bluuebunny/crossref_metadata_2025 huggingface dataset:
Morton Neuroma Excision
Authors: Shah Ashish , Pinter Zachariah , Lehtonen Eva , Naranje Sameer , Odom Christopher , Paul Kyle , Huntley Samuel , Dahlgren Nicholas , DeBell Henry
Published: September 2018

Category:

Midfoot/Forefoot

Introduction/Purpose:

Morton’s Neuroma is a benign enlargement of the second or third common digital branch of the medial plantar nerve. This causes a compressive neuropathy of the distal medial plantar nerve. When conservative management fails, surgery becomes the treatment of choice via either a dorsal or plantar approach to the nerve. When using a dorsal approach for a Morton Neurectomy, neuroma commonly recurs due to insufficiently resection of the medial plantar nerve. It is unclear how far the nerve can be resected and which type of retractor provides superior visualization to allow greater resection. The present cadaveric study investigates how proximally the nerve can be resected and examines both the Laminar spreader and Galpie retractor to determine which instrument facilitates maximal proximal resection of the nerve.

Methods:

This study involved 12 fresh-frozen below-knee cadaver specimens that underwent a dorsal approach to the medial plantar nerve with proximal resection of the nerve in both the 2nd and 3rd intermetatarsal spaces as is performed during a Morton Neurectomy. The senior surgeon made a 3 cm incision just proximal to the 2nd and 3rd webspaces, and used blunt dissection to the level of the transverse intermetatarsal ligament. The transverse intermetatarsal ligament was then transected, and either a Laminar spreader or Galpie retractor was used to improve visualization of the intermetatarsal space. The medial plantar nerve was then identified and transected, and the lengths of the distal segment of the cut nerves were measured and recorded. These values were then compared based on the retractor employed.

Results:

In the 2nd intermetatarsal space, the Laminar spreader allowed the nerve to be dissected an average of 2.42 cm proximal to the distal end of the 3rd metatarsal (head)compared to 1.93 cm by the Galpie retractor. Thus, use of the Laminar spreader rather than the Galpie retractor resulted in greater resection of the nerve, although this was not significant. In the 3rd intermetatarsal space, the Laminar spreader allowed the nerve to be dissected an average of 2.14 cm proximal to the distal end of the 3rd metatarsal, while the Galpie retractor allowed 1.48 cm. Thus, use of the Laminar spreader in the 3rd intermetatarsal space resulted in greater excision of the nerve than the Galpie retractor, although this was not significant.

Conclusion:

These results demonstrate that use of the Laminar spreader during dorsal approach to a Morton Neuroma results in superior proximal resection of the medial plantar nerve when compared to use of the Galpie retractor, thereby decreasing the risk of recurrent Morton Neuroma. Further evaluation of the available retractors is needed to support the superiority of the laminar spreader compared to the Galpie retractor.
Suture Button versus Syndesmotic Screw for Syndesmotic Injuries
Authors: Shimozono Yoshiharu , Hurley Eoghan , Kennedy John
Published: September 2018

Category:

Trauma

Introduction/Purpose:

Syndesmotic injuries are a common athletic injury and involved in approximately 13% of ankle fractures. Screw fixation (SS) has been the most common fixation treatment for syndesmotic injury, however syndesmosis malreduction has been reported to occur up to more than 50% in syndesmotic screw fixation. Recently, suture-button fixation (SB) technique has been developed to restore anatomic function of the syndesmosis, with potential advantages of allowing physiological movement of syndesmosis, anatomic healing, avoidance of implant removal and earlier rehabilitation. However, optimal surgical treatment is still controversial to date. The purpose of this study was to compare the clinical outcomes of SB and SS fixation techniques for syndesmotic injuries with a meta-analysis of the clinical studies comparing SB and SS fixation for syndesmosis injuries.

Methods:

The literature search was performed according to the PRISMA guidelines to identify cohort studies comparing SB and SS fixation for syndesmosis injuries. The level of evidence (LOE) was assessed based on the criteria by the Oxford-Centre for Evidence Based Medicine. Statistical analysis was performed using RevMan, and a p-value of < 0.05 was considered to be statistically significant.

Results:

Ten clinical studies were identified comparing 222 patients with SB to 235 patients with SS fixation. Patients treated with SB had a higher postoperative AOFAS score at a mean of 17.2 months (90.9 vs 87.3, p = 0.002). SB resulted in a lower rate of implant failure (0.0% vs 27.1%, p < 0.0001), implant removal failure (4.0% vs 37.5%, p < 0.0001), and joint malreduction (0.8% vs 10.7%, p = 0.009). However, there was no significant difference in the rate of other complications with SB (4.2% vs 8.6%, p = 0.21).

Conclusion:

SB fixation results in improved functional outcomes, lower rates of implant failure, and joint malreduction. Based on the findings of this meta-analysis SB appears to be favorable to SS for treating syndesmotic injuries.
Postoperative analgesia with the use of peripheral nerve block of the foot and ankle
Authors: Stéfani Kelly , Ferraz Gabriel
Published: September 2018

Category:

Basic Sciences/Biologics

Introduction/Purpose:

Peripheral nerve block in the foot and ankle is usually used for anesthesia in forefoot and midfoot surgeries. However, since the postoperative analgesia obtained is prolonged, we can expand its use, as an adjuvant after the end of the spinal or general anesthesia. The aim of this study was to evaluate the use of peripheral nerve block of the foot and ankle as a method of postoperative analgesia.

Methods:

A prospective, randomized, blinding study was performed. The study group included 30 patients (32 feet) submitted to peripheral anesthetic block after surgery with spinal anesthesia and the control group (30 patients, 31 feet) were patients not submitted to nerve block. The inclusion criterion was: patients submitted to foot and ankle surgery at our institution. Patients answered the questionnaire postoperatively, with the measurement of pain intensity by the Visual Analog Scale (VAS) and the time of onset of pain. All local peripheral block was performed by the same orthopedic team with 20 mL of Ropivacaine at a concentration of 7.5 mg / mL (0.75%).

Results:

The mean patient age was 52,5 years, and the majority of patients were women (66%). The results showed a statistically significant difference between the control group and the study group, with a longer time of postoperative analgesia (p <0.001) and lower pain intensity in the immediate postoperative period (p <0.001) in patients submitted to blockade anesthetic. There was no statistical difference between the two groups regarding pain intensity on the first and second postoperative day.

Conclusion:

In the study group, the mean postoperative pain (six hours after surgery) was lower when compared to the control group, with statistical significance. This result showed that the ankle block helped to control pain, in a safe and effective mode. The use of ropivacaine presents a sensitive block similar to bupivacaine, but with shorter motor block, allowing early initiation of rehabilitation. The study demonstrated that peripheral nerve block in the foot and ankle region can be used effectively in postoperative analgesia, reducing pain intensity in the immediate postoperative period and also prolonging analgesia and thus maximizing physiotherapy postoperative period.
A Comparison of Two Methods of Regional Anesthesia
Authors: Stith Andrew , Griffin Matthew , Haytmanek Thomas , Hirose Christopher
Published: September 2018

Category:

Other

Introduction/Purpose:

Poorly controlled post-operative pain is a common cause of patient dissatisfaction. With future emphasis on value-based medicine, optimization of cost-effectiveness and patient satisfaction is critical. Popliteal and saphenous nerve blocks are routinely use in foot and ankle orthopaedic surgery and have become the gold standard for immediate post-operative analgesia. Traditionally a single long-acting local anesthetic agent is utilized which achieves analgesia for 6-24 hours. Recent evidence has shown that multimodal anesthesia with combined anesthetic agents remains effective for a longer duration compared to single-medication nerve blocks. The purpose of this study is to determine if patients undergoing foot and ankle surgery safely benefit from multi-modal compared with traditional single-medication nerve blocks.

Methods:

This was a two-armed, prospective, randomized, double-blinded study. The study population consisted of 70 patients from a single institution undergoing foot and ankle surgery by two fellowship-trained orthopaedic foot and ankle surgeons. 34 patients received a local anesthetic only popliteal and saphenous nerve block (Bupivacaine) and the other 36 patients received a triple additive nerve block (Dexamethasone, Clonidine, and Buprenorphine) in addition to Bupivacaine. Pre- and Post-operative assessments were performed to determine VAS pain scores, numbness, duration of anesthesia, patient satisfaction with analgesia, and oral pain medication use.

Results:

Triple additive (TA) nerve block mean duration to onset of pain was longer than for single agent (LA) nerve blocks (40.2 hrs vs 24.3 hrs respectively). Time to complete block resolution was also longer for the TA nerve blocks (82.3 hours) compared to LA blocks (38.7 hrs). 17/34 TA block patients had residual numbness at 1 week compared to 5/36 LA block patients. However, by 3 months there was no difference (8/34 TA and 7/36 LA). There was no significant difference in VAS scores or patient satisfaction rates at 1 week or 3 months. 7/34 TA block patients required narcotic refills compared to 6/36 LA block patients. There was no significant difference in complications between the groups.

Conclusion:

Triple agent nerve blocks give a longer duration of effective postoperative analgesia compared to single agent blocks. There was a higher rate of lingering numbness in the triple agent blocks at one week but not at 3 months. Patient satisfaction was very high for both groups regardless of their VAS pain scores. Triple agent nerve blocks demonstrate equivalent safety compared with single agent nerve blocks.
Rigid Internal Fixation of Proximal Crescentic Metatarsal Osteotomy in Hallux Valgus Correction
Authors: Stith Andrew , Griffin Matthew , Flint Wesley , Coughlin Michael
Published: September 2018

Category:

Bunion

Introduction/Purpose:

Proximal first metatarsal crescentic osteotomies are an effective means for correction of moderate to severe hallux valgus deformities. The originally described fixation construct included an intramedullary screw and a Kirschner wire which crossed the joint and required removal at 6 weeks. Elevation malunion of the first ray was also frequently noted postoperatively. The purpose of this study was to evaluate the outcomes of utilizing a low-profile titanium plate and screw construct for rigid fixation of proximal crescentic osteotomies.

Methods:

There were 53 patients (60 feet, 7 bilateral) with hallux valgus deformities enrolled in the study. They were all treated operatively with a proximal crescentic osteotomy and distal soft tissue correction with or without an Akin osteotomy. The crescentic osteotomy was fixed with a low-profile titanium plate and screws. Postoperatively patients were assessed at 3 months, 6 months and 1 year. Outcomes assessed included the need for hardware removal, change in elevatus of the first ray, as well as pre- and post-op VAS pain scores, radiographic evaluation, AOFAS score, MTP joint range of motion, and complications.

Results:

Of the 60 hallux valgus cases enrolled, 56 have completed their final follow-up (93%). At 1 year 55/56 patients had achieved radiographic union of their osteotomy. Nine patients had their hardware removed (16%). Range of motion at the 1st MTP joint decreased from 76.5 to 59.6 degrees. Hallux valgus angle improved from a mean of 28.8 to 9.6 degrees. The mean 1-2 intermetatarsal angle decreased from 14.1 to 6.4 degrees. Elevatus of the first ray increased from a mean of 2.5 mm pre-op to 3.2 mm (<1 mm) post-op. Mean VAS score improved from 4.43 to 0.68 (3.75 points). AOFAS score improved from 54.7 to 88.5 points. Complications included 4 superficial infections, 2 delayed wound healing cases and one DVT.

Conclusion:

Proximal crescentic metatarsal osteotomy with distal soft tissue repair is a safe and reliable method for operative treatment of hallux valgus. Utilization of a low-profile titanium plate and screw construct to rigidly fix the osteotomy yields a high rate of union and deformity correction with a low incidence of hardware removal and minimal increase in elevation of the first ray at final follow up.
Return to work after surgical treatment for displaced calcaneus fractures treated with a sinus tarsi approach
Authors: Swords Michael , Simon Ann
Published: September 2018

Category:

Trauma

Introduction/Purpose:

Calcaneus fractures most often occur as a result of a high-energy injury in patients of working age. While it is known that patients will require time to recover, the rate of return to work and at what time frame is not well known. The purpose of this registry is to evaluate return to work issues after surgical treatment of a displaced calcaneus fracture treated operatively with plate fixation by a sinus tarsi approach.

Methods:

Subjects with displaced intra-articular calcaneal fractures surgically treated with a variable angle locking calcaneal plate by a sinus tarsi approach were included in a registry. Descriptive statistics were calculated for demographics, pre-operative, operative and post-operative characteristics.

Results:

The registry included 27 consecutive patients. According to Sanders classification, nine cases (33.3%) had type II fractures, sixteen cases (59.3%) had type III, and two cases (7.4) had type IV fractures. 23/27 (85%) patients were able to return to work at their pre injury occupation involving prolonged standing. Four (4) of the 23 patients required work restrictions, Return to work occurred at an average of 16.5 weeks from injury (range 9-22 weeks) for individuals with weight bearing occupations. One patient was able to return at 4 weeks to a temporary sit down position. Three (3) patients were unable to return to their prior occupation. Return to work information was unknown for 1 patient.

Conclusion:

The data demonstrates that patients treated for displaced intra articular calcaneus fractures with a variable angle locking plate by a sinus tarsi approach return to work to standing occupations at a high rate. The return to work data may be used to counsel patients and employers on realistic return to work expectations.
Effect of Type 1 and Type 2 Diabetes Mellitus on Complication and Reoperation Rates of Ankle Arthrodesis and Total Ankle Arthroplasty
Authors: Tucker William , Morris Brandon , Tarakemeh Armin , Mullen Scott , Schroeppel Paul , Vopat Bryan
Published: September 2018

Category:

Diabetes

Introduction/Purpose:

Diabetes mellitus (DM) poses a risk for increased rate of complications in many orthopaedic procedures, especially in patients undergoing elective arthroplasty procedures. Treatment of end-stage ankle arthritis includes both arthroplasty and arthrodesis. Current literature provides minimal guidance regarding outcomes of total ankle replacement (TAR) or ankle arthrodesis (AA) in diabetic patients. The authors of this study utilized a large database to compare rates of postoperative complications and reoperations of diabetic patients undergoing surgical management of ankle arthritis to rates seen in non-diabetic patients.

Methods:

Using the PearlDiver Technologies, Inc. database, Medicare patients diagnosed with ankle arthritis using ICD-9 codes were identified from 2005 to 2014. Patients were then sorted as diabetic or non-diabetic. Diabetic patients were then further stratified into Type 1 diabetes (T1DM) and Type 2 diabetes (T2DM). Type 2 diabetics requiring insulin (T2ID) and not requiring insulin (T2NID) were also isolated. Patients were identified who underwent either AA or TAR utilizing ICD-9 procedure and CPT codes. These groups were evaluated for postoperative complications and reoperation rates. Chi-Squared testing was used to determine significance. Multivariate analysis was performed to determine whether diabetes represents an independent risk factor.

Results:

1477 diabetic patients underwent TAR and 5399 underwent AA versus 3900 TAR and 7838 AA in nondiabetics. Diabetics undergoing AA experienced complications at 32.2%, reoperations at 30.8%, and revisions at 18.7% versus 13.3%, 22.3%, and 19.2% respectively in patients without diabetes(P<0.05). In diabetics undergoing TAR, the complication rate was 21.6% and reoperation rates were 16.9% versus 12.5% and 13% respectively in their non-diabetic counterparts(P<0.05). Revision rates were similar. Patients with T1DM had more reoperations and complications in both TAR and AA compared to those with T2DM (P<0.05). In both surgical groups, Patients with T2ID had more complications and reoperations than those with T2NID(P<0.05). Multivariate analysis revealed diabetes as an independent risk factor for complication and reoperation in AA but only complication in TAR(P <0.05).

Conclusion:

Patients with a diagnosis of diabetes mellitus experienced higher complication and total reoperation rates when undergoing either TAR or AA. T1DM appears to impart a greater risk of surgical complication and repeat surgical intervention than does T2DM. However when insulin is required in T2DM, complication and reoperation rates are similar to those of T1DM. Patient selection for surgical management of end-stage ankle arthritis should incorporate diabetic type and insulin dependency when considering surgical intervention.
Early vascular parameters in the micro- and macrocirculation in type 2 diabetes
Authors: Kannenkeril Dennis , Bosch Agnes , Harazny Joanna , Karg Marina , Jung Susanne , Ott Christian , Schmieder Roland E.
Published: September 2018

Background

Diabetes converts from a metabolic disorder into a predominantly vascular disease, once its duration extends over several years or/and when additional cardiovascular risk factors such as hypertension coexist. In a cross-sectional analysis we analyzed various vascular parameters in the renal, retinal and systemic circulation, with the goal to identify which vascular parameter of early organ damage is the earliest that can be clinically detected.

Methods

In 111 patients with type 2 diabetes (T2DM) (off any anti-diabetic medication for at least 4 weeks) and 54 subjects without T2DM we compared various parameters of early vascular remodeling in the same patient: urinary albumin creatinine ratio ([UACR], early morning spot urine) and estimated glomerular filtration rate (eGFR), retinal capillary flow (RCF) and intercapillary distance (ICD) as parameters of capillary rarefaction, wall-to-lumen ratio (WLR) of the retinal arterioles [all assessed by Scanning Laser Doppler Flowmetry], and central systolic pressure (cSBP) and central pulse pressure (cPP) [measured by pulse wave analysis, Syphygmocor] both reflecting vascular stiffness of large arteries.

Results

Compared to subjects without T2DM, patients with T2DM (diabetes duration: median 48 months, interquartile range 24–88 months) were older (59.8 ± 7.3 vs 43.4 ± 12.9 years, p < 0.001), more females (33.3 vs 20.4%, p < 0.001), but 24-h systolic and diastolic blood pressure did not differ between the two groups. The analysis adjusted for age, gender and cardiovascular risk factors revealed that ICD (23.9 ± 5.1 vs 20.8 ± 3.5 µm, p value = 0.001) and cPP (41.8 ± 11.7 vs 34.8 ± 10.6 mmHg, p value < 0.001) were significantly higher and eGFR (91.7 ± 9.9 vs 95.9 ± 17.3 ml/min/1.73 m2, p value < 0.001) was significantly lower in patients with T2DM than in subjects without T2DM.

Conclusion

These data suggest that at similar blood pressure capillary rarefaction in the retinal circulation (ICD), decreased eGFR in the renal circulation and increased central pulse pressure (cPP) of large arteries are earlier detectable than other vascular remodeling parameters of the micro- (WLR, RCF, UACR) and macrocirculation (cSBP) in patients with T2DM.

Trial registration Trial registration number: NCT02471963, Date of registration: June 15, 2015, retrospectively registered; Trial registration number: NCT01319357, Date of registration: March 21, 2011, retrospectively registered; Trial registration number: NCT02383238, Date of registration: March 9, 2015, retrospectively registered; Trial registration number: NCT00152698, Date of registration: September 9, 2005, prospectively registered; Trial registration number: NCT00136188, Date of registration: August 26, 2005, prospectively registered
The impact of human papillomavirus (HPV) status on functional outcomes and quality of life (QOL) after surgical treatment of oropharyngeal carcinoma with free-flap reconstruction
Authors: Marzouki Hani Z. , Biron Vincent L. , Dziegielewski Peter T. , Ma Andrew , Vaz Jason , Constantinescu Gabriela , Harris Jeffrey , O'Connell Daniel , Seikaly Hadi
Published: September 2018

Background

To determine the impact of Human Papillomavirus (HPV) status on speech, swallowing, and quality of life (QOL) outcomes after surgical treatment of oropharyngeal cancer (OPSCC).

Methods

A retrospective review of a prospectively collected database of all patients with OPSCC diagnosed and treated from 1998 to 2009. Speech, swallowing, and quality of life data were gathered at 3 different evaluation points. HPV status was determined using p16 positivity as a surrogate marker. Univariate and multivariate statistical analyses were performed to identify whether p16 status is a significant predictor of functional outcome and QOL.

Results

One hundred twelve patients with OPSCC and known p16 status were treated with primary surgery between 1998 and 2009, with mean age of 56 years. Out of those patients 63 (56%) were p16 positive. Speech intelligibility remained high at 1-year post operation (95.4%). Only 11.5% of the patients required a feeding tube at 1 year after surgery to maintain their daily caloric requirements and the risk of aspiration after surgery was not significant ( p = 0.097). There was no statistically or clinically significant difference in speech, swallowing ability, swallowing safety and QOL outcomes between p16-positive and negative OPSCC.

Conclusions

Surgically treated OPSCC patients demonstrate excellent swallowing function and can achieve excellent speech perception. P16 status may not be predictive of functional outcomes or QOL in surgically treated OPSCC.
UK circulating strains of human parainfluenza 3: an amplicon based next generation sequencing method and phylogenetic analysis
Authors: Smielewska Anna , Emmott Edward , Ranellou Kyriaki , Popay Ashley , Goodfellow Ian , Jalal Hamid
Published: September 2018

Background:Human parainfluenza viruses type 3 (HPIV3) are a prominent cause of respiratory infection with a significant impact in both pediatric and transplant patient cohorts.  Currently there is a paucity of whole genome sequence data that would allow for detailed epidemiological and phylogenetic analysis of circulating strains in the UK. Although it is known that HPIV3 peaks annually in the UK, to date there are no whole genome sequences of HPIV3 UK strains available. 

Methods:Clinical strains were obtained from HPIV3 positive respiratory patient samples collected between 2011 and 2015.  These were then amplified using an amplicon based method, sequenced on the Illumina platform and assembled using a new robust bioinformatics pipeline. Phylogenetic analysis was carried out in the context of other epidemiological studies and whole genome sequence data currently available with stringent exclusion of significantly culture-adapted strains of HPIV3.

Results:In the current paper we have presented twenty full genome sequences of UK circulating strains of HPIV3 and a detailed phylogenetic analysis thereof.  We have analysed the variability along the HPIV3 genome and identified a short hypervariable region in the non-coding segment between the M (matrix) and F (fusion) genes. The epidemiological classifications obtained by using this region and whole genome data were then compared and found to be identical.

Conclusions:The majority of HPIV3 strains were observed at different geographical locations and with a wide temporal spread, reflecting the global distribution of HPIV3. Consistent with previous data, a particular subcluster or strain was not identified as specific to the UK, suggesting that a number of genetically diverse strains circulate at any one time. A small hypervariable region in the HPIV3 genome was identified and it was shown that, in the absence of full genome data, this region could be used for epidemiological surveillance of HPIV3.
La emperatriz Isabel de Portugal con el príncipe Felipe en brazos (1529): en busca de un retrato perdido de António de Holanda
Authors: Romero Dorado Antonio
Published: September 2018

En 1529 el pintor António de Holanda realizó varios trabajos pictóricos para el emperador Carlos V e Isabel de Portugal, entre ellos un retrato de la emperatriz con su heredero, el príncipe Felipe, en brazos, a la manera de la Virgen con el Niño. Este trabajo presenta una pintura que podría ser la versión más cercana a dicho retrato original, que se considera perdido.
Bárbara de Braganza. Una aproximación a su faceta como coleccionista.
Authors: García Martínez José Luis
Published: September 2018

La presente investigación analiza la faceta coleccionista de la reina Bárbara de Braganza tomando como referencia a su predecesora en el trono español, Isabel de Farnesio, y a partir de las pinturas y piezas de orfebrería que donó al monasterio de las Salesas Reales. Para ello analizamos previamente la educación recibida y su papel en la corte de Fernando VI. Adjuntamos la transcripción del inventario correspondiente a las pinturas.
Dos arquetas relicario de San Vitores (Cerezo de Río Tirón) hechas en Flandes (1466) y Burgos (1525)
Authors: Barrón García Aurelio A.
Published: September 2018

Estudiamos las arquetas con las reliquias de San Vitores. La urna interior es gótica, fue realizada, en torno a 1465, probablemente en Brujas (Flandes), y está adornada con hierro forjado y cuero trabajado con la técnica del cuir-ciselé. El arca exterior se hizo en Burgos en 1525. Presenta escudos de la familia Velasco y ornato de lazos, cruces y anagramas de Cristo y María.
La Real Academia de San Fernando y la proyección de consistorios en los reinos andaluces (1777-1808)
Authors: Ruiz Carrasco Jesús María
Published: September 2018

Como parte del proceso de implantación de los preceptos arquitectónicos promovidos por la Real Academia de San Fernando a nivel estatal entre 1777 y 1808, destacó la labor reguladora ejercida por dicha institución sobre la proyección de consistorios en los reinos andaluces. Con especial atención al papel desempeñado por los arquitectos académicos en los citados territorios, este artículo se centra en el esclarecimiento de las circunstancias que determinaron la evaluación de los diseños elaborados para dichos consistorios y sus consecuencias.
Graffiti e igualdad de género: La artista ICAT y el proyecto educativo del IES Trassierra (Córdoba)
Authors: Luque Rodrigo Laura
Published: September 2018

La ciudad ha sido a lo largo de la historia un espacio dedicado al hombre, la mujer encontraba su espacio dentro de la casa. Sin embargo, poco a poco la mujer comienza a ocupar el espacio urbano, también desde el arte. El arte urbano resulta un medio de comunicación magnífico puesto que llega a todos los ciudadanos, lo que le da un poder inmenso si se quiere usar como medio para educar en cuanto a cultura visual colectiva. En el texto trataremos de casos concretos como la artista ICAT y el IES Trassierra.
Trans*itando el cuerpo: Una propuesta de investigación artística basada en el cuerpo como no lugar
Authors: Caballero Caballero Jesús
Published: September 2018

Con el presente estudio se pretende aportar desde la creación artística una nueva perspectiva adherida a los estudios de género y los principios queer. Ambiciona cooperar en ese cometido que defiende la diferencia, sin desigualdades, para ampliar los horizontes y no responder a lo que social y culturalmente se establece como correcto. Continuando con la investigación artística iniciada en trabajos anteriores la cual aborda el estudio de la experiencia transexual, se propone, a partir de lecturas y de experiencias derivadas del estudio de la actividad artística contemporánea, el cuerpo como un no lugar. Para ello, se transitará por las pautas de Marc Augé, así como de otras investigaciones y artistas que han reflexionado sobre la cuestión. El texto se organiza según tres partes: en primer lugar, desde la perspectiva de género donde se analiza cómo los no lugares y el cuerpo comparten una serie de rasgos que permiten establecer conexiones. En el siguiente apartado se desarrollan cuestiones como lenguaje, entendido como código, temporalidad, viaje y etnología de sí mismo entre otras; para entender el cuerpo como no lugar desde la experiencia transexual. Finalmente, planteo un debate en torno a las cuestiones abordadas en los apartados anteriores para proyectar estas reflexiones en una propuesta de investigación artística: Trans*itando el cuerpo.
El gestus y las prácticas feministas performativas
Authors: Rodríguez Caldas María del Mar
Published: September 2018

En este artículo examinaremos prácticas artísticas feministas que, en su confrontación con lo real, han indagando en formas de contar desde el cuerpo, retomando la herencia del gestus del teatro brechtiano. Son prácticas que no sólo procuran conocimientos, sino que los producen. Se trata de trabajos que han politizado el cuerpo y los espacios privado y público desde el terreno de lo performativo; pertenezcan por definición al ámbito de la performance o del arte de acción, o se hayan materializado en otros medios, como el fotográfico o el fílmico. Indicaremos una genealogía de obras feministas realizadas en los años 70 y desde los 90 cuya búsqueda común es revelar un gestus social a partir de los cuerpos. Ambos periodos son ricos en prácticas artísticas comprometidas en lo social y en lo político; tras el solipsismo de cierta cultura posmoderna, el activismo del 68 resurgirá en los 90 buscando el reencuentro con la intersubjetividad y con la realidad social (Sánchez 2007).
El Sin Título: Un relato estético desde la práctica artística
Authors: Garbayo Alvero Natividad
Published: September 2018

El sin Título es una obra audiovisual que da forma al fundamento empírico de la investigación sobre el comportamiento y desarrollo experimental del artista dentro y fuera del Laboratorio del Arte. La incertidumbre artística e intelectual nos planteó como artistas la importancia y la relación existente entre la práctica artística y la investigadora, generando una reflexión: ¿Qué investigan artistas que experimentan en y desde su práctica artística? Para poder abordar los fenómenos planteados por el sujeto creador, construimos un relato estético-visual con un enfoque metodológico experimental apoyado en la Ley de los Cambios del artista Jorge Oteiza. Nuestro interés por analizar y estructurar ese proceso de cambio fue conformando una estética de conocimiento que relacionaba lenguaje, escritura y pensamiento. Un discurso que en su creación audiovisual, combinó la lógica de los sentidos con el proceso de recuperación del yo, de lo sensorial y lo subjetivo con un marcado trasfondo poético.
Koloratzaile-laserra, ezinbesteko argi iturria eguneroko bizitzan
Authors: Avellanal-Zaballa Edurne , Bañuelos Jorge
Published: September 2018

Gure eguneroko bizitzan erabiltzen ditugun hainbat gailu elektroniko laser-igorpenean oinarritzen dira. Erradiazio mota honen ezaugarri bereziak, hots, monokromatizitatea, koherentzia eta norabide zuzena, aplikazio arrakastatsu eta eraginkorraren arrazoi nagusia dira. Lan honetan, gure helburu nagusia izan da laserren garrantzia agerian jartzea eta azaltzea zergatik agertzen den erradiazio mota hori. Horretarako, laserren oinarria azaldu da eta argiaren igorpen-mota hori lortzeko beharrezkoak diren eskakizunak aipatu dira. Bukaeran, laser organiko izeneko gailuetan ipini dugu arreta; horietan, koloratzaile fluoreszenteak erabiltzen dira ingurune aktibo gisa. Ildo honetatik, gure ikerkuntza-taldean azken urteetan orokorrean egindako aurrerapausoak iruzkintzen dira. Egindako ikerkuntzaren helburua, laser-seinalearen eraginkortasuna eta ponpaketaren aurrean egonkortasuna areagotzeaz gain, espektro-eremu ultramore ikusgai osoan zehar koloratzaile-laserrak egoera likidoan zein solidoan lortzea izan da.
MALDI-TOF masa espektrometriaren erabilera polimeroak ezaugarritzeko
Authors: Veloso Antonio , Sola-Llano Rebeca
Published: September 2018

Gaur egun, materialak ezaugarritzekoerabiltzen diren teknikek informazio dezente uzten dute agerian, baina oraindik nahiko zaila da egiturari buruzko informazio osatua lortzea. Informazio hau garrantzi handikoa eta beharrezkoa da modu sakon batean polimero horietatik eratorritako materialen propietateak ezagutzeko. Polimeroak karakterizatzeko, Matrix Assisted Laser Desorption-Ionization Time of Flight Mass Spectrometry (MALDI/TOF MS) sortu zenetik, gero eta gehiago hedatu da teknika honen erabilera arlo desberdinetan.Masa-espektrometria teknika hau hedatu egin da polimeroen karakterizazioan, masa molarraren banaketaz gain, polimeroen unitate monomerikoa, polisakabanatzea eta kateen muturrak ezagutzea lor daitekeelako, hain zuzen ere.Lan honetan MALDI/TOF teknikaren oinarriak labur azalduko dira: masa espektrometroak nola funtzionatzen duen, zein den matrizearen garrantzia, zeintzuk diren matrize ohikoenak... Eta zenbait polimeroren karakterizazio adibideak aztertuko dira. Zehazki, bi karakterizazio-prozedura erakutsiko dira: Gel Permeation Chromatography (GPC) teknikan estandartzat erabiltzen den poliestireno homopolimeroa eta Latemul, emultsionatzaile polimerizagarri komertzial moduan erabiltzen den kopolimeroa.
Makina-erreminten errendimendua eta zehaztasuna
Authors: Arrizubieta Jon Iñaki , Celaya Ainhoa , Ukar Eneko , Lamikiz Aitzol
Published: September 2018

Zehaztasunaren ikuspuntutik makina-erreminten diseinuan, eraikuntzan eta martxan jartzean kontuan eduki behar diren puntu garrantzitsuenak bildu dira ikerlan honetan. Horregatik, artikulu honetan, makina-erremintaren diseinu-printzipio garrantzitsuenak azaltzen dira. Gainera, makina-erremintetan ager daitezkeen erroreen ondoriozko ziurgabetasuna zenbatesteko gaur egun gehien erabiltzen den metodoan sakontzen da: errore-aurrekontua. Are gehiago, diseinu egokirako kontuan hartu behar diren printzipioak deskribatzen dira. Azkenik, makina-erreminta muntatu ostean, haren zehaztasuna zenbatesteko existitzen diren nazioarteko arau garrantzitsuenak aztertu dira.
DIRETRIZES CURRICULARES PARA A FORMAÇÃO DOCENTE: PERCEPÇÕES DE PROFESSORES FORMADORES
Authors: Voigt Jane Mery Richter , Pesce Marly Krüger de
Published: September 2018

O objetivo deste artigo é discutir como os professores que atuam em disciplinas relacionadas às práticas pedagógicas percebem os impactos das diretrizes curriculares para a formação inicial. Esta pesquisa, de abordagem qualitativa, obteve os dados por meio de entrevista com professores que atuam em cursos de licenciatura. A análise dos dados pautou-se nas diretrizes nacionais (BRASIL, 2002; 2015) e em teóricos como Tardif (2011), Imbernón (2011) e Dourado (2015). Os resultados apontam que, para os formadores, diferentes saberes têm interfaces comuns e que a aproximação da universidade com a educação básica se mostra fundamental, pois a escola é reconhecida como um espaço de formação. Todavia há um silenciamento em relação a aspectos apontados nas diretrizes, como a formação do professor pesquisador, imprescindível para a atuação e formação docente, considerando as demandas e os desafios da educação.
STRATEGIC BEHAVIOURS TO PRESERVE CURRICULUM STUDIES AS A FIELD
Authors: Pérez David Callejo , Breault Donna Adair
Published: September 2018

Nos últimos dez anos, os professores da área de estudos do currículo assistiram ao encolhimento de seus programas. Em meio a estes desafios, muitos dos envolvidos no ensino do tema estão buscando um realinhamento para manter diálogos complicados, com risco de perderem seus programas. O presente trabalho explora os contextos histórico e organizacional para buscar trajetórias estratégicas para que os estudos do currículo se conectem em novas formas. Nosso artigo não pretende ser um tratado sobre a morte dos programas de doutorado na área de estudos do currículo, mas sim uma avaliação das mudanças drásticas que estão acontecendo na área. As preocupações em nosso trabalho estão contextualizadas na natureza mutante da educação e dos programas de doutorado. Argumentamos que os estudos do currículo não se encaixam nos novos modelos de trabalhos da pós-graduação, pois buscam sua identidade, se afastam das aplicações mais práticas da teoria para tentar reparar a lacuna que divide as várias perspectivas da área e seu papel no trabalho sobre currículo. Historicamente, o currículo tem se prestado a um trabalho crítico e unificador na educação para entender a vida cotidiana dos educadores; dar suporte ao processo de ensino reflexivo; e melhorar a valorização da educação como política.  Com isto em mente, consideramos que, para que a área de estudos do currículo sobreviva, precisamos encontrar novas formas de conectar prática e política.
ESCRITA ACADÊMICA: REPERCUSSÕES E RESSONÂNCIAS PROPAGADAS EM UM COLETIVO
Authors: Cardonetti Vivien Kelling , Oliveira Marilda Oliveira de
Published: September 2018

Este artigo busca tecer discussões em relação à produção da escrita acadêmica. Tem como propósito investigar as repercussões e as ressonâncias que foram propagadas no movimento de ler, escrever e partilhar as pesquisas em um grupo de pós-graduação em educação. A intenção é interrogar e problematizar os movimentos e os pensamentos que atravessam uma escrita acadêmica quando produzida no coletivo. Alguns questionamentos estiveram presentes neste percurso: que textos-leituras brotaram deste compartilhamento de leituras? Que textos-leituras respingaram nas escritas acadêmicas dos envolvidos? Que repercussões e ressonâncias foram propagadas na experiência de ler as investigações dos colegas e escrever as próprias pesquisas? Dessa forma, com intuito de atender aos anseios desta investigação, optou-se pela perspectiva narrativa, presentificada no atravessamento de múltiplas vozes e no compartilhamento de experiências dos envolvidos, como forma de pensar o que foi possível aprender neste processo. Alguns conceitos passaram a movimentar o pensamento dessa investigação: repercussão e ressonância (BACHELARD, 1993), leitura e escrita (BARTHES, 2007a, 2007b, 2012; DELEUZE, 2006a, 2006b; DELEUZE; GUATTARI, 1995a, 1995b, 2005; SKLIAR, 2014). As problematizações suscitadas a partir dos autores convidados e das narrativas dos envolvidos agiram como um vetor de ressonâncias, brindando com a oportunidade de pensar algumas possibilidades em relação à escrita acadêmica.
O INSTRUMENTO DA NORMA E SEUS EFEITOS SOBRE OS CORPOS: CENAS DE UMA ESCOLA
Authors: Cervi Gicele Maria , Schütz Monique Cristina Francener Hammes
Published: September 2018

O presente trabalho tem como objetivo problematizar como, na escola contemporânea, o instrumento da norma produz efeitos sobre os corpos. Os principais aportes teóricos são Foucault (2006; 2014), Deleuze (1992), Dussel e Caruso (2003), Cervi (2010), Passetti (2003) e Veiga-Neto (2014). Utilizou-se, como estratégia teórico-metodológica, a perspectiva pós-crítica. Realizou-se a pesquisa de campo em uma escola municipal de educação básica no estado de Santa Catarina no ano de 2015. Os instrumentos de produção de dados foram: fotografias, diário de campo e o Projeto Político-Pedagógico da instituição. Infere-se, a partir dos dados produzidos, que o instrumento da norma compara, diferencia, hierarquiza, homogeneíza, avalia, exclui, define, marca os desvios, os limites, o anormal e corrige o corpo. Ainda que o dispositivo siga disciplinando, controlando, esta escola conseguiu e consegue ser outra escola no interior dela mesma, inventiva, resistente, em que amizade e o cuidar com o outro se estabelecem em pequenos momentos do cotidiano.
Skookum Root: Ethnobotany of Hellebore (Veratrum viride) in Northwest British Columbia
Authors: Armstrong Chelsey Geralda
Published: September 2018

This research considers some of the uses and harvest protocols of one of the most important medicinal plants for Indigenous peoples throughout British Columbia, Vertarum viride (skookum root, green false hellebore, Indian poke, Indian hellebore). The medicinal qualities of V. viride are well respected given its equally powerful ability to paralyze and kill. Using botanical, ethnographic, ethnohistoric, and linguistic data, a broad overview of hellebore is provided for the northwest coast of North America, followed by an in-depth consideration of Gitxsan harvest protocol, witnessed through participant observation.
Diabetično stopalo kot zaplet sladkorne bolezni
Authors: Meklav Klementina , Flis Vojko , Stričević Jadranka , Sruk Vida
Published: September 2018

Uvod: Diabetično stopalo je skupina sindromov, pri katerih nevropatija, ishemija in infekcija pripeljejo do destrukcije tkiva, končna posledica je zbolevnost, lahko pa tudi amputacija. Namen raziskave je bil ugotoviti pogostost pojava diabetičnega stopala pri pacientih s sladkorno boleznijo.Metode: V raziskavi je bila uporabljena raziskava mešanih metod. Tehnika zbiranja podatkov je bilo anketiranje 60 pacientov s sladkorno boleznijo in delno strukturiran intervju z dvema medicinskima sestrama, ki delata v diabetološki ambulanti. Kvantitativni podatki so bili analizirani z opisno in bivariatno statistiko. Kvalitativni podatki so bili analizirani s pomočjo metode analize vsebine.Rezultati: Ugotovili smo, da amputacija noge ni pogost zaplet diabetičnega stopala (U = 4,4, p = 0,217) in da ne moremo trditi, da je diabetično stopalo pogostejše pri moških kot pri ženskah (U = 0,6, p = 0,417), ter da so pacienti zelo dobro poučeni glede nege stopal in pravilne obutve.Diskusija in zaključek: Najpomembnejša informacija o zdravstveni vzgoji pri diabetičnem stopalu za paciente je, da so o tem zapletu ozaveščeni pisno in ustno. Diabetično stopalo za paciente najpogosteje prinese spremembo v kakovosti življenja. Možnost za nadaljevanje raziskave bi bila izvedba enake raziskave na večjem številu pacientov.
Perineal trauma during vaginal birth in Slovenia
Authors: Petročnik Petra , Mivšek Ana Polona , Škodič Zakšek Teja , Verdenik Ivan , Jug Došler Anita
Published: September 2018

Introduction: The aim of this retrospective study was to examine the rates of perineal tears during childbirth in Slovenian  maternity hospitals in the period from 2013 to 2015.Methods: A causal non-experimental method of quantitative empirical approach was conducted. Data were pooled from the Slovenian National Perinatal Information System and analysed for the period of 2013 to 2015. Data analysis was performed with the use of frequency distribution of attributive variables and the basic descriptive statistics of numerical variables.Results: The incidence of perineal trauma during childbirth in all the 14 maternity hospitals varies from the "perineum without injury" to the "fourth degree perineal tear". Overall, 26.1 % of women sustained a first degree perineal tear, whereas 4.8 % of women had a second degree perineal tear. Severe perineal trauma included 0.8 % of third degree tears and 0.1 % of fourth degree tears.Discussion and conclusion: Perineal trauma varies between Slovenian maternity hospitals. Women who have sustained tears that cut into their bowels may face serious health problems and should be given relevant advice regarding the state of their pelvic floor after childbirth. It is of great importance to appropriately recognise the severity of the perineal trauma. Moreover, health professionals should be familiar with the perineal trauma classification and the factors that may cause the perineum to tear during childbirth.
NEUROGENIC SPINAL DEFORMITIES IN ADULTS: MODERN PROBLEMS AND APPROACHES TO TREATMENT
Authors: Prudnikova O. G. , Gushcha A. O. , Shatina I. N.
Published: September 2018

Objective.To present the features of clinical manifestations, diagnostic aspects and approaches to the treatment of neurogenic deformi- ties of the spine in adults based on the literature data.

Material and Methods.The literature review was performed using PubMed, Medline, Web of Science, Scopus, CrossRef, AOSpine, Clini- cal Key, eLibrary databases and references of key articles published in the period from 06.02.2017 till 04.11.2017.

Results.General trends in the treatment of adult patients with neurogenic deformities of the spine have been determined. Assessment of the risk from performing an intervention, taking into account possible complications and potential outcome, determines the approach to surgery in these patients. It is necessary to develop protocols of management with the definition of the main clinical symptoms, the ratio- nale for the use of non-invasive, minimally invasive or other options for care. Surgical treatment of patients with spinal deformities asso- ciated with neurodegenerative diseases (Parkinson’s disease) is accompanied by a high rate of complications and repeated interventions. Tactical algorithms for these patients should include the consistency of non-surgical and mini-invasive techniques and considering clinical manifestations of myopathy, mielo-, radiculopathy, which, in comparison with diagnostic tests, can determine the indications and volume of decompressive interventions, and the extent and levels of spinal fixation.

Conclusion.The complexity of pathogenetic mechanisms and ambiguous results of non-surgical and surgical treatment determine the need for multidisciplinary approach and the development of protocols for the management of adult patients with neurogenic deformities of the spine.
SURGICAL CORRECTION OF ADULT IDIOPATHIC SCOLIOSIS IN PATIENTS OF YOUNG AND MIDDLE AGE
Authors: Mikhaylovskiy M. V. , Vasyura A. S. , Novikov V. V. , Sarnadsky V. N. , Gubina E. V. , Chernyadjeva M. A.
Published: September 2018

Objective.To evaluate the results of surgical correction of idiopathic scoliosis in patients aged 18-50 years, in terms of different age groups.

Material and Methods.A total of 393 patients (348 women, 45 men) with idiopathic scoliosis were operated on during 1996-2015. In all cases, posterior correction of the deformity was performed using segmental third-generation instrumentation. The primary curve and structural countercurve were included in the fusion area. Hook fixation was performed in 298 cases, and hybrid (hooks and pedicle screws) in 95. The period of postoperative follow-up was 4.4 years on average. Analysis of immediate and long-term results was performed using X-ray and computer optical topography in three age groups (age at the time of surgery): 18 to 24 years (274 patients), 25 to 34 years (95 patients), 35 years and older (24 patients).

Results.No statistically significant differences between age groups were revealed, both in initial parameters (magnitude of the primary curve, countercurve, and the apical vertebra rotation) and in surgical results (magnitude of correction, loss of correction and mobility). When interviewing patients with the SRS-24 questionnaire, the best results were obtained in the group of age 18-24, worse in the group of age 25-34, and even worse in the group of age over 35. Computer topography also revealed the absence of statistically significant difference between age groups.

Conclusion.Surgical treatment of adult idiopathic scoliosis provides quite satisfactory results, especially in terms of improving the quality of life, that do not have significant differences when comparing three age groups within the age range exceeding 30 years.