Efeito de dietas semi-simplificadas formuladas com subprodutos de mandioca ensilados ou não sobre o desempenho e características de carcaça de coelhos - doi: 10.4025/actascianimsci.v33i1.9643 Effect of half-simplified diets formulated with cassava by-product ensiled or not on performance and carcass characteristics of rabbits - doi: 10.4025/actascianimsci.v33i1.9643

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Ana Carolina Monteiro

2011-02-01

Full Text Available Foram avaliados o desempenho da desmama ao abate e as características de carcaça de 144 coelhos da raça Nova Zelândia Branco, oriundos de matrizes alimentadas com dietas referência ou semi-simplificada com 79,83% de subprodutos de mandioca, distribuídos em gaiolas, em esquema fatorial 2 x 3 (duas rações fornecidas às matrizes e láparos até a desmama versus três rações fornecidas aos animais da desmama até o abate com 12 repetições e dois animais por unidade experimental. As dietas fornecidas, após a desmama, consistiram de uma referência e duas semi-simplificadas com 81,63% de subprodutos de mandioca ensilados ou não antes da sua incorporação. Coelhos cujas mães foram alimentadas com dieta semi-simplificadas se apresentaram mais leves à desmama que os desmamados com dieta-referência. Observou-se menor consumo de ração para os coelhos que receberam a dieta maternidade semi-simplificada até a desmama, resultando em melhor conversão alimentar. Os pesos da carcaça e dos cortes comerciais foram maiores nos animais alimentados com as rações referência maternidade e referência crescimento. O uso de dietas semi-simplificadas com subprodutos de mandioca ensilados ou não, da desmama ao abate, reduziu o ganho de peso diário e o consumo de ração, porém melhorou a conversão alimentar e diminuiu o custo de ração. A utilização das rações semi-simplificadas apresenta-se como alternativa interessante para a produção de coelhos.This study evaluated the performance from weaning to slaughter and carcass characteristics of 144 New Zealand White rabbits, from does fed with a reference diet or half-simplified diet containing 79.83% cassava by-product, allocated in iron cages, in a 2 x 3 factorial arrangement (two diets used for does and litters until weaning versus three diets supplied for animals from weaning to slaughter with 12 replications and two animals per experimental unit. The supplied diets after weaning

Abordagem da dependencia de substancias psicoativas na adolescencia: reflexao etica para a enfermagem

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Cecilia Nogueira Valenca

2013-09-01

Full Text Available O uso indiscriminado de drogas entre os jovens cresce progressivamente no Brasil e no mundo. Este estudo objetivou refletir acerca da abordagem ética da enfermagem na atenção a adolescentes usuários de drogas lícitas e ilícitas. Trata-se de um estudo teórico de caráter reflexivo fundamentado em uma revisão bibliográfica do tipo narrativa, utilizando livros e artigos científicos. Emergiram reflexões sobre a dependência de substâncias psicoativas em expansão na adolescência que culminaram na discussão sobre a abordagem ética da enfermagem ao adolescente usuário de drogas. O enfermeiro pode priorizar uma assistência voltada para a promoção da saúde do adolescente em uma perspectiva emancipatória dos jovens na prevenção do uso de drogas. Concluiu-se que o enfermeiro deve realizar uma abordagem ética aos adolescentes dependentes químicos, considerando seu contexto e sua subjetividade.

A criança hiperativa: uma visão da abordagem gestáltica

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Antony, Sheila; Ribeiro, Jorge Ponciano

2004-01-01

A pesquisa objetivou investigar o funcionamento psicológico da criança hiperativa em base a teoria do ciclo do contato da abordagem gestáltica, proposta por Ribeiro (1997). O Transtorno de Déficit de Atenção/Hiperatividade (TDAH) caracteriza-se por distúrbios motores, perceptivos, emocionais e comportamentais. Segundo os critérios diagnósticos do DSM-IV (1994), esse transtorno reúne 18 sintomas básicos de desatenção, hiperatividade e impulsividade. A pesquisa adotou uma abordagem qualitativa....

ABORDAGEM DO BIOMA CERRADO EM LIVROS DIDÁTICOS DE BIOLOGIA DO ENSINO MÉDIO

OpenAIRE

Rafael Gonçalves Bezerra; Rodrigo Capelle Suess

2013-01-01

A educação brasileira tem os livros didáticos como principal recurso de informação a alunos e professores. Este trabalho analisa como ocorre a abordagem do bioma Cerrado em seis livros didáticos de biologia destinados ao Ensino Médio. Os aspectos analisados foram o número de páginas destinadas ao tema, figuras, exemplificações acerca da fauna e flora local e abordagem do tema. A análise mostrou que todos os aspectos são apresentados de maneira resumida. Exemplos da fauna e flora local, quando...

Posterior glenoid rim deficiency in recurrent (atraumatic) posterior shoulder instability

International Nuclear Information System (INIS)

Weishaupt, D.; Zanetti, M.; Hodler, J.; Nyffeler, R.W.; Gerber, C.

2000-01-01

Objective. To assess the shape of the posterior glenoid rim in patients with recurrent (atraumatic) posterior instability.Design and patients. CT examinations of 15 shoulders with recurrent (atraumatic) posterior instability were reviewed in masked fashion with regard to abnormalities of the glenoid shape, specifically of its posterior rim. The glenoid version was also assessed. The findings were compared with the findings in 15 shoulders with recurrent anterior shoulder instability and 15 shoulders without instability. For all patients, surgical correlation was available.Results. Fourteen of the 15 (93%) shoulders with recurrent (atraumatic) posterior shoulder instability had a deficiency of the posteroinferior glenoid rim. In patients with recurrent anterior instability or stable shoulders such deficiencies were less common (60% and 73%, respectively). The craniocaudal length of the deficiencies was largest in patients with posterior instability. When a posteroinferior deficiency with a craniocaudal length of 12 mm or more was defined as abnormal, sensitivity and specificity for diagnosing recurrent (atraumatic) posterior instability were 86.7% and 83.3%, respectively. There was a statistically significant difference in glenoid version between shoulders with posterior instability and stable shoulders (P=0.01).Conclusion. Recurrent (atraumatic) posterior shoulder instability should be considered in patients with a bony deficiency of the posteroinferior glenoid rim with a craniocaudal length of more than 12 mm. (orig.)

Abordagem diagnóstica da tosse crônica em pacientes não-tabagistas: diagnostic approach

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Jacomelli Márcia

2003-01-01

Full Text Available A tosse, como mecanismo fisiológico, tem fundamental importância na remoção das secreções respiratórias, constituindo, assim, um dos mecanismos de defesa pulmonar. No entanto, os quadros de tosse crônica constituem uma das principais causas de procura por assistência médica no mundo, o que ressalta o significado da correta identificação e tratamento dos fatores desencadeantes e/ou perpetuadores. Dentre os vários fatores relacionados aos quadros de tosse crônica, alguns assumem papel de relevada importância, tais como o refluxo gastroesofágico, a rinorréia posterior ou a asma, já que, isolada ou conjuntamente, constituem cerca de 95% das causas. O passo fundamental para o sucesso terapêutico nos quadros de tosse crônica é uma abordagem diagnóstica racional, que investigue a tosse crônica de maneira progressiva, permitindo, assim, a instituição do tratamento de forma mais custo-efetiva. Para isso, a proposta de um algoritmo a ser seguido serve como base para essa investigação inicial.

Abordagem neurologica na sindrome do X fragil

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Marilisa Mantovani Guerreiro

1993-01-01

Resumo: Com o propósito de realizar a abordagem neurológica na Síndrome do X Frágil (SXF), estudaram-se 11 pacientes com este diagnóstico citogenético. A idade variou de 8 a 19 anos. Nove pacientes eram do sexo masculino e dois do feminino. Todos os indivíduos apresentaram pavilhões auriculares grandes e faces alongadas. Observou-se fronte proeminente em 63% dos casos e macrorquidia em 33% dentre aqueles do sexo masculino. Atraso na aquisição da fala, fala repetitiva, perseverativa, impulsiva...

Abordagem multidisciplinar no trauma facial: um relato de caso

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Carolina Ando Matsuno

2014-10-01

Full Text Available Introdução: Em todo o mundo, diversas medidas de segurança têm sido aplicadas para minimizar os danos relacionados aos acidentes de trabalho. Ainda assim, muitos casos são rotineiramente encaminhados aos Prontos Socorros do Sistema Único de Saúde (SUS, particularmente nas zonas rurais. Objetivo: Relatar a abordagem multidisciplinar de um caso de traumatismo facial grave secundário a acidente de trabalho atendido no Conjunto Hospitalar de Sorocaba (CHS. Relato do Caso: Paciente masculino, 19 anos, branco, trabalhador rural, vítima de trauma após ter saltado de um trator em movimento durante o exercício de sua atividade laboral, trazido por seus familiares com hemiface direita, desfigurada pela avulsão da pele e da musculatura com exposição óssea, caracterizada à TC como fratura complexa zigomático-maxilar Le Fort tipo 2 à direita além da destruição do seio maxilar, do assoalho da órbita e dos rebordos orbitários lateral, superior e inferior. A abordagem cirúrgica foi realizada pelas equipes de Cirurgia Plástica, Cirurgia Bucomaxilofacial e Cirurgia Oftalmológica que procederam à reconstrução óssea por placas de titânio, estabilização da arcada dentária superior por amarramento e reposicionamento das partes moles. O globo ocular foi preservado por apresentar-se íntegro. Conclusões: A abordagem multidisciplinar das fraturas faciais complexas busca primariamente restaurar a complexa anatomia de toda essa região por primeira intenção. Considerando tratar-se de fratura secundária a um “acidente de trabalho”, ilustramos aqui uma trágica consequência do não uso dos equipamentos de proteção individual e da inobservância das normas de segurança.

Nova abordagem no tratamento da esquizofrenia

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Walter Speltri

1966-12-01

Full Text Available Foram tratados 11 casos de esquizofrenia com a guanetidina, substância considerada, do ponto de vista farmacodinâmico, como simpaticoplégica. Na opinião do autor, os surpreendentes e significativos resultados obtidos autorizam uma nova abordagem nas pesquisas à procura da etiopatogenia da esquizofrenia e, a partir dos elementos colhidos, considera plausível uma "teoria psicossomática da esquizofrenia". Recusa-se, entretanto, a cair no atraente, mas inútil, terreno especulativo. Prefere aguardar que os farmacologistas e fisiologistas forneçam dados pais precisos sobre o mecanismo de ação da guanetidina e que novos estudos confirmem seus resultados para, depois, dar publicidade à sua teoria.

Setorectomia posterior direita laparoscópica no tratamento dos tumores hepáticos Laparoscopic right posterior sectioniectomy for treating hepatic tumors

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Sergio Renato Pais Costa

2010-12-01

Full Text Available INTRODUÇÃO: A ressecção de neoplasias no setor posterior direito costuma ser um desafio técnico pela dificuldade de sua abordagem. Adicionalmente, as hepatectomias laparoscópicas tem se tornado alternativa interessante em virtude de muitas vantagens (baixa morbidade, curto tempo de internação, retorno precoce as atividades laborais e bons resultados cosméticos. OBJETIVO: Relatar experiência em doentes submetidos à setorectomia posterior direita laparoscópica por uma única equipe. MÉTODOS: Cinco doentes foram operados entre novembro de 2008 a agosto de 2010. A idade variou de 21 a 63 anos com mediana de 43 anos. Foram quatro mulheres e um homem. A causa das neoplasias foi: adenoma (n=2, hepatocarcinoma (n=1 e metástases (n=2. A lesão foi solitária em três casos (60 %. A média do tamanho das lesões foi 3,3 cm (1,8-5. Foram analisados: tempo cirúrgico, sangramento operatório, morbimortalidade, tempo de internação e tempo de retorno à atividade habitual. RESULTADOS: A média de tempo cirúrgico foi de 160 minutos (90-260. A de sangramento intra-operatório foi de 200 ml (0-500. Nenhum doente foi transfundido. Não houve mortalidade e a morbidade foi nula. A mediana de internação foi de três dias (2-5. A mediana de retorno às atividades cotidianas foi de 12 dias (7-20. A mediana de seguimento foi de 13 meses (1-20. Não houve recidiva de lesão. CONCLUSÃO: A setorectomia posterior direita laparoscópica representa boa opção tática para o tratamento dos tumores hepáticos situados no setor posterior do lobo direito. É opção segura que evita grandes incisões com morbimortalidade. Também apresenta bom resultado cosmético e retorno precoce ao trabalho.BACKGROUND: Resection of neoplasms arising in the posterior right sector is usually a technical challenge due to approach difficulties. Additionally, laparoscopic hepatectomy has become an interesting alternative with several advantages (low morbidity, short hospital

Princípios e Regras: Uma abordagem evolutiva

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Antonio Henrique Lindemberg Baltazar

2009-01-01

Este trabalho pretende realizar uma reflexão sobre o atual modelo constitucional principiológico. Para tanto, adotamos como metodologia a abordagem histórico-evolutiva do Estado Jusnaturalista ao moderno Estado Pós-Positivista. A evolução jurídica, desde o jusnaturalismo até o pós-positivismo nos mostra a tentativa de se lançar mão de um Estado principiológico, cujos valores são alçados como fund...

Modelagem Simplificada Para Estimativa do Balanço de Energia à Superfície em Escala Regional (R-SSEB

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Argemiro Lucena de Araújo

Full Text Available Resumo Este estudo apresenta uma metodologia simplificada e ajustada a partir de algoritmos existentes a dados de sensores orbitais disponíveis para a região Nordeste do Brasil (NEB com o intuito de operacionalizar a determinação espacial da evapotranspiração (ET apenas com dados de sensoriamento remoto, utilizando dados MODIS/Terra do período de 2002 a 2011. Os resultados obtidos para diversos alvos espalhados pelo NEB foram comparados a dados CLM (Common Land Model e MOD16. Obteve-se erro médio percentual (EMP e erro médio absoluto (EMA da ordem de 23,6% e 181 mm.ano−1, respectivamente, nos valores de ET quando comparados a dados CLM. Avaliou-se a ET obtida pelo algoritmo proposto, com dados de ET do produto MOD16, o que resultou em valores de EMP e EMA de 38,6% e 288 mm.ano−1, respectivamente. Os dados médios anuais da ET variaram de 482 a 1105 mm.ano−1 relativos a áreas de Caatinga e floresta tropical pluvial, respectivamente. Os resultados apresentaram-se condizentes com a literatura e evidenciaram que a metodologia proposta possibilita operacionalizar o cômputo da ET em toda a região Nordeste, não obstante a grande heterogeneidade topográfica e climática da região.

Princípios e Regras: Uma abordagem evolutiva

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Antonio Henrique Lindemberg Baltazar

2009-12-01

Full Text Available Este trabalho pretende realizar uma reflexão sobre o atual modelo constitucional principiológico. Para tanto, adotamos como metodologia a abordagem histórico-evolutiva do Estado Jusnaturalista ao moderno Estado Pós-Positivista. A evolução jurídica, desde o jusnaturalismo até o pós-positivismo nos mostra a tentativa de se lançar mão de um Estado principiológico, cujos valores são alçados como fundamento do edifício jurídico.

Abordagem do marketing de relacionamento no ensino superior

OpenAIRE

Nunes, Getúlio Tadeu; Lanzer, Edgar Augusto; Serra, Fernando Ribeiro; Ferreira, Manuel Portugal

2008-01-01

O artigo apresenta uma análise do atual cenário competitivo do Ensino Superior brasileiro, com o objetivo de demonstrar que a utilização de estratégias de marketing é um fator crítico de sucesso para essas organizações. O trabalho trata da existência de barreiras contra uma abordagem de marketing nas universidades, fruto de um modelo de gestão acadêmica desenvolvido tendo como base um mercado sem competição, comprovando que há uma resistência contra o uso de estratégias mercadológica...

Abordagem do paciente ferido por arma branca na zona de Ziedler

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Decio Luis Portella

2016-10-01

Full Text Available Introdução: Ferimentos cardíacos penetrantes já foram considerados letais e intratáveis. Homero fez a primeira descrição da morte de Sarpedon em A Ilíada, em 3000 a.C. Em 1883, Billroth afirmou em um Congresso Europeu de Cirurgia que "o cirurgião que tentar suturar um ferimento cardíaco deverá perder o respeito de seus colegas". Em 1897, Rehn apresentou o primeiro caso bem sucedido de cardiorrafia de ventrículo direito Cerca de 87% das lesões cardiovasculares são, em particular, oriundas de trauma penetrante. E, as lesões ventriculares são mais frequentes que as atriais Objetivo: Descrever a abordagem realizada no serviço para pacientes com ferimento por arma branca (FAB na zona de Ziedler, através da experiência de sete casos relatados em 7 anos Discutir a relevância da utilização do FAST (Focused Assesment with Sonography for Trauma na avaliação primária do protocolo ATLS (Advanced Trauma Life Support e a sequência de reavaliação, e analisar qual o melhor procedimento diagnóstico e terapêutico para cada apresentação clínica do paciente. Método: Realizou-se um estudo retrospectivo, descritivo e analítico de sete pacientes atendidos no pronto atendimento do Politrauma do Conjunto Hospitalar de Sorocaba. O conteúdo deste trabalho foi obtido através da revisão de prontuário e descrição cirúrgica, registro fotográficos, além de revisão da literatura. Resultados: A experiência do serviço mostra que a abordagem inicial descrita pelo ATLS é fundamental para guiar o atendimento ao ferido. Quando da realização do FAST na avaliação primária indicando ausência de líquido na janela pericárdica deve-se manter o paciente com FAB em zona de Ziedler na sala de urgência sendo assistido por profissionais capacitados. A necessidade de Tomografia Computadorizada com contraste demonstra-se relevante para os casos em que há FAST inconclusivo, ainda que com paciente estável. A amostra exibe um caso de

Posterior microphthalmos pigmentary retinopathy syndrome.

Science.gov (United States)

Pehere, Niranjan; Jalali, Subhadra; Deshmukh, Himanshu; Kannabiran, Chitra

2011-04-01

Posterior Microphthalmos Pigmentary Retinopathy Syndrome (PMPRS). Posterior microphthalmos (PM) is a relatively infrequent type of microphthalmos where posterior segment is predominantly affected with normal anterior segment measurements. Herein, we report two siblings with posterior microphthalmos retinopathy syndrome with postulated autosomal recessive mode of inheritance. A 13-year-old child had PM and retinitis pigmentosa (RP) and his 7-year-old sister had PM, RP, and foveoschisis. The genetics of this syndrome and variable phenotype is discussed. Importance of being aware of posterior microphthalmos and its posterior segment associations is highlighted.

Echocardiographic Wall Motion Abnormality in Posterior Myocardial Infarction: The Diagnostic Value of Posterior Leads

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A Darehzereshki

2008-06-01

Full Text Available Background: For the purpose of ascertaining myocardial infarction (MI and ischemia, the sensitivity of the initial 12-lead ECG is inadequate. It is risky to diagnose posterior MI using only precordial reciprocal changes, since the other leads may be more optimally positioned for the identification of electrocardiographic changes. In this study, we evaluated the relationship between electrocardiography changes and wall motion abnormalities in patients with posterior MI for earlier and better diagnosis of posterior MI.Methods: In this prospective cross-sectional study, we enrolled patients with posterior MI who had come to the Emergency Department of Shariati Hospital with their first episode of chest pain. A 12-lead surface electrocardiogram using posterior leads (V7-V9 was performed for all participants. Patients with ST elevation >0.05 mV or pathologic Q wave in the posterior leads, as well as those with specific changes indicating posterior MI in V1-V2, were evaluated by echocardiography in terms of wall motion abnormalities. All data were analyzed using SPSS and p<0.05 were considered statistically significant.Results: Of a total 79 patients enrolled, 48 (60.8% were men, and the mean age was 57.35±8.22 years. Smoking (54.4% and diabetes (48% were the most prevalent risk factors. In the echocardiographic evaluation, all patients had wall motion abnormalities in the left ventricle and 19 patients (24.1% had wall motion abnormalities in the right ventricle. The most frequent segment with motion abnormality among the all patients was the mid-posterior. The posterior leads showed better positive predictive value than the anterior leads for posterior wall motion abnormality.Conclusion: Electrocardiography of the posterior leads in patients with acute chest pain can help in earlier diagnosis and in time treatment of posterior MI.

Cálculo K: uma abordagem alternativa para a relatividade especial

OpenAIRE

Conto,G. De; Lima,A.; Ortega,P.H.; Schmitz,E.R.

2013-01-01

Neste artigo apresentamos a abordagem alternativa feita por Bondi para a teoria da relatividade especial. Durante o desenvolvimento, analisamos os diagramas de Bondi, recursos visuais dos quais podemos retirar algumas informações sobre os sistemas analisados, e discutimos o fator K da teoria de Bondi, que está no cerne deste trabalho. Posteriormente, discutimos alguns dos principais resultados obtidos pela relatividade especial de Einstein tais como a dilatação temporal, a contração espacial ...

Posterior fossa epidural hematoma

International Nuclear Information System (INIS)

Kushner, M.J.; Luken, M.G. III

1983-01-01

CT demonstrated posterior fossa epidural hematoma in three patients with head trauma in whom this diagnosis was not clinically apparent. No patient was in stupor or coma and no patient experienced a lucid interval. Only one patient had signs referable to the posterior fossa. Two patients had occipital skull fracture disclosed by plain radiographs. CT revealed a unilateral biconvex hematoma in two cases, and a bilateral hematoma with supratentorial extension in the third. All patients underwent suboccipital craniectomy and recovered. Therapeutic success in these cases was facilitated by early CT and the rapid disclosure of the unsuspected posterior fossa lesions. CT showing contiguous hematoma below and above the tentorium cerebelli after posterior head trauma is highly suggestive of epidural hematoma arising from the posterior fossa. (orig.)

Irreducible Traumatic Posterior Shoulder Dislocation

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Blake Collier

2017-01-01

Full Text Available History of present illness: A 22-year-old male presented to the Emergency Department complaining of right shoulder pain after a motocross accident. He was traveling at approximately 10 mph around a turn when he lost control and was thrown over the handlebars, landing directly on his right shoulder. On arrival, he was holding his arm in adduction and internal rotation. An area of swelling was noted over his anterior shoulder. He was unable to abduct his shoulder. No humeral gapping was noted. He had normal neuro-vascular status distal to the injury. Significant findings: Radiographs demonstrated posterior displacement of the humeral head on the “Y” view (see white arrow and widening of the glenohumeral joint space on anterior-posterior view (see red arrow. The findings were consistent with posterior dislocation and a Hill-Sachs type deformity. Sedation was performed and reduction was attempted using external rotation, traction counter-traction. An immediate “pop” was felt during the procedure. Post-procedure radiographs revealed a persistent posterior subluxation with interlocking at posterior glenoid. CT revealed posterior dislocation with acute depressed impaction deformity medial to the biceps groove with the humeral head perched on the posterior glenoid, interlocked at reverse Hill-Sachs deformity (see blue arrow. Discussion: Posterior shoulder dislocations are rare and represent only 2% of all shoulder dislocations. Posterior shoulder dislocations are missed on initial diagnosis in more than 60% of cases.1 Posterior shoulder dislocations result from axial loading of the adducted and internally rotated shoulder, violent muscle contractions (resulting from seizures or electrocution, a direct posterior force applied to the anterior shoulder.1 Physical findings include decreased anterior prominence of the humeral head, increased palpable posterior prominence of the humeral head below the acromion, increased palpable prominence of the

Uma Abordagem de Monitoração de Tráfego de Rede utilizando Lógica Difusa

OpenAIRE

Silveira, Enio Rovere; Universidade Federal de Santa Catarina; Dantas, M. A.R.; Universidade Federal de Santa Catarina

2005-01-01

Neste artigo, apresentamos um trabalho de pesquisa de monitoração de tráfego de rede utilizando uma abordagem de lógica difusa. Nossa contribuição está focada na criação de um protótipo que pudesse ser avaliado em uma configuração real de produção de uma grande organização, utilizando-se de hardware e software existentes na empresa. Resultados experimentais obtidos através de estudos de casos reais no ambiente, indicam o sucesso da abordagem na melhoria da monitoração de tráfego da rede....

ABORDAGEM DO BIOMA CERRADO EM LIVROS DIDÁTICOS DE BIOLOGIA DO ENSINO MÉDIO

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Rafael Gonçalves Bezerra

2013-03-01

Full Text Available A educação brasileira tem os livros didáticos como principal recurso de informação a alunos e professores. Este trabalho analisa como ocorre a abordagem do bioma Cerrado em seis livros didáticos de biologia destinados ao Ensino Médio. Os aspectos analisados foram o número de páginas destinadas ao tema, figuras, exemplificações acerca da fauna e flora local e abordagem do tema. A análise mostrou que todos os aspectos são apresentados de maneira resumida. Exemplos da fauna e flora local, quando presente nos livros, são citados apenas com o nome popular. Como resultado, o bioma Cerrado é tratado de maneira acrítica quanto à sua situação de degradação e importância para a manutenção da biodiversidade mundial.

Para uma abordagem virtuosa do Jornalismo

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Rogério Christofoletti

2012-06-01

Full Text Available As últimas décadas têm favorecido o crescimento do interesse e dos estudos sobre a ética jornalística. No Brasil e em outras praças, as abordagens deste tema têm sido na maioria das vezes por um caráter deontológico ou utilitarista. Neste artigo, chamamos a atenção para uma perspectiva que privilegie as virtudes como pontos de partida para os debates acerca das condutas dos profissionais. Uma ética das virtudes remete a Aristóteles e aos estoicos, mas vem sendo retomada por autores mais contemporâneos, como Macintyre e Comte-Sponville, entre outros. No jornalismo, esta abordagem não é definitiva ou totalizante, mas contribui para uma compreensão mais ampla da discussão, chamando inclusive a atenção para recomendações éticas úteis, práticas e atuais.

Classification of posterior vitreous detachment

Science.gov (United States)

Kakehashi, Akihiro; Takezawa, Mikiko; Akiba, Jun

2014-01-01

Diagnosing a posterior vitreous detachment (PVD) is important for predicting the prognosis and determining the indication for vitreoretinal surgery in many vitreoretinal diseases. This article presents both classifications of a PVD by slit-lamp biomicroscopy and of a shallow PVD by optical coherence tomography (OCT). By biomicroscopy, the vitreous condition is determined based on the presence or absence of a PVD. The PVD then is classified as either a complete posterior vitreous detachment (C-PVD) or a partial posterior vitreous detachment (P-PVD). A C-PVD is further divided into a C-PVD with collapse and a C-PVD without collapse, while a P-PVD is divided into a P-PVD with shrinkage of the posterior hyaloid membrane (P-PVD with shrinkage) and a P-PVD without shrinkage of the posterior hyaloid membrane (P-PVD without shrinkage). A P-PVD without shrinkage has a subtype characterized by vitreous gel attachment through the premacular hole in a posterior hyaloid membrane to the macula (P-PVD without shrinkage [M]). By OCT, a shallow PVD is classified as the absence of a shallow PVD or as a shallow PVD. A shallow PVD is then subclassified as a shallow PVD without shrinkage of the posterior vitreous cortex, a shallow PVD with shrinkage of the posterior vitreous cortex, and a peripheral shallow PVD. A shallow PVD without shrinkage of the posterior vitreous cortex has two subtypes: an age-related shallow PVD and a perifoveal PVD associated with a macular hole. PMID:24376338

Overlapping sphincteroplasty and posterior repair.

Science.gov (United States)

Crane, Andrea K; Myers, Erinn M; Lippmann, Quinn K; Matthews, Catherine A

2014-12-01

Knowledge of how to anatomically reconstruct extensive posterior-compartment defects is variable among gynecologists. The objective of this video is to demonstrate an effective technique of overlapping sphincteroplasty and posterior repair. In this video, a scripted storyboard was constructed that outlines the key surgical steps of a comprehensive posterior compartment repair: (1) surgical incision that permits access to posterior compartment and perineal body, (2) dissection of the rectovaginal space up to the level of the cervix, (3) plication of the rectovaginal muscularis, (4) repair of internal and external anal sphincters, and (5) reconstruction of the perineal body. Using a combination of graphic illustrations and live video footage, tips on repair are highlighted. The goals at the end of repair are to: (1) have improved vaginal caliber, (2) increase rectal tone along the entire posterior vaginal wall, (3) have the posterior vaginal wall at a perpendicular plane to the perineal body, (4) reform the hymenal ring, and (5) not have an overly elongated perineal body. This video provides a step-by-step guide on how to perform an overlapping sphincteroplasty and posterior repair.

Late-onset Alzheimer disease genetic variants in posterior cortical atrophy and posterior AD.

Science.gov (United States)

Carrasquillo, Minerva M; Khan, Qurat ul Ain; Murray, Melissa E; Krishnan, Siddharth; Aakre, Jeremiah; Pankratz, V Shane; Nguyen, Thuy; Ma, Li; Bisceglio, Gina; Petersen, Ronald C; Younkin, Steven G; Dickson, Dennis W; Boeve, Bradley F; Graff-Radford, Neill R; Ertekin-Taner, Nilüfer

2014-04-22

To investigate association of genetic risk factors for late-onset Alzheimer disease (LOAD) with risk of posterior cortical atrophy (PCA), a syndrome of visual impairment with predominant Alzheimer disease (AD) pathology in posterior cortical regions, and with risk of "posterior AD" neuropathology. We assessed 81 participants with PCA diagnosed clinically and 54 with neuropathologic diagnosis of posterior AD vs 2,523 controls for association with 11 significant single nucleotide polymorphisms (SNPs) from published LOAD risk genome-wide association studies. There was highly significant association with APOE ε4 and increased risk of PCA (p = 0.0003, odds ratio [OR] = 3.17) and posterior AD (p = 1.11 × 10(-17), OR = 6.43). No other locus was significant after corrections for multiple testing, although rs11136000 near CLU (p = 0.019, OR = 0.60) and rs744373 near BIN1 (p = 0.025, OR = 1. 63) associated nominally significantly with posterior AD, and rs3851179 at the PICALM locus had significant association with PCA (p = 0.0003, OR = 2.84). ABCA7 locus SNP rs3764650, which was also tested under the recessive model because of Hardy-Weinberg disequilibrium, also had nominally significant association with PCA risk. The direction of association at APOE, CLU, and BIN1 loci was the same for participants with PCA and posterior AD. The effects for all SNPs, except rs3851179, were consistent with those for LOAD risk. We identified a significant effect for APOE and nominate CLU, BIN1, and ABCA7 as additional risk loci for PCA and posterior AD. Our findings suggest that at least some of the genetic risk factors for LOAD are shared with these atypical conditions and provide effect-size estimates for their future genetic studies.

International comparative evaluation of fixed-bearing non-posterior-stabilized and posterior-stabilized total knee replacements.

Science.gov (United States)

Comfort, Thomas; Baste, Valborg; Froufe, Miquel Angel; Namba, Robert; Bordini, Barbara; Robertsson, Otto; Cafri, Guy; Paxton, Elizabeth; Sedrakyan, Art; Graves, Stephen

2014-12-17

Differences in survivorship of non-posterior-stabilized compared with posterior-stabilized knee designs carry substantial economic consequences, especially with limited health-care resources. However, these comparisons have often been made between relatively small groups of patients, often with short-term follow-up, with only small differences demonstrated between the groups. The goal of this study is to compare the outcomes of non-posterior-stabilized and posterior-stabilized total knee arthroplasties with use of a unique collaboration of multiple established knee arthroplasty registries. A distributed health data network was developed by the International Consortium of Orthopaedic Registries and was used in this study to reduce barriers to participation (such as security, propriety, legal, and privacy issues) compared with a centralized data warehouse approach. The study included only replacements in osteoarthritis patients who underwent total knee procedures involving fixed-bearing devices from 2001 to 2010. The outcome of interest was time to first revision. On average, not resurfacing showed a more harmful effect than resurfacing did when posterior-stabilized and non-posterior-stabilized knee replacements were compared, while the risk of revision for posterior-stabilized compared with non-posterior-stabilized knees was highest in year zero to one, followed by year one to two, years eight through ten, and years two through eight. Posterior-stabilized knees did significantly worse than non-posterior-stabilized knees did when the patella was not resurfaced. This difference was most pronounced in the first two years (year zero to one: hazard ratio [HR] = 2.15, 95% confidence interval [CI] = 1.56 to 2.95, p < 0.001; year one to two: HR = 1.61, 95% CI = 1.48 to 1.75, p < 0.001). When the patella was resurfaced, posterior-stabilized knees did significantly worse than non-posterior-stabilized knees did. This was again most pronounced in the first two years (year zero

Mediastinite Aguda: Estudo Retrospetivo de 8 Anos de Abordagem em Cuidados Intensivos

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Ana Bastos Furtado

2018-02-01

Conclusão: A nossa série difere do reportado na literatura relativamente aos dados demográficos (mulheres, com idade média superior e à etiologia das mediastinites (perfuração do esófago e mediastinites descendentes. Para o sucesso do tratamento é fundamental o diagnóstico e abordagem atempada em ambiente de cuidados intensivos pela gravidade, complexidade e multiplicidade das técnicas aplicadas.

Posterior capsule opacification.

Science.gov (United States)

Wormstone, I Michael; Wang, Lixin; Liu, Christopher S C

2009-02-01

Posterior Capsule Opacification (PCO) is the most common complication of cataract surgery. At present the only means of treating cataract is by surgical intervention, and this initially restores high visual quality. Unfortunately, PCO develops in a significant proportion of patients to such an extent that a secondary loss of vision occurs. A modern cataract operation generates a capsular bag, which comprises a proportion of the anterior and the entire posterior capsule. The bag remains in situ, partitions the aqueous and vitreous humours, and in the majority of cases, houses an intraocular lens. The production of a capsular bag following surgery permits a free passage of light along the visual axis through the transparent intraocular lens and thin acellular posterior capsule. However, on the remaining anterior capsule, lens epithelial cells stubbornly reside despite enduring the rigours of surgical trauma. This resilient group of cells then begin to re-colonise the denuded regions of the anterior capsule, encroach onto the intraocular lens surface, occupy regions of the outer anterior capsule and most importantly of all begin to colonise the previously cell-free posterior capsule. Cells continue to divide, begin to cover the posterior capsule and can ultimately encroach on the visual axis resulting in changes to the matrix and cell organization that can give rise to light scatter. This review will describe the biological mechanisms driving PCO progression and discuss the influence of IOL design, surgical techniques and putative drug therapies in regulating the rate and severity of PCO.

Proposta de uma abordagem psicoeducacional em grupos para pacientes adultos com Transtorno de Déficit de Atenção/Hiperatividade

OpenAIRE

Grevet, Eugenio Horácio; Abreu, Paulo Belmonte de; Shansis, Flávio

2003-01-01

Os autores do presente artigo propõem, a partir do modelo pedagógico proposto por Antoni Zabala, uma abordagem psicoeducativa grupal para pacientes adultos portadores de Transtorno de Déficit de Atenção/Hiperatividade. Para tanto, adaptam esta estrutura pedagógica para fundamentar a abordagem de grupos psicoeducacionais. O presente trabalho adiciona uma nova técnica para o tratamento do TDAH no adulto a partir da interface entre a pedagogia e a psicoterapia. TIn this paper the authors sugg...

Design de sistemas de informação centrado no usuário e a abordagem do sense-making

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Edmeire Cristina Pereira

Full Text Available Esta pesquisa analisa alguns aspectos da interação ser humano-computador e da abordagem do Sense-Making (Dervin e outros, também reconhecida na literatura como "abordagem centrada no usuário" ou, ainda, "abordagem da percepção do usuário". Examina um site de uma empresa carioca (Rio de Janeiro, Brasil do setor de farmácia, cosméticos e perfumaria, levando-se em consideração o lay-out das sucessivas telas com janelas, menus, botões, ícones e todos os componentes do sistema visíveis para o usuário. Como resultado das análises do conteúdo das páginas, da comunicação visual e de sua interatividade com os usuários potenciais, evidencia-se que o site não atende a todos os critérios de qualidade sugeridos pela literatura e, nem tampouco, a todas as diretrizes básicas para o design de sistemas de informação centrado no usuário, por Schneiderman e Bastien & Scapin.

Posterior Urethral Valves

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Steve J. Hodges

2009-01-01

Full Text Available The most common cause of lower urinary tract obstruction in male infants is posterior urethral valves. Although the incidence has remained stable, the neonatal mortality for this disorder has improved due to early diagnosis and intensive neonatal care, thanks in part to the widespread use of prenatal ultrasound evaluations. In fact, the most common reason for the diagnosis of posterior urethral valves presently is the evaluation of infants for prenatal hydronephrosis. Since these children are often diagnosed early, the urethral obstruction can be alleviated rapidly through catheter insertion and eventual surgery, and their metabolic derangements can be normalized without delay, avoiding preventable infant mortality. Of the children that survive, however, early diagnosis has not had much effect on their long-term prognosis, as 30% still develop renal insufficiency before adolescence. A better understanding of the exact cause of the congenital obstruction of the male posterior urethra, prevention of postnatal bladder and renal injury, and the development of safe methods to treat urethral obstruction prenatally (and thereby avoiding the bladder and renal damage due to obstructive uropathy are the goals for the care of children with posterior urethral valves[1].

O ENIGMA DE KASPAR HAUSER (1812?-1833): UMA ABORDAGEM PSICOSSOCIAL

OpenAIRE

Saboya, Maria Clara Lopes

2001-01-01

A partir de uma abordagem histórico-cultural em Psicologia, este trabalho analisa o percurso de desenvolvimento de Kaspar Hauser, um personagem real e enigmático que, quando encontrado em Nuremberg, em 1928, com supostamente 15 anos, não sabia falar, nem andar e não se comportava como humano. Até hoje o seu enigma persiste: apesar de muitas hipóteses e suspeitas, não se descobriu sua origem. Apoiando-se em estudos de Vygotsky e Luria, que indicam que a percepção depende, sobretudo, da práxis ...

Abordagem do enfermeiro no grupo educativo com gestantes candidatas à laqueadura

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Arlete de Souza Barros

1993-06-01

Full Text Available Enfocamos neste trabalho a abordagem do enfermeiro enquanto coordenador de grupo educativo com gestantes candidatas à laqueadura. Enfatizamos a necessidade de um referencial teórico específico para trabalharmos com grupos de pacientes. Queremos evidenciar também o papel de educador inerente ao enfermeiro e a importância da sua atuação na equipe multiprofissional da área de saúde. A metodologia do grupo educativo é suscintamente descrita, na forma de um protocolo, que apresentamos como sugestão para o desenvolvimento de atividades semelhantes.

Distrofia corneana policromática posterior Polychromatic posterior corneal dystrophy

OpenAIRE

Patrick Frensel de Moraes Tzelikis; Ulisses Roberto dos Santos; Marco Antônio Guarino Tanure; Fernando Cançado Trindade

2007-01-01

Os autores descrevem quatro raros casos de distrofia corneana policromática posterior, ainda não descrito na literatura nacional. Observam-se opacidades puntiformes, policromáticas, de tamanho uniforme, localização estromal profunda, distribuídas de limbo a limbo e que não interferem na acuidade visual. É apresentada uma revisão dos casos de distrofia pré-Descemet existentes na literatura.The authors describe four rare cases of polychromatic posterior corneal dystrophy, not describe in nation...

Posterior Pole Sparing Laser Photocoagulation Combined with Intravitreal Bevacizumab Injection in Posterior Retinopathy of Prematurity

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Rebecca Kim

2014-01-01

Full Text Available Purpose. To report the results of the posterior pole sparing laser photocoagulation combined with intravitreal bevacizumab injection (IVB in retinopathy of prematurity (ROP. Methods. A retrospective chart review of premature babies with ROP, all of whom received laser photocoagulation with IVB. Eleven eyes of 6 infants with advanced zone I ROP underwent laser ablation sparing posterior pole with concurrent IVB. The results were compared with those of full-laser treatment combined with IVB to 8 eyes of 5 infants with advanced ROP without involvement of the posterior pole. Results. The posterior pole sparing laser with IVB was performed with zone I, stage 3+ ROP at the mean postmenstrual age of 36 weeks and 5 days. The plus sign decreased significantly at postoperative day 1, the neovascular proliferation regressed by postoperative week 1, and the normal vascularization started at postoperative day 32 on the average. Two months after treatment, vascularization of the spared avascular area was completed. There was no macular dragging, tractional retinal detachment, foveal destruction by laser scars, or any other adverse event. No significant anatomical differences were identified from those of full-laser ablation combined with IVB. Conclusions. Posterior pole sparing laser with IVB can give favorable results without destruction of posterior pole retina.

Endoscopic Management of Posterior Epistaxis

OpenAIRE

Paul, J.; Kanotra, Sohit Paul; Kanotra, Sonika

2011-01-01

The traditional method of management of posterior epistaxis has been with anteroposterior nasal packing. Apart from the high failure rate of 26–50% reported in various series, nasal packing is associated with marked discomfort and several complications. In order to avoid nasal packing, we started doing endoscopic cauterization in cases of posterior epistaxis. A total of 23 patients with posterior epistaxis were subjected to nasal endoscopy with the intent to stop bleeding by cauterization of ...

Posterior labral injury in contact athletes.

Science.gov (United States)

Mair, S D; Zarzour, R H; Speer, K P

1998-01-01

Nine athletes (seven football offensive linemen, one defensive lineman, and one lacrosse player) were found at arthroscopy to have posterior labral detachment from the glenoid. In our series, this lesion is specific to contact athletes who engage their opponents with arms in front of the body. All patients had pain with bench pressing and while participating in their sport, diminishing their ability to play effectively. Conservative measures were ineffective in relieving their symptoms. Examination under anesthesia revealed symmetric glenohumeral translation bilaterally, without evidence of posterior instability. Treatment consisted of glenoid rim abradement and posterior labral repair with a bioabsorbable tack. All patients returned to complete at least one full season of contact sports and weightlifting without pain (minimum follow-up, > or = 2 years). Although many injuries leading to subluxation of the glenohumeral joint occur when an unanticipated force is applied, contact athletes ready their shoulder muscles in anticipation of impact with opponents. This leads to a compressive force at the glenohumeral joint. We hypothesize that, in combination with a posteriorly directed force at impact, the resultant vector is a shearing force to the posterior labrum and articular surface. Repeated exposure leads to posterior labral detachment without capsular injury. Posterior labral reattachment provides consistently good results, allowing the athlete to return to competition.

Bony landmark between the attachment of the medial meniscus posterior root and the posterior cruciate ligament: CT and MR imaging assessment

Energy Technology Data Exchange (ETDEWEB)

Fujii, Masataka; Furumatsu, Takayuki; Miyazawa, Shinichi; Kodama, Yuya; Hino, Tomohito; Kamatsuki, Yusuke; Ozaki, Toshifumi [Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Department of Orthopaedic Surgery, Science of Functional Recovery and Reconstruction, Okayama (Japan)

2017-08-15

(1) To reveal the prevalence of the bony recess (posterior dimple) and (2) to determine the position of the posterior dimple on the tibial plateau using three-dimensional computed tomography (3DCT). In this study, a retrospective review of 112 patients was performed to identify the posterior dimple and to evaluate its position on 3DCT. Magnetic resonance images (MRIs) were also used to determine the positional relationship among the posterior cruciate ligament (PCL), medial meniscus posterior insertion (MMPI), and posterior dimple. The posterior dimple was observed in 100 of 112 knees (89.3%) on 3DCT. The center of the posterior dimple was 13.6 ± 0.8 mm from the medial tibial eminence apex. MRI showed that the posterior dimple separated the tibial attachment of the PCL and MMPI. This is the first study to discuss the prevalence and position of the bony recess in the posterior intercondylar fossa. (orig.)

Bony landmark between the attachment of the medial meniscus posterior root and the posterior cruciate ligament: CT and MR imaging assessment

International Nuclear Information System (INIS)

Fujii, Masataka; Furumatsu, Takayuki; Miyazawa, Shinichi; Kodama, Yuya; Hino, Tomohito; Kamatsuki, Yusuke; Ozaki, Toshifumi

2017-01-01

(1) To reveal the prevalence of the bony recess (posterior dimple) and (2) to determine the position of the posterior dimple on the tibial plateau using three-dimensional computed tomography (3DCT). In this study, a retrospective review of 112 patients was performed to identify the posterior dimple and to evaluate its position on 3DCT. Magnetic resonance images (MRIs) were also used to determine the positional relationship among the posterior cruciate ligament (PCL), medial meniscus posterior insertion (MMPI), and posterior dimple. The posterior dimple was observed in 100 of 112 knees (89.3%) on 3DCT. The center of the posterior dimple was 13.6 ± 0.8 mm from the medial tibial eminence apex. MRI showed that the posterior dimple separated the tibial attachment of the PCL and MMPI. This is the first study to discuss the prevalence and position of the bony recess in the posterior intercondylar fossa. (orig.)

Imaging findings in posterior instability of the shoulder

International Nuclear Information System (INIS)

Harish, Srinivasan; Rebello, Ryan; O'Neill, John; Nagar, Arpit; Moro, Jaydeep; Pugh, David

2008-01-01

Posterior shoulder instability refers to the symptoms and signs resulting from excessive posterior translation of the humerus. Magnetic resonance (MR) imaging is the radiological modality of choice in the diagnostic assessment of posterior instability. Computed tomography (CT) is useful in the evaluation of osseous abnormalities associated with posterior instability. A detailed description of the posterior osseous and labroligamentous abnormalities has evolved recently, and many variant lesions of the posteroinferior labrum and/or capsular structures have been described. As the recommended surgical management of lesions associated with posterior instability is a lesion-specific approach, awareness of the specific lesions that have been described in association with posterior instability helps in pre-surgical planning. The purpose of this article is to review the classification of, and injury mechanisms leading to, posterior shoulder instability and to describe imaging findings associated with posterior instability, with emphasis on MR imaging. (orig.)

Imaging findings in posterior instability of the shoulder

Energy Technology Data Exchange (ETDEWEB)

Harish, Srinivasan; Rebello, Ryan; O' Neill, John [St. Joseph' s Healthcare, Department of Diagnostic Imaging, Hamilton, ON (Canada); McMaster University, Faculty of Health Sciences, Hamilton (Canada); Nagar, Arpit [St. Joseph' s Healthcare, Department of Diagnostic Imaging, Hamilton, ON (Canada); Moro, Jaydeep [St. Joseph' s Healthcare, Department of Orthopedic Surgery, Hamilton, ON (Canada); McMaster University, Faculty of Health Sciences, Hamilton (Canada); Pugh, David [Brantford General Hospital, Department of Orthopedic Surgery, Brantford, ON (Canada)

2008-08-15

Posterior shoulder instability refers to the symptoms and signs resulting from excessive posterior translation of the humerus. Magnetic resonance (MR) imaging is the radiological modality of choice in the diagnostic assessment of posterior instability. Computed tomography (CT) is useful in the evaluation of osseous abnormalities associated with posterior instability. A detailed description of the posterior osseous and labroligamentous abnormalities has evolved recently, and many variant lesions of the posteroinferior labrum and/or capsular structures have been described. As the recommended surgical management of lesions associated with posterior instability is a lesion-specific approach, awareness of the specific lesions that have been described in association with posterior instability helps in pre-surgical planning. The purpose of this article is to review the classification of, and injury mechanisms leading to, posterior shoulder instability and to describe imaging findings associated with posterior instability, with emphasis on MR imaging. (orig.)

Primary Posterior Mediastinum Hydatid Cyst

International Nuclear Information System (INIS)

Ahmed, M.; Eid, A. F.; Sheikh, M. Y.; Yiannakou, N.

2014-01-01

Primary posterior mediastinal hydatid cyst is a serious health problem for the Mediterranean countries. We diagnosed a case of a 46-year-old female with a primary posterior mediastinum hydatid cyst on CT and MRI. It was provisionally identified as either a hydatid cyst or bronchogenic cyst or neuroenteric cyst. CT guided aspiration with 18 gauge needle confirmed as hydatid sand. This is very rare in this population but it should be kept in mind when one is looking at any cyst in the posterior mediastinum. (author)

Treatment implications of posterior fossa ependymoma subgroups.

Science.gov (United States)

Ramaswamy, Vijay; Taylor, Michael D

2016-11-15

Posterior fossa ependymoma comprises two distinct molecular entities, ependymoma_posterior fossa A (EPN_PFA) and ependymoma_posterior fossa B (EPN_PFB), with differentiable gene expression profiles. As yet, the response of the two entities to treatment is unclear. To determine the relationship between the two molecular subgroups of posterior fossa ependymoma and treatment, we studied a cohort of 820 patients with molecularly profiled, clinically annotated posterior fossa ependymomas. We found that the strongest predictor of poor outcome in patients with posterior fossa ependymoma across the entire age spectrum was molecular subgroup EPN_PFA, which was recently reported in the paper entitled "Therapeutic impact of cytoreductive surgery and irradiation of posterior fossa ependymoma in the molecular era: a retrospective multicohort analysis" in the Journal of Clinical Oncology. Patients with incompletely resected EPN_PFA tumors had a very poor outcome despite receiving adjuvant radiation therapy, whereas a substantial proportion of patients with EPN_PFB tumors can be cured with surgery alone.

Psicologia Positiva: uma nova abordagem para antigas questões

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Simone dos Santos Paludo

2007-04-01

Full Text Available Historicamente, a Psicologia preocupou-se em investigar patologias, negligenciado os aspectos saudáveis dos seres humanos. Mas, a partir de 1998, assumindo a presidência da American Psychological Association, Seligman iniciou movimento denominado Psicologia Positiva, que visa oferecer nova abordagem às potencialidades e virtudes humanas, estudando as condições e processos que contribuem para a prosperidade dos indivíduos e comunidades. Este artigo apresenta e discute essa nova proposta científica, que promete melhorar a qualidade de vida dos indivíduos e prevenir patologias; também as lacunas existentes nas investigações em Ciências Humanas, as contribuições teóricas e empíricas e as possíveis aplicações desse conhecimento.

Posterior column reconstruction improves fusion rates at the level of osteotomy in three-column posterior-based osteotomies.

Science.gov (United States)

Lewis, Stephen J; Mohanty, Chandan; Gazendam, Aaron M; Kato, So; Keshen, Sam G; Lewis, Noah D; Magana, Sofia P; Perlmutter, David; Cape, Jennifer

2018-03-01

To determine the incidence of pseudarthrosis at the osteotomy site after three-column spinal osteotomies (3-COs) with posterior column reconstruction. 82 consecutive adult 3-COs (66 patients) with a minimum of 2-year follow-up were retrospectively reviewed. All cases underwent posterior 3-COs with two-rod constructs. The inferior facets of the proximal level were reduced to the superior facets of the distal level. If that was not possible, a structural piece of bone graft either from the local resection or a local rib was slotted in the posterior column defect to re-establish continual structural posterior bone across the lateral margins of the resection. No interbody cages were used at the level of the osteotomy. There were 34 thoracic osteotomies, 47 lumbar osteotomies and one sacral osteotomy with a mean follow-up of 52 (24-126) months. All cases underwent posterior column reconstructions described above and the addition of interbody support or additional posterior rods was not performed for fusion at the osteotomy level. Among them, 29 patients underwent one or more revision surgeries. There were three definite cases of pseudarthrosis at the osteotomy site (4%). Six revisions were also performed for pseudarthrosis at other levels. Restoration of the structural integrity of the posterior column in three-column posterior-based osteotomies was associated with > 95% fusion rate at the level of the osteotomy. Pseudarthrosis at other levels was the second most common reason for revision following adjacent segment disease in the long-term follow-up.

Praxiologia motriz e a abordagem crítico-superadora: Aproximações preliminares

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Pablo Aires Araujo

2014-12-01

Full Text Available O presente estudo tem por objetivo propor uma aproximação dentro do campo teórico-metodológico entre a abordagem crítico-superadora e os elementos conceituais da Praxiologia Motriz no sentido de apresentar as primeiras orientações para a prática pedagógica do professor de Educação Física. Acredita-se que através da apropriação dessas duas temáticas poder-se-á obter uma ferramenta a mais para o ensino dos Jogos e Desportos, mediante o processo metodológico da abordagem crítico-superadora. Desse modo, chega-se a um mais claro entendimento acerca do funcionamento dos jogos e desportos, já que a Praxeologia Motriz possibilita esse aprofundamento na compreensão da lógica interna dessas práticas, contribuindo, portanto, para uma melhor compreensão da lógica dialética que sustenta os pressupostos da proposta crítico-superadora. Para ilustrar tais afirmações utilizou-se como exemplo o jogo de Voleibol. O exercício teórico desenvolvido neste estudo evidenciou que o conhecimento praxiológico poderá instrumentalizar professores e alunos possibilitando o entendimento das relações inerentes a cada modalidade desportiva no sentido de superar os modelos desportivizados.

A criança hiperativa: uma visão da abordagem gestáltica

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Sheila Antony

Full Text Available A pesquisa objetivou investigar o funcionamento psicológico da criança hiperativa em base a teoria do ciclo do contato da abordagem gestáltica, proposta por Ribeiro (1997. O Transtorno de Déficit de Atenção/Hiperatividade (TDAH caracteriza-se por distúrbios motores, perceptivos, emocionais e comportamentais. Segundo os critérios diagnósticos do DSM-IV (1994, esse transtorno reúne 18 sintomas básicos de desatenção, hiperatividade e impulsividade. A pesquisa adotou uma abordagem qualitativa. A amostra foi composta por 20 sujeitos: cinco casais, cinco professoras e cinco crianças entre oito e 11 anos de idade. Utilizaram-se a entrevista aberta e o Teste de Apercepção Infantil com figuras de animais (CAT-A, como instrumentos de coleta de dados. Concluímos que a criança hiperativa apresenta processos psicológicos específicos que formam a base de sua personalidade. A hiperatividade é a característica que define o transtorno. Não há propriamente um déficit de atenção. Propomos, portanto, uma terminologia diferente: Transtorno de Hiperatividade/Atenção.

Wittgenstein: an expressivist approach about emotions = Wittgenstein: uma abordagem expressivista sobre as emoções

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Carmo, Juliano Santos do

2014-01-01

Full Text Available Neste trabalho, tem-se a intenção de mostrar que a abordagem de Wittgenstein sobre os conceitos de sensação e emoção pode lançar luz sobre muitos dilemas filosóficos que permanecem presentes no debate contemporâneo. A minha análise tem como ponto de partida a abordagem de Jesse Prinz sobre as emoções, a qual é fortemente influenciada pela teoria fisiológica de William James. Nesse sentido, procurarei mostrar que Prinz está sujeito as mesmas críticas que Wittgenstein endereçou à teoria de William James. Por fim, eu argumentarei que Wittgenstein, nas Investigações filosóficas, defendeu um tipo peculiar de expressivismo que, apesar de manter profundas diferenças com o expressivismo tradicional, é capaz de figurar como uma posição não-cognitivista. Argumentarei, adicionalmente, que o erro na teoria de William James (e, portanto, também o erro de Prinz é não considerar os múltiplos usos dos termos psicológicos (ou seja, pensar que os termos psicológicos possuem um uso uniforme

Endoscopic management of posterior epistaxis.

Science.gov (United States)

Paul, J; Kanotra, Sohit Paul; Kanotra, Sonika

2011-04-01

The traditional method of management of posterior epistaxis has been with anteroposterior nasal packing. Apart from the high failure rate of 26-50% reported in various series, nasal packing is associated with marked discomfort and several complications. In order to avoid nasal packing, we started doing endoscopic cauterization in cases of posterior epistaxis. A total of 23 patients with posterior epistaxis were subjected to nasal endoscopy with the intent to stop bleeding by cauterization of the bleeding vessel. Of these, in four cases unsuspected diagnosis was made. Of the remaining 19, in three patients, the bleeding point could not be localized accurately and these patients were managed by anteroposterior packing. The rest of the 16 patients were managed by endoscopic cauterization. In four patients, there was recurrence of bleeding within 24 h. In one of these, cauterization controlled the bleeding while in the rest nasal packing had to be resorted to. Thus, of the 23 patients of posterior epistaxis subjected to nasal endoscopy, we could avoid nasal packing in 17 (74%). To conclude, endoscopic nasal cauterization is recommended as the first line to treatment in all cases of posterior epistaxis. This will not only prevent the uncomfortable and potentially dangerous nasal packing but also help in finding the underlying pathology.

Management of posterior urethral disruption injuries.

Science.gov (United States)

Myers, Jeremy B; McAninch, Jack W

2009-03-01

Posterior urethral disruption is a traumatic injury to the male urethra, which most often results from pelvic fracture. After trauma, the distraction defect between the two ends of the urethra often scars and becomes fibrotic, blocking the urethra and bladder emptying. Increasing evidence suggests that many posterior urethral disruptions occur at the junction between the membranous urethra and the bulbar urethra, which is distal to the rhabdosphincter. In the acute setting, when a posterior urethral disruption is suspected, retrograde urethrography should be performed. Posterior urethral disruptions can be managed acutely by realignment of the urethra over a urethral catheter or by placement of a suprapubic catheter for bladder drainage only. Once fibrosis has stabilized, the patient can undergo posterior urethroplasty. In most cases, this procedure can be performed via a perineal approach in a single-stage surgery. The results of this single-stage perineal urethroplasty are excellent, and a patent urethra can be re-established in the majority of men who undergo surgery.

Delayed Single Stage Perineal Posterior Urethroplasty.

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Ali, Shahzad; Shahnawaz; Shahzad, Iqbal; Baloch, Muhammad Umar

2015-06-01

To determine the delayed single stage perineal posterior urethroplasty for treatment of posterior urethral stricture/distraction defect. Descriptive case series. Department of Urology, Jinnah Postgraduate Medical Centre, Karachi, from January 2009 to December 2011. Patients were selected for delayed single stage perineal posterior urethroplasty for treatment of posterior urethral stricture / distraction defect. All were initially suprapubically catheterized followed by definitive surgery after at least 3 months. Thirty male patients were analyzed with a mean follow-up of 10 months, 2 patients were excluded as they developed failure in first 3 months postoperatively. Mean patient's age was 26.25 ± 7.9 years. On follow-up, 7 patients (23.3%) experienced recurrent stricture during first 10 months. Five (16.6%) patients were treated successfully with single direct visual internal urethrotomy. Two patients (6.6%) had more than one direct visual internal urethrotomy and considered failed. Re-do perineal urethroplasty was eventually performed. The overall success rate was 93.3% with permissive criteria allowing single direct visual internal urethrotomy and 76.6% with strict criteria allowing no more procedures postoperatively. Posterior anastomotic urethroplasty offers excellent long-term results to patients with posterior urethral trauma and distraction defect even after multiple prior procedures.

Hematomas na fossa craniana posterior Haematomata in the posterior fossa

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Mário S. Cademartori

1969-09-01

Full Text Available São relatados 6 casos de hematomas sub-tentorias (um de hematoma subdural crônico, quatro de hematomas intra-cerebelares, um de hematoma extra-dural. Salientando a pequena freqüência dos hematomas da fossa craniana posterior, o autor mostra a necessidade de vários exames complementares para o diagnóstico exato, indispensável para a aplicação de terapêutica cirúrgica adequada.Six cases of sub-tentorial haematomata (one chronic sub-dural, four intra-cerebellar, one extra-dural are reported. Emphasizing the relative rarity of haematomata in the posterior cranial fossa, the author claims the necessity of complementary examinations for proper diagnosis, indispensable for adequate surgical treatment.

Posterior encephalopathy with vasospasm: MRI and angiography

International Nuclear Information System (INIS)

Weidauer, S.; Gaa, J.; Lanfermann, H.; Zanella, F.E.; Sitzer, M.; Hefner, R.

2003-01-01

Posterior encephalopathy is characterised by headache, impairment of consciousness, seizures and progressive visual loss. MRI shows bilateral, predominantly posterior, cortical and subcortical lesions with a distribution. Our aim was to analyse the MRI lesion pattern and angiographic findings because the pathophysiology of posterior encephalopathy is incompletely understood. We report three patients with clinical and imaging findings consistent with posterior encephalopathy who underwent serial MRI including diffusion-weighted imaging (DWI) and construction of apparent diffusion coefficient (ADC) maps, and four-vessel digital subtraction angiography (DSA). DWI revealed symmetrical subcortical and cortical parieto-occipital high signal. High and also low ADCs indicated probable vasogenic and cytotoxic oedema. On follow-up there was focal cortical laminar necrosis, while the white-matter lesions resolved almost completely, except in the arterial border zones. DSA revealed diffuse arterial narrowing, slightly more marked in the posterior circulation. These findings suggest that posterior encephalopathy may in some cases be due to diffuse, severe vasospasm affecting especially in the parieto-occipital grey matter, with its higher vulnerability to ischemia. Cerebral vasospasm due to digitoxin intoxication, resulting in posterior encephalopathy, has not yet been described previously. (orig.)

Mapas de taxas epidemiológicas: uma abordagem Bayesiana

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Assunção Renato Martins

1998-01-01

Full Text Available Neste artigo, apresentamos métodos estatísticos desenvolvidos recentemente para a análise de mapas de taxas de morbidade quando as unidades geográficas possuem pequenas populações de risco. Eles adotam a abordagem Bayesiana e utilizam métodos computacionais intensivos para estimação do risco de cada área. O objetivo dos métodos é separar a variabilidade das taxas devida às diferenças entre as regiões do risco subjacente daquela devida à pura flutuação aleatória. As estimativas de risco possuem um erro quadrático médio total menor que as estimativas usuais. Aplicamos esses novos métodos para estimar o risco de mortalidade infantil nos municípios de Minas Gerais em 1994.

One-stage posterior approaches for treatment of thoracic spinal infection: Transforaminal and costotransversectomy, compared with anterior approach with posterior instrumentation.

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Kao, Fu-Cheng; Tsai, Tsung-Ting; Niu, Chi-Chien; Lai, Po-Liang; Chen, Lih-Huei; Chen, Wen-Jer

2017-10-01

Treating thoracic infective spondylodiscitis with anterior surgical approaches carry a relatively high risk of perioperative and postoperative complications. Posterior approaches have been reported to result in lower complication rates than anterior procedures, but more evidence is needed to demonstrate the safety and efficacy of 1-stage posterior approaches for treating infectious thoracic spondylodiscitis.Preoperative and postoperative clinical data, of 18 patients who underwent 2 types of 1-stage posterior procedures, costotransversectomy and transforaminal thoracic interbody debridement and fusion and 7 patients who underwent anterior debridement and reconstruction with posterior instrumentation, were retrospectively assessed.The clinical outcomes of patients treated with 1-stage posterior approaches were generally good, with good infection control, back pain relief, kyphotic angle correction, and either partial or solid union for fusion status. Furthermore, they achieved shorter surgical time, fewer postoperative complications, and shorter hospital stay than the patients underwent anterior debridement with posterior instrumentation.The results suggested that treating thoracic spondylodiscitis with a single-stage posterior approach might prevent postoperative complications and avoid respiratory problems associated with anterior approaches. Single-stage posterior approaches would be recommended for thoracic spine infection, especially for patients with medical comorbidities.

Spondylolisthesis and Posterior Instability

International Nuclear Information System (INIS)

Niggemann, P.; Beyer, H.K.; Frey, H.; Grosskurth, D.; Simons, P.; Kuchta, J.

2009-01-01

We present the case of a patient with a spondylolisthesis of L5 on S1 due to spondylolysis at the level L5/S1. The vertebral slip was fixed and no anterior instability was found. Using functional magnetic resonance imaging (MRI) in an upright MRI scanner, posterior instability at the level of the spondylolytic defect of L5 was demonstrated. A structure, probably the hypertrophic ligament flava, arising from the spondylolytic defect was displaced toward the L5 nerve root, and a bilateral contact of the displaced structure with the L5 nerve root was shown in extension of the spine. To our knowledge, this is the first case described of posterior instability in patients with spondylolisthesis. The clinical implications of posterior instability are unknown; however, it is thought that this disorder is common and that it can only be diagnosed using upright MRI

Spondylolisthesis and Posterior Instability

Energy Technology Data Exchange (ETDEWEB)

Niggemann, P.; Beyer, H.K.; Frey, H.; Grosskurth, D. (Privatpraxis fuer Upright MRT, Koeln (Germany)); Simons, P.; Kuchta, J. (Media Park Klinik, Koeln (Germany))

2009-04-15

We present the case of a patient with a spondylolisthesis of L5 on S1 due to spondylolysis at the level L5/S1. The vertebral slip was fixed and no anterior instability was found. Using functional magnetic resonance imaging (MRI) in an upright MRI scanner, posterior instability at the level of the spondylolytic defect of L5 was demonstrated. A structure, probably the hypertrophic ligament flava, arising from the spondylolytic defect was displaced toward the L5 nerve root, and a bilateral contact of the displaced structure with the L5 nerve root was shown in extension of the spine. To our knowledge, this is the first case described of posterior instability in patients with spondylolisthesis. The clinical implications of posterior instability are unknown; however, it is thought that this disorder is common and that it can only be diagnosed using upright MRI.

Traumatic lesions of the posterior urethra.

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Velarde-Ramos, L; Gómez-Illanes, R; Campos-Juanatey, F; Portillo-Martín, J A

2016-11-01

The posterior urethral lesions are associated with pelvis fractures in 5-10% of cases. The posterior urethra is attached to the pelvis bone by puboprostatic ligaments and the perineal membrane, which explains why disruption of the pelvic ring can injure the urethra at this level. To identify suspected cases of posterior urethral trauma and to perform the diagnosis and its immediate or deferred management. Search in PubMed of articles related to traumatic posterior urethral lesions, written in English or Spanish. We reviewed the relevant publications including literature reviews and chapters from books related to the topic. With patients with pelvis fractures, we must always rule out posterior urethral lesions. The diagnostic examination of choice is retrograde urethrography, which, along with the severity of the condition, will determine the management in the acute phase and whether the treatment will be performed immediately or deferred. Early diagnosis and proper acute management decrease the associated complications, such as strictures, urinary incontinence and erectile dysfunction. Despite the classical association between posterior urethral lesions and pelvic fractures, the management of those lesions (whether immediate or deferred) remains controversial. Thanks to the growing interest in urethral disease, there are an increasing number of studies that help us achieve better management of these lesions. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Delayed Single Stage Perineal Posterior Urethroplasty

International Nuclear Information System (INIS)

Ali, S.; Shahnawaz; Shahzad, I.; Baloch, M. U.

2015-01-01

Objective: To determine the delayed single stage perineal posterior urethroplasty for treatment of posterior urethral stricture/distraction defect. Study Design: Descriptive case series. Place and Duration of Study: Department of Urology, Jinnah Postgraduate Medical Centre, Karachi, from January 2009 to December 2011. Methodology: Patients were selected for delayed single stage perineal posterior urethroplasty for treatment of posterior urethral stricture / distraction defect. All were initially suprapubically catheterized followed by definitive surgery after at least 3 months. Results: Thirty male patients were analyzed with a mean follow-up of 10 months, 2 patients were excluded as they developed failure in first 3 months postoperatively. Mean patients age was 26.25 ± 7.9 years. On follow-up, 7 patients (23.3 percentage) experienced recurrent stricture during first 10 months. Five (16.6 percentage) patients were treated successfully with single direct visual internal urethrotomy. Two patients (6.6 percentage) had more than one direct visual internal urethrotomy and considered failed. Re-do perineal urethroplasty was eventually performed. The overall success rate was 93.3 percentage with permissive criteria allowing single direct visual internal urethrotomy and 76.6% with strict criteria allowing no more procedures postoperatively. Conclusion: Posterior anastomotic urethroplasty offers excellent long-term results to patients with posterior urethral trauma and distraction defect even after multiple prior procedures. (author)

Epidural hematomas of posterior fossa

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Radulović Danilo

2004-01-01

Full Text Available Background. Posterior fossa epidural hematomas represent 7-14% of all traumatic intracranial epidural hematomas. They are most frequently encountered posttraumatic mass lesions in the posterior fossa. The aim of this study was to identify clinical features that could lead to the early diagnosis of posterior fossa epidural hematoma. Methods. Between 1980 and 2002, 28 patients with epidural hematoma of the posterior fossa were operated on at the Institute for Neurosurgery, Belgrade. Clinical course neuroradiological investigations, and the results of surgical treatment of the patients with posterior fossa epidural hematomas were analyzed retrospectively. Results. Almost two thirds of patients were younger than 16 years of age. In 20 cases injury was caused by a fall, in 6 cases by a traffic accident, and in 2 by the assault. Clinical course was subacute or chronic in two thirds of the patients. On the admission Glasgow Coma Scale was 7 or less in 9 injured, 8-14 in 14 injured, and 15 in 5 injured patients. Linear fracture of the occipital bone was radiographically evident in 19 patients, but was intraoperatively encountered in all the patients except for a 4-year old child. In 25 patients the diagnosis was established by computer assisted tomography (CAT and in 3 by vertebral angiography. All the patients were operated on via suboccipital craniotomy. Four injured patients who were preoperatively comatose were with lethal outcome. Postoperatively, 24 patients were with sufficient neurologic recovery. Conclusion. Posterior fossa epidural hematoma should be suspected in cases of occipital injury, consciousness disturbances, and occipital bone fracture. In such cases urgent CAT-scan is recommended. Early recognition early diagnosis, and prompt treatment are crucial for good neurological recovery after surgery.

Distrofia corneana policromática posterior Polychromatic posterior corneal dystrophy

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Patrick Frensel de Moraes Tzelikis

2007-08-01

Full Text Available Os autores descrevem quatro raros casos de distrofia corneana policromática posterior, ainda não descrito na literatura nacional. Observam-se opacidades puntiformes, policromáticas, de tamanho uniforme, localização estromal profunda, distribuídas de limbo a limbo e que não interferem na acuidade visual. É apresentada uma revisão dos casos de distrofia pré-Descemet existentes na literatura.The authors describe four rare cases of polychromatic posterior corneal dystrophy, not describe in national literature. The opacities are deep in the stroma, dotlike, polychromatic, uniform in size, distributed from limbus to limbus, leading no reduction in visual acuity. It is also presented a bibliographic review of pre-Descemet's dystrophy.

Posterior alien hand syndrome: case report

International Nuclear Information System (INIS)

Rohde, S.; Weidauer, S.; Lanfermann, H.; Zanella, F.

2002-01-01

The alien hand syndrome (AHS) is involuntary uncontrolled movement of an arm with a sense of estrangement from the limb itself. AHS was initially used to describe interhemispheric disconnection phenomena in patients with lesions in the anterior corpus callosum, but it has been found in patients with posterior cerebral lesions without involvement of the corpus callosum, for example parietal infarcts or corticobasal degeneration. The posterior alien hand syndrome is less frequent and presents with nonpurposive behaviour like lifting the arm or writhing fingers. We report an 80-year-old woman with a posterior AHS of the dominant right hand. MRI showed atrophy of the pre- and postcentral gyri without involvement of the corpus callosum. We discuss the aetiology of the posterior AHS and the differences from the anterior varieties. (orig.)

Distrofia corneana amorfa posterior: relato de caso Posterior amorphous corneal dystrophy: case report

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Lauro Augusto de Oliveira

2006-12-01

Full Text Available O objetivo deste trabalho é alertar o oftalmologista da possibilidade de se deparar com casos raros de distrofias corneanas. Neste caso correlacionamos os achados clínicos da distrofia amorfa posterior com refração, topografia e biomicroscopia ultra-sônica.The purpose of this paper is to warn the ophthalmologist about the possibility of facing rare cases of corneal dystrophies. Clinical findings of a case of posterior amorphous dystrophy were correlated with refraction, topography, and ultrasound biomicroscopy.

Visão e abordagem cultural de professores em sala de aula de LE (inglês e os PCNs

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Oldinê Ribeiro de França

2011-09-01

Full Text Available O presente artigo relata um estudo cujo objetivo foi identificar a visão de professores de língua estrangeira - LE (inglês sobre o ensino de cultura e a abordagem cultural adotada em sala de aula, especialmente se espaços interculturais eram criados, como apregoam os documentos oficiais, a saber, os Parâmetros Curriculares Nacionais (PCNs, que orientam o Ensino Fundamental e Médio no Brasil. O estudo ocorreu em uma escola pública de línguas com dois professores; os dados foram obtidos por meio de observações de aulas, questionários e entrevistas. Os resultados indicaram diferenças evidentes entre eles, e embora ambos reconheçam a interdependência entre língua e cultura e as considerem importantes no processo de ensino/aprendizagem de línguas, notamos contradições entre o discurso e a prática. Observamos que um deles não desenvolve o elemento cultural de forma sistemática, todavia o explora, e que o outro o trabalha de forma superficial. Depreendemos que eles não estabeleceram a abordagem cultural adotada, mas constatamos que um deles trabalha de forma bastante próxima da abordagem intercultural de modo intuitivo e implícito. Os resultados revelam ainda que os professores não enfocam profundamente espaços interculturais tão importantes para preparar o aprendiz para viver no mundo contemporâneo, conforme explicitam os PCNs.

Congenital abnormalities of the posterior fossa.

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Bosemani, Thangamadhan; Orman, Gunes; Boltshauser, Eugen; Tekes, Aylin; Huisman, Thierry A G M; Poretti, Andrea

2015-01-01

The frequency and importance of the evaluation of the posterior fossa have increased significantly over the past 20 years owing to advances in neuroimaging. Nowadays, conventional and advanced neuroimaging techniques allow detailed evaluation of the complex anatomic structures within the posterior fossa. A wide spectrum of congenital abnormalities has been demonstrated, including malformations (anomalies due to an alteration of the primary developmental program caused by a genetic defect) and disruptions (anomalies due to the breakdown of a structure that had a normal developmental potential). Familiarity with the spectrum of congenital posterior fossa anomalies and their well-defined diagnostic criteria is crucial for optimal therapy, an accurate prognosis, and correct genetic counseling. The authors discuss the spectrum of posterior fossa malformations and disruptions, with emphasis on neuroimaging findings (including diagnostic criteria), neurologic presentation, systemic involvement, prognosis, and risk of recurrence. RSNA, 2015

Posterior Probability Matching and Human Perceptual Decision Making.

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Richard F Murray

2015-06-01

Full Text Available Probability matching is a classic theory of decision making that was first developed in models of cognition. Posterior probability matching, a variant in which observers match their response probabilities to the posterior probability of each response being correct, is being used increasingly often in models of perception. However, little is known about whether posterior probability matching is consistent with the vast literature on vision and hearing that has developed within signal detection theory. Here we test posterior probability matching models using two tools from detection theory. First, we examine the models' performance in a two-pass experiment, where each block of trials is presented twice, and we measure the proportion of times that the model gives the same response twice to repeated stimuli. We show that at low performance levels, posterior probability matching models give highly inconsistent responses across repeated presentations of identical trials. We find that practised human observers are more consistent across repeated trials than these models predict, and we find some evidence that less practised observers more consistent as well. Second, we compare the performance of posterior probability matching models on a discrimination task to the performance of a theoretical ideal observer that achieves the best possible performance. We find that posterior probability matching is very inefficient at low-to-moderate performance levels, and that human observers can be more efficient than is ever possible according to posterior probability matching models. These findings support classic signal detection models, and rule out a broad class of posterior probability matching models for expert performance on perceptual tasks that range in complexity from contrast discrimination to symmetry detection. However, our findings leave open the possibility that inexperienced observers may show posterior probability matching behaviour, and our methods

Retention of the posterior cruciate ligament versus the posterior stabilized design in total knee arthroplasty: a prospective randomized controlled clinical trial

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van den Akker-Scheek Inge

2009-09-01

Full Text Available Abstract Background Prosthetic design for the use in primary total knee arthroplasty has evolved into designs that preserve the posterior cruciate ligament (PCL and those in which the ligament is routinely sacrificed (posterior stabilized. In patients with a functional PCL the decision which design is chosen depends largely on the favour and training of the surgeon. The objective of this study is to determine whether the patient's perceived outcome and speed of recovery differs between a posterior cruciate retaining total knee arthroplasty and a posterior stabilized total knee arthroplasty. Methods/Design A randomized controlled trial will be conducted. Patients who are admitted for primary unilateral TKA due to primary osteoarthrosis are included when the following inclusion criteria are met: non-fixed fixed varus or valgus deformity less than 10 degrees, age between 55 and 85 years, body mass index less than 35 kg/m2 and ASA score (American Society of Anaesthesiologists I or II. Patients are randomized in 2 groups. Patients in the posterior cruciate retaining group will receive a prosthesis with a posterior cut-out for the posterior cruciate ligament and relatively flat topography. In patients allocated to the posterior stabilized group, in which the posterior cruciate ligament is excised, the design may substitute for this function by an intercondylar tibial prominence that articulates with the femur in flexion. Measurements will take place preoperatively and 6 weeks, 3 months, 6 months and 1 year postoperatively. At all measurement points patient's perceived outcome will be assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC. Secondary outcome measures are quality of life (SF-36 and physician reported functional status and range of motion as determined with the Knee Society Clinical Rating System (KSS. Discussion In the current practice both posterior cruciate retaining and posterior stabilized designs

Biomechanical Effects of Posterior Condylar Offset and Posterior Tibial Slope on Quadriceps Force and Joint Contact Forces in Posterior-Stabilized Total Knee Arthroplasty

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Kyoung-Tak Kang

2017-01-01

Full Text Available This study aimed to determine the biomechanical effect of the posterior condylar offset (PCO and posterior tibial slope (PTS in posterior-stabilized (PS fixed-bearing total knee arthroplasty (TKA. We developed ±1, ±2, and ±3 mm PCO models in the posterior direction and −3°, 0°, 3°, and 6° PTS models using a previously validated FE model. The influence of changes in the PCO and PTS on the biomechanical effects under deep-knee-bend loading was investigated. The contact stress on the PE insert increased by 14% and decreased by 7% on average as the PCO increased and decreased, respectively, compared to the neutral position. In addition, the contact stress on post in PE insert increased by 18% on average as PTS increased from −3° to 6°. However, the contact stress on the patellar button decreased by 11% on average as PTS increased from −3° to 6° in all different PCO cases. The quadriceps force decreased by 14% as PTS increased from −3° to 6° in all PCO models. The same trend was found in patellar tendon force. Changes in PCO had adverse biomechanical effects whereas PTS increase had positive biomechanical effects. However, excessive PTS should be avoided to prevent knee instability and subsequent failure.

Abordagem integrativa: reterritorialização do saber clínico?

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Ana Cristina Sundfeld

Full Text Available Este artigo contextualiza o surgimento e a consolidação da Psicologia como ciência no período da modernidade e as repercussões do pensamento dessa época para o modelo e a prática psicológicos. Apresenta também as características da pós-modernidade e da subjetividade contemporânea a partir de uma perspectiva complexa, que redimensiona a visão clássica e propõe uma racionalidade diversa para a compreensão dos seres vivos. Baseando-se no pensamento complexo, aborda o movimento da abordagem integrativa em psicologia clínica, considerando-a uma expressão de importantes questionamentos no interior da Psicologia.

CT findings of posterior pararenal effusion

International Nuclear Information System (INIS)

Koh, Byung Hee; Cho, On Koo; Kim, Sonn Yong

1990-01-01

The posterior pararenal space(PPS) is a potential space between the posterior renal fascia and the transversalis fascia. We reviewed 12 cases of posterior pararenal effusion. The causes of the effusion were retroperitoneal hemorrhage due to trauma(7 cases) or rupture of renal tumor(1 case), pancreatitis(2 cases), urinoma (1 case) and amebic colitis of the cecum(1 case). The CT findings of the effusion were semilunar fluid density in the dependant portion of the PPS(9/12), partial obliteration of the PPS extending to the flank stripe(2/12), and total obliteration of the PPS extending to the anterior abdominal wall(1/12). The effusion in the ipsilateral perirenal space and thickening of the ipsilateral posterior renal fascia were combined in all cases. The effusion in the ipsilateral anterior pararenal space was associated in 11 cases of 12. The effusion in the PPS is not uncommon findings of retroperitoneal hemorrhage or effusion, but usually related with perirenal or anterior pararenal effusion with no clinical significance

No difference in gait between posterior cruciate retention and the posterior stabilized design after total knee arthroplasty

NARCIS (Netherlands)

van den Boom, Lennard G. H.; Halbertsma, Jan P. K.; van Raaij, Jos J. A. M.; Brouwer, Reinoud W.; Bulstra, Sjoerd K.; van den Akker-Scheek, Inge

2014-01-01

In the present study, knee joint kinematics (e.g. knee flexion/extension) and kinetics (e.g. knee flexion moments) are assessed after total knee arthroplasty (TKA) between patients implanted with either a unilateral posterior stabilized (PS) and a posterior cruciate-retaining (PCR) design. It was

Posterior distributions for likelihood ratios in forensic science.

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van den Hout, Ardo; Alberink, Ivo

2016-09-01

Evaluation of evidence in forensic science is discussed using posterior distributions for likelihood ratios. Instead of eliminating the uncertainty by integrating (Bayes factor) or by conditioning on parameter values, uncertainty in the likelihood ratio is retained by parameter uncertainty derived from posterior distributions. A posterior distribution for a likelihood ratio can be summarised by the median and credible intervals. Using the posterior mean of the distribution is not recommended. An analysis of forensic data for body height estimation is undertaken. The posterior likelihood approach has been criticised both theoretically and with respect to applicability. This paper addresses the latter and illustrates an interesting application area. Copyright © 2016 The Chartered Society of Forensic Sciences. Published by Elsevier Ireland Ltd. All rights reserved.

MRI evaluation of the posterior meniscus root tear

International Nuclear Information System (INIS)

Zhang Jianjun; Zheng Zhuozhao; Li Xuan

2010-01-01

Objective: To determine the value of MRI for diagnosing the posterior meniscus root tear. Methods: MR examinations of 30 patients with tear of the posterior meniscus root confirmed by knee arthroscopies were retrospectively reviewed. Of the 30 patients, 17 with posterior medial meniscus root tear (MMRT) and 13 with posterior lateral meniscus root tear (LMRT). The diagnostic sensitivity of' MRI for the posterior meniscus root tear was analyzed. Fisher's exact test was used to compare the detection rate of MRI for MMRT with that for LMRT. Results: All 17 cases with MMRT and 9 cases out of 13 with LMRT were correctly diagnosed by MRI and the diagnostic sensitivity of MRI for the posterior meniscus root tear was 86.7% (26/30). The main MR appearance of the posterior meniscus root tear was distortion of the meniscal root, with its low signal replaced by abnormal high signal. The detection rate of MRI for MMRT (17/17) was significantly greater than that for LMRT (9/13) (P=0.026). The prevalence of MMRT associated with meniscus extrusion (15/17) was significantly greater than that of LMRT (6/13) (P=0.020), but the prevalence of MMRT associated with anterior cruciate ligament (ACL) injury (5/17) was significantly lower than that of LMRT (11/13) (P=0.004). Conclusion: MRI is a relatively good method for detection of posterior meniscus root tears and associated injuries. (authors)

Variations of posterior vitreous detachment

OpenAIRE

Kakehashi, A.; Kado, M.; Akiba, J.; Hirokawa, H.

1997-01-01

AIMS—To identify variations in posterior vitreous detachment (PVD) and establish a clinical classification system for PVD.
METHODS—400 consecutive eyes were examined using biomicroscopy and vitreous photography and classified the PVD variations—complete PVD with collapse, complete PVD without collapse, partial PVD with thickened posterior vitreous cortex (TPVC), or partial PVD without TPVC.
RESULTS—In each PVD type, the most frequently seen ocular pathologies were as follows: in complete PVD ...

Isolated posterior capsular rupture following blunt head trauma

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Mansour AM

2014-11-01

Full Text Available Ahmad M Mansour, Mahmoud O Jaroudi, Rola N Hamam, Fadi C Maalouf Department of Ophthalmology, American University of Beirut, Beirut, Lebanon Abstract: Closed-globe traumatic cataract is not uncommon in males in the pediatric age group. However, there is a relative paucity of literature on isolated posterior lens capsule rupture associated with closed-globe traumatic cataract. We report a case of a 6-year-old boy who presented with white cataract 1 day after blunt trauma to the forehead associated with posterior capsular rupture that was detected by B-scan ultrasonography preoperatively. No stigmata of trauma outside the posterior capsule could be detected by slit-lamp exam, funduscopy, and optical coherence tomography. Phacoemulsification with posterior chamber intraocular lens implant was performed 24 hours after trauma, with the patient achieving 6/6 visual acuity 1 week and 6 months after surgery. Our case is unique, being the youngest (amblyogenic age to be reported, with prompt surgical intervention, and with no signs of trauma outside the posterior capsule. Keywords: posterior capsule rupture, forehead trauma, traumatic cataract, pediatric cataract

Uma abordagem sociológica da sociologia: a ciência como campo

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Vívian Matias dos Santos

2012-03-01

Full Text Available O presente ensaio objetiva analisar como o conceito de campo de Pierre Bourdieu pode contribuir para uma abordagem sociológica da Sociologia. A discussão desdobra-se desde a reflexão mais geral de como se firma a ciência até as possibilidades de compreensão da Sociologia neste espaço. Para tanto, fez-se necessário abordar o “campo científico” por meio das relações entre sua estrutura e seus agentes - relações “multidimensionais” que podem representar uma exitosa tentativa de superação da dicotomia ação/estrutura; indivíduo/sociedade; micro e macroteorização.

A abordagem da Avaliação Educacional em Larga Escala nos cursos de graduação em Pedagogia

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Marcela Mara dos Santos Silva

Full Text Available Resumo: A pesquisa fez um levantamento sobre a abordagem do conteúdo de Avaliação Educacional em Larga Escala (Aele nos cursos de Pedagogia presenciais, públicos e privados do País, bem como verificou a percepção de professores e coordenadores acerca da relevância dessa abordagem. Concluiu-se que foi baixo o índice de instituições de ensino superior (IES participantes desta pesquisa que ministram o conteúdo Aele, devendo-se atentar para tal ocorrência uma vez que o ensino desse conteúdo está previsto na legislação específica dos cursos de graduação em Pedagogia. Em geral, há embasamento legal na formulação da matriz curricular dos cursos e a maioria dos profissionais pesquisados tanto considera importante que o conteúdo seja contemplado quanto acompanha os resultados nacionais e estaduais, inserindo-os em sala de aula.

Posterior Urethroplasty Complexity and Prognosis Can be Described by a Novel Method: Posterior Urethral Stenosis Score.

Science.gov (United States)

Wang, Lin; Lv, Xiangguo; Jin, Chongrui; Guo, Hailin; Shu, Huiquan; Fu, Qiang; Sa, Yinglong

2018-02-01

To develop a standardized PU-score (posterior urethral stenosis score), with the goal of using this scoring system as a preliminary predictor of surgical complexity and prognosis of posterior urethral stenosis. We retrospectively reviewed records of all patients who underwent posterior urethral surgery at our institution from 2013 to 2015. The PU-score is based on 5 components, namely etiology (1 or 2 points), location (1-3 points), length (1-3 points), urethral fistula (1 or 2 points), and posterior urethral false passage (1 point). We calculated the score of all patients and analyzed its association with surgical complexity, stenosis recurrence, intraoperative blood loss, erectile dysfunction, and urinary incontinence. There were 144 patients who underwent low complexity urethral surgery (direct vision internal urethrotomy, anastomosis with or without crural separation) with a mean score of 5.1 points, whereas 143 underwent high complexity urethroplasty (anastomosis with inferior pubectomy or urethrorectal fistula repair, perineal or scrotum skin flap urethroplasty, bladder flap urethroplasty) with a mean score of 6.9 points. The increase of PU-score was predictive of higher surgical complexity (P = .000), higher recurrence (P = .002), more intraoperative blood loss (P = .000), and decrease of preoperative (P = .037) or postoperative erectile function (P = .047). However, no association was observed between PU-score and urinary incontinence (P = .213). The PU-score is a novel and meaningful scoring system that describes the essential factors in determining the complexity and prognosis for posterior urethral stenosis. Copyright © 2017. Published by Elsevier Inc.

Tradução - Uma Abordagem de Ensino/Aprendizagem para o Secretariado Executivo

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Aline Cantarotti

2012-07-01

Full Text Available O objetivo deste artigo é o de proporcionar aos professores e alunos de tradução no curso de Secretariado Executivo uma visão mais ampla acerca da abordagem de ensino/aprendizagem nessa área, apresentando primeiramente teorias e procedimentos da atividade tradutória e em seguida, propondo-se uma sequência didática tendo como gênero utilizado para a prática da tradução os contratos empresariais. Sua relevância se dá devido ao fato de ser necessária uma abordagem de ensino específica de tradução que se adeque às necessidades profissionais do secretário executivo, pois devido a globalização, as empresas estão cada vez mais expandindo seus negócios para o exterior. Para isso, elas precisam da intermediação do profissional de secretariado que esteja capacitado a realizar traduções adequadas, já que uma tradução mal sucedida pode comprometer toda a comunicação e trabalho de uma organização. A partir do plano de aula proposto, é possível demonstrar procedimentos para o ensino/aprendizagem de tradução que contribuam para uma sólida formação do secretário executivo especificamente em línguas estrangeiras e tradução, além de demonstrar a transformação do pensamento dos alunos sobre o conceito de tradução.DOI:10.7769/gesec.v3i1.98

Early endoscopic realignment in posterior urethral injuries.

Science.gov (United States)

Shrestha, B; Baidya, J L

2013-01-01

Posterior urethral injury requires meticulous tertiary care and optimum expertise to manage successfully. The aim of our study is to describe our experiences with pelvic injuries involving posterior urethra and their outcome after early endoscopic realignment. A prospective study was carried out in 20 patients with complete posterior urethral rupture, from November 2007 till October 2010. They presented with blunt traumatic pelvic fracture and underwent primary realignment of posterior urethra in our institute. The definitive diagnosis of urethral rupture was made after retrograde urethrography and antegrade urethrography where applicable. The initial management was suprapubic catheter insertion after primary trauma management in casualty. After a week of conservative management with intravenous antibiotics and pain management, patients were subjected to the endoscopic realignment. The follow up period was at least six months. The results were analyzed with SPSS software. After endoscopic realignment, all patients were advised CISC for the initial 3 months. All patients voided well after three months of CISC. However, 12 patients were lost to follow up by the end of 6 postoperative months. Out of eight remaining patients, two had features of restricture and were managed with DVU followed by CISC again. One patient with restricture had some degree of erectile dysfunction who improved significantly after phospodiesterase inhibitors. None of the patients had features of incontinence. Early endoscopic realignment of posterior urethra is a minimally invasive modality in the management of complete posterior urethral injury with low rates of incontinence and impotency.

Atividade lenta posterior: correlação eletro-clínica Posterior EEG slow activity: electro-clinical correlation

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Salustiano Gomes Lins

1971-06-01

Full Text Available Inicialmente é feita breve exposição dos cinco principais tipos de atividade lenta posterior descritas na literatura eletrencefalográfica: variedade lenta do ritmo alfa, ritmo theta posterior, ondas lentas posteriores a 4 hertz, ritmo delta associado ao pequeno mal e ondas Pi. Em seguida o autor expõe seus achados, baseado num material clínico composto por 760 pacientes, colhidos ao acaso, dos dois sexos e com idades variáveis entre 5 e 24 anos. Excetuando a variedade lenta do ritmo alfa, um ou mais dos outros quatro grafo-elementos referidos foram observados em 131 destes pacientes (80 do sexo masculino e 51 do sexo feminino pertencentes aos 3 primeiros grupos etários (5 a 19 anos. Sua predominância no sexo masculino não alcançou nível de significação estatística, mas a maior incidência nos grupos de menor idade foi significativa a 0,01. O ritmo theta posterior associou-se significativamente apenas a distúrbios de conduta com forte agressividade. Dos 131 casos referidos, 10 eram portadores de pequeno mal e destes, 5 apresentavam ritmo delta posterior (3 do sexo masculino e 2 do sexo feminino. Apenas em dois casos foi observado o ritmo lento posterior a 4 hertz, ambos com comemorativos de traumatismo craniano, seguido de distúrbios da conduta e agressividade.The five principal types of posterior slow activity are reviwed: the slow alpha variant rhythm; the posterior theta rhythm; the posterior slow waves at 4 c/s; the delta rhythm associated with petit mal; the so called Pi waves. The results with EEG tracings of 760 patients of both sexes with ages between 5 and 24 years are reviewed. Except for the slow alpha variant, at least one of the four other phenomena as observed in 131 patients (80 males end 51 females. The theta rhythm was observed in 49 cases (29 males and 20 females. This higher frequence among the males is not significant but the higher frequence among the younger and the association with a clinical picture of

Selective posterior lumbosacral rhizotomy for the management ...

African Journals Online (AJOL)

tion in 95% of cases. The majority showed ... selective posterior rhizotomy technique whereby the cauda equina ... assessed pre- and postoperatively by means of clinical examination ... were attending cerebral palsy schools and receiving spe- cialised ... root sections on cats demonstrated clearly that posterior root section ...

Possibly Ill-behaved Posteriors in Econometric Models

NARCIS (Netherlands)

L.F. Hoogerheide (Lennart); H.K. van Dijk (Herman)

2008-01-01

textabstractHighly non-elliptical posterior distributions may occur in several econometric models, in particular, when the likelihood information is allowed to dominate and data information is weak. We explain the issue of highly non-elliptical posteriors in a model for the effect of education on

Ipsilateral Traumatic Posterior Hip Dislocation, Posterior Wall and Transverse Acetabular Fracture with Trochanteric Fracture in an adult: Report of First Case

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Skand Sinha

2013-10-01

Full Text Available Introduction: Posterior dislocation of the hip joint with associated acetabular and intertrochanteric fracture is a complex injury. Early recognition, prompt and stable reduction is needed of successful outcome. Case Report: 45 year old male patient presented with posterior dislocation of the hip with transverse fracture with posterior wall fracture of acetabulam and intertrochanteric fracture on the ipsilateral side. The complex fracture geometry was confirmed by CT scan. The patient was successfully managed by open reduction and internal fixation of intertrochanteric fracture was achieved with dynamic hip screw (DHS plate fixation followed by fixation of acetabular fracture with reconstruction plate. Conclusion: Hip dislocation combined with acetabular fracture is an uncommon injury; this article presents a unique case of posterior wall and transverse fractures of ipsilateral acetabulum with intertrochanteric fracture in a patient who sustained traumatic posterior hip dislocation. Early surgical intervention is important for satisfactory outcomes of such complex fracture-dislocation injuries. Keywords: Hip dislocation; acetabular fractures; intertrochanteric fracture; operative treatment.

Abordagem da Catarata Congênita: análise de série de casos Approach to Congenital Cataract: case series analysis

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Marina Soares Viegas Moura Rezende

2008-02-01

Full Text Available A catarata congênita é uma causa importante de deficiência visual, principalmente por ambliopia, com prevalência aproximada de 0,4%. Seu manejo cirúrgico, inclusive em crianças, tem se desenvolvido, levando a melhores resultados visuais e contribuindo para o controle da ambliopia. OBJETIVO: Relatar os resultados precoces de uma série de casos submetidos a diferentes modalidades cirúrgicas para catarata congênita no Serviço de Catarata do Instituto de Oftalmologia Tadeu Cvintal (IOTC de janeiro de 2004 a janeiro de 2005. MÉTODOS: Estudo retrospectivo em 19 crianças (32 olhos com catarata congênita. A série de casos foi dividida em três grupos de acordo com a abordagem cirúrgica: lensectomia via pars plana, facoaspiração com e sem implante de lente intraocular. A acuidade visual corrigida final foi registrada com quatro meses de pós-operatório. RESULTADOS: Oito olhos foram submetidos à lensectomia, treze (13 à facoaspiração com implante de lente intra-ocular, e onze (11 à facoaspiração sem implante de lente intra-ocular. Em dez olhos foi realizada capsulotomia posterior primária. A única complicação observada foi opacidade de cápsula posterior em 60% (n=05 dos casos. Aproximadamente 43% dos pacientes (n=14 desenvolveram AV final corrigida entre 20/20 (LogMAR + 0.0 e 20/40 (LogMAR +0.3. Destes, oito (57% eram olhos de crianças operadas de ambos os olhos (catarata bilateral. A média de idade em que foram operadas, neste grupo de melhor acuidade, foi de sete anos. Sete (50% olhos foram submetidos a facoaspiração com implante de lente intra-ocular, e cinco (35% destes foram submetidos á capsulotomia posterior secundária. CONCLUSÃO: A série de casos analisada apresentou bons resultados cirúrgicos e funcionais precoces, embora trata-se de um número pequeno e heterogêneo de pacientes. O acompanhamento a longo prazo desses pacientes é essencial para avaliarmos que papel as diferentes indicações cirúrgicas t

A modalidade escrita do português como L2 para alunos surdos: análise de abordagem em classe de inclusão no ensino médio

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José de Sousa Silva

2011-04-01

Full Text Available Neste artigo buscamos analisar a abordagem de ensinar Língua Portuguesa em modalidade escrita numa classe inclusiva composta de alunos com surdez profunda e alunos ouvintes a partir da filmagem de uma aula de produção de texto com o intuito de interpretar evidências de adequação do insumo oferecido e co-construído em sala e de permeabilidade do filtro sócio-afetivo. Registrou-se uma abordagem formal textualistapouco voltada para a verdadeira inserção do surdo na escola regular dos ouvintes.

CT findings of traumatic posterior hip dislocation after reduction

International Nuclear Information System (INIS)

Moon, Sung Kyoung; Park, Ji Seon; Ryu, Kyung Nam; Jin, Wook; Jin Wook

2008-01-01

To evaluate the CT images of reduced hips after posterior hip dislocation and to propose specific diagnostic criteria based on the CT results. We retrospectively reviewed the CT findings on 18 reduced hips from 17 patients with radiographs and clinical histories of traumatic posterior hip dislocations by evaluating 18 corresponding CT scans for joint space asymmetry, intra-articular abnormalities (intra-articular fat obliteration, loose bodies, and joint effusion), changes in posterior soft tissue (capsule, muscles, and adjacent fat), the presence, and location of fractures (acetabulum and femoral head). All 18 hips (100%) showed posterior soft tissue changes. In total, 17 hips (94.4%) had intra-articular abnormalities and 15 hips (83.3%) had joint space asymmetries. In addition, 17 hips (94.4%) had fractures involving the acetabula (15 cases, 88.2%) the femoral head (13 cases, 76.5%), or on both sides (11 cases, 64.7%). The most frequent fracture location was in he posterior wall (13/15, 86.7%) of the acetabulum and in the anterior aspect (10/13, 76.9%) of the femoral head. Patients with a prior history of posterior hip dislocation showed specific CT findings after reduction, suggesting the possibility of previous posterior hip dislocations in patients

Posterior Reversible Encephalopathy (PRES)

International Nuclear Information System (INIS)

Moron E, Fanny E; Diaz Marchan, Pedro

2005-01-01

The Posterior Reversible Encephalopathy Syndrome (PRES) is a clinical Syndrome composed of cephalea, alteration in vision and convulsions, usually observed in patients with sudden elevation of arterial pressure. The imagenologic evidence shows reversible vasogenic brain edema without stroke. Its location is predominantly posterior; it affects the cortex and the subcortical white matter of the occipital, parietal and temporal lobes. The treatment with antihypertensive drugs and the removing of immunosupressor medication are generally associated with complete neurological recovery; this is reflected also in the images which return to their basal condition. The untreated hypertension, on the other side, can result in a progressive defect of the autoregulation system of the central nervous system with cerebral hemorrhage, irreversible brain stroke, coma and death

Post-partum posterior reversible encephalopathy syndrome

OpenAIRE

B. V. Triveni; Salman Mohammed Sheikh; Deepak Shedde

2014-01-01

Posterior Reversible Encephalopathy Syndrome (PRES) is a clinicopathological syndrome associated with various clinical conditions presenting with headache, encephalopathy, seizure and cortical visual disturbances. Radiological findings in PRES are thought to be due to vasogenic edema predominantly in posterior cerebral hemispheres and are reversible with appropriate management. We present a case of post partum PRES,A 29 year old primigravida of 33 weeks 3 days period of gestation who prese...

Posterior longitudinal ligament status in cervical spine bilateral facet dislocations

International Nuclear Information System (INIS)

Carrino, John A.; Manton, Geoffrey L.; Morrison, William B.; Flanders, Adam E.; Vaccaro, Alex R.; Schweitzer, Mark E.

2006-01-01

It is generally accepted that cervical spine bilateral facet dislocation results in complete disruption of the posterior longitudinal ligament. The goal of this study was to evaluate the integrity of numerous spine-stabilizing structures by MRI, and to determine if any associations between injury patterns exist with respect to the posterior longitudinal ligament status. Retrospective case series. A retrospective review was performed of 30 cervical spine injury subjects with bilateral facet dislocation. Assessment of 1.5T MRI images was carried out for: intervertebral disc disruption, facet fracture, and ligamentous disruption. Statistical analyses were performed to evaluate for associations between various injury patterns and posterior longitudinal ligament status. The frequency of MRI abnormalities was: anterior longitudinal ligament disruption (26.7%), disc herniation or disruption (90%), posterior longitudinal ligament disruption (40%), facet fracture (63.3%) and disruption of the posterior column ligament complex (97%). There were no significant associations between injury to the posterior longitudinal ligament and other structures. Compared to surgical reports, MRI was accurate for determining the status for 24 of 26 ligaments (three of three anterior longitudinal ligament, seven of nine posterior longitudinal ligament, and 14 of 14 posterior column ligament complex) but generated false negatives in two instances (in both MRI showed an intact posterior longitudinal ligament that was torn at surgery). (orig.)

O PROGRAMA PRIMEIRA INFÂNCIA MELHOR NO RIO GRANDE DO SUL: UMA AVALIAÇÃO À LUZ DA ABORDAGEM DAS CAPACITAÇÕES

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Melody de Campos Soares Porsse

2012-09-01

Full Text Available A Abordagem das Capacitações, desenvolvida por Amartya Sen, consiste em um amplo modelo normativo que pode ser usado como um instrumento alternativo para o desenho e avaliação de políticas públicas de acordo com seu impacto sobre as capacitações humanas. O artigo, empregando esse background, analisa o Programa Primeira Infância Melhor (PIM, uma política pública do Estado do Rio Grande do Sul lançada em 2003, e verificar se tal política está baseada na Abordagem das Capacitações. O trabalho usa informações referentes ao PIM para identificar quais os funcionamentos (e capacitações que o Programa insere em suas linhas de ação e que visa alcançar com a execução dessas ações. Embora o PIM não tenha sido criado com base na Abordagem das Capacitações, pode-se inferir que o Programa é orientado por essa perspectiva em suas linhas de ação, contribuindo para a expansão das capacitações humanas e para a redução da pobreza; tem como um dos seus alicerces a comunidade e a família, notadamente às mães, como os agentes cruciais na promoção do desenvolvimento e da saúde.

An unusual and spectacular case of spindle cell lipoma of the posterior neck invading the spinal cervical canal and posterior cranial fossa.

Science.gov (United States)

Petit, Damien; Menei, Philippe; Fournier, Henri-Dominique

2011-11-01

The authors describe the first case of spindle cell lipoma of the posterior neck invading the upper cervical spinal canal and the posterior cranial fossa. Spindle cell lipoma is an extremely rare variant of benign lipoma. It usually occurs as a solitary subcutaneous well-circumscribed lesion in the posterior neck or shoulders of adult men. Local aggressiveness is unusual. This 61-year-old man presented with an increased left cerebellar syndrome and headaches. He also had a posterior neck tumefaction, which had been known about for a long time. Computed tomography and MR imaging studies revealed a voluminous mass extending to the upper cervical canal and posterior cranial fossa and eroding the neighboring bones. The lesion was well delimited, and contrast enhancement was intense and heterogeneous. The tumor, which had initially developed under the muscles of the posterior neck, was totally resected. Histological assessment revealed numerous fat cells with spindle cells secreting collagen. The large size of the tumor and the submuscular location, bone erosion, and compression of the CNS were unusual in this rare subtype of benign adipose tumor. Its presentation could simulate a sarcoma.

Analytic posteriors for Pearson's correlation coefficient.

Science.gov (United States)

Ly, Alexander; Marsman, Maarten; Wagenmakers, Eric-Jan

2018-02-01

Pearson's correlation is one of the most common measures of linear dependence. Recently, Bernardo (11th International Workshop on Objective Bayes Methodology, 2015) introduced a flexible class of priors to study this measure in a Bayesian setting. For this large class of priors, we show that the (marginal) posterior for Pearson's correlation coefficient and all of the posterior moments are analytic. Our results are available in the open-source software package JASP.

Analytic posteriors for Pearson's correlation coefficient

OpenAIRE

Ly, A.; Marsman, M.; Wagenmakers, E.-J.

2018-01-01

Pearson's correlation is one of the most common measures of linear dependence. Recently, Bernardo (11th International Workshop on Objective Bayes Methodology, 2015) introduced a flexible class of priors to study this measure in a Bayesian setting. For this large class of priors, we show that the (marginal) posterior for Pearson's correlation coefficient and all of the posterior moments are analytic. Our results are available in the open‐source software package JASP.

Evaluation of the outcomes after posterior urethroplasty.

Science.gov (United States)

Liberman, Daniel; Pagliara, Travis J; Pisansky, Andrew; Elliott, Sean P

2015-03-01

Posterior urethral injury is a clinically significant complication of pelvic fractures. The management is complicated by the associated organ injuries, distortion of the pelvic anatomy and the ensuing fibrosis that occurs with urethral injury. We report a review of the outcomes after posterior urethroplasty in the context of pelvic fracture urethral injury.

Frequency and determinants for hemorrhagic transformation of posterior cerebral stroke : Posterior ischemic stroke and hemorrhagic transformation.

Science.gov (United States)

Valentino, Francesca; Gentile, Luana; Terruso, Valeria; Mastrilli, Sergio; Aridon, Paolo; Ragonese, Paolo; Sarno, Caterina; Savettieri, Giovanni; D'Amelio, Marco

2017-11-13

hemorrhagic transformation is a threatening ischemic stroke complication. Frequency of hemorrhagic transformation differs greatly among studies, and its risk factors have been usually studied in patients with anterior ischemic stroke who received thrombolytic therapy. We evaluated, in a hospital-based series of patients with posterior ischemic stroke not treated with thrombolysis, frequency and risk factors of hemorrhagic transformation. Patients with posterior circulation stroke were seen in our Department during the period January 2004 to December 2009. Demographic and clinical information were collected. We estimated risk for spontaneous hemorrhagic transformation by means of uni- and multivariate logistic regression analyses. 119 consecutive patients were included (73 males, 61.3%). Hemorrhagic transformation was observed in 7 patients (5.9%). Only clinical worsening was significantly associated with hemorrhagic transformation (OR 6.8, 95% CI 1.3-34.5). Our findings indicate that patients with posterior have a low risk of spontaneous hemorrhagic transformation, suggesting that these patients might have greater advantage from intravenous thrombolysis.

Management of Posterior Urethral Valves in Rural Kenya

African Journals Online (AJOL)

Management of Posterior Urethral Valves in Rural. Kenya .... Antwi S. Audit of Posterior Urethral Valve (PUV) in Children at ... Community Paediatrics Committee, Infectious. Diseases ... Effect of Circumcision on Risk of Urinary Tract. Infection in ...

Tuberothalamic Artery Infarction Following Coil Embolization of a Ruptured Posterior Communicating Artery Aneurysm Belonging to a Transitional Type Posterior Cerebral Artery

Science.gov (United States)

Lee, Kyeong Duk; Kwon, Soon Chan; Muniandy, Sarawana; Park, Eun Suk; Sim, Hong Bo; Lyo, In Uk

2013-01-01

Summary There are many potential anatomical variations in the connection between the internal carotid artery and the posterior circulation through the posterior communicating artery (PCoA). We describe the endovascular treatment of an aneurysm arising near the origin of the PCoA belonging to a transitional type posterior cerebral artery. Coil embolization subsequently resulted in thrombo-occlusion of the adjacent PCoA causing thalamic infarction even though sufficient retrograde flow had been confirmed pre-operatively by Allcock’s test. PMID:24070079

Convergence of posteriors for discretized log Gaussian Cox processes

DEFF Research Database (Denmark)

Waagepetersen, Rasmus Plenge

2004-01-01

In Markov chain Monte Carlo posterior computation for log Gaussian Cox processes (LGCPs) a discretization of the continuously indexed Gaussian field is required. It is demonstrated that approximate posterior expectations computed from discretized LGCPs converge to the exact posterior expectations...... when the cell sizes of the discretization tends to zero. The effect of discretization is studied in a data example....

Posterior Mediastinal Tumors: Outcome of Surgery

International Nuclear Information System (INIS)

Abd Rahman, A.M.; Sedera, M.A.; Mourad, I.A.; Aziz, S.A.; Saber, T.K.H.; Al Sakary, M.A.

2005-01-01

The incidence of posterior mediastinal tumors relative to all tumors of the mediastinum is 23% to 30%. The posterior mediastinum is a potential space along each side of the vertebral column and adjacent proximal portion of the ribs. Primary tumors of posterior mediastinum are usually neurogenic. The aim of this study was to evaluate different surgical approaches used for the resection of posterior mediastinal tumors, and to assess morbidity, mortality and patients survival. Patients and Methods: Between January 200 I and January 2004, 30 patients with posterior mediastinal tumors were included. CT scan of the chest and CT guided biopsy were done for all patients; whereas MRI was done for suspected intraspinal extension. Posterolateral thoracotomy was the approach used in most of the patients. The Akwari approach was used in most of the patients with Dumbbell tumors. Neurogenic tumors constituted 67% of cases, being neuroblastoma in 60%. The non neurogenic tumors included a heterogenous group of rare tumors (n=10). Dumbbell tumors were found in 10 patients. Neuroblastoma was the commonest tumor to cause intraspinal extension (40%). Wide local excision was done in 13 patients; whereas extended resection was done in the remaining 17 patients. The mean intra-operative blood loss was 800cc and the mean hospital stay was 12 days. The size of the resected tumor ranged from 3X4cm to 30X22cm, 80% of tumors were malignant. Morbidity in relation to the procedures developed in 8 patients (atelectasis, meningitis, paraplegia, Horner syndrome and mild wound sepsis in 4, I, I, 1 and I of the patients; respectively). One postoperative mortality, due to meningitis was recorded. The overall survival by the end of three years was 87.7% with a mean survival of 30.4 months. The overall disease free survival was 55.9% with a mean disease free survival of 26.2 months. Posterior mediastinal tumors may reach large size before becoming symptomatic. Complete surgical excision (including

Posterior amorphous corneal dystrophy: case report

OpenAIRE

Oliveira, Lauro Augusto de [UNIFESP; Vieira, Luiz Antônio [UNIFESP; Freitas, Denise de [UNIFESP; Sousa, Luciene Barbosa de [UNIFESP

2006-01-01

O objetivo deste trabalho é alertar o oftalmologista da possibilidade de se deparar com casos raros de distrofias corneanas. Neste caso correlacionamos os achados clínicos da distrofia amorfa posterior com refração, topografia e biomicroscopia ultra-sônica.The purpose of this paper is to warn the ophthalmologist about the possibility of facing rare cases of corneal dystrophies. Clinical findings of a case of posterior amorphous dystrophy were correlated with refraction, topography, and ultras...

Posterior atlantoaxial dislocation without odontoid fracture

International Nuclear Information System (INIS)

Chaudhary, Reema; Raut, Abhijit; Chaudhary, Kshitij; Metkar, Umesh; Rathod, Ashok; Sanghvi, Darshana

2008-01-01

We report a case of posterior atlantoaxial dislocation without a fracture of the odontoid in a 35-year-old woman. There have been nine reported cases of similar injury in the English literature. The integrity of the transverse ligament following posterior atlantoaxial dislocations has not been well documented in these reports. In the present case, MRI revealed an intact transverse ligament, which probably contributed to the stability of the C1-C2 complex following closed reduction. (orig.)

Vermian agenesis without posterior fossa cyst

International Nuclear Information System (INIS)

Adamsbaum, C.; Moreau, V.; Bulteau, C.; Burstyn, J.; Lair Milan, F.; Kalifa, G.

1994-01-01

We report 11 cases of vermian partial agenesis without posterior fossa cyst or hemispheric abnormalities. Characteristic MR signs were: absence of the posterior lobe, hypoplasia of the anterior lobe, a narrow sagittal cleft separating the hemispheres (''buttocks sign'') and fourth ventricle deformity. The main clinical signs were complex oculomotor dysfunction and developmental delay. None of the patients had respiratory symptoms. Consideration is given to the relationship between Joubert syndrome and this entity as well as to embroyological data. (orig.)

Mature teratoma of the posterior mediastinum

International Nuclear Information System (INIS)

Kurosaki, Y.; Tanaka, Y.O.; Itai, Y.

1998-01-01

The vast majority of germ cell tumors in the thorax arise at or near the thymus. We report a case of a 41-year-old man with mature teratoma of the posterior mediastinum. He was asymptomatic and was incidentally found to have a posterior mediastinal mass. Computed tomography was helpful in suggesting a diagnosis of mature teratoma by demonstrating the presence of fat and calcification. The differential diagnosis included neurogenic tumors, liposarcoma, and extramedullary hematopoiesis. (orig.)

Late presentation of posterior urethral valves.

Science.gov (United States)

Jalbani, Imran Khan; Biyabani, Syed Raziuddin

2014-05-01

Presence of posterior urethral valves (PUV) is the most common cause of urinary tract obstruction in the male neonate. Late presentation occurs in 10% of cases. We present a case of PUVs in an adult male who presented with history of obstructive lower urinary tract symptoms and hematuria. On evaluation, he was found to have raised serum creatinine level. A voiding cystourethrogram (VCUG) could not be completely performed because of narrowing in the posterior urethra. A rigid urethrocystoscopy was performed at which he was found to have type-I posterior urethral valve which were fulgurated. A repeat uroflowmetry revealed maximum flow rate of 12 ml/second. This case highlights that PUVs is not solely a disease of infancy but may also present late. VCUG is the radiological investigation of choice but the diagnosis may be missed. A urethrocystoscopy is advised if there is a high index of suspicion.

Surgical revascularization of posterior coronary arteries without cardiopulomonary bypass

Directory of Open Access Journals (Sweden)

Lobo Filho J. Glauco

1999-01-01

Full Text Available OBJECTIVE: To assess the results observed during the early postoperative period in patients who had the posterior coronary arteries revascularized without cardiopulmonary bypass (CPB, in regard to the following parameters: age, sex,bypass grafts types, morbidity and mortality. METHODS: From January 1995 to June 1998, 673 patients underwent myocardial revascularization (MR. Of this total, 607 (90.20% MR procedures were performed without CPB. The posterior coronary arteries (PCA were revascularized in 298 (44.27% patients, 280 (93.95% without CPB. The age of the patients ranged from 37 to 88 years (mean, 61 years. The male gender predominated, with 198 men (70.7%. The revascularization of the posterior coronary arteries had the following distribution: diagonalis artery (31 patients, 10%; marginal branches of the circumflex artery (243 patients, 78.7%; posterior ventricular artery (4 patients, 1.3%; and posterior descending artery (31 patients, 10%. RESULTS: Procedure-related complications without death occurred in 7 cases, giving a morbidity of 2.5%. There were 11 deaths in the early postoperative period (mortality of 3.9%. CONCLUSION: Similarly to the anterior coronary arteries, the posterior coronary arteries may benefit from myocardial revascularization without CPB.

Cisternography of the posterior fossa with metrizamide

Energy Technology Data Exchange (ETDEWEB)

Kobayashi, N.; Saito, Y.; Miyashita, T.; Tajika, Y.

1981-12-01

Nine patients underwent metrizamide cisternography of the posterior fossa. Excellent opacification of the fourth ventricle resulted when the patient's head was suitably positioned and the contrast material was introduced via a C1-2 puncture. With this technique, a benign aqueductal stenosis can be readily identified and the posterior fossa and fourth ventricle can be studied easily.

Posterior mediastinal teratoma diagnosis by computerized tomography and ultrasonography

Energy Technology Data Exchange (ETDEWEB)

Choo, Yeon Myung; Im, Chung Kie; Yeon, Kyung Mo; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1984-09-15

Teratomas, usually arising in the anterior mediastinum, are very uncommon in the posterior mediastinum. Embryologic development of anterior mediastinal teratoma is thought to be from thymic anlage which descends from the third bronchial cleft and pouch, while that of posterior mediastinal teratoma is thought to be from the remnant of notochord. CT findings of posterior mediastinal teratomas are not different from teratomas elsewhere, containing fat, calcification, soft tissue and thick walled cyst. Ultrasonographic findings are mixed echogenic mass containing cystic portion, highly reflective solid portion and area of acoustic shadowing. Authors recently experienced 2 cases of surgically proven posterior mediastinal teratoma and report with review of literature.

Posterior mediastinal teratoma diagnosis by computerized tomography and ultrasonography

International Nuclear Information System (INIS)

Choo, Yeon Myung; Im, Chung Kie; Yeon, Kyung Mo; Han, Man Chung

1984-01-01

Teratomas, usually arising in the anterior mediastinum, are very uncommon in the posterior mediastinum. Embryologic development of anterior mediastinal teratoma is thought to be from thymic anlage which descends from the third bronchial cleft and pouch, while that of posterior mediastinal teratoma is thought to be from the remnant of notochord. CT findings of posterior mediastinal teratomas are not different from teratomas elsewhere, containing fat, calcification, soft tissue and thick walled cyst. Ultrasonographic findings are mixed echogenic mass containing cystic portion, highly reflective solid portion and area of acoustic shadowing. Authors recently experienced 2 cases of surgically proven posterior mediastinal teratoma and report with review of literature.

Two cases of posterior scleritis and findings of computerized tomography and ultrasonography

International Nuclear Information System (INIS)

Ohara, Takakazu; Uji, Yukitaka; Fujioka, Chieko; Mori, Kazuma

1982-01-01

Two cases of unilateral posterior scleritis, seen in 56-year-old and 68-year-old females, are reported. Computerized tomography showed characteristic findings, as follows: 1) Thickening of the posterior sclera and surrounding tissue. 2) Irregularity of the posterior wall of the eyeball. 3) Increased radiographic density in the posterior wall of the eyeball. Ultrasonography also suggested thickening of the posterior sclera. Computerized tomography and ultrasonography are considered useful in the diagnosis of posterior scleritis. (author)

Uma abordagem arquitetural para o desenvolvimento rigoroso de sistemas confiáveis baseados em componentes

OpenAIRE

Patrick Henrique da Silva Brito

2009-01-01

Resumo: A incorporação de tolerância a falhas em sistemas de software normalmente acarreta em um aumento da complexidade, o que consequentemente torna a sua análise mais difícil. Além disso, o uso de mecanismos de tratamento de exceções de uma maneira não-sistemática pode acarretar na adição de novas falhas ao sistema. Esta tese apresenta uma abordagem rigorosa e centrada na arquitetura para o desenvolvimento de sistemas de software tolerantes a falhas. Dependendo do modelo de falhas e da dis...

Abordagem proteômica para estudos de fotobiologia e fotoinativação de fungos

OpenAIRE

Guilherme Thomaz Pereira Brancini

2015-01-01

A proteômica é uma técnica muito importante e amplamente utilizada na elucidação de diversos mecanismos biológicos. Essa técnica pode ser usada, por exemplo, na avaliação da resposta celular a estímulos ou na determinação de modificações proteicas resultantes de um tratamento. Neste trabalho, a abordagem proteômica foi utilizada em dois sistemas diferentes: (1) na elucidação da resposta à luz no fungo Metarhizium acridum e (2) na determinação dos danos proteicos causados pelo tratamento fotod...

Ensino interativo na abordagem de Eletricidade numa escola portuguesa

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Maria José Quintas

2016-12-01

Full Text Available http://dx.doi.org/10.5007/2175-7941.2016v33n3p839 A exploração de materiais didáticos interactivos é vista como potenciadora de uma melhor aprendizagem da Física. Neste trabalho apresentam-se alguns resultados obtidos da realização de atividades práticas de laboratório (APL e exploração de ferramentas baseadas em recursos educativos digitais (RED, na abordagem de Eletricidade em algumas escolas portuguesas. Nesta investigação, os alunos foram divididos em Grupo Experimental (GE e Grupo de Controlo (GC. Na recolha dos dados foram usadas fichas, relatórios de aula, inquéritos e entrevistas. Os resultados apontam para uma melhor aprendizagem dos alunos do GE, validando assim as hipóteses de qualidade e de continuidade desta prática de ensino e aprendizagem nas escolas. Este trabalho mostra também que quer a utilização pelos alunos dos materiais interativos quer a formação dos professores na exploração desses materiais, são necessárias para promover uma aprendizagem colaborativa.

Unsuccessful outcomes after posterior urethroplasty.

Science.gov (United States)

Engel, Oliver; Fisch, Margit

2015-03-01

Posterior urethroplasty is the most common strategy for the treatment of post-traumatic urethral injuries. Especially in younger patients, post-traumatic injuries are a common reason for urethral strictures caused by road traffic accidents, with pelvic fracture or direct trauma to the perineum. In many cases early endoscopic realignment is the first attempt to restore the junction between proximal and distal urethra, but in some cases primary realignment is not possible or not enough to treat the urethral injury. In these cases suprapubic cystostomy alone and delayed repair by stricture excision and posterior urethroplasty is an alternative procedure to minimise the risk of stricture recurrence.

Mature teratoma of the posterior mediastinum

Energy Technology Data Exchange (ETDEWEB)

Kurosaki, Y.; Tanaka, Y.O.; Itai, Y. [Department of Radiology, Institute of Clinical Medicine, University of Tsukuba, Tsukuba-shi, Ibaraki-ken 305 (Japan)

1998-02-01

The vast majority of germ cell tumors in the thorax arise at or near the thymus. We report a case of a 41-year-old man with mature teratoma of the posterior mediastinum. He was asymptomatic and was incidentally found to have a posterior mediastinal mass. Computed tomography was helpful in suggesting a diagnosis of mature teratoma by demonstrating the presence of fat and calcification. The differential diagnosis included neurogenic tumors, liposarcoma, and extramedullary hematopoiesis. (orig.) With 2 figs., 18 refs.

Computação dendrítica : uma abordagem de física estatística

OpenAIRE

Lyra Gollo, Leonardo

2007-01-01

No campo da neurociência computacional, a atividade elétrica dos neurônios é tradicionalmente modelada por equações diferenciais não-lineares acopladas, representando a evolução do potencial de membrana e certas variáveis relacionadas às condutâncias iônicas presentes no sistema. Uma tendência recente consiste na extensão desta estratégia de modelagem, detalhando as árvores dendríticas neuronais através da abordagem compartimental. Essa modelagem fina visa examinar a possibilid...

Alteraciones del polo posterior en la miopía degenerativa Alterations of the posterior pole in degenerative myopia patients

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Suzel Ivón Lapido Polanco

2012-12-01

Full Text Available La miopía degenerativa constituye una de las causas fundamentales de pérdida de la visión. Esto está relacionado con las alteraciones del polo posterior, que afectan la retina neurosensorial, el epitelio pigmentario de la retina y las capas más internas de la coroides. Su curso lento y progresivo demanda una exploración integral, con seguimiento en el tiempo y constituye un reto para el oftalmólogo. Se realizó una revisión de artículos publicados e indexados en la base de datos de PubMed que se refirieran a las características clínicas del fondo de ojo en pacientes con miopía degenerativa, para describir las principales alteraciones del polo posterior del globo ocular en esta entidad. Se encontró entre las lesiones típicas de la alta miopía, al estafiloma posterior como un signo patognomónico de la enfermedad, asociado a la atrofia coriorretiniana en parches o difusa, así como las estrías de laca y las hemorragias maculares secundarias a ellas o provenientes de membranas neovasculares coroideas. La tomografía de coherencia óptica ha permitido un diagnóstico más preciso de otras lesiones maculares como la foveosquisis, el agujero macular y, más recientemente, la mácula en domo. Los cambios degenerativos del polo posterior parecen guardar relación unos con otros pero la patogenia no ha sido bien esclarecida a pesar de los avances tecnológicos.Degenerative myopia is one of the main causes of visual impairment. This is related to disorders in the posterior pole, affecting the neurosensorial retina, the retinal pigmented epithelium and the inner choroidal layers. The slow and progressive course of this condition demands comprehensive assessment and long follow-up, which is a challenging task for ophthalmologists. A review of the articles indexed in PubMed regarding the clinical characteristics of the fundus in patients with degenerative myopia was made to describe the main disorders of the posterior pole of the eyeball

The bihemispheric posterior inferior cerebellar artery

International Nuclear Information System (INIS)

Cullen, Sean P.; Ozanne, Augustin; Alvarez, Hortensia; Lasjaunias, Pierre

2005-01-01

Rarely, a solitary posterior inferior cerebellar artery (PICA) will supply both cerebellar hemispheres. We report four cases of this variant. We present a retrospective review of clinical information and imaging of patients undergoing angiography at our institution to identify patients with a bihemispheric PICA. There were four patients: three males and one female. One patient presented with a ruptured arteriovenous malformation, and one with a ruptured aneurysm. Two patients had normal angiograms. The bihemispheric PICA was an incidental finding in all cases. The bihemispheric vessel arose from the dominant left vertebral artery, and the contralateral posterior inferior cerebellar artery was absent or hypoplastic. In all cases, contralateral cerebellar supply arose from a continuation of the ipsilateral PICA distal to the choroidal point and which crossed the midline dorsal to the vermis. We conclude that the PICA may supply both cerebellar hemispheres. This rare anatomic variant should be considered when evaluating patients with posterior fossa neurovascular disease. (orig.)

Agenesis of the posterior arch of the atlas

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Torriani Martin

2002-01-01

Full Text Available PURPOSE: To illustrate the radiological findings and review the current literature concerning a rare congenital abnormality of the posterior arch of the atlas. CASE REPORT: An adult female without neurological symptoms presented with an absent posterior arch of the atlas, examined with plain films and helical computerized tomography. Complete agenesis of the posterior arch of the atlas is a rare entity that can be easily identified by means of plain films. Although it is generally asymptomatic, atlantoaxial instability and neurological deficits may occur because of structural instability. Computerized tomography provides a means of assessing the extent of this abnormality and can help evaluate the integrity of neural structures. Although considered to be rare entities, defects of the posterior arch of the atlas may be discovered as incidental asymptomatic findings in routine cervical radiographs. Familiarity with this abnormality may aid medical professionals in the correct management of these cases.

Abordagem do paciente reanimado, pós-parada cardiorrespiratória Care of patient resuscitated from cardiac arrest

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João Carlos Ramos Gonçalves Pereira

2008-06-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: A parada cardiorrespiratória (PCR ocorrida em ambulatório tem elevada mortalidade, sendo a sobrevida entre 5% e 35%. Dos pacientes que são reanimados uma percentagem elevada permanece com déficits neurológicos, resultantes das lesões ocorridas, tanto no período de ausência de circulação ou durante a reperfusão. No entanto a compreensão dos mecanismos da lesão cerebral não tem traduzido na melhoria do prognóstico. A hipotermia terapêutica após a reanimação parece ser uma opção válida associada à diminuição destas seqüelas neurológicas. O objetivo deste estudo foi rever a evidência científica relativa à abordagem do paciente reanimado após PCR. CONTEÚDO: Descrição e abordagem dos principais fatores de risco associados à lesão neurológica após PCR, bem como dos seus critérios de prognóstico.Feita pesquisa não sistemática na base de dados PubMed dos artigos referentes à abordagem terapêutica dos pacientes reanimados de parada cardíaca. As referências bibliográficas dos artigos de revisão foram igualmente analisadas. Elaboradas normas práticas para essa abordagem. CONCLUSÕES: Os pacientes que sobrevivem à PCR têm elevado risco de permanecer com lesões neurológicas graves. A hipotermia terapêutica e o controle das variáveis fisiológicas, com otimização da perfusão cerebral, podem melhorar o seu prognóstico.BACKGROUND AND OBJECTIVES: Out-of-hospital cardiac arrest is a major cause of death with survival rates as low as 5% to 35%. A large number of patients who survive resuscitation will face significant neurological damage, as a result of the ischemia that occurs both during cardiac arrest and reperfusion. However understanding of the mechanisms responsible for brain damage has not resulted in prognostic improvement. Therapeutic hypothermia after resuscitation may be a valid option associated to reduction of neurological damage. The purpose of this study was to

Neurenteric cyst of the posterior mediastinum

International Nuclear Information System (INIS)

Setty, H.A.N.; Hegde, K.K.S.; Narvekar, V.N.

2005-01-01

We report a case of a large posterior mediastinal neurenteric cyst in a neonate demonstrated by chest radiographs, barium swallow examination, ultrasonography and CT of the thorax. All the investigations revealed a large posterior mediastinal cystic mass with vertebral anomalies in the form of scoliosis and hemivertebra. The cyst was completely excised by a right posterolateral thoracotomy and biopsy showed the features of a neurenteric cyst. The rarity of the lesion prompted us to report this case Copyright (2005) Blackwell Publishing Asia Pty Ltd

Minimally invasive surgical approach to treat posterior urethral diverticulum

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Ossamah Alsowayan

2015-01-01

Full Text Available Urethral diverticulum is a localized saccular or fusiform out-pouching of the urethra. It may occur at any point along the urethra in both male and females. Male urethral diverticulum is rare, and could be either congenital or acquired, anterior or posterior. The mainstay treatment of posterior urethral diverticulum (PUD is the open surgical approach. Here we discuss our minimally invasive surgical approach (MIS in managing posterior urethral diverticulum.

AROMAS E SABORES: UMA ABORDAGEM GEOGRÁFICA NA EDUCAÇÃO AMBIENTAL

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Leonardo Pinto dos Santos

2013-04-01

Full Text Available O presente trabalho visa explorar as possiblidades presentes nos sentidos paladar, olfato e/ou tato dentro do ensino da ciência geográfica com abordagem para a Educação Ambiental, levando discentes e educadores a (re inventar saberes e fazeres na educação básica. Dentro da oficina intitulada de “geografia dos aromas e sabores” os alunos participantes do Programa Institucional de Bolsa de Iniciação à Docência explorarão a sensibilidade propiciada por parte dos sentidos humanos na compreensão da ampla interdependência global a qual estamos vivendo, levando-os a percepção do quando se torna importante pensarmos em uma conscientização coletiva sobre o meio ambiente e sobre nossas práticas cotidianas.

Retention of the posterior cruciate ligament versus the posterior stabilized design in total knee arthroplasty : a prospective randomized controlled clinical trial

NARCIS (Netherlands)

van den Boom, L.G.H.; Brouwer, R.W.; van den Akker-Scheek, I.; Bulstra, S.K.; van Raaij, J.J.A.M.

2009-01-01

Background: Prosthetic design for the use in primary total knee arthroplasty has evolved into designs that preserve the posterior cruciate ligament (PCL) and those in which the ligament is routinely sacrificed (posterior stabilized). In patients with a functional PCL the decision which design is

Distrofia corneana polimorfa posterior em Síndrome de Alport

OpenAIRE

Godoy, Flavia Ribeiro Monteiro de; Qahtani, Elham Al; Lyons, Christopher J.

2016-01-01

ABSTRACT We describe a six-year-old boy with a history of hematuria, posterior polymorphous corneal dystrophy and dots and fleck retinopathy. Alport syndrome should be ruled out in patients presenting with posterior polymorphous corneal dystrophy or anterior lenticonus and a family history of renal disease. RESUMO Descrevemos um paciente de 6 anos de idade com história de hematúria, distrofia corneana polimorfa posterior e retinopatia em "dots and flecks". Síndrome de Alport deve ser exclu...

Distrofia policromática posterior da córnea

OpenAIRE

Coelho, Letícia Maria; Muinhos, Guilherme Kfoury; Tanure, Marco Antônio Guarino; Almeida, Homero Gusmão de; Sieiro, Reinaldo de Oliveira

2015-01-01

Os autores descrevem dois casos de distrofia policromática posterior da córnea, uma distrofia pré-Descemet, pouco descrita nas literaturas nacional e mundial, em que se observam pontos policromáticos difusos no estroma posterior da córnea, sem aparente comprometimento da visão. The authors describe two cases of posterior polychromatic corneal dystrophy, a pre-Descemet dystrophy, poorly described in national and world literatures, characterized by diffuse polychromatic points on the posteri...

Language teaching and fairytales: contextualized teaching, a new approach = Ensino de língua e contos de fada: ensino contextualizado, uma nova abordagem

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Baratz, Ana Hemmons

2012-01-01

Full Text Available Como podemos instigar a imaginação da criança em favor do ensino de língua? Egan (1992 aponta uma abordagem de ensino infantil que difere do comum. Essa abordagem trás para o centro do currículo a imaginação da criança. ‘Ensinando com contexto’ (usando contos de fadas pode ser relacionando aos gêneros de Bakhtin. Eles estão presentes no nosso cotidiano e são impossíveis de separar do aprendizado de língua. Duas versões de um mesmo conto-de-fadas foram linguisticamente comparados através de uma análise de corpus com o fim de investigar qual versão seria a ideal para uso em contexto escolar. As estórias analisadas são de Branca de Neve e Cinderela, uma versão traduzida do Alemão e outra recentemente adaptada da mesma

Difficult management of posterior urethra gunshot wound combined ...

African Journals Online (AJOL)

Posterior urethra gunshot wounds are poorly described in the literature. They are often associated with pelvic vital lesions making difficult early repair of urethral injuries. They can be complicated by urethrorectal fistula, which makes their management more complicated. We report a new case of posterior urethra disruption ...

Medial epiphyseal fracture-detachment of the sternoclavicular joint with posterior displacement in a judo athlete - equivalent of posterior sternoclavicular dislocation

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Rui Pimenta

2013-04-01

Full Text Available Posterior sternoclavicular dislocation is a rare traumatic injury that presents a potential risk of injury to mediastinal structures. The diagnosis is fundamentally clinical and treatment is done on an emergency basis. The authors report the clinical case of a young judo athlete with post-traumatic medial epiphyseal fracture-detachment, with posterior displacement (lesion equivalent to posterior sternoclavicular dislocation at pediatric ages. He underwent open reduction and ligament repair by means of a mini-anchor.The radiological and clinical outcome was excellent, and the athlete returned to his sports activity without limitations. We discuss the particular features of this pathological condition, along with the different therapeutic approaches and their complications

Traumatic Posterior Atlantoaxial Dislocation Without Associated Fracture but With Neurological Deficit

Science.gov (United States)

Xu, Yong; Li, Feng; Guan, Hanfeng; Xiong, Wei

2015-01-01

Abstract Posterior atlantoaxial dislocation without odontoid fracture is extremely rare and often results in fatal spinal cord injury. According to the reported literature, all cases presented mild or no neurologic deficit, with no definite relation to upper spinal cord injury. Little is reported about traumatic posterior atlantoaxial dislocation, with incomplete quadriplegia associated with a spinal cord injury. We present a case of posterior atlantoaxial dislocation without associated fracture, but with quadriplegia, and accompanying epidural hematoma and subarachnoid hemorrhage. The patient underwent gentle traction in the neutral position until repeated cranial computed tomography revealed no progression of the epidural hematoma. Thereafter, the atlantoaxial dislocation was reduced by using partial odontoidectomy via a video-assisted transcervical approach and maintained with posterior polyaxial screw-rod constructs and an autograft. Neurological status improved immediately after surgery, and the patient recovered completely after 1 year. Posterior fusion followed by closed reduction is the superior strategy for posterior atlantoaxial dislocation without odontoid fracture, according to literature. But for cases with severe neurological deficit, open reduction may be the safest choice to avoid the lethal complication of overdistraction of the spinal cord. Also, open reduction and posterior srew-rod fixation are safe and convenient strategies in dealing with traumatic posterior atlantoaxial dislocation patients with neurological deficit. PMID:26512572

Delayed primary realignment of posterior urethral rupture | Shittu ...

African Journals Online (AJOL)

The treatment of acute posterior urethral rupture is controversial. Twelve patients who presented with acute posterior urethral rupture over a five--year period were treated by delayed primary realignment of the injury. The technique of this procedure and the outcome are the subject of this presentation. Eight patients had ...

TPM na TRECAR : uma nova abordagem à gestão da manutenção

OpenAIRE

Resende, António Pedro Ferreira Carreira

2014-01-01

A manutenção tem vindo a assumir um papel preponderante na atividade industrial, uma vez que é esta área departamental que possibilita à produção, um fluxo contínuo de atividade, atenuando os tempos de paragem dos equipamentos (downtime). A evolução histórica mostra este avanço e a importância da manutenção nas indústrias, apesar de atualmente se verificar uma redução nas despesas associadas a este setor, devido à crise económica global. O TPM surge como uma abordagem à gestão da manutenção, ...

To compare efficacy & discomfort in posterior nasal packing with foley's catheters versus bipp gauze packing in cases of posterior epistaxis

International Nuclear Information System (INIS)

Khan, M.A.; Ahmed, A.

2015-01-01

To compare efficacy and discomfort in posterior nasal packing with Foley's catheters versus BIPP gauze packing in cases of posterior epistaxis. Study Design: Randomized controlled trial. Place and Duration of Study: Combined Military Hospital (CMH) Kharian from October 2011 to October 2013. Material and Methods: A total of 206 patients of posterior epistaxis were included in the study through non-probability convenience sampling and randomly divided in two groups of 103 each. In group A patients were treated by posterior nasal packing with Foley's catheter and in group B patients were treated by posterior nasal packing with BIPP gauze and results in terms of control of epistaxis and discomfort during pack insertion, while the packs were in situ and pack removal, based on VAS (Visual Analogue Scale) were observed. Results: Average age in group A was 52.64 years (SD=9.57) and in group B it was 50.27 years (SD ± 10.13). There were 71 (68.9%) males in group A while 67 (65%) males in group B. During posterior nasal pack insertion, the mean pain score in Group A was 6.21 (SD ± I.13) and in Group B was 7.43 (SD ± 1.19). The mean pain score with the pack in situ was 4.27 (SD ± 0.08) in Group A versus 4.76 (SD ± 0.09) Group B. Similarly pack removal was also more painful in group B than group A (6.14 ± 0.91 vs 6.89 ± 1.09) (p =0.000). In the group A, 31 (30.1%) patients had rebleeding after pack removal, out of which 9 (8.7%) had significant bleeding requiring repacking. In 22 (21.4%) cases there was mild bleeding which settled without repacking. In group B 22 (21.4%) patients had rebleeding after pack removal, out of which 5 (4.7%) had significant bleeding requiring repacking. Conclusion: It is concluded that posterior nasal packing with BIPP gauze pack is effective for controlling posterior epistaxis but causes more discomfort to the patients as compared to Foley's catheter packing. (author)

Síndrome de Cushing: é possível simplificar e padronizar sua abordagem diagnóstica?

OpenAIRE

Rollin, Guilherme A.F.S.; Czepielewski, Mauro A.

2003-01-01

A síndrome de Cushing representa um desafio diagnóstico, requerendo suspeita clínica apurada, conhecimento adequado da regulação hormonal do eixo hipotálamo-hipófise-adrenal, aplicação precisa de testes funcionais que estimulam ou inibem este eixo e a indicação de exames de imagem resolutivos para as diversas etiologias investigadas. Neste artigo, discutimos a abordagem diagnóstica da síndrome de Cushing, analisando a aplicação dos diversos testes utilizados tanto para o diagnóstico sindrômic...

Abordagem profissional da violência familiar contra o idoso em uma unidade básica de saúde

OpenAIRE

Wanderbroocke,Ana Claudia Nunes de Souza; Moré,Carmen Leontina Ojeda Ocampo

2013-01-01

O presente artigo tem como objetivo descrever a abordagem profissional da violência familiar contra idosos em uma unidade básica de saúde (UBS). Trata-se de pesquisa qualitativa, com dados coletados por meio de observação participante com registro em diário de campo e entrevistas semiestruturadas. Participaram das entrevistas dez profissionais da UBS. Os dados foram analisados segundo o referencial da Grounded Theory e duas categorias foram discutidas: manejo profissional de situações de viol...

Intraoperative CT in the assessment of posterior wall acetabular fracture stability.

Science.gov (United States)

Cunningham, Brian; Jackson, Kelly; Ortega, Gil

2014-04-01

Posterior wall acetabular fractures that involve 10% to 40% of the posterior wall may or may not require an open reduction and internal fixation. Dynamic stress examination of the acetabular fracture under fluoroscopy has been used as an intraoperative method to assess joint stability. The aim of this study was to demonstrate the value of intraoperative ISO computed tomography (CT) examination using the Siemens ISO-C imaging system (Siemens Corp, Malvern, Pennsylvania) in the assessment of posterior wall acetabular fracture stability during stress examination under anesthesia. In 5 posterior wall acetabular fractures, standard fluoroscopic images (including anteroposterior pelvis and Judet radiographs) with dynamic stress examinations were compared with the ISO-C CT imaging system to assess posterior wall fracture stability during stress examination. After review of standard intraoperative fluoroscopic images under dynamic stress examination, all 5 cases appeared to demonstrate posterior wall stability; however, when the intraoperative images from the ISO-C CT imaging system demonstrated that 1 case showed fracture instability of the posterior wall segment during stress examination, open reduction and internal fixation was performed. The use of intraoperative ISO CT imaging has shown an initial improvement in the surgeon's ability to assess the intraoperative stability of posterior wall acetabular fractures during stress examination when compared with standard fluoroscopic images. Copyright 2014, SLACK Incorporated.

O uso da fontanela posterior no diagnóstico ultra-sonográfico das hemorragias periintraventriculares Use of posterior fontanelle in the ultrasound diagnosis of intraventricular/periventricular hemorrhage

Directory of Open Access Journals (Sweden)

Luciana D. V. Gauzzi

2008-12-01

Full Text Available OBJETIVO: Avaliar o uso da fontanela posterior em recém-nascidos prematuros (OBJECTIVE: To evaluate the use of the posterior fontanelle in premature neonates (< 37 weeks with a birth weight < 1,500 g in the ultrasound diagnosis of intraventricular/periventricular hemorrhage and to assess whether the use of the anterior fontanelle associated with the posterior fontanelle changes the interrater agreement. METHODS: Eighty-five premature neonates were evaluated in this prospective study. Ultrasound was performed using the anterior fontanelle, and later, the posterior fontanelle. A consensus diagnosis between two raters was used to analyze the agreement between the anterior fontanelle alone and in association with the posterior fontanelle. If there was no consensus, a third observer was involved to decide. RESULTS: Agreement between the first two raters had a kappa of 0.80 (95%CI 0.76-0.84. However, when the anterior fontanelle was evaluated alone, kappa was 0.74 (95%CI 0.70-0.78. Thirty-seven hemispheres had grade II hemorrhage, of which 17 (45.9% had their diagnosis performed using the anterior fontanelle; in 10 (27%, diagnosis was suspected by the anterior fontanelle and confirmed by the posterior fontanelle; and in 10 (27%, diagnosis was exclusively performed using the posterior fontanelle. Of the 454 hemispheres, in 20 (4.4% the diagnosis of intraventricular hemorrhage was performed exclusively by the posterior fontanelle (p < 0.001. CONCLUSIONS: In this study, the anterior fontanelle associated with the posterior fontanelle was better than the use of the anterior fontanelle alone in the identification of intraventricular/periventricular hemorrhage. Ultrasound using the posterior fontanelle allowed diagnosis of unsuspected grade II hemorrhage by the anterior fontanelle. Use of the posterior fontanelle was also useful to clarify presence of hemorrhage in inconclusive examinations by the anterior fontanelle.

Tuberothalamic Artery Infarction Following Coil Embolization of a Ruptured Posterior Communicating Artery Aneurysm Belonging to a Transitional Type Posterior Cerebral Artery: A Case Report

OpenAIRE

Lee, Kyeong Duk; Kwon, Soon Chan; Muniandy, Sarawana; Park, Eun Suk; Sim, Hong Bo; Lyo, In Uk

2013-01-01

There are many potential anatomical variations in the connection between the internal carotid artery and the posterior circulation through the posterior communicating artery (PCoA). We describe the endovascular treatment of an aneurysm arising near the origin of the PCoA belonging to a transitional type posterior cerebral artery. Coil embolization subsequently resulted in thrombo-occlusion of the adjacent PCoA causing thalamic infarction even though sufficient retrograde flow had been confirm...

Arthroscopic management of posterior instability: evolution of technique and results.

Science.gov (United States)

Savoie, Felix H; Holt, M Shaun; Field, Larry D; Ramsey, J Randall

2008-04-01

The purpose of this study was to evaluate the effectiveness of arthroscopic posterior shoulder reconstruction. We treated 136 shoulders in 131 patients with a diagnosis of primary posterior instability who failed 6 months of vigorous rehabilitation by operative stabilization between 1989 and 2001. Inclusion criterion was primary posterior instability that failed an extensive rehabilitative program with functional impairment and pain. Exclusion criterion was less than 12 months of follow-up and Suretac (Smith & Nephew, Andover, MA) or laser stabilization, leaving 92 shoulders in 90 patients available for the study (69 male, 21 female). Follow-up ranged from 12 to 132 months (average, 28 months). Each patient underwent diagnostic arthroscopy and surgical repair at the same time using one of several primary procedures. The procedure used was based on the pathologic entity noted at the time of surgery. At an average follow-up of 28 months, 97% of the shoulders were stable and considered a success based on the Neer-Foster rating scale. Posterior pathology varied, and a reverse Bankart lesion alone was found 51% of the time, a stretched posterior capsule 67% of the time, and a combination of a reverse Bankart lesion and capsular stretching 16% of the time. The rotator interval was obviously damaged in 61% of cases. Multiple accompanying lesions were found, including anterior-superior labral tears and SLAP tears (20%), superior glenohumeral ligament injury (7%), middle glenohumeral ligament injury (38%), anteroinferior glenohumaral ligament injury (37%), and an enlarged axillary pouch (20%). No essential lesion is present for posterior instability. Multiple varied pathologies will be present in a shoulder presenting with posterior instability. Arthroscopic surgery allows inspection of the joint and anatomic-specific repairs based on pathology. Careful attention to all the supporting structures of the shoulder, including the rotator interval, the anterior-superior labrum

Tibialis Posterior Tenosynovitis: A Unique Musculoskeletal Manifestation of Gout.

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Shupper, Peter; Stitik, Todd P

2018-02-01

Extra-articular manifestations of gout can present in several ways, including tenosynovitis. We present a rare case of acute tibialis posterior gouty tenosynovitis. An 82-year-old man with a history of well-controlled gout presented with acute onset of left ankle pain, occurring without inciting event. The medial ankle was slightly erythematous with moderate dorsal-medial swelling and mild dorsal-lateral swelling, with severe tenderness to palpation over the medial retro-malleolar region. Range of motion and manual muscle testing were pain limited throughout. Ultrasound examination revealed a left posterior tibialis tendon sheath tenosynovitis with effusion and overlying soft tissue edema. Tendon sheath aspirate revealed sodium urate crystals and a white blood cell count of 6400/μL. Tendon sheath injection with a mixture of 1% lidocaine and dexamethasone 4 mg resulted in symptom resolution. Repeat ultrasound examination demonstrated no evidence of tibialis posterior tendon sheath effusion. This case is unique not only because acute gouty posterior tibialis tenosynovitis is very rare, particularly in a normouricemic individual, but also because the sonographic evidence of gouty infiltration into the posterior tibialis tendon and overlying subcutaneous tissue considerably aided in arriving at the correct diagnosis in a timely manner.

Flexor Digitorum Accessorius Longus: Importance of Posterior Ankle Endoscopy

Directory of Open Access Journals (Sweden)

Jorge Pablo Batista

2015-01-01

Full Text Available Endoscopy for the posterior region of the ankle through two portals is becoming more widespread for the treatment of a large number of conditions which used to be treated with open surgery years ago. The tendon of the flexor hallucis longus (FHL travels along an osteofibrous tunnel between the posterolateral and posteromedial tubercles of the talus. Chronic inflammation of this tendon may lead to painful stenosing tenosynovitis. The aim of this report is to describe two cases depicting an accessory tendon which is an anatomical variation of the flexor hallucis longus in patients with posterior friction syndrome due to posterior ankle impingement and associated with a posteromedial osteochondral lesion of the talus. The anatomical variation (FDAL described was a finding during an endoscopy of the posterior region of the ankle, and we have spared it by sectioning the superior flexor retinaculum only. The accessory flexor digitorum longus is an anatomical variation and should be taken into account when performing an arthroscopy of the posterior region of the ankle. We recommend this treatment on this type of injury although we admit this does not make a definite conclusion.

[Posterior polymorphous dystrophy, case report and literature review].

Science.gov (United States)

Mendoza-Adam, G; Hernandez-Camarena, J C; Valdez-García, J E

2015-09-01

Posterior Polymorphous Dystrophy (DPP) is a rare posterior corneal dystrophy that is genetically transmitted as autosomal dominant. Corneal structures affected in this dystrophy are Descemet membrane and the endothelium. A case is presented on a 47 years old woman with no relevant history, with typical findings of DPP (vesicular and band lesions at the endothelium and posterior Descemet). To our knowledge there are no reported cases of DPP in Latin-American patients in the literature. The clinical manifestations in our patient were found to be very similar to the cases reported in other populations. Copyright © 2014 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

Overpowering posterior lumbar instrumentation and fusion with hyperlordotic anterior lumbar interbody cages followed by posterior revision: a preliminary feasibility study.

Science.gov (United States)

Kadam, Abhijeet; Wigner, Nathan; Saville, Philip; Arlet, Vincent

2017-12-01

OBJECTIVE The authors' aim in this study was to evaluate whether sagittal plane correction can be obtained from the front by overpowering previous posterior instrumentation and/or fusion with hyperlordotic anterior lumbar interbody fusion (ALIF) cages in patients undergoing revision surgery for degenerative spinal conditions and/or spinal deformities. METHODS The authors report their experience with the application of hyperlordotic cages at 36 lumbar levels for ALIFs in a series of 20 patients who underwent revision spinal surgery at a single institution. Included patients underwent staged front-back procedures: ALIFs with hyperlordotic cages (12°, 20°, and 30°) followed by removal of posterior instrumentation and reinstrumentation from the back. Patients were divided into the following 2 groups depending on the extent of posterior instrumentation and fusion during the second stage: long constructs (≥ 6 levels with extension into thoracic spine and/or pelvis) and short constructs (lumbar lordosis increased from 44.3° to 59.8° (p lumbar levels that have pseudarthrosis from the previous posterior spinal fusion. Meticulous selection of levels for ALIF is crucial for safely and effectively performing this technique.

Traumatic posterior fossa epidural hematoma

International Nuclear Information System (INIS)

Ikeda, Yukio; Nakazawa, Shozo; Yamakawa, Kazuomi; Kobayashi, Shiro; Tsuji, Yukihide

1981-01-01

In this paper three acute cases and two subacute cases are reported. CT findings in acute cases show two different types. ''Type I'' shows crescent or lenticular high density area which is not enhanced after contrast infusion. ''Type II'' shows lenticular low density area with membranous high density region in its medial side after contrast infusion. In subacute cases plain CT scan shows lenticular iso or low density area with membranous high density region in its medial side. Forty five cases of posterior fossa epidural hematoma in the review of literature of this country are discussed. Disturbances of the consciousness are the most predominant symptoms in acute cases, while in subacute cases cerebellar signs, vomiting, headache and choked disc are noted. Angiographical examinations may not always be valuable in collecting the direct information of the existence of the epidural hematoma. Liquor cavity in the posterior fossa which is thought to serve as a buffer action of hematoma is about 20 ml, so we discuss about the volume of hematoma, especially of 20 ml, associated with clinical course and prognosis. Volume of epidural hematoma is one of the most important factors affecting clinical course and prognosis. In summary of these our experiences, we again emphasize the value of CT scan as the rapid, noninvasive, accurate radiological examination in the diagnosis of traumatic posterior fossa epidural hematoma. (author)

Single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation in surgical treatment for single-segment lumbar spinal tuberculosis

OpenAIRE

Zeng, Hao; Wang, Xiyang; Zhang, Penghui; Peng, Wei; Zhang, Yupeng; Liu, Zheng

2015-01-01

Objective: The aim of this study is to determine the feasibility and efficacy of surgical management of single-segment lumbar spinal tuberculosis (TB) by using single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation.Methods: Seventeen cases of single-segment lumbar TB were treated with single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reco...

Intraoperative 3-dimensional navigation and ultrasonography during posterior decompression with instrumented fusion for ossification of the posterior longitudinal ligament in the thoracic spine.

Science.gov (United States)

Tian, Wei; Weng, Chong; Liu, Bo; Li, Qin; Sun, Yu-Qing; Yuan, Qiang; Zhang, Bo; Wang, Yong-Qing; He, Da

2013-08-01

A retrospective clinical study was conducted. The purpose of this study was to describe the clinical outcomes of intraoperative 3D navigation (ITN) and ultrasonography during posterior decompression and instrumented fusion for thoracic myelopathy due to ossification of the posterior longitudinal ligament (OPLL). The symptoms caused by thoracic-ossification of the posterior longitudinal ligament (T-OPLL) are usually progressive and do not respond to conservative treatment-surgical intervention is the only effective treatment option. Various methods have been described for the treatment of symptomatic T-OPLL, all of which have limitations. The study included 18 patients with T-OPLL who underwent posterior decompression with instrumented fusion from 2006 to 2011. A staged operative procedure was used. First, pedicle screws were placed with ITN and a wide laminectomy was performed with resection of ossification of the ligamentum flavum (if present). With insufficient decompression on intraoperative ultrasonography, additional circumferential decompression was performed through a transpedicular approach. ITN-guided OPLL resection was performed using a burr attached to a navigational tracker. In all cases, posterior instrumented fusion was performed in situ. The outcomes were evaluated with the modified Japanese Orthopaedic Association scores and recovery rates. Intraoperative ultrasonography showed that posterior laminectomy was sufficient in 6 patients; the remaining 12 were treated with additional circumferential decompression. The follow-up period ranged from 1 to 6 years (mean period, 2.8 y). Postoperative transient neurological deterioration occurred in 1 patient, and cerebrospinal fluid leakage occurred in 4 patients. All patients showed neurological recovery with a mean Japanese Orthopaedic Association score that improved from 5.5 points preoperatively to 8.5 points at the final follow-up and a mean recovery rate of 54.5%. Intraoperative ultrasonography and ITN

Lumbar posterior marginal intra-osseous cartilaginous node

Energy Technology Data Exchange (ETDEWEB)

Laredo, J.D.; Bard, M.; Chretien, J.; Kahn, M.F.

1986-03-01

This report concerns 12 patients, eight young adults and four adolescents, presenting with lumbar or sciatic pain. This was associated with an unusual defect of the inferior and posterior edges of the vertebral bodies of L4 or L5, together with a small bony ridge protruding into the spinal canal. We found 11 similar cases in the literature, all involving adolescents except for one young adult. It has been considered to be the result of a fracture of the posterior ring apophysis in association with a herniated disc. In our cases, in the absence of any known previous trauma, the radiological features and surgical results and the similarity and frequent association with typical lesions of Scheuermann disease, all suggest a posterior marginal cartilaginous node. The inferior lumbar location and frequent association with herniated disc and sciatic nerve root compression in young patients are discussed.

Lumbar posterior marginal intra-osseous cartilaginous node

International Nuclear Information System (INIS)

Laredo, J.D.; Bard, M.; Chretien, J.; Kahn, M.F.

1986-01-01

This report concerns 12 patients, eight young adults and four adolescents, presenting with lumbar or sciatic pain. This was associated with an unusual defect of the inferior and posterior edges of the vertebral bodies of L4 or L5, together with a small bony ridge protruding into the spinal canal. We found 11 similar cases in the literature, all involving adolescents except for one young adult. It has been considered to be the result of a fracture of the posterior ring apophysis in association with a herniated disc. In our cases, in the absence of any known previous trauma, the radiological features and surgical results and the similarity and frequent association with typical lesions of Scheuermann disease, all suggest a posterior marginal cartilaginous node. The inferior lumbar location and frequent association with herniated disc and sciatic nerve root compression in young patients are discussed. (orig.)

Reversible posterior leukoencephalopathy syndrome

Energy Technology Data Exchange (ETDEWEB)

Lee, Eun Ja; Yu, Won Jong; Ahn, Kook Jin; Jung, So Lyung; Lee, Yeon Soo; Kim, Ji Chang; Kang, Si Won [The Catholic Univ. of Korea, Taejon (Korea, Republic of); Song, Chang Joon [Chungnam National Univ. School of Medicine, Cheonju (Korea, Republic of); Song, Soon-Young; Koo, Ja Hong [Kwandong Univ. College of Medicine, Myungji Hospital, Seoul (Korea, Republic of); Kim, Man Deuk [College of Medicine Pochon CHA Univ., Seoul (Korea, Republic of)

2001-10-01

To review reversible posterior leukoencephalopathy syndrome. We reviewed 22 patients (M:F=3:19; age, 17-46 years) with the characteristic clinical and imaging features of reversible posterior leukoencephalopathy syndrome. All underwent brain MRI, and in three cases both CT and MRI were performed. In one, MRA was obtained, and in eleven, follow-up MR images were obtained. We evaluated the causes of this syndrome, its clinical manifestations, and MR findings including the locations of lesions, the presence or absence of contrast enhancement, and the changes seen at follow-up MRI. Of the 22 patients, 13 had eclampsia (six during pregnancy and seven during puerperium). Four were receiving immunosuppressive therapy (three, cyclosporine ; one, FK 506). Four suffered renal failure and one had complicated migraine. The clinical manifestations included headache (n=12), visual disturbance (n=13), seizure (n=15), focal neurologic sign (n=3), and altered mental status (n=2). Fifteen patients had hypertension and the others normotension. MRI revealed that lesions were bilateral (n=20) or unilateral (n=2). In all patients the lesion was found in the cortical and subcortical areas of the parieto-occipital lobes ; other locations were the basal ganglia (n=9), posterior temporal lobe (n=8), frontal lobe (n=5), cerebellum (n=5), pons (n=2), and thalamus (n=1). All lesions were of high signal intensity on T2-weighted images, and of iso to low intensity on T1-weighted images. One was combined with acute hematoma in the left basal ganglia. In eight of 11 patients who underwent postcontrast T1-weighted MRI, there was no definite enhancement ; in one, enhancement was mild, and in tow, patchy. CT studies showed low attenuation, and MRA revealed mild vasospasm. The symptoms of all patients improved. Follow-up MRI in nine of 11 patients depicted complete resolution of the lesions ; in two, small infarctions remained but the extent of the lesions had decreased. Reversible posterior

Reversible posterior leukoencephalopathy syndrome

International Nuclear Information System (INIS)

Lee, Eun Ja; Yu, Won Jong; Ahn, Kook Jin; Jung, So Lyung; Lee, Yeon Soo; Kim, Ji Chang; Kang, Si Won; Song, Chang Joon; Song, Soon-Young; Koo, Ja Hong; Kim, Man Deuk

2001-01-01

To review reversible posterior leukoencephalopathy syndrome. We reviewed 22 patients (M:F=3:19; age, 17-46 years) with the characteristic clinical and imaging features of reversible posterior leukoencephalopathy syndrome. All underwent brain MRI, and in three cases both CT and MRI were performed. In one, MRA was obtained, and in eleven, follow-up MR images were obtained. We evaluated the causes of this syndrome, its clinical manifestations, and MR findings including the locations of lesions, the presence or absence of contrast enhancement, and the changes seen at follow-up MRI. Of the 22 patients, 13 had eclampsia (six during pregnancy and seven during puerperium). Four were receiving immunosuppressive therapy (three, cyclosporine ; one, FK 506). Four suffered renal failure and one had complicated migraine. The clinical manifestations included headache (n=12), visual disturbance (n=13), seizure (n=15), focal neurologic sign (n=3), and altered mental status (n=2). Fifteen patients had hypertension and the others normotension. MRI revealed that lesions were bilateral (n=20) or unilateral (n=2). In all patients the lesion was found in the cortical and subcortical areas of the parieto-occipital lobes ; other locations were the basal ganglia (n=9), posterior temporal lobe (n=8), frontal lobe (n=5), cerebellum (n=5), pons (n=2), and thalamus (n=1). All lesions were of high signal intensity on T2-weighted images, and of iso to low intensity on T1-weighted images. One was combined with acute hematoma in the left basal ganglia. In eight of 11 patients who underwent postcontrast T1-weighted MRI, there was no definite enhancement ; in one, enhancement was mild, and in tow, patchy. CT studies showed low attenuation, and MRA revealed mild vasospasm. The symptoms of all patients improved. Follow-up MRI in nine of 11 patients depicted complete resolution of the lesions ; in two, small infarctions remained but the extent of the lesions had decreased. Reversible posterior

Tuberothalamic artery infarction following coil embolization of a ruptured posterior communicating artery aneurysm belonging to a transitional type posterior cerebral artery. A case report.

Science.gov (United States)

Lee, Kyeong Duk; Kwon, Soon Chan; Muniandy, Sarawana; Park, Eun Suk; Sim, Hong Bo; Lyo, In Uk

2013-09-01

There are many potential anatomical variations in the connection between the internal carotid artery and the posterior circulation through the posterior communicating artery (PCoA). We describe the endovascular treatment of an aneurysm arising near the origin of the PCoA belonging to a transitional type posterior cerebral artery. Coil embolization subsequently resulted in thrombo-occlusion of the adjacent PCoA causing thalamic infarction even though sufficient retrograde flow had been confirmed pre-operatively by Allcock's test.

Abnormalities of fixation, saccade and pursuit in posterior cortical atrophy.

Science.gov (United States)

Shakespeare, Timothy J; Kaski, Diego; Yong, Keir X X; Paterson, Ross W; Slattery, Catherine F; Ryan, Natalie S; Schott, Jonathan M; Crutch, Sebastian J

2015-07-01

The clinico-neuroradiological syndrome posterior cortical atrophy is the cardinal 'visual dementia' and most common atypical Alzheimer's disease phenotype, offering insights into mechanisms underlying clinical heterogeneity, pathological propagation and basic visual phenomena (e.g. visual crowding). Given the extensive attention paid to patients' (higher order) perceptual function, it is surprising that there have been no systematic analyses of basic oculomotor function in this population. Here 20 patients with posterior cortical atrophy, 17 patients with typical Alzheimer's disease and 22 healthy controls completed tests of fixation, saccade (including fixation/target gap and overlap conditions) and smooth pursuit eye movements using an infrared pupil-tracking system. Participants underwent detailed neuropsychological and neurological examinations, with a proportion also undertaking brain imaging and analysis of molecular pathology. In contrast to informal clinical evaluations of oculomotor dysfunction frequency (previous studies: 38%, current clinical examination: 33%), detailed eyetracking investigations revealed eye movement abnormalities in 80% of patients with posterior cortical atrophy (compared to 17% typical Alzheimer's disease, 5% controls). The greatest differences between posterior cortical atrophy and typical Alzheimer's disease were seen in saccadic performance. Patients with posterior cortical atrophy made significantly shorter saccades especially for distant targets. They also exhibited a significant exacerbation of the normal gap/overlap effect, consistent with 'sticky fixation'. Time to reach saccadic targets was significantly associated with parietal and occipital cortical thickness measures. On fixation stability tasks, patients with typical Alzheimer's disease showed more square wave jerks whose frequency was associated with lower cerebellar grey matter volume, while patients with posterior cortical atrophy showed large saccadic intrusions

Gait adaptations in patients with chronic posterior instability of the knee.

Science.gov (United States)

Hooper, D M; Morrissey, M C; Crookenden, R; Ireland, J; Beacon, J P

2002-03-01

A retrospective analysis was performed to assess gait in individuals with a long history of posterior knee instability. Descriptive study. There are few studies in the literature concerning evaluation of the biomechanics of the knee in patients with knee posterior instability. Nine individuals with posterior knee instability and a matched control group of uninjured subjects were tested in regards to knee kinematics and kinetics while walking and ascending and descending stairs. The mean follow up time for the individuals with posterior instability was 11.1 years. Individual satisfaction with the knee was measured by having participants complete the Flandry (also known as Hughston Clinic) self-assessment questionnaire. It was found that patients with knee posterior instability who indicated a higher level of satisfaction on the Flandry score walked in a manner that demonstrated greater peak knee extensor torque during stance phase, while less satisfied patients with knee posterior instability demonstrated lower peak knee extensor torque. There was a significant correlation between the self-assessment score and the peak knee extensor torque during level walking (P=0.003). During stair ascent and descent, patients with posterior instability averaged lower knee extensor torque and power than the control subjects, but those differences were only statistically significant in power while descending stairs (P=0.048). Individuals with chronic knee posterior instability modify their gait, and the adaptation can be predicted based upon the individuals self-assessment of their knee using the Flandry questionnaire. These data suggest that gait retraining may be a valuable addition to the traditional muscle strengthening programs, which are commonly used during conservative management of knee posterior instability.

Visual attention in posterior stroke

DEFF Research Database (Denmark)

Fabricius, Charlotte; Petersen, Anders; Iversen, Helle K

Objective: Impaired visual attention is common following strokes in the territory of the middle cerebral artery, particularly in the right hemisphere. However, attentional effects of more posterior lesions are less clear. The aim of this study was to characterize visual processing speed...... and apprehension span following posterior cerebral artery (PCA) stroke. We also relate these attentional parameters to visual word recognition, as previous studies have suggested that reduced visual speed and span may explain pure alexia. Methods: Nine patients with MR-verified focal lesions in the PCA......-territory (four left PCA; four right PCA; one bilateral, all >1 year post stroke) were compared to 25 controls using single case statistics. Visual attention was characterized by a whole report paradigm allowing for hemifield-specific speed and span measurements. We also characterized visual field defects...

The effect of posterior tibial slope on knee flexion in posterior-stabilized total knee arthroplasty.

Science.gov (United States)

Shi, Xiaojun; Shen, Bin; Kang, Pengde; Yang, Jing; Zhou, Zongke; Pei, Fuxing

2013-12-01

To evaluate and quantify the effect of the tibial slope on the postoperative maximal knee flexion and stability in the posterior-stabilized total knee arthroplasty (TKA). Fifty-six patients (65 knees) who had undergone TKA with the posterior-stabilized prostheses were divided into the following 3 groups according to the measured tibial slopes: Group 1: ≤4°, Group 2: 4°-7° and Group 3: >7°. The preoperative range of the motion, the change in the posterior condylar offset, the elevation of the joint line, the postoperative tibiofemoral angle and the preoperative and postoperative Hospital for Special Surgery (HSS) scores were recorded. The tibial anteroposterior translation was measured using the Kneelax 3 Arthrometer at both the 30° and the 90° flexion angles. The mean values of the postoperative maximal knee flexion were 101° (SD 5), 106° (SD 5) and 113° (SD 9) in Groups 1, 2 and 3, respectively. A significant difference was found in the postoperative maximal flexion between the 3 groups (P slope resulted in a 1.8° flexion increment (r = 1.8, R (2) = 0.463, P slope can significantly increase the postoperative maximal knee flexion. The tibial slope with an appropriate flexion and extension gap balance during the operation does not affect the joint stability.

Abordagem otimizada na ressuscitação cardiocerebral

Directory of Open Access Journals (Sweden)

Karl B. Kern

2011-04-01

Full Text Available A ressuscitação cardiocerebral (RCC é uma nova abordagem à ressuscitação de pacientes com parada cardíaca fora do hospital (PCFH. O primeiro componente principal da RCC são as compressões torácicas contínuas (CTC, também chamadas de RCP com compressões torácicas isoladas ou "RCP somente com compressões torácicas" ("Hands-only" CPR, recomendadas como parte da RCC por todos os observadores que testemunhem um colapso súbito de origem presumidamente cardíaco. O segundo componente é um novo algoritmo de tratamento de Suporte Avançado de Vida em Cardiologia (ACLS para Serviços Médicos de Emergência (SME. Esse algoritmo enfatiza compressões torácicas ininterruptas a despeito de outros procedimentos contínuos como parte do esforço de resgate. Um terceiro componente foi recentemente adicionado à RCC, e é o cuidado agressivo pós-ressuscitação. A RCC tem aumentado a participação de testemunhas e tem melhorado as taxas de sobrevivência em varias comunidades. Essa é a hora para outras comunidades re-examinarem seus próprios desfechos com parada cardíaca e considerar a possibilidade de se juntar a essas cidades e comunidades que dobraram e até mesmo triplicaram as suas taxas de sobrevivência de PCFH.

An unusual cause of posterior mediastinal cyst

Directory of Open Access Journals (Sweden)

Sahajal Dhooria

2015-01-01

Full Text Available Cystic lesions of the mediastinum may be congenital or acquired. The differential diagnosis depends on their location in the mediastinum. Cysts in the posterior mediastinum are generally developmental cysts and are neurogenic or of foregut origin. We report the case of a 14-year-old boy, who presented with dry cough and progressively increasing breathlessness, and was found to have a cystic lesion in the posterior mediastinum. Fine needle aspiration from the cyst helped make a diagnosis of tuberculosis.

Reversible posterior leucoencephalopathy syndrome in a peripartum patient.

Science.gov (United States)

Prout, R E; Tuckey, J P; Giffen, N J

2007-01-01

We present the case of a multiparous parturient who developed hypertension associated with a severe headache in the immediate post-partum period. She subsequently suffered a generalised tonic clonic seizure on the fifth post-partum day. Following recovery of consciousness, she developed a left homonymous hemianopia. Apart from hypertension, headache and convulsion, she had no symptoms and no proteinuria or other biochemical or haematological changes associated with eclampsia. The magnetic resonance imaging findings were consistent with vasogenic oedema in the right posterior parieto-occipital white matter and these in turn are consistent with reversible posterior leucoencephalopathy syndrome. The differential diagnosis of convulsions in the post-partum period is discussed and the clinical and radiological features of reversible posterior leucoencephalopathy syndrome are described.

Malignant ectomesenchymoma of the posterior mediastinum

International Nuclear Information System (INIS)

Khan, M. H.; Iqbal, R.; Hafeez-UR-Rehman; Yaqub, N.; Anwar-ul-Haq

2001-01-01

The surgical management of a four years old female child, presented at the Islamic International Medical Complex (IIMC), Islamabad, with three months history of recurrent chest infections and failure to thrive, is discussed. Posterior mediastinal tumor was diagnosed radiologically. Tumor had flimsy attachments with pericardium and thoracic aorta but was densely adherent with lower lobe of left lung. The tumor was completely removed along with a segment of lung. The postoperative recovery was uneventful. The diagnosis of malignant ectomesenchymoma was made on histopathology. The patients is well in follow-up. This is the first reported case of malignant ectomesenchymoma arising within posterior mediastinum. (author)

Abordagem da equipe de enfermagem ao usuário na emergência em saúde mental em um pronto atendimento

Directory of Open Access Journals (Sweden)

Érika Hissae Kondo

2011-04-01

Full Text Available Pesquisa qualitativa exploratória desenvolvida em 2008, num Centro Municipal de Urgências Médicas/Curitiba. Objetivos: conhecer a concepção da equipe de enfermagem sobre emergências em saúde mental e analisar como se desenvolve a abordagem da equipe de enfermagem ao usuário com transtorno mental em situação de emergência. Participaram 6 enfermeiros e 7 técnicos em enfermagem que atuam na emergência e internamento. Os dados foram obtidos mediante entrevista semi-estruturada e organizados em categorias temáticas. Para os participantes, emergências psiquiátricas são situações que apresentam risco de vida para a pessoa ou a terceiros. Como características de emergência citaram: comportamento agressivo e agitado, tentativa de suicídio e abuso de substâncias. A primeira impressão do comportamento do paciente e a tentativa de diálogo determinam quais condutas os profissionais adotam. Reconhecem dificuldade e despreparo na abordagem ao paciente. Conclui-se que há necessidade de educação permanente sobre novos serviços e adaptações dos existentes para o atendimento nessa área.

Single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation in surgical treatment for single-segment lumbar spinal tuberculosis.

Science.gov (United States)

Zeng, Hao; Wang, Xiyang; Zhang, Penghui; Peng, Wei; Liu, Zheng; Zhang, Yupeng

2015-01-01

The aim of this study is to determine the feasibility and efficacy of surgical management of single-segment lumbar spinal tuberculosis (TB) by using single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation. Seventeen cases of single-segment lumbar TB were treated with single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation. The mean follow-up was 36.9 months (range: 24-62 months). The kyphotic angle ranged from 15.2-35.1° preoperatively, with an average measurement of 27.8°. The American Spinal Injury Association (ASIA) score system was used to evaluate the neurological deficits and erythrocyte sedimentation rate (ESR) used to judge the activity of TB. Spinal TB was completely cured in all 17 patients. There was no recurrent TB infection. The postoperative kyphotic angle was 6.6-10.2°, 8.1° in average, and there was no significant loss of the correction at final follow-up. Solid fusion was achieved in all cases. Neurological condition in all patients was improved after surgery. Single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation can be a feasible and effective method the in treatment of single-segment lumbar spinal TB.

Alterations in right posterior hippocampus in early blind individuals

DEFF Research Database (Denmark)

Chebat, Daniel-Robert; Chen, Jan-Kai; Schneider, Fabien

2007-01-01

This study compares hippocampal volumes of early blind and sex/age-matched sighted controls through volumetric and localization analyses. Early blind individuals showed a significantly smaller right posterior hippocampus compared with controls. No differences in total hippocampal volumes were fou...... of the posterior hippocampus in early blind individuals suggests the implication of this region in visual spatial memory. Udgivelsesdato: 2007-Mar-5......This study compares hippocampal volumes of early blind and sex/age-matched sighted controls through volumetric and localization analyses. Early blind individuals showed a significantly smaller right posterior hippocampus compared with controls. No differences in total hippocampal volumes were found...

Abordagem ambulatorial do nutricionista em anemia hemolítica Nutritional ambulatory approach in hemolytic anemia

Directory of Open Access Journals (Sweden)

Maria Aparecida Vieira

1999-04-01

Full Text Available Descreve a atuação do nutricionista em ambulatório de Hematologia Pediátrica em um hospital escola e relata as condutas dietéticas necessárias na abordagem de crianças com anemia hemolítica com e sem sobrecarga de ferro, e também as atitudes mais freqüentes dos familiares em relação à alimentação desses pacientes.The Authors describe the performance of the Dietitian in a Pediatric Hematology Ambulatory. They emphasize the necessary dietetic procedures for adequate management of children with hemolytic anemia, with and without iron overload. Furthermore, they approach the family's attitude towards the patient's nutrition.

Gestão de projetos em empresas no Brasil: abordagem "tamanho único"? Project management in companies in Brazil: a "one size fits all" approach?

Directory of Open Access Journals (Sweden)

Luiz José Marques Junior

2011-01-01

Full Text Available A pequena taxa de sucesso dos projetos num cenário de importância crescente para realização das estratégias das empresas levanta questionamentos sobre a efetividade das abordagens de gestão de projetos. A revisão da bibliografia sobre o tema sugere a existência de uma abordagem predominante de gestão de projetos que utiliza técnicas e ferramentas de planejamento e controle com o propósito de racionalizar e normatizar a gestão de projetos. Em contraponto a essa abordagem tradicional predominante, surgiu a abordagem adaptativa. Nela, a gestão de cada projeto é adaptada às suas especificidades. Neste contexto, este artigo apresenta o resultado de um estudo exploratório preliminar sobre abordagens de gestão de projetos em seis empresas que atuam no Brasil. Os dados empíricos coletados permitem concluir que há predominância de abordagens focadas numa visão racional e normativa da gestão de projetos. Porém, os mesmos dados coletados também indicam a presença de práticas de abordagens adaptativas na gestão de projetos considerados estratégicos, sugerindo que não há abordagem "tamanho único" na gestão de projetos dessas empresas.The low success rate of projects in a scenario where they are increasingly important for the companies' strategies raises questions about the effectiveness of project management approaches. A literature review on this topic suggests that there is a predominant approach to project management, which makes use of planning and control tools and techniques to encourage a rational and normative perspective to project management. As a counterpoint to this predominant traditional approach, the adaptive approach has emerged arguing that the management of each project should be adapted to its specificities. In this context, this paper presents the result of a preliminary exploratory study about project management approaches on six companies in Brazil. The empirical data collected allow concluding that the

Current management of posterior wall fractures of the acetabulum.

Science.gov (United States)

Moed, Berton R; Kregor, Philip J; Reilly, Mark C; Stover, Michael D; Vrahas, Mark S

2015-01-01

The general goals for treating an acetabular fracture are to restore congruity and stability of the hip joint. These goals are no different from those for the subset of fractures of the posterior wall. Nevertheless, posterior wall fractures present unique problems compared with other types of acetabular fractures. Successful treatment of these fractures depends on a multitude of factors. The physician must understand their distinctive radiologic features, in conjunction with patient factors, to determine the appropriate treatment. By knowing the important points of posterior surgical approaches to the hip, particularly the posterior wall, specific techniques can be used for fracture reduction and fixation in these often challenging fractures. In addition, it is important to develop a complete grasp of potential complications and their treatment. The evaluation and treatment protocols initially developed by Letournel and Judet continue to be important; however, the surgeon also should be aware of new information published and presented in the past decade.

Back to Normal! Gaussianizing posterior distributions for cosmological probes

Science.gov (United States)

Schuhmann, Robert L.; Joachimi, Benjamin; Peiris, Hiranya V.

2014-05-01

We present a method to map multivariate non-Gaussian posterior probability densities into Gaussian ones via nonlinear Box-Cox transformations, and generalizations thereof. This is analogous to the search for normal parameters in the CMB, but can in principle be applied to any probability density that is continuous and unimodal. The search for the optimally Gaussianizing transformation amongst the Box-Cox family is performed via a maximum likelihood formalism. We can judge the quality of the found transformation a posteriori: qualitatively via statistical tests of Gaussianity, and more illustratively by how well it reproduces the credible regions. The method permits an analytical reconstruction of the posterior from a sample, e.g. a Markov chain, and simplifies the subsequent joint analysis with other experiments. Furthermore, it permits the characterization of a non-Gaussian posterior in a compact and efficient way. The expression for the non-Gaussian posterior can be employed to find analytic formulae for the Bayesian evidence, and consequently be used for model comparison.

COMPUTED TOMOGRAPHIC EVALUATION OF POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME

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Vishwaprem Raj

2016-04-01

Full Text Available BACKGROUND AND PURPOSE Posterior Reversible Encephalopathy Syndrome (PRES is a neurotoxic state that occurs secondary to the inability of posterior circulation to autoregulate. The clinical spectrum and the underlying pathophysiology are still poorly defined. No conclusive evidence has been put forward regarding the relationship between clinical conditions and specific imaging findings of severity or location of oedema. PURPOSE To assess the role of computed tomography in evaluation of Posterior Reversible Encephalopathy Syndrome. MATERIALS AND METHODS 55 patients referred to the Department of Radio-Diagnosis, with a history of neurological abnormalities, including altered mental function, visual loss, stupor with a predisposing history favouring PRES and followed up for a period of 10 – 30 days. RESULTS 21 patients (38.2% were females. 32 patients (58.1% were in the age group between 21 to 30 years. Predisposing condition; 16 (29.1% presented with pre-eclampsia, 12 (21.8% with post-partum status in altered sensorium, 9 (16.4% with seizures, 7 (12.7% with hypertension, 6 (10.9% with visual disturbances, 4 (7.3% with eclampsia and 1 (1.8% with uraemia. 20 cases (36.4% showed findings suggestive of posterior reversible encephalopathy syndrome on initial computed tomography examination. 35 cases showed no initial radiological evidence suggestive of posterior reversible encephalopathy syndrome. Of the 20 cases which showed computed tomographic evidence of posterior reversible encephalopathy syndrome, recovery was noted in 5 cases (9.1%. Persistence of findings detected on first CT was noted in 13 patients (23.6%. Regional predominance of the lesions was as follows. Frontal lobe (39%, Parietal lobe (32%, Temporal lobe (15% and occipital lobe (15%. CONCLUSION Varied clinical manifestations are associated with anatomical findings recognisable by neuro-imaging as PRES. Prompt imaging is necessary for the recognition of the condition and appropriate

Bilateral, posterior parietal polymicrogyria as part of speech therapy ...

African Journals Online (AJOL)

SA Journal of Radiology ... Magnetic resonance imaging (MRI) has been associated with either diffuse polymicrogyria around the entire extent of the sylvian fissure or in the posterior aspects of the parietal regions, in which case it is called posterior parietal ... This article discusses the possible embryological origin of these

Gastroesophageal scintigraphy in children. A comparison of posterior and anterior imaging

International Nuclear Information System (INIS)

Reyhan, M.; Yapar, A.F.; Aydin, M.; Sukan, A.

2005-01-01

The purpose of this study was to compare the posterior dynamic imaging with the anterior imaging in the evaluation of children with gastroesophageal reflux (GER). Sixty-eight children (26 female, 42 male; age range 4 months to 7 years, median 21 months) were studied. After 4-hour fasting, all the subjects underwent gastroesophageal scintigraphy. Synchronous dynamic imaging in the anterior and posterior projections was performed with the subject in the supine position with a dual-head gamma camera equipped with low-energy general-purpose collimators at a rate of 30 s/frame for 40 min. The anterior and posterior images were visually evaluated for the presence of gastroesophageal reflux by two nuclear medicine physicians. The anterior and posterior images were correlated by Pearson correlation analysis, and inter-observer variability was evaluated by paired t-test and kappa value. There was a good correlation between the two projections with r-values of 0.906-0.990. The inter-observer agreement for interpretation of the anterior and posterior imaging was excellent (k: 0.83). In conclusion, anterior and posterior dynamic imaging showed excellent correlation in detection of GER in children. Posterior imaging is superior to anterior imaging in that it is more comfortable, and it reduces motion artifacts, especially for infants and anxious children; thus, it may be preferred over anterior imaging. (author)

Álcool e direção: uma abordagem preventiva entre clientes de bares

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Bernardo Pires Sampaio

2018-04-01

Full Text Available Objetivo: Identificar em clientes de bares atitudes de risco e conscientizá-los dos perigos desses comportamentos via abordagem preventiva. Método: Trabalho prospectivo de caráter descritivo realizado com 119 clientes de bares entrevistados randomicamente em maio de 2016, em Ilhéus, Bahia. Usou-se questionário semiestruturado acerca das variáveis: sexo, etnia, idade, grau de escolaridade, hábito de usar cinto de segurança, consumo de álcool no momento da entrevista, responsabilidade pela condução veicular no período da realização da entrevista, hábito de dirigir alcoolizado, histórico de acidente de trânsito sob efeito de bebidas alcoólicas e local de residência. Durante a realização do questionário foi promovida uma abordagem preventiva sobre os riscos de dirigir alcoolizado e sem cinto de segurança. Resultados: Predominaram indivíduos do sexo masculinos (54%, caucasianos (41%, com idade média de 27 anos, cuja faixa etária entre 25 a 34 anos compôs mais da metade da amostra (53%, e cursando ensino superior (48%. Grande parte dos entrevistados usava cinto de segurança enquanto motoristas (77% ou como passageiros (73%. Prevaleceram entrevistados que estavam fazendo consumo de bebidas alcoólicas (74%, com predomínio daqueles que não iriam conduzir veículos após a saída do estabelecimento (58%. Preponderaram motoristas que têm hábito de dirigir sob influência de álcool (65%, dentre os quais parcela importante já se envolveu em acidente de trânsito em decorrência de tal prática (18%. A maioria dos entrevistados residia em Ilhéus (72%. Conclusão: Dirigir alcoolizado ainda é uma prática corriqueira. Contudo, os entrevistados se mostraram receptivos a intervenções preventivas acerca de acidentes de trânsito.

The MR imaging features of the posterior intermalleolar ligament in patients with posterior impingement syndrome of the ankle

International Nuclear Information System (INIS)

Fiorella, D.

1999-01-01

Objective. To describe the MR imaging features of the posterior intermalleolar ligament (IML) in patients with posterior impingement syndrome (PIS) of the ankle.Design and patients. Three patients (one male and two females, 13-25 years of age) are presented. Each patient presented clinically with symptoms of PIS of the ankle. Plain film examination was negative for a structural cause of the PIS in all patients. MR images were obtained with a 1.5 T scanner using an extremity coil. Clinical data and, in one patient, findings at ankle arthroscopy, were correlated with the results of MR imaging.Results. Ankle MR images from the three patients with a clinical diagnosis of PIS are presented. Findings in all patients included: (1) absence of another structural cause of the PIS (i.e., an os trigonum, trigonal process, fracture, loose bodies, etc.), (2) identification of the IML as a structure discrete from the posterior talofibular and tibiofibular ligaments, and (3) prominence of the IML as indicated by (a) identification of the IML in three different imaging planes, and (b) a caliber of the IML comparable to that of the conventional posterior ankle ligaments visualized in the same imaging plane. Arthroscopic resection of a meniscoid IML resulted in resolution of the PIS in one of the patients presented.Conclusions. MR imaging is an effective means of investigating the IML as a potential cause of PIS. The identification of a prominent IML in the absence of another structural cause of PIS indicates that impingement of the IML is the most likely cause of PIS. (orig.)

The MR imaging features of the posterior intermalleolar ligament in patients with posterior impingement syndrome of the ankle

Energy Technology Data Exchange (ETDEWEB)

Fiorella, D. [Duke Univ. Medical Center, Durham, NC (United States). Dept. of Radiology; Duke Univ., Durham, NC (United States). Medical Center; Helms, C.A. [Duke Univ. Medical Center, Durham, NC (United States). Dept. of Radiology; Nunley, J.A. II [Dept. of Orthopedic Surgery, Duke University Medical Center, Durham, NC (United States)

1999-10-01

Objective. To describe the MR imaging features of the posterior intermalleolar ligament (IML) in patients with posterior impingement syndrome (PIS) of the ankle.Design and patients. Three patients (one male and two females, 13-25 years of age) are presented. Each patient presented clinically with symptoms of PIS of the ankle. Plain film examination was negative for a structural cause of the PIS in all patients. MR images were obtained with a 1.5 T scanner using an extremity coil. Clinical data and, in one patient, findings at ankle arthroscopy, were correlated with the results of MR imaging.Results. Ankle MR images from the three patients with a clinical diagnosis of PIS are presented. Findings in all patients included: (1) absence of another structural cause of the PIS (i.e., an os trigonum, trigonal process, fracture, loose bodies, etc.), (2) identification of the IML as a structure discrete from the posterior talofibular and tibiofibular ligaments, and (3) prominence of the IML as indicated by (a) identification of the IML in three different imaging planes, and (b) a caliber of the IML comparable to that of the conventional posterior ankle ligaments visualized in the same imaging plane. Arthroscopic resection of a meniscoid IML resulted in resolution of the PIS in one of the patients presented.Conclusions. MR imaging is an effective means of investigating the IML as a potential cause of PIS. The identification of a prominent IML in the absence of another structural cause of PIS indicates that impingement of the IML is the most likely cause of PIS. (orig.)

Measurement of Posterior Tibial Slope Using Magnetic Resonance Imaging.

Science.gov (United States)

Karimi, Elham; Norouzian, Mohsen; Birjandinejad, Ali; Zandi, Reza; Makhmalbaf, Hadi

2017-11-01

Posterior tibial slope (PTS) is an important factor in the knee joint biomechanics and one of the bone features, which affects knee joint stability. Posterior tibial slope has impact on flexion gap, knee joint stability and posterior femoral rollback that are related to wide range of knee motion. During high tibial osteotomy and total knee arthroplasty (TKA) surgery, proper retaining the mechanical and anatomical axis is important. The aim of this study was to evaluate the value of posterior tibial slope in medial and lateral compartments of tibial plateau and to assess the relationship among the slope with age, gender and other variables of tibial plateau surface. This descriptive study was conducted on 132 healthy knees (80 males and 52 females) with a mean age of 38.26±11.45 (20-60 years) at Imam Reza hospital in Mashhad, Iran. All patients, selected and enrolled for MRI in this study, were admitted for knee pain with uncertain clinical history. According to initial physical knee examinations the study subjects were reported healthy. The mean posterior tibial slope was 7.78± 2.48 degrees in the medial compartment and 6.85± 2.24 degrees in lateral compartment. No significant correlation was found between age and gender with posterior tibial slope ( P ≥0.05), but there was significant relationship among PTS with mediolateral width, plateau area and medial plateau. Comparison of different studies revealed that the PTS value in our study is different from other communities, which can be associated with genetic and racial factors. The results of our study are useful to PTS reconstruction in surgeries.

Posterior epidural disc fragment masquerading as spinal tumor: Review of the literature.

Science.gov (United States)

Park, Taejune; Lee, Ho Jun; Kim, Jae Seong; Nam, Kiyeun

2018-03-09

Posterior epidural lumbar disc fragment is infrequent because of anatomical barriers, and it is difficult to diagnose posterior epidural lumbar disc fragment because of its rare incidence and the ambiguity of radiologic evaluations. And it is difficult to differentiate it from other diseases such as spinal tumors. Differential diagnosis of posterior epidural lumbar disc fragment is clinically important because its diagnosis can affect treatment and prognosis. To investigate the incidence, anatomical concern, etiology, symptom, diagnostic tool, management and prognosis of posterior epidural lumbar disc fragment, we reviewed articles including case report. We performed a search of all clinical studies of posterior epidural lumbar disc fragment published to date. The following keywords were searched: Posterior epidural lumbar disc fragment, disc migration, posterior epidural disc, extradural migration, dorsal epidural migration, sequestrated disc, and disc fragment. We identified 40 patients of posterior epidural lumbar disc fragment from 28 studies. The most common presentation of posterior epidural lumbar disc fragment was sudden onset radiculopathy (70.0%), followed by cauda equina syndrome (27.5%). The most frequently used diagnostic modality was magnetic resonance imaging (MRI), conducted in 36 cases (90.0%), and followed by computed tomography in 14 cases (35.0%). After the imaging studies, the preoperative diagnoses were 45.0% masses, 20.0% lesions, and 12.5% tumors. Characteristic MRI findings in posterior epidural lumbar disc fragment are helpful for diagnosis; it typically displays low signals on T1-weighted images and high signals on T2-weighted images with respect to the parent disc. In addition, most of the disc fragments show peripheral rim enhancement on MRI with gadolinium administration. Electrodiagnostic testing is useful for verifying nerve damage. Surgical treatment was performed in all cases, and neurologic complications were observed in 12.5%. As

Posterior fossa meningioma (surgical experiences)

African Journals Online (AJOL)

Wael M. Moussa

2012-08-27

Aug 27, 2012 ... of the CNS, representing about a third of brain tumors. They arise from the ... subtypes based on cell structure.1–4 In 1979, the World Health. Organization .... anterior or posterior to the internal auditory meatus), petrocli-.

Treatment planning of implants in posterior quadrants.

Science.gov (United States)

Jivraj, S; Chee, W

2006-07-08

Differences in anatomy and biomechanics make treatment of posterior quadrants with dental implants substantially different to that of anterior areas. Without implants, when posterior teeth were lost, treatment options included a long span fixed partial denture or a removable prosthesis, especially when no terminal abutment was available. Today, with the use of implants, options are available that allow preservation of unrestored teeth.(1) When teeth are missing, implant supported restorations can be considered the treatment of choice from the perspective of occlusal support, preservation of adjacent teeth and avoidance of a removable partial denture.

Posterior instrumentation, anterior column reconstruction with single posterior approach for treatment of pyogenic osteomyelitis of thoracic and lumbar spine.

Science.gov (United States)

Gorensek, M; Kosak, R; Travnik, L; Vengust, R

2013-03-01

Surgical treatment of thoracolumbar osteomyelitis consists of radical debridement, reconstruction of anterior column either with or without posterior stabilization. The objective of present study is to evaluate a case series of patients with osteomyelitis of thoracic and lumbar spine treated by single, posterior approach with posterior instrumentation and anterior column reconstruction. Seventeen patients underwent clinical and radiological evaluation pre and postoperatively with latest follow-up at 19 months (8-56 months) after surgery. Parameters assessed were site of infection, causative organism, angle of deformity, blood loss, duration of surgery, ICU stay, deformity correction, time to solid bony fusion, ambulatory status, neurologic status (ASIA impairment scale), and functional outcome (Kirkaldy-Willis criteria). Mean operating time was 207 min and average blood loss 1,150 ml. Patients spent 2 (1-4) days in ICU and were able to walk unaided 1.6 (1-2) days after surgery. Infection receded in all 17 patients postoperatively. Solid bony fusion occurred in 15 out of 17 patients (88 %) on average 6.3 months after surgery. Functional outcome was assessed as excellent or good in 82 % of cases. Average deformity correction was 8 (1-18) degrees, with loss of correction of 4 (0-19) degrees at final follow-up. Single, posterior approach addressing both columns poses safe alternative in treatment of pyogenic vertebral osteomyelitis of thoracic and lumbar spine. It proved to be less invasive resulting in faster postoperative recovery.

Posterior perforation of gastric ulcer: a rare surgical emergency ...

African Journals Online (AJOL)

BACKGROUND:Gastric ulcer perforation is a rare surgical emergency.Posterior gastric ulcer is even rarer and usually has a delayed presentation with attendant greater morbidity and mortality. AIM:To report a case of posterior perforation of gastric ulcer and review the literature. CASE REPORT:A 65yr old driver was seen in ...

Distrofia policromática posterior da córnea

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Letícia Maria Coelho

2015-06-01

Full Text Available Os autores descrevem dois casos de distrofia policromática posterior da córnea, uma distrofia pré-Descemet, pouco descrita nas literaturas nacional e mundial, em que se observam pontos policromáticos difusos no estroma posterior da córnea, sem aparente comprometimento da visão.

[Buffering capacity of the vitreous body in aggressive posterior retinopathy of prematurity].

Science.gov (United States)

Amkhanitskaia, L I; Sidorenko, E I; Nikolaeva, G V; Kuznetsova, Iu D

2014-01-01

To investigate the role of vitreous body changes in the pathogenesis of aggressive posterior retinopathy of prematurity. The study included 60 children with stage 4-5 retinopathy of prematurity demonstrating either classical or aggressive posterior form of progression. In all cases vitreous samples for laboratory testing were taken during surgery. The study showed that aggressive posterior retinopathy of prematurity is associated with more significant metabolic changes in comparison with classical form of the disease. The degree of biochemical imbalance of the vitreous appeared directly related to the stage of the disease, which was determined by the type and extent of retinal detachment. Volcano-shaped retinal detachment with intensive exudation within the posterior eye segment is considered the most severe variant of aggressive posterior retinopathy of prematurity. Aggressive posterior retinopathy of prematurity is characterized by substantial disturbance of metabolism of the vitreous body, which contributes to exudation and proliferation, thus aggravating the course of the disease and worsening the prognosis.

Radial tear of posterior horn of the medial meniscus and osteonecrosis of the knee

International Nuclear Information System (INIS)

Motoyama, Tatsuo; Ihara, Hidetoshi; Kawashima, Mahito

2003-01-01

We studied the relation between a radial tear of the posterior horn of the medial meniscus and osteonecrosis of the knee. Thirty-eight knees of 37 patients were diagnosed as medial meniscus tear and received arthroscopic knee surgery. We divided them into two groups: knees having radial tear of the posterior horn of the medial meniscus (posterior horn group) and knees containing radial tear except for posterior horn, horizontal tear, degenerative tear, and flap tear of the medial meniscus (non-posterior horn group). The posterior horn group consisted of 14 knees (average age: 65.1 years old) and the non-posterior horn group consisted of 24 knees (average age: 59.6 years old). All cases underwent MRI before arthroscopy. MRI findings were classified into three types (typical osteonecrosis, small osteonecrosis, and non-osteonecrosis). In the posterior horn group, typical osteonecrosis were five knees and small osteonecrosis were five knees, while in the non-posterior horn group only three knees were small osteonecrosis. These findings suggest the relevance between radial tear of the posterior horn of the medial meniscus and osteonecrosis of the knee (Mann-Whitney test p<0.01). The etiology of spontaneous osteonecrosis of the knee joint is unknown, however one etiology could be the radial tear of the posterior horn of the medial meniscus. (author)

Posterior consistency for Bayesian inverse problems through stability and regression results

International Nuclear Information System (INIS)

Vollmer, Sebastian J

2013-01-01

In the Bayesian approach, the a priori knowledge about the input of a mathematical model is described via a probability measure. The joint distribution of the unknown input and the data is then conditioned, using Bayes’ formula, giving rise to the posterior distribution on the unknown input. In this setting we prove posterior consistency for nonlinear inverse problems: a sequence of data is considered, with diminishing fluctuations around a single truth and it is then of interest to show that the resulting sequence of posterior measures arising from this sequence of data concentrates around the truth used to generate the data. Posterior consistency justifies the use of the Bayesian approach very much in the same way as error bounds and convergence results for regularization techniques do. As a guiding example, we consider the inverse problem of reconstructing the diffusion coefficient from noisy observations of the solution to an elliptic PDE in divergence form. This problem is approached by splitting the forward operator into the underlying continuum model and a simpler observation operator based on the output of the model. In general, these splittings allow us to conclude posterior consistency provided a deterministic stability result for the underlying inverse problem and a posterior consistency result for the Bayesian regression problem with the push-forward prior. Moreover, we prove posterior consistency for the Bayesian regression problem based on the regularity, the tail behaviour and the small ball probabilities of the prior. (paper)

Magnetic resonance imaging of hypothalamus hypophysis axis lesions; Relationship between posterior pituitary function and posterior bright spot

Energy Technology Data Exchange (ETDEWEB)

Shiina, Takeki; Uno, Kimiichi; Arimizu, Noboru; Yoshida, Sho (Chiba Univ. (Japan). School of Medicine); Yamada, Kenichi

1990-04-01

Magnetic resonance imaging (MRI) using a 0.5T superconductive machine was performed to the thirty three cases with a variety of the sellar and parasellar tumors and with dysfunction of the hypothalamus-hypophysis axis. Posterior pituitary bright spot (PBS) on T1 weighted image was evaluated with the pituitary hormonal function. These cases were 12 cases of post-treated tumors including pituitary adenoma (9 patients), suprasellar germinoma (2 patients) and craniopharyngioma (one patient), and non-tumorous conditions including 15 cases of central diabetes insipidus (DI), Syndrome of inappropriate secretion of ADH (SIADH) (one patient), Sheehan's syndrome (3 patients) and anorexia nervosa (2 patients). Pituitary bright spot was not seen in all 19 cases with overt DI. On the other hand, PBS was not seen in 9 cases without overt DI. Three cases of these 9 cases showing Sheehan's syndrome with insufficient antidiuretic hormone (ADH) secretion was considered as the state of subclinical DI. Posterior bright spot was not seen in all 13 cases of empty sella including partial empty sella. The results suggested that disappearance of PBS represents abnormality or loss of posterior pituitary function and also it was considered to be closely related to the empty sella. (author).

Good outcome after posterior reversible encephalopathy syndrome (PRES) despite elevated cerebral lactate

DEFF Research Database (Denmark)

Ewertsen, Caroline; Kondziella, Daniel; Danielsen, Else R

2015-01-01

Posterior reversible encephalopathy syndrome (PRES) may cause irreversible brain damage. The diagnosis is confirmed by magnetic resonance imaging (MRI), where vasogenic edema may be seen especially in the posterior parts of the brain. MR spectroscopy (MRS) may be included to help predict the outc......Posterior reversible encephalopathy syndrome (PRES) may cause irreversible brain damage. The diagnosis is confirmed by magnetic resonance imaging (MRI), where vasogenic edema may be seen especially in the posterior parts of the brain. MR spectroscopy (MRS) may be included to help predict...

Radiology of posterior lumbar apophyseal ring fractures: Report of 13 cases

Energy Technology Data Exchange (ETDEWEB)

Dietemann, J.L.; Beaujeux, R.; Wackenheim, A.; Runge, M.; Bonneville, J.F.; Badoz, A.; Dosch, J.C.

1988-08-01

The authors report radiological findings in 13 cases of avulsion of the posterior lumbar apophyseal ring. The lesion affected young adults in 10 cases and adolescents in 3 cases. The lesion involved the inferior endplate of L4 in 11, and of L5 in 2 patients. 6 patients presented with unilateral sciatica, 3 with bilateral sciatica, and 4 with low back pain. Acute spinal trauma was evident only in 2 adolescents. Radiological recognition of the lesion was possible on plain films in 9 cases. CT demonstrates association of avulsion of the posterior vertebral apophyseal ring and herniated disc in all cases. Avulsion of the posterior apophyseal ring has to be differentiated from posterior longitudinal ligament, annulus, or herniated disc calcifications, as well as from posterior degenerative ridge osteophytes. Controversy about physiopathology of the lesion remains: Weakness of the apophyseal ring during childhood and in patients with Scheuermann's disease may explain avulsion of the apophyseal ring in association with median disc herniation.

Radiology of posterior lumbar apophyseal ring fractures: Report of 13 cases

International Nuclear Information System (INIS)

Dietemann, J.L.; Beaujeux, R.; Wackenheim, A.; Runge, M.; Bonneville, J.F.; Badoz, A.; Dosch, J.C.

1988-01-01

The authors report radiological findings in 13 cases of avulsion of the posterior lumbar apophyseal ring. The lesion affected young adults in 10 cases and adolescents in 3 cases. The lesion involved the inferior endplate of L4 in 11, and of L5 in 2 patients. 6 patients presented with unilateral sciatica, 3 with bilateral sciatica, and 4 with low back pain. Acute spinal trauma was evident only in 2 adolescents. Radiological recognition of the lesion was possible on plain films in 9 cases. CT demonstrates association of avulsion of the posterior vertebral apophyseal ring and herniated disc in all cases. Avulsion of the posterior apophyseal ring has to be differentiated from posterior longitudinal ligament, annulus, or herniated disc calcifications, as well as from posterior degenerative ridge osteophytes. Controversy about physiopathology of the lesion remains: Weakness of the apophyseal ring during childhood and in patients with Scheuermann's disease may explain avulsion of the apophyseal ring in association with median disc herniation. (orig.)

Prevention of posterior capsular opacification

NARCIS (Netherlands)

Nibourg, Lisanne M; Gelens, Edith; Kuijer, Roelof; Hooymans, Johanna Mm; van Kooten, Theo G; Koopmans, Steven A

Posterior capsular opacification (PCO) is a common complication of cataract surgery. The development of PCO is due to a combination of the processes of proliferation, migration, and transdifferentiation of residual lens epithelial cells (LECs) on the lens capsule. In the past decades, various forms

Fatal atypical reversible posterior leukoencephalopathy syndrome: a case report

Directory of Open Access Journals (Sweden)

Golombeck Stefanie Kristin

2013-01-01

Full Text Available Abstract Introduction Reversible posterior leukoencephalopathy syndrome – a reversible subacute global encephalopathy clinically presenting with headache, altered mental status, visual symptoms such as hemianopsia or cortical blindness, motor symptoms, and focal or generalized seizures – is characterized by a subcortical vasogenic edema symmetrically affecting posterior brain regions. Complete reversibility of both clinical signs and magnetic resonance imaging lesions is regarded as a defining feature of reversible posterior leukoencephalopathy syndrome. Reversible posterior leukoencephalopathy syndrome is almost exclusively seen in the setting of a predisposing clinical condition, such as pre-eclampsia, systemic infections, sepsis and shock, certain autoimmune diseases, various malignancies and cytotoxic chemotherapy, transplantation and concomitant immunosuppression (especially with calcineurin inhibitors as well as episodes of abrupt hypertension. We describe for the first time clinical, radiological and histological findings in a case of reversible posterior leukoencephalopathy syndrome with an irreversible and fatal outcome occurring in the absence of any of the known predisposing clinical conditions except for a hypertensive episode. Case presentation A 58-year-old Caucasian woman presented with a two-week history of subacute and progressive occipital headache, blurred vision and imbalance of gait and with no evidence for raised arterial blood pressure during the two weeks previous to admission. Her past medical history was unremarkable except for controlled arterial hypertension. Cerebral magnetic resonance imaging demonstrated cortical and subcortical lesions with combined vasogenic and cytotoxic edema atypical for both venous congestion and arterial infarction. Routine laboratory and cerebrospinal fluid parameters were normal. The diagnosis of reversible posterior leukoencephalopathy syndrome was established. Within hours after

Posterior Slope of the Tibia Plateau in Malaysian Patients Undergoing Total Knee Replacement

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R Yoga

2009-05-01

Full Text Available The posterior slope of the tibial plateau is an important feature to preserve during knee replacement. The correct slope aids in the amount of flexion and determines if the knee will be loose on flexion. This is a study on the posterior tibial plateau slope based on preoperative and postoperative radiographs of 100 consecutive patients who had total knee replacements. The average posterior slope of the tibia plateau was 10.1 degrees. There is a tendency for patients with higher pre-operative posterior tibial plateau slope to have higher post-operative posterior tibial plate slope.

Perawatan Crossbite Posterior pada Maloklusi Angle Klas III dengan Alat Ortodontik Cekat Teknik Begg

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Trio Wijayanto

2011-12-01

Full Text Available Latar Belakang: Crossbite posterior merupakan hubungan abnormal dari gigi-gigi posterior secara bukolingual pada rahang atas atau bawah pada saat kedua lengkung gigi berada dalam oklusi sentrik yang dapat terjadi pada satu atau kedua sisi rahang. Posterior crossbite adalah maloklusi yang paling sering muncul pada masa gigi susu dan awal gigi bercampur. Tujuan Perawatan: mengoreksi crossbite posterior dan mengembalikan fungsi pengunyahan yang baik. Kasus: Perempuan 20 tahun dengan maloklusi Angle klas III disertai crossbite posterior kanan, crowding rahang atas dan bawah. Penanganan: menggunakan alat cekat teknik Begg dengan pencabutan gigi premolar I rahang atas kiri, kedua premolar I rahang bawah, cross elastik, toe-in, dan toe out digunakan untuk koreksi crossbite. Kesimpulan: Perawatan crossbite posterior dengan teknik Begg menunjukkan hasil yang cukup memuaskan. Prognatik mandibula berkurang, crossbite terkoreksi, overjet normal, overbite normal, dan fungsi pengunyahan menjadi lebih baik.   Background: Posterior crossbite is defined as any abnormal bucal-lingual relations between posterior teeth of upper and lower jaw in centric occlusion which can occur in one side only or both. Posterior crossbite is one of the most prevalent malocclusion in primary and early mixed dentition. Purpose: to correct posterior and restore normal mastication. Case: 20 years old woman with Angle’s class II accompanied by posterior crossbite on the right side and crowding in anterior segment of upper and lower jaw. Management: using the Begg fixed appliance techniques with the extraction of upper left, and two lower first premolars. Cross elastic along with toe in and toe out on the main wire was used to correct posterior crossbite. Conclusion: Posterior crossbite treatment with Begg technique showed satisfactory results. Prognatism mandibula had reduced, regained normal overjet and overbite, and restored good mastication.

Posterior leukoencephalopathy syndrome in poststretococcal acute glomerulonephritis

International Nuclear Information System (INIS)

Bazzino Borzone, F.; Pandolfo Arias, M.; Protasio Palomino, L.; Pujadas Ferrer, M.; Cerisola Cardozo, A.; Gonzalez, G.; Caggiani Malzone, M.; Rubio Santoro, I.

2005-01-01

Reversible posterior leukoencephalopathy (LEPR) is a clinical entity that affects radiation usually the white matter of the cerebral hemispheres. It is frequently associated with acute arterial hypertension and immunosuppressive therapy, among other causes. The clinical presentation is varied, with headache, nausea, vomiting, impaired consciousness and abnormal behavior, seizures and visual disturbances, symptoms that often regress. Computed tomography (CT) and magnetic resonance imaging (MRI) images show white matter edema predominantly in posterior regions of the brain. We present a 10 year old boy with leprosy in the course of a nephrotic syndrome secondary to acute diffuse glomerunefritis (GNDA) poststreptococcal. (author) [es

A quantitative study of computer tomography images of the lumbar posterior elements

International Nuclear Information System (INIS)

Yamazaki, Ken

1985-01-01

The posterior elements of the lumbar spine in 125 vertebrae of 62 cases were studied quantitatively by computer tomography. The cases were classified into 4 groups: Group I (15 cases): Young (20 - 50 years old), normal by radiography and asymptomatic. Group II (15 cases): Aged (over 50 years old), spondylosis deformans by radiography and asymptomatic. Group III (15 cases): Aged spondylosis deformans by radiography and symptomatic. Group IV (17 cases): Aged, degenerative spondylolisthesis by radiography and symptomatic. The posterior recess consisting of the superior articular process (SAP) and the inferior articular process (IAP) (canal side) was measured by computer tomography. A relationship was found between the onset of symptoms and the effective area of the posterior recess (i.e. the area of the posterior recess without yellow ligament) for normal function (i.e. no block observed by myelography). In particular a bulging disc was observed near the entrance of the posterior recess by CT scan in the symptomatic groups. The factors which were related to the effective area were changes in the disc and yellow ligament, the entrance of the posterior recess, the prominence of IAP (canal side), and the superior articular facet angle. An index of the decrease in the effective area of the posterior recess calculated from four factors. Given that the length of the entrance of the posterior recess is the interfacetal distance (IFD), the depth of the posterior recess is the midsagittal distance (MSD) and the effective area is S, then RS = (IFD x MSD x 1/2-S)/(IFD x MSD x 1/2) x 100 (%) = [1 - (2 x S/(IFD x MSD))] x 100 (%) where RS = the narrowing ratio. The quantitative index of decrease in the effective area of the posterior recess (i.e. the narrowing ratio) may be useful in the diagnosis of degenerative lumbar spinal disease where the disc was bulging. (J.P.N.)

Pseudoaneurysm of the posterior circumflex humeral artery diagnosed by sonography

DEFF Research Database (Denmark)

Damgaard, Bodil; Court-Payen, Michel; Larsen, Lone

2009-01-01

with a painless, nonpulsatile mass in the posterior shoulder region and was suspected of a malignant soft-tissue tumor. Sonography, including power Doppler imaging, demonstrated a pseudoaneurysm, with the intralesional blood-filled cavity developed from the posterior circumflex humeral artery. The diagnosis...

The ectopic posterior pituitary gland

African Journals Online (AJOL)

2013-11-04

Nov 4, 2013 ... crinology with short stature, delayed bone age and biochemical features suggestive of hypo pituitarism. Magnetic resonance imaging of the brain demonstrated a flattened anterior pituitary gland within the sella, associated with absence of the infundibular stalk and an ectopic posterior pituitary gland (Fig.

Digestibilidade aparente dos nutrientes de dietas simplificadas baseadas em forragens para coelhos em crescimento Apparent digestibility of nutrients of simplified diets based on forages for growing rabbits

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W.M. Ferreira

2007-04-01

Full Text Available Avaliaram-se os efeitos de dietas simplificadas à base de forragens sobre a digestibilidade aparente dos nutrientes em coelhos Nova Zelândia branco. As dietas experimentais foram: referência (REF, feno de alfafa (FAL, feno das folhas de rami (FRA, feno das folhas de amoreira (FAM e feno do terço superior da rama da mandioca (FMA. A digestibilidade das dietas foi influenciada pelo tipo de alimento estudado; a FMA apresentou coeficientes de digestibilidade inferiores às demais dietas para todos os princípios nutritivos analisados. Para a dieta FAM, os coeficientes de digestibilidade aparente dos princípios nutritivos foram maiores (P0,05. Os valores estimados de energia digestível (kcal ED/kg MS e proteína digestível (%PD/MS foram, respectivamente, para o feno de alfafa: 2285,27 e 16,04; feno das folhas de rami: 1857,88 e 16,37; feno das folhas de amoreira: 2838,48 e 15,12 e feno do terço superior da mandioca: 2155,55 e 10,57.The effect of simplified diets based on forages on the apparent digestibility in white New Zealand rabbits was evaluated. The treatments were based on the following diets: reference (REF, hay of alfalfa (FAL, hay of rami leaves (FRA, hay of mulberry leaves (FAM and hay of upper to 1/3 aereal part of cassava (FMA. The type of food affected the digestibility of the diets. The FMA diet showed low coefficients of digestibility in comparison to the other diets for all the analyzed nutrients. For the FAM diet the coefficients of apparent digestibility of the nutrients had higher values (P0.05. The estimated values of digestible energy (kcal DE/kg DM and digestible protein (%DP/DM were, respectively, 2285.27 and 16.04 for alfalfa hay, 1857.88 and 16.37 for hay of rami leaves, 2838.48 and 15.12 for hay of mulberry leaves and 2155.55 and 10.57 for hay of upper to 1/3 aereal part of cassava.

Blunt pediatric anterior and posterior urethral trauma: 32-year experience and outcomes.

Science.gov (United States)

Voelzke, Bryan B; Breyer, Benjamin N; McAninch, Jack W

2012-06-01

To analyze our experience with delayed repair of pediatric urethral trauma. From 1978 to 2007, 26 boys posterior urethral injuries were separately stratified. There were 8 anterior and 18 posterior urethral strictures. All patients presented in a delayed fashion. Mean follow up of the anterior cohort was 2.9 years. All repairs were performed via a ventral onlay buccal graft or anastomotic approach. The mean follow up of the posterior cohort was 1.1 years, and all posterior urethral injuries were repaired via an anastomotic approach. Overall success for anterior stricture disease was 88.9% and for posterior stricture disease was 89.5%. All three urethroplasty failures responded favorably to internal urethrotomy; however, one failed anterior repair and one of the two failed posterior repairs required two internal urethrotomy operations for success. No secondary urethroplasty operations were required and ultimately all patients were voiding per urethra without need for urethral dilation. Delayed, definitive repair of pediatric urethral trauma via open urethroplasty has a high success rate. Copyright © 2011 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Total knee reconstruction without posterior stabilization in rheumatoid arthritis patients

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Radu Prejbeanu

2010-12-01

Full Text Available Objectives: to present the results with posterior cruciate ligament-retaining total knee arthroplasty in rheumatoid arthritis (RA patients. Background: Total knee replacement in RA patients has many particularities. One of them is the difficulty of obtaining a proper ligamentous balance.Methods: 24 RA patients were followed for a 5-year period after posterior cruciate ligament-retaining total knee arthroplasty. Clinical assessments analyzed general health status by using Hospital for Special Surgery Knee Evaluation Form (HSSKEF and mediolateral and anteroposterior ligament stability by using varus-valgus and posterior drawer tests. Radiological assessments evaluated axial alignment, size and position of components, radiolucent lines in anteroposterior and lateral standard views, integrity of the posterior cruciate ligament on lateral view X-ray at 45 degrees of flexion.Results: the mean HSSKEF score increased from 32 to 84 points at the end of follow-up. Preoperative mean range of motion was 60 degrees; postoperative mean range of motion was of 105 degrees, with significant statistical difference (p<0.05. The mean femoral component axial deviation was 6 degrees. The tibial component had a mean axial deviation of 1 degree of varus. There were no radioluscency lines of more than 1mm. 21 patients had excellent results. None of the knees was unstable. Conclusion: posterior cruciate ligament-retaining total knee arthroplasty can be used in RA patients without excessive valgus deformity (over 15 degrees, providing thus sufficient stabilization. The outcomes re similar to those patients who followed a posterior stabilized endoprosthesis.

Aneurisma verdadeiro bilateral de artéria tibial posterior True bilateral aneurysm of the posterior tibial artery

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Silvio Romero de Barros Marques

2006-03-01

Full Text Available Neste artigo, faz-se o relato de um caso de aneurisma verdadeiro bilateral da artéria tibial posterior em paciente de 57 anos. Os aneurismas surgiram em épocas diferentes. Os aspectos clínicos, diagnósticos e terapêuticos deste caso são discutidos. Este relato é importante, pois os autores não têm conhecimento de caso semelhante na literatura consultada.This article reports a case of true bilateral aneurysm of the tibial posterior artery in a 57 year-old patient. The aneurysms occurred at different times. The clinical, diagnostic and therapeutic aspects of this case are discussed. This report is important because the authors did not find a similar description in the literature.

Improvising a Posterior Nasal Pack with Equipment in a Basic First Aid Kit.

Science.gov (United States)

Royer, Allison K; Royer, Mark C

2016-09-01

Posterior epistaxis is a serious condition that can be difficult to treat in a wilderness setting. The initial standard of care involves packing the affected nostril with a 7 to 9 cm nasal pack to tamponade the bleed. These packs are often unavailable outside of the emergency or operating room. This study set out to determine whether a posterior nasal pack could be constructed from the supplies present in a basic first aid kit in order to control massive nasal hemorrhage in a wilderness setting. A basic first aid kit was utilized to construct a posterior nasal pack that was inserted into an anatomical model and visibly compared with the Rapid Rhino (Posterior, 7.5 cm; Smith & Nephew, Austin, TX) nasal packing. The shape, size, and anatomical areas of compression (ie, into nasopharynx and posterior aspect of inferior turbinate) of this pack was similar to the commercially available posterior nasal pack. Placement in an anatomical model appears to provide similar compression as the commercially available posterior pack. This technique may provide short-term hemorrhage control in cases of serious posterior nasal hemorrhage where standard treatment options are not available. Copyright © 2016 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

MR imaging as a problem solving tool in posterior ankle pain: A review

Energy Technology Data Exchange (ETDEWEB)

Wong, Gloria N.L., E-mail: gnlwong@gmail.com; Tan, Tien Jin, E-mail: tien_jin_tan@cgh.com.sg

2016-12-15

Highlights: • Conditions causing posterior ankle pain may occur in isolation or in co-existence. • Identification of the causative pathology is therefore often difficult. • The pathology and MR imaging findings of common causative conditions are discussed. • MRI aids accurate and timely diagnoses in cases of posterior ankle pain. - Abstract: Posterior ankle pain is a cause of chronic pain and disability, afflicting a wide range of individuals. While proper identification of the cause is essential for timely and adequate treatment, identifying the cause and excluding mimickers is often challenging for the physician due to the complex nature of the joint. In addition, pathology that can cause posterior ankle pain may occur on their own or in co-existence. Clinical conditions that can present as posterior ankle pain include: posterior ankle impingement, Achilles tendon pathology, medial flexor tendon pathology, peroneal pathology, retrocalcaneal bursitis, posterior subtalar tarsal coalition, sinus tarsi, and tarsal tunnel syndrome. In this review we introduce current concepts of pathophysiology in the main conditions involved in posterior ankle pain, and review the role of MR in the diagnosis and management of each condition. When pathology can be detected earlier and with more specificity, appropriate and time-sensitive treatment can be commenced, thus improving clinical outcomes.

The appearance of a lurking ligament in Laparoscopic Sleeve Gastrectomy; Posterior Gastric Ligament

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Mutlu Ünver

2017-03-01

Full Text Available Objective: The aim of this study was to demonstrate a lurking ligament and its various formation types and to mention the importance of this ligament in Laparoscopic sleeve gastrectomy Methods: One hundred and twelve patients had laparoscopic sleeve gastrectomy (LSG procedure in our clinic between March 2011 and September 2013. All procedures were performed with a standard operative technique. Only difference for the last 50 patients was to avoid the excessive dissection of posterior gastric wall. The existence of posterior gastric ligament was recorded and different types of posterior gastric ligament was demonstrated. Results: Posterior gastric ligament was observed in all of the cases in different formation types. Three types of ligament; complete, partial and skippy, was demonstrated. 53(47.3% of the patients had skippy, while 41 (36.6% had partial and 18 (16.1% had complete type of posterior gastric ligament. Conclusion: A ligament named as ‘posterior gastric ligament’ and its various forms were defined in the third dimensional plane of stomach. Posterior gastric ligament remains as the only structure in LSG for preventing the mobility and ability of the stomach to rotate. The excessive dissection of the posterior gastric ligament should be avoided to prevent complications such as kinking and volvulus

MR imaging as a problem solving tool in posterior ankle pain: A review

International Nuclear Information System (INIS)

Wong, Gloria N.L.; Tan, Tien Jin

2016-01-01

Highlights: • Conditions causing posterior ankle pain may occur in isolation or in co-existence. • Identification of the causative pathology is therefore often difficult. • The pathology and MR imaging findings of common causative conditions are discussed. • MRI aids accurate and timely diagnoses in cases of posterior ankle pain. - Abstract: Posterior ankle pain is a cause of chronic pain and disability, afflicting a wide range of individuals. While proper identification of the cause is essential for timely and adequate treatment, identifying the cause and excluding mimickers is often challenging for the physician due to the complex nature of the joint. In addition, pathology that can cause posterior ankle pain may occur on their own or in co-existence. Clinical conditions that can present as posterior ankle pain include: posterior ankle impingement, Achilles tendon pathology, medial flexor tendon pathology, peroneal pathology, retrocalcaneal bursitis, posterior subtalar tarsal coalition, sinus tarsi, and tarsal tunnel syndrome. In this review we introduce current concepts of pathophysiology in the main conditions involved in posterior ankle pain, and review the role of MR in the diagnosis and management of each condition. When pathology can be detected earlier and with more specificity, appropriate and time-sensitive treatment can be commenced, thus improving clinical outcomes.

Abordagem Anestésica na Síndrome de Kounis - Um Inimigo Cardíaco Pouco Conhecido: A Propósito de um Caso Clínico

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Carolina Gonçalves

2018-05-01

Com esta publicação pretende-se fazer uma revisão teórica acerca da abordagem anestésica direcionada para esta síndrome dado que se trata de um tema re-cente, pouco conhecido e com envolvimento multidisciplinar (Anestesiologia, Cardiologia e Medicina Intensiva.

ESTRUTURA E DINÂMICA DA PAISAGEM NO MUNICÍPIO DE LIMA DUARTE (MG: UMA ABORDAGEM GEOECOLÓGICA

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Roberto Marques Neto

2014-12-01

Full Text Available O presente artigo se encarrega de divulgar os resultados referentes ao estudo da fragilidade ambiental no município de Lima Duarte mediante abordagem geoecológica subsidiada por técnicas de geoprocessamento, sendo correlacionados, em ambiente ArcGIS, os seguintes atributos: declividade, formas de relevo, solos, uso da terra e cobertura vegetal. A carta de fragilidade, gerada a partir da sobreposição destes documentos cartográficos precedentes, discerniu cerca de cinco classes de fragilidade: muito baixa, baixa, média, alta, muito alta, estabelecida em estreita consonância às variáveis analisadas previamente.

As Armas Não Letais como Abordagem Temática para o Ensino de Química

OpenAIRE

Razuck, Fernando Barcellos

2017-01-01

Nos últimos anos o Brasil acompanhou uma série de manifestações reivindicando a melhoria na qualidade dos serviços públicos. Como resposta a essas manifestações houve uma intensa abordagem policial, com o uso de armas não letais, como o gás lacrimogêneo e o spray de pimenta. Considerando a importância de se atrelar o momento histórico à presença da ciência, este trabalho, realizado em uma escola pública na forma de oficina temática durante a Semana de Educação para a Vida, teve o objetivo de ...

Late rupture of the posterior cruciate ligament after total knee replacement.

OpenAIRE

Montgomery, R. L.; Goodman, S. B.; Csongradi, J.

1993-01-01

To our knowledge there have been no reports of late rupture of the posterior cruciate ligament (PCL) as a cause of instability in PCL-retaining total knee prostheses. In our experience of 150 total knee replacements using PCL-retaining prosthesis, three cases (2.0%) of late rupture of the posterior cruciate ligament have occurred, each leading to chronic instability, disabling pain, and revision arthroplasty. In each case rupture of the posterior cruciate ligament was confirmed at the time of...

Transtorno obsessivo compulsivo em crianças e adolescentes: revisão de literatura e abordagem odontológica

OpenAIRE

Marinho, Erika von Söhsten; Junior, Esio de Carvalho Coelho; Alves, Klécio de Andrade; Ximenes, Rosana Christine Cavalcanti; Barreira, Alice Kelly; Couto, Geraldo Bosco Lindoso

2016-01-01

O transtorno obsessivo compulsivo (TOC) é um transtorno psiquiátrico crônico que atinge de 1 a 2% da população de crianças e adolescentes, necessitando de uma abordagem adequada durante o atendimentoodontológico devido ao aumento da ansiedade, às medicações utilizadas no tratamento do transtorno e, possivelmente, devido a comportamentos compulsivos. O objetivo deste trabalho foi fazer um levantamentobibliográfico a respeito das principais características do TOC na infância e adolescência e tr...

Partial-coverage posterior ceramic restorations. Part 1: a return to diligence.

Science.gov (United States)

Liebenberg, W H

2001-01-01

The application of multisurfaced tooth-colored restorations in the posterior dentition is an exercise in risk tolerance when dentin occupies the bulk of the tooth substrate. Not only is interfacial integrity capricious, but also a recent in vivo study has confirmed that dentin bond strengths deteriorate with time. Although the literature is replete with esthetic guidelines for posterior restitution, most practicing clinicians appreciate the prime tenet that clinical success involves more than esthetic realism in the posterior dentition. Success with indirect ceramic restorations is dependent on interfacial integrity, which, although multitudinous, is contingently related to operative competence. Innovative clinical techniques are described in this two-part article, along with a discussion of the probationary status of current adhesive options and the need for excellence in all phases of this demanding restorative sequence. Restorative success in the posterior dentition is profoundly influenced by the variability of operative competence and diligence. This article discusses the precincts of posterior indirect ceramic restorations and submits a number of innovative solutions to the clinical challenge.

Multiclass Posterior Probability Twin SVM for Motor Imagery EEG Classification.

Science.gov (United States)

She, Qingshan; Ma, Yuliang; Meng, Ming; Luo, Zhizeng

2015-01-01

Motor imagery electroencephalography is widely used in the brain-computer interface systems. Due to inherent characteristics of electroencephalography signals, accurate and real-time multiclass classification is always challenging. In order to solve this problem, a multiclass posterior probability solution for twin SVM is proposed by the ranking continuous output and pairwise coupling in this paper. First, two-class posterior probability model is constructed to approximate the posterior probability by the ranking continuous output techniques and Platt's estimating method. Secondly, a solution of multiclass probabilistic outputs for twin SVM is provided by combining every pair of class probabilities according to the method of pairwise coupling. Finally, the proposed method is compared with multiclass SVM and twin SVM via voting, and multiclass posterior probability SVM using different coupling approaches. The efficacy on the classification accuracy and time complexity of the proposed method has been demonstrated by both the UCI benchmark datasets and real world EEG data from BCI Competition IV Dataset 2a, respectively.

Outcomes of Surgery for Posterior Polar Cataract Using Torsional Ultrasound

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Selçuk Sızmaz

2013-10-01

Full Text Available Purpose: The aim of this study is to report outcomes of surgery for posterior polar cataract using torsional ultrasound. Material and Method: Medical records of 26 eyes of 21 consecutive patients with posterior polar cataract who had cataract surgery using the torsional phacoemulsification were evaluated retrospectively. The surgical procedure used, phacoemulsification parameters, intraoperative complications, and postoperative visual outcome were recorded. Results: Of the 26 eyes, 24 (92.3% had small to medium posterior polar opacity. Two eyes had large opacity. All surgeries were performed using the torsional handpiece. Posterior capsule rupture occurred in 4 (15.3% eyes. The mean visual acuity improved significantly after surgery (p<0.001. The postoperative visual acuity was worse than 20/20 in 5 eyes. The cause of the low acuity was amblyopia. Discussion: Successful surgical results and good visual outcome can be achieved with phacoemulsification using the torsional handpiece. (Turk J Ophthalmol 2013; 43: 345-7

Posterior lattice degeneration characterized by spectral domain optical coherence tomography.

Science.gov (United States)

Manjunath, Varsha; Taha, Mohammed; Fujimoto, James G; Duker, Jay S

2011-03-01

The purpose of this study was to use high-resolution spectral domain optical coherence tomography in the characterization of retinal and vitreal morphological changes overlying posterior lattice degeneration. A cross-sectional retrospective analysis was performed on 13 eyes of 13 nonconsecutive subjects with posterior lattice degeneration seen at the New England Eye Center, Tufts Medical Center between October 2009 and January 2010. Spectral domain optical coherence tomography images taken through the region of lattice degeneration were qualitatively analyzed. Four characteristic changes of the retina and vitreous were seen in the 13 eyes with lattice degeneration: 1) anterior/posterior U-shaped vitreous traction; 2) retinal breaks; 3) focal retinal thinning; and 4) vitreous membrane formation. The morphologic appearance of vitreous traction and retinal breaks were found to be consistent with previous histologic reports. It is possible to image posterior lattice degeneration in many eyes using spectral domain optical coherence tomography and to visualize the spectrum of retinal and vitreous changes throughout the area of lattice degeneration.

Posterior epistaxis: Common bleeding sites and prophylactic electrocoagulation.

Science.gov (United States)

Liu, Juan; Sun, Xicai; Guo, Limin; Wang, Dehui

2016-01-01

Posterior epistaxis is a frequent emergency, and the key to efficient management is identification of the bleeding point. We performed a retrospective study of 318 patients with posterior epistaxis treated with endoscopic bipolar electrocautery during a 4-year period. Distribution of the bleeding sites was recorded. Patients with no definite bleeding sites in the first operation were assigned to Group A (n = 39) and Group B (n = 34). Patients in Group A were only observed in the ward. Patients in Group B were given prophylactic electrocoagulation at the common bleeding points. Of the 318 patients, bleeding sites were successfully identified and coagulated in 263 patients. All of them were located posteriorly, with 166 on the lateral nasal wall, 86 on the septum, and 11 on the anterior face of the sphenoid sinus. The rebleeding rate of Group B (8.8%) was lower than that of Group A (38.5%) (p < 0.01).

A provocação poética dos elementos materiais: novas categorias de análise na abordagem sócio-poética

Directory of Open Access Journals (Sweden)

Cláudia Tavares

1999-06-01

Full Text Available Gauthier, Santos (1996 descrevem a sócio-poética como uma abordagem no conhecimento do ser humano e da sociedade, um caminho para a produção do conhecimento, que por meio de práticas diferenciadas de pesquisa e do educar mutual transforma poeticamente o saber para melhor conhecer. Os idealizadores da sócio-poética utilizam os lugares sócio-míticos, como categorias de produção e análise dos dados. Mas estimulam aqueles que trabalham com esta abordagem, a criarem novas técnicas e vivências, que facilitem a produção de dados no grupo pesquisador. Atendendo a este desafio e inspiradas no conceito de Imaginação Material de Gaston Bachelard, na Técnica da Imaginação Ativa de C.G.Jung e nos experimentos de crescimento da gestalt-terapia de John Stevens, criamos novas técnicas e categorias de estudo na abordagem sócio-poética denominando-as de Técnica dos Elementos Materiais. Como os primeiros filósofos gregos, acreditamos que muito das imagens que produzimos provêm da provocação dos 4 elementos materiais (água, terra, fogo e ar. A pesquisa foi desenvolvida com diferentes grupos de enfermeiras, professoras de enfermagem, pós-graduandas em enfermagem e equipe de enfermagem de um hospital psiquiátrico. Evidenciou-se que a Técnica dos Elementos Materiais favorece a expressão de conteúdos inconscientes ou silenciados que interferem no cuidado de enfermagem, possibilitando à enfermeira explorar criativamente a si mesma, para inovar sua prática profissional.

Transseptumpellucidumrostrostomy: anatomical considerations and neuroendoscopic approach Transseptopelucidorostrostomia: considerações anatômicas e abordagem neuroendoscópica

Directory of Open Access Journals (Sweden)

Eduardo José Takashi Fuziki

2011-01-01

Full Text Available PURPOSE: Verify the presence of the rostral lamina of the corpus callosum, and set parameters for neuroendoscopy. METHODS: Relationship of the floor of the frontal horn of lateral ventricle and the hypothalamic-septal region were studied after sagittal and axial sections of the brains. Measurements were compared using F and Student t tests. The correlations between anterior-posterior diameter of the interventricular foramen / anterior-posterior diameter of the fornix column, and between anterior-posterior diameter of the interventricular foramen / length of the rostral lamina were performed by Pearson index test. RESULTS: There was no statistically significant difference in measurements performed in both hemispheres (pOBJETIVO: Verificar a presença da lâmina rostral do corpo caloso e padronizar parâmetros para a realização de neuroendoscopia. MÉTODOS: A relação do assoalho do corno frontal do ventrículo lateral e a região hipotálamo-septal lateral foi estudada através de secções sagitais e axiais dos cérebros. As medidas foram comparadas utilizando os testes F e t-Student. As correlações entre diâmetro ântero-posterior do forame interventricular / diâmetro ântero-posterior da coluna do fornix, e entre o diâmetro ântero-posterior do forame interventricular / comprimento da lâmina rostral foram estudadas pelo teste de Pearson. RESULTADOS: Não houve diferença estatisticamente significante nas medidas realizadas em ambos hemisférios (p <0.05. Correlações positivas foram observadas entre diâmetros ântero-posteriores do forame interventricular / coluna do fornix (R = 0.35, os diâmetros ântero-posteriores do forame interventricular / comprimento da lâmina rostral (R = 0.23. CONCLUSÃO: A lâmina rostral foi observada em todos espécimes. Foi possível realizar uma fenestração endoscópica na lâmina rostral, comunicando com segurança o ventrículo lateral a uma cisterna poligonal subcalosa.

STUDY OF POSTERIOR FOSSA TUMORS BY HIGH RESOLUTION MRI

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Sree Hari

2016-01-01

Full Text Available INTRODUCTION Magnetic Resonance Imaging (MRI is the imaging modality used for the assessment of infratentorial neoplasms. Although Computed Tomography (CT provides better demonstration of small or subtle calcifications within tumors. OBJECTIVES Study is done to assess the potential of MRI in characterisation of different tumors in posterior fossa by evaluating various unenhanced and gadolinium enhanced sequences and to compare high resolution FSE MRI sequences with routine FSE MRI sequences in diagnosing posterior fossa brain tumors. Also correlate findings on Magnetic Resonance Imaging with Pathological diagnosis. MATERIALS AND METHODS A total of 52 patients were diagnosed by CT brain as having posterior fossa brain for a year of 2 years were included in the study. In all studies MR imaging was performed with a clinical 1.5 T system (General electrical medical systems. A dedicated phased-array coil was used. RESULTS The age group ranged from 1 year to 60 years, majority were between 1 to 20 years (39%. Slight male preponderance was seen (males 29, females 23. Commonest tumor encountered in our study was vestibular schwannoma. DWI alone can differentiate different pediatric posterior fossa brain tumors. One case of pilocytic astrocytoma showed solid lesion instead of typical cystic lesion with mural nodule. One case AT-RT showed 2 lesions one in cerebrum, one in CP angle. Common feature being intra-axial lesion involving cerebellum. MRI was able to predict diagnosis in 50 of the 52 tumors. CONCLUSION Magnetic Resonance Imaging was found to be a highly sensitive imaging procedure and method of choice for posterior fossa brain tumors.

Transverse posterior element fractures associated with torsion

International Nuclear Information System (INIS)

Abel, M.S.

1989-01-01

Six examples of a previously undescribed class of transverse vertebral element fractures are presented. These fractures differ from Chance and Smith fractures and their variants in the following respects: (1) the etiology is torsion and not flexion; (2) there is neither distraction of posterior ring fragments nor posterior ligament tears; (3) in contrast to Chance and Smith fractures, extension of the fracture into the vertebral body is absent or minimal; (4) the transverse process of the lumbar vertebra is avulsed at its base with a vertical fracture, not split horizontally. These fractures occur in cervical, lumbar, and sacral vertebrae in normal or compromised areas of the spine. (orig.)

Posterior reversible encephalopathy syndrome: Some novel ...

African Journals Online (AJOL)

The third, a thalassaemic child receiving regular blood transfusions, had PRES ... anterior brain instead of the classically described posterior parts of .... 7 months. 3 years. 5 years. 4 years. Gender. Female. Male. Female. Female ... Developed.

Ultrasound assessment of hamstring muscle size using posterior thigh muscle thickness.

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Abe, Takashi; Loenneke, Jeremy P; Thiebaud, Robert S

2016-05-01

Several studies have investigated the relationship between ultrasound-measured muscle thickness (MT) and individual muscle cross-sectional area (CSA) and muscle volume (MV) in extremity and trunk muscles; however, the hamstring muscle has not been studied. The purpose of this study was to examine the relationship between posterior thigh MT by ultrasound and the muscle CSA and MV of the hamstring obtained by magnetic resonance imaging (MRI). Ten young women aged 20-31 had MT measured by ultrasound at three sites on the medial anterior (50% of thigh length; TL) and posterior (50% and 70% of TL) aspects of the thigh. On the same day, a series of continuous muscle CSA along the thigh was measured by MRI. In each slice, the anatomical CSA of the hamstring (biceps femoris, semitendinosus and semimembranosus) and quadriceps muscle was analysed, and the CSAs at 50% and 70% of TL and maximal CSA of the hamstring (CSAmax ) were determined. MV was calculated by multiplying CSA by slice thickness. A significant correlation was observed between posterior 50% MT and 50% hamstring CSA (r = 0·848, P = 0·002) and between posterior 70% MT and 70% hamstring CSA (r = 0·679, P = 0·031). Posterior 50% MT (r = 0·732, P = 0·016) and 50% MTxTL (r = 0·873, P = 0·001) were also correlated to hamstring MV. Anterior:posterior 50% thigh MT ratio was correlated to MV ratio of quadriceps and hamstring muscles (r = 0·803, P = 0·005). Our results suggest that posterior thigh MT reflects hamstring muscle CSA and MV. The anterior:posterior MT ratio may serve as a surrogate for MV ratio of quadriceps and hamstring. © 2014 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Early results of two methods of posterior spinal stabilization in ...

African Journals Online (AJOL)

2013-04-17

Apr 17, 2013 ... Discussion. PSR has become the gold standard in posterior spinal fusion techniques. Its success has revolutionized spinal surgery. The Advantages include three column fusion as against one column fusion as is seen in other posterior fusion techniques like Rogers and Bohlman's techniques.[9‑13] Other.

Evaluation of the mechanical and physical properties of a posterior ...

African Journals Online (AJOL)

To evaluate the mechanical and physical properties of a micro-hybrid resin composite used in adult posterior restorations A micro-hybrid, light curing resin composite Unolux BCS Composite Restorative, (UnoDent, England) was used to restore 74 carious classes I and II cavities on posterior teeth of 62 adult patients.

Parascapular mass revealing primary tuberculosis of the posterior arch

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Arbault, Anais; Ornetti, Paul; Chevallier, Olivier; Avril, Julien; Pottecher, Pierre

2016-01-01

We report the case of a parascapular abscess revealing primary tuberculosis of the posterior arch in a 31-year-old man. Sectional imaging is essential in order to detect the different lesions of this atypical spinal tuberculosis as osteolysis of the posterior arch extendible to vertebral body, osteocondensation, epidural extension which is common in this location, and high specificity of a zygapophysial, costo-vertebral or transverse arthritis. PMID:27709081

Posterior Lattice Degeneration Characterized by Spectral Domain Optical Tomography

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Manjunath, Varsha; Taha, Mohammed; Fujimoto, James G.; Duker, Jay S.

2011-01-01

PURPOSE: To utilize high-resolution spectral domain optical coherence tomography (SD-OCT) in the characterization of retinal and vitreal morphological changes overlying posterior lattice degeneration. METHODS: A cross-sectional, retrospective analysis was performed on 13 eyes of 13 nonconsecutive subjects with posterior lattice degeneration seen at the New England Eye Center, Tufts Medical Center between October 2009 and January 2010. SD-OCT images taken through the region of latti...

Iatrogenic injury of an aberrant right posterior sectoral bile duct

African Journals Online (AJOL)

(Figs 1 and 2). A week later, an endoscopic retrograde cholangiopancreatography. (ERCP) examination was performed. This showed no filling of the right posterior sectoral ducts but normal opacification of the other ducts. (Figs 3a and b). These findings led to the diagnosis of an aberrant right posterior sectoral bile duct that ...

Management of Posterior Reversible Syndrome in Preeclamptic Women

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S. Poma

2014-01-01

Full Text Available Posterior reversible encephalopathy syndrome (PRES is a neurological syndrome associated with a number of conditions including preeclampsia. It is characterized by seizures, alteration of consciousness, visual disturbances, and symmetric white matter abnormalities, typically in the posterior parietooccipital regions of the cerebral hemispheres, at computed tomography (CT and magnetic resonance (MRI. We report three new cases of PRES in preeclamptic patients and describe the management of these patients. We present a brief review of other cases in the literature, with particular attention to the anesthetic management.

Cervical disc hernia operations through posterior laminoforaminotomy.

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Yolas, Coskun; Ozdemir, Nuriye Guzin; Okay, Hilmi Onder; Kanat, Ayhan; Senol, Mehmet; Atci, Ibrahim Burak; Yilmaz, Hakan; Coban, Mustafa Kemal; Yuksel, Mehmet Onur; Kahraman, Umit

2016-01-01

The most common used technique for posterolateral cervical disc herniations is anterior approach. However, posterior cervical laminotoforaminomy can provide excellent results in appropriately selected patients with foraminal stenosis in either soft disc prolapse or cervical spondylosis. The purpose of this study was to present the clinical outcomes following posterior laminoforaminotomy in patients with radiculopathy. We retrospectively evaluated 35 patients diagnosed with posterolateral cervical disc herniation and cervical spondylosis with foraminal stenosis causing radiculopathy operated by the posterior cervical keyhole laminoforaminotomy between the years 2010 and 2015. The file records and the radiographic images of the 35 patients were assessed retrospectively. The mean age was 46.4 years (range: 34-66 years). Of the patients, 19 were males and 16 were females. In all of the patients, the neurologic deficit observed was radiculopathy. The posterolaterally localized disc herniations and the osteophytic structures were on the left side in 18 cases and on the right in 17 cases. In 10 of the patients, the disc level was at C5-6, in 18 at C6-7, in 2 at C3-4, in 2 at C4-5, in 1 at C7-T1, in 1 patient at both C5-6 and C6-7, and in 1 at both C4-5 and C5-6. In 14 of these 35 patients, both osteophytic structures and protruded disc herniation were present. Intervertebral foramen stenosis was present in all of the patients with osteophytes. Postoperatively, in 31 patients the complaints were relieved completely and four patients had complaints of neck pain and paresthesia radiating to the arm (the success of operation was 88.5%). On control examinations, there was no finding of instability or cervical kyphosis. Posterior cervical laminoforaminotomy is an alternative appropriate choice in both cervical soft disc herniations and cervical stenosis.

Reversible Posterior Leukoencephalopathy Syndrome Induced by Pazopanib

International Nuclear Information System (INIS)

Chelis, Leonidas; Kakolyris, Stylianos; Souftas, Vasilios; Amarantidis, Kiriakos; Xenidis, Nikolaos; Chamalidou, Eleni; Dimopoulos, Prokopios; Michailidis, Prodromos; Christakidis, Evagelos; Prassopoulos, Panagiotis

2012-01-01

The reversible posterior leukoencephalopathy syndrome is a clinical/radiological syndrome characterized by headache, seizures, impaired vision, acute hypertension, and typical magnetic resonance imaging findings. There are several reports in the literature that depict its occurrence in cancer patients. The list of common anticancer and supportive care drugs that predispose to reversible posterior leukoencephalopathy syndrome is expanding and includes not only a large number of chemotherapeutic agents but also an increased number of new targeted drugs, particularly angiogenesis inhibitors such as bevacizumab,sorefenib and sunitinib. Pazopanib is an oral tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor, platelet-derived growth factor receptor, and c-Kit which after a positive phase III randomized clinical trial in patients with advanced renal cell cancer received FDA approval for the treatment of advanced renal cell carcinoma. Until now no cases of reversible posterior leukoencephalopathy syndrome induced by pazopanib have been reported. We present the case of a 40 years old female patient with heavily pre-treated metastatic renal cell carcinoma who received pazopanib as salvage treatment. After 21 days of pazopanib therapy the patient referred to the emergency department with epileptic seizure, impaired vision at both eyes and headache. MRI of the brain revealed subcortical oedema at the occipital and parietal lobes bilaterally. She was treated with anticonvulsants, i.v. administration of mannitol and antihypertensives and she recovered completely from her symptoms and was discharged on the tenth hospital day. A brain MRI performed 3 weeks after showed that the subcortical oedema had been subsided. In conclusion this is the first case of pazopanib induced reversible posterior leukoencephalopathy syndrome. Although usually reversible, this syndrome is a serious and potentially life threatening adverse effect, if untreated, that should

Reversible Posterior Leukoencephalopathy Syndrome Induced by Pazopanib

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Chelis Leonidas

2012-10-01

Full Text Available Abstract Background The reversible posterior leukoencephalopathy syndrome is a clinical/radiological syndrome characterized by headache, seizures, impaired vision, acute hypertension, and typical magnetic resonance imaging findings. There are several reports in the literature that depict its occurrence in cancer patients. The list of common anticancer and supportive care drugs that predispose to reversible posterior leukoencephalopathy syndrome is expanding and includes not only a large number of chemotherapeutic agents but also an increased number of new targeted drugs, particularly angiogenesis inhibitors such as bevacizumab,sorefenib and sunitinib. Pazopanib is an oral tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor, platelet-derived growth factor receptor, and c-Kit which after a positive phase III randomized clinical trial in patients with advanced renal cell cancer received FDA approval for the treatment of advanced renal cell carcinoma. Until now no cases of reversible posterior leukoencephalopathy syndrome induced by pazopanib have been reported. Case report We present the case of a 40 years old female patient with heavily pre-treated metastatic renal cell carcinoma who received pazopanib as salvage treatment. After 21 days of pazopanib therapy the patient referred to the emergency department with epileptic seizure, impaired vision at both eyes and headache. MRI of the brain revealed subcortical oedema at the occipital and parietal lobes bilaterally. She was treated with anticonvulsants, i.v. administration of mannitol and antihypertensives and she recovered completely from her symptoms and was discharged on the tenth hospital day. A brain MRI performed 3 weeks after showed that the subcortical oedema had been subsided. Conclusion In conclusion this is the first case of pazopanib induced reversible posterior leukoencephalopathy syndrome. Although usually reversible, this syndrome is a serious and

The role of high-resolution CT in evaluating disease of the posterior tympanum

International Nuclear Information System (INIS)

Funai, Hiroaki; Takubo, Masamichi; Iinuma, Toshitaka; Horiuchi, Yasuharu; Ichimura, Keiichi; Oyama, Kazuyuki.

1989-01-01

The posterior tympanum consists of several irregular eminences, ridges, and sinuses. These sinuses do not communicate with the mastoid air cell system, and cholesteatoma and/or granulation tissue prefer to fill them. This area cannot be visualized with ease by the usual surgical approach, and is thus quite important for surgeons. Recent developments in high-resolution computed tomography (HRCT) allow more than ever precise identification of subtle changes in the posterior tympanum. Axial HRCT sections provide essential information for the preoperative evaluation of the posterior tympanum. The performance of surgeons has been promoted both in evaluation and treatment planning of patient with suspected posterior tympanic lesions. HRCT findings were compared with the operative findings in 52 patients (54 ears) who had the operation for chronic otitis media. Important findings by HRCT diagnosis of posterior tympanum are as follows; (1) Bone destruction in the posterosuperior part of the tympanic anulus and in the lateral wall of the facial sinus are the important findings for the diagnosis of invasion of cholesteatoma in the posterior tympanum. (2) Similarly important finding is the bone destruction of the pyramidal eminence. This was found in 6 of 9 cases with cholesteatomas extending into the sinus tympani. (3) The soft tissue density in the posterior tympanum does not necessarily indicate pathological processes. Effusion in the posterior tympanum is imaged as soft tissue density, and can not be differentiated from cholesteatoma or granulation by present HRCT. (author)

[Posterior ceramic bonded partial restorations].

Science.gov (United States)

Mainjot, Amélie; Vanheusden, Alain

2006-01-01

Posterior ceramic bonded partial restorations are conservative and esthetic approaches for compromised teeth. Overlays constitute a less invasive alternative for tooth tissues than crown preparations. With inlays and onlays they are also indicated in case of full arch or quadrant rehabilitations including several teeth. This article screens indications and realization of this type of restorations.

Posterior Fossa Tumors and Intellectual Impairment

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J Gordon Millichap

2005-01-01

Full Text Available The effect of cerebellar damage on intellectual function in 76 children treated surgically for malignant posterior fossa tumor was investigated at the Gustave Roussy Institute, Villejuif, and the Department of Pediatric Neurosurgery, Necker Hospital, Paris, France.

A abordagem sócio-histórica como orientadora da pesquisa qualitativa

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Maria Teresa de Assunção Freitas

2002-07-01

Full Text Available O artigo analisa as perspectivas abertas pela abordagem sócio-histórica para a investigação qualitativa no âmbito das ciências humanas, apoiando-se nas idéias de Vygotsky, Luria e Bakhtin. Aponta que uma forma outra de fazer ciência, envolvendo a arte da descrição complementada pela explicação, pode ser encontrada na pesquisa qualitativa desenvolvida a partir de uma orientação sócio-histórica. Enfatiza nessa abordagem a compreensão dos fenômenos a partir de seu acontecer histórico no qual o particular é considerado uma instância da totalidade social. A pesquisa é vista como uma relação entre sujeitos, portanto dialógica, na qual o pesquisador é uma parte integrante do processo investigativo. Essas idéias têm implicações nas características processuais e éticas do fazer pesquisa em Ciências Humanas que se refletem na relação pesquisador-pesquisado, nos próprios instrumentos utilizados e na análise de dados. Apresenta um relato descritivo do processo metodológico desenvolvido em uma pesquisa qualitativa de cunho sócio-histórico.This article analyzes the vistas opened up by a socio-historical approach to qualitative research in the realm of the social sciences, based in the ideas of Vygotsky, Luria and Bakhtin. It points to another way of doing science, involving the art of description complemented by explication, which can be found in qualitative research developed on the basis of a socio-historical orientation. This approach emphasizes understanding phenomena based on the historical context of events in which the particular is seen as just an instance of the social totality. Research is seen as the relationship among subjects and is therefore one of dialogue, where the researcher is an integral part of the investigative process. These ideas have implications for the procedural and ethical aspects of social science research which are reflected in the relationship between researcher and researched, both in

Early effectiveness of endoscopic posterior urethra primary alignment.

Science.gov (United States)

Kim, Fernando J; Pompeo, Alexandre; Sehrt, David; Molina, Wilson R; Mariano da Costa, Renato M; Juliano, Cesar; Moore, Ernest E; Stahel, Philip F

2013-08-01

Posterior urethra primary realignment (PUPR) after complete transection may decrease the gap between the ends of the transected urethra, tamponade the retropubic bleeding, and optimize urinary drainage without the need of suprapubic catheter facilitating concurrent pelvic orthopedic and trauma procedures. Historically, the distorted anatomy after pelvic trauma has been a major surgical challenge. The purpose of the study was to assess the relationship of the severity of the pelvic fracture to the success of endoscopic and immediate PUPR following complete posterior urethral disruption using the Young-Burgess classification system. A review of our Level I trauma center database for patients diagnosed with pelvic fracture and complete posterior urethral disruption from January 2005 to April 2012 was performed. Pelvic fracture severity was categorized according to the Young-Burgees classification system. Management consisted of suprapubic catheter insertion at diagnosis followed by early urethral realignment when the patient was clinically stable. Failure of realignment was defined as inability to achieve urethral continuity with Foley catheterization. Clinical follow-up consisted of radiologic, pressure studies and cystoscopic evaluation. A total of 481 patients with pelvic trauma from our trauma registry were screened initially, and 18 (3.7%) were diagnosed with a complete posterior urethral disruption. A total of 15 primary realignments (83.3%) were performed all within 5 days of trauma. The success rate of early realignment was 100%. There was no correlation between the type of pelvic ring fracture and the success of PUPR. Postoperatively, 8 patients (53.3%) developed urethral strictures, 3 patients (20.0%) developed incontinence, and 7 patients (46.7%) reported erectile dysfunction after the trauma. The mean follow-up of these patients was 31.8 months. Endoscopic PUPR may be an effective option for the treatment of complete posterior urethral disruption and

3DCRT for posterior fossa: Sparing of surrounding organs at risk

African Journals Online (AJOL)

Azza Helal

2013-06-25

Jun 25, 2013 ... including non-posterior fossa brain, pituitary, cochlea, eyes, optic nerves, optic chiasm, ... grams; Rt.C, right cochlea; Lt. C, left cochlea; Non P.F, non posterior ... child's cognitive function and quality of life.6 Although the.

AVANÇOS ALCANÇADOS POR PROFESSORES NA IMPLEMENTAÇÃO DA ABORDAGEM TEMÁTICA EM UMA ESCOLA PÚBLICA ESTADUAL DO INTERIOR DO RS

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Alexandre Giacomini

Full Text Available RESUMO: O presente artigo, de caráter qualitativo e que utiliza algumas ferramentas metodológicas da etnografia, tem como tema o currículo balizado pela abordagem temática. Buscou-se, neste trabalho, analisar as compreensões e as percepções dos professores de uma escola pública estadual do interior do Rio Grande do Sul acerca dos avanços alcançados quando se implementam intervenções curriculares pautadas pela abordagem temática. O referencial teórico que baliza a pesquisa está alicerçado nos pressupostos do educador Paulo Freire e em ideais das repercussões educacionais do movimento Ciência-Tecnologia-Sociedade (CTS. Os resultados emergiram a partir de uma variedade de instrumentos utilizados na coleta de dados. Mediante a metodologia de Análise Textual Discursiva, foram sintetizados e apresentados sob a forma de categorias de avanços, intituladas de: o tema trabalhado a partir da realidade, do contexto do(s aluno(s; a mudança na concepção de currículo; e o diálogo entre professor-aluno e aluno-aluno.

Two-step technique for posterior optic buttonholing of intraocular lens.

Science.gov (United States)

Agarwal, Tushar; Jhanji, Vishal; Singh, Digvijay; Khokhar, Sudarshan

2014-04-01

This study aims to describe a two-step surgical technique for placement of a posterior chamber intraocular lens (IOL) in cases with crystalline lens subluxation resulting from non-progressive zonular dialysis. The first stage entails a phacoemulsification with creation of a 4-mm posterior capsular opening using an automated vitrector. The second stage performed 6 weeks later includes an anterior vitrectomy and injection of a foldable three-piece IOL in the sulcus. The haptics of IOL are positioned in the sulcus while the optic is pushed behind the posterior capsular opening therefore "buttonholing" the IOL. Seven eyes of seven patients with posttraumatic zonular dialysis were operated using this technique. Follow-up of all cases revealed a well-centered IOL with good postoperative visual acuity (20/20 to 20/80). Our two-stage surgical technique precludes the insertion of capsular tension ring in cases with non-progressive zonular dialysis. The technique is recommended in the presence of less than or equal to 6 clock hours of zonular dialysis with preexisting posterior capsular tear or herniation of vitreous in the anterior chamber.

Imaging features of posterior mediastinal chordoma in a child

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Soudack, Michalle; Guralnik, Ludmilla; Engel, Ahuva [Rambam Health Care Campus, Department of Diagnostic Imaging, Haifa (Israel); Ben-Nun, Alon [Rambam Health Care Campus, Department of Thoracic Surgery, Haifa (Israel); Berkowitz, Drora [Rambam Health Care Campus, Department of Pediatrics B, Haifa (Israel); Postovsky, Sergey [Rambam Health Care Campus, Department of Pediatric Hemato-Oncology, Haifa (Israel); Vlodavsky, Eugene [Rambam Health Care Campus, Department of Pathology, Haifa (Israel)

2007-05-15

A 51/2-year-old boy presented with repeated episodes of stridor and cough. Chest radiography demonstrated a widened mediastinum. Evaluation by CT revealed a low-density posterior mediastinal mass initially diagnosed as benign tumor. Histopathological analysis of the resected mass disclosed a malignant chordoma. Our radiological results are described with an analysis of the imaging findings in the medical literature. We present our suggestions for preoperative evaluation of posterior mediastinal tumors. (orig.)

Podoplanin and the posterior heart field: epicardial-myocardial interaction

OpenAIRE

Mahtab, Edris Ahmad Faiz

2008-01-01

This thesis introduces the posterior heart field contributing to the venous pole of the heart by epithelial-mesenchymal-transformation of the coelomic epithelium. Based on studying of podoplanin and Sp3 (novel genes in cardiogenesis) wildtype and knockout mouse embryos between stages 9.5-18.5, we postulate that the posterior heart field contributes through mesenchymal and myocardial cell populations. The mesenchymal population is involved in the formation of the proepicardial organ, epicardiu...

AVALIAÇÃO DA EFICIÊNCIA BANCÁRIA POR MEIO DA ABORDAGEM DE INTERMEDIAÇÃO: UMA ANÁLISE COMPARATIVA DE INSTITUIÇÕES FINANCEIRAS BRASILEIRAS

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Murilo Carneiro

Full Text Available Resumo Este estudo avalia, de forma comparativa, por meio da abordagem de intermediação, o grau de eficiência de 99 instituições financeiras que atuaram, em 2013, no mercado financeiro brasileiro. Foi a atividade de intermediação financeira que gerou o surgimento e a consolidação das instituições financeiras por todo o mundo. Portanto, essa foi uma das razões que motivou a escolha da abordagem de intermediação para se avaliar a eficiência das instituições financeiras. Acredita-se que seja relevante avaliar se tais instituições, no Brasil, estão conseguindo ser eficientes em sua atividade mais tradicional, a intermediação financeira. É importante ressaltar que, além da abordagem de intermediação, há também duas outras principais abordagens para se avaliar a eficiência das instituições financeiras: produção e rentabilidade. A técnica data envelopment analysis (DEA, cuja aplicabilidade para avaliação da eficiência bancária é muito difundida na literatura, foi adotada para calcular os escores de eficiência das instituições, que foram classificadas de acordo com quatro critérios: origem do capital, porte, risco (rating de crédito e setor de atuação. Foram identificadas 22 instituições com maior grau de eficiência, havendo certa heterogeneidade em relação à origem do capital, porte e setor de atuação. Por outro lado, foi identificado um indício de que há uma relação diretamente proporcional positiva entre o rating de crédito e a eficiência.

Posterior circulation aneurysms: A 10-year institutional analysis

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Saurabh Sharma

2012-01-01

Full Text Available Background : Aneurysms are uncommon and challenging to manage. Materials and Methods: A retrospective study was designed to report 53 patients who are treated from June 2002 to June 2011. Results: The mean age at presentation was 46.34 ± 13.67 years (males, 26. Clinical features included subarachnoid hemorrhage (median Hunt and Hess Grade II, n = 42, cranial nerve palsies (9, hydrocephalus (5, and incidentally diagnosed (5. Locations included superior cerebellar artery (3, posterior cerebral artery (2, basilar trunk (4, vertebral (8, anterior inferior cerebellar artery (AICA (5, posterior inferior cerebellar artery (PICA (13, vertebrobasilar junction (6, and basilar top (13. Management included both endovascular intervention (26 and surgery (19, and both (2. Five patients presented as poor grade and underwent only extraventricular drain placement while one patient had thrombosed aneurysm and was managed conservatively. Mortality was 26.4% (n = 14 and morbidity included vasospasm (10, meningitis (2, pseudomeningocele (2, pneumonitis (2, and myocardial infarction (1. Conclusion: Posterior circulation aneurysms are highly challenging. They require the multimodality approach, and decision regarding surgery or embolization has to be individualized.

Posterior capsule opacification and neovascularization treated with intravitreal bevacizumab and Nd:YAG capsulotomy

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Grimelda Yuriana Sánchez-Castro

2008-10-01

Full Text Available Grimelda Yuriana Sánchez-Castro1, Alejandra Hitos-Fájer1, Erick Mendoza-Schuster1, Raul Velez-Montoya2, Cecilio Francisco Velasco-Barona11Asociación para Evitar la Ceguera en México. Hospital “Dr. Luis Sánchez Bulnes”, México, D.F. Ophthalmology Department – Anterior Segment; 2Asociación para Evitar la Ceguera en México. Hospital “Dr. Luis Sánchez Bulnes”, México, D.F. Ophthalmology Department – Retina departmentAbstract: We reported a 75-year-old diabetic man, who developed opacification and neovascularization of the posterior capsule after extracapsular cataract extraction and posterior chamber intraocular lens implantation. The patient was treated with two injections of 2.5 mg of intravitreal bevacizumab. The treatment produced an important regression of the posterior capsular new vessels, allowing us to perform a successful Nd:YAG capsulotomy, clearing the visual axis and improving the visualization of the posterior pole. Even though, best corrected visual acuity was 20/200 due to diabetic macular edema.Keywords: posterior capsule opacification, posterior capsule neovascularization, cataract surgery, postoperative complications, intravitreal bevacizumab

O estudo dos neologismos semânticos no ensino de português: abordagem a partir de textos publicitários

OpenAIRE

Elida Ferreira Martins

2015-01-01

Neste trabalho, enfocamos um aspecto do léxico do português que diz respeito aos neologismos semânticos, bem como sua abordagem no ensino de Língua Portuguesa no Brasil. O objetivo principal da pesquisa consiste em analisar, qualitativamente, os neologismos semânticos encontrados em textos publicitários de revistas noticiosas de circulação nacional, a partir de uma perspectiva pedagógica. Para a constituição do corpus de neologismos, utilizamos uma amostra do Acervo Digital da revista Veja...

Robotic posterior retroperitoneal adrenalectomy.

Science.gov (United States)

Okoh, Alexis Kofi; Yigitbas, Hakan; Berber, Eren

2015-09-01

Since its initial description by Mercan et al. laparoscopic posterior retroperitoneal (PR) adrenalectomy has served as an alternaltive to the transabdominal (TL) approach for the treatment of adrenal pathologies. Robotic adrenal surgery has been reported to improve surgeon ergonomics and facilitate dissection. In patients with bilateral adrenal masses, PR adrenalectomy may be the approach of choice. We herein describe the technique, discuss its limitations and present a critical review of the current literature. © 2015 Wiley Periodicals, Inc.

Regression of an atlantoaxial rheumatoid pannus following posterior instrumented fusion.

Science.gov (United States)

Bydon, Mohamad; Macki, Mohamed; Qadi, Mohamud; De la Garza-Ramos, Rafael; Kosztowski, Thomas A; Sciubba, Daniel M; Wolinsky, Jean-Paul; Witham, Timothy F; Gokaslan, Ziya L; Bydon, Ali

2015-10-01

Rheumatoid patients may develop a retrodental lesion (atlantoaxial rheumatoid pannus) that may cause cervical instability and/or neurological compromise. The objective is to characterize clinical and radiographic outcomes after posterior instrumented fusion for atlantoaxial rheumatoid pannus. We retrospectively reviewed all patients who underwent posterior fusions for an atlantoaxial rheumatoid pannus at a single institution. Both preoperative and postoperative imaging was available for all patients. Anterior or circumferential operations, non-atlantoaxial panni, or prior C1-C2 operations were excluded. Primary outcome measures included Nurick score, Ranawat score (neurologic status in patients with rheumatoid arthritis), pannus regression, and reoperation. Pannus volume was determined with axial and sagittal views on both preoperative and postoperative radiological images. Thirty patients surgically managed for an atlantoaxial rheumatoid pannus were followed for a mean of 24.43 months. Nine patients underwent posterior instrumented fusion alone, while 21 patients underwent posterior decompression and instrumented fusion. Following a posterior instrumented fusion in all 30 patients, the pannus statistically significantly regressed by 44.44%, from a mean volume of 1.26cm(3) to 0.70cm(3) (ppannus radiographically regressed by 44.44% over a mean of 8.02 months, and patients clinically improved per the Nurick score. The Ranawat score did not improve, and 20% of patients required reoperation over a mean of 13.18 months. The annualized reoperation rate was approximately 13.62%. Copyright © 2015 Elsevier B.V. All rights reserved.

Posterior atlanto-occipital and atlanto-axial area and its surgical interest

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Newton José Godoy Pimenta

2014-10-01

Full Text Available Classic anatomical studies describe two membranes – atlanto-occipital and atlanto-axial in the posterior aspect of the craniocervical region. During many surgical procedures in this area, however, we have not found such membranes. Objective To clarify the anatomical aspects and structures taking part of the posterior atlanto-occipital and atlanto-axial area. Method Analysis of histological cuts of three human fetuses and anatomical studies of 8 adult human cadavers. Results In both atlanto-occipital and atlanto-axial areas, we have observed attachment between suboccipital deep muscles and the spinal cervical dura. However, anatomical description of such attachments could not be found in textbooks of anatomy. Conclusion Our study shows the absence of the classical atlanto-occipital and atlanto-axial membranes; the occipito-C1 and C1-C2 posterior intervals are an open area, allowing aponeurotic attachment among cervical dura mater and posterior cervical muscles.

Early vitrectomy effective for bilateral combined anterior and posterior persistent fetal vasculature syndrome.

Science.gov (United States)

Walsh, Mark K; Drenser, Kimberly A; Capone, Antonio; Trese, Michael T

2010-04-01

The purpose of this study was to review our surgical experience with patients with bilateral combined anterior and posterior persistent fetal vasculature syndrome (PFVS). We retrospectively reviewed the charts of all patients seen in our tertiary care pediatric retinal practice from 1988 to 2008 with a potential diagnosis of bilateral PFVS with posterior involvement. Clinical diagnosis required the presence of either bilateral persistent hyaloidal stalk tissue with retinal involvement or bilateral dense retrolental fibrovascular plaques (usually with no posterior view preoperatively) without a family history or genetic testing consistent with Norrie disease or familial exudative vitreoretinopathy. Chart review showed 22 vitrectomized patients with clinical findings consistent with bilateral PFVS with posterior involvement who did not have a family history or genetic testing consistent with Norrie disease or familial exudative vitreoretinopathy. All 22 of these patients with posterior retinal involvement also had anterior findings and thus can be classified as combined anterior and posterior PFVS. Of the 13 patients with visual acuity follow-up data, 9 patients (69%) maintained at least light perception vision in at least 1 eye at last follow-up. Of the 28 operated eyes in 16 patients with follow-up data, 3 eyes (11%) were phthisical at last follow-up. Children with bilateral PFVS with posterior retinal involvement have a dismal visual prognosis if left unoperated. In this relatively large series of a rare condition, we find that vitrectomy with or without lensectomy is beneficial in bilateral combined anterior and posterior PFVS in two regards: maintenance or restoration of vision and avoidance of phthisis bulbi.

Hindfoot endoscopy for posterior ankle pain

NARCIS (Netherlands)

van Dijk, C. Niek

2006-01-01

Hindfoot pain can be caused by a variety of pathologies, most of which can be diagnosed and treated with endoscopy. The main indications are posterior tibial tenosynovectomy, diagnosis of a longitudinal peroneus brevis rupture, peroneal tendon adhesiolysis, flexor hallucis longus release, os

Frozen shoulder or missed posterior dislocation?

African Journals Online (AJOL)

initial diagnosis and management. ... D Leijnen,1,2 MD, MMed (Sports Med); J T Viljoen,1 BSc (Physio), MPhil (Exercise Sci); J H Kirby,1 MB ChB, MSc (Sports Med); ... diagnosis of posterior shoulder dislocation at the time of injury could.

Posterior reversible encephalopathy syndrome in patient

African Journals Online (AJOL)

abp

2015-05-26

May 26, 2015 ... reversible Posterior leukoencephalopathy syndrome [1, 2]. The. PRES is a clinical and radiological entity associating varying degrees, headaches, impaired consciousness, seizures and visual disturbances to neurological and radiological abnormalities of the parietal-occipital white matter [3]. PRES has a ...

Visual Dysfunction in Posterior Cortical Atrophy

Science.gov (United States)

Maia da Silva, Mari N.; Millington, Rebecca S.; Bridge, Holly; James-Galton, Merle; Plant, Gordon T.

2017-01-01

Posterior cortical atrophy (PCA) is a syndromic diagnosis. It is characterized by progressive impairment of higher (cortical) visual function with imaging evidence of degeneration affecting the occipital, parietal, and posterior temporal lobes bilaterally. Most cases will prove to have Alzheimer pathology. The aim of this review is to summarize the development of the concept of this disorder since it was first introduced. A critical discussion of the evolving diagnostic criteria is presented and the differential diagnosis with regard to the underlying pathology is reviewed. Emphasis is given to the visual dysfunction that defines the disorder, and the classical deficits, such as simultanagnosia and visual agnosia, as well as the more recently recognized visual field defects, are reviewed, along with the evidence on their neural correlates. The latest developments on the imaging of PCA are summarized, with special attention to its role on the differential diagnosis with related conditions. PMID:28861031

Visual Dysfunction in Posterior Cortical Atrophy

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Mari N. Maia da Silva

2017-08-01

Full Text Available Posterior cortical atrophy (PCA is a syndromic diagnosis. It is characterized by progressive impairment of higher (cortical visual function with imaging evidence of degeneration affecting the occipital, parietal, and posterior temporal lobes bilaterally. Most cases will prove to have Alzheimer pathology. The aim of this review is to summarize the development of the concept of this disorder since it was first introduced. A critical discussion of the evolving diagnostic criteria is presented and the differential diagnosis with regard to the underlying pathology is reviewed. Emphasis is given to the visual dysfunction that defines the disorder, and the classical deficits, such as simultanagnosia and visual agnosia, as well as the more recently recognized visual field defects, are reviewed, along with the evidence on their neural correlates. The latest developments on the imaging of PCA are summarized, with special attention to its role on the differential diagnosis with related conditions.

Desenvolvimento moral: considerações teóricas a partir de uma abordagem sociocultural construtivista

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Martins Lincoln Coimbra

2001-01-01

Full Text Available Partindo da análise de trabalhos tradicionalmente realizados na área de desenvolvimento moral, o artigo sinaliza a necessidade de desenvolver uma abordagem teórica que trate o tema dentro de um enfoque que considere os aspectos socioculturais, cognitivos e afetivos. A questão central reside em abordar de forma sistêmica e integrada a dinâmica do desenvolvimento moral do indivíduo, resgatando a dimensão interativa e contextual envolvida na resolução dos conflitos morais e no desenvolvimento de crenças e valores. O trabalho parte dos pressupostos da perspectiva histórica socio-cultural construtivista do desenvolvimento humano, explicitando as exigências metodológicas implicadas na adoção dos conceitos e categorias utilizados no âmbito de tal perspectiva.

Desenvolvimento moral: considerações teóricas a partir de uma abordagem sociocultural construtivista

Directory of Open Access Journals (Sweden)

Lincoln Coimbra Martins

Full Text Available Partindo da análise de trabalhos tradicionalmente realizados na área de desenvolvimento moral, o artigo sinaliza a necessidade de desenvolver uma abordagem teórica que trate o tema dentro de um enfoque que considere os aspectos socioculturais, cognitivos e afetivos. A questão central reside em abordar de forma sistêmica e integrada a dinâmica do desenvolvimento moral do indivíduo, resgatando a dimensão interativa e contextual envolvida na resolução dos conflitos morais e no desenvolvimento de crenças e valores. O trabalho parte dos pressupostos da perspectiva histórica socio-cultural construtivista do desenvolvimento humano, explicitando as exigências metodológicas implicadas na adoção dos conceitos e categorias utilizados no âmbito de tal perspectiva.

Algumas ressonâncias entre a abordagem enativa e a psicologia histórico-cultural

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Beatriz Sancovschi

2008-06-01

Full Text Available O artigo examina as ressonâncias entre a abordagem enativa de F. Varela e a psicologia histórico-cultural de L. S. Vygotski, tomando como foco os mecanismos de construção da cognição. O mecanismo histórico-dialético e o mecanismo autopoiético são comparados quanto à possibilidade de darem conta da inventividade da cognição. A metodologia utilizada tem por base as indicações fornecidas por Y. Clot na coletânea Avec Vygotski. São analisadas as ressonâncias entre os autores, sublinhando seus pontos de afastamento e de proximidade, com destaque para as respectivas contribuições ao entendimento da aprendizagem, envolvendo o questionamento do foco na solução de problemas e do determinismo do meio ambiente.

Recurrent Massive Epistaxis from an Anomalous Posterior Ethmoid Artery

OpenAIRE

Greco, Marco Giuseppe; Mattioli, Francesco; Alberici, Maria Paola; Presutti, Livio

2016-01-01

A 50-year-old man, with no previous history of epistaxis, was hospitalized at our facility for left recurrent posterior epistaxis. The patient underwent surgical treatment three times and only the operator’s experience and radiological support (cranial angiography) allowed us to control the epistaxis and stop the bleeding. The difficult bleeding management and control was attributed to an abnormal course of the left posterior ethmoidal artery. When bleeding seems to come from the roof of the ...

Surgical approach to posterior inferior cerebellar artery aneurysms.

Science.gov (United States)

La Pira, Biagia; Sturiale, Carmelo Lucio; Della Pepa, Giuseppe Maria; Albanese, Alessio

2018-02-01

The far-lateral is a standardised approach to clip aneurysms of the posterior inferior cerebellar artery (PICA). Different variants can be adopted to manage aneurysms that differ in morphology, topography, ruptured status, cerebellar swelling and surgeon preference. We distinguished five paradigmatic approaches aimed to manage aneurysms that are: proximal unruptured; proximal ruptured requiring posterior fossa decompression (PFD); proximal ruptured not requiring PFD; distal unruptured; distal ruptured. Preoperative planning in the setting of PICA aneurysm surgery is of paramount importance to perform an effective and safe procedure, to ensure an adequate PFD and optimal proximal control before aneurysm manipulation.

A case report of inverted papilloma of the posterior urethra

OpenAIRE

長谷川, 総一郎; 絹川, 常郎; 松浦, 治; 竹内, 宜久; 服部, 良平; 小野, 佳成; 大島, 伸一; 村上, 榮

1987-01-01

Sixty-seven cases of inverted papilloma have been reported in many anatomical sites of urinary tract but only 9 cases involving the posterior urethra have been described in Japan. We report the 10th case of inverted papilloma of the posterior urethra in a 27-year-old male who complained of macroscopic hematuria. The lesion was diagnosed cystoscopically and treated by transurethral resection.

Long-Term Metastatic Risk after Biopsy of Posterior Uveal Melanoma

DEFF Research Database (Denmark)

Bagger, Mette; Smidt-Nielsen, Isabel; Andersen, Mette K

2018-01-01

PURPOSE: Biopsy of posterior uveal melanoma continues to be intensely debated in terms of the clinical benefits and safety profile. Although several studies have reported a low frequency of ocular complications after tumor biopsy, the potential long-term risk of iatrogenic dissemination remains...... unresolved. The purpose of this study was to assess the risk of metastatic disease after biopsy of posterior uveal melanoma. DESIGN: Retrospective nationwide cohort study linking clinical and histopathologic records to pathology, cancer, and mortality registries. PARTICIPANTS: All patients with posterior...... uveal melanoma treated in Denmark between January 1985 and December 2016. METHODS: For each patient, we recorded detailed information on age, gender, tumor characteristics, and diagnostic and therapeutic measures, including tumor biopsy, if any, and the primary treating hospital. Absolute risk...

Orthodontic treatment for posterior crossbites.

Science.gov (United States)

Agostino, Paola; Ugolini, Alessandro; Signori, Alessio; Silvestrini-Biavati, Armando; Harrison, Jayne E; Riley, Philip

2014-08-08

A posterior crossbite occurs when the top back teeth bite inside the bottom back teeth. When it affects one side of the mouth, the lower jaw may have to move to one side to allow the back teeth to meet together. Several treatments have been recommended to correct this problem. Some treatments widen the upper teeth while others are directed at treating the cause of the posterior crossbite (e.g. breathing problems or sucking habits). Most treatments have been used at each stage of dental development. This is an update of a Cochrane review first published in 2001. To assess the effects of orthodontic treatment for posterior crossbites. We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 21 January 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 1), MEDLINE via OVID (1946 to 21 January 2014), and EMBASE via OVID (1980 to 21 January 2014). We searched the US National Institutes of Health Trials Register and the World Health Organization (WHO) Clinical Trials Registry Platform for ongoing trials. We placed no restrictions on the language or date of publication when searching the electronic databases. Randomised controlled trials (RCTs) of orthodontic treatment for posterior crossbites in children and adults. Two review authors, independently and in duplicate, screened the results of the electronic searches, and extracted data and assessed the risk of bias of the included studies. We attempted to contact the first named authors of the included studies for missing data and for clarification. We used risk ratios (RR) and 95% confidence intervals (CIs) to summarise dichotomous (event) data, and mean differences (MD) with 95% CIs to summarise continuous data. We performed meta-analyses using fixed-effect models (we would have used random-effects models if we had included four or more studies in a meta-analysis) when comparisons and outcomes were sufficiently similar. We

IMPLICAÇÕES DE UM CENTRO DE SERVIÇOS COMPARTILHADOS NA CONTABILIDADE GERENCIAL: UMA ABORDAGEM INSTITUCIONAL

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Ilse Maria Beuren

Full Text Available RESUMO Este estudo analisa, sob a abordagem institucional, as implicações da implantação de um Centro de Serviços Compartilhados (CSC nas funções da Contabilidade Gerencial. Para tal, foi realizada uma pesquisa de natureza descritiva com abordagem qualitativa, a partir de um estudo de caso em empresa situada na região Sul do Brasil, constituída sob a forma de um CSC. Sob a lente da Teoria Institucional, consubstanciada no modelo proposto por Burns e Scapens (2000, foi analisada a institucionalização de regras e rotinas na Contabilidade Gerencial da empresa. Os resultados da pesquisa mostram que a implantação do CSC teve implicações diretas e indiretas nas funções da Contabilidade Gerencial, visto que foi necessário alterar várias de suas funções, atividades, divisionalizações, inclusive profissionais, portanto, uma reestruturação ampla e profunda em todo o setor. Quanto às dicotomias de mudanças ocorridas com a implantação do CSC, foram observadas mais mudanças formais do que informais, evolucionárias do que revolucionárias e progressivas do que regressivas nas funções da Contabilidade Gerencial. Conclui-se com base na análise triangulada dos dados coletados, que a implantação do CSC na empresa pesquisada teve implicações significativas na estrutura organizacional e na natureza das funções da Contabilidade Gerencial, as quais resultaram na institucionalização de novas regras e rotinas nos moldes preconizados por Burns e Scapens (2000. Os resultados do estudo contribuem para o desenvolvimento de novos papéis na Contabilidade Gerencial, sob o argumento que o modelo de CSC gerou novas regras e rotinas em toda a corporação, com implicações diretas e indiretas nos papéis gerenciais institucionalizados.

Abordagem grassroots e resistência: atualizando a concepção de desenvolvimento sustentável

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Augusto Marcos Carvalho de Sena

Full Text Available Resumo Em contrapartida às especificidades impositivas do modelo de produção capitalista - incluindo-se nesse modelo os meandros de arranjos produtivos que inserem o meio ambiente enquanto alinhado à versão tríplice da concepção tradicional de desenvolvimento sustentável -, tem surgido uma massa crítica de literatura focada na resistência ao modo de funcionamento do capitalismo ocidental. Em relação à teoria, economia solidária (pilar econômico, movimentos sociais (pilar social, ecologia política (pilar ambiental e raízes culturais (pilar cultural são aparatos importantes que não devem ficar à margem na estruturação de uma concepção alternativa do desenvolvimento sustentável. Tais aparatos são considerados elementos de resistência, visto terem fatores diferenciados quando comparados com as características tradicionais dos pilares da criticada concepção de desenvolvimento sustentável. Assim, o objetivo do presente ensaio teórico é conceber alternativas à concepção padrão do desenvolvimento sustentável, considerando aspectos da abordagem grassroots importantes para esse propósito. A contribuição é relevante tendo em vista a consideração de aspectos alternativos e complementares envolvidos na leitura da atualização conjecturada. Os prospectos do desenvolvimento grassroots têm sido usados como guia prático em ações de desenvolvimento local envolvendo comunidades menos desenvolvidas em várias partes do mundo, sem a conjectura que sinaliza para elementos conceituais que podem oferecer uma conformação alternativa à concepção do desenvolvimento sustentável. Conclui-se que a versão tradicional do desenvolvimento sustentável pode ser atualizada com elementos alternativos advindos da abordagem grassroots.

Super-selective Balloon Test Occlusion of the Posterior Communicating Artery in the Treatment of a Posterior Cerebral Artery Fusiform Aneurysm: a Case Report

OpenAIRE

Isozaki, Makoto; Arai, Hiroshi; Neishi, Hiroyuki; Kitai, Ryuhei; Kikuta, Ken-ichiro

2016-01-01

We report the case of a 49-year-old man with underlying hypertension who developed diplopia lasting 2 months. Magnetic resonance imaging and digital subtraction angiography showed multi-lobular unruptured aneurysms in the P2 portion of the posterior cerebral artery (PCA) migrating into the interpeduncular cistern of the midbrain. Because the shapes of the aneurysms were serpentine fusiform and the posterior communicating artery (PCoA) was the fetal type, we planned anastomosis of the occipita...

Ombro flutuante associado à luxação escápulo-umeral posterior: relato de caso Floating shoulder combined with posterior scapulohumeral dislocation

Directory of Open Access Journals (Sweden)

Alessandro Ulhôa Rodrigues

2007-10-01

Full Text Available Apresenta-se rara variação de ombro flutuante associada a luxação glenoumeral posterior em paciente masculino, 26 anos de idade, vítima de acidente motociclístico. Ao exame, queixava-se de dor no ombro esquerdo, limitação dos movimentos, principalmente da rotação externa. A radiografia em ântero-posterior (AP verdadeiro mostrou fratura do colo da glenóide, sem envolvimento articular, e fratura do processo coracóide. A radiografia em perfil, axilar e a tomografia computadorizada confirmaram a luxação posterior. Os autores discutem as questões que fazem deste um caso singular no qual se optou por redução aberta e fixação da fratura com placa de reconstrução pélvica. O controle radiológico confirmou o restabelecimento da anatomia. A fratura consolidou-se, resultando em um ombro normal e funcional.A rare variation of the floating shoulder is presented, combined with a posterior glenohumeral dislocation in a male, 26 year old patient, victim of a motorcycle accident. On physical examination, he complained of pain in the left shoulder, limitation of should movements, in particular external rotation. True anteroposterior X-ray showed a fracture of the glenoid neck without joint involvement and fracture of the coracoid process. Profile, axillary X-ray and CT scan confirmed the posterior dislocation. The authors discuss the features that make this case a unique case for which open reduction and fracture fixation with a pelvic reconstruction plate were chosen. Radiological follow-up confirmed recovery of the anatomy. The fracture healed and the result is a normal, functional shoulder.

Posterior Urethral Strictures

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Joel Gelman

2015-01-01

Full Text Available Pelvic fracture urethral injuries are typically partial and more often complete disruptions of the most proximal bulbar and distal membranous urethra. Emergency management includes suprapubic tube placement. Subsequent primary realignment to place a urethral catheter remains a controversial topic, but what is not controversial is that when there is the development of a stricture (which is usually obliterative with a distraction defect after suprapubic tube placement or urethral catheter removal, the standard of care is delayed urethral reconstruction with excision and primary anastomosis. This paper reviews the management of patients who suffer pelvic fracture urethral injuries and the techniques of preoperative urethral imaging and subsequent posterior urethroplasty.

Posterior Urethral Strictures

Science.gov (United States)

Gelman, Joel; Wisenbaugh, Eric S.

2015-01-01

Pelvic fracture urethral injuries are typically partial and more often complete disruptions of the most proximal bulbar and distal membranous urethra. Emergency management includes suprapubic tube placement. Subsequent primary realignment to place a urethral catheter remains a controversial topic, but what is not controversial is that when there is the development of a stricture (which is usually obliterative with a distraction defect) after suprapubic tube placement or urethral catheter removal, the standard of care is delayed urethral reconstruction with excision and primary anastomosis. This paper reviews the management of patients who suffer pelvic fracture urethral injuries and the techniques of preoperative urethral imaging and subsequent posterior urethroplasty. PMID:26691883

Tumors of the posterior cranial fossa; Tumoren der hinteren Schaedelgrube

Energy Technology Data Exchange (ETDEWEB)

Papanagiotou, P.; Politi, M. [Klinikum Bremen-Mitte/Bremen-Ost, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Bremen (Germany)

2016-11-15

Various types of brain tumor can occur in the region of the posterior fossa. Brain metastases in adults are the most common malignancies at this localization. Ependymomas, medulloblastomas and pilocytic astrocytomas occur mostly in children and only rarely in adults. Other tumors that occur in the posterior fossa are meningiomas, schwannomas, hemangioblastomas, brain stem gliomas and epidermoid tumors. Due to the fact that the various tumors of the posterior fossa have different treatment approaches and prognoses, an accurate and specific diagnosis is mandatory. This review discusses the imaging aspects by computed tomography (CT) and magnetic resonance imaging (MRI) of the most frequent tumors of the posterior fossa. (orig.) [German] Im Bereich der hinteren Schaedelgrube treten verschiedene Typen von Hirntumoren auf, wobei Hirnmetastasen bei Erwachsenen die haeufigsten Malignitaeten in dieser Region darstellen. Ependymome, Medulloblastome und pilozytische Astrozytome kommen meistens bei Kindern und nur selten bei Erwachsenen vor. Weitere Tumoren der hinteren Schaedelgrube sind Meningeome, Schwannome, Haemangioblastome, Hirnstammgliome und Epidermoide. Da die verschiedenen Tumoren der hinteren Schaedelgrube unterschiedliche Behandlungsansaetze sowie Prognosen haben, ist eine genaue und spezifische Diagnose obligatorisch. Dieser Review diskutiert die bildgebenden CT- und MRT-Aspekte der haeufigsten Tumoren der hinteren Schaedelgrube. (orig.)

Gamificação: abordagem e construção conceitual para aplicativosem TV Digital Interativa

Directory of Open Access Journals (Sweden)

Marcos Américo

2013-12-01

Full Text Available A implantação da TV Digital no Brasil abre espaço para o desenvolvimento de conteúdos educativos baseados nos conceitos de t-learning e edutretenimento. O estudo propõe a aplicação da gamificação como elo comunicacional para incentivar e modificar o comportamento dos usuários. No entanto, esbarra-se na problemática conceitual do termo, uma vez que a literatura traz diversas e amplas definições, que variam de acordo com o contexto de aplicação. O objetivo deste trabalho, de caráter exploratório, é propor uma abordagem conceitual, a fim de construir um conceito delimitado e que fundamente o sistema de gamificação em TV Digital Interativa.

Predisposing factors in posterior circulation infarcts: a vascular morphological assessment

Energy Technology Data Exchange (ETDEWEB)

Coban, Goekcen; Cifci, Egemen; Yildirim, Erkan; Agildere, Ahmet Muhtesem [Baskent University Faculty of Medicine, Department of Radiology, Konya (Turkey)

2015-05-01

The aim of the study is to assess the effect of shape, diameter, elongation and deviation criteria of basilar artery (BA), convergence angle and diameter variations of vertebral arteries, and concurrent chronic diseases on posterior circulation infarcts. Between January 2010 and May 2013, 186 patients who underwent brain and diffusion magnetic resonance imaging (MRI) with suspected cerebrovascular accident and were diagnosed with posterior circulation infarct and 120 infarct negative control subjects were included in this case-control retrospective study. Vertebral artery (VA) and BA diameter, right (R) and left (L) VA angles at the level of bifurcation, and BA elongation-deviation, and shape of BA were assessed in a total of 306 subjects. Ischemic lesions in the posterior circulation were classified according to their anatomical location and vascular perfusion areas. No significant difference was noted between the control and patient groups with respect to BA diameter (p = 0.676). The most effective risk factors for posterior circulation infarcts were as follows: BA elongation of 2 or 3, BA transverse location of 2 or 3, increase in left VA angle, and history of hypertension, hypercholesterolemia, and diabetes mellitus. Our results suggest that prominent elongation and deviation, C and J shape of BA, and increased L VA angle may be the predictors of at-risk patients in posterior circulation infarcts. Reporting marked morphological BA and VA variations detected at routine brain MRI will aid in selection of patients. Timely detection and treatment of at-risk patients may be life-saving. (orig.)

Hip morphology predicts posterior hip impingement in a cadaveric model.

Science.gov (United States)

Morris, William Z; Fowers, Cody A; Weinberg, Douglas S; Millis, Michael B; Tu, Leigh-Anne; Liu, Raymond W

2018-05-01

Posterior hip impingement is a recently-identified cause of hip pain. The purpose of this study is to characterise posterior femoroacetabular and ischiofemoral impingement and identify its predisposing morphologic traits. Two hundred and six cadaveric hips were randomly selected and taken through controlled motion in two pure axes associated with posterior hip impingement: external rotation (through the mechanical axis) and adduction (coronal plane). The range of motion and location of impingement was noted for each specimen. Morphologic traits including femoral/acetabular version, and true neck-shaft angle (TNSA) were also measured. External rotation impingement occurred between the femoral neck and acetabulum in 83.0% of hips, and between the lesser trochanter and ischial tuberosity in 17.0%. Adduction impingement occurred between the lesser trochanter and ischial tuberosity in 78.6% of hips, and between the femoral neck and acetabulum in 21.4%. Multiple regression revealed that increased femoral/acetabular version predicted earlier external rotation and adduction impingement. Unstandardised betas ranging from -0.39 to -0.64 reflect that each degree of increased femoral/acetabular version individually accounts for a loss of external rotation or adduction of approximately half a degree before impingement ( p < 0.001 for each). Increased TNSA was associated with earlier adduction impingement only (unstandardised beta -0.35, p = 0.005). Relative femoral/acetabular anteversion was associated with earlier posterior hip impingement. Coxa valga was associated with earlier adduction impingement, but protective against external rotation impingement. These findings highlight the importance of monitoring correction during femoral/acetabular osteotomies, as overcorrection of retroversion may predispose to earlier posterior impingement.

Predisposing factors in posterior circulation infarcts: a vascular morphological assessment

International Nuclear Information System (INIS)

Coban, Goekcen; Cifci, Egemen; Yildirim, Erkan; Agildere, Ahmet Muhtesem

2015-01-01

The aim of the study is to assess the effect of shape, diameter, elongation and deviation criteria of basilar artery (BA), convergence angle and diameter variations of vertebral arteries, and concurrent chronic diseases on posterior circulation infarcts. Between January 2010 and May 2013, 186 patients who underwent brain and diffusion magnetic resonance imaging (MRI) with suspected cerebrovascular accident and were diagnosed with posterior circulation infarct and 120 infarct negative control subjects were included in this case-control retrospective study. Vertebral artery (VA) and BA diameter, right (R) and left (L) VA angles at the level of bifurcation, and BA elongation-deviation, and shape of BA were assessed in a total of 306 subjects. Ischemic lesions in the posterior circulation were classified according to their anatomical location and vascular perfusion areas. No significant difference was noted between the control and patient groups with respect to BA diameter (p = 0.676). The most effective risk factors for posterior circulation infarcts were as follows: BA elongation of 2 or 3, BA transverse location of 2 or 3, increase in left VA angle, and history of hypertension, hypercholesterolemia, and diabetes mellitus. Our results suggest that prominent elongation and deviation, C and J shape of BA, and increased L VA angle may be the predictors of at-risk patients in posterior circulation infarcts. Reporting marked morphological BA and VA variations detected at routine brain MRI will aid in selection of patients. Timely detection and treatment of at-risk patients may be life-saving. (orig.)

Predisposing factors in posterior circulation infarcts: a vascular morphological assessment.

Science.gov (United States)

Çoban, Gökçen; Çifçi, Egemen; Yildirim, Erkan; Ağıldere, Ahmet Muhteşem

2015-05-01

The aim of the study is to assess the effect of shape, diameter, elongation and deviation criteria of basilar artery (BA), convergence angle and diameter variations of vertebral arteries, and concurrent chronic diseases on posterior circulation infarcts. Between January 2010 and May 2013, 186 patients who underwent brain and diffusion magnetic resonance imaging (MRI) with suspected cerebrovascular accident and were diagnosed with posterior circulation infarct and 120 infarct negative control subjects were included in this case-control retrospective study. Vertebral artery (VA) and BA diameter, right (R) and left (L) VA angles at the level of bifurcation, and BA elongation-deviation, and shape of BA were assessed in a total of 306 subjects. Ischemic lesions in the posterior circulation were classified according to their anatomical location and vascular perfusion areas. No significant difference was noted between the control and patient groups with respect to BA diameter (p = 0.676). The most effective risk factors for posterior circulation infarcts were as follows: BA elongation of 2 or 3, BA transverse location of 2 or 3, increase in left VA angle, and history of hypertension, hypercholesterolemia, and diabetes mellitus. Our results suggest that prominent elongation and deviation, C and J shape of BA, and increased L VA angle may be the predictors of at-risk patients in posterior circulation infarcts. Reporting marked morphological BA and VA variations detected at routine brain MRI will aid in selection of patients. Timely detection and treatment of at-risk patients may be life-saving.

A posterior tibial tendon skipping rope

NARCIS (Netherlands)

van Sterkenburg, M. N.; Haverkamp, D.; van Dijk, C. N.; Kerkhoffs, G. M. M. J.

2010-01-01

This report presents an athletic patient with swelling and progressive pain on the posteromedial side of his right ankle on weight bearing. MRI demonstrated tenosynovitis and suspicion of a length rupture. On posterior tibial tendoscopy, there was no rupture, but medial from the tendon a tissue cord

Posterior reversible encephalopathy syndrome: Some novel ...

African Journals Online (AJOL)

Two cases occurred following cerebral anoxia due to accidental strangulation and near-drowning, respectively. The third patient, a child known to have E-β thalassaemia, presented with transient encephalopathy following blood transfusion but involving the anterior brain rather than the posterior part classically described in ...

One-stage posterior approaches for treatment of thoracic spinal infection

OpenAIRE

Kao, Fu-Cheng; Tsai, Tsung-Ting; Niu, Chi-Chien; Lai, Po-Liang; Chen, Lih-Huei; Chen, Wen-Jer

2017-01-01

Abstract Treating thoracic infective spondylodiscitis with anterior surgical approaches carry a relatively high risk of perioperative and postoperative complications. Posterior approaches have been reported to result in lower complication rates than anterior procedures, but more evidence is needed to demonstrate the safety and efficacy of 1-stage posterior approaches for treating infectious thoracic spondylodiscitis. Preoperative and postoperative clinical data, of 18 patients who underwent 2...

Relationship between posterior crossbite and postural alterations in children

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Juliana Jaqueline de Matos Lopes

2009-12-01

Full Text Available Objective: To evaluate the posture of individuals with functional posterior crossbite, malocclusion is one of the most in need of orthodontic treatment. Methods: This work presents an analysis of postural among children 6 to 12 years who present functional posterior cross bite of both genders who are in mixed dentition or no intervention prior orthodontic and orthopedic. Was obtained images in the plans: front and back where it was analyzed the asymmetry or symmetry of the individual in the image and in the lateral, anterior, a posterior or normality. Results: 100% had some kind of postural change, and the asymmetry between the scapulae (shoulder found the greatest change, as one of extreme importance in this age group represents a growing skeletal muscle. Conclusion: analyzes all of the children showed postural abnormalities and malocclusion are also of great importance not only to be treating the problem orally, but the postural problem with the help of a multidisciplinary team.

Reversible posterior leucoencephalopathy syndrome associated with bone marrow transplantation.

Science.gov (United States)

Teive, H A; Brandi, I V; Camargo, C H; Bittencourt, M A; Bonfim, C M; Friedrich, M L; de Medeiros, C R; Werneck, L C; Pasquini, R

2001-09-01

Reversible posterior leucoencephalopathy syndrome (RPLS) has previously been described in patients who have renal insufficiency, eclampsia, hypertensive encephalopathy and patients receiving immunosuppressive therapy. The mechanism by which immunosuppressive agents can cause this syndrome is not clear, but it is probably related with cytotoxic effects of these agents on the vascular endothelium. We report eight patients who received cyclosporine A (CSA) after allogeneic bone marrow transplantation or as treatment for severe aplastic anemia (SSA) who developed posterior leucoencephalopathy. The most common signs and symptoms were seizures and headache. Neurological dysfunction occurred preceded by or concomitant with high blood pressure and some degree of acute renal failure in six patients. Computerized tomography studies showed low-density white matter lesions involving the posterior areas of cerebral hemispheres. Symptoms and neuroimaging abnormalities were reversible and improvement occurred in all patients when given lower doses of CSA or when the drug was withdrawn. RPLS may be considered an expression of CSA neurotoxicity.

POSTERIOR APPROACH FOR HIP ARTHROPLASTY: A SINGLE ...

African Journals Online (AJOL)

postulated advantages and disadvantages. Objective: Presentation of a case series of primary and revision arthroplasty utilizing the posterior approach. ... Centre over a period of one year were queried and data extracted and recorded.

A análise dos impactos socioeconômicos na estruturação do EIA/RIMA: a importância da Abordagem Humanista para a Sustentabilidade The analysis of socio-economic impacts on the structure of EIA / RIMA: the importance of humanist approach to sustainability

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Leandro Carlos Dias Conde

2013-03-01

Full Text Available DOI: 10.5902/198346597686O presente trabalho trata da defesa da abordagem humanista na estruturação da análise de Impacto Ambiental (EIA e do seu Relatório de Impacto Ambiental (RIMA, no que concerne aos impactos socioeconômicos abordados, por compreender que a abordagem convencional não dá conta das demandas sociais, pois somente esta nova abordagem dará, de fato, o caráter sustentável da EIA/RIMA. The present work deals with the defense of the humanistic approach in structuring the analysis of Environmental Impact Assessment (EIA and its Environmental Impact Report (RIMA in relation to socioeconomic impacts addressed to realize that the conventional approach does not account social demands, as only this new approach will in fact the sustainable nature of the EIA / RIMA.

Venous anomalies and abnormalities of the posterior fossa

International Nuclear Information System (INIS)

Goulao, A.; Alvarez, H.; Garcia Monaco, R.; Pruvost, P.; Lasjaunias, P.

1990-01-01

The authors report a series of 16 patients with venous anomalies or abnormalities of the posterior fossa studied by angiography, CT and/or MRI. We believe that so-called 'venous angioma' are extreme anatomic variants that drain normal territories, and we prefer to call them developmental venous anomalies (DVA). Posterior fossa DVA, like the supra-tentorial ones are classified according to their drainage into deep and superficial type. They are exclusively located in the cerebellum or tectum. In 4 cases DVA was an incidental finding, in 3 an associated cerebral venous malformation (CVM) was found and felt to be the cause of the symptoms and only in one (Trigeminal pain) was a link between both suspected. Cavernous venous malformation (CVM) were found in frequent association with DVA (27%). 4 cases were single and 2 multiple. 5 CVM were located in the brain stem and 3 in the cerebellum. The clinical and radiological files were reviewed and a direct relationship between symptoms and localization was found in all patients with CVM. In 2 cases venous dysplasia was found: 1 Sturge-Weber and 1 First branchial arch syndrome. Both posterior fossa venous abnormalities were incidental findings. (orig.)

Management of the failed posterior/multidirectional instability patient.

Science.gov (United States)

Forsythe, Brian; Ghodadra, Neil; Romeo, Anthony A; Provencher, Matthew T

2010-09-01

Although the results of operative treatment of posterior and multidirectional instability (P-MDI) of the shoulder have improved, they are not as reliable as those treated for anterior instability of the shoulder. This may be attributed to the complexities in the classification, etiology, and physical examination of a patient with suspected posterior and multidirectional instability. Failure to address the primary and concurrent lesion adequately and the development of pain and/or stiffness are contributing factors to the failure of P-MDI procedures. Other pitfalls include errors in history and physical examination, failure to recognize concomitant pathology, and problems with the surgical technique or implant failure. Patulous capsular tissues and glenoid version also play in role management of failed P-MDI patients. With an improved understanding of pertinent clinical complaints and physical examination findings and the advent of arthroscopic techniques and improved implants, successful strategies for the nonoperative and operative management of the patient after a failed posterior or multidirectional instability surgery may be elucidated. This article highlights the common presentation, physical findings, and radiographic workup in a patient that presents after a failed P-MDI repair and offers strategies for revision surgical repair.

Cervical disc hernia operations through posterior laminoforaminotomy

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Coskun Yolas

2016-01-01

Full Text Available Objective: The most common used technique for posterolateral cervical disc herniations is anterior approach. However, posterior cervical laminotoforaminomy can provide excellent results in appropriately selected patients with foraminal stenosis in either soft disc prolapse or cervical spondylosis. The purpose of this study was to present the clinical outcomes following posterior laminoforaminotomy in patients with radiculopathy. Materials and Methods: We retrospectively evaluated 35 patients diagnosed with posterolateral cervical disc herniation and cervical spondylosis with foraminal stenosis causing radiculopathy operated by the posterior cervical keyhole laminoforaminotomy between the years 2010 and 2015. Results: The file records and the radiographic images of the 35 patients were assessed retrospectively. The mean age was 46.4 years (range: 34-66 years. Of the patients, 19 were males and 16 were females. In all of the patients, the neurologic deficit observed was radiculopathy. The posterolaterally localized disc herniations and the osteophytic structures were on the left side in 18 cases and on the right in 17 cases. In 10 of the patients, the disc level was at C5-6, in 18 at C6-7, in 2 at C3-4, in 2 at C4-5, in 1 at C7-T1, in 1 patient at both C5-6 and C6-7, and in 1 at both C4-5 and C5-6. In 14 of these 35 patients, both osteophytic structures and protruded disc herniation were present. Intervertebral foramen stenosis was present in all of the patients with osteophytes. Postoperatively, in 31 patients the complaints were relieved completely and four patients had complaints of neck pain and paresthesia radiating to the arm (the success of operation was 88.5%. On control examinations, there was no finding of instability or cervical kyphosis. Conclusion: Posterior cervical laminoforaminotomy is an alternative appropriate choice in both cervical soft disc herniations and cervical stenosis.

Posterior breast cancer: Mammographic and ultrasonographic features

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Janković Ana

2013-01-01

Full Text Available Background/Aim. Posterior breast cancers are located in the prepectoral region of the breast. Owing to this distinctive anatomical localization, physical examination and mammographic or ultrasonographic evaluation can be difficult. The purpose of the study was to assess possibilities of diagnostic mammography and breast ultrasonography in detection and differentiation of posterior breast cancers. Methods. The study included 40 women with palpable, histopathological confirmed posterior breast cancer. Mammographic and ultrasonographic features were defined according to Breast Imaging Reporting and Data System (BI-RADS lexicon. Results. Based on standard two-view mammography 87.5%, of the cases were classified as BI-RADS 4 and 5 categories, while after additional mammographic views all the cases were defined as BIRADS 4 and 5 categories. Among 96 mammographic descriptors, the most frequent were: spiculated mass (24.0%, architectural distortion (16.7%, clustered microcalcifications (12.6% and focal asymmetric density (12.6%. The differentiation of the spiculated mass was significantly associated with the possibility to visualize the lesion at two-view mammography (p = 0.009, without the association with lesion diameter (p = 0.083 or histopathological type (p = 0.055. Mammographic signs of invasive lobular carcinoma were significantly different from other histopathological types (architectural distortion, p = 0.003; focal asymmetric density, p = 0.019; association of four or five subtle signs of malignancy, p = 0.006. All cancers were detectable by ultrasonography. Mass lesions were found in 82.0% of the cases. Among 153 ultrasonographic descriptors, the most frequent were: irregular mass (15.7%, lobulated mass (7.2%, abnormal color Doppler signals (20.3%, posterior acoustic attenuation (18.3%. Ultrasonographic BI-RADS 4 and 5 categories were defined in 72.5% of the cases, without a significant difference among various histopathological types (p = 0

Gluteo-vaginal fistula after posterior intravaginal slingplasty: a case report.

Science.gov (United States)

Grynberg, Michael; Teyssedre, Jacques; Staerman, Frederic

2009-07-01

In patients with posthysterectomy prolapse of the vaginal vault, the posterior intravaginal slingplasty (posterior IVS, Tyco Healthcare, USA) has been suggested as an alternative to traditional vaginal vault suspensions. The goal of this technique is to recreate the uterosacral ligaments and to reinforce the rectovaginal fascia with the use of prosthetic material. We report the case of a 53-year-old woman with a history of 27 months of perineal suppurative discharge after she underwent a vaginal vault prolapse and rectocele repair using a posterior IVS (Tyco Healthcare, USA). The IVS tape was reinforced by interposing a rectovaginal monofilament polypropylene mesh (Parietex, Sofradim, France). Imaging studies and surgical exploration confirmed infection of the IVS mesh with the formation of a gluteo-vaginal fistula while the rectovaginal mesh was intact.

Anomalous Posterior Intercostal Arterial Trunk Arising From the Abdominal Aorta

Energy Technology Data Exchange (ETDEWEB)

Jie, Bing, E-mail: jbshh@163.com; Yu, Dong, E-mail: yudong-mail@126.com; Jiang, Sen, E-mail: jasfly77@vip.163.com [Tongji University School of Medicine, Department of Radiology, Shanghai Pulmonary Hospital (China)

2016-04-15

A common trunk of the ipsilateral posterior intercostal artery (PIA) arising from the thoracic aorta is usually an anatomical variation. However, a common trunk of bilateral posterior intercostal arterial trunk (PIAT) arising from the abdominal aorta is rare. It is important to recognize this anatomical variation of PIA when performing interventional radiological procedures. We present a rare case of an anomalous PIAT that originated from the abdominal aorta in a patient with hemoptysis caused by tuberculosis sequelae. Bilateral 4th to 11th PIAs arose from a common trunk and the trunk arising from the posterior aspect of the abdominal aorta at the level of T12/L1 intervertebral space. The pathological right 4th and 5th PIAs and bronchial arteries were embolized. Hemoptysis has been controlled for 3 months.

Syphilitic posterior placoid chorioretinitis as initial presentation of early neurosyphilis.

Science.gov (United States)

Molina-Sócola, F E; López-Herrero, F; Medina-Tapia, A; Rueda-Rueda, T; Contreras-Díaz, M; Sánchez-Vicente, J L

2017-10-01

A 36 year-old male with a recent HIV diagnosis, presented with loss of vision of his left eye. Ophthalmoscopy revealed a unilateral yellowish placoid lesion in the macula. After fluorescein angiography, optical coherence tomography, optical coherence tomography angiography, syphilis serology, and cerebrospinal fluid results, he was diagnosed with neurosyphilis and syphilitic posterior placoid chorioretinitis. Acute syphilitic posterior placoid chorioretinitis is a rare ocular manifestation of syphilis. All patients with characteristic clinical and angiographic findings of acute syphilitic posterior placoid chorioretinitis should be tested for a neurosyphilis and human immunodeficiency virus co-infection. Early treatment with intravenous penicillin is usually effective with good visual results. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

An unusual stress fracture: Bilateral posterior longitudinal stress fracture of tibia.

Science.gov (United States)

Malkoc, Melih; Korkmaz, Ozgur; Ormeci, Tugrul; Oltulu, Ismail; Isyar, Mehmet; Mahirogulları, Mahir

2014-01-01

Stress fractures (SF) occur when healthy bone is subjected to cyclic loading, which the normal carrying range capacity is exceeded. Usually, stress fractures occur at the metatarsal bones, calcaneus, proximal or distal tibia and tends to be unilateral. This article presents a 58-year-old male patient with bilateral posterior longitudinal tibial stress fractures. A 58 years old male suffering for persistent left calf pain and decreased walking distance for last one month and after imaging studies posterior longitudinal tibial stress fracture was detected on his left tibia. After six months the patient was admitted to our clinic with the same type of complaints in his right leg. All imaging modalities and blood counts were performed and as a result longitudinal posterior tibial stress fractures were detected on his right tibia. Treatment of tibial stress fracture includes rest and modified activity, followed by a graded return to activity commensurate with bony healing. We have applied the same treatment protocol and our results were acceptable but our follow up time short for this reason our study is restricted for separate stress fractures of the posterior tibia. Although the main localization of tibial stress fractures were unilateral, anterior and transverse pattern, rarely, like in our case, the unusual bilateral posterior localization and longitudinal pattern can be seen. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

International comparative evaluation of knee replacement with fixed or mobile-bearing posterior-stabilized prostheses.

Science.gov (United States)

Graves, Stephen; Sedrakyan, Art; Baste, Valborg; Gioe, Terence J; Namba, Robert; Martínez Cruz, Olga; Stea, Susanna; Paxton, Elizabeth; Banerjee, Samprit; Isaacs, Abby J; Robertsson, Otto

2014-12-17

Posterior-stabilized total knee prostheses were introduced to address instability secondary to loss of posterior cruciate ligament function, and they have either fixed or mobile bearings. Mobile bearings were developed to improve the function and longevity of total knee prostheses. In this study, the International Consortium of Orthopaedic Registries used a distributed health data network to study a large cohort of posterior-stabilized prostheses to determine if the outcome of a posterior-stabilized total knee prosthesis differs depending on whether it has a fixed or mobile-bearing design. Aggregated registry data were collected with a distributed health data network that was developed by the International Consortium of Orthopaedic Registries to reduce barriers to participation (e.g., security, proprietary, legal, and privacy issues) that have the potential to occur with the alternate centralized data warehouse approach. A distributed health data network is a decentralized model that allows secure storage and analysis of data from different registries. Each registry provided data on mobile and fixed-bearing posterior-stabilized prostheses implanted between 2001 and 2010. Only prostheses associated with primary total knee arthroplasties performed for the treatment of osteoarthritis were included. Prostheses with all types of fixation were included except for those with the rarely used reverse hybrid (cementless tibial and cemented femoral components) fixation. The use of patellar resurfacing was reported. The outcome of interest was time to first revision (for any reason). Multivariate meta-analysis was performed with linear mixed models with survival probability as the unit of analysis. This study includes 137,616 posterior-stabilized knee prostheses; 62% were in female patients, and 17.6% had a mobile bearing. The results of the fixed-effects model indicate that in the first year the mobile-bearing posterior-stabilized prostheses had a significantly higher hazard

Subarachnoid pouches of the posterior fossa with syringomyelia

Energy Technology Data Exchange (ETDEWEB)

Williams, B [Midland Centre for Neurosurgery and Neurology, Smethwick (UK)

1979-01-01

Three men are presented, all of whom were born with difficulty and later developed severe syringomyelia with collapsing cords on air myelography. Each had hydrocephalus and a sizable subarachnoid pouch in the posterior fossa. The clinical features and investigations are presented with a discussion of the aetiology and possible mechanisms concerned in pathogenesis and treatment. All three men had posterior fossa exploration over fifty years after birth, and the first two were also treated by valved ventriculo-atrial shunts. Each patient has improved a little since operation, but no certainly that this was due to surgery has been proved in any case; none has progressed since the last operation.

Bilateral Posterior Native Hip Dislocations after Fall from Standing

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Jane Xiao

2017-10-01

Full Text Available We present a case of bilateral posterior native hip dislocations after a fall from standing. This exceedingly rare diagnosis is classically associated with younger patients whose bones are strong enough to dislocate rather than fracture in the setting of a high-momentum collision. We present an unusual case of an 88-year-old male with native hips who sustained a low-energy collision after falling from standing and was found to have bilateral posterior hip dislocations without associated pelvis or femur fractures.

Extensive Supratentorial Hemorrhages Following Posterior Fossa ...

African Journals Online (AJOL)

Remote supratentorial hematoma soon after posterior fossa surgery for the removal of a space-occupying lesion is a rare but dramatic and dreaded complication, carrying significant morbidity and mortality. A 47-year-old woman presented with headache of 1-year duration that worsened over last 2 months, progressive ...

The POLPSA lesion: MR imaging findings with arthroscopic correlation in patients with posterior instability

International Nuclear Information System (INIS)

Yu, Joseph S.; Ashman, Carol J.; Jones, Grant

2002-01-01

Objective. To evaluate the features of the posterior labrocapsular periosteal sleeve avulsion (POLPSA) lesion on MR imaging in athletes with posterior shoulder instability.Design and patients. Six male athletes (age range 19-43 years) with avulsion of the posterior glenoid periosteum were identified on MR imaging. There were four football players, one wrestler, and one competitive weightlifter. The weightlifter had a bilateral condition so that seven shoulders were evaluated. MR imaging was performed with a 1.5 T magnet utilizing conventional and fat-saturated fast spin-echo coronal oblique and sagittal oblique sequences and a 3D-GRE transaxial sequence. Surgical correlation was available in all shoulders.Results. All patients presented with pain and a joint effusion. The size of the periosteal sleeve and redundant joint recess was variable. Fibrous proliferation was noted arthroscopically in four shoulders beneath the sleeve. Although the posterior labrum was detached in all studies, only one labrum had a tear while two showed marked degeneration.Conclusion. The POLPSA lesion is an abnormality that can be associated with posterior instability. It differs from a reverse Bankart lesion because the periosteum, although detached, remains intact with the posterior capsule and detached posterior labrum. This lesion may represent an acute form of a Bennett lesion. (orig.)

SINDROME DE COLAPSO DE MORDIDA POSTERIOR

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Paula Alejandra Baldión

2012-12-01

Full Text Available El Síndrome de Colapso de Mordida posterior es una patología oclusal que se presenta como consecuencia de problemas dentales, periodontales y oclusales, que exige la correcta evaluación de los signos y síntomas que lo caracterizan.  El objetivo del artículo es describir la manera como evoluciona la enfermedad, la evaluación multidisciplinaria para obtener un diagnóstico preciso y la secuencia de tratamiento integral, revisando los conceptos para un mejor entendimiento del tratamiento periodontal y restaurativo que requieren los pacientes con síndrome de colapso de mordida posterior; caracterizado por procesos patológicos como enfermedad periodontal, caries dental con subsecuente alteración de la integridad del arco dentario que genera perdida de soporte posterior conllevando a un trauma oclusal secundario y disminución de la dimensión vertical oclusal. El control del proceso inflamatorio y la estabilización periodontal son puntos de partida indispensables en el tratamiento integral del paciente. La migración patológica de los dientes y las alteraciones del plano oclusal pueden exigir la corrección ortodóntica de los arcos y en algunos casos el concurso de cirugía oral para la nivelación del plano oclusal. La secuencia organizada del tratamiento por fases permite la restauración predecible de los pacientes con este síndrome, tomando en cuenta las diferentes alternativas protésicas tanto removibles como fijas con o sin implantes de oseointegración, para el éxito integral a largo plazo.

Posterior urethral valve in a six year old boy with nocturnal ...

African Journals Online (AJOL)

We report a case of posterior urethral valve (PUV) in a six year old boy with nocturnal eneuresis and failure to thrive as the only presenting symptoms. The clinically occult lesion was only unravelled when micturating cystourethrogram revealed a dilated posterior urethra with a distal narrow stream of opacified urine, bilateral ...

Rare association of female pseudohermaphroditism, phallic urethra, and posterior cloaca.

Science.gov (United States)

Macarthur, Mairi; Mahomed, Anies

2006-03-01

We describe a child with the rare clinical entity of female pseudohermaphroditism, accessory phallic urethra, and posterior cloaca who was successfully treated with posterior sagittal anorectovaginourethroplasty. Masculinization was limited to the external genitalia, and no chromosomal, metabolic, or adrenal abnormalities were detected. Associated pathology included bilateral vesicoureteric reflux, a non functioning dysplastic kidney, and bicornuate uterus. The investigation and surgical management of this particularly challenging combination of anomalies is detailed.

Ligamentous and capsular restraints to experimental posterior elbow joint dislocation

DEFF Research Database (Denmark)

Deutch, S.R.; Olsen, B.S.; Jensen, S.L.

2003-01-01

the anterior capsule and the lateral collateral ligament complex (LCLC), whereas in the flexed elbow the anterior capsule did not have a stabilizing effect. In flexed joint positions, the LCLC seems to be the only immediate stabilizer against PEFR, and thereby against posterolateral instability and possibly...... against posterior dislocation. The medial collateral ligament did not have any immediate stabilizing effect, but it prevented the final step of the posterior dislocation....

Resolução de conflitos em centros integrados de cidadania: uma abordagem à luz da perspectiva sociotécnica de grupos de trabalho

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Almir Cordeiro Júnior

Full Text Available Por meio da análise do modelo de Centro Integrado de Cidadania, implantado em Vitória, e dos equipamentos que o antecederam, busca-se, neste artigo: identificar os serviços que devem estar presentes num equipamento urbano dessa natureza, à luz dos instrumentos governamentais que originaram sua concepção; categorizar os serviços identificados segundo algumas das principais classificações existentes na literatura específica (Chase, 1978; Lovelock, 1983; Schmenner, 1986; discutir as unidades de atendimento como integrantes de um processo de produção induzido pelo cliente, à luz das estruturas básicas propostas por Wild (1977; direcionar o foco da abordagem para as unidades que estão voltadas à resolução pacífica de conflitos, confrontando seus subsistemas técnico e social com os pressupostos da Escola Sociotécnica (Biazzi Júnior, 1994; comparar a atuação dessas unidades com o job design para grupos semiautônomos (Cherns, 1994 e, por fim, comentar a importância da estruturação dessas unidades como grupos autogeridos, mostrando que esta abordagem contribui sobremaneira para a integração operacional e a gestão dessas unidades.

As aulas de Educação Física na classe especial na abordagem psicomotora

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Roberta Bevilaqua de Quadros

2013-07-01

Full Text Available http://dx.doi.org/10.5007/2175-8042.2013v25n40p41 O estudo baseia-se em um relato de experiência das aulas de Educação Física de uma turma de Classe Especial, visando demonstrar a importância desta disciplina como prática pedagógica, seguindo a abordagem psicomotora. A classe em questão era formada por seis crianças com necessidades educacionais especiais, e ocorriam duas vezes por semana, uma juntamente com uma turma de classe regular. Através do planejamento e execução das aulas constatou-se a importância do componente curricular educação física, pois os alunos vivenciaram atividades que privilegiaram a cooperação, criatividade e coletividade, refletindo no desenvolvimento motor, cognitivo, e afetivo-social.

Trypan blue-assisted posterior capsulorhexis in pediatric cataract surgery

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Lotfy A

2017-01-01

Full Text Available Ayman Lotfy,1,2 Ayman Abdelrahman1,2 1Ophthalmology Department, Zagazig University Hospital, 2Alpha Vision Center, Zagazig, Egypt Purpose: To evaluate the safety and efficacy of staining the posterior capsule with trypan blue during capsulorhexis in pediatric cataract surgery.Patients and methods: This was a prospective randomized comparative study carried out at Alpha Vision Center, Zagazig, Egypt. This study included 2 groups of children with pediatric cataract randomly allocated to undergo irrigation and aspiration. In the trypan group, which included 11 eyes, trypan blue was used to stain the posterior capsule during posterior capsulorhexis. In the control group, which included 10 eyes, no staining was performed. All surgeries were performed by the same surgeon. The 2 groups were compared for criteria such as completion of capsulorhexis, disruption of vitreous face and in-the-bag intraocular lens implantation.Results: This study included 21 eyes of 16 patients (age range: 6 months–4 years. A statistically significant difference was observed for the following parameters between the 2 groups: capsulorhexis completion (P=0.04, vitreous face disruption (P=0.01 and in-the-bag intraocular lens implantation (P=0.022.Conclusion: This study suggests that staining of the posterior capsule during capsulorhexis in pediatric cataract operation gives better results than capsulorhexis without staining. The stain changes the capsule texture making capsulorhexis easier with fewer complications. Keywords: staining, capsulorhexis, pediatric, cataract, trypan

Novel posterior reconstruction technique during robot-assisted laparoscopic prostatectomy: description and comparative outcomes.

Science.gov (United States)

Jeong, Chang Wook; Oh, Jong Jin; Jeong, Seong Jin; Hong, Sung Kyu; Byun, Seok-Soo; Choe, Gheeyoung; Lee, Sang Eun

2012-07-01

The aim of the present study was to assess the impact of a novel posterior reconstruction technique during robot-assisted laparoscopic prostatectomy on continence recovery. A total of 116 consecutive patients who received the novel posterior reconstruction (case group) were retrospectively compared with a cohort of 126 patients who did not receive posterior reconstruction (control group). The primary end-point was the duration of continence recovery (no pad use) after robot-assisted laparoscopic prostatectomy. The posterior reconstruction was obtained by opposing the median dorsal fibrous raphe to the posterior counterpart of the detrusor apron, rather than the Denonvilliers' fascia. The case group showed higher continence rates at all points of evaluation, which were 2 weeks (30.1% vs 19.8%), 1 month (58.4% vs 45.7%), 3 months (82.7% vs 70.5%) and 6 months postoperatively (95.3% vs 86.4%) (P = 0.007). Application of the novel posterior reconstruction technique, age and length of membranous urethra were significant variables for the complete recovery of continence on multivariable analysis. This study shows that the application of this novel PR technique significantly improves the recovery of continence in patients undergoing robot-assisted laparoscopic prostatectomy. © 2012 The Japanese Urological Association.

Dissociating medial frontal and posterior cingulate activity during self-reflection.

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Johnson, Marcia K; Raye, Carol L; Mitchell, Karen J; Touryan, Sharon R; Greene, Erich J; Nolen-Hoeksema, Susan

2006-06-01

Motivationally significant agendas guide perception, thought and behaviour, helping one to define a 'self' and to regulate interactions with the environment. To investigate neural correlates of thinking about such agendas, we asked participants to think about their hopes and aspirations (promotion focus) or their duties and obligations (prevention focus) during functional magnetic resonance imaging and compared these self-reflection conditions with a distraction condition in which participants thought about non-self-relevant items. Self-reflection resulted in greater activity than distraction in dorsomedial frontal/anterior cingulate cortex and posterior cingulate cortex/precuneus, consistent with previous findings of activity in these areas during self-relevant thought. For additional medial areas, we report new evidence of a double dissociation of function between medial prefrontal/anterior cingulate cortex, which showed relatively greater activity to thinking about hopes and aspirations, and posterior cingulate cortex/precuneus, which showed relatively greater activity to thinking about duties and obligations. One possibility is that activity in medial prefrontal cortex is associated with instrumental or agentic self-reflection, whereas posterior medial cortex is associated with experiential self-reflection. Another, not necessarily mutually exclusive, possibility is that medial prefrontal cortex is associated with a more inward-directed focus, while posterior cingulate is associated with a more outward-directed, social or contextual focus.

Classification of posterior vitreous detachment

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Kakehashi, Akihiro; Takezawa, Mikiko; Akiba, Jun

2013-01-01

Akihiro Kakehashi,1 Mikiko Takezawa,1 Jun Akiba21Department of Ophthalmology, Jichi Medical University, Saitama Medical Center, Saitama, 2Kanjodori Eye Clinic, Asahikawa, JapanAbstract: Diagnosing a posterior vitreous detachment (PVD) is important for predicting the prognosis and determining the indication for vitreoretinal surgery in many vitreoretinal diseases. This article presents both classifications of a PVD by slit-lamp biomicroscopy and of a shallow PVD by optical coherence tomography...

Alveolar ridge expansion-assisted orthodontic space closure in the mandibular posterior region.

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Ozer, Mete; Akdeniz, Berat Serdar; Sumer, Mahmut

2013-12-01

Orthodontic closure of old, edentulous spaces in the mandibular posterior region is a major challenge. In this report, we describe a method of orthodontic closure of edentulous spaces in the mandibular posterior region accelerated by piezoelectric decortication and alveolar ridge expansion. Combined piezosurgical and orthodontic treatments were used to close 14- and 15-mm-wide spaces in the mandibular left and right posterior areas, respectively, of a female patient, aged 18 years and 9 months, diagnosed with skeletal Class III malocclusion, hypodontia, and polydiastemas. After the piezoelectric decortication, segmental and full-arch mechanics were applied in the orthodontic phase. Despite some extent of root resorption and anchorage loss, the edentulous spaces were closed, and adequate function and esthetics were regained without further restorative treatment. Alveolar ridge expansion-assisted orthodontic space closure seems to be an effective and relatively less-invasive treatment alternative for edentulous spaces in the mandibular posterior region.

Psicose e esquizofrenia: efeitos das mudanças nas classificações psiquiátricas sobre a abordagem clínica e teórica das doenças mentais

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Fernando Tenório

Full Text Available Resumo Abordam-se as mudanças nos sistemas de classificação diagnóstica das doenças mentais, em especial o enfraquecimento conceitual da categoria “psicose” e a dominância da esquizofrenia como psicose única. As classificações atuais priorizam uma abordagem fisicalista da patologia mental. Ocorrem, então, a medicalização das condições antes associadas à neurose e à subjetividade; a localização de quadros antes reconhecidos como psicóticos na rubrica dos transtornos de personalidade; e a redução da psicose à esquizofrenia, abordada como deficit das funções psíquicas. Aponta-se a validade clínica e operatória da noção de “psicose” como categoria nosográfica que permite abordagem mais complexa da “esquizofrenia”, última noção, na psiquiatria, com o peso simbólico da loucura.

Non-syndromic posterior lenticonus a cause of childhood cataract: evidence for X-linked inheritance.

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Russell-Eggitt, I M

2000-12-01

When an X-linked pedigree of posterior lenticonus with cataract was identified further evidence for X-linked inheritance of this condition was sought. Forty-three cases of posterior lenticonus were identified from a database of 354 children with cataract. Two children with the X-linked syndromes of Lowe and Nance-Horan and 3 children with Fanconi syndrome have been excluded from further analysis. None of the children was deaf. None of the non-syndromic cases had microcornea. There were 38 cases of non-syndromic posterior lenticonus (approximately 11%). There were 15 children from 13 pedigrees and 23 apparently sporadic cases. Of the 106 cases on the database with unilateral cataract 15 had posterior lenticonus (approximately 14%). Eleven of 13 pedigrees were compatible with X-linked inheritance or autosomal dominant inheritance with variable expression. However, in 2 pedigrees there was father to son transmission. Posterior lenticonus is a common cause of unilateral infantile cataract, but is thought to be a rare cause of bilateral cataracts. This study suggests that posterior lenticonus is responsible for a significant proportion of childhood cataracts (approximately 14% of unilateral and approximately 9% of bilateral cases). Posterior lenticonus is generally thought to occur as a sporadic condition. This study demonstrates that there is a family history of early-onset cataract in a significant number of bilateral cases (approximately 58%).

Posterior composite restoration update: focus on factors influencing form and function

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Bohaty, Brenda S; Ye, Qiang; Misra, Anil; Sene, Fabio; Spencer, Paulette

2013-01-01

Restoring posterior teeth with resin-based composite materials continues to gain popularity among clinicians, and the demand for such aesthetic restorations is increasing. Indeed, the most common aesthetic alternative to dental amalgam is resin composite. Moderate to large posterior composite restorations, however, have higher failure rates, more recurrent caries, and increased frequency of replacement. Investigators across the globe are researching new materials and techniques that will improve the clinical performance, handling characteristics, and mechanical and physical properties of composite resin restorative materials. Despite such attention, large to moderate posterior composite restorations continue to have a clinical lifetime that is approximately one-half that of the dental amalgam. While there are numerous recommendations regarding preparation design, restoration placement, and polymerization technique, current research indicates that restoration longevity depends on several variables that may be difficult for the dentist to control. These variables include the patient’s caries risk, tooth position, patient habits, number of restored surfaces, the quality of the tooth–restoration bond, and the ability of the restorative material to produce a sealed tooth–restoration interface. Although clinicians tend to focus on tooth form when evaluating the success and failure of posterior composite restorations, the emphasis must remain on advancing our understanding of the clinical variables that impact the formation of a durable seal at the restoration–tooth interface. This paper presents an update of existing technology and underscores the mechanisms that negatively impact the durability of posterior composite restorations in permanent teeth. PMID:23750102

Effect of posterior gingival smile on the perception of smile esthetics.

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Rodríguez-Martínez, Alicia; Vicente-Hernández, Ascensión; Bravo-González, Luis-Alberto

2014-01-01

To evaluate and compare the influence of posterior gummy smile on the perception of smile esthetics by orthodontists, general-dentists and laypersons. A frontal photograph of a smile with normal gum exposure was chosen and manipulated digitally using Adobe Photoshop C3 to generate three further images with posterior gum exposure of 4, 6 and 8mm. These four images were assessed by the three evaluator groups: orthodontists (n=40), general-dentists (n=40) and laypersons (n=40). Both orthodontists and dentists had at least ten years professional experience and laypersons were aged between 40-50 years. The proportion of men to women was 20:20 in each group. Evaluators awarded a score to the smile esthetics of each image: 1=acceptable, 2=moderately acceptable, 3=unacceptable. Afterwards, each evaluator placed the four images in order of esthetic preference. No significant differences (p>0.05) were detected between the three evaluator groups for the photo without posterior gummy smile. The perception of smile esthetics for a the 4mm posterior gummy smile (median for orthodontists=2, general-dentists= 1, laypersons=1), the 6mm (median for orthodontists=2, general-dentists=1, laypersons=1) and the 8mm (median for orthodontists=3, general-dentists=2, laypersons=2) was significantly different between orthodontists and the other two evaluator groups (pesthetic preference. Posterior gummy smile influences the perception of smile esthetics more negatively among orthodontists than the rest of the groups.

Shining a light on posterior cortical atrophy.

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Crutch, Sebastian J; Schott, Jonathan M; Rabinovici, Gil D; Boeve, Bradley F; Cappa, Stefano F; Dickerson, Bradford C; Dubois, Bruno; Graff-Radford, Neill R; Krolak-Salmon, Pierre; Lehmann, Manja; Mendez, Mario F; Pijnenburg, Yolande; Ryan, Natalie S; Scheltens, Philip; Shakespeare, Tim; Tang-Wai, David F; van der Flier, Wiesje M; Bain, Lisa; Carrillo, Maria C; Fox, Nick C

2013-07-01

Posterior cortical atrophy (PCA) is a clinicoradiologic syndrome characterized by progressive decline in visual processing skills, relatively intact memory and language in the early stages, and atrophy of posterior brain regions. Misdiagnosis of PCA is common, owing not only to its relative rarity and unusual and variable presentation, but also because patients frequently first seek the opinion of an ophthalmologist, who may note normal eye examinations by their usual tests but may not appreciate cortical brain dysfunction. Seeking to raise awareness of the disease, stimulate research, and promote collaboration, a multidisciplinary group of PCA research clinicians formed an international working party, which had its first face-to-face meeting on July 13, 2012 in Vancouver, Canada, prior to the Alzheimer's Association International Conference. Copyright © 2013 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Posterior transverse interarch discrepancy on HbE β thalassemia patients

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Yuniar Zen

2011-03-01

Full Text Available Background: One of the symptoms that often arises on thalassemia patients is disharmony dentofacial, class II skeletal malocclusion, as a result of the malrelation of maxilla and mandible. This malrelation can be affected by either maxillary bone position, dentoalveolar maxillary position, mandibular bone position, dentoalveolar mandibular position, or combinations of those components. Purpose: The study was aimed to examine whether there is posterior transverse interarch discrepancy on the HbE β thalassemia patients or not. Methods: This study is an observational research with cross-sectional design. The sample consisted of 33 HbE β thalassemia patients and 33 non-thalassemia patients as a control group aged 12–14 years. Lateral cephalogram was carried out and dental casts of maxillary and mandibular dental arches were also taken in all of those patients. Results: There was no difference between the maxillary intermolar width of the HbE β thalassemia patients and that of the normal ones, but the mandibular intermolar width of the HbE β thalassemia patients was significantly smaller than that of the normal ones. Beside that, posterior transverse interarch discrepancy of of the HbE β thalassemia patients was significantly greater than that of the normal ones, which showed great difference between maxillary and mandibular intermolar widths. Conclusion: Posterior transverse interarch discrepancy of the HbE β thalassemia patients was different from that of the normal ones. The dentofacial abnormalities on the HbE β thalassemia patients aged 12–14 years primarily was due to disporposional dentofacial growth in the vertical, sagittal, and transversal directions, especially in the posterior region.Latar belakang: Salah satu akibat yang sering timbul pada penderita talasemia adalah disharmoni dentofasial berupa maloklusi skeletal kelas II yang merupakan kelainan hubungan maksila dan mandibula. Malrelasi ini dapat dipengaruhi oleh posisi

Clinical analysis of surgical treatment of traumatic hematomas of the posterior cranial fossa

International Nuclear Information System (INIS)

Wang Wenhua; Zhou Youxin; Zhu Fengqing; Zhou Dai

2000-01-01

Objective: To discuss the clinical features and surgical outcome of the traumatic hematomas posterior cranial fossa. Methods: Fifteen patients with traumatic hematomas posterior cranial fossa in authors' hospital during the period from 1995 to 1998 were reviewed. Results: Thirteen patients had an occipital skull fracture, 11 pure epidural hematomas among whom 4 had cerebellar contusion and hematomas 4 posterior cranial fossa hematoma with associated cerebral hematoma or contusion, and 5 acute hydrocephalus. Fifteen patients were treated by emergency surgery, 9 had good recovery and 1 had severe disability in GCS between 9 and 15 marking, 1 had good recovery, 1 had severe disability and 3 died in GCS between 3 and 8. Nine patients had good recovery in 11 patient having pure epidural hematoma of posterior cranial fossa. Conclusions: The clinical course of the traumatic hematomas posterior cranial fossa was acute and severe. The GCS value below 9 predicts the poor out-come for patients. Early diagnosis and appropriately and promptly treatment are crucial for achieving good results

[Endoscopic realignment for post-traumatic rupture of posterior urethra].

Science.gov (United States)

Tazi, Hicham; Ouali, Mohammed; Lrhorfi, My Hfid; Moudouni, Saïd; Tazi, Karim; Lakrissa, Ahmed

2003-12-01

To analyse the long-term results of treatment of posterior urethral disruptions with endoscopic realignment, and to assess the efficacy, simplicity and benefit of this technique. Between 1989 and 2001, thirty six patients were treated by endoscopic realignment for traumatic rupture of the posterior urethra. The analysis of the results took in consideration the quality of urinary stream, the continence and the erectile function. With a mean follow-up of thirty four months (12 to 72 months), the 36 patients treated by endoscopic realignment are continent and urinate with a satisfactory urine output. This result was obtained after internal urethrotomy in 13 patients (36.1%), and after transperineal urethroplasty in two patients. Only 7 patients (19.4%) developed an impotence. The endoscopic realignment can be considered like initial treatment of all post-traumatic rupture of the posterior urethra. This simple and little aggressive technique doesn't compromise the recourse to another type of ulterior treatment and resulted in negligible morbidity. The secondary urethral strictures are short and accessible to an endoscopic urethrotomy.

Anatomical reconstruction of unstable trochanteric fractures through posterior approach

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Partha Saha

2015-01-01

Full Text Available Objective Unstable intertrochanteric fractures continue to be a challenge for orthopedic surgeons due to the functional limitations it results in the postoperative period. Anatomical reconstruction of the posteromedial fragment becomes difficult through conventional lateral approach, leading to excessive fracture collapse and limping. Materials and Methods: prospective, nonrandomized study was done with 40 patients. They were operated in prone position through posterior approach. Cancellous screws or SS-wires were used to fix the greater or lesser trochanteric fragments and dynamic hip screw (DHS or dynamic condylar screw (DCS for the main two fragments. Bone grafts were used to pack cavities at the posterior trochanteric regions. Results: Fracture healing occurred earlier compared to conventional lateral approach without excessive fracture collapse in majority of cases (average time to achieve union was 13.8 weeks; range: 10–18 weeks. Good functional recovery was noted with 75% 'Good' or 'Excellent' Harris Hip Scores at 24 weeks. Conclusion: Anatomical reconstruction of unstable trochanteric fractures becomes easier through posterior approach with earlier and better functional recovery.

Spectral Domain Optical Coherence Tomography Findings in Posterior Microphthalmia

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Emine Tınkır Kayıtmazbatır

2014-05-01

Full Text Available The retinal spectral domain optical coherence tomography (SD-OCT findings of two posterior microphthalmia cases are presented in this case report. For this purpose, the findings of two siblings aged five and seven years who presented to our clinic with the complain of far-sightedness and high hypermetropia were evaluated. Both cases diagnosed to have posterior microphthalmia demonstrated normal biomicroscopic anterior segment examination and gonioscopy findings and the axial lengths were measured to be shorter than 17mm. The SD-OCT analysis of papillomacular folds detected in fundus examination revealed contribution of only neurosensorial retina. Beneath the retinal fold, we observed bilateral cysts in the intraretinal area in one of the cases and a triangle-shaped hyporeflective space with an apex corresponding to that of the retinal fold in the subretinal area in both cases. SD-OCT is an adjunctive imaging tool for diagnosis and follow-up of degenerative changes in posterior microphthalmia. These changes may be also important for visual prognosis. (Turk J Ophthalmol 2014; 44: 240-2

Effect of posterior crown margin placement on gingival health.

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Reitemeier, Bernd; Hänsel, Kristina; Walter, Michael H; Kastner, Christian; Toutenburg, Helge

2002-02-01

The clinical impact of posterior crown margin placement on gingival health has not been thoroughly quantified. This study evaluated the effect of posterior crown margin placement with multivariate analysis. Ten general dentists reviewed 240 patients with 480 metal-ceramic crowns in a prospective clinical trial. The alloy was randomly selected from 2 high gold, 1 low gold, and 1 palladium alloy. Variables were the alloy used, oral hygiene index score before treatment, location of crown margins at baseline, and plaque index and sulcus bleeding index scores recorded for restored and control teeth after 1 year. The effect of crown margin placement on sulcular bleeding and plaque accumulation was analyzed with regression models (Prisk of bleeding at intrasulcular posterior crown margins was approximately twice that at supragingival margins. Poor oral hygiene before treatment and plaque also were associated with sulcular bleeding. Facial sites exhibited a lower probability of sulcular bleeding than lingual surfaces. Type of alloy did not influence sulcular bleeding. In this study, placement of crown margins was one of several parameters that affected gingival health.

Política pública de educação: uma abordagem da extensão universitária na Universidade Estadual do Maranhão (UEMA

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Lucas Carneiro Santos Veras

2017-12-01

Full Text Available Este trabalho objetiva fazer analisar as práticas da extensão universitária como política pública da educação na UEMA. Apresenta-se um levantamento da legislação nacional e intra-institucional pertinente às práticas extensionistas. Mostram-se aspectos teóricos referentes à extensão, e em seguida, relaciona-se a teoria com o que foi observado nas normas da UEMA. O método utilizado foi o fenomenológico-hermenêutico. A pesquisa é de natureza básica, de abordagem qualitativa, os objetivos são exploratórios. Os procedimentos técnicos foram a pesquisa bibliográfica, a documental, de campo e um estudo de caso. Também utilizou-se de duas visitas in loco para observação. Entende-se que extensão é uma atividade acadêmica que visa à difusão de conhecimento acadêmico, e a interação deste com o saber popular (senso comum para melhor compreensão de problemas e demandas sociais. Respondendo ao problema desta pesquisa, escreve-se que as normas superiores de extensão universitária na UEMA são debatidas e estabelecidas pelo CEPE, para posterior sanção do CONSUN. No que se refere à execução a nível intermediário, cabe à PROEXAE, e especificamente, à Coordenação de Extensão, o planejamento e controle das práticas extensionistas, sejam elas cursos ou projetos de extensão. No nível operacional é obrigatório pelo menos um docente da UEMA para comandar cada ação extensionista.

Huge interparietal posterior fontanel meningohydroencephalocele

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Jorge Félix Companioni Rosildo

2015-03-01

Full Text Available Congenital encephalocele is a neural tube defect characterized by a sac-like protrusion of the brain, meninges, and other intracranial structures through the skull, which is caused by an embryonic development abnormality. The most common location is at the occipital bone, and its incidence varies according to different world regions. We report a case of an 1-month and 7-day-old male child with a huge interparietal-posterior fontanel meningohydroencephalocele, a rare occurrence. Physical examination and volumetric computed tomography were diagnostic. The encephalocele was surgically resected. Intradural and extradural approaches were performed; the bone defect was not primarily closed. Two days after surgery, the patient developed hydrocephaly requiring ventriculoperitoneal shunting. The surgical treatment of the meningohydroencephalocele of the interparietal-posterior fontanel may be accompanied by technical challenges and followed by complications due to the presence of large blood vessels under the overlying skin. In these cases, huge sacs herniate through large bone defects including meninges, brain, and blood vessels. The latter present communication with the superior sagittal sinus and ventricular system. A favorable surgical outcome generally follows an accurate strategy taking into account individual features of the lesion.

[A Case of Ruptured Internal Carotid-Posterior Communicating Artery Aneurysm Associated with Acute Subdural Hematoma, Extending from the Interhemispheric Space to the Posterior Fossa].

Science.gov (United States)

Otsuka, Hiroaki; Fukuda, Yuhtaka; Yoshimura, Shouta; Somagawa, Chika; Hiu, Takeshi; Ono, Tomonori; Ushijima, Ryujirou; Toda, Keisuke; Tsutsumi, Keisuke

2016-06-01

A 69-year-old woman was admitted to our hospital because of a sudden severe headache without a history of head trauma. CT and MRI revealed an acute subdural hematoma (ASDH) extending from the right interhemispheric space to the posterior fossa bilaterally, with a small amount of subarachnoid hemorrhage that was predominantly localized to the left side of the basal cistern. CT angiogram demonstrated a long protruding ruptured aneurysm at the junction of the right internal carotid and posterior communicating arteries (IC/PC AN) with a posteroinferior projection, associated with a small bleb located near the tentorial edge close to the ipsilateral posterior clinoid process, for which she received clipping surgery. Though rare, IC/PC AN could cause pure or nearly pure ASDH in the above-mentioned distribution. Therefore, in patients with such ASDH, especially without a history of head injury or precise information regarding the situation at the time of onset, urgent imaging evaluation and early intervention are essential to prevent devastating re-rupture events.

MRI of the fetal posterior fossa

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Adamsbaum, Catherine; Andre, Christine; Merzoug, Valerie; Ferey, Solene [St Vincent de Paul Hospital, Department of Radiology, Paris Cedex 14 (France); Moutard, Marie Laure [St Vincent de Paul Hospital, Department of Neuropaediatrics, Paris (France); Quere, Marie Pierre [CHU, Department of Radiology, Nantes (France); Lewin, Fanny [St Vincent de Paul Hospital, Maternity Department, Paris (France); Fallet-Bianco, Catherine [Ste Anne Hospital, Department of Neuropathology, Paris (France)

2005-02-01

MRI is a useful tool to complement US for imaging of the fetal posterior fossa (PF). In France, the discovery of a PF malformation in the fetus frequently leads to termination of pregnancy (80% in a personal series). However, despite improved accuracy in the diagnosis of PF abnormalities, prognosis remains uncertain. The first objective of this review is to document the normal MRI landmarks of the developing fetal PF. Because of their thinness, the visibility of the cerebellar fissures is dramatically delayed on MRI compared to macroscopic data. An important landmark is identification of the primary fissure of the vermis, normally seen at around 25-26 weeks' gestation (WG) on the sagittal slice, separating the larger posterior lobe from the anterior lobe (volume ratio around 2:1). The prepyramidal and secondary fissures are usually only identifiable after 32 WG and the hemispheric fissures are difficult to see until the end of pregnancy. Considering the signal changes, high signal on T2-weighted (T2-W) sequences is seen from 25 WG in the posterior part of the brain stem (tegmentum and ascending sensory tracts) related to myelination. The low signal intensities seen within the cerebellum on T2-W images correspond to high cellularity of grey matter (deep nuclei), as there is no myelination within the white matter before 38 WG. The second objective is to highlight the signs highly predictive of a poor neurological prognosis. Lack of pontine curvature or vermian agenesis without a PF cyst (small volume of PF) is greatly associated with poor neurological status. The third objective is to propose a diagnostic strategy in difficult cases where prognosis is important, e.g. the Dandy Walker continuum. (orig.)

MRI of the fetal posterior fossa

International Nuclear Information System (INIS)

Adamsbaum, Catherine; Andre, Christine; Merzoug, Valerie; Ferey, Solene; Moutard, Marie Laure; Quere, Marie Pierre; Lewin, Fanny; Fallet-Bianco, Catherine

2005-01-01

MRI is a useful tool to complement US for imaging of the fetal posterior fossa (PF). In France, the discovery of a PF malformation in the fetus frequently leads to termination of pregnancy (80% in a personal series). However, despite improved accuracy in the diagnosis of PF abnormalities, prognosis remains uncertain. The first objective of this review is to document the normal MRI landmarks of the developing fetal PF. Because of their thinness, the visibility of the cerebellar fissures is dramatically delayed on MRI compared to macroscopic data. An important landmark is identification of the primary fissure of the vermis, normally seen at around 25-26 weeks' gestation (WG) on the sagittal slice, separating the larger posterior lobe from the anterior lobe (volume ratio around 2:1). The prepyramidal and secondary fissures are usually only identifiable after 32 WG and the hemispheric fissures are difficult to see until the end of pregnancy. Considering the signal changes, high signal on T2-weighted (T2-W) sequences is seen from 25 WG in the posterior part of the brain stem (tegmentum and ascending sensory tracts) related to myelination. The low signal intensities seen within the cerebellum on T2-W images correspond to high cellularity of grey matter (deep nuclei), as there is no myelination within the white matter before 38 WG. The second objective is to highlight the signs highly predictive of a poor neurological prognosis. Lack of pontine curvature or vermian agenesis without a PF cyst (small volume of PF) is greatly associated with poor neurological status. The third objective is to propose a diagnostic strategy in difficult cases where prognosis is important, e.g. the Dandy Walker continuum. (orig.)

Can the human lumbar posterior columns be stimulated by transcutaneous spinal cord stimulation? A modeling study.

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Danner, Simon M; Hofstoetter, Ursula S; Ladenbauer, Josef; Rattay, Frank; Minassian, Karen

2011-03-01

Stimulation of different spinal cord segments in humans is a widely developed clinical practice for modification of pain, altered sensation, and movement. The human lumbar cord has become a target for modification of motor control by epidural and, more recently, by transcutaneous spinal cord stimulation. Posterior columns of the lumbar spinal cord represent a vertical system of axons and when activated can add other inputs to the motor control of the spinal cord than stimulated posterior roots. We used a detailed three-dimensional volume conductor model of the torso and the McIntyre-Richard-Grill axon model to calculate the thresholds of axons within the posterior columns in response to transcutaneous lumbar spinal cord stimulation. Superficially located large-diameter posterior column fibers with multiple collaterals have a threshold of 45.4 V, three times higher than posterior root fibers (14.1 V). With the stimulation strength needed to activate posterior column axons, posterior root fibers of large and small diameters as well as anterior root fibers are coactivated. The reported results inform on these threshold differences, when stimulation is applied to the posterior structures of the lumbar cord at intensities above the threshold of large-diameter posterior root fibers. © 2011, Copyright the Authors. Artificial Organs © 2011, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

When and how to operate the posterior malleolus fragment in trimalleolar fractures: a systematic literature review.

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Verhage, Samuel Marinus; Hoogendoorn, Jochem Maarten; Krijnen, Pieta; Schipper, Inger Birgitta

2018-05-12

Whether or not and how to fixate the posterior malleolus fracture seems to depend on the fracture fragment size and its amount of dislocation, but clear guidelines for daily practice are lacking. In this review, we summarize the literature on preferred treatment of the posterior fragment in trimalleolar fractures. A systematic review of publications between January 1995 and April 30 2017 on this topic in the PubMed, Embase, and Cochrane databases was performed according to the PRISMA statement. Seventeen (2 prospective and 15 retrospective) of the 180 identified studies were included. Six studies report on indications for fixation of posterior malleolus fracture fragments. Eleven studies compare different fixation approaches and techniques for the posterior fragment. Meta-analysis was not possible due to varying fixation criteria and outcomes. There was no clear association between posterior fragment size and functional outcome or development of osteoarthritis. The non-anatomical reduction of the fragment was of more influence on outcome. Radiological and functional outcome was better after open reduction and internal fixation via the posterolateral approach than after percutaneous anterior-to-posterior screw fixation. The posterior fragment size is not a clear indication for its fixation. A step-off, however, seems an important indicator for developing posttraumatic osteoarthritis and worse functional outcome. Posterior fragments involving the intra-articular surface need to be reduced and fixated to prevent postoperative persisting step-off. Furthermore, fixation of the posterior malleolus via an open posterolateral approach seems superior to percutaneous anterior-to-posterior fixation. However, these results need to be confirmed in a prospective comparative trial. Therapeutic level II.

Technical note: Dynamic MRI in a complicated giant posterior urethral diverticulum

International Nuclear Information System (INIS)

Kundum, Prasad R; Gupta, Arun K; Thottom, Prasad V; Jana, Manisha

2010-01-01

Congenital posterior urethral diverticulum is an uncommon anomaly, sometimes complicated by infection or calculi formation. A conventional voiding cystourethrogram (VCUG) is the most commonly used diagnostic modality. Dynamic magnetic resonance imaging (MRI) has not been frequently described in this entity. We describe a case of posterior urethral diverticulum complicated with secondary calculi, where the patient was evaluated using dynamic MRI and conventional VCUG

Early surgical managment of penetrating ocular injuries involving the posterior segment.

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Michels, R G

1976-09-01

Pars plana vitrectomy technic can be used in the early management of certain penetrating ocular injuries involving the posterior segment, including selected intraocular foreign bodies. This study reports the results of ten consecutive cases of intraocular foreign bodies in the posterior segment treated by a combination of vitrectomy (including lensectomy when necessary) and foreign-body extraction with forceps. The foreign body was successfully removed in nine of ten eyes, and nine of ten eyes were salvaged. This favorable experience using early vitreous surgery suggests that the vitrectomy technic can be used in other penetrating injuries involving the posterior segment that are not associated with intraocular foreign bodies. Possible indications for early vitrectomy are presented, including cases with a poor prognosis when managed by conventional methods.

Space closure in the maxillary posterior area through the maxillary sinus.

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Park, Jae Hyun; Tai, Kiyoshi; Kanao, Akira; Takagi, Masato

2014-01-01

A common dilemma in adult orthodontic treatment is deciding how best to treat missing posterior teeth. One treatment option is to orthodontically close the space. But closure can be difficult, especially if the open space is in the maxillary posterior area, because tooth movement through the maxillary sinus is limited. The increased difficulty of moving teeth in the maxillary sinus is similar to moving a tooth in the atrophic posterior mandibular ridge. If space closure is selected as a treatment method, proper mechanics and light forces should be applied. In this article, we report movement of teeth through the maxillary sinus and discuss various implications related to orthodontic treatment in the maxillary sinus. Copyright © 2014 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Shoulder Magnetic Resonance Arthrography: A Prospective Randomized Study of Anterior and Posterior Ultrasonography-Guided Contrast Injections

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Koivikko, M.P.; Mustonen, A.O.T. (Dept. of Radiology, Helsinki Univ. Central Hospital, Helsinki (Finland))

2008-10-15

Background: Magnetic resonance (MR) arthrography is an accurate imaging method for internal shoulder derangements and rotator cuff pathologies. Both anterior and posterior contrast injection techniques, under palpatory, fluoroscopic, or ultrasonographic guidance have been described in the literature. However, clinical comparisons of the injection techniques remain few. Purpose: To compare the performance of anterior and posterior ultrasonography (US)-guided arthrography injections of the shoulder regarding patient discomfort and influence on diagnostic MR reading, and to illustrate the typical artifacts resulting from contrast leakage in the respective techniques. Material and Methods: 43 MR arthrographies were prospectively randomized into anterior and posterior US-guided contrast injections and performed by two radiologists, with the study of artifacts from contrast leakage. Pain from the injections was assessed by a survey utilizing a 100-mm visual analogue scale (VAS). Results: Of the 23 anterior injections, nine caused contrast artifacts in the subscapular tendon, and in three the leakage extended further anteriorly. Of the 20 posterior injections, 12 showed injection artifacts of the rotator cuff, extending outside the cuff in seven. Two of the anterior and none of the posterior artifacts compromised diagnostic quality. In posterior injections, the leakage regularly occurred at the caudal edge of the infraspinatus muscle and was easily distinguishable from rotator cuff tears. All patients completed the pain survey. Mean VAS scores were 25.0 (median 18, SD 22) for anterior, and 25.4 (median 16, SD 25) for posterior injections. The two radiologists achieved different mean VAS scores but closely agreed as to anterior and posterior VAS scores. Conclusion: Arthrography injections were fairly simple to perform under US guidance. Patient discomfort for anterior and posterior injections was equally minor. A tailored approach utilizing anterior or posterior injections

[Efficacy of retained rectal posterior mucosa in procedure for prolapse and hemorrhoids].

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Zheng, Chenguo; Jin, Chun; Lian, Shaoxiong; Jin, Dingguo

2014-12-01

To evaluate the efficacy and necessity of retained rectal posterior mucosa in procedure for prolapse and hemorrhoids (PPH). Clinical data of 260 cases with severe hemorrhoids in our hospital from January 2010 to May 2012 were analyzed retrospectively. A total of 132 cases with severe hemorrhoids excluding in rectal posterior wall were enrolled in retained rectal posterior mucosa in PPH (improvement group), other 128 cases of severe hemorrhoids were assigned to PPH (conventional group). Operative parameters, efficacy and complication after operation were compared. Two groups of patients received successful operations. Postoperative pain duration, frequency of analgesic drugs and postoperative hospital stay in improvement group were significantly reduced [(1.3 ± 0.5) d vs. (4.8 ± 0.7) d, 1.1 ± 0.3 vs. 5.9 ± 0.6, (5.2 ± 0.8) d vs. (5.8 ± 0.5) d, all Phemorrhoids excluding in rectal posterior wall can significantly reduce postoperative complications. But long-term efficacy needs further observation.

Surgical treatment of traumatic cervical facet dislocation: anterior, posterior or combined approaches?

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Catarina C. Lins

Full Text Available ABSTRACT Surgical treatment is well accepted for patients with traumatic cervical facet joint dislocations (CFD, but there is uncertainty over which approach is better: anterior, posterior or combined. We performed a systematic literature review to evaluate the indications for anterior and posterior approaches in the management of CFD. Anterior approaches can restore cervical lordosis, and cause less postoperative pain and less wound problems. Posterior approaches are useful for direct reduction of locked facet joints and provide stronger fixation from a biomechanical point of view. Combined approaches can be used in more complex cases. Although both anterior and posterior approaches can be used interchangeably, there are some patients who may benefit from one of them over the other, as discussed in this review. Surgeons who treat cervical spine trauma should be able to perform both procedures as well as combined approaches to adequately manage CFD and improve patients’ final outcomes.

Hematomas na fossa craniana posterior

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Mário S. Cademartori

1969-09-01

Full Text Available São relatados 6 casos de hematomas sub-tentorias (um de hematoma subdural crônico, quatro de hematomas intra-cerebelares, um de hematoma extra-dural. Salientando a pequena freqüência dos hematomas da fossa craniana posterior, o autor mostra a necessidade de vários exames complementares para o diagnóstico exato, indispensável para a aplicação de terapêutica cirúrgica adequada.

Posterior cranial fossa dimensions in the Chiari I malformation: relation to pathogenesis and clinical presentation

International Nuclear Information System (INIS)

Stovner, L.J.; Bergan, U.; Nilsen, G.; Sjaastad, O.

1993-01-01

Skull dimensions were measured on lateral skull radiographs in 33 adult patients with MRI-verified Chiari I malformations and in 40 controls. The posterior cranial fossa was significantly smaller and shallower in patients than in controls. In the patients, there was a positive correlation between posterior fossa size and the degree of the cerebellar ectopia, which might indicate that a posterior cranial fossa which was originally too small had been expanded by the herniation of hindbrain structures at an early stage. No special clinical presentation was associated with a very small posterior cranial fossa, which may indicate that a small posterior cranial per se has little or no clinical significance, although it may be the primary developmental anomaly. (orig./GD)

Insuficiência cardíaca com fração de ejeção preservada: combater equívocos para uma nova abordagem

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Ricardo Fontes-Carvalho

2011-06-01

Full Text Available Durante as últimas décadas, a insuficiência cardíaca com fração de ejeção preservada (ICFEP foi alvo de menor atenção por parte das comunidades médica e científica, o que levou ao aparecimento de um conjunto de equívocos relativamente às suas características, diagnóstico e abordagem terapêutica. Nos últimos anos surgiram novos estudos que alteraram os conceitos classicamente associados à ICFEP, contribuindo para uma nova visão dessa doença. Com esta revisão pretendemos abordar as mais recentes evidências existentes na área da ICFEP e combater os principais equívocos a ela associados, de forma a melhorar a sua abordagem diagnóstica e terapêutica. Temos hoje vários dados que demonstram que a ICFEP é uma entidade que necessita de uma abordagem clínica distinta da utilizada na insuficiência cardíaca sistólica (ICS. A ICFEP deixou de ser vista como uma doença "benigna", porque está associada a um mau prognóstico e a uma elevada prevalência. A sua fisiopatologia é complexa, não está totalmente esclarecida e, para além da disfunção diastólica, foram recentemente descobertos outros fatores, cardíacos e extracardíacos, que estão também implicados no seu aparecimento. Dispomos hoje de critérios objetivos para o seu diagnóstico, sobretudo recorrendo aos novos parâmetros ecocardiográficos de avaliação da função diastólica, nomeadamente ao cálculo da relação E/e' obtida por meio do Doppler tecidual. Finalmente, o tratamento da ICFEP continua a ser uma incógnita, porque não dispomos atualmente de nenhuma estratégia terapêutica capaz de alterar o prognóstico da ICFEP. Desse modo, abordaremos também os potenciais novos alvos terapêuticos que poderão revolucionar o tratamento futuro da ICFEP.

Recurrent Massive Epistaxis from an Anomalous Posterior Ethmoid Artery.

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Greco, Marco Giuseppe; Mattioli, Francesco; Alberici, Maria Paola; Presutti, Livio

2016-01-01

A 50-year-old man, with no previous history of epistaxis, was hospitalized at our facility for left recurrent posterior epistaxis. The patient underwent surgical treatment three times and only the operator's experience and radiological support (cranial angiography) allowed us to control the epistaxis and stop the bleeding. The difficult bleeding management and control was attributed to an abnormal course of the left posterior ethmoidal artery. When bleeding seems to come from the roof of the nasal cavity, it is important to identify the ethmoid arteries always bearing in mind the possible existence of anomalous courses.

Recurrent Massive Epistaxis from an Anomalous Posterior Ethmoid Artery

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Marco Giuseppe Greco

2016-01-01

Full Text Available A 50-year-old man, with no previous history of epistaxis, was hospitalized at our facility for left recurrent posterior epistaxis. The patient underwent surgical treatment three times and only the operator’s experience and radiological support (cranial angiography allowed us to control the epistaxis and stop the bleeding. The difficult bleeding management and control was attributed to an abnormal course of the left posterior ethmoidal artery. When bleeding seems to come from the roof of the nasal cavity, it is important to identify the ethmoid arteries always bearing in mind the possible existence of anomalous courses.

Abordagem da violência no sistema classificatório DSM na perspectiva psicanalítica

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Ângela Buciano do Rosário

2014-08-01

Full Text Available Neste trabalho, propõe-se a discussão da importância assumida pela medicalização da vida na contemporaneidade. Após breve levantamento da abordagem da violência nas principais vertentes da psicopatologia, destacam-se as consequências da operacionalização dos sistemas classificatórios promovida, sobretudo, pelo DSM, em duas vertentes: a degradação do diagnóstico a um levantamento formal de sintomas e a acentuação da correlação histórica entre psicopatia e delinquência. Considera-se que a violência é intrínseca e estruturante ao homem. Ao circunscrever a violência como patologia, inviabiliza-se qualquer resposta do sujeito acerca de seu ato e uma possível punição, entendida como necessária para o reconhecimento de um dispositivo de regulação social e sustentação da cultura.

Retocele posterior em paciente do sexo masculino: qual o significado Posterior rectocele in a male patient: what does it mean?

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Marcos Soares Campos

2008-12-01

Full Text Available A retocele é uma projeção sacular anormal da parede retal, de etiologia multifatorial e uma causa muito significativa de sintomas anorretais como plenitude retal, sensação de peso anal durante a defecação, evacuação incompleta e dor retoanal. Muito tem se discutido sobre retoceles em mulheres, mas poucas publicações têm mencionado a presença de retocele em pacientes do sexo masculino e somente um artigo discute os detalhes da retocele em homens com distúrbios de defecação. A retocele posterior em homens, em especial, é uma disfunção incomum e possivelmente apresenta como causas a constipação intestinal, o esforço evacuatório longo e excessivo, a síndrome do descenso perineal, a fraqueza do assoalho pélvico e a contração paradoxal do músculo puborretal. É apresentado o caso de um paciente com história de dor anorretal crônica e defecação obstruída associadas à retocele posterior, doença hemorroidária, prolapso e intussuscepção retal.Rectocele is an abnormal sac-like projection of the rectum wall with multiple etiologies and an important cause of anorectal symptoms like rectoanal weight sensation during evacuation, incomplete evacuation and anorectal pain. Many reports have discussed rectoceles in women, but few have mentioned rectoceles in male patients and only one report has discussed the details of rectoceles in men with defecation disorders. Posterior rectocele in men, in particular, is an unusual disturb and possible causes are intestinal constipation, long and excessive straining, descending perineum syndrome, weakness of the pelvic floor and puborectalis muscle syndrome. We report a case of a male patient with chronic anorectal pain and outlet obstruction associated with posterior rectocele, hemorrhoidal disease, rectal mucous prolapse and intussusception.

Reversible posterior leucoencephalopathy syndrome associated with bone marrow transplantation Leucoencefalopatia posterior reversível associada a transplante de medula óssea

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Hélio A.G. Teive

2001-09-01

Full Text Available Reversible posterior leucoencephalopathy syndrome (RPLS has previously been described in patients who have renal insufficiency, eclampsia, hypertensive encephalopathy and patients receiving immunosuppressive therapy. The mechanism by which immunosuppressive agents can cause this syndrome is not clear, but it is probably related with cytotoxic effects of these agents on the vascular endothelium. We report eight patients who received cyclosporine A (CSA after allogeneic bone marrow transplantation or as treatment for severe aplastic anemia (SSA who developed posterior leucoencephalopathy. The most common signs and symptoms were seizures and headache. Neurological dysfunction occurred preceded by or concomitant with high blood pressure and some degree of acute renal failure in six patients. Computerized tomography studies showed low-density white matter lesions involving the posterior areas of cerebral hemispheres. Symptoms and neuroimaging abnormalities were reversible and improvement occurred in all patients when given lower doses of CSA or when the drug was withdrawn. RPLS may be considered an expression of CSA neurotoxicity.A síndrome de leucoencefalopatia posterior reversível (SLPR tem sido descrita em pacientes com insuficiência renal, eclâmpsia, encefalopatia hipertensiva e em pacientes que recebem terapia imunossupressora. O mecanismo pelo qual os agentes imunossupressores podem causar a síndrome ainda não são conhecidos, porém estão provavelmente relacionados aos efeitos citotóxicos destes agentes no endotélio vascular. Relatamos oito pacientes que receberam ciclosporina A (CSA após transplante de medula óssea alogênico ou para tratamento de anemia aplástica severa e que desenvolveram a SLPR. Os sinais e sintomas mais comuns foram convulsões e cefaléia. A disfunção neurológica ocorreu simultaneamente ou precedida por elevação da pressão arterial sistêmica e disfunção renal aguda em seis pacientes. O exame de

Efectividad del Nd- Yag láser en la capsulotomía posterior Effectiveness of Nd-Yag laser in posterior capsulotomy

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Alina Pedroso Llanes

2004-06-01

Full Text Available Este trabajo se propuso determinar la efectividad del neodimio YAG láser (Nd-YAG láser en la realización de capsulotomía posterior a 150 pacientes (ojos operados de catarata senil o presenil en el centro de Microcirugía Ocular en Serie del Hospital Oftalmológico Docente "Ramón Pando Ferrer" en el período comprendido de febreroa diciembre de 1999. En este grupo se analizaron como variables la edad, sexo, raza, implante o no de lente intraocular, tipo de opacidad de cápsula posterior, agudeza visual con corrección pre y postratamiento, complicaciones encontradas, comportamiento de la presión intraocular, así como la energía empleada para realizar dicho proceder. Estos datos se analizaron a través de tablas de contingencias Chi cuadrado. Como resultado de esta investigación se encontró que el láser es altamente efectivo para el mejoramiento de la agudeza visual en los pacientes afectados de catarata secundaria (74,7 %. Se observó además aumento transitorio de la presión intraocular en las dos primeras horas posteriores al láser (60,7 %, y no se encontró ninguna complicación que afectara la visión de los ojos estudiadosThe aim of this paper was to determine the effectiveness of neodymium YAG laser (Nd-YAG laser on performing the posterior capsulotomy in 150 patients (eyes operated on of senile or presenile cataract at the Center of Serial Ocular Microsurgery (CSOM of "Ramón Pando Ferrer" Ophthalmological Teaching Hospital from February to December 1999. Age, sex, race, implantation or not of the intraocular lens (IOL, type of opacity of the posterior capsule, visual acuity with pre- and posttreatment correction (Avcc, complications found, behavior of the intraocular pressure (IOP, as well as the energy used to carry out such procedure, were analyzed. The Chi square contingency tables were used to this end. As a result of this research, it was found that the laser is highly effective for improving visual acuity in patients

Oronasal complications in patients after transsphenoidal hypophyseal surgery Complicações oronasais em pacientes pós-abordagem hipofisária via transesfenoidal

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Carolina Petry

2009-06-01

Full Text Available Transsphenoidal surgery is the most commonly used surgical procedure to handle the hypophyseal region, sometimes associated with oronasal complications. MATERIAL AND METHODS/AIM: To evaluate prospectively (specific questionnaire, clinical evaluation undiagnosed chronic oronasal complications in patients submitted to conventional transsphenoidal adenomectomy surgery, operated at different neurosurgery services more than 6 months ago. RESULTS: 49 patients were evaluated, 37/45 presented macroadenoma. 28,5% were submitted to more than one intervention, 2/5 transsphenoidally. Transsphenoidal approach 92.8% through sublabial route. No patient had spontaneous complaint. With the specific questionnaire 63.2% presented complaints. One patient presented an oronasal fistula, 1 stenosis of the nasal valve area with external nasal deformity. Rhinoscopy detected alterations in 77.5%, nasal endoscopy in 87.7%. Septal perforation was present in 10/12 patients with scabs and 2 with purulent secretion. All 4 patients submitted to 2 transsphenoidal approaches presented septal perforation and nasal synechiae. In the endonasal, synechiae (2, alteration in medium meatus (1 and stenosis of the nasal valve area (1 were observed. Only two patients presented normal evaluation. CONCLUSION: A high incidence of nasal complications after conventional transsphenoidal surgery observed through examination and not reported spontaneously point to the need of otorhinolaryngological investigation complemented by nasal endoscopy in patients submitted to procedures through this route.A cirurgia transesfenoidal é o procedimento cirúrgico mais utilizado para abordagem da região hipofisária, sendo por vezes associada a complicações oronasais. MATERIAL E MÉTODOS/OBJETIVO: Estudo prospectivo, através de questionário específico e avaliação clínica complicações oronasais crônicas não-diagnosticadas, em pacientes submetidos à cirurgia transesfenoidal convencional em

Posterior crossbite and temporomandibular disorders (TMDs): need for orthodontic treatment?

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Thilander, Birgit; Bjerklin, Krister

2012-12-01

The aim of this work was to update the bibliography regarding the concept of 'temporomandibular disorder (TMD)' and 'posterior crossbite' and try to find out if there is any association between some special signs/symptoms of TMD and type of posterior crossbite. A literature search from 1970 to 2009, due to specified criterion, resulted in 14 publications that were found to be relevant for the present systematic review. An association between TMD and posterior crossbite (Yes-group) was reported as often as absence of such a relationship (No-group). The samples in the two groups showed similarities as well as differences with respect to number, gender, and age. Most articles reported only on 'presence' or 'absence' of crossbite and only few on type of crossbite opposite to a thorough account of clinical signs and symptoms of TMD. This review seems, however, to state that a functional posterior crossbite (mandibular guidance with midline deviation) is associated with headache, temporomandibular joint and muscular pain, and clicking. As evident from the discussion, such type needs orthodontic treatment to rehabilitate the asymmetric muscular activity between the crossbite and non-crossbite sides and the changed condyle/temporal relationship caused by mandibular deviation. Whether this treatment also will avoid future TMD problems can be answered only after clinical follow-up studies have been performed.

Immediate Effects of Anterior-to-Posterior Talocrural Joint Mobilization after Prolonged Ankle Immobilization: A Preliminary Study

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Landrum, Elizabeth L.; Kelln, Cdr. Brent M.; Parente, William R.; Ingersoll, Christopher D.; Hertel, Jay

2008-01-01

Ankle dorsiflexion range of motion (ROM) typically decreases after prolonged immobilization. Anterior-to-posterior talocrural joint mobilizations are purported to increase dorsiflexion ROM and decrease joint stiffness after immobilization. The purpose of this study was to determine if a single bout of Grade III anterior-to-posterior talocrural joint mobilizations immediately affected measures of dorsiflexion ROM, posterior ankle joint stiffness, and posterior talar translation in ankles of pa...

Distrofia polimorfa posterior: a propósito de un caso Posterior polymorphous dystrophy: A case presentation

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Alexeide de la C. Castillo Pérez

2008-12-01

Full Text Available Presentamos el caso de una paciente del sexo femenino de 15 años de edad con antecedentes de miopía que acude a consulta para chequeo de su ametropía. En el examen biomicroscópico se observaron opacidades disciformes, pequeñas, de color blanco grisáceo, irregulares a nivel de la membrana de Descemet y del endotelio. Se realizó examen ocular completo, refracción, topografía, paquimetría, queratometría, biometría y microscopia confocal in vivo de la córnea. Finalmente llegamos al diagnóstico de distrofia polimorfa posterior.The case of a female 15 years-old patient with a history of myopia, who went to the physician´s office for an ametrophy checkout, was presented in this paper. The biomicroscopic examination revealed small white/gray-coloured irregular and diffuse opacities at the level of Descement´s membrane and of the endothelium. A complete ophthalmological examination was performed including visual acuity, refraction, corneal topography, pakimetry, keratometry, biometry and in vivo confocal microscopy of the cornea. Finally, posterior polymorphous dystrophy was diagnosed.

Intravitreal bevacizumab (Avastin for post laser anterior segment ischemia in aggressive posterior retinopathy of prematurity

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Shah Parag

2007-01-01

Full Text Available Aggressive posterior retinopathy of prematurity (formerly known as fulminate/type II/rush disease occurs in zone 1 or posterior zone 2. Treatment involves extensive near confluent laser ablation of a large area of avascular retina. Anterior segment ischemia is a rare complication that can occur due to injury to the long posterior ciliary arteries in the horizontal meridians during aggressive posterior laser treatment. The outcome of this rare complication is very poor. This case describes a favorable outcome of intravitreal injection of bevacizumab (Avastin in a case of anterior segment ischemia.

Ultrasound Guidance in Performing a Tendoscopic Surgery to Treat Posterior Tibial Tendinitis: A Useful Tool?

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Akinobu Nishimura

2016-01-01

Full Text Available A 25-year-old man with a pronation-external rotation type of fracture was surgically treated using a fibular plate. Five years later, he underwent resection of bone hyperplasia because of the ankle pain and limitation of range of motion. Thereafter, the left ankle became intermittently painful, which persisted for about one year. He presented at the age of 43 with persistent ankle pain. Physical and image analysis findings indicated a diagnosis of posttraumatic posterior tibial tendinitis, which we surgically treated using tendoscopy. Endoscopic findings showed tenosynovitis and fibrillation on the tendon surface. We cleaned and removed the synovium surrounding the tendon and deepened the posterior tibial tendon groove to allow sufficient space for the posterior tibial tendon. Full weight-bearing ambulation was permitted one day after surgery and he returned to his occupation in the construction industry six weeks after surgery. The medial aspect of the ankle was free of pain and symptoms at a review two years after surgery. Although tendoscopic surgery for stage 1 posterior tibial tendon dysfunction has been reported, tendoscopic surgery to treat posttraumatic posterior tibial tendinitis has not. Our experience with this patient showed that tendoscopic surgery is useful not only for stage 1 posterior tibial dysfunction, but also for posttraumatic posterior tibial tendinitis.

Diagnosis of radial tear of posterior horn of medial meniscus by MR imaging. Prospective study

International Nuclear Information System (INIS)

Motoyama, Tatsuo; Ihara, Hidetoshi; Kawashima, Mahito

2002-01-01

It is not easy to detect radial tears of the posterior horn of the medial meniscus (torn posterior horn) under arthroscopy if the surgeon does not notice the tear before arthroscopy. Occasionally the tear goes undetected or is missed during arthroscopy. The sagittal view of MR imaging is very useful for diagnosing torn posterior horns. The normal posterior horn of the medial meniscus appears as an image of low intensity triangle of the sagittal MRI medial slice next to the PCL. On the contrary, the image of the torn posterior horn shows a high intensity triangle, so we refer to the feature as a white meniscus sign. We prospectively examined the accuracy of white meniscus sign of MRI. Forty-two knees in 41 patients were studied. They were over 40 years of age, diagnosed with medial meniscus tear and had undergone MRI before arthroscopy. Before arthroscopy, we predicted the existence of torn posterior horn by the white meniscus sign and examined the accuracy of the MRI after arthroscopy. Total accuracy rate was 90.5%, sensitivity was 94.1%, and specificity was 88.0%. We concluded that the white meniscus sign on MRI is very useful for defecting torn posterior horn of the medial meniscus. (author)

Posterior reversible encephalopathy syndrome: An atypical postpartum complication

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Debashish Paul

2016-01-01

Full Text Available Posterior reversible encephalopathy syndrome (PRES is presented by headache, altered mental status, blurring of vision, vomiting and seizure in conjunction with radiological finding of posterior cerebral white matter edema. Data suggest that most cases occur in young middle-aged with marked female preponderance, hypertension being the most common cause. In this case, it was diagnosed in a normotensive patient in the postnatal period that underwent cesarean section. The initial symptoms had misled toward a diagnosis of postdural puncture headache. Symptomatic treatment was started immediately in the ICU. This is an interesting case as the patient was a normotensive one without any other contributory factors and there was unanticipated delay in diagnosing the case until the time we could get a magnetic resonance imaging report.

Koreksi gigitan terbalik posterior dan anterior dengan alat cekat rapid maxillary expansion dan elastik intermaksila

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Retno Dewati

2014-06-01

Full Text Available Background: Children with anterior and posterior crossbite usually have a complaint in aesthetic and masticatory function. It could caused by bad habits and hereditary factors which made worse condition. Purpose: The purpose of this case report was to report the use of orthodontic appliance rapid maxillary expansion (RPE and intermaxillary elastic to correct posterior and anterior crossbite in teenage patient. Case: A fourteen years-old teenage female patient came to Dental Hospital Dentistry Universitas Airlangga with case of anterior posterior cross bite and unerupted permanent teeth. Case management: The case was treated using orthodontic fixed appliance rapid maxillary expansion (RPE and followed by intermaxillary elastics. The posterior cross bite treatment took 4 weeks used of orthodontic fixed appliance RPE, while, treatment of anterior cross bite which used intermaxillary elactic was done within three month to achieved normal occlusion. Conclusion: This case report showed that the orthodontic appliance rapid maxillary expansion (RPE and intermaxillary elastic could be used to correct posterior and anterior crossbite.Latar belakang: Anak dengan gigitan terbalik anterior dan posterior pada umumnya mempunyai keluhan dalam hal estetik dan fungsi pengunyahan. Kondisi gigitan terbalik biasanya disebabkan oleh adanya kebiasaan buruk dan faktor keturunan yang semakin memperparah keadaan tersebut. Tujuan: Laporan kasus ini melaporkan pemakaian alat cekat rapid maxillary expansion (RPE dan elastik intermaksila untuk mengkoreksi gigitan terbalik posterior dan anterior pada anak remaja. Kasus: Pasien remaja perempuan berusia 14 tahun datang ke Rumah Sakit Gigi dan Mulut Fakultas Kedokteran Gigi Universitas Airlangga Surabaya dengan kasus gigitan terbalik anterior posterior dan terdapat gigi permanen yang tidak tumbuh. Tatalaksana kasus: Perawatan yang dilakukan adalah koreksi gigitan terbalik dengan menggunakan alat ortodonsia cekat rapid maxillary

Traumatic acute posterior fossa subdural hematoma – A case report and review of literature

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Jaiswal Manish

2014-12-01

Full Text Available Traumatic subdural hematomas of the posterior fossa are rare but dangerous neurosurgical emergencies that require prompt diagnosis and management to avoid the uniformly poor outcome. We present a case of a teenager with severe TBI and acute subdural hematoma of the posterior fossa that deteriorated rapidly before surgery but eventually made a good recovery. We also the review the literature concerning traumatic posterior fossa subdural hematomas [PFSDH].

Two cases of benign polyps of the posterior urethra (ectopic prostatic tissue)

OpenAIRE

多田, 晃司; 山羽, 正義; 田村, 公一; 藤広, 茂; 河田, 幸道

1990-01-01

We report two cases of benign polyps of the posterior urethra. Their first symptoms were gross hematuria and urinary frequency. Both specimens obtained by transurethral resection were histologically identified as prostatic tissue. Discussion on benign polyps of the posterior urethra as ectopic prostatic tissue was done with review of literature.

Inverse cutting of posterior lamellar corneal grafts by a femtosecond laser.

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Hjortdal, Jesper; Nielsen, Esben; Vestergaard, Anders; Søndergaard, Anders

2012-01-01

Posterior lamellar grafting of the cornea has become the preferred technique for treatment of corneal endothelial dysfunction. Posterior lamellar grafts are usually cut by a micro-keratome or a femto-second laser after the epithelial side of the donor cornea has been applanated. This approach often results in variable central graft thickness in different grafts and an increase in graft thickness towards the periphery in every graft. The purpose of this study was to evaluate if posterior lamellar grafts can be prepared from the endothelial side by a femto-second laser, resulting in reproducible, thin grafts of even thickness. A CZM 500 kHz Visumax femto-second laser was used. Organ cultured donor grafts were mounted in an artifical anterior chamber with the endothelial side up and out. Posterior grafts of 7.8 mm diameter and 130 micron thickness were prepared by femto-second laser cutting. A standard DSAEK procedure was performed in 10 patients with Fuchs endothelial dystrophy. Patients were followed-up regularly and evaluated by measurement of complications, visual acuity, corneal thickness (Pentacam HR), and endothelial cell density. Femto-laser cutting of grafts and surgery was uncomplicated. Rebubbling was necessary in 5 of 10 cases (normally only in 1 of 20 cases). All grafts were attached and cleared up during the first few weeks. After six months, the average visual acuity was 0.30 (range: 0.16 to 0.50), corneal thickness was 0.58 mm (range 0.51 to 0.63), and endothelial cell density was 1.570 per sq. mm (range: 1.400 to 2.000 cells per sq. mm). The grafts were of uniform thickness, but substantial interface haze was present in most grafts. Posterior lamellar corneal grafts can be prepared from the endothelial side using a femto-second laser. All grafts were clear after 6 months with satisfying endothelial cell counts. Poor visual acuity caused by interface scatter was observed in most patients. Femto-second laser cutting parameters needs to be optimised to

MRI tight posterior fossa sign for prenatal diagnosis of Chiari type II malformation

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Ando, Kumiko; Ishikura, Reiichi; Ogawa, Masayo; Takada, Yoshihiro; Yamamoto, Satoshi; Fujiwara, Masayuki; Hirota, Shozo [Hyogo College of Medicine, Department of Radiology, Nishinomiya, Hyogo (Japan); Shakudo, Miyuki [Osaka City General Hospital, Department of Radiology, Osaka (Japan); Tanaka, Hiroyuki [Hyogo College of Medicine, Department of Gynecology, Nishinomiya (Japan); Minagawa, Kyoko [Hyogo College of Medicine, Department of Pediatrics, Nishinomiya (Japan)

2007-12-15

Chiari type II malformation (CMII) is one of three hindbrain malformations that display hydrocephalus. We have observed that cerebrospinal fluid (CSF) signal in the posterior fossa, which is always apparent on normal fetal MR images, is not visible in a fetus with CMII. We use the term 'tight posterior fossa' for this MR imaging finding, and evaluate the diagnostic value of this finding on fetal MR images. Included in the study were 21 fetuses which underwent brain MR imaging at 1.5 T using two-dimensional balanced turbo-field-echo (2-D balanced-TFE) in the axial and sagittal planes. Postnatal diagnoses were CMII (n=5), CNS abnormalities other than CMII (n=8), and no abnormality (n=8). A tight posterior fossa was defined as an absent or slit-like water signal space around the hindbrain in the posterior fossa on both sagittal and axial MR images. All CMII fetuses displayed a tight posterior fossa on MR images. Hydrocephalus was visualized in all CMII fetuses and myelomeningocele in four fetuses, but hindbrain herniation was visualized only in two of five fetuses. The CSF signal surrounding the hindbrain was clearly visible in all the other 16 fetuses, including five with hydrocephalus not associated with CMII, although it was slightly narrower in a fetus with a cloverleaf skull than in the normal fetuses. Tight posterior fossa in the presence of hydrocephalus is a useful and characteristic finding of CMII on fetal MRI. (orig.)

MRI tight posterior fossa sign for prenatal diagnosis of Chiari type II malformation

International Nuclear Information System (INIS)

Ando, Kumiko; Ishikura, Reiichi; Ogawa, Masayo; Takada, Yoshihiro; Yamamoto, Satoshi; Fujiwara, Masayuki; Hirota, Shozo; Shakudo, Miyuki; Tanaka, Hiroyuki; Minagawa, Kyoko

2007-01-01

Chiari type II malformation (CMII) is one of three hindbrain malformations that display hydrocephalus. We have observed that cerebrospinal fluid (CSF) signal in the posterior fossa, which is always apparent on normal fetal MR images, is not visible in a fetus with CMII. We use the term 'tight posterior fossa' for this MR imaging finding, and evaluate the diagnostic value of this finding on fetal MR images. Included in the study were 21 fetuses which underwent brain MR imaging at 1.5 T using two-dimensional balanced turbo-field-echo (2-D balanced-TFE) in the axial and sagittal planes. Postnatal diagnoses were CMII (n=5), CNS abnormalities other than CMII (n=8), and no abnormality (n=8). A tight posterior fossa was defined as an absent or slit-like water signal space around the hindbrain in the posterior fossa on both sagittal and axial MR images. All CMII fetuses displayed a tight posterior fossa on MR images. Hydrocephalus was visualized in all CMII fetuses and myelomeningocele in four fetuses, but hindbrain herniation was visualized only in two of five fetuses. The CSF signal surrounding the hindbrain was clearly visible in all the other 16 fetuses, including five with hydrocephalus not associated with CMII, although it was slightly narrower in a fetus with a cloverleaf skull than in the normal fetuses. Tight posterior fossa in the presence of hydrocephalus is a useful and characteristic finding of CMII on fetal MRI. (orig.)

Factors affecting visualization of posterior rib fractures in abused infants

International Nuclear Information System (INIS)

Kleinman, P.K.; Adams, V.I.; Blackbourne, B.D.; Marks, S.C.

1987-01-01

Rib fractures in abused infants commonly occur in the posterior rib arcs. Fractures occurring near the costovertebral articulations are usually identified radiographically only once callus has formed. To assess the factors influencing the visibility of fractures near the costovertical articulations, the authors studied 103 posterior rib fractures occurring in 16 abused infants. Radiologic findings were correlated with CT findings and pathologic material from nine ribs in four patients. The limited visibility of fractures relates to (1) the frequent superimposition of the transverse process over the rib fracture site, (2) a fracture line that crosses at an obliquity to the x-ray beam, and (3) nondisplacement of rib fragments due to preservation of the posterior periosteum. Fresh rib fractures invisible on a frontal projection may be clearly defined on axial CT scans, or on postmortem radiographs. A knowledge of the factors influencing the visibility of these important injuries is useful in planning an appropriate diagnostic evaluation of suspected infant abuse

Quantitative regional validation of the visual rating scale for posterior cortical atrophy

International Nuclear Information System (INIS)

Moeller, Christiane; Benedictus, Marije R.; Koedam, Esther L.G.M.; Scheltens, Philip; Flier, Wiesje M. van der; Versteeg, Adriaan; Wattjes, Mike P.; Barkhof, Frederik; Vrenken, Hugo

2014-01-01

Validate the four-point visual rating scale for posterior cortical atrophy (PCA) on magnetic resonance images (MRI) through quantitative grey matter (GM) volumetry and voxel-based morphometry (VBM) to justify its use in clinical practice. Two hundred twenty-nine patients with probable Alzheimer's disease and 128 with subjective memory complaints underwent 3T MRI. PCA was rated according to the visual rating scale. GM volumes of six posterior structures and the total posterior region were extracted using IBASPM and compared among PCA groups. To determine which anatomical regions contributed most to the visual scores, we used binary logistic regression. VBM compared local GM density among groups. Patients were categorised according to their PCA scores: PCA-0 (n = 122), PCA-1 (n = 143), PCA-2 (n = 79), and PCA-3 (n = 13). All structures except the posterior cingulate differed significantly among groups. The inferior parietal gyrus volume discriminated the most between rating scale levels. VBM showed that PCA-1 had a lower GM volume than PCA-0 in the parietal region and other brain regions, whereas between PCA-1 and PCA-2/3 GM atrophy was mostly restricted to posterior regions. The visual PCA rating scale is quantitatively validated and reliably reflects GM atrophy in parietal regions, making it a valuable tool for the daily radiological assessment of dementia. (orig.)

Quantitative regional validation of the visual rating scale for posterior cortical atrophy

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Moeller, Christiane; Benedictus, Marije R.; Koedam, Esther L.G.M.; Scheltens, Philip [VU University Medical Center, Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, P.O. Box 7057, Amsterdam (Netherlands); Flier, Wiesje M. van der [VU University Medical Center, Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, P.O. Box 7057, Amsterdam (Netherlands); VU University Medical Center, Department of Epidemiology and Biostatistics, Neuroscience Campus Amsterdam, P.O. Box 7057, Amsterdam (Netherlands); Versteeg, Adriaan; Wattjes, Mike P.; Barkhof, Frederik [VU University Medical Center, Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, P.O. Box 7057, Amsterdam (Netherlands); Vrenken, Hugo [VU University Medical Center, Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, P.O. Box 7057, Amsterdam (Netherlands); VU University Medical Center, Department of Physics and Medical Technology, Neuroscience Campus Amsterdam, P.O. Box 7057, Amsterdam (Netherlands)

2014-02-15

Validate the four-point visual rating scale for posterior cortical atrophy (PCA) on magnetic resonance images (MRI) through quantitative grey matter (GM) volumetry and voxel-based morphometry (VBM) to justify its use in clinical practice. Two hundred twenty-nine patients with probable Alzheimer's disease and 128 with subjective memory complaints underwent 3T MRI. PCA was rated according to the visual rating scale. GM volumes of six posterior structures and the total posterior region were extracted using IBASPM and compared among PCA groups. To determine which anatomical regions contributed most to the visual scores, we used binary logistic regression. VBM compared local GM density among groups. Patients were categorised according to their PCA scores: PCA-0 (n = 122), PCA-1 (n = 143), PCA-2 (n = 79), and PCA-3 (n = 13). All structures except the posterior cingulate differed significantly among groups. The inferior parietal gyrus volume discriminated the most between rating scale levels. VBM showed that PCA-1 had a lower GM volume than PCA-0 in the parietal region and other brain regions, whereas between PCA-1 and PCA-2/3 GM atrophy was mostly restricted to posterior regions. The visual PCA rating scale is quantitatively validated and reliably reflects GM atrophy in parietal regions, making it a valuable tool for the daily radiological assessment of dementia. (orig.)

Invasive Ductal Carcinoma of Breast : Correlation between Sonographic Posterior Acoustic Patterns with Histopathology

International Nuclear Information System (INIS)

Cho, Hyun Cheol; Lee, Yong Woo; Hwang, Mi Soo; Cho, Kil Ho; Chang, Jae Chun; Kim, Dong Sug; Bae, Young Kyung

1996-01-01

To evaluate the frequency of posterior sonic attenuation and enhancement in invasive ductal carcinoma of breast on ultrasound, and to compare with histo-pathologic findings. Sonographic findings of 26 histologically proven invasive ductal carcinomas were retrospectively reviewed in point of posterior echo pattern regardless other ultrasonic features. They were classified in two groups according to posterior echo pattern such as enhancement or shadowing, and compared with various internal histologic characteristics such as amount of connective tissue, degree of elastosis, necrosis, gross circumscription,harboring inflammation, histologic differentiation, nuclear pleomorphism, and mitotic index. The acoustic shadowing was seen in 34.6%, whereas posterior sonic enhancement was seen in 65.4% of cases. The acoustic shadowing group had more connective tissue, elastosis, and poor demarcated margin than the sonic enhancement group(p < 0.05). But no significant differences were seen in other histopathologic findings representing malignancy between two groups. A close relationship between posterior echo pattern and amount of connective tissue or elastosis is found in invasive ductal carcinoma of breast. The acoustic shadowing known as a characteristic ultrasonographic finding of malignant breast mass does not represent the degree of malignancy

Y-type urethral duplication with posterior perineal fistula: A new variant

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Sandesh V Parelkar

2017-05-01

Full Text Available 13 months old boy presented with constipation and straining during micturition with poor urinary stream and voiding of urine per rectum. Perineal examination revealed posterior perineal fistula. Voiding cysto-urethrogram showed bilateral vesicoureteral reflux with bladder diverticuli, normal dorsal urethra and dye going from urethra to rectum suggestive of Y type urethral duplication. Under stoma cover, he underwent excision of posterior perineal fistula with accessory ventral urethra and anorectoplasty was done. At present patient is passing urine in good stream without straining. The uniqueness of our case is the presence of Y type of urethral duplication with normal calibre dorsal urethra and presence of posterior perineal fistula. Therefore, we consider our case to be an unusual variant of Y type of urethral duplication that has not been described before.

Locked posterior dislocation of the shoulder: A report of three cases.

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Benhamida, M K; Ouertatani, M; Hasayri, I; Benhassine, A; Meherzi, M; Bouhdiba, S; Mestiri, M

2015-04-01

Posterior shoulder dislocations account for 4% of all shoulder dislocations. In two-thirds of the cases, the diagnosis is made only once the shoulder is locked, which radically changes the treatment and prognosis. We report three clinical cases of locked posterior shoulder dislocation. Closed reduction was attempted in one case but failed. All patients underwent open reduction and subscapularis transfer according to either Neer's (2 cases) or McLaughlin's technique (1 case). The functional outcome was satisfactory in two cases despite recurrent dislocation on the third day after surgery. The third patient eventually developed post-traumatic shoulder osteoarthritis. The best treatment consists of detecting posterior dislocations immediately when they occur under suggestive circumstances (electrocution, epileptic seizure, severe trauma shoulder). Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Surgical site infection in posterior spine surgery

African Journals Online (AJOL)

2016-03-20

Mar 20, 2016 ... Methodology: All consecutive patients who had posterior spine surgeries between January 2012 ... However, spinal instrumentation, surgery on cervical region and wound inspection on or ... While advances have been made in infection control ... costs, due to loss of productivity, patient dissatisfaction and.

Metachronous Bilateral Posterior Tibial Artery Aneurysms in Ehlers-Danlos Syndrome Type IV

International Nuclear Information System (INIS)

Hagspiel, Klaus D.; Bonatti, Hugo; Sabri, Saher; Arslan, Bulent; Harthun, Nancy L.

2011-01-01

Ehlers-Danlos syndrome type IV is a life-threatening genetic connective tissue disorder. We report a 24-year-old woman with EDS-IV who presented with metachronous bilateral aneurysms/pseudoaneurysms of the posterior tibial arteries 15 months apart. Both were treated successfully with transarterial coil embolization from a distal posterior tibial approach.

Posterior epidural migration of sequestered lumbar disc fragment causing cauda equina syndrome Migración epidural posterior de fragmento de disco lumbar secuestrado que causa síndrome de cauda equina Migração epidural posterior de fragmento de disco lombar sequestrado que causa síndrome da cauda equina

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Abolfazl Rahimizadeh

2013-01-01

Full Text Available Posterior epidural migration (PEM of a sequestered free lumbar disc fragment is rare. The rarity is due to presence of several anatomical restraints which restrict a free fragment to move to the posterior compartment. This unusual presentation of disc herniation appeared in the literature either as a single case report or in small series from two to six cases. Herein two new demonstrative cases will be presented with a brief review of the literature.La migración epidural (PEM posterior Epidural Migration de fragmento de disco lumbar libre secuestrado es rara. La rareza se debe a la existencia de varias restricciones anatómicas impidiendo que el fragmento libre se mueva hacia el compartimento posterior. Esa presentación no común de hernia de disco apareció en la literatura como un relato de caso único o en pequeñas series de dos a seis casos. En este artículo, se presentan dos casos nuevos demostrativos, conjuntamente con una revisión breve de la literatura.A migração epidural posterior (PEM posterior epidural migration de fragmento de disco lombar livre sequestrado é rara. A raridade deve-se à presença de várias restrições anatômicas que impedem que o fragmento livre se mova para o compartimento posterior. Essa apresentação incomum de hérnia de disco apareceu na literatura como relato de caso único ou em pequenas séries de dois a seis casos. Neste artigo, são apresentados dois novos casos demonstrativos, com uma breve revisão da literatura.

Anterior ST depression with acute transmural inferior infarction due to posterior infarction. A vectorcardiographic and scintigraphic study

International Nuclear Information System (INIS)

Mukharji, J.; Murray, S.; Lewis, S.E.; Croft, C.H.; Corbett, J.R.; Willerson, J.T.; Rude, R.E.

1984-01-01

The hypothesis that anterior ST segment depression represents concomitant posterior infarction was tested in 49 patients admitted with a first transmural inferior myocardial infarction. Anterior ST depression was defined as 0.1 mV or more ST depression in leads V1, V2 or V3 on an electrocardiogram recorded within 18 hours of infarction. Serial vectorcardiograms and technetium pyrophosphate scans were obtained. Eighty percent of the patients (39 of 49) had anterior ST depression. Of these 39 patients, 34% fulfilled vectorcardiographic criteria for posterior infarction, and 60% had pyrophosphate scanning evidence of posterior infarction. Early anterior ST depression was neither highly sensitive (84%) nor specific (20%) for the detection of posterior infarction as defined by pyrophosphate imaging. Of patients with persistent anterior ST depression (greater than 72 hours), 87% had posterior infarction detected by pyrophosphate scan. In patients with inferior myocardial infarction, vectorcardiographic evidence of posterior infarction correlated poorly with pyrophosphate imaging data. Right ventricular infarction was present on pyrophosphate imaging in 40% of patients with pyrophosphate changes of posterior infarction but without vectorcardiographic evidence of posterior infarction. It is concluded that: 1) the majority of patients with acute inferior myocardial infarction have anterior ST segment depression; 2) early anterior ST segment depression in such patients is not a specific marker for posterior infarction; and 3) standard vectorcardiographic criteria for transmural posterior infarction may be inaccurate in patients with concomitant transmural inferior myocardial infarction or right ventricular infarction, or both

Management for the anterior combined with posterior urethral stricture: a 9-year single centre experience

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Deng, Tuo; Liao, Banghua; Luo, Deyi; Liu, Bing; Wang, Kunjie; Liu, Jiaming; Jin, Tao

2015-01-01

Objective: Therapy for anterior combined with posterior urethral stricture is difficult and controversial. This study aims to introduce a standard process for managing anterior combined with posterior urethral stricture. Patients and methods: 19 patients with anterior combined with posterior urethral stricture were treated following our standard process. Average (range) age was 52 (21-72) years old. In this standard process, anterior urethral stricture should be treated first. Endoscopic surgery is applied for anterior urethra stricture as a priority as long as obliteration does not occur, and operation for posterior urethral stricture can be conducted in the same stage. Otherwise, an open reconstructive urethroplasty for anterior urethral is needed; while in this condition, the unobliterated posterior urethra can also be treated with endoscopic surgery in the same stage; however, if posterior urethra obliteration exists, then open reconstructive urethroplasty for posterior urethral stricture should be applied 2-3 months later. Results: The median (range) follow-up time was 25.8 (3-56) months. All 19 patients were normal in urethrography after 1 month of the surgery. 4 patients (21.1%) recurred urethral stricture during follow-up, and the locations of recurred stricture were bulbomembranous urethra (2 cases), bulbar urethra (1 case) and bladder neck (1 case). 3 of them restored to health through urethral dilation, yet 1 underwent a second operation. 2 patients (10.5%) complaint of dripping urination. No one had painful erection, stress urinary incontinence or other complications. Conclusions: The management for anterior combined with posterior urethral stricture following our standard process is effective and safe. PMID:26064293

Epicardial mapping of ventricular fibrillation over the posterior descending artery and left posterior papillary muscle of the swine heart.

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Nielsen, Thomas D; Huang, Jian; Rogers, Jack M; Killingsworth, Cheryl R; Ideker, Raymond E

2009-01-01

Recent studies suggest that during ventricular fibrillation (VF) epicardial vessels may be a site of conduction block and the posterior papillary muscle (PPM) in the left ventricle (LV) may be the location of a "mother rotor." The goal of this study was to obtain evidence to support or refute these possibilities. Epicardial activation over the posterior LV and right ventricle (RV) was mapped during the first 20 s of electrically induced VF in six open-chest pigs with a 504 electrode plaque covering a 20 cm(2) area centered over the posterior descending artery (PDA). The locations of epicardial breakthrough as well as reentry clustered in time and space during VF. Spatially, reentry occurred significantly more frequently over the LV than the RV in all 48 episodes, and breakthrough clustered near the PPM (p < 0.001). Significant temporal clustering occurred in 79% of breakthrough episodes and 100% of reentry episodes. These temporal clusters occurred at different times so that there was significantly less breakthrough when reentry was present (p < 0.0001). Conduction block occurred significantly more frequently near the PDA than elsewhere. The PDA is a site of epicardial block which may contribute to VF maintenance. Epicardial breakthrough clusters near the PPM. Reentry also clusters in space but at a separate site. The fact that breakthrough and reentry cluster at different locations and at different times supports the possibility of a drifting filament at the PPM so that at times reentry is present on the surface but at other times the reentrant wavefront breaks through to the epicardium.

Radial head fracture associated with posterior interosseous nerve injury

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Bernardo Barcellos Terra

Full Text Available ABSTRACT Fractures of the radial head and radial neck correspond to 1.7-5.4% of all fractures and approximately 30% may present associated injuries. In the literature, there are few reports of radial head fracture with posterior interosseous nerve injury. This study aimed to report a case of radial head fracture associated with posterior interosseous nerve injury. CASE REPORT: A male patient, aged 42 years, sought medical care after falling from a skateboard. The patient related pain and limitation of movement in the right elbow and difficulty to extend the fingers of the right hand. During physical examination, thumb and fingers extension deficit was observed. The wrist extension showed a slight radial deviation. After imaging, it became evident that the patient had a fracture of the radial head that was classified as grade III in the Mason classification. The patient underwent fracture fixation; at the first postoperative day, thumb and fingers extension was observed. Although rare, posterior interosseous nerve branch injury may be associated with radial head fractures. In the present case, the authors believe that neuropraxia occurred as a result of the fracture hematoma and edema.

Functional outcome of intra-articular tibial plateau fractures: the impact of posterior column fractures.

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van den Berg, Juriaan; Reul, Maike; Nunes Cardozo, Menno; Starovoyt, Anastasiya; Geusens, Eric; Nijs, Stefaan; Hoekstra, Harm

2017-09-01

INTRODUCTION: Although regularly ignored, there is growing evidence that posterior tibial plateau fractures affect the functional outcome. The goal of this study was to assess the incidence of posterior column fractures and its impact on functional outcome and general health status. We aimed to identify all clinical variables that influence the outcome and improve insights in the treatment strategies. A retrospective cohort study including 218 intra-articular tibial plateau fractures was conducted. All fractures were reclassified and applied treatment was assessed according to the updated three-column concept. Relevant demographic and clinical variables were studied. The patient reported outcome was assessed using the Knee injury and Osteoarthritis Outcome Score (KOOS). Median follow-up was 45.5 (IQR 24.9-66.2) months. Significant outcome differences between operatively and non-operatively treated patients were found for all KOOS subscales. The incidence of posterior column fractures was 61.9%. Posterior column fractures, sagittal malalignment and an increased complication rate were associated with poor outcome. Patients treated according to the updated three-column concept, showed significantly better outcome scores than those patients who were not. We could not demonstrate the advantage of posterior column fracture fixation, due to a limited patient size. Our data indicates that implementation of the updated three-column classification concept may improve the surgical outcome of tibial plateau fractures. Failure to recognize posterior column fractures may lead to inappropriate utilization of treatment techniques. The current concept allows us to further substantiate the importance of reduction and fixation of posterior column fractures with restoration of the sagittal alignment. 3.

Congenital posterior urethral diverticula causing bladder outlet obstruction in a young male

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Saurabh Agrawal

2008-01-01

Full Text Available We present a case of 26-year-old male presenting with mild renal failure. Ultrasound findings were suggestive of posterior urethral valve, but micturating cystourethrogram and endoscopic evaluation confirmed the diagnosis of posterior urethral diverticulae. Transurethral resection of diverticulae was performed. Patient is voiding well and his renal function has stabilized.

Posterior vaginal wall Gartner′s duct cyst

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Ripan Bala

2015-01-01

Full Text Available Cyst of posterior vaginal wall is very rare. This case relates to a patient who presented with polypoidal mass protruding out from vagina which could have been easily mistaken as uterovaginal prolapse, but appropriate clinical evaluation supported with investigations clinched the diagnosis easily.

Detection of posterior vortex veins in eyes with pathologic myopia by ultra-widefield indocyanine green angiography.

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Moriyama, Muka; Cao, Kejia; Ogata, Satoko; Ohno-Matsui, Kyoko

2017-09-01

To analyse the characteristics of posterior vortex veins detected in highly myopic eyes by wide-field indocyanine green angiography (ICGA). One hundred and fifty-eight consecutive patients (302 eyes) with high myopia (myopic refractive error >8.0 dioptres (D) or axial length ≥26.5 mm) were studied. Wide-field ICGA was performed with the Spectralis HRA module. Posterior vortex veins were found in 80 eyes (26%). The prevalence of posterior staphyloma was significantly higher in eyes in which posterior vortex vein was detected than in eyes without posterior vortex vein. The posterior vortex veins were classified into five types according to the site of exit from the eye; around the optic nerve in 28%, in the macular area in 17%, along the border of staphyloma in 6%, along the margin of macular atrophy or large peripapillary conus in 21%, and elsewhere in 28%. In one eye, two posterior vortex veins collected the choroidal venous blood from the entire fundus. Wide-field ICGA can analyse the characteristic features of choroidal blood outflow system through posterior vortex veins in highly myopic eyes. They may play an important role as routes of choroidal outflow in highly myopic eyes. 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/.

Modificaciones de la curvatura posterior corneal después de la cirugía refractiva láser Modifications in the corneal posterior curve after laser refractive surgery

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Lorelei Ortega Díaz

2011-06-01

Full Text Available OBJETIVO: Describir las modificaciones de la curvatura posterior corneal en pacientes sometidos a cirugía refractiva láser en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer" en el período de mayo a octubre de 2010. MÉTODOS: Se realizó un estudio descriptivo, longitudinal y prospectivo, con un universo de 257 pacientes (504 ojos sometidos a cirugía refractiva láser. La muestra quedó conformada por 31 pacientes (59 ojos. Se analizaron variables como edad, sexo, equivalente esférico, paquimetría preoperatoria, cantidad de ablación, estroma residual y diferencia de elevación posterior corneal, esta última obtenida del mapa de diferencia del topógrafo Galilei, con medición preoperatoria al mes y a los tres meses de la cirugía. Mediante análisis de regresión múltiple fueron valorados dichos cambios de la paquimetría, la cantidad de ablación y el estroma residual. RESULTADOS: El equivalente esférico, la paquimetría, la cantidad de ablación y el estroma residual se encontraron dentro de los parámetros de seguridad establecidos. La diferencia promedio de la elevación corneal posterior fue de 15,62 µm al mes y de 11,78 µm a los tres meses, con disminución significativa con el tiempo (p= 0,000. Se observó asociación con la paquimetría preoperatoria y el estroma residual, y se encontró una correlación inversa entre este último y la elevación corneal posterior a los tres meses. CONCLUSIONES: La cirugía refractiva láser induce un aumento precoz en la elevación corneal posterior, con disminución progresiva hacia el tercer mes. Los factores que más influyeron en estos cambios fueron el estroma residual y la paquimetría preoperatoria.OBJECTIVES: To describe the modifications in the corneal posterior curve in patients underwent laser refractive surgery in the "Ramón Pando Ferrer" Cuban Institute of Ophthalmology from May to October, 2020. METHODS: A prospective, longitudinal and descriptive study was conducted

A Dynamic Systems: constraints approach to rehabilitation Uma abordagem dos sistemas dinâmicos: restrições para a reabilitação

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Kenneth G. Holt

2010-12-01

Full Text Available BACKGROUND: Classification systems (Nagi, International Classification for Function [ICF] have become popular for categorizing the level of ability (ICF or disability (Nagi associated with movement disorders. Nevertheless, these classifications do not explore the ways in which one level may influence other levels. For example, how might the weakness and stiffness associated with some cases of cerebral palsy result in a stereotypical toe-gait? In this overview we describe a dynamic systems/constraints (DS/C approach to understand relationships between levels, and how the approach can be used to rationalize a novel process for the evaluation and treatment of movement disorders. OBJECTIVES: There are three specific aims in this paper: first to present a general systems approach to understanding behavior at different levels; second to present tools of, and the results of empirical work using the DS/C approach; third to discuss the clinical implications and results of clinical interventions motivated by DS/C analysis for children with cerebral palsy, and individuals with Parkinson disease.CONTEXTUALIZAÇÃO: Sistemas de classificação (Nagi e Classificação International de Funcionalidade (CIF têm se tornado populares para categorização do nível de habilidade (CIF ou de incapacidade (Nagi associado com distúrbios do movimento. No entanto, essas classificações não exploram as formas pelas quais um nível pode influenciar outros níveis; por exemplo, como a fraqueza e a rigidez observadas em alguns casos de paralisia cerebral podem resultar no padrão estereotipado de marcha equina. Neste artigo, descreve-se uma abordagem denominada sistemas dinâmicos/restrições (DS/C para compreender as relações entre níveis e como ela pode ser utilizada para racionalizar um novo processo que norteie a avaliação e a intervenção de distúrbios do movimento. OBJETIVOS: Este artigo tem três objetivos específicos: apresentar uma abordagem geral sist

[Diagnosis and management of posterior urethra disruptions].

Science.gov (United States)

Bensalah, K; Manunta, A; Guillé, F; Patard, J J

2006-10-01

Rupture of posterior urethra is usually seen in major traumas with associated pelvic fractures. Clinical presentation classically associates blood at the uretral meatus and urinary retention. Urinary diversion should be achieved by suprapubic puncture and major associated traumatic injuries (abdominal, orthopaedic, and neurological lesions) must be treated prior to urological management. Retrograde uretrocystography is performed a few days later in order to localize and classify the urethral lesion. Treatment of posterior urethral ruptures has evolved over the years. Immediate open repair is no longer recommended. The supra-pubic catheter can be left in place until resorption of the pelvic hematoma. Obliteration occurs in 100% of the cases and is treated by open surgery at 3 months. More and more patients are treated by early endoscopic realignment which has diminished by half the incidence of urethral strictures. Impotence and incontinence secondary to trauma or surgery occur in 20% and 10% of the patients respectively. Long term follow-up should be achieved in every patient.

Posterior reversible encephalopathy syndrome: A case report

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Kostić Dejan

2015-01-01

Full Text Available Posterior reversible encephalopathy syndrome (PRES is characterized by the following symptoms: seizures, impaired consciousness and/or vision, vomiting, nausea, and focal neurological signs. Diagnostic imaging includes examination by magnetic resonance (MR and computed tomography (CT, where brain edema is visualized bi-laterally and symmetrically, predominantly posteriorly, parietally, and occipitally. Case report. We presented a 73-year-old patient with the years-long medical history of hipertension and renal insufficiency, who developed PRES with the symptomatology of the rear cranium. CT and MR verified changes in the white matter involving all lobes on both sides of the brain. After a two-week treatment (antihypertensive, hypolipemic and rehydration therapy clinical improvement with no complications occurred, with complete resolution of changes in the white matter observed on CT and MR. Conclusion. PRES is a reversible syndrome in which the symptoms withdraw after several days to several weeks if early diagnosis is made and appropriate treatment started without delay.

Hypertension as the trigger for posterior reversible encephalopathy ...

African Journals Online (AJOL)

RESEARCH. Posterior reversible encephalopathy syndrome (PRES) is a neuro ..... rise of blood pressure instead of the sustained levels of hypertension in these patients. .... high prevalence and more extensive imaging findings. Am J Kidney ...

Manual rotation to decrease operative delivery in posterior or transverse positions.

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Le Ray, Camille; Deneux-Tharaux, Catherine; Khireddine, Imane; Dreyfus, Michel; Vardon, Delphine; Goffinet, François

2013-09-01

To assess the effect of a policy of manual rotation on the mode of delivery of fetuses in posterior or transverse positions at full dilatation. This was a prospective study to compare two policies of management for posterior and transverse positions in two different hospitals (Hospital 1: no manual rotation and Hospital 2: manual rotation). We used univariable and multivariable analyses to study the association between the management policy for posterior and transverse positions at full dilatation in these hospitals and maternal and neonatal outcomes. The principal end point was operative delivery (ie, cesarean or instrumental vaginal delivery). All factors associated with the risk of operative delivery in the univariable analysis (Pmanual rotation was independently associated with a reduction in operative deliveries. The rate of posterior or transverse positions at full dilatation was 15.9% (n=111) in Hospital 1 and 15.3% (n=220) in Hospital 2 (P=.75). Of the 172 attempts of manual rotation in Hospital 2, 155 (90.1%) were successful. The rate of operative delivery was significantly lower in Hospital 2, which performed manual rotations (23.2% compared with 38.7% in Hospital 1, adjusted odds ratio [OR] 0.52, 95% confidence interval [CI] 0.28-0.95). After multivariable analysis, manual rotation remained significantly associated with a reduction in the risk of operative delivery (adjusted OR 0.45, 95% CI 0.25-0.85). Five-minute Apgar score and arterial pH at birth were similar in the two hospitals. For fetuses in posterior or transverse positions at full dilatation, a strategy of manual rotation is associated with a reduction in the rate of operative delivery. III.

Posterior diaphragmatic defect detected on chest CT: the incidence according to age and the lateral chest radiographic appearances

International Nuclear Information System (INIS)

Lee, Son Youl; Choi, Yo Won; Jeon, Seok Chol; Heo, Jeong Nam; Park, Choong Ki

2007-01-01

We wanted to investigate the incidence of posterior diaphragmatic defect on chest CT in various age groups and its lateral chest radiographic appearances. The chest CT scans of 78 patients of various ages with posterior diaphragmatic defect were selected among 1,991 patients, and they were analyzed for the incidence of defect in various age groups, the defect location and the herniated contents. Their lateral chest radiographs were analyzed for the shape of the posterior diaphragm and the posterior costophrenic sulcus. The patients' ages ranged from 34 to 87 with the tendency of a higher incidence in the older patients. The defect most frequently involved the medial two thirds (n = 49, 50.4%) and middle one third (n = 36, 37%) of the posterior diaphragm. The retroperitoneal fat was herniated into the thorax through the defect in all patients, and sometimes with the kidney (n = 8). Lateral chest radiography showed a normal diaphragmatic contour (n = 51, 49.5%), blunting of the posterior costophrenic sulcus (n = 41, 39.8%), focal humping of the posterior diaphragm (n = 7, 6.8%), or upward convexity (n = 4, 3.9%) of the posterior costophrenic sulcus on the affected side. The posterior diaphragmatic defect discovered in asymptomatic patients who are without a history of peridiaphragmatic disease is most likely acquired, and this malady increases in incidence according to age. An abnormal contour of the posterior diaphragm or the costophrenic sulcus on a lateral chest radiograph may be a finding of posterior diaphragmatic defect

[Acute epidural hematoma of the posterior fossa caused by forehead impact].

Science.gov (United States)

Abe, S; Furukawa, K; Endo, S; Hoshi, S; Kanaya, H

1988-03-01

A rare case of acute epidural hematoma of the posterior fossa caused by forehead impact is reported. This 36-year-old man fell from a truck and hit his face. He was conscious and was brought to our center 30 minutes after the injury. On admission, a contused wound of the right forehead was noticed. He was restless and had severe pain in the neck and upper extremities. Skull X-ray showed a linear fracture of the frontal bone and computed tomography (CT) scan was normal. He continued to be restless and sudden respiratory arrest and pupillary dilation occurred 10 hours after the admission. A CT scan revealed a lenticular high density area in the left posterior fossa which extended to the supratentorial region. The 4th ventricle was compressed and displaced to the right and also the quadrigeminal and ambient cisterns were not visualized at all. Immediate surgery disclosed a 30 g epidural hematoma of the left posterior fossa and the supratentorium and the clot was completely evacuated. The source of bleeding could not be identified. Opening of the dura revealed contusion in the occipital lobe. He died on the 17th postoperative day. The possible mechanism in the production of the posterior fossa hematoma in this case is discussed.

Difficult management of posterior urethra gunshot wound combined with urethro-rectal fistula

OpenAIRE

Walid Kerkeni; Ahmed Saadi; Mohamed Hédi Rebai; Abderrazak Bouzouita; Mohamed Cherif; Amine Derouiche; Tahar Khalfallah; Mohamed Riadh Ben Slama; Mohamed Chebil

2015-01-01

Posterior urethra gunshot wounds are poorly described in the literature. They are often associated with pelvic vital lesions making difficult early repair of urethral injuries. They can be complicated by urethro-rectal fistula, which makes their management more complicated. We report a new case of posterior urethra disruption due to a gunshot wound and complicated by urethro-rectal fistula.

Venous hemodynamics of arteriovenous meningeal fistulas in the posterior cranial fossa

International Nuclear Information System (INIS)

Brainin, M.; Samec, P.

1983-01-01

The etiology of arteriovenous meningeal fistulas (AVMFs) of the posterior fossa often remains unclear. Analyses of three personal cases, however, suggest a change in venous hemodynamics due to a primary lesion, the cases being of sinus thrombosis, intracerebral abcess with oedema and arteriovenous malformation. It is suggested that increase of venous pressure in the posterior fossa leads to increased drainage and, consequently, to dilatation of infratentorial veins and of meningeal branches of the external carotid and vertebral artery. Clinical findings and anatomical facts underlying AVMF lesions tend to confirm the view that the concept of a congenital malformation decompensating with age cannot be upheld for all AVMFs, especially when located in the posterior fossa and when clinical symptoms arise in middle age. It is proposed that a pressure activated mechanism of growth results in widening of normally insignificantly small dural vessels. (orig.)

MR imaging of acute intermittent porphyria mimicking reversible posterior leukoencephalopathy syndrome

International Nuclear Information System (INIS)

Utz, N.; Kinkel, B.; Hedde, J.P.; Bewermeyer, H.

2001-01-01

Reversible posterior leukoencephalopathy syndrome (PLS) is characterized by headache, altered mental function, visual disturbances and seizures. Neuroimaging studies suggest a white-matter oedema, predominantly in the posterior parietal-temporal-occipital regions of the brain. We present the case of a 30-year-old woman who had suffered her first attack of acute intermittent porphyria (AIP). Following 1 week of abdominal pain she developed several generalized seizures, and hallucinations, and exhibited a progressive deterioration of the consciousness. T2-weighted images, especially fluid-attenuated inversion recovery (FLAIR) sequences showed bilateral lesions in the posterior frontal, parietal and occipital cortex and subcortical white matter. Following treatment with haematin and a high carbohydrate diet the patient's condition improved. Follow-up magnetic resonance imaging (MRI) revealed complete resolution of the lesions. To our knowledge, this is the first report concerning a completely reversible PLS in AIP. (orig.)

Intravitreal Triamcinolone in Posterior Segment Diseases – Method ...

African Journals Online (AJOL)

DR OLULEYE

prolonged action and lack of tissue toxicity noted in animal and human studies.2 .... peeling and triamcinolone-assisted posterior vitreous removal in diffuse diabetic ... Spaide RF, Soronson J, Maranan L. Photodynamic therapy with verteporfin ...

Corpectomia da coluna toracolombar com colocação de cage por acesso único via posterior: técnica cirúrgica e resultados de seis pacientes Corpectomía de la columna toracolumbar con la colocación de cage por abordaje único vía posterior: técnica quirúrgica y los resultados de seis pacientes Thoracolumbar spine corpectomy with placement of a cage by single posterior approach: surgical technique and results of six patients

Directory of Open Access Journals (Sweden)

Fabiano Morais Nogueira

2011-01-01

Full Text Available OBJETIVO: Avaliar retrospectivamente os resultados de uma série de pacientes submetidos à corpectomia torácica e/ou lombar por via exclusivamente posterior associado à colocação de cage e à artrodese instrumentada segmentar e descrever a técnica cirúrgica. MÉTODOS: Foram avaliados retrospectivamente seis pacientes portadores de colapso vertebral, instabilidade biomecânica ou lesão neurológica por diferentes etiologias. Estes pacientes apresentavam indicação de descompressão neural e receberam indicação para a realização de corpectomia e reconstrução circunferencial com cage sendo realizado por via exclusivamente posterior. RESULTADOS: Quatro pacientes eram do sexo masculino e dois do sexo feminino. A idade média foi de 58 anos (22 a 82 anos com tempo médio de acompanhamento de 10,5 meses (2 a 24 meses. Em três casos a ressecção foi de um corpo vertebral e em três casos de dois corpos vertebrais. Todos os pacientes apresentaram melhora do seu estado neurológico e melhora da dor lombar ou radicular. As indicações ao procedimento foram três casos por espondilodiscite, um por fratura osteoporótica, um tumor metastático e um tumor primário. Três pacientes apresentaram complicações necessitando de revisão cirúrgica evoluindo com melhora dos sintomas. As complicações foram fístula liquórica, radiculopatia lombar, infecção de ferida operatória, meningite e falha da instrumentação. CONCLUSÃO: Os pacientes submetidos à corpectomia por via exclusivamente posterior apresentaram resultados favoráveis com melhora do déficit neurológico ou dor em todos os casos. Esta técnica mostrou-se eficiente na reconstrução circunferencial da coluna evitando as complicações da abordagem tradicional por dupla via.OBJETIVO: Evaluar retrospectivamente los resultados de una serie de pacientes sometidos a corpectomía vertebral por una vía exclusivamente posterior con la colocación de cage y artrodesis instrumentada

MR imaging diagnosis of posterior cruciate ligament injury: importance of ancillary findings

International Nuclear Information System (INIS)

Hwang, Kang Ik; Lee, Jong Hwa; Kim, Young Sun; Lee, Jung Hwoi; Ki, Tae Sung; Park, Jong Oag

1997-01-01

To evaluate the importance of two ancillary findings of anterior tibial plateau bruise/fracture and popliteus muscle strain on MR diagnosis of posterior cruicate ligament injury. We retrospectively evaluated 48 patients with confirmed posterior cruciate ligament tear. We studied the incidence of anterior tibial plateau injury and popliteus muscle strain, and the specificity of popliteus muscle strain with or without bony injury. A complete tear of the posterior cruciate ligament was noted in 37 cases, a partial tear in 11. Anterior tibial plateau lesion was found in 21 of 48 cases (44%); This total was made up of 17/37 PCL complete tears (46%) and 4/11 partial tears (36%). The difference in the incidence of complete and partial tears is not statistically significant. Popliteus muscle injury was found in 20 of 48 cases (42%), the total consisted of 19/37 PCL complete tears (51%) and 1/11 partial tears (10%). The incidence of 42% is relatively high, approximating that of bony injury. The difference in the incidence of complete and partial tears is statistically significant (p < 0.006). Specificity for posterior cruciate ligament tear is 69%(20/29), and when concomitant with anterior tibial plateau injury is 94%(16/17). As in the case of anterior cruciate ligament injury, these documented ancillary findings of anterior tibial plateau and popliteus muscle injuries are very helpful when MR diagnosis of posterior cruciate ligament injury itself and differentiation of partial and complete rupture are doubtful

The effect of variable size posterior wall acetabular fractures on contact characteristics of the hip joint.

Science.gov (United States)

Olson, S A; Bay, B K; Pollak, A N; Sharkey, N A; Lee, T

1996-01-01

The indications for open reduction and internal fixation of posterior wall acetabular fractures associated with a clinically stable hip joint are unclear. In previous work a large posterior wall defect (27% articular surface area) resulted in significant alteration of load transmission across the hip; specifically, there was a transition from evenly distributed loading along the acetabular articular surface to loading concentrated mainly in the superior portion of the articular surface during simulated single leg stance. However, the majority of posterior wall fractures involve a smaller amount of the articular surface. Posterior wall acetabular fractures not associated with instability of the hip are commonly treated nonoperatively. This practice does not account for the size of the posterior wall fracture. To study the biomechanical consequences of variably sized articular defects, a laboratory experiment was conducted evaluating three progressively larger posterior wall defects of the acetabulum during simulated single leg stance using superlow Fuji prescale film (Itochu International, New York): (a) 1/3 articular surface width through a 50 degrees arc along the posterior wall of the acetabulum, (b) 2/3, and (c) 3/3 articular width defects through the same 50 degrees arc along the posterior wall of the acetabulum. In the intact acetabulum, 48% of the total articular contact was located in the superior acetabulum. Twenty-eight percent of articular contact was in the anterior wall region of the acetabulum and 24% in the posterior wall region. After the 1/3 width posterior wall defect, 64% of the articular contact was located in the superior acetabulum (p = 0.0011). The 2/3 width posterior wall defect resulted in 71% of articular contact area being located in the superior acetabulum (p = 0.0006). After the 3/3 width posterior wall defect, 77% of articular contact was located in the superior acetabulum, significantly greater than the intact condition (p < 0

Extremely long posterior communicating artery diagnosed by MR angiography: report of two cases.

Science.gov (United States)

Uchino, Akira; Suzuki, Chihiro; Tanaka, Masahiko

2015-07-01

We report two cases of an extremely long left posterior communicating artery (PCoA) diagnosed by magnetic resonance (MR) angiography. The PCoA arose from the normal point of the supraclinoid internal carotid artery and fused with the posterior cerebral artery (PCA) at its posterior ambient segment, forming an extremely long PCoA and extremely long precommunicating segment of the PCA. To our knowledge, this is the first report of such variation. Careful observation of MR angiographic images is important for detecting rare arterial variations. To identify these anomalous arteries on MR angiography, partial maximum-intensity-projection images are useful.

Bilateral en-masse distalization of maxillary posterior teeth with skeletal anchorage: a case report

Directory of Open Access Journals (Sweden)

Saeed Noorollahian

Full Text Available ABSTRACT Objective: The aim of this study was to introduce a new method for bilateral distal movement of the entire maxillary posterior segment. Case report: A 17-year-old girl with Class I skeletal malocclusion (end-to-end molar relationships, deviated midline and space deficiency for left maxillary canine was referred for orthodontic treatment. She did not accept maxillary first premolars extraction. A modified Hyrax appliance (Dentaurum Ispringen, Germany was used for bilateral distalization of maxillary posterior teeth simultaneously. Expansion vector was set anteroposteriorly. Posterior legs of Hyrax were welded to first maxillary molar bands. All posterior teeth on each side consolidated with a segment of 0.017 × 0.025-in stainless steel wire from the buccal side. Anterior legs of Hyrax were bent into eyelet form and attached to the anterior palate with two mini-screws (2 × 10 mm (Jeil Medical Corporation Seoul, South Korea. Hyrax opening rate was 0.8 mm per month. Lateral cephalometric radiographs were used to evaluate the extent of distal movement. 3.5-mm distalization of posterior maxillary teeth was achieved in five months. Results: A nearly bodily distal movement without anchorage loss was obtained. Conclusion: The mini-screw-supported modified Hyrax appliance was found to be helpful for achieving en-masse distal movement of maxillary posterior teeth.

The Neuroanatomical Basis for Posterior Superior Parietal Lobule Control Lateralization of visuospatial Attention

Directory of Open Access Journals (Sweden)

Yan eWu

2016-03-01

Full Text Available The right hemispheric dominance in visuospatial attention in human brain has been well established. Converging evidence has documented that ventral posterior parietal cortex (PPC plays an important role in visuospatial attention. The role of dorsal PPC subregions, especially the superior parietal lobule (SPL in visuospatial attention is still controversial. In the current study, we used repetitive transcranial magnetic stimulation (rTMS and diffusion magnetic resonance imaging (MRI techniques to test the role of posterior SPL in visuospatial attention and to investigate the potential neuroanatomical basis for right hemisphere dominance in visuospatial function. TMS results unraveled that the right SPL predominantly mediated visuospatial attention compared to left SPL. Anatomical connections analyses between the posterior SPL and the intrahemispheric frontal subregions and the contralateral PPC revealed that right posterior SPL has stronger anatomical connections with the ipsilateral middle frontal gyrus, with the ipsilateral inferior frontal gyrus, and with contralateral PPC than that of the left posterior SPL. Furthermore, these asymmetric anatomical connections were closely related to behavioral performances. Our findings indicate that SPL plays a crucial role in regulating visuospatial attention, and dominance of visuospatial attention results from unbalanced interactions between the bilateral fronto-parietal networks and the interhemispheric parietal network.

Oral azithromycin for treatment of posterior blepharitis.

Science.gov (United States)

Igami, Thais Zamudio; Holzchuh, Ricardo; Osaki, Tammy Hentona; Santo, Ruth Miyuki; Kara-Jose, Newton; Hida, Richard Y

2011-10-01

To evaluate the effects of oral azithromycin in patients with posterior blepharitis. Twenty-six eyes of 13 patients with posterior blepharitis diagnosed by a qualified ophthalmologist were enrolled in this study. Patients were instructed to use oral azithromycin 500 mg per day for 3 days in 3 cycles with 7-day intervals. Subjective clinical outcomes were graded and scored 1 day before and 30 days after the end of the treatment (53 days after initiating the treatment) based on severity scores of: (1) eyelid debris; (2) eyelid telangiectasia; (3) swelling of the eyelid margin; (4) redness of the eyelid margin; and (5) ocular mucus secretion. For the assessment of global efficacy, patients were asked by the investigator to rate the subjective symptoms (eyelid itching, ocular itching, eyelid hyperemia, ocular hyperemia, ocular mucus secretion, photophobia, foreign body sensation, and dry eye sensation) on a scale of 0 (no symptoms) to 5 (severe symptoms). Break-up time, Schirmer I test, corneal fluorescein staining score, and rose bengal staining score were also performed in all patients. All clinical outcomes scoring showed statistically significant improvement after oral azithromycin, except for eyelid swelling. Average subjective symptom grading improved statistically after treatment with oral azithromycin, except for eyelid hyperemia, photophobia, and foreign body sensation. Average tear film break-up time values showed statistically significant improvement after the treatment with oral azithromycin. No statistically significant improvement was observed on average values of Schirmer I test, corneal fluorescein staining score, and rose bengal staining score. The combination of multiple clinical parameters shown in this study supports the clinical efficacy of pulsed oral azithromycin therapy for the management of posterior blepharitis.

Importance of tibial slope for stability of the posterior cruciate ligament deficient knee.

Science.gov (United States)

Giffin, J Robert; Stabile, Kathryne J; Zantop, Thore; Vogrin, Tracy M; Woo, Savio L-Y; Harner, Christopher D

2007-09-01

Previous studies have shown that increasing tibial slope can shift the resting position of the tibia anteriorly. As a result, sagittal osteotomies that alter slope have recently been proposed for treatment of posterior cruciate ligament (PCL) injuries. Increasing tibial slope with an osteotomy shifts the resting position anteriorly in a PCL-deficient knee, thereby partially reducing the posterior tibial "sag" associated with PCL injury. This shift in resting position from the increased slope causes a decrease in posterior tibial translation compared with the PCL-deficient knee in response to posterior tibial and axial compressive loads. Controlled laboratory study. Three knee conditions were tested with a robotic universal force-moment sensor testing system: intact, PCL-deficient, and PCL-deficient with increased tibial slope. Tibial slope was increased via a 5-mm anterior opening wedge osteotomy. Three external loading conditions were applied to each knee condition at 0 degrees, 30 degrees, 60 degrees, 90 degrees, and 120 degrees of knee flexion: (1) 134-N anterior-posterior (A-P) tibial load, (2) 200-N axial compressive load, and (3) combined 134-N A-P and 200-N axial loads. For each loading condition, kinematics of the intact knee were recorded for the remaining 5 degrees of freedom (ie, A-P, medial-lateral, and proximal-distal translations, internal-external and varus-valgus rotations). Posterior cruciate ligament deficiency resulted in a posterior shift of the tibial resting position to 8.4 +/- 2.6 mm at 90 degrees compared with the intact knee. After osteotomy, tibial slope increased from 9.2 degrees +/- 1.0 degrees in the intact knee to 13.8 degrees +/- 0.9 degrees. This increase in slope reduced the posterior sag of the PCL-deficient knee, shifting the resting position anteriorly to 4.0 +/- 2.0 mm at 90 degrees. Under a 200-N axial compressive load with the osteotomy, an additional increase in anterior tibial translation to 2.7 +/- 1.7 mm at 30 degrees was

[Open-wedge osteotomy of the glenoid for treatment of posterior shoulder instability with increased glenoid retroversion].

Science.gov (United States)

Pogorzelski, J; Braun, S; Imhoff, A B; Beitzel, K

2016-12-01

Treatment of posterior shoulder instability with increased retroversion of the glenoid using open-wedge osteotomy of the glenoid neck stabilized with an autologous bone block. Symptomatic, atraumatic posterior shoulder instability with increased retroversion (>20°) of the glenoid and previously failed conservative or surgical treatment. General contraindications against surgery. Relative contraindications: osteoporosis, nicotine abuse, or suspected patient noncompliance. Posterior approach with a 7 cm long incision starting medial of the posterolateral corner of the acromion heading to the posterior axillary fold and subsequent preparation of the deltoid muscle and the infraspinatus muscle. The posterior glenohumeral capsule is incised by performing a capsular T‑shift. The osteotomy is performed intracapsulary medial to the genoid rim. The wedge bone graft, harvested from spina scapulae or iliac spine, is placed "press fit" in position. Additional fixation of the graft is not necessary if the anterior cortex is intact. For reinforcing the posterior capsule, a posterior capsule shift should be performed. Insertion of extracapsular wound drainage. Successive wound closure. Postoperative immobilization in a 0° shoulder orthesis for 6 weeks; avoidance of horizontal abduction for 8 weeks. After removing the wound drainage, start of limited active-assisted range of motion. Over-head sports after 6 months. From 2009-2015, 6 posterior open wedge glenoid osteotomies were performed. Postoperative retroversion of the glenoid was 11.2 ± 9.4° compared to 26.0 ± 8.6° before surgery. Of 6 shoulders, 2 showed postoperative signs of persistent posterior instability; the other 4 shoulders were free of complaints. No revision surgery was needed.

Surpresa refrativa pós-facoemulsificação em distrofia corneana posterior amorfa Post-phacoemulsification refractive surprise in a posterior amorphous corneal dystrophy patient

Directory of Open Access Journals (Sweden)

Giuliano de Oliveira Freitas

2010-02-01

Full Text Available Relato de um caso de surpresa refracional pós-operatória não pretendida em paciente portador de distrofia corneana posterior amorfa submetida à facoemulsificação. A provável causa do erro, bem como a conduta tomada a partir do reconhecimento da mesma, são discutidas neste relato.One case of post-phacoemulsification refractive surprise in a posterior amorphous corneal dystrophy patient is reported herein. Its likely causative factor, as well as our approach once it was recognized are discussed in this report.

Case report: Management of severe posterior open bite due to primary failure of eruption.

LENUS (Irish Health Repository)

Mc Cafferty, J

2010-06-01

Primary failure of tooth eruption (PFE) is a rare condition affecting any or all posterior quadrants. Unilateral involvement of maxillary and mandibular quadrants causes a dramatic posterior open bite that requires complex management strategies.

MR imaging of displaced meniscal tears of the knee. Importance of a 'disproportional posterior horn sign'

International Nuclear Information System (INIS)

Chen, H.C.; Hsu, C.Y.; Shih, T.T.F.; Huang, K.M.; Li, Y.W.

2001-01-01

Purpose: Meniscal tears associated with displaced fragments are clinically significant. We propose the 'disproportional posterior horn sign' as a supportive criterion to identify a posterocentrally displaced meniscal fragment on MR imaging studies. If the meniscal posterior horn in the central portion appears larger than that in the peripheral section, it is considered positive for 'disproportional posterior horn sign'. Material and Methods: MR images obtained in 42 patients with 43 lesions, confirmed to have displaced meniscal tears, were included in this study. The MR images were retrospectively evaluated for the presence of the 'disproportional posterior horn sign', as well as the other known signs. Results: The 'disproportional posterior horn sign' was seen in 9 (20.9%) of 43 lesions, including 1 lateral discoid meniscal tear, 5 lateral meniscal tears and 3 medial meniscal tears. Five of them also had other signs of a displaced meniscal fragment. However, the remaining 4 cases only exhibited the 'disproportional posterior horn sign'. For the other MR signs, the 'absent bow tie sign' was detected in 40 (93%) of 43 lesions, the 'flipped meniscus sign' in 27 (62.8%) of 43 lesions, the 'double posterior cruciate ligament sign' in 17 (39.5%) of 43 lesions and the 'notch fragment sign' in 22 (51.2%) of 43 lesions. Conclusion: The 'disproportional posterior horn sign' is helpful in demonstrating a posterocentrally displaced meniscal fragment, especially when other characteristic signs are unremarkable or absent

Tibial avulsion fracture of the posterior root of the medial meniscus in children

DEFF Research Database (Denmark)

Iversen, Jonas Vestergård; Krogsgaard, Michael Rindom

2012-01-01

of displaced avulsion fractures of the posterior root of the medial meniscus in children are presented along with a concise report of the literature regarding avulsion fractures of the posterior root of the medial meniscus. Both avulsions were reattached arthroscopically by trans-tibial pull-out sutures...

Difficult management of posterior urethra gunshot wound combined with urethro-rectal fistula

Directory of Open Access Journals (Sweden)

Walid Kerkeni

2015-06-01

Full Text Available Posterior urethra gunshot wounds are poorly described in the literature. They are often associated with pelvic vital lesions making difficult early repair of urethral injuries. They can be complicated by urethro-rectal fistula, which makes their management more complicated. We report a new case of posterior urethra disruption due to a gunshot wound and complicated by urethro-rectal fistula.

Reduced modulation of scanpaths in response to task demands in posterior cortical atrophy.

Science.gov (United States)

Shakespeare, Timothy J; Pertzov, Yoni; Yong, Keir X X; Nicholas, Jennifer; Crutch, Sebastian J

2015-02-01

A difficulty in perceiving visual scenes is one of the most striking impairments experienced by patients with the clinico-radiological syndrome posterior cortical atrophy (PCA). However whilst a number of studies have investigated perception of relatively simple experimental stimuli in these individuals, little is known about multiple object and complex scene perception and the role of eye movements in posterior cortical atrophy. We embrace the distinction between high-level (top-down) and low-level (bottom-up) influences upon scanning eye movements when looking at scenes. This distinction was inspired by Yarbus (1967), who demonstrated how the location of our fixations is affected by task instructions and not only the stimulus' low level properties. We therefore examined how scanning patterns are influenced by task instructions and low-level visual properties in 7 patients with posterior cortical atrophy, 8 patients with typical Alzheimer's disease, and 19 healthy age-matched controls. Each participant viewed 10 scenes under four task conditions (encoding, recognition, search and description) whilst eye movements were recorded. The results reveal significant differences between groups in the impact of test instructions upon scanpaths. Across tasks without a search component, posterior cortical atrophy patients were significantly less consistent than typical Alzheimer's disease patients and controls in where they were looking. By contrast, when comparing search and non-search tasks, it was controls who exhibited lowest between-task similarity ratings, suggesting they were better able than posterior cortical atrophy or typical Alzheimer's disease patients to respond appropriately to high-level needs by looking at task-relevant regions of a scene. Posterior cortical atrophy patients had a significant tendency to fixate upon more low-level salient parts of the scenes than controls irrespective of the viewing task. The study provides a detailed characterisation of

Uma abordagem investigativa do trabalho experimental no ensino da química a alunos não-químicos na universidade

OpenAIRE

Figueiredo, Margarida; Maia, Maria Elisa

2005-01-01

Pretende-se divulgar os resultados de um estudo sobre a implementação de um tipo de abordagem ao Trabalho Experimental de Química, cujos objectivos são: - Contribuir para motivar os alunos para a aprendizagem da Química; - Contribuir para melhorar o sucesso na formação em Química dos alunos que não sendo de Química necessitam de fazer aprendizagens nesse domínio; - Contribuir para uma revalorização do trabalho experimental enquanto estratégia privilegiada para o ensino da Química....

[Posterior reversible encephalopathy syndrome after neurosurgery: A literature review].

Science.gov (United States)

Durán Paz, S; Moreno Casanova, I; Benatar-Haserfaty, J

2015-12-01

Posterior reversible encephalopathy syndrome is a clinical-radiological characterized by decreased level of consciousness, seizures, and visual disturbances, as well as radiologically ras brain edema, predominantly in parieto-occipital white matter regions. There are many situations that can trigger the disorder, including the administration of immunosuppressants, chemotherapy agents, hypertensive disorders, and sepsis. The case is described of a patient diagnosed with stage IV prostate adenocarcinoma, receiving chemotherapy, andundergoing a posterior reversible encephalopathy syndrome after surgery for resection of brain metastasis. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Posterior Mesh Tracheoplasty for Cervical Tracheomalacia: A Novel Trachea-Preserving Technique.

Science.gov (United States)

Wilson, Jennifer L; Folch, Erik; Kent, Michael S; Majid, Adnan; Gangadharan, Sidhu P

2016-01-01

Tracheal resection or placement of airway prostheses (stents, tracheostomy tubes, or T tubes) are techniques currently used to treat severe cervical tracheomalacia. We have developed a new technique to secure a polypropylene splint to the posterior membrane of the cervical trachea in a patient with diffuse, acquired tracheobronchomalacia. This novel posterior tracheoplasty avoids anastomotic and intraluminal adverse events that may occur with existing techniques. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Inlay buccal mucosal graft for reoperative posterior urethroplasty.

Science.gov (United States)

Tang, Shou-Hung; Kao, Chien-Chang; Wu, Seng-Tang; Meng, En; Cha, Tai-Lung

2012-04-01

Posterior urethral distraction injury following major pelvic trauma is a surgical challenge. Although rarely seen, cases of failure after formal urethral reconstruction are even more problematic. We adapted the concept of augmented free buccal mucosal grafts, which have been successful in anterior urethroplasty, for repairing the posterior urethra in these rare cases with the aim of reducing the likelihood of penile chordee postoperatively. During 2007-2009, four patients were candidates for the proposed procedure because they had received formal transperineal urethral reconstruction but were unable to urinate through the urethra. The urethra was approached transperineally and opened in the midline, rather than divided. Buccal mucosal grafts of an appropriate size were placed in the created urethral groove from 4- to 8 o'clock in the lithotomy view. After the procedure, the urethral catheter was kept for 3 weeks. All patients voided through the urethra after the procedure. The maximal postoperative urinary flow rates were between 12-15 ml/seconds in all cases for a follow-up period of 18-30 months. The recurrence rate was 50% (2/4). Recurrent strictures were minor, and they showed a web-like stricture ring near the suture line. Restricture within 6 months of surgery responded well to endoscopic internal urethrotomy plus dilatations. In conclusion, without further compromising urethral length, reoperative posterior urethroplasty with the inlay grafting technique can be considered in selective cases. Copyright © 2012. Published by Elsevier B.V.

Inlay buccal mucosal graft for reoperative posterior urethroplasty

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Shou-Hung Tang

2012-04-01

Full Text Available Posterior urethral distraction injury following major pelvic trauma is a surgical challenge. Although rarely seen, cases of failure after formal urethral reconstruction are even more problematic. We adapted the concept of augmented free buccal mucosal grafts, which have been successful in anterior urethroplasty, for repairing the posterior urethra in these rare cases with the aim of reducing the likelihood of penile chordee postoperatively. During 2007–2009, four patients were candidates for the proposed procedure because they had received formal transperineal urethral reconstruction but were unable to urinate through the urethra. The urethra was approached transperineally and opened in the midline, rather than divided. Buccal mucosal grafts of an appropriate size were placed in the created urethral groove from 4- to 8 o’clock in the lithotomy view. After the procedure, the urethral catheter was kept for 3 weeks. All patients voided through the urethra after the procedure. The maximal postoperative urinary flow rates were between 12–15 ml/seconds in all cases for a follow-up period of 18–30 months. The recurrence rate was 50% (2/4. Recurrent strictures were minor, and they showed a web-like stricture ring near the suture line. Restricture within 6 months of surgery responded well to endoscopic internal urethrotomy plus dilatations. In conclusion, without further compromising urethral length, reoperative posterior urethroplasty with the inlay grafting technique can be considered in selective cases.

Posterior white matter disease distribution as a predictor of amyloid angiopathy

Science.gov (United States)

Thanprasertsuk, Sekh; Martinez-Ramirez, Sergi; Pontes-Neto, Octavio Marques; Ni, Jun; Ayres, Alison; Reed, Anne; Swords, Kyleen; Gurol, M. Edip; Greenberg, Steven M.

2014-01-01

Objectives: We sought to examine whether a posterior distribution of white matter hyperintensities (WMH) is an independent predictor of pathologically confirmed cerebral amyloid angiopathy (CAA) and whether it is associated with MRI markers of CAA, in patients without lobar intracerebral hemorrhage. Methods: We developed a quantitative method to measure anteroposterior (AP) distribution of WMH. A retrospective cohort of patients without intracerebral hemorrhage and with pathologic evaluation of CAA was examined to determine whether posterior WMH distribution was an independent predictor of CAA (n = 59). The relationship of AP distributions of WMH to strictly lobar microbleeds (MBs) (n = 259) and location of dilated perivascular spaces (DPVS) (n = 85) was examined in a separate cohort of patients evaluated in a memory clinic. Results: A more posterior WMH distribution was found to be an independent predictor of pathologic evidence of CAA (p = 0.001, odds ratio [95% confidence interval] = 1.19 [1.07–1.32]), even in the subgroup without lobar MBs (p = 0.016, odds ratio [95% confidence interval] = 1.18 [1.03–1.36]). In the memory clinic cohort, strictly lobar MBs were independently associated with more posterior WMH distribution (p = 0.009). AP distribution of WMH was also associated with location of DPVS (p = 0.001), in that patients with predominant DPVS in the white matter over the basal ganglia harbored a more posterior WMH distribution. Conclusions: Our results suggest that AP distribution of WMH may represent an additional marker of CAA, irrespective of the presence of lobar hemorrhages. Classification of evidence: This study provides Class III evidence that there is a significant association between the AP distribution of WMH on MRI with the presence of pathologically confirmed CAA pathology. PMID:25063759

Anatomy and classification of the posterior tibial fragment in ankle fractures.

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Bartoníček, Jan; Rammelt, Stefan; Kostlivý, Karel; Vaněček, Václav; Klika, Daniel; Trešl, Ivo

2015-04-01

The aim of this study was to analyze the pathoanatomy of the posterior fragment on the basis of a comprehensive CT examination, including 3D reconstructions, in a large patient cohort. One hundred and forty one consecutive individuals with an ankle fracture or fracture-dislocation of types Weber B or Weber C and evidence of a posterior tibial fragment in standard radiographs were included in the study. The mean patient age was 49 years (range 19-83 years). The exclusion criteria were patients below 18 years of age, inability to provide written consent, fractures of the tibial pilon, posttraumatic arthritis and pre-existing deformities. In all patients, post-injury radiographs were obtained in anteroposterior, mortise and lateral views. All patients underwent CT scanning in transverse, sagittal and frontal planes. 3D CT reconstruction was performed in 91 patients. We were able to classify 137 cases into one of the following four types with constant pathoanatomic features: type 1: extraincisural fragment with an intact fibular notch, type 2: posterolateral fragment extending into the fibular notch, type 3: posteromedial two-part fragment involving the medial malleolus, type 4: large posterolateral triangular fragment. In the 4 cases it was not possible to classify the type of the posterior tibial fragment. These were collectively termed type 5 (irregular, osteoporotic fragments). It is impossible to assess the shape and size of the posterior malleolar fragment, involvement of the fibular notch, or the medial malleolus, on the basis of plain radiographs. The system that we propose for classification of fractures of the posterior malleolus is based on CT examination and takes into account the size, shape and location of the fragment, stability of the tibio-talar joint and the integrity of the fibular notch. It may be a useful indication for surgery and defining the most useful approach to these injuries.

A patient with posterior cortical atrophy possesses a novel mutation in the presenilin 1 gene.

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Emilia J Sitek

Full Text Available Posterior cortical atrophy is a dementia syndrome with symptoms of cortical visual dysfunction, associated with amyloid plaques and neurofibrillary tangles predominantly affecting visual association cortex. Most patients diagnosed with posterior cortical atrophy will finally develop a typical Alzheimer's disease. However, there are a variety of neuropathological processes, which could lead towards a clinical presentation of posterior cortical atrophy. Mutations in the presenilin 1 gene, affecting the function of γ-secretase, are the most common genetic cause of familial, early-onset Alzheimer's disease. Here we present a patient with a clinical diagnosis of posterior cortical atrophy who harbors a novel Presenilin 1 mutation (I211M. In silico analysis predicts that the mutation could influence the interaction between presenilin 1 and presenilin1 enhancer-2 protein, a protein partner within the γ-secretase complex. These findings along with published literature support the inclusion of posterior cortical atrophy on the Alzheimer's disease spectrum.

A Patient with Posterior Cortical Atrophy Possesses a Novel Mutation in the Presenilin 1 Gene

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Sitek, Emilia J.; Narożańska, Ewa; Pepłońska, Beata; Filipek, Sławomir; Barczak, Anna; Styczyńska, Maria; Mlynarczyk, Krzysztof; Brockhuis, Bogna; Portelius, Erik; Religa, Dorota; Barcikowska, Maria

2013-01-01

Posterior cortical atrophy is a dementia syndrome with symptoms of cortical visual dysfunction, associated with amyloid plaques and neurofibrillary tangles predominantly affecting visual association cortex. Most patients diagnosed with posterior cortical atrophy will finally develop a typical Alzheimer's disease. However, there are a variety of neuropathological processes, which could lead towards a clinical presentation of posterior cortical atrophy. Mutations in the presenilin 1 gene, affecting the function of γ-secretase, are the most common genetic cause of familial, early-onset Alzheimer's disease. Here we present a patient with a clinical diagnosis of posterior cortical atrophy who harbors a novel Presenilin 1 mutation (I211M). In silico analysis predicts that the mutation could influence the interaction between presenilin 1 and presenilin1 enhancer-2 protein, a protein partner within the γ-secretase complex. These findings along with published literature support the inclusion of posterior cortical atrophy on the Alzheimer's disease spectrum. PMID:23593396

Utopia, teoria e ação:: leitura das propostas grupais na abordagem centrada na pessoa

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Maria Luisa Sandoval Schmidt

Full Text Available O presente ensaio analisa as contribuições e os problemas da visão sobre os grupos de Carl Rogers, as concepções de grupo de encontro e de encontro de comunidade e os âmbitos de sua prática, localizandoos em relação à história de constituição da abordagem centrada na pessoa, bem como os conceitos de poder e política construídos por Rogers a partir da psicoterapia centrada no cliente. Da explicitação da trama de ideias e práticas grupais deriva, assim, uma interpretação da presença da utopia e da ideologia no pensamento rogeriano. Essa leitura tem como referência as facetas construtivas e negativas da utopia e da ideologia em suas relações de oposição e complementaridade, tal como tematizadas por Paul Ricoeur.

Severe complication of posterior nasal packing: Case Report

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Pinto, José Antônio

2012-01-01

Full Text Available Introduction: Severe Epistaxis is common in patients with head trauma, especially when associated with multiple fractures of the face and skull base. Several methods of controlling bleeding that can be imposed. The anterior nasal tapenade associated with posterior Foley catheter is one of the most widespread, and the universal availability of necessary materials or their apparent ease of execution. Methods: Case report on control of severe epistaxis after severe TBI, with posterior nasal packing by Foley catheter and control tomography showing multiple fractures of the skull base and penetration of the probe into the brain parenchyma. Conclusion: This is a rare but possible complication in the treatment of severe nose bleeds associated with fracture of the skull base. This brief report highlights risks related to the method and suggests some care to prevent complications related through a brief literature review.

Severe complication of posterior nasal packing: Case Report.

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Pinto, José Antônio; Cintra, Pedro Paulo Vivacqua da Cunha; Sônego, Thiago Branco; Leal, Carolina de Farias Aires; Artico, Marina Spadari; Soares, Josemar Dos Santos

2012-10-01

 Severe Epistaxis is common in patients with head trauma, especially when associated with multiple fractures of the face and skull base. Several methods of controlling bleeding that can be imposed. The anterior nasal tapenade associated with posterior Foley catheter is one of the most widespread, and the universal availability of necessary materials or their apparent ease of execution.  Case report on control of severe epistaxis after severe TBI, with posterior nasal packing by Foley catheter and control tomography showing multiple fractures of the skull base and penetration of the probe into the brain parenchyma.  This is a rare but possible complication in the treatment of severe nose bleeds associated with fracture of the skull base. This brief report highlights risks related to the method and suggests some care to prevent complications related through a brief literature review.

Calcifying epithelial odontogenic tumor of the posterior maxilla

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Vidya Ajila

2016-01-01

Full Text Available Calcifying epithelial odontogenic tumor (CEOT is a rare odontogenic neoplasm comprising <1% of all odontogenic tumors. It is commonly seen in the third to fifth decades of life without any gender predilection. It usually occurs in the mandibular posterior region. A painless, slow growing swelling with bone expansion is the most common clinical feature of CEOT. Radiographically, it presents as a mixed lesion with or without an associated impacted tooth. Confirmation of the diagnosis is by histopathological examination. We describe an unusual case of CEOT occurring in the maxillary posterior region and involving the maxillary sinus. The associated impacted third molar was displaced to the lateral wall of the nose and root resorption was seen in all the teeth associated with the lesion. There was no evidence of calcification in conventional as well as computed tomography images.

Data analysis in emission tomography using emission-count posteriors

International Nuclear Information System (INIS)

Sitek, Arkadiusz

2012-01-01

A novel approach to the analysis of emission tomography data using the posterior probability of the number of emissions per voxel (emission count) conditioned on acquired tomographic data is explored. The posterior is derived from the prior and the Poisson likelihood of the emission-count data by marginalizing voxel activities. Based on emission-count posteriors, examples of Bayesian analysis including estimation and classification tasks in emission tomography are provided. The application of the method to computer simulations of 2D tomography is demonstrated. In particular, the minimum-mean-square-error point estimator of the emission count is demonstrated. The process of finding this estimator can be considered as a tomographic image reconstruction technique since the estimates of the number of emissions per voxel divided by voxel sensitivities and acquisition time are the estimates of the voxel activities. As an example of a classification task, a hypothesis stating that some region of interest (ROI) emitted at least or at most r-times the number of events in some other ROI is tested. The ROIs are specified by the user. The analysis described in this work provides new quantitative statistical measures that can be used in decision making in diagnostic imaging using emission tomography. (paper)

Data analysis in emission tomography using emission-count posteriors

Science.gov (United States)

Sitek, Arkadiusz

2012-11-01

A novel approach to the analysis of emission tomography data using the posterior probability of the number of emissions per voxel (emission count) conditioned on acquired tomographic data is explored. The posterior is derived from the prior and the Poisson likelihood of the emission-count data by marginalizing voxel activities. Based on emission-count posteriors, examples of Bayesian analysis including estimation and classification tasks in emission tomography are provided. The application of the method to computer simulations of 2D tomography is demonstrated. In particular, the minimum-mean-square-error point estimator of the emission count is demonstrated. The process of finding this estimator can be considered as a tomographic image reconstruction technique since the estimates of the number of emissions per voxel divided by voxel sensitivities and acquisition time are the estimates of the voxel activities. As an example of a classification task, a hypothesis stating that some region of interest (ROI) emitted at least or at most r-times the number of events in some other ROI is tested. The ROIs are specified by the user. The analysis described in this work provides new quantitative statistical measures that can be used in decision making in diagnostic imaging using emission tomography.

CT and MRI diagnosis of posterior fossa atypical ependymoma

International Nuclear Information System (INIS)

Yu Bolang; Zhang Ming; Luo Lin; Wang Shijie; Zhu Liping

2000-01-01

Objective: To analyse the CT and MRI features of posterior fossa atypical ependymoma. Methods: Sixteen cases of posterior fossa atypical ependymoma proved by surgery and pathology had CT and (or) MRI scanning. There were 11 males and 5 females. The age ranged from 17 to 46 (mean, 31.2). Twelve cases ranged from 20 to 40 years old. the main symptoms of all cases were dizziness, unsteady walking and vomiting. Results: The locations of all cases were cerebellum (12 cases), vermis (3 cases) and cerebellopontile angle (1 cases). Fifteen cases were solid with multiple cystic changes and 1 case in the cerebellopontile angle was cystic. The tumor was usually close to the surface of cerebellum with rather extensive connection with dura mater or tentorium. Calcifications were shown in 3 cases. The tumors revealed inhomogeneous density on CT scan and inhomogeneous intensity on MRI. Mild inhomogeneous enhancement was shown in most cases, while intense irregular enhancement in the others. Conclusions: The characteristic findings of the posterior fossa atypical ependymoma ependymoma were cerebellar intraparenchymatous multiple small cystic changes within solid tumor in most cases and inhomogeneous density and intensity on CT and MRI. The differential diagnosis is meningioma, metastasis and acoustic schwannoma

Aneurysms of the anterior and posterior cerebral circulation: comparison of the morphometric features.

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Tykocki, Tomasz; Kostkiewicz, Bogusław

2014-09-01

Intracranial aneurysms (IAs) located in the posterior circulation are considered to have higher annual bleed rates than those in the anterior circulation. The aim of the study was to compare the morphometric factors differentiating between IAs located in the anterior and posterior cerebral circulation. A total number of 254 IAs diagnosed between 2009 and 2012 were retrospectively analyzed. All patients qualified for diagnostic, three-dimensional rotational angiography. IAs were assigned to either the anterior or posterior cerebral circulation subsets for the analysis. Means were compared with a t-test. The univariate and stepwise logistic regression analyses were used to determine the predictors of morphometric differences between the groups. For the defined predictors, ROC (receiver-operating characteristic) curves and interactive dot diagrams were calculated with the cutoff values of the morphometric factors. The number of anterior cerebral circulation IAs was 179 (70.5 %); 141 (55.5 %) aneurysms were ruptured. Significant differences between anterior and posterior circulation IAs were found for: the parent artery size (5.08 ± 1.8 mm vs. 3.95 ± 1.5 mm; p 45) and aspect ratio (AR) (1.91 ± 0.8 vs. 2.75 ± 1.8; p = 0.02). Predicting factors differentiating anterior and posterior circulation IAs were: the AR (OR = 2.20; 95 % CI 1.80-270; Is 270 correct or should it be 2.70 and parent artery size (OR = 0.44; 95 % CI 0.38-0.54). The cutoff point in the ROC curve was 2.185 for the AR and 4.89 mm for parent artery size. Aspect ratio and parent artery size were found to be predictive morphometric factors in differentiating between anterior and posterior cerebral IAs.

Abordagem transxifóidea sem esternotomia para correção da comunicação interatrial Transxiphoid approach without sternotomy for the correction of atrial septal defect

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Miguel Barbero-Marcial

1996-12-01

Full Text Available OBJETIVO: Avaliação de uma nova abordagem cirúrgica para fechamento da comunicação interatrial. MÉTODOS: A abordagem da comunicação interatrial através da janela xifóidea foi realizada em 6 pacientes do sexo masculino e 1 do sexo feminino e a idade variou de 6 meses a 14 anos, com média de idades de 5,1 anos. Em todos, foi utilizada acirculação extracorpórea, através de canulação da artéria femoral e átrio direito e videotoracoscopia para auxiliar a visibilização da aorta e do canal arterial, assim como das estruturas correspondentes às cavidades esquerdas. RESULTADOS: Não houve complicações intra-operatórias ou pós-operatórias e, em todos os pacientes, foi possível a extubação na sala de operações. CONCLUSÃO: A janela xifóidea, sem a abertura do esterno, permitiu a correção da comunicação interatrial com bons resultados, podendo constituir-se em uma nova abordagem, minimamente invasiva.PURPOSE: Evaluate a new access for surgical correction of atrial septal defects. METHODS: The access by xiphoid window was done in 7 cases with atria! septal defect type ostium secundum. The age ranged from 6 months to 14 years, mean-age 5.1 years old. In all cases the extracorporeal circulation was done with femoral artery and right atrial cannulation and aortic clamping. The video-assisted endoscopy was utilized to help the visualization of the aorta, ductus arteriosus and the anatomy of the left intracardiac structures. RESULTS: There was no intraoperative or postoperative complications and in our 7 cases the extubation at the operating room was possible. CONCLUSION: The xiphoid window without opening the sternum permited correction of the atrial septal defect with good results and without complications, and could be used as a new technique, less invasive, to correct these defects.

Transformation of Bayesian posterior distribution into a basic analytical distribution

International Nuclear Information System (INIS)

Jordan Cizelj, R.; Vrbanic, I.

2002-01-01

Bayesian estimation is well-known approach that is widely used in Probabilistic Safety Analyses for the estimation of input model reliability parameters, such as component failure rates or probabilities of failure upon demand. In this approach, a prior distribution, which contains some generic knowledge about a parameter is combined with likelihood function, which contains plant-specific data about the parameter. Depending on the type of prior distribution, the resulting posterior distribution can be estimated numerically or analytically. In many instances only a numerical Bayesian integration can be performed. In such a case the posterior is provided in the form of tabular discrete distribution. On the other hand, it is much more convenient to have a parameter's uncertainty distribution that is to be input into a PSA model to be provided in the form of some basic analytical probability distribution, such as lognormal, gamma or beta distribution. One reason is that this enables much more convenient propagation of parameters' uncertainties through the model up to the so-called top events, such as plant system unavailability or core damage frequency. Additionally, software tools used to run PSA models often require that parameter's uncertainty distribution is defined in the form of one among the several allowed basic types of distributions. In such a case the posterior distribution that came as a product of Bayesian estimation needs to be transformed into an appropriate basic analytical form. In this paper, some approaches on transformation of posterior distribution to a basic probability distribution are proposed and discussed. They are illustrated by an example from NPP Krsko PSA model.(author)

Quantitative imaging analysis of posterior fossa ependymoma location in children.

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Sabin, Noah D; Merchant, Thomas E; Li, Xingyu; Li, Yimei; Klimo, Paul; Boop, Frederick A; Ellison, David W; Ogg, Robert J

2016-08-01

Imaging descriptions of posterior fossa ependymoma in children have focused on magnetic resonance imaging (MRI) signal and local anatomic relationships with imaging location only recently used to classify these neoplasms. We developed a quantitative method for analyzing the location of ependymoma in the posterior fossa, tested its effectiveness in distinguishing groups of tumors, and examined potential associations of distinct tumor groups with treatment and prognostic factors. Pre-operative MRI examinations of the brain for 38 children with histopathologically proven posterior fossa ependymoma were analyzed. Tumor margin contours and anatomic landmarks were manually marked and used to calculate the centroid of each tumor. Landmarks were used to calculate a transformation to align, scale, and rotate each patient's image coordinates to a common coordinate space. Hierarchical cluster analysis of the location and morphological variables was performed to detect multivariate patterns in tumor characteristics. The ependymomas were also characterized as "central" or "lateral" based on published radiological criteria. Therapeutic details and demographic, recurrence, and survival information were obtained from medical records and analyzed with the tumor location and morphology to identify prognostic tumor characteristics. Cluster analysis yielded two distinct tumor groups based on centroid location The cluster groups were associated with differences in PFS (p = .044), "central" vs. "lateral" radiological designation (p = .035), and marginally associated with multiple operative interventions (p = .064). Posterior fossa ependymoma can be objectively classified based on quantitative analysis of tumor location, and these classifications are associated with prognostic and treatment factors.

Gliosarcoma of the posterior cranial fossa: MRI findings

International Nuclear Information System (INIS)

Nitta, H.; Hayase, H.; Moriyama, Y.; Yamashima, T.; Yamashita, J.

1993-01-01

We report the MR findings of a biopsy-proven gliosarcoma of the posterior cranial fossa. Multiple homogeneously enhancing lesions had shaggy margins and broad-based dural attachments, which may reflect the gliomatous and sarcomatous element of this tumour. (orig.)

Surgical Anatomy of the Vertebrobasilar Territory and Posterior ...

African Journals Online (AJOL)

RESULTS: The male: female ratio was 1.9:1 and a mean age of 44 years. Statistical analysis showed significant differences between the sizes of posterior inferior cerebellar arteries and ... Fifty-six percent of the brains had no anomalies.

The flying buttress construct for posterior spinopelvic fixation: a technical note

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van Ooij Bas

2011-04-01

Full Text Available Abstract Background Posterior fusion of the spine to the pelvis in paediatric and adult spinal deformity is still challenging. Especially assembling of the posterior rod construct to the iliac screw is considered technically difficult. A variety of spinopelvic fixation techniques have been developed. However, extreme bending of the longitudinal rods or the use of 90-degree lateral offset connectors proved to be difficult, because the angle between the rod and the iliac screw varies from patient to patient. Methods We adopted a new spinopelvic fixation system, in which iliac screws are side-to-side connected to the posterior thoracolumbar rod construct, independent of the angle between the rod and the iliac screw. Open angled parallel connectors are used to connect short iliac rods from the posterior rod construct to the iliac screws at both sides. The construct resembles in form and function an architectural Flying Buttress, or lateral support arches, used in Gothic cathedrals. Results and discussion Three different cases that illustrate the Flying Buttress construct for spinopelvic fixation are reported here with the clinical details, radiographic findings and surgical technique used. Conclusion The Flying Buttress construct may offer an alternative surgical option for spinopelvic fixation in circumstances wherein coronal or sagittal balance cannot be achieved, for example in cases with significant residual pelvic obliquity, or in revision spinal surgery for failed lumbosacral fusion.

The flying buttress construct for posterior spinopelvic fixation: a technical note

Science.gov (United States)

2011-01-01

Background Posterior fusion of the spine to the pelvis in paediatric and adult spinal deformity is still challenging. Especially assembling of the posterior rod construct to the iliac screw is considered technically difficult. A variety of spinopelvic fixation techniques have been developed. However, extreme bending of the longitudinal rods or the use of 90-degree lateral offset connectors proved to be difficult, because the angle between the rod and the iliac screw varies from patient to patient. Methods We adopted a new spinopelvic fixation system, in which iliac screws are side-to-side connected to the posterior thoracolumbar rod construct, independent of the angle between the rod and the iliac screw. Open angled parallel connectors are used to connect short iliac rods from the posterior rod construct to the iliac screws at both sides. The construct resembles in form and function an architectural Flying Buttress, or lateral support arches, used in Gothic cathedrals. Results and discussion Three different cases that illustrate the Flying Buttress construct for spinopelvic fixation are reported here with the clinical details, radiographic findings and surgical technique used. Conclusion The Flying Buttress construct may offer an alternative surgical option for spinopelvic fixation in circumstances wherein coronal or sagittal balance cannot be achieved, for example in cases with significant residual pelvic obliquity, or in revision spinal surgery for failed lumbosacral fusion. PMID:21489256

Posterior midline cervical fetal cystic hygroma.

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Oak S

1992-04-01

Full Text Available Posterior midline cervical cystic hygromas (PMC are frequently found associated with chromosomal aberrations and usually do not survive. The present report illustrates diagnosis of this condition by sonography in an 18 weeks old fetus and an amniocentesis revealed 45 x0 karyotype and increased concentration of alpha-fetoproteins. Pregnancy was terminated in view of Turner′s syndrome. The etiology and natural history of the condition is reviewed.

Complications in posterior lumbar interbody fusion

OpenAIRE

Kreuzer, Rolf-Peter

2010-01-01

From 1993 to 2000, 220 consecutive patients with unstable degenerative spondylolisthesis were studied after posterior lumbar interbody fusion (PLIF) using different types of grafts and pedicle screw systems. In a retrospective review the author detail the associated complications and their correlation with perioperative factors. The causes, strategies for their avoidance, and the clinical course of these complications are also disscused. The study group was composed of 136 women and 84 men...

Fluoroscopically-Guided Posterior Approach for Shoulder Magnetic Resonance Arthrography: Comparison with Conventional Anterior Approach

International Nuclear Information System (INIS)

Yoo, Koun J.; Ha, Doo Hoe; Lee, Sang Min

2011-01-01

To prospectively evaluate the usefulness of the fluoroscopically-guided posterior approach compared with the anterior approach for shoulder magnetic resonance(MR) arthrography. Institutional review board approval and informed consent were obtained. Among 60 shoulder MR arthrographies performed on 59 patients with symptomatic shoulders, an intra-articular injection was performed (30 cases using the anterior approach and 30 using the posterior approach). Procedure-related pain was assessed by using a 5 score visual analogue scale (VAS). Depth of the puncture and standardized depth of puncture by body mass index (BMI) were recorded. The contrast leakage along the course of the puncture was evaluated by reviewing the MR. The statistical analyses included the Mann-Whitney U and Kruskal-Wallis test. There was no significant difference in VAS scores between the anterior and posterior groups (1.77 ± 1.10 vs. 1.80 ± 0.96). Depth of puncture and standardized depth of puncture by BMI were significantly shorter in the posterior group than those in the anterior group (4.4 ± 0.8 cm and 1.8 ± 0.3 cm vs. 6.6 ± 0.9 cm and 2.8 ± 0.4 cm, p < 0.001), respectively. The incidence of contrast leakage was more frequent in the posterior group (p = 0.003). The posterior approach will be useful in shoulder MR arthrography with a suspected anterior pathology, a postoperative follow-up study or obese patient.

Posterior treatment of delayed traumatic atlantoaxial joint dislocation with apofix internal fixation

International Nuclear Information System (INIS)

Qing Wei; Jiang Weimin; Shi Jinhui; Li Xuefeng; Yang Huilin; Tang Tiansi

2010-01-01

Objective: To assess the effect of posterior fixation and fusion with Apofix device for the treatment of delayed traumatic atlantoaxial joint dislocation. Methods: Eighteen patients with delayed traumatic atlantoaxial joint dislocation were included. Posterior fixation and fusion with Apofix device were performed. First step was one or two week skull traction. After the atlantoaxial joint dislocation had been reduced, the posterior fixation and fusion with Apofix was performed. Using local anaesthesia, atlantoaxial interval and posterior structure of atlas and dentata were exposed by midline operative approach. Apofix interlaminar clamps were placed at posterior arch of atlas and odontoid vertebral laminae, autologous iliac bone graft was placed for fusion. Then the device to proper position was pressurized and items locked. Results: All of the patients were followed up, the mean follow-up period was 38 months (13 ∼ 84 months). Fifteen patients obtained complete reduction, the others were partial reduction. Seventeen patients had successful fusion after 3 or 4 months, only 1 patient who had partial reduction had internal fixation loose and nonfusion, leading to recurrence of atlantoaxial joint dislocation. An occipitocervical fusion surgery was performed on this patient. As to neurological assessment, 16 patients had neurological deficit before operation, while 6 of them recovered completely after operation, another 10 patients' neurological status improved significantly. JOA score was improved from 9.5 pre-operative to 15.8 post-operative. Conclusion: Apofix internal fixation and fusion seems to be feasible in treatment of delayed traumatic atlantoaxial joint dislocation. Successful reduction before operation and proper treatment after operation is also important. (authors)

Passive Posterior Tibial Subluxation on Routine Knee MRI as a Secondary Sign of PCL Tear

International Nuclear Information System (INIS)

Degnan, A.J.; Adam, R.J.; Maldjian, C.; Harner, Ch.D.

2014-01-01

The posterior drawer test is an accurate clinical test to diagnose posterior cruciate ligament (PCL), indicating laxity of the PCL that allows posterior tibial translation. This study aimed to determine whether posterior tibial translation relative to the femur on routine MRI could serve as an additional sign of PCL tear. Routine knee MRI in eleven patients (7 males, 4 females) with arthroscopically confirmed isolated PCL tears were reviewed independently by two musculoskeletal radiologists. Measurements of tibial translation were made in the medial and lateral compartments of patients and controls (10 males, 12 females) without clinical or MRI evidence of ligament injury. Significant medial compartment posterior tibial translation was present in patients with PCL tear compared to controls (+2.93 mm versus +0.03 mm, Ρ=0.002) with excellent interobserver agreement (intraclass correlation coefficient (ICC) = 0.94). No significant difference in lateral compartment tibial translation was observed (+0.17 mm versus -0.57 mm, Ρ=0.366) despite excellent interobserver agreement (ICC = 0.96). Posterior tibial translation in the midmedial compartment may be a secondary sign of isolated PCL tear on routine knee MRI with passive extension without manipulation or weight bearing. Additional work in a larger cohort may better address the accuracy of this finding

The isolated posterior malleolar fracture and syndesmotic instability: A case report and review of the literature

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Diederik P.J. Smeeing

Full Text Available Introduction: Ankle fractures are among the most common type of fractures in the lower extremity. A posterior malleolar fracture is frequently part of a more complex ankle fracture and only in rare cases it occurs as isolated injury. Posterior malleolar fractures often occur with associated injuries, such as a Maisonneuve fracture or with bi- or trimalleolar ligamentous injuries. Knowledge about these associated injuries is essential to prevent missed diagnoses. The aim of this article is to describe the isolated posterior malleolar fracture, the possible associated injuries, the diagnostic work-up and therapeutic consequences. Presentation of case: We present a case of a 26-year-old male patient who sustained an isolated posterior malleolar fracture with 4.5 years follow-up. Discussion: Isolated fractures of the posterior malleolus are uncommon injuries. Diagnosis, treatment and outcome can seldom be extracted from large series. However, several cases have been described in literature, which we have summarized. Conclusion: This case report and literature review shows that isolated posterior malleolar fractures might occur as part of a more complex ankle injury, in combination with a fracture of the lower leg or after high energy trauma. Physicians should be aware of these associated injuries. Diagnostic work-up should include X-rays of the knee and lower leg and a CT scan of the ankle. If diagnosed and treated properly, isolated posterior malleolar fractures have a good long-term functional outcome. Keywords: Ankle fracture, Earle’s fracture, Syndesmotic fixation, Unimalleolar fracture, Volkmann’s fracture, Posterior malleolar fracture

Sindrome de encefalopatia posterior reversível: relato de caso Reversible posterior encephalopathy syndrome: case report

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Francine Judith Freitas Fernandes

2002-09-01

Full Text Available A encefalopatia posterior reversível é uma síndrome aguda / subaguda geralmente causada pela encefalopatia hipertensiva, eclâmpsia, neurotoxicidade a ciclosporina-A, encefalopatia urêmica e púrpura trombocitopênica trombótica.. A maioria dos pacientes apresenta elevação acentuada dos níveis tensionais outros, níveis moderados ou normais. Os sintomas são progressivos e compreendem cefaléia, diminuição do nível de consciência, crises epilépticas e distúrbios visuais. A sintomatologia regride completamente se corrigidas em tempo as causas determinantes, caso contrário, podem instalar-se danos irreversíveis como a cegueira cortical e morte. A tomografia computadorizada (TC e, sobretudo, a ressonância magnética (RM contribuem para o diagnóstico. Tais métodos evidenciam edema da substância branca e cinzenta, principalmente das regiões parieto-occipitais. Os achados podem apresentar dificuldade no diagnóstico, hoje superado em parte, com a técnica de difusão pela RM, capaz de diferenciar edema citotóxico de vasogênico. Apresentamos um caso de encefalopatia posterior reversível decorrente de encefalopatia hipertensiva estudada com TC e RM.The posterior reversible leukoencephalopathy syndrome (PRES is a recently proposed cliniconeuroradiologic entity.The most common causes of PRES are hypertensive encephalopathy, eclampsia, cyclosporin A neurotoxicity and the uremic encephalopathies.Most patients are markedly hypertensive at presentation, although some have only middly elevated or even normal blood pressure. Symptoms may include headache, nausea , vomiting, altered mental status, seizures,stupor, and visual disturbances. On CT and MR studies, edema has been reported in a relatively symmetrical pattern, typically in the subcortical white matter and occasionally in the cortex of the occipital and parietal lobes. These often striking imaging findings usually are resolved on follow-up studies obtained after appropiate

Posterior reversible encephalopathy syndrome in a adult female

African Journals Online (AJOL)

occipital regions. Atypical imaging finding of contrast enhancement of lesion can occur, but is less common. A 20‑year‑old primiparous lady presented with posterior reversible encephalopathy syndrome. To the best of our knowledge, this is the first ...

Abordagem atual dos pacientes com doença de Hodgkin Current approach to patients with Hodgkin's disease

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Nelson Spector

2004-03-01

Full Text Available Nos últimos anos, houve um progresso substancial na abordagem do paciente com doença de Hodgkin. Uma nova classificação histopatológica foi adotada, e fatores prognósticos reprodutíveis foram identificados. Os pacientes são tratados de acordo com o estádio clínico e, no caso de pacientes com doença localizada, também de acordo com os fatores prognósticos. Uma consistente série de estudos em pacientes com doença localizada tornou obsoleta a realização de laparotomia e a abordagem radioterápica isolada. Nos pacientes com doença avançada, o ABVD emergiu como o regime com a melhor relação risco/benefício após uma dura seqüência de comparações com o MOPP e combinações de MOPP e ABVD. Dois regimes inovadores estão em testes, o Stanford V e o BEACOPP. Entretanto, o avanço dos resultados terapêuticos depende da redução da toxicidade nos pacientes de baixo risco e da melhora do controle da doença nos pacientes de alto risco.In recent years, significant progress has been made in the approach to the patient with Hodgkin's disease. A new histopathologic classification has been adopted and reproducible prognostic factors have been recognized. Patients are treated according to their clinical stage and, in patients with early-stage disease, also according to their prognostic factors. A consistent sequence of studies in patients with early-stage disease has made laparotomy followed by radiation therapy obsolete. In patients with advanced disease, ABVD emerged as the regimen with the best risk/benefit ratio after a hard series of direct comparisons against MOPP and combinations of MOPP and ABVD. Two innovative regimens, Stanford V and BEACOPP, are currently undergoing a thorough evaluation. However, the improvement of treatment outcome is ultimately dependent on reducing the therapy-related toxicity for patients with low-risk disease, while improving disease control for patients with poor-risk disease through a risk

Early Vitreous Surgery in the Treatment of Aggressive Posterior Retinopathy of Prematurity

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A. V. Tereshhenko

2017-01-01

Full Text Available The goal is to identify objective indications for early primary vitreous surgery in infants with aggressive posterior ROP and to develop a methodology. Patients and methods. The study included 20 preterm infants (40 eyes with aggressive posterior ROP at the stage of formation exudative-tractional retinal detachment, which were divided into two groups. The main group consisted of 10 infants (20 eyes with severe manifestations of aggressive posterior ROP. The control group included 10 premature infants (20 eyes with aggressive posterior ROP, who underwent transpupillary laser coagulation of the retina (LC. In all cases (20 eyes 5-8 days after LC was recorded the progression of the disease. Based on data from a complex ophthalmic examination, given the progression of the disease after LC in the control group and baseline severe aggressive posterior ROP in the main group with the control with identical clinical picture, patients in both groups was made early vitreous surgery: in the main group — after ophthalmological examination and control after 8-16 days after LC. Results. In the main group after 6 months in 15 eyes (75% formed the correct vitreomacular interface, in 5 cases (25% were diagnosed with the smoothness of the foveolar pits by sealing the internal limiting membrane with no signs of retinal edema. In the control group after 6 months in 6 eyes (30% formed the right macular interface in 11 (55% — was defined by flatness or lack foveolar pit with no signs of retinal edema. On 3 eyes (15% in the 2nd zone remained a local retinal detachment. Conclusion. Primary vitrectomy performed according to the developed indications, allows to optimize the treatment of patients with aggressive posterior ROP in cases of inefficiency of the LC. It is an alternative and pathogenetically substantiated technology, which efficiency is not inferior to the traditional approach, including LС followed by vitreous surgery.

Anterior capsular support for posterior chamber intraocular lenses following vitreous loss in endocapsular surgery

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Jacob Pushpa

1993-01-01

Full Text Available We used anterior capsular support for posterior chamber intraocular lenses (PC IOLs in fourteen eyes with large posterior capsular ruptures. An endocapsular technique preserved the anterior capsule and facilitated implantation. With a median follow up of 8.5 months, all patients had a visual acuity of 6/9 or better. One lens was lost in the vitreous and one patient had a clinically significant cystoid macular edema. In the event of a posterior capsular rupture we suggest this technique as an alternative to anterior chamber or scleral-fixated lenses

Posterior rib fractures in a young infant who received chiropractic care.

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Wilson, Paria Majd; Greiner, Mary V; Duma, Elena M

2012-11-01

We report on a 21-day-old infant with healing posterior rib fractures that were noted after a chiropractic visit for colic. Chiropractors are the third largest group of health care professionals in the United States, and colic is the leading complaint for pediatric chiropractic care. Rib fractures, specifically when posterior, are traditionally considered to be secondary to nonaccidental trauma. Thorough investigation is necessary to rule out bone fragility and genetic disorders, but patient history is key when evaluating unexplained fractures.

Lumbar Posterior Apophyseal Ring Fracture Combined with Spondylolysis in Pediatric Athletes: A Report of Three Cases.

Science.gov (United States)

Tamaki, Shunsuke; Yamashita, Kazuta; Higashino, Kosaku; Sakai, Toshinori; Takata, Yoichiro; Sairyo, Koichi

2016-01-01

Lumbar posterior apophyseal ring fracture is an uncommon finding in children, but lumbar spondylolysis is a common disorder. Both disorders are prevalent in young athletes. We describe 3 adolescent athletes who showed both lumbar spondylolysis and lumbar posterior apophyseal ring fracture. Because lumbar spondylolysis is comparatively easy to diagnose, a concurrent posterior lumbar apophyseal ring fracture is likely to be overlooked. In patients with severe low back and radicular pain in whom spondylolysis is suspected, it is important to perform not only magnetic resonance imaging and radiography but also computed tomography for identifying posterior apophyseal ring fractures.

Restoration of the endodontically treated posterior tooth

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Andrea Polesel

2014-06-01

Results and conclusions: Direct adhesive restorations, indirect bonded restorations and traditional full crown are three therapeutic options for the single posterior endodontically treated teeth. The amount of remaining sound tooth structure is the most significant factor influencing the therapeutic approach. The clinician's operative skill is a determining aspect for long-term success of adhesive inlays.

Uma abordagem semiótica e indicial da identidade na era de YouTube

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Fernando Andacht

2015-12-01

Full Text Available O artigo estuda os efeitos comunicacionais e imaginários produzidos pelos vlogs, quer autênticos, quer falsos, no YouTube através de alguns casos célebres na história desse site para carregar e compartilhar vídeos. Em muitas dessas produções audiovisuais há um predomínio dos signos indiciais – a classe de significação que surge do contato do signo com seu objeto, como as pegadas ou os sintomas. Na época atual, estes signos são muito procurados pelos públicos para satisfazer o interesse coletivo por um corpo a corpo com os realizadores amadores – ou aqueles que se apresentam assim – de vlogs autobiográficos. A abordagem teórica da semiótica triádica de Peirce é usada para a análise da identidade humana na era da internet, e também para uma análise da dúvida sobre o autêntico e seu oposto, o simulado, um elemento inseparável dessa experiência midiática

Posterior superior temporal sulcus responses predict perceived pleasantness of skin stroking

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Monika Davidovic

2016-09-01

Full Text Available Love and affection is expressed through a range of physically intimate gestures, including caresses. Recent studies suggest that posterior temporal lobe areas typically associated with visual processing of social cues also respond to interpersonal touch. Here, we asked whether these areas are selective to caress-like skin stroking. We collected functional magnetic resonance imaging (fMRI data from 23 healthy participants and compared brain responses to skin stroking and vibration. We did not find any significant differences between stroking and vibration in the posterior temporal lobe; however, right posterior superior temporal sulcus (pSTS responses predicted healthy participant's perceived pleasantness of skin stroking, but not vibration. These findings link right pSTS responses to individual variability in perceived pleasantness of caress-like tactile stimuli. We speculate that the right pSTS may play a role in the translation of tactile stimuli into positively valenced, socially relevant interpersonal touch and that this system may be affected in disorders associated with impaired attachment.

Acute Spontaneous Posterior Fossa Subdural Hematoma

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Osama Shukir Muhammed Amin

2014-02-01

Full Text Available Acute posterior fossa subdural hematomas are rare and most of them are trauma-related. Non-traumatic ones have been reported in patients who had idiopathic thrombocytopenic purpura or those who had been receiving anticoagulant therapy. We report on the case of 57-year-old Iranian man who developed sudden severe occipital headache, drowsiness, repeated vomiting, and instability of stance and gait. He was neither hypertensive nor diabetic. No history of head trauma was obtained and he denied illicit drug or alcohol ingestion. A preliminary diagnosis of acute intra-cerebellar hemorrhage was made. His CT brain scan revealed an acute right-sided, extra-axial, crescent-shaped hyperdense area at the posterior fossa. His routine blood tests, platelets count, bleeding time, and coagulation profile were unremarkable. The patient had spontaneous acute infratentorial subdural hematoma. He was treated conservatively and discharged home well after 5 days. Since then, we could not follow-up him, clinically and radiologically because he went back to Iran. Our patient’s presentation, clinical course, and imaging study have called for conservative management, as the overall presentation was relatively benign. Unless the diagnosis is entertained and the CT brain scan is well-interpreted, the diagnosis may easily escape detection.

Bayesian posterior distributions without Markov chains.

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Cole, Stephen R; Chu, Haitao; Greenland, Sander; Hamra, Ghassan; Richardson, David B

2012-03-01

Bayesian posterior parameter distributions are often simulated using Markov chain Monte Carlo (MCMC) methods. However, MCMC methods are not always necessary and do not help the uninitiated understand Bayesian inference. As a bridge to understanding Bayesian inference, the authors illustrate a transparent rejection sampling method. In example 1, they illustrate rejection sampling using 36 cases and 198 controls from a case-control study (1976-1983) assessing the relation between residential exposure to magnetic fields and the development of childhood cancer. Results from rejection sampling (odds ratio (OR) = 1.69, 95% posterior interval (PI): 0.57, 5.00) were similar to MCMC results (OR = 1.69, 95% PI: 0.58, 4.95) and approximations from data-augmentation priors (OR = 1.74, 95% PI: 0.60, 5.06). In example 2, the authors apply rejection sampling to a cohort study of 315 human immunodeficiency virus seroconverters (1984-1998) to assess the relation between viral load after infection and 5-year incidence of acquired immunodeficiency syndrome, adjusting for (continuous) age at seroconversion and race. In this more complex example, rejection sampling required a notably longer run time than MCMC sampling but remained feasible and again yielded similar results. The transparency of the proposed approach comes at a price of being less broadly applicable than MCMC.

[Posterior partial trochanteric osteotomy for the treatment of the roof involved acetabular fractures].

Science.gov (United States)

Wang, Pan-Feng; Xu, Shuo-Gui; Zhang, Chun-Cai; Fu, Qing-Ge; Zhang, Yun-Tong; Liu, Xin-Wei; Niu, Yun-Fei; Tang, Yang

2013-11-01

To introduce a new trochanteric osteotomy,and evaluate the outcome of the procedure combined a posterior lateral approach in treating acetabular fractures which involving the roof. Between March 2007 and Novmber 2010,30 patients with displaced acetabular fractures involving the dome need trochanteric osteotomy were retrospectively reviewed. There were 21 males and 9 females,ranging in age from 18 to 70 years with an average of 35.2 years at the time of injury. According to Letournel-Judet classification, there were 10 posterior wall fractures,7 posterior column fractures,5 transverse fractures, 2 T-shape fractures, 1 transverse associated with posterior wall fracture, 3 posterior column and wall fractures and 2 bicolumn fractures. The standards of Matta,the modified Merle d'Aubigne-Postel, Medical Research Council were respectively used to evaluate the reduction result, function of hip joint and the strength of hip abduction. All patients were followed up with an average time of 25 months (18 to 40) and all osteotomy sites obtained bone union with an average time of 8.4 weeks (6 to 12). No bone non-union, bone block displaceing, internal fixation looseing and breaking,infection of deep part were found. Seventeen patients got anatomic reduction, 12 got satisfied reduction, and 1 got unsatisfied result according to the criteria of Matta. At final follow-up, function of hip joint obtained excellent results in 11 cases, good in 15, fair in 3 and poor in 1. The strength of the abductors of 3 patients were grade 4 and 27 patients were grade 5. Posterior partial great trochanteric osteotomy can enhance the exposure and provide a more accurate reduction and degrade the difficulty of acetabular fracture fixation without increasing the risk of complications. The method provide a new way for the treatment of the roof involved acetabular fractures.

Ossificação do ligamento longitudinal posterior na coluna cervical: relato de caso Ossification of the posterior longitudinal ligament in the cervical spine: case report

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ROSANA HERMINIA SCOLA

1998-09-01

Full Text Available A ossificação do ligamento longitudinal posterior (OLLP é causa incomum de mielopatia compressiva na população caucasiana. É relatado o caso de um paciente do sexo masculino com um quadro de paraparesia espástica, cuja investigação radiológica mostrou OLLP. O raio-X de coluna cervical mostrou imagem laminar, vertical, com densidade óssea, posterior aos corpos vertebrais, que se estendia de C2 a T1. A tomografia computadorizada (TC e a mielotomografia mostravam OLLP causando compressão medular ântero-posterior no segmento descrito. Na ressonância magnética, observou-se área de hiperintensidade em T2 no segmento C7-T1, compatível com mielomalácia. O paciente foi submetido a laminoplastia tipo "open-door", com melhora do quadro parético dos membros inferiores. A OLLP deve entrar no diagnóstico diferencial das mielopatias cervicais, sendo facilmente diagnosticada através de radiografias e TC da coluna cervical. São revisados os aspectos clínicos e radiológicos e o tratamento da OLLP.Ossification of the posterior longitudinal ligament (OPLL is an uncommon cause of compressive myelopathy in the Caucasian population. A case of spastic paraparesis in a Caucasian man whose radiological investigation showed OPLL is presented. The radiographs of the cervical spine showed a strip of bony density posterior to the vertebral bodies, extending from C2 to T1. Computerized tomography (CT and CT myelography showed OPLL at the same level. Magnetic resonance showed an area of increased signal on T2-weighted sequences at C7-T1 level suggestive of myelomalacia. The patient underwent an open-door laminoplasty (C2 to C7 with improvement of the paraparesis. OPLL should be included in the differential diagnosis of cervical myelopathy. It can be easily detected by plain radiographs and CT of the cervical spine. A review of the clinical and radiological features and the treatment of OPLL is presented.

Em busca de uma abordagem não atomizada para o exame das relações entre liderança transformacional e comprometimento organizacional

OpenAIRE

Maciel, Cristiano de Oliveira; Nascimento, Mauricio Reinert

2013-01-01

As pesquisas tradicionais sobre liderança fazem uso de uma abordagem atomizada, que desconsidera os efeitos de diferentes padrões (gestalts) do construto e prioriza a lógica de uma variável por vez. A partir dessa crítica, o objetivo no presente trabalho é analisar a relação de distintas gestalts (configurações) de liderança transformacional com o comprometimento organizacional. Para a consecução desse objetivo, foram analisados 331 questionários de funcionários de oito organizações do setor ...

A and B mode ultrasonography in preoperative evaluation of lens and posterior segment of dogs eyes with cataract

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Bianca C. Martins

2010-02-01

Full Text Available Ultrasonography of the lens and posterior segment is an indispensable step in the preoperative evaluation of dogs with cataracts, since ophthalmoscopy is not feasible when there is opacification of the lens. This study evaluated the echographic conditions of cataractous lens and fundus of the eye in dogs affected by cataracts. The study was conducted in 30 dogs (56 eyes, 10 males and 20 females, with different types of cataracts at different stages of development. Echography in A and B modes, simultaneously, was carried out for the examination of the lens and posterior segment. The examinations revealed anterior cortical, posterior cortical and nuclear cataract in 12 eyes (21.4%, anterior cortical, posterior cortical, nuclear and posterior capsular in 23 eyes (41%, anterior cortical, posterior cortical and posterior capsular cataract in one eye (1.7%, anterior cortical and nuclear cataract in one eye (1.7%, anterior cortical, nuclear and posterior capsular cataract in five eyes (8.9%, and anterior cortical cataract in seven eyes (12.5%. Abnormal ultrasonographic alterations were observed in the posterior segment in 26 eyes evaluated (46.4%. Vitreal degeneration was detected in 12 eyes (21.4%, images of vitreal exudate or hemorrhage in seven eyes (12.5%, persistence of hyaloid artery in four eyes (7.1% and lens subluxation in three eyes (5.3%. The results obtained reiterate the importance of ultrasonography in canine patients presented for cataract surgery given that alterations of the posterior segment are difficult to identify in a clinical examination when the lens is opacified.A ultrassonografia do segmento posterior do bulbo do olho é etapa indispensável na avaliação de cães com catarata que serão submetidos à facectomia, uma vez que a oftalmoscopia não é factível quando há opacificação da lente, notadamente nas cataratas maduras. Este estudo avaliou as condições ecográficas da lente cataratogênica e do fundo de olho de c

Cerebellar Mutism Syndrome and Other Complications After Surgery in the Posterior Fossa in Adults

DEFF Research Database (Denmark)

Wibroe, Morten; Rochat, Per; Juhler, Marianne

2018-01-01

BACKGROUND: Cerebellar mutism syndrome (CMS) is rarely described in adults; however, data on self-assessed linguistic complications after posterior fossa surgery do not exist. METHODS: Through a prospective single-center study, data on 59 tumor operations in the posterior fossa were collected pre...

Posterior arch defects of the cervical spine

Energy Technology Data Exchange (ETDEWEB)

Schwartz, A.M.; Wechsler, R.J.; Landy, M.D.; Wetzner, S.M.; Goldstein, S.A.

1982-05-01

Spondylolysis and absence of the pedicle are congenital anomalies of the posterior cervical spine. Their roentgenographic changes may be confused with other more serious entities which may necessitate either emergent therapy or require extensive diagnostic testing and treatment. Four cases are present and the literature is reviewed. A hypothesis for the embryologic etiology of these entities is proposed.

Posterior arch defects of the cervical spine

International Nuclear Information System (INIS)

Schwartz, A.M.; Wechsler, R.J.; Landy, M.D.; Wetzner, S.M.; Goldstein, S.A.

1982-01-01

Spondylolysis and absence of the pedicle are congenital anomalies of the posterior cervical spine. Their roentgenographic changes may be confused with other more serious entities which may necessitate either emergent therapy or require extensive diagnostic testing and treatment. Four cases are present and the literature is reviewed. A hypothesis for the embryologic etiology of these entities is proposed. (orig.)

[Displacement of the posterior part of the eyeball in myopia].

Science.gov (United States)

Akizawa, Yasuko; Masahiro, Ida

2006-12-01

The principal aim of this study was to investigate displacement of the posterior part of the eyeball within the muscle cone in myopic eyes, particularly in moderately myopic subjects as well as in high myopes. Secondly, the correlation of the amount of displacement and the outer axial length of the globe was studied. The direction of displacement was also examined to clarify whether the eyeball tends to shift toward a certain direction. Seven patients with moderate myopia (moderate myopia group), fifteen patients with high myopia without esotropia (high myopia group), five patients with high myopia and esotropia (myopic esotropia group), and twenty-two controls (control group) were examined. Using magnetic resonance imaging, the outer axial length and the displacement of the posterior portion of the eyeball in the muscle cone were measured. In order to eliminate interindividual differences in the facial configuration, the coronal scanning was done perpendicularly to the orbital axis. The displacement was measured in a plane 4 mm anterior to the globe-optic nerve junction. The displacement was represented by the distance and direction of the globe center from the center of the muscle cone. In the moderate myopia group, there was no displacement of the posterior part of the eyeball in the muscle cone. It was the same as in the control group. But among the three groups, the displacement (mean standard deviation) was significantly greater in the myopic esotropia group (1.53 +/- 0.49 mm) and the high myopia group (0.94 +/- 0.52 mm) than in the control group (0.11 +/- 0.18 mm) (one way ANOVA and multiple comparison). The outer axial length and the distance of the displacement in all cases was significantly correlated (r = 0.87, p = 0.01). Moreover, the posterior part of the eyeball of the myopic esotropia group and the high myopia group was displaced superiorly and temporally. The posterior part of the eyeball of myopic eyes was displaced superotemporally in the muscle

Paism: um marco na abordagem da saúde reprodutiva no Brasil

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Osis Maria José Martins Duarte

1998-01-01

Full Text Available O Programa de Assistência Integral à Saúde Mulher (PAISM foi lançado pelo Ministério da Saúde em 1983, sendo anunciado como uma nova e diferenciada abordagem da saúde da mulher. Paradoxalmente, o PAISM constitui-se também na primeira vez em que o Estado brasileiro propôs explicitamente, e implantou, embora de modo parcial, um programa que contemplava a regulação da fecundidade. Isso suscitou suspeitas acerca de possíveis intenções ocultas de controle da natalidade. Porém, analisando brevemente a história desse Programa e seu significado social, conclui-se que o PAISM foi pioneiro, inclusive no cenário mundial, ao propor o atendimento à saúde reprodutiva das mulheres, no âmbito da atenção integral à saúde, e não mais a utilização de ações isoladas em planejamento familiar. Por isso mesmo, os movimentos de mulheres, de imediato, passaram a lutar por sua implementação. Seu conteúdo inclui plenamente a definição de saúde reprodutiva adotada pela Organização Mundial da Saúde em 1988, ampliada e consolidada no Cairo em 1994 e em Beijing em 1995. Conseqüentemente, a adoção do PAISM representou, sem dúvida, um passo significativo em direção ao reconhecimento dos direitos reprodutivos das mulheres, mesmo antes que essa expressão ganhasse os diversos foros internacionais de luta.

Magnetic resonance imaging signal intensity of temporomandibular joint disk and posterior attachment in patients with internal derangement

International Nuclear Information System (INIS)

Jeong, Yeon Hwa; Cho, Bong Hae

2001-01-01

To analyze the possible association between magnetic resonance imaging signal intensity of temporomandibular joint disk and posterior attachment, and the type and extent of disk displacement, disk donfiguration, effusion and clinical signs in patients with internal derangement. Magnetic resonance images of the 132 temporomandibular joints of 66 patients with temporomandibular joint displacement were analyzed. The clinical findings were obtained by retrospective review of the patients' records. The type and extent of disk displacement, disk configuration and effusion were evaluated on the proton density MR images. The signal intensity from the anterior band, posterior band and posterior attachment were measured on MR images. The associations between the type and extent of disk displacement, disk configuration, effusion and clinical signs and the MR signal intensity of disk and posterior attachment were statistically analyzed by student's t-test. Of 132 joints, 87 (65.9%) showed anterior disk displacement with reduction (ADR) and 45 (34.1%) showed anterior disk displacement without reduction (ADnR). This signals from posterior attachments were lower in joints with ADnR than those of ADR (p<0.05). The results showed statistically significant (p<0.05) association between the type and extent of disk displacement and disk configuration, and decreased signal intensity of posterior attachment. There were no statistical associations between pain, noise and limited mouth opening, and signal intensity of disk and posterior attachment. The average signal from posterior attachment was lower in joints with ADnR than that of ADR. The type and extent of disk displacement and disk configuration appeared to be correlated with the signal intensity from posterior attachment

Microanatomical bases for intraoperative division of the posterior communicating artery.

Science.gov (United States)

Gabrovsky, N

2002-11-01

Micro-anatomical parameters of the hypoplastic posterior communicating artery (PCoA) are assessed and compared with the micro-anatomical parameters of the adult type PCoA. Based on the results obtained, the safest place is proposed for PCoA division during basilar tip aneurysm surgery via the pterional route. In 35 human cadaver brains, red coloured latex was injected and micro-anatomical dissection was performed. Seventy PCoA were found. Adult type PCoA was found in 29 cases (41.43%) with mean length 12.58 mm. Reduction of the PCoA diameter from its anterior to its posterior third by up to 20% was found in 27% and by more than 20% in 10% of the cases. The mean perforating vessel number was 8.17, distributed in each third: 3.48, 2.90 and 1.79, respectively. A hypoplastic PCoA was found in 33 cases (47.14%) with mean length 16.09 mm. The PCoA's diameter reduction by up to 20% was found in 24% and by more in 27% of the cases. In 6% of the cases an extreme reduction by up to 70% was observed. The mean perforating vessel (PV) number was 8.82, distributed in each third: 3.18, 3.36 and 2.27, respectively. Hypoplastic PCoA tends to be longer and with a more distinct diameter reduction from the anterior to the posterior third than the adult type PCoA. The PV anatomical parameters are similar for both groups. The posterior third of the PCoA seems to be the area where the risk of perforating vessel damage is the least when performing intra-operative PCoA division.

Foot segmental motion and coupling in stage II and III tibialis posterior tendon dysfunction.

Science.gov (United States)

Van de Velde, Maarten; Matricali, Giovanni Arnoldo; Wuite, Sander; Roels, Charlotte; Staes, Filip; Deschamps, Kevin

2017-06-01

Classification systems developed in the field of posterior tibialis tendon dysfunction omit to include dynamic measurements. Since this may negatively affect the selection of the most appropriate treatment modality, studies on foot kinematics are highly recommended. Previous research characterised the foot kinematics in patients with posterior tibialis tendon dysfunction. However, none of the studies analysed foot segmental motion synchrony during stance phase, nor compared the kinematic behaviour of the foot in presence of different posterior tibialis tendon dysfunction stages. Therefore, we aimed at comparing foot segmental motion and coupling in patients with posterior tibialis tendon dysfunction grade 2 and 3 to those of asymptomatic subjects. Foot segmental motion of 11 patients suffering from posterior tibialis tendon dysfunction stage 2, 4 patients with posterior tibialis tendon dysfunction stage 3 and 15 asymptomatic subjects was objectively quantified with the Rizzoli foot model using an instrumented walkway and a 3D passive motion capture system. Dependent variables were the range of motion occurring at the different inter-segment angles during subphases of stance and swing phase as well as the cross-correlation coefficient between a number of segments. Significant differences in range of motion were predominantly found during the forefoot push off phase and swing phase. In general, both patient cohorts demonstrated a reduced range of motion compared to the control group. This hypomobility occurred predominantly in the rearfoot and midfoot (pfoot which should be considered in the decision making process since it may help explaining the success and failure of certain conservative and surgical interventions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Temporary vesicostomy-assisted urethroplasty for recurrent obliterated posterior urethral stricture.

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Liu, Jui-Ming; Wang, Ta-Min; Chiang, Yang-Jen; Chen, Hsiao-Wen; Chu, Sheng-Hsien; Liu, Kuan-Lin; Lin, Kuo-Jen

2012-01-01

We report the outcomes of temporary vesicostomy- assisted anastomotic urethroplasty in patients with recurrent obliterated posterior urethral stricture. A review of the medical records identified 12 men (mean age 35.8 years) who had undergone anastomotic urethroplasty for recurrent obliterated posterior stricture. Preoperative evaluation of the urethral defect included a simultaneous retrograde urethrogram and cystogram. The mean estimated preoperative radiographic length of the urethral disruption was 4.25 cm. All patients underwent 1-stage bulboprostatic anastomotic repair which was assisted by an intraoperative temporary vesicostomy. The initial objective success rate was 83%. The mean follow-up was 22 months. Voiding cystourethrography performed postoperatively demonstrated a wide, patent anastomosis in all but two cases. Urethroscopy performed 1 month after surgery revealed a patent anastomosis with normal urethral mucosa in all but two patients. The mean peak flow rate at the last follow-up visit was 16.3 ml/s. Two patients developed an anastomotic stricture 6 weeks after surgery that was successfully treated by direct visual internal urethrotomy. Finally, all patients had a patent urethra after salvage treatment postoperatively. An open 1-stage temporary vesicostomy- assisted urethroplasty for recurrent obliterated posterior urethral stricture provides satisfactory outcomes and minimal morbidities.

MRI features of posterior ankle impingement syndrome in ballet dancers: a review of 25 cases

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Peace, K.A.L. E-mail: kalpeace@hotmail.com; Hillier, J.C.; Hulme, A.; Healy, J.C

2004-11-01

AIM: To describe the magnetic resonance imaging (MRI) features of posterior ankle impingement syndrome (PAIS) in classical ballet dancers. MATERIALS AND METHODS: A retrospective review was undertaken of 25 MRI examinations of the ankle performed on 23 ballet dancers over a 26-month period. Images were examined for the presence of osseous and soft-tissue anatomical variants at the posterior ankle and imaging signs of PAIS. All patients presented with symptoms and signs suggestive of PAIS including posterior ankle pain, swelling and stiffness during plantar flexion. RESULTS: Anatomical variants predisposing to PAIS including as os trigonum and tuberosity arising from the superior calcaneum were clearly depicted. The most common imaging feature of PAIS in our series was high T2 signal posterior to the talocalcaneal joint indicating synovitis (n=25). Thickening of the posterior capsule (n=13) and tenosynovitis of flexor hallucis longus (n=17) were also common. An os trigonum was an infrequent finding (n=7). Bone marrow oedema, commonly in the posterior talus (n=10) or in a patchy distribution (n=10) was often noted. CONCLUSION: MRI is a useful diagnostic tool in PAIS, and in the present series, clearly demonstrates the anatomical variants and range of osseous and soft-tissue abnormalities associated with this condition. Prospective studies are needed to understand the significance and importance of individual MRI findings in producing the symptoms of PAIS.

MRI features of posterior ankle impingement syndrome in ballet dancers: a review of 25 cases

International Nuclear Information System (INIS)

Peace, K.A.L.; Hillier, J.C.; Hulme, A.; Healy, J.C.

2004-01-01

AIM: To describe the magnetic resonance imaging (MRI) features of posterior ankle impingement syndrome (PAIS) in classical ballet dancers. MATERIALS AND METHODS: A retrospective review was undertaken of 25 MRI examinations of the ankle performed on 23 ballet dancers over a 26-month period. Images were examined for the presence of osseous and soft-tissue anatomical variants at the posterior ankle and imaging signs of PAIS. All patients presented with symptoms and signs suggestive of PAIS including posterior ankle pain, swelling and stiffness during plantar flexion. RESULTS: Anatomical variants predisposing to PAIS including as os trigonum and tuberosity arising from the superior calcaneum were clearly depicted. The most common imaging feature of PAIS in our series was high T2 signal posterior to the talocalcaneal joint indicating synovitis (n=25). Thickening of the posterior capsule (n=13) and tenosynovitis of flexor hallucis longus (n=17) were also common. An os trigonum was an infrequent finding (n=7). Bone marrow oedema, commonly in the posterior talus (n=10) or in a patchy distribution (n=10) was often noted. CONCLUSION: MRI is a useful diagnostic tool in PAIS, and in the present series, clearly demonstrates the anatomical variants and range of osseous and soft-tissue abnormalities associated with this condition. Prospective studies are needed to understand the significance and importance of individual MRI findings in producing the symptoms of PAIS

INFORMATIVITY OF SPECTRAL OPTICAL COHERENT TOMOGRAPHY IN AGGRESSIVE POSTERIOR RETINOPATHY OF PREMATURITY

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A. V. Tereshchenko

2017-01-01

Full Text Available The purpose: to evaluate the informativity of optical coherence tomography in patients with aggressive posterior retinopathy of prematurity. Patients and methods. spectral optical coherence tomography using portable device iVue-100 with a removable camera (Optovue, USA was held in 32 children (64 eyes with aggressive posterior retinopathy of prematurity with a gestational period 26–31 week. Results. Children with aggressive posterior retinopathy of prematurity at the stage of early clinical manifestations, in addition to the indication that the immaturity of the retina, according to the spectral optical coherence tomography revealed only a few areas of epiretinal proliferation, which are not visualized with a digital retinoscopy and binocular indirect ophthalmoscopy. When the process is more pronounced in children with retinopathy of prematurity aggressive rear stage manifestation already determined multiple zones epiretinal proliferation as a "mushroom" and "flake" conglomerates with rear zone hyaloid membrane had an uneven seal. Coarser structural disorders of the retina and the vitreoretinal interface have been identified in patients with advancedstage aggressive posterior retinopathy of prematurity. We determined the shaft extraretinal proliferation as a "comb", as well as portions of epiretinal proliferation on the border of vascularized and avascular retina, which tended to merge, and the formation of massive hyperreflection complexes, lifted back hyaloid membrane, which was not only uneven sealed, but in some places is stratified. Conclusion. Despite the complexity of the procedure and the complexity of its implementation, the data obtained are particularly valuable and informative because they allow to complement the clinical picture and objectify it. It helps to choose the optimal tactics and improvement of a differentiated approach to the treatment of aggressive posterior retinopathy of prematurity.

A comparison of laparoscopic-assisted (LAARP) and posterior ...

African Journals Online (AJOL)

A comparison of laparoscopic-assisted (LAARP) and posterior sagittal (PSARP) anorectoplasty in the outcome of intermediate and high anorectal malformations. ... There were slightly more complications in the LAARP group; intra-operative injury to the vas deferens and urethra occurred once each. Post-operatively, 2 ...

Traumatic posterior atlantoaxial dislocation without fracture of the odontoid process: A case report and literature review

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KIm, Yong Kyun; Park, Jin Gyoon; Jung, Hyun Nyeong [Dept. of Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of); Kim, Ju Won [Dept. of Radiology, Chonnam National University Hwasun Hospital, Hwasun (Korea, Republic of); Lee, Seung Jin [Dept. of Radiology, Chonnam National University Bitgoeul Hospital, Gwangju (Korea, Republic of)

2017-03-15

Traumatic posterior atlantoaxial dislocation without odontoid fracture is very rare. Patient prognosis depends on the neurologic symptoms or the extent of damage to the structures. In this case, a 78-year-old-male suffered a posterior atlantoaxial dislocation without odontoid fracture after a traffic accident. We report this case because an exact diagnosis and proper treatment can reduce the neurologic complications in patients with posterior atlantoaxial dislocation.

ABORDAGEM CLÍNICA DA INFORMAÇÃO E AT-9: INVESTIGANDO O UNIVERSO DA TOMADA DE DECISÃO PELA VIA SIMBÓLICO-AFETIVA

OpenAIRE

Araujo, Eliane Pawlowski de Oliveira; Paula, Claudio Paixão Anastácio de

2013-01-01

A proposta deste artigo é apresentar os resultados parciais de uma pesquisa realizada com o objetivo de analisar a subjetividade de indivíduos envolvidos em atividades de tomada de decisão e seus esforços para interpretar a realidade em um contexto marcado pela cultura da urgência. O estudo configurou-se na investigação dos comportamentos informacionais por meio de métodos que privilegiaram as dimensões simbólicas e afetivas – em especial a Abordagem Clínica da Informação e o Teste Arquétipo ...

Lentes intraoculares fácicas de câmara posterior

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Mara Barreto Theiss

Full Text Available Resumo O objetivo deste artigo foi reunir estudos que reportam resultados disponíveis na literatura científica, considerando a previsibilidade, segurança, eficácia, e estabilidade das lentes intraoculares fácicas de câmara posterior. E relatar as complicações documentadas para estas lentes. A revisão criteriosa dos estudos publicados na literatura ate o momento revelam resultado satisfatórios quanto à eficácia, elevada previsibilidade, estabilidade e segurança do implante de lente intraocular de câmara posterior, para correção das miopia, hipermetropia e astigmatismo.

Is biologic width of anterior and posterior teeth similar?

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Amir Alireza Rasouli Ghahroudi

2014-09-01

Full Text Available The biologic width (BW includes attached epithelial cells and connective tissue attachment complex being very important in the periodontal health during prosthetic treatments as invading this zone can cause bone resorption and gingival recession. The present study investigated biologic width values in the normal periodontium in anterior and posterior teeth. 30 patients that referred from restorative department to periodontics department of Tehran University of medical sciences who need crown lengthening procedure on their teeth with no history of orthodontic, prosthodontic and periodontal treatment were randomly enrolled in this cross-sectional trial. Sulcus depths (SD as well as the distance between free gingival margin and the bone crest (FB of anterior and posterior teeth were measured by UNC-15 probe and compared. periodontium thickness was also assessed. The data were subjected to Student t test. Mean BW in the 43 anterior and 47 posterior teeth was measured and not significantly different (1.4651±0.39 mm vs. 1.6312±0.49 mm was observed; however, BW was significantly more in the teeth with thick periodontium compared to those with thin periodontium (1.703±0.5 vs. 1.408±0.35; P=0.002. BW not only is different in individuals but also could be dissimilar in different teeth and should be calculated independently prior to restorative treatments.

Posterior coronal plating for tibial fractures: technique and advantages

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Montu Jain

2014-04-01

Full Text Available Objective:Tibial shaft fractures are straightforward to treat but when associated with soft tissue injury particularly at the nail entry/plate insertion site or there is significant comminution proximally or a large butterfly fragment/a second split component in the posterior coronal plane, it is a challenge to the treating surgeon. The aim of the present report is to describe the technique of posterior coronal plating in such a scenario and its advantages. Methods:Between July 2008 and June 2011, 12 patients were pro spectively treated by this approach using 4.5 mm broad dynamic compression plates. Results:The time of bony consolidation and full weight bearing averaged 21.7 weeks (range, 16-26 weeks. Patients were followed up for at least 24 months (range, 24-48 months. At 1 year postoper atively, no loss in reduction or alignment was observed. Mean Hospital for Lower Extremity Measurement Functional Score was 72.8 (range, 64-78. All patients were satisfied with their treatment outcomes. Conclusion:Direct posterior approach and fixation using prone position helps to visualise the fracture fragments and provide rigid fixation. The approach is simple and extensile easily, apart from advantages of less soft tissue and hardware problems compared to standard medial or lateral plating. Key words: Tibial fractures; Bone plates; Orthopedic procedures

Anterior-posterior regionalized gene expression in the Ciona notochord.

Science.gov (United States)

Reeves, Wendy; Thayer, Rachel; Veeman, Michael

2014-04-01

In the simple ascidian chordate Ciona, the signaling pathways and gene regulatory networks giving rise to initial notochord induction are largely understood and the mechanisms of notochord morphogenesis are being systematically elucidated. The notochord has generally been thought of as a non-compartmentalized or regionalized organ that is not finely patterned at the level of gene expression. Quantitative imaging methods have recently shown, however, that notochord cell size, shape, and behavior vary consistently along the anterior-posterior (AP) axis. Here we screen candidate genes by whole mount in situ hybridization for potential AP asymmetry. We identify 4 genes that show non-uniform expression in the notochord. Ezrin/radixin/moesin (ERM) is expressed more strongly in the secondary notochord lineage than the primary. CTGF is expressed stochastically in a subset of notochord cells. A novel calmodulin-like gene (BCamL) is expressed more strongly at both the anterior and posterior tips of the notochord. A TGF-β ortholog is expressed in a gradient from posterior to anterior. The asymmetries in ERM, BCamL, and TGF-β expression are evident even before the notochord cells have intercalated into a single-file column. We conclude that the Ciona notochord is not a homogeneous tissue but instead shows distinct patterns of regionalized gene expression. Copyright © 2013 Wiley Periodicals, Inc.

Frontal-posterior coherence and cognitive function in older adults.

Science.gov (United States)

Fleck, Jessica I; Kuti, Julia; Brown, Jessica; Mahon, Jessica R; Gayda-Chelder, Christine

2016-12-01

The reliable measurement of brain health and cognitive function is essential in mitigating the negative effects associated with cognitive decline through early and accurate diagnosis of change. The present research explored the relationship between EEG coherence for electrodes within frontal and posterior regions, as well as coherence between frontal and posterior electrodes and performance on standard neuropsychological measures of memory and executive function. EEG coherence for eyes-closed resting-state EEG activity was calculated for delta, theta, alpha, beta, and gamma frequency bands. Participants (N=66; mean age=67.15years) had their resting-state EEGs recorded and completed a neuropsychological battery that assessed memory and executive function, two cognitive domains that are significantly affected during aging. A positive relationship was observed between coherence within the frontal region and performance on measures of memory and executive function for delta and beta frequency bands. In addition, an inverse relationship was observed for coherence between frontal and posterior electrode pairs, particularly within the theta frequency band, and performance on Digit Span Sequencing, a measure of working memory. The present research supports a more substantial link between EEG coherence, rather than spectral power, and cognitive function. Continued study in this area may enable EEG to be applied broadly as a diagnostic measure of cognitive ability. Copyright © 2016 Elsevier B.V. All rights reserved.

Safety of different acupuncture manipulations for posterior circulation ischemia with vertigo

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Yan Wen

2016-01-01

Full Text Available Acupuncture at Fengchi (GB20 in the posterior neck improves vertigo. However, subarachnoid hemorrhage and spinal epidural hematoma have been reported to occur after acupuncture in the posterior neck. Therefore, in the present study, we assessed the safety of acupuncture at Fengchi. Laboratory tests and adverse event reports were used to evaluate the safety of different acupuncture manipulations for the treatment of posterior circulation ischemia with vertigo. A total of 136 patients were randomly assigned to four groups. Verum acupuncture was conducted with different needle insertion directions (contralateral paropia or prominentia laryngea and different needle twisting frequencies (60 or 120 times/minute at Fengchi and matching acupoints (for example, Zhongwan [CV12], Qihai [CV6], Zusanli [ST36], and Fenglong [ST40]. The patients received 14 treatments over 3–4 weeks. Routine blood analysis, hepatic and renal function tests, urine and feces tests and electrocardiography were performed before the first treatment session and after the final session. Adverse events were recorded after every session. Of the 136 patients, 120 completed the study. There were no significant differences between pretreatment and posttreatment test results in any of the groups. Only five patients suffered from minor adverse events (needling pain, slight hematoma and transient chest tightness. No serious adverse events were found. Our results indicate that a 14-session course of needling at Fengchi is relatively safe for treating posterior circulation ischemia with vertigo.

Efficacy of ultrasonography-guided shoulder MR arthrography using a posterior approach

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Gokalp, Gokhan; Dusak, Abdurrahim; Yazici, Zeynep [Uludag University Medical Faculty, Goeruekle Kampusu, Department of Radiology, Bursa (Turkey)

2010-06-15

Shoulder MR arthrography has an important role in the assessment of rotator cuff lesions, labral tears, glenohumeral ligaments, rotator interval lesions, and postoperative shoulder status. Injection in direct MR arthrography can be performed with palpation, fluoroscopy, ultrasonography (US), or MRI. Recently, the posterior approach is the preferred method due to the presence of fewer stabilizers, absence of important articular structures and less extravasation, has been advocated. Our aim was to assess the efficacy of US-guided MR arthrography via a posterior approach on the glenohumeral joint. Thirty MR arthrographies were performed on 29 patients. Ultrasonography (Xario, Toshiba) examinations were conducted by a wide-band 5-12 Mhz linear array transducer set to muscle-skeleton. Diluted contrast medium (1 ml gadolinium chelate and 100 ml saline, approximately 15 ml) was delivered into the glenohumeral joint space from between the humeral head and posterior labrum with a 20-gauge spinal needle. MRI examination was conducted by a 1.5 T scanner. Fat-saturated T1-weighted spin echo was applied on coronal, axial, and sagittal planes within the first 30 min after contrast material injection. One (3.3%) arthrography was not successful due to technical reasons associated with obesity. Contrast extravasation around the infraspinatus and teres minoer muscles was depicted in twelve examinations. One (3.3%) patient developed vasovagal collapse. Ultrasonography-guided posterior approach is an easy, reliable, fast, and comfortable method in experienced hands. It may be an alternative for fluoroscopy-guided shoulder MR arthrography. (orig.)

Efficacy of ultrasonography-guided shoulder MR arthrography using a posterior approach

International Nuclear Information System (INIS)

Gokalp, Gokhan; Dusak, Abdurrahim; Yazici, Zeynep

2010-01-01

Shoulder MR arthrography has an important role in the assessment of rotator cuff lesions, labral tears, glenohumeral ligaments, rotator interval lesions, and postoperative shoulder status. Injection in direct MR arthrography can be performed with palpation, fluoroscopy, ultrasonography (US), or MRI. Recently, the posterior approach is the preferred method due to the presence of fewer stabilizers, absence of important articular structures and less extravasation, has been advocated. Our aim was to assess the efficacy of US-guided MR arthrography via a posterior approach on the glenohumeral joint. Thirty MR arthrographies were performed on 29 patients. Ultrasonography (Xario, Toshiba) examinations were conducted by a wide-band 5-12 Mhz linear array transducer set to muscle-skeleton. Diluted contrast medium (1 ml gadolinium chelate and 100 ml saline, approximately 15 ml) was delivered into the glenohumeral joint space from between the humeral head and posterior labrum with a 20-gauge spinal needle. MRI examination was conducted by a 1.5 T scanner. Fat-saturated T1-weighted spin echo was applied on coronal, axial, and sagittal planes within the first 30 min after contrast material injection. One (3.3%) arthrography was not successful due to technical reasons associated with obesity. Contrast extravasation around the infraspinatus and teres minoer muscles was depicted in twelve examinations. One (3.3%) patient developed vasovagal collapse. Ultrasonography-guided posterior approach is an easy, reliable, fast, and comfortable method in experienced hands. It may be an alternative for fluoroscopy-guided shoulder MR arthrography. (orig.)

Longevity of posterior composite restorations: not only a matter of materials.

Science.gov (United States)

Demarco, Flávio F; Corrêa, Marcos B; Cenci, Maximiliano S; Moraes, Rafael R; Opdam, Niek J M

2012-01-01

Resin composites have become the first choice for direct posterior restorations and are increasingly popular among clinicians and patients. Meanwhile, a number of clinical reports in the literature have discussed the durability of these restorations over long periods. In this review, we have searched the dental literature looking for clinical trials investigating posterior composite restorations over periods of at least 5 years of follow-up published between 1996 and 2011. The search resulted in 34 selected studies. 90% of the clinical studies indicated that annual failure rates between 1% and 3% can be achieved with Class I and II posterior composite restorations depending on several factors such as tooth type and location, operator, and socioeconomic, demographic, and behavioral elements. The material properties showed a minor effect on longevity. The main reasons for failure in the long term are secondary caries, related to the individual caries risk, and fracture, related to the presence of a lining or the strength of the material used as well as patient factors such as bruxism. Repair is a viable alternative to replacement, and it can increase significantly the lifetime of restorations. As observed in the literature reviewed, a long survival rate for posterior composite restorations can be expected provided that patient, operator and materials factors are taken into account when the restorations are performed. Copyright © 2011 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Magnetic resonance imaging textural evaluation of posterior cranial fossa tumors in childhood; Avaliacao textural por ressonancia magnetica dos tumores da fossa posterior em criancas

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Santos, Joelson Alves dos; Costa, Maria Olivia Rodrigues da; Otaduy, Maria Concepcion Garcia; Lacerda, Maria Teresa Carvalho de; Leite, Claudia da Costa [Sao Paulo Univ., SP (Brazil). Faculdade de Medicina. Dept. de Radiologia]. E-mail: joelson_alves@ig.com.br; Matsushita, Hamilton [Sao Paulo Univ., SP (Brazil). Faculdade de Medicina. Dept. de Neurologia

2004-08-01

Objective: To distinguish healthy from pathological tissues in pediatric patients with posterior cranial fossa tumors using calculated textural parameters from magnetic resonance images. Materials And Methods: We evaluated 14 pediatric patients with posterior cranial fossa tumors using the software MaZda to define the texture parameters in selected regions of interest representing healthy and pathological tissues based on T2-weighted magnetic resonance images. Results: There was a statistically significant difference between normal and tumoral tissues as well as between supposedly normal tissues adjacent and distant from the tumoral lesion. Conclusion: Magnetic resonance textural evaluation is an useful tool for determining differences among various tissues, including tissues that appear apparently normal on visual analysis. (author)

Remote Supratentorial Hemorrhage After Posterior Fossa Surgery: A Brief Case Report

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Moscote-Salazar Luis Rafael

2014-10-01

Full Text Available The supratentorial hemorrhage after posterior fossa surgery is an unusual but delicate complication that carries high mortality and morbidity. A 50 year old woman presented vertigo 6 months of evolution, which worsened in the last 2 months accompanied by ataxia. She showed left cerebellar signs, had no focal motor or sensory deficits. A brain MRI identified cerebellopontine angle lesion with mass effect. The patient was treated on suboccipital craniectomy and resection of right posterior fossa tumor, the histopathological diagnosis was consistent with typical meningioma. (WHO Class I.

Foraminotomia cervical posterior en el tratamiento de conflictos foraminales

Science.gov (United States)

Campero, Álvaro; Barrera, Ramiro; Ajler, Pablo

2012-01-01

Introducción: La foraminomotima cervical posterior es un procedimiento utilizado para la descompresion radicular por via posterior y constituye una alternativa a la via clásica anterior. En este trabajo evaluamos nuestra serie de pacientes tratados por esta via. Método: Desde enero de 2008 a diciembre de 2011, 17 pacientes (18 foraminotomías) fueron operados por presentar cervicobraquialgia a causa de un conflicto foraminal, realizando un foraminotomía cervical posterior. Los pacientes fueron evaluados en el postoperatorio inmediato, al mes y a los 3 meses de la cirugía. Los parámetros para valorar los resultados fueron la Escala Análoga del Dolor (VAS), la Neck Disability Index y los criterios de Odom. Resultados: El dolor radicular por conflicto foraminal secundario a hernia de disco cervical fue el síntoma y la patología predominante. El nivel más afectado fue C5-C6. La resolución completa del dolor radicular se observó en casi todos los pacientes. La VAS preoperatoria en promedio fue de 8.8 (mínimo 8 – máximo 10), con una franca mejoría en todos los casos (0.4 en el último control). La media en la Neck Disability Index al inicio fue de 35.3 (mínimo 32 – máximo 45), con una evolución favorable en la evaluación final (0.6). Los Criterios de Odom para la evaluación de pacientes operados de columna cervical fueron satisfactorios con un promedio de 1.17. Se observaron complicaciones en 4 pacientes (23%), todas tuvieron una evolución favorable. No hubo infecciones, discitis ni empeoramiento de los síntomas preexistentes en ningún paciente. Conclusión: La foraminotomía cervical posterior es un procedimiento efectivo para el tratamiento del dolor radicular en los conflictos foraminales PMID:23596556

Hippocampal and posterior parietal contributions to developmental increases in visual short-term memory capacity.

Science.gov (United States)

von Allmen, David Yoh; Wurmitzer, Karoline; Klaver, Peter

2014-10-01

Developmental increases in visual short-term memory (VSTM) capacity have been associated with changes in attention processing limitations and changes in neural activity within neural networks including the posterior parietal cortex (PPC). A growing body of evidence suggests that the hippocampus plays a role in VSTM, but it is unknown whether the hippocampus contributes to the capacity increase across development. We investigated the functional development of the hippocampus and PPC in 57 children, adolescents and adults (age 8-27 years) who performed a visuo-spatial change detection task. A negative relationship between age and VSTM related activity was found in the right posterior hippocampus that was paralleled by a positive age-activity relationship in the right PPC. In the posterior hippocampus, VSTM related activity predicted individual capacity in children, whereas neural activity in the right anterior hippocampus predicted individual capacity in adults. The findings provide first evidence that VSTM development is supported by an integrated neural network that involves hippocampal and posterior parietal regions.

Cyclosporine-related reversible posterior leukoencephalopathy: MRI

International Nuclear Information System (INIS)

Jarosz, J.M.; Howlett, D.C.; Cox, T.C.S.; Bingham, J.B.

1997-01-01

Three patients aged 48, 11 and 40 years, two of whom were recent recipients of renal transplants and one of a bone marrow transplant, developed seizures, with cortical blindness in two cases. All were immunosuppressed with cyclosporine and were hypertensive at the onset of symptoms. MRI showed predominantly posterior signal changes in all three cases. The abnormalities were more conspicuous on fast FLAIR images than on conventional T2-weighted spin-echo images. (orig.). With 4 figs

Oracle posterior rates in the White Noise Model

NARCIS (Netherlands)

Babenko, A.

2010-01-01

All the results about posterior rates obtained until now are related to the optimal (minimax) rates for the estimation problem over the corresponding nonparametric smoothness classes, i.e. of a global nature. In the meantime, a new local approach to optimality has been developed within the

Posterior reversible encephalopathy syndrome in a adult female ...

African Journals Online (AJOL)

Typical imaging findings characteristically involve the white matter bilaterally in the parieto-occipital regions. Atypical imaging finding of contrast enhancement of lesion can occur, but is less common. A 20-year-old primiparous lady presented with posterior reversible encephalopathy syndrome. To the best of our knowledge, ...

Posterior composite restoration update: focus on factors influencing form and function

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Bohaty BS

2013-05-01

Full Text Available Brenda S Bohaty,1,2 Qiang Ye,3 Anil Misra,3,4 Fabio Sene,6 Paulette Spencer3,51Department of Pediatric Dentistry, University of Missouri-Kansas City School of Dentistry, Kansas City, MO, USA; 2Department of Pediatric Dentistry, Children's Mercy Hospital, Kansas City, MO, USA; 3Bioengineering Research Center, 4Department of Civil, Environmental, and Architectural Engineering, 5Department of Mechanical Engineering, University of Kansas, Lawrence, KS, USA; 6Department of Restorative Dentistry, State University of Londrina, School of Dentistry, Londrina, BrazilAbstract: Restoring posterior teeth with resin-based composite materials continues to gain popularity among clinicians, and the demand for such aesthetic restorations is increasing. Indeed, the most common aesthetic alternative to dental amalgam is resin composite. Moderate to large posterior composite restorations, however, have higher failure rates, more recurrent caries, and increased frequency of replacement. Investigators across the globe are researching new materials and techniques that will improve the clinical performance, handling characteristics, and mechanical and physical properties of composite resin restorative materials. Despite such attention, large to moderate posterior composite restorations continue to have a clinical lifetime that is approximately one-half that of the dental amalgam. While there are numerous recommendations regarding preparation design, restoration placement, and polymerization technique, current research indicates that restoration longevity depends on several variables that may be difficult for the dentist to control. These variables include the patient's caries risk, tooth position, patient habits, number of restored surfaces, the quality of the tooth–restoration bond, and the ability of the restorative material to produce a sealed tooth–restoration interface. Although clinicians tend to focus on tooth form when evaluating the success and failure of

Can FDG-PET/CT replace blind bone marrow biopsy of the posterior iliac crest in Ewing sarcoma?

International Nuclear Information System (INIS)

Kasalak, Oemer; Glaudemans, Andor W.J.M.; Overbosch, Jelle; Kwee, Thomas C.; Jutte, Paul C.

2018-01-01

To determine and compare the value of 18 F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (FDG-PET/CT) to blind bone marrow biopsy (BMB) of the posterior iliac crest in detecting metastatic bone marrow involvement in newly diagnosed Ewing sarcoma. This retrospective study included 20 patients with newly diagnosed Ewing sarcoma who underwent pretreatment FDG-PET/CT and a total of 38 blind BMBs (two unilateral and 18 bilateral) of the posterior iliac crest. FDG-PET/CT scans were evaluated for bone marrow involvement, both in the posterior iliac crest and other sites, and compared to blind BMB results. FDG-PET/CT was positive for bone marrow involvement in 7/38 posterior iliac crests, whereas BMB was positive in 5/38 posterior iliac crests. FDG-PET/CT and BMB results in the posterior iliac crest agreed in 36/38 cases (94.7%, 95% confidence interval [CI]: 82.7-98.5%). On a patient level, FDG-PET/CT was positive for bone marrow involvement in 4/20 patients, whereas BMB of the posterior iliac crest was positive in 3/20 patients. On a patient level, FDG-PET/CT and BMB results agreed in 19/20 patients (95.0%, 95% CI: 76.4-99.1%). The only discrepancies between FDG-PET/CT and BMB were observed in two BMBs of one patient. Both BMBs in this patient were negative, whereas FDG-PET/CT indicated bilateral posterior iliac crest involvement and also extensive bone marrow involvement elsewhere. FDG-PET/CT appears to be a valuable method for metastatic bone marrow assessment in newly diagnosed Ewing sarcoma. The routine use of blind BMB of the posterior iliac crest should be reconsidered when FDG-PET/CT is available. (orig.)

Can FDG-PET/CT replace blind bone marrow biopsy of the posterior iliac crest in Ewing sarcoma?

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Kasalak, Oemer; Glaudemans, Andor W.J.M.; Overbosch, Jelle; Kwee, Thomas C. [University of Groningen, Department of Radiology, Nuclear Medicine and Molecular Imaging, University Medical Center Groningen (Netherlands); Jutte, Paul C. [University of Groningen, Department of Orthopedics, University Medical Center Groningen (Netherlands)

2018-03-15

To determine and compare the value of {sup 18}F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (FDG-PET/CT) to blind bone marrow biopsy (BMB) of the posterior iliac crest in detecting metastatic bone marrow involvement in newly diagnosed Ewing sarcoma. This retrospective study included 20 patients with newly diagnosed Ewing sarcoma who underwent pretreatment FDG-PET/CT and a total of 38 blind BMBs (two unilateral and 18 bilateral) of the posterior iliac crest. FDG-PET/CT scans were evaluated for bone marrow involvement, both in the posterior iliac crest and other sites, and compared to blind BMB results. FDG-PET/CT was positive for bone marrow involvement in 7/38 posterior iliac crests, whereas BMB was positive in 5/38 posterior iliac crests. FDG-PET/CT and BMB results in the posterior iliac crest agreed in 36/38 cases (94.7%, 95% confidence interval [CI]: 82.7-98.5%). On a patient level, FDG-PET/CT was positive for bone marrow involvement in 4/20 patients, whereas BMB of the posterior iliac crest was positive in 3/20 patients. On a patient level, FDG-PET/CT and BMB results agreed in 19/20 patients (95.0%, 95% CI: 76.4-99.1%). The only discrepancies between FDG-PET/CT and BMB were observed in two BMBs of one patient. Both BMBs in this patient were negative, whereas FDG-PET/CT indicated bilateral posterior iliac crest involvement and also extensive bone marrow involvement elsewhere. FDG-PET/CT appears to be a valuable method for metastatic bone marrow assessment in newly diagnosed Ewing sarcoma. The routine use of blind BMB of the posterior iliac crest should be reconsidered when FDG-PET/CT is available. (orig.)

Ensino por problemas: uma abordagem para o desenvolvimento do aluno Teaching through problems: an approach to student development

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Raquel Aparecida Marra da Madeira Freitas

2012-06-01

Full Text Available O ensino por meio de problemas tem sido caracterizado, no Brasil, como proposta inovadora, geralmente aparecendo em duas abordagens: aprendizagem baseada em problemas e metodologia da problematização. Tais abordagens apresentam-se como metodologias que superam o ensino tradicional, com a clara intenção de propiciar a aprendizagem ativa do aluno. Ambas contribuem, de fato, para tornar o aluno mais ativo na aprendizagem, mas também apresentam algumas insuficiências. Neste texto, são discutidas essas insuficiências e apresentada uma abordagem situada na perspectiva da teoria histórico-cultural: a teoria do ensino desenvolvimental. Tal teoria também valoriza o ensino por problemas, avançando nos seguintes aspectos: explicação teórica e metodológica da atividade de aprendizagem numa perspectiva histórico-cultural; explicação da formação de conceitos como processo de mudança qualitativa do pensamento do aluno e de sua capacidade para estabelecer novas relações com o conhecimento associado a ações transformadoras. Argumenta-se que essa abordagem histórico-cultural é mais promissora, uma vez que realça a formação do pensamento teórico-científico do aluno como fator de desenvolvimento de suas capacidades intelectuais, de sua atividade pensante. Além disso, propõe-se um sistema de ações de aprendizagem que ajudam o aluno a formar um método de pensamento baseado na compreensão do objeto de conhecimento em sua gênese e movimento de transformação. Na conclusão, destaca-se que essa abordagem histórico-cultural pode potencializar os efeitos do ensino no desenvolvimento do aluno e conferir mais qualidade à aprendizagem, sendo útil nos diversos níveis de ensino.In Brazil, teaching through problems has been characterized as an innovative proposal, usually appearing in two approaches: problem-based learning and methodology of questioning. Such approaches are presented as methods that go beyond traditional teaching

Visual Attention in Posterior Stroke and Relations to Alexia

DEFF Research Database (Denmark)

Petersen, Anders; Vangkilde, Signe; Fabricius, Charlotte

2016-01-01

that reduced visual speed and span may explain pure alexia. Eight patients with unilateral PCA strokes (four left hemisphere, four right hemisphere) were selected on the basis of lesion location, rather than the presence of any visual symptoms. Visual attention was characterized by a whole report paradigm......Impaired visual attention is common following strokes in the territory of the middle cerebral artery, particularly in the right hemisphere, while attentional effects of more posterior lesions are less clear. Commonly, such deficits are investigated in relation to specific syndromes like visual...... agnosia or pure alexia. The aim of this study was to characterize visual processing speed and apprehension span following posterior cerebral artery (PCA) stroke. In addition, the relationship between these attentional parameters and single word reading is investigated, as previous studies have suggested...

A brainstem variant of reversible posterior leukoencephalopathy syndrome

Energy Technology Data Exchange (ETDEWEB)

Kitaguchi, H.; Tomimoto, H.; Terada, K. [Kyoto University, Department of Neurology, Graduate School of Medicine, Sakyo-ku, Kyoto (Japan); Miki, Y.; Yamamoto, A. [Kyoto University, Department of Nuclear Medicine and Diagnostic Imaging, Graduate School of Medicine, Sakyo-ku, Kyoto (Japan); Satoi, H.; Kanda, M. [Ijinkai Takeda General Hospital, Department of Neurology, Fushimi-ku, Kyoto (Japan); Fukuyama, H. [Kyoto University, Human Brain Research Center, Graduate School of Medicine, Sakyo-ku, Kyoto (Japan)

2005-09-01

Reversible posterior leukoencephalopathy syndrome (RPLS) is caused by various heterogeneous factors, the commonest being hypertension, followed by nonhypertensive causes such as eclampsia, renal diseases and immunosuppressive therapy. Patients with RPLS exhibit bilateral white and gray matter abnormalities in the posterior aspects of the cerebral hemispheres. However, this syndrome may affect the brainstem predominantly, and these cases are designated as hypertensive brainstem encephalopathy. We present here two patients with reversible brainstem encephalopathy: one with hypertension and the other without hypertension. These patients presented with swelling and diffuse hyperintensities of the brainstem in fluid-attenuated inversion-recovery (FLAIR) and T2-weighted MRI, but with relatively mild clinical symptoms. They recovered without major neurological deficits, but had residual lacunar lesions in the pons. Reversible brainstem encephalopathy with characteristic MRI features was found in both hypertensive and nonhypertensive patients. These patients were diagnosed with a brainstem variant of RPLS, which is potentially fully reversible after an adequate treatment, and therefore should be carefully differentiated from other brainstem disease conditions. (orig.)

A brainstem variant of reversible posterior leukoencephalopathy syndrome

International Nuclear Information System (INIS)

Kitaguchi, H.; Tomimoto, H.; Terada, K.; Miki, Y.; Yamamoto, A.; Satoi, H.; Kanda, M.; Fukuyama, H.

2005-01-01

Reversible posterior leukoencephalopathy syndrome (RPLS) is caused by various heterogeneous factors, the commonest being hypertension, followed by nonhypertensive causes such as eclampsia, renal diseases and immunosuppressive therapy. Patients with RPLS exhibit bilateral white and gray matter abnormalities in the posterior aspects of the cerebral hemispheres. However, this syndrome may affect the brainstem predominantly, and these cases are designated as hypertensive brainstem encephalopathy. We present here two patients with reversible brainstem encephalopathy: one with hypertension and the other without hypertension. These patients presented with swelling and diffuse hyperintensities of the brainstem in fluid-attenuated inversion-recovery (FLAIR) and T2-weighted MRI, but with relatively mild clinical symptoms. They recovered without major neurological deficits, but had residual lacunar lesions in the pons. Reversible brainstem encephalopathy with characteristic MRI features was found in both hypertensive and nonhypertensive patients. These patients were diagnosed with a brainstem variant of RPLS, which is potentially fully reversible after an adequate treatment, and therefore should be carefully differentiated from other brainstem disease conditions. (orig.)

Advances in drug delivery to the posterior segment.

Science.gov (United States)

Pearce, William; Hsu, Jason; Yeh, Steven

2015-05-01

Emerging developments and research for drug delivery to the posterior segment offer a promising future for the treatment of vitreoretinal disease. As new technologies enter the market, clinicians should be aware of new indications and ongoing clinical trials. This review summarizes the advantages and shortcomings of the most commonly used drug delivery methods, including vitreous dynamics, physician sustainability and patient preferences. Currently available, intravitreal, corticosteroid-release devices offer surgical and in-office management of retinal vascular disease and posterior uveitis. The suprachoroidal space offers a new anatomic location for the delivery of lower dose medications directly to the target tissue. Implantable drug reservoirs would potentially allow for less frequent intravitreal injections reducing treatment burdens and associated risks. Newer innovations in encapsulated cell technology offer promising results in early clinical trials. Although pars plana intravitreal injection remains the mainstay of therapy for many vitreoretinal diseases, targeted delivery and implantable eluting devices are rapidly demonstrating safety and efficacy. These therapeutic modalities offer promising options for the vitreoretinal therapeutic landscape.

Redes e observatórios da agrobiodiversidade, como e para quem? Uma abordagem exploratória na região de Cruzeiro do Sul, Acre

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Laure Emperaire

Full Text Available Resumo A diversidade de plantas cultivadas, selecionadas e conservadas pelos agricultores tradicionais, é de interesse tanto local quanto nacional, além de constituir um patrimônio biológico e cultural. No caso da Amazônia, apesar de atualmente dispormos de uma suma de dados sobre a agrobiodiversidade, a diversidade das opções metodológicas mobilizadas torna difícil uma visão sintética de suas dinâmicas. Para entendê-las, torna-se imprescindível assegurar um monitoramento, em longo prazo, de localidades sentinelas ou observatórios, e construir indicadores a serem compartilhados entre populações locais, pesquisadores e formuladores de políticas públicas. Como exemplo, propomos uma abordagem exploratória da agrobiodiversidade levantada junto a 52 agricultores de duas comunidades da região de Cruzeiro do Sul (Acre, a partir de uma abordagem qualitativa sobre as formas locais de denominação das plantas e quantitativa, fundamentada sobre a medida da riqueza (número de espécies ou variedades presentes. A amplitude da riqueza é de 338 plantas, principalmente variedades locais, levantadas com uma alta frequência de espécies ou de variedades apenas cultivadas por um ou dois agricultores, sua estruturação é marcada pela presença de um modelo aninhado, sendo evidenciado o núcleo de plantas de maior coesão.

Flexibilidade na utilização de Diesel ou Biodiesel: uma abordagem via Opções Reais

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Edson Daniel Lopes Gonçalves

2008-01-01

Full Text Available Este trabalho abordará o desenvolvimento do Biodiesel como combustível de fontes renováveis na matriz energética brasileira. Em especial será abordada a flexibilidade de utilização entre o Diesel tradicional de origem petrolífera e o Biodiesel de origem vegetal. Assim, nosso objetivo é avaliar a flexibilidade existente entre o Diesel mineral e o Biodiesel. Para tanto, utilizaremos uma abordagem via opções reais, no qual a escolha do combustível para abastecimento é modelada como uma sequência de opções européias. Estas "Switch Input Real Options" geram valor ao projeto e minimizam riscos associados a falta de oferta de energia, outro problema recorrente em nossa realidade.Por fim, será comentado o potencial de ganho no agregado para um país como o Brasil, com um modal de transportes predominantemente rodoviário e dependente do Diesel.