Multi-detector thoracic CT findings in cerebro-costo-mandibular syndrome: rib gaps and failure of costo-vertebral separation.

Science.gov (United States)

Watson, Tom Anthony; Arthurs, Owen John; Muthialu, Nagarajan; Calder, Alistair Duncan

2014-02-01

Cerebro-costo-mandibular syndrome (CCMS) describes a triad of mandibular hypoplasia, brain dysfunction and posterior rib defects ("rib gaps"). We present the CT imaging for a 2-year-old girl with CCMS that highlights the rib gap defects and shows absent transverse processes with abnormal fusion of the ribs directly to the vertebral bodies. We argue that this is likely to relate to abnormal lateral sclerotome development in embryology, with the failure of normal costo-vertebral junctions compounding impaired thoracic function. The case also highlights the use of CT for specific indications in skeletal dysplasia.

Impingement syndrome of the shoulder; Schulterimpingement

Energy Technology Data Exchange (ETDEWEB)

Mayerhoefer, M.E. [Klinische Abteilung fuer Osteologie, Klinik fuer Radiodiagnostik der Universitaet Wien (Austria); Klinische Abteilung Radiodiagnostik fuer chirurgische Faecher, Klinik fuer Radiodiagnostik der Universitaet Wien (Austria); Klinische Abteilung fuer Osteologie, Klinik fuer Radiodiagnostik der Universitaet, Waehringer Guertel 18-20, 1090, Wien (Austria); Breitenseher, M.J. [Klinische Abteilung fuer Osteologie, Klinik fuer Radiodiagnostik der Universitaet Wien (Austria); Waldviertelklinikum Horn (Austria)

2004-06-01

The impingement syndrome is a clinical entity characterized by shoulder pain due to primary or secondary mechanical irritation of the rotator cuff. The primary factors for the development of impingement are a curved or hook-shaped anterior acromion as well as subacromial osteophytes, which may lead to tearing of the supraspinatus tendon. Secondary impingement is mainly caused by calcific tendinopathy, glenohumeral instability, os acromiale and degenerative changes of the acromioclavicular joint. Conventional radiographs are initially obtained, mainly for evaluation of the bony structures of the shoulder. If available, sonography can be used for detection of lesions and tears of the rotator cuff. Finally, MR-imaging provides detailed information about the relationship of the acromion and the acromioclavicular joint to the rotator cuff itself. In many cases however, no morphologic cause for impingement syndrome can be found. While patients are initially treated conservatively, chronic disease usually requires surgical intervention. (orig.) [German] Das Impingementsyndrom ist ein klinisches Krankheitsbild multifaktorieller Genese, bei dem es primaer oder sekundaer zu einer schmerzhaften mechanischen Beeintraechtigung der Rotatorenmanschette kommt. Als primaere Faktoren gelten ein gebogener oder hakenfoermiger Vorderrand des Akromions oder von diesem entspringende Osteophyten, was zu Laesionen der Supraspinatussehne fuehren kann. Zu den sekundaeren Faktoren zaehlt man v. a. eine Tendinitis calcarea, eine glenohumerale Instabilitaet, ein Os acromiale sowie degenerative Veraenderungen im Bereich des Akromioklavikulargelenks. Bildgebend steht an erster Stelle ein Nativroentgen, mit dem sich die knoechernen Strukturen gut darstellen lassen. Falls vorhanden, kann in weiterer Folge die Sonographie Auskunft ueber den Zustand der Rotatorenmanschette geben. Mit der MRT schliesslich laesst sich die Beziehung von Akromion und gelenkassoziierten Strukturen zur Rotatorenmanschette

Unusual case of left iliac vein compression secondary to May-Thurner syndrome and crossed fused renal ectopia

International Nuclear Information System (INIS)

Elsharawy, Mohamed A.; Moghazy, Kahled M.; Alsaif, Hind S.; Al-Asiri, Mosad M.

2008-01-01

External compression of the left iliac vein against the fifth lumbar vertebra by the right iliac artery (May and Thurner Syndrome) is a well known anatomic variant. We identified a rare case of May-Thurner syndrome associated with crossed fused renal ectopia on the left side. The patient presented with complete thrombosis of the left common iliac vein down to the popliteal vein. He was treated with catheter directed thrombolysis followed by anticoagulant therapy. (author)

Surgical criteria for femoroacetabular impingement syndrome

DEFF Research Database (Denmark)

Peters, Scott; Laing, Alisha; Emerson, Courtney

2017-01-01

BACKGROUND: The purpose of this review was to analyse and report criteria used for open and arthroscopic surgical treatment of femoroacetabular impingement syndrome (FAIS). METHODS: A librarian-assisted computer search of Medline, CINAHL and Embase for studies related to criterion for FAIS surgery...

Malunited anterior inferior iliac spine fracture as a cause of hip impingement: A case report and review of literature

Institute of Scientific and Technical Information of China (English)

Desai Pingal; Timothy Marqueen; Karanvir Prakash

2016-01-01

Apophyseal injuries of the pelvis have increased recently with increased participation of teenagers in contact sports.Apophyseal fractures of the pelvis should be ruled out from apophysitis,os acetabuli and bony tumors.We report a case of fracture of anterior-inferior iliac spine following indirect injury to the hip in a young football player.The patient failed to get better with nonoperative management and continued to have pain in the left hip and signs and symptoms of impingement.He improved following surgical excision of the heterotopic bone and did not have any evidence of recurrence at 2 years followup.

The cerebro-costo-mandibular syndrome: third report of familial occurrence

NARCIS (Netherlands)

Hennekam, R. C.; Beemer, F. A.; Huijbers, W. A.; Hustinx, P. A.; van Sprang, F. J.

1985-01-01

Two male sibs with cerebro-costo-mandibular syndrome and spina bifida are described. The parents are physically and radiologically normal. A short review of the pertinent literature is given with special emphasis on the mode of inheritance

Multi-detector thoracic CT findings in cerebro-costo-mandibular syndrome: rib gaps and failure of costo-vertebral separation

Energy Technology Data Exchange (ETDEWEB)

Watson, Tom Anthony; Arthurs, Owen John; Calder, Alistair Duncan [Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Radiology, London (United Kingdom); Muthialu, Nagarajan [Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Cardiothoracic surgery, London (United Kingdom)

2014-02-15

Cerebro-costo-mandibular syndrome (CCMS) describes a triad of mandibular hypoplasia, brain dysfunction and posterior rib defects (''rib gaps''). We present the CT imaging for a 2-year-old girl with CCMS that highlights the rib gap defects and shows absent transverse processes with abnormal fusion of the ribs directly to the vertebral bodies. We argue that this is likely to relate to abnormal lateral sclerotome development in embryology, with the failure of normal costo-vertebral junctions compounding impaired thoracic function. The case also highlights the use of CT for specific indications in skeletal dysplasia. (orig.)

Multi-detector thoracic CT findings in cerebro-costo-mandibular syndrome: rib gaps and failure of costo-vertebral separation

International Nuclear Information System (INIS)

Watson, Tom Anthony; Arthurs, Owen John; Calder, Alistair Duncan; Muthialu, Nagarajan

2014-01-01

Cerebro-costo-mandibular syndrome (CCMS) describes a triad of mandibular hypoplasia, brain dysfunction and posterior rib defects (''rib gaps''). We present the CT imaging for a 2-year-old girl with CCMS that highlights the rib gap defects and shows absent transverse processes with abnormal fusion of the ribs directly to the vertebral bodies. We argue that this is likely to relate to abnormal lateral sclerotome development in embryology, with the failure of normal costo-vertebral junctions compounding impaired thoracic function. The case also highlights the use of CT for specific indications in skeletal dysplasia. (orig.)

Subacromial Impingement Syndrome Caused by a Voluminous Subdeltoid Lipoma

Directory of Open Access Journals (Sweden)

Jean-Christophe Murray

2014-01-01

Full Text Available Subacromial impingement syndrome is a clinical diagnosis encompassing a spectrum of possible etiologies, including subacromial bursitis, rotator cuff tendinopathy, and partial- to full-thickness rotator cuff tears. This report presents an unusual case of subdeltoid lipoma causing extrinsic compression and subacromial impingement syndrome. The patient, a 60-year-old man, presented to our institution with a few years' history of nontraumatic, posteriorly localized throbbing pain in his right shoulder. Despite a well-followed 6-months physiotherapy program, the patient was still suffering from his right shoulder. The MRI scan revealed a well-circumscribed 6 cm × 2 cm × 5 cm homogenous lesion compatible with a subdeltoid intermuscular lipoma. The mass was excised en bloc, and subsequent histopathologic examination confirmed a benign lipoma. At 6-months follow-up, the patient was asymptomatic with a complete return to his activities. Based on this case and a review of the literature, a subacromial lipoma has to be included in the differential diagnosis of a subacromial impingement syndrome refractory to nonoperative treatment. Complementary imaging modalities are required only after a failed conservative management to assess the exact etiology and successfully direct the surgical treatment.

Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome

DEFF Research Database (Denmark)

Storgaard, Filip Holst; Pedersen, Christina Gravgaard; Jensen, Majbritt Lykke

Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome.......Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome....

Effectiveness of Kinesiotaping and Subacromial Corticosteroid Injection in Shoulder Impingement Syndrome.

Science.gov (United States)

Şahin Onat, Şule; Biçer, Seda; Şahin, Zehra; Küçükali Türkyilmaz, Ayşegül; Kara, Murat; Özbudak Demir, Sibel

2016-08-01

The aim of this study was to investigate whether kinesiotaping or subacromial corticosteroid injection provides additional benefit when used with nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with shoulder impingement syndrome. Patients with shoulder impingement syndrome were divided into 3 groups as follows: NSAID group (n = 33), kinesiotaping group (kinesiotaping + NSAID) (n = 33), and injection group (subacromial corticosteroid injection + NSAID) (n = 33). Outcome measures including visual analog scale, shoulder ranges of motion, Shoulder Disability Questionnaire, and University of California-Los Angeles (UCLA) scale were evaluated before and after the treatment (fourth week). A total of 99 patients (21 male and 78 female patients) were enrolled in this study. Demographic and baseline clinical characteristics of the groups (except for body mass index and visual analog scale at night, both P = 0.05) were similar between the groups (all P > 0.05). Clinical parameters were found to have improved in the 3 groups (all P kinesiotaping and injection groups showed similar improvements (all P > 0.05), each group had better outcome than did the NSAID group as regards pain (activity visual analog scale), ranges of motion, and Shoulder Disability Questionnaire and UCLA scale scores (all P kinesiotaping or subacromial corticosteroid injection to NSAID treatment seems to have better/similar effectiveness in patients with shoulder impingement syndrome. Therefore, kinesiotaping might serve as an alternative treatment in case (injection of) corticosteroids are contraindicated. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES:: Upon completion of this article, the reader should be able to: (1) Delineate appropriate treatment options for shoulder impingement syndrome; (2) Identify treatment benefits of kinesiotaping and corticosteroid injections in shoulder impingement syndrome; and (3) Incorporate

Diagnosis of shoulder impingement syndrome; Diagnostik des Schulterimpingementsyndroms

Energy Technology Data Exchange (ETDEWEB)

Hodler, J. [Orthopaedische Universitaetsklinik Balgrist, Zuerich (Switzerland)

1996-12-01

This article reviews the pathogenesis and clinical and imaging findings in shoulder impingement syndrome. Different stages of impingement syndrome are described. Stage I relates to edema and hemorrhage of the supraspinatus tendon. Stage II is characterized by bursal inflammation and fibrosis, as well as tendinopathy. In stage III there is a tear of the rotator cuff. Clinical signs many overlap. Moreover, calcifying tendinitis, fractures and pain originating from the cervical spine may mimic shoulder impingement syndrome. Imaging is important for the exact diagnosis. Standard radiographs are the basis of imaging in shoulder impingement syndrome. They may demonstrate subchondral sclerosis of the major tuberosity, subacromial spurs, and form anomalies of the acromion. They are also important in the differential diagnosis of shoulder impingement syndrome and demonstrate calcifying tendinitis, fractures and neoplasm. Ultrasonography has found acceptance as a screening tool and even as a final diagnostic method by many authors. However, there is a high interobserver variability in the demonstration of rotator cuff tears. Its usefulness has therefore been questioned. MR imaging is probably the method of choice in the evaluation of the rotator cuff and surrounding structures. Several investigations have demonstrated that differentiation of early findings, such as tendinopathy versus partial tears, may be difficult with MR imaging. However, reproducibility for fullthickness tears appears to be higher than for sonography. Moreover, specificity appears to be superior to sonography. MR arthrography is not universally accepted. However, it allows for more exact differentiation of discrete findings and may be indicated in preoperative planning. Standard arthrography and CT have a limited role in the current assessment of the rotator cuff. (orig.) [Deutsch] Grundlage des Impingementsyndroms ist eine Kompression des Supraspinatus am akromioklavikularen Bogen vor allem bei Flexion

Shoulder impingement syndrome : evaluation of the causes with MRI

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Choi, Yong Ho; Song, In Sup; Chung, Hun Young; Yoon, Sang Jin; Kim, Yang Soo; Shim, Hyung Jin; Choi, Young Hee; Lee, Jong Beum; Lee, Yong Chul; Kim, Kun Sang [Chungang Univ. College of Medicine, Seoul (Korea, Republic of); Choi, Yun Sun [Eulji Hospital, College of Medicine, Seoul (Korea, Republic of)

1999-12-01

Various mechanical causes which induce shoulder impingement syndrome have been identified with the help of MRI. The aim of this study is to evaluate the incidence of such causes. A total of 54 patients with clinically confirmed shoulder impingement syndrome and a normal control group(n=20) without symptoms were included. We evaluated the incidence of hook shaped acromion, low lying acromion, downward slope of the acromion, subacromial spur, acromioclavicular joint hypertrophy, coracoacromial ligament hypertrophy, high cuff muscle bulk, and os acromiale. Among the 54 patients, the following conditions were present: acromioclavicular joint hypertrophy(n=36), coracoacromial ligament hypertrophy(n=20), subacromial spur(n=18), downward sloping of the acromion(n=16), hook shaped acromion(n=11), relatively high cuff muscle bulk(n=6), low lying acromion relative to the clavicle(n=3), and os acromiale(n=1). In the normal control group there were nine cases of acromioclavicular joint hypertrophy, nine of coracoacromial ligament hypertrophy, nine of downward sloping acromion, and three of low lying acromion, but hook shaped acromion, high cuff muscle bulk, and os acromiale were not found. Among 54 patients, the syndrome was due to five simultancous causes in one patient, four causes in two, three causes in 12, two causes in 22, and one cause in 17. Hook shaped acromion and subacromial spur are the statistically significant causes of shoulder impingement syndrome. In 69% of patients, the condition was due to more than one cause.

Shoulder impingement syndrome : evaluation of the causes with MRI

International Nuclear Information System (INIS)

Choi, Yong Ho; Song, In Sup; Chung, Hun Young; Yoon, Sang Jin; Kim, Yang Soo; Shim, Hyung Jin; Choi, Young Hee; Lee, Jong Beum; Lee, Yong Chul; Kim, Kun Sang; Choi, Yun Sun

1999-01-01

Various mechanical causes which induce shoulder impingement syndrome have been identified with the help of MRI. The aim of this study is to evaluate the incidence of such causes. A total of 54 patients with clinically confirmed shoulder impingement syndrome and a normal control group(n=20) without symptoms were included. We evaluated the incidence of hook shaped acromion, low lying acromion, downward slope of the acromion, subacromial spur, acromioclavicular joint hypertrophy, coracoacromial ligament hypertrophy, high cuff muscle bulk, and os acromiale. Among the 54 patients, the following conditions were present: acromioclavicular joint hypertrophy(n=36), coracoacromial ligament hypertrophy(n=20), subacromial spur(n=18), downward sloping of the acromion(n=16), hook shaped acromion(n=11), relatively high cuff muscle bulk(n=6), low lying acromion relative to the clavicle(n=3), and os acromiale(n=1). In the normal control group there were nine cases of acromioclavicular joint hypertrophy, nine of coracoacromial ligament hypertrophy, nine of downward sloping acromion, and three of low lying acromion, but hook shaped acromion, high cuff muscle bulk, and os acromiale were not found. Among 54 patients, the syndrome was due to five simultancous causes in one patient, four causes in two, three causes in 12, two causes in 22, and one cause in 17. Hook shaped acromion and subacromial spur are the statistically significant causes of shoulder impingement syndrome. In 69% of patients, the condition was due to more than one cause

Lumbo-costo-vertebral syndrome with congenital lumbar hernia.

Science.gov (United States)

Gupta, Lucky; Mala, Tariq Ahmed; Gupta, Rahul; Malla, Shahid Amin

2014-01-01

Lumbo-costo-vertebral syndrome (LCVS) is a set of rare abnormalities involving vertebral bodies, ribs, and abdominal wall. We present a case of LCVS in a 2-year-old girl who had a progressive swelling over left lumbar area noted for the last 12 months. Clinical examination revealed a reducible swelling with positive cough impulse. Ultrasonography showed a defect containing bowel loops in the left lumbar region. Chest x-ray showed scoliosis and hemivertebrae with absent lower ribs on left side. Meshplasty was done.

Dual compression is not an uncommon type of iliac vein compression syndrome.

Science.gov (United States)

Shi, Wan-Yin; Gu, Jian-Ping; Liu, Chang-Jian; Lou, Wen-Sheng; He, Xu

2017-09-01

Typical iliac vein compression syndrome (IVCS) is characterized by compression of left common iliac vein (LCIV) by the overlying right common iliac artery (RCIA). We described an underestimated type of IVCS with dual compression by right and left common iliac arteries (LCIA) simultaneously. Thirty-one patients with IVCS were retrospectively included. All patients received trans-catheter venography and computed tomography (CT) examinations for diagnosing and evaluating IVCS. Late venography and reconstructed CT were used for evaluating the anatomical relationship among LCIV, RCIA and LCIA. Imaging manifestations as well as demographic data were collected and evaluated by two experienced radiologists. Sole and dual compression were found in 32.3% (n = 10) and 67.7% (n = 21) of 31 patients respectively. No statistical differences existed between them in terms of age, gender, LCIV diameter at the maximum compression point, pressure gradient across stenosis, and the percentage of compression level. On CT and venography, sole compression was commonly presented with a longitudinal compression at the orifice of LCIV while dual compression was usually presented as two types: one had a lengthy stenosis along the upper side of LCIV and the other was manifested by a longitudinal compression near to the orifice of external iliac vein. The presence of dual compression seemed significantly correlated with the tortuous LCIA (p = 0.006). Left common iliac vein can be presented by dual compression. This type of compression has typical manifestations on late venography and CT.

Clinical application of arthroscopy in the diagnosis and treatment of anterior impingement syndrome of the ankle joint in physical workers.

Science.gov (United States)

Wu, Wen-Te; Chen, Zhi-Wei; Zhou, Yu-Cheng

2012-10-01

To evaluate the clinical application of arthroscopy in the diagnosis and treatment of anterior impingement syndrome of the ankle joint in physical workers. A retrospective study was carried out at the Department of Orthopedics, the First Hospital affiliated to Nanhua University, Hengyang, China from March 2005 to December 2011. Seventeen cases of anterior impingement syndrome of the ankle joint were confirmed, and treated through arthroscopy. All these patients conformed to regular follow-up postoperatively, and clinical details, as well as postoperative prognosis were retrieved and analyzed retrospectively. The efficacy was evaluated by the American Orthopedic Foot and Ankle Society (AOFAS) hindfoot-ankle scoring system, and pain relief was assessed by visual analogue scoring (VAS). Anterolateral impingement syndrome was found in 11 patients, anteromedial impingement syndrome in 4, while anterior impingement syndrome in 2 via arthroscopic examination. The VAS was reduced from 5.2-1.1, and the AOFAS score was elevated from 76.4-95.8 postoperatively; both of which demonstrated statistical differences when compared to preoperative scores. It was also found that concomitant cartilage damage was an indicator of poor prognosis in arthroscopic treatment of impingement syndrome of the ankle joint. Satisfactory results could be achieved for physical workers with anterior impingement syndrome treated by arthroscopy. As the cartilage damage is an indicator of poor prognosis, an early operation is advocated when the prognosis of anterior impingement syndrome is confirmed.

Excellent long-term results with iliac stenting in local anesthesia for post-thrombotic syndrome

DEFF Research Database (Denmark)

Klitfod, Lotte; Just, Sven; Foegh, Pia

2015-01-01

BACKGROUND: Only 20% of iliac veins will recanalize on anticoagulation (AC) treatment alone and may, therefore, develop venous obstruction after iliofemoral deep venous thrombosis (DVT). A considerable number of these patients will suffer from post-thrombotic syndrome (PTS) leading to impaired qu...... stent was 89% (17/19) and 16 patients (84 %) had almost or total symptom relief at follow-up. CONCLUSION: Endovascular stenting of iliac obstruction in local anesthesia is minimally invasive and shows excellent long-term outcomes for patients suffering from PTS....

Early prenatal diagnosis of a lumbo-costo-vertebral syndrome.

Science.gov (United States)

Pristavu, Anda Ioana; Furnica, Cristina; Ifrim, Mona Mihaela; Popovici, Razvan Mihai

2018-04-01

Lumbo-costo-vertebral syndrome (LCVS) is a rare type of lumbar hernia with associated abnormalities of the vertebral bodies, ribs, and trunk muscles. Only a few cases have been reported in the literature, all of which were diagnosed after birth. We present a case of LCVS diagnosed early in the second trimester of pregnancy using two- and three-dimensional ultrasound. In our case, the associated anomalies were: multiple costovertebral anomalies, lumbar hernia, anal imperforation, left hand supernumerary digit, and clubfoot.

MR imaging in the diagnosis of impingement syndrome

International Nuclear Information System (INIS)

Seeger, L.L.; Gold, R.H.; Bassett, L.W.; Ellman, H.

1986-01-01

The impingement syndrome is entrapment of the supraspinatus tendon by either the acromion, or a subacromial or acromioclavicular spur. Arthrography is normal during stages I (tendon inflammation) and II (fibrosis). The lack of objective findings often delays diagnosis until stage III (ischemic rotator cuff tear) is present. The purpose was to determine if MR imaging is useful in diagnosing this condition. T1-weighted surface coil scans were obtained on eight patients using a 0.3-T MR system. An axial scout allowed oblique alignment for imaging the osseous-soft tissue relationship and the supraspinatus tendon. MR is capable of displaying the specific pathologic anatomy of this disorder. Impinging spurs can be seen, and the adjacent tendon shows inferior displacement and abnormal signal intensity

Acromion types and role of corticosteroid with shoulder impingement syndrome

International Nuclear Information System (INIS)

Akram, M.; Gillani, S.F.U.S.; Awais, S.M.

2016-01-01

To determine the association between shoulder impingement and morphological characteristics of acromion and the role of sub-acromial injection of methylprednisolone in the short-term treatment for relieving pain and improve functional disability of these patients. Study Design: A descriptive study. Place and Duration of Study: Department of Orthopedic Surgery and Traumatology Unit-I (DOST-I), Mayo Hospital, Lahore, between November 2013 to June 2014. Methodology: All patients presented in OPD with shoulder pain were included as subjects and evaluated by clinical test and categorised using X-ray scapula Y-view. Patients with impingement syndrome were correlated with Bigliani types and offered intra-lesional injection into sub-acromial space with 2ml of xylocaine 2% and 40 mg of methylprednisolone using 22 gauge needle. The effectiveness was assessed in terms of relieving pain and good functional outcomes; and rotator cuff tear was clinically assessed among impingement positive patient. The pain was assessed using visual analogue score before and after the administration of the injection. Demographic variables for frequencies and their associations were analysed using SPSS version 20.0. Significance level was p<0.05. Among the 101 cases, there was no case of tear of rotator cuff tendon on clinical assessment. Majority of the patients (58.4%) were females with mean age of 31.38 +-1.13 years. Majority 57 (56.4%) of the patients had acromion type II (curved), which was the most common cause of shoulder impingement. Most had moderate pain. Thirty-four patients required intralesional steroid, which relieved the pain in 31 of them. Conclusion: Shoulder impingement syndrome without tear of rotator cuff tendon was found in younger age group between 40 to 45 years, which was relieved by intralesional corticosteroid administration. These patients had type II (curved) acromion, according to Bigliani classification. (author)

Ischiofemoral impingement syndrome: a meta-analysis

Energy Technology Data Exchange (ETDEWEB)

Singer, Adam D.; Subhawong, Ty K.; Jose, Jean; Tresley, Jonathan; Clifford, Paul D. [Jackson Memorial Hospital, Department of Diagnostic Radiology, Section of Musculoskeletal Imaging, Miami, FL (United States)

2015-06-01

clinical findings. Using the proposed measurement thresholds may better identify patients with this impingement syndrome so that optimal treatment options can be pursued. (orig.)

Percutaneous aspiration thrombectomy with adjunctive venoplasty for iliac vein compression syndrome with lower extremity deep venous thrombosis

International Nuclear Information System (INIS)

Wang Yiping; Zhang Xiquan; Sun Yequan

2013-01-01

Objective: To investigate the clinical effect of mechanical aspiration thrombectomy with adjunctive PTA and stenting for iliac vein compression syndrome with lower extremity deep venous thrombosis. Materials and Methods: The clinical data of 184 patients who had iliac vein compression syndrome with lower extremity DVT were analyzed retrospectively. The healthy femoral vein was accessed, then a 12-14 F sheath was introduced via a guide wire to aspirate thrombus in the iliofemoral; For the cases with femoropopliteal thrombus, the thrombus was macerated and pulled by Fogarty balloon catheter, then performing mechanical aspiration thrombectomy. After thrombus removal, PTA and stenting were performed on stenosis or occlusion of common iliac vein that displayed on venography. Results: The thrombus removal rate: Grade Ⅲ 80.89% and Grade Ⅱ 19.02%. The circumference of affected limbs at 15 cm above and below knee joints were (43.9±4.7) cm and (31.5±4.1) cm, respectively, after being discharged from hospital, the differences were statistical significance (t=6.43, t=-5.79, both P=0.000)compared to be hospitalized. The follow -up result: the treatment efficiency was 97.75%. The stent patency rate of postoperation at 6, 12, and 24 months were 97.19%, 94.94%, 92.13%, respectively, on sonography or digital subtract angiography. Conclusion: Mechanical aspiration thrombectomy with adjunctive venoplasty for iliac vein compression syndrome with lower extremity deep venous thrombosis is an effective and safe therapy having notable therapeutic effect in short l middle-term follow-up and shorter hospitalization time. (authors)

Glyceryl trinitrate patches—An alternative treatment for shoulder impingement syndrome

Directory of Open Access Journals (Sweden)

Yusuf Assem

2015-01-01

Full Text Available Transdermal glyceryl trinitrate patches have been investigated as an alternative therapeutic intervention for a range of tendinopathies, due to the ease of titration of dosage and the ease of their application. Glyceryl trinitrate has been inferred to reduce pain and inflammation secondary to their nitric oxide-producing action. Shoulder impingement syndrome is a soft tissue condition that manifests as anterior shoulder pain, weakness, and difficulty in daily activities. This review will evaluate the efficacy of glyceryl trinitrate patches in treating a variety of rotator cuff tendinopathies related to shoulder impingement, based on human and animal trials, and suggest its practical application in future trials and management.

Methods on simple radiogaphy of impingement syndrome in shoulder joint

International Nuclear Information System (INIS)

Kweon, Dae Cheol; Kim, Moon Sun; Kim, Yong Seob; Chung, Kyung Mo

2000-01-01

To evaluation of patients who have shoulder impingement syndrome is by diagnostic radiography. Shoulder impingement is a problem which occurs in young, active individuals as well as older individuals. In fact, the pain is probably caused by repetitive stress placed on the shoulder joint either through recreational activities of your occupation. Impingement series approach to radiographic examination of the shoulder is take five projections. First anteroposterior oblique projection. Second standard anteroposterior projection. Third superoinferior axial projection. Fourth supraspinatus outlet projection offers a view of the outlet of the supraspinatus tendon unit as it passes under the coraacromial arch. Fifth anteroposterior 30 deg caudal projection will adequately demonstrate the anterior acromial spur or ossification in the coraacromial ligament and more reliable to demonstrate spurring of the anterior acromion than supraspinatus outlet projection. This decreased the need for additional radiographic veiws, reduces the patient's exposure to x-ray radiation and decreases use of film. This can lower the cost of the evaluation and improve patient satisfaction.=20

Methods on simple radiogaphy of impingement syndrome in shoulder joint

Energy Technology Data Exchange (ETDEWEB)

Kweon, Dae Cheol; Kim, Moon Sun; Kim, Yong Seob; Chung, Kyung Mo [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

2000-06-01

To evaluation of patients who have shoulder impingement syndrome is by diagnostic radiography. Shoulder impingement is a problem which occurs in young, active individuals as well as older individuals. In fact, the pain is probably caused by repetitive stress placed on the shoulder joint either through recreational activities of your occupation. Impingement series approach to radiographic examination of the shoulder is take five projections. First anteroposterior oblique projection. Second standard anteroposterior projection. Third superoinferior axial projection. Fourth supraspinatus outlet projection offers a view of the outlet of the supraspinatus tendon unit as it passes under the coraacromial arch. Fifth anteroposterior 30 deg caudal projection will adequately demonstrate the anterior acromial spur or ossification in the coraacromial ligament and more reliable to demonstrate spurring of the anterior acromion than supraspinatus outlet projection. This decreased the need for additional radiographic veiws, reduces the patient's exposure to x-ray radiation and decreases use of film. This can lower the cost of the evaluation and improve patient satisfaction.=20.

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

IMPINGEMENT-SYNDROME OF PERONEUS BREVIS TENDON AFTER CALCANEAL FRACTURES (MORPHOLOGICAL ASPECTS

Directory of Open Access Journals (Sweden)

N. S. Konovalchuk

2017-01-01

Full Text Available Background. One of the main causes of pain in patients with consequences of calcaneal fractures is the lateral impingement syndrome. This term means lateral displacement of outer calcaneal wall at the moment of fracture, narrowing of anatomical space under the lateral malleolus and compression of soft tissues in this region, including tendons of short and long peroneal muscles. This leads to chronic traumatization of tendons, alteration of their normal tracking and development of tendinitis and tenosynovitis. At this moment there are no articles in foreign or Russian literature describing how prolonged traumatization influences the internal structure of the tendons. The purpose of this study was to evaluate the morphological changes in structure of peroneus brevis tendon after different duration of compression between outer wall of calcaneus and the tip of the lateral malleolus in patients with calcaneal malunion.Materials and methods. Fifteen patients with calcaneal malunion and lateral impingement syndrome were treated operatively between 2016 and 2017. To confirm the lateral impingement syndrome, the authors performed clinical examination and AP x-rays of ankle joint. Two peroneus brevis tendon specimens were obtained intraoperatively in each of 15 patients: one specimen from compressed and one from non-compressed area. Obtained specimens were histologically examined according to standard protocol.Results. Microscopically all specimens showed separation of collagen bundles with loose connective tissue degeneration, increase of vascularization and inflammation. The degree of these changes differed according to the compression duration. This allowed us to analyze the dynamics of these changes.Conclusion. The morphological changes in structure of peroneus brevis tendon during the compression between outer wall of calcaneus and the tip of the lateral malleolus correspond with dynamics of common pathologic reactions. Early stages showed signs of

Impingement syndrome of the shoulder following double row suture anchor technique for arthroscopic rotator cuff repair: a case report

Directory of Open Access Journals (Sweden)

Rambani Rohit

2009-06-01

Full Text Available Abstract Introduction Arthroscopic repair of the rotator cuff is a demanding surgery. Accurate placement of anchors is key to success. Case presentation A 38-year-old woman received arthroscopic repair of her rotator cuff using a double row suture anchor technique. Postoperatively, she developed impingement syndrome which resulted from vertical displacement of a suture anchor once the shoulder was mobilised. The anchor was removed eight weeks following initial surgery and the patient had an uneventful recovery. Conclusion Impingement syndrome following arthroscopic repair of the rotator cuffs using double row suture anchor has not been widely reported. This is the first such case where anchoring has resulted in impingement syndrome.

Specific or general exercise strategy for subacromial impingement syndrome-does it matter?

DEFF Research Database (Denmark)

Shire, Alison R; Stæhr, Thor A B; Overby, Jesper B

2017-01-01

Background Exercise is frequently suggested as a treatment option for patients presenting with symptoms of subacromial impingement syndrome. Some would argue implementing a specific exercise strategy with special focus on correction of kinematic deficits would be superior to general exercise stra...

The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement.

Science.gov (United States)

Griffin, D R; Dickenson, E J; O'Donnell, J; Agricola, R; Awan, T; Beck, M; Clohisy, J C; Dijkstra, H P; Falvey, E; Gimpel, M; Hinman, R S; Hölmich, P; Kassarjian, A; Martin, H D; Martin, R; Mather, R C; Philippon, M J; Reiman, M P; Takla, A; Thorborg, K; Walker, S; Weir, A; Bennell, K L

2016-10-01

The 2016 Warwick Agreement on femoroacetabular impingement (FAI) syndrome was convened to build an international, multidisciplinary consensus on the diagnosis and management of patients with FAI syndrome. 22 panel members and 1 patient from 9 countries and 5 different specialties participated in a 1-day consensus meeting on 29 June 2016. Prior to the meeting, 6 questions were agreed on, and recent relevant systematic reviews and seminal literature were circulated. Panel members gave presentations on the topics of the agreed questions at Sports Hip 2016, an open meeting held in the UK on 27-29 June. Presentations were followed by open discussion. At the 1-day consensus meeting, panel members developed statements in response to each question through open discussion; members then scored their level of agreement with each response on a scale of 0-10. Substantial agreement (range 9.5-10) was reached for each of the 6 consensus questions, and the associated terminology was agreed on. The term 'femoroacetabular impingement syndrome' was introduced to reflect the central role of patients' symptoms in the disorder. To reach a diagnosis, patients should have appropriate symptoms, positive clinical signs and imaging findings. Suitable treatments are conservative care, rehabilitation, and arthroscopic or open surgery. Current understanding of prognosis and topics for future research were discussed. The 2016 Warwick Agreement on FAI syndrome is an international multidisciplinary agreement on the diagnosis, treatment principles and key terminology relating to FAI syndrome.Author note The Warwick Agreement on femoroacetabular impingement syndrome has been endorsed by the following 25 clinical societies: American Medical Society for Sports Medicine (AMSSM), Association of Chartered Physiotherapists in Sports and Exercise Medicine (ACPSEM), Australasian College of Sports and Exercise Physicians (ACSEP), Austian Sports Physiotherapists, British Association of Sports and Exercise

Subscapulais injuries associated with acromiohumeral instability in patients with shoulder impingement syndrome

Energy Technology Data Exchange (ETDEWEB)

Moon, Tae Young; Jeong, Hee Seok; Lee, Seung Jun; Jeong, Yeo Jin [Pusan National University Yangsan Hospital, Yangsan (Korea, Republic of)

2017-07-15

To evaluate the association of subscapularis (SSC) injuries with acromiohumeral instability (AHI) in patients with shoulder impingement syndrome with supraspinatus (SSP) tears. Pre-operative shoulder magnetic resonance images of 106 patients with subsequent arthroscopic confirmation of shoulder impingement syndrome were reviewed retrospectively. Patients with SSC injuries were divided into the following 3 groups: 1) those with no injury symbolized to the SSC[0] (n = 38), 2) those with partial injuries to the SSC[1] (n = 41), and 3) those with complete disruption of the SSC[2] (n = 27). AHI was categorized into 5 stages depending on the SSP lesions: partial tear or pretear tendinosis symbolized to the SSP[0] (n = 24) and according to retraction severity of the SSP tendon with complete tear such as SSP[1] (n = 19), SSP[2] (n = 27), SSP[3] (n = 29), and SSP[4] (n = 7). Also, AHI was divided into two groups such as the mild group summed with SSP plus SSP plus SSP and the severe group summed with SSP plus SSP, including 70 patients and 36 patients, respectively. Twenty-nine patients (63.0%) among 46 patients with SSC[0] and thirty-two patients (78.0%) among 41 patients with SSC[1] were related to mild AHI. Eighteen patients (66.7%) among 27 patients with SSC[2] were associated with severe AHI. The SSC injury groups were statistically significantly associated with AHI (estimate 0.207, standard error 0.057, p < 0.01). SSC injuries could be related to AHI in patients with shoulder impingement syndrome.

Cerebro-costo-mandibular syndrome: Clinical, radiological, and genetic findings.

Science.gov (United States)

Tooley, Madeleine; Lynch, Danielle; Bernier, Francois; Parboosingh, Jillian; Bhoj, Elizabeth; Zackai, Elaine; Calder, Alistair; Itasaki, Nobue; Wakeling, Emma; Scott, Richard; Lees, Melissa; Clayton-Smith, Jill; Blyth, Moira; Morton, Jenny; Shears, Debbie; Kini, Usha; Homfray, Tessa; Clarke, Angus; Barnicoat, Angela; Wallis, Colin; Hewitson, Rebecca; Offiah, Amaka; Saunders, Michael; Langton-Hewer, Simon; Hilliard, Tom; Davis, Peter; Smithson, Sarah

2016-05-01

Cerebro-Costo-Mandibular syndrome (CCMS) is a rare autosomal dominant condition comprising branchial arch-derivative malformations with striking rib-gaps. Affected patients often have respiratory difficulties, associated with upper airway obstruction, reduced thoracic capacity, and scoliosis. We describe a series of 12 sporadic and 4 familial patients including 13 infants/children and 3 adults. Severe micrognathia and reduced numbers of ribs with gaps are consistent findings. Cleft palate, feeding difficulties, respiratory distress, tracheostomy requirement, and scoliosis are common. Additional malformations such as horseshoe kidney, hypospadias, and septal heart defect may occur. Microcephaly and significant developmental delay are present in a small minority of patients. Key radiological findings are of a narrow thorax, multiple posterior rib gaps and abnormal costo-transverse articulation. A novel finding in 2 patients is bilateral accessory ossicles arising from the hyoid bone. Recently, specific mutations in SNRPB, which encodes components of the major spliceosome, have been found to cause CCMS. These mutations cluster in an alternatively spliced regulatory exon and result in altered SNRPB expression. DNA was available from 14 patients and SNRPB mutations were identified in 12 (4 previously reported). Eleven had recurrent mutations previously described in patients with CCMS and one had a novel mutation in the alternative exon. These results confirm the specificity of SNRPB mutations in CCMS and provide further evidence for the role of spliceosomal proteins in craniofacial and thoracic development. © 2016 Wiley Periodicals, Inc.

Ex utero intrapartum treatment for an infant with cerebro-costo-mandibular syndrome.

Science.gov (United States)

Ogasawara, Kei; Honda, Yoshinobu; Hosoya, Mitsuaki

2014-08-01

Cerebro-costo-mandibular syndrome (CCMS) is a rare disorder characterized by multiple rib abnormalities, micrognathia described as Pierre-Robin sequence, and cerebral involvement. Appropriate management of respiratory distress immediately after birth is crucial to rescue these patients. A boy, having a mother with Pierre-Robin sequence and a sister with CCMS, was diagnosed prenatally with CCMS and successfully treated with ex utero intrapartum treatment (EXIT) at 36 weeks 6 days of gestation. EXIT would be an effective option for rescuing patients with prenatally diagnosed CCMS and preventing neonatal hypoxia. © 2014 Japan Pediatric Society.

Os acromiale causing shoulder impingement syndrome: a case report

International Nuclear Information System (INIS)

Romero, I.; Rodriguez, A.; Roca, M.; Garcia, Y.

2001-01-01

Shoulder impingement syndrome is caused by repeated mechanical trauma to the rotator cuff due to encroachment of the coracoacromial ligament; in most cases, it is a primary lesion. Os acromiale, an anatomic variant of the shoulder structures, is one of the predisposing factors for the development of this entity. We present a case of os acromiale complicated by complete rupture of the tendon of the supraspinatus muscle and luxation of the long head of the biceps tendon. We stress the importance of magnetic resonance in the study of this anatomic variant and in the detection of complications or associated lesions. (Author) 10 refs

Ultrasound measurement of rotator cuff thickness and acromio-humeral distance in the diagnosis of subacromial impingement syndrome of the shoulder.

Science.gov (United States)

Cholewinski, Jerzy J; Kusz, Damian J; Wojciechowski, Piotr; Cielinski, Lukasz S; Zoladz, Miroslaw P

2008-04-01

The usefulness of ultrasound measurements in the diagnosis of the subacromial impingement syndrome of the shoulder was evaluated. Fifty-seven patients with unilateral symptoms of the impingement syndrome underwent ultrasound examination of both shoulder joints, which included assessment of rotator cuff integrity, measurement of rotator cuff thickness and the distance between the infero-lateral edge of acromion and the apex of the greater tuberosity of humerus (AGT distance) in the standard ultrasonographic positions. As a control group, 36 volunteers (72 shoulders) with no history of shoulder pain were examined sonographically. Ultrasonographic assessment of humeral head elevation, measured as the AGT distance, proved to be useful in establishing the diagnosis of the subacromial impingement syndrome of the shoulder. A difference in rotator cuff thickness of more than 1.1 mm and a difference in the AGT distance of more than 2.1 mm between both shoulder joints may reflect dysfunction of rotator cuff muscles.

Preoperative conventional magnetic resonance images versus magnetic resonance arthrography of subacromial impingement syndrome

International Nuclear Information System (INIS)

Ahn, Sang Hyuk; Park, Jung Hwan; Moon, Tae Yong; Lee, In Sook; Lee, Seung Jun

2012-01-01

To evaluate the usefulness of conventional magnetic resonance images (MRI) for arthroscopic surgery in subacromial impingement syndrome of the shoulder, as an alternative to MR arthrography with additional T2 fat saturation images (MRA). The preoperative MRI of 77 patients (45 females, 32 males) (52 right, 25 left) and MRA of 34 patients (14 females, 20 males) (24 right, 10 left) with subsequent arthroscopic confirmation of subacromial impingement syndrome were reviewed retrospectively. The lesions requiring arthroscopic surgery were 95 subacromial spurs, 101 subacromial bursitis, and 51 full-thickness and 44 partial thickness tears of the supraspinatus among 111 cases for both studies. A two by two table was constructed in order to calculate the sensitivity and specificity of both studies against arthroscopic outcomes. Also we analyzed the false positive and false negative cases of the full-thickness tears individually. The detection rates of subacromial spur and bursitis and full and partial thickness tears of the supraspinatus were 91%, 94%, 77%, and 65% in MRI and 93%, 100%, 83%, and 77% in MRA respectively. Their specificities were 33%, 33%, 90%, and 76% in MRI and 50%, 75%, 100%, and 71% in MRA respectively. Eleven false negative cases in regards to MRI resulted in Ellman's grade 3 partial thickness tear (72.7%), mild bursitis (63.6%), greater tuberosity erosion (45.5%), and negative fluid signal of the glenohumeral joint (81.8%). Three false positive cases on the MRI were induced from errors with lower window depth and width on the imagings. Two false negative cases on MRA were induced from the adhesion between Ellman's grade 3 rim rent tear and the glenohumeral joint cavity. Conventional MR images could be used to decide the arthroscopic surgery in subacromial impingement syndrome, as an alternative to MR arthrography with additional T2 fat saturation images

Preoperative conventional magnetic resonance images versus magnetic resonance arthrography of subacromial impingement syndrome

Energy Technology Data Exchange (ETDEWEB)

Ahn, Sang Hyuk; Park, Jung Hwan; Moon, Tae Yong [Pusan National Univ. Yangsan Hospital, Yangsan (Korea, Republic of); Lee, In Sook; Lee, Seung Jun [Pusan National Univ. Hospital, Busan (Korea, Republic of)

2012-09-15

To evaluate the usefulness of conventional magnetic resonance images (MRI) for arthroscopic surgery in subacromial impingement syndrome of the shoulder, as an alternative to MR arthrography with additional T2 fat saturation images (MRA). The preoperative MRI of 77 patients (45 females, 32 males) (52 right, 25 left) and MRA of 34 patients (14 females, 20 males) (24 right, 10 left) with subsequent arthroscopic confirmation of subacromial impingement syndrome were reviewed retrospectively. The lesions requiring arthroscopic surgery were 95 subacromial spurs, 101 subacromial bursitis, and 51 full-thickness and 44 partial thickness tears of the supraspinatus among 111 cases for both studies. A two by two table was constructed in order to calculate the sensitivity and specificity of both studies against arthroscopic outcomes. Also we analyzed the false positive and false negative cases of the full-thickness tears individually. The detection rates of subacromial spur and bursitis and full and partial thickness tears of the supraspinatus were 91%, 94%, 77%, and 65% in MRI and 93%, 100%, 83%, and 77% in MRA respectively. Their specificities were 33%, 33%, 90%, and 76% in MRI and 50%, 75%, 100%, and 71% in MRA respectively. Eleven false negative cases in regards to MRI resulted in Ellman's grade 3 partial thickness tear (72.7%), mild bursitis (63.6%), greater tuberosity erosion (45.5%), and negative fluid signal of the glenohumeral joint (81.8%). Three false positive cases on the MRI were induced from errors with lower window depth and width on the imagings. Two false negative cases on MRA were induced from the adhesion between Ellman's grade 3 rim rent tear and the glenohumeral joint cavity. Conventional MR images could be used to decide the arthroscopic surgery in subacromial impingement syndrome, as an alternative to MR arthrography with additional T2 fat saturation images.

Important clinical descriptors to include in the examination and assessment of patients with femoroacetabular impingement syndrome

DEFF Research Database (Denmark)

Reiman, M P; Thorborg, K; Covington, K

2017-01-01

PURPOSE: Determine which examination findings are key clinical descriptors of femoroacetabular impingement syndrome (FAIS) through use of an international, multi-disciplinary expert panel. METHODS: A three-round Delphi survey utilizing an international, multi-disciplinary expert panel operationally...

Risk of surgery for subacromial impingement syndrome in relation to neck-shoulder complaints and occupational biomechanical exposures

DEFF Research Database (Denmark)

Svendsen, Susanne Wulff; Dalbøge, Annett; Andersen, JH

2013-01-01

OBJECTIVES: The aim of this longitudinal study was to evaluate the risk of surgery for subacromial impingement syndrome (SIS) in relation to neck-shoulder complaints and occupational biomechanical shoulder exposures. METHODS: The study was based on the Musculoskeletal Research Database at the Dan......OBJECTIVES: The aim of this longitudinal study was to evaluate the risk of surgery for subacromial impingement syndrome (SIS) in relation to neck-shoulder complaints and occupational biomechanical shoulder exposures. METHODS: The study was based on the Musculoskeletal Research Database....... Using no neck-shoulder complaints and low shoulder load at baseline as a reference, no neck-shoulder complaints and high shoulder load showed an adjusted hazard ratio (HR adj) of 2.55 [95% confidence interval (95% CI) 1.59-4.09], while neck-shoulder complaints in combination with high shoulder load...

Force steadiness, muscle activity, and maximal muscle strength in subjects with subacromial impingement syndrome

DEFF Research Database (Denmark)

Bandholm, Thomas; Rasmussen, Lars; Aagaard, Per

2006-01-01

physically active in spite of shoulder pain and nine healthy matched controls were examined to determine isometric and isokinetic submaximal shoulder-abduction force steadiness at target forces corresponding to 20%, 27.5%, and 35% of the maximal shoulder abductor torque, and maximal shoulder muscle strength......We investigated the effects of the subacromial impingement syndrome (SIS) on shoulder sensory-motor control and maximal shoulder muscle strength. It was hypothesized that both would be impaired due to chronic shoulder pain associated with the syndrome. Nine subjects with unilateral SIS who remained...

Cerebro-costo-mandibular syndrome: prognosis and proposal for classification.

Science.gov (United States)

Nagasawa, Hiroyuki; Yamamoto, Yutaka; Kohno, Yoshinori

2010-09-01

Cerebro-costo-mandibular syndrome (CCMS) is a very rare syndrome characterized by micrognathia and posterior rib gap, with a poor prognosis. To date, only 75 cases have been reported worldwide. The overall survival rate for patients with this disorder has not been reported, and a classification of the patients on the basis of the prognosis is not yet available. The present study analyzed the figures and prognoses of past patients and documented a new case of CCMS. Formerly published case reports and personal communications were used to reveal the prognosis and classification of CCMS. The occurrence ratios of rib gap defects and of missing ribs were examined. Patients were divided into the following three groups according to their life span: lethal type, where the patients died before 1 month; severe type, where the patients lived for 1-12 months; and mild type, where they survived for more than 1 year. A comparison was made of the number of rib gaps, missing ribs, and the rib gap ratio (defined as the number of rib gaps divided by the number of all existing ribs) among these three groups. A significant difference in the number of rib defects between the lethal type and other types was noted. Short life span of severe type patients, compared to mild type, was attributed to their subjection to severe respiratory infection. CCMS can be classified into three categories--lethal, severe, and mild--according to the severity of the symptoms and prognosis.

Effect of cause of iliac vein stenosis and extent of thrombus in the lower extremity on patency of iliac venous stent placed after catheter-directed thrombolysis of acute deep venous thrombosis in the lower extremity

International Nuclear Information System (INIS)

Jung, Sung Il; Choi, Young Ho; Yoon, Chang Jin; Lee, Min Woo; Chung, Jin Wook; Park, Jae Hyung

2003-01-01

To assess the CT findings of acute deep venous thrombosis (DVT) in a lower extremity prior to catheter-directed thrombolysis, and to evaluate their relevance to the patency of an iliac venous stent placed with the help of CT after catheter-directed thrombolysis of DVT. Fourteen patients [M:F=3:11; age, 33-68 (mean, 50.1) years] with acute symptomatic DVD of a lower extremity underwent CT before and after catheter-directed thrombolysis using an iliac venous stent. The mean duration of clinical symptoms was 5.0 (range, 1-14 days. The CT findings prior to thrombolysis were evaluated in terms of their anatomic cause and the extent of the thrombus, and in all patients, the patency of the iliac venous stent was assessed at CT performed during a follow-up period lasting 6-31 (mean, 18.9) months. All patients were assigned to the patent stent group (n=9) or the occluded stent group (n=5). In the former, the anatomic cause of patency included typical iliac vein compression (May-Thurner syndrome) (n=9), and a relatively short segmental thrombus occurring between the common iliac and the popliteal vein (n=8). Thrombi occurred in the iliac vein (n=3), between the common iliac and the femoral vein (n=3), and between the common iliac and the popliteal vein (n=2). In one case, a relatively long segmental thrombus occurred between the common iliac vein and the calf vein. In the occluded stent group, anatomic causes included atypical iliac vein compression (n=3) and a relatively long segmental thrombus between the common iliac and the calf vein (n=4). Typical iliac vein compression (May-Thurner syndrome) occurred in two cases, and a relatively short segmental thrombus between the external iliac and the common femoral vein in one. Factors which can affect the patency of an iliac venous stent positioned after catheter-directed thrombolysis are the anatomic cause of the stenosis, and the extent of a thrombus revealed at CT of acute DVT and occurring in a lower extremity prior to

Effect of cause of iliac vein stenosis and extent of thrombus in the lower extremity on patency of iliac venous stent placed after catheter-directed thrombolysis of acute deep venous thrombosis in the lower extremity

Energy Technology Data Exchange (ETDEWEB)

Jung, Sung Il; Choi, Young Ho; Yoon, Chang Jin; Lee, Min Woo; Chung, Jin Wook; Park, Jae Hyung [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

2003-10-01

To assess the CT findings of acute deep venous thrombosis (DVT) in a lower extremity prior to catheter-directed thrombolysis, and to evaluate their relevance to the patency of an iliac venous stent placed with the help of CT after catheter-directed thrombolysis of DVT. Fourteen patients [M:F=3:11; age, 33-68 (mean, 50.1) years] with acute symptomatic DVD of a lower extremity underwent CT before and after catheter-directed thrombolysis using an iliac venous stent. The mean duration of clinical symptoms was 5.0 (range, 1-14 days. The CT findings prior to thrombolysis were evaluated in terms of their anatomic cause and the extent of the thrombus, and in all patients, the patency of the iliac venous stent was assessed at CT performed during a follow-up period lasting 6-31 (mean, 18.9) months. All patients were assigned to the patent stent group (n=9) or the occluded stent group (n=5). In the former, the anatomic cause of patency included typical iliac vein compression (May-Thurner syndrome) (n=9), and a relatively short segmental thrombus occurring between the common iliac and the popliteal vein (n=8). Thrombi occurred in the iliac vein (n=3), between the common iliac and the femoral vein (n=3), and between the common iliac and the popliteal vein (n=2). In one case, a relatively long segmental thrombus occurred between the common iliac vein and the calf vein. In the occluded stent group, anatomic causes included atypical iliac vein compression (n=3) and a relatively long segmental thrombus between the common iliac and the calf vein (n=4). Typical iliac vein compression (May-Thurner syndrome) occurred in two cases, and a relatively short segmental thrombus between the external iliac and the common femoral vein in one. Factors which can affect the patency of an iliac venous stent positioned after catheter-directed thrombolysis are the anatomic cause of the stenosis, and the extent of a thrombus revealed at CT of acute DVT and occurring in a lower extremity prior to

Contabilidad de Costos II.

OpenAIRE

Morillo Moreno, Marysela C.

2008-01-01

ÍNDICE Presentación Orientaciones para el usuario Capítulo 1: Contabilidad de costos por procesos Sistemas de Contabilidad de Costos por Proceso Costos de Producción Conjunta. Productos Principales y Secundarios Capítulo 2: Contabilidad de costos predeterminados Presupuesto Estático y Presupuesto Flexible Sistema de Costos Estándar Capítulo 3: Sistema de costos variables Capítulo 4: Respuestas Bibliografía recomendada 1-...

MR-imaging of anterior tibiotalar impingement syndrome: Agreement, sensitivity and specificity of MR-imaging and indirect MR-arthrography

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Haller, Joerg [Department of Radiology, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria); Ludwig Boltzmann Institute for Osteology, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria); Bernt, Reinhard [Department of Radiology, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria)]. E-mail: reinhard.bernt@wgkk.sozvers.at; Seeger, Thomas [Department of Trauma Surgery, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria); Weissenbaeck, Alexander [Department of Trauma Surgery, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria); Tuechler, Heinrich [Ludwig Boltzmann Institute for Hematology, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria); Resnick, Donald [Department of Radiology, VA Medical Center, UCSD, 3350 La Jolla Village Dr, San Diego, CA 92161 (United States)

2006-06-15

Objective: To clarify the role of MR-imaging in the diagnosis of anterior ankle impingement syndromes. Materials and methods: We prospectively examined 51 consecutive patients with chronic ankle pain by MR-imaging. Arthroscopy was performed in 29 patients who previously underwent non-enhanced MR-imaging; in 11 patients, indirect MR-arthrography additionally was performed. MR-examinations were correlated with clinical findings; MR and arthroscopy scores were statistically compared, agreement was measured. Results: Arthroscopy demonstrated granulation tissue in the lateral gutter (38%) and anterior recess (31%), lesions of the anterior tibiofibular (31%) and the anterior talofibular ligament (21%) as well as intraarticular bodies (10%). Stenosing tenosynovitis and a ganglionic cyst were revealed as extraarticular causes for chronic ankle pain by MR-examination (17%). Agreement of MR-imaging and arthroscopy was fair for the anterior talofibular ligament and the anterior joint cavity (kappa 0.40). Major discrepancy was found for non-enhanced MR scans (kappa 0.49) when compared with indirect MR-arthrography (kappa 0.03) in the anterior cavity. The sensitivity for lesions of the anterior talofibular and calcaneofibular ligament and the anterior cavity (0.91-0.87) detected by MR-imaging was superior in comparison to lesions of the anterior tibiofibular ligament and anteromedial cavity (0.50-0.24). Conclusion: MR-imaging provides additional information about the mechanics of chronic ankle impingement rather than an accurate diagnosis of this clinical entity. The method is helpful in differentiating extra- from intra-articular causes of ankle impingement. Indirect MR-arthrography has little or no additional value in patients with ankle impingement syndrome.

MR-imaging of anterior tibiotalar impingement syndrome: Agreement, sensitivity and specificity of MR-imaging and indirect MR-arthrography

International Nuclear Information System (INIS)

Haller, Joerg; Bernt, Reinhard; Seeger, Thomas; Weissenbaeck, Alexander; Tuechler, Heinrich; Resnick, Donald

2006-01-01

Objective: To clarify the role of MR-imaging in the diagnosis of anterior ankle impingement syndromes. Materials and methods: We prospectively examined 51 consecutive patients with chronic ankle pain by MR-imaging. Arthroscopy was performed in 29 patients who previously underwent non-enhanced MR-imaging; in 11 patients, indirect MR-arthrography additionally was performed. MR-examinations were correlated with clinical findings; MR and arthroscopy scores were statistically compared, agreement was measured. Results: Arthroscopy demonstrated granulation tissue in the lateral gutter (38%) and anterior recess (31%), lesions of the anterior tibiofibular (31%) and the anterior talofibular ligament (21%) as well as intraarticular bodies (10%). Stenosing tenosynovitis and a ganglionic cyst were revealed as extraarticular causes for chronic ankle pain by MR-examination (17%). Agreement of MR-imaging and arthroscopy was fair for the anterior talofibular ligament and the anterior joint cavity (kappa 0.40). Major discrepancy was found for non-enhanced MR scans (kappa 0.49) when compared with indirect MR-arthrography (kappa 0.03) in the anterior cavity. The sensitivity for lesions of the anterior talofibular and calcaneofibular ligament and the anterior cavity (0.91-0.87) detected by MR-imaging was superior in comparison to lesions of the anterior tibiofibular ligament and anteromedial cavity (0.50-0.24). Conclusion: MR-imaging provides additional information about the mechanics of chronic ankle impingement rather than an accurate diagnosis of this clinical entity. The method is helpful in differentiating extra- from intra-articular causes of ankle impingement. Indirect MR-arthrography has little or no additional value in patients with ankle impingement syndrome

Shouldering the blame for impingement: the rotator cuff continuum ...

African Journals Online (AJOL)

The aim of this article was to summarise recent research on shoulder impingement and rotator cuff pathology. A continuum model of rotator cuff pathology is described, and the challenges of accurate clinical diagnosis, imaging and best management discussed. Keywords: shoulder impingement syndrome, subacromial ...

Disrupted auto-regulation of the spliceosomal gene SNRPB causes cerebro-costo-mandibular syndrome.

Science.gov (United States)

Lynch, Danielle C; Revil, Timothée; Schwartzentruber, Jeremy; Bhoj, Elizabeth J; Innes, A Micheil; Lamont, Ryan E; Lemire, Edmond G; Chodirker, Bernard N; Taylor, Juliet P; Zackai, Elaine H; McLeod, D Ross; Kirk, Edwin P; Hoover-Fong, Julie; Fleming, Leah; Savarirayan, Ravi; Majewski, Jacek; Jerome-Majewska, Loydie A; Parboosingh, Jillian S; Bernier, Francois P

2014-07-22

Elucidating the function of highly conserved regulatory sequences is a significant challenge in genomics today. Certain intragenic highly conserved elements have been associated with regulating levels of core components of the spliceosome and alternative splicing of downstream genes. Here we identify mutations in one such element, a regulatory alternative exon of SNRPB as the cause of cerebro-costo-mandibular syndrome. This exon contains a premature termination codon that triggers nonsense-mediated mRNA decay when included in the transcript. These mutations cause increased inclusion of the alternative exon and decreased overall expression of SNRPB. We provide evidence for the functional importance of this conserved intragenic element in the regulation of alternative splicing and development, and suggest that the evolution of such a regulatory mechanism has contributed to the complexity of mammalian development.

Subacromial impingement in patients with whiplash injury to the cervical spine

Directory of Open Access Journals (Sweden)

Giddins Grey E

2008-06-01

Full Text Available Abstract Background Impingement syndrome and shoulder pain have been reported to occur in a proportion of patients following whiplash injuries to the neck. In this study we aim to examine these findings to establish the association between subacromial impingement and whiplash injuries to the cervical spine. Methods and results We examined 220 patients who had presented to the senior author for a medico-legal report following a whiplash injury to the neck. All patients were assessed for clinical evidence of subacromial impingement. 56/220 patients (26% had developed shoulder pain following the injury; of these, 11/220 (5% had clinical evidence of impingement syndrome. Only 3/11 patients (27% had the diagnosis made prior to evaluation for their medico-legal report. In the majority, other clinicians had overlooked the diagnosis. The seatbelt shoulder was involved in 83% of cases (p Conclusion After a neck injury a significant proportion of patients present with shoulder pain, some of whom have treatable shoulder pathology such as impingement syndrome. The diagnosis is, however, frequently overlooked and shoulder pain is attributed to pain radiating from the neck resulting in long delays before treatment. It is important that this is appreciated and patients are specifically examined for signs of subacromial impingement after whiplash injuries to the neck. Direct seatbelt trauma to the shoulder is one possible explanation for its aetiology.

Contralateral Deep Vein Thrombosis after Iliac Vein Stent Placement in Patients with May-Thurner Syndrome.

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Le, Trong Binh; Lee, Taeg Ki; Park, Keun-Myoung; Jeon, Yong Sun; Hong, Kee Chun; Cho, Soon Gu

2018-04-25

To investigate the incidence and potential causes of contralateral deep vein thrombosis (DVT) after common iliac vein (CIV) stent placement in patients with May-Thurner syndrome (MTS). Data of 111 patients (women: 73%) who had CIV stent implantation for symptomatic MTS at a single center were retrospectively analyzed. Mean patient age was 63.1 ± 15.2 years. Median follow-up was 36 months (range, 1-142 months). Stent location was determined by venogram and classified as extended to the inferior vena cava (IVC), covered the confluence, or confined to the iliac vein. Potential causes of contralateral DVT were presumed based on venographic findings. The relationship between stent location and contralateral DVT was analyzed. Ten patients (9%, men/women: 4/6) exhibited contralateral DVT at a median timing of 40 months (range, 6-98 months). Median age was 69 years (range, 42-85 years). Median follow-up was 73.5 months (range, 20-134 months). Potential causes were venous intimal hyperplasia (VIH) (n = 7), "jailing" (n = 2), and indeterminate (n = 1). All patients with VIH had previous CIV stents overextended to the IVC. Overextension of CIV stent was associated with contralateral DVT (P VIH should be considered a potential cause. Copyright © 2018 SIR. Published by Elsevier Inc. All rights reserved.

The Effect of Platelet-Rich Plasma (PRP on Improvement in Pain and Symptoms of Shoulder Subacromial Impingement Syndrome

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Parisa Nejati

2015-08-01

Full Text Available Abstract Background: Subacromial impingement is one of the most common complaints of shoulder. Treatments include avoiding of painful activities, oral anti-pain drugs, physical therapy modalities, corticosteroid injection and exercise therapy. Some studies have shown that platelet- rich plasma(PRP is effective on tendinitis and tearing of tendons, ligaments and muscles, but evidence that has proved PRP as a conservative treatment in shoulder pathologies is very limited. This study aims to investigate the effect of PRP injection on relieving pain and improving daily function of patients with shoulder impingement syndrome. Materials and Methods: In this clinical trial study, patients older than 40 with pain more than three months were included. If they had three of four positive diagnostic clinical tests of shoulder impingement that were confirmed by shoulder MRI, could be injected PRP twice. The time between injections was 1 month. Pain was measured by visual analog scale (VAS and function was measured by two questionnaires named disabilities of the arm, shoulder and hand (DASH and western Ontario rotator cuff index (WORC. Range of motion (ROM of shoulder was measured in five directions by goniometry . All of these parameters were evaluated before intervention and in 1, 3, 6 months later. Results: with due attention to a six-month folloe-up, PRR injection was effective in pain reduction and improvement of patient's function (p<0.05. Shoulder Rom increased in all directions except external rotation and the power of shoulder muscles was evidently improved statistically in flexion, abduction and internal toration. Conclusion: PRP injection could effectively reduce pain and improve daily activities in patients with shoulder impingement syndrome.

Test-Retest Reliability of Handgrip Strength as an Outcome Measure in Patients With Symptoms of Shoulder Impingement Syndrome.

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Savva, Christos; Mougiaris, Paraskevas; Xadjimichael, Christoforos; Karagiannis, Christos; Efstathiou, Michalis

The purpose of this study was to investigate the degree of test-retest reliability of grip strength measurement using a hand dynamometer in patients with shoulder impingement syndrome. A total of 19 patients (10 women and 9 men; mean ± standard deviation age, 33.2 ± 12.9 years; range 18-59 years) with shoulder impingement syndrome were measured using a hand dynamometer by the same data collector in 2 different testing sessions with a 7-day interval. During each session, patients were encouraged to exert 3 maximal isometric contractions on the affected hand and the mean value of the 3 efforts (measured in kilogram-force [Kgf]) was used for data analysis. The intraclass correlation coefficient (ICC 2,1 ) as well as the standard error of measurement (SEM) and Bland-Altman plot were used to estimate the degree of test-retest reliability and the measurement error, respectively. Grip strength data analysis revealed an ICC 2,1 score of 0.94, which, based on the Shrout classification, is considered as excellent test-retest reliability of grip strength measurement. The small values of SEMs reported in both sessions (SEM 1 , 2.55 Kgf; SEM 2 , 2.39 Kgf) and the small width of the 95% limits of agreement in the Bland-Altman plot (ranging from -7.39 Kgf to 7.03 Kgf) reflected the measurement precision and the narrow variation of the differences during the 2 testing sessions. Results from this study identified excellent test-retest reliability of grip strength measurement in shoulder impingement syndrome, indicating its potential use as an outcome measure in clinical practice. Copyright © 2018. Published by Elsevier Inc.

A case of severe type of cerebro-costo-mandibular syndrome.

Science.gov (United States)

Matić, Aleksandra; Velisavljev-Filipović, Gordana; Lovrenski, Jovan; Gajdobranski, Djordje

2016-01-01

Cerebro-costo-mandibular syndrome (CCMS) is a rare disorder, with only 75 cases described in the literature to date. CCMS is characterized by association of micrognathia and specific multiple rib defects. It is accompanied by mental deficiency in considerable number of cases. Sometimes, there are associated anomalies and problems, such as spine deformities, brain, heart, kidney or ear anomalies, feeding difficulties, delayed psychomotor development, and growth impairment. Depending on severity of deformities and consecutive respiratory insufficiency, in about 35–50% of CCMS cases, death occurs during the first year of life. These cases are referred to as severe types of CCMS. In this paper we present a female infant with severe type of CCMS. Diagnosis was established in the first day of life, based on micrognathia and findings of posterior rib-gap defects on the chest X-ray, accompanied by dyspnea. Progressive severe respiratory insufficiency caused by chest and air-way deformities and exacerbated by episodes of pneumonia, led to respiratory failure and death at the age of 7.5 months. CCMS should be considered in every infant with micrognathia and rib-gap defects on chest X-ray.

A case of severe type of cerebro-costo-mandibular syndrome

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Matić Aleksandra

2016-01-01

Full Text Available Introduction. Cerebro-costo-mandibular syndrome (CCMS is a rare disorder, with only 75 cases described in the literature to date. CCMS is characterized by association of micrognathia and specific multiple rib defects. It is accompanied by mental deficiency in considerable number of cases. Sometimes, there are associated anomalies and problems, such as spine deformities, brain, heart, kidney or ear anomalies, feeding difficulties, delayed psychomotor development, and growth impairment. Depending on severity of deformities and consecutive respiratory insufficiency, in about 35-50% of CCMS cases, death occurs during the first year of life. These cases are referred to as severe types of CCMS. Case Outline. In this paper we present a female infant with severe type of CCMS. Diagnosis was established in the first day of life, based on micrognathia and findings of posterior rib-gap defects on the chest X-ray, accompanied by dyspnea. Progressive severe respiratory insufficiency caused by chest and air-way deformities and exacerbated by episodes of pneumonia, led to respiratory failure and death at the age of 7.5 months. Conclusion. CCMS should be considered in every infant with micrognathia and rib-gap defects on chest X-ray.

Effectiveness of Standardized Physiotherapy Exercises for Patients With Difficulty Returning to Usual Activities After Decompression Surgery for Subacromial Impingement Syndrome

DEFF Research Database (Denmark)

Christiansen, David Høyrup; Frost, Poul; Falla, Deborah

2016-01-01

BACKGROUND: Little is known about the effectiveness of exercise programs after decompression surgery for subacromial impingement syndrome. For patients with difficulty returning to usual activities, special efforts may be needed to improve shoulder function. OBJECTIVE: The purpose of this study w...

Radiotherapy for shoulder impingement; Bestrahlung beim Impingementsyndrom des Schultergelenks

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Adamietz, B. [Universitaetsklinikum Erlangen (Germany). Inst. fuer Radiologie; Sauer, R.; Keilholz, L. [Universitaetsklinikum Erlangen (Germany). Strahlentherapeutische Klinik

2008-05-15

Background and Purpose: Up to now, degenerative shoulder diseases were summarized by the term 'periarthritis humeroscapularis'. Actual shoulder diseases can be differentiated etiopathologically according to a primary and secondary impingement syndrome. Narrowing of the subacromial space, which is caused by an osseous shape variant, leads to primary impingement. Secondary impingement develops, when the subacromial space is reduced by swelling tissue below the osseous shoulder roof. This study aimed for the exact diagnosis to indicate therapy and to classify the results according to the Constant score. Patients and Methods: From August 1999 to September 2002, 102 patients with 115 shoulder joint conditions underwent radiation therapy (RT). All joints received two RT series (6 x 0.5 Gy/series) applied in two to three weekly fractions, totaling a dosage of 6.0 Gy (250 kV, 15 mAs, 1-mm Cu filter). The second RT course started 6 weeks after the end of the first. 115 shoulders were examined before RT, 6 weeks after the second RT course and, finally, during the follow-up from January to May 2003. Results: Pain relief was achieved in 94/115 shoulder joints (82%) after 18-month follow-up (median). A significant difference existed between secondary impingement and primary/non-impingement according to response. Tendinosis calcarea, bursitis subdeltoidea, tendovaginitis of the long biceps tendon, and capsulitis adhaesiva responded well to therapy. Conclusion: Shoulder diseases of secondary impingement demonstrate a good response to RT. Less or no benefit was found in primary impingement syndrome or complete rotator cuff disruption and acute shoulder injuries, respectively. (orig.)

[Arthroscopic therapy of ankle joint impingement syndrome after operation of ankle joint fracture dislocation].

Science.gov (United States)

Feng, Zhibin; Mi, Kun; Wei, Renzhi; Liu, Wu; Wang, Bin

2011-07-01

To study the operative procedure and the effectiveness of arthroscopic therapy for ankle joint impingement syndrome after operation of ankle joint fracture dislocation. Between March 2008 and April 2010, 38 patients with ankle joint impingement syndrome after operation of ankle joint fracture dislocation were treated. Among them, there were 28 males and 10 females with an average age of 28 years (range, 18 to 42 years). The time from internal fixation to admission was 12-16 months (mean, 13.8 months). There were pressing pain in anterolateral and anterior ankle. The dorsal extension ranged from -20 to -5 degrees (mean, -10.6 degrees), and the palmar flexion was 30-40 degrees (mean, 35.5 degrees). The total score was 48.32 +/- 9.24 and the pain score was 7.26 +/- 1.22 before operation according to American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot score system. The X-ray films showed osteophyte formation in anterior tibia and talus; MRI showed cartilage injury in 22 cases. Arthroscopic intervention included removing osteophytes, debriding fabric scars and synovial membrane tissues, and removing osteochondral fragments. Arthroscopic microfracture technique was used in 22 patients with cartilage injury. All incisions healed primarily. Thirty-eight cases were followed up 10-26 months (mean, 16 months). At last follow-up, 26 patients had normal range of motion (ROM); the dorsal extension was 15-25 degrees (mean, 19.6 degrees) and the palmar flexion was 35-45 degrees (mean, 40.7 degrees). Eight patients had mild limited ROM; the dorsal extension was 5-15 degrees (mean, 7.2 degrees) and the palmar flexion was 35-45 degrees (mean, 39.5 degrees). Four patients had mild limited ROM and pain in posterior portion of the ankle after a long walking (3-4 hours); the dorsal extension was 0-5 degrees (mean, 2.6 degrees) and the palmar flexion was 35-40 degrees (mean, 37.5 degrees). The total score was 89.45 +/- 9.55 and the pain score was 1.42 +/- 1.26 after

The Use of Physiotherapy among Patients with Subacromial Impingement Syndrome

DEFF Research Database (Denmark)

Christiansen, David Høyrup; Frost, Poul; Frich, Lars Henrik

2016-01-01

BACKGROUND: Physiotherapy with exercises is generally recommended in the treatment of patients with subacromial impingement syndrome (SIS). OBJECTIVE: We aimed to investigate the use of physiotherapy in patients with SIS in Danish hospital settings as part of initial non-surgical treatment...... and after SIS-related surgery and to evaluate to which extent sex, socio-demographic and clinical factors predict the use of physiotherapy. METHODS: Using national health registers, we identified 57,311 patients who had a first hospital contact with a diagnosis of ICD-10, groups M75.1-75.9, 1 July 2007...... to 30 June 2011. Records of physiotherapy were extracted within 52 weeks after first contact (or until surgery), and for surgically treated patients within 26 weeks after surgery. Predictors of the use of physiotherapy after first contact and after surgery were analysed as time-to-event. RESULTS: Within...

Los costos del crimen en Uruguay

OpenAIRE

Diego Aboal; Jorge Campanella; Bibiana Lanzilotta

2013-01-01

En este trabajo se estiman algunos de los costos asociados a la criminalidad y la violencia en Uruguay. El método utilizado es el de la contabilidad de costos. Entre los costos considerados se incluyen costos de seguridad y prevención del delito, de justicia, reclusión y rehabilitación de reclusos, costos de bienes robados, costos de salud y por pérdida de vidas a consecuencia de la violencia, y costos asociados a la pérdida de tiempo productivo en prisión de los reclusos. Para esto se ha uti...

Anterior internal impingement of the shoulder in rugby players and other overhead athletes

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Siddharth R. Shah, MBBS, MSc Sports Medicine (UK, MRCS-Ed

2017-04-01

Conclusion: This series of anterior internal impingement, which we believe is the largest in the literature to date, demonstrates the value of an to assess and successfully treat overhead athletes with anterior impingement syndrome.

Magnetic Resonance Imaging of Rotator Cuff Tears in Shoulder Impingement Syndrome

International Nuclear Information System (INIS)

Freygant, Magdalena; Dziurzyńska-Białek, Ewa; Guz, Wiesław; Samojedny, Antoni; Gołofit, Andrzej; Kostkiewicz, Agnieszka; Terpin, Krzysztof

2014-01-01

Shoulder joint is a common site of musculoskeletal pain caused, among other things, by rotator cuff tears due to narrowing of subacromial space, acute trauma or chronic shoulder overload. Magnetic resonance imaging (MRI) is an excellent modality for imaging of soft tissues of the shoulder joint considering a possibility of multiplanar image acquisition and non-invasive nature of the study. The aim of this study was to evaluate the prevalence of partial and complete rotator cuff tears in magnetic resonance images of patients with shoulder impingement syndrome and to review the literature on the causes and classification of rotator cuff tears. We retrospectively analyzed the results of 137 shoulder MRI examinations performed in 57 women and 72 men in Magnetic Resonance facility of the Department of Radiology and Diagnostic Imaging at the St. Jadwiga the Queen Regional Hospital No. 2 in Rzeszow between June 2010 and February 2013. Examinations were performed using Philips Achieva 1.5T device, including spin echo and gradient echo sequences with T1-, T2- and PD-weighted as well as fat saturation sequences in transverse, frontal and sagittal oblique planes. Patients were referred from hospital wards as well as from outpatient clinics of the subcarpathian province. The most frequently reported injuries included partial supraspinatus tendon tear and complete tearing most commonly involved the supraspinatus muscle tendon. The smallest group comprised patients with complete tear of subscapularis muscle tendon. Among 137 patients in the study population, 129 patients suffered from shoulder pain, including 57 patients who reported a history of trauma. There was 44% women and 56% men in a group of patients with shoulder pain. Posttraumatic shoulder pain was predominantly reported by men, while women comprised a larger group of patients with shoulder pain not preceded by injury. Rotator cuff injury is a very common pathology in patients with shoulder impingement syndrome

'Right-Sided' May-Thurner Syndrome

International Nuclear Information System (INIS)

Abboud, Georges; Midulla, Marco; Lions, Christophe; El Ngheoui, Ziad; Gengler, Laurent; Martinelli, Thomas; Beregi, Jean-Paul

2010-01-01

The May-Thurner syndrome is a well-known anatomical anomaly where the left common iliac vein (LCIV) is compressed between the right common iliac artery and the fifth vertebral body. This report describes the case of a 'right-sided' May-Thurner syndrome where the right common iliac vein (RCIV) is compressed by the left common iliac artery in a patient with a left-sided inferior vena cava (IVC). A 26-year-old woman was admitted to our institution with acute edema of the right lower limb. The diagnosis of May-Thurner syndrome was done by CT scan and confirmed by phlebography. An endovascular treatment with stenting was carried out, with good patency and clinical result at 12-month follow-up.

The relationship of strength and muscle balance to shoulder pain and impingement syndrome in elite quadriplegic wheelchair rugby players.

Science.gov (United States)

Miyahara, M; Sleivert, G G; Gerrard, D F

1998-04-01

Wheelchair athletes are susceptible to injuries related to overuse of the shoulder, in particular shoulder impingement syndrome. The present study examined the relationship of shoulder pain to demographic details, isokinetic strength and muscle balance in 8 elite quadriplegic rugby players. Demographic data were collected using personal interviews and each subject was clinically examined for signs of impingement syndrome by a physician. In addition each subject underwent bilateral isokinetic strength testing of the shoulder at 60 and 180 deg/s for abduction/adduction and internal/external rotation. A series of step-wise multiple discriminant analysis successfully predicted clinical symptoms from demographic, muscular strength and balance data. In particular, there was a significant deficit in adductor strength and this was related to shoulder pain and wasting of the scapular muscles. This strength deficit may be due to the high level of spinal lesions in the quadriplegic population. The level of spinal lesion may contribute to the aetiology of shoulder pathology in quadriplegia, and differentiate it from that observed in able-bodied athletes who exhibit weak abductors.

Iliac Artery Stent Placement Relieves Claudication in Patients with Iliac and Superficial Femoral Artery Lesions

International Nuclear Information System (INIS)

Ichihashi, Shigeo; Higashiura, Wataru; Itoh, Hirofumi; Sakaguchi, Shoji; Kichikawa, Kimihiko

2013-01-01

Purpose. To evaluate the efficacy of iliac artery stent placement for relief of claudication in patients with both iliac and superficial femoral artery (SFA) lesions. Methods. Stent placement for only iliac artery occlusive disease was performed in 94 limbs (74 patients) with both iliac and SFA occlusive disease on the same limb. All procedures were performed because intermittent claudication did not improve after continuation of antiplatelet medication therapy and home-based exercise for 3 months. Rutherford classification was 2 in 20 limbs and 3 in 74 limbs. Patients with critical limb ischemia were excluded. Median duration of follow-up was 40 months. Primary patency rates of the iliac stent, clinical improvement rates, and risk factors for requiring additional SFA procedures were evaluated. Results. Primary patency rates of the iliac stent at 1, 3, 5, and 7 years were 97, 93, 79, and 79 %, respectively. The initial clinical improvement rate was 87 %. Continued clinical improvement rates at 1, 3, 5, and 7 years were 87, 81, 69, and 66 %, respectively. SFA Trans-Atlantic Inter-Society Consensus (TASC) II C/D lesion was a significant risk factor for requiring additional SFA procedures. Conclusion. Intermittent claudication was relieved by iliac stent placement in most patients with both iliac and SFA lesions. Thus, the indications for treatment of the SFA intended for claudicants should be evaluated after treatment of the iliac lesion.

Diagnostic imaging of shoulder impingement

International Nuclear Information System (INIS)

Merl, T.; Weinhardt, H.; Oettl, G.; Lenz, M.; Riel, K.A.

1996-01-01

Magnetic resonance imaging is a method that has been advancing in the last few years to the modality of choice for diagnostic evaluation of the bone joints, as the method is capable of imaging not only the ossous but also the soft tissue components of the joint. MRI likewise has become an accepted method for diagnostic evaluation of syndromes of the shoulder, with high diagnostic accuracy in detecting rotator cuff lesions, or as an efficient MRI arthrography for evaluation of the instability or lesions of the labrocapsular complex. In the evaluation of early stages of shoulder impingement, the conventional MRI technique as a static technique yields indirect signs which in many cases do not provide the diagnostic certainty required in order to do justice to the functional nature of the syndrome. In these cases, functional MRI for imaging of the arm in abducted position and in rotational movement may offer a chance to early detect impingement and thus identify patients who will profit from treatment at an early stage [de

Does taping in addition to physiotherapy improve the outcomes in subacromial impingement syndrome? A systematic review.

Science.gov (United States)

Saracoglu, Ismail; Emuk, Yusuf; Taspinar, Ferruh

2018-04-01

Taping is used with or without other interventions for many purposes, especially to manage pain and improve functional activity in patients with shoulder pain. The aim of this review was to determine whether any taping technique in addition to physiotherapy care is more effective than physiotherapy care alone in patients with shoulder impingement syndrome. A systematic search of Cochrane Database of Systematic Review, MEDLINE (EBSCO), Physiotherapy Evidence Database (PEDro), CINAHL (EBSCO), PUBMED, AMED, EMBASE (OVID), The Kinesio Kinesio® Taping Method, Kinesio® Tex Tape UK and International websites ( www.kinesiotaping.co.uk ; www.kinesiotaping.com ) was conducted to June 2015. The outcome measures were pain, disability, range of motion and muscle strength. As data were not suitable for meta-analysis, narrative synthesis were applied. Three randomized controlled trials and one controlled trial (135 patients) were included. The results were conflicting and weak on the effectiveness of taping as an adjunct therapy for improvement of pain, disability, range of motion and muscle strength. Clinical taping in addition to physiotherapy interventions (e.g. exercise, electrotherapy, and manual therapy) might be an optional modality for managing patients with shoulder impingement syndrome, especially for the initial stage of the treatment; however, we need further robust, placebo controlled and consistent studies to prove whether it is more effective than physiotherapy interventions without taping.

The Effect of Theraband Training on Position Sense of Internal and External Rotator Muscles in Male Athletes with Shoulder Impingement Syndrome

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Ramin Moharrami

2015-10-01

Full Text Available Objective: This study evaluated the effect of theraband training on Position sense of internal and external rotator muscles in male athletes with shoulder impingement syndrome. Materials & Methods: In this semi-experimental interventional study 30 cases of men with Shoulder syndrome with age range of 20 to 30 years participated. They were divided in test and control groups, each group including 15 people through non-random and purposeful method Biodex System 3 Made in America was used to measure position sense of internal and external rotator muscles. For data analysis independent 7 paired t-test was used in SPSS software (version 21. Results: The experimental group showed significant improvement after six weeks of theraband training in the internal and external rotator muscles in three 90,45,0 degree angle at a significance level of 0.05 (P=0.05. Conclusion: The results of this study showed that of theraband training resulted in improved position sense of internal and external rotator muscles in male athletes with impingement syndrome thus, the benefits of these exercises can be used widely in team sports and also for easy and quick rehabilitation of patients.

FIJACIÓN DE PRECIOS Costo Plus (Costo más margen y Target Costing (Costeo Objetivo

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Carlos Fernando Cuevas Villegas

2002-01-01

Full Text Available Los tres factores básicos a considerar en la fijación de precios de productos o servicios son los clientes, la competencia y los costos. Dos enfoques son básicamente utilizados a partir de la información de la Contabilidad Gerencial. El enfoque de Cost-Plus (costo más un margen utiliza una fórmula general que agrega un margen (Mark up al costo base, como punto de partida de la decisión de fijación de precios. Muchos costos distintos (como los absorbentes de producción o totales pueden servir como base del costo, al aplicar la fórmula del costo más margen. Después los precios se modifican con base en las reacciones de los clientes y las respuestas de los competidores. El enfoque de fijación de precios más usado hoy es el Costo Objetivo (Target Cost, en el cual primero se fija el precio objetivo que están dispuestos a pagar los clientes por un producto o servicio. Una utilidad de operación objetivo por unidad se resta al precio objetivo para determinar el costo objetivo por unidad. El reto para la organización es hacer las mejoras necesarias en sus costos mediante la ingeniería de valor y el mejoramiento continuo.

Contabilidad de Costos II. - Presentación

OpenAIRE

Morillo Moreno, Marysela C.

2008-01-01

ÍNDICE Presentación Orientaciones para el usuario Capítulo 1: Contabilidad de costos por procesos Sistemas de Contabilidad de Costos por Proceso Costos de Producción Conjunta. Productos Principales y Secundarios Capítulo 2: Contabilidad de costos predeterminados Presupuesto Estático y Presupuesto Flexible Sistema de Costos Estándar Capítulo 3: Sistema de costos variables Capítulo 4: Respuestas Bibliografía recomendada Pr...

The reliability of three-dimensional scapular attitudes in healthy people and people with shoulder impingement syndrome

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Hébert Luc J

2007-06-01

Full Text Available Abstract Background Abnormal scapular displacements during arm elevation have been observed in people with shoulder impingement syndrome. These abnormal scapular displacements were evaluated using different methods and instruments allowing a 3-dimensional representation of the scapular kinematics. The validity and the intrasession reliability have been shown for the majority of these methods for healthy people. However, the intersession reliability on healthy people and people with impaired shoulders is not well documented. This measurement property needs to be assessed before using such methods in longitudinal comparative studies. The objective of this study is to evaluate the intra and intersession reliability of 3-dimensional scapular attitudes measured at different arm positions in healthy people and to explore the same measurement properties in people with shoulder impingement syndrome using the Optotrak Probing System. Methods Three-dimensional scapular attitudes were measured twice (test and retest interspaced by one week on fifteen healthy subjects (mean age 37.3 years and eight subjects with subacromial shoulder impingement syndrome (mean age 46.1 years in three arm positions (arm at rest, 70° of humerothoracic flexion and 90° of humerothoracic abduction using the Optotrak Probing System. Two different methods of calculation of 3-dimensional scapular attitudes were used: relative to the position of the scapula at rest and relative to the trunk. Intraclass correlation coefficient (ICC and standard error of measure (SEM were used to estimate intra and intersession reliability. Results For both groups, the reliability of the three-dimensional scapular attitudes for elevation positions was very good during the same session (ICCs from 0.84 to 0.99; SEM from 0.6° to 1.9° and good to very good between sessions (ICCs from 0.62 to 0.97; SEM from 1.2° to 4.2° when using the method of calculation relative to the trunk. Higher levels of

The evaluation of the effectiveness of occupational therapy, using its different programs for the people who are experiencing shoulder impingement syndrome

OpenAIRE

Sadauskytė, Sigita

2015-01-01

S. Sadauskytė: The evaluation of the effectiveness of occupational therapy, using its different programs for the people who are experiencing shoulder impingement syndrome. A Master‘s thesis. Research supervisor is dr. E. Sendžikaitė; Institute of sports, Faculty of nursing, Medical Academy,Lithuanian University of Health Sciences, – Kaunas, 2015.

Femoroacetabular impingement

International Nuclear Information System (INIS)

Kassarjian, Ara; Brisson, Melanie; Palmer, William E.

2007-01-01

Femoroacetabular impingement is a relatively recently appreciated 'idiopathic' cause of hip pain and degenerative change. Two types of impingement have been described. The first, cam impingement, is the result of an abnormal morphology of the proximal femur, typically at the femoral head-neck junction. Cam impingement is most common in young athletic males. The second, pincer impingement, is the result of an abnormal morphology or orientation of the acetabulum. Pincer impingement is most common in middle-aged women. This article reviews the imaging findings of cam and pincer type femoroacetabular impingement. Recognition of these entities will help in the selection of the appropriate treatment with the goal of decreasing the likelihood of early degenerative change of the hip

Cerebro-costo-mandibular Syndrome

Science.gov (United States)

McNicholl, B.; Egan-Mitchell, B.; Murray, J. P.; Doyle, J. F.; Kennedy, J. D.; Crome, L.

1970-01-01

Three sibs with a hitherto unreported syndrome are described, the main features being mental handicap, palatal defects, micrognathia, and severe costovertebral defects, involving segmentation of most ribs and fusion of their dorsal ends to the vertebral bodies. In addition one infant had hypoplasia of an elbow together with defects of sacrum and coccyx; she and one other sib had minor dental defects. The syndrome is potentially lethal in the neonatal period; one of the sibs has survived. The inheritance is probably autosomal recessive. ImagesFIG. 1FIG. 2FIG. 3FIG. 4 PMID:5427859

Capítulo I: Contabilidad de costos - Capítulo II : Costos estimados

OpenAIRE

Rojas Medina, Ricardo Alfredo

2014-01-01

Me permito poner a su consideración los capítulos I y II del libro titulado: Costos un enfoque administrativo y de gerencia, contenido que fue realizado para mejorar y reestructurar el libro titulado Sistemas de costos un proceso para su implementación, que tuvo gran acogida dado el volumen de consulta y descarga del repositorio de la UN. En la primera unidad se trabaja lo referente a costos para la toma de decisiones, presentado un marco teórico y los fundamentos básicos del costeo direct...

Ultrasound elastography-based assessment of the elasticity of the supraspinatus muscle in impingement syndrome: does elastography has any diagnostic value?

Science.gov (United States)

Demirel, Adnan; Baykara, Murat; Koca, Tuba Tülay; Berk, Ejder

2018-06-01

Ultrasound elastography (UE) is a new ultrasound-based imaging technique that provides information about elasticity and stiffness of tissues. This cross-sectional study aimed to identify the diagnostic importance of UE in supraspinatus impingement syndrome. Forty-one subjects, aged 38-70 years, were included in the study. UE was used to determine the elasticity of the supraspinatus muscle. The strain ratio was calculated as the evaluation criteria to measure the elasticity of the muscle. High strain ratio indicated low elasticity. The measurements were made by the blinded radiologist while the patients sat with their shoulder in a neutral position. The diagnostic value of the strain ratio was evaluated using the receiver operating characteristic (ROC) analysis. The mean strain value of the supraspinatus muscle on the intact and pathological shoulders determined by UE was 0.74 ± 0.33 and 0.31 ± 0.24, respectively. A low strain ratio value in the supraspinatus muscle on the side with impingement syndrome was measured. When the test variable was evaluated as "strain ratio" according to ROC curve analysis, it was found to be above the reference line [0.849 (> 0.5)] (P = 0.00). When the cutoff value was selected as 0.495, the sensitivity and specificity were found to be 75.6 and 78% (the strain ratio value > 0.495), respectively. Measurement of strain ratio with UE can be used as a noninvasive, inexpensive, and practical diagnostic test for the shoulder impingement disease.

Contabilidad de Costos II. - Bibliografía recomendada

OpenAIRE

Morillo Moreno, Marysela C.

2008-01-01

ÍNDICE Presentación Orientaciones para el usuario Capítulo 1: Contabilidad de costos por procesos Sistemas de Contabilidad de Costos por Proceso Costos de Producción Conjunta. Productos Principales y Secundarios Capítulo 2: Contabilidad de costos predeterminados Presupuesto Estático y Presupuesto Flexible Sistema de Costos Estándar Capítulo 3: Sistema de costos variables Capítulo 4: Respuestas Bibliografía recomendada Pr...

Contabilidad de Costos II. - Orientaciones para el usuario

OpenAIRE

Morillo Moreno, Marysela C.

2008-01-01

ÍNDICE Presentación Orientaciones para el usuario Capítulo 1: Contabilidad de costos por procesos Sistemas de Contabilidad de Costos por Proceso Costos de Producción Conjunta. Productos Principales y Secundarios Capítulo 2: Contabilidad de costos predeterminados Presupuesto Estático y Presupuesto Flexible Sistema de Costos Estándar Capítulo 3: Sistema de costos variables Capítulo 4: Respuestas Bibliografía recomendada Pr...

Co-occurrence of outlet impingement syndrome of the shoulder and restricted range of motion in the thoracic spine - a prospective study with ultrasound-based motion analysis

Directory of Open Access Journals (Sweden)

Fuchs-Winkelmann Susanne

2010-06-01

Full Text Available Abstract Background Shoulder complaints, and especially the outlet-impingement syndrome, are a common condition. Among other things, poor posture has been discussed as a cause. A correlation between impingement syndrome and restricted mobility of the thoracic spine (T has been described earlier, but there has been no motion analysis of the thoracic spine to show these correlations. In the present prospective study, we intended to find out whether there is a significant difference in the thoracic sagittal range of motion (ROM between patients with a shoulder outlet impingement syndrome and a group of patients who had no shoulder pathology. Secondly, we wanted to clarify whether Ott's sign correlates with ultrasound topometric measurements. Methods Two sex- and age-matched groups (2 × n = 39 underwent a clinical and an ultrasound topometric examination. The postures examined were sitting up straight, sitting in maximal flexion and sitting in maximal extension. The disabilities of the arm, shoulder and hand (DASH score (obtained by means of a self-assessment questionnaire and the Constant score were calculated. Lengthening and shortening of the dorsal projections of the spine in functional positions was measured by tape with Ott's sign. Results On examination of the thoracic kyphosis in the erect seated posture there were no significant differences between the two groups (p = 0.66. With ultrasound topometric measurement it was possible to show a significantly restricted segmental mobility of the thoracic spine in the study group compared with the control group (p = 0.01. An in-depth look at the mobility of the subsegments T1-4, T5-8 and T9-12 revealed that differences between the groups in the mobility in the lower two sections of the thoracic spine were significant (T5-8: p = 0.03; T9-12: p = 0.02. The study group had an average Constant score of 35.1 points and the control group, 85.5 (p Conclusion The mobility of the thoracic spine should

Prevalência de marcadores de trombofilia em pacientes portadores da síndrome de May-Thurner e trombose de veia ilíaca comum esquerda Prevalence of thrombophilia factors in patients with May-Thurner syndrome and left common iliac vein thrombosis

Directory of Open Access Journals (Sweden)

Marcos Arêas Marques

2010-12-01

Full Text Available CONTEXTO: A relação entre trombose venosa profunda e trombofilia tem sido pouco estudada em indivíduos portadores de compressão da veia ilíaca comum esquerda, conhecida clinicamente como síndrome de May-Thurner. OBJETIVO: Avaliar a prevalência de marcadores de trombofilia nos pacientes portadores de síndrome de May-Thurner e trombose de veia ilíaca comum esquerda. MÉTODOS: Entre março de 1999 e dezembro de 2008, 20 pacientes com síndrome de May-Thurner e trombose de veia ilíaca comum esquerda foram avaliados retrospectivamente quanto à presença de marcadores de trombofilia. RESULTADOS: Foi detectada a associação entre síndrome de May-Thurner e marcadores de trombofilia em 8 pacientes (40%. CONCLUSÃO: A presença de marcadores de trombofilia em pacientes com trombose de veia ilíaca comum esquerda e síndrome de May-Thurner é frequente, porém não difere da prevalência encontrada em pacientes portadores de trombose venosa profunda sem a síndrome associada.BACKGROUND: The relationship between deep venous thrombosis and thrombophilia has been little studied in patients with left common iliac vein compression, clinically known as May-Thurner syndrome. OBJECTIVE: To evaluate the prevalence of thrombophilia markers in patients with May-Thurner syndrome and left common iliac vein thrombosis. METHODS: From March 1999 to December 2008, 20 patients with May-Thurner syndrome and left common iliac vein thrombosis were retrospectively investigated for the presence of thrombophilia markers. RESULTS: The association between May-Thurner syndrome and thrombophilia markers was found in 8 patients (40%. CONCLUSION: There is a high prevalence of thrombophilia markers in patients with May-Thurner syndrome and left common iliac vein thrombosis. The prevalence, however, is not different from that found in patients with deep venous thrombosis without May-Thurner syndrome.

Bi-iliac distance and iliac bone position compared to the vertebral column in normal fetal development

DEFF Research Database (Denmark)

Hartling, U B; Fischer Hansen, B; Skovgaard, L T

2001-01-01

Prenatal standards of bi-iliac width were not found in the literature based on autopsy investigations, nor was the caudo-cranial position of the ilia compared to the vertebral column. The first purpose of the present study was to establish normal standard values for the bi-iliac distance in fetal...... life, the second to evaluate the level of the iliac bones proportional to the ossified vertebral column. Whole body radiographs in antero-posterior projections from 98 human fetuses (36 female and 44 male fetuses, as well as 18 fetuses on which the sex had not been determined) were analyzed...... caliper. The caudo-cranial position of the iliac bones was evaluated. The present study shows that in normal fetal development there is a continuous linear enlargement of the pelvic region in the transverse and vertical planes. The upper iliac contour stays at the level of the first sacral vertebral body...

Investigation of adverse events associated with an off-label use of arterial stents and CE-marked iliac vein stents in the iliac vein: insights into developing a better iliac vein stent.

Science.gov (United States)

Shida, Takuya; Umezu, Mitsuo; Iwasaki, Kiyotaka

2018-06-01

We analyzed the adverse events associated with an off-label use of arterial stents and CE-marked iliac vein stents for the treatment of iliac venous thromboembolism and investigated their relationships with the anatomical features of the iliac vein, to gain insights into the development of a better iliac vein stent. Reports of adverse events following the use of stents in the iliac vein were retrieved from the Manufacturer and User Facility Device Experience (MAUDE) database that contain suspected device-associated complications reported to the Food and Drug Administration. Data from 2006 to 2016 were investigated. The literature analysis was also conducted using PubMed, Cochrane Library, EMBASE, and Web of Science focusing on English articles published up to 4 October 2016. The analysis of 88 adverse events from the MAUDE database and 182 articles from the literature revealed that a higher number of adverse events had been reported following the use of arterial stents in the iliac vein compared to CE-marked iliac vein stents. While stent migration and shortening were reported only for the arterial stents, stent fracture and compression occurred regardless of the stent type, even though a vein does not pulsate. A study of the anatomical features of the iliac vein implies that bending, compression, and kink loads are applied to the iliac vein stents in vivo. For designing, developing, and pre-clinical testing of stents intended for use in the iliac vein, the above mechanical load environments induced by the anatomical features should be considered.

Contabilidad de Costos II. - Capítulo 4. Respuestas

OpenAIRE

Morillo Moreno, Marysela C.

2008-01-01

ÍNDICE Presentación Orientaciones para el usuario Capítulo 1: Contabilidad de costos por procesos Sistemas de Contabilidad de Costos por Proceso Costos de Producción Conjunta. Productos Principales y Secundarios Capítulo 2: Contabilidad de costos predeterminados Presupuesto Estático y Presupuesto Flexible Sistema de Costos Estándar Capítulo 3: Sistema de costos variables Capítulo 4: Respuestas Bibliografía recomendada Pr...

[Effectiveness of physiotherapy on painful shoulder impingement syndrome].

Science.gov (United States)

Gomora-García, Mónica; Rojano-Mejía, David; Solis-Hernández, José Luis; Escamilla-Chávez, Carolina

2016-01-01

Painful shoulder impingement syndrome is one of the first reasons for care in rehabilitation centres. As the evidence regarding the effectiveness of physical measures as adjuvant treatment is limited, the aim of this study was to determine the effectiveness of physiotherapy on shoulder pain. A retrospective and analytical study was conducted using the medical records of patients with shoulder pain who attended in a rehabilitation centre from October 2010 to September 2011. The demographic and clinical data were collected, and the clinical improvement was determined as: complete, incomplete, or no improvement. Chi squared was used to determine whether there were differences between the different modalities of physiotherapy, as well as the level of improvement. The study included a total of 181 patients, with a mean age of 54.3 years, and a mean of 4.6 months of onset of pain. The physiotherapy treatments included: warm compresses plus interferential current (60.2%), and warm compresses plus ultrasound (17.1%). Just over half (53.6%) obtained a moderate recovery, 36.4% slight improvement, and 9.9% no improvement. No significant differences were found between the different forms of therapy. The supervised rehabilitation program consists of 9 sessions of physiotherapy. A functional improvement of 90% was obtained, without finding any statistical differences between the therapies used. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

Endovascular Treatment for Iliac Vein Compression Syndrome: a Comparison between the Presence and Absence of Secondary Thrombosis

Energy Technology Data Exchange (ETDEWEB)

Lou, Wen Sheng; Gu, Jian Ping; He, Xu; Chen, Liang; Su, Hao Bo; Chen, Guo Ping; Song, Jing Hua; Wang, Tao [Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing (China)

2009-04-15

To evaluate the value of early identification and endovascular treatment of iliac vein compression syndrome (IVCS), with or without deep vein thrombosis (DVT). Three groups of patients, IVCS without DVT (group 1, n = 39), IVCS with fresh thrombosis (group 2, n = 52) and IVCS with non-fresh thrombosis (group 3, n = 34) were detected by Doppler ultrasonography, magnetic resonance venography, computed tomography or venography. The fresh venous thrombosis were treated by aspiration and thrombectomy, whereas the iliac vein compression per se were treated with a self-expandable stent. In cases with fresh thrombus, the inferior vena cava filter was inserted before the thrombosis suction, mechanical thrombus ablation, percutaneous transluminal angioplasty, stenting or transcatheter thrombolysis. Stenting was performed in 111 patients (38 of 39 group 1 patients and 73 of 86 group 2 or 3 patients). The stenting was tried in one of group 1 and in three of group 2 or 3 patients only to fail. The initial patency rates were 95% (group 1), 89% (group 2) and 65% (group 3), respectively and were significantly different (p = 0.001). Further, the six month patency rates were 93% (group 1), 83% (group 2) and 50% (group 3), respectively, and were similarly significantly different (p = 0.001). Both the initial and six month patency rates in the IVCS patients (without thrombosis or with fresh thrombosis), were significantly greater than the patency rates of IVCS patients with non-fresh thrombosis. From the cases examined, the study suggests that endovascular treatment of IVCS, with or without thrombosis, is effective

Cerebro-costo-mandibular syndrome

NARCIS (Netherlands)

Plotz, FB; vanEssen, AJ; Bosschaart, AN; Bos, AP

1996-01-01

We describe two boys with the cerebro-costomandibular syndrome (CCMS). Both patients presented with Pierre Robin anomaly and respiratory insufficiency and died 12 hours and 10 months after birth. The first boy had muscular hypotonia, severe micrognathia, glossoptosis, short; palate, preauricular

A study on iliac index in Koran children

International Nuclear Information System (INIS)

Kim, Chu Wan

1973-01-01

Abnormal pelvic configuration with resultant abnormal value of acetabular angle, iliac angle and iliac index is well known in some congenital and hereditary diseases and its measurement is valuable in establishing diagnosis in these diseases. Considering that there is no available standard values of Korean children, we measured acetabular angles, iliac angles and iliac indices in 150 normal Korean children, 10 cases of congenital dislocation of hip and 2 cases of mongolism. The results are as follows: 1. The values of acetabular angle, iliac angle and lilac index are significantly lower than those of American children. 2. Significant increase in acetabular angle is observed in patients with congenital dislocation of hip and significant decrease in iliac index in patients with mongolism is observed. 3. Iliac index seems to be more reliable than either of acetabular angle and iliac angle in the detection of abnormal pelvic contuor in patients with mongolism. We considered that the pelvic mensuration should be done in large number of normal and patients and further study in this fields should be carried out

Trunk, pelvis and hip biomechanics in individuals with femoroacetabular impingement syndrome: Strategies for step ascent.

Science.gov (United States)

Diamond, Laura E; Bennell, Kim L; Wrigley, Tim V; Hinman, Rana S; Hall, Michelle; O'Donnell, John; Hodges, Paul W

2018-03-01

Femoroacetabular impingment (FAI) syndrome is common among young active adults and a proposed risk factor for the future development of hip osteoarthritis. Pain is dominant and drives clinical decision-making. Evidence for altered hip joint function in this patient population is inconsistent, making the identification of treatment targets challenging. A broader assessment, considering adjacent body segments (i.e. pelvis, trunk) and individual movement strategies, may better inform treatment programs. This exploratory study aimed to compare trunk, pelvis, and hip biomechanics during step ascent between individuals with and without FAI syndrome. Fifteen participants diagnosed with symptomatic cam-type or combined (cam plus pincer) FAI who were scheduled for arthroscopic surgery, and 11 age-, and sex-comparable pain- and disease-free individuals, underwent three-dimensional motion analysis during a step ascent task. Trunk, pelvis and hip biomechanics were compared between groups. Participants with FAI syndrome exhibited altered ipsilateral trunk lean and pelvic rise towards the symptomatic side during single-leg support compared to controls. Alterations were not uniformly adopted across all individuals with FAI syndrome; those who exhibited more pronounced alterations to frontal plane pelvis control tended to report pain during the task. There were minimal between-group differences for hip biomechanics. Exploratory data suggest biomechanics at the trunk and pelvis during step ascent differ between individuals with and without FAI syndrome. Those with FAI syndrome implement a range of proximal strategies for task completion, some of which may have relevance for rehabilitation. Longitudinal investigations of larger cohorts are required to evaluate hypothesized clinical and structural consequences. Copyright © 2018 Elsevier B.V. All rights reserved.

Mutations in SNRPB, encoding components of the core splicing machinery, cause cerebro-costo-mandibular syndrome.

Science.gov (United States)

Bacrot, Séverine; Doyard, Mathilde; Huber, Céline; Alibeu, Olivier; Feldhahn, Niklas; Lehalle, Daphné; Lacombe, Didier; Marlin, Sandrine; Nitschke, Patrick; Petit, Florence; Vazquez, Marie-Paule; Munnich, Arnold; Cormier-Daire, Valérie

2015-02-01

Cerebro-costo-mandibular syndrome (CCMS) is a developmental disorder characterized by the association of Pierre Robin sequence and posterior rib defects. Exome sequencing and Sanger sequencing in five unrelated CCMS patients revealed five heterozygous variants in the small nuclear ribonucleoprotein polypeptides B and B1 (SNRPB) gene. This gene includes three transcripts, namely transcripts 1 and 2, encoding components of the core spliceosomal machinery (SmB' and SmB) and transcript 3 undergoing nonsense-mediated mRNA decay. All variants were located in the premature termination codon (PTC)-introducing alternative exon of transcript 3. Quantitative RT-PCR analysis revealed a significant increase in transcript 3 levels in leukocytes of CCMS individuals compared to controls. We conclude that CCMS is due to heterozygous mutations in SNRPB, enhancing inclusion of a SNRPB PTC-introducing alternative exon, and show that this developmental disease is caused by defects in the splicing machinery. Our finding confirms the report of SNRPB mutations in CCMS patients by Lynch et al. (2014) and further extends the clinical and molecular observations. © 2014 WILEY PERIODICALS, INC.

Interventional procedures of the isolated iliac arterial aneurysm

Energy Technology Data Exchange (ETDEWEB)

Ohm, Joon Young [The Catholic Univ. of Korea College of Medicine, Bucheon (Korea, Republic of); Shin, Byung Seok; Ahn, Moon Sang [Chungnam National Univ. Hospital, Daejeon (Korea, Republic of); Park, Mi Hyun [Dankook Univ. Hospital, Cheonan (Korea, Republic of); Kim, Ho Jun [Konyang Univ. Hospital, Daejeon (Korea, Republic of)

2012-05-15

To report the results of treatment isolated iliac arterial aneurysms by interventional procedures. Over a period of 5 years, 7 isolated iliac artery aneurysms (4 in the common iliac artery, 3 in the internal iliac artery) in 7 patients (3 women, 4 men; mean age, 65.7 years) were treated using interventional procedures. The mean aneurysm size was 35 mm (range, 30-45 mm). The common iliac aneurysms were treated using a unilateral stent graft (2 balloon expandable, 2 self expandable) with coil embolization of the internal iliac artery (n = 3), except for 1 aneurysm that ruptured. Coil embolization alone was performed for aneurysms involving only the internal iliac artery (n = 3). All patients were treated successfully, except for 1 with an initial remnant of type 2 endoleak. There were no perioperative complications. No leakage or complication occurred at the mean follow up of 14 months (range 2-29 months). One patient with a ruptured aneurysm died of multi organ failure during the follow up period. Three aneurysms had decreased in size on follow up CT. Interventional procedures with stent grafting and coil embolization are safe and effective treatments for isolated iliac artery aneurysms.

Impingement syndrome and rotator cuff tears: US findings in 140 patients

International Nuclear Information System (INIS)

Malvestiti, Oreste; Scorsolini, Alessandro; Ratti, Francesco; Ferraris, Giuseppe; Columbaro, Guido; Mariani, Claudio

1997-01-01

The authors investigated the role of rotator cuff impingement in causing tears of supraspinatus and biceps tendons and the comparative reliability of plain radiography and sonography (US). One hundred forty patients with symtoms referrable to the rotator cuff were examined with plain radiography and US of the shoulder. The differential diagnosis must distinguish all these common causes of shoulder dysfunction and cuff problems from other conditions. The authors conclude that US and plain radiography are accurate routine tests of rotator cuff integrity and rotator cuff impingement

[Athletic pubalgia and hip impingement].

Science.gov (United States)

Berthaudin, A; Schindler, M; Ziltener, J-L; Menetrey, J

2014-07-16

Athletic pubalgia is a painful and complex syndrom encountered by athletes involved in pivoting and cutting sports such as hockey and soccer. To date, there is no real consensus on the criteria for a reliable diagnostic, the different investigations, and the appropriate therapy. Current literature underlines intrinsic and extrinsic factors contributing to athletic pubalgia. This review article reports upon two novelties related to the issue: the importance and efficience of prevention program and the association of femoro-acetabular impingement with the pubalgia.

Effect of aorto-iliac bifurcation and iliac stenosis on flow dynamics in an abdominal aortic aneurysm

Science.gov (United States)

Patel, Shivam; Usmani, Abdullah Y.; Muralidhar, K.

2017-06-01

Physiological flows in rigid diseased arterial flow phantoms emulating an abdominal aortic aneurysm (AAA) under rest conditions with aorto-iliac bifurcation and iliac stenosis are examined in vitro through 2D PIV measurements. Flow characteristics are first established in the model resembling a symmetric AAA with a straight outlet tube. The influence of aorto-iliac bifurcation and iliac stenosis on AAA flow dynamics is then explored through a comparison of the nature of flow patterns, vorticity evolution, vortex core trajectory and hemodynamic factors against the reference configuration. Specifically, wall shear stress and oscillatory shear index in the bulge portion of the models are of interest. The results of this investigation indicate overall phenomenological similarity in AAA flow patterns across the models. The pattern is characterized by a central jet and wall-bounded vortices whose strength increases during the deceleration phase as it moves forward. The central jet impacts the wall of AAA at its distal end. In the presence of an aorto-iliac bifurcation as well as iliac stenosis, the flow patterns show diminished strength, expanse and speed of propagation of the primary vortices. The positions of the instantaneous vortex cores, determined using the Q-function, correlate with flow separation in the bulge, flow resistance due to a bifurcation, and the break in symmetry introduced by a stenosis in one of the legs of the model. Time-averaged WSS in a healthy aorta is around 0.70 N m-2 and is lowered to the range ±0.2 N m-2 in the presence of the downstream bifurcation with a stenosed common iliac artery. The consequence of changes in the flow pattern within the aneurysm on disease progression is discussed.

Effect of aorto-iliac bifurcation and iliac stenosis on flow dynamics in an abdominal aortic aneurysm

International Nuclear Information System (INIS)

Patel, Shivam; Usmani, Abdullah Y; Muralidhar, K

2017-01-01

Physiological flows in rigid diseased arterial flow phantoms emulating an abdominal aortic aneurysm (AAA) under rest conditions with aorto-iliac bifurcation and iliac stenosis are examined in vitro through 2D PIV measurements. Flow characteristics are first established in the model resembling a symmetric AAA with a straight outlet tube. The influence of aorto-iliac bifurcation and iliac stenosis on AAA flow dynamics is then explored through a comparison of the nature of flow patterns, vorticity evolution, vortex core trajectory and hemodynamic factors against the reference configuration. Specifically, wall shear stress and oscillatory shear index in the bulge portion of the models are of interest. The results of this investigation indicate overall phenomenological similarity in AAA flow patterns across the models. The pattern is characterized by a central jet and wall-bounded vortices whose strength increases during the deceleration phase as it moves forward. The central jet impacts the wall of AAA at its distal end. In the presence of an aorto-iliac bifurcation as well as iliac stenosis, the flow patterns show diminished strength, expanse and speed of propagation of the primary vortices. The positions of the instantaneous vortex cores, determined using the Q -function, correlate with flow separation in the bulge, flow resistance due to a bifurcation, and the break in symmetry introduced by a stenosis in one of the legs of the model. Time-averaged WSS in a healthy aorta is around 0.70 N m −2 and is lowered to the range ±0.2 N m −2 in the presence of the downstream bifurcation with a stenosed common iliac artery. The consequence of changes in the flow pattern within the aneurysm on disease progression is discussed. (paper)

Effect of aorto-iliac bifurcation and iliac stenosis on flow dynamics in an abdominal aortic aneurysm

Energy Technology Data Exchange (ETDEWEB)

Patel, Shivam; Usmani, Abdullah Y; Muralidhar, K, E-mail: kmurli@iitk.ac.in [Department of Mechanical Engineering, Indian Institute of Technology Kanpur, Kanpur 208016 (India)

2017-06-15

Physiological flows in rigid diseased arterial flow phantoms emulating an abdominal aortic aneurysm (AAA) under rest conditions with aorto-iliac bifurcation and iliac stenosis are examined in vitro through 2D PIV measurements. Flow characteristics are first established in the model resembling a symmetric AAA with a straight outlet tube. The influence of aorto-iliac bifurcation and iliac stenosis on AAA flow dynamics is then explored through a comparison of the nature of flow patterns, vorticity evolution, vortex core trajectory and hemodynamic factors against the reference configuration. Specifically, wall shear stress and oscillatory shear index in the bulge portion of the models are of interest. The results of this investigation indicate overall phenomenological similarity in AAA flow patterns across the models. The pattern is characterized by a central jet and wall-bounded vortices whose strength increases during the deceleration phase as it moves forward. The central jet impacts the wall of AAA at its distal end. In the presence of an aorto-iliac bifurcation as well as iliac stenosis, the flow patterns show diminished strength, expanse and speed of propagation of the primary vortices. The positions of the instantaneous vortex cores, determined using the Q -function, correlate with flow separation in the bulge, flow resistance due to a bifurcation, and the break in symmetry introduced by a stenosis in one of the legs of the model. Time-averaged WSS in a healthy aorta is around 0.70 N m{sup −2} and is lowered to the range ±0.2 N m{sup −2} in the presence of the downstream bifurcation with a stenosed common iliac artery. The consequence of changes in the flow pattern within the aneurysm on disease progression is discussed. (paper)

Cerebro-costo-mandibular syndrome in a father and a female fetus: early prenatal ultrasonographic diagnosis and autosomal dominant transmission.

Science.gov (United States)

Morin, G; Gekas, J; Naepels, P; Gondry, J; Devauchelle, B; Testelin, S; Sevestre, H; Thépôt, F; Mathieu, M

2001-10-01

Ultrasonography in a female fetus revealed cystic cervical hygroma, severe micrognathia, and vertebral and upper limb anomalies suggestive of cerebro-costo-mandibular syndrome (CCMS) which was diagnosed ultrasonographically at 16 weeks' gestation. The father is affected and presents with a Pierre Robin sequence, short stature and typical costovertebral anomalies. CCMS is a rare and severe disorder. The high frequency of sporadic cases, vertical transmission, and the excess of sibs affected via horizontal transmission suggest dominant autosomal mutation with possible germinal mosaicism. The vertical familial case detailed in the present report is a reminder of the high risk when one parent or one sibling is affected and the extreme variability of phenotype and costal ossification. Early prenatal ultrasound diagnosis is possible in a severely affected fetus. Copyright 2001 John Wiley & Sons, Ltd.

Acute Iliac Artery Rupture: Endovascular Treatment

International Nuclear Information System (INIS)

Chatziioannou, A.; Mourikis, D.; Katsimilis, J.; Skiadas, V.; Koutoulidis, V.; Katsenis, K.; Vlahos, L.

2007-01-01

The authors present 7 patients who suffered iliac artery rupture over a 2 year period. In 5 patients, the rupture was iatrogenic: 4 cases were secondary to balloon angioplasty for iliac artery stenosis and 1 occurred during coronary angioplasty. In the last 2 patients, the rupture was secondary to iliac artery mycotic aneurysm. Direct placement of a stent-graft was performed in all cases, which was dilated until extravasation was controlled. Placement of the stent-graft was successful in all the cases, without any complications. The techniques used, results, and mid-term follow-up are presented. In conclusion, endovascular placement of a stent-graft is a quick, minimally invasive, efficient, and safe method for emergency treatment of acute iliac artery rupture, with satisfactory short- and mid-term results

Costos económicos en la producción de servicios de salud: del costo de los insumos al costo de manejo de caso

Directory of Open Access Journals (Sweden)

ARREDONDO ARMANDO

1997-01-01

Full Text Available Objetivo. Generar información sobre los costos de producción de servicios de salud. Material y métodos. Siguiendo los criterios de Kessner se seleccionaron como trazadores: hipertensión, diabetes, diarreas y neumonías. Posteriormente, se definió el manejo de casos y, por medio de la metodología de costeo por manejo de caso, se definieron las funciones de producción, así como los insumos y costos unitarios requeridos para satisfacer la demanda de servicios médicos de cada enfermedad. Se procesaron los datos en una hoja de cálculo para identificar los costos de manejo de casos hospitalarios y ambulatorios. Resultados. Los hallazgos indican que a partir del costo de manejo de casos hospitalarios y ambulatorios para cada enfermedad de estudio es posible identificar el peso relativo, tanto de las distintas funciones de producción, como de los diferentes tipos de insumos. Dependiendo de las frecuencias relativas, tanto insumos como funciones de producción se clasificaron en alto, medio y bajo impacto sobre el costo total de manejo de caso. Conclusiones. A partir de la información generada se sugiere replantear los procesos de planeación, organización y asignación de recursos, en función de demandas de servicios hospitalarios y ambulatorios para cada trazador. Asimismo, se sugieren acciones para propiciar ganancias económicas en la utilización de recursos y en el uso más eficiente de los mismos.

The clinical and sonographic effects of kinesiotaping and exercise in comparison with manual therapy and exercise for patients with subacromial impingement syndrome: a preliminary trial.

Science.gov (United States)

Kaya, Derya Ozer; Baltaci, Gul; Toprak, Ugur; Atay, Ahmet Ozgur

2014-01-01

The purpose of this study was to compare the effects of manual therapy with exercise to kinesiotaping with exercise for patients with subacromial impingement syndrome. Randomized clinical before and after trial was used. Fifty-four patients diagnosed as having subacromial impingement syndrome who were referred for outpatient treatment were included. Eligible patients (between 30 and 60 years old, with unilateral shoulder pain) were randomly allocated to 2 study groups: kinesiotaping with exercise (n = 28) or manual therapy with exercise (n = 26). In addition, patients were advised to use cold packs 5 times per day to control for pain. Visual analog scale for pain, Disability of Arm and Shoulder Questionnaire for function, and diagnostic ultrasound assessment for supraspinatus tendon thickness were used as main outcome measures. Assessments were applied at the baseline and after completing 6 weeks of related interventions. At the baseline, there was no difference between the 2 group characteristics (P > .05). There were significant differences in both groups before and after treatment in terms of pain decrease and improvement of Disability of Arm and Shoulder Questionnaire scores (P .05). The only difference between the groups was at night pain, resulting in favor of the kinesiotaping with exercise group (P kinesiotaping with exercise and manual therapy with exercise. Both treatments may have similar results in reducing pain and disability in subacromial impingement in 6 weeks. Copyright © 2014 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

Kidney transplantation in a patient with absent right common iliac artery and congenital renal abnormalities.

Science.gov (United States)

Tay, Clifton Ming; Siew, Edwin Poh Yiew; Ng, Tze-Kiat; Vathsala, Anantharanam; Tiong, Ho Yee

2015-01-01

Congenital atresia of the common and external iliac arteries is a rare vascular anomaly that may be associated with congenital renal or genitourinary malformations. In ESRD patients, its presence may pose potential problems during renal transplantation. We report a rare case of kidney transplantation in a patient with VACTERL syndrome who was found to have absent right common and external iliac arteries during pre-operative imaging. Vascular supply to the right lower limb is derived from an anomalous branch from the left internal iliac artery which takes on a convoluted course across the pelvis. Kidney transplantation was performed successfully with implantation performed on the left side. Isolated cases of congenital iliac artery atresia have been described in association with urological abnormalities but no clear association has yet been established. However, we feel that it may be useful to perform routine angiographic evaluation for ESRD patients with congenital genitourinary abnormalities being planned for kidney transplantation. While most cases of congenital iliac artery anomalies are symptomatic with claudication, some remain asymptomatic with normal physical examination findings. There is some evidence in literature suggesting the usefulness of routine pre-operative CT in a selective group of patients. Kidney transplantation in such cases is safe and we recommend routine pre-operative imaging of patients known to have congenital genitourniary abnormalities. The kidney should be implanted heterotopically to the contralateral side of the vascular anomaly and care must be taken to preserve vascular supply to the lower limbs. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

PERBANDINGAN ANTARA KOMBINASI LATIHAN STABILISASI BAHU DAN TRAKSI HUMERUS KE INFERIOR DENGAN KOMBINASI LATIHAN FUNGSIONAL BAHU DAN TRAKSI HUMERUS KE INFERIOR DALAM MENURUNKAN DISABILITAS BAHU DAN LENGAN PADA SUBACROMIAL IMPINGEMENT SYNDROME MAHASISWA AKAD

Directory of Open Access Journals (Sweden)

Mawaddah -

2015-08-01

Full Text Available Shoulder impingement causing interference on the motion of the shoulder joint activities and result in functional activity disorder. These injuries usually are caused by faulty movement, overuse, poor posture, occupational factors and trauma. This will cause a burden on one part of the body and cause imbalances in anatomy, which will eventually lead to disruption of the body that experienced work. This study aimed to investigate the effect of functional shoulder exercise and traction humerus to inferior with shoulder stabilization exercises and traction humerus to inferior to the decline in the shoulder and arm disabilities in subacromial impingement syndrome. This research method was experimental clinical trials with pre test and post test group design. Population student Academy Physiotherapy Widya Husada Semarang, which consists of 3 men and 12 women, aged between 18-21 years, divided into two groups. Group I was given Shoulder Stabilization exercises and Traction humerus to Inferior (n=7 and group II Functional Shoulder Exercise and Traction humerus to Inferior (n=8. This research was conducted for 3 weeks. Measurement of the value of disability shoulder and arm by using the Shoulder Pain and Disability Index (SPADI. The test results on the group I average value pre 34.17, SB = 6.31, and the average value of post 11.54, SB = 4.02, p = 0.001 found significant differences obtained test results paired sample t-test, and testing group II average value pre 40.18, SB = 3.53, and the average value of post 7.82, SB = 1.57, p = 0.001 found significant differences obtained test results paired sample t-test. Comparison of Group I and II, p = 0.005 there were significant differences, test results obtained independent sample t-test. Conclusions: The combination of shoulder stabilization exercises and traction humerus to inferior can reduce disability shoulder and arm on subacromial impingement syndrome. The combination functional shoulder exercise and

Vascular Ehlers-Danlos Syndrome With a Novel Missense COL3A1 Mutation Present With Pulmonary Complications and Iliac Arterial Dissection.

Science.gov (United States)

Gu, Guangchao; Yang, Hang; Cui, Lijia; Fu, Yuanyuan; Li, Fangda; Zhou, Zhou; Zheng, Yuehong

2018-02-01

Vascular Ehlers-Danlos syndrome (vEDS) is a life-threatening connective tissue disorder due to its high tendency of arterial and organ rupture. Pulmonary complications in vEDS are rare. We present a young male patient with vEDS who developed severe pulmonary complications and severe rupture of the iliac artery at different stages of his life. Vascular Ehlers-Danlos syndrome was diagnosed based on clinical manifestations and confirmed by the identification of COL3A1 gene mutation. Due to high bleeding tendency and weak cardiopulmonary capacity, conservative treatment was taken for him. To our knowledge, this is the first report of vEDS case in which the patient developed both pulmonary complications and dissection of large arteries. Our report emphasizes the importance of considering vEDS when an adolescent develops unexplained pulmonary cysts with fragility of lung tissues. Genetic counseling and close monitoring should be performed for earlier diagnosis and prevention of severe complications of large arteries. The typical presentations of vEDS were also discussed by means of a review of case reports on vEDS with pulmonary complications.

Umbilical vein draining into the inferior vena cava via the internal iliac vein, bypassing the liver

International Nuclear Information System (INIS)

Currarino, G.; Stannard, M.W.; Texas Univ., Dallas, TX; Kolni, H.

1991-01-01

This is the third report of an anomalous umbilical vein draining ectopically in a left pelvic vein, probably the left internal iliac, and through the inferior vena cava into the right atrium. The anomaly was encountered in a newborn infant with nonimmune hydrops fetalis, hypertrophic cardiomyopathy, multiorgan failure and possibly Noonan Syndrome. (orig.)

Umbilical vein draining into the inferior vena cava via the internal iliac vein, bypassing the liver

Energy Technology Data Exchange (ETDEWEB)

Currarino, G.; Stannard, M.W. (Children' s Medical Center, Dallas, TX (United States). Dept. of Radiology Texas Univ., Dallas, TX (United States). Southwestern Medical Center); Kolni, H. (Methodist Hospital, Dallas, TX (United States). Dept. of Pediatrics)

1991-05-01

This is the third report of an anomalous umbilical vein draining ectopically in a left pelvic vein, probably the left internal iliac, and through the inferior vena cava into the right atrium. The anomaly was encountered in a newborn infant with nonimmune hydrops fetalis, hypertrophic cardiomyopathy, multiorgan failure and possibly Noonan Syndrome. (orig.).

Criterios para identificar patolog?as de alto costo en Colombia

OpenAIRE

Cuenta de alto costo, MinSalud

2010-01-01

Al identificar posibles pacientes de alto costo se debe definir si existen caracter?sticas que determinan su comportamiento como pacientes de alto costo, para definir si dicha patolog?a puede considerarse como Enfermedad de Alto Costo en Colombia.

Contabilización del cuarto elemento del costo

Directory of Open Access Journals (Sweden)

Carlos Augusto Rincón Soto

2008-01-01

servicios de externalización deben ser asignados en un espacio exclusivo para ellos en la recopilación de los costos y para la contabilización, pues este no pertenece a ninguno de los tres elementos del costo* dados en los conceptos comunes en la mayoría de textos académicos de contabilidad de costos, siendo el uso de este dato importante explicitarlo en la contabilidad para análisis y toma de decisiones.

False iliac artery aneurysm following renal transplantation

DEFF Research Database (Denmark)

Levi, N; Sønksen, Jens Otto Reimers; Schroeder, T V

1999-01-01

We report a very rare case of a false iliac artery aneurysm following renal transplantation. The patient was a 51-year-old women who presented with a painful 10 x 10 cm pulsating mass in her left iliac fossa. The patient had received a second cadaveric renal transplantation 5 years previously....... The graft never functioned and transplant nephrectomy was performed 2 weeks later. A CT-scanning showed a 10 x 10 cm large aneurysm arising from the left external iliac artery. At operation a large false aneurysm was identified arising from the original transplant anastomotic site. Due to the extent...

Costos económicos en la producción de servicios de salud: del costo de los insumos al costo de manejo de caso

OpenAIRE

ARREDONDO ARMANDO; DAMIÁN TERESA

1997-01-01

Objetivo. Generar información sobre los costos de producción de servicios de salud. Material y métodos. Siguiendo los criterios de Kessner se seleccionaron como trazadores: hipertensión, diabetes, diarreas y neumonías. Posteriormente, se definió el manejo de casos y, por medio de la metodología de costeo por manejo de caso, se definieron las funciones de producción, así como los insumos y costos unitarios requeridos para satisfacer la demanda de servicios médicos de cada enfermedad. Se proces...

Perspectives on fish impingement

International Nuclear Information System (INIS)

Sharma, R.K.

1977-01-01

Data on fish impingement and related parameters are being gathered at a large number of power stations throughout the country at substantial monetary and manpower costs. A national survey of fish impingement at power plants was conducted and much of the information compiled in a standardized format--an effort that we think will aid in planning improvements in the design, siting, and operation of the cooling-water intakes. This paper examines the objectives of the fish impingement studies, monitoring programs, variables affecting fish impingement, siting and design criteria, state-of-the-art of screening systems, and suggestions for meeting 316(b) requirements. It also discusses where the emphasis should be placed in future fish-impingement related activities

Surgical criteria for femoroacetabular impingement syndrome: a scoping review.

Science.gov (United States)

Peters, Scott; Laing, Alisha; Emerson, Courtney; Mutchler, Kelsey; Joyce, Thomas; Thorborg, Kristian; Hölmich, Per; Reiman, Michael

2017-11-01

The purpose of this review was to analyse and report criteria used for open and arthroscopic surgical treatment of femoroacetabular impingement syndrome (FAIS). A librarian-assisted computer search of Medline, CINAHL and Embase for studies related to criterion for FAIS surgery was used in this study. Inclusion criteria included studies with the primary purpose of surgery or surgical outcomes for treatment of FAIS with and without labral tear, and reporting criteria for FAIS surgery. Diagnostic imaging was a criterion for surgery in 92% of the included studies, with alpha angle the most frequently reported (68% of studies) criterion. Reporting of symptoms was a criterion for surgery in 75%, and special tests a criterion in 70% of studies. Range-of-motion limitations were only a required criterion in 30%, only 12% of studies required intra-articular injection and 44% of studies described previously failed treatment (non-surgical or physiotherapist-led rehabilitation) as a criterion for surgery. Only 56% of included studies utilised the combination of symptoms, clinical signs and diagnostic imaging combined for diagnosis of FAIS as suggested by the Warwick Agreement on FAIS meeting. Diagnostic imaging evidence of FAIS was the most commonly reported criterion for surgery. Only 56% of included studies utilised the combination of symptoms, clinical signs and diagnostic imaging for diagnosis of FAIS as suggested by the Warwick Agreement on FAIS meeting, and only 44% of studies had failed non-surgical treatment (and 18% a failed trial of physiotherapy) as a criterion for surgery. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Effect of Adding Interferential Current in an Exercise and Manual Therapy Program for Patients With Unilateral Shoulder Impingement Syndrome: A Randomized Clinical Trial.

Science.gov (United States)

Gomes, Cid André Fidelis de Paula; Dibai-Filho, Almir Vieira; Moreira, William Arruda; Rivas, Shirley Quispe; Silva, Emanuela Dos Santos; Garrido, Ana Claudia Bogik

The purpose of this study was to measure the additional effect of adding interferential current (IFC) to an exercise and manual therapy program for patients with unilateral shoulder impingement syndrome. Forty-five participants were randomly assigned to group 1 (exercise and manual therapy), group 2 (exercise and manual therapy + IFC), or group 3 (exercise and manual therapy + placebo ultrasound). Individuals participated in 16 treatment sessions, twice a week for 8 weeks. The primary outcome of the study was total score of the Shoulder Pain and Disability Index (SPADI). The secondary outcomes were the pain and disability subscales of SPADI, Numeric Rating Scale, and Pain-Related Self-Statement Scale. Adjusted between-group mean differences (MDs) and 95% confidence intervals (CIs) were calculated using linear mixed models. After 16 treatment sessions, statistically significant but not clinically important differences were identified in favor of the exercise and manual therapy program alone in the SPADI-total (group 1 vs group 2, MD 11.12 points, 95% CI 5.90-16.35; group 1 vs group 3, MD 13.43 points, 95% CI 8.21-18.65). Similar results were identified for secondary outcomes. The addition of IFC does not generate greater clinical effects in an exercise and manual therapy program for individuals with unilateral shoulder impingement syndrome. Copyright © 2018. Published by Elsevier Inc.

Guideline for diagnosis and treatment of subacromial pain syndrome

NARCIS (Netherlands)

Diercks, Ronald; Bron, Carel; Dorrestijn, Oscar; Meskers, Carel; Naber, René; de Ruiter, Tjerk; Willems, Jaap; Winters, Jan; van der Woude, Henk Jan

Treatment of "subacromial impingement syndrome" of the shoulder has changed drastically in the past decade. The anatomical explanation as "impingement" of the rotator cuff is not sufficient to cover the pathology. "Subacromial pain syndrome", SAPS, describes the condition better. A working group

Reconstruction of Traumatic External Iliac Artery Dissection Due to Vascular Clamping.

Science.gov (United States)

Kırnap, Mahir; Özçelik, Ümit; Akdur, Aydıncan; Ayvazoğlu Soy, Ebru H; Işıklar, İclal; Yarbuğ Karakayalı, Feza; Moray, Gökhan; Haberal, Mehmet

2017-10-31

Traumatic external iliac artery dissection after renal transplant is a rare complication, but it should be urgently managed due to its devastating effects on graft and lower limb circulation. External iliac artery dissection is seen more in recipients with diabetes mellitus and comorbid disease. Recipients with external iliac artery dissection should be treated immediately by percutaneus angioplasty or surgical reconstruction. In this study, we reported the management of 2 kidney transplant cases with external iliac artery dissection due to vascular clamping of the artery. External iliac artery dissection was diagnosed by ultrasonography in both cases. After failed percutaneous interventional angioplasty, we reconstructed the external iliac artery dissection surgically and replaced the external iliac artery with polytetra-fluoroethylene grafts in both patients. Both patients were discharged with normal functioning grafts showing 0.9 and 0.8 mg/dL serum creatinine levels at month 3 posttransplant. Close monitoring of recipients after transplant is mandatory for early diagnosis and early management of external iliac artery dissection to prevent graft loss and preserve lower limb circulation. Routine Doppler ultrasonography is an inexpensive and useful tool for early diagnosis in cases of sudden cessation or decrease in urine. In cases of failed percutaneous interventional angioplasty, reconstruction with synthetic vascular grafts can be safely applied in external iliac artery dissection.

Estimados del costo de reconstrucción de edificios en Puerto Rico

OpenAIRE

Botero, Jorge; Lluch, José

2005-01-01

Las metodologías para estimar la pérdida máxima probable (PML) se componen de dos partes, el modelo de daño y el costo de reparación o reemplazo. Este trabajo se enfoca en la segunda parte y tiene como objetivo determinar estos costos para Puerto Rico. Se hizo una encuesta entre contratistas, diseñadores y propietarios y se obtuvieron costos por pie cuadrado, costos por unidades de servicio, costos por parámetros, costo por componentes, salarios de mano de obra y la distribución de la misma e...

Coupled Lagrangian impingement spray model for doublet impinging injectors under liquid rocket engine operating conditions

Directory of Open Access Journals (Sweden)

Qiang WEI

2017-08-01

Full Text Available To predict the effect of the liquid rocket engine combustion chamber conditions on the impingement spray, the conventional uncoupled spray model for impinging injectors is extended by considering the coupling of the jet impingement process and the ambient gas field. The new coupled model consists of the plain-orifice sub-model, the jet-jet impingement sub-model and the droplet collision sub-model. The parameters of the child droplet are determined with the jet-jet impingement sub-model using correlations about the liquid jet parameters and the chamber conditions. The overall model is benchmarked under various impingement angles, jet momentum and off-center ratios. Agreement with the published experimental data validates the ability of the model to predict the key spray characteristics, such as the mass flux and mixture ratio distributions in quiescent air. Besides, impinging sprays under changing ambient pressure and non-uniform gas flow are investigated to explore the effect of liquid rocket engine chamber conditions. First, a transient impingement spray during engine start-up phase is simulated with prescribed pressure profile. The minimum average droplet diameter is achieved when the orifices work in cavitation state, and is about 30% smaller than the steady single phase state. Second, the effect of non-uniform gas flow produces off-center impingement and the rotated spray fan by 38°. The proposed model suggests more reasonable impingement spray characteristics than the uncoupled one and can be used as the first step in the complex simulation of coupling impingement spray and combustion in liquid rocket engines.

Coupled Lagrangian impingement spray model for doublet impinging injectors under liquid rocket engine operating conditions

Institute of Scientific and Technical Information of China (English)

Qiang WEI; Guozhu LIANG

2017-01-01

To predict the effect of the liquid rocket engine combustion chamber conditions on the impingement spray,the conventional uncoupled spray model for impinging injectors is extended by considering the couplingof the jet impingement process and the ambient gas field.The new coupled model consists of the plain-orifice sub-model,the jet-jet impingement sub-model and the droplet collision sub-model.The parameters of the child droplet are determined with the jet-jet impingement sub-model using correlations about the liquid jet parameters and the chamber conditions.The overall model is benchmarked under various impingement angles,jet momentum and offcenter ratios.Agreement with the published experimental data validates the ability of the model to predict the key spray characteristics,such as the mass flux and mixture ratio distributions in quiescent air.Besides,impinging sprays under changing ambient pressure and non-uniform gas flow are investigated to explore the effect of liquid rocket engine chamber conditions.First,a transient impingement spray during engine start-up phase is simulated with prescribed pressure profile.The minimum average droplet diameter is achieved when the orifices work in cavitation state,and is about 30％ smaller than the steady single phase state.Second,the effect of non-uniform gas flow produces off-center impingement and the rotated spray fan by 38°.The proposed model suggests more reasonable impingement spray characteristics than the uncoupled one and can be used as the first step in the complex simulation of coupling impingement spray and combustion in liquid rocket engines.

De la contabilidad de costos al control de gestión

OpenAIRE

Machado Rivera, Marco Antonio

2002-01-01

La contabilidad y el control de la gestión, son dos elementos esenciales que permiten el diseño de instrumentos para el seguimiento (monitoreo) de los costos de las actividades desarrolladas por un ente. La gestión de los costos se constituye en un sistema estratégico en entornos de alta competencia, donde se requieren sistemas integrados de información y control de causas y efectos de los costos, más que de medición de costos y determinación de precios. El tablero de control de los costos de...

Balloon Occlusion of the Contralateral Iliac Artery to Assist Recanalization of the Ipsilateral Iliac Artery in Total Aortoiliac Occlusion: A Technical Note

Directory of Open Access Journals (Sweden)

Abdel Aziz A. Jaffan

2013-01-01

Full Text Available Endovascular recanalization of chronic total aortoiliac occlusion is technically challenging. Inability to reenter the true aortic lumen, following retrograde iliac recanalization, is one of the most common causes of failure. We describe a case of a total aortoiliac occlusion where balloon occlusion of the right common iliac artery, following its recanalization from a brachial approach, was used to facilitate antegrade recanalization of the occluded contralateral left common iliac artery.

Contabilidad de Costos I. - Problemas sobre el Ciclo de la Contabilidad de Costo, a través del estado de costos de producción y ventas

OpenAIRE

Morillo Moreno, Marysela C.

2008-01-01

ÍNDICE Introducción Problemas sobre terminología básica Problemas básicos sobre el Ciclo de la Contabilidad de Costos Problemas sobre contabilización de las actividades relacionadas con los materiales Problemas sobre la contabilización de las actividades relacionadas con la mano de obra Problemas sobre la contabilización de las actividades relacionadas con los costos indirectos de fabricación Problemas sobre el Ciclo de la Contabilida...

Impingement: an annotated bibliography

International Nuclear Information System (INIS)

Uziel, M.S.; Hannon, E.H.

1979-04-01

This bibliography of 655 annotated references on impingement of aquatic organisms at intake structures of thermal-power-plant cooling systems was compiled from the published and unpublished literature. The bibliography includes references from 1928 to 1978 on impingement monitoring programs; impingement impact assessment; applicable law; location and design of intake structures, screens, louvers, and other barriers; fish behavior and swim speed as related to impingement susceptibility; and the effects of light, sound, bubbles, currents, and temperature on fish behavior. References are arranged alphabetically by author or corporate author. Indexes are provided for author, keywords, subject category, geographic location, taxon, and title

Shoulder functionality after manual therapy in subjects with shoulder impingement syndrome: a case series.

Science.gov (United States)

Heredia-Rizo, Alberto Marcos; López-Hervás, Antonia; Herrera-Monge, Patricia; Gutiérrez-Leonard, Ana; Piña-Pozo, Fernando

2013-04-01

The aim of the study was to identify the differences in functionality of the upper limb in subjects suffering from shoulder impingement syndrome after intervention by two manual therapy protocols. Randomized, single-blind study with a sample of 22 subjects (58 ± 10.86 years old) divided into two groups. The conventional-group (n = 11) received mobilizations of the shoulder and the experimental-group (n = 11) was treated with soft tissue techniques in the cervical and upper thoracic regions. These two groups received electrotherapy and postural advices. The treatment lasted three weeks (15 daily sessions of 1 h and 30 min). Both active and passive range of motion (ROM) and self-perceived functionality of the upper limb (DASH questionnaire) were measured. The experimental group showed a significant improvement in the DASH scores and both groups improved mobility in the intra-group comparison pre-intervention versus post-intervention (p .05). Our results suggest that a combined treatment with electrotherapy, postural hygiene and manual therapy, regardless of the protocol, improves shoulder mobility and functionality. Copyright © 2012 Elsevier Ltd. All rights reserved.

Thoracic meningocele in lumbo-costo-vertebral syndrome in a child: possible enlargement with repeated motion by anchoring to the diaphragm.

Science.gov (United States)

Wataya, Takafumi; Horikawa, Kyohei; Kitagawa, Masashi; Tashiro, Yuzuru

2016-08-01

Lumbo-costo-vertebral syndrome (LCVS) is a rare disorder in children that is characterized by hemivertebrae, congenital absence of ribs, meningocele, and hypoplasia of the truncal and abdominal wall presenting as a congenital lumbar hernia. An otherwise healthy 12-month-old girl was referred to the authors' hospital with soft swelling on her left middle back; scoliosis had been present since birth. Imaging revealed a thoracic meningocele, ectopia of the spleen suggesting lumbar hernia, multiple anomalies of the thoracic vertebral columns, and defects of the ribs; thus, LCVS was diagnosed. Surgical observation revealed that the meningocele was firmly anchored to part of the diaphragm, which created stretching tension in the meningocele continuously with exhalation. Once detached, the meningocele shrank spontaneously and never developed again after cauterization. In this case, continuous or pulsatile pressure in the presence of a vertebral defect was thus considered to be an important factor for formation of the thoracic meningocele.

Femoroacetabular impingement

International Nuclear Information System (INIS)

Anderson, Suzanne E.; Siebenrock, Klaus Arno; Tannast, Moritz

2012-01-01

Femoroacetabular impingement (FAI) is a pathomechanical concept describing the early and painful contact of morphological changes of the hip joint, both on the acetabular, and femoral head sides. These can lead clinically to symptoms of hip and groin pain, and a limited range of motion with labral, chondral and bony lesions. Pincer impingement generally involves the acetabular side of the joint where there is excessive coverage of the acetabulum, which may be focal or more diffuse. There is linear contact of the acetabulum with the head/neck junction. Cam impingement involves the femoral head side of the joint where the head is associated with bony excrescences and is aspheric. The aspheric femoral head jams into the acetabulum. Imaging appearances are reviewed below. This type is evident in young males in the second and third decades. The main features of FAI are described.

Internal Impingement of the Shoulder: A Risk of False Positive Test Outcomes in External Impingement Tests?

Directory of Open Access Journals (Sweden)

Tim Leschinger

2017-01-01

Full Text Available Background. External impingement tests are considered as being particularly reliable for identifying subacromial and coracoid shoulder impingement mechanisms. The purpose of the present study was to evaluate if these tests are likely to provoke an internal shoulder impingement mechanism which, in cases of a pathologic condition, can lead to a positive test result. Method. In 37 subjects, the mechanical contact between the glenoid rim and the rotator cuff (RC was measured quantitatively and qualitatively in external impingement test positions using an open MRI system. Results. Mechanical contact of the supraspinatus with the posterosuperior glenoid was present in 30 subjects in the Neer test. In the Hawkins test, the subscapularis was in contact with the anterosuperior glenoid in 33 subjects and the supraspinatus in 18. In the horizontal impingement test, anterosuperior contact of the supraspinatus with the glenoid was identified in 35 subjects. Conclusion. The Neer, Hawkins, and horizontal impingement tests are likely to provoke the mechanism of an internal shoulder impingement. A posterosuperior internal impingement mechanism is being provoked predominately in the Neer test. The Hawkins test narrows the distance between the insertions of the subscapularis and supraspinatus and the anterosuperior labrum, which leads to an anterosuperior impingement mechanism.

Complete absence of rib ossification, micrognathia and ear anomalies: extreme expression of cerebro-costo-mandibular syndrome?

NARCIS (Netherlands)

Hennekam, R. C.; Goldschmeding, R.

1998-01-01

We describe a newborn with complete absence of ossification of the ribs, extreme micrognathia, absence of external ear canals and the inner ears, and diminished mobility in the upper extremities. It is suggested that this represents an unusually severe expression of the cerebro-costo-mandibular

Costos en entidades prestadoras de servicios

Directory of Open Access Journals (Sweden)

Carlos Arturo Gómez Restrepo

2000-12-01

Full Text Available Se analiza cómo el proceso de aparición de las empresas prestadoras de servicios estuvo desligado de los costos y a través del tiempo se hace evidente su interrelación. Se hace un recuento sobre el desarrollo teórico de la contabilidad de costos, encontrando que desde la década de los años setenta ya algunos autores la relacionaban no sólo con entidades productoras de bienes sino con la prestación de servicios.

La contabilidad de costos y rentabilidad en la PYME

OpenAIRE

García Pérez De Lema, Domingo; Marín Hérnandez, Salvador; Martínez García, Francisco Javier

2006-01-01

Este trabajo tiene dos objetivos: por un lado, analizar las características de las empresas que tienen implantado un sistema de contabilidad de costos para la gestión; por otro, verificar empíricamente la relación existente entre el grado de utilización de sistemas de costos sobre el rendimiento de la Pyme. Para ello se realiza un estudio empírico con 1,425 Pyme del estado de Veracruz (México). Las Pyme con un mayor grado de implantación de modelos de costos se caracterizan por...

Computed tomography of sacro-iliac joints

International Nuclear Information System (INIS)

Miquel, A.; Laredo, J.D.

1995-01-01

Actual technologies to explore sacro-iliac joints are conventional radiography, computed tomography , scintigraphy and nuclear magnetic resonance imaging. Standards films are sufficient, except in beginning sacro-iliac septic inflammations where the computed tomography is superior. Two problems are generally posed for the radiologist, to differentiate a septic arthritis from a rheumatic pathology An other problem in diagnosis is to make the difference between a degenerative arthropathy (which does not need a further investigation) and an infectious rheumatic pathology where more exploration is necessary. 28 refs., 3 tabs., 13 figs

Las directrices del costo como fuentes de ventajas competitivas.

Directory of Open Access Journals (Sweden)

José Reinel Bermeo Muñoz

2005-01-01

Full Text Available Este trabajo pretende describir con el mayor detalle y actualización posible el comportamiento de los costos dentro de una actividad de valor con base en los diez factores estructurales que influyen en el costo, denominados por Michael E. Porter (1985, como guías o directrices del costo en su libro La Ventaja Competitiva. Estas directrices actúan como fuentes directas para establecer y sostener el posicionamiento estratégico asumido por la empresa, para determinar la posición relativa de costos y para explicar, en gran parte, la generación temporal de valor en las diversas actividades desarrolladas a lo largo de la cadena de valor. Por esto constituyen uno de los fundamentos para explicar las diferencias de resultados entre empresas pertenecientes al mismo sector de actividad económica y fuentes de ventajas competitivas sostenibles.

Costos directos del glaucoma primario de ángulo abierto

OpenAIRE

Fernández García, Ariana; Triana Casado, Idalia; Villar Valdés, Rosendo

2012-01-01

Introducción: la magnitud del costo asociado al glaucoma primario de ángulo abierto deriva de la atención sanitaria y de la disminución de la calidad de vida del paciente. Objetivos: estimar los costos del glaucoma primario de ángulo abierto en los pacientes atendidos durante el 2010 en el servicio de glaucoma del hospital "Dr. Salvador Allende." Métodos: se realizó un estudio retrospectivo, en el campo de la Evaluación Económica en Salud es un estudio del tipo de descripción de costos, que a...

A case of radionecrosis of the iliac bone

International Nuclear Information System (INIS)

Kondo, Masakazu; Tomishige, Mamoru; Okuda, Tetsuaki; Matsuo, Yoso; Naruto, Yoshio

1975-01-01

Radiation necrosis of the femoral neck in postirradiated carcinoma of the cervix is well known. But, radionecrosis of the iliac bone is rare. The authors have recently experienced such a case. A woman, forty-six years old, had treatment with irradiation for the carcinoma of the cervix eight years ago. In January 1975, she noticed pain in the left leg. A roentgenogram of the pelvis showed fine sclerosis fanning into the left ilium from the sacroiliac joint. Seven months after onset of the pain an oblique fracture in the left iliac wing was observed. Following concervative therapy for four months, osteosynthesis of the iliac wing was done when callus formation of the lesion was seen. The patient was crutch-walking four months after. (J.P.N.)

Surgery for subacromial impingement syndrome in relation to intensities of occupational mechanical exposures across 10-year exposure time windows

DEFF Research Database (Denmark)

Dalbøge, Annett; Frost, Poul; Andersen, Johan Hviid

2018-01-01

OBJECTIVES: We aimed to identify intensities of occupational mechanical exposures (force, arm elevation and repetition) that do not entail an increased risk of surgery for subacromial impingement syndrome (SIS) even after prolonged durations of exposure. Additionally, we wanted to evaluate...... if exposure to hand-arm vibration (HAV) is an independent risk factor. METHODS: We used data from a register-based cohort study of the entire Danish working population (n=2 374 403). During follow-up (2003-2008), 14 118 first-time events of surgery for SIS occurred. For each person, we linked register...... of exposure at specific intensities above minimal (low, medium and high). We used a logistic regression technique equivalent to discrete survival analysis adjusting for cumulative effects of other mechanical exposures. RESULTS: We found indications of safe exposure intensities for repetition (median angular...

The Natural History of Femoroacetabular Impingement

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Benjamin D. Kuhns

2015-11-01

Full Text Available Femoroacetabular impingement (FAI is a clinical syndrome resulting from abnormal hip joint morphology and is a common cause of hip pain in young adults. FAI has been posited as a precursor to hip osteoarthritis, however, conflicting evidence exists and the true natural history of the disease is unclear. The purpose of this article is to review the current understanding of how FAI damages the hip joint by highlighting its pathomechanics and etiology. We then review the current evidence relating FAI to osteoarthritis. Lastly, we will discuss the potential of hip preservation surgery to alter the natural history of FAI, reduce the risk of developing osteoarthritis and the need for future arthroplasty.

Manual para la elaboración del estado de costo de producción y ventas en los sistemas convencionales de la contabilidad de costos - Conclusiones

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Morillo Moreno, Marysela C.

2008-01-01

Índice General Dedicatoria Agradecimientos Lista de cuadros Lista de figuras Introducción Objetivos de la investigación, justificación de la investigación y marco metodológico Capítulo 1: El ciclo de la contabilidad de costos expresado mediante el estado de costos de producción y ventas Capítulo 2: Estado de costo de producción y ventas en un sistema d...

Manual para la elaboración del estado de costo de producción y ventas en los sistemas convencionales de la contabilidad de costos - Agradecimientos

OpenAIRE

Morillo Moreno, Marysela C.

2008-01-01

Índice General Dedicatoria Agradecimientos Lista de cuadros Lista de figuras Introducción Objetivos de la investigación, justificación de la investigación y marco metodológico Capítulo 1: El ciclo de la contabilidad de costos expresado mediante el estado de costos de producción y ventas Capítulo 2: Estado de costo de producción y ventas en un sistema d...

Manual para la elaboración del estado de costo de producción y ventas en los sistemas convencionales de la contabilidad de costos - Dedicatoria

OpenAIRE

Morillo Moreno, Marysela C.

2008-01-01

Índice General Dedicatoria Agradecimientos Lista de cuadros Lista de figuras Introducción Objetivos de la investigación, justificación de la investigación y marco metodológico Capítulo 1: El ciclo de la contabilidad de costos expresado mediante el estado de costos de producción y ventas Capítulo 2: Estado de costo de producción y ventas en un sistema d...

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

International Nuclear Information System (INIS)

Fiorella, D.

1999-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

1999-10-01

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

Anterolateral ankle impingement in adolescents: outcomes of nonoperative and operative treatment.

Science.gov (United States)

Edmonds, Eric W; Chambers, Reid; Kaufman, Elizabeth; Chambers, Henry G

2010-03-01

Ankle sprains in adolescents usually resolve with conservative management but a few patients may develop ankle impingement syndrome. There have been adult studies addressing surgical treatment of this pathology, but our study evaluated the surgical management of anterolateral ankle impingement in adolescents by comparing their outcomes after nonoperative treatment and subsequent surgical intervention. Thirteen patients (children and adolescents) diagnosed with ankle impingement by history, physical examination, and magnetic resonance imaging during a 9-year period at our institution underwent eventual arthroscopic debridement. A retrospective chart review of these patients was performed and they were evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) functional rating scale on 3 separate occasions: (1) initial presentation, (2) termination of nonoperative management, and (3) final postoperative follow-up visit. Thirteen adolescents (11 girls and 2 boys; 14 ankles) with a mean age of 15.6 (11.9-18.3) years met the inclusion criteria; of these, all had arthroscopic surgery. Mean duration of reported symptoms was 9.6 (4-15) months and mean duration of nonoperative management (physical therapy, activity modifications) was 6.9 (2-12) months. The mean AOFAS rating (out of 100 total) at initial presentation was 68.4 (40-84) and after nonoperative management was no better with a mean of 68.2 (63-76). The mean AOFAS rating at final follow-up was 90.6 (52-100), which was statistically significant (Pankle impingement in the adolescent population.

Modelo de costos para bases de datos en memoria principal

OpenAIRE

Martí, José Luis; Brand, Horst H. von

2002-01-01

El modelo de costos de un optimizador de consultas es un componente esencial de cualquier sistema administrador de bases de datos y, en especial, para un sistema basado en la memoria principal, en el cual los factores de costos son mucho más, en número y complejidad, que aquéllos usados por los tradicionales sistemas basados en el disco. El presente trabajo ejemplifica una propuesta destinada a plantear un modelo de costos para tal entorno, la que se basa en expresiones genéricas construidas ...

The common iliac artery in the ground squirrel (Citellus citellus

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Blagojević M.

2013-01-01

Full Text Available The common iliac arteries (a. iliaca communis dextra et a. iliaca communis sinistra are the terminal branches of the abdominal aorta. The paired external iliac artery (a. iliaca externa dextra et a. iliaca externa sinistra is a stronger branch of the paired common iliac artery. Before they leave the abdominal cavity and continue as the femoral arteries (a. femoralis dextra et a. femoralis sinistra each external iliac artery forms the following branches: 1. The internal pudendal artery (a. pudenda interna which, with its branches, supplies the tensor fasciae latae and quadriceps muscles (a. circumflexa femoris lateralis, cranial region of the urinary bladder, cranial end of the uterine horn in females, the deferent duct and tail of the epididymis in males (a. umbilicalis the rectum, the external anal sphincter and perineum (a. rectalis caudalis with blood. 2. The obturator artery (a. obturatoria, which supplies both of the obturator muscles, as well as the proximal end of the adductor muscle. 3. The pudendoepigastric trunk (truncus pudendoepigastricus is a short vessel, which with its branches (a. pudenda externa, a. epigastrica caudalis et a. urethrogenitalis supplies the caudal end of the rectus abdominis muscle, tip of the penis, preputium, superficial inguinal lymph nodes, scrotum in males and inguinal mamma in females, transversus and internus abdominis muscles, neck of the urinary bladder, urethra, vagina and vulva in females and accessory glands in males. 4. Paired internal iliac arteries (a. iliaca interna dextra et a. iliaca interna sinistra are thinner branches than the external iliac arteries. The internal iliac artery with its branches supplies the cranial and caudal parts of the gluteal muscles (a. glutea cranialis et a. glutea caudalis, as well as the muscles of the lateral side of the tail (a. caudalis lateralis. [Projekat Ministarstva nauke Republike Srbije, br. 143018

Vascular type Ehlers-Danlos Syndrome with fatal spontaneous rupture of a right common iliac artery dissection: case report and review of literature

Science.gov (United States)

Abayazeed, Aly; Hayman, Emily; Moghadamfalahi, Mana; Cain, Darren

2014-01-01

Vascular Ehlers-Danlos Syndrome (previously Ehlers-Danlos IV) is a rare autosomal dominant collagen vascular disorder caused by a 2q31 COL3A1 gene mutation encoding pro-alpha1 chain of type III collagen (in contrast to classic Ehlers-Danlos, caused by a COL5A1 mutation). The vascular type accounts for less than 4% of all Ehlers-Danlos cases and usually has a poor prognosis due to life threatening vascular ruptures and difficult, frequently unsuccessful surgical and vascular interventions. In 70% of cases, vascular rupture or dissection, gastrointestinal perforation, or organ rupture is a presenting sign. We present a case of genetically proven vascular Ehlers-Danlos with fatal recurrent retroperitoneal hemorrhages secondary to a ruptured right common iliac artery dissection in a 30-year-old male. This case highlights the need to suspect collagen vascular disorders when a young adult presents with unexplained retroperitoneal hemorrhage, even without family history of such diseases. PMID:24967021

Control permanente de la gestión sanitaria por monitoreo de costos mediante acontecimientos indicadores

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Horacio Villanueva

2001-12-01

Full Text Available Objetivos. Determinar el costo operacional de un servicio quirúrgico, comparar los resultados con estándares y determinar la incidencia de costos. Obtener una metodología eficaz para este fin, extrapolable a todo tipo de servicio asistencial y de fácil instrumentación en una herramienta informática convencional (base de datos de alta difusión y bajo costo que pueda usarse en el control permanente de la gestión. Métodos. El estudio se realizó durante 1999 en el Servicio de Ortopedia y Traumatología del Hospital Estatal "Domingo Funes", Córdoba, Argentina. De los 817 pacientes sometidos a procedimientos diagnósticos o terapéuticos en ese servicio a lo largo del año, se seleccionaron los 154 que necesitaron internación y maniobras quirúrgicas o instrumentales. Se utilizó el método de acontecimientos indicadores descrito por Kessner. Dichos acontecimientos, clasificados en función de su complejidad (alta, mediana, escasa o nula, fueron seleccionados y definidos por consenso de expertos: especialistas médicos y economistas. Se valoraron los costos directos e indirectos para estudiar su peso en el costo total, en cuya estimación se utilizaron nueve variables que se aplicaron a los diferentes acontecimientos indicadores. Resultados. El mayor peso del costo total, tanto estándar como real, recayó en ambos casos sobre la variable "día cama". De la variable "día cama" en el total de acontecimientos indicadores, el 51,2% correspondió a la internación social (costo indirecto y el 48,8% a la internación terapéutica (costo directo. Su diferencia con respecto al costo estándar fue un aumento del orden del 117%. Los costos indirectos (internación social e insumos terapéuticos absorbieron casi la mitad del costo real total. El costo real de todos los acontecimientos investigados, sin incluir los costos indirectos, solo superó al costo estándar en un 6,4%. Incluyendo los costos indirectos (internación social e insumos terap

Costos en pacientes con infección por Acinetobacter baumanniien Colombia

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Elkin V Lemos

Full Text Available Objetivo: Determinar el impacto económico como resultado de la adquisición de una infección por A. baumannii en Colombia. Métodos: Se consideró la información de un estudio previo de cohorte prospectivo, multicéntrico. Se incluyeron 165 pacientes ingresados en las Unidades de Cuidados Intensivos (UCIs participantes entre abril de 2006 y abril de 2010. Se cuantificaron los costos directos e indirectos de la atención desde la perspectiva de la sociedad utilizando la técnica de microcosteo, y se realizaron modelos uni y multivariados. Resultados: La mayoría de los pacientes eran menores de 65 años de edad (75%, hombres (64% y una tercera parte (32% estaban infectados por un A. baumannii resistente (resistencia a 5 o más familias de antimicrobianos. El costo total hospitalario en la población de pacientes del estudio fue de US $ 10.180 (Costos directos US $ 10.105 SD ± 6.671 y costos indirectos US $ 75 ± 106 por paciente. El costo de los antimicrobianos fue de US $ 3.497 ± 3.510 por paciente. Conclusiones: Los pacientes con A. baumannii que fueron ingresados en la UCI son altamente costosos para el sistema de salud Colombiano. Aunque el costo principal estuvo asociado directamente a la atención en salud, cada paciente y su familia también asumieron costos, que se estimaron aproximadamente en 30% del salario mensual mínimo legal vigente para el año 2012.

Elección de escuela y costos de cambio

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Juan Gallegos Mardones

2017-01-01

Full Text Available Antecedentes: Los sistemas de vales en educación se basan fundamentalmente en la capacidad de los padres para elegir la escuela de sus hijos. Sin embargo, esta capacidad se reduce cuando enfrentan costos de cambio.Método: Se identificaron los datos de los estudiantes que cursaban cuarto grado en 2000 y octavo grado en 2004, y se verificó si estos, habían cambiado de escuela. Además, comparamos la utilidad que reporta la escuela elegida con respecto a otras, no disponibles en 2000, determinando así la existencia de costos de cambio.Resultados: Encontramos que los costos de cambios son estadísticamente significativos y económicamente relevantes, además, afectan la decisión de cambiar de escuela. También mostramos qué cambios marginales en niveles de utilidad no son suficientemente significativos para cambiar de escuela identificando un eventual umbral.Conclusiones: La preocupación natural de los padres con respecto a la capacidad de reacción está condicionada por la existencia de costos de cambio.

Fish impingement at Montecello Nuclear Plant

International Nuclear Information System (INIS)

Grotbeck, L.M.; Bechthold, J.L.

1975-01-01

To properly evaluate total impact of power generation facilities on aquatic systems, it is necessary to perform site specific fish impingement studies. Intake and screen approach velocities should not be averaged when considering potential screen impingement problems because of wide vertical and horizontal variation in velocity which tend to trap fish. It was estimated that 2,952 fish were impinged during 4 months of sampling with 90.9% of these comprised of black bullheads (Ictalurus melas) and black crappies (Pomoxis nigromaculatus). Distinct relationships can be found between number of impinging fish and river flow, percentage river diverted through the plant, water temperature, and the time of year. For the months of June, July, August, and September, approx 55% of all impingement occurs in June

Costos de la analgesia epidural de parto. Instituto Nacional Materno Perinatal. Enero 2006

OpenAIRE

Arias Lazarte, Silvia E.; Montes Ruiz, Celina H.; Arias Lazarte, Gladys C.

2010-01-01

Objetivo: Determinar el costo unitario y el costo operacional, para identificar los elementos y más importantes variables. Material y método: Diseño: retrospectivo, descriptivo y transversal. Los pacientes fueron 53 mujeres en trabajo de parto. Ellas reciberon analgesia epidural en enero de 2006 en el Instituto Nacional Materno Perinatal INMP. El instrumento utilizado fue una encuesta para analizar los costos. Los tipos de costos fueron calculados por la metodología del sistema de"información...

Funciones de costos internos y externos en un modelo estratégico de transporte de carga

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Luis Gabriel Márquez Díaz

2010-11-01

Full Text Available Se revisan las funciones de costos internos y externos,con fines de modelación estratégica del transportede carga. Se estudian el costo interno del tiempo, elcosto interno de operación y cinco componentes delcosto externo: costo externo de la congestión, costoexterno de los accidentes, costos de la polución delaire, costo del cambio climático y costo externo dela infraestructura; a partir de estos se deriva la funciónde costo marginal total. Se encuentra que es posibleestimar de forma empírica los parámetros de lasfunciones aplicables al transporte de cargainterregional en Colombia en los modos de transportecarretero, ferroviario y fluvial, y con ellos estudiarlos costos marginales sobre una red estratégica detransporte de carga.

Metallic stent for the treatment of iliac arterial stenosis

Energy Technology Data Exchange (ETDEWEB)

Park, Jae Hyung; Chung, Jin Wook; Han, Joon Koo; Suh, Chul Soo; Yoo, Jae Wook; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of); Song, Chi Sung [Seoul City Boramae Hospital, Seoul (Korea, Republic of)

1993-07-15

In order to study the clinical efficacy of the metallic stent of the treatment of iliac arterial stenosis, the clinical and arteriographic findings of the 8 patients were retrospectively reviewed. All 8 patients were males with an age of 51 to 79. The Fontaine class for the functional status of lower extremities was II in 4 patients, III in 3 patents and IV in 1 patient. Self expandable Gianturco stent was inserted of in 7 iliac arteries and balloon expandable Palmaz stent was inserted in 2 iliac arteries in the 8 patients. The indications for the metallic stent application were localized dissection with significant residual stenosis in 6 sites, recoiling due to calcification in one case and eccentricity of the stenosislesionin 2 sites. The deployment of the metallic stent was successful in all the cases to maintain the patency of iliac arteries with residual stenosis less than 30%. The Fontaine class was improved to 1 in 6 patients, IIa in 1 patient and IIb in another one. During the follow up period of 3 to 14 month, none except one developed recurrence of the symptom. On the basis of our experience, we believe that metallic stent is safe and effective for the treatment of iliac arterial stenosis. However, we think that it is a complementary measure to the percutaneous transluminal angioplasty. The comparative study between different types of metallic stent and the long term effect should be investigated further.

MAGNETIC RESONANCE IMAGING EVALUATION OF ROTATOR CUFF IMPINGEMENT

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Chandrakanth K. S

2017-06-01

Full Text Available BACKGROUND Shoulder pain is a common clinical problem. Impingement syndrome of the shoulder is believed to be the most common cause of shoulder pain. The term ‘impingement syndrome’ was first used by Neer to describe a condition of shoulder pain associated with chronic bursitis and partial thickness tear of Rotator Cuff (RC. The incidence of Rotator Cuff (RC tear is estimated to be about 20.7% in the general population. This study is intended to analyse various extrinsic and intrinsic causes of shoulder impingement. MATERIALS AND METHODS 110 consecutive patients referred for MRI with clinical suspicion of shoulder impingement were prospectively studied. All the patients were evaluated for Rotator Cuff (RC degeneration and various extrinsic factors that lead to degeneration like acromial shape, down-sloping acromion, Acromioclavicular (AC joint degeneration and acromial enthesophyte. Intrinsic factors like degeneration and its correlation with age of the patients were evaluated. RESULTS Of the total 110 patients, 19 (17.3% patients had FT RC tear and 31 (28.2% had PT (both bursal and articular surface tears. There was no statistically significant correlation (p=0.76 between acromion types and RC tear. Down-sloping acromion and enthesophytes had statistically significant association with RC tear (p=0.008 and 0.008, respectively. Statistically significant (0.008 correlation between the severity of AC joint degeneration and RC tears was noted. AC joint degeneration and RC pathologies also showed a correlation with the age of the patients with p values of <0.001 and 0.001, respectively. CONCLUSION No statistically significant correlation between RC pathologies with hooked acromion was found, that makes the role played by hooked acromion in FT RC tear questionable. AC joint degeneration association with RC tear is due to the association of both RC tear and AC joint degeneration with age of the patient. Down-sloping acromion, AC joint degeneration

Manual para la elaboración del estado de costo de producción y ventas en los sistemas convencionales de la contabilidad de costos - Lista de figuras

OpenAIRE

Morillo Moreno, Marysela C.

2008-01-01

Índice General Dedicatoria Agradecimientos Lista de cuadros Lista de figuras Introducción Objetivos de la investigación, justificación de la investigación y marco metodológico Capítulo 1: El ciclo de la contabilidad de costos expresado mediante el estado de costos de producción y ventas Capítulo 2: Estado de costo de producción y ventas en un sistema d...

Manual para la elaboración del estado de costo de producción y ventas en los sistemas convencionales de la contabilidad de costos - Lista de cuadros

OpenAIRE

Morillo Moreno, Marysela C.

2008-01-01

Índice General Dedicatoria Agradecimientos Lista de cuadros Lista de figuras Introducción Objetivos de la investigación, justificación de la investigación y marco metodológico Capítulo 1: El ciclo de la contabilidad de costos expresado mediante el estado de costos de producción y ventas Capítulo 2: Estado de costo de producción y ventas en un sistema d...

Manual para la elaboración del estado de costo de producción y ventas en los sistemas convencionales de la contabilidad de costos - Introducción

OpenAIRE

Morillo Moreno, Marysela C.

2008-01-01

Índice General Dedicatoria Agradecimientos Lista de cuadros Lista de figuras Introducción Objetivos de la investigación, justificación de la investigación y marco metodológico Capítulo 1: El ciclo de la contabilidad de costos expresado mediante el estado de costos de producción y ventas Capítulo 2: Estado de costo de producción y ventas en un sistema d...

Las Normas Contables Profesionales y los Costos

OpenAIRE

Demonte, Norberto G.

2005-01-01

El trabajo relaciona las normas contables profesionales y la doctrina más avanzada de costo con el objetivo de exponer adecuadamente la realidad económica, tanto en los estados contables como en la información de gestión. A partir de una rigurosa clasificación e identificación de los costos se propone aplicar el sistema de costeo variable en el estado de resultados conjuntamente con la valuación al “precio de venta en bloque” de los bienes de cambio en el estado de situación patrimonial. Se a...

An Unusual Endovascular Therapeutic Approach for a Rare Case of May-Thurner Syndrome.

Science.gov (United States)

DaSilva-DeAbreu, Adrian; Masha, Luke; Peerbhai, Shareez

2017-03-06

BACKGROUND The etiology of deep venous thrombosis (DVT) may pose a significant diagnostic challenge because truly reversible causes of DVT are rare. In this regard, known pelvic anatomic abnormalities such as aortic and iliac aneurysms should be seriously considered as a complicating factor in patients presenting with acute DVT so as not to miss a potentially curable etiology of May-Thurner syndrome (MTS). CASE REPORT We report the case of a 69-year-old man with a known abdominal aortic aneurysm and bilateral iliac artery aneurysms who presented with an acute DVT. A computed tomography scan of the abdomen and pelvis showed increased dilation of his aneurysmal disease with new resultant compression of the left iliac vein representing acquired MTS. The patient underwent endovascular aneurysm repair of the infra-renal abdominal aortic aneurysm and right common iliac artery aneurysm with a Gore Excluder endoprosthesis in lieu of venous stenting, with resolution of symptoms. CONCLUSIONS Infra-renal aortic and iliac aneurysms causing MTS are extremely rare, and patients at risk for MTS through these mechanisms do not fit the classical demographics associated with this syndrome. Furthermore, this is the first case described in which MTS was treated by addressing the aneurysm through an endoprosthetic approach instead of venous stenting, which is the conventional intervention for MTS.

Los costos económicos de la violencia en El Salvador

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Carlos ACEVEDO

2009-01-01

Full Text Available RESUMEN: Este trabajo efectúa un ejercicio de cuantificación de los costos económicos asociados a las diversas manifestaciones y consecuencias de la situación de violencia prevaleciente en El Salvador, utilizando información para 2007. Tales costos son clasificados en cuatro grandes categorías: i costos en salud; ii costos institucionales (legales, judiciales y policiales; iii costos preventivos en seguridad privada; y iv pérdidas materiales. Los resultados de las estimaciones efectuadas indican que, en dicho año, la violencia impuso sobre El Salvador un costo económico equivalente a 10,9% del Producto Interno Bruto (PIB y a más del doble de las asignaciones presupuestarias para Educación y Salud. ABSTRACT: This essay carries out an accounting exercise on the economic costs derived from the violence situation which prevails in El Salvador, using information for 2007. Those costs are classified into four main categories: i costs on health; ii institutional costs (legal, judiciary and police; iii preventive costs for private security; and iv material losses. The results from the estimations performed indicate that, in 2007, the different expressions and consequences derived from the violence situation imponed on El Salvador an economic cost which was equivalent to 10,9% of Gross Domestic Product (GDP and more than twice the combined budget allocations to Education and Health.

Ruptured internal iliac artery aneurysm presenting as Cullen’s sign

OpenAIRE

Choon K. Gan; Srinivasan Ravi; Rachel Archibald; David Hodgson; Fung J. Foo; William Wong

2010-01-01

Cullen?s sign or periumbilical ecchymosis, is classically considered as an indicator of acute hemorrhagic pancreatitis or ruptured ectopic pregnancy. Internal iliac artery aneurysms are rare and are usually asymptomatic. We present a case of a contained rupture of the internal iliac artery aneurysm presenting with Cullen?s sign.

Transpedal approach for iliac artery stenting: A pilot study

Energy Technology Data Exchange (ETDEWEB)

Zachariah, Jips J., E-mail: jzachariah@chpnet.org [Mount Sinai Beth Israel Hospital, New York, NY (Israel); Ratcliffe, Justin A.; Ruisi, Michael; Puma, Joseph [Mount Sinai Beth Israel Hospital, New York, NY (Israel); Bertrand, Olivier [Quebec Heart and Lung Institute, Quebec (Canada); Kwan, Tak [Mount Sinai Beth Israel Hospital, New York, NY (Israel)

2016-12-15

Objective: To demonstrate the safety and feasibility of the transpedal approach as an alternate arterial access site for iliac artery intervention. Background: The common femoral artery is the traditional access site for the endovascular treatment of iliac artery stenoses. However, this approach is associated with complication rates as high as 2%, including retroperitoneal bleeding which carries high patient morbidity and mortality. Furthermore, the standard femoral approach is associated with longer recovery times and longer time to ambulation which are important considerations especially when performing procedures in an ambulatory setting. Methods: Twelve patients were prospectively followed after treatment for symptomatic iliac artery stenosis via transpedal access. Under ultrasound guidance, one of the pedal arteries was visualized and accessed, and stenting of the iliac arteries were performed as per protocol. The patient was monitored immediately post procedure and clinical follow up was performed at one week and one month later. Results: The average age of the patients was 71 years old. 58% were male. Most patients had Rutherford class III symptoms. Successful stent placement was achieved in all 12 patients via transpedal access. No conversion to femoral access was required. No complications immediately post procedure nor at any time period during follow up were noted. Lower extremity arterial duplex at one month showed patent stents and patent pedal access site vessels in all patients. Conclusion: Transpedal arterial access may be a safe and feasible approach for iliac artery stenting. Given the possible benefits of avoiding femoral artery access, larger studies should be conducted directly comparing the different approaches.

Los costos de alimentación en relación con los costos totales en establecimientos típicos de tambo en países del Mercosur

OpenAIRE

Ostrowski, Bernardo

2003-01-01

p.1-10 Se analizan doce modelos de tambos típicos en la región MERCOSUR, desagregando los costos de alimentación en pastoreo directo, reservas forrajeras y concentrados, diferenciando entre verdeos anuales y pasturas perennes para el primero de los rubros especificados. Se relacionan los costos de la alimentación con los niveles de productividad media de los rodeos, con la escala de la empresa, con diferentes tecnologías y con los costos de los factores de producción intervinientes en la p...

Manual para la elaboración del estado de costo de producción y ventas en los sistemas convencionales de la contabilidad de costos - Referencias bibliográficas

OpenAIRE

Morillo Moreno, Marysela C.

2008-01-01

Índice General Dedicatoria Agradecimientos Lista de cuadros Lista de figuras Introducción Objetivos de la investigación, justificación de la investigación y marco metodológico Capítulo 1: El ciclo de la contabilidad de costos expresado mediante el estado de costos de producción y ventas Capítulo 2: Estado de costo de producción y ventas en un sistema d...

Guideline for diagnosis and treatment of subacromial pain syndrome: a multidisciplinary review by the Dutch Orthopaedic Association

NARCIS (Netherlands)

Diercks, R.; Bron, C.; Dorrestijn, O.; Meskers, C.; Naber, R.; Ruiter, T. de; Willems, J.; Winters, J.; Woude, H.J. van der; et al.,

2014-01-01

Treatment of "subacromial impingement syndrome" of the shoulder has changed drastically in the past decade. The anatomical explanation as "impingement" of the rotator cuff is not sufficient to cover the pathology. "Subacromial pain syndrome", SAPS, describes the condition better. A working group

Costo día cama servicio pensionado para una enfermedad en un hospital de Chile

Directory of Open Access Journals (Sweden)

Alex Medina Giacomozzi

2015-12-01

Full Text Available Uno de los temas de mayor complejidad en salud es la determinación de los costos involucrados en una atención de una enfermedad, por la gran cantidad de costos indirectos incurridos que provienen de los diversos servicios que directa o indirectamente intervienen, por lo que su asignación al usuario requirente, afectado por un problema de salud, ya sea de recuperación o rehabilitación, es sin lugar a dudas el problema más importante a resolver de cualquier sistema de costos. Además, es un problema ineludible pues la organización necesita tener información confiable, oportuna y lo más exacta posible sobre el costo de sus productos, para una correcta toma de decisiones, por lo que el objetivo del presente artículo es calcular el costo indirecto incurrido por procedimiento y su asignación por inductor de costos a un caso real para una atención cerrada en la unidad de pensionado de un hospital público chileno. La metodología seguida implicó identificar todas las actividades y costos involucrados en una atención, mediante la identificación de los inductores de costos y su distribución a una enfermedad en particular, siguiendo el criterio de costo por paciente-enfermedad. El resultado demuestra que es posible incorporar la valorización del día cama y, por tanto, reconocer los costos indirectos incurridos en la atención de una enfermedad en particular, lo que permite contar con un instrumento de identificación de costos, que responda a las necesidades de información para un establecimiento en concreto y que es posible replicar, con las adecuaciones pertinentes, a otros establecimientos de salud.

Ruptured internal iliac artery aneurysm presenting as Cullen’s sign

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Choon K. Gan

2010-11-01

Full Text Available Cullen’s sign or periumbilical ecchymosis, is classically considered as an indicator of acute hemorrhagic pancreatitis or ruptured ectopic pregnancy. Internal iliac artery aneurysms are rare and are usually asymptomatic. We present a case of a contained rupture of the internal iliac artery aneurysm presenting with Cullen’s sign.

Fluorescence Imaging Study of Impinging Underexpanded Jets

Science.gov (United States)

Inman, Jennifer A.; Danehy, Paul M.; Nowak, Robert J.; Alderfer, David W.

2008-01-01

An experiment was designed to create a simplified simulation of the flow through a hole in the surface of a hypersonic aerospace vehicle and the subsequent impingement of the flow on internal structures. In addition to planar laser-induced fluorescence (PLIF) flow visualization, pressure measurements were recorded on the surface of an impingement target. The PLIF images themselves provide quantitative spatial information about structure of the impinging jets. The images also help in the interpretation of impingement surface pressure profiles by highlighting the flow structures corresponding to distinctive features of these pressure profiles. The shape of the pressure distribution along the impingement surface was found to be double-peaked in cases with a sufficiently high jet-exit-to-ambient pressure ratio so as to have a Mach disk, as well as in cases where a flow feature called a recirculation bubble formed at the impingement surface. The formation of a recirculation bubble was in turn found to depend very sensitively upon the jet-exit-to-ambient pressure ratio. The pressure measured at the surface was typically less than half the nozzle plenum pressure at low jet pressure ratios and decreased with increasing jet pressure ratios. Angled impingement cases showed that impingement at a 60deg angle resulted in up to a factor of three increase in maximum pressure at the plate compared to normal incidence.

Femoroacetabular impingement surgery

DEFF Research Database (Denmark)

Reiman, Michael P; Thorborg, Kristian

2015-01-01

both the examination and treatment of FAI does not appear to accommodate this exponential growth. In fact, the direction currently taken for FAI is similar to previously described paths of other orthopaedic and sports medicine pathologies (eg, shoulder impingement, knee meniscus tear) for which we have......Femoroacetabuler impingement (FAI) is becoming increasingly recognised as a potential pathological entity for individuals with hip pain. Surgery described to correct FAI has risen exponentially in the past 10 years with the use of hip arthroscopy. Unfortunately, the strength of evidence supporting...

Contabilidad de Costos I. - Problemas sobre la contabilización de las actividades relacionadas con los costos indirectos de fabricación

OpenAIRE

Morillo Moreno, Marysela C.

2008-01-01

ÍNDICE Introducción Problemas sobre terminología básica Problemas básicos sobre el Ciclo de la Contabilidad de Costos Problemas sobre contabilización de las actividades relacionadas con los materiales Problemas sobre la contabilización de las actividades relacionadas con la mano de obra Problemas sobre la contabilización de las actividades relacionadas con los costos indirectos de fabricación Problemas sobre el Ciclo de la Contabilida...

Anterolateral Ankle Impingement Syndrome (review)%踝关节前外侧撞击综合征的研究进展

Institute of Scientific and Technical Information of China (English)

闵红巍; 刘克敏

2014-01-01

临床将踝关节扭伤后无骨折脱位，反复出现踝关节前外侧肿痛称为踝关节前外侧撞击综合征，为慢性踝关节疼痛的主要病因之一，受到广泛关注。本文就其发病机制、临床表现、诊断及治疗进行综述。%Ankle sprain without fracture or dislocation, accompanied by repeated ankle swelling is called as Anterolateral Ankle Im-pingement Syndrome. It is a major reason of chronic ankle pain and received extensive attention. This paper summarized its pathogenesis, clinical manifestations, diagnosis and treatment.

COSTO DE CAPITAL EN ENTORNOS ECONÓMICOS CAMBIANTES: CASO VALLE DE ABURRÁ (ANTIOQUIA

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JENNY MOSCOSO ESCOBAR

2012-01-01

Full Text Available El objetivo del presente estudio es establecer en qué medida el costo de capital de las empresas medianas y grandes pertenecientes al cluster construcción en el Valle de Aburrá, presenta un comportamiento diferente en épocas de auge y de crisis económica. Se utilizó una metodología descriptiva que permite confrontar la teoría financiera con la información empresarial, obtenida del Sistema de Información y Riesgo Empresarial -SIREM- de la Superintendencia de Sociedades de Colombia para el periodo comprendido entre 2005 y 2009. A partir de esta información se calcula el costo de la deuda, el costo del patrimonio y el costo de capital, con el fin de analizar su comportamiento en el período de tiempo considerado. Como principales hallazgos de la investigación, se evidencia que no existe una diferencia marcada en el comportamiento en el costo de capital en los ciclos económicos considerados, hay un crecimiento moderado del patrimonio, siendo similar el comportamiento del costo de capital al del patrimonio.

Predictors for adverse outcome after iliac angioplasty and stenting for limb-threatening ischemia.

Science.gov (United States)

Timaran, Carlos H; Stevens, Scott L; Freeman, Michael B; Goldman, Mitchell H

2002-09-01

The role of iliac artery angioplasty and stenting (IAS) for the treatment of limb-threatening ischemia is not defined. IAS has been used primarily for patients with disabling claudication. Because poorer results have been shown in patients with critical ischemia after iliac artery angioplasty, the purpose of this study was to estimate the influence of risk factors on the outcome of iliac angioplasty and stent placement in patients with limb-threatening ischemia. During a 5-year period (from 1996 to 2001), 85 iliac angioplasty and stent placement procedures (107 stents) were performed in 31 women and 43 men with limb-threatening ischemia. Patients with claudication were specifically excluded. The criteria prepared by the Ad Hoc Committee on Reporting Standards (Society for Vascular Surgery/International Society for Cardiovascular Surgery) were followed to define the variables. The TransAtlantic InterSociety Consensus classification was used to characterize the type of iliac lesions. Both univariate (Kaplan-Meier [KM]) and multivariate analyses (Cox proportional hazards model) were used to determine the association between variables, cumulative patency, limb salvage, and survival. Indications for iliac angioplasty with stenting were ischemic rest pain (56%) and tissue loss (44%). Primary stenting was performed in 36 patients (42%). Stents were placed selectively after iliac angioplasty mainly for residual stenosis or pressure gradient (43%). Overall, primary stent patency rate was 90% at 1 year, 74% at 3 years, and 69% at 5 years. Primary stent patency rate was significantly reduced in women compared with men (KM, log-rank test, P 1.6 mg/dL; KM, log-rank test, P IAS. Limb salvage, as shown in this study, is not affected by previous iliac stent failure.

Sacro-iliac joint arthrography in low back pain: feasibility of MRI guidance

International Nuclear Information System (INIS)

Ojala, Risto; Klemola, Rauli; Karppinen, Jaro; Sequeiros, Roberto Blanco; Tervonen, Osmo

2001-01-01

Objective: Evaluation of the feasibility of MR-guidance in sacro-iliac joint arthrography in patients whose low back pain is suspected to arise from the sacro-iliac joint (SIJ). Methods and patients: Twenty patients with low back pain underwent MR-guided sacro-iliac joint arthrography. Needles made from titanium (size 20 G, MDTech, USA) were used. For image guidance a 0.23T open-configuration C arm magnet (Proview, Marconi Medical Systems, USA) with special interventional hardware and software package (I-Path 200, Marconi Medical Systems) containing an MR compatible in-room console, large-screen (36'') display, optical navigator and accompanying software with dedicated sequences was used. No other image guidance modalities were used. Results: MR-guided SIJ arthrography was successfully performed in all twenty patients without complications. The optimal imaging sequence both for preoperative and intraoperative images was 3D-Gradient Echo sequence. The dispersal of the injected saline and anaesthetic could be determined inside the joint in all cases with heavily T2-weighted fast spin echo sequence. In the present study, 60% of the patients had significant reduction of pain after sacro-iliac joint arthrography and sacro-iliac joint was considered to be the source of patients low back pain in these patients. Conclusion: The present study shows that MR guidance with open configuration low field scanner is an accurate guiding method for sacro-iliac joint arthrography

EVALUATION OF RIGHT ILIAC FOSSA MASS-A RETROSPECTIVE STUDY

OpenAIRE

Raja Billy Graham; Vijayabhasker

2016-01-01

Mass in right iliac fossa is one of the common clinical surgical entity with varied etiologies, involving intra peritoneal organs like vermiform appendix, caucus, ileum, retroperitoneal structures like kidneys, blood vessels etc., and abdominal wall masses like desmoids tumor. To know the etiology and the various pattern of presentation of right iliac fossa mass in our institution a retrospective study was designed including all adult patients diagnosed to have a mass in right ili...

Costos logísticos en empresas de servicios – Hospital Universitario

Directory of Open Access Journals (Sweden)

Arley Torres Hinestroza

2014-06-01

Full Text Available Este artículo hace parte de los resultados del proyecto de investigación denominado “Metodología de costos para instituciones prestadoras de servicios de salud: aplicación de los Grupos Relacionados por el Diagnóstico – GRD” que proporcionó los elementos técnicos, administrativos, financieros y contables requeridos para el diseño y posterior implementación de un modelo de costos en instituciones en empresas prestadoras de servicios de salud. Desde tal perspectiva, se presenta aquí una propuesta de modelo matemático para desarrollar una herramienta informática que permita controlar los costos ocultos y sobrecostos en el sistema de prestación de servicios de salud en hospitales públicos. El modelo se planteó con base en el método del Case Mix (mezcla de casos para definir el producto hospitalario a partir de Grupos Relacionados por el Diagnóstico o GRD, los cuales se constituyeron en los objetos de costos finales. Asimismo, se planteó una estructura de costos basada en procesos, de conformidad con los lineamientos establecidos por la Contaduría General de la Nación y los criterios técnicos propuestos por la Dirección Distrital de Contaduría del Distrito Capital para la implementación del sistema de costos en las Empresas Sociales del Estado. La herramienta desarrollada a partir del modelo matemático se probó en un hospital departamental, denominado piloto para proteger las operaciones y buen nombre de la institución.

Costos logísticos en empresas de servicios – Hospital Universitario

Directory of Open Access Journals (Sweden)

Arley Torres Hinestroza

2014-07-01

Full Text Available Este artículo hace parte de los resultados del proyecto de investigación denominado “Metodología de costos para instituciones prestadoras de servicios de salud: aplicación de los Grupos Relacionados por el Diagnóstico – GRD” que proporcionó los elementos técnicos, administrativos, financieros y contables requeridos para el diseño y posterior implementación de un modelo de costos en instituciones en empresas prestadoras de servicios de salud. Desde tal perspectiva, se presenta aquí una propuesta de modelo matemático para desarrollar una herramienta informática que permita controlar los costos ocultos y sobrecostos en el sistema de prestación de servicios de salud en hospitales públicos. El modelo se planteó con base en el método del Case Mix (mezcla de casos para definir el producto hospitalario a partir de Grupos Relacionados por el Diagnóstico o GRD, los cuales se constituyeron en los objetos de costos finales. Asimismo, se planteó una estructura de costos basada en procesos, de conformidad con los lineamientos establecidos por la Contaduría General de la Nación y los criterios técnicos propuestos por la Dirección Distrital de Contaduría del Distrito Capital para la implementación del sistema de costos en las Empresas Sociales del Estado. La herramienta desarrollada a partir del modelo matemático se probó en un hospital departamental, denominado piloto para proteger las operaciones y buen nombre de la institución.

Cryoplasty for the treatment of iliac artery stenosis in canine model

International Nuclear Information System (INIS)

Wu Zhengzhong; Yang Weizhu; Jiang Na; Zheng Qubin; Huang Keyao; Huang Ning; Shen Quan

2013-01-01

Objective To evaluate the treatment effect of balloon angioplasty and cryoplasty on iliac artery stenosis in canine model. Methods: Canine models of iliac artery stenosis were established with surgical ligation and transfixion. Models were randomly divided into two groups: iliac artery stenosis treated by cryoplasty (n = 8) and by balloon angioplasty (n = 8). The degree of iliac artery stenosis of two model groups was assessed by digital subtraction angiography (DSA) immediately and two weeks after the angioplasties. Then all the dogs were executed for pathological observation of the target vessels. Results: Sixteen canine models of iliac artery stenosis were established by surgical ligation and transfixion method with 100% success rate. DSA showed there was (45 ± 12)% of residual artery stenosis in the cryoplasty group immediately after surgery, while it was (39-12)% in the balloon angioplasty group, and there was no significant difference between them (t = 3.183, P > 0.05). The artery stenosis of cryoplasty group was (48 ± 17)% after two weeks and not significantly different from that after surgery immediately (t = -1.271, P > 0.05). The artery stenosis of balloon angioplasty group was (67 ± 13)% after two weeks, and it was significantly higher compared with at after surgery immediately (t = -6.666, P < 0.01). The degree of vascular stenosis in balloon angioplasty group was severer than that in cryoplasty group two weeks after angiography (P = 0.041). The pathological examination showed artery intimal hyperplasia in cryoplasty group was milder than that in balloon angioplasty group and neointimal content of collagen in cryoplasty group was less than that in balloon angioplasty group. Conclusions: The animal models of iliac artery stenosis were established successfully with surgical ligation and transfixion by damaging the intima and media of arterial wall. Compared with balloon angioplasty, the cryoplasty was able to inhibit proliferation of intimal and reduce

ADMINISTRACIÓN DE LA CONTABILIDAD DE COSTOS. APUNTES DE CLASES Y EJERCICIOS (CASOS). BORRADOR.

OpenAIRE

Fernando Rubio

2004-01-01

OBJETIVOS: Dar a conocer los principios y técnicas de la contabilidad de costos; Permitir el análisis de la contabilidad de costos desde la perspectiva de la gestión de empresas; Capacitar al alumno en el manejo y uso de la información de costos para lograr una eficiente administración a través de la toma de decisiones, la planificación y el control; Desarrollar habilidades para evaluar e implementar sistemas de información de costos en una organización; Proporcionar el criterio y las técnica...

GESTIÓN ESTRATÉGICA DE COSTOS EN LA INDUSTRIA AVÍCOLA ZULIANA

OpenAIRE

Rosana Meleán; Rafael Moreno; Guillermo Rodríguez

2009-01-01

El objetivo de la presente investigación es analizar la gestión estratégica de costos en la industria avícola zuliana, desde la perspectiva de Shank y Govindarajan (1995) que considera la cadena de valor, el posicionamiento estratégico y los causales de costos. La investigación es de tipo analítica, no experimental, de campo. Los resultados indican que la industria avícola, maneja adecuadamente su cadena de valor; la estrategia asumida es la de liderazgo en costos, los cuales se manejan de ma...

Vena Cava Filter Retrieval with Aorto-Iliac Arterial Strut Penetration.

Science.gov (United States)

Holly, Brian P; Gaba, Ron C; Lessne, Mark L; Lewandowski, Robert J; Ryu, Robert K; Desai, Kush R; Sing, Ronald F

2018-05-03

To evaluate the safety and technical success of inferior vena cava (IVC) filter retrieval in the setting of aorto-iliac arterial strut penetration. IVC filter registries from six large United States IVC filter retrieval practices were retrospectively reviewed to identify patients who underwent IVC filter retrieval in the setting of filter strut penetration into the adjacent aorta or iliac artery. Patient demographics, implant duration, indication for placement, IVC filter type, retrieval technique and technical success, adverse events, and post procedural clinical outcomes were identified. Arterial penetration was determined based on pre-procedure CT imaging in all cases. The IVC filter retrieval technique used was at the discretion of the operating physician. Seventeen patients from six US centers who underwent retrieval of an IVC filter with at least one strut penetrating either the aorta or iliac artery were identified. Retrieval technical success rate was 100% (17/17), without any major adverse events. Post-retrieval follow-up ranging from 10 days to 2 years (mean 4.6 months) was available in 12/17 (71%) patients; no delayed adverse events were encountered. Findings from this series suggest that chronically indwelling IVC filters with aorto-iliac arterial strut penetration may be safely retrieved.

Hybrid management of a spontaneous ilio-iliac arteriovenous fistula: a case report

LENUS (Irish Health Repository)

O'Brien, Gavin C

2011-08-22

Abstract Introduction Spontaneous iliac arteriovenous fistulae are a rare clinical entity. Such localized fistulation is usually a result of penetrating traumatic or iatrogenic injury. Clinical presentation can vary greatly but commonly includes back pain, high-output congestive cardiac failure and the presence of an abdominal bruit. Diagnosis, therefore, is often incidental or delayed. Case presentation We report a case of a spontaneous ilio-iliac arteriovenous fistula in a 68-year-old Caucasian man detected following presentation with unilateral claudication and congestive cardiac failure. Following computed tomography evaluation, the fistula was successfully treated with a combined endovascular (aorto-uni-iliac device) and open (femoro-femoral crossover) approach. Conclusion Endovascular surgery has revolutionized the management of such fistulae and we report an interesting case of a high-output iliac arteriovenous fistulae successfully treated with a hybrid vascular approach.

Costos de neumonia nosocomial en una unidad de cuidados intensivos en Cartagena, Colombia

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Arnaldo Sanmartin-Ávila

Full Text Available Resumen Objetivo: Estimar el exceso de costos directos de atención atribuible a la neumonía asociada a ventilador mecánico en una unidad de cuidados intensivos de adultos en la ciudad de Cartagena durante los años 2009 al 2014. Material y Método: Se plantea un estudio de evaluación económica parcial centrado en el análisis de costos directos de atención contrastando los escenarios de neumonía asociada a ventilador mecánico versus los escenarios sin neumonía asociada a ventilador mecánico. La población de estudio la constituye 23 pacientes con neumonía asociada a ventilador mecánico. Del mismo modo, se tomaron 46 controles. La información correspondiente a los costos directos se obtuvo a través del departamento de costos de la institución hospitalaria. Se estimó la razón de costos que permite establecer el exceso de costo atribuible a la enfermedad nosocomial. Resultados: La estancia promedio en los casos fue de 47 días mientras que en los controles fue de 9 días. El costo promedio de un caso de neumonía asociada a ventilador mecánico fue de US$ 44.354 mientras que el de un control fue de US$ 5.037. Discusión: El exceso de costo promedio total así como el incurrido en antibióticos y en estancia resultan ser mucho más altos que los encontrados en otros estudios realizados. Conclusiones: Un caso de neumonía asociada a ventilador mecánico cuesta 10 veces más con respecto a los medicamentos y 8 veces más con relación a exámenes de laboratorio se insumos. La estancia resulta ser 6,6 veces más costosa que cuando no se presenta esta patología. El costo que se asume en antibióticos es 7,8 veces más alto. Los casos de neumonía asociada a ventilador mecánico cuestan en promedio 8,8 veces más que los controles.

COSTOS DE LA IMPLANTACIÓN DE MEDIDAS DE SEGURIDAD DEL TRABAJO EN EDIFICACIONES VERTICALES

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Nelma Mirian Chagas de Araujo

2001-01-01

Full Text Available

Este trabajo, producto de una pesquisa de maestrado, define y cuantifica los costos originales de la implantación del PCMAT (Programa de Condiciones y Medio Ambiente de Trabajo en la Industria de la Construcción en obras de edificaciones verticales, del tipo residencial y con más de cuatro plantas, en el municipio de Joã Pessosa. Los resultados de la investigación definen como costos de la implantación del PCMAT: costos de la implantación y costos de evaluación.

Fish impingement at Lake Michigan power plants

International Nuclear Information System (INIS)

Sharma, R.K.; Freeman, R.F.; Spigarelli, S.A.

1976-01-01

A study was initiated in 1974 to survey the magnitude and to evaluate the impact of fish impingement at 20 power plants on the Great Lakes. Data on impingement rates, site characteristics, intake designs and operational features have been collected and analyzed. Interpretive analyses of these data are in progress. The objectives of this study were: to summarize fish impingement data for Lake Michigan (16/20 plants surveyed are on Lake Michigan); to assess the significance of total and source-related mortalities on populations of forage and predator species; and to expand the assessment of power plant impingement to include all water intakes on Lake Michigan. Data are tabulated

Performance of jet impingement in unglazed air collectors

Energy Technology Data Exchange (ETDEWEB)

Belusko, M.; Saman, W.; Bruno, F. [Institute for Sustainable Systems and Technologies, University of South Australia, Mawson Lakes Boulevard, Mawson Lakes, SA 5095 (Australia)

2008-05-15

Jet impingement is effective at improving the heat transfer between air and a heated surface. Studies have shown that jet impingement can marginally improve the thermal efficiency of a glazed collector. However, little attention has been placed on applying jet impingement to an unglazed solar air collector. This paper presents a theoretical and experimental investigation identifying the performance characteristics of jet impingement. Overall, jet impingement was able to improve the thermal efficiency of the collector by 21%. An increase in the pressure loss was also measured but found to be small. The flow distribution of jets along the collector was the most significant factor in determining the efficiency. Increasing the hole spacing was found to improve the efficiency. (author)

The use of evidence-based practices for the management of shoulder impingement syndrome among Indian physical therapists: a cross-sectional survey

Directory of Open Access Journals (Sweden)

Vandana Phadke

2015-12-01

Full Text Available ABSTRACT Background: The understanding of the pathomechanics of shoulder impingement has evolved over the years. Likewise, assessment techniques and effective treatment strategies have also been developed. Physical therapists should keep up-to-date on the current evidence. Objective: This study explored the practices currently used by Indian physical therapists for the assessment and management of shoulder impingement syndrome (SIS. Method: Using an online questionnaire, therapists were asked to declare the causes, methods of assessment and their choices of physical therapy techniques for the management of SIS. The proportions of therapists using different techniques were analyzed descriptively, and comparisons across gender, experience level, and training were made. Data were analyzed to see if the choices of respondents compared with their responses for etiology. Results: A total of 211 responses were analyzed. Most respondents (>75% believed that overuse and abnormal motion/posture are the most significant causes of SIS. However, fewer respondents reported assessing posture (60.2% and dyskinesis, especially in women (24.2%. Ninety-four percent of the respondents reported using exercises, but exercise prescription was rather generic. Therapists additionally trained in the techniques of joint mobilization or taping declared using these techniques more frequently. The use of interferential therapy and ultrasound was reported by 89.5% and 98.4% of respondents, respectively Conclusion: Most therapists declared awareness of current recommended practices, but patient assessment, exercise prescription, and use of electrotherapy modalities were only partially based on current evidence. The study helps to identify gaps in current physical therapy approaches to SIS in India.

Oblique radiograph for the detection of bone spurs in anterior ankle impingement

International Nuclear Information System (INIS)

Dijk, Niek C. van; Wessel, Ronald N.; Tol, Johannes L.; Maas, M.

2002-01-01

Objective: The aim of this study was to develop a radiographic view to detect anteromedial talotibial osteophytes that remain undetected on standard radiographs. Design and patients: In 10 cadaver specimens the maximal size was measured of anteromedial tibial osteophytes that remain undetected on a standard lateral radiograph projection, due to the presence of the anteromedial tibial rim. The average projection of the most prominent anterolateral tibial rim over the anteromedial rim was found to be 7.3 mm. A 7 mm barium-clay osteophyte was attached to this anteromedial rim of the distal tibia. Anteromedial osteophytes become most prominent on an oblique view, in which the radiographic beam is tilted into a 45 craniocaudal direction with the leg in 30 external rotation. This oblique view was compared with the findings of arthroscopic surgery in 25 consecutive patients with anterior ankle impingement syndrome. Results: Medially located tibial and talar osteophytes remained undetected on a standard lateral projection and became visible on the oblique anteromedial impingement (AMI) radiograph. Anterolateral tibial and talar osteophytes were well detected on a standard lateral radiograph projection but were invisible on the AMI view. There was a high correlation between the location of the osteophyte and the location of symptoms and the findings at arthroscopy. Conclusion: A combination of lateral and oblique radiographs can be used to differentiate between anteromedial and anterolateral bony ankle impingement. (orig.)

El costo promedio ponderado de capital en Colombia

Directory of Open Access Journals (Sweden)

Eduardo Beltrán Rodríguez

1988-04-01

Full Text Available RESUMEN El presente escrito tiene como objeto exponer la importancia de la conformación financiera y el costo de capital en las diferentes líneas de financiación de la empresa y el rendimiento que los ahorradores exigen por ceder su liquidez durante un período de tiempo dado. El objetivo de las finanzas (Gerente General o Gerente Financiero es maximizar el valor de la empresa. Para lograrlo, las finanzas han desarrollado elementos teóricos y prácticos para medir el costo de los recursos utilizados por los negocios, esos métodos serán explicados en el presente escrito.

Temporally stratified sampling programs for estimation of fish impingement

International Nuclear Information System (INIS)

Kumar, K.D.; Griffith, J.S.

1977-01-01

Impingement monitoring programs often expend valuable and limited resources and fail to provide a dependable estimate of either total annual impingement or those biological and physicochemical factors affecting impingement. In situations where initial monitoring has identified ''problem'' fish species and the periodicity of their impingement, intensive sampling during periods of high impingement will maximize information obtained. We use data gathered at two nuclear generating facilities in the southeastern United States to discuss techniques of designing such temporally stratified monitoring programs and their benefits and drawbacks. Of the possible temporal patterns in environmental factors within a calendar year, differences among seasons are most influential in the impingement of freshwater fishes in the Southeast. Data on the threadfin shad (Dorosoma petenense) and the role of seasonal temperature changes are utilized as an example to demonstrate ways of most efficiently and accurately estimating impingement of the species

GESTIÓN ESTRATÉGICA DE COSTOS EN LA INDUSTRIA AVÍCOLA ZULIANA

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Rosana Meleán

2009-07-01

Full Text Available El objetivo de la presente investigación es analizar la gestión estratégica de costos en la industria avícola zuliana, desde la perspectiva de Shank y Govindarajan (1995 que considera la cadena de valor, el posicionamiento estratégico y los causales de costos. La investigación es de tipo analítica, no experimental, de campo. Los resultados indican que la industria avícola, maneja adecuadamente su cadena de valor; la estrategia asumida es la de liderazgo en costos, los cuales se manejan de manera tradicional. Se concluye, que a pesar de existir herramientas novedosas en la contabilidad de gestión, las empresas analizadas están arraigadas a sistemas de contabilidad heredados del pasado, ignorando los beneficios otorgados por nuevos enfoques, entre los que destacan la racionalización de costos a medida que se fortalece la posición estratégica de la empresa.

Hip morphology predicts posterior hip impingement in a cadaveric model.

Science.gov (United States)

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

2018-05-01

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

MRI features of posterior ankle impingement syndrome in ballet dancers: a review of 25 cases

Energy Technology Data Exchange (ETDEWEB)

Peace, K.A.L. E-mail: kalpeace@hotmail.com; Hillier, J.C.; Hulme, A.; Healy, J.C

2004-11-01

AIM: To describe the magnetic resonance imaging (MRI) features of posterior ankle impingement syndrome (PAIS) in classical ballet dancers. MATERIALS AND METHODS: A retrospective review was undertaken of 25 MRI examinations of the ankle performed on 23 ballet dancers over a 26-month period. Images were examined for the presence of osseous and soft-tissue anatomical variants at the posterior ankle and imaging signs of PAIS. All patients presented with symptoms and signs suggestive of PAIS including posterior ankle pain, swelling and stiffness during plantar flexion. RESULTS: Anatomical variants predisposing to PAIS including as os trigonum and tuberosity arising from the superior calcaneum were clearly depicted. The most common imaging feature of PAIS in our series was high T2 signal posterior to the talocalcaneal joint indicating synovitis (n=25). Thickening of the posterior capsule (n=13) and tenosynovitis of flexor hallucis longus (n=17) were also common. An os trigonum was an infrequent finding (n=7). Bone marrow oedema, commonly in the posterior talus (n=10) or in a patchy distribution (n=10) was often noted. CONCLUSION: MRI is a useful diagnostic tool in PAIS, and in the present series, clearly demonstrates the anatomical variants and range of osseous and soft-tissue abnormalities associated with this condition. Prospective studies are needed to understand the significance and importance of individual MRI findings in producing the symptoms of PAIS.

MRI features of posterior ankle impingement syndrome in ballet dancers: a review of 25 cases

International Nuclear Information System (INIS)

Peace, K.A.L.; Hillier, J.C.; Hulme, A.; Healy, J.C.

2004-01-01

AIM: To describe the magnetic resonance imaging (MRI) features of posterior ankle impingement syndrome (PAIS) in classical ballet dancers. MATERIALS AND METHODS: A retrospective review was undertaken of 25 MRI examinations of the ankle performed on 23 ballet dancers over a 26-month period. Images were examined for the presence of osseous and soft-tissue anatomical variants at the posterior ankle and imaging signs of PAIS. All patients presented with symptoms and signs suggestive of PAIS including posterior ankle pain, swelling and stiffness during plantar flexion. RESULTS: Anatomical variants predisposing to PAIS including as os trigonum and tuberosity arising from the superior calcaneum were clearly depicted. The most common imaging feature of PAIS in our series was high T2 signal posterior to the talocalcaneal joint indicating synovitis (n=25). Thickening of the posterior capsule (n=13) and tenosynovitis of flexor hallucis longus (n=17) were also common. An os trigonum was an infrequent finding (n=7). Bone marrow oedema, commonly in the posterior talus (n=10) or in a patchy distribution (n=10) was often noted. CONCLUSION: MRI is a useful diagnostic tool in PAIS, and in the present series, clearly demonstrates the anatomical variants and range of osseous and soft-tissue abnormalities associated with this condition. Prospective studies are needed to understand the significance and importance of individual MRI findings in producing the symptoms of PAIS

Iliac hyperdense line: a new radiographic sign of gluteal muscle contracture

International Nuclear Information System (INIS)

Cai, Jin-Hua; Gan, Lan-Feng; Zheng, He-Lin; Li, Hao

2005-01-01

A hyperdense line on the ilium that runs roughly parallel to the sacroiliac joint (we called it ''iliac hyperdense line sign'') was frequently observed on pelvic radiographs of patients with gluteal muscle contracture (GMC). A literature search revealed no description of this sign. To determine the relationship between the iliac hyperdense line sign and GMC and to explore how this sign is formed. Pelvic plain films of 103 cases of GMC and those of 200 control individuals were reviewed for the presence or absence of the iliac hyperdense line sign. Pelvic CT scans in 8 of 103 cases and 13 of 200 controls were analyzed with relation to the plain films. The iliac hyperdense line sign was visualized in 85 of 103 (82.5%) cases of GMC and none of the 200 controls. In the GMC group, pelvic CT scans showed a deformity of the posterior ilium. The lateral cortex of the posterior ilium took on a partly or completely anteroposterior course, while in the control group the course appeared as an oblique orientation from posteromedial to anterolateral. The iliac hyperdense line on pelvic plain film can be used as a radiographic sign to suggest a diagnosis of GMC. This sign might be a result of the long and persistent pulling effect of the contracted gluteus maximus muscle, which deforms the lateral cortex of the posterior ilium from an oblique course to an anteroposterior course tangential to the X-ray beam. (orig.)

Iliac hyperdense line: a new radiographic sign of gluteal muscle contracture

Energy Technology Data Exchange (ETDEWEB)

Cai, Jin-Hua; Gan, Lan-Feng; Zheng, He-Lin; Li, Hao [Chongqing Medical University, Department of Radiology, Children' s Hospital, Chongqing (China)

2005-10-01

A hyperdense line on the ilium that runs roughly parallel to the sacroiliac joint (we called it ''iliac hyperdense line sign'') was frequently observed on pelvic radiographs of patients with gluteal muscle contracture (GMC). A literature search revealed no description of this sign. To determine the relationship between the iliac hyperdense line sign and GMC and to explore how this sign is formed. Pelvic plain films of 103 cases of GMC and those of 200 control individuals were reviewed for the presence or absence of the iliac hyperdense line sign. Pelvic CT scans in 8 of 103 cases and 13 of 200 controls were analyzed with relation to the plain films. The iliac hyperdense line sign was visualized in 85 of 103 (82.5%) cases of GMC and none of the 200 controls. In the GMC group, pelvic CT scans showed a deformity of the posterior ilium. The lateral cortex of the posterior ilium took on a partly or completely anteroposterior course, while in the control group the course appeared as an oblique orientation from posteromedial to anterolateral. The iliac hyperdense line on pelvic plain film can be used as a radiographic sign to suggest a diagnosis of GMC. This sign might be a result of the long and persistent pulling effect of the contracted gluteus maximus muscle, which deforms the lateral cortex of the posterior ilium from an oblique course to an anteroposterior course tangential to the X-ray beam. (orig.)

Proximal iliotibial band syndrome: case report

Directory of Open Access Journals (Sweden)

Guilherme Guadagnini Falotico

2013-08-01

Full Text Available OBJECTIVE: The overuse injuries in the hip joint occur commonly in sports practitioners and currently due to technical advances in diagnostic imaging, especially magnetic resonance imaging (MRI, are often misdiagnosed. Recently, a group of people were reported, all female, with pain and swelling in the pelvic region.T2-weighted MRI showed increased signal in the enthesis of the iliotibial band (ITB along the lower border of the iliac tubercle. We report a case of a 34 year old woman, non-professional runner, with pain at the iliac crest with no history of trauma and whose MRI was compatible with the proximal iliotibial band syndrome.

Costo energético de las labores de preparación de suelo en Cuba

OpenAIRE

Pedro Paneque Rondón; Dailyn Soto León

2007-01-01

El objetivo fundamental del trabajo fue determinar el costo energético de las operaciones agrícolas mecanizadas y comparar los costos energéticos de los distintos tamaños (anchos de trabajo) de los aperos más utilizados en el país para la preparación de suelo, testando la hipótesis de que el costo energético expresado en MJ/ha es independiente del tamaño del equipo. Los resultados de la investigación permitieron llegar a las siguientes conclusiones: los mayores costos energéticos cor...

Las Normas Contables Profesionales y los Costos

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Norberto G. Demonte

2005-12-01

Full Text Available El trabajo relaciona las normas contables profesionales y la doctrina más avanzada de costo con el objetivo de exponer adecuadamente la realidad económica, tanto en los estados contables como en la información de gestión. A partir de una rigurosa clasificación e identificación de los costos se propone aplicar el sistema de costeo variable en el estado de resultados conjuntamente con la valuación al “precio de venta en bloque” de los bienes de cambio en el estado de situación patrimonial. Se analizan críticamente las normas vigentes en los últimos años y se brinda un ejemplo numérico donde puede apreciarse el resultado del período segregado por función.

The acquired hyperostosis syndrome

International Nuclear Information System (INIS)

Dihlmann, W.; Hering, L.; Bargon, G.W.

1988-01-01

Sterno-costo-clavicular hyperostosis (SCCH) is the most common manifestation of a syndrome, consisting of increased bone metabolism, mostly new bone formation and heterotopic ossification of fibrous tissue, which we have characterised as the acquired hyperostosis syndrome. In part I we discuss the terminology, radiological appearances, scintigraphy, clinical and laboratory findings, bacteriology, histology, nosology, complications, treatment and differential diagnosis of SCCH. Chronic recurrent multifocal osteomyelitis (CRMO) is regarded as a phaenotype of SCCH, depending on the age. CRMO occurs in children, adolescents and young adults, SCCH predominantly in middleaged and elderly adults. (orig.) [de

Sistemas de Información de costos para la gestión hospitalaria

OpenAIRE

Vilma Vargas González; Carmen Hernández

2009-01-01

El presente trabajo pretende exponer aspectos fundamentales para el desarrollo de sistemas de información de costos para la gestión hospitalaria. Sistemas de información de costos, útiles en la toma de decisiones para la gestión hospitalaria, y cónsonos con los objetivos sociales que persiguen los hospitales, implica que el conocimiento de información de costos no tiene como objetivo la búsqueda de rentabilidad económica, sino optimización del uso de los recursos desde el punto de vista socia...

Costos operativos en la gestión administrativa y financiera en unidades hospitalarias

OpenAIRE

Burgos Ruela, Juan Pablo; Mora Aristega, Julio Ernesto; Huilcapi Masacon, Magdalena Rosario; Bayas Huilcapi, Grace Vanessa; García Silvera, Franklin Amalio

2017-01-01

Los costos operativos las unidades médicas del Instituto Ecuatoriano de Seguridad Social, ofrecen servicios de salud a la clase afiliada, en tal actividad se generan costos por diversos elementos tales como la materia prima directa que para el caso lo constituyen los fármacos, los insumos médicos y los materiales biodontológicos; las entidades deben realizar un control exhaustivo de tal forma que se conozca con certeza los costos operativos a fin de que se puedan tomar decisiones que estén en...

Isolated iliac artery aneurysms with associated hydronephrosis.

LENUS (Irish Health Repository)

O'Driscoll, D

2012-02-03

An isolated iliac artery aneurysm is where there is aneurysmal dilatation of one or more branches of the iliac system, with no associated dilatation of the aorta. Such aneurysms are rare and comprise 1% of all intra-abdominal aneurysms. The signs and symptoms of such an aneurysm are influenced by its concealed location within the bony pelvis. Awareness of these special characteristics improves the chances of early diagnosis and proper treatment before possible rupture. We present the clinical and radiological features of three such aneurysms. Ultrasound was the first imaging modality to be performed. Ipsilateral hydronephrosis was demonstrated in each case, this lead to imaging the pelvis and the correct diagnosis. We review the clinical and radiological literature and conclude that the pelvis should be imaged in all cases of unexplained hydronephrosis.

Common iliac vein thrombosis as a result of proximal venous stenosis following renal transplantation: A case report

Directory of Open Access Journals (Sweden)

Atish Chopra

2016-12-01

Full Text Available Proximal iliac vein stenosis resulting in iliac vein thrombus and venous outflow obstruction in renal transplant patients is an exceedingly rare occurrence. We present a case of a 63-year-old male who underwent deceased donor renal transplantation and presented 12 days later with ipsilateral lower extremity swelling and plateauing serum creatinine. Further work-up demonstrated proximal iliac vein deep venous thrombosis and anticoagulation was initiated. However, propagation of the thrombus developed despite receiving therapeutic anticoagulation. Subsequent venography demonstrated proximal iliac venous stenosis and the patient underwent successful catheter-directed alteplase thrombolysis, inferior vena cava filter placement and iliac vein stenting with salvage of the renal allograft. A diagnostic strategy and management algorithm for iliac vein stenosis and thrombosis in a renal transplant recipient is proposed.

Endoluminal embolization of bilateral atherosclerotic common iliac aneurysms with fibrin tissue glue (Beriplast)

International Nuclear Information System (INIS)

Beese, Richard C.; Tomlinson, Mark A.; Buckenham, Timothy M.

2000-01-01

The standard surgical approach to nonleaking iliac aneurysms found at repair of a leaking abdominal aortic aneurysm is to minimize the operative risk by repairing the abdominal aorta only. This means that the bypassed iliac aneurysms may have to be repaired later. As this population of patients are usually elderly with coexisting medical problems, interventional radiology is being used to embolize these aneurysms, thus avoiding the morbidity and mortality associated with further general anesthesia and surgery. Various materials and stents have been reported to be effective in the treatment of iliac aneurysms. We report the successful use of endoluminal fibrin tissue glue (Beriplast) to treat two large iliac aneurysms in a patient who had had a previous abdominal aortic aneurysm repair. We discuss the technique involved and the reasons why we used tissue glue in this patient.

MÉTODO MATRICIAL FHER EN UN SISTEMA DE COSTOS POR PROCESOS, O EN LÍNEA

Directory of Open Access Journals (Sweden)

Fernando Villarreal Vásquez

2009-01-01

Full Text Available La investigación centra su atención en el diseño de una herramienta de costos que permite manipular y entregar resultados de los costos por procesos o en línea en una matriz de manera sencilla y entendible, esta matriz ha sido desarrollada y probada por los autores del artículo,  con estudiantes  de contaduría pública en varias mypimes  y ha demostrado su facilidad para que el estudiante comprenda y el empresario lo manipule dentro de su información financiera. El método matricial  FHER (forma horizontal de establecer resultados en un sistema de costos por  procesos, es una forma metodológica innovadora y fácil  de realizar el cálculo de los costos unitarios por producto, en el sistema de costos por procesos o en línea.   Este modelo  matricial, facilita a los estudiantes el aprendizaje de los costos por proceso o en línea, pues las matrices tradicionales muestran el modelo por proceso de manera compleja.

Optimización del costo del sistema de aprovechamiento de madera en bosques naturales de Pinus caribaea

OpenAIRE

Cándano Acosta,Fidel; Leite,Angelo Marcio Pinto; Martínez Cantón,José Luis

2012-01-01

El trabajo se realizó en bosques naturales de Pinus caribaea en áreas de la empresa forestal La Palma en la provincia de Pinar del Río - Cuba. El objetivo de la investigación fue minimizar el costo del sistema de aprovechamiento de madera a partir de la interacción entre el costo de camino y el costo de arrastre en base a la densidad de camino y patios de carga, además de la interacción del costo de camino y el costo del transporte de madera en base a la calidad de la capa de rodamiento del c...

Costo-efectividad de intervenciones para insuficiencia renal crónica terminal

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Armando Arredondo

1998-12-01

Full Text Available OBJETIVO: Analisó el costo-efectividad en intervenciones para pacientes con insuficiencia renal crónica terminal (IRCT en términos de los costos económicos de cada intervención, los años de vida ganados y la calidad de vida que generan tres alternativas comparables y mutuamente excluyentes: diálisis peritoneal contínua ambulatoria (DPCA, la hemodiálisis (HD y el trasplante renal (TR. MÉTODO: El diseño del estudio fue de tipo longitudinal. Los costos de cada intervención se determinaron mediante la técnica de manejo de caso promedio. Las medidas para evaluar los criterios de efectividad elegidos fueron la probabilidad de sobrevida y el Año de Vida Ajustado por Calidad (QALY, Quality Adjusted Life Year medido por el Indice de Rosser. RSULTADOS: Los costos de manejo anual de caso fueron: diálisis peritoneal $5,643.07, hemodiálisis $9,631.60 y trasplante $3,021.63. En cuanto a la efectividad, la sobrevida del injerto de trasplante renal resultó de 89,9% y 79,6% a uno y tres años respectivamente, mientras que los pacientes sometidos a DPCA tienen una sobrevida de 86,2% y 66,9% a un año y a tres años respectivamente. En cuanto a los QALY's, los resultados para cada intervención fueron: DPCA 0,879; HD 0,864; y para el TR 0,978. CONCLUSIÓN: La intervención más costo-efectiva resultó el trasplante renal con un coeficiente de 3,088.69, seguido de la DPCA y la hemodiálisis, cuyos coeficientes fueron de 6,416.95 y 11,147.68 respectivamente. Por lo tanto se recomienda promover y utilizar el trasplante renal como la intervención más costo-efectiva para pacientes con IRCT.

Effectiveness of individualized physiotherapy on pain and functioning compared to a standard exercise protocol in patients presenting with clinical signs of subacromial impingement syndrome. A randomized controlled trial

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de Bie Rob A

2010-06-01

Full Text Available Abstract Background Shoulder impingement syndrome is a common musculoskeletal complaint leading to significant reduction of health and disability. Physiotherapy is often the first choice of treatment although its effectiveness is still under debate. Systematic reviews in this field highlight the need for more high quality trials to investigate the effectiveness of physiotherapy interventions in patients with subacromial impingement syndrome. Methods/Design This randomized controlled trial will investigate the effectiveness of individualized physiotherapy in patients presenting with clinical signs and symptoms of subacromial impingement, involving 90 participants aged 18-75. Participants are recruited from outpatient physiotherapy clinics, general practitioners, and orthopaedic surgeons in Germany. Eligible participants will be randomly allocated to either individualized physiotherapy or to a standard exercise protocol using central randomization. The control group will perform the standard exercise protocol aiming to restore muscular deficits in strength, mobility, and coordination of the rotator cuff and the shoulder girdle muscles to unload the subacromial space during active movements. Participants of the intervention group will perform the standard exercise protocol as a home program, and will additionally be treated with individualized physiotherapy based on clinical examination results, and guided by a decision tree. After the intervention phase both groups will continue their home program for another 7 weeks. Outcome will be measured at 5 weeks and at 3 and 12 months after inclusion using the shoulder pain and disability index and patients' global impression of change, the generic patient-specific scale, the average weekly pain score, and patient satisfaction with treatment. Additionally, the fear avoidance beliefs questionnaire, the pain catastrophizing scale, and patients' expectancies of treatment effect are assessed. Participants

Direct contrast-enhanced MR venography in the diagnosis of May-Thurner Syndrome

Energy Technology Data Exchange (ETDEWEB)

Gurel, Kamil, E-mail: kamilgurel@hotmail.com [Baskent University, School of Medicine, Adana Medical and Research Center, Department of Radiology (Turkey); Gurel, Safiye; Karavas, Erdal [Abant Izzet Baysal University, Izzet Baysal School of Medicine, Department of Radiology (Turkey); Buharalioglu, Yavuz; Daglar, Bahadir [Abant Izzet Baysal University, Izzet Baysal School of Medicine, Department of Cardiovascular Surgery (Turkey)

2011-11-15

Visualization of lower extremity veins with MR venography still needs improvement. The latest advancement is direct contrast-enhanced 3D MR venography which is based on display of venous system during direct injection of paramagnetic extracellular contrast agent into pedal veins. We used automated injection of contrast agent with a power injector makings this application simpler and faster, achieved to show the iliac vein compression syndrome and post-thrombotic changes of the left iliac and femoral veins.

Lower gastrointestinal bleeding due to iliac artery-cecal fistulax: A late presentation of blunt injury abdomen

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Ambrish Kumar

2017-01-01

Full Text Available We report a case of an arterio-enteric fistula between an Right iliac artery and otherwise healthy cecum, presenting with torrential lower gastrointestinal bleed in an 14-year-old patient. Whilst fistulization to the aorta and common iliac arteries has been reported, to our knowledge no previous cases of post traumatic fistulization between an right iliac artery and normal cecum has been reported. Successful open exploration primary repair of iliac artery rent with ileostomy and colostomy was done. Later stoma reversal was done successfully.

Age-related changes in vertebral and iliac crest 3D bone microstructure--differences and similarities.

Science.gov (United States)

Thomsen, J S; Jensen, M V; Niklassen, A S; Ebbesen, E N; Brüel, A

2015-01-01

Age-related changes of vertebra and iliac crest 3D microstructure were investigated, and we showed that they were in general similar. The 95th percentile of vertebral trabecular thickness distribution increased with age for women. Surprisingly, vertebral and iliac crest bone microstructure was only weakly correlated (r = 0.38 to 0.75), despite the overall similar age-related changes. The purposes of the study were to determine the age-related changes in iliac and vertebral bone microstructure for women and men over a large age range and to investigate the relationship between the bone microstructure at these skeletal sites. Matched sets of transiliac crest bone biopsies and lumbar vertebral body (L2) specimens from 41 women (19-96 years) and 39 men (23-95 years) were micro-computed tomography (μCT) scanned, and the 3D microstructure was quantified. For both women and men, bone volume per total volume (BV/TV), connectivity density (CD), and trabecular number (Tb.N) decreased significantly, while structure model index (SMI) and trabecular separation (Tb.Sp) increased significantly with age at either skeletal site. Vertebral trabecular thickness (Tb.Th) was independent of age for both women and men, while iliac Tb.Th decreased significantly with age for men, but not for women. In general, the vertebral and iliac age-related changes were similar. The 95th percentile of the Tb.Th distribution increased significantly with age for women but was independent of age for men at the vertebral body, while it was independent of age for either sex at the iliac crest. The Tb.Th probability density functions at the two skeletal sites became significantly more similar with age for women, but not for men. The microstructural parameters at the iliac crest and the vertebral bodies were only moderately correlated from r = 0.38 for SMI in women to r = 0.75 for Tb.Sp in men. Age-related changes in vertebral and iliac bone microstructure were in general similar. The iliac

INCIDENCIA DE UN PRESUPUESTO EN SEGURIDAD Y SALUD OCUPACIONAL EN LOS COSTOS Y GASTOS

OpenAIRE

Flores Pariona, Cecilia Flores Pariona Mirtha

2017-01-01

Este artículo aborda aquellos desembolsos en seguridad y salud ocupacional que deben ser considerados como una inversión frente a todos aquellos costos y gastos que puedan desencadenarse, producto de un accidente o enfermedad ocupacional. Un accidente deviene en costos de la mano de obra directa del accidentado, del compañero que emplea su tiempo para auxiliarlo, el personal de reemplazo, el costo de la mano de obra indirecta del supervisor y gastos como las indemnizaciones al accidentado, ga...

Post-operative internal hernia through an orifice underneath the right common iliac artery after Dargent's operation.

Science.gov (United States)

Ardelt, M; Dittmar, Y; Scheuerlein, H; Bärthel, E; Settmacher, U

2014-01-01

We report the case of a 39-year-old woman with ileus resulting from a small bowel incarceration underneath the right common iliac artery. The patient had a history of a radical trachelectomy with laparoscopic pelvic lymphadenectomy ("Dargent's operation") for cervical carcinoma. After dissection of the iliac vessels, a small bowel loop could slide underneath the common iliac artery. The hernia was closed by gluing a collagen patch over the right common iliac artery onto the retroperitoneal cavity. To our knowledge, such a case has not previously been reported in the medical literature.

Exercises versus arthroscopic decompression in patients with subacromial impingement: a randomised, controlled study in 90 cases with a one year follow up

DEFF Research Database (Denmark)

Haahr, J. P.; Ostergaard, S.; Dalsgaard, J.

2005-01-01

, the difference being non-significant. No group differences in mean pain and dysfunction score improvement were found. CONCLUSIONS: Surgical treatment of rotator cuff syndrome with subacromial impingement was not superior to physiotherapy with training. Further studies are needed to qualify treatment choice...

Atención médica ambulatoria en México: el costo para los usuarios

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Arredondo Armando

1999-01-01

Full Text Available Objetivo. Analizar los resultados de la Encuesta Nacional de Salud II (ENSA-II, en lo relativo a los costos del proceso de búsqueda y obtención de la atención médica ambulatoria en diferentes instituciones del sector público y privado. Material y métodos. La informacion se obtuvo a partir de los indicadores de costos de la atención médica que notificó la población de estudio de la ENSA-II. Los costos para el bolsillo del consumidor fueron la variable dependiente, y las independientes, la condición de aseguramiento y el ingreso económico. La significancia de los niveles de variación se identificó aplicando la prueba de Duncan. Resultados. Los costos en todo el país, en dólares estadunidenses, fueron: transporte, $ 2.20; consulta general, $ 7.90; medicamentos, $ 9.60, y estudios de diagnóstico, $13.6. El costo promedio total de la atención ambulatoria fue de $ 22.70. Los hallazgos empíricos permiten sugerir una nueva propuesta de análisis de los costos en salud, tanto directos como indirectos, en que incurren los consumidores de servicios de salud; dichos costos representan una carga importante en relación con el ingreso familiar, situación que se agudiza en el caso de la población no asegurada. Conclusiones. La incorporación de la perspectiva económica en el análisis de los problemas de los sistemas de salud, no debe limitarse a los costos de producción de servicios en que incurren los proveedores, sobre todo si lo que se busca es resolver los problemas de equidad y accesibilidad que actualmente caracterizan a la oferta de servicios médicos en México.

Sirenomelia (mermaid syndrome): an infant from parents who used a special form of snuff.

Science.gov (United States)

Taghavi, M M; Jafari Naveh, H R; Shariati, M; Morteza Zade, F

2009-05-01

We report the first case of a fetus with sirenomelia or mermaid syndrome, whose Afghanian parents were heavy user of a special form of snuff. The case was diagnosed as a mermaid syndrome but some of the features were common to both symmelia dipus and symmelia apus, for example, the single lower extremity had the normal femur, tibia and fibula, but the single foot was rotated medially. The digestive tube ended to a massive closed saclike structure and the anus was absence. The external genital organs were rudiment and the normal testes were undescended. Aorta was divided to branches, such that the external iliac arteries were very small in comparison to the internal iliac arteries. Inferior Vena cava was placed on to the left side of the aorta and unlike the majority of reported mermaid syndrome, the bladder was present. So, the researchers believe that the present case is a rare variant of the mermaid syndrome.

Impingement jet cooling in gas turbines

CERN Document Server

Amano, R S

2014-01-01

Due to the requirement for enhanced cooling technologies on modern gas turbine engines, advanced research and development has had to take place in field of thermal engineering. Impingement jet cooling is one of the most effective in terms of cooling, manufacturability and cost. This is the first to book to focus on impingement cooling alone.

Análisis costo beneficio del Programa de Detección Oportuna del Cáncer Cervicouterino

OpenAIRE

HERNÁNDEZ-PEÑA PATRICIA; LAZCANO-PONCE EDUARDO CÉSAR; ALONSO-DE RUIZ PATRICIA; CRUZ-VALDEZ AURELIO; MENESES-GONZÁLEZ FERNANDO; HERNÁNDEZ-AVILA MAURICIO

1997-01-01

Objetivo. Determinar el costo beneficio de la reorganización del Programa de Detección Oportuna del Cáncer Cervicouterino (PDOC) mediante intervenciones de garantía de calidad. Material y métodos. Se siguieron tres etapas: a) identificación y cuantificación de costos; b) identificación y cuantificación de beneficios, y c) evaluación económica del costo beneficio. Resultados. El costo unitario de operación por citología -obtención, fijación, el traslado al centro de lectura, su tinción e inter...

Impingement of juvenile and adult fishes during cooling water withdrawal

International Nuclear Information System (INIS)

McFarlane, R.W.

1978-01-01

Juvenile and adult fishes are impinged upon trash removal screens as Savannah River water is withdrawn for use on the Savannah River Plant (SRP). Thirty-six species of fish, representing half of all riverine species known from the area, were impinged on the screens at three SRP pumping stations during 1977. Based on the average of 11.2 fish impinged per day, annual impingement is estimated to be 4088 fish. SRP thus ranks third lowest for impingement recently reported for 33 electric power plants

Valve-Like and Protruding Calcified Intimal Flap Complicating Common Iliac Arteries Kissing Stenting

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George S. Georgiadis

2015-01-01

Full Text Available Endovascular therapy for iliac artery chronic total occlusions is nowadays associated with low rates of procedure-related complications and improved clinical outcomes, and it is predominantly used as first-line therapy prior to aortobifemoral bypass grafting. Herein, we describe the case of a patient presenting with an ischemic left foot digit ulcer and suffering complex aortoiliac lesions, who received common iliac arteries kissing stents, illustrating at final antegrade and retrograde angiograms the early recognition of a blood flow obstructing valve-like calcified intimal flap protruding through the stent struts, which was obstructing antegrade but not retrograde unilateral iliac arterial axis blood flow. The problem was resolved by reconstructing the aortic bifurcation at a more proximal level. Completion angiogram verified normal patency of aorta and iliac vessels. Additionally, a severe left femoral bifurcation stenosis was also corrected by endarterectomy-arterioplasty with a bovine patch. Postintervention ankle brachial pressure indices were significantly improved. At the 6-month and 2-year follow-up, normal peripheral pulses were still reported without intermittent claudication suggesting the durability of the procedure. Through stent-protruding calcified intimal flap, is a very rare, but existing source of antegrade blood flow obstruction after common iliac arteries kissing stents.

Unsuspected reason for sciatica in Bertolotti's syndrome.

Science.gov (United States)

Shibayama, M; Ito, F; Miura, Y; Nakamura, S; Ikeda, S; Fujiwara, K

2011-05-01

Patients with Bertolotti's syndrome have characteristic lumbosacral anomalies and often have severe sciatica. We describe a patient with this syndrome in whom standard decompression of the affected nerve root failed, but endoscopic lumbosacral extraforaminal decompression relieved the symptoms. We suggest that the intractable sciatica in this syndrome could arise from impingement of the nerve root extraforaminally by compression caused by the enlarged transverse process.

Iliac hyperdense line: a new X-ray sign of gluteal muscle contracture

International Nuclear Information System (INIS)

Cai Jinhua; Gan Lanfeng; Zheng Helin; He Ling; Yu Guorong

2003-01-01

Objective: To elucidate the relationship between gluteal muscle contracture (GMC) and the iliac hyperdense line on pelvic plain film, and to explore how the iliac hyperdense line is formed. Methods: The pelvic plain films of 103 cases with GMC confirmed by operation and those of 200 individuals as control were analyzed. Pelvic CT scanning was performed in 8 cases GMC and 13 cases of normal controls. Results: The iliac hyperdense line at the side of sacroiliac joint was found on the pelvic plain film in 85 of 103 cases with GMC and 5 of 200 in control group. In 103 cases of GMC, the iliac hyperdense line was detected in 81 of 88 patients beyond 5 years, and 83 of 94 was mostly the gluteus maximus contracture. In control group, pelvic CT showed that the outer cortex of posterior ilium at the level of sacroiliac joint appeared as an oblique plane, oriented from posteromedial side to anterolateral side, while in GMC group, the oblique plane became steeper and almost oriented posteroanteriorly. In addition, the posterior part of the ilium which gave the attachment of contracted gluteus maximus muscle deformed and widened. Conclusion: The iliac hyperdense line on the pelvic plain film is resulted from the long and persistent pulling effect of contracted gluteus maximus muscle, which causes the change the oblique plane of posterior ilium into a posteroanterior course parallel to the X-ray beam

Postoperative internal iliac artery embolisation as salvage therapy ...

African Journals Online (AJOL)

Postoperative internal iliac artery embolisation as salvage therapy for ... of blood products. Damage control surgery was performed, and bleeding was ultimately only ... abdomen was packed with adrenalin-soaked swabs. Coagulation.

Duplex-guided percutaneous transluminal angioplasty in iliac arterial occlusive disease.

Science.gov (United States)

Krasznai, A G; Sigterman, T A; Welten, R J; Heijboer, R; Sikkink, C J J M; van de Akker, L H J M; Bouwman, L H

2013-11-01

Chronic renal insufficiency (CRI) is a growing global problem. PTA can be performed without nephrotoxic contrast, utilizing Doppler-ultrasound (Duplex) guidance. Duplex-guided infra-inguinal interventions and access-related interventions have been reported. Duplex-guided iliac interventions have not been performed to any extent because of the anatomic location. In our study we evaluated the safety and efficacy of Duplex-guided percutaneous transluminal angioplasty (DuPTA) in iliac arteries. From June 2012 until February 2013, 31 patients (35 iliac lesions), underwent DuPTA. Indications ranged from Rutherford 3 to 5. Preoperative evaluation included Ankle Brachial Index (ABI), Duplex and MRA. Procedural success was defined as crossing the lesion with a guidewire and dilating or stenting the lesion. Clinical success was defined as 50% reduction in peak systolic velocity (PSV) or clinical improvement. PSV was evaluated after PTA, then at 2 weeks. Clinical results were assessed 2 weeks after the procedure. Procedural success was achieved in 94% of patients (33/35), all of whom also had clinical success. Post-procedural PSV reduction showed an average improvement of 63% (431 cm/s to 153 cm/s). Mean preoperative ABI was 0.72 and improved to 0.88 postoperatively. PTA using Duplex-guidance in significant iliac stenosis is a safe method with major advantages in patients at high risk for developing contrast-induced nephropathy. Copyright © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Costo, volumen, precio y utilidad: dinámica del desempeño financiero industria confecciones infantiles

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Ofelia Gómez Niño

2012-06-01

Full Text Available Este artículo resume los resultados de investigación en 52 empresas de la industria de confección infantil en Bucaramanga. Es un estudio descriptivo, que permitió establecer las relaciones existentes entre procesos de producción, sistemas de costeo y estrategias, en función del costo, volumen y utilidad, en la dinámica del desempeño financiero de estas organizaciones. Los hallazgos, evidencia la relación entre producción, costos y estrategias que son las variables influyentes del desempeño financiero, en esta industria. Asimismo, la relación costo-volumen-utilidad contribuyen en el análisis, porque el precio se fija en función del costo, los costos según los recursos consumidos y volumen de producción, y el margen de contribución resulta de la diferencia entre precio y costo, que se equipara para cubrir los gastos operacionales e impuestos, y proporcionar utilidad. Además, las estrategias se enfocan hacia la productividad, sustentada en la capacitación, la tecnología y asociatividad, para fortalecer el desempeño financiero y la sostenibilidad en el mercado.

The mechanoreceptors of the costo-vertebral joints

Science.gov (United States)

Godwin-Austen, R. B.

1969-01-01

1. Unitary recording in the thoracic dorsal roots of mechanoreceptor discharges from the costo-vertebral joints was carried out in the cat and rabbit. Criteria for the identification of costo-vertebral joint mechanoreceptors were established. 2. The majority of rib joint mechanoreceptors are slowly adapting and fifty-three such receptors were studied. Five rapidly adapting receptors were also identified. 3. The responses of these receptors have been correlated with rib position and movement. The slowly adapting receptors gave a monotonic response to different rib positions. 72% showed an increase of discharge rate with displacements towards expiratory rib positions. 4. In response to manually imposed rib movements slowly adapting joint mechanoreceptors gave a dynamic response which was directly related to the velocity of the movement and adapted within 2 sec. The movements of breathing produced a corresponding alteration of the discharge frequency of the slowly adapting receptors. 5. Slowly adapting receptors were localized to the capsule of the costo-transverse joint by probing. They responded to increased intra-articular pressure with an increase of discharge rate and were silenced by intra-articular lignocaine, 0·4%. 6. Rapidly adapting joint mechanoreceptors responded to rib movement with a brief burst of discharges. 7. The rib joint mechanoreceptors signal rib joint position, and the direction and velocity of rib movement. It is suggested that these afferent discharges provide the basis for the perception of respiratory movements of the chest. The significance of these receptors to the `sense of effort' resulting from a resistance to breathing is discussed. PMID:5789947

Iliac vein stenosis is an underdiagnosed cause of pelvic venous insufficiency.

Science.gov (United States)

Santoshi, Ratnam K N; Lakhanpal, Sanjiv; Satwah, Vinay; Lakhanpal, Gaurav; Malone, Michael; Pappas, Peter J

2018-03-01

Reflux in the ovarian veins, with or without an obstructive venous outflow component, is reported to be the primary cause of pelvic venous insufficiency (PVI). The degree to which venous outflow obstruction plays a role in PVI is currently ill-defined. We retrospectively reviewed the charts of 227 women with PVI who presented to the Center for Vascular Medicine from January 2012 to September 2015. Assessments and interventions consisted of an evaluation for other causes of chronic pelvic pain by a gynecologist; preintervention and postintervention visual analog scale (VAS) pain score; complete venous duplex ultrasound examination; and Clinical, Etiology, Anatomy, and Pathophysiology classification. All patients underwent diagnostic venography of their pelvic and left ovarian veins as well as intravascular ultrasound of their iliac veins. Patients were treated in one of six ways: ovarian vein embolization (OVE) alone (chemical ± coils), OVE with staged iliac vein stenting, OVE with simultaneous iliac vein stenting, iliac vein stenting alone, OVE with venoplasty, and venoplasty alone. Of the 227 women treated, the average age and number of pregnancies was 46.4 ± 10.4 years and 3.36 ± 1.99, respectively. Treatment distribution was the following: OVE, n = 39; OVE with staged stenting, n = 94; OVE with simultaneous stenting, n = 33; stenting alone, n = 50; OVE with venoplasty, n = 8; and venoplasty alone, n = 3. Seven patients in the OVE and stenting groups (staged) and one patient in the OVE + venoplasty group required a second embolization of the left ovarian vein. Eighty percent (181/227) of patients demonstrated an iliac stenosis >50% by intravascular ultrasound. Average VAS scores for the entire cohort before and after intervention were 8.45 ± 1.11 and 1.86 ± 1.61 (P ≤ .001). In the staged group, only 9 of 94 patients reported a decrease in the VAS score with OVE alone. VAS score decreased from 8.6 ± 0.89 before OVE to 7.97 ± 2.10 after OVE

Funciones de costos translogarítmicas. Una aplicación para el sector manufacturero mexicano

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Héctor Salgado Banda

2010-01-01

Full Text Available Se utiliza funciones de costos translogarítmicas para estimar elasticidades precio y de sustitución de las demandas por insumos, economías de escala y costos medios en las manufacturas mexicanas. Se analiza datos de la Encuesta Industrial Anual para 1996, 2000 y 2003. Se muestra que un modelo que no permite homoteticidad ni elasticidades unitarias en la función de costos parece ser el más adecuado para representar la estructura de producción. Elasticidades de Allen-Uzawa indican la existencia de posibilidades de sustitución entre los insumos. La demanda por electricidad es de elasticidad unitaria. Todas las elasticidades cruzadas son menores a 1. Tanto las economías de escala como los costos medios disminuyen conforme el tamaño de las clases de actividad aumenta. Las economías de escala aumentan para cualquier nivel de producción. Las diferencias en costos medios entre pequeñas y grandes clases de actividad se han reducido mientras que algunas disparidades se mantienen en ciertos grupos manufactureros.

Costos económicos en la producción de servicios de salud: del costo de los insumos al costo de manejo de caso Economic costs for the production of health services: from cost of inputs to cost of case-management

OpenAIRE

ARMANDO ARREDONDO; TERESA DAMIÁN

1997-01-01

Objetivo. Generar información sobre los costos de producción de servicios de salud. Material y métodos. Siguiendo los criterios de Kessner se seleccionaron como trazadores: hipertensión, diabetes, diarreas y neumonías. Posteriormente, se definió el manejo de casos y, por medio de la metodología de costeo por manejo de caso, se definieron las funciones de producción, así como los insumos y costos unitarios requeridos para satisfacer la demanda de servicios médicos de cada enfermedad. Se proces...

Treatment of a Common Iliac Aneurysm by Endovascular Exclusion Using the Amplatzer Vascular Plug and Femorofemoral Crossover Graft

International Nuclear Information System (INIS)

Coupe, Nicholas J.; Ling, Lynn; Cowling, Mark G.; Asquith, John R.; Hopkinson, Gregory B.

2009-01-01

We report our initial experience using the Amplatzer Vascular Plug II (AVP2) in the treatment of a left common iliac aneurysm. Following investigation by computerized tomographic angiography and catheter angiography, a 79-year-old man was found to have a markedly tortuous iliac system, with a left common iliac artery aneurysm that measured 48 mm in maximal diameter. Due to the patient's age and comorbidities the surgical opinion was that conventional open repair was not suitable. However, due to the tortuous nature of the aneurysm and iliac vessels, standard endovascular repair, using either a bifurcated or an aorto-uni-iliac stent graft, was also not possible. A combined approach was used by embolizing the ipsilateral internal iliac artery using coils and excluding the aneurysm using two AVP2 occlusion devices, followed by femorofemoral crossover grafting. Total aneurysm occlusion was achieved using this method and this allowed the patient to have a much less invasive surgical procedure than with conventional open repair of common iliac aneurysms, thus avoiding potential comorbidity and mortality.

The Effect of Iliac Crest Autograft on the Outcome of Fusion in the Setting of Degenerative Spondylolisthesis

Science.gov (United States)

Radcliff, Kristen; Hwang, Raymond; Hilibrand, Alan; Smith, Harvey E.; Gruskay, Jordan; Lurie, Jon D.; Zhao, Wenyan; Albert, Todd; Weinstein, James

2012-01-01

Background: There is considerable controversy about the long-term morbidity associated with the use of posterior autologous iliac crest bone graft for lumbar spine fusion procedures compared with the use of bone-graft substitutes. The hypothesis of this study was that there is no long-term difference in outcome for patients who had posterior lumbar fusion with or without iliac crest autograft. Methods: The study population includes patients enrolled in the degenerative spondylolisthesis cohort of the Spine Patient Outcomes Research Trial who underwent lumbar spinal fusion. Patients were divided according to whether they had or had not received posterior autologous iliac crest bone graft. Results: There were 108 patients who had fusion with iliac crest autograft and 246 who had fusion without iliac crest autograft. There were no baseline differences between groups in demographic characteristics, comorbidities, or baseline clinical scores. At baseline, the group that received iliac crest bone graft had an increased percentage of patients who had multilevel fusions (32% versus 21%; p = 0.033) and L5-S1 surgery (37% versus 26%; p = 0.031) compared with the group without iliac crest autograft. Operative time was higher in the iliac crest bone-graft group (233.4 versus 200.9 minutes; p case-by-case basis for lumbar spinal fusion. Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence. PMID:22878599

Costos secundarios por infecciones nosocomiales en dos unidades pediátricas de cuidados intensivos

Directory of Open Access Journals (Sweden)

Navarrete-Navarro Susana

1999-01-01

Full Text Available OBJETIVO. Estimar los costos asociados a infecciones nosocomiales en niños tratados en dos unidades de terapia intensiva. MATERIAL Y MÉTODOS. Se realizó un estudio parcial de costos en la Unidad de Cuidados Intensivos Neonatales (UCIN y en la Unidad de Cuidados Intensivos Pediátricos (UTIP de un hospital infantil de tercer nivel de atención médica. Se investigaron los costos de las pruebas diagnósticas y de los recursos terapéuticos empleados, así como el exceso de estancia hospitalaria debida a la presencia de una infección nosocomial. RESULTADOS. Se detectaron 102 infecciones, 46 en UCIN y 56 en UTIP, en el lapso de un año, tiempo que duró el estudio. El costo promedio por infección fue de 91 698 pesos y el gasto global fue de 9.3 millones de pesos. Neumonía, flebitis y septicemia abarcaron 65% de los costos. En los niños infectados se registró una estancia hospitalaria extra de 9.6 días, 13.7 exámenes de laboratorio y 3.3 cultivos en promedio, debido a la presencia de una infección intrahospitalaria. La estancia hospitalaria representó 97% del gasto total. CONCLUSIONES. Esta evaluación representa una estimación de costos directos de infección. Los resultados justifican el establecimiento de programas preventivos agresivos para reducir las complicaciones dentro de los hospitales.

LOS COSTOS DE LA MALA CALIDAD COMO QUINTO ELEMENTO DEL COSTO: APROXIMACIÓN TEÓRICA EN LA GESTIÓN DE LA COMPETITIVIDAD EN MEDIO DE LA CONVERGENCIA CONTABLE

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LUIS FERNANDO VALENZUELA JIMÉNEZ

2016-01-01

Full Text Available Este artículo examina el tratamiento de los costos de calidad y de la mala calidad contrastando la teoría de los costos con los procesos de gestión y su tratamiento contable, para intentar demostrar cómo los reportes tradicionales no cumplen satisfactoriamente la idea de las normas de la revelación plena y la utilidad de la información para la toma de decisiones, invocadas por las normas interna - cionales de contabilidad, en el contexto de la convergencia que adelanta Colombia en materia con - table y de aseguramiento. Como resultado de la discusión se proponen mecanismos concretos para revelar apropiadamente los costos de la calidad y de la mala calidad de forma que tal información cumpla apropiadamente las aspiraciones de los usuarios en la toma de decisiones.

Los costos de la calidad: conceptos y aplicaciones en la industria farmacéutica

OpenAIRE

Enrique Yacuzzi; Fernando Martín

2003-01-01

Este documento de trabajo es una introducción práctica al estudio de los costos de la calidad (CC). En las primeras secciones se describen algunos métodos y aplicaciones sencillas. Utilizando ejemplos de la implantación de un sistema de CC en el área de acondicionamiento de un laboratorio farmacéutico multinacional que opera en la Argentina, se presentan definiciones y cálculos de costos, con ejemplos de los informes y planillas más comunes. Se estudia la clasificación de los costos y se brin...

Can FDG-PET/CT replace blind bone marrow biopsy of the posterior iliac crest in Ewing sarcoma?

International Nuclear Information System (INIS)

Kasalak, Oemer; Glaudemans, Andor W.J.M.; Overbosch, Jelle; Kwee, Thomas C.; Jutte, Paul C.

2018-01-01

To determine and compare the value of 18 F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (FDG-PET/CT) to blind bone marrow biopsy (BMB) of the posterior iliac crest in detecting metastatic bone marrow involvement in newly diagnosed Ewing sarcoma. This retrospective study included 20 patients with newly diagnosed Ewing sarcoma who underwent pretreatment FDG-PET/CT and a total of 38 blind BMBs (two unilateral and 18 bilateral) of the posterior iliac crest. FDG-PET/CT scans were evaluated for bone marrow involvement, both in the posterior iliac crest and other sites, and compared to blind BMB results. FDG-PET/CT was positive for bone marrow involvement in 7/38 posterior iliac crests, whereas BMB was positive in 5/38 posterior iliac crests. FDG-PET/CT and BMB results in the posterior iliac crest agreed in 36/38 cases (94.7%, 95% confidence interval [CI]: 82.7-98.5%). On a patient level, FDG-PET/CT was positive for bone marrow involvement in 4/20 patients, whereas BMB of the posterior iliac crest was positive in 3/20 patients. On a patient level, FDG-PET/CT and BMB results agreed in 19/20 patients (95.0%, 95% CI: 76.4-99.1%). The only discrepancies between FDG-PET/CT and BMB were observed in two BMBs of one patient. Both BMBs in this patient were negative, whereas FDG-PET/CT indicated bilateral posterior iliac crest involvement and also extensive bone marrow involvement elsewhere. FDG-PET/CT appears to be a valuable method for metastatic bone marrow assessment in newly diagnosed Ewing sarcoma. The routine use of blind BMB of the posterior iliac crest should be reconsidered when FDG-PET/CT is available. (orig.)

Can FDG-PET/CT replace blind bone marrow biopsy of the posterior iliac crest in Ewing sarcoma?

Energy Technology Data Exchange (ETDEWEB)

Kasalak, Oemer; Glaudemans, Andor W.J.M.; Overbosch, Jelle; Kwee, Thomas C. [University of Groningen, Department of Radiology, Nuclear Medicine and Molecular Imaging, University Medical Center Groningen (Netherlands); Jutte, Paul C. [University of Groningen, Department of Orthopedics, University Medical Center Groningen (Netherlands)

2018-03-15

To determine and compare the value of {sup 18}F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (FDG-PET/CT) to blind bone marrow biopsy (BMB) of the posterior iliac crest in detecting metastatic bone marrow involvement in newly diagnosed Ewing sarcoma. This retrospective study included 20 patients with newly diagnosed Ewing sarcoma who underwent pretreatment FDG-PET/CT and a total of 38 blind BMBs (two unilateral and 18 bilateral) of the posterior iliac crest. FDG-PET/CT scans were evaluated for bone marrow involvement, both in the posterior iliac crest and other sites, and compared to blind BMB results. FDG-PET/CT was positive for bone marrow involvement in 7/38 posterior iliac crests, whereas BMB was positive in 5/38 posterior iliac crests. FDG-PET/CT and BMB results in the posterior iliac crest agreed in 36/38 cases (94.7%, 95% confidence interval [CI]: 82.7-98.5%). On a patient level, FDG-PET/CT was positive for bone marrow involvement in 4/20 patients, whereas BMB of the posterior iliac crest was positive in 3/20 patients. On a patient level, FDG-PET/CT and BMB results agreed in 19/20 patients (95.0%, 95% CI: 76.4-99.1%). The only discrepancies between FDG-PET/CT and BMB were observed in two BMBs of one patient. Both BMBs in this patient were negative, whereas FDG-PET/CT indicated bilateral posterior iliac crest involvement and also extensive bone marrow involvement elsewhere. FDG-PET/CT appears to be a valuable method for metastatic bone marrow assessment in newly diagnosed Ewing sarcoma. The routine use of blind BMB of the posterior iliac crest should be reconsidered when FDG-PET/CT is available. (orig.)

Reconstruction of iliac crest with rib to prevent donor site complications: A prospective study of 26 cases

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Dave B

2007-01-01

Full Text Available Background: The tricortical bone graft from the iliac crest are used to reconstruct the post corpectomy spinal defects. The donor iliac area defect is large and may give rise to pain at donor site, instability of pelvis, fracture of ilium, donor site muscle herniation or abdominal content herniation. Rib removed during thoracotomy was used by us to reconstruct the iliac crest defect. Materials and Methods: Twenty-six patients who underwent thoracotomy for dorsal spine corpectomy or curettage for various spinal pathologies from June 2002 to May 2004 were included in the study. After adequate decompression the spine was reconstructed by tricortical bone graft from iliac crest and reconstruction of the iliac crest was done with the rib removed for exposure during thoracotomy. Results: The mean follow up was 15 months. All patients had good graft incorporation which was evaluated on the basis of local tenderness and radiographs. One patient had graft displacement. Conclusion: The reconstruction of iliac crest by rib is a simple and effective procedure to prevent donor site complications.

Deep Vein Thrombosis of the Left Leg: A Case of May-Thurner Syndrome

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Jiten Desai

2018-02-01

Full Text Available A 56-year-old woman presented with gradually worsening shortness of breath associated with dull left leg pain over 5 days. She denied any recent travel, recent surgeries or immobilization. CT pulmonary angiography and CT venography revealed multiple bilateral pulmonary emboli and extensive left pelvic and left lower extremity deep vein thromboses. Contrast-enhanced CT showed that the right common iliac artery crossed the left common iliac vein and compressed it externally, indicative of May–Thurner syndrome. Catheter-directed thrombolysis of the left lower extremity was performed and heparin infusion was started. The patient also underwent left iliac vein balloon angioplasty with stenting and infra-renal inferior vena cava filter placement via the jugular approach to prevent further embolization.

Empirical model of impingement impact. Environmental Sciences Division publication No. 1289

International Nuclear Information System (INIS)

Barnthouse, L.W.; DeAngelis, D.L.; Christensen, S.W.

1979-01-01

A simple model, derived from Ricker's (1975) theory of fisheries dynamics, that can be used to estimate the impact of impingement of juvenile fish by power plants on year-class abundance in vulnerable species is described. The only data required are estimates of the initial number of impingeable juveniles, the number impinged, and the rate of total mortality during the period of vulnerability. The impact of impingement is expressed in the model as the conditional mortality rate, rather than the more commonly used exploitation rate. The conditional mortality rate is superior as a measure of impact for two reasons: it accounts for the differential impact of impinging fish of different ages, and it is numerically equivalent to the fractional reduction in year-class abundance due to impingement. We present an application of the model using the 1974 year-class of the Hudson River striped bass population as an example. We then show how the model can be modified to account for seasonal fluctuations in the rate of impingement, discuss the effect of these fluctuations on the calculated impact, and discuss the influence on model output of errors in the measurement of abundance, impingement, and total mortality. It is evident from this analysis that estimates of impingement impact are as sensitive to errors in estimates of population size and mortality as to estimates of the number of fish impinged. Thus, it is not possible to reliably estimate the impact of impingement on a vulnerable fish species unless a substantial effort is devoted to population studies

Aulas-laboratorios de bajo costo, usando TIC

Directory of Open Access Journals (Sweden)

Silvia E. Calderón

2015-01-01

Full Text Available En este trabajo se presentan los resultados de una propuesta educativa orientada a promover el desarrollo de un pensamiento critico y un mayor interes por las ciencias experimentales. Con este fin desarrollamos propuestas de proyectos educativos susceptibles de ser destinadas a las aulas y laboratorios de las escuelas secundarias y primeros anos de la universidad, que resaltan los aspectos metodologicos de las ciencias. Aqui, realizamos una compilacion de varios proyectos, que ilustran formas de incorporar las tecnologias de la informacion y la comunicacion (TIC en diversos experimentos de ciencias, muchos de ellos publicados individualmente anteriormente, y que en conjunto se pueden utilizar para implementar un aula-laboratorio de bajo costo. Con TIC hacemos referencia a la convergencia de computadoras, sistemas audiovisuales, Internet, telefonia, y diversos equipos que se integran con algunos de ellos. Los proyectos intentan integrar areas como fisica, matematica, quimica, informatica, arte, etc. y apuntan a que los estudiantes puedan responder a las preguntas: .Como sabemos esto?, .Por que creemos en aquello? Preguntas que ilustran la naturaleza del pensamiento cientifico. Nuestra contribucion mas significativa es haber desarrollado ≪aulas-laboratorios≫ de muy bajo costo, usando TIC. Con el advenimiento de programas como ≪Una Laptop por Nino≫ que se estan implementando en varios paises de Latinoamerica, resulta oportuno utilizar este recurso como base para generar laboratorios de bajo costo, que creemos pueden ser una herramienta util para mejorar el aprendizaje de las ciencias, incentivar vocaciones y contribuir a desarrollar un pensamiento critico, a la par de desarrollar habilidades con el uso de las TIC que pueden ser de utilidad en diversos ambitos academicos y laborales.

Costos y rentabilidad del proceso de producción apícola en México

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Miguel A. Magaña Magaña

2011-01-01

Full Text Available En este estudio se buscó determinar y analizar el nivel y la estructura del costo y la rentabilidad del proceso de producción de la miel de abeja en los siete principales estados productores de México. Se encontró que la estructura de los costos de producción de la miel se compone mayoritariamente por el costo variable (67.1% cuyos principales rubros son la erogación para el pago de mano de obra y compra de insumos alimenticios, mientras que en el caso de los costos fijos (32.9% el principal valor lo constituyó la depreciación en infraestructura (23.3%. Esta composición del costo total tiene relevancia en la administración de la producción apícola nacional, pues las variaciones en los precios hacia la baja afectan en forma más sensible a los apicultores cuyo costo fijo medio es menor. Por su parte, la principal causa que puede provocar la variación en el nivel de la rentabilidad de las explotaciones apícolas la representa el nivel del ingreso por la venta de miel, el cual determina el precio que se le paga al productor mexicano, que depende del mercado donde realice la transacción. Finalmente, se encontró que la rentabilidad por colmena en México asciende a 158 pesos y a 305.3 pesos por cada mil pesos invertidos en activos fijos, en tanto que la relación beneficio-costo indica una rentabilidad de 38 centavos por cada peso invertido; esta actividad es rentable porque lo invertido supera la recuperación que se obtendría en pagarés de renta fija.

Diagnostic performance of susceptibility-weighted magnetic resonance imaging for the assessment of sub-coracoacromial spurs causing subacromial impingement syndrome.

Science.gov (United States)

Nörenberg, Dominik; Armbruster, Marco; Bender, Yi-Na; Walter, Thula; Ebersberger, Hans U; Diederichs, Gerd; Hamm, Bernd; Ockert, Ben; Makowski, Marcus R

2017-03-01

To evaluate the potential of susceptibility-weighted-magnetic-resonance-imaging (SWMR) for the detection of sub-coracoacromial spurs in patients with clinically suspected subacromial impingement syndrome (SAIS), compared to standard MR-sequences and radiographs. Forty-four patients with suspected SAIS were included. All patients underwent radiography, standard MRI of the shoulder and SWMR. Radiograph-based identification of sub-coracoacromial spurs served as goldstandard. Radiographs identified twenty-three spurs in twenty-three patients. Twenty-one patients without spur formation served as reference group. Detection rate, sensitivity/specificity and interobserver-agreements were calculated. Linear regression was applied to determine the relationship between size measurements on radiographs and MRI. Detection rates for spurs on standard MRI and SWMR were 47.8 % and 91.3 % compared to radiography (pformation in patients with SAIS and is superior to standard MR-sequences using radiography as goldstandard. • SWMR has the potential to reliably identify sub-coracoacromial spurs without radiation exposure. • SWMR provides comparable detection rates to conventional radiography for sub-coracoacromial spur formation. • SWMR yields higher detection rates compared to standard-MR regarding sub-coracoacromial spur formation. • SWMR can be implemented in routine shoulder MRI protocols.

Evaluation of aorto-iliac disease with Doppler ultrasound and isotope clearance techniques

International Nuclear Information System (INIS)

Appleberg, M.; Lewis, J.D.

1975-01-01

The clearance of 99 mTc from the hamstring muscle compartment of patients with aorto-iliac or iliac disease was examined with the patients at rest and after exercise. The values were compared with those obtained in a group of controls and another group with superficial femoral, or femoropopliteal arterial occlusion. A statistically significant difference in the rate of 99 mTc clearance was found in patients with proximal vascular disease

Sistema de costos en MYPES industriales y de servicios en condiciones de desorganización

OpenAIRE

Gavelán Izaguirre, Jorge Jesús

2014-01-01

En el Perú, existen limitaciones para formular y aplicar un Sistema de Costos convencional, a través del cual se identifique los elementos del costo de producción atribuibles a un lote de productos elaborados o servicios prestados, debido a que en las empresas no se aplica regular y permanente los principios generales de la administración, en particular: Organización y Control, a lo que suma el alto costo de la formalidad laboral y tributaria. Cambiar la mentalidad de los directivos de las MY...

Migration to the pulmonary artery of nine metallic coils placed in the internal iliac vein for treatment of giant rectal varices

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Wataru Yamasaki

2012-07-01

Full Text Available Transcatheter venous embolization with metallic coils is a safe and reliable method for the treatment of pelvic congestion syndrome and pelvic varicocele. While rare, coil migration to the pulmonary arteries is potentially fatal. We report the migration to the pulmonary artery of a cluster of nine metallic microcoils placed in the internal iliac vein to obliterate giant rectal varices. Our patient suffered no severe sequelae. To avoid coil migration to the pulmonary arteries, the coils chosen for placement must take into consideration the characteristics of the target vessels, particularly of larger veins.

Is Internal Iliac Artery Embolization Essential Prior to Endovascular Repair of Aortoiliac Aneurysms?

International Nuclear Information System (INIS)

Bharwani, N.; Raja, J.; Choke, E.; Belli, A. M.; Thompson, M. M.; Morgan, R. A.; Munneke, G.

2008-01-01

Patients who undergo endovascular repair of aorto-iliac aneurysms (EVAR) require internal iliac artery (IIA) embolization (IIAE) to prevent type II endoleaks after extending the endografts into the external iliac artery. However, IIAE may not be possible in some patients due to technical factors or adverse anatomy. The aim of this study was to assess retrospectively whether patients with aorto-iliac aneurysms who fail IIAE have an increase in type II endoleak after EVAR compared with similar patients who undergo successful embolization. We retrospectively analyzed the records of 148 patients who underwent EVAR from December 1997 to June 2005. Sixty-one patients had aorto-iliac aneurysms which required IIAE before EVAR. Fifty patients had successful IIAE and 11 patients had unsuccessful IIAE prior to EVAR. The clinical and imaging follow-up was reviewed before and after EVAR. The endoleak rate of the embolized group was compared with that of the group in whom embolization failed. After a mean follow-up of 19.7 months in the study group and 25 months in the control group, there were no statistically significant differences in outcome measures between the two groups. Specifically, there were no type II endoleaks related to the IIA in patients where IIAE had failed. We conclude that failure to embolize the IIA prior to EVAR should not necessarily preclude patients from treatment. In patients where there is difficulty in achieving coil embolization, it is recommended that EVAR should proceed, as clinical sequelae are unlikely

Costos de producción de árboles de navidad (Cupressus lusitanica MILL. en Costa Rica

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Olman Murillo

2017-01-01

Full Text Available La producción de árboles de navidad es, en Costa Rica, una actividad económica con base en el ciprés (Cupressus lusitanica Mill. desde los años 60. Se elaboró una base de costos exhaustiva del cultivo de árboles de navidad en Costa Rica, a partir de un paquete tecnológico para un ciclo de producción de 2,5 años, que inició con la siembra de 4444 árboles.ha-1 (a 1,5 x 1,5 m y la venta de 3111 (70%. La estructura de costos incluye como costos directos el establecimiento de 200 m de cercas.ha-1 más una estimación del costo de mano de obra que incluye la seguridad social voluntaria. El costo del jornal en el país al II semestre del 2016 se establece en ¢11.273,75 ($20,13 a una tasa de cambio de US $ 1 = C.R. ¢560. El ciclo completo de producción requiere aproximadamente 373 jornales en 3 años, unos a 125 jornales.año-1. El costo total de producción se determinó en ¢6.170.786 ($11.019,3 por hectárea, donde 60,5% corresponde a mano de obra y 39,5% a insumos agrícolas. El costo total de producción por árbol es de ¢1984 ($3,54, mientras que el precio de venta es siempre superior a ¢7500 o 4 veces el costo de producción. La base de datos utilizada fue confiable estadísticamente y realista, a partir de la producción de árboles de navidad en Costa Rica. Se concluyé que toda mejora en el paquete tecnológico se vería reflejada en aumento de los indicadores de productividad y en disminución de costos de producción, para lo cual es vital nutrir y actualizar permanentemente la base de datos.

Bone formation in cranial, mandibular, tibial and iliac bone grafts in rats

DEFF Research Database (Denmark)

Solheim, E; Pinholt, E M; Talsnes, O

1995-01-01

Several studies have suggested that grafts from membranous derived bone (e.g., calvarial grafts) retain their volume better than those from endochondral derived bone (e.g., iliac bone grafts). Increased osteogenesis in grafts of the former type has been offered as the explanation. However, simple...... volume measurements of the recovered grafts do not differentiate between viable and dead bone. We studied fresh syngeneic full-thickness bone grafts from calvaria, mandibula, tibia diaphysis, and iliac bone implanted in the back muscles of young Lewis rats. Bone formation in grafts recovered 3 weeks...... that the anatomical area of harvest is important regarding new bone formation in syngeneic bone grafts. However, the results do not support the contention that better maintenance of volume of calvarial grafts compared with iliac bone grafts is due to enhanced osteogenesis in the former....

Costos de transacción, un hallazgo no tan reciente. Aproximaciones a la teoría de los costos de circulación de Karl Marx

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Germán Valencia

2006-04-01

Full Text Available Los aportes de la escuela neoinstitucionalista son reconocidos hoy como uno de los mayores en el campo económico; esto debido a que en su análisis económico del mercado incluyen una gama de aspectos que son fundamentales en la toma de decisiones de las empresas y los agentes llamado costos de transacción. Lo paradójico es que parte de este “gran hallazgo” ya había sido expuesto un siglo antes por Karl Marx en el segundo tomo de El Capital, Crítica de la Economía Política y aun no ha sido reconocido. La contribución de Marx sobre costos de Circulación es enorme, pues define, clasifica y propone soluciones a dichos costos de una manera rigurosa y novedosa, incluso aventajando a las propuestas actuales; lo extraño es que esta propuesta teórica no ha sido reconocida por ninguno de los economistas que trabajan en el tema

Atomization of Impinging Droplets on Superheated Superhydrophobic Surfaces

Science.gov (United States)

Emerson, Preston; Crockett, Julie; Maynes, Daniel

2017-11-01

Water droplets impinging smooth superheated surfaces may be characterized by dynamic vapor bubbles rising to the surface, popping, and causing a spray of tiny droplets to erupt from the droplet. This spray is called secondary atomization. Here, atomization is quantified experimentally for water droplets impinging superheated superhydrophobic surfaces. Smooth hydrophobic and superhydrophobic surfaces with varying rib and post microstructuring were explored. Each surface was placed on an aluminum heating block, and impingement events were captured with a high speed camera at 3000 fps. For consistency among tests, all events were normalized by the maximum atomization found over a range of temperatures on a smooth hydrophobic surface. An estimate of the level of atomization during an impingement event was created by quantifying the volume of fluid present in the atomization spray. Droplet diameter and Weber number were held constant, and atomization was found for a range of temperatures through the lifetime of the impinging droplet. The Leidenfrost temperature was also determined and defined to be the lowest temperature at which atomization ceases to occur. Both atomization and Leidenfrost temperature increase with decreasing pitch (distance between microstructures).

Evaluation of aorto-iliac disease with Doppler ultrasound and isotope clearance techniques

Energy Technology Data Exchange (ETDEWEB)

Appleberg, M [University of the Witwatersrand, Johannesburg (South Africa). Dept. of Surgery; Lewis, J D

1975-10-04

The clearance of /sup 99/mTc from the hamstring muscle compartment of patients with aorto-iliac or iliac disease was examined with the patients at rest and after exercise. The values were compared with those obtained in a group of controls and another group with superficial femoral, or femoropopliteal arterial occlusion. A statistically significant difference in the rate of /sup 99/mTc clearance was found in patients with proximal vascular disease.

Sistemas de Información de costos para la gestión hospitalaria

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Vilma Vargas González

2009-01-01

Full Text Available El presente trabajo pretende exponer aspectos fundamentales para el desarrollo de sistemas de información de costos para la gestión hospitalaria. Sistemas de información de costos, útiles en la toma de decisiones para la gestión hospitalaria, y cónsonos con los objetivos sociales que persiguen los hospitales, implica que el conocimiento de información de costos no tiene como objetivo la búsqueda de rentabilidad económica, sino optimización del uso de los recursos desde el punto de vista social. En la elaboración del estudio, se realizó un análisis teórico-bibliográfico, articulación de la teoría con la evidencia empírica y revisión del marco legal. Se concluye sobre la necesidad de fortalecer el cálculo y desarrollo de indicadores y sistemas de información de costos con personal capacitado para su implementación, asegurando la confiabilidad, pertinencia y oportunidad de los resultados generados por dichos sistemas, y su uso efectivo para la gestión hospitalaria.

Calculations of slurry pump jet impingement loads

International Nuclear Information System (INIS)

Wu, T.T.

1996-01-01

This paper presents a methodology to calculate the impingement load in the region of a submerged turbulent jet where a potential core exits and the jet is not fully developed. The profile of the jet flow velocities is represented by a piece-wise linear function which satisfies the conservation of momentum flux of the jet flow. The adequacy of the of the predicted jet expansion is further verified by considering the continuity of the jet flow from the region of potential core to the fully developed region. The jet impingement load can be calculated either as a direct impingement force or a drag force using the jet velocity field determined by the methodology presented

Directional Atherectomy in Iliac Stent Failure: Clinical Technique and Histopathologic Correlation

International Nuclear Information System (INIS)

Ettles, Duncan F.; MacDonald, Alastair W.; Burgess, Paul A.; Nicholson, Anthony A.; Dyet, John F.

1998-01-01

Purpose: To assess the feasibility and efficacy of directional atherectomy in the treatment of iliac stent stenosis or occlusion and to evaluate the histologic composition of excised atherectomy specimens. Methods: Directional atherectomy of six occluded and 10 severely stenosed iliac stents was undertaken in 12 patients at a mean interval of 28 months (range 3-69 months) after stent insertion for occlusive aortoiliac disease. In cases of stent occlusion, atherectomy was preceded by low-dose thrombolysis. In all patients stent clearance with return of femoral pulses was achieved within 24 hr and there were no significant complications. All excised specimens were sent for histologic examination. Results: Eleven patients (92%) remain symptom free with unlimited walking distance at a mean follow-up interval of 11.5 months (range 3-31 months) after treatment. Histologic examination revealed typical myointimal hyperplasia at three excision sites, intimal fibrosis at three sites, atheroma at four sites and organized thrombus at six sites. Conclusion: Atherectomy offers an effective treatment in iliac stent occlusion and restenosis with no significant adverse effects. Debulking of these lesions seems to offer a more logical approach than simple balloon angioplasty. Clinical and duplex follow-up confirms satisfactory outcome within the first year but longer-term results are not yet known. The histologic data obtained demonstrate that stent restenosis and occlusion are likely to be multifactorial, and challenge the assumption that myointimal hyperplasia is the sole cause of iliac stent occlusion

Sistema de costos basado en actividades en hoteles cuatro estrellas del estado Mérida, Venezuela

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Marysela Coromoto Morillo Moreno

2017-03-01

Full Text Available Las empresas actualmente demandan sistemas de costos que reporten un mayor detalle en la información generada, con el propósito de orientar la aplicación de estrategias que conduzcan a captar y apropiarse de mayores espacios de mercado, sobre todo cuando la competitividad es elevada; por ello, se formuló un sistema de costos basado en actividades, conocido por sus siglas en inglés como abc (Activity-Based Costing, aplicado a los hoteles de turismo de cuatro estrellas de Mérida, en Venezuela, para el control y reducción de costos en los servicios prestados. A partir de una investigación de carácter exploratorio, con un diseño de campo y con apoyo documental, se halló que el sector hotelero encuentra en el abc una oportunidad para afinar controles sobre los altos y variados costos en los que incurre a partir del conocimiento profundo de actividades consumidas, con sus medidas y frecuencia. De esta manera, se obtiene el costo real de los distintos servicios al vincularlos con las actividades desarrolladas para su obtención; finalmente, se sugiere un conjunto de variables que pudieran fungir como generadoras de valor e indicadoras de eficiencia. Se concluye que el abc representa una herramienta de gestión que orienta las decisiones estratégicas y el control de los costos con la consecuente reducción de los mismos para la maximización de beneficios.

Non-vascularized iliac bone grafting for scaphoid nonunion with avascular necrosis.

Science.gov (United States)

Kim, Jihyeung; Park, Jin Woo; Chung, Jeehyeok; Jeong Bae, Kee; Gong, Hyun Sik; Baek, Goo Hyun

2018-01-01

We present the surgical outcomes of non-vascularized bone grafting taken from the iliac crest in 24 patients with scaphoid nonunion and avascular necrosis. The Fisk-Fernandez technique was used in 11 patients, and cancellous bone grafting was used in 13 patients. Bony union was achieved in 22 of the 24 patients. Non-vascularized iliac bone grafting can be used for the surgical management of scaphoid nonunion with avascular necrosis. Although revascularization of the proximal fragment after surgery was not evaluated, bony union was confirmed in nearly all patients. IV.

Atención médica ambulatoria en México: el costo para los usuarios

OpenAIRE

Arredondo Armando; Nájera Patricia; Leyva René

1999-01-01

Objetivo. Analizar los resultados de la Encuesta Nacional de Salud II (ENSA-II), en lo relativo a los costos del proceso de búsqueda y obtención de la atención médica ambulatoria en diferentes instituciones del sector público y privado. Material y métodos. La informacion se obtuvo a partir de los indicadores de costos de la atención médica que notificó la población de estudio de la ENSA-II. Los costos para el bolsillo del consumidor fueron la variable dependiente, y las independientes, la con...

Kyste hydatique à localisation costo vertébrale

Science.gov (United States)

Marouf, Rachid

2014-01-01

L'hydatidose est une affection parasitaire due à la contamination de l'homme par la forme larvaire de ténia échinococcus granulosus, la forme costo vertébrale est une localisation très rare qui représente 0,18 à 1,21% de l'ensemble des localisations hydatiques. Nous rapportons le cas d'une femme de 32 ans qui présente un kyste hydatique multi vésiculaire à localisation costovertébrale, traité par chirurgie radicale associée à un traitement médical anti parasitaire pour une durée de 6 mois, avec bonne évolution. L'atteinte costo-vertébrale par la maladie hydatique est rare et l’évolution est insidieuse. Malgré un traitement chirurgical radical, la fréquence des récidives rend le pronostic sombre. PMID:25922632

Costo-beneficio en una unidad de cuidados intensivos neonatales

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Rafael Amador Morán

2011-06-01

Full Text Available INTRODUCCIÓN. El Sistema Nacional de Salud de Cuba ha desarrollado un conjunto de reformas encaminadas a lograr una mayor eficiencia en la prestación de servicios, para preservar logros como la efectividad y la accesibilidad. El objetivo de esta investigación fue identificar los costos en la Unidad de Terapia Intensiva Neonatal del Hospital Ginecoobstétrico de Guanabacoa en el período de un año. MÉTODOS. Se realizó un estudio descriptivo prospectivo del período de enero a diciembre del 2009. La muestra quedo constituida por 65 recién nacidos graves y críticos. Las variables independientes estudiadas fueron: antibióticos, inmunomoduladores, fármacos vasoactivos, soluciones para hidratación, yodo, peróxido de hidrógeno, vitaminas y minerales, oxígeno, material desechable, material de oficina y medios diagnósticos. La información recogida se introdujo en una base de datos, y se procesó con el programa Epidat 3.0. RESULTADOS. Existió un costo total de 70 605,83 CU, que representó unos 2 824,23 CUC, con costo total por paciente de 74,32 CUC. El mayor gasto correspondió al uso de materiales desechables, las soluciones para hidratación y los antibióticos.

Modelo del Costo Basado en la Actividad aplicado a consultas por trazadores de enfermedades cardiovasculares

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Marteau Silvia A.

2001-01-01

Full Text Available OBJETIVO: Hacer un análisis de costos, de la atención médica en consultas externas, mediante la metodología del Costo Basado en la Actividad (ABC, por sus siglas en inglés y en relación con eventos trazadores de enfermedades cardiovasculares de origen isquémico en las instituciones del sector público. MATERIAL Y MÉTODOS: El estudio se basó en consultas por enfermedades o eventos trazadores (n=290 y no trazadores (n=1 710, de una muestra de 2 000 consultas de primera vez de un hospital zonal general de agudos (San Roque de Gonnet, de la provincia de Buenos Aires, Argentina, y se realizó de abril a octubre de 1998. El costo se evaluó con la metodología del ABC. RESULTADOS: El mejoramiento de las actividades de atención en el servicio de Clínica Médica conllevaría un ahorro sustancial en los costos indirectos, equivalente a un porcentaje promedio de 7.11 sobre los productos definidos como consultas por hipertensión arterial (HTA, dislipidemia y diabetes. El ahorro total en el costo unitario por producto que se produciría si se eliminaran las actividades mencionadas, estaría en el orden de 11.78% para el producto HTA, de 13.96% para dislipidemia, de 19.05% para diabetes y de 11.45% para las enfermedades no trazadores. Se asignó o se gastó ineficientemente 66.26% de los costos totales indirectos correspondientes al producto dislipidemia y 61.80% de los correspondientes a diabetes. El costo unitario total de las consultas en el servicio de Clínica Médica, según el método tradicional, es de $22.98, valor que en algunos casos está muy por debajo del costo obtenido a partir del método ABC aplicado en este estudio. CONCLUSIONES: Es necesario trabajar en el rediseño del proceso de atención para evaluar las actividades que no agreguen valor al mismo; éstas únicamente generan molestias y demoras al paciente y provocan ineficiencias en el sistema, dado que se asignan recursos a actividades que no optimizan la gestión y, como

Technique, Complication, and Long-Term Outcome for Endovascular Treatment of Iliac Artery Occlusion

International Nuclear Information System (INIS)

Ozkan, Ugur; Oguzkurt, Levent; Tercan, Fahri

2010-01-01

The aim of this study was to report technical details, procedure-related complications, and results of endovascular treatment in chronic iliac artery occlusion. Between 2001 and 2008, endovascular treatments of 127 chronic iliac artery occlusions in 118 patients (8 women and 110 men; mean age, 59 years) were retrospectively reviewed. The study was based on Ad Hoc Committee on Reporting Standards (Society for Vascular Surgery/International Society for Cardiovascular Surgery Standards). All occlusions were treated with stent placement with or without preliminary balloon angioplasty. Kaplan-Meier estimators were used to determine patency rates. Univariate and multivariate analyses were performed to determine variables affecting successful recanalization, major complications, early stent thrombosis (≤30 days), and primary and secondary patency rates. Initial technical success was achieved in 117 (92%) procedures. Successful recanalization was obtained by antegrade approach in 69 of 77 (90%) procedures and by retrograde approach in 52 of 105 (50%) procedures (p < 0.001). Complications were encountered in 28 (24%) patients [minor in 7 patients (6%) and major in 22 patients (19%)]. One death occurred in the operative period secondary to iliac artery rupture. Early stent thrombosis was seen in eight (7%) patients. Presence of critical limb ischemia (p = 0.03), subintimal recanalization (p = 0.03), and major complication (p = 0.02) were the independent predictors of early stent thrombosis on multivariate analysis. Primary and secondary patency rates at 5 years were 63 and 93%, respectively. Presence of critical limb ischemia, TASC type C iliac lesions, combined occlusions of both common and external iliac arteries, and major complications were associated with decreased patency rates on univariate analysis, whereas these factors were not independent predictors of stent patency on multivariate analysis. In conclusion, endovascular treatment of iliac artery occlusion has a

Experimental investigation of submerged single jet impingement using Cu–water nanofluid

International Nuclear Information System (INIS)

Li Qiang; Xuan Yimin; Yu Feng

2012-01-01

Jet impingement cooling is a vital technique for thermal management of electronic devices of high-heat-flux by impinging fluid on a heater surface due to its high local heat transfer rates. In this paper, two types of Cu–water nanofluids (Cu particles with 25 nm diameter or 100 nm) are introduced into submerged single jet impingement cooling system as the working fluid. The heat transfer features of the nanofluids were experimentally investigated. The effects of the nanoparticle concentration, Reynolds number, nozzle-to-plate distance, fluid temperature, and nanoparticle diameter on the heat transfer performances of the jet impingement of nanofluids are discussed. The experimental results show that the suspended nanoparticles remarkably increase the convective heat transfer coefficient of the base fluid. The convective heat transfer coefficient of Cu–water nanofluid with the volume fraction of 3.0% has 52% higher than the pure water. The experiments also revealed that the suspended nanoparticles brought almost no extra addition of pressure drop in both submerged single jet impingement. In addition, by considering the effects of the suspended nanoparticles as well as the condition of impinging jet, a new heat transfer correlation of nanofluids for the submerged single jet impingement has been proposed. - Highlights: ► Cu–water nanofluids are introduced into submerged single jet impingement. ► The affecting parameters on the heat transfer performances of nanofluids are discussed. ► New heat transfer correlation of nanofluid for single jet impingement is proposed.

Percutaneous Iliac Screws for Minimally Invasive Spinal Deformity Surgery

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Michael Y. Wang

2012-01-01

Full Text Available Introduction. Adult spinal deformity (ASD surgeries carry significant morbidity, and this has led many surgeons to apply minimally invasive surgery (MIS techniques to reduce the blood loss, infections, and other peri-operative complications. A spectrum of techniques for MIS correction of ASD has thus evolved, most recently the application of percutaneous iliac screws. Methods. Over an 18 months 10 patients with thoracolumbar scoliosis underwent MIS surgery. The mean age was 73 years (70% females. Patients were treated with multi-level facet osteotomies and interbody fusion using expandable cages followed by percutaneous screw fixation. Percutaneous iliac screws were placed bilaterally using the obturator outlet view to target the ischial body. Results. All patients were successfully instrumented without conversion to an open technique. Mean operative time was 302 minutes and the mean blood loss was 480 cc, with no intraoperative complications. A total of 20 screws were placed successfully as judged by CT scanning to confirm no bony violations. Complications included: two asymptomatic medial breaches at T10 and L5, and one patient requiring delayed epidural hematoma evacuation. Conclusions. Percutaneous iliac screws can be placed safely in patients with ASD. This MIS technique allows for successful caudal anchoring to stress-shield the sacrum and L5-S1 fusion site in long-segment constructs.

Iliac artery myointimal hyperplasia in rabbits submitted to angioplasty and treated with Moringa oleifera.

Science.gov (United States)

Rolim, Jânio Cipriano; Nogueira, Manoel Ricardo Sena; Lima, Paulo Roberto da Silva; Bandeira, Francisco Chavier Vieira; Pordeus, Mizael Armando Abrantes; Castro, Aldemar Araújo; Pitta, Guilherme Benjamin; Diniz, Margareth de Fátima Formiga Melo; Pereira, Adamastor Humberto

2016-02-01

to assess post-angioplasty myointimal hyperplasia in iliac artery of rabbits treated with extract of Moringa oleifera leaves. we conducted a randomized trial in laboratory animals for five weeks of follow-up, developed in the Vivarium of Pharmaceutical Technology Laboratory of the Universidade Federal da Paraíba. We used rabbits from the New Zealand breed, subjected to a hypercholesterolemic diet and angioplasty of the external iliac artery, randomized into two groups: M200 Group (n=10) - rabbits treated with 200mg/kg/day of Moringa oleifera leaves extract orally; SF group (n=10) - rabbits treated with 0.9% saline orally. After five weeks, the animals were euthanized and the iliac arteries prepared for histology. Histological sections were analyzed by digital morphometry. Statistical analysis was performed using the Student's t test. The significance level was 0.05. there was no significant difference in myointimal hyperplasia between M200 and SF groups when comparing the iliac arteries submitted to angioplasty. there was no difference of myointimal hyperplasia between groups treated with saline and Moringa oleifera after angioplasty.

Iliac artery myointimal hyperplasia in rabbits submitted to angioplasty and treated with Moringa oleifera

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Jânio Cipriano Rolim

Full Text Available Objective: to assess post-angioplasty myointimal hyperplasia in iliac artery of rabbits treated with extract of Moringa oleifera leaves. Methods : we conducted a randomized trial in laboratory animals for five weeks of follow-up, developed in the Vivarium of Pharmaceutical Technology Laboratory of the Universidade Federal da Paraíba. We used rabbits from the New Zealand breed, subjected to a hypercholesterolemic diet and angioplasty of the external iliac artery, randomized into two groups: M200 Group (n=10 - rabbits treated with 200mg/kg/day of Moringa oleifera leaves extract orally; SF group (n=10 - rabbits treated with 0.9% saline orally. After five weeks, the animals were euthanized and the iliac arteries prepared for histology. Histological sections were analyzed by digital morphometry. Statistical analysis was performed using the Student's t test. The significance level was 0.05. Results : there was no significant difference in myointimal hyperplasia between M200 and SF groups when comparing the iliac arteries submitted to angioplasty. Conclusion : there was no difference of myointimal hyperplasia between groups treated with saline and Moringa oleifera after angioplasty.

Primary stent placement for recanalization of iliac artery occlusions: Using a self-expanding spiral stent

International Nuclear Information System (INIS)

Kim, Jae-Kyu; Kim, Yun-Hyeon; Chung, Sang-Yeung; Kang, Heoung-Keun

1999-01-01

Purpose: To report the clinical results for recanalizations of an occluded iliac artery by a self-expanding spiral stent.Methods: We attempted to recanalize 36 iliac artery occlusions in 34 patients [33 men, 1 woman, aged 51-75 years (average 61.6 years)]. The average lesion length was 6.92 cm (range 1-14 cm). The patients's chief complaints were intermittent claudication and resting pain. Fontaine classification was assigned before and after the procedure. Technical and clinical success were also analyzed.Results: Forty-five stents were successfully deployed in 34 patients. All 36 lesions (13 in the external iliac artery, 12 in the common iliac artery, and 11 in both) were patently recanalized on angiography. The follow-up period ranged from 6 months to 36 months (mean 11.9 months). Fourteen stents (39%) with incomplete expansion were dilated with a balloon catheter. Good technical (100%) and clinical (94%) results were obtained. The only complication was one hematoma at the puncture site. Reocclusions were noted in two lesions (5%) at 1 week and 15 months, respectively.Conclusion: A self-expanding spiral stent is a safe and effective device for recanalization of an iliac artery occlusion as the primary stent without any previous intervention.

Análisis costo beneficio del Programa de Detección Oportuna del Cáncer Cervicouterino

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HERNÁNDEZ-PEÑA PATRICIA

1997-01-01

Full Text Available Objetivo. Determinar el costo beneficio de la reorganización del Programa de Detección Oportuna del Cáncer Cervicouterino (PDOC mediante intervenciones de garantía de calidad. Material y métodos. Se siguieron tres etapas: a identificación y cuantificación de costos; b identificación y cuantificación de beneficios, y c evaluación económica del costo beneficio. Resultados. El costo unitario de operación por citología -obtención, fijación, el traslado al centro de lectura, su tinción e interpretación y la notificación de resultados- se estimó en USD$ 11.6. En conjunto, las intervenciones en calidad al PDOC elevarían el costo de cada citología en 32.7%. Sin embargo, la nueva organización generaría una razón beneficio/costo de 2 y un beneficio neto de 88 millones de dólares para los próximos cinco años. Conclusiones. La operación del programa propuesto resulta socialmente deseable, siempre y cuando las modificaciones se lleven a cabo, particularmente la capacitación, la notificación personalizada de los casos positivos, el incremento de cobertura, la introducción de mecanismos de control de calidad, el monitoreo contínuo y el tratamiento en mujeres con anormalidades detectadas.

Análisis de costos de las líneas de servicios de Phoenix English Institute”

OpenAIRE

Rivarola, Natanael Kay

2015-01-01

PRESENTACION DEL PROYECTO - 1. Introducción - 2. Metodología - 3. Objetivos del trabajo - 4. Límites y alcance del trabajo - DESARROLLO DEL PROYECTO - Capítulo Nº 1: Marco Teórico del Trabajo. - 1. Contabilidad de Gestión y Contabilidad de Costos - 2. Costos - 2.1. Clasificación de costos - 3. Sistemas de Costeo - 4. Costeo Basado en Actividades - 4.1. Particularidades en PyMEs del sector servicios - 4.2. Pasos de aplicación - 5. Contribución Marginal - 6. Reportes por segmentos. - ...

Complete resection of locally advanced ovarian carcinoma fixed to the pelvic sidewall and involving external and internal iliac vessels.

Science.gov (United States)

Nishikimi, Kyoko; Tate, Shinichi; Matsuoka, Ayumu; Shozu, Makio

2017-08-01

Locally advanced ovarian carcinomas may be fixed to the pelvic sidewall, and although these often involve the internal iliac vessels, they rarely involve the external iliac vessels. Such tumors are mostly considered inoperable. We present a surgical technique for complete resection of locally advanced ovarian carcinoma fixed to the pelvic sidewall and involving external and internal iliac vessels. A 69-year-old woman presented with ovarian carcinoma fixed to the right pelvic sidewall, which involved the right external and internal iliac arteries and veins and the right lower ureter, rectum, and vagina. We cut the external iliac artery and vein at the bifurcation and at the inguinal ligament to resect the external artery and vein. Then, we reconstructed the arterial and venous supplies of the right external artery and vein with grafts. After creating a wide space immediately inside of the sacral plexus to allow the tumor fixed to pelvic sidewall with the internal iliac vessels to move medially, we performed total internal iliac vessel resection. We achieved complete en bloc tumor resection with the right external and internal artery and vein, right ureter, vagina, and rectum adhering to the tumor. There were no intra- or postoperative complications, such as bleeding, graft occlusion, infection, or limb edema. Exfoliation from the sacral plexus and total resection with external and internal iliac vessels enables complete resection of the tumor fixed to the pelvic sidewall. Copyright © 2017 Elsevier Inc. All rights reserved.

Hybrid Endovascular Aortic Aneurysm Repair: Preservation of Pelvic Perfusion with External to Internal Iliac Artery Bypass.

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Mansukhani, Neel A; Havelka, George E; Helenowski, Irene B; Rodriguez, Heron E; Hoel, Andrew W; Eskandari, Mark K

2017-07-01

Diminished pelvic arterial flow as a result of intentional coverage/embolization of internal iliac arteries (IIA) during isolated endovascular common iliac artery aneurysm (CIAA) repair or endovascular repair of abdominal aortic aneurysms (EVAR) may result in symptomatic pelvic ischemia. Although generally well tolerated, in severe cases, pelvic ischemia may manifest as recalcitrant buttock claudication, vasculogenic impotence, or perineal, vesicle, rectal, and/or spinal cord ischemia. Branched graft technology has recently become available; however, many patients are not candidates for endovascular repair with these devices. Therefore, techniques to preserve pelvic arterial flow are needed. We reviewed our outcomes of isolated endovascular CIAA repair or EVAR in conjunction with unilateral external-internal iliac artery bypass. Single-center, retrospective review of 10 consecutive patients who underwent hybrid endovascular abdominal aortic aneurysm (AAA) or CIAA repair with concomitant external-internal iliac artery bypass between 2006 and 2015. Demographics, index procedural details, postoperative symptoms, hospital length of stay (LOS), follow-up imaging, and bypass patency were recorded. The cohort of 10 patients was all men with a mean age of 71 years (range: 56-84). Hybrid repair consisted of contralateral IIA coil embolization followed by EVAR with external iliac artery-internal iliac artery (EIA-IIA) bypass. All EIA-IIA bypasses were performed via a standard lower quadrant retroperitoneal approach with a prosthetic bypass graft. Technical success was 100%, and there were no perioperative deaths. One patient developed transient paraplegia, 1 patient had buttock claudication on the side of his hypogastric embolization contralateral to his iliac bypass, and 1 developed postoperative impotence. 20% of patients sustained long-term complications (buttock claudication and postoperative impotence). Mean LOS was 2.8 days (range: 1-9 days). Postoperative imaging

Primary extraskeletal mesenchymal chondrosarcoma arising from the iliac vein

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Hua Zhang

2017-10-01

Full Text Available The iliac vein is an extremely rare site for mesenchymal chondrosarcoma, and patients with primary extraskeletal mesenchymal chondrosarcoma arising from a vein always suffer a very poor prognosis. We report a case of a 45-year-old female who presented with a 5-month history of left leg edema in 2015. Contrast-enhanced computed tomography showed a large mass in the left iliac vein with scattered calcifications. Wide-margin resection was performed, and histopathologic and immunohistochemical analyses confirmed the presence of intraluminal mesenchymal chondrosarcoma with local invasion out of the vein wall. Due to poor patient compliance, postoperative neoadjuvant chemotherapy and radiotherapy were not started, and a bone scan performed 16 weeks postoperatively showed multiple bone metastases. The patient died on the twenty-fourth postoperative week.

Four-jet impingement: Noise characteristics and simplified acoustic model

International Nuclear Information System (INIS)

Brehm, C.; Housman, J.A.; Kiris, C.C.; Barad, M.F.; Hutcheson, F.V.

2017-01-01

Highlights: • Large eddy simulation of unique four jet impingement configuration. • Characterization of flow features using POD, FFT, and wavelet decomposition. • Noise source identification utilizing causality method. • Development of simplified acoustic model utilizing equivalent source method. • Comparison with experimental data from BENS experiment. - Abstract: The noise generation mechanisms for four directly impinging supersonic jets are investigated employing implicit large eddy simulations with a higher-order weighted essentially non-oscillatory scheme. Although these types of impinging jet configurations have been used in many experiments, a detailed investigation of the noise generation mechanisms has not been conducted before. The flow field is highly complex and contains a wide range of temporal and spatial scales relevant for noise generation. Proper orthogonal decomposition is utilized to characterize the unsteady nature of the flow field involving unsteady shock oscillations, large coherent turbulent flow structures, and the sporadic appearance of vortical flow structures in the center of the four-jet impingement region. The causality method based on Lighthills acoustic analogy is applied to link fluctuations of flow quantities inside the source region to the acoustic pressure in the far field. It will be demonstrated that the entropy fluctuation term plays a vital role in the noise generation process. Consequently, the understanding of the noise generation mechanisms is employed to develop a simplified acoustic model of the four-jet impingement device by utilizing the equivalent source method. Finally, three linear acoustic four-jet impingement models of the four-jet impingement device are used as broadband noise sources inside an engine nacelle and the acoustic scattering results are validated against far-field acoustic experimental data.

Lower limb biomechanics in femoroacetabular impingement syndrome: a systematic review and meta-analysis.

Science.gov (United States)

King, Matthew G; Lawrenson, Peter R; Semciw, Adam I; Middleton, Kane J; Crossley, Kay M

2018-05-01

(1) Identify differences in hip and pelvic biomechanics in patients with femoroacetabular impingement syndrome (FAIS) compared with controls during everyday activities (eg, walking, squatting); and (2) evaluate the effects of interventions on hip and pelvic biomechanics during everyday activities. Systematic review. Medline, CINAHL, EMBASE, Scopus and SPORTDiscus until February 2017. Primary aim: studies that investigated hip or pelvic kinematics and/or joint torques of everyday activities in patients with FAIS compared with the asymptomatic contralateral limb or a control group. Secondary aim: studies that evaluated effects of conservative or surgical interventions on patients with FAIS using pre-post or controlled clinical trial designs. Biomechanical data must have been collected using three-dimensional motion capture devices. Reporting quality was assessed using the Epidemiological Appraisal Instrument and data were pooled (standardised mean difference (SMD), 95% CI) where populations and primary outcomes were similar. Fourteen studies were included (11 cross-sectional and three pre/post intervention), varying between low and moderate reporting quality. Patients with FAIS walked with a lower: peak hip extension angle (SMD -0.40, 95% CI -0.71 to -0.09), peak internal rotation angle (-0.67, 95% CI -1.19 to -0.16) and external rotation joint torque (-0.71, 95% CI -1.07 to -0.35), and squatted to a lesser depth with no difference in hip flexion range. Pre/post intervention data were limited in number and quality, and to surgical cohorts. This review suggests that patients with FAIS may demonstrate hip biomechanical impairments during walking and squatting, with minimal literature available to comment on other tasks. The information presented in the review provides insight into the biomechanical differences associated with FAIS; however, the between-group differences were small to moderate. This information may aid in the development of management strategies for

del análisis de costo de servir

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Christopher Mejía-Argueta

2015-01-01

Full Text Available El objetivo de esta investigación es generar esquemas logísticos y comerciales rentables, para lo cual seconstruye una metodología que mide el costo de servir y se determina la rentabilidad a partir de losestados financieros, que va de lo general a lo específico, permitiendo cerrar las brechas identificadas enel análisis de costo de servir para mercados emergentes. La metodología consta de 3 fases y 12 pasos quealinean la estrategia, alcance, procesos y costeo de actividades con la segmentación de cuentas rentables,marginales y no rentables, para generar mayor rentabilidad. Como resultado se construyen herramientasque permiten priorizar a los clientes, así como definir la estrategia logística y comercial ideal para losobjetos de estudio (cliente, producto, etc..© 2015 Universidad ICESI. Publicado por Elsevier España, S.L.U. Este es un artículo Open Access bajo lalicencia CC BY (http://creativecommons.org/licenses/by/4.0/.

The establishment of bilateral external iliac artery stenosis model in experimental canines and its angiographic evaluation

International Nuclear Information System (INIS)

Xia Yonghui; Li Weixiao; Bi Yonghua; Xu Ke

2011-01-01

Objective: To establish an experimental canine model of bilateral external iliac artery stenosis by surgical method with absorbable suture. Methods: Under general anesthesia bilateral external iliac arteries were partly obstructed (about 50%) with absorbable suture in ten dogs. Three months later angiography was performed to evaluate the arterial stricture degree. Results: Bilateral external iliac artery stenosis model was successfully established in eight dogs and the other two dogs died within two weeks after the procedure. Angiography performed three months after the procedure showed that the stricture degree of arterial lumen was (60.6±12.5)%. Conclusion: Satisfactory experimental canine model of bilateral external iliac artery stenosis can be established by surgical method with absorbable suture. This method can be used for reference when peripheral artery stenosis model is to be prepared in larger animals. (authors)

Supersonic impinging jet noise reduction using a hybrid control technique

Science.gov (United States)

Wiley, Alex; Kumar, Rajan

2015-07-01

Control of the highly resonant flowfield associated with supersonic impinging jet has been experimentally investigated. Measurements were made in the supersonic impinging jet facility at the Florida State University for a Mach 1.5 ideally expanded jet. Measurements included unsteady pressures on a surface plate near the nozzle exit, acoustics in the nearfield and beneath the impingement plane, and velocity field using particle image velocimetry. Both passive control using porous surface and active control with high momentum microjet injection are effective in reducing nearfield noise and flow unsteadiness over a range of geometrical parameters; however, the type of noise reduction achieved by the two techniques is different. The passive control reduces broadband noise whereas microjet injection attenuates high amplitude impinging tones. The hybrid control, a combination of two control methods, reduces both broadband and high amplitude impinging tones and surprisingly its effectiveness is more that the additive effect of the two control techniques. The flow field measurements show that with hybrid control the impinging jet is stabilized and the turbulence quantities such as streamwise turbulence intensity, transverse turbulence intensity and turbulent shear stress are significantly reduced.

Investigation of impingement attack mechanism of copper alloy condenser tubes

Energy Technology Data Exchange (ETDEWEB)

Fukumura, Takuya; Nakajima, Nobuo; Arioka, Koji; Totsuka, Nobuo; Nakagawa, Tomokazu [Institute of Nuclear Safety System Inc., Mihama, Fukui (Japan)

2001-09-01

In order to investigate generation and growth mechanisms of impingement attacks of sea water against copper alloy condenser tubes used in condensers of nuclear power plants, we took out condenser tubes from actual condensers, cut them into several pieces and carried out several material tests mainly for impinged spots. In addition water flow inside of a pit was analyzed. From the results of the investigation, it was found that all of impingement attacks were found in the marks left by sessile organisms and none were found in downstream of the marks as frequently proposed so far. At the pits generated inside the marks, iron coating was striped and zinc content was deficient in some cases. Combining these data and the result of flow analysis, we considered the following mechanism of the impingement attacks: sessile organisms clinging to the surface of the condenser tube and growth, occlusion of the tube, extinction and decomposition of sessile organisms, pollution corrosion under the organisms and cavity formation, occlusion removal by the cleaning, generation of impingement attacks by flow collision inside the cavity, growth of the impingement attacks. (author)

Intravascular ultrasound for iliac artery imaging. Clinical review

DEFF Research Database (Denmark)

Vogt, K G; Schroeder, T V

2001-01-01

IVUS is able to produce trans-sectional images of the iliac arteries at a high resolution. The three layered appearance of the arterial wall can be visualized. In the atherosclerotic diseased artery calcified plaques can be discerned from non-calcified plaques, and the distribution of the plaque...

Cryoplasty for Canine Iliac Artery Stenosis and its Impact on Expression of TIMP-2 and MMP-2.

Science.gov (United States)

Wu, Zhengzhong; Zang, Shengbing; Liu, Wenwen; Jiang, Na; Yang, Weizhu

2015-01-01

This study was performed to observe the effects of cryoplasty on canine iliac artery stenosis and the expression of tissue inhibition of matrix metalloproteinase 2 (TIMP-2) and matrix metalloproteinase 2 (MMP-2). We produced a reliable canine model to mimic the atherosclerotic stenosis in the iliac artery by suturing the artery followed by vessel ligation to create an injury to intimal and medial walls. Sixteen mongrel dogs with iliac artery stenosis were randomized to conventional balloon angioplasty (n = 8) or cryoplasty (n = 8). Four weeks posttreatment, the cryoplasty group with less collagen fibers and smooth muscle demonstrated significantly larger luminal diameter of iliac artery compared to the balloon angioplasty group (P < .001). Expression of TIMP-2 significantly increased and expression of MMP-2 significantly reduced in iliac artery of the cryoplasty group compared to conventional balloon angioplasty. Our study suggests cryoplasty might increase the expression of TIMP-2 and decrease the expression of MMP-2, thereby inhibiting vascular hyperplasia and collagen fibers synthesis of the stenotic vessels. © The Author(s) 2015.

Subperiosteal hematoma of the iliac bone: imaging features of acute and chronic stages with emphasis on pathophysiology

Energy Technology Data Exchange (ETDEWEB)

Guillin, Raphael [Rennes University Hospital, Department of Musculoskeletal Imaging, Rennes Cedex 2 (France); Moser, Thomas [Montreal University Hospital, Department of Musculoskeletal Imaging, Montreal (Canada); Koob, Meriam [Strasbourg University Hospital, Department of Pediatric Imaging, Strasbourg (France); Khoury, Viviane [Mc Gill University Health center, Department of Radiology, Montreal (Canada); Chapuis, Madeleine [Rennes University Hospital, Department of Pediatric Orthopedic Surgery, Rennes (France); Ropars, Mickael [Rennes University Hospital, Department of orthopedic surgery, Rennes (France); Cardinal, Etienne [Radiologie Laennec, Montreal (Canada)

2012-06-15

The goal of this work is to describe the radiological appearance and clinical presentation of subperiosteal iliac hematoma and present a review of the literature. We retrospectively reviewed the radiological and clinical files of 19 patients (age range: 12-75; mean: 47) who presented with acute or chronic subperiosteal iliac hematomas. Imaging findings and relevant clinical information were recorded. A thorough literature search was performed to find additional cases of this rare condition. Three young patients presented with acute subperiosteal iliac hematoma following a fall. Clinical presentation was characterized by pain and gait disturbance presumed to result from crural nerve compression. Unilateral or bilateral lenticular hematomas deep in the iliacus muscle were demonstrated by CT for all patients while MRI was also available for two of them. In 16 asymptomatic patients, chronic ossified subperiosteal iliac hematomas were incidentally detected by CT. Progressive ossification of acute hematoma was demonstrated at follow-up in two patients. Subperiosteal iliac hematoma is rare but has typical imaging findings that may present acutely in adolescents or chronically in asymptomatic adults. (orig.)

Contabilidad de costos ambientales en la industria cárnica, recomendaciones para su desarrollo

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Yunier Maresma-Hernández

2016-01-01

Full Text Available La contabilidad ambiental ha logrado darle un matiz económico y financiero al uso, cuidado y conservación del medio ambiente, convirtiéndose esta, en una valiosa herramienta para la toma de decisiones, generando beneficios tanto para las organizaciones como para el medio natural. Es por tal razón que se enfoca este trabajo al estudio de los sistemas de costos empleados por la industria cárnica; tomando como estudio de caso la Empresa Cárnica Holguín. Para la realización de la investigación se utilizaron los métodos revisión de documentos, estudio de casos, análisis y síntesis, entrevistas a especialistas contables donde se pudo esclarecer aspectos descritos en el manual de costo. Se realizó un examen a los sistemas de costos empleados y los procedimientos contables que se aplican para la distribución de los gastos y como resultado de esta investigación se dan sugerencias para la implementación de un sistema de costos ambientales en esta entidad.

Productividad total de factores y reducción de costos en la industria manufacturera mexicana, 1994–-1999

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Armando Nevárez Sida

2004-01-01

Full Text Available El presente trabajo analiza la productividad total de factores en la industria manufacturera mexicana en el periodo de 1994 a 1999. El cambio experimentado por esta variable es interpretado como reducción o incremento real de costos de acuerdo con la metodología propuesta por Harberger (1998. Se logró la identificación de aquellos subsectores y clases industriales que redujeron o aumentaron costos, así como la magnitud de estos cambios en términos monetarios. Las clases industriales que presentan una reducción de costos significativa al interior de un subsector son generalmente pocas, mientras que el resto presenta pequeñas reducciones de costos o incrementos.

Costo económico de la discapacidad causada por lesiones de tránsito en México durante 2012

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Patricia G. Sánchez-Vallejo

2015-04-01

Full Text Available Para estimar el costo económico de la discapacidad permanente causada por lesiones de tránsito en México durante 2012, desde las perspectivas del Sistema de Salud y de la Sociedad, se realizó un estudio de costos que utiliza metodología bottom-up, considerando costos directos médicos (hospitalización, consultas ambulatorias y de rehabilitación y prótesis, y costos indirectos (pérdida de productividad del lesionado y cuidador con una aproximación de capital humano. La discapacidad causada por lesiones de tránsito tiene un alto costo para el sistema de salud y la sociedad mexicana. Desde la perspectiva del sistema de salud, el costo en pesos mexicanos de la discapacidad permanente fue de US$269.529.480,72, equivalente a US$1.496,33 por persona. Desde la perspectiva de la sociedad, se estimaron US$3.445,45 durante el primer año. En promedio, se estimó un costo total de US$4.941,77 por persona, resultando en un total de US$1.119.761.632,53 en 2012. Los resultados de este estudio evidencian la necesidad de diseñar e implementar políticas más enérgicas y eficientes para el control de las lesiones de tránsito en México

Inter- and intrarater reliability of goniometry and hand held dynamometry for patients with subacromial impingement syndrome.

Science.gov (United States)

Fieseler, Georg; Laudner, Kevin G; Irlenbusch, Lars; Meyer, Henrike; Schulze, Stephan; Delank, Karl-Stefan; Hermassi, Souhail; Bartels, Thomas; Schwesig, René

2017-12-01

The purpose of this study was to examine the intra- and interrater reliability of measuring shoulder range of motion (ROM) and strength among patients diagnosed with subacromial impingement syndrome (SAIS). Twenty-five patients (14 female patients; mean age, 60.4± 7.84 years) diagnosed with SAIS were assessed to determine the intrarater reliability for glenohumeral ROM. Twenty-five patients (16 female patients; mean age, 60.4± 7.80 years) and 76 asymptomatic volunteers (52 female volunteers; mean age, 29.4± 14.1 years) were assessed for interrater reliability. Dependent variables were active shoulder ROM and isometric strength. Intrarater reliability was fair-to-excellent for the SAIS patients (intraclass correlation coefficient [ICC], 0.52-0.97; standard error of measurement [SEM], 4.4°-9.9° N; coefficient of variation [CV], 7.1%-44.9%). Based on the ICC, 11 of 12 parameters (92%) displayed an excellent reliability (ICC> 0.75). The interrater reliability showed fair-to-excellent results (SAIS patients: ICC, 0.13-0.98; SEM, 2.3°-8.8°; CV, 3.6%-37.0%; controls: ICC, 0.11-0.96; SEM, 3.0°-35.4°; CV, 5.6%-26.4%). In accordance with the intrarater reliability, glenohumeral adduction ROM was the only parameter with an ICC below 0.75 for both samples. Painful shoulder ROM in the SAIS patients showed no influence on the quality of reliability for measurement. Therefore, these protocols should be considered reliable assessment techniques in the prevention, diagnosis, and treatment of painful shoulder conditions such as SAIS.

Incidence of greater trochanteric pain syndrome in patients suspected for femoroacetabular impingement evaluated using magnetic resonance arthrography of the hip.

Science.gov (United States)

Pozzi, Grazia; Lanza, Ezio; Parra, Cleber Garcia; Merli, Ilaria; Sconfienza, Luca Maria; Zerbi, Alberto

2017-03-01

We evaluated the incidence of greater trochanter pain syndrome (GTPS) in patients who underwent magnetic resonance arthrography (MRA) of the hip for a suspected femoroacetabular impingement (FAI) syndrome. Hip MRA performed at our institution (3/2012-1/2014) were reviewed. The absence/presence of FAI (cam, pincer, and mixed) was noted. GTPS diagnosis was based on gluteus medius/minimus tendinopathy/tears, trochanteric bursitis, fascia lata thickening, and trochanter bone oedema/erosion. Subgroup analysis for age (under/over 40 years) and FAI type (cam, pincer, and mixed) was also performed. N = 189 patients were included (n = 125 males; age 39 ± 12 years). FAI was diagnosed in n = 133 (70, 4%): cam type, n = 85 (63, 9%); pincer type, n = 22 (16, 6%); and mixed type, n = 26 (19, 5%). N = 72 patients (38.1%) had tendinopathy, n = 14 (7.4%) had trochanter erosion, n = 31 (16.4%) had bursitis, n = 4 had bone oedema (2.1%), and n = 3 (1.6%) had fascia lata thickening, resulting in GTPS diagnosis in n = 74 patients (39.2%). The association of normal hip morphology/GTPS was significantly higher (P = 0.023) than that of FAI/GTPS. Under 40 years, GTPS incidence was higher in patients with normal hip and pincer-type FAI (P = 0.028). Over 40 years, no difference between patients with/without FAI (P = 0.119) was seen. GTPS was more frequently observed in patients with normal hip morphology than in patients with FAI, particularly in patients under 40.

El costo de la soberanía monetaria en México

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Carlos Encinas Ferrer

2010-01-01

Full Text Available En el marco de la globalización que estamos viviendo y de la integración económica que la acompaña, las economías emergentes enfrentan un proceso gradual de remonetización al dólar (fenómeno conocido popularmente como "dolarización" durante el cual el porcentaje que los activos y pasivos financieros en dólares o euros alcanzan frente a los nacionales es elevado y creciente. Lo anterior, aunado a la flotación del tipo de cambio de las monedas nacionales, limita cada vez más las posibilidades de establecer una política monetaria soberana. De esta manera, los inconvenientes de tener una moneda propia se vuelven cada vez más evidentes, afectando en forma importante la competitividad de nuestras economías. México, por ejemplo, con una elevada integración comercial y financiera con los Estados Unidos de América y altos coeficientes de dolarización de activos y pasivos, enfrenta limitaciones marcadas en la efectividad de establecer políticas monetarias autónomas que le permitan alcanzar objetivos endógenos de crecimiento económico. En el presente escrito el autor presenta un análisis de los costos que tiene para el país el mantener una unidad monetaria nacional. Los mismos tienen su origen fundamentalmente dos áreas: los costos derivados de la conversión y cambio de monedas y los costos por los diferenciales de tasas de interés asociados al riesgo país. De acuerdo con los cálculos realizados en esta investigación la suma de estos dos tipos de costos alcanzaron en el año 2008 los $414,774.3 millones de pesos, equivalentes al 3.43% del PIB. Finalmente se señala la conveniencia que representaría establecer una unión monetaria con los Estados Unidos de América que permitiera a nuestro país mantener los beneficios del señoreaje y del impuesto inflacionario, eliminando aquellos costos que reducen la competitividad de nuestra economía.

Direct Flame Impingement

Energy Technology Data Exchange (ETDEWEB)

None

2005-09-01

During the DFI process, high velocity flame jets impinge upon the material being heated, creating a high heat transfer rate. As a result, refractory walls and exhaust gases are cooler, which increases thermal efficiency and lowers NOx emissions. Because the jet nozzles are located a few inches from the load, furnace size can be reduced significantly.

Thermal-hydraulic performance of convective boiling jet array impingement

International Nuclear Information System (INIS)

Jenkins, R; De Brún, C; Kempers, R; Lupoi, R; Robinson, A J

2016-01-01

Jet impingement boiling is investigated with regard to heat transfer and pressure drop performance using a novel laser sintered 3D printed jet impingement manifold design. Water was the working fluid at atmospheric pressure with inlet subcooling of 7 o C. The convective boiling performance of the impinging jet system was investigated for a flat copper target surface for 2700≤Re≤5400. The results indicate that the heat transfer performance of the impinging jet is independent of Reynolds number for fully developed boiling. Also, the investigation of nozzle to plate spacing shows that low spacing delays the onset of nucleate boiling causing a superheat overshoot that is not observed with larger gaps. However, no sensitivity to the gap spacing was measured once boiling was fully developed. The assessment of the pressure drop performance showed that the design effectively transfers heat with low pumping power requirements. In particular, owing to the insensitivity of the heat transfer to flow rate during fully developed boiling, the coefficient of performance of jet impingement boiling in the fully developed boiling regime deteriorates with increased flow rate due to the increase in pumping power flux. (paper)

Estrategias para la toma de decisiones sobre costos en un proceso productivo. Toma de decisiones sobre costos en la pesca del atún

Directory of Open Access Journals (Sweden)

Gladys Fernández de H.

2000-01-01

Full Text Available La contabilidad de costos ha adquirido un papel fundamental dentro de las organizaciones modernas, considerándose una herramienta valiosa en el control y la toma de decisiones estratégi- cas, utilizando para ello nuevas técnicas, tales como el costeo basado en actividades (ABC y el en- foque de la cadena de valor, a través de los cuales se controlan las actividades desempeñadas en los procesos y se logra el entendimiento del comportamiento de los costos. En este sentido se seleccio- nó el proceso de pesca del atún para identificar las actividades que intervienen en el mismo y dife- renciar aquellas que agregan o no valor al producto. Se tomó como muestra un barco atunero, por el método del muestreo aleatorio al azar simple, para garantizar la representatividad de la misma. El estudio se realizó aplicando técnicas de recolección de información, tales como la entrevista y la ob- servación directa. Con la identificación de actividades se espera que la empresa encargada del pro- ceso de pesca del atún pueda realizar un mejor control de estas y alcanzar un nivel de desempeño por actividad, a la vez que permita la planificación de las mismas. Se determinó además las actividades que no agregan valor, en las cuales se pueden lograr reducciones de costos.

Results of operative treatment of avulsion fractures of the iliac crest apophysis in adolescents.

Science.gov (United States)

Li, Xigong; Xu, Sanzhong; Lin, Xiangjin; Wang, Quan; Pan, Jun

2014-04-01

Avulsion fracture of the iliac crest apophysis is a rare condition that commonly occurs in adolescent athletes. Conservative treatment for this injury can produce excellent functional outcomes. However, the rehabilitation process requires a rather long immobilisation period. This study aimed to evaluate the use of cannulated screws for fixation of avulsion fractures of iliac crest apophysis. Ten patients with avulsion fractures of iliac crest apophysis were treated by open reduction and internal fixation using cannulated screws. The mean age of patients was 14.6 years (range, 13-15 years). The mean intraoperative blood loss was 14.9 ml (range, 10-25 ml). The mean operative time was 40.3 min (range, 33-52 min). The mean follow-up period was 11.2 months (range, 6-20 months). At the 4-week follow-up, all patients returned to previously normal activity without pain and had no evidence of lower extremity muscle weakness. At the final follow-up, all patients resumed their athletic activity without any complications. Open reduction and internal fixation for the treatment of avulsion fracture of iliac crest apophysis can be recommended for patients requiring rapid rehabilitation. Copyright © 2013 Elsevier Ltd. All rights reserved.

Current concepts in the diagnosis and treatment of shoulder impingement

Directory of Open Access Journals (Sweden)

Bijayendra Singh

2017-01-01

Full Text Available Subacromial impingement syndrome (SIS is a very common cause of shoulder pain in the young adults. It can cause debilitating pain, dysfunction, and affects the activities of daily living. It represents a spectrum of pathology ranging from bursitis to rotator cuff tendinopathy which can ultimately lead to degenerative tear of the rotator cuff. Various theories and concepts have been described and it is still a matter of debate. However, most published studies suggest that both extrinsic and intrinsic factors have a role in the development of SIS. The management is controversial as both nonoperative and operative treatments have shown to provide good results. This article aims to provide a comprehensive current concepts review of the pathogenesis, etiologies, clinical diagnosis, appropriate use of investigations, and discussion on the management of SIS.

Aorto-iliac angioplasty

International Nuclear Information System (INIS)

Kotb, M.; Bennett, J.; Kadir, S.

1990-01-01

This paper reports on the results and complications of aortoiliac balloon percutaneous transluminal angioplasty (PTA) and Simpson atherectomy that are compared to determine the role of the latter procedure in the management of aortoiliac disease. In 1984--1988, 92 patients underwent 126 angioplasties of the aortoiliac region. In 1986--1989, 21 patients underwent iliac artery atherectomy. Both groups had similar symptoms, risk factors, and age ranges. The overall technical success rate was 97.6or PTA and 100% for atherectomy. The initial clinical success was 92.8% for PTA and 100% for atherectomy. The 2-year clinical patency rate was 60% for PTA and 64% for artherectomy. Complications requiring surgery occurred in four of 126 (3%) PTA patients and one of 21 (5%) atherectomy patients. Groin hematomas were observed in 16% of PTA patients and 19% of atherectomy patients

Aberrant Ovarian Collateral Originating from External Iliac Artery During Uterine Artery Embolization

Energy Technology Data Exchange (ETDEWEB)

Kwon, Joon Ho; Kim, Man Deuk, E-mail: mdkim@yuhs.ac; Lee, Kwang-hun; Lee, Myungsu; Lee, Mu Sook; Won, Jong Yun; Park, Sung Il; Lee, Do Yun [Yonsei University College of Medicine, Department of Radiology, Research Institute of Radiological Science, Severance Hospital (Korea, Republic of)

2013-02-15

We report a case of a 35-year-old woman who underwent uterine artery embolization (UAE) for symptomatic multiple uterine fibroids with collateral aberrant right ovarian artery that originated from the right external iliac artery. We believe that this is the first reported case in the literature of this collateral uterine flow by the right ovarian artery originated from the right external iliac artery. We briefly present the details of the case and review the literature on variations of ovarian artery origin that might be encountered during UAE.

Aberrant Ovarian Collateral Originating from External Iliac Artery During Uterine Artery Embolization

International Nuclear Information System (INIS)

Kwon, Joon Ho; Kim, Man Deuk; Lee, Kwang-hun; Lee, Myungsu; Lee, Mu Sook; Won, Jong Yun; Park, Sung Il; Lee, Do Yun

2013-01-01

We report a case of a 35-year-old woman who underwent uterine artery embolization (UAE) for symptomatic multiple uterine fibroids with collateral aberrant right ovarian artery that originated from the right external iliac artery. We believe that this is the first reported case in the literature of this collateral uterine flow by the right ovarian artery originated from the right external iliac artery. We briefly present the details of the case and review the literature on variations of ovarian artery origin that might be encountered during UAE.

Costos de los servicios prestados por los hoteles tres estrellas del municipio Libertador del estado Mérida

Directory of Open Access Journals (Sweden)

Marysela Coromoto Morillo Moreno

2014-01-01

Full Text Available A objeto de describir el proceso de determinación de costos de los servicios prestados por los hoteles turísticos de tres estrellas del municipio Libertador del estado Mérida, de cara a la optimización de dicho proceso, se diseñó una investigación no experimental, en la cual se recolectaron datos a través de un guión de observación y la aplicación de una encuesta a los gerentes y administradores de dichos establecimientos. Los resultados indican que los hoteles ofrecen diversas opciones de alojamiento, además de diversos servicios (restaurantes, salones para eventos y lavanderías, los cuales poseen tarifas separadas. Por otra parte, el 72% de los hoteles tres estrellas del municipio mencionado calculan el costo total de todos los servicios que prestan, lo cual evidencia la existencia de un sistema de acumulación de costos inadecuado que imposibilita la disposición de información exacta y precisa acerca del costo de cada uno de los servicios prestados, lo que a su vez limita la toma de decisiones y la correcta operatividad empresarial. En este sentido, se sugiere la identificación de los objetos de costos en centros funcionales y operativos, así como métodos de asignación para el cálculo del costo de cada servicio

Impacto de la enfermedad cardiovascular en los costos de hospitalización de pacientes con artritis reumatoidea.

Directory of Open Access Journals (Sweden)

Ricardo Pineda-Tamayo

2004-12-01

Full Text Available El objetivo del presente estudio fue analizar las causas y los costos directos de hospitalización de pacientes con artritis reumatoidea, establecer la morbilidad asociada y evaluar su impacto sobre los costos de la hospitalización. Para tal fin, se revisaron las historias clínicas y los registros del Departamento de Estadística y Contabilidad de todos los pacientes con artritis reumatoidea admitidos a la Clínica Universitaria Bolivariana en Medellín, en el periodo comprendido entre enero de 1999 y junio de 2003. Se hospitalizaron 41 pacientes en 62 oportunidades (0,34 hospitalizaciones por paciente por año. La principal causa de hospitalización fue la actividad de la enfermedad (60%, seguida de cirugía (18% e infección (10%. En 30 casos hospitalizados (48,4% se observó, al menos, una morbilidad asociada; la más frecuente fue la enfermedad cardiovascular (32%. El promedio de estancia fue de 5±6 días. El promedio de los costos totales fue de US$1.277, y el costo promedio del día de hospitalización fue de US$235. Los medicamentos representaron el 54% de los costos totales, mientras que los de asistencia médica representaron apenas el 3%. La enfermedad cardiovascular fue el determinante más importante de altos costos de hospitalización (p

Formulación de Funciones de Costo de Incertidumbre en Pequeñas Centrales Hidroeléctricas dentro de una Microgrid

Directory of Open Access Journals (Sweden)

Ferney Sadid Molina Sanchez

2017-02-01

Full Text Available El presente artículo propone extender el concepto de costo de incertidumbre en la operación de sistemas de energía que contienen fuentes renovables (solar y eólica a sistemas de potencia con penetración de pequeñas centrales hidroeléctricas (PCHs. La extensión propuesta se logra obtener conociendo la probabilidad de distribución del caudal donde está la PCH. Para ello, se presenta el desarrollo analítico de los costos de incertidumbre en pequeñas centrales hidroeléctricas, obteniendo la probabilidad de potencia inyectada por la central y desarrollando la formulación matemática de los costos por subestimar y sobreestimar la potencia disponible. Adicionalmente, se presenta la validación de la formulación analítica a través de simulaciones de Monte Carlo, comprobando que en los dos casos (costo de incertidumbre con la formula analítica y valor esperado de la simulación de Monte Carlo se llega al mismo costo de incertidumbre. Adicionalmente, se presentan los códigos que calculan el costo esperado mediante la formulación analítica obtenida y el costo esperado mediante el valor medio de los costos de la simulación de Monte Carlo.

Gerencia basada en valor: la inclusión del costo financiero como un costo de oportunidad.

OpenAIRE

Vera C., Mary A.

2007-01-01

SUMARIO Editorial. Chacón P., Galia B. Artículos Análisis cuantitativo y mejora de la calidad del costo de capital en las Pequeñas y Medianas Empresas (PYMES). Quantitative analysis and improvement of the quality of the cost of capital in small and medium sized companies. Altuve, José Germán La responsabilidad patronal frente a los infortunios en el trabajo. The supervisor responsibility front to the accidents in the work. Cabeza R., María Alejandra y...

COSTOS TRANSACCIONALES Y CADENA DE ABASTECIMIENTO: Un Asunto de Competitividad

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Andrés Velásquez Contreras

2003-07-01

Full Text Available En este artículo se contemplan tanto aspectos vinculados a la microeconomía y a la gestión empresarial, con el fin de ofrecer una visión renovada de la relación entre entorno y empresa. Por este motivo se estudian, en términos de costos, las relaciones y los efectos de una organización como parte de una cadena de abastecimiento y esta última como parte de un mercado. Los conceptos de cadena de abastecimiento, de logística y de gestión del conocimiento son piedra angular para la construcción de un nuevo enfoque de interpretación de la teoría de los costos de transacción. La cadena de abastecimiento en términos económicos podría estudiarse como un micromercado o como una estructura económica particular dentro de un mercado. La búsqueda de la eficiencia transaccional en las cadenas de abastecimiento ha llevado al concepto de coopetitividad (competencia más cooperación es necesario para comprender por qué las empresas de una cadena de abastecimiento han desarrollo modelos de organización homogéneos que minimizan los costos de transacción, adaptando las organizaciones a la estructura del mercado.

Subintimal stent placement in patients with long segment occlusion of the iliac artery

Energy Technology Data Exchange (ETDEWEB)

Yu, Ho Jung; Kim, Young Hwan; Kim, Si Hyung; Ko, Sung Min; Choi, Jin Soo; Lee, Hyun Jin; Kim, Hyung Tae; Jo, Won Hyun [Dongsan Medical Center, Keimyung University College of Medicine, Daegu (Korea, Republic of); Kim, Yong Joo [Andong General Hospital, Andong (Korea, Republic of)

2008-01-15

We evaluated the technical feasibility and clinical efficacy of subintimal stent placement for long segment occlusion of the iliac artery. From March 2003 to February 2007, subintimal stent placement for long segment occlusion of the iliac artery of 24 limbs in 22 patients was analyzed retrospectively. Endovascular access was performed via the ipsilateral femoral artery in 7 cases, via the contralateral femoral artery in 6 cases, via both femoral arteries in 10 cases and via the brachial artery in one case. The SAFARI (subintimal arterial flossing with antegrade-retrograde intervention) technique using a microcatheter was performed to recannalize iliac artery occlusion in three cases. Medical records were reviewed for the collection of follow-up data. The stent patency rate was analyzed by use of the Kaplan-Meier method. Subintimal stent placement was technically successful in 23 of 24 procedures (95.8%). The mean ankle-brachial index (ABI) increased form 0.26 to 0.82. The Fontaine classification was improved after stent placement in all patients. Major complications occurred in four procedures: three distal embolizations and one arterial rupture. All of the complications were successfully treated by endovascular intervention. The primary stent patency rates at 6-months, 1-, 2-and 3-years were 95%, 88%, 88% and 88%, respectively. Subintimal stent placement is a safe and effective treatment for long segment occlusion of the iliac artery.

Valoración del costo de los recursos propios de las empresas. caso particular: empresas de servicios a la persona en Francia

OpenAIRE

Acuña Rodriguez, Amelia Maria

2014-01-01

El WACC o Coste Medio Ponderado de Capital es la tasa a la que se deben descontar los flujos para evaluar un proyecto o empresa. Para calcular esta tasa es necesario determinar el costo de la deuda y el costo de los recursos propios de la compañía; el costo de la deuda es la tasa actual del mercado que la empresa está pagando por su deuda, sin embargo el costo de los recursos propios podría ser difícil y más complejo de estimar ya que no existe un costo explícito. En este trabajo se prese...

Analysis of impingement impacts on Hudson River fish populations

International Nuclear Information System (INIS)

Barnthouse, L.W.; van Winkle, W.

1988-01-01

Impacts of impingement, expressed as reductions in year-class abundance, were calculated for six Hudson River fish populations. Estimates were made for the 1974 and 1975 year classes of white perch, striped bass, Atlantic tomcod, and American shad, and the 1974 year classes of alewife and blueback herring. The maximum estimated reductions in year-class abundance were less than 5% for all year classes except the 1974 and 1975 white perch year classes and the 1974 striped bass year class. Only for white perch were the estimates greater than 10% per year. For striped bass, the 146,000 fish from the 1974 year class that were killed by impingement could have produced 12,000-16,000 5-year-old fish or 270-300 10-year-olds. Also estimated were the reductions in mortality that could have been achieved had closed-cycle cooling systems been installed at one or more of three power plants (Bowline point, Indian Point, and Roseton) and had the screen-wash systems at Bowline Point and Indian Point been modified to improve the survival of impinged fish. Closed-cycle cooling at all three plants would have reduced impingement impacts on white perch, striped bass, and Atlantic tomcod by 75% or more; installation of closed-cycle cooling at Indian Point alone would have reduced impingement impacts on white perch and Atlantic tomcod by 50%-80%. Modified traveling screens would have been less effective than closed-cycle cooling, but still would have reduced impingement impacts on white perch by roughly 20%. 23 refs., 1 fig., 3 tabs

Trochanteric impingement: is it a source of pain after THR?

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Mark J. Isaacson, DO

2015-09-01

Full Text Available While uncommon, trochanteric-pelvic impingement may lead to significant lateral hip pain. We defined “impingement distance” as the radiographic distance from the medial aspect of the greater trochanter and the corresponding lateral edge of the acetabular bone or component and compared this to the contralateral normal hip. We present two painful total hip replacement (THR cases, each featuring a patient with severe lateral hip pain when walking and sitting. Both patients had diminished femoral offset and trochanteric-pelvic clearance, compared to the contralateral normal hip. The impingement distance was increased an average of 10 mm with the exchange to a longer femoral head. Both patients had immediate and complete pain relief with operative treatment to increase the impingement distance.

Factores que inciden en el costo del servicio de buffet en un hotel citadino

Directory of Open Access Journals (Sweden)

Lourdes Cisneros Mustelier

2011-01-01

Full Text Available El objetivo de nuestro trabajo consiste en determinar los principales factores que inciden en el costo del servicio de buffet en un hotel de cuatro estrellas de ciudad. Para ello, se revisaron los productos alimenticios que tienen mayor incidencia tanto por el costo como por el consumo; se encontró que el rubro de frutas frescas fue el que presentó una alta incidencia tanto en costo y consumo, así como bajo porcentaje de aprovechamiento, por lo que se calculó su rendimiento mediante el uso de la técnica de clasificación abc. Se presentan propuestas de diferentes cortes que se pueden realizar a frutas como la naranja, toronja y piña que inciden de manera positiva en el ahorro económico en este tipo de servicio.

Costos y beneficios del ingreso en el hogar

Directory of Open Access Journals (Sweden)

Nidia Márquez Morales

1998-10-01

Full Text Available Se realizó una investigación descriptiva para estimar los costos y beneficios del ingreso en el hogar. El análisis económico se realizó desde una perspectiva social. Los grupos poblacionales donde más se utilizó la técnica fueron las gestantes y los menores de 1 año. Las enfermedades respiratorias altas y la gestación a término fueron los que más incidencia tuvieron; los medicamentos más utilizados estuvieron en correspondencia con las enfermedades y su disponibilidad. El tiempo hospitalario no se comportó de igual forma en todos los grupos. Los gastos de bolsillo representaron el mayor porcentaje dentro de los costos directos tangibles, ocasionados en su mayoría por alimentación adicional. Los gastos del sector salud fueron superiores a los de familiares y pacientes. Los costos indirectos fueron inferiores a los directos. El estudio demostró que el 88,6% se curó, se complicó el 8,8% y falleció el 2,5%A descriptive research was conducted to estimate the costs and benefits of home admission. The economic analysis was made from a social perspective. This technique was more used among pregnant women and children under 1. Upper respiratory diseases and term gestations had the greatest incidence. The most administered drugs were in correspondence with their availability and the diseases. Hospital stay did not have the same behavior in all groups. Pocket expenses accounted for the highest percentage within the tangible direct costs mainly caused by additional food. Health sector expenditures were higher than those of relatives and patients. Indirect costs were lower than the direct ones. The study showed that 88.6 % got cured, 8.8 % presented complications and 2.5 % died

¿Cómo aplicar la flexibilidad administrativa en las entidades de educación superior mediante el sistema de costos abc?

Directory of Open Access Journals (Sweden)

Dilia Castillo

2005-10-01

Full Text Available El método de Costos Basado en Actividades se ha creado para generar en las organizaciones, estructuras administrativas flexibles mediante la clasificación de las actividades (cadena valor, en centros primarios y de apoyo. Este sistema permite la acumulación de costos en forma directa en cada dependencia responsable de desarrollar tareas que enconjunto originan que una organización ofrezca a sus clientes un producto terminado o un servicio eficiente a un costo real previamente determinado. Las tareas producidas por una causa común son agrupadas en pools, minimizando aquellos factores que no generen valor agregado. Para la implementación de este sistema de costos es necesario llevar a cabo cinco etapas: definición y clasificación de actividades primarias y de apoyo, definición de los inductores de costo, realización del reparto primario y la acumulación de costos en los centros de actividad, realización del reparto secundario en los centros de actividad primarios y presentación de los resultados por cada actividad principal. El sistema de costos ABC, es una alternativa para el manejo de la flexibilidad en la administración de una entidad de educación superior, y supera el problema de la sub. o sobre-aplicación de los costos totales en cada actividad necesaria para la prestación del servicio.

Cumulative occupational shoulder exposures and surgery for subacromial impingement syndrome: a nationwide Danish cohort study.

Science.gov (United States)

Dalbøge, Annett; Frost, Poul; Andersen, Johan Hviid; Svendsen, Susanne Wulff

2014-11-01

The primary aim was to examine exposure-response relationships between cumulative occupational shoulder exposures and surgery for subacromial impingement syndrome (SIS), and to compare sex-specific exposure-response relationships. The secondary aim was to examine the time window of relevant exposures. We conducted a nationwide register study of all persons born in Denmark (1933-1977), who had at least 5 years of full-time employment. In the follow-up period (2003-2008), we identified first-time events of surgery for SIS. Cumulative exposure estimates for a 10-year exposure time window with a 1-year lag time were obtained by linking occupational codes with a job exposure matrix. The exposure estimates were expressed as, for example, arm-elevation-years in accordance with the pack-year concept of tobacco consumption. We used a multivariable logistic regression technique equivalent to discrete survival analysis. The adjusted OR (ORadj) increased to a maximum of 2.1 for arm-elevation-years, repetition-years and force-years, and to 1.5 for hand-arm-vibration-years. Sex-specific exposure-response relationships were similar for men and women, when assessed using a relative risk scale. The ORadj increased gradually with the number of years contributing to the cumulative exposure estimates. The excess fraction was 24%. Cumulative occupational shoulder exposures carried an increase in risk of surgery for SIS with similar exposure-response curves for men and women. The risk of surgery for SIS increased gradually, when the period of exposure assessment was extended. In the general working population, a substantial fraction of all first-time operations for SIS could be related to occupational exposures. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Costo de capital: estudio de la incidencia de las variables determinantes del costo de capital y el consiguiente reflejo en los estados financieros de las Pymes del sector avícola de Bogotá, durante el período 2000-2005

Directory of Open Access Journals (Sweden)

Luís Eduardo Gama Díaz

2007-07-01

Full Text Available En la primera parte del estudio se denota la importancia que, desde el punto de vista financiero, tiene el concepto del costo del uso del capital en la situación de cualquier organización; luego se presenta una breve reseña del sector avícola y su importancia en la economía colombiana, como también, la población y la muestra de las empresas objeto de este estudio. En la segunda, se encuentra la importancia que tiene esta herramienta financiera para el apoyo de la información necesaria al tomar decisiones. En la tercera, se expone el análisis de la información obtenida, se realiza el cálculo del costo de capital para Colombia en el período 1995-2005 y se determina la importancia que cada variable estudiada tiene en dicho costo. En esta parte también se hace el cálculo del costo del capital promedio ponderado para las empresas seleccionadas y la incidencia que este costo tiene en los estados financieros de las empresas estudiadas. Por último, se presentan las conclusiones respectivas y los anexos correspondientes.

Sterno-costo-clavicular hyperostosis

International Nuclear Information System (INIS)

Hallas, J.; Olesen, K.P.

1988-01-01

The clinical and radiologic findings in a case of sterno-costo-clavicular hyperostosis are reported and compared with the findings in the 23 Caucasian and about 300 Japanese cases reported in the literature. The main complaints are pain in the upper anterior chest wall and sometimes limited mobility of the shoulders. Radiologically, the clavicles, the sternum and the first ribs are grossly enlarged with complete fusion between them. As reported in previous cases, our patient had conspicuous congestion of the external jugular veins, but no other signs of compression in the thoracic inlet. There was asymptomatic compression of both subclavian veins, but none of the previously reported skin manifestations and no complaints from other parts of the locomotive system. The patient was HLA-B27 negative. (orig.)

Massive Bleeding from Guidewire Perforation of an External Iliac Artery: Treatment with Hand-made Stent-Graft Placement

Energy Technology Data Exchange (ETDEWEB)

Mehta, Vimal, E-mail: drvimalmehta@yahoo.co.in; Pandit, Bhagya Narayan; Mehra, Pratishtha; Nigam, Arima; Vyas, Aniruddha; Yusuf, Jamal; Mukhopadhyay, Saibal; Trehan, Vijay [G.B. Pant Institute of Postgraduate Medical Education and Research (India)

2016-01-15

We report life-threatening bleeding from an external iliac artery perforation following guidewire manipulation in a patient with atherosclerotic iliac artery disease. This complication was successfully managed by indigenous hand-made stent-graft made from two peripheral stents in the catheterization laboratory.

Massive Bleeding from Guidewire Perforation of an External Iliac Artery: Treatment with Hand-made Stent-Graft Placement

International Nuclear Information System (INIS)

Mehta, Vimal; Pandit, Bhagya Narayan; Mehra, Pratishtha; Nigam, Arima; Vyas, Aniruddha; Yusuf, Jamal; Mukhopadhyay, Saibal; Trehan, Vijay

2016-01-01

We report life-threatening bleeding from an external iliac artery perforation following guidewire manipulation in a patient with atherosclerotic iliac artery disease. This complication was successfully managed by indigenous hand-made stent-graft made from two peripheral stents in the catheterization laboratory

Costos económicos en la producción de servicios de salud: del costo de los insumos al costo de manejo de caso Economic costs for the production of health services: from cost of inputs to cost of case-management

Directory of Open Access Journals (Sweden)

ARMANDO ARREDONDO

1997-03-01

Full Text Available Objetivo. Generar información sobre los costos de producción de servicios de salud. Material y métodos. Siguiendo los criterios de Kessner se seleccionaron como trazadores: hipertensión, diabetes, diarreas y neumonías. Posteriormente, se definió el manejo de casos y, por medio de la metodología de costeo por manejo de caso, se definieron las funciones de producción, así como los insumos y costos unitarios requeridos para satisfacer la demanda de servicios médicos de cada enfermedad. Se procesaron los datos en una hoja de cálculo para identificar los costos de manejo de casos hospitalarios y ambulatorios. Resultados. Los hallazgos indican que a partir del costo de manejo de casos hospitalarios y ambulatorios para cada enfermedad de estudio es posible identificar el peso relativo, tanto de las distintas funciones de producción, como de los diferentes tipos de insumos. Dependiendo de las frecuencias relativas, tanto insumos como funciones de producción se clasificaron en alto, medio y bajo impacto sobre el costo total de manejo de caso. Conclusiones. A partir de la información generada se sugiere replantear los procesos de planeación, organización y asignación de recursos, en función de demandas de servicios hospitalarios y ambulatorios para cada trazador. Asimismo, se sugieren acciones para propiciar ganancias económicas en la utilización de recursos y en el uso más eficiente de los mismos.Objective. To generate information on costs of health services. Material and methods. Using Kessner’s criteria the tracer conditions selected were: hypertension, diabetes, diarrhea and pneumonia. Case-management definitions were established and then, -using the case-management costing method- the production functions, inputs and unit costs necessary to meet the demand for medical care per condition. Data were processed in a spreadsheet software package to estimate in-patient and out-patient case-management costs. Results. Findings from this

Lethal Progressive Thoracic Insufficiency in a Neonate Due to Jarcho Levin Syndrome

Science.gov (United States)

Bhutia, Euden; Maria, Arti; Verma, Arushi; Sethi, Sidharth Kumar

2014-01-01

A rare case of Jarcho Levin syndrome (JLS) presenting as a lethal progressive respiratory insufficiency in early neonatal period is reported. The neonate had classical features of this syndrome including vertebral segmentation defects, typical costo-vertebral fusion defects and scoliosis resulting in small thoracic volume and limited chest expansion; all consistent with a clinical diagnosis of JLS with thoracic insufficiency. In addition, our case had a rare association of dextrocardia and acyanotic congenital heart disease. PMID:24741543

Aorto-iliac occlusive disease in the different population groups ...

African Journals Online (AJOL)

Background. It has previously been accepted that atherosclerotic disease is uncommon among blacks worldv.ride; however, recent studies have increasingly reported atherosclerotic disease in this group. Study design. Prospective study of hospital patients with aorta-iliac occlusive disease presenting to the vascUlar ...

Effectiveness of telerehabilitation programme following surgery in shoulder impingement syndrome (SIS): study protocol for a randomized controlled non-inferiority trial.

Science.gov (United States)

Pastora-Bernal, Jose-Manuel; Martín-Valero, Rocío; Barón-López, Francisco Javier; García-Gómez, Oscar

2017-02-23

Shoulder pain is common in society, with high prevalence in the general population. Shoulder impingement syndrome (SIS) is the most frequent cause. Patients suffer pain, muscle weakness and loss of movement in the affected joint. Initial treatment is predominantly conservative. The surgical option has high success rates and is often used when conservative strategy fails. Traditional physiotherapy and post-operative exercises are needed for the recovery of joint range, muscle strength, stability and functionality. Telerehabilitation programmes have shown positive results in some orthopaedic conditions after surgery. Customized telerehabilitation intervention programmes should be developed to recover shoulder function after SIS surgery. The objective of this study is to evaluate the feasibility and effectiveness of a telerehabilitation intervention compared with usual care in patients after subacromial decompression surgery. We will compare an intervention group receiving videoconferences and a telerehabilitation programme to a control group receiving traditional physiotherapy intervention in a single-blind, randomized controlled non-inferiority trial study design. Through this study, we will further develop our preliminary data set and practical experience with the telerehabilitation programmes to evaluate their effectiveness and compare this with traditional intervention. We will also explore patient satisfaction and cost-effectiveness. Patient enrolment is ongoing. ClinicalTrials.gov, NCT02909920 . 14 September 2016.

Impinging jets - a short review on strategies for heat transfer enhancement

Science.gov (United States)

Nastase, Ilinca; Bode, Florin

2018-02-01

In industrial applications, heat and mass transfer can be considerably increased using impinging jets. A large number of flow phenomena will be generated by the impinging flow, such as: large scale structures, large curvature involving strong shear and normal stresses, stagnation in the wall boundary layers, heat transfer with the impinged wall, small scale turbulent mixing. All these phenomena are highly unsteady and even if nowadays a substantial number of studies in the literature are dedicated, the impinging jets are still not fully understood due to the highly unsteady nature and more over due to great difficulty of performing detailed numerical and experimental investigations.

Aplicación de la Contabilidad de Costos en las Cajas Rurales de Ahorro y Crédito en el Perú, Arequipa - 2013

OpenAIRE

Pacheco Zegarra, Edward Víctor

2017-01-01

El presente trabajo de investigación busca determinar el grado de aplicación de la contabilidad de costos en las Cajas Rurales de Ahorro y Crédito en el Perú. ENUNCIADO “APLICACIÓN DE LA CONTABILIDAD DE COSTOS EN LA CAJAS RURALES DE AHORRO Y CRÉDITO EN EL PERÚ, AREQUIPA – 2013” La variable a investigar fue la aplicación de la contabilidad de costos cuyos indicadores son las generalidades de la aplicación de la contabilidad de costos, objetivos de la contabilidad de costos...

Costing of scaling up HIV/AIDS treatment in Mexico Costos del tratamiento de VIH/SIDA en México

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Sergio Bautista-Arredondo

2008-01-01

Full Text Available OBJECTIVE: To determine the net effect of introducing highly active antiretroviral treatment (HAART in Mexico on total annual per-patient costs for HIV/AIDS care, taking into account potential savings from treatment of opportunistic infections and hospitalizations. MATERIAL AND METHODS: A multi-center, retrospective patient chart review and collection of unit cost data were performed to describe the utilization of services and estimate costs of care for 1003 adult HIV+ patients in the public sector. RESULTS: HAART is not cost-saving and the average annual cost per patient increases after initiation of HAART due to antiretrovirals, accounting for 90% of total costs. Hospitalizations do decrease post-HAART, but not enough to offset the increased cost. CONCLUSIONS: Scaling up access to HAART is feasible in middle income settings. Since antiretrovirals are so costly, optimizing efficiency in procurement and prescribing is paramount. The observed adherence was low, suggesting that a proportion of these high drug costs translated into limited health benefits.OBJETIVO: Determinar el efecto neto de la introducción de la terapia antirretroviral altamente activa (TARAA en México sobre los costos anuales totales por paciente en el tratamiento de VIH/SIDA, tomando en cuenta el posible ahorro en el tratamiento de infecciones oportunistas y hospitalización. MATERIAL Y MÉTODOS: Se hizo un estudio retrospectivo, multicéntrico, mediante la revisión de los expedientes de los pacientes y la recolección de datos de costos unitarios para describir la utilización de los servicios y calcular los costos de la atención de 1 003 pacientes adultos VIH positivos en el sector público. RESULTADOS: La TARAA no ahorra costos y el costo promedio anual por paciente aumenta después de su inicio debido a los antirretrovirales, que representan 90% del costo total. Las hospitalizaciones disminuyen después de iniciada la TARAA, pero no lo suficiente como para compensar el

DISEÑO E IMPLANTACIÓN DE UN PROCEDIMIENTO PARA UN SISTEMA DE COSTOS TOTALES DE LA CALIDAD EN EL CENTRO NACIONAL DE BIOPREPARADOS

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Marielis Armenteros Arencibia

2007-09-01

Full Text Available

Rotational effects on impingement cooling

Science.gov (United States)

Epstein, A. H.; Kerrebrock, J. L.; Koo, J. J.; Preiser, U. Z.

1987-01-01

The present consideration of rotation effects on heat transfer in a radially exhausted, impingement-cooled turbine blade model gives attention to experimental results for Reynolds and Rossby numbers and blade/coolant temperature ratio values that are representative of small gas turbine engines. On the basis of a model that encompasses the effects of Coriolis force and buoyancy on heat transfer, bouyancy is identified as the cause of an average Nusselt number that is 20-30 percent lower than expected from previous nonrotating data. A heuristic model is proposed which predicts that the impingement jets nearest the blade roots should deflect inward, due to a centripetal force generated by their tangential velocity counter to the blade motion. Potentially serious thermal stresses must be anticipated from rotation effects in the course of blade design.

RECONSTRUCTION OF ATROPHIC MAXILLA BY ANTERIOR ILIAC CREST BONE GRAFTING VIA NEUROAXIAL BLOCKADE TECHNIQUE: A CASE REPORT

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Erol CANSIZ

2017-01-01

Full Text Available Anterior iliac crest bone grafting is a well-established modality in the treatment of alveolar bone deficiencies. However, this procedure may also have considerable postoperative morbidity which is mostly related to general anesthesia. Postoperative pain-related complications can be managed by neuroaxial blockade techniques which provide adequate surgical analgesia and reduce postoperative pain. This clinical report describes the reconstruction of a severely atrophic maxilla with anterior iliac crest bone grafting using combined spinal epidural anesthesia. Neuroaxial blockade techniques may be a useful alternative to eliminate general anesthesia related challenges of anterior iliac crest bone grafting procedures.

Costos de producción en el proceso de extracción de aceite de palma: Estudio de un caso

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Rosana Meleán Romero

2014-01-01

Full Text Available El objetivo de esta investigación es analizar los costos de producción del proceso de extracción de aceite de palma, basados en el estudio de una de las empresas que conforman el sector palmicultor, ubicada en el estado Zulia-Venezuela. Se cataloga como analítica-proyectiva, de campo y transeccional; apoyada en material bibliográfico y otros documentos de interés necesarios para construir un instrumento de recolección de información (cuestionario, aplicado a informantes clave de una empresa del sector; se analiza la información recopilada, obteniendo como resultados que los costos se manejan de manera tradicional y dadas las complejidades del proceso que desarrolla la empresa, impide la determinación exacta del costo de los productos que elaboran: aceite rojo, aceite de palmiste y harina de palmiste. En función de ello, se propone una metodología híbrida de costeo que combina características del sistema de acumulación de costos por procesos y del costeo basado en actividades. Se concluye que una vez aplicada la propuesta realizada, la empresa podrá sistematizar sus costos de producción, obtener el costo unitario de los productos elaborados, además de encaminar el diseño de un sistema de información de costos ajustado a sus necesidades

Una revisión a la teoría general del costo

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Amaro Yardin

2002-12-01

Full Text Available El trabajo tiene como objetivo definir qué debe entenderse por una Teoría General del Costo y, en consecuencia, cuál debe ser su contenido. Se comienza por emitir algunas consideraciones sobre el concepto de "Teoría" y, complementariamente, el de "Teoría General del Costo". Se exponen consideraciones sobre la naturaleza y los objetivos de las distintas manifestaciones de la técnica contable, concretadas en la Contabilidad Patrimonial y la Contabilidad de Gestión. La parte medular del trabajo alude al modelo del costeo completo y sus características, examinando si éstas permiten que este criterio pueda ser incluido en una Teoría General del Costo. Se sostiene que el modelo del costeo completo es válido exclusivamente como apoyo a la Contabilidad de Costos, en su carácter de apéndice de la Contabilidad Patrimonial. El aporte concluye con una propuesta de revisión del estado actual de la Teoría General del Costo, sosteniendo que el modelo del costeo completo debe estar fuera del ámbito de la misma, por ser incompatible con sus objetivos.This paper aims to define what should be understood as a General Cost Theory and, consequently, what its contents should be. First, some considerations are made on the concept of "Theory" and, complementarily, the concept of "General Cost Theory". Next, the nature and objectives of the different manifestations of accounting are considered, which are concretized in Financial and Management Accounting. The central part of the article deals with the full cost method and its characteristics, examining if these allow for the inclusion of this criterion in a General Cost Theory. It is asserted that the full cost model is only valid when functioning in support to Cost Accounting, as an appendix of Financial Accounting. Finally, a review of the current state of General Cost Theory is proposed, asserting that the full cost method should not be included in its field, since it is not compatible with the

Diseño e implementación de un sistema de costos por ordenes de producción

OpenAIRE

Martínez Hernández, Luis Alfredo

2009-01-01

Prontarepa E.U es una empresa líder en el mercado del Valle y durante el último año sus competidores han aumentado notablemente, ofreciendo productos innovadores a un precio mas bajo. Ante la inminente amenaza la empresa fija su mirada al control y manejo de los costos como elemento directamente relacionado con el concepto de productividad y rentabilidad, en la medida que los costos son una parte fundamental en la generación de utilidad de la empresa. Al diagnosticar el sistema de costos de P...

Kikuchi Disease Presented with External Iliac Lymphadenitis in a 7-year-old Girl: A Case Report

International Nuclear Information System (INIS)

Kim, Young Tong; Yoo, Kyung Hee; Cho, Hyun Deuk; Oh, Mee Hye; Shin, Hyeong Cheol

2010-01-01

Kikuchi disease of the iliac lymph node is rare, and even more rare is lymphadenitis with abdominal pain caused by Kikuchi disease. We report the US and CT findings of Kikuchi disease of the external iliac node in a 7 year-old-girl who complained of fever and abdominal pain in the left lower quadrant

Shear layer characteristics of supersonic free and impinging jets

Science.gov (United States)

Davis, T. B.; Kumar, R.

2015-09-01

The initial shear layer characteristics of a jet play an important role in the initiation and development of instabilities and hence radiated noise. Particle image velocimetry has been utilized to study the initial shear layer development of supersonic free and impinging jets. Microjet control employed to reduce flow unsteadiness and jet noise appears to affect the development of the shear layer, particularly near the nozzle exit. Velocity field measurements near the nozzle exit show that the initially thin, uncontrolled shear layer develops at a constant rate while microjet control is characterized by a rapid nonlinear thickening that asymptotes downstream. The shear layer linear growth rate with microjet control, in both the free and the impinging jet, is diminished. In addition, the thickened shear layer with control leads to a reduction in azimuthal vorticity for both free and impinging jets. Linear stability theory is used to compute unstable growth rates and convection velocities of the resultant velocity profiles. The results show that while the convection velocity is largely unaffected, the unstable growth rates are significantly reduced over all frequencies with microjet injection. For the case of the impinging jet, microjet control leads to near elimination of the impingement tones and an appreciable reduction in broadband levels. Similarly, for the free jet, significant reduction in overall sound pressure levels in the peak radiation direction is observed.

Análisis de costos médicos y resultados de la cirugía coronaria sin circulación extracorpórea

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Raúl A. Borracci

2006-01-01

Full Text Available Antecedentes Algunos estudios han sugerido que la cirugía coronaria “sin bomba” disminuiría la morbimortalidad posoperatoria y reduciría los costos al compararlos con la cirugía tradicional. Una característica regional importante para la Argentina es el alto costo de los insumos, en su mayoría importados, y el relativo bajo costo de internación, lo cual crea condiciones locales diferentes al pretender comparar la relación costo-efectividad de la cirugía sin circulación extracorpórea (CEC. Objetivos Realizar una evaluación de los costos médicos y los resultados de la cirugía coronaria sin CEC en comparación con la técnica tradicional y estimar a la vez su relación costo-eficacia. Material y métodos El análisis retrospectivo de costos se realizó a partir de una serie de 200 cirugías coronarias con CEC y sin CEC, efectuadas entre 2004 y 2005. Se empleó la técnica de microcosteo directo para determinar los costos de quirófano y se extrapoló el valor día/cama de la internación, de acuerdo con los datos suministrados por el prestador, para el caso de cirugías sin complicaciones (caso base. La influencia de las complicaciones en el costo final se estimó en forma indirecta mediante el uso de las tasas de complicaciones publicadas en ensayos clínicos controlados y su correspondiente costo incremental por evento, según modelos probabilísticos publicados previamente. Por tratarse de un modelo parcialmente estocástico, se informan sólo los costos netos con uno y otro procedimiento, a fin de obtener la diferencia o beneficio neto entre el uso de cirugía con CEC y sin CEC. Finalmente, se realizó un análisis de sensibilidad de costos por medio de una simulación dinámica computarizada (parámetros predictores: número de usos del estabilizador y tasa de uso de cirugía sin CEC. Resultados En una cirugía coronaria que evoluciona sin complicaciones, el costo se halló entre $9.340 y $12.540 (mediana = $10.750 para el

Proposal for a new classification of variations in the iliac venous system based on internal iliac veins: a case series and a review of double and left inferior vena cava.

Science.gov (United States)

Hayashi, Shogo; Naito, Munekazu; Hirai, Shuichi; Terayama, Hayato; Miyaki, Takayoshi; Itoh, Masahiro; Fukuzawa, Yoshitaka; Nakano, Takashi

2013-09-01

There are many reports on variations in the inferior vena cava (IVC), particularly double IVC (DIVC) and left IVC (LIVC). However, no systematic report has recorded iliac vein (IV) flow patterns in the DIVC and LIVC. In this study, we examined IV flow patterns in both DIVC and LIVC observed during gross anatomy courses conducted for medical students and in previously reported cases. During the gross anatomy courses, three cases of DIVC and one case of LIVC were found in 618 cadavers. The IV flow pattern from these four cases and all other previously reported cases can be classified into one of the following three types according to the vein into which the internal iliac vein drained: the ipsilateral external IV; confluence of the ipsilateral external IV and IVC; and the communicating vein, which connects the IVC and the contralateral IVC or its iliac branch. This classification, which is based on the internal IV course, is considered to be useful because IV variations have the potential to cause clinical problems during related retroperitoneal surgery, venous interventional radiology, and diagnostic procedures for pelvic cancer.

Trousseau's syndrome in a patient with advanced stage gastric cancer.

Science.gov (United States)

Chien, Tai-Long; Rau, Kung-Ming; Chung, Wen-Jung; Tai, Wei-Chen; Wang, Shih-Ho; Chiu, Yi-Chun; Wu, Keng-Liang; Chou, Yeh-Pin; Wu, Chia-Che; Chen, Yen-Hao; Chuah, Seng-Kee

2015-09-14

Patients with cancer are at high risk for thrombotic events, which are known collectively as Trousseau's syndrome. Herein, we report a 66-year-old male patient who was diagnosed with terminal stage gastric cancer and liver metastasis and who had an initial clinical presentation of upper gastrointestinal bleeding. Acute ischemia of the left lower leg that resulted in gangrenous changes occurred during admission. Subsequent angiography of the left lower limb was then performed. This procedure revealed arterial thrombosis of the left common iliac artery with extension to the external iliac artery, the left common iliac artery, the posterior tibial artery, and the peroneal artery, which were occluded by thrombi. Aspiration of the thrombi demonstrated that these were not tumor thrombi. The interesting aspect of our case was that the disease it presented as arterial thrombotic events, which may correlate with gastric adenocarcinoma. In summary, we suggested that the unexplained thrombotic events might be one of the initial presentations of occult malignancy and that thromboprophylaxis should always be considered.

Costos y beneficios de la emisión de obligaciones y el apalancamiento financiero ante impuestos

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Christian Morán Montalvo

2016-06-01

Full Text Available La creciente participación de empresas en el mercado de valores pone de manifiesto que la forma de financiarse a través de la emisión de obligaciones ha tenido éxito en el país. En consecuencia, el presente artículo tiene como objetivo principal analizar y determinar los costos, beneficios y la forma de conseguir apalancamiento por medio de los impuestos que implica la emisión de obligaciones para las empresas. Por lo tanto, fue necesario evaluar aquellos costos que se incurren en el proceso como: los costos de emisión y los costos de colocación. El primero se refiere a la estructura financiera y legal, calificadora de riesgo, mientras que el segundo, al agente colocador, los intereses por pagar. Adicionalmente, se analizó el apalancamiento financiero en los impuestos corporativos. Los métodos de investigación utilizados fueron exploratoria y descriptiva. El caso de estudio permitió realizar proyecciones que proporcionaron respuestas al problema planteado. Según el análisis realizado, los resultados del financiamiento por medio de obligaciones estarán en función del tipo de tasa que se ofrezca y de los costos de la emisión, así como del tiempo y del monto requerido. Palabras clave: Finanzas, emisión de obligaciones, bolsa de valores, apalancamiento financiero, impuestos corporativos.

Practicality of profile-wire screen in reducing entrainment and impingement

International Nuclear Information System (INIS)

Hanson, B.N.; Bason, W.H.; Beitz, B.E.; Charles, K.E.

1978-01-01

Experimental studies indicated that 1.01-mm slot profile-wire well screen operated at an intake velocity of 15.24 cm/s virtually eliminated impingement of fishes larger than 15 mm fork length (FL). Intake velocities as high as 53.34 cm/s produced low impingement. Tests of fish less than 40 mm FL held near a functioning intake (15.24 cm/s) for as long as 3 hr yielded no impingement or stress. Many striped bass between 8 and 17 mm FL were capable of resisting impingement at more than 30.48 cm/s velocity for longer than 30 min; larger specimens (12 to 17 mm) showed excellent ability to escape when impinged. The screen excluded virtually all striped bass eggs from the cooling water. Preliminary egg mortality studies indicate that at least 95% survival can be expected at an approach velocity of 15.24 cm/s and impingement durations up to 2 min. Fouling studies showed that screens were highly resistant to clogging, essentially self-cleaning in a current, and easily backwashed. In-situ studies in the Chesapeake and Delaware Canal have shown that a 61.0- x 76.2-cm, 1.01-mm-slot screen is capable of providing its designed capacity for weeks without backwashing or cleaning. Biofouling proved to be the greatest operational problem. Entrainment samples from the in-situ intake have shown significant reductions in organisms/m 3 of filtered versus ambient water

Sacroiliac joint injection using the posterior superior iliac spines as ...

African Journals Online (AJOL)

Limitations in the availability of such image guided techniques in health ... School of Medical Sciences, University of Science and Technology between 2006 and ... The needle position from the posterior superior iliac spine and its angle of ...

Exceso de costos por sepsis intrahospitalaria en dos servicios de neonatología de Trujilo, Perú 2003-2005

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Ruth A. Vargas-Gonzales

2008-04-01

Full Text Available Objetivos. Cuantificar el exceso de costos de la sepsis intrahospitalaria en los servicios de neonatología de dos hospitales del norte del Perú. Materiales y métodos. Se realizó un estudio de costos en el Hospital Belén y Regional Docente del Ministerio de Salud en Trujillo utilizando una metodología propuesta por la OPS. Se seleccionaron 141 casos con sepsis intrahospitalaria a partir de los registros del sistema de vigilancia de infecciones intrahospitalarias, contrastándose con neonatos hospitalizados sin sepsis durante el periodo 2003 - 2005. Los indicadores de costo utilizados fueron días-cama, uso de antimicrobianos traducido a dosis diarias definidas (DDD y número de hemocultivos. Resultados. El exceso de costos en tarifas subsidiadas por sepsis intrahospitalaria en neonatos del Hospital Regional Docente de Trujillo (n = 53 ascendió a US$ 7 580 por hospitalización, 408 por fármacos antimicrobianos y 144 por hemocultivos. En el Hospital Belén de Trujillo (n = 88 de US$ 15 997 por hospitalización, 733 en antibióticos y 914 en hemocultivos. Conclusiones. La sepsis intrahospitalaria neonatal genera un mayor costo al sistema, principalmente por días-cama. Se deben implementar adecuadamente programas de prevención para reducir los costos asociados y la morbimortalidad que producen.

Metallic stent implantation in patients with iliac artery occlusion: long-term patency rate and factors related to recurrence

Energy Technology Data Exchange (ETDEWEB)

Chung, Seok Kyun; Kim, Jae Kyu; Yoon, Woong; Kim, Jeong; Park, Jin Gyoon; Kang, Heoung Keun; Choi, Soo JinNa [Chonnam National University Hospital School of Medicine, Gwangju (Korea, Republic of)

2003-09-01

To determine the long-term patency rate in 68 patients with iliac artery occlusion who underwent metallic stent implantation, and to analyze the factors related to recurrence. Sixty-eight patients with occlusive disease of the iliac artery underwent implantation of a self-expandable metallic stent. The clinical symptoms were intermittent claudication (n=48), resting pain (n=11), and gangrene (n=9). Stent patency was determined by follow-up angiography and color Doppler imaging, and the cumulative patency rate using the Kaplan-Meier method. Cox's proportional hazard model was used to analyse recurrence-related factors involving clinical symptoms (Fontaine stage), risk factors, and anatomical factors such as lesion location, length, and the development of collaterals. The duration of follow-up varied from 1 day to 73 months (mean, 23.8 months). Arterial occlusion recurred in 16 of 68 patients (23.5%), and the cumulative patency rate was as follows: 95.4% at one month, 93.2% at six months, 80.1% at one year, 73.2% at two years, 68.9% at three years, and 62% at five years. According to a statistical analysis of risk factors, the recurrence (p=0.04) than in those without it, but in patients who smoked, hypertension, DM, and previous cerebrovascular disease were not statistically significant. With regard to anatomical factors, the recurrent rate for lesions involving the external iliac artery was 6.5 times higher (p=0.02) than for those involving the common iliac artery. Variations in the fontaine stage were not statistically significant indicators of recurrence. The recurrence rate after implantation of an iliac artery stent is higher in patients with heart disease than in those without it, and higher for occlusive lesions involving the external iliac artery than for those of the common iliac artery.

Metallic stent implantation in patients with iliac artery occlusion: long-term patency rate and factors related to recurrence

International Nuclear Information System (INIS)

Chung, Seok Kyun; Kim, Jae Kyu; Yoon, Woong; Kim, Jeong; Park, Jin Gyoon; Kang, Heoung Keun; Choi, Soo JinNa

2003-01-01

To determine the long-term patency rate in 68 patients with iliac artery occlusion who underwent metallic stent implantation, and to analyze the factors related to recurrence. Sixty-eight patients with occlusive disease of the iliac artery underwent implantation of a self-expandable metallic stent. The clinical symptoms were intermittent claudication (n=48), resting pain (n=11), and gangrene (n=9). Stent patency was determined by follow-up angiography and color Doppler imaging, and the cumulative patency rate using the Kaplan-Meier method. Cox's proportional hazard model was used to analyse recurrence-related factors involving clinical symptoms (Fontaine stage), risk factors, and anatomical factors such as lesion location, length, and the development of collaterals. The duration of follow-up varied from 1 day to 73 months (mean, 23.8 months). Arterial occlusion recurred in 16 of 68 patients (23.5%), and the cumulative patency rate was as follows: 95.4% at one month, 93.2% at six months, 80.1% at one year, 73.2% at two years, 68.9% at three years, and 62% at five years. According to a statistical analysis of risk factors, the recurrence (p=0.04) than in those without it, but in patients who smoked, hypertension, DM, and previous cerebrovascular disease were not statistically significant. With regard to anatomical factors, the recurrent rate for lesions involving the external iliac artery was 6.5 times higher (p=0.02) than for those involving the common iliac artery. Variations in the fontaine stage were not statistically significant indicators of recurrence. The recurrence rate after implantation of an iliac artery stent is higher in patients with heart disease than in those without it, and higher for occlusive lesions involving the external iliac artery than for those of the common iliac artery

Iliac artery stenting in patients with poor distal runoff: Influence of concomitant infrainguinal arterial reconstruction.

Science.gov (United States)

Timaran, Carlos H; Ohki, Takao; Gargiulo, Nicholas J; Veith, Frank J; Stevens, Scott L; Freeman, Michael B; Goldman, Mitchell H

2003-09-01

Inadequate infrainguinal runoff is considered an important risk factor for iliac stent failure. However, the influence of concomitant infrainguinal arterial reconstruction (CIAR) on iliac stent patency is unknown. This study evaluated the influence of CIAR on outcome of iliac angioplasty and stenting (IAS) in patients with poor distal runoff. Over 5 years (1996 to 2001), 68 IAS procedures (78 stents) were performed in 62 patients with poor distal runoff (angiographic runoff score >or=5). The SVS/AAVS reporting standards were followed to define outcome variables and risk factors. Data were analyzed with both univariate analysis (Kaplan-Meier method [K-M]) and regression analysis (Cox proportional hazards model). Indications for iliac artery stenting were disabling claudication (59%) and limb salvage (41%). Of the 68 procedures, IAS with CIAR was performed in 31 patients (46%), and IAS alone was performed in 37 patients (54%). Patients undergoing IAS with CIAR were older (P =.03) and had more extensive and multifocal iliac artery occlusive disease, with more TASC (TransAtlantic Inter-Society Consensus) type C lesions (P =.03), compared with patients undergoing IAS alone. No other significant differences in risk factors were noted. Runoff scores between patients undergoing IAS with CIAR and those undergoing IAS alone were not significantly different (median runoff scores, 6 [range, 5-8] and 7 [range, 5-9], respectively; P =.77). Primary stent patency rate at 1, 3, and 5 years was 87%, 54%, and 42%, respectively, for patients undergoing IAS with CIAR, and was 76%, 66%, and 55%, respectively, for patients undergoing IAS. Univariate analysis revealed that primary stent patency rate was not significantly different between the 2 groups (K-M, log-rank test, P =.81). Primary graft patency rate for CIAR was 81%, 52%, and 46% at 1, 3, and 5 years, respectively. Performing CIAR did not affect primary iliac stent patency (relative risk, 1.1; 95% confidence interval, 0.49-2.47; P

COSTO-PACIENTE POR SESION Y CALIDAD EN LOS PROCESOS PRIORITARIOS DE HEMODIÁLISIS EN EL HOSPITAL NACIONAL CARLOS ALBERTO SEGUÍN ESCOBEDO, AREQUIPA – 2015

OpenAIRE

VALDIVIA MAZEYRA, MARIEL FABIOLA

2016-01-01

COSTOS EN LA GESTIÓN EN SALUD OBJETIVOS DE LA CONTABILIZACIÓN DE COSTOS CLASIFICACIÓN DE COSTOS MÉTODOS DE DETERMINACIÓN DE COSTOS CALIDAD EN SERVICIOS DE SALUD CONCEPTO DE CALIDAD EVALUACIÓN DE LA CALIDAD EN LA ATENCIÓN DE SALUD INDICADORES DE CALIDAD EN ATENCIÓN SANITARIA CALIDAD EN HEMODIÁLISIS

New treatment of iliac artery disease: focus on the Absolute Pro® Vascular Self-Expanding Stent System

Directory of Open Access Journals (Sweden)

Gates L

2013-09-01

Full Text Available Lindsay Gates, Jeffrey Indes Vascular and Endovascular Surgery, Yale University School of Medicine, New Haven, CT, USA Abstract: Management of iliac artery disease has evolved over the years, from a surgical-only approach to a primarily endovascular-only approach as the first line treatment option. This has been continuously improved upon with the advent of new devices and applied technologies. Most recently in particular, the literature has shown good, reliable outcomes with the use of self-expandable stents in iliac artery atherosclerotic lesions. Nevertheless, no device is without its limitations, and the Absolute Pro® Vascular Self-Expanding Stent System was designed with the intent of overcoming some of the shortcomings of other available stents while maintaining acceptable postprocedural outcomes. Based on preliminary industry-acquired data, it has achieved these goals and appears to be an emergent competitor for the treatment of both focal and complex iliac artery lesions. Keywords: Absolute-Pro®, iliac stent, self-expanding stents, atherosclerotic disease

La exposición de los costos ocultos de la tributación en el sistema de presupuesto y contabilidad pública

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Sergio Miguel Hauque

2012-03-01

Full Text Available El principal objeto de este trabajo es aproximarnos a la lista completa y la clasificación de los costos sociales de un sistema tributario. Propone además exponerlos lo más explícitamente posible en el sistema presupuestario y contable del Sector Público armonizado, en el marco del actual proceso de transición desde una información puramente financiera, hacia un sistema de información integrado para la toma de decisiones. Sostenemos a lo largo de este trabajo, que el sistema presupuestario y contable del Sector Público debería poder separar los siguientes conceptos que actualmente se encuentran “enmascarados dentro del neto recaudado, ermitiendo así determinar correctamente el flujo completo de recursos tributarios a través de la cuantificación de los Costos “internos” del Sector Público: • Los costos por “gastos tributarios” • Los costos representados por la evasión tributaria • Los costos de la incobrabilidad efectiva de los tributos y sus accesorios y los Costos “externos” al Sector Público • Los costos sociales de los contribuyentes • Los costos sociales de eficiencia de la imposición de tributos distorsivos. Al mismo tiempo, se concluye que el sistema presupuestario y contable del Sector Público debe reconocer los efectos sobre los flujos y stocks relativos al sistema tributarios que producen los cambios en el nivel general de precios absolutos del sistema económico.

Experimental and Computational Study of Underexpanded Jet Impingement Heat Transfer

Science.gov (United States)

Rufer, Shann J.; Nowak, Robert J.; Daryabeigi, Kamran; Picetti, Donald

2009-01-01

An experiment was performed to assess CFD modeling of a hypersonic-vehicle breach, boundary-layer flow ingestion and internal surface impingement. Tests were conducted in the NASA Langley Research Center 31-Inch Mach 10 Tunnel. Four simulated breaches were tested and impingement heat flux data was obtained for each case using both phosphor thermography and thin film gages on targets placed inside the model. A separate target was used to measure the surface pressure distribution. The measured jet impingement width and peak location are in good agreement with CFD analysis.

Endovascular Aortic Aneurysm Repair with the Talent Stent-Graft: Outcomes in Patients with Large Iliac Arteries

International Nuclear Information System (INIS)

England, Andrew; Butterfield, John S.; McCollum, Charles N.; Ashleigh, Raymond J.

2008-01-01

The purpose of this study is to report outcomes following endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm (AAA) in patients with ectatic common iliac arteries (CIAs). Of 117 AAA patients treated by EVAR between 1998 and 2005, 87 (74%) had CIAs diameters 18 but <25 mm. All patients were treated with Talent stent-grafts, 114 bifurcated and 3 AUI devices. Departmental databases and patient records were reviewed to assess outcomes. Technical success, iliac-related outcome, and iliac-related reintervention (IRSI) were analyzed. Patients with EVAR extending into the external iliac artery were excluded. Median (range) follow-up for the study group was 24 (1-84) months. Initial technical success was 98% for CIAs <18 mm and 100% for CIAs ≥18 mm (p = 0.551). There were three distal type I endoleaks (two in the ectatic group) and six iliac limb occlusions (one in an ectatic patient); there were no statistically significant differences between groups (p = 0.4). There were nine IRSIs (three stent-graft extensions, six femorofemoral crossover grafts); three of these patients had one or both CIAs ≥18 mm (p = 0.232). One-year freedom from IRSI was 92% ± 3% and 84% ± 9% for the <18-mm and ≥18-mm CIA groups, respectively (p = 0.232). We conclude that the treatment of AAA by EVAR in patients with CIAs 18-24 mm appears to be safe and effective, however, it may be associated with more frequent reinterventions.

Pelvic instability after bone graft harvesting from posterior iliac crest: report of nine patients

Energy Technology Data Exchange (ETDEWEB)

Chan, K.; Pathria, M.; Jacobson, J. [Dept. of Radiology, Univ. of California, San Diego, CA (United States); Resnick, D. [Dept. of Radiology, Veterans Affairs Medical Center, San Diego, CA (United States)

2001-05-01

Objective. To report the imaging findings in nine patients who developed pelvic instability after bone graft harvest from the posterior aspect of the iliac crest.Design and patients. A retrospective study was performed of the imaging studies of nine patients who developed pelvic pain after autologous bone graft was harvested from the posterior aspect of the ilium for spinal arthrodesis. Plain films, bone scans, and CT and MR examinations of the pelvis were reviewed. Pertinent aspects of the clinical history of these patients were noted, including age, gender and clinical symptoms.Results. The age of the patients ranged from 52 to 77 years (average 69 years) and all were women. The bone graft had been derived from the posterior aspect of the iliac crest about the sacroiliac joint. All patients subsequently developed subluxation of the pubic symphysis. Eight patients had additional insufficiency fractures of the iliac crest adjacent to the bone graft donor site, and five patients also revealed subluxation of the sacroiliac joint. Two had insufficiency fractures of the sacrum and one had an additional fracture of the pubic ramus.Conclusions. Pelvic instability is a potential complication of bone graft harvesting from the posterior aspect of the iliac crest. The pelvic instability is manifested by insufficiency fractures of the ilium and subluxation of the sacroiliac joints and pubic symphysis. (orig.)

Pelvic instability after bone graft harvesting from posterior iliac crest: report of nine patients

International Nuclear Information System (INIS)

Chan, K.; Pathria, M.; Jacobson, J.; Resnick, D.

2001-01-01

Objective. To report the imaging findings in nine patients who developed pelvic instability after bone graft harvest from the posterior aspect of the iliac crest.Design and patients. A retrospective study was performed of the imaging studies of nine patients who developed pelvic pain after autologous bone graft was harvested from the posterior aspect of the ilium for spinal arthrodesis. Plain films, bone scans, and CT and MR examinations of the pelvis were reviewed. Pertinent aspects of the clinical history of these patients were noted, including age, gender and clinical symptoms.Results. The age of the patients ranged from 52 to 77 years (average 69 years) and all were women. The bone graft had been derived from the posterior aspect of the iliac crest about the sacroiliac joint. All patients subsequently developed subluxation of the pubic symphysis. Eight patients had additional insufficiency fractures of the iliac crest adjacent to the bone graft donor site, and five patients also revealed subluxation of the sacroiliac joint. Two had insufficiency fractures of the sacrum and one had an additional fracture of the pubic ramus.Conclusions. Pelvic instability is a potential complication of bone graft harvesting from the posterior aspect of the iliac crest. The pelvic instability is manifested by insufficiency fractures of the ilium and subluxation of the sacroiliac joints and pubic symphysis. (orig.)

Análisis de costo-efectividad y costo-beneficio Programa de Detección Temprana de Cáncer Gástrico en Costa Rica

Directory of Open Access Journals (Sweden)

Schram, Albert

2009-01-01

Full Text Available En la primera sección del estudio se calcula e costo-efectividad en términos de dólares gastados para salvar una vida en el programa de detección temprana de cáncer gástrico en el hospital Max Peralta en Cartago, Costa Rica, para el período 1996-2000. En la segunda parte del estudio, se aplica un método de medición directa a través encuestas para determinar el valor de una vida estadística salvada, lo que nos permite comparar costos y beneficios del programa. La disponibilidad de pagar de los pacientes de la Caja Costarricense de Seguro Social se tomó como base para este análisis. Si tomaríamos la comparación del costo para salvar una vida con el valor de una vida estadística salvada como criterio para evaluar el programa, existiría una fuerte justificación para este programa en Costa Rica, siempre cuando la productividad y la efectividad del tamizaje sean suficientes. Para lograr este nivel de productividad y efectividad, en términos de personas de grupos de alto riesgo tamizadas por día, se requieren algunos mejoramientos en la organización del programa. En el caso que no se realice este tipo de mejoramientos, una justificación menos fuerte existe in términos de beneficios para la sociedad. Sin embargo, hay que subrayar que una similar comparación nunca puede ser la única base para la toma de decisiones.

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.

Propuesta de metodología para el cálculo del costo del No Mantenimiento.

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O. Fabelo García

2009-01-01

Full Text Available Si tan importante es el control de los costos del mantenimiento, es también el determinar los costos provocados por acciones deficientes en el mismo por cualquier causa que este lo provoque, a fin de ser considerado en los análisis de la gestión del mantenimiento y por consecuencia en la gestión empresarial.En la revisión de la literatura sobre este último tema, no se ha encontrado un método que permita al menos controlar estos costos, por lo que en este trabajo se analizarán una serie de elementos, con el objetivo de determinar los costos que están asociados al no mantenimiento y a partir de ellos, evaluar el comportamiento del mismo.The cost control of maintenance is as important as the determination of the costs caused by inadequate maintenance actions. These should be considered in the maintenance management analysis, and consequently in business management.Reviewing literature related to the topic is clear that it hasn’t been found a method that allows, at least, to control these costs. That’s why, in this research some elements will be analysed to determine the costs associated to the non maintenance, and from that point on, to evaluate their behaviour.

Isolated aneurysms of the iliac arteries

International Nuclear Information System (INIS)

Eckmann, A.; Schild, H.; Schmiedt, W.; Groenninger, J.

1988-01-01

Isolated aneurysms of the iliac arteries are rare. They must be considered as a disease pattern of their own as against aneurysms of the abdominal aorta because of the specific anatomical conditions in the pelvis. The clinical symptomatology is determinated by their localisation and topographical relationships within teh pelvis; this can give rise to problems in differential diagnosis primary urological, neurological or gastrointestinal diseases. The prognosis is decisively determined early and correct diagnosis because of the danger of rupture. Sonography, computed tomography and angiography are indispensable aids in preoperative planning. (orig.) [de

Internal iliac artery embolotherapy for primary postpartum hemorrhage

International Nuclear Information System (INIS)

Chen Weijun; Mei Haibing; He Zhongwei; Li Meimei

2001-01-01

Objective: To evaluate the effectiveness of internal iliac artery embolotherapy (IIAE) for primary postpartum hemorrhage (PPH). Methods: 9 cases of PPH were treated with IIAE. Results: Selective catheterization and embolotherapy were successful in 9 cases of PPH, with only one case of left lower extremity arterial thrombosis. No serious complications occurred in others. Conclusions: IIAE is a quick, safe, effective technique for PPH

Impact of impingement on the Hudson River white perch population

International Nuclear Information System (INIS)

Barnthouse, L.W.; Van Winkle, W.

1980-01-01

The impact of power plant impingement on the 1974 and 1975 year classes of the Hudson River white perch population is assessed using a simple model derived from Ricker's theory of fisheries dynamics. The impact of impingement is expressed in the model as the conditional mortality rate, rather than as the more commonly used exploitation rate. Since the calculated impact is sensitive to errors in the estimation of population size and total mortality, ranges of probable values of these quantities are used to compute upper and lower bounds on the fractional reduction in abundance of each year class. Best estimates of abundance and mortality are used to compute the conditional impingement mortality rate separately for each plant and month. The results are used to assess the relative impacts of white perch impingement at six Hudson River power plants and to identify the seasons during which the impact is highest

The management of thoracic inlet syndrome associated with Hurler's syndrome: a novel surgical technique.

LENUS (Irish Health Repository)

Ahsan, Rauf M

2012-02-01

A 21-year-old male developed significant swelling of his tongue after a respiratory arrest. The patient had a history of Hurler\\'s syndrome. Magnetic resonance imaging (MRI) angiogram delineated that the swelling was due to compression of his internal jugular veins at the level of the first rib, resulting in thoracic inlet obstruction. The standard surgical treatment of thoracic inlet obstruction was not suitable in this patient\\'s case due to his short thick neck and his characteristic Hurler\\'s syndrome body habitus. Therefore, a novel surgical strategy was used to decompress his head and neck vessels. The manubrium was widened using an iliac crest bone graft, stabilised using internal fixation plates and reconstructed with a pectoral muscle flap.

Study design and rationale of the 'Balloon-Expandable Cobalt Chromium SCUBA Stent versus Self-Expandable COMPLETE-SE Nitinol Stent for the Atherosclerotic ILIAC Arterial Disease (SENS-ILIAC Trial) Trial': study protocol for a randomized controlled trial.

Science.gov (United States)

Choi, Woong Gil; Rha, Seung Woon; Choi, Cheol Ung; Kim, Eung Ju; Oh, Dong Joo; Cho, Yoon Hyung; Park, Sang Ho; Lee, Seung Jin; Hur, Ae Yong; Ko, Young Guk; Park, Sang Min; Kim, Ki Chang; Kim, Joo Han; Kim, Min Woong; Kim, Sang Min; Bae, Jang Ho; Bong, Jung Min; Kang, Won Yu; Seo, Jae Bin; Jung, Woo Yong; Cho, Jang Hyun; Kim, Do Hoi; Ahn, Ji Hoon; Kim, Soo Hyun; Jang, Ji Yong

2016-06-25

The self-expandable COMPLETE™ stent (Medtronic) has greater elasticity, allowing it to regain its shape after the compression force reduces, and has higher trackability, thus is easier to maneuver through tortuous vessels, whereas the balloon-expandable SCUBA™ stent (Medtronic) has higher radial stiffness and can afford more accurate placement without geographic miss, which is important in aortoiliac bifurcation lesions. To date, there have been no randomized control trials comparing efficacy and safety between the self-expanding stent and balloon-expandable stent in advanced atherosclerotic iliac artery disease. The purpose of our study is to examine primary patency (efficacy) and incidence of stent fracture and geographic miss (safety) between two different major representative stents, the self-expanding nitinol stent (COMPLETE-SE™) and the balloon-expanding cobalt-chromium stent (SCUBA™), in stenotic or occlusive iliac arterial lesions. This trial is designed as a prospective, randomized, multicenter trial to demonstrate a noninferiority of SCUBA™ stent to COMPLETE-SE™ stent following balloon angioplasty in iliac arterial lesions, and a total of 280 patients will be enrolled. The primary end point of this study is the rate of primary patency in the treated segment at 12 months after intervention as determined by catheter angiography, computed tomography angiography, or duplex ultrasound. The SENS-ILIAC trial will give powerful insight into whether the stent choice according to deployment mechanics would impact stent patency, geographic miss, or stent fracture in patients undergoing stent implantation in iliac artery lesions. National Institutes of Health Clinical Trials Registry (ClinicalTrials.gov identifier: NCT01834495 ), registration date: May 8, 2012.

Experimental study on boiling heat transfer to an impinging jet on a hot block

International Nuclear Information System (INIS)

Kamata, Choko

1997-01-01

Previous studies on boiling heat transfer by impinging jets are mainly concerned with the impinging point by using small heat transfer surfaces of about 20 mm. An experimental study of the boiling heat transfer to an impinging water jet on a massive hot block is made. The upward heating surface is made of copper. Its diameter and nozzle diameter are 80 mm and 2.2 mm, respectively. The velocity of the impinging jet was varied from 0.6 to 2.1 m/s. Saturated water normally impinged on the heating surface, flowed radially, and subsequently dispersed into the atmosphere. The present study clarifies that heat transfer characteristics vary with the temperature of heat transfer surface, and also with the distance from the impinging point. (author)

Diseño de un sistema de acumulación de costos para la micro, pequeña y mediana industria panadera

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Marysela C. Morillo Moreno

2006-01-01

Full Text Available Las micro, pequeñas y medianas industrias (MPyMI son fundamentos en una economía sólida, ellas deben diseñar estrategias gerenciales y de apoyo acorde a sus características que les permitan mejorar su competitividad y buscar su consolidación; de allí la necesidad de contar con sistemas de acumulación de costos que generen información apropiada, oportuna y detallada. Luego de un diagnóstico realizado en las industrias panaderas del municipio Barinas, estado Barinas, se constató que éstas son en su mayoría MPyMI, y que no poseen un sistema de acumulación de costos adecuado que permita calcular costos de producción precisos para la planificación, control y toma de decisiones. Por ello, se presentan los resultados de una investigación proyectiva ubicada en el nivel comprensivo, en la cual se diseña un sistema de costos adaptado a las necesidades de estas industrias, compatible con la naturaleza de sus actividades fabriles, a objeto de facilitar y difundir su uso. Se propone un Sistema de Acumulación de Costos Híbrido, a partir de la combinación del sistema de costos por proceso y del sistema de costos por operaciones, para obtener información sistemática, oportuna y confiable, de los costos de producción para la toma de decisiones, dotados a la vez de procedimientos y mecanismos de control.

Noise characteristics and flow field of an impinging jet on a conical obstacle

Energy Technology Data Exchange (ETDEWEB)

Liu, Xin; Xie, Junlong; Shu, Shuiming; Zhang, Yi, E-mail: hustxjl@163.com [School of Energy and Power Engineering, Huazhong University of Science and Technology, Wuhan, 430074 (China)

2017-12-15

The noise characteristics and flow field of a low-speed impinging jet on a conical obstacle have been numerically simulated using the kinetic energy transport subgrid-scale model of the large-eddy simulation method. Noise measurement is carried out to validate the proposed simulation method. The effects of the impinging distance on the development, separation and diffusion of vortices on the back of the conical obstacle are investigated. The jet structure is better preserved and the vorticity value becomes larger as the impinging distance increases. Simulation results of the noise spectrums and overall sound pressure level (OASPL) agree well with the experimental data. The noise spectrums are analyzed and combined with simulation results for the flow field. When the impinging distance is small, the main acoustic sources with the broadband characteristic consist of the dipole source produced by pressure fluctuation on the surface of the obstacle, and the quadrupole source produced by vortices. As the impinging distance increases, the quadrupole source becomes the major acoustic source with low-frequency characteristics. In addition, the OASPL of the impinging jet is obtained at different impinging distances. (paper)

El Costo de Capital en Industrias Reguladas: Una aplicación a la Distribución de Electricidad en el Perú.

OpenAIRE

Raúl Pérez-Reyes Espejo; Raúl Lizardo García Carpio

2005-01-01

Tanto en los regímenes de regulación de monopolios naturales basados en la estimación de costos como en aquellos basados en el diseño de incentivos, un elemento de discusión, entre empresas, usuarios y organismo regulador, es el relacionado con el valor del costo de capital a ser utilizado en el proceso de fijación de tarifas. El costo de capital de un inversionista representa la medición del costo de oportunidad disponible para él respecto del capital que dicho agente está dispuesto a invert...

Open and Arthroscopic Surgical Treatment of Femoroacetabular Impingement

Directory of Open Access Journals (Sweden)

Benjamin D. Kuhns

2015-12-01

Full Text Available Femoroacetabular impingement (FAI is a common cause of hip pain, and when indicated, can be successfully managed through open surgery or hip arthroscopy. The goal of this review is to describe the different approaches to the surgical treatment of FAI. We present the indications, surgical technique, rehabilitation, and complications associated with (1 open hip dislocation, (2 reverse peri-acetabular osteotomy, (3 the direct anterior mini-open approach, and (4 arthroscopic surgery for femoroacetabular impingement.

Repair of abdominal aortic aneurysms with aortouni- iliac stentgraft ...

African Journals Online (AJOL)

The aorto-uni-iliac (AUI) graft configuration with femoro-femoral bypass (FFBP) is a promising alternative which may extend the scope of EVAR for AAAs. The aim of ... Open surgery posed an unacceptably high risk to all patients owing to advanced age and/or American Society of Anesthesiologists (ASA) classification 3/4.

Personalised Hip Therapy: development of a non-operative protocol to treat femoroacetabular impingement syndrome in the FASHIoN randomised controlled trial.

Science.gov (United States)

Wall, Peter Dh; Dickenson, Edward J; Robinson, David; Hughes, Ivor; Realpe, Alba; Hobson, Rachel; Griffin, Damian R; Foster, Nadine E

2016-10-01

Femoroacetabular impingement (FAI) syndrome is increasingly recognised as a cause of hip pain. As part of the design of a randomised controlled trial (RCT) of arthroscopic surgery for FAI syndrome, we developed a protocol for non-operative care and evaluated its feasibility. In phase one, we developed a protocol for non-operative care for FAI in the UK National Health Service (NHS), through a process of systematic review and consensus gathering. In phase two, the protocol was tested in an internal pilot RCT for protocol adherence and adverse events. The final protocol, called Personalised Hip Therapy (PHT), consists of four core components led by physiotherapists: detailed patient assessment, education and advice, help with pain relief and an exercise-based programme that is individualised, supervised and progressed over time. PHT is delivered over 12-26 weeks in 6-10 physiotherapist-patient contacts, supplemented by a home exercise programme. In the pilot RCT, 42 patients were recruited and 21 randomised to PHT. Review of treatment case report forms, completed by physiotherapists, showed that 13 patients (62%) received treatment that had closely followed the PHT protocol. 13 patients reported some muscle soreness at 6 weeks, but there were no serious adverse events. PHT provides a structure for the non-operative care of FAI and offers guidance to clinicians and researchers in an evolving area with limited evidence. PHT was deliverable within the National Health Service, is safe, and now forms the comparator to arthroscopic surgery in the UK FASHIoN trial (ISRCTN64081839). ISRCTN 09754699. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Unsuspected costo-vertebral fractures demonstrated by bone scanning in the child abuse syndrome

Energy Technology Data Exchange (ETDEWEB)

Smith, F W; Gilday, D L; Ash, J M; Green, M D

1980-01-01

Many patterns of injury have been described in the child abuse syndrome. Until recently, all the bone manifestations of this syndrome have been diagnosed radiologically. Four cases of multiple costovertebral fracture diagnosed by bone scan are described and their etiology discussed. The use of bone scanning in identifying fractures which previously would have been missed is advocated.

Unsuspected costo-vertebral fractures demonstrated by bone scanning in the child abuse syndrome

International Nuclear Information System (INIS)

Smith, F.W.; Gilday, D.L.; Ash, J.M.; Green, M.D.

1980-01-01

Many patterns of injury have been described in the child abuse syndrome. Until recently, all the bone manifestations of this syndrome have been diagnosed radiologically. Four cases of multiple costovertebral fracture diagnosed by bone scan are described and their etiology discussed. The use of bone scanning in identifying fractures which previously would have been missed is advocated. (orig.) [de

ESTRUCTURA DE CAPITAL ÓPTIMA EN PRESENCIA DE COSTOS DE DIFICULTADES FINANCIERAS

Directory of Open Access Journals (Sweden)

Alejandro Vargas Sánchez

2014-07-01

Full Text Available En el presente documento se presentan los conceptos relacionados con la estructura de capital desde una perspectiva de mercados financieros imperfectos. El objetivo principal es mostrar mediante un estudio de caso, cómo una empresa puede generar un impacto positivo en su valor de mercado a través de sus decisiones de endeudamiento. La exposición del trabajo se desarrolla a través de los planteamientos de Franco Modigliani y Merton Miller referidos a la estructura de capital, analizando cada uno sus supuestos, se realiza un recorrido sobre los principales trabajos de investigación en la materia que intentan explicar la importancia que tienen este tipo de decisiones cuando los mercados de capitales presentan imperfecciones, operan bajo asimetrías de información, existen costos de agencia y costos de quiebra. La aplicación fue orientada a la evaluación de una empresa industrial cuyas acciones no cotizan en un mercado bursátil. Los resultados encontrados permitieron comprobar que bajo la presencia de costos de dificultad financiera y mediante la aplicación de la Teoría Estática de Intercambio es posible determinar un nivel de apalancamiento financiero óptimo que permita maximizar el valor de la empresa.

Costs of publicly provided maternity services in Rosario, Argentina Los costos de servicios maternos públicos en Rosario, Argentina

Directory of Open Access Journals (Sweden)

Josephine Borghi

2003-01-01

Full Text Available OBJECTIVE: This study estimates the costs of maternal health services in Rosario, Argentina. MATERIAL AND METHODS: The provider costs (US$ 1999 of antenatal care, a normal vaginal delivery and a caesarean section, were evaluated retrospectively in two municipal hospitals. The cost of an antenatal visit was evaluated in two health centres and the patient costs associated with the visit were evaluated in a hospital and a health centre. RESULTS: The average cost per hospital day is $114.62. The average cost of a caesarean section ($525.57 is five times greater than that of a normal vaginal delivery ($105.61. A normal delivery costs less at the general hospital and a c-section less at the maternity hospital. The average cost of an antenatal visit is $31.10. The provider cost is lower at the health centre than at the hospital. Personnel accounted for 72-94% of the total cost and drugs and medical supplies between 4-26%. On average, an antenatal visit costs women $4.70. Direct costs are minimal compared to indirect costs of travel and waiting time. CONCLUSIONS: These results suggest the potential for increasing the efficiency of resource use by promoting antenatal care visits at the primary level. Women could also benefit from reduced travel and waiting time. Similar benefits could accrue to the provider by encouraging normal delivery at general hospitals, and complicated deliveries at specialised maternity hospitals.OBJETIVO: En este artículo se presenta una estimación de los costos de los servicios maternos en Rosario, Argentina. MATERIAL Y MÉTODOS: Evaluamos retrospectivamente el costo (US$ 1999 en dos hospitales municipales, de un parto normal vaginal, y de una cesárea y de una visita prenatal. El costo de atención prenatal fue evaluado en dos centros de salud y los costos asumidos por las pacientes fueron evaluados en un hospital y un centro de salud. RESULTADOS: El costo promedio por día-cama es de $114.62. El costo promedio de una ces

Mechanical Thrombectomy of Iliac Vein Thrombosis in a Pig Model Using the Rotarex and Aspirex Catheters

Energy Technology Data Exchange (ETDEWEB)

Minko, P., E-mail: peterminko@yahoo.com; Bücker, A. [University Hospital Homburg/Saar, Department of Diagnostic and Interventional Radiology (Germany); Laschke, M.; Menger, M. [University Hospital Homburg/Saar, Institute of Clinical and Experimental Surgery (Germany); Bohle, R. [University Hospital Homburg/Saar, Department of Pathology (Germany); Katoh, M. [University Hospital Homburg/Saar, Department of Diagnostic and Interventional Radiology (Germany)

2013-06-08

PurposeTo investigate the efficacy and safety of mechanical thrombectomy for iliac vein thrombosis using Rotarex and Aspirex catheters in a pig model.Materials and MethodsIliac vein thrombosis was induced in six pigs by means of an occlusion-balloon catheter and thrombin injection. The presence of thrombi was verified by digital subtraction angiography (DSA) and computed tomography (CT). Thrombectomy was performed using 6F and 8F Rotarex and 6F, 8F, and 10F Aspirex catheters (Straub Medical AG, Wangs, Switzerland). After intervention, DSA and CT were repeated to evaluate the efficacy of mechanical thrombectomy and to exclude local complications. In addition, pulmonary CT was performed to rule out pulmonary embolism. Finally, all pigs were killed, and iliac veins were dissected to perform macroscopic and histological examination.ResultsThrombus induction was successfully achieved in all animals as verified by DSA and CT. Subsequent thrombectomy lead to incomplete recanalization of the iliac veins with residual thrombi in all cases. However, the use of the 6F and 8F Rotarex catheters caused vessel perforation and retroperitoneal hemorrhage in all cases. Application of the Aspirex device caused one small transmural perforation in a vessel treated with a 10F Aspirex catheter, and this was only seen microscopically. Pulmonary embolism was detected in one animal treated with the Rotarex catheters, whereas no pulmonary emboli were seen in animals treated with the Aspirex catheters.ConclusionThe Aspirex catheter allowed subtotal and safe recanalization of iliac vein thrombosis. In contrast, the use of the Rotarex catheter caused macroscopically obvious vessel perforations in all cases.

Comparison of Endotoxin Exposure Assessment by Bioaerosol Impinger and Filter-Sampling Methods

OpenAIRE

Duchaine, Caroline; Thorne, Peter S.; Mériaux, Anne; Grimard, Yan; Whitten, Paul; Cormier, Yvon

2001-01-01

Environmental assessment data collected in two prior occupational hygiene studies of swine barns and sawmills allowed the comparison of concurrent, triplicate, side-by-side endotoxin measurements using air sampling filters and bioaerosol impingers. Endotoxin concentrations in impinger solutions and filter eluates were assayed using the Limulus amebocyte lysate assay. In sawmills, impinger sampling yielded significantly higher endotoxin concentration measurements and lower variances than filte...

¿Aerolíneas de bajo costo en colombia?

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Carlos Alberto Mantilla

2003-11-01

Full Text Available Con la apertura del mercado en Colombia, la competencia entre aerolíneas se agudizó ante la entrada de nuevos operadores y la flexibilización de tarifas como estrategia para la captación de una mayor demanda. Las ventajas competitivas de cada aerolínea fueron el punto clave para la disputa del mercado y todas ellas trabajan hoy en fórmulas que les permitan maximizar beneficios y minimizar costos, enfrentando así la crisis que vive la industria, debido a los acontecimientos del 11 de septiembre de 2001. Puede decirse que los grandes esfuerzos se hacen en los departamentos comerciales, pues debido al auge de las tecnologías y al uso del internet, tanto empresas de transporte aéreo como agentes turísticos deben enfrentar el problema de la competencia de precios. Sin embargo, esto les ofrece a las aerolíneas la oportunidad de comercializar sus servicios a "bajo costo", esquema que ha resultado favorable para empresas y clientes.

Evaluación de costo-efectividad de los nuevos anticoagulantes orales en pacientes con fibrilación auricular no valvular

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Ángel Alberto García-Peña

2017-03-01

Full Text Available La fibrilación auricular es el trastorno más frecuente del ritmo cardíaco y una de las causas potencialmente tratables de cardioembolia y ataque cerebrovascular. La disponibilidad de nuevos anticoagulantes para pacientes con fibrilación auricular no valvular, plantea retos, derivados principalmente de los costos de su uso, perfiles de eficacia y seguridad, tolerancia y disponibilidad. Se llevó a cabo un análisis de costo-efectividad con base en un modelo de Markov, que permite comparar las estrategias de anticoagulación disponibles para fibrilación auricular no valvular en el país (apixabán, dabigatrán, rivaroxabán. La perspectiva empleada fue la del tercero pagador (sistema de salud colombiano, considerando solo costos médicos directos. Se siguieron las guías metodológicas para este tipo de estudios propuestas por ISPOR (International Society for Pharmacoeconomics and Outcomes Research e INAHTA (International Network of Agencies for Health Technology Assessment. El horizonte temporal fue de 5 años, 10 años y toda la vida, en tanto que la tasa de descuento fue del 3%. Luego de la evaluación del modelo, con base en los análisis de sensibilidad realizados y el umbral de costo-efectividad para Colombia, se encontró que para el caso base, las diferentes moléculas evaluadas, si bien son costo-efectivas, exceden el umbral propuesto para este trabajo, siendo rivaroxabán y dabigatrán las únicas estrategias costo-efectivas con un horizonte temporal a 10 años con una tasa de descuento del 3% y para un horizonte temporal de toda la vida y tasa de descuento del 3%, las tres moléculas alcanzan el umbral de costo-efectividad establecido para Colombia. Dichas consideraciones son altamente sensibles al costo de los medicamentos.

Imaging features of a rare case of scapuloiliac dysostosis (Kosenow syndrome in an ambulatory child

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John Joseph

2011-02-01

Full Text Available Scapuloiliac dysostosis, also known as pelvis-shoulder dysplasia and Kosenow syndrome, is a rare skeletal dysplasia described first by Kosenow et al. in 1970. The main components of the syndrome are varying degrees of bilateral iliac and scapular hypoplasia. Various other skeletal abnormalities including exaggerated lumbar lordosis, and clavicular, vertebral, rib and long bone anomalies and extra-skeletal abnormalities, most commonly those of eye and ear, have also been reported. We report the plain radiography, CT and MRI findings of an interesting case of the syndrome.

COSTOS INTERNACIONALES PARA IMPORTAR Y EXPORTAR

OpenAIRE

Rodríguez Chavez, Agustin

2016-01-01

Los cambios experimentados constantemente por los procesos de negocios internacionales se originan en la variación de las políticas de los países, el uso de nuevas tecnologías o la implementación de estrategias corporativas de negocios frente a los operadores logísticos y las fluctuaciones de la economía. Debido a ello, en la actualidad es importante estudiar y analizar los costos asociados a las importaciones y exportaciones. En el año 2010 el Perú importaba 21 mil millones de dólares y expo...

Transitional lumbosacral vertebrae and low back pain: diagnostic pitfalls and management of Bertolotti's syndrome

OpenAIRE

Almeida,Daniel Benzecry de; Mattei,Tobias Alécio; Sória,Marília Grando; Prandini,Mirto Nelso; Leal,André Giacomelli; Milano,Jerônimo Buzzeti; Ramina,Ricardo

2009-01-01

OBJECTIVE: Bertolotti's syndrome is a spine disorder characterized by the occurrence of a congenital lumbar transverse mega-apophysis in a transitional vertebral body that usually articulates with the sacrum or the iliac bone. It has been considered a possible cause of low back pain. METHOD: We analyzed the cases of Bertolotti's syndrome that failed clinical treatment and reviewed the literature concerning this subject. RESULTS: Five patients in our series had severe low back pain due to the ...

MR imaging of nerve root impingement in the lumbar spine

International Nuclear Information System (INIS)

Teresi, L.M.; Bradley, W.G. Jr.; Bloze, A.E.; Davis, S.J.; Amster, J.; Berger, P.E.

1990-01-01

This paper determines the relationship between MR imaging findings of nerve root impingement, presenting symptoms, and physical examination findings, and physiologic data (DSEP and EMG) in a population of patients presented with classic radicular symptoms. Fifty-eight patients presenting with classic radicular pain were studied with MR imaging, DSER, and EMG, MR imaging was performed with a GE Signa imaging system with use of T1- and T2-weighted sequences and 5-mm-thick sections. Nerve root impingement in the subarticular recess (the root exiting the next lowest level) was distinguished from nerve root impingement in the superior intervertebral foramen (the root exiting the same level)

Impaired hip muscle strength in patients with femoroacetabular impingement syndrome.

Science.gov (United States)

Kierkegaard, Signe; Mechlenburg, Inger; Lund, Bent; Søballe, Kjeld; Dalgas, Ulrik

2017-12-01

Patients with femoroacetabular impingement (FAI) experience hip pain as well as decreased function and lowered quality of life. The aim was to compare maximal isometric and isokinetic muscle strength (MVC) during hip flexion and extension and rate of force development (RFD) during extension between patients with FAI and a matched reference group. Secondary, the aim was to compare patient hips and subgroups defined by gender and age as well as to investigate associations between hip muscle strength and self-reported outcomes. Design Cross-sectional, comparative study Methods Sixty patients (36±9 years, 63% females) and 30 age and gender matched reference persons underwent MVC tests in an isokinetic dynamometer. During hip flexion and extension, patients' affected hip showed a strength deficit of 15-21% (phip of the patients was significantly weaker than their contralateral hip. RFD was significantly decreased for both patient hips compared to the reference group (phip muscle strength. Patients with FAI demonstrate decreased hip flexion and extension strength when compared to (1) reference persons and (2) their contralateral hip. There seems to be a gender specific affection which should be investigated further and addressed when planning training protocols. Furthermore, self-reported measures were associated with isometric muscle strength, which underlines the clinical importance of the reduced muscle strength. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Impact of impingement on the Hudson River white perch population. Final report

Energy Technology Data Exchange (ETDEWEB)

Barnthouse, L.W.; Van Winkle, W.; Kirk, B.L.; Vaughan, D.S.

1982-02-01

This report summarizes a series of analyses of the magnitude and biological significance of the impingement of white perch at the Indian Point Nuclear Generating Station and other Hudson River power plants. Included in these analyses were evaluations of: (1) two independent lines of evidence relating to the magnitude of impingement impacts on the Hudson River white perch population; (2) the additional impact caused by entrainment of white perch; (3) data relating to density-dependent growth among young-of-the-year white perch; (4) the feasibility of performing population-level analyses of impingement impacts on the white perch populations of Chesapeake Bay and the Delaware River; and (5) the feasibility of using simple food chain and food web models to evaluate community-level effects of impingement and entrainment. Estimated reductions in the abundances of the 1974 and 1975 white perch year classes, caused by impingement and entrainment, were high enough that the possibility of adverse long-term effects cannot be excluded.

A study on the velocity characteristics of the spray formed by two impinging jets

International Nuclear Information System (INIS)

Choo, Yeon Jun; Seo, Kwi Hyun; Kang, Bo Seon

2001-01-01

In this study, the velocity characteristics of liquid elements formed by two impinging jets is analysed using double pulse image capturing technique. For the droplets formed by low speed impinging jets, the droplet velocities are higher with smaller azimuthal and impingement angle. The maximum droplet velocities are about 25% lower than jet velocity. With an increase of azimuthal angle, the shedding angles increases but remains lower than azimuthal angle. The velocities of ligaments formed by high speed impinging jets gradually decreases with an increase of azimuthal angle. The maximum ligament velocities are about 40% lower than jet velocity. Higher impingement angles produce lower ligament velocities. The shedding angles of ligament almost increases with the same value of azimuthal angle, which implies that the moving direction of ligaments is radial from the origin as the impingement point

Tearing of the left iliac vessels in lumbar surgery revealed by multiphase post-mortem CT-angiography (MPMCTA).

Science.gov (United States)

Vilariño Villaverde, Raquel; Bruguier, Christine; Zerlauth, Jean-Baptiste; De Froidmont, Sébastien; Grabherr, Silke

2016-05-01

Lumbar surgery is regularly applied in cases of discal hernia and acquired lumbar stenosis. In this report, we present a case of a laceration in the left common iliac artery and iliac vein during a lumbar surgery and discuss the literature concerning this kind of event. In the present case, the surgical procedure was followed by a sudden decrease in blood pressure, and the surgeon discovered an intra-abdominal haemorrhage that led to the patient's death. Postmortem investigation confirmed the intra-abdominal haemorrhage and revealed a laceration of the proximal portion of the left common iliac artery and left iliac vein. The source of bleeding could be detected especially thanks to multi-phase postmortem CT angiography (MPMCTA), which was performed prior to autopsy. We also found a haemorrhagic path through the intervertebral disc between the L4-L5 vertebrae, caused by the surgeon's instrument (pituitary rongeur). To date, a few cases have been described of iatrogenic death resulting from a tear in the iliac vessels during lumbar surgery, but not from the postmortem perspective. Such investigations have recently been modernized thanks to the introduction of forensic imaging. In particular, MPMCTA offers new possibilities in postmortem investigations and can be considered the new gold standard for investigating deaths related to medical intervention. Here we describe the first case of a death during lumbar surgery using this new method. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Apollo Video Photogrammetry Estimation Of Plume Impingement Effects

Science.gov (United States)

Immer, Christopher; Lane, John; Metzger, Philip T.; Clements, Sandra

2008-01-01

The Constellation Project's planned return to the moon requires numerous landings at the same site. Since the top few centimeters are loosely packed regolith, plume impingement from the Lander ejects the granular material at high velocities. Much work is needed to understand the physics of plume impingement during landing in order to protect hardware surrounding the landing sites. While mostly qualitative in nature, the Apollo Lunar Module landing videos can provide a wealth of quantitative information using modem photogrammetry techniques. The authors have used the digitized videos to quantify plume impingement effects of the landing exhaust on the lunar surface. The dust ejection angle from the plume is estimated at 1-3 degrees. The lofted particle density is estimated at 10(exp 8)- 10(exp 13) particles per cubic meter. Additionally, evidence for ejection of large 10-15 cm sized objects and a dependence of ejection angle on thrust are presented. Further work is ongoing to continue quantitative analysis of the landing videos.

Trailing edge cooling using angled impingement on surface enhanced with cast chevron arrangements

Science.gov (United States)

Lee, Ching-Pang; Heneveld, Benjamin E.; Brown, Glenn E.; Klinger, Jill

2015-05-26

A gas turbine engine component, including: a pressure side (12) having an interior surface (34); a suction side (14) having an interior surface (36); a trailing edge portion (30); and a plurality of suction side and pressure side impingement orifices (24) disposed in the trailing edge portion (30). Each suction side impingement orifice is configured to direct an impingement jet (48) at an acute angle (52) onto a target area (60) that encompasses a tip (140) of a chevron (122) within a chevron arrangement (120) formed in the suction side interior surface. Each pressure side impingement orifice is configured to direct an impingement jet at an acute angle onto an elongated target area that encompasses a tip of a chevron within a chevron arrangement formed in the pressure side interior surface.

The jet impingement phase of molten core-concrete interactions

International Nuclear Information System (INIS)

Sienicki, J.J.; Spencer, B.W.

1986-01-01

Scoping calculations have been carried out demonstrating that a significant and abrupt reduction in the corium temperature may be realized when molten corium drains as a jet from a localized breach in the RPV lower head to impinge upon the concrete basemat. The temperature decrease may range from a value of ∼170 K (∼140 K) for limestone (basaltic) aggregate concrete to a value approaching the initial corium superheat depending upon whether the forced convection impingement heat flux is assumed to be controlled by either thermal conduction across a slag film layer or the temperature boundary condition represented by a corium crust. The magnitude of the temperature reduction remains significant as the initial corium temperature, impinging corium mass, and initial localized breach size are varied over their range of potential values

Infrainguinal arterial reconstructions in patients with aortoiliac occlusive disease: the influence of iliac stenting.

Science.gov (United States)

Timaran, C H; Stevens, S L; Freeman, M B; Goldman, M H

2001-12-01

Iliac artery angioplasty (IAA) is an effective adjunct when combined with infrainguinal arterial reconstructions (IARs) in appropriate patients with multilevel occlusive disease. However, the effect of iliac artery stenting (IAS) on the outcome of patients undergoing distal bypass procedures is not defined. The purpose of this study was to estimate the influence of previous IAS for iliac occlusive disease on the outcome of IARs, compared with those after IAA alone or aortofemoral bypass grafting procedures (AFBs). During a 5-year period (1995-2000), 105 patients with previous intervention for iliac occlusive disease underwent 120 IARs. The criteria prepared by the Ad Hoc Committee on Reporting Standards (Society for Vascular Surgery/International Society for Cardiovascular Surgery) were followed to define the variables. The TransAtlantic Inter-Society Consensus classification was used to characterize the type of iliac lesions. Univariate (Kaplan-Meier) and multivariate analyses (Cox proportional hazards model) were used to determine the association between preoperative variables and cumulative primary patency. Forty-five IARs were performed in patients with an earlier IAS repair, 33 in patients with an earlier IAA repair, and 42 in patients with an earlier AFB repair. There were not significant differences between patients in the IAS and IAA groups, except for a more frequent use of polytetrafluoroethylene grafts for IARs in the IAS group (40% vs 15%; chi(2) test, P = .03). The 5-year primary patency rate for IARs was 68% in the IAS group, 46% in the IAA group, and 61% in the AFB group. Univariate analyses revealed that primary patency rates for IARs in patients with previous IAS were significantly higher than those in the IAA group (Kaplan-Meier, log-rank test, P = .02). Previous IAA repair was associated with a two-fold increased risk of IAR graft failure (relative risk, 2.2; 95% CI, 1.1-4.8; P = .04). IARs in patients with previous IAS have significantly

Análisis de costo de la enfermedad, del tratamiento, las complicaciones e intervenciones de la hipercolesterolemia en México en 2016.

Science.gov (United States)

Baeza-Cruz, German; Peniche-Otero, Gustavo; Alva-Esqueda, Mónica E; Naranjo-Muedano, Mariana; Soria-Suárez, Noé; Morales-Flores, Héctor J

2018-04-20

Describir los costos y el impacto económico de la atención de pacientes diagnosticados con hipercolesterolemia en México en el año 2016. METODOLOGíA: Se desarrolla una evaluación económica del tipo análisis de costo de la enfermedad donde se cuantifican los recursos médicos utilizados para el tratamiento de la hipercolesterolemia así como para sus complicaciones. Los costos de los recursos médicos utilizados son obtenidos de los costos unitarios por nivel de atención del Instituto Mexicano del Seguro Social (IMSS) así como de las licitaciones publicadas en el portal de compras del IMSS. El uso de recursos se obtiene mediante un panel de expertos y para el porcentaje de presencia de las complicaciones se efectúa una revisión de literatura. Los costos médicos directos son estimados multiplicando la frecuencia de uso por el costo unitario, agrupándolos y obteniendo así los costos individuales de cada recurso médico. Los casos de hipercolesterolemia en prevención secundaria con enfermedad coronaria y enfermedad cardiovascular representan un mayor costo promedio anual ($111,835.19, D.E. $84,276.37), seguido de la hipercolesterolemia en prevención secundaria con enfermedad coronaria sin enfermedad cardiovascular ($56,352.13, D.E. $29,004.04), los cuales no incluyen los costos generados por las complicaciones. El resto de los grupos de hipercolesterolemia representan una carga económica menor. La carga económica de la hipercolesterolemia representa en promedio por caso al año $258,761.37, esto traducido a los aproximadamente 445,075 de casos diagnosticados y tratados al año representaría un impacto económico en el sistema de salud de más de ciento quince mil millones ($115,168,331,355.11). Copyright © 2018. Published by Elsevier Inc.

An improved method for sacro-iliac joint imaging: a study of normal subjects, patients with sacro-iliitis and patients with low back pain

International Nuclear Information System (INIS)

Ayres, J.; Hilson, A.J.W.; Maisey, M.N.; Laurent, R.; Panayi, G.S.; Saunders, A.J.

1981-01-01

A new method is described for quantitative measurement of the uptake of sup(99m)Tc-methylene diphosphonate (MDP) by the sacro-iliac joints. The method uses 'regions of interest' providing advantages over the previously described 'slice' method; the two methods are compared in normal subjects, patients with known sacro-iliitis and patients with low back pain. Sacro-iliac activity, as calculated by the sacro-iliac index (SII) in normal patients, was shown to decrease with age in females but not in males. The SII was compared with radiographs of the sacro-iliac joints in the patients with known sacro-iliac joint disease and in those with low back pain. The method is useful for the exclusion of sacro-iliitis as a specific cause of back pain. (author)

Iliac artery pseudoaneurysm after lumbar disc hernia operation

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Mehmet Atay

2016-03-01

Full Text Available Lumbar disc herniation surgery is usually performed through a posterior approach. Vascular injuries can be counted among the complications. 39 years old male patient had lower extremity pain which has started after lumbar disc herniation surgery and continued for a month. Iliac arterial pseudoaneurysm has been detected in computerized tomography. It was successfully treated with vascular surgery [Cukurova Med J 2016; 41(0.100: 5-7

Costos del tratamiento de las telangiectasias y várices tronculares con escleroterapia con espuma en el Hospital "Freyre de Andrade" de La Habana

Directory of Open Access Journals (Sweden)

Anai García Fariñas

2013-03-01

Full Text Available Objetivo: determinar cuánto cuesta por paciente el tratamiento de várices por la técnica de escleroterapia con espuma en la consulta externa de Angiología y Cirugía Vascular del Hospital C.Q. "Freyre de Andrade". Método: evaluación económica del tipo descripción de costo. Se estudió el costo directo institucional del tratamiento ambulatorio para várices en extremidades inferiores con escleroterapia con espuma y donde el principio activo fue Polidocanol al 0,5% a una dosis de 2ml. Se emplearon las partidas recursos humanos, material gastable y medicamento. Se determinó el costo promedio por paciente, total y según tipo de consulta. Resultados: el costo total por paciente atendido fue de 68,60 pesos cubanos. El costo medio por paciente de la consulta de clasificación fue de 0,18 centavos de pesos cubanos (DS 95%= 0,12. El costo medio de la consulta de tratamiento fue de 50,60 pesos cubanos (DS 95%=7,65. No hubo diferencias significativas entre los diferentes tipos de varices a tratar. Conclusiones: el costo directo institucional del tratamiento de telangiectasias y varices tronculares con escleroterapia con espuma fue similar. A corto plazo, el tratamiento de las várices con escleroterapia con espuma genera menores costos que la opción quirúrgica.

Revascularization of calvarial, mandibular, tibial, and iliac bone grafts in rats

DEFF Research Database (Denmark)

Pinholt, E M; Solheim, E; Talsnes, O

1994-01-01

Some studies have suggested that membranous bone grafts undergo less resorption than endochondral grafts, and faster revascularization of the former has been proposed as the explanation. We studied fresh syngeneic full-thickness bone grafts from calvaria, mandibula, tibia diaphysis, and iliac bone...... implanted in the back muscles of young Lewis rats. As a measure of the quantity of cancellous bone in grafts before implantation, the ratio of the total area of soft-tissue spaces to the total area of the graft was measured histomorphometrically. Revascularization in grafts 3 weeks postoperatively...... was evaluated by deposit of 141Ce-labeled microspheres. Both the quantity of cancellous bone (before implantation) and the revascularization (3 weeks postoperatively) were greater in the mandibular and iliac bone grafts than in the calvarial and tibia diaphyseal grafts. The results suggest that the anatomical...

DETERMINACIÓN Y ANÁLISIS DE LOS COSTOS DE EXTRACCIÓN DE PLASMA EN EL BANCO DE SANGRE DE CIENFUEGOS. CUBA

Directory of Open Access Journals (Sweden)

Pérez Falco, Grisel

2013-01-01

Full Text Available La información de costos resulta herramienta indispensable para la planeación, el control y la toma de decisiones oportunas dentro de las organizaciones y constituye un elemento vital para la gestión y análisis interno de las entidades. Conocer con precisión los costos de las producciones o servicios permite valorar y analizar puntualmente los procesos, actividades y rendimientos en la producción. El banco de sangre provincial de Cienfuegos no logra determinar los costos de sus producciones individualmente, las cuales se derivan de la sangre extraída y requieren de procesos diversos para la obtención del producto final. El objetivo de este trabajo radica en el establecimiento de un procedimiento para la determinación de los costos de las producciones derivadas de la sangre en la entidad objeto de estudio; éste se logra mediante el diseño y aplicación de un costeo por procesos vinculando técnicas de la contabilidad de gestión, en función de aportar elementos precisos para la toma de decisiones. De esta forma se demuestra que el costeo que se aplica en la actualidad en esta entidad es inadecuado pues arroja un costo único para todas sus producciones cuando en realidad cada una implica un costo diferente.

Age-related changes in vertebral and iliac crest 3D bone microstructure-differences and similarities

DEFF Research Database (Denmark)

Thomsen, Jesper Skovhus; Jensen, Michael Vinkel; Niklassen, Andreas Steenholt

2015-01-01

Summary Age-related changes of vertebra and iliac crest 3D microstructure were investigated, and we showed that they were in general similar. The 95th percentile of vertebral trabecular thickness distribution increased with age for women. Surprisingly, vertebral and iliac crest bone microstructure...... was only weakly correlated (r = 0.38 to 0.75), despite the overall similar age-related changes.Introduction The purposes of the study were to determine the age-related changes in iliac and vertebral bone microstructure for women and men over a large age range and to investigate the relationship between...... the bone microstructure at these skeletal sites.Methods Matched sets of transiliac crest bone biopsies and lumbar vertebral body (L2) specimens from 41 women (19–96 years) and 39 men (23–95 years) were micro-computed tomography (μCT) scanned, and the 3D microstructure was quantified.Results For both women...

La economía de la salud, la eficiencia y el costo de oportunidad

OpenAIRE

Alberto Baly Gil; María Eugenia Toledo; Félix Rodríguez Jústiz

2001-01-01

Resumen La organización del sistema de salud en Cuba, que tiene como base la Atención Primaria de Salud, tendrá necesariamente que abordar el estudio y la implementación de la evaluación económica. La presente comunicación permite un acercamiento a conceptos relacionados con la Economía de la Salud. Se abordan las definiciones de economía, evaluación económica, eficiencia económica, costo, beneficio y costo de oportunidad, en el contexto de un ejemplo hipotético de un problema de salud en la ...

Aproximación a un modelo de costo eficacia de protectores auditivos en el ambiente laboral

Directory of Open Access Journals (Sweden)

Ivonne Valero-Pacheco

2014-06-01

Full Text Available Introducción: La escasa información disponible en relación con modelos de evaluación de costo efectividad de la protección auditiva, para la prevención de la hipoacusia neurosensorial inducida por el ruido laboral en Colombia, así como la confiabilidad de la información del nivel de atenuación de ruido que es suministrada por los fabricantes de elementos de protección auditiva, justificaron el desarrollo de esta investigación. Objetivos: Proponer un modelo de evaluación de costo eficacia de protectores auditivos ofertados en el mercado colombiano, frente a las necesidades de atenuación contra el ruido establecidas por la legislación colombiana. Materiales y Métodos: Se elaboró un modelo de costo eficacia de protectores auditivos en Colombia. Para ello se seleccionó del total de la oferta existente en el mercado colombiano un protector tipo copa y otro tipo inserción, a los cuales se les aplicó la metodología ANSI S3.19 para determinar el Nivel de Reducción del Ruido (NRR. En la prueba participaron 21 sujetos. En el modelo se consideraron variables como el costo equivalente anual, el nivel de atenuación real y la relación costo eficacia. Resultados: El nivel de atenuación del ruido suministrado en las fichas técnicas del fabricante difiere del encontrado en la prueba realizada para cada uno de los protectores, en el caso de los de tipo copa su eficacia es del 37% menos de lo esperado y para los de inserción del 59%. El cálculo de la Razón de Costo Efectividad (RCE para los protectores tipo copa muestra un valor de $90.055 por cada unidad de eficacia, mientras que la RCE de los protectores de inserción es de $465.034. Discusión/Conclusiones: Aunque las diferencias en el nivel de eficacia observado pueden estar afectadas por factores humanos, la metodología de la prueba y las características propias del protector auditivo, estos hallazgos son consistentes con la recomendación de National Institute for Occupational

Perigraft Plug Embolization of the Internal Iliac Artery and Implantation of a Bifurcated Stentgraft: One Treatment Option for Insufficient Tubular Stentgraft Repair of a Common Iliac Artery Aneurysm

Energy Technology Data Exchange (ETDEWEB)

Goltz, Jan Peter, E-mail: janpeter.goltz@uksh.de; Loesaus, Julia; Frydrychowicz, Alex; Barkhausen, Jörg [University Hospital of Schleswig-Holstein, Department for Radiology and Nuclear Medicine (Germany); Wiedner, Marcus [University Hospital of Schleswig-Holstein, Clinic for Surgery (Germany)

2016-02-15

We report an endovascular technique for the treatment of type Ia endoleak after a plain tubular stentgraft had been implanted for a large common iliac artery aneurysm with an insufficient proximal landing zone and without occlusion of the hypogastric in another hospital. CT follow-up showed an endoleak with continuous sac expansion over 12 months. This was classified as type Ia by means of dynamic contrast-enhanced MRI. Before a bifurcated stentgraft was implanted to relocate the landing zone more proximally, the still perfused ipsilateral hypogastric artery was embolized to prevent a type II endoleak. A guidewire was manipulated alongside the indwelling stentgraft. The internal iliac artery could then be selectively intubated followed by successful plug embolization of the vessel’s orifice despite the stentgraft being in place.

Modelling of soft impingement during solidification

Indian Academy of Sciences (India)

TECS

soft impingement problem and related to shape instability by constitutional supercooling theory. This analysis ... the context of the stir casting process, it has been pointed ... This transformation when applied to Fick's second law gives the ...

Contabilidad de Costos I. - Problemas sobre contabilización de las actividades relacionadas con los materiales

OpenAIRE

Morillo Moreno, Marysela C.

2008-01-01

ÍNDICE Introducción Problemas sobre terminología básica Problemas básicos sobre el Ciclo de la Contabilidad de Costos Problemas sobre contabilización de las actividades relacionadas con los materiales Problemas sobre la contabilización de las actividades relacionadas con la mano de obra Problemas sobre la contabilización de las actividades relacionadas con los costos indirectos de fabricación Problemas sobre el Ciclo de la Contabilida...

Hydrodynamics and PIV study in the impingement zone formed by a droplet train

Science.gov (United States)

Kanjirakat, Anoop; Sadr, Reza; Zhang, Taolue; Muthusamy, Jayaveera; Alvarado, Jorge; Texas A; M University at Qatar Collaboration; Texas A; M University College Station Collaboration

2016-11-01

Droplet impingement is encountered in numerous technical applications, such as ink jet printing, spray cooling, and fuel injection in internal combustion engines. Even though many studies in droplet impingement were conducted in past, not many have measured the near-wall velocities in the droplet impingement zone. With the goal of gaining a better understanding of the hydrodynamics in the impingement zone, well-controlled experiments are performed in combination with micro-PIV measurements and numerical simulations. Hydrodynamics of HFE-7100 droplets generated using a piezoelectric droplet generator, impinging on a pre-wetted surface is investigated. Micro-PIV studies in the high-velocity impingement zone are performed using one-micron meter fluorescent particles dispersed in HFE-7100 along with the double exposed images. Three-dimensional and 2D-axisymmetric numerical modeling for a transient droplet crown development is performed. The interface between the gas and the liquid is modeled using a Volume of Fluid (VOF) method. Numerical simulation results obtained are observed to be in good agreement with that of the experimental observations. Supported by National Priority Research Program (NPRP) of Qatar National Research Fund (QNRF), Grant No.: NPRP 6-1304-2-525.

La relación costo-calidad. Algunos aspectos económicos del confort térmico

Directory of Open Access Journals (Sweden)

Amarilla, Beatriz Cecilia

1994-02-01

Full Text Available This paper proposes a methodology for joint analysis of cost and quality in dwelling buildings. In order to give an illustrative example of the application of this methodology, the "cost" referred to the construction, maintenance and energy for heating, while the "quality", in its turn, referred to some aspects of thermal comfort. The authors try to prove that there is not always a directly proportional relation between the cost of buildings and the real quality reached in them. Bioclimatic, social, economic, technological and morphological variables have been analyzed. The final objective is to obtain a "weighting cost" (cost according to the achieved thermal benefit. This allows the determination of an order of priorities among various alternative solutions proposed for mass construction of dwellings.

El presente trabajo propone una metodología para analizar conjuntamente aspectos de costo y calidad en los edificios para vivienda. A los efectos de ilustrar mediante un ejemplo de aplicación de dicha metodología, el "costo" se ha referido a la construcción, mantenimiento y energía para calefacción; la "calidad", por su parte, se ha identificado con algunos aspectos del confort térmico. Se intenta demostrar que no siempre existe una relación directamente proporcional entre el costo de los edificios y las calidades objetivas que en ellos se alcanzan. Se estudiaron y relacionaron variables de tipo bioclimático, social, económico, tecnológico y morfológico. El objetivo final es obtener un "costo ponderado" (costo en relación al beneficio térmico conseguido. Ello permite determinar un orden de prioridades entre varias soluciones alternativas que se proponen para la construcción masiva de viviendas.

Modular jet impingement assemblies with passive and active flow control for electronics cooling

Energy Technology Data Exchange (ETDEWEB)

Zhou, Feng; Dede, Ercan Mehmet; Joshi, Shailesh

2016-09-13

Power electronics modules having modular jet impingement assembly utilized to cool heat generating devices are disclosed. The modular jet impingement assemblies include a modular manifold having a distribution recess, one or more angled inlet connection tubes positioned at an inlet end of the modular manifold that fluidly couple the inlet tube to the distribution recess and one or more outlet connection tubes positioned at an outlet end of the modular manifold that fluidly coupling the outlet tube to the distribution recess. The modular jet impingement assemblies include a manifold insert removably positioned within the distribution recess and include one or more inlet branch channels each including an impinging slot and one or more outlet branch channels each including a collecting slot. Further a heat transfer plate coupled to the modular manifold, the heat transfer plate comprising an impingement surface including an array of fins that extend toward the manifold insert.

Embolization of the Internal Iliac Artery: Cost-Effectiveness of Two Different Techniques

International Nuclear Information System (INIS)

Pellerin, Olivier; Caruba, Thibaud; Kandounakis, Yanis; Novelli, Luigi; Pineau, Judith; Prognon, Patrice; Sapoval, Marc

2008-01-01

The purpose of this study was to compare the cost-effectiveness of coils versus the Amplatzer Vascular Plug (AVP) for occlusion of the internal iliac artery (IAA). Between 2002 and January 2006, 13 patients (mean age 73 ± 13 years) were referred for stent-grafting of abdominal aortic aneurysm (n = 6); type I distal endoleak (n = 3), isolated iliac aneurysm (n = 3), or rupture of a common iliac aneurysm (n = 1). In all patients, extension of the stent-graft was needed because the distal neck was absent. Two different techniques were used to occlude the IIA: AVP in seven patients (group A) and coil embolization in six patients (group C). Immediate results and direct material costs were assessed retrospectively. Immediate success was achieved in all patients, and simultaneous stent-grafting was successfully performed in two of six patients in group C versus five of seven patients in group A. In all group A patients, a single AVP was sufficient to achieve occlusion of the IIA, accounting for a mean cost of 485 Euro , whereas in group C patients, an average of 7 ± 3 coils were used, accounting for a mean cost of 1,745 Euro . Mean average cost savings using the AVP was 1,239 Euro . When IIA occlusion is needed, the AVP allows a single-step procedure at significant cost savings.

Multicentre study on capsular closure versus non-capsular closure during hip arthroscopy in Danish patients with femoroacetabular impingement (FAI)

DEFF Research Database (Denmark)

Dippmann, Christian; Kraemer, Otto; Lund, Bent

2018-01-01

in patients without additional risk factors for instability such as hypermobility or dysplasia of the hip. We hypothesised that capsular closure will lead to a superior outcome in hip arthroscopy for femoroacetabular impingement syndrome (FAIS) compared with non-capsular closure. METHODS AND ANALYSIS...... years and FAIS according to the Warwick agreement. Exclusion criteria are: previous hip surgery in either hip, previous conditions of Legg-Calvé-Perthes or slipped capital femoral epiphysis, malignant disease, recent hip or pelvic fractures, arthritis, Ehlers-Danlos or Marfan disease, recent (within 6...

A new building block: costo-osteochondral graft for intra-articular incongruity after distal radius fracture.

Science.gov (United States)

Tang, Chris Yuk Kwan; Fung, Boris; Poon, T L; Fok, Margaret

2014-01-01

Even with the invention of locking plates, intra-articular fractures of distal radius with extreme comminution remain a challenge for orthopaedic surgeons. Osteochondral graft is a potential choice to reconstruct the articular defect. We report a patient who had a fracture of distal radius with costo-osteochondral graft for articular reconstruction which has not yet been described in the English literature. At nine-year follow-up, he was pain free and had full range of movement of the wrist. The authors suggest that costo-osteochondral graft could be an option with satisfactory result.

Sistema de costos basado en actividades en hoteles cuatro estrellas del estado Mérida, Venezuela

OpenAIRE

Marysela Coromoto Morillo Moreno; Cororina del Carmen Cardozo

2017-01-01

Las empresas actualmente demandan sistemas de costos que reporten un mayor detalle en la información generada, con el propósito de orientar la aplicación de estrategias que conduzcan a captar y apropiarse de mayores espacios de mercado, sobre todo cuando la competitividad es elevada; por ello, se formuló un sistema de costos basado en actividades, conocido por sus siglas en inglés como abc (Activity-Based Costing), aplicado a los hoteles de turismo de cuatro estrellas de Mérida, en Vene...

Costo-efectividad de dos terapias antivirales para Hepatitis B crónica en el Perú: Entecavir y tenofovir

Directory of Open Access Journals (Sweden)

Rafael Bolaños-Díaz

Full Text Available RESUMEN Objetivos Comparar en términos de costo-efectividad a entecavir (ETV y tenofovir (TDF en el tratamiento del virus de la hepatitis B (HBV en hospitales públicos del Perú. Materiales y métodos Estructuramos un modelo de Markov, definimos la efectividad en años de vida ajustados a calidad (AVAC. Incluimos los costos directos del tratamiento en soles desde la perspectiva del Ministerio de Salud del Perú. Calculamos la relación entre costo y efectividad incrementales (ICER. Realizamos análisis de sensibilidad determinístico y probabilístico, considerando un rango de disponibilidad de pago (WTP desde uno hasta tres veces el producto bruto interno (PBI per-cápita, y el beneficio monetario neto (BMN o ICER en el caso del análisis de tornado. Resultados El tratamiento con TDF es más efectivo y menos costoso que ETV. El ETV tuvo un costo por AVAC de S/ 4482, y de S/ 1526 para TDF. El TDF mantiene un BMN progresivamente mayor conforme aumenta la WTP. La tasa de descuento fue la única variable con efecto significativo en la incertidumbre del modelo. Conclusiones El tratamiento con TDF es más costo-efectivo que ETV en hospitales públicos del Perú.

Accuracy of S2 Alar-Iliac Screw Placement Under Robotic Guidance.

Science.gov (United States)

Laratta, Joseph L; Shillingford, Jamal N; Lombardi, Joseph M; Alrabaa, Rami G; Benkli, Barlas; Fischer, Charla; Lenke, Lawrence G; Lehman, Ronald A

Case series. To determine the safety and feasibility of S2 alar-iliac (S2AI) screw placement under robotic guidance. Similar to standard iliac fixation, S2AI screws aid in achieving fixation across the sacropelvic junction and decreasing S1 screw strain. Fortunately, the S2AI technique minimizes prominent instrumentation and the need for offset connectors to the fusion construct. Herein, we present an analysis of the largest series of robotic-guided S2AI screws in the literature without any significant author conflicts of interest with the robotics industry. Twenty-three consecutive patients who underwent spinopelvic fixation with 46 S2AI screws under robotic guidance were analyzed from 2015 to 2016. Screws were placed by two senior spine surgeons, along with various fellow or resident surgical assistants, using a proprietary robotic guidance system (Renaissance; Mazor Robotics Ltd., Caesara, Israel). Screw position and accuracy was assessed on intraoperative CT O-arm scans and analyzed using three-dimensional interactive viewing and manipulation of the images. The average caudal angle in the sagittal plane was 31.0° ± 10.0°. The average horizontal angle in the axial plane using the posterior superior iliac spine as a reference was 42.8° ± 6.6°. The average S1 screw to S2AI screw angle was 11.3° ± 9.9°. Two violations of the iliac cortex were noted, with an average breach distance of 7.9 ± 4.8 mm. One breach was posterior (2.2%) and one was anterior (2.2%). The overall robotic S2AI screw accuracy rate was 95.7%. There were no intraoperative neurologic, vascular, or visceral complications related to the placement of the S2AI screws. Spinopelvic fixation achieved using a bone-mounted miniature robotic-guided S2AI screw insertion technique is safe and reliable. Despite two breaches, no complications related to the placement of the S2AI screws occurred in this series. Level IV, therapeutic. Copyright © 2017 Scoliosis Research Society. Published by Elsevier

Comparative analysis of arthroscopic debridement in osseous versus soft tissue anterior ankle impingement.

Science.gov (United States)

Devgan, Ashish; Rohilla, Rajesh; Tanwar, Milind; Jain, Aditya; Siwach, Karan; Devgan, Radika

2016-01-01

Arthroscopic debridement has been a gold standard procedure for anterior ankle impingement, both in cases of osseous and soft tissue impingement. There is sparse literature on comparative outcome with respect to functional results between the two types of impingement post-arthroscopic debridement. Our study included 14 patients diagnosed as cases of anterior ankle impingement on the basis of clinical and radiological examination. They were segregated into two groups (on the basis of cause of impingement (osseous versus soft tissue)). Both groups were treated by arthroscopic debridement. Primary outcome was patient satisfaction, which was assessed by Likert scale and clinical outcomes were measured using AOFAS ankle-hind foot scale, VAS score, range of motion and time to return to pre-injury activity level in both groups. Mean follow-up was of 15 months where eleven patients reported an excellent recovery, two patients had good recovery while one patient reported poor outcome. Mean AOFAS ankle hind foot scale improved from 50.5 preoperatively to 85.71 postoperatively (statistically significant; p value - 0.0001). Mean Likert scale value post-operative was 4.21. VAS score showed significant improvement in patients of both the groups. Range of motion was slightly better in soft tissue impingement type with a relatively shorter time to return to sports or preinjury activity level as compared to osseous impingement group. The patients in both the groups had comparable outcomes with no statistically significant difference with regard to patient satisfaction and clinical outcome.

Análisis de costos por ausentismo laboral atribuibles a licencias médicas por enfermedad. Hospital Nacional Arzobispo Loayza 2015

OpenAIRE

Jave Escalante, Gladys Lizeth

2015-01-01

Determina el costo generado por el ausentismo laboral atribuible a licencias médicas por enfermedad en el Hospital Nacional Arzobispo Loayza 2015. METODOLOGÍA: Estudio no experimental. La muestra estuvo conformada por 118 médicos asistenciales y personal de enfermería. Para el análisis de los costos se utilizó el costo de tiempo perdido del paciente, ingresos dejados de percibir por el hospital y descuento económico al trabajador. Además se realizó un análisis económico y de sensibilidad. ...

The impact of subacromial impingement syndrome on muscle activity patterns of the shoulder complex: a systematic review of electromyographic studies

Directory of Open Access Journals (Sweden)

Smith Toby O

2010-03-01

Full Text Available Abstract Background Subacromial impingement syndrome (SIS is a commonly reported cause of shoulder pain. The purpose of this study was to systematically review the literature to examine whether a difference in electromyographic (EMG activity of the shoulder complex exists between people with SIS and healthy controls. Methods Medline, CINAHL, AMED, EMBASE, and grey literature databases were searched from their inception to November 2008. Inclusion, data extraction and trial quality were assessed in duplicate. Results Nine studies documented in eleven papers, eight comparing EMG intensity and three comparing EMG onset timing, representing 141 people with SIS and 138 controls were included. Between one and five studies investigated each muscle totalling between 20 and 182 participants. The two highest quality studies of five report a significant increase in EMG intensity in upper trapezius during scaption in subjects with SIS. There was evidence from 2 studies of a delayed activation of lower trapezius in patients with SIS. There was otherwise no evidence of a consistent difference in EMG activity between the shoulders of subjects with painful SIS and healthy controls. Conclusions A difference may exist in EMG activity within some muscles, in particular upper and lower trapezius, between people with SIS and healthy controls. These muscles may be targets for clinical interventions aiding rehabilitation for people with SIS. These differences should be investigated in a larger, high quality survey and the effects of therapeutically targeting these muscles in a randomised controlled trial.

Physics of Particle Entrainment Under the Influence of an Impinging Jet

Science.gov (United States)

2008-12-01

Approved for public release; distribution unlimited 1 PHYSICS OF PARTICLE ENTRAINMENT UNDER THE INFLUENCE OF AN IMPINGING JET Robert Haehnel...Ing. Wesen. Heft 361). Phares, D.J., Smedley , G.T. and Flagan, R.C. (2000) "The wall shear stress produced by the normal impingement of a jet on a

Reliability of impingement sampling designs: An example from the Indian Point station

International Nuclear Information System (INIS)

Mattson, M.T.; Waxman, J.B.; Watson, D.A.

1988-01-01

A 4-year data base (1976-1979) of daily fish impingement counts at the Indian Point electric power station on the Hudson River was used to compare the precision and reliability of three random-sampling designs: (1) simple random, (2) seasonally stratified, and (3) empirically stratified. The precision of daily impingement estimates improved logarithmically for each design as more days in the year were sampled. Simple random sampling was the least, and empirically stratified sampling was the most precise design, and the difference in precision between the two stratified designs was small. Computer-simulated sampling was used to estimate the reliability of the two stratified-random-sampling designs. A seasonally stratified sampling design was selected as the most appropriate reduced-sampling program for Indian Point station because: (1) reasonably precise and reliable impingement estimates were obtained using this design for all species combined and for eight common Hudson River fish by sampling only 30% of the days in a year (110 d); and (2) seasonal strata may be more precise and reliable than empirical strata if future changes in annual impingement patterns occur. The seasonally stratified design applied to the 1976-1983 Indian Point impingement data showed that selection of sampling dates based on daily species-specific impingement variability gave results that were more precise, but not more consistently reliable, than sampling allocations based on the variability of all fish species combined. 14 refs., 1 fig., 6 tabs

Impingement of water droplets on wedges and diamond airfoils at supersonic speeds

Science.gov (United States)

Serafini, John S

1953-01-01

An analytical solution has been obtained for the equations of motion of water droplets impinging on a wedge in a two-dimensional supersonic flow field with a shock wave attached to the wedge. The closed-form solution yields analytical expressions for the equation of the droplet trajectory, the local rate of impingement and the impingement velocity at any point on the wedge surface, and the total rate of impingement. The analytical expressions are utilized to determine the impingement on the forward surfaces of diamond airfoils in supersonic flow fields with attached shock waves. The results presented include the following conditions: droplet diameters from 2 to 100 microns, pressure altitudes from sea level to 30,000 feet, free-stream static temperatures from 420 degrees to 460 degrees R. Also, free-stream Mach numbers from 1.1 to 2.0, semi-apex angles for the wedge from 1.14 degrees to 7.97 degrees, thickness-to-chord ratios for the diamond airfoil from 0.02 to 0.14, chord lengths from 1 to 20 feet, and angles of attack from zero to the inverse tangent of the airfoil thickness-to-chord ratio.

Estimación de costos de desarrollo, caso de estudio: Sistema de Gestión de calidad del Reactor TRIGA Mark III

OpenAIRE

Tereso Antonio Antúnez Barbosa

2016-01-01

El proceso de estimación de costos en Ingeniería del software no es una tarea sencilla, más que eso es un proceso que debe tratarse cuidadosamente para obtener una estrategia que permita resolver problemas asociadas al esfuerzo, costo y tiempo de las activ idades que se realizan en un proyecto de desarrollo de sistemas de información. En este contexto , lo principal tanto para desarrolladores como para los clientes es el costo, lo s primeros p...

Knowledge of practising radiographers of the supraspinatus outlet projection for shoulder impingement syndrome in the Eastern Cape, South Africa

International Nuclear Information System (INIS)

Williams, R.; Morton, D.G.

2016-01-01

Background/Aim: There are many projections in plain film imaging to demonstrate the specific aspects of the anatomy of the shoulder. However, reproducing the required projections can be challenging especially if radiographers are not familiar with the projections and their evaluation criteria. The aim of the study was to explore and describe the knowledge of practising radiographers regarding the supraspinatus outlet projection for shoulder impingement syndrome. Method: A quantitative, exploratory and descriptive design was followed. The population served as the sample and included all the practising radiographers in the public and private hospitals of a metropolitan municipality in the Eastern Cape, South Africa. A total of 84 respondents completed the structured, self-administered questionnaire. Results: The data revealed that in many cases, the majority of radiographers in the study, due to inadequate knowledge levels would not be able to produce an optimal radiographic image of the supraspinatus outlet. The results of the chi-squares indicated statistically significant differences (p < 0.05) between public and private hospitals regarding certain aspects of the scapular Y projection and SOP. Conclusion: It was found that the radiographers in the study had inadequate knowledge of scapular Y projections and SOPs in relation to SIS. Therefore, it is essential to ensure that radiographers are updated on their knowledge of radiographic practice on a continuous basis. - Highlights: • Many radiographers unable to produce an optimal image of the supraspinatus outlet. • Radiographers had poor knowledge of scapular Y and supraspinatus outlet projections. • It is essential that radiographers update their knowledge of radiographic practice.

Relationship between width of greater trochanters and width of iliac wings in tronchanteric bursitis.

Science.gov (United States)

Viradia, Neal K; Berger, Alex A; Dahners, Laurence E

2011-09-01

Trochanteric bursitis is a common disorder that is characterized by inflammation of the bursa, superficial to the greater trochanter of the femur, leading to pain in the lateral hip, and often occurs because of acute trauma or repetitive friction involving the iliotibial band, the greater trochanter, and the bursa. In the study reported here, we hypothesized that the increased incidence of bursitis may be the result of the increased prominence of the trochanter in relation to the wings of the iliac crest. Distances between the outermost edges of trochanters and iliac wings were measured in 202 patients from the University of North Carolina Health Care System-101 without a known diagnosis and 101 with a clinical diagnosis of trochanteric bursitis. To determine significance, t tests for nonpaired data were used. Mean (SD) difference between trochanter and iliac wing widths was 28 (20) mm in the group diagnosed with trochanteric bursitis and 17 (18) mm in the control group. The difference between the groups in this regard was significant (Pbursitis group and 1.05 (.06) in the control group. The difference between these groups was significant (Pbursitis.

Shwachman-Diamond syndrome: clinical, radiological and sonographic findings

International Nuclear Information System (INIS)

Berrocal, T.; Simon, M.J.; Al-Assir, I.; Prieto, C.; Pastor, I.; Pablo, L. de; Lama, R.

1995-01-01

Six children with Shwachman-Diamond syndrome have been diagnosed and treated in our hospital since 1986. We describe the radiological and sonographic findings of this rare disease, which is characterized by metaphyseal chondrodysplasia, neutropenia and exocrine pancreatic insufficiency. It presents with varying extremity shortening, ''cup'' deformation of the ribs, metaphyseal widening and hypoplasia of the iliac bones, as well as increased echogenicity of the normal-sized pancreas. We discuss the differential diagnosis and review the literature. (orig.)

Shwachman-Diamond syndrome: clinical, radiological and sonographic aspects

International Nuclear Information System (INIS)

Berrocal, T.; Simon, M.J.; Al-Assir, I.; Prieto, C.; Pastor, I.; Pablo, L. de; Lama, R.

1995-01-01

Six children with Shwachman-Diamond syndrome have been diagnosed and treated in our hospital since 1986. We describe the radiological and sonographic findings of this rare disease which is characterized by metaphyseal chondrodysplasia, neutropenia and pancreatic exocrine insufficiency. It presents with variable extremity shortening, ''cup'' deformation of the ribs, metaphyseal widening and hypoplasia of the iliac bones, and increased echogenicity of the pancreas without change in size. We discuss the differential diagnosis and review the literature. (orig.)

Shwachman-Diamond syndrome: clinical, radiological and sonographic findings

Energy Technology Data Exchange (ETDEWEB)

Berrocal, T. [Servicio de Radiologia Pediatrica, Hospital Infantil `La Paz`, Madrid (Spain); Simon, M.J. [Servicio de Radiologia Pediatrica, Hospital Infantil `La Paz`, Madrid (Spain); Al-Assir, I. [Servicio de Radiologia Pediatrica, Hospital Infantil `La Paz`, Madrid (Spain); Prieto, C. [Servicio de Radiologia Pediatrica, Hospital Infantil `La Paz`, Madrid (Spain); Pastor, I. [Servicio de Radiologia Pediatrica, Hospital Infantil `La Paz`, Madrid (Spain); Pablo, L. de [Servicio de Radiologia Pediatrica, Hospital Infantil `La Paz`, Madrid (Spain); Lama, R. [Servicio de Gastroenterologia, Hospital Infantil `La Paz`, Madrid (Spain)

1995-07-01

Six children with Shwachman-Diamond syndrome have been diagnosed and treated in our hospital since 1986. We describe the radiological and sonographic findings of this rare disease, which is characterized by metaphyseal chondrodysplasia, neutropenia and exocrine pancreatic insufficiency. It presents with varying extremity shortening, ``cup`` deformation of the ribs, metaphyseal widening and hypoplasia of the iliac bones, as well as increased echogenicity of the normal-sized pancreas. We discuss the differential diagnosis and review the literature. (orig.)

Shwachman-Diamond syndrome: clinical, radiological and sonographic aspects

Energy Technology Data Exchange (ETDEWEB)

Berrocal, T. [Dept. of Pediatric Radiology, `La Paz` Children`s Hospital, Madrid (Spain); Simon, M.J. [Dept. of Pediatric Radiology, `La Paz` Children`s Hospital, Madrid (Spain); Al-Assir, I. [Dept. of Pediatric Radiology, `La Paz` Children`s Hospital, Madrid (Spain); Prieto, C. [Dept. of Pediatric Radiology, `La Paz` Children`s Hospital, Madrid (Spain); Pastor, I. [Dept. of Pediatric Radiology, `La Paz` Children`s Hospital, Madrid (Spain); Pablo, L. de [Dept. of Pediatric Radiology, `La Paz` Children`s Hospital, Madrid (Spain); Lama, R. [Dept. of Gastroenterology, `La Paz` Children`s Hospital, Madrid (Spain)

1995-06-01

Six children with Shwachman-Diamond syndrome have been diagnosed and treated in our hospital since 1986. We describe the radiological and sonographic findings of this rare disease which is characterized by metaphyseal chondrodysplasia, neutropenia and pancreatic exocrine insufficiency. It presents with variable extremity shortening, ``cup`` deformation of the ribs, metaphyseal widening and hypoplasia of the iliac bones, and increased echogenicity of the pancreas without change in size. We discuss the differential diagnosis and review the literature. (orig.)

Blood pressure shifts resulting from a concealed arteriovenous fistula associated with an iliac aneurysm: a case report.

Science.gov (United States)

Doi, Shintaro; Motoyama, Yoshiaki; Ito, Hiromi

2016-01-01

A solitary iliac aneurysm (SIA) is more uncommon than an abdominal aortic aneurysm. The aneurysm is located in the deep pelvis and is diagnosed when it reaches a large size with symptoms of compression around adjacent structures and organs or when it ruptures. A definite diagnosis of an arteriovenous fistula (AVF) associated with a SIA is difficult preoperatively because there might not be enough symptoms and time for diagnosis. Here, we present a patient with asymptomatic rupture of SIA into the common iliac vein with characteristic blood pressure shifts. A 41-year-old man with a huge SIA underwent aortobifemoral graft replacement. Preoperatively, his blood pressure showed characteristic shifts for one or two heartbeats out of five beats, indicating that an AVF was present and that the shunt was about to having a high flow. During surgery, an AVF associated with the SIA was found to be concealed owing to compression from the huge iliac artery aneurysm, and the shunt showed a high flow, resulting in shock during the surgery. No complications were noted after aortobifemoral graft replacement. Postoperatively, we noted an enhanced paravertebral vein on computed tomography (CT), which indicated the presence of an AVF. Definite diagnosis of an AVF offers advantages in surgical and anesthetic management. We emphasize that a large SIA can push the iliac vein and occlude an AVF laceration, concealing the enhancement of the veins in the arterial phase on CT. Blood pressure shifts might predict the existence of a concealed AVF that has a large shunt. Even if the vena cava and the iliac veins are not enhanced on CT, anesthesiologists should carefully determine whether their distal branches are enhanced.

Presentation of an uncommon form of aortic dissection and rupture in Marifoan syndrome

International Nuclear Information System (INIS)

Delgado, I.; Ruiz, R.; Villanueva, J.M.; Fernandez Cueto, J.L.

1995-01-01

In Marfan syndrome, aneurysmatic enlargement of ascending aorta and dissection starting at the root are the most common cardiovascular complications. We present an infrequent case of a 15-year-old patient with a typical case of Marfan syndrome. CT disclosed an aorta and aortic arch of normal size with dissection originating distally with respect to the point where left subclavian artery arises. The disecction extended to descending aorta and to iliac and femoral arteries. Aortic rupture occurred in the arch, with massive hemothorax. The CT findings were confirmed at necropsy. 9 refs

Transverse jet-cavity interactions with the influence of an impinging shock

International Nuclear Information System (INIS)

Zare-Behtash, H.; Lo, K.H.; Kontis, K.; Ukai, T.; Obayashi, S.

2015-01-01

Highlights: • Experimental study of shock-jet-cavity in a supersonic freestream is conducted. • Shock impingement at the cavity leading edge lifts the shear layer, encouraging momentum transfer. • Shock impingement close to the jet location increases the number of smaller turbulent structures. - Abstract: For high-speed air breathing engines, fuel injection and subsequent mixing with air is paramount for combustion. The high freestream velocity poses a great challenge to efficient mixing both in macroscale and microscale. Utilising cavities downstream of fuel injection locations, as a means to hold the flow and stabilise the combustion, is one mechanism which has attracted much attention, requiring further research to study the unsteady flow features and interactions occurring within the cavity. In this study we combine the transverse jet injection upstream of a cavity with an impinging shock to see how this interaction influences the cavity flow, since impinging shocks have been shown to enhance mixing of transverse jets. Utilising qualitative and quantitative methods: schlieren, oilflow, PIV, and PSP the induced flowfield is analysed. The impinging shock lifts the shear layer over the cavity and combined with the instabilities generated by the transverse jet creates a highly complicated flowfield with numerous vertical structures. The interaction between the oblique shock and the jet leads to a relatively uniform velocity distribution within the cavity

Investigation of vertical liquid film width upon impingement on flat plate

International Nuclear Information System (INIS)

Kim, Won J.; Son, Hyung M.; Suh, Kune Y.

2003-01-01

In the early, high pressure phase during a Large-Break Loss-Of-Coolant Accident (LBLOCA), the Emergency Core Cooling (ECC) water of the Direct Vessel Injection (DVI) system is supplied from the Safety Injection Tank (SIT). After the shortage of the SIT, the In-containment Refueling Water Storage Tank (IRWST) supplies water to the safety system. Velocity of the injection flow varies during the process from the initial value of over 10 m/s in the blowdown phase to 2∼3 m/s in the later phase of reflood. During the safety injection, such important phenomena are observed as impingement, bypass, entrainment and sweepout, and condensation. The impingement is referred to the case where the ECC water is injected to strike on the reactor inner vessel. Accordingly, the water generates a liquid film to form a ridge on the wall. The liquid film then flows down the wall due to gravity. This impingement is interrupted by the steam-water mixture bypass flow to the break. The bypass, in turn, is affected by the impingement. This study is intended to understand the impinged water flow behavior neglecting such secondary effects as the temperature-dependent thermodynamic properties and the reactor vessel curvature. An emphasis is put on interpreting the results of visual inspection to understand the underlying mechanism of rather complex turbulent flow in the downcomer

A rare case of large isolated internal iliac artery aneurysm with ureteral obstruction and hydronephrosis: Compression symptoms are limitation for endovascular procedures.

Science.gov (United States)

Nenezic, Dragoslav; Tanaskovic, Slobodan; Gajin, Predrag; Ilijevski, Nenad; Novakovic, Aleksandra; Radak, Djordje

2015-04-01

In this report, we aim to present a rare case of isolated internal iliac artery aneurysm with associated left ureteric obstruction and consequent hydronephrosis. A 66-year-old male patient was admitted for occasional pain in the lower back that appeared one month earlier. CT arteriography revealed isolated internal iliac artery (diameter 99 mm) with ureteral obstruction, hydroureter and left kidney hydronephrosis occurrence. Aneurysm was resected, after six months the patient was doing well. Bearing in mind that 77% of the patients with isolated internal iliac artery have symptoms caused by aneurysmal compression on adjacent organs, we wanted to highlight that despite the amazing expansion of endovascular procedures in the last decades, its therapeutic effect in isolated internal iliac artery's treatment is to a great extent limited since compression symptoms cannot be solved. Open surgery remains the gold standard for isolated internal iliac artery's treatment considering significant limitations of endovascular procedures due to the inability to eliminate problems caused by compression. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Sports hernia and femoroacetabular impingement in athletes: A systematic review.

Science.gov (United States)

Munegato, Daniele; Bigoni, Marco; Gridavilla, Giulia; Olmi, Stefano; Cesana, Giovanni; Zatti, Giovanni

2015-09-16

To investigate the association between sports hernias and femoroacetabular impingement (FAI) in athletes. PubMed, MEDLINE, CINAHL, Embase, Cochrane Controlled Trials Register, and Google Scholar databases were electronically searched for articles relating to sports hernia, athletic pubalgia, groin pain, long-standing adductor-related groin pain, Gilmore groin, adductor pain syndrome, and FAI. The initial search identified 196 studies, of which only articles reporting on the association of sports hernia and FAI or laparoscopic treatment of sports hernia were selected for systematic review. Finally, 24 studies were reviewed to evaluate the prevalence of FAI in cases of sports hernia and examine treatment outcomes and evidence for a common underlying pathogenic mechanism. FAI has been reported in as few as 12% to as high as 94% of patients with sports hernias, athletic pubalgia or adductor-related groin pain. Cam-type impingement is proposed to lead to increased symphyseal motion with overload on the surrounding extra-articular structures and muscle, which can result in the development of sports hernia and athletic pubalgia. Laparoscopic repair of sports hernias, via either the transabdominal preperitoneal or extraperitoneal approach, has a high success rate and earlier recovery of full sports activity compared to open surgery or conservative treatment. For patients with FAI and sports hernia, the surgical management of both pathologies is more effective than sports pubalgia treatment or hip arthroscopy alone (89% vs 33% of cases). As sports hernias and FAI are typically treated by general and orthopedic surgeons, respectively, a multidisciplinary approach for diagnosis and treatment is recommended for optimal treatment of patients with these injuries. The restriction in range of motion due to FAI likely contributes to sports hernias; therefore, surgical treatment of both pathologies represents an optimal therapy.

MÉTODO MATRICIAL FHER EN UN SISTEMA DE COSTOS POR PROCESOS, O EN LÍNEA

OpenAIRE

Fernando Villarreal Vásquez; Carlos Augusto Rincón Soto

2009-01-01

La investigación centra su atención en el diseño de una herramienta de costos que permite manipular y entregar resultados de los costos por procesos o en línea en una matriz de manera sencilla y entendible, esta matriz ha sido desarrollada y probada por los autores del artículo,  con estudiantes  de contaduría pública en varias mypimes  y ha demostrado su facilidad para que el estudiante comprenda y el empresario lo manipule dentro de su información financiera. El método matricial  FHER (form...

Análisis costo beneficio del Programa de Detección Oportuna del Cáncer Cervicouterino Cost benefit analysis of the Cervical Cancer Screening Program

OpenAIRE

PATRICIA HERNÁNDEZ-PEÑA; EDUARDO CÉSAR LAZCANO-PONCE; PATRICIA ALONSO-DE RUIZ; AURELIO CRUZ-VALDEZ; FERNANDO MENESES-GONZÁLEZ; MAURICIO HERNÁNDEZ-AVILA

1997-01-01

Objetivo. Determinar el costo beneficio de la reorganización del Programa de Detección Oportuna del Cáncer Cervicouterino (PDOC) mediante intervenciones de garantía de calidad. Material y métodos. Se siguieron tres etapas: a) identificación y cuantificación de costos; b) identificación y cuantificación de beneficios, y c) evaluación económica del costo beneficio. Resultados. El costo unitario de operación por citología -obtención, fijación, el traslado al centro de lectura, su tinción e inter...

Break dance hip: chronic avulsion of the anterior superior iliac spine.

Science.gov (United States)

Winkler, A R; Barnes, J C; Ogden, J A

1987-01-01

A case of chronic, progressive avulsion of the anterior superior iliac spine leading to the formation of a long, attenuated spur of bone in an 18-year-old black male break dancer is described. The mechanism of formation appeared to be repetitive avulsion from break dancing.

Break dance hip: Chronic avulsion of the anterior superior iliac spine

International Nuclear Information System (INIS)

Winkler, A.R.; Barnes, J.C.

1987-01-01

A case of chronic, progressive avulsion of the anterior iliac spine leading to the formation of a long, attenuated spur of bone in an 18-year-old black male break dancer is described. The mechanism of formation appeared to be repetitive avulsion from break dancing. (orig.)

Percutaneous Treatment of Deep Vein Thrombosis in May-Thurner Syndrome

International Nuclear Information System (INIS)

Kim, Jong-Youn; Choi, Donghoon; Guk Ko, Young; Park, Sungha; Jang, Yangsoo; Lee, Do Yun

2006-01-01

Background/Purpose. May-Thurner syndrome is an uncommon disease entity in which the left common iliac vein is compressed by the right common iliac artery with subsequent development of deep vein thrombosis and chronic venous insufficiency. We report our experience on the treatment of extensive iliofemoral deep venous thrombosis due to May-Thurner syndrome using endovascular techniques. Methods. The study group comprised 21 patients (8 men, 13 women; mean age 51 years) diagnosed with May-Thurner syndrome by venogram. Eighteen patients were treated with catheter-guided thrombolysis; 3 patients with short segment involvement did not require thrombolysis. After completion of the thrombolytic therapy, the residual venous narrowing was treated by balloon angioplasty and/or placement of a self-expandable stent. Results. The mean total dose of urokinase was 4.28 ± 1.89 million units, and the mean duration of infusion was 72 ± 35 hr. Eighteen of the 21 patients received stent deployment. The mean diameter of the stents was 12.9 ± 2.0 mm. Initial technical successes with immediate symptom resolution were achieved in 20 of the 21 patients (95%). We performed a follow-up venogram 6 months after procedure and checked clinical symptoms at outpatient clinics (mean follow-up duration 10.8 months). Among the patients who received stent implantation, 2 had recurrent thrombotic occlusion during the follow-up period. Three patients, who did not receive stent implantation, all had recurrent thrombosis. There were no major bleeding complications except in 1 patient who developed retroperitoneal hematoma. Conclusion. Catheter-guided thrombolysis and angioplasty with stent implantation is a safe and effective method for the treatment of May-Thurner syndrome

Combined Radial and Femoral Access Strategy and Radial-Femoral Rendezvous in Patients With Long and Complex Iliac Occlusions.

Science.gov (United States)

Hanna, Elias B; Mogabgab, Owen N; Baydoun, Hassan

2018-01-01

We present cases of complex, calcified iliac occlusive disease revascularized via a combined radial-femoral access strategy. Through a 6-French, 125-cm transradial guiding catheter, antegrade guidewires and catheters are advanced into the iliac occlusion, while retrograde devices are advanced transfemorally. The transradial and transfemoral channels communicate, allowing the devices to cross the occlusion into the true lumen (radial-femoral antegrade-retrograde rendezvous).

CÁLCULO DE LOS COSTOS DE CALIDAD EN LA UNIDAD EMPRESARIAL DE BASE PRODUCCIONES VARIAS, CIENFUEGOS

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Gómez Alfonso, Elizabeth

2013-01-01

Full Text Available El cálculo de los costos de calidad como elemento integrante del Sistema de Gestión de la Calidad, es una necesidad para los directivos de las empresas cubanas, al constituir una técnica identificada como instrumento avanzado de gestión, que permitirá mejorar la competitividad y servir de fuente informativa. Identificar y calcular los costos de calidad, así como proponer planes de medidas, que propicien una disminución de los gastos operativos, lo cual puede ser utilizado como herramienta para mejorar los procesos. La Unidad Empresarial de Base Producciones Varias de Cienfuegos presenta el diagnóstico para dar paso al Perfeccionamiento Empresarial y a la certificación de su Sistema de Gestión de la Calidad, según la Norma NC-ISO 9001:2008 y el decreto Ley 281, por lo que el objetivo de la investigación fue calcular los costos de calidad por procesos en dicha empresa. Para lograrlo se utilizaron métodos de nivel empírico y técnicas como la observación directa, revisión documental y el trabajo en grupos, lo cual permitió calcular los costos de calidad en todos los procesos. Los resultados alcanzados son aplicables a empresas que operan en la economía cubana y según el modelo económico cubano puesto en práctica a partir del año 2011.

Numerical modeling of normal turbulent plane jet impingement on solid wall

Energy Technology Data Exchange (ETDEWEB)

Guo, C.Y.; Maxwell, W.H.C.

1984-10-01

Attention is given to a numerical turbulence model for the impingement of a well developed normal plane jet on a solid wall, by means of which it is possible to express different jet impingement geometries in terms of different boundary conditions. Examples of these jets include those issuing from VTOL aircraft, chemical combustors, etc. The two-equation, turbulent kinetic energy-turbulent dissipation rate model is combined with the continuity equation and the transport equation of vorticity, using an iterative finite difference technique in the computations. Peak levels of turbulent kinetic energy occur not only in the impingement zone, but also in the intermingling zone between the edges of the free jet and the wall jet. 20 references.

An unusual case: right proximal ureteral compression by the ovarian vein and distal ureteral compression by the external iliac vein

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Halil Ibrahim Serin

2015-12-01

Full Text Available A 32-years old woman presented to the emergency room of Bozok University Research Hospital with right renal colic. Multidetector computed tomography (MDCT showed compression of the proximal ureter by the right ovarian vein and compression of the right distal ureter by the right external iliac vein. To the best of our knowledge, right proximal ureteral compression by the ovarian vein together with distal ureteral compression by the external iliac vein have not been reported in the literature. Ovarian vein and external iliac vein compression should be considered in patients presenting to the emergency room with renal colic or low back pain and a dilated collecting system.

Computations of droplet impingement on airfoils in two-phase flow

International Nuclear Information System (INIS)

Kim, Sang Dug; Song, Dong Joo

2005-01-01

The aerodynamic effects of leading-edge accretion can raise important safety concerns since the formulation of ice causes severe degradation in aerodynamic performance as compared with the clean airfoil. The objective of this study is to develop a numerical simulation strategy for predicting the particle trajectory around an MS-0317 airfoil in the test section of the NASA Glenn Icing Research Tunnel and to investigate the impingement characteristics of droplets on the airfoil surface. In particular, predictions of the mean velocity and turbulence diffusion using turbulent flow solver and continuous random walk method were desired throughout this flow domain in order to investigate droplet dispersion. The collection efficiency distributions over the airfoil surface in simulations with different numbers of droplets, various integration time-steps and particle sizes were compared with experimental data. The large droplet impingement data indicated the trends in impingement characteristics with respect to particle size; the maximum collection efficiency located at the upper surface near the leading edge, and the maximum value and total collection efficiency were increased as the particle size was increased. The extent of the area impinged on by particles also increased with the increment of the particle size, which is similar as compared with experimental data

Entrainment and impingement of aquatic fauna at cooling water system of Madras Atomic Power Station (MAPS)

International Nuclear Information System (INIS)

Barath Kumar, S.; Das, N.P.I.; Satpathy, K.K.

2015-01-01

Marine organisms get impinged to the intake screens of Madras Atomic Power Station (MAPS) due to the suction force of the cooling water system of the power plant. The present work has studied the loss of aquatic organism at MAPS due to impingement at cooling water screens. In total 67 species of marine faunas impinged on the water intake screens of MAPS during the study. The proportion of fish, shrimp, crab, jellyfish and others, with respect to the total biomass of impinged organisms are 1.59 % (33 species), 0.30% (9), 2.77 % (16), 95.10% (3) and 0.24% (4), respectively. Jellyfishes were observed to be the largest entrained group covering around 44.85% of individual and constituting almost 94.82 % of biomass recorded during the study period and sea nettle jelly (Chrysaora quinquecirrha) was impinged with highest frequency. The diel study shows higher impingement occurred during night time, on full moon day and at low tides in contrast to their counterparts. Fishes accounts for 14.84 % of individual count and mere 1.67 % of biomass. Totally 33 number of fish species were observed. The highest impinged species were pony fishes (Secutor ruconius, Secutor insidiator, Photopectoralis bindus, Alepes kleinii and Leiognathus equulus) (21% occurrence). These few entrained fishes are mostly very small in size and have less commercial value. The total loss of marine fauna by impingement during study period was estimated to be 4779 (or 463.46 kg). The present data when compared with the impingement data from other coastal power plants, shows that the impinged fish biomass at MAPS cooling water system is much less than the other temperate and tropical power plants. (author)

El costo de la atención ambulatoria del lupus eritematoso sistémico en Colombia. Contrastes y comparaciones con otras poblaciones.

OpenAIRE

Calixto, Omar-Javier; Vargas-Zambrano, Juan-Camilo; Franco, Juan-Sebastian; Molano-Gonzalez, Nicolas; Salazar, Juan-Carlos; Rodríguez-Jímenez, Mónica; Vicente-Celis, Zayhro De San; Rojas-Villarraga, Adriana

2015-01-01

Introducción: el lupus eritematoso sistémico (LES) es considerado una enfermedad de alto costo. La expresión clínica de la enfermedad depende de la ubicación geografía y la etnicidad. El objetivo de este estudio fue el calcular los costos ambulatorios relacionado al LES en una cohorte colombiana, identificar los predictores de costos y comparar nuestro resultados con otras poblaciones. Métodos: Se realizó una aproximación de tipo prevalencia en 100 pacientes LES en quienes se evaluaron los...

Costos ocultos en la producción inmobiliaria. / Hidden costs in housing production.

Directory of Open Access Journals (Sweden)

Pallarés T., María Eugenia

2001-07-01

Full Text Available La gestión de proyectos inmobiliarios corresponde a un área de negocios en que la financiación se rige por parámetros estándares, independiente de las características del proceso productivo. El ambiente de la producción de los bienes inmuebles se caracteriza por corresponder a una actividad económica que difiere de otros procesos productivos de la industria manufacturera, principalmente por la cantidad de materias primas que emplea y por los distintos valores que incorpora. La cantidad de eventos que confluyen a la ejecución de los proyectos y que no incorporan valor constituye una de las razones más importantes para el establecimiento de las tasas de descuento que se les exige a estos proyectos. Los hechos que no incorporan valor y que significan costo se cargan en el precio de venta, luego es transferido y quien finalmente lo paga es el demandante. Detectar las variables que incorporan costos, aislarlas y cuantificarlas es el objetivo principal. Consignar todos los costos efectivos de los proyectos representa el anhelo de quienes participan en este mercado. Determinar la incidencia de los costos ocultos y evitables es la forma que permitirá establecer la comparación cierta entre proyectos alternativos. Establecer la tasa de descuento real para el sector, y sus sensibilidades para las tipologías de proyectos es el resultado proyectable de este estudio./ The subject of this work is hidden costs in property production. The principal objective is the identification, isolation and quantification of the variables which incorporate costs. The assignment of all the effective costs of projects represents the aspiration of all who participate in the market. Determination of the incidence of hidden and avoidable costs is the means of establishing the approprate comparison between alternative projects. The foreseeable result of the study is the real discount rate, and its sensitivity to project typology, for the sector.

Comparison of fracture site callus with iliac crest bone marrow as the source of plastic-adherent cells

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Achmad Zaki

2013-05-01

Full Text Available Background: Red marrow has been described as the main source of mesenchymal stem cells although its aspiration and isolation from bone marrow was reported to have significant donor site morbidity. Since secondary bone healing occurs through formation of callus as the result of proliferation and differentiation of mesenchymal stem cells, callus may become alternative source for mesenchymal stem cells. In this study, we compared the number of plastic-adherent cells from fracture site callus and bone marrow of iliac crest after two and four weeks of culture.Methods: Sixteen New Zealand rabbits were fracturized at the femoral shaft. Then, these rabbits were taken care. After two weeks of fracturization, 3 mL iliac crest bone marrow aspiration and callus extraction of eight rabbits were cultured (group I. The other eight rabbits were treated equally after four weeks of fracturization (group II. Simultaneously, the cultures were observed after one and two weeks. Four weeks later, they were harvested. Cells were counted using Neubauer hemocytometer. The average number of cells between the sources and groups were statistically analyzed using the unpaired t-test. Results: In group I, there were 2.6 ± 0.1 x 104 cells in the culture of iliac crest bone marrow aspirate and 2.5 ± 0.1 x 104 cells in culture of callus extract from fracture site (p = 0.34. In group II, there were 2.7 ± 0.1 x 104 cells and 2.1 ± 0.1 x 104 cells, respectively (p < 0.001.Conclusion: Fracture site callus at the second week post-fracturization may be potential as source of plastic-adherent cells compared with iliac crest bone marrow. (Med J Indones. 2013;22:70-5Keywords: Bone marrow, fracture site callus, iliac crest, long bone, mesenchymal stem cell, plastic-adherent cells

Midterm results of endovascular treatment of iliac artery lesions: analysis of 59 cases

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Leonardo Ghizoni Bez

2013-06-01

Full Text Available BACKGROUND: Endovascular treatment of peripheral arterial occlusive disease has become increasingly frequent in the past few years. Because it is a less invasive procedure, lower morbidity and mortality rates are associated with this form of treatment. OBJECTIVES: To describe the endovascular procedures performed in iliac arteries for the treatment of peripheral arterial occlusive disease. METHODS: This retrospective study assesses 59 cases of iliac artery angioplasty performed according to a specific protocol from January 2004 to February 2010. RESULTS: Mean age of patients was 62 years (minimum: 42, maximum: 89. Thirty seven were male (62.72% and 22 female (37.28%. The main indications for treatment were moderate to severe intermittent claudication in 30 cases (50.84% and rest pain or trophic lesions (critical ischemia in 29 cases (49.15%. Postoperative follow-up included ankle-brachial index measurements and a duplex ultrasound at 30 days, 3 months, 6 months, 12 months, and every 6 months thereafter. Minimum follow-up time was 3 months, and maximum, 72 months (6 years, with primary and secondary patency rates of 91.37 and 94.82%, respectively. CONCLUSIONS: The results of this case series, combined with literature review results, allow to conclude that the endovascular approach is an effective and safe option to treat peripheral arterial occlusive disease in iliac arteries.

Aplicación del costo-eficiencia en un área de salud

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Miguel Mukodsi Caran

2000-10-01

Full Text Available Se realiza un estudio descriptivo de corte transversal de costo-eficiencia en el policlínico "Turcios Lima" en Ciudad de La Habana, que correlaciona los gastos y resultados de salud alcanzados en el período de un año. Se analiza el presupuesto y los costos unitarios, obtenidos de la aplicación del sistema aprobado para ese fin por el Ministerio de Salud Pública. Se muestra el comportamiento de un grupo de indicadores de salud seleccionados, que reflejan el grado de eficacia. Se establece una relación entre ambos aspectos, concluyendo que existen reservas de eficiencia económica sin explotar, basándonos para ello en los resultados siguientes: el salario representa el 75 % de los gastos, los altos costos por consulta del Plan Familia son de $ 3,65, en Interconsultas de $ 11,09, en Atención Médica Especializada de $ 10,59 y en Psicología de $ 10,50. Los consultorios en centros de trabajo y educacionales son caros, al igual que los medios diagnósticos. Se recomienda la evaluación sistemática en las reuniones del GBT de los resultados de costosA cross-sectional descriptive study of cost-efficiency was conducted at "Turcios Lima" Polyclinic in Havana City to correlate the health expenditures and the results attained during a year. The budget as well as the unitary costs resulting from the application of the system approved by the Ministry of Public Health are analyzed. The behavior of a group of selected health indicators reflecting the degree of efficiency is shown. A relationship between both aspects is established and it is concluded that there are reserves of economic efficiency that have not been exploted yet based on the following results: the salary accounts for 75% of the expenditures, the high costs by consultation of the Family Physician Plan are $3,65; in Interconsultations, $11,09; in Specialized Medical Attention, $10,59; and in Psychology, $10,50. The physcian?s offices in working and educational centers are expensive, as a

Costo-efectividad de medios de contraste isoosmolales e hiposmolales en pacientes con alto riesgo de nefropatía inducida por medio de contraste

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Liliana Alejandra Chicaíza-Becerra

2012-06-01

Full Text Available Introducción. Los medios de contraste pueden provocar falla renal aguda por toxicidad directa sobre las células tubulares e isquemia medular renal. Los pacientes diabéticos y los hospitalizados presentan mayor riesgo de desarrollar nefropatía inducida por medios de contraste que la población general. Objetivo. Establecer el costo-efectividad de los medios de contraste isosmolales e hiposmolales en pacientes con alto riesgo. Materiales and métodos. El análisis se basó en una revisión sistemática de la literatura científica, comparando los efectos nefrotóxicos de los medios isosmolales e hipoosmolales. Se consideraron sólo los costos directos, obtenidos del manual tarifario. Se calcularon las tasas del incremento del costoefectividad, las curvas de eficiencia y de aceptabilidad. Se hicieron análisis univariados de sensibilidad para costos y efectos, así como probabilísticos. Se aplicaron tasas de descuento de 0 y 3 % a losresultados. Se usó como umbral de costo-efectividad por año de vida ganado, el producto interno bruto per cápita. Resultados. Las alternativas con Iopamidol y Iodixanol dominan a las demás porque reducen el riesgo de nefropatía inducida por contraste a un menor costo. La razón del incremento del costo-efectividad del iodixanol comparado con el iopamidol es de US$ 14.660 por año de vida ganado que más que duplica el umbral. Conclusión. El medio de baja osmolalidad, iopamidol, parece ser costo-efectivo comparado con iohexol u otros medios hiposmolares (iopromide, iobitridol, iomeprol, iopentol y ioxilan, en pacientes con alto riesgo de nefropatía inducida por contraste. La elección del medio hiposmolar, depende de la disponibilidad a pagar o del costo por ampolleta.   doi: http://dx.doi.org/10.7705/biomedica.v32i2.367

Contribución al cálculo y evaluación de los costos de calidad en entidades petroleras

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Regla Caridad Gómez

2016-12-01

Full Text Available Como parte de las estrategias utilizadas para la implementación del nuevo modelo eco-nómico cubano se desarrolló el presente trabajo,  con el  objetivo principal de calcular y evaluar sobre bases científicas de los costos de calidad, con la utilización de métodos teóricos y empíricos que fundamenten los resultados. Se partió de la determinaron de las actividades que generan costos de calidad en los procesos de transportación, así como los elementos de gasto en cada una de ellas, el cálculo de los costos incurridos en el año 2015 de lo cual se obtuvo valores insignificantes comparados con los de ventas y gastos totales del área; se constató además, que existen inconformidades en los servicios por deficiente calidad de los mismos, las cuales no generan gastos por su aceptación por parte de los clientes pero sí constituyen productos no conformes. Palabras clave: Costos de calidad; gestión; sistema; procesos; eficiencia; entidades petroleras

VARIABLES MACROECONÓMICAS Y MICROECONÓMICAS QUE INFLUYEN EN LA ESTIMACIÓN DEL COSTO DE CAPITAL: UN ESTUDIO DE CASO

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DANIEL CARDONA ECHEVERRI

2017-01-01

Full Text Available Este artículo identifica y contrasta la significancia estadística de variables macroeconómicas y mi- croeconómicas, que desde la teoría pueden influir sobre el costo de capital. Utilizando información de las empresas listadas en la Bolsa de Valores de Colombia (BVC entre los periodos 2003-4 a 2012-1 y modelos de paneles dinámicos para explicar el Costo de Capital Promedio Ponderado (WACC, se encuentra que la mayoría de las variables propuestas resultan estadísticamente significativas, así mismo se prueba la e xistencia de inercia entre el costo de capital actual y el del periodo pasado.

[Comparison of the Latissimus dorsi insertions on the iliac crest in chimpanzee (Pan troglodytes) and in man].

Science.gov (United States)

Vacher, C; Ben Hadj Yahia, S; Braun, M; Journeau, P

2014-03-01

Comparing to other primates, one of the most important specificities of the human anatomy are consequences of bipedalism. Although bone consequences are well known (lumbar lordosis, horizontal position of the foramen magnum, lengthening of the lower limbs, reduction of the pelvis, specialization of the foot), consequences of our locomotion on the Latissimus dorsi are still unclear. One dissection of a chimpanzee Latissimus dorsi (Pan troglodytes) has been performed and compared to 30 human Latissimus dorsi dissections (10 fresh cadavers and 20 formoled cadavers). In each dissection, the existence of direct muscular insertions on the iliac crest has been investigated and the constitution of the thoracolumbar fascia has been described. In chimpanzee dissection, a muscular direct insertion of the Latissimus dorsi was present on the iliac crest of 9 cm long. The TLF was made of the superficial and the deep fascias of the Latissimus dorsi and the superficial fascia of the erector spinae muscles which was deeper. In man, there was no direct muscular insertion of the Latissimus dorsi in 90 % of cases, the TLF was constituted the same way. This study suggests that the Latissimus dorsi has been separated from the iliac crest in man during the evolution because of the permanent bipedalism and that it stayed inserted on the iliac crest in chimpanzee because of the brachiation. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Correlation of Peripheral Vein Tumour Marker Levels, Internal Iliac Vein Tumour Marker Levels and Radical Prostatectomy Specimens in Patients with Prostate Cancer and Borderline High Prostate-Specific Antigen: A Pilot Study.

Science.gov (United States)

Farrelly, Cormac; Lal, Priti; Trerotola, Scott O; Nadolski, Gregory J; Watts, Micah M; Gorrian, Catherine Mc; Guzzo, Thomas J

2016-05-01

To correlate prostate-specific antigen (PSA), free to total PSA percentage (fPSA%) and prostatic acid phosphatase (PAP) levels from peripheral and pelvic venous samples with prostatectomy specimens in patients with prostate adenocarcinoma and borderline elevation of PSA. In this prospective institutional review board approved study, 7 patients with biopsy proven prostate cancer had a venous sampling procedure prior to prostatectomy (mean 3.2 days, range 1-7). Venous samples were taken from a peripheral vein (PVS), the right internal iliac vein, a deep right internal iliac vein branch, left internal iliac vein and a deep left internal iliac vein branch. Venous sampling results were compared to tumour volume, laterality, stage and grade in prostatectomy surgical specimens. Mean PVS PSA was 4.29, range 2.3-6 ng/ml. PSA and PAP values in PVS did not differ significantly from internal iliac or deep internal iliac vein samples (p > 0.05). fPSA% was significantly higher in internal iliac (p = 0.004) and deep internal iliac (p = 0.003) vein samples compared to PVS. One of 7 patients had unilateral tumour only. This patient, with left-sided tumour, had a fPSA% of 6, 6, 6, 14 and 12 in his peripheral, right internal iliac, deep right internal iliac branch, left internal iliac and deep left internal iliac branch samples respectively. There were no adverse events. fPSA%, unlike total PSA or PAP, is significantly higher in pelvic vein compared to peripheral vein samples when prostate cancer is present. Larger studies including patients with higher PSA values are warranted to further investigate this counterintuitive finding.

Costo-osteochondral graft for post-traumatic osteonecrosis of the radial head in an adolescent boy.

Science.gov (United States)

Iwai, S; Sato, K; Nakamura, T; Okazaki, M; Itoh, Y; Toyama, Y; Ikegami, H

2011-01-01

We present a case of post-traumatic osteonecrosis of the radial head in a 13-year-old boy which was treated with costo-osteochondral grafts. A satisfactory outcome was seen at a follow-up of two years and ten months. Although costo-osteochondral grafting has been used in the treatment of defects in articular cartilage, especially in the hand and the elbow, the extension of the technique to manage post-traumatic osteonecrosis of the radial head in a child has not previously been reported in the English language literature. Complete relief of pain was obtained and an improvement in the range of movement was observed. The long-term results remain uncertain.

Iliac renal ectopia explored by {sup 99m}Tc-DTPA and {sup 99m}Tc-DMSA scintigraphy. Report of one case; Ectopie renale iliaque exploree par scintigraphie au {sup 99m}Tc-DTPA et au {sup 99m}Tc-DMSA. A propos d'un cas

Energy Technology Data Exchange (ETDEWEB)

Ghfir, I.; Ben Rais, N. [Hopital Ibn Sina, CHU de Rabat, Service de Medecine Nucleaire de Rabat (Morocco)

2008-11-15

Introduction Renal ectopia is a malposition by anomaly of migration during the embryonic development. It can be high, low or crossed. Association with an obstructive malformation is rather frequent. The objective of this work is to highlight the interest of {sup 99m}Tc-DTPA and {sup 99m}Tc-DMSA scintigraphy in the exploration of this type of malformation through the observation of a patient presenting an iliac right renal ectopia associated with an ureteral-pelvic junction syndrome. Observation A 38-year-old patient with an ureteral-pelvic junction syndrome on a right iliac renal ectopia revealed by intravenous urography. The dynamic renal scintigraphy using {sup 99m}Tc-DTPA with furosemide test evidenced an organic obstruction in the right urinary tract with a right renal function estimated at 40% on the {sup 99m}Tc-DMSA scintigraphy. A right pyelo-plasty was carried out. The evolution was marked by the disappearance of pain and a remarkable improvement of the permeability of the right urinary tract on the follow-up scintigraphy. Discussion Renal ectopia is not an unfrequent urinary malformation. It is generally low, pelvic or iliac. Association with an ureteral-pelvic junction obstruction is rather frequent. In this purpose, renal scintigraphy intervenes as a means of functional exploration, with low ionizing radiation and non-invasive to assess the permeability of the urinary tracts of the ectopic kidney and to appreciate the relative renal function. This contributes to the orientation of diagnosis and the improvement of therapeutic strategy.

Costo-efectividad del tratamiento con interferón beta en pacientes con síndrome clínico aislado de alto riesgo en Colombia

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Luis Alfonso Zarco

2014-03-01

Full Text Available Introducción. En 85 % de los pacientes con esclerosis múltiple se presenta como manifestación inicial un primer evento desmielinizante o síndrome clínico aislado. En estos casos, el tratamiento con interferón beta retrasa hasta dos años la progresión a esclerosis múltiple. Sin embargo, en Colombia este medicamento es costoso. Objetivo. Determinar si el tratamiento del síndrome clínico aislado con interferón beta es costo-efectivo al retrasar la esclerosis múltiple en dos años. Materiales y métodos. Se realizó un análisis de costo-efectividad empleando un árbol de decisiones basado en la perspectiva del paciente y la sociedad. A partir de una revisión sistemática de la literatura y de conceptos de expertos se definieron las diversas probabilidades. Los costos de la enfermedad se calcularon por medio de la revisión de historias y la aplicación de encuestas a los pacientes atendidos en el Hospital Universitario San Ignacio. Para controlar la incertidumbre se realizó un análisis de sensibilidad mediante una simulación de Monte Carlo con mil pacientes. Resultados. El costo del tratamiento con interferón sobrepasa los Col$ 95’000.000 (US$ 50.000 por paciente durante los dos años. Aproximadamente, 80 % corresponde a los costos del medicamento. El costo de la recaída se acerca a Col$ 39’139.200 (US$ 21.744, y los costos indirectos corresponden a Col$ 10’958.400 (US$ 6.088. La tasa representativa del mercado fue de Col$ 1.800. Con el tratamiento se ganan sólo 0,06 años de vida ajustados por discapacidad (AVAD adicionales. La razón de costo-efectividad ‘incremental’ (sic. supera el umbral, incluso en el análisis de sensibilidad. Conclusión. La administración de interferón beta en pacientes con síndrome clínico aislado de alto riesgo en los primeros dos años no es costo-efectiva en Colombia.

Syndromes and Disorders Associated with Omphalocele (III: Single Gene Disorders, Neural Tube Defects, Diaphragmatic Defects and Others

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Chih-Ping Chen

2007-06-01

Full Text Available Omphalocele can be associated with single gene disorders, neural tube defects, diaphragmatic defects, fetal valproate syndrome, and syndromes of unknown etiology. This article provides a comprehensive review of omphalocele-related disorders: otopalatodigital syndrome type II; Melnick–Needles syndrome; Rieger syndrome; neural tube defects; Meckel syndrome; Shprintzen–Goldberg omphalocele syndrome; lethal omphalocele-cleft palate syndrome; cerebro-costo-mandibular syndrome; fetal valproate syndrome; Marshall–Smith syndrome; fibrochondrogenesis; hydrolethalus syndrome; Fryns syndrome; omphalocele, diaphragmatic defects, radial anomalies and various internal malformations; diaphragmatic defects, limb deficiencies and ossification defects of skull; Donnai–Barrow syndrome; CHARGE syndrome; Goltz syndrome; Carpenter syndrome; Toriello–Carey syndrome; familial omphalocele; Cornelia de Lange syndrome; C syndrome; Elejalde syndrome; Malpuech syndrome; cervical ribs, Sprengel anomaly, anal atresia and urethral obstruction; hydrocephalus with associated malformations; Kennerknecht syndrome; lymphedema, atrial septal defect and facial changes; and craniosynostosis- mental retardation syndrome of Lin and Gettig. Perinatal identification of omphalocele should alert one to the possibility of omphalocele-related disorders and familial inheritance and prompt a thorough genetic counseling for these disorders.

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

Science.gov (United States)

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

Treatment strategy for sacroiliac joint-related pain at or around the posterior superior iliac spine.

Science.gov (United States)

Murakami, Eiichi; Kurosawa, Daisuke; Aizawa, Toshimi

2018-02-01

Pain at or around the posterior superior iliac spine (PSIS) is characteristic of sacroiliac joint (SIJ) -related pain. This pain can be treated by either a peri- or intra-articular injection into the joint, with the former being much easier to perform. We investigated whether peri- or intra-articular injections were more frequently effective in patients with SIJ-related pain, and aimed to create an efficient treatment strategy for SIJ-related pain at or around the PSIS. Prospective case-control study. We evaluated 85 patients with pain at or around the posterior superior iliac spine as indicated by the one finger test. First, we performed a peri-articular sacroiliac joint injection. If it was ineffective, an intra-articular injection was later given. Groin pain, sitting pain, sacroiliac joint shear test results, and posterior superior iliac spine and sacro-tuberous ligament tenderness were also compared between patients for whom a peri- or intra-articular injection was effective. Seventy-two (85%) of 85 patients had an effective injection. Out of these 72 patients, 58 (81%) had a positive peri-articular injection and 14 (19%) had a positive intra-articular injection. Four items, excluding tenderness of the sacro-tuberous ligament had no significant difference between these two injection types. To treat sacroiliac joint-related pain at or around the posterior superior iliac spine, a peri-articular injection should be performed first, and only if it is not effective should an intra-articular injection be administered. Using this strategy, we expect that most patients with sacroiliac joint-related pain will be efficiently diagnosed and treated. Copyright © 2017 Elsevier B.V. All rights reserved.

Anatomical reconstruction of the fourth brachymetatarsia with one-stage iliac bone and cartilage cap grafting.

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Woo, Sang Hyun; Bang, Chi Young; Ahn, Hee-Chan; Kim, Sung-Jung; Choi, Jun-Young

2017-05-01

We present a one-stage procedure for lengthening the fourth brachymetatarsia with autogenous iliac bone and cartilage cap grafting for the anatomical reconstruction of the metatarsophalangeal (MTP) joint METHODS: During the last 8 years, 56 feet in 41 patients with congenital brachymetatarsia of the fourth toe were corrected with a one-stage operation to reposition the articular cartilage cap to the distal part of interpositional iliac bone graft at the metatarsal epiphysis. The length of the harvested iliac bone graft was 22.9 mm on average. The mean fixation period was 58.5 days, and the mean gain in length and percentage increase was 20.9 mm and 39%, respectively. MRI showed a stable MTP joint over viable cartilage cap in 83.3% of the cases. Mean postoperative American Orthopedic Foot and Ankle Society lesser MTP-interphalangeal score was 82.0. Neither neurovascular impairment nor recurrence of brachymetatarsia occurred in the mean follow-up period of 43.6 months. All patients were satisfied with the postoperative cosmetic results. Thirteen patients (23.2%) complained of limited active dorsiflexion of the fourth toe, and extensor adhesion was released by extensor tenolysis in only one patient. In a single case of nonunion at the bone graft site, additional surgery was not necessary. Anatomical reconstruction of the fourth brachymetatarsia with one-stage interpositional iliac bone and cartilage cap grafting resulted in excellent cosmetic results and a physiologic MTP joint, providing the benefits of one-stage lengthening with a low complication rate. Therapeutic, IV. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

The Use of Physiotherapy among Patients with Subacromial Impingement Syndrome: Impact of Sex, Socio-Demographic and Clinical Factors

Science.gov (United States)

Christiansen, David Høyrup; Frost, Poul; Frich, Lars Henrik; Falla, Deborah; Svendsen, Susanne Wulff

2016-01-01

Background Physiotherapy with exercises is generally recommended in the treatment of patients with subacromial impingement syndrome (SIS). Objective We aimed to investigate the use of physiotherapy in patients with SIS in Danish hospital settings as part of initial non-surgical treatment and after SIS-related surgery and to evaluate to which extent sex, socio-demographic and clinical factors predict the use of physiotherapy. Methods Using national health registers, we identified 57,311 patients who had a first hospital contact with a diagnosis of ICD-10, groups M75.1–75.9, 1 July 2007 to 30 June 2011. Records of physiotherapy were extracted within 52 weeks after first contact (or until surgery), and for surgically treated patients within 26 weeks after surgery. Predictors of the use of physiotherapy after first contact and after surgery were analysed as time-to-event. Results Within 52 weeks after first contact, 43% of the patients had physiotherapy and 30% underwent surgery. Within 26 weeks after surgery, 80% had a record of physiotherapy. After first contact and after surgery, exercise was part of physiotherapy in 65% and 84% of the patients, respectively. A public hospital contact, physiotherapy before hospital contact, administrative region, female sex, a diagnosis of other or unspecified disorders (M75.8-M75.9), and surgical procedure predicted higher use of physiotherapy. Low education level predicted slightly lower use of physiotherapy after first contact, but not after surgery. Conclusion In patients with SIS in Danish hospital settings, physiotherapy was more often used after surgery than as part of initial non-surgical treatment. The use of physiotherapy was less common among men than women, whereas unequal use of physiotherapy in relation to education level was not noticeable. The use of physiotherapy with exercises in initial non-surgical treatment was relatively limited. PMID:26954692

Donor site complications in bone grafting: comparison of iliac crest, calvarial, and mandibular ramus bone.

Science.gov (United States)

Scheerlinck, Laura M E; Muradin, Marvick S M; van der Bilt, Andries; Meijer, Gert J; Koole, Ronald; Van Cann, Ellen M

2013-01-01

To compare the donor site complication rate and length of hospital stay following the harvest of bone from the iliac crest, calvarium, or mandibular ramus. Ninety-nine consecutively treated patients were included in this retrospective observational single-center study. Iliac crest bone was harvested in 55 patients, calvarial bone in 26 patients, and mandibular ramus bone in 18 patients. Harvesting of mandibular ramus bone was associated with the lowest percentages of major complications (5.6%), minor complications (22.2%), and total complications (27.8%). Harvesting of iliac crest bone was related to the highest percentages of minor complications (56.4%) and total complications (63.6%), whereas harvesting of calvarial bone induced the highest percentage of major complications (19.2%). The length of the hospital stay was significantly influenced by the choice of donor site (P = .003) and age (P = .009); young patients with the mandibular ramus as the donor site had the shortest hospital stay. Harvesting of mandibular ramus bone was associated with the lowest percentage of complications and the shortest hospital stay. When the amount of bone to be obtained is deemed sufficient, mandibular ramus bone should be the first choice for the reconstruction of maxillofacial defects.

Costo-efectividad de linezolid comparado con vancomicina en el manejo de la neumonía asociada a ventilación mecánica en Colombia

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Fabio Varón

2014-12-01

Full Text Available Objetivo: Estimar la costo-efectividad de linezolid versus vancomicina en el manejo de neumonía asociada a ventilación mecánica (NAV causada por Staphylococcus aureus resistente a meticilina (SARM en Colombia. Materiales y métodos: Se construyó un árbol de decisión para determinar la razón de costo-efectividad incremental de linezolid (600 mg iv/12 h comparado con vancomicina (15 mg/kg iv/12 h en el tratamiento de NAV por SARM. La perspectiva fue la del sistema de salud incluyendo solo costos directos. Todas las unidades monetarias se expresan en pesos colombianos del 2013 sin descuento (1 USD =$ 1.876,22. Se empleó un horizonte temporal de 30 días. Los resultados se midieron en proporción de pacientes curados. Los datos de eficacia y seguridad se tomaron de la literatura. Los costos de los procedimientos se obtuvieron del manual tarifario ISS del 2001, para medicamentos se utilizó el SISMED y la regulación de precios vigente. Se realizaron análisis de sensibilidad univariados y probabilísticos. Resultados: Los costos totales esperados por paciente curado fueron: $ 2.600.094 para linezolid y $ 1.992.753 para vancomicina. La proporción de pacientes curados fue: 53% con linezolid y 41%.con vancomicina. La razón de costo-efectividad de linezolid comparado con vancomicina fue $ 5.061.173 por paciente curado. Para cada alternativa, los resultados fueron sensibles a la probabilidad de éxito del tratamiento, a la probabilidad de presentar eventos adversos y al costo del tratamiento. Conclusión: En Colombia, linezolid sería una alternativa costo-efectiva en el tratamiento de NAV por SARM, para disponibilidades a pagar superiores a $ 5.061.173 por paciente curado.

DISEÑO DE UN SISTEMA DE COSTOS PARA LA TOMA DE DECISIONES EN UNA EMPRESA DE SALUD

OpenAIRE

Lezcano, German Eduardo

2016-01-01

INTRODUCCIÓN -- METODOLOGÍA -- RESULTADOS Y DISCUSIÓN -- 1. ESTUDIO EXPLORATORIO BIBLIOGRÁFICO SOBRE COSTOS DE PRODUCCIÓN DE SERVICIO EN EMPRESAS DE SALUD -- 2. ESTUDIO DESCRIPTIVO DE "CLÍNICA PRIVADA ESTÉTICA Y RECONSTRUCTIVA -- DISEÑO DEL PLAN PARA "CLÍNICA PRIVADA ESTÉTICA Y RECONSTRUCTIVA" EN BASE A LOS MÉTODOS DE COSTEO -- CONCLUSIONES -- BIBLIOGRAFIA El objetivo de este trabajo fue diseñar un sistema de costos para la toma de decisiones en una empresa de salud radicada en la ciudad d...

Clinical evaluation of internal iliac artery anticancer drug infusion for the treatment of androgen-independent prostate cancer

International Nuclear Information System (INIS)

Cao Ye; Wang Jin; Nie Yong; Chen Hua; Huang Xinjie

2008-01-01

Objective: To evaluate the clinical efficacy of bilateral internal iliac artery chemotherapy infusion for the treatment of androgen-independent prostate cancer (ALPC). Methods: Thirty eight eases of confirmed AIPC were randomly divided into treatment group and control group. The patients in treatment group (23 cases) were treated with androgen deprivation therapy and regular internal iliac artery chemotherapy, while patients in control group (15 cases) were only received androgen deprivation therapy. The therapeutic efficacies of the two groups were compared and analyzed after completion of the treatment. Results: The clinical symptoms and maximum urine flow rates of' treatment group were improved rapidly 6 months later. After 2 years follow-up, the total efficacies of treatment group and control group were 65.2% and 26.7% respectively, showing a significant statistical difference (P<0.05). Conclusions: The treatment of AlPC with bilateral internal iliac artery chemotherapy is effective, providing melioration the quality of life and alleviation of the symptoms. (authors)

Costo de la atención materno infantil en el Estado de Morelos, México Cost of mother-child care in Morelos State

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Lucero Cahuana-Hurtado

2004-08-01

Full Text Available OBJETIVO: Comparar el costo actual de servicios de salud materno infantiles (modelo actual con el costo hipotético de su provisión bajo estándares definidos por el Paquete Madre Bebé, de la Organización Mundial de la Salud. MATERIAL Y MÉTODOS: Se realizó un estudio piloto de caso, de corte transversal, en septiembre de 2001, en establecimientos de salud de la Jurisdicción Sanitaria III de los Servicios de Salud del Estado de Morelos, México. Se eligieron para el estudio dos centros de salud rurales, un centro de salud urbano y un hospital general de la Secretaría de Salud. Se calculó el costo total y por intervención del modelo actual y del modelo Paquete Madre Bebé, usando el Modelo de estimación de costos de este Paquete. RESULTADOS: Se encontró que el costo total del Paquete Madre Bebé es dos veces mayor que el costo del modelo actual. De las 18 intervenciones evaluadas, la atención prenatal y el parto normal consumen la mayor proporción de los costos totales. Los costos de personal representan más de la mitad de los costos totales. CONCLUSIONES: El Modelo de estimación de costos es una herramienta práctica para la estimación y comparación de costos, y es útil para guiar la distribución de recursos financieros destinados a la atención materno infantil. Sin embargo, su aplicación es de limitada utilidad si su adaptación no responde a las características de cada sistema de atención.OBJECTIVE: To compare the cost of maternal and child health care (current model to that of the WHO Mother-Baby Package if it were implemented. MATERIAL AND METHODS: A pilot cross-sectional case study was conducted in September 2001 in Sanitary District No. III, Morelos State, Mexico. Two rural health centers, an urban health center, and a general hospital, all managed by the Ministry of Health, were selected for the study. The Mother-Baby Package Costing Spreadsheet was used to estimate the total cost and cost per intervention for the

Evaluación costo-efectividad de lidocaína al 5 % y bupivacaína al 0,5 % en anestesia espinal

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Eréndira González Orozco

Full Text Available Se realizó un estudio económico prospectivo de costo-efectividad con datos primarios de efectividad obtenidos de un ensayo clínico aleatorizado, donde se comparan 2 anestésicos vía espinal: lidocaína al 5 % y bupivacaína al 0,5 %. La efectividad se evaluó como la probabilidad de aparición de síntomas neurológicos transitorios, reacción adversa propia de este grupo de medicamentos. Se formaron aleatoriamente 2 grupos de pacientes que requerían cirugías por debajo del ombligo con una duración no mayor de 120 min, con la aplicación de cada una de las opciones de anestesia estudiada a cada grupo, 109 pacientes en el grupo de lidocaína y 97 en el grupo de bupivacaína. Un especialista en Neurología evaluó a ciegas la condición neurológica posquirúrgica de cada paciente antes y 24 h después de la intervención. Se calcularon los costos de cada alternativa, que incluyeron los ocasionados por la toxicidad neurológica, y se determinaron las relaciones costo-efectividad y los costos incrementales. El grupo de bupivacaína resultó la alternativa con mejor relación costo-efectividad

Cost-benefit of energy saving in bioclimatic designs; Costo-beneficio del ahorro de energia en los disenos bioclimatios

Energy Technology Data Exchange (ETDEWEB)

Lopez P, J. Manuel A. [Doble dos soluciones de Negocios (Mexico); Morillon G, David; Rdriguez V, Luis [Universidad Autonoma de Mexico (Mexico)

2001-06-01

Tools and criteria for Cost-Benefit Analysis (ACB) of energy saving in bioclimatic designs (DB) are presented, for which a reference project is established. Based on the traditional design of air conditioning of a building and with the support of this one, the estimation of costs and benefits of the same building is made; but with passive systems. The tools used consider related resources such as time and money. Criteria are used such as: Present value (VP), Equivalent Annual Cost (EAC) and the Cost of the conserved Energy (CEC). The costs related to the construction, maintenance and operation of the design are taken into consideration. The differences between the design of reference and the Bioclimatic Design, established from the application of these criteria, allow evaluating the economic margin as far as operation and maintenance. Finally, the cost of the conserved energy of the bioclimatic measures is evaluated as an initiative for energy saving and calculates the present value from them in all of the period of useful life of the bioclimatic design. [Spanish] Se presentan herramientas y criterios para el analisis Costo-Beneficio (ACB) del ahorro de energia en los disenos bioclimaticos (DB), para lo cual se establece un proyecto de referencia. Basado en el diseno tradicional de la climatizacion de un edificio y con apoyo en este, se realiza la estimacion de costos y beneficios del mismo edificio; pero con sistema pasivos. Las herramientas usadas consideran recursos relacionados como son tiempo y dinero. Se usan criterios tales como: Valor Presente (VP), Costo Anual Equivalente (CAE) y el Costo de la Energia conservada (CEC). Se toman en consideracion los costos relacionados con la construccion, mantenimiento y operacion del diseno. Las diferencias entre el diseno de referencia y el Diseno Bioclimatico, establecidas a partir de la aplicacion de estos criterios, permiten evaluar el margen economico en cuanto a la operacion y el mantenimiento. Finalmente, se

Is tube repair of aortic aneurysm followed by aneurysmal change in the common iliac arteries?

Science.gov (United States)

Provan, J L; Fialkov, J; Ameli, F M; St Louis, E L

1990-10-01

To address the concern that tube repair of an abdominal aortic aneurysm might be followed by aneurysmal change in the common iliac arteries, 23 patients who had undergone the operation were re-examined 3 to 5 years later. Although 9 had had minimal ectasia of these arteries preoperatively, in none of the 23 was there symptomatic or radiologic evidence of aneurysmal change on follow-up. Measurements of the maximum intraluminal diameters were made by computed tomography; they indicated no significant differences between the preoperative and follow-up sizes of the common iliac arteries. The variation in time to follow-up also showed no significant correlation with change in artery diameter.

Diagnostic performance of susceptibility-weighted magnetic resonance imaging for the assessment of sub-coracoacromial spurs causing subacromial impingement syndrome

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Noerenberg, Dominik; Armbruster, Marco [Munich University Hospitals Campus Grosshadern, Department of Clinical Radiology, Munich (Germany); Bender, Yi-Na; Walter, Thula; Diederichs, Gerd; Hamm, Bernd [Charite - University Medicine Berlin, Department of Radiology, Berlin (Germany); Ebersberger, Hans U. [Heart Center Munich-Bogenhausen, Department of Cardiology and Intensive Care Medicine, Munich (Germany); Ockert, Ben [Munich University Hospitals Campus Grosshadern, Department of Trauma and Orthopedic Surgery, Shoulder and Elbow Service, Munich (Germany); Makowski, Marcus R. [Charite - University Medicine Berlin, Department of Radiology, Berlin (Germany); King' s College London, Division of Imaging Sciences and Biomedical Engineering, London (United Kingdom)

2017-03-15

To evaluate the potential of susceptibility-weighted-magnetic-resonance-imaging (SWMR) for the detection of sub-coracoacromial spurs in patients with clinically suspected subacromial impingement syndrome (SAIS), compared to standard MR-sequences and radiographs. Forty-four patients with suspected SAIS were included. All patients underwent radiography, standard MRI of the shoulder and SWMR. Radiograph-based identification of sub-coracoacromial spurs served as goldstandard. Radiographs identified twenty-three spurs in twenty-three patients. Twenty-one patients without spur formation served as reference group. Detection rate, sensitivity/specificity and interobserver-agreements were calculated. Linear regression was applied to determine the relationship between size measurements on radiographs and MRI. Detection rates for spurs on standard MRI and SWMR were 47.8 % and 91.3 % compared to radiography (p<0.001). SWMR demonstrated a sensitivity of 97.7 % (CI=0.92-1) and a specificity of 91.3 % (CI=0.788-1) for the identification of spurs. Standard MR-sequences achieved a sensitivity of 47.8 % (CI=0.185-0.775) and a specificity of 80.8 % (CI=0.642-0.978). Size measurements between SWMR and radiography showed a good correlation (R{sup 2}=0.75;p<0.0001), while overestimating lesion size (5.7±1.2 mm; 4.3±1.3 mm;p<0.0001). Interobserver-agreement for spurs was high on SWMR (R{sup 2}=0.74;p<0.0001), but low on standard MRI (R{sup 2}=0.24;p<0.0001). SWMR allows a reliable detection of sub-coracoacromial spur formation in patients with SAIS and is superior to standard MR-sequences using radiography as goldstandard. (orig.)

Diagnostic performance of susceptibility-weighted magnetic resonance imaging for the assessment of sub-coracoacromial spurs causing subacromial impingement syndrome

International Nuclear Information System (INIS)

Noerenberg, Dominik; Armbruster, Marco; Bender, Yi-Na; Walter, Thula; Diederichs, Gerd; Hamm, Bernd; Ebersberger, Hans U.; Ockert, Ben; Makowski, Marcus R.

2017-01-01

To evaluate the potential of susceptibility-weighted-magnetic-resonance-imaging (SWMR) for the detection of sub-coracoacromial spurs in patients with clinically suspected subacromial impingement syndrome (SAIS), compared to standard MR-sequences and radiographs. Forty-four patients with suspected SAIS were included. All patients underwent radiography, standard MRI of the shoulder and SWMR. Radiograph-based identification of sub-coracoacromial spurs served as goldstandard. Radiographs identified twenty-three spurs in twenty-three patients. Twenty-one patients without spur formation served as reference group. Detection rate, sensitivity/specificity and interobserver-agreements were calculated. Linear regression was applied to determine the relationship between size measurements on radiographs and MRI. Detection rates for spurs on standard MRI and SWMR were 47.8 % and 91.3 % compared to radiography (p<0.001). SWMR demonstrated a sensitivity of 97.7 % (CI=0.92-1) and a specificity of 91.3 % (CI=0.788-1) for the identification of spurs. Standard MR-sequences achieved a sensitivity of 47.8 % (CI=0.185-0.775) and a specificity of 80.8 % (CI=0.642-0.978). Size measurements between SWMR and radiography showed a good correlation (R 2 =0.75;p<0.0001), while overestimating lesion size (5.7±1.2 mm; 4.3±1.3 mm;p<0.0001). Interobserver-agreement for spurs was high on SWMR (R 2 =0.74;p<0.0001), but low on standard MRI (R 2 =0.24;p<0.0001). SWMR allows a reliable detection of sub-coracoacromial spur formation in patients with SAIS and is superior to standard MR-sequences using radiography as goldstandard. (orig.)

Gout in the spine and sacri-iliac joints: radiological manifestations

International Nuclear Information System (INIS)

Jajic, I.

1982-01-01

It is well known that deposits of urates in soft tissues occur commonly in gout, particularly in para-articular areas and in articular cartilages of the limbs. Involvement of the spine and sacro-iliac joints by such deposits, however, has been regarded as being relatively unusual and has attracted little attention in the literature. As we were impressed by the frequency of episodes of acute back pain in our patients with gouty arthritis, established definitely on clinical and biochemical grounds, we undertook a radiological investigation of the spine and sacro-iliac joints in a series of 54 subjects. It was suspected that their episodes of pain were clinical manifestations of gout, and 12 of the group had suffered one or more attacks. Of these 12 subjects, eight were found to have radiological abnormalities. In six subjects, evidence of sacro-iliitis was demonstrated, which is comparable to the report of Resnick and Reinke [8], and in two patients vertebral lesions corresponded to those described by Jaffe [5]. Hyperostotic spondylosis was present in no fewer than 29 of the series. Although lacking histological confirmation of the lesions demonstrated radiologically, we believe that our suspicions have been confirmed

Gout in the spine and sacri-iliac joints: Radiological manifestations

International Nuclear Information System (INIS)

Jajic, I.

1982-01-01

It is well known that deposits of urates in soft tissues occur commonly in gout, particularly in para-articular areas and in articular cartilages of the limbs. Involvement of the spine and sacro-iliac joints by such deposits, however, has been regarded as being relatively unusual and has attracted little attention in the literature. As we were impressed by the frequency of episodes of acute back pain in our patients with gouty arthritis, established definitely on clinical and biochemical grounds, we undertook a radiological investigation of the spine and sacro-iliac joints in a series of 54 subjects. It was suspected that their episodes of pain were clinical manifestations of gout, and 12 of the group had suffered one or more attacks. Of these 12 subjects, eight were found to have radiological abnormalities. In six subjects, evidence of sacro-iliitis was demonstrated, which is comparable to the report of Resnick and Reinke [8], and in two patients vertebral lesions corresponded to those described by Jaffe [5]. Hyperostotic spondylosis was present in no fewer than 29 of the series. Although lacking histological confirmation of the lesions demonstrated radiologically, we believe that our suspicions have been confirmed. (orig.)

Correlation of Peripheral Vein Tumour Marker Levels, Internal Iliac Vein Tumour Marker Levels and Radical Prostatectomy Specimens in Patients with Prostate Cancer and Borderline High Prostate-Specific Antigen: A Pilot Study

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Farrelly, Cormac, E-mail: farrellycormac@gmail.com [Hospital of the University of Pennsylvania, Perelman School of Medicine at the University of Pennsylvania, Division of Interventional Radiology, Department of Radiology (United States); Lal, Priti [University of Pennsylvania Perelman School of Medicine, Department of Pathology and Laboratory Medicine (United States); Trerotola, Scott O.; Nadolski, Gregory J.; Watts, Micah M. [Hospital of the University of Pennsylvania, Perelman School of Medicine at the University of Pennsylvania, Division of Interventional Radiology, Department of Radiology (United States); Gorrian, Catherine Mc. [Mater Misericordiae University Hospital, University College Dublin School of Medicine & Medical Science (Ireland); Guzzo, Thomas J. [University of Pennsylvania Perelman School of Medicine, Department of Urology and Surgery (United States)

2016-05-15

PurposeTo correlate prostate-specific antigen (PSA), free to total PSA percentage (fPSA%) and prostatic acid phosphatase (PAP) levels from peripheral and pelvic venous samples with prostatectomy specimens in patients with prostate adenocarcinoma and borderline elevation of PSA.Materials and MethodsIn this prospective institutional review board approved study, 7 patients with biopsy proven prostate cancer had a venous sampling procedure prior to prostatectomy (mean 3.2 days, range 1–7). Venous samples were taken from a peripheral vein (PVS), the right internal iliac vein, a deep right internal iliac vein branch, left internal iliac vein and a deep left internal iliac vein branch. Venous sampling results were compared to tumour volume, laterality, stage and grade in prostatectomy surgical specimens.ResultsMean PVS PSA was 4.29, range 2.3–6 ng/ml. PSA and PAP values in PVS did not differ significantly from internal iliac or deep internal iliac vein samples (p > 0.05). fPSA% was significantly higher in internal iliac (p = 0.004) and deep internal iliac (p = 0.003) vein samples compared to PVS. One of 7 patients had unilateral tumour only. This patient, with left–sided tumour, had a fPSA% of 6, 6, 6, 14 and 12 in his peripheral, right internal iliac, deep right internal iliac branch, left internal iliac and deep left internal iliac branch samples respectively. There were no adverse events.ConclusionfPSA%, unlike total PSA or PAP, is significantly higher in pelvic vein compared to peripheral vein samples when prostate cancer is present. Larger studies including patients with higher PSA values are warranted to further investigate this counterintuitive finding.