Resultados del tratamiento quirúrgico de los aneurismas del complejo cerebral anterior-arteria comunicante anterior

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Armando Alemán Rivera

2001-06-01

Full Text Available Se realiza un estudio de 30 pacientes con aneurismas localizados en el complejo de la arteria cerebral anterior-arteria comunicante anterior (ACoA, operados en el Servicio de Neurocirugía del Hospital Universitario "Arnaldo Milián Castro", durante un período de 7 años. Se analizan variables tales como edad, sexo, estado neurológico preoperatorio, momento quirúrgico, complicaciones y estado al egreso. La mortalidad general fue del 10 %The authors carried out a study in 30 patients with aneurysms located in the anterior communicating artery-anterior cerebral complex (ACA-ACC, that were operated on at the Neurosurgery Service of "Arnaldo Milián Castro" Teaching Hospital, during a period of 7 years. Variables such as age, sex, preoperative neurologic state, surgical moment, complications and status on discharge were analyzed. General mortality was 10 %

Artrodesis C1C2 con tornillos transarticulares en artritis reumatoidea: experiencia y revisión de la literatura Artrodese C1 C2 com parafusos transarticulares em artrite reumatoide: experiência e revisão de literatura C1 C2 arthrodesis with transarticular screws in rheumatoid arthritis: experience and literature review

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Lyonel Beaulieu Lalanne

2011-01-01

Full Text Available OBJETIVO: Describir los resultados clínicos e imagenológicos utilizando la técnica de fijación C1 C2 con tornillos transarticulares y asas de alambre en pacientes portadores de AR en un seguimiento a largo plazo y revisar la literatura actual. MÉTODO: Entre los años 2002 y 2006, 11 pacientes (9 mujeres y 2 hombres con inestabilidad C1 C2 secundaria a AR fueron intervenidos quirúrgicamente. Se realizó fijación C1 C2 con tornillos transarticulares por vía posterior más asas de alambre y aplicación de injerto óseo autólogo de cresta ilíaca. Se registró Índice de Ranawat pre y posoperatorio, Distancia Anterior Atlas Odontoides (DAAO pre y posoperatorio, tiempo operatorio, días de hospitalización, complicaciones intra y posoperatorias y tiempo de consolidación radiológica, con un seguimiento promedio de 34 meses. RESULTADOS: Todos los pacientes presentaron mejoría del Índice de Ranawat en el postoperatorio. La DAAO preoperatoria promedio fue de 11,9 mm (DS ± 2,57, rango 7 a 16, y la DAAO postoperatoria promedio fue de 3 mm (DS ± 1,20, rango 2 a 6. El tiempo quirúrgico fue de 94 minutos en promedio y el promedio de días de hospitalización fue de 7 días. No se presentaron complicaciones intraoperatorias. Un caso presentó seroma de herida operatoria que requirió tratamiento quirúrgico. El tiempo de consolidación fue en promedio 14 semanas. CONCLUSIÓN: La artrodesis atlantoaxial con tornillos y amarras es una buena alternativa para el manejo de la inestabilidad C1-C2 en pacientes portadores de AR, consiguiendo buenos resultados clínicos e imagenológicos en un seguimiento a largo plazo.OBJETIVO: Apresentar a experiência com a técnica de fixação C1-C2 com parafusos transarticulares e cerclagem de fio metálico nos pacientes portadores de AR, assim como a revisão da literatura. MÉTODO: Entre os anos 2002 e 2006, 11 pacientes (9 mulheres e 2 homens com instabilidade C1-C2 e portadores de AR foram submetidos a

Aneurismas del complejo arteria cerebral anterior / arteria comunicante anterior: Resultados del tratamiento quirúrgico Aneurysms of the anterior cerebral artery-anterior communicating artery complex: Results of the surgical treatment

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Justo L González González

2006-03-01

Full Text Available Los aneurismas del complejo arteria cerebral anterior-arteria comunicante anterior figuran entre los más frecuentes de localización intracraneal y, debido a su variabilidad anatómica y características hemodinámicas, constituyen un reto especial para cualquier esfuerzo terapéutico. Con el objetivo de caracterizarlos y evaluar los resultados del tratamiento quirúrgico de estas lesiones, se estudian los pacientes operados en el Servicio de Neurocirugía del Hospital Clinicoquirúrgico «Hermanos Ameijeiras», entre enero de 1983 y agosto de 1998. Se observó que el 71,1 % de la muestra egresó en excelente estado; el 13,44 %, con secuelas mínimas; el 3,48 %, con secuelas graves y que la mortalidad fue del 11,53 %. Se concluye que estos aneurismas son más frecuentes en el sexo masculino, en la cuarta y quinta décadas de la vida (media de 39,9 años y que el tamaño crítico de ruptura se ubica mayoritariamente entre 6 mm y 11 mm. De igual forma se observó que la edad, el tamaño sacular, el vasoespasmo y la ruptura transoperatoria influyen sobre los resultados y que la influencia de estas dos últimas complicaciones es muy fuerte. El infarto cerebral isquémico fue la causa de muerte más frecuente

Influência da extensão da artrodese lombossacra nos resultados clínicos e funcionais Influencia de la extensión de la artrodesis lumbosacra en los resultados clínicos y funcionales Influence of the extent of lumbosacral arthrodesis in clinical and functional outcomes

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Alberto Ofenhejm Gotfryd

2012-01-01

Full Text Available OBJETIVO: Verificar a influência da extensão da fusão póstero-lateral lombossacra e seu impacto nos resultados clínicos e funcionais. MÉTODOS: Foram avaliados 22 pacientes portadores de estenose central, foraminal ou hérnia de disco lombar, associadas a instabilidade segmentar, submetidos ao tratamento cirúrgico para a descompressão neural e artrodese póstero-lateral. Os pacientes foram divididos em dois grupos, de acordo com quantidade de níveis artrodesados: Grupo 1: fusão em um nível e Grupo 2: fusão em dois ou mais níveis. Os pacientes preencheram questionários referentes ao acompanhamento pós-operatório (uso de medicamentos analgésicos e satisfação com o tratamento e escala analógica visual de dor lombar e ciática. Além disto, foram aplicados os questionários Oswestry e SF-36 para avaliação da qualidade de vida. RESULTADOS: Os resultados do SF-36 mostraram bons níveis de qualidade de vida em ambos os grupos, com exceção do domínio "Aspectos Físicos". Não houve correlação significativa entre a extensão da artrodese e os desfechos clínicos. CONCLUSÕES: Os pacientes submetidos à artrodese póstero-lateral apresentaram qualidade de vida satisfatória, exceto pela diminuição da aptidão física. Entretanto, o maior número de níveis artrodesados não teve impacto negativo sobre os aspectos clínicos e funcionais.OBJETIVO: Investigar la influencia del grado de la fusión posterolateral lumbosacral y su impacto en los resultados clínicos y funcionales. MÉTODOS: Se evaluaron 22 pacientes con estenosis central, foraminal o hernia de disco lumbar, asociadas a inestabilidad segmentaria; se sometieron a cirugía para la descompresión neural y la artrodesis posterolateral. Los pacientes fueron divididos en dos grupos según el número de niveles fusionados: Grupo 1: la fusión en un nivel, y Grupo 2: la fusión en dos o más niveles. Los pacientes completaron cuestionarios sobre seguimiento posoperatorio (uso

Estenosis isquémica tardía tras resección anterior de recto Late ischemic stricture following anterior rectal resection

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J. Zuloaga

2008-01-01

Full Text Available Existe una incidencia no despreciable de lesiones de colon de origen isquémico tras resecciones anteriores bajas por cáncer. Presentamos un caso de estenosis isquémica de colon, no relacionada con radioterapia, a los 5 años de la cirugía. Se discute la dificultad del diagnóstico diferencial con recidiva tumoral, así como el importante papel que desempeña la endoscopia en el abordaje de estos pacientes.A considerable incidence of colonic strictures after oncologic low anterior resections has been reported. The present paper describes a colonic stricture 5 years after the surgery, and not related to radiotherapy, that required a challenging differential diagnosis with local recurrence of rectal cancer. The role of endoscopy in the management of this condition is discussed.

Influência do suporte e fixação anterior na resistência mecânica do fixador interno vertebral Influencia del soporte y de la fijación anterior sobre la resistencia mecánica del fijador interno vertebralartrodesis cervical anterior por hernia del disco cervica The influence of anterior reconstruction and fixation on the mechanical performance of an internal fixator

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Gisele Cristina Ale dos Santos

2009-03-01

Full Text Available OBJETIVO: avaliar a influência da reconstrução e fixação anterior no desempenho mecânico do fixador interno da coluna vertebral. MÉTODOS: foram formados três grupos experimentais de acordo com a reconstrução e fixação anterior: grupo I -sem suporte anterior; grupo II - com suporte anterior; grupo III - com suporte e fixação anterior. Os corpos de prova foram submetidos a ensaios mecânicos de flexo-compressão, flexão lateral e torção, realizados em máquina de universal de ensaios, tendo sido realizados dez ensaios para cada modalidade (flexo-compressão, flexão lateral e torção em cada grupo experimental, perfazendo um total de 90 ensaios mecânicos. As propriedades mecânicas estudadas foram: o momento-fletor, o torque e a rigidez obtidos a partir da curva carga x deflexão de cada ensaio mecânico. RESULTADOS: observou-se que a colocação do suporte e da fixação anterior aumentou a resistência mecânica nos ensaios de flexo-compressão. Nos ensaios de flexão lateral observou-se aumento da resistência mecânica somente com a fixação anterior. CONCLUSÃO: nos ensaios de torção o suporte anterior e a fixação anterior não aumentaram a resistência mecânica do sistema de fixação vertebral.OBJETIVO: evaluar la influencia de la reconstrucción y fijación anterior en el desempeño mecánico del fijador interno de la columna vertebral. MÉTODOS: fueron formados tres grupos experimentales de acuerdo com la reconstrucción y fijación anterior: grupo I- sin soporte anterior, grupo II- con soporte anterior y grupo III- con soporte y fijación anterior. Los cuerpos de prueba fueron sometidos a ensayos mecánicos de flexocompresión, flexión lateral y torción, realizados en la máquina universal de ensayos, habiéndose realizados 10 ensayos para cada modalidad (flexocompresión, flexión lateral y torción en cada grupo experimental,con untotal de 90 ensayos mecánicos. Las propiedades mecánicas estudiadas fueron el

Fijación lumbopelviana con tornillos en pacientes adultos. [Lumbopelvic fixation with screws in adult patients

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Pablo Rizzi

2013-05-01

Full Text Available Introducción Lograr una artrodesis sólida a nivel de L5-S1 constituye siempre una dificultad mayor que en otros niveles de la columna lumbar o torácica. La fijación con tornillos a las alas ilíacas representa una alternativa dentro de los diversos métodos de fijación. Objetivo Evaluar los resultados de la fijación pelviana con tornillos en pacientes adultos sin problemas de la marcha, considerando especialmente la fijación en 4 pun- tos por debajo de L5. Materiales y métodos: Veinticinco pacientes, con un seguimiento mínimo de 12 meses. Diagnósticos predomi- nantes: escoliosis, seudoartrosis. Resultados Veintinueve pacientes con distintas patologí- as fueron tratados por medio de fijación con tornillos pelvianos y los resultados se evaluaron mediante control clínico (escala analógica visual [EAV] y escala de Oswestry y control radiográfico. Los resultados obtenidos fueron: EAV preoperatoria 7,8% y EAV posoperatoria 3,1%. El puntaje para dolor ilíaco posoperatorio en la EAV fue del 3,3% y el puntaje Oswestry preoperatorio, del 74,4%, mientras que el del período posoperatorio fue, en promedio, del 31,5%. En cuatro pacientes fue necesario retirar el implante, en todos los casos por radiolucidez de los tornillos ilíacos. Se produjo la rotura de ambos tornillos ilíacos en 2 casos y se logró la fusión en los 24 casos restantes. Conclusión  La fijación con tornillos pelvianos en fusiones largas, si bien no está exenta de complicaciones, es un método eficaz para lograr un alto índice de fusión lumbosacra en casos especialmente complejos por el largo de la fusión o por el fracaso de cirugías previas; es una técnica sencilla y con un moderado índice de dolor pelviano no solo en el número de pacientes, sino también en la intensidad del dolor, lo que quedó evidenciado por el bajo número de pacientes que fueron reintervenidos para el retiro de los tornillos.

Artrosis de muñeca, estudio y opciones de tratamiento

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Dr. G. Francisco Andrade

2014-09-01

Full Text Available La artrosis de muñeca es una patología que se origina generalmente tras una lesión ligamentosa intraósea del carpo, debido a una no unión de fractura de escafoides o después de una fractura articular del radio. Se sabe que la artrosis no mejora ni retrocede, por lo que se debe tener el tratamiento ideal para cada paciente según sus propias necesidades, que van desde el manejo médico (cambios de actividad, inmovilización, AINES o infiltración con corticoides. Cuando falla el tratamiento médico, se pueden realizar procedimientos poco invasivos como la denervación, carpectomía proximal o una artrodesis de cuatro esquinas. En estadios avanzados, sólo se puede proponer una artroplastia o artrodesis total de la muñeca.

Uso de morfina intratecal en artrodesis lumbar Uso da morfina intratecal na artrodese lombar Intrathecal morphine in lumbar spine fusion

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Ronald Schulz Ibaceta

2009-12-01

Full Text Available OBJETIVO: determinar la eficacia y la seguridad del uso de morfina intratecal, en bajas dosis, en pacientes sometidos a cirugía de instrumentación y artrodesis lumbar. MÉTODOS: estudio prospectivo, randomizado, ciego y controlado. Fueron utilizados dos grupos de pacientes: Grupo Estudio, que recibió morfina intratecal al final de su cirugía, y Grupo Control que sólo recibió el protocolo de analgesia estándar. RESULTADOS: se encontraron diferencias significativas en la escala visual análoga (EVA entre los dos grupos a las 12 horas postoperatorias. La EVA en reposo promedio del Grupo Estudio fue de 2,15 cm y el del Grupo Control, 5 cm (p=0,013. En actividad, el Grupo Estudio presentó una EVA promedio de 4,36 cm, y el Grupo Control 6,9 cm (p=0,029. No se encontraron diferencias en relación a las complicaciones entre los dos grupos. CONCLUSIÓN: el uso de morfina intratecal, en bajas dosis, es seguro y efectivo en el control del dolor en las primeras 12 horas postoperatorias en cirugía de artrodesis lumbar.OBJETIVO: determinar a eficácia e a seguridade do uso da morfina intratecal, em baixas doses, em pacientes submetidos à cirurgia de instrumentação e artrodese lombar. MÉTODOS: estudo prospectivo, randomizado, cego e controlado. Foram utilizados dois grupos de pacientes: Grupo Estudo, que recebeu morfina intratecal no final da cirurgia e o Grupo Controle, que recebeu somente o protocolo de analgesia padrão. RESULTADOS: foram encontradas diferenças significativas na escala visual analógica (EVA entre os dois grupos às 12 horas pós-operatórias. A EVA em repouso, em média, do Grupo Estudo foi de 2,15 cm e do Grupo Controle, 5 cm (p=0,013. Durante atividade, o Grupo Estudo apresentou uma EVA de aproximadamente 4,36 cm e no Grupo Controle, 6,9 cm (p=0,029. Não foram encontradas diferenças com relação às complicações entre os dois grupos. CONCLUSÃO: o uso de morfina intratecal, em baixas doses, foi seguro e efetivo no

The anterior cingulate cortex

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Pavlović D.M.

2009-01-01

Full Text Available The anterior cingulate cortex (ACC has a role in attention, analysis of sensory information, error recognition, problem solving, detection of novelty, behavior, emotions, social relations, cognitive control, and regulation of visceral functions. This area is active whenever the individual feels some emotions, solves a problem, or analyzes the pros and cons of an action (if it is a right decision. Analogous areas are also found in higher mammals, especially whales, and they contain spindle neurons that enable complex social interactions. Disturbance of ACC activity is found in dementias, schizophrenia, depression, the obsessive-compulsive syndrome, and other neuropsychiatric diseases.

Desafío con wssv bajo fluctuaciones de temperatura

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Sonnenholzner, Stanislaus

2002-01-01

Desafío con WSSV bajo fluctuaciones de temperatura En trabajos anteriores sobre el efecto de la temperatura del agua sobre la supervivencia del camarón infectado con el virus de la Mancha Blanca, se demostró que una temperatura constante de 33ºC por 8 días genera una respuesta inmune en el camarón correlacionada a una supervivencia superior al 90%, lo cual se tradujo posteriormente en una propuesta práctica de cultivo de camarón en estanques con invernaderos, actualmente en evaluación e...

74. Reparación Con Neocuerdas en Distintos Tipos de Prolapso Mitral

OpenAIRE

R. García Fuster; A. García; E. Martín; F. Paredes; R. Payá; J. Fontana

2012-01-01

la resección cuadrangular es referente en la reparación del prolapso de velo posterior. El velo anterior plantea más limitaciones, siendo la transposición de cuerdas y el implante de neocuerdas los procedimientos más empleados. Analizamos eficacia y versatilidad de la reparación con neocuerdas en cinco variantes de prolapso mitral (vídeo). Material y métodos: han sido intervenidos 5 pacientes con distintos tipos de prolapso. Tres con deficiencia fibroelástica: varón de 52 años con prolapso...

Tratamento cirúrgico por via anterior na mielopatia cervical espondilótica com seguimento mínimo de dez anos Tratamiento quirúrgico por vía anterior en la mieolopatía cervical espondilótica con seguimiento mínimo de diez años Anterior decompression and fusion for spondilotic cervical mielopathy with a minimal ten-year follow-up

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Rui Peixoto Pinto

2010-06-01

Full Text Available OBJETIVO: a mielopatia cervical espondilótica (MEC é uma causa frequente de disfunção da medula espinhal na população adulta. O tratamento implica em descompressão cirúrgica precoce. O objetivo foi apresentar um estudo retrospectivo da descompressão anterior e artrodese para MEC com um seguimento mínimo de dez anos. MÉTODOS: pacientes operados entre Janeiro de 1990 e Dezembro de 1994 foram avaliados por sexo, idade, número de níveis operados, avaliação funcional pela escala de Nurick pré-operatória um ano após cirurgia e após a revisão final que ocorreu em 2004, evidência de consolidação e complicações. RESULTADOS: foram avaliados 91 pacientes, 69 do sexo masculino, 22 do sexo feminino, com uma média de idade de 56,6 anos (42-86 e um seguimento médio de 11,9 anos. Ocorreram cinco óbitos: três pacientes no pós-operatório imediato, um no primeiro ano e um durante o restante período. Em média, foram operados 2,7±1,0 níveis por paciente (1-4. O valor médio de Nurick pré-operatório foi de 3,8±0,9. Houve uma melhoria significativa do estado neurológico um ano após a cirurgia (2,2±1,1; pOBJETIVO: la mielopatía cervical espondilótica (MEC es una causa frecuente de disfunción de la médula espinal en la población adulta. El tratamiento implica una descompresión quirúrgica precoz. El objetivo es presentar un estudio retrospectivo de la descompresión anterior y artrodesis para MEC con un seguimiento mínimo de diez años. MÉTODOS: pacientes operados entre Enero de 1990 y Diciembre de 1994 fueron evaluados según el sexo, la edad, el número de niveles operados, la evaluación funcional por la escala de Nurick pre operatoria un año después de la cirugía y después de la revisión final que fue en el 2004, evidencia de consolidación y complicaciones. RESULTADOS: fueron evaluados 91 pacientes, 69 del sexo masculino, 22 del sexo femenino, con un promedio de edades de 56.6 años (42 a 86 y un seguimiento

Registro Español de Ablación con Catéter. IV Informe Oficial (2004

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Miguel Álvarez López

2006-01-01

Conclusiones: Aun con una participación ligeramente inferior a la de años anteriores, el volumen de ablaciones recogidas (> 4.000 y los resultados concordantes con los registros precedentes confirman la validez y la consistencia de nuestro registro.

Riesgo familiar total en familias con mujeres diagnosticadas con neoplasia de mama

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Nancy Cecilia Charrys-Bravo

2017-07-01

Full Text Available Objetivo: Determinar el riesgo familiar total de las familias con mujeres diagnosticadas con cáncer de mama, que asisten a un centro de salud oncológico en la ciudad de Barranquilla. Materiales y Métodos: El estudio fue de tipo descriptivo, transversal con abordaje cuantitativo. Se utilizó el instrumento Riesgo Familiar Total RFT 5-33. El universo estuvo conformado por familias con mujeres diagnosticadas con cáncer en mama. La muestra fue de 41 familias que integraron a 154 miembros; se abordó el estudio de manera censal, y no por medio de una muestra, porque el acceso a la información de la totalidad de las familia fue viable. Resultados: Los resultados mostraron que las familias, en su mayoría, son de tipo 2. El 68 % de las pacientes categorizan sus familias como amenazadas, el 5 % como familias de alto riesgo y un 27 % de las familias con un bajo riesgo. Conclusiones: Los hallazgos encontrados en esta investigación son importantes para las familias, lo cual permitirá establecer acciones y actividades que logren orientar e implementar procesos de atención específicos con el propósito de cuidar a las familias para que se mantengan sanos en un nivel de bajo riesgo; además, desarrollar controles y seguimiento a aquellas familias que se encuentran en un riesgo alto de amenazas, mediante acciones de promoción y prevención de la enfermedad de una manera amplia. Por lo anterior, se deben emprender programas más agresivos de prevención y promoción, especialmente con las familias que asisten en busca de apoyo médico para este padecimiento; de esta forma, se podrán diagnosticar los casos de forma temprana y proceder al respectivo tratamiento.

Tratamiento ortodóncico-quirúrgico de una adaquia anterior Orthodontic-surgical treatment of anterior open bite

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Anselmo López Rodríguez

2004-08-01

Full Text Available En la práctica y desarrollo de la cirugía ortognática en el Hospital Universitario "Comandante Manuel Fajardo" a lo largo de los años, la morbilidad de diferentes anomalías del desarrollo maxilo-mandibulares ha mostrado que la adaquia o mordida abierta anterior es bastante frecuente. Desde tempranas edades se detectan y son tratadas por el especialista en Ortodoncia. El cerrar una adaquia en ocasiones se torna difícil y es cuando el análisis del paciente debe realizarse en el grupo multidisciplianrio integrado por cirujanos maxilofaciales, ortodoncistas y protesistas. Se han detectado diferentes causas que pueden producir una adaquia y en su mayor parte son hábitos nocivos que perduran en el paciente; por ejemplo, la interferencia con el centro de crecimiento condilar, la succión del pulgar, la deglución atípica o lengua protractil, la respiración bucal, entre otras. Este trabajo está encaminado en mostrar los diferentes tratamientos que en la actualidad se emplean para reducir una mordida abierta anterior y presenta el caso de una niña de 14 años de edad portadora de una adaquia de más de 18 mm.In the context of orthognathic surgery practice and development at "Comandante Manuel Fajardo" university hospital, morbidity from several anomalies in the maxillomandibular growth has shown that anterior open bite is pretty common. Such anomalies are detected and treated by the orthodontist at early childhood. To close an anterior open bite is difficult sometimes and requires the analysis of the patient by a multidisciplinary group made up of maxillofacial surgeons, orthodontists and denture specialists. A number of causes may be the origin of anterior open bite, mainly harmful habits that persist in the patient such as interference with the condylar growth center, dummy sucking, atypical deglutition or proctatile tongue, mouth breathing, among others. This paper is aimed at showing different therapies that presently reduce anterior open

Iliac crest autograft versus alternative constructs for anterior cervical spine surgery: Pros, cons, and costs

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Epstein, Nancy E.

2012-01-01

Background: Grafting choices available for performing anterior cervical diskectomy/fusion (ACDF) procedures have become a major concern for spinal surgeons, and their institutions. The “gold standard”, iliac crest autograft, may still be the best and least expensive grafting option; it deserves to be reassessed along with the pros, cons, and costs for alternative grafts/spacers. Methods: Although single or multilevel ACDF have utilized iliac crest autograft for decades, the implant industry now offers multiple alternative grafting and spacer devices; (allografts, cages, polyether-etherketone (PEEK) amongst others). While most studies have focused on fusion rates and clinical outcomes following ACDF, few have analyzed the “value-added” of these various constructs (e.g. safety/efficacy, risks/complications, costs). Results: The majority of studies document 95%-100% fusion rates when iliac crest autograft is utilized to perform single level ACDF (X-ray or CT confirmed at 6-12 postoperative months). Although many allograft studies similarly quote 90%-100% fusion rates (X-ray alone confirmed at 6-12 postoperative months), a recent “post hoc analysis of data from a prospective multicenter trial” (Riew KD et. al., CSRS Abstract Dec. 2011; unpublished) revealed a much higher delayed fusion rate using allografts at one year 55.7%, 2 years 87%, and four years 92%. Conclusion: Iliac crest autograft utilized for single or multilevel ACDF is associated with the highest fusion, lowest complication rates, and significantly lower costs compared with allograft, cages, PEEK, or other grafts. As spinal surgeons and institutions become more cost conscious, we will have to account for the “value added” of these increasingly expensive graft constructs. PMID:22905321

Tratamiento quirúrgico de la rizartrosis: evaluación de resultados de distintas técnicas

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Francisco-Javier García-Bernal

Full Text Available Introducción y Objetivo. Larizartrosis o artrosis de la articulación trapeciometacarpiana (TMC es uno de los principales motivos de consulta en una Unidad de Cirugía de Mano. Ante el fracaso del tratamiento conservador, recomendamos el tratamiento quirúrgico. Existen distintas opciones terapéuticas y la elección debe ser individualizada para cada paciente en función de varios factores: edad, grado de artrosis, demanda funcional, etc. En este trabajo analizamos los resultados obtenidos en nuestra práctica con las distintas técnicas. Material y Método. Entre abril de 2011 y febrero de 2015 intervinimos 97 casos de rizartrosis. La edad media de los pacientes fue de 54.01 años, con claro predominio del sexo femenino (85.5%. La técnica más frecuentemente empleada fue la artroplastia con reconstrucción ligamentaria y suspensión según técnica de Weilby, con 79 casos. En 9 casos realizamos una artroplastia artroscópica (ATK; en 4 una artrodesis TMC; y en 5 una ligamentoplastia. Resultados. De los 97 pacientes pudimos controlar postoperatoriamente a 49, con un seguimiento medio de 18,3 meses. Los pacientes experimentaron una mejoría de la fuerza de pinza del 24.28% con la técnica de Weilby; del 18.74% con la ATK; del 45.75% con la artrodesis TMC; y del 31.42% con la ligamentoplastia. Respecto al dolor, valorado según una escala visual analógica (0-10 la mejoría fue de 5.50, 5.1, 6.34 y 6.33 puntos respectivamente, en relación a la situación preoperatoria. Conclusiones. Los resultados obtenidos nos confirman la utilidad de la artroplastia de suspensión-interposición como técnica de elección para el paciente habitual de rizartrosis. En determinados casos, factores como la edad, la demanda funcional o el grado de degeneración articular nos encaminaran a elegir otras técnicas, buscando satisfacer las necesidades de cada paciente en concreto.

Reporte de caso: restauración del sector anterior con prótesis parcial fija en cerámica de fluorapatita

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Janeth Mercedes Rojas Murillo

2013-01-01

Full Text Available La necesidad de restauración del sector anterior, no solo por estética sino para mejorar la función y autoestima del paciente, lleva a pensar en satisfacer estos requerimientos teniendo en cuenta los inconvenientes que dependen del estado inicial, involucrando los tejidos duros y blandos, que pueden llevar a un éxito o fracaso del tratamiento; por lo cual se debe tener una planeación adecuada del tratamiento, dependiendo las características individuales del paciente. La utilización de prótesis realizadas en metal cerámica, que ha venido siendo reemplazada por el uso de sistemas totalmente cerámicos ha llevado a desarrollar materiales con una resistencia y propiedades equivalentes a las prótesis convencionales con el fin de dar un resultado final más estético. Al encontrar pacientes cuya preocupación es el cambio de prótesis removibles por prótesis fijas en los que se encuentra una  mayor pérdida dental, se debe evaluar la posibilidad y  viabilidad de realizar prótesis fijas , que pueden ofrecer resultados más estéticos, sin comprometer la resistencia y duración del tratamiento a largo plazo, además de encontrar condiciones desfavorables como puede ser la perdida de dimensión vertical, o desgastes dentales extensos que requieran de una rehabilitación integral para el éxito del  tratamiento, aspectos importantes para la elección del material ideal para el caso individual del paciente.

Reporte de caso: restauración del sector anterior con prótesis parcial fija en cerámica de fluorapatita

Directory of Open Access Journals (Sweden)

Janeth Mercedes Rojas Murillo

2012-09-01

Full Text Available La necesidad de restauración del sector anterior, no solo por estética sino para mejorar la función y autoestima del paciente, lleva a pensar en satisfacer estos requerimientos teniendo en cuenta los inconvenientes que dependen del estado inicial, involucrando los tejidos duros y blandos, que pueden llevar a un éxito o fracaso del tratamiento; por lo cual se debe tener una planeación adecuada del tratamiento, dependiendo las características individuales del paciente. La utilización de prótesis realizadas en metal cerámica, que ha venido siendo reemplazada por el uso de sistemas totalmente cerámicos ha llevado a desarrollar materiales con una resistencia y propiedades equivalentes a las prótesis convencionales con el fin de dar un resultado final más estético. Al encontrar pacientes cuya preocupación es el cambio de prótesis removibles por prótesis fijas en los que se encuentra una  mayor pérdida dental, se debe evaluar la posibilidad y  viabilidad de realizar prótesis fijas , que pueden ofrecer resultados más estéticos, sin comprometer la resistencia y duración del tratamiento a largo plazo, además de encontrar condiciones desfavorables como puede ser la perdida de dimensión vertical, o desgastes dentales extensos que requieran de una rehabilitación integral para el éxito del  tratamiento, aspectos importantes para la elección del material ideal para el caso individual del paciente.

Tratamiento de la tiroiditis de Riedel con triamcinolona

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Germán Brito Sosa

Full Text Available Se presenta el primer paciente con una tiroiditis de Riedel que se le aplica un tratamiento alternativo con triamcinolona creado por el profesor Juan Gualberto Vivó Núñez. Es el caso de una mujer de 48 años de edad, que acude al cuerpo de guardia por aumento de volumen de la región anterior del cuello y referir ligera disfagia. Tiene antecedente inicialmente de hipertiroidismo, a los 9 años comenzó con hipotiroidismo y hace aproximadamente un año se le diagnosticó una tiroiditis de Hashimoto, con seguimiento por endocrinología. La ecografía del tiroides muestra un aumento marcado de la glándula tiroidea y las imágenes de la biopsia por aspiración con aguja fina (BAAF son compatibles con una tiroiditis de Hashimoto. Con estos resultados se decide intervenirla quirúrgicamente eliminando así los signos compresivos. La biopsia postoperatoria describe una tiroiditis de Riedel. Por el gran tamaño de los lóbulos tiroideos, se le infiltra triamcinolona 1/2 cc en cada lóbulo, una vez al mes durante cuatro meses; logrando reducir aproximadamente el 50 % de los lóbulos tiroideos. Por lo que se puede apreciar los resultados obtenidos con el uso de la triamcinolona.

Tratamiento Temprano de la Maloclusión Clase III con aparatología Ortopédica: Reporte de caso con 7 años de control

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Alzate-J

2014-01-01

Full Text Available Una de las maloclusiones más complejas de diagnosticar y de tratar es la maloclusión clase III.\tSe caracteriza por una alteración en la relación sagital de los maxilares, ya sea por una deficiencia o retrusión maxilar o por un prognatismo o macrognatismo mandibular, o bien sea una combinación de las anteriores. La etiología es multifactorial y es debida a una interacción de factores hereditarios y ambientales. Se presenta una paciente de 4 años de edad, sexo femenino, con patrón hereditario de clase III en su familia materna. Relación esquelética clase III con mandíbula aumentada en longitud, protruida, rotando posterior y maxilar superior retruído. Tipo de crecimiento vertical, con un perfil recto y mordida cruzada anterior y posterior unilateral izquierda. Se instauró tratamiento con aparatología ortopédica durante el periodo de dentición decidua hasta la dentición permanente, para lograr así, equilibrar el crecimiento maxilomandibular. Uno de los aspectos clínicos más complicados del manejo ortopédico de la maloclusión clase III es la recidiva después del período de tratamiento activo; sin embargo en nuestra paciente se consiguen cambios a nivel esquelético, dental y estéticos que se mantuvieron durante el tratamiento

Is antibiotic prophylaxis in nasal packing for anterior epistaxis needed?

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Francisco Pérez

2016-03-01

Full Text Available La epistaxis es un problema extremadamente común que en ocasiones requiere de taponamiento anterior. Usualmente se indican antibióticos de forma concomitante para la prevención de complicaciones infecciosas, aunque el rol de esta medida es controvertido. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos una revisión sistemática que incluye tres estudios primarios, ninguno de ellos controlado y aleatorizado. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que no está claro si los antibióticos profilácticos disminuyen las complicaciones infecciosas en pacientes con taponamiento nasal por epistaxis anterior porque la certeza de la evidencia es muy baja.

Relación de la experiencia anterior de caries con la posterior actividad cariogénica en escolares de 7 a 14 años

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Aracelys Rivero López

2000-12-01

Full Text Available Se examinó un grupo de 378 niños con edades comprendidas entre 7 y 14 años, a los cuales se les confeccionó un dentigrama con el objetivo de recoger la experiencia anterior de caries. Se utilizó una clasificación de 0-1 y 2. Se empleó el mismo dentigrama en un examen clínico realizado al año y a los 2 años. Los resultados obtenidos muestran que los niños clasificados inicialmente en el grupo 0-1, presentaron menor actividad cariogénica al año (25,1 %, con una incidencia de 0,4, y a los 2 años (50 %, con una incidencia de 1,1. Los niños que presentaron al inicio del estudio una incidencia de caries ³ 2, fueron los más afectados al año (92,1 %, con un índice de 1,9, y a los 2 años (79,2 %, con un índice de 2,8. La diferencia entre los grupos fue significativa (p £ 0,001. La certeza fue de 84,6 % al año y de 69,3 % a los 2 años, por lo que sugerimos la clasificación propuesta para el examen clínico, como método predictivo de caries.A group of 378 children aged 7-14 was examined and a dental chart was made in order to know the previous caries experience. A classification of 0 - l and 2 was used. The same dental chart was used in a clinical examination made at one year and at two years. The results obtained showed that the children initially classified in the group 0 - 1 had a lower cariogenic activity at one year (25.1 % with an incidence of 0.4. This activity was higher at 2 years (50 % with an incidence of 1.1. Those children who had an incidence of caries IV 2 at the beginning of the study were the most affected at one year (92.l % with an incidence of 1.9. The affection index was 79.2 % with an incidence of 2.8 at two years. The difference between the groups was significant (p £ 0.001. Certainty was 84.6 % at one year and 69.3 % at two years, so we suggest the classification proposed for the clinical examination as a predictive method of caries.

Anterior perineal hernia after anterior exenteration

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Ka Wing Wong

2017-10-01

Full Text Available Perineal hernia is a rare complication of anterior exenteration. We reported this complication after an anterior exenteration for bladder cancer with bleeding complication requiring packing and second-look laparotomy. Perineal approach is a simple and effective method for repair of perineal hernia.

Uso de fijador externo en la inestabilidad de la pared torácica anterior (volet esternal: Presentación de un caso Use of the external fixative in the instability of the anterior thoraxic wall (sternal volet: A case report

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Orestes N Mederos Curbelo

2005-03-01

Full Text Available Se presenta un paciente con inestabilidad de la pared torácica anterior y esternón tratado previamente con un dispositivo creado por los autores en 1995 para el volet costal. Las costillas artificiales externas del dispositivo, diseñado para el cerclaje subperióstico, actúan como elemento de fijación y han conseguido resultados satisfactorios. Se presenta un paciente, que producto de un accidente automovilístico, sufre lesiones en cráneo, tórax, abdomen y extremidades, entre las que resaltan contusión cerebral, lesión hepática, fractura de fémur e inestabilidad de la pared torácica anterior. Esta última requirió de prioridad extrema, pues habría llevado rápidamente al paciente a la insuficiencia respiratoria de no ser solucionado el problema. Se realizó la estabilización externa mediante un equipo que se utiliza en nuestro hospital, reutilizable y aplicable en cualquier inestabilidad torácica independientemente de la localización de esta. El fijador se confecciona con láminas de duraluminio maleables que permiten su adaptabilidad e introduce una forma de tratamiento en las lesiones torácicas bilaterales con inestabilidad esternal, situación compleja en la que puede resultar un instrumento valioso de tratamientoA patient with instability of the anterior thoracic wall and sternum previously treated with a device created by the authors in 1995 for the costal volet, is presented. The artificial external ribs of the device designed for subperiosteous cerclage act as a fixation element with satisfactory results. The case of a patient that due to a car accident suffers from lesions in the cranium, thorax, abdomen and limbs, among which cerebral contusion, liver lesion, femur fracture and instability of the anterior thoracic wall stand out, is reported. Maximum priority was given to the instability of the anterior thoracic wall, since it could have rapidly led to respiratory failure if the problem would have not been solved. The

Resultados imediatos da correção cirúrgica de escoliose idiopática do adolescente por via posterior com instrumentação após liberação anterior por videotoracoscopia Resultados inmediatos de la corrección quirúrgica de escoliosis idiopática del adolescente por vía posterior con instrumentación después de liberación anterior por videotoracoscopia Short term results of surgical correction of adolescents' idiopathic scoliosis by posterior approach instrumentation following videothoracoscopic anterior release

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Eduardo Barros Puertas

2009-12-01

Full Text Available OBJETIVO: descrever os resultados imediatos da aplicação da liberação anterior por videotoracoscopia, seguida de instrumentação por via posterior para correção cirúrgica da escoliose idiopática do adolescente. MÉTODOS: foram selecionados 20 pacientes, no período de agosto de 1989 a maio de 2001, com escoliose idiopática do adolescente, padrão de curva torácica direita rígida, King III. Inicialmente realizou-se a abordagem pela via anterior com liberação por videotoracoscopia e depois a via posterior para correção e fixação com instrumental de Hartshill, em um mesmo tempo cirúrgico. RESULTADOS: todos os procedimentos foram completados com sucesso com videotoracoscopia, sem necessidade de conversão para toracotomia. A média de idade dos pacientes foi de 15,7 anos (12 a 21 anos. Em relação aos dias de internação, obteve-se um tempo médio de permanência de 9,45 dias (5 a 26 dias. A média entre os valores angulares foi, no pré-operatório, de 66,25º Cobb (48º a 92º Cobb, e no pós-operatório, de 31,2º Cobb (15º a 45º Cobb. Como complicações, quatro pacientes tiveram nevralgia intercostal (20% e um caso de atelectasia (5%. CONCLUSÕES: a discectomia por videotoracoscopia é um método efetivo e seguro para tornar flexíveis as curvas escolióticas rígidas. No entanto, trata-se de um procedimento tecnicamente difícil, que requer treinamento árduo e prolongado, com curva de aprendizado extensa.OBJETIVO: describir los resultados inmediatos de la aplicación de la liberación anterior por videotoracoscopia, seguida de instrumentación por vía posterior para corrección quirúrgica de escoliosis idiopática del adolescente. MÉTODOS: fueron seleccionados 20 pacientes, en el periodo de agosto de 1989 a mayo de 2001, con escoliosis idiopática del adolescente, con un padrón de curva torácica derecha rígida, King III. Inicialmente se realizó un abordaje por la vía anterior con liberación por

Historia natural de la oclusión aguda de gran arteria de la circulación cerebral anterior : serie clínica de 120 pacientes.

OpenAIRE

Hernández Pérez, María

2012-01-01

: Para estudiar la historia natural del ictus isquémico por oclusión de gran vaso de la circulación anterior se seleccionó una muestra prospectiva de pacientes con ictus agudo que no recibieron terapias de reperfusión en los que se confirmó una oclusión de gran vaso de la circulación anterior mediante Dúplex transcraneal. El 74% de los pacientes tuvo mal pronóstico. Los pacientes con oclusión de la a.carótida interna terminal y de la a.cerebral media proximal tuvieron peor pronóstico funciona...

Lesiones traumáticas de los anexos y del segmento anterior del ojo en los boxeadores Traumatic lesions of the adnexa and of the anterior segment of the eye in fighters

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Agustín Fernández Sánchez

2003-06-01

Full Text Available Se realizó un estudio retrospectivo con una muestra de 71 boxeadores a los cuales se les examinaron las estructuras de referencia mediante oftalmoscopia directa y biomicroscopia ocular, antes de las 6 horas posteriores al término de sus peleas; donde se obtuvo como resultado que los anexos afectados fueron los párpados con 5 hematomas, 4 edemas y 1 excoriación; y la conjuntiva con 4 hiperemias y 8 hemorragias. En el segmento anterior del ojo sólo se afectó la córnea con 13 lesiones en total, divididas en 10 excoriaciones superficiales y 3 profundas. Las lesiones traumáticas predominantes en los anexos del ojo son las de los párpados y las de la conjuntiva y las del segmento anterior del ojo, las de la córnea. El ojo más afectado fue el izquierdo y las lesiones más frecuentes fueron en las categorías de 13 y 14, 17 y 18 y 19 y 34 años las corneales, las conjuntivales y la de los párpados, respectivamente.A retrospective study was carried out with a sample of 71 fighters, whose reference structures were examined by direct ophthalmoscopy and ocular biomicroscopy within the 6 hours following their fights. As a result, it was observed that the affected adnexa were the eyelids with 5 hematomas, 4 edemas and 1 excoriation; and the conjunctiva with 4 hyperemias and 8 hemorrhages. In the anteriro segment, only the cornea was affected with 13 lesions in all, divided into 10 superficial and 3 deep excoriations.The traumatic lesions prevailing in the adnexa of the eye are those of the eyelids and the conjunctiva, whereas the predominating traumatic lesions of the anterior segment of the eye are those of the cornea. The left eye was the most affected and the most frequent lesions were in the categories 13 and 14, 17 and 18 and 19 and 34 years old in the cornea, the conjunctiva and the eyelids, respectively.

Películas biodegradables con propiedades bioactivas

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Adriana Isabel Montes Hernández

2017-07-01

Full Text Available El envasado pasivo como barrera física entre el alimento y su entorno no permite posibles interacciones beneficiosas. Por otro lado, la acumulación del material plástico derivado del petróleo usado en el envasado es una problemática mundial, por causa de su naturaleza contaminante. En razón de lo anterior, el desarrollo de nuevos materiales para envasado que ofrezcan nuevas funcionalidades, menos impacto ambiental, y además, beneficio económico, actualmente es una necesidad. En esta revisión se recopiló información ampliamente disponible sobre avances en la elaboración de películas biodegradables, especialmente las basadas en almidón, que pueden ser consideradas como envases activos por la incorporación de aditivos antimicrobianos y/o antioxidantes. En líneas generales, las investigaciones se orientan a sistemas de envasado antimicrobiano y/o con actividad antioxidante con un enfoque en películas biodegradables elaboradas con polisacáridos y otros materiales.

Experiencia con el colgajo de Kirschbaum en secuelas de quemaduras cérvico-faciales

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P. Rossell-Perry

2014-06-01

Full Text Available Presentamos nuestra experiencia con el colgajo de Kirschbaum (colgajo en charretera en la corrección de retracciones cicatriciales de la región cervical anterior y del tercio inferior de la cara. Llevamos a cabo un estudio retrospectivo sobre una serie de 63 pacientes con retracciones cicatriciales de la región cervical anterior y del tercio inferior facial, operados por el primer autor entre los años 1996 y 2012 dentro del marco de las campañas quirúrgicas desarrolladas a lo largo del país (Perú en las áreas geográficas con mayor necesidad de atención especializada. En todos los casos empleamos el colgajo en charretera tomado de la región lateral del cuello y de la región deltoidea. Evaluamos a los pacientes mediante el examen físico y la documentación fotográfica obtenida en los periodos pre y postoperatorio. Obtuvimos mejoría en diferentes grados de la limitación funcional de la región cervical y facial en todos los casos operados, con viabilidad total del colgajo en 59 casos (93,65 % y parcial en 4 casos (6,34 % . No hubo ningún caso de pérdida total. Las complicaciones recogidas fueron pocas, principalmente hematomas, 6 casos (9,52 % e infección, 2 casos (3,17 % . Las zonas donantes evolucionaron con cicatriz hipertrófica en 22 de los casos (34,92 % . En conclusión, nuestra experiencia con el uso de esta técnica quirúrgica ha demostrado ser de utilidad en el tratamiento de las secuelas de quemadura con retracción cicatricial cervical y facial, por lo que consideramos que el colgajo de Kirschbaum es seguro y tiene pocas complicaciones.

Does adding interbody fusion to posterolateral fusion increase success in the surgical management of degenerative lumbar spondylolisthesis?

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Arturo Meissner-Haecker

2018-01-01

Full Text Available Resumen INTRODUCCIÓN Frecuentemente se agrega una artrodesis intersomática a la artrodesis posterolateral en el tratamiento quirúrgico de la espondilolistesis degenerativa. Sin embargo, la real utilidad de esta medida no está clara. MÉTODOS Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante búsquedas en múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, reanalizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES Identificamos cuatro revisiones sistemáticas que en conjunto incluyen nueve estudios primarios, de los cuales ninguno corresponde a un ensayo aleatorizado. Concluimos que agregar una artrodesis intersomática a una artrodesis posterolateral en el tratamiento quirúrgico de la espondilolistesis degenerativa podría asociarse a una disminución en el deslizamiento del cuerpo vertebral y a una leve mejoría de la calidad de vida de los pacientes, pero asociado también a un mayor costo.

Anterior cervical fusion: the role of anterior plating.

Science.gov (United States)

Daffner, Scott D; Wang, Jeffrey C

2009-01-01

Treatment of cervical pathology requires a clear understanding of the biomechanical benefits and limitations of cervical plates, their indications, and their associated complications. The use of anterior cervical plates has evolved significantly since their early application in cervical trauma. They have become widely used for anterior cervical decompression and fusion for cervical spondylosis. Plate design has undergone significant refinement and innovation, from the initial unlocked plates requiring bicortical purchase to the latest rotationally and translationally semiconstrained dynamic plates. Excellent clinical results have been reported for single-level anterior cervical decompression and fusion with or without plate fixation; however, the addition of an anterior cervical plate clearly leads to earlier fusion and better clinical results in longer fusions. Longer fusions should ideally consist of corpectomies and strut grafting because the decreased number of fusion surfaces tends to lead to higher fusion rates. Although anterior plate fixation leads to higher fusion rates in fusions of three or more levels, the associated pseudarthrosis rate is still high. The use of dynamic plates, through increased load sharing across the graft and decreased stress shielding, may improve fusion rates, particularly in long fusions. Nevertheless, adjuvant posterior fixation is recommended for fusions of more than three vertebral levels. Anterior plate fixation may be of particular benefit in the management of traumatic injuries, in revision settings, and in the treatment of smokers. Complications unique to plate fixation include hardware breakage and migration as well as ossification of the adjacent disk levels.

Avaliação radiográfica da descompensação do tronco após artrodese seletiva torácica em portadores de escoliose idiopática do adolescente King II (Lenke B e C Evaluación radiográfica de la descompensación del tronco después de una artrodesis selectiva torácica en portadores de escoliosis idiopática del adolescente King II (Lenke B y C Radiographic evaluation of trunk decompensation with selective thoracic arthrodesis in patients with adolescent idiopathic scoliosis type King II (Lenke B e C

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Osmar Avanzi

2009-12-01

Full Text Available OBJETIVO: avaliar a incidência de descompensação radiográfica do tronco após a artrodese seletiva torácica com instrumental de 3º geração na escoliose idiopática do adolescente (EIA King II (Lenke B e C após acompanhamento mínimo de um ano. MÉTODOS: foram avaliadas retrospectivamente as radiografias pré-operatórias, pós-operatórias imediatas e do último acompanhamento de 22 pacientes tratadas no período de 1993 a 2007. Observou-se a porcentagem de correção da curva torácica e lombar pelo método de Cobb, e o balanço coronal do tronco do início e do final do acompanhamento foi avaliado pelos critérios da Scoliosis Research Society. RESULTADOS: após correção média da curva torácica de 56 ± 11% e da lombar de 49 ±13%, verificamos descompensação coronal imediata em seis pacientes (27,20%. Após acompanhamento médio de 65 meses, quatro pacientes (18,18% estavam com o tronco descompensado. Em apenas um paciente foi necessária extensão da artrodese, incluindo a curva lombar. CONCLUSÕES: a descompensação grave do tronco com necessidade de segundo procedimento para artrodese lombar foi complicação não frequente nesta série de casos.OBJETIVO: evaluar la incidencia de descompensación radiográfica del tronco después de una artrodesis selectiva torácica con instrumental de tercera generación en la escoliosis idiopática del adolescente (EIA King II (Lenke B y C, después de un acompañamiento mínimo de un año. MÉTODOS: fueron evaluados retrospectivamente las radiografías preoperatorias, postoperatorias inmediatas y del último acompañamiento de 22 pacientes tratados en el periodo de 1993 a 2007. Se observó un porcentaje de correlación de la curva torácica y lumbar, por el método de Cobb, y el balance coronal del tronco al inicio y al final del acompañamiento por los criterios de la Scoliosis Research Society. RESULTADOS: después de la corrección promedio de la curva torácica de 56±11% y de la

La reproducción de experimentos históricos en relación con la forja de ethos científico

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Sierra, C.

2006-01-01

Full Text Available Se propone en este ensayo la imbricación natural entre el experimento recreativo típico y su contexto histórico por la vía de la reproducción de experimentos históricos de valor pedagógico, no sólo en los niveles elementales de la enseñanza científica, sino en el universitario, con miras al fomento de un modo científico natural de entender el mundo, un ethos científico. Se justifica lo anterior desde la óptica sugerida por la antropología filosófica a fin de no escindir en forma tajante el experimento recreativo del histórico, a buen tono con el concepto de formación integral. Así mismo, se ilustra lo anterior con ejemplos emanados de la experiencia educativa del autor.

¿Es neutral el IRPF en relación con la inversión en productos financieros agregados y desagregados?

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Maria E. Rodríguez Macho

2002-12-01

Full Text Available En este trabajo se estudia si se producen o no supuestos de falta de neutralidad fiscal en el IRPF español, analizando si son gravados por igual los supuestos en los que se produce la igualdad del valor actual de los flujos financieros generados por distintos diseños financieros. En sintonía con lo anterior, este estudio se propone demostrar que el supuesto anterior se verifica en la medida que un mismo rendimiento financiero, tal y como es el que se produce con la prima recibida por la venta de una opción put o con el beneficio obtenido por la compra de una opción call, dependiendo de la estructura en la que se presente tributará como un rendimiento de capital mobiliario o como una ganancia patrimonial, estableciéndose unas importantes diferencias de fiscalidad entre dos productos que generan flujos financieramente idénticos.

La hemiplejia en el reblandecimiento anterior del bulbo

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J. O. Trelles

1971-03-01

Full Text Available A propósito de un caso de reblandecimiento limitado al territorio arterial anterior y mediano del bulbo que se traducía, clínicamente, por una hemiplejía controlateral con trastornos sensitivos y ausencia de compromiso del facial o de la lengua, y del análisis de 8 casos anatomo-clínicos encontrados en una revisión bibliográfica, los autores discuten el problema de la irrigación arterial del bulbo, el cuadro clínico y el tan debatido asunto de la pretendida flaccidez de estas hemiplejias. Desde el punto de vista de la vascularización arterial del bulbo, se insiste en que ésta es compleja y variable según que se trate del sector oral contiguo a la protuberancia, del sector caudal contiguo a la médula o del sector intermediario a los dos. Desde el punto de vista clínico, en los casos típicos, se trata de una hemiplejia espástica con trastornos sensitivos sin compromiso del facial, ni del hipogloso. De los nueve casos anatomo-clínicos registrados hasta el presente, seis con larga sobrevida, presentaron hemiplejia espástica; dos, con sobrevidas cortas, se encontraban en la etapa de transición hacia la espasticidad; uno con lesiones extensas presentó una flaccidez permanente. En lo que se refiere al problema de la pretendida flaccidez de estas hemiplejias vemos que las hemiplejías bulbares no escapan a la regla de las lesiones del haz piramidal, las que después de una primera etapa de flaccidez evolucionan hacia la espasticidad. Por tanto las conclusiones doctrinarias referentes al haz piramidal basadas en ésta pretendida flaccidez de la hemiplejía bulbar son erróneas y deben revisarse.

Iris en sayuela signo clínico nuevo asociado al síndrome tóxico del segmento anterior: a new clinical sign associated to the anterior segment toxic syndrome Iris in underskirt

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Iván Hernández López

2010-01-01

Full Text Available OBJETIVO: Presentar un nuevo signo clínico como resultado del desprendimiento gigante del epitelio pigmentado posterior del iris en el curso de un síndrome tóxico del segmento anterior tras una cirugía de catarata. MÉTODOS: Presentamos un paciente intervenido de catarata mediante facoemulsificación con implante de lente intraocular de cámara posterior plegable, sin incidencias ni complicaciones transoperatorias. Se le realizó evaluación biomicroscópica en el posoperatorio inmediato diagnosticándosele un síndrome tóxico del segmento anterior asociado a un desprendimiento gigante del epitelio pigmentado posterior del iris. Se tomaron fotos durante la evolución del paciente para documentar este raro signo clínico. RESULTADOS: Al provocar la dilatación pupilar farmacológica nos encontramos con la retracción de todas las capas anteriores del iris, mostrando por debajo al epitelio pigmentado posterior del iris sinequiado al lente intraocular y tan extensamente desprendido que simulaba un segundo iris. No encontramos este hallazgo clínico reportado en la literatura revisada. Denominamos este signo como iris en sayuela. CONCLUSIONES: El desprendimiento del epitelio pigmentado posterior del iris constituye un hallazgo clínico que puede aparecer raramente asociado al síndrome tóxico del segmento anterior y cuando es muy extenso puede presentarse de forma insólita como el signo del iris en sayuela.OBJECTIVE: To present a new clinical sign as a result of a huge posterior pigmented epithelium detachment of the iris in the course of at toxic anterior segment syndrome after a successful cataract surgery. METHOD: A patient who had undergone a cataract surgery by phacoemulsification with posterior chamber foldable intraocular lens implantation, without any incidence or transoperative complication. He was evaluated through biomicroscopy in the immediate postoperative period where a huge posterior pigmented epithelium detachment of the iris

anomalous left anterior cerebral artery with hypoplastic right anterior ...

African Journals Online (AJOL)

2018-02-28

Feb 28, 2018 ... We report an extremely rare anomalous variation of left anterior cerebral artery arising from the ... paraclinoid internal carotid artery and right ... Studies on the arteries of the brain: II-The anterior cerebral artery: Some anatomic ...

Hernioplastia laparoscópica y reparación anterior sin tensión: ¿qué dicen las evidencias? Laparoscopic hernioplasty and without tension anterior repair: What about evidences?

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Felipe Jorge Aragón Palmero

2009-12-01

Full Text Available El tratamiento quirúrgico de la hernia inguinal permanece controversial a pesar de los avances experimentados en los últimos 20 años en materia de biomateriales e instrumentación. Las técnicas de reparación laparoscópica forman parte del arsenal quirúrgico, pero su lugar en este tipo de cirugía aún no está bien definido. Con el objetivo de determinar el papel de la reparación abierta por vía anterior a base de prótesis y del abordaje laparoscópico de la hernia inguinal, se revisaron las publicaciones con alto nivel de evidencias, de los últimos 10 años, usando diferentes estrategias de búsqueda en bases de datos disponibles en Infomed.Surgical treatment of inguinal hernia remains controversial despite the advances achieved in past 20 years related to biomaterial and instrumentation. Laparoscopic repair techniques are part of surgical armamentarium, but its place in this type of surgery still is not well defined. To determine the role of open repair via anterior to prosthesis basis and of laparoscopic approach of inguinal hernia, authors reviewed the publications with a high level of evidence from the past 10 years using different strategies of search in databases available in Infomed.

Nueva variante de queratoplastia lamelar anterior profunda por abordaje esclerolimbal con técnica de viscodisección

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Armando Capote Cabrera

Full Text Available Objetivos: describir las características de la nueva variante de queratoplastia lamelar anterior profunda, por abordaje desde la zona esclerolimbal empleando técnica de viscodisección y, analizar los resultados logrados en la cirugía experimental. Métodos: el procedimiento fue realizado en el Instituto Cubano de Oftalmología «Ramón Pando Ferrer», a 10 globos oculares humanos no útiles para trasplante. A través de incisión radial a nivel de la esclera adyacente al limbo se diseca hasta visualizar el tejido corneal más oscuro que indica el plano predescemético. Por el espacio creado, se avanza e inyecta viscoelástico desprendiendo controladamente la membrana de Descemet y endotelio. Resultados: en todos los ojos se pudo completar el procedimiento hasta lograr la disección de la membrana de Descemet. En ocho de ellos (80 %, no se produjo ninguna complicación intraoperatoria, en un ojo (10 %, hubo una perforación periférica de la membrana de Descemet, el proceder fue completado satisfactoriamente por otra incisión similar. En otro ojo (10 %, se produjo ruptura de la Descemet al inyectar viscoelástico para ampliar el desprendimiento. En el total de los casos se logró una disección que permitió aislar la membrana de Descemet transparente, con una superficie lisa y homogénea. El tiempo quirúrgico promedio fue de 18,4 minutos. Conclusiones: la técnica propuesta resultó segura y rápida en globos oculares enucleados. La disección se realiza en un área periférica de más seguridad. Este proceder también puede resultar de utilidad en la disección de la Descemet para la queratoplastia endotelial de la membrana de la Descemet.

COMPARISON OF THE RESISTANCE OF THREE CERAMIC SYSTEMS IN ANTERIOR FIXED PROSTHETIC SEGMENTS. A FINITE ELEMENT ANALYSIS

OpenAIRE

Pineda Duque, Érika Alejandra; Escobar Restrepo, Julio César; Latorre Correa, Federico; Villarraga Ossa, Junes Abdul

2013-01-01

Introducción: el propósito de este estudio fue evaluar mediante el método de elementos finitos, la distribución de los esfuerzos en prótesis parcial fija (PPF) de tres unidades en la zona anterior, elaborados en tres sistemas cerámicos con diferentes variaciones en los conectores. Métodos: se modelaron cuatro tramos de PPF; tres de estos representaron los sistemas cerámicos: disilicato de litio, alúmina y circona y un cuarto modelo de disilicato de litio con un conector de 9 mm2 de área. Las ...

Presentación de un adolescente con gigantismo

OpenAIRE

Romero Paiffer, Iranis; Tamayo Rodríguez, Wilber; Odou Cobian, José Ramón

2016-01-01

El gigantismo es una enfermedad hormonal causada por la excesiva secreción de la hormona del crecimiento por parte de la hipófisis anterior antes del cierre la epífisis del hueso, que ocasiona un crecimiento desmesurado de la estatura de todo el cuerpo. Se presentó el caso de un adolescente de 18 años, procedente de una comuna pobre de Haití, con dolor en miembros inferiores y decaimiento, refiere historia previa de crecimiento exagerado en la longitud de su cuerpo, en las manos y pies. En el...

Conduta na lesão dural intraoperatória em artrodese da coluna lombar Conducta en lesión de duramadre intraoperatoria en artrodesis de la columna lumbar Management of intraoperatory dural tear in lumbar spine arthrodesis

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Fabiano de Mendonça Grandese

2010-12-01

Full Text Available OBJETIVO: estudo retrospectivo de pacientes com lesão dural intraoperatória de cirurgia da coluna vertebral lombar, conduzido por meio de um protocolo independente da extensão da lesão, complicações associadas e resultados após seguimento mínimo de um ano. MÉTODOS: um total de 10 pacientes com durotomia acidental em cirurgias de descompressão e artrodese da coluna vertebral lombar, no período de Janeiro de 2007 a Janeiro de 2009, para tratamento de doença degenerativa, tiveram seus prontuários revisados, após terem sido tratados por meio de um protocolo embasado em reparo primário da lesão, drenagem subaracnoidea fechada, subfascial e subcutânea aspirativa realizados por cirurgião experiente, associado a repouso relativo com mobilidade precoce e terapia medicamentosa. Suas anotações e exames radiológicos foram verificados com seguimento pós-operatório e direcionados para identificação de sintomas sugestivos de complicações. RESULTADOS: todos os pacientes apresentaram boa evolução, sem ocorrência de fístula liquórica ou infecção pós-operatória; três deles apresentaram cefaleia pós-operatória de leve intensidade. Não houve necessidade de reoperação em nenhum desses pacientes. CONCLUSÃO: concluiu-se que a conduta adotada é segura e de bom resultado para os pacientes quando ocorre esse tipo de lesão, independentemente da extensão da mesma.OBJETIVO: un estudio retrospectivo de pacientes con lesión de la duramadre intraoperatoria de cirugía en la columna lumbar, llevada a cabo por medio de un protocolo independiente de la extensión de la lesión, complicaciones asociadas y los resultados de seguimiento después de un mínimo de un año. MÉTODOS: 10 pacientes con durotomía accidental en la descompresión quirúrgica y artrodesis de la columna vertebral lumbar, en el período de enero de 2007 a enero de 2009, para el tratamiento de enfermedades degenerativas, tuvieron sus registros revisados después de

Válvula de uretra anterior Anterior urethral valves

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Silvio Tucci Jr.

2003-02-01

Full Text Available Objetivo: apresentar os aspectos clínicos, diagnósticos e terapêuticos de pacientes portadores de válvula da uretra anterior. Descrição: em dois neonatos, o diagnóstico presuntivo de patologia obstrutiva do trato urinário foi sugerido pela ultra-sonografia realizada no período pré-natal, confirmando-se o diagnóstico de válvula de uretra anterior pela avaliação pós-natal. Os pacientes foram submetidos a tratamento cirúrgico paliativo, com vesicostomia temporária e, posteriormente, definitivo, pela fulguração endoscópica das válvulas. Ambos evoluíram com função renal normal. Comentários: a válvula da uretra anterior é anomalia rara que deve ser considerada em meninos com quadro radiológico pré-natal sugestivo de obstrução infravesical, secundariamente à hipótese mais comum de válvula da uretra posterior. Ressaltamos a utilização da vesicostomia como derivação urinária temporária nestes casos, prevenindo potenciais complicações pela manipulação da uretra do recém-nascido.Objective: to discuss clinical signs, diagnostic tools and therapeutics of anterior urethral valves, an obstructive anomaly of the urinary system in males. Description: signs of urinary tract obstruction were identified on pre-natal ultrasound in two male fetuses and the diagnosis of anterior urethral valves was made through post-natal evaluation. As an initial treatment, vesicostomy was performed in both patients. Later, the valves were fulgurated using an endoscopic procedure. During the follow-up period both patients presented normal renal function. Comments: anterior urethral valves are a rare form of urethral anomaly that must be ruled out in boys with pre-natal ultrasound indicating infravesical obstruction. Vesicostomy used as an initial treatment rather than transurethral fulguration may prevent potential complications that can occur due to the small size of the neonatal urethra.

Perawatan Ortodontik Gigitan Terbuka Anterior

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Yuniar Zen

2014-06-01

Full Text Available Perawatan gigitan terbuka anterior telah lama dianggap sebagai tantangan bagi ortodontis. Prevalensi gigitan terbuka anterior antara 3,5% hingga 11% terdapat pada berbagai usia dan kelompok etnis, serta ada sekitar 17% pasien ortodonti memiliki gigitan terbuka. Stabilitas hasil perawatan gigitan terbuka anterior sangat sulit, karena adanya kombinasi diskrepansi anteroposterior dengan gigitan terbuka skeletal sehingga dibutuhkan tingkat keterampilan diagnosis dan klinis yang tinggi. Etiologi gigitan terbuka anterior sangat kompleks karena dapat melibatkan skeletal, dental, dan faktor-faktor habitual. Eliminasi faktor etiologi merupakan hal yang penting dalam perawatan gigitan terbuka anterior. Berbagai cara perawatan untuk koreksi gigitan terbuka anterior diantaranya bedah ortognatik dan perawatan ortodontik kamuflase, seperti high-pull headgear, chincup, bite blocks, alatfungsional, pencabutan gigi, multi-loop edgewise archwires dan mini implan. Stabilitas hasil perawatan adalah kriteria yang paling penting dalam menentukan cara perawatan gigitan terbuka anterior. Orthodontic Treatment of Anterior Open Bite. An anterior open bite therapy has long been considered a challenge to orthodontist. The prevalence of anterior openbite range from 3,5 % to 11% among various age and ethnic groups and it has been shown that approximately 17% of orthodontic patients have open bite. Stability of treatment result of anterior open bite with well-maintained results is difficult, because the combination of anteroposteriorly discrepancy with skeletal open bite requires the highest degree of diagnostic and clinical skill. The etiology is complex, potentially involving skeletal, dental and habitual factors. The importance of an anterior open bite therapy is to eliminate the cause of the open bite. Various treatment modalities for the correction of an anterior open bite have been proposed, orthognatic surgery and orthodontic camouflage treatment such as high

Laparoscopic graduated cardiomyotomy with anterior fundoplication as treatment for achalasia: experience of 48 cases

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A. Etchegaray-Dondé

2018-04-01

quirúrgico, para garantizar la inclusión de todo el EEI, 6 cm por arriba de la UGE y 2 cm en sentido caudal, para asegurar la medición laparoscópica. El objetivo del estudio fue evaluar los resultados obtenidos con esta técnica. Material y métodos: Estudio descriptivo, retrospectivo, longitudinal, observacional, en una cohorte de pacientes con diagnóstico de acalasia, en la Clínica de Tracto Digestivo Superior, del Hospital General de México «Dr. Eduardo Liceaga». Resultados: Se incluyeron 48 pacientes; 40 sin tratamiento quirúrgico previo y 8 con recurrencia. En 47 casos el abordaje fue laparoscópico (97.9%; se requirió conversión a procedimiento abierto en 2 casos (tasa conversión 4.25%. La evolución postoperatoria fue satisfactoria en todos los casos, con inicio de la vía oral a las 52 h en promedio y una estancia intrahospitalaria promedio de 5.7 días. Durante el seguimiento de 35.75 meses en promedio no se han registrado recurrencias. No se presentó mortalidad. Conclusiones: La cardiomiotomía graduada (estrictamente medida con funduplicatura anterior mediante abordaje laparoscópico es una opción reproducible, eficaz y segura para el tratamiento quirúrgico de la acalasia. Keywords: Achalasia, Cardiomyotomy, Laparoscopy, Anterior fundoplication, Palabras clave: Acalasia, Cardiomiotomía, Laparoscopía, Funduplicatura anterior

Revisión sistemática sobre la efectividad del tratamiento de fisioterapia tras la reconstrucción del ligamento cruzado anterior

OpenAIRE

Aguado Llorente, Mariola

2013-01-01

La rotura del LCA es una lesión frecuente a nivel deportivo. Se caracteriza por dolor, hinchazón e inestabilidad. tras su lesión es imposible seguir un protocolo de rehabilitación con fisioterapia para recuperar la funcionalidad de la rodilla. con este trabajo pretendo comprobar la eficacia del tratamiento de fisioterapia tras la cirugía del LCA utilizando las bases de datos Medline, Pedro, Cochrane, Gopubmed y Science direct, utilizando las palabras "anterior crucial ligament", "post surgery...

COORDINACION DE ABASTECIMIENTO CON INFORMACION COMPARTIDA EN PYMES AGROALIMENTARIAS COLOMBIANAS.

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MARTÍN DARIO ARANGO SERNA

2011-01-01

Full Text Available Este artículo, propone un modelo de Inventario Gestionado por el Vendedor (Vendor Managed Inventory-VMI- mejorado respecto al modelo propuesto por Yao [1] en una cadena de abastecimiento para dos eslabones con un vendedor y un comprador, que considera los costos de envío del proveedor al comprador y un inventario sincronizado. Se analizan los costos totales relevantes de la cadena de abastecimiento y los benefi cios para cada uno de los eslabones en comparación con las situaciones en que no se implemente la política de VMI y en la que se implemente el modelo de VMI propuesto por Yao[1]. Se revisa el impacto de la aplicación de VMI en el sector panifi cador en Colombia, con el uso de parámetros que fueron determinados en estudios anteriores [2] y se obtiene que la implementación de una política de coordinación de inventarios es benefi ciosa tanto para el proveedor como para el comprador.

Ejercicios de Cole como prevención de lesión de ligamento cruzado anterior en sujetos deportistas. Revisión bibliográfica.

OpenAIRE

Nebreda Medrano, Eider

2017-01-01

Introducción: La rotura del ligamento cruzado anterior es una de las lesiones que se dan con mayor incidencia y gravedad a nivel de rodilla en el mundo deportivo. Es por esto que con el fin de reducir su aparición, es importe realizar programas de prevención. El trabajo de core es una de las modalidades de entrenamiento de prevención que más se utiliza actualmente por su popularidad, y por la relación que se está viendo que tiene el trabajo de dicha zona, con el cambio biomecánico de la extre...

Catarata polar anterior piramidal deslocada para a câmara anterior causando edema de córnea: relato de caso Corneal edema caused by a pyramidal anterior polar cataract dislocated to the anterior chamber: case report

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Ramon Coral Ghanem

2004-08-01

Full Text Available Cataratas polares anteriores piramidais são opacidades cônicas que se projetam para a câmara anterior a partir da cápsula anterior do cristalino. Na grande maioria dos pacientes a opacidade permanece aderida e estável durante toda a vida. O objetivo deste trabalho é documentar uma manifestação incomum desse tipo de catarata: a deiscência espontânea das pirâmides para a câmara anterior causando descompensação endotelial e edema corneal bilateral. Relatamos o caso de uma paciente feminina, de 66 anos, branca, que apresentava edema corneal localizado inferiormente no olho direito associado à lesão nodular branco-esclerótica compatível com a pirâmide anterior da catarata polar. O olho esquerdo apresentava edema corneal difuso intenso e presença de uma catarata polar anterior com a região piramidal deslocada para a câmara anterior. Sabe-se que a pirâmide anterior pode permanecer inabsorvida na câmara anterior por longo período, pois é composta de tecido colágeno denso. Isto causa perda endotelial progressiva e edema corneal e deve ser considerada indicação de remoção cirúrgica da catarata polar anterior e de seu fragmento. Ressalta-se, também, a importância do bom senso no julgamento das cataratas polares anteriores, considerando-se tamanho da opacidade, simetria das opacidades e componente cortical associado, na tentativa de se evitar ambliopia.Pyramidal anterior polar cataracts are conical opacities that project into the anterior chamber from the anterior capsule of the lens. In the vast majority of patients the opacity remains bound and stable throughout life. We report an unusual complication of this type of cataract: spontaneous dehiscence of the pyramids to the anterior chamber causing bilateral endothelial damage and corneal edema. 66-year-old white woman presented with inferior corneal edema in the right eye and diffuse corneal edema in the left eye. A white nodular lesion was observed in the inferior angle

Anterior tibial stress fractures treated with anterior tension band plating in high-performance athletes.

Science.gov (United States)

Cruz, Alexandre Santa; de Hollanda, João Paris Buarque; Duarte, Aires; Hungria Neto, José Soares

2013-06-01

The non-surgical treatment of anterior tibial cortex stress fractures requires long periods of abstention from sports activities and often results in non-union. Many different surgical techniques have already been previously described to treat these fractures, but there is no consensus on the best treatment. We describe the outcome of treatment using anterior tibial tension band plating in three high-performance athletes (4 legs) with anterior tibial cortex stress fractures. Tibial osteosynthesis with a 3.5-mm locking compression plate in the anterolateral aspect of the tibia was performed in all patients diagnosed with anterior tibial stress fracture after September 2010 at Santa Casa Hospital. All of the fractures were consolidated within a period of 3 months after surgery, allowing for an early return to pre-injury levels of competitive sports activity. There were no infection, non-union, malunion or anterior knee pain complications. Anterior tibial tension band plating leads to prompt fracture consolidation and is a good alternative for the treatment of anterior tibial cortex stress fractures. Bone grafts were shown to be unnecessary.

Anterior ankle arthroscopy, distraction or dorsiflexion?

Science.gov (United States)

de Leeuw, Peter A J; Golanó, Pau; Clavero, Joan A; van Dijk, C Niek

2010-05-01

Anterior ankle arthroscopy can basically be performed by two different methods; the dorsiflexion- or distraction method. The objective of this study was to determine the size of the anterior working area for both the dorsiflexion and distraction method. The anterior working area is anteriorly limited by the overlying anatomy which includes the neurovascular bundle. We hypothesize that in ankle dorsiflexion the anterior neurovascular bundle will move away anteriorly from the ankle joint, whereas in ankle distraction the anterior neurovascular bundle is pulled tight towards the joint, thereby decreasing the safe anterior working area. Six fresh frozen ankle specimens, amputated above the knee, were scanned with computed tomography. Prior to scanning the anterior tibial artery was injected with contrast fluid and subsequently each ankle was scanned both in ankle dorsiflexion and in distraction. A special device was developed to reproducibly obtain ankle dorsiflexion and distraction in the computed tomography scanner. The distance between the anterior border of the inferior tibial articular facet and the posterior border of the anterior tibial artery was measured. The median distance from the anterior border of the inferior tibial articular facet to the posterior border of the anterior tibial artery in ankle dorsiflexion and distraction was 0.9 cm (range 0.7-1.5) and 0.7 cm (range 0.5-0.8), respectively. The distance in ankle dorsiflexion significantly exceeded the distance in ankle distraction (P = 0.03). The current study shows a significantly increased distance between the anterior distal tibia and the overlying anterior neurovascular bundle with the ankle in a slightly dorsiflexed position as compared to the distracted ankle position. We thereby conclude that the distracted ankle position puts the neurovascular structures more at risk for iatrogenic damage when performing anterior ankle arthroscopy.

Anterior ankle arthroscopy, distraction or dorsiflexion?

OpenAIRE

de Leeuw, P.A.J.; Golanó, P.; Clavero, J.A.; van Dijk, C.N.

2010-01-01

Anterior ankle arthroscopy can basically be performed by two different methods; the dorsiflexion- or distraction method. The objective of this study was to determine the size of the anterior working area for both the dorsiflexion and distraction method. The anterior working area is anteriorly limited by the overlying anatomy which includes the neurovascular bundle. We hypothesize that in ankle dorsiflexion the anterior neurovascular bundle will move away anteriorly from the ankle joint, where...

Glaucoma maligno en paciente con cirugía previa de catarata traumática e implante valvular: reporte de caso

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Juan Carlos Serna-Ojeda

2015-07-01

Full Text Available El glaucoma maligno es un glaucoma secundario asociado con un bloqueo ciliar y dirección equivocada del flujo del humor acuoso. Se presenta el caso de un paciente masculino de 19 años con antecedente de explosión de filtro metálico en ojo derecho. Se encuentra con una presión intraocular de 52 mmHg y cristalino luxado a cámara anterior. Se inicia terapia máxima para glaucoma y se realiza facoemulsificación con posterior colocación de válvula de Ahmed, y 3 semanas después de la cirugía presenta hallazgos clínicos compatibles con glaucoma maligno. Se presenta el seguimiento del paciente y los estudios de imagen indicados

Lipoabdominoplastia con cicatriz reducida sin neo-onfaloplastia en abdomen tipo III (Matarasso Short scar lipoabdominoplasty without neoumbilicoplasty in tipe III abdomen (Matarasso

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P. Centurión

2009-12-01

Full Text Available Presentamos una innovadora técnica quirúrgica para el tratamiento de la región abdominal, en la cual combinamos lipoescultura y abdominoplastia con incisiones reducidas, sin neoonfaloplastia, en pacientes tipo III según Clasificación de Matarasso. Realizamos un estudio retrospectivo sobre pacientes intervenidos con esta nueva propuesta quirúrgica, entre los años 2002 y 2008. La lipoescultura corporal superficial y profunda incluyó también la pared abdominal anterior. La técnica quirúrgica se basa en el uso de incisiones reducidas a nivel suprapúbico, máximo de 18 cm. de longitud, con disección de un túnel de aproximadamente 10 cm. en plano supraponeurótico, desinserción del ombligo, plicatura de la diástasis de músculos rectos abdominales y posterior reinserción del ombligo inferiormente. Usamos una férula de yeso durante el postoperatorio. Evaluamos 64 lipoabdominoplastias, todas realizadas en mujeres con edad media de 41,9 años. El tiempo quirúrgico promedio fue de 3 horas y media, el volumen aspirado de la pared abdominal anterior tuvo un promedio de 1000 ml. El 14,1% de las pacientes presentaron seroma como complicación. Como conclusión creemos que esta técnica permite buenos resultados estéticos corporales totales al obtener una cicatriz corta, un colgajo abdominal anterior adelgazado y ausencia de cicatriz umbilical.We present an innovative surgical technique for treatment of abdominal region, in which we combine liposculpture and limited-incisions abdominoplasty without neoumbilicoplasty, in Type III Matarasso Classification patients. We conducted a retrospective study of patients undergoing surgery with this new proposal, between 2002 to 2008. The deep and superficial body liposculpture also included anterior abdominal wall. The surgical technique is based on the use of small incisions at the suprapubic region up to 18 cm long, with dissection of a supraaponeurotical tunnel of 10 cm approximately, with

Caracterización del nervio digital palmar en el miembro anterior equino

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Carolina Ortiz

2017-05-01

Full Text Available A partir de 60 miembros anteriores de caballos mestizos recolectados de un matadero en Santiago, Chile, se determinó que lo más frecuente es que el nervio digital palmar emita sus ramas dorsal y palmar antes (33% o al comienzo de la articulación metacarpofalángica (33%. En un 60% de los nervios analizados se evidenció la presencia de una a cuatro ramas accesorias y que ésta se presenta de manera similar entre diversas zonas, siendo la presentación más frecuente (26% en la zona de la articulación interfalángica proximal y que se dirigen hacia dorsal. En un 46,66% de las muestras el nervio digital palmar no se relaciona íntimamente con alguna estructura, seguido con 33,33% por la unión de éste al ligamento del espolón. Es muy poco frecuente que el nervio emita ramas superficiales que se dirijan hacia la dermis (6,66%, que se divida en tres grandes ramas en la articulación metacarpofalángica (3,33% o que pase bajo la arteria digital (3,33%, y más frecuente es que éste se disponga sobre la arteria en algún lugar de su recorrido hecho que ocurrió en el 35% de los casos. Estos resultados se presentan de manera relevante de considerar en procedimientos diagnósticos o quirúrgicos en la zona distal del miembro anterior del equino, ya que pueden alterar su sensibilidad y eficacia.

Estudio para el desarrollo y optimización del espumado de policarbonato con agentes de siembra en el proceso de inyección

OpenAIRE

Vargas Isaza, Carlos Andrés

2012-01-01

1 CD-ROM El presente trabajo aborda el desarrollo experimental para obtener piezas inyectadas espumadas en policarbonato (ver anexo 10.1.1), con características de alta densidad de espuma, mediante la incorporación de agentes nucleantes, tales como cargas inorgánicas y/o nanocargas. Con lo anterior, se busca implementar un proceso alternativo de espumado por inyección, el cual sea mas económico que los procesos comerciales, los cuales requieren una gran inversión en equipos. Se comenzó con...

Reconstrucción de Piso Orbitario con esclera en Fracturas del Tercio Medio. Presentación de caso

OpenAIRE

Alexis A. Amador-Velázquez; Martha Rodríguez-Milord; Reynaldo Oro-Canelles

2011-01-01

Presentó un caso el cual fue víctima de una agresión con un objeto cortante que le produjo una fractura compleja del tercio medio facial provocándole una Fractura Le Fort III unilateral izquierda y Le Fort II unilateral derecha con herida perforante y extensa en globo ocular izquierdo que fue necesario realizar su eviseración, extrayendo de este un fragmento de esclera del segmento anterior de mas menos 1cm de largo para reparar una fractura mediana en piso orbital derecho logrando su fijaci...

Traumatic anterior hip dislocation in a 12-year-old child

Directory of Open Access Journals (Sweden)

Gupta Vinay

2013-04-01

Full Text Available 【Abstract】Hip dislocation in children can occur congenitally in isolation or in conjunction with other con-genital abnormalities. Traumatic hip dislocations in children are relatively uncommon and anterior dislocation of hip joint is even rarer. We report such a case following unusual mode of injury in a 12-year-old child. The patient underwent suc-cessful emergent closed reduction of left hip. The clinical course and follow-up assessment of the patient was other-wise uneventful. At 2 years’ follow-up there was no evi-dence of osteoarthritis, coxa magna, heterotrophic calcification, in congruency of the joints or avascular ne-crosis of the head of femur. Key words: Hip; Dislocations; Child

Los cuadernillos de Unamuno anteriores a la etapa socialista y la crisis del racionalismo

OpenAIRE

Tanganelli, Paolo

1998-01-01

[ES] Se examinan los más significativos cuadernillos inéditos de Unamuno anteriores a su etapa socialista (octubre 1894) con el fin de calibrar qué conciencia tuviera el autor vasco del impasse racionalista en estos primeros años en los que su labor filosófico-literaria ensaya un camino sincrético entre idealismo y positivismo. [EN] The most remarkable Unamuno's unpublished note-books preceding his socialist period (october 1894) are examined in order to evaluate what kind of awareness the...

Anterior ankle arthroscopy, distraction or dorsiflexion?

NARCIS (Netherlands)

de Leeuw, P.A.J.; Golanó, P.; Clavero, J.A.; van Dijk, C.N.

2010-01-01

Anterior ankle arthroscopy can basically be performed by two different methods; the dorsiflexion- or distraction method. The objective of this study was to determine the size of the anterior working area for both the dorsiflexion and distraction method. The anterior working area is anteriorly

Evisceración en estafiloma escleral anterior gigante Evisceration of the giant anterior scleral staphyloma

Directory of Open Access Journals (Sweden)

Irene Rojas Rondón

2010-01-01

Full Text Available La evisceración es la técnica quirúrgica seleccionada para el tratamiento de muchas afecciones oculares graves como: endoftalmitis, ojo ciego doloroso por trauma crónico, glaucoma absoluto, desprendimiento de retina crónico, uveítis crónica, pthisis bulbi, buftalmos y por razones estéticas. Paciente de 21 años de edad que acude a consulta solicitando mejoría de su apariencia facial. Al examen ocular encontramos aumento de volumen localizado en toda la zona superior del globo ocular desde hora 9 hasta hora 3 del ojo derecho, donde se observaba adelgazamiento escleral con extensas zonas de coroides expuesta, leucoma corneal que ocupaba eje visual y exotropia 30° x Hirshberg, como secuela de trauma ocular. El diagnóstico fue estafiloma escleral anterior en el ojo derecho con riesgo de perforación escleral. La evisceración fue el proceder quirúrgico de elección en este tipo de afección, se colocó implante orbitario, sin complicaciones. Inmediatamente después de la cirugía se coloca conformador en la cavidad y luego de un mes se coloca prótesis ocular. De esta forma se logra mejorar el componente estético así como una adecuada rehabilitación y por ello la calidad de vida de nuestro paciente.Evisceration is the surgical technique selected for the treatment of many serious ocular illnesses such as endophthalmitis, painful blind eye due to chronic trauma, absolute glaucoma, chronic retinal detachment, chronic uveitis, pthisis bulbi, buphthalmos and for aesthetic reasons. A 21 years-old patient went to the doctor's office to request some assistance to improve her facial look. On ocular exam, increased volume located in the upper area of the eyeball from hour 9 to hour 3 of the right eye was observed; also scleral thinning with extensive areas of exposed choroid, corneal leukoma occupying the visual axis and 30° exotropia x Hirshberg, as ocular trauma sequel. The diagnosis was anterior scleral staphyloma with risk of scleral

Cognitive Performance and Locomotor Adaptation in Persons With Anterior Cruciate Ligament Reconstruction.

Science.gov (United States)

Stone, Amanda E; Roper, Jaimie A; Herman, Daniel C; Hass, Chris J

2018-05-01

Persons with anterior cruciate ligament reconstruction (ACLR) show deficits in gait and neuromuscular control following rehabilitation. This altered behavior extends to locomotor adaptation and learning, however the contributing factors to this observed behavior have yet to be investigated. The purpose of this study was to assess differences in locomotor adaptation and learning between ACLR and controls, and identify underlying contributors to motor adaptation in these individuals. Twenty ACLR individuals and 20 healthy controls (CON) agreed to participate in this study. Participants performed four cognitive and dexterity tasks (local version of Trail Making Test, reaction time test, electronic pursuit rotor test, and the Purdue pegboard). Three-dimensional kinematics were also collected while participants walked on a split-belt treadmill. ACLR individuals completed the local versions of Trails A and Trails B significantly faster than CON. During split-belt walking, ACLR individuals demonstrated smaller step length asymmetry during EARLY and LATE adaptation, smaller double support asymmetry during MID adaptation, and larger stance time asymmetry during DE-ADAPT compared with CON. ACLR individuals performed better during tasks that required visual attention and task switching and were less perturbed during split-belt walking compared to controls. Persons with ACLR may use different strategies than controls, cognitive or otherwise, to adapt locomotor patterns.

Descrição de técnica de redução cirúrgica das luxações facetárias da coluna cervical baixa por via anterior Descripción de la técnica quirúrgica para reducción de las luxaciones facetarias de la columna cervical baja por acceso anterior Description of surgical technique for reduction of facet dislocations of the lower cervical spine by anterior approach

Directory of Open Access Journals (Sweden)

André Rafael Hübner

2012-12-01

Full Text Available O trabalho descreve uma técnica cirúrgica de redução anterior das luxações facetárias da coluna cervical e discute as indicações para cirurgia por via anterior para as luxações da coluna cervical baixa. A técnica descrita neste artigo oferece excelentes resultados, conforme revisão bibliográfica e dos resultados do Serviço, tendo sido aplicada em até 95% dos casos de fraturas-luxações. Não será abordada a apresentação de resultados neste trabalho, apenas a descrição e discussão da técnica aberta por via anterior. Observações de quarenta e um pacientes tratados nos últimos dez anos por esta técnica demonstram bons resultados quanto a pós-operatório menos doloroso, recuperação funcional extremamente rápida e complicações pouco frequentes.El artículo describe una técnica quirúrgica para las luxaciones facetarias de la columna cervical y discute las indicaciones para la cirugía de luxación de la columna cervical baja por lo acceso anterior. La técnica descrita en este artículo proporciona excelentes resultados según la revisión de la literatura y los resultados del Servicio, después de haber sido aplicado a 95% de los casos de fracturas-luxaciones. No serán abordados resultados, sino que únicamente la descripción y discusión de la técnica de reducción abierta por acceso vía anterior. Las observaciones en cuarenta y un pacientes operados en los últimos diez años por esta técnica muestran resultados sorprendentes con respecto a un pos operatorio menos doloroso, con recuperación funcional extremadamente rápida y complicaciones menos frecuentes.This paper describes a surgical technique for anterior reduction of the spinal facets dislocations and discusses its indications for surgery of lower cervical dislocations by anterior approach. The technique described in this article provides excellent results according to literature review and the results of the Service, having been applied to 95% of

CREADIS (Centro de Recursos Electrónicos para Alumnos Universitarios con Discapacidad: una iniciativa académica para la alfabetización informacional de los estudiantes universitarios con discapacidad.

Directory of Open Access Journals (Sweden)

Ana Nieves Millán Reyes

2011-07-01

Full Text Available CREADIS (Centro de Recursos Electrónicos para Alumnos Universitarios con Discapacidad se presenta como un portal web de contenidos destinado a los estudiantes universitarios con alguna discapacidad que están vinculados a la Universidad de Granada, y en general a cualquier universidad andaluza o española, como un recurso colectivo, gratuito y de calidad controlada para favorecer el aprendizaje y el acceso a la información desde el principio de la igualdad de oportunidades, la no-discriminación y la accesibilidad universal que se contemplan en la normativa legal que lo avala. Asimismo, está dirigido a aquellas otras personas, asociaciones, educadores, que realicen tareas de asesoramiento. Se presenta como un repositorio de recursos electrónicos de calidad, con valor añadido, que sirva de ventana abierta a la información y al aprendizaje a lo largo de la vida. Constituye una muestra de la responsabilidad social de la universidad y de los profesionales de la información para favorecer los valores anteriores.

Imagenología y distribución de cargas en la muñeca normal y postquirúrgica

OpenAIRE

Márquez Flórez, Kalenia María

2014-01-01

En este trabajo se determinó la distribución de cargas en la articulación radio-carpiana en la muñeca, bajo condiciones de carga y geometría, asociadas a tratamientos de artrodesis en estado estático. Para esto, se empleó el método discreto Rigid Body Spring Model (RBSM) en un modelo tridimensional de una muñeca sana. El método RBSM también se aplicó a modelos en los cuales se simularon condiciones de la muñeca luego de algún tratamiento de artrodesis, y los resultados obtenido...

Mild toxic anterior segment syndrome mimicking delayed onset toxic anterior segment syndrome after cataract surgery

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Su-Na Lee

2014-01-01

Full Text Available Toxic anterior segment syndrome (TASS is an acute sterile postoperative anterior segment inflammation that may occur after anterior segment surgery. I report herein a case that developed mild TASS in one eye after bilateral uneventful cataract surgery, which was masked during early postoperative period under steroid eye drop and mimicking delayed onset TASS after switching to weaker steroid eye drop.

La oclusión dentaria en interacción con la postura corporal

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José Miguel Montero Parrilla

Full Text Available Introducción: en décadas recientes se ha sugerido que las alteraciones en el Sistema Estomatognático como las maloclusiones, pueden influenciar completamente la postura del cuerpo. Objetivo: identificar diversas variables oclusales según su interacción con la postura corporal. Métodos: se realizó un estudio observacional descriptivo transversal en el período comprendido entre febrero de 2011 y marzo 2012, en el cual se seleccionó una muestra de 122 estudiantes de 3er. año en la Facultad de Estomatología, de un universo de 235, sin dientes ausentes por otra causa que no sea el tratamiento ortodóncico. Se examinó la oclusión dentaria y posteriormente se realizó el examen postural. Resultados: los pacientes con la postura Tipo C, o sea con el plano escapular posterior y la cabeza en una posición más anterior, presentaron menores valores medios de resalte, espacio libre y mayor sobrepase, 2,86; 3,33; 3,40 mm respectivamente. El 40 % de los pacientes tuvo una postura Tipo B. Las interferencias oclusales en lateralidad se apreciaron en mayor medida en 66 pacientes con desequilibrio derecho de hombros y de pelvis. Conclusiones: los estudiantes con postura Tipo C, mostraron los menores valores medios de resalte, espacio libre y los que tenían la postura tipo E, el mayor sobrepase. Predominaron los pacientes con postura Tipo B y con neutroclusión. Más de la mitad de los casos con mordida cruzada presentaron un desequilibrio derecho de las pelvis.

MRI appearances of the anterior fibulocalcaneus muscle: a rare anterior compartment muscle

Energy Technology Data Exchange (ETDEWEB)

Upadhyay, Bhavin [Basildon and Thurrock University Hospitals NHS Foundation Trust, Imaging Department, Essex (United Kingdom); Amiras, Dimitri [Imperial College Health Care NHS Trust, Imaging Department, London (United Kingdom)

2015-05-01

MRI of a 62-year-old female presenting with ankle pain demonstrated an accessory muscle within the anterior compartment of the lower leg. The muscle originated from the fibula and anterior crural septum. The tendon passed anterior to the lateral malleolus and inserted at the critical angle of Gissane on the calcaneus. This muscle was initially described in the anatomic literature by Lambert and Atsas in 2010. To our knowledge, this is the first time the MRI appearances of this muscle has been described in the radiological literature. Awareness of the fibulocalcaneal muscle is important as it may represent a cause of ankle pain. In addition, the tendon could potentially be harvested for use in reconstructive procedures. (orig.)

Estudio clínico, genético y molecular en un paciente con atrofia muscular espinal

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Ibis Menéndez Alejo

1998-03-01

Full Text Available Las atrofias musculares espinales (AME infantiles son enfermedades neuromusculares hereditarias caracterizadas por la degeneración de las motoneuronas alfa del asta anterior de la médula espinal. La enfermedad de Werdnig-Hoffmann, AME tipo I, es la forma más grave, se transmite como un carácter autosómico recesivo y los afectados suelen fallecer durante el primer año de vida por fallo respiratorio. En este trabajo se presenta una familia cubana con 2 hijos con AME tipo I, en la cual el estudio molecular en uno de ellos permitió identificar los 2 cromosomas parentales asociados con ésta. Se encontró además en el paciente una deleción de ambas copias del gen SMN (exón 8 y del gen NAIP (exón 5. Los hallazgos ilustran la utilidad de estos estudios, con vistas a posibilitar el diagnóstico prenatal de la enfermedad.The infantile spinal muscular atrophies (SMA are hereditary neuromuscular diseases characterized by degenerated Alfa-motoneurons of the anterior spinal marrow horn. Werdning-Hoffman disease, Type 1 SMA, is the most serious affection being transmitted as an autosomal recessive character, so those affected may die from respiratory failures in the first year of life. This paper presents a Cuban family with two kids who suffer from Type-1 SMA; the molecular analysis carried out in one of them identified two parental chromosomes responsible for the disease. Also, a deletion of both copies of SMN gene (exon 8 and NAIP gene (exon 5 were discovered in this patient. These findings showed the usefulness of this kind of studies with a view to making a prenatal diagnosis of Werdning-Hoffman disease.

Anterior approach for knee arthrography

International Nuclear Information System (INIS)

Zurlo, J.V.; Towers, J.D.; Golla, S.

2001-01-01

Objective. To develop a new method of magnetic resonance arthrography (MRA) of the knee using an anterior approach analogous to the portals used for knee arthroscopy.Design. An anterior approach to the knee joint was devised mimicking anterior portals used for knee arthroscopy. Seven patients scheduled for routine knee MRA were placed in a decubitus position and under fluoroscopic guidance a needle was advanced from a position adjacent to the patellar tendon into the knee joint. After confirmation of the needle tip location, a dilute gadolinium solution was injected.Results and conclusion. All the arthrograms were technically successful. The anterior approach to knee MRA has greater technical ease than the traditional approach with little patient discomfort. (orig.)

Capsulorhexis contraction after cataract surgery: Comparison of sharp anterior edge and modified anterior edge acrylic intraocular lenses

DEFF Research Database (Denmark)

Corydon, C.; Lindholt, M.; Knudsen, E.B.

2007-01-01

eyes) were included in a prospective randomized study. All had phacoemulsification followed by implantation of an IOL with a modified anterior edge (38 eyes) or a sharp anterior edge (46 eyes). One day (baseline) and 3 months postoperatively, the area of the anterior capsule opening was measured using...... retroillumination photographs. RESULTS: There was a significant reduction in the area of the anterior capsule opening from 1 day to 3 months postoperatively in both groups (Psharp...

Anterior vitrectomy and partial capsulectomy via anterior approach to treat chronic postoperative endophthalmitis

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Mete Güler

2013-02-01

Full Text Available AIM:To describe the results of vitrectomy and partial capsulectomy via anterior approach surgical technique in treatment of chronic postoperative endophthalmitis (CPE.METHODS:Clinical records of 9 patients treated for CPE between 2006 and 2010 were reviewed retrospectively. All of these patients were treated with vitrectomy and partial capsulectomy via anterior approach.RESULTS:Six of 9 patients were male. The average patients’ age was (60±8.1 years. The average period between cataract extraction and onset of signs and symptoms was (3.6±1.3 weeks. The average presenting visual acuity was 0.3±0.1 and the average final post operative visual acuity was 0.7±0.2. The mean follow-up period was (28.1±8.9 weeks. In all patients, the inflammation subsided after surgery.CONCLUSION:Our results suggest that anterior vitrectomy and partial capsulectomy via anterior approach may be considered as potentially useful and relatively less invasive technique to treat CPE.

[Anterior guidance in complete dentures].

Science.gov (United States)

Dubreuil, J; Trevelo, A

1990-01-01

Although the anterior guidance in complete dentures is not really a guide, the arrangement of the anterior maxillary and mandibular prosthetic teeth, defines a propulsive line called the virtual anterior guidance, a part from the cinematic criterias. The influence of this guide on cuspal movement is superior, in all mandibular points, to the influence of the condylar pathway. If this line is not respected, the practitioner may have to do excessive grindings during occlusal adjustments.

Immediate postoperative anterior knee stability: double- versus triple-bundle anterior cruciate ligament reconstructions.

Science.gov (United States)

Mae, Tatsuo; Shino, Konsei; Matsumoto, Norinao; Yoneda, Kenji; Yoshikawa, Hideki; Nakata, Ken

2013-02-01

The purpose of this study was to compare the triple-bundle (TB) anterior cruciate ligament (ACL) reconstruction with the double-bundle (DB) ACL reconstruction in immediate postoperative anterior knee stability. This study involved 133 patients who had undergone the anatomic ACL reconstruction with autogenous hamstring tendon unilaterally. Then 83 patients (mean age, 28.8 years) underwent the DB between November 2004 and December 2005, and 50 patients (mean age, 29.6 years) underwent the TB ACL reconstruction between January and December 2006. The 2 femoral tunnels were created in the ideal ACL attachment area, whereas 2 tibial tunnels for the DB and 3 tunnels for the TB were created in the ACL footprint. The 2 doubled tendon grafts were fixed with EndoButton-CL (Smith & Nephew Endoscopy, Andover, MA) on the femur. The grafts were fixed to the tibia using a Double Spike Plate and a screw under the total initial tension of 20 N at 20° of flexion, after meticulous in situ pretensioning using a tensioning boot. Then immediate postoperative anterior knee laxity in response to 89 N of anterior load was measured by one experienced examiner (T.M.) with the KT-2000 Knee Arthrometer (MEDmedtric, San Diego, CA) under general anesthesia at 30° of knee flexion with muscle relaxants. The measured anterior laxity was 3.4 ± 1.2 mm in the DB and 2.5 ± 0.7 mm in the TB ACL reconstruction, a statistically significant difference. The side-to-side difference of the laxity was -3.2 ± 1.6 mm in the DB and -4.2 ± 2.0 mm in the TB, again a significant difference. TB ACL reconstruction resulted in better immediate postoperative anterior knee stability than DB ACL reconstruction under 89 N of anterior tibial load (P = .031). Level III, therapeutic retrospective comparative study. Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

38 CFR 3.379 - Anterior poliomyelitis.

Science.gov (United States)

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Anterior poliomyelitis. 3... Specific Diseases § 3.379 Anterior poliomyelitis. If the first manifestations of acute anterior poliomyelitis present themselves in a veteran within 35 days of termination of active military service, it is...

The Efficacy of Bulbar Urethral Mobilization for Anastomotic Anterior Urethroplasty in a Case With Recurrent Anterior Urethral Stricture

OpenAIRE

Fukui, Shinji; Aoki, Katsuya; Kaneko, Yoshiteru; Samma, Shoji; Fujimoto, Kiyohide

2014-01-01

A 2-month-old boy was diagnosed with febrile urinary tract infection. Voiding cystourethrography showed bulbar and anterior urethral strictures, and endoscopic internal urethrotomy was performed. He developed febrile urinary tract infection again and revealed the recurrence of the anterior urethral stricture. Consequently, endoscopic internal urethrotomy was performed 4 times. Because the anterior urethral stricture had not improved, he was referred to us. Anterior urethroplasty was performed...

Resultados del tratamiento quirúrgico en aneurismas intracraneales múltiples de la circulación anterior

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Armando Alemán Rivera

2001-09-01

Full Text Available Se realiza un análisis de 10 pacientes con aneurismas múltiples de la porción anterior del polígono de Willis, los cuales representan el 10 % de todos los pacientes con aneurismas operados en el Servicio de Neurocirugía del Hospital Universitario «Arnaldo Milián Castro» de Santa Clara, Villa Clara. En 2 pacientes, los sacos aneurismáticos se localizaban bilateralmente. En un enfermo, la operación fue unilateral, mientras que en el otro, donde los aneurismas se localizaban en ambas arterias cerebrales medias, segmento M2 (aneurismas en espejo, el abordaje se realizó en 2 tiempos quirúrgicos. Todos los sacos aneurismáticos se presillaron y se reportó una mortalidad del 10 %An analysis of 10 patients with multiple aneurysms of the anterior portion of the circle of Willis that accounted for 10 % of all patients with aneurysms operated on at the Neurosurgery Service of "Arnaldo Milián Castro" Teaching Hospital of Santa Clara, Villa Clara, was made. The aneurysmatic sacs were bilaterally located in 2 patients. In one patient, the operation was unilateral, whereas in the other one, in whom the aneurysms were located in both middle cerebral arteries, M2 segment (mirror aneurysms, the operation was performed in 2 surgical times. All the aneurysmatic sacs were stapled and a 10 % mortality was re

Características clínico epidemiológicas de pacientes con infarto miocárdico agudo

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Omar Lóriga García

2013-12-01

Full Text Available Introducción: la cardiopatía isquémica, y entre estas el Infarto Agudo del Miocardio con elevación del segmento ST, es la primera causa de muerte a nivel mundial. Objetivo: describir las características clínico epidemiológicas de pacientes con infarto agudo del miocardio de la unidad de cuidados coronarios del Hospital General Docente Abel Santamaría Cuadrado de Pinar del Río, en 2011 y 2012. Material y Método: estudio observacional, descriptivo, retrospectivo transversal; universo 644 pacientes ingresados con elevación del ST. Los datos se tomaron de las historias clínicas. Resultados: 62% tenían entre 60- 79 años. 84.5% de los pacientes entre 30 y 49 años eran hombres. 81,6% fumaba y el 45,5% era diabético. La localización topográfica del infarto fue: inferior el 70,8%, anterior el 22,9% y anterior extensa el 6,2% de los pacientes. Como complicación, la arritmia se presentó en el 34% de los pacientes, la insuficiencia cardiaca en el 14,9% y la muerte en 7,7%. El 68,5% de los pacientes con arritmias tuvo fibrilación auricular. La trombolisis se empleó en el 55,2% de los pacientes apareciendo, entre las complicaciones, la hipotensión en el 30,7%. Conclusiones: el infarto miocárdico agudo fue más frecuente en pacientes de mayor edad, siendo antes de los 50 años cinco veces más frecuente entre los hombres. Los factores de riesgo más representados fueron el hábito de fumar y la diabetes mellitus. La localización más frecuente fue la inferior y la complicación las arritmias y dentro de estas la fibrilación auricular. La trombolisis se complica principalmente con hipotensión, pudiendo ser más empleada.

Long anterior zonules and pigment dispersion.

Science.gov (United States)

Moroi, Sayoko E; Lark, Kurt K; Sieving, Paul A; Nouri-Mahdavi, Kouros; Schlötzer-Schrehardt, Ursula; Katz, Gregory J; Ritch, Robert

2003-12-01

To describe pigment dispersion associated with long anterior zonules. Multicenter observational case series. Fifteen patients, seven of whom were treated for glaucoma or ocular hypertension, were identified with long anterior zonules and pigment dispersion. Transmission electron microscopy was performed on one anterior capsule specimen. All patients had anterior zonules that inserted centrally on the lens capsule. Signs of pigment dispersion included corneal endothelial pigmentation, loss of the pupillary ruff, and variable trabecular meshwork pigmentation. Ultrasound biomicroscopy verified the lack of posterior iris insertion and concavity. There was no exfoliation material. Transmission electron microscopy showed zonular lamellae with adherent pigment granules, and no exfoliation material. Long anterior zonules inserted onto the central lens capsule may cause mechanical disruption of the pigment epithelium at the pupillary ruff and central iris leading to pigment dispersion.

Fenestration of the anterior cerebral artery

International Nuclear Information System (INIS)

Ito, J.; Washiyama, K.; Hong Kim, C.; Ibuchi, Y.

1981-01-01

Three cases of angiographically demonstrated fenestration of the anterior cerebral artery are reported. Fenestration occurred at the medial half of the horizontal segment of the anterior cerebral artery in all cases. Its embryology and clinical significance are briefly discussed, and the anatomical and radiological literature on fenestration of the anterior cerebral artery is reviewed. (orig.)

The Efficacy of Bulbar Urethral Mobilization for Anastomotic Anterior Urethroplasty in a Case With Recurrent Anterior Urethral Stricture.

Science.gov (United States)

Fukui, Shinji; Aoki, Katsuya; Kaneko, Yoshiteru; Samma, Shoji; Fujimoto, Kiyohide

2014-05-01

A 2-month-old boy was diagnosed with febrile urinary tract infection. Voiding cystourethrography showed bulbar and anterior urethral strictures, and endoscopic internal urethrotomy was performed. He developed febrile urinary tract infection again and revealed the recurrence of the anterior urethral stricture. Consequently, endoscopic internal urethrotomy was performed 4 times. Because the anterior urethral stricture had not improved, he was referred to us. Anterior urethroplasty was performed when he was 5 years. After excision of the scarred portions of the urethra, the defect of the urethra was 20 mm. Transperineal bulbar urethral mobilization was performed, and a single-stage end-to-end anterior urethroplasty without tension could be performed simultaneously.

Análisis descriptivo de la miología flexora y extensora del miembro anterior de Polychrus acutirostris (Squamata, Polychrotidae

Directory of Open Access Journals (Sweden)

Silvia Moro

2004-01-01

Full Text Available Se describe la musculatura de la extremidad anterior de Polychrus acutirostris. Se analizó la anatomía de los músculos flexores y extensores, tomándose en cuenta para cada uno los sitios de origen e inserción y las características principales. Los objetivos principales de este trabajo son: contribuir a la identificación de los complejos musculares del antebrazo y la mano; actualizar la nomenclatura de ciertos músculos complicados, y presentar un modelo de la musculatura de la extremidad anterior de un lagarto arborícola, que permita comparar con la anatomía muscular de lagartos con otros hábitos locomotores.The musculature of the forelimb of Polychrus acutirostris is described. The anatomy of the flexor and extensor muscles was analyzed, with a record of the sites of origin and insertion and main characteristics for each muscle. The main purposes of this work are: to contribute to the identification of the muscular complexes of the forearm and manus; to update the nomenclature of certain complicated muscles; and to present a model of the forelimb musculature of an arboreal lizard, to allow comparisons with the muscular anatomy of lizards with other locomotor habits.

Cervical disc arthroplasty: Pros and cons.

Science.gov (United States)

Moatz, Bradley; Tortolani, P Justin

2012-01-01

Cervical disc arthroplasty has emerged as a promising potential alternative to anterior cervical discectomy and fusion (ACDF) in appropriately selected patients. Despite a history of excellent outcomes after ACDF, the question as to whether a fusion leads to adjacent segment degeneration remains unanswered. Numerous US investigational device exemption trials comparing cervical arthroplasty to fusion have been conducted to answer this question. This study reviews the current research regarding cervical athroplasty, and emphasizes both the pros and cons of arthroplasty as compared with ACDF. Early clinical outcomes show that cervical arthroplasty is as effective as the standard ACDF. However, this new technology is also associated with an expanding list of novel complications. Although there is no definitive evidence that cervical disc replacement reduces the incidence of adjacent segment degeneration, it does show other advantages; for example, faster return to work, and reduced need for postoperative bracing.

Herniation of the anterior lens capsule

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Pereira Nolette

2007-01-01

Full Text Available Herniation of the anterior lens capsule is a rare abnormality in which the capsule bulges forward in the pupillary area. This herniation can be mistaken for an anterior lenticonus where both the capsule and the cortex bulge forward. The exact pathology behind this finding is still unclear. We report the clinical, ultrasound biomicroscopy (UBM and histopathological findings of a case of herniation of the anterior lens capsule. UBM helped to differentiate this entity from anterior lenticonus. Light microscopy revealed capsular splitting suggestive of capsular delamination and collection of fluid (aqueous in the area of herniation giving it a characteristic appearance.

Multidisciplinary management of anterior diastemata

DEFF Research Database (Denmark)

Furuse, Adilson Yoshio; Herkrath, Fernando José; Franco, Eduardo Jacomino

2007-01-01

Anterior diastemata may compromise the harmony of a patient's smile. Consideration of etiologic factors, previous gingival conditioning, and individual treatment planning are essential in the proper management of anterior diastemata. An integrated orthodontic-restorative approach may enhance the ...

The Efficacy of Bulbar Urethral Mobilization for Anastomotic Anterior Urethroplasty in a Case With Recurrent Anterior Urethral Stricture

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Shinji Fukui

2014-05-01

Full Text Available A 2-month-old boy was diagnosed with febrile urinary tract infection. Voiding cystourethrography showed bulbar and anterior urethral strictures, and endoscopic internal urethrotomy was performed. He developed febrile urinary tract infection again and revealed the recurrence of the anterior urethral stricture. Consequently, endoscopic internal urethrotomy was performed 4 times. Because the anterior urethral stricture had not improved, he was referred to us. Anterior urethroplasty was performed when he was 5 years. After excision of the scarred portions of the urethra, the defect of the urethra was 20 mm. Transperineal bulbar urethral mobilization was performed, and a single-stage end-to-end anterior urethroplasty without tension could be performed simultaneously.

LA MINERÍA MANUAL EN COLOMBIA: UNA COMPARACIÓN CON AMÉRICA LATINA

OpenAIRE

GÜIZA-SUÁREZ, LEONARDO

2014-01-01

En el mundo y particularmente en América Latina, la minería no mecanizada o manual ha sido utilizada como medio de sustento por los pobladores rurales o migrantes de ciudades que van a trabajar a estas zonas y que la llevan a cabo en condiciones sociales desfavorables por lo que resulta importante conocer los aspectos socio-jurídicos que envuelven la actividad. Con el fin de llevar a cabo lo anterior, se realizó una investigación de tipo descriptivo sobre tres variables dependientes: conceptu...

MARCO TEÓRICO Y CONCEPTUAL DE LA EDUCACIÓN INCLUSIVA Y SU VINCULACIÓN CON LA EDUCACIÓN PARA LA PAZ.

OpenAIRE

Filiberto Rivera Meneses

2015-01-01

El presente artículo analiza de manera general el contexto en el que se desarrolla la educación Inclusiva en nuestro país y su relación con los estudios de paz que se vienen gestando en el Estado de México. Lo anterior, vinculado con la construcción de paz y la convivencia escolar armónica en un Centro de Atención Múltiple del municipio de Ixtapaluca. El análisis particulariza el Programa de Convivencia Escolar promovido por la Secretaría de Educación Pública en el presente ciclo escolar 2014...

Combination nivolumab- and cabiralizumab-associated acute bilateral anterior and posterior scleritis and anterior uveitis

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John A. Gonzales

2018-06-01

Full Text Available Purpose: To report on a case of uveitis and scleritis resulting as an immune-mediated side effect of cancer immunotherapy with nivolumab and cabiralizumab. Observations: Bilateral anterior nongranulomatous anterior uveitis and bilateral diffuse anterior and posterior scleritis occurred following the use of combination cancer immunotherapy. The uveitis and scleritis resolved following temporary discontinuation of nivolumab and cabiralizumab as well as systemic prednisone. Conclusions and importance: Ophthalmologists should be aware of the possibility of acute ocular inflammation developing with cancer immunotherapy. Systemic corticosteroids play a first-line role in managing such immune-mediated side effects. Keywords: Uveitis, Scleritis, Cancer immunotherapy, Side effects, Nivolumab, Cabiralizumab

Anterior spinal cord syndrome of unknown etiology

OpenAIRE

Klakeel, Merrine; Thompson, Justin; Srinivasan, Rajashree; McDonald, Frank

2015-01-01

A spinal cord injury encompasses a physical insult to the spinal cord. In the case of anterior spinal cord syndrome, the insult is a vascular lesion at the anterior spinal artery. We present the cases of two 13-year-old boys with anterior spinal cord syndrome, along with a review of the anatomy and vasculature of the spinal cord and an explanation of how a lesion in the cord corresponds to anterior spinal cord syndrome.

Características funcionales orofaciales en pacientes jóvenes con mordida abierta interior

OpenAIRE

Malca Borja, Leslie Natalia

2016-01-01

La estabilidad de las funciones orofaciales tales como succión, respiración, masticación, deglución y habla está directamente relacionada con la forma de las estructuras estomatognáticas, de tal manera que cualquier alteración en dichas estructuras puede interrumpir la correcta función de las mismas. Las maloclusiones dentarias, según su severidad, pueden ocasionar alteraciones en las funciones orofaciales y una de ellas es la mordida abierta anterior. La investigación tiene como objetivo des...

Hernioplastia laparoscópica y reparación anterior sin tensión: ¿qué dicen las evidencias?

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Felipe Jorge Aragón Palmero

Full Text Available El tratamiento quirúrgico de la hernia inguinal permanece controversial a pesar de los avances experimentados en los últimos 20 años en materia de biomateriales e instrumentación. Las técnicas de reparación laparoscópica forman parte del arsenal quirúrgico, pero su lugar en este tipo de cirugía aún no está bien definido. Con el objetivo de determinar el papel de la reparación abierta por vía anterior a base de prótesis y del abordaje laparoscópico de la hernia inguinal, se revisaron las publicaciones con alto nivel de evidencias, de los últimos 10 años, usando diferentes estrategias de búsqueda en bases de datos disponibles en Infomed.

MRI of tibialis anterior tendon rupture

International Nuclear Information System (INIS)

Gallo, Robert A.; DeMeo, Patrick J.; Kolman, Brett H.; Daffner, Richard H.; Sciulli, Robert L.; Roberts, Catherine C.

2004-01-01

Ruptures of the tibialis anterior tendon are rare. We present the clinical histories and MRI findings of three recent male patients with tibialis anterior tendon rupture aged 58-67 years, all of whom presented with pain over the dorsum of the ankle. Two of the three patients presented with complete rupture showing discontinuity of the tendon, thickening of the retracted portion of the tendon, and excess fluid in the tendon sheath. One patient demonstrated a partial tear showing an attenuated tendon with increased surrounding fluid. Although rupture of the tibialis anterior tendon is a rarely reported entity, MRI is a useful modality in the definitive detection and characterization of tibialis anterior tendon ruptures. (orig.)

Humeral avulsion of the anterior shoulder stabilizing structures after anterior shoulder dislocation: demonstration by MRI and MR arthrography

International Nuclear Information System (INIS)

Tirman, P.F.J.; Steinbach, L.S.; Feller, J.F.; Stauffer, A.E.

1996-01-01

Objective. To demonstrate the MRI findings of an anterior shoulder capsular avulsion from the humerus, with or without subscapularis rupture, after anterior dislocation or severe abduction external rotation injury. Design and patients. We retrospectively reviewed the MRI and MR arthrographic examinations of seven patients who were identified at surgery with avulsion of the anterior shoulder stabilizers from the humerus. MRI was correlated with clinical history and surgical results. Results. MRI findings included: inhomogeneity or frank disruption of the anterior capsule at the humeral insertion (all), fluid intensity anterior to the shoulder (six patients), tear of the subscapularis tendon (six patients), dislocation of the biceps tendon (four patients), and a Hill-Sachs deformity (four patients). MR arthrography additionally found extravasation of contrast through the capsular defect (two patients). Conclusions. Our findings suggest that MRI is helpful for diagnosing humeral avulsion of the anterior glenohumeral capsule, especially when a tear of the subscapularis tendon insertion is present. MR arthrography may be of benefit for diagnosing capsular avulsion without associated subscapularis tendon abnormality. (orig.). With 4 figs

Artroplastia total de disco cervical com prótese de Bryan: resultados clínicos e funcionais Artroplastía cervical total con prótesis de Bryan: resultados clínicos y funcionales Cervical total disc arthroplasty with Bryan disc: clinical and functional outcomes

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Eduardo Machado de Menezes

2012-09-01

resultados buenos y excelentes, 10% satisfactorios y el 7% malos. Hubo sólo una complicación (3%, que se revirtió con artrodesis anterior. CONCLUSIONES: La artroplastia discal cervical ha demostrado ser un método seguro y eficaz para el tratamiento de casos seleccionados de hernia de disco cervical asociada a la radiculopatía y/o a compresión de la médula espinal en el corto y mediano plazo.OBJECTIVE: To evaluate results of cervical disc arthroplasty with the Bryan prosthesis for treatment of cervicobrachial pain (radiculopathy and spinal cord compression (myelopathy. METHODS: From 2002 to 2007, the CECOL surgical staff has operated 65 patients. Only 28 patients were found in 2010 to a new data collection. The pre- and post-operative evaluation was conducted using the CSOQ questionnaire (Cervical Spine Outcomes Questionnaire. Odom criteria were used only in the postoperative evaluation. Both were translated and adapted to local culture. RESULTS: There was a significant symptomatic and functional improvement in most patients. The reduction of neck pain (axial and brachial pain (radicular was similar. Odom criteria showed 82.1% good and excellent results, 10% satisfactory and 7% poor. There was only one complication (3% which was reversed with anterior arthrodesis. CONCLUSIONS: The total cervical disc arthroplasty has proved to be a safe and effective method to treat selected cases of cervical disc herniation with radiculopathy and/or myelopathy in the short and medium term.

Anterior insula activation during inhibition to smoking cues is associated with ability to maintain tobacco abstinence

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Jodi M. Gilman

2018-06-01

Full Text Available Relapse to smoking after initial abstinence is a major clinical challenge with significant public health consequences. At the brain and behavioral level, those who relapse to tobacco smoking have both greater cue-reactivity and lower inhibitory control than those who remain abstinent. Little is known about neural activation during inhibitory control tasks in the presence of drug-related cues. In the current study, tobacco smokers (SMK; n = 22 and non-smoking controls (CON; n = 19 completed a Go/NoGo task involving smoking cues during a functional magnetic resonance imaging (fMRI scan. Following the scan session, smokers were required to quit smoking, and maintenance of abstinence was evaluated as part of a 12-week smoking cessation trial. We evaluated pre-cessation brain activity during NoGo trials in smokers who were versus were not able to quit smoking. We then compared fMRI and inhibitory control measures between smokers and non-smokers. We did not find differences between SMK and CON in performance or activation to smoking or neutral cues. However, compared to SMK who relapsed, SMK who attained biochemically-validated abstinence at the end of the smoking cessation trial had greater neural activation in the anterior insula during NoGo trials specifically with smoking-related cues. Results indicate that within SMK, decreased inhibitory control activation during direct exposure to drug-related stimuli may be a marker of difficulty quitting and relapse vulnerability. Keywords: Smoking cessation, Tobacco, fMRI, Insula, Cue, Relapse, Anterior cingulate cortex, ACC

Imaging findings of anterior hip dislocations

Energy Technology Data Exchange (ETDEWEB)

Pfeifer, Kyle [Mallinckrodt Institute of Radiology, Department of Radiology, St. Louis, MO (United States); Leslie, Michael [Yale School of Medicine, Department of Orthopedics and Rehabilitation, New Haven, CT (United States); Menn, Kirsten; Haims, Andrew [Yale University School of Medicine, Department of Radiology and Biomedical Imaging, New Haven, CT (United States)

2017-06-15

Anterior hip dislocations are rare orthopedic emergencies resulting from high-energy trauma and have unique imaging characteristics on radiography, computed tomography (CT), and magnetic resonance imaging (MRI). Imaging findings on CT and MRI allow for the prompt recognition and classification of anterior hip dislocations, which guides patient management and reduces complications. The purpose of this article is to review imaging findings of anterior hip dislocations, specifically focusing on CT and MRI. (orig.)

A NOVEL ANOMALY OF THE ANTERIOR DIGASTRIC MUSCLE. UNA ANOMALÍA NUEVA DEL MÚSCULO DIGÁSTRICO ANTERIOR

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Timothy W Hegeman

2016-03-01

Full Text Available Documentamos una anomalía del músculo digástrico anterior en un cadáver femenino de 85 años de edad. La anomalía consiste en cuatro vientres adicionales que salen entre los dos típicos digástricos anterior. Analizamos el significado embriológico y clínico de esta variante. El músculo digástrico es derivado de dos arcos branquiales o arcos faríngeos. El primer arco branquial forma el vientre anterior y el segundo forma el vientre posterior. Actuando juntos, los vientres ayudan a impulsar hacia abajo la mandíbula y a estabilizar el hioides. Varias anormalidades en el vientre anterior del digástrico han sido previamente descriptas en la literatura, pero ninguna ha replicado la formación precisa descripta aquí.  We document a novel anomaly of the anterior digastrics of an 85 year old female cadaver, consisting of four additional muscle bellies existing between the two typical anterior digastrics and go on to explain the embryologic and clinical significance of the variant. The digastric muscle is derived from two pharyngeal arches, the first pharyngeal arch forming the anterior belly and the second forming the posterior belly. Acting together, both bellies help to depress the mandible and stabilize the hyoid. Several abnormalities in the anterior belly of the digastric muscle have previously been described in the literature, but none have replicated the precise formation described here.

Modulators of the extracellular matrix and risk of anterior cruciate ligament ruptures.

Science.gov (United States)

Rahim, Masouda; Mannion, Sasha; Klug, Blake; Hobbs, Hayden; van der Merwe, Willem; Posthumus, Michael; Collins, Malcolm; September, Alison V

2017-02-01

The extracellular matrix (ECM) of ligaments continuously undergoes remodelling in order to maintain tissue homeostasis. Several key mediators of ECM remodelling were chosen for investigation in the present study. It is thought that polymorphisms within genes encoding signalling molecules may contribute to inter-individual variation in the responses to mechanical loading, potentially altering risk of injury. A genetic association study was conducted on 232 asymptomatic controls (CON) and 234 participants with surgically diagnosed anterior cruciate ligament (ACL) ruptures; of which 135 participants reported a non-contact mechanism of injury (NON subgroup). All participants were genotyped for ten variants in eight genes encoding ECM remodelling proteins. Haplotypes and allele combinations were also inferred. The CASP8 rs3834129 ins allele was significantly over-represented in the male CON group compared to the male NON subgroup (p=0.047, OR: 1.46, 95% CI: 1.01-2.12). In female participants, the IL1B rs16944 TT genotype was significantly under-represented in the CON group compared to the NON subgroup (p=0.039, OR: 3.06, 95% CI: 1.09-8.64). Haplotype analysis revealed an under-representation of the CASP8 rs3834129-rs1045485 del-G haplotype in the CON group compared to both the ACL group (p=0.042; haplo.score:2.03) and the NON subgroup (p=0.037; haplo.score:2.09). Furthermore, following a pathway-based approach, genetic variants involved in the cell signalling cascade were associated with ACL injury risk. The novel independent associations and allele combinations observed implicate the apoptosis and cell signalling cascades as potential contributors to ACL injury susceptibility. Furthermore, these genetic variants may potentially modulate ECM remodelling in response to loading and ultimately contribute to ligament capacity. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Arteria Tibial Anterior Hipoplásica Asociada con la Continuación de la Arteria Fibular como Arteria Dorsal del Pié: Un Reporte de Caso

OpenAIRE

Shetty, Surekha D; Nayak, Satheesha; Kumar, Naveen; Abhinitha, P

2013-01-01

Arterial variations of distal parts of lower limb are well documented. However, continuation of fibular artery as dorsalis pedis artery is a rare finding. Unusual course and distribution of the anterior tibial artery and fibular artery were observed during routine anatomical dissection of the right lower limb of an approximately 40-year-old male cadaver. The arteries of the crural region arose from the popliteal artery, as usual. However the anterior tibial artery was hypoplastic. The fibular...

Esporas de microsporidios: nueva apariencia con el microscopio electrónico

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Orlando Torres Fernández

2001-12-01

Full Text Available El phylum Microsporidia comprende un gran número de especies de protozoarios parásitos ubicuos en la naturaleza. Algunas tienen importancia médica como agentes causales de infecciones oportunistas en pacientes con sida. Desde las primeras imágenes de esporas de microsporidios obtenidas con el microscopio electrónico (1, su apariencia ha sido la mismaquese observa en lasfiguras 1-2. La pared de la espora exhibe dos capas: la endospora y la exospora. La endospora es de apariencia transparente y el contenido interno de la espora (esporoplasma no se distingue fácilmente porque es muy oscuro y se rompe con los cortes ultrafinos. Otra imagen característica es la del tubo polar que en corte transversal muestra un centro oscurO rodeado por un anillo claro. Así se ven las esporas de microsporidios de cualquier especie cuando se fijan con el método convencional de fijación con tetróxido de osmio (OsO4 . Estos rasgos ultraestructurales de las esporas son muy útiles para la taxonomiadel phylum Microsporidia (Microspora (2. Un nuevo procedimiento para la microscopia electrónica de los microsporidios, basado en la utilización de tetróxido de rutenio como fijador, revela otros detalles ultraestructurales de la pared de la espora (3. En este artículo se exhiben las primeras imágenes de las esporas completas de microsporidios procesadas con este método. Se revela el contenido de la endospora y se preserva mejor la estructura del esporoplasma. El tubo polar en corte transversal difiere del tubo polar fijado con tetróxido de osmio. El centro es claro y está rodeadopor un anillo oscuro. Esta diferencia también se observa en las esporas de Polydispyrenia sirnulii (3. El contraste en la densidad electrónica de las capas del tubo polar podría explicarse por diferencias en la composición de lípidos de acuerdo con las propiedades de los dos fijadores (OsO4 y Ruo4 (3. Estas imágenes completan la descripción de las esporas de microsporidios

LIPOMA CEREBRAL EN CUERPO CALLOSO: HALLAZGO INCIDENTAL EN PACIENTE CON EVENTO CEREBROVASCULAR

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Gloria Cárcamo-Portillo

2016-07-01

Full Text Available Los lipomas intracraneales son lesiones infrecuentes y benignas que representan el 0,03 al 0,08% de todas las masas intracraneales. Estos se encuentran relacionados a un defecto de la línea media debido a un mal cierre del tubo neural; lo que conlleva a una mala diferenciación y una persistencia anormal de la meninge primitiva con posterior diferenciación al tejido adiposo. La mitad de los casos permanecen asintomáticos y son diagnosticados como un hallazgo incidental en los estudios imagenológicos. Sin embargo, otros casos se asocian a sintomatología neurológica como retraso psicomotor, cefalea, epilepsia y parálisis cerebral. Se presenta el caso de una paciente de 46 años de edad, con antecedentes de hipertensión arterial y diabetes mellitus tipo 2; que cursa con sintomatología de Evento Cerebrovascular Isquémico por lo que le realizan –una Tomografía Computarizada (TC y una Resonancia Magnética (RM. En el reporte se describen múltiples infartos a nivel del hemisferio cerebral izquierdo mientras que al nivel de la línea media se observó una imagen compatible con lipoma cerebral que afectaba el rostro, la rodilla y la porción anterior del cuerpo calloso. La identificación de este hallazgo fue incidental. Palabras claves: Lipoma Cerebral; Cuerpo Calloso; Resonancia Magnética; Accidente Cerebrovascular. (Fuente: DeCS BIREME.

An anterior signaling center patterns and sizes the anterior neuroectoderm of the sea urchin embryo.

Science.gov (United States)

Range, Ryan C; Wei, Zheng

2016-05-01

Anterior signaling centers help specify and pattern the early anterior neuroectoderm (ANE) in many deuterostomes. In sea urchin the ANE is restricted to the anterior of the late blastula stage embryo, where it forms a simple neural territory comprising several types of neurons as well as the apical tuft. Here, we show that during early development, the sea urchin ANE territory separates into inner and outer regulatory domains that express the cardinal ANE transcriptional regulators FoxQ2 and Six3, respectively. FoxQ2 drives this patterning process, which is required to eliminate six3 expression from the inner domain and activate the expression of Dkk3 and sFRP1/5, two secreted Wnt modulators. Dkk3 and low expression levels of sFRP1/5 act additively to potentiate the Wnt/JNK signaling pathway governing the positioning of the ANE territory around the anterior pole, whereas high expression levels of sFRP1/5 antagonize Wnt/JNK signaling. sFRP1/5 and Dkk3 levels are rigidly maintained via autorepressive and cross-repressive interactions with Wnt signaling components and additional ANE transcription factors. Together, these data support a model in which FoxQ2 initiates an anterior patterning center that implements correct size and positions of ANE structures. Comparisons of functional and expression studies in sea urchin, hemichordate and chordate embryos reveal striking similarities among deuterostome ANE regulatory networks and the molecular mechanism that positions and defines ANE borders. These data strongly support the idea that the sea urchin embryo uses an ancient anterior patterning system that was present in the common ambulacrarian/chordate ancestor. © 2016. Published by The Company of Biologists Ltd.

Atraumatic Anterior Dislocation of the Hip Joint

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Tadahiko Ohtsuru

2015-01-01

Full Text Available Dislocation of the hip joint in adults is usually caused by high-energy trauma such as road traffic accidents or falls from heights. Posterior dislocation is observed in most cases. However, atraumatic anterior dislocation of the hip joint is extremely rare. We present a case of atraumatic anterior dislocation of the hip joint that was induced by an activity of daily living. The possible causes of this dislocation were anterior capsule insufficiency due to developmental dysplasia of the hip, posterior pelvic tilt following thoracolumbar kyphosis due to vertebral fracture, and acetabular anterior coverage changes by postural factor. Acetabular anterior coverage changes in the sagittal plane were measured using a tomosynthesis imaging system. This system was useful for elucidation of the dislocation mechanism in the present case.

preescolares desnutridos con madres con obesidad y sin obesidad

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Viridiana Vanessa Conzuelo-González

2009-01-01

Full Text Available El primer objetivo fue conocer cuántos menores de cinco años con diferentes grados de desnutrición tienen una madre con sobrepeso/obesidad/ en una comunidad indígena que vive en extrema pobreza y bajo condiciones de migración masculina internacional. El segundo fue comparar tres variables socionutricionales (ingreso familiar, educación de la madre y adecuación nutrimental de la dieta diaria entre estos hogares y los hogares con desnutrición infantil y madres sin obesidad. Se realizó un estudio transversal (2006-2007, en la comunidad mazahua de San Francisco Tepeolulco, Municipio de Temascalcingo; que incluyó a 85 hogares integrados por preescolares con desnutrición inscritos al programa Oportunidades. Se determinó el estado nutrición de los preescolares con indicadores antropométricos y se obtuvo el IMC de las madres de estos infantes. Se aplicó una encuesta socionutricional, incluida el recordatorio de 24 horas, y complementado con la observación participante (cualitativa. Se encontró que 83% de las madres mazahuas presentaron sobrepeso u obesidad. El estado de nutrición de los preescolares con madres con obesidad presentó un porcentaje mayor de desnutrición (76%. En la variable género, se encontró que 54% de los niños con madres con obesidad tenía baja talla. Al relacionar el nivel educativo de la madre, esta variable resultó ser estadísticamente significativa (p=0.015, donde el analfabetismo está más relacionado con la desnutrición infantil que tienen madres de bajo y/o peso normal. La elevada prevalencia de hogares conformados con preescolares con desnutrición y madres con obesidad, es un síntoma más de la pobreza en zonas indígenas en México, con bajo índice de desarrollo humano.

Do patients prefer mesh or anterior colporrhaphy for primary correction of anterior vaginal wall prolapse: a labelled discrete choice experiment

NARCIS (Netherlands)

Notten, K. J. B.; Essers, B. A.; Weemhoff, M.; Rutten, A. G. H.; Donners, J. J. A. E.; van Gestel, I.; Kruitwagen, R. F. M. P.; Roovers, J. P. W. R.; Dirksen, C. D.

2015-01-01

We investigated patients' preferences for anterior colporrhaphy or mesh surgery as surgical correction of anterior vaginal wall prolapse. Labelled discrete choice experiment. Three Dutch teaching hospitals. Women with anterior vaginal wall prolapse Pelvic Organ Prolapse Quantification stage 2 or

Anterior pseudoarthrectomy for symptomatic Bertolotti's syndrome.

Science.gov (United States)

Malham, Gregory M; Limb, Rebecca J; Claydon, Matthew H; Brazenor, Graeme A

2013-12-01

Painful L5/S1 pseudoarthrosis has been previously managed with posterior excision and/or lumbar fusion. To our knowledge, the anterior approach for L5/S1 pseudoarthrectomy in the treatment of Bertolotti's syndrome has not been described. We present two patients with severe symptomatic L5/S1 pseudoarthroses that were successfully excised via an anterior retroperitoneal approach with 2 year clinical and radiological follow-up. The literature regarding surgical treatments for Bertolotti's syndrome is reviewed. The technique for an anterior retroperitoneal approach is described. This approach has been safe and effective in providing long term symptomatic relief to our two patients. Further studies comparing the outcomes of anterior versus posterior pseudoarthrectomy will guide the management of this condition. Copyright © 2013 Elsevier Ltd. All rights reserved.

Utilidad del tratamiento con hidratación y nifedipino en la amenaza de parto pretérmino

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Carmen A. Argote Viñals

2014-08-01

Full Text Available Se realizó un estudio transversal en gestantes ingresadas con el diagnóstico de amenaza de parto pretérmino, en la sala de cuidados maternos-perinatales del Servicio de Obstetricia del Hospital General Docente “Dr. Ernesto Guevara” de Las Tunas, con el objetivo de determinar la utilidad del tratamiento de la amenaza de parto pretérmino con el empleo de hidratación y nifedipino como terapéutica de elección, en una muestra de 86 gestantes con embarazo viable entre 28 y 34 semanas, que recibieron como tratamiento de ataque la hidratación endovenosa, el reposo en cama y el uso de bloqueadores de los canales del calcio. Se estudiaron como variables: edad materna, edad gestacional al ingreso, paridad, antecedentes personales, tiempo para la desaparición de los síntomas, estadía en la sala de cuidados maternos perinatales y tocolíticos empleados. Predominaron las gestantes de entre 20 y 24 años de edad; las de edad gestacional al ingreso entre 32 a 34 semanas, 37 casos para un 43,1%; las que tenían un parto anterior, 42 (48,8%. Los abortos espontáneos previos (26,7% y el parto prematuro anterior (24,4% resultaron los antecedentes patológicos maternos más significativos. El 53,6% de las gestantes necesitaron tres horas para la desaparición de los síntomas y tres días para estar de alta. El 89,6% pudo llegar al término de su gestación. El empleo de nifedipino e hidratación como tratamiento de elección en la amenaza de parto pretérmino se relacionó con la reducción en el tiempo de alivio de los síntomas, una menor estadía y la prolongación de la gestación, lo que hace a este esquema terapéutico como el más recomendable para la atención de este problema de salud en condiciones similares a la de la investigación

Tiempo máximo aceptable de trabajo para tareas ejecutadas con miembros superiores e inferiores

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Juan C. Velásquez V.

2015-12-01

Full Text Available Introducción: La carga física de trabajo es uno de los principales factores de riesgo a los que se enfrentan los trabajadores. En la actualidad los métodos propuestos para evaluar la carga física dinámica contemplan el trabajo con todo el cuerpo y no discriminan por segmentos corporales. Objetivo: Determinar el tiempo máximo aceptable de trabajo cuando el trabajo se ejecuta con todo el cuerpo, con los miembros superiores o los miembros inferiores. Métodos: Se realizó medición de consumo de oxígeno mediante ergoespirometria y monitorización de la frecuencia cardiaca en 30 trabajadores expuestos a diversas cargas ejecutadas con todo el cuerpo, miembros inferiores y miembros superiores. Se determinó el umbral anaeróbico por coeficiente respiratorio, el cual sirvió de base para de determinación del tiempo máximo aceptable de trabajo. Resultados: Los tiempos máximos aceptables de trabajo fueron similares para tareas con todo el cuerpo y con miembros inferiores, pero significativamente menores para tareas realizadas con miembros superiores. Se halló un modelo de correlación exponencial negativo entre en tiempo de trabajo, el consumo de oxígeno, y la frecuencia cardiaca, R > 0,9 en todos los casos. Se plantearon 9 ecuaciones de regresión para determinar el tiempo máximo aceptable de trabajo. Conclusiones: El tiempo máximo aceptable de trabajo para miembros inferiores y para todo el cuerpo se comportan de manera similar. El tiempo máximo aceptables de trabajo con miembros superiores es significativamente inferior a los anteriores. La frecuencia cardiaca relativa parece ser el mejor indicador para medir el tiempo máximo aceptables de trabajo en campo.

The anterior interhemispheric approach: a safe and effective approach to anterior skull base lesions.

Science.gov (United States)

Mielke, Dorothee; Mayfrank, Lothar; Psychogios, Marios Nikos; Rohde, Veit

2014-04-01

Many approaches to the anterior skull base have been reported. Frequently used are the pterional, the unilateral or bilateral frontobasal, the supraorbital and the frontolateral approach. Recently, endoscopic transnasal approaches have become more popular. The benefits of each approach has to be weighted against its complications and limitations. The aim of this study was to investigate if the anterior interhemispheric approach (AIA) could be a safe and effective alternative approach to tumorous and non-tumorous lesions of the anterior skull base. We screened the operative records of all patients with an anterior skull base lesion undergoing transcranial surgery. We have used the AIA in 61 patients. These were exclusively patients with either olfactory groove meningioma (OGM) (n = 43), ethmoidal dural arteriovenous fistula (dAVF) ( n = 6) or frontobasal fractures of the anterior midline with cerebrospinal fluid (CSF) leakage ( n = 12). Patient records were evaluated concerning accessibility of the lesion, realization of surgical aims (complete tumor removal, dAVF obliteration, closure of the dural tear), and approach related complications. The use of the AIA exclusively in OGMs, ethmoidal dAVFs and midline frontobasal fractures indicated that we considered lateralized frontobasal lesions not suitable to be treated successfully. If restricted to these three pathologies, the AIA is highly effective and safe. The surgical aim (complete tumor removal, complete dAVF occlusion, no rhinorrhea) was achieved in all patients. The complication rate was 11.5 % (wound infection (n = 2; 3.2 %), contusion of the genu of the corpus callosum, subdural hygroma, epileptic seizure, anosmia and asymptomatic bleed into the tumor cavity (n = 1 each). Only the contusion of the corpus callosum was directly related to the approach (1.6 %). Olfaction, if present before surgery, was preserved in all patients, except one (1.6 %). The AIA is an effective and a safe approach

Recuperación de la autoestima en una adulta mayor rehabilitada con prótesis dental

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Ana Margarita Vinent Céspedes

2015-06-01

Full Text Available Se describe el caso clínico de una paciente de 67 años de edad, asistida en la Clínica Estomatológica del Policlínico Docente "Camilo Torres Restrepo" de Santiago de Cuba, quien había portado, por más de 10 años, prótesis superior acrílica desajustada, y además refería haber disminuido de peso corporal por la presencia de importantes dificultades masticatorias y dolor ocasional en las articulaciones temporomandibulares; asimismo, la afectada mostraba inconformidad con su estética facial. Todo lo anterior había dañado su autoestima y, consecuentemente, le producía limitaciones sociales en los planos laboral y personal. La paciente fue rehabilitada con prótesis total superior acrílica y parcial inferior acrílica, con lo cual mejoraron su estética y la función masticatoria. Fue remitida a consulta de Fisioterapia para completar el tratamiento del trastorno articular

Innervation of the Anterior Sacroiliac Joint.

Science.gov (United States)

Cox, Marcus; Ng, Garrett; Mashriqi, Faizullah; Iwanaga, Joe; Alonso, Fernando; Tubbs, Kevin; Loukas, Marios; Oskouian, Rod J; Tubbs, R Shane

2017-11-01

Sacroiliac joint pain can be disabling and recalcitrant to medical therapy. The innervation of this joint is poorly understood, especially its anterior aspect. Therefore, the present cadaveric study was performed to better elucidate this anatomy. Twenty-four cadaveric sides underwent dissection of the anterior sacroiliac joint, with special attention given to any branches from regional nerves to this joint. No femoral, obturator, or lumbosacral trunk branches destined to the anterior sacroiliac joint were identified in the 24 sides. In 20 sides, one or two small branches (less than 0.5 mm in diameter) were found to arise from the L4 ventral ramus (10%), the L5 ventral ramus (80%), or simultaneously from both the L4 and L5 ventral rami (10%). The length of the branches ranged from 5 to 31 mm (mean, 14 mm). All these branches arose from the posterior part of the nerves and traveled to the anterior surface of the sacroiliac joint. No statistical significance was found between sides or sexes. An improved knowledge of the innervation of the anterior sacroiliac joint might decrease suffering in patients with chronic sacroiliac joint pain. Copyright © 2017 Elsevier Inc. All rights reserved.

Diagnóstico y tratamiento de los aneurismas saculares de la arteria cerebral anterior

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Raúl F. Matera

1956-12-01

Full Text Available Hacemos un estudio anátomo-funcional de la arteria cerebral anterior recalcando la importancia que tiene la ligadura de esta arteria. Sintetizamos la patogenia de los aneurismas en cuatro hechos fundamentales: los aneurismas vestigiales originados en brotes vasculares no desarrollados o que no han involucionado normalmente; la falta de desarrollo de la túnica elástica en la zona de bifurcación de los grandes vasos; la arterioesclerosis; los procesos inflamatorios de la túnica media (sífilis y micosis. Hacemos un estudio clínico de los aneurismas del complejo cerebral-comunicante anterior, llamando la atención sobre aquellos en los que, a las hemorragias subaracnoidales, se asocian manifestaciones en el fondo de ojo, trastornos psíquicos y fenómenos motores. Llamamos la atención sobre las formas pseudo-tumorales quiasmáticas y los denominados aneurismas trombosantes que originan el síndrome progresivo fronto-cíngulo-calloso. Estudiamos la radiología simple de los aneurismas de esta región, llamando la atención sobre las calcificaciones cirsoideas suprasellares y los fenómenos de erosión de la silla turca. Llamamos la atención sobre la importancia de la arteriografía para confirmar el diagnóstico, estudiar la circulación colateral, el tamaño, la forma y el pedículo del aneurisma, elementos fundamentales para el plan operatório. En el tratamiento quirúrgico descartamos, por ineficaz, la ligadura de la carótida interna en el cuello. Es fundamental el abordaje intracraneano por vía subfrontal en los aneurismas de la porción précomunicante y comunicante con desarrollo hacia abajo, mientras que, la via sagital-frontal se utilizará en los aneurismas de desarrollo hacia arriba ya sea de la comunicante o de la porción distal de la arteria cerebral anterior o sus ramas. Insistimos sobre un hecho muy importante cual es la anestesia y, en especial, el uso de la hipotensión controlada, insistiendo de que la tensión se

Anterior, posterior, left anterior oblique, and geometric mean views in gastric emptying studies using a glucose solution

Energy Technology Data Exchange (ETDEWEB)

Phillips, W.T. [Dept. of Radiology, Univ. of Texas Health Science Center, San Antonio, TX (United States); McMahan, C.A. [Dept. of Pathology, Univ. of Texas Health Science Center, San Antonio, TX (United States); Lasher, J.C. [Dept. of Radiology, Univ. of Texas Health Science Center, San Antonio, TX (United States); Blumhardt, M.R. [Dept. of Pathology, Univ. of Texas Health Science Center, San Antonio, TX (United States); Schwartz, J.G. [Dept. of Pathology, Univ. of Texas Health Science Center, San Antonio, TX (United States)

1995-02-01

Previous research has shown that the single anterior view of the stomach overestimates the gastric half-emptying time of a solid meal compared to the geometric mean of the anterior and posterior views. Little research has been performed comparing the various views of gastric emptying of a glucose solution. After an overnight fast, 49 nondiabetic subjects were given a 450 ml solution containing 50 g of glucose and 200 {mu}Ci of technetium-99m sulfur colloid. Sequential 1-min anterior, posterior, and left anterior oblique views were obtained every 15 min. The mean percent solution remaining in the stomach for all three views differed from the geometric mean by 1.9% or less at all time points. Average gastric half-emptying times were: geometric mean, 62.7{+-}3.3 min; anterior, 61.9{+-}3.2 min; posterior, 63.5{+-}3.5 min; and left anterior oblique, 61.6{+-}3.3 min. These half-emptying times were not statistically different. For individual patients, differences between all three views and the geometric mean were not clinically important. Approximately 95% of all patients are expected to have gastric half-emptying times measured by any of the three single views within 17 min of the gastric half-emptying time obtained using the geometric mean. The imaging of gastric emptying using glucose solutions can be performed using a convenient single view which allows continuous dynamic imaging. (orig.)

Anterior approach to the cervicothoracic junction: case series and literature review Acceso anterior de las lesiones de la unión cérvicotoracica: serie de casos y revisión de la literatura Acesso anterior das lesões da junção cérvicotorácica: série de casos e revisão da literatura

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Asdrubal Falavigna

2009-06-01

intensity, analgesic drugs intake and the length of hospital stay.OBJETIVO: relatar la experiencia de los autores en el acceso anterior de la unión cérvicotoracica C7 a T4, en relación a la definición de cuánto es necesaria la realización de la manubriotomía, cuáles las particularidades de esta cirugía y la evaluación de los resultados. MÉTODOS: estudio de cohorte prospectivo de 14 pacientes que fueron tratados quirúrgicamente de enfermedades de la transición cérvicotoracica, durante el periodo de Enero de 1996 a Enero de 2009. Los pacientes fueron evaluados en el pre operatorio con tomografía computadorizada y resonancia magnética, a fin de identificar en cuáles casos la manubriotomía sería necesaria. La cirugía fue realizada preferiblemente por el lado izquierdo utilizando la vía de acceso anterior de Smith-Robinson y en caso de necesidad, sería combinado con una abertura del manubrio. Cuando realizada la corpectomía fueron utilizados Mesh y placa cervical para estabilización, mientras que en la cirugía de hernia discal C7-T1 la reconstrucción fue hecho con PEEK y placa cervical. RESULTADOS: la edad promedio fue de 63 años, siendo siete de sexo masculino. La patología más común fue la enfermedad metastásica (n=8, seguida por la hernia discal C7-T1 (n=4. Las complicaciones relacionadas al procedimiento quirúrgico fueron dos: un paciente con disfonía causada por hematoma local y otro caso con infección pulmonar. El tiempo promedio de cirugía, el volumen de sangramiento, la intensidad del dolor, la necesidad de medicación analgésica y el tiempo de hospitalización fueron menores en los pacientes en que la manubriotomía no fue necesaria. CONCLUSIÓN: el acceso anterior a la unión cérvicotoracica es un acceso rápido y de baja morbilidad. Lesiones que envuelven el cuerpo vertebral de T1 o el espacio discal de C7-T1 fueron abordadas solamente por la vía cervical sin abertura del manubrio. Las lesiones del cuerpo de T1 y/o de T2 fueron

Y para usted: ¿Cuál es su compromiso con la democracia?

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Pablo Quirós Orozco

2017-07-01

Full Text Available El Instituto de Formación y Estudios en Democracia planifica y ejecuta programas de formación para la ciudadanía y para los partidos políticos, a fin de promover el efectivo ejercicio de los derechos políticos y el fortalecimiento de la cultura cívica, atendiendo a la diversidad regional, socioeconómica y cultural de los costarricenses. Dentro de esta dinámica y por medio de un convenio con el Museo Nacional, durante los meses de octubre de 2013 a junio de 2014 se exhibió en ese espacio cultural una muestra museográfica titulada “Vivamos la democracia”. Como parte de la exposición, se acondicionó la simulación de un recinto electoral en el que los visitantes, en lugar de votar, completaran la frase Mi compromiso con la democracia es…, en papelitos dispuestos para ese propósito, y que posteriormente fueran depositados en la respectiva urna. Con base en lo anterior, el artículo presenta un estudio de la historia de la democracia costarricense y un análisis de las opiniones expresadas por quienes asistieron a la exhibición

Learning in archaeological sites with mobile devices = Aprendizaje con dispositivos móviles en yacimientos arqueológicos

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IBÁÑEZ-ETXEBERRIA, A., VICENT, N., ASENSIO, M., CUENCA, J.M., FONTAL, O.

2014-01-01

Full Text Available La relevancia social del mobile learning es cada vez más evidente. Estos mecanismos, a través de TICs y dispositivos móviles, se aplican ya en programas educativos en yacimientos arqueológicos y museos, pero la pregunta es si estos programas son efectivos para el aprendizaje. Para investigar esta cuestión, hemos evaluado la implementación de un programa educativo con contenidos histórico- patrimoniales ofertado para estudiantes de secundaria. Noventa estudiantes participaron en este estudio respondiendo un cuestionario que abordaba cuestiones relacionadas con la asimilación de contenidos conceptuales, la atención y la eficacia del programa, así como aspectos relacionados con la satisfacción, utilidad percibida y dificultad de uso de la tecnología móvil. Los resultados son satisfactorios respecto a la asimilación de contenidos, y se aprecian mejores resultados con la combinación de metodologías receptivas y el uso de tecnología móvil. La satisfacción y la percepción de la utilidad confirman los buenos resultados de anteriores trabajos.

Anterior capsulotomy using the CO2 laser

Science.gov (United States)

Barak, Adiel; Ma-Naim, Tova; Rosner, Mordechai; Eyal, Ophir; Belkin, Michael

1998-06-01

Continuous circular capsulorhexis (CCC) is the preferred technique for removal of the anterior capsule during cataract surgery due to this technique assuring accurate centration of the intraocular lens. During modern cataract surgery, especially with small or foldable intra ocular lenses, centration of the lens is obligatory. Radial tears at the margin of an anterior capsulotomy may be associated with the exit of at least one loop of an intraocular lens out of the capsular bag ('pea pod' effect) and its subsequent decentration. The anterior capsule is more likely to ream intact if the continuous circular capsulorhexis (CCC) technique is used. Although manual capsulorhexis is an ideal anterior capsulectomy technique for adults, many ophthalmologists are still uncomfortable with it and find it difficult to perform, especially in complicated cases such as these done behind small pupil, cataract extraction in children and pseudoexfoliation syndrome. We have developed a technique using a CO2 laser system for safe anterior capsulotomy and tested it in animal eyes.

El cine como recurso para el conocimiento de las personas con discapacidad: Veinticinco películas de la última década

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Mª Inés MONJAS CASARES

2016-11-01

Full Text Available Es indudable el poder del cine para transmitir informaciones, para provocar emociones y para estimular la empatía con los personajes y sus situaciones. Por ese motivo se propone la utilización de películas con protagonistas con discapacidad para favorecer la “visibilidad”, la normalización y el acercamiento a la realidad y a la situación de las personas con discapacidad. Para ello se han seleccionado veinticinco películas de la última década con protagonistas con discapacidad intelectual, física, motora, visual, auditiva y con trastornos del espectro autista. Los resultados más relevantes del análisis efectuado muestran que los problemas físicos, de autismo y de discapacidad intelectual son los más considerados, que los protagonistas con discapacidad son en gran medida jóvenes y adultos varones, que se presentan una gran variedad de temas (personales, interpersonales y afectivo-sexuales, familiares, médicos…, siendo los aspectos familiares los que tienen mayor relevancia y que se evidencia la presencia de actores con discapacidad. Asimismo es preciso constatar que la imagen de las personas con discapacidad en estas películas es mucho más ajustada a la realidad y más positiva que lo que habitualmente ocurría en la filmografía de décadas anteriores.

Experience in infection images with new radio antibiotic the {sup 99m}Tc-ceftizoxime (TCF); Experiencia en imagenes de infecciones con un nuevo radio-antibiotico la ceftizoxima-{sup 99m}Tc (CFT)

Energy Technology Data Exchange (ETDEWEB)

Soroa, Victoria E; Rabiller, Graciela; Velasquez Espeche, Maria del H. [Comision Nacional de Energia Atomica, Buenos Aires (Argentina). Centro de Medicina Nuclear; Fioriolli, Marcelo H; Rodriguez, Hernan [Hospital de Clinicas Jose de San Martin, Buenos Aires (Argentina); Roca, Manuel; Martin-Comin, Joseph [Hospital Universitario Bellvitge, Barcelona (Spain). Servicio de Medicina Nuclear

2004-07-01

Previous results obtained in the detection of infections with {sup 99m}Tc-ceftizoxime encourage to the group of work to investigate the behavior of an antibiotic of third generation: the ceftizoxime radiolabelled with {sup 99m}Tc and to compare it with other radio-labels in different infectious / inflammatory pathologies. [Spanish] Anteriores resultados obtenidos en la deteccion de infecciones con el {sup 99m}TC-ceftizoxima incentivo al grupo de trabajo a investigar el comportamiento de un antibiotico de tercera generacion: la ceftizoxima radiomarcada con {sup 99m}Tc y compararlo con otros radiomarcadores en diferentes patologias infecciosas/inflamatorias.

Aphasia following anterior cerebral artery occlusion

International Nuclear Information System (INIS)

Shimosaka, Shinichi; Waga, Shiro; Kojima, Tadashi; Shimizu, Takeo; Morikawa, Atsunori

1982-01-01

We have report two cases of aphasia that had infarcts in the distribution of the left or right anterior cerebral artery, as confirmed by computed tomography. Case 1 is a right-handed, 65-year-old man in whom computerized tomographic scanning revealed an infarction of the territory of the left anterior cerebral artery after the clipping of the anterior communicating artery aneurysm. The standard language test of aphasia (SLTA) revealed non-fluent aphasia with dysarthria, good comprehension, almost normal repetition with good articulation, and a defectiveness in writing. This syndrome was considered an instance of transcortical motor aphasia. Although three years had passed from the onset, his aphasia did not show any improvement. Case 2 is a 37-year-old man who is right-handed but who can use his left hand as well. He was admitted because of subarachnoid hemorrhage from an anterior communicating aneurysm. Because of postoperative spasm, an infarction in the distribution of the right anterior cerebral artery developed. He was totally unable to express himself vocally, but he could use written language quite well to express his ideas and had a good comprehension of spoken language. This clinical picture was considered that of an aphemia. After several weeks, his vocalization returned, but the initial output was still hypophonic. (J.P.N.)

Anterior ethmoid anatomy facilitates dacryocystorhinostomy.

Science.gov (United States)

Blaylock, W K; Moore, C A; Linberg, J V

1990-12-01

The ethmoid air cell labyrinth lies adjacent to the medial orbital wall, extending even beyond the sutures of the ethmoid bone. Its anatomic relationship to the lacrimal sac fossa is important in lacrimal surgery. We evaluated computed tomographic scans of 190 orbits with normal ethmoid anatomy to define the anatomic relationship of anterior ethmoid air cells to the lacrimal sac fossa. In 93% of the orbits, the cells extended anterior to the posterior lacrimal crest, with 40% entering the frontal process of the maxilla. This anatomic relationship may be used to facilitate the osteotomy during dacryocystorhinostomy. During a 10-year period (310 cases), one of us routinely entered the anterior ethmoid air cells to initiate the osteotomy during dacryocystorhinostomy. This technique has helped to avoid lacerations of the nasal mucosa.

LA ESTRATEGIA EXPORTADORA DE LA EMPRESA Y SU RELACIÓN CON EL RESULTADO INTERNACIONAL

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Flor Peris, M.L

2010-01-01

Full Text Available En este trabajo se examinan las estrategias seguidas por las empresas en los mercados exteriores a través de la exportación y se analiza su relación con el resultado exportador. Para ello, adoptamos un enfoque taxonómico y planteamos la estrategia exportadora a partir del alcance geográfico, la adaptación del marketing mix a los mercados exteriores y el tipo de ventaja competitiva perseguida por las empresas. El estudio empírico se ha realizado a partir de la información proporcionada por 88 empresas. Los resultados indican que diferentes grupos de empresas configuran su estrategia exportadora con diversos grados de énfasis en las dimensiones anteriores. Respecto a la relación entre la estrategia y el resultado exportador, éstos destacan la importancia de las estrategias que, independientemente del ámbito geográfico escogido, adaptan el marketing mix y delimitan claramente la base sobre la que va a competir.

Fijación de radioyodo en huesos maxilares simulando metástasis en pacientes con Carcinoma Diferenciado de Tiroides (CDT): False- Positive images in patients with Differentiated Thyroid Carcinoma. (DTC)

OpenAIRE

Degrossi, O. J.; Gutiérrez, S.; Fadel, A.; Degrossi, E. B.; Valdivieso, M. C.; Balbuena, R. L.; Alak, M. del C.; de Cabrejas, M.

2008-01-01

En estudios centellográficos con 131I (CCT) para seguimiento, postablación o tratamiento de pacientes portadores de carcinoma diferenciado de tiroides (CDT) se observan frecuentemente en tiempos precoces áreas de captación del radiotrazador en macizo facial. Estas áreas corresponden, generalmente, a glándulas salivares y extremo anterior de mucosa nasal y se mantienen durante las primeras 48 horas y no son observadas generalmente a las 72 horas. Pero con menor frecuencia se presentan otras qu...

Winging of scapula due to serratus anterior tear

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Varun Singh Kumar

2014-10-01

Full Text Available 【Abstract】Winging of scapula occurs most commonly due to injury to long thoracic nerve supplying serratus anterior muscle. Traumatic injury to serratus anterior muscle itself is very rare. We reported a case of traumatic winging of scapula due to tear of serratus anterior muscle in a 19-year-old male. Winging was present in neutral position and in extension of right shoulder joint but not on "push on wall" test. Patient was managed conservatively and achieved satisfactory result. Key words: Serratus anterior tear; Scapula; Wounds and injuries

Impact of Isometric Contraction of Anterior Cervical Muscles on Cervical Lordosis.

Science.gov (United States)

Fedorchuk, Curtis A; McCoy, Matthew; Lightstone, Douglas F; Bak, David A; Moser, Jacque; Kubricht, Brett; Packer, John; Walton, Dustin; Binongo, Jose

2016-09-01

This study investigates the impact of isometric contraction of anterior cervical muscles on cervical lordosis. 29 volunteers were randomly assigned to an anterior head translation (n=15) or anterior head flexion (n=14) group. Resting neutral lateral cervical x-rays were compared to x-rays of sustained isometric contraction of the anterior cervical muscles producing anterior head translation or anterior head flexion. Paired sample t-tests indicate no significant difference between pre and post anterior head translation or anterior head flexion. Analysis of variance suggests that gender and peak force were not associated with change in cervical lordosis. Chamberlain's to atlas plane line angle difference was significantly associated with cervical lordosis difference during anterior head translation (p=0.01). This study shows no evidence that hypertonicity, as seen in muscle spasms, of the muscles responsible for anterior head translation and anterior head flexion have a significant impact on cervical lordosis.

La minería manual en colombia: una comparación con américa latina

OpenAIRE

Güiza Suárez, Leonardo

2014-01-01

En el mundo y particularmente en América Latina, la minería no mecanizada o manual ha sido utilizada como medio de sustento por los pobladores rurales en condiciones sociales desfavorables por lo que resulta importante conocer los aspectos socio-jurídicos que envuelven la actividad. Con el fin de llevar a cabo lo anterior, se realizó una investigación de tipo descriptivo sobre tres variables dependientes: conceptualización, legalidad y formalidad minera, cuyos datos se obtuvieron a través de ...

Perfil de adolescentes com repetição da gravidez atendidas num ambulatório de pré-natal Perfil de las adolescentes con repetición del embarazo atendidas en un ambulatorio de prenatal Profile of adolescents with repeated pregnancies attended at a prenatal clinic

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Lia Persona

2004-10-01

Full Text Available Este trabalho identificou o perfil biopsicossocial das adolescentes com repetição da gravidez, atendidas num ambulatório de pré-natal. Os dados obtidos através do prontuário médico e entrevista foram analisados quantitativamente. Através dos resultados encontrados e de acordo com a literatura, foram selecionados, do perfil das adolescentes, fatores mais fortemente associados à ocorrência da repetição da gravidez. São eles: menarca precoce, primeira relação sexual após curto intervalo da menarca, repetência escolar, abandono escolar, ausência de ocupação remunerada, baixa renda familiar, envolvimento com parceiros mais velhos, residir com o parceiro, união consensual com o parceiro, um parceiro fixo, baixo uso de condon, história familiar de gravidez na adolescência, ausência do pai por morte ou abandono, reação positiva da família à gravidez anterior, aborto anterior, parto anterior bem conceituado pela adolescente, e ausência à revisão pós-parto anterior.Este trabajo identificó el perfil biopsicosocial de las adolescentes con repetición del embarazo, atendidas en un ambulatorio de prenatal. Los datos obtenidos por medio del prontuario médico y entrevista, fueron analizados cuantitativamente. Por medio de los resultados y de acuerdo con la literatura, fueron seleccionados, entre los perfiles de las adolescentes, factores más fuertemente asociados a la ocurrencia de la repetición del embarazo. Ellos son: menarca precoz; primera relación sexual tras corto intervalo de la menarca; repetición escolar; abandono escolar; ausencia de ocupación remunerada; baja renta familiar; envolvimiento con parejas más viejas; residir con la pareja; unión consensual con la pareja; pareja fija; bajo uso de condón; historia familiar de embarazo en la adolescencia; ausencia del padre por muerte o abandono; reacción positiva de la familia al embarazo anterior; aborto anterior; parto anterior bien conceptuado por la adolescente

La fisioterapia en el proceso de readaptación físico – deportiva mediante el uso de gimnasio en el paciente postoperado de reconstrucción de ligamento cruzado anterior. Caso clínico

OpenAIRE

Raúl Ernesto Cortés González; Mauricio Alberto Ravelo Izquierdo

2017-01-01

La ruptura del ligamento cruzado anterior (LCA) tiene gran incidencia en deportistas, el procedimiento quirúrgico es vital para la restauración de su funcionamiento, pero sin tratamiento fisioterapéutico posquirúrgico, la cirugía no cumple con las expectativas deseadas. En este artículo, se analiza el caso clínico de un paciente femenino de 28 años, futbolista recreativa, intervenida quirúrgicamente por reconstrucción de LCA izquierdo con autoinjerto de semitendinoso, que recibió tratamiento ...

Passive Anterior Tibial Subluxation in the Setting of Anterior Cruciate Ligament Injuries: A Comparative Analysis of Ligament-Deficient States.

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McDonald, Lucas S; van der List, Jelle P; Jones, Kristofer J; Zuiderbaan, Hendrik A; Nguyen, Joseph T; Potter, Hollis G; Pearle, Andrew D

2017-06-01

Static anterior tibial subluxation after an anterior cruciate ligament (ACL) injury highlights the abnormal relationship between the tibia and femur in patients with ACL insufficiency, although causal factors including injuries to secondary stabilizers or the time from injury to reconstruction have not been examined. To determine static relationships between the tibia and femur in patients with various states of ACL deficiency and to identify factors associated with anterior tibial subluxation. Cross-sectional study; Level of evidence, 3. Patients treated for ACL injuries were identified from an institutional registry and assigned to 1 of 4 cohorts: intact ACL, acute ACL disruption, chronic ACL disruption, and failed ACL reconstruction (ACLR). Anterior tibial subluxation of the medial and lateral compartments relative to the femoral condyles were measured on magnetic resonance imaging (MRI), and an MRI evaluation for meniscal tears, chondral defects, and injuries to the anterolateral ligament (ALL) was performed. One hundred eighty-six ACL-insufficient knees met inclusion criteria, with 26 patients without an ACL injury utilized as a control group. In the lateral compartment, the mean anterior tibial subluxation measured 0.78 mm for the control group (n = 26), 2.81 mm for the acute ACL injury group (n = 74), 3.64 mm for the chronic ACL injury group (n = 40), and 4.91 mm for the failed ACLR group (n = 72). In the failed ACLR group, 37.5% of patients demonstrated lateral compartment anterior subluxation ≥6 mm, and 11.1% of this group had anterior subluxation of the lateral compartment ≥10 mm. Multivariate regression revealed that the presence of both medial and lateral chondral defects was associated with a mean 1.09-mm increase in subluxation of the medial compartment ( P = .013). The combination of medial and lateral meniscal tears was an independent predictor of increased lateral tibia subluxation by 1.611 mm ( P = .0022). Additionally, across all knee states

Toracotomía posterior: doble abordaje vertebral torácico con incisión única Toracotomia posterior: dupla abordagem vertebral torácica com incisão única Posterior thoracotomy: a two-step spinal thoracic approach

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Mariano Augusto Noel

2010-09-01

Full Text Available INTRODUCCIÓN: durante los últimos diez años, hemos utilizado la toracotomía posterior para abordar la porción superior del tórax en procedimientos combinados anteriores y posteriores. Actualmente hemos extendido esta indicación a toda la columna torácica en remplazo de la toracotomía convencional y toracoscopía. OBJETIVO: evaluar el rango de posibilidades y complicaciones asociadas con este nuevo abordaje, que permite combinar la cirugía vertebral torácica anterior y posterior con la misma incisión cutánea posterior. Métodos: fueron evaluados, retrospectivamente, 35 pacientes operados entre los años del 2003 y 2007. En todos se realizó doble abordaje, combinando una toracotomía posterior y abordaje posterior, mediante una sola incisión medial, para diferentes objetivos: descompresión medular, artrodesis, osteotomías o vertebrectomías. Se evaluaron los valores angulares, las etiologías, la edad, los niveles vertebrales, la cantidad de toracotomías y las complicaciones. RESULTADOS: hubo un promedio de edad de 14,1 años (1-65, diez cifosis, valor promedio 96,8 (76-131; 24 escoliosis valor promedio 80 (60-105. Etiología: síndromes genéticos, 11; escoliosis idiopática, 6; neurológicas, 5; congénitas, 4; tumores, 4; fracturas, 2; hernia discal, 1; infección, 1. Toracotomía de 1 nivel 30 doble 5. Nivel superior T3 e inferior T10. Complicaciones: 1 hemotórax y dos infecciones de herida. CONCLUSIÓN: esta vía permite acceder a todo nivel torácico en procedimientos combinados mediante una sola incisión cutánea.INTRODUÇÃO: nos últimos dez anos, foi utilizada a toracotomia posterior para a abordagem da porção superior do tórax em procedimentos combinados anteriores e posteriores. Atualmente, esta indicação tem sido estendida por toda a coluna torácica ao invés da toracotomia convencional e da toracoscopia. OBJETIVO: avaliar as possibilidades e complicações associadas a esta nova abordagem, que permite

Artrodese na coluna cervical utilizando SICAP como substituto de enxerto ósseo Artrodesis en la columna cervical utilizando SICAP como sustituto de injerto óseo Cervical spine fusion utilizing silicated calcium phosphate bone graft substitute (SICAP

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Juliano Fratezi

2011-01-01

Tech EE.UU, Reino Unido es un injerto óseo compuesto de calcio-fosfato con una sustitución de silicato en la estructura química, con una estructura tridimensional que parece hueso natural. MÉTODOS: 19 pacientes fueron sometidos a fusión ósea cervical y analizados retrospectivamente. La evaluación radiográfica y la evaluación clínica fueron realizadas utilizandose el cuestionario Neck Disability Index y la escala análoga del dolor (VAS pre y postoperación. RESULTADOS: El período promedio de seguimiento postoperatorio fue de 14 meses ± 5 meses (7-30 meses. Once pacientes fueron sometidos a fusión vía anterior; 5 pacientes vía posterior y 3 pacientes vía anterior y posterior. La revisión radiográfica mostró 19/19 (100% de fusión ósea, ningún caso presentó subsidencia, rotura o soltura de material de implante o movimiento en los niveles fusionados. Ningún ejemplo de osificación heterotópica o de crecimiento óseo intracanal fue observado. Clínicamente, el promedio de las puntuaciones del Neck Disability disminuyeron 13,3 puntos (promedio preop. de 34,5, postop. de 21,2, mejora de 39%, el promedio de VAS para dolor cervical disminuyó 2 puntos (2,7 preop. para 0,7 postop.; mejora de 74,1%. No fueron observadas complicaciones como infección, osteólisis o edema excesivo de las partes blandas. CONCLUSIÓN: Los resultados preliminares obtenidos en esta serie feuron estimulantes con el uso de SICaP como injerto óseo, con sólida fusión ósea obtenida en todos los casos y sin formación de osificación heterotópica o crecimiento de hueso intracanal. SIcaP demuestra ser un sustituto confiable para el injerto óseo autólogo en la columna cervical.OBJECTIVE: Bone graft substitutes have been developed to obviate the need for autograft from the iliac crest and its resultant complications. SiCaP (Actifuse, ApaTech US, UK is a calcium phosphate bone graft substitute with selective controlled silicate substitution in a patented 3-dimensional structure

Mediastinotomía anterior: Modalidad diagnóstica predictiva en el cáncer de pulmón

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José Quintana Marrero

1999-04-01

Full Text Available Se analizaron los resultados de 83 mediastinotomías anteriores realizadas a pacientes con diagnóstico presuntivo de cáncer de pulmón. La base inicial del diagnóstico fue la radiografía simple de tórax. El 68,67 % de los casos padecía de cáncer del pulmón izquierdo. La enfermedad de inicio en 10 pacientes fue el síndrome compresivo de cava superior. Se comprobó la efectividad de la mediastinotomía en el estadiamiento del tumor pulmonar y se demuestra lo inocuo del procederThe results of 83 anterior mediastinotomies performed on patients with presumptive diagnosis of lung cancer were analyzed. The base line of the diagnosis was the simple thorax X ray. 68.67 of the cases suffered from left lung cancer. The compressive syndrome of the superior vena cava was the initial disease in 10 patients. It was proved the effectiveness of mediastinotomy in lung tumor staging, and it was also demonstrated that it is an innocuous procedure

Fatores associados ao acesso anterior à gestação a serviços de saúde por adolescentes gestantes Factores asociados con el acceso anterior a la gestación a los servicios de salud por adolescentes gestantes Factors associated with access to health services prior to pregnancy by pregnant adolescents

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Ingrid Espejo Carvacho

2008-10-01

ómico, administrativo, psicosocial y de información. Participaron 200 adolescentes primigestas (10 a 19 años atendidas en una unidad básica de salud del municipio de Indaiatuba (Sureste de Brasil, en 2003. Se aplicó a las participantes en el momento de su primera consulta pre-natal un cuestionario con preguntas abiertas y cerradas referentes al acceso al último servicio de salud utilizado, anterior a la gestación. Los datos fueron analizados por medio de la prueba de Chi cuadrado de Pearson o exacto de Fischer y por regresión logística múltiple, considerando las cinco dimensiones del acceso. RESULTADOS: Más de la mitad (63,7% de las adolescentes utilizó algún servicio de salud para consulta ginecológica. Entre las que nunca consultaron un ginecólogo, las justificativas dadas fueron falta de información (43,8% o sentimiento de miedo o vergüenza (37,0%. La principal dificultad de acceso al servicio estuvo relacionada con barreras psicosociales, identificadas por 77,0% de las adolescentes. CONCLUSIONES: Entre las barreras de acceso al servicio de salud, fueron significativas solo las psicosociales. Son necesarias nuevas estrategias para facilitar el acceso al servicio de salud a las adolescentes, incluyendo acciones que disminuyan las barreras de género y que se consideren sus características sociodemográficas y el vínculo con sus parejas.OBJECTIVE: To assess determinants of access to primary care services prior to pregnancy by pregnant adolescents. METHODS: Theory-based cross-sectional study conducted to examine access to heath services at five dimensions: geographic, economic, administrative, psychosocial and information. There were included in the study 200 first-time pregnant adolescents (aged 10 to 19 years who attended a primary care unit in the municipality of Indaiatuba, Southeastern Brazil, in 2003. Data was collected using a semi-structured questionnaire applied in face-to-face interviews conducted just before their first pre-natal care visit. Data analyses

Riesgo de ictus isquémico en niños con Sβ talasemia. Estudio con Doppler transcraneal Risks of ischemic stroke in children suffering Sβ-thalassemia. Transcranial Doppler study

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Claudio Enrique Scherle-Matamoros

2012-06-01

Full Text Available En niños con anemia por células falciformes, el riesgo de ictus isquémico varía según el genotipo de la hemoglobinopatía. En estos casos, la determinación de la velocidad de flujo sanguíneo mediante Doppler transcraneal (DTC puede predecir la ocurrencia de isquemia cerebral. Con el objetivo de describir las características del DTC en la Sβ talasemia, se estudiaron 32 enfermos menores de 18 años atendidos en el Instituto de Hematología e Inmunología y remitidos para su evaluación con ultrasonido. La edad media de los niños fue de 10,5 años. Se estudió la misma cantidad de enfermos con cada genotipo Sβ; solamente en un paciente la ventana temporal no fue útil. En el 97 % de los enfermos la velocidad media de flujo en las arterias cerebrales medias era inferior a 170 cm/s y solo en un niño estaban en el rango del grupo condicional. Se registraron asimetrías interhemisféricas en la velocidad media de flujo de las arterias cerebrales anteriores en el 29 % de los casos; en el 19,6 % en las arterias cerebrales medias; y en el 6,4 % en las carótidas internas extracraneales. Los niveles más altos de velocidad media de flujo se registraron en los enfermos con Sβ0 talasemia y en las arterias cerebrales medias. Existió una correlación inversa entre la edad y los niveles de hemoglobina con la velocidad de flujo de los 3 vasos estudiados. El riesgo de ictus isquémico en la Sβ talasemia es bajo, sin diferencia entre los 2 genotipos evaluados.In children with sickle cell anemia, the risk of ischemic stroke varies according to genotype of hemoglobinopathy. In these cases, determining the velocity of blood flow by transcranial Doppler (TCD can predict the occurrence of cerebral ischemia. In order to describe the characteristics of DTC in Sβ thalassemia, we studied 32 patients younger than 18 treated at the Institute of Hematology and Immunology, who were referred for ultrasound assessment. The age rate of children was 10.5 years old

Intervención psicológica en pacientes con diagnóstico de diabetes mellitus

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Gina Castro Cabeza

2013-12-01

Full Text Available La diabetes es una enfermedad que tiene su origen en una alteración orgánica, sin embargo, y dada la complejidad de la naturaleza humana, existen variables de orden psicológico que intervienen en el desarrollo de la enfermedad, estas dependen de las características y habilidades comportamentales de los pacientes para afrontar la enfermedad. Dado lo anterior es importante educar al paciente para que sea capaz de asumir de forma adaptativa y eficaz el tratamiento con el objetivo de mejorar su calidad de vida. Las estrategias de intervención se construyen a partir de la educación y evaluación de las esferas conductual, cognitiva y emocional del paciente, así mismo, de las habilidades de autocuidado, adherencia al tratamiento y recursos de afrontamiento frente al estrés; con el fin de diseñar propuestas ideográficas de intervención en dichos pacientes.

Alteraciones electrocardiográficas y factores de riesgo cardiovascular en pacientes con diabetes tipo 2

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Rodríguez-Morán Martha

1999-01-01

Full Text Available Objetivo. Determinar cuáles son las alteraciones del ritmo y la conducción cardiaca más frecuentes en pacientes con diabetes tipo 2 sin cardiopatía previa y establecer su asociación con los factores de riesgo cardiovascular. Material y métodos. Se incluyeron pacientes con diabetes tipo 2 sin presencia o antecedentes de cardiopatía. Se determinaron los factores de riesgo cardiovascular, el índice de masa corporal y los niveles séricos de glucosa, colesterol y triglicéridos. Se registró electrocardiograma convencional en reposo. La asociación de las variables en estudio con la ocurrencia de arritmias se calculó con un modelo de análisis multivariado ajustado por sexo. Resultados. Se integraron 199 pacientes: 113 mujeres (56.8% y 86 hombres (43.2%, y se identificó algún tipo de alteración electrocardiográfica en 29.1% de los sujetos. El hemibloqueo fascicular anterior (HFA y el bloqueo completo de rama derecha del Haz de His (BRDHH, constituyeron 75.9% de las alteraciones identificadas. Los pacientes con trastornos del ritmo y la conducción tienen niveles más elevados de colesterol y triglicéridos. La aparición de arritmias se relaciona directamente con el incremento de la edad (r= 0.75, p= 0.01. En el análisis multivariado ajustado por sexo la hipercolesterolemia y la edad se asociaron significativamente con las alteraciones del ritmo y la conducción: RM 1.5, IC95% 1.1-4.6, p< 0.05 y RM 1.3, IC95% 1.0-5.2, p< 0.05, respectivamente. Conclusiones. Las alteraciones del ritmo y la conducción cardiaca más frecuentes en la diabetes tipo 2 son el HFA y el BRDHH; la hipercolesterolemia y la edad son los factores asociados a su presencia.

Anterior Urethral Valves

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Vidyadhar P. Mali

2006-07-01

Full Text Available We studied the clinical presentation and management of four patients with anterior urethral valves; a rare cause of urethral obstruction in male children. One patient presented antenatally with oligohydramnios, bilateral hydronephrosis and bladder thickening suggestive of an infravesical obstruction. Two other patients presented postnatally at 1 and 2 years of age, respectively, with poor stream of urine since birth. The fourth patient presented at 9 years with frequency and dysuria. Diagnosis was established on either micturating cystourethrogram (MCU (in 2 or on cystoscopy (in 2. All patients had cystoscopic ablation of the valves. One patient developed a postablation stricture that was resected with an end-to-end urethroplasty. He had an associated bilateral vesicoureteric junction (VUJ obstruction for which a bilateral ureteric reimplantation was done at the same time. On long-term follow-up, all patients demonstrated a good stream of urine. The renal function is normal. Patients are continent and free of urinary infections. Anterior urethral valves are rare obstructive lesions in male children. The degree of obstruction is variable, and so they may present with mild micturition difficulty or severe obstruction with hydroureteronephrosis and renal impairment. Hence, it is important to evaluate the anterior urethra in any male child with suspected infravesical obstruction. The diagnosis is established by MCU or cystoscopy and the treatment is always surgical, either a transurethral ablation or an open resection. The long-term prognosis is good.

Causes and consequences of anterior pharyngeal pouch after total laryngectomy.

Science.gov (United States)

Anderson, S; Hogan, D; Panizza, B

2014-07-01

To assess the frequency of anterior pharyngeal pouch formation after total laryngectomy, and to discuss the causes and consequences of anterior pharyngeal pouch formation. A prospective, observational study of 43 patients undergoing total laryngectomy. Data collected included laryngeal defect closure type, tumour staging and demographic information. A barium swallow was performed on day 7-14 after surgery to assess for anterior pharyngeal pouch formation and fistula formation. The incidence of anterior pharyngeal pouch formation was 47 per cent. Patients who did not have an anterior pharyngeal pouch on swallow imaging assessment were less likely to develop a pharyngo-cutaneous fistula. There was no statistically significant association between laryngeal defect closure type and anterior pharyngeal pouch formation. The anterior pharyngeal pouch is a dynamic phenomenon best investigated with a fluoroscopic swallow imaging study. Its causes are multi-factorial. Absence of an anterior pharyngeal pouch appears to confer protection against pharyngo-cutaneous fistula formation, hastening commencement of adjuvant therapy and an oral diet.

Rotura del Bíceps Distal. Evaluación de resultados con técnica de doble fijación. [Distal biceps rupture: evaluation of results with double fixation technique

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Miguel Ángel Capomassi

2013-11-01

Full Text Available In­tro­duc­ción La rotura del bíceps distal es una lesión poco frecuente producida por la aplicación de una fuerza excéntrica sobre el codo flexionado. El objetivo de este trabajo es analizar los resultados obtenidos para la reinserción del bíceps distal mediante técnica de doble fijación con botón de anclaje cortical y tornillo interferencial de biotenodesis a través de una incisión anterior única. Materiales­ y­ Métodos Entre agosto de 2008 y febrero de 2013, registramos 19 casos de rotura del bíceps distal tratados quirúrgicamente por vía anterior limitada. Los 17 últimos casos consecutivos fueron tratados con doble fijación utilizando botón extracortical y tornillo de biotenodesis, y forman parte del estudio. Todos eran hombres, con una mediana de la edad de 41 años (rango 27-59. Los pacientes fueron evaluados con el Cuestionario DASH y el Puntaje Subjetivo/Objetivo de Andrews y Carson, y la fuerza de flexión y supinación se controló con la escala del British Medical Research Council modificada por Mackinnon y Dellon (M0-M5. Resultados El cuestionario DASH arrojó un valor mediano de 1,7 (0-5,83 y el de Andrews y Carson, de 195 (170-200 para el total; con 15 resultados excelentes y 2 buenos. Todos consiguieron una fuerza M5 para flexión y supinación de antebrazo. El seguimiento tuvo una mediana de 12 meses (4-32. En dos pacientes, se registraron complicaciones, ambas con recuperación ad íntegrum. Conclusión La técnica descrita ha demostrado ser confiable y eficaz, y permitió lograr resultados satisfactorios y una baja tasa de complicaciones.

Perawatan Ortodontik Gigi Anterior Berjejal dengan Tulang Alveolar yang Tipis

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Miesje K. Purwanegara

2015-09-01

Full Text Available Anterior teeth movement in orthodontic treatment is limited to labiolingual direction by very thin alveolar bone. An uncontrolled anterior tooth movement to labiolingual direction can cause alveolar bone perforation at its root segment. This case report is to remind us that alveolar bone thickness limits orthodontc tooth movement. A case of crowded anterior teeth with thin alveolar bone in malocclusion I is reported. This case is treated using adgewise orthodontic appliance. Protraction of anterior teeth is anticipated due to thin alveolar bone on the anterior surface. The conclusion is although the alveolar bone surrounding the crowded anterior teeth is thin, by controlling the movement the teeth reposition is allowed.

Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS)

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Roemer, Frank W; Frobell, Richard; Lohmander, Stefan

2014-01-01

OBJECTIVE: To develop a whole joint scoring system, the Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS), for magnetic resonance imaging (MRI)-based assessment of acute anterior cruciate ligament (ACL) injury and follow-up of structural sequelae, and to assess its reliability. DESIGN...

Biomechanical Measures During Landing and Postural Stability Predict Second Anterior Cruciate Ligament Injury After Anterior Cruciate Ligament Reconstruction and Return to Sport

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Paterno, Mark V.; Schmitt, Laura C.; Ford, Kevin R.; Rauh, Mitchell J.; Myer, Gregory D.; Huang, Bin; Hewett, Timothy E.

2016-01-01

Background Athletes who return to sport participation after anterior cruciate ligament reconstruction (ACLR) have a higher risk of a second anterior cruciate ligament injury (either reinjury or contralateral injury) compared with non–anterior cruciate ligament–injured athletes. Hypotheses Prospective measures of neuromuscular control and postural stability after ACLR will predict relative increased risk for a second anterior cruciate ligament injury. Study Design Cohort study (prognosis); Level of evidence, 2. Methods Fifty-six athletes underwent a prospective biomechanical screening after ACLR using 3-dimensional motion analysis during a drop vertical jump maneuver and postural stability assessment before return to pivoting and cutting sports. After the initial test session, each subject was followed for 12 months for occurrence of a second anterior cruciate ligament injury. Lower extremity joint kinematics, kinetics, and postural stability were assessed and analyzed. Analysis of variance and logistic regression were used to identify predictors of a second anterior cruciate ligament injury. Results Thirteen athletes suffered a subsequent second anterior cruciate ligament injury. Transverse plane hip kinetics and frontal plane knee kinematics during landing, sagittal plane knee moments at landing, and deficits in postural stability predicted a second injury in this population (C statistic = 0.94) with excellent sensitivity (0.92) and specificity (0.88). Specific predictive parameters included an increase in total frontal plane (valgus) movement, greater asymmetry in internal knee extensor moment at initial contact, and a deficit in single-leg postural stability of the involved limb, as measured by the Biodex stability system. Hip rotation moment independently predicted second anterior cruciate ligament injury (C = 0.81) with high sensitivity (0.77) and specificity (0.81). Conclusion Altered neuromuscular control of the hip and knee during a dynamic landing task

Memory-guided attention in the anterior thalamus.

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Leszczyński, Marcin; Staudigl, Tobias

2016-07-01

The anterior thalamus is densely connected with both the hippocampus and the prefrontal cortex. It is known to play a role in learning and episodic memory. Given its connectivity profile with the prefrontal cortex, it may also be expected to contribute to executive functions. Recent studies in both rodents and humans add to our understanding of anterior thalamic function, suggesting that it is a key region for allocating attention. We discuss the convergence between studies in rodents and humans, both of which imply that the anterior thalamus may play a key role in memory-guided attention. We suggest that efficient allocation of attention to memory representations requires interaction between the memory-related hippocampal and the attention related fronto-parietal networks. We further propose that the anterior thalamus is a hub that connects and modulates both systems. Copyright © 2016 Elsevier Ltd. All rights reserved.

Anterior Segment Ischemia after Strabismus Surger

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Emine Seyhan Göçmen

2017-01-01

Full Text Available A 46-year-old male patient was referred to our clinic with complaints of diplopia and esotropia in his right eye that developed after a car accident. The patient had right esotropia in primary position and abduction of the right eye was totally limited. Primary deviation was over 40 prism diopters at near and distance. The patient was diagnosed with sixth nerve palsy and 18 months after trauma, he underwent right medial rectus muscle recession. Ten months after the first operation, full-thickness tendon transposition of the superior and inferior rectus muscles (with Foster suture was performed. On the first postoperative day, slit-lamp examination revealed corneal edema, 3+ cells in the anterior chamber and an irregular pupil. According to these findings, the diagnosis was anterior segment ischemia. Treatment with 0.1/5 mL topical dexamethasone drops (16 times/day, cyclopentolate hydrochloride drops (3 times/day and 20 mg oral fluocortolone (3 times/day was initiated. After 1 week of treatment, corneal edema regressed and the anterior chamber was clean. Topical and systemic steroid treatment was gradually discontinued. At postoperative 1 month, the patient was orthophoric and there were no pathologic symptoms besides the irregular pupil. Anterior segment ischemia is one of the most serious complications of strabismus surgery. Despite the fact that in most cases the only remaining sequel is an irregular pupil, serious circulation deficits could lead to phthisis bulbi. Clinical properties of anterior segment ischemia should be well recognized and in especially risky cases, preventative measures should be taken.

A simple method for quantitative evaluation of the missing area of the anterior glenoid in anterior instability of the glenohumeral joint

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Barchilon, Vidal S. [Sapir Medical Center, Department of Orthopedic Surgery, Shoulder Service, Kfar-Saba (Israel); Kotz, Eugene [Sapir Medical Center, Department of Imaging, Kfar-Saba (Israel); Barchilon Ben-Av, Mercedes [Achva College of Education, Department of Mathematics, MP Shikmim (Israel); Glazer, Ernesto [Rabin Medical Center, Department of Imaging, Petah Tikva (Israel); Nyska, Meir [Sapir Medical Center, Department of Orthopedic Surgery, Kfar-Saba (Israel)

2008-08-15

The objective of this study was to describe and validate a simple method to quantitatively calculate the missing area of the anterior part of the glenoid in anterior glenohumeral instability. The calculations were developed from three-dimensional (3D)-reconstructed computerized tomography en face images of the glenoid with 'subtraction' of the humeral head in 13 consecutive cases with known anterior glenohumeral joint instability diagnosed by history and clinical examination. The inferior portion of the glenoid was approximated to a true circle whose center was determined by means of a femoral head gauge. The eroded anterior area was calculated as the ratio between the depth (a perpendicular line from the center of the circle to the eroded edge of the anterior glenoid) and the radius of the inferior glenoid circle. This data was then compared to the results obtained by two additional different methods: direct computerized measurements of the missing area and direct computerized measurement of the ratio between the radius and depth, on two dimensional computed tomography (CT) en face view reconstructions of the glenoid. We provide a function that correlates the ratio between depth and radius of the inferior glenoid circle and the area of the missing anterior glenoid. The results obtained by three different methods were comparable. Simple trigonometric calculations showed that a 5% area defect corresponds to 0.8 (12.5%) of the radius of the inferior glenoid, while a 20% area defect corresponds to 0.5 (50%) of the same radius. Using this simple method and the function provided, the eroded area of the anterior part of the glenoid in anterior glenohumeral instability can be calculated preoperatively using a 3D CT reconstruction of the glenoid with 'subtraction' of the humeral head, obviating the need for sophisticated software to obtain this critical information for preoperative decision making. (orig.)

Anterior Face Height Values in a Nigerian Population | Folaranmi ...

African Journals Online (AJOL)

... Anterior Upper Face Height 47.7 (4) mm, Anterior Total Face Height (ATFH) 108.5 (5) mm, ratio of ALFH to ATFH ALFH: ATFH 56 (4)%. Conclusion: This study provides anterior face height measurements, which will be of great significance in evaluating facial proportions andesthetics in orthodontics, orthognathic surgery, ...

Tratamiento de una maloclusión clase III en dentición decidua y mixta con expansión rápida palatina y máscara facial

OpenAIRE

Carlos Soldevilla, Luciano; Aliaga Del Castillo, Arón

2014-01-01

Reportamos el seguimiento de un caso clínico de mordida cruzada que en un inicio comprometió el uso de un aparato de expansión palatina adhesivo de acrílico, que después de la estabilización del tratamiento y coincidente con el recambio dentario anterosuperior, sufrió recidiva de la mordida cruzada anterior, la cual fue corregida con el uso de máscara facial. El propósito de corregir la mordida cruzada en edades tempranas permite que se produzca mejoras en el patrón esquelético de clase III y...

Anterior tension band plating for anterior tibial stress fractures in high-performance female athletes: a report of 4 cases

NARCIS (Netherlands)

Borens, Olivier; Sen, Milan K.; Huang, Russel C.; Richmond, Jeffrey; Kloen, Peter; Jupiter, Jesse B.; Helfet, David L.

2006-01-01

Stress fracture of the anterior tibial cortex is an extremely challenging fracture to treat, especially in the high-performance female athlete who requires rapid return to competition. Previous reports have not addressed treating these fractures in the world-class athlete with anterior plating. We

OBTENCIÓN DE echinococcus GRANULOSUS EN CANINOS INFECTADOS EXPERIMENTALMENTE CON PROTOESCÓLICES DE QUISTES HIDATÍDICOS.

OpenAIRE

Rosales G., Sofía; Gavidia C., César; Lopera B., Luis; Barrón G., Eduardo; Ninaquispe B., Berenice; Calderón S., Carmen; Gonzáles Z., Armando

2012-01-01

El presente estudio tuvo por objetivo reproducir experimentalmente el ciclo biológico del Echinococcus granulosus en perros. Se utilizó 12 perros (4-50 meses de edad) que fueron infectados experimentalmente con 80,000 a 308,000 protoescólices de quistes hidatídicos de pulmón e hígado de ovinos procedentes de Junín y Ayacucho. Los perros se sacrificaron 28 a 39 días post infección (p.i). El intestino delgado se dividió en tres porciones iguales (anterior, media y posterior). Los parásitos fuer...

Application and experience of anterior vitrectomy in phacoemulsification

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Xiao-Bo Zeng

2016-02-01

Full Text Available AIM: To observe and discuss the clinical application and effect of anterior vitrectomy in phacoemulsification for the treatment of vitreous prolapse caused by posterior capsular rupture or suspensory ligament transection.METHODS:Retrospective analysis of 28 cases(35 eyeswith cataract in whom vitreous prolapse caused by posterior capsular rupture or suspensory ligament transection occurred in phacoemulsification and intraocular lens implantation and anterior vitrectomy were performed was conducted. RESULTS:Anterior vitrectomy for timely and accurate treatment for vitreous prolapse caused by posterior capsular rupture or suspensory ligament transection occurred in phacoemulsification was satisfied. CONCLUSION: Anterior vitrectomy has good curative effect for vitreous prolapse caused by posterior capsular rupture or suspensory ligament transection occurred in phacoemulsification and is effective with less severe complications.

Atención visual y envejecimiento: Modelo de adaptación cognitiva positiva relacionada con la edad

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osé Manuel Rodríguez-Ferrer

2014-12-01

Full Text Available Se han estudiado los efectos del envejecimiento normal en la atención visual. Han participado un grupo de 38 personas mayores sanas con una edad media de 67.8 años y ungrupo de 39 personas jóvenes sanas con edad media de 19.2 años. En un primer experimento de detección visual, se midieron los tiempos de respuesta, con y sin atención encubierta, a la presentación de estímulos (círculos grises de 0.5º de diámetro y que aparecen en tres excentricidades (2.15, 3.83 y 5.53º de campo visual y con tres niveles de contraste (6, 16 y 78%. En un segundo experimento de discriminación visual de la forma, se presentaron círculos y cuadrados con las mismas características que en el experimento anterior, pero en este caso solo se debía responder a la aparición de los círculos. En ambos grupos de edad, la atención encubierta redujo los tiempos de respuesta. En comparación con los jóvenes, el grupo de mayores logró mejores resultados en algunos aspectos de las pruebas de atención y redujo más los tiempos de respuesta en los estímulos de mayor excentricidad. Los datos sugieren que en el envejecimiento existe un mecanismo de adaptación en el que la atención visual favorece especialmente la percepción de aquellos estímulos más difíciles de detectar.

Inferior Oblique Overaction: Anterior Transposition Versus Myectomy.

Science.gov (United States)

Rajavi, Zhale; Feizi, Mohadeseh; Behradfar, Narges; Yaseri, Mehdi; Sayanjali, Shima; Motevaseli, Tahmine; Sabbaghi, Hamideh; Faghihi, Mohammad

2017-07-01

To compare the efficacy of inferior oblique myectomy and anterior transposition for correcting inferior oblique overaction (IOOA). This retrospective study was conducted on 56 patients with IOOA who had either myectomy or anterior transposition of the inferior oblique muscle from 2010 to 2015. The authors compared preoperative and postoperative inferior oblique muscle function grading (-4 to +4) as the main outcome measure and vertical and horizontal deviation, dissociated vertical deviation (DVD), and A- and V-pattern between the two surgical groups as secondary outcomes. A total of 99 eyes of 56 patients with a mean age of 5.9 ± 6.5 years were included (47 eyes in the myectomy group and 52 eyes in the anterior transposition group). There were no differences in preoperative best corrected visual acuity, amblyopia, spherical equivalent, and primary versus secondary IOOA between the two groups. Both surgical procedures were effective in reducing IOOA and satisfactory results were similar between the two groups: 61.7% and 67.3% in the myectomy and anterior transposition groups, respectively (P = .56). After adjustment for the preoperative DVD, there was no statistically significant difference between the two groups postoperatively. The preoperative hypertropia was 6 to 14 and 6 to 18 prism diopters (PD) in the myectomy and anterior transposition groups, respectively. After surgery, no patient had a vertical deviation greater than 5 PD. Both the inferior oblique myectomy and anterior transposition procedures are effective in reducing IOOA with similar satisfactory results. DVD and hypertropia were also corrected similarly by these two surgical procedures. [J Pediatr Ophthalmol Strabismus. 2017;54(4):232-237.]. Copyright 2017, SLACK Incorporated.

Morphometric Study of the Anterior Thalamoperforating Arteries

Science.gov (United States)

Kim, Sung-Ho; Yeo, Dong-Kyu; Shim, Jae-Joon; Yoon, Seok-Mann; Chang, Jae-Chil

2015-01-01

Objective To evaluate the morphometry of the anterior thalamoperforating arteries (ATPA). Methods A microanatomical study was performed in 79 specimens from 42 formalin-fixed adult cadaver brains. The origins of the ATPAs were divided into anterior, middle, and posterior segments according to the crowding pattern. The morphometry of the ATPAs, including the premammillary artery (PMA), were examined under a surgical microscope. Results The anterior and middle segments of the ATPAs arose at mean intervals of 1.75±1.62 mm and 5.86±2.05 mm from the internal carotid artery (ICA), and the interval between these segments was a mean of 3.17±1.64 mm. The posterior segment arose at a mean interval of 2.43±1.46 mm from the posterior cerebral artery (PCA), and the interval between the middle and posterior segments was a mean of 3.45±1.39 mm. The mean numbers of perforators were 2.66±1.19, 3.03±1.84, and 1.67±0.98 in the anterior, middle, and posterior segments, respectively. The PMA originated from the middle segment in 66% of cases. A perforator-free zone was located >2 mm from the ICA in 30.4% and >2 mm from the PCA in 67.1% of cases. Conclusion Most perforators arose from the anterior and middle segments, within the anterior two-thirds of the posterior communicating artery (PCoA). The safest perforator-free zone was located closest to the PCA. These anatomical findings may be helpful to verify safety when treating lesions around the PCoA and in the interpeduncular fossa. PMID:26113962

Anatomia microcirúgica da substâcia perfurada anterior basal humana Microsurgical anatomy of the human basal anterior perforated substance

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Arlindo Alfredo Silveira D’Ávila

2006-06-01

Full Text Available A substância perfurada anterior constitui referencial na base do encéfalo. Localizada acima da bifurcação subaracnóidea da artéria carótida interna em sua porção basal e junto à artéria comunicante anterior na face inter-hemisférica, é transfixada por ramos perfurantes dirigidos aos núcleos telencefálicos corticais, cápsula interna e parte do tálamo. Por injeção intravascular de gelatina carminada, resina de Batson e látex, analisamos 50 hemisférios cerebrais humanos adultos de ambos os sexos, sob o microscópio cirúrgico. Objetivamos contribuir para a determinação da origem, número e topografia dos ramos destinados a essa região, seu curso, anastomoses e territórios de penetração. Propusemo-nos também a analisar a contribuição da artéria comunicante anterior à substância perfurada anterior. Foram encontradas variações anatômicas, incluindo anastomoses, envolvendo principalmente a artéria cerebral média e a artéria coróidea anterior. Estes conhecimentos são de interesse clínico-cirúrgico em razão da freqüência de patologias vasculares e tumorais a ela relacionadas.The anterior perforated substance (APS is a landmark in the basal forebrain. It has a basal face located above the carotid bifurcation in the subarachnoid space, and an interhemispheric one. It is the site of passage of the arteries to the caudate nucleus, putamen, internal capsule, adjacent areas of the globus pallidus and thalamus. Fifty hemispheres from twenty-five adult cadavers were obtained. The arteries were perfused with colored latex, Batson’s resin and gelatin colored with carmine. Using a surgical microscope we have determined the origin, local and number of origin from the parent vessel. The sites of penetration in the mediolateral and anteroposterior direction were also recorded. The anterior communicating artery contribution to the basal APS was reviewed. Significant vascular variations and anastomoses were encountered

Totally thrombosed giant anterior communicating artery aneurysm

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V R Roopesh Kumar

2015-01-01

Full Text Available Giant anterior communicating artery aneurysmsarerare. Apatient presented with visual dysfunction, gait ataxia and urinary incontinence. MRI showed a giant suprasellar mass.At surgery, the lesion was identified as being an aneurysm arising from the anterior communicating artery.The difficulty in preoperative diagnosis and relevant literature are reviewed.

Fiber-reinforced Composite for Chairside Replacement of Anterior ...

African Journals Online (AJOL)

Fiber-reinforced Composite for Chairside Replacement of Anterior Teeth: A Case Report. ... investigation will be required to provide additional information on the survival of directly-bonded anterior fixed prosthesis made with FRC systems.

Orbicularis oris musculomucosal flap for anterior palatal fistula

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Tiwari V

2006-01-01

Full Text Available Anterior palatal fistulae or residual anterior clefts are a frequent problem following palatoplasty. Various techniques have been used to repair such fistulae, each having its own advantages and disadvantages. We have successfully used orbicularis oris musculomucosal flap to close anterior fistula and residual clefts in 25 patients. This study shows the superiority of this flap over other techniques because of its reliable blood supply, easy elevation and transfer to fistula site and finally because it is a single-stage procedure.

Diffuse Anterior Retinoblastoma with Sarcoidosis-Like Nodule

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Koji Kitazawa

2015-12-01

Full Text Available Background: Retinoblastomas account for 4% of malignancies in children, 1-2% of which are diffuse infiltrating retinoblastomas. Diffuse anterior retinoblastoma is rare and does not involve the retina. Here, we report on a diffuse anterior retinoblastoma with large sarcoidosis-like nodules on the iris that were responsive to anti-inflammatory therapy. Case: We present a 6-year-old girl who had anterior uveitis with white nodules on the iris and posterior surface of the cornea in her right eye. The nodules initially responded well to anti-inflammatory treatment. However, anterior segment optical coherence tomography (AS-OCT showed that the nodules gradually grew, shrinking the iris. We then collected the aqueous humor for diagnosis. A biopsy revealed clusters of small cells with a high nuclear-to-cytoplasm ratio with partial rosette formation. Therefore, we diagnosed diffuse anterior retinoblastoma without retinal involvement and performed enucleation of the right eye. The histopathology demonstrated undifferentiated cells similar to those seen on the biopsy, and tumor cells invaded the iris stroma, posterior surface of the cornea, ciliary body, and sclera. After the enucleation, she underwent chemotherapy and remains alive. Conclusion: A differential diagnosis of retinoblastoma should be considered when white nodules refractory to anti-inflammatory therapy occur in the eye, even in the absence of obvious retinal masses. AS-OCT findings are useful in assessing retinoblastoma.

URETHROPLASTY FOR COMPLICATED ANTERIOR URETHRAL STRICTURES.

Science.gov (United States)

Aoki, Katsuya; Hori, Shunta; Morizawa, Yosuke; Nakai, Yasushi; Miyake, Makito; Anai, Satoshi; Torimoto, Kazumasa; Yoneda, Tatsuo; Tanaka, Nobumichi; Yoshida, Katsunori; Fujimoto, Kiyohide

2016-01-01

(Objectives) To compare efficacy and outcome of urethroplasty for complicated anterior urethral strictures. (Methods) Twelve patients, included 3 boys, with anterior urethral stricture underwent urethroplasty after the failure of either urethral dilatation or internal urethrotomy. We evaluated pre- and post-operative Q max and surgical outcome. (Results) Four patients were treated with end-to-end anastomosis, included a case of bulbar urethral elongation simultaneously, one patient was treated with augmented anastomotic urethroplasty, three patients were treated with onlay urethroplasty with prepucial flap, one patient was treated with tubed urethroplasty with prepucial flap (Ducket procedure) and three patients were treated with onlay urethroplasty with buccal mucosal graft. Postoperative Qmax improved in all patients without major complications and recurrence during follow-up periods ranging from 17 to 102 months (mean 55 months). (Conclusions) Urethroplasty is an effective therapeutic procedure for complicated anterior urethral stricture.

Anterior fixation of the axis.

Science.gov (United States)

Traynelis, Vincent C; Fontes, Ricardo B V

2010-09-01

Although anterior fixation of the axis is not commonly performed, plate fixation of C2 is an important technique for treating select upper cervical traumatic injuries and is also useful in the surgical management of spondylosis. To report the technique and outcomes of C2 anterior plate fixation for a series of patients in which the majority presented with symptomatic degenerative spondylosis. Forty-six consecutive patients underwent single or multilevel fusions over a 7-year period; 30 of these had advanced degenerative disease manifested by myelopathy or deformity. Exposure was achieved with rostral extension of the standard anterior cervical exposure via careful soft tissue dissection, mobilization of the superior thyroid artery, and the use of a table-mounted retractor. It was not necessary to remove the submandibular gland, section the digastric muscle, or make additional skin incisions. Screws were placed an average of 4.6 mm (+/- 2.3 mm) from the inferior C2 endplate with a mean sagittal trajectory of 15.7 degrees (+/- 7.6 degrees). Short- and long-term procedure-related mortality was 4.4%, and perioperative morbidity was 8.9%. Patients remained intubated an average of 2.5 days following surgery. Dysphagia was initially reported by 15.2% of patients but resolved by the 8th postoperative week in all patients. Arthrodesis was achieved in all patients available for long-term follow-up. Multilevel fusions were not associated with longer hospitalization or morbidity. Anterior plate fixation of the axis for degenerative disease can be accomplished with acceptable morbidity employing an extension of the standard anterolateral route.

Anterior knee pain

Energy Technology Data Exchange (ETDEWEB)

LLopis, Eva [Hospital de la Ribera, Alzira, Valencia (Spain) and Carretera de Corbera km 1, 46600 Alzira Valencia (Spain)]. E-mail: ellopis@hospital-ribera.com; Padron, Mario [Clinica Cemtro, Ventisquero de la Condesa no. 42, 28035 Madrid (Spain)]. E-mail: mario.padron@clinicacemtro.com

2007-04-15

Anterior knee pain is a common complain in all ages athletes. It may be caused by a large variety of injuries. There is a continuum of diagnoses and most of the disorders are closely related. Repeated minor trauma and overuse play an important role for the development of lesions in Hoffa's pad, extensor mechanism, lateral and medial restrain structures or cartilage surface, however usually an increase or change of activity is referred. Although the direct relation of cartilage lesions, especially chondral, and pain is a subject of debate these lesions may be responsible of early osteoarthrosis and can determine athlete's prognosis. The anatomy and biomechanics of patellofemoral joint is complex and symptoms are often unspecific. Transient patellar dislocation has MR distinct features that provide evidence of prior dislocation and rules our complication. However, anterior knee pain more often is related to overuse and repeated minor trauma. Patella and quadriceps tendon have been also implicated in anterior knee pain, as well as lateral or medial restraint structures and Hoffa's pad. US and MR are excellent tools for the diagnosis of superficial tendons, the advantage of MR is that permits to rule out other sources of intraarticular derangements. Due to the complex anatomy and biomechanic of patellofemoral joint maltracking is not fully understood; plain films and CT allow the study of malalignment, new CT and MR kinematic studies have promising results but further studies are needed. Our purpose here is to describe how imaging techniques can be helpful in precisely defining the origin of the patient's complaint and thus improve understanding and management of these injuries.

Anterior knee pain

International Nuclear Information System (INIS)

LLopis, Eva; Padron, Mario

2007-01-01

Anterior knee pain is a common complain in all ages athletes. It may be caused by a large variety of injuries. There is a continuum of diagnoses and most of the disorders are closely related. Repeated minor trauma and overuse play an important role for the development of lesions in Hoffa's pad, extensor mechanism, lateral and medial restrain structures or cartilage surface, however usually an increase or change of activity is referred. Although the direct relation of cartilage lesions, especially chondral, and pain is a subject of debate these lesions may be responsible of early osteoarthrosis and can determine athlete's prognosis. The anatomy and biomechanics of patellofemoral joint is complex and symptoms are often unspecific. Transient patellar dislocation has MR distinct features that provide evidence of prior dislocation and rules our complication. However, anterior knee pain more often is related to overuse and repeated minor trauma. Patella and quadriceps tendon have been also implicated in anterior knee pain, as well as lateral or medial restraint structures and Hoffa's pad. US and MR are excellent tools for the diagnosis of superficial tendons, the advantage of MR is that permits to rule out other sources of intraarticular derangements. Due to the complex anatomy and biomechanic of patellofemoral joint maltracking is not fully understood; plain films and CT allow the study of malalignment, new CT and MR kinematic studies have promising results but further studies are needed. Our purpose here is to describe how imaging techniques can be helpful in precisely defining the origin of the patient's complaint and thus improve understanding and management of these injuries

Congenital anterior urethral diverticulum

International Nuclear Information System (INIS)

Jung, Hyun Sub; Chung, Young Sun; Suh, Chee Jang; Won, Jong Jin

1985-01-01

Two cases of congenital anterior urethral diverticular which have occurred in a 4 year old and one month old boy are presented. Etiology, diagnostic procedures, and its clinical results are briefly reviewed

Anterior Visceral Endoderm SMAD4 Signaling Specifies Anterior Embryonic Patterning and Head Induction in Mice

Science.gov (United States)

Li, Cuiling; Li, Yi-Ping; Fu, Xin-Yuan; Deng, Chu-Xia

2010-01-01

SMAD4 serves as a common mediator for signaling of TGF-β superfamily. Previous studies illustrated that SMAD4-null mice die at embryonic day 6.5 (E6.5) due to failure of mesoderm induction and extraembryonic defects; however, functions of SMAD4 in each germ layer remain elusive. To investigate this, we disrupted SMAD4 in the visceral endoderm and epiblast, respectively, using a Cre-loxP mediated approach. We showed that mutant embryos lack of SMAD4 in the visceral endoderm (Smad4Co/Co;TTR-Cre) died at E7.5-E9.5 without head-fold and anterior embryonic structures. We demonstrated that TGF-β regulates expression of several genes, such as Hex1, Cer1, and Lim1, in the anterior visceral endoderm (AVE), and the failure of anterior embryonic development in Smad4Co/Co;TTR-Cre embryos is accompanied by diminished expression of these genes. Consistent with this finding, SMAD4-deficient embryoid bodies showed impaired responsiveness to TGF-β-induced gene expression and morphological changes. On the other hand, embryos carrying Cre-loxP mediated disruption of SMAD4 in the epiblasts exhibited relatively normal mesoderm and head-fold induction although they all displayed profound patterning defects in the later stages of gastrulation. Cumulatively, our data indicate that SMAD4 signaling in the epiblasts is dispensable for mesoderm induction although it remains critical for head patterning, which is significantly different from SMAD4 signaling in the AVE, where it specifies anterior embryonic patterning and head induction. PMID:20941375

Nonnecrotizing anterior scleritis mimicking orbital inflammatory disease

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Lynch MC

2013-08-01

Full Text Available Michelle Chen Lynch,1 Andrew B Mick21Optometry Clinic, Ocala West Veterans Affairs Specialty Clinic, Ocala, FL, USA; 2Eye Clinic, San Francisco VA Medical Center, San Francisco, CA, USABackground: Anterior scleritis is an uncommon form of ocular inflammation, often associated with coexisting autoimmune disease. With early recognition and aggressive systemic therapy, prognosis for resolution is good. The diagnosis of underlying autoimmune disease involves a multidisciplinary approach.Case report: A 42-year-old African American female presented to the Eye Clinic at the San Francisco Veteran Affairs Medical Center, with a tremendously painful left eye, worse on eye movement, with marked injection of conjunctiva. There was mild swelling of the upper eyelid. Visual acuity was unaffected, but there was a mild red cap desaturation. The posterior segment was unremarkable. The initial differential diagnoses included anterior scleritis and orbital inflammatory disease. Oral steroid treatment was initiated with rapid resolution over a few days. Orbital imaging was unremarkable, and extensive laboratory work-up was positive only for antinuclear antibodies. The patient was diagnosed with idiopathic diffuse, nonnecrotizing anterior scleritis and has been followed for over 5 years without recurrence. The rheumatology clinic monitors the patient closely, as suspicion remains for potential arthralgias including human leukocyte antigen-B27-associated arthritis, lupus-associated arthritis, seronegative rheumatoid arthritis, recurrent juvenile idiopathic arthritis, and scleroderma, based on her constitutional symptoms and clinical presentation, along with a positive anti-nuclear antibody lab result.Conclusion: Untreated anterior scleritis can progress to formation of cataracts, glaucoma, uveitis, corneal melting, and posterior segment disease with significant risk of vision loss. Patients with anterior scleritis must be aggressively treated with systemic anti

Propiedades de la Utrecht Work Engagement Scale (uwes-s 9: análisis exploratorio con estudiantes en Ecuador

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Cecilia Alexandra Portalanza Chavarría

2017-03-01

Full Text Available En el estudio del engagement académico se han desarrollado diversas medidas en función de las teorías o perspectivas que dan soporte a dicho concepto; en consonancia con lo anterior, el presente artículo tiene como objetivo analizar las propiedades psicométricas de una escala de engagement académico, con base en una muestra de 102 estudiantes pertenecientes a una institución de educación superior en Ecuador. El cuestionario empleado fue la versión española de la Utrecht Work Engagement Scale (uwes-s 9. Se analizó la estructura factorial de la escala con el método de estimación robusta. Los resultados obtenidos muestran que el modelo de dos factores presenta mejores índices de ajuste que el de uno y tres factores, por lo que se concluye que la estructura de dos factores es la más apropiada. De igual forma, los resultados llevan a concluir que la escala UWES-S 9 puede ser utilizada para estudiar el engagement en el contexto ecuatoriano.

Anterior cruciate ligament tears: MRI versus arthroscopy

International Nuclear Information System (INIS)

Tosch, U.; Felix, R.; Schauwecker, W.; Dreithaler, B.

1992-01-01

Because of suspected rupture of the anterior cruciate ligament sixteen acute traumatised patients were investigated by MR and arthroscopy. The MR diagnosis of a lesion of the anterior cruciate ligament proved to be correct by arthroscopy in fifteen of sixteen cases. Diagnostic criteria for lesions of the anterior cruciate ligament were: increased signal intensity in T 1 - and T 2 weighted images, increased volume and discontinuity of ligamentous structures. Additional MR findings of meniscal tears were correct in three of four cases laterally and in four of four cases medially. Femoral cartilage lesions were correctly identified by MR in three cases. MR normal findings proved to be correct by arthroscopy in another five cases. (orig.) [de

Dos casos de quiste de intestino anterior en cavidad oral

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Celso Chuquisana-Mostacero

Full Text Available Antecedentes y Objetivo: El quiste de intestino anterior es una entidad congénita poco frecuente. Cuando aparece, su localización más frecuente es el íleon y, aunque pueden aparecer a lo largo de todo el tracto digestivo, es rara su ubicación en la cavidad oral. A menudo se caracteriza por tres hallazgos principales: presencia de una capa de músculo liso bien desarrollada, una capa epitelial típica de alguna porción del tracto alimentario, y la unión íntima a alguna porción del tracto gastrointestinal. Las lesiones quísticas del suelo de boca en la edad infantil más frecuentes son los quistes salivares y las malformaciones linfáticas, ambas englobables en el término ránula. Sin embargo hay otras posibilidades, y la duplicación de intestino anterior, como aparece en los casos que presentamos, es una de ellas. Material y Método: Presentamos 2 pacientes en edad pediátrica con lesión lingual o de suelo de boca, que tras el estudio de imagen adecuado fueron operados por vía intraoral para la extirpación de la tumoración. En uno de los casos se usó abordaje cervical para extirpación de un segundo locus quístico. Resultados: El estudio anatomopatológico mostró en uno de los casos epitelio respiratorio, y en el segundo mucosa gástrica y epitelio respiratorio. Conclusiones: La importancia del diagnóstico y la extirpación completa en este tipo de lesiones viene dada por el riesgo de degeneración maligna en la edad adulta.

Anestesia em paciente com insensibilidade congênita a dor e anidrose Anestesia en paciente con insensibilidad congénita al dolor y anhidrosis Anesthesia in a patient with congenital insensitivity to pain and anhidrosis

Directory of Open Access Journals (Sweden)

Carlos Rogério Degrandi Oliveira

2009-10-01

ómica tipo IV (NHSA tipo IV, es una neuropatía autosómica recesiva rara del grupo de las neuropatías hereditarias sensoriales y autonómicas (NHSA, caracterizada por la insensibilidad al estímulo doloroso, anhidrosis y retraso mental. Existen pocos relatos sobre la conducta anestésica en pacientes con ICDA, debido a su extrema raridad. El objetivo de este relato, fue presentar la conducta anestésica en paciente con ICDA sometida a la artrodesis de tobillo izquierdo con colocación de vástago y discutir las características de interés para la anestesia en esos pacientes. RELATO DEL CASO: Paciente con historial de ICDA que fue admitida para artrodesis de tobillo izquierdo debido a la artropatía de Charcot. En la sala de operación, fue monitorizada con electrocardiógrafo, índice bispectral, SEF 95%, presión arterial no invasiva y saturación periférica de la hemoglobina, y medicada con midazolam como preanestésico. Posteriormente fue sometida a anestesia venosa con propofol y cisatracurio. No hubo necesidad de administrar analgésicos. Después de la intubación traqueal, se le monitoreó la presión expiratoria final del gas carbónico y de la temperatura esofágica. No presentó complicaciones en el período perioperatorio. Obtuvo su alta al segundo día del postoperatorio. CONCLUSIONES: Aunque presenten insensibilidad al dolor, algunos pacientes debutan con hiperestesia táctil, lo que podría causar sensaciones desagradables durante la manipulación quirúrgica. A pesar de los relatos en la literatura de pacientes sometidos a bloqueos en el neuro eje, e incluso a procedimientos sin anestesia, en ese caso se usó la anestesia venosa, proporcionando condiciones adecuadas para el procedimiento anestésico-quirúrgico.ACKGROUND AND OBJECTIVES: Congenital insensitivity to pain and Anhidrosis (CIPA or hereditary sensory and autonomic neuropathy type IV (HSAN IV is a rare autosomal recessive neuropathy of the group of hereditary sensory and autonomic neuropathies

Anterior capsular rupture following blunt ocular injury

Science.gov (United States)

Gremida, Anas; Kassem, Iris; Traish, Aisha

2011-01-01

Summary A 10-year-old boy suffered a large, oblique anterior capsular tear following blunt injury to his right eye. The boy was followed daily for hyphema resolution and progressive traumatic cataract formation. After the hyphema had resolved, the lens was removed using an anterior approach and an intraocular lens was placed with excellent visual outcome. PMID:23362402

ARTHROSCOPIC TREATMENT OF ANTERIOR IMPINGEMENT IN THE ANKLE

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Martin Mikek

2004-12-01

Full Text Available Background. Anterior soft tissue impingement is a common cause of chronic pain in the ankle. The preferred method of operative treatment is an arthroscopic excision of hypertrophic fibrous and synovial tissue in the anterior part of the ankle joint.Methods. We present the results of arthroscopic treatment of anterior ankle impingement in group of 14 patients.Results. Subjective improvement after the procedure was observed in all patients and 13 of them (93% were without any symptoms after the operation. One patient reported of intermittent pain, especially when walking on uneven grounds.Conclusions. We conclude that arthroscopic excision of hypertrophic synovial tissue in the anterior part of the ankle which causes the symptoms of impingement is a minimally invasive procedure that is both safe and reliable. When used for appropriate indications, an improvement can be expected in over 90% of patients.

[The "window" surgical exposure strategy of the upper anterior cervical retropharyngeal approach for anterior decompression at upper cervical spine].

Science.gov (United States)

Wu, Xiang-Yang; Zhang, Zhe; Wu, Jian; Lü, Jun; Gu, Xiao-Hui

2009-11-01

To investigate the "window" surgical exposure strategy of the upper anterior cervical retropharyngeal approach for the exposure and decompression and instrumentation of the upper cervical spine. From Jan. 2000 to July 2008, 5 patients with upper cervical spinal injuries were treated by surgical operation included 4 males and 1 female with and average age of 35 years old ranging from 16 to 68 years. There were 2 cases of Hangman's fractures (type II ), 2 of C2.3 intervertebral disc displacement and 1 of C2 vertebral body tuberculosis. All patients underwent the upper cervical anterior retropharyngeal approach through the "window" between the hypoglossal nerve and the superior laryngeal nerve and pharynx and carotid artery. Two patients of Hangman's fractures underwent the C2,3 intervertebral disc discectomy, bone graft fusion and internal fixation. Two patients of C2,3 intervertebral disc displacement underwent the C2,3 intervertebral disc discectomy, decompression bone graft fusion and internal fixation. One patient of C2 vertebral body tuberculosis was dissected and resected and the focus and the cavity was filled by bone autografting. C1 anterior arch to C3 anterior vertebral body were successful exposed. Lesion resection or decompression and fusion were successful in all patients. All patients were followed-up for from 5 to 26 months (means 13.5 months). There was no important vascular and nerve injury and no wound infection. Neutral symptoms was improved and all patient got successful fusion. The "window" surgical exposure surgical technique of the upper cervical anterior retropharyngeal approach is a favorable strategy. This approach strategy can be performed with full exposure for C1-C3 anterior anatomical structure, and can get minimally invasive surgery results and few and far between wound complication, that is safe if corresponding experience is achieved.

Fibrinous anterior uveitis following laser in situ keratomileusis

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Parmar Pragya

2009-01-01

Full Text Available A 29-year-old woman who underwent laser in situ keratomileusis (LASIK for myopic astigmatism in both eyes presented with severe pain, photophobia and decreased visual acuity in the left eye eight days after surgery. Examination revealed severe anterior uveitis with fibrinous exudates in the anterior chamber, flap edema and epithelial bullae. Laboratory investigations for uveitis were negative and the patient required systemic and intensive topical steroids with cycloplegics to control the inflammation. This case demonstrates that severe anterior uveitis may develop after LASIK and needs prompt and vigorous management for resolution.

con dietas suplementadas con Cromo-L-metionina

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Ram\\u00F3n Garc\\u00EDa-Castillo

2006-01-01

Full Text Available Un total de 48 cerdos (Sus scrofa domesticus; 24 machos castrados y 24 hembras cruzados (Yorkshire, Hampshire, Duroc y Landrace de 3,5 a 4,0 meses de edad y 60,0 ± 5,0 kg PV en finalización. Se alimentaron con dietas isoproteícas (14,5 % PC e isoenergéticas (3.400 kcal EM/kg de MS, adicionadas con Cr-L-metionina (MiCroPlex® (0, 200, 400 y 600 ppb. El experimento tuvo una duración de 45 días y se realizó de agosto a noviembre del 2002 en las instalaciones de la Universidad Autónoma Agraria Antonio Narro, localizada en Saltillo, Coahuila, México. Al tener los animales aproximadamente 95 kg PV, se tomó muestra de 15 ml de sangre por cada animal para determinar la concentración de glucosa, ácido úrico, creatinina, urea, proteinas totales y colesterol. Se aplicó un diseño completamente al azar con arreglo factorial 2 x 4; dos para el factor sexo y cuatro para nivel de cromo. Los metabolitos en suero no fueron afectados (P>0,05 por el factor sexo. La glucosa en suero disminuyó (P<0,05 y el colesterol incrementó (P<0,05 con cromo en la dieta. Se concluye que el Cr incrementa el metabolismo de glucosa y disminuye el de colesterol, con lo cual puede haber energía disponible para síntesis de proteína la cual es necesaria para el crecimiento de los animales

Las incapacidades de aprendizaje organizacional y su relación con los estilos de aprendizaje organizacional en la Mipyme

OpenAIRE

José Gerardo Ignacio Gómez Romero; María Deyanira Villarreal Solís; Francisco Martín Villarreal Solís

2015-01-01

En este estudio se analizaron 200 empresas micro, pequenas ˜ y medianas de la ciudad de Durango, México, con el propósito de encontrar la posible relación entre las incapacidades de aprendizaje y los estilos de aprendizaje organizacional y su repercusión en el aprendizaje organizacional; así como su repercusión en el aprendizaje de las mismas. Para lograr lo anterior se aplicó un instrumento de medicióna las mencionadas empresas, el mismo que fue debidamente adaptado al contexto, probado y va...

Política fiscal óptima en un modelo de Lucas con externalidades.

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Seijas Macías, J. Antonio.

2003-01-01

Full Text Available En este trabajo se desarrolla una política fiscal capaz de proporcionar los incentivos adecuados para que el equilibrio competitivo sea óptimo en el modelo de Lucas con externalidades, tanto en el estado estacionario como a lo largo de la transición. A diferencia de trabajos anteriores, supondremos que la función de producción es del tipo CES. El capital humano medio tiene un efecto externo positivo sobre la producción, lo que provoca que la fracción de tiempo dedicada al estudio sea inferior a la óptima. Para corregir el fallo de mercado provocado por la externalidad, se introduce un subsidio al capital humano y se muestra cómo puede ser financiado.

A Rare Nasal Bone Fracture: Anterior Nasal Spine Fracture

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Egemen Kucuk

2014-04-01

Full Text Available Anterior nasal spine fractures are a quite rare type of nasal bone fractures. Associated cervical spine injuries are more dangerous than the nasal bone fracture. A case of the anterior nasal spine fracture, in a 18-year-old male was presented. Fracture of the anterior nasal spine, should be considered in the differential diagnosis of the midface injuries and also accompanying cervical spine injury should not be ignored.

Asociación entre el precio de los alimentos y la glucemia en adultos estadounidenses con diabetes de tipo 2

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Tobenna D. Anekwé

2015-06-01

Full Text Available OBJETIVOS: Calculamos la asociación entre el precio de diversas categorías de alimentos saludables y menos saludables y la glucemia en adultos estadounidenses con diabetes de tipo 2. MÉTODOS: Vinculamos la información de salud contenida en la Encuesta Nacional de Salud y Nutrición 1999-2006 y el precio de los alimentos a partir de la base trimestral de datos de precios de los alimentos. Aplicamos una regresión de los valores de glucemia con respecto al precio de los alimentos en el trimestre anterior, con control de la región del mercado y otras covariables. Examinamos asimismo si la asociación entre el precio de los alimentos y la glucemia variaba entre distintos grupos de ingresos. RESULTADOS: Tanto el precio de las frutas y verduras como el precio de los productos lácteos magros se asocian a la glucemia en las personas con diabetes de tipo 2. En concreto, un precio mayor de las frutas y verduras y de los productos lácteos se asocia a valores más altos de glu-cohemoglobina y de glucemia en ayunas tres meses después. La asociación entre el precio de los alimentos y la glucemia es mayor en las personas de ingresos bajos que en las de ingresos elevados, en la dirección esperada. CONCLUSIONES: Un precio mayor de los alimentos saludables se asocia a cifras más elevadas de glucemia en las personas con diabetes de tipo 2. Esta asociación fue especialmente pronunciada en las personas con diabetes de tipo 2 con ingresos bajos.

LOS CLUBES DEPORTIVOS CHILENOS Y SU RELACIÓN CON SU ENTORNO. EL CASO DE LA REGIÓN DEL BIOBÍO

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Carlos Matus Castillo

2015-08-01

Full Text Available Objetivo: Verificar y analizar la relación de los clubes deportivos chilenos con las organizaciones públicas y privadas con y sin fines de lucro. Problemática: Las organizaciones deportivas son un objeto carente de análisis en Latinoamérica y también en Chile. En este país, las exiguas investigaciones no se han enfocado exclusivamente en la figura del club, por lo tanto no existen mayores evidencias respecto a sus relaciones con el entorno, lo cual ha generado un desconocimiento de información que podría emplearse en el diseño de estrategias que permitieran abordarlos. Referentes teóricos: La comprensión de la relación de los clubes con otras organizaciones de la sociedad se enfoca a partir de la teoría del tercer sector (Levitt, 1973; Salamon et al., 1999. Junto a ello, se observan las características de los clubes (Heinemann, 1999 que permiten distinguirlos de otras organizaciones del deporte. Los anteriores onstructos teóricos se sitúan desde el deporte como un sistema abierto (Puig y Heinemann, 1991. Metodología: Se trata de un estudio descriptivo, experimental y de corte transversal, con enfoque cuantitativo. Se aplicó un cuestionario a ciento cincuenta dirigentes deportivos provenientes de clubes de la región del Biobío. La muestra fue probabilística y estratificada, y el análisis de los datos se realizó a través de estadística descriptiva. Conclusiones: Se observó que los clubes presentaban una importante cercanía con las instituciones públicas. Llamó la atención también que tuvieran más vínculos con otras organizaciones de la sociedad que no están relacionadas directamente con el deporte.

Automatic anterior chamber angle assessment for HD-OCT images.

Science.gov (United States)

Tian, Jing; Marziliano, Pina; Baskaran, Mani; Wong, Hong-Tym; Aung, Tin

2011-11-01

Angle-closure glaucoma is a major blinding eye disease and could be detected by measuring the anterior chamber angle in the human eyes. High-definition OCT (Cirrus HD-OCT) is an emerging noninvasive, high-speed, and high-resolution imaging modality for the anterior segment of the eye. Here, we propose a novel algorithm which automatically detects a new landmark, Schwalbe's line, and measures the anterior chamber angle in the HD-OCT images. The distortion caused by refraction is corrected by dewarping the HD-OCT images, and three biometric measurements are defined to quantitatively assess the anterior chamber angle. The proposed algorithm was tested on 40 HD-OCT images of the eye and provided accurate measurements in about 1 second.

Reconstruction of the Anterior Cruciate Ligament : Alternative Strategies

NARCIS (Netherlands)

van Eijk, F.

2009-01-01

This thesis describes the long-term results of reconstruction of the anterior cruciate ligament with an allograft. Due to the poor results found, further studies were performed to investigate alternative strategies for reconstruction of the anterior cruciate ligament in the field of tissue

Measurements of anterior chamber depth, white-to-white distance, anterior chamber angle, and pupil diameter using two Scheimpflug imaging devices

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Alberto Domínguez-Vicent

2014-08-01

Full Text Available Purpose: To compare the ocular anterior chamber depth, white-to-white distance, anterior chamber angle, and pupil diameter, as measured with two different Scheimpflug imaging devices. Methods: This transversal study included 80 right eyes from 80 subjects aged from 20 to 40 years. Their spherical equivalents ranged from -4.25 to +1.00 diopters (D. Each eye's anterior chamber depth, white-to-white distance, anterior chamber angle, and pupil diameter, were measured for far vision using both the Galilei G4 (double Scheimpflug camera and the Pentacam HR (single Scheimpflug camera systems. Results: Mean anterior chamber depths were calculated as 3.12 ± 0.23 mm and 3.19 ± 0.24 mm when measured with the Galilei G4 and the Pentacam HR, respectively. The mean white-to-white distance measured was 11.84 ± 0.31 mm and 11.90 ± 0.43 mm when measured with the Galilei G4 and the Pentacam HR, respectively. Mean pupil diameters were measured as 3.22 ± 0.58 mm and 3.22 ± 0.52 mm when measured with the Galilei G4 and the Pentacam HR, respectively. Finally, the mean anterior chamber angle was 34.30 ± 2.86 degrees when it was measured with the Galilei G4, and 39.26 ± 2.85 degrees when measured with the Pentacam HR. A comparative analysis revealed that the Galilei G4 yielded a significantly lower (P0.05 for both devices were obtained for the white-to-white distance measurements. Conclusion: The Galilei G4 and Pentacam HR Scheimpflug systems cannot be used interchangeably because they produce significant measurement differences.

Clinical commissioning of an in vivo range verification system for prostate cancer treatment with anterior and anterior oblique proton beams

Science.gov (United States)

Hoesl, M.; Deepak, S.; Moteabbed, M.; Jassens, G.; Orban, J.; Park, Y. K.; Parodi, K.; Bentefour, E. H.; Lu, H. M.

2016-04-01

The purpose of this work is the clinical commissioning of a recently developed in vivo range verification system (IRVS) for treatment of prostate cancer by anterior and anterior oblique proton beams. The IRVS is designed to perform a complete workflow for pre-treatment range verification and adjustment. It contains specifically designed dosimetry and electronic hardware and a specific software for workflow control with database connection to the treatment and imaging systems. An essential part of the IRVS system is an array of Si-diode detectors, designed to be mounted to the endorectal water balloon routinely used for prostate immobilization. The diodes can measure dose rate as function of time from which the water equivalent path length (WEPL) and the dose received are extracted. The former is used for pre-treatment beam range verification and correction, if necessary, while the latter is to monitor the dose delivered to patient rectum during the treatment and serves as an additional verification. The entire IRVS workflow was tested for anterior and 30 degree inclined proton beam in both solid water and anthropomorphic pelvic phantoms, with the measured WEPL and rectal doses compared to the treatment plan. Gafchromic films were also used for measurement of the rectal dose and compared to IRVS results. The WEPL measurement accuracy was in the order of 1 mm and after beam range correction, the dose received by the rectal wall were 1.6% and 0.4% from treatment planning, respectively, for the anterior and anterior oblique field. We believe the implementation of IRVS would make the treatment of prostate with anterior proton beams more accurate and reliable.

Pigment dispersion syndrome masquerading as acute anterior uveitis.

Science.gov (United States)

Gonzalez-Gonzalez, Luis Alonso; Rodríguez-García, Alejandro; Foster, C Stephen

2011-06-01

Signs and symptoms of pigment dispersion may be confused with those of acute anterior uveitis. This case series is intended to aid the ophthalmologist in the clinical differentiation between these two disorders. The authors present a series of 6 patients with pigment dispersion who were initially diagnosed as having acute anterior uveitis and treated with anti-inflammatory medication, including corticosteroids. The patients were referred for a second opinion due to poor or no response to therapy and were found to have pigment dispersion instead of uveitis. Symptoms of pigment dispersion may consist of blurred vision, redness, ocular pain, and photophobia, all of which are also symptoms of acute anterior uveitis. These symptoms, plus the fact that pigment floating in the aqueous humor can be mistaken for inflammation, make diagnosis challenging. Moreover, the possible co-existence of true anterior uveitis and pigment dispersion makes the diagnosis and treatment more difficult.

Direct composite restoration of permanent anterior teeth uncomplicated crown fractures

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Ashley Evans Nicholas

2018-01-01

Full Text Available An uncomplicated crown fracture is a fracture that involves only the tooth enamel or the dentin and tooth enamel without any damage or exposure to the pulp. Crown fracture of the anterior teeth usually caused by traumatic forces such as falls, accidents, violence, or sports activities. Traumatic injuries of the oral region frequently involve the anterior teeth, especially maxillary incisors due to the anatomic factors which may affect the functional and aesthetical values of the teeth. The objective of this literature study was to know more about uncomplicated crown fracture of the anterior teeth and its restoration. This research was a literature study performed by researching, highlighting various interesting facts and compiling the relevant published journals. The most common and ideal direct restoration of the anterior teeth was the composite resin restoration. The anterior teeth restoration was considered to be a complex and challenging case to solves due to the fact that besides reconstructing the tooth and regaining the function, the aesthetical aspect was also becoming the main objectives. The permanent anterior teeth uncomplicated crown fracture was the most common case of tooth fractures which was mainly caused by traumatic injuries such as falls, accidents, excessive forces, violence, and also sports activities. Dental injuries of the anterior teeth also affected the aesthetical properties and the function of the tooth. Composite resin restoration was able to performed directly on the permanent anterior teeth uncomplicated crown fracture.

[Two cases of Vogt-Koyanagi-Harada disease presenting shallow anterior chamber].

Science.gov (United States)

Takemoto, Daisuke; Ijiri, Shigeyuki; Shimizu, Michiharu; Higashide, Tomomi; Sugiyama, Kazuhisa

2015-05-01

We report two cases of Vogt-Koyanagi-Harada disease (VKH) in which shallow anterior chambers were improved after steroid pulse therapy. The patients were women aged 65 and 72. They had headaches, decreased visual acuity and shallow anterior chamber in both eyes. There was no inflammation in the anterior chamber. Ultrasound biomicroscopy (UBM) showed ciliary edema, ciliochoroidal detachment, and angle closure. One case showed high intraocular pressure (IOP), and a diagnosis of acute primary angle closure was made. Although cataract surgery was performed in the left eye, postoperative optical coherence tomography (OCT) revealed serous retinal detachment in both eyes. The shallow anterior chamber and UBM findings were improved and serous retinal detachment disappeared after steroid pulse therapy in both cases. VKH may cause shallow anterior chamber and angle closure. The inflammatory changes of VKH in the anterior segment, i. e. ciliary edema and ciliochoroidal detachment, may exacerbate the shallow anterior chambers and narrow angles and result in an acute increase in IOP in eyes with short axial length. VKH associated with shallow anterior chamber may be misdiagnosed as acute primary angle closure. For differential diagnosis, examinations of the ocular fundus including OCT are useful.

Approach-related morbidity in transthoracic anterior spine surgery: a clinical study and review of literature Morbilidad relacionada con el abordaje torácico anterior de la columna: estudio clínico y revisión de la literatura Morbidade relacionada à abordagem transtorácica anterior da coluna: estudo clínico e revisão da literatura

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Juliane Zenner

2010-03-01

presente estudio fue observar los resultados relacionados con la morbilidad de la toracotomía abierta para la corrección de la deformidad de la columna vertebral y toracotomía para la colocación de tubo de drenaje torácica, utilizando ese grupo como Control. MÉTODOS: con base en un cuestionario respondido por los pacientes; y relacionado con la evaluación de la morbilidad del abordaje anterior de la columna torácica y utilizando criterios estrictos de inclusión de los pacientes, fueron evaluados 43 pacientes sometidos a toracotomía abierta para tratamiento de la escoliosis; y 30 pacientes portadores de otras enfermedades de menor gravedad, que fueron sometidos a la toracotomía para la colocación de dreno de tórax después del procedimiento. RESULTADOS: el promedio de edad de los pacientes sometidos al procedimiento en el tórax y a la toracotomía para la colocación de dreno o toracotomía abierta para tratamiento de escoliosis fue, respectivamente: 50.2 años y 16.5 años; el seguimiento clínico fue de 32.2 meses y 54.8 meses; y la extensión de la incisión de la piel 2.5 cm y 25 cm. El promedio del número de vértebras artrosadas fue 5.8 en el grupo sometido a la toracotomía abierta para la corrección de deformidad. La morbilidad promedio (variando de 0% - ninguna morbilidad a 100% - alta morbilidad en el grupo de pacientes sometidos a la toracotomía para colocación de dreno de tórax fue de 10.8±15.4 (0-59.5%, y un 42% de los pacientes no presentaron morbilidad. En el grupo sometido a la toracotomía abierta para la colocación del dreno de tórax fue observada neuralgia intercostal en 16.7%, y 35% de los pacientes presentaron morbilidad mayor que 10% (pormedio de un 27.5%. La morbilidad fue definida como la presencia de dolor crónico después de la toracotomía. En el grupo sometido a la toracotomía abierta para tratamiento de escoliosis el promedio de la morbilidad fue 7.0±12.7% (0-52.1%, y 44% no presentaron morbilidad. Señales de neuralgia

Molecular Age-Related Changes in the Anterior Segment of the Eye

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Luis Fernando Hernandez-Zimbron

2017-01-01

Full Text Available Purpose. To examine the current knowledge about the age-related processes in the anterior segment of the eye at a biological, clinical, and molecular level. Methods. We reviewed the available published literature that addresses the aging process of the anterior segment of the eye and its associated molecular and physiological events. We performed a search on PubMed, CINAHL, and Embase using the MeSH terms “eye,” “anterior segment,” and “age.” We generated searches to account for synonyms of these keywords and MESH headings as follows: (1 “Eye” AND “ageing process” OR “anterior segment ageing” and (2 “Anterior segment” AND “ageing process” OR “anterior segment” AND “molecular changes” AND “age.” Results. Among the principal causes of age-dependent alterations in the anterior segment of the eye, we found the mutation of the TGF-β gene and loss of autophagy in addition to oxidative stress, which contributes to the pathogenesis of degenerative diseases. Conclusions. In this review, we summarize the current knowledge regarding some of the molecular mechanisms related to aging in the anterior segment of the eye. We also introduce and propose potential roles of autophagy, an important mechanism responsible for maintaining homeostasis and proteostasis under stress conditions in the anterior segment during aging.

Current approach in diagnosis and management of anterior uveitis

OpenAIRE

Agrawal, Rupesh V; Murthy, Somasheila; Sangwan, Virender; Biswas, Jyotirmay

2010-01-01

Uveitis is composed of a diverse group of disease entities, which in total has been estimated to cause approximately 10% of blindness. Uveitis is broadly classified into anterior, intermediate, posterior and panuveitis based on the anatomical involvement of the eye. Anterior uveitis is, however, the commonest form of uveitis with varying incidences reported in worldwide literature. Anterior uveitis can be very benign to present with but often can lead to severe morbidity if not treated...

Reconstruction of the Anterior Cruciate Ligament : Alternative Strategies

OpenAIRE

van Eijk, F.

2009-01-01

This thesis describes the long-term results of reconstruction of the anterior cruciate ligament with an allograft. Due to the poor results found, further studies were performed to investigate alternative strategies for reconstruction of the anterior cruciate ligament in the field of tissue engineering.

Uso de hipnóticos durante la titulación con presión positiva en la vía aérea superior

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Franklin Escobar-Córdoba

2015-01-01

Full Text Available Objetivo: Establecer algunas recomendaciones sobre el uso de hipnóticos en el procedimiento de titulación con presión positiva de aire. Metodología: Revisión narrativa de la literatura mediante búsqueda bibliográfica en bases de datos: Pubmed, Scopus, Web of Science y SciELO Citation Index. Resultados: Diferentes estudios han evaluado el efecto de la premedicación con agentes hipnóticos y/o sedantes no benzodiacepínicos sobre los parámetros de sueño que afectan la calidad del procedimiento de titulación con CPAP , y han demostrado que son efectivos para promover la conciliación, reducir la latencia del sueño, incrementar el tiempo total del mismo y mejorar su eficiencia con mínimos efectos adversos al día siguiente; por lo anterior son usados habitualmente, con excelentes resultados, pocos efectos adversos y respetando la legislación vigente. Conclusión: Se presentan algunas recomendaciones de seguridad para la inducción del sueño en el paciente sometido a titulación con presión positiva de aire que apoyen al per - sonal de salud de los laboratorios de sueño antes, durante y después del uso de hipnóticos, brindan seguridad al paciente y evitan desenlaces adversos prevenibles.

Management of anterior dental crossbite with removable appliances

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Ayca Tuba Ulusoy

2013-01-01

Full Text Available This case report describes the treatment of an 8-year-old girl with anterior dental crossbite using a series of removable appliances to bring the teeth into a normal position. Clinical presentation and intervention: A removable acrylic appliance with a bite plate incorporating a screw was used to correct the anterior dental crossbite and align the incisors. The subsequent eruption of the maxillary left lateral incisor on the palatinal side was treated with a second acrylic plate incorporating a labiolingual spring. After an 8-month period, the anterior crossbite involving multiple incisors was corrected.

Optical coherence tomography in anterior segment imaging

Science.gov (United States)

Kalev-Landoy, Maya; Day, Alexander C.; Cordeiro, M. Francesca; Migdal, Clive

2008-01-01

Purpose To evaluate the ability of optical coherence tomography (OCT), designed primarily to image the posterior segment, to visualize the anterior chamber angle (ACA) in patients with different angle configurations. Methods In a prospective observational study, the anterior segments of 26 eyes of 26 patients were imaged using the Zeiss Stratus OCT, model 3000. Imaging of the anterior segment was achieved by adjusting the focusing control on the Stratus OCT. A total of 16 patients had abnormal angle configurations including narrow or closed angles and plateau irides, and 10 had normal angle configurations as determined by prior full ophthalmic examination, including slit-lamp biomicroscopy and gonioscopy. Results In all cases, OCT provided high-resolution information regarding iris configuration. The ACA itself was clearly visualized in patients with narrow or closed angles, but not in patients with open angles. Conclusions Stratus OCT offers a non-contact, convenient and rapid method of assessing the configuration of the anterior chamber. Despite its limitations, it may be of help during the routine clinical assessment and treatment of patients with glaucoma, particularly when gonioscopy is not possible or difficult to interpret. PMID:17355288

Disminución del rendimiento académico con el Plan Bolonia respecto al plan anterior en España

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María Isabel LÓPEZ RODRÍGUEZ

2016-05-01

Full Text Available La incorporación del Sistema Europeo de Transferencia de Créditos (ECTS verá sus frutos en breve con la salida al mercado laboral de los primeros egresados. En este estudio se realiza una primera valoración de los resultados obtenidos, analizando si el plan de estudios (grado o licenciatura y el uso de las nuevas metodologías docentes han marcado diferencias significativas en el rendimiento académico. Los resultados indican que éste es mayor en los licenciados y para los alumnos que se han beneficiado de una nueva herramienta pedagógica. Se han considerado los datos de dos promociones de doble licenciatura y doble grado. Descartadas, como causas, inputs potencialmente importantes como nivel preuniversitario y opción de bachillerato se plantea, como causa de la disminución del rendimiento, la implantación de los grados con una inversión prácticamente nula, lo que habría supuesto que el alumnado carezca de la disminución de presencialidad requerida para la correcta autogestión académica

Abordaje de un grupo familiar con displasia ectodérmica hipohidrótica a partir de salud familiar

Directory of Open Access Journals (Sweden)

Sara Caro de Pallares

2011-01-01

Full Text Available La salud del grupo familiar está sujeta a una complejidad de condiciones socioeconómicas, culturales, ambientales, biológicas, genéticas, psicológicas y relacionales, que configuran los factores condicionantes de la salud. Por lo anterior, la Salud Familiar incide de manera importante en la dinámica poblacional, en el desencadenamiento de la enfermedad, en el cumplimiento de funciones claves en el desarrollo biopsicosocial del ser humano y en las decisiones acerca de la utilización de los servicios de salud. En las familias con enfermedades de origen genético, sus miembros desarrollan temores a morir a una determinada edad. El caso objeto de estudio se presentó en un centro de salud de la ciudad de Barranquilla (Colombia con una escolar que llegó a control de Crecimiento y Desarrollo, quien fue asignada a un estudiante para su seguimiento. Luego de una evaluación médica multidisciplinaria, fue diagnosticada Displasia Ectodérmica Hipohidrotica.

Effect of early implementation of electrical muscle stimulation to prevent muscle atrophy and weakness in patients after anterior cruciate ligament reconstruction.

Science.gov (United States)

Hasegawa, Satoshi; Kobayashi, Masahiko; Arai, Ryuzo; Tamaki, Akira; Nakamura, Takashi; Moritani, Toshio

2011-08-01

Following anterior cruciate ligament (ACL) reconstruction, restricted weight bearing and immobilization results in thigh and calf muscle atrophy and weakness. The purpose of this study was to assess the effect of electrical muscle stimulation (EMS) on prevention of muscle atrophy in patients during the early rehabilitation stage after ACL reconstruction. Twenty patients with acute ACL tears were divided into two groups randomly. The control group (CON group) participated in only the usual rehabilitation program. In addition to this protocol, the electrical muscle stimulation group (EMS group) received EMS training using the wave form of 20 Hz exponential pulse from the 2nd post-operative day to 4 weeks after the surgery. Muscle thickness of vastus lateralis and calf increased significantly 4 weeks after surgery in the EMS group, while it decreased significantly in the CON group. The decline of knee extension strength was significantly less in the EMS group than in the CON group at 4 weeks after the surgery, and the EMS group showed greater recovery of knee extension strength at 3 months after surgery. EMS implemented during the early rehabilitation stage is effective in maintaining and increasing muscle thickness and strength in the operated limb. Copyright © 2011 Elsevier Ltd. All rights reserved.

Transanal stent in anterior resection does not prevent anastomotic leakage

DEFF Research Database (Denmark)

Bülow, Steffen; Bulut, O; Christensen, Ib Jarle

2006-01-01

OBJECTIVE: A defunctioning transanal stent may theoretically reduce the leakage rate after anterior rectal resection. We present a randomized open study with the aim of comparing the leakage rate after anterior resection with a loop ileostomy, a transanal stent, both or neither. PATIENTS AND METH....... On this basis it was decided to discontinue the study prematurely for ethical reasons. CONCLUSION: Decompression of the anastomosis with a transanal stent does not reduce the risk of anastomotic leakage after anterior resection.......OBJECTIVE: A defunctioning transanal stent may theoretically reduce the leakage rate after anterior rectal resection. We present a randomized open study with the aim of comparing the leakage rate after anterior resection with a loop ileostomy, a transanal stent, both or neither. PATIENTS...... AND METHODS: Randomized open trial of 194 patients operated in 11 hospitals during September 2000 to September 2003 with anterior resection for a mobile rectal tumour, 115 men and 79 women, median age 68 years (range 37-90 years). The surgeon decided upon the use of a protective ileostomy, and after...

[Microsurgical anatomy importance of A1-anterior communicating artery complex].

Science.gov (United States)

Monroy-Sosa, Alejandro; Pérez-Cruz, Julio César; Reyes-Soto, Gervith; Delgado-Hernández, Carlos; Macías-Duvignau, Mario Alberto; Delgado-Reyes, Luis

2013-01-01

The anterior cerebral artery originates from the bifurcation of the internal carotid artery lateral to the optic chiasm, then joins with its contralateral counterpart via the anterior communicating artery. A1-anterior communicating artery complex is the most frequent anatomical variants and is the major site of aneurysms between 30 to 37%. Know the anatomy microsurgical, variants anatomical and importance of complex precommunicating segment-artery anterior communicating in surgery neurological of the pathology vascular, mainly aneurysms, in Mexican population. The study was performed in 30 brains injected. Microanatomy was studied (length and diameter) of A1-anterior communicating artery complex and its variants. 60 segments A1, the average length of left side was 11.35 mm and 11.84 mm was right. The average diameter of left was 1.67 mm and the right was 1.64 mm. The average number of perforators on the left side was 7.9 and the right side was 7.5. Anterior communicating artery was found in 29 brains of the optic chiasm, its course depended on the length of the A1 segment. The average length of the segment was 2.84 mm, the average diameter was 1.41 mm and the average number of perforators was 3.27. A1-anterior communicating artery complex variants were found in 18 (60%) and the presence of two blister-like aneurysms. It is necessary to understand the A1-anterior communicating artery complex microanatomy of its variants to have a three-dimensional vision during aneurysm surgery.

Psychological Aspects of Recovery Following Anterior Cruciate Ligament Reconstruction.

Science.gov (United States)

Christino, Melissa A; Fantry, Amanda J; Vopat, Bryan G

2015-08-01

Recovery following anterior cruciate ligament reconstruction is an arduous process that requires a significant mental and physical commitment to rehabilitation. Orthopaedic research in recent years has focused on optimizing anterior cruciate ligament surgical techniques; however, despite stable anterior cruciate ligament reconstructions, many athletes still never achieve their preinjury ability or even return to sport. Psychological factors associated with patient perceptions and functional outcomes following anterior cruciate ligament reconstruction are important to acknowledge and understand. Issues related to emotional disturbance, motivation, self-esteem, locus of control, and self-efficacy can have profound effects on patients' compliance, athletic identity, and readiness to return to sport. The psychological aspects of recovery play a critical role in functional outcomes, and a better understanding of these concepts is essential to optimize the treatment of patients undergoing anterior cruciate ligament reconstruction, particularly those who plan to return to sport. Identifying at-risk patients, encouraging a multidisciplinary approach to patient care, and providing early referral to a sports psychologist may improve patient outcomes and increase return-to-play rates among athletes. Copyright 2015 by the American Academy of Orthopaedic Surgeons.

Remediación in situ de agua contaminada con diesel por oxidación con peróxido de hdrógeno

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Cardona Gallo Santiago Alonso

2011-11-01

Full Text Available Las grandes cantidades de hidrocarburos que se manejan en el mundo y en México, generan derrames de crudo y sus derivados, deteriorando en gran medida el medioambiente y especialmente las fuentes de suministro de agua subterránea. En México, el 27% del agua potable proviene de los acuíferos. Lo anterior permite plantear la necesidad de desarrollar sistemas de tratamiento viables que pueden reducir la contaminación rápida y económicamente de los acuíferos. Este trabajo presenta la oxidación del diesel combustible en solución con un agente oxidante, peróxido de hidrógeno; grado industrial al 50%. Se utilizó el H2O2, porque es un agente oxidante fuerte muy conocido, de fácil manejo, de bajo costo y una solubilidad mayor en el agua que el oxígeno molecular. Se tuvo una concentración inicial de diesel en solución de 45.000 mg/L, bajo agitación horizontal continua en un sistema en serie durante 114 horas. Las muestras fueron tomadas periódicamente. Al final de las 114 horas, la concentraci��n del hidrocarburo descendió hasta 24.000 mg/L, obteniendo una velocidad de la reacción de 0,0047 h-1 (0,1128 d-1. El estudio fue llevado a cabo sin catalizador. El efluente presentó un intervalo de pH entre 6,5 y 7,5. Con los resultados previos fueron diseñadas las columnas y operadas intermitentemente, y se comparó con columnas sin adición de peróxido de hidrógeno. La eficiencia del sistema y el bajo costo pueden ser aplicados en diferentes sistemas para el tratamiento de diesel en barreras reactivas permeables, zonas reactivas o aguas subterráneas.

Modeling the drug transport in the anterior segment of the eye.

Science.gov (United States)

Avtar, Ram; Tandon, Deepti

2008-10-02

The aim of the present work is the development of a simple mathematical model for the time course concentration profile of topically administered drugs in the anterior chamber aqueous humor and investigation of the effects of various model parameters on the aqueous humor concentration of lipophilic and hydrophilic drugs. A simple pharmacokinetic model for the transient drug transport in the anterior segment has been developed by using the conservation of mass in the precorneal tear film, Fick's law of diffusion and Michaelis-Menten kinetics of drug metabolism in cornea, and the conservation of mass in the anterior chamber. An analytical solution describing the drug concentration in the anterior chamber has been obtained. The model predicts that an increase in the drug metabolic (consumption) rate in the corneal epithelium reduces the drug concentration in the anterior chamber for both lipophilic and hydrophilic molecules. A decrease in the clearance rate and distribution volume of the drug in the anterior chamber raises the aqueous humor concentration significantly. It is also observed that decay rate of drug concentration in the anterior chamber is higher for lipophilic molecules than that for hydrophilic molecules. The bioavailability of drugs applied topically to the eye may be improved by a rise in the precorneal tear volume, diffusion coefficient in corneal epithelium and distribution coefficient across the endothelium anterior chamber interface, and by reducing the drug metabolism, drug clearance rate and distribution volume in anterior chamber.

Galvanic vestibular stimulation may improve anterior bending posture in Parkinson's disease.

Science.gov (United States)

Okada, Yohei; Kita, Yorihiro; Nakamura, Junji; Kataoka, Hiroshi; Kiriyama, Takao; Ueno, Satoshi; Hiyamizu, Makoto; Morioka, Shu; Shomoto, Koji

2015-05-06

This study investigated the effects of binaural monopolar galvanic vestibular stimulation (GVS), which likely stimulates the bilateral vestibular system, on the anterior bending angle in patients with Parkinson's disease (PD) with anterior bending posture in a single-blind, randomized sham-controlled crossover trial. The seven PD patients completed two types of stimulation (binaural monopolar GVS and sham stimulation) applied in a random order 1 week apart. We measured each patient's anterior bending angles while he or she stood with eyes open and eyes closed before/after the stimulations. The anterior bending angles in both the eyes-open and the eyes-closed conditions were significantly reduced after the GVS. The amount of change in the eyes-closed condition post-GVS was significantly larger than that by sham stimulation. The amount of change in anterior bending angles in the GVS condition was not significantly correlated with Unified Parkinson's Disease Rating Scale motor score, disease duration, the duration of the postural deformities, and the anterior bending angles before the GVS. Binaural monopolar GVS might improve anterior bending posture in PD patients, irrespective of the duration and the severity of disease and postural deformities. Binaural monopolar GVS might be a novel treatment strategy to improve anterior bending posture in PD.

THREE-DIMENSIONAL RECONSTRUCTION OF THE ANTERIOR OLFACTORY NUCLEUS IN THE HUMAN OLFACTORY BULB AND PEDUNCLE. Reconstrucción tridimiensional del núcleo olfatorio anterior en el bulbo y pedúnculo olfatorio humano

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Steven Berendsen

2016-03-01

Full Text Available El bulbo y pedúnculo olfatorio humano contienen muchos grupos celulares más o menos separados que habitualmente son considerados como parte del núcleo olfatorio anterior retro-bulbar (AON. La presunción que estos grupos celulares sean considerados como extensión rostral del AON en el hemisferio rostral retrocede a la descripción de un único caso por Crosby y Humphrey (1941. Para mejorar nuestra comprensión de la anatomía del AON bulbar y peduncular humano investigamos la morfología, forma y tamaño de estas partes en este núcleo en tejido post-mortem de individuos de edades conocidas. Se obtuvieron seis bulbos y pedúnculos olfatorios, incluyendo la sustancia perforada anterior (SPA, de cerebros donados; se realizaron cortes seriales horizontales a 40µm y se tiñó con substancia de Nissl. Las neuronas de tamaño mediano a grande de esta parte del AON se tiñeron intensamente y tenían un diámetro promedio de 16µm. La reconstruc-ción tridimensional demostró que en todos los casos, excepto uno, el AON bulbar y peduncular consistieron en una cadena discontinua de grupos celulares conectados por puentes de neuropilas pobres o libres de células. El número de grupos celulares y de puentes conectores difiere en cada individuo. Concluimos que las porciones bulbar y peduncular del AON humano debería ser considerado como una especialización humana más que como una extensión rostral del área AON retro-bulbar. Esto es acorde con las propiedades neuro-clínicas previamente publicadas y la degeneración temprana selectiva, pre-clínica, de estos nichos celulares en la enfermedad neuro-degenerativa. The human olfactory bulb and peduncle contain several more or less separated cell groups that are usually regarded to be part of the retrobulbar anterior olfactory nucleus (AON. The assumption that these cell groups are to be considered as the rostral extension of the AON in the rostral hemisphere goes back to the description of one single

Experiencia en reconstrucción auricular en cáncer de piel con colgajo en "quesadilla"

Directory of Open Access Journals (Sweden)

C. Gutiérrez Gómez

Full Text Available La reconstrucción auricular es una de las más difíciles ya que implica reproducir las sofisticadas y delicadas formas del pabellón auricular. Cuando hay que resecar piel en la oreja por un cáncer cutáneo y dejamos expuesto el cartílago, sin pericondrio, suele suceder que al colocar injertos no hay una integración adecuada de los mismos por las caprichosas formas y relieves del pabellón auricular; cuando es necesario resecar el pericondrio estamos obligados a cubrir el defecto con un colgajo y no con un simple injerto. Frente a esta dificultad técnica, diseñamos un colgajo ricamente vascularizado que preserva el cartílago no afectado con una buena cubierta y al mismo tiempo respeta la anatomía de la oreja. Para la cobertura del cartílago auricular anterior usamos un colgajo fasciocutáneo posterior que se asemeja a un plato típico de la cocina mexicana que llamamos "quesadilla", donde el cartílago por su color blanco recuerda el queso y el gran colgajo fasciocutaneo recuerda la tortilla que cubre al queso. Este colgajo incluye la piel enrollada del hélix, que en un segundo tiempo retornará a su lugar de origen anatómico mediante una z-plastía asimétrica. Presentamos, de entre una serie de 13 pacientes con carcinoma de pabellón auricular, 2 casos resueltos mediante esta técnica.

Postural stability in subjects with anterior cruciate ligament injury

OpenAIRE

Kolář, Miroslav

2011-01-01

6 Abstract Title: Postural stability in subjects with anterior cruciate ligament injury. Objectives: The aim of this thesis was to find out if the postural stability is differed in subjects with anterior cruciate ligament injury and in the control group after the "4 steps - one leg stance" test had been performed. Methods: This study compared a group with anterior cruciate ligament injury and a control group on the basis of the "4 steps - one leg stance" test. Methods of comparison and analys...

Tratamiento con implantes Leader-Nano en paciente con oligodoncia

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Salvador Javier Santos Medina

2015-03-01

Full Text Available Los implantes dentales de titanio han revolucionado el mundo de la rehabilitación desde su surgimiento. De manera particular, el empleo de implantes de carga inmediata acorta el tiempo quirúrgico y protésico, con el consiguiente bienestar estético. Se presenta el caso de una paciente femenina de 32 años de edad, con antecedentes de oligodoncia de ambos incisivos laterales superiores y portadora de prótesis parcial acrílica. Fue atendida por el equipo multidisciplinario de implantes en la Clínica Estomatológica Docente “3 de Octubre” y se le realizó tratamiento de rehabilitación integral con implantes Leader-Nano y prótesis fija con corona acrílica sobre dichos implantes. La implantología fue satisfactoria en la paciente; la mejoría estética y funcional, así como la satisfacción de la paciente, fueron los principales logros obtenidos

Elevator Muscle Anterior Resection: A New Technique for Blepharoptosis.

Science.gov (United States)

Zigiotti, Gian Luigi; Delia, Gabriele; Grenga, Pierluigi; Pichi, Francesco; Rechichi, Miguel; Jaroudi, Mahmoud O; d'Alcontres, Francesco Stagno; Lupo, Flavia; Meduri, Alessandro

2016-01-01

Blepharoptosis is a condition of inadequate upper eyelid position, with a downward displacement of the upper eyelid margin resulting in obstruction of the superior visual field. Levator resection is an effective technique that is routinely used to correct aponeurotic ptosis. The anterior levator resection is the procedure of choice in moderate blepharoptosis when there is moderate to good levator muscle function, furthermore, with an anterior approach, a greater resection can be achieved than by a conjunctival approach. The authors describe a modification in the Putterman technique with a resection done over a plicated elevator, plication that was suggested by Mustardè. The technique has been named as elevator muscle anterior resection. The elevator muscle anterior resection inspires from the Fasanella-Servat operation by the use of a clamp, making the operation simple and predictable.

Fijación de radioyodo en huesos maxilares simulando metástasis en pacientes con Carcinoma Diferenciado de Tiroides (CDT): False- Positive images in patients with Differentiated Thyroid Carcinoma. (DTC) Uptake of 131-I in maxillary bones mimicking salivary glands

OpenAIRE

O. J. Degrossi; S. Gutiérrez; A. Fadel; E. B. Degrossi; M. C. Valdivieso; R. L. Balbuena; M. del C. Alak; M. de Cabrejas

2008-01-01

En estudios centellográficos con 131I (CCT) para seguimiento, postablación o tratamiento de pacientes portadores de carcinoma diferenciado de tiroides (CDT) se observan frecuentemente en tiempos precoces áreas de captación del radiotrazador en macizo facial. Estas áreas corresponden, generalmente, a glándulas salivares y extremo anterior de mucosa nasal y se mantienen durante las primeras 48 horas y no son observadas generalmente a las 72 horas. Pero con menor frecuencia se presentan otras qu...

Anterior Cortical Development During Adolescence in Bipolar Disorder.

Science.gov (United States)

Najt, Pablo; Wang, Fei; Spencer, Linda; Johnston, Jennifer A Y; Cox Lippard, Elizabeth T; Pittman, Brian P; Lacadie, Cheryl; Staib, Lawrence H; Papademetris, Xenophon; Blumberg, Hilary P

2016-02-15

Increasing evidence supports a neurodevelopmental model for bipolar disorder (BD), with adolescence as a critical period in its development. Developmental abnormalities of anterior paralimbic and heteromodal frontal cortices, key structures in emotional regulation processes and central in BD, are implicated. However, few longitudinal studies have been conducted, limiting understanding of trajectory alterations in BD. In this study, we performed longitudinal neuroimaging of adolescents with and without BD and assessed volume changes over time, including changes in tissue overall and within gray and white matter. Larger decreases over time in anterior cortical volumes in the adolescents with BD were hypothesized. Gray matter decreases and white matter increases are typically observed during adolescence in anterior cortices. It was hypothesized that volume decreases over time in BD would reflect alterations in those processes, showing larger gray matter contraction and decreased white matter expansion. Two high-resolution magnetic resonance imaging scans were obtained approximately 2 years apart for 35 adolescents with bipolar I disorder (BDI) and 37 healthy adolescents. Differences over time between groups were investigated for volume overall and specifically for gray and white matter. Relative to healthy adolescents, adolescents with BDI showed greater volume contraction over time in a region including insula and orbitofrontal, rostral, and dorsolateral prefrontal cortices (p adolescence in BDI in anterior cortices, including altered developmental trajectories of anterior gray and white matter. Published by Elsevier Inc.

Experiencias de haber crecido con un padre/madre con trastorno mental severo (TMS)

OpenAIRE

Vivanco B, Gabriela; Grandón F, Pamela

2016-01-01

Introducción. La experiencia de vivir con personas que presentan un Trastorno Mental Severo (TMS) es difícil para las familias, en especial para los hijos quienes han sido poco estudiados. El objetivo de la investigación fue conocer cómo la experiencia de haber vivido con un padre o madre con un trastorno mental severo influyó en la infancia, adolescencia y adultez joven de sus hijos e hijas. Método. Se analizan las experiencias de convivencia con un padre/madre con TMS en 10 hijos (6 hombres...

Anterior process calcaneal fractures: a systematic evaluation of associated conditions

Energy Technology Data Exchange (ETDEWEB)

Petrover, David [NYU Hospital for Joint Disease, Radiology Department, New York, NY (United States); Hopital Beaujon, Service de Radiologie, Paris (France); Schweitzer, Mark E. [NYU Hospital for Joint Disease, Radiology Department, New York, NY (United States); Laredo, J.D. [Hopital Lariboisiere, Service de Radiologie, Paris (France)

2007-07-15

The objective was to evaluate the association, by MRI, of anterior calcaneal process fractures with tarsal coalitions, ankle sprains, and bifurcate ligament abnormalities. A retrospective review of 1,479 foot and ankle MR images was performed, over a period of 5 years, for isolated anterior process fractures of the calcaneus. Fifteen 1.5-T MR examinations were systematically evaluated by two radiologists in consensus. Marrow edema patterns, presence of a calcaneonavicular coalition, as well as bifurcate and anterior talofibular ligaments, were evaluated. There were 15 fractures of the anterior calcaneal process with an incidence of 1%. The average patient age was 51 years (range 25-82). Twelve patients were women and 3 were men. The majority of the fractures (14 out of 15) presented as an edema pattern on T2-weighted images, either diffuse (9 out of 15), or vertical (5 out of 15). One case did not show marrow edema, but rather a hypointense line. Nine patients (60%) demonstrated calcaneonavicular coalition and anterior calcaneal process fracture. In 6 patients (50%) the anterior talofibular ligament (ATFL) was thickened. Three patients did not have axial images, and were classified as non-conclusive for the ATFL evaluation. The bifurcate ligament was thickened with hyperintense signal demonstrating a sprain in 9 out of 13 (69%). Only 2 patients (16.5%) had an anterior calcaneal process fracture without any associated abnormality. We believe that there is a probable association of anterior process fractures and calcaneonavicular coalitions. We also feel, based on our results and the prior literature that there is likely also an association with both ATFL injuries and bifurcate ligament injuries. (orig.)

Anterior process calcaneal fractures: a systematic evaluation of associated conditions

International Nuclear Information System (INIS)

Petrover, David; Schweitzer, Mark E.; Laredo, J.D.

2007-01-01

The objective was to evaluate the association, by MRI, of anterior calcaneal process fractures with tarsal coalitions, ankle sprains, and bifurcate ligament abnormalities. A retrospective review of 1,479 foot and ankle MR images was performed, over a period of 5 years, for isolated anterior process fractures of the calcaneus. Fifteen 1.5-T MR examinations were systematically evaluated by two radiologists in consensus. Marrow edema patterns, presence of a calcaneonavicular coalition, as well as bifurcate and anterior talofibular ligaments, were evaluated. There were 15 fractures of the anterior calcaneal process with an incidence of 1%. The average patient age was 51 years (range 25-82). Twelve patients were women and 3 were men. The majority of the fractures (14 out of 15) presented as an edema pattern on T2-weighted images, either diffuse (9 out of 15), or vertical (5 out of 15). One case did not show marrow edema, but rather a hypointense line. Nine patients (60%) demonstrated calcaneonavicular coalition and anterior calcaneal process fracture. In 6 patients (50%) the anterior talofibular ligament (ATFL) was thickened. Three patients did not have axial images, and were classified as non-conclusive for the ATFL evaluation. The bifurcate ligament was thickened with hyperintense signal demonstrating a sprain in 9 out of 13 (69%). Only 2 patients (16.5%) had an anterior calcaneal process fracture without any associated abnormality. We believe that there is a probable association of anterior process fractures and calcaneonavicular coalitions. We also feel, based on our results and the prior literature that there is likely also an association with both ATFL injuries and bifurcate ligament injuries. (orig.)

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)

A small absorbable stent for treatment of anterior glottic web.

Science.gov (United States)

Bhongmakapat, Thongchai; Kantapasuantara, Kanjalak; Praneevatakul, Phurich

2012-03-01

A new one-stage approach for treatment of selected anterior glottic web has been successful. This case report illustrates its simplicity in microlaryngoscopy with complete lysis of the anterior glottic web by CO(2) laser. Then a small neck horizontal incision is made at the level of anterior commissure to gain exposure to thyroid cartilage. Absorbable suture is passed through the midline of thyroid cartilage below and above the anterior commissure. A knot is tied over thyroid ala. The suture acts as a tiny stent to prevent recurrence of the web. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Propuesta de un programa de intervención neuropsicológica en un adolescente con dificultades en el proceso lector.

Directory of Open Access Journals (Sweden)

Exequiel Guevara Delgado

2016-01-01

Full Text Available Las alteraciones en el proceso lector son relativamente comunes en los diferentes establecimientos educacionales, en especial aquellos a los cuales asisten niños y adolescentes con carencias afectivas y socio-culturales. Su implicancia es tan determinante, debido a que es la puerta de acceso a los aprendizajes y contenidos desplegados a lo largo de todo el ciclo educativo. A raíz de lo anterior es necesario abordar de manera temprana, estimulando todas aquellas funciones neuropsicológicas consideradas fundamentales para el desarrollo de la lectura. Sin embargo, en ocasiones esta pesquisa no ocurre en los primeros años de enseñanza formal, acarreando éstas complicaciones en los años siguientes, con las consecuencias desfavorables que esto implica. El objetivo de este artículo es mostrar un programa de intervención neuropsicológica, enfocado principalmente en estimular el nivel fonológico del lenguaje, en un caso de un adolescente con alteraciones en el proceso lector. Los resultados evidencian mejoras tanto en los indicadores considerados para esta investigación, así como en la velocidad y destreza lectora.

Adolescentes costarricenses con problemas judiciales y consumo de drogas

Directory of Open Access Journals (Sweden)

Sandra Fonseca-Chaves

2012-12-01

Full Text Available El objetivo de este estudio fue determinar los niveles de consumo de drogas y su relación con la comisión de delitos en una muestra de jóvenes, en su mayoría hombres, de entre 12 y 17 años de edad en un centro de detención juvenil de Costa Rica (Centro de Formación Juvenil Zurquí en los años 2006 al 2008. Un técnico capacitado realizó las entrevistas mediante un cuestionario estándar diseñado por la Comisión Interamericana para el Control de Abuso de Drogas de la Organización de Estados Americanos (CICAD/OEA utilizado en varios países de América Latina. El cuestionario preguntó a los jóvenes acerca de su situación sociodemográfica, los períodos anteriores y actuales de detención, los antecedentes penales, los patrones de uso de varias categorías de drogas, edad de inicio, la presión social, la contención familiar, la percepción y el conocimiento y la información en relación con el consumo de drogas. Los jóvenes entrevistados reportaron mayor consumo de alcohol, tabaco y una variedad de drogas ilícitas y en la mayoría de ellos había una estrecha relación entre el consumo de drogas y el delito. Mientras que la relación entre el abuso de sustancias y la comisión del delito no es bien conocida, la evidencia disponible sugiere que el consumo de sustancias exacerba el delito y preceden a ello, debido a las condiciones sociales y económicas, así como otros factores de la familia/comunidad. Además, el estudio encuentra que los infractores tienden a comenzar a experimentar con sustancias a edades más tempranas, que los no infractores.

Factors associated with anterior open bite in children with developmental disabilities.

Science.gov (United States)

de Castilho, Lia Silva; Abreu, Mauro Henrique Nogueira Guimarães; Pires E Souza, Luiz Gustavo de Almeida; Romualdo, Leiliane Teresinha de Almeida; Souza E Silva, Maria Elisa; Resende, Vera Lúcia Silva

2018-01-01

To investigate factors associated with anterior open bite in individuals aged from 2 to 33 years with developmental disabilities. This is a cross-sectional study. A total of 271 dental records were examined. The anterior open bite analyzed was determined based on clinic exam. These variables were also analyzed: gender, age, education level of mother, International Code of Diseases (ICD), mouth breathing, use of anticonvulsant drugs, hyperkinesis, pacifier use, thumb sucking, seizure, and involuntary movements. For the purposes of analysis, the individuals were categorized as being with and without anterior open bite. Variables with a p-value of open bite than nasal breathers. Pacifier users are more likely to have an anterior open bite (3.32-fold, 95% CI: 1.62-6.77). Individuals with reported involuntary movements had a 2.66-fold (95% CI: 1.26-5.63) greater chance of exhibiting anterior open bite. Users of anticonvulsants drugs had a 3.05 (95% CI: 1.57-5.92) greater chance of showing anterior open bite. Involuntary movements, mouth breathing, using anticonvulsant drugs, and using pacifier are factors associated with anterior open bite in patients with developmental disabilities. © 2017 Special Care Dentistry Association and Wiley Periodicals, Inc.

ANTERIOR KNEE PAIN AND LOWER EXTREMITY FUNCTIONS IN INDIAN ADOLESCENT POPULATION

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Riddhi Shroff

2016-01-01

Full Text Available Background & Purpose - Anterior knee pain is one of the most common musculoskeletal complain seen in Indian adolescent population with high incidence among those who are active in sports and recreation. The purpose of this study was to investigate the age of onset of anterior knee pain, to find its effect on sports participation and also to find the activities which are maximally affected due to anterior knee pain in Indian population. Method- A questionnaire based survey was conducted among 50 subjects using three outcome measures namely self made demographic questionnaire, anterior knee pain scale and lower extremity functional scale. Result- Maximally affected activities are running, jumping & squatting and maximally affected functions are squatting, running on uneven ground, making sharp turns while running and hopping with increase incidence of anterior knee pain among those who participate daily in sports. Conclusion- The study concluded, that in adolescent age group of 11-17 years, anterior knee pain is more prevalent in adolescent girls with the age of onset being around 13 years for girls & 14.5 years in boys and it also showed moderate positive correlation between anterior knee pain and lower extremity functions.

Crecimiento de Casuarina equisetifolia (Casuarinaceae en suelo con diésel, y aplicación de bioestimulación y bioaumentación

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María Esther Díaz-Martínez

2013-09-01

Full Text Available La fitorremediación es una biotecnología ecológicamente racional que está dirigida a la limpieza de suelos contaminados; sin embargo, el estudio de especies arbóreas para la fitorremediación de suelos con hidrocarburos del petróleo es limitado. Más aún, la combinación de la fitorremediación con procesos de bioaumentación y bioestimulación es también limitada. Por lo anterior, este estudio evaluó el efecto de la inoculación de Glomus intraradices, un consorcio bacteriano (M2BOS1-R2 y M2BOSI-F4 y Trichoderma viride en el crecimiento de plantas de Casuarina equisetifolia L. fertilizadas con Floranid® o Triple 17, en suelo contaminado con diésel (7 500mg/kg. El experimento factorial 2x5x3 incluyó 30 tratamientos y 10 repeticiones, distribuidos completamente al azar en invernadero, durante 120 días. El diésel disminuyó significativamente la altura, la biomasa total y el índice de calidad (ICP de planta. Glomus o las bacterias aumentaron significativamente la altura, la biomasa seca total y el ICP con respecto al tratamiento sin inocular o con la triple inoculación. El Floranid redujo el crecimiento vegetal y el ICP, en presencia de diésel. El Triple 17 combinado con los tres microorganismos produjo mayor crecimiento vegetal en ausencia de contaminación, pero en presencia de diésel, el Triple 17 combinado con bacterias o con Trichoderma, estimuló la biomasa seca total y el ICP. La colonización micorrízica fue inhibida por el diesel, especialmente con la fertilización del Floranid. El Triple 17 (bioestimulación combinado con los microorganismos (bioaumentación, favoreció el crecimiento de Casuarina en suelo contaminado con diésel.

Panoramic radiographs underestimate extensions of the anterior loop and mandibular incisive canal

International Nuclear Information System (INIS)

De Brito, Ana Caroline Ramos; Nejaim, Yuri; De Freitas, Deborah Queiroz; De Oliveira Santos, Christiano

2016-01-01

The purpose of this study was to detect the anterior loop of the mental nerve and the mandibular incisive canal in panoramic radiographs (PAN) and cone-beam computed tomography (CBCT) images, as well as to determine the anterior/mesial extension of these structures in panoramic and cross-sectional reconstructions using PAN and CBCT images. Images (both PAN and CBCT) from 90 patients were evaluated by 2 independent observers. Detection of the anterior loop and the incisive canal were compared between PAN and CBCT. The anterior/mesial extension of these structures was compared between PAN and both cross-sectional and panoramic CBCT reconstructions. In CBCT, the anterior loop and the incisive canal were observed in 7.7% and 24.4% of the hemimandibles, respectively. In PAN, the anterior loop and the incisive canal were detected in 15% and 5.5% of cases, respectively. PAN presented more difficulties in the visualization of structures. The anterior/mesial extensions ranged from 0.0 mm to 19.0 mm on CBCT. PAN underestimated the measurements by approximately 2.0 mm. CBCT appears to be a more reliable imaging modality than PAN for preoperative workups of the anterior mandible. Individual variations in the anterior/mesial extensions of the anterior loop of the mental nerve and the mandibular incisive canal mean that is not prudent to rely on a general safe zone for implant placement or bone surgery in the interforaminal region

Panoramic radiographs underestimate extensions of the anterior loop and mandibular incisive canal

Energy Technology Data Exchange (ETDEWEB)

De Brito, Ana Caroline Ramos; Nejaim, Yuri; De Freitas, Deborah Queiroz [Dept. of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Sao Paulo (Brazil); De Oliveira Santos, Christiano [Dept. of Stomatology, Public Oral Health and Forensic Dentistry, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Sao Paulo (Brazil)

2016-09-15

The purpose of this study was to detect the anterior loop of the mental nerve and the mandibular incisive canal in panoramic radiographs (PAN) and cone-beam computed tomography (CBCT) images, as well as to determine the anterior/mesial extension of these structures in panoramic and cross-sectional reconstructions using PAN and CBCT images. Images (both PAN and CBCT) from 90 patients were evaluated by 2 independent observers. Detection of the anterior loop and the incisive canal were compared between PAN and CBCT. The anterior/mesial extension of these structures was compared between PAN and both cross-sectional and panoramic CBCT reconstructions. In CBCT, the anterior loop and the incisive canal were observed in 7.7% and 24.4% of the hemimandibles, respectively. In PAN, the anterior loop and the incisive canal were detected in 15% and 5.5% of cases, respectively. PAN presented more difficulties in the visualization of structures. The anterior/mesial extensions ranged from 0.0 mm to 19.0 mm on CBCT. PAN underestimated the measurements by approximately 2.0 mm. CBCT appears to be a more reliable imaging modality than PAN for preoperative workups of the anterior mandible. Individual variations in the anterior/mesial extensions of the anterior loop of the mental nerve and the mandibular incisive canal mean that is not prudent to rely on a general safe zone for implant placement or bone surgery in the interforaminal region.

Superior dislocation hip with anterior column acetabular fracture ...

African Journals Online (AJOL)

Superior variety of anterior dislocation of the hip is a rare injury. Its occurrence with acetabular fractures has been documented infrequently. We report a case of superior dislocation of the hip with anterior column acetabular fracture. Open reduction of the hip and internal fixation of the fracture was carried out using a twin ...

Correlación entre los resultados de valoración funcional y de fuerza de la rodilla en pacientes con rotura del ligamento cruzado anterior

OpenAIRE

Álvarez Santana, David

2016-01-01

Programa de doctorado: Avances en Traumatología. Medicina del Deporte. Cuidado de Heridas. La fecha de publicación es la fecha de lectura [ES]Objetivos: Determinar si existen diferencias en la fuerza isométrica en la rodilla afecta con respecto a la sana en pacientes con rotura de LCA y un grupo control. Estudiar si existe correlación significativa entre el desplazamiento tibial, la fuerza isométrica generada por la musculatura de las rodillas, los resultados en cuestionarios de valoración...

MRI anatomy of anteriorly displaced anus: what obstructs defecation?

International Nuclear Information System (INIS)

AbouZeid, Amr Abdelhamid; Mohammad, Shaimaa Abdelsattar; Khairy, Khaled Talaat

2014-01-01

Anteriorly displaced anus is an anomaly that is debated with regard to its nomenclature, diagnosis and management. To describe MRI anatomy of the anal canal in children with anteriorly displaced anus and its impact on the process of defecation. We prospectively examined ten children (7 girls, 3 boys; age range 7 months to 8 years, mean 3 years) with anteriorly displaced anus between August 2009 and April 2012. Noncontrast MRI examinations were performed on a 1.5-T magnet. T1- and T2-weighted turbo spin-echo images were acquired in axial, sagittal and coronal planes of the pelvis. The anorectal angle and the relative hiatal distance were measured in mid-sagittal images, and compared with those of a control group using the Mann-Whitney test. In children with anteriorly displaced anus, no anatomical abnormality was depicted at the level of the proximal anal canal. However, the distal anal canal was displaced anteriorly, running out its external muscle cuff, which remained un-displaced at the usual site of the anus. This changes the orientation of the central axis of the anal canal by passing across instead of along the fibers of the longitudinal muscle coat. Children with anteriorly displaced anus had a more obtuse anorectal angle (mean 112.1 ), which was significantly greater than that of the control group (mean 86.2 ). MRI is a valuable tool in studying the anatomy of the anal canal in children with anteriorly displaced anus. The abnormal orientation of the longitudinal muscle across the anal canal can explain the obstructed defecation in these children. Based on this study, it might be of interest to use MRI in studying equivocal cases and children with unexplained constipation. (orig.)

MRI anatomy of anteriorly displaced anus: what obstructs defecation?

Energy Technology Data Exchange (ETDEWEB)

AbouZeid, Amr Abdelhamid [Ain-Shams University, Department of Pediatric Surgery, Cairo (Egypt); Mohammad, Shaimaa Abdelsattar; Khairy, Khaled Talaat [Ain-Shams University, Department of Radiodiagnosis, Cairo (Egypt)

2014-07-15

Anteriorly displaced anus is an anomaly that is debated with regard to its nomenclature, diagnosis and management. To describe MRI anatomy of the anal canal in children with anteriorly displaced anus and its impact on the process of defecation. We prospectively examined ten children (7 girls, 3 boys; age range 7 months to 8 years, mean 3 years) with anteriorly displaced anus between August 2009 and April 2012. Noncontrast MRI examinations were performed on a 1.5-T magnet. T1- and T2-weighted turbo spin-echo images were acquired in axial, sagittal and coronal planes of the pelvis. The anorectal angle and the relative hiatal distance were measured in mid-sagittal images, and compared with those of a control group using the Mann-Whitney test. In children with anteriorly displaced anus, no anatomical abnormality was depicted at the level of the proximal anal canal. However, the distal anal canal was displaced anteriorly, running out its external muscle cuff, which remained un-displaced at the usual site of the anus. This changes the orientation of the central axis of the anal canal by passing across instead of along the fibers of the longitudinal muscle coat. Children with anteriorly displaced anus had a more obtuse anorectal angle (mean 112.1 ), which was significantly greater than that of the control group (mean 86.2 ). MRI is a valuable tool in studying the anatomy of the anal canal in children with anteriorly displaced anus. The abnormal orientation of the longitudinal muscle across the anal canal can explain the obstructed defecation in these children. Based on this study, it might be of interest to use MRI in studying equivocal cases and children with unexplained constipation. (orig.)

Roentgenographic findings following anterior cervical fusion

Energy Technology Data Exchange (ETDEWEB)

Gore, D R; Gardner, G M; Sepic, S B; Murray, M P

1986-10-01

We reviewed the pre- and postoperative lateral cervical roentgenograms in 90 patients who had anterior fusions and compared their findings with age and sex-matched people without neck problems. The average interval from surgery to review was 5 years. Preoperatively, all patients had a higher incidence of degenerative spondylosis at the levels to be fused than their asymptomatic counterparts. Postoperatively, there was no difference in the incidence of degenerative change between the operated and the control group at the levels above and below the fusion with the exception of anterior osteophyte formation which was more frequent in those with fusions.

Replacement of Missing Anterior Teeth in a Patient with Temporomandibular Disorder

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Satheesh B. Haralur

2014-01-01

Full Text Available The loss of anterior teeth leads to extreme psychological trauma, along with functional and esthetic debilitations. Healthy anterior teeth play an important role of protecting the posterior teeth during excursive mandibular movement. Loss of anterior teeth induces posterior interference with extended disocclusion time. Posterior disocclusion is critical to remove the harmful force on the teeth temporomandibular joint and eliminate muscle hypertonicity. Occlusal interference is considered as contributing factor to temporomandibular disorder (TMD symptoms. Prosthesis design should eliminate deleterious tooth contacts. Establishing optimum anterior guidance is a key to establishing harmonious functional occlusion in addition to the correction of the esthetic and phonetic disabilities. This case report explains the steps involved in the rehabilitation of the TMD patient with loss of maxillary anterior teeth.

Combined anterior C2-C3 fusion and C2 pedicle screw fixation for the treatment of unstable hangman's fracture: a contrast to anterior approach only.

Science.gov (United States)

Xie, Ning; Khoo, Larry T; Yuan, Wen; Ye, Xiao-Jian; Chen, De-Yu; Xiao, Jian-Ru; Ni, Bin

2010-03-15

A retrospective clinical study was used to evaluate the effect of a new surgical treatment of the hangman's fractures. To determine the treatment efficacy of combined anterior C2-C3 reduction and fusion and posterior compressive C2 pedicle screw fixation for the management of unstable hangman's fractures. The classification of hangman's fractures as proposed by Levine-Edwards was used to classify and guide the treatment of these injuries. Most of these fractures respond to a variety of conservative therapies, but recently, earlier surgery has been increasingly advocated by authors from several countries for the rapid stabilization of these fractures. If surgery is indicated, an anterior approach using a C2-C3 reduction and fusion is preferred usually. Another well-accepted surgical method is the direct transpedicular osteosynthesis by the dorsal approach. However, there was rare report of the combined use of these 2 techniques. A group of 45 surgical patients were all diagnosed with radiograph, magnetic resonance imaging (MRI), and 3D CT scans. Initial and final radiographs were measured for anterior translation and angulation of the C2-C3 complex. Initial external skull traction with extension was used in all patients after admission to reduce the fracture. Then an anterior C2-C3 discectomy followed by an interbody fusion and locking plate fixation was performed. Intraoperative reduction was confirmed by fluoroscopic control. About 29 patients therefore received anterior surgeries only since satisfactory reduction was achieved during the procedure. For the 16 patients who had persistent large residual gaps after the anterior procedure, additional same stage posterior C2 compressive pedicle screws were placed. Clinical and radiologic comparisons were performed in these 2 groups. The follow-up ranged from 24 to 54 months, with an average 33.6 months. There was radiographic evidence of continuity of the fracture and the bone graft seen at 4.7 months on average. Neck

Prediction of parent artery of anterior communicating artery aneurysm on CT angiography

International Nuclear Information System (INIS)

Chung, Jin Young; Han, Tae Il; Kim, Dae Hong; Han, Hyun Young; Kim, Hyun Jung; Song, Mun Kab

1999-01-01

To determine whether CT angiography can predict the parent artery of an anterior communicating aneurysm on the basis of characteristics of the aneurysm and precommunication anterior cerebral artery. Eighteen patients with anterior communication aneurysm were studied prospectively using CT angiography and conventional angiography. The parent artery of an aneurysm was predicted by evaluating aneurysm neck location, direction of aneurysm projection, and size of the precommunicating anterior cerebral artery, as seen on CT angiography. A somatom Plus-4 spiral CT scanner was used and shaded-surface display three-dimensional images were constructed. Aneurysm neck was located near the parent artery in 12 cases(66.7%), and aneurysm projection was against the parent artery in 11 cases(61.1%). The parent artery of the anterior cerebral artery was larger in 15 cases(83.3%), including ten cases of hypoplasia or agenesis of the contralateral anterior cerebral artery. In 17 of 18 aneurysms(94.4%) the parent artery seen on DSA was correctly predicted by CT angiography. The parent artery of an anterior communicating aneurysm can be predicted by evaluating aneurysm neck location, direction of aneurysm projection, and precommunicating anterior cerebral artery, as seen on CT angiography

Bloqueio "3 em 1" por via anterior: bloqueio parcial, completo ou superdimensionado? Correlação entre anatomia, clínica e radio imagens Bloqueo "3 en 1" por vía anterior: bloqueo parcial, completo o superdimensionado? Correlación entre anatomía, clínica y radio imágenes Anterior "3-in-1" blockade: partial, total or overdimensioned block? Correlation between anatomy, clinic and radio images

Directory of Open Access Journals (Sweden)

Karl Otto Geier

2004-08-01

em 1" ou "2,5 em 1", sem a participação do nervo obturador. Com cateter curto (G2, o bloqueio "3 em 1" foi classificado como completo em 6,6% dos casos (um paciente. Porém, com cateter longo (G3, o resultado tende a ser mais previsível em relação aos outros grupos, especialmente quando o cateter alcança o espaço paravertebral lombossacral, resultando num bloqueio "3 em 1" completo em 20% dos casos (três pacientes ou, raramente, num bloqueio "3 em 1" superdimensionado em 13,2% dos casos (dois pacientes.JUSTIFICATIVA Y OBJETIVOS: El clásico bloqueo "3 en 1" por vía anterior ha suscitado divergencias cuanto al envolvimiento anestésico de sus tres participantes, el nervio femoral, el nervio cutáneo lateral del muslo y el nervio obturador. El objetivo de este estudio es verificar el resultado del bloqueo "3 en 1" por vía anterior, a través de las técnicas: inyección única (G1, catéteres cortos (G2 y catéteres largos (G3. Los bloqueos "3 en 1", clínicamente identificados como completos o superdimensionados fueron, adicionalmente, investigados por medio de radio imagen. MÉTODO: La identificación del espacio subfascial ilíaco en los bloqueos "3 en 1" con inyección única o con catéteres fue hecha por la pérdida de resistencia al aire. En varios eventos dolorosos, el volumen anestésico administrado varió entre 30 y 40 ml y la introducción cranial de los catéteres fue hasta 18 cm en el espacio subfascial ilíaco. Cuando la pesquisa clínica apuntaba envolvimiento del nervio obturador o de otro nervio adicional al bloqueo "3 en 1", se complementava la investigación con estudio radiográfico y tomodensiométrico con el propósito de establecer correspondencia con la anatomía pélvica. RESULTADOS: El envolvimiento de los nervios femoro cutáneo lateral y obturador no fueron constantes, al contrario del nervio femoral. En el estudio, ningún bloqueo "3 en 1" completo con inyección única (G1 se manifestó, y si un bloqueo "2 en 1", con la

Case study: limitations of panoramic radiography in the anterior mandible.

LENUS (Irish Health Repository)

Walker, Cameron

2009-12-01

Dental Panoramic Tomography (DPT) is a widely used and valuable examination in dentistry. One area prone to artefacts and therefore misinterpretation is the anterior region of the mandible. This case study discusses a periapical radiolucency related to lower anterior teeth that is discovered to be a radiographic artefact. Possible causes of the artefact include a pronounced depression in the mental region of the mandible or superimposition of intervertebral spaces. Additional limitations of the DPT image include superimposition of radio-opaque structures, reduced image detail compared to intra-oral views and uneven magnification. These problems often make the DPT inappropriate for imaging the anterior mandible. Clinical Relevance: Panoramic radiography is often unsuitable for radiographic examination of the anterior mandible.

Does concomitant anterior fundoplication promote dysphagia after laparoscopic Heller myotomy?

Science.gov (United States)

Tapper, Donovan; Morton, Connor; Kraemer, Emily; Villadolid, Desiree; Ross, Sharona B; Cowgill, Sarah M; Rosemurgy, Alexander S

2008-07-01

Concerns for gastroesophageal reflux after laparoscopic Heller myotomy for achalasia justify considerations of concomitant anterior fundoplication. This study was undertaken to determine if concomitant anterior fundoplication reduces symptoms of reflux after myotomy without promoting dysphagia. From 1992 to 2004, 182 patients underwent laparoscopic Heller myotomy without fundoplication. After a prospective randomized trial justified its concomitant application, anterior fundoplication was undertaken with laparoscopic Heller myotomy in 171 patients from 2004 to 2007. All patients have been prospectively followed. Pre and postoperatively, patients scored the frequency and severity of symptoms of achalasia (including dysphagia, choking, vomiting, regurgitation, chest pain, and heartburn) using a Likert Scale (0 = never/not bothersome to 10 = always/very bothersome). Before myotomy, symptoms of achalasia were frequent and severe for all patients. After myotomy, the frequency and severity of all symptoms of achalasia significantly decreased for all patients (P Heller myotomy alone, concomitant anterior fundoplication led to significantly less frequent and severe heartburn after myotomy (P Heller myotomy reduces the frequency and severity of symptoms of achalasia. Concomitant anterior fundoplication decreases the frequency and severity of heartburn and dysphagia after laparoscopic Heller myotomy. Concomitant anterior fundoplication promotes salutary relief in the frequency and severity of symptoms after myotomy and is warranted.

Análise de fatores associados à lesão do nervo laríngeo recorrente em cirurgias de discectomia cervical via anterior Análisis de factores asociados a la lesión del nervio laríngeo recurrente en cirugías de discectomía cervical por vía anterior Analysis of factors associated with laryngeal nerve injury in anterior disc herniation surgery

Directory of Open Access Journals (Sweden)

Erasmo Abreu Zardo

2011-01-01

cirúrgico, e dificuldades técnicas que possam aumentar o tempo cirúrgico podem estar associados com lesão do NLR. Novos estudos avaliando as variáveis acima estudadas devem ser considerados.OBJETIVO: Estudiar los posibles factores asociados con la lesión del NLR postcirugía de hernia de disco cervical con abordaje anterior. MÉTODOS: En el periodo de Junio/2009 hasta Junio/2010 evaluamos 30 pacientes sometidos a tratamiento quirúrgico de hernia de disco por via anterior en el Hospital São Lucas de la PUC-RS. En el preoperatorio, fue realizada la medida de la circunferencia cervical (en el nivel del cartílago cricoides y de la altura cervical (del ángulo de la mandíbula borde superior de la clavicula. En el perioperatorio evaluamos el tiempo de intubación, el tiempo quirúrgico, el lado del abordaje, el número de niveles operados, bien como el tipo de incisión (transversal/longitudinal y el uso de halo craneano. Se realizó una evaluación videoendoscópica de laringe (VEL, en la búsqueda de lesión del NLR en el preoperatorio y en el décimo dia después de la cirugía. Pacientes que presentaron un resultado anormal de la VEL (asimetría de movimiento de las dobladuras al verbalizar las vocales A, E, I, O y U fueron considerados con lesión del NLR y fueran reevaluadosmensualmente hasta la recuperación espontánea o en el periodo máximo de 6 meses, cuando la lesión fue considerada definitiva. RESULTADOS: Encontramos 3/30 (10% casos de lesiones no definitivas del NLR que se recuperaron en hasta 120 dias postoperatorios. Los pacientes con lesión del NLR presentaban una mayor circunferencia del cuello, tiempo quirúrgico y número de niveles operados con relación a los pacientes sin lesión del NLR. También, pacientes con lesión del NLR presentaban una menor longitud del cuello. Dos lesiones ocurrieron en el abordaje por el lado derecho y una por el lado izquierdo. Todos los pacientes con lesión tuvieron incisión transversal y no hicieron

Derrame pericárdico grave en un paciente con hipotiroidismo Severe pericardial effusion in a patient with hypothyroidism

Directory of Open Access Journals (Sweden)

María Norbelis Viamonte Tapia

2012-12-01

Full Text Available Se expone el caso clínico de un paciente de 40 años de edad, con aparente buena salud, atendido en el Hospital Clinicoquirúrgico Docente "Dr. Joaquín Castillo Duany" de Santiago de Cuba por presentar, desde hacía varios meses, dolor abdominal en epigastrio, no irradiado, asociado a molestia en la región anterior del tórax, dificultad para respirar, hinchazón en las piernas, decaimiento, somnolencia y dolores articulares, así como andar lento y disminución de la memoria, entre otros síntomas. Los resultados de los exámenes complementarios confirmaron que se trataba de un derrame pericárdico de causa hipotiroidea. Se indicó tratamiento sustitutivo con hormonas tiroideas (levotiroxina sódica. Evolucionó favorablemente y egresó de la institución hospitalaria, pero fue reevaluado a los 3 meses, observándose una mejoría significativa.The case of an apparently healthy 40 year-old patient is reported, who was attended in "Dr. Joaquín Castillo Duany" Clinical Surgical Hospital of Santiago de Cuba to present with epigastric abdominal pain for several months, no irradiated and associated with discomfort in anterior chest, breathing difficulty, swelling of the legs, weakness, drowsiness and joint pains, as well as slow gait, impaired memory, and other symptoms. The results of additional tests confirmed a pericardial effusion of hypothyroid cause. A replacement therapy was administered with thyroid hormones (sodium levothyroxine. He made good progress and was discharged from the hospital, but he was reevaluated at 3 months and a significant improvement was observed.

[Capsular retensioning in anterior unidirectional glenohumeral instability].

Science.gov (United States)

Benítez Pozos, Leonel; Martínez Molina, Oscar; Castañeda Landa, Ezequiel

2007-01-01

To present the experience of the Orthopedics Service PEMEX South Central Hospital in the management of anterior unidirectional shoulder instability with an arthroscopic technique consisting of capsular retensioning either combined with other anatomical repair procedures or alone. Thirty-one patients with anterior unidirectional shoulder instability operated-on between January 1999 and December 2005 were included. Fourteen patients underwent capsular retensioning and radiofrequency, and in 17 patients, capsular retensioning was combined with suture anchors. Patients with a history of relapsing glenohumeral dislocations and subluxations, with anterior instability with or without associated Bankart lesions were selected; all of them were young. The results were assessed considering basically the occurrence of instability during the postoperative follow-up. No cases of recurring instability occurred. Two cases had neuroma and one experienced irritation of the suture site. Six patients had residual limitation of combined lateral rotation and abduction movements, of a mean of 10 degrees compared with the healthy contralateral side. The most frequent incident was the leak of solutions to the soft tissues. Capsular retensioning, whether combined or not with other anatomical repair techniques, has proven to result in a highly satisfactory rate of glenohumeral stabilization in cases of anterior unidirectional instabilities. The arthroscopic approach offers the well-known advantages of causing less damage to the soft tissues, and a shorter time to starting rehabilitation therapy and exercises.

Prevalence and Length of the Anterior Loop of the Inferior Alveolar Nerve in Iranians.

Science.gov (United States)

Moghddam, Maryam Rastegar; Davoudmanesh, Zeinab; Azizi, Nasim; Rakhshan, Vahid; Shariati, Mahsa

2017-10-01

The anterior loop of the inferior alveolar nerve is a sensitive anatomical feature that should be taken into account during installation of dental implants anterior to the mental foramen. This study was conducted to explore the controversy regarding prevalence and length. A total of 452 mandible quadrants of 234 patients (age: 50.1 ± 13.3 years, 113 males, 121 females) were studied using cone-beam computerized tomography. After reconstructing axial, frontal, and sagittal slices, the region between the most anterior point on the mental foramen and the most anterior part of the mandibular nerve was inspected for signs of anterior loop presence. If positive, the length of the anterior loop was measured in mm as the distance between the anterior border of mental foramen and the anterior border of the loop. Prevalence and length of the anterior loop were compared statistically between sexes and age groups. The anterior loop was observed in 106 quadrants (23.5% of 451 quadrants) of 95 patients (40.6% of 234 patients), of whom 11 had bilateral anterior loops. Prevalences were similar in males (41%) and females (39%, chi-square P =.791). The mean anterior loop length was 2.77 ± 1.56 mm (95% CI: 2.5-3.1 mm), without significant sex (regression beta = -0.159, P = .134) or age (beta = -0.059, P = .578) differences. The anterior loop might exist in about 40% of patients, regardless of their gender. The mean safe anterior distance from the anterior loop is about 3 mm + (2.5-3.1 mm) = 5.5-6.1 mm, regardless of age.

Injerto de tejido conectivo subpediculado con utilización de hidroxiapatita para aumento de reborde alveolar: reporte de un caso

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Antonio José Díaz Caballero

2013-10-01

Full Text Available ResumenLa reconstrucción quirúrgica de rebordes atrofiados mediante injertos de tejido conectivo y la hidroxiapatita es una opción que permite la fijación de los implantes de manera estética y funcional, ofrece un resultado previsible con bajas tasas de morbilidad y una ganancia notable de tejido óseo y tejidos blandos, gracias a su alta biocompatibilidad, alta capacidad de regeneración del tejido, una perfecta integración y elevados resultados, bajo riesgo de infección y ausencia de signos de rechazo. Presentamos el caso de una paciente con una pérdida ósea marcada en la zona anterior del maxilar, secundaria a procesos inflamatorios periodontales con la posterior pérdida de órganos dentarios prematuros, lo que conlleva a una perdida ósea. Se le realizó la cirugía tomando porciones de tejido conectivo donadas por el mismo paciente con la posterior utilización de hidroxiapatita porosa en la zona receptora para así lograr el aumento del reborde que se encontraba atrófico.Se constatan buenos resultados como respuesta biológica al material y al procedimiento, con una adecuada respuesta clínica y radiográfica, por lo que se recomienda el uso de este material en el tratamiento de defectos óseos bucofaciales por su biocompatibilidad, debido a su similitud con el hueso. Considerando así que se abren nuevos horizontes con la utilización de este material en este tipo de afección. (Duazary 2008; 1: 48 - 55AbstractSurgical reconstruction of atrophies residual ridges by use of connective tissue grafts plus hydroxyapatite is an option that allows the implant fixation in an esthetic and functional manner, offers a predictable outcome with low rates of morbidity and a remarkable gain of bone and soft tissue, Thanks to its high biocompatibility, high capacity for regeneration of tissue, a perfect integration and high performance, low risk of infection and the absence of signs of rejection. In this paper we present the case of a patient

Mini-implantes ortodônticos como auxiliares da fase de retração anterior Orthodontic mini-implants assisting the anterior retraction phase

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Carlo Marassi

2008-10-01

Full Text Available INTRODUÇÃO: os mini-implantes ortodônticos se estabeleceram como um importante método de ancoragem e vêm auxiliando os ortodontistas nas várias etapas do tratamento ortodôntico, eliminando, em grande parte, a necessidade de colaboração dos pacientes e tornando os resultados mais previsíveis. OBJETIVO: este artigo descreve os principais aspectos do uso dos mini-implantes como auxiliares da fase de retração anterior, trazendo considerações sobre suas indicações, quantidade de movimentação dos dentes anteriores, os vetores de força de retração, o controle vertical, o posicionamento dos mini-implantes, os tipos de apoio na região anterior e a força a ser utilizada. São citados os sítios de instalação mais usados para a retração anterior e abordados fatores que deverão ser controlados durante o fechamento de espaço. Por fim, são citadas algumas considerações clínicas sobre o uso dos mini-implantes nessa importante fase do tratamento ortodôntico.INTRODUCTION: The use of orthodontic mini-implants has settled as an important anchorage method and is aiding the orthodontists in the several stages of the treatment, largely eliminating the need of patients' compliance, and turning the results more predictable. AIM: This article describes the main aspects of the use of mini-implants as auxiliaries on the retraction phase of the anterior teeth, bringing considerations about their indications, amount of movement of the anterior teeth, the vectors of retraction force, the vertical control and evaluation of the incisors vestibulolingual tipping, the positioning of the mini-implants, the support types in the anterior area and the force to be applied. The placement sites best used for the anterior retraction are mentioned, and the factors that should be controlled during the space closure are approached. Lastly, some clinical considerations on the use of mini-implants in such important phase of the orthodontic treatment are

Anterior Knee Pain (Chondromalacia Patellae).

Science.gov (United States)

Garrick, James G.

1989-01-01

This article presents a pragmatic approach to the definition, diagnosis, and management of anterior knee pain. Symptoms and treatment are described. Emphasis is on active involvement of the patient in the rehabilitation exercise program. (IAH)

Aspectos Psicosociales Relacionados con el TEPT en Pacientes con Cáncer de Mama

OpenAIRE

Hernández Moreno, Fresia Paloma; Landero Hernández, René

2015-01-01

El objetivo del estudio fue analizar la relación del estrés, la depresión y las estrategias de afrontamiento con el Trastorno de Estrés Postraumático (TEPT) en una muestra de pacientes con cáncer de mama. Se realizó con una muestra no probabilística de 52 mujeres con cáncer de mama. Se encontró una relación entre TEPT y estrés (r= .344, p= .014), TEPT y depresión (rs=.346, p= .013). El TEPT correlacionó con evitación cognitiva (r= .437, p= .001), TEPT y desesperanza (rs= .437, p= .001) y TEPT...

Polymerase chain reaction in unilateral cases of presumed viral anterior uveitis.

Science.gov (United States)

Shoughy, Samir S; Alkatan, Hind M; Al-Abdullah, Abdulelah A; El-Khani, Albarah; de Groot-Mijnes, Jolanda Df; Tabbara, Khalid F

2015-01-01

Anterior uveitis is the most common form of intraocular inflammation. The main aim of this study was to determine the viral etiology in patients with unilateral cases of anterior uveitis. A total of 12 consecutive patients with the diagnosis of idiopathic unilateral anterior uveitis were included prospectively. Aqueous specimens were obtained from each patient by anterior chamber paracentesis and subjected to the detection of viral DNA/RNA genome by polymerase chain reaction assay for herpes simplex virus, varicella zoster virus, cytomegalovirus, Epstein-Barr virus, and rubella virus. There were six male and six female patients. The mean age was 43 years, with an age range of 11-82 years. All 12 cases presented with unilateral anterior uveitis. In four (33%) patients, polymerase chain reaction was positive for viral genome. Two patients were positive for herpes simplex virus type 1, one patient was positive for cytomegalovirus and one for Epstein-Barr virus. Recent molecular diagnostic assays would help in the identification of the causative agent in patients with unilateral anterior uveitis.

The Palatal Approach to Distraction Osteogenesis of the Anterior Maxillary Alveolus.

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Bell, Robert E

2015-07-01

This report describes the palatal approach to gain access for osteodistraction of the anterior maxilla to improve the vector of force during distraction. This case report illustrates a novel approach to anterior maxillary osteodistraction. The palatal approach allows the maxillary segment to be moved anteriorly and inferiorly. This is in contrast to the buccal approach, in which the palatal tissue creates a vector of force toward the palate. The vascular pedicle for the transport segment is the labial mucosa and musculature. In the present case, the alveolar segment was advanced 3.6 mm anteriorly and 12.2 mm inferiorly as measured by pre- and postoperative computed tomograms. This patient with a large vertical alveolar defect and high smile line had successful restoration with dental implants. The result has been stable for 14 months. In this case, the palatal approach to the anterior maxillary osteotomy was shown to be an effective method of reconstructing a large vertical anterior defect. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Acute anterior uveitis following intravitreal bevacizumab but not subsequent ranibizumab

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Antonopoulos C

2011-11-01

Full Text Available Christina Antonopoulos1, Maxwell Stem2, Grant M Comer21Department of Ophthalmology, Boston University, Boston, MA, USA; 2WK Kellogg Eye Center, Department of Ophthalmology, University of Michigan, Ann Arbor, MI, USAPurpose: Previous reports have identified noninfectious uveitis as a potential sequela following both intravitreal bevacizumab and ranibizumab injections. We present two unique cases of acute anterior uveitis following intravitreal bevacizumab that did not occur with subsequent ranibizumab injections.Methods: Case report.Conclusion: These cases may reflect differences in the etiology of anterior uveitis following intravitreal bevacizumab and ranibizumab. Given these differences, it may be reasonable to offer ranibizumab to patients who have experienced presumed bevacizumab-induced anterior uveitis.Keywords: adverse effect, age-related macular degeneration, anterior uveitis, bevacizumab, ranibizumab, uveitis

Interaccion de promastigotes de Leishmania donovani con celulas de exudado peritonial de ratones mediante la influencia de la quimotripsina

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Lucila Arcay

1986-06-01

Full Text Available Se hace un estudio de la interacción de promastigotes de Leishmania donovani con células de exudado peritoneal de ratón (c e p mediante la influencia de la quimotripsina. La adhesión de los promastigotes a las c e p fue terminal y marginal, y en observaciones hechas a partir de los 10 minutos de enfrentamiento, esta adhesión fue nula hasta los 30 minutos en el grupo tratado, y sólo a las das horas hubo un pequeño incremento (2.4% con respecto al control. Se observa marcada disminución en todos los parámetro medidos, tales como enlace, penetración, multiplicación intracelular, división de formas flageladas, en el grupo tratado. La quimotripsina favorece la formación de formas intermedias flageladas, heciendose el parásito piriforme y esférico, apareciendo una forma aberrante de extremo anterior cilindrico que semeja a una forma coanoflagelada. Se sospecha que la enzima reduce efectivamente fragmentos proteicos o péptidos, los cuales pueden haber sido tan pequeños como para esconder a otros ligandos relacionados con la adhesión macrófago-parásito.

Passage of an Anterior Odontoid Screw through Gastrointestinal Tract.

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Leitner, L; Brückmann, C I; Gilg, M M; Bratschitsch, G; Sadoghi, P; Leithner, A; Radl, R

2017-01-01

Purpose . Anterior screw fixation has become a popular surgical treatment method for instable odontoid fractures. Screw loosening and migration are a rare, severe complication following anterior odontoid fixation, which can lead to esophagus perforation and requires revision operation. Methods . We report a case of screw loosening and migration after anterior odontoid fixation, which perforated the esophagus and was excreted without complications in a 78-year-old male patient. Results . A ventral dislocated anterior screw perforated through the esophagus after eight years after implantation and was excreted through the gastrointestinal (GI) tract. At a 6-month follow-up after the event the patient was asymptomatic. Conclusion . Extrusion via the GI tract is not safe enough to be considered as a treatment option for loosened screws. Some improvements could be implemented to prevent such an incident. Furthermore, this case is a fine example that recent preoperative imaging is mandatory before revision surgery for screw loosening.

Passage of an Anterior Odontoid Screw through Gastrointestinal Tract

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L. Leitner

2017-01-01

Full Text Available Purpose. Anterior screw fixation has become a popular surgical treatment method for instable odontoid fractures. Screw loosening and migration are a rare, severe complication following anterior odontoid fixation, which can lead to esophagus perforation and requires revision operation. Methods. We report a case of screw loosening and migration after anterior odontoid fixation, which perforated the esophagus and was excreted without complications in a 78-year-old male patient. Results. A ventral dislocated anterior screw perforated through the esophagus after eight years after implantation and was excreted through the gastrointestinal (GI tract. At a 6-month follow-up after the event the patient was asymptomatic. Conclusion. Extrusion via the GI tract is not safe enough to be considered as a treatment option for loosened screws. Some improvements could be implemented to prevent such an incident. Furthermore, this case is a fine example that recent preoperative imaging is mandatory before revision surgery for screw loosening.

Histologic Anatomy of the Anterior Vagina and Urethra.

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Mazloomdoost, Donna; Westermann, Lauren B; Mutema, George; Crisp, Catrina C; Kleeman, Steven D; Pauls, Rachel N

Vaginal and urethral histology is important to understanding the pathophysiology of the pelvic floor. En bloc removal of 4 female cadaveric pelvises was performed, with 18 to 25 serial sections obtained from each. The vaginal and urethral lengths were divided into distal and proximal sections; urethra was divided into anterior and posterior segments as well. Innervation and vasculature were qualified as small and large and quantified per high-power field. The mean vaginal length was 7.45 cm, and the mean urethral length was 3.38 cm. A distinct vaginal fibromuscular layer was noted, without evidence of a dense sheet of continuous collagen. An epithelial, lamina propria, and muscular layer surrounded the urethral lumen. Adipose and loose fibroconnective tissue separated the urethra from the anterior vagina in 41% of slides. Nerves and vasculature were concentrated in the lamina propria. More small nerves and vessels were grossly seen compared with larger counterparts in both the vagina and urethra. No significant differences in layer thickness, innervation, or vasculature were observed along the vaginal length. The posterior urethra had greater innervation than did the anterior (P = 0.012). The distal posterior urethra had more large vessels than did the proximal posterior urethra (P = 0.03). No other differences were noted in urethral sections. A vaginal fibromuscular layer was confirmed, refuting a true fascia. Innervation and vasculature were quantitatively the same along the anterior vagina. However, the posterior urethra had greater innervation than did anterior and is most innervated proximally. Nerve and vascular histology may relate to pelvic floor disorder etiology.

Diagnóstico e tratamento do lenticone anterior

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Ana Luiza Biancardi

2011-08-01

Full Text Available Relato de caso de um paciente de 18 anos com sindrome de Alport apresentando perda visual progressiva. A biomicroscopia revelou lenticone anterior bilateral. O paciente realizou tomografia de córnea e segmento anterior com o sistema Scheimpflug (Pentacam e aberrometria e topografia corneana (i-Trace. O paciente foi submetido à facoemulsificação com implante de lente intraocular peça única hidrofóbica (Acrysof® SN60AT. As imagens de Scheimpflug documentaram o lenticone anterior. A aberrometria total mostrou acentuado astigmatismo miópico com acentuada aberração esférica negativa, havendo grande impacto das aberrações de alta ordem (HOA na conversão da letra E de Snellen. O mapa de integração da aberrometria do olho todo com a topografia corneana mostrou maior semelhança das aberrrações totais com as aberrações intraoculares do que com as aberrações da superfície anterior da córnea. Após a cirurgia, o paciente apresentou acuidade visual corrigida igual a 20/20 em ambos os olhos, as imagens de Scheimpflug revelaram lentes intraoculares tópicas e os mapas diferenciais revelaram resolução da miopia e redução das aberrações da alta ordem (total e interna. Os exames de imagem foram úteis para demonstrar o impacto do lenticone anterior na qualidade visual e a resolução das aberrações ópticas após a cirurgia.

Pembuatan Cantilever Bridge Anterior Rahang Atas sebagai Koreksi Estetik

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Yusrina Sumartati

2012-12-01

Full Text Available Latar belakang. Kehilangan gigi anterior rahang atas mengakibatkan gangguan fungsi fonetik dan estetik. Gangguan fungsi estetik menyebabkan pasie menjadi rendah diri. Kondisi ini dapat diatasi oleh dokter gigi, salah satunya dengan pembuatan cantilever bridge. Tujuan. Penulisan ini yaitu untuk memberi informasi bahwa pada kasus kehilangan gigi-gigi anterior rahang atas dengan space yang telah menyempit dan malposisi gigi dapat dibuatkan protesa berupa gigi tiruan cekat dengan desain cantilever bridge. Kasus dan perawatan. Laporan kasus ini membahas tentang pasien perempuan umur 39 tahun yang datang ke Rumah Sakit Gigi dan Mulut Prof. Soedomo, dengan keluhan merasa kurang percaya diri karena gigi depan rahang atas hilang sejak 5 tahun yang lalu akibat kecelakaan. Gigi-gigi anterior rahang atas yang masih ada mengalami malposisi akibat pemakaian gigi tiruan sebagian lepasan yang tidak baik. Perawatan yang dilakukan adalah dengan pembuatan cantilever bridge pada gigi 11, 12, 13 dan 21, 22, 23. Kesimpulan. Gangguan fungsi estetik pada gigi anterior rahang atas dapat diatasi dengan pembuatan cantilever bridge.   Background. Maxillary anteriortooth loss resulting in impaired function of phonetic and aesthetic. Impaired function of aesthetic cause patients to become self conscious. This condition can be treated by a dentist, one with a cantilever bridge. Purpose. To inform that in case of missing anterior teeth of the upper jaw with a space that has been narrowed, and malposition of teeth can be made prosthesis denture fixed bridge with a cantilever design. Case and treatment. This case report discusses the 39 years old female patient who came to he Dental Hospital Prof. Soedomo, with complaints of feeling less confident due to the maxillary front teeth missing since 5 years ago due to an accident. Anterior teeth of the upper jaw are still experiencing malposition due to the use of removable partial dentures are not good. The treatment is done is by

Paciente con esquizofrenia tratado con ziprasidona + clozapina

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Pol Yanguas E.

2013-05-01

Full Text Available P es un paciente diagnosticado de esquizofrenia, sigue en un piso tutelado un programa de rehabilitación, está medicado con clozapina 500 mg/día y ziprasidona 280 mg/ día. Padece hipercolesterolemia, tabaquismo y sus hábitos alimenticios no son buenos. La medicación que utiliza desde 2007 hasta ahora se refleja en la tabla 1. El último tratamiento se le introdujo el 7 de agosto de 2012, habiendo presentado un electro cardiograma (ECG normal, pero con ligera taquicardia ventricular y prolactinemia de 44,8 ng/ml (valores normales: 2-18 ng/ml.

Landmarks for Identifying the Suprascapular Foramen Anteriorly: Application to Anterior Neurotization and Decompressive Procedures.

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Manouvakhova, Olga V; Macchi, Veronica; Fries, Fabian N; Loukas, Marios; De Caro, Raffaele; Oskouian, Rod J; Spinner, Robert J; Tubbs, R Shane

2018-02-01

Additional landmarks for identifying the suprascapular nerve at its entrance into the suprascapular foramen from an anterior approach would be useful to the surgeon. To identify landmarks for the identification of this hidden site within an anterior approach. In 8 adult cadavers (16 sides), lines were used to connect the superior angle of the scapula, the acromion, and the coracoid process tip thus creating an anatomic triangle. The suprascapular nerve's entrance into the suprascapular foramen was documented regarding its position within this anatomical triangle. Depths from the skin surface and specifically from the medial-most point of the clavicular attachment of the trapezius to the suprascapular nerve's entrance into the suprascapular foramen were measured using calipers and a ruler. The clavicle was then fractured and retracted superiorly to verify the position of the nerve's entrance into the suprascapular foramen. From the trapezius, the nerve's entrance into the foramen was 3 to 4.2 cm deep (mean, 3.5 cm). The mean distance from the tip of the corocoid process to the suprascapular foramen was 3.8 cm. The angle best used to approach the suprascapular foramen from the surface was 15° to 20°. Based on our study, an anterior suprascapular approach to the suprascapular nerve as it enters the suprascapular foramen can identify the most medial fibers of the trapezius attachment onto the clavicle and insert a finger at an angle of 15° to 20° laterally and advanced to an average depth of 3.5 cm. Copyright © 2017 by the Congress of Neurological Surgeons

Laparoscopic-assisted repair of Morgagni–Larrey hernia by anterior ...

African Journals Online (AJOL)

Various techniques have been described to repair Morgagni–Larrey hernia. There is still concerns on the sufficiency of a simple laparoscopic anterior abdominal wall fixation. We aim to report of two children undergoingthe laparoscopic-assisted anterior abdominal wall repair for Morgagni–Larrey hernia, and to discuss this ...

Germ Cell Tumor Located in the Midline of the Anterior Neck

OpenAIRE

Tatyana PIRDOPSKA; Ivan TERZIEV; Sv. HRISTOVA; W. MLADENOVSKY; R. PETKOV

2011-01-01

Primary germ cell tumors involving midline of the anterior neck are extremely rare. Here we report a 68-year-old male who was operated due to a mass lesion in the anterior neck with infiltration of the isthmus of the thyroid gland. Histopathological examination revealed a germ cell tumor with extragonadal localization in the anterior neck infiltrating the isthmus of the thyroid gland.

Sonourethrography in the evaluation of anterior urethral strictures

International Nuclear Information System (INIS)

Kim, Jong Chul; Kwag, Jin Geun

1994-01-01

To determine the reliability of sonourethrography (SUG) in the evaluation of male anterior urethral strictures. Both SUG with retrograde saline infusion and retrograde urethrography (RUG) were performed in 5 young normal volunteers and 20 patients with symptoms of impaired urine flow. Those findings were compared with urethroscopic and operative findings in all patients. SUG was more accurate in the evaluation of the stricture length and degree than RUG in 7 patients with anterior urethral strictures, when compared with their subsequent open urethroplasty findings. Only SUG could classify the degree of spongiofibrosis surrounding the strictures in 15 patients. So, SUG was diagnostically as efficacious as or, superior to, RUG in all 20 patients. SUG can be used as one of complementary and reliable tools for diagnosis, evaluation and follow-up of anterior urethral strictures

Refraction and eye anterior segment parameters in schizophrenic patients

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Tongabay Cumurcu

2015-06-01

Full Text Available ABSTRACT Purpose: To evaluate the difference in terms of refractive errors and anterior segment parameters between schizophrenic patients and healthy volunteers. Methods: This study compared 70 patients (48 men who were diagnosed with schizophrenia with a control group of 60 (35 men who were similar in terms of age, gender, education, and socioeconomic level. Anterior segment examination was performed using a Scheimflug system. Axial length and lens thickness (LT were measured using optic biometry. The following tests were administered to the psychiatric patient group: Brief Psychiatric Rating Scale (BPRS, Scale for the Assessment of Negative Symptoms (SANS, and Scale for the Assessment of Positive Symptoms (SAPS. Results: Mild myopia was detected in both the schizophrenic and control groups, with no statistically significant difference (p>0.005. Corneal volume (CV, anterior chamber volume (ACV, anterior chamber depth (ACD, and central corneal thickness (CCT values were lower in the schizophrenic group, and there was a statistically significant between-group difference (p=0.026, p=0.014, p=0.048, and p=0.005, respectively. LT was greater in schizophrenics, and the difference was found to be statistically significant (p=0.006. A statistically significant negative correlation was found between SAPS and cylinder values (p=0.008. The axial eye length, cylinder value, pupil diameter, mean keratometric value, and anterior chamber angle revealed no statistically significant difference between the groups (p>0.05. Conclusion: No statistically significant difference was detected in terms of refraction disorders between schizophrenics and the healthy control group, while some differences in anterior chamber parameters were present. These results demonstrate that schizophrenics may exhibit clinical and structural differences in the eye.

Changes in anterior segment morphology in response to illumination and after laser iridotomy in Asian eyes: an anterior segment OCT study

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See, Jovina L S; Chew, Paul T K; Smith, Scott D; Nolan, Winifred P; Chan, Yiong‐Huak; Huang, David; Zheng, Ce; Foster, Paul J; Aung, Tin; Friedman, David S

2007-01-01

Aim Using the anterior segment optical coherence tomography (AS‐OCT) to quantify changes in anterior segment morphology going from light to dark and following laser iridotomy (LI). Methods Prospective observational study. 17 consecutive subjects without peripheral anterior synechiae undergoing LI were evaluated using gonioscopy and AS‐OCT. Angle configuration including angle opening distance (AOD) at 500 microns anterior to the scleral spur, AOD500, trabecular‐iris space area up to 750 microns from the scleral spur, TISA750 and the increase in angle opening going from dark to light conditions was determined. Results Both mean AOD500 and TISA750 increased nearly threefold going from dark to light. Both also significantly increased following LI (p<0.001) as did gonioscopic grading of the angle in all quadrants (p<0.001, McNemar's test). Angles were more than twice as wide on average in the dark after LI than before LI (p<0.05). Both the mean absolute change and the mean proportionate change in AOD500 and TISA750 when going from light to dark were greater after LI than before (p<0.05). Conclusion Increased illumination as well as LI resulted in significant widening of the anterior chamber angle. AS‐OCT (which does not require a water bath and can be performed with the patient at the slit lamp) identified similar magnitude changes as those previously reported using ultrasound biomicroscopy (UBM). Furthermore, the angle appears to open more both in absolute terms and and proportionate terms in response to illumination after LI. PMID:17504852

Dosificación de hormigones ligeros con cascarilla de café

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Jaime Salazar C.

1984-01-01

Full Text Available El presente trabajo hace parte de la línea de investigación que, sobre materiales de construcción, ha venido trabajando la sección de construcciones agrícolas del Departamento de Ingeniería Agrícola de esta Universidad. Se ha querido por tanto ahondar en un material de común conocimiento y aplicación pero que dosificado con áridos orgánicos provenientes de desechos de la agroindustria, como es el caso de la cascarilla o cisco de café, no se conoce ni su comportamiento mecánico ni sus propiedades térmicas. Se pensó, además, en que siendo Colombia el segundo productor mundial de café, debería estudiarse un subproducto de su beneficio como lo es la cascarilla, para contribuir en la racionalización de sus desperdicios. Fue así como nació esta idea que condujo a revisar literatura al respecto, visitar entidades del ramo como la Federación Nacional de Cafeteros, encontrándose que el tema propuesto de la dosificación de un hormigón con dicho árido no había sido desarrollado anteriormente. Concebido lo anterior se propuso el tema como proyecto de grado en el Departamento, el cual se presenta en este artículo siguiendo las etapas que fueron necesarias para determinar el proporcionamiento cemento-agua-cascarilla.

Epidermoid cyst in Anterior, Middle

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Kankane Vivek Kumar

2016-09-01

Full Text Available Epidermoid cysts are benign slow growing more often extra-axial tumors that insinuate between brain structures, we present the clinical, imaging, and pathological findings in 35 years old female patients with atypical epidermoid cysts which was situated anterior, middle & posterior cranial fossa. NCCT head revealed hypodense lesion over right temporal and perisylvian region with extension in prepontine cistern with mass effect & midline shift and MRI findings revealed a non-enhancing heterogeneous signal intensity cystic lesion in right frontal & temporal region extending into prepontine cistern with restricted diffusion. Patient was detoriated in night of same day of admission, emergency Fronto-temporal craniotomy with anterior peterousectomy and subtotal resection was done. The histological examination confirms the epidermoid cyst. The timing of ectodermal tissue sequestration during fetal development may account for the occurrence of atypical epidermoid cysts.

Abordaje subcraneal discusión y revisión histórica de la técnica quirúrgica Anterior subcranial approach: Discussion and historical review of the surgical technique

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I. Zubillaga Rodríguez

2009-02-01

Full Text Available Introducción. La cirugía de la base craneal es en la actualidad una realidad que se ha ido consolidando en las últimas décadas. El vertiginoso avance tecnológico desarrollado ha actuado como motor en la evolución de las técnicas quirúrgicas que abordan dicha región anatómica. Su impulso definitivo se ha cimentado en el concepto básico de equipo multidisciplinario. Material y métodos. Se describe el abordaje subcraneal como alternativa a los tradicionales abordajes a la base craneal anterior. Discusión y revisión histórica de los distintos pasos claves en la realización del mismo. Discusión. La elección del abordaje más adecuado a la base craneal en cada caso es esencial para la obtención de resultados quirúrgicos globales satisfactorios. Inicialmente dependerá de la localización anatómica exacta de la lesión dentro de la base craneal y de su extensión tridimensional, así como de la naturaleza de la misma. El abordaje subcraneal representa un paso importante en el desarrollo de las técnicas quirúrgicas de la base craneal. Conclusiones. El abordaje subcraneal permite una amplia y óptima exposición de todos los planos de la fosa craneal anterior, desde el techo etmoidal anterior hasta el clivus-planum esfenoidale incluyendo los techos orbitarios. Este objetivo se logra sin retracción de los lóbulos frontales evitando de esta manera la morbimortalidad asociada que dicha maniobra conlleva. Favorece el manejo precoz preciso de patología oncológica con afectación intra-extradural y el tratamiento de fracturas tras impactos de alta energía con afectación de la fosa craneal anterior.Introduction. Skull base surgery is now a reality that has become consolidated over the last decades. The dizzyingly rapid technological advances that have taken place have served as a motor for the development of surgical techniques to approach this anatomic region. The foundation for the definitive push forward of this technique was

Examination of the sprained ankle: Anterior drawer test or arthrography

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Laehde, S.; Putkonen, M.; Puranen, J.; Raatikainen, T.

1988-11-01

The accuracy of the anterior drawer test for the diagnosis of recent lateral ligament tears in the ankle was evaluated in a series of 192 patients using surgical or arthrographic findings for reference. Considerable overlapping of results was obtained in ankles with and without ligament tear. Twenty-eight per cent of the anterior talofibular ligament tears, and 38% of the combined anterior talofibular and calcaneofibular tears were not detected, and single and combined tears could not be differentiated. It is concluded that the anterior drawer test is too unreliable as a basis for any decision regarding surgical treatment of a recent sprain. Therefore, arthrography is recommended as the method of choice in such cases of recent ankle sprain, where the need of surgery has to be supported by X-ray analysis.

Examination of the sprained ankle: Anterior drawer test or arthrography?

International Nuclear Information System (INIS)

Laehde, S.; Putkonen, M.; Puranen, J.; Raatikainen, T.

1988-01-01

The accuracy of the anterior drawer test for the diagnosis of recent lateral ligament tears in the ankle was evaluated in a series of 192 patients using surgical or arthrographic findings for reference. Considerable overlapping of results was obtained in ankles with and without ligament tear. Twenty-eight per cent of the anterior talofibular ligament tears, and 38% of the combined anterior talofibular and calcaneofibular tears were not detected, and single and combined tears could not be differentiated. It is concluded that the anterior drawer test is too unreliable as a basis for any decision regarding surgical treatment of a recent sprain. Therefore, arthrography is recommended as the method of choice in such cases of recent ankle sprain, where the need of surgery has to be supported by X-ray analysis. (orig.)

Multi drug resistant tuberculosis presenting as anterior mediastinal mass

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Parmarth Chandane

2016-01-01

Full Text Available Enlargement of the mediastinal lymphatic glands is a common presentation of intrathoracic tuberculosis (TB in children. However, usually, the mediastinal TB nodes enlarge to 2.8 ± 1.0 cm. In this report, we describe a case of anterior mediastinal lymphnode TB seen as huge mass (7 cm on computed tomography (CT thorax without respiratory or food pipe compromise despite anterior mediastinum being an enclosed space. CT guided biopsy of the mass cultured Mycobacterium TB complex which was resistant to isoniazide, rifampicin, streptomycin ofloxacin, moxifloxacin, and pyrazinamide. Hence, we report primary multi drug resistant TB presenting as anterior mediastinal mass as a rare case report.

REDUCCIÓN DE ÓXIDOSDE NITROGENO CON CATALIZADORES ZEOLÍTICOS INTERCAMBIADOS CON COBALTO

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Enrique Alexis García Moya

2012-10-01

Full Text Available Se presenta un estudio sobre la reducción catalítica selectiva (RCS de NOx con metano en presencia de oxígeno en exceso con varios catalizadores a base de las zeolitas mordenita, ferrierita y ZSM-5 intercambiadas con diferentes cargas de cobalto y con las correspondientes zeolitas en forma acida. Cuando la mezcla reactiva contenía mayormente NO2 en lugar de NO, los catalizadores ácidos mostraron las más altas velocidades de formación de N2 en condiciones secas. Las mayores actividades se obtuvieron con los catalizadores Co-mordenita, siguiendo en orden de actividad los catalizadores Co-Ferrierita y Co-ZSM-5. El catalizador Co-Mordenita más activo se ensayó con una mezcla reactiva donde predominó el NO en lugar del NO2 bajo condiciones secas e hidrotérmicas y en presencia de SO2. Con la adición de 8% de agua a la mezcla de reacción se observó desactivación reversible, especialmente a bajas temperaturas. La adición de 60 ppm de SO2 disminuyó la velocidad de reacción aproximadamente a la mitad debido posiblemente al envenenamiento de algunos sitios activos.

Correção da cifose de Scheuermann: estudo comparativo da fixação híbrida com ganchos e parafusos versus fixação apenas com parafusos Corrección de la cifosis de Scheuermann: estudio comparativo de la fijación híbrida con ganchos y tornillos versus fijación solo con tornillos Correction of Scheuermann kyphosis: comparative study of hybrid fixation using hooks and screws versus screw-only fixation

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Enguer Beraldo Garcia

2009-12-01

Full Text Available OBJETIVOS: avaliar o grau de correção da cifose de Scheuermann, em 6 pacientes que se submeteram à instrumentação híbrida composta por ganchos e parafusos (H e 17 fixados apenas com parafusos (P. MÉTODOS: 23 pacientes, com cifose de Scheuermann, submetidos a tratamento cirúrgico por dupla via com início pela via anterior, seguido pela via posterior. Do conjunto de pacientes, 6 foram operados com fixação híbrida e 17 com uso exclusivo de parafusos pediculares. O tratamento cirúrgico foi indicado para cifose rígida, variando de 60º e 105º e portadores do sinal de Risser acima de 4. RESULTADOS: observou-se, no Grupo H, cifose pré-operatória média de 84,17º e no pós-operatório de 47,5º. No Grupo P, a média de cifose no pré-operatório era de 80,35º e, no pós-operatório, de 33,53º. CONCLUSÃO: concluiu-se que os dois tipos de fixação apresentaram resultados muito satisfatórios, contudo, sendo ainda superior quando fixados só com parafusos.OBJETIVO: evaluar el grado de corrección de la cifosis de Scheuermann, en seis pacientes que se sometieron a la instrumentación híbrida compuesta por ganchos y tornillos (H y 17 fijados solamente con tornillos (P. MÉTODOS: fueron veintitrés pacientes, con cifosis de Scheuermann, sometidos al tratamiento quirúrgico por dupla vía con inicio por la vía anterior seguido por la posterior. Del conjunto de pacientes, 6 fueron operados con fijación híbrida y 17 con uso exclusivo de tornillos pediculares. El tratamiento quirúrgico fue indicado para cifosis rígida, variando de 60º a 105º y portadores de la Señal de Risser por encima de 4. RESULTADOS: se observó, en el Grupo H, una cifosis preoperatoria promedio de 84.17º y en el postoperatorio de 47.5º. En el Grupo P el promedio de la cifosis en el preoperatorio era de 80.35º y en el postoperatorio de 33.53º. CONCLUSIÓN: los dos tipos de fijación presentaron resultados muy satisfactorios; no obstante, fue superior con la

Index of fatigue quadriceps in soccer athletes after anterior cruciate ligament reconstruction

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Maria Luzete Costa Cavalcante

Full Text Available ABSTRACT OBJECTIVE: The present study aimed to evaluate the muscle fatigue of the quadriceps muscle in high-performance soccer players undergoing (anterior cruciate ligament ACL reconstruction. METHODS: We evaluated 17 high-performance soccer players from three professional soccer teams of a state in Brazil from August 2011 to July 2012. All subjects were evaluated between 5.5 and 7 months after ACL reconstruction with a Biodex(r isokinetic dynamometer (System 4 Pro with test protocol CON/CON at 60°/s and 300°/s with 5 and 15 repetitions, respectively. In the calculation of local muscle fatigue, the fatigue index was used, which is calculated by dividing the labor done in the first one-third of the repetitions by that done at the final one-third of the repetitions, and multiplying by 100 to express a unit in percentage (i.e., as a discrete quantitative variable. RESULTS: All subjects were male, with a mean age of 21.3 ± 4.4 years and mean BMI 23.4 ± 1.53 cm; left dominance was observed in 47% (n = 8 of athletes, and right dominance, in 53% (n = 9 of athletes; and the limb involved in the lesion was the dominant in 29% (n = 5 and the non-dominant in 71% (n = 12. Fatigue rates were 19.6% in the involved limb and 29.0% in the non-involved limb. CONCLUSION: The results allow us to conclude that there was no significant difference between the limbs involved and not in ACL injuries regarding local muscle fatigue. No association was observed between the dominant side and the limb involved in the ACL injury.

Recomendaciones en la prescripción del entrenamiento con pesas (contra resistencia para diabéticos e hipertensos

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Jessenia Hernández Elizondo

2004-01-01

Full Text Available El organismo humano es capaz de mantener un control bastante preciso de los niveles de glucosa sanguínea durante el reposo y en condiciones de ejercicio, sin embargo las concentraciones de insulina en personas con diabetes no responden al ejercicio de manera normal, y el equilibrio entre la utilización de glucosa periférica y hepática se puede alterar. A pesar de lo anterior, se ha considerado que el ejercicio físico es un elemento clave que provee grandes beneficios a la persona diabética. Por otra parte, una de las patologías que está muy asociada con la diabetes es la hipertensión o presión arterial alta (Hipertensión. Cuando queremos prescribir ejercicio en personas hipertensas debemos recordar que el entrenamiento con pesas no mejora la condición cardiovascular, pero sí hace que los músculos y huesos sean más fuertes y se incremente el metabolismo. El presente trabajo se realizó con el propósito de dar a conocer a los profesionales en Educación Física y en Ciencias del Movimiento Humano, los ejercicios de pesas (contra resistencia que no se recomiendan en la prescripción de programas para personas que padecen de diabetes e hipertensión. Además de proveer una herramienta descriptiva y útil para la educación de todas las personas interesadas en la actividad física y especialmente para aquellos que realizan entrenamiento contra resistencia

Incremento del dominio conceptual escolar con base en la interdisciplinariedad

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Yamile Borrero De Castillo

2017-06-01

Full Text Available Este artículo es extractado de la investigación Interdisciplinariedad de la Educación Física y las Ciencias Naturales para Mejorar los Aprendizajes en Niños de Tercer Grado de Básica Primaria realizado en la CUC durante 2013 y 2014, con el objeto de dar a conocer los resultados conceptuales mejorados en el aprendizaje de las Ciencias Naturales y la Educación Física. Como herramienta metodológica, la disciplinariedad aplicada en esta investigación, tuvo su base en los aportes conceptuales de Fogarty expresados en su obra Ten Ways to Integrated Curriculum, Educational Leadership 1991. Y los Modelos disciplinarios desarrollados por Cone Theresa, Peter Werner, Stephen Cone y colaboradores para la enseñanza de la Educacíón Física. Tomaron parte del estudio 42 estudiantes, llegándose a la conclusión que la hipótesis de trabajo se cumplió, por cuanto mejoró la efectividad de la interdisciplinariedad entre la Educación Física y las Ciencias Naturales evidenciado en un mejoramiento en el dominio de los conceptos básicos de ambas disciplinas por parte de las niñas. Se concluye además que la clase interdisciplinar permite un mejor ambiente de trabajo, mucho más gratificante para el docente y alumnos dados que genera una mayor motivación que da como resultado un aprendizaje con sentido y significación. Por lo anterior, se recomienda ampliar los alcances de la investigación en Barranquilla con el ánimo de incluir un mayor número de instituciones educativas y diferentes grados que permitan dar un diagnóstico más generalizado; implementar esta investigación en otras áreas del currículo, como Ciencias Sociales, Matemática o Estética y actualizar al maestro de básica primaria, en interdisciplinariedad, de forma que se puedan implementar en la escuela este tipo de herramientas metodológicas.

Terapias alternativas con animales para niños con necesidades especiales

OpenAIRE

Cea-Chueca, Aihnoa

2014-01-01

El presente trabajo de fin de grado consiste en la realización de un análisis y descripción de la literatura acerca de las distintas terapias animales, destinadas a niños con necesidades especiales: cómo y por qué surgieron, en qué consisten las terapias, cómo podemos utilizarlas, etc. Las terapias alternativas con animales se conocen como una alternativa terapéutica, donde se utiliza a un animal como co-terapeuta para poder desarrollar diferentes capacidades de los niños con necesidades espe...

Evaluación del efecto que produce la aparatología ortopédica pre-quirúrgica de Hotz en paciente con LPH. Reporte de caso

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Daniel González Abundez

2017-01-01

Full Text Available El labio y paladar hendido, son malformaciones congénitas de origen multifactorial de tipo facial y bucal que ocurren durante la 6ta y 8va semana del desarrollo embrionario. Sus etiologías son: factores genéticos y ambientales, alterando la fusión de los procesos labiales y palatinos durante el desarrollo embrionario, lo que origina desórdenes de la alimentación, respiración, lenguaje, masticación, deglución, fonación, estética y autoestima. Por lo anterior, es importante realizar una rehabilitación ortopédica para lograr un adecuado desarrollo y crecimiento del aparato estomatognático. Objetivo: Evaluar el efecto que produce la aparatología ortopédica pre-quirúrgica de Hotz, desde su colocación, hasta el primer tiempo quirúrgico en un paciente con Labio y Paladar Hendido (LPH. Reporte del caso: Paciente masculino, de dos semanas de edad, con LPH, acude a Clínica de Atención Integral para el Paciente de la Escuela Nacional de Estudios Superiores, Unidad León. Antecedentes patológicos: labio y paladar hendido completo unilateral izquierdo. Tratamiento: Colocación de ortopedia prequirúrgica. Resultados: El uso de la aparatología ortopédica previa a la intervención quirúrgica funcionó como contención en el sector anterior, ayudando al arco dental en la cirugía primaria al momento de la labioplastía, obteniendo uniones mucoperiósticas menos agresivas, conservando el tamaño entre los procesos alveolares y el de la brecha de la hendidura en la zona anterior, mientras que en la zona posterior, aumentó favoreciendo positivamente al paciente para una succión nutricia más eficaz y funcional. Conclusiones: La placa pre-quirúrgica y la cirugía, pueden ser significativamente eficaces para un mejor desarrollo maxilofacial, mejorando la forma de la arcada y alineación pasiva del maxilar en paciente con LPH, siendo de gran ayuda para la alimentación en los pacientes postnatales.

Radial head button holing: a cause of irreducible anterior radial head dislocation

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Shin, Su-Mi; Chai, Jee Won; You, Ja Yeon; Park, Jina [Seoul National University Seoul Metropolitan Government Boramae Medical Center, Department of Radiology, Seoul (Korea, Republic of); Bae, Kee Jeong [Seoul National University Seoul Metropolitan Government Boramae Medical Center, Department of Orthopedic Surgery, Seoul (Korea, Republic of)

2016-10-15

''Buttonholing'' of the radial head through the anterior joint capsule is a known cause of irreducible anterior radial head dislocation associated with Monteggia injuries in pediatric patients. To the best of our knowledge, no report has described an injury consisting of buttonholing of the radial head through the annular ligament and a simultaneous radial head fracture in an adolescent. In the present case, the radiographic findings were a radial head fracture with anterior dislocation and lack of the anterior fat pad sign. Magnetic resonance imaging (MRI) clearly demonstrated anterior dislocation of the fractured radial head through the torn annular ligament. The anterior joint capsule and proximal portion of the annular ligament were interposed between the radial head and capitellum, preventing closed reduction of the radial head. Familiarity with this condition and imaging findings will aid clinicians to make a proper diagnosis and fast decision to perform an open reduction. (orig.)

Modelo de gestión de relaciones con los clientes en empresas de consultoría

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Efra De La Hoz

2017-11-01

Full Text Available En este artículo de investigación se presentan los resultados obtenidos durante el desarrollo del proyecto Diseño de un modelo de Gestión de Relaciones con los clientes en una Empresa de Consultoría de Barranquilla, Colombia. Inicialmente se hace una revisión bibliográfica de los desarrollos conceptuales de la gestión de clientes, gerencia del servicio, calidad del servicio, servicio y servicio al cliente, así como de modelos relacionados con la gestión y servicio al cliente, los cuales sirvieron de soporte conceptual para el diseño del modelo propuesto. Lo anterior a través de un análisis cualitativo, descriptivo propositivo y cuantitativo, soportado en un análisis  de simulación de la satisfacción de los clientes de la empresa para lo cual se utilizó la dinámica de sistemas. Del modelo de gestión de relaciones con los clientes, se puede concluir que mejora el nivel de satisfacción de los clientes,  lo que redunda en una mayor fidelización del mismo. Finalmente el trabajo realizado constituye un aporte de importancia para el sector de consultoría en la medida que se proporciona un modelo de gestión que mejora los niveles de satisfacción de sus clientes.

Pseudoaneurysm of the Anterior Tibial Artery following Ankle Arthroscopy in a Soccer Player

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Ichiro Tonogai

2017-01-01

Full Text Available Ankle arthroscopy carries a lower risk of vascular complications when standard anterolateral and anteromedial portals are used. However, the thickness of the fat pad at the anterior ankle affords little protection for the thin-walled anterior tibial artery, rendering it susceptible to indirect damage during procedures performed on the anterior ankle joint. To our knowledge, only 11 cases of pseudoaneurysm involving the anterior tibial artery after ankle arthroscopy have been described in the literature. Here we reported a rare case of a 19-year-old soccer player who presented with pseudoaneurysm of the anterior tibial artery following ankle arthroscopy using an ankle distraction method and underwent anastomosis for the anterior tibial artery injury. Excessive distraction of the ankle puts the neurovascular structures at greater risk for iatrogenic injury of the anterior tibial artery during ankle arthroscopy. Surgeons should look carefully for postoperative ankle swelling and pain after ankle arthroscopy.

Traumatic Anterior Cerebral Artery Pseudoaneurysmal Epistaxis.

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Liu, Qing Lin; Xue, Hao; Qi, Chang Jing; Zhao, Peng; Wang, Dong Hai; Li, Gang

2017-04-01

Pseudoaneurysmal epistaxis is a rare but emergent condition. We report a case of traumatic anterior cerebral artery pseudoaneurysmal epistaxis and review the published literature. A 49-year-old man sustained severe head trauma. He was diagnosed with multiple skull bone fractures, left subdural hematoma, subarachnoid hemorrhage, pneumocephalus, and right frontal hematoma. Subdural hematoma evacuation was done at a local hospital. In the following months, he experienced repeated epistaxis that required nasal packing to stop the bleeding. Digital subtraction angiography showed an anterior cerebral artery pseudoaneurysm protruding into the posterior ethmoid sinus. Embolization of the aneurysm was performed with microcoils, and the parent artery was occluded by thrombosis. The patient presented 1 month later with another epistaxis episode. Digital subtraction angiography showed recanalization of the parent artery and recurrence of the aneurysm. The parent artery was occluded for the second time with coils and Onyx embolic agent. Pseudoaneurysmal epistaxis is rare, and this is the first report of an anterior cerebral artery pseudoaneurysm that manifested with epistaxis. Endovascular intervention has become the first choice of treatment for this disease. The high recurrence rate is the main disadvantage of endovascular intervention. Aneurysm trapping with bypass surgery is another treatment option. Copyright © 2016 Elsevier Inc. All rights reserved.

Anterior cruciate ligament ganglion: case report

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André Pedrinelli

Full Text Available CONTEXT: A ganglion is a cystic formation close to joints or tendinous sheaths, frequently found in the wrist, foot or knee. Intra-articular ganglia of the knee are rare, and most of them are located in the anterior cruciate ligament. The clinical picture for these ganglia comprises pain and movement restrictions in the knee, causing significant impairment to the patient. Symptoms are non-specific, and anterior cruciate ligament ganglia are usually diagnosed through magnetic resonance imaging or arthroscopy. Not all ganglia diagnosed through magnetic resonance imaging need to undergo surgical treatment: only those that cause clinical signs and symptoms do. Surgical results are considered good or excellent in the vast majority of cases. CASE REPORT: A 29-year-old male presented with pain in the left knee during a marathon race. Physical examination revealed limitation in the maximum range of knee extension and pain in the posterior aspect of the left knee. Radiographs of the left knee were normal, but magnetic resonance imaging revealed a multi-lobed cystic structure adjacent to the anterior cruciate ligament, which resembled a ganglion cyst. The mass was removed through arthroscopy, and pathological examination revealed a synovial cyst. Patient recovery was excellent, and he resumed his usual training routine five months later.

Neuropatia óptica isquêmica anterior e poliarterite nodosa: relato de caso Anterior ischemic optic neuropathy and polyarteritis nodosa: case report

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Christie Michelle Graf

2006-02-01

Full Text Available Descreve-se uma paciente com diagnóstico de poliarterite nodosa, em tratamento com citostáticos e corticosteróides que desenvolveu neuropatia óptica isquêmica anterior, uma manifestação considerada bastante rara para esta doença.We describe a patient with polyarteritis nodosa being treated with cytostatics and corticosteroids who developed an anterior ischemic optic neuropathy, a rare manifestation of this pathology.

A 3-year follow-up after anterior colporrhaphy compared with collagen-coated transvaginal mesh for anterior vaginal wall prolapse

DEFF Research Database (Denmark)

Rudnicki, Martin; Laurikainen, E; Pogosean, R

2016-01-01

departments of obstetrics and gynaecology in Norway, Sweden, Finland, and Denmark. POPULATION: A total of 138 women, of 55 years of age or older, admitted for stage ≥2 anterior vaginal wall prolapse. METHODS: The women scheduled for primary anterior vaginal wall prolapse surgery were randomised between...... the groups was observed regarding PFIQ-7, PFDI-20, and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) scores. The number of mesh exposures did not change during the study period and all exposures were minor. CONCLUSION: Our study demonstrates that although the objective outcome...

The anterior cruciate ligament-lateral meniscus complex: A histological study.

Science.gov (United States)

Furumatsu, Takayuki; Kodama, Yuya; Maehara, Ami; Miyazawa, Shinichi; Fujii, Masataka; Tanaka, Takaaki; Inoue, Hiroto; Ozaki, Toshifumi

2016-01-01

The anterior root of the lateral meniscus (LM) dives underneath the tibial attachment of the anterior cruciate ligament (ACL). Although the distinct role of meniscal attachments has been investigated, the relationship between the LM anterior insertion (LMAI) and ACL tibial insertion (ACLTI) remains unclear. This study histologically analyzed the LMAI and ACLTI. Samples were divided into four regions in an anterior-to-posterior direction. Histological measurements of these insertion sites were performed using safranin O-stained coronal sections. Distribution and signal densities of type I and II collagen were quantified. The ACLTI and LMAI formed the ACL-LM complex via fiber connections. The anterior part of the ACLTI had a widespread attachment composed of dense fibers. Attachment fibers of the LMAI became dense and wide gradually at the middle-to-posterior region. The ACL-LM transition zone (ALTZ) was observed between the LMAI and the lateral border of the ACLTI at the middle part of the ACL tibial footprint. Type II collagen density of the LMAI was higher than that of the ACLTI and ALTZ. Our results can help create an accurate tibial bone tunnel within the dense ACL attachment during ACL reconstruction surgery.

Situación del Rezago Educativo en Yucatán, México con Enfoque de Género (1990-2010)

OpenAIRE

Burgos-Suárez, Lucelly Carolina; Universidad Autónoma de Yucatán; Ortiz-Pech, Rafael; Universidad Autónoma de Yucatán; Albornoz-Mendoza, Lilian; Universidad Autónoma de Yucatán

2016-01-01

El artículo analiza cómo el género femenino se encuentra en situación de retraso educativo en el periodo 1990-2010 en Yucatán y en México. Para lograr lo anterior, se comparan los datos retraso educativo entre mujeres, hombres y el total de la población, por  nivel de instrucción y por rango de edad en el periodo citado y en los ámbitos territoriales correspondientes. Además, se introducen indicadores de disminución de retraso educativo con el fin de presentar un panorama de la evolución del ...

Variables socionutricionales de hogares mazahuas integrados por preescolares desnutridos con madres con obesidad y sin obesidad

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Conzuelo González, Viridiana Vanessa

2009-01-01

Full Text Available El primer objetivo fue conocer cuántos menores de cinco años con diferentes grados de desnutrición tienen una madre con sobrepeso/obesidad/ en una comunidad indígena que vive en extrema pobreza y bajo condiciones de migración masculina internacional. El segundo fue comparar tres variables socionutricionales (ingreso familiar, educación de la madre y adecuación nutrimental de la dieta diaria entre estos hogares y los hogares con desnutrición infantil y madres sin obesidad. Se realizó un estudio transversal (2006-2007, en la comunidad mazahua de San Francisco Tepeolulco, Municipio de Temascalcingo; que incluyó a 85 hogares integrados por preescolares con desnutrición inscritos al programa Oportunidades. Se determinó el estado nutrición de los preescolares con indicadores antropométricos y se obtuvo el IMC de las madres de estos infantes. Se aplicó una encuesta socionutricional, incluida el recordatorio de 24 horas, y complementado con la observación participante (cualitativa. Se encontró que 83% de las madres mazahuas presentaron sobrepeso u obesidad. El estado de nutrición de los preescolares con madres con obesidad presentó un porcentaje mayor de desnutrición (76%. En la variable género, se encontró que 54% de los niños con madres con obesidad tenía baja talla. Al relacionar el nivel educativo de la madre, esta variable resultó ser estadísticamente significativa (p=0.015, donde el analfabetismo está más relacionado con la desnutrición infantil que tienen madres de bajo y/o peso normal. La elevada prevalencia de hogares conformados con preescolares con desnutrición y madres con obesidad, es un síntoma más de la pobreza en zonas indígenas en México, con bajo índice de desarrollo humano.

Involuntary masturbation and hemiballismus after bilateral anterior cerebral artery infarction.

Science.gov (United States)

Bejot, Yannick; Caillier, Marie; Osseby, Guy-Victor; Didi, Roy; Ben Salem, Douraied; Moreau, Thibault; Giroud, Maurice

2008-02-01

Ischemia of the areas supplied by the anterior cerebral artery is relatively uncommon. In addition, combined hemiballismus and masturbation have rarely been reported in patients with cerebrovascular disease. We describe herein a 62-year-old right-handed man simultaneously exhibiting right side hemiballismus and involuntary masturbation with the left hand after bilateral infarction of the anterior cerebral artery territory. Right side hemiballismus was related to the disruption of afferent fibers from the left frontal lobe to the left subthalamic nucleus. Involuntary masturbation using the left hand was exclusively linked to a callosal type of alien hand syndrome secondary to infarction of the right side of the anterior corpus callosum. After 2 weeks, these abnormal behaviours were completely extinguished. This report stresses the wide diversity of clinical manifestations observed after infarction of the anterior cerebral artery territory.

Glaucoma anterior chamber morphometry based on optical Scheimpflug images.

Science.gov (United States)

Alonso, Ruiz Simonato; Ambrósio Junior, Renato; Paranhos Junior, Augusto; Sakata, Lisandro Massanori; Ventura, Marcelo Palis

2010-01-01

To compare the performance of gonioscopy and noncontact morphometry with anterior chamber tomography (High Resolution Pentacam - HR) using optical Scheimpflug images in the evaluation of the anterior chamber angle (ACA). Transversal study. 112 eyes from 74 subjects evaluated at the Glaucoma Department, Fluminense Federal University, underwent gonioscopy and Pentacam HR. Using gonioscopy, the ACA was graded using the Shaffer Classification (SC) by a single experienced examiner masked to the Pentacam HR findings. Narrow angle was determined in eyes in which the posterior trabecular meshwork could not be seen in two or more quadrants on non-indentation gonioscopy (SC Grade 2 or less). Pentacam HR images of the nasal and temporal quadrants were evaluated by custom software to automatically obtain anterior chamber measurements, such as: anterior chamber angle (ACA), anterior chamber volume (ACV) and anterior chamber depth (ACD). Based on gonioscopy results, 74 (60.07%) eyes of patients classified as open-angle (SC 3 and 4) and 38 (33.93%) eyes of patients classified as narrow-angle (SC 1 and 2). Noncontact morphometry with Scheimpflug images revealed a mean ACA of 39.20 ± 5.31 degrees for open-angle and 21.18 ± 7.98 degrees for narrow-angle. The open-angle group showed significant greater ACV and ACD values when compared to narrow-angle group (ACV of 193 ± 36 mm³ vs. 90 ± 25 mm³, respectively, p<0.001; and ACD of 3,09 ± 0,42 mm vs. 1,55 ± 0,64 mm, respectively, p<0.0001.). In screening eyes with open-angle and narrow-angle with the Pentacam ACA of 20º (SC Grade 2) using the ROC curves, the analysis showed 52.6% of sensitivity and 100% of specificity. The Pentacam showed ability in detecting eyes at risk for angle closure analyzing ACV and ACD.

Role of Fusiform and Anterior Temporal Cortical Areas in Facial Recognition

Science.gov (United States)

Nasr, Shahin; Tootell, Roger BH

2012-01-01

Recent FMRI studies suggest that cortical face processing extends well beyond the fusiform face area (FFA), including unspecified portions of the anterior temporal lobe. However, the exact location of such anterior temporal region(s), and their role during active face recognition, remain unclear. Here we demonstrate that (in addition to FFA) a small bilateral site in the anterior tip of the collateral sulcus (‘AT’; the anterior temporal face patch) is selectively activated during recognition of faces but not houses (a non-face object). In contrast to the psychophysical prediction that inverted and contrast reversed faces are processed like other non-face objects, both FFA and AT (but not other visual areas) were also activated during recognition of inverted and contrast reversed faces. However, response accuracy was better correlated to recognition-driven activity in AT, compared to FFA. These data support a segregated, hierarchical model of face recognition processing, extending to the anterior temporal cortex. PMID:23034518

Activation of anterior paralimbic structures during guilt-related script-driven imagery.

Science.gov (United States)

Shin, L M; Dougherty, D D; Orr, S P; Pitman, R K; Lasko, M; Macklin, M L; Alpert, N M; Fischman, A J; Rauch, S L

2000-07-01

Several recent neuroimaging studies have examined the neuroanatomical correlates of normal emotional states, such as happiness, sadness, fear, anger, anxiety, and disgust; however, no previous study has examined the emotional state of guilt. In the current study, we used positron emission tomography and the script-driven imagery paradigm to study regional cerebral blood flow (rCBF) during the transient emotional experience of guilt in eight healthy male participants. In the Guilt condition, participants recalled and imagined participating in a personal event involving the most guilt they had ever experienced. In the Neutral condition, participants recalled and imagined participating in an emotionally neutral personal event. In the Guilt versus Neutral comparison, rCBF increases occurred in anterior paralimbic regions of the brain: bilateral anterior temporal poles, anterior cingulate gyrus, and left anterior insular cortex/inferior frontal gyrus. These results, along with those of previous studies, are consistent with the notion that anterior paralimbic regions of the brain mediate negative emotional states in healthy individuals.

Late Results of Anterior Cervical Discectomy and Fusion with Interbody Cages

OpenAIRE

Da?l?, Murat; Er, Uygur; ?im?ek, Serkan; Bavbek, Murad

2013-01-01

Study Design Retrospective analysis. Purpose To evaluate the effectiveness of anterior cervical discectomy with fusion for degenerative cervical disc disease. Overview of Literature Anterior spinal surgery originated in the mid-1950s and graft for fusion was also employed. Currently anterior cervical microdiscectomy and fusion with an intervertebral cage is a widely accepted procedure for treatment of cervical disc hernia. Artificial grafts and cages for fusion are preferred because of their ...

Polymerase chain reaction in unilateral cases of presumed viral anterior uveitis

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Shoughy SS

2015-12-01

Full Text Available Samir S Shoughy,1 Hind M Alkatan,2,4 Abdulelah A Al-Abdullah,2 Albarah El-Khani,2 Jolanda DF de Groot-Mijnes,3 Khalid F Tabbara1,4,5 1Department of Ophthalmology, The Eye Center and The Eye Foundation for Research in Ophthalmology, 2Department of Pathology & Laboratory Medicine and Uveitis Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; 3Department of Virology and Ophthalmology, University Medical Center Utrecht, Utrecht, the Netherlands; 4Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 5The Wilmer Ophthalmological Institute of The Johns Hopkins University School of Medicine, Baltimore, MD, USA Background and objectives: Anterior uveitis is the most common form of intraocular inflammation. The main aim of this study was to determine the viral etiology in patients with unilateral cases of anterior uveitis.Patients and methods: A total of 12 consecutive patients with the diagnosis of idiopathic unilateral anterior uveitis were included prospectively. Aqueous specimens were obtained from each patient by anterior chamber paracentesis and subjected to the detection of viral DNA/RNA genome by polymerase chain reaction assay for herpes simplex virus, varicella zoster virus, cytomegalovirus, Epstein–Barr virus, and rubella virus.Results: There were six male and six female patients. The mean age was 43 years, with an age range of 11–82 years. All 12 cases presented with unilateral anterior uveitis. In four (33% patients, polymerase chain reaction was positive for viral genome. Two patients were positive for herpes simplex virus type 1, one patient was positive for cytomegalovirus and one for Epstein–Barr virus.Conclusion: Recent molecular diagnostic assays would help in the identification of the causative agent in patients with unilateral anterior uveitis. Keywords: viral anterior uveitis, PCR, herpes simplex virus, cytomegalovirus, diffuse keratic precipitates, anterior chamber

Diagnóstico psiquiátrico, discapacidad intelectual y criterios de diagnóstico para trastornos psiquiátricos en adultos con discapacidad de aprendizaje/retraso mental (DC-LD)

OpenAIRE

2004-01-01

La clasificación de las psicopatologías a través de unos criterios de diagnóstico operacionalizados constituye uno de los componentes del proceso de evaluación psiquiátrica. La literatura anterior ha demostrado que existen limitaciones a la hora de utilizar la Clasificación Internacional de Enfermedades-10 (CIE-10) y el Manual Diagnóstico y Estadístico (DSM-IV) en adultos con discapacidad intelectual.

Complex aesthetic treatment on anterior maxillary teeth with malposition

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Febriastuti Febriastuti

2008-12-01

Full Text Available Background: Complex aesthetic treatment on anterior teeth involves more than one caries tooth with malformed shape and malposition. Purpose: The purpose of this paper is to find the alternative treatment for anterior maxillary teeth with malposition. Case: In this case, a 25 year-old man with a peg shaped teeth and caries on several teeth and malposition can be treated with complex aesthetic treatment. Case management: Endodontic pulpectomy treatment on anterior maxillary teeth and post construction with splint porcelain fused to metal crowns on 11, 12, and 21, 22 to correct the shape and position into normal position. Conclusion: Malformed and malpositioned teeth with caries can be treated with complex aesthetic treatment.

Lenticonus diagnosis in Alport's syndrome: Anterior capsule apical angle calculation using Scheimpflug imagery.

Science.gov (United States)

Jarrín, E; Jarrín, I; Arnalich-Montiel, F

2015-08-01

We describe a simplified method to detect anterior lenticonus. Three eyes of 2 patients with anterior lenticonus, plus 16 eyes from 16 healthy controls underwent Scheimpflug imaging of their anterior segment with Pentacam. The anterior capsule apex angle was manually identified and automatically measured by AutoCAD. The mean angle was 173.06° (SD: 1.91) in healthy subjects, and 158.33° (SD: 3.05) in anterior lenticonus eyes. The angle obtained from patients was more than 3 SD steeper than those from healthy subjects. The apical angle calculation method seems to discriminate well between normal eyes and eyes suspected of having anterior lenticonus. Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

Subcranial approach in the surgical treatment of anterior skull base trauma.

Science.gov (United States)

Schaller, B

2005-04-01

Fractures of the anterior skull base, because of the region's anatomical relationships, are readily complicated by neurological damage to the brain or cranial nerves. This review highlights the use of a subcranial approach in the operative treatment of injuries of the anterior skull base and compares it to the more traditional neurosurgical transcranial approach. The extended anterior subcranial approach takes advantage of the specific features of injuries in this region and allows direct access to the central anterior cranial base in order to repair fractures, close CSF fistulae and relieve of optic nerve compression. It avoids extensive frontal lobe manipulation. The success of the approach in achieving the aims of surgery with low morbidity is reviewed.

Evaluación clínica y radiográfica de la técnica de distracción osteogénica en la reconstrucción de rebordes alveolares atróficos en la región anterior del maxilar superior A clinical and radiographic evaluation of the distraction osteogenesis technique for the reconstruction of atrophic alveolar ridges in the anterior region of the upper maxilla

Directory of Open Access Journals (Sweden)

M.E. Allais de Maurette

2005-06-01

Full Text Available Este estudio tiene como objetivo evaluar clínica y radiográficamente la técnica de distracción osteogénica alveolar en la región anterior del maxilar superior y las posibles complicaciones que pueden aparecer durante el tratamiento. Fueron evaluados 15 pacientes, sometidos a reconstrucción alveolar del maxilar superior en la región anterior con distracción osteogénica, usando un distractor yuxtaóseo. Del total de 15 pacientes encontramos que 13 pacientes (86,6% obtuvieron un éxito total de la técnica, obteniendo una ganancia ósea real media de 7,04 mm; en 1 paciente (6,66% fue parcial (2,62 mm y en 1 paciente (6,66% se evidenció un fracaso en la técnica, al alcanzar solo 0,76 mm debido a problemas en la activación del distractor. En cuanto a las complicaciones surgidas durante el tratamiento fueron divididas en complicaciones menores, toda aquella que no interfirió en el éxito del tratamiento, y que estuvieron presentes en 8 pacientes (53,33%, y complicaciones mayores aquellas que no permitieron la rehabilitación con implantes, y que fue encontrado solo en 1 paciente (6,66%. La técnica de distracción osteogénica alveolar, demostró ser eficaz en la reconstrucción de rebordes alveolares atróficos con un éxito de 93,33%, presentado pequeñas complicaciones que pueden ser solventadas por medio de un seguimiento por parte del profesional.This study evaluates clinically and radiographically the distraction osteogenesis technique for the reconstruction of atrophic alveolar ridges in the anterior maxilla region, and the possible complications that arise during treatment. Fifteen patients were evaluated, clinically and radiographically, that had been treated with alveolar distraction osteogenesis in the anterior region, using a juxta-osseous distractor. In 13 patients (86.6% the technique was completely successful, there being an effective bone gain of 7,04 mm. In 1 patient (6.66% this was partial (2.62 mm and in 1 patient (6

Toxic anterior-segment syndrome (TASS

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Cetinkaya S

2014-10-01

Full Text Available Servet Cetinkaya,1 Zeynep Dadaci,2 Hüsamettin Aksoy,3 Nursen Oncel Acir,2 Halil Ibrahim Yener,4 Ekrem Kadioglu5 1Ophthalmology Clinics, Turkish Red Crescent Hospital, Konya, 2Department of Ophthalmology, Faculty of Medicine, Mevlana University, Konya, 3Ophthalmology Clinics, Karaman State Hospital, Karaman, 4Konya Eye Center Hospital, Konya, 5Ophthalmology Clinics, Beyhekim State Hospital, Konya, Turkey Purpose: To evaluate the clinical findings and courses of five patients who developed toxic anterior-segment syndrome (TASS after cataract surgery and investigate the cause.Materials and methods: In May 2010, on the same day, ten patients were operated on by the same surgeon. Five of these patients developed TASS postoperatively.Results: Patients had blurred-vision complaints on the first day after the operation, but no pain. They had different degrees of diffuse corneal edema, anterior-chamber reaction, fibrin, hypopyon, iris atrophies, and dilated pupils. Their vision decreased significantly, and their intraocular pressures increased. Both anti-inflammatory and antiglaucomatous therapies were commenced. Corneal edema and inflammation resolved in three cases; however, penetrating keratoplasty was needed for two cases and additional trabeculectomy was needed for one case. Although full investigations were undertaken at all steps, we could not find the causative agent.Conclusion: TASS is a preventable complication of anterior-segment surgery. Recognition of TASS, differentiating it from endophthalmitis, and starting treatment immediately is important. Controlling all steps in surgery, cleaning and sterilization of the instruments, and training nurses and other operation teams will help us in the prevention of TASS. Keywords: cataract, phacoemulsification, TASS, corneal edema, inflammation

Relation between anterior displacement of the temporomandibular joint disc and size of the condyle

International Nuclear Information System (INIS)

Ohgushi, Masatoshi; Kubota, Hisashi; Yamaguchi, Kouichi; Shibata, Takanori

1996-01-01

To elucidate the cause of anterior displacement of the disc, we evaluated the relation between anterior displacement and the size of the condyle from MR images in 301 patients (602 TMJs) with clinical diagnosis of internal derangement. We found that the size of condyles with anterior displacement of the disc was significantly smaller than that of condyles without anterior displacement. This result suggests that small condyles may give rise to anterior displacement of the disc. (author)

Neuromielitis óptica con alta expresión de acuaporina-4 y anticuerpos anti-acuaporina-4 positivos en suero

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Alejandra Báez

2012-04-01

Full Text Available La presencia de anticuerpos IgG en suero, con blanco en los canales de acuaporina-4, es específica de la neuromielitis óptica (NMO. El 60% de los pacientes con NMO presentan lesiones cerebrales en la resonancia magnética (RM; en un 8% (mayoría niños estas lesiones se consideraron "atípicas". Presentamos dos pacientes con NMO y lesiones en el SNC de alta expresión de acuaporina-4. Caso 1: varón de 50 años, que comenzó con pérdida de visión en ojo derecho (OD. Recibió tratamiento empírico con metilprednisolona 1 g/d x 3 días. Al mes presentó dolor generalizado y hemiparesia derecha; nuevamente recibió metilprednisolona 1 g/d x 5 días e IgG IV 400 mg/kg/d × 5 días. Recuperó la deambulación persistiendo el dolor y fenómenos paroxísticos en los 4 miembros. Potenciales evocados visuales: P100, ojo izquierdo (OI 123 mseg. OD sin respuesta. La RM de cerebro (FLAIR mostró hiperintensidad en nervio óptico derecho, hipotálamo y comisura blanca anterior. RM cervical: lesión medular extensa (5 cuerpos vertebrales. Caso 2: mujer de 53 años, con disminución de la agudeza visual en ambos ojos y parestesias en miembros inferiores que remitieron espontáneamente. Evolucionó al mes con cuadriparesia e incontinencia esfinteriana. Recibió metilprednisolona 1 g/d x 5 días, sin mejoría. Potenciales evocados visuales: P100 OI 124 mseg. OD 128 mseg. RM cerebro: (FLAIR hiperintensidad hipotalámica y periacueductal. RM cervical: lesión medular extensa (7 cuerpos vertebrales. Anticuerpos anti-acuaporina-4 positivos en ambos pacientes (inmunofluorescencia indirecta. Las lesiones consideradas "atípicas", como aquí, en sitios con alta densidad de proteínas canales de agua AQP4 deberán considerarse para el diagnóstico diferencial.

Terapia regenerativa con plasma rico en plaquetas en pacientes con quemaduras

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María del Carmen Franco Mora

2015-10-01

Full Text Available Se realizó un estudio comparativo, longitudinal y prospectivo de 60 adultos con quemaduras profundas, atendidos en el Hospital General docente "Dr. Juan Bruno Zayas Alfonso" de Santiago de Cuba, desde febrero de 2013 hasta igual mes de 2014, para evaluar la efectividad de la terapia regenerativa con plasma rico en plaquetas para la cicatrización de estas lesiones. La muestra fue dividida en 2 grupos de 30 integrantes cada uno: a los del primero se les aplicó plasma rico en plaquetas y a los del segundo sulfadiazina de plata. Se utilizaron las frecuencias absolutas y el porcentaje como medidas de resumen para variables cualitativos, así como la media aritmética y la desviación estándar para las cuantitativas. Con el proceder aplicado la cicatrización se completó en un tiempo menor, de manera que se demostró la efectividad de esta alternativa terapéutica en relación con el tratamiento convencional

Reflex muscle contraction in anterior shoulder instability.

Science.gov (United States)

Wallace, D A; Beard, D J; Gill, R H; Eng, B; Carr, A J

1997-01-01

Reduced proprioception may contribute to recurrent anterior shoulder instability. Twelve patients with unilateral shoulder instability were investigated for evidence of deficient proprioception with an activated pneumatic cylinder and surface electromyography electrodes; the contralateral normal shoulder was used as a control. The latency between onset of movement and the detection of muscle contraction was used as an index of proprioception. No significant difference in muscle contraction latency was detected between the stable and unstable shoulders, suggesting that there was no significant defect in muscular reflex activity. This study does not support the use proprioception-enhancing physiotherapy in the treatment of posttraumatic anterior shoulder instability.

A conservative approach for restoring anterior guidance: a case report.

Science.gov (United States)

Pontons-Melo, Juan Carlos; Pizzatto, Eduardo; Furuse, Adilson Yoshio; Mondelli, José

2012-06-01

One of the most common dental problems in today's clinics is tooth wear, specifically when related to bruxism. In such cases, the esthetics of anterior teeth may be compromised when excessive wear to the incisal surfaces occurs. Anterior tooth wear resulting from parafunctional bruxism can be conservatively treated with the use of direct resin composite restorations. This restorative approach has the advantages of presenting good predictability, load resistance, acceptable longevity, preservation of healthy dental tissues, and lower cost when compared with indirect restorations. The use of resin composites to solve esthetic problems, however, requires skill and practice. Thus, the present article demonstrates a conservative approach for restoring the esthetics and function of worn anterior teeth with the aid of direct resin composite restorations and selective occlusal adjustment. A conservative approach to restore anterior teeth with excessive wear is possible with direct resin composites. © 2011 Wiley Periodicals, Inc.

A Rare Case of Neglected Traumatic Anterior Dislocation of Hip in a Child.

Science.gov (United States)

Mootha, Aditya Krishna; Mogali, Kasi Viswanadam

2016-01-01

Post traumatic hip dislocations are very rare in children. Neglected anterior hip dislocations in children are not described in literature so far. Here, we present a case of 6 weeks old anterior hip dislocation successfully managed by open reduction. A 9-year-old male child presented with neglected anterior hip dislocation on left side. Open reduction carried out through direct anterior approach to hip. Congruent reduction is achieved. At final follow up of 1 year, the child had unrestricted activities of daily living and no radiological signs of osteonecrosis or any joint space reduction. There is paucity of literature over neglected post traumatic anterior hip dislocations in children. The treatment options vary from closed reduction after heavy traction to sub trochanteric osteotomy. However, we feel that open reduction through direct anterior approach is the preferred mode of management whenever considered possible.

Estudio electrofisiológico de la funcion neuromuscular en una poblacion intoxicada con plomo

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O. M. Genovese

1988-03-01

Full Text Available Un grupo de 12 pacientes con cifras elevadas de plombemia y disminuidas de ALA D fueron estudiados electrofisiológicamente. Se efectuaron las siguientes determinaciones: amplitud de potencial evocado muscular; latencia distal motora; velocidad de conducción motora en los nervios mediano, ciático poplíteo externo y radial; velocidad de conducción sensitiva y amplitud del potencial evocado sensitivo de nervio en el mediano; exploración electromiográfica convencional; estudio de la transmisión neuromuscular, mediante estimulación repetitiva del nervio ciático popliteo externo a diversas frecuencias, con registro de la amplitud del potencial en músculo tibial anterior. Los datos obtenidos fueron comparados con controles. Se buscaron correlaciones entre las determinaciones bioquímicas y los diferentes hallazgos electrofisiológicos que a su vez se correlacionaron entre si y también con el tiempo de evolución de la intoxicación. Los hallazgos pusieron de manifiesto la presencia de neuropatía axonal junto a moderada desmielinización. La exploración de la transmisión neuromuscular mostró ocasional decremento o incremento de la amplitud del potencial muscular evocado, hechos que suponen cierta participación de la unión neuromuscular. Se halló correlación solamente entre disminución de ALA D y la disminución de las amplitudes del potencial sensitivo del mediano y el evocado muscular del mismo nervio y con la disminución de la VCM del nervio radial. Una débil relación se observó entre el tiempo de exposición y la disminución de la VCS del nervio mediano y VCM del radial. Las determinaciones bioquímicas y el tiempo de exposición transcurridos no probaron ser parámetros sensibles para determinar el grado de afectación del sistema nervioso periférico. El conjunto do hallazgos sugiere que el desarrollo de la neuropatía puede estar ligado a factores individuales de predisposición al daño nervioso.

Prevalence and factors associated with anterior open bite in 2 to 5 ...

African Journals Online (AJOL)

Prevalence and factors associated with anterior open bite in 2 to 5 year old children in Benin city, Nigeria. ... Background: Anterior open bite is said to exist when there is an actual vertical gap between the upper and lower incisors with the teeth in centric occlusion. This could occur in the anterior or posterior region, and may ...

Endothelial cell density after deep anterior lamellar keratoplasty (Melles technique)

NARCIS (Netherlands)

Van Dooren, BTH; Mulder, PGH; Nieuwendaal, CP; Beekhuis, WH; Melles, GRJ

PURPOSE: To measure the recipient endothelial cell loss after the Melles technique for deep anterior lamellar keratoplasty. METHODS: In 21 eyes of 21 patients, a deep anterior lamellar keratoplasty procedure was performed. Before surgery and at 6, 12, and 24 months after surgery, specular microscopy

RadConEd: A Graphical Data Editor for the Radiological Consequences Model, RadCon

International Nuclear Information System (INIS)

Crawford, J.; Domel, R.U.

2000-05-01

This document describes the application, RadConEd, which has been designed and implemented to enable users of the RadCon system to update these parameter files. The RadCon system is written in the Java programming language, and as such provides portability across computer platforms. The software described in this report was developed in line with the portability requirements of RadCon, thus providing a uniform user interface across computer platforms and bypassing the need of using system editors. In addition a number of data integrity measures were implemented

Right bundle branch block and anterior wall ST elevation myocardial infarction.

Science.gov (United States)

Trofin, Monica; Israel, Carsten W; Barold, S Serge

2017-09-01

We report the case of an acute anterior wall ST elevation myocardial infarction with new left anterior fascicular block and pre-existing right bundle branch block. Due to a wide right bundle branch block, no ST segment elevation was visible in lead V1. The left anterior fascicular block was caused by proximal occlusion of the left artery descending and disappeared after acute revascularization. However, also the R' of the right bundle branch block became significantly shorter after revascularization, dismanteling a minor ST segment elevation. The ST elevation in lead V1 in anterior wall infarction and right bundle branch block may merge with the R' and cause a further QRS widening as an "equivalent" to the ST elevation.

Bilateral agenesis of the anterior cruciate ligament: MRI evaluation

Energy Technology Data Exchange (ETDEWEB)

Bedoya, Maria A.; Jaramillo, Diego [The Children' s Hospital of Philadelphia, Radiology Department, Philadelphia, PA (United States); McGraw, Michael H. [Hospitalof theUniversityof Pennsylvania, Divisionof Orthopaedics, Philadelphia, PA (United States); Wells, Lawrence [The Children' s Hospital of Philadelphia, Division of Orthopaedics, Philadelphia, PA (United States)

2014-09-15

Bilateral agenesis of the anterior cruciate ligament (ACL) is extremely rare. We describe a 13-year-old girl who presented with bilateral knee pain without history of trauma; she has two family members with knee instability. Magnetic resonance imaging showed bilateral absence of the ACL, and medial posterior horn meniscal tears. Bilateral arthroscopic partial meniscectomy and anterior cruciate ligament reconstruction was performed. (orig.)

The effect of anterior proton beams in the setting of a prostate-rectum spacer

Energy Technology Data Exchange (ETDEWEB)

Christodouleas, John P., E-mail: christojo@uphs.upenn.edu [Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA (United States); Tang, Shikui [Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA (United States); Susil, Robert C.; McNutt, Todd R.; Song, Danny Y. [Department of Radiation Oncology and Radiation Molecular Sciences, Johns Hopkins Hospital, Baltimore, MD (United States); Bekelman, Justin; Deville, Curtiland; Vapiwala, Neha [Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA (United States); DeWeese, Theodore L. [Department of Radiation Oncology and Radiation Molecular Sciences, Johns Hopkins Hospital, Baltimore, MD (United States); Lu, Hsiao-Ming [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Both, Stefan [Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA (United States)

2013-10-01

Studies suggest that anterior beams with in vivo range verification would improve rectal dosimetry in proton therapy for prostate cancer. We investigated whether prostate-rectum spacers would enhance or diminish the benefits of anterior proton beams in these treatments. Twenty milliliters of hydrogel was injected between the prostate and rectum of a cadaver using a transperineal approach. Computed tomography (CT) and magnetic resonance (MR) images were used to generate 7 uniform scanning (US) and 7 single-field uniform dose pencil-beam scanning (PBS) plans with different beam arrangements. Pearson correlations were calculated between rectal, bladder, and femoral head dosimetric outcomes and beam arrangement anterior scores, which characterize the degree to which dose is delivered anteriorly. The overall quality of each plan was compared using a virtual dose-escalation study. For US plans, rectal mean dose was inversely correlated with anterior score, but for PBS plans there was no association between rectal mean dose and anterior score. For both US and PBS plans, full bladder and empty bladder mean doses were correlated with anterior scores. For both US and PBS plans, femoral head mean doses were inversely correlated with anterior score. For US plans and a full bladder, 4 beam arrangements that included an anterior beam tied for the highest maximum prescription dose (MPD). For US plans and an empty bladder, the arrangement with 1 anterior and 2 anterior oblique beams achieved the highest MPD in the virtual dose-escalation study. The dose-escalation study did not differentiate beam arrangements for PBS. All arrangements in the dose-escalation study were limited by bladder constraints except for the arrangement with 2 posterior oblique beams. The benefits of anterior proton beams in the setting of prostate-rectum spacers appear to be proton modality dependent and may not extend to PBS.

The effect of anterior proton beams in the setting of a prostate-rectum spacer

Science.gov (United States)

Christodouleas, John P.; Tang, Shikui; Susil, Robert C.; McNutt, Todd R.; Song, Danny Y.; Bekelman, Justin; Deville, Curtiland; Vapiwala, Neha; DeWeese, Theodore L.; Lu, Hsiao-Ming; Both, Stefan

2014-01-01

Studies suggest that anterior beams with in vivo range verification would improve rectal dosimetry in proton therapy for prostate cancer. We investigated whether prostate-rectum spacers would enhance or diminish the benefits of anterior proton beams in these treatments. Twenty milliliters of hydrogel was injected between the prostate and rectum of a cadaver using a transperineal approach. Computed tomography (CT) and magnetic resonance (MR) images were used to generate 7 uniform scanning (US) and 7 single-field uniform dose pencil-beam scanning (PBS) plans with different beam arrangements. Pearson correlations were calculated between rectal, bladder, and femoral head dosimetric outcomes and beam arrangement anterior scores, which characterize the degree to which dose is delivered anteriorly. The overall quality of each plan was compared using a virtual dose-escalation study. For US plans, rectal mean dose was inversely correlated with anterior score, but for PBS plans there was no association between rectal mean dose and anterior score. For both US and PBS plans, full bladder and empty bladder mean doses were correlated with anterior scores. For both US and PBS plans, femoral head mean doses were inversely correlated with anterior score. For US plans and a full bladder, 4 beam arrangements that included an anterior beam tied for the highest maximum prescription dose (MPD). For US plans and an empty bladder, the arrangement with 1 anterior and 2 anterior oblique beams achieved the highest MPD in the virtual dose-escalation study. The dose-escalation study did not differentiate beam arrangements for PBS. All arrangements in the dose-escalation study were limited by bladder constraints except for the arrangement with 2 posterior oblique beams. The benefits of anterior proton beams in the setting of prostate-rectum spacers appear to be proton modality dependent and may not extend to PBS. PMID:23578497

Consideraciones sobre la administración de proyectos de desarrollo de software, con ciclo de vida ágil, en el contexto costarricense

Directory of Open Access Journals (Sweden)

Anayansie Fallas Badilla

2011-10-01

Full Text Available En Costa Rica, la adopción de metodologías ágiles para el desarrollo de software ha traído consigo nuevas interrogantes para los administradores de proyectos: ¿cómo planificar este tipo de proyectos?, ¿cómo darles control y seguimiento en su ejecución? ¿cuáles competencias son las deseables para quienes tengan que administrar este tipo de proyectos? Este artículo presenta un marco teórico al respecto, da un panorama general del desarrollo de software en Costa Rica y del profesional en tecnologías de la información con que cuenta el país, y a partir de lo anterior enumera una serie de consideraciones que puedan servir como guía para quien requiera administrar proyectos de desarrollo de software con este tipo de metodología en el contexto costarricense.

Anterior Colporrhaphy Technique and Approach Choices: Turkey Evaluation

Directory of Open Access Journals (Sweden)

Serdar Aydın

2016-09-01

Full Text Available Aim: To evaluate the diversity in techniques and approaches for anterior colporrhaphy among operators in Turkey. Methods: A survey evaluating the preoperative examination, technique of anterior colporrhaphy, operation choice and postoperative care was presented to surgeons. We contacted via directly, mail or telephone. We used 28 item questionnaire. Results: Majority (87.9% was composed of young gynecologists. Urologists composed of the 9.5% of the study population. The rate of paravaginal defect evaluation was 75.9% and mostly by inspection the presence of vaginal rugae. The use of transperineal 3D pelvic floor ultrasonography was low (5.7%. The evaluation of levator ani muscle defect was 46.6%. The usage of the transperineal 3D ultrasonography for levator ani muscle defect was 19 percent of operators. There were diversity in use of hydrodissection, fascial plication, excision of vaginal mucosa and suture choice. Usage of mesh for anterior colporrhaphy was limited (17.8% and mostly in recurrent cases (12.2%. Paravaginal defect repair rate was 31.9%. The urinary catheter was generally removed one or two day after operation. Vaginal pack usually removed 24 hours after. Conclusion: Several techniques and approaches for anterior vaginal wall repair among operators in Turkey. The variety of techniques suggested that there is no consensus on best surgical technique.

Anterior chest wall examination reviewed

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F. Trotta

2011-09-01

Full Text Available Anterior chest wall involvement is not infrequently observed within inflammatory arthropaties, particularly if one considers seronegative spondiloarthritides and SAPHO syndrome. Physical examination is unreliable and conventional X-rays analysis is an unsatisfactory tool during diagnostic work-up of this region. Scintigraphic techniques yield informations both on the activity and on the anatomical extent of the disease while computerized tomography visualize the elementary lesions, such as erosions, which characterize the process. Moreover, when available, magnetic resonance imaging couple the ability to finely visualize such lesions with the possibility to show early alterations and to characterize the “activity” of the disease, presenting itself as a powerful tool both for diagnosis and follow-up. This review briefly shows the applications of imaging techniques for the evaluation of the anterior chest wall focusing on what has been done in the SAPHO syndrome which can be considered prototypical for this regional involvement since it is the osteo-articular target mainly affected by the disease.

Calidad de vida, satisfacción con el tratamiento y bienestar emocional en pacientes con diabetes LADA

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Granado Casas, Minerva

2014-01-01

Introducción: La calidad de vida, satisfacción con el tratamiento y bienestar emocional en pacientes con diabetes mellitus están relacionados con el control metabólico, las complicaciones y algunas variables socioeconómicas. Actualmente, no existe ningún estudio científico que analice la calidad de vida, satisfacción con el tratamiento y bienestar emocional en pacientes con diabetes LADA. Objetivos: Los objetivos principales fueron conocer la calidad de vida, satisfacción con el tratamient...

Endothelial cell density after deep anterior lamellar keratoplasty (Melles technique)

NARCIS (Netherlands)

van Dooren, Bart T. H.; Mulder, Paul G. H.; Nieuwendaal, Carla P.; Beekhuis, W. Houdijn; Melles, Gerrit R. J.

2004-01-01

To measure the recipient endothelial cell loss after the Melles technique for deep anterior lamellar keratoplasty. In 21 eyes of 21 patients, a deep anterior lamellar keratoplasty procedure was performed. Before surgery and at 6, 12, and 24 months after surgery, specular microscopy was performed to

Single-stage anterior high sacrectomy for locally recurrent rectal cancer.

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Fawaz, Khaled; Khaled, Fawaz; Smith, Myles J; Moises, Cukier; Smith, Andrew J; Yee, Albert J M

2014-03-01

A review of prospectively collected data on a consecutive series of patients undergoing single-stage anterior high sacrectomy for locally recurrent rectal carcinoma (LRRC). To determine the clinical outcome of patients who underwent anterior high sacrectomy for LRRC. High sacrectomy for oncological resection remains technically challenging. Surgery has the potential to achieve cure in carefully selected patients. Complete (R0) tumor excision in LRRC may require sacrectomy. High sacral resections (S3 and above) typically require a combined anterior/supine and posterior/prone procedure. We investigated our experience performing single-stage anterior high sacrectomy for LRRC. A consecutive series of patients with LRRC without systemic metastases who underwent resection with curative intent requiring high sacrectomy were identified. A review of a prospectively maintained colorectal and spine cancer database data was performed. An oblique dome high sacral osteotomy was performed during a single-stage anterior procedure. Outcome measures included surgical resection margin status, hospital length of stay, postoperative complications, physical functioning status, and overall survival. Nineteen consecutive patients were treated between 2002 and 2011. High sacrectomy was performed at sacral level S1-S2 in 4 patients, S2-S3 in 9 patients, and through S3 in 6 patients. An R0 resection margin was achieved histologically in all 19 cases. There was 1 early (<30 d) postoperative death (1/19, 5%). At median follow-up of 38 months, 13 patients had no evidence of residual disease, 1 was alive with disease, and 4 had died of disease. Morbidities occurred in 15 of the 19 patients (79%). Although high sacrectomy may require a combined anterior and posterior surgical approach, our series demonstrates the feasibility of performing single-stage anterior high sacrectomy in LRRC, with acceptable risks and outcomes compared with the literature. The procedure described by us for LRRC lessens

Multiparametric MRI of the anterior prostate gland: clinical–radiological–histopathological correlation

International Nuclear Information System (INIS)

Moosavi, B.; Flood, T.A.; Al-Dandan, O.; Breau, R.H.; Cagiannos, I.; Morash, C.; Malone, S.C.; Schieda, N.

2016-01-01

Anterior prostate cancer (APC) is defined as a tumour in which more than half of malignant tissue is located anterior to the urethra. APCs are increasingly recognized as clinically important, particularly in patients undergoing active surveillance and for patients with negative non-targeted systematic transrectal ultrasound (TRUS)-guided biopsies but with persistent clinical suspicion of cancer. Multiparametric (mp) MRI has a crucial role for the diagnosis of anterior tumours, eventual histological sampling of suspicious lesions using image-guided targeted biopsy techniques, and potentially, to improve local staging of disease. mpMRI is accurate for the detection of APC and for differentiation of tumour from other anterior prostatic structures including benign prostatic hyperplasia (BPH) and the anterior fibromuscular stroma (AFMS). Characterization and reporting of APC should rely on the recently revised Prostate Imaging and Data Reporting System (PI-RADS) version 2.0 document. T2-weighted (T2W) imaging is emphasized as the determining sequence for assessment of the anterior prostate and specific features for APC on T2W imaging include: ill-defined/spiculated margin, lenticular shape, anterior/inferior location, and growth pattern (invasion of urethra or AFMS and crossing midline). Functional imaging, mainly with diffusion-weighted imaging, is also contributory and improves the sensitivity for detection of APC compared to T2W imaging alone. APCs commonly show positive surgical margins after radical prostatectomy and staging of disease extent using conventional clinical parameters is limited. mpMRI may have a future role to improve local staging of APC. This review illustrates the importance of mpMRI in APC using a clinical–radiological–histopathological approach.

Sacral nerve stimulation can be an effective treatment for low anterior resection syndrome.

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Eftaiha, S M; Balachandran, B; Marecik, S J; Mellgren, A; Nordenstam, J; Melich, G; Prasad, L M; Park, J J

2017-10-01

Sacral nerve stimulation has become a preferred method for the treatment of faecal incontinence in patients who fail conservative (non-operative) therapy. In previous small studies, sacral nerve stimulation has demonstrated improvement of faecal incontinence and quality of life in a majority of patients with low anterior resection syndrome. We evaluated the efficacy of sacral nerve stimulation in the treatment of low anterior resection syndrome using a recently developed and validated low anterior resection syndrome instrument to quantify symptoms. A retrospective review of consecutive patients undergoing sacral nerve stimulation for the treatment of low anterior resection syndrome was performed. Procedures took place in the Division of Colon and Rectal Surgery at two academic tertiary medical centres. Pre- and post-treatment Cleveland Clinic Incontinence Scores and Low Anterior Resection Syndrome scores were assessed. Twelve patients (50% men) suffering from low anterior resection syndrome with a mean age of 67.8 (±10.8) years underwent sacral nerve test stimulation. Ten patients (83%) proceeded to permanent implantation. Median time from anterior resection to stimulator implant was 16 (range 5-108) months. At a median follow-up of 19.5 (range 4-42) months, there were significant improvements in Cleveland Clinic Incontinence Scores and Low Anterior Resection Syndrome scores (P syndrome and may therefore be a viable treatment option. Colorectal Disease © 2017 The Association of Coloproctology of Great Britain and Ireland.

MR imaging of the anatomy of the anterior horn of the medial meniscus.

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De Coninck, Tineke; Vanrietvelde, Frederik; Seynaeve, Patrick; Verdonk, Peter; Verstraete, Koenraad

2017-04-01

Background In cadaveric and arthroscopic studies different insertion locations of the anterior horn of the medial meniscus (AHMM) have been described. Purpose To investigate if the different insertion locations of the AHMM, as described in cadaveric studies, can be determined on magnetic resonance imaging (MRI). Material and Methods MR images of 100 patients without meniscal tears on MRI were retrospectively evaluated. Two observers classified the AHMM insertion based on its position relative to the anterior tibial edge and the medial tibial spine. The association between AHMM insertion and tibial plateau slope, meniscal radial displacement, and anterior intermeniscal ligament (AIL) presence was investigated. Results The AHMM inserted posterior to the anterior tibial edge in 93 knees and anterior to the tibial edge in seven knees (= type III). Of the 93 knees with AHMM insertion posterior to the anterior tibial edge, 63 inserted lateral to the medial tibial spine (= type I) and 30 medial (= type II). The AHMMs inserting anterior to the tibial edge had a significantly ( P  0.05). A strong inter- and intra-observer agreement was observed. Conclusion Three different bony insertion locations of the AHMM, as described in cadaveric studies, could be identified on MRI. All AHMMs inserting anterior to the tibial edge displayed an AIL. Whether there is a clinical correlation with these insertion patterns remains unclear.

Salud y autocuidado en madres de niños con hemofilia: estudio de casos

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Leonor Rodríguez Estrada

2011-12-01

Full Text Available Este artículo describe los hallazgos del estudio “Intervención en autocuidado para cuidadoras primarias del Grupo de Madres” de la Asociación Costarricense de Hemofilia, una intervención desde la Psicología de la Salud. El estudio se realizó con N = 8 mujeres de la asociación entre los 21 y 56 años de edad. Tuvo un diseño pre prueba-post prueba (ABA, en el cual se hizo un diagnostico del estado de salud con n = 4 mujeres anterior y posterior a la intervención. Esta consistió en ocho sesiones donde se abordaron temas como autocuidado, autoestima, técnicas de relajación, nutrición, actividad física, expresión emocional, comunicación asertiva y maternidad en hemofilia, entre otros. Uno de los hallazgos principales de esta intervención es la posible relación que existe entre la salud de las mujeres y su rol de género: la hemofilia, al ser una enfermedad hereditaria, en la mayoría de los casos conlleva una responsabilidad que se asocia con la madre como portadora del gen recesivo, lo cual se convierte en una especie de “culpa inconsciente”. La maternidad para estas mujeres demanda un grado de perfección y de exigencia muy alto, porque la hemofilia se percibe como un “fracaso propio” de ellas como mujeres y madres y parece implicar que no es posible cometer más errores. Esta exigencia conlleva un alto nivel de sacrificio personal para estas mujeres lo cual repercute en su salud y se manifiesta de diferentes maneras como carencia de redes de apoyo, con estilos de vida sedentarios, depresión y enfermedades crónicas. La enfermedad del “otro” se vuelve propia y se manifiesta como “autocastigo”.

Anterior capsulotomy with an ultrashort-pulse laser.

Science.gov (United States)

Tackman, Ramon Naranjo; Kuri, Jorge Villar; Nichamin, Louis D Skip; Edwards, Keith

2011-05-01

To assess the precision of laser anterior capsulotomy compared with that of manual continuous curvilinear capsulorhexis (CCC). Asociación Para Evitar La Ceguera en México IAP, Hospital Dr. Luis Sánchez Bulnes, Mexico City, Mexico. Nonrandomized single-center clinical trial. In patients presenting for cataract surgery, the LensAR Laser System was used to create a laser anterior capsulotomy of the surgeon's desired size. Capsule buttons were retrieved and measured and then compared with buttons retrieved from eyes having a manually torn CCC. Deviation from the intended diameter and the regularity of shape were assessed. When removing the capsule buttons at the start of surgery, the surgeon rated the ease of removal on a scale of 1 to 10 (1 = required manual capsulorhexis around the whole diameter; 10 = button free floating or required no manual detachment from remaining capsule during removal). The mean deviation from the intended diameter was 0.16 mm ± 0.17 (SD) for laser anterior capsulotomy and 0.42 ± 0.54 mm for CCC (P=.03). The mean absolute deviation from the intended diameter was 0.20 ± 0.12 mm and 0.49 ± 0.47 mm, respectively (P=.003). The mean of the average squared residuals was 0.01 ± 0.03 and 0.02 ± 0.04, respectively (P=.09). The median rating of the ease of removal was 9 (range 5 to 10). Laser anterior capsulotomy created a more precise capsule opening than CCC, and the buttons created by the laser procedure were easy to remove at the beginning of cataract surgery. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Diagnosis and treatment of anterior uveitis: optometric management

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Harthan JS

2016-03-01

Full Text Available Jennifer S Harthan,1 Dominick L Opitz,2 Stephanie R Fromstein,1 Christina E Morettin3 1Cornea Center for Clinical Experience, 2Ophthalmology Services and Practice Development, 3Urgent Eye Care Service, Illinois College of Optometry, Chicago, IL, USA Abstract: Anterior uveitis encompasses inflammation of the iris and/or ciliary body and is one of the most common types of ocular inflammation that primary eye care practitioners will encounter. Anterior uveitis may be caused by a variety of etiologies, including infectious, noninfectious, and masquerade diseases. The short-term and long-term treatment of uveitis should include the evaluation of location, duration, pathology, and laterality, in addition to presenting signs and symptoms of the disease. A complete review of systems, thorough examination, and laboratory testing, may assist the practitioner in narrowing the list of possible causes for the uveitis. This is imperative as once a list of diagnoses has been made, a targeted approach to treatment can be pursued. Keywords: anterior uveitis, iritis, inflammation

Anterior transposition of the radial nerve--a cadaveric study.

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Yakkanti, Madhusudhan R; Roberts, Craig S; Murphy, Joshua; Acland, Robert D

2008-01-01

The radial nerve is at risk during the posterior plating of the humerus. The purpose of this anatomic study was to assess the extent of radial nerve dissection required for anterior transposition through the fracture site (transfracture anterior transposition). A cadaver study was conducted approaching the humerus by a posterior midline incision. The extent of dissection of the nerve necessary for plate fixation of the humerus fracture was measured. An osteotomy was created to model a humeral shaft fracture at the spiral groove (OTA classification 12-A2, 12-A3). The radial nerve was then transposed anterior to the humeral shaft through the fracture site. The additional dissection of the radial nerve and the extent of release of soft tissue from the humerus shaft to achieve the transposition were measured. Plating required a dissection of the radial nerve 1.78 cm proximal and 2.13 cm distal to the spiral groove. Transfracture anterior transposition of the radial nerve required an average dissection of 2.24 cm proximal and 2.68 cm distal to the spiral groove. The lateral intermuscular septum had to be released for 2.21 cm on the distal fragment to maintain laxity of the transposed nerve. Transfracture anterior transposition of the radial nerve before plating is feasible with dissection proximal and distal to the spiral groove and elevation of the lateral intermuscular septum. Potential clinical advantages of this technique include enhanced fracture site visualization, application of broader plates, and protection of the radial nerve during the internal fixation.

Evaluation of the anterior chamber angle in pseudoexfoliation syndrome.

Science.gov (United States)

Iwanejko, Małgorzata; Turno-Kręcicka, Anna; Tomczyk-Socha, Martyna; Kaczorowski, Kamil; Grzybowski, Andrzej; Misiuk-Hojło, Marta

2017-08-01

Pseudoexfoliation syndrome (PEX) is the most frequently identifiable cause of secondary open-angle glaucoma, known as pseudoexfoliation glaucoma. The exact pathophysiology and etiology of PEX and associated glaucoma remains obscure. The purpose of this study was to determine the differences in the morphology of the anterior chamber angle in people with pseudoexfoliation syndrome and pseudoexfoliation glaucoma compared to a control group. We also evaluated the correlation between intraocular pressure (IOP) and pigmentation of the angle with the amount of exfoliated material in the anterior segment. The study group was composed of 155 eyes from 103 patients aged between 43 and 86 years. Each patient underwent a complete ophthalmological examination. Some difference was found in intraocular pressure between the PEX group and the control group and between the pseudoexfoliation glaucoma group and the control group, but no significant difference was found between the 2 study groups. There was a significant difference in the incidence of some degree of pigmentation in the anterior chamber angle and no difference in the widths of the angle between each group. A significant positive relationship was observed between intraocular pressure and the degree of pigmentation of the anterior chamber angle in both the PEX group and the pseudoexfoliation glaucoma group. The results of this study indicate that the amount of pigmentation and exfoliation material in the anterior segment significantly correlates with the level of IOP and possibly with the degree of trabecular dysfunction. It seems that for clear identification of PEX and pseudoexfoliation glaucoma factors, clinical assessment appears to be insufficient.

CT evaluation of the anterior epitympanic recess

International Nuclear Information System (INIS)

Yamasoba, Tatsuya; Kikuchi, Shigeru; Takeuchi, Naonobu; Harada, Takehiko; Nomura, Yasuya

1991-01-01

The structures of the anterior epitympanic recess and its surrounding tissues were examined among non-inflammatory ear, chronic otitis media with central perforation and cholesteatoma, using axial scans of high resolution computed tomography. The length and width of the recess, as well as the number of the slices where the cog was determined, had no significant differences among them. Thus, the bony structure of the recess was considered to be seldom influenced by inflammatory processes. In the non-inflammatory ear, the degree of pneumatization around the recess was similar to that of the petrous apex cells and lower than that of the mastoid cells. In the chronic otitis media with central perforation and cholesteatoma, the pneumatization of the whole temporal bones was suppressed and the tendency was also found that the cells around the recess were less pneumatized than the mastoid cells. When cholesteatoma invaded into the anterior epitympanic recess, the destruction of the bony protrusion of the lateral wall between the recess and the epitympanum was recognized, as well as the disappearance of the cog. The bony protrusion was considered to be an inferior extention of the cog toward the anterior tympanic spine. (author)

A Review on Biomechanics of Anterior Cruciate Ligament and Materials for Reconstruction

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Marieswaran, M.; Jain, Ishita; Garg, Bhavuk; Sharma, Vijay

2018-01-01

The anterior cruciate ligament is one of the six ligaments in the human knee joint that provides stability during articulations. It is relatively prone to acute and chronic injuries as compared to other ligaments. Repair and self-healing of an injured anterior cruciate ligament are time-consuming processes. For personnel resuming an active sports life, surgical repair or replacement is essential. Untreated anterior cruciate ligament tear results frequently in osteoarthritis. Therefore, understanding of the biomechanics of injury and properties of the native ligament is crucial. An abridged summary of the prominent literature with a focus on key topics on kinematics and kinetics of the knee joint and various loads acting on the anterior cruciate ligament as a function of flexion angle is presented here with an emphasis on the gaps. Briefly, we also review mechanical characterization composition and anatomy of the anterior cruciate ligament as well as graft materials used for replacement/reconstruction surgeries. The key conclusions of this review are as follows: (a) the highest shear forces on the anterior cruciate ligament occur during hyperextension/low flexion angles of the knee joint; (b) the characterization of the anterior cruciate ligament at variable strain rates is critical to model a viscoelastic behavior; however, studies on human anterior cruciate ligament on variable strain rates are yet to be reported; (c) a significant disparity on maximum stress/strain pattern of the anterior cruciate ligament was observed in the earlier works; (d) nearly all synthetic grafts have been recalled from the market; and (e) bridge-enhanced repair developed by Murray is a promising technique for anterior cruciate ligament reconstruction, currently in clinical trials. It is important to note that full extension of the knee is not feasible in the case of most animals and hence the loading pattern of human ACL is different from animal models. Many of the published reviews on

hmmr mediates anterior neural tube closure and morphogenesis in the frog Xenopus.

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Prager, Angela; Hagenlocher, Cathrin; Ott, Tim; Schambony, Alexandra; Feistel, Kerstin

2017-10-01

Development of the central nervous system requires orchestration of morphogenetic processes which drive elevation and apposition of the neural folds and their fusion into a neural tube. The newly formed tube gives rise to the brain in anterior regions and continues to develop into the spinal cord posteriorly. Conspicuous differences between the anterior and posterior neural tube become visible already during neural tube closure (NTC). Planar cell polarity (PCP)-mediated convergent extension (CE) movements are restricted to the posterior neural plate, i.e. hindbrain and spinal cord, where they propagate neural fold apposition. The lack of CE in the anterior neural plate correlates with a much slower mode of neural fold apposition anteriorly. The morphogenetic processes driving anterior NTC have not been addressed in detail. Here, we report a novel role for the breast cancer susceptibility gene and microtubule (MT) binding protein Hmmr (Hyaluronan-mediated motility receptor, RHAMM) in anterior neurulation and forebrain development in Xenopus laevis. Loss of hmmr function resulted in a lack of telencephalic hemisphere separation, arising from defective roof plate formation, which in turn was caused by impaired neural tissue narrowing. hmmr regulated polarization of neural cells, a function which was dependent on the MT binding domains. hmmr cooperated with the core PCP component vangl2 in regulating cell polarity and neural morphogenesis. Disrupted cell polarization and elongation in hmmr and vangl2 morphants prevented radial intercalation (RI), a cell behavior essential for neural morphogenesis. Our results pinpoint a novel role of hmmr in anterior neural development and support the notion that RI is a major driving force for anterior neurulation and forebrain morphogenesis. Copyright © 2017 Elsevier Inc. All rights reserved.

Unilateral hypoplasia with contralateral hypertrophy of anterior belly of digastric muscle: a case report.

Science.gov (United States)

Ochoa-Escudero, Martin; Juliano, Amy F

2016-10-01

Anomalies of the anterior belly of the digastric muscle (DM) are uncommon. We present a case of hypoplasia of the anterior belly of the left DM with hypertrophy of the anterior belly of the contralateral DM. The importance of recognizing this finding is to differentiate hypoplasia of the anterior belly of the DM from denervation atrophy, and not to confuse contralateral hypertrophy with a submental mass or lymphadenopathy. In denervation atrophy of the anterior belly of the DM, associated atrophy of the ipsilateral mylohyoid muscle is present. Hypertrophy of the anterior belly of the contralateral DM can be differentiated from a submental mass or lymphadenopathy by recognizing its isodensity on computed tomography and isointensity on magnetic resonance imaging to other muscles, without abnormal contrast enhancement.

Anterior cingulate cortex surface area relates to behavioral inhibition in adolescents with and without heavy prenatal alcohol exposure.

Science.gov (United States)

Migliorini, Robyn; Moore, Eileen M; Glass, Leila; Infante, M Alejandra; Tapert, Susan F; Jones, Kenneth Lyons; Mattson, Sarah N; Riley, Edward P

2015-10-01

Prenatal alcohol exposure is associated with behavioral disinhibition, yet the brain structure correlates of this deficit have not been determined with sufficient detail. We examined the hypothesis that the structure of the anterior cingulate cortex (ACC) relates to inhibition performance in youth with histories of heavy prenatal alcohol exposure (AE, n = 32) and non-exposed controls (CON, n = 21). Adolescents (12-17 years) underwent structural magnetic resonance imaging yielding measures of gray matter volume, surface area, and thickness across four ACC subregions. A subset of subjects were administered the NEPSY-II Inhibition subtest. MANCOVA was utilized to test for group differences in ACC and inhibition performance and multiple linear regression was used to probe ACC-inhibition relationships. ACC surface area was significantly smaller in AE, though this effect was primarily driven by reduced right caudal ACC (rcACC). AE also performed significantly worse on inhibition speed but not on inhibition accuracy. Regression analyses with the rcACC revealed a significant group × ACC interaction. A smaller rcACC surface area was associated with slower inhibition completion time for AE but was not significantly associated with inhibition in CON. After accounting for processing speed, smaller rcACC surface area was associated with worse (i.e., slower) inhibition regardless of group. Examining processing speed independently, a decrease in rcACC surface area was associated with faster processing speed for CON but not significantly associated with processing speed in AE. Results support the theory that caudal ACC may monitor reaction time in addition to inhibition and highlight the possibility of delayed ACC neurodevelopment in prenatal alcohol exposure. Copyright © 2015 Elsevier B.V. All rights reserved.

Three-dimensional bone kinematics in an anterior laxity test of the ankle joint

NARCIS (Netherlands)

Kerkhoffs, G.; Blankevoort, L.; Kingma, I.; van Dijk, C.N.

2007-01-01

Questions addressed in this in-vitro study are (1) what are the actual three-dimensional kinematics of talus and calcaneus during an anterior drawer test as performed with the quasi-static anterior ankle tester (QAAT) (2) does laxity measurement with the QAAT represent the true anterior translation

Vocal characteristics of congenital anterior glottic webs in children: A case report.

Science.gov (United States)

Shah, Jay; White, Katherine; Dohar, Joseph

2015-06-01

This case report describes a 5-year-old girl with chronic dysphonia and high-pitched voice since birth. Vocal quality was noted to be harsh. Videostroboscopy revealed significant hyperfunction and a Type II congenital anterior glottic web. Endoscopic division of the anterior glottic web was performed with significant improvement in vocal quality and quality of life. This paper describes methods of analyzing, diagnosing, and treating anterior glottic web with a focus on quality of life. Also, unique acoustic and aerodynamic voice features are identified. No other descriptions of a voice characteristic for anterior glottic web currently exist in the literature. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Mastopexia con prótesis: técnica triplanar con colgajo en cola de pez para mamas con pobre calidad de cobertura

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M. Berrocal-Revueltas

2013-12-01

Full Text Available La mastopexia con implantes de silicona, es uno de los procedimientos más frecuentes en la práctica diaria en Cirugía Plástica. Sin embargo, la pobre calidad de la cobertura de las mamas, relacionada con piel estriada, escaso tejido subcutáneo y pérdida del parénquima mamario secundarios a la lactancia prolongada y a la pérdida masiva de peso, son causa del incremento progresivo de resultados insatisfactorios a medio y largo plazo que han sido evaluados, analizados y discutidos por los especialistas. Los resultados insatisfactorios más frecuentes en mastopexia con implantes en posición retromuscular son: doble contorno mamario, asimetrías y desplazamiento de los implantes. Los objetivos del presente estudio son: describir el nuevo método triplanar como alternativa útil para lograr mejores resultados en pacientes con mala calidad de cobertura y analizar los resultados obtenidos con el mismo. Realizamos un estudio observacional, descriptivo, prospectivo, en un grupo de 268 pacientes con diagnóstico de ptosis mamaria con hipotrofia y mala calidad de cobertura por piel estriada, escaso tejido celular subcutáneo y pérdida del parénquima mamario, secundarios a lactancia prolongada y pérdida masiva de peso, entre otros, a las que se les practicó mamoplastia de aumento con implantes de silicona mediante la aplicación del método triplanar descrito por la autora, entre enero del 2004 y enero del 2013 en el Hospital de Bocagrande de Cartagena, Colombia. El diseño de la técnica se basa en los principios de cicatriz vertical descrita por Lassus o Lejour o mediante cicatriz en "J", descrita por la autora. El método triplanar se basa en tres planos de cobertura del implante. Plano I: submuscular, para cubrir los dos tercios superiores del implante. Plano II: colgajo dermoglandular con dos prolongaciones distales triangulares de tejido adiposo, en forma de pez, para cubrir el tercio inferior del implante y el borde libre del m

Características clínicas de los pacientes menores de 18 años con atrofia muscular espinal en Medellín, 2008 - 2013

OpenAIRE

Valencia, Hernán Darío; Rendón Muñoz, Jonathan; Pineda, Nicolás; Ortiz, Blair; Montoya, Jorge Hernán; Cornejo, José William

2016-01-01

Introducción: La atrofia muscular espinal (AME) es una enfermedad degenerativa que afecta las neuronas motoras del asta anterior de la médula espinal, se manifiesta por debilidad muscular progresiva de predominio proximal, hipotonía y arreflexia osteotendinosa, la etiología es una mutación en el gen de supervivencia neuronal SMN. Objetivo: determinar las características clínicas de los pacientes menores de 18 años con atrofia muscular espinal en de Medellín, durante el período 2008-2013. Mate...

Management of anterior teeth damage caused by complex caries through aesthetic endorestoration

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Nanik Zubaidah

2011-03-01

Full Text Available Background: Dental caries is a microbiological disease that result in localized dissolution and destruction of the calcified tissue. It is multifactorial, therefore prevention must be based on a multifactorial approach. The damage of anterior teeth due to complex caries, for certain person may interfere their performance and decrease their self confidence aesthetically. Restoration of tooth form and function, especially on anterior teeth is highly valuable. Purpose: To present a case of maxillary anterior teeth with complex caries, through endorestoration treatment for recovering its original function and aesthetic. Case: The 21 years old male patient with complex carries on maxillary anterior teeth number 12, 11, 21, 22 and 23. The patient felt bad about his performance and affect his self confidence. The patient visited the clinic to repair his teeth and to get its form and function aesthetically. Case management: The endorestoration treatment was performed for carious teeth through pulpectomy followed by insertion of post retention and porcelain fused to metal crowns. Conclusion: Anterior teeth with severed complex caries can be managed through endorestoration treatment to recover its performance and function aesthetically.Latar belakang: Dental karies adalah penyakit infeksi yang berakibat kerusakan jaringan kalsifikasi dan bersifat multifactorial. Oleh karena itu pencegahan dilakukan dengan pendekatan multifactorial. Kerusakan gigi anterior karena karies kompleks untuk orang-orang tertentu mungkin berdampak pada penampilan dan penurunan kepercayaan diri karena factor estetik. Perbaikan gigi anterior dari berbagai kerusakan baik dalam hal bentuk maupun fungsinya sangat besar nilainya. Tujuan: Untuk menunjukkan kasus gigi anterior rahang atas karena karies kompleks melalui perawatan endorestorasi untuk mengembalikan fungsi gigi asli dan estetik. Kasus: Laki-laki usia 21 tahun dengan karies kompleks pada gigi anterior rahang atas 12, 11, 21

The Outcomes of Anterior Spinal Fusion for Cervical Compressive Myelopathy—A Retrospective Review

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Tsz-King Suen

2011-12-01

Conclusion: Anterior cervical decompression with bone fusion is a viable surgical option for patients with one level of anterior cervical cord compression, especially for patients with kyphosis or straight canal spine. For patients with two- to three-level involvement, anterior cervical decompression with bone fusion provides good functional result in proper selection of cases. We also identified some prognostic factors (male sex, symptoms less than 1 year, and age less than 70 years in predicting a favourable outcome of anterior spinal fusion for CCM.

CT Analysis of the Anterior Mediastinum in Idiopathic Pulmonary Fibrosis and Nonspecific Interstitial Pneumonia

International Nuclear Information System (INIS)

Lee, Chang Hyun; Lee, Hyun Ju; Son, Kyu Ri; Chun, Eun Ju; Lim, Kun Young; Goo, Jin Mo; Im, Jung Gi; Heo, Jeong Nam; Song, Jae Woo

2006-01-01

We wanted to determine whether the amount and shape of the anterior mediastinal fat in the patients suffering with usual interstitial pneumonia (UIP) or nonspecific interstitial pneumonia (NSIP) was different from those of the normal control group. We selected patients who suffered with UIP (n 26) and NSIP (n = 26) who had undergone CT scans. Twenty-six controls were selected from individuals with normal CT findings and normal pulmonary function tests. All three groups (n = 78) were individually matched for age and gender. The amounts of anterior mediastinal fat, and the retrosternal anteroposterior (AP) and transverse dimensions of the anterior mediastinal fat were compared by one-way analysis of variance and Bonferroni's test. The shapes of the anterior mediastinum were compared using the Chi-square test. Exact logistic regression analysis and polychotomous logistic regression analysis were employed to assess whether the patients with NSIP or UIP had a tendency to show a convex shape of their anterior mediastinal fat. The amount of anterior mediastinal fat was not different among the three groups (p 0.175). For the UIP patients, the retrosternal AP dimension of the anterior mediastinal fat was shorter (p = 0.037) and the transverse dimension of the anterior mediastinal fat was longer (p = 0.001) than those of the normal control group. For the NSIP patients, only the transverse dimension was significantly longer than those of the normal control group (p < 0.001). The convex shape of the anterior mediastinum was predictive of NSIP (OR = 19.7, CI 3.32-∞, p < 0.001) and UIP (OR = 24.42, CI 4.06-∞, p < 0.001). For UIP patients, the retrosternal AP and transverse dimensions are different from those of normal individuals, whereas the amounts of anterior mediastinal fat are similar. UIP and NSIP patients have a tendency to have a convex shape of their anterior mediastinal fat

Estudio comparativo del efecto del cepillado con una crema dental con propóleos rojos y de un gel con clorofila

OpenAIRE

Estela Gispert Abreu; Elena Cantillo Estrada; Aracelys Rivero López; Berta Oramas Rodríguez

1998-01-01

Se analiza comparativamente el efecto de un gel dental de clorofila y de una crema dental con propóleos rojos sobre varios parámetros relacionados con la caries dental, en escolares que se cepillaron durante 21 días con dichos productos. Se obtuvieron resultados favorables principalmente en la disminución del grado de infección por Streptococcus mutans y la elevación de la capacidad individual de remineralización; salvo en este último no hubo diferencias estadísticamente significativas.Author...

Análisis de comparación fractal de la Sagrada Familia con las Catedrales Góticas

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Samper, A.

2015-06-01

Full Text Available The “Sagrada Familia” is considered to be a no-gothic temple. This negation is due to the known fact that the force distribution in the Gothic style is structurally counteracted by means of support elements. In this temple, however, the force distribution is structurally counteracted “in an organic fashion”, i.e., it is neutralised through the construction of quadric surfaces which naturally generate such distribution. Without denying that the “Sagrada Familia” is a no-gothic building, in this paper we use fractal, descriptive and computational Geometry techniques and we apply them to the basic projections of the temple in order to parameterize the characteristic which describes the space-filling effectiveness of the design, the roughness of its elements. We conclude that such characteristic is indeed gothic and matches the Gothic style, particularly the cathedrals in Burgos, Paris, Amiens and Chartres.El Templo de la Sagrada Familia es considerado construcción no gótica. Esta negación, en parte, es debida por el conocido hecho de que la distribución de fuerzas, en el Gótico, queda contrarrestada estructuralmente con elementos de apoyo laterales. Sin embargo, en el Templo la distribución de fuerzas se contrarresta estructuralmente «de manera orgánica»; o sea, se neutraliza con la construcción de superficies cuádricas que de manera natural genera tal distribución. Sin negar lo anterior, aquí, con técnicas de Geometría fractal, descriptiva y computacional, aplicadas a las proyecciones básicas del proyecto del Templo, parametrizamos la característica consistente en la efectividad de ocupar espacio, la escabrosidad de sus elementos. Concluiremos que tal característica sí es gótica, con semejanza general a las catedrales góticas, y en especial con las catedrales de Burgos, París, Amiens y Chartres.

Morphometric Analysis of Bone Resection in Anterior Petrosectomies.

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Ahmed, Osama; Walther, Jonathan; Theriot, Krystle; Manuel, Morganne; Guthikonda, Bharat

2016-06-01

Introduction The anterior petrosectomy is a well-defined skull base approach to lesions such as petroclival meningiomas, posterior circulation aneurysms, petrous apex lesions (chondrosarcomas, cholesteatomas), ventrolateral brainstem lesions, clival chordomas, trigeminal neurinomas, and access to cranial nerves III, IV, V, and VII. Methods and Materials Fourteen anterior petrosectomies on eight cadaveric heads were performed in a skull base dissection laboratory. Predissection and postdissection thin-cut computed tomography scans were obtained to compare the bone resection. A computer program was used (InVivo5, Anatomage, San Jose, California, United States) to measure the bone resection and the improved viewing angle. Results The average bone removed in each plane was as follows: anterior to posterior plane was 10.57 mm ± 2.00 mm, superior to inferior was 9.39 mm ± 1.67 mm, and lateral to medial was 17.46 mm ± 4.64 mm. The average increased angle of view was 13.01 ± 2.35 degrees (Table 1). The average volume was 1786.94 ± 827.40 mm(3). Conclusions Anterior petrosectomy is a useful approach to access the ventrolateral brainstem region. We present a cadaveric study quantitating the volume of bone resection and improvement in the viewing angle. These data provide useful preoperative information on the utility of this skull base approach and the gain in the viewing angle after bony removal.

Síndrome de distensión del saco capsular: Presentación de un caso Capsular bag distension syndrome: A case presentation

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Belmary Aragonés Cruz

2006-12-01

Full Text Available La capsulorrexis es el método preferido para la realización de la capsulotomía anterior. El síndrome de distensión del saco capsular es una complicación posoperatoria poco frecuente asociada a esta técnica. En este artículo presentamos un caso clínico de una mujer de 70 años, que presentaba una catarata nuclear dura en ojo izquierdo, a la cual se le realizó cirugía extracapsular técnica de Mini Nuc de Blumenthal, con capsulorrexis anterior e implante de LIO de Polimetil Metacrilato en cápsula posterior. Un mes más tarde la paciente acude con disminución de la visión, con sobrerrefracción miópica postoperatoria y desplazamiento anterior del lente. Se realizó capsulotomía anterior periférica con láser Nd YAG que resolvió la complicación, con recuperación de la profundidad de la cámara anterior y reposicionamiento del lente. La capsulotomía anterior periférica con láser es la mejor opción terapéutica, al ser inocua, de rápida recuperación, excelentes resultados visuales y mínimas complicacionesCapsulorrhexis is the preferred method to perform anterior capsulotomy. Capsular bag distension syndrome is one of the less frequent postoperative complications associated to this technique. This article prresented the clinical case of a 70-years-old woman who presented with hard nuclear cataract in hter left eye and underwent an extracapsular surgery by Mini Nuc technique, with anterior capsulorrhexis and polymethyl-metacrylate IoL implant in posterior capsule. A month after surgery, the patient went to the doctor´s with reduced vision, posoperative myopic overrefraction and anterior displacement of the lens. Then, peripheral anterior capsulotomy with Nd YAG laser was used to overcome this problem; anterior chamber depth and repositioning of the lens were recovered. Peripheral anterior capsulotomy with laser is the best therapeutic choice since it is harmless, and offers rapid recovery, excellent visual results and minimal

Cell life and death in the anterior pituitary gland: role of oestrogens.

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Seilicovich, A

2010-07-01

Apoptotic processes play an important role in the maintenance of cell numbers in the anterior pituitary gland during physiological endocrine events. In this review, we summarise the regulation of apoptosis of anterior pituitary cells, particularly lactotrophs, somatotrophs and gonadotrophs, and analyse the possible mechanisms involved in oestrogen-induced apoptosis in anterior pituitary cells. Oestrogens exert apoptotic actions in several cell types and act as modulators of pituitary cell renewal, sensitising cells to both mitogenic and apoptotic signals. Local synthesis of growth factors and cytokines induced by oestradiol as well as changes in phenotypic features that enhance the responsiveness of anterior pituitary cells to pro-apoptotic factors may account for cyclical apoptotic activity in anterior pituitary cells during the oestrous cycle. Considering that tissue homeostasis results from a balance between cell proliferation and death and that mechanisms involved in apoptosis are tightly regulated, defects in cell death processes could have a considerable physiopathological impact.

Anterior cervical spine surgery-associated complications in a retrospective case-control study

OpenAIRE

Tasiou, Anastasia; Giannis, Theofanis; Brotis, Alexandros G.; Siasios, Ioannis; Georgiadis, Iordanis; Gatos, Haralampos; Tsianaka, Eleni; Vagkopoulos, Konstantinos; Paterakis, Konstantinos; Fountas, Kostas N.

2017-01-01

Anterior cervical spine procedures have been associated with satisfactory outcomes. However, the occurrence of troublesome complications, although uncommon, needs to be taken into consideration. The purpose of our study was to assess the actual incidence of anterior cervical spine procedure-associated complications and identify any predisposing factors. A total of 114 patients undergoing anterior cervical procedures over a 6-year period were included in our retrospective, case-control study. ...

[Esthetic analysis on immediate single-tooth implant restoration in anterior maxilla].

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Li, Shao-wei; Wang, Guo-shi; Sha, Yan-zhi

2015-10-01

To evaluate the esthetic outcomes of immediate single-tooth implant restoration in anterior maxilla with the pink esthetic score (PES). Nine patients were treated with 9 Straumann implants by immediate single-tooth implant restoration in anterior maxilla. Assessment of PES after crown placement at 1 week (baseline) and 6 months after implantation was conducted. Statistical analysis was performed using SPSS 16.0 software package. Nine implants achieved a retention rate of 100%. PES for single-tooth implant was 10.33 ± 1.50 at 1 week and 11.44 ± 0.88 at 6 months after crown placement. The difference was significant(P=0.021). This study indicates that immediate single-tooth implant restoration in anterior maxilla is predictable. Immediate single-tooth implantation can result in good clinical esthetic results in most patients with single-tooth missing in anterior maxilla.

Paired anterior spinal arteries in a case of locked-in syndrome

International Nuclear Information System (INIS)

Kawamura, J.; Matsubayashi, K.; Fukuyama, H.; Kitanaka, H.

1981-01-01

Paired anterior spinal arteries have rarely been demonstrated angiographically, although several anatomical studies have shown that they are not uncommonly observed. This report describes the angiographic and autopsy findings of such a variation, which was observed in a 65-year-old man with a locked-in syndrome. The paired trunks of the anterior spinal artery were visualized in a retrograde fashion through the left inferior thyroid artery and a radical branch at the 5th cervical level by left retrograde brachial angiography. The uppermost segments of either vertebral artery and the lower portion of the basilar artery were opacified through these channels. The autopsy confirmed the paired trunks of the anterior spinal artery, occlusion of the vertebral arteries just caudal to the origin of the main branches of the anterior spinal artery, and an old infarct involving the pontine tegmentum and cerebellum. (orig.)

Características sociodemográficas y clínicas de pacientes con diabetes tipo 2 y microangiopatías

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Teresa Mendizábal

2010-03-01

Full Text Available Objetivo: Determinar las características sociodemográficas y clínicas de pacientes con diabetes tipo 2 y microangiopatías. Diseño: Estudio descriptivo, de serie de casos. Institución: Hospital Nacional Daniel Alcides Carrión del Callao, hospital docente. Participantes: Pacientes adultos con diabetes mellitus. Intervenciones: Se realizó un estudio de 48 pacientes adultos con diabetes mellitus 2 con y sin microangiopatías. Se determinó edad, sexo, tiempo de enfermedad, glicemia, y características posibles de relacionarse con la ausencia de complicaciones microvasculares, susceptibles o no de modificación: nivel educativo, nivel socioeconómico, atención mínima (endocrinólogo, atención estándar (endocrinólogo y nutricionista, atención integral (profesionales anteriores más otro especialista, percepción de apoyo familiar, asistencia al control médico, adherencia a dieta sin azúcares simples y actividad física regular. Principales medidas de resultados: Presentación de microangiopatías y otras complicaciones. Resultados: La edad promedio fue 55,6 años y 52% de los pacientes presentó microangiopatía. Los pacientes sin complicaciones tuvieron menor edad, tiempo de enfermedad y antecedentes familiares de diabetes; mayor nivel educativo y socioeconómico; mejor estado nutricional y menor nivel de glicemia. La ausencia de microangiopatías se asoció a una atención estándar (endocrinólogo y nutricionista (p=0,013. Conclusiones: La microangiopatía se presentó en 52% de pacientes del estudio. Los pacientes sin complicaciones tuvieron menor edad, menor tiempo de enfermedad y antecedentes familiares de diabetes; mayor nivel educativo y socioeconómico; mejor estado nutricional y menor nivel de glicemia.

Relación de la succión no nutritiva con la maloclusión en niños ecuatorianos

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Myriam Isabel Carrillo Valencia

2016-09-01

Full Text Available Objetivo: Determinar la relación que existe entre los Hábitos de Succión No Nutritiva (HSNN y la presencia de Maloclusiones, en los niños(as de 5 a 9 años de edad de tres Centros Educativos del cantón Ambato, Ecuador. Materiales y métodos: En el presente estudio transversal se evaluaron 435 niños de ambos sexos. El examen clínico fue realizado por un Dentista entrenado siguiendo los criterios diagnósticos de maloclusión según Hurtado et al., 2012. La recolección de datos fue a través de una ficha estructurada. Fueron estudiadas las variables relacionadas con las características propias del niño y la duración del hábito, con la presencia de HSNN y maloclusión. Los datos fueron analizados a través del test estadístico del Chi cuadrado y la correlación de Spearman con un nivel de significancia del 5%. Resultados: La prevalencia del HSNN fue del 52.6%, la prevalencia de maloclusión 38.6%, el tipo de HSNN más frecuente fue la succión digital con 21.6%, la maloclusión más frecuente fue la mordida cruzada anterior con 8.7%; en cuanto al sexo, la edad y la duración del hábito no hubo diferencias estadísticamente significativas. Conclusiones: No hubo relación estadísticamente significativa entre los HSNN y la presencia de maloclusiones, en niños(as entre 5 a 9 años de edad de los 3 centros de educación básica de la ciudad de Ambato.

Anterior mediastinal paraganglioma: A case for preoperative embolization

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Shakir Murtaza

2012-07-01

Full Text Available Abstract Background Paraganglioma is a rare but highly vascular tumor of the anterior mediastinum. Surgical resection is a challenge owing to the close proximity to vital structures including the heart, trachea and great vessels. Preoperative embolization has been reported once to facilitate surgical treatment. Case presentation We report a case of anterior mediastinal paraganglioma that was embolized preoperatively, and was resected without the need for cardiopulmonary bypass and without major bleeding complications. Conclusion We make a case to further the role of preoperative embolization in the treatment of mediastinal paragangliomas.

Anterior Lens Capsule and Iris Thicknesses in Pseudoexfoliation Syndrome.

Science.gov (United States)

Batur, Muhammed; Seven, Erbil; Tekin, Serek; Yasar, Tekin

2017-11-01

The aim of this study was to evaluate anatomic properties of the lens capsule and iris by anterior segment optical coherence tomography (AS-OCT) in patients with pseudoexfoliation (PEX). This prospective study included 62 eyes of 62 patients with PEX syndrome and 43 eyes of 43 age- and gender-matched controls. All subjects underwent full ophthalmologic examinations including AS-OCT. Pupillary diameter, midperipheral stromal iris thickness, central and temporal lens capsule thicknesses, and peripheral pseudoexfoliation material thickness on the anterior lens capsule surface were measured and recorded. Mean age was 66.8 ± 9.3 years in the PEX group and 65.5 ± 8.9 years in the control group (p = 0.44). The PEX group consisted of 62 patients: 38 men (61.3%) and 24 women (38.7%); the control group included 43 subjects: 25 men (58.1%) and 18 women (41.9%). Pupillary diameter after pharmacologic mydriasis was 21% smaller in the PEX group than controls. Mean midperipheral iris thickness was 36 ± 7.2 μm (7.8%) thinner in the PEX group than that of control group (p = 0.047). The central anterior capsule was a mean of 3.40 ± 0.51 μm (18%) thicker in the PEX group compared to the control group (p = 0.0001). The temporal anterior lens capsule was a mean of 0.17 ± 0.15 μm thicker in the PEX group compared to the control group (p = 0.81). With high-resolution OCT imaging, it has become possible to evaluate the anterior lens capsule without histologic examination and demonstrate that it is thicker than normal in PEX patients.

Anterior mediastinal synovial sarcoma: A case report and literature review

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Wen-xiang YUE

2015-01-01

Full Text Available Objective　To study the clinical manifestations, pathologic features, diagnosis, treatment and prognosis of primary synovial sarcoma in the anterior mediastinum. Methods　A case of primary synovial sarcoma in the anterior mediastinum was reported. Clinical features, imaging manifestations, pathology features and therapeutic effect were analysed and the relevant literature was reviewed. Results　A 48-year-male patient was admitted with complaint of right chest pain for 4 days. Chest computerized tomography revealed a large mass located at the right anterior mediastinum, and it was primarily diagnosed as invasive thymoma. Pathological examination by CT-guided percutaneous needle biopsy manifested that, under microscope, the tumor cells were short and spindle in shape forming a nest structure, suggested it was a thymoma. The patient then underwent resection of thymoma with removal of fat and connective tissue in the anterior mediastinum. During the operation the size of the tumor was 15cm×15cm×10cm, being located at the anterior mediastinum, and it tended to bleed. The diagnosis of primary monophasic synovial sarcoma in the mediastinum was confirmed by postoperative/pathology examination. Immunohistochemistry staining showed that the tumor cells were positive for the markers Bcl-2 and EMA, but negative for the markers CK (pan and S100. The patient suffered from local recurrence with metastases to lung 4 months after surgery. The patient received 2 chemotherapeutic courses with ifosfamide, epirubicin and cisplatin. He died 6 months after surgery. Conclusion　Primary synovial sarcoma in the anterior mediastinum is an extremely rare and highly malignant tumor with poor prognosis. The diagnosis depends on the pathological features, immunohistochemistry and RT-PCR. Radical resection combined with comprehensive treatment may improve the survival rate. DOI: 10.11855/j.issn.0577-7402.2014.12.12

Unilateral Anterior Epistaxis Electrocautery versus Chemical Cautery

International Nuclear Information System (INIS)

Umar, A. S.; Rahat, Z. M.; Hussain, S. S.; Khan, M. Z.; Fareed, G.

2013-01-01

Objective: To evaluate and compare the two methods, electrocautery versus chemical cautery, for controlling unilateral anterior epistaxis and to identify the complications. Design: Randomized control trial. Place and Duration: This study was conducted in ENT Department PNS Shifa Hospital Karachi from August 2009 to June 2011. Patients and Methods: Ninety two cases with unilateral anterior epistaxis were divided using random number trials into two groups i.e. group A and group B containing 46 cases each. In group A electrocautery and in group B chemical cautery with 50% silver nitrate was done and the results were compared. Results: In this study 92 cases were divided randomly into two groups i.e. group A and group B containing 46 cases in each group. In group A 44 (95.6%) out of 46 cases were treated successfully with a single visit as an outpatient by electrocautery, the patients were called for follow up on the fifth day and then fortnightly for three months after the procedure, only 2 (4.3%) cases reported in first five days with mild recurrence of bleeding. In group B 42 (91.3%) cases out of 46 cases were treated successfully in a single visit and recurrence of bleeding occured in 4 (8.7%) cases who required a second visit during the first five days. There were no major complications found in either group except few complaints of post cauterization pain and mucosal inflammation observed slightly more in group B patients. Conclusion: Electrocautery and chemical cautery with 50% silver nitrate both are equally effective procedures to control anterior epistaxis if the bleeding point is visible and small. Both procedures are reliable and there are no major complications. Occasionally if the bleeding point in the anterior nasal septum is large then electrocautery may be a preferred option. (author)

Perineal anterior dislocation of the hip with avulsion fracture of ...

African Journals Online (AJOL)

Traumatic anterior dislocation of the hip is rare even in children. Very uncommon also is the perineal variant of the inferior type of anterior dislocation with concomitant avulsion fracture of the greater trochanter. We report such a case highlighting the peculiarity of its management. No similar case of triumvirate injury of the hip ...

[Anterior lumbar interbody fusion. Indications, technique, advantages and disadvantages].

Science.gov (United States)

Richter, M; Weidenfeld, M; Uckmann, F P

2015-02-01

Anterior lumbar interbody fusion (ALIF) for lumbar interbody fusion from L2 to the sacrum has been an established technique for decades. The advantages and disadvantages of ALIF compared to posterior interbody fusion techniques are discussed. The operative technique is described in detail. Complications and avoidance strategies are discussed. This article is based on a selective literature search using PubMed and the experience of the authors in this medical field. The advantages of ALIF compared to posterior fusion techniques are the free approach to the anterior disc space without opening of the spinal canal or the neural foramina. This gives the possibility of an extensive anterior release and placement of the largest possible cages without the risk of neural structure damage. The disadvantages of ALIF are the additional anterior approach and the related complications. The most frequent complication is due to damage of vessels. The rate of complications is significantly increased in revision surgery. The ALIF technique meaningfully expands the repertoire of the spinal surgeon especially for the treatment of non-union after interbody fusion, in patients with epidural scar tissue at the index level and spinal infections. Advantages and disadvantages should be considered when evaluating the indications for ALIF.

Modified protrusion arch for anterior crossbite correction - a case report.

Science.gov (United States)

Roy, Abhishek Singha; Singh, Gulshan Kr; Tandon, Pradeep; Chaudhary, Ramsukh

2013-01-01

Borderline and mild skeletal Class III relationships in adult patients are usually treated by orthodontic camouflage. Reasonably rood results have been achieved with nonsurgical teatment of anterior crossbite. Class III malocclusion may be associated with mandibular prognathism, maxillary retrognathism, or both. Class III maxillary retrognathism generally involves anterior crossbite, which must be opened if upper labial brackets are to be bonded. If multiple teeth are in crossbite, after opening the bite usual step is to ligate forward or advancement arch made of 0.018" or 0.020" stainless steel or NiTi wire main arch that must be kept separated 2 mm from the slot ofupper incisor braces. Two stops or omegas are made 1 mm mesial to the tubes of the molar bands that will impede main arch from slipping,and in this manner the arch will push the anterior teeth forward Here we have fabricated a modified multiple loop protrusion arch to correct an anterior crossbite with severe crowding that was not amenable to correct by advancement arches.

Imaging assessment of anterior knee pain and patellar maltracking

International Nuclear Information System (INIS)

McNally, E.G.

2001-01-01

Anterior knee pain is a common complaint in the orthopaedic clinic. The differential diagnosis is wide and the principal goal of initial assessment is to detect remediable causes. The majority of patients do not have a specific disease and increasingly interest has focused on the role of patello-femoro-tibial morphology and of patellar maltracking in the aetiology of anterior knee pain. Classification in this group of patients is poor and there is no uniform agreement on which patient groups benefit from treatment and which treatment is best. Much of the literature involves relatively small numbers of patients, is poorly controlled and there is little agreement on outcome measures [1, 2]. The purpose of this review is to outline the current status of the imaging assessment of recalcitrant anterior knee pain with particular reference to patellar maltracking. (orig.)

Con Ortega: el ensayo como alternativa a una filosofía de funámbulos

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Enrique Ferrari Nieto

2012-01-01

Full Text Available RESUMEN: Tanto el ensayo, como género literario, como el ensayo español, en su concreción histórica, son temas de estudio con un vigor extraordinario en la crítica contemporánea. Como posibilidad estilística para una reflexión que renuncia a ser estrictamente sistemática, este trabajo apuntala en la literatura en español sus orígenes en Ortega y Gasset porque, a pesar de haber otros precedentes destacados, anteriores a Ortega, con el escritor madrileño el ensayo toma conciencia de ser forma de un nuevo planteamiento filosófico que se justifica, precisamente, en su dinamicidad frente al sistema. ABSTRACT: The essay (as literary genre and the Spanish essay (in its historical specificity are subjects of study with a special force in contemporary criticism. This paper examines the origins of the essay in Spanish literature in Ortega y Gasset, understanding it as a stylistic form of reflection that is not strictly systematic. Despite the existence of important predecessors, with Ortega the essay comes to recognize itself as the form of a new philosophical approach that is justified precisely in its dynamism.

Operation for recurrent cystocele with anterior colporrhaphy or non-absorbable mesh: patient reported outcomes

DEFF Research Database (Denmark)

Nüssler, Emil Karl; Greisen, Susanne; Kesmodel, Ulrik Schiøler

2013-01-01

Abstract INTRODUCTION AND HYPOTHESIS: The aim of this study was to compare patient reported outcomes and complications after repair of recurrent anterior vaginal wall prolapse in routine health care settings using standard anterior colporrhaphy or non-absorbable mesh. METHODS: The study is based...... on prospective data from the Swedish National Register for Gynaecological Surgery. 286 women were operated on for recurrent anterior vaginal wall prolapse in 2008-2010; 157 women had an anterior colporrhaphy and 129 were operated on with a non-absorbable mesh. Pre-, and perioperative data were collected from...... (0.6 %) in the anterior colporrhaphy group (p = 0.58). The infection rate was higher after mesh (8.5 %) than after anterior colporrhaphy (2.5 %; OR 3.19 ; 1.07-14.25). CONCLUSION: Implantation of synthetic mesh during operation for recurrent cystocele more than doubled the cure rate, whereas...

Solución numérica de procesos de transferencia de calor en aleaciones con condiciones de contorno no lineales

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Alhama, F.

2005-12-01

Full Text Available Thermal properties of a great number of alloys, especially specific heat, show a sharply temperature dependence both during the phase change and the allotropic transformations. This fact, in conjunction with the existence of convection or radiation boundary conditions, or both simultaneously, increase the complexity of the transient heat transfer problem because of the inherent no linearity. The numerical model proposed for the solution of this problem is able to assume the above hypothesis as well as the temperature dependencies of the thermal conductivity. Applications to alloys are presented.

Las propiedades térmicas de numerosas aleaciones, especialmente la capacidad calorífica, acusan una marcada dependencia con la temperatura tanto en los cambios de fase como en las transformaciones alotrópicas. Este hecho, junto con la aplicación de condiciones de contorno de convección, radiación o ambas, simultáneamente, aumentan la complejidad del problema de transferencia de calor en los procesos transitorios debido a la no linealidad inherente. El modelo numérico propuesto para la solución de este problema es capaz de asumir las hipótesis anteriores así como las posibles dependencias de la conductividad térmica con la temperatura. Se presentan aplicaciones a procesos térmicos en aleaciones.

A Review on Biomechanics of Anterior Cruciate Ligament and Materials for Reconstruction

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M. Marieswaran

2018-01-01

Full Text Available The anterior cruciate ligament is one of the six ligaments in the human knee joint that provides stability during articulations. It is relatively prone to acute and chronic injuries as compared to other ligaments. Repair and self-healing of an injured anterior cruciate ligament are time-consuming processes. For personnel resuming an active sports life, surgical repair or replacement is essential. Untreated anterior cruciate ligament tear results frequently in osteoarthritis. Therefore, understanding of the biomechanics of injury and properties of the native ligament is crucial. An abridged summary of the prominent literature with a focus on key topics on kinematics and kinetics of the knee joint and various loads acting on the anterior cruciate ligament as a function of flexion angle is presented here with an emphasis on the gaps. Briefly, we also review mechanical characterization composition and anatomy of the anterior cruciate ligament as well as graft materials used for replacement/reconstruction surgeries. The key conclusions of this review are as follows: (a the highest shear forces on the anterior cruciate ligament occur during hyperextension/low flexion angles of the knee joint; (b the characterization of the anterior cruciate ligament at variable strain rates is critical to model a viscoelastic behavior; however, studies on human anterior cruciate ligament on variable strain rates are yet to be reported; (c a significant disparity on maximum stress/strain pattern of the anterior cruciate ligament was observed in the earlier works; (d nearly all synthetic grafts have been recalled from the market; and (e bridge-enhanced repair developed by Murray is a promising technique for anterior cruciate ligament reconstruction, currently in clinical trials. It is important to note that full extension of the knee is not feasible in the case of most animals and hence the loading pattern of human ACL is different from animal models. Many of the

Respuesta del garbanzo (Cicer arietinum L. a la inoculación con Azotobacter vineladii y Burkholderia cepacia a dosis reducida de fertilizante nitrogenado

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Juan Manuel Sánchez-Yáñez

2014-01-01

Full Text Available ResumenEl cultivo de garbanzo “Cicer arietinumL.” demanda fertilizante nitrogenado (FN, que aplicado en excesoprovoca pérdida de fertilidad del suelo y contaminación ambiental. Una alternativa para este problema es lareducción y optimización de la dosis de FN, con inoculantes a base de bacteriaspromotoras de crecimientovegetal (BPCV.Así, el objetivo de este trabajo fue analizar la respuesta del garbanzo a la inoculación conAzotobactervinelandiiyBurkholderiacepaciaa la dosis 50% del FN. Para ello se utilizó un diseñoexperimental de bloques al azar. Con nitrato de amonio (NO3NH4 como FN a las dosis 100% (10g/L y 50 %(5g/L para el garbanzo inoculado con las BPCV; con las variables/respuesta en su semilla: por ciento (% degerminación; luego su fenotípia y biomasa aérea y radical, los datos experimentales se analizaron por ANOVAy Tukey. Los resultados indicaron una respuesta positiva de la semilla de garbanzo a la doble inoculación conambas BPCV, al igual que aplántula y floración, donde el garbanzo alcanzo un peso seco total (PST de 0,82g, valor estadísticamente diferente y significativo, comparado con los 0,71g de PST del garbanzo sin inocularcon el FN al 100% o control relativo (CR. Lo anterior sugiereuna respuesta positiva del garbanzo queoptimizó la dosis 50% del FN, por una acción sinérgica de los dos géneros de BPCV en sus raíces, lo quepodría evitar en parte la perdida de fertilidad del suelo y la contaminación ambiental, por la aplicación enexceso del FN.

Anterior mediastinal masses in the Framingham Heart Study: Prevalence and CT image characteristics

International Nuclear Information System (INIS)

Araki, Tetsuro; Nishino, Mizuki; Gao, Wei; Dupuis, Josée; Washko, George R.; Hunninghake, Gary M.; Murakami, Takamichi; O’Connor, George T.; Hatabu, Hiroto

2015-01-01

To investigate the prevalence and CT image characteristics of anterior mediastinal masses in a population-based cohort and their association with the demographics of the participants. Chest CT scans of 2571 Framingham Heart Study participants (mean age 58.9 years, 51% female) were evaluated by two board-certified radiologists with expertise in thoracic imaging for the presence of anterior mediastinal masses, their shape, contour, location, invasion of adjacent structures, fat content, and calcification. For participants with anterior mediastinal masses, a previous cardiac CT scan was reviewed for interval size change of the masses, when available. The demographics of the participants were studied for any association with the presence of anterior mediastinal masses. Of 2571, 23 participants (0.9%, 95% CI: 0.6–1.3) had anterior mediastinal masses on CT. The most common CT characteristics were oval shape, lobular contour, and midline location, showing soft tissue density (median 32.1 HU). Fat content was detected in a few cases (9%, 2/23). Six out of eight masses with available prior cardiac CT scans demonstrated an interval growth over a median period of 6.5 years. No risk factors for anterior mediastinal masses were detected among participants’ demographics, including age, sex, BMI, and cigarette smoking. The prevalence of anterior mediastinal masses is 0.9% in the Framingham Heart Study. Those masses may increase in size when observed over 5–7 years. Investigation of clinical significance in incidentally found anterior mediastinal masses with a longer period of follow-up would be necessary

Phase image characterization of ventricular contraction in left anterior hemiblock

International Nuclear Information System (INIS)

Ono, Akifumi; Mizuno, Haruyoshi; Tahara, Yorio; Ishikawa, Kyozo

1991-01-01

We investigated whether or not left anterior hemiblock is present in patients with left axis deviation using first-harmonic Fourier analysis of gated blood-pool images. Gated blood-pool images were taken in 50 patients without contraction abnormality. They included 14 normal subjects, 8 patients with right bundle branch block (RBBB), 20 with left axis deviation (LAD) and 8 with both RBBB and LAD (RBBB+LAD). ECG gated blood-pool scans were acquired in the anterior and 'best septal' left anterior oblique projections. First, the phase images were displayed cinematically as a continuous-loop movie. Next, for quantitative analysis of the phase image, the whole left ventricular and left ventricular high lateral regions of interest were drawn. The 'regional phase shift' (RPS) was then defined as {RPS=A-a} where 'A' is the mean value of the whole left ventricular phase angles and 'a' is that of phase angles in the high lateral region. The left ventricular phase changes and the RPSs in the RBBB and LAD groups were similar to those in the normal group. In the RBBB+LAD group, the latest phase changes occurred in the high anterolateral region. The RPSs of this group were significantly lower than those in the other 3 groups (p<0.01). These data suggest that left anterior hemiblock might coexist with RBBB in patients with RBBB+LAD, whereas left anterior hemiblock might not exist in the majority of patients with LAD alone. (author)

Experience with titanium cages in anterior cervical discectomy and fusion

International Nuclear Information System (INIS)

Junaid, M.; Afsheen, A.; Bukhari, S.S.; Rashid, M.U.; Kalsoom, A.

2016-01-01

Background: Anterior cervical discectomy is a common procedure for treating patients for cervical disc prolapse. This study was conducted to study the surgical outcome and demographic characteristics of patients who were treated for anterior cervical disc prolapse. Methods: Study was conducted in the combined military hospital (CMH) Peshawar. Study interval was 3 years from 1st September, 2011 to 31st August, 2014. Total number of patients were 84. Males were 54 (64.28 percentage) and females were 30 (35.71 percentage). All the patients had undergone the procedure of anterior cervical discectomy and fusion with titanium cages (ACDF). All the patients had plain MRI cervical spine done for diagnosis of anterior cervical disc prolapse. Results: Total 84 patients were operated. In the patients who complained of brachialgia, 100 percentage improvement was seen after the operation. Three (3.5 percentage) of the patients, who presented with axial neck pain, continued to complain of pain and 2 (2.5 percentage) of the patients complained of pain at the donor site after the operation. One of the patient had dural tear which resulted in subcutaneous cerebrospinal fluid (CSF) accumulation and was treated conservatively with repeated aspiration. Fusion rate was 100 percentage with titanium cages used for fusion after anterior cervical discectomy. No complications were noted after the surgery at 1 year of interval. Conclusion: Results with titanium cages are expectedly good. Symptoms resolved and fusion rate was 100 percentage at 1 year follow up. (author)

Compression and contact area of anterior strut grafts in spinal instrumentation: a biomechanical study.

Science.gov (United States)

Pizanis, Antonius; Holstein, Jörg H; Vossen, Felix; Burkhardt, Markus; Pohlemann, Tim

2013-08-26

Anterior bone grafts are used as struts to reconstruct the anterior column of the spine in kyphosis or following injury. An incomplete fusion can lead to later correction losses and compromise further healing. Despite the different stabilizing techniques that have evolved, from posterior or anterior fixating implants to combined anterior/posterior instrumentation, graft pseudarthrosis rates remain an important concern. Furthermore, the need for additional anterior implant fixation is still controversial. In this bench-top study, we focused on the graft-bone interface under various conditions, using two simulated spinal injury models and common surgical fixation techniques to investigate the effect of implant-mediated compression and contact on the anterior graft. Calf spines were stabilised with posterior internal fixators. The wooden blocks as substitutes for strut grafts were impacted using a "pressfit" technique and pressure-sensitive films placed at the interface between the vertebral bone and the graft to record the compression force and the contact area with various stabilization techniques. Compression was achieved either with posterior internal fixator alone or with an additional anterior implant. The importance of concomitant ligament damage was also considered using two simulated injury models: pure compression Magerl/AO fracture type A or rotation/translation fracture type C models. In type A injury models, 1 mm-oversized grafts for impaction grafting provided good compression and fair contact areas that were both markedly increased by the use of additional compressing anterior rods or by shortening the posterior fixator construct. Anterior instrumentation by itself had similar effects. For type C injuries, dramatic differences were observed between the techniques, as there was a net decrease in compression and an inadequate contact on the graft occurred in this model. Under these circumstances, both compression and the contact area on graft could only

N-terminal prolactin-derived fragments, vasoinhibins, are proapoptoptic and antiproliferative in the anterior pituitary.

Science.gov (United States)

Ferraris, Jimena; Radl, Daniela Betiana; Zárate, Sandra; Jaita, Gabriela; Eijo, Guadalupe; Zaldivar, Verónica; Clapp, Carmen; Seilicovich, Adriana; Pisera, Daniel

2011-01-01

The anterior pituitary is under a constant cell turnover modulated by gonadal steroids. In the rat, an increase in the rate of apoptosis occurs at proestrus whereas a peak of proliferation takes place at estrus. At proestrus, concomitant with the maximum rate of apoptosis, a peak in circulating levels of prolactin is observed. Prolactin can be cleaved to different N-terminal fragments, vasoinhibins, which are proapoptotic and antiproliferative factors for endothelial cells. It was reported that a 16 kDa vasoinhibin is produced in the rat anterior pituitary by cathepsin D. In the present study we investigated the anterior pituitary production of N-terminal prolactin-derived fragments along the estrous cycle and the involvement of estrogens in this process. In addition, we studied the effects of a recombinant vasoinhibin, 16 kDa prolactin, on anterior pituitary apoptosis and proliferation. We observed by Western Blot that N-terminal prolactin-derived fragments production in the anterior pituitary was higher at proestrus with respect to diestrus and that the content and release of these prolactin forms from anterior pituitary cells in culture were increased by estradiol. A recombinant preparation of 16 kDa prolactin induced apoptosis (determined by TUNEL assay and flow cytometry) of cultured anterior pituitary cells and lactotropes from ovariectomized rats only in the presence of estradiol, as previously reported for other proapoptotic factors in the anterior pituitary. In addition, 16 kDa prolactin decreased forskolin-induced proliferation (evaluated by BrdU incorporation) of rat total anterior pituitary cells and lactotropes in culture and decreased the proportion of cells in S-phase of the cell cycle (determined by flow cytometry). In conclusion, our study indicates that the anterior pituitary production of 16 kDa prolactin is variable along the estrous cycle and increased by estrogens. The antiproliferative and estradiol-dependent proapoptotic actions of this

N-terminal prolactin-derived fragments, vasoinhibins, are proapoptoptic and antiproliferative in the anterior pituitary.

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Jimena Ferraris

Full Text Available The anterior pituitary is under a constant cell turnover modulated by gonadal steroids. In the rat, an increase in the rate of apoptosis occurs at proestrus whereas a peak of proliferation takes place at estrus. At proestrus, concomitant with the maximum rate of apoptosis, a peak in circulating levels of prolactin is observed. Prolactin can be cleaved to different N-terminal fragments, vasoinhibins, which are proapoptotic and antiproliferative factors for endothelial cells. It was reported that a 16 kDa vasoinhibin is produced in the rat anterior pituitary by cathepsin D. In the present study we investigated the anterior pituitary production of N-terminal prolactin-derived fragments along the estrous cycle and the involvement of estrogens in this process. In addition, we studied the effects of a recombinant vasoinhibin, 16 kDa prolactin, on anterior pituitary apoptosis and proliferation. We observed by Western Blot that N-terminal prolactin-derived fragments production in the anterior pituitary was higher at proestrus with respect to diestrus and that the content and release of these prolactin forms from anterior pituitary cells in culture were increased by estradiol. A recombinant preparation of 16 kDa prolactin induced apoptosis (determined by TUNEL assay and flow cytometry of cultured anterior pituitary cells and lactotropes from ovariectomized rats only in the presence of estradiol, as previously reported for other proapoptotic factors in the anterior pituitary. In addition, 16 kDa prolactin decreased forskolin-induced proliferation (evaluated by BrdU incorporation of rat total anterior pituitary cells and lactotropes in culture and decreased the proportion of cells in S-phase of the cell cycle (determined by flow cytometry. In conclusion, our study indicates that the anterior pituitary production of 16 kDa prolactin is variable along the estrous cycle and increased by estrogens. The antiproliferative and estradiol-dependent proapoptotic

CT Analysis of the Anterior Mediastinum in Idiopathic Pulmonary Fibrosis and Nonspecific Interstitial Pneumonia

Energy Technology Data Exchange (ETDEWEB)

Lee, Chang Hyun; Lee, Hyun Ju; Son, Kyu Ri; Chun, Eun Ju; Lim, Kun Young; Goo, Jin Mo; Im, Jung Gi [Seoul National University College of Medicine, Seoul (Korea, Republic of); Heo, Jeong Nam; Song, Jae Woo [University of Ulsan College of Medicine, Seoul (Korea, Republic of)

2006-09-15

We wanted to determine whether the amount and shape of the anterior mediastinal fat in the patients suffering with usual interstitial pneumonia (UIP) or nonspecific interstitial pneumonia (NSIP) was different from those of the normal control group. We selected patients who suffered with UIP (n 26) and NSIP (n = 26) who had undergone CT scans. Twenty-six controls were selected from individuals with normal CT findings and normal pulmonary function tests. All three groups (n = 78) were individually matched for age and gender. The amounts of anterior mediastinal fat, and the retrosternal anteroposterior (AP) and transverse dimensions of the anterior mediastinal fat were compared by one-way analysis of variance and Bonferroni's test. The shapes of the anterior mediastinum were compared using the Chi-square test. Exact logistic regression analysis and polychotomous logistic regression analysis were employed to assess whether the patients with NSIP or UIP had a tendency to show a convex shape of their anterior mediastinal fat. The amount of anterior mediastinal fat was not different among the three groups (p 0.175). For the UIP patients, the retrosternal AP dimension of the anterior mediastinal fat was shorter (p = 0.037) and the transverse dimension of the anterior mediastinal fat was longer (p = 0.001) than those of the normal control group. For the NSIP patients, only the transverse dimension was significantly longer than those of the normal control group (p < 0.001). The convex shape of the anterior mediastinum was predictive of NSIP (OR = 19.7, CI 3.32-{infinity}, p < 0.001) and UIP (OR = 24.42, CI 4.06-{infinity}, p < 0.001). For UIP patients, the retrosternal AP and transverse dimensions are different from those of normal individuals, whereas the amounts of anterior mediastinal fat are similar. UIP and NSIP patients have a tendency to have a convex shape of their anterior mediastinal fat.

Investigando con personas con dificultades de aprendizaje

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Borja González Luna

2013-12-01

Full Text Available El artículo muestra los orígenes de lo que Walmsley (2008 denomina «investigación inclusiva». Para comprender qué se entiende por investigación inclusiva tenemos que remontarnos a los debates epistemológicos sobre las metodologías cuantitativas y cualitativas, acontecidos en la década de los 90, en torno a la revista Disability & Society. A partir de una síntesis de dichos debates, focalizados en el ámbito de la «discapacidad intelectual y del desarrollo», se exponen dos estrategias de colaboración con dicha población: a una aproximación etnográfica (de trabajo grupal, y b una aproximación biográfica (de trabajo individual. A continuación se esboza un posible diseño de trabajo de campo que intenta superar el paradigma cualitativo «clásico» con el objetivo de incluir a dicho colectivo más allá del rol de «sujetos de la investigación». Para finalizar se recoge el debate sobre la accesibilidad de los resultados de la investigación a los participantes en dichas investigaciones, y con ello la necesaria innovación en el ámbito de las «devoluciones» de los resultados, cuando se trata de incluir a personas que presentan limitaciones para la comprensión del lenguaje abstracto oral y/o escrito.

El concepto de esquema corporal en niñas y niños con y sin necesidades educativas especiales, de preescolar, segundo y cuarto grado

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Zulay Pereira-Pérez

2006-06-01

Full Text Available La investigación realizada acerca del concepto de esquema corporal de niñas y niños con y sin necesidades educativas especiales (nee de preescolar, segundo y cuarto grados, proporciona información relevante sobre la construcción de este concepto. La mayor parte de las y los estudiantes con necesidades educativas especiales, de los tres niveles educativos, expresan conceptos de cuerpo relacionados con las características y las cualidades corporales, aunque algunos también refieren a habilidades corporales. Es importante resaltar que estos conceptos no presentan diferencias sustanciales con los expresados por las y los estudiantes sin necesidades educativas. El número de partes del cuerpo mencionadas aumenta a medida que lo hace el nivel educativo y se ve reflejado en las representaciones gráficas de sus cuerpos. No obstante, la mayoría de las y los estudiantes con necesidades educativas especiales presentaron mayor dificultad en la ubicación de partes del cuerpo con su respectiva lateralidad. Conforme aumenta a nivel educativo, se identifica que las y los estudiantes con necesidades educativas especiales asumen las labores domésticas y expresan tener mayor dificultad para las actividades escolares. Asimismo, indican que sienten malestar cuando las personas importantes de su entorno les dicen cosas relacionadas con su cuerpo. No obstante, la mayoría de las y los estudiantes con y sin necesidades educativas especiales expresan percepciones positivas relacionadas con su cuerpo y tienen un sentimiento de respeto por sí mismas(os. Por lo anterior, se recomienda que en los procesos educativos se tomen en consideración los conocimientos previos de las y los estudiantes y se enfatice en la enseñanza de aspectos no solo referidos a conocimientos del cuerpo, sino relacionados con la imagen corporal. Es valiosa la aplicación de actividades didácticas que permitan la vivencia y construcción de los conceptos estudiados, para prevenir los

Unilateral anterior ischemic optic neuropathy

DEFF Research Database (Denmark)

Herbst, Kristina; Sander, Birgit; Lund-Andersen, Henrik

2013-01-01

of this study was to investigate the ipRGC mediated pupil response in patients with a unilateral non-arteritic anterior ischemic optic neuropathy (NAION). Consensual pupil responses during and after exposure to continuous 20 s blue (470 nm) or red (660 nm) light of high intensity (300 cd/m(2)) were recorded...

MODELADO CON REDES DE PETRI E IMPLEMENTACIÓN CON GRAFCET DE UN SISTEMA DE MANUFACTURA FLEXIBLE CON PROCESOS CONCURRENTES Y RECURSOS COMPARTIDOS

OpenAIRE

Johanna Stella Castellanos Arias; Leonardo Enrique Solaque Guzmán

2010-01-01

En este trabajo, se presenta el modelado de un Sistema de Manufactura Flexible (SMF), con procesos concurrentes y recursos compartidos mediante Sistemas a Eventos Discretos (SED), específicamente Redes de Petri (RdP), y GRAFCET. El SMF se plantea como un modelo hipotético que se modela con una RdP con el objeto de identificar su dinámica y hallar la secuencia óptima de funcionamiento del sistema. Se desarrolló un modelo matemático que permite estimar el vector de tiempo acumulado de un proces...

Análise radiográfica comparativa da cifose juncional entre instrumentação híbrida, ganchos e parafusos na escoliose idiopática do adolescente Análisis radiográfico comparativo de la cifosis de unión entre los instrumentos híbridos, los ganchos y los tornillos en escoliosis idiopática del adolescente Comparative radiographic analysis of junctional kyphosis between hybrid instrumentation, hooks and screws in adolescent idiopathic scoliosis

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Hans Grohs

2012-12-01

estudio retrospectivo de evaluación radiográfica de 34 pacientes sometidos a artrodesis de la columna con instrumentación posterior, 10 con ganchos (Grupo I, 13 con ganchos y tornillos (Grupo II y 11 con tornillos (Grupo III, entre junio de 1997 y diciembre de 2009. Se evaluó la aparición de cifosis proximal y distal a la artrodesis en los períodos preoperatorio, postoperatorio inmediato y al final del seguimiento, período postoperatorio tardío, de por lo menos 12 meses. RESULTADOS: Los pacientes del Grupo I presentaron menor valor de cifosis torácica preoperatoria, pero la lordosis lumbar se mantuvo sin cambios durante la evolución. Los pacientes en el grupo II y grupo III mostraron incremento del valor verificado de lordosis lumbar en el postoperatorio. No hubo diferencia significativa en la aparición de cifosis proximal a la unión entre los tres grupos. En cuanto a la cifosis por unión distal, se produjo un aumento estadísticamente significativo del valor entre preoperatorio y postoperatorio en los grupos II y III. CONCLUSIÓN: La evaluación radiográfica de la cifosis por unión proximal y distal en pacientes sometidos a artrodesis y diferentes tipos de instrumentación como tratamiento quirúrgico de escoliosis idiopática del adolescente reveló la presencia preoperatoria de cifosis proximales a la unión , que no evolucionaron para deformidad postoperatoria por unión y además, ausencia completa de anormalidad de la unión distal.OBJECTIVE: Radiographic evaluation of proximal and distal junctional kyphosis in patients undergoing spinal fusion and different types of posterior instrumentation, in the surgical treatment for adolescent idiopathic scoliosis (AIS. METHOD: A retrospective review was done with radiographic evaluation of 34 patients who were submitted to spinal fusion with posterior instrumentation, divided as follows: 10 using only hooks (Group I, 13 hybrid fixation (screws and hooks (Group II and 11 using only pedicle screws (Group III

Etiology of the anterior ankle impingement syndrome: A descriptive anatomical study

NARCIS (Netherlands)

Tol, Johannes L.; van Dijk, C. Niek

2004-01-01

Background: In the anterior ankle impingement syndrome, recurrent traction to the anterior joint capsule is stated to be the cause of formation of talotibial osteophytes. This hypothesis involves the assumption that the osteophytes originate at the site where a capsular attachment is located. A soft

Effect of retinoic acid on midkine gene expression in rat anterior pituitary cells.

Science.gov (United States)

Maliza, Rita; Fujiwara, Ken; Azuma, Morio; Kikuchi, Motoshi; Yashiro, Takashi

2017-06-29

Retinoic acid (RA) is converted from retinal by retinaldehyde dehydrogenases (RALDHs) and is an essential signaling molecule in embryonic and adult tissue. We previously reported that RALDH1 was produced in the rat anterior pituitary gland and hypothesized that RA was generated in the gland. Midkine (MK) is an RA-inducible growth factor, and MK production in the rat anterior pituitary gland was recently reported. However, the mechanism that regulates gene expression of MK in the pituitary gland has not been determined. To investigate regulation of MK production in the anterior pituitary gland, we analyzed changes in MK mRNA in cultured rat anterior pituitary cells. We identified MK-expressing cells by double-staining with in situ hybridization and immunohistochemical techniques for RALDH1. MK mRNA was expressed in RALDH1-producing cells in the anterior pituitary gland. Using isolated anterior pituitary cells of rats, we examined the effect of RA on gene expression of MK. Quantitative real-time PCR revealed that 72 h exposure to a concentration of 10 -6 M of retinal and all-trans retinoic acid increased MK mRNA levels by about 2-fold. Moreover, the stimulatory effect of all-trans retinoic acid was mimicked by the RA receptor agonist Am80. This is the first report to show that RA is important in regulating MK expression in rat anterior pituitary gland.

Carotid-anterior cerebral artery anastomosis on MR angiography: a university hospital-based study

Energy Technology Data Exchange (ETDEWEB)

Uchino, Akira; Saito, Naoko; Okada, Yoshitaka; Inoue, Kaiji [Saitama Medical University International Medical Center, Department of Diagnostic Radiology, Hidaka, Saitama (Japan)

2012-01-15

Rarely in the anterior circulation, an anastomosis of the carotid and anterior cerebral arteries occurs when an anomalous branch arises from the ophthalmic segment of the internal carotid artery and anastomoses with the A1-A2 junction of the anterior communicating artery. Right-side predominance is known. To our knowledge, the incidence of carotid-anterior cerebral artery anastomosis has not been reported, so we researched cases in our institution records to determine incidence and investigated characteristic features of the condition on magnetic resonance (MR) angiography. To isolate such cases, we retrospectively reviewed cranial MR angiographic images of 3,491 consecutive patients in our institution. We found three cases with carotid-anterior cerebral artery anastomosis (two men, one woman), representing an incidence of 0.086%. The anastomosis was on the right in all three cases. A normal A1 segment of the anterior cerebral artery (ACA) was present in two cases but could not be identified in the remaining case on MR angiographic images that included source images. Two of the three patients demonstrated associated arterial variations in their carotid systems. On MR angiography, we observed a 0.086% incidence of carotid-anterior cerebral artery anastomosis in our institution and reaffirmed the right-side predominance of this anomaly. We found a high frequency of other associated arterial variations in the carotid system. (orig.)

Complications and Management of Deep Anterior Lamellar Keratoplasty

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Banu Torun Acar

2014-10-01

Full Text Available Objectives: To report the intraoperative and postoperative follow-up complications and management of these in deep anterior lamellar keratoplasty (DALK surgery. Materials and Methods: Two hundred eighty-four eyes of 252 patients followed up in our cornea clinic who underwent DALK using Anwar’s big-bubble technique with healthy Descemet’s membrane and endothelium were included in this study. Intraoperative and postoperative complications as well as the management and treatment of these complications were evaluated. Results: Big bubble was created in 220 (77.5% eyes of 284 eyes, and lamellar dissection was performed in 64 (22.5% eyes. Perforation occurred during trephination in 4 eyes, and the procedure was accomplished by penetrating keratoplasty (PK. Intraoperative microperforation occurred in 44 eyes. Perforation enlarged in 4 eyes and PK was performed. Operation was continued in 40 eyes with air injection into the anterior chamber. In postopertive follow-up period, double anterior chamber (DAC occurred in 32 of 40 eyes. DAC spontaneously regressed in 8 eyes, and air was given into the anterior chamber with a second surgical intervention in 24 eyes. DAC improved in 20 eyes. Four eyes underwent PK. Fungal keratitis evolved at the interface in one eye, because of no healing during the follow-up period, this eye underwent PK under antifungal therapy. Eyes with interface haze and Descemet’s membrane folds were followed. Conclusion: DALK is a difficult technique with a steep learning curve. In addition to the complications seen in PK, specific complications can occur in lamellar surgery. (Turk J Ophthalmol 2014; 44: 337-40

Spindle neurons of the human anterior cingulate cortex

Science.gov (United States)

Nimchinsky, E. A.; Vogt, B. A.; Morrison, J. H.; Hof, P. R.; Bloom, F. E. (Principal Investigator)

1995-01-01

The human anterior cingulate cortex is distinguished by the presence of an unusual cell type, a large spindle neuron in layer Vb. This cell has been noted numerous times in the historical literature but has not been studied with modern neuroanatomic techniques. For instance, details regarding the neuronal class to which these cells belong and regarding their precise distribution along both ventrodorsal and anteroposterior axes of the cingulate gyrus are still lacking. In the present study, morphological features and the anatomic distribution of this cell type were studied using computer-assisted mapping and immunocytochemical techniques. Spindle neurons are restricted to the subfields of the anterior cingulate cortex (Brodmann's area 24), exhibiting a greater density in anterior portions of this area than in posterior portions, and tapering off in the transition zone between anterior and posterior cingulate cortex. Furthermore, a majority of the spindle cells at any level is located in subarea 24b on the gyral surface. Immunocytochemical analysis revealed that the neurofilament protein triple was present in a large percentage of these neurons and that they did not contain calcium-binding proteins. Injections of the carbocyanine dye DiI into the cingulum bundle revealed that these cells are projection neurons. Finally, spindle cells were consistently affected in Alzheimer's disease cases, with an overall loss of about 60%. Taken together, these observations indicate that the spindle cells of the human cingulate cortex represent a morphological subpopulation of pyramidal neurons whose restricted distribution may be associated with functionally distinct areas.

Bioengineered anterior cruciate ligament

Science.gov (United States)

Martin, Ivan (Inventor); Altman, Gregory (Inventor); Kaplan, David (Inventor); Vunjak-Novakovic, Gordana (Inventor)

2001-01-01

The present invention provides a method for producing an anterior cruciate ligament ex vivo. The method comprises seeding pluripotent stem cells in a three dimensional matrix, anchoring the seeded matrix by attachment to two anchors, and culturing the cells within the matrix under conditions appropriate for cell growth and regeneration, while subjecting the matrix to one or more mechanical forces via movement of one or both of the attached anchors. Bone marrow stromal cells are preferably used as the pluripotent cells in the method. Suitable matrix materials are materials to which cells can adhere, such as a gel made from collagen type I. Suitable anchor materials are materials to which the matrix can attach, such as Goinopra coral and also demineralized bone. Optimally, the mechanical forces to which the matrix is subjected mimic mechanical stimuli experienced by an anterior cruciate ligament in vivo. This is accomplished by delivering the appropriate combination of tension, compression, torsion, and shear, to the matrix. The bioengineered ligament which is produced by this method is characterized by a cellular orientation and/or matrix crimp pattern in the direction of the applied mechanical forces, and also by the production of collagen type I, collagen type III, and fibronectin proteins along the axis of mechanical load produced by the mechanical forces. Optimally, the ligament produced has fiber bundles which are arranged into a helical organization. The method for producing an anterior cruciate ligament can be adapted to produce a wide range of tissue types ex vivo by adapting the anchor size and attachment sites to reflect the size of the specific type of tissue to be produced, and also adapting the specific combination of forces applied, to mimic the mechanical stimuli experienced in vivo by the specific type of tissue to be produced. The methods of the present invention can be further modified to incorporate other stimuli experienced in vivo by the

Alteraciones electrocardiográficas y factores de riesgo cardiovascular en pacientes con diabetes tipo 2 Electrocardiographic abnormalities and cardiovascular risk factors in patients with type 2 diabetes

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Martha Rodríguez-Morán

1999-01-01

Full Text Available Objetivo. Determinar cuáles son las alteraciones del ritmo y la conducción cardiaca más frecuentes en pacientes con diabetes tipo 2 sin cardiopatía previa y establecer su asociación con los factores de riesgo cardiovascular. Material y métodos. Se incluyeron pacientes con diabetes tipo 2 sin presencia o antecedentes de cardiopatía. Se determinaron los factores de riesgo cardiovascular, el índice de masa corporal y los niveles séricos de glucosa, colesterol y triglicéridos. Se registró electrocardiograma convencional en reposo. La asociación de las variables en estudio con la ocurrencia de arritmias se calculó con un modelo de análisis multivariado ajustado por sexo. Resultados. Se integraron 199 pacientes: 113 mujeres (56.8% y 86 hombres (43.2%, y se identificó algún tipo de alteración electrocardiográfica en 29.1% de los sujetos. El hemibloqueo fascicular anterior (HFA y el bloqueo completo de rama derecha del Haz de His (BRDHH, constituyeron 75.9% de las alteraciones identificadas. Los pacientes con trastornos del ritmo y la conducción tienen niveles más elevados de colesterol y triglicéridos. La aparición de arritmias se relaciona directamente con el incremento de la edad (r= 0.75, p= 0.01. En el análisis multivariado ajustado por sexo la hipercolesterolemia y la edad se asociaron significativamente con las alteraciones del ritmo y la conducción: RM 1.5, IC95% 1.1-4.6, pObjective. To determine the most frequent alterations in rhythm and cardiac conduction in patients with type 2 diabetes without previous cardiopathy, and to establish the association of this disease with cardiovascular risk factors. Material and methods. Subjects with type 2 diabetes, without cardiopathy antecedents were included in the study. Cardiovascular risk factors, body mass index and serum glucose, cholesterol and trygliceride levels were determined. A resting electrocardiogram was recorded. The association between the variables under study and

Head position in the MEG helmet affects the sensitivity to anterior sources.

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Marinkovic, K; Cox, B; Reid, K; Halgren, E

2004-11-30

Current MEG instruments derive the whole-head coverage by utilizing a helmet-shaped opening at the bottom of the dewar. These helmets, however, are quite a bit larger than most people's heads so subjects commonly lean against the back wall of the helmet in order to maintain a steady position. In such cases the anterior brain sources may be too distant to be picked up by the sensors reliably. Potential "invisibility" of the frontal and anterior temporal sources may be particularly troublesome for the studies of cognition and language, as they are subserved significantly by these areas. We examined the sensitivity of the distributed anatomically-constrained MEG (aMEG) approach to the head position ("front" vs. "back") secured within a helmet with custom-tailored bite-bars during a lexical decision task. The anterior head position indeed resulted in much greater sensitivity to language-related activity in frontal and anterior temporal locations. These results emphasize the need to adjust the head position in the helmet in order to maximize the "visibility" of the sources in the anterior brain regions in cognitive and language tasks.

Agenesis of internal carotid artery associated with congenital anterior hypopituitarism

International Nuclear Information System (INIS)

Moon, W.-J.; Porto, L.; Lanfermann, H.; Zanella, F.E.; Weis, R.

2002-01-01

We report a rare case of unilateral agenesis of the internal carotid artery in association with congenital anterior hypopituitarism. The collateral circulation is supplied by a transsellar intercavernous anastomotic vessel connecting the internal carotid arteries. These abnormalities are well depicted on MRI and MRA. The agenesis of the internal carotid artery may explain the pathogenesis of some of congenital anterior hypopituitarism. (orig.)

Nanoparticulas basadas en complejos de Fe(II) con transicion de espin: sintesis, caracterizacion y aplicaciones en electronica molecular

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Monrabal Capilla, Maria

Esta tesis doctoral esta organizada en 5 capitulos y esta destinada al estudio de sistemas de Fe (II) que presentan el fenomeno de la transicion de espin a escala nanometrica. El capitulo 1 contiene una introduccion general sobre materiales moleculares multifuncionales, destacando aquellos ejemplos mas importantes. Por otro lado, se explicara el fenomeno de la transicion de espin, tratando aspectos conceptuales, los antecedentes mas importantes y la situacion actual. En el capitulo 2 se describen los diferentes procesos existentes para la obtencion de diferentes tipos de nanoparticulas. Ademas, se presenta la sintesis y caracterizacion de nanoparticulas del polimero de coordinacion unidimensional [Fe(Htrz)2(trz)]BF4, obtenidas mediante el metodo de micelas inversas. Estas nanoparticulas, con una estrecha distribucion de tamanos centrada alrededor de los 11 nm, presentan una transicion de espin muy abrupta, con un ancho ciclo de histeresis termica de unos 40K. En el capitulo 3 se describe el proceso de modificacion del tamano de las nanoparticulas descritas en el capitulo anterior, llevado a cabo variando la proporcion de surfactante/H2O en el medio. Ademas, con el objetivo de modificar las propiedades magneticas de las nanoparticulas obtenidas en el capitulo 2, se lleva a cabo la sintesis de nanoparticulas de polimeros de la misma familia del [Fe(Htrz)2(trz)]BF4. En concreto se sintetizaron 3 nuevos tipos de nanoparticulas basadas en el polimero [Fe(Htrz)1-x(NH2trz)x](ClO4)2, siendo x = 0.05, 0.15 y 0.3, en cada caso. Estas nanoparticulas siguen presentando una estrecha distribucion de tamanos y una transicion de espin muy abrupta y con un ancho ciclo de histeresis. Ademas, se observa que este ciclo se desplaza a temperaturas mas proximas a la temperatura ambiente a medida que se aumenta el porcentaje de 4-amino-1, 2, 4- triazol en la muestra. Pero al mismo tiempo se produce una disminucion de la anchura de este ciclo. Por ultimo, en este capitulo se presenta la

con mala calidad de vida

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Agustín Martín-Rodríguez

2007-01-01

Full Text Available En este estudio ex post facto se ha analizado si los familiares de pacientes con mala calidad de vida presentan diferencias en las variables clínicas de personalidad y relaciones familiares en función de que el paciente haya estado o no ingresado en una Unidad de Cuidados Intensivos. Seleccionamos dos grupos: 29 familiares de pacientes traumatizados graves transcurridos cuatro años de su ingreso en una UCI de Traumatología y con mala calidad de vida (debido a secuelas físicas y/o psicológicas tras el ingreso, tales como traumatismos craneoencefálicos, politraumatismos y tetraplejias traumáticas y 32 familiares de pacientes con mala calidad de vida con cuatro años de evolución de su enfermedad física (hipertensión, diabetes, artritis reumatoide y síndrome de intestino irritable que no han estado ingresados en la UCI. Para alcanzar nuestro objetivo empleamos una Encuesta Psicosocial y los siguientes instrumentos: Cuestionario de Análisis Clínico, Escala de Clima Social en la Familia y Escala de Adaptación Psicosocial de la Enfermedad. Los resultados mostraron que los familiares de pacientes con mala calidad de vida que estuvieron ingresados en la UCI hace cuatro años, presentan diferencias significativas en las variables agitación y expresividad comparados con los familiares de pacientes con mala calidad de vida que no han estado ingresados en la UCI.

Incidence and Outcomes of Acute Implant Extrusion Following Anterior Cervical Spine Surgery.

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Smith, Gabriel A; Pace, Jonathan; Corriveau, Mark; Lee, Sungho; Mroz, Thomas E; Nassr, Ahmad; Fehlings, Michael G; Hart, Robert A; Hilibrand, Alan S; Arnold, Paul M; Bumpass, David B; Gokaslan, Ziya; Bydon, Mohamad; Fogelson, Jeremy L; Massicotte, Eric M; Riew, K Daniel; Steinmetz, Michael P

2017-04-01

Multi-institutional retrospective case series of 8887 patients who underwent anterior cervical spine surgery. Anterior decompression from discectomy or corpectomy is not without risk. Surgical morbidity ranges from 9% to 20% and is likely underreported. Little is known of the incidence and effects of rare complications on functional outcomes following anterior spinal surgery. In this retrospective review, we examined implant extrusions (IEs) following anterior cervical fusion. A retrospective multicenter case series study involving 21 high-volume surgical centers from the AOSpine North America Clinical Research Network. Medical records for 17 625 patients who received cervical spine surgery (levels from C2 to C7) between January 1, 2005, and December 31, 2011, were reviewed to identify occurrence of 21 predefined treatment complications. Following anterior cervical fusion, the incidence of IE ranged from 0.0% to 0.8% across 21 institutions with 11 cases reported. All surgeries involved multiple levels, and 7/11 (64%) involved either multilevel corpectomies or hybrid constructs with at least one adjacent discectomy to a corpectomy. In 7/11 (64%) patients, constructs ended with reconstruction or stabilization at C7. Nine patients required surgery for repair and stabilization following IE. Average length of hospital stay after IE was 5.2 days. Only 2 (18%) had residual deficits after reoperation. IE is a very rare complication after anterior cervical spine surgery often requiring revision. Constructs requiring multilevel reconstruction, especially at the cervicothoracic junction, have a higher risk for failure, and surgeons should proceed with caution in using an anterior-only approach in these demanding cases. Surgeons can expect most patients to regain function after reoperation.

Anterior cervical spine surgery-associated complications in a retrospective case-control study.

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Tasiou, Anastasia; Giannis, Theofanis; Brotis, Alexandros G; Siasios, Ioannis; Georgiadis, Iordanis; Gatos, Haralampos; Tsianaka, Eleni; Vagkopoulos, Konstantinos; Paterakis, Konstantinos; Fountas, Kostas N

2017-09-01

Anterior cervical spine procedures have been associated with satisfactory outcomes. However, the occurrence of troublesome complications, although uncommon, needs to be taken into consideration. The purpose of our study was to assess the actual incidence of anterior cervical spine procedure-associated complications and identify any predisposing factors. A total of 114 patients undergoing anterior cervical procedures over a 6-year period were included in our retrospective, case-control study. The diagnosis was cervical radiculopathy, and/or myelopathy due to degenerative disc disease, cervical spondylosis, or traumatic cervical spine injury. All our participants underwent surgical treatment, and complications were recorded. The most commonly performed procedure (79%) was anterior cervical discectomy and fusion (ACDF). Fourteen patients (12.3%) underwent anterior cervical corpectomy and interbody fusion, seven (6.1%) ACDF with plating, two (1.7%) odontoid screw fixation, and one anterior removal of osteophytes for severe Forestier's disease. Mean follow-up time was 42.5 months (range, 6-78 months). The overall complication rate was 13.2%. Specifically, we encountered adjacent intervertebral disc degeneration in 2.7% of our cases, dysphagia in 1.7%, postoperative soft tissue swelling and hematoma in 1.7%, and dural penetration in 1.7%. Additionally, esophageal perforation was observed in 0.9%, aggravation of preexisting myelopathy in 0.9%, symptomatic recurrent laryngeal nerve palsy in 0.9%, mechanical failure in 0.9%, and superficial wound infection in 0.9%. In the vast majority anterior cervical spine surgery-associated complications are minor, requiring no further intervention. Awareness, early recognition, and appropriate management, are of paramount importance for improving the patients' overall functional outcome.

Concomitant surgical correction of severe stress urinary incontinence and anterior vaginal wall prolapse by anterior vaginal wall wrap: 18 months outcomes

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Zargham, Mahtab; Alizadeh, Farshid; Tadayyon, Farhad; Khorrami, Mohammad-Hatef; Nouri-Mahdavi, Kia; Gharaati, Mohammad Reza; Izadpanahi, Mohammad Hossein; Yazdani, Mohammad; Mazdak, Hamid

2013-01-01

Background: The aim of this study is to evaluate the outcome of an innovative, minimally invasive sling technique with autologous tissue in women with concomitant incontinence and anterior vaginal wall prolapse (AVWP). Materials and Methods: Fifty-six women with stress urinary incontinence (SUI) or mixed urinary incontinence and AVWP were randomly assigned into two groups: In Group A (26 patients), anterior colporrhaphy (Kelly placation) and sling placement using a strip of anterior vaginal wall were performed, and in Group B (30 patients), transvaginal mesh correction of AVWP and tension-free vaginal tape (TVT) insertion (retropubic – craniocaudal route) using polypropylene mesh were carried out. The patients were followed-up for over 18 months and were assessed objectively using a 48 h frequency-volume chart, a 48 h pad test and a standardized stress test. Related surgical complications and outcomes were recorded and compared. Results: Surgical cure rates for Group A and Group B at the first (3 days) and last (18 months) post-operative visits were 62% and 84%; and 54%, and 72%, respectively (P = 0.09 and 0.31). Complications occurred in 9 patients (44%) of Group B, but only 3 patients (12%) in Group A. Conclusion: Vaginal sling surgery using an anterior vaginal wall strip can improve SUI and in comparison with propylene mesh is associated with lower complication rates. Although, the surgical success rate of this technique is lower than T-Sling, larger studies with selected patients will help assess the suitable patients for this pelvic reconstructive surgery. PMID:24516492

Concomitant surgical correction of severe stress urinary incontinence and anterior vaginal wall prolapse by anterior vaginal wall wrap: 18 months outcomes

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Mahtab Zargham

2013-01-01

Full Text Available Background: The aim of this study is to evaluate the outcome of an innovative, minimally invasive sling technique with autologous tissue in women with concomitant incontinence and anterior vaginal wall prolapse (AVWP. Materials and Methods : Fifty-six women with stress urinary incontinence (SUI or mixed urinary incontinence and AVWP were randomly assigned into two groups: In Group A (26 patients, anterior colporrhaphy (Kelly placation and sling placement using a strip of anterior vaginal wall were performed, and in Group B (30 patients, transvaginal mesh correction of AVWP and tension-free vaginal tape (TVT insertion (retropubic - craniocaudal route using polypropylene mesh were carried out. The patients were followed-up for over 18 months and were assessed objectively using a 48 h frequency-volume chart, a 48 h pad test and a standardized stress test. Related surgical complications and outcomes were recorded and compared. Results: Surgical cure rates for Group A and Group B at the first (3 days and last (18 months post-operative visits were 62% and 84%; and 54%, and 72%, respectively (P = 0.09 and 0.31. Complications occurred in 9 patients (44% of Group B, but only 3 patients (12% in Group A. Conclusion: Vaginal sling surgery using an anterior vaginal wall strip can improve SUI and in comparison with propylene mesh is associated with lower complication rates. Although, the surgical success rate of this technique is lower than T-Sling, larger studies with selected patients will help assess the suitable patients for this pelvic reconstructive surgery.

Anterior ankle impingement after tendo-Achilles lengthening for long-standing equinus deformity in residual poliomyelitis.

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Sung, Ki Hyuk; Chung, Chin Youb; Lee, Kyoung Min; Lee, Seung Yeol; Park, Moon Seok

2013-09-01

This study was performed to investigate anterior ankle impingement after tendo-Achilles lengthening for long-standing equinus deformity in patients with residual poliomyelitis and to investigate whether the severity of preoperative equinus deformity affected the occurrence of symptomatic anterior impingement. Twenty-seven consecutive patients (mean age, 43.8 ± 9.4 years) with residual poliomyelitis who underwent tendo-Achilles lengthening for equinus foot deformity were included. On lateral foot-ankle weight-bearing radiographs, the tibiocalcaneal angle, plantigrade angle, and McDermott grade were measured and the presence of anterior blocking spur was evaluated. Eleven patients (40.7%) had anterior ankle impingement on radiographic findings preoperatively and 24 patients (88.9%) at latest follow-up. There was a significant difference in McDermott grade between preoperative and latest follow-up (P poliomyelitis had anterior ankle impingement after tendo-Achilles lengthening for long-standing equinus deformity, and the presence of symptomatic anterior ankle impingement was significantly associated with the severity of the equinus deformity. Therefore, for residual poliomyelitis patients with severe long-standing equinus deformity, surgeons should consider the possibility of a subsequent anterior procedure for anterior impingement after tendo-Achilles lengthening. Level IV, retrospective case series.

Biomechanical comparison of supraacetabular external fixation and anterior pelvic bridge plating.

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Çavuşoğlu, Ali Turgay; Erbay, Fatma Kübra; Özsoy, Mehmet Hakan; Demir, Teyfik

2017-10-01

Unstable pelvic ring injuries are complex and risky injuries due to high morbidity and mortality. Although anterior pelvic external fixator is a suitable method for rapid stabilization of an injured pelvic ring, due to some disadvantages such as high complication rate, nerve damage, and difficulties of patient's mobility and comfort, there has recently been increased searching for alternative methods for stabilization of the pelvic ring. Pubic symphysis zone freely moves in pelvic models. This study aims to evaluate the biomechanical stability of anterior pelvic bridge plating and compare it with supraacetabular external fixators in an untreated unstable pelvic fracture model. Samples were loaded statically with 2-mm/min loading rate in single leg standing position. Maximum load was 2.3 kN. When loading the samples, photographs were taken continuously. Stiffness values were calculated from the load displacement curves. Some reference parameters were described and were measured from unloaded and 2.3-kN-loaded photographs of the test. The mean stiffness values were 491.14 ± 52.22, 478.55 ± 41.44, and 470.25 ± 44.51 N/mm for anterior pelvic bridge plating group, supraacetabular external fixator group, and Control group, respectively. According to the measured parameters from photographs, the mean displacement at the pubic symphysis was 4.7 ± 0.32, 15.8 ± 2.01, and 18.2 ± 0.47 mm for anterior pelvic bridge plating, supraacetabular external fixator, and Control group, respectively. The highest displacement in the pubic symphysis was found in Control group, and minimum displacement was observed in anterior pelvic bridge plating group. When the perpendicular distance between the right and left lower end of ischium was examined, it was observed that displacement was minimum in anterior pelvic bridge plating group compared to other two groups, regarding to the high stability of pubic symphysis. In conclusion, this study revealed

Bypass grafting to the anterior tibial artery.

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Armour, R H

1976-01-01

Four patients with severe ischaemia of a leg due to atherosclerotic occlusion of the tibial and peroneal arteries had reversed long saphenous vein grafts to the patent lower part of the anterior tibial artery. Two of these grafts continue to function 19 and 24 months after operation respectively. One graft failed on the fifth postoperative day and another occluded 4 months after operation. The literature on femorotibial grafting has been reviewed. The early failure rate of distal grafting is higher than in the case of femoropopliteal bypass, but a number of otherwise doomed limbs can be salvaged. Contrary to widely held views, grafting to the anterior tibial artery appears to give results comparable to those obtained when the lower anastomosis is made to the posterior tibial artery.

Cataract Surgery in Anterior Megalophthalmos: A Review

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GALVIS, Virgilio; TELLO, Alejandro; M. RANGEL, Carlos

2015-01-01

Anterior megalophthalmos is characterized by megalocornea associated with a very broad anterior chamber and ciliary ring elongation. It is also called X-linked megalocornea. It is accompanied by early development of cataracts, zonular anomalies, and, rarely, vitreoretinal disorders. Subluxation of a cataract can occur in cataract surgery because of zonular weakness. In addition, in most patients, standard intraocular lens (IOL) decentration is a risk because of the enlarged sulcus and capsular bag. These unique circumstances make cataract surgery challenging. To date, several approaches have been developed. Implantation of a retropupillary iris-claw aphakic intraocular lens may be a good option because it is easier than suturing the IOL and can have better and more stable anatomic and visual outcomes, compared to other techniques. PMID:27350950

Experiencia inicial con el retiro de electrodos de estimulación cardiaca mediante una técnica de extracción percutánea mecánica

OpenAIRE

Mauricio Duque; Juan C. Díaz; Jorge E. Marín; Julián M. Aristizábal; Jorge E. Velásquez; Laura Duque; William Uribe

2015-01-01

Introducción: En Colombia el uso de técnicas de extracción de electrodos de estimulación cardiaca es infrecuente, en parte debido al alto costo de los materiales utilizados para la extracción percutánea y por otra parte por los riesgos percibidos asociados al procedimiento. Esto ha llevado a que muchos electrodos disfuncionantes o infectados sean abandonados o retirados mediante cirugía abierta. Con base en lo anterior se ha desarrollado un programa de extracción de electrodos mediante el uso...

[Benign paroxysmal positional vertigo of the anterior semicircular canal: clinical aspects and treatment].

Science.gov (United States)

Lorin, P

2005-01-01

To describe the videonystagmographic characteristics and the treatment of the patients reached with a canalolithiasis or a cupulolithiasis of the anterior semicircular canal. Retrospective study concerning patients treated for a Benign Paroxysmal Positional Vertigo (BPPV) of the anterior semicircular canal. Each patient after analysis under videonystagmoscopy (VNS) and under videonystagmography (VNG) was treated by maneuvers. On 462 observations of typical BPPV 6 cases of VPPB of the anterior semicircular canal were treated concerning 5 patients (1.3%). The BPPV of the anterior semicircular canal are rare. We modified our method of diagnosis, and our therapeutic techniques could be validated with the help of the two-dimensional videonystagmography.

Myocardial Bridges and their Relationship to the Anterior Interventricular Branch of the Left Coronary Artery

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Lima Vanildo Júnior de Melo

2002-01-01

Full Text Available OBJECTIVE: To analyze the relationship between myocardial bridges and the anterior interventricular branch (anterior descending of the left coronary artery. METHODS: The study was carried out with postmortem material, and methods of dissection and observation were used. We assessed the perimeter of the anterior interventricular branch of the left coronary artery using a pachymeter, calculated its proximal and distal diameters in relation to the myocardial bridge, and also its diameter under the myocardial bridge in 30 hearts. We also observed the position of the myocardial bridge in relation to the origin of the anterior interventricular branch. RESULTS: The diameters of the anterior interventricular branch were as follows: the mean proximal diameter was 2.76±0.76 mm; the mean diameter under the myocardial bridge was 2.08±0.54 mm; and the mean distal diameter was 1.98±0.59 mm. In 33.33% (10/30 of the cases, the diameter of the anterior interventricular branch under the myocardial bridge was lower than the diameter of the anterior interventricular branch distal to the myocardial bridge. In 3.33% (1/30 of the cases, an atherosclerotic plaque was found in the segment under the myocardial bridge. The myocardial bridge was located in the middle third of the anterior interventricular branch in 86.66% (26/30 of the cases. CONCLUSION: Myocardial bridges are more frequently found in the middle third of the anterior interventricular branch of the left coronary artery. The diameter of the anterior interventricular branch of the left coronary artery under the myocardial bridge may be smaller than after the bridge. Myocardial bridges may not provide protection against the formation of atherosclerotic plaque inside the anterior interventricular branch of the left coronary artery.

Anterior chamber angle imaging with swept-source optical coherence tomography: measuring peripheral anterior synechia in glaucoma.

Science.gov (United States)

Lai, Isabel; Mak, Heather; Lai, Gilda; Yu, Marco; Lam, Dennis S C; Leung, Christopher K S

2013-06-01

To investigate the use of swept-source optical coherence tomography (OCT) for measuring the area and degree of peripheral anterior synechia (PAS) involvement in patients with angle-closure glaucoma. Cross-sectional study. Twenty-three eyes with PAS (detected by indentation gonioscopy) from 20 patients with angle-closure glaucoma (20 eyes had primary angle-closure glaucoma and 3 eyes had angle-closure glaucoma secondary to chronic anterior uveitis [n = 2] and Axenfeld-Rieger syndrome [n = 1]). The anterior chamber angles were evaluated with indentation gonioscopy and imaged by swept-source OCT (Casia OCT, Tomey, Nagoya, Japan) in room light and in the dark using the "angle analysis" protocol, which was composed of 128 radial B-scans each with 512 A-scans (16-mm scan length). The area and degree of PAS involvement were measured in each eye after manual detection of the scleral spur and the anterior irido-angle adhesion by 2 masked observers. The interobserver variability of the PAS measurements was calculated. The agreement of PAS assessment by gonioscopy and OCT, the area and the degree of PAS involvement, and the intraclass correlation coefficient (ICC) of interobserver PAS measurements. The area of PAS (mean ± standard deviation) was 20.8 ± 16.9 mm(2) (range, 3.9-74.9 mm(2)), and the degree of PAS involvement was 186.5 ± 79.9 degrees (range, 42-314 degrees). There was no difference in the area of PAS (P = 0.90) and the degree of PAS involvement (P = 0.95) between images obtained in room light and in the dark. The interobserver ICCs were 0.99 (95% confidence interval [CI], 0.98-1.00) for the area of PAS and 0.99 (95% CI, 0.97-1.00) for the degree of PAS involvement. There was good agreement of PAS assessment between gonioscopy and OCT images (kappa = 0.79; 95% CI, 0.67-0.91). Swept-source OCT allows visualization and reproducible measurements of the area and degree of PAS involvement, providing a new paradigm for evaluation of PAS progression and risk assessment

Perawatan gigi impaksi anterior rahang atas pada remaja (The treatment of maxillary anterior impacted teeth in adolescent

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Herdi Eko Pranjoto

2005-09-01

Full Text Available The incidence of impacted tooth in adolescent is usually found by oral surgeon or orthodontist during their sequence of treatments. The maxillary anterior teeth, especially canine and third lower molar are the most common impacted teeth found as the result of their eruption disturbances. The surgical technique principle is to facilitate the impacted tooth, so that it can be erupted by creating a window and take the bone obstructed surrounding the tooth crown surgically and afterward it is orthodontically tracted. In a case of third molar germ which is predicted to be impacted in mesio version position, germinectomy is preferred to prevent anterior mechanical drive during its development which may cause mal-alignment of the mandibular teeth. Germinectomy which is usually easier than odontectomy, the germ position, and less complication after the surgical intervention are three factors that should be considered in making decision.

TRAMPEO DE Phytophthora cinnamomi EN BOSQUE DE ENCINO CON DOS ESPECIES ORNAMENTALES E INDUCCIÓN DE SU ESPORULACIÓN

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Alejandra Almaraz-Sánchez

2013-01-01

Full Text Available La mortalidad del encino se ha acentuado recientemente en varios estados del país. La etiología en muchos casos se desconoce. Los bosques de encino están siendo afectados por la “enfermedad de la tinta” (Phytophthora cinnamomi Rands. en los estados de Colima, Jalisco y Guerrero. La enfermedad causada por P. cinnamomi es de gran importancia; sin embargo, el aislamiento y la esporulación del patógeno representan una gran dificultad. Debido a lo anterior, los objetivos del presente estudio fueron a evaluar la eficiencia de dos plantas trampa, Camellia japonica y Rhododendron indicum (L. Sweet utilizando una suspensión de suelo y b inducir la esporulación del patógeno. Para ello, discos de tejido foliar (6 mm de las especies trampa fueron embebidos en una suspensión de suelo por 24 y 48 h para luego ser sembrados en medio selectivo PARPH. La especie R. indicum presentó una mayor efectividad de captura de 64.10 % comparada con 6.83 % de C. japonica. Los mejores resultados de esporulación se obtuvieron con una mezcla de agua-suelo (350 mL-200 g.

Evaluation of anterior urethral stricture using thick slab SSFSE MR urethrography

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Park, Byung Kwan; Kim, Chan Kyo (Dept. of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan Univ. School of Medicine, Seoul (Korea)), e-mail: rapark@skku.edu; Lee, Sung Won (Dept. of Urology, Samsung Medical Center, Sungkyunkwan Univ. School of Medicine, Seoul (Korea))

2010-12-15

Background: Magnetic resonance urethrography (MRU) can be used for depicting not only anterior urethral strictures but also periurethral anatomy in order to produce a management plan. Purpose: To determine if thick slab single-shot fast spin echo (SSFSE) MRU is useful for evaluating anterior urethral stricture compared to fast recovery fast spin echo (FRFSE) MRU. Material and Methods: Ten patients with benign anterior urethral stricture underwent both thick slab SSFSE MRU and FRFSE MRU using sterile jelly for urethral distension before retrograde urethrography. The glans penis was tied at the time of MRU. The two types of MR image were compared regarding stricture length, scan time, and image quality. We also determined whether or not both of the two MR sequences could display an entire anterior urethra on one image. Results: The stricture length on thick slab SSFSE and FRFSE MRU ranged from 4.0 to 71.3 mm (36.4 {+-} 21.8 mm) and from 4.0 to 67.5 mm (35.7 {+-} 20.8 mm), respectively (P > 0.05). The mean scan time for thick slab SSFSE and FRFSE sequences was 2 s and 194 s, respectively (P < 0.05). However, regarding image quality, thick slab SSFSE MRU was inferior to FRFSE MRU (P < 0.05). All the thick slab SSFSE MRU displayed the entire anterior urethra on one image, while only five FRFSE MRU did so (P < 0.05). Conclusion: Thick slab SSFSE MRU can provide a concordant stricture length when compared to the FRFSE MRU and imaging of the entire length of the anterior urethral stricture with subjective reduced image quality and scan time.

Evaluation of anterior urethral stricture using thick slab SSFSE MR urethrography

International Nuclear Information System (INIS)

Park, Byung Kwan; Kim, Chan Kyo; Lee, Sung Won

2010-01-01

Background: Magnetic resonance urethrography (MRU) can be used for depicting not only anterior urethral strictures but also periurethral anatomy in order to produce a management plan. Purpose: To determine if thick slab single-shot fast spin echo (SSFSE) MRU is useful for evaluating anterior urethral stricture compared to fast recovery fast spin echo (FRFSE) MRU. Material and Methods: Ten patients with benign anterior urethral stricture underwent both thick slab SSFSE MRU and FRFSE MRU using sterile jelly for urethral distension before retrograde urethrography. The glans penis was tied at the time of MRU. The two types of MR image were compared regarding stricture length, scan time, and image quality. We also determined whether or not both of the two MR sequences could display an entire anterior urethra on one image. Results: The stricture length on thick slab SSFSE and FRFSE MRU ranged from 4.0 to 71.3 mm (36.4 21.8 mm) and from 4.0 to 67.5 mm (35.7 20.8 mm), respectively (P > 0.05). The mean scan time for thick slab SSFSE and FRFSE sequences was 2 s and 194 s, respectively (P < 0.05). However, regarding image quality, thick slab SSFSE MRU was inferior to FRFSE MRU (P < 0.05). All the thick slab SSFSE MRU displayed the entire anterior urethra on one image, while only five FRFSE MRU did so (P < 0.05). Conclusion: Thick slab SSFSE MRU can provide a concordant stricture length when compared to the FRFSE MRU and imaging of the entire length of the anterior urethral stricture with subjective reduced image quality and scan time.

Calidad de vida relacionada con la salud del niño y del adolescente con obesidad

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Hurtado-Valenzuela, Jaime Gabriel; Álvarez-Hernández, Gerardo

2014-01-01

Objetivo Estimar la calidad de vida relacionada con la salud (CVRS) en un grupo de niños y adolescentes con obesidad de la ciudad de Hermosillo, Sonora, México. Métodos Se realizó un estudio transversal utilizando el cuestionario PedsQL® para comparar la CVRS de 200 niños y adolescentes con obesidad al igual que a sus padres, con dos grupos de control, uno de la comunidad (n=400) y otro grupo de usuarios (n=200) del Hospital Infantil del Estado de Sonora. Las diferencias en la CVRS fueron eva...

Diagnóstico del estado nutricional de los pacientes con demencia tipo Alzheimer registrados en el Grupo de Neurociencias, Medellín, 2004.

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Angélica María Muñoz

2006-03-01

Full Text Available Introducción. Los pacientes con demencia tipo Alzheimer presentan riesgo de deterioro del estado nutricional por cambios fisiológicos, socioeconómicos y psicológicos relacionados con la enfermedad, lo que se suma al proceso de envejecimiento. Objetivo. Describir el estado nutricional de los pacientes con demencia tipo Alzheimer del Grupo de Neurociencias de la Universidad de Antioquia según el estadio de evolución. Materiales y métodos. Estudio descriptivo transversal. Cada paciente fue evaluado para obtener información general, de salud, composición corporal, alimentaria, signos clínicos y aspectos psicosociales. Resultados. Se evaluaron 77 pacientes con edad promedio de 65,5±12,8 años, 48 de ellos con antecedentes familiares de la enfermedad y 39 con más de 60 meses de diagnóstico; el estadio más frecuente fue el moderado y el tipo de demencia más común, la familiar precoz; la enfermedad se diagnosticó antes de los 50 años en 26 pacientes. Hubo diferencias estadísticamente significativas en el índice de masa corporal, el área grasa braquial y el área magra braquial por estadio, y mayor compromiso en el estadio grave (p=0,001, p=0,000 y p=0,000; en todos los estadios se presentó compromiso de la reserva energética y muscular. El calcio y los folatos fueron los nutrientes más comprometidos en el consumo. Conclusión. Aun en el estadio inicial, los pacientes presentaron compromiso del estado nutricional, evidenciado por déficit en la reserva energética y muscular, signos clínicos y consumo inadecuado de calcio y folatos. A medida que avanza la enfermedad, el compromiso de los indicadores nutricionales es mayor. Lo anterior evidencia la necesidad del cuidado nutricional individual de acuerdo con el estadio de la enfermedad.

Effect of the Mitral Valve's Anterior Leaflet on Axisymmetry of Transmitral Vortex Ring.

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Falahatpisheh, Ahmad; Pahlevan, Niema M; Kheradvar, Arash

2015-10-01

The shape and formation of transmitral vortex ring are shown to be associated with diastolic function of the left ventricle (LV). Transmitral vortex ring is a flow feature that is observed to be non-axisymmetric in a healthy heart and its inherent asymmetry in the LV assists in efficient ejection of the blood during systole. This study is a first step towards understanding the effects of the mitral valve's anterior leaflet on transmitral flow. We experimentally study a single-leaflet model of the mitral valve to investigate the effect of the anterior leaflet on the axisymmetry of the generated vortex ring based on the three-dimensional data acquired using defocusing digital particle image velocimetry. Vortex rings form downstream of a D-shaped orifice in presence or absence of the anterior leaflet in various physiological stroke ratios. The results of the statistical analysis indicate that the formed vortex ring downstream of a D-shaped orifice is markedly non-axisymmetric, and presence of the anterior leaflet improves the ring's axisymmetry. This study suggests that the improvement of axisymmetry in presence of the anterior leaflet might be due to coupled dynamic interaction between rolling-up of the shear layer at the edges of the D-shaped orifice and the borders of the anterior leaflet. This interaction can reduce the non-uniformity in vorticity generation, which results in more axisymmetric behavior compared to the D-shaped orifice without the anterior leaflet.

Pulpotomía con electrocauterio en pacientes con hemofilia A

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Carbonell Rodriguez, Rosario

2017-01-01

Rehabilita la salud oral de un niños con Hemofilia A, empleando el Electrocauterio como una alternativa en la terapia pulpar, específicamente en la pulpotomía, para lo cual se realiza un minucioso examen clínico y anamnesis, que respaldados con exámenes complementarios, permite determinar el plan de tratamiento. La rehabilitación integral se llevó a cabo, previo consentimiento informado del padre, en sala de operaciones bajo anestesia general, debido a la condición sistémica del niño. Incl...

Intervención con menores con adicciones desde Proyecto Hombre

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Pardo-Esteban, Belén; Escalza-González, Amaia

2015-01-01

En el citado seminario informaremos del programa de atención y prevención de las toxicomanías y otras adicciones, llevado a cabo por la Asociación Proyecto hombre. A continuación, trataremos la formación en adicciones y toxicomanía con los estudiantes, mediante charla, cuestionarios sobre conocimientos básicos en prevención de toxicomanía en menores y los diferentes programas de intervención posibles aducados a los perfiles de los usuarios. Terminaremos con un debate sobre los temas tra...

NARRATIVAS CONVERSACIONALES CON FAMILIAS Y DOCENTES DE NIÑOS Y NIÑAS CON DISCAPACIDAD: UN APORTE METODOLÓGICO

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NORA ANETH PAVA-RIPOLL

2015-01-01

Full Text Available Se presentan algunas ventajas y limitaciones de las narrativas conversacionales como estrategia de investigación para el trabajo con familias y docentes de niños con discapacidad. La narración realizada por muchas voces, como sucede en una conversación, privilegia la relación y el discurso entre las personas como fuente de construcción consensuada de significados. La interacción triádica entre familia, inclusión educativa y salud orientó los encuentros conversacionales con padres, acudientes y profesores de estos niños en la ciudad de Manizales (Colombia. Los participantes conformaron equipos conversacionales y equipos reflexivos y conversaron sobre preguntas propuestas, previamente elaboradas. Con este ejercicio investigativo se resalta el valor interaccional de esta estrategia desde tres ámbitos: entre los par ticipantes, con el investigador y con el contexto situacional. Se argumenta que la reflexividad está más relacionada con el hacer que con el ser y el sentir de las personas, las cuales no necesariamente se transforman en la narrativa...

Laparoendoscopic single-site Heller myotomy with anterior fundoplication for achalasia.

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Barry, Linda; Ross, Sharona; Dahal, Sujat; Morton, Connor; Okpaleke, Chinyere; Rosas, Melissa; Rosemurgy, Alexander S

2011-06-01

Laparoendoscopic single-site (LESS) surgery is beginning to include advanced laparoscopic operations such as Heller myotomy with anterior fundoplication. However, the efficacy of LESS Heller myotomy has not been established. This study aimed to evaluate the authors' initial experience with LESS Heller myotomy for achalasia. Transumbilical LESS Heller myotomy with concomitant anterior fundoplication for achalasia was undertaken for 66 patients after October 2007. Outcomes including operative time, complications, and length of hospital stay were recorded and compared with those for an earlier contiguous group of 66 consecutive patients undergoing conventional multi-incision laparoscopic Heller myotomy with anterior fundoplication. Symptoms before and after myotomy were scored by the patients using a Likert scale ranging from 0 (never/not severe) to 10 (always/very severe). Data were analyzed using the Mann-Whitney U test, the Wilcoxon matched-pairs test, and Fisher's exact test where appropriate. Patients undergoing LESS Heller myotomy were similar to those undergoing conventional laparoscopic Heller myotomy in gender, age, body mass index (BMI), blood loss, and length of hospital stay. However, the patients undergoing LESS Heller myotomies had operations of significantly longer duration (median, 117 vs. 93 min with the conventional laparoscopic approach) (pHeller myotomy, additional ports/incisions were required. No patients were converted to "open" operations, and no patients had procedure-specific complications. Symptom reduction was dramatic and satisfying after both LESS and conventional laparoscopic myotomy with fundoplication. The symptom reduction was similar with the two procedures. The LESS approach left no apparent umbilical scar. Heller myotomy with anterior fundoplication effectively treats achalasia. The findings showed LESS Heller myotomy with anterior fundoplication to be feasible, safe, and efficacious. Although the LESS approach increases operative

The significance of biometric parameters in determining anterior teeth width

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Strajnić Ljiljana

2013-01-01

Full Text Available Background/Aim. An important element of prosthetic treatment of edentulous patients is selecting the size of anterior artificial teeth that will restore the natural harmony of one’s dentolabial structure as well as the whole face. The main objective of this study was to determine the correlation between the inner canthal distance (ICD and interalar width (IAW on one side and the width of both central incisors (CIW, the width of central and lateral incisors (CLIW, the width of anterior teeth (ATW, the width between the canine cusps (CCW, which may be useful in clinical practice. Methods. A total of 89 subjects comprising 23 male and 66 female were studied. Their age ranged from 19 to 34 years with the mean of 25 years. Only the subjects with the preserved natural dentition were included in the sample. All facial and intraoral tooth measurements were made with a Boley Gauge (Buffalo Dental Manufacturing Co., Brooklyn NY, USA having a resolution of 0.1mm. Results. A moderate correlation was established between the interalar width and combined width of anterior teeth and canine cusp width (r = 0.439, r = 0.374. A low correlation was established between the inner canthal distance and the width of anterior teeth and canine cusp width (r = 0.335, r = 0.303. The differences between the two genders were highly significant for all the parameters (p < 0.01. The measured facial distances and width of anterior teeth were higher in men than in women. Conclusion. The results of this study suggest that the examined interalar width and inner canthal distance cannot be considered reliable guidelines in the selection of artificial upper anterior teeth. However, they may be used as a useful additional factor combined with other methods for objective tooth selection. The final decision should be made while working on dentures fitting models with the patient’s consent.

Ritidoplastia con doble anclaje: una técnica para principiantes

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B. Mole

2013-09-01

Full Text Available Nuestra opción técnica del lifting cérvico-facial reposa sobre los tres principios siguientes: disección subcutánea después de haber efectuado una pasada con una cánula fina, introducida por 2 o 3 mini-incisiones, primer anclaje clásico a la altura del SMAS y segundo anclaje tras lograr la tensión apropiada del colgajo cutáneo a 1 cm de la incisión inicial. Reconocemos las siguientes ventajas de este método: seguridad en el plano de disección, ausencia de tracción a nivel de las cicatrices y respeto del capital capilar, proporcionando un resultado final natural de acuerdo a la solicitud por parte del tipo de pacientes que por lo general vemos en Francia. La técnica propuesta puede ser particularmente útil para aquellos cirujanos con experiencia limitada. Presentamos una serie de 132 casos recogidos en los últimos 5 años. La tasa de reintervención fue del 3 % , pero pensamos que subestima la calidad de los resultados y que debemos continuar esforzándonos por evitar las eventuales correcciones insuficientes de la ptosis yugal, de los surcos nasogenianos y del contorno mandibular. Preconizamos como vía de acceso la vía anterior, sobre todo en los cuellos difíciles y limitamos al máximo la disección mastoidea. Limitamos en lo posible las técnicas de tensión malar, origen de postoperatorios difíciles de manejar, y preferimos la restauración del volumen de la región empelando lipoinfiltración secundaria o el uso si es necesario, de algunos de los productos voluminizadores que actualmente están disponibles.

Sonografía de bazo y timo como elemento evaluador de la respuesta inmune en niños con infecciones recurrentes

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Jesús Rabaza

2010-08-01

Full Text Available El bazo es un órgano linfoide secundario. Dentro de sus funciones encontramos la formación de anticuerpos de clase IgM e IgG, fundamentalmente, y la fagocitosis de bacterias encapsuladas. Nos propusimos mensurar las dimensiones del bazo en niños con infecciones recurrentes, con el propósito de describirlas como marcador diagnóstico y explorar la probable relación existente entre las características tímicas y las dimensiones del bazo. Se estudiaron 81 pacientes que acudieron a la consulta de inmunología del hospital materno infantil "Dr. Ángel Arturo Aballí Arellano" por infecciones recurrentes, en las edades entre 8 meses y 9 años. Se excluyeron todos los niños con valor nutricional menor del tercer percentil, los que habían consumido esteroides en los 45 días anteriores, así como diversas enfermedades agudas y crónicas que cursan con aumento o disminución del volumen del bazo. Las áreas tímica y esplénica fueron medidas por ecografía mediastinal y abdominal. La longitud, el índice esplénico y el peso fueron menores en los pacientes con infecciones recurrentes, siendo este hallazgo significativo para el grupo de 12 a 23 meses de edad. El peso y el índice esplénico fueron menores en niños con depleción del área tímica. Todo parece indicar que la evaluación sonográfica del bazo es muy importante en los pacientes comprendidos entre 1 y 2 años de edad y en aquellos que presentan depleción del área tímica, pacientes estos que por encontrarse en edades donde se administran las vacunas programadas en el Esquema Cubano de Inmunización y tener afectado un órgano central de la respuesta inmune podrían presentar una respuesta deficitaria y requerir esquemas especiales.

MODELADO CON REDES DE PETRI E IMPLEMENTACIÓN CON GRAFCET DE UN SISTEMA DE MANUFACTURA FLEXIBLE CON PROCESOS CONCURRENTES Y RECURSOS COMPARTIDOS

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Johanna Stella Castellanos Arias

2010-01-01

Full Text Available En este trabajo, se presenta el modelado de un Sistema de Manufactura Flexible (SMF, con procesos concurrentes y recursos compartidos mediante Sistemas a Eventos Discretos (SED, específicamente Redes de Petri (RdP, y GRAFCET. El SMF se plantea como un modelo hipotético que se modela con una RdP con el objeto de identificar su dinámica y hallar la secuencia óptima de funcionamiento del sistema. Se desarrolló un modelo matemático que permite estimar el vector de tiempo acumulado de un proceso modelado mediante una RdP, el cual constituye la base para hallar la mejor secuencia posible del sistema modelado. Por último, se realizó una implementación en el Laboratorio de Automatización de la Universidad Militar Nueva Granada, que simula el funcionamiento del SMF modelado por un montaje electrohidroneumático controlado con GRAFCET mediante PLC.

Relación del perfil salival con el grado de inmunosupresión en pacientes infectados con VIH con y sin tratamiento antirretroviral

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Vera Cruz, Moisés; Cornejo Salaza, José; Chiyong, Teresa Evaristo; Arevalo Abanto, Jorge A.; Villanueva Vílchez, Hugo G.

2014-01-01

El objetivo del estudio fue evaluar el perfil salival de pacientes con infección por VIH con y sin Tratamiento Antirretroviral de Gran Actividad (TARGA), por medio de la evaluación de los síntomas de hipofunción salival (Xerostomía, Disgeusia, Disfagia y Susceptibilidad de desarrollar úlceras orales), la Tasa de Flujo salival no estimulado, el pH salival y la viscosidad salival; estableciendo su relación con el Grado de Inmunosupresión, evaluado por medio del Recuento de Linfocitos CD4/μl. Se...

Activation of anterior insula during self-reflection.

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Modinos, Gemma; Ormel, Johan; Aleman, André

2009-01-01

Functional neuroimaging studies have suggested activation of midline frontoparietal brain regions to be at the core of self-related processes. However, although some studies reported involvement of the insula, little attention has been paid to this region as forming part of the "self"-network. Using functional magnetic resonance imaging (fMRI), we aimed at replicating and extending previous studies by scanning subjects whilst reflecting upon their own personal qualities as compared to those of an acquaintance. A third condition with statements about general knowledge was used to control for attention, semantic processing and decision making processes. The results showed a significant effect of task in brain activity, consistent with previous findings, by which both person conditions recruited a common set of medial prefrontal and posterior regions, yet significant differences between self and other were found in the medial prefrontal cortex (MPFC) and the anterior cingulate cortex (ACC). Notably, significant neural activation in the left anterior insula was observed as uniquely associated with self-reflection. The results provide further evidence for the specific recruitment of anterior MPFC and ACC regions for self-related processing, and highlight a role for the insula in self-reflection. As the insula is closely connected with ascending internal body signals, this may indicate that the accumulation of changes in affective states that might be implied in self-processing may contribute to our sense of self.

Retención y Penetración en Estacones de Eucalyptus Saligna. Sometidos a Tratamiento con CuSO4 y Sal CCC, en Baño Caliente y frio y Vacio-Presión

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Escobar C. Oscar

1987-09-01

Full Text Available Este trabajo describe y da los resultados obtenidos con el pretratamiento de estacones de Eucalyptus saligna a tres soluciones de CUS04 y su posterior tratamiento con sales CCA (OSMOSE K-33. El sulfato de cobre se aplicó por el método de baño caliente y frío, seguido por el proceso de difusión durante una semana; para los anteriores tratamientos se usó madera verde o parcialmente seca al aire; las sales CCA se aplicaron a madera seca por el método de vacío-presión. Una de las razones para llevar a cabo este refuerzo de las sales CCA, es haber encontrado postes de eucalipto severamente atacados por hongos, en especial con pudrición blanda. Los estacones fueron tratados inicialmente con soluciones de sulfato de cobre a 1 %, 2% y 3% de concentración; luego los estacones fueron tratados con una solución de sal CCA al 2.5% de concentración por vacío-presión. Se usaron 40 estacones distribuídos en 4 grupos de 10: tres (3 grupos fueron usados para el tratamiento con las soluciones de CUS04 y solución de CCA; el grupo restante fue tratado con la sal CCA únicamente, el cual fue usado como grupo testigo para fines de comparación en los ensayos de campo (cementerios.

Successful anterior capsulotomy in comorbid anorexia nervosa and obsessive-compulsive disorder: case report.

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Barbier, Johan; Gabriëls, Loes; van Laere, Koen; Nuttin, Bart

2011-09-01

State-of-the-art treatment of anorexia nervosa (AN) and obsessive-compulsive disorder (OCD) often proves ineffective. Both disorders have common features, and anterior capsulotomy is a last-resort treatment for OCD. We document the effect of bilateral anterior capsulotomy in a patient with comorbid AN and OCD. A 38-year-old woman with life-threatening, chronic, treatment-refractory AN and OCD underwent anterior capsulotomy. Psychiatric and neuropsychological evaluations at baseline and at follow-up document the severity and progress of the case. Bilateral anterior capsulotomy resulted in normalization of eating pattern and weight and a significant decrease of food-related and overall obsessive-compulsive symptoms. Psychiatric evaluations and exposure to food cues confirmed the clinical improvement that was evident immediately after surgery and sustained at 3-month follow-up. This case report suggests that bilateral anterior capsulotomy can be a therapeutic option for patients with comorbid AN and OCD. However, a well-controlled study is warranted.

Open Approaches to the Anterior Skull Base in Children: Review of the Literature.

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Wasserzug, Oshri; DeRowe, Ari; Ringel, Barak; Fishman, Gadi; Fliss, Dan M

2018-02-01

Introduction  Skull base lesions in children and adolescents are rare, and comprise only 5.6% of all skull base surgery. Anterior skull base lesions dominate, averaging slightly more than 50% of the cases. Until recently, surgery of the anterior skull base was dominated by open procedures and endoscopic skull base surgery was reserved for benign pathologies. Endoscopic skull base surgery is gradually gaining popularity. In spite of that, open skull base surgery is still considered the "gold standard" for the treatment of anterior skull base lesions, and it is the preferred approach in selected cases. Objective  This article reviews current concepts and open approaches to the anterior skull base in children in the era of endoscopic surgery. Materials and Methods  Comprehensive literature review. Results  Extensive intracranial-intradural invasion, extensive orbital invasion, encasement of the optic nerve or the internal carotid artery, lateral supraorbital dural involvement and involvement of the anterior table of the frontal sinus or lateral portion of the frontal sinus precludes endoscopic surgery, and mandates open skull base surgery. The open approaches which are used most frequently for surgical resection of anterior skull base tumors are the transfacial/transmaxillary, subcranial, and subfrontal approaches. Reconstruction of anterior skull base defects is discussed in a separate article in this supplement. Discussion  Although endoscopic skull base surgery in children is gaining popularity in developed countries, in many cases open surgery is still required. In addition, in developing countries, which accounts for more than 80% of the world's population, limited access to expensive equipment precludes the use of endoscopic surgery. Several open surgical approaches are still employed to resect anterior skull base lesions in the pediatric population. With this large armamentarium of surgical approaches, tailoring the most suitable approach to a

Maxillary anterior segmental distraction osteogenesis with 2 different types of distractors.

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Choi, Hye-Young; Hwang, Chung-Ju; Kim, Hee-Jin; Yu, Hyung-Seog; Cha, Jung-Yul

2012-05-01

Maxillary anterior segmental distraction osteogenesis (DO) has been the alternative treatment option for patients with midfacial retrusion. To investigate a potentially more effective maxillary anterior segmental DO, a newly designed intraoral alveolar distractor was applied. The objectives of this study were to investigate the skeletal and dental effects of maxillary anterior segmental DO and the relapse pattern. The study was carried out for 8 patients with unilateral cleft lip and palate (mean age, 16 years 7 months). Four patients were treated with an intraoral appliance (IA), and the remaining with a rigid external distractor (RED). Dental and skeletal measurements were obtained for both groups. These measurements were compared for different time points including pre-DO (T1), post-DO (T2), postconsolidation (T3), and 1-year follow-up (T4). Horizontal change of A point was significantly larger after distraction period (T2) in the RED group (mean, 11.0 mm; median, 10.1 mm) than in the IA group (mean, 6.6 mm; median, 7.4 mm) (P distraction, showing a significant difference between groups (P Maxillary anterior segmental DO is effective for the treatment of patients with cleft lip and palate. The alveolar space is regained, and the facial profile is improved without velopharyngeal problems. Superior results are obtained using the RED appliance for maxillary anterior segmental DO relative to the use of the intraoral distractor appliance.

Kinematic analysis of anterior cruciate ligament reconstruction in total knee arthroplasty

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Liu, Hua-Wei; Ni, Ming; Zhang, Guo-Qiang; Li, Xiang; Chen, Hui; Zhang, Qiang; Chai, Wei; Zhou, Yong-Gang; Chen, Ji-Ying; Liu, Yu-Liang; Cheng, Cheng-Kung; Wang, Yan

2016-01-01

Background: This study aims to retain normal knee kinematics after knee replacement surgeries by reconstructing anterior cruciate ligament during total knee arthroplasty. Method: We use computational simulation tools to establish four dynamic knee models, including normal knee model, posterior cruciate ligament retaining knee model, posterior cruciate ligament substituting knee model, and anterior cruciate ligament reconstructing knee model. Our proposed method utilizes magnetic resonance images to reconstruct solid bones and attachments of ligaments, and assemble femoral and tibial components according representative literatures and operational specifications. Dynamic data of axial tibial rotation and femoral translation from full-extension to 135 were measured for analyzing the motion of knee models. Findings: The computational simulation results show that comparing with the posterior cruciate ligament retained knee model and the posterior cruciate ligament substituted knee model, reconstructing anterior cruciate ligament improves the posterior movement of the lateral condyle, medial condyle and tibial internal rotation through a full range of flexion. The maximum posterior translations of the lateral condyle, medial condyle and tibial internal rotation of the anterior cruciate ligament reconstructed knee are 15.3 mm, 4.6 mm and 20.6 at 135 of flexion. Interpretation: Reconstructing anterior cruciate ligament in total knee arthroplasty has been approved to be an more efficient way of maintaining normal knee kinematics comparing to posterior cruciate ligament retained and posterior cruciate ligament substituted total knee arthroplasty. PMID:27347334

Síndrome de Brown-Séquard por hérnia discal cervical a duplo nível: caso clínico e revisão da literatura Síndrome de Brown-Séquard por hernia discal cervical en nivel doble: caso clínico y revisión de la literatura Brown-Séquard syndrome by double level cervical disc herniation: case report and review of the literature

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Jorge Miguel Silva Ribeiro Olliveira Alves

2012-09-01

Full Text Available Descrição do caso clínico de um paciente com síndrome de Brown-Séquard por hérnia de disco cervical em duplo nível, 40 anos, do sexo masculino, sem história de patologia prévia da coluna cervical; teve início insidioso de paresia nos membros direitos, associada à diminuição da sensibilidade dolorosa e térmica do hemicorpo esquerdo, após mergulho que ocasionou trauma indireto da coluna cervical. A RM da coluna cervical mostrou hérnias discais paramedianas direitas nos níveis C4-C5 e C5-C6 com compressão da metade direita do cordão medular e hiperintensidade em T2. Foi realizada descompressão por via anterior e artrodese dos níveis afetados. O paciente recuperou-se parcialmente dos déficits neurológicos, após um longo programa de reabilitação funcional. O tratamento cirúrgico e um programa de reabilitação precoce são da maior importância para a recuperação neurológica de paciente com síndrome de Brown-Séquard por hérnia de disco cervical.Descripción del caso clínico de un paciente con síndrome de Brown-Séquard por hernia de disco cervical en nivel doble, 40 años, del sexo masculino, sin historial de patología previa de la columna cervical; tuvo inicio insidioso de paresia en los miembros derechos, vinculada con la disminución de la sensibilidad dolorosa y térmica del hemicuerpo izquierdo, después de zambullida que ocasionó traumatismo indirecto de la columna vertebral. La RM de la columna cervical mostró hernias discales paramedianas derechas, en los niveles C4-C5 y C5-C6, con compresión de la mitad derecha del cordón medular e hiperintensidad en T2. Se realizó descompresión por vía anterior y artrodesis de los niveles afectados. El paciente se recuperó, parcialmente, de los déficits neurológicos, después de un programa prolongado de rehabilitación funcional. El tratamiento quirúrgico y un programa de rehabilitación precoz son de máxima importancia para la recuperación neurológica del

Role of estrogens in anterior pituitary gland remodeling during the estrous cycle.

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Zárate, S; Zaldivar, V; Jaita, G; Magri, L; Radl, D; Pisera, D; Seilicovich, A

2010-01-01

In this review, we analyze the action of estrogens leading to the remodeling of the anterior pituitary gland, especially during the estrous cycle. Proliferation and death of anterior pituitary cells and especially lactotropes is regulated by estrogens, which act by sensitizing these cells to both mitotic and apoptotic stimuli such as TNF-alpha, FasL and dopamine. During the estrous cycle, the changing pattern of gonadal steroids is thought to modulate both cell proliferation and death in the anterior pituitary gland, estrogens being key players in cell turnover. The mechanisms involved in estrogen-modulated cell renewal in the anterior pituitary gland during the estrous cycle could include an increase in the expression of proapoptotic cytokines as well as the increase in the Bax/Bcl-2 ratio at proestrus, when estrogen levels are highest and a peak of apoptosis, in particular of lactotropes, is evident in this gland. Estrogens exert rapid antimitogenic and proapoptotic actions in the anterior pituitary through membrane-associated estrogen receptors, a mechanism that might also be involved in remodeling of this gland during the estrous cycle. Copyright (c) 2010 S. Karger AG, Basel.

The Anterior Thalamus Provides A Subcortical Circuit Supporting Memory And Spatial Navigation

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Shane M O‘Mara

2013-08-01

Full Text Available The anterior thalamic nuclei, a central component of Papez’ circuit, are generally assumed to be key constituents of the neural circuits responsible for certain categories of learning and memory. Supporting evidence for this contention is that damage to either of two brain regions, the medial temporal lobe and the medial diencephalon, is most consistently associated with anterograde amnesia. Within these respective regions, the hippocampal formation and the anterior thalamic nuclei (anteromedial, anteroventral, anterodorsal are the particular structures of interest. The extensive direct and indirect hippocampal-anterior thalamic interconnections and the presence of theta-modulated cells in both sites further support the hypothesis that these structures constitute a neuronal network crucial for memory and cognition. The major tool in understanding how the brain processes information is the analysis of neuronal output at each hierarchical level along the pathway of signal propagation coupled with neuroanatomical studies. Here, we discuss the electrophysiological properties of cells in the anterior thalamic nuclei with an emphasis on their role in spatial navigation. In addition, we describe neuroanatomical and functional relationships between the anterior thalamic nuclei and hippocampal formation.

ANÁLISIS E INTERPRETACIÓN DE SPOTS CON CONTENIDO CIENTÍFICO COMO RECURSO PARA LA IMPLEMENTACIÓN DE UNA ESTRATEGIA DIDÁCTICA

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Martha Cecilia Betancur Taborda

2014-05-01

Full Text Available Esta propuesta se centra en el diseño e implementación de una estrategia didáctica desarrollada a partir del análisis e interpretación de contenidos e ideas de ciencias naturales encontrados en algunos spot publicitarios. El estudio parte del reconocimiento de diferentes anuncios que presentan contenidos científicos, para posteriormente observarlos con los niños con el propósito de comprobar si los conocimientos adquiridos por los estudiantes, en el marco de las clases de ciencias, les permiten ser críticos cuando observan un spot con contenido científico. Lo anterior permite realizar un contraste entre las ideas que genera el observar la publicidad en su cotidianidad y su incidencia en las concepciones de ciencia construidas por los estudiantes.   La población objeto de estudio son niños de quinto grado, jornada mañana de educación básica primaria del colegio José Martí IED ubicado en la ciudad de Bogotá.   Los spot con contenido científico escogidos, fueron analizados e interpretados tanto por expertos en cada una de las disciplinas como por los niños, los resultados arrojados fueron el punto de partida para el diseño y aplicación de una unidad didáctica sobre el concepto de energía en este caso obedece al análisis de los contenidos de ciencia encontrados en el spot que es uff “un cereal”.

Usurering af osteosyntesemateriale gennem øsofagus efter anterior cervikalkirurgi

DEFF Research Database (Denmark)

Wiis, Julie Therese; Nittby, Henrietta Carolina; Lauritsen, Anne Oberg

2014-01-01

The rare, potentially life-threatening complication to anterior cervical surgery, oesophageal perforation, occurs after surgical trauma or due to erosion by migrating hardware. Symptoms are hoarseness, dysphagia, neck/throat pain, subcutaneous emphysema and fever. Imaging and endoscopic diagnosis...... can give false negative results. We present a case of a 74-year-old male, who was readmitted with sepsis and abscess in the operation area three weeks after anterior cervical surgery. Veillonella parvula was found in the abscess material and computed tomography confirmed the diagnosis of oesophageal...

SATISFACCIÓN CON EL TRATAMIENTO EN PACIENTES DE ATENCIÓN PRIMARIA CON ARTROSIS

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Carmen Llanos Val Jiménez

2017-01-01

Full Text Available Fundamentos: Al igual que en otros problemas crónicos, en el abor - daje del paciente con artrosis se tiende a un modelo de toma de decisiones compartidas, en el que el punto de vista del paciente debe ser considerado en la elección del tratamiento. El objetivo de este trabajo fue evaluar la sa - tisfacción con el tratamiento en pacientes diagnosticados de osteoartrosis y comprobar si existen diferencias entre diferentes opciones farmacológicas, así como determinar si existe asociación con el estado funcional y las carac - terísticas clínicas y sociodemográficas. Métodos: Se realizó un estudio observacional transversal en una muestra de 487 pacientes seleccionados mediante muestreo consecutivo. La variable principal fue el nivel de satisfacción con el tratamiento (cuestionario ARTS. El estado funcional de los pacientes fue evaluado mediante la escala WO - MAC. Otras variables fueron: características del tratamiento, adherencia te - rapéutica, eventos adversos, y variables clínicas y sociodemográficas. Resultados: En el cuestionario ARTS los pacientes, en un rango entre 28 y 87, obtuvieron una puntuación media de 65,3 (DE: 9,9. La puntuación no fue significativamente diferente en consumidores de 1, 2 o más fármacos. Entre quienes consumían un solo fármaco, no hubo diferencias entre los di - ferentes tipos de fármacos. En el estado funcional se obtuvo una puntuación media de 30,2 puntos (DE: 20,8 y se observó una débil correlación negativa con el nivel de satisfacción (r= - 0,252; p<0,001. Mediante regresión lineal múltiple, se observó mayor puntuación en la escala ARTS (p<0,05 en pa - cientes con menor puntuación en la escala WOMAC, mayor edad y ausencia de eventos adversos. Conclusión : En pacientes con osteoartritis se observa un nivel mode - rado de satisfacción con el tratamiento farmacológico, condicionado por su situación funcional, sus características sociodemográficas y por la presencia de eventos

Insuficiência tricúspide pós trauma associada a agnesia de músculo papilar anterior Post-traumatic tricuspid insufficiency associated with agenesis of the anterior papillary muscle

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Ronaldo Ducceschi FONTES

2000-09-01

Full Text Available Relatamos o caso de paciente do sexo masculino com 36 anos de idade com sinais e sintomas de insuficiência cardíaca direita. A história revelou trauma torácico há aproximadamente cinco anos. Submetido a operação para tratamento de insuficiência tricúspide, notou-se ausência do músculo papilar anterior da valva tricúspide, fenda na cúspide anterior e dilatação do anel tricuspídeo. Foi realizada sutura da fenda localizada na cúspide anterior e feita sua sustentação utilizando-se tira de pericárdio bovino fixada na face atrial e base do músculo papilar posterior. A operação foi completada com anuloplastia de Revuelta. O paciente obteve nítida melhora dos sintomas no pós-operatório imediato, mantendo-se em classe funcional I (NYHA, após 22 meses de evolução.Tricuspid regurgitation arising from chest trauma five years earlier was successfully corrected by valve reconstruction in a 36 year-old man. During correction a fissure of the anterior leaflet, absence of the anterior papillary muscle, chordae tendineae and tricuspid annulus dilatation were found. Tricuspid valvuloplasty was feasible using an anchored suture of the anterior leaflet fissure, artificial bovine chordae, pericardium implantation and Revuelta ring annuloplasty. There were no complications and no early or late mortality. At 22 months follow-up tricuspid valve function has remained with mild regurgitation. The patient is in good clinical condition.

Laparoscopic anterior resection and total mesorectal excision for rectal cancer: a prospective nonrandomized study.

Science.gov (United States)

Palanivelu, C; Sendhilkumar, K; Jani, Kalpesh; Rajan, P S; Maheshkumar, G S; Shetty, Roshan; Parthasarthi, R

2007-04-01

The purpose of this study was to present our experience of laparoscopic total mesorectal resection, including ultralow resection and coloanal anastomosis. Between 1993 and 2005, patients fit for general anesthesia, with resectable cancers, and with lower edge of tumor beyond 5 cm of the anal verge were subjected to laparoscopic anterior resection with sphincter preservation. Double stapling technique is used to establish bowel continuity. A total of 170 patients, 88 males and 82 females, were subjected to successful laparoscopic anterior resection, which included high anterior resection (n=90), low anterior resection (n=52), ultralow anterior resection (n=20), and coloanal anastomosis (n=8). The average age of patients was 58.4 years (12-90 years). Mean operating time was 130 min and mean hospital stay was 7 days. The morbidity was 13.5% with nil mortality. With an average follow-up of 49 months (range 9 years to 3 months), 9 patients developed local recurrence and 45 patients developed distant metastasis. In selected cases, laparoscopic anterior resection is possible for all levels of rectal tumors, allowing sphincter preservation and maintaining oncological safety.

Hidroxilación de fenol con catalizadores ZSM-5 modificado con cobre

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César Augusto Caro

2005-01-01

Full Text Available Se sintetizaron varios catalizadores Cu-ZSM-5 con diferentes relaciones Si/Al y Si/Cu. Usando metilamina o hidróxido de sodio como agente mineralizante. Los catalizadores se caracterizaron por DRX, IR, análisis BET, UV-VIS y análisis elemental. El desempeño catalítico de los catalizadores sintetizados se evaluó en la hidroxilación de fenol con H2O2. Se encontró que la relación catecol (CAT/(hidroquinona (HQ + p-benzoquinona (PBQ aumentó con el contenido de agua, presentó un máximo cuando la relación en peso de agua/fenol fue de 53/1 y se favoreció a altas temperaturas, con el aumento del contenido de aluminio o con la disminución en el contenido de catalizador. El contenido de cobre no fue un factor determinante para la conversión ni para la selectividad en la hidroxilación de fenol. La producción de la p-benzoquinona (PBQ, producto de oxidación de la hidroquinona, fue mínimo cuando se usaron las siguientes condiciones: 80 ºC, fenol: 1 mmol, relación molar fenol/H2O2 de 3/1, catalizador: 20 mg, agua: 5 g, tiempo de reacción: 4 h.

ESTUDIO DE LA DIGESTION HUMANA CON ALUMNOS CON DIFICULTADES DE APRENDIZAJE

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Mª Begoña Carretero Gómez

2009-01-01

Full Text Available En esta experiencia se han seleccionado una serie de actividades relacionadas con la digestión con el fin de lograr una reestructuración de ideas y cambios conceptuales, y así con la conseguir que el alumnado aprenda a construir sus propios conocimientos acerca de cómo y donde se dan los procesos de digestión necesarios para la nutrición del organismo. El trabajo se ha llevado a cabo con alumnos de 3º de Educación Secundaria Obligatoria, pertenecientesal programa de diversificación curricular. Hemos querido hacer la ciencia más cercana para que comprendan que algunos procesos tienen su explicación científica y que la ciencia forma parte de nuestro día a día, fomentando el interés del estudiante así como su implicación en el proceso de enseñanza-aprendizaje. Por ello hemos trabajado a base de pequeñas investigaciones, donde es el alumno el que marca su ritmo de trabajo, investiga y hace sus aportaciones. Han aprendido a trabajar de una forma meticulosa donde el rigor esfundamental, contagiándose del afán investigador de manera que al realizar las experiencias se han aproximado al trabajo científico a la vez que aclaran y reestructuran conocimientos.

Analysis of maxillary anterior teeth proportion in relationship with lower facial height and malocclusion

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Rajesh Gyawali

2017-07-01

Full Text Available Background & Objectives: Maxillary anterior tooth to tooth proportion has a special value in dental esthetics. This study aimed to assess the apparent proportion of maxillary anteriors and possible association with lower anterior facial height and malocclusion type. Materials & Methods: One-hundred and sixty samples with well aligned maxillary dentition were selected and the lower anterior facial height was measured with digital caliper. Molar relationship was examined and intraoral frontal photograph was taken for digital measurement of tooth proportion. The ratio of maxillary canine to lateral and lateral to central incisors were measured and compared between gender and the sides. These ratios were further compared among various malocclusion type using ANOVA and its association with lower anterior facial height was evaluated with Pearson’s correlation.Results: Most of the samples had Class I molar relationship (70% followed by Class II (23% and Class III (7%. The mean lower anterior facial height was 62.82mm and ratio of maxillary lateral to central incisor and canine to lateral incisor was 0.68 and 0.76 respectively. No statistically significant difference was found when the ratio was compared between the gender and the sides. These ratios were statistically different from the golden ratio and has no significant correlation with lower anterior facial height. These mean ratios were also found similar across the malocclusion type.Conclusion: Ratio of apparent dimension of maxillary canine to lateral incisor and lateral to central incisor was different from the golden ratio and showed no association with lower anterior facial height and malocclusion type.

Anterior Versus Posterolateral Approach for Total Laparoscopic Splenectomy: A Comparative Study

Science.gov (United States)

Ji, Bai; Wang, Yingchao; Zhang, Ping; Wang, Guangyi; Liu, Yahui

2013-01-01

Objective: Although the anterior approach is normally used for elective laparoscopic splenectomy (LS), the posterolateral approach may be superior. We have retrospectively compared the effectiveness and safety of these approaches in patients with non-severe splenomegaly scheduled for elective total LS. Methods: Patients with surgical spleen disorders scheduled for elective LS between March 2005 and June 2011 underwent laparoscopic splenic mobilization via the posterolateral or anterior approach. Main outcome measures included operation time, intraoperative blood loss, frequency of postoperative pancreatic leakage, and length of hospital stay. Results: During the study period, 203 patients underwent LS, 58 (28.6%) via the posterolateral and 145 (71.4%) via the anterior approach. Three patients (1.5%) required conversion to laparotomy due to extensive perisplenic adhesions. The posterolateral approach was associated with significantly shorter operation time (65.0 ± 12.3 min vs. 95.0 ± 21.3 min, P 0.05) Conclusions: The posterolateral approach is more effective and safer than the anterior approach in patients without severe splenomegaly (< 30 cm). PMID:23372427

Cambios en los ácidos grasos de membrana de Microbacterium esteraromatlcum GNP-5 con diferentes temperaturas y osmolaridades

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Graciela Natalia Pucci

2006-07-01

Full Text Available Microbacterium esteraromaticum es un microorganismo que se aísla con frecuencia de Jandfarming o procesos de biorremediación de hidrocarburos en la meseta de la Patagonia central (Argentina y se halla sometido a variaciones de temperatura y a cambios de salinidad que se producen naturalmente. Su adaptabilidad a esos cambios climáticos indujo al estudio de las modificaciones que se producen en su membrana celular para resistirlos. En este trabajo se estudió el efecto conjunto de la temperatura y la concentración de cloruro de sodio sobre la composición de los ácidos grasos de membrana en la cepa de Microbacterium esteraromaticum GNP-5b. M. esteraromaticum utiliza, frente al incremento de la temperatura, la estrategia es aumentar la longitud de sus ácidos grasos de cadenas ramificada impar (17 átomos de carbono con disminución de 15:0 anteiso, así como el porcentaje de ácidos grasos 15:0 iso (de mayor punto de fusión a partir del respectivo anteiso. El aumento de la salinidad modifica la composición de ácidos grasos siguiendo patrones diferentes según sea la temperatura de incubación. A 14 Y28 oc incrementa los 15:0 iso y 17:0 iso en detrimento de sus homólogos anteiso. A 37 "C este grupo de ácidos grasos no sigue los mismos patrones anteriores. La longitud de cadena, expresada como el índice C15jC17, es errática con el aumento de la salinidad.

Evaluation of the Effects of Menstrual Cycle on Anterior Chamber Parameters as Measured with Pentacam

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Arzu Seyhan Karatepe

2013-01-01

Full Text Available Pur po se: To evaluate the effects of endogenous gonadotropic hormones (follicle-stimulating hormone, luteinizing hormone and sex steroids (progesterone, estrogen to anterior segment parameters. Ma te ri al and Met hod: Thirty healthy females who had a menstrual cycle of 28±1 day and with a mean age of 36.5±7.56 (range, 20 – 46 years were included in the study. Starting from the first day of their cycle, Pentacam Scheimpflug camera measurements were performed on the 1st, 3rd, 7th, 12th, 16th, 21st, 26th, and 28th days. The central corneal thickness, anterior chamber depth, anterior segment volume, keratometric values, anterior chamber angle value, and pupilla diameter of both eyes were evaluated. Repeated measures analysis of variance test was used for statistical analysis. Re sults: No difference that reaches statistical significance was found in the means of central corneal thickness, anterior chamber volume, keratometric values, anterior chamber angle, and pupilla diameter between the days. Mean anterior chamber depth measurement of the right eyes on the 1st day was 2.72±0.44 mm, whereas it was 2.77±0.46 mm on the 26th day. Mean anterior chamber depth measurement of the left eyes on the 1st day was 2.74±0.42 mm, whereas it was 2.80±0.43 mm on the 26th day. This increment of anterior chamber depth value from the 1st to the 26th days was found to be statistically significant (p≤0.05. Dis cus si on: Progesterone and estrogen that rise in the second half of the menstrual cycle might have a deepening effect on the anterior chamber. These findings should be further investigated with more profound studies that also evaluate the hormonal values and their correlations with anterior segment parameters. (Turk J Ophthalmol 2013; 43: 15-8

Esporotricosis cutánea diseminada con compromiso articular en una mujer con diabetes tipo 2

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Sendy Solorzano

Full Text Available La esporotricosis diseminada es una presentación infrecuente de esta micosis. Aunque ha sido descrita en sujetos inmunocompetentes, con frecuencia existe compromiso de la inmunidad mediada por células T. Reportamos el caso de una mujer con diabetes tipo 2 no controlada que desarrolló esporotricosis cutánea diseminada. El curso de la enfermedad presentó varias complicaciones que incluyeron hepatitis secundaria a itraconazol y artritis de la rodilla con cultivo positivo para Sporothrix schenckii durante el tratamiento con solución saturada de ioduro de potasio. La discusión del caso incluye aspectos de la patogénesis de la esporotricosis diseminada y el manejo de la infección y sus complicaciones.

The management of over closured anterior teeth due to attrition

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Eha Djulaeha

2009-12-01

Full Text Available Background: Tooth is the hardest tissue in human body, that can be injured because of attrition process. For old people, denture attrition process is caused by psysiological process relating with the mastication function which also supported by some bad habits such an bruxism, premature contact, and consuming habit of abrasive food. Attrition or abrasion can also be happened with patien’t dentition who does not have teeth subtutition for long time due the lost of their maxillary as well as mandibulary. The pasient will loose their vertical dimension of occlusion, injure, and the lower jaw becomes over closed which is called over closure. Purpose: This article reported the management of over closured anterior teeth due to attrition. Case: a seventy six year old woman patient came to Prosthodontic Clinic in Faculty of Dentistry, Airlangga University, to rehabilitate her upper and lower severe attrited anterior teeth and her posterior teeth. The patient has experienced of wearing acrylic removable mandibular partial denture ten years ago. Unfortunaly, the denture was uncomfortable, and she did not wear it anymore since five years ago. Case management: The severe attrition of anterior teeth with the lost of occlusal vertical dimension can be treated by improving the occlusal vertical dimension gradually. The treatment is then followed by the increasing of the height of the anterior teeth by lengthening the crown teeth of upper jaw with 12 units of span bridge and the acrylic removable partial denture of lower jaw. Conclusion: The severe attrition of anterior teeth with the lost of occlusal vertical dimension can be treated by improving the occlusal vertical dimension gradually, using long span bridge and acrylic removable partial denture.

Go ahead, grow a head! A planarian's guide to anterior regeneration

Science.gov (United States)

2016-01-01

Abstract The unique ability of some planarian species to regenerate a head de novo, including a functional brain, provides an experimentally accessible system in which to study the mechanisms underlying regeneration. Here, we summarize the current knowledge on the key steps of planarian head regeneration (head‐versus‐tail decision, anterior pole formation and head patterning) and their molecular and cellular basis. Moreover, instructive properties of the anterior pole as a putative organizer and in coordinating anterior midline formation are discussed. Finally, we highlight that regeneration initiation occurs in a two‐step manner and hypothesize that wound‐induced and existing positional cues interact to detect tissue loss and together determine the appropriate regenerative outcomes. PMID:27606065

Acometer contra un ERP con Software Libre

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Esteban Crespo

2018-03-01

Full Text Available La seguridad de la información es una preocupación creciente en empresas y organizaciones, siendo más alta aun cuando se vincula a plataformas financieras donde existe información sensible. Este artículo resume las técnicas utilizadas en el pentesting realizado al software ERP desarrollado en APEX 5 por la Universidad del Azuay; para ello se han contemplado seis etapas que sugiere una prueba de penetración: i la conceptualización, donde se define el alcance de las pruebas a realizar; ii la preparación del laboratorio, en la que se identifican algunas de las herramientas que servirán para el inicio de las pruebas de seguridad; iii la obtención de información, donde se hace el reconocimiento y escaneo de posibles objetivos que posteriormente serán explorados con mayor profundidad para identificar características intrínsecas que puedan ser aprovechadas; iv el análisis de las vulnerabilidades encontradas en la etapa anterior; v la explotación de vulnerabilidades; y vi la post explotación, etapa que contempla la destrucción de evidencias del ataque y la conservación de la conexión y los accesos logrados para extraer información. Todas estas etapas fueron efectuadas dentro de las instalaciones de la Universidad del Azuay, considerando el ambiente de desarrollo en el que actualmente se encuentra este software.

A chondrosarcoma in the anterior mediastinum mimicking a thymoma

International Nuclear Information System (INIS)

Østergaard, Mia L; Petersen, Rene H; Kalhauge, Anna

2015-01-01

A chondrosarcoma in the anterior mediastinum is a rare finding with a relatively good prognosis. We describe a case of a 75-year-old man with a 2-year history of neck discomfort and weight loss. Imaging showed a homogenous tumor with a minor compression on the anterior part of the heart. It had close relation to the ribs, no surrounding fat, and a thymoma was suspected. Biopsy prior to surgery was impossible due to the location of the tumor. Unfortunately, final pathology from the surgical specimen revealed a chondrosarcoma

Mucoepidermoid carcinoma of the anterior maxilla: A rare entity

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Smitha Kullaje

2014-01-01

Full Text Available Mucoepidermoid carcinoma is the second most common salivary gland tumor primarily involving major salivary glands and intraoral minor salivary glands. Although rare, it can occur in the jaw bones, but it is very rare in the maxillary anterior region. Here, we present a case of mucoepidermoid carcinoma occurring in maxillary anterior region in a 33-year-old male patient presented as painless swelling clinically appearing similar to a periapical or nasopalatine cyst. The final diagnosis of this lesion was made after microscopic examination of biopsy specimen.

Relative Frequencies of Arteritic and Nonarteritic Anterior Ischemic Optic Neuropathy in an Arab Population.

Science.gov (United States)

Gruener, Anna M; Chang, Jessica R; Bosley, Thomas M; Al-Sadah, Zakeya M; Kum, Clarissa; McCulley, Timothy J

2017-12-01

To evaluate the relative frequencies of arteritic and nonarteritic anterior ischemic optic neuropathy (AION) in an Arab population and to compare and contrast these findings with known epidemiological data from Caucasian populations. A retrospective review of the medical records of all patients diagnosed with AION at the King Khaled Eye Specialist Hospital (KKESH) in Riyadh, Saudi Arabia, between 1997 and 2012. Of 171 patients with AION, 4 had biopsy-proven giant-cell arteritis (GCA). The relative frequencies of arteritic anterior ischemic optic neuropathy (AAION) and nonarteritic anterior ischemic optic neuropathy (NAION) in this Arab cohort were 2.3% and 97.7%, respectively. The relative frequencies of arteritic anterior ischemic optic neuropathy and nonarteritic anterior ischemic optic neuropathy differ between Arab and North American clinic-based populations, with giant-cell arteritis-related ischemia being much less frequent in Saudi Arabia.

Aproximación al tratamiento precoz de la mordida cruzada anterior

OpenAIRE

Espasa Suárez de Deza, José Enrique; Boj Quesada, Juan Ramón; Ustrell i Torrent, Josep Maria, 1953-

1994-01-01

La mordida cruzada anterior debe tratarse precozmente, para mejorar el entorno dentoalveolar y favorecer el crecimiento correcto de los maxilares. En este artículo se analizan: la etiología, el diagnóstico de la mordida cruzada anterior y se mencionan diferentes formas de tratamiento de esta maloclusión en dentición primaria y mixta.

Laser speckle flowgraphy for differentiating between nonarteritic ischemic optic neuropathy and anterior optic neuritis.

Science.gov (United States)

Maekubo, Tomoyuki; Chuman, Hideki; Nao-I, Nobuhisa

2013-07-01

The aim of this study was to investigate the usefulness of laser speckle flowgraphy (LSFG) for the differentiation of acute nonarteritic ischemic optic neuropathy (NAION) from anterior optic neuritis (ON). To investigate blood flow in the optic disc under normal conditions, NAION, and anterior ON, we compared the tissue blood flow of the right eye with that of the left eye in the control group, and that of the affected eye with that of the unaffected eye in the NAION and anterior ON groups. In the normal control group, the tissue blood flow did not significantly differ between the right and left eyes. In the NAION group, all 6 patients had decreased optic disc blood flow in the NAION eye when compared with the unaffected eye. By contrast, in the anterior ON group, all 6 patients had increased optic disc blood flow in the anterior ON eye when compared with the unaffected eye. In the NAION group, the mean blur rate (MBR) of the affected eyes was 29.5 % lower than that of the unaffected eyes. In the anterior ON group, the MBR of the affected eyes was 15.9 % higher than that of the unaffected eyes. LSFG could be useful in differentiating between NAION and anterior ON. In addition, this imaging technique saves time and is noninvasive.

Invisalign® treatment in the anterior region: were the predicted tooth movements achieved?

Science.gov (United States)

Krieger, Elena; Seiferth, Jörg; Marinello, Ivana; Jung, Britta A; Wriedt, Susanne; Jacobs, Collin; Wehrbein, Heinrich

2012-09-01

Based on our previous pilot study, the objective of this extended study was to compare (a) casts to their corresponding digital ClinCheck® models at baseline and (b) the tooth movement achieved at the end of aligner therapy (Invisalign®) to the predicted movement in the anterior region. Pre- and post-treatment casts as well as initial and final ClinChecks® models of 50 patients (15-63 years of age) were analyzed. All patients were treated with Invisalign® (Align Technology, Santa Clara, CA, USA). Evaluated parameters were: upper/lower anterior arch length and intercanine distance, overjet, overbite, dental midline shift, and the irregularity index according to Little. The comparison achieved/predicted tooth movement was tested for equivalence [adjusted 98.57% confidence interval (- 1.00; + 1.00)]. Before treatment the anterior crowding, according to Little, was on average 5.39 mm (minimum 1.50 mm, maximum 14.50 mm) in the upper dentition and 5.96 mm (minimum 2.00 mm, maximum 11.50 mm) in the lower dentition. After treatment the values were reduced to 1.57 mm (minimum 0 mm, maximum 4.5 mm) in the maxilla and 0.82 mm (minimum 0 mm, maximum 2.50 mm) in the mandible. We found slight deviations between pretreatment casts and initialClinCheck® ranging on average from -0.08 mm (SD ± 0.29) for the overjet and up to -0.28 mm (SD ± 0.46) for the upper anterior arch length. The difference between achieved/predicted tooth movements ranged on average from 0.01 mm (SD ± 0.48) for the lower anterior arch length, up to 0.7 mm (SD ± 0.87) for the overbite. All parameters were significantly equivalent except for the overbite (-1.02; -0.39). Performed with aligners (Invisalign®), the resolvement of the partly severe anterior crowding was successfully accomplished. Resolving lower anterior crowding by protrusion of the anterior teeth (i.e., enlargement of the anterior arch length) seems well predictable. The initial ClinCheck® models provided high accuracy compared to the

Análisis de la coestimulación en la respuesta inmune de pacientes con síndrome de hiperinmunoglobulinemia E con infecciones recurrentes

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Pablo Javier Patiño Grajales

2000-02-01

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El síndrome de hiperinmunoglobulinemia E con infecciones recurrentes (SHIEIR es una inmunodeficiencia primaria caracterizada por niveles séricos extremadamente elevados de inmunoglobulina E, eczema de aparición temprana, eosinofilia, infecciones a repetición de la piel y neumonías con formación de neumatoceles (1. El análisis reciente de 30 pacientes y 70 de sus familiares ha permitido redefinirlo como un desorden multisistémico que afecta la dentición, el esqueleto, el tejido conectivo y el sistema inmune; se ha sugerido que se hereda como un rasgo autonómico dominante con expresividad variable (2.

Las anormalidades inmunológicas en este síndrome incluyen alteraciones del funcionamiento de los linfocitos T y B, al igual que las células fagocíticas. Pese a que dichos defectos no se han logrado documentar consistentemente en todos los pacientes, sí se ha observado de manera persistente una incapacidad de los linfocitos T para activarse, in vivo e in vitro, cuando son estimulados con antígenos específicos, aunque mantienen intacta su capacidad de respuesta a mitógenos. Este fenómeno, aunado a una marcada susceptibilidad de los individuos afectados por adquirir infecciones que comprometen preferencialmente algunos órganos y sistemas (piel y aparato respiratorio y cuyos agentes etiológicos son muy característicos (especialmente el Staphylococcus aureus, nos llevaron a proponer que el defecto en la respuesta inmune en dichos sitios anatómicos y contra microorganismos específicos puede deberse a alguna alteración en las moléculas accesorias que se expresan tanto en los linfocitos T como en las células presentadoras de antígenos.

Por lo anterior nos proponemos evaluar la actividad de las mol

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