bluuebunny/crossref_metadata_2025 huggingface dataset:
Initial approach to patients with acute lower back pain
Authors: Joaquim Andrei Fernandes
Published: May 2016

Summary Low back pain is in one of the most common reasons for seeking medical care in emergency care units, and also the second most common cause of work absenteeism. The recognition of red flags for serious diseases such as tumors and fractures, through proper history-taking and clinical examination, is essential for proper treatment and to rule out differential diagnoses. In the absence of suspected severe underlying disease, subsidiary radiological examinations are unnecessary. Analgesic and anti-inflammatory drugs are the treatment of choice and can be cautiously associated with muscle relaxants and opioids in more severe cases. Most patients will have complete improvement of symptoms after a few months, but a minority can develop chronic low back pain or present with recurrent episodes. The proper understanding of all of the above can optimize results and avoid diagnostic and therapeutic errors.
O discurso midiático e a 'nova classe média': articulações de uma experiência social em processo
Authors: Oliveira-Cruz Milena Carvalho Bezerra Freire de , Ronsini Veneza Mayora
Published: May 2016

Resumo O texto problematiza diferentes dimensões da "nova classe média", em especial abordagens do discurso midiático que partem de associações com frações de classe de diferente capital econômico. A partir de pesquisa bibliográfica dos temas que articulam teoricamente a questão, observa o fenômeno da "nova classe média" em uma perspectiva relacional e considera seus reflexos na vida concreta de toda a sociedade. Assim, discute o modo como as vivências proporcionadas pelo aumento do poder de consumo entre esses sujeitos são representadas nos meios de Comunicação, remetendo a novas experiências para percepção de si e de sua posição social, colaborando para a conformação da sua identidade de classe e da sua relação com os demais grupos. Por fim, a partir de uma perspectiva que se filia à teoria de Raymond Williams, o texto aborda a "nova classe média" como uma formação cultural em estado pré-emergente, uma experiência social em processo, cujas implicações não estão totalmente classificadas.
Aggressive Behavior of Children in a Daycare Center
Authors: Filho Sidnei Rinaldo Priolo , Pompermaier Henrique Mesquita , Almeida Nancy Vinagre Fonseca de , Souza Débora de Hollanda
Published: May 2016

Abstract The present work examined aggressive behavior in a sample of children attending a child daycare center in relation to their teachers' behaviors and the types of activities proposed by them. Four teachers and their respective students were observed for an average of six sessions, during which they performed activities, which could be free (without instruction) or guided. The most frequent behaviors were pushing/pulling, fighting over objects/taking an object from someone else, and kicking/throwing objects, with 77.61% of the aggressive behavior occurring during the free activities. An association between free activities and aggressive behavior was found. The categories kicking/throwing, fighting over objects/taking an object from someone else and slapping the face were associated with free activity. These results indicate the need for more attention directed toward children's free activities, providing them with adequate space for play and diverse opportunities for exploration and object manipulation.
Heat transfer within frozen slopes in subarctic Yukon, Canada
Authors: Steeves Joel T , Barbour Sidney Lee , Ferguson Grant , Carey Sean K
Published: May 2016

The dominant mechanism of heat transfer during ground thaw is typically assumed to be vertical conduction. However, the addition of lateral subsurface water flow introduces the potential for the forced convection of energy, having an influence on ground temperatures and thaw rates. Field observations of snowmelt run-off and rates of ground thaw for two slopes within the Wolf Creek basin, Yukon, Canada, highlighted different rates of ground thaw with slope position. Ground temperatures were numerically simulated to evaluate the relative influence of conduction and convection on the thawing of these slopes; each slope comprised different soils and had a different slope aspect. Both slopes were composed of an organic layer overlying a mineral soil. Lateral water flow above the frozen layer occurred within both slopes as a result of a perched saturated zone above the organic–mineral interface. The numerical models reveal that lateral diversion within a surficial, high-hydraulic conductivity layer, such as an organic layer, can initiate convective heat transfer. However, the observed differential thaw was determined to be a result of conduction and variations in the initial ice content and snow cover rather than lateral convection of heat.
Mediated Public Diplomacy of the Islamic State in Iraq and Syria: The Synergistic Use of Terrorism, Social Media and Branding
Authors: Melki Jad , Jabado May
Published: May 2016

This study aims to provide an initial theoretical model for understanding and analyzing the mediated public diplomacy strategy of virtual states. It examines the mediated public diplomacy strategy of the Islamic State in Iraq and Syria (ISIS) and its ability to synchronize terrorism tactics with communication strategies to gain media access and exposure, push news frames that serve its interests, and target stakeholders with a dual message using sophisticated branding strategies that resonate with cultural values and help it ultimately recruit supporters and deter foes.
Проблемы режиссуры театра
Authors: Юркин Вячеслав Александрович
Published: May 2016

В статье анализируются цели и задачи режиссуры театра, роль режиссера в процессе работы коллектива над созданием спектакля. 
О проблемах детского и юношеского репертуара в педагогической и конкурсной деятельности
Authors: Фадеева-Москалева Людмила Владимировна
Published: May 2016

В статье перечисляются наиболее частые проблемы детского и юношеского песенного репертуара, который составляется педагогами, родителями без учета возраста, опыта, характера детей. Даются практические рекомендации.
Выборы глав регионов в России в 2015 году (анализ процесса избирательной кампании и ее результатов)
Authors: Махора Екатерина Витальевна
Published: May 2016

В статье анализируются процесс и итоги выборов глав регионов России осенью 2015 г., в том числе в Иркутской области. На основе исследования процесса и результатов этой избирательной кампании выявляются некоторые особенности выборов глав регионов после возвращения в электоральный процесс процедуры выборов региональных руководителей.
Cardiac involvement Is Underdiagnosed in Patients with Biopsy-Proven Systemic AL Amyloidosis
Authors: Zheng Haoyi , Mazumder Amitabha , Katz Stuart
Published: May 2016

Background: Clinical recognition of cardiac involvement and cardiac response to therapy is an important element of clinical care in patients with AL amyloidosis. The new criteria including NT-proBNP, troponin, and echocardiography for assessment of cardiac involvement in patients with systemic AL amyloidosis were proposed in 2004, but there are limited data on the utilization of these in clinical practice

Methods: We retrospectively reviewed the clinical data of 28 patients with AL amyloidosis. Clinical diagnosis of cardiac amyloidosis was based on medical record documentation of symptomatic heart failure without other causes. Then we use the criteria from the current NCCN Guidelines to reassess cardiac involvement.

Results: 14 cases (50%) had clinical diagnosis of cardiac amyloidosis at the time of diagnosis and also met the NCCN criteria. An additional 6 cases without clinical diagnosis of cardiac amyloidosis met the NCCN criteria. In total, 20 patients (71.4%) met the NCCN criteria for cardiac involvement. No routine follow-up testing with echocardiography and biomarkers was documented during treatment for any of the patients.
Coronary tortuosity: normal variant or pathological condition?
Authors: Cortese Francesca , Gesualdo Michele , Acquaviva Tommaso , Palumbo Vincenzo , De Cillis Emanuela , Bortone Alessandro , Ciccone Marco M , Cortese Cosma , Ciccone Andrea
Published: May 2016

Highlights
Coronary tortuosity is a common coronary angiography finding. The aetiology and the clinical significant are not well defined, generally considered a normal variant. We showed a case of marked tortuosity of all coronary arteries associated with myocardial ischemia. 
To What Extent Do Popular ESL Textbooks Incorporate Oral Fluency and Pragmatic Development
Authors: Diepenbroek Lori G. , Derwing Tracey M.
Published: May 2016

We examined several popular integrated skills textbooks used in Language Instruc- tion for Newcomers to Canada (LINC) and English as a second language (ESL) programs for pragmatics and oral fluency activities. Although many instructors use other resources to supplement classroom instruction, the textbook is still the backbone of many language courses. We wanted to know to what extent textbooks focus on pragmatics and oral fluency, as well as the range of activities featured in each. In light of the recent federal evaluation of LINC programs in Canada, which indicated extremely limited improvement in speaking and listening skills as a result of language instruction, it is important to know which textbooks offer the best opportunities for pragmatics and fluency development. We determined that very few textbook series are consistent in their inclusion of pragmatic content in terms of scope, quality, and quantity. As might be expected, oral fluency is not a major focus in integrated skills texts; however, those activities that are intended to enhance fluency development could easily be improved by an instructor.
English for the Workplace: Doing Patient-Centred Care in Medical Communication
Authors: Dahm Maria R. , Yates Lynda
Published: May 2016

Canada, like other first-world countries, relies in large part on professional im- migrants trained in other cultures and languages to complement its workforce in a wide range of professions, including medicine. International medical graduates (IMGs) who are nonnative English-speaking (NNES) and who have trained in different medical contexts are often unfamiliar with the sociopragmatic norms underlying both general communication and medical practice in their new host countries, and as a result they can have difficulty using the pragmalinguistic resources needed to strike the appropriate interpersonal note in patient-centred approaches to communication. In this article we used data collected through role-plays performed in an Australian setting by practicing, locally trained, native English-speaking (NES) doctors and NNES IMGs to identify the features of patient-centred medical communication that the latter can find challenging. This approach allowed us to use the discourse to highlight those features of approachability that are likely to be relevant to immigrant professionals in both Canada and Australia. It also helped us to illustrate how discourse data can be used to identify culturally appropriate ways of communicating that can, in turn, contribute to an accurate evidence base from which culturally appropriate communication courses for IMGs and other professionals may be developed.
Is It Rude Language? Children Learning Pragmatics Through Visual Narrative
Authors: Ishihara Noriko
Published: May 2016

There has been an upsurge of interest in teaching second/foreign language (L2) pragmatics in recent years, but much of this effort has been targeted at adult learners. This article introduces small-scale informal instruction exploring the pragmatic development of 9-year-olds in Tokyo, facilitated through dialogic in- tervention on pragmatics using the visual presentation of narratives. Although the instruction took place in an English as a foreign language (EFL) context, the same dialogic approach is relevant to ESL in Canada and elsewhere, as picture books enrich narratives, visually mediating the context of language use in a manner comprehensible and captivating to young learners. The learners’ pragmatic development was scaffolded dialogically through instructional materials doubling as teacher-based assessments, including formality judgment tasks, discourse completion tasks, and student-generated visual discourse completion tasks, assessed through predesigned rubrics and written reflections by the teacher. Video-recorded data showed that repeated visual assistance provided by the teacher and peers led to enhanced pragmatic awareness and metapragmatic judgments of the relative levels of formality and politeness of the target pragmatic formulas. However, with little L2 exposure, these learners were often unable to produce newly introduced expressions and failed to match the demands of the context with appropriate language choices during this isolated series of instructional events.
Incorporating Language Structure in a Communicative Task: An Analysis of the Language Component of a Communicative Task in the LINC Home Study Program
Authors: Lenchuk Iryna
Published: May 2016

The purpose of this article is to analyze a task included in the LINC Home Study (LHS) program. LHS is a federally funded distance education program offered to newcomers to Canada who are unable to attend regular LINC classes. A task, in which a language structure (a gerund) is chosen and analyzed, was selected from one instructional module of LHS offered as a demonstration module for the general public. Specifically, the analysis presented in this article focuses on how language structure is integrated into the task. The integration of language structure into the task is assessed against the criteria outlined in the Task-Based Language Teaching and Learning (TBLT) literature and the Canadian Language Benchmarks (CLBs) guidelines. The analysis of the task demonstrates that the presentation of language structure in the task violates the main principle of a meaning-based approach to second language teaching (i.e., task-based instruction) that emphasizes the primacy of meaning over language forms. Considering that LHS is a national program identified as one of the Best Practices in Settlement Services language programs, this article calls for more research on the topic.L’objectif de cet article est d’analyser une tâche du programme de formation à domicile LINC. Ce programme d’éducation à distance est financé par le gouvernement fédéral et offert aux nouveaux arrivants qui ne peuvent pas assister aux cours LINC réguliers. Nous avons choisi une tâche impliquant l’analyse d’une structure linguistique (un gérondif) d’un module pédagogique du programme qui est offert au grand public comme module de démonstration. Plus précisément, l’analyse présentée dans cet article porte sur l’intégration de la structure langagière dans la tâche. L’intégration est évaluée selon les critères découlant de la littérature sur l’enseignement des langues basés sur les tâches et selon les normes linguistiques canadiennes. L’analyse de la tâche a démontré que la présentation de la structure langagière allait à l’encontre du principe sur lequel s’appuie l’approche de l’enseignement d’une langue seconde axée sur le sens (c’est à dire, basée sur les tâches) et faisant prévaloir le sens sur la forme. Le programme de formation à domicile LINC étant un programme national identifié comme une des pratiques exemplaires en matière de services d’établissement, cet article s’exprime en faveur de recherches plus approfondies à ce sujet.
Evaluation of Factors Influencing Thigh Circumference Measurement in Dogs
Authors: Duerr Felix Michael , Bascuñán Ana Luisa , Kieves Nina , Goh Clara , Hart Juliette , Regier Penny , Rao Sangeeta , Foster Sasha , Palmer Ross
Published: May 2016

Objective: To evaluate inter- and intra-observer variability, influence of hair clipping and laser guidance on canine thigh circumference (TC) measurements amongst observers.

Background: It was our goal to further study the reliability of canine TC measurements as currently performed. For this purpose we designed a cadaveric model that allows for controlled inflation of the thigh resembling increase of muscle mass. We also investigated the impact of novel technologies (laser guidance) and hair clipping on TC measurements in this model. 

Evidentiary value: Phase 1 cadaveric study - five long-haired, large breed canine cadavers; Phase 2 clinical study - eight clinically healthy Golden Retrievers. This study should impact clinical research and practice.

Methods: Phase 1 - Canine cadaveric thigh girth was manually expanded to three different levels using a custom, submuscular inflation system before and after hair clipping; Phase 2 - TC of Golden Retrievers was measured with and without laser guidance. TC measurements for both phases were performed by four observers in triplicate resulting in a total of 552 measurements. 

Results: Phase 1 - TC measurements before and after hair clipping were significantly different (3.44cm difference, p<0.001). Overall inter-observer and intra-observer variability were 2.26±1.18cm and 0.90±0.61cm, respectively. Phase 2 - Laser guidance nominally improved inter-observer variability (3.34 ±1.09cm versus 4.78 ±2.60cm) but did not affect intra-observer variability (1.14 ±0.66cm versus 1.13 ±0.77cm).

Conclusion: TC measurement is a low fidelity outcome measure with a large inter- and intra-observer variability even under controlled conditions in a cadaveric setting. Current methods of canine TC measurement may not produce a valid outcome measurement. If utilised, hair coat clipping status should be considered and an intra-observer variability of at least 1cm should be assumed when comparing repeated TC measurements. Laser guidance may be helpful to nominally reduce inter-observer variability in settings with multiple observers. Further investigation of alternative methods for canine TC measurement should be pursued.

Application: This information should be considered by everyone utilizing TC measurements as an outcome assessment for clinical or research purposes. 

  
Direct and indirect trophic effects of predator depletion on basal trophic levels
Authors: Chen Huili , Hagerty Steven , Crotty Sinead M. , Bertness Mark D.
Published: May 2016

Human population growth and development have heavily degraded coastal ecosystems with cascading impacts across multiple trophic levels. Understanding both the direct and indirect trophic effects of human activities is important for coastal conservation. In New England, recreational overfishing has triggered a regional trophic cascade. Predator depletion releases the herbivorous purple marsh crab from consumer control and leads to overgrazing of marsh cordgrass and salt marsh die‐off. The direct and indirect trophic effects of predator depletion on basal trophic levels, however, are not understood. Using observational and experimental data, we examined the hypotheses that (1) direct trophic effects of predator depletion decrease meiofaunal abundance by releasing deposit feeding fiddler crabs from consumer control, and/or (2) indirect trophic effects of predator depletion increase meiofaunal abundance by releasing blue carbon via the erosion of centuries of accreted marsh peat. Experimental deposit feeder removal led to 23% higher meiofaunal density at die‐off than at healthy sites, while reciprocally transplanting sediment from die‐off and healthy sites revealed that carbon‐rich die‐off sediment increased meiofauna density by over 164%: six times stronger than direct trophic effects. Recovering sites had both carbon‐rich sediment and reduced deposit feeding leading to higher meiofauna densities than both die‐off and healthy sites. This suggests that consequences of the trophic downgrading of coastal habitats can be driven by both direct and indirect trophic mechanisms that may vary in direction and magnitude, making their elucidation dependent on experimental manipulations.
Predictors Of Risky Health Behaviours Among Secondary School Students With Hearing Impairment In South -West, Nigeria
Authors: Isaiah O.O , Ola Taiwo Adebanke
Published: May 2016

Like every adolescent, students with hearing impairment engaged in Risky Health Behaviour (RHB) such as alcohol consumption, cigarette consumption, drug abuse, inadequate physical activities, unhealthy dietary behaviour as well as indiscriminate sexual acts. These activities have therefore become issues of public health concern. Previous studies have focused majorly on the academic performance, emotional stability and psychological adjustment of students with hearing impairment than on their RHB and its socio-economic predisposing factors. This study, therefore, examined social (discrimination, home, health awareness, peer influence and false belief) and economic (poverty and purchasing power) factors as predictors of RHB among Secondary School Students with Hearing Impairment (SSSHI) in south-west, Nigeria.. The study adopted a descriptive survey design. Purposive sampling technique was used to select 980 students with hearing impairment from some secondary schools in southwest Nigeria. Five hypotheses were tested at 0.05 level of significance. Data was analysed using descriptive statistics, multiple regression. Social and economic factors had significant composite contribution to RHB (F(7,973)=22.80; R=0.37) and accounted for 17.0% of the variance of RHB. The relative contributions of the independent variables to risky health bebehaviour are: Peer influence (β=0.25), Purchasing power (β=0.23), discrimination (0.15), poverty (β=0.10) home (β=0.08), false belief (β=0.07) )and health awareness(0.02). Unfriendly home situation, negative peer influence, false beliefs, poverty and low purchasing power predicted risky health behaviour among secondary school students with hearing impairment Therefore, government should organise periodic health and sensitization programmes on health issues for students, parents and teachers.
Le Capital Immatériel : Evaluation Et Importance Cas Des Entreprises Marocaines Cotées En Bourse
Authors: Taouab Omar , Benazzou Lotfi , Babounia Aziz
Published: May 2016

Currently, we live in an economy that has changed considerably since the 1990s. This is the time where the economies have moved from the industrial to the information age. For about a decade, companies have switched to the immaterial economy in addition to the physical value (fixed assets: buildings, workshops, computers, vehicles, etc.) and the cash value (cash, receivables, etc.).There is a gaseous value, which is the intangible capital. This new notable concept is the subject of this research, which is to calculate the intangible capital of a sample of listed Moroccan companies, according to an approximate approach, based on publicly available data on Casablanca Stock Exchange website. The purpose of this research is to answer the following questions: What is intellectual capital? What are the components of intangible capital? And what is the weight of intangible capital in Moroccan companies?
Approaching Hysteria through an Irigararian Perspective in Fay Weldon’s Praxis
Authors: Abdullah Omar Mohammed
Published: May 2016

Hysteria is read as ‘the female malady’, a disease or sickness women suffer from. This reading could be one among other such readings that construe hysteria as a transgressive force by which women achieve or regain some lost desire. Luce Irigaray considers hysteria as a non-verbal language employed as a form of protest against patriarchal law which is instrumental in bequeathing hysteric symptoms to women. Constant fear, disturbed sleep, marginalization, trauma … etc., are products of patriarchy which manifest in women. The heroine in Fay Weldon’s Praxis also suffers similar symptoms. Irigaray’s reading of hysteria with sub-concepts of Mimicry and Masquerade will help to explore and reveal hysteria as a transgressive means by which women fight for their existence and attain their desires. This reading is applied to Weldon’s novel to reveal how the protagonist managed to construct an identity she strived for through hysteria.
The Determinants Of Renewable Energy Consumption: An Empirical Analysis For The Balkans
Authors: Akar Basak Gul
Published: May 2016

As a measure of development, energy has a priority in economic literature. However, both economic and social costs caused by traditional energy sources have led to question on the importance of these resources. In addition to this, various problems such as pollution and dependence on foreign energy has brought about new researches instead of existing energy sources. Alternative and renewable energy sources, which are named as “clean energy”, are expected to take the place of the old method. However, there are many factors affecting the use of new energy sources. These factors include energy prices, energy production, energy dependence, economic growth, trade openness, and the use of carbon dioxide. Besides, development levels of countries have a significant influence on the degree of interaction between these factors. In the present study, firstly, renewable energy consumption and the determinants of this energy use were discussed in the theoretical context. Consequently, the required empirical tests were applied for Balkan countries - Albania, Bosnia-Herzegovina, Bulgaria, Croatia, Montenegro, Kosovo, Macedonia, Romania, Serbia, Slovenia, Turkey, and Greece. Dynamic panel data method was preferred for analysis. However, this panel covers a period between the years of 1998-2011. According to the results obtained through a dynamic panel data analysis, it was found that there is a negative and statistically significant relationship between economic growth and renewable energy consumption. On the other hand, trade openness and natural gas rents are determined to have a positive effect on renewable energy consumption in the Balkans.
Etude Anatomique du Système Artériel Carotidien de l’Aulacode (Thryonomysswinderianus, Temminck 1827)
Authors: Edem James Yaovi , Espérance Broalet , Tchin Darre , Yvan Zunon-Kipre , Amegnona Agbonon , Gagnon Amouzouvi , Akpo Sibabi , Messanvi Gbeassor , Komlavi James
Published: May 2016

The Cane rat (Thryonomysswinderianus) is an African rodent described in 1827 by Temminck. In order to make of it a model animal of laboratory, it is subjected to research in many domains for few years. Objective: The aim of this work was to describe the anatomy of the carotid Artery System of the cane rate.Materials and methods: It was about a prospective experimental study carried out on a series of eight adult sacrificed and put at death cane rats. After realizing a previous thoracic shutter, a vascular washing was performed by cardiac path followed by two injections of latex colored differently. The first one in red color and the second in blue are respectively carried out on the left and right heart. The Craniospinal blocks carrying the heart and the supra cardiac vessels were removed and immersed in a solution of formaldehyde at 10% during 72 hours. The anatomy of carotid artery was studied after dissection of the blocks. Results: With their origin, the two common arteries carotid were born by a common trunk at the convexity level of the aortic arch. They had an ascending way along the trachea and were divided then into two branches under the solid massif of the mandible: An external branch for the bodies of the face and an internal branch which moves towards the cerebral trunk. Conclusion: This study enables us to show that the two arteries common carotids are born by a joint base from the aortic arc and that the internal artery carotid does not take part in the constitution of the arterial circle of the base.
Identidad, igualdad y educación
Authors: Cerletti Alejandro
Published: May 2016

Nuestro mundo actual se nos presenta como “un” mundo, único y omnipresente: el mundo del capitalismo globalizado en el que todas las relaciones, en mayor o menor medida, se han mercantilizado y todo (productos o informaciones) puede llegar a cualquier rincón del planeta. La diversidad es asumida como un elemento más de la circulación de mercancías (comerciales o culturales) y completa un cuadro homogéneo en el que cada cosa tiene su lugar asignado. En este trabajo emplearemos algunos aportes de Alain Badiou para abordar esta cuestión, intentando  mostrar su entramado constitutivo, y ofrecer algunas perspectivas alternativas. En especial nos interesará exhibir la posibilidad de pensar un mundo que dé lugar a todos los mundos posibles, y que no sea el mero sometimiento planetario a la expansión del capital ni la simple aceptación “tolerante” del “otro”. Esta concepción del vínculo entre los humanos será la base para repensar la cuestión educativa en el mundo de hoy.

 
Reflexiones sobre evaluación de la enseñanza del diseño gráfico en la universidad
Authors: García Pacheco Nancy Patricia
Published: May 2016

El objeto del texto es reflexionar sobre la práctica evaluativa. Para ello se aborda una experiencia con estudiantes universitarios del programa de diseño gráfico de la Universidad de Boyacá, donde se indaga acerca de la percepción que tienen sobre la evaluación. Es vital pensar en una cultura evaluativa que busque una verdadera calidad en la educación y que se articule con la innovación en las prácticas pedagógicas. Es prioritario dejar de lado las mediciones que no dan cuenta de los procesos cognitivos que desarrolla cada ser humano a partir de su propia experiencia de aprendizaje. En la presente investigación se encontró que para el diseño gráfico la evaluación es subjetiva, otorgándole el poder al maestro de generar argumentos desde su propia interpretación de una realidad visual, que puede diferir con la percepción y el significado que cada individuo le otorga a una imagen. Posteriormente se presentan algunas posturas de los docentes del programa acerca de este tema. El texto finaliza con algunas conclusiones que suscita dicha reflexión.

 
La «chrematistik» nella Politica di Aristotele: articolazioni concettuali e ricadute etico-antropologiche
Authors: Fermani Arianna
Published: May 2016

Questo contributo ha l’obiettivo di studiare le due fondamentali concezioni della nozione, complessa ed estremamente ampia, di chrematistiké (crematistica) nella Politica di Aristotele, esaminata nei suoi nessi con la nozione di oikonomia, focalizzando particolarmente l’attenzione sui capitoli 8-11 del I libro della Politica. Le due diverse forme di crematistica sono basate su due atteggiamenti psicologici molto diversi: 1) in un primo caso c’è un desiderio canalizzato, gestito e organizzato dalla saggezza in vista di un fine ulteriore; 2) nel secondo caso il desiderio è fine a se stesso, insaziabile, senza limiti e refrattario ai comandi della saggezza. La conclusione è che, secondo lo Stagirita, la ricchezza non è un male, e non lo è neanche, in quanto tale, la ricerca della ricchezza, cioè appunto la crematistica che, se correttamente inquadrata e orientata in funzione del fine, costituisce la conditio sine qua non della vita buona, ordinata e felice a livello individuale e politico.
Os esportes radicais como conteúdo interdisciplinar no contexto escolar
Authors: Tomio Bruno Wilwert , Silva Daniela da , Dalcastagné Giovanni , Lamar Adolfo Ramos
Published: May 2016

A interdisciplinaridade evidencia-se como possibilidade de renovação curricular e de busca por uma educação de qualidade, que visa uma substituição da fragmentação e particularidades para uma visão de totalidade, coletiva e social. Já os Esportes Radicais se apresentam pela possibilidade inovadora e de reflexão no âmbito escolar. Diante do exposto, esta pesquisa teve como objetivo analisar a percepção dos professores das escolas básicas municipais de Blumenau, Santa Catarina, Brasil, sobre a inserção dos Esportes Radicais como conteúdo interdisciplinar no contexto escolar. Este estudo caracteriza-se como sendo uma pesquisa de campo de caráter qualitativo, em que foi realizada uma entrevista semiestruturada com professores de diferentes disciplinas das escolas básicas municipais de Blumenau. Com base na pesquisa, é possível destacar a necessidade de romper e superar as barreiras presentes no sistema educacional e social para de fato proporcionar uma perspectiva interdisciplinar aos conteúdos abordados na escola, nesse caso especificamente, os Esportes Radicais.
Experiencia en hernioplastía inguinal con anestesia local.
Authors: Aliaga Chávez Noél
Published: May 2016

Objetivo: Evaluar la utilidad de la cirugía ambulatoria con anestesia local en pacientes con patología herniaria inguinal. Material y métodos: Se realizó un estudio descriptivo tipo serie de casos, entre abril de 1996 y marzo de 1999, en el Servicio de Cirugía de la Clínica Fiori. Se intervinieron 1,167 pacientes por patología de pared abdominal, de las cuales 432 correspondieron a pacientes intervenidos por patología herniaria inguinal, de ellos 372 fueron operados con anestesia local, los cuales fueron incluidos en el estudio. Las técnicas quirúrgicas empleadas fueron las de Bassini y McVay, con un tiempo operatorio promedio de 30 minutos y un control a los 3 días post-cirugía. Resultados: El 72.9% de la patología herniaria inguinal se presentó en los pacientes entre los 31 y 70 años de edad. Solo el 2.6% (10 pacientes) presentaron complicaciones post-operatorias, 6 con recidivas de hernia inguinal, 2 con infección de herida operatoria, 1 con seroma y 1 con hematoma, ninguno resultó ser de gravedad; y 97.4 % (362) no presentaron ninguna complicación. No hubo complicaciones anestésicas. Conclusiones: La hernioplastia inguinal con anestesia local es efectiva, segura y económica.(Rev Med Hered 2003; 14:158-162).
Frecuencia de diagnósticos de la especialidad de otorrinolaringología en el consultorio de medicina general en un centro de salud.
Authors: DIAZ LEDESMA Lizeth , DAVILA ACOSTA Jorge Humberto , RODRIGUEZ SALAZAR Victor Manuel , AÑAÑOS FLORES Dirck Martin
Published: May 2016

Objetivos: Determinar la frecuencia de los diagnósticos por especialidad en consulta externa de medicina general y describir los diagnósticos más frecuentemente realizados dentro de la especialidad de otorrinolaringología. Material y Métodos: Estudio descriptivo transversal. Se determinó la frecuencia de diagnósticos por especialidad y dentro de la especialidad de otorrinolaringología realizados en un consultorio de medicina general entre los meses de junio y setiembre del 2002. Los diagnósticos fueron consignados según la codificación internacional (CIE-10). Resultados:Durante este período se realizaron 2,116 consultas con 2,499 diagnósticos. La edad promedio fue 29.85 + 17.11 años. 852 consultas (40%) se realizaron en varones y 1,264 (60%) en mujeres. Del total de diagnósticos realizados,1,226 (49%) correspondieron a afecciones otorrinolaringológicas, 219 (8.8%) a problemas gastrointestinales, 189 (7.6%) a problemas neumológicos, 170 (6.8%) reumatológicos y 163 (6.5%) infecciones generales. Los diagnósticos dentro de la especialidad de otorrinolaringología fueron en orden de frecuencia 405 (33%) casos de rinofaringitis aguda, 361 (29.4%) de faringitis aguda y 358 (29.2%) de amigdalitis aguda. Conclusiones: Las afecciones otorrinolaringológicas correspondieron a la primera causa de consulta para el médico general en un centro de salud de la Sanidad de la Fuerza Aérea del Perú. Esto puede ser extrapolado a los demás centros de salud. Es por ello que la formación médica debería estar más orientada a este tipo de patología. (Rev Med Hered 2003; 14: 163-166).
Nivel de satisfacción general y análisis de la relación médico paciente de los médicos en entrenamiento en las salas de hospitalización de medicina interna.
Authors: TSUCHIDA FERNANDEZ Marisa Beatriz , BANDRES SANCHEZ María Pilar , GUEVARA LINARES Ximena
Published: May 2016

Revisar la relación médico paciente y conocer el nivel de satisfacción general de los pacientes hospitalizados con respecto a los médicos. Pacientes y métodos: Estudio descriptivo transversal. Se encuestó a 64 pacientes hospitalizados en las salas de medicina interna del Hospital Nacional Arzobispo Loayza en marzo de 2003. Se valoraron los niveles de satisfacción general de los pacientes con respecto a los médicos y su comportamiento. Se consignaron las variables clínicas y demográficas: edad, sexo, nivel educativo, nivel socioeconómico, empleo, estancia hospitalaria, tiempo de enfermedad mayor a un año, número de hospitalizaciones previas en los últimos 5 años, médico en entrenamiento identificado como su médico encargado y número de pacientes a su cargo. Resultados: La edad de los pacientes en promedio fue de 42 años, 56% fueron mujeres, 34% con educación primaria, 67% en el nivel socioeconómico E, 88% veía al interno como el médico en formación más próximo a él. El nivel de satisfacción general fue 82.8%, con niveles de satisfacción menores para las habilidades de comunicación con el paciente 73%, el ejercicio de la autonomía 31%, la consideración de la perspectiva del paciente y sus valores 21% y los aspectos psicosociales 18%. Conclusión: El nivel de satisfacción general es similar al evaluado en otros países, siendo necesario reforzar en los médicos en entrenamiento: las habilidades de la comunicación, el ejercicio de la autonomía de los pacientes, la valoración de la perspectiva del paciente y los aspectos psicosociales. (Rev Med Hered 2003;14: 175-180).
Conocimientos sobre incontinencia urinaria en pacientes hospitalizados.
Authors: GUILLEN LOPEZ Otto , LLANOS ZAVALAGA Fernando , LECCA GARCIA Leonid
Published: May 2016

Objetivo: Determinar el nivel de conocimientos sobre incontinencia urinaria (IU) en pacientes hospitalizados. Material y métodos: Estudio transversal, descriptivo; se entrevistó una muestra por saturación de 325 pacientes hospitalizados de 30 años a más del Hospital Nacional Cayetano Heredia (HNCH), Lima – Perú, utilizando un cuestionario de conocimientos sobre incontinencia, considerándose como adecuado conocimiento cuando había más de 50% de aciertos en él. Resultados: Solamente 35.7% tuvieron conocimiento adecuado sobre IU. Hasta 90% conocía acerca del éxito del tratamiento y posibilidad de curación de los pacientes incontinentes. Sin embargo, 75% consideraron erróneamente que la IU era consecuencia inevitable del envejecimiento, mientras menos de 50% de pacientes conocía el papel de ciertos medicamentos y ejercicios en la IU. Conclusiones: Se demostró un pobre conocimiento general sobre la IU, siendo necesaria una intervención de los profesionales de la salud en la educación de la población, sobre todo hospitalizada y con factores predisponentes para desarrollar IU, para así poder modificar las ideas erróneas que existen sobre el tema. (Rev Med Hered 2003; 14: 186-194).
Bacteremia por Staphylococcus epidermidis y abceso de partes blandas en un paciente postoperado: Reporte de un caso.
Authors: GARCIA APAC Coralith
Published: May 2016

We report a case of an 11 year old male who presented with bacteremia by S. epidermidis and soft tissue abscesses after a bone autograft procedure. The patient received only medical treatment, resolving the abscesses successfully. We also did a review of the literature on S. epidermidis bacteremia, an entity which has acquired increasing importance in the etiology of hospital infections. (Rev Med Hered 2003; 14:221-223)
Obtención de ácido desoxirribonucleico (ADN) útil para análisis genético, a partir de uñas recortadas.
Authors: CERVANTES GONZALES Jorge Luis,
Published: May 2016

Obtaining deoxyribonucleic acid (DNA) is the starting point for most genetic analysis. Nails are an accessible source of DNA. The present communication reports the successful extraction of genomic DNA from fresh nails, as well as from nails collected a month before the extraction. Amplification in two different regions of the human beta-globin gene was achieved by of the polymerase chain reaction. The described method, is a simple, non invasive method. Nail clipping material may be considered a convenient material for genetic analysis. (Rev Med Hered 2003; 14:230-233).
Fracturas de tibia: Tratamiento con clavo intramedular no fresado (UTN). Experiencia en el Hospital Nacional Cayetano Heredia.
Authors: RUIZ SEMBA Carlos , PRETELL MAZZINI Juan
Published: May 2016

Objetivo: Determinar la utilidad del uso del clavo sólido intramedular no fresado (UTN) en el tratamiento de las fracturas diafisiarias de tibia cerradas, expuestas y en seudoartrosis. Material y métodos: Se realizó un estudio de cohorte prospectivo y longitudinal en 12 pacientes con fractura diafisiaria de tibia tratados en el servicio de traumatología del Hospital Nacional Cayetano Heredia desde febrero 2000 hasta junio del 2001. La técnica usada para colocar el UTN fue la descrita en el Manual de Técnicas Quirúrgicas de la AO. El tiempo de seguimiento total fue de 1 año. Resultados: La consolidación con el uso de este clavo se dio en promedio a las 16 semanas, no presentándose ningún caso de no unión. A pesar de que algunos de nuestros pacientes presentaron lesiones en piel y tejidos blandos, no observamos infecciones superficiales ni profundas. Por otro lado el movimiento de la rodilla, tobillo y articulación subtalar, se inicio en el postoperatorio inmediato, logrando los pacientes hasta el momento un rango articular normal. Conclusiones: El Clavo Intramedular no fresado, es una buena alternativa en el tratamiento quirúrgico de las fracturas diafisiarias de tibia tanto cerradas y expuestas de Iº grado, así como en seudoartrosis, debido a todas las ventajas y buenos resultados obtenidos.
Estudio comparativo de los hallazgos radiográficos pre y post tratamiento en pacientes con diagnóstico clínico de sinusitis maxilar aguda.
Authors: SALAS SANCHEZ Willy Alfredo , CENTENO HUAMAN Jorge , LANDA CONTRERAS Ernesto , AMAYA CHUNGA José Manuel , BENITES GALVEZ Maria del Rosario
Published: May 2016

Objetivo: Determinar los hallazgos radiográficos pre y post tratamiento en pacientes con diagnóstico clínico de Sinusitis Maxilar Aguda. Material y métodos: Se realizó un estudio prospectivo descriptivo comparativo en pacientes que tuvieron diagnóstico clínico de sinusitis maxilar aguda. Se incluyeron 28 pacientes. Todos presentaron curación clínica luego de un tratamiento antibiótico por 10 días. La radiografía post tratamiento fue tomada entre la primera y segunda semana post-tratamiento. Resultados: La edad promedio del grupo de estudio fue: 26 años. La distribución de sexo fue 17 (60.71%) mujeres y 11 (39.29%) hombres. Los hallazgos radiográficos pre-tratamiento fueron: Opacidad Total bilateral 8 (28.6%), Opacidad parcial unilateral 8 (28.6%), Opacidad parcial bilateral 6 (21.4%), Nivel hidroaéreo 2 (7.1%) y Normal 4 (14.2%). Los hallazgos radiográficos post-tratamiento fueron: Normal 17 (60.7%), Opacidad total bilateral 3 (10.7%), Opacidad parcial unilateral 5 (17.9%), Nivel hidroaéreo 2 (7.1%) y Engrosamiento de mucosa 1 (3.5%). Conclusión: La opacidad de tipo parcial o total fue el hallazgo radiográfico más frecuente en la radiografía de senos paranasales pre-tratamiento. El nivel hidroaéreo es poco frecuente en los pacientes con diagnóstico clínico de sinusitis maxilar aguda. La radiografía de senos paranasales post-tratamiento fue normal en aproximadamente la mitad de los casos.
Ofidismo en la provincia de Chanchamayo, Junín: Revisión de 170 casos consecutivos en el Hospital de Apoyo de La Merced.
Authors: VILLANUEVA FORERO Miguel , MAGUIÑA VARGAS Ciro , CABADA SAMAME Miguel Mauricio , DE MARINI CARO Julio , ALVAREZ SACIO Héctor , GOTUZZO HERENCIA Eduardo
Published: May 2016

Objetivo: Describir las características clínico-epidemiológicas del ofidismo en la provincia de Chanchamayo, Junín, Perú. Materiales y métodos: Se revisaron todas las historias clínicas de pacientes con diagnóstico de ofidismo en el “Hospital de Apoyo de La Merced” (HALM), Junín, Perú entre enero de 1998 y diciembre del 2000. Se recogieron datos de demográficos y clínico-epidemiológicos. Resultados: Las historias clínicas revisadas fueron 195, de estas, 170 fueron incluidas en el análisis. La media edad fue 26.2 años (rango: 1-76 años). La mayoría (62.4%) era de sexo masculino. El 43.5% provenía del distrito de La Merced. Los casos de ofidismo ocurrieron con mayor frecuencia (67%) durante los meses de lluvia (de diciembre a mayo). La localización más frecuente de la mordedura fue en los miembros inferiores (67.7%). El tiempo entre el accidente y la atención médica fue en promedio de 5 hrs. 43 min. (± 5 hrs. 56 min.). El animal agresor se identificó en 37.6% de las veces, siendo el más frecuente el Bothrops atrox (36.5%). Los síntomas más comunes que acompañaron el cuadro clínico fueron dolor, edema, eritema (80%). La mayoría (78.3%) recibió suero antiofídico, de estos, 18.8% presentaron reacciones anafilactoides o urticariformes luego de la administración. La complicación más frecuente fue celulitis, presentándose mas comúnmente en pacientes que recibieron corticoides por más de 5 días (p=0.024). Ningún paciente falleció. Conclusiones: La mayoría de accidentes ofídicos en esta región ocurren en el ámbito rural. La utilización de corticoides por más de 5 días se asoció con una mayor frecuencia de celulitis. Las reacciones de hipersensibilidad hacia el suero antiofídico no son raras, siendo recomendable realizar la prueba intradérmica antes de su administración.
Epilepsia Ausencias en el Hospital Nacional Cayetano Heredia (1998-2002).
Authors: ESPINOZA QUINTEROS Iván , GUILLÉN PINTO Daniel , CAMPOS OLAZABAL Patricia , VÁSQUEZ VALENZUELA Pábel , BOTTO BONIVENTO Carlos , RIVAS LOZÁN María , CARO KAHN Inés , MERA AYALA César , BOJORQUEZ RIVERA María Teresa , LIENDO CHOCANO María Elena
Published: May 2016

Objetivo: Describir las caracteristicas clínicas y epidemiologicas de la epilepsia-ausencias en niños en el Hospital Nacional Cayetano Heredia (HNCH). Material y Métodos: Estudio descriptivo-retrospectivo. Se identificaron los pacientes con diagnóstico de ausencias del Servicio de Neuropediatría atendidos desde enero de 1998 hasta diciembre del 2002. Criterios de inclusión: manifestaciones clínicas de ausencias y Electroencefalograma característico. Exclusión: pacientes con lesiones cerebrales. Resultados: Se incluyeron 33 pacientes (6.4% del total). La edad promedio al inicio de enfermedad fue 6.6 años, sexo femenino: 54.5% y tiempo de enfermedad antes del diagnóstico: 12.5 meses. Presentaron antecedente familiar de convulsiones 30.3% y antecedente de eventos perinatales adversos 18.2%. El 39.4% de pacientes presentó ausencias simples y 60.6% ausencias complejas. El 36.4% tuvo inicialmente un patrón electroencefalográfico bilateral asimétrico que posteriormente se tornó simétrico. Todos recibieron ácido valproico pero en 6% se tuvo que cambiar de medicación debido a efectos adversos y 12% tuvieron que recibir terapia combinada por falta de control. Edad, sexo, tipo de crisis, EEG, antecedentes familiares o perinatales, no influyeron en las características clínicas, electroencefalográficas o respuesta terapéutica. Conclusión: Las ausencias representan 6.4% de todas las epilepsias. La edad promedio es de 6.6 años, los antecedentes familiares están presentes en 30.3% de los pacientes y los eventos adversos perinatales en 18.2%. Las ausencias complejas con automatismos son las más frecuentes y el ácido valproico es un tratamiento efectivo. El tiempo de enfermedad antes del diagnóstico fue 12.5 meses por lo cual se recomienda mayor difusión a nivel de padres, educadores y personal de salud para diagnóstico y control oportunos.