bluuebunny/crossref_metadata_2025 huggingface dataset:
A Practical Approach To Estimating The Cost Of Equity For South African Firms Undertaking Cross-Border Investments
Authors: Moyo Vusani
Published: April 2018

Corporate finance literature has developed a number of models for use in estimating the cost equity in for cross-border investments. Most of the models, if not all, are specifically developed for use by US firms investing in emerging markets. The widely used models are the home country CAPM, the local CAPM, the country-risk adjusted CAPM or the Lessard model, the Godfrey-Espinosa model, the Goldman Sachs model, the Gamma model and the SalomonSmithBarney model. Using a hypothetical case study of FirstRand Limited’s proposed investments in Ireland and Turkey, this study tests for the suitability of the reverse-engineered versions of these models in estimating the cost of equity for a South African firm planning to invest in both Ireland (developed country) and Turkey (emerging country). The results of the study indicate that the Godfrey-Espinosa the Goldman-Sachs models are equivalent.  The Lassard model is equivalent to the Gamma or Damodaran mode, and both models yielded estimates closer to the SalomonSmithBarney model. All the models’ estimates for the Turkish investment are consistent with the credit ratings of both Turkey and South Africa. The cost equity estimates show that FirstRand Limited investors will demand an additional risk premium for investments in Turkey. The cost of equity estimates for the Irish investment are mixed, inconsistent with the Ireland’s credit rating and had a higher standard deviation than the estimates for the Turkish investment. The Irish estimates seem to be largely affected by the country’s high country and banking industry betas. The reverse-engineered versions of these models are suitable for use by firms in emerging countries.
epistolario de Gregorio Bermann a Deodoro Roca
Authors: Vera de Flachs Maria Cristina
Published: April 2018

El objetivo del presente artículo y su relevancia es dar a conocer algunas cartas privadas hasta hoy desconocidas y enviadas a Deodoro Roca por un intelectual reformista: el Dr. Gregorio Bermann. Para indagar la correspondencia utilizamos el análisis de contenido que permite descubrir el ADN de los mensajes y reconstruir su arquitectura, conocer su estructura, y sus componentes básicos. En síntesis la correspondencia analizada permite constatar la amistad entre Bermann y Roca a lo largo de sus vidas, la preocupación por la cuestión universitaria y los problemas de la generación del 18.
Carta ao Editor: Parabéns Acta Médica Portuguesa! Quase 40 Anos de Indexação na PubMed… (Mas Para Quando uma Revista Portuguesa de Psiquiatria Indexada na PubMed?)
Authors: Gama Marques João
Published: April 2018

N/A.
Multiple Familial Trichoepithelioma
Authors: Monteiro Ana Filipe , Rato Margarida , Luís Pedro , Tavares Ermelindo
Published: April 2018

N/A.
Errata a “Tradução e Validação da Escala FOUR para a Pediatria e o seu Uso Como Indicador Prognóstico: Um Estudo Piloto”
Authors: Ferreira Sofia Simões , Meireles Daniel , Pinto Alexandra , Abecasis Francisco
Published: April 2018

O artigo “Tradução e Validação da Escala FOUR para a Pediatria e o seu Uso Como Indicador Prognóstico: Um Estudo Piloto”, publicado na edição da Acta Médica Portuguesa de Setembro de 2017 [Acta Med Port 2017 Sep;30(9):599-607] incluía o erro que passamos a descrever:Na página 600, parágrafo 4, onde se lê:“Porém, a GCS avalia apenas os dois últimos, podendo não detetar devidamente a profundidade do coma.4”Deverá ler-se:“A GCS não inclui indicadores importantes para uma avaliação adequada da gravidade do coma, isto é, avalia apenas a função cortical, não incluindo parâmetros da avaliação da função do tronco cerebral, tais como o padrão respiratório, o tamanho e os reflexos pupilares e os movimentos oculares, podendo não detetar devidamente a profundidade do coma.4” Artigo publicado com erro: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8052
Cuidados Paliativos no Reino Unido: A Minha Experiência em Manchester
Authors: Cochofel André , Cardoso Ana , Tapley Michael
Published: April 2018

N/A.
Predatory Publishing: An Industry that Is Threatening Science
Authors: Revés Joana , Da Silva Bernardo Marques , Durão José , Ribeiro Nuno Vouga , Lemos Samuel , Escada Pedro
Published: April 2018

N/A.
Multiple Victims of Carbon Monoxide Poisoning in the Aftermath of a Wildfire: A Case Series
Authors: Santos Luís Ramos dos , Alves-Correia Magna , Câmara Margarida , Lélis Manuela , Caldeira Carmo , Brazão Maria da Luz , Nóbrega José Júlio
Published: April 2018

Introduction: Carbon monoxide poisoning may occur in several contexts.Material and Methods: Retrospective of 37 carbon monoxide poisoning cases that underwent hyperbaric oxygen during wildfires in Funchal in August 2016.Results: The studied sample included 37 patients, mean age of 38 years, 78% males. Ten were firefighters, four children and two pregnant victims. Neurological symptoms were the most reported. Median carboxyhemoglobin level was 3.7% (IQR 2.7). All received high-flow oxygen from admission to delivery of hyperbaric oxygen. Persistence of symptoms was the main indication for hyperbaric oxygen. Median time to hyperbaric oxygen was 4.8 hours (IQR 9.5), at 2.5 ATA for 90 minutes, without major complications. Discharge in less than 24 hours occurred in 92% of the cases. Thirty days follow-up: five patients presented clinical symptoms of late neurological syndrome; twelve patients were lost to follow-up. Carboxyhemoglobin levels on admission and mean time to hyperbaric oxygen were no different between those who did and did not develop the syndrome at 30 days (p = 0.44 and p = 0.58, respectively).Discussion: Late neurological syndrome at 30 days occurred in 20% and no new cases were reported at 12 months.Conclusion: Use of hyperbaric oxygen appears to have reduced the incidence of the syndrome. This seems to be the first Portuguese series reporting use of hyperbaric oxygen in carbon monoxide poisoning due to wildfires. The authors intend to alert to the importance of referral of these patients because the indications and benefits of this treatment are well documented. This is especially important given the ever-growing issue of wildfires in Portugal.
Funduplicatura Nissen laparoscópica ambulatoria: claves en el manejo para el éxito ambulatorio
Authors: Coret Franco Alba , Planells Roig Manuel , Arnal Bertomeu Consuelo , Garcia Espinosa Rafael , Carrau Giner Miguel
Published: April 2018

Objetivo: El tratamiento de elección para la enfermedad por refl ujo gastroesofágico (ERGE) es la funduplicatura Nissen laparoscópica (FNL), pero su manejo ambulatorio no ha sido aceptado ampliamente hasta el momento por la comunidad quirúrgica. Nuestro objetivo es transmitir nuestra experiencia actual en funduplicatura Nissen laparoscópica ambulatoria (FNLA) mediante la comunicación de los resultados de 65 pacientes intervenidos mediante un protocolo de manejo perioperatorio, afianzado durante 13 años de experiencia en la técnica, con el fin de aportar a los cirujanos herramientas y pasos de seguridad claves a tener en cuenta para conseguir el éxito del manejo ambulatorio de esta patología.Material y métodos: Describimos el proceso pre-, intra- y de seguimiento posoperatorio realizado a 65 pacientes sometidos a cirugía antirrefl ujo (CAR), manejados de forma ambulatoria mediante un estudio prospectivo observacional de cohortes durante un periodo de 13 años (de enero de 2004 a diciembre de 2016). Comunicamos las exploraciones complementarias, protocolos de estudio y cuestionarios a realizar en el pre- y postoperatorio, así como el seguimiento clínico y radiológico, tanto del resultado de la técnica como especialmente de la valoración del dolor posoperatorio, consumo de analgésicos y recuperación de las actividades de la vida diaria de los pacientes intervenidos.Resultados: En el periodo comprendido entre enero 2004 y diciembre de 2015 se intervinieron 100 pacientes mediante CAR, a 65 de ellos se les realizó funduplicatura Nissen laparoscópica en régimen ambulatorio. Del total, 38 fueron varones y 27 mujeres, con una edad mediana de 44.1 años (DS de 12.2). No existieron complicaciones mayores en el grupo ambulatorio. Todas las cirugías se desarrollaron por parte del mismo equipo quirúrgico. Se consideró como ambulatoria una estancia posoperatoria inferior a 8 horas. En 65 casos se cumplió el manejo ambulatorio planeado (menos de 8 horas), y 35 casos precisaron la permanencia en el hospital mediante ingreso o «estancia overnight» (menos de 24 horas). La severidad de la ERGE se evaluó mediante la escala REFA, que se mostró como una herramienta útil para la estadificación preoperatoria y en la identificación de pacientes susceptibles de ser ambulatorios. La tasa de readmisión fue del 0 %, sin que existiera mortalidad ni complicaciones en el grupo ambulatorio.Conclusiones: Existen pasos claves de seguridad dirigidos a realizar la funduplicatura Nissen laparoscópica en régimen ambulatorio. Nuestro protocolo de manejo perioperatorio se basa en la experiencia de 13 años de trabajo en este ámbito, incluyendo los puntos principales de manejo perioperatorio y de seguimiento de los pacientes para conseguir el éxito ambulatorio.
La hernia del deportista: ¿hay alguna certeza en el enigma del dolor inguinal en los atletas?
Authors: Marsh Simon K.
Published: April 2018

El dolor inguinal en el atleta es de origen multifactorial, con patologías superpuestas y un rango de diagnósticos y de potenciales tratamientos que anuncian el comienzo de casi todos los trabajos o conferencias sobre el tema. ¡De hecho, la condición parece volverse más compleja cada año que pasa! Pero, tal vez en nuestro deseo de comprender el dolor inguinal en su totalidad, ¡hemos perdido el sitio del síndrome clínico original y específico que ha generado tanta discusión y confusión!
Velarde Pérez Fontana (1897-1975) el genial cirujano uruguayo. Un ejemplo a seguir. Sus valiosas aportaciones a la cirugía de la hernia
Authors: Carbonell Tatay Fernando
Published: April 2018

Se describen, además de una concisa biografía de este gran humanista y cirujano uruguayo con proyección internacional; sus aportaciones a la cirugía de la hernia, con especial mención a su técnica personal: técnica de Pérez Fontana para la hernia inguinal, así como la menos conocida y modificada por él, del procedimiento de Antonio de Gimbernat, para el tratamiento quirúrgico de la hernia crural. Se menciona también su estudio sobre la hernia epigástrica y, la modificación técnica, también personal, en la cirugía de la hernia inguinal en el niño. Se recogen las imágenes de sus publicaciones originales mostrando las técnicas paso a paso. Abarca este artículo, además, sus opiniones y comentarios a las descripciones anatómicas clásicas de la región inguinocrural. Un repaso a su trayectoria humanística y profesional en toda la mitad del siglo XX, período previo a la utilización generalizada de las prótesis en la cirugía de la hernia, y cuando las técnicas llamadas clásicas o anatómicas, tenían que ser realizadas con los máximos conocimientos anatómicos y una depurada técnica para conseguir los excelentes resultados que el Dr. Pérez Fontana publica.
Et al.: el uso correcto de las abreviaturas en los textos científicos
Authors: Latorre Lidia
Published: April 2018

Las abreviaturas constituyen uno de los principales problemas de la edición de textos científicos. Este hecho se debe al uso excesivo y dispar que los investigadores hacen de ellas. Si bien constituyen una herramienta lingüística que otorga dinamismo y agilidad a la lectura del texto, su aparición abundante puede dificultar la comprensión del lector.Es por ello que artículos y manuales de estilo recomiendan un uso moderado y limitado a contextos concretos. Hemos de evitar el uso de abreviaciones especialmente en el título y en el resumen del texto, para que el lector pueda obtener siempre una información completa.
Hernia inguinal incarcerada por un fecaloma asociado a un dolicomegacolon idiopático
Authors: Ortiz de Solórzano Aurusa Francisco Javier , Gómez Carmona Zahira , Ferreras García Carlos , Gónzalez Obeso Elvira , De Andrés Asenjo Beatriz , Beltrán de Heredia Rentería Juan
Published: April 2018

Presentamos el caso clínico de un paciente con antecedentes de estreñimiento de larga evolución. Presentaba una hernia inguinal derecha incarcerada, secundaria a la presencia de un fecaloma gigante asociado a un dolicomegacolon idiopático. Se intervino de forma programada realizando una hernioplastia inguinal y una colectomía sigmoidea . La evolución posoperatoria fue satisfactoria. Se realiza una revisión de esta rara entidad de la que no hemos encontrado ninguna referencia bibliográfica.
Los peligros de modernizar por el mero hecho de ser moderno
Authors: Bendavid Robert
Published: April 2018

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Hernia inguinal con útero y anexos como contenido del saco herniario: Reporte de caso y revisión de la literatura
Authors: Carvajal López Alejandro , Naranjo Aristizabal Fred Alexander , Flórez Arango Natalia , Carvajal López Ana María , Valencia Gómez Yeliana Mailyn
Published: April 2018

INTRODUCCIÓN: La cirugía de hernia inguinal es una de las más comunes practicada por los cirujanos generales y menos del 1% de los casos contiene el útero o sus anexos en el saco herniario.OBJETIVO: Describir el caso de una paciente con una hernia útero-inguinal, sus características clínicas y manejo quirúrgico. MATERIALES Y METODOS: Previo consentimiento informado se tomaron los datos de la historia clínica de una paciente llevada a corrección quirúrgica electiva de hernia inguinal con evidencia de útero y anexos en el saco herniario. Se analizaron los datos clínicos, se realizó descripción de los hallazgos intraoperatorios y el manejo definitivo.RESULTADOS: Una paciente de 56 años de edad se llevó a cirugía de hernia inguinal cuyo saco herniario contenía el útero con un mioma y los anexos. Se realizó una reparación sin tensión con malla de polipropileno sin complicaciones y con adecuada evolución postoperatoria.CONCLUSIONES: La hernia inguinal con útero y/o anexos en el saco herniario es una entidad rara, más frecuente en pacientes jóvenes, con manifestaciones clínicas variables e inespecíficas. Existe poca literatura y la mayoría se limita a reportes de casos aislados, con respuesta adecuada al manejo quirúrgico
Técnica de Browse-Hurst modificada para reparación de eventración de la línea media. Seis años de experiencia en una Sección de Cirugía de la Pared Abdominal
Authors: Domínguez Ayala Maite , Zorraquino González Ángel , Gutiérrez Ferreras Ana Isabel , Elías Aldama Mónica , Pérez de Villareal Amilburu Patricia , Hierro-Olabarria Salgado Lorena , Bengoetxea Peña Iker , Roca Domínguez Begoña
Published: April 2018

Introducción y objetivos: La reparación de la eventración de línea media con prótesis puede realizarse a diferentes niveles de la pared abdominal. Proponemos describir y evaluar la eficacia del procedimiento de Browse-Hurst modificado (premuscular subaponeurótico) en pacientes con esta patología.Material y método: Estudio retrospectivo de los pacientes intervenidos con esta técnica entre enero de 2010 y diciembre de 2015. La variable principal a estudio fue recidiva de la eventración. Las variables secundarias fueron las siguientes: características los pacientes y de la eventración (tamaño del defecto, localización), días de drenaje y estancia hospitalaria, complicaciones y meses de seguimiento.Resultados: Fueron intervenidos 147 pacientes, con una media de edad de 66 años. Las características de los pacientes son: 32 diabéticos (21.8 %), 39 fumadores (26.5 %), 29 EPOC (19.7 %). El IMC medio fue de 30.6, y la localización del defecto, 67 supraumbilical (48 %), 19 infraumbilical (13.7 %), 32 periumbilical (23 %) y 21 suprainfraumbilical (15.1 %). El tamaño medio fue de 6.4 cm. Hubo una relación significativa entre el tamaño de defecto y la aparición de seroma. El tiempo medio de drenaje fue de 3.9 días, con una estancia hospitalaria media de 4.7 días. La complicación más frecuente fue seroma (11.2 %). La tasa de recidiva de la técnica fue de 4.9 %. El seguimiento en consultas fue de 10.4 meses.Conclusiones: La técnica B-H modificada es segura, eficaz y reproducible. La probabilidad de seroma clínico aumenta significativamente cuando aumenta el tamaño del defecto.
Reconstrucción de la pared abdominal y reparación de hernia compleja: más allá de la cirugía de control de daños
Authors: Latifi Rifat
Published: April 2018

Editorial
Hernia lumbar, espacio oval y reconstrucción de la pared abdominal posterior
Authors: Moreno-Egea Alfredo
Published: April 2018

Introducción: La anatomía de la pared abdominal posterior es fundamental para tratar correctamente las herniaslumbares. El modelo anatómico basado en dos espacios débiles es insufi ciente para poder explicar todas las herniaslumbares y justifi car una adecuada reconstrucción lumbar.Material y método: Estudio realizado en 10 cadáveres humanos, entre 2014 y 2015, en la Universidad Católica SanAntonio. Los cadáveres fueron disecados siguiendo la técnica quirúrgica habitual. Se realizó un estudio de transiluminaciónparietal anterior y posterior, plano por plano, y fotografi ado con el apoyo de un foco de iluminación portátil.Resultados: La disección quirúrgica del cadáver nos mostró, sobre el plano retroperitoneal, la existencia de unespacio oval lumbar que englobaba todas las áreas débiles donde se podrían originar las hernias lumbares, y permitióplantear una adecuada reconstrucción integral de la pared abdominal posterior.Conclusión: Nuestro estudio concluye con la defi nición de un espacio oval lumbar retroperitoneal que sirve comomodelo teórico y clínico para explicar el origen de las hernias lumbares. Este modelo sugiere la recomendación dereconstruir la pared abdominal posterior utilizando una malla de gran tamaño en el plano retroperitoneal.
Validez de la fórmula del volumen de un elipsoide para establecer el volumen de la cavidad abdominal en un modelo experimental en ratas
Authors: Avendaño-Peza Héctor , García-Bravo Mariela , Monter Andrea , Espinosa de los Monteros Antonio
Published: April 2018

En el contexto de la reconstrucción de la pared abdominal por defectos complejos es apropiado medir con precisión elvolumen de la cavidad abdominal, ya que su relación con el volumen herniado tiene impactos pronósticos y terapéuticos,a la vez que algunas terapias adyuvantes emergentes tienen como propósito incrementar dicho volumen.Recientemente se ha propuesto emplear la fórmula del volumen de un elipsoide para establecer el volumen de lacavidad abdominal. Por otro lado, en el contexto de la cirugía de pared abdominal, algunas modalidades terapéuticasse estudian en modelos experimentales antes de ser desarrolladas en humanos. El propósito de este estudio ha sido elde establecer la validez del empleo de dicha forma en la estimación del volumen de la cavidad abdominal.Se estudiaron 60 ratas. Se obtuvo el volumen de las vísceras calculado mediante el método de inmersión en unrecipiente con líquido (VCA1), el volumen de un molde de yeso de la cavidad abdominal vacía (VCA2) y el volumena partir de la fórmula del volumen de un elipsoide (VCA3). Los volúmenes fueron signifi cativamente mayores en ratashembra que en ratas macho. Hubo correlación positiva entre los tres grupos. El VCA3 fue signifi cativamente menorque los VCA1 y VCA2. Para obtener el VCA en un modelo experimental en ratas hay que multiplicar el resultadoobtenido a partir de la fórmula del volumen de un elipsoide por 1.22. La cavidad abdominal no es un elipsoide perfecto.Es conveniente establecer un método que permita calcular el VCA en humanos con precisión y sencillez.
Student's Need Analysis for the Development of Chemistry Modules Based Guided Inquiry to Improve Science Process Skill
Authors: Arantika Jane , Saputro Sulistyo , Mulyani Sri
Published: April 2018

Science process skills (SPS) are an important aspect of learning science. SPS help students to develop creativity in learning. Process skills such as observing, formulating questions, interpreting, experimenting, hypothesizing, applying concepts, and communicating. This study aims to analyze the need for development resources needs of science filled with science process skills. Requirement analysis of the development of teaching materials with the skill of the process of science needs to be done because the textbook is the reference a teacher in the class. The subjects matter of chemistry the study was three senior high schools in Sambas, West Borneo. Needs analysis conducted using a qualitative approach, in terms of needs in classroom learning and content of process skills on teaching materials. Data were collected by interviews and questionnaires were analyzed descriptively. The results showed that as many as 27 percents of students perceive the book used in learning has not yet trained the science process skills. As many as 73 percents of students perceive that they need instructional materials in the form of inquiry-based chemistry modules to improve science process skills. Modules are developed based guided inquiry for having guided inquiry learning stages that can practice students' science process skills.
The Effect of an ACL Reconstruction in Controlling Rotational Knee Stability in Knees with Intact and Physiologic Laxity of Secondary Restraints as Defined by Tibiofemoral Compartment Translations and Graft Forces
Authors: Noyes Frank R. , Huser Lauren E. , Levy Martin S.
Published: April 2018

Background:

The effect of an anterior cruciate ligament (ACL) reconstruction on restoring normal knee kinematics in unstable knees with physiologic laxity of secondary ligamentous restraints remains unknown. The purpose of this study was to determine the stabilizing function of an ACL reconstruction and the resulting ACL graft forces in knees with severely abnormal anterior subluxation due to associated laxity of secondary restraints.

Methods:

A 6-degree-of-freedom robotic simulator was used to test 21 cadaveric knees studied as a whole and in subgroups of lax secondary restraints (Lax-SR) and intact secondary restraints (Intact-SR), based on abnormal translations and tibial rotations. Native, ACL-sectioned, and ACL-reconstructed conditions were tested. An instrumented bone-patellar tendon-bone (BPTB) graft measured ACL graft forces. The loading profile involved the Lachman test (25° of flexion and 100-N anterior load), anterior tibial loading (100-N anterior load across 10° to 90° of flexion), internal rotation (25° of flexion and 5-Nm torque), and 2 pivot-shift simulations (100-N anterior load, 7-Nm valgus, and either 5 Nm of internal rotation [Pivot Shift 1] or 1 Nm of internal rotation [Pivot Shift 2]). Equivalence between conditions was defined as being within 2 mm for compartment translation and within 2° for internal tibial rotation, with p < 0.05.

Results:

ACL sectioning increased center translation in the Lachman test by a mean of 10.9 mm (95% confidence interval [CI], 9.3 to 12.5 mm; p = 0.99), which was equivalent to native values after ACL reconstruction in all knees (mean difference, 0.0 mm [95% CI, −0.4 to 0.4 mm]; p = 0.0013), and in subgroups of Lax-SR (mean difference, 0.2 mm [95% CI, −0.5 to 0.8 mm]; p = 0.03) and Intact-SR (mean difference, −0.2 mm [95% CI, –0.8 to 0.4 mm]; p = 0.002). ACL sectioning in the pivot-shift (5-Nm) test increased lateral compartment translation to non-native-equivalent levels, which were restored to native-equivalent values after ACL reconstruction in all knees (mean difference, 0.9 mm [95% CI, 0.4 to 1.4 mm]; p = 0.055), in the Intact-SR subgroup (mean difference, 1.1 mm [95% CI, 0.5 to 1.8 mm]; p = 0.03), and to nearly native-equivalence in the Lax-SR subgroup (mean difference, 0.6 mm [95% CI, −0.3 to 1.6 mm; p = 0.06). The highest ACL graft force reached a mean of 190.9 N in the pivot-shift (5-Nm) test.

Conclusions:

The ACL reconstruction restored native kinematics and native rotational stability in all knees, including knees having laxity of secondary ligamentous restraints and clinically equivalent Grade-3 pivot-shift subluxation, and did so at ACL graft forces that were not excessive.

Clinical Relevance:

An ACL reconstruction with a BPTB graft restored normal stability parameters regardless of the integrity of secondary ligamentous restraints.
The Socioeconomic Implications of Isolated Tibial and Femoral Fractures from Road Traffic Injuries in Uganda
Authors: O’Hara Nathan N. , Mugarura Rodney , Potter Jeffrey , Stephens Trina , Rehavi M. Marit , Francois Patrick , Blachut Piotr A. , O’Brien Peter J. , Mezei Alex , Beyeza Tito , Slobogean Gerard P.
Published: April 2018

Background:

The purpose of this study was to determine the socioeconomic implications of isolated tibial and femoral fractures caused by road traffic injuries in Uganda.

Methods:

This prospective longitudinal study included adult patients who were admitted to Uganda’s national referral hospital with an isolated tibial or femoral fracture. The primary outcome was the time to recovery following injury. We assessed recovery using 4 domains: income, employment status, health-related quality of life (HRQoL) recovery, and school attendance of the patients’ dependents.

Results:

The majority of the study participants (83%) were employed, and they were the main income earner for their household (74.0%) at the time of injury, earning a mean annual income of 2,375 U.S. dollars (USD). All of the patients had been admitted with the intention of surgical treatment; however, because of resource constraints, only 56% received operative treatment. By 2 years postinjury, only 63% of the participants had returned to work, and 34% had returned to their previous income level. Overall, the mean monthly income was 62% less than preinjury earnings, and participants had accumulated 1,069 USD in debt since the injury; 41% of the participants had regained HRQoL scores near their baseline, and 62% of school-aged dependents, enrolled at the time of injury, were in school at 2 years postinjury.

Conclusions:

At 2 years postinjury, only 12% of our cohort of Ugandan patients who had sustained an isolated tibial or femoral fracture from a road traffic injury had recovered both economically and physically.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Assessing the Risk-Benefit Ratio of Scoliosis Surgery in Cerebral Palsy: Surgery Is Worth It
Authors: Miyanji Firoz , Nasto Luigi A. , Sponseller Paul D. , Shah Suken A. , Samdani Amer F. , Lonner Baron , Yaszay Burt , Clements David H. , Narayanan Unni , Newton Peter O.
Published: April 2018

Background:

The true benefits of scoliosis surgery in cerebral palsy (CP) remain uncertain. Our aims were to determine the benefits of spinal fusion according to health-related quality of life (HRQoL) improvement at long-term follow-up and to explore the effect of surgery-related complications on clinical outcomes.

Methods:

The cases of consecutive patients who had Gross Motor Function Classification System (GMFCS) level-IV or V cerebral palsy with 5-year follow-up from a prospective, longitudinal, multicenter database were analyzed. Caregivers completed the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD) questionnaire and 4 Likert-type anchor questions preoperatively and at 1, 2, and 5 years of follow-up. Data on complications were collected prospectively. Preoperative CPCHILD scores were compared with postoperative scores at the 1, 2, and 5-year follow-up evaluations. Preoperative CPCHILD scores were compared with postoperative scores at the 1, 2, and 5-year follow-up evaluations using repeated-measures analysis of variance (ANOVA). Spearman correlation coefficient was used to explore the association between changes in the CPCHILD at 1, 2, and 5-year follow-up and the reported complications within the follow-up period. Similarly, a comparative analysis between the percentage distribution of the answers to the 4 anchor questions and the reported complications was also performed.

Results:

Sixty-nine patients with a mean age (and standard deviation) of 13.4 ± 2.6 years at enrollment were analyzed. The major Cobb angle was a mean of 81.9° ± 26.7° preoperatively and improved to a mean of 28.7° ± 14.4° at 2 years and 30.7° ± 15.3° at 5 years postoperatively. Significant improvements in CPCHILD personal care, positioning, and comfort domains were noted at all time points. The mean increase in the total score was 7.19 (p < 0.001) at 1 year, and the score gain was maintained at 2 and 5 years postoperatively. The overall complication rate was 46.4% at 1 year, 1.4% between 1 and 2 years, and 4.3% at 2 to 5 years postoperatively, with surgical intervention required in 6 patients within 1 year and in 2 additional patients within 5 years following scoliosis surgery. There was no correlation between complications and CPCHILD scores postoperatively at all time points, with the only exception of a weak correlation (ρ = –0.450, p = 0.002) with CPCHILD comfort score at 1 year after surgery.

Conclusions:

Scoliosis surgery in patients with CP leads to a significant improvement in HRQoL, which is maintained 5 years following surgery. The substantial complication rate does not correlate with HRQoL changes postoperatively, suggesting that the benefits of surgery outweigh the risks in this fragile population.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Motor-Evoked Potential Analysis of Femoral Nerve Status During the Direct Anterior Approach for Total Hip Arthroplasty
Authors: Ishimatsu Tetsuro , Kinoshita Koichi , Nishio Jun , Tanaka Jun , Ishii Satohiro , Yamamoto Takuaki
Published: April 2018

Background:

During the direct anterior approach for total hip arthroplasty, a retractor is placed on the anterior wall of the acetabulum to retract the iliopsoas muscle. This step with the retractor has been reported to put the patient at risk for femoral nerve damage. The present study aimed to clarify the effects of the anterior acetabular retractor on the status of the femoral nerve during the direct anterior approach on the basis of transcranial motor-evoked potential (MEP) analysis.

Methods:

Between July 2016 and February 2017, 22 patients underwent primary total hip arthroplasty via the direct anterior approach with MEP analysis. The integrity of the femoral nerve was tested at 3 time points: preoperatively, as a control (first period); just after retractor placement on the anterior wall of the acetabulum (second period); and after the procedure (third period). The association between operative time and femoral nerve status was examined. Postoperative femoral nerve damage was determined by the presence of causalgia and the results of a manual muscle test (MMT) for strength of knee extension.

Results:

The mean amplitude of the femoral nerve was significantly reduced, from 100% in the first period to 54% (range, 5% to 100%) in the second period (p < 0.01), but then significantly improved to 77% (range, 20% to 100%) in the third period (p < 0.01). In 17 (77%) of the 22 patients, the amplitude of the femoral nerve in the second period was reduced, while only 5 patients (23%) showed no reduction. The mean operative time was 83 minutes (range, 63 to 104 minutes), and no significant correlation was observed between operative time and improvement of femoral nerve status between the second and third periods (p = 0.83 and r = −0.05). All 22 patients had a postoperative MMT grade of 5 for knee extension without causalgia of the femoral nerve.

Conclusions:

On the basis of the MEP analysis, 17 (77%) of the 22 patients showed a significant reduction of the femoral nerve amplitude despite careful placement of the retractor on the anterior wall of the acetabulum. Although this reduction appears reversible, placement of an anterior retractor should be performed with careful attention to the femoral nerve.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Controversies in the Management of Central Cord Syndrome
Authors: Wagner Peter J. , DiPaola Christian P. , Connolly Patrick J. , Stauff Michael P.
Published: April 2018

➤ Traumatic central cord syndrome is an incomplete spinal cord injury characterized primarily by disproportionate motor and sensory loss in the upper extremities compared with the lower extremities.

➤ Initial management of central cord syndrome includes immobilization in a rigid cervical orthosis, maintaining mean arterial pressure, and performing serial neurologic examinations.

➤ Treatment with high-dose methylprednisolone is no longer recommended for the treatment of central cord syndrome.

➤ Central cord syndrome is generally treated surgically, but the timing and surgical approach depend on injury characteristics, including the injury pattern, neurologic examination and its evolution, and patient comorbidities.

➤ Early surgery may be performed safely in the appropriate patient, but there is little evidence to support the notion that earlier surgery affects neurologic outcomes.
Prevalence and Long-Term Outcomes of Femoroacetabular Impingement in Elite Athletes and Military Service Members
Authors: Glynn Blake A. , Villarreal Richard A.
Published: April 2018

Femoroacetabular impingement (FAI) is prevalent among elite athletes and military service members who present with hip and groin pain. Arthroscopic management of FAI has accelerated return to sport and duty. This review of the current literature examines the elevated prevalence of FAI among elite athletes and military service members, the short-term success of treatment, and the long-term outcomes. In the long term, elite athletes fared better than military service members. More research is needed to improve the quality of life in these populations, namely delaying the development of hip osteoarthritis and total hip replacement.
Karakterisasi Laju Korosi Baja ST 40 Berlapis Polyester Putty Dalam Lingkungan Air Payau
Authors: Anwar Muhammad Jamaluddin , Widodo Edi
Published: April 2018

The attack caused damage of corrosion (rust) is the general problem that causes the degradation of the material as the interaction with the environment and shorten the lifetime of material. Steel ST 40 is a common material used in the industrial, shipping, engineering products, home wares and others. Prevent the occurrence of direct contact with the outside environment by using a coating of polyester putty, serves to prevent the occurrence of oxidation reactions of the nature of corrosion. Coating using polyester putty give influence on the material test of resistance to corrosion. The missing mass on the specimen using a coating of polyester putty of mass loss reached 2,090 mg. whereas in the specimen undergoes the smallest mass loss of 1,090 mg. Whereas in the material without upholstery polyester putty of mass lost most of the specimens that do not use coating polyester putty with the missing mass reach 4,390 mg. Whereas in the specimen menggalami the smallest mass loss of 3,560 mg. On the specimen that is experiencing the highest rate of corrosion occurred in unpublished material using polyester putty of 26.11 Mpy whereas the smallest lajukorosi reached 21.52 Mpy. While the biggest missing mass on a material without polyester putty of 0.98 Mpy, the rate of corrosion of the smallest reach 0.56 Mpy.
COMBINATION THERAPY OF AH IN CLINICAL PRACTICE
Authors: Karpov Y. A. , Bulkina O. S.
Published: April 2018

High blood pressure (BP) is thr major independent risk factor for cardiovascular disease and the associated high mortality in this country. [1] Arterial hypertension (AH) is often called the silent killer because the disease may proceed without any symptoms and does not manifest itself until the occurrence of severe complications - myocardial infarction or cerebrovascular disease. However, there is convincing evidence for the forecast improvement with regular use of antihypertensive drugs, while achievement of blood pressure control (target level) is a crucial factor in reducing the risk of fatal and nonfatal cardiovascular events. [2, 3] The article examines the results of the most recent clinical trials and guidelines on the management of hypertensive patients, the choice of the best management approach and achievement of the target BP levels, adherence to drug therapy and overcoming barriers to blood pressure control. A clinical case is described which could help the practitioner to make the right choice of antihypertensive therapy in a challenging situation.
PRIMARY PREVENTION OF CARDIOVASCULAR DISEASE AND ANTIPLATELET THERAPY. CLINICAL LECTURE
Authors: Minushkina L. O.
Published: April 2018

Today, treatment with low doses of acetylsalicylic acid (ASA) (alone or in combination with other antiplatelet drugs) is the key element in the secondary prevention of coronary artery disease. Long-term therapy with low-dose ASA is recommended to patients with stable coronary artery disease, patients after acute coronary syndrome with or without ST segment elevation, and after revascularization. [1–3] The need for antithrombotic therapy in the primary prevention of cardiovascular events raises many questions. The currently available guidelines are contradictory – from complete denial of the need for antiplatelet therapy to designation of the specific groups of patients for whom ASA treatment is recommended. [4, 5] Findings of clinical trials underlie those contradictory opinions. ASA is the only antiplatelet agent the administration of which is debated for primary prevention. Administration of ASA in primary prevention usually results in a reduced risk of cardiovascular complications, but the positive effect is largely offset by an increased risk of bleeding, particularly gastrointestinal. Therefore, the challenge is in the selection of patients for whom the benefit from antithrombotic therapy could outweigh the risks associated with bleeding. Risk scores are commonly used to assess the risk of complications.
SUBCLINICAL SYSTOLIC DYSFUNCTION OF THE LEFT VENTRICLE IN PREECLAMPTIC WOMEN WITHOUT PROTEINURIA. THE POSSIBILITIES OF ECHOCARDIOGRAPHY IN EARLY DIAGNOSIS
Authors: Doroshenko D. A. , Zubarev A. R. , Lapochkina O. B.
Published: April 2018

The article presents the main pathophysiological mechanisms associated with the development of complications of pregnancy against the background of arterial hypertension in patients without clinical manifestations of left ventricular dysfunction, the possibilities of speckle tracking of echocardiography in revealing latent systolic dysfunction of the left ventricle in pregnant women on the background of preeclampsia not accompanied by proteinuria are shown.

Goal. To identify early markers of left ventricular systolic dysfunction in pregnant women with preeclampsia without proteinuria according to speckle tracking echocardiography.

Material and methods. 100 pregnant women with hypertension and a gestation period of 29–40 weeks are divided into 2 groups: 1 st group – 50 patients without an arterial hypertension in the anamnesis, 2 nd group – 50 patients with an arterial hypertension in the anamnesis (without the proteinuria during pregnancy). For all patients, echocardiography with evaluation of cardiomyocyte function by speckle-tracking was performed on ultrasonic scanners Aplio ™ 500 and Aplio ™ Artida from Toshiba.

Results. Ejection fraction of the left ventricle in the groups was not significantly different, while the longitudinal, radial and circular deformation parameters differed between the groups, with the lowest values characterizing the global longitudinal deformation.

Conclusions. In assessing the function of the left ventricle in pregnant women with preeclampsia without diurnal proteinuria, it is not enough to focus on traditional parameters, shifting the emphasis towards derivatives of force, speed and time. Study of myocardium with the help of speckle tracking echocardiography promotes the detection of subclinical left ventricular dysfunction in patients with arterial hypertension without daily proteinuria.
Factors affecting expression of estrus in dairy cows with high milk yields
Authors: GAVELIS AURIMAS , ŽILAITIS VYTUOLIS , JUOZAITIS ARŪNAS , JUOZAITIENĖ VIDA , PALUBINSKAS GIEDRIUS , YILMAZ AYHAN
Published: April 2018

The objectives of this study were to define the effect of the milk progesterone (P4) concentration on estrus expression in dairy cows with high milk yield and to identify the effect of milk yield and parity on the milk P4 concentration and cow’s pregnancy after artificial insemination (AI). In this study, 48 clinically healthy cows without reproduction disorders, on day 90-100 after calving were used. At the beginning of estrus and 12 hours after the beginning of estrus, the milk P4 concentration in dairy cows with high milk yield (group 3) was higher than in group 2 (33.66; 22.36%) and in group 1 (51.60; 65.26%) (P <0.001). The milk P4 concentration in the ≥3 lactation cows was higher than the second (13.45%; P>0.05) and the first (28.28%; P<0.01) lactation ones (28.28%; P<0.01). The milk P4 concentration at the beginning of estrus and 12 hours after the beginning of estrus in pregnant and non-pregnant cows was 2.58 and 3.32; 4.20 and 5.00 ng/ml, respectively (P<0.001). As a result, it was concluded that high progesterone concentration affected the expression of estrus and pregnancy results in dairy cows, and the measuring of progesterone concentration in milk can be used as a non-invasive method to provide detailed information about fertility in high milk yield cows..
Comparative study of midazolam-propofol and metamizole-propofol clinical effects in domestic pigeons
Authors: MOUSAVI AMIRABBAS , ABEDI GHOLAMREZA , JAHANDIDEH ALIREZA , HESARAKI SAEED
Published: April 2018

This study was conducted to determine the quality of anesthesia by evaluating the clinical effects of midazolam-propofol and metamizole-propofol on domestic pigeons. The aim of the study was to choose an appropriate injectable anesthetic protocol by utilizing midazolam and metamizole as pre-anesthetic drugs in order to reduce the dose of propofol and decrease side effects. Eighteen male pigeons weighing 304.2±32.3g (mean±SD) were randomly allocated to three groups of six pigeons each. Midazolam (6 mg/kg/IM) and metamizole (500 mg/kg/IM) were used five minutes prior to administration of propofol (8 mg/kg/IV) in groups I and II, respectively, while the birds in group III (control group) received metamizole (500 mg/kg/IM). Five minutes after the last injection, clinical parameters of various systems were evaluated. Nervous system parameters declined in groups I and II, while reflexes could still be elicited in group III (P<0.05). There were no significant changes in the heart rate, dysrhythmia, or gastrointestinal parameters in the three groups (P>0.05). The birds in group II showed reduced jaw and limb muscle tone (P<0.05). Corneal and palpebral reflexes were absent in groups I and II (P<0.05). Both respiratory depth and pattern were irregular in group I, while all the parameters were normal in group II (P<0.05). The respiratory rate decreased in all groups after injection, although this reduction was significant only in group I (P<0.05). In conclusion, the combination of metamizole-propofol is safer and more compatible with the physiology of pigeons and can be used for short operations, especially when inhalation agents are contraindicated..
Patrimônio cultural e geologia do Quadrilátero Ferrífero
Authors: Bustamante Ana Maria Goulart , Gonzalez Sidney Ribeiro
Published: April 2018

O uso inovador do patrimônio histórico cultural pode representar importante componente do crescimento econômico e da geração de empregos, da coesão social e da sustentabilidade ambiental de um país. Pode-se estimular a inovação na relação da população com os bens culturais materiais e imateriais, propondo novas maneiras de interligar o patrimônio cultural e outros componentes como a geografia física e a geologia, entre muitas possibilidades. Uma forma de enriquecer as pesquisas sobre patrimônio cultural e sobre geociências poderia ser a utilização do patrimônio histórico edificado como recurso nos estudos de geologia. No Brasil, pode servir de exemplo para essas possibilidades o Quadrilátero Ferrífero, região de grande importância histórica e econômica devido a seus recursos minerais, como ouro, ferro e pedra-sabão.
Avaliação da fragilidade emergente na bacia do rio São Mateus e o enquadramento da APA de Conceição da Barra (ES)
Authors: Pinheiro Carlos Alberto Kuster , Vale Claudia Câmara , Coelho André Luiz Nascentes
Published: April 2018

O trabalho que ora se apresenta consiste no mapeamento das classes de fragilidade ambiental emergente da bacia do rio São Mateus, abrangendo terras dos municípios de Ecoporanga, Ponto Belo, Boa Esperança, Vila Pavão, Água Doce do Norte, Barra de São Francisco, Mantenópolis, Nova Venécia, Jaguaré, Conceição da Barra e São Mateus. Tais classes de fragilidade foram extraídas a partir da modelagem em ambiente de SIG utilizando ainda produtos, técnicas de sensoriamento remoto e validação do mapeamento com base em registros documentais, fotográficos e trabalhos de campo. Buscou-se também inserir a APA de Conceição da Barra no mapa de fragilidade ambiental para verificar o nível de fragilidade em que a mesma se encontra. Os resultados permitiram delimitar e calcular as áreas em graus e percentuais de fragilidade, comprovando sua eficiência nos registros e dados obtidos no campo. Tal metodologia possibilitou delimitação de outras áreas de bacias hidrográficas, municípios e regiões do Brasil, constituindo-se numa importante informação no auxílio das tomadas de decisões a exemplo dos planos de drenagem urbana e/ou manejo de bacias hidrográficas.
La historiografia ambiental en la República Argentina
Authors: Miraglia Marina
Published: April 2018

Con motivo de realizarse la III Escuela de Posgraduación de la Sociedad Latinoameriana y del Caribe de Historia Ambiental (SOLCHA) en la Universidad Unievangélica (Goias-Brasil), y en ocasión de participar en la mesa redonda sobre Impactos de la Historiografía Ambiental en la Disciplina Histórica en América Latina, se presenta en este dossier, un trabajo sobre la historiografía ambiental en Argentina, donde se reseñan las principales actividades académicas realizadas en torno al ambiente en las Universidades y Centros de investigación públicos argentinos en los últimos años. Se organiza el artículo por regiones geográficas (Noroeste, Noreste, Cuyo, Patagonia y Pampeana y Metropolitana de Buenos Aires), autores e instituciones y se realiza una reseña de los aportes académicos en la disciplina.
Análise histórica do uso da terra em Antropogeomorfologia: alguns exemplos paulistas
Authors: Botura Stefanuto Estêvão , Scudeller Zanatta Felipe Augusto , Lupinacci Cenira Maria
Published: April 2018

Com a intensa modificação do ambiente e consequentemente do modelado do relevo, constata-se o surgimento da antropogeomorfologia, na qual se insere dados históricos de uso da terra à análise do relevo, visando o entendimento das formas e processos geomorfológicos sob as condições atuais de alteração antrópica. Neste artigo objetiva-se demonstrar a importância dessa análise para identificar alterações nas dinâmicas reconhecidas pela ciência geomorfológica. Essa perspectiva exigiu uma revisão dos princípios clássicos da Teoria Geral dos Sistemas; de noções de incerteza, complexidade e não linearidade; e a análise de estudos de caso em áreas urbanas, rurais e de mineração. Conclui-se que os dados históricos permitem levantar hipóteses sobre a possível dinâmica desses ambientes alterados, contribuindo para reduzir o grau de incerteza.