Electrical burns of the abdomen

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Rakesh Kumar Srivastava

2013-01-01

Full Text Available A 35-year-old male farmer came in contact with 11,000 volts high tension electric wire and sustained full thickness burn wounds over scapula, upper limb and anterior abdominal wall along with perforation of the intestine. Patient was initially managed conservatively in general surgery ward and was referred to us after 3 days with necrosis of the burned skin and muscles over the shoulder and abdomen. Patient was initially managed conservatively and then thorough debridement of the necrotic skin over the left shoulder and upper arm was done and the area was split skin grafted. Patient developed enterocutaneous fistula, which healed over a period of 8 weeks. The granulating wound over the abdomen was also skin grafted and patient was discharged after 18 days. About 4 months, after the discharge patient presented with ventral hernia. Repair of ventral hernia by synthetic mesh application and reconstruction of the abdominal wall with a free tensor fascia lata flap was done over the mesh, but the flap failed. Then after debridement two random pattern transposition skin flaps, one from the right upper and another from the left lower abdomen were transposed over the abdominal wound and donor area was skin grafted. Patient was discharged after 17 days.

Portable abdomen radiography. Moving to thickness-based protocols

International Nuclear Information System (INIS)

Sanchez, Adrian A.; Reiser, Ingrid; Baxter, Tina; Zhang, Yue; Finkle, Joshua H.; Lu, Zheng Feng; Feinstein, Kate A.

2018-01-01

Default pediatric protocols on many digital radiography systems are configured based on patient age. However, age does not adequately characterize patient size, which is the principal determinant of proper imaging technique. Use of default pediatric protocols by inexperienced technologists can result in patient overexposure, inadequate image quality, or repeated examinations. To ensure diagnostic image quality at a well-managed patient radiation exposure by transitioning to thickness-based protocols for pediatric portable abdomen radiography. We aggregated patient thickness data, milliamperes (mAs), kilovoltage peak (kVp), exposure index (EI), source-to-detector distance, and grid use for all portable abdomen radiographs performed in our pediatric hospital in a database with a combination of automated and manual data collection techniques. We then analyzed the database and used it as the basis to construct thickness-based protocols with consistent image quality across varying patient thicknesses, as determined by the EI. Retrospective analysis of pediatric portable exams performed at our adult-focused hospitals demonstrated substantial variability in EI relative to our pediatric hospital. Data collection at our pediatric hospital over 4 months accumulated roughly 800 portable abdomen exams, which we used to develop a thickness-based technique chart. Through automated retrieval of data in our systems' digital radiography exposure logs and recording of patient abdomen thickness, we successfully developed thickness-based techniques for portable abdomen radiography. (orig.)

Portable abdomen radiography. Moving to thickness-based protocols

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Sanchez, Adrian A.; Reiser, Ingrid; Baxter, Tina; Zhang, Yue; Finkle, Joshua H.; Lu, Zheng Feng; Feinstein, Kate A. [University of Chicago Medical Center, Department of Radiology, Chicago, IL (United States)

2018-02-15

Default pediatric protocols on many digital radiography systems are configured based on patient age. However, age does not adequately characterize patient size, which is the principal determinant of proper imaging technique. Use of default pediatric protocols by inexperienced technologists can result in patient overexposure, inadequate image quality, or repeated examinations. To ensure diagnostic image quality at a well-managed patient radiation exposure by transitioning to thickness-based protocols for pediatric portable abdomen radiography. We aggregated patient thickness data, milliamperes (mAs), kilovoltage peak (kVp), exposure index (EI), source-to-detector distance, and grid use for all portable abdomen radiographs performed in our pediatric hospital in a database with a combination of automated and manual data collection techniques. We then analyzed the database and used it as the basis to construct thickness-based protocols with consistent image quality across varying patient thicknesses, as determined by the EI. Retrospective analysis of pediatric portable exams performed at our adult-focused hospitals demonstrated substantial variability in EI relative to our pediatric hospital. Data collection at our pediatric hospital over 4 months accumulated roughly 800 portable abdomen exams, which we used to develop a thickness-based technique chart. Through automated retrieval of data in our systems' digital radiography exposure logs and recording of patient abdomen thickness, we successfully developed thickness-based techniques for portable abdomen radiography. (orig.)

Emergency management of acute abdomen in children.

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Balachandran, Binesh; Singhi, Sunit; Lal, Sadhna

2013-03-01

Acute abdomen can be defined as a medical emergency in which there is sudden and severe pain in abdomen with accompanying signs and symptoms that focus on an abdominal involvement. It accounts for about 8 % of all children attending the emergency department. The goal of emergency management is to identify and treat any life-threatening medical or surgical disease condition and relief from pain. In mild cases often the cause is gastritis or gastroenteritis, colic, constipation, pharyngo-tonsilitis, viral syndromes or acute febrile illnesses. The common surgical causes are malrotation and Volvulus (in early infancy), intussusception, acute appendicitis, and typhoid and ischemic enteritis with perforation. Lower lobe pneumonia, diabetic ketoacidosis and acute porphyria should be considered in patients with moderate-severe pain with little localizing findings in abdomen. The approach to management in ED should include, in order of priority, a rapid cardiopulmonary assessment to ensure hemodynamic stability, focused history and examination, surgical consult and radiologic examination to exclude life threatening surgical conditions, pain relief and specific diagnosis. In a sick patient the initial steps include rapid IV access and normal saline 20 ml/kg (in the presence of shock/hypovolemia), adequate analgesia, nothing per oral/IV fluids, Ryle's tube aspiration and surgical consultation. An ultrasound abdomen is the first investigation in almost all cases with moderate and severe pain with localizing abdominal findings. In patients with significant abdominal trauma or features of pancreatitis, a Contrast enhanced computerized tomography (CECT) abdomen will be a better initial modality. Continuous monitoring and repeated physical examinations should be done in all cases. Specific management varies according to the specific etiology.

Vacuum-assisted closure of the open abdomen in a resource-limited ...

African Journals Online (AJOL)

Vacuum-assisted closure of the open abdomen in a resource-limited setting. ... Massive delays in presentation of patients with acute abdomen are common. Closure at initial laparotomy is not possible in many cases ... with an open abdomen. The management of these patients is particularly labour intensive for nursing staff.

49 CFR 572.75 - Lumbar spine, abdomen, and pelvis assembly and test procedure.

Science.gov (United States)

2010-10-01

...) ANTHROPOMORPHIC TEST DEVICES 6-Year-Old Child § 572.75 Lumbar spine, abdomen, and pelvis assembly and test procedure. (a) Lumbar spine, abdomen, and pelvis assembly. The lumbar spine, abdomen, and pelvis consist of... 49 Transportation 7 2010-10-01 2010-10-01 false Lumbar spine, abdomen, and pelvis assembly and...

Unusual causes of acute abdomen in a Nigerian hospital ...

African Journals Online (AJOL)

Acute abdomen is the most common abdominal emergency associated with high morbidity and mortality in General surgical practice. Over a 7-year period, a study of unusual causes of acute abdomen was undertaken, with the aim of identifying these causes and outcome of operative management. Eleven cases were ...

Dengue Haemorrhagic Fever presenting as Acute Abdomen

OpenAIRE

Al-Araimi, Hanaa; Al-Jabri, Amal; Mehmoud, Arshad; Al-Abri, Seif

2011-01-01

We describe a case of a 38 year-old Sri Lankan female who was referred to the surgeon on call with a picture of acute abdomen. She presented with a three-day history of fever, headache, abdominal pain and diarrhoea; however, the physical examination was not consistent with acute abdomen. Her platelet count was 22 ×109/L. A diagnosis of dengue haemorrhagic fever (DHF) was made and dengue serology was positive. Dengue epidemics have been associated with a variety of gastrointestinal symptoms an...

Diffusion weighted imaging (DWI) in the abdomen

International Nuclear Information System (INIS)

Collaku, A.

2013-01-01

Full text: Introduction: The use of diffusion weighted images when performing abdomen MRI has been increased during the last years; achieving high quality images for a short period of time remains still a challenge. Learning points: We present a literature review together with our experience in optimizing the DW imaging in the abdomen, focused on creating high density ADC maps and handling the uncooperative patients. Discussion: The factors that influence the image quality are discussed as well. Conclusion: The factors that influence the image quality are discussed as well

Surgical Tips in Frozen Abdomen Management: Application of Coliseum Technique.

Science.gov (United States)

Kyriazanos, Ioannis D; Manatakis, Dimitrios K; Stamos, Nikolaos; Stoidis, Christos

2015-01-01

Wound dehiscence is a serious postoperative complication, with an incidence of 0.5-3% after primary closure of a laparotomy incision, and represents an acute mechanical failure of wound healing. Relatively recently the concept of "intentional open abdomen" was described and both clinical entities share common pathophysiological and clinical pathways ("postoperative open abdominal wall"). Although early reconstruction is the target, a significant proportion of patients will develop adhesions between abdominal viscera and the anterolateral abdominal wall, a condition widely recognized as "frozen abdomen," where delayed wound closure appears as the only realistic alternative. We report our experience with a patient who presented with frozen abdomen after wound dehiscence due to surgical site infection and application of the "Coliseum technique" for its definitive surgical management. This novel technique represents an innovative alternative to abdominal exploration, for cases of "malignant" frozen abdomen due to peritoneal carcinomatosis. Lifting the edges of the surgical wound upwards and suspending them under traction by threads from a retractor positioned above the abdomen facilitates approach to the peritoneal cavity, optimizes exposure of intra-abdominal organs, and prevents operative injury to the innervation and blood supply of abdominal wall musculature, a crucial step for subsequent hernia repair.

Radiological diagnostics of abdomen and thorax. Image interpretation considering anatomical landmarks and clinical symptoms; Radiologische Diagnostik Abdomen und Thorax. Bildinterpretation unter Beruecksichtigung anatomischer Landmarken und klinischer Symptome

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Krombach, Gabriele A. [Universitaetsklinikum Giessen (Germany). Klinik fuer Diagnostische und Interventionelle Radiologie; Mahnken, Andreas H. (ed.) [Universitaetsklinikum Marburg (Germany). Diagnostische und Interventionelle Radiologie

2015-07-01

The book on radiological diagnostics of abdomen and thorax - image interpretation considering anatomical landmarks and clinical symptoms - includes three chapters: (1) imaging of different parts of the body: thorax and abdomen. (II) Thorax: head and neck; mediastinum; heard and pericardium; large vessels; lungs and pleura; mamma. (III) Abdomen: liver; gall bladder and biliary tract; pancreas; gastrointestinal tract; spleen and lymphatic system; adrenal glands; kidneys and urinary tract; female pelvis; male pelvis.

Usefulness of CT in the diagnosis and management of acute abdomen

International Nuclear Information System (INIS)

Suzuki, Takuya; Matsumoto, Junichi; Funakubo, Masakatsu; Yamashita, Hirotaka; Ehara, Norishige; Minowa, Yoshiyuki; Nakajima, Yasuo

2010-01-01

We prospectively evaluated the usefulness of computed tomography (CT) in the diagnosis and management of acute abdomen. Ninety-four patients with acute abdomen were enrolled. We compared the final diagnosis and management CT diagnosis and management. Then, we evaluated how many of the CT examinations were useful and the degree to which they were useful. In more than 90% of cases, CT was very useful for the diagnosis and management of acute abdomen. (author)

Intussusceptions as acute abdomen caused by Burkitt lymphoma: a case report

OpenAIRE

Hoxha, Faton T; Hashani, Shemsedin I; Krasniqi, Avdyl S; Kurshumliu, Fisnik I; Komoni, Driton S; Hasimja, Shpresa M; Maxhuni, Mehmet

2009-01-01

Introduction Burkitt's lymphoma is a highly malignant, aggressive and rapidly growing B-cell neoplasm, which has low long-term survival rates. The abdomen is the most frequent onset site of non endemic Burkitt's lymphoma. Symptoms are often misleading and make diagnosis difficult. Ileum intussusception as acute abdomen caused by Burkitt lymphoma is rare. Case presentation We are presenting a case of a 16 year-old male with acute abdomen, which three weeks prior initially has been surgically t...

Torsion of a Wandering Spleen Presenting as Acute Abdomen

International Nuclear Information System (INIS)

Chauhan, Narvir Singh; Kumar, Satish

2016-01-01

Wandering spleen is a rare condition which if uncorrected, can result in torsion and infarction. Clinical presentation of a wandering spleen can vary from asymptomatic abdominal mass to acute abdominal pain. Radiological investigations play a pivotal role in diagnosis as the clinical diagnosis is usually impossible. We present a case of wandering spleen with torsion and complete infarction that occurred in a 32-year-old multiparous female. The diagnosis was established preoperatively on colour Doppler and CT of the abdomen with subsequent confirmation on surgery. Wandering spleen is a rare clinical condition which can present as acute abdomen. An increased awareness of this entity together with the timely use of ultrasound and CT of the abdomen can play an important role in preoperative diagnosis and surgical management

Non Obstetric Acute Abdomen in Pregnancy – An Experience from Kashmir

Directory of Open Access Journals (Sweden)

Ajaz Ahmad Rather

2013-11-01

Full Text Available Objectives: The objective of this study was to study the profile of pregnant patients who were managed by general surgical unit of a referral hospital in Kashmir valley for non obstetric causes of acute abdomen over a period of seven years. Methods: The study was done retrospectively after acquiring data from databank related to pregnant patients managed for acute abdomen over a period of seven years (from January 2006 to December 2012 in the general surgical department of the medical college of SK Institute of Medical Sciences, Srinagar, Kashmir. Results: 49 non obstetric acute abdomen were managed in pregnant females over a period of seven years. 23 (46.9% patients reported with a delay of more than 12 hours and 34 (69.4% cases underwent surgical interventions. Appendicitis was the commonest cause of acute abdomen and Ultrasonography was the only imaging modality utilized. Only 3 cases had preterm labor. Conclusions: Acute abdomen in pregnant females should be assessed with high level of suspicion .Delay in presentation and intervention leads to adverse outcomes.

A CLINICAL STUDY ON BLUNT INJURY ABDOMEN

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G. Kishore Babu

2016-10-01

Full Text Available BACKGROUND Abdominal trauma continues to account for a large number of trauma-related injuries and deaths. Motor vehicle accidents and urban violence, respectively, are the leading causes of blunt and penetrating trauma to this area of the body. Unnecessary deaths and complications can be minimized by improved resuscitation, evaluation and treatment. The new techniques and diagnostic tools available are important in the management of abdominal trauma. These improved methods, however, still depend on experience and clinical judgment for application and determination of the best care for the injured patient. The aim of the study is to 1. Analyse the incidence, clinical characteristics, diagnosis, indications for laparotomy, therapeutic methods and morbidity & mortality rates. 2. To study nature of blunt abdominal trauma. 3. To assess patient for surgical intervention and to avoid negative laparotomy. 4. To assess morbidity rate in different organs injury. 5. To evaluate modalities of treatment, complications and prognosis. MATERIALS AND METHODS This study is a prospective study on 97 patients with Blunt injuries to the abdomen admitted in S.V.R.R.G.G. Hospital, Tirupati during October 2013-15. Inclusion Criteria Patients > 13 years, with Blunt injury to abdomen either by RTA, fall, object contact, assault giving written informed consent. Exclusion Criteria Patients <13 yrs. Blunt injuries due to blasts, patients with severe cardiothoracic and head injuries who are hemodynamically unstable. CONCLUSION Blunt Trauma to abdomen is on rise due to excessive use of motor vehicles. It poses a therapeutic and diagnostic dilemma for the attending surgeon due to wide range of clinical manifestations ranging from no early physical findings to progression to shock. So, the Trauma surgeon should rely on his physical findings in association with use of modalities like x-ray abdomen, USG abdomen and abdominal paracentesis. Hollow viscus perforations are

Differential diagnosis of the acute abdomen. Pt. 2

International Nuclear Information System (INIS)

Wiesner, Walter; Kirchhoff, Timm D.; Opherk, Jan Patrick

2009-01-01

The imaging of the acute abdomen has undergone fundamental changes in the recent past. The diagnostic strategy requires an up-date since ultrasound and computed-tomography have replaced classic radiography in cases of acute lower abdominal pain as well. The present contribution is the second of four reviews on this issue and focuses on the acute lower quadrant pain while part three will depict diffuse acute abdominal pain and, finally, the diagnostic strategy of the acute abdomen in childhood will be described in part four. (orig.)

Abdominal compartment syndrome and open abdomen management with negative pressure devices.

Science.gov (United States)

Surace, Alessandra; Ferrarese, Alessia; Marola, Silvia; Cumbo, Jacopo; Valentina, Gentile; Borello, Alessandro; Solej, Mario; Martino, Valter; Nano, Mario

2015-01-01

Abdominal compartment syndrome (ACS) is defined as an increase of intra-abdominal pressure (IAH) to values higher than 20 mmHg, associated with reduced perfusion and organ dysfunction. There is a classification of open abdomen which stratifies patients according to the natural history of improvement or clinical deterioration. The aim of treatment is to maintain the open abdomen at the lowest level and to prevent progression to a more complex level. Surgical treatment essentially consists in abdominal decompression by leaving the abdomen open. Analysis of the literature shows that negative pressure increases the rate of primary fascial closure; entero-cutaneous fistulas are seen in a minority of cases, without seeming consequence of the application of the dressing. Open abdomen management consists of three treatment stages: acute (24-48 hours), intermediate (from 48 hours to 10 days) and late or reconstruction (from 10 days to the final closure). It's important to recognize patients at risk of IAH and the first signs of ACS and intervene early with abdominal decompression if this will establish itself. Management of the open abdomen is now facilitated by negative pressure devices, which positively affect the morbidity and mortality of patients with ACS.

Perforated duodenal ulcer -a rare cause of acute abdomen in pregnancy.

Science.gov (United States)

Goel, Bharti; Rani, Jyotsna; Huria, Anju; Gupta, Pratiksha; Dalal, Usha

2014-09-01

Acute abdomen during pregnancy is a medico-surgical emergency demanding concerted, synchronized specialties approach of obstetrician, surgeon and gastroenterologist. Duodenal perforation is one of the rarer causes of acute abdomen in pregnancy. Here, we report a case of duodenal perforation with peritonitis in third trimester of pregnancy requiring surgical management. Our aim of reporting this case is to stress the physicians to keep the differential of duodenal perforation also in mind while dealing with cases of acute abdomen in pregnancy and to proceed with multidisciplinary approach for better feto-maternal outcome.

Tomografia computadorizada sem contraste intravenoso no abdome agudo: quando e por que usar When and why use unenhanced computed tomography in patients with acute abdomen

Directory of Open Access Journals (Sweden)

Edison de Oliveira Freire Filho

2006-02-01

Full Text Available A tomografia computadorizada sem contraste intravenoso tem sido freqüentemente proposta na avaliação inicial de pacientes com suspeita de abdome agudo, ocupando o espaço de outros métodos diagnósticos. Os autores apresentam uma revisão bibliográfica dos principais aspectos e eficácia da tomografia computadorizada sem contraste intravenoso no diagnóstico de apendicite aguda, cólica nefrética, diverticulite, pancreatite aguda, apendicite epiplóica, pneumoperitônio e obstrução intestinal. Discutem quais as vantagens e limitações desta técnica de exame, bem como seus aspectos práticos.The use of unenhanced computed tomography has been frequently recommended for the initial assessment of patients with clinical suspicion of acute abdomen instead of other diagnostic methods. The authors present a review of the literature on the main aspects, advantages, limitations and efficacy of unenhanced computed tomography for the diagnosis of acute appendicitis, renal colic, diverticulitis, acute pancreatitis, primary epiploic appendicitis, pneumoperitoneum and small bowel obstruction. The advantages and limitations of this technique are also discussed.

MRI of the abdomen – how we do it?

International Nuclear Information System (INIS)

Zlatanov, Y.; Penkov, M.

2013-01-01

Full text: Introduction: Currently MR tomography in comparison with multidetector CT plays a subordinate role in the diagnostic and imaging algorithm in the study of abdomen organs. However, technical innovation occurring in magnetic resonance imaging, allow us to obtain images with high resolution at an acceptable duration of the study. Moreover assessment of the condition of the biliary system can be optimized through the use of MR cysto- pancreatography that allows non-invasive assessment of pancreatic biliary system, and the use of MR angiography, which visualized in the abdominal vessels. What you will learn: methods for approach to patient for abdominal examination; the advantages and disadvantages of different MR sequences in imaging of organs and structures in the abdomen; the advantages and disadvantages of different types MR cysto- pancreatography for the purpose of magnetic resonance tomography in patients with diseases in the abdomen. Discussion: MR is used for diseases of the organs in the abdomen especially for diagnosis and staging of neoplastic processes, to differentiate between tumors and inflammatory processes, and in the characterization of the cystic lesion. MRI scan has three main tasks in the assessment of the conditions of the organs in the abdomen: should provide a definitive diagnosis in patients with inconclusive data on abdominal ultrasound or CT scan for any pathological process , must allow proper staging of malignancies in order to preoperative assessment of the state of patient and sometimes non-resectability of the tumor formations due to their advancing, should characterize cystic lesions whose frequency increases in the conduct of routine or diagnostic CT studies. Conclusion: As a result of rapid technological progress current protocols for MR examinations of the abdomen are very different from those used 10 years ago. Most sequences can be performed during one or more breath-hold cycle and 3D sequences with thin consecutive

Analysis of the computed tomography in the acute abdomen

International Nuclear Information System (INIS)

Hochhegger, Bruno; Moraes, Everton; Haygert, Carlos Jesus Pereira; Antunes, Paulo Sergio Pase; Gazzoni, Fernando; Lopes, Luis Felipe Dias

2007-01-01

Introduction: This study tends to test the capacity of the computed tomography in assist in the diagnosis and the approach of the acute abdomen. Material and method: This is a longitudinal and prospective study, in which were analyzed the patients with the diagnosis of acute abdomen. There were obtained 105 cases of acute abdomen and after the application of the exclusions criteria were included 28 patients in the study. Results: Computed tomography changed the diagnostic hypothesis of the physicians in 50% of the cases (p 0.05), where 78.57% of the patients had surgical indication before computed tomography and 67.86% after computed tomography (p = 0.0546). The index of accurate diagnosis of computed tomography, when compared to the anatomopathologic examination and the final diagnosis, was observed in 82.14% of the cases (p = 0.013). When the analysis was done dividing the patients in surgical and nonsurgical group, were obtained an accuracy of 89.28% (p 0.0001). The difference of 7.2 days of hospitalization (p = 0.003) was obtained compared with the mean of the acute abdomen without use the computed tomography. Conclusion: The computed tomography is correlative with the anatomopathology and has great accuracy in the surgical indication, associated with the capacity of increase the confident index of the physicians, reduces the hospitalization time, reduces the number of surgeries and is cost-effective. (author)

Multi-detector computed tomography of acute abdomen

International Nuclear Information System (INIS)

Leschka, Sebastian; Alkadhi, Hatem; Wildermuth, Simon; Marincek, Borut; University Hospital of Zurich

2005-01-01

Acute abdominal pain is one of the most common causes for referrals to the emergency department. The sudden onset of severe abdominal pain characterising the ''acute abdomen'' requires rapid and accurate identification of a potentially life-threatening abdominal pathology to provide a timely referral to the appropriate physician. While the physical examination and laboratory investigations are often non-specific, computed tomography (CT) has evolved as the first-line imaging modality in patients with an acute abdomen. Because the new multi-detector CT (MDCT) scanner generations provide increased speed, greater volume coverage and thinner slices, the acceptance of CT for abdominal imaging has increased rapidly. The goal of this article is to discuss the role of MDCT in the diagnostic work-up of acute abdominal pain. (orig.)

Open Abdomen Therapy with Vacuum and Mesh Mediated Fascial Traction After Aortic Repair: an International Multicentre Study.

Science.gov (United States)

Acosta, Stefan; Seternes, Arne; Venermo, Maarit; Vikatmaa, Leena; Sörelius, Karl; Wanhainen, Anders; Svensson, Mats; Djavani, Khatereh; Björck, Martin

2017-12-01

Open abdomen therapy may be necessary to prevent or treat abdominal compartment syndrome (ACS). The aim of the study was to analyse the primary delayed fascial closure (PDFC) rate and complications after open abdomen therapy with vacuum and mesh mediated fascial traction (VACM) after aortic repair and to compare outcomes between those treated with open abdomen after primary versus secondary operation. This was a retrospective cohort, multicentre study in Sweden, Finland, and Norway, including consecutive patients treated with open abdomen and VACM after aortic repair at six vascular centres in 2006-2015. The primary endpoint was PDFC rate. Among 191 patients, 155 were men. The median age was 71 years (IQR 66-76). Ruptured abdominal aortic aneurysm (RAAA) occurred in 69.1%. Endovascular/hybrid and open repairs were performed in 49 and 142 patients, respectively. The indications for open abdomen were inability to close the abdomen (62%) at primary operation and ACS (80%) at secondary operation. Duration of open abdomen was 11 days (IQR 7-16) in 157 patients alive at open abdomen termination. The PDFC rate was 91.8%. Open abdomen initiated at primary (N=103), compared with secondary operation (N=88), was associated with less severe initial open abdomen status (p=.006), less intestinal ischaemia (p=.002), shorter duration of open abdomen (p=.007), and less renal replacement therapy (RRT, popen abdomen initiated at primary versus secondary operation. VACM was associated with a high PDFC rate after prolonged open abdomen therapy following aortic repair. Patient outcomes seemed better when open abdomen was initiated at primary, compared with secondary operation but a selection effect is possible. Copyright © 2017 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

A role of abdomen in butterfly's flapping flight

Science.gov (United States)

Jayakumar, Jeeva; Senda, Kei; Yokoyama, Naoto

2017-11-01

Butterfly's forward flight with periodic flapping motion is longitudinally unstable, and control of the thoracic pitching angle is essential to stabilize the flight. This study aims to comprehend roles which the abdominal motion play in the pitching stability of butterfly's flapping flight by using a two-dimensional model. The control of the thoracic pitching angle by the abdominal motion is an underactuated problem because of the limit on the abdominal angle. The control input of the thorax-abdomen joint torque is obtained by the hierarchical sliding mode control in this study. Numerical simulations reveal that the control by the abdominal motion provides short-term pitching stabilization in the butterfly's flight. Moreover, the control input due to a large thorax-abdomen joint torque can counteract a quite large perturbation, and can return the pitching attitude to the periodic trajectory with a short recovery time. These observations are consistent with biologists' view that living butterflies use their abdomens as rudders. On the other hand, the abdominal control mostly fails in long-term pitching stabilization, because it cannot directly alter the aerodynamic forces. The control for the long-term pitching stabilization will also be discussed.

CT arteriography of the upper abdomen

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Hasuo, K; Matsuura, K; Baba, H; Numaguchi, Y; Komaki, S [Kyushu Univ., Fukuoka (Japan). Faculty of Medicine

1980-04-01

The technique of CT arteriography was introduced, and CT images of the upper abdomen were explained. Very clear enhancement of parenchyma and vessels (especially portal vein) of the object organs could be obtained by CT arteriography of the upper abdomen, anatomical structures of organs were identified more easily by CT arteriography than by conventional CT, and the amount of information obtained was increased by using CT arteriography. However, the indication of CT arteriography must be limited, because of its complexity that CT arteriography is performed after angiography and involves the invasion of patients' bodies. As described in many reports, CT arteriography is useful for malignant tumors of the liver, and it is worthwhile, especially when surgery for hepatocellular carcinoma is considered. CT arteriography for organs except the liver has not been discussed sufficiently. Therefore, an application of this method for other organs must be decided after consideration of the balance of the amount of information obtained by CT arteriography with invasion to patients.

Acute Abdomen in Pediatric Patients Admitted to the Pediatric Emergency Department

Directory of Open Access Journals (Sweden)

Yu-Ching Tseng

2008-08-01

Conclusion: The etiology of acute abdomen varied depending on the age of the patient. Acute appendicitis was the most common cause of acute abdomen in children older than 1 year of age, followed by traumatic injury. Abdominal CT scanning was a useful diagnostic imaging modality in patients with both traumatic and non-traumatic abdominal pain.

Parenteral nutrition including polyamine under experimental irradiation of the abdomen

International Nuclear Information System (INIS)

Moroz, B.B.; Fedorovskij, L.L.; Lyashchenko, Yu.N.

1982-01-01

White rats-males were used in experiments. Irradiation dose of abdomen area is 13.5 Gy (1400 R). Parenteral nutrition using aminoacid preparation of polyamine affects favourably during radiation damage resulted from local irradiation of abdomen area. This was manifested in weakening of gastroenteric syndrom, reduction of 3.5 day death of animals and increase of their 30 day survival rate, intensification of recovery processes in small intestine, decrease of cell devastation in bone marrow

Acute abdomen in pregnancy requiring surgical management: a 20-case series.

Science.gov (United States)

Unal, Aysun; Sayharman, Sema Etiz; Ozel, Leyla; Unal, Ethem; Aka, Nurettin; Titiz, Izzet; Kose, Gultekin

2011-11-01

The obstetrician often has a difficult task in diagnosing and managing the acute abdomen in pregnancy. A reluctance to operate during pregnancy adds unnecessary delay, which may increase morbidity for both mother and fetus. In this study, we present our experience in pregnant patients with acute abdomen. Pregnant patients with acute abdomen requiring surgical exploration were enrolled from 2007 to 2010. Demographics, gestational age, symptoms, fetal loss, preterm delivery, imaging studies, operative results, postoperative complications and histopathologic evaluations were recorded. Ultrasound (US) and magnetic resonance (MR) imaging studies were evaluated. Data analyses were performed with Microsoft Excel and statistical evaluations were done by using Student's t-test. There were 20 patients with a mean age of 32 years. The rate of emergency surgery was seen to be significantly higher in the second trimester (pacute abdomen (30% and 15%, respectively). All patients tolerated surgery well, and postoperative complications included wound infection, 10%, preterm labor, 5%, and prolonged paralytic ileus, 5%. One patient died from advanced gastric carcinoma and the only fetal death was seen in this case. Prompt diagnosis and appropriate therapy are crucial in pregnant with acute abdomen. The use of US may be limited and CT is not desirable due to fetal irradiation. MR has thus become increasingly popular in the evaluation of such patients. Adhesive small bowel obstruction should be kept in mind as an important etiology. Copyright © 2011. Published by Elsevier Ireland Ltd.

The role of open abdomen in non-trauma patient: WSES Consensus Paper

NARCIS (Netherlands)

Coccolini, Federico; Montori, Giulia; Ceresoli, Marco; Catena, Fausto; Moore, Ernest E.; Ivatury, Rao; Biffl, Walter; Peitzman, Andrew; Coimbra, Raul; Rizoli, Sandro; Kluger, Yoram; Abu-Zidan, Fikri M.; Sartelli, Massimo; de Moya, Marc; Velmahos, George; Fraga, Gustavo Pereira; Pereira, Bruno M.; Leppaniemi, Ari; Boermeester, Marja A.; Kirkpatrick, Andrew W.; Maier, Ron; Bala, Miklosh; Sakakushev, Boris; Khokha, Vladimir; Malbrain, Manu; Agnoletti, Vanni; Martin-Loeches, Ignacio; Sugrue, Michael; Di Saverio, Salomone; Griffiths, Ewen; Soreide, Kjetil; Mazuski, John E.; May, Addison K.; Montravers, Philippe; Melotti, Rita Maria; Pisano, Michele; Salvetti, Francesco; Marchesi, Gianmariano; Valetti, Tino M.; Scalea, Thomas; Chiara, Osvaldo; Kashuk, Jeffry L.; Ansaloni, Luca

2017-01-01

The open abdomen (OA) is defined as intentional decision to leave the fascial edges of the abdomen un-approximated after laparotomy (laparostomy). The abdominal contents are potentially exposed and therefore must be protected with a temporary coverage, which is referred to as temporal abdominal

Automatic national network of radiation environmental monitoring in Mexico; Red nacional automatica de monitoreo radiologico ambiental en Mexico

Energy Technology Data Exchange (ETDEWEB)

Aguirre, Jaime; Delgado, Jose L.; Lopez, Manuel; Zertuche, Jorge V., E-mail: jaguirre@cnsns.gob.mx, E-mail: jldelgado@cnsns.gob.mx, E-mail: mlopez@cnsns.gob.mx, E-mail: jorge.zertuche@cnsns.gob.mx [Comision Nacional de Seguridad Nuclear y Salvaguardias (CNSNS), D.F. (Mexico). Direccion de Vigilancia Radiologica

2013-07-01

The Direccion de Vigilancia Radiologica (DVR) of the Comision Nacional de Seguridad Nuclear y Salvaguardias (CNSNS) de Mexico, performs several function for environmental radiation monitoring. One of these functions is the permanent monitoring of the environmental gamma radiation. For this, it implemented the Red Nacional Automatica de Monitoreo Radiologico Ambiental (RENAMORA) - the National Automated Network for Environmental Radiation Monitoring,which currently comprises 60 detector probes for gamma radiation which with a programmable system that includes information technologies, data transmission and software can send the information in real time to a primary center of data located in the facilities of CNSNS. - When the data are received, the system performs the verification and extraction of the information organized in Tables and charts, and generates a report of environmental gamma radiation dose rate average for each of the probes and for each period of time determined bu CNSNS. The RENAMORA covers the main cities and allows to establish the bases of almost the entire country, as well as to warn about abnormal situations caused by incidents or natural events generated by human activities inside or outside the country which involves radioactive materials; paying special attention to main radiological sites, such as the surroundings of the Laguna Verde Nuclear Power Plants, research centers and the radioactive waste disposal sites.

Damage control surgery and open abdomen in trauma patients with exsanguinating bleeding.

Science.gov (United States)

Mutafchiĭski, V; Popivanov, G

2014-01-01

Acute coagulopathy with exsanguinating bleeding occurs in 2-5% of all trauma cases carrying mortality rate near 100% after conventional management. In the last few decades, the development of damage control surgery (DCS) in combination with the technique of open abdomen led to significantly improved survival among these patients. A descriptive study based on a retrospective analysis of 12 consecutive blast victims with exsanguinating bleeding underwent DCS and open abdomen management. All patients were soldiers injured during their deployment in Iraq and Afghanistan during 2002-2007, treated by our deployed surgical teams. Vacuum Assisted Closure (V.A.C., KCI) and vacuum pack (VP) was used for a temporary closure of abdomen. A cumulative analysis of all relevant series used these methods during the period 2000-2013 was performed. DCS was applied in 12 of 114 consecutive blast victims (10.5%) with survival rate 66.7% (8/12). Eleven had open abdomen with temporary closure with V.A.C. in 6 and VP in 5. Four patients died before the definitive closure (36.4%). The survivors (n = 8) were with a mean age 28.5 years, suffered from a critical trauma with a mean Injury Severity Score 35.5. V.A.C was used in 4 of them, VP in 3. Primary closure of abdomen was achieved in 6 (85.7%) within 3.5 days and mean 1.3 dressing changes. Due to ACS, the abdomen was closed through skin suture only and a creation of planned ventral hernia in 1 patient treated with VP (1/7, 14.3%). Wound infection was observed in 1 case (14.3%). Despite the small sample size, our series clearly demonstrate the benefits of DCS and open abdomen in trauma patients with exsangiunating bleeding. The survival rate is highly dependent on the rapid implementation of DCS in properly selected patients. V.A.C. and VP provide a high rate of primary fascial closure in trauma.

Intestinal obstruction by eosinophilic jejunitis Aspectos quirúrgicos de la enteritis eosinofílica

Directory of Open Access Journals (Sweden)

J. M. Álamo Martínez

2004-04-01

Full Text Available Eosinophilic enteritis is an uncommon disease that rarely devel-ops as a surgical emergency. Although it may be associated with infestation by Ancylostoma caninum, its etiology is unknown and often related to a personal or family history of atopy. A transmural involvement may cause intestinal obstruction -more frequently in the jejunum- or even acute abdomen, which may or may not be accompanied by intestinal perforation. The latter two conditions tend to be more commonly associated with ileum disease, causing pain in the lower right quadrant of the abdomen. Patient history, eosinophil count -which may be paradoxically reduced when the disease appears in this way-, ultrasonography, and/or CT lead to the suspicion of this condition before a surgical procedure is considered. A definitive diagnosis, however, must be reached by means of an anatomopathological study. Macroscopically, intestinal loops exhibit a thickened appearance with an elastic consistency. Laparoscopic intestinal biopsy may play a major role in the diagnosis of disease.La enteritis eosinofílica es una enfermedad poco frecuente que debuta de forma extraordinaria como urgencia quirúrgica. Su etiopatogenia, aunque pudiera estar asociada a la infestación por Ancylostoma caninum, se desconoce, y en muchas ocasiones se relaciona con antecedentes personales o familiares de atopia. La afectación transmural puede ocasionar síndrome obstructivo intestinal, más frecuente a nivel yeyunal, o incluso un abdomen agudo acompañado o no de perforación entérica. Estas dos últimas entidades suelen estar asociadas más usualmente con el asentamiento de la enfermedad en íleon, provocando dolor en la fosa iliaca derecha. Los antecedentes del enfermo, el recuento de eosinófilos en sangre, que paradójicamente puede estar disminuido cuando la enfermedad debuta de esta forma, la ecografía y/o la TAC, pueden hacernos sospechar de esta patología antes de plantearse la intervención quir

Noncommunicating isolated enteric duplication cyst in the abdomen ...

African Journals Online (AJOL)

... Surgery 2013, 9:124–126. Keywords: abdomen, children, duplication, isolated, noncommunicating. Department of Pediatric Surgery, Seoul National University College of Medicine, .... M Abdominal pain, anorexia, fever. Ileum. Respiratory.

Infected Congenital Epicardial Cyst Presenting as Acute Abdomen.

Science.gov (United States)

Dribin, Timothy; Files, Matthew D; Rudzinski, Erin R; Kaplan, Ron; Stone, Kimberly P

2016-12-01

A previously healthy 3-year-old boy presented to the emergency department with abdominal pain, fever, and emesis. Laboratory and radiologic evaluation for causes of acute abdomen were negative; however, review of the abdominal x-ray demonstrated cardiomegaly with the subsequent diagnosis of pericardial cyst by echocardiogram and computed tomography. The patient underwent surgical decompression and attempted removal of the cystic structure revealing that the cyst originated from the epicardium. His abdominal pain and fever resolved postoperatively and he completed a 3-week course of ceftriaxone for treatment of Propionibacterium acnes infected congenital epicardial cyst. Emergency department physicians must maintain a broad differential in patients with symptoms of acute abdomen to prevent complications from serious cardiac or pulmonary diseases that present with symptoms of referred abdominal pain.

Role of ultrasonography in the evaluation of children with acute abdomen in the emergency set-up

Directory of Open Access Journals (Sweden)

Aviral

2005-01-01

Full Text Available Background: Acute abdomen in children has been aptly described as Pandora′s box. Unlike computerized tomography (CT scan, ultrasonography (USG has no radiation hazard and the present study analyses the diagnostic yield of the USG in acute abdomen in children. Materials and Methods: Between September 2001 to October 2003, 75 patients with acute abdomen underwent clinical examination, routine biochemical tests, erect X-ray abdomen, USG and CT scan. Laparotomy and histological examination established final diagnosis. Results: The accuracy of correct diagnosis was 60%, 66.6%, 64%, 98.7% with clinical examination alone, USG alone, clinical examination combined with conventional radiography, and clinical evaluation combined with conventional radiography and USG respectively. USG helped to prevent unnecessary laparotomy in 16.3% of patients. Conclusions: USG is good investigative modality in the management of acute abdomen in children.

Acute abdomen. Diagnostic radiology according to principal signs

International Nuclear Information System (INIS)

Krestin, G.P.

1994-01-01

The acute abdomen is a frequent and very often dangerous syndrome which requires sophisticated diagnostic evaluation. A decisive factor determining the following case history is efficient and exact diagnosis, calling for experienced clinical and diagnostic experts for efficient application of available methods, and correct interpretation of findings. The book offers: 1. Practice-oriented diagnostic strategies, based on 13 principal signs and constellations derived from clinical experience, presented in each chapter as a combination of - suitable differential diagnostic procedures and methods,- exhaustive description of the clinical signs and diagnostic findings specific of the various symptoms,- algorithmic presentations. 2. A special chapter on the pediatric acute abdomen. 3. The most important findings shown in more than 250 original pictures. 4. A graphical design and presentation of the information which permits quick access to the important content. (orig./CB) [de

Update on the management of non-obstetric acute abdomen in pregnant patients.

Science.gov (United States)

Barber-Millet, Sebastián; Bueno Lledó, José; Granero Castro, Pablo; Gómez Gavara, Immaculada; Ballester Pla, Neus; García Domínguez, Rafael

2016-05-01

Acute abdomen is a rare entity in the pregnant patient, with an incidence of one in 500-635 patients. Its appearance requires a quick response and an early diagnosis to treat the underlying disease and prevent maternal and fetal morbidity. Imaging tests are essential, due to clinical and laboratory masking in this subgroup. Appendicitis and complicated biliary pathology are the most frequent causes of non-obstetric acute abdomen in the pregnant patient. The decision to operate, the timing, and the surgical approach are essential for a correct management of this pathology. The aim of this paper is to perform a review and update on the diagnosis and treatment of non-obstetric acute abdomen in pregnancy. Copyright © 2015 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Sci-Fri AM: MRI and Diagnostic Imaging - 02: Quality Improvement: Diagnostic Reference Levels for Interior Health CT exams – L-Spine, Chest/Abdomen/pelvis, Abdomen/Pelvis, Head

Energy Technology Data Exchange (ETDEWEB)

Bjarnason, Thorarin [Diagnostic Imaging / Interior Health, Mathematics, Statistics, Physics & Computer Science / UBCO (Canada); Radiology / UBC (Canada)

2016-08-15

Diagnostic Reference Levels are used to optimize patient dose and image quality in the clinical setting. It is assumed that the majority of exams are of diagnostic quality, or the radiologists would request protocol adjustments. By investigating the dose indicator distributions from all scanners, the upper DRL can be set to the 75th percentile of the distribution and a lower DRL can be set to the 10th percentile. Scanners using doses consistently outside the upper/lower DRL range can be adjusted accordingly. 11 CT scanners, all contributing to the American College of Radiology Dose Index Registry (ACR DIR) were used in this study. Dose indicator data were compiled from the ACR DIR data and local DRLs established. Scanners with median doses outside the upper/lower DRL were followed-up with. Using effective dose and exam volumes, collective dose was determined before and after protocol adjustments to evaluate the effect of this quality improvement effort. The quality initiative is complete for L-spine and Chest/Abdomen/Pelvis exams and only initial surveys were completed for Head and Abdomen/Pelvis examsg. Median Scanner Dose reductions were 8.8 and 4.9 % for L-spine and Chest/Abdomen/Pelvis exams, respectively, resulting with collective dose reductions of 0.7 and 3.2 person•Sv/yr. Follow-up is ongoing for Abdomen/Pelvis and Head exams.

Sci-Fri AM: MRI and Diagnostic Imaging - 02: Quality Improvement: Diagnostic Reference Levels for Interior Health CT exams – L-Spine, Chest/Abdomen/pelvis, Abdomen/Pelvis, Head

International Nuclear Information System (INIS)

Bjarnason, Thorarin

2016-01-01

Diagnostic Reference Levels are used to optimize patient dose and image quality in the clinical setting. It is assumed that the majority of exams are of diagnostic quality, or the radiologists would request protocol adjustments. By investigating the dose indicator distributions from all scanners, the upper DRL can be set to the 75th percentile of the distribution and a lower DRL can be set to the 10th percentile. Scanners using doses consistently outside the upper/lower DRL range can be adjusted accordingly. 11 CT scanners, all contributing to the American College of Radiology Dose Index Registry (ACR DIR) were used in this study. Dose indicator data were compiled from the ACR DIR data and local DRLs established. Scanners with median doses outside the upper/lower DRL were followed-up with. Using effective dose and exam volumes, collective dose was determined before and after protocol adjustments to evaluate the effect of this quality improvement effort. The quality initiative is complete for L-spine and Chest/Abdomen/Pelvis exams and only initial surveys were completed for Head and Abdomen/Pelvis examsg. Median Scanner Dose reductions were 8.8 and 4.9 % for L-spine and Chest/Abdomen/Pelvis exams, respectively, resulting with collective dose reductions of 0.7 and 3.2 person•Sv/yr. Follow-up is ongoing for Abdomen/Pelvis and Head exams.

MRI of the fetal abdomen

International Nuclear Information System (INIS)

Hoermann, M.; Brugger, P.C.; Witzani, L.; Prayer, D.

2006-01-01

Magnetic resonance imaging (MRI) is an important diagnostic component for central nervous system and thoracic diseases during fetal development. Although ultrasound remains the method of choice for observing the fetus during pregnancy, fetal MRI is being increasingly used as an additional technique for the accurate diagnosis of abdominal diseases. Recent publications confirm the value of MRI in the diagnosis of fetal gastrointestinal tract and urogenital system diseases. The following report provides an overview of MRI-examination techniques for the most frequent diseases of the abdomen. (orig.) [de

Doses in pediatric patients undergoing chest and abdomen CT examinations. Preliminary results

International Nuclear Information System (INIS)

Jornada, Tiago S.; Silva, Teogenes A. da

2011-01-01

Computed tomography (CT) is a non-invasive method of image production that imparts significant doses to a patient, it is expected that pediatric CT examinations will increase the risk of induced cancer in children. In this study the effective doses in a five year-old child submitted to chest or abdomen CT scans were assessed for comparison purposes. The CTEXPO computed program was used with data from routine protocols of a 0 to 13 year-old children in two public hospitals in Belo Horizonte. Hospital A used a Siemens Dual-Slice unit with 80 kV, 41 mA and pitch 2 for chest or abdomen; hospital B used a Multislice GE unit with 120 kV, 45 mA and pitch 1 for chest and 120 kV, 55 mA. and pitch 1 for abdomen. Results of effective doses in a five year-old child were 1.7 and 1.0 mSv in hospital A and 9.1 and 7.2 mSv in hospital B, for chest and abdomen, respectively. Results were compared to the reference effective doses of 7.2 and 5.0 mSv for chest and abdomen respectively that were derived from the air kerma length product values given in ICRP publication 87. Results of hospital A showed that low dose exposures also can be achieved in CT scans of children. Results showed that even a hospital with a modern facility (hospital B) can provided doses higher than reference values if protocols are not adjusted for children. Preliminary results suggested that there is a room for optimizing children exposure submitted to CT scans. (author)

Spontaneous Spleen Rupture in a Teenager: An Uncommon Cause of Acute Abdomen

Directory of Open Access Journals (Sweden)

Verroiotou Maria

2013-01-01

Full Text Available Spontaneous spleen rupture is a rare complication of infectious diseases and it can become a potentially life-threatening condition if not diagnosed in time. A 17-year-old Greek female presented to the ER due to acute abdominal pain, mainly of the left upper quadrant. She had no recent report of trauma. The patient was pale, her blood pressure was 90/70 mmHg, and her pulse was 120 b/min. Clinical examination of the abdomen revealed muscle contraction and resistance. The patient was submitted to an ultrasound of the upper abdomen and to a CT scanning of the abdomen that revealed an extended intraperitoneal hemorrhage due to spleen rupture. Due to the patient’s hemodynamic instability, she was taken to the operation room and splenectomy was performed. Following a series of laboratory examinations, the patient was diagnosed to be positive for current cytomegalovirus infection. The postoperative course was uneventful, and in a two year follow-up the patient is symptom-free. Spontaneous spleen rupture due to Cytomegalovirus infection is a rare clinical entity, described in few case reports in the world literature and should always be taken into consideration in differential diagnosis of acute abdomen, especially in adolescents with no recent report of trauma.

A Study of Physicochemical Properties of Subcutaneous Fat of the Abdomen and its Implication in Abdominal Obesity.

Science.gov (United States)

Pandey, Arvind Kumar; Kumar, Pramod; Kodavoor, Srinivas Aithal; Kotian, Sushma Rama; Yathdaka, Sudhakar Narahari; Nayak, Dayanand; Souza, Anne D; Souza, Antony Sylvan D

2016-05-01

The lower abdominal obesity is more resistant to absorption as compared to that of upper abdomen. Differences in the physicochemical properties of the subcutaneous fat of the upper and lower abdomen may be responsible for this variation. There is paucity of the scientific literature on the physicochemical properties of the subcutaneous fat of abdomen. The present study was undertaken to create a database of physicochemical properties of abdominal subcutaneous fat. The samples of subcutaneous fat from upper and lower abdomen were collected from 40 fresh autopsied bodies (males 33, females 7). The samples were prepared for physicochemical analysis using organic and inorganic solvents. Various physicochemical properties of the fat samples analysed were surface tension, viscosity, specific gravity, specific conductivity, iodine value and thermal properties. Data was analysed by paired and independent sample t-tests. There was a statistically significant difference in all the physicochemical parameters between males and females except surface tension (organic) and surface tension (inorganic) of upper abdominal fat, and surface tension (organic) of lower abdominal fat. In males, viscosity of upper abdominal fat was more compared to that of lower abdomen (both organic and inorganic) unlike the specific conductivity that was higher for the lower abdominal fat as compared to that of the upper abdomen. In females there were statistically significant higher values of surface tension (inorganic) and specific gravity (organic) of the upper abdomen fat as compared to that of lower abdomen. The initial and final weight loss of the lower abdominal fat as indicated by Thermo Gravimetric Analysis was significantly more in males than in female. The difference in the physicochemical properties of subcutaneous fat between upper and lower abdomen and between males and females could be responsible for the variant behaviour of subcutaneous abdominal fat towards resorption.

[Anesthesiological management of patients with an acute abdomen].

Science.gov (United States)

Sakka, Samir G; Wappler, Frank

2008-11-01

Patients with an acute abdomen present with marked deterioration in physiological and pathophysiological conditions, which make general anesthesia to a challenging but also potentially dangerous procedure. A broad and fundamental knowledge of the pathophysiologically involved mechanisms of cardiovascular functions during anesthesia and appropriate anesthesiological approach are crucial for a successful peri-operative management. The anesthesiologist's goal is to perform adequate anesthesia while maintaining cardiovascular stability. Monitoring and management of acid-base-status as well as cardiovascular functions are required to maintain sufficient tissue oxygenation during anesthesia. The postoperative anesthesiological management may also crucially influence the further course and therefore should be considered in the anesthesiological planning. Finally, adequate pain management in all these patients is an important and not to underestimate part in the treatment. This article gives an overview on the major aspects in the different fields in the anesthesiological management of patients with an acute abdomen.

FAST ultrasound in abdomen closed trauma: literature review

International Nuclear Information System (INIS)

Perez Chacon, Cristian Alonso

2010-01-01

The management of polytraumatized patients has been important to know the scope and limitations of ultrasonography resources. A literature review was performed on FAST ultrasound in closed trauma in the abdomen. FAST (focused assessment with sonography for trauma) has been a study performed on the patient who has suffered both abdominal and thoracic trauma to determine the presence or absence of free fluid in these body cavities. The use is directed to locate intraabdominal drugs that may lead to bleeding and endanger the patient's life. Different techniques existent are recommended to use the original FAST as has been the extended FAST. In the United States the three diagnostic techniques generally have been: diagnostic peritoneal lavage, computed tomography (CT) of the abdomen and ultrasonography for the evaluation of patients with trauma abdominal; each of them have had their own advantages and disadvantages to study [es

Diagnostics of vascular diseases as a cause for acute abdomen; Diagnostik vaskulaerer Erkrankungen als Ursache fuer das akute Abdomen

Energy Technology Data Exchange (ETDEWEB)

Juchems, M.S. [Universitaetsklinikum Ulm, Klinik fuer Diagnostische und Interventionelle Radiologie, Ulm (Germany); Aschoff, A.J. [Klinikum Kempten-Oberallgaeu, Abteilung fuer Radiologie, Kempten (Germany)

2010-03-15

Vascular pathologies are rare causes of an acute abdomen. If the cause is a vascular disease a rapid diagnosis is desired as vascular pathologies are associated with high mortality. A differentiation must be made between arterial and venous diseases. An occlusion of the superior mesenteric artery is the most common reason for acute mesenteric ischemia but intra-abdominal arterial bleeding is also of great importance. Venous pathologies include thrombotic occlusion of the portal vein, the mesenteric vein and the vena cava. Multi-detector computed tomography (MDCT) is predestined for the diagnostics of vascular diseases of the abdomen. Using multiphasic contrast protocols enables reliable imaging of the arterial and venous vessel tree and detection of disorders with high sensitivity and specificity. Although conventional angiography has been almost completely replaced by MDCT as a diagnostic tool, it is still of high importance for minimally invasive interventions, for example in the management of gastrointestinal bleeding. (orig.) [German] Vaskulaere Pathologien sind seltene Ursachen fuer den klinischen Zustand eines akuten Abdomens. Liegt eine vaskulaere Erkrankung vor, ist jedoch aufgrund der hohen Mortalitaet eine zuegige Diagnostik von grosser Wichtigkeit. Bei den Erkrankungen der abdominellen Gefaesse sind arterielle von venoesen Ursachen zu unterscheiden. Ein Verschluss der A. mesenterica superior ist die haeufigste Ursache fuer die akute Mesenterialischaemie, daneben sind Blutungen in den abdominellen Gefaessprovinzen des arteriellen Gefaessbaums von Bedeutung. Venoese Pathologien betreffen thrombotische Verschluesse der Pfortader, der V. mesenterica und der V. cava. Die Multidetektor-CT (MDCT) ist zur Diagnostik vaskulaerer Erkrankungen des Abdominalraums praedestiniert. Mit mehrphasigen Untersuchungsprotokollen gelingt es, den arteriellen und venoesen Gefaessbaum zuverlaessig darzustellen und Erkrankungen mit hoher Sensitivitaet und Spezifitaet zu

Improving abdomen tumor low-dose CT images using a fast dictionary learning based processing

International Nuclear Information System (INIS)

Chen Yang; Shi Luyao; Shu Huazhong; Luo Limin; Coatrieux, Jean-Louis; Yin Xindao; Toumoulin, Christine

2013-01-01

In abdomen computed tomography (CT), repeated radiation exposures are often inevitable for cancer patients who receive surgery or radiotherapy guided by CT images. Low-dose scans should thus be considered in order to avoid the harm of accumulative x-ray radiation. This work is aimed at improving abdomen tumor CT images from low-dose scans by using a fast dictionary learning (DL) based processing. Stemming from sparse representation theory, the proposed patch-based DL approach allows effective suppression of both mottled noise and streak artifacts. The experiments carried out on clinical data show that the proposed method brings encouraging improvements in abdomen low-dose CT images with tumors. (paper)

Varicella Zoster Infection: A Rare Cause of Abdominal Pain Mimicking Acute Abdomen

OpenAIRE

Olmez, Deniz; Boz, Alper; Erkan, Nazif

2009-01-01

Varicella zoster is an acute viral infection that results from reactivation of a latent varicella zoster virus. It usually occurs in adult population and immune compromised patients. It rarely occurs in healthy children. Here we present a 14 years old male with varicella zoster that had abdominal pain mimicking acute abdomen to alert others who are consulted for the differentiation of acute abdomen and others who may be consulted for pain management. Keywords Varicella zoster; Abdominal pain

Obstructive acute abdomen: reviewing important points; Abdome agudo obstrutivo: revisando pontos fundamentais

Energy Technology Data Exchange (ETDEWEB)

Francisco, Marina Celli; Abud, Thiago Giansante; Reibscheid, Samuel; Szejnfeld, Jacob; Lederman, Henrique Manoel [Universidade Federal de Sao Paulo (UNIFESP-EPM), Sao Paulo, SP (Brazil). Dept. de Diagnostico por Imagem]. E-mail: nana_celli@hotmail.com; Neves, Felipe Trentin [Hospital Ipiranga, Sao Paulo, SP (Brazil); Colleone Neto, Ramiro [Universidade Federal de Sao Paulo (UNIFESP-EPM), Sao Paulo, SP (Brazil)

2008-07-01

The obstructive acute abdomen is a common presentation, for which safe and effective management depends on a fast and accurate diagnosis. Conventional radiograph remains the first choice among the imaging exams because of its availability, low cost and the possibility to be done serially to follow the patient's clinical progression. The ultrasonography does not require ionizing radiation. It is a dynamic and in realtime exam. Computed tomography is used increasingly due to the provision of essential diagnostic information not apparent from radiographs, such as the confirmation of the obstruction, degree and place of the occlusion, presence of ischemia as well as the causes of the obstruction. Magnetic resonance imaging has presented great technological advances and it may play a role in the future of obstructive acute abdomen diagnosis. The objective of this pictorial essay is to review the different imaging techniques used on diagnosing obstructive acute abdomen. (author)

Normal sonographic anatomy of the abdomen of coatis (Nasua nasua Linnaeus 1766).

Science.gov (United States)

Ribeiro, Rejane G; Costa, Ana Paula A; Bragato, Nathália; Fonseca, Angela M; Duque, Juan C M; Prado, Tales D; Silva, Andrea C R; Borges, Naida C

2013-06-23

The use of ultrasound in veterinary medicine is widespread as a diagnostic supplement in the clinical routine of small animals, but there are few reports in wild animals. The objective of this study was to describe the anatomy, topography and abdominal sonographic features of coatis. The urinary bladder wall measured 0.11 ± 0.03 cm. The symmetrical kidneys were in the left and right cranial quadrant of the abdomen and the cortical, medullary and renal pelvis regions were recognized and in all sections. The medullary rim sign was visualized in the left kidney of two coatis. The liver had homogeneous texture and was in the cranial abdomen under the rib cage. The gallbladder, rounded and filled with anechoic content was visualized in all coatis, to the right of the midline. The spleen was identified in the left cranial abdomen following the greater curvature of the stomach. The parenchyma was homogeneous and hyperechogenic compared to the liver and kidney cortex. The stomach was in the cranial abdomen, limited cranially by the liver and caudo-laterally by the spleen. The left adrenal glands of five coatis were seen in the cranial pole of the left kidney showing hypoechogenic parenchyma without distinction of cortex and medulla. The pancreas was visualized in only two coatis. The left ovary (0.92 cm x 0.56 cm) was visualized on a single coati in the caudal pole of the kidney. The uterus, right adrenal, right ovary and intestines were not visualized. Ultrasound examination of the abdomen of coatis may be accomplished by following the recommendations for dogs and cats. It is possible to evaluate the anatomical and topographical relationships of the abdominal organs together with the knowledge of the peculiarities of parenchymal echogenicity and echotexture of the viscera.

Development of a finite element model of the human abdomen.

Science.gov (United States)

Lee, J B; Yang, K H

2001-11-01

Currently, three-dimensional finite element models of the human body have been developed for frequently injured anatomical regions such as the brain, chest, extremities and pelvis. While a few models of the human body include the abdomen, these models have tended to oversimplify the complexity of the abdominal region. As the first step in understanding abdominal injuries via numerical methods, a 3D finite element model of a 50(th) percentile male human abdomen (WSUHAM) has been developed and validated against experimental data obtained from two sets of side impact tests and a series of frontal impact tests. The model includes a detailed representation of the liver, spleen, kidneys, spine, skin and major blood vessels. Hollow organs, such as the esophagus, stomach, small and large intestines, gallbladder, bile ducts, ureters, rectum and adrenal glands are grouped into three bodybags in order to provide realistic inertial properties and to maintain the position of the solid organs in their appropriate locations. Using direct connections, the model was joined superiorly to a partial model of the human thorax, and inferiorly to models of the human pelvis and the lower extremities that have been previously developed. Material properties for various tissues of the abdomen were derived from the literature. Data obtained in a series of cadaveric pendulum impact tests conducted at Wayne State University (WSU), a series of lateral drop tests conducted at Association Peugeot-Renault (APR) and a series of cadaveric lower abdomen frontal impact tests conducted at WSU were used to validate the model. Results predicted by the model match these experimental data for various impact speeds, impactor masses and drop heights. Further study is still needed in order to fully validate WSUHAM before it can be used to assess various impact loading conditions associated with vehicular crashes.

Pharmacokinetics of a new subcutaneous diclofenac formulation administered to three body sites: quadriceps, gluteus, and abdomen.

Science.gov (United States)

Salomone, Salvatore; Piazza, Cateno; Vitale, Daniela Cristina; Cardì, Francesco; Gugliotta, Barbara; Drago, Filippo

2014-02-01

To assess the relative bioavailability of a new subcutaneous (SC) diclofenac hydroxypropyl b-cyclodextrin (HPbCD) formulation administered to three body sites: quadriceps, gluteus, and abdomen. This was a pilot, single-dose, randomized, three-way crossover relative bioavailability study. A total of 12 healthy subjects received a single SC injection of diclofenac HPbCD 50 mg/1 mL in the quadriceps, gluteus, or abdomen. The AUC was comparable after SC diclofenac HPbCD in the quadriceps, gluteus, and abdomen. The Cmax was comparable after SC administration in the quadriceps or abdomen, and ~ 17% higher in the gluteus. The absorption was rapid (30 minutes) after administration of the treatment at any site. The treatment was well tolerated. The relative bioavailability of SC diclofenac HPbCD was comparable when administered to the quadriceps, gluteus, and abdomen. The new diclofenac formulation can therefore be administered subcutaneously to any of these sites without clinically significant differences. A further adequately powered study would be necessary to reveal any differences among injection sites in terms of peak plasma concentration.

Síndrome de abdomen en ciruela pasa y dextrocardia, asociación infrecuente

Directory of Open Access Journals (Sweden)

Hermann Silva

2015-01-01

Full Text Available Se describe un neonato con Síndrome de abdomen en ciruela pasa, de sexo masculino, nacido de 36 semanas de gestación y pesó 3 650 g al nacer. El examen clínico mostró un neonato con un abdomen globuloso, con redundancia de la piel que huelga a los costados rebosantes, la palpación del abdomen no descubre la tonalidad muscular. No se palpa visceromegalia y hay presencia normal de ruidos hidroaéreos. El examen físico del tórax y cardiovascular fueron aparentemente normales. Normocéfalo y facies no peculiar. La radiografía de tórax muestra dextrocardía. La ecografía renal mostró dilatación pielocalicial. Revela además criptorquidia bilateral.

Surgically treated acute abdomen at Gondar University Hospital ...

African Journals Online (AJOL)

Conclusion: This study has shown what the commonest symptoms of acute abdomen are and that the outcome of emergency laparotomy may be affected by different factors. Some of these factors were duration of illness, age, presence of peritonitis, Haematocrit level and complication detection time. Since the management ...

Aspectos que interfieren en la movilidad estudiantil

Directory of Open Access Journals (Sweden)

María Mercedes Ramírez-Ordoñez

2014-12-01

Full Text Available Objetivo: Identificar los aspectos que interfieren en la realización de movilidad estudiantil. Materiales y Métodos: Esta investigación es cuantitativa de tipo descriptivo transversal por conveniencia, constituida por 243 estudiantes que hacen parte de un programa de enfermería en una institución de educación superior X, de los cuales se entrevistaron a 237. Para la recolección de la información se diseñó un cuestionario donde se evalúa el aspecto económico, académico y familiar y su interferencia con el programa de movilidad de la institución. Para su estructuración se realizó revisión bibliográfica, evaluación de expertos, alfa de cronbach y prueba piloto. Resultados: El aspecto económico ocupa el primer lugar en interferir en la movilidad estudiantil con un 73%, es importante resaltar que la población encuestada pertenece al estrato 2 por lo tanto cuentan con pocos recursos. El segundo lugar fue para el aspecto académico con un 63.45% y en menor dimensión el aspecto familiar con 26%; el 77% manifiesta tener un interés por participar del programa de movilidad, de los cuales el 43.78% prefiere el nivel internacional, el 29,79 % nacional y ambas opciones el 25,95%. Conclusiones: Al relacionar los aspectos económicos, académicos y familiares con el total de la población se encontró que solo el 12% de los estudiantes cumplen la totalidad de estos requisitos y pueden participar de la movilidad estudiantil.

Critical Structure for Telescopic Movement of Honey bee (Insecta: Apidae) Abdomen: Folded Intersegmental Membrane.

Science.gov (United States)

Zhao, Jieliang; Yan, Shaoze; Wu, Jianing

2016-01-01

The folded intersegmental membrane is a structure that interconnects two adjacent abdominal segments; this structure is distributed in the segments of the honey bee abdomen. The morphology of the folded intersegmental membrane has already been documented. However, the ultrastructure of the intersegmental membrane and its assistive role in the telescopic movements of the honey bee abdomen are poorly understood. To explore the morphology and ultrastructure of the folded intersegmental membrane in the honey bee abdomen, frozen sections were analyzed under a scanning electron microscope. The intersegmental membrane between two adjacent terga has a Z-S configuration that greatly influences the daily physical activities of the honey bee abdomen. The dorsal intersegmental membrane is 2 times thicker than the ventral one, leading to asymmetric abdominal motion. Honey bee abdominal movements were recorded using a high-speed camera and through phase-contrast computed tomography. These movements conformed to the structural features of the folded intersegmental membrane. © The Authors 2016. Published by Oxford University Press on behalf of Entomological Society of America.

Roentogenologic diagnosis of an acute abdomen in children

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Oka, Makio; Chiba, Nobuyuki; Miyagi, Tetsuo (Kanagawa Children' s Medical Center, Yokohama (Japan))

1983-05-01

An acute abdomen is one of the main topics among emergency practice for children. We have experienced about 300 acute abdomen cases per year at our Children's Hospital since 1970. Radiological technologists provide a 24-hour emergency service using special knowledge and techniques in our radiological investigation. In the noenatal period esophageal atresia should be diagnosed by plain up-right film with a coiled-up rubber tube, and a contrast examination is contraindicated to prevent severe aspiration pneumonia. In the cases with intestinal atresia, the contrast examination is not necessary again, because the findings of plain film such as the distribution of air-filled intestinal loops, dilated bowel with air-fluid level gives us enough information for the diagnosis of these congenital anomalies. On the contrary, barium enema is useful and harmless for the neonatal age group. It is practical for diagnosing Hirschsprung's disease, midgut malrotation with volvulus, ileal and colonic atresia and necrotizing enterocolitis. An imperforate anus should be classified into the high and low type in the neonatal period to define the treatment. Invertogram is an only way for the differentiation of a baby without external fistula, and we have established the technique for this. The level is diagnosed by the relationship between the gas-filled rectal pouch and ischiac bone. In the infant group intussusception is the most common and urgent acute abdomen. We use a special device to fix the bady, dilute the barium with warm saline (to avoid water intoxication), limit the water pressure to within one meter, and avoid abdominal manipulation and longtime exposure. The successful reduction rate that our team has obtained is almost 85%.

Roentogenologic diagnosis of an acute abdomen in children

International Nuclear Information System (INIS)

Oka, Makio; Chiba, Nobuyuki; Miyagi, Tetsuo

1983-01-01

An acute abdomen is one of the main topics among emergency practice for children. We have experiencing about 300 acute abdomen cases per year at our Children's Hospital since 1970. We radiological technologists provide a 24-hour emergency service using special knowledge and techniques in our radiological investigation. In the noenatal period esophageal atresia should be diagnosed by plain up-right film with a coiled-up rubber tube, and a contrast examination is contraindicated to prevent severe aspiration pneumonia. In the cases with intestinal atresia, the contrast examination is not necessary again, because the findings of plain film such as the distribution of air-filled intestinal loops, dilated bowel with air-fluid level gives us enough information for the diagnosis of these congenital anomalies. On the contrary, barium enema is useful and harmless for the neonatal age group. It is practical for diagnosing Hirschsprung's disease, midgut malrotation with volvulus, ileal and colonic atresia and necrotizing enterocolitis. An imperforate anus should be classified into the high and low type in the neonatal period to define the treatment. Invertogram is an only way for the differentiation of a baby without external fistula, and we have established the technique for this. The level is diagnosed by the relationship between the gas-filled rectal pouch and ischiac bone. In the infant group intussusception is the most common and urgent acute abdomen. We use a special device to fix the bady, dilute the barium with warm saline (to avoid water intoxication), limit the water pressure to within one meter, and avoid abdominal manipulation and longtime exposure. The successful reduction rate that our team has obtained is almost 85 %. (author)

Detection of Hyperechoic Inflammatory Fatty Tissue during Transabdominal Ultrasonography: Diagnostic Role in Acute Abdomen

International Nuclear Information System (INIS)

Park, Seong Jin; Lee, Hae Kyung; Yi, Bum Ha; Kim, Hyun Cheol

2005-01-01

To assess the incidence and diagnostic role of hyperechoic inflammatory fatty tissue (HIFT) in transabdominal ultrasonography (TAUS) for acute abdomen. With TAUS, we examined 98 consecutive patients (68 women, 30 men: mean age, 32 years: age range, 4-84 years) having acute abdominal pain. We examined the abdomen and pelvis by TAUS to determine the cause of acute abdomen, to check for the presence of HIFT, and to investigate whether it was easier and earlier to find the main cause and HIFT presence. We also prospectively evaluated the shape, distribution, and diagnostic role of HIFT. Final diagnoses consisted of 47 cases of acute appendicitis, 14 of enterocolitis, 13 of PID, 7 of gynecological hemoperitoneum, 5 of colonic diverticulitis, 3 of ovarian torsion, 2 of colon perforation, 2 of only presence of non-specific HIFT, 1 of mesenteric lymphadenitis, and 4 of normal. HIFT were seen in 67 patients (68.4%), including 44/47(93.6%) of acute appendicitis, 2/14(14.3%) of enterocolitis, 11/13(84.6%) of PID, 0/7 of hemoperitoneum, 5/5 of colonic diverticulitis, 0/3 of ovarian torsion, 2/2 of colon perforation, and 1/1 mesenteric lymphadenitis. HIFT were detected earlier than the main cause in 17/44 of acute appendicitis, 6/11 of PID, and 4/5 of colonic diverticulitis. In acute appendicitis, the shape of HIFT appeared as fat thickening along the mesoappendix in 12/44, fat thickening along the mesoappendix and the opposite side in 13/44, fat encircled appendix in 6/44, fatty mass wrapping abscess in 10/44, and diffuse intraperitoneal fat thickening in 3/44. In PID, HIFT appeared as a single fatty mass in the pelvis and lower abdomen in 6/11, wrapping pelvic abscess in 2/11, and multiple fatty masses scattered in abdomen and pelvis in 3/11. In colonic diverticulitis, all 5 cases appeared as hyperechoic hemispheric mass covering the inflamed diverticulum. HIFT are a usual US finding in patients with acute abdomen, particularly on abdominal and pelvic inflammatory conditions

Frequency, pattern and management of acute abdomen in dengue fever in Karachi, Pakistan.

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Shamim, Muhammad

2010-07-01

This study aimed to determine the frequency, pattern and management of acute abdomen in patients with dengue fever. This descriptive case series is a prospective analysis of acute abdomen in dengue fever that was performed at three secondary care hospitals in Karachi, Pakistan from June 1, 2005 to December 31, 2008. The inclusion criterion was all patients with confirmed diagnosis of dengue fever. Patients with incomplete laboratory, ultrasound or histopathology data were excluded. Among 357 patients with dengue fever, 43 (12.04%) had acute abdomen. There were 15 men and 28 women, with a median age of 29 years. These included 26 cases of acute cholecystitis, 7 cases of acute appendicitis, 7 cases of nonspecific peritonitis, and 3 cases of acute pancreatitis. Dengue hemorrhagic fever/shock syndrome was found in acute pancreatitis, and two of these patients died. Emergency surgery was required in eight patients (5 appendectomy and 3 open cholecystectomy). Substantial transfusion of blood and its components was required in eight patients who underwent emergency surgery. Early diagnosis and prompt conservative management of dengue acute abdomen is necessary to avoid mortality and emergency surgery-related morbidity. However, if needed, surgery can be performed with acceptable morbidity. Copyright © 2010 Asian Surgical Association. Published by Elsevier B.V. All rights reserved.

Treatment of the complex abdomen and acute intestinal failure

NARCIS (Netherlands)

de Vries, F.E.E.

2018-01-01

Management of the complex abdomen and acute intestinal failure (IF) is challenging and requires specialized multidisciplinary treatment. Due to the small numbers and heterogeneity of the patient group high-quality evidence for some of the research questions is probably unachievable. Nevertheless,

Burst abdomen in pregnancy: A proposed management algorithm ...

African Journals Online (AJOL)

Management of the burst abdomen is complex due to the co-morbidities associated with it. When coupled with intraabdominal sepsis and pregnancy, it becomes even more difficult due to the ethical issues that have to be considered when managing both mother and child. Due to the paucity of literature on this subject, ...

Frequency, Pattern and Management of Acute Abdomen in Dengue Fever in Karachi, Pakistan

OpenAIRE

Muhammad Shamim

2010-01-01

This study aimed to determine the frequency, pattern and management of acute abdomen in patients with dengue fever. Methods: This descriptive case series is a prospective analysis of acute abdomen in dengue fever that was performed at three secondary care hospitals in Karachi, Pakistan from June 1, 2005 to December 31, 2008. The inclusion criterion was all patients with confirmed diagnosis of dengue fever. Patients with incomplete laboratory, ultrasound or histopathology data were excluded...

Gossypiboma of the Abdomen and Pelvis; A Recurring Error

African Journals Online (AJOL)

Moi Hospital, Voi, Kenya. Correspondence to: Dr. Gilbert Maranya, P.O Box 91066-80103 Mombasa, Kenya. Email: gilbertmaranya@gmail.com. CASE SERIES. Abstract. Introduction: Gossypiboma is a retained surgical sponge commonly in the abdomen and pelvis. Risk factors include emergency and prolonged surgery.

Synthesis of a posterior indicator protein in normal embryos and double abdomens of Smittia sp. (Chironomidae, Diptera).

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Jäckle, H; Kalthoff, K

1980-01-01

In embryos of the chironomid midge Smittia, synthesis of a posterior indicator protein designated PI1 (Mr approximately 50,000; pI approximately 5.5) forecasts development of an abdomen as opposed to head and thorax. The protein is synthesized several hours before germ anlage formation. In normal embryos at early blastoderm stages, synthesis of PI1 is restricted to posterior embryonic fragments but not to pole cells. In "double-abdomen" embryos, a mirror-image duplication of the abdomen is formed by cells that would otherwise develop into head and thorax. Embryos were programmed for double-abdomen development by UV irradiation of the anterior pole, and half of them were reprogrammed for normal development by subsequent exposure to visible light (photoreversal). Correspondingly, PI1 was synthesized in anterior fragments of UV-irradiated embryos but not after photoreversal. In a control experiment, UV irradiation of the posterior pole caused neither double-abdomen formation nor PI1 synthesis in anterior fragments. The identity of PI1 formed in anterior fragments of prospective double abdomens with the protein found in posterior fragments was revealed by two-dimensional gel electrophoresis and limited proteolysis. Suppression of PI1 synthesis in anterior fragments of normal embryos is ascribed to the activity of cytoplasmic ribonucleoprotein particles thought to act as anterior determinants. Images PMID:6935679

Nutritional management of a patient with an open abdomen

African Journals Online (AJOL)

2014-08-14

Aug 14, 2014 ... Keywords: nutritional, management, open abdomen. Introduction ... lower than required energy intake (25 kCal/kg), and increasing it to target over the ..... Trauma and surgery lead to an intense inflammatory response and possible ... state, characterised by muscle breakdown, acute protein malnutrition ...

Acute abdomen: An unusual presentation of disseminated Penicillium marneffei infection

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George I

2008-01-01

Full Text Available Varied clinical presentations of Penicillium marneffei , an opportunistic pathogen in HIV disease has been rarely described in literature. We report a patient with advanced AIDS who presented to us with prolonged fever and had features of an acute abdomen. On radiologic imaging he had features of intestinal obstruction and mesenteric lymphadenitis. A diagnosis was made possible by endoscopic biopsies of the small bowel and bone marrow culture which grew P . Marneffei . He was treated with intravenous amphotericin for 2 weeks followed by oral itraconazole. This case is reported for its rarity and unusual presentation and to sensitise clinicians and microbiologists to consider this as an aetiology in patients with advanced HIV/AIDS who present with acute abdomen, more so in patients from a distinct geographic region - South-East Asia

Acute abdomen: an unusual presentation of disseminated Penicillium marneffei infection.

Science.gov (United States)

George, I A; Sudarsanam, T D; Pulimood, A B; Mathews, M S

2008-01-01

Varied clinical presentations of Penicillium marneffei, an opportunistic pathogen in HIV disease has been rarely described in literature. We report a patient with advanced AIDS who presented to us with prolonged fever and had features of an acute abdomen. On radiologic imaging he had features of intestinal obstruction and mesenteric lymphadenitis. A diagnosis was made possible by endoscopic biopsies of the small bowel and bone marrow culture which grew P. Marneffei. He was treated with intravenous amphotericin for 2 weeks followed by oral itraconazole. This case is reported for its rarity and unusual presentation and to sensitise clinicians and microbiologists to consider this as an aetiology in patients with advanced HIV/AIDS who present with acute abdomen, more so in patients from a distinct geographic region--South-East Asia.

Gross anatomy of superficial fascia and future localised fat deposit areas of the abdomen in foetus

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Pramod Kumar

2013-01-01

Full Text Available Background: The development and popularity of body contouring procedures such as liposuction and abdominoplasty has renewed interest in the anatomy of the superficial fascia and subcutaneous fat deposits of the abdomen. The study of anatomy of fascia and fetal adipose tissue was proposed as it may be of value in understanding the possible programing of prevention of obesity. Objectives: The present study was undertaken to understand the gross anatomy of superficial fascia of abdomen and to study the gross anatomy of future localized fat deposits (LFDs area of abdomen in fetus. Materials and Methods: Four fetus (two male & two female of four month of intrauterine life were dissected. Attachments & layers of superficial fascia and future subcutaneous fat deposit area of upper and lower abdomen were noted. Results: Superficial fascia of the abdomen was multi layered in mid line and number of layers reduced laterally as in adult. The future abdominal LFD (localized fat deposits area in fetus shows brownish-white blubbary tissue without well-defined adult fat lobules. Conclusion: The attachment and gross anatomy of superficial fascia of the fetus was similar to that in adults. The future LFD areas showed brownish white blubbary tissue with ill-defined fat lobules.

The role of US examination in the management of acute abdomen.

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Mazzei, Maria Antonietta; Guerrini, Susanna; Cioffi Squitieri, Nevada; Cagini, Lucio; Macarini, Luca; Coppolino, Francesco; Giganti, Melchiore; Volterrani, Luca

2013-07-15

Acute abdomen is a medical emergency, in which there is sudden and severe pain in abdomen of recent onset with accompanying signs and symptoms that focus on an abdominal involvement. It can represent a wide spectrum of conditions, ranging from a benign and self-limiting disease to a surgical emergency. Nevertheless, only one quarter of patients who have previously been classified with an acute abdomen actually receive surgical treatment, so the clinical dilemma is if the patients need surgical treatment or not and, furthermore, in which cases the surgical option needs to be urgently adopted. Due to this reason a thorough and logical approach to the diagnosis of abdominal pain is necessary. Some Authors assert that the location of pain is a useful starting point and will guide a further evaluation. However some causes are more frequent in the paediatric population (like appendicitis or adenomesenteritis) or are strictly related to the gender (i.e. gynaechologic causes). It is also important to consider special populations such as the elderly or oncologic patients, who may present with atypical symptoms of a disease. These considerations also reflect a different diagnostic approach. Today, surely the integrated imaging, and in particular the use of multidetector Computed Tomography (MDCT) has revolutionised the clinical approach to this condition, simplyfing the diagnosis but burdening the radiologists with the problems related to the clinical management. However although CT emerging as a modality of choice for evaluation of the acute abdomen, ultrasonography (US) remains the primary imaging technique in the majority of cases, especially in young and female patients, when the limitation of the radiation exposure should be mandatory, limiting the use of CT in cases of nondiagnostic US and in all cases where there is a discrepancy between the clinical symptoms and negative imaging at US.

Elephantiasis nostras verrucosa on the legs and abdomen with morbid obesity in an Indian lady.

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Sarma, Podila S; Ghorpade, Ashok

2008-12-15

Elephantiasis nostras verrucosa (ENV) of the legs and abdomen in a morbidly obese woman with multiple medical problems is reported. The diagnosis was suggested by the classical clinical features and confirmed by histopathology. The patient succumbed due to her multisystem diseases. Elephantiasis nostras verrucosa involving the abdomen is uncommon and has been reported only five times in the past.

Causes and Clinical Outcomes in Neonates with Acute Abdomen ...

African Journals Online (AJOL)

Causes and Clinical Outcomes in Neonates with Acute Abdomen Requiring Surgery at ... Neonatal surgery is challenging, particularly in the emergency setting whereby ... Other causes included peritonitis (6.9%) and abdominal wall defects (4.7%). ... accounting for 13 cases (30.2%) and mortality was 34.9 % ( 15 neonates).

Well differentiated papillary mesothelioma of abdomen- a rare case with diagnostic dilemma.

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Saha, Aniruddha; Mandal, Palash Kumar; Manna, Anupam; Khan, Kalyan; Pal, Subrata

2018-01-01

Well-differentiated papillary mesothelioma is a rare tumor occurring predominantly in the peritoneum of young women, a few with history of asbestos exposure. A 28-year-old woman presented with ascites and pain abdomen. Ultrasonography and computed tomography scan of the abdomen revealed a mass in the retroperitoneum measuring 15 cm × 12 cm. Histopathological examination along with immunohistochemistry (IHC) confirmed it to be a papillary mesothelioma in the peritoneum. It is difficult to differentiate from more common malignant mesothelioma and papillary adenocarcinoma, which also have poorer prognosis. The difficulty can be resolved by clinico-radiological correlation along with histopathological examination and IHC.

Acute Abdomen in Diabetic Patients – Analysis of Complications and Mortality

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Dejeu Dănuț

2014-12-01

Full Text Available Background and Aims. We aimed to analyze the complications and mortality of acute abdomen cases in diabetic patients compared to non-diabetic patients. Materials and Method. This observational, retrospective, cohort study was conducted between 2008 - 2011, on a total of 4021 cases with acute abdomen admitted to the Surgical Ward I of the Clinical County Emergency Hospital Oradea. Of these, 488 were diabetic patients and 3533 non-diabetics. Results. Women represented the majority in both groups (62.24% respectively 58.40%. Entero-mesenteric infarction and acute pancreatitis were more common in diabetic patients compared to non-diabetics. Peritonitis was more frequent in non-diabetics, with statistically significant difference (p = 0.0003. In diabetic patients the postoperative morbidity was 36.27%, significantly higher than in non-diabetic patients (14.43%. The mortality was significantly higher in diabetic patients than in nondiabetics (9.84% vs. 5.38%. Average length of stay in Surgical Ward I is 3.8 days. For non-diabetic patients, mean hospitalization for acute abdomen was 5.1 days, and for diabetics 7.8 days. Conclusions. This study showed important differences between diabetics and non-diabetic patients in the clinical evolution, complications, mortality and length of hospitalization.

Role of inflammatory markers as predictors of laparotomy in patients presenting with acute abdomen.

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Dias, Brendan H; Rozario, Anthony P; Olakkengil, Santosh A

2015-10-01

There is a need for an ideal indicator of surgery in patients presenting with acute abdomen. Several markers have been analysed, but the search still continues as none have proven effective. This study aimed to analyse and compare the predictive value of plasma procalcitonin (PCT) strip test in patients presenting with acute abdomen and identify a useful cut-off value to differentiate patients that would benefit with surgery from those that require conservative management. A prospective study was conducted in the department of general surgery from June 2012 to June 2013. Plasma PCT was estimated by the semi-quantitative strip test. The levels of plasma PCT and other routinely used markers of inflammation were analysed and compared. Of the total of 58 patients, 44 patients (76%) were men with a mean age of 45 years. Forty patients required emergency surgical intervention. A plasma PCT value of >0.5 ng/mL at admission was 80% sensitive and 100% specific for predicting need for antibiotics in patients with acute abdomen that were managed conservatively. The mean plasma PCT value in the patients undergoing surgery (5.0-10.0 ng/mL) was significantly more than in those managed conservatively (0.5-2.0 ng/mL). Using receiver operating characteristic (ROC) curves a cut-off for plasma PCT of >5.0 ng/mL was 75% sensitive and 100% specific for considering surgical intervention in patients presenting with acute abdomen. Plasma PCT (value >5 ng/mL) could be used as an adjunct to clinical examination to predict requirement of surgery in patients presenting with acute abdomen. © 2015 Royal Australasian College of Surgeons.

Acute abdomen and ascites as presenting features of autosomal dominant polycystic kidney disease.

Science.gov (United States)

Chaudhary, Sanjay; Qian, Qi

2012-12-27

We describe a patient with sudden onset of abdominal pain and ascites, leading to the diagnosis of autosomal dominant polycystic kidney disease (ADPKD). Her presentation was consistent with acute liver cyst rupture as the cause of her acute illness. A review of literature on polycystic liver disease in patients with ADPKD and current management strategies are presented. This case alerts physicians that ADPKD could occasionally present as an acute abdomen; cyst rupture related to ADPKD may be considered in the differential diagnoses of acute abdomen.

Chilaiditi's syndrome as an acute abdomen | Jambo | Port Harcourt ...

African Journals Online (AJOL)

The interposed loop of bowel reduced spontaneously following conservative management. Conclusion: As Chilaiditi syndrome is a rare disease entity, a high index of suspicion is required to make an accurate diagnosis. It should be considered as one of the differential diagnoses of an acute abdomen. Keywords: Acute ...

Impalement Injury to the Abdomen: Report of a Case

African Journals Online (AJOL)

2017-10-26

Oct 26, 2017 ... is even more demanding in environments where health-care personnel, facilities for emergency care, and communications infrastructure are absent or poorly funded and equipped. The primary objective of ... palm tree and got impaled through his lower abdomen on a sharp, freshly cut branch of a tree.

Osteossarcoma parosteal: aspectos na radiologia convencional

OpenAIRE

Nanci Neto,Francisco; Marchiori,Edson; Vianna,Alberto Domingues; Aymoré,Ierecê Lins; Almeida,Ana Luiza Brito de; Irion,Klaus L.; Collares,Felipe Birchal

2007-01-01

OBJETIVO: Avaliar os achados clínicos mais importantes do osteossarcoma parosteal e descrever os seus aspectos mais comuns na radiologia convencional. MATERIAIS E MÉTODOS: Estudo retrospectivo com 26 pacientes com osteossarcoma parosteal, provenientes do arquivo do Clube do Osso, Rio de Janeiro, RJ, e análise dos principais achados clínicos e aspectos radiológicos. RESULTADOS: A doença predominou em pacientes do sexo feminino e teve idade média de acometimento na terceira década de vida. Os a...

Underdiagnosis of Vertebral Collapse on Routine Multidetector Computed Tomography Scan of the Abdomen

International Nuclear Information System (INIS)

Obaid, H.; Husamaldin, Z.; Bhatt, R.

2008-01-01

Background: Vertebral fractures are commonly associated with osteoporosis and have significant morbidity and mortality rates. Osteoporotic vertebral fractures are presently considered as a treatable and preventable condition, and early detection is vital for further management. The evaluation of vertebral compression on multidetector computed tomography (MDCT) scans of the abdomen has, to our knowledge, not been reported before. Purpose: To assess the prevalence of vertebral collapse on routine abdominal CT scans, and to evaluate the usefulness of the multiplanar reconstruction (MPR) capability of MDCT scans in accurately identifying vertebral abnormalities such as vertebral collapse, spondylolisthesis, and retrolisthesis. Material and Methods: A retrospective review of 307 MDCT scans of the abdomen was carried out at a university teaching hospital. Identifiable patient information was anonymized for data protection. All images were reviewed on a picture archiving and communications system (PACS) using sagittal MPR and bone window for the assessment of the vertebrae. Data were collected from the Computerized Radiology Information System (CRIS). Results: Vertebral collapse was seen in 42 (13.6%) of the 307 patients undergoing routine MDCT of the abdomen. Multilevel and single-level collapses were seen in 24 and 18 patients, respectively. Spondylolisthesis was identified in 5.5% (n=17), and retrolisthesis was seen in 0.6% (n=2). All patients with vertebral fracture were older than 50 years. Women were more commonly affected than men. Conclusion: A significant number of patients with vertebral collapse were diagnosed using MPR on MDCT routine scans of the abdomen

Acute abdomen. Clinical background and demands on imaging; Akutes Abdomen. Klinische Begriffsbestimmung und Anforderungen an die Bildgebung

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Graeb, C.; Jauch, K.W. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Klinik und Poliklinik fuer Chirurgie, Muenchen (Germany); Reiser, M.; Graser, A. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany)

2010-03-15

The term ''acute abdomen'' does not describe a specific disease entity but is more a critical clinical state which incorporates very heterogeneous clinical presentations. The prognosis of any disease depends on the time frame from the onset of symptoms to the initiation of a specific therapy. For this reason there are special expectations by clinicians regarding the diagnostic assessment provided by radiology which is expected to deliver an immediate diagnosis supporting further therapeutic decisions. Along with the patient's clinical history, physical examination and blood tests, radiological diagnostics are essential for enabling a specific treatment. From a surgical point of view the radiologist is expected to help in differentiating between cases with indications for emergency surgery and cases eligible for elective surgery or conservative treatment. (orig.) [German] Der Begriff ''akutes Abdomen'' stellt keine eigenstaendige Erkrankung dar, sondern beschreibt einen kritischen klinischen Zustand, unter dessen Oberbegriff sich die unterschiedlichsten Krankheitsbilder subsumieren lassen. Das Zeitintervall zwischen dem Auftreten der ersten Symptome bis zur Einleitung einer gezielten Therapie ist fuer die Prognose der Patienten der entscheidende Faktor. Aus diesem Grund bestehen besondere Anforderungen an die bildgebende Diagnostik, die dazu beitragen soll, innerhalb kuerzester Zeit eine moeglichst genaue Diagnose zu stellen. Neben Anamnese, klinischer Untersuchung und Labordiagnostik stellt die radiologische Untersuchung einen wesentlichen Baustein vor der Therapieeinleitung dar. Aus chirurgischer Sicht muessen Krankheitsbilder, die eine sofortige Notfalloperation erforderlich machen, von Erkrankungen differenziert werden, die eine elektive Chirurgie oder ein konservatives Vorgehen indizieren. (orig.)

Management of the open abdomen: clinical recommendations for the trauma/acute care surgeon and general surgeon.

Science.gov (United States)

Fernández, Luis G

2016-09-01

Traditionally, the surgical approach to managing abdominal injuries was to assess the extent of trauma, repair any damage and close the abdomen in one definitive procedure rather than leave the abdomen open. With advances in medicine, damage control surgery using temporary abdominal closure methods is being used to manage the open abdomen (OA) when closure is not possible. Although OA management is often observed in traumatic injuries, the extension of damage control surgery concepts, in conjunction with OA, for the management of the septic patient requires that the general surgeon who is faced with these challenges has a comprehensive knowledge of this complex subject. The purpose of this article is to provide guidance to the acute care and general surgeon on the use of OA negative pressure therapy (OA-NPT; ABTHERA™ Open Abdomen Negative Pressure Therapy System, KCI, an ACELITY Company, San Antonio, TX) for OA management. A literature review of published evidence, clinical recommendations on managing the OA and a case study demonstrating OA management using OA-NPT have been included. © 2016 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

A RETROSPECTIVE STUDY ON BLUNT INJURY ABDOMEN

OpenAIRE

Kopperundevi; Jagadeesan; Kiruthiga

2016-01-01

Blunt injury abdomen is the leading cause of morbidity and mortality in all age groups. Blunt trauma differs from penetrating trauma as different organs are characteristically injured by compression from blunt straining. A total of 53 cases of blunt trauma were studied in this study for the period of 1 year. In this study, commonest cause for blunt abdominal trauma was road traffic accident. The maximum incidence was noted in 20-40 middle age group of which 90% male patients were ...

Guillain-Barre Syndrome Presenting as Acute Abdomen

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Faruk incecik

2015-09-01

Full Text Available Guillain-Barr and eacute; syndrome (GBS is the most common cause of acute flaccid paralysis in childhood. Symmetric weakness, headache, respiratory symptom, neuropathic pain, muscle pain, paresthesia, and facial palsy were the most common clinical presentations. We report 13-year-old boy with GBS who presented with acute abdominal pain. This is the first report, to our knowledge, first presented of acute abdomen of a pediatric patient with GBS. [Cukurova Med J 2015; 40(3.000: 601-603

Damage control surgery by keeping the abdomen open during pregnancy: favorable outcome, a case report

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Marty François

2009-09-01

Full Text Available Abstract Background Acute abdomen in advanced pregnancy is one of the most challenging surgical situations. In life-threatening situations, despite optimal management, foetus distress and preterm delivery may occur. Although laparostomy is a useful treatment of abdominal sepsis, its successful management has not been reported previously in pregnant women. Case 30-year-old woman at 23 week of pregnancy was investigated for non-specific abdominal pain. Surgical exploration revealed extensive ischemic bowel necrosis. Multiple segmental resections were performed and abdomen was left open with vacuum assisted dressing, maintained for 48 hours. At the third surgical look the continuity was restored and abdominal wall closed. The foetal condition stayed unperturbed under pharmacologic tocolysis. Pregnancy was carried to full term delivery. Conclusion Open abdomen strategy can be successfully applied in pregnant woman.

Acute abdomen due to primary omental torsion: case report.

Science.gov (United States)

Tsironis, Apostolos; Zikos, Nikolaos; Bali, Christina; Pappas-Gogos, George; Koulas, Spiridon; Katsamakis, Nikolaos

2013-01-01

Primary torsion of the greater omentum is an uncommon cause of acute abdominal pain that mainly affects adults in their fourth or fifth decade. It was first described by Eitel in 1899. Since then, more than 300 cases have been reported in the published literature. Clinical presentation and imaging findings are often of limited value in the diagnosis of primary omental torsion (POT). The patients usually undergo laparotomy for "acute appendicitis" or acute abdomen of poorly defined origin. To provide a detailed description of this rare cause of acute abdomen. We report a case of POT in a woman of reproductive age and discuss contemporary methods in diagnosis and management of the condition. Nowadays, laparoscopy is a safe and effective approach for the diagnosis and management of POT, with the advantages of reduced postoperative pain and hospital stay. Conservative management has also been advocated by some authors in selected patients with a preoperative diagnosis of POT based on computed tomography findings. Copyright © 2013 Elsevier Inc. All rights reserved.

Estimation of breast dose and cancer risk in chest and abdomen CT procedures

International Nuclear Information System (INIS)

Eltahir, Suha Abubaker Ali

2013-05-01

The use of CT in medical diagnosis delivers radiation doses to patents that are higher than those from other radiological procedures. Lack of optimized protocols be an additional source of increased dose in developing countries. The aims of this study are first, to measure patient doses during CT chest and abdomen procedures, second, to estimate the radiation dose to the breast, and third to quantify the radiation risks during the procedures. Patient doses from two common CT examinations were obtained from four hospitals in Khartoum.The patient doses were estimated using measurement of CT dose indexes (CTDI), exposure-related parameters, and the IMPACT spreadsheet based on NRPB conversion factors. A large variation of mean organ doses among hospitals was observed for similar CT examinations. These variations largely originated from different CT scanning protocols used in different hospitals and scanner type. The largest range was found for CT of the chest, for which the dose varied from 2.3 to 47 (average 24.7) mSv and for abdomen CT, it was 1.6 to 18.8 (average 10.2) mSv. Radiation dose to the breast ranged from 1.6 to 32.9 mSv for the chest and 1.1 to 13.2 mSv for the abdomen. The radiation risk per procedure was high. The obtained values were mostly higher than the values of organ doses reported from the other studies. It was concluded that current clinical chest and abdomen protocols result in variable radiation doses to the breast. The magnitude of exposure may have implications for imaging strategies.(Author)

Accessory spleen presenting as acute abdomen: A case report and operative management

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A. Landmann

2016-09-01

Full Text Available Accessory spleens are found in 10–30% of patients and are asymptomatic. Rarely, torsion of an accessory spleen can cause abdominal pain and acute abdomen. We present the case of an 8-year-old girl who arrives to the emergency room with left upper quadrant abdominal pain. CT scan revealed a non-enhancing soft tissue mass and multiple small splenules. Laparoscopy revealed a torsed accessory spleen and malrotation. Accessory spleen is a common congenital anomaly that is frequently asymptomatic. Rarely, an accessory spleen may become torsed around its vascular pedicle resulting in severe abdominal pain. Treatment is surgical resection. Torsion of accessory splenic tissue is a rare cause of acute abdomen in pediatric patients.

Hacia lenguajes de metamodelado orientados a aspectos

OpenAIRE

Reina Quintero, Antonia María; Torres Valderrama, Jesús; Toro Bonilla, Miguel

2006-01-01

En este artículo se propone la extensión de los lenguajes de metamodelado con constructores de la orientación a aspectos. Tras justificar brevemente el interés que en la actualidad está teniendo el metamodelado, y sentar las bases necesarias para entender la propuesta, se presenta, a través de ejemplos, la necesidad de extender un lenguaje de metamodelado como Kermeta con conceptos introducidos en el ámbito de la orientación a aspectos

Diagnostics of vascular diseases as a cause for acute abdomen

International Nuclear Information System (INIS)

Juchems, M.S.; Aschoff, A.J.

2010-01-01

Vascular pathologies are rare causes of an acute abdomen. If the cause is a vascular disease a rapid diagnosis is desired as vascular pathologies are associated with high mortality. A differentiation must be made between arterial and venous diseases. An occlusion of the superior mesenteric artery is the most common reason for acute mesenteric ischemia but intra-abdominal arterial bleeding is also of great importance. Venous pathologies include thrombotic occlusion of the portal vein, the mesenteric vein and the vena cava. Multi-detector computed tomography (MDCT) is predestined for the diagnostics of vascular diseases of the abdomen. Using multiphasic contrast protocols enables reliable imaging of the arterial and venous vessel tree and detection of disorders with high sensitivity and specificity. Although conventional angiography has been almost completely replaced by MDCT as a diagnostic tool, it is still of high importance for minimally invasive interventions, for example in the management of gastrointestinal bleeding. (orig.) [de

Septic Arthritis of The Hip Joint presenting as Acute Abdomen ...

African Journals Online (AJOL)

These cases illustrate the maxim that any painful movement of the hip joint with associated unexplained fever should raise suspicion of septic arthritis. The close relationship of the hip joint to the pelvis sometimes confuses hip diseases with pelvic pathologies. Key Words: Septic arthritis, acute abdomen, pathological ...

Huge Mesenteric Lymphangioma – A Rare Cause of Acute Abdomen

African Journals Online (AJOL)

Lymphangiomas are benign congenital masses which occur most commonly in head and neck of children and incidence of mesenteric lymphangiomas is very rare. We report such a case of huge mesenteric lymphangioma in a 20 year old male who presented to us with acute abdomen. Pre-operative diagnosis is difficult ...

Clinical course of Crohn's disease first diagnosed at surgery for acute abdomen.

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Latella, G; Cocco, A; Angelucci, E; Viscido, A; Bacci, S; Necozione, S; Caprilli, R

2009-04-01

The severity of clinical activity of Crohn's disease is high during the first year after diagnosis and decreases thereafter. Approximately 50% of patients require steroids and immunosuppressants and 75% need surgery during their lifetime. The clinical course of patients with Crohn's disease first diagnosed at surgery has never been investigated. To assess the clinical course of Crohn's disease first diagnosed at surgery for acute abdomen and to evaluate the need for medical and surgical treatment in this subset of patients. Hospital clinical records of 490 consecutive Crohn's disease patients were reviewed. Patients were classified according to the Vienna criteria. Sex, extraintestinal manifestations, family history of inflammatory bowel diseases, appendectomy, smoking habit and medical/surgical treatments performed during the follow-up period were assessed. Kaplan-Meier survival method and Cox proportional hazards regression model. Of the 490 Crohn's disease patients, 115 had diagnosis of Crohn's disease at surgery for acute abdomen (Group A) and 375 by conventional clinical, radiological, endoscopic and histologic criteria (Group B). Patients in Group A showed a low risk of further surgery (Log Rank test pacute abdomen showed a low risk for reintervention and less use of steroids and immunosuppressants during follow-up than those not operated upon at diagnosis. Early surgery may represent a valid approach in the initial management of patients with Crohn's disease, at least in the subset of patients with ileal and complicated disease.

Aspectos biopsicosociales asociados al embarazo adolescente

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Regina Cogollo Jiménez

2012-12-01

Full Text Available Introducción: El embarazo en la adolescencia, es un evento inesperado, sorpresivo. Este artículo establece la importancia de identificar los aspectos biopsicosociales asociados al embarazo adolescente en las embarazadas asistentes al programa de Control Prenatal de una Empresa Social del Estado de nivel 1 en Montería en 2009, para comprender las actitudes y los comportamientos asociados a esta etapa tan temprana. Materiales y Métodos: Es un estudio descriptivo, cuantitativo, de corte transversal. Población y muestra: 30 adolescentes embarazadas asistentes al Programa, el muestreo por conveniencia. Se utilizó la encuesta y la observación directa, previa autorización del Director de la empresa. Resultados: Caracterización de la población: predominó la edad de 15 a 19 años (adolescencia tardía, uniones libres, baja escolaridad debido a la deserción escolar, ingreso económico menor al salario mínimo legal vigente. Aspectos Biológicos: la menarquía a temprana edad (9 a 14 años, y en ella la mitad de los embarazos. La mayoría de los segundos embarazos terminaron en parto, la minoría en cesárea y aborto. La captación para los controles prenatales fue tardía, algunas no cumplieron con las citas programadas. Aspectos Psicológicos: inestabilidad con la pareja al enterarse del embarazo, tuvieron soporte familiar moral y económico, abandonaron sus estudios y presentaron malestares como estrés, depresión y tristeza. Aspectos Sociales: predominó la convivencia con la familia extensa. Hubo aceptación en el colegio y en los amigos. Discusión y Conclusiones: Se plantean estrategias para disminuir estos aspectos: elaboración de una cartilla sobre “Cuidado de la adolescente embarazada”, creación de espacios de reflexión, jornadas lúdicas educativas, entre otros. (Rev Cuid 2012; 3(3:385-93.Palabras clave: Embarazo en Adolescencia, Bienestar Materno, Atención Prenatal. (Fuente: De

Acute Abdomen: A Rare Presentation of Lung Cancer Metastasis

OpenAIRE

Guérin, E.; Gilbert, O.; Dequanter, D.

2009-01-01

Surgical emergencies caused by bowel metastases from carcinoma of the lung are very rare. We describe two cases of symptomatic gastrointestinal metastatic small cell carcinoma: the first one concerns a 69-year-old man with an acute abdomen and the second is a 72-year-old man complaining of a gastric ulcer symptoms. We also discuss the current management and the prognosis of these patients.

Acute Abdomen Due to Uncontrolled Use of Warfarin: Spontaneous Intra-abdominal

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Fatih Dal

2017-12-01

Full Text Available Warfarin is an oral anticoagulant, which is commonly used in the treatment and prophylaxis of thromboembolic conditions. Bleeding is the primary adverse effect associated with warfarin. The majority of warfarin-related bleedings are spontaneous minor hemorrhages occurring in the subcutaneous or intramuscular tissues and can be treated by decreasing the dose of oral anticoagulants. However, although rare, it is possible to encounter spontaneous major bleedings with increased risk of mortality. Conservative approach is the preferred initial therapy for hemodynamically stable patients with major intra-abdominal hemorrhages that we define as the intermediate group patients. Nevertheless, surgery is required for hemodynamically unstable patients with acute abdominal pain in cases of ongoing active hemorrhage, generalized peritonitis, obstruction, acute abdomen, intestinal ischemia, and perforation. In this article, we present a rare case of acute abdomen and spontaneous intra-abdominal hemorrhage resulting from uncontrolled use of warfarin and a new classification requirement.

Pattern and presentation of acute abdomen in a Nigerian teaching hospital.

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Agboola, John Owoade; Olatoke, Samuel Adegboyega; Rahman, Ganiyu Abebisi

2014-05-01

Abdominal pain of sudden onset is the hallmark of most non-traumatic emergency surgical presentations. This presents a scenario of urgency to the young surgeon who has to determine which of a myriad of disease conditions the patient is presenting with. Such a physician has to rely on experience and a sound knowledge of the local aetiological spectrum in making a clinical diagnosis. To determine the epidemiology and aetiological spectrum of diseases presenting as acute abdomen in the adult population at the hospital surgical emergency unit. Two hundred and seventy-six patients presenting at the University of Ilorin Teaching Hospital emergency unit and managed by the general surgeons between 1(st) of May 2009 and 30(th) of April 2010 were recruited and followed-up throughout the period of admission. The biodata and clinical information inclusive of diagnosis, investigations, treatment modality and outcome were entered in a structured questioner. Standardised treatment was given to all patients and difficulties encountered in their management were also noted. The data collected was evaluated using SPSS16. Acute abdomen constituted 9.6% of total surgical emergency admissions with patients aged 16-45 years constituting 78.3%. The commonest cause of acute abdomen was appendicitis (30.3%) followed by intestinal obstruction (27.9%), perforated typhoid ileitis 14.9% and peptic ulcer disease (7.6%), respectively. The result from the study is similar to what has been reported in other tropical settings with inflammatory lesions being the major problem. There is also a rising incidence of post-operative adhesions and gradual decline in incidence of obstructed hernia.

Laparostomy management using the ABThera™ open abdomen negative pressure therapy system in a grade IV open abdomen secondary to acute pancreatitis.

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Fitzgerald, James E F; Gupta, Shradha; Masterson, Sarah; Sigurdsson, Helgi H

2013-04-01

Wound control in laparostomy for the treatment of intra-abdominal hypertension remains challenging and numerous techniques have been described. We report the first UK experience with a new commercially available device specifically designed to facilitate management of the open abdomen. A 44-year-old gentleman presented with a 3-day history of constant severe epigastric pain and associated vomiting. Amylase was markedly elevated and he was admitted for supportive management of pancreatitis, with subsequent transfer to intensive care due to severe systemic inflammatory syndrome. The patient decompensated, developing intra-abdominal hypertension with renal and respiratory failure. This was successfully managed by performing a laparostomy and using an ABThera™ Open Abdomen Negative Pressure Therapy System (KCI, San Antonio, TX). We describe its use to facilitate wound control, including enteroatmospheric fistula, allowing granulation and eventual restoration of gastrointestinal continuity 383-days after admission. We found the ABThera™ System proved to be a useful treatment adjunct, protecting intra-abdominal contents while removing large volumes of exudate and infected material from within the abdominal cavity. Complex cases such as this remain infrequent and this article provides a summary of our experience, including a review of indications for laparostomy and the underlying basic science in this difficult area. © 2012 The Authors. International Wound Journal © 2012 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

Aspectos gerais do poliestireno

OpenAIRE

Montenegro, Ricardo Sá Peixoto; Serfaty, Moysés Elias

2002-01-01

O presente trabalho pretende dar uma visão geral e atualizada do poliestireno, o mais antigo termoplástico fabricado comercialmente no mundo. Apresenta-se uma visão simplificada do cenário mundial, da América do Sul e do Brasil, bem como alguns aspectos das tecnologias de fabricação e ambiental. Bibliografia: p. 136

Dose estimation in CT exams of the abdomen based on values of DLP

International Nuclear Information System (INIS)

Kikuti, C.F.; Medeiros, R.B.; Salvadori, P.S.; Costa, D.M.C; D'lppolito, G.

2013-01-01

One of the challenges of multidetector computerized tomography is to minimize the risk of ionizing radiation using optimized protocols since higher doses are necessary to obtain high image quality. It was also noted that, due to the geometry in image acquisition using MDCT becomes necessary to estimate dose values consistent with the hypothesis clinically and with the specificities of the tomographic equipment. The aim of this study was to estimate the doses in abdomen exams from the data recorded on the MDCT console and dimensions obtained from DICOM images of patients undergoing different clinical protocols. Were collected, from the image DICOM of 101 exams, values of the dose length product (DLP) provided by Philips Health Care - Brilliance 64 equipment console, in order to relate them with the dose values obtained by means of thermoluminescent dosimeters ( TLD ) of CasSo 4 :Mn placed on the surface of a cylindrical simulator abdomen acrylic manufactured under the technical - operational conditions for a typical abdomen exam. From the data obtained, it was possible to find a factor of 1.16 ( 5 % ) indicating that the DLP values Brilliance 64 console underestimate the doses and this should be used with correction factor to estimate the total dose of the patient. (author)

Laparoscopy in the acute abdomen.

Science.gov (United States)

Navez, Benoit; Navez, Julie

2014-02-01

Laparoscopy has become a routine procedure in the management of acute abdominal disease and can be considered both an excellent therapeutic and additional diagnostic tool in selected cases. However, a high level of expertise in laparoscopic and emergency surgery is required. Hemodynamic instability, huge abdominal distension, fecal peritonitis and perforated cancer are relative contraindications for the laparoscopic approach. In recent years, abdominal emergencies have increasingly been managed successfully by laparoscopy. In acute appendicitis, acute cholecystitis and perforated peptic ulcer, randomized controlled trials have proven that the laparoscopic approach is as safe and as effective as open surgery, with fewer complications and a quicker postoperative recovery. Other indications such as blunt and penetrating trauma to the abdomen, small bowel occlusion and perforated diverticular disease are under debate, indicating that more randomized controlled trials comparing laparoscopic and open surgery are still necessary. Copyright © 2013 Elsevier Ltd. All rights reserved.

MREIT conductivity imaging of the postmortem canine abdomen using CoReHA

International Nuclear Information System (INIS)

Jeon, Kiwan; Lee, Chang-Ock; Minhas, Atul S; Kim, Young Tae; Jeong, Woo Chul; Kim, Hyung Joong; Woo, Eung Je; Kang, Byeong Teck; Park, Hee Myung; Seo, Jin Keun

2009-01-01

Magnetic resonance electrical impedance tomography (MREIT) is a new bio-imaging modality providing cross-sectional conductivity images from measurements of internal magnetic flux densities produced by externally injected currents. Recent experimental results of postmortem and in vivo imaging of the canine brain demonstrated its feasibility by showing conductivity images with meaningful contrast among different brain tissues. MREIT image reconstructions involve a series of data processing steps such as k-space data handling, phase unwrapping, image segmentation, meshing, modelling, finite element computation, denoising and so on. To facilitate experimental studies, we need a software tool that automates these data processing steps. In this paper, we summarize such an MREIT software package called CoReHA (conductivity reconstructor using harmonic algorithms). Performing imaging experiments of the postmortem canine abdomen, we demonstrate how CoReHA can be utilized in MREIT. The abdomen with a relatively large field of view and various organs imposes new technical challenges when it is chosen as an imaging domain. Summarizing a few improvements in the experimental MREIT technique, we report our first conductivity images of the postmortem canine abdomen. Illustrating reconstructed conductivity images, we discuss how they discern different organs including the kidney, spleen, stomach and small intestine. We elaborate, as an example, that conductivity images of the kidney show clear contrast among cortex, internal medulla, renal pelvis and urethra. We end this paper with a brief discussion on future work using different animal models

Delayed rupture of thoracic aorta aneurysm following a kick to the abdomen.

Science.gov (United States)

Oliva, Antonio; De Giorgio, Fabio; Partemi, Sara; Pascali, Vincenzo L; Carbone, Arnaldo

2009-03-01

Several theories have been proposed to explain the Blunt Traumatic Aortic Rupture (BTAR) because different mechanical forces act on the aorta, at anatomically susceptible sites, including shearing, torsion and stretching, but the origin, transduction and relative importance of these forces remain uncertain. We report a case of a 74-year-old man injured by a kick to the abdomen. After 2 days he felt chest pain paroxysm and weakness in his left leg. The patient was admitted to an emergency care department where he experienced sudden and severe hemodynamic deterioration, dying rapidly. The autopsy, performed 3 days later, showed haemorragic infarction of hypogastric subcutaneous tissues and revealed an extended dissecting aneurysm of the thoracic aorta with following haemopericardium. In our case we considered that a low energy compression to the abdomen, in presence of underlying atherosclerosis, caused aortic dissection rather than rupture and then the 48h time span after the traumatic event and the cardiac tamponade was enough to complete the aortic retrograde dissection. We finally emphasise the importance of the careful surveillance of any trauma close to the abdomen in view of initially unpredictable, as well as eventful injuries. The finding of early signs of neointima formation in thoracoabdominal portions of aortic dissection strongly supported our interpretation. The forensic interest of this case is correlated to the voluntary character of the inflicted injury. The culprit was thus charged with manslaughter.

Extra-skeletal Ewing's sarcoma resembling acute abdomen. Case report.

Science.gov (United States)

Valdivia Gómez, Gilberto Guzmán; Soto Guerrero, María Teresa; Cedillo de la Cruz, María Isabel

2010-01-01

Extraosseous Ewing's sarcoma is a rare tumor of neuroectodermal origin. It presents mainly in the soft tissue of the extremities and thorax. Histologically, it is similar to Ewing's sarcoma of the bone. We present the case of a male who arrived at the emergency room with acute abdomen, leucocytosis and imaging techniques (abdominal ultrasound and computed tomography) suggestive of complicated diverticular disease. He was treated with emergency surgery. Intraoperative findings were an unsuspected tumor (20 x 15 x 15 cm). Treatment consisted of extirpation of the tumor, separating it from the adjacent viscera and followed by chemotherapy based on epirubicin, cyclophosphamide and vincristine for six cycles. Because the control abdominal CT demonstrated tumor activity in the retroperitoneum adjacent to the ascending colon and cecum, further resection was decided upon. In a review of the literature, no previous reports of extraosseous Ewing's sarcoma were found presenting as acute abdomen. Due to the rarity of this tumor, only case reports or series have been found in the literature without randomized or comparative studies. Surgery was the cornerstone of treatment, without reports of preoperative chemotherapy. If the patient's condition permits, percutaneous needle biopsy is mandatory to obtain optimum treatment as well as to improve prognosis.

Calculations on the dose decreasing and image quality improving effects of an abdomen dodger

International Nuclear Information System (INIS)

Koblinger, L.

1974-07-01

A Monte Carlo computer program is performed to study the effects of an abdomen dodger. For this study the inhomogeneous Snyder phantom is assumed to be irradiated by an X-ray tube operated at 80 kV. By the use of a dodger which compensates the varying thickness of the body the exposure distribution on the photoreceptor can be made more uniform and the absorbed dose decreases. As different patients have different dimensions, the results presented here cannot be applied for any given abdomen examination, but can be used as average values, characteristic for an average examination, thus applicable in the estimations for the total population. (K.A.)

Definitive identification of magnetite nanoparticles in the abdomen of the honeybee Apis mellifera

Energy Technology Data Exchange (ETDEWEB)

Desoil, M [Biological Physics Department, University of Mons-Hainaut (Belgium); Gillis, P [Biological Physics Department, University of Mons-Hainaut (Belgium); Gossuin, Y [Biological Physics Department, University of Mons-Hainaut (Belgium); Pankhurst, Q A [London Centre for Nanotechnology, University College London, London WC1E 7HN (United Kingdom); Hautot, D [London Centre for Nanotechnology, University College London, London WC1E 7HN (United Kingdom); Institute for Science and Technology in Medicine, Keele University, Thornburrow Drive, Hartshill, Stoke-en-Trent, ST4 7QB (United Kingdom)

2005-01-01

The biogenic magnetic properties of the honeybee Apis mellifera were investigated with a view to understanding the bee's physiological response to magnetic fields. The magnetisations of bee abdomens on one hand, and heads and thoraxes on the other hand, were measured separately as functions of temperature and field. Both the antiferromagnetic responses of the ferrihydrite cores of the iron storage protein ferritin, and the ferrimagnetic responses of nanoscale magnetite (Fe{sub 3}O{sub 4}) particles, were observed. Relatively large magnetite particles (ca. 30 nm or more), capable of retaining a remanent magnetisation at room temperature, were found in the abdomens, but were absent in the heads and thoraxes. In both samples, more than 98% of the iron atoms were due to ferritin.

Definitive identification of magnetite nanoparticles in the abdomen of the honeybee Apis mellifera

Science.gov (United States)

Desoil, M.; Gillis, P.; Gossuin, Y.; Pankhurst, Q. A.; Hautot, D.

2005-01-01

The biogenic magnetic properties of the honeybee Apis mellifera were investigated with a view to understanding the bee's physiological response to magnetic fields. The magnetisations of bee abdomens on one hand, and heads and thoraxes on the other hand, were measured separately as functions of temperature and field. Both the antiferromagnetic responses of the ferrihydrite cores of the iron storage protein ferritin, and the ferrimagnetic responses of nanoscale magnetite (Fe3O4) particles, were observed. Relatively large magnetite particles (ca. 30 nm or more), capable of retaining a remanent magnetisation at room temperature, were found in the abdomens, but were absent in the heads and thoraxes. In both samples, more than 98% of the iron atoms were due to ferritin.

Definitive identification of magnetite nanoparticles in the abdomen of the honeybee Apis mellifera

International Nuclear Information System (INIS)

Desoil, M; Gillis, P; Gossuin, Y; Pankhurst, Q A; Hautot, D

2005-01-01

The biogenic magnetic properties of the honeybee Apis mellifera were investigated with a view to understanding the bee's physiological response to magnetic fields. The magnetisations of bee abdomens on one hand, and heads and thoraxes on the other hand, were measured separately as functions of temperature and field. Both the antiferromagnetic responses of the ferrihydrite cores of the iron storage protein ferritin, and the ferrimagnetic responses of nanoscale magnetite (Fe 3 O 4 ) particles, were observed. Relatively large magnetite particles (ca. 30 nm or more), capable of retaining a remanent magnetisation at room temperature, were found in the abdomens, but were absent in the heads and thoraxes. In both samples, more than 98% of the iron atoms were due to ferritin

Open abdomen and VAC® in severe diffuse peritonitis.

Science.gov (United States)

Mutafchiyski, Ventsislav M; Popivanov, G I; Kjossev, K T; Chipeva, S

2016-02-01

Currently, the open abdomen technique is the widely recognised method for treatment of life-threatening trauma, intra-abdominal sepsis, abdominal compartment syndrome and wound dehiscence. The techniques for temporary closure using negative pressure have gained increasing popularity. Although negative pressure wound therapy has been proved as an effective method in trauma, the results in diffuse peritonitis are contradictory. Overall, 108 patients with diffuse peritonitis and open abdomen were prospectively enrolled from January 2006 to December 2013--69 treated with mesh-foil laparostomy without negative pressure and 49 with vacuum-assisted closure (VAC(®)) The primary endpoints were the rate of primary fascial closure and mortality. The secondary outcomes were the rate of complications--enteroatmospheric fistulas, intra-abdominal abscesses, wound infection and necrotising fasciitis, intensive care unit (ICU) and overall hospital stay. VAC was associated with higher overall (73% vs 53%) and late primary fascial closure rates (31% vs 7%), lower rates of necrotising fasciitis (2% vs 15%, p=0.012), intra-abdominal abscesses (10% vs 20%), enteroatmospheric fistulas (8% vs 19%), overall mortality (31% vs 53%, pVAC in comparison to the temporary abdominal closure without negative pressure in the cases with severe diffuse peritonitis. However, to a large extent, our results might be attributed to the combination of VAC with dynamic fascial closure. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Frequency, Pattern and Management of Acute Abdomen in Dengue Fever in Karachi, Pakistan

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Muhammad Shamim

2010-07-01

Conclusion: Early diagnosis and prompt conservative management of dengue acute abdomen is necessary to avoid mortality and emergency surgery-related morbidity. However, if needed, surgery can be performed with acceptable morbidity.

Blunt liver injury with intact ribs under impacts on the abdomen: a biomechanical investigation.

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Yu Shao

Full Text Available Abdominal trauma accounts for nearly 20% of all severe traffic injuries and can often result from intentional physical violence, from which blunt liver injury is regarded as the most common result and is associated with a high mortality rate. Liver injury may be caused by a direct impact with a certain velocity and energy on the abdomen, which may result in a lacerated liver by penetration of fractured ribs. However, liver ruptures without rib cage fractures were found in autopsies in a series of cases. All the victims sustained punches on the abdomen by fist. Many studies have been dedicated to determining the mechanism underlying hepatic injury following abdominal trauma, but most have been empirical. The actual process and biomechanism of liver injury induced by blunt impact on the abdomen, especially with intact ribs remained, are still inexhaustive. In order to investigate this, finite element methods and numerical simulation technology were used. A finite element human torso model was developed from high resolution CT data. The model consists of geometrically-detailed liver and rib cage models and simplified models of soft tissues, thoracic and abdominal organs. Then, the torso model was used in simulations in which the right hypochondrium was punched by a fist from the frontal, lateral, and rear directions, and in each direction with several impact velocities. Overall, the results showed that liver rupture was primarily caused by a direct strike of the ribs induced by blunt impact to the abdomen. Among three impact directions, a lateral impact was most likely to cause liver injury with a minimum punch speed of 5 m/s (the momentum was about 2.447 kg.m/s. Liver injuries could occur in isolation and were not accompanied by rib fractures due to different material characteristics and injury tolerance.

The Clinical anatomy of the physical examination of the abdomen: A comprehensive review.

Science.gov (United States)

Bilal, Muhammad; Voin, Vlad; Topale, Nitsa; Iwanaga, Joe; Loukas, Marios; Tubbs, R Shane

2017-04-01

Physical examination of the abdomen is an essential skill. Knowledge of its clinical anatomy and application is vital for making diagnoses. Misinterpretation of anatomy during examination can have serious consequences. This review addresses understanding of the anatomy, methodology, and complications of abdominal physical examination. It includes particular reference to modern technology and investigations. Physical examination is performed for diagnostic purposes. However, the art of physical examination is declining as more and more clinicians rely on newer technology. This can have regrettable consequences: negligence, waste of time and resources, and deterioration of clinical skills. With a sound knowledge of clinical anatomy, and realization of the importance of physical examination of the abdomen, clinician, and patients alike can benefit. Clin. Anat. 30:352-356, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Splenic rupture following idiopathic rupture of the urinary bladder presenting as acute abdomen

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Jurisic D

2007-01-01

Full Text Available Idiopathic rupture of the urinary bladder is an uncommon condition and represents less than 1% of all bladder rupture cases. In most of the cases the main etiological factor was heavy alcohol ingestion. A combined injury of the spleen and bladder is a very rare condition that is almost often associated with trauma and foreign bodies. In this paper we present the extremely rare clinical course of acute abdomen caused by a combined spontaneous intraperitoneal injury; spontaneous rupture of the urinary bladder and spleen. According to our opinion, spontaneous bladder rupture caused by bladder distension due to alcohol ingestion led to urinary ascites and abdominal distension. Finally, repeated minor abdominal blunt trauma during everyday life, to a moderately distended abdomen caused a spontaneous splenic rupture in the patient with abnormal coagulation studies.

Comparison of Outcomes between Early Fascial Closure and Delayed Abdominal Closure in Patients with Open Abdomen: A Systematic Review and Meta-Analysis

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Yu Chen

2014-01-01

Full Text Available Up to the present, the optimal time to close an open abdomen remains controversial. This study was designed to evaluate whether early fascial abdominal closure had advantages over delayed approach for open abdomen populations. Medline, Embase, and Cochrane Library were searched until April 2013. Search terms included “open abdomen,” “abdominal compartment syndrome,” “laparostomy,” “celiotomy,” “abdominal closure,” “primary,” “delayed,” “permanent,” “fascial closure,” and “definitive closure.” Open abdomen was defined as “fail to close abdominal fascia after a laparotomy.” Mortality, complications, and length of stay were compared between early and delayed fascial closure. In total, 3125 patients were included for final analysis, and 1942 (62% patients successfully achieved early fascial closure. Vacuum assisted fascial closure had no impact on pooled fascial closure rate. Compared with delayed abdominal closure, early fascial closure significantly reduced mortality (12.3% versus 24.8%, RR, 0.53, P<0.0001 and complication incidence (RR, 0.68, P<0.0001. The mean interval from open abdomen to definitive closure ranged from 2.2 to 14.6 days in early fascial closure groups, but from 32.5 to 300 days in delayed closure groups. This study confirmed clinical advantages of early fascial closure over delayed approach in treatment of patients with open abdomen.

Abdomen agudo quirúrgico en el anciano

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Jesús M Valdés Jiménez

2002-04-01

Full Text Available Se presenta un estudio descriptivo retrospectivo de 156 enfermos mayores de 65 años, con diagnóstico de abdomen agudo quirúrgico (AAQ, operados en el Hospital Clinicoquirúrgico «Manuel Fajardo» e ingresados en la Unidad de Cuidados Intermedios Polivalente, durante el trienio comprendido entre 1995 y 1998. Las causas más frecuentes del síndrome fueron la oclusión intestinal (58,9 %, la colecistitis aguda (13,5 % y la úlcera péptica gastroduodenal perforada (10,9 %. Las enfermedades asociadas de mayor prevalencia eran la cardiopatía isquémica (62,2 % y la hipertensión arterial (48,7 %. La mortalidad aumentó con el avance de la edad, y alcanzó el 70,4 % en los mayores de 85 años. Entre las complicaciones predominaron la infección de la herida quirúrgica (12,8 % y la bronconeumonía (5,8 %. La principal causa de muerte fue la sepsis (10,3 %A descriptive and retrospective study of 156 patients over 65 with diagnosis of acute surgical abdomen (ASA that were operated on at "Manuel Fajardo" Clinical and Surgical Hospital and admitted at the Polyvalent Intermediate Care Unit, from 1995 to 1998, was conducted. The most common causes of the syndrome were intestinal occlusion (58.9 %, acute cholecystitis (13.5 % and the gastroduodenal perforated peptic ulcer (10.9 %. The associated diseases of highest prevalence were ischemic heart disease (62.2 % and arterial hypertension (48.7 %. Mortality increased with age and amounted to 70.4 % in patients over 85. The infection of the surgical wound (12.8 % and bronchopneumonia (5.8% prevailed among the complications. Sepsis (10.3 % was the main cause of death

Placenta percreta causing acute abdomen in the second trimester of pregnancy

International Nuclear Information System (INIS)

Hussain, M.; Bhutta, S. Z.; Sarwar, S.

2004-01-01

Two cases of acute abdomen due to haemoperitoneum caused by placenta percreta in the second trimester are presented. Both had a history of previous lower segment caesarean section, a factor well-known to predispose the condition. How- ever, the rarity of the condition, presenting in mid pregnancy makes diagnosis and management difficult. Optimum ways of management are discussed. (author)

Can vacuum-assisted closure and instillation therapy (VAC-Instill therapy) play a role in the treatment of the infected open abdomen?

Science.gov (United States)

D'Hondt, M; D'Haeninck, A; Dedrye, L; Penninckx, F; Aerts, R

2011-03-01

Severe superimposed infection during open abdomen treatment with development of intra-abdominal sepsis is a challenging complication associated with high mortality rates. We report our experience with VAC-Instill therapy (KCI, San Antonio, USA) used for treatment of an infected open abdomen following pancreatic surgery. A literature search revealed no analogous case reports using VAC-Instill therapy for treatment of an infected laparostomy. The encouraging result of the case presented seems to indicate that VAC-Instill therapy could be used as adjunctive treatment in the management of the infected open abdomen when traditional therapy fails to control the infection.

Mechanical response of the herniated human abdomen to the placement of different prostheses.

Science.gov (United States)

Hernández-Gascón, Belén; Peña, Estefanía; Grasa, Jorge; Pascual, Gemma; Bellón, Juan M; Calvo, Begoña

2013-05-01

This paper describes a method designed to model the repaired herniated human abdomen just after surgery and examine its static mechanical response to the maximum intra-abdominal pressure provoked by a physiological movement (standing cough). The model is based on the real geometry of the human abdomen bearing a large incisional hernia with several anatomical structures differentiated by MRI. To analyze the outcome of hernia repair, the surgical procedure was simulated by modeling a prosthesis placed over the hernia. Three surgical meshes with different mechanical properties were considered: an isotropic heavy-weight mesh (Surgipro®), a slightly anisotropic light-weight mesh (Optilene®), and a highly anisotropic medium-weight mesh (Infinit®). Our findings confirm that anisotropic implants need to be positioned such that the most compliant axis of the mesh coincides with the craneo-caudal direction of the body.

Accuracy and precision of flash glucose monitoring sensors inserted into the abdomen and upper thigh compared with the upper arm.

Science.gov (United States)

Charleer, Sara; Mathieu, Chantal; Nobels, Frank; Gillard, Pieter

2018-06-01

Nowadays, most Belgian patients with type 1 diabetes use flash glucose monitoring (FreeStyle Libre [FSL]; Abbott Diabetes Care, Alameda, California) to check their glucose values, but some patients find the sensor on the upper arm too visible. The aim of the present study was to compare the accuracy and precision of FSL sensors when placed on different sites. A total of 23 adults with type 1 diabetes used three FSL sensors simultaneously for 14 days on the upper arm, abdomen and upper thigh. FSL measurements were compared with capillary blood glucose (BG) measurements obtained with a built-in FSL BG meter. The aggregated mean absolute relative difference was 11.8 ± 12.0%, 18.5 ± 18.4% and 12.3 ± 13.8% for the arm, abdomen (P = .002 vs arm) and thigh (P = .5 vs arm), respectively. Results of Clarke error grid analysis for the arm and thigh were similar (zone A: 84.9% vs 84.5%; P = .6), while less accuracy was seen for the abdomen (zone A: 69.4%; P = .01). Apart from the first day, the accuracy of FSL sensors on the arm and thigh was more stable across the 14-day wear duration than accuracy of sensors on the abdomen, which deteriorated mainly during week 2 (P < .0005). The aggregated precision absolute relative difference was markedly lower for the arm/thigh (10.9 ± 11.9%) compared with the arm/abdomen (20.9 ± 22.8%; P = .002). Our results indicate that the accuracy and precision of FSL sensors placed on the upper thigh are similar to the upper arm, whereas the abdomen performed unacceptably poorly. © 2018 John Wiley & Sons Ltd.

Analysis of the computed tomography in the acute abdomen; Analise da tomografia computadorizada no abdome agudo

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Hochhegger, Bruno [Complexo Hospitalar Santa Casa de Porto Alegre, RS (Brazil); Moraes, Everton [Universidade Federal de Santa Maria (UFSM), RS (Brazil); Haygert, Carlos Jesus Pereira; Antunes, Paulo Sergio Pase [Hospital Universitario de Santa Maria, RS (Brazil); Gazzoni, Fernando [Pontificia Universidade Catolica de Porto Alegre (PUC-RS), Porto Alegre, RS (Brazil). Hospital Sao Lucas; Andrade, Rubens Gabriel Feijo [Fundacao Universitaria de Cardiologia de Porto Alegre, RS (Brazil). Inst. de Cardiologia; Bueno, Leticia Rossi [Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS (Brazil); Lopes, Luis Felipe Dias [Universidade Federal de Santa Maria (UFSM), RS (Brazil). Dept. de Estatistica]. E-mail: brunorgs@pop.com.br

2007-07-01

Introduction: This study tends to test the capacity of the computed tomography in assist in the diagnosis and the approach of the acute abdomen. Material and method: This is a longitudinal and prospective study, in which were analyzed the patients with the diagnosis of acute abdomen. There were obtained 105 cases of acute abdomen and after the application of the exclusions criteria were included 28 patients in the study. Results: Computed tomography changed the diagnostic hypothesis of the physicians in 50% of the cases (p < 0.05), and the confidence index in 85.71% of the cases (p 0.014). Computed tomography also altered the management in 46.43% of the cases (p > 0.05), where 78.57% of the patients had surgical indication before computed tomography and 67.86% after computed tomography (p = 0.0546). The index of accurate diagnosis of computed tomography, when compared to the anatomopathologic examination and the final diagnosis, was observed in 82.14% of the cases (p = 0.013). When the analysis was done dividing the patients in surgical and nonsurgical group, were obtained an accuracy of 89.28% (p 0.0001). The difference of 7.2 days of hospitalization (p = 0.003) was obtained compared with the mean of the acute abdomen without use the computed tomography. Conclusion: The computed tomography is correlative with the anatomopathology and has great accuracy in the surgical indication, associated with the capacity of increase the confident index of the physicians, reduces the hospitalization time, reduces the number of surgeries and is cost-effective. (author)

Mesenteric defect with internal herniation in the pediatric emergency department: an unusual presentation of acute abdomen.

Science.gov (United States)

Hu, Mei-Hua; Huang, Go-Shine; Chen, Jeng-Chang; Wu, Chang-Teng

2014-04-01

Internal herniation is a rare cause of intestinal obstruction, especially in the emergency department. We report a child with acute abdomen resulting from transmesenteric internal herniation of the small bowel. Radiographic findings revealed gaseous distension of the bowel loops in the upper abdominal area with a paucity of gas in the lower abdomen. Operative finding showed gangrenous small bowel due to mesenteric defect with an internal herniation. The gangrenous bowel was resected and the patient was discharged with an uneventful outcome. We emphasize that early recognition of internal herniation warrants further evaluation and appropriate management. Copyright © 2012. Published by Elsevier B.V.

Clinical validation of a dose reduction study in paediatric abdomen MSCT scanning

International Nuclear Information System (INIS)

Ciccarone, A.; Fonda, C.; Zatelli, Giovanna; Mazzocchi, S.

2008-01-01

Full text: In our previous work an individual dose adaptation in abdomen of paediatric patients has been showed at the Meyer children hospital of Florence. For each kV really feasible in our MSCT scanner, a table of mAs versus abdomen thickness and width ratio has been developed only on the basis of water cylinder phantoms. The choice of the water arise by the fact that in pediatric patient the quantity of water inside the body is major than that of adult. In this way a reduction dose has showed with respect to the ordinary paediatric scanning protocol in use before and the same image quality has been preserved in the case of an optimized CT scanning technique of a standard adult patient of height 175 cm and weight 70 kg. However these results were only theoretical because relied on water phantoms. Now this work concerns the clinical validation of our dose reduction study on phantoms. So 50 examinations were acquired with the dose reduction scanning technique and scored randomly, without knowing weight and height of patient by three radiologists. These scores were compared with that of other 50 abdomen examination before dose reduction study. The scores refers to the noise perceived by radiologist and to the diagnostic quality of radiograph. As last, a score on the low contrast tissue separation between muscle and fat and a score on visibility of structure therein have been asked to the radiologists. The same work has concerned the abdomen examinations with iodine contrast medium. In this study the score of each radiographs has been catalogued in four range of age, 0 - 1; 1 - 3; 3 - 8; 8 - 13 years. Aligned rank and Wilcoxon's signed rank tests were used for statistical analyses. The table of modulating mAs with respect to the size of patient obtained with only water phantom study has been revised so that none reduced detection in low-visibility structures like fat or muscle or liver was evident. Nevertheless a reduction in CTDI of 30 % has been reached in our new

Role of Definitive Radiation Therapy in Carcinoma of Unknown Primary in the Abdomen and Pelvis

International Nuclear Information System (INIS)

Kelly, Patrick; Das, Prajnan; Varadhachary, Gauri R.; Fontanilla, Hiral P.; Krishnan, Sunil; Delclos, Marc E.; Jhingran, Anuja; Eifel, Patricia J.; Crane, Christopher H.

2012-01-01

Objectives: Carcinoma of unknown primary (CUP) in the abdomen and pelvis is a heterogeneous group of cancers with no standard treatment. Considered by many to be incurable, these patients are often treated with chemotherapy alone. In this study, we determined the effectiveness of radiation therapy in combination with chemotherapy in patients with CUP in the abdomen and pelvis. Patients and Methods: Medical records were reviewed for 37 patients with CUP treated with radiation therapy for disease located in the soft tissues and/or nodal basins of the abdomen and pelvis at University of Texas M.D. Anderson Cancer between 2002 and 2009. All patients underwent chemotherapy, either before or concurrent with radiation therapy. Patients were selected for radiation therapy on the basis of histologic type, disease extent, and prior therapy response. Twenty patients underwent definitive radiation therapy (defined as radiation therapy targeting all known disease sites with at least 45 Gy) and 17 patients underwent palliative radiation therapy. Only 6 patients had surgical resection of their disease. Patient and treatment characteristics were extracted and the endpoints of local disease control, progression-free survival (PFS), overall survival (OS), and treatment-related toxicity incidence were analyzed. Results: The 2-year PFS and OS rates for the entire cohort were 32% and 57%, respectively. However, in patients treated with definitive radiation therapy, the rates were 48% and 76%, and 7 patients lived more than 3 years after treatment with no evidence of disease progression. Nevertheless, radiation-associated toxicity was significant in this cohort, as 40% experienced Grade 2 or higher late toxicities. Conclusions: The use of definitive radiation therapy should be considered in selected patients with CUP in the soft tissues or nodal basins of the abdomen and pelvis.

Diffusion-weighted magnetic resonance imaging of the abdomen; Diffusionsgewichtete Magnetresonanztomographie des Abdomens

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Schmid-Tannwald, C.; Reiser, M.F.; Zech, C.J. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany)

2011-03-15

Diffusion-weighted magnetic resonance imaging (DW-MRI) provides qualitative and quantitative information of tissue cellularity and the integrity of cellular membranes. Since DW-MRI can be performed without ionizing radiation exposure and contrast media application, DW-MRI is a particularly attractive tool for patients with allergies for gadolinium-based contrast agents or renal failure. Recent technical developments have made DW-MRI a robust and feasible technique for abdominal imaging. DW-MRI provides information on the detection and characterization of focal liver lesions and can also visualize treatment effects and early changes in chronic liver disease. In addition DW-MRI is a promising tool for the detection of inflammatory changes in patients with Crohn's disease. (orig.) [German] Die diffusionsgewichtete (DW-)MRT ermoeglicht die Erfassung qualitativer und quantitativer Informationen bzgl. der Gewebezellularitaet und Membranintegritaet. Die DW-MRT ist insbesondere bei Patienten mit einer Allergie gegen gadoliniumhaltige Kontrastmittel oder eingeschraenkter Nierenfunktion attraktiv, da ihr Einsatz nicht mit Strahlenexposition oder Kontrastmittelgabe verbunden ist. Durch technische Weiterentwicklungen ist die robuste Anwendung der DW-MRI in der Bildgebung des Abdomens seit einiger Zeit moeglich geworden. In der Leberdiagnostik lassen sich Zusatzinformationen zur Detektion und Charakterisierung von Leberlaesionen gewinnen, aber auch Therapieerfolge dokumentieren und fruehe chronische Leberveraenderungen visualisieren. Neben ihrer Rolle bei hepatologischen und onkologischen Fragestellungen erscheint der Einsatz der DW-MRT zudem bei entzuendlichen Fragestellungen wie dem Morbus Crohn sehr viel versprechend. (orig.)

Acute abdomen caused by ingested chicken wishbone: a case report

OpenAIRE

Hoxha, Faton T; Hashani, Shemsedin I; Komoni, Driton S; Gashi-Luci, Lumturije H; Kurshumliu, Fisnik I; Hashimi, Medita SH; Krasniqi, Avdyl S

2009-01-01

Introduction An ingested foreign body often passes the gastrointestinal tract without any complications. Foreign bodies, such as dentures, fish bones, chicken bones, and toothpicks, have been known to cause perforation of the GI tract. Case presentation We are presenting a case of a fifty-year-old male with acute abdomen; diffuse fibro purulent peritonitis, i.e. ileum perforation, caused by accidentally ingesting a chicken wishbone. He was treated surgically with ileum resection, and temporar...

AN ANALYSIS ON HOLLOW VISCERAL INJURY AND ITS MANAGEMENT FOLLOWING BLUNT TRAUMA ABDOMEN AT A TERTIARY HEALTHCARE CENTRE

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Niranjan Sahoo

2017-10-01

Full Text Available BACKGROUND Trauma is “the neglected disease of modern developing nations.” Hollow viscous injury following blunt trauma to abdomen is not common. The incidence of hollow viscous injuries following abdominal trauma varies from 2 to 15%. The following study was conducted at Department of General Surgery, MKCG Medical College and Hospital, Berhampur, a tertiary care hospital. MATERIALS AND METHODS All the patients admitted to MKCG Medical College and Hospital, Berhampur, with history of blunt trauma to abdomen were examined carefully. Those patients with symptoms and signs suggestive of visceral injury were identified and subjected to xray chest and abdomen erect view and ultrasound abdomen/CT scan. Those with features of pneumoperitoneum are subjected to laparotomy and treated according to location of perforation. Duration of study was from January 2016 to July 2017. RESULTS This study included people of different age groups from 13 to 65 years. Majority of the patients were men (83.5% and most common mode was found to be road traffic accident (69.6%. Most of the patients injured were young and belonged to earning group (81.44%. Most common viscera injured was ileum (37.85% Most common type of injury encountered in our study was isolated perforation and the common surgical procedure was primary closure. CONCLUSION In cases of polytrauma, blunt abdominal trauma contributes significantly to morbidity and mortality. Both the sexes were affected with a male preponderance. The most common mode of blunt trauma was found to be Road Traffic Accident (RTA. Adequate knowledge regarding suspecting intra-abdominal injuries and timely management at tertiary care centre can definitely bring a marked difference in the prognosis of polytrauma patients with history of blunt trauma to abdomen.

A Rare Cause of Acute Abdomen: Diagnosis and Management of Adult Colonic Intussusception.

Science.gov (United States)

Sertkaya, Mehmet; Emre, Arif; Pircanoglu, Eyüp Mehmet; Yazar, Fatih Mehmet; Tepe, Murat; Cengiz, Emrah; Isler, Ali; Vicdan, Halit

2016-01-01

Intussusception in adults is very rarely seen, and this cause acute abdomen. A computed tomography (CT) scan, clinical suspicion, history, and a physical examination are important for the diagnosis. We present two cases of colonic intussusceptions induced by lipoma. The cases had similar locations, diagnoses, and management. Both lipomas were located close to the cecum in the ascending colon, and a right segmental colon resection was performed in both cases. The follow-up of both cases was uneventful. Although benign lesions can cause colonic intussusception, the high incidence of malignancy in colonic lesions should always be considered. Therefore, oncologic surgical procedures should be applied. The definitive diagnosis can be made by histopathology. Sertkaya M, Emre A, Pircanoglu EM, Yazar FM, Tepe M, Cengiz E, Isler A, Vicdan H. A Rare cause of Acute Abdomen: Diagnosis and Management of Adult Colonic Intussusception. Euroasian J Hepato-Gastroenterol 2016;6(2):179-182.

Hernia interna de Quain como causa de abdomen agudo

OpenAIRE

García-Oria, M.; Muñoz de la Fuente, A.; Peraza Casajús, J.M.; Bodega Quiroga, I.; Martínez Pozuelo, A.; Serrano Muñoz, A

2012-01-01

Presentamos el caso de una paciente de 47 años de edad que consulta en urgencias por un cuadro de 8 horas de evolución, de dolor abdominal continuo y difuso, acompañado de vómitos alimentarios al inicio y biliosos después. La paciente presenta estabilidad hemodinámica permaneciendo afebril. El hemiabdomen inferior presenta signos de irritación peritoneal. En los análisis destaca la presencia de neutrofilia y leucocitosis, la radiología simple de abdomen es compatible con suboclusión de intest...

Delayed pneumothorax after stab wound to thorax and upper abdomen: Truth or myth?

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Zehtabchi, Shahriar; Morley, Eric J; Sajed, Dana; Greenberg, Oded; Sinert, Richard

2009-01-01

Stab wounds to the thorax and upper abdomen have the potential to cause pneumothorax (PTX). When a CXR (CXR) obtained during initial resuscitation is negative, a second CXR (CXR-2) is commonly performed with the goal of identifying delayed PTX. To assess the diagnostic yield of the CXR-2 in identifying delayed PTX. Prospective observational study of patients (age >or=13 years) with stab wounds to the thorax (chest/back) and upper abdomen with suspected PTX, in a level 1 trauma centre. Patients were included if they had a negative initial CXR followed by a repeat CXR 3-6h after the initial one. patients who died, were transferred out of the ED, or received chest tubes before the second CXR. The outcome of interest was delayed PTX. All CXR were read by an attending radiologist. To test the inter-observer agreement, another blinded radiologist reviewed 20% of CXR. Continuous data is presented as mean+/-standard deviation and categorical data as percentages with 95% confidence interval (CI). Kappa statistics were used to measure the inter-observer agreement between radiologists. Between January 2003 and December 2006 a total of 185 patients qualified for the enrollment (mean age: 28+/-10 years, age range: 13-65, 94% male). Only 2 patients (1.1%, 95% CI, 0.4- 4.1%) had PTX on the CXR-2. Both patients received chest tubes. The inter-observer agreement for radiology reports was high (kappa: 0.79). Occurrence of delayed PTX in patients with stab wounds to the thorax and upper abdomen and negative triage CXR is rare.

MELAS syndrome presenting as an acute surgical abdomen.

Science.gov (United States)

Dindyal, S; Mistry, K; Angamuthu, N; Smith, G; Hilton, D; Arumugam, P; Mathew, J

2014-01-01

MELAS (mitochondrial cytopathy, encephalomyopathy, lactic acidosis and stroke-like episodes) is a syndrome in which signs and symptoms of gastrointestinal disease are uncommon if not rare. We describe the case of a young woman who presented as an acute surgical emergency, diagnosed as toxic megacolon necessitating an emergency total colectomy. MELAS syndrome was suspected postoperatively owing to persistent lactic acidosis and neurological symptoms. The diagnosis was later confirmed with histological and genetic studies. This case highlights the difficulties in diagnosing MELAS because of its unpredictable presentation and clinical course. We therefore recommend a high index of suspicion in cases of an acute surgical abdomen with additional neurological features or raised lactate.

Accuracy of Focused Assessment with Sonography for Trauma (FAST) in Blunt Trauma Abdomen-A Prospective Study.

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Kumar, Subodh; Bansal, Virinder Kumar; Muduly, Dillip Kumar; Sharma, Pawan; Misra, Mahesh C; Chumber, Sunil; Singh, Saraman; Bhardwaj, D N

2015-12-01

Focused assessment with sonography for trauma (FAST) is a limited ultrasound examination, primarily aimed at the identification of the presence of free intraperitoneal or pericardial fluid. In the context of blunt trauma abdomen (BTA), free fluid is usually due to hemorrhage, bowel contents, or both; contributes towards the timely diagnosis of potentially life-threatening hemorrhage; and is a decision-making tool to help determine the need for further evaluation or operative intervention. Fifty patients with blunt trauma abdomen were evaluated prospectively with FAST. The findings of FAST were compared with contrast-enhanced computed tomography (CECT), laparotomy, and autopsy. Any free fluid in the abdomen was presumed to be hemoperitoneum. Sonographic findings of intra-abdominal free fluid were confirmed by CECT, laparotomy, or autopsy wherever indicated. In comparing with CECT scan, FAST had a sensitivity, specificity, and accuracy of 77.27, 100, and 79.16 %, respectively, in the detection of free fluid. When compared with surgical findings, it had a sensitivity, specificity, and accuracy of 94.44, 50, and 90 %, respectively. The sensitivity of FAST was 75 % in determining free fluid in patients who died when compared with autopsy findings. Overall sensitivity, specificity, and accuracy of FAST were 80.43, 75 and 80 %, respectively, for the detection of free fluid in the abdomen. From this study, we can safely conclude that FAST is a rapid, reliable, and feasible investigation in patients with BTA, and it can be performed easily, safely, and quickly in the emergency room with a reasonable sensitivity, specificity, and accuracy. It helps in the initial triage of patients for assessing the need for urgent surgery.

Peritoneal cavity lavage reduces the presence of mitochondrial damage associated molecular patterns in open abdomen patients.

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Martinez-Quinones, Patricia A; McCarthy, Cameron G; Mentzer, Caleb J; Wenceslau, Camilla F; Holsten, Steven B; Webb, R Clinton; O'Malley, Keith

2017-12-01

Mitochondrial damage-associated molecular patterns (mtDAMPs), such as mitochondrial DNA and N-formylated peptides, are endogenous molecules released from tissue after traumatic injury. mtDAMPs are potent activators of the innate immune system. They have similarities with bacteria, which allow mtDAMPs to interact with the same pattern recognition receptors and mediate the development of systemic inflammatory response syndrome (SIRS). Current recommendations for management of an open abdomen include returning to the operating room every 48 hours for peritoneal cavity lavage until definitive procedure. These patients are often critically ill and develop SIRS. We hypothesized that mitochondrial DAMPs are present in the peritoneal cavity fluid in this setting, and that they accumulate in the interval between washouts. We conducted a prospective pilot study of critically ill adult patients undergoing open abdomen management in the surgical and trauma intensive care units. Peritoneal fluid was collected daily from 10 open abdomen patients. Specimens were analyzed via quantitative polymerase chain reaction (qPCR) for mitochondrial DNA (mtDNA), via enzyme immunoassay for DNAse activity and via Western blot analysis for the ND6 subunit of the NADH: ubiquinone oxidoreductase, an N-formylated peptide. We observed a reduction in the expression of ND6 the day after lavage of the peritoneal cavity, that was statistically different from the days with no lavage (% change in ND6 expression, postoperative from washout: -50 ± 11 vs. no washout day, 42 ± 9; p abdomen. It is possible that increased frequency of peritoneal cavity lavage may lead to decreased systemic absorption of mtDAMPs, thereby reducing the risk of SIRS. Prospective study, Case Series, Level V.

Imaging findings of Castleman disease of the abdomen and pelvis

International Nuclear Information System (INIS)

Zhou Liangping; Wang Peihua; Peng Weijun; Yang Wentao; Zhang Bei; Guan Yubao; Zhou Kangrong

2006-01-01

Objective: The purpose of this work was to analysis the most suggestive imaging findings of Castleman disease in the abdomen and pelvis and to improve the recognition of this rare disease. Methods: Ten patients with pathologically proved Castleman disease in the abdomen (n=9) and pelvis (n=1) were included in this study. Patients were 18-56 yeas old (mean=40); 7 were men and 3 women. Imaging findings (CT and MRI, n=4; only CT, n=4; only MRI, n=2) were retrospectively reviewed and correlated with clinical and pathologic findings. Results: The lesions were divided into localized (n=9) and disseminated (n=1) group. The pathologic subtypes of all 9 cases of localized disease were hyaline vascular type. Imaging findings showed a single large mass in six and a single dominant mass with small satellite nodules in three. On plain CT images, the lesions manifested as homogeneous soft masses, which is isoattenuating to muscle. After intravenous injection of contrast media, most of the masses enhanced sharply (5/7) with the attenuation similar to large arteries at arterial phase and delay scans. On MR imaging, the lesions also were homogenous and had isointense or slightly low signal intensity compared with that of muscle on T 1 weighted images and high signal intensity on T 2 weighted images, and showed contrast enhancement in a similar pattern to contrast enhanced CT. After intravenous injection of contrast media, areas of central lower radial attenuation in the mass were noted in 4 cases of large masses ( > 5 cm) and proved to be fibrotic component pathologically. The pathologic subtypes of 1 cases of disseminated disease was plasma cell type. Imaging findings showed several well-defined nodules lied in the retroperitoneal zone that enhanced sharply with the attenuation similar to large arteries after intravenous injection of contrast media. Conclusion: Imaging findings of Castleman disease in the abdomen and pelvis are closely associated with its pathology. The most

Laparoscopic management of ovarian dysgerminoma presenting with acute abdomen caused by adnexal torsion in a 17-year-old girl.

Science.gov (United States)

Takeda, Akihiro; Mori, Masahiko; Sakai, Kotaro; Mitsui, Takashi; Nakamura, Hiromi

2009-02-01

Ovarian dysgerminoma cases very rarely present with acute abdomen due to adnexal torsion and the successful laparoscopic management of such a case has not been reported previously. A 17-year-old sexually inactive high school girl presenting with acute abdomen was referred to our emergency department. Transabdominal ultrasonography showed the presence of homogeneous tumor in the lower abdomen. Emergency laparoscopic surgery was performed and left ovarian tumor with adnexal torsion was identified. Left salpingo-oophorectomy was performed carefully to avoid damaging the tumor capsule and the excised tissue was removed after retrieval in an endobag. The histopathological diagnosis was pure ovarian dysgerminoma. The postoperative course was uneventful. Laparoscopic management with careful postoperative follow-up to monitor recurrence could be a treatment option in a young girl with dysgerminoma, if the disease condition is detected in the early stage.

Non Obstetric Causes and Presentation of Acute Abdomen among the Pregnant Women.

Science.gov (United States)

Haque, Monoarul; Kamal, Farah; Chowdhury, Shahanaz; Uzzaman, Monir; Aziz, Itrat

2014-09-01

To identify the non-obstetric causes and presentation of acute abdomen among pregnant women. This was a cross sectional hospital-based study among 128 pregnant women by face to face interview using a semi-structured questionnaire. This study was conducted at the Gynecology & Obstetric Ward of 250 Bed General Hospital, Noakhali, Bangladesh, from January to August 2013. Data were analyzed by a software package used for statistical analysis (SPSS) version 11.5 (SPSS, Inc., Chicago, IL, USA). Mean age of participants was 25±4 years. Our findings showed that 81% were Muslim, 67% were lower middle income group, as well as 47% completed primary level of education. The results revealed that 28% had biliary ascariasis, 24% had peptic ulcer disease and 10% had lower urinary tract infection. We also found that 6% had acute pyelonephritis, 6% had acute gastroenteritis, 6% had acute cholecystitis, 6% had acute appendicitis, 2% had acute pancreatitis, 3% had choledocolithiasis, 2% had ovarian solid mass, 2% had twisted ovarian cyst, 4% had renal colic, and 1% had renal calculus. In non-obstetrical presentation of acute abdomen, the study found that 84% of respondents complained their pain lasting more than 24 hours. Besides, half of respondents felt pain in epigastrium and right hypochondrium. Cramping, prickling and aching type of pain were more, while 66% suffered from continuous pain. Our results also showed that 73% did not explain any aggravating factor and relieving factor, and the rest said food, fasting state and position change aggravated pain as well as relieved pain. The study concludes that precise diagnosis of the acute abdomen in pregnant women by continual updating of abdominal assessment knowledge, and clinical skills is necessary in the management of abdominal pain in obstetric settings.

Incidence of seed migration to the chest, abdomen, and pelvis after transperineal interstitial prostate brachytherapy with loose 125I seeds

International Nuclear Information System (INIS)

Sugawara, Akitomo; Shigematsu, Naoyuki; Nakashima, Jun; Kunieda, Etsuo; Nagata, Hirohiko; Mizuno, Ryuichi; Seki, Satoshi; Shiraishi, Yutaka; Kouta, Ryuichi; Oya, Mototsugu

2011-01-01

The aim was to determine the incidence of seed migration not only to the chest, but also to the abdomen and pelvis after transperineal interstitial prostate brachytherapy with loose 125 I seeds. We reviewed the records of 267 patients who underwent prostate brachytherapy with loose 125 I seeds. After seed implantation, orthogonal chest radiographs, an abdominal radiograph, and a pelvic radiograph were undertaken routinely to document the occurrence and sites of seed migration. The incidence of seed migration to the chest, abdomen, and pelvis was calculated. All patients who had seed migration to the abdomen and pelvis subsequently underwent a computed tomography scan to identify the exact location of the migrated seeds. Postimplant dosimetric analysis was undertaken, and dosimetric results were compared between patients with and without seed migration. A total of 19,236 seeds were implanted in 267 patients. Overall, 91 of 19,236 (0.47%) seeds migrated in 66 of 267 (24.7%) patients. Sixty-nine (0.36%) seeds migrated to the chest in 54 (20.2%) patients. Seven (0.036%) seeds migrated to the abdomen in six (2.2%) patients. Fifteen (0.078%) seeds migrated to the pelvis in 15 (5.6%) patients. Seed migration occurred predominantly within two weeks after seed implantation. None of the 66 patients had symptoms related to the migrated seeds. Postimplant prostate D90 was not significantly different between patients with and without seed migration. We showed the incidence of seed migration to the chest, abdomen and pelvis. Seed migration did not have a significant effect on postimplant prostate D90

Ecchymosis and/or haematoma formation after prophylactic administration of subcutaneous enoxaparin in the abdomen or arm of the critically ill patient.

Science.gov (United States)

Jareño-Collado, R; Sánchez-Sánchez, M M; Fraile-Gamo, M P; García-Crespo, N; Barba-Aragón, S; Bermejo-García, H; Sánchez-Izquierdo, R; Sánchez-Muñoz, E I; López-López, A; Arias-Rivera, S

Ecchymosis and/or haematoma are the most common adverse events after subcutaneous administration of low molecular weight heparin. There is no strong recommendation as to the puncture site. To evaluate the adverse events, ecchymosis and/or haematoma after the administration of prophylactic subcutaneous enoxaparin in the abdomen vs the arm in the critically ill patient. A randomised, two-arm clinical trial (injection in the abdomen vs the arm), performed between July 2014 and January 2017, in an 18-bed, polyvalent intensive care unit. Patients receiving prophylactic enoxaparin, admitted >72h, with no liver or haematological disorders, a body mass index (BMI) >18.5, not pregnant, of legal age and with no skin lesions which would impede assessment were included. We excluded patients who died or who were transferred to another hospital before completing the evaluation. We gathered demographic and clinical variables, and the onset of ecchymosis and/or haematomas at the injection site after 12, 24, 48 and 72hours. A descriptive analysis was undertaken, with group comparison and logistic regression. The study was approved by the ethics committee with the signed consent of patients/families. 301 cases (11 excluded): 149 were injected in the abdomen vs 141 in the arm. There were no significant differences in demographic and clinical variables, BMI, enoxaparin dose or antiplatelet administration [ecchymosis, abdomen vs arm, n(%): 66(44) vs 72(51), P=.25] [haematoma abdomen vs arm, n(%): 9(6) vs 14(10), P=.2]. Statistical significance was found in the size of the haematomas after 72h: [area of haematoma (mm 2 ) abdomen vs arm, median (IQR): 2(1-5.25) vs 20(5.25-156), P=.027]. In our patient cohort, prophylactic subcutaneous enoxaparin administered in the abdomen causes fewer haematomas after 72hours, than when administered in the arm. The incidence rate of ecchymosis and haematoma was lower than the published incidence in critically ill patients, although patients receiving

Presentación del Libro, “Epilepsia. Aspectos Clínicos y Psicosociales”.

Directory of Open Access Journals (Sweden)

Carlos Medina Malo

2006-12-01

aspectos biológicos. Es excelente porque muestra el equipo que reunió el Dr. Medina, a los integrantes de la Liga contra la Epilepsia, que se ve reflejada en ese aspecto biopsicosocial de la persona con epilepsia.

Neuroendocrine tumors of the abdomen; Neuroendokrine Tumoren des Abdomens

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Juchems, M. [Klinikum Konstanz, Diagnostische und Interventionelle Radiologie, Konstanz (Germany)

2018-01-15

Gastroenteropancreatic neuroendocrine neoplasia (GEP-NEN) are a heterogeneous group of complex tumors, which is often difficult to classify due to heterogeneity and varying locations. Ultrasound, computed tomography (CT), magnetic resonance imaging (MRI) and positron-emission tomography computed tomography (PET/CT) are available for the localization of NEN as well as for the staging. In particular, nuclear medical examination methods with somatostatin analogues are of great importance since radioactively labeled receptor ligands make tumors visible with high sensitivity. CT and MRT have high detection rates for GEP-NEN and have been further improved by developments such as diffusion weighted imaging. The nuclear medical methods, however, are superior in detection, especially in gastrointestinal NEN It is important for the radiologist to become acquainted with the NEN as they can occur ubiquitously in the abdomen and should be identified as such. Since GEP-NEN are predominantly hypervascularized, a biphasic examination technique is obligatory for contrast-enhanced cross-sectional imaging. PET/CT with somatostatin analogs should be used for further diagnosis. (orig.) [German] Gastroenteropankreatische neuroendokrine Neoplasien (GEP-NEN) sind eine heterogene Gruppe komplexer Tumoren, deren Einteilung aufgrund der Heterogenitaet und unterschiedlichen Lokalisation haeufig schwerfaellt. Fuer die Lokalisation der NEN sowie zur Ausbreitungsdiagnostik und Metastasensuche stehen Ultraschalldiagnostik, Computertomographie (CT), Magnetresonanztomographie (MRT) und die Positronenemissionstomographie-Computertomographie (PET-CT) zur Verfuegung. Insbesondere nuklearmedizinische Untersuchungsmethoden mit Somatostatinanaloga sind von hoher Wertigkeit, da sie ueber radioaktiv markierte Rezeptoliganden Tumoren mit hoher Sensitivitaet sichtbar machen. CT und MRT haben hohe Detektionsraten bei den GEP-NEN und konnten durch Weiterentwicklungen, wie Diffusionsbildgebung, weiter

Magnetic resonance imaging of the abdomen

International Nuclear Information System (INIS)

Kulkarni, M.V.

1986-01-01

MRI of the abdomen currently competes with CT and ultrasonography as an imaging technique for abdominal pathology. Although ultrasonography has certain advantages, such as real-time scanning, the major comparison is to be made between MR and CT. CT has slightly superior spatial resolution and minimal motion artifacts, and enables the use of contrast agents in bowel. MR, on the other hand, has improved capabilities in contrasting soft tissues and providing multiplanar imaging. The greatest advantage of CT is the experience that the medical community has gained with it over the last decade. Further development in technology and improvement in the clinical experience with MR will be important in determining its future role in abdominal imaging. Large series of clinical trials are required for further experience. Chemical spectroscopy with proton and possibly other nuclei may improve diagnostic specificity. Paramagnetic contrast agents for bowel specification would certainly improve imaging quality. Thus, MR will play a significant role in abdominal imaging in the future

Intrarectal negative pressure system in the management of open abdomen with colorectal fistula: A case report☆

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Yetişir, Fahri; Salman, A. Ebru; Mamedov, Ruslan; Aksoy, Mustafa; Yalcin, Abdussamet; Kayaalp, Cüneyt

2014-01-01

INTRODUCTION To present the management of open abdomen with colorectal fistula by application of intrarectal negative pressure system (NPS) in addition to abdominal NPS. PRESENTATION OF CASE Twenty-year old man had a history of injuries by a close-range gunshot to the abdomen eight days ago and he had been treated by bowel repairs, resections, jejunal anastomosis and Hartman's procedure. He was referred to our center after deterioration, evisceration with open abdomen and enteric fistula in septic shock. There were edematous, fibrinous bowels and large multiple fistulas from the edematous rectal stump. APACHE II, Mannheim Peritoneal Index and Björck scores were 18, 33 and 3, respectively (expected mortality 100%). After intensive care for 5 days, he was treated by abdominal and intrarectal NPS. NPS repeated for 5 times and the fistula was recovered on day 18 completely. Fascial closure was facilitated with a dynamic abdominal closure system (ABRA) and he was discharged on day 33 uneventfully. There was no herniation and any other problem after 12 months follow-up. DISCUSSION Management of fistula in OA can be extremely challenging. Floating stoma, fistula VAC, nipple VAC, ring and silo VAC, fistula intubation systems are used for isolation of the enteric effluent from OA. Several biologic dressings such as acellular dermal matrix, pedicled flaps have been used to seal the fistula opening with various success. Resection of the involved enteric loop and a new anastomosis of the intestine is very hard and rarely possible. In all of these reports, usually patients are left to heal with a giant hernia. In contrast to this, there is no hernia in our case during one year follow up period. CONCLUSION Combination of intra and extra luminal negative pressure systems and ABRA is a safe and successful method to manage open abdomen with colorectal fistula. PMID:24584042

Intrarectal negative pressure system in the management of open abdomen with colorectal fistula: A case report.

Science.gov (United States)

Yetişir, Fahri; Salman, A Ebru; Mamedov, Ruslan; Aksoy, Mustafa; Yalcin, Abdussamet; Kayaalp, Cüneyt

2014-01-01

To present the management of open abdomen with colorectal fistula by application of intrarectal negative pressure system (NPS) in addition to abdominal NPS. Twenty-year old man had a history of injuries by a close-range gunshot to the abdomen eight days ago and he had been treated by bowel repairs, resections, jejunal anastomosis and Hartman's procedure. He was referred to our center after deterioration, evisceration with open abdomen and enteric fistula in septic shock. There were edematous, fibrinous bowels and large multiple fistulas from the edematous rectal stump. APACHE II, Mannheim Peritoneal Index and Björck scores were 18, 33 and 3, respectively (expected mortality 100%). After intensive care for 5 days, he was treated by abdominal and intrarectal NPS. NPS repeated for 5 times and the fistula was recovered on day 18 completely. Fascial closure was facilitated with a dynamic abdominal closure system (ABRA) and he was discharged on day 33 uneventfully. There was no herniation and any other problem after 12 months follow-up. Management of fistula in OA can be extremely challenging. Floating stoma, fistula VAC, nipple VAC, ring and silo VAC, fistula intubation systems are used for isolation of the enteric effluent from OA. Several biologic dressings such as acellular dermal matrix, pedicled flaps have been used to seal the fistula opening with various success. Resection of the involved enteric loop and a new anastomosis of the intestine is very hard and rarely possible. In all of these reports, usually patients are left to heal with a giant hernia. In contrast to this, there is no hernia in our case during one year follow up period. Combination of intra and extra luminal negative pressure systems and ABRA is a safe and successful method to manage open abdomen with colorectal fistula. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Honey bees (Apis mellifera ligustica) swing abdomen to dissipate residual flying energy landing on a wall

Science.gov (United States)

Zhao, Jieliang; Huang, He; Yan, Shaoze

2017-03-01

Whether for insects or for aircrafts, landing is one of the indispensable links in the verification of airworthiness safety. The mechanisms by which insects achieve a fast and stable landing remain unclear. An intriguing example is provided by honeybees (Apis mellifera ligustica), which use the swinging motion of their abdomen to dissipate residual flying energy and to achieve a smooth, stable, and quick landing. By using a high-speed camera, we observed that touchdown is initiated by honeybees extending their front legs or antennae and then landing softly on a wall. After touchdown, they swing the rest of their bodies until all flying energy is dissipated. We suggested a simplified model with mass-spring dampers for the body of the honeybee and revealed the mechanism of flying energy transfer and dissipation in detail. Results demonstrate that body translation and abdomen swinging help honeybees dissipate residual flying energy and orchestrate smooth landings. The initial kinetic energy of flying is transformed into the kinetic energy of the abdomen's rotary movement. Then, the kinetic energy of rotary movement is converted into thermal energy during the swinging cycle. This strategy provides more insight into the mechanism of insect flying, which further inspires better design on aerial vehicle with better landing performance.

Entrance doses during lateral lumbar spine and antero-posterior abdomen examinations: generator waveform dependence

International Nuclear Information System (INIS)

Morrison, G.D.; Underwood, A.C.

1995-01-01

In North Trent, UK, an entrance dose survey of lateral lumbar spine and antero-posterior (AP) abdomen examinations has been carried out in 17 radiology departments. The survey comprised 294 lateral lumbar spine and 322 AP abdomen entrance dose measurements. The mean entrance doses were found to be approximately half of the relevant national reference entrance dose levels of 30 mGy and 10 mGy, respectively. The effect of generator waveform on entrance dose was studied by separating the generators into two types: ''pulsating potential'' (PP) generators and ''constant potential'' (CP) generators for each examination. PP generators comprised 23% of the total number of examinations. The mean entrance dose and radiographic exposure factors from CP generators were found to be significantly lower than those from PP generators. The use of CP type generators, together with low attenuation components can significantly reduce patient entrance doses for these examinations. (author)

Impact of quality control radiation doses received by patients undergoing abdomen x-ray examination in ten hospitals

International Nuclear Information System (INIS)

Aghahadi, B.; Zhang, Z.; Zareh, S.; Sarkar, S.; Tayebi, P. S.

2006-01-01

The X-ray machines used for radiodiagnosis should meet certain quality assurance programmes. These are necessary to have good quality radiographs at reasonably low exposure to patients. Materials and Methods: Dose reduction methods in abdomen X-ray examination were carried out in 10 hospitals in Tehran. This paper presents the work, which was implemented on 200 patients and evaluated using the entrance skin dose in the Anterior-Posterior abdomen projection measured directly at the center of the X-ray field. In addition, the machine room, and dark room parameters, as well as work practices and repeat rates were studied. Results: The quality control parameters and the entrance skin dose were evaluated utilizing an anthropologic phantom to define the optimal exposure condition at all hospitals before and after quality control . Results show that after using the quality control parameters and optimization of the exposure conditions, the mean of mAs and entrance skin dose can be decreased by 62% and 65% respectively. Conclusion: The quality of the radiographs generally increased. The reported method is easily implemented in any clinical situation where optimization of abdomen radiography is necessary

MR imaging of the abdomen in pregnancy

International Nuclear Information System (INIS)

Klasen, J.; Antoch, G.; Blondin, D.

2011-01-01

Sonography is still the method of choice for imaging diseases in pregnant women. The changed physiognomy of the women increases the known limitations of sonography while the advantages of MRI (large field of view, excellent soft-tissue contrast, sensitive diagnosis of edema) are not affected. The available sequences allow the differentiation of various pathologies. Most of these can frequently be visualized without intravenous administration of contrast material. Although the significance of techniques like DWI and ASL has not yet been explored, initial descriptions are promising and MR imaging in pregnancy will be increasingly important in the future. Therefore, knowledge of the most frequent diseases in pregnancy and their image appearance is relevant to radiologists. The advantages of MRI in comparison to sonography and its important role in imaging pathologies of the acute abdomen in pregnancy are illustrated and discussed. (orig.)

The role of the computerized axial tomography(CT) of the abdomen and pelvis in follow-up studies for the follicular lymphoma patients

International Nuclear Information System (INIS)

Oh, Y.K.; Ha, C.S.; McLaughlin, P.; Cabanillas, F.; Hess, M.A.; Cox, J. D.

1997-01-01

Purpose/Objective: A large proportion of patients with stage I, II or III follicular lymphoma remains free of recurrence for a long period of time after a complete response(CR) to the initial treatment. The yield of the costly follow-up tests, especially the CT of the abdomen and pelvis, for this indolent lymphoma has not been systematically studied. Materials and Methods: A total of 328 patients with previously untreated stage I, II or III follicular lymphoma were treated at our institution between 1978 and 1994. Two hundred fifty seven patients achieved CR to treatments: seventy eight of them relapsed. Their median age was 55 years. Their stages were; I-15, II-28, III-35. Their treatments were; radiation therapy-15, chemotherapy-12, combined modality with radiation and chemotherapy-51. The medical records of these 78 patients were reviewed in detail to analyze the yield of the CT of the abdomen and pelvis in detecting the recurrence relative to history/physical exam(H/PE), complete blood count(CBC), serum chemistry, chest roentgenogram(CXR), and KUB to visualize the residual lymphangiogram dye(KUB/LAG). A positive study was defined as one which led to or was abnormal at the time of the diagnosis of recurrence. Results: The median follow-up period was 101 months. Patients were usually followed in the clinic every 3 to 6 months for the initial 5 years and then yearly thereafter. The number of the positive studies per total number of follow-up studies performed in the period between CR and recurrence were; H/PE-55/568, CBC-1/534, serum chemistry-5/517, CXR-6/488, KUB/LAG-13/190, CT of abdomen-29/259, CT of pelvis-19/242. Eleven relapses were detected only by CT of abdomen and pelvis. Conclusion: Fourteen percent ((11(78))) of the relapses were detected solely by CT of the abdomen and pelvis. This implies 4.3 % ((11(257))) of the patients who achieved CR benefited from the CT of the abdomen and pelvis for recurrence detection. The yield of the routine use of the CT

Prostheses size dependency of the mechanical response of the herniated human abdomen.

Science.gov (United States)

Simón-Allué, R; Hernández-Gascón, B; Lèoty, L; Bellón, J M; Peña, E; Calvo, B

2016-12-01

Hernia repairs still exhibit clinical complications, i.e. recurrence, discomfort and pain and mesh features are thought to be highly influent. The aim of this study is to evaluate the impact of the defect size and mesh type in an herniated abdominal wall using numerical models. To do so, we have started from a FE model based on a real human abdomen geometry obtained by MRI, where we have provoked an incisional hernia of three different sizes. The surgical procedure was simulated by covering the hernia with a prostheses, and three surgical meshes with distinct mechanical properties were used for the hernia repair: an isotropic heavy-weight mesh (Surgipro @ ), a slightly anisotropic light-weight mesh (Optilene @ ) and a highly anisotropic medium-weight mesh (Infinit @ ). The mechanical response of the wall to a high intraabdominal pressure (corresponding to a coughing motion) was analyzed here. Our findings suggest that the anisotropy of the mesh becomes more relevant with the increase of the defect size. Additionally, according to our results Optilene @ showed the closest deformation to the natural distensibility of the abdomen while Infinit @ should be carefully used due to its excessive compliance.

Diffusion-weighted MR imaging of the abdomen with pulse triggering

International Nuclear Information System (INIS)

Muertz, P.; Pauleit, D.; Traeber, F.; Kreft, B.P.; Schild, H.H.

2000-01-01

Purpose: The aim of this work was to reduce the influence of motion on diffusion-weighted MR images of the abdomen by pulse triggering of single-shot sequences. Methods: Five healthy volunteers were examined both without and with finger pulse-triggering of a diffusion-weighted single-shot echo planar MR imaging sequence at 1.5 T. Series of diffusion-weighted images were acquired at different phases of the cardiac cycle by varying the time delay between finger pulse and sequence acquisition. The measurements were repeated three times. The diffusion weighted images were analysed by measuring the signal intensities and by determining the ADC values within the spleen, kidney and liver. Results: The magnitude of motion artifacts on diffusion weighted images shows a strong dependence on the trigger delay. The optimum trigger delay is found to be between 500 and 600 ms. For these values the abdominal organs appear homogeneous on all diffusion weighted images and the strongest signal intensities are detected. At optimum triggering the accuracy of the apparent diffusion coefficients is up to 10 times better than without triggering. Moreover, the standard deviation of the repeated measurements is smaller than 12% for all volunteers and for all organs. Without triggering the standard deviation is larger by a factor of 4 on average. Conclusion: Pulse triggering of single-shot sequences leads to significant reduction of motion related artifacts on diffusion weighted images of the abdomen and provides more accurate and reproducible ADC values. (orig.) [de

Results of emergency management of acute abdomen in adults based on clinical assessment and basic imaging investigations: are advanced imaging techniques always necessary for successful treatment?

OpenAIRE

Sangram Karandikar

2016-01-01

Background: The term acute abdomen refers to signs and symptoms of abdominal pain and tenderness, a clinical presentation that may require emergency surgical treatment. Patients suffering from both, surgical as well as medical diseases may present with acute abdomen. The main objectives of the study are to identify common causes of acute abdomen, to assess the need for urgent surgical intervention in these patients and to evaluate role of basic diagnostic techniques and need of advanced imagi...

Open abdomen procedure in managing abdominal compartment syndrome in a child with severe fungal peritonitis and sepsis after gastric perforation

Directory of Open Access Journals (Sweden)

Wei Lai

2016-04-01

Full Text Available Abdominal compartment syndrome with increased abdominal pressure resulted in multi-organ dysfunctions can be lethal in children. The open abdomen procedure intentionally leaves the abdominal cavity open in patients with severe abdominal sepsis and abdominal compartment syndrome by temporarily relieving the abdominal pressure. We reported our experience of open abdomen procedure in successfully treating a 4-year old boy with abdominal compartment syndrome caused by severe fungal peritonitis and sepsis after gastric perforation.

Acute abdomen. Clinical background and demands on imaging

International Nuclear Information System (INIS)

Graeb, C.; Jauch, K.W.; Reiser, M.; Graser, A.

2010-01-01

The term ''acute abdomen'' does not describe a specific disease entity but is more a critical clinical state which incorporates very heterogeneous clinical presentations. The prognosis of any disease depends on the time frame from the onset of symptoms to the initiation of a specific therapy. For this reason there are special expectations by clinicians regarding the diagnostic assessment provided by radiology which is expected to deliver an immediate diagnosis supporting further therapeutic decisions. Along with the patient's clinical history, physical examination and blood tests, radiological diagnostics are essential for enabling a specific treatment. From a surgical point of view the radiologist is expected to help in differentiating between cases with indications for emergency surgery and cases eligible for elective surgery or conservative treatment. (orig.) [de

[The acute (surgical) abdomen - epidemiology, diagnosis and general principles of management].

Science.gov (United States)

Grundmann, R T; Petersen, M; Lippert, H; Meyer, F

2010-06-01

This review comments on epidemiology, diagnosis and general principles of surgical management in patients with acute abdomen. DEFINITION AND EPIDEMIOLOGY: The most common cause of acute abdominal pain is non-specific abdominal pain (24 - 44.3 % of the study populations), followed by acute appendicitis (15.9 - 28.1 %), acute biliary disease (2.9 - 9.7 %) and bowel obstruction or diverticulitits in elderly patients. Acute appendicitis represents the cause of surgical intervention in two-thirds of the children with acute abdomen. A standardised physical examination combined with ultrasonography (US) represents the initial investigation in patients with acute abdominal pain. Due to the risk associated with radiation and due to the costs, a selective use of CT imaging is recommended. The work-flow given in this paper restricts the use of CT imaging to less than 50 % of patients with acute abdominal pain. Diagnostic laparoscopy should be considered in patients without a specific diagnosis after appropriate imaging and as an alternative to active clinical observation which is the current practice in patients with non-specific abdominal pain. Acute small bowel obstruction has previously been considered as a relative contraindication for laparoscopic management, but it has been shown in the meantime that laparoscopic treatment is an elegant tool for the management of simple band small bowel obstruction. Bedside diagnostic laparoscopy is recommended in intensive care unit (ICU) patients with acute abdomen or sepsis of unknown origin, in suspicion of acute cholecystitis, diffuse gut hypoperfusion and mesenteric ischaemia or in refractory lactic acidosis, especially after cardiac surgery. Early administration of analgesia to patients with acute abdominal pain in the emergency department will reduce the patient's discomfort without impairing clinically important diagnostic accuracy and is recommended on the basis of some prospective randomised trials. However, the impact on

Independent predictors of enteric fistula and abdominal sepsis after damage control laparotomy: results from the prospective AAST Open Abdomen registry.

Science.gov (United States)

Bradley, Matthew J; Dubose, Joseph J; Scalea, Thomas M; Holcomb, John B; Shrestha, Binod; Okoye, Obi; Inaba, Kenji; Bee, Tiffany K; Fabian, Timothy C; Whelan, James F; Ivatury, Rao R

2013-10-01

Enterocutaneous fistula (ECF), enteroatmospheric fistula (EAF), and intra-abdominal sepsis/abscess (IAS) are major challenges for surgeons caring for patients undergoing damage control laparotomy after trauma. To determine independent predictors of ECF, EAF, or IAS in patients undergoing damage control laparotomy after trauma, using the AAST Open Abdomen Registry. The AAST Open Abdomen registry of patients with an open abdomen following damage control laparotomy was used to identify patients who developed ECF, EAF, or IAS and to compare these patients with those without these complications. Univariate analyses were performed to compare these groups of patients. Variables from univariate analyses differing at P IAS. Fourteen level I trauma centers. A total of 517 patients with an open abdomen following damage control laparotomy. Complication of ECF, EAF, or IAS. More patients in the ECF/EAF/IAS group than in the group without these complications underwent bowel resection (63 of 111 patients [57%] vs 133 of 406 patients [33%]; P 48 hours after surgery, the ECF/EAF/IAS group received more colloids (P IAS group underwent almost twice as many abdominal reexplorations as did the group without these complications (mean [SD] number, 4.1 [4.1] vs 2.2 [3.4]; P IAS were a large bowel resection (adjusted odds ratio [AOR], 3.56 [95% CI, 1.88-6.76]; P 48 hours of between 5 and 10 L (AOR, 2.11 [95% CI, 1.15-3.88]; P = .02) or more than 10 L (AOR, 1.93 [95% CI, 1.04-3.57]; P = .04), and an increasing number of reexplorations (AOR, 1.14 [95% CI, 1.06-1.21]; P IAS in patients with an open abdomen after damage control laparotomy.

Bilateral ovarian teratoma presenting with a clinical picture of acute abdomen

Directory of Open Access Journals (Sweden)

Massimiliano Rocchietti March

2012-12-01

Full Text Available We describe the case of a 30-year-old patient with bilateral mature cystic teratoma (MCT of the ovaries. The patient had been complaining of mild abdominal pain for several months that had suddenly become severe. Early diagnosis at the emergency room was acute appendicitis, but definitive diagnosis was bilateral ovarian teratoma. We therefore recommend considering ovarian teratomas in the differential diagnosis of acute abdomen in young women in an emergency care setting.

Aspectos psicosociales en universitarias embarazadas

OpenAIRE

Estupiñán-Aponte, María R.; Rodríguez-Barreto, Lucía

2009-01-01

Objetivo Determinar los aspectos psicosociales relacionados con el embarazo en estudiantes universitarias.Metodología A partir de la revisión de archivos y el muestreo intencional, se seleccionaron 68 estudiantes que tuvieron un embarazo adolescente. Mediante relatos de vida y entrevistas en profundidad se analizan las implicaciones del embarazo en la condición personal, familiar y académica.Resultados Durante el primer trimestre de embarazo, se generan crisis y ajustes en la estructura famil...

PMHS impact response in 3 m/s and 8 m/s nearside impacts with abdomen offset.

Science.gov (United States)

Miller, Carl S; Madura, Nathaniel H; Schneider, Lawrence W; Klinich, Kathleen D; Reed, Matthew P; Rupp, Jonathan D

2013-11-01

Lateral impact tests were performed using seven male post-mortem human subjects (PMHS) to characterize the force-deflection response of contacted body regions, including the lower abdomen. All tests were performed using a dual-sled, side-impact test facility. A segmented impactor was mounted on a sled that was pneumatically accelerated into a second, initially stationary sled on which a subject was seated facing perpendicular to the direction of impact. Positions of impactor segments were adjusted for each subject so that forces applied to different anatomic regions, including thorax, abdomen, greater trochanter, iliac wing, and thigh, could be independently measured on each PMHS. The impactor contact surfaces were located in the same vertical plane, except that the abdomen plate was offset 5.1 cm towards the subject. The masses of the sleds and the force- deflection characteristics of the energy-absorbing interface material between the sleds were set to provide the impactor sled with a velocity profile that matched the average driver door velocity history produced in a series of side NCAP tests. Impactor padding was also selected so that average ATD pelvis and thorax responses from the same series of side NCAP tests were reproduced when the ATD used in these tests was impacted using the average door-velocity history. Each subject was first impacted on one side of the body using an initial impactor speed of 3 m/s. If a post-test CT scan and strain-gage data revealed two or fewer non-displaced rib fractures, then the PMHS was impacted on the contralateral side of the body at a speed of 8 m/s or 10 m/s. The results of tests in the 3 m/s and 8 m/s conditions were used to develop force-deflection response corridors for the abdomen, force history response corridors for the pelvis (iliac wing and greater trochanter), the midthigh, and the thorax. Response corridors for the lateral acceleration of the pelvis were also developed. Future work will compare side impact ATD

Necrotizing myofasciitis: an atypical cause of ''acute abdomen'' in an immunocompromised child

International Nuclear Information System (INIS)

Donnelly, L.F.; Frush, D.P.; O'Hara, S.M.; Bisset, G.S. III

1998-01-01

We report the case of an immunocompromised 15-year-old boy who presented with symptoms mimicking an ''acute abdomen'' related to necrotizing myofasciitis of the anterior abdominal wall. CT demonstrated the abdominal wall process as the cause of the patient's symptoms and sonographically guided aspiration confirmed the diagnosis. Despite prompt diagnosis and aggressive surgical debridement, the infection continued to progress and the patient died within 24 h of presentation. (orig.)

Rare cause of acute surgical abdomen with free intraperitoneal air: Spontaneous perforated pyometra. A report of 2 cases.

Science.gov (United States)

Lim, Siew Fung; Lee, Song Liang; Chiow, Adrian Kah Heng; Foo, Chek Siang; Wong, Andrew Siang Yih; Tan, Su-Ming

2012-01-01

The acute abdomen accounts for up to 40% of all emergency surgical hospital admissions and a large proportion are secondary to gastrointestinal perforation. Studies have shown the superiority of the abdominal CT over upright chest radiographs in demonstrating free intraperitoneal air. Spontaneous perforated pyometra is a rare cause of the surgical acute abdomen with free intraperitoneal air. Only 38 cases have been reported worldwide. We report 2 cases of spontaneously perforated pyometra in our hospital's general surgery department. Both underwent exploratory laparotomy: one had a total hysterectomy and bilateral salpingo-oophorectomy, while the other had an evacuation of the uterine cavity, primary repair of uterine perforation and a peritoneal washout. A literature search was conducted and all reported cases reviewed in order to describe the clinical presentations and management of the condition. Of the 40 cases to date, including 2 of our cases, the most common presenting symptoms were abdominal pain (97.5%), fever (37.5%) and vomiting (25.0%). The main indication for exploratory laparotomy was pneumoperitoneum (97.5%). Pyometra is an unusual but serious condition in elderly women presenting with an acute abdomen. A high index of suspicion is needed to make the appropriate diagnosis.

Pulmonary histiocytosis X - imaging aspects of pulmonary involvement; Histiocitose X - aspectos radiologicos do acometimento pulmonar

Energy Technology Data Exchange (ETDEWEB)

Sabedotti, Ismail Fernando; Maeda, Lucimara; Ferreira, Daniel Miranda; Montandon, Cristiano; Marins, Jose Luiz C. [Universidade Estadual de Campinas, SP (Brazil). Faculdade de Ciencias Medicas. Dept. de Radiologia

1999-06-01

Pulmonary histiocytosis X is an idiopathic disease which is and uncommon but important cause of pulmonary fibrosis in young adults. Chest radiographs and high resolution computed tomographic (HRCT) scans of the lungs of 7 patients diagnosed as pulmonary histiocytosis X were examined retrospectively. The authors reviewed the pathologic, clinical and radiographic features of pulmonary histiocytosis X, focusing on differential diagnosis and disease progression. Pulmonary histiocytosis X can be suspected on the basis of chest radiographic findings; predominantly upper lobe nodules and cysts present an increased sensitivity and are virtually pathognomonic of this disorder. Chest HRCT allows good assessment of the evolution of pulmonary histiocytosis X and is also valuable in distinguishing histiocytosis from other disorders that produces nodules or cysts. (author)

Role of computed tomography of abdomen in difficult to diagnose typhoid fever: a case series.

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Hafeez, Wajid; Rajalakshmi, S; Sripriya, S; Madhu Bashini, M

2018-04-01

Background and Aim Diagnosis of typhoid is challenging when blood cultures fail to isolate Salmonella species. We report our experience with interpreting computed tomography (CT) abdomen findings in a case series of typhoid fever. Methods The case series consisted of patients who had a CT abdomen done as part of their investigations and a final diagnosis of typhoid fever. The CT films were reviewed and findings evaluated for distinctive features. Results During 2011-2017, 11 patients met the inclusion criteria. Indication for CT was pyrexia of unknown origin in the majority of patients. Review of CT films revealed mesenteric lymphadenopathy (100%), terminal ileum thickening (85%), hepatosplenomegaly (45%), retroperitoneal lymphadenopathy (18%) and ascites (9%). Conclusions Enhancing discrete mesenteric lymphadenopathy and terminal ileum thickening are non-specific findings noted in typhoid fever. Absence of matted necrotic nodes and peritoneal thickening rule out tuberculosis and raise suspicion of typhoid fever in endemic regions.

Intraoperative radiation in the canine para-aortic abdomen

International Nuclear Information System (INIS)

Hoopes, P.J.; Gillette, E.L.

1984-01-01

Twenty adult beagle dogs received intraoperatively delivered 6 MeV electrons to the para-aortic abdomen and bladder. The dogs were equally divided into 4 dose groups receiving 22 Gy, 30 Gy, 38.5 Gy and 47 Gy. The 5 cm x 8 cm radiation field included a variable portion of the left kidney, the left ureter, the abdominal aorta and vena cava, the base of the bladder and the left sciatic and femoral nerves. The lesions observed were fibroelastic proliferation of the aortic intima, severe renal atrophy and fibrosis, ureteral stenosis, bladder fibrosis and demyelinating peripheral neuropathies. Histologic, morphometric and dose response analyses are compared with responses of dogs receiving more conventional fractionated doses to a total of 60 Gy, 70 Gy or 80 Gy x-ray in 6 weeks

Swordfish bill injury involving abdomen and vertebral column: case report and review

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Drossos Charalambos

2010-10-01

Full Text Available Abstract Background Penetrating injuries of the abdomen and spinal canal that involve organic material of animal origin are extremely rare and derive from domestic and wild animal attacks or fish attacks. Case presentation In this case report we present the unique, as far as the literature is concerned, unprovoked woman's injury to the abdomen by a swordfish. There are only four cases of swordfish attacks on humans in the literature - one resulted to thoracic trauma, two to head trauma and one to knee trauma, one of which was fatal - none of which were unprovoked. Three victims were professional or amateur fishermen whereas in the last reported case the victim was a bather as in our case. Our case is the only case where organic debris of animal's origin remained in the spinal canal after penetrating trauma. Conclusions Although much has been written about the management of penetrating abdominal and spinal cord trauma, controversy remains about the optimal management. Moreover, there is little experience in the management of patients with such spinal injuries, due to the fact that such cases are extremely rare. In this report we focus on the patient's treatment with regard to abdominal and spinal trauma and present a review of the literature.

Acute abdomen: An unusual presentation of disseminated Penicillium marneffei infection

OpenAIRE

George I; Sudarsanam T; Pulimood A; Mathews M

2008-01-01

Varied clinical presentations of Penicillium marneffei , an opportunistic pathogen in HIV disease has been rarely described in literature. We report a patient with advanced AIDS who presented to us with prolonged fever and had features of an acute abdomen. On radiologic imaging he had features of intestinal obstruction and mesenteric lymphadenitis. A diagnosis was made possible by endoscopic biopsies of the small bowel and bone marrow culture which grew P . Marneffei . He was treated with ...

Gd-DTPA: a bowel contrast agent for magnetic resonance imaging of the abdomen

International Nuclear Information System (INIS)

Vlahos, L.; Gouliamos, A.; Clauss, W.; Kalovidouris, A.; Hadjiioannou, A.; Athanasopoulou, A.; Trakadas, S.; Papavasiliou, C.

1992-01-01

Forty patients with suspected pathology in the abdomen and pelvis have been investigated with MRI before and after administration of Gd-DTPA as an oral or rectal solution. The findings are analysed with respect to: (a) filling of the GI tract; (b) contrast in the region of interest, surrounding fat and vessels; (c) diagnostic yield in comparison to non-enhanced MRI and contrast CT. At a concentration of 1 mmol/l Gd-DTPA provided consistent positive contrast in the stomach and bowel in all cases. In 57.5% of cases we achieved complete filling of the GI tract. The opacification in the region of interest was good or satisfactory in 90% of cases. The diagnostic value of contrast MRI was better in 93% of cases than the non-enhanced MRI of the abdomen. In comparison with contrast CT, the contrast MRI was better or of the same value in 92% of cases. Despite the disadvantage of poor fat-to-bowel contrast (35% of cases were classified as poor), it is concluded that Gd-DTPA-enhanced MRI provides good delineation of organs adjacent to the bowel so this contrast agent has potential for a future role in abdominal MRI. (orig.)

Gd-DTPA: a bowel contrast agent for magnetic resonance imaging of the abdomen

Energy Technology Data Exchange (ETDEWEB)

Vlahos, L. [Dept. of Radiology, Univ. of Athens, Areteion Hospital (Greece); Gouliamos, A. [Dept. of Radiology, Univ. of Athens, Areteion Hospital (Greece); Clauss, W. [Schering A. G., Berlin (Germany); Kalovidouris, A. [Dept. of Radiology, Univ. of Athens, Areteion Hospital (Greece); Hadjiioannou, A. [Dept. of Radiology, Univ. of Athens, Areteion Hospital (Greece); Athanasopoulou, A. [Dept. of Radiology, Univ. of Athens, Areteion Hospital (Greece); Trakadas, S. [Dept. of Radiology, Univ. of Athens, Areteion Hospital (Greece); Papavasiliou, C. [Dept. of Radiology, Univ. of Athens, Areteion Hospital (Greece)

1992-08-01

Forty patients with suspected pathology in the abdomen and pelvis have been investigated with MRI before and after administration of Gd-DTPA as an oral or rectal solution. The findings are analysed with respect to: (a) filling of the GI tract; (b) contrast in the region of interest, surrounding fat and vessels; (c) diagnostic yield in comparison to non-enhanced MRI and contrast CT. At a concentration of 1 mmol/l Gd-DTPA provided consistent positive contrast in the stomach and bowel in all cases. In 57.5% of cases we achieved complete filling of the GI tract. The opacification in the region of interest was good or satisfactory in 90% of cases. The diagnostic value of contrast MRI was better in 93% of cases than the non-enhanced MRI of the abdomen. In comparison with contrast CT, the contrast MRI was better or of the same value in 92% of cases. Despite the disadvantage of poor fat-to-bowel contrast (35% of cases were classified as poor), it is concluded that Gd-DTPA-enhanced MRI provides good delineation of organs adjacent to the bowel so this contrast agent has potential for a future role in abdominal MRI. (orig.)

Anatomic atlas for computed tomography in the mesaticephalic dog: caudal abdomen and pelvis

International Nuclear Information System (INIS)

Smallwood, J.E.; George, T. II.

1993-01-01

The purpose of this study was to produce a comprehensive anatomic atlas of CT anatomy of the dog for use by veterinary radiologists, clinicians, and surgeons. Whole-body CT images of two mature beagle dogs were made with the dogs supported in sternal recumbency and using a slice thickness of 13 mm. At the end of the CT session, each dog was euthanized, and while carefully maintaining the same position, the body was frozen. The body was then sectioned at 13-mm intervals, with the cuts matched as closely as possible to the CT slices. The frozen sections were cleaned, photographed, and radiographed using xeroradiography. Each CT image was studied and compared with its corresponding xeroradiograph and anatomic section to assist in the accurate identification of specific structures. Clinically relevant anatomic structures were identified and labeled in the three corresponding photographs (CT image, xeroradiograph, and anatomic section). In previous papers, the head and neck, and the thorax and cranial abdomen of the mesaticephalic (beagle) dog were presented. In this paper, the caudal part of the abdomen and pelvis of the bitch and male dog are presented

Función del diafragma durante la colocación de cargas sobre el abdomen en sujetos normales

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Sergio G. Monteiro

2012-04-01

Full Text Available Los efectos de las cargas en el abdomen con el objeto de producir entrenamiento del diafragma, no han sido suficientemente evaluados. Estudiamos la función del diafragma durante la colocación de cargas sobre el abdomen y con cambios en el patrón respiratorio. Se estudiaron 6 voluntarios normales. Se obtuvo flujo en la boca, presión gástrica (Pga, presión esofágica (Pes, movimiento torácico (TX y abdominal (AB, presión inspiratoria máxima (PImax y presión transdiafragmática media (Pdi y máxima (Pdimax. Se calculó la relación Pdi/Pdimax y el índice tensión-tiempo del diafragma (TTdi. Etapas: patrón normal (PN, patrón abdominal (PA y carga de 1, 2, 4 y 6 kg con PN y PA. El PA fue facilitado por las cargas sobre el abdomen. Solo con 6 kg (PN y PA la Pga a capacidad residual funcional aumentó significativamente (p 0.001. La Pdi siguió a las variaciones de la Pga y aumentó con todos los PA (p < 0.001. Con PA y carga el índice TTdi alcanzó un valor de 0.05 ± 0.02 (p < 0.001. Las cargas no aumentaron este índice más de lo que hizo el PA solo. Nuestros hallazgos sugieren que las cargas sobre el abdomen aumentan la propiocepción relacionada con los movimientos respiratorios y descenso del diafragma. Las cargas producen cambios leves en la mecánica del diafragma (en sujetos normales, 1/3 de la carga necesaria para desarrollar fatiga. En sujetos normales estos cambios parecen ser insuficientes para producir entrenamiento de los músculos respiratorios.

Unusual cause of acute abdomen in a child--torsion of greater omentum: report of two cases.

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Pogorelić, Zenon; Katić, Josip; Gudelj, Karla; Mrklić, Ivana; Vilović, Katarina; Perko, Zdravko

2015-08-01

Torsion of the omentum is twisting along its long axis and a rare cause of acute abdomen. Depending on associated conditions, it is classified as primary and secondary. It may mimic different pathologies presenting as acute abdomen, most common of them being acute appendicitis. Current choice for management of omental torsion is laparoscopic surgery. We present two cases of omental torsion of two boys who presented with abdominal pain, nausea and vomiting and underwent emergency laparoscopy. Omental torsion is very rare, and its diagnosis is usually made only after surgery. At laparoscopy, omental torsion is suspected when the appendix is normal and the symptoms and findings of torsion are present. Laparoscopy is a safe and effective approach for the diagnosis and management of omental torsion, with the advantages of reduced postoperative pain and hospital stay. © The Author(s) 2015.

Aspectos subjetivos relacionados con la violencia intrafamiliar. Caso municipio de Sabaneta Antioquia

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Naidalis Yadira Martínez

2016-01-01

Full Text Available El artículo identifica las interacciones en aspectos familiares y subjetivos. En el artículo se desarrollan los aspectos subjetivos de las dinámicas familiares que justifican el uso y la implementación de la violencia intrafamiliar, se da cuenta de la naturalización de la violencia intrafamiliar en la interacción de los grupos familiares, convirtiéndola en un elemento de la relación que se establece entre los miembros de la familia. En el análisis realizado se identifican aspectos coyunturales asociados a situaciones que se vivieron en la dinámica de la familia de origen, pero que al momento han sido pocas las condiciones que permiten la modi- ficación de estas conductas ya que las familias han asumido estas expresiones de violencia intrafamiliar como parte de sus vidas.

Clinical evaluation of digital radiography based on a large-area cesium iodide-amorphous silicon flat-panel detector compared with screen-film radiography for skeletal system and abdomen

International Nuclear Information System (INIS)

Okamura, Terue; Tanaka, Saori; Koyama, Koichi; Norihumi, Nishida; Daikokuya, Hideo; Matsuoka, Toshiyuki; Yamada, Ryusaku; Kishimoto, Kenji; Hatagawa, Masakatsu; Kudoh, Hiroaki

2002-01-01

The aim of this clinical study was to compare the image quality of digital radiography using the new digital Bucky system based on a flat-panel detector with that of a conventional screen-film system for the skeletal structure and the abdomen. Fifty patients were examined using digital radiography with a flat-panel detector and screen-film systems, 25 for the skeletal structures and 25 for the abdomen. Six radiologists judged each paired image acquired under the same exposure parameters concerning three observation items for the bone and six items for the abdomen. Digital radiographic images for the bone were evaluated to be similar to screen-film images at the mean of 42.2%, to be superior at 50.2%, and to be inferior at 7.6%. Digital radiographic images for the abdomen were judged to be similar to screen-film images at the mean of 43.4%, superior at 52.4%, and inferior at 4.2%; thus, digital radiographic images were estimated to be either similar as or superior to screen-film images at over 92% for the bone and abdomen. On the statistical analysis, digital radiographic images were also judged to be preferred significantly in the most items for the bone and abdomen. In conclusion, the image quality of digital radiography with a flat-panel detector was superior to that of a screen-film system under the same exposure parameters, suggesting that dose reduction is possible with digital radiography. (orig.)

Exploración de repositorios de software y análisis de potenciales extensiones a aspectos

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Graciela Beatriz Vidal

2014-06-01

Full Text Available Tanto el Desarrollo basado en Componentes como el Desarrollo de Software orientado a Aspectos son enfoque propuestos para abordar diversos problemas que surgen en el proceso de desarrollo de aplicaciones. Ambos enfoques tienen como objetivo el reuso de software, ante esta situación surge la necesidad de que componentes y aspectos compartan un espacio común en el cual puedan ser publicados, recuperados y reutilizados. Los repositorios actuales parecen no proveer aspectos de manera explícita, en ocasiones los aspectos son utilizados para especificar el componente, pero no son reusables. La tarea de publicar y recuperar componentes es muy compleja, existen diversos métodos de publicación y recuperación a tal fin. En este trabajo se exploraron diferentes repositorios analizando criterios al igual que se exponen los métodos de publicación y recuperación con el fin de determinar si es posible la adaptación o extensión de los repositorios a aspectos.

Effective dose evaluation of head and abdomen CT exams in adult patients at the Instituto de Radiologia of Faculdade de Medicina of University of Sao Paulo, SP, Brazil

International Nuclear Information System (INIS)

Nersissian, Denise Y.; Scolastici, Eric F.; Doro, Renato B.; Furquim, Tania A.C.

2013-01-01

This paper presents an estimate of the effective dose from CTDI vol for exams of skull and abdomen in adult patients. Thereafter, measurements were taken of CTDI using an ionization chamber type pencil (Radcal Corportation, model 10 x 5 - 3CT) and cylindrical phantom of PMMA equivalent to regions of the skull (diameter = 16 cm) and abdomen (diameter = 32 cm). The results of effective dose for abdomen varied between 7,3 and 12,1 mSv and for skull between 1,4 and 5,0 mSv. Comparing with the literature data, for abdomen exams between 5 and 7 mSV and skull exams between 1 and 2 mSv, it is shown that it is possible to optimize these protocols, aiming to reduce the doses to patients

O exercício físico e os aspectos psicobiológicos El ejercicio físico y los aspectos psicobiológicos Physical exercise and the psychobiological aspects

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Marco Túlio de Mello

2005-06-01

Full Text Available O objetivo desta revisão é trazer parte dos estudos sobre um assunto pouco explorado: a relação entre o exercício físico e os aspectos psicobiológicos. A importância da compreensão desses aspectos e como eles afetam a qualidade de vida do ser humano é o que estimula as pesquisas sobre esse assunto. A literatura destaca que a prática regular de exercício físico traz resultados positivos não somente ao sono e aos seus possíveis distúrbios, mas também aos aspectos psicológicos e aos transtornos de humor, como a ansiedade e a depressão, e aos aspectos cognitivos, como a memória e a aprendizagem. Contudo, há indivíduos que se envolvem na prática de exercícios físicos com tal intensidade e/ou freqüência ou, ainda, fazem uso de drogas ilícitas que podem trazer prejuízos à saúde, como, por exemplo, o dependente de exercício físico e o usuário de esteróides anabolizantes. O exercício físico provoca alterações fisiológicas, bioquímicas e psicológicas, portanto, pode ser considerado uma intervenção não-medicamentosa para o tratamento de distúrbios relacionados aos aspectos psicobiológicos.El objetivo de esta revisión es trazer parte de los estudios sobre un asunto poco explorado: la relación ejercicio físico y los aspectos psicobiológicos. La importancia de la comprensión de estos aspectos y como ellos afectan la calidad de vida del ser humano és lo que estimula las pesquisas sobre este asunto. La literatura destaca que la práctica regular del ejercicio físico trae resultados positivos no solamente al sueño y a los posibles distúrbios, más también a los aspectos psicológicos y los trastornos del humor, como la ansiedad y la depresión, y los aspectos cognitivos, como la memoria y el aprendizaje. Con todo hay individuos que se envuelven en la práctica de ejercícios físicos con tal intensidad y / o frecuencia o, donde, hacen usos de drogas ilícitas que pueden traer perjuicios a la salud, como

Lymphangioma of the jejunal mesentery and jejunal polyps presenting as an acute abdomen in a teenager.

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Jayasundara, Jasb; Perera, E; Chandu de Silva, M V; Pathirana, A A

2017-03-01

Cystic lymphangioma of the small bowel mesentery is a rare clinical entity, especially after childhood. Medical literature reveals a limited number of such cases presenting as acute abdomen due to bowel obstruction, small bowel volvulus and bleeding into the tumour. We present the management experience of an 18-year-old woman who presented with rapid onset diffuse peritonism and raised inflammatory markers. Computed tomography showed a mass in the small bowel mesentery with suspicion of segmental bowel ischaemia. Emergency laparotomy revealed a mass in the mid-jejunal mesentery close to the bowel wall with no bowel ischaemia. The patient made an uncomplicated recovery after segmental bowel resection and end-to-end anastomosis. Histology confirmed the mass as a cystic lymphangioma involving the jejunal mesentery and two small jejunal polyps. Lymphangioma could be considered in the differential diagnosis of an acute abdomen in a young adult when the presentation is atypical.

Criptococose pulmonar: aspectos na tomografia computadorizada

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Silva Ana Carina Gamboa da

2003-01-01

Full Text Available A criptococose pulmonar é uma doença causada pelo Criptococcus neoformans, um fungo unimórfico que possui distribuição mundial, existindo na mesma forma tanto no seu habitat natural quanto em animais e humanos. A doença possui apresentações clínica e patológica variáveis e pode manifestar-se tanto em pacientes com a imunidade normal como em imunocomprometidos, que representam a maioria dos casos. Neste trabalho são analisados os aspectos encontrados nas tomografias computadorizadas do tórax de 14 pacientes com criptococose pulmonar confirmada. Os achados mais freqüentes na tomografia do tórax foram as massas e os nódulos pulmonares. Outros aspectos observados foram as áreas de escavação, as consolidações, o espessamento do interstício peribroncovascular e o reticulado difuso. Massa pulmonar foi o achado isolado mais comum (64,2%, seguido dos nódulos isolados ou múltiplos (35,7%. Doença pulmonar difusa foi vista em apenas 14,2% dos casos. Os lobos superiores foram os mais comprometidos, sendo a doença mais comum nas regiões anteriores. A tomografia do tórax permitiu avaliar com precisão o grau de comprometimento do parênquima pulmonar.

Radiographic image quality and dose at thorax, abdomen and skull of patients at HC-FMB-UNESP

International Nuclear Information System (INIS)

Alvarez, Matheus; Giacomini, Guilherme; Bacchim Neto, Fernando A.; Alves, Allan F.F.; Velo, Alexandre F.; Miranda, Jose R.A.; Pina, Diana R. de

2013-01-01

ICRP 103 specifies reference dose levels to be used during radiographic exams. Usually, the radiographer qualitative determines the best radiographic technique (kV and mAs) in order to obtain better image quality with the lowest dose. The objective of this study was to evaluate the doses used in examination of the chest, abdomen and skull in patients of different physical sizes, and infer about the amount of dose required to maintain acceptable radiological contrast in patients of different physical sizes. Techniques used by experienced radiographers of HC-FMB-UNESP for examinations of the chest (PA), abdomen (AP) and skull (AP) for patients of different thickness (small, medium and thick body) were obtained. Dose measurements were performed referring to all kV/mAs combinations. PMMA phantoms were placed below the ionization chamber. The Signal Difference Noise Ratio (SDNR) of the images of the phantoms were calculated from an area of contrast and a region of normal tissue. The Figure of Merit (FoM) was calculated for each of the exam modality. Measured FoM decreased according to the thickness of the chest and abdomen, indicating the need to increase the dose level to maintain the same level of image contrast. Patients thicker usually end up getting more than twice the dose of lean patients. Required image quality levels for correct diagnosis should be obtained using dose levels as low as reasonably practicable examination. These factors highlight the need for a program of quality assurance and effective dose studies in actual service. (author)

International consensus conference on open abdomen in trauma.

Science.gov (United States)

Chiara, Osvaldo; Cimbanassi, Stefania; Biffl, Walter; Leppaniemi, Ari; Henry, Sharon; Scalea, Thomas M; Catena, Fausto; Ansaloni, Luca; Chieregato, Arturo; de Blasio, Elvio; Gambale, Giorgio; Gordini, Giovanni; Nardi, Guiseppe; Paldalino, Pietro; Gossetti, Francesco; Dionigi, Paolo; Noschese, Giuseppe; Tugnoli, Gregorio; Ribaldi, Sergio; Sgardello, Sebastian; Magnone, Stefano; Rausei, Stefano; Mariani, Anna; Mengoli, Francesca; di Saverio, Salomone; Castriconi, Maurizio; Coccolini, Federico; Negreanu, Joseph; Razzi, Salvatore; Coniglio, Carlo; Morelli, Francesco; Buonanno, Maurizio; Lippi, Monica; Trotta, Liliana; Volpi, Annalisa; Fattori, Luca; Zago, Mauro; de Rai, Paolo; Sammartano, Fabrizio; Manfredi, Roberto; Cingolani, Emiliano

2016-01-01

A part of damage-control laparotomy is to leave the fascial edges and the skin open to avoid abdominal compartment syndrome and allow further explorations. This condition, known as open abdomen (OA), although effective, is associated with severe complications. Our aim was to develop evidence-based recommendations to define indications for OA, techniques for temporary abdominal closure, management of enteric fistulas, and methods of definitive wall closure. The literature from 1990 to 2014 was systematically screened according to PRISMA [Preferred Reporting Items for Systematic Reviews and Meta-analyses] protocol. Seventy-six articles were reviewed by a panel of experts to assign grade of recommendations (GoR) and level of evidence (LoE) using the GRADE [Grading of Recommendations Assessment, Development, and Evaluation] system, and an international consensus conference was held. OA in trauma is indicated at the end of damage-control laparotomy, in the presence of visceral swelling, for a second look in vascular injuries or gross contamination, in the case of abdominal wall loss, and if medical treatment of abdominal compartment syndrome has failed (GoR B, LoE II). Negative-pressure wound therapy is the recommended temporary abdominal closure technique to drain peritoneal fluid, improve nursing, and prevent fascial retraction (GoR B, LoE I). Lack of OA closure within 8 days (GoR C, LoE II), bowel injuries, high-volume replacement, and use of polypropylene mesh over the bowel (GoR C, LoE I) are risk factors for frozen abdomen and fistula formation. Negative-pressure wound therapy allows to isolate the fistula and protect the surrounding tissues from spillage until granulation (GoR C, LoE II). Correction of fistula is performed after 6 months to 12 months. Definitive closure of OA has to be obtained early (GoR C, LoE I) with direct suture, traction devices, component separation with or without mesh. Biologic meshes are an option for wall reinforcement if bacterial

Sonographic findings of ovarian hemorrhage presenting acute abdomen

International Nuclear Information System (INIS)

Sun, Joo Sung; Lee, Eun Ju; Kang, Hae Jin; Suh, Jung Ho

2000-01-01

To obtain the characteristic sonographic findings of ovarian hemorrhage and investigate the usefulness of ultrasonography in the diagnosis. Forty-nine cases presenting acute abdomen diagnosed as ovarian hemorrhage by ultrasonography or surgicopathological confirmation. We observed the size and margin of the ovary, size, pattern, shape, wall and internal echogenecity of the masses and the amount of hemoperitoneum. We also performed a color Doppler study to evaluate the blood flow pattern and resistive index (RI). The age of patients were between 21-41. Most symptoms occurred from days 14 to 30 of her menstrual cycle and were presented for less than 24 hours. Twenty patients had a history of intercourse shortly before the onset of the symptom. Thirty two cases involved the right ovary while the other 17 cases involved the left. All patients had a negative urine or serum hCG test except for 4 pregnant women. The size of the ovary was measured as mean 5.1 cm and marginal irregularly was noted in 36 cases. Mixed echoic solid masses were observed in 6 cases and variable echogenecity of cystic masses were seen in 43 cases. Maximal diameter of adnexal masses were measured as mean 3.95 cm. Internal echogenecity of cystic masses appeared as mainly heterogeneous (21). Twenty two cystic masses had a thick irregular wall and 17 had a thin smooth wall. Hypoechoic rim like halo surrounding was noted in 17 cystic masses. 17 cases seemed to have a small amount of hemoperitoneum, a moderate amount in 22 cases and a large amount in 9 cases. The blood flow pattern of cystic masses showed a rim (29) and spotty (8) pattern in the color Doppler study. Measured RI was 0.41 (mean). Fertile women with the complaint of acute abdominal pain, who has the laboratory data of negative hCG test, ultrasonographic findings of enlargement of ovary with irregular margin, heterogeneous echoic cystic mass, peripheral halo surrounding the mass, hemoperitoneum and low resistance index of peripheral blood

Contenedores: Aspectos tecnicos, biologicos y economicos

Science.gov (United States)

Tara Luna; Thomas D. Landis; R. Kasten Dumroese

2012-01-01

La elección del contenedor es una de las consideraciones más importantes al establecer un nuevo vivero o empezar a producir una especie nueva. El tipo y tamaño de contenedor no sólo determina la cantidad de agua y nutrientes minerales que están disponibles para el crecimiento de una planta, sino que también afecta otros aspectos operativos del vivero, como el tamaño de...

Evaluation of body simulator for chest and abdomen in digital X-ray equipment

International Nuclear Information System (INIS)

Soares, Sidney S.; Cardoso, Gabriela P.; Oliveira, Giovanni Antônio P.; Batista, Adriana S.M.; Pereira, Esther Lorrayne M.

2017-01-01

The use of body simulators to control the quality of X-ray images is a practice that guarantees the control of essential parameters for diagnosis by the technique. The evolution of the equipment, between the analogue, digital computerized radiology (CR) and direct radiography (DR), requires evaluation of the equivalence in grayscale, of simulators, for an adjustment according to the specific technology of obtaining the image. In this sense, the present work presents the evaluation of a body simulator with regard to the representation of mean values of signal, noise and contrast obtained in chest radiographs and panoramic of the abdomen. For the thorax the cardiac region was considered as simulation target and for the abdomen simulation of the liver and small intestine. We used a retrospective study of images obtained with X-ray equipment - CR system, in which the images were studied using the ImageJ program, generating a data catalog. These were subsequently compared with those obtained experimentally using gel filled polymer body simulator. For the validation of the simulator, it was observed the gel equivalence of filling of the polymer box required to reach the image parameters of the cataloged radiographs. The results are discussed as to the physical principles of radiation interaction with biological and equivalent tissues

Meningites bacterianas no lactente aspectos neurológicos

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M. Valeriana L. de Moura-Ribeiro

1990-06-01

Full Text Available Aspectos clínicos, neurológicos e laboratoriais das meningites bacterianas agudas no lactente são criticamente analisados em função da experiência da autora. São apresentadas considerações fisiopatológicas sobre os eventos que ocorrem na fase aguda desses processos.

ASPECTOS NORTEADORES NA ORIENTAÇÃO DE MONOGRAFIA A DISTÂNCIA

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monica seixas mello

2012-12-01

Full Text Available O objetivo do presente estudo é analisar os aspectos norteadores na orientação de monografia na modalidade a distância a partir de relato de experiência em curso de pó-graduação Lato Sensu em Gestão Pública., constatando-se que na orientação a distância em ambientes virtuais de aprendizagem as interações entre professor e aluno observam os seguintes aspectos: pedagógico, gerencial, social e técnico Palavras-chaves: educação, distância, orientação, monografia, pos-graduação.

[Efficacy of intestinal splinting in hostile abdomen secondary to postoperative flanges in pediatric patients].

Science.gov (United States)

Bracho-Blanchet, Eduardo; Langarica-Bulos, Mónica; Dávila-Pérez, Roberto; Fernández-Portilla, Emilio; Zalles-Vidal, Cristian; Nieto-Zermeño, Jaime

2016-10-01

Objetivo: Mostrar la eficacia de la FI para prolongar el tiempo libre de oclusión intestinal quirúrgica en niños con abdomen hostil secundario a bridas posquirúrgicas. Método: Análisis retrospectivo de FI por abdomen hostil de 2000 a 2011 y su seguimiento a largo plazo. Comparamos el tiempo libre de oclusión quirúrgica antes y después de la FI. Resultados: Se incluyeron 20 FI en 19 pacientes. Predominaron las causas congénitas, la mediana de edad en la cirugía fue de 6 meses, todos tenían cirugías previas con mediana de tres, y dos de ellas fueron por oclusión intestinal previa. La férula se quitó a los 28 días (mediana). Con un seguimiento de 1-183 meses, hubo una recurrencia de oclusión quirúrgica. El tiempo libre de oclusión quirúrgica posferulización fue significativamente mayor que el preferulización mediante la prueba de Wilcoxon, con un valor Z = -3.594; p = el tiempo libre de oclusión quirúrgica.

Usefulness of the helical CT in gastro intestinally caused acute abdomen

International Nuclear Information System (INIS)

Cruz, R. A. de la; Martel, J.; Albillos, J. C.; Oliver, J. M.; Lopez, J.; Trapero, M. A.

2000-01-01

At present, there is a vivid debate on the role of the Helical CT (HCT) in the acute abdomen, principally on the usefulness of the non contrast HCT. We aim to present the most common semiological findings and the differential diagnoses, and to give a short description of the indications and protocols, according to the existing literature and to our experience with HCT during the last three years. We believe that the generalization of the use of HCT in emergencies avoid unnecessary surgery and shorten observation times on many occasions, with clear benefits in the clinical management of the patients. (Author) 30 refs

MANEJO LOCAL DE UNA FÍSTULA ENTERO-ATMOSFÉRICA EN EL ABDOMEN ABIERTO: CURA EN CHIMENEA PRESENTACIÓN DE CASO

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Sánchez-Manuel FJ

2015-01-01

Full Text Available INTRODUCTION: The open abdomen is both a resource and a surgical sequela after damage-control surgery, that helps saving the live of critically ill patients. It can have significant complications, the most severe one is the entero-atmospheric fistula. CASE REPORT: We report the case of a patient from our hospital, treated with longstanding open abdomen because of a traumatic pancreatitis and development of an enteroatmospheric fistula, handled with a variation of the fistula ring technique: a "fireplace" design in a vacuum system. A review of the literature on the subject is made. RESULTS AND CONCLUSIONS: This strategy proved effective for the management of the fistula until the final repair of the bowel. The management of an enteroatmospheric fistula is a major technical challenge to prevent the leak of intestinal contents on the surrounding exposed bowel and granulation tissue. The "fireplace" design represents a good option for distal ileum fistulas, greatly simplifying the treatment of the patient by maintaining the open abdomen clean and the fistula effluent isolated until the transit repair, which is usually carried out along with the abdominal wall repair, few months later.

Ct enterography/ct abdomen and pelvis using neutral oral contrast. a new combination of natural products

International Nuclear Information System (INIS)

Aslam, M.O.

2014-01-01

Our purpose was to assess the performance of a new combination of neutral oral contrast for CT abdomen and CT Enterography in comparison with commercially available neutral oral contrast VoLumen. Seventy three consecutive patients were given sorbitol/CMC (Carboxy Methyl Cellulose) solution or VoLumen as oral contrast agent for abdominal computed tomography (CT) scan. 23 patients were male and 37 females. Age range was between 16 and 67 years. Since the use of CT scan for abdominal pathologies, there was need to separate bowel loops to localize the pathology. Three types of oral contrast can be used in CT-Scan abdomen; Positive, Neutral and negative. The above used contrasts are Neutral contrast these refers to agents that have an attenuation value similar to that of water (0-30 H).Our results show this new combination of Cc and Sorbitol to be equally good as VoLumen, for luminal distension and mural details, in duodenum and jejunum. While better than VoLumen for Ileal distension. (author)

Ruptured Granulosa Cell Tumor of the Ovary as a Cause of Acute Abdomen in Postmenopausal Woman

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Tufan Oge

2012-01-01

Full Text Available Acute abdomen with hemoperitoneum is a very rare entity in postmenopausal women due to gynecologic conditions. A 54-year-old, postmenopausal woman was brought to emergency department with severe abdominal pain. Physical examination revealed acute abdomen findings with 15 cm pelvic mass on the right adnexal region. Immediate exploratory laparotomy was performed. During laparotomy 1000 cc of bloodstained fluid, ruptured and actively bleeding large mass arising from right ovary was observed. Right salpingo-oopherectomy was performed in emergency conditions, and pathology report revealed an adult type of granulosa cell tumor. After this result, staging surgery was performed and patient was diagnosed as granulosa cell tumor stage 1 c. Cisplatin, etoposide, and bleomycin chemotherapy was given. Clinicians should be aware of granulosa cell tumors which may occur at any age and prone to rupture. Frozen section will be helpful in order to avoid incomplete surgeries especially in postmenopausal women presented with intra-abdominal bleeding.

Aspectos sociotécnicos das TI & Relacionamento Humano & Sinergia

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Sergio Vieira Holtz Filho

2008-06-01

Full Text Available As Tecnologias de Informação (TI estão entre os principais agentes de mudança sociais. Para gerir tais mudanças, uma miríade de áreas do conhecimento humano têm muito a contribuir para a abordagem dos aspectos sociotécnicos das TI e promover sinergia. Como uma organização empresarial atua no sentido de provocar mudanças no comportamento das pessoas, visando a melhoria contínua, esse processo de mudança provocada chama-se aprendizagem. Isto posto, neste artigo apresentaremos resultados observados em empresas em processo de reengenharia e submetidas a utilização de metodologias integradas (PDCA, Método Paulo Freire e Roteiro Integração de Equipes, abordando os aspectos sociotécnicos das TI & relacionamentos humanos pela praxe da pedagogia como elemento de sinergia.

IDIOPATHIC OMENTAL INFARCTION : A RARE CAUSE OF ACUTE PAIN ABDOMEN

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Narendra Nath

2015-02-01

Full Text Available Omental torsion leading on to omental infarction is an unusual cause of acute abdominal pain in adults. Often the condition mimics common causes of acute abdomen like acute cholecystitis, acute appendicitis or acute pancreatitis. A review of literature reveals that this enigmatic condition has been managed both non - operatively and by surgery in the past. We report the case of a 46 - year - old man who presented with a 4 - day history of severe right - sided abdominal pain mimicking acute cholecystitis. Abdominal CT scan revealed a right upper quadrant mass with a whirl - like appearance, suspicious for omental infarction. He was started on conservative management with analgesics and antibiotics. He improved symptomatically and was discharged

Evaluation of the usefulness of computed tomography on diagnosis and management of acute abdomen

International Nuclear Information System (INIS)

Sakai, Takehiro; Yagihashi, Nobuo; Osawa, Tadaharu; Harada, Osamu; Ito, Hiroyuki

2007-01-01

We evaluated the usefulness of computed tomography (CT) in diagnosing and managing acute abdomen. Subjects were 91 patients admitted complaining of acute abdominal pain and divided into two groups-those undergoing CT within 24 hours of admission (emergency CT group, n=70), those without CT (Non-CT group, n=21). The emergency CT group was subdivided into those with bowel obstruction (bowel obstruction group, n=29), those with acute appendicitis and other diseases necessitating differential diagnosis (appendicitis group, n=36), those with perforation of the digestive tract (perforation group, n=4), and other disease (n=1). We evaluated the accuracy of admission diagnosis retrospectively in each group. The final diagnosis of the bowel obstruction group was adhesive bowel obstruction in 16, colon cancer in 5, external hernia in 3 and other in 5. That in the appendicitis group was acute appendicitis in 25, colonic diverticulitis in 3, pelvic inflammatory disease in 3, ovarian hemorrhage in 2 and other in 5. The origin of perforation in the perforation group was upper digestive tract in 2 and lower digestive tract in 2. The sensitivity, specificity and accuracy of admission diagnosis in the emergency CT group was 91.1, 100 and 91.4%, respectively. The accuracy of admission diagnosis was 96.5% in the bowel obstruction group, 88.9% in the appendicitis group and 75.9% in the perforation group. Patients who could not be diagnosed precisely consisted of 6 patients in the emergency CT group. Those who could not be diagnosed precisely included 3 with pericecal abscess, 1 with acute appendicitis, 1 with stercoral perforation of the sigmoid colon and 1 with impacted bezoar in the small intestine. Evaluated retrospectively, 4 patients were able to be diagnosed by CT on admission. In diagnosis of acute abdomen, CT was useful in differential diagnosis of bowel obstruction and acute appendicitis, detection of fine free air, and determine of perforated sites. Emergency CT was thus

La gestión por procesos, su surgimiento y aspectos teóricos

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Daysi Ruiz - Fuentes

2013-01-01

Full Text Available Abordó aspectos históricos y teóricos relacionados con la gestión por procesos, se precisa las potencialidades de su aplicación para el perfeccionamiento de la dirección de las empresas. Presentó un análisis de diferentes definiciones de este término a partir del c ual se determinan las regularidades que lo caracterizan. Se puntualizan algunos aspectos teóricos vinculados con esta forma de gestión empresarial.

La gestión por procesos, su surgimiento y aspectos teóricos

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Daysi Ruiz-Fuentes; Rosa Mercedes Almaguer-Torres; Isabel Cristina Torres-Torres; Alejandro Miguel Hernández-Peña

2014-01-01

Abordó aspectos históricos y teóricos relacionados con la gestión por procesos, se precisa las potencialidades de su aplicación para el perfeccionamiento de la dirección de las empresas. Presentó un análisis de diferentes definiciones de este término a partir del c ual se determinan las regularidades que lo caracterizan. Se puntualizan algunos aspectos teóricos vinculados con esta forma de gestión empresarial.

Acute abdomen and ascites as presenting features of autosomal dominant polycystic kidney disease

OpenAIRE

Chaudhary, Sanjay; Qian, Qi

2012-01-01

We describe a patient with sudden onset of abdominal pain and ascites, leading to the diagnosis of autosomal dominant polycystic kidney disease (ADPKD). Her presentation was consistent with acute liver cyst rupture as the cause of her acute illness. A review of literature on polycystic liver disease in patients with ADPKD and current management strategies are presented. This case alerts physicians that ADPKD could occasionally present as an acute abdomen; cyst rupture related to ADPKD may be ...

Aspectos nutricionales de la anorexia nerviosa

OpenAIRE

Delgado Santirso, Pablo

2017-01-01

El estudio que se presentará en las siguientes líneas pretende la actualización de los datos sobre los aspectos nutricionales de uno de los principales Trastornos de la Conducta Alimentaria (TCA), la Anorexia Nerviosa (AN), así como aportar información acerca de sus características generales, etiopatogenia, evaluación y diagnóstico y tratamiento. Se centrará fundamentalmente en las medidas higiénico-dietéticas necesarias del tratamiento nutricional y en el establecimiento de la función del di...

Estilo de vida materno e aspectos nutricionais do pré-escolar

OpenAIRE

Érica Bezerra Nobre

2016-01-01

INTRODUÇÃO: Muitos dos comportamentos de saúde envolvidos no aparecimento das doenças crônicas não comunicáveis são originados na infância sob influência dos pais. A mãe é a pessoa mais envolvida na educação e nos cuidados de saúde da criança. O estilo de vida (EdV) é um determinante social da saúde. Nunca se compreendeu características de EdV materno associadas com aspectos da nutrição infantil. OBJETIVO: Verificar a associação dos EdV materno comportamental e não comportamental com aspectos...

Factors that affect the accuracy in the precise radiotherapy for abdomen tumors

International Nuclear Information System (INIS)

Yang Tieming; Ju Yongjian

2008-01-01

The precise radiotherapy has been widely used in the clinics. But there are many factors that affect the accuracy in the course of implementation. Finally the effect of radiotherapy is affected. These factors are reviewed. And the previous research data about the abdomen tumors is summed up. Also how the accuracy was affected by the respiratory movement, positioning, position fixed technology, weight, retraction and motion of the tumor and the situation of surrounding organs will be analyzed. At last, how to avoid these errors in clinics will be discussed. (authors)

Aspectos prosódicos da fala de sujeitos parkinsonianos

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Lourenço Chacon

2001-02-01

Full Text Available

Problemas de prosódia na fala de parkinsonianos têm sido apontados nos estudos sobre parkinsonismo. Contudo, nesses estudos a prosódia é freqüentemente desvinculada dos fatores comunicativos da fala. O propósito deste artigo foi investigar fatores comunicativos relacionados a aspectos prosódicos da fala de sujeitos com doença de Parkinson. As amostras 'de fala foram extraídas de conversas espontâneas de dois sujeitos parkinsonianos, do sexo masculino. A análise mostrou que os elementos prosódicos ocorreram em diversas combinações, possibilitando a identificação de: a atos de fala; b alguns aspectos da organização conversacional; e c diferentes vozes no discurso. Foram destacadas algumas implicações desses resultados para uma melhor compreensão da atividade verbal em condições patológicas, bem como para avaliação, diagnóstico e terapia de parkinsonianos.

Whole-abdomen radiotherapy for non-Hodgkin's lymphoma using twice-daily fractionation

International Nuclear Information System (INIS)

Liauw, Stanley L.; Yeh, Alexander M.; Morris, Christopher G.; Olivier, Kenneth R.; Mendenhall, Nancy Price

2006-01-01

Purpose: To report the tolerability and efficacy of twice-daily whole-abdomen irradiation (WAI) for non-Hodgkin's lymphoma (NHL). Methods and Materials: Of 123 patients treated for NHL with WAI, 37% received previous chemotherapy, 28% received WAI as part of comprehensive lymphatic irradiation (CLI), and 32% received WAI for palliation. The median dose to the whole abdomen was 25.0 Gy, followed by a median tumor boost of 9.8 Gy in 58 patients. Fractionation was 1.0 Gy once daily (54%) or 0.8 Gy twice daily (46%). Blood counts were measured weekly. Results: At a median follow-up of 4.3 years, local control was 72% and overall survival was 55% at 5 years. Median time of WAI was 42 days for once-daily treatment and 32 days for twice-daily treatment. Patients receiving twice-daily WAI did not have a significantly higher rate of acute side effects (e.g., nausea, diarrhea, platelet or red blood cell toxicity). Overall, acute thrombocytopenia was the most frequent side effect of treatment; 24 of 96 patients (25%) with available hematologic data had Grade 3+ toxicity. There was no acute Grade 3 gastrointestinal toxicity and no late small bowel obstruction. Multiple regression indicated that patients with four or less involved sites and disease size ≤6 cm had improved local control and overall survival. Conclusions: Twice-daily WAI using 0.8 Gy/fraction does not appear to have any greater toxicity compared with once-daily treatment using 1 Gy/fraction. Small doses per fraction (0.8-1 Gy/fx) are effective, tolerated well in the acute setting, and associated with a low rate of late toxicity

Prophylaxis of radiotherapy induced diarrhea after irradiation of the pelvis or the abdomen

International Nuclear Information System (INIS)

Hombrink, J.; Voss, A.C.; Froehlich, D.; Glatzel, M.; Krauss, A.; Glaser, F.H.

1995-01-01

Radiotherapy induced diarrhea and convulsive pain are severe side-effects of irradiation of the pelvis and the abdomen leading often to an interruption of the treatment. Up to now these side-effects were only treated symptomatically, prophylactic therapies are not known. During the years 1992 and 1993 174 patients who obtained radiotherapy in the pelvis or the abdomen because of different malignancies were observed referring to the diarrhea-prophylactic effect of Smectite (=Skilpin R ). 80 patients received Smectite at the beginning of radiotherapy, 94 patients of the controlgroup were treated with motility modifying drugs when diarrhea appeared. The following parameters were compared: Frequency, consistence and incontinence of stool, tenesmus and the onset of diarrhea. 67,0% (n=63) of the patients in the controlgroup developed diarrhea, whereas in the pretreated Smectite-group only 37,5% of the cases (n=30) developed diarrhea. The first appearance of diarrhea was at day 17 in the pretreated group and averagely at day 11 in the controlgroup. 44% of the patients in the controlgroup suffered from tenesmus versus 25% in the Smectite-group. In comparison to the symptomatic treatment of radiation enteritis the prophylactic application of Smectite is able to reduce the diarrhea from the beginning of raditherapy or at least to reduce the pathological frequency of stool and therefore to increase the quality of life. (orig.) [de

Aspectos ergonômicos e estatísticos no projeto de um carro do metrô

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Costa Neto Pedro Luiz de Oliveira

2002-01-01

Full Text Available Este artigo descreve experimentos realizados como parte de um trabalho envolvendo aspectos do projeto de um carro para uma nova linha do Metrô de São Paulo. Nele são considerados aspectos ergonômicos relacionados com a posição de barras de segurança e assentos, bem como aspectos estatísticos relacionados com o fluxo de passageiros entrando e saindo do carro na estação. Nesse estudo, é de particular interesse o uso da técnica do quadrado latino na análise de regressão múltipla, como forma de reduzir o porte do experimento.

Abdomen disease diagnosis in CT images using flexiscale curvelet transform and improved genetic algorithm.

Science.gov (United States)

Sethi, Gaurav; Saini, B S

2015-12-01

This paper presents an abdomen disease diagnostic system based on the flexi-scale curvelet transform, which uses different optimal scales for extracting features from computed tomography (CT) images. To optimize the scale of the flexi-scale curvelet transform, we propose an improved genetic algorithm. The conventional genetic algorithm assumes that fit parents will likely produce the healthiest offspring that leads to the least fit parents accumulating at the bottom of the population, reducing the fitness of subsequent populations and delaying the optimal solution search. In our improved genetic algorithm, combining the chromosomes of a low-fitness and a high-fitness individual increases the probability of producing high-fitness offspring. Thereby, all of the least fit parent chromosomes are combined with high fit parent to produce offspring for the next population. In this way, the leftover weak chromosomes cannot damage the fitness of subsequent populations. To further facilitate the search for the optimal solution, our improved genetic algorithm adopts modified elitism. The proposed method was applied to 120 CT abdominal images; 30 images each of normal subjects, cysts, tumors and stones. The features extracted by the flexi-scale curvelet transform were more discriminative than conventional methods, demonstrating the potential of our method as a diagnostic tool for abdomen diseases.

Relationship of the Cold-Heat Sensation of the Limbs and Abdomen with Physiological Biomarkers.

Science.gov (United States)

Pham, Duong Duc; Lee, JeongHoon; Kim, GaYul; Song, JiYeon; Kim, JiEun; Leem, Chae Hun

2016-01-01

The present study explored the relationship between the regional Cold-Heat sensation, the key indicator of the Cold-Heat patterns in traditional East Asian medicine (TEAM), and various biomarkers in Korean population. 734 apparently healthy volunteers aged 20 years and older were enrolled. Three scale self-report questions on the general thermal feel in hands, legs, and abdomen were examined. We found that 65% of women tended to perceive their body, particularly their hands and legs, to be cold, versus 25% of men. Energy expenditure and temperature load at resting state were lower in women, independently of body mass index (BMI). Those with warm hands and warm legs had a 0.74 and 0.52 kg/m 2 higher BMI than those with cold hands and cold legs, respectively, regardless of age, gender, and body weight. Norepinephrine was higher, whereas the dynamic changes in glucose and insulin during an oral glucose tolerance test were lower in those with cold extremities, particularly hands. No consistent differences in biomarkers were found for the abdominal dimension. These results suggest that gender, BMI, the sympathetic nervous system, and glucose metabolism are potential determinants of the Cold-Heat sensation in the hands and legs, but not the abdomen.

Relationship of the Cold-Heat Sensation of the Limbs and Abdomen with Physiological Biomarkers

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Duong Duc Pham

2016-01-01

Full Text Available The present study explored the relationship between the regional Cold-Heat sensation, the key indicator of the Cold-Heat patterns in traditional East Asian medicine (TEAM, and various biomarkers in Korean population. 734 apparently healthy volunteers aged 20 years and older were enrolled. Three scale self-report questions on the general thermal feel in hands, legs, and abdomen were examined. We found that 65% of women tended to perceive their body, particularly their hands and legs, to be cold, versus 25% of men. Energy expenditure and temperature load at resting state were lower in women, independently of body mass index (BMI. Those with warm hands and warm legs had a 0.74 and 0.52 kg/m2 higher BMI than those with cold hands and cold legs, respectively, regardless of age, gender, and body weight. Norepinephrine was higher, whereas the dynamic changes in glucose and insulin during an oral glucose tolerance test were lower in those with cold extremities, particularly hands. No consistent differences in biomarkers were found for the abdominal dimension. These results suggest that gender, BMI, the sympathetic nervous system, and glucose metabolism are potential determinants of the Cold-Heat sensation in the hands and legs, but not the abdomen.

Aspectos Técnicos en la Producción de Caucho Hevea

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Uribe Henao Alfonso

1950-09-01

Full Text Available El propósito primordial de este trabajo es el de hacer una exposición de los principales factores o aspectos técnicos que deben tenerse en cuenta en el planeamiento y desarrollo del cultivo de la Hevea, para poder obtener de él en la forma más económica el máximo beneficio. Se ha dacio preferencia a los aspectos técnicos concernientes al Hevea de mayor importancia, sin pretender exponerlos todos. No es pues su objetivo dar a conocer todos aquellos detalles y sistemas aconsejables y necesarios en su explotación que pudieran considerarse como principios elementales, y que más bien vienen a ser prácticas corrientes del cultivo.

505 Effective Medicated Abdomen Wrapper Best External Care for Lingering Diseases Unconventional Product for Vigorous Health

Institute of Scientific and Technical Information of China (English)

1993-01-01

505 Effective Medicated Abdomen Wrapper,a national patent product(patent num-ber 90202386.1),together with its serial products,has filled in the gaps in the field ofChina’s medical science and health care products.The development of the product wasbrought into line with the State Spark Programme by the State Commission for Science

Aspectos ultra-estruturais da forma epimastigota do Trypanosoma cruzi em meio LIT

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Wanderley de Souza

1975-06-01

Full Text Available E feito um estudo da ultra-estrutura da forma epismastigota do Trypanosoma cruzi mantida em meio de cultivo acelular. O núcleo das formas em divisão apresenta um aspecto homogêneo. Microtúbulos intranucleares são observados durante a divisão. No entanto, a membrana nuclear permanece íntegra. O citoplasma apresenta-se com vacúolos de dimensões e aspectos variados. Com o método do ácido periódico-tiosemicarbazida-proteinato de prata, polissacaríáeos e/ou glicoproteínas foram localizados na membrana celular e na membrana que delimita certos vacúolos citoplasmáticos.

Evaluation of amylase and lipase levels in blunt trauma abdomen patients.

Science.gov (United States)

Kumar, Subodh; Sagar, Sushma; Subramanian, Arulselvi; Albert, Venencia; Pandey, Ravindra Mohan; Kapoor, Nitika

2012-04-01

There are studies to prove the role of amylase and lipase estimation as a screening diagnostic tool to detect diseases apart from acute pancreatitis. However, there is sparse literature on the role of serum and urine amylase, lipase levels, etc to help predict the specific intra-abdominal injury after blunt trauma abdomen (BTA). To elucidate the significance of elevation in the levels of amylase and lipase in serum and urine samples as reliable parameters for accurate diagnosis and management of blunt trauma to the abdomen. A prospective analysis was done on the trauma patients admitted in Jai Prakash Narayan Apex Trauma Center, AIIMS, with blunt abdomen trauma injuries over a period of six months. Blood and urine samples were collected on days 1, 3, and 5 of admission for the estimation of amylase and lipase, liver function tests, serum bicarbonates, urine routine microscopy for red blood cells, and complete hemogram. Clinical details such as time elapsed from injury to admission, type of injury, trauma score, and hypotension were noted. Patients were divided into groups according to the single or multiple organs injured and according to their hospital outcome (dead/discharged). Wilcoxon's Rank sum or Kruskal-Wallis tests were used to compare median values in two/three groups. Data analysis was performed using STATA 11.0 statistical software. A total of 55 patients with median age 26 (range, 6-80) years, were enrolled in the study. Of these, 80% were males. Surgery was required for 20% of the patients. Out of 55 patients, 42 had isolated single organ injury [liver or spleen or gastrointestinal tract (GIT) or kidney]. Patients with pancreatic injury were excluded. In patients who suffered liver injuries, urine lipase levels on day 1, urine lipase/amylase ratio along with aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP) on days 1, 3, and 5, were found to be significant. Day 1 serum amylase, AST, ALT, hemoglobin, and

Sew it up! A Western Trauma Association multi-institutional study of enteric injury management in the postinjury open abdomen.

Science.gov (United States)

Burlew, Clay Cothren; Moore, Ernest E; Cuschieri, Joseph; Jurkovich, Gregory J; Codner, Panna; Crowell, Kody; Nirula, Ram; Haan, James; Rowell, Susan E; Kato, Catherine M; MacNew, Heather; Ochsner, M Gage; Harrison, Paul B; Fusco, Cynthia; Sauaia, Angela; Kaups, Krista L

2011-02-01

Use of damage control surgery techniques has reduced mortality in critically injured patients but at the cost of the open abdomen. With the option of delayed definitive management of enteric injuries, the question of intestinal repair/anastomosis or definitive stoma creation has been posed with no clear consensus. The purpose of this study was to determine outcomes on the basis of management of enteric injuries in patients relegated to the postinjury open abdomen. Patients requiring an open abdomen after trauma from January 1, 2002 to December 31, 2007 were reviewed. Type of bowel repair was categorized as immediate repair, immediate anastomosis, delayed anastomosis, stoma and a combination. Logistic regression was used to determine independent effect of risk factors on leak development. During the 6-year study period, 204 patients suffered enteric injuries and were managed with an open abdomen. The majority was men (77%) sustaining blunt trauma (66%) with a mean age of 37.1 years±1.2 years and median Injury Severity Score of 27 (interquartile range=20-41). Injury patterns included 81 (40%) small bowel, 37 (18%) colonic, and 86 (42%) combined injuries. Enteric injuries were managed with immediate repair (58), immediate anastomosis (15), delayed anastomosis (96), stoma (10), and a combination (22); three patients died before definitive repair. Sixty-one patients suffered intra-abdominal complications: 35 (17%) abscesses, 15 (7%) leaks, and 11 (5%) enterocutaneous fistulas. The majority of patients with leaks had a delayed anastomosis; one patient had a right colon repair. Leak rate increased as one progresses toward the left colon (small bowel anastomoses, 3% leak rate; right colon, 3%; transverse colon, 20%; left colon, 45%). There were no differences in emergency department physiology, injury severity, transfusions, crystalloids, or demographic characteristics between patients with and without leak. Leak cases had higher 12-hour heart rate (148 vs. 125, p=0

Aspectos de regulación sanitaria en Brasil

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Jose Carlos Buzanello

2016-06-01

Full Text Available Mira a algunos aspectos de la regulación de los servicios de saneamiento en Brasil, específicamente la política de regulación resultante del proceso de reforma del Estado de 1995. Cuestiona los resultados de la productividad de los servicios de agua y alcantarillado de los concesionarios y el alcance de estas medidas al consumismo usuario.

Aspectos éticos de la obesidad

OpenAIRE

de Santiago Martín, Sandra

2016-01-01

El sobrepeso y la obesidad se están convirtiendo en uno de los problemas de salud de mayor preocupación, convirtiéndose en los últimos años en una verdadera pandemia mundial. Los objetivos de esta revisión bibliográfica son analizar los aspectos éticos de la obesidad, desde el punto de vista de la familia y la sociedad, las buenas prácticas sanitarias, los principios bioéticos y de los derechos del paciente obeso. Para realizar este trabajo de investigación se accedieron a las bases de ...

Aspectos puntuales del estado vegetativo persistente

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Hodelín Tablada, Ricardo

2013-01-01

El estado vegetativo persistente es una condición clínica caracterizada por la ausencia completa de conciencia sobre uno mismo y el entorno, unido a ciclos de sueño-vigilia, con preservación total o parcial de las funciones hipotalámicas y autonómicas del tallo encefálico. En el presente artículo, el autor discute aspectos puntuales sobre la entidad clínica, basado en su experiencia y en la revisión de la bibliografía sobre el tema; igualmente se exponen elementos clínicos y epidemiológicos d...

Aspectos comportamentais na gestão de projetos: uma análise bibliométrica (1988-2014

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Diane Aparecida dos Reis Silva

Full Text Available Resumo A demanda por gerentes de projetos é crescente. Um dos principais fatores que impactam no desempenho desse profissional relaciona-se ao aspecto comportamental, ou seja, àquele em que as relações e o entendimento entre os indivíduos de um grupo são fundamentais. Ante essa problemática, o objetivo deste trabalho foi realizar uma análise bibliométrica sobre aspectos comportamentais na gestão de projetos, buscando identificar as relações entre aspectos comportamentais e o gerenciamento de projetos. Para tanto, utilizou-se a metodologia bibliométrica: as bases de dados que compõem a amostra foram coletadas em ISI Web of Science e Scopus, desde que os artigos da Scopus também estivessem na base principal da ISI Web of Science. As análises sugerem ou evidenciam que os aspectos comportamentais, o “lado humano”, se apresenta como fator essencial para o sucesso na gestão de projetos.

The deceased organ donor with an "open abdomen": proceed with caution.

Science.gov (United States)

Watkins, A C; Vedula, G V; Horan, J; Dellicarpini, K; Pak, S-W; Daly, T; Samstein, B; Kato, T; Emond, J C; Guarrera, J V

2012-06-01

In solid organ transplantation, the disparity between donor supply and patients awaiting transplant continues to increase. The organ shortage has led to relaxation of historic contraindications to organ donation. A large percentage of deceased organ donors have been subjected to traumatic injuries, which can often result in intervention that leads to abdominal packing and intensive care unit resuscitation. The donor with this "open abdomen" (OA) presents a situation in which the risk of organ utilization is difficult to quantify. There exists a concern for the potential of a higher risk for both bacterial and fungal infections, including multidrug-resistant (MDR) pathogens because of the prevalence of antibiotic use and critical illness in this population. No recommendations have been established for utilization of organs from these OA donors, because data are limited. Herein, we report a case of a 21-year-old donor who had sustained a gunshot wound to his abdomen, resulting in a damage-control laparotomy and abdominal packing. The donor subsequently suffered brain death, and the family consented to organ donation. A multiorgan procurement was performed with respective transplantation of the procured organs (heart, liver, and both kidneys) into 4 separate recipients. Peritoneal swab cultures performed at the time of organ recovery grew out MDR Pseudomonas aeruginosa on the day after procurement, subsequently followed by positive blood and sputum cultures as well. All 4 transplant recipients subsequently developed infections with MDR P. aeruginosa, which appeared to be donor-derived with similar resistance patterns. Appropriate antibiotic coverage was initiated in all of the patients. Although 2 of the recipients died, mortality did not appear to be clearly associated with the donor-derived infections. This case illustrates the potential infectious risk associated with organs from donors with an OA, and suggests that aggressive surveillance for occult infections

ASPECTOS ERGONÔMICOS E POSTURAIS EM CENTRO DE MATERIAL

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Neusa Maria Cosía Alexandre

Full Text Available Determinados fatores ambientais inadequados podem provocar lesões na coluna vertebral. Este trabalho discute certos aspectos ergonômicos e posturais específicos em Centro de Material com o objetivo de desenvolver uma consciência crítica a respeito dos efeitos do local de trabalho sobre a saúde.

Aspectos da tomografia computadorizada craniana na neurocisticercose na infância

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Marilisa M. Guerreiro

1989-06-01

Full Text Available Os autores relatam aspectos tomográficos da neurocisticercose na infância a propósito da análise de 27 exames em 18 pacientes, que foram distribuídos em três grupos segundo o quadru clínico e os achados tomográficos. O grupo 1 foi caracterizado basicamente por epilepsias e calcificações. O grupo 2 caracterizou-se por hipertensão intracraniana e diversos aspectos tomográficos: edema, cistos e nódulos em três pacientes; hidrocefalia e calcificações em dois pacientes e normal em um paciente. O grupo 3 consistiu clinicamente de epilepsia e cefaléia, com vários padrões tomográficos. Os resultados são discutidos à luz da literatura disponível.

Advantages and disadvantages of using non-coplanar techniques in radiotherapy of the abdomen formed 3D; Ventajas e inconvenientes del uso de tecnicas con coplanares en radiaoterpia 3D conformada de abdomen

Energy Technology Data Exchange (ETDEWEB)

Urena Llinares, A.; Castro Ramirez, I.; Iborra Oquendo, M. A; Quinones Rodriguez, L. A.; Angulo Pain, E.

2011-07-01

3D Radiotherapy locations abdomen, especially in pancreas and stomach cancers is often extremely difficult if we are to meet the dose constraints to organs at risk due to proximity and many of these (liver, kidneys, intestines, lungs, bone. ..). Of these, the most critical are the kidneys, which also present values of tolerance, in most cases difficult to meet. This is done in our hospital are using non-coplanar techniques performing well both as coating PTV dose to both kidneys.

Algunos aspectos éticos en la práctica de la obstetricia

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DR. P. Sergio Valenzuela

2014-11-01

Full Text Available La obstetricia ejercida en el contexto clínico asistencial es una fuente permanente de cuestionamientos éticos para los especialistas. En este artículo, que tiene carácter de ensayo, se aborda una primera parte introductoria, que da cuenta de la dimensión antropológica del cuidado obstétrico. Luego se destaca la necesidad de referirse a un número mayor de principios en la fundamentación del quehacer obstétrico. Por último, profundiza principalmente en los aspectos éticos de su ejercicio como obstetricia de urgencia y la ética del diagnóstico; quedando aspectos importantes para discutir en una futura oportunidad.

Planificación estratégica: aspectos introductorios (I)

OpenAIRE

Galindo Reyes, Fuensanta Carmen; De la Varga Salto, José María

2016-01-01

Transparencias como material docente para la asignatura de Administración de Organizaciones. Se corresponden con la etapa primera del proceso administrativo de las organizaciones, la planificación estratétiga. En concreto, incluyen aspectos introductorios relacionados con los conceptos y elementos principales de la planificación estratégica. Planificación estratégica

Adaptive iterative dose reduction (AIDR) 3D in low dose CT abdomen-pelvis: Effects on image quality and radiation exposure

International Nuclear Information System (INIS)

Ang, W C; Hashim, S; Karim, M K A; Bahruddin, N A; Salehhon, N; Musa, Y

2017-01-01

The widespread use of computed tomography (CT) has increased the medical radiation exposure and cancer risk. We aimed to evaluate the impact of AIDR 3D in CT abdomen-pelvic examinations based on image quality and radiation dose in low dose (LD) setting compared to standard dose (STD) with filtered back projection (FBP) reconstruction. We retrospectively reviewed the images of 40 patients who underwent CT abdomen-pelvic using a 80 slice CT scanner. Group 1 patients ( n =20, mean age 41 ± 17 years) were performed at LD with AIDR 3D reconstruction and Group 2 patients ( n =20, mean age 52 ± 21 years) were scanned with STD using FBP reconstruction. Objective image noise was assessed by region of interest (ROI) measurements in the liver and aorta as standard deviation (SD) of the attenuation value (Hounsfield Unit, HU) while subjective image quality was evaluated by two radiologists. Statistical analysis was used to compare the scan length, CT dose index volume (CTDI vol ) and image quality of both patient groups. Although both groups have similar mean scan length, the CTDI vol significantly decreased by 38% in LD CT compared to STD CT ( p <0.05). Objective and subjective image quality were statistically improved with AIDR 3D ( p <0.05). In conclusion, AIDR 3D enables significant dose reduction of 38% with superior image quality in LD CT abdomen-pelvis. (paper)

Aspectos sociales de la malaria importada en Latinoamérica

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Alfonso J. Rodríguez-Morales

2008-04-01

Full Text Available La malaria continúa siendo un grave problema de salud pública mundial, ya no sólo en países endémicos, sino comenzando a representar un dilema médico en países distantes por la llegada de casos importados. Ahora bien, aun cuando en términos de las disciplinas médicas convencionales se ha publicado muchos estudios clínico-epidemiológicos y reportes de caso, los aspectos sociales, que parecerían obvios en el contexto de la malaria importada por supeditarse a la migración de la población, no han sido exhaustivamente explorados en relación con este fenómeno. Por estas razones, en esta revisión se analiza los aspectos sociales relacionados con el fenómeno de la malaria importada con énfasis al contexto epidemiológico de América Latina.

Aspectos éticos en Pediatría, las inmunodeficiencias primarias

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Martha Leonor Paradoa Pérez

2012-12-01

Full Text Available Las inmunodeficiencias primarias son enfermedades genéticas, caracterizadas por infecciones crónicas devastadoras que conllevan a la muerte, al desarrollo de tumores y a enfermedades autoinmunes, y la mayoría de estas enfermedades cursan en la edad pediátrica. Desde la última década del pasado siglo, el desarrollo de la tecnología, el surgimiento del Proyecto del Genoma Humano y la profundización en los aspectos bioéticos, han dado lugar a especificidades en la atención médica e investigativa del paciente pediátrico y del que desarrolla una enfermedad inmunológica. Este trabajo recoge los aspectos bioéticos más importantes y los dilemas éticos con los que se enfrenta el inmunólogo pediátrico en la atención al paciente con inmunodeficiencia primaria, el cual demanda la atención de, prácticamente, todas las especialidades pediátricas.

Automatically pairing measured findings across narrative abdomen CT reports.

Science.gov (United States)

Sevenster, Merlijn; Bozeman, Jeffrey; Cowhy, Andrea; Trost, William

2013-01-01

Radiological measurements are one of the key variables in widely adopted guidelines (WHO, RECIST) that standardize and objectivize response assessment in oncology care. Measurements are typically described in free-text, narrative radiology reports. We present a natural language processing pipeline that extracts measurements from radiology reports and pairs them with extracted measurements from prior reports of the same clinical finding, e.g., lymph node or mass. A ground truth was created by manually pairing measurements in the abdomen CT reports of 50 patients. A Random Forest classifier trained on 15 features achieved superior results in an end-to-end evaluation of the pipeline on the extraction and pairing task: precision 0.910, recall 0.878, F-measure 0.894, AUC 0.988. Representing the narrative content in terms of UMLS concepts did not improve results. Applications of the proposed technology include data mining, advanced search and workflow support for healthcare professionals managing radiological measurements.

Aspectos geopolíticos en el desarrollo de la zona franca industrial de Ilo

OpenAIRE

Cardenas Nuñez, Gilberto; Cardenas Nuñez, Gilberto

1994-01-01

El presente trabajo de Tesis enfatiza el aspecto geopolítico en el desarrollo de la Zona franca Industrial de Ilo (ZOFRI-IL0). La razón de tal énfasis es simple: por este aspecto específicamente es que se creó la ZOFRI-ILO. En consecuencia, el tratamiento del tema tiene que ver con la influencia geopolítica en las sucesivas etapas de su desarrollo, considerando sus posibilidades de desarrollo a futuro en el marco de las tendencias internacionales de la globalización de la economía mundial. ...

Evaluation of amylase and lipase levels in blunt trauma abdomen patients

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Subodh Kumar

2012-01-01

Full Text Available Background: There are studies to prove the role of amylase and lipase estimation as a screening diagnostic tool to detect diseases apart from acute pancreatitis. However, there is sparse literature on the role of serum and urine amylase, lipase levels, etc to help predict the specific intra-abdominal injury after blunt trauma abdomen (BTA. Aim: To elucidate the significance of elevation in the levels of amylase and lipase in serum and urine samples as reliable parameters for accurate diagnosis and management of blunt trauma to the abdomen. Materials and Methods: A prospective analysis was done on the trauma patients admitted in Jai Prakash Narayan Apex Trauma Center, AIIMS, with blunt abdomen trauma injuries over a period of six months. Blood and urine samples were collected on days 1, 3, and 5 of admission for the estimation of amylase and lipase, liver function tests, serum bicarbonates, urine routine microscopy for red blood cells, and complete hemogram. Clinical details such as time elapsed from injury to admission, type of injury, trauma score, and hypotension were noted. Patients were divided into groups according to the single or multiple organs injured and according to their hospital outcome (dead/discharged. Wilcoxon′s Rank sum or Kruskal-Wallis tests were used to compare median values in two/three groups. Data analysis was performed using STATA 11.0 statistical software. Results: A total of 55 patients with median age 26 (range, 6-80 years, were enrolled in the study. Of these, 80% were males. Surgery was required for 20% of the patients. Out of 55 patients, 42 had isolated single organ injury [liver or spleen or gastrointestinal tract (GIT or kidney]. Patients with pancreatic injury were excluded. In patients who suffered liver injuries, urine lipase levels on day 1, urine lipase/amylase ratio along with aspartate aminotransferase (AST, alanine aminotransferase (ALT, and alkaline phosphatase (ALP on days 1, 3, and 5, were found to

Identification of Avian and Hemoparasite DNA in Blood-Engorged Abdomens of Culex pipiens (Diptera; Culicidae) from a West Nile Virus Epidemic region in Suburban Chicago, Illinois.

Science.gov (United States)

Boothe, Emily; Medeiros, Matthew C I; Kitron, Uriel D; Brawn, Jeffrey D; Ruiz, Marilyn O; Goldberg, Tony L; Walker, Edward D; Hamer, Gabriel L

2015-05-01

Multiple mosquito-borne parasites cocirculate in nature and potentially interact. To understand the community of parasites cocirculating with West Nile virus (WNV), we screened the bloodmeal content of Culex pipiens L. mosquitoes for three common types of hemoparasites. Blood-fed Cx. pipiens were collected from a WNV-epidemic area in suburban Chicago, IL, from May to September 2005 through 2010. DNA was extracted from dissected abdomens and subject to PCR and direct sequencing to identify the vertebrate host. RNA was extracted from the head or thorax and screened for WNV using quantitative reverse transcriptase PCR. Seventy-nine engorged females with avian host origin were screened using PCR and amplicon sequencing for filarioid nematodes, Haemosporida, and trypanosomatids. Filarioid nematodes were identified in 3.8% of the blooded abdomens, Plasmodium sp. in 8.9%, Haemoproteus in 31.6%, and Trypanosoma sp. in 6.3%. The sequences from these hemoparasite lineages were highly similar to sequences from birds in prior studies in suburban Chicago. Overall, 50.6% of blood-fed Culex pipiens contained hemoparasite DNA in their abdomen, presumably from current or prior bloodmeals. Additionally, we detected hemoparasite DNA in the blooded abdomen of three of 10 Cx. pipiens infected with WNV. © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Aspectos “Subjetivos” do Fetichismo da Mercadoria Cultural no Ensaio Sobre Música Popular de T. W. Adorno

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Fábio César da Silva

2017-05-01

Full Text Available Neste artigo, apresento uma leitura do ensaio Sobre Música Popular (1941 de T. W. Adorno (1903-1969, enfatizando os aspectos “subjetivos” do fetichismo da mercadoria cultural. Considero aspectos “subjetivos” do fetichismo quando se enfatiza o consumo de mercadorias. Esse ensaio fez parte dos resultados de pesquisa de rádio da Universidade de Princeton, feita nos Estados Unidos entre 1938 a 1940, cujo objetivo era analisar as programações radiofônicas. Focarei a leitura na seção Teoria do Ouvinte, pois nela Adorno enfatizou esses aspectos “subjetivos” por meio de análises específicas do consumo da música popular americana supondo seus modos de recepção.

Comparison of CT and anatomic pathological findings of the abdomen in HIV infection

International Nuclear Information System (INIS)

Tosch, U.; Witt, H.; Jautzke, G.; Ruf, B.

1990-01-01

In a retrospective study the results of abdominal computed tomography (CT) from 48 patients, who died of the complications of HIV infection, were compared with those obtained at autopsy. The CT diagnosis was confirmed at autopsy in 39 cases (81.3%). In nine patients CT results did not correlate with the postmortal findings. This was caused by lack of cooperation, cachexia and the time between the last CT study and the death of the patients. Nevertheless, CT with its standardised imaging planes is an important method for diagnosing and monitoring HIV-related diseases of the abdomen. (orig.) [de

SU-E-P-08: Establishment of Local Diagnostic Reference Levels of Routine Abdomen Exam in Computed Tomography According to Body Weight

International Nuclear Information System (INIS)

Wang, H; Wang, Y; Weng, H

2015-01-01

Purpose: The national diagnostic reference levels (NDRLs) is an efficient, concise and powerful standard for optimizing radiation protection of a patient. However, for each hospital the dose-reducing potential of focusing on establishment of local DRLs (LDRLs). A lot of study reported that Computed tomography exam contributed majority radiation dose in different medical modalities, therefore, routine abdomen CT exam was choose in initial pilot study in our study. Besides the mAs of routine abdomen CT exam was decided automatic exposure control by linear attenuation is relate to body shape of patient. In this study we would like to establish the local diagnostic reference levels of routine abdomen exam in computed tomography according to body weight of patient. Methods and Materials: There are two clinical CT scanners (a Toshiba Aquilion and a Siemens Sensation) were performed in this study. For CT examinations the basic recommended dosimetric quantity is the Computed Tomography Dose Index (CTDI). The patient sample involved 82 adult patients of both sexes and divided into three groups by their body weight (50–60 kg, 60–70 kg, 70–80 kg).Carried out the routine abdomen examinations, and all exposure parameters have been collected and the corresponding CTDIv and DLP values have been determined. The average values were compared with the European DRLs. Results: The majority of patients (75%) were between 50–70 Kg of body weight, the numbers of patient in each group of weight were 40–50:7; 50–60:29; 60–70:33; 70–80:13. The LDRLs in each group were 10.81mGy, 14.46mGy, 20.27mGy and 21.04mGy, respectively. The DLP were 477mGy, 630mGy, 887mGy and 959mGy, respectively. No matter which group the LDRLs were lower than European DRLs. Conclusions: We would like to state that this was a pioneer work in local hospital in Chiayi. We hope that this may lead the way to further developments in Taiwan

SU-E-P-08: Establishment of Local Diagnostic Reference Levels of Routine Abdomen Exam in Computed Tomography According to Body Weight

Energy Technology Data Exchange (ETDEWEB)

Wang, H; Wang, Y; Weng, H [Chiayi Chang Gung Memorial Hospital of The C.G.M.F, Puzi City, Chiayi County, Taiwan (China)

2015-06-15

Purpose: The national diagnostic reference levels (NDRLs) is an efficient, concise and powerful standard for optimizing radiation protection of a patient. However, for each hospital the dose-reducing potential of focusing on establishment of local DRLs (LDRLs). A lot of study reported that Computed tomography exam contributed majority radiation dose in different medical modalities, therefore, routine abdomen CT exam was choose in initial pilot study in our study. Besides the mAs of routine abdomen CT exam was decided automatic exposure control by linear attenuation is relate to body shape of patient. In this study we would like to establish the local diagnostic reference levels of routine abdomen exam in computed tomography according to body weight of patient. Methods and Materials: There are two clinical CT scanners (a Toshiba Aquilion and a Siemens Sensation) were performed in this study. For CT examinations the basic recommended dosimetric quantity is the Computed Tomography Dose Index (CTDI). The patient sample involved 82 adult patients of both sexes and divided into three groups by their body weight (50–60 kg, 60–70 kg, 70–80 kg).Carried out the routine abdomen examinations, and all exposure parameters have been collected and the corresponding CTDIv and DLP values have been determined. The average values were compared with the European DRLs. Results: The majority of patients (75%) were between 50–70 Kg of body weight, the numbers of patient in each group of weight were 40–50:7; 50–60:29; 60–70:33; 70–80:13. The LDRLs in each group were 10.81mGy, 14.46mGy, 20.27mGy and 21.04mGy, respectively. The DLP were 477mGy, 630mGy, 887mGy and 959mGy, respectively. No matter which group the LDRLs were lower than European DRLs. Conclusions: We would like to state that this was a pioneer work in local hospital in Chiayi. We hope that this may lead the way to further developments in Taiwan.

Ovarian vein thrombosis mimicking acute abdomen: a case report and literature review

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Arkadopoulos Nikolaos

2011-12-01

Full Text Available Abstract Background Ovarian vein thrombosis (OVT is a rare, but serious condition that affects mostly postpartum women. A high index of suspicion is required in order to diagnose this unusual cause of abdominal pain. Case presentation A 19-year-old woman at three days postpartum was admitted to our hospital because of severe right lower quandrant abdominal pain and fever 38.5'C. Physical examination revealed an acutely ill patient and right lower quadrant tenderness with positive rebound and Giordano signs. The patient underwent appendectomy which proved to be negative for acute appendicitis. Postoperatively fever and pain persisted and abdominal CT-scan with intravenous contrast agent demonstrated a thrombosed right ovarian vein. The patient was initiated on low-molecular weight heparin (LMWH and antibiotic treatment and a month later a new abdominal CT-scan showed a patent right ovarian vein. Discussion Pathophysiologically, OVT is explained by Virchow's triad, because pregnancy is associated with a hypercoagulable state, venous stasis due to compression of the inferior vena cava by the uterus and endothelial trauma during delivery or from local inflammation. Common symptoms and signs of OVT include lower abdomen or flank pain, fever and leukocytosis usually within the first ten days after delivery. The reported incidence of OVT ranges 0,05-0,18% of pregnancies and in most cases the right ovarian vein is the one affected. Anticoagulation and antibiotics is the mainstay of treatment of OVT. Complications of OVT include sepsis, extension of the thrombus to the inferior vena cava and renal veins, and pulmonary embolism. The incidence of pulmonary embolism is reported to be 13.2% and represents the main source of mortality due to OVT. Conclusions OVT is a rare condition, usually in the postpartum period. A high index of suspicion is required for the prompt diagnosis and management especially in cases that mimic acute abdomen.

A STUDY OF POST-SURGICAL COMPLICATIONS IN ACUTE ABDOMEN CONDITIONS

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Bhooma Reddy Muthyala

2016-09-01

Full Text Available BACKGROUND The most common causes of the acute abdomen are acute appendicitis which may be perforated, typhoid ileal perforation, acute intestinal obstruction, gastroduodenal perforations, nonspecific abdominal pain, abdominal injuries, and acute cholecystitis. A summary of all the acute complications taken together will be the fact that all are associated with post-surgical complications. A sincere effort has been made to study the post-operative complications that a surgeon encounters while treating the acute abdomen cases. This study is intended to help the practising surgeons who deal with such complications. It also is intended to help the doctors who practice to identify such complications and thus refer the patients for immediate intervention. METHODS This study was conducted in the Department of General Surgery, Government Medical College, Nizamabad, Telangana. This study was done from June 2013 to May 2016. One hundred sixty patients who were admitted in the hospital after surgery for acute abdominal conditions were considered for the study. Thorough clinical examination was conducted and the complications that were encountered were noted and the complications were treated as per the need of the hour. The complications faced by the treating surgeon in each and every entity that was discussed earlier was duly noted and statistical analysis was conducted. All the statistical analysis was done using the latest SPSS software 2015 (California. RESULT In our study, the mean age of the study population was found to be 29.8 years. That means the majority of the patients who turn up in the Department of Emergency is young and generally in the third decade of life. In Acute Intestinal Obstruction and blunt abdominal injuries, significance of mortality is high (p<0.05. CONCLUSION The study was successful in proving that abdominal injuries are the main factors of causing morbidity and mortality in the younger generation. The surgical mode of

Los aspectos socioculturales de la migración en la frontera norte

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Oscar Priego Hernández

2011-12-01

Full Text Available México se considera el país de emigrantes más importante del mundo y Estados Unidos el principal país de inmigrantes. Su posición geográfica en la frontera Norte lo convierten atractivo para los flujos migratorios de los países centroamericanos. Hoy enfrenta los retos de la crisis financiera internacional de los últimos años que afecta las economías y las relaciones bilaterales. Este trabajo consiste en realizar un estudio de la problemática de los aspectos socioculturales provocada por la migración de personas, analizar fortalezas y debilidades, identificar los nuevos aspectos de la migración y proponer alternativas para mejorar las condiciones de vida de los migrantes mexicanos.

Critique of Sew it Up! A Western Trauma Association Multi-Institutional Study of Enteric Injury Management in the Postinjury Open Abdomen

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Nuri Abdurraheim

2013-03-01

Full Text Available Background: Use of damage control surgery techniques has reduced mortality in critically injured patients but at the cost of the open abdomen. With the option of delayed definitive management of enteric injuries, the question of intestinal repair/anastomosis or definitive stoma creation has been posed with no clear consensus. The purpose of this study was to determine outcomes on the basis of management of enteric injuries in patients relegated to the postinjury open abdomen.Methods: Patients requiring an open abdomen after trauma from January 1, 2002 to December 31, 2007 were reviewed. Type of bowel repair was categorized as immediate repair, immediate anastomosis, delayed anastomosis, stoma and a combination. Logistic regression was used to determine independent effect of risk factors on leak development.Results: During the 6-year study period, 204 patients suffered enteric injuries and were managed with an open abdomen. The majority was men (77% sustaining blunt trauma (66% with a mean age of 37.1 years±1.2 years and median Injury Severity Score of 27 (interquartile range=20-41. Injury patterns included 81 (40% small bowel, 37 (18% colonic, and 86 (42% combined injuries. Enteric injuries were managed with immediate repair (58, immediate anastomosis (15, delayed anastomosis (96, stoma (10, and a combination (22; three patients died before definitive repair. Sixty-one patients suffered intra-abdominal complications: 35 (17% abscesses, 15 (7% leaks, and 11 (5% enterocutaneous fistulas. The majority of patients with leaks had a delayed anastomosis; one patient had a right colon repair. Leak rate increased as one progresses toward the left colon (small bowel anastomoses, 3% leak rate; right colon, 3%; transverse colon, 20%; left colon, 45%. There were no differences in emergency department physiology, injury severity, transfusions, crystalloids, or demographic characteristics between patients with and without leak. Leak cases had higher 12-hour

Radiation dose evaluation in patients submitted to conventional radiological examinations; Avaliacoes de doses de radiacao em pacientes submetidos a exames radiologicos convencionais

Energy Technology Data Exchange (ETDEWEB)

Tilly, Junior, Joao G

1997-07-01

This work presents the results of the evaluation of radiation dose delivered to the patients undergoing conventional radiological procedures. Based in the realized measurement some indicators are settled to quantitative appraisal of the radiological protection conditions offered to the population. Data assessment was done in the county of Curitiba, in Parana State, Brazil, from 12/95 to 04/96, in ten rooms of three different institutions, under 101 patients, adults with 70 {+-} 10 kg, during real examinations of chest PA, chest LAT and abdomen AP. (author)

Abdomen agudo ocasionado por apendicitis aguda de probable origen tuberculoso. Informe de un caso

OpenAIRE

Montiel-Jarquín, Álvaro José; Alvarado-Ortega, Iván; Romero-Figueroa, María del Socorro; Rodríguez-Pérez, Fabiola; Rodríguez-Lima, Felipe; Loria-Castellanos, Jorge

2017-01-01

RESUMEN Antecedentes: la apendicitis aguda tuberculosa es una enfermedad rara, constituye de 0,001 % a 0,01 % de las formas clínicas de tuberculosis. Se presenta un caso de apendicitis aguda probablemente tuberculosa como causa de abdomen agudo quirúrgico. Caso clínico: hombre de 29 años con cuadro de dolor abdominal leve a moderado que se intensificó y localizó en el hemiabdomen derecho, claudicación, febrícula, vómito, mal estado general, leucocitosis de 11 300/µL y neutrofilia de 91 %....

VALIDITY OF PARACENTESIS IN DIAGNOSING BLUNT TRAUMA ABDOMEN

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Fahad Bin Abdul Majeed

2017-03-01

Full Text Available BACKGROUND Blunt abdominal trauma is a common case that comes to an emergency department and it is the most easily missed diagnosis resulting in catastrophic consequences. Delay in diagnosing a case is due to the nonspecific character of the symptoms with which it presents. Clinical signs that could be elicited in blunt trauma abdomen are equally nonspecific. Thus, to avoid delay and save the life of the patient, a doctor has to depend on various investigations to rule out blunt trauma abdomen. The modalities which help include paracentesis, diagnostic peritoneal lavage, Focused Abdominal Sonography for Trauma (FAST and ContrastEnhanced Computed Tomography (CECT. To choose the right investigation for the right patient helps in saving precious lives. Validity of each investigation, availability, condition of the patient are the main points to look into before deciding on the right investigative modality. Paracentesis is the simplest investigation that could be done in emergency department and also at the site of accident to triage the patient. Paracentesis has low sensitivity to detect blunt trauma. FAST is a better investigation with higher validity rates than paracentesis. This study aims to validate paracentesis, which is the simplest and commonest investigation used to identify blunt abdominal trauma. MATERIALS AND METHODS In this study, 106 patients who fulfilled the inclusion and exclusion criteria were followed up by detailed history, clinical examination, paracentesis and FAST to identify blunt abdominal trauma and then compared with a gold standard investigation, which was assigned as CECT for haemodynamically stable patients and laparotomy for haemodynamically unstable patients. Commonest organs injured in blunt trauma and their management was noted. Patients were followed up till discharge or death. Subsequently, the data were compiled using excel sheet and evaluated using tables and charts. RESULTS Paracentesis is found to have a

Planificación estratégica: aspectos introductorios (II)

OpenAIRE

Galindo Reyes, Fuensanta Carmen; De la Varga Salto, José María

2016-01-01

Transparencias como material docente para la asignatura de Administración de Organizaciones. Se corresponden con la etapa primera del proceso administrativo de las organizaciones, la planificación estratégica. En concreto, incluyen aspectos introductorios relacionados con el análisis del entorno y el análisis interno, así como con el concepto y las características de los objetivos estratégicos.

Meckel's Diverticulitis as a Cause of an Acute Abdomen in the Second Trimester of Pregnancy: Laparoscopic Management.

Science.gov (United States)

Pandeva, Ivilina; Kumar, Sumit; Alvi, Atif; Nosib, Hema

2015-01-01

Introduction. Meckel's diverticulitis is an extremely rare cause of an acute abdomen in pregnancy. Its clinical presentation tends to be rather unusual and therefore commonly delaying diagnosis. The surgical method of exploration can be either by laparoscopy or through an open incision. Case Report. We report a case of a 34-year-old, P1 with previous Caesarean section, who presented at 20 weeks with worsening right-sided abdominal pain, distention, and peritonism. Ultrasound scan showed an area of a possibly thickened loop of bowel inconsistent with an appendicitis. The findings at laparoscopy were purulent fluid in the pelvis, a congested appendix, and inflamed Meckel's diverticulum. An appendectomy and excision of the diverticulum was performed using stapler technique. Discussion. Meckel's diverticulitis in pregnancy can have nonspecific presentation and poses difficulties for preoperative diagnosis. Delay in diagnosis and management poses significant maternal and fetal risks. The use of laparoscopy if the gestational age and uterine size permit its use allows a thorough exploration of the abdominal cavity and management of rarer and unexpected pathology. Laparoscopic management of acute abdomen in the midtrimester of pregnancy has been found to be safe and effective.

[Successful treatment of hyperthyroidism simulating acute abdomen and psychosis].

Science.gov (United States)

Kósa, D; Patakfalvi, A; Györi, L

1992-07-19

A 49 years old female patient entered the surgical department because of epigastric and ileocoecal pains with the symptoms of acute abdomen. A surgical intervention was performed because of supposed appendicitis, but it was not verified. During the surgical observation the patient was confused and negativistic so she was transferred to the psychiatric department. Because of loss of 20 kg weight, high blood sedimentation and anaemia she was sent to our department with the suspicion of an organic disease. A moderate exophthalmos, glittering eyes and Graefe's sign was noted, therefore hyperthyroidism was diagnosed, which was proved by Kocher's blood picture, low serum cholesterol, extremely high T3 and T4 level, and iodine storage diagram. The antithyreotic treatment resulted a dramatic improvement in the extremely serious moreover hopeless case and after a long-term treatment the patient became symptom-free without complaints. Later because of regression of hyperthyreoidism and the growing nodular goitre the patient was treated on two occasions with radioactive iodine. At present the patient is in remission.

Eugenia vinculada a aspectos bioéticos: uma revisão integrativa

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Vanessa Cruz Santos

Full Text Available O objetivo do estudo é analisar o que versam as produções científicas sobre eugenia, vinculando-as com aspectos bioéticos. Trata-se de uma revisão integrativa de literatura. Os dados foram coletados nas bases de dados Lilacs e SciELO, por meio dos descritores: eugenia, etnia e saúde, ética e bioética. Para a análise e posterior síntese dos artigos foi utilizada figura sinóptica. Verificou-se que a eugenia viola os direitos humanos, contradiz com o princípio da solidariedade e coloca em risco a diversidade humana. Conclui-se que houve déficit de artigos que abordem aspectos bioéticos vinculados à eugenia, assim, este estudo poderá contribuir para a reflexão sobre essa articulação.

Aspectos valorizados por porfissionais de enfermagem na higiene pessoal e na higiene corporal do paciente

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Elóide André Oliveira

2003-10-01

Full Text Available Survey descritivo, com o qual se objetivou identificar que aspectos da higiene corporal são valorizados pelos componentes da equipe de enfermagem, na higiene corporal pessoal e na higiene corporal do paciente. A pesquisa foi desenvolvida em oito instituições públicas de saúde e a amostra foi composta por 126 profissionais de enfermagem, correspondendo a 12,8% do total de 986 componentes das equipes de enfermagem destas instituições. Na higiene corporal pessoal, chamou a atenção o fato de que os cuidados com as unhas e com os cabelos tenham suplantado, no número de citações dos profissionais de enfermagem, aspectos básicos como o cuidado com as mãos. Na higiene corporal do paciente, o banho foi o aspecto considerado mais importante pelas três categorias profissionais; a higiene oral, pelas(os enfermeiras(os e auxiliares de enfermagem; e as unhas, pelas(os enfermeiras(os e técnicas(os de enfermagem.

Aspectos bioéticos del consentimiento informado en investigación con población vulnerable

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Fabio Alberto Garzón Díaz

2009-01-01

Full Text Available El presente artículo es el resultado de 10 años de investigación en el tema del Consentimiento Informado en Investigación Biomédica. Este artículo presenta un análisis sistemático de los aspectos teóricos y prácticos del consentimiento informado en personas y poblaciones vulnerables. Aborda la cuestión a partir de todos los ángulos pertinentes, desde el histórico hasta el jurídico, pasando por la fundamentación filosófica, psicológica, antropológica y didáctica del consentimiento informado. La profundidad en el recorrido por los aspectos teóricos se ve complementada por la presentación de los aspectos más prácticos, que llega hasta la formulación de propuestas muy concretas para la mejora del consentimiento informado.

Aspectos biopsicossociais na surdocegueira Bio psycho social aspects in deaf blindness

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Susana Maria Mana de Aráoz

2008-04-01

Full Text Available O presente artigo tem por objetivo discutir aspectos biopssicossociais referentes a pessoas com surdocegueira e suas famílias com o objetivo trazer a tona estas questões que se tem mostrado importantes para o desenvolvimento dos atendimentos aos surdocegos. Está baseado em dados bibliográficos de pesquisas com pais e outras divulgações abordando as causas que são, principalmente, Rubéola Congênita, prematuridade, infecções, acidentes, síndromes genéticas ou não. Coloca as conseqüências das mesmas, o desenvolvimento educacional alcançado e as necessidades das famílias em aspectos ligadas às áreas da saúde, educação, lazer, segurança e inclusão social. Também trata da adaptação das famílias ao impacto produzido pela surdocegueira tendo em conta aspectos orgânicos, afetivo-relacional, sócio-culturais e de produtividade. Reflete sobre a necessidade da divulgação dos conhecimentos e da ação conjunta de todas as partes envolvidas nos mais diversos aspectos da vida dos surdocegos para conseguir o desenvolvimento dos atendimentos para os surdocegos.The objective of the present article is to discuss bio-psycho-social aspects related to people with deaf blindness and their families so as to highlight those issues that have become important for the development of working methods in deaf blindness. It is based on bibliographic data found in research with parents of deaf blind children and other publications that deal with the causes of the condition. The main causes are congenital German measles, prematurity, infection, genetic or non genetic syndromes. The authors discuss the results of the various presentations, the expected educational development and the needs of the families in aspects related to health, education, leisure, safety and social inclusion. They also discusses issues of family adaptation to the impact produced by deaf blindness, taking into account organic, social-cultural, affect and inter

Magnetic resonance imaging of the abdomen and pelvis

International Nuclear Information System (INIS)

Anon.

1989-01-01

Magnetic resonance imaging (MRI) of the abdomen presents greater inherent difficulties than other anatomic regions. However, new techniques now allow imaging comparable in quality to computed tomography (CT). Magnetic resonance imaging offers the advantages of greater tissue contrast, multiplanar imaging, and lack of ionizing radiation or risk of toxic reactions from iodinated contrast media. Its use remains limited by high cost, limited availability, lack of a bowel contrast agent, and long imaging time, which some patients cannot tolerate. In many areas of abdominal imaging, MRI is now comparable to CT, but because of the greater availability and lesser cost, CT remains the procedure of choice. Magnetic resonance imaging is more accurate for staging neoplasms of the liver, adrenal glands, kidneys, bladder, prostate, uterus, and cervix and may aid in diagnosis of hepatic, adrenal, and uterine masses. In selected patients, especially those in whom CT is inconclusive or those who cannot tolerate iodinated contrast material, MRI can provide valuable information. Development of faster scanning techniques and MRI contrast agents and wider availability will probably increase the usefulness of abdominal MRI. At this time, MRI complements other abdominal imaging procedures. In a small number of patients, however, it can provide unique information in a virtually risk-free manner

Linguagem e aspectos visuo-espaciais : uma abordagem neurolinguistica

OpenAIRE

Carla Queiroz Pereira

2006-01-01

Resumo: O objetivo deste trabalho de pesquisa é investigar como o sujeito JS - não afásico após sofrer três acidentes vasculares cerebrais isquêmicos (AVCi?s) que lesionaram regiões parieto-occipitais de ambos os hemisférios cerebrais - realiza determinadas atividades lingüístico-cognitivas que envolvem aspectos vísuo-espaciais relacionados ao corpo, à escrita, à leitura de textos e de horas. Com base na Neurolingüística discursivamente orientada, na Neuropsicologia luriana e nas bases biológ...

Techniques, clinical applications and limitations of 3D reconstruction in CT of the abdomen

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Maher, Michael M.; Kalra, Mannudeep K.; Sahani, Dushyant V.; Perumpillichira, James J.; Rizzo, Stephania; Saini, Sanjay; Mueller, Peter R. [Massachusetts General Hospital and Harvard Medical School, Boston (United States)

2004-03-15

Enhanced z-axis coverage with thin overlapping slices in breath-hold acquisitions with multidetector CT (MDCT) has considerably enhanced the quality of multiplanar 3D reconstruction. This pictorial essay describes the improvements in 3D reconstruction and technical aspects of 3D reconstruction and rendering techniques available for abdominal imaging. Clinical applications of 3D imaging in abdomen including liver, pancreaticobiliary system, urinary and gastrointestinal tracts and imaging before and after transplantation are discussed. In addition, this article briefly discusses the disadvantages of this-slice acquisitions including increasing numbers of transverse images, which must be reviewed by the radiologist.

Techniques, clinical applications and limitations of 3D reconstruction in CT of the abdomen

International Nuclear Information System (INIS)

Maher, Michael M.; Kalra, Mannudeep K.; Sahani, Dushyant V.; Perumpillichira, James J.; Rizzo, Stephania; Saini, Sanjay; Mueller, Peter R.

2004-01-01

Enhanced z-axis coverage with thin overlapping slices in breath-hold acquisitions with multidetector CT (MDCT) has considerably enhanced the quality of multiplanar 3D reconstruction. This pictorial essay describes the improvements in 3D reconstruction and technical aspects of 3D reconstruction and rendering techniques available for abdominal imaging. Clinical applications of 3D imaging in abdomen including liver, pancreaticobiliary system, urinary and gastrointestinal tracts and imaging before and after transplantation are discussed. In addition, this article briefly discusses the disadvantages of this-slice acquisitions including increasing numbers of transverse images, which must be reviewed by the radiologist

Étude du comportement interne de l’abdomen lors d’un impact : observations par échographie ultrarapide

OpenAIRE

HELFENSTEIN , Clémentine

2013-01-01

Due to limitations of observation techniques, past researches in impact biomechanics on the abdomen have been mostly limited to the description of the externals responses. This study focuses on the internal response of abdominal organs using recent observation techniques: ultrafast ultrasound imaging and shearwave elastography. First, the effects of perfusion conditions on the geometrical and internal shear moduli of ex vivo porcine kidneys were evaluated. The considerable effect of the appli...

The Appropriateness of the Length of Insulin Needles Based on Determination of Skin and Subcutaneous Fat Thickness in the Abdomen and Upper Arm in Patients with Type 2 Diabetes

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Kang Hee Sim

2014-04-01

Full Text Available BackgroundLonger needle and complicated insulin injection technique such as injecting at a 45-degree angle and making skinfolds may decrease patient compliance to insulin injection therapy. In this light, shorter insulin needles have been recently developed. However, it is necessary to ascertain that such shorter needles are appropriate for Korean patients with diabetes as well.MethodsFirst, the diverse demographic and diabetic features of 156 Korean adults with diabetes were collected by a questionnaire and a device unit of body fat measurement. The skin and subcutaneous fat thicknesses of each subject were measured by Ultrasound device with a 7- to 12-MHz probe. Data were analyzed using analysis of variance and multiple linear regression.ResultsThe mean skin thickness was 2.29±0.37 mm in the abdomen and 2.00±0.34 mm in the upper arms, and the mean subcutaneous fat thickness was to 10.15±6.54 mm in the abdomen and 5.50±2.68 mm in the upper arms. Our analysis showed that the factors affecting the skin thickness of the abdomen and upper arms were gender and body mass index (BMI, whereas the factors influencing the subcutaneous fat thickness in the abdomen were gender and BMI, and the factors influencing the subcutaneous fat thickness in the upper arms were gender, BMI, and age. Insulin fluids may not appear to be intradermally injected into the abdomen and upper arms at any needle lengths. The risk of intramuscular injection is likely to increase with longer insulin needles and lower BMI.ConclusionIt is recommended to fully inform the patients about the lengths of needles for insulin injections. As for the recommended needle length, the findings of this study indicate that needles as short as 4 mm are sufficient to deliver insulin for Korean patients with diabetes.

Una plataforma multiagente para la búsqueda de recursos educacionales considerando aspectos culturales

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Bender, Cristina

2006-01-01

Full Text Available En este trabajo se propone una arquitectura multiagente para la recuperación de recursos educacionales, que ayude a los usuarios a encontrar cursos que se adecuen a sus características personales y aspectos culturales. En este trabajo, se considera como aspectos culturales a las características que permiten distinguir las preferencias de estudiantes pertenecientes a distintas regiones geográficas. La plataforma multiagente planteada incluye varios tipos de agentes que tienen funcionalidades diferentes. En particular, se modela el Educational Resources Finder Agent como un agente BDI Graduado. Este agente se encarga de la recuperación de los mejores cursos de acuerdo al perfil de cada estudiante. Se describe el sistema multiagente completo y se presenta un ejemplo ilustrativo del proceso de búsqueda.

ASPECTOS AMBIENTALES EN LA EXPERIMENTACIÓN QUÍMICA PARA PREVENIR RIESGOS A LA SALUD Y AL AMBIENTE

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María O. Peña O.

2011-01-01

Full Text Available Un aspecto ambiental se considera como cualquier material o elemento físico o químico que el hombre arroja al agua, al aire y al suelo o que interactúe con el ambiente y propicie un riesgo para la salud y para el medio ambiente. Los residuos originados durante el desarrollo de actividades relacionadas con la experimentación química, aunque en una proporción menor que en un proceso industrial, ellos pueden ser residuos peligrosos al medio ambiente. Los aspectos ambientales se asocian con las actividades de generación de residuos, derrames, emisión a la atmósfera, el consumo de recursos naturales y ruido. Este estudio tuvo como objetivo proponer directrices para identificar y clasificar a los residuos que son generados en una experimentación química e introducir aspectos de seguridad para la salud y para el medio ambiente dentro de los procedimientos analíticos. Se inició con una evaluación diagnóstica sobre el conocimiento de la normativa en materia de gestión de los residuos o desechos, dirigida a técnicos y profesores que realizan actividades en ocho laboratorios para la enseñanza de la Química. Se siguió con la selección de un procedimiento analítico, como caso estudio, para revisar y aplicar estrategias de reusar, reciclar y reducir la generación de los residuos. Se encontró un desconocimiento de la normativa ambiental, representada por el 73% de los encuestados y un escaso tratamiento de residuos. Se concluye que la extensión de aspectos ambientales en los procedimientos analíticos puede ayudar a prevenir la contaminación ambiental, a fortalecer aspectos toxicológicos, de seguridad y de prevención de riesgos laborales.

The relationship of body mass index and abdominal fat on the radiation dose received during routine computed tomographic imaging of the abdomen and pelvis.

Science.gov (United States)

Chan, Victoria O; McDermott, Shaunagh; Buckley, Orla; Allen, Sonya; Casey, Michael; O'Laoide, Risteard; Torreggiani, William C

2012-11-01

To determine the relationship of increasing body mass index (BMI) and abdominal fat on the effective dose acquired from computed tomography (CT) abdomen and pelvis scans. Over 6 months, dose-length product and total milliamp-seconds (mAs) from routine CT abdomen and pelvis scans of 100 patients were recorded. The scans were performed on a 64-slice CT scanner by using an automatic exposure control system. Effective dose (mSv) based on dose-length product, BMI, periumbilical fat thickness, and intra-abdominal fat were documented for each patient. BMI, periumbilical fat thickness, and intra-abdominal fat were compared with effective dose. Thirty-nine men and 61 women were included in the study (mean age, 56.3 years). The mean BMI was 26.2 kg/m(2). The mean effective dose was 10.3 mSv. The mean periumbilical fat thickness was 2.4 cm. Sixty-five patients had a small amount of intra-abdominal fat, and 35 had a large amount of intra-abdominal fat. The effective dose increased with increasing BMI (P abdominal fat (P abdominal fat significantly increases the effective dose received from CT abdomen and pelvis scans. Copyright © 2012 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

LABORATORIO DE HORMONAS: ASPECTOS PRÁCTICOS

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René E. Díaz T., DR.

2015-11-01

Full Text Available Las técnicas de laboratorio de análisis hormonales han experimentado grandes progresos en las últimas décadas, actualmente se pueden realizar determinaciones hormonales con gran precisión y automatización, sin embargo, existen muchos elementos que es necesario tener en consideración al momento de interpretar un examen hormonal. El elegir el examen adecuado para la condición que estamos estudiando, el conocer sus limitaciones y potenciales falsos positivos y negativos es parte del conocimiento que es fundamental tener como clínicos. En este artículo se pretende entregar una breve revisión de las principales determinaciones hormonales, orientado a aspectos que puedan ser de utilidad al médico no especialista en su práctica clínica.

Aspectos podológicos en la Encuesta Nacional de Salud

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Antonio Martínez Sabater

Full Text Available Objetivo: la Encuesta Nacional de Salud (ENS es el instrumento para detectar el nivel de salud de la población, por lo que se plantea como objetivo el análisis de las diferentes ediciones para valorar la presencia de los aspectos podológicos y de la figura del profesional de podología en la atención a las personas mayores. Metodología: se ha realizado un análisis de contenido de las diferentes ENS tras la recopilación de las diferentes ediciones (8. Después de la lectura en profundidad y análisis por parte de dos investigadores, se han cumplimentado las fichas de análisis y se han categorizado los diferentes transcriptores, y se ha realizado el análisis e interpretación de la información encontrada. Resultados: en las diferentes ediciones no aparece ninguna mención a la profesión de podología; sí que aparecen referencias a otras figuras como naturópatas, quiroprácticos, entre otros. En relación con los descriptores sobre las afecciones de los pies, solo aparece una referencia en la edición de 1987. No obstante, la referencia a aspectos podológicos es prácticamente inexistente. Conclusiones: la ENS es el instrumento básico para conocer el estado de salud de la población general, pero presenta limitaciones al omitir los aspectos podológicos que suponen una merma en el diagnóstico de las necesidades y, por consiguiente, en la calidad de vida de las personas, principalmente mayores. Al igual que ocurre con la cartera de servicios del SNS, obvia a los/as profesionales formados para la atención básica de los problemas podológicos en el equipo de salud.

Combing a novel device and negative pressure wound therapy for managing the wound around a colostomy in the open abdomen: A case report.

Science.gov (United States)

Sun, Xiaofang; Wu, Shaohan; Xie, Ting; Zhang, Jianping

2017-12-01

An open abdomen complicated with small-bowel fistulae becomes a complex wound for local infection, systemic sepsis and persistent soiling irritation by intestinal content. While controlling the fistulae drainage, protecting surrounding skin, healing the wound maybe a challenge. In this paper we described a 68-year-old female was admitted to emergency surgery in general surgery department with severe abdomen pain. Resection part of the injured small bowel, drainage of the intra-abdominal abscess, and fashioning of a colostomy were performed. She failed to improve and ultimately there was tenderness and lot of pus under the skin around the fistulae. The wound started as a 3-cm lesion and progressed to a 6 ×13  (78 cm) around the stoma. In our case we present a novel device for managing colostomy wound combination with negative pressure wound therapy. This tube allows for an effective drainage of small-bowel secretion and a safe build-up of granulation tissue. Also it could be a barrier between the bowel suction point and foam. Management of open abdomen wound involves initial dressing changes, antibiotic use and cutaneous closure. When compared with traditional dressing changes, the NPWT offers several advantages including increased granulation tissue formation, reduction in bacterial colonization, decreased of bowel edema and wound size, and enhanced neovascularization. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Meckel’s Diverticulitis as a Cause of an Acute Abdomen in the Second Trimester of Pregnancy: Laparoscopic Management

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Ivilina Pandeva

2015-01-01

Full Text Available Introduction. Meckel’s diverticulitis is an extremely rare cause of an acute abdomen in pregnancy. Its clinical presentation tends to be rather unusual and therefore commonly delaying diagnosis. The surgical method of exploration can be either by laparoscopy or through an open incision. Case Report. We report a case of a 34-year-old, P1 with previous Caesarean section, who presented at 20 weeks with worsening right-sided abdominal pain, distention, and peritonism. Ultrasound scan showed an area of a possibly thickened loop of bowel inconsistent with an appendicitis. The findings at laparoscopy were purulent fluid in the pelvis, a congested appendix, and inflamed Meckel’s diverticulum. An appendectomy and excision of the diverticulum was performed using stapler technique. Discussion. Meckel’s diverticulitis in pregnancy can have nonspecific presentation and poses difficulties for preoperative diagnosis. Delay in diagnosis and management poses significant maternal and fetal risks. The use of laparoscopy if the gestational age and uterine size permit its use allows a thorough exploration of the abdominal cavity and management of rarer and unexpected pathology. Laparoscopic management of acute abdomen in the midtrimester of pregnancy has been found to be safe and effective.

Aspectos psicossociais da homofobia intrafamiliar e saúde de jovens lésbicas e gays

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Juliana Perucchi

2014-03-01

Full Text Available O número de pesquisas sobre diferentes aspectos da homofobia cresceu nos últimos dez anos. Entretanto, há uma carência de estudos que analisem os aspectos psicossociais que envolvem as experiências de jovens lésbicas e gays mediante situações de violência e os desdobramentos destas na sua saúde. O presente artigo busca relatar os resultados de uma pesquisa que objetivou analisar como se constituem as situações de homofobia no âmbito das relações familiares vividas por jovens lésbicas e gays, analisando os aspectos psicossociais dos processos de ruptura ou afastamento temporário ou permanente do vínculo familiar. A hipótese confirmada ao longo desses anos de pesquisa é de que o preconceito se articula no contexto familiar como dispositivo de legitimação da violência e, consequentemente, ocasiona a ruptura do vínculo, o afastamento temporário ou permanente entre jovens lésbicas e gays e seus familiares, levando, muitas vezes, à saída ou à expulsão da casa dos pais em circunstâncias complexas e, frequentemente, dolorosas.

Advantages and disadvantages of using non-coplanar techniques in radiotherapy of the abdomen formed 3D

International Nuclear Information System (INIS)

Urena Llinares, A.; Castro Ramirez, I.; Iborra Oquendo, M. A; Quinones Rodriguez, L. A.; Angulo Pain, E.

2011-01-01

3D Radiotherapy locations abdomen, especially in pancreas and stomach cancers is often extremely difficult if we are to meet the dose constraints to organs at risk due to proximity and many of these (liver, kidneys, intestines, lungs, bone. ..). Of these, the most critical are the kidneys, which also present values of tolerance, in most cases difficult to meet. This is done in our hospital are using non-coplanar techniques performing well both as coating PTV dose to both kidneys.

El maltrato infantil: aspectos psicológicos y programas de tratamientos

OpenAIRE

González Díaz, Adriana

2013-01-01

La presente revisión recoge los aspectos psicológicos derivados del maltrato infantil. Expone la tipología, así la evaluación psicológica de los menores en estos casos y las patologías asociadas al maltrato. Finalmente se exponen los principales programas de intervención y tratamiento en estos casos

Small bowel obstruction in the virgin abdomen: time to challenge surgical dogma with evidence.

Science.gov (United States)

Ng, Yvonne Ying-Ru; Ngu, James Chi-Yong; Wong, Andrew Siang-Yih

2018-01-01

Although adhesions account for more than 70% of small bowel obstruction (SBO), they are thought to be less likely aetiologies in patients without previous abdominal surgery. Expedient surgery has historically been advocated as prudent management in these patients. Emerging evidence appears to challenge such a dogmatic approach. A retrospective analysis was performed in all SBO patients with a virgin abdomen admitted between January 2012 and August 2014. Patients with obstruction secondary to abdominal wall hernias were excluded. Patient demographics, clinical presentation, management strategy and pathology involved were reviewed. A total of 72 patients were included in the study. The majority of patients were males (66.7%), with a median age of 58 years (range: 23-101). Abdominal pain (97%) and vomiting (86%) were the most common presentations while abdominal distention (60%) and constipation (25%) were reported less frequently. Adhesions accounted for the underlying cause in 44 (62%) patients. Other aetiologies included gallstone ileus (n = 5), phytobezoar (n = 5), intussusception (n = 4), internal herniation (n = 4), newly diagnosed small bowel tumour (n = 3), mesenteric volvulus (n = 3), stricture (n = 3) and Meckel's diverticulum (n = 1). Twenty-nine (40%) patients were successfully managed conservatively while the remaining 43 (60%) underwent surgery. The intraoperative findings were in concordance with the preoperative computed tomography scan in 76% of cases. Adhesions remain prevalent despite the absence of previous abdominal surgery. Non-operative management is feasible for SBO in a virgin abdomen. Computed tomography scan can be a useful adjunct in discerning patients who may be treated non-operatively by elucidating the underlying cause of obstruction. © 2016 Royal Australasian College of Surgeons.

La obesidad: aspectos psicológicos y conductuales

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Bersh, Sonia

2006-01-01

Introducción: La obesidad es un problema médico de creciente gravedad por su morbilidad y su alta y creciente prevalencia. Objetivo: Realizar una revisión actualizada acerca de la obesidad y su tratamiento, con énfasis en los aspectos de mayor interés para la práctica psiquiátrica. Resultados: La obesidad es una enfermedad crónica de difícil manejo y alta tasa de recurrencia, que se asocia con complicaciones médicas graves. Los factores psicológicos y conductuales son muy relevantes en el cur...

Contribution to the radiological study of the eosinophilic granuloma of the mandible (Unifocal granuloma due to Langherans' cell histiocytosis); Contributo allo studio radiologico del granuloma eosinofilo della mandibola (granuloma unifocale da istiocitosi delle cellule di Lagherhans)

Energy Technology Data Exchange (ETDEWEB)

Chigi, Gino; Pastremoli, Alessandro; Pisi, Paolo; Pastremoli, Alfredo [Bologna Univ., Bologna (Italy). Dipartimento di scienze odontomastologiche; Bianchi, Giuseppe [Istituti Ortopedici Rizzoli, Bologna (Italy)

2005-04-01

non completamente risolto per talune condizioni patologiche, nelle quali i dati obiettivi ed anamnestici sono relativamente uniformi e il quadro radiologico privo di qualsiasi caratteristica. Materiale e metodi: Il materiale � costituito da sei casi di istiocitosi delle cellule di Langherans della mandibola osservati nell'arco di un decennio. Lo studio � basato sulla valutazione della documentazione radiologica tradizionale. Le radiografie sono state eseguite in proiezione latero-laterale-obliqua che, come noto, libera quasi completamente la porzione orizzontale della mandibola dalla sovrapposizione delle immagini di altre strutture ossee. Risultati: I risultati delle indagini radiologiche sono riportati nella tabella I. Si tratta di reticoloendoteliopatie capaci di dar luogo ad un processo granulomatoso costituito da polinucleati eosinofili, plasmacellule e linfociti e, fondamentalmente, da grandi cellule istiocitarie mononucleate dotate di attivit� granulopessica e fagocitaria, spiccatamente proliferanti nel tessuto osseo, identificabili con le cellule di Langherhans della pelle, delle mucose, degli spazi periodontali, del midollo osseo. Il tessuto granulomatoso che ne deriva si infiltra tra gli elementi costitutivi dell'organo colpito ed estendendosi comprime, atrofizza e tende a distruggere il tessuto, sostituendosi ad esso. Le alterazioni determinate dal granuloma isiocitario di Langherhans prevalgono nettamente nel sistema scheletrico e si verificano, in ordine di frequenza, nel cranio, nelle ossa lunghe dell'estremit�, nel piede, nelle coste e nella colonna vertebrale. L'interessamento della mucosa orale � eccezionale. Conclusioni: Nel granuloma istiocitario unifocale di Langherhans della mandibola l'indagine radiologica � indispensabile per l'approccio allo studio della tumefazione premandibolare fermo restando che la diagnosi di natura si basa esclusivamente sulla biopsia. Oltre all'esame radiologico digitale o

A Rare Case of Acute Abdomen: Perforation Secondary to Intramural Hematoma at Rectosigmoid Region

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Orhan Yagmurkaya

2013-06-01

Full Text Available Intramural hematoma is a clinical situation which is secondary to anticoagulant therapy. In this study, a chronic atrial fibrilation patient taking anticoagulant, had perforation at rectosigmoid region which was secondary to intramural hematoma, is presented. Our case was a eighty-three-year-old male presented with acute abdomen at emergency room. In computerized tomography, intraabdominal free air and hematoma at rectosigmoid region were seen. Due to these, the decision of immidiate exploration was made. This should be noted that intramural hematoma can emerge in patientd on anticoagulant theraphy without trauma. Additionally, it shold be considered that intramural hematoma can lead to lethal complication such as perforation.

Effective dose conversion coefficients for X-ray radiographs of the chest and the abdomen

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Lima, F.R.A. [Centro regional de Ciencias Nucleares, CRCN/CNEN, Rua Conego Barata, 999, Tamarineira, Recife, PE (Brazil); Kramer, R.; Vieira, J.W.; Khoury, H.J. [Departamento de Energia Nuclear, DEN/UFPE, Cidade Universitaria, Recife, PE (Brazil)]. E-mail: falima@cnen.gov.br

2004-07-01

The recently developed MAX (Male Adult voXel) and the FAXht (Female Adult voXel) head and trunk phantoms have been used to calculate organ and tissue equivalent dose conversion coefficients for X-ray radiographs of the chest and the abdomen as a function of source and field parameters, like voltage, filtration, field size, focus-to-skin distance, etc. Based on the equivalent doses to twenty three organs and tissues at risk, the effective dose has been determined and compared with corresponding data for others phantoms. The influence of different radiation transport codes, different tissue compositions and different human anatomies have been investigated separately. (Author)

Effective dose conversion coefficients for X-ray radiographs of the chest and the abdomen

International Nuclear Information System (INIS)

Lima, F.R.A.; Kramer, R.; Vieira, J.W.; Khoury, H.J.

2004-01-01

The recently developed MAX (Male Adult voXel) and the FAXht (Female Adult voXel) head and trunk phantoms have been used to calculate organ and tissue equivalent dose conversion coefficients for X-ray radiographs of the chest and the abdomen as a function of source and field parameters, like voltage, filtration, field size, focus-to-skin distance, etc. Based on the equivalent doses to twenty three organs and tissues at risk, the effective dose has been determined and compared with corresponding data for others phantoms. The influence of different radiation transport codes, different tissue compositions and different human anatomies have been investigated separately. (Author)

Treatment of a case of emphysematous pyelonephritis that presented with acute abdomen and pneumoperitoneum: a case report.

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Park, Sang Hyun; Kim, Ki Hoon

2015-08-01

Emphysematous pyelonephritis is a severe, life-threatening infection of the renal parenchyma and perinephric tissues. This condition is primarily encountered in patients with diabetes mellitus or ureteral obstruction, and is characterized by the production of intrarenal and perinephric gas. Emphysematous pyelonephritis is associated with a high degree of morbidity and a high mortality rate. A 72-year-old woman with a history of diabetes mellitus, hypertension, and renal calculi was referred to our emergency department following 6 days of abdominal pain. She suddenly developed pain in the entire abdomen, and was transferred. Physical examination was a distended abdomen with hypoactive bowel sounds. The tenderness was diffuse, but was most prominent in the right upper abdominal quadrant; moreover, rebound tenderness was noted. Laboratory tests revealed a white blood cell count of 4,480/mm(3), platelet count of 17,000/mm(3), creatinine level of 1.64 mg/dl, and serum glucose level of 603 mg/dl. Abdominal computed tomography indicated the presence of free air in the intraperitoneal cavity and right perirenal space, hydronephrosis of the right kidney, and stones in the right distal ureter. After 1 hour, the vital signs changed and she appeared to become drowsy. Therefore, the patient was transferred to the operation room for laparotomy. On exploration of the abdomen, 1.5 L of pus-colored fluid was removed. Although the abdominal viscera and pelvic organs were examined, hollow viscus perforation site could not be observed. Moreover, tissue necrosis and a perforation site were identified at the superior border of the right kidney. Thus, emphysematous pyelonephritis was diagnosed and she underwent right radical nephrectomy. After the surgery, the patient was admitted to the intensive care unit for postoperative management. Follow-up CT performed after 10 days showed fluid collection and hematoma at the nephrectomy site. Hence, percutaneous drainage was performed. Another

ALGUNOS ASPECTOS A CONSIDERAR SOBRE LA SEXUALIDAD DEL ADULTO MAYOR

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Zoila Edith Hernández Zamora

2008-12-01

Full Text Available La presente investigación expone, a partir de una serie de entrevistas realizadas a una muestra de adultos mayores, aspectos relativos a la satisfacción general en la vida, así como las actitudes, conocimientos y prácticas de la sexualidad de un grupo de adultos mayores que asisten regularmente a una estancia diurna de la ciudad de Xalapa, Veracruz, México, misma que fue diseñada especialmente para este grupo etario. Se encontraron diferencias estadísticamente significativas entre la actitud hacia el ejercicio de la sexualidad de las personas mayores entre los hombres y las mujeres de la muestra, y entre .las personas que tienen pareja con relación a las que no tienen; así como que hay una diferencia estadísticamente significativa entre aquellas personas que tiene una o ninguna enfermedad y las que tienen dos o más enfermedades con respecto a su frecuencia de actividad sexual. Es de resaltar la escasez de conocimientos sobre aspectos básicos de la sexualidad que poseen estas personas mayores, lo que hace necesario el establecimiento de programas educativos que incluyan al personal de salud y a los mismos senectos.

Utility of screening computed tomography of chest, abdomen and pelvis in patients after heart transplantation

International Nuclear Information System (INIS)

Dasari, Tarun W.; Pavlovic-Surjancev, Biljana; Dusek, Linda; Patel, Nilamkumar; Heroux, Alain L.

2011-01-01

Introduction: Malignancy is a late cause of mortality in heart transplant recipients. It is unknown if screening computed tomography scan would lead to early detection of such malignancies or serious vascular anomalies post heart transplantation. Methods: This is a single center observational study of patients undergoing surveillance computed tomography of chest, abdomen and pelvis atleast 5 years after transplantation. Abnormal findings, included pulmonary nodules, lymphadenopathy and intra-thoracic and intra-abdominal masses and vascular anomalies such as abdominal aortic aneurysm. The clinical follow up of each of these major abnormal findings is summarized. Results: A total of 63 patients underwent computed tomography scan of chest, abdomen and pelvis at least 5 years after transplantation. Of these, 54 (86%) were male and 9 (14%) were female. Mean age was 52 ± 9.2 years. Computed tomography revealed 1 lung cancer (squamous cell) only. Non specific pulmonary nodules were seen in 6 patients (9.5%). The most common incidental finding was abdominal aortic aneurysms (N = 6 (9.5%)), which necessitated follow up computed tomography (N = 5) or surgery (N = 1). Mean time to detection of abdominal aortic aneurysms from transplantation was 14.6 ± 4.2 years. Mean age at the time of detection of abdominal aortic aneurysms was 74.5 ± 3.2 years. Conclusion: Screening computed tomography scan in patients 5 years from transplantation revealed only one malignancy but lead to increased detection of abdominal aortic aneurysms. Thus the utility is low in terms of detection of malignancy. Based on this study we do not recommend routine computed tomography post heart transplantation.

ASPECTOS BASICOS DEL DERECHO ADUANERO PARA ESTUDIANTES DE PREGRADO

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Castro Rangel, Jesus David; Garcia Vargas, Kristhell; Sepulveda Mora, Myriam

2008-01-01

La presente investigación comprende un estudio en un grado fundamental y a nivel general del Derecho Aduanero y una herramienta pedagógica dirigida a facilitar, a los alumnos de Pregrado de la Universidad Libre de Cúcuta, el entendimiento y aprendizaje de los aspectos básicos del Derecho Aduanero, teniendo en cuenta que Cúcuta es una zona fronteriza. El estudiante a través del presente trabajo encontrará las herramientas que le permitirán ubicarse dentro del contexto aduanero y...

Nonlinear image blending for dual-energy MDCT of the abdomen: can image quality be preserved if the contrast medium dose is reduced?

Science.gov (United States)

Mileto, Achille; Ramirez-Giraldo, Juan Carlos; Marin, Daniele; Alfaro-Cordoba, Marcela; Eusemann, Christian D; Scribano, Emanuele; Blandino, Alfredo; Mazziotti, Silvio; Ascenti, Giorgio

2014-10-01

The objective of this study was to compare the image quality of a dual-energy nonlinear image blending technique at reduced load of contrast medium with a simulated 120-kVp linear blending technique at a full dose during portal venous phase MDCT of the abdomen. Forty-five patients (25 men, 20 women; mean age, 65.6 ± 9.7 [SD] years; mean body weight, 74.9 ± 12.4 kg) underwent contrast-enhanced single-phase dual-energy CT of the abdomen by a random assignment to one of three different contrast medium (iomeprol 400) dose injection protocols: 1.3, 1.0, or 0.65 mL/kg of body weight. The contrast-to-noise ratio (CNR) and noise at the portal vein, liver, aorta, and kidney were compared among the different datasets using the ANOVA. Three readers qualitatively assessed all datasets in a blinded and independent fashion. Nonlinear blended images at a 25% reduced dose allowed a significant improvement in CNR (p < 0.05 for all comparisons), compared with simulated 120-kVp linear blended images at a full dose. No statistically significant difference existed in CNR and noise between the nonlinear blended images at a 50% reduced dose and the simulated 120-kVp linear blended images at a full dose. Nonlinear blended images at a 50% reduced dose were considered in all cases to have acceptable image quality. The dual-energy nonlinear image blending technique allows reducing the dose of contrast medium up to 50% during portal venous phase imaging of the abdomen while preserving image quality.

A Case Involving Needles in the Medulla Oblongata, Cervical Spinal Cord, and Abdomen.

Science.gov (United States)

Zhang, Hao-Yu; Li, Da; Wu, Zhen; Zhang, Li-Wei; Zhang, Jun-Ting

2014-10-01

It is extremely rare to encounter intracranial foreign bodies caused by penetrating injuries other than gunshot wounds or low-velocity wounds. We present a case describing a 5-year-old girl with metallic foreign bodies in the medulla oblongata, cervical spinal cord, and abdomen. The foreign bodies may have been there and remained silent for several years until the patient developed nausea and vomiting that persisted for 3 months. A craniotomy and a laparotomy were performed after a thorough discussion. Five pieces of metallic foreign bodies were removed, and the patient had a good outcome. Despite the precarious location of the needles in the medulla oblongata and cervical spinal cord, this rare case supports the use of surgery to remove the foreign bodies.

SPLENIC INFARCTION: an intriguing and important cause of pain abdomen in high altitude

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P. K. Hota

2015-01-01

Full Text Available Background: Patients with Sickle cell trait (SCT are usually asymptomatic. They are usually unaware of their condition unless they have a family history. There are specific situations, where these people suffer from the effects of sickle cell trait. Splenic syndrome at high altitude is one of the specific problems. It is usually seen after a patient with SCT has been inducted to high altitude like in case of mountaineers and military personnel deployed in high altitude warfare. Pain abdomen due to splenic infarction in individuals with SCT is one of the manifestations. These patients, if diagnosed in time, they can be spared from unnecessary surgical interventions. We present herewith our experience of splenic infarction due to SCT in high altitude and their management.

Aspectos moleculares da anemia falciforme

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Galiza Neto Gentil Claudino de

2003-01-01

Full Text Available No presente artigo abordaram-se vários aspectos relacionados à natureza molecular da anemia falciforme, desordem hematológica de caráter hereditário que acomete expressivo número de indivíduos em várias regiões do mundo. As pesquisas realizadas em torno desta patologia da hemácia, ao longo de quase um século, a partir de 1910, cooperaram para a criação de um novo e importante segmento da ciência, denominado biologia molecular. A descoberta dos polimorfismos da mutação (GAT->GTG no gene que codifica a cadeia beta da hemoglobina, originando diferentes haplótipos da doença, permitiu um melhor e mais amplo conhecimento em torno da heterogeneidade clínica nos pacientes falcêmicos. Analisando a hemoglobina na sua estrutura normal e mutante, sua produção e evolução, pode-se ter um entendimento mais completo da fisiopatologia desta doença e da sua complexidade clínica.

Aspectos Comportamentais no Julgamento Profissional dos Auditores Independentes

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José Emerson Firmino

2013-12-01

Full Text Available Alguns estudos evidenciam que a adoção das International Financial Reporting Standards (IFRS proporcionou melhorias na qualidade das informações contábeis. Mas, o conjunto de Procedimentos descritos nas IFRSs é fortemente afetado pelo julgamento profissional dos contadores. O mesmo fato ocorre com o auditor, que deve avaliar se a aplicação das normas resulta em fair presentation. Esse julgamento dependerá da interpretação do auditor sobre o nível de probabilidade associada a determinadas expressões presentes no texto das normas contábeis. Alguns autores evidenciam que existem diferenças significativas na interpretação das expressões verbais de probabilidade entre os auditores e que aspectos comportamentais estão influenciando a emissão do parecer de auditoria. Diante desse cenário, o objetivo deste estudo foi investigar como se comportam os auditores no julgamento de situações subjetivas, inseridos em um cenário pessimista ou otimista, no momento da avaliação dos critérios de reconhecimento e/ou mensuração, quando da execução dos trabalhos da auditoria. A amostra desta pesquisa é composta por 258 auditores independentes com registro de responsáveis técnicos junto à Comissão de Valores Mobiliários (CVM. Os resultados obtidos, por intermédio da análise das respostas dos auditores para situações subjetivas, sugerem que o julgamento do auditor em situações de subjetividade é influenciado por aspectos comportamentais, sendo que eles podem apresentar opiniões distintas em seus relatórios.

Efficient organ localization using multi-label convolutional neural networks in thorax-abdomen CT scans

Science.gov (United States)

Efrain Humpire-Mamani, Gabriel; Arindra Adiyoso Setio, Arnaud; van Ginneken, Bram; Jacobs, Colin

2018-04-01

Automatic localization of organs and other structures in medical images is an important preprocessing step that can improve and speed up other algorithms such as organ segmentation, lesion detection, and registration. This work presents an efficient method for simultaneous localization of multiple structures in 3D thorax-abdomen CT scans. Our approach predicts the location of multiple structures using a single multi-label convolutional neural network for each orthogonal view. Each network takes extra slices around the current slice as input to provide extra context. A sigmoid layer is used to perform multi-label classification. The output of the three networks is subsequently combined to compute a 3D bounding box for each structure. We used our approach to locate 11 structures of interest. The neural network was trained and evaluated on a large set of 1884 thorax-abdomen CT scans from patients undergoing oncological workup. Reference bounding boxes were annotated by human observers. The performance of our method was evaluated by computing the wall distance to the reference bounding boxes. The bounding boxes annotated by the first human observer were used as the reference standard for the test set. Using the best configuration, we obtained an average wall distance of 3.20~+/-~7.33 mm in the test set. The second human observer achieved 1.23~+/-~3.39 mm. For all structures, the results were better than those reported in previously published studies. In conclusion, we proposed an efficient method for the accurate localization of multiple organs. Our method uses multiple slices as input to provide more context around the slice under analysis, and we have shown that this improves performance. This method can easily be adapted to handle more organs.

Blunt-tip coaxial introducer: a revisited tool for difficult CT-guided biopsy in the chest and abdomen.

Science.gov (United States)

de Bazelaire, Cedric; Farges, Cecile; Mathieu, Olivier; Zagdanski, Anne-Marie; Bourrier, Pierre; Frija, Jacques; de Kerviler, Eric

2009-08-01

We describe a coaxial introducer provided with an additional blunt-tip stylet that allows safe access to difficult-to-reach lymph nodes in the chest, abdomen, and pelvis under CT control. Once the thoracic, abdominal, or pelvic wall is crossed by the introducer fitted with the sharp-tip stylet, the blunt-tip stylet replaces the sharp stylet for further progression in the fat toward the target. The soft-tip stylet carries a smaller risk of inadvertent perforation displacing vital structures.

Applying the PCXMC software for dose assessment in patients submitted to abdomen and pelvis X-ray examinations

International Nuclear Information System (INIS)

Oliveira, V.L.S.; Silva, T.A. da

2009-01-01

The PCXMC R computational methodology was applied as a evaluation tool of the organ doses in patients submitted to different X-ray conventional diagnoses examinations. Simulations were made based in x-ray parameters and exposure geometry of three patient of same age group in an Emergency Hospital of the metropolitan area of Belo Horizonte city. Contributions to the effective dose from critical organs were evaluated and analyzed in terms of patient height and weight for the examinations of abdomen and pelvis. (author)

Aspectos motivacionais e afetivos na mediação de professores alfabetizadores

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Azevedo, Cleomar

2010-01-01

Full Text Available Este artigo é o resultado de uma pesquisa que parte da seguinte questão: o que diferencia o professor que obtém sucesso no processo de alfabetização? Levanto a hipótese que na mediação os aspectos motivacionais e afetivos são componentes que se fazem presente na atuação desses professores alfabetizadores. O objetivo desta pesquisa foi o de levantar os aspectos motivacionais e afetivos na mediação do processo de alfabetização, através da fala de professores alfabetizadores. Foram entrevistados 18 professores com a premissa de serem bons alfabetizadores. Investigar o que mobiliza e caracteriza a ação dos docentes, que mesmo possuindo inúmeras variáveis que interfiram negativamente nesse processo, conseguem obter êxito no desenvolvimento da alfabetização de seus alunos é uma possibilidade de levantar questões voltadas à problemática da aprendizagem do processo de alfabetização

Management of the open abdomen using negative pressure wound therapy with instillation in severe abdominal sepsis: A review of 48 cases in Hospital Mexico, Costa Rica.

Science.gov (United States)

Sibaja, Pablo; Sanchez, Alfredo; Villegas, Guillermo; Apestegui, Alvaro; Mora, Esteban

2017-01-01

Despite the numerous advances in recent years, severe abdominal sepsis (with associated organ failure associated with infection) remains a serious, life-threatening condition with a high mortality rate. OA is a viable alternative to the previously used scheduled repeat laparotomy or continuous peritoneal lavage. The use of Negative Pressure Wound Therapy (NPWT) has been described as a successful method of management of the open abdomen. Adding instillation of saline solution to NPWT in a programmed and controlled manner, could offer the clinician an additional tool for the management of complex septic abdomen. To explore if the concept of active two-way therapy (Negative pressure wound therapy with instillation or NPWT-I) yields superior control of underlying, life-threatening abdominal infections and its effects on survival and morbidity in patients with severe abdominal sepsis when management with an open abdomen is required. A retrospective review of 48 patients with severe abdominal sepsis, who were managed with and open abdomen and NPWT-I was performed. NPWT-I was initiated utilizing the same parameters on all patients, this consisted of cycles of instillation of saline solution, which was removed through negative pressure after a short dwell period. We observed the effects on primary fascia closure rate, mortality, hospital and SICU length of stay and associated complications. Our patient group consisted of 20 (42%) males and 28 (58%) females. Average age was 48 years. Mortality in these patients was attributed to pulmonary embolism (n=1), acute renal failure (n=2) and cardiopulmonary arrest (n=1). Average total hospital stay was 24days, and stay in the SICU (n=26) averaged 7.5days. No acute complications related to the NPWT-I. All patients presenting with abdominal compartment syndrome resolved after initiation of the NPWT-I. A total of 46 patients (96%) patients achieved fascia closure after NPWT-I therapy after an average of 6days. Four patients (8%) died

Satisfacción con el aspecto dental general y tratamientos deseados en estudiantes universitarios

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Clarisse Virginia Díaz Reissner

2015-08-01

Full Text Available La apariencia dental es considerada un componente de la belleza facial, que al ser restaurada por el odontólogo, podría influir con un efecto positivo en la valoración personal y la calidad de vida. El objetivo del estudio fue determinar la satisfacción general con la apariencia dental en estudiantes de las carreras de Artes Visuales y Diseño de Indumentaria del Instituto Superior de Arte de la Facultad de Arquitectura Diseño y Arte de la Universidad Nacional de Asunción, matriculados en el 2014. Se aplicó un cuestionario que contenía preguntas sobre datos demográficos, satisfacción con el aspecto dental general y con diversos aspectos dentales, así como también sobre el tratamiento estético deseado. La muestra quedó conformada por 108 estudiantes, que corresponde al 49,1% de la población. Se observó que el 48,2% se encontraba insatisfecho con el aspecto general de sus dientes, siendo los tratamientos de elección: blanqueamiento (63,9% y ortodoncia (47,2%. Los factores predisponentes a la insatisfacción fueron residir en Gran Asunción e interior del país y percibir sus dientes como desalineados. Por otro lado, favoreció la satisfacción el haberse sentirse a gusto con el color de sus dientes.

Abdominal intra-compartment syndrome - a non-hydraulic model of abdominal compartment syndrome due to post-hepatectomy hemorrhage in a man with a localized frozen abdomen due to extensive adhesions: a case report.

Science.gov (United States)

Bressan, Alexsander K; Kirkpatrick, Andrew W; Ball, Chad G

2016-09-15

Postoperative hemorrhage is a significant cause of morbidity and mortality following liver resection. It typically presents early within the postoperative period, and conservative management is possible in the majority of cases. We present a case of late post-hepatectomy hemorrhage associated with overt abdominal compartment syndrome resulting from a localized functional compartment within the abdomen. A 68-year-old white man was readmitted with sudden onset of upper abdominal pain, vomiting, and hemodynamic instability 8 days after an uneventful hepatic resection for metachronous colon cancer metastasis. A frozen abdomen with adhesions due to complicated previous abdominal surgeries was encountered at the first intervention, but the surgery itself and initial recovery were otherwise unremarkable. Prompt response to fluid resuscitation at admission was followed by a computed tomography of his abdomen that revealed active arterial hemorrhage in the liver resection site and hemoperitoneum (estimated volume abdominal compartment syndrome. Surgical exploration confirmed a small volume of ascites and blood clots (1.2 L) under significant pressure in his supramesocolic region, restricted by his frozen lower abdomen, which we evacuated. Dramatic improvement in his ventilatory pressure was immediate. His abdomen was left open and a negative pressure device was placed for temporary abdominal closure. The fascia was formally closed after 48 hours. He was discharged home at postoperative day 6. Intra-abdominal pressure and radiologic findings of intra-abdominal hemorrhage should be carefully interpreted in patients with extensive intra-abdominal adhesions. A high index of suspicion and detailed understanding of abdominal compartment mechanics are paramount for the timely diagnosis of abdominal compartment syndrome in these patients. Clinicians should be aware that abnormal anatomy (such as adhesions) coupled with localized pathophysiology (such as hemorrhage) can create a so

Abdominal wall hernias: computed tomography findings; Hernias da parede abdomino-pelvica: aspectos tomograficos

Energy Technology Data Exchange (ETDEWEB)

D' Ippolito, Giuseppe; Rosas, George de Queiroz; Mota, Marcos Alexandre; Akisue, Sandra R. Tsukada; Galvao Filho, Mario de Melo[Hospital e Maternidade Sao Luiz, Sao Paulo, SP (Brazil). Setor de US/TC/RMN]. E-mail: giuseppe_dr@uol.com.br

2005-07-15

Abdominal hernias are a common clinical problem Clinical diagnosis of abdominal hernias can sometimes be challenging, particularly in obese patients or patients with previous abdominal surgery. CT scan of the abdomen allows visualization of hernias and their contents and the differentiation from other masses of the abdominal wall such as tumors, hematomas and abscesses. Moreover, CT may identify complications such as incarceration, bowel obstruction, volvulus and strangulation. This study illustrates the CT scan findings observed in different types of abdominal wall hernias. (author)

Atitudes frente a aspectos relevantes da prática médica: estudo transversal randomizado com alunos de segundo e sexto anos

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Adriana Rainha Mascia

Full Text Available Estudo transversal com duas amostras randomizadas de 50 alunos do segundo e 50 do sexto ano de graduação em Medicina. Foi aplicado um questionário com questões abertas e a escala "Instrumento de avaliação de atitudes de estudantes de medicina frente a aspectos relevantes da prática médica" (Colares, 2002. A escala contém 52 questões referentes à: 1. Aspectos psicológicos e emocionais nas doenças orgânicas e mentais; 2. Manejo de situações relacionadas à morte; 3. Atenção primária à saúde; 4. Aspectos relacionados à doença mental; 5. Contribuição do médico ao avanço científico da medicina; 6. Outros aspectos relacionados à atuação médica e às políticas de saúde. As atitudes são categorizadas em positivas, negativas e conflitantes. Observou-se que os estudantes apresentaram atitudes positivas frente a pelo menos três dos seis aspectos abordados; os alunos do segundo ano e do sexto ano apresentaram diferença estatisticamente significativa (chi² = 6,901, g.l. = 1, p < 0,05 nas atitudes relacionadas ao fator 2 (manejo de situações relacionadas à morte.

Influence of ADP on the course of radiation sickness and some metabolic processes in rats after irradiation of abdomen and parenteral feeding

International Nuclear Information System (INIS)

Grozdov, S.P.; Fedorovskij, L.L.; Protserova, T.K.

1985-01-01

The intrapertitoneal administration of ADP (150-75 mg/kg/day) to rats on days 1-3 after exposure of abdomen to X-rays (13.5 Gy) enhanced the assimilation of glucose, amino acids and electrolytes introduced with the parenteral feeding and increased considerably the survival rate of animals

An investigation of human body model morphing for the assessment of abdomen responses to impact against a population of test subjects.

Science.gov (United States)

Beillas, Philippe; Berthet, Fabien

2017-05-29

Human body models have the potential to better describe the human anatomy and variability than dummies. However, data sets available to verify the human response to impact are typically limited in numbers, and they are not size or gender specific. The objective of this study was to investigate the use of model morphing methodologies within that context. In this study, a simple human model scaling methodology was developed to morph two detailed human models (Global Human Body Model Consortium models 50th male, M50, and 5th female, F05) to the dimensions of post mortem human surrogates (PMHS) used in published literature. The methodology was then successfully applied to 52 PMHS tested in 14 impact conditions loading the abdomen. The corresponding 104 simulations were compared to the responses of the PMHS and to the responses of the baseline models without scaling (28 simulations). The responses were analysed using the CORA method and peak values. The results suggest that model scaling leads to an improvement of the predicted force and deflection but has more marginal effects on the predicted abdominal compressions. M50 and F05 models scaled to the same PMHS were also found to have similar external responses, but large differences were found between the two sets of models for the strain energy densities in the liver and the spleen for mid-abdomen impact simulations. These differences, which were attributed to the anatomical differences in the abdomen of the baseline models, highlight the importance of the selection of the impact condition for simulation studies, especially if the organ location is not known in the test. While the methodology could be further improved, it shows the feasibility of using model scaling methodologies to compare human models of different sizes and to evaluate scaling approaches within the context of human model validation.

Gadolinium-DTPA as an oral contrast medium for MR tomography of the abdomen

International Nuclear Information System (INIS)

Krahe, T.; Doelken, W.; Lackner, K.; Houselog, M.

1990-01-01

150 MR examinations of the upper abdomen were carried out after the oral administration of 5 ml/kg body weight of a gadolinium DTPA formulation (1.0 mmol/l, 15 g/l manitol), with reference to the delineation of the pancreas, the liver and intra-abdominal fat. For comparison, 100 MR examinations without oral opacification of the G.I. tract were evaluated. Contrast administration resulted in a signal-intensive demonstration of the G.I tract for all measurement sequences. The intraluminal contrast improved the distinction between normal and abnormal structures, T 1 and T 2 sequences and the demonstration of fat on T 2 -weighted series. T 1 -weighted series showed the best diagnostic results. In 25% there was meteorism and diarrhoea within 24 hours of the administration of the oral contrast. (orig.) [de

Direito a moradia e inclusão social: aspectos positivos e negativos do "programa minha casa minha vida"

OpenAIRE

Desordi, Jordana Laís; Strücker, Bianca

2016-01-01

O presente artigo pretende analisar aspectos conceituais e doutrinários referentes ao direito à moradia e à inclusão social, fazendo referência aos aspectos positivos e negativos do programa habitacional brasileiro “Minha Casa Minha Vida” (PMCMV). A pesquisa dá ênfase ao PMCMV, momento em que é analisada a legislação que cria e institui o Programa em suas duas versões existentes até este momento. Destaca-se, ainda, os reflexos que o programa causou ao proporcionar o acesso do indivíduo a sua ...

A import??ncia dos aspectos psicomotores na educa????o infantil

OpenAIRE

Silva, ??talo Cardoso Barreto da

2016-01-01

Introdu????o: Os aspectos psicomotores proporcionam atribui????es significativas para o desenvolvimento do aluno e pode ainda contribuir para sua evolu????o cognitiva, o tornando h??bil para realiza????o de diferentes movimentos. A educa????o f??sica escolar tem o poder de criar, estimular uma ampla gama de a????es motoras, novas viv??ncias que iriam estimular e desenvolver as crian??as. Criando tamb??m a capacidade de inclus??o, diversidade, respeito entre elas e quem as cerca. Objetivo: O p...

Tillandsia recurvata L. (Bromeliaceae: aspectos farmacognósticos

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Alex Lucena de Vasconcelos

2013-01-01

Full Text Available A cobertura superior das florestas tropicais, formada pelas copas das árvores, constitui um ambiente de extrema diversidade vegetal. Contribuindo com a grande riqueza dessas florestas encontram-se as espécies botânicas epífitas, cuja importância pode ser observada do ponto de vista ecológico, faunístico, etnobotânico e até mesmo farmacológico. Dentre as espécies adaptadas à vida epifítica podemos citar as bromeliáceas, que compõem uma das famílias mais representativas dessa flora com elevada variabilidade genética. Tillandsia recurvata é uma espécie epífita cosmopolita, nativa, adaptada a habitats áridos, utilizada para o tratamento de diversas doenças, mas pouco se tem publicado a respeito das comprovações científicas de suas propriedades. O presente trabalho revisa os aspectos etnofarmacológicos, atividades biológicas e compostos químicos relacionados à espécie em questão, pertencente à Bromeliaceae. A partir do levantamento de dados realizado, observa-se que esta se trata de uma espécie de conhecido uso popular no tratamento de diferentes distúrbios, com alguns estudos farmacológicos que comprovam suas propriedades terapêuticas. Do ponto de vista químico observa-se a presença de terpenos, flavonoides e derivados cinâmicos em sua constituição, em que alguns compostos isolados ilustram a potencialidade desta espécie como fonte de biomoléculas de interesse. Todos estes aspectos considerados nesta revisão contribuem para o conhecimento a respeito da importância biológica e o potencial terapêutico acerca dos metabólitos desta promissora espécie.

Automatic Bolus Tracking Versus Fixed Time-Delay Technique in Biphasic Multidetector Computed Tomography of the Abdomen

International Nuclear Information System (INIS)

Adibi, Atoosa; Shahbazi, Ali

2014-01-01

Bolus tracking can individualize time delay for the start of scans in spiral computed tomography (CT). We compared automatic bolus tracking method with fixed time-delay technique in biphasic contrast enhancement during multidetector CT of abdomen. Adult patients referred for spiral CT of the abdomen were randomized into two groups; in group 1, the arterial and portal phases of spiral scans were started 25 s and 55 s after the start of contrast material administration; in group 2, using the automatic bolus tracking software, repetitive monitoring scans were performed within the lumen of the descending aorta as the region of interest with the threshold of starting the diagnostic scans as 60 HU. The contrast enhancement of the aorta, liver, and spleen were compared between the groups. Forty-eight patients (23 males, 25 females, mean age=56.4±13.5 years) were included. The contrast enhancement of the aorta, liver, and spleen at the arterial phase was similar between the two groups (P>0.05). Regarding the portal phase, the aorta and spleen were more enhanced in the bolus-tracking group (P<0.001). The bolus tracking provided more homogeneous contrast enhancement among different patients than the fixed time-delay technique in the liver at portal phase, but not at the arterial phase. The automatic bolus-tracking method, results in higher contrast enhancement of the aorta and spleen at the portal phase, but has no effect on liver enhancement. However, bolus tracking is associated with reduced variability for liver enhancement among different patients

Jeroky Mbaekua - aspectos da etnoarte indígena.

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Oseias de Oliveira

2015-06-01

Full Text Available A idéia de arte compartilhada na cultura ocidental tradicionalmente tem sido entendida a partir de elementos conceituais e categorizações que não podem ser aplicados na cultura indígena. Assim, considerar a arte indígena significa observar sua complexidade, de forma a perpassar todas as instâncias da vida desses sujeitos. Desta forma, o texto busca discutir aspectos da etnoarte indígena que não é focada em uma noção de arte centralizada e homogeneizadora mas, sim atenta à uma perspectiva que busca contemplar melhor o seu modo de construção de símbolos, significados e representações culturais.

Tabaco y salud infantil: un aspecto no suficientemente valorado

OpenAIRE

Rubio, Ivonne; Kanopa, Virginia

2015-01-01

La campaña que se desarrolla en Uruguay contra el consumo de tabaco enfatiza sobre los efectos nocivos que produce el cigarrillo en la salud de la población adulta que fuma y en fumadores pasivos. La disminución de afecciones cardiovasculares como el infarto de miocardio y del cáncer de pulmón ha mostrado resultados alentadores en relación a la disminución del número de consumidores, si bien aún no se ha logrado el descenso esperado. La campaña enfoca varios aspectos dirigidos a la presentaci...

Calidad de servicio (QoS en procesos: Escenarios de procesamiento con aspectos

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Hector Manuel Soto Pérez

2016-12-01

En resumen el presente trabajo estudia conceptos básicos de calidad de servicio y algunos de sus marcos de aplicación siguiendo un enfoque aspectual. Planteando posibles casos de uso genéricos para aplicar mejoras en la prestación de la QoS mediante aspectos en la planificación y gestión de recursos de aplicaciones tradicionales.

Sobressalto patológico: aspectos clínicos e eletrencefalográficos

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Frederico Dahne Kliemann

1967-06-01

Full Text Available Os autores relatam o caso de um paciente apresentando crises de sobressalto provocadas por estímulos auditivos, sensitivos e visuais, sem crises epilépticas espontâneas nem retardo psicomotor. Estudam os aspectos clínicos e eletrencefalográficos e revisam a situação da entidade entre as assim chamadas epilepsias reflexas.

ANÁLISIS DE LA TRAZABILIDAD DESDE LA PERSPECTIVA DE LA ORIENTACIÓN A ASPECTOS

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Marta Silvia Tabares

Full Text Available En este artículo se presenta un análisis acerca de la trazabilidad de los intereses de un sistema de software, desde el enfoque del desarrollo de software orientado a aspectos. Para esto se abordarán los conceptos generales de trazabilidad, de la orientación a aspectos y de las características que esta técnica puede proveer para verificar la fiabilidad y evolución de los requisitos en el proceso de desarrollo de software. Tratar la trazabilidad desde este enfoque pretende orientar al desarrollador a identificar elementos generales para determinar la traza de los intereses de corte transversal cuando estos afectan otros intereses del sistema y a su vez cómo diferentes piezas de un artefacto de software asociadas a este tipo de intereses han evolucionado y afectado a otras a lo largo del ciclo de vida de desarrollo.

Prótesis dental en el paciente anciano: aspectos relevantes

OpenAIRE

Almeida, Erika Oliveira de; Silva, Eulália Maria Martins da; Falcón Antenucci, Rosse Mary; Freitas Junior, Amílcar Chagas

2014-01-01

Para el paciente anciano la prótesis dental es una integradora familiar, social, mantenedora de la salud general y elevadora de la expectativa de vida. Algunos cambios fisiológicos, patológicos y funcionales que ocurren con los elementos dentales en la tercera edad pueden repercutir en el tratamiento protésico. La siguiente revisión de literatura destaca los aspectos  fundamentales que deben ser considerados en el tratamiento protésico de pacientes ancianos. Se destacan las particularidades d...

Fetal demise by umbilical cord around abdomen and stricture.

Science.gov (United States)

Tan, Shun-Jen; Chen, Chi-Huang; Wu, Gwo-Jang; Chen, Wei-Hwa; Chang, Cheng-Chang

2010-01-01

Umbilical cord abnormalities are accepted as conditions associated with intrauterine fetal demise (IUFD), and umbilical cord stricture is most frequently encountered. In addition, although cord entanglement with multiple loops rarely increases the perinatal mortality, it is associated with a significant increase in variable kind of morbidity such as growth restriction. We describe a 27-year-old woman, with a missed abortion history at about 10 weeks' gestation in her first pregnancy, who presented to our outpatient department at 34 4/7 weeks of gestation due to decreased fetal activity during the preceding week. No fetal heart activity and blood flow had been detected by ultrasonography and pulsed-wave Doppler. A demised fetus with umbilical cord stricture and three loops around abdomen was delivered and was weighted 1,830 g that was below the tenth percentile for the gestational age. Either umbilical cord stricture or entanglement around the body can affect the development of the fetus and even be lethal. The former might play a more important role in this case. Their etiology and the sequence of the events are still undetermined, and additional evaluation such as autopsy and further research may be needed. In addition, counsel and frequent fetal surveillance should be done in patients with previous IUFD attributed to cord stricture during next pregnancy because of undetermined risk of recurrence.

Principles of three-dimensional printing and clinical applications within the abdomen and pelvis.

Science.gov (United States)

Bastawrous, Sarah; Wake, Nicole; Levin, Dmitry; Ripley, Beth

2018-04-04

Improvements in technology and reduction in costs have led to widespread interest in three-dimensional (3D) printing. 3D-printed anatomical models contribute to personalized medicine, surgical planning, and education across medical specialties, and these models are rapidly changing the landscape of clinical practice. A physical object that can be held in one's hands allows for significant advantages over standard two-dimensional (2D) or even 3D computer-based virtual models. Radiologists have the potential to play a significant role as consultants and educators across all specialties by providing 3D-printed models that enhance clinical care. This article reviews the basics of 3D printing, including how models are created from imaging data, clinical applications of 3D printing within the abdomen and pelvis, implications for education and training, limitations, and future directions.

Non-traumatic acute abdomen in the adult: a critical review of imaging modalities

International Nuclear Information System (INIS)

Buitrago-Tellez, C.; Boos, S.; Heinemann, F.; Wenz, W.

1992-01-01

Two different series collected at the University Hospital of Freiburg are presented as a basis for the critical appraisal of available imaging tests and their correlation with anatomic pain sites. The first series comprises 284 patients of non-traumatic acute abdomen admitted to the emergency department during 1990. The radiological approach revealed an increased use of immediate ultrasound (58%) followed by plain film radiography (53%), contrast studies (15%), and computed tomography (9.8%). Five groups of entities were identified according to the diagnostic imaging procedure prior to surgery. In a second series, the clinical presentation, the distribution and the efficacy of imaging studies for the confirmation of acute mesenteric ischemia were evaluated in 55 patients over a period of 14 years. A reduced mortality rate emphasizes the value of early and agressive diagnosis and angiographic management. (orig.)

Radiological clinical correlation of pulmonary and extrapulmonary tuberculosis with CD4 T lymphocyte counts in patients with V.I.H. in the San Juan de Dios Hospital during the period 2004 to the first half of 2009; Correlacion clinico radiologica de la tuberculosis pulmonar y extrapulmonar con el conteo de linfocitos T CD4 en pacientes con V.I.H. en el Hospital San Juan de Dios durante el periodo 2004 hasta el primer semestre de 2009

Energy Technology Data Exchange (ETDEWEB)

Campos Fallas, Christian

2010-07-01

The association between radiographic presentation of tuberculosis (TB), pulmonary and extrapulmonary, and the count of CD4 T lymphocytes in patients infected with Human Immunodeficiency Virus (HIV), are investigated. The order has been to achieve a diagnosis and isolation early of coinfected patients. A retrospective analysis was performed of the clinical history, chest radiograph, CD4 T lymphocyte count of 25 HIV-infected patients with documented pulmonary or extrapulmonary tuberculosis diagnosis. 18 patients diagnosed (72%) with radiologic atypical skipper, 14 of them with significant immunosuppression (TB patients with CD4 T count <200 / mm {sup 3}), while only 6 (24%) with radiologic typical skipper of TB was associated with negative sputum smears (p=0.06). In HIV patients with CD4 T lymphocyte counts T <200 / mm {sup 3}, no respiratory symptoms and atypical radiographic pattern, may be suspected active TB, even with negative sputum smears. (Author) [Spanish] La asociacion entre la presentacion radiografica de tuberculosis (TB), pulmonar y extrapulmonar, y el conteo de linfocitos T CD4 en pacientes con infeccion por Virus de Inmuno Deficiencia Humana (VIH), son investigados. El fin ha sido lograr un diagnostico y aislamiento temprano de pacientes coinfectados. Un analisis retrospectivo fue realizado de la historia clinica, radiografia de torax, conteo de Linfocitos T CD4, de 25 pacientes con infeccion por VIH con diagnostico documentado de tuberculosis pulmonar o extrapulmonar. 18 pacientes diagnosticados (72%) con patron radiologico atipico, 14 de ellos con inmunosupresion significativa (pacientes con TB con conteo de Linfocitos T CD4 <200/mm{sup 3}), mientras que solo 6 (24%) con patron radiologico tipico de TB fue asociado con baciloscopias negativas, (p=0.06). En pacientes con VIH con conteos de Linfocitos T CD4 <200/mm{sup 3}, no sintomaticos respiratorios y con patron radiologico atipico, puede ser sospechado TB activa, aun con baciloscopias negativas

Aspectos metodologicos de la medición en el sitio de ocurrencia de lesiones por accidentes de tráfico

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Híjar-Medina Martha C.

1997-01-01

Full Text Available Os acidentes de trânsito de veículos a motor representam problema de saúde pública, em nível mundial. No México, a pesquisa, nesse campo, é limitada e a metodologia para seu estudo é pouco desenvolvida. Na literatura científica internacional são escassos os artigos que discutem os aspectos metodológicos de pesquisa nesse campo. Assim, realizou-se estudo com o objetivo de apresentar alguns aspectos metodológicos úteis para os interessados em pesquisar lesões por acidentes de trânsito. Foram discutidos aspectos sobre como medir, no local de ocorrência, as variáveis básicas para o estudo dessas lesões, tais como: se o motorista sofreu ou não lesões, uso de cinto de segurança, velocidade e consumo de álcool.

Comparison of image quality and radiation dose between combined automatic tube current modulation and fixed tube current technique in CT of abdomen and pelvis

Energy Technology Data Exchange (ETDEWEB)

Lee, Sanghee (Dept. of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan Univ. School of Medicine (Korea, Republic of)); Yoon, Sang-Wook; Yoo, Seung-Min; Kim, Kyoung Ah; Kim, Sang Heum; Lee, Jong Tae (Dept. of Diagnostic Radiology, CHA Bundang Medical Center, CHA Univ. (Korea, Republic of)), email: jansons@cha.ac.kr; Ji, Young Geon (Preventive Medicine, CHA Bundang Medical Center, CHA Univ. (Korea, Republic of))

2011-12-15

Background. Tube current is an important determinant of radiation dose and image quality in X-ray-based examination. The combined automatic tube current modulation technique (ATCM) enables automatic adjustment of the tube current in various planes (x-y and z) based on the size and attenuation of the body area scanned. Purpose. To compare image quality and radiation dose of the ATCM with those of a fixed tube current technique (FTC) in CT of the abdomen and pelvis performed with a 16-slice multidetector row CT. Material and Methods. We reviewed 100 patients in whom initial and follow-up CT of the abdomen and pelvis were performed with FTC and ATCM. All acquisition parameters were identical in both techniques except for tube current. We recorded objective image noise in liver parenchyma, subjective image noise and diagnostic acceptability by using a five-point scale, radiation dose, and body mass index (BMI, kg/m2). Data were analyzed with parametric and non-parametric statistical tests. Results. There was no significant difference in image noise and diagnostic acceptability between two techniques. All subjects had acceptable subjective image noise in both techniques. The significant reduction in radiation dose (45.25% reduction) was noted with combined ATCM (P < 0.001). There was a significant linear statistical correlation between BMI and dose reduction (r = -0.78, P < 0.05). Conclusion. The ATCM for CT of the abdomen and pelvis substantially reduced radiation dose while maintaining diagnostic image quality. Patients with lower BMI showed more reduction in radiation dose

Aspectos de diseño de un entorno de programación colaborativo

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David Bracho

2008-12-01

Full Text Available ResumenLa programación colaborativa, o programación en par, es una de las áreas más estudiadas actualmente debido a su impacto en el proceso de desarrollo de software. El propósito de la presente investigación consistió en determinar los aspectos básicos de diseño que un entorno de programación colaborativo debe ofrecer a los desarrolladores. La metodología utilizada consistió en realizar un análisis documental sobre la propuesta de Lussier acerca de la programacióncolaborativa con la finalidad de determinar los aspectos de diseño, estructura e implementación de este tipo de entornos. Como resultado se obtuvo que desde el punto de vista del diseño, la comunicación entre desarrolladores, la revisión de código y la construcción del proyecto de software son los principales aspectos a considerar, y desde el punto de vista de la implementación se propone utilizar el modelo cliente - servidor y una arquitectura multiplataforma.AbstractCollaborative programming or pair programming is today one of the most studied areas, because of its impact on the software developing process. The purpose of the present investigation was to determine the basic design aspects that a collaborative programming environment must offer to developers. The methodology used was a documental review of Lussier’s work about collaborative programming, to determine the design aspects, the structure and the implementation aspects of this type of environments. As result, from the design point of view, the communication between developers, code review and the construction of software project are the basic aspects to consider, and from the implementation point of view, the use of the client - server model and a multiplatform architecture are proposed.

Método de las invariantes en la conducta a seguir ante un paciente con abdomen agudo quirúrgico en el nivel primario de atención

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Esteban Regalado García

2003-08-01

Full Text Available El médico que hoy formamos tiene una visión más integral de los problemas de salud del ser humano. En nuestro sistema de salud, el nivel primario constituye, en gran medida, su puerta de entrada. Los profesionales que laboran en este nivel deben estar preparados para resolver los problemas de salud propios de su especialidad e identificar aquellas entidades que deben ser resueltas en los otros niveles del sistema. El abdomen agudo quirúrgico es de los problemas de salud que deben ser atendidos oportunamente para evitar complicaciones, incluso fatales, en nuestros pacientes. Un método pedagógico para aprender los conocimientos necesarios, con calidad y que orienta la conducta correcta ante cada paciente, es el método de las invariantes. El concepto de invariante contempla la identificación de aquellas cuestiones fundamentales, esenciales y necesarias para poder sospechar un diagnóstico. Cuando el Médico General Integral conoce las invariantes de una entidad, puede tomar decisiones con un elevado margen de seguridad. Un abdomen agudo quirúrgico puede ser producido por cientos de enfermedades y estudiarlas una por una sería interminable; dada su gravedad, cualquier error que se cometa en su manejo puede ser fatal. Hemos identificado 7 signos invariantes en el abdomen agudo quirúrgico, estos signos que presentamos en este trabajo, pueden ser reconocidos en 9 de cada 10 pacientes que consultan con un dolor abdominal agudo. Existen dificultades para su identificación en un pequeño número de pacientes, a lo que hemos llamado "Situaciones Especiales".The physicians that we are preparing today have more comprehensive vision of the health problems of the human being. In our health care system, the primary health care level constitutes, in a greater extent, an entry door. Health professionals working at this level should be ready to solve health problems inherent to their specialty and to identify those entities that should be resolved at

Diseases of the hepatobiliary system as a cause of acute abdomen; Erkrankungen des hepatobiliaeren Systems als Ursache des akuten Abdomens

Energy Technology Data Exchange (ETDEWEB)

Schima, W.; Eisenhuber-Stadler, E. [Krankenhaus Goettlicher Heiland, Abteilung fuer Radiologie und bildgebende Diagnostik, Wien (Austria); Koelblinger, C.; Kulinna-Cosentini, C.; Ba-Ssalamah, A. [Medizinische Universitaet Wien, Universitaetsklinik fuer Radiodiagnostik, Wien (Austria)

2010-03-15

Diseases of the liver and biliary system are common causes of acute abdominal pain and gallstone disease predisposes to cholecystitis and cholangiolithiasis. Sonography is the method of choice for the assessment of cholecystitis, whereas magnetic resonance cholangiopancreaticography (MRCP) is the standard technique to detect stones in the common bile duct. Multi-detector computed tomography (MDCT) is ideal for detection of associated complications, including abscess formation and gall stone ileus. Pyogenic, amebic and fungal liver abscesses are reliably diagnosed with MDCT which can also be used for interventional radiologic therapy of liver abscesses by percutaneous aspiration or drainage procedures. The second most common cause of liver rupture after blunt trauma is spontaneous rupture of hypervascular liver tumors (i.e., HCC, adenoma, angiosarcoma) and due to medical procedures. Multi-phase contrast-enhanced MDCT can reliably detect active bleeding to guide further therapy in these cases. (orig.) [German] Die Cholezystitis ist eine der haeufigsten Ursachen fuer ein akutes Abdomen. Waehrend die Sonographie die Methode der Wahl zum Nachweis einer Cholezystolithiasis und Cholezystitis ist, steht bei der Entwicklung von Komplikationen die Multidetektorcomputertomographie (MDCT) diagnostisch im Vordergrund. Die Magnetresonanzcholangiopankreatikographie (MRCP) hat einen hohen Stellenwert bei der Abklaerung der Cholangiolithiasis, v. a. bei der Differenzialdiagnose zu anderen Ursachen einer Cholestase. Die Diagnose bakterieller, Amoeben- oder fungaler Leberabszesse kann mittels Sonographie oder MDCT rasch gestellt werden, wobei diese Methoden auch fuer die interventionelle radiologische Therapie von Leberabszessen (Punktion oder Drainage) gut geeignet sind. Die mehrphasige, kontrastmittelverstaerkte MDCT ist die Methode der Wahl fuer den Nachweis von Leberinfarkten oder -rupturen, da bei diesen Erkrankungen bzw. Verletzungsfolgen die Darstellung der

Dose estimation in CT exams of the abdomen based on values of DLP; Estimativa da dose em exames de tomografia de abdome com base nos valores de DLP

Energy Technology Data Exchange (ETDEWEB)

Kikuti, C.F.; Medeiros, R.B.; Salvadori, P.S.; Costa, D.M.C; D' lppolito, G., E-mail: kikuticf@gmail.com, E-mail: rbitelli2011@gmail.com [Universidade Federal de Sao Paulo (UNIFESP), SP (Brazil). Coordenadoria de Fisica e Higiene das Radiacoes. Departamento de Diagnostico por Imagem

2013-10-01

One of the challenges of multidetector computerized tomography is to minimize the risk of ionizing radiation using optimized protocols since higher doses are necessary to obtain high image quality. It was also noted that, due to the geometry in image acquisition using MDCT becomes necessary to estimate dose values consistent with the hypothesis clinically and with the specificities of the tomographic equipment. The aim of this study was to estimate the doses in abdomen exams from the data recorded on the MDCT console and dimensions obtained from DICOM images of patients undergoing different clinical protocols. Were collected, from the image DICOM of 101 exams, values of the dose length product (DLP) provided by Philips Health Care - Brilliance 64 equipment console, in order to relate them with the dose values obtained by means of thermoluminescent dosimeters ( TLD ) of CasSo{sub 4}:Mn placed on the surface of a cylindrical simulator abdomen acrylic manufactured under the technical - operational conditions for a typical abdomen exam. From the data obtained, it was possible to find a factor of 1.16 ( 5 % ) indicating that the DLP values Brilliance 64 console underestimate the doses and this should be used with correction factor to estimate the total dose of the patient. (author)

Tumores em animais de produção: aspectos comparativos

OpenAIRE

Ramos,Adriano Tony; Souza,Arlete Benta de; Norte,Diego Mollerke; Ferreira,João Luiz Montiel; Fernandes,Cristina Gevehr

2008-01-01

Com o objetivo de realizar um estudo retrospectivo de tumores em animais de produção (bovinos, ovinos, eqüinos e suínos), foi realizada uma revisão nos casos suspeitos de neoplasmas recebidos pelo Laboratório Regional de Diagnóstico da Faculdade de Veterinária da Universidade Federal de Pelotas num período de 24 anos (1978-2002). Os aspectos epidemiológicos dos neoplasmas nessas espécies foram relatados, e uma classificação concisa para padronizar a nomenclatura, seguindo padrões internaciona...

Radiological and echographic aspects of breasts with silicone implants; Aspectos radiologicos e ecograficos das mamas com protese de silicone

Energy Technology Data Exchange (ETDEWEB)

Pace Bauab, S de [Instituto de Radiodiagnostico Rio Preto, Sao Jose do Rio Preto, SP (Brazil)

1994-10-01

The silicone prosthesis, its application in breast augmentation mammoplasty and the studies about its association with auto-immune diseases and cancer, are commented. The normal and the pathologic radiologic and echographic aspects of breasts with implants are discussed, concerning to the prosthesis itself and to the adjacent parenchyma. The validity of mammographic and ultrasound mammography in the detection of cancer and of alterations of the implants are emphasized and also the importance of exams of high technical quality.(author). 16 refs, 13 figs.

Aspectos relativos a la salud laboral y los riesgos psicosociales de los equipos de proyectos

OpenAIRE

Donate Fernández, Alejandro

2013-01-01

Es el objetivo del presente trabajo presentar una serie de directrices relacionadas con la salud laboral y los riesgos psicosociales de los equipos de proyectos y, en algunos aspectos centrándose en el principal responsable: el director de proyecto.

Abdomen and spinal cord segmentation with augmented active shape models.

Science.gov (United States)

Xu, Zhoubing; Conrad, Benjamin N; Baucom, Rebeccah B; Smith, Seth A; Poulose, Benjamin K; Landman, Bennett A

2016-07-01

Active shape models (ASMs) have been widely used for extracting human anatomies in medical images given their capability for shape regularization of topology preservation. However, sensitivity to model initialization and local correspondence search often undermines their performances, especially around highly variable contexts in computed-tomography (CT) and magnetic resonance (MR) images. In this study, we propose an augmented ASM (AASM) by integrating the multiatlas label fusion (MALF) and level set (LS) techniques into the traditional ASM framework. Using AASM, landmark updates are optimized globally via a region-based LS evolution applied on the probability map generated from MALF. This augmentation effectively extends the searching range of correspondent landmarks while reducing sensitivity to the image contexts and improves the segmentation robustness. We propose the AASM framework as a two-dimensional segmentation technique targeting structures with one axis of regularity. We apply AASM approach to abdomen CT and spinal cord (SC) MR segmentation challenges. On 20 CT scans, the AASM segmentation of the whole abdominal wall enables the subcutaneous/visceral fat measurement, with high correlation to the measurement derived from manual segmentation. On 28 3T MR scans, AASM yields better performances than other state-of-the-art approaches in segmenting white/gray matter in SC.

[Abdomen specific bioelectrical impedance analysis (BIA) methods for evaluation of abdominal fat distribution].

Science.gov (United States)

Ida, Midori; Hirata, Masakazu; Hosoda, Kiminori; Nakao, Kazuwa

2013-02-01

Two novel bioelectrical impedance analysis (BIA) methods have been developed recently for evaluation of intra-abdominal fat accumulation. Both methods use electrodes that are placed on abdominal wall and allow evaluation of intra-abdominal fat area (IAFA) easily without radiation exposure. Of these, "abdominal BIA" method measures impedance distribution along abdominal anterior-posterior axis, and IAFA by BIA method(BIA-IAFA) is calculated from waist circumference and the voltage occurring at the flank. Dual BIA method measures impedance of trunk and body surface at the abdominal level and calculates BIA-IAFA from transverse and antero-posterior diameters of the abdomen and the impedance of trunk and abdominal surface. BIA-IAFA by these two BIA methods correlated well with IAFA measured by abdominal CT (CT-IAFA) with correlatipn coefficient of 0.88 (n = 91, p abdominal adiposity in clinical study and routine clinical practice of metabolic syndrome and obesity.

Dor neuropática central após lesão medular traumática: capacidade funcional e aspectos sociais

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Vall, Janaina; Braga, Violante Augusta Batista

2005-01-01

Estudo de caso comparativo com o objetivo de avaliar a capacidade funcional e os aspectos sociais de dois pacientes, ambos com lesão medular traumática, sem e com dor neuropática central associada, respectivamente. Para avaliar a capacidade funcional, foi utilizado como instrumento o Functional Independence Measure ou Escala de Independência Funcional. E para avaliar os aspectos sociais foi construído o ecomapa de cada paciente, preconizado pelo modelo Calgary de avaliação de famílias. Ambos ...

Aspectos cuantitativos de los programas universitarios de administración de empresas en Colombia

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Carlos Henao Restrepo

1991-05-01

Full Text Available RESUMEN La estabilización o el crecimiento en la oferta universitaria de este programa, en términos  cuantitativos como cualitativos, es uno de los aspectos críticos para las instituciones que postulan mejoras de calidad dentro de las nuevas reglas del mercado educativo.

Can independent coronal multiplanar reformatted images obtained using state-of-the-art MDCT scanners be used for primary interpretation of MDCT of the abdomen and pelvis? A feasibility study

International Nuclear Information System (INIS)

Sebastian, Sunit; Kalra, Mannudeep K.; Mittal, Pardeep; Saini, Sanjay; Small, William C.

2007-01-01

Purpose: To evaluate if coronal reformatted images can be used for primary interpretation of MDCT of the abdomen and pelvis using 64-slice MDCT. Materials and methods: IRB approval was obtained. We reviewed MDCT studies of the abdomen and pelvis of 220 consecutive patients performed with 64 row MDCT with constant scanning parameters. Based on a 0.625 mm raw data set, transverse images were reconstructed at 5 mm and coronal images at 3 mm using standard reconstruction algorithms. Reader familiarity was achieved by simultaneous evaluation of transverse and coronal reformats in an initial group of 20 separate cases for findings in consensus. Two subsequent phases of image analysis were then performed in two groups of 100 patients each. In the first phase two radiologists evaluated the added utility of simultaneous review of MDCT of transverse and coronal reformatted images over transverse images alone in 100 consecutive patients referred for MDCT of the abdomen and pelvis. In the second phase, the same radiologists evaluated whether coronal multiplanar reformats could be used for primary interpretation of MDCT of the abdomen and pelvis in a separate but similar cohort of 100 consecutive abdominopelvic MDCT studies. The number of lesion(s), their location, size of smallest lesion, presence of artifacts and likely diagnosis were noted at each image interpretation. Image quality and confidence for interpretation was evaluated using five-point and three-point scale, respectively. The time required for primary interpretation of coronal reformats and transverse images were recorded. Statistical analysis was performed using Wilcoxon signed rank test. Results: Both readers detected additional findings (n = 37, 35), respectively, on simultaneous review of transverse and coronal reformats as compared with transverse images alone (p < 0.001). Excellent interobserver agreement was noted (r = 0.94-0.96). Both readers detected additional findings (n = 62, 53), respectively, on

Variability interexaminer of chronic apical periodontitis diagnostics in panoramic radiographs; Variabilidad interexaminador del diagnostico de periodontitis apical cronica en radiografias panoramicas

Energy Technology Data Exchange (ETDEWEB)

Montero Aguilar, Mauricio; Zeledon Mayorga, Rodolfo; Ramirez Mora, Tatiana; Monestel Umana, Silvia [Univ. de Costa Rica, Facultad de Odontologia (Costa Rica)

2009-01-15

The accuracy of radiological diagnosis of Apical Periodontitis (AP) is reported between examiners with differents levels of clinical experience using panoramic radiographs. 1032 teeth in 41 panoramic radiographs have been diagnosed. The evaluation of the x-rays and radiological diagnosis is performed by three independent dentists for AP to each tooth. The teeth have presented without radiological signs of AP in 96.6%. The number of teeth classified with an uncertain diagnosis of AP at the has been inversely proportional to the number of years of experience of the examiner. The examiner A has been used as a reference and compared the diagnoses of other examiners.The percentage agreement for all teeth was 95% for examiner B and 94% for examiner C. Kappa for all has been of 0.44 for examiner B and 0.43 for examiner C. The different categories were analyzed separately, the inferior teeth and the anterior teeth have obtained the best results. The level of clinical experience of the examiner has been indifferent in the diagnosis of AP in panoramic radiographs; however, it is important experience in the number of radiographs extras that will be needed to give a radiological diagnosis definitive. The panoramic radiographs were reliable diagnostic tools for AP. (author) [Spanish] La precision del diagnostico radiologico de la Periodontitis Apical Cronica (PAC) es reportado entre examinadores con diferentes niveles de experiencia clinica al utilizar radiografias panoramicas. 1032 dientes en 41 radiografias panoramicas han sido diagnosticados. La evaluacion de las radiografias y el diagnostico radiologico es realizado por tres odontologos independientes para la PAC a cada diente. Los dientes tampoco han presentado signos radiologicos de PAC en 96.6%. El numero de dientes clasificados con un diagnostico incierto de PAC ha sido inversamente proporcional al numero de anos de experiencia del examinador. El examinador A ha sido utilizado como referencia y se han comparado los

Delayed diagnosis of a heterotopic pregnancy as a cause of acute abdomen: A case report

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Fatma Turkan Ayan

2013-09-01

Full Text Available Introduction: Heterotopic pregnancy is a life threating condition of intrauterine and extrauterine gestations which occur at the same time. We report a delayed diagnosed case of heterotopic pregnancy. Case: A 31 year-old primigravida was referred to our Emergency Gynaecology Service complicated by acute abdomen. She had been treated with clomiphene citrate and on admission intrauterine a missed abortus of about 8 weeks complicated by a large subchorionic hematoma was detected. Emergency laparotomy was performed because of diffuse intra-abdominal haemorrhage. A right-sided ectopic focus was recognized and excised, and dilatation - curettage was performed. Coclusion: Delay in diagnosing the condition can be fatal to both the mother and the intrauterine fetus. [J Contemp Med 2013; 3(3.000: 207-208

Whole abdomen irradiation in epithelial ovarian cancer - state of the art

International Nuclear Information System (INIS)

Gocheva, L.

2009-01-01

Epithelial ovarian cancer (OC) as a malignancy which poses multiple challenges has led to growing attention and concern during recent years. The not very noteworthy treatment results achieved during the last three decades with contemporary chemotherapeutic schemes have led to the need for research and development of new therapeutic approaches, as well as to a resurgence of interest in radiotherapy (RT) as part of a combined modality approach and as salvage therapy for patients with small volume persistent disease after primary cytoreductive surgery and chemotherapy. This article reviews the state of the art of whole abdomen irradiation (WAI) (excluding the moving strip field technique) as part of the complex treatment of epithelial OC. The prognostic factors and risk groups of epithelial OC are discussed as indicators for WAI, giving in detail the applied treatment modalities, fractionation and total doses. Toxicity and second primary malignancies following WAI are analyzed. The clinical experience accumulated during the last decades, as adjuvant, consolidative, salvage and palliative WAI in combined treatment of epithelial OC, is presented. Current issues in the radiotherapeutic management are discussed along with ideas for future clinical research directions. (author)

Responsabilidad de directores de sociedades en Estados Unidos. Aspectos procesales

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Héctor José Miguens

2015-01-01

El objeto de este artículo es describir este régimen en su totalidad y realizar un juicio crítico de las normas que rigen las acciones procesales de la responsabilidad de los directores de sociedades comerciales en el derecho societario en Estados Unidos. La metodología utilizada en este trabajo responde a la sistemática de los autores norteamericanos citados, que se caracteriza por centrarse en los aspectos prácticos, la solución de problemas particulares y el comentario crítico de la jurisprudencia aplicable a la cuestión.

Aspectos das relações interpessoais em Freud: questionamentos morais

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Virginia Helena Ferreira da Costa

2014-01-01

O objetivo principal da dissertação é problematizar, a partir de textos de Freud, o prolongamento de expectativas e fantasias próprias da infância em aspectos sociais e políticos da vida adulta. Para tanto, as relações interpessoais são consideradas mediante dois pontos de vista da teoria freudiana, a saber, o do desenvolvimento individual e das relações e estruturas sociais. Como pano de fundo para tal problemática, são abordadas a experiência edípica infantil e a situação de desamparo como ...

Aspectos psicológicos del paciente con cáncer

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R. Labarca B.

2017-05-01

Full Text Available El profundo cambio que ha experimentado lamedicina en los últimos años, ha traído como consecuencia un deterioro en la relación médico-paciente. La consecuencia de este hecho es un distanciamiento entre médico y enfermo, situación que afecta seriamente a los pacientes con enfermedades incurables o terminales. El presente artículo revisa los aspectos psicológicos principales del enfermo con cáncer y concluye que la única actitud que cabe ante el enfermo canceroso es la verdadera relación médico-paciente.

ASPECTOS REPRODUCTIVOS EN MUJERES PORTADORAS DE MUTACIONES GENÉTICAS BRCA

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Dr. Octavio Peralta; Dr. Tulio Rodríguez; Dra. Adela Camus

2017-01-01

Se analizan diferentes aspectos reproductivos en mujeres portadoras de mutaciones genéticas BRCA. Se revisa la evidencia científica del riesgo que agrega el uso de anticoncepción hormonal a mujeres con diferentes niveles de riesgo concluyendo que con las formulaciones recientes después del 2010 no hay aumento del riesgo de cáncer de mama. En portadoras de mutaciones BRCA, el uso prolongado antes de los 25 años se asocia a un leve mayor riesgo de diagnóstico temprano de cáncer de mama. Se a...

EMPREENDEDORISMO CORPORATIVO - ASPECTOS DE INOVAÇÃO E MUDANÇA ORGANIZACIONAL

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Luciana Gehlen

2016-11-01

Full Text Available Este artigo analisa o conceito de empreendedorismo corporativo – conhecido também como empreendedorismo interno ou intra-empreendedorismo, seus aspectos relacionados aos fatores de criatividade, inovação e mudança organizacional como fatores de competitividade das organizações, bem como o perfil do empreendedor corporativo e o ambiente organizacional necessário para que o empreendedorismo interno aconteça. Palavras-chave: empreendedorismo corporativo, empreendedorismo interno, intra-empreendedorismo, inovação, mudança organizacional.

The value of the abdominal radiograph in the assessment of the acute abdomen- work in progress

International Nuclear Information System (INIS)

Verma, R.; Kew, J.; Davies, R.P.

2002-01-01

Full text: The value of the abdominal radiograph in the assessment of the acute abdomen was evaluated for those patients who also had abdominal ultrasound and/or CT. The value of each modality in patient management is reviewed. Retrospective review of 52 consecutive patients presented to a tertiary hospital emergency department with acute abdominal pain who underwent abdominal radiographs (AXR) and abdominal ultrasound (US) and / or computed tomography (CT) within 24 hours of presentation was undertaken. There were 37 males and 15 females. The mean age was 53 years (range 18-95y). Abdominal radiographs were reviewed by two radiologists.Two patients had two separate admissions one week apart. There were 35 normal abdominal radiographs. 19 studies showed clinically relevant abnormalities. Of the normal group, 14 out of 21 patients had abnormal findings on CT and 8 out of 16 had abnormal US examinations. Of the 19 patients with abnormal AXR, 17 out of 19 patients had abnormal CT and 2 out of 5 had abnormal ultrasound examinations. There were 5 cases where both CT scan and US was performed. The positive and negative predictive value for AXR vs CT scan was 89% and 33% respectively and for AXR vs US scan was 40% and 50% respectively. For patients with normal AXR and abnormal CT, there was only one case (a non calcified abdominal aortic aneurysm) which might have required immediate surgical intervention. The preliminary results suggest that the abnormal radiograph is sensitive in the detection of relevant abnormalities in the acute abdomen in the context of appropriate clinical selection. Both CT and ultrasound provide additional diagnostic accuracy for some indications.A further 50 patients are being reviewed and the combined results will be presented. Copyright (2002) Blackwell Science Pty Ltd

Ferric ammonium citrate as a positive bowel contrast agent for MR imaging of the upper abdomen

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Kivelitz, D.; Taupitz, M.; Hamm, B. [Universitaetsklinikum Charite, Berlin (Germany). Inst. fuer Radiologie; Gehl, H.B. [Medizinische Univ. Luebeck (Germany). Inst. fuer Radiologie; Heuck, A. [Muenchen Univ. (Germany). Radiologische Klinik; Krahe, T. [Koeln Univ. (Germany). Inst. fuer Radiologische Diagnostik; Lodemann, K.P. [Bracco-Byk Gulden GmbH, Konstanz (Germany)

1999-07-01

Purpose: To evaluate the safety and diagnostic efficacy of two different doses of ferric ammonium citrate as a paramagnetic oral contrast agent for MR imaging of the upper abdomen. Material and methods: Ninety-nine adult patients referred for MR imaging for a known or suspected upper abdominal pathology were included in this randomized multicenter double-blind clinical trial. Imaging was performed with spin-echo (T1- and T2-weighted) and gradient-echo (T1-weighted) techniques before and after administration of either 1200 mg or 2400 mg of ferric ammonium citrate dissolved in 600 ml of water. Safety analysis included monitoring of vital signs, assessment of adverse events, and laboratory testing. Efficacy with regard to organ distension, contrast distribution, bowel enhancement and delineation of adjacent structures was graded qualitatively. Results: No serious adverse events were reported for either of the two concentrations. A total of 31 minor side effects were noted, of which significantly more occurred in the higher dose group (p<0.01). The diagnostic confidence in defining or excluding disease was graded as better after contrast administration for 48% of all images. Marked or moderate enhancement of the upper gastrointestinal tract was achieved at both doses in 69.5% of cases with no evident difference between the two doses. The higher dose tended to show better results in terms of the contrast assessment parameters. Conclusion: Ferric ammonium citrate is a safe and effective oral contrast agent for MR imaging of the upper abdomen at two different dose levels. The higher dose showed a tendency toward better imaging results while the lower dose caused significantly fewer side effects. Therefore, the 1200 mg dose can be recommended in view of the risk-to-benefit ratio. (orig.)

Toxicologia do tolueno: aspectos relacionados ao abuso

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Forster Letícia M.K.

1994-01-01

Full Text Available O tolueno está presente em muitos produtos de uso doméstico e industrial e é o principal solvente envolvido no abuso de substâncias e na exposição ocupacional. O problema mais grave no estudo de patologias relacionadas ao tolueno é que este está geralmente associado, em suas preparações comerciais, a outras substâncias. O potencial tóxico do tolueno foi abordado nos seguintes aspectos: parâmetros farmacológicos; características físico-químicas; exposição; estudos clínicos; diagnóstico; pesquisa experimental; tolerância e dependência; efeitos agudos e crônicos; neurotoxicidade; teratogenicidade; doenças psiquiátricas; carcinogenicidade e tratamento. Conclui-se ser de grande importância e urgência que se realizem estudos clínicos com amostras maiores para definição mais precisa das conseqüências do uso crônico

Toxicologia do tolueno: aspectos relacionados ao abuso

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Letícia M.K. Forster

1994-04-01

Full Text Available O tolueno está presente em muitos produtos de uso doméstico e industrial e é o principal solvente envolvido no abuso de substâncias e na exposição ocupacional. O problema mais grave no estudo de patologias relacionadas ao tolueno é que este está geralmente associado, em suas preparações comerciais, a outras substâncias. O potencial tóxico do tolueno foi abordado nos seguintes aspectos: parâmetros farmacológicos; características físico-químicas; exposição; estudos clínicos; diagnóstico; pesquisa experimental; tolerância e dependência; efeitos agudos e crônicos; neurotoxicidade; teratogenicidade; doenças psiquiátricas; carcinogenicidade e tratamento. Conclui-se ser de grande importância e urgência que se realizem estudos clínicos com amostras maiores para definição mais precisa das conseqüências do uso crônico

Impacto de las redes sociales e internet en la adolescencia: aspectos positivos y negativos

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L. Elías Arab, Dr.

2015-01-01

Full Text Available Este artículo presenta una revisión teórica del impacto, tanto positivo como negativo, de las redes sociales en los adoles- centes y de la relación directa entre esto y el uso o abuso de las nuevas tecnologías. A su vez, se establece el vínculo entre las formas de utilizarlas y las características psicológi- cas individuales, los desarrollos previos de personalidad y el control parental. Se toma como punto de partida el desa- rrollo adolescente asociado a la construcción de la identidad juvenil en el contexto de un nuevo paradigma comunica- cional (cibercomunicación, donde el límite entre lo públi- co y lo privado se torna cada vez más difuso. Se expone la terminología propia de las redes sociales y se pone énfasis en las estrategias de supervisión y control adulto. Se deta- llan los aspectos positivos que las nuevas tecnologías ofre- cen (diversas oportunidades de aprendizaje, entretención, socialización, desarrollo de habilidades, creatividad y me- jora de la motivación al aprendizaje especialmente en ado- lescentes, entre otros y los aspectos negativos asociados (distanciamiento afectivo, pérdida de límites en la comuni- cación y pérdida de la capacidad de escucha, entre otros. Este artículo destaca la necesidad de entregar y estimular modelos de comunicación social reales y una educación en el uso de las nuevas tecnologías. El objetivo es actualizar y orientar a profesionales de la salud sobre los aspectos posi- tivos y/o negativos de las redes sociales en los adolescentes.

Difficult airway management with bonfils fiberscope in case of emergency: acute abdomen with ileus.

Science.gov (United States)

Maldini, Branka; Novotny, Zdenko; Letica-Brnadić, Renata; Brkljacić, Ana; Bartolek, Dubravka

2012-09-01

This clinical report describes an emergency case of a 49-year-old man, ASA E III status, with clinical symptoms of acute abdomen and ileus, who was scheduled for urgent surgery. Predictors of difficult intubation (Mallampati test Class III, short thyro-mental (management decided on one attempt of Bonfils fiberoptic intubation as primary intervention and urgent tracheotomy, if needed, as secondary intervention. Immediately after assuming supine position on the operating table, the patient lost consciousness and cardiac arrest developed. Successful intubation with oxygenation was followed by cardiopulmonary resuscitation. Upon stabilization of the patient's vital functions, urgent surgery was performed. In the emergency case presented, we succeeded quickly to secure the airway with Bonfils fiberoptic intubation, which allowed for appropriate oxygenation and starting resuscitation. The high risk of the possible aspiration was avoided by timely provision of airway in the experienced anesthetist's hands.

Evidências neuropsicológicas da existiência de um nódulo de aspecto

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Celso Novaes

2012-11-01

Full Text Available Assumindo que todas as línguas naturais compartilham das mesmascategorias funcionais, mostrando assim um alto grau de uniformidade,este trabalho apresenta algumas evidências neuropsicológicas quedizem respeito à dissociação entre a expressão lingüística de tempoe a expressão lingüística de aspecto, em indivíduos com patologiada linguagem – afasia de Broca. Essas evidências nos permitemdefender a hipótese de que a camada flexional seria formada de pelomenos duas subcamadas, sendo uma dessas a camada que projetaindependentemente os traços de aspecto. Essa hipótese vem aoencontro da proposta de Pollock (1989 de que a camada flexionalseria constituída de dois nódulos e da proposta de Chomsky (1995de que somente os traços semanticamente interpretáveis nas interfaceslingüísticas projetariam uma categoria funcional.

Aspectos ergonômicos relacionados com o ambiente e equipamentos hospitalares Aspectos ergonómicos relacionados con el ambiente y aparatos hospitalarios Ergonomic aspects of the hospital working environment and equipment

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Neusa Maria Costa Alexandre

1998-10-01

Full Text Available A ergonomia tem sido difundida como uma das mais importantes estratégias para reduzir os problemas originados por situações de trabalho que causam lesões no sistema músculo-esquelético. O presente trabalho discute determinados aspectos do ambiente como espaço de trabalho, altura da superfície de trabalho, limites de alcance e equipamentos, relacionando-os com as atividades ocupacionais da enfermagem.La ergonomía ha sido difundida como una de las más importantes estratégias para disminuir los problemas originados por situaciones de trabajo que causan lesiones en el sistema musculosquelético. El presente trabajo discute determinados aspectos del ambiente como espacio de trabajo, altura de la superficie de trabajo, limites del alcance y aparatos, relacionándolos con las actividades ocupacionales de enfermería.Ergonomics has been one of the most important strategies for reducing musculoskeletal injuries caused by working conditions. The present report discusses particular aspects of the working environment such as work space, working heights, as well as the limits of reach and of the equipment used, and attempts to relate these to the occupational activities in nursing.

A Rare Cause of Acute Abdomen: Urinary Bladder Rupture due to Foley Catheter

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Ömer Engin

2013-07-01

Full Text Available Urinary bladder rupture is usually found due to blunt or penetrating traumas and iatrogenic injuries, and spontaneous intraperitoneal perforation is very rare. 57 years old male patient was consulted to general surgery department due to abdominal pain, nausia-vomiting and fever. He had Diabetes Mellitus, Multiple Sclerosis, Leriche Syndrome and operation for benign prostatic hypertrophy 5 years ago on his medical history which the case catheterised him urinary bladder himself frequently in nonsterile conditions. He did not care about sterility. On physical examination, suprapubic defence and rebound was noted more prominently on right lower quadrant. He was taken to operating room with the diagnosis of acute abdomen. On exploration, infection was seen on all layers of the whole urinary bladder, abscess formation and necrosis causing a microperforation which is detected by methylene blue was also present. Intraabdominal abscess drainage, cystostomy and primary suturing of the urinary bladder was performed. Patient died due to sepsis at the 9.th post operative day.

Radiotherapy of ovarian epithelial cancer by total orthogonal field irradiation of the abdomen

International Nuclear Information System (INIS)

Delouche, G.; Valinta, D.; Bachelot, F.

1981-01-01

Isotopic intraperitoneal curietherapy by 32 P is the simplest method for irradiating the peritoneum, but it has only limited indications. This irradiation has usually to be given by the percutaneous route, but because of the size of the region to be irradiated it raises delicate problems poorly resolved by the traditional methods applied. For this reason, a particular method is suggested including, among other characteristics: 4 orthogonal fields; 2 sessions daily, irradiating one part of the abdomen in the morning and the other part in the afternoon; spreading of the doses in confirmity with current specifications; and modulation of the total dose as a function of the maximum size of the tumoral remnants. Abdominal radiotherapy is currently the method of choice in cases where lesions are in their early stages, in so far as chemotherapy, much more restrictive for the patient, has not yet demonstrated its long-term efficacy. A controlled clinical study is necessary in order to determine the most effective method [fr

Abscess of urachal remnants presenting with acute abdomen: a case series

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Tazi Fadl

2012-07-01

Full Text Available Abstract Introduction Urachal diseases are rare and may develop from a congenital anomaly in which a persistent or partial reopening of the fetal communication between the bladder and the umbilicus persists. The most frequently reported urachal anomalies in adults are infected urachal cyst and urachal carcinoma. The diagnosis of this entity is not always easy because of the rarity of these diseases and the atypical symptoms at presentation. Imaging techniques, such as ultrasonography and computed tomography have a significant role in recognizing the presence of urachus-derived lesions. Cases presentations Case presentation 1: A 25-year-old Arab-Berber man presented with a 10-day history of progressive lower abdominal pain accompanied by fever, vomiting, and low urinary tract symptoms to our emergency department. Laboratory data revealed leucocytosis. The diagnosis of an acute peritonitis was made initially. Abdominal ultrasonography revealed a hypoechoic tract from the umbilicus to the abdominal wall, and the diagnosis was rectified (infected urachal remnants. The patient was initially treated with intravenous antibiotics in combination with a percutaneous drainage. Afterwards an extraperitoneal excision of the urachal remnant including a cuff of bladder was performed. The histological analysis did not reveal a tumor of the urachal remnant. Follow-up examinations a few months later showed no abnormality. Case presentation 2: A 35-year-old Arab-Berber man, without prior medical history with one week of abdominal pain, nausea and vomiting, associated with fever but without lower urinary tract symptoms visited our emergency department. Laboratory data revealed leucocytosis. Abdominal ultrasonography was not conclusive. Computed tomography of the abdomen was the key to the investigation and the diagnosis of an abscess of urachal remnants was made. The patient underwent the same choice of medical-surgical treatment as previously described for case

Improving the diagnosis of acute appendicitis in children with atypical clinical findings using the technetium-99m hexamethylpropylene amine oxime-labelled white-blood-cell abdomen scan

International Nuclear Information System (INIS)

Yan Dahchin; Shiau Yuchien; Wang Jhijoung; Ho Shungtai; Kao Chiahung

2002-01-01

Heading AbstractBackground. Diagnosing acute appendicitis in children with equivocal signs and symptoms may be difficult. The usual approach is hospital observation and frequent re-examination. However, many surgeons are reluctant to delay surgery because of the risk of perforation and a negative laparotomy.Objective. To assess and compare the value of the technetium-99m hexamethylpropylene amine oxime ( 99m Tc-HMPAO)-labelled white-blood-cell (WBC) abdomen scan in the diagnosis of acute appendicitis in children with atypical clinical presentation.Patients and methods. Fifty children with acute right lower quadrant abdominal pain and possible acute appendicitis, but atypical findings were included. After IV injection of 99m Tc-HMPAO-labelled WBCs, serial anterior abdomen scans were obtained using a gamma camera.Results. Thirty-three children underwent surgery, while 17 children were managed conservatively and were followed up for at least 1 month. Four children had false-positive results and one child had a false-negative scan result. The overall sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the scan to diagnose acute appendicitis in children with atypical findings was 96.7, 80.0, 90.0, 87.8 and 94.1%, respectively.Conclusions. The 99m Tc-HMPAO WBC abdomen scan is a potential tool for diagnosing acute appendicitis in children with atypical clinical findings. The high sensitivity and negative predictive value allows early discharge from the emergency department to avoid costly observation in hospital and potentially unnecessary surgery in those patients with negative scans. (orig.)

Cinema novo e sua relação com o Modernismo literário: reflexões sobre aspectos similares

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Julierme Morais

2017-07-01

Full Text Available No presente artigo visamos problematizar a relação entre os movimentos culturais brasileiros do Cinema Novo e do Modernismo literário, buscando demonstrar como o movimento cinematográfico potencializado nos anos de 1960 possui alguns aspectos similares ao movimento literário iniciado oficialmente na Semana de Arte Moderna de 1922. Para tanto, abordamos dois aspectos fundamentais. A saber: a adoção das conquistas artísticas de vanguarda, acompanhada da desintegração da linguagem artística tradicional, e a busca da “legítima” expressão artística nacional.

La Entomofagia en México. Algunos aspectos culturales

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Felipe Carlos Viesca González

2009-01-01

Full Text Available En este trabajo se abordan aspectos culturales del consumo de insectos con fines alimenticios en México y el mundo; particularmente se analiza la entomofagia en la época prehispánica y nuestros días, así como las causas por las cuales ha disminuido el consumo de estos artrópodos. Se explica porqué se ha creado una aversión hacia los insectos en diversos países y algunas regiones de México. Se reflexiona acerca del valor nutritivo de los insectos y las distintas culturas que han hecho posible que sobreviva esta práctica culinaria en el centro y sur del territorio nacional, algunas formas de preparar platillos basados en insectos, así como los problemas que enfrenta actualmente esta costumbre alimenticia entre los mexicanos y sus perspectivas.

SU-E-P-11: Comparison of Image Quality and Radiation Dose Between Different Scanner System in Routine Abdomen CT

Energy Technology Data Exchange (ETDEWEB)

Liao, S; Wang, Y; Weng, H [Chiayi Chang Gung Memorial Hospital of The C.G.M.F, Puzi City, Chiayi County, Taiwan (China)

2015-06-15

Purpose To evaluate image quality and radiation dose of routine abdomen computed tomography exam with the automatic current modulation technique (ATCM) performed in two different brand 64-slice CT scanners in our site. Materials and Methods A retrospective review of routine abdomen CT exam performed with two scanners; scanner A and scanner B in our site. To calculate standard deviation of the portal hepatic level with a region of interest of 12.5 mm x 12.5mm represented to the image noise. The radiation dose was obtained from CT DICOM image information. Using Computed tomography dose index volume (CTDIv) to represented CT radiation dose. The patient data in this study were with normal weight (about 65–75 Kg). Results The standard deviation of Scanner A was smaller than scanner B, the scanner A might with better image quality than scanner B. On the other hand, the radiation dose of scanner A was higher than scanner B(about higher 50–60%) with ATCM. Both of them, the radiation dose was under diagnostic reference level. Conclusion The ATCM systems in modern CT scanners can contribute a significant reduction in radiation dose to the patient. But the reduction by ATCM systems from different CT scanner manufacturers has slightly variation. Whatever CT scanner we use, it is necessary to find the acceptable threshold of image quality with the minimum possible radiation exposure to the patient in agreement with the ALARA principle.

SU-E-P-11: Comparison of Image Quality and Radiation Dose Between Different Scanner System in Routine Abdomen CT

International Nuclear Information System (INIS)

Liao, S; Wang, Y; Weng, H

2015-01-01

Purpose To evaluate image quality and radiation dose of routine abdomen computed tomography exam with the automatic current modulation technique (ATCM) performed in two different brand 64-slice CT scanners in our site. Materials and Methods A retrospective review of routine abdomen CT exam performed with two scanners; scanner A and scanner B in our site. To calculate standard deviation of the portal hepatic level with a region of interest of 12.5 mm x 12.5mm represented to the image noise. The radiation dose was obtained from CT DICOM image information. Using Computed tomography dose index volume (CTDIv) to represented CT radiation dose. The patient data in this study were with normal weight (about 65–75 Kg). Results The standard deviation of Scanner A was smaller than scanner B, the scanner A might with better image quality than scanner B. On the other hand, the radiation dose of scanner A was higher than scanner B(about higher 50–60%) with ATCM. Both of them, the radiation dose was under diagnostic reference level. Conclusion The ATCM systems in modern CT scanners can contribute a significant reduction in radiation dose to the patient. But the reduction by ATCM systems from different CT scanner manufacturers has slightly variation. Whatever CT scanner we use, it is necessary to find the acceptable threshold of image quality with the minimum possible radiation exposure to the patient in agreement with the ALARA principle

Variation in the quality of CT images of the upper abdomen when CT automatic exposure control is employed

International Nuclear Information System (INIS)

Aizawa, Isao; Muramatsu, Yoshihisa; Nomura, Keiichi; Shimizu, Fuminori

2010-01-01

The aim of this study was to analyze the reason for variation of image quality in the upper abdomen CT with the use of CT-automatic exposure control (AEC). The CT investigated was 3D modulation in the 16 multi detector row CT (MDCT) and lung cancer screening CT (LSCT) phantom was used to simulate the patient. When there was a phase difference, an image noise increase of around 15% at the maximum was accepted. It is concluded that the major reason for variation in image quality is respiratory motion and the importance of respiration control must be recognized. (author)

Aspectos legales al utilizar las principales redes sociales en Colombia

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Manuel Adolfo Alvarado Carmona

2017-01-01

Full Text Available Se analizaron los aspectos legales al utilizar las dos principales redes sociales en Colombia como los son facebook y twitter. Cuando un usuario se conecta a cualquiera de las redes sociales debe hacerlo de forma responsable porque de lo contrario puede incurrir en la violación de la normatividad Colombiana en la cual se encuentran los delitos informáticos, la protección de la información y los datos, injuria y calumnia, ciberacoso y derechos de autor. Se determinaron los problemas que conllevan cuando no se utiliza bien la información en las redes sociales en el ámbito jurídico.

Comparison of virtual unenhanced CT images of the abdomen under different iodine flow rates.

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Li, Yongrui; Li, Ye; Jackson, Alan; Li, Xiaodong; Huang, Ning; Guo, Chunjie; Zhang, Huimao

2017-01-01

To assess the effect of varying iodine flow rate (IFR) and iodine concentration on the quality of virtual unenhanced (VUE) images of the abdomen obtained with dual-energy CT. 94 subjects underwent unenhanced and triphasic contrast-enhanced CT scan of the abdomen, including arterial phase, portal venous phase, and delayed phase using dual-energy CT. Patients were randomized into 4 groups with different IFRs or iodine concentrations. VUE images were generated at 70 keV. The CT values, image noise, SNR and CNR of aorta, portal vein, liver, liver lesion, pancreatic parenchyma, spleen, erector spinae, and retroperitoneal fat were recorded. Dose-length product and effective dose for an examination with and without plain phase scan were calculated to assess the potential dose savings. Two radiologists independently assessed subjective image quality using a five-point scale. The Kolmogorov-Smirnov test was used first to test for normal distribution. Where data conformed to a normal distribution, analysis of variance was used to compare mean HU values, image noise, SNRs and CNRs for the 4 image sets. Where data distribution was not normal, a nonparametric test (Kruskal-Wallis test followed by stepwise step-down comparisons) was used. The significance level for all tests was 0.01 (two-sided) to allow for type 2 errors due to multiple testing. The CT numbers (HU) of VUE images showed no significant differences between the 4 groups (p > 0.05) or between different phases within the same group (p > 0.05). VUE images had equal or higher SNR and CNR than true unenhanced images. VUE images received equal or lower subjective image quality scores than unenhanced images but were of acceptable quality for diagnostic use. Calculated dose-length product and estimated dose showed that the use of VUE images in place of unenhanced images would be associated with a dose saving of 25%. VUE images can replace conventional unenhanced images. VUE images are not affected by varying iodine

Apendicitis epiploica. Causa poco común de abdomen agudo en niños. Presentación de un caso y revisión de la literatura

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SA Solórzano-Morales

2016-04-01

requiere tratamiento con analgésicos. La mayoría de los casos han sido descritos en pacientes adultos; sin embargo, el caso que presentamos es el segundo diagnosticado en el Instituto Nacional de Pediatría.   CASO CLÍNICO: niño de 9 años con diagnóstico clínico presuntivo de apendicitis, se diagnosticó por ultrasonido y tomografía computada como apendicitis epiploica, lo que se corroboró en la pieza anatomopatológica.   CONCLUSIONES: nuestro propósito es describir la apendicitis epiploica en niños como causa de abdomen agudo, así como los hallazgos clínicos, ultrasonográficos, de tomografía computada e histopatológicos de esta patología como causa rara de abdomen agudo. Es importante que se conozca el valor de los estudios de imagen de esta entidad a fin de evitar tratamientos invasivos innecesarios.

Severe acute abdomen caused by symptomatic Meckel's diverticulum in three children with trisomy 18.

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Hayashi, Anri; Kumada, Tomohiro; Furukawa, Oki; Nozaki, Fumihito; Hiejima, Ikuko; Shibata, Minoru; Kusunoki, Takashi; Fujii, Tatsuya

2015-10-01

Meckel's diverticulum (MD) is the most prevalent congenital anomaly of the gastrointestinal tract and often presents a diagnostic challenge. Patients with trisomy 18 frequently have MD, but the poor prognosis and lack of consensus regarding management for neonates has meant that precise information on the clinical manifestations in infants and children with MD is lacking. We describe the cases of three children with trisomy 18 who developed symptomatic MD. Intussusception was diagnosed in Patient 1, intestinal volvulus in Patient 2, and gastrointestinal bleeding in Patient 3. All three patients underwent surgical treatment and only the Patient 1 died due to pulmonary hypertensive crisis. The other two patients experienced no further episodes of abdominal symptoms. In patients with trisomy 18, although consideration of postoperative complications and prognosis after surgical treatment is necessary, symptomatic MD should carry a high index of suspicion in patients presenting with acute abdomen. © 2015 Wiley Periodicals, Inc.

Audición espacial en ambientes reverberantes: aspectos teóricos relevantes

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Claudia Arias; Oscar A. Ramos

2003-01-01

En ambientes reverberantes el sonido se propaga en múltiples direcciones sufriendo cambios físicos de importancia. El sistema auditivo debe se capaz de resolver la competencia perceptual que se produce entre el sonido original y sus reflexiones. En este artículo se presentan aspectos teóricos relevantes de la audición espacial con especial tratamiento del efecto precedente. Se trata de una estrategia inconciente que el individuo utiliza para enfrentar la información sonora conf...

Portomesenteric venous thrombosis as a rare cause of acute abdomen in a young patient: What should be the process of diagnosis and management?

Science.gov (United States)

İnan, Mehmet; Sarıoğlu, Tansel; Serhat, Tülay Hakkı

2013-01-01

This report aimed to discuss indications for radiological evaluation, laboratory investigation for thrombophilic risk factors, and the duration of anticoagulation therapy in porto-mesenteric venous thrombosis, based on a young patient who presented with acute abdomen and ascites. We investigated the acquired and genetic thrombophilic risk factors and the diagnostic process. Abdominal CT and Doppler US were found to be useful radiological tools in both diagnosis and follow-up of portomesenteric thrombosis. The investigated thrombophilic factors, PT G20210A, MTHFR C677T and MTHFR A1298C, were positive for heterozygous mutations and high levels of lupus anticoagulant and factor VIII were detected. Rapid ascites resolution and an improvement in abdominal pain after meals were observed following anticoagulation. Follow-up examination after six months showed that the portomesenteric thrombosis had completely resolved. Evaluation by CT is recommended for patients with acute abdomen and ascites, especially if ultrasonography failed to show any specific pathology. Several acquired or genetic thrombophilic factors were identified in a patient in whom local precipitating factors were absent. For patients with genetic thrombophilic risk factors and thrombosis at an uncommon site in the body, lifelong treatment with anticoagulants is recommended.

Medicina Genómica Aspectos éticos, legales y sociales del Genoma Humano

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Rodolfo E. Ávila

2011-01-01

Full Text Available La Medicina Genómica es el uso de la inf ormación de los genomas y sus deriv ados (ARN, proteínas y met abolitos que permite guiar la toma de decisiones médicas, es un c omponente clave de la medicina personalizada. La Medicina Genómica permite conocer la cartografía del genoma hum ano y proporciona una valiosa información a tener en cuenta a la hora de detect ar genes implicados en ciert as enfermedades. Esto conlleva a que en la actualidad nos centremos más en la predicción de patologías que en l a prevención, por lo que la tendencia es que en el futuro la Medicina Genómica acabe desbancando a la Medicina P reventiva. El Proyecto Genoma Humano presenta diversas aplicaciones que, al no tener una clara cobert ura legal, traen consigo un nuevo paradigma con problemas éticos, sociales y legales que la comunidad científica trat a de resolver para compaginar los aspectos morales con el progreso en la investigación. El objetivo del presente trabajo es describir brevemente los aspectos éticos, legales y sociales del Genoma Humano.

Management of a Septic Open Abdomen Patient with Spontaneous Jejunal Perforation after Emergent C/S with Confounding Factor of Mild Acute Pancreatitis.

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Yetisir, Fahri; Sarer, Akgün Ebru; Acar, Hasan Zafer; Osmanoglu, Gokhan; Özer, Mehmet; Yaylak, Faik

2016-01-01

Introduction. We report the management of a septic Open Abdomen (OA) patient by the help of negative pressure therapy (NPT) and abdominal reapproximation anchor (ABRA) system in pregnant woman with spontaneous jejunal perforation after emergent cesarean section (C/S) with confounding factor of mild acute pancreatitis (AP). Presentation of Case. A 29-year-old and 34-week pregnant woman with AP underwent C/S. She was arrested after anesthesia induction and responded to cardiopulmonary resuscitation (CPR). There were only ash-colored serosanguinous fluid within abdomen during C/S. After C/S, she was transferred to intensive care unit (ICU) with vasopressor support. On postoperative 1st day, she underwent reoperation due to fecal fluid coming near the drainage. Leakage point could not be identified exactly and operation had to be deliberately abbreviated due to hemodynamic instability. NPT was applied. Two days later source control was provided by conversion of enteroatmospheric fistula (EAF) to jejunostomy. ABRA was added and OA was closed. No hernia developed at 10-month follow-up period. Conclusion. NPT application in septic OA patient may gain time to patient until adequate source control could be achieved. Using ABRA in conjunction with NPT increases the fascial closure rate in infected OA patient.

Management of a Septic Open Abdomen Patient with Spontaneous Jejunal Perforation after Emergent C/S with Confounding Factor of Mild Acute Pancreatitis

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Fahri Yetisir

2016-01-01

Full Text Available Introduction. We report the management of a septic Open Abdomen (OA patient by the help of negative pressure therapy (NPT and abdominal reapproximation anchor (ABRA system in pregnant woman with spontaneous jejunal perforation after emergent cesarean section (C/S with confounding factor of mild acute pancreatitis (AP. Presentation of Case. A 29-year-old and 34-week pregnant woman with AP underwent C/S. She was arrested after anesthesia induction and responded to cardiopulmonary resuscitation (CPR. There were only ash-colored serosanguinous fluid within abdomen during C/S. After C/S, she was transferred to intensive care unit (ICU with vasopressor support. On postoperative 1st day, she underwent reoperation due to fecal fluid coming near the drainage. Leakage point could not be identified exactly and operation had to be deliberately abbreviated due to hemodynamic instability. NPT was applied. Two days later source control was provided by conversion of enteroatmospheric fistula (EAF to jejunostomy. ABRA was added and OA was closed. No hernia developed at 10-month follow-up period. Conclusion. NPT application in septic OA patient may gain time to patient until adequate source control could be achieved. Using ABRA in conjunction with NPT increases the fascial closure rate in infected OA patient.

Prevalence and Severity of Off-Centering During Diagnostic CT: Observations From 57,621 CT scans of the Chest, Abdomen, and/or Pelvis.

Science.gov (United States)

Akin-Akintayo, Oladunni O; Alexander, Lauren F; Neill, Rebecca; Krupinksi, Elizabeth A; Tang, Xiangyang; Mittal, Pardeep K; Small, William C; Moreno, Courtney C

2018-02-23

To determine distances between patient centroid and gantry isocenter during CT imaging of the chest, abdomen, and/or pelvis, and to evaluate differences based on patient gender, scan region, patient position, and gantry aperture. A water phantom and an anthropomorphic phantom were imaged in the centered position in the CT gantry and at several off-centered positions. Additionally, data from 57,621 adult chest, abdomen, and/or pelvic CT acquisitions were evaluated. Data were analyzed with an analysis of variance using the centroid-to-isocenter data as the dependent variable and the other parameters as independent variables. The majority of patient acquisitions (83.7% (48271/57621)) were performed with the patient's centroid positioned below isocenter (mean 1.7 cm below isocenter (SD 1.8 cm); range 12.1 cm below to 7.8 cm above isocenter). Off-centering in the x-axis was less severe (mean 0.01 cm left of isocenter (SD 1.6 cm)). Distance between centroid and isocenter in the y-axis did not differ as a function of sex but did differ based on scan region, patient position, and gantry aperture. Off-centering is common during CT imaging and has been previously demonstrated to impact dose and image quality. Copyright © 2018 Elsevier Inc. All rights reserved.

Aspectos claves relacionados con la gestión del e.Learning

OpenAIRE

Francisco Lupiáñez Villanueva

2006-01-01

La introducción y uso de las Tecnologías de la Información y la Comunicación, especialmente Internet, en el ámbito de la salud, la medicina y los sistemas sanitarios enfrenta a todos los agentes e instituciones ante numerosos retos. La educación y la formación, como actividades claves tanto de la sociedad de la información como de los sistemas sanitarios, también se ven afectadas por este proceso de cambio. La finalidad de este artículo es identificar y analizar algunos de los aspectos claves...

ASPECTOS TAXONÔMICOS, FITOGEOGRÁFICOS E USOS DE Pectis uniaristata DC. var. jangadensis (S.Moore) Keil (ASTERACEAE)

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PEREIRA, ARILDO GONÇALO; NETO, GERMANO GUARIM

2014-01-01

Este trabalho discute os aspectos taxonômicos, fitogeográficos e outros relacionados à Pectis uniaristata var. jangadensis (S. Moore) Keil (Asteraceae) uma planta de ocorrência na vegetação do cerrado e do pantanal de Mato Grosso.

Correlación clínica, laparoscópica e histológica en el abdomen agudo

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María Elena Trujillo Toledo

1995-12-01

Full Text Available Se presentan 132 pacientes con diagnóstico clínico de abdomen agudo durante 1991 a 1993, a quienes se les realizó laparoscopia de urgencia. Las afecciones más frecuentes en que se realizó laparoscopia fueron: apendicitis aguda y las enfermedades ginecológicas. La efectividad de la laparoscopia en relación con el resultado histológico fue del 97,1 %, y no coincidió en 3 pacientes con diagnóstico laparoscópico de apendicitis aguda, hematosalpinx derecho y peritonitis pélvica, sin especificar factor causal. En el 19,6 % la conclusión laparoscópica evitó una intervención quirúrgica

Improved regression models for ventilation estimation based on chest and abdomen movements

International Nuclear Information System (INIS)

Liu, Shaopeng; Gao, Robert; He, Qingbo; Staudenmayer, John; Freedson, Patty

2012-01-01

Non-invasive estimation of minute ventilation is important for quantifying the intensity of physical activity of individuals. In this paper, several improved regression models are presented, based on the measurement of chest and abdomen movements from sensor belts worn by subjects (n = 50) engaged in 14 types of physical activity. Five linear models involving a combination of 11 features were developed, and the effects of different model training approaches and window sizes for computing the features were investigated. The performance of the models was evaluated using experimental data collected during the physical activity protocol. The predicted minute ventilation was compared to the criterion ventilation measured using a bidirectional digital volume transducer housed in a respiratory gas exchange system. The results indicate that the inclusion of breathing frequency and the use of percentile points instead of interdecile ranges over a 60 s window size reduced error by about 43%, when applied to the classical two-degrees-of-freedom model. The mean percentage error of the minute ventilation estimated for all the activities was below 7.5%, verifying reasonably good performance of the models and the applicability of the wearable sensing system for minute ventilation estimation during physical activity. (paper)

Scanning and contrast enhancement protocols for multi-slice CT in evaluation of the upper abdomen

International Nuclear Information System (INIS)

Awai, Kazuo; Onishi, Hiromitsu; Takada, Koichi; Yamaguchi, Yasuo; Eguchi, Nobuko; Hiraishi, Kumiko; Hori, Shinichi

2000-01-01

The advent of multi-slice CT is one of the quantum leaps in computed tomography since the introduction of helical CT. Multi-slice CT can rapidly scan a large longitudinal (z-axis) volume with high longitudinal resolution and low image artifacts. The rapid volume coverage speed of multi-slice CT can increase the difficulty in optimizing the delay time between the beginning of contrast material injection and the acquisition of images and we need accurate knowledge about optimal temporal window for adequate contrast enhancement. High z-axis resolution of multi-slice can improve the quality of three-dimensional images and MPR images and we must select adequate slice thickness and slice intervals in each case. We discuss basic considerations for adequate contrast enhancement and scanning protocols by multi-slice CT scanner in the upper abdomen. (author)

Multidetector CT of blunt traumatic venous injuries in the chest, abdomen, and pelvis.

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Holly, Brian P; Steenburg, Scott D

2011-01-01

Venous injuries as a result of blunt trauma are rare. Even though current protocols for multidetector computed tomography (CT) of patients with trauma are designed to evaluate primarily the solid organs and arteries, blunt venous injuries may nevertheless be identified, or at least suspected, on the basis of the multidetector CT findings. Venous injuries are associated with high morbidity and mortality rates. Diagnosis of a possible venous injury is crucial because the physical findings of a venous injury are nonspecific and may be absent. This article aims to make the radiologist aware of various venous injuries caused by blunt trauma and to provide helpful hints to aid in the identification of venous injuries. Multidetector CT technology, in combination with interactive manipulation of the raw dataset, can be useful in the creation of multiplanar reconstructed images and in the identification of a venous injury caused by blunt trauma. Familiarity with direct and indirect signs of venous injuries, as well as with examples of blunt traumatic venous injuries in the chest, abdomen, and pelvis, will help in the diagnosis of these injuries.

Cómo realizar una comunicación científica. Aspectos tipográficos (III

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Gutierrez Couto, U

2005-09-01

Full Text Available Resumen: El objetivo de este artículo es revisar los principales aspectos tipográficos para facilitar la legibilidad y la facilidad de lectura en la Web de un texto científico escrito.Abstract: The aim of this paper is review main typographical aspects to improve the legibility and readability of a scientific writing in the Web.

Acute abdomen in a patient with Mayer-Rokitansky-Kuster-Hauser syndrome

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Petrić Aleksandra

2008-01-01

Full Text Available Background. Mayer-Rokitansky-Kuster-Hauser (MRKH syndrome is a malformation of female genital tract (incidence 1 in 4000 female newborn children. It appears as a result of a disorder in the development of Millerian cannals. Etiology is unknown. Syndrome MRKH is the most frequent cause of primary amenorrhoea (90%. Patients with MRKH have a normal female phenotype, with normal pubic hairness and thelarche, and female karyotype (46XX followed by primary amenorrhoea. Hormonal status corresponds to healthy women, where the appearance of ovarian tumors and tumors on rudiment parts of uterus is possible. Case report. We presented a case of acute abdomen in a patient with previously not diagnosed MRKH. The diagnosis was done during the operation. Small pelvis and an abdominal part were filled with torquated tumor lump, where ovaries, oviducts, uterus or something resembling rudiment of uterus were not recognized through careful examination. Furthemore, the patient had a short, dead-end vagina. Tumorectomy was done and hystopathological finding showed the presence of vascular leiomyoma. Conclusion. The diagnosis of complex syndromes, such as MRKH, can, despite modern diagnostics, be absent for non-medical and psycho-social reasons. We can expect ovarian and uterine pathology on hypoplastic structures in these patients, as well as in healthy women. Vascular leiomyoma in the patients with MRKH was not found in the available literature.

Aspectos sociopsicológicos del climaterio y la menopausia

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Dayana Couto Núñez

2014-10-01

Full Text Available El climaterio y la menopausia adquieren mayor trascendencia con el transcurso del tiempo. Al respecto, el concepto de calidad de vida se ha ido convirtiendo en un aspecto importante cuando la mujer climatérica se presenta ante el especialista, en busca de un mayor bienestar posible. En la edad mediana, el organismo se torna más frágil como consecuencia de las variaciones fisiológicas naturales del climaterio y la repercusión del contexto social sobre la persona, cuya sobrecarga física y mental favorece la aparición de procesos que deterioran la salud femenina y hacen más crítico el cuadro sintomático en este período, todo lo cual puede agravarse si existen un trastorno psicogénico previo y algunos elementos desfavorables del medio circundante

Aspectos claves-tiempo dependientes que amenazan la vida en el prehospitalario

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Patricio A. Cortés P., Dr.

2011-09-01

En esta misma perspectiva, la resolución de oportunidad y calidad se logra apuntando hacia los aspectos claves-tiempo dependientes que amenazan la vida del paciente, siendo estos clínicos (parocardiorespiratorio, compromiso de la vía aérea y la ventilación, compromiso de la perfusión tisular y el enfrentamiento al dolor torácico con su expresión máxima que es el síndrome coronario agudo, como también organizacionales (entre algunos la presencia de médicos en el Prehospitalario (Ph o el uso de determinados recursos sensibles como el traslado heliportado.

An Extremely Rare Case of Lower Urinary Tract Symptoms: Floating Benign Mesenchymal Mass in Abdomen

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Bulent Kati

2017-01-01

Full Text Available A 48-year-old man admitted to the urology outpatient clinic with major symptoms of right-side pain and intermittent lower urinary tract symptoms (LUTSs such as low urine flow rate, dysuria, and frequency. Uroflowmetry showed low urine flow, and laboratory tests revealed no pathology. Ultrasound (US showed a 7 cm calcific mass above the bladder and a kidney cyst with a diameter of 5.3 cm in the upper pole of the right kidney. Enhanced computed tomography confirmed the US findings. Laparoscopic transperitoneal renal cyst decortication was performed. There was no sign of additional tumors. An independent mass in the abdomen was diagnosed, and the mass was removed. Based on the pathology, the diagnosis was a benign mesenchymal calcific mass. This is the first report of LUTSs due to a free benign mesenchymal mass in the published literature.

Presencia, tendencias y aspectos diferenciadores de la formación sobre derechos de autor en la alfabetización informacional a nivel universitario

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Uribe Tirado, Alejandro

2010-01-01

Objetivo. Analizar la presencia de la temática de los derechos de autor, de los aspectos legales de la información académica y científica, en distintos programas, cursos o programas de aprendizaje de alfabetización informacional (ALFIN) de diferentes universidades alrededor del mundo, para identificar las tendencias y aspectos diferenciadores que se están presentando en la actualidad respecto a la formación en estas temáticas en relación con la información digital. También se a...

Los Derechos de admisión y permanencia en los partidos políticos : aspectos constitucionales

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Escobar Roca, Guillermo

1993-01-01

En este trabajo se estudia un doble aspecto del Derecho de partidos (la admisión y permanencia en los mismos), seguramente no central, pero cuyo correcto tratarniento jurídico puede coadyuvar a la ruptura de la impermeabilidad característica de estas organizaciones, formalmente privadas pero que desempeñan funciones públicas.

Aspectos Farmacológicos y Socioculturales del consumo de hoja de coca en indígenas Koguis respecto al consumo de cocaína en ambientes urbanos

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Katiuska Vera Zambrano

2002-07-01

Full Text Available La investigación compara los aspectos farmacológicos y socioculturales del consumo de la hoja de coca en indígenas Kogui de la Sierra Nevadade Santa Marta en Colombia frente a los aspectos farmacológicos y socioculturales del  consumo de cocaína en los ambientes urbanos, relacionados con los conceptos de tolerancia y dependencia a sustancias psicoactivas. Los resultados aportan al desarrollo  y diseño de programas de prevención, tratamiento y reducción de riesgo y daño en fármaco dependencia, al igual que sugiere la inclusión de aspectos relevantes en futuras políticas sociales de prevención en drogas.

Aspectos ultra-sonográficos da trombose da veia porta Ultrasonographic features of portal vein thrombosis

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Márcio Martins Machado

2006-04-01

Full Text Available A trombose da veia porta pode estar associada a várias alterações, como a presença de tumores (por exemplo: hepatocarcinoma, doença metastática hepática e carcinoma do pâncreas, pancreatite, hepatite, septicemia, trauma, esplenectomia, derivações porto-cava, estados de hipercoagulabilidade (por exemplo: gravidez, em neonatos (por exemplo: onfalite e cateterização da veia umbilical e desidratação aguda. Os autores discutem, neste artigo, os aspectos ultra-sonográficos da trombose de veia porta e alguns aspectos de relevância clínica.Portal vein thrombosis may be associated with many alterations, such as the presence of tumors (for example, hepatocellular carcinoma, metastatic liver disease and carcinoma of the pancreas as well as pancreatitis, hepatitis, septicemia, trauma, splenectomy, portacaval shunts, hypercoagulable conditions (for example, pregnancy, in neonates (for example, omphalitis and umbilical vein catheterization and in acute dehydration. The authors discuss herein the sonographic features of portal vein thrombosis as well as some aspects of clinical relevance.

Neoplastic and other pathologic effects of fractionated fast neutrons or photons on the thorax and anterior abdomen of beagles

International Nuclear Information System (INIS)

Zook, B.C.; Bradley, E.W.; Casarett, G.W.; Rogers, C.C.

1986-01-01

Thirty-nine adult male beagle dogs received either fast-neutron or photon irradiation to the right hemithorax and right rostral abdomen. Twenty-four dogs (six per group) received fast neutrons (15 MeV) to total doses of 1000, 1500, 2250, or 3375 cGy in four fractions per week for six weeks. Fifteen dogs received 3000, 4500, or 6750 cGy of photons in an identical fractionation pattern. One photon-irradiated dog and 13 neutron-irradiated dogs died or were euthanatized because of hepatic and gastrointestinal disturbances 47 to 708 days after irradiation; 20 dogs died of other causes. These 34 dogs were necropsied and have been studied microscopically; the remaining five dogs are still alive seven years after irradiation. Neutron-induced lesions included hemorrhage, necrosis, fibrosis, and atrophy of the heart, liver, pancreas, pylorus, duodenum, and kidney. All lesions were associated with degenerative and occlusive vascular changes including coronary arteriosclerosis. The relative biological effectiveness (RBE) of fast neutrons, assessed by clinical signs and by gross and microscopic pathology, is between 3 and 4.5 for pancreas, ∼4.5 for heart, pylorus, duodenum, and kidney, and greater than 6.75 for liver. Ten malignancies and two benign tumors developed in the irradiated field of six of 12 neutron-exposed dogs that survived over one year after irradiation. Two malignancies and one benign tumor arose in three of 12 photon-exposed dogs surviving over one year postirradiation. Only one neoplasm developed in the same field in 11 nonirradiated controls or in 62 dogs irradiated at sites other than the thorax or abdomen. The neutron RBE for neoplasia is approximately 6.75. 85 refs., 8 figs., 3 tabs

Aspectos discursivos em As Bruxas de Salem: peça e filme

OpenAIRE

Pinheiro, Eder Sergio

2009-01-01

Esta pesquisa, cujo título é Aspectos Discursivos em As Bruxas de Salem: eça e Filme, propõe discutir a transposição da linguagem escrita, neste caso, as rubricas da peça de teatro para a linguagem fílmica, devido a problemática das duas linguagens se diferenciarem, convergirem-se e cruzarem-se ao mesmo tempo. Deste modo, dois fragmentos foram escolhidos para análise, sendo eles: um trecho da peça escrita As Bruxas de Salem (1953) e outro do filme (1976), ambos os trechos são correspondent...

CLIMATERIO Y POSTMENOPAUSIA: ASPECTOS EDUCATIVOS A CONSIDERAR SEGUN LA ETAPA DEL PERIODO

OpenAIRE

ARAYA GUTIERREZ,ALEJANDRA; URRUTIA SOTO,MARIA TERESA; CABIESES VALDES,BALTICA

2006-01-01

El periodo del climaterio es una etapa de transición en la vida de la mujer caracterizada por cambios físicos, psicológicos y sociales. Es una etapa dinámica marcada por la repercusión de los cambios hormonales, principalmente por la paulatina disminución de los estrógenos. La presente revisión bibliográfica describe las características generales del periodo, cambios que ocurren y aspectos a educar en las mujeres durante el climaterio y la postmenopausia, con el propósito de dar una visión ac...

Estudo dos aspectos éticos dos transplantes na América Latina

OpenAIRE

Virgínia Maria Coelho de Holanda; Francélia Loureiro Nery; Marta Barrozo Azevedo; Tânia Cristina Botelho Mendes

1994-01-01

Respeitando recomendações da OMS, foi feito estudo retrospectivo comparativo das Legislações de 16 Países da América Latina, a saber Argentina, Bolívia, Brasil, Colômbia, Costa Rica, Chile, Cuba, Equador, Guatemala, Honduras, México, Panamá, Paraguai, Peru, República Dominicana e Venezuela, do período de 1963 a 1992, enfatizando-se os aspectos éticos referentes a doação, determinação da morte, conflito de interesses, seleção do receptor, comercialização e intercâmbio internacional de órgãos. ...

Diagnostic Algorithm in the Management of Acute Febrile Abdomen in Patients with Autosomal Dominant Polycystic Kidney Disease.

Science.gov (United States)

Neuville, Marie; Hustinx, Roland; Jacques, Jessica; Krzesinski, Jean-Marie; Jouret, François

2016-01-01

Acute febrile abdomen represents a diagnostic challenge in patients with autosomal dominant polycystic kidney disease (ADPKD). Although criteria have been proposed for cyst infection (CyI) and hemorrhage (CyH), there is a lack of comparative assessments. Furthermore, distinguishing cystic from non-cystic complications remains problematic. ADPKD patients presenting with abdominal pain and/or fever between 01/2005 and 06/2015 were retrospectively identified in a systematic computerized billing database. CyH was defined as spontaneous intracystic density above 50 Hounsfield units on computed tomography (CT). CyI was definite if confirmed by cyst puncture, and probable if 4 criteria were met: 3-day fever, loin/liver tenderness, C-reactive protein (CRP) plasma levels >50mg/L and no CT evidence for CyH. Other episodes were grouped as inflammation of unknown origin (IUO). Among a cohort of 173 ADPKD patients, 101 presented with 205 episodes of abdominal pain (n = 172) and/or fever (n = 33). 20 patients experienced 30 CyH, whereas 16 presented 23 episodes of definite (n = 11) or probable (n = 12) CyI. 35 IUO were observed in 31 patients. Clinically, fever was observed in 7% vs. 100% vs. 66% of CyH, CyI and IUO, respectively. Biologically, CRP cut-off at 70 mg/dl showed 92% sensitivity and 81% specificity in CyI diagnosis. Urine or blood cultures remained sterile in >90% of CyH, but were contributive in 53.4% of CyI and IUO, with a 74.2% prevalence for E. coli. Radiologically, ultrasounds, CT and magnetic resonance diagnosed CyI in 2.6%, 20% and 16.7% of cases, respectively. 18F-FDG positron-emission tomography (PET)/CT was done within a median period of 7 days post antibiotics, and significantly changed patient management in 71.4%. This retrospective single-center series underscores the usefulness of clinical-fever-and biological-CRP-parameters, but emphasizes the limitations of bacteriological and radiological investigations in cases of acute febrile abdomen in ADPKD

Relacionamentos de Marketing em Empresas Varejistas: Aspectos Positivos e Negativos

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Cléria Donizete da Silva Lourenço

2013-09-01

Full Text Available O objetivo deste trabalho é compreender as relações de trocas comerciais sob a ótica dos clientes, funcionários e proprietários de empresas varejistas. A pesquisa, de natureza qualitativa, foi feita utilizando-se como método a etnografia. Os dados foram coletados em cinco empresas varejistas de um município de pequeno porte no Sul de Minas Gerais – um supermercado, uma farmácia, uma panificadora, um posto de combustíveis e uma loja de hortifrutigranjeiros – durante o período de um ano (dez/2008 a dez/2009. A observação participante e a entrevista em profundidade foram utilizadas como técnicas de coleta de dados. Para tratamento dos mesmos, utilizou-se a análise de conteúdo. Por meio da análise empreendida, identificou-se que os relacionamentos de marketing são compostos tanto por aspectos positivos quanto negativos. Contudo, os aspectos positivos são predominantes, especialmente pelo fato de que o cultivo de relacionamentos nas empresas varejistas analisadas é uma ocorrência natural, podendo, portanto, ser caracterizado como “genuíno”. Em termos teóricos, uma das principais descobertas feitas nesta pesquisa é que o relacionamento de marketing pode trazer também implicações negativas para as empresas confirmando as descobertas de Grayson and Ambler (1999 quando eles afirmam que o marketing de relacionamento pode trazer benefícios, mas também desvantagens inerentes. Em termos gerenciais, há que se ressaltar o papel fundamental que os funcionários exercem na construção de relacionamentos duradouros. Sendo assim, maior atenção deveria ser dispensada ao desenvolvimento de habilidades de relacionamentos daqueles que estão face a face com o cliente. DOI: 10.5585/remark.v12i3.2513

El aspecto lúdico en la enseñanza del ELE

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Varela, Patricia

2010-10-01

Full Text Available Jugar y aprender son dos acciones íntimamente relacionadas, de forma que su complementación da lugar a un ambiente ameno en clase haciendo que el alumno se sienta más cómodo y abierto al aprendizaje. El objetivo de este artículo es analizar la importancia de la motivación en el alumno y los medios con los que contamos los docentes para desarrollarla de la forma más amena posible. Tendremos en cuenta la importancia del aspecto lúdico en la enseñanza del español como lengua extranjera y a la vez poner en práctica diversas posibilidades de aplicación del mismo

Miastenia grave: aspectos históricos Myasthenia gravis: historical aspects

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FRANCISCO MARCOS B. CUNHA

1999-06-01

Full Text Available Foram pesquisados aspectos históricos da miastenia grave desde as primeiras descrições da doença em 1672, pelo clínico inglês Thomas Willis. São descritas as dificuldades encontradas no manuseio dos primeiros pacientes diagnosticados. Pesquisaram-se fatos históricos ligados à investigação da doença, o tratamento, bem como curiosidades pouco citadas na literatura.We studied historical aspects of myasthenia gravis starting from its first description by the English physician, Sir Thomas Willis, in 1672. We also describe the difficulties in managing triating the first diagnosed patient. Historical facts related to the investigation and the initial treatment of this disorder as well as curiosities seldom mentioned in the literature are part of this paper.

Roman wall-painting technical aspects | Aspectos técnicos de la pintura mural romana | Aspectos técnicos de la pintura mural romana

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Lorenzo Abad Casal

1982-12-01

Full Text Available Se estudian diversos aspectos técnicos de la pintura mural romana: composición de los morteros, sistemas de unión entre las diversas capas, trazados previos, técnica pictórica y técnicas de conservación y restauración. Todo ello se plasma en una serie de gráficas que ilustran las técnicas romanas y su evolución a través de los siglos. | Etude des divers aspects techniques de la peinture murale romainne: composition des mortiers, systèmes d'union entre les différents couches, dessins préparatoires, technique de la peinture et procedés de conservation et de restauration. Un resumé sous forme graphique permet une vision synoptique de l'évolution des techniques de peinture romaine au cours des siècles.

Dor neuropática central após lesão medular traumática: capacidade funcional e aspectos sociais Dolor neuropático central después de lesión medular traumática: capacidad funcional y aspectos sociales Central neuropathic pain after traumatic spinal cord injury: functional capacity and social aspects

OpenAIRE

Janaina Vall; Violante Augusta Batista Braga

2005-01-01

Estudo de caso comparativo com o objetivo de avaliar a capacidade funcional e os aspectos sociais de dois pacientes, ambos com lesão medular traumática, sem e com dor neuropática central associada, respectivamente. Para avaliar a capacidade funcional, foi utilizado como instrumento o Functional Independence Measure ou Escala de Independência Funcional. E para avaliar os aspectos sociais foi construído o ecomapa de cada paciente, preconizado pelo modelo Calgary de avaliação de famílias. Ambos ...

BIOÉTICA Y DISCAPACIDAD PSIQUIÁTRICA: ASPECTOS CLÍNICOS Y JURÍDICOS BIOETICA E INCAPACIDADE PSIQUIÁTRICA: ASPECTOS CLÍNICOS E JURÍDICOS BIOETHICS AN PSYCHIATRIC DISSABILITY: CLINICAL AND JURIDICAL APECTS

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Laura Rueda Castro

2003-01-01

Full Text Available La presente monografía busca establecer un nexo interdisciplinario entre la bioética y los aspectos clínicos y jurídicos que se conectan en la atención, protección y rehabilitación de las personas afectadas por enfermedades psiquiátricas. El análisis se centra en aquellas personas adultas, privadas de razón como consecuencia de un proceso psicopatológico, titulares de todos sus derechos civiles, pero que, por motivos de la enfermedad, se encuentran con dificultades para ejercerlosA presente monografia busca estabelecer nexo interdisciplinar entre bioética e aspectos clínicos e jurídicos na atenção, proteção e reabilitação de pessoas portadoras de enfermidades psiquiátricas. A análise é centrada em pacientes adultos privados de razão em decorrência de processo psicopatológico, titulares de todos direitos civis, mas que, em função da enfermidade, encontram-se em dificuldades para exercê-losThis monography seeks to establish an interdisciplinary link between bioethics and the clinical and juridical aspects that connect with attention, protection and rehabilitation of persons with psychiatric illness. The analysis is centered those adults, on deprived of reasoning because of a psycopathologic process, entitled to civil rights, but with dificulties to exercise them due to their illness

Consolidation whole abdomen irradiation following adjuvant carboplatin-paclitaxel based chemotherapy for advanced uterine epithelial cancer: feasibility, toxicity and outcomes

International Nuclear Information System (INIS)

Rochet, Nathalie; Kahn, Rachel S; Niemierko, Andrzej; Delaney, Thomas F; Russell, Anthony H

2013-01-01

To evaluate feasibility and preliminary outcomes associated with sequential whole abdomen irradiation (WAI) as consolidative treatment following comprehensive surgery and systemic chemotherapy for advanced endometrial cancer. We conducted a retrospective analysis of patients treated at our institution from 2000 to 2011. Inclusion criteria were stage III-IV endometrial cancer patients with histological proof of one or more sites of extra-uterine abdomen-confined disease, treated with WAI as part of multimodal therapy. Endpoints were feasibility, acute toxicity, late effects, recurrence-free survival (RFS) and overall survival (OS). Twenty patients were identified. Chemotherapy consisted of 3 to 6 cycles of a platinum-paclitaxel regimen in 18 patients. WAI was delivered using conventional technique to a median total dose of 27.5 Gy. No grade 4 toxicities occurred during chemotherapy or radiotherapy. No radiation dose reduction was necessary. Three patients developed small bowel obstruction, all in the context of recurrent intraperitoneal disease. Kaplan-Meier estimates and 95% confidence intervals for RFS and OS at one year were 63% (38–80%) and 83% (56-94%) and at 3 years 57% (33-76%) and 62% (34-81%), respectively. On univariate Cox analysis, stage IVB and serous papillary (SP) histology were found to be statistically significantly (at the p = 0.05 level) associated with worse RFS and OS. The peritoneal cavity was the most frequent site of initial failure. Consolidative WAI following chemotherapy is feasible and can be performed without interruption with manageable acute and late toxicity. Patients with endometrioid adenocarcinoma, especially stage FIGO III, had favorable outcomes possibly meriting prospective evaluation of the addition of WAI following chemotherapy in selected patients. Patients with SP do poorly and do not routinely benefit from this approach

Depressão na infância e adolecência: aspectos sociais

OpenAIRE

Lúcia Helena Siqueira Barbosa

1987-01-01

Este trabalho contém três partes. Uma primeira intitulada Introdução. Uma segunda focalizada sob o título de Material Clínico :apresentação, comentários e considerações sobre a prática do Serviço Social e, uma terceira, Considerações Finais. A primeira tenta discutir dois pontos: - algumas considerações sobre o conceito de depressão na infância e adolescência: caracterização de quadros clínicos com aspectos depressivos nítidos, mais ou menos "puros" e de "reações depressivas", em que tais asp...

Estudo dos aspectos éticos dos transplantes na América Latina

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Virgínia Maria Coelho de Holanda

1994-06-01

Full Text Available Respeitando recomendações da OMS, foi feito estudo retrospectivo comparativo das Legislações de 16 Países da América Latina, a saber Argentina, Bolívia, Brasil, Colômbia, Costa Rica, Chile, Cuba, Equador, Guatemala, Honduras, México, Panamá, Paraguai, Peru, República Dominicana e Venezuela, do período de 1963 a 1992, enfatizando-se os aspectos éticos referentes a doação, determinação da morte, conflito de interesses, seleção do receptor, comercialização e intercâmbio internacional de órgãos.

Aproximación Neuropsicológica al Constructo de Empatía: Aspectos Cognitivos y Neuroanatómicos

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Vanessa Arán Filippetti

2012-01-01

Full Text Available Los modelos integradores definen a la empatía como un constructo multidimensional que incluye aspectos afectivos (EA; empatía afectiva y aspectos cognitivos (EC; empatía cognitiva. El objetivo del presente trabajo es exponer el estado del arte de la asociación entre la empatía y las funciones ejecutivas (FE y tratar de proponer una integración de las ideas al respecto. Para esto, se adopta un marco conceptual y se revisan estudios que conciben a la EA y a la EC como aspectos complementarios pero diferenciados tanto desde el punto de vista funcional como neurobiológico; ambos componentes se activarían conjuntamente durante la interacción social, pero podrían actuar por separado tal como se evidencia, por ejemplo, en el daño cerebral y en la psicopatología. Desde una perspectiva multidimensional, la relación empatía-FE podría explicarse a partir de la relación ECfTeoría de la MenteFE, así como mediante un modelo que admita la influencia de procesos top-down - a través de funciones ejecutivas - en el proceso empático. Adoptar una visión multidimensional de la empatía no sólo es relevante desde el punto de vista funcional, sino que aporta evidencia significativa para el diagnóstico, la evaluación y la comprensión del déficit empático en la clínica neurológica y psiquiátrica.

Jejunal Diverticulosis Presented with Acute Abdomen and Diverticulitis Complication: A Case Report

International Nuclear Information System (INIS)

Fidan, Nurdan; Mermi, Esra Ummuhan; Acay, Mehtap Beker; Murat, Muammer; Zobaci, Ethem

2015-01-01

Jejunal diverticulosis is a rare, usually asymptomatic disease. Its incidence increases with age. If symptomatic, diverticulosis may cause life-threatening acute complications such as diverticulitis, perforation, intestinal hemorrhage and obstruction. In this report, we aimed to present a 67-year-old male patient with jejunal diverticulitis accompanying with abdominal pain and vomiting. A 67-year-old male patient complaining of epigastric pain for a week and nausea and fever for a day presented to our emergency department. Ultrasonographic examination in our clinic revealed diverticulum-like images with thickened walls adjacent to the small intestine loops, and increase in the echogenicity of the surrounding mesenteric fat tissue. Contrast-enhanced abdominal computed tomography showed multiple diverticula, thickened walls with showing contrast enhancement and adjacent jejunum in the left middle quadrant, increased density of the surrounding mesenteric fat tissue, and mesenteric lymph nodes. The patient was hospitalized by general surgery department with the diagnosis of jejunal diverticulitis. Conservative intravenous fluid administration and antibiotic therapy were initiated. Clinical symptoms regressed and the patient was discharged from hospital after 2 weeks. In cases of diverticulitis it should be kept in mind that in patients with advanced age and pain in the left quadrant of the abdomen, diverticular disease causing mortality and morbidity does not always originate from the colon but might also originate from the jejunum

Evaluation of the usefulness and validity of imaging diagnosis for acute abdomen

International Nuclear Information System (INIS)

Sakai, Takehiro; Sudo, Yasuhiro

2007-01-01

We retrospectively evaluated the usefulness and validity of imaging diagnosis for acute abdomens. Sixty-one patients who had complained of acute abdominal pain upon hospital admittance were and divided into four groups according to the diagnostic imaging modalities that were used: X-ray alone (X-P group, n=11), ultrasonography (US group, n=12), computed tomography (CT group, n=14), and both ultrasonography and CT (US/CT group, n=24). The diagnosis made at the time of admission was also evaluated, and the patients were divided into three groups and analyzed statistically: bowel obstructions (bowel obstruction group, n=20), acute appendicitis or other diseases necessitating a differential diagnosis (appendicitis group, n=35), and perforations of the digestive tract (perforation group, n=6). X-ray and CT examinations were useful for making a diagnosis in the bowel obstruction and perforation groups. Ultrasonography was regarded as important in the appendicitis group. The accuracy of the diagnosis made upon admission was 95.0% in the bowel obstruction group, 88.6 % in the appendicitis group, and 100 % in the perforation group. Although a prospective evaluation is necessary, CT appears to be useful for diagnosing bowel obstructions and perforations of the digestive tract. Although ultrasonography is useful for diagnosing acute appendicitis, CT is recommended in patients in whom a differential diagnosis is difficult to obtain. (author)

Contrast enhancement in multidetector-row computed tomography (MDCT) of the abdomen: intraindividual comparison of contrast media containing 300 mg versus 370 mg iodine per ml

International Nuclear Information System (INIS)

Behrendt, F.F.; Mahnken, A.H.; Keil, S.; Das, M.; Hohl, C.; Guenther, R.W.; Muehlenbruch, G.; Bauer, D.; Seidensticker, P.; Jost, E.; Wildberger, J.E.

2008-01-01

The purpose of this study was to intraindividually evaluate the difference in intraluminal vessel and parenchyma contrast enhancement of two different iodine concentrations in multidetector-row computed tomography (MDCT) of the abdomen. Eighty-three patients underwent baseline and follow-up MDCT-scanning (Somatom Sensation 16; Siemens, Forchheim, Germany) of the abdomen using contrast media containing 370 mg iodine/ml (protocol A; Ultravist 370, Bayer Schering Pharma, Berlin, Germany) and 300 mg iodine/ml (protocol B; Ultravist 300). The total iodine load (37 g iodine) and the iodine delivery rate (1.29 g iodine/s) were identical for both protocols. Contrast enhancement in the portal venous phase was measured in the abdominal aorta, inferior vena cava, portal vein, liver, spleen, pancreas and kidney. Mean attenuation values were compared using paired t-test. Intraindividual comparison revealed no statistically significant differences of the mean attenuation values between protocols A and B for all anatomic sites: abdominal aorta, inferior vena cava, portal vein, liver, spleen, pancreas and kidney (all P > 0.05). Given an injection protocol with constant total iodine load and constant iodine delivery rate, the iodine concentration of contrast media does not significantly influence abdominal contrast enhancement in the portal venous phase. (orig.)

Modelo integral de productividad, aspectos importantes para su implementación

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Jorge Eduardo Medina Fernández de Soto

2010-08-01

Full Text Available El Modelo Integral busca la optimización de la productividad, a partir de los objetivos estratégicos empresariales y el análisis y mejoramiento de la propuesta de valor para el cliente, identificando el nivel de operación óptimo y los recursos tangibles realmente necesarios. También identifica los procesos empresariales de creación de valor y es una guía hacia el desarrollo de la propuesta de valor. Además, analiza las inversiones necesarias para las nuevas propuestas de valor, buscando un crecimiento estratégico sostenible. El artículo explica en primer lugar los fundamentos y componentes del modelo y luego algunos aspectos importantes para su implementación.

La actitud crítica un aspecto fundamental en la educación

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Eduard Mauricio Wong Jaramillo

2016-03-01

Full Text Available En este artículo se reflexiona sobre el papel de la actitud crítica en la educación, dado que la capacidad de pensar por sí mismo y decidir de acuerdo con criterios racionales son aspectos decisivos que todo estudiante debe desarrollar, con el fin de propiciar sujetos que evalúen el saber. Otra razón que la hace necesaria es que la enseñanza pretende incentivar la formación de personas autónomas, que participen activamente en la vida política, social y cultural, aspectos que implican el ejercicio crítico y reflexivo. En la primera parte del documento se presentan algunos rasgos que identifican a la educación crítica, en tanto modelo que propende por formar seres humanos que piensen por sí mismos. Luego, se indaga acerca del fomento de prácticas educativas que permiten el desarrollo de competencias lógicas y argumentativas dado que la actitud crítica implica una evaluación racional. Por último, se resalta el papel de la filosofía y de la ciencia, pues en ellas se promueven deliberaciones sobre problemas teóricos y prácticos. En conclusión, la necesidad de estimular la actitud crítica es un elemento prioritario que la educación debe tener en cuenta, si lo que desea es promover seres humanos y sociedades que enfrenten de forma racional los problemas actuales

Aspectos morfológicos da placenta da preguiça, Bradypus variegatus Shinz, 1825

OpenAIRE

Marleyne José Afonso Accyoli Lins Amorin; Maria Angélica Miglino; Adelmar Afonso Amorin Júnior; Tatiana Carlesso dos Santos

2003-01-01

Estudaram-se os aspectos morfológicos da placenta e das membranas fetais de 03 placentas de bichos-preguiça (Bradypus variegatus), adultas e prenhes, originárias da Zona da Mata do Estado de Pernambuco. Essas estruturas foram obtidas de 03 fêmeas doadas pela Universidade Federal de Pernambuco, das quais duas encontravam-se congeladas e a terceira foi colhida mediante realização de cirurgia cesariana, onde mãe e feto foram preservados. Depois de descongeladas, as placentas foram fixadas em sol...

La dispepsia funcional: Aspectos biopsicosociales, evaluación y terapia psicológica

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Stefano Vinaccia Alpi

2008-09-01

Full Text Available Se abordan los aspectos conceptuales del trastorno gastrointestinal Dispepsia funcional (DP, en lo que se refiere a su definición, prevalencia, clasificación y diagnóstico.; las causas y consecuencias de la DF desde una perspectiva biopsicosocial (variables socioeconómicas, demandas psicosociales, evaluación cognitiva y estrategias de afrontamiento, personalidad y comportamiento, mecanismos psicobiológicos, calidad de vida, tratamiento y evolución; la evaluación psicológica de la DF desde la perspectiva procesual; y la intervención psicológica, con énfasis en el enfoque cognitivo conductual.

Fine focal spot size improves image quality in computed tomography abdomen and pelvis

Energy Technology Data Exchange (ETDEWEB)

Goh, Yin P.; Low, Keat; Kuganesan, Ahilan [Monash Health, Diagnostic Imaging Department, 246, Clayton Road, Clayton, Victoria (Australia); Lau, Kenneth K. [Monash Health, Diagnostic Imaging Department, 246, Clayton Road, Clayton, Victoria (Australia); Monash University, Department of Medicine, Faculty of Medicine, Nursing and Health Sciences, Victoria (Australia); Buchan, Kevin [Philips Healthcare, Clinical Science, PO Box 312, Mont Albert, Victoria (Australia); Oh, Lawrence Chia Wei [Flinders Medical Centre, Division of Medical Imaging, Bedford Park South (Australia); Huynh, Minh [Swinburne University, Department of Statistics, Data Science and Epidemiology, School of Health Sciences, Faculty of Health, Arts and Design, Hawthorn (Australia)

2016-12-15

To compare the image quality between fine focal spot size (FFSS) and standard focal spot size (SFSS) in computed tomography of the abdomen and pelvis (CTAP) This retrospective review included all consecutive adult patients undergoing contrast-enhanced CTAP between June and September 2014. Two blinded radiologists assessed the margin clarity of the abdominal viscera and the detected lesions using a five-point grading scale. Cohen's kappa test was used to examine the inter-observer reliability between the two reviewers for organ margin clarity. Mann-Whitney U testing was utilised to assess the statistical difference of the organ and lesion margin clarity. 100 consecutive CTAPs were recruited. 52 CTAPs were examined with SFSS of 1.1 x 1.2 mm and 48 CTAPs were examined with FFSS of 0.6 x 0.7 mm. Results showed that there was substantial agreement for organ margin clarity (mean κ = 0.759, p < 0.001) among the reviewers. FFSS produces images with clearer organ margins (U = 76194.0, p < 0.001, r = 0.523) and clearer lesion margins (U = 239, p = 0.052, r = 0.269). FFSS CTAP improves image quality in terms of better organ and lesion margin clarity. Fine focus CT scanning is a novel technique that may be applied in routine CTAP imaging. (orig.)

INTRA-ABDOMINAL INFECTION AND ACUTE ABDOMEN-EPIDEMIOLOGY, DIAGNOSIS AND GENERAL PRINCIPLES OF SURGICAL MANAGEMENT

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Jovanović Dušan

2015-03-01

Full Text Available Intra-abdominal infections are multifactorial and present an complex inflammatory response of the peritoneum to microorganisms followed by exudation in the abdominal cavity and systemic response Despite advances in management and critical care of patients with acute generalized peritonitis due to hollow viscus perforation, prognosis is still very poor, with high mortality rate. Early detection and adequate treatment is essential to minimize complications in the patient with acute abdomen. Prognostic evaluation of complicated IAI by modern scoring systems is important to assess the severity and the prognosis of the disease. Control of the septic source can be achieved either by nonoperative or operative means. Nonoperative interventional procedures include percutaneous drainages of abscesses. The management of primary peritonitis is non-surgical and antibiotic- treatment. The management of secondary peritonitis include surgery to control the source of infection, removal of toxins, bacteria, and necrotic tissue, antibiotic therapy, supportive therapy and nutrition. "Source control" is sine qua non of success and adequate surgical procedure involves closure or resection of any openings into the gastrointestinal tract, resection of inflamed tissue and drainage of all abdominal and pelivic collections.

Aspectos psicosociales del embarazo en la adolescencia, año 2000

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Elena Ávila Gálvez

2002-12-01

Full Text Available Se realizó un estudio explicativo-observacional, de tipo estudio de casos y controles, en adolescentes entre 10 y 19 años, del sexo femenino, provenientes del Policlínico Docente "Wilfredo Pérez Pérez", en el año 2000, compartidos en 2 grupos: el estudio, con 53 casos que se embarazaron, y el control con 106 adolescentes que no lo hicieron. Se compararon diferentes aspectos de la sexualidad, esfera familiar y sociodemográficos, con el fin de determinar la influencia de algunos aspectos psicosociales del embarazo en la adolescencia. La mayoría de las adolescentes del grupo estudio se incluían en la adolescencia tardía, con inestabilidad en la pareja, mejor nivel de instrucción de los padres, mayor porcentaje que no estudiaba ni trabajaba, con padres divorciados, criadas solamente por la madre, de familias disfuncionales, con inicio precoz de la actividad sexual sin anticonceptivos, con problemas psicológicos que se enmarcaban en el hogar y la familia.An explanatory-observational case-control type-study was performed on female adolescents aged 10-19 years from "Wilfredo Pérez Pérez Teaching Polyclinics in the year 2000. They were divided into two groups: the study group comprising 53 pregnant patients and the control group including 106 adolescents who were not pregnant. Several aspects related to sexuality, family environment and also socio-demographic questions were compared to determine the impact of some psychosocial aspects of pregnancy in adolescence. Most of the adolescents in the study group were in their late adolescence, they had no permanent partner, their parents had a higher level of education; a high number of them neither studied nor worked, their parents were mostly divorced, they were raised by their mothers only, they were from dysfunctional families, with early beginning of sexual intercourse without contraceptives and psychological problems involving the family and the house.

Aspectos médicos, genéticos y psicosociales del síndrome Usher

OpenAIRE

Dyce Gordon, Elisa; Mapolón Arcendor, Yolanda; Santana Álvarez, Jorge

2011-01-01

Fundamento: el síndrome Usher es una enfermedad genética, que se caracteriza por hipoacusia neurosensorial progresiva bilateral congénita, pérdida de visión debida a la retinosis pigmentaria y en ocasiones presenta también trastornos vestibulares. Objetivo: describir los principales aspectos médicos, genéticos y psicosociales presentes en los pacientes con síndrome Usher. Método: se realizó un estudio descriptivo transversal en 14 pacientes con diagnóstico de síndrome Usher atendidos en el Ce...

Conjecturas da Epistemológia Jurídica e Aspectos da Teoria da Linguagem

OpenAIRE

Oliveira, Rita de Cássia Cartelli de; Cesumar; Motta, Ivan Dias; Cesumar

2008-01-01

Apresentar-se-ão reflexões em torno da epistemologia jurídica e alguns aspectos da teoria da linguagem; a necessidade de acompanhamento e aprimoramento da linguagem jurídica, para que o direito não se distancie da realidade, mantendo-se apenas como um sistema do status quo; uma breve análise de algumas teorias da ciência do direito e da linguagem; as especificidades dos termos lingüísticos para a análise da ciência do direito, pautada na contemporaneidade sob a perspectiva humanista, buscando...

Aspectos da aposentadoria por tempo de serviço nos estados-partes do Mercosul

OpenAIRE

Oliveira, Aldemir de.

2008-01-01

Tese (doutorado) - Universidade Federal de Santa Catarina, Centro de Ciências Jurídicas. Programa de Pós-Graduação em Direito. O objeto desta tese são os aspectos da Aposentadoria por tempo de serviço nos Estados-Partes do MERCOSUL. A escolha do tema é dar uma contribuição jurídica, para que os trabalhadores mercosulinos, em especial argentinos, paraguaios e uruguaios, na qualidade de segurados obrigatórios, por prestarem, ou terem prestado serviços, nesses territórios, e sujeitos à legis...

Plain X-ray diagnosis of the acute abdomen: A surgical handbook with notes on clinical presentation and differential diagnosis

International Nuclear Information System (INIS)

Gough, M.H.; Gear, M.W.; Daar, A.S.

1985-01-01

Taken in conjunction with a history and clinical examination, the plain X-ray film may provide invaluable help in reaching or confirming a diagnosis in the patient with an acute abdomen. Designed for the casualty officer or trainee surgeon, this clinical handbook is a practical guide to the interpretation of the plain abdominal X-ray. The format of the first edition has been retained, providing typical examples of X-rays of the conditions which present as abdominal emergencies. Each X-ray is accompanied by a legend in four sections: the characteristic radiological signs demonstrated in the film; the differential diagnosis suggested by the X-ray; the presenting signs and symptoms of the condition under discussion; and a list of possible clinical differential diagnoses

ASPECTOS SEMÁNTICOS EN LOS ENTORNOS VIRTUALES DE FORMACIÓN

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Ana Vanessa Leguízamo León

2010-07-01

Full Text Available La semántica es un elemento necesario en cualquier actividad de aprendizaje, independientemente del contexto en el que nos encontremos. Los entornos virtuales de formación, como instituciones sociales mediadas por tecnología, tienen también una semántica asociada, que muchas veces es poco valorada por las personas que los diseñan. El componente semántico en estos entornos facilita la negociación de significados, que debe ocurrir para que los estudiantes puedan apropiarse de conocimiento y asociarlo con alguno de los patrones semánticos que ya posee, o crear uno nuevo. Se muestran aquí los aspectos semánticos que deben estar presentes en los entornos virtuales de formación, para situar al estudiante en el contexto semántico propuesto por el docente y que lo conduzca a un aprendizaje significativo.

Aspectos biológicos y control de un gracilláriido (Gracillariidae: Lepidóptera) en Caesalpinia spinosa (Mol.) Kuntze (1898), en Cajamarca, Perú

OpenAIRE

Murga Orrillo, Hipólito; Abanto Rodriguez, Carlos; Polo Vargas, Ana Rosa

2016-01-01

Se tuvo por objetivo determinar aspectos biológicos, identificar enemigos naturales, y establecer periodos oportunos de control de un gracillariido plaga de tara. Los aspectos biológicos y los enemigos naturales se evaluaron en campo y en laboratorio, los periodos oportunos de control se determinó por interacción hospedero-plaga. Los resultados, el huevo dura 7,8 días y mide 0,34x0,21mm; la larva presenta 4 instares y dura 35,7 días, variando de medidas entre 1o y 4o instar de 0,09 a 0,65 mm ...

Diagnostic Algorithm in the Management of Acute Febrile Abdomen in Patients with Autosomal Dominant Polycystic Kidney Disease.

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Marie Neuville

Full Text Available Acute febrile abdomen represents a diagnostic challenge in patients with autosomal dominant polycystic kidney disease (ADPKD. Although criteria have been proposed for cyst infection (CyI and hemorrhage (CyH, there is a lack of comparative assessments. Furthermore, distinguishing cystic from non-cystic complications remains problematic.ADPKD patients presenting with abdominal pain and/or fever between 01/2005 and 06/2015 were retrospectively identified in a systematic computerized billing database. CyH was defined as spontaneous intracystic density above 50 Hounsfield units on computed tomography (CT. CyI was definite if confirmed by cyst puncture, and probable if 4 criteria were met: 3-day fever, loin/liver tenderness, C-reactive protein (CRP plasma levels >50mg/L and no CT evidence for CyH. Other episodes were grouped as inflammation of unknown origin (IUO.Among a cohort of 173 ADPKD patients, 101 presented with 205 episodes of abdominal pain (n = 172 and/or fever (n = 33. 20 patients experienced 30 CyH, whereas 16 presented 23 episodes of definite (n = 11 or probable (n = 12 CyI. 35 IUO were observed in 31 patients. Clinically, fever was observed in 7% vs. 100% vs. 66% of CyH, CyI and IUO, respectively. Biologically, CRP cut-off at 70 mg/dl showed 92% sensitivity and 81% specificity in CyI diagnosis. Urine or blood cultures remained sterile in >90% of CyH, but were contributive in 53.4% of CyI and IUO, with a 74.2% prevalence for E. coli. Radiologically, ultrasounds, CT and magnetic resonance diagnosed CyI in 2.6%, 20% and 16.7% of cases, respectively. 18F-FDG positron-emission tomography (PET/CT was done within a median period of 7 days post antibiotics, and significantly changed patient management in 71.4%.This retrospective single-center series underscores the usefulness of clinical-fever-and biological-CRP-parameters, but emphasizes the limitations of bacteriological and radiological investigations in cases of acute febrile abdomen in

Importancia de los aspectos psicosociales en la enfermedad celíaca

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Trini Fragoso Arbelo

2002-06-01

Full Text Available Se revisan los conceptos clínicos actuales sobre la enfermedad celíaca. Se definen con precisión los términos enfermedad celíaca activa, silente, latente y potencial. Se enfatiza en los aspectos psicosociales que influyen en su tratamiento y se trazan pautas generales acerca del manejo integral de los pacientes afectados, dada la importancia de la dieta sin gluten de por vida como único tratamiento.The current clinical concepts of celiac disease are reviewed. The terms active, silent, latent and potential related to celiac disease are accurately defined. Emphasis is made on the psychosocial aspects influencing its treatment and general guidelines are drawn on the comprehensive management of the patients suffering from this disease, given the importance of diet without gluten as the only lifelong treatment.

Modelo teórico práctico de atención médica al adulto mayor con abdomen agudo quirúrgico

OpenAIRE

Rodríguez Pascual, Yazmín

2011-01-01

En los 100 últimos años ha transcurrido una revolución silenciosa e inusitada: la de la longevidad. Fenómeno demográfico mundial que provoca un incremento de adultos mayores, eleva la asistencia a los servicios de urgencias hospitalarios de este grupo de edad, aumenta el número de operados de esta afección, aumentan las complicaciones y muertes, es un problema de salud. La investigación tuvo como objetivo un modelo teórico práctico de atención médica al adulto mayor con abdomen ag...

Study of dosimetric quantities and image quality in pediatric examinations of chest and abdomen computed tomography

International Nuclear Information System (INIS)

Jornada, Tiago da Silva

2013-01-01

This work had the objective to achieve the knowledge of the dosimetric quantities related to chest and abdomen computed tomography (CT) examinations of pediatric patients, in Belo Horizonte city. The reason of this work is based on the fact that the probability of health detriment in children, which it may be caused by radiation, is higher than in adults. Besides, although in many countries the knowledge and control of patient doses is a normal procedure, this safety culture does not exist in Brazil. Another objective of this work was to compare the dosimetric quantity values with the Diagnostic Reference Levels (DRLs); when it was needed, an optimization process was applied and the quality of the diagnostic image obtained with the optimized technical parameters was analyzed. This study was carried out in five hospitals, where the weighted air kerma index (Cw), the volumetric air kerma index (Cvol), the air kerma - length product (PKL,CT), the Effective Dose (E) and the Normalized Effective Dose (En) were determined; three methods were adopted for measurements: the ionization chamber inside a chest pediatric phantom, radiochromic films and the CT-EXPO software. The optimization process was applied to a single hospital through variations in the current (mA) and voltage (kV) of the x-ray tube for the protocols used for abdomen CT examinations. The analysis of the quality of the diagnostic image was done by Normal Distribution and ROC analysis; spatial resolution analysis was used through MTF determination and the noise level was judged in terms quantitative and qualitative. Results of the dosimetric quantities showed that they significantly differed between single-slice and multi-slice tomography units, but their values were always below the recommended DRLs. The optimized values of the dosimetric quantities obtained after the optimization process showed that it was possible to reduce the radiation exposure of pediatric patient without losing the image quality

Aspectos éticos e estratégias para a participação voluntária da criança em pesquisa Aspectos éticos y estrategias para la participación voluntaria de niños en la investigación Ethical issues and strategies for the voluntary participation of children in research

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Cecília Helena de Siqueira Sigaud

2009-12-01

Full Text Available A literatura de saúde tem abordado os aspectos éticos da investigação com seres humanos há décadas, mas ainda há desafios a serem reconhecidos e superados, tais como os referentes à pesquisa com crianças. Este artigo apresenta e discute aspectos éticos da pesquisa com crianças. Descreve estratégias de abordagem conformes às necessidades infantis, segundo seu processo de desenvolvimento e características individuais, para garantir a participação voluntária da criança na pesquisa.La literatura de salud ha tratado de los aspectos éticos de la investigación con seres humanos hace décadas, pero aun hay retos que deben ser reconocidos y superados, tales como los referentes a la investigación con la población infantil. Este artículo presenta y discute aspectos éticos de la investigación con niños y niñas. Describe estrategias de abordaje adecuadas a las necesidades infantiles, según su proceso de desarrollo y características individuales, para garantizar la participación voluntaria de niños y niñas en investigaciones.Ethical issues about research with human beings have been addressed in health literature since decades. In spite of this, it is necessary to enhance actions to face many challenges, like the ones related to investigation of childhood. This paper presents and discusses ethical issues in research with children. It describes some strategies to perform with children, considering their developmental process and individual characteristics, in order to guarantee their voluntary participation in research.

Tres reformas educativas europeas: Reino Unido, Francia y España: aspectos comparativos.

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Inmaculada Egido Gálvez

1997-01-01

Full Text Available Desde una perspectiva unicamente aproximativa, este trabajo lleva a cabo un breve repaso de las reforrnas realizadas en los ultimos afios en el sistema educativo de tres paises europeos: Reino Unido, Francia y Espana. Tras la consideracion de los principales cambios introducidos por las leyes de reforma en relaci6n con la estructura del sistema, el curriculum, el profesorado y el gobiemo y la administraci6n de la educacion, se presenta lavaloraci6n crftica de algunos de los aspectos mas relevantes de las reformas. Por ultimo, se realizan algunas reflexiones globales derivadas de la comparaci6n entre los tres casos tratados

Equilibrio liquido-liquido-vapor de misturas ternarias : algoritimo de calculo e aspectos termodinamicos

OpenAIRE

Maria Helena Cano de Andrade

1991-01-01

Resumo: Este trabalho é uma contribuição ao estudo de processos de separação envolvendo fases em equilibrio liquido-liquido-vapor. Os seguintes aspectos são abordados: (1) desenvolvimento de um algoritmo eficiente de cálculo de flash liquido-liquido-vapor e sua aplicação para gerar diagramas de fases e em cálculos de destilação; (2) avaliação da utilização de parâmetros binários do modelo UNIQUAC obtidos de dados bifásicos em cálculos trifásicos de misturas ternárias; (3) medidas experimentai...

Application of Optical Measurement Techniques During Stages of Pregnancy: Use of Phantom High Speed Cameras for Digital Image Correlation (D.I.C.) During Baby Kicking and Abdomen Movements

Science.gov (United States)

Gradl, Paul

2016-01-01

Paired images were collected using a projected pattern instead of standard painting of the speckle pattern on her abdomen. High Speed cameras were post triggered after movements felt. Data was collected at 120 fps -limited due to 60hz frequency of projector. To ensure that kicks and movement data was real a background test was conducted with no baby movement (to correct for breathing and body motion).

VIABILIDADE ECONÔMICA DE PROJETOS E ASPECTOS PARTICULARES EM EMPREENDIMENTOS TIPO PROJECT FINANCE APLICADOS A INVESTIMENTOS MEDIANTE PARCERIA PÚBLICO-PRIVADA EM INFRAESTRUTURA DE TRANSPORTES

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Alexandre da Costa Pereira

2013-01-01

Full Text Available O artigo tem por objetivo destacar aspectos relacionados com a análise da viabilidade de projetos de infraestrutura de transportes, aplicados a estudos de ampliação de capacidade de sistemas de transporte, sendo destacado no trabalho o aspecto da relevante importância da participação da iniciativa privada como parceira nos investimentos em infraestrutura. São abordados os métodos e estudos de viabilidade técnica e econômica, empréstimos, financiamentos e aspectos particulares a estudos para avaliação de projetos na área de infraestrutura de transportes. Como método para a avaliação de viabilidade financeira de projetos de concessões em investimentos em infraestrutura foi escolhido o Project Finance, tanto por seu potencial para a obtenção de parâmetros fundamentais para a tomada de decisão sobre alternativas de investimento, notadamente em projetos que considerem a participação privada como importante na viabilização do projeto, como para a análise de fatores intervenientes no risco de um investimento em obras de infraestrutura de transportes.

Transtornos alimentares: o papel dos aspectos culturais no mundo contemporâneo Transtornos alimentarios: el papel de los aspectos culturales en el mundo contemporáneo Eating disorders: the role of cultural aspects in the contemporary world

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Leticia Langlois Oliveira

2010-09-01

Full Text Available Os transtornos alimentares são patologias caracterizadas primordialmente pelo medo mórbido de engordar. Vários são os fatores envolvidos tanto na etiologia quanto na manutenção e na gravidade dessas doenças, principalmente fatores individuais, familiares e culturais. Em relação a estes últimos, salienta-se o papel dos aspectos históricos, estéticos, midiáticos, transculturais, socioeconômicos, raciais e de gênero. Pesquisas atuais realizadas em diversas culturas demonstram a existência de uma relação entre esses fatores e os índices de anorexia nervosa e bulimia nervosa. A busca por um padrão estético globalizado (magreza, segundo a literatura, tem um papel central no aumento do número de casos. O objetivo deste artigo é apresentar uma discussão teórica acerca dos aspectos culturais envolvidos no aumento do número de casos de transtornos alimentares. Este trabalho pretende também destacar a necessidade de que profissionais de diversas áreas estejam atentos para os perigos do padrão de beleza atual, a fim de potencializar intervenções preventivas.Los transtornos alimentarios son patologías caracterizadas primordialmente por el miedo mórbido de engordar. Varios son los factores involucrados ya sea en la etiología cuanto en la manutención y en la gravedad de esas enfermidades: individuales, familiares y culturales. Con relación a esos últimos, se resalta el papel de los aspectos históricos, estéticos, midiáticos, transculturales, socio económicos, raciales y de género. Investigaciones actuales realizadas en diferentes culturas muestran la existencia de una relación entre esos factores y los índices de anorexia nervosa y bulimia nervosa. El objetivo de ese artículo es presentar una discusión a cerca de los aspectos culturales involucrados en el aumento del número de casos de transtornos alimentarios. Ese trabajo pretende también destacar la necesidad de que profesionistas de diversas áreas estean

Aspectos socioeconómicos y familiares asociados en niños y adolescentes obesos

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William José González Cabriles

2013-01-01

Full Text Available El estudio es transversal y correlacional donde se analizaron las variables socioeconómicas y familiares de una muestra no probabilística, constituida por 528 familias de niños con obesidad exógena, de 2 a 18 años, provenientes de diversos sectores del país, atendidos en la consulta de primera del Centro de Atención Nutricional Infantil Antímano. El objetivo fue determinar los aspectos socioeconómicos y familiares asociados en niños y adolescentes con obesidad que asistieron al Centro. Los datos se procesaron con el programa SPSS 9.0. Se analizaron las distribuciones de frecuencias y el estadístico Chi-cuadrado para probar asociación entre las variables. El nivel de significancia fue 95%. En las familias de niños obesos se encontró que la mayoría de los jefes de familia eran obesos; las familias con pobreza extrema y la población infantil mayor de 15 años presentaron mayor sedentarismo; por último, las madres en general no participaron en la toma de decisiones en la compra de alimentos y no poseían nociones de alimentación equilibrada que les permitieran planificar la compra de alimentos. Estos aspectos se erigen como claves para ser abordados y resueltos por el trabajador social durante la intervención con el fin de favorecer la recuperación nutricional del niño obeso y su familia.

Aspectos psicológicos en el cáncer ginecológico

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María Eugenia Olivares Crespo

2004-01-01

Full Text Available En el presente trabajo se abordan los aspectos psicológicos concomitantes a la patologíaoncológica ginecológica. De forma habitual estas pacientes están sometidas a diferentes modalidadesterapéuticas que provocan efectos acumulativos. En términos generales, el tratamiento deelección es quirúrgico, principalmente mastectomía e histerectomía. Estos tratamientos quirúrgicosprovocan efectos antes, durante y después de los mismos. Entre los que cabe citar: alteraciones sexuales, cambios en la imagen corporal, infertilidad y menopausia inducida. Para concluir, seespecifican los procedimientos terapéuticos psicológicos del proceso, tanto del diagnóstico como deltratamiento quirúrgico y de los efectos derivados del mismo.

Aspectos do Desenvolvimento Político e Econômico da Guyana

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Iuri Cavlak

2014-07-01

Full Text Available Este artigo visa analisar alguns aspectos do desenvolvimento político e econômico da Guyana, pequeno país sul-americano situado no extremo norte do subcontinente. Tendo seu passado ligado a Holanda e a Inglaterra, a Guyana só conquistou sua independência em 1966, num contexto de avanço dos movimentos sociais, empolgados na construção de uma nova nação, e oposição dos Estados Unidos, tentando frear a difusão das ideias socialistas e o apego da política externa guianense ao bloco soviético. A busca por uma economia nacionalizada e planejada foi constante, embora com resultados deveras aquém do esperado.

Childhood motocross truncal injuries: high-velocity, focal force to the chest and abdomen

Science.gov (United States)

Kennedy, Raelene D; Potter, D Dean; Osborn, John B; Zietlow, Scott; Zarroug, Abdalla E; Moir, Christopher R; Ishitani, Michael B; McIntosh, Amy

2012-01-01

Objectives To review the need for operative intervention and critical care services for motocross truncal injuries in children. Design cohort Retrospective review of patients identified via the hospital trauma registry. Setting Our Level 1 Pediatric Trauma Center serves five motocross tracks. These patients require frequent medical care for injuries. Participants All patients ≤17 years of age with truncal injuries sustained during motocross activities, between 2000 and 2011, were identified through the trauma registry. Primary and secondary outcome measures Operative intervention, intensive care unit (ICU) admission, length of stay, morbidity and demographics were reviewed. Results Motocross injured 162 children. Thirty (18.5%) were thoracic or abdominal injuries. Operative intervention was required in eight (27%) patients. Mean injury severity score (ISS) was 11.8. ICU admission was required in 50% and average hospital length of stay was 4.1 days. The most common injuries include pulmonary contusion, pneumothorax, spleen and liver lacerations. 13% of subjects suffered truncal injury from motocross on more than one occasion. Conclusions Paediatric motocross-related truncal injuries are significant. Surgical intervention is required in 27% of patients. The lower ISS incurred from motocross combined with high surgical and ICU admission rates suggests focal high-impact injuries to the chest and abdomen. Despite significant injury, 13% of motocross patients suffer recurrent injuries. Parents and children need injury prevention education. PMID:23166134

Aspectos genéticos del procesamiento de antígenos intracelulares

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Beatriz Martínez

1993-03-01

Full Text Available La activación de los linfocitos T (LT, un aspecto fundamental en la generación de la respuesta inmune (RI, se produce mediante el contacto de sus receptores antigénicos (TCR con un complejo formado por un péptido derivado del antígeno y una molécula del complejo mayor de Histocompatibilidad (MHC, HLA en el humano sobre la superficie de una célula presentadora de antígenos (APC. El origen del péptido puede ser exógenooextracelular, como sucede con la mayoría de los antígenos presentados por las moléculas MHC clase II, o endógeno (intracelular, como es el caso de las proteínas virales. sintetizadas por la célula y presentadas por las moléculas MHC Clase.

Um aspecto da diversidade cultural do caboclo amazônico: a religião

OpenAIRE

Maués, Raymundo Heraldo

2005-01-01

ESTE TRABALHO trata de um aspecto da diversidade cultural do caboclo amazônico, isto é, a religião. Esta se constitui numa espécie de catolicismo popular, que mantém relações com o xamanismo nativo - a pajelança cabocla -, e que se originou de antigas práticas e crenças dos índios Tupinambás, que habitaram parte da região amazônica no período colonial, bem como de influências portuguesas e africanas.HIS PAPER deals with a particular aspect of the Amazon caboclo's cultural diversity, namely, r...

Aspectos psicosociales en el embarazo en mujeres menores de edad en España

OpenAIRE

Ibáñez Blanco, Raquel

2015-01-01

Me decidí a realizar mi Trabajo de Fin de Grado sobre los aspectos fisiológicos y emocionales en mujeres menores de edad porque considero que la gestación es uno de los momentos claves en la vida de cualquier mujer. Esta situación se ve llevada al extremo cuando tiene lugar en una menor de edad. Aunque en principio pueda parecer algo lejano y puntual, podremos comprobar que es una situación más habitual de lo que esperamos. Además de los importantes cambios anatómicos y fisiológicos que se pr...

Contrast-enhanced 3D MR angiography of the chest and abdomen with breath-holding using phase reordering

International Nuclear Information System (INIS)

Amanuma, Makoto; Sugimoto, Eiichi; Enomoto, Kyoko; Watabe, Tsuneya; Heshiki, Atsuko; Hirata, Hisashi; Kimura, Toshihiko; Takizawa, Osamu.

1995-01-01

This report presents the feasibility of phase-reordered contrast-enhanced three-dimensional MR angiography in 32 consecutive patients with vascular abnormalities in the chest and abdomen. To suppress motion artifacts due to respiratory corruption, a phase-reordering technique was introduced so that the low frequency components of the phase data were obtained first during the imaging period. Image quality and degree of motion suppression were assessed by four radiologists independently without information on breath-holding time. Abnormalities were detected in 30 cases (93.8%), and their extent was correctly assessed in 28 cases (87.5%). More confident assessment was possible in abnormalities of the pulmonary vessels and thoracic aorta than in those of the abdominal aorta and portal venous system. With phase reordering, more than 20 seconds of breath-holding ensured image quality sufficient to correctly assess the vascular abnormalities. While this technique is easy and requires only single breath-holding, it can provide excellent MRA without slice-to-slice spatial misregistration. (author)

High energy (42-66 MeV reactions) fast neutron dose optimization studies in the head and neck, thorax, upper abdomen, pelvis and extremities

International Nuclear Information System (INIS)

Griffin, T.W.; Laramore, G.E.; Maor, M.H.; Hendrickson, F.R.; Parker, R.G.; Davis, L.W.

1990-01-01

550 Patients were entered into a set of dose-searching studies designed to determine normal tissue tolerances to high energy (42-66 MeV reactions) fast neutrons delivered in 12 equal fractions over 4 weeks. Patients were stratified by treatment facility and then randomized to receive 16, 18 or 20 Gy for tumors located in the upper abdomen or pelvis, and 18, 20 or 22 Gy for tumors located in the head and neck, thorax or extremities. Following completion of the randomized protocols, additional patients were studied at the 20.4 Gy level in the head and neck, thorax and pelvis. Normal tissue effect scoring was accomplished using the RTOG-EORTC acute and late normal tissue effect scales. Acute Grade 3+ toxicity rates in the head and neck were 19 per cent for 20/20.4 Gy and 20 per cent for 22 Gy. Time adjusted late toxicity rates in the head and neck at 12 months were 15 per cent for 20/20.4 Gy and 0 per cent for 22 Gy. The 18 Gy treatment arm of the head and neck protocol was dropped early in the study after only two patients were accrued. For cases treated in the thorax, acute Grade 3+ toxicity rates were 6 per cent for 18 Gy, 15 per cent for 20/20.4 Gy and 7 per cent for 22 Gy. Late toxicity rates at 12 months were 0 per cent for 18 Gy, 11 per cent for 20/20.4 Gy and 18 per cent for 22 Gy. Acute Grade 3+ toxicity rates in the upper abdomen were 0 per cent for 16 Gy, 18 per cent for 18 Gy and 12 per cent for 20 Gy. There were no Grade 3+ late toxicities in the upper abdomen. In the pelvis acute Grade 3+ toxicity rates were 0 per cent for 16 Gy, 3 per cent for 18 Gy and 3 per cent for 20/20.4 Gy. Late Grade 3+ toxicities at 24 months were 20 per cent for 16 Gy, 5 per cent for 18 Gy and 24 per cent for 20/20.4 Gy. In the extremities, acute Grade 3+ toxicity rates were 7 per cent for 20 Gy and 21 per cent for 22 Gy, while at 12 months, late Grade 3+ toxicity rates were 14 and 35 per cent respectively. The 18 Gy treatment arm of the extremities protocol was dropped early

Aspectos éticos en la investigación cualitativa con niños

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Luisa Fernanda Moscoso Loaiza

2018-01-01

Full Text Available La incorporación de los niños como participantes de estudios investigativos es una práctica más frecuente en la actualidad debido a la necesidad de conocer y entender su visión acerca de las experiencias de vida, lo que plantea nuevos retos y responsabilidades que se centran principalmente en las consideraciones éticas y metodológicas de la investigación. Este artículo describe los aspectos éticos que deben ser tenidos en cuenta en la investigación cualitativa con niños. Es un artículo de revisión con búsqueda sistemática en bases de datos, incluyendo artículos científicos, libros y literatura gris. Asimismo, se abordan las consideraciones éticas que se encuentran implicadas desde la vinculación de los niños como participantes, hasta la obtención de la información y la socialización de los resultados. Para la investigación se seleccionó la información relevante en torno a ocho temas conforme al proceso investigativo. Con esto se evidenció que la cuestión ética constituye un aspecto central en el momento de iniciar y desarrollar cualquier estudio investigativo, por lo que está presente desde su planteamiento hasta su finalización. Pudo concluirse que el cumplimiento de los criterios de rigor metodológico, como la dependencia, credibilidad, transferibilidad y confirmación, asegura la calidad de la investigación cualitativa con niños, y esto permite la adecuada aplicación de los principios éticos de beneficencia y no maleficencia, justicia, autonomía y confidencialidad.

Atores profissionais e estudantes de teatro: aspectos vocais relacionados à prática

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Juliana Richinitti Vilanova

Full Text Available RESUMO Objetivo: identificar e comparar, em atores profissionais e estudantes de teatro, os aspectos relacionados à prática profissional, ao uso profissional da voz, hábitos e cuidados vocais, hábitos de saúde e condições ambientais no trabalho. Métodos: participaram 60 sujeitos de ambos os sexos, subdivididos em 2 grupos: Grupo Profissional - atores profissionais de teatro e Grupo Alunos - alunos de teatro sem experiência profissional teatral. Ambos os grupos responderam a um questionário que abordou aspectos relacionados à prática profissional, à voz, hábitos vocais, de saúde, condições ambientais e cuidados vocais. Resultados: os indivíduos do Grupo Profissional apresentaram maior ocorrência de rouquidão; maior ocorrência dos hábitos de usar a voz profissional quando está gripado, em posturas corporais e com respiração inadequadas, gritar, e permanecer em local com mofo ou pouca ventilação, fechado e empoeirado, e realizar ensaio em local diferente do local do espetáculo. O hábito de saúde de ingerir bebidas geladas foi maior no Grupo Alunos. O número de sujeitos que não possuem dificuldade em cena e que realizam aquecimento vocal é significantemente maior no Grupo Profissional. O tipo de aquecimento realizado significantemente mais pelo Grupo Profissional foi som de "s", respiração costo-diafragmática, som basal e vogais. Conclusão: constatou-se que ambos os grupos realizam hábitos prejudiciais e estão expostos a ambiente de trabalho inadequado para saúde vocal. Estes dados apontam a necessidade de ações de saúde vocal, a fim de minimizar o risco de alterações vocais nos profissionais e preparar os estudantes para o aumento da demanda vocal.

First identification of nanoparticles on thorax, abdomen and wings of the worker bee Apis dorsata Fabricius

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Bhattacharyya Atanu

2016-06-01

Full Text Available The presence of nanoparticles on the body of the honeybee Apis dorsata Fabricius, was investigated for the first time to better understand the bee’s behaviour. These have been observed by using Scanning Electron Microscopy (SEM, Transmission Electron Microscopy (TEM and confirmed by Atomic Force Microscopy (AFM. Our study clearly denotes that the Indian rock honey bee Apis dorsata possess calcium silicate and calcium phosphate nanoparticles on its body surface of 5-50 nm in diameter. In particular, the nanoparticles on the abdomen and thorax of A. dorsata have an average diameter of about 10 nanometers and they are smaller than those found on wings of the same bees which are about 20 nanometers. The nanoparticles found are different of the ones previously observed on honey bees or other insects. The origin and role of these natural nanoparticles on the body of the Indian rock bee need to be to be further investigated; more research in the subject might raise important aspects in relation to the conservation of these unique pollinators.

Aspectos disautonômicos da porfiria aguda intermitente: a propósito de seis casos

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Charles P. Tilbery

1979-06-01

Full Text Available Foram estudados seis casos de porfiria aguda intermitente, sendo enfocados os aspectos disautonômicos apresentados durante a longa permanência hospitalar dos doentes (média de 64 dias. Foram observados taquicardia sinusal e hipertensão arterial (4 casos, parada cardíaca (3 casos e depressão respiratória (5 casos. Os autores tecem comentários a propósito da fisiopatologia destas alterações e chamam a atenção sobre o prognóstico sombrio da porfiria aguda intermitente.

Algunos aspectos de la Reforma al Código de Procedimiento Laboral (Ley 712 de 2001

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Armando Rojas

2002-01-01

Full Text Available El pasado 9 de junio entró en vigencia la ley 712 del 2001, ley quereformó algunos aspectos del código procesal del trabajo que ahora sellama código procesal del trabajo y de la seguridad social. La razón desu creación obedeció a la necesidad de actualizar un estatuto procesal demás de cincuenta años a la práctica procesal de la actualidad, necesitadade la urgente descongestión de los procesos en los despachos judiciales

Whole abdomen radiation therapy in ovarian cancers: a comparison between fixed beam and volumetric arc based intensity modulation

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Clivio Alessandro

2010-11-01

Full Text Available Abstract Purpose A study was performed to assess dosimetric characteristics of volumetric modulated arcs (RapidArc, RA and fixed field intensity modulated therapy (IMRT for Whole Abdomen Radiotherapy (WAR after ovarian cancer. Methods and Materials Plans for IMRT and RA were optimised for 5 patients prescribing 25 Gy to the whole abdomen (PTV_WAR and 45 Gy to the pelvis and pelvic nodes (PTV_Pelvis with Simultaneous Integrated Boost (SIB technique. Plans were investigated for 6 MV (RA6, IMRT6 and 15 MV (RA15, IMRT15 photons. Objectives were: for both PTVs V90% > 95%, for PTV_Pelvis: Dmax Results IMRT and RapidArc resulted comparable for target coverage. For PTV_WAR, V90% was 99.8 ± 0.2% and 93.4 ± 7.3% for IMRT6 and IMRT15, and 98.4 ± 1.7 and 98.6 ± 0.9% for RA6 and RA15. Target coverage resulted improved for PTV_Pelvis. Dose homogeneity resulted slightly improved by RA (Uniformity was defined as U5-95% = D5%-D95%/Dmean. U5-95% for PTV_WAR was 0.34 ± 0.05 and 0.32 ± 0.06 (IMRT6 and IMRT15, 0.30 ± 0.03 and 0.26 ± 0.04 (RA6 and RA15; for PTV_Pelvis, it resulted equal to 0.1 for all techniques. For organs at risk, small differences were observed between the techniques. MU resulted 3130 ± 221 (IMRT6, 2841 ± 318 (IMRT15, 538 ± 29 (RA6, 635 ± 139 (RA15; the average measured treatment time was 18.0 ± 0.8 and 17.4 ± 2.2 minutes (IMRT6 and IMRT15 and 4.8 ± 0.2 (RA6 and RA15. GAIIMRT6 = 97.3 ± 2.6%, GAIIMRT15 = 94.4 ± 2.1%, GAIRA6 = 98.7 ± 1.0% and GAIRA15 = 95.7 ± 3.7%. Conclusion RapidArc showed to be a solution to WAR treatments offering good dosimetric features with significant logistic improvements compared to IMRT.

Ileum perforation due to accidental chicken bone ingestion a rare cause of the acute abdomen

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Doklestić Krstina S.

2012-03-01

Full Text Available Ingestion of foreign bodies is not an uncommon occurrence, but most of them will pass through the gastrointestinal tract without consequences. Complication such as perforation is rare. We present a case of small bowel perforation secondary to the accidental ingestion of a chicken bone. The patient presented with abdominal pain, constipation and vomiting. Clinical examination confirmed generalized abdominal tenderness and rebound tenderness. Abdominal radiography showed multiple dilated loops of small bowel, and abdominal ultrasound (US showed inflammatory changes on small bowel loops, with free fluid and fluid collection around intestinal loops. The patient underwent an emergency laparotomy. Intra operative findings revealed diffuse fibro purulent peritonitis with abscess between central small bowels loops. At about 60 cm from Bauchini valve we found a perforation of ileum at the anti-mesenteric site caused by a sharp chicken wishbone. The patient was treated with resection of the ileum segment (10 cm and primary end-to-end anastomosis. Even that intestinal perforation by a foreign body is rare, physicians should consider possibility of intestinal perforation by a foreign body in the differential diagnosis of acute abdomen in patients presenting with abdominal pain.

Estado nutricional y aspectos alimentarios de mujeres indígenas del departamento de Presidente Hayes, Paraguay

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Gloria Echagüe; Valentina Díaz; Laura Mendoza; Pamela Mongelos; Graciela Giménez; Malvina Paez; Florentina Laspina; Amalia Castro; María Isabel Rodríguez; Patricia Araújo; Wilberto Castro; Ramón Marecos; Santiago Evers; Gerardo Deluca; Alejandra Picconi

2015-01-01

Introducción: Las comunidades indígenas presentan un mayor riesgo de inseguridad alimentaria y malnutrición, menor disponibilidad de recursos, y una creciente dependencia de alimentos más baratos aunque con un alto grado de procesamiento. Objetivo: Identificar el estado nutricional y aspectos alimentarios en mujeres indígenas de tres comunidades del Departamento de Presidente Hayes, Chaco Paraguayo. Metodología: Estudio observacional de diseño transversal con componente analítico, que incluyó...

La ingeniería de requisitos orientada a aspectos: una experiencia de aplicación en un sistema de ayuda en línea

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MARTA S. TABARES

2007-01-01

Full Text Available La Ingeniería de Rrequisitos Orientada a Aspectos provee enfoques para la elicitación y especificación de los asuntos y asuntos transversales en etapas tempranas de desarrollo de software. Este artículo presenta un caso de estudio para evaluar un modelo de la separación multidimensional de asuntos orientados a aspectos. Con el caso de estudio, se revisan sus características para la elicitación, análisis y trazabilidad de requisitos, así como algunas limitaciones del modelo y cómo este puede ser adaptado al proceso de desarrollo. Además, planteamos un conjunto de argumentos que podrían promover el desarrollo y evolución de este modelo

Función del diafragma durante la colocación de cargas sobre el abdomen en sujetos normales Study of diaphragmatic muscle function during abdominal weight in normal subjects

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Sergio G. Monteiro

2012-04-01

Full Text Available Los efectos de las cargas en el abdomen con el objeto de producir entrenamiento del diafragma, no han sido suficientemente evaluados. Estudiamos la función del diafragma durante la colocación de cargas sobre el abdomen y con cambios en el patrón respiratorio. Se estudiaron 6 voluntarios normales. Se obtuvo flujo en la boca, presión gástrica (Pga, presión esofágica (Pes, movimiento torácico (TX y abdominal (AB, presión inspiratoria máxima (PImax y presión transdiafragmática media (Pdi y máxima (Pdimax. Se calculó la relación Pdi/Pdimax y el índice tensión-tiempo del diafragma (TTdi. Etapas: patrón normal (PN, patrón abdominal (PA y carga de 1, 2, 4 y 6 kg con PN y PA. El PA fue facilitado por las cargas sobre el abdomen. Solo con 6 kg (PN y PA la Pga a capacidad residual funcional aumentó significativamente (p 0.001. La Pdi siguió a las variaciones de la Pga y aumentó con todos los PA (p The effects of the abdominal weight with the intention of producing training of the diaphragm, have not been sufficiently evaluated. We studied the function of the diaphragm during the abdominal weight training and during associated changes in the respiratory pattern. Six normal volunteers were studied. Flow at the mouth at functional residual capacity (FRC was obtained as well as gastric pressure (Pga, esophageal pressure (Pes, thoracic and abdominal movements, maximal inspiratory pressure and mean and maximal transdiaphragmatic pressure (Pdi and Pdi max. Pdi/Pdimax and the diaphragm tension-time index (TTdi were calculated. Studied steps: normal pattern (NP, abdominal pattern (AP and weight of 1, 2, 4 and 6 kg with NP and AP as well. We found 1 The AP was facilitated by the abdominal weight, 2 Only with 6 kg (NP and AP the Pga at FRC increased significantly (p 0.001, 3 the Pdi followed the variations of the Pga and increased with all the AP (p < 0.001, 4 The index TTdi load reached a value of 0.05 ± 0.02 (p < 0.001. The charges did not

A imagem do Brasil no discurso do New York Times. Aspectos sociais

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Maria Inez Mateus Dota

2010-01-01

Full Text Available Este texto presenta un análisis de las noticias publicadas en el periódico The New York Times, versión digital, entre los meses de enero y junio de 2004. Al relacionarlas con los aspectos sociales del Brasil se intenta ver cuál es la imagen que ese periódico muestra del Brasil. El artículo adopta como fundamentos teóricos y metodológicos el análisis del discurso, principalmente las contribuiciones de Bell (1991, Fairclough (1995 y 2001, Fowler (1991 y Sousa (2004, discute las estrategias discursivas usadas para representar al Brasil y examina qué elementos escoge y los recursos de lenguaje que son empleados para la producción de los textos analizados.

Aspectos neuropsicológicos da depressão Aspectos neuropsicológicos de la depresión Neuropsychological aspects of depression

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Marcia Rozenthal

2004-08-01

Full Text Available Este artigo objetiva rever os principais achados neuropsicológicos na depressão, procurando diferenciar o tipo unipolar do bipolar, com ou sem psicose, tanto nos períodos de fase aguda quanto nos períodos intercríticos. Procurou-se, ainda, correlacionar os achados neuropsicológicos descritos na literatura consultada com os seus correlatos neuroanatômicos e neurofuncionais, ressaltando-se as áreas frontais e seus principais circuitos. Considerando-se estudos neuropsicológicos dos transtornos afetivos, algumas alterações têm se mostrado mais consistentes, sendo descritas disfunções importantes nas fases críticas, mas também no paciente assintomático. Nestas, interessam principalmente os aspectos atentivos e mnêmicos e o funcionamento executivo. Estudos desta natureza têm profundas implicações terapêuticas, apontando para a necessidade de desenvolver outras técnicas coadjuvantes, tais como reabilitação cognitiva e intervenções psicossociais, tornando o tratamento mais abrangente e incisivo nestes casos.Este artículo tiene por objetivo revisar los principales hallazgos neuropsicológicos en la depresión, procurando diferenciar sus formas de presentación unipolar y bipolar, con o sin sintomatología psicótica, tanto en el cuadro agudo como en los periodos inter-críticos. Busca, además, correlacionar los hallazgos neuropsicológicos descritos en la literatura consultada con los aspectos neuroanatómicos y neurofuncionales, destacando el área cortical frontal y sus circuitos principales. Considerándose estudios neuropsicológicos en trastornos afectivos, algunas alteraciones de atención, memoria y de funciones ejecutivas se han presentado más frecuentemente, siendo descritas en los periodos de crisis y también en el paciente asintomático. Estudios de esa naturaleza tienen profundas implicaciones terapéuticas, señalando además la necesidad de desarrollar otras técnicas terapéuticas coadyuvantes, tales como la

ASPECTOS FINANCIEROS DE LA REFORMA LOCAL

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Amable Corcuera Torres

2015-01-01

Full Text Available En este trabajo se analizan los aspectos jurídico-financieros más relevantes que incluye la Ley 27/2013, de 27 de diciembre, de racionalización y sostenibilidad de la Administración Local. Las nuevas medidas incluidas en la citada Ley afectan tanto a los ingresos de los entes locales como a sus gastos. Al respecto, se abordan cuestiones relativas a los efectos económicos de la fusión de municipios, la supresión general de licencias, el contenido de los planes económico-financieros, el cálculo del coste efectivo de los servicios, el redimensionamiento del sector público local, la novedosa atribución a la Junta de Gobierno Local de la competencia para aprobar ciertos actos financieros, la disolución de entidades de ámbito territorial inferior al Municipio que no presenten sus cuentas antes de 31 de diciembre de 2014 o la posibilidad de reducir la deuda comercial o financiera a través de la venta de patrimonio público del suelo. In this work the most important legal and financial aspects including the Law 27/2013, of 27 December, rationalization and sustainability of local government are analyzed. The new measures included in that Act affect both the income of local authorities and their expenses. In this regard, issues concerning the economic effects of the merger of municipalities, the general abolition of licenses, the content of financial plans, the calculation of the actual cost of services, the local public sector downsizing, the novel addresses allocation to the Local Government of the power to grant certain financial actions, the dissolution of entities below the Municipality territory who do not submit their accounts before December 31, 2014 or the possibility of reducing the commercial or financial debt through the sale of public land heritage.

Bronquiolite constritiva: aspectos tomográficos e correlação anatomopatológica

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Nobre Luiz Felipe

2002-01-01

Full Text Available Os autores relatam os principais aspectos da bronquiolite constritiva na tomografia computadorizada de alta resolução (TCAR do tórax em ins e expiração, e os comparam aos achados anatomopatológicos, mediante estudo de três casos da doença em mulheres com idade entre 29 e 46 anos que apresentavam dispnéia incaracterística, de caráter progressivo, encaminhadas para realização de espirometria, TCAR do tórax e biópsia pulmonar. A TCAR do tórax em ins e expiração demonstrou, em dois casos, padrão de atenuação em mosaico difuso, acentuado na expiração. No terceiro caso foram observados nódulos centrolobulares, não sendo realizado estudo em expiração. O material histopatológico demonstrou estenose importante de luzes bronquiolares por espessamento fibroso da lâmina própria e atrofia do epitélio bronquiolar, alterações diagnósticas da bronquiolite constritiva. A realização de TCAR do tórax em ins e expiração mostrou-se de fundamental importância na suspeição de doenças relacionadas à obstrução de pequenas vias aéreas, sendo o aspecto de atenuação em mosaico na expiração característico da topografia periférica das lesões. O diagnóstico de bronquiolite constritiva deve ser confirmado por biópsia pulmonar por meio de toracotomia.

Aspectos Contábeis dos Créditos de Carbono: Estudo com Autores Nacionais

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Vanderlei dos Santos

2013-12-01

Full Text Available O estudo objetiva verificar o entendimento de autores nacionais no que concerne à classificação, forma de reconhecimento e mensuração das operações com créditos de carbono. O estudo de natureza descritiva foi realizado em 2011, por meio de pesquisa de levantamento ou survey, com abordagem quantitativa. Utilizou-se o questionário como instrumento de coleta de dados, que foi enviado a 23 pesquisadores nacionais que possuem publicação de artigos relacionados à contabilização dos créditos de carbono em periódicos nacionais. Obtiveram-se nove respostas, que constituíram numa amostra por acessibilidade. Para a análise dos dados obtidos optou-se pelo uso da técnica da entropia informacional. Os resultados do estudo mostraram que, quanto à classificação dos créditos de carbono, há um entendimento maior entre os autores de que se trata de ativos especiais e que não podem ser considerados como commodity. Observou-se que não há consenso entre os autores em classificar os créditos de carbono como ativo intangível ou estoque. Deste modo, concluiu-se que ainda existem divergências no entendimento dos autores analisados no que concerne aos aspectos contábeis das operações com créditos de carbono. O artigo contribui principalmente na medida em que busca consolidar diferentes opiniões de autores, que pesquisam sobre a temática, demonstrando aspectos convergentes e divergentes, além de enfatizar lacunas para desenvolver pesquisas futuras.

Apuntes sobre globalización: aspectos culturales, tecnológicos y económicos

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Mayden Solano Jiménez

2014-01-01

Full Text Available La internacionalización de las economías con una consecuente apertura de mercados, la modernización de los organismos tanto públicos como privados, el incremento en la competitividad, las privatizaciones, la reducción del tamaño del Estado y el enlazamiento de las economías; bien por la vía de la regionalización económica de áreas continentales o la integración de mercados en los que intervienen las más disímiles zonas geográficas del mundo; son algunas características propias del reacomodamiento o nuevo orden mundial. Dentro de este contexto, el presente artículo busca analizar el fenómeno de la globalización desde los aspectos: cultural, económico y tecnológico; los cuales han permeado varios sectores de la sociedad global, generando una interrelación e integración entre diversos actores, en donde no sólo confluye el Estado- nación, también da cabida a otros actores del Sistema Internacional. Por lo cual, se analiza el comportamiento de la aldea global y la cultura dentro del fenómeno de la globalización a partir de aspectos económicos y tecnológicos, resaltando la importancia de los medios de comunicación o la llamada era de la información, el mercado financiero global y por último, el papel que juega el proceso de integración y la necesidad de reestructurar las principales instituciones internacionales.

Aspectos metodológicos na construção de projetos de pesquisa em Nutrição Clínica

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Deyliane Aparecida De almeida Pereira

2014-10-01

Full Text Available O objetivo deste texto é fomentar a reflexão e a crítica no processo de elaboração de projetos de pesquisa em nutrição clínica. São apresentados aspectos relativos a evidências, validade e confiabilidade dos resultados dos estudos nesse campo. É imprescindível que ocorra adequado planejamento da pesquisa, desde a definição do delineamento e do tipo do experimento, passando pelos aspectos éticos, escolha da população e cálculo do tamanho amostral até a avaliação da factibilidade dos riscos envolvidos na sua condução. Após a coleta das informações, as etapas seguintes correspondem à descrição dos resultados, análise estatística, verificação da consistência desses resultados e, ao final, sua adequada interpretação.

La Participación Transnacional en los Aspectos Religiosos de las Fiestas del Santo Patrón en una Comunidad Michoacana

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Sergio M. Martínez

2007-12-01

Full Text Available En este trabajo de investigación se analiza la participación transnacional en las mayordomías y en los aspectos religiosos durante las fiestas patronales de San Miguel Arcángel en un pueblo de la rivera del Lago de Pátzcuaro, Michoacán. Mediante un acercamiento etnográfico colaborativo en que los investigadores han participado activamente y han tomado apuntes durante los días de la fiesta se ha involucrando la descripción densa y análisis reflexivo de cada uno de los eventos religiosos. Al final se han triangulado los resultados para concluir que participación transnacional en esta comunidad es de suma importancia en varios aspectos, pero especialmente para mantener los vínculos religiosos de los emigrantes y lugareños y de la participación en el culto al santo patrón de futuras generaciones que transmigran entre México—Estados Unidos.

A contribution to quality control in veterinary radiology. Development and calibration of a test-phantom for the control of the picture quality of radiographs of the abdomen of the cat

International Nuclear Information System (INIS)

Mueller-Wabro, A.

1996-10-01

The theme of this thesis was the extension of the application of a test phantom developed at the institute of medical physics (University of Veterinary Medicine/Vienna) and the calibration for the abdomen of the cat. The test phantom is a stepped test body consisting of a material, which absorbs and scatters X-rays similar to bony tissue. On the baseplate of the staircase there are holes 0.5 and 0.7 mm in diameter. Objective parameters of a radiograph - radiographic density latitude, contrast and detail visibility - can be examined with the phantom. By using subjective 'good' rated radiographs it was possible to establish an indirect relation between the soft tissue of the abdomen and the phantom by comparing the optical density. Thus the practicability of the application for abdominal radiographs could be demonstrated. The recognizability of the holes means a measure of detail visibility. For the represented parameters of an X-ray picture are connected, one can conclude radiograph quality from detail visibility. On the basis of the results of a judgement by test-persons a nomogram was designed, which is of use in quick classifying and controlling X-ray pictures. (author)

Formación en recreación en Colombia: aspectos fundamentales para el estudio

OpenAIRE

Juan Manuel Carreño Cardozo; Narda Dioselina Robayo Fique

2010-01-01

El escrito presenta la reflexión fundamental de la investigación Estado del arte de los conceptos de recreación en Colombia, en Instituciones de educación técnica-tecnológica y de pregrado en recreación y afines originado en la línea de Investigación formar - Formación de Maestros en Recreación3 del programa Licenciatura en Recreación de la Facultad de Educación Física en la Universidad Pedagógica Nacional. La reflexión contiene los aspectos fundamentales que se postulan en la investigación p...

Apontamentos sobre educação e trabalho no Brasil contemporâneo: aspectos da contrarreforma educacional

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Fabiana de Cássia Rodrigues

2017-12-01

Full Text Available O presente artigo articula a temática da educação e trabalho com os desafios brasileiros em sua inserção na divisão internacional do trabalho, segundo as especificidades de sua formação social, marcada pelo capitalismo dependente e subdesenvolvido. Partimos da formulação das seguintes questões: De que educação necessitam os trabalhadores na realidade brasileira atual, segundo a ótica do capital? O esvaziamento de conteúdos e sentidos da educação estaria em consonância com as mudanças na estrutura ocupacional brasileira? A simplificação dos conteúdos trabalhados na escola traz quais exigências à formação docente? A fim de discuti-las a redação foi dividida em duas partes. Na primeira parte do texto, partiremos dos retrocessos atuais na estrutura produtiva, procurando evidenciar as suas determinações históricas. Coloca-se também em destaque as diretrizes educacionais formuladas pelos organismos multilaterais em consonância com as mudanças na estrutura ocupacional brasileira que contribuem para explicar as políticas que esvaziam a formação das trabalhadoras e trabalhadores. Na segunda parte, trataremos de aspectos da política educacional brasileira que materializam as perspectivas dos organismos multilaterais para a educação no contexto social brasileiro. Foram abordados três aspectos: 1 A elaboração da Base Nacional Comum Curricular; 2 As novas diretivas para formação de professores; 3 O Projeto Escola Sem Partido como mecanismo de pressão para minimizar o caráter formativo da escola. Percebemos que os três aspectos em questão articulados promovem um esvaziamento da escola e da formação de professores de conhecimentos científicos e político-culturais, contrários às reivindicações educacionais na luta pela redemocratização nos anos de 1980, conformando, desse modo, um movimento de contrarreforma.

Aspectos más significativos en la revisión de proyectos de cimientos y estructuras de edificación

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Gómez Hermoso, Jesús

2000-08-01

Full Text Available This document show all important aspects on the foundation and structure building project check. No speaking about calculation problems, it enumerate the qualities aspects that could be checked and all that have major effect in a good project and construction quality. It considerers at first, the relation between the structure and the architecture and the equipment building, and with the urbanistic aspects and the soil characteristics. Later, it talks about the typical aspects of structure, like materials, actions, general calculation and the checking of different elements (fancing pile, supports , beams and slabs. It speaks about concrete, metallic and wood structures.En el presente artículo se muestran todos aquellos aspectos que se consideran importantes en la revisión del proyecto de la cimentación y la estructura de un edificio. Sin entrar en problemas concretos de cálculo, se enumeran los aspectos cualitativos que han de comprobarse y se subrayan todos aquéllos que pueden tener una mayor repercusión en la buena calidad del proyecto y de la obra. Se tiene en cuenta, en primer lugar, la interrelación de la estructura con la arquitectura y las instalaciones del edificio, así como la que tiene (junto a la cimentación con el entorno urbanístico y las características del terreno. Posteriormente se tratan los aspectos más propios del proyecto de estructura, como son los materiales, las acciones, el cálculo general y la comprobación de los distintos elementos (zapatas, pilotes, encepados. pilas. vigas y forjados. Junto a las estructuras de hormigón armado se analizan las metálicas y las de madera laminada encolada.

Benefits of sinogram-affirmed iterative reconstruction in 0.4 mSv ultra-low-dose CT of the upper abdomen following transarterial chemoembolisation: comparison to low-dose and standard-dose CT and filtered back projection technique

International Nuclear Information System (INIS)

Bodelle, B.; Isler, S.; Scholtz, J.-E.; Frellesen, C.; Luboldt, W.; Vogl, T.J.; Beeres, M.

2016-01-01

Aim: To evaluate the advantage of sinogram-affirmed iterative reconstruction (SIR) compared to filtered back projection (FBP) in upper abdomen computed tomography (CT) after transarterial chemoembolisation (TACE) at different tube currents. Materials and methods: The study was approved by the institutional review board. Written informed consent was obtained from all patients. Post-TACE CT was performed with different tube currents successively varied in four steps (180, 90, 45 and 23 mAs) with 40 patients per group (mean age: 60±12 years, range: 23–85 years, sex: 70 female, 90 male). The data were reconstructed with standard FBP and five different SIR strengths. Image quality was independently rated by two readers on a five-point scale. High (Lipiodol-to-liver) as well as low (liver-to-fat) contrast-to-noise ratios (CNRs) were intra-individually compared within one dose to determine the optimal strength (S1–S5) and inter-individually between different doses to determine the possibility of dose reduction using the Kruskal–Wallis test. Results: Subjective image quality and objective CNR analysis were concordant: intra-individually, SIR was significantly (p<0.001) superior to FBP. Inter-individually, regarding different doses (180 versus 23 ref mAs), there was no significant (p=1.00) difference when using S5 SIR at 23 mAs instead of FBP. Conclusion: SIR allows for an 88% dose reduction from 3.43 to 0.4 mSv in unenhanced CT of the liver following TACE without subjective or objective loss in image quality. - Highlights: • Diagnostic image quality and radiation dose of ultra-low-dose CT of the upper abdomen using sinogram affirmed iterative reconstruction following transarterial chemoembolization in comparison to low-dose and standard dose CT and filtered back projection technique. • Ultra-low dose CT of the upper abdomen using sinogram affirmed iterative reconstruction allows for significant dose reduction by 88%. • Ultra-low dose CT of the upper abdomen

The open abdomen and temporary abdominal closure systems--historical evolution and systematic review.

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Quyn, A J; Johnston, C; Hall, D; Chambers, A; Arapova, N; Ogston, S; Amin, A I

2012-08-01

Several techniques for temporary abdominal closure have been developed. We systematically review the literature on temporary abdominal closure to ascertain whether the method can be tailored to the indication. Medline, Embase, the Cochrane Central Register of Controlled Trials and relevant meeting abstracts until December 2009 were searched using the following headings: open abdomen, laparostomy, VAC (vacuum assisted closure), TNP (topical negative pressure), fascial closure, temporary abdominal closure, fascial dehiscence and deep wound dehiscence. The data were analysed by closure technique and aetiology. The primary end-points included delayed fascial closure and in-hospital mortality. The secondary end-points were intra-abdominal complications. The search identified 106 papers for inclusion. The techniques described were VAC (38 series), mesh/sheet (30 series), packing (15 series), Wittmann patch (eight series), Bogotá bag (six series), dynamic retention sutures (three series), zipper (15 series), skin only and locking device (one series each). The highest facial closure rates were seen with the Wittmann patch (78%), dynamic retention sutures (71%) and VAC (61%). Temporary abdominal closure has evolved from simple packing to VAC based systems. In the absence of sepsis Wittmann patch and VAC offered the best outcome. In its presence VAC had the highest delayed primary closure and the lowest mortality rates. However, due to data heterogeneity only limited conclusions can be drawn from this analysis. © 2012 The Authors. Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland.

64-Slice multidetector row CT angiography of the abdomen: comparison of low versus high concentration iodinated contrast media in a porcine model

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Holalkere, N-S; Matthes, K; Kalva, S P; Brugge, W R; Sahani, D V

2011-01-01

Objective In this study we aimed to assess the image quality and degree of vascular enhancement using low-concentration contrast media (LCCM) (300 mg I ml–1) and high-concentration contrast media (HCCM) (370 mg I ml–1) on 64-slice multidetector row CT (MDCT) abdominal CT angiography (CTA). In addition, we aimed to study the feasibility of using HCCM with a reduced total iodine dose. Methods CTA of the abdomen on a 64-slice MDCT was performed on 15 anaesthetised pigs. Study pigs were divided into three groups of five each based on the iodine concentration and dose received: Group A (LCCM; 300 mg I ml–1), Group B (HCCM; 370 mg I ml–1) and Group C HCCM with 20% less iodine dose. The total iodine injected was kept constant (600 mg kg–1) in Groups A and B. Qualitative and quantitative analyses were performed to study and compare each group for image quality, visibility of the branch order of the superior mesenteric artery (SMA), artefacts, degree of enhancement in the aorta and main stem arteries and uniformity of enhancement in the aorta. Groups were compared using the analysis of variance test. Results The image quality of 64-slice MDCT angiography was excellent with a mean score of 4.63 and confident visualisation of the third to fifth order branches of the SMA in all groups. Group B demonstrated superior vascular enhancement, as compared with Groups A and C (p≤0.05). Uniform aortic enhancement was achieved with the use of LCCM and HCCM with 20% less iodine dose. Conclusion 64-slice MDCT angiography of the abdomen was of excellent quality. HCCM improves contrast enhancement and overall CTA image quality and allows the iodine dose to be reduced. PMID:21081582

A cross-platform survey of CT image quality and dose from routine abdomen protocols and a method to systematically standardize image quality

International Nuclear Information System (INIS)

Favazza, Christopher P; Duan, Xinhui; Zhang, Yi; Yu, Lifeng; Leng, Shuai; Kofler, James M; Bruesewitz, Michael R; McCollough, Cynthia H

2015-01-01

Through this investigation we developed a methodology to evaluate and standardize CT image quality from routine abdomen protocols across different manufacturers and models. The influence of manufacturer-specific automated exposure control systems on image quality was directly assessed to standardize performance across a range of patient sizes. We evaluated 16 CT scanners across our health system, including Siemens, GE, and Toshiba models. Using each practice’s routine abdomen protocol, we measured spatial resolution, image noise, and scanner radiation output (CTDI vol ). Axial and in-plane spatial resolutions were assessed through slice sensitivity profile (SSP) and modulation transfer function (MTF) measurements, respectively. Image noise and CTDI vol values were obtained for three different phantom sizes. SSP measurements demonstrated a bimodal distribution in slice widths: an average of 6.2  ±  0.2 mm using GE’s ‘Plus’ mode reconstruction setting and 5.0  ±  0.1 mm for all other scanners. MTF curves were similar for all scanners. Average spatial frequencies at 50%, 10%, and 2% MTF values were 3.24  ±  0.37, 6.20  ±  0.34, and 7.84  ±  0.70 lp cm −1 , respectively. For all phantom sizes, image noise and CTDI vol varied considerably: 6.5–13.3 HU (noise) and 4.8–13.3 mGy (CTDI vol ) for the smallest phantom; 9.1–18.4 HU and 9.3–28.8 mGy for the medium phantom; and 7.8–23.4 HU and 16.0–48.1 mGy for the largest phantom. Using these measurements and benchmark SSP, MTF, and image noise targets, CT image quality can be standardized across a range of patient sizes. (paper)

A cross-platform survey of CT image quality and dose from routine abdomen protocols and a method to systematically standardize image quality.

Science.gov (United States)

Favazza, Christopher P; Duan, Xinhui; Zhang, Yi; Yu, Lifeng; Leng, Shuai; Kofler, James M; Bruesewitz, Michael R; McCollough, Cynthia H

2015-11-07

Through this investigation we developed a methodology to evaluate and standardize CT image quality from routine abdomen protocols across different manufacturers and models. The influence of manufacturer-specific automated exposure control systems on image quality was directly assessed to standardize performance across a range of patient sizes. We evaluated 16 CT scanners across our health system, including Siemens, GE, and Toshiba models. Using each practice's routine abdomen protocol, we measured spatial resolution, image noise, and scanner radiation output (CTDIvol). Axial and in-plane spatial resolutions were assessed through slice sensitivity profile (SSP) and modulation transfer function (MTF) measurements, respectively. Image noise and CTDIvol values were obtained for three different phantom sizes. SSP measurements demonstrated a bimodal distribution in slice widths: an average of 6.2  ±  0.2 mm using GE's 'Plus' mode reconstruction setting and 5.0  ±  0.1 mm for all other scanners. MTF curves were similar for all scanners. Average spatial frequencies at 50%, 10%, and 2% MTF values were 3.24  ±  0.37, 6.20  ±  0.34, and 7.84  ±  0.70 lp cm(-1), respectively. For all phantom sizes, image noise and CTDIvol varied considerably: 6.5-13.3 HU (noise) and 4.8-13.3 mGy (CTDIvol) for the smallest phantom; 9.1-18.4 HU and 9.3-28.8 mGy for the medium phantom; and 7.8-23.4 HU and 16.0-48.1 mGy for the largest phantom. Using these measurements and benchmark SSP, MTF, and image noise targets, CT image quality can be standardized across a range of patient sizes.

Aspectos fundamentais no desenvolvimento de sistemas microemulsionados contendo anfotericina B para uso oftálmico

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Walteçá Louis Lima Silveira

2013-01-01

Full Text Available A exemplo do que ocorre com outros fármacos, a biodisponibilidade da anfotericina B (AmB através da via ocular repreesenta um grande desafio para a pesquisa científica. Na verdade, a baixa biodisponibilidade apresentada por tal molécula é devido, principalmente, a presença das barreiras oculares que impedem a absorção deste fármaco para os tecidos internos. A toxicidade associada a este fármaco, assim como a sua baixa capacidade em permear a córnea íntegra também consiste em um problema associado ao seu uso clínico. Novos veículos seguros e eficazes para a liberação ocular da AmB são, portanto, necessários. As microemulsões (MEs aparecem como um interessante sistema devido à sua transparência, estabilidade termodinâmica e favorável viscosidade. O conhecimento do processo de formação das MEs contendo AmB, assim como a compreensão de toda a sua caracterização físicoquímica correspondem a aspectos importantes para se determinar as condições favoráveis para que estes sistemas venham a ser empregados como colírios. Esta revisão tem como objetivo, portanto, abordar este tema enfatizando os principais aspectos relacionados com a utilização de MEs como sistemas de liberação para a AmB através da via tópica oftálmica.

Diversos aspectos atinentes a la esclavitud en Buenos Aires derivados del análisis de las fuentes notariales, 1821-1830

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Miguel A. Rosal

2004-11-01

Full Text Available El presente trabajo constituye un avance de la investigación sobre el negro porteño a partir de la segunda década post-revolucionaria, a través de la consulta de los distintos registros de los Protocolos Notariales, conservados en el Archivo General de la Nación. En síntesis, el artículo pretende ilustrar aspectos que quizá no hayan merecido la necesaria atención por parte de los investigadores de la problemática afroporteña durante el período independiente; nos referimos al análisis del fenómeno de la manumisión, preciada o graciosa, de la libertad futura condicional, de la figura del negro propietario de bienes inmuebles y de esclavos, como así también de los testamentos de las personas "de color". Parece útil, entonces, intentar estos estudios que nos podrán iluminar sobre aspectos poco o nada conocidos de los morenos y pardos de Buenos Aires durante el siglo XIX.

Aspectos de la infección urinaria en el adulto

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Daisy María Contreras Duverger

1998-02-01

Full Text Available Se realiza una revisión bibliográfica de aspectos importantes de la infección urinaria inespecífica, que se consideran de interés para la mejor preparación del médico general integral. Se describen las terminologías microbiológicas y las utilizadas para evaluar la respuesta al tratamiento, así como la clasificación más actual de esta entidad. Se mencionan los tipos de tratamiento y las drogas más utilizadas, y se enfatiza en el uso de las quinolonasIt is made a bibliographic review of some important aspects of unspecific urinary infection that are considered of interest for a better training of the general comprehensive physician. A description is made of the microbiological terminolgies and of those used to evaluate the response to the treatment, as well as of the latest classification of this disease. The different types of treatment and the most used drugs are mentioned here. Emphasis is made on the use of quinolines

Aspecto de la Agricultura Intensiva en la Provincia de Ocaña, Departamento Norte de Santander.

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Obregón Botero Rafael

1941-10-01

Full Text Available Un inteligente sentido de lógica deducción, unido al patriótico esfuerzo por el mejoramiento de su tierra, llevó al Dr. Luis Carvajalino Jácome a la conclusión de que el problema de la agricultura intensiva en la Provincia de Ocaña (Santander del Norte presentaba aspectos tan diversos y complejos, que quiso por todos los medios interesar a los Gobiernos Nacional y Departamental en una favorable solución. Fue así como en el cumplimiento de un programa de resurgimiento progresivo de la industria agrícola, este conocido profesional nortesantandereano pidió al Ministerio de la Economía Nacional se comisionara a un Fitopatólogo y a un Entomólogo para estudiar los problemas surgidos del creciente aumento de plagas y enfermedades en la región y especialmente el decaimiento que por estos factores notábase en la industria cebollera. Atendiendo a la insinuación, el Ministerio de la Economía tuvo a bien encargarnos de tan interesante comisión y para el mejor cumplimiento a nuestro juicio, estudiamos y observamos con algún detenimiento los diferentes aspectos de su agricultura. Estas observaciones y conclusiones las queremos presentar y ofrecer como una modesta cooperación al programa de progreso en cuyos resultados finales están empeñados tanto sus dirigentes como el pueblo de Santander. A pesar de que nuestra misión se limitaba al estudio de la sanidad de los cultivos, quisimos hacer extensivas las observaciones a otros puntos de vital importancia, toda vez que las modalidades de la región presentaban aspectos de un problema que pudiéramos llamar nuevo para nuestra agricultura nacional. Quizás el cultivo del café en las tierras del Quindío tienen un verdadero aspecto de agricultura intensiva con caracteres de económica importancia, pero aparte de ésta y de contadas regiones del país, nos atrevemos a opinar que la localidad ahora descrita se perfila como exponente de la futura agricultura intensiva a la cual

Sindrome de Landau Kleffner aspectos clinicos, eletrencefalograficos e psicossociais : estudo de seguimento a longo prazo

OpenAIRE

Marcos Henrique Coelho Duran

2008-01-01

Resumo: Objetivos: A Síndrome de Landau-Kleffner (SLK) é uma entidade rara, caracterizada por epilepsia e afasia. Ocorre em crianças com aquisição normal da linguagem, geralmente, entre 3 e 7 anos de idade. A evolução a longo prazo é controversa e pouco estudada. O presente estudo tem como objetivo verificar a evolução em uma série de sujeitos com diagnóstico de SLK, enfocando os aspectos clínicos, eletrencefalográficos, psicossociais e da qualidade de vida. Métodos: Trata-se de um estudo tra...

Aspectos históricos de libros relevantes de la historia de la pediatría

OpenAIRE

Vargas Rubiano, Alfonso

2010-01-01

El comité Editorial de Pediatría, Diagnostico y Tratamiento, me ha solicitado la redacción del Prólogo para su segunda edición, "deseando que se haga mención de algunos aspectos históricos del desarrollo de la Pediatría en la Universidad Nacional de Colombia y la contribución a éste proceso del profesor José Ignacio Barberi y del Hospital de la Misericordia." Para cumplir tan obligante invitación de los profesores Edgar Rojas, Hector Ulloque, Fernando Sarmiento y Carlos Medina, he revisado la...

Placentação em cutias (Dasyprocta aguti, CARLETON, M.D.): aspectos morfológicos

OpenAIRE

Rodrigues, Rosângela Felipe; Miglino, Maria Angelica; Ferraz, Rosa Helena dos Santos; Morais-Pinto, Luciano de

2003-01-01

A cutia é um roedor silvestre, encontrado no sul da América Central e em regiões tropicais da América do Sul, principalmente nas regiões norte, nordeste e sudeste do Brasil. Estes animais fornecem proteína de origem animal e por isso, apresentam importância sócio-econômica para as regiões do norte e nordeste do Brasil. Para o presente trabalho foram utilizadas sete placentas de cutias (Dasyprocta aguti), em diferentes fases da gestação. Nos aspectos morfológicos a placenta da cutia apresenta ...

Aspectos significativos surgidos de la experiencia de haber sido responsable de un evento adverso en salud

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Augusto Hernán Ferreira-Umpiérrez

2014-01-01

Full Text Available Objetivo: conocer los aspectos significativos para las enfermeras sobre su experiencia de haber sido responsables de un evento ad- verso en salud. Materiales y métodos: estudio cualitativo exploratorio, con el enfoque de la hermenéutica dialéctica. Se utilizó la técnica de análisis de contenido. Muestra constituida por doce enfermeras que tuvieron al menos una experiencia de responsabilidad ante un evento adverso con un paciente, y por cuatro supervisores de enfermería con responsabilidad de supervisión al ocurrir el evento adverso. Resultados: bajo el enfoque de la hermenéutica dialéctica, el análisis de los datos permitió construir las siguientes categorías relacio- nadas con la organización de salud y los recursos humanos: el contexto organizacional, el desconocimiento del proceso de notifi cación, la sobrecarga de trabajo, la ausencia de descanso. Conclusiones: reconocer la importancia del contexto organizacional donde se desarrollan los cuidados, el desconocimiento del proceso de notificación como aspecto por mejorar, la sobrecarga de trabajo y la ausencia d e descanso del personal. Es necesario profundizar en el tema mediante investigaciones y desarrollo de intervenciones que promuevan la cult ura de seguridad en la atención sanitaria, con implicaciones en la práctica y para la formación de las enfermeras.

Ensino da Arte na escola pública e aspectos da política educacional: contexto e perspectivas Enseñanza del arte en la escuela pública y aspectos de la política educacional: contexto y perspectivas Teaching of art at public schools and educational politics aspects: contexts and perspectives

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Karina Barra Gomes

2008-12-01

Full Text Available Este artigo procura ampliar constatações e considerações que abrangem o ensino da Arte na escola pública e aspectos da política educacional. Nossa inquietação, quanto ao percurso do ensino artístico no país e a sua realidade nos dias atuais, levounos a contextualizá-lo a aspectos da política educacional, associando o ensino a questões que incitam a conscientização dos professores de Arte, sua atuação e o envolvimento com a prática pedagógica diante das condições educacionais que nos permite viver a política educacional marcada pela globalização e pela pós-modernidade.Este artículo busca ampliar constataciones y consideraciones que abarcan la enseñanza del Arte en la escuela pública y aspectos de la política educacional. Nuestra inquietud con relación al curso de la enseñanza artística en el país y su realidad en los días actuales nos llevó a contextualizarla a aspectos de la política educacional, asociando la enseñanza a cuestiones que incitan la concientización de los profesores del Arte, su actuación y el envolvimiento con la práctica pedagógica frente a las condiciones educacionales que nos permite vivir la política educacional, marcada por la globalización y por la pos-modernidad.This article aims to amplify the evidences and considerations that deal with the teaching of Art in public schools and also with some public politics aspects. Our worries about the teaching of Art path in this country and its reality nowadays has driven us to conceptualize it with some educational politics aspects, associating the teaching of Art to subjects that stir teachers' awareness, their performance and their involvement in pedagogic practices in the pedagogic conditions, that allowed us to live the pedagogic politics which are marked by globalization and postmodernism.

Historical and social aspects of halitosis Los aspectos históricos y sociales de halitosis Aspectos históricos e sociais da halitose

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Marina Sá Elias

2006-10-01

Full Text Available Buccal odors have always been a factor of concern for society. This study aims to investigate the historical and social base of halitosis, through systematized research in the database BVS (biblioteca virtual em saúde - virtual library in health and also in books. Lack of knowledge on how to prevent halitosis allows for its occurrence, limiting quality of life. As social relationships are one of the pillars of the quality of life concept, halitosis needs to be considered a factor of negative interference. Education in health should be accomplished with a view to a dynamic balance, involving human beings' physical and psychological aspects, as well as their social interactions, so that individuals do not become jigsaw puzzles of sick parts.Los olores bucales siempre han sido un factor de preocupación para la sociedad, y ellos todavía son ahora. El objetivo de este estudio es hacer una base histórica y social en la halitosis. Fue efectuada una investigación sistematizada en la base de datos BVS (biblioteca virtual em saúde - la biblioteca virtual en salud y también en los libros. La ignorancia en cómo prevenir la halitosis permite su ocurrencia, que limita la calidad de vida. Siendo las relaciones sociales uno de los pilares del concepto de calidad de vida, es necesario considerar la halitosis un factor de interferencia negativa. La educación en salud se debe llevar a cabo buscando un equilibrio dinámico, involucrando los aspectos físicos y psicológicos del ser humano, así como sus interacciones sociales, para que los individuos no se vuelvan rompecabezas de partes enfermas.O problema referente aos odores bucais sempre foi fator de preocupação para a sociedade e ainda hoje se mostra presente. O objetivo do presente estudo foi realizar um embasamento histórico e social sobre a halitose. Para tanto, foi feita busca sistematizada, selecionando artigos por meio da base de dados BVS (Biblioteca Virtual em Saúde e também pesquisa em

Attainment of dosimetric pediatrics grandeur to computed tomography examinations of the abdomen

International Nuclear Information System (INIS)

Jormada, Tiago S.

2013-01-01

Currently, 10% of all computerized tomography exams (CT) are made in pediatric patients. In developed countries, the practice of obtaining the dosimetric quantities (weighted index dose C w , index air kerma volumetric C vol product kerma-length P KL , CT ) and effective dose (E) in pediatric CT scans is common. In Brazil, data like these are practically nonexistent. The goal of this work is to obtain the dosimetric quantities and the dose effective in pediatric CT scans, and study its application in the optimization process. The study took place in a thermographs' Toshiba Asteion Single-Slice and a GE Brightsped's multi-slice where measurements were made with type pencil ionization chamber and a trunk's phantom of PMMA with diameter of 16 cm. In single-slice CT scanner, the results obtained for the C vol , P KL , CT and E were 18.73 mGy, 15.61 mGy and 6.87 mSv mGy.cm 343.51, respectively, whereas in multi-slice CT scanner the results were 18.81 mGy, 20.07 mGy, 441.64 mGy.cm and 8,83 mSv. There was no significant difference between the values of C w obtained already in the values of the Cvol, P KL , CT and E dose the differences between the results were quite significant. Comparing the C w and P KL , CT and with the values recommended by UCRP 87 (25 mGy for C vol and 360 mGy.cm for P KL , CT in pediatric CT scans of the abdomen), the two scanners were below reference levels for C w and not require an start on process of optimization. (author)

Globalización: aspectos políticos, económicos y sociales

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Jambell García

2010-01-01

Full Text Available En el artículo se exploran las dimensiones políticas, económicas y sociales del proceso de globalización. La revisión documental, bibliográfica y hemerográfica, permite identificar los aspectos que involucra este fenómeno mundial. Como resultado se observa que mientras persista el actual esquema de reproducción capitalista a escala global, la globalización tenderá a favorecer más a un pequeño grupo de países altamente desarrollados, en detrimento de la mayoría de la población del planeta, haciendo difícil superar los retos del desarrollo humano. Se concluye la necesidad de un cambio de paradigma y de comportamiento por parte de la sociedad para alcanzar un desarrollo económico y social equitativo.

Game, game, game and again game, de Jason Nelson: aspectos da contemporaneidade

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Flavio Pereira Senra

2016-01-01

Full Text Available Embora pensadores como o escritor Mario Vargas Llosa afirmem que os tempos hodiernos têm como característica principal a frivolidade, por conta da velocidade e quantidade de informações a serem digeridas diariamente, artistas em sua pulsão criativa exploram tais paradoxos de grandeza/pequenez em suas obras de arte. Este artigo visa apreender na obra Game, game, game and again game aspectos da contemporaneidade, como o conceito de lúdico e a enorme gama de entretenimentos voltados a um público imerso na indústria da cultura, através da forma como eles são trabalhados junto a conceitos como interatividade como forma de coautoria da obra de arte, finitude artística e permanência no meio digital, e transmidialidade na criação estética.

Audición espacial en ambientes reverberantes: aspectos teóricos relevantes

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Claudia Arias

2003-01-01

Full Text Available En ambientes reverberantes el sonido se propaga en múltiples direcciones sufriendo cambios físicos de importancia. El sistema auditivo debe se capaz de resolver la competencia perceptual que se produce entre el sonido original y sus reflexiones. En este artículo se presentan aspectos teóricos relevantes de la audición espacial con especial tratamiento del efecto precedente. Se trata de una estrategia inconciente que el individuo utiliza para enfrentar la información sonora conflictiva de los espacios reverberantes. Es el fenómeno perceptual de fusión espacial que ocurre cuando dos sonidos similares se presentan desde diferentes lugares, separados por un breve retardo de tiempo. El individuo escucha sólo un sonido que localiza según la dirección del sonido que llegó primero

Prenatal radiation doses from radiopharmaceuticals; Dosis absorbida en el feto por administracion de radiofarmacos

Energy Technology Data Exchange (ETDEWEB)

Rojo, A M; Gomez Parada, I M; Di Trano, J L

1999-12-31

The radiopharmaceutical administration with diagnostic or therapeutic purpose during pregnancy implies a prenatal radiation dose. The dose assessment and the evaluation of the radiological risks become relevant due to the great radiosensitivity of the fetal tissues in development. This paper is a revision of the available data for estimating fetal doses in the cases of the more frequently used radiopharmaceuticals in nuclear medicine, taking into account recent investigation in placental crossover. The more frequent diagnostic and therapeutic procedures were analyzed according to the radiation doses implied. (author) 8 refs. [Espanol] La administracion de radiofarmacos con fines diagnosticos o terapeuticos durante el embarazo, resulta en una dosis absorbida en el feto. La evaluacion de esta dosis y la consiguiente estimacion del riesgo radiologico asociado, adquiere relevancia dada la mayor radiosensibilidad de los tejidos fetales con respecto a la de los adultos. El proposito de este trabajo es hacer una revision de los lineamientos existentes sobre las hipotesis a considerar en el calculo de dosis al feto para los radiofarmacos de uso mas frecuente, incorporando las investigaciones recientes que aportan informacion sobre la transferencia placentaria, teniendo en cuenta la edad gestacional. Se analizan las practicas diagnosticas y terapeuticas mas frecuentes comparando las dosis que implican en el feto con los limites internacionalmente aceptados. Se pretende asi disponer de las herramientas necesarias para responder a las consultas sobre los riesgo radiologicos debidos a la administracion de radiofarmacos a embarazadas. (autor)

Thoracic manifestations of Kaposi`s sarcoma in AIDS: radiological findings; Manifestacoes toracicas do sarcoma de Kaposi na sindrome da imunodeficiencia adquirida: aspectos radiologicos

Energy Technology Data Exchange (ETDEWEB)

Marchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia; [Universidade Federal, Rio de Janeiro, RJ (Brazil); Baptista, Maria Ines Garcia; Cardenas, Gloria Pamela; Costa Praxedes, Marcia da [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia; Boechat, Lucia de Fatima; Quaresma, Patricia Souto Maior [Universidade Federal, Rio de Janeiro, RJ (Brazil). Hospital Universitario Clementino Fraga Filho. Servico de Radiodiagnostico

1995-09-01

The radiological findings of 189 cases of Kaposi`s sarcoma occurring in patients with AIDS were studied. There was also made pathological correlations in these patients. Interstitial reticular infiltrations were frequently detected on thoracic examination showing paracardiac confluent areas. There was also lymphadenopathy, gross nodules and pleural fluid accumulation. Although there was no detection of any pathognomonic aspect, the interstitial reticular infiltration finding together with the paracardiac confluent areas and associated with gross nodules, is highly indicative to thoracic involvement by the disease. (author). 32 refs., 5 figs., 2 tabs.

Radiological aspects of Crohn's disease in small intestine: iconographic assay; Aspectos radiologicos da doenca de Crohn no intestino delgado: ensaio iconografico

Energy Technology Data Exchange (ETDEWEB)

Barros, Nestor de; Juliano, Adriana G.; Polizini, Jose M.R.; Rejtman, Debora; Cerri, Giovanni Guido; Rocha, Manoel de Souza [Sao Paulo Univ., SP (Brazil). Faculdade de Medicina. Dept. de Radiologia

1999-12-01

The authors present the radiological features of Crohn's disease in small intestine as ways of differential diagnosis of others diseases of duodenum and adjacent organs. In this differentiation or confirmation of Crohn's disease the US and TC have proven to be clinically efficacious in the identification of lesions.

Whole abdomen radiation therapy in ovarian cancers: a comparison between fixed beam and volumetric arc based intensity modulation

International Nuclear Information System (INIS)

Mahantshetty, Umesh; Shrivastava, Shyamkishore; Cozzi, Luca; Jamema, Swamidas; Engineer, Reena; Deshpande, Deepak; Sarin, Rajiv; Fogliata, Antonella; Nicolini, Giorgia; Clivio, Alessandro; Vanetti, Eugenio

2010-01-01

A study was performed to assess dosimetric characteristics of volumetric modulated arcs (RapidArc, RA) and fixed field intensity modulated therapy (IMRT) for Whole Abdomen Radiotherapy (WAR) after ovarian cancer. Plans for IMRT and RA were optimised for 5 patients prescribing 25 Gy to the whole abdomen (PTV-WAR) and 45 Gy to the pelvis and pelvic nodes (PTV-Pelvis) with Simultaneous Integrated Boost (SIB) technique. Plans were investigated for 6 MV (RA6, IMRT6) and 15 MV (RA15, IMRT15) photons. Objectives were: for both PTVs V 90% > 95%, for PTV-Pelvis: D max < 105%; for organs at risk, maximal sparing was required. The MU and delivery time measured treatment efficiency. Pre-treatment Quality assurance was scored with Gamma Agreement Index (GAI) with 3% and 3 mm thresholds. IMRT and RapidArc resulted comparable for target coverage. For PTV-WAR, V 90% was 99.8 ± 0.2% and 93.4 ± 7.3% for IMRT6 and IMRT15, and 98.4 ± 1.7 and 98.6 ± 0.9% for RA6 and RA15. Target coverage resulted improved for PTV-Pelvis. Dose homogeneity resulted slightly improved by RA (Uniformity was defined as U 5-95% = D 5% -D 95% /D mean ). U 5 - 95% for PTV-WAR was 0.34 ± 0.05 and 0.32 ± 0.06 (IMRT6 and IMRT15), 0.30 ± 0.03 and 0.26 ± 0.04 (RA6 and RA15); for PTV-Pelvis, it resulted equal to 0.1 for all techniques. For organs at risk, small differences were observed between the techniques. MU resulted 3130 ± 221 (IMRT6), 2841 ± 318 (IMRT15), 538 ± 29 (RA6), 635 ± 139 (RA15); the average measured treatment time was 18.0 ± 0.8 and 17.4 ± 2.2 minutes (IMRT6 and IMRT15) and 4.8 ± 0.2 (RA6 and RA15). GAI IMRT6 = 97.3 ± 2.6%, GAI IMRT15 = 94.4 ± 2.1%, GAI RA6 = 98.7 ± 1.0% and GAI RA15 = 95.7 ± 3.7%. RapidArc showed to be a solution to WAR treatments offering good dosimetric features with significant logistic improvements compared to IMRT

Aspectos nutricionais relacionados ao ciclo menstrual Nutritional aspects related to menstrual cycle

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Helena Alves de Carvalho SAMPAIO

2002-09-01

Full Text Available O objetivo da presente revisão é apresentar os principais tópicos discutidos na literatura quanto à associação da nutrição com o ciclo menstrual, contribuindo para a implementação do atendimento nutricional de mulheres. São revisados aspectos referentes à fisiologia da menstruação, alterações metabólicas durante o ciclo menstrual e comportamentos alimentares associados a ele. Considerando-se o ciclo menstrual dividido em duas fases, a folicular e a lútea, é nesta última que são descritas mais alterações, como retenção de água, elevação de peso, aumento de demanda energética, modificações no perfil lipídico e no metabolismo de vitamina D, cálcio, magnésio e ferro, hipersensibilidade emocional, dores generalizadas e mudança do comportamento alimentar. Em relação a este último item, podem ocorrer maior ingestão energética e o desenvolvimento de compulsões alimentares, principalmente por chocolate, doces e alimentos muito salgados. É fundamental que todos os aspectos citados sejam investigados durante a consulta nutricional, a fim de serem adotadas condutas mais específicas.The aim of the present review is to show the most important topics discussed in literature about the association between nutrition and menstrual cycle, contributing to improve the nutritional care for women. Aspects related to physiology of the menstruation, metabolic changes and feeding behavior during the menstrual cycle are reviewed. Considering the menstrual cycle divided in two phases, follicular and luteal, it is in this last one that more alterations are described, like fluid retention, weight gain, increase in caloric needs, modifications in the lipid profile and in the metabolism of vitamin D, calcium, magnesium and iron, emotional hypersensitivity, aches and changes in feeding behavior. In relation to this last item, it can occur a higher caloric intake and the development of food cravings, mainly for chocolate, candies and

Aspectos psicobiológicos do comportamento alimentar Psychobiological aspects of feeding behavior

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Rosana Passos Beinner Cambraia

2004-06-01

Full Text Available Esta revisão aborda alguns aspectos psicobiológicos ligados à manifestação do comportamento alimentar, e tem como objetivo evidenciar a relação entre os principais processos neuropsicológicos e a neurociência nutricional. Algumas estruturas neurais estão associadas ao controle alimentar por mecanismos distintos e correlatos que ocorrem no hipotálamo, hipocampo e em outras áreas como no cerebelo, bulbo olfatório, glândulas pituitária e pineal que exercem funções distintas, porém influênciam o comportamento alimentar, intermediadas geralmente por neurotransmissores comuns. Os precursores dos neuroquímicos apresentam funções específicas, sendo a influência na alimentação relevante no contexto comportamental da escolha de alimentos. Os processos sensoriais na alimentação como paladar, olfato, visão e audição interagem entre si e com outras estruturas e vias neurais, participando também do controle do apetite e da saciedade, que culminam na iniciação e no término da alimentação. A interação entre aspectos neurais no processo de consumo de alimento promove a manifestação do comportamento alimentar específico para cada espécie em seu ambiente.This review shows how some psychobiological aspects are related to feeding behavior manifestation, and has as it objective to provide evidence as to the relation between neuropsychological processes and nutritional neuroscience. Several neural structures are associated with alimentary controls, which are distinct but correlated mechanisms; for example: hypothalamus, hypocampus, cerebellum, olfactory bulb, pituitary and pineal glands, all presenting distinct functions, but affecting feeding behavior directly or indirectly through common neurotransmitters. Neurochemical precursors present specific functions and their influence on feeding is evident in behavioral food selection. The sensory processes in feeding, principally taste, olfaction, vision and hearing, interact with

Aspectos históricos da vulcanização Historical aspects of vulcanization

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Helson M. da Costa

2003-06-01

Full Text Available As borrachas, para serem convertidas em materiais úteis do ponto de vista de aplicações, precisam ser misturadas a alguns ingredientes, os quais vão lhes dar as características desejadas para, então, serem vulcanizadas. Neste artigo, os aspectos históricos da vulcanização são abordados bem como a evolução dos aditivos essenciais à maioria das formulações.Rubbers, to be turned into useful materials from the commercial applications point of view, need the addition of a few other ingredients which, upon vulcanization, will impart the desired characteristics to the material. In this paper, historical aspects of vulcanization are revised as well as the evolution of the additives used in most of the formulations.

Aspectos biopsicosociales que inciden en la salud del adulto mayor Bio-psycho social aspects shattering elderly health

OpenAIRE

Aida Chong Daniel

2012-01-01

El presente trabajo trata acerca de algunos factores biosicosociales que inciden en la salud del adulto mayor, se parte del concepto de que el envejecimiento no es un proceso de causa única, sino el resultado de una compleja asociación de interacciones y modificaciones estructurales y funcionales, entre lo biológico, lo psicológico y lo socio-ambiental. Teniendo en cuenta estos elementos el objetivo de este trabajo es exponer algunos aspectos que inciden en la salud del adulto mayor, para que...

Aspectos económicos del aislamiento acústico

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Amarilla, Beatriz C.

1990-12-01

Full Text Available The general objective of this study was to analyze the soundproofing/cost ratio with different building alternatives for interior walls and floors. This technical-economic study was divided into three parts: — Dividing walls (environmental noises — Floors (impact noises — Special Solutions (double walls, floating floors, etcetera The results show that in developing countries the most costly solutions are not always the best for housing, as far as soundproofing is concerned. A good knowledge of the economic aspects related to this matter allows obtaining a good quality at a moderate cost, which is a priority in this type of country.

El objetivo general de este trabajo fue el de analizar el comportamiento de la relación costo-aislamiento acústico en soluciones constructivas alternativas para muros interiores y entrepisos. Este estudio técnico-económico comprende tres partes: * Muros divisorios (ruidos aéreos. * Entrepisos (ruidos de impacto. * Soluciones especiales (muros de doble hoja, pisos flotantes, etc. Se llega a la conclusión que, en los países en desarrollo, no siempre las mejores soluciones para la vivienda, desde el punto de vista acústico, son las de mayor costo. Conocer en profundidad los aspectos económicos de esta cuestión significa poder lograr una buena calidad con costos moderados, lo cual constituye una prioridad en este tipo de países.

Aspectos negativos no modelo de reporte proposto pela GRI: a opinião das organizações que reportam

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Thiago Ferreira-Quilice

2015-12-01

Full Text Available RESUMO O objetivo neste estudo foi identificar aspectos negativos no modelo de reporte proposto pelo Global Reporting Initiative (GRI, na opinião dos funcionários responsáveis pelo reporte. A importância deste estudo reside no fato de que poucos trabalhos investigam os relatórios de sustentabilidade a partir desse ponto de vista, e por oferecer ao GRI pontos específicos para serem melhorados. A pesquisa foi conduzida por meio da análise de conteúdo das respostas de 27 empresas à seguinte questão: que aspectos negativos você identifica no modelo de reporte proposto pelo GRI? Essa questão foi enviada a todas as empresas brasileiras que publicaram o relatório GRI, referente ao ano-base 2010, entre os anos 2011 e 2013. Como resultado, os respondentes consideraram que as empresas têm dificuldade em entender o modelo proposto pelo GRI, o qual foi considerado complexo, ambíguo e flexível demais, o que dificulta a padronização e a comparação entre os relatórios. Esse fato tem implicações para o GRI, que poderia propor uma metodologia mais simples e menos flexível.

ASPECTOS DA PRODUÇÃO CIENTÍFICA SOBRE CONTROLE GERENCIAL

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Cleyton de Oliveira Ritta

2017-09-01

Full Text Available O objetivo geral da pesquisa é avaliar aspectos da produção científica sobre controle gerencial na perspectiva da contabilidade gerencial nos periódicos internacionais da base de dados da Web of Science, disponíveis até 2014. A pesquisa caracteriza-se como descritiva com abordagem quantitativa por meio de estudo bibliométrico. Os procedimentos de coleta resultaram em 32 artigos disponíveis em 8 periódicos. Os resultados da pesquisa mostraram que: maioria dos artigos foi do tipo empírico e de natureza exploratória. O foco das pesquisas tem como temas a funcionalidade de artefatos contábeis e da estrutura do sistema de controle gerencial. A teoria da Contingência foi a principal base teórica do constructo dos artigos. Conclui-se que as pesquisas sobre controle gerencial possuem amplo campo de assuntos para futuras pesquisas. Os fenômenos organizacionais contemporâneos e as novas estruturas organizacionais demandam por estudos exploratórios para compreender a função do sistema de controle gerencial na condução dos negócios.

Evaluation of entrance surface-skin doses in animals submitted on exams of abdomen in veterinary radiology using Tl dosimetry

International Nuclear Information System (INIS)

Veneziani, G. R.; Matsushima, L. C.; Campos, L. L.; Filho, A. M.

2014-08-01

The radiation protection has recently gained considerable attention in human medicine. In veterinary medicine has been some advances in radiodiagnostic and therapy for domestic animal like dogs and cats. It is notable the increase of the costs with domestic animals that are considered, by many people in the whole world, like members of family. However, an important parameter that must be taken into account is the increasing use of computed tomography and other equipment s that uses ionizing radiation, which may lead to comparatively high exposure of critical organs. The radiation dose is determined by the balance between therapeutic benefit and possible damage to surrounding normal tissues. This study aimed the evaluation of entrance surface-skin doses in dogs submitted to radiodiagnostic procedures of abdomen using the technique of thermoluminescent dosimetry (TLD). The radiation doses were measured using thermoluminescent dosimeters of LiF:Mg,Ti (TLD 100) and a dog phantom made with a plastic container, proportional to the dog size, fulfilled with water. (Author)

Evaluation of entrance surface-skin doses in animals submitted on exams of abdomen in veterinary radiology using Tl dosimetry

Energy Technology Data Exchange (ETDEWEB)

Veneziani, G. R.; Matsushima, L. C.; Campos, L. L. [Instituto de Pesquisas Energeticas e Nucleares, Gerencia de Metrologia das Radiacoes / CNEN, Av. Lineu Prestes 2242, Cidade Universitaria, 05508-000 Sao Paulo (Brazil); Filho, A. M., E-mail: venezianigr@gmail.com [Centro Universitario de Rio Petro - UNIRP, Rodovia Br 153 (Transbrasiliana), Km. 69 Sao Jose do Rio Preto, Sao Paulo (Brazil)

2014-08-15

The radiation protection has recently gained considerable attention in human medicine. In veterinary medicine has been some advances in radiodiagnostic and therapy for domestic animal like dogs and cats. It is notable the increase of the costs with domestic animals that are considered, by many people in the whole world, like members of family. However, an important parameter that must be taken into account is the increasing use of computed tomography and other equipment s that uses ionizing radiation, which may lead to comparatively high exposure of critical organs. The radiation dose is determined by the balance between therapeutic benefit and possible damage to surrounding normal tissues. This study aimed the evaluation of entrance surface-skin doses in dogs submitted to radiodiagnostic procedures of abdomen using the technique of thermoluminescent dosimetry (TLD). The radiation doses were measured using thermoluminescent dosimeters of LiF:Mg,Ti (TLD 100) and a dog phantom made with a plastic container, proportional to the dog size, fulfilled with water. (Author)

Aspectos clínico-patológicos e controle da paratuberculose em rebanho bovino leiteiro

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Elise M Yamasaki

2010-11-01

Full Text Available A paratuberculose ou doença de Johne é uma enterite granulomatosa causada por Mycobacterium avium subsp. paratuberculosis. Descrevem-se os aspectos epidemiológicos, clínico-patológicos e laboratoriais da paratuberculose em rebanho bovino leiteiro no município de Rio Claro, região Sul do Estado do Rio de Janeiro. No período de 2006 a 2009, oito vacas adultas da raça Girolanda apresentaram diarreia crônico-intermitente e perda progressiva de peso. À necropsia, observaram-se linfonodos mesentéricos aumentados de volume e úmidos ao corte, vasos linfáticos subserosos das alças intestinais proeminentes, serosa do intestino com aspecto anelado e cerebroide e a mucosa espessada, pregueada e com aspecto microgranular. À microscopia havia, desde o duodeno até o reto, inflamação granulomatosa difusa, marcada dilatação dos vasos linfáticos no ápice das vilosidades, linfangiectasia e linfangite granulomatosa na submucosa, muscular e serosa. A inflamação granulomatosa também foi vista nos linfonodos mesentéricos. A coloração de Ziehl-Neelsen revelou variável quantidade de bacilos álcool-ácido resistentes no interior de macrófagos, de células gigantes de Langhans e livres na mucosa e submucosa dos intestinos delgado e grosso e em linfonodos mesentéricos. Em alguns animais, a lâmina própria da mucosa, principalmente do jejuno e íleo exibia acentuada hipertrofia. Mycobacterium avium subsp. paratuberculosis foi isolado em cultivo bacteriano de Herrold com micobactina, a partir de amostras de fezes, de raspado de mucosa intestinal e de leite e identificado pela técnica de PCR IS900. Através da avaliação sorológica semestral, foram analisadas 298 vacas do mesmo rebanho a partir de três anos de idade, observou-se cerca de 40% de animais reagentes ao teste ELISA indireto no período estudado. O diagnóstico da paratuberculose foi baseado nos dados clínico-patológicos, na sorologia, no isolamento e identificação do

Sistema de indicadores ambientales de la Universidad Nacional (2008-2011. Aspectos de significancia: electricidad, agua, combustible y teléfono

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David Benavides Ramírez

2013-03-01

Full Text Available Como parte de los esfuerzos ambientales llevados a cabo por la Universidad Nacional (UNA de Costa Rica, incluyendo todas sus dependencias, oficinas, centros y sedes y el Programa UNA Campus Sostenible, nuestra institución ha consolidado en el tiempo un Sistema de Indicadores Ambientales con aspectos de significancia enmarcados en un Programa de Gestión Ambiental Institucional (PGAI, el cual mide el desempeño ambiental de la institución desde 2008, generando iniciativas como la campaña “Únase al ahorro”, la cual busca disminuir la facturación de los servicios públicos. Por medio de la aplicación de esta herramienta de evaluación ambiental, la Dirección de Gestión de Calidad Ambiental (DIGECA-MINAET y la UNA han establecido una medición del desempeño ambiental de forma estandarizada e integrada en cuatro aspectos ambientales que se mencionan a continuación: • Consumo eléctrico • Consumo de agua • Consumo de combustibles • Uso del teléfono Las principales características del modelo que impulsa el PGAI se basan en los conceptos de integración y sostenibilidad, que analizan los aspectos ambientales mencionados y las actividades asociadas para su mitigación y minimización, con el fin de llegar a una ecoeficiencia en la operatividad propia de la Universidad. Recientemente, la UNA presentó la “Actualización del Plan de Gestión Ambiental Institucional” ante la DIGECA-MINAET, el cual cumple de manera satisfactoria con lo requerido por esta Dirección, según lo establecido en el Decreto Ejecutivo 36499-S-MINAET. Se debe mencionar que este proceso se ha llevado a cabo gracias a la colaboración y participación activa de toda la comunidad universitaria y que se deben redoblar esfuerzos para continuar con esta visión ambiental propia y pionera de la UNA hacia los nuevos retos ambientales.

Aspectos claves relacionados con la gestión del e.Learning

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Francisco Lupiáñez Villanueva

Full Text Available La introducción y uso de las Tecnologías de la Información y la Comunicación, especialmente Internet, en el ámbito de la salud, la medicina y los sistemas sanitarios enfrenta a todos los agentes e instituciones ante numerosos retos. La educación y la formación, como actividades claves tanto de la sociedad de la información como de los sistemas sanitarios, también se ven afectadas por este proceso de cambio. La finalidad de este artículo es identificar y analizar algunos de los aspectos claves relacionados con la introducción de las TIC e Internet en el ámbito de la educación médica continuada desde el punto de vista organizacional. Esta visión nos permite combinar factores pedagógicos, tecnológicos y organizativos. Todos ellos necesarios a la hora de abordar las complejas interacciones que se producen en la implantación de un proyecto de e.Learning.

Aspectos claves relacionados con la gestión del e.Learning

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Francisco Lupiáñez Villanueva

2006-12-01

Full Text Available La introducción y uso de las Tecnologías de la Información y la Comunicación, especialmente Internet, en el ámbito de la salud, la medicina y los sistemas sanitarios enfrenta a todos los agentes e instituciones ante numerosos retos. La educación y la formación, como actividades claves tanto de la sociedad de la información como de los sistemas sanitarios, también se ven afectadas por este proceso de cambio. La finalidad de este artículo es identificar y analizar algunos de los aspectos claves relacionados con la introducción de las TIC e Internet en el ámbito de la educación médica continuada desde el punto de vista organizacional. Esta visión nos permite combinar factores pedagógicos, tecnológicos y organizativos. Todos ellos necesarios a la hora de abordar las complejas interacciones que se producen en la implantación de un proyecto de e.Learning.

Aspectos estructurales del comercio fronterizo entre México y Estados Unidos

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Bernardo González-Aréchiga

1985-01-01

Full Text Available El objetivo de esta presentación es discutir algunos aspectos estructurales de la frontera y someter a discusión la estrategia de investigación del Departamento de Estudios Económicos de CEFNOMEX. Aquí se explica cómo la frontera norte cuenta con una estructura comercial dual con patrones variables de consumo de servicios en Estados Unidos, tales como los educacionales, médicos, asistenciales, etc., que han afectado a la creación de una infraestructura local, y que la zona fronteriza del norte de México exhibe importantes distorsiones estructurales que deben estudiarse para entender sus funcionamiento económico. Es importante mejorar la base informativa con recolección directa. La investigación económica de la región requiere tanto del estudio de sus instituciones, como del monitoreo constante y cuidadoso de sus signos vitales. Una estrategia adecuada de investigación debe combinar ambos y aprovechar las complementariedades de los dos tipos de estudio.

ESTUDIO DE ASPECTOS RELEVANTES DE LOS HABITANTES DE CAZUCÁ (SECTOR 4

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Gregorio Clavijo Parrado

2007-01-01

Full Text Available Esta investigación de tipo descriptivo tuvo como objetivo general el acercamiento a la realidad social, económi - ca y demográfica de un sector de la comunidad de Cazucá, en aspectos considerados relevantes, tales como: vivienda, educación, ocupación, ingresos, gastos, edad y otros. Aunque la observación de campo se realizó en el sector cuatro de Cazucá (Soacha/Cundinamarca, se podría considerar como una muestra representativa de lo que podría estar sucediendo con el total de la comunidad. Dadas las características socioeconómicas de las familias, como unidades de observación, los resultados de - tectaron su vulnerabilidad a través de dimensiones tangibles y no tangibles relacionadas con la pobreza que, posteriormente, podrían ser objeto de indagación más profunda. Los resultados se socializarán con la comunidad y con las entidades y organismos que en Cazucá están o estén adelantando programas culturales, educativos, microempresariales y otros.

Aromatherapy Massage on the Abdomen for Alleviating Menstrual Pain in High School Girls: A Preliminary Controlled Clinical Study

Science.gov (United States)

Hur, Myung-Haeng; Lee, Myeong Soo; Seong, Ka-Yeon; Lee, Mi-Kyoung

2012-01-01

This study investigated the alleviating effects of aromatherapy massage and acetaminophen on menstrual pain in Korean high school girls. Subjects were divided into two groups: the aromatherapy massage (treatment) group (n = 32) and the acetaminophen (control) group (n = 23). Aromatherapy massage was performed on subjects in the treatment group. The abdomen was massaged once using clary sage, marjoram, cinnamon, ginger, and geranium in a base of almond oil. The level of menstrual pain was assessed using a visual analogue scale at baseline and twenty-four hours afterward. The reduction of menstrual pain was significantly higher in the aromatherapy group than in the acetaminophen group. Using multiple regression, aromatherapy massage was found to be more highly associated with reduction in the level of menstrual pain than acetaminophen. These finding suggest that aromatherapy massage may be an effective treatment for menstrual pain in high school girls. However, it could not be verified whether the positive effects derived from the aromatherapy, the massage, or both. Further rigorous studies should be conducted using more objective measures. PMID:21949670

Respiratory-Gated MRgHIFU in Upper Abdomen Using an MR-Compatible In-Bore Digital Camera

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Vincent Auboiroux

2014-01-01

Full Text Available Objective. To demonstrate the technical feasibility and the potential interest of using a digital optical camera inside the MR magnet bore for monitoring the breathing cycle and subsequently gating the PRFS MR thermometry, MR-ARFI measurement, and MRgHIFU sonication in the upper abdomen. Materials and Methods. A digital camera was reengineered to remove its magnetic parts and was further equipped with a 7 m long USB cable. The system was electromagnetically shielded and operated inside the bore of a closed 3T clinical scanner. Suitable triggers were generated based on real-time motion analysis of the images produced by the camera (resolution 640×480 pixels, 30 fps. Respiratory-gated MR-ARFI prepared MRgHIFU ablation was performed in the kidney and liver of two sheep in vivo, under general anaesthesia and ventilator-driven forced breathing. Results. The optical device demonstrated very good MR compatibility. The current setup permitted the acquisition of motion artefact-free and high resolution MR 2D ARFI and multiplanar interleaved PRFS thermometry (average SNR 30 in liver and 56 in kidney. Microscopic histology indicated precise focal lesions with sharply delineated margins following the respiratory-gated HIFU sonications. Conclusion. The proof-of-concept for respiratory motion management in MRgHIFU using an in-bore digital camera has been validated in vivo.

Revisión de algunos aspectos importantes

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J. A. Ávila

2012-01-01

Full Text Available El soporte nutricional adecuado y oportuno contribuye en la reducción del riesgo de infecciones, mejora la función inmune y el pronóstico del paciente; es por esto que se destaca la importancia de mantener un adecuado estado nutricional en los pacientes críticamente enfermos. Con este propósito, el presente documento resalta el valor de la nutrición parenteral y su papel en aquellos animales con desnutrición presente o prevista, siempre y cuando la vía enteral no esté disponible o sea insuficiente; esto, en razón de su metabolismo alterado, el cual predispone a un mayor catabolismo mus-cular. La correcta elaboración de un plan nutricional debe tener en cuenta aspectos de gran importancia como la evaluación integral de los hallazgos históricos, clínicos y paraclínicos, con el fin de detectar el grado o riesgo de desnutrición; por su parte, la selección del tipo de nutrición más adecuada y el tipo de solución por emplear, son variables igualmente relevantes pues varían según cada caso particular, dependiendo de la condición del paciente y el tipo de patologías asociadas. Así pues, el cálculo de los requerimientos calóricos y la manera en que estos serán suplementados, son variables que deben manejarse con cautela, con el fin de no exceder la capacidad metabólica y desencadenar complicaciones que representen mayor morbilidad y mortalidad. Por úl-timo, es importante resaltar que la nutrición parenteral debe descontinuarse tan pronto como sea posible para disminuir los problemas relacionados con la misma, como la atrofia gastrointestinal.

Discrimination and anatomical mapping of PET-positive lesions: comparison of CT attenuation-corrected PET images with coregistered MR and CT images in the abdomen

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Kuhn, Felix P.; Crook, David W.; Mader, Caecilia E.; Appenzeller, Philippe; Schulthess, G.K. von; Schmid, Daniel T. [University Hospital Zurich, Department of Medical Radiology, Zurich (Switzerland)

2013-01-15

PET/MR has the potential to become a powerful tool in clinical oncological imaging. The purpose of this prospective study was to evaluate the performance of a single T1-weighted (T1w) fat-suppressed unenhanced MR pulse sequence of the abdomen in comparison with unenhanced low-dose CT images to characterize PET-positive lesions. A total of 100 oncological patients underwent sequential whole-body {sup 18}F-FDG PET with CT-based attenuation correction (AC), 40 mAs low-dose CT and two-point Dixon-based T1w 3D MRI of the abdomen in a trimodality PET/CT-MR system. PET-positive lesions were assessed by CT and MRI with regard to their anatomical location, conspicuity and additional relevant information for characterization. From among 66 patients with at least one PET-positive lesion, 147 lesions were evaluated. No significant difference between MRI and CT was found regarding anatomical lesion localization. The MR pulse sequence used performed significantly better than CT regarding conspicuity of liver lesions (p < 0.001, Wilcoxon signed ranks test), whereas no difference was noted for extrahepatic lesions. For overall lesion characterization, MRI was considered superior to CT in 40 % of lesions, equal to CT in 49 %, and inferior to CT in 11 %. Fast Dixon-based T1w MRI outperformed low-dose CT in terms of conspicuity and characterization of PET-positive liver lesions and performed similarly in extrahepatic tumour manifestations. Hence, under the assumption that the technical issue of MR AC for whole-body PET examinations is solved, in abdominal PET/MR imaging the replacement of low-dose CT by a single Dixon-based MR pulse sequence for anatomical lesion correlation appears to be valid and robust. (orig.)