyer S. , Ridderbusch K. , Stücker R. , Rupprecht M.
Published: February 2017

Background:

The aim of this study was to evaluate the outcome at skeletal maturity of combined pelvic and femoral varus osteotomies in children with Legg-Calvé-Perthes (LCP) disease.

Methods:

From January 1998 to December 2009, 69 patients with LCP disease underwent combined osteotomies at our institution. Fifty-two children (19 girls and 33 boys) met the inclusion criteria and were enrolled in the study. The LCP disease was classified and the cases of all patients were reviewed at skeletal maturity. The mean age (and standard deviation) at the time of diagnosis was 6.9 ± 2.4 years, and the mean age at the time of surgery was 7.9 ± 2.3 years. The mean time to follow-up was 10.8 ± 3.5 years. The final follow-up radiographs were assessed according to the Stulberg classification and the sphericity deviation score.

Results:

The mean Harris hip score at the time of follow-up was 90 ± 13.2. According to the Harris hip score grading system, 37 patients (71%) had an excellent outcome; 8 patients (15%), a good result; 3 patients (6%), a fair result; and 4 patients (8%), a poor result. Seven patients (13%) were classified as having a Stulberg class-I hip; 20 (38%), a class-II hip; 15 (29%), a class-III hip; 6 (12%), a class-IV hip; and 4 (8%), a class-V hip. The mean sphericity deviation score was 24.4 ± 14.4 at skeletal maturity. There was a strong relationship between a younger age at diagnosis and better functional and radiographic outcomes.

Conclusions:

In the absence of a randomized study design, conclusions have to be drawn with caution. Combined pelvic and femoral osteotomies in these children with LCP disease did not result in better functional or radiographic outcomes compared with the historic results of Salter osteotomy or proximal femoral osteotomy alone.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Vancomycin and Ceftazidime in Bone Cement as a Potentially Effective Treatment for Knee Periprosthetic Joint Infection
Authors: Hsu Yung-Heng , Hu Chih-chien , Hsieh Pang-Hsin , Shih Hsin-Nung , Ueng Steve W.N. , Chang Yuhan
Published: February 2017

Background:

The aim of this study was to determine the optimal formulation of antibiotic-loaded bone cement for knee periprosthetic joint infection. We used both in vitro and in vivo models incorporating various broad-spectrum antibiotics and tested their efficacy against gram-positive and gram-negative bacteria.

Methods:

Bone cement specimens loaded with 4 g of either vancomycin or teicoplanin and 4 g of ceftazidime, imipenem, or aztreonam were studied to measure their in vitro antibiotic release characteristics and antibacterial capacities against methicillin-susceptible Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, and Escherichia coli. Bone cement spacers loaded with the antibiotics with the superior in vitro antibacterial capacity were then implanted into 8 patients (4 women and 4 men between 51 and 79 years of age) diagnosed with chronic knee periprosthetic joint infection. The antibiotic concentrations and antibacterial activities in the joint fluid at the site of the infection were measured following spacer implantation.

Results:

Cement samples loaded with vancomycin and ceftazidime exhibited in vitro antibacterial activity against the test microorganisms that lasted for as long as or longer than that of cement loaded with the other antibiotic combinations. Joint fluid samples exhibited activity against bacteria including American Type Culture Collection (ATCC) strains and clinically isolated strains.

Conclusions:

Bone cement loaded with vancomycin and ceftazidime provided broad-spectrum antibacterial capacity both in vitro and in vivo and was shown to be a potentially effective therapeutic measure in the treatment of knee periprosthetic joint infections.

Clinical Relevance:

This study confirmed the potential effectiveness of drug delivery from bone cement spacers impregnated with vancomycin and ceftazidime.
Long-Term Outcome After Pectoralis Major Transfer for Irreparable Anterosuperior Rotator Cuff Tears
Authors: Moroder Philipp , Schulz Eva , Mitterer Marian , Plachel Fabian , Resch Herbert , Lederer Stefan
Published: February 2017

Background:

Promising short-term outcomes after pectoralis major tendon transfer for the treatment of an irreparable anterosuperior rotator cuff tear have been reported. The purpose of this study was to evaluate the long-term outcome.

Methods:

Twenty-seven consecutive patients with irreparable anterosuperior rotator cuff tears without advanced cuff arthropathy or advanced humeral head migration were treated with a partial subcoracoid pectoralis major tendon transfer between 2004 and 2005. At an average of 10 years (range, 9 to 11 years) postoperatively, 22 patients (82%) with an average age of 62 years (range, 42 to 74 years) at the time of surgery had a long-term follow-up examination that included the pain score, strength and range-of-motion assessment, Constant score, Simple Shoulder Test (SST), as well as radiographic and ultrasonographic imaging. The long-term results were compared with the preoperative findings as well as the short-term results that were collected from a previous evaluation.

Results:

The adjusted Constant score increased from 54% to 87% at the short-term follow-up (p < 0.001) and remained improved at the long-term follow-up, with a mean score of 83% (p = 0.001). While the significant improvement of the pain level at the short-term follow-up was maintained at the time of final follow-up (p = 0.001), the increase in strength returned to the preoperative level (p = 0.178), and the improvement in range of motion diminished again over time despite remaining significantly improved (p = 0.029), especially with regard to internal rotation (p < 0.001). At the long-term follow-up, 77% of the patients were very satisfied with the procedure. A third of the patients had no progression of cuff arthropathy, a third had progression by 1 grade, and a third had progression by ≥2 grades. At the time of final follow-up, 1 patient (5%) had undergone revision surgery to reverse shoulder arthroplasty.

Conclusions:

Pectoralis major tendon transfer for the treatment of irreparable anterosuperior rotator cuff tears results in a significant clinical improvement even 10 years after surgery, especially with respect to pain and internal rotation. Despite long-term radiographic progression of cuff arthropathy, patient satisfaction remains high over time, with a low rate of salvage with reverse shoulder arthroplasty.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Early Results of Acetabular Reconstruction After Wide Periacetabular Oncologic Resection
Authors: Abdel Matthew P. , von Roth Philipp , Perry Kevin I. , Rose Peter S. , Lewallen David G. , Sim Franklin H.
Published: February 2017

Background:

Reliable acetabular fixation in total hip arthroplasty following periacetabular resections is challenging. Tantalum components have been successfully implemented for difficult revision arthroplasties, but, to our knowledge, have not been reported for acetabular reconstruction following oncologic periacetabular resection. The primary purpose of the current study was to determine the early clinical outcomes, complications, and radiographic findings for acetabular reconstruction after oncologic periacetabular resection. In addition, a novel classification scheme for primary periacetabular resections and reconstructions is presented.

Methods:

We reviewed 10 consecutive patients treated with tantalum acetabular reconstruction following periacetabular resection. All patients had a primary acetabular malignancy including chondrosarcoma (n = 7) and osteosarcoma (n = 3). The cohort included 6 males (60%). The mean age was 54 years (range, 30 to 73 years). The mean follow-up was 59 months (range, 8 to 113 months).

Results:

At the most recent follow-up, 9 patients were alive and 1 had died of the respective disease. All patients obtained full ambulatory status with the use of gait aids. Postoperative complications included dislocation (n = 3), wound-healing disturbance (n = 1), and deep venous thrombosis (n = 1). Two patients underwent reoperations for recurrent dislocations. The mean postoperative Harris hip score was 75 points (range, 49 to 92 points).

Conclusions:

Preliminary results of tantalum reconstruction following periacetabular resections provide reasonable improvement in early clinical outcomes and stable fixation in situations with massive bone loss and compromised bone quality. As expected due to the lack of a functioning abductor mechanism from the wide oncologic resection, early dislocations remain a concern. As such, we now consider the primary use of increasing constraint, but it must be balanced with the often compromised host bone.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Hay “derecho y literatura” en Argentina
Authors: Roggero Jorge
Published: February 2017

Este artigo propõe uma leitura do desenvolvimento dos estudos em Direito e Literatura na Argentina. Para tanto, são abordados: o surgimento da teoria crítica e sua relação com a epistemologia; a ideia de interdisciplinaridade e de ilusão no campo jurídico, desenvolvidas a partir do movimento Direito e Literatura; o papel da teoria crítica do direito na transição democrática argentina. Ao final, formula algumas conclusões sobre a relevância dos estudos de Direito e Literatura na Argentina.
Entre a insustentabilidade e a futilidade: a jurisdição, o direito e o imaginário social sobre o juiz
Authors: Espíndola Angela Araújo da Silveira
Published: February 2017

Este “ensaio” pretende tecer uma abordagem despretensiosa sobre o problema da “falta de sentido” (falta de base epistemológica) do direito e da jurisdição a partir da problemática da decisão judicial e do papel (social) do julgador bem como do modo de produção do próprio direito. A reflexão é feita a partir do paradigma do jurisprudencialismo de Castanheira Neves e sua obra “O direito hoje e com que sentido?”, bem como a partir do movimento law and literature, buscando inspiração em Milan Kundera para discutir as representações do direito e do imaginário social do juiz
Changes in the frequency and characteristics of children diagnosed with autistic disorder in two Norwegian cohorts: 1992 and 2009
Authors: Romhus Sidsel , Herder Gyro Aas , Grindheim Elisabeth , Schjølberg Synnve , Howlin Patricia
Published: February 2017

Background:

Is the increasing prevalence of autistic disorder (AD) a well-documented trend or merely a reflection of the wider recognition of AD among both the public at large and health care professionals? Data from relevant studies are frequently compromised by comparisons of different sites and different diagnostic methods.

Objectives:

To explore changes over time, we reviewed the following: 1) the frequency of AD diagnoses; 2) the characteristics of the diagnosed children; and 3) the ages of the children when initial concerns were addressed and AD diagnoses made.

Method:

We compared the case records of children between the ages of 1 and 17 years who were residing in Nordland County, Norway, and who were diagnosed with AD during two different data collection periods: 1992 (Cohort 1) and 2009 (Cohort 2).

Results:

In Cohort 1, 28 children were diagnosed with AD; 71 children in Cohort 2 received AD diagnoses. The increase was greatest among children with intelligence quotient (IQ) values of at least 70. The proportion of children with genetic syndromes was around 20% in both cohorts. Median age at AD diagnosis did not differ between the two cohorts (4.5 vs. 5.0 years, respectively). When the two cohorts were combined, children with IQ values of 70 or more without a genetic syndrome and those with IQ values of less than 50 with genetic syndromes were diagnosed at approximately the same age (5.5 and 5.3 years, respectively). Both groups were significantly older at diagnosis as compared with children with IQ values of less than 50 without genetic syndromes (3.5 years).

Conclusions:

The increase in the number of children diagnosed with AD is consistent with findings from international studies. Contrary to predictions, the age at diagnosis was not reduced over time. A higher proportion of children with IQ values in the average range in the latter cohort may have contributed to this. A delayed diagnosis of AD among children with genetic syndromes may indicate that early autism symptoms are attributed to the genetic condition. Clinical implications are discussed.
Prevalence of the Short Face Pattern in Individuals of Bauru-Brazil
Authors: Bastos Douglas Rezende , de Castro Ferreira Conti Ana Cláudia , Filho Leopoldino Capelozza , de Almeida-Pedrin Renata Rodrigues , de Almeida Cardoso Maurício
Published: February 2017

Aim:

This study aimed at assessing the prevalence and severity of short face pattern in ethnically different individuals.

Material and Methods:

The sample comprised 4,409 Brazilians (2,192 females and 2,217 males), with a mean age of 13 years, enrolled in secondary schools in the municipality of Bauru. The sample inclusion criteria involved subjects with vertically impaired facial relationship based on excessive lip compression, when standing at natural head position, with the lips at rest. Once short face syndrome had been identified, the individuals were classified into three severity subtypes: mild, moderate, and severe. The sample was then stratified by ethnic background as White (Caucasoid), Black (African descent), Brown (mixed Caucasian–African descent), Yellow (Asian descent), and Brazilian Indian (Native Brazilian descent), using the Brazilian Institute of Geography and Statistics classification. The chi-square test at the 5% significance level was used to compare frequency ratios of individuals with vertically impaired facial relationships and across different ethnicities, according to severity.

Results:

The prevalence of short face pattern was 3.15%, as 1.11%, 1.99%, and 0.02% considered mild, moderate and severe subtypes, respectively. The severe subtype was rare (0.02%) and found only in one White individual. The White group had the highest relative frequency (45.53%) of the moderate subtype, followed by Brown individuals (43.40%). In the mild subtype, Yellow (68.08%) and White (62.21%) individuals showed similar and higher relative frequency values.

Conclusion:

The prevalence of short face pattern was 3.15%, and White individuals had the highest prevalence.
Alveolar Bone Fracture: Pathognomonic Sign for Clinical Diagnosis
Authors: Gutmacher Zvi , Peled Eli , Norman Doron , Lin Shaul
Published: February 2017

Aim:

Dental injuries, especially luxation and avulsion, are common. Dental trauma can cause alveolar bone fracture that can lead to tooth loss and malocclusion. Single tooth alveolar bone fractures are difficult to identify unless it protrudes through the overlying mucosa and can be visualized. Pain, malocclusion, and tooth mobility provide signs of suspected alveolar bone fractures. Integrity of the proximate alveolar bone should be examined for fractures where avulsion, luxation, or other tooth trauma is detected. Any suggestion of alveolar fractures should be further investigated with an appropriate radiograph.

This case report shows a pathognomonic sign that detects and diagnosis single tooth alveolar bone fractures,i.e., a localized hematoma crossing the attached gingiva from the free gingival margin to the vestibular mucosa. This should serve as a warning for localized alveolar bone fracture.

A visualized hematoma and gentle, careful palpation may help detect covered fractures when the overlying mucosa is not perforated.
Pulp Revascularization: A Literature Review
Authors: Araújo Pollyana Rodrigues de Souza , Silva Luciano Barreto , Neto Alexandrino Pereira dos Santos , Almeida de Arruda José Alcides , Álvares Pâmella Recco , Sobral Ana Paula Veras , Júnior Severino Alves , Leão Jair Carneiro , Braz da Silva Rodivan , Sampaio Gerhilde Callou
Published: February 2017

Reestablishing blood flow and allowing the continuation of root development are some of the objectives of pulp revascularization. This procedure is currently indicated for teeth with incomplete root formation as an alternative to the traditional treatment of apecification, which consists of inserting calcium hydroxide paste into the root canal for a determined time period in order to induce the formation of a calcified barrier. Although it is considered as the most classically employed therapy, the permanence of the paste for long time periods may lead to the weakening of the root due to hygroscopic properties, as well as proteolytic activities of calcium hydroxide. Therefore, there has been a permanent search for alternatives which allow the full development of immature teeth. Revascularization has emerged as such an alternative, and a range of treatment protocols can be found in the scientific literature. The aim of this paper is to accomplish a literature review concerning this issue.
DENSIDADE ENERGÉTICA DAS REFEIÇÕES OFERECIDAS PELO SERVIÇO DE NUTRIÇÃO E DIETÉTICA DE UM HOSPITAL
Authors: Bergjohann Patricia , Adami Fernanda Scherer , Fassina Patricia
Published: February 2017

A Densidade Energética pode ser utilizada na recuperação do estado nutricional, já que a desnutrição é comum em indivíduos hospitalizados. O objetivo do estudo foi verificar a DE de sete dias das refeições oferecidas pelo Serviço de Nutrição e Dietética de um hospital do interior do Rio Grande do Sul. A DE das preparações foi obtida pelo quociente do Valor Energético Total pelo volume (g) e classificada segundo o National Center for Chronic Disease Prevention and Health Promotion, 2005. Para a análise estatística utilizou-se o software Statistical Package for the Social Sciences, adotando-se o nível de significância de 5% (p
AVALIAÇÃO DA DEGRADAÇÃO DA CAFEÍNA EM AMOSTRAS DE ÁGUA USANDO ESPECTROFOTOMETRIA APÓS TRATAMENTO COM PROCESSOS OXIDATIVOS AVANÇADOS
Authors: Mafioleti Joseane Parizzi , Ribeiro Rosecler , Kuhn Daniel , Stulp Simone , Hoehne Lucélia
Published: February 2017

As técnicas convencionais de tratamento de água se mostram ineficientes na remoção de contaminantes conhecidos como micropoluentes emergentes que são associados principalmente ao esgoto doméstico. Estes micropoluentes são classificados como fármacos, produtos de cuidado pessoal e desreguladores endócrinos e são substâncias que causam efeitos adversos ao meio ambiente e a saúde pública. A cafeína é incluída no grupo dos fármacos, muito utilizado em alimentos, bebidas e condimentos e se mostra como um indicador potencial de contaminação de águas por esgoto doméstico. A proposta para o tratamento destes micropoluentes emergentes são os processos oxidativos avançados (POAs), os quais utilizam técnicas de oxidação química que geram radicais hidroxilas extremamente reativos que transformam estas substâncias indesejáveis em outras menos tóxicas. No presente trabalho foi avaliada a degradação da cafeína em amostras de águas, após a aplicação de processos oxidativos avançados fenton, foto-fenton e fotólise de peróxido de hidrogênio. Para realização dos experimentos de foto-fenton e fotocatálise de peróxido de hidrogênio foi utilizado o planejamento fatorial 23 tendo como variáveis a concentração de ferro, peróxido de hidrogênio e o tempo de exposição à radiação UV. Para testes do processo fenton foram simuladas duas situações variando as concentrações de ferro e peróxido de hidrogênio. Após a aplicação dos testes com POAs, foi avaliada a melhor condição de tratamento, que foi a fotólise de peróxido de hidrogênio utilizando 68 mg/L de peróxido de hidrogênio e 5 minutos de exposição a radiação UV, que resultou em 100% de degradação da cafeína.
PROPOSTAS DE ABORDAGENS POR MEIO DE METODOLOGIAS ATIVAS NO ENSINO SUPERIOR
Authors: Magedanz Adriana , Herber Jane , De Almeida Silva Maria Cristina
Published: February 2017

Nos últimos anos se investigam novas metodologias para o processo de ensinar, que estimulem o aprender, possibilitando que os estudantes se tornem protagonistas. No nível superior, o trabalho com “Aprendizagem Baseada em Problemas”, conhecida por ABP, está muito presente em artigos de docentes que desenvolvem estratégias enfatizando o aprendizado autodirigido, principalmente no que tange a área da saúde. Neste sentido, a partir dos encontros de estudos intitulado “(Re)Construindo as práticas pedagógicas, integrando as diferentes áreas do CETEC”, realizados ao longo de 2015 por um grupo de professores de graduação, buscou-se construir uma proposta experimental, enfocando aspectos pertinentes às metodologias ativas, em três disciplinas do Centro de Ciências Exatas e Tecnológicas (CETEC) do Centro Universitário UNIVATES, localizado em Lajeado-RS, são elas: Introdução às Ciências Exatas, Química Orgânica I e Tratamento de Efluentes. O principal desafio, do grupo de professores que conduziu o trabalho, foi desenvolver um processo de ensino e de aprendizagem que permitisse que o estudante fizesse efetivamente parte do procedimento, não como um mero espectador, e que o docente assumisse um papel de tutor ou mediador, rompendo com a clássica formação de sala de aula. Ao finalizar o semestre foi possível concluir que as atividades desenvolvidas, utilizando estratégias diferenciadas, conforme proposição inicial, possibilitaram aos estudantes o abandono da passividade tradicional, interagindo de maneira mais intensa, assimilando conceitos e aprimorando conhecimentos. Tais constatações evidenciam-se nos relatos dos discentes, que se mostraram muito mais participativos e autônomos, na busca por diferentes saberes.
ANÁLISE DE AÇÚCARES TOTAIS, REDUTORES E NÃO-REDUTORES EM REFRIGERANTES PELO MÉTODO TITULOMÉTRICO DE EYNON-LANE
Authors: Santos Gabriela Lima dos , Gemmer Ruan Ezequiel , Oliveira Eniz Conceição
Published: February 2017

Os refrigerantes são compostos principalmente de água potável, açúcares e/ou edulcorantes, suco ou extrato de fruta e gás carbônico. O açúcar está presente na faixa de 8% a 12% do produto final, sendo um importante item a ser avaliado em análises laboratoriais pela indústria. O Método titulométrico de oxirredução de Eynon-Lane é o método oficial do MAPA para determinação quantitativa deste insumo no produto final. Buscou-se identificar a quantidade de açúcares e o tipo de açúcar utilizado em amostras de refrigerantes de diferentes empresas, para isso, aplicou-se o método oficial para a determinação de açúcares, onde quantificou-se os açúcares redutores, não redutores e totais (AT) na bebida que está na prateleira. Os resultados obtidos variam entre 8,76% a 10,69% de AT na amostra, verificando-se uma diferença mínima entre os açúcares totais informados nos rótulos das amostras dos encontrados nas análises.
A UTILIZAÇÃO DE APLICATIVOS DA COMPUTAÇÃO EM NUVEM NO ENSINO SUPERIOR
Authors: Horn Körbes Lucas , Schorr Wildner Maria Claudete
Published: February 2017

O presente artigo constitui-se na identificação da percepção dos docentes e discentes de uma instituição de Ensino Superior, em relação ao uso do cloud computing, computação em nuvem, no ensino. Com isso, pode-se verificar como os docentes e discentes veem a aplicação dessa tecnologia, se têm dificuldades no manuseio e quais os benefícios obtidos. Para tanto, tornou-se fundamental uma abordagem sobre o avanço da tecnologia da informação, conceitos de cloud computing e sua aplicação no ensino, entre outros. O método para levantamento de dados foi uma pesquisa exploratória de caráter qualitativo e quantitativo, através de um questionário estrutural, análise documental e pesquisa bibliográfica. Após o levantamento teórico e a análise do ambiente, foram apresentadas as conclusões para aperfeiçoar o uso da tecnologia.
Derechos fundamentales y relaciones de empleo
Authors: Calderón Chacón Adrián
Published: February 2017

La aplicación de los derechos fundamentales a las relaciones de trabajo conlleva una nueva visión del Derecho Laboral, según la cual se busca ubicar a la persona trabajadora en una posición de preferencia en la que sus garantías básicas o elementales que emanan del texto de la Constitución, se convierten en una protección reforzada contra el ejercicio de las potestades del empresario.
La Teoría de la Indiferencia de la Concausa en la jurisprudencia de la Sala Segunda de la Corte Suprema de Justicia
Authors: Herrera Vargas Norman Armando
Published: February 2017

Este artículo pretende ofrecer a quienes operan el Derecho Laboral una herramienta que les  permita dimensionar el hecho de que no todos los supuestos de personas trabajadoras que se vean afectadas por patologías degenerativas que en apariencia no guardan relación directa con sus trabajos, deben excluirse de la posibilidad de ampararse a través de las prestaciones que da la seguridad social, ya que bajo ciertas condiciones que deben acreditarse con una prueba médica especializada, el siniestro acaecido sí debe de ser calificado como una enfermedad del trabajo y por ende, como riesgo laboral, pues en nuestro medio hay un completo vacío temático y una falta de aplicación de la teoría de la indiferencia de la concausa en detrimento de la clase trabajadora.
Percepção visual inserida nas estruturas fílmicas
Authors: Campos Josiane Vieira , Gonçalves Marília Matos , Vieira Milton Horn
Published: February 2017

A partir do século XXI surgiram outras maneiras de consumir imagens e informações por meio de diversos canais, em especial os digitais. Desde o aparecimento do cinema no século XIX, as imagens ganharam movimento e passaram a ter mais representatividade. Com o advento da cultura digital e das imagens e sons em alta definição, o cinema se tornou ainda mais fascinante e repleto de significados.A convergência digital possibilita que os diversos suportes sejam canais de construção e apresentação destas narrativas. Inserido nesse contexto, este estudo trata de investigar a percepção visual como elemento da comunicação visual, em especial nas interfaces cinematográficas, para compreender a imagem como formadora e transmissora de significados. Dessa forma, faz-se necessário estudar a história do cinema e sua trajetória até a cibercultura e como se relaciona com a cognição e a percepção visual. Com o objetivo de entender a geração de significados pelo espectador, realizou-se uma análise de duas cenas de filmes distintos para identificar os elementos de percepção existentes nas cenas e como eles formulam significações. São sugeridas decodificações plausíveis destes signos pelo espetador e suas possíveis sensações e assimilações.
Protótipos físicos e virtuais (CAD 3D): uma pesquisa descritiva sobre o processo de construção de uma saia godê
Authors: Pires Gisely Andressa , Menezes Marizilda Dos Santos , Paschoarelli Luis Carlos , Pereira Livia Marsari , Scacchetti Fabio Alexandre Pereira
Published: February 2017

Este artigo discute sobre a prática da construção de protótipos na indústria do vestuário. O protótipo refere-se à construção de um modelo que está em processo de planejamento e teste para ser comercializado. Atualmente a forma mais difundida é realizando a construção efetiva das peças, porém existe disponível no mercado softwares que realizam essa atividade virtualmente. Assim, esse estudo tem como objetivo investigar o processo construção de protótipos por meio de software CAD 3D de prototipagem de vestuário e das técnicas tradicionais manuais utilizadas atualmente na indústria a fim de verificar as caraterísticas de cada etapa e os resultados alcançados. Para tanto, foi desenvolvida uma pesquisa descritiva, como forma de abordagem do problema foram realizados dois experimentos que compreendem a construção de protótipos de uma saia godê orientados pela técnica virtual e a manual. Os resultados permitiram compreender que as duas possibilidades para a elaboração de protótipos produzem resultados similares, são eficientes e uma valiosa ferramenta para avaliar uma peça de vestuário antes de ser produzida a venda.
Estudo da influência das dimensões dos metatarsos no conforto dos calçados femininos: o caso da cidade de Campina Grande - PB
Authors: Domingues Carolina Ângelo Jerônimo , Lucena Luiz Felipe De Almeida
Published: February 2017

O pé é a base estrutural de todo o corpo humano e um dos sistemas vitais mais negligenciados, mas, ainda assim capaz de exercer todas as suas funções. No intuito de proteger os pés e evitar as lesões surge o calçado. Em contrapartida, existe uma padronização excessiva deste artefato que atende apenas a um segmento da população. Embora existam vários estudos no Brasil que versem sobre a ergonomia e usabilidade do calçado, percebe-se a necessidade de adequação antropométrica deste produto. Com base nas diferenças entre a antropometria de diversas etnias e biótipos percebe-se que os calçados devem possuir dimensões e formatos de acordo com a morfologia do pé de cada população. O objetivo deste estudo foi medir os pés da população feminina urbana da cidade de Campina Grande-PB por meio de técnicas antropométricas e comparar estas medidas com a NBR 15159:2013 a fim de compreender a relação entre a influência do perímetro dos metatarsos sob o conforto dos calçados. O método utilizado possui natureza aplicada e abordagem mista, caracterizada por procedimentos metodológicos como levantamento bibliográfico e survey. A amostra foi definida pela estatística probabilística, composta por 408 mulheres com idade entre 15 e 44 anos, residentes fixas ou temporárias na cidade de Campina Grande-PB. Os resultados mostraram diferenças entre as dimensões do pé direito e o pé esquerdo, bem como identificaram uma discrepância entre as medidas do perímetro do metatarso quando comparado com a norma brasileira. Portanto, conclui-se que essas diferenças são refletidas na sensação de desconforto proporcionada pelos calçados, além de propiciar o surgimento de anomalias e deformidade dos pés como as calosidades e bolhas.
The Association of Allergic Sensitization with Radiographic Sinus Opacification
Authors: Brook Christopher D. , Kuperstock Jacob E. , Rubin Samuel J. , Ryan Matthew W. , Platt Michael P.
Published: February 2017

Background

The relationship between allergic sensitization and radiographic sinus inflammation remains unclear.

Objectives

To determine whether specific allergen sensitization is correlated with sinonasal radiographic opacification.

Methods

Patients with chronic sinonasal symptoms were selected and included if they had allergy testing and a computed tomography (CT) of the paranasal sinuses. Data regarding demographic characteristics, in vitro allergy test results, and comorbidities were collected. CTs were reviewed, and an overall Lund-Mackay score (LMS) was calculated for each patient. A two-sample t-test was used to compare mean LMS between patients who were sensitized and patients who were not sensitized. A multiple linear regression model was used to determine whether a relationship existed among LMS and allergy results, asthma, nasal polyps, immunoglobulin E (IgE) level, medication usage, in-season versus out-of-season CTs, age, and sex. Significance was determined at an alpha level of 0.05.

Results

There were 437 patients included, of whom, 251 had positive specific allergen test results and 186 had negative test results. A total of 282 patients had allergic rhinitis symptoms without a documented diagnosis of sinusitis, and 155 carried a diagnosis of chronic rhinosinusitis. The mean LMS did not differ between patients who were sensitized and patients who were not sensitized (5.56 versus 5.28; p = 0.61). Linear regression demonstrated an increase in LMS in patients with asthma (p = 0.02), male sex (p < 0.01), elevated IgE (p < 0.01), a history of anaphylaxis (p = 0.03), and nasal polyps (p < 0.01). There was a statistically significant decrease in LMS in patients with an in-season CT (p = 0.02).

Conclusions

Patients with a positive specific in vitro allergen test result did not have higher overall rates of radiographic sinus inflammation. Asthma, male sex, polyps, elevated IgE, and a history of anaphylaxis were associated with higher LMS.
Endoscopic Sinus Surgery for Chronic Rhinosinusitis with Nasal Polyps: Clinical Outcome and Predictive Factors of Recurrence
Authors: Veloso-Teles Rafaela , Cerejeira Rui
Published: February 2017

Background

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a highly prevalent disease of the nasal cavity and paranasal sinus, but its exact etiology is still unclear and remains a difficult-to-treat condition.

Hypothesis

Endoscopic sinus surgery (ESS) is an effective treatment for medically recalcitrant CRSwNP. There are independent variables that can predict surgical outcomes in patients with CRSwNP.

Objectives

To evaluate ESS efficacy in CRSwNP treatment and to establish prognostic factors for disease recurrence.

Methods

Eighty-five patients with CRSwNP submitted to ESS, and a minimum follow-up of 9 months was selected. Patient demographics, occupational organic exposure (e.g., cotton, fuel gas, wood dust) and inorganic dust exposure (e.g., bleach, metals, cement), comorbidities, previous nasal surgeries, pre- and postoperative symptoms, ear, nose and throat examination findings, computed tomography results, and medical and surgical treatment information were collected from medical records. Statistical analysis was performed.

Results

All rhinologic symptoms improved after surgery, in a statistically significant way, with the best recovery rate for nasal obstruction and the worst for hyposmia. The major and minor complications rates were 1.2 and 15.3%, respectively. Disease recurrence occurred in 31% of the patient, but only 7% required surgical reintervention. Multivariate logistic regression analysis identified occupational dust exposure (p = 0.001) and non-immunoglobulin E (IgE) mediated asthma (p = 0.012) as independent predictive variables in CRSwNP recurrence, unlike the other tested variables: age, sex, IgE-mediated asthma, allergic rhinitis, smoking habits, nasal polyps endoscopic grade, Lund-Mackay score, and postoperative topical corticoid use. The adjusted logistic model presented a good discriminatory capacity with a receiver operating characteristic area under the curve of 0.82 (95% confidence interval, 0.73-0.91; p < 0.001).

Conclusion

ESS proved to be an effective treatment in CRSwNP but with a considerable rate of recurrence. These results indicated an important correlation of occupational dust exposure and non-IgE-mediated asthma with disease recurrence.
Outbreak of hepatitis A associated with men who have sex with men (MSM), England, July 2016 to January 2017
Authors: Beebeejaun Kazim , Degala Srilaxmi , Balogun Koye , Simms Ian , Woodhall Sarah Charlotte , Heinsbroek Ellen , Crook Paul David , Kar-Purkayastha Ishani , Treacy Juli , Wedgwood Kate , Jordan Kate , Mandal Sema , Ngui Siew Lin , Edelstein Michael
Published: February 2017

Between July 2016 and January 2017, 37 confirmed cases of hepatitis A with two unique IA genotype strains primarily among men who have sex with men, were reported across eight areas in England and Northern Ireland. Epidemiological and laboratory investigations indicate that these strains may have been imported several times from Spain, with secondary sexual transmission in the United Kingdom. Local and national public health services are collaborating to control this ongoing outbreak.
Emergence of the lymphogranuloma venereum L2c genovariant, Hungary, 2012 to 2016
Authors: Petrovay Fruzsina , Balla Eszter , Erdősi Tímea
Published: February 2017

In eastern Europe, few countries have so far reported laboratory-confirmed cases of lymphogranuloma venereum (LGV). Here we describe 22 LGV cases in men who have sex with men (MSM) detected in Hungary from November 2012 to July 2016. Sequence analyses show that 16 of these 22 cases were affected by the L2c genovariant, with from 2012 to 2014, one LGV L2c case detected per year, followed by seven cases in 2015 and six up to July 2016. Of the 16 total L2c LGV cases, 10 had severe haemorrhagic proctitis. These findings are concerning as cases with this new genovariant among MSM have not been frequently reported in Europe to date. More research is needed to assess the spread of the L2c genovariant and its potential association with virulence and severe clinical manifestation.
Prozessketteneinflüsse auf die Wärmebehandlung*
Authors: Hoffmann F. , Kleff J.
Published: February 2017

Kurzfassung

Das Ergebnis einer Wärmebehandlung wird durch den Ausgangszustand des Werkstoffs beeinflusst. Das hat zur Folge, dass unterschiedliche Fertigungsketten bei gleicher Endwärmebehandlung zu Unterschieden im Gefügezustand und zu einem unterschiedlichen Verzugsverhalten führen können. Dies beeinflusst somit sowohl die Eigenschaften als auch den eventuellen Aufwand bei einer End-Hartbearbeitung. Der Artikel zeigt Beispiele für Wechselwirkungen infolge von Fertigungseinflüssen anhand einer Fertigungskette für eine thermochemische Wärmebehandlung (Einsatzhärten und Nitrieren) auf.
Retrospective review of previous minor leak before major subarachnoid hemorrhage diagnosed by MRI as a predictor of occurrence of symptomatic delayed cerebral ischemia
Authors: Oda Shinri , Shimoda Masami , Hirayama Akihiro , Imai Masaaki , Komatsu Fuminari , Shigematsu Hideaki , Nishiyama Jun , Hotta Kazuko , Matsumae Mitsunori
Published: February 2017

OBJECTIVE

This study attempted to determine whether a previous minor leak correlated with the occurrence of symptomatic delayed cerebral ischemia (sDCI).

METHODS

The authors retrospectively evaluated sDCI-related clinical features and findings from MRI, including T1-weighted imaging (T1WI)–FLAIR mismatch at the time of admission, in 151 patients admitted with subarachnoid hemorrhage (SAH) within 48 hours of ictus.

RESULTS

The overall incidence of sDCI was 23% (35 of 151 patients). In all subjects, multivariate analysis revealed that World Federation of Neurosurgical Societies Grades II–V, age 70 years or older, presence of rebleeding after admission, a previous minor leak before the major SAH attack as diagnosed by T1WI-FLAIR mismatch, acute infarction on diffusion-weighted imaging, and CT SAH score were significantly associated with occurrence of sDCI. In patients with no previous minor leak before major SAH as diagnosed by T1WI-FLAIR mismatch, the incidence of sDCI was only 7% (7 of 97 patients).

CONCLUSIONS

A previous minor leak before major SAH as diagnosed by T1WI-FLAIR mismatch represents an important sDCI-related factor. When the analysis was restricted to patients with true acute SAH without a previous minor leak diagnosed by T1WI-FLAIR mismatch, the incidence of sDCI was extremely low.
Minimally invasive scoliosis surgery assisted by O-arm navigation for Lenke Type 5C adolescent idiopathic scoliosis: a comparison with standard open approach spinal instrumentation
Authors: Zhu Weiguo , Sun Weixiang , Xu Leilei , Sun Xu , Liu Zhen , Qiu Yong , Zhu Zezhang
Published: February 2017

OBJECTIVE

Recently, minimally invasive scoliosis surgery (MISS) was introduced for the correction of adult scoliosis. Multiple benefits including a good deformity correction rate and fewer complications have been demonstrated. However, few studies have reported on the use of MISS for the management of adolescent idiopathic scoliosis (AIS). The purpose of this study was to investigate the outcome of posterior MISS assisted by O-arm navigation for the correction of Lenke Type 5C AIS.

METHODS

The authors searched a database for all patients with AIS who had been treated with either MISS or PSF between November 2012 and January 2014. Levels of fusion, density of implants, operation time, and estimated blood loss (EBL) were recorded. Coronal and sagittal parameters were evaluated before surgery, immediately after surgery, and at the last follow-up. The accuracy of pedicle screw placement was assessed according to postoperative axial CT images in both groups. The 22-item Scoliosis Research Society questionnaire (SRS-22) results and complications were collected during follow-up.

RESULTS

The authors retrospectively reviewed the records of 45 patients with Lenke Type 5C AIS, 15 who underwent posterior MISS under O-arm navigation and 30 who underwent posterior spinal fusion (PSF). The 2 treatment groups were matched in terms of baseline characteristics. Comparison of radiographic parameters revealed no obvious difference between the 2 groups immediately after surgery or at the final follow-up; however, the MISS patients had significantly less EBL (p < 0.001) and longer operation times (p = 0.002). The evaluation of pain and self-image using the SRS-22 showed significantly higher scores in the MISS group (p = 0.013 and 0.046, respectively) than in the PSF group. Postoperative CT showed high accuracy in pedicle placement in both groups. No deep wound infection, pseudarthrosis, additional surgery, implant failure, or neurological complications were recorded in either group.

CONCLUSIONS

Minimally invasive scoliosis surgery is an effective and safe alternative to open surgery for patients with Lenke Type 5C AIS. Compared with results of the open approach, the outcomes of MISS are promising, with reduced morbidity. Before the routine use of MISS, however, long-term data are needed.
Risk factors for surgical site infection following nonshunt pediatric neurosurgery: a review of 9296 procedures from a national database and comparison with a single-center experience
Authors: Sherrod Brandon A. , Arynchyna Anastasia A. , Johnston James M. , Rozzelle Curtis J. , Blount Jeffrey P. , Oakes W. Jerry , Rocque Brandon G.
Published: February 2017

OBJECTIVE

Surgical site infection (SSI) following CSF shunt operations has been well studied, yet risk factors for nonshunt pediatric neurosurgery are less well understood. The purpose of this study was to determine SSI rates and risk factors following nonshunt pediatric neurosurgery using a nationwide patient cohort and an institutional data set specifically for better understanding SSI.

METHODS

The authors reviewed the American College of Surgeons National Surgical Quality Improvement Program–Pediatric (ACS NSQIP-P) database for the years 2012–2014, including all neurosurgical procedures performed on pediatric patients except CSF shunts and hematoma evacuations. SSI included deep (intracranial abscesses, meningitis, osteomyelitis, and ventriculitis) and superficial wound infections. The authors performed univariate analyses of SSI association with procedure, demographic, comorbidity, operative, and hospital variables, with subsequent multivariate logistic regression analysis to determine independent risk factors for SSI within 30 days of the index procedure. A similar analysis was performed using a detailed institutional infection database from Children's of Alabama (COA).

RESULTS

A total of 9296 nonshunt procedures were identified in NSQIP-P with an overall 30-day SSI rate of 2.7%. The 30-day SSI rate in the COA institutional database was similar (3.3% of 1103 procedures, p = 0.325). Postoperative time to SSI in NSQIP-P and COA was 14.6 ± 6.8 days and 14.8 ± 7.3 days, respectively (mean ± SD). Myelomeningocele (4.3% in NSQIP-P, 6.3% in COA), spine (3.5%, 4.9%), and epilepsy (3.4%, 3.1%) procedure categories had the highest SSI rates by procedure category in both NSQIP-P and COA. Independent SSI risk factors in NSQIP-P included postoperative pneumonia (OR 4.761, 95% CI 1.269–17.857, p = 0.021), immune disease/immunosuppressant use (OR 3.671, 95% CI 1.371–9.827, p = 0.010), cerebral palsy (OR 2.835, 95% CI 1.463–5.494, p = 0.002), emergency operation (OR 1.843, 95% CI 1.011–3.360, p = 0.046), spine procedures (OR 1.673, 95% CI 1.036–2.702, p = 0.035), acquired CNS abnormality (OR 1.620, 95% CI 1.085–2.420, p = 0.018), and female sex (OR 1.475, 95% CI 1.062–2.049, p = 0.021). The only COA factor independently associated with SSI in the COA database included clean-contaminated wound classification (OR 3.887, 95% CI 1.354–11.153, p = 0.012), with public insurance (OR 1.966, 95% CI 0.957–4.041, p = 0.066) and spine procedures (OR 1.982, 95% CI 0.955–4.114, p = 0.066) approaching significance. Both NSQIP-P and COA multivariate model C-statistics were > 0.7.

CONCLUSIONS

The NSQIP-P SSI rates, but not risk factors, were similar to data from a single center.
Subdural hematoma as a major determinant of short-term outcomes in traumatic brain injury
Authors: Lee Jonathan J. , Segar David J. , Morrison John F. , Mangham William M. , Lee Shane , Asaad Wael F.
Published: February 2017

OBJECTIVE

Early radiographic findings in patients with traumatic brain injury (TBI) have been studied in hopes of better predicting injury severity and outcome. However, prior attempts have generally not considered the various types of intracranial hemorrhage in isolation and have typically not excluded patients with potentially confounding extracranial injuries. Therefore, the authors examined the associations of various radiographic findings with short-term outcome to assess the potential utility of these findings in future prognostic models.

METHODS

The authors retrospectively identified 1716 patients who had experienced TBI without major extracranial injuries, and categorized them into the following TBI subtypes: subdural hematoma (SDH), traumatic subarachnoid hemorrhage, intraparenchymal hemorrhage (which included intraventricular hemorrhage), and epidural hematoma. They specifically considered isolated forms of hemorrhage, in which only 1 subtype was present.

RESULTS

In general, the presence of an isolated SDH was more likely to result in worse outcomes than the presence of other isolated forms of traumatic intracranial hemorrhage. Discharge to home was less likely and perihospital mortality rates were generally higher in patients with SDH. These findings were not simply related to age and were not fully captured by the admission Glasgow Coma Scale (GCS) score. The presence of SDH had a much higher sensitivity for poor outcome than the presence of other TBI subtypes, and was more sensitive for these poor outcomes than having a low GCS score (3–8).

CONCLUSIONS

In these ways, SDH was the most important finding associated with poor outcome, and the authors show that consideration of SDH, specifically, can augment age and GCS score in classification and prognostic models for TBI.
Tumoral calcinosis of the craniovertebral junction as a cause of dysphagia with treatment by transoral decompression: case report
Authors: Mooney Michael A. , Oppenlander Mark E. , Kakarla U. Kumar , Theodore Nicholas
Published: February 2017

Tumoral calcinosis is characterized by tumor-like deposition of calcium in periarticular soft tissue. Spinal involvement is rare, and perioperative diagnosis of tumoral calcinosis can be difficult because lesions may be confused with bony neoplasms. Symptoms of tumoral calcinosis result from bony involvement and/or direct compression of surrounding anatomical structures, for which treatment with surgical decompression can be highly successful. The craniovertebral junction is rarely affected by tumoral calcinosis, and patients with this condition may present with distinct symptoms. Herein, to their knowledge the authors present the first case of tumoral calcinosis affecting the craniovertebral junction in a patient who presented with severe dysphagia and required transoral decompression. Recognition of tumoral calcinosis by neurosurgeons is essential for facilitating diagnosis and treatment, and the transoral approach is an effective method for decompression in select patients.