Agenesia sacra asociada a disrrafismo espinal e hidrocefalia

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Lisett Hernández León

Full Text Available Introducción: la agenesia sacra es una malformación congénita rara que forma parte del síndrome de regresión caudal. Se caracteriza por un grupo de anomalías en las cuales la columna caudal está ausente. Esta enfermedad es la malformación más frecuente en los hijos de madres diabéticas, además se ha relacionado con otros factores predisponentes, como deficiencias de ácido fólico, de vitaminas, uso de insulina en el embarazo, e incluso, la hipoxia. Entre un 30-40 % de pacientes con agenesia sacra completa, pueden tener asociado un mielomeningocele, y el desplazamiento de las raíces nerviosas empeora los trastornos neurológicos. En estos casos, la hidrocefalia, muchas veces también asociada a malformación Chiari tipo II, está ya presente al nacer. Caso clínico: se presenta el caso de un neonato con agenesia sacra asociada a disrrafismo espinal e hidrocefalia. La intervención quirúrgica fue precoz, se le colocó derivación ventrículo peritoneal y se realizó la reparación del defecto del tubo neural. La evolución posoperatoria fue favorable, aunque persistieron los déficits neurológicos preoperatorios. Conclusiones: no se hallaron factores predisponentes en este paciente y el análisis del cariotipo fue normal. Las anomalías óseas de miembros inferiores fueron las más llamativas, así como la presencia de hidrocefalia asociada a malformación Chiari tipo II y mielomeningocele. El tratamiento a estos casos requiere de un enfoque multidisciplinar, y la reparación quirúrgica del mielomeningocele debe ser precoz para conseguir una evolución favorable. Las formas graves pueden ocasionar una muerte temprana neonatal, en cambio, los niños que sobreviven, generalmente presentan inteligencia normal.

Transcriptome profiling of the theca interna in transition from small to large antral ovarian follicles.

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Nicholas Hatzirodos

Full Text Available The theca interna layer of the ovarian follicle forms during the antral stage of follicle development and lies adjacent to and directly outside the follicular basal lamina. It supplies androgens and communicates with the granulosa cells and the oocyte by extracellular signaling. To better understand developmental changes in the theca interna, we undertook transcriptome profiling of the theca interna from small (3-5 mm, n = 10 and large (9-12 mm, n = 5 healthy antral bovine follicles, representing a calculated >7-fold increase in the amount of thecal tissue. Principal Component Analysis and hierarchical classification of the signal intensity plots for the arrays showed no clustering of the theca interna samples into groups depending on follicle size or subcategories of small follicles. From the over 23,000 probe sets analysed, only 76 were differentially expressed between large and small healthy follicles. Some of the differentially expressed genes were associated with processes such as myoblast differentiation, protein ubiquitination, nitric oxide and transforming growth factor β signaling. The most significant pathway affected from our analyses was found to be Wnt signaling, which was suppressed in large follicles via down-regulation of WNT2B and up-regulation of the inhibitor FRZB. These changes in the transcriptional profile could have been due to changes in cellular function or alternatively since the theca interna is composed of a number of different cell types it could have been due to any systematic change in the volume density of any particular cell type. However, our study suggests that the transcriptional profile of the theca interna is relatively stable during antral follicle development unlike that of granulosa cells observed previously. Thus both the cellular composition and cellular behavior of the theca interna and its contribution to follicular development appear to be relatively constant throughout the follicle growth

Enfermedad pulmonar intersticial asociada a rituximab

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Marcelo Fernández Casares

2013-08-01

Full Text Available La introducción en la práctica clínica del anticuerpo anti-CD20 rituximab ha mejorado sustancialmente el pronóstico de diversas enfermedades autoinmunes y hematológicas. Con el incremento de su uso ha aumentado el registro de efectos adversos, entre ellos la toxicidad pulmonar. Una de sus complicaciones más serias es la enfermedad pulmonar intersticial, entidad potencialmente fatal que debe ser considerada en pacientes que han recibido rituximab y presentan disnea, fiebre y tos sin clara evidencia de infección. Presentamos un caso de enfermedad pulmonar intersticial asociada a rituximab.

Manual de procedimiento de auditoría interna enfocado a riesgos.

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Cabrera, Rosita

2008-01-01

Esta guía pretende ser una herramienta práctica para el desarrollo de la actividad del departamento de Auditoría interna, de la Cooperativa de Ahorro y Crédito “Pablo Muñoz Vega”. Los siguientes conceptos básicos, son incluidos dada su importancia; ya que toman en cuenta las normas, principios de contabilidad y disposiciones legales que debe cumplir el personal que conforma que conforma la Unidad de Auditoría Interna. Control interno, se define ampliamente como un proceso realizado po...

Auditoria interna numa autarquia local

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Mendes, Nuno Filipe Sousa

2014-01-01

A exigência do mundo atual, quer em termos sociais, quer em termos económicos, obriga a que sejam constantemente desenvolvidos novos indicadores de qualidade e transparência. Estes factos, associados a diferentes formas de organização e de suporte da informação, convocam novas medidas de controlo interno mitigadoras dos riscos, mais atuais e mais sustentadas legalmente, fazendo assim apelo a níveis profissionais elevados. É neste contexto que a auditoria interna vem ganhando uma importânci...

Pancreatitis aguda grave asociada a gangrena vesicular

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Arroyo-Sánchez, Abel S; Aguirre-Mejía, Rosa Y; Echenique-Martínez, Sergio E

2014-01-01

Se presenta el caso un paciente diabético que desarrolló un cuadro de pancreatitis aguda grave asociada a gangrena vesicular, en el que se evaluó la aplicabilidad de los criterios de clasificación y manejo de la hoja de ruta para pancreatitis aguda, así mismo se proponen algunos tópicos que pudieran ser investigados a futuro We present a diabetic patient who developed severe acute pancreatitis associated to gallbladder gangrene, in this case we assessed the applicability of classification ...

Resumen de tesis. Violencia y psicopatía en mujeres internas de un centro penitenciario

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Rovelo Escoto, Nubia Carolina

2014-01-01

[ES]Este estudio se llevó a cabo con mujeres internas Centro de Readaptación Social Femenil San José el Alto, Querétaro, México, de quienes nos interesaba realizar una evaluación psicológica científica de la conducta violenta, rasgos de psicopatía y reincidencia para dotar de una técnica espacífica al sistema carcelario. Se trata de lograr una lasificación objetiva de las internas y una mejor comprensión de su personalidad, es el primer estudio Clínico/actuarial con internas de CeReSo Fe...

Fístula carótido-cavernosa asociada al parto

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David Magaña-García

2016-07-01

Conclusión: Este caso nos parece interesante al tratarse de una fístula carótido-cavernosa de alto flujo asociada al parto. Esto no representa la etiología más frecuente, ni el cuadro clínico que se esperaría encontrar en una presentación espontánea debida a este suceso.

Manual de auditoría interna para Instituto de Altos Estudios Nacionales

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Bungacho Lamar, Fredy, Dr.

2010-01-01

La Ley Orgánica de Administración Financiera y Control responsabiliza a cada institución del Estado la implementación y aplicación del Sistema de Control Interno con la finalidad de precautelar los recursos públicos. Este trabajo investigativo sirve como guía para unificar los procedimientos, en la ejecución de las Auditoría de los profesionales que integren la Unidad de auditoría Interna del Instituto de altos Estudios Nacionales. Este Manual de Auditoría Interna, se compone de 6 capí...

Cultura y compromiso afectivo: ¿influyen sobre la transferencia interna del conocimiento?

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Aurora Irma Máynez Guaderrama

2016-01-01

Full Text Available En la nueva economía el conocimiento se reconoce como un activo estratégico, y su transferencia se destaca como una actividad relevante. Por ello, en este trabajo de investigación se examina la influencia de la cultura or ganizacional y del compromiso afectivo sobre la transferencia interna de conocimiento en la empresa; además, se analiza si la cultura de la organización influye significativamente sobre el compromiso afectivo. P ara ello, se llevó a cabo una investigación transversal en una muestra no probabilística de 342 sujetos que laboran en el sector industrial localizado en la frontera norte de México. El análisis estadístico se realizó a través de un modelo de ecuaciones estructurales. Los resultados confirman que la cultura organizacional incide positiva y significativamente sobre la transferencia interna de conocimiento y sobre el compromiso afecti vo. Asimismo, la evidencia empírica apunta que el compromiso afectivo no influye sobre la transferencia interna de conocimiento.

Revisao de 15 casos submetidos a oclusao temporaria bilateral de arteria iliaca interna em pacientes com alto risco para hemorragia obstetrica

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Mariana Krutman

2013-09-01

Full Text Available OBJETIVO: Analisar os resultados de 15 pacientes com elevado risco de sangramento obstétrico, submetidas ao implante de catéteres balão profilático para oclusão temporária das artérias hipogástricas. MÉTODOS: Uma análise retrospectiva foi realizada com base em prontuários de 15 pacientes submetidas ao implante de catéteres balão profilático, de janeiro/2008 a dezembro/2011. Todas as pacientes incluídas no estudo foram diagnosticadas no período antenatal com doença placentária associada a alto risco de hemorragia obstétrica. RESULTADOS: A média de idade das pacientes estudadas foi de 36 anos (32-42 anos. Nove pacientes eram portadoras de acretismo placentário, quatro possuíam placenta prévia, uma estava com gestação ectópica e uma apresentava miomatose uterina e coagulopatia associada a Lupus Eritematosos Sistêmico. O volume total de contraste utilizado para o procedimento variou entre 20 e 160 ml (média de 84 ml. A média do número total de dias de internação e o número de dias de internação após o procedimento foram, respectivamente, 12,4 e 4,9 dias. Em oito (53% casos, não houve necessidade de transfusão sanguínea no intraoperatório ou após a cirurgia. A média do número de unidades de sangue transfundida foi 2,06. A única complicação associada ao procedimento foi a trombose arterial de artéria ilíaca externa, observada em dois casos. CONCLUSÃO: A oclusão temporária de artérias hipogástricas é um método seguro e efetivo para controle de hemorragia em pacientes com elevado risco de sangramento obstétrico, quando realizado por equipe experiente. Os resultados deste estudo são observacionais, retrospectivos e não randomizados; portanto, não podemos apoiar o uso rotineiro dessa técnica, mas podemos incluí-la no arsenal de recursos para casos selecionados com potencial para sangramento.

Rastreamento de resultados adversos nas internações do Sistema Único de Saúde

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Monica Aguilar Estevam Dias

2012-08-01

Full Text Available OBJETIVO: Descrever a frequência de rastreadores de potenciais resultados adversos em internações no Sistema Único de Saúde. MÉTODOS: Estudo retrospectivo, incluindo as internações de adultos na clínica médica (n = 3.565.811 e clínica cirúrgica (n = 2.614.048 no Brasil em 2007. O Sistema de Informações Hospitalares foi utilizado como fonte de informação. A mensuração dos resultados adversos baseou-se no rastreamento de 11 condições clínicas, definidas em estudos internacionais anteriores, registradas no campo diagnóstico secundário. Foram realizadas análises bivariada e multivariada, no intuito de associar resultado adverso, óbito (variável dependente e outras variáveis como idade, utilização de unidade de terapia intensiva e realização de cirurgia. RESULTADOS: A frequência obtida foi 3,6 potenciais resultados adversos por 1.000 internações para ambas as clínicas, superior na clínica médica (5,3 por 1.000 em relação à clínica cirúrgica (1,3 por 1.000. Houve diferenças no perfil das internações: na clínica médica predominaram idosos, maior tempo médio de permanência, maior taxa de mortalidade e menor custo total de internação. O rastreador de resultado adverso mais frequente foi pneumonia hospitalar. Choque/parada cardíaca apresentou maior risco de óbito (OR = 5,76 em relação aos demais resultados adversos. Os maiores gastos com internações estiveram relacionados à sepse hospitalar. Os rastreadores de potencial resultado adverso apresentaram altas chances de óbito, mesmo com a introdução de variáveis como uso de terapia intensiva e realização de cirurgia. CONCLUSÕES: A alta frequência de resultados adversos em internações indica a necessidade de desenvolver estratégias de monitoramento e melhorias dirigidas para a segurança do paciente.

Desinserción espontánea y bilateral del tendón cuadricipital.

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Jesuan Zordan

2016-02-01

Full Text Available La ruptura espontánea bilateral del tendón cuadricipital es una patología infrecuente (<5% de todas las rupturas cuadricipitales. El mayor número de casos reportados, se asocia a insuficiencia renal crónica,  obesidad, diabetes, lupus eritematoso sistémico, vasculitis e hiperparatiroidismo. Nuestro paciente, de 41 años de edad presenta insuficiencia renal crónica en tratamiento con hemodiálisis desde hace 8 años, asociada a hiperparatiroidismo secundario. Ingresa a nuestro servicio por incapacidad a la extensión de ambos miembros inferiores, tras incorporarse desde una silla, destacando en el examen físico una depresión palpable suprarrotuliana. Se realizan radiografías de ambas rodillas frente y perfil, ecografía de zona suprarrotuliana y resonancia magnética nuclear. Al  constatar lesión bilateral a nivel del tendón cuadricipital, se programa su reparación quirúrgica, la cual se realizó por cuestiones ajenas a nuestro servicio a los 30 días del diagnóstico. Se intervinieron de manera simultánea ambas rodillas utilizando como técnica, tunelización patelar y empleando suturas no reabsorbible. Se obtuvo un resultado excelente en ambos miembros inferiores según el Score Knee Society (S.N.S..

Neumonía intersticial linfoidea asociada a inmunodeficiencia común variable Interstitial lymphoid pneumonia associated with common variable immunodeficiency

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Gonzalo Peralta

2011-10-01

Full Text Available La neumonía intersticial linfoidea (NIL es una rara entidad, descripta como hiperplasia no neoplásica del tejido linfoide pulmonar y clasificada dentro de las enfermedades intersticiales idiopáticas. Se la ha descripto asociada a infección por HIV, fenómenos autoinmunes, hipergamaglobulinemia policlonal o menos frecuentemente a hipogammaglobulinemia. Presentamos una paciente de 66 años de edad con diabetes mellitus, síndrome de Sjögren e hipertensión arterial, derivada a nuestro centro por tos seca y disnea clase funcional II-III. En el examen físico presentaba rales tipo “velcro” bibasales y esplenomegalia. Los estudios de laboratorio evidenciaron plaquetopenia (50 000/mm³ e hipogammaglobulinemia; la tomografía axial computarizada (TAC de tórax mostró compromiso intersticial bibasal, con nódulos peribroncovasculares menores a un centímetro. Se realizó una videotoracoscopia con biopsia pulmonar, la anatomía patológica mostró hallazgos compatibles con neumonía intersticial linfoidea. Se inició tratamiento con metilprednisona 40 mg/día vía oral e infusión endovenosa de gammaglobulina 500 mg/kg, mensual, evolucionando con mejoría clínico-radiológica. Por persistencia de plaquetopenia, asociada a hiperesplenismo, se realizó esplenectomía con buena respuesta. En la anatomía patológica no se observo clonalidad linfoide.The interstitial lymphoid pneumonia (LIP is an uncommon disorder, described as non-neoplastic lung lymphoid tissue hyperplasia and classified as an interstitial lung disease. It has been described in association with HIV infection, autoimmune disorders, policlonal hypergammaglobulinemia and less frequently, with hypogammaglobulinemia. We report the case of a 66 year old female patient with a history of diabetes, Sjögren syndrome and hypertension. She was referred to our hospital due to a dry cough and dyspnea (FC II-III. The physical examination showed bilateral dry crackles and splenomegaly

Flora asociada a sitios minados

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Grisel Herrero-Hechavarría

2004-03-01

Full Text Available En Ocujal de Mayarí, provincia Holguín, se realizó una investigación con el objetivo de conocer en qué medida se recupera la biodiversidad y el endemismo por medio de la flora asociada a sitios minados, recultivados después de sustituir plantaciones de Casuarina equisetifolia. Para su ejecución se talaron en áreas minadas parcelas de Casuarina (especie pionera de 4, 6, 7 y 9 años de edad para poner en su lugar Pinus cubensis, la especie autóctona del sitio. Se realizó una medición detallada del sotobosque en las distintas parcelas replicadas de pino, en las cuales se identificaron las especies en los diferentes estratos, así como la cantidad de individuos por especie y familias, al igual que otros datos de interés: endemismo, distribución y forma vital.

Bilateral cochlear implantation in a patient with bilateral temporal bone fractures.

Science.gov (United States)

Chung, Jae Ho; Shin, Myung Chul; Min, Hyun Jung; Park, Chul Won; Lee, Seung Hwan

2011-01-01

With the emphasis on bilateral hearing nowadays, bilateral cochlear implantation has been tried out for bilateral aural rehabilitation. Bilateral sensorineural hearing loss caused by head trauma can get help from cochlear implantation. We present the case of a 44-year-old man with bilateral otic capsule violating temporal bone fractures due to head trauma. The patient demonstrated much improved audiometric and psychoacoustic performance after bilateral cochlear implantation. We believe bilateral cochlear implantation in such patient can be a very effective tool for rehabilitation. Copyright © 2011 Elsevier Inc. All rights reserved.

Manejo de la salinidad en aguas asociadas de producción de la industria petrolera.

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Carlos Alberto Guerrero Fajardo

2005-09-01

Full Text Available En este artIculo se presenta el diseno conceptual de una alternativa complementaria de la solución al manelo de las aguas asociadas de producción dentro de un marco ambiental y técnico factible, cuyo fin es la recuperación de la sal de mayor porcentale, mediante un proceso de cristalización fraccionada tipo I.Para plantear y analizar la alternativa de trabalo con las aguas asociadas de producción provenientes de las estaciones La Gloria, La Gloria Norte y Morichal, pertenecientes a la Asociación Casanare, dado que las anteriores producen un efluente con alto contenido de sales, la propuesta está enfocada al tratamiento del 30% del volumen de agua asociada producida, esperada para el ano 2000 (1239 m3/dIa en los campos de estudio.El proceso permite recuperar un 92% de NaCl presente, equivalente a 0.918 Ton/h, con una pureza del 97%.Para garantizar la calidad del producto final y aprovechar las facilidades del campo, se proponen sistemas de aireación y evaporación previos a la etapa de cristalización.

A auditoria interna em instituições do ensino superior: o caso do Ensino Público Politécnico

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Saraiva, Elsa Cristina de Sá Martins

2010-01-01

Sumário A prática regular de Auditoria interna e externa na Administração Pública é, cada vez mais, uma realidade para avaliar a correcta aplicação dos recursos públicos. A Auditoria Interna tem sido impulsionada, uma vez que se reconhece produzir valor acrescentado, ajudando a gestão, até no que diz respeito a questões de combate à corrupção. Pelo simples facto de existir, a actividade de Auditoria Interna é dissuasora da potencial prática de actos fraudulentos. Assim, t...

La dimensión expresiva del habla interna

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Pablo Fossa

Full Text Available Resumen Este texto constituye una propuesta teórica sobre la dimensión expresiva del habla interna. Se describe el fenómeno de interés enfatizando la propuesta de Karl Bühler respecto a la expresividad del lenguaje, los estudios de Heinz Werner sobre una dimensión fisionómica-organísmica del lenguaje humano y la aproximación teórico-empírico de Lev Vygotsky respecto al fenómeno del habla interior en la experiencia humana. Se concluye que en algunos pasajes de la obra de Vygotsky están las claves para una comprensión del habla interna expresiva, específicamente en la influencia de la esfera afectivo-volitiva en el desarrollo del pensamiento y de la palabra. Finalmente, se propone una integración de la concepción monológica vygotskyana del lenguaje interior, la noción werneriana del lenguaje fisionómico-organísmico y la propuesta bühleriana de la dimensión expresiva del lenguaje humano, para una comprensión integradora de la expresividad del lenguaje interior.

Consenso chileno de prevención, diagnóstico y tratamiento de la diarrea asociada a Clostridium difficile

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Hernández-Rocha, Cristian; Pidal, Paola; Ajenjo, M. Cristina; Quera, Rodrigo; Quintanilla, Marcela; Lubascher, Jaime; Jemenao, M. Irene; Ibáñez, Patricio; Álvarez-Lobos, Manuel; Diomedi, Alexis; Marcotti, Alejandra; Acuña, Mirta; Arab, Juan P; Riquelme, Arnoldo; Candía, Roberto

2016-01-01

Introducción: La diarrea asociada a Clostridium difficile (DACD) ha adquirido gran relevancia debido al aumento en su incidencia, gravedad, capacidad de recurrencia y carga económica asociada. Contar con una guía de consenso local es fundamental para mejorar su manejo. Objetivo: Elaborar un consenso multidisciplinara y basado en la evidencia en la prevención, diagnóstico y tratamiento de la DACD. Métodos: Se convocó a un panel de expertos en el área de enfermedades infecciosas, gastroenterolo...

Fortalezas internas y externas de adolescentes que no consumen alcohol

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Mydori Harumi Téllez Vásquez

2017-06-01

Full Text Available Introducción: el consumo de alcohol en adolescentes mexicanos es un problema de salud pública, que requiere enfocar los esfuerzos de investigación en la prevención. Este estudio se basa en el modelo de fortalezas de Benson (2007, quien plantea que los jóvenes poseen recursos individuales y contextuales que promueven un desarrollo positivo y limitan el involucramiento en conductas de riesgo. Objetivo: analizar las diferencias en fortalezas internas y externas entre estudiantes de secundaria que presentan diferentes niveles de consumo de alcohol. Metodo: participaron 990 estudiantes de secundarias públicas de la Ciudad de México, 52.1% mujeres y 47.9% hombres, de una media de edad de 13.6 años. Se evaluaron siete fortalezas internas y siete externas. Resultados: 53.9% de los participantes nunca ha usado alcohol, 28.3% sí lo ha consumido pero nunca o sólo una vez ha abusado, y 17.8% reportó haber abusado del consumo en el último mes. Hombres y mujeres que no han usado alcohol reportaron puntajes significativamente más altos en fortalezas internas. En el caso de las fortalezas externas, los jóvenes sin consumo fueron los que obtuvieron puntajes más altos, excepto en amigos saludables (tanto hombres como mujeres, y en apoyo y supervisión del padre (hombres. Conclusiones: los resultados contribuyen a la explicación del consumo de alcohol en jóvenes y proporcionan elementos para el diseño de intervenciones, pues señalan las fortalezas que deben promoverse para evitar que los jóvenes consuman alcohol a edades tempranas.

Síndrome do andar superior da cápsula interna. Hemiplegia sensitivo-motora capsular

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A. Borges Fortes

1944-03-01

Full Text Available Desde Türck (1859 os autores têm se preocupado com a passagem de fibras sensitivas pela cápsula interna. Muitas escolas neurológicas têm estudado a questão não só sob o ponto de vista clínico mas também anatômico e experimental. O autor passa em revista a opinião dos autores franceses (Charcot, Dejerine, Roussy, Long, etc. baseados na anátomo-clínica; dos ingleses com base na experimentação (Horsley, Beevor, Grünbaum, Sherrington, Oppenheim; suíços (Monakow e americanos (Grinker sobre as desordens sensitivas nas lesões da cápsula interna. O autor apresenta dois casos anátomo-clínicos de hemiplegia com perturbações sensitivas devidas a lesões da cápsula interna comprovadas anatomicamente. O tálamo estava indene em ambos os casos. A cápsula interna é um diedro formado pelo encontro de dois planos: o segmento anterior e o segmento posterior. Pela parte mais alta (andar superior do segmento posterior passam as fibras que saem do tálamo em busca da cortiça parietal (fibras tálamo-parietais, as que descem ao pedúnculo cerebral (fibras piramidais e as que ficam entre o núcleo lenticular e o tálamo (fibras extra-piramidais. No andar inferior do mesmo segmento passam somente as fibras piramidais. O autor estuda do ponto de vista anátomo-clínico a síndrome talâmica de Dejerine e Roussy, os estados talâmicos (Austregesilo e Colares e a hemiplegia capsular puramente motora. Mostra a inexistência de alterações sensitivas nas hemiplegias devidas à lesão do andar inferior da cápsula interna posterior. Estuda a síndrome do andar superior da cápsula interna posterior ou hemiplegia sensitivo-motora capsular. Documenta dois casos de hemiplegia sensitivo-motora com o estudo anatômico no qual se viu a lesão do andar superior do braço posterior da cápsula interna e integridade do tálamo. Salienta as diferenças existentes entre a mão talâmica e a capsular e chama a atenção para a contratura em flexão com

Características sociodemográficas e clínicas das internações psiquiátricas de mulheres com depressão

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Richardson Miranda Machado

2013-03-01

Full Text Available Estudo retrospectivo e exploratório, realizado com objetivos de identificar e analisar características sociodemográficas e clínicas de internações psiquiátricas de mulheres acometidas por depressão. O estudo foi realizado a partir do Sistema de Internações Hospitalares de um serviço especializado. A amostra foi constituída por 24.161 pacientes admitidos; 1.160 tiveram diagnóstico de depressão (4,8%, com predominância do sexo feminino (761-65,6%, faixa etária de 41 a 50 anos (194-25,4%, procedentes para internação de diferentes serviços de saúde (273-35,8%, com tempo de internação de 60 dias (311-40,8%, altas médicas (687-90,2%, uma internação hospitalar (661-86,8% e internações pagas pelo Sistema Único de Saúde (633-83,2%. Os aspectos biológicos (hormonais, culturais (papel da mulher na sociedade, automedicação, diagnóstico tardio e coocorrência com outras doenças foram os principais fatores relacionados ao acometimento por depressão pelas mulheres e internação. Tais aspectos devem direcionar uma melhor abordagem do cuidado e promoção da saúde mental.

A Rare Entity: Bilateral First Rib Fractures Accompanying Bilateral Scapular Fractures

OpenAIRE

Gulbahar, Gultekin; Kaplan, Tevfik; Turker, Hasan Bozkurt; Gundogdu, Ahmet Gokhan; Han, Serdar

2015-01-01

First rib fractures are scarce due to their well-protected anatomic locations. Bilateral first rib fractures accompanying bilateral scapular fractures are very rare, although they may be together with scapular and clavicular fractures. According to our knowledge, no case of bilateral first rib fractures accompanying bilateral scapular fractures has been reported, so we herein discussed the diagnosis, treatment, and complications of bone fractures due to thoracic trauma in bias of this rare en...

A Rare Entity: Bilateral First Rib Fractures Accompanying Bilateral Scapular Fractures.

Science.gov (United States)

Gulbahar, Gultekin; Kaplan, Tevfik; Turker, Hasan Bozkurt; Gundogdu, Ahmet Gokhan; Han, Serdar

2015-01-01

First rib fractures are scarce due to their well-protected anatomic locations. Bilateral first rib fractures accompanying bilateral scapular fractures are very rare, although they may be together with scapular and clavicular fractures. According to our knowledge, no case of bilateral first rib fractures accompanying bilateral scapular fractures has been reported, so we herein discussed the diagnosis, treatment, and complications of bone fractures due to thoracic trauma in bias of this rare entity.

[Bilateral cochlear implants].

Science.gov (United States)

Müller, J

2017-07-01

Cochlear implants (CI) are standard for the hearing rehabilitation of severe to profound deafness. Nowadays, if bilaterally indicated, bilateral implantation is usually recommended (in accordance with German guidelines). Bilateral implantation enables better speech discrimination in quiet and in noise, and restores directional and spatial hearing. Children with bilateral CI are able to undergo hearing-based hearing and speech development. Within the scope of their individual possibilities, bilaterally implanted children develop faster than children with unilateral CI and attain, e.g., a larger vocabulary within a certain time interval. Only bilateral implantation allows "binaural hearing," with all the benefits that people with normal hearing profit from, namely: better speech discrimination in quiet and in noise, as well as directional and spatial hearing. Naturally, the developments take time. Binaural CI users benefit from the same effects as normal hearing persons: head shadow effect, squelch effect, and summation and redundancy effects. Sequential CI fitting is not necessarily disadvantageous-both simultaneously and sequentially fitted patients benefit in a similar way. For children, earliest possible fitting and shortest possible interval between the two surgeries seems to positively influence the outcome if bilateral CI are indicated.

Cirurgia de revascularização do miocárdio associada a endarterectomia carotídea bilateral: relato de caso

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Giancarlo Grossi MOTA

1998-10-01

Full Text Available O objetivo deste trabalho é relatar o caso de paciente, do sexo feminino, portadora de importante estenose de ambas as artérias carótidas internas, tanto do ponto de vista anatômico quanto hemodinâmico, associada a insuficiência coronária grave, apresentava quadro clínico compatível de acidente vascular cerebral em evolução, tornando imperativa a intervenção cirúrgica imediata; decidida a revascularização do miocárdio simultaneamente à endarterectomia carotídea bilateral, procedimento que pode ser realizado segura e eficazmente, e reservado para os casos onde ambos os territórios estão acometidos e sobrevier a instabilização de algum dos subsistemas em questão.This report refers to a 69 year old woman, presenting severe stenosis of both carotid arteries, associated with coronary insufficiency. An acute incomplete transitory brain stroke made mandatory the simultaneous surgical approach of bilateral carotid arteries for endarterectomy and myocardial revascularization. The procedure can be performed safely in very selected and unstable cases.

A Rare Entity: Bilateral First Rib Fractures Accompanying Bilateral Scapular Fractures

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Gultekin Gulbahar

2015-01-01

Full Text Available First rib fractures are scarce due to their well-protected anatomic locations. Bilateral first rib fractures accompanying bilateral scapular fractures are very rare, although they may be together with scapular and clavicular fractures. According to our knowledge, no case of bilateral first rib fractures accompanying bilateral scapular fractures has been reported, so we herein discussed the diagnosis, treatment, and complications of bone fractures due to thoracic trauma in bias of this rare entity.

Rationes implícitas y sensaciones internas en las Meditationes de Prima Philosophia

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Mauricio Otaíza

2014-01-01

Full Text Available Descartes afirma que el cogito se “experimenta en uno” (apud se experiatur o se “siente en uno mismo” (“il sent in lui-même”, pero también ha señalado que uno no siente sino a través del cuerpo. El problema es que, en las Meditaciones, el cogito fue caracterizado cuando todavía no se había demostrado la existencia del cuerpo. Pese a esto, Descartes parece haberse dejado influir por ciertas sen- saciones internas de duda y certeza. En el trabajo se sostiene que esto fue posible porque esas sensaciones internas son efecto de una ratio implícita: la existencia de un Dios no engañador.

As diferenças entre comunicação interna e endomarketing

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Carolina Girotto Ochoa

2014-01-01

Full Text Available Atualmente, a comunicação empresarial é algo imprescindível no mundo dos negócios. Em busca de crescimento e melhores resultados, as empresas sempre investiram na comunicação destinada aos clientes, o público externo. Porém, há algum tempo, percebeu-se a necessidade de conquistar o público interno, basicamente composto por empregados e familiares, para que os bons resultados e qualidade de produtos e serviços sejam mantidos. As empresas passaram a investir em ações de comunicação interna e de endomarketing para estreitar relacionamento e motivar os empregados, com o objetivo de obter os resultados esperados. Muitos profissionais costumam, erroneamente, conceituar comunicação interna e endomarketing como sinônimos. Este artigo tem por objetivo diferenciá-los.

El desarrollo laboral sustentable y su relación con la migración interna en México

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Jesús Sergio Sánchez Rodríguez

2014-01-01

Full Text Available en este trabajo se estudió la interacción entre la mi - gración interestatal y el desarrollo laboral sustentable en México del año 2000 al 2010, de acuerdo con la visión de Amartya Sen. Este desarrollo se midió con el índice de competitividad social, y la interacción con la migración interna se evaluó con un modelo de ecuaciones simultá - neas. Los resultados confirmaron que a mayor desarrollo laboral sustentable, el grado de inmigración fue más y vi - ceversa. Por otro lado, no se encontró relación alguna entre la emigración interna y el desarrollo laboral sustentable. Al desagregar el índice de competitividad social, se encontró una relación causal mutua entre el índice de la ausencia de pobreza salarial y la inmigración interna, así como una relación causa-efecto positiva entre ausencia de pobreza salarial sobre la emigración interna, la cual no se da en el otro sentido.

A longitudinal study of the bilateral benefit in children with bilateral cochlear implants.

Science.gov (United States)

Asp, Filip; Mäki-Torkko, Elina; Karltorp, Eva; Harder, Henrik; Hergils, Leif; Eskilsson, Gunnar; Stenfelt, Stefan

2015-02-01

To study the development of the bilateral benefit in children using bilateral cochlear implants by measurements of speech recognition and sound localization. Bilateral and unilateral speech recognition in quiet, in multi-source noise, and horizontal sound localization was measured at three occasions during a two-year period, without controlling for age or implant experience. Longitudinal and cross-sectional analyses were performed. Results were compared to cross-sectional data from children with normal hearing. Seventy-eight children aged 5.1-11.9 years, with a mean bilateral cochlear implant experience of 3.3 years and a mean age of 7.8 years, at inclusion in the study. Thirty children with normal hearing aged 4.8-9.0 years provided normative data. For children with cochlear implants, bilateral and unilateral speech recognition in quiet was comparable whereas a bilateral benefit for speech recognition in noise and sound localization was found at all three test occasions. Absolute performance was lower than in children with normal hearing. Early bilateral implantation facilitated sound localization. A bilateral benefit for speech recognition in noise and sound localization continues to exist over time for children with bilateral cochlear implants, but no relative improvement is found after three years of bilateral cochlear implant experience.

Auditorias internas como fonte de informa??o para o conhecimento organizacional: estudo de caso em uma IFES

OpenAIRE

Santos, Ludinaura Regina Souza dos

2012-01-01

O objetivo geral desta pesquisa foi o de analisar como os processos de auditoria interna v?m se transformando em fonte de informa??o para o conhecimento organizacional em uma IFES. O marco te?rico foi estruturado em quatro partes: (1) discuss?o sobre conhecimento organizacional, (2) teoria da cria??o do conhecimento organizacional, (3) o controle da administra??o p?blica no Brasil e (4) auditorias internas governamentais. Quanto ? caracteriza??o da pesquisa, apresentou um aspec...

Hernia diafragmática congénita y malformaciones asociadas.

OpenAIRE

Austin-Ward, Enrique Daniel; Nazer H, Julio; Castillo T, Silvia

1998-01-01

La hernia diafragmática congénita (HDC) continua siendo me patología que pone en peligro la vida a pesar de los adelantos en su manejo. Las malformaciones congénitas asociadas resultan ser uno de los factores más importantes que contribuyen a elevar los tasas de mortalidad en estos pacientes. En este trabajo presentamos nuestra experiencia con relación a esta anomalía, la cual forma parte del Estudio Colaborativo Latinoamericano de Malformaciones Congénitos (ECLAMC), enfocado principalmente e...

Poluentes do ar e internações devido a doenças cardiovasculares em São José do Rio Preto, Brasil

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Kátia Cristina Cota Mantovani

2016-02-01

Full Text Available Resumo O presente estudo teve como objetivo estimar os efeitos de poluentes ambientais sobre o número de internações por doenças cardiovasculares. Foi um estudo ecológico com dados de internações hospitalares de residentes em São José do Rio Preto, São Paulo, Brasil, com diagnóstico nas categorias de I-00 a I-99, entre 01/10/11 e 30/09/12. Os poluentes analisados foram partículas finas (PM2,5, ozônio, monóxido de carbono, óxido de nitrogênio e dióxido de nitrogênio. Foram estimados pelo modelo CCATT-BRAMS. O uso do modelo aditivo de regressão de Poisson foi utilizado para estimar associação entre a exposição ao PM2,5 e internação por doença cardiovascular. Foram calculados os excessos de internação e os gastos por estas doenças. Observou-se que a exposição ao PM2,5 no quinto dia após a exposição (lag 5 foi significativo para internação e aumentou em 15 ppts segundo incremento de 10µg /m3 na concentração de PM2,5. Foram identificadas 650 internações evitáveis com custos da ordem de R$ 1,9 milhão. Desse modo, foi possível identificar associação entre exposição ao PM2,5 e internações devido a doenças cardiovasculares em cidades de médio porte como São José do Rio Preto fornecendo subsídios aos gestores municipal e regional de Saúde.

Las bioconstrucciones de corales y sus facies asociadas durante el Malm en la Cordillera Ibérica Central (provincia de Zaragoza

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Meléndez, A.

1987-08-01

Full Text Available The differents types of bioconstructions and associated facies in the Central Iberian Chain (Higueruelas Formation, Upper Kimmeridgian have been studied. Biohermes of different thickness (decimetric to metric and less lateral continuity are developped, highly colonized by corals, that are associated to oncolitic, bioclastic and oolitic of high energy facies, in marginal areas, near the litoral developpment. At the same time takes place an important set up of mud mounds, with a small coral colonisation, in protected arcas in a inner shelf, or in outer areas, where the action of the waves is not so effective. The environment protection is been generated in some places due to the appearance of oolitic barrier islands.Se estudian los diferentes tipos de bioconstrucciones de corales, y sus facies asociadas, presentes en el sector central de la rama aragonesa de la Cordillera Ibérica, en la Formación Higueruelas (Kimmeridgiense superior. Se desarrollan biohermos de potencias métricas a decimétricas y escasa continuidad lateral, intensamente colonizados por corales coloniales, que se encuentran asociados a facies oncolíticas, bioclásticas y oolíticas de alta energía en zonas marginales, próximas al desarrollo litoral. Al mismo tiempo tiene lugar una importante instalación de mud mounds, con escasa colonización de corales, en zonas protegidas dentro de la plataforma interna o en zonas más externas, donde la acción del oleaje no es efectiva. La protección del medio viene condicionada en algunos puntos por la aparición de islas barrera oolíticas.

Genes y variantes polimórficas asociadas a la enfermedad cardiovascular

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Eliana C. Portilla

2014-09-01

Full Text Available La aterosclerosis se considera como la principal causante de enfermedades cardiovasculares. Es una enfermedad multifactorial, caracterizada por procesos inflamatorios y la internalización continua de moléculas lipídicas al interior del vaso. Los estudios de genes candidato han proporcionado conocimiento acerca de la fisiopatología de esta enfermedad y han permitido la postulación de algunos polimorfismos como responsables de la susceptibilidad genética en diversas poblaciones. En particular, estos polimorfismos que modulan ciertas vías moleculares tales como el estrés oxidativo, el metabolismo lipídico y la trombogénesis se asocian con el desarrollo de las enfermedades cardiovasculares. Se han conducido varios estudios para identificar nuevas variantes asociadas con la enfermedad que han permitido el descubrimiento de nuevas vías de la enfermedad. Aunque el hallazgo de nuevos genes asociados a la enfermedad cardiovascular a través de enfoques como el escaneo global del genoma ha contribuido al entendimiento del desarrollo de esta condición, el conocimiento aún es limitado y poco concluyente. El objetivo de esta revisión es identificar los genes y las variantes polimórficas asociadas a la enfermedad cardiovascular, de acuerdo con los diferentes enfoques de análisis de asociación genética.

Actividad investigadora de los residentes de medicina interna de Galicia

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IRIA ÍÑIGUEZ

2012-03-01

Full Text Available OBJETIVO: Conocer la actividad investigadora de los residentes de medicina interna (MI de Galicia.MÉTODO: encuesta remitida a los residentes (MIR de Medicina Interna de Galicia en Mayo de 2011. Las variables analizadas fueron: comunicaciones a congresos, publicaciones en revistas, capítulos de libros, Diploma de Estu-dios Avanzados (DEA, tesis doctoral y participación en proyectos de investi-gación financiados. Los resultados se clasificaron según el año de residencia.RESuLTADOS: participaron 39 residentes (68% de los MIR de MI de Gali-cia: 9 MIR de 1º año, 14 MIR 2º, 6 MIR 3º, 6 MIR 4º y 4 MIR 5º. Se registró una media de comunicaciones a congresos autonómicos por residente de 5,.85 (DS 5.22, 2,51 (3.64 a congresos nacionales y 0,74 (1,9 a internacionales. El 41% y el 87,2% no había participado en ninguna comunicación a congresos nacionales e internacionales, respectivamen-te. Se registraron un total de 29 publicaciones, con una media inferior a 1 publicación por residente. El 71,8% no había participado en ninguna publicación. El 15% estaba realizando o habían obtenido el DEA. No se observaron diferencias en la actividad investigadora en relación al avance en los años de residencia. Tampoco se observaron diferencias en cuanto a si los residentes procedían o no de hospitales universitarios. CONCLUSIÓN: la actividad investigadora de los residentes de medicina interna de Galicia es deficiente. Es preciso conseguir una mayor impli-cación por parte de los residentes, tutores y unidades de docencia de los distintos hospitales y acometer las medidas necesarias para cambiar esta situación, estimulando actividades de formación y promoción de la investigación en los hospitales de Galicia.

Preditores de internação hospitalar em pacientes com síncope atendidos em hospital cardiológico

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Leonardo Marques Fischer

2013-12-01

Full Text Available FUNDAMENTO: No atendimento ao episódio sincopal é necessário estratificar o risco para melhor diferenciar pacientes que necessitam de internação hospitalar daqueles que podem ser liberados. Os critérios utilizados pelos médicos avaliadores desses pacientes em emergências cardiológicas em nosso meio são desconhecidos. OBJETIVOS: Analisar quais os critérios adotados para internação hospitalar, diferenciá-los dos utilizados nos pacientes liberados e compará-los com os preditores de alto risco definidos pelo escore de OESIL já validado para esse fim. MÉTODOS: Estudo transversal em pacientes diagnosticados com síncope na emergência em nossa instituição no ano de 2011. RESULTADOS: Dos 46.476 atendimentos realizados naquele ano, 216 foram descritos como síncope. Dos 216 pacientes analisados, 39% foram internados, sendo que as principais variáveis associadas à admissão foram síncope prévia, doença cardíaca conhecida, história negativa para acidente vascular encefálico no passado, ECG alterado e possuir plano de súde. Na comparação internação contra não internação, os escores OESIL 0-1 foram associados a maior chance de liberação hospitalar; os escores 2-3 apresentaram maior associação com internação. Um escore OESIL >2 demonstrou razão de chances 7,8 vezes maior de internação comparado com o escore 0 (p < 0,001; IC95%: 4,03-15,11. Aproximadamente 39% dos pacientes não tiveram definição etiológica e em 18% foi identificada uma causa cardiológica. CONCLUSÕES: Fatores como doença cardiovascular conhecida, história sincopal prévia, ausência de AVC prévio, possuir seguro de saúde e eletrocardiograma alterado foram os critérios utilizados pelos médicos em emergência para indicar internação hospitalar. Houve boa correlação entre os critérios clínicos e os critérios de risco do OESIL descritos na literatura.

Bilateral bone conduction devices: improved hearing ability in children with bilateral conductive hearing loss.

Science.gov (United States)

Dun, Catharina A J; Agterberg, Martijn J H; Cremers, Cor W R J; Hol, Myrthe K S; Snik, Ad F M

2013-01-01

The aim of the study was to investigate whether children with bilateral conductive hearing loss benefit from their second device (i.e., the bilateral bone conduction device [BCD]). Speech recognition in noise was assessed in 10 children fitted with bilateral BCDs during childhood. Speech recognition was measured in 2 conditions with both BCDs active. Spatial resolution was tested with the Minimum Audible Angle test in the bilateral and monaural listening conditions. Children demonstrated an improvement in speech recognition when speech was presented from the front and noise was presented from the right-hand side as compared with both speech and noise being presented from the front. The minimum audible angle decreased from 57° in the best monaural condition to 13° in the bilateral condition. The audiological outcomes demonstrate the advantage of bilateral BCD fitting in children with bilateral conductive hearing loss.

Infecciones intrahospitalarias asociadas a dispositivos invasivos en unidades de cuidados intensivos de un hospital nacional de Lima, Perú

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Omayra Chincha

2013-12-01

Full Text Available Con el objetivo de describir la incidencia de infecciones intrahospitalarias asociadas a dispositivos invasivos en unidades de cuidados intensivos (UCI del Hospital Nacional Cayetano Heredia se realizó un estudio observacional retrospectivo utilizando datos de la Oficina de Epidemiología y Salud Ambiental durante los años 2010 al 2012. Se notificó un total de 222 infecciones intrahospitalarias, la UCI de Medicina tuvo la incidencia por 1000 días de uso del dispositivo más alta para neumonía asociada a ventilador mecánico (28,6; infección del torrente sanguíneo asociado a catéter venoso central (11,9, e infección del tracto urinario asociado a catéter (8,1. Los principales agentes infecciosos aislados fueron Pseudomona sp. (32,3% en la UCI de emergencia, Staphylococcus coagulasa negativo(36% en la UCI de medicina y Candida sp (69,2% en la UCI de cirugía. Las tasas de infecciones asociadas a dispositivos invasivos se reportaron altas semejantes a otros hospitales nacionales con limitados recursos e infraestructura

Infecciones intrahospitalarias asociadas a dispositivos invasivos en unidades de cuidados intensivos de un hospital nacional de Lima, Perú

Directory of Open Access Journals (Sweden)

Omayra Chincha

Full Text Available Con el objetivo de describir la incidencia de infecciones intrahospitalarias asociadas a dispositivos invasivos en unidades de cuidados intensivos (UCI del Hospital Nacional Cayetano Heredia se realizó un estudio observacional retrospectivo utilizando datos de la Oficina de Epidemiología y Salud Ambiental durante los años 2010 al 2012. Se notificó un total de 222 infecciones intrahospitalarias, la UCI de Medicina tuvo la incidencia por 1000 días de uso del dispositivo más alta para neumonía asociada a ventilador mecánico (28,6; infección del torrente sanguíneo asociado a catéter venoso central (11,9, e infección del tracto urinario asociado a catéter (8,1. Los principales agentes infecciosos aislados fueron Pseudomona sp. (32,3% en la UCI de emergencia, Staphylococcus coagulasa negativo(36% en la UCI de medicina y Candida sp (69,2% en la UCI de cirugía. Las tasas de infecciones asociadas a dispositivos invasivos se reportaron altas semejantes a otros hospitales nacionales con limitados recursos e infraestructura

Headache in a patient with Klinefelter’s syndrome and hyperostosis frontalis interna

OpenAIRE

Ramchandren, Sindhu; Liebeskind, David S.

2007-01-01

Hyperostosis frontalis interna (HFI) has been reported in older women, but reports in men are rare. We present a novel case of migraine headache in a gentleman with Klinefelter’s syndrome and HFI, along with a discussion of possible pathophysiologic mechanisms underlying both the headache and the HFI.

Corte y sellado reversible de dientes para obtener superficies internas de esmalte incólumes

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Ana Milena Santiago-Medina

2015-07-01

Full Text Available Las superficies internas de los dientes, que se obtienen por cortes con discos, están generalmente desorganizadas por los giros, la velocidad y la rugosidad del disco. El calor altera la superficie y el agua de la refrigeración la composición química porque disuelve los componentes. En estudios de difusión, el perfil se borra por el corte, lo que anula resultados. Objetivo: desarrollar un método de sellado de superficies internas, ya cortadas antes de los ensayos de difusión, sin dejar trazas químicas o partículas. Materiales y metedos: se probó in vitro la habilidad de cuatro materiales de sellado con 40 especimenes, provenientes de 20 coronas de terceros molares, cortadas sagitalmente. Los especímenes se distribuyeron aleatoriamente en cuatro grupos (n = 10: G1: Teflón (Topex®, G2: Tela de caucho (Dental DAM®, G3: película de cloruro de polivinilo (Vinilpel® y G4: Cinta aislante (Tesa®. Se usó una solución de azul de metileno (AM al 2% por 6 días como indicadora de filtración. Por observación visual de cada muestra, se le asignó un valor (sí o no dependiendo de la presencia o ausencia de cualquier punto MB sobre la superficie de sellado. Los resultados fueron analizados siguiendo un modelo estadístico de respuesta binomial. Resultados: Siguiendo los procedimientos descritos, el teflón es el único material que previene la filtración de AM en la superficie interna expuesta por el corte. Conclusión: Se propone un protocolo de sellado reversible de las superficies internas con teflón, previo al corte de los dientes, para no alterar los resultados experimentales.

Hemipelvectomia interna: relato de oito casos Internal hemipelvectomy: report on eight cases

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Alexandre Ferreira Oliveira

2012-01-01

Full Text Available A hemipelvectomia interna é um procedimento cirúrgico adequado no tratamento de certos tumores de cintura pélvica. É uma alternativa terapêutica capaz de preservar o membro inferior do paciente, ao contrário das amputações clássicas como a amputação interilioabdominal (AIIA e desarticulação coxofemoral. De acordo com a classificação de Enneking, existem quatro tipos de hemipelvectomia interna, mas, se for necessário, é possível a associação de diferentes tipos de ressecção em um único procedimento. É fundamental que esta cirurgia seja indicada de forma correta para que interfira positivamente na morbimortalidade e qualidade de vida do paciente. Relatamos oito casos de hemipelvectomia interna em pacientes diagnosticados com tumores de cintura pélvica, bem como os tipos de tratamento neoadjuvantes e adjuvantes a que eles foram submetidos e o follow-up dos mesmos.Internal hemipelvectomy is a surgical procedure adequate for treatment of certain tumors of the pelvic girdle. Being a lower limb-preserving approach, it is a therapeutic alternative to the classical interilioabdominal amputation and hip joint disarticulation. According to Enneking`s classification, there are four types of internal hemipelvectomies, although the association of different types of resection in the same procedure is feasible if necesary. This surgical approach should be correctly indicated to positively affect the patient`s morbidity, mortality and quality of life. We report eight cases of internal hemipelvectomy in patients diagnosed with tumors of the pelvic girdle. We also discuss the neoadjuvant and adjuvant treatments used, along with their follow-up.

Comunicación Interna y Desempeño Laboral en el Programa Nacional de Infraestructura Educativa 2015

OpenAIRE

Padilla Pinedo, Pedro

2016-01-01

La presente investigación tuvo como objetivo general el determinar qué relación existe entre la Comunicación interna y el desempeño laboral en el Programa Nacional de Infraestructura Educativa 2015; Constituido por 200 trabajadores Administrativos del PRONIED, la muestra censal consideró toda la población, en los cuales se ha empleado las variables: Comunicación Interna y Desempeño Laboral. El método empleado en la investigación fue el hipotético deductivo, esta investigació...

La comunicación interna en las empresas

OpenAIRE

Martínez Delgado, Juan Carlos

2014-01-01

La gestión eficaz de la comunicación interna en las empresas va a ser clave para la supervivencia de las empresas que quieran competir en un mundo globalizado donde los sistemas de información y comunicación juegan un papel fundamental. Es por tanto una herramienta clave de la que todos los miembros de la organización deberán ser partícipes en su desarrollo, principalmente los mandos intermedios. Lo difícil, la gestión del cambio en las organizaciones actuales, más acusado en el caso ...

Automatização de um dinamômetro hidráulico para ensaios de motores de combustão interna

OpenAIRE

Albuquerque, Luiz Eduardo Nunes de

2016-01-01

Esta dissertação apresenta a automatização de um dinamômetro hidráulico instalado na cabine de testes de motores de combustão interna do laboratório de máquinas térmicas da Universidade de Brasília. O dinamômetro é operado por meio de um controlador analógico que comanda o freio do equipamento pela variação da pressão interna gerada pelo vórtice da água no circuito hidráulico. A pressão interna, por sua vez, é controlada por uma válvula borboleta acoplada a um servo motor de corrente contínua...

Neumonía intersticial linfoidea asociada a inmunodeficiencia común variable

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Gonzalo Peralta

2011-10-01

Full Text Available La neumonía intersticial linfoidea (NIL es una rara entidad, descripta como hiperplasia no neoplásica del tejido linfoide pulmonar y clasificada dentro de las enfermedades intersticiales idiopáticas. Se la ha descripto asociada a infección por HIV, fenómenos autoinmunes, hipergamaglobulinemia policlonal o menos frecuentemente a hipogammaglobulinemia. Presentamos una paciente de 66 años de edad con diabetes mellitus, síndrome de Sjögren e hipertensión arterial, derivada a nuestro centro por tos seca y disnea clase funcional II-III. En el examen físico presentaba rales tipo “velcro” bibasales y esplenomegalia. Los estudios de laboratorio evidenciaron plaquetopenia (50 000/mm³ e hipogammaglobulinemia; la tomografía axial computarizada (TAC de tórax mostró compromiso intersticial bibasal, con nódulos peribroncovasculares menores a un centímetro. Se realizó una videotoracoscopia con biopsia pulmonar, la anatomía patológica mostró hallazgos compatibles con neumonía intersticial linfoidea. Se inició tratamiento con metilprednisona 40 mg/día vía oral e infusión endovenosa de gammaglobulina 500 mg/kg, mensual, evolucionando con mejoría clínico-radiológica. Por persistencia de plaquetopenia, asociada a hiperesplenismo, se realizó esplenectomía con buena respuesta. En la anatomía patológica no se observo clonalidad linfoide.

Bilateral breast carcinoma: results with breast conservation therapy and a comparison with bilateral mastectomy

International Nuclear Information System (INIS)

Kim, David H.; Haffty, Bruce G.

1996-01-01

Purpose: To assess outcome of patients with bilateral breast carcinoma treated with bilateral breast conserving surgery with radiation therapy (CS+RT) and to compare their outcome to (1) patients with unilateral disease treated with CS+RT and (2) patients of comparable stage treated with bilateral mastectomy. Methods and Materials: The charts of all patients with the diagnosis of breast cancer treated with CS+RT at our facilities prior to 1993 were reviewed to identify patients with bilateral disease. A total of 50 patients identified as having bilateral breast cancer conservatively treated(BCT) served as the index population. Out of the 50 patients, 23 presented with synchronous bilateral breast cancer and 27 presented with metachronous bilateral breast cancer. A group of 984 patients with unilateral breast cancer (UCT) treated with CS+RT during the same time interval served as the first control group. A second control group was comprised of 42 patients with early stage bilateral breast cancer presenting during the same time interval treated with bilateral mastectomy (BMAST). Patients who had locally advanced disease in either breast or those patients treated exclusively for lobular carcinoma in situ in either breast were excluded from the analysis. Of the 42 BMAST patients, 33 presented with synchronous disease and nine presented with metachronous disease. Local-regional relapse rates were calculated from the date of treatment of each breast. Overall survival and distant relapse rates were calculated from the date of treatment of the second breast cancer diagnosed. Survival curves were calculated via the life table method and statistical comparisons between curves were performed using the log rank statistic. Chi square analysis was used to detect differences between categorical variables. Results: As of December 1995, the median follow-up of the bilateral conservatively treated patient population was 9.4 years. No statistically significant differences were noted

Enfermedad gingival asociada al paciente pediátrico asmático

OpenAIRE

Carfi Marin, Indhira Del Valle; Alarcón Palacios, Marco

2014-01-01

El asma es una enfermedad infl amatoria crónica del sistema respiratorio, caracterizada por ser hipersensible y episódica, reversible y con síntomas de abstracción del fl ujo de aire. La prevalencia del asma ha ido en aumento a través de todas las edades, sexo y grupos raciales; y resulta ser mayor entre los niños que en adultos. Últimamente ha sido asociada en numerosas investigaciones a la prevalencia de caries y enfermedad periodontal, donde diversos factores y la respuesta inmune actúan d...

La enfermedad periodontal asociada al paciente con Síndrome de Down

Directory of Open Access Journals (Sweden)

Rubens Demicheri A.

Full Text Available Resumen: El Síndrome de Down es una de las condiciones de discapacidad más comunes. Dentro de las patologías bucales más prevalentes, la enfermedad periodontal es una de las asociadas con este síndrome. Se considera que la persona con Síndrome de Down presenta una mayor susceptibilidad a contraer esta enfermedad. En este artículo se describen los factores etiológicos y las características clínicas de la enfermedad en pacientes portadores del síndrome

Mulheres em idade fértil: causas de internação em Unidade de Terapia Intensiva e resultados

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Cátia Millene Dell Agnolo

2014-08-01

Full Text Available Introdução: Pacientes obstétricas representam uma fração significativa das admissões em unidades de cuidado intensivo e consistem em um desafio para a equipe. Objetivo: Analisar as principais causas de internação e morte materna de mulheres em idade fértil ocorridas em unidades de terapia intensiva de hospitais de um município do Noroeste do Paraná, Sul do Brasil. Métodos: Estudo exploratório, descritivo, retrospectivo, realizado com mulheres em idade fértil (10 a 49 anos internadas em três unidades de terapia intensiva existentes em um município do Noroeste do Paraná, por causas obstétricas e não obstétricas, no período de janeiro de 2005 a dezembro de 2009. Resultados: Foram encontradas 775 internações de mulheres em idade fértil, com uma média de idade de 33,7±10,3 anos, com duração média de internação de 5,0±8,4 dias. A maior parte das mulheres era do município estudado (67,2%, com baixa escolaridade (nível primário, 68,2%. Entre as causas obstétricas de internação, a pré-eclâmpsia grave e a eclâmpsia se constituíram na principal causa (71,3%; a pielonefrite se destacou sob outras condições no período gestacional (53%. Não foi encontrada associação estatística entre internações por causas obstétricas em unidade de terapia intensiva e óbito. Conclusão: As causas não obstétricas representaram a maioria das internações de mulheres em idade fértil nas unidades de terapia intensiva do município, no período estudado e, entre as causas obstétricas, a pré-eclâmpsia grave e eclampsia constituíram a principal causa.

Deep brain stimulation of the antero-medial globus pallidus interna for Tourette syndrome.

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Perminder S Sachdev

Full Text Available BACKGROUND: We have previously reported the results of Deep Brain Stimulation (DBS of the antero-medial globus pallidus interna (GPi for severe Tourette Syndrome (TS in 11 patients. We extend this case series to 17 patients and a longer follow-up to a maximum of 46 months. METHODS: 17 patients (14 male; mean age 29.1 years, range 17-51 years with severe and medically intractable TS were implanted with Medtronic quadripolar electrodes bilaterally in the antero-medial GPi. The primary outcome measure was the Yale Global Tic Severity Scale (YGTSS. Secondary outcome measures included the Yale-Brown Obsessive Compulsive Scale, Hamilton Depression Rating Scale, Gilles de la Tourette Quality of Life Scale and Global Assessment of Functioning. Follow up was at one month, three months and finally at a mean 24.1 months (range 8-46 months following surgery. RESULTS: Overall, there was a 48.3% reduction in motor tics and a 41.3% reduction in phonic tics at one month, and this improvement was maintained at final follow-up. 12 out of 17 (70.6% patients had a>50% reduction in YGTSS score at final follow up. Only 8 patients required ongoing pharmacotherapy for tics post-surgery. Patients improved significantly on all secondary measures. Adverse consequences included lead breakage in 4 patients, infection (1, transient anxiety (2, dizziness (1, poor balance (1 and worsening of stuttering (1. CONCLUSIONS: This case series provides further support that antero-medial GPi DBS is an effective and well tolerated treatment for a subgroup of severe TS, with benefits sustained up to 4 years.

Mortalidade e o tempo de internação em uma unidade de terapia intensiva cirúrgica

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Abelha Fernando José

2006-01-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: Em cuidados intensivos os resultados podem ser relacionados aos índices de mortalidade ou morbidade. Quando avaliada de forma isolada, a mortalidade é uma medida insuficiente do resultado na Unidade de Terapia Intensiva (UTI; o tempo de internação pode ser uma medida indireta do resultado relacionado com a morbidade. O objetivo do presente estudo foi avaliar a incidência e os fatores preditivos para mortalidade e tempo de internação dos pacientes admitidos numa UTI cirúrgica. MÉTODO: Participaram deste estudo prospectivo, realizado, entre abril e julho de 2004, todos os 185 pacientes submetidos a procedimentos programados ou de emergência, admitidos numa UTI cirúrgica. Foram registrados os seguintes parâmetros: idade, sexo, altura e peso, temperatura central estado físico segundo a ASA, tipo de intervenção cirúrgica, porte cirúrgico, técnica anestésica, quantidade e qualidade de fluídos administrados durante a anestesia, monitorização da temperatura ou de técnica de aquecimento corporal peri-operatório, duração da anestesia, tempo de permanência na UTI e no hospital e escore SAPS II. RESULTADOS: O tempo médio de internação na UTI foi de 4,09 ± 10,23 dias. Fatores de risco significativos para permanências mais prolongadas na UTI foram o valor do escore SAPS II, estado físico ASA, quantidade administrada, durante a intervenção cirúrgica, de colóides, unidades de plasma fresco e unidades de concentrados de hemáceas. Quatorze pacientes (7,60% morreram durante a internação na UTI e 29 (15,70% morreram durante a internação hospitalar. Fatores de risco independentes de mortalidade com diferença estatística significativa foram intervenções cirúrgicas de emergência, de grande porte, escores altos SAPS II, permanência prolongada na UTI e no hospital. Fatores protetores com diferença estatística significativa para risco de morte hospitalar foram baixo peso corporal e baixo �

Bilateral herpes zoster

OpenAIRE

Singh K; Bajaj A; Dwivedi N; Merchery A

1993-01-01

A case of bilateral herpes zoster of lumbosacral region is reported in association with diabetes mellitus in a 55 years old female. The case is of interest due to bilateral distribution which is rare and sacral region involvement which is quite uncommon.

Bilateral Testicular Tumors Resulting in Recurrent Cushing Disease After Bilateral Adrenalectomy

NARCIS (Netherlands)

Puar, T.; Engels, M.; Herwaarden, A.E. van; Sweep, F.C.; Hulsbergen-van de Kaa, C.A.; Kamphuis-van Ulzen, K.; Chortis, V.; Arlt, W.; Stikkelbroeck, N.; Claahsen-van der Grinten, H.L.; Hermus, A.R.M.M.

2017-01-01

Context: Recurrence of hypercortisolism in patients after bilateral adrenalectomy for Cushing disease is extremely rare. Patient: We present a 27-year-old man who previously underwent bilateral adrenalectomy for Cushing disease with complete clinical resolution. Cushingoid features recurred 12 years

Influencia de la consulta monográfica de insuficiencia cardiaca crónica y comorbilidad asociada dirigida por internistas sobre la calidad asistencial y hospitalizaciones relacionadas

Directory of Open Access Journals (Sweden)

José Manuel Cerqueiro González

2012-09-01

Full Text Available OBJETIVO: Determinar la repercusión de una consulta monográfica para pacientes con insuficiencia cardíaca crónica (ICC y comorbilidad asocia-da, dirigida por internistas y enfermería cualificada, sobre la calidad asis-tencial y los reingresos y la influencia en los ingresos de estos pacientes. Así como la influencia en los ingresos globales del hospital por IC.MATERIAL Y MÉTODOS: Estudio de cohortes retro y prospectivo de 169 pacientes con ICC, incluidos en dos consultas monográficas similares, pertenecientes a dos hospitales de diferente ámbito asistencial (comarcal y provincial. Se evalúan porcentaje de pacientes que recibe fármacos de 1º línea, la adherencia al seguimiento y se compara los ingresos por ICC realizados el año previo y posterior al seguimiento. Para conocer el impacto de estas consultas, en base a los datos de los centros, se analiza la evolución en el nº de ingresos totales y estancias medias por ICC (GRDs 127, 544 durante los años 2001-2009. Coincide el ecuador de este pe-riodo con la puesta en marcha de estas consultas.RESULTADOS: Los pacientes sometidos al seguimiento recibieron fárma-cos de 1º línea en un porcentaje elevado (97.8% para IECAS/ARA-II,y 88% para BB, con una adherencia al seguimiento muy alta (90% y con una reducción de los reingresos de hasta un 69%, con respecto al año previo. Desde los datos facilitados por ambos hospitales, se observa una disminución de la estancia hospitalaria global del servicio de Medicina interna por ICC de 3.5 días, un aumento de pacientes atendidos en Medi-cina interna y una disminución de los ingreso por ICC. CONCLUSIONES: El seguimiento por internistas y enfermería de los pacien-tes con ICC y comorbilidad, basado en una atención continuada e integral, en la información y en la disponibilidad, es un buen método no solo para disminuir reingresos hospitalarios , sino que además puede influir en la me-jora de las cifras globales de la hospitalización por

Bilateral herpes zoster

Directory of Open Access Journals (Sweden)

Singh K

1993-01-01

Full Text Available A case of bilateral herpes zoster of lumbosacral region is reported in association with diabetes mellitus in a 55 years old female. The case is of interest due to bilateral distribution which is rare and sacral region involvement which is quite uncommon.

Diferencias regionales en la mortalidad urbana asociada a la nutrición en la España contemporánea (1900-1974)

OpenAIRE

Castelló Botía, Isabel; Pina Romero, José Aurelio

2004-01-01

A lo largo del siglo XX, la población española fue consolidando su proceso de transición demográfica y nutricional. A medida que fue avanzando el siglo, las causas de mortalidad asociadas a nutrición de la población urbana fueron variando desde muertes por desnutrición y enfermedades infecciosas transmitidas por agua y alimentos (diarrea, clorosis, avitaminosis, fiebre tifoidea) en una primera etapa del siglo y en la etapa de la posguerra, hasta muertes asociadas a malnutrición en exceso (dia...

Bacteriemia asociada a catéter epicutáneo en la unidad de cuidado intensivo neonatal de la Fundación Cardioinfantil

OpenAIRE

Pinilla Reyes, Darly Rocio

2013-01-01

La bacteriemia asociada a catéter afecta a pacientes en las unidades de cuidado intensivo con una alta morbilidad, mortalidad y aumento de los costos al sistema de salud. Los recién nacidos son la población de más alto riesgo por el mayor uso de catéteres centrales. Objetivo: Caracterizar factores de riesgo para bacteriemia asociada a catéter en la Unidad de Cuidado Intensivo Neonatal de la Fundación Cardioinfantil entre 2005 - 2010 Materiales y método: Estudio descriptivo de corte tra...

Auditoria interna de sistema de gestão ambiental: estudo de caso no Verdegreen Hotel

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Adriano Lucena da Silva

2017-06-01

Full Text Available Esta pesquisa analisa as contribuições e os desafios associados às auditorias internas no Verdegreen Hotel, empreendimento hoteleiro de grande destaque na cidade de João Pessoa-PB, selecionado como unidade de estudo por dispor de um Sistema de Gestão Ambiental (SGA ISO 14001 implantado e certificado. Este estudo trata de uma pesquisa descritiva, baseada em um estudo de caso qualitativo. As técnicas utilizadas na metodologia foram: levantamento bibliográfico sobre as normas ISO que abordam as temáticas SGA e auditoria; questionários aplicados aos membros do comitê verde; e análise documental do manual do SGA. Para este estudo, três categorias foram selecionadas: i instrumentos, ii procedimentos e iii recursos humanos. A partir da análise de conteúdo das respostas dos questionários aplicados e do manual do SGA, foi constatado que as auditorias internas do Verdegreen Hotel ocorrem baseadas em métodos bem definidos de coleta e tratamento de informações e que o hotel mantém programas de capacitação para seus colaboradores. Com base nos resultados da pesquisa, tornou-se possível compreender como as questões relacionadas à aplicação da auditoria interna são oportunidades de aprimoramento do SGA implantado.

Bilateral breast carcinoma

International Nuclear Information System (INIS)

Kim, Eung Jo; Oh, Ki Keun

1990-01-01

We evaluate 311 breast cancer patients admitted to Yong Dong Severance Hospital Between October 1st 1985 and July 31th 1989, and were able to obtain the following conclusions. 1) There were 14(4.5%) bilateral breast cancers among the 311 confirmed breast cancers. 2) Among the bilateral breast cancers, 5(31%) were synchronous and 9(69%) metachronous. 3) Average interval between the first and the second breast cancer in metachronous cancers was 3.8 year(1-15 years). 4) Bilateral breast cancer was most prevalent in the fifth decade (6/14) with the mean age of 47 years. 5) Film mammogram and sonomammogram showed findings of typical breast malignancies. There was no additional specific findings for each cancer in bilateral breast cancers which was different from unilateral cancers. Therefor, in the patients with unilateral breast cancer, possibility of the second lesion in the contralateral side must be considered and a close follow up observation should be done for at least 3 years

A SECOND CASE OF BILATERAL RHEGMATOGENOUS RETINAL DETACHMENTS REPAIRED WITH SIMULTANEOUS BILATERAL PNEUMATIC RETINOPEXY.

Science.gov (United States)

Rubin, Uriel; De Jager, Cornelis; Zakour, Moayed; Gonder, J Thomas

2017-01-01

To present a case of a patient with simultaneous bilateral retinal detachments treated successfully with bilateral pneumatic retinopexy. Case report. This is a case of an otherwise healthy 49-year-old woman with no remarkable ocular history that presented with simultaneous phakic superior bilateral rhegmatogenous retinal detachments. Treatment on the day of presentation included laser retinopexy of the inferior lattice degeneration in the left eye and bilateral intravitreal injection of 0.4 cc of 100% C3F8 gas preceded by topical anesthesia. After 48 hours, both retinas were completely reattached, and bilateral laser retinopexy was performed to the superior tears. After a review of the literature, the authors could find only two reported cases of simultaneous bilateral retinal detachments treated successfully with pneumatic retinopexy. This is not only a cost-effective procedure but also allows treatment when there is no immediate operating room availability or a when a quick referral for surgery is not possible.

Comunicação Interna na Era da Colaboração: A IBM Brasil

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Ademir Balbino Siqueira Filho

2015-11-01

Full Text Available A transformação em seu modelo de negócio, deixando de ser somente fábrica de computadores os desafios do mundo globalizado e o surgimento de novos valores socioculturais determinaram novos rumos à comunicação interna da International Business Machine (IBM Brasil, empresa subsidiária de uma das maiores empresas de Tecnologia da Informação do mundo – a IBM. Diante de novas estratégias de comunicação interna, meios tradicionais de comunicação dividem o espaço ou, então, dão espaço a novos meios, no qual os colaboradores interagem entre si e com a empresa de uma maneira mais direta, mais rápida e menos formal. 

Implante coclear en enfermedad de Ménière bilateral. Descripción de un caso

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Ainhoa MORENO-BRAVO

2017-03-01

Full Text Available Introducción: La enfermedad de Ménière se caracteriza por síntomas cocleares y vestibulares. Puede ser unilateral o bilateral. Cuando la pérdida de audición asociada es severa-profunda de forma bilateral o unilateral pero con problemas de audición en el otro oído, dicha audición puede beneficiarse de un implante coclear. Si además, presenta crisis de vértigo y Tumarkin refractarias al tratamiento médico, se puede plantear la realización simultánea de una laberintectomía quirúrgica y colocación de un implante coclear. Descripción: Se describe el caso de un paciente con enfermedad de Ménière bilateral con hipoacusia neurosensorial profunda de oído derecho con fluctuaciones auditivas izquierdas que asocia crisis vertiginosas y de Tumarkin sin respuesta a corticoides orales e intratimpánicos ni a gentamicina intratimpánica. Se le realizó una laberintectomía quirúrgica con implante coclear en el mismo acto quirúrgico anticipándonos al probable deterioro auditivo contralateral. Posteriormente presenta buen rendimiento del implante y desaparición de las crisis del oído intervenido. Discusión: El objetivo del tratamiento es controlar las crisis preservando la función, pero en pacientes en los que las medidas conservadoras fallan, se han de considerar otras más destructivas como es la laberintectomía química, que consigue altas tasas de control de las crisis, y el implante coclear, indicado para restaurar la audición en el oído afectado por enfermedad de Ménière. Si ambas se realizan en un mismo tiempo quirúrgico, se consigue reducir riesgos asociados con otros procedimientos quirúrgicos y anestésicos y evitar las modificaciones histológicas tras una laberintectomía química que dificultarían la posterior colocación del implante colear.

Educación Ambiental asociada a la formación Ciudadana

OpenAIRE

Daza Franco, Astrid Liliana; Cabrales Salazar, Omar

2017-01-01

181 páginas : gráficos, tablas. La presente investigación se formuló como objetivo general: el diseño de una propuesta pedagógica en educación ambiental que contribuya a la formación ciudadana del estudiante, la cual está enfocada en la comprensión del concepto “educación ambiental asociada a la formación ciudadana”, cuyo desarrollo se concibió desde una institución educativa oficial del municipio de Sopó, a modo de respuesta frente a la necesidad de formación dada la actual crisis ambient...

Importancia do conjugado arteria carotida interna-seio cavernoso

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Milton Baggio Moreira

1977-12-01

Full Text Available O autor considera necessário o conjugado anatômico artério-venoso representado pela artéria carótida interna e seio cavernoso, bem como o plexo venoso carotídeo que reveste a carótida interna dentro do canal carotídeo da porção petrosa do osso temporal. Julga que, além de proteger a parede vascular arterial nas hipertensões arteriais súbitas, possa contribuir no mecanismo de controle e regulação do fluxo sanguíneo carotídeo, por considerar diferentes as condições fisiológicas do seio cavernoso em relação aos demais seios venosos durais e o sistema venoso endocraniano; consequente de sua constituição cavernosa, diferente dos demais canais sanguíneos venosos, com fisiollogia venosa própria e funções diferentes. Procura assemelhá-los aos demais distritos do organismo em que existem plexos cavernosos nos quais a tensão venosa chega a grandes proporções, comparada às demais regiões em que não existe esta constituição morfológica. Estabelece a correlação resultante ao mecanismo de resistência cérebro-vascular do qual considera participar, diferindo dos demais seios durais conjugado artéria carotida-beio cavernoso e veias encefálicas. Ainda valoriza o sifão carotídeo fisiologicamente e julga que o mesmo participa da hemodinâmica quando o paciente se encontra caído (em plano horizontal com hipotensão arterial, favorecendo a chegada sanguínea ao cérebro, evitando a anóxia e descerebração consequente dentro de determinados limites, sendo mais um meio de defesa do organismo.

Distribuição espacial das internações hospitalares de idosos nas cinco regiões do Brasil

OpenAIRE

Freitas, Denise Cuoghi Carvalho Veríssimo; Oliveira Friestino, Jane Kelly; Fontenele Pimenta, Marta Eugênia; Ferreira, José Ferdinando Ramos

2016-01-01

O presente estudo analisa os dados de registros de internações hospitalares de sujeitos com 60 anos e mais no Brasil e sua respectiva distribuição espacial nas cinco regiões do país. Trata-se de um estudo epidemiológico, que utiliza dados secundários e retrospectivos referentes às internações hospitalares registrados pelo Sistema Único de Saúde no ano de 2013. Os dados foram obtidos em pesquisa por regiões na base nacional do Sistema de Informações Hospitalares do Sistema Único de Saúde e do ...

Bilateral acute retinal necrosis associated with bilateral uveal effusion in an immunocompetent patient: A challenging association

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S Bala Murugan

2018-01-01

Full Text Available Bilateral uveal effusion syndrome associated with bilateral acute retinal necrosis is a diagnostic and therapeutic challenge. A 52 year old man presented with bilateral angle closure with choroidal detachment. With restricted fundus view, parenteral steroid was started. During close follow up bilateral discrete areas of peripheral retinitis were noted. Parenteral steroids were promptly stopped and parenteral antivirals with oral steroids were continued. It showed healing response with nil recurrences till last follow up. Aggressive treatment of bilateral uveal effusion with parenteral steroids can cause progression of bilateral acute retinal necrosis leading to phthisis bulbi. However early diagnosis, prompt intervention and close follow up are the key elements to therapeutic success even during diagnostic surprises and avoid costly mistakes.

38 CFR 4.26 - Bilateral factor.

Science.gov (United States)

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Bilateral factor. 4.26... DISABILITIES General Policy in Rating § 4.26 Bilateral factor. When a partial disability results from disease... disability. The bilateral factor will be applied to such bilateral disabilities before other combinations are...

A crise interna do México e a Gripe Suína

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Pedro dos Santos de Borba

2009-05-01

Full Text Available

Desgoverno econômico e narcotráfico põem

em questão a institucionalidade do Estado Mexicano,

enquanto a Gripe Suína alardeia a crise interna.

Pregnancy following bilateral salpingectomy

DEFF Research Database (Denmark)

Oturai, Annette Bang

2008-01-01

This report presents a rare case of spontaneous pregnancy following bilateral salpingectomy. A woman with a history of bilateral salpingectomy was admitted to hospital because of abdominal pain and positive urine HCG. Surprisingly, ultrasound confirmed a live intrauterine fetus. The pregnancy...... was unwanted, and the woman decided to terminate the pregnancy. She was offered diagnostic examination to localise a potential fistula, but she declined. In a MEDLINE search of English literature this is only the second case of spontaneous pregnancy following bilateral salpingectomy Udgivelsesdato: 2008/4/21...

Sentido y alcance de las investigaciones internas en la empresa

OpenAIRE

Montiel, Juan Pablo

2013-01-01

En un contexto de notable expansión del fenómeno del "criminal compliance" en el plano práctico y científico, las investigaciones internas aparecen llamativamente como uno de los temas menos trabajados. Sin embargo, el interés de la doctrina ha crecido notablemente en los últimos años como consecuencia de su potencial relevancia en la atenuación y exclusión de la responsabilidad penal. La presente contribución acerca una introducción general en la que se delimitan conceptualmente las investig...

Bilateral persistent hyperplastic primary vitreous

Directory of Open Access Journals (Sweden)

Jain Tarun

2009-01-01

Full Text Available A case of bilateral persistent hyperplastic primary vitreous (PHPV in a 3-month-old male infant, who had bilateral leukokoria, is presented. The child was referred for imaging with a clinical suspicion of retinoblastoma. Gray-scale ultrasound evaluation revealed an echogenic band in the posterior segment of both globes, extending from the posterior surface of the lens capsule to the optic disc. Doppler examination revealed the presence of arterial flow in the band in both globes. Associated echogenic hemorrhage was also seen, which was confirmed by computed tomography. Most cases of PHPV are sporadic and unilateral, and bilateral PHPV is rare. The imaging features in this case suggest the diagnosis of bilateral PHPV and differentiate it from retinoblastoma. This entity, although infrequent, should be considered in the differential diagnosis while evaluating bilateral leukokoria.

Radiographic imaging of otitis media and interna in pigs

International Nuclear Information System (INIS)

Harlizius, J.; Kluczniok, C.; Bollwahn, W.

1997-01-01

Middle and inner ear infections have been reported as a clinical entity in swine, other animal species and humans. In pigs, the anatomical-pathological and microbiological findings have been described. In this report, we describe radiographic findings in affected pigs. A total of 25 pigs with a head tilt and circling, as clinical signs of otitis media and interna, were examined. The majority were weaner-pigs with dyspnea or rhinitis. In radiographs, there was an increased opacity of the bulla tympanica, often accompanied by marginal destruction or thickening of the bulla wall. The radiographic findings confirmed the clinical diagnosis in each affected pig, but there were 5 false positive interpretations

Estimadores de consistencia interna en las investigaciones en salud: el uso del coeficiente alfa

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Franciele Cascaes da Silva

Full Text Available La producción académica ha aumentado en el área de la salud, exigiendo cada vez más calidad en las publicaciones de gran impacto. Una de las formas de considerar la calidad es por medio de procedimientos que aumentan la consistencia del análisis de los datos, como la confiabilidad, que dependiendo del tipo de datos, puede ser evaluada por diferentes coeficientes, en especial el coeficiente alfa. Basados en lo anterior, la presente revisión reúne sistemáticamente artículos científicos producidos en los últimos cinco años, que de manera metodológica hicieron uso psicométrico del coeficiente α como un estimador de consistencia interna y de confiabilidad en procesos de construcción, adaptación y validación de instrumentos. La identificación de los estudios fue realizada sistemáticamente en las bases de datos Biomed Central Journals, Google Scholar, Web of Science, Wiley Online Library, Medline via Pubmed, Scielo, Scopus, Journals@Ovid, BMJ y Springer por medio del Portal de Periódicos CAPES, utilizando criterios de inclusión y exclusión. El análisis de los datos fue realizado por medio de triangulación, análisis de contenido y análisis descriptivo. Se obtuvo que la mayoría de los estudios fueron realizados principalmente en Irán (f=3, España (f=2 y Brasil (f=2, estos estudios tuvieron como objetivo testar las propiedades psicométricas de instrumentos, siendo que ocho estudios utilizaron el coeficiente α para evaluar la confiabilidad y nueve para evaluar la consistencia interna. Todos los estudios fueron clasificados como investigaciones metodológicas al analizar sus objetivos. Adicionalmente, cuatro estudios también fueron clasificados como correlacionales y uno como descriptivo-correlacional. Se puede concluir que a pesar de que el coeficiente α es ampliamente utilizado como uno de los principales parámetros para la evaluación de consistencia interna de instrumentos de medición del tipo cuestionario en el �

ESTRUCTURA DE LAS COMUNIDADES MACROALGALES ASOCIADAS AL LITORAL ROCOSO DEL DEPARTAMENTO DE CÓRDOBA, COLOMBIA

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JORGE A. QUIRÓS-RODRÍGUEZ

2010-12-01

Full Text Available El comportamiento ecológico de las comunidades macroalgales en el Caribe cordobés es desconocido, por lo tanto para determinar la diversidad, la abundancia y la distribución de las especies se evaluó la estructura de las comunidades macrolagales asociadas a litoral rocoso del departamento de Córdoba durante los meses de mayo de 2004 hasta octubre de 2005, estableciendo siete puntos de muestreo; cuatro en la ecorregión Morrosquillo y tres en la ecorregión Darién. Para establecer la cobertura de las macroalgas, se utilizó un cuadrante de 625 cm2 con cinco repeticiones dispuestas al azar en cada punto de muestreo. Se reportaron 50 especies de algas bentónicas, de las cuales 27 son rodofitas, 17 clorofitas y 12 feofitas; de las 20 familias encontradas, Dictyotaceae presentó el mayor número de especies (10, seguida por Gracilariaceae (7 y Rhodomelaceae (7 y Halymeniaceae (4. Los géneros con mayor número de especies fueron Gracilaria (6, Padina (5 y Caulerpa (4. La composición de las comunidades macroalgales asociadas al sector comprendido entre Punta Bolívar y Punta Mestizos estuvo integrada por tres divisiones, siendo las rodofitas las que presentaron mayor porcentaje de cobertura (78%, seguida por las clorofitas (14% y finalmente las feofitas (9%. En el sector que comprende el litoral que va desde Punta Broqueles hasta Puerto Escondido, las rodofitas mostraron el mayor porcentaje de cobertura (62%, seguida por las feofitas (23% y finalmente las clorofitas (15%. El análisis de clasificación (UPGMA, registró un coeficiente de afinidad del 57%, indicando que la estructura y la composición de las comunidades algales asociadas se comportaron de manera similar en las dos ecorregiones; este comportamiento mostró la conformación de unidades estables en cada punto de muestreo, manifestando cierta homogeneidad espacial, lo cual puede estar relacionado con el tipo de sustrato y las perturbaciones ambientales propias de cada estación.

Curva de estimativa das internações hospitalares nas regiões metropolitanas brasileiras: um estudo de série histórica

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Graziella Denúbila Gomes

2012-03-01

Full Text Available O objetivo deste estudo foi investigar as variações temporais na distribuição das internações hospitalares realizadas no Sistema Único de Saúde (SUS em todas as Regiões Metropolitanas brasileiras entre os anos de 1995 e 2006. Trata-se de estudo ecológico de série histórica com dados secundários referentes às 36 regiões metropolitanas brasileiras. Realizou-se a análise descritiva dos dados, correlação de Spearman e curva de estimativa. Os resultados indicam que o Teste F foi significativo em ordem decrescente para os modelos linear (p=0,001, quadrático (p=0,002 e cúbico (p=0,004. Por outro lado, os valores de R2 apresentaram ordem crescente de valores – 0,277; 0,307 e 0,338, respectivamente. O modelo cúbico mostrou que o percentual médio de internações hospitalares em 2006 apresentou tendência de queda quando comparado ao percentual médio de internações no ano de 1995. Conclui-se que o percentual de internações hospitalares realizadas no SUS nas regiões metropolitanas brasileiras decresceu durante o período analisado.

Idiopathic bilateral male breast abscess.

Science.gov (United States)

Sinha, Rajan Kumar; Sinha, Mithilesh Kumar; Gaurav, Kumar; Kumar, Amar

2014-03-10

A 38-year-old man presented with bilateral breast swelling, along with pain and redness for 7 days. Bilateral axillary nodes were also palpable; which were multiple and discrete. A provisional diagnosis of bilateral breast abscess was made with suspicion of underlying malignancy. Incision and drainage through subareolar incision was performed and the adjoining tissue was excised and sent for histopathological examination.

Arañas asociadas a la floración de Drimys granadensis (Winteraceae)

OpenAIRE

MARQUÍNEZ, XAVIER; JULIANA, CEPEDA; LARA, KATHERINE; SARMIENTO, RODRIGO

2010-01-01

Drimys granadensis (Winteraceae) es un árbol frecuente en los bosques altoandinos, con un sistema de polinización entomófilo abierto. En este trabajo se identificaron las arañas asociadas a D. granadensis en relación con las fases fenológicas florales y con los insectos visitantes. Encontramos un total de 53 adultos de arañas de siete familias (Araneidae, Thetragnathidae, Theridiidae, Linyphiidae, Thomisidae, Salticidae y Aniphaenidae) y 12 morfoespecies. Las arañas tuvieron preferencia por f...

Medida Socioeducativa de Internação: dos Corpos Dóceis às Vidas Nuas

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Andrea Cristina Coelho Scisleski

Full Text Available O presente artigo tem como objetivo a problematização dos modos pelos quais a tecnologia disciplinar, presente nas medidas socioeducativas de internação direcionadas aos jovens em conflito com a lei, vem sendo operacionalizada. Tomamos como fio condutor as reflexões de Michel Foucault e Giorgio Agamben para problematizar a vida enquanto objeto político a ser governado para determinado fim e que sofre intervenções não apenas para seu fortalecimento, mas que levam à desproteção jurídica e à morte política, ou mesmo biológica. A investigação se desenvolveu em três momentos metodológicos: oitiva de audiências na Vara da Infância e da Juventude, visita a uma unidade educacional de internação e leitura de processos jurídicos e das normativas legais voltadas para a população em questão. Assim, por meio do que encontramos na pesquisa, entende-se que a tecnologia disciplinar, do modo que vem sendo utilizada nas medidas socioeducativas de internação, assemelha-se mais a um dispositivo de controle com o objetivo meramente de docilizá-los, reduzindo o sujeito à vida nua; isto é, como mero corpo biológico que sofre efeitos de uma ação, do que propriamente um método socioeducativo como estabelecem o Estatuto da Criança e do Adolescente e o Sistema Nacional de Atendimento Socioeducativo.

Bilateral Endoscopic Medial Maxillectomy for Bilateral Inverted Papilloma

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Satoru Kodama

2012-01-01

Full Text Available Inverted papilloma (IP is a benign tumor of the nasal cavity and paranasal sinuses that is unilateral in most cases. Bilateral IP, involving both sides of the nasal cavity and sinuses, is extremely rare. This paper describes a large IP that filled in both sides of the nasal cavity and sinuses, mimicking association with malignancy. The tumor was successfully treated by bilateral endoscopic medial maxillectomy (EMM. The patient is without evidence of the disease 24 months after surgery. If preoperative diagnosis does not confirm the association with malignancy in IP, endoscopic sinus surgery (ESS should be selected, and ESS, including EMM, is a good first choice of the treatment for IP.

Bilateral Endoscopic Medial Maxillectomy for Bilateral Inverted Papilloma

Science.gov (United States)

Kodama, Satoru; Kawano, Toshiaki; Suzuki, Masashi

2012-01-01

Inverted papilloma (IP) is a benign tumor of the nasal cavity and paranasal sinuses that is unilateral in most cases. Bilateral IP, involving both sides of the nasal cavity and sinuses, is extremely rare. This paper describes a large IP that filled in both sides of the nasal cavity and sinuses, mimicking association with malignancy. The tumor was successfully treated by bilateral endoscopic medial maxillectomy (EMM). The patient is without evidence of the disease 24 months after surgery. If preoperative diagnosis does not confirm the association with malignancy in IP, endoscopic sinus surgery (ESS) should be selected, and ESS, including EMM, is a good first choice of the treatment for IP. PMID:22953103

Análise da medida de fluxo por tempo de trânsito da artéria torácica interna direita anastomosada para a artéria interventricular anterior comparada com a artéria torácica interna esquerda

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Rodrigo Milani

2014-04-01

Full Text Available Introdução: Avaliamos por meio da medida de fluxo por tempo de trânsito o desempenho das artérias torácicas direita e esquerda quando utilizadas como enxerto para revascularização da artéria interventricular anterior. Métodos: Cinquenta pacientes submetidos à operação para revascularização do miocárdio sem circulação extracorpórea foram divididos em dois grupos. No grupo A, os pacientes receberam enxerto de artéria torácica interna direita para o ramo interventricular anterior. No grupo B, os pacientes receberam enxerto de artéria torácica interna esquerda para o mesmo ramo. Ao término da operação, o fluxo foi avaliado por meio da medida de fluxo por tempo de trânsito. Resultados: No grupo A, idade média foi de 60,6±9,49 anos. A média de peso e altura do grupo foi de 80,4±10,32 Kg e 169,2±6,86 cm. A média de pontes por paciente neste grupo foi de 3,28±1,49. O fluxo médio e a resistência distal obtidos na artéria torácica interna direita foi de 42,1±23,4 ml/min e 2,8±0,9 respectivamente. No grupo B, a idade média foi de 59,8±9,7 anos. A média de peso e altura deste grupo foi de 77,7±14,2215,7 Kg e 166,0±8,2 cm. A média de pontes por paciente neste grupo foi de 3,08±0,82. O fluxo médio e a resistência distal observados neste grupo foi de 34,2±19,1ml⁄min e 2,0±0,7. Não houve óbitos nesta série. Conclusão: A artéria torácica interna direita apresentou um comportamento similar ao da artéria torácica interna esquerda quando anastomosada ao ramo interventricular anterior da coronária esquerda. Não houve diferença estatística entre a medida de fluxo obtida entre ambas as artérias.

Daño pulmonar agudo asociada a transfusión en el embarazo

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Silvia María Melians Abreu

2014-06-01

Full Text Available Introducción: el daño pulmonar agudo asociado a la transfusión es una reacción adversa a la transfusión poco frecuente, la mortalidad se ha estimado entre 1-10 %. Su diagnóstico es clínico e infrecuentemente sospechado, su incidencia es baja. Presentación del caso: se presentaron dos transfusión-related-acute-lunginjury en dos gestantes con 28,5 y 32 semanas de embarazo respectivamente, hospitalizadas en la salas de cuidados materno perinatales con enfermedades asociadas al embarazo, a quienes se le administraron componentes sanguíneos, ambas a las 5 horas de transfundidas; presentaron el síndrome clínico con hipoxemia moderada y necesitaron ventilación; con estos hallazgos y la relación temporal con la transfusión. Se realizó el diagnóstico de síndrome de dificultad respiratoria aguda moderada asociada a transfusión. Conclusiones: el resultado fue óptimo con resolución completa del evento respiratorio. Se considera importante reportar ambos casos dado su aparición en embarazadas, causa poco frecuente informada en la literatura y la importancia de conservar la salud de la madre del niño y la niña e incentivar la notificación de esta reacción adversa a la transfusión al banco de sangre para fortalecer el sistema de hemovigilancia.

MOÇAMBIQUE: compulsando as migrações internas e internacionais

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Gonçalves Patrício

2016-08-01

Los estudios sobre las migraciones se han llevado a cabo principalmente en el contexto Norte-Sur, como si se tratara de un movimiento unidireccional, cuando la realidad muestra que estos flujos se producen también en el plano horizontal, es decir, dentro de las regiones del Sur, como se puede observar en el continente africano. Mediante este artículo se pretende hacer una reflexión sobre las migraciones internas e internacionales, en lo cual hacemos hincapié la entrada de extranjeros sea en forma regular e principalmente irregular cada vez más pronunciada en Mozambique. El procedimiento de recolección y procesamiento de datos fueron basados principalmente en la investigación bibliográfica, revisión de documentos y el análisis de los datos estadísticos disponibles sobre la migración en Mozambique. Los resultados de la investigación sugieren que la migración y la movilidad en Mozambique varían según la ubicación, perfil histórico, económico y ambiental de las regiones. Continúa la tendencia de la migración a los países vecinos, especialmente a Sudáfrica, al mismo tiempo que se observa la entrada de inmigrantes de diversas partes del mundo, provenientes en su mayoría de países africanos, que atraídos por la relativa estabilidad socioeconómica y política del país, buscan seguridad y mejores condiciones de vida. Palabras clave: Mozambique; Inmigrantes; Migraciones Internas; Migraciones Internacionales.

Internações sensíveis na atenção primária como indicador de avaliação da Estratégia Saúde da Família Internaciones sensibles en la atención primaria como indicador de evaluación de la Estrategia Salud de la Familia Hospitalizations sensitive to primary care as an evaluation indicator for the Family Health Strategy

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Viviane Braga Lima Fernandes

2009-12-01

Full Text Available OBJETIVO: Identificar variáveis associadas a internações sensíveis ao cuidado primário. MÉTODOS: Inquérito de morbidade hospitalar realizado com amostra aleatória de 660 pacientes internados em enfermarias de clínica médica e cirúrgica de hospitais conveniados com o Sistema Único de Saúde, em Montes Claros, MG, de 2007 a 2008. Foram realizadas entrevistas com os pacientes e seus familiares utilizando formulário próprio e pesquisa aos prontuários. A definição das condições consideradas sensíveis ao cuidado primário baseou-se na lista do Ministério da Saúde. A associação entre variáveis socioeconômicas e de saúde com as internações sensíveis foi analisada utilizando-se análises bivariadas e de regressão logística múltipla. RESULTADOS: O percentual de internações sensíveis ao cuidado primário no grupo estudado foi de 38,8% (n=256. As variáveis que se mantiveram estatisticamente associadas com as condições sensíveis ao cuidado primário foram: internação prévia (OR=1,62; IC 95%: 1,51;2,28, visitas regulares a unidades de saúde (OR=2,20; IC 95%: 1,44;3,36, baixa escolaridade (OR=1,50; IC 95%: 1,02;2,20, controle de saúde não realizado por equipe de saúde da família (OR=2,48; IC 95%: 1,64;3,74, internação solicitada por médicos que não atuam na equipe de saúde da família (OR=2,25; IC 95%: 1,03;4,94 e idade igual ou superior a 60 anos (OR=2,12; IC 95%: 1,45;3,09. CONCLUSÕES: As variáveis associadas às internações sensíveis são sobretudo próprias do paciente, como idade, escolaridade e internações prévias, mas o controle regular da saúde fora da Estratégia de Saúde da Família duplica a probabilidade de internação.RESUMEN OBJETIVO: Identificar variables asociadas a internaciones sensibles al cuidado primario. MÉTODOS: Pesquisa de morbilidad hospitalaria realizada con muestra aleatoria de 660 pacientes internados en enfermerías de clínica médica y quirúrgica de hospitales

Trombose da artéria carótida interna devida a trauma penetrante no pálato mole: relato de caso

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BORGES GUILHERME

1999-01-01

Full Text Available Descrevemos caso de trauma penetrante na região oral em criança, evoluindo com oclusão da artéria carótida interna e déficit neurológico correspondente. A tomografia computadorizada e a ressonância nuclear magnética demonstram a oclusão completa da artéria carótida interna. Enfatizamos esta rara complicação de trauma oral, comum em crianças e discutimos os aspectos patogênicos.

Análisis del comportamiento elasto-plástico de grietas internas presurizadas en uniones soldadas de tubos de acero bajo carbono

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Martín Julián Fernández Cueto

2011-01-01

Full Text Available Se analizó el comportamiento elasto-plástico de áreas con grietas internas planas presurizadas. El análisis se efectuó desde el metal base (uniones soldadas de tubos de acero bajo carbono sometidos a presión interna pasando por la zona afectada por el calor hasta el metal depositado. Se usó el programa comercial ANSYS 8.0 [MR] para la simulación en tres dimensiones de modelos geométricos de tubos con grietas internas presurizadas. Se consideró el endurecimiento cinemático y las propiedades reales del material para cada región, mediante elementos finitos con condiciones no lineales de deformación. Se determinaron las trayectorias de fractura y se obtuvieron expresiones que permiten calcular la presión en la grieta y en el tubo. Esto conduce a la fractura de la zona agrietada.

Bilateral, independent juvenile nasopharyngeal angiofibroma

DEFF Research Database (Denmark)

Mørkenborg, Marie-Louise; Frendø, M; Stavngaard, T

2015-01-01

BACKGROUND: Juvenile nasopharyngeal angiofibroma is a benign, vascular tumour that primarily occurs in adolescent males. Despite its benign nature, aggressive growth patterns can cause potential life-threatening complications. Juvenile nasopharyngeal angiofibroma is normally unilateral, originating...... from the sphenopalatine artery, but bilateral symptoms can occur if a large tumour extends to the contralateral side of the nasopharynx. This paper presents the first reported case of true bilateral extensive juvenile nasopharyngeal angiofibroma involving clinically challenging pre-surgical planning...... embolisation. Radical removal performed as one-step, computer-assisted functional endoscopic sinus surgery was performed. The follow-up period was uncomplicated. CONCLUSION: This case illustrates the importance of suspecting bilateral juvenile nasopharyngeal angiofibroma in patients presenting with bilateral...

BILATERAL SINGLE SESSION URETEROSCOPY FOR URETERAL ...

African Journals Online (AJOL)

Objectives: To determine the feasibility, safety and success rate of bilateral single session rigid retrograde ureteroscopy (URS) for bilateral ureteral calculi. Patients and Methods: Thirty-five patients underwent bilateral single session ureteroscopic calculus removal. Results: Out of 70 renal units in 35 patients treated, ...

Acute Bilateral Superior Branch Vestibular Neuropathy

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Dario A. Yacovino

2018-05-01

Full Text Available The rapid onset of a bilateral vestibular hypofunction (BVH is often attributed to vestibular ototoxicity. However, without any prior exposure to ototoxins, the idiopathic form of BVH is most common. Although sequential bilateral vestibular neuritis (VN is described as a cause of BVH, clinical evidence for simultaneous and acute onset bilateral VN is unknown. We describe a patient with an acute onset of severe gait ataxia and oscillopsia with features compatible with acute BVH putatively due to a bilateral VN, which we serially evaluated with clinical and laboratory vestibular function testing over the course of 1 year. Initially, bilateral superior and horizontal semicircular canals and bilateral utricles were impaired, consistent with damage to both superior branches of each vestibular nerve. Hearing was spared. Only modest results were obtained following 6 months of vestibular rehabilitation. At a 1-year follow-up, only the utricular function of one side recovered. This case is the first evidence supporting an acute presentation of bilateral VN as a cause for BVH, which would not have been observed without critical assessment of each of the 10 vestibular end organs.

Envejecimiento demográfico y migración interna de personas con 60 años y más de edad en Cuba y países de América Latina

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Cristina López-Calleja Hiort-Lorenzen

2015-01-01

Full Text Available Este trabajo busca determinar comparativamente diferencias y semejanzas de características específicas de la población migrante interna con 60 años y más de edad entre las divisiones administrativas mayores (DAM en Cuba y 14 países de América Latina. Se procesó información sobre migración interna de censos latinoamericanos de la década del 2000, proveniente de la página WEB del Centro Latinoamericano y Caribeño de Demografía (CELADE. Asimismo se presenta información relativa al envejecimiento de Cuba y los restantes países y se han calculado otros indicadores como porcentaje de migrantes y no migrantes, y también se estima un conjunto de indicadores expresivos de cierta propensión a migrar entre las DAM en los últimos 5 años previos al censo para la población de 60 y más años de edad. Se han empleado técnicas propias de la estadística, como tablas de contingencias, así como métodos de análisis estadístico de correspondencias simples y múltiples para explorar las relaciones existentes entre las categorías de las diferentes características demográficas de los migrantes en países seleccionados. Uno de los resultados muestra que en Cuba y el resto de la región aún no se observan signos de migración interna asociada a la salida de la actividad laboral, lo cual sucede a partir de los 60 años de edad en países desarrollados. Los análisis de correspondencia múltiple, permitieron conocer grupos afines de categorías de las variables estudiadas cuando estas se analizan simultáneamente. Así se encontró similitud entre Cuba y Chile por el valor de las variables de población con 60 años y más, esperanza de vida al nacer, tasa global de fecundidad e índice de envejecimiento. Las proporciones más elevadas de migrantes de “toda la vida” se observen en aquellos países que registran un mayor nivel relativo de desarrollo económico y social; Cuba, Argentina y en menor medida Chile, muestran los más altos

Especies de dryophthorinae (coleoptera: curculionidae) asociadas a plátano y banano (musa spp.) en colombia

OpenAIRE

RUBIO-GOMEZ, JOSE; SEPULVEDA-CANO, PAULA

2009-01-01

RESUMEN

Se presenta una sinopsis de los escarabajos de la subfamilia Dryophthorinae (Coleoptera: Curculionidae) asociados a cultivos de plátano y banano en Colombia. Adicionalmente se ofrecen claves ilustradas para las especies del país. Se registran seis especies asociadas a dichos cultivos: Cosmopolites sordidus (Germar, 1824), Metamasius hemipterus (Linnaeus, 1758), Metamasius hebetatus (Gyllenhal, 1838), Metamasius submaculatus Champion, 1910, Rhyncophorus palmarum...

IDENTIFICACIÓN MOLECULAR DE POBLACIONES BACTERIANAS ASOCIADAS AL CARACOL PALA (Strombus gigas DEL CARIBE COLOMBIANO

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EDINSON ACOSTA

2009-05-01

Full Text Available RESUMEN El caracol Pala, Strombus gigas (Strombidae, es de gran importancia ecológica y socioeconómica en el área caribeña colombiana. Sin embargo, es una especie catalogada como “vulnerable” y existe muy poca información referente a las especies bacterianas asociadas al caracol que puedan ser importantes para el desarrollo, manejo productivo y de seguridad acuícola de estos gastrópodos. En este trabajo, nosotros empleamos un estudio microbiológico y molecular de la región intergénica entre los genes 16S y 23S rDNA, análisis del gen rDNA 16S y secuenciación, para analizar las bacterias asociadas al caracol Pala (S. gigas. La composición de bacterias cultivables asociadas fue evaluada por su capacidad para crecer en agar marino y en medios de cultivos selectivos. De un total de 28 muestras analizadas encontramos que el número de bacterias cultivadas en condiciones aerobias fue de alrededor 106 ufc mL-1 donde las bacterias pertenecientes a la familia Vibrionacea fueron las más abundantes, cerca de >105 ufc mL-1 . El análisis molecular de la región intergénica entre los genes 16S y 23S rDNA de las diferentes muestras, reveló una gran complejidad bacteriana asociada a S. gigas. Las secuencias de los amplificados del gen rDNA 16S identificó Pseudoalteromonas sp., Halomonas sp., Psycrobacter sp., Cobetia sp., Pseudomonas sp. y Vibrios sp. Nuestros resultados podrían sugerir un rol importante de estas bacterias como componentes de la comunidad asociada al S. gigas. Esta información puede complementar los estudios que se están implementando en los procesos para la conservación y repoblamiento de las poblaciones de S. gigas en Colombia. Palabras clave: Strombus gigas, Caracol pala, Bacteria, Región intergénica 16S-23S, rDNA 16S. ABSTRACT The Queen Conch, Strombus gigas (Strombidae, is a species of great ecological and socioeconomic importance in the Caribbean area of Colombia. However, it is currently catalogued as �

Propuesta de salvaguardas para la independencia de la función de auditoría interna

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Aurora V. Perez Lopez

2014-04-01

Full Text Available La presente investigación tiene por objetivo proponer un conjunto de salvaguardas que sirva de referencia a auditores internos y entidades, con el fin de garantizar la existencia de independencia en la función de auditoría interna. Para conseguir este objetivo se aplicó el método Delphi. Los principales resultados obtenidos evidencian que no existen opiniones diferentes por grupos de expertos sobre la importancia de las salvaguardas, pudiéndose proponer un uniforme conjunto de salvaguardas, con la excepción de la externalización de la función de auditoría interna, la cual, según el grupo de auditores internos, es considerada como la menos importante. La independencia sobre las actividades y los sistemas de control interno es la salvaguarda considerada de forma unánime como la más importante.

La democracia interna en los partidos políticos españoles: el caso del Partido Socialista Obrero Español (PSOE

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Gema Sánchez Medero

2011-01-01

Full Text Available Se habla mucho de la democracia interna en los partidos políticos, es más, en el art. 6 de la Constitución española, sostiene que la estructura interna y funcionamiento de los partidos deberán ser democráticos. Pero habría que preguntarse hasta qué punto se cumple este precepto realmente. De ahí, que este artículo tiene como propósito analizar el grado de democracia interna del que parecen disfrutar los militantes del PSOE. Por eso, hemos estudiado la capacidad que tienen los afiliados para intervenir y participar en todos aquellos espacios en los que se toman decisiones relevantes para la organización. De manera que podremos averiguar si los militantes pueden participar verdaderamente a la hora de determinar el rumbo y acción de su partido, o si incluso, podrían llegar a variar las decisiones que se adoptan en los órganos ejecutivos del mismo.

Comunicación interna incluyente: dos estudios de caso de inclusión laboral de personas con discapacidad auditiva en Bogotá

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Sandra Meléndez-Labrador

2015-05-01

Full Text Available La presente investigación da cuenta de la manera como puede influir la gestión de la comunicación interna en procesos de inclusión laboral de personas con discapacidad auditiva a partir de dos estudios de caso en Bogotá: Carrefour y McDonald's. Este estudio cualitativo de corte interpretativo se realizó a través de observación y entrevistas semiestructuradas, encontrando que tal influencia se ejerce desde los siguientes aspectos: 1 importancia de la comunicación interna en la empresa, 2 lenguaje y discurso, 3 formas de comunicar e informar, 4 imagen y motivación y 5 participación e interacción. Se concluye que la comunicación interna puede eliminar o perpetuar barreras generales y específicas de la comunicación organizacional, siguiendo a Margarida K. Kunsch (2003, en los procesos de inclusión laboral de personas con discapacidad auditiva.

Comunicación interna incluyente. Dos estudios de caso de inclusión laboral de personas con discapacidad auditiva en Bogotá

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Sandra Meléndez Labrador

2016-06-01

Full Text Available La presente investigación da cuenta de la manera como puede influir la gestión de la comunicación interna en procesos de inclusión laboral de personas con discapacidad auditiva a partir de dos estudios de caso en Bogotá: Carrefour y McDonald’s. Este estudio cualitativo de corte interpretativo se realizó a través de observación y entrevistas semiestructurada y encontró que tal influencia se ejerce desde los siguientes aspectos: 1 importancia de la comunicación interna en la empresa, 2 lenguaje y discurso, 3 formas de comunicar e informar, 4 imagen y motivación y 5 participación e interacción. Se concluye que la comunicación interna puede eliminar o perpetuar barreras generales y específicas de la comunicación organizacional, en los procesos de inclusión laboral de personas con discapacidad auditiva.

Bilateral Testicular Tumors Resulting in Recurrent Cushing Disease After Bilateral Adrenalectomy.

Science.gov (United States)

Puar, Troy; Engels, Manon; van Herwaarden, Antonius E; Sweep, Fred C G J; Hulsbergen-van de Kaa, Christina; Kamphuis-van Ulzen, Karin; Chortis, Vasileios; Arlt, Wiebke; Stikkelbroeck, Nike; Claahsen-van der Grinten, Hedi L; Hermus, Ad R M M

2017-02-01

Recurrence of hypercortisolism in patients after bilateral adrenalectomy for Cushing disease is extremely rare. We present a 27-year-old man who previously underwent bilateral adrenalectomy for Cushing disease with complete clinical resolution. Cushingoid features recurred 12 years later, with bilateral testicular enlargement. Hormonal tests confirmed adrenocorticotropic hormone (ACTH)-dependent Cushing disease. Surgical resection of the testicular tumors led to clinical and biochemical remission. Gene expression analysis of the tumor tissue by quantitative polymerase chain reaction showed high expression of all key steroidogenic enzymes. Adrenocortical-specific genes were 5.1 × 105 (CYP11B1), 1.8 × 102 (CYP11B2), and 6.3 × 104 (MC2R) times higher than nonsteroidogenic fibroblast control. This correlated with urine steroid metabolome profiling showing 2 fivefold increases in the excretion of the metabolites of 11-deoxycortisol, 21-deoxycortisol, and total glucocorticoids. Leydig-specific genes were 4.3 × 101 (LHCGR) and 9.3 × 100 (HSD17B3) times higher than control, and urinary steroid profiling showed twofold increased excretion of the major androgen metabolites androsterone and etiocholanolone. These distinctly increased steroid metabolites were suppressed by dexamethasone but unresponsive to human chorionic gonadotropin stimulation, supporting the role of ACTH, but not luteinizing hormone, in regulating tumor-specific steroid excess. We report bilateral testicular tumors occurring in a patient with recurrent Cushing disease 12 years after bilateral adrenalectomy. Using mRNA expression analysis and steroid metabolome profiling, the tumors demonstrated both adrenocortical and gonadal steroidogenic properties, similar to testicular adrenal rest tumors found in patients with congenital adrenal hyperplasia, suggesting the presence of pluripotent cells even in patients without congenital adrenal hyperplasia. Copyright © 2017 by the Endocrine Society

Transcriptome comparisons identify new cell markers for theca interna and granulosa cells from small and large antral ovarian follicles.

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Nicholas Hatzirodos

Full Text Available In studies using isolated ovarian granulosa and thecal cells it is important to assess the degree of cross contamination. Marker genes commonly used for granulosa cells include FSHR, CYP19A1 and AMH while CYP17A1 and INSL3 are used for thecal cells. To increase the number of marker genes available we compared expression microarray data from isolated theca interna with that from granulosa cells of bovine small (n = 10 for both theca and granulosa cells; 3-5 mm and large (n = 4 for both theca and granulosa cells, > 9 mm antral follicles. Validation was conducted by qRT-PCR analyses. Known markers such as CYP19A1, FSHR and NR5A2 and another 11 genes (LOC404103, MGARP, GLDC, CHST8, CSN2, GPX3, SLC35G1, CA8, CLGN, FAM78A, SLC16A3 were common to the lists of the 50 most up regulated genes in granulosa cells from both follicle sizes. The expression in theca interna was more consistent than in granulosa cells between the two follicle sizes. Many genes up regulated in theca interna were common to both sizes of follicles (MGP, DCN, ASPN, ALDH1A1, COL1A2, FN1, COL3A1, OGN, APOD, COL5A2, IGF2, NID1, LHFP, ACTA2, DUSP12, ACTG2, SPARCL1, FILIP1L, EGFLAM, ADAMDEC1, HPGD, COL12A1, FBLN5, RAMP2, COL15A1, PLK2, COL6A3, LOXL1, RARRES1, FLI1, LAMA2. Many of these were stromal extracellular matrix genes. MGARP, GLDC, CHST8, GPX3 were identified as new potential markers for granulosa cells, while FBLN5, OGN, RAMP2 were significantly elevated in the theca interna.

La auditoria interna en la optimización del gobierno corporativo a nivel de una empresa de producción de biocombustibles

OpenAIRE

Prado Palomino, Jorge Luis

2008-01-01

En la tesis, se planteó como objetivo, determinar si la auditoria interna influye en la optimización del gobierno corporativo en las empresas de producción de biocombustibles, determinándose como resultado del trabajo de campo, que el grado de independencia, objetividad, servicios de aseguramiento y consultoría por parte de Auditoria Interna incide en el logro de mayor grado de coordinación entre los intereses de los individuos, las empresas y la sociedad; que mediante el aseguramiento influy...

Padrão temporal das internações e óbitos por diarréia em crianças, 1995 a 1998, Rio de Janeiro

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Pauline Lorena Kale

2004-02-01

Full Text Available OBJETIVO: Analisar o padrão temporal dos óbitos e internações, no período de 1995 a 1998, associadas à diarréia em crianças menores de cinco anos de idade para subsidiar ações específicas de prevenção e controle dessa doença. MÉTODOS: Os dados foram obtidos do Sistema de Informações sobre Mortalidade (SIM e Sistema de Internações Hospitalares (SIH do Ministério da Saúde. As séries mensais de internações e de óbitos por diarréia foram decompostas em componentes de tendência linear estocástica, sazonalidade determinística e irregularidades mediante a aplicação dos modelos estruturais para análise de séries temporais. RESULTADOS: Os níveis de ambas as séries apresentaram mudanças ao longo do tempo, com declínio mais perceptível na série de internações. A variação das taxas de inclinação foi constante para cada uma das séries, em média, a menos 5,3 internações por mês (p-valor <0,001 e menos um óbito por mês (p-valor <0,1, respectivamente. Na análise dos resíduos do modelo de internações, observou-se mudança no nível da tendência em janeiro de 1996. O componente sazonal de ambos os modelos foi estatisticamente significante (p-valor <0,0001, sendo maio e junho os meses com maior excesso de internações e óbitos. Os pressupostos de normalidade e de independência temporal dos resíduos não puderam ser rejeitados ao nível de 0,05. CONCLUSÕES: Os resultados sugerem a predominância da etiologia viral das diarréias moderadas e graves. Neste caso, a vacinação específica é a medida mais eficaz na prevenção e controle, sendo necessários estudos de eficácia de novas candidatas à vacina contra o rotavírus no Brasil.

Padrão temporal das internações e óbitos por diarréia em crianças, 1995 a 1998, Rio de Janeiro

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Kale Pauline Lorena

2004-01-01

Full Text Available OBJETIVO: Analisar o padrão temporal dos óbitos e internações, no período de 1995 a 1998, associadas à diarréia em crianças menores de cinco anos de idade para subsidiar ações específicas de prevenção e controle dessa doença. MÉTODOS: Os dados foram obtidos do Sistema de Informações sobre Mortalidade (SIM e Sistema de Internações Hospitalares (SIH do Ministério da Saúde. As séries mensais de internações e de óbitos por diarréia foram decompostas em componentes de tendência linear estocástica, sazonalidade determinística e irregularidades mediante a aplicação dos modelos estruturais para análise de séries temporais. RESULTADOS: Os níveis de ambas as séries apresentaram mudanças ao longo do tempo, com declínio mais perceptível na série de internações. A variação das taxas de inclinação foi constante para cada uma das séries, em média, a menos 5,3 internações por mês (p-valor <0,001 e menos um óbito por mês (p-valor <0,1, respectivamente. Na análise dos resíduos do modelo de internações, observou-se mudança no nível da tendência em janeiro de 1996. O componente sazonal de ambos os modelos foi estatisticamente significante (p-valor <0,0001, sendo maio e junho os meses com maior excesso de internações e óbitos. Os pressupostos de normalidade e de independência temporal dos resíduos não puderam ser rejeitados ao nível de 0,05. CONCLUSÕES: Os resultados sugerem a predominância da etiologia viral das diarréias moderadas e graves. Neste caso, a vacinação específica é a medida mais eficaz na prevenção e controle, sendo necessários estudos de eficácia de novas candidatas à vacina contra o rotavírus no Brasil.

Environmental pollutants and stroke-related hospital admissions Poluentes ambientais e internações devido a acidente vasculoencéfalico

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Luiz Fernando Costa Nascimento

2012-07-01

Full Text Available Some effects of environmental pollution on human health are known, especially those affecting the respiratory and cardiovascular systems. The current study aimed to estimate these effects on the production of hospital admissions for stroke. This was an ecological study using hospital admissions data in São José dos Campos, São Paulo State, Brazil, with diagnosis of stroke, from January 1, 2007, to April 30, 2008. The target pollutants were particulate matter, sulfur dioxide, and ozone. Use of a Poisson linear regression model showed that same-day exposure to particulate matter was associated with hospitalization for stroke (RR = 1.013; 95%CI: 1.001-1.025. An increase of 10µg/m³ in this pollutant increased the risk of hospitalization by 12% (RR = 1.137; 95%CI: 1.014-1.276. In the multi-pollutant model, it was thus possible to identify particulate matter as associated with hospitalization for stroke in a medium-sized city like São José dos Campos.Alguns dos efeitos da poluição ambiental na saúde humana são conhecidos, destacando aqueles nos sistemas respiratório e cardiovascular. Este trabalho tem por objetivo estimar esses efeitos na gênese das internações por acidente vasculoencefálico. Foi um estudo ecológico realizado com dados de internações da cidade de São José dos Campos, São Paulo, Brasil, relativos aos diagnósticos de acidente vascular cerebral, entre 1º de janeiro de 2007 e 30 de abril de 2008. Os poluentes estudados foram material particulado, dióxido de enxofre e ozônio. Utilizando-se de modelo linear generalizado da regressão de Poisson, foi possível identificar exposição ao material particulado, no mesmo dia, como associado à internação por acidente vasculoencefálico (RR = 1,013; IC95%: 1,001-1,025. O aumento de 10µg/m3 desse poluente aumenta o risco de internação em 12% (RR = 1,137; IC95%: 1,014-1,276. Assim, foi possível identificar o material particulado, no modelo multipoluente, como

Medidas da rotação interna glenoumeral em tenistas e em nadadores assintomáticos comparados com um grupo-controle

OpenAIRE

Renato Rangel Torres

2008-01-01

Introdução: O déficit de rotação interna glenoumeral, freqüentemente observado em praticantes de esportes que envolvem movimentos repetidos do membro superior sobre a cabeça, tem sido associado ao surgimento de lesões secundárias no ombro. Objetivos: Medir e comparar a amplitude de rotação interna glenoumeral em praticantes assintomáticos de tênis e natação, esportes com características diferentes, mas que envolvem esse tipo de movimento. Métodos: 54 voluntários assintomáticos do sexo masculi...

Perfil de la Arquitectura de la Gestion del Conocimiento en Empresas Manufactureras.

OpenAIRE

Gómez Hernández, Marian; Rodríguez Monroy, Carlos; Guaita, Wilfredo

2009-01-01

La investigación tuvo como propósito determinar el perfil de la arquitectura de la GC en empresas manufactureras, tomando como referencia las variables asociadas al conocimiento organizacional en las etapas: creación; identificación y adquisición; clasificación, almacenamiento y protección; aplicación y actualización; transferencia y medición. Soportado por cuatro pilares correspondiente a la plataforma interna: cultura y liderazgo, memorias corporativas, TIC, comunidades colaborativas ...

Algunas paradojas en la enseñanza actual de la medicina interna en Argentina

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D. Outomuro

Full Text Available Este trabajo tiene como propósito reflexionar sobre algunas circunstancias que, en Argentina, contribuyen a la crisis de la educación médica y al descontento tanto de pacientes como de profesionales. El centro de atención es la medicina interna. Del análisis surgen algunas paradojas vinculadas con la actual formación de grado y posgrado. Si bien el primer nivel de atención de la salud, en el marco de la atención primaria, puede resolver el 80% de los problemas de salud de la población, la enseñanza de la medicina interna continúa realizándose sobre el paciente hospitalizado. Esto afecta a la forma en que se practica la medicina, pues se privilegia la tecnología en el diagnóstico y tratamiento sobre la prevención de las enfermedades y la promoción de la salud. Las causas de este panorama son varias, destacando el poco tiempo dedicado a la educación en el ámbito del consultorio con pacientes ambulatorios.

Validez de constructo interna y externa del AGQ y PTEGQ en español

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Francisco Ruiz-Juan

2015-05-01

Full Text Available El objetivo es analizar las propiedades psicométricas del Achievement Goals Questionnaire (AGQ y el Perceptions of Teacher's Emphasis on Goals Questionnaire (PTEGQ en español, para determinar la fiabilidad, la validez de constructo interna, así como la validez externa partiendo de la hipótesis de que metas de logro y clima motivacional percibido en Educación Física pueden predecir la motivación y la satisfacción intrínseca en los sujetos que realizan actividad físico-deportiva de tiempo libre. Los análisis psicométricos confirman las cuatro dimensiones que se hipotetizan desde el modelo teórico original. Se ha demostrado la validez estructural apoyando la hipótesis de que están basados en el principio de compatibilidad. También ha quedado demostrada su validez de constructo interna, así como la validez de externa ya que las metas de logro y el clima motivacional percibido en Educación Física pueden predecir la motivación y la satisfacción intrínseca en los sujetos activos. Su fiabilidad ha sido aceptable.

AUDITORIA INTERNA: SUA IMPORTÂNCIA NAS ORGANIZAÇÕES EMPRESARIAIS NO ÂMBITO COMPETITIVO

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Erica Aparecida Hott

2017-03-01

Full Text Available A auditoria interna passou a ser um instrumento de amplo controle para os gestores, através de atividades que auxilia a administração como meio de identificar que os processos internos e políticas definidos pela companhia, assim como sistemas contábeis e de controle interno, estão sendo efetivamente seguidos e que as transações realizadas estão refletidas contabilmente em concordância com os critérios definidos previamente, permitindo-lhes exercer com segurança o processo decisório sobre as importantes transações empresariais, sendo um diferencial no meio competitivo. Neste contexto, o presente trabalho teve por objetivo apresentar a importância da auditoria interna dentro do âmbito organizacional nos dias atuais. Utilizou-se uma pesquisa descritiva, com base em estudos publicados que abordam o tema central deste estud. Conclui-se que a organização que investir na contratação do auditor interno terá mais chances de se alavancar no mercado competitivo diante dos avanços econômicos.

Bilateral tension pneumothorax related to acupuncture.

Science.gov (United States)

Tagami, Rumi; Moriya, Takashi; Kinoshita, Kosaku; Tanjoh, Katsuhisa

2013-06-01

We report on a patient with a rare case of bilateral tension pneumothorax that occurred after acupuncture. A 69-year-old large-bodied man, who otherwise had no risk factors for spontaneous pneumothorax, presented with chest pressure, cold sweats and shortness of breath. Immediately after bilateral pneumothorax had been identified on a chest radiograph in the emergency room, his blood pressure and percutaneous oxygen saturation suddenly decreased to 78 mm Hg and 86%, respectively. We confirmed deterioration in his cardiopulmonary status and diagnosed bilateral tension pneumothorax. We punctured his chest bilaterally and inserted chest tubes for drainage. His vital signs promptly recovered. After the bilateral puncture and drainage, we learnt that he had been treated with acupuncture on his upper back. We finally diagnosed a bilateral tension pneumothorax based on the symptoms that appeared 8 h after the acupuncture. Because the patient had no risk factors for spontaneous pneumothorax, no alternative diagnosis was proposed. We recommend that patients receiving acupuncture around the chest wall must be adequately informed of the possibility of complications and expected symptoms, as a definitive diagnosis can be difficult without complete information.

Efecto de la cobertura de rastrojos en la germinación del arroz (Oryza sativa L. y principales malezas asociadas

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Yemel M. Ortega

2005-01-01

Full Text Available Efecto de la cobertura de rastrojos en la germinacióndel arroz (Oryza sativaL. y principales malezas asociadas. Para determinar el grado de interferencia causado por distintas cantidades de rastrojos de arroz (Oryza sativaL. sobrela emergencia de arroz y malezas asociadas al cultivo, en el2003 se realizaron tres experimentos simultáneos en la hacienda el Pelón de la Bajura, Guanacaste, Costa Rica. Se aplicaron nueve tratamientos (0 a 9 t/ha de coberturas con rastrojosde la variedad de arroz CR 1113 para medir los efectos en laemergencia del arroz y malezas. Las malezas asociadas incluyen las más frecuentes en agroecosistemas arroceros inundados: Oryza sativa, Echinochloa colona, Cyperusspp., Fim-bristylisspp., Ludwigiaspp. y Heteranthera limosa. En losprimeros dos experimentos se determinaron relaciones inversas entre el grado de cobertura y la densidad de plántulas demalezas emergidas (R2>0,89, y entre el grado de cobertura yel porcentaje de germinación del arroz (R2=0,86, respectivamente. Usando coberturas con rastrojos de frijol (Phaseolusvulgaris en el tercer experimento, no se observó efecto supresor en la germinación del arroz, probablemente debido a supronta descomposición. Aunque la germinación del arroz nose afectó aún a las intensidades más altas de rastrojos evaluadas, conviene realizar pruebas similares a largo plazo para determinar posibles efectos debidos a la descomposición de residuos, alelopatía y acarreo de herbicidas después de variosciclos consecutivos del cultivo de arroz.

Bilateral, independent juvenile nasopharyngeal angiofibroma: case report.

Science.gov (United States)

Mørkenborg, M-L; Frendø, M; Stavngaard, T; Von Buchwald, C

2015-10-01

Juvenile nasopharyngeal angiofibroma is a benign, vascular tumour that primarily occurs in adolescent males. Despite its benign nature, aggressive growth patterns can cause potential life-threatening complications. Juvenile nasopharyngeal angiofibroma is normally unilateral, originating from the sphenopalatine artery, but bilateral symptoms can occur if a large tumour extends to the contralateral side of the nasopharynx. This paper presents the first reported case of true bilateral extensive juvenile nasopharyngeal angiofibroma involving clinically challenging pre-surgical planning and surgical strategy. A 21-year-old male presented with increasing bilateral nasal obstruction and discharge. Examination revealed tumours bilaterally and imaging demonstrated non-contiguous tumours. Pre-operative angiography showed strictly ipsilateral vascular supplies requiring bilateral embolisation. Radical removal performed as one-step, computer-assisted functional endoscopic sinus surgery was performed. The follow-up period was uncomplicated. This case illustrates the importance of suspecting bilateral juvenile nasopharyngeal angiofibroma in patients presenting with bilateral symptoms. Our management, including successful pre-operative planning, enabled one-step total removal of both tumours and rapid patient recovery.

Morbimortalidad Asociada A La Fractura De Cadera Del Paciente Anciano. Analisis De Nuestro Medio

OpenAIRE

Juste Lucero, Marta

2012-01-01

La fractura de cadera es una patología prevalente en la población anciana, con un crecimiento exponencial, altas tasas de morbimortalidad asociada, implicaciones en la calidad de vida y consumo de recursos sanitarios. Objetivos: Conocer las variables epidemiológicas de esta patología, el impacto en la atención médica y el proceso que implica para la adecuada previsión de recursos. Describir las causas de demora quirúrgica y sus posibles consecuencias, e implicaciones de todo lo anterior en la...

Crear y Definir las Condiciones de Funcionamiento de la Unidad de Auditoría Interna para Mejorar La Gestión Administrativa y de Servicios de Imbauto S.A.

OpenAIRE

Valenzuela, Fernando

2009-01-01

El presente trabajo de investigación para “Crear y definir las condiciones de funcionamiento de la Unidad de Auditoría Interna para mejorar la gestión administrativa y de servicios de IMBAUTO S.A.” se realizó con la colaboración de los señores Accionistas, Funcionarios y Empleados de IMBAUTO S.A., por la necesidad de definir las condiciones de funcionamiento de la Unidad de Auditoría Interna. El problema es que IMBAUTO S. A. no tiene una Unidad de Auditoría Interna y un Manual de Auditoría In...

Bilateral internal laryngoceles mimicking asthma

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Elif A Aksoy

2013-01-01

Full Text Available Laryngocele is an air-filled, abnormal dilation of the laryngeal saccule that extends upward within the false vocal fold, in communication with the laryngeal lumen. A case of 43-year-old male with bilateral internal laryngoceles, who has been treated as asthma for 4 years, is presented. The patient had dyspnea, cough, and excessive phlegm for a month and a late onset stridor. Flexible nasopharyngolaryngoscopy showed bilateral cystic enlargements of the false vocal folds and true vocal folds could not be visualized. Laryngeal CT without contrast enhancement showed bilateral internal laryngoceles. Submucosal total excision of bilateral cystic masses including parts of false vocal folds was performed. The symptoms resolved immediately after surgery. Although the incidence of internal laryngocele is rare, it should be remembered in the differential diagnosis of upper airway problems and diagnostic flexible nasopharnygolaryngoscopy is routinely indicated for airway evaluation in at-risk patients.

Hyperostosis frontalis interna, a genetic disease?: Two medieval cases from Southern Poland.

Science.gov (United States)

Glab, H; Szostek, K; Kaczanowski, K

2006-01-01

Two cases of thickening of the internal tables of the frontal bones (hyperostosis frontalis interna, (HFI)) have been examined. These were two female skeletons from the 16th century Dominican Church in Raciborz (Southwest Poland). The similarity of their morphological and metrical traits indicates that they could be related, and suggests that HFI is likely to have a genetic base. These two skeletons are the subject of an analysis which may possibly throw some new light on the controversial and continually disputed nature of this illness.

Simultaneous and staged bilateral total hip arthroplasty

DEFF Research Database (Denmark)

Lindberg-Larsen, Martin; Joergensen, Christoffer Calov; Husted, Henrik

2013-01-01

Bilateral total hip arthroplasty (BTHA) and bilateral simultaneous total hip arthroplasty (BSTHA) are done increasingly. Previous studies evaluating outcomes after bilateral procedures have found different results. The aim of this study was to investigate length of hospital stay (LOS), 30 days...

Bilateral spontaneous hemotympanum: Case report

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Economou Nicolas C

2006-10-01

Full Text Available Abstract Background The most common causes of hemotympanum are therapeutic nasal packing, epistaxis, blood disorders and blunt trauma to the head. Hemotympanum is characterized as idiopathic, when it is detected in the presence of chronic otitis media. A rare case of spontaneous bilateral hemotympanum in a patient treated with anticoagulants is presented herein. Case presentation A 72-year-old male presented with acute deterioration of hearing. In the patient's medical history aortic valve replacement 1 year before presentation was reported. Since then he had been administered regularly coumarinic anticoagulants, with INR levels maintained between 3.4 and 4.0. Otoscopy revealed the presence of bilateral hemotympanum. The audiogram showed symmetrical moderately severe mixed hearing loss bilaterally, with the conductive component predominating. Tympanograms were flat bilaterally with absent acoustic reflexes. A computerized tomography scan showed the presence of fluid in the mastoid and middle ear bilaterally. Treatment was conservative and consisted of a 10-day course of antibiotics, anticongestants and temporary interruption of the anticoagulant therapy. After 3 weeks, normal tympanic membranes were found and hearing had returned to previous levels. Conclusion Anticoagulant intake should be included in the differential diagnosis of hemotympanum, because its detection and appropriate treatment may lead to resolution of the disorder.

AUDITORIA INTERNA: EMBASAMENTO CONCEITUAL E SUPORTE TECNOLÓGICO

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Maria Goreth Miranda Almeida Paula

2009-09-01

Full Text Available O contexto competitivo mundial tem impulsionado as entidades a se enquadrarem em um universo de evolução tecnológica, onde o tempo e a qualidade no atendimento as demandas e na obtenção de informações são fundamentais. O crescimento das comunicações e dos negócios em âmbito internacional tornou o mundo mais dinâmico e mutável. A concorrência acirrada trouxe maior complexidade às transações, e as operações passaram a trazer maior incerteza. Competência, tecnologia e criatividade são valores indispensáveis no contexto. As questões aqui discutidas são, principalmente, fruto da inquietação quanto à forma de atuação da Auditoria Interna nesse novo contexto economico-politico-social, conseqüência da globalização.

Nivel de conocimiento sobre la especialidad de medicina interna y percepción de los usuarios sobre el rol y capacidades del médico internista

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Franco Romaní-Romaní

2009-03-01

Full Text Available Introducción: La especialidad de medicina interna enfrenta muchos retos para permanecer competitiva en el sistema de salud, siendo el escaso conocimiento del público sobre la definición, capacidades y competencias de la medicina interna y del internista uno de esos retos. Objetivos: Determinar cuáles son los conocimientos y la percepción de los pacientes sobre el rol de la medicina interna y del médico internista. Diseño: Estudio transversal, descriptivo y analítico. Lugar: Hospital Nacional Arzobispo Loayza, Hospital Nacional Edgardo Rebagliati y una clínica privada. Participantes: Pacientes adultos que visitaron los servicios de Medicina interna de los tres hospitales. Intervención: Se invitó a llenar un cuestionario anónimo y autoadministrado a los participantes entre el 1 y el 15 de septiembre de 2008. Principales medidas de resultados: Nivel de conocimiento sobre medicina interna e internista, percepción de confianza hacia el internista. Resultados: Quinientos pacientes completaron el cuestionario, 42,8% del Hospital Loayza, 40% del Hospital Rebagliati y 17,2% de una clínica privada. Solo 12,2% alcanzó un buen nivel de conocimiento. El 79% de pacientes tuvo percepción de confianza en el internista para el manejo de síntomas, 50,2% confió en la habilidad clínica del internista y 45,9% confió en el manejo de las enfermedades específicas. Conclusiones: Los pacientes no tienen una definición clara de la medicina interna y el rol del internista. La percepción de confianza es alta con respecto al manejo de los síntomas, pero disminuye al tratarse de enfermedades específicas y de las habilidades clínicas del internista. Por lo tanto, debe realizarse esfuerzos de educación pública para mejorar el entendimiento del rol del internista como especialista en medicina de adultos.

Silicosis with bilateral spontaneous pneumothorax

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Fotedar Sanjay

2010-01-01

Full Text Available Presentation with simultaneous bilateral pneumothorax is uncommon and usually in the context of secondary spontaneous pneumothorax.The association of pneumothorax and silicosis is infrequent and most cases are unilateral. Bilateral pneumothorax in silicosis is very rare with just a few reports in medical literature.

Internações hospitalares por acidentes de moto no Vale do Paraíba Hospitalization due to motorcycle accidents in the Paraíba Valley using spatial analysis

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Marcela Neves Nunes

2010-01-01

Full Text Available OBJETIVO: Identificar aglomerados de municípios com elevadas taxas de internações por acidentes de moto no Vale do Paraíba. MÉTODOS: Foi um estudo ecológico e exploratório com dados do DATASUS referentes ao período compreendido de 2001 a 2005, de 27 municípios do Vale do Paraíba paulista com uma população em torno de um milhão de habitantes. A análise espacial utilizou o programa Terraview e foram obtidos os coeficientes de Moran Global para taxa de internação e para frota de motocicleta e a correlação de Pearson para internação. Foram construídos mapas temáticos com informações sobre a distribuição espacial e do BoxMap. Os dados de internação foram abordados como taxas por 100 mil habitantes. RESULTADOS: No período de estudo foram internados 1268 pessoas, variando entre uma internação até 608 internações por município. Os coeficientes de Moran (global I = 0,34 (p = 0,02 para a taxa de internação e I = 0,42 (p = 0,012 para taxa de internação de acordo com a frota. Para a taxa de internação por acidente de moto, também houve forte correlação entre frota de moto e internação (r = 0,94. CONCLUSÃO: Foi possível identificar um grande aglomerado que envolve nove municípios na região oeste do Vale do Paraíba, que localiza a residência dos internados por acidentes de moto, apontando municípios em que medidas preventivas devem ser aplicadas.OBJECTIVE: To identify clusters of municipalities with high rates of hospitalization due to motorcycle accidents in the "Vale do Paraíba". METHODS: This was an ecological study and exploratory data was obtained by DATASUS for the period 2001 to 2005 in 27 municipalities in the "Vale do Paraíba Paulista", covering a population of about one million inhabitants. The spatial analysis used the program Terraview and the Moran Global coefficients with respect to hospitalization rate and fleet of motorcycle were obtained. while the Pearson correlation was used for

Bilateral Keratectasia 34 Years after Corneal Transplant

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Xavier Valldeperas

2010-07-01

Full Text Available We report the clinical findings of a patient with severe bilateral keratectasia 34 years after a penetrating keratoplasty (PK in both eyes. An otherwise healthy 67-year-old man complained of deterioration of the eyesight in both eyes over the last 6 months. The patient was diagnosed with bilateral keratoconus at the age of 32 years, and he underwent a bilateral PK. At presentation, visual acuity was 20/200 in the right eye and light perception in the left eye. A Pentacam pachymetric map revealed a central pachymetry of 720 µm in the right eye and of 710 µm in the left eye, as well as an average paracentral pachymetry of 436 and 270 µm in the 9-mm zone in the right and the left eye, respectively. Corneal topography revealed bilateral irregular and asymmetric bowing with generalized steepening and high corneal power. We describe a case of bilateral keratectasia 34 years after PK in a patient who was originally diagnosed with bilateral keratoconus.

A boy with bilateral SUNA

DEFF Research Database (Denmark)

Vuković Cvetković, Vlasta; Jensen, Rigmor Højland

2017-01-01

secondary causes should be searched for vigorously if there are bilateral symptoms. Despite a number of therapeutic trials, effective management for the majority of SUNA patients is not available at present. Management of SUNA is often difficult. Case We report the case of a young boy with bilateral SUNA...

Bilateral juvenile nasopharyngeal angiofibroma: report of a case.

Science.gov (United States)

Wu, Edward C; Chark, Davin W; Bhandarkar, Naveen D

2014-07-01

Juvenile nasopharyngeal angiofibroma (JNA) is the most common benign neoplasm of the nasopharynx. Almost always unilateral on diagnosis, JNAs are locally invasive and may extend across the midline, giving a false bilateral appearance; as such, true bilateral JNA is exceedingly rare. We present a recent case of true bilateral JNA. Single case report of a patient with bilateral JNA, including clinical presentation, diagnosis, and management. The patient presented with unilateral nasal obstruction and recurrent epistaxis. Computed tomography and magnetic resonance imaging demonstrated bilateral, noncontiguous masses. Angiography revealed independent vascular supplies from each respective side with no bilateral supply noted. The patient underwent preoperative embolization followed by endoscopic surgical removal of the larger mass; no complications were noted. Follow-up at 2 years demonstrated no recurrence or growth. The vast majority of JNAs are unilateral, though invasive growth to the contralateral side may appear "bilateral" in presentation. Proper identification of true bilateral JNA is helpful in guiding management, wherein excision of both tumors may not be necessary. © 2014 ARS-AAOA, LLC.

Comunicación interna hospitalaria: una aproximación desde la creatividad

OpenAIRE

Medina-Aguerrebere, P. (Pablo); Río-Pérez, J. (Jorge) del

2015-01-01

La gestión profesional de la comunicación institucional se ha convertido en una iniciativa estratégica para aquellos hospitales que desean crear una marca sólida. Para ello, la definición de la arquitectura de marca (identidad, valores, misión, visión, cultura e imagen) y su difusión entre los stakeholders internos resulta fundamental. El objetivo de este artículo es reflexionar sobre el impacto que tiene la creatividad publicitaria en las acciones de comunicación interna que realiza un hospi...

Bacterias halotolerantes/alcalofilas productoras de acido indol acético (AIA asociadas a Arthrospira platensis (Cyanophyceae

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Liliana Cecilia Gómez Gómez

2012-07-01

Full Text Available Título en ingles: Halotolerant alkalophilic and indolacetic acid producing acid producing bacteria associated with Arthrospira platensis (Cyanophyceae Resumen: Este trabajo tuvo como propósito contribuir al conocimiento de la interacción entre la cianobacteria alcalófila Arthrospira platensis y las bacterias que crecen asociadas a su mucilago. Se desarrolló un  medio de cultivo heterotrófico en el cual se aislaron cinco cepas bacterianas asociadas a un monocultivo de A. platensis. Se determinó la capacidad de estas cinco cepas para producir ácido 3- indol acético (AIA. La tipificación molecular de los aislamientos bacterianos permitió identificarlos como Exiguobacterium aurantiacum str. DSM 20416, Xanthomonas sp. ML-122, Halomonas sp. Ap-5, Bacillus okhensis str.  Kh10-101, Indibacter alkaliphilus, type str. LW1T; todas las cepas bacterianas obtenidas  son halotolerantes, alcalófilas y productoras de AIA. Los resultados aportan evidencia para sugerir una interacción benéfica entre A. platensis y sus bacterias asociadas,  quizá como estrategia evolutiva  de cooperación para desarrollarse en  un ambiente hipersalino.    Palabras claves: Bacillus okhensis, Exiguobacterium aurantiacum, Halomonas sp., Indibacter alkaliphilus. Xanthomonas sp. Abstract: The aim of this study was contribute to knowledge over alkalophilic cianobacteryum  Arthrospira platensis  and their  interaction with some associated bacteria growing in their mucilage. Heterotrophic culture medium was designed, in this medium were isolated five bacterial strains associated to single culture of A. platensis. It was measured the 3-indol acetic acid (IAA production by these bacterial strains. Molecular typing allowed identify these bacterial strains like Exiguobacterium aurantiacum str. DSM 20416, Xanthomonas sp. ML-122, Halomonas sp. Ap-5, Bacillus okhensis str. Kh10-101, Indibacter alkaliphilus, type str. LW1T; all these bacteria are halotolerant

Factores de personalidad, perceptuales y cognitivas asociadas con las experiencias anómalo/paranormales en personal de enfermería

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Alejandro Parra

2017-09-01

Cómo citar este artículo: Parra A. Factores de personalidad, perceptuales y cognitivas asociadas con las experiencias anómalo/paranormales en personal de enfermería. Rev Cuid. 2017; 8(3: 1733-48. http://dx.doi.org/10.15649/cuidarte.v8i3.408

Bilateral complex regional pain syndrome following spinal cord injury and bilateral calcaneus fracture

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Ahmet Boyacı

2013-09-01

Full Text Available Complex regional pain syndrome (CRPS is a disease affectingone or more extremities, characterized by spontaneouspain, allodynia, hyperpathia and hyperalgesia.CRPS is separated into Type 1 and Type 2. CRPS whichdevelops after a nociceptive event is labeled as Type 1and when it develops following peripheral nerve damage,Type 2. Although the pathogenesis is not fully understood,peripheral and central sensitivity are held responsible.Bilateral lower extremity involvement is extremely rare.However, it should be borne in mind that it can develop intraumatic injuries which occur in more than one area anddiagnosis and commencement of a rehabilitation programshould be made in the early period. The case is presentedhere of bilateral Type 1 CRPS developing after incompletespinal cord injury and bilateral calcaneus fracture. JClin Exp Invest 2013; 4 (3: 360-363Key words: complex regional pain syndrome, calcaneusfracture, spinal cord injury

Diferencias en manifestaciones de estrés asociadas al sexo a lo largo de la adolescencia

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Lima-Ramos, Juan Francisco

2017-01-01

La evidencia empírica muestra un amplio acuerdo respecto a las diferencias en estrés asociadas al sexo, encontrando una mayor incidencia de estresores y un mayor impacto emocional de los mismos en chicas (Byrne, Davenport y Mazanov, 2007; Moksnes, Eilertsen y Lazarewicz, 2016). Ellas informan de sufrir mayores estresores en el dominio de las relaciones interpersonales, con familia, iguales y pareja (Forns, Kirchner, Abad y Amador, 2012; Hamilton, Stange, Abramson y Alloy, 2015). Asimismo, las...

Complicaciones pulmonares asociadas a ventilación mecánica en el paciente neonatal

OpenAIRE

Cristabel Torres-Castro; Jaime Valle-Leal; Alba J. Martínez-Limón; Zaira Lastra-Jiménez; Lesvia Carmina Delgado-Bojórquez

2016-01-01

Introducción: Se buscó determinar la incidencia de complicaciones pulmonares asociadas a ventilación mecánica en pacientes ingresados a un servicio de cuidados intensivos neonatales (UCIN) en un hospital de 2° nivel. Metodología: Estudio analítico retrospectivo en expedientes de recién nacidos ingresados a una sala de UCIN y que recibieron ventilación mecánica en un hospital de segundo nivel de atención médica. Se recabaron datos demográficos, de la ventilación mecánica, la intubación y co...

Módulo para la medición de variables en motores de combustión interna

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Flavio Humberto Fernández-Morales

2013-01-01

Full Text Available Los motores de combustión interna son ampliamente utilizados como fuentes de alimentación en lugares de difícil acceso. Usualmente estos motores, de baja y media potencia, no cuentan con la instrumentación adecuada para que el usuario pueda establecer su correcto funcionamiento en variables como: temperatura, presión de aceite y velocidad de giro. En este trabajo se describe el diseño y puesta a punto de un módulo para la medición de las anteriores variables, que puede ser empleado en motores de combustión interna de funcionamiento estacionario. Se fabricó una tarjeta de adquisición de datos basada en el PIC 16F873, al cual se adaptaron los sensores de estado sólido requeridos para la medición de las variables. Este módulo permite la visualización de las variables a medir y puede ser programado para establecer rangos de operación según el motor con el que se quiera trabajar.

Generador oxihidrógeno para motor de combustión interna

OpenAIRE

Cebrián López, Héctor

2014-01-01

La pujada de preus dels carburants per la crisi econòmica actual motiva a investigar fonts d'energia alternatives. Les fonts d'energia convencionals com els combustibles fòssils són contaminants i costoses, i l'hidrogen generat a través de l'electròlisi de l'aigua és una solució ecològica i econòmica. En aquest projecte es dissenya un generador d'oxihidrógeno i s'estudien els efectes de l'addició d'aquest gas en 2 motors de combustió interna de 2 temps i 50 cc. Els resultats indiquen que, ...

Bilateral Facial Paralysis Caused by Bilateral Temporal Bone Fracture: A Case Report and a Literature Review

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Sultan Şevik Eliçora

2015-01-01

Full Text Available Bilateral facial paralysis caused by bilateral temporal bone fracture is a rare clinical entity, with seven cases reported in the literature to date. In this paper, we describe a 40-year-old male patient with bilateral facial paralysis and hearing loss that developed after an occupational accident. On physical examination, House-Brackmann (HB facial paralysis of grade 6 was observed on the right side and HB grade 5 paralysis on the left. Upon temporal bone computed tomography (CT examination, a fracture line exhibiting transverse progression was observed in both petrous temporal bones. Our patient underwent transmastoid facial decompression surgery of the right ear. The patient refused a left-side operation. Such patients require extensive monitoring in intensive care units because the presence of multiple injuries means that facial functions are often very difficult to evaluate. Therefore, delays may ensue in both diagnosis and treatment of bilateral facial paralysis.

Bilateral optic neuropathy in acute cryptococcal meningitis

Institute of Scientific and Technical Information of China (English)

Qi Zhe Ngoo; Li Min Evelyn Tai; Wan Hazabbah Wan Hitam; John Tharakan

2016-01-01

We reported a case of cryptococcal meningitis presenting with bilateral optic neuropathy in an immunocompetent patient. A 64-year-old Malay gentleman with no medical comorbidities presented with acute bilateral blurring of vision for a week, which was associated with generalised throbbing headache and low grade fever. He also had som-nolence and altered consciousness. Visual acuity in both eyes was no perception of light with poor pupillary reflexes. Extraocular muscle movements were normal. Anterior segments were unremarkable bilaterally. Fundoscopy revealed bilateral optic disc swelling. CT scan of the brain showed multifocal infarct, but no meningeal enhancement or mass. Cerebrospinal fluid opening pressure was normal, while its culture grew Cryptococcus neoformans. A diagnosis of cryptococcal meningitis with bilateral optic neuropathy was made. Patient was treated with a six-week course of intravenous flu-conazole and started concomitantly on a fortnight's course of intravenous amphotericin B. After that, his general condition improved, but there was still no improvement in his visual acuity. On reviewing at two months post-initiation of treatment, fundi showed bilateral optic atrophy. Bilateral optic neuropathy secondary to cryptococcal meningitis was rare. The prognosis was guarded due to the sequelae of optic atrophy. Anti-fungal medication alone may not be sufficient to manage this condition. However, evidence for other treatment modalities is still lacking and further clinical studies are required.

Validade de construto e consistência interna da Escala de Práticas no Lazer (EPL para adultos

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Rubian Diego Andrade

Full Text Available Resumo Este estudo propõe e analisa a validade de construto e a consistência interna da Escala de Práticas no Lazer (EPL. O instrumento busca identificar as preferências e o envolvimento em práticas nos diferentes contextos do lazer em adultos. A construção do instrumento deu-se a partir dos conteúdos culturais do lazer (artístico, manual, físico-esportivo, intelectual, social, turístico, virtual e contemplação/ócio. O processo de validação foi realizado com: a Análise de conteúdo por especialistas em lazer, que avaliaram o instrumento quanto à clareza da linguagem e pertinência prática, o que permitiu o cálculo do coeficiente de validade de conteúdo (CVC; b Reprodutibilidade em teste-reteste com 51 sujeitos para o cálculo do coeficiente de variação temporal; e c Análise de consistência interna com 885 participantes. A avaliação de conteúdo apresentou coeficientes adequados, tanto com relação à clareza da linguagem (CVCt = 0,883, quanto à pertinência prática (CVCt = 0,879. Os coeficientes de reprodutibilidade foram de moderados a excelentes. A escala apresentou adequada consistência interna (0,72. A EPL apresentou qualidade psicométrica e valores aceitáveis em sua estrutura, podendo ser utilizada para investigar o envolvimento em práticas nos diferentes conteúdos do lazer de adultos.

Bilateral renal calculi

Science.gov (United States)

Sreenevasan, G

1974-01-01

Bilateral renal calculi were present in 114 (10.7%) of 1,070 cases of proved urinary calculus admitted to the Urological Department of the General Hospital, Kuala Lumpur, during the period November 1968—May 1973. The management of bilateral renal calculi is discussed with reference to the first 100 cases in this series. The introduction of renography has greatly facilitated the decision as to which kidney should be operated on first. The management of patients with and without uraemia is discussed and the use of the modified V and V—Y incisions for the removal of staghorn calculi is described. Complications and results are briefly reviewed. ImagesFig. 1Fig. 4Fig. 6Fig. 7 PMID:4845653

FLOWING BILATERAL FILTER: DEFINITION AND IMPLEMENTATIONS

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Maxime Moreaud

2015-06-01

Full Text Available The bilateral filter plays a key role in image processing applications due to its intuitive parameterization and its high quality filter result, smoothing homogeneous regions while preserving the edges of the objects. Considering the image as a topological relief, seeing pixel intensities as peaks and valleys, we introduce a way to control the tonal weighting coefficients, the flowing bilateral filter, reducing "halo" artifacts typically produced by the regular bilateral filter around a large peak surrounded by two valleys of lower values. In this paper we propose to investigate exact and approximated versions of CPU and parallel GPU (Graphical Processing Unit based implementations of the regular and flowing bilateral filter using the NVidia CUDA API. Fast implementations of these filters are important for the processing of large 3D volumes up to several GB acquired by x-ray or electron tomography.

Bilateral cochlear implantation: current concepts, indications, and results.

Science.gov (United States)

Basura, Gregory J; Eapen, Rose; Buchman, Craig A

2009-12-01

The optimal treatment for bilateral hearing loss continues to evolve as cochlear implant (CI) and hearing aid technologies advance, as does our understanding of the central auditory system. Ongoing discussions continue on the validity and feasibility of bilateral CI in terms of performance, justification of need, medical/surgical safety concerns, and economics. The purpose of this review article is to provide an update on the advantages and disadvantages of bilateral CI and to provide a discussion on timing (simultaneous vs. sequential), technology (bimodal vs. binaural) and feasibility. Binaural advantages are found in both adult and pediatric bilateral CI recipients, the greatest being the head shadow effect and improvements in localization and loudness summation. This theoretically offers an advantage over their unilateral implanted counterparts in terms of improved sound localization and enhanced speech perception under noisy conditions. Most investigators agree that bilateral stimulation during critical periods of development is paramount for optimizing auditory functioning in children. Currently, bilateral CI is widely accepted as a safe and effective means of bilateral auditory stimulation.

Achondroplasia Associated with Bilateral Keratoconus

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Ammar M. Al Mahmood

2012-01-01

Full Text Available We report a rare case of bilateral keratoconus in association with achondroplasia. A 26-year-old male, with a known case of achondroplasia, complained of bilateral gradual deterioration in vision for the past few years. Slit lamp biomicroscopy showed bilateral central corneal protrusion and stromal thinning at the apex consistent with keratoconus. a trial of hard contact lens fitting failed to improve VA in the left eye (LE. Right eye (RE improved to 20/25. The patient underwent penetrating keratoplasty (PKP in his LE. Twenty-seven months postoperatively, uncorrected visual acuity (UCVA was 20/30. Ophthalmologists should be aware that patients with achondroplasia who complain of poor vision should be suspected of having keratoconus once other more common conditions are ruled out.

Bilateral Complex Regional Pain Syndrome after Fracture of Bilateral Tibia and Fibula

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Senem Şaş

2017-04-01

Full Text Available Complex regional syndrome type 1 (CRPS-1 is a painful clinical condition. It occurs after a painful event and characterized by allodynia, hyperalgesia, edema, abnormalities in skin blood flow and abnormal sudomotor activity. When CRPS-1 is associated with nerve injury, it is defined as CRPS-2. Central and peripheral theory are responsible in etiopathogenesis of CRPS-1. Generally it occurs in the injured limb. But, it may ocur in the opposite extremities. In this article, we present a case developing bilateral CRPS-1 after bilateral tibia and fibula fracture by reviewing current literatüre.

Capacidad administrativa como factor de eficiencia interna y global de las organizaciones

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Carlos E. Martínez Fajardo

1997-06-01

Full Text Available El concepto de eficiencia ha sido precisado y simplificado por los autores de la teoría clásica de la administración en el sentido de maximizar la producción de las organizaciones con los mínimos costos. En el presente artículo se analizará la eficiencia interna y global de las organizaciones de acuerdo con nuevos criterios adicionales que permitan estudiar el problema con un enfoque de mayor complejidad la naturaleza, fines y estructura de las organizaciones, entre ellos la incidencia del factor de este siglo denominado capacidad administrativa.

Inseguridad alimentaria: variables asociadas y elementos para la política social

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Sara E. Del Castillo

2012-12-01

Full Text Available Introducción. La vigencia de las explicaciones cambia con las transiciones demográfica, epidemiológica y nutricional. Objetivo. Establecer la magnitud de inseguridad alimentaria y sus variables asociadas. Materiales y métodos. Se clasificaron 432 hogares mediante cinco métodos; se utilizaron las escalas de percepción de seguridad alimentaria (EPSA, la latinoamericana y caribeña (ELCSA, y otros tres:a según el consumo usual de energía del jefe del hogar, b según el consumo usual de energía de todos los miembros, y c según un algoritmo basado en el consumo y la condición de los menores. Mediante regresión binomial, se establecieron las variables asociadas a la inseguridad alimentaria. Resultados. La inseguridad varió entre 35,9 y 87 %. Según la ELCSA y b, los hogares con menores tienen menor riesgo de inseguridad 0,51 (IC95% 0,25-0,90 y 0,72 (IC95% 0,48-0,96. Según la EPSA y la ELCSA, no pagar los servicios públicos 1,75 (IC95% 1,23-2,28 y que el jefe del hogar declare que no accede a los alimentos 1,48 (IC95% 1,20-1,68, aumentan la inseguridad. Obtener ingresos esporádicamente se asoció con el método a, 1,34 (IC95% 1,04-1,53 y el método b, 1,32 (IC95% 1,03-1,52. Pagar arriendo 1,12 (IC95% 1,01-1,16, el tiempo de permanencia en el municipio 0,59 (IC95%0,23-0,93 y no contar con alcantarillado 1,13 (IC95% 1,01-1,16, se asociaron a la inseguridad por el método c. Conclusiones. No es pertinente o útil recomendar estos métodos con fines de elaborar la políticasocial.   doi: http://dx.doi.org/10.7705/biomedica.v32i4.766

Armazenamento sob atmosfera controlada de tomates com injúria interna de impacto

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Moretti Celso Luiz

2002-01-01

Full Text Available A injúria interna de impacto causa redução significativa da qualidade de frutos de tomate. O presente trabalho teve como objetivo avaliar a utilização do armazenamento sob atmosfera controlada na redução do desenvolvimento de uma desordem de amadurecimento conhecida como injúria interna de impacto. Tomates (Lycopersicon esculentum Mill, cv. Solimar, foram colhidos no estádio de amadurecimento verde-maduro e tratados com etileno, por 12 horas, a 20degreesC. Ao atingirem o estádio verde-rosado, sofreram uma queda de 40 cm de altura sobre uma superfície plana, lisa e maciça. Metade dos frutos foi então armazenada sobre atmosfera controlada (3% O2; 4% CO2; balanço com N2 por 8 dias a 20degreesC e 85-95% de umidade relativa, e então foram transferidos para atmosfera ambiente até completamente maduros. A outra metade dos frutos foi mantida continuamente em atmosfera ambiente à mesma temperatura e umidade relativa. Quando estavam completamente maduros, os frutos que sofreram injúria mecânica, armazenados sob atmosfera controlada e sob atmosfera ambiente, desenvolveram sintomas de injúria interna de impacto no tecido locular. O armazenamento sob atmosfera controlada não produziu efeitos significativos no conteúdo de vitamina C total e carotenóides totais para o pericarpo e o tecido locular injuriados. Entretanto, o tecido locular injuriado do tratamento armazenado sob atmosfera controlada possuía acidez titulável 15% superior (ao redor de 162 meq ácido cítrico. kg-1 do que o tratamento sob atmosfera ambiente (ao redor de 140 meq ácido cítrico. kg-1 e era similar ao tratamento não injuriado, armazenado em atmosfera ambiente (ao redor de 174 meq ácido cítrico. kg-1. O tecido pericárpico da região injuriada possuía atividade da poligalacturonase similar para os tratamentos armazenados sob ar ou sob atmosfera controlada. O extravasamento de eletrólitos do pericarpo injuriado foi similar para os tratamentos sob atmosfera

Bilateral tension pneumothorax after acupuncture.

Science.gov (United States)

Mohammad, Nurashikin

2018-04-19

Acupuncture is an ancient complementary medicine which is currently used worldwide. Many serious adverse events have been reported which include a spectrum of mild-to-fatal complications. However, the level of awareness with regard to complications is still low both to physicians and patients. We report a 63-year-old who presented with acute shortness of breath 2 hours after having had acupuncture. On examination, there was absent breath sound heard on the left lung and slightly reduced breath sound on the right lung. She had type 1 respiratory failure. Urgent chest radiograph confirmed bilateral pneumothorax which was more severe on the left with tension pneumothorax and mediastinal shift. Chest tubes were inserted bilaterally after failed needle aspiration attempts. Subsequently, the pneumothoraces resolved, and she was discharged well. The bilateral pneumothoraces caused by acupuncture were curable but could have been potentially fatal if diagnosis was delayed. This case report adds to the limited current literature on the complications of acupuncture leading to bilateral pneumothoraces. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Tinnitus after Simultaneous and Sequential Bilateral Cochlear Implantation.

Science.gov (United States)

Ramakers, Geerte G J; Kraaijenga, Véronique J C; Smulders, Yvette E; van Zon, Alice; Stegeman, Inge; Stokroos, Robert J; Free, Rolien H; Frijns, Johan H M; Huinck, Wendy J; Van Zanten, Gijsbert A; Grolman, Wilko

2017-01-01

There is an ongoing global discussion on whether or not bilateral cochlear implantation should be standard care for bilateral deafness. Contrary to unilateral cochlear implantation, however, little is known about the effect of bilateral cochlear implantation on tinnitus. To investigate tinnitus outcomes 1 year after bilateral cochlear implantation. Secondarily, to compare tinnitus outcomes between simultaneous and sequential bilateral cochlear implantation and to investigate long-term follow-up (3 years). This study is a secondary analysis as part of a multicenter randomized controlled trial. Thirty-eight postlingually deafened adults were included in the original trial, in which the presence of tinnitus was not an inclusion criterion. All participants received cochlear implants (CIs) because of profound hearing loss. Nineteen participants received bilateral CIs simultaneously and 19 participants received bilateral CIs sequentially with an inter-implant interval of 2 years. The prevalence and severity of tinnitus before and after simultaneous and sequential bilateral cochlear implantation were measured preoperatively and each year after implantation with the Tinnitus Handicap Inventory (THI) and Tinnitus Questionnaire (TQ). The prevalence of preoperative tinnitus was 42% (16/38). One year after bilateral implantation, there was a median difference of -8 (inter-quartile range (IQR): -28 to 4) in THI score and -9 (IQR: -17 to -9) in TQ score in the participants with preoperative tinnitus. Induction of tinnitus occurred in five participants, all in the simultaneous group, in the year after bilateral implantation. Although the preoperative and also the postoperative median THI and TQ scores were higher in the simultaneous group, the median difference scores were equal in both groups. In the simultaneous group, tinnitus scores fluctuated in the 3 years after implantation. In the sequential group, four patients had an additional benefit of the second CI: a total

Hydraulic bilateral construction robot; Yuatsushiki bilateral kensetsu robot

Energy Technology Data Exchange (ETDEWEB)

Maehata, K.; Mori, N. [Kayaba Industry Co. Ltd., Tokyo (Japan)

1999-05-15

Concerning a hydraulic bilateral construction robot, its system constitution, structures and functions of important components, and the results of some tests are explained, and the researches conducted at Gifu University are described. The construction robot in this report is a servo controlled system of a version developed from the mini-shovel now available in the market. It is equipped, in addition to an electrohydraulic servo control system, with various sensors for detecting the robot attitude, vibration, and load state, and with a camera for visualizing the surrounding landscape. It is also provided with a bilateral joy stick which is a remote control actuator capable of working sensation feedback and with a rocking unit that creates robot movements of rolling, pitching, and heaving. The construction robot discussed here, with output increased and response faster thanks to the employment of a hydraulic driving system for the aim of building a robot system superior in performance to the conventional model designed primarily for heavy duty, proves after tests to be a highly sophisticated remotely controlled robot control system. (NEDO)

Bilateral pallidotomy for generalized dystonia Palidotomia bilateral para distonias generalizadas

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Hélio A. G. Teive

2001-06-01

Full Text Available OBJECTIVE: To evaluate the efficacy and safety of bilateral pallidotomies in five patients with generalized dystonia. BACKGROUND: Generalized dystonias are frequently a therapeutic challenge, with poor responses to pharmacological treatment. GPi (globus pallidus internus pallidotomies for Parkinson's disease ameliorate all kinds of dyskinesias/dystonia, and recent studies reported a marked improvement of refractory dystonias with this procedure. METHODS: Five patients with generalized dystonias refractory to medical treatment were selected; one posttraumatic and four idiopathic. The decision to perform bilateral procedures was based on the predominant axial involvement in these patients. Dystonia severity was assessed with the Burke-Fahn-Marsden Dystonia Scale (BFM. Simultaneous procedures were performed in all but one patient, who had a staged procedure. They were reevaluated with the same scale (BFM by an unblinded rater at 1, 2, 3, 30, 60, 90, 120 and 180 days post-operatively. RESULTS: The four patients with idiopathic dystonia showed a progressive improvement up to three months; the patient with posttraumatic dystonia relapsed at three months. One patient had a marked improvement, being able to discontinue all the medications. A mean decrease in the BFM scores of 52,58% was noted. One patient had a trans-operative motor seizure followed by a transient hemiparesis secondary to rack hemorrhage; other was lethargic up to three days after the procedure. CONCLUSIONS: Our results show that bilateral GPi pallidotomies may be a safe and effective approach to medically refractory generalized dystonias; it can also be speculated that the posttraumatic subgroup may not benefit with this procedure.As distonias generalizadas são freqüentemente um desafio terapêutico, com pobres respostas aos tratamentos farmacológicos. As cirurgias estereotáxicas, como a palidotomia, têm sido utilizadas com êxito no tratamento da doença de Parkinson e estudos

Simultaneous bilateral elbow dislocation with bilateral medial epicondyle fractures in a 13-year-old female gymnast with hyperlaxity

Science.gov (United States)

Bauer, Stefan; Dunne, Ben; Whitewood, Colin

2012-01-01

Bilateral simultaneous elbow dislocations are extremely rare and have only been described in 12 cases. In the paediatric population unilateral elbow dislocations are rare with 3–6% of all elbow injuries and there are only few studies describing this injury exclusively in children. There is only one case report of a paediatric patient who sustained a simultaneous bilateral elbow dislocation with medial epicondyle fractures. We present a second paediatric case of simultaneous bilateral elbow dislocation with associated displaced bilateral medial epicondyle fractures in a gymnast with joint hyperlaxity (3 of 5 Wynne-Davies criteria) treated with closed reduction and short-term immobilisation (3 weeks). The patient returned to full trampoline gymnastics between 4 and 5 months postinjury and made an uneventful recovery. PMID:23234820

THE EUROPEAN UNION’S BILATERAL APPROACH

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Ludmila BORTA

2014-12-01

Full Text Available The EU is a world economic power and a major trading partner for most countries. All the time, this region has been interested and has acted towards a free and fair trade. The decrease and even the elimination of tariff and non-tariff barriers in the world trade are among the main objectives of the EU strategy for international trade. At the moment, the elusive outcome of the WTO Doha Round has led to the proliferation of bilateral trade agreements worldwide. Although the EU remains committed to further development of the multilateral trading system, however, the EU still has appealed also to the development of bilateral trade relations. The aim of this paper is to illustrate the current bilateral dimension of the common commercial policy of the EU. In conclusion, to describe this bilateral approach of the EU we are using one word, namely “diversity”.

A case of bilateral tubal pregnancy

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Ayano Funamizu

2017-11-01

Full Text Available Bilateral tubal pregnancy is very rare and occurs in only 1 out of every 200,000 spontaneous pregnancies. In this case, a 29-year-old woman with a history of primary infertility underwent treatment with human menopausal gonadotropin (hMG-human chorionic gonadotropin (hCG, and became pregnant. A gestational sac (GS was not detected in the uterus and transvaginal ultrasonography (USG revealed GS with fetal heartbeat in the left adnexa at 7 weeks and 6 days of gestation. The patient underwent laparoscopic surgery and ultimately, bilateral tubal pregnancy was diagnosed. Consequently, bilateral fallopian tube resection was performed. Afterwards, she conceived by assisted reproductive technology (ART and delivered vaginally. This case suggests that even if a GS is found in one fallopian tube by USG, it is important to evaluate the other fallopian tube carefully. Keywords: bilateral tubal pregnancy, ectopic pregnancy, human menopausal gonadotropin, laparoscopy

Bilateral sarkoidose i glandula parotis

DEFF Research Database (Denmark)

Hahn, Pernille; Krogdahl, Annelise; Godballe, Christian

2012-01-01

We describe an unusual case of sarcoidosis in which the patient presented with a bilateral swelling of the parotid salivary glands and no other manifestation of the disease. Sarcoidosis is a multisystem granulomatous disorder of unknown cause in which there may be multiple exocrine involvement......, including the salivary glands. This case emphasises the importance of including sarcoidosis in the differential diagnosis of bilateral parotid swelling....

MODERN VIEWS ON BILATERAL BREAST CANCER

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Ye. A. Fesik

2014-01-01

Full Text Available Presented modern literature data on the features of the pathogenesis, course, clinical and morphological expression and tumor characteristics, parameters and nodal metastasis of hematogenous bilateral breast cancer. Highlight the results of domestic and foreign studies in recent years to determine the prognostic factors and recurrence of synchronous and metachronous bilateral breast cancer. It was revealed that the frequency of bilateral breast tumor lesions varies widely, ranging from 0.1 to 20%, with metachronous tumors recorded significantly higher (69.6% than the synchronous (22.7%. The probability of occurrence of metachronous breast cancer is higher in women with a family history, as well as if they have a gene mutation BRCA-1. Found that the most common histological type of breast tumor with bilateral lesions is invasive ductal. However, the incidence of invasive lobular cancer and non-invasive lobular cancer is slightly higher among synchronous bilateral cancer compared with unilateral disease. Studies have shown that in a double-sided synchronous breast cancer tumor, as a rule, has a lower degree of differentiation, and the higher the expression level of estrogen receptors and progesterone receptors. Relevance of the issue because the identification of patterns in the study of lymphatic and hematogenous features bilateral metastasis of mammary tumors provides a basis for speculation about the differences in the progression of neoplastic disease in these groups and is a cause for further detailed research in this area to identify and evaluate the prognosis and also the choice of tactics of such patients.

Restos de megafauna asociadas a artefactos en la Sabana de Bogotá Restos de megafauna asociadas a artefactos en la Sabana de Bogotá

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Correal Urrego Gonzalo

1982-12-01

Full Text Available Luego de una amplia exploración que cubrió el Valle del río Cauca y la Sabana de Bogotá, excavaciones recientes dentro del plan de estudios "Medio ambiente pleistocénico y el hombre prehistórico en Colombia", permitieron el hallazgo por primera vez en nuestro territorio de evidencias culturales precerámicas asociadas a fauna pleistocénica.  Las investigaciones aquí resumidas se adelantaron por el Instituto de Ciencias Naturales - Museo de Historia Natural- Facultad de Ciencias de la Universidad Nacional de Colombia, con el apoyo financiero de la Fundación de Investigaciones Arqueológicas del Banco de la República.At the archaelogical site TIBITÓ 1, Sabana de Bogotá, there have been found for the first time in Colombia stone and bone artifacts associated with the remains of mastodon (Haplomastodon sp.; Cuvieronius hyodon, horse (Equus amerhippus sp. and deer (Odocoileus virginianus. Bone fragments dated by the C-14 process gave an age of 11.740 ± 110 y BO (Late Pleistocene.

Lipidosis hepática asociada con malnutrición y preñez en dos perras

OpenAIRE

Giordano, Andrea; Arias, Daniel Osvaldo; Araus, S.; Cohen, M.; Gobello, Cristina

2004-01-01

En algunos países latinoamericanos se observó que la ascites ocurre en diferentes momentos post parto en perras alimentadas con dietas hipoproteicas. El objetivo de este articulo fue describir 2 casos de perras con ascitis asociada a lipidosis hepática desarrollada después del parto. Las muestras de sangre evidenciaron anormarmalidades compatibles con enfermedad hepática. La paracentesis abdominal reveló un trasudado aséptico y la ultrasonografía hiperecogenicidad hepática. Se arribó al diagn...

El georrádar como técnica de diagnóstico de presas mineras abandonadas. El distrito de Linares (Jaén, España)

OpenAIRE

Martínez, Julián; Rey Arrans, Javier; Hidalgo Estévez, Mari Carmen; Luque Espinar, Juan Antonio

2013-01-01

En Linares (Jaén) existió una gran actividad minera asociada a un cortejo filoniano de sulfuros metálicos. Estas antiguas labores mineras generaron grandes volúmenes de residuos acumulados sin ningún tipo de actuación correctora previa. En este trabajo se han seleccionado dos presas mineras de finos de lavadero (La Cañada I y La Mejor 1ª-2ª). La caracterización interna de estas estructuras se ha realizado mediante técnicas de prospección electromagnética, en concreto, con ge...

Trabajo en turnos, privación de sueño y sus consecuencias clínicas y médicolegales

OpenAIRE

Serra M. Leonardo, Dr.

2013-01-01

El trabajo en turnos es una realidad frecuente y produce consecuencias negativas para una proporción significativa de quienes lo ejercen. Estas efectos son en base a dos mecanismos fundamentales: el desfase de los ritmos biológicos (tanto con el medio externo, como una desincronía interna) y por privación de sueño. Las consecuencias en salud asociadas se dan con mayor intensidad en turnos rotativos y nocturnos, e incluyen enfermedad coronaria, cerebrovascular, depresión, síndrome metabólico, ...

A IMPORTÂNCIA DA COMUNICAÇÃO INTERNA NAS ORGANIZAÇÕES E A GESTÃO DO CONHECIMENTO

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Jose Dirnece Paes Tavares

2016-10-01

Full Text Available Esse trabalho discute sobre a importância da comunicação interna nas organizações atuais, e objetiva trazer maiores contribuições e condições para auxiliar na gestão dos colaboradores e alavancar melhores resultados. O propósito deste estudo é compreender o uso e o conhecimento que os gestores possuem das ferramentas da comunicação. O clima de conflito foi constatado sobretudo pela falta de integração entre os colaboradores internos x externos, o que de fato prejudicou sobremaneira a organização estudada. Um novo modelo de comunicação deve ser incentivado, objetivando quebra de paradigmas, reduzindo ou até eliminando dessa forma o tabu do relacionamento. No desenvolver desse estudo foi identificada a dificuldade que a organização em pauta tem em praticar e estimular a comunicação interna.

EVALUACIÓN DE LAS PROPIEDADES MECÁNICAS DE LA ESTRUCTURA INTERNA DE LA GUADUA CON UN MODELO MATEMATICO

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JAIRO ALEXANDER OSORIO SARAZ

2009-01-01

Full Text Available Se caracterizo la estructura interna del Bambú-Guadua angustifolia kunth (GAK, en su zona media, encontrando la composición interna de este material compuesto, como son el porcentaje de la matriz (parénquima y de fibras (células de fibras y tejido conductivo. Se determinó las propiedades mecánicas como la resistencia a tensión y a flexión en sentido tangencial, y la Relación de Poisson del material y la resistencia de la fibra. Se valido un modelo matemático para materiales compuestos propuesto por Chandrupatla & Belegundu (1999, y se encontraron algunas ecuaciones que permiten predecir la resistencia del material en función de la resistencia de la fibra, y también para realizar modelos computacionales útiles para la industria de laminados de pisos en Bambuguadua. Los resultados experimentales no difirieron significativamente de los resultados obtenidos con los modelos matemáticos.

Probióticos para la prevención de la diarrea asociada al clostridium difficile en adultos y niños

Directory of Open Access Journals (Sweden)

2014-05-01

Resultados principales: Sobre la base de esta revisión sistemática y del metanálisis de 23 ensayos controlados aleatorios con 4213 pacientes, las pruebas de calidad moderada indican que los probióticos son tanto seguros como efectivos para prevenir la diarrea asociada al Clostridium difficile.

Intervenciones preventivas de la violencia interna en el trabajo: políticas de buenas prácticas y gestión de conflictos

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Antonia Bernat Jiménez

Full Text Available La violencia interna en el lugar de trabajo es la que tiene lugar entre los trabajadores, incluidos mandos y directivos. Incluye la violencia física, el acoso sexual y el acoso psicológico, abarcando también otras conductas de violencia psicológica diferenciadas de éste. Debe ser considerada como un riesgo psicosocial, que supone un peligro importante para la salud y seguridad de las personas, y tiene repercusiones organizacionales a través de costes directos e indirectos. Considerar la violencia interna con este enfoque de riesgo laboral, supone que su abordaje se ha de realizar aplicando los principios de la acción preventiva, a la vez que permite adoptar estrategias de actuación dirigidas a la prevención del fenómeno. Las principales organizaciones a nivel mundial y nacional proponen la implementación de una política de prevención de la violencia en el lugar de trabajo. Este artículo trata sobre la conveniencia del desarrollo e implementación en las organizaciones de una política de prevención de la violencia interna, de carácter integral e integrado, que involucre a toda la organización, orientada a lograr entornos de trabajo más saludables y con un enfoque centrado en los factores organizativos y psicosociales. En el artículo se contemplan las premisas esenciales de esa política preventiva de la violencia interna, abordándose también los momentos básicos de la estrategia preventiva: - La evaluación de riesgo psicosociales. - La política de buenas prácticas. - Los procedimientos de gestión de conflictos y acoso psicológico en el trabajo. - Las estrategias de comunicación organizacional y las acciones formativas. Para conseguir auténtica efectividad, las políticas de prevención de la violencia interna deben incorporarse al Sistema de Gestión de la Prevención de la organización, que, a su vez, estará integrado en todos los sistemas de gestión restantes de la empresa.

Estudio descriptivo de la relación entre el cine, la nutrición y patologías asociadas

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José Miguel BISCAIA FERNÁNDEZ

2018-01-01

Full Text Available La repercusión social del cine puede estudiarse a partir de la influencia que ejerce sobre diferentes patrones comportamentales como las conductas alimentarias. En el presente estudio descriptivo se analiza cuantitativa y cualitativamente la presencia de temáticas relacionadas con la nutrición y las diferentes patologías asociadas en películas recientes galardonadas en los Oscar (2000?2015. Los resultados reflejan que en el 32% de las obras estudiadas aparecen personajes o tramas que de forma relevante refieren a los alimentos, la nutrición o patologías asociadas como la obesidad o la anorexia. Además, en un 23% de las películas analizadas los intérpretes modificaron radicalmente su peso corporal por el personaje a interpretar. Pese a la heterogeneidad en el rigor, tratamiento e influencia de las obras estudiadas, destaca la visión positiva frente a hábitos alimentarios saludables de algunas obras de animación (30,8% de las analizadas, películas destinadas fundamentalmente a un público vulnerable como el infantil?juvenil.

Paresia diafragmática bilateral idiopática Idiopathic bilateral diaphragmatic paresis

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Mônica Corso Pereira

2006-10-01

Full Text Available Relata-se o caso de um paciente com dispnéia intensa ao se deitar, em que foram excluídas doenças pulmonares, neuromusculares ou cardíacas, cuja investigação revelou paresia diafragmática bilateral. Um sinal chave para o diagnóstico foi a evidência de respiração paradoxal com o doente em decúbito supino. Havia piora da oxigenação e da capacidade vital forçada com a mudança da posição ortostática para supina. A fluoroscopia ortostática foi normal. A pressão inspiratória máxima estava muito reduzida. A estimulação elétrica transcutânea do diafragma foi normal, e a eletroestimulação do nervo frênico mostrou ausência de resposta, permitindo o diagnóstico de paresia bilateral do diafragma.We report the case of a patient with severe dyspnea upon reclining. Lung disease, neuromuscular disorders and heart disease were ruled out. However, during the course of the investigation, bilateral diaphragmatic paresis was discovered. A key sign leading to the diagnosis was evidence of paradoxical respiration in the dorsal decubitus position. When the patient was moved from the orthostatic position to the dorsal decubitus position, oxygenation and forced vital capacity worsened. The orthostatic fluoroscopy was normal. Maximal inspiratory pressure was severely reduced. The responses to transcutaneous electric stimulation of the diaphragm were normal. However, electric stimulation of the phrenic nerve produced no response, leading to the diagnosis of bilateral diaphragmatic paresis.

Bilateral microperc in a severe kyphoscoliosis

OpenAIRE

Dağgülli, Mansur; Penbegül, Necmettin; Dede, Onur; Utanğaç, Mehmet Mazhar

2016-01-01

Percutaneous nephrolithotomy is the standard modality for large renal calculi in normal and abnormal renal anatomic situations. This case report describes a 57-year-old male patient who presented with bilateral kidney stones and severe kyphoscoliosis. He had successfully been treated with a bilateral microperc technique.

A case of bilateral trench foot.

Science.gov (United States)

Parsons, S L; Leach, I H; Charnley, R M

1993-12-01

A case of severe bilateral trench foot is presented in a patient who lived rough for 3 weeks without removing his boots. Non-operative management yielded no clinical improvement and bilateral below-knee amputation was necessary. Histology revealed subcutaneous and muscle necrosis with secondary arterial thrombosis.

Patrones y flujos de la migración interna en la Gran Área Metropolitana de Costa Rica, en el período 1995-2000

OpenAIRE

Wendy Molina-Varela

2009-01-01

Los más recientes cambios en los patrones de migración interna en varios países de Latinoamérica, apuntan a los crecientes flujos de migración intrametropolitana desde los centros urbanos hacia la periferia, asociados a procesos de urbanización residencial de zonas rurales cercanas a la zona metropolitana. Este artículo analiza este fenómeno para Costa Rica, estimando los patrones de migración interna dentro del Gran Área Metropolitana (GAM), y tratando de determinar algunos factores de atr...

Ceratite bilateral por Acanthamoeba: relato de caso Bilateral Acanthamoeba keratitis: case report

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Wilson Nahmatallah Obeid

2003-12-01

Full Text Available A ceratite por Acanthamoeba é uma infecção ocular grave que, apesar dos recentes progressos no diagnóstico e tratamento, ainda provoca prolongada morbidade e perda da acuidade visual. Relatamos um caso de ceratite bilateral por Acanthamoeba em usuário de lentes de contato, que é o primeiro caso descrito na literatura brasileira.Acanthamoeba keratitis is a severe ocular infection which even with recent progress in diagnosis and treatment still causes long morbidity and loss of visual acuity. We describe a case of bilateral Acanthamoeba keratitis in a user of contact lenses, which is the first case discussed in Brazilian literature.

Internações por doenças relacionadas ao saneamento ambiental inadequado na rede pública de saúde da região metropolitana de Porto Alegre, Rio Grande do Sul, 2010-2014

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Mariana Santiago Siqueira

Full Text Available Resumo OBJETIVO: descrever a ocorrência, as características e os gastos com internações por doenças relacionadas ao saneamento ambiental inadequado (DRSAI financiadas pelo Sistema Único de Saúde (SUS entre residentes na Região Metropolitana de Porto Alegre-RS, no período de 2010 a 2014. MÉTODOS: estudo descritivo com dados do Sistema de Informações Hospitalares do SUS (SIH/SUS. RESULTADOS: das 13.929 internações por DRSAI, 93,7% relacionaram-se às doenças de transmissão feco-oral e 20,4% foram de crianças de 1 a 4 anos de idade (28,1 internações/10 mil hab./ano; a letalidade hospitalar foi de 2,2%, tendo as doenças de transmissão feco-oral como principais causas de óbito; em 2,0% das internações, houve utilização de unidade de terapia intensiva (UTI; o gasto total com as internações foi de cerca de R$6,1 milhões. CONCLUSÃO: as DRSAI permanecem como um importante problema na região metropolitana de Porto Alegre-RS, embora esta apresente bons indicadores de desenvolvimento.

Tinnitus after Simultaneous and Sequential Bilateral Cochlear Implantation

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Geerte G. J. Ramakers

2017-11-01

Full Text Available ImportanceThere is an ongoing global discussion on whether or not bilateral cochlear implantation should be standard care for bilateral deafness. Contrary to unilateral cochlear implantation, however, little is known about the effect of bilateral cochlear implantation on tinnitus.ObjectiveTo investigate tinnitus outcomes 1 year after bilateral cochlear implantation. Secondarily, to compare tinnitus outcomes between simultaneous and sequential bilateral cochlear implantation and to investigate long-term follow-up (3 years.Study designThis study is a secondary analysis as part of a multicenter randomized controlled trial.MethodsThirty-eight postlingually deafened adults were included in the original trial, in which the presence of tinnitus was not an inclusion criterion. All participants received cochlear implants (CIs because of profound hearing loss. Nineteen participants received bilateral CIs simultaneously and 19 participants received bilateral CIs sequentially with an inter-implant interval of 2 years. The prevalence and severity of tinnitus before and after simultaneous and sequential bilateral cochlear implantation were measured preoperatively and each year after implantation with the Tinnitus Handicap Inventory (THI and Tinnitus Questionnaire (TQ.ResultsThe prevalence of preoperative tinnitus was 42% (16/38. One year after bilateral implantation, there was a median difference of −8 (inter-quartile range (IQR: −28 to 4 in THI score and −9 (IQR: −17 to −9 in TQ score in the participants with preoperative tinnitus. Induction of tinnitus occurred in five participants, all in the simultaneous group, in the year after bilateral implantation. Although the preoperative and also the postoperative median THI and TQ scores were higher in the simultaneous group, the median difference scores were equal in both groups. In the simultaneous group, tinnitus scores fluctuated in the 3 years after implantation. In the sequential group

Bilateral agenesis of the anterior cruciate ligament: MRI evaluation

Energy Technology Data Exchange (ETDEWEB)

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

2014-09-15

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

Staged bilateral carotid endarterectomy

DEFF Research Database (Denmark)

Schroeder, T; Sillesen, H; Engell, Hans Christian

1986-01-01

In a series of 56 staged bilateral carotid endarterectomies, new neurologic symptoms developed in 5% and 20% following the first and second procedure, respectively. All complications were transient or minor. The incidence of postendarterectomy hypertension was significantly higher following...... the second procedure, when operations were staged less than 3 weeks apart. A correlation between these hypertensive episodes and the occurrence of new neurologic symptoms could not be shown. However, as this correlation has been proved in several other reports, bilateral carotid endarterectomy is advised...... to be staged at least 3 weeks apart. In addition, a conservative attitude towards contralateral asymptomatic lesions is proposed....

Comunicación interna hospitalaria: una aproximación desde la creatividad/ Hospital internal communication : an approach from creativity

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Pablo Medina Aguerrebere

2015-07-01

Full Text Available La gestión profesional de la comunicación institucional se ha convertido en una iniciativa estratégica para aquellos hospitales que desean crear una marca sólida. Para ello, la definición de la arquitectura de marca (identidad, valores, misión, visión, cultura e imagen y su difusión entre los stakeholders internos resulta fundamental. El objetivo de este artículo es reflexionar sobre el impacto que tiene la creatividad publicitaria en las acciones de comunicación interna que realiza un hospital para crear marca. Para ello, se realiza una revisión bibliográfica sobre la comunicación institucional hospitalaria, la comunicación interna y la creatividad publicitaria. El artículo concluye que la creatividad contribuye positivamente a dinamizar la comunicación interna del hospital y a crear una marca hospitalaria sólida. The professional management of corporate communication has become a strategic initiative to those hospitals that wish to create a strong brand. To do this, the definition of brand architecture (identity, values, mission, vision, culture and image and its dissemination among internal stakeholders is essential. This paper aims to reflect on the impact of advertising creativity in internal communication actions that takes a hospital to create brand. For this, a literature review on hospital corporate communication, internal communication and advertising creativity is performed. This paper concludes that creativity contributes positively to energize the hospital internal communication and create a strong brand

Reinnervation of bilateral posterior cricoarytenoid muscles using the left phrenic nerve in patients with bilateral vocal fold paralysis.

Directory of Open Access Journals (Sweden)

Meng Li

Full Text Available OBJECTIVE: To evaluate the feasibility, effectiveness, and safety of reinnervation of the bilateral posterior cricoarytenoid (PCA muscles using the left phrenic nerve in patients with bilateral vocal fold paralysis. METHODS: Forty-four patients with bilateral vocal fold paralysis who underwent reinnervation of the bilateral PCA muscles using the left phrenic nerve were enrolled in this study. Videostroboscopy, perceptual evaluation, acoustic analysis, maximum phonation time, pulmonary function testing, and laryngeal electromyography were performed preoperatively and postoperatively. Patients were followed-up for at least 1 year after surgery. RESULTS: Videostroboscopy showed that within 1 year after reinnervation, abductive movement could be observed in the left vocal folds of 87% of patients and the right vocal folds of 72% of patients. Abductive excursion on the left side was significantly larger than that on the right side (P 0.05. No patients developed immediate dyspnea after surgery, and the pulmonary function parameters recovered to normal reference value levels within 1 year. Postoperative laryngeal electromyography confirmed successful reinnervation of the bilateral PCA muscles. Eighty-seven percent of patients in this series were decannulated and did not show obvious dyspnea after physical activity. Those who were decannulated after subsequent arytenoidectomy were not included in calculating the success rate of decannulation. CONCLUSIONS: Reinnervation of the bilateral PCA muscles using the left phrenic nerve can restore inspiratory vocal fold abduction to a physiologically satisfactory extent while preserving phonatory function at the preoperative level without evident morbidity.

Reinnervation of Bilateral Posterior Cricoarytenoid Muscles Using the Left Phrenic Nerve in Patients with Bilateral Vocal Fold Paralysis

Science.gov (United States)

Zheng, Hongliang; Chen, Donghui; Zhu, Minhui; Wang, Wei; Liu, Fei; Zhang, Caiyun

2013-01-01

Objective To evaluate the feasibility, effectiveness, and safety of reinnervation of the bilateral posterior cricoarytenoid (PCA) muscles using the left phrenic nerve in patients with bilateral vocal fold paralysis. Methods Forty-four patients with bilateral vocal fold paralysis who underwent reinnervation of the bilateral PCA muscles using the left phrenic nerve were enrolled in this study. Videostroboscopy, perceptual evaluation, acoustic analysis, maximum phonation time, pulmonary function testing, and laryngeal electromyography were performed preoperatively and postoperatively. Patients were followed-up for at least 1 year after surgery. Results Videostroboscopy showed that within 1 year after reinnervation, abductive movement could be observed in the left vocal folds of 87% of patients and the right vocal folds of 72% of patients. Abductive excursion on the left side was significantly larger than that on the right side (P 0.05). No patients developed immediate dyspnea after surgery, and the pulmonary function parameters recovered to normal reference value levels within 1 year. Postoperative laryngeal electromyography confirmed successful reinnervation of the bilateral PCA muscles. Eighty-seven percent of patients in this series were decannulated and did not show obvious dyspnea after physical activity. Those who were decannulated after subsequent arytenoidectomy were not included in calculating the success rate of decannulation. Conclusions Reinnervation of the bilateral PCA muscles using the left phrenic nerve can restore inspiratory vocal fold abduction to a physiologically satisfactory extent while preserving phonatory function at the preoperative level without evident morbidity. PMID:24098581

MRI features of bilateral parotid haemangiomas of infancy

International Nuclear Information System (INIS)

Andronikou, Savvas; Jadwat, Saaleeha; McHugh, Kieran; Linward, Jane

2003-01-01

The aim of this article is to report the MRI features of bilateral parotid haemangiomas of infancy and highlight the diagnostic and prognostic value of MRI especially with regard to those lesions that may cause respiratory compromise. Retrospective review of MRI scans in six infants with bilateral parotid haemangiomas. The bilateral haemangiomas were symmetrical in all but one patient. On T1-weighted images the masses were isointense to muscle and on T2 they were hyperintense with numerous small vessels giving a septated appearance. There was vivid enhancement with gadolinium in all cases. In three patients, deep bilateral extensions were demonstrated involving the parapharyngeal spaces resulting in respiratory compromise which required tracheostomy. Bilateral parotid haemangiomas are rare, but when present may have deep extensions, which can result in respiratory compromise requiring tracheostomy. (orig.)

MRI features of bilateral parotid haemangiomas of infancy

Energy Technology Data Exchange (ETDEWEB)

Andronikou, Savvas; Jadwat, Saaleeha [Institute of Child Health, University of Cape Town, Klipfontein Road, Rondebosch, 7700, Cape Town (South Africa); McHugh, Kieran; Linward, Jane [Department of Radiology, Great Ormond Street Hospital for Children, London, WC1N 3JH (United Kingdom)

2003-04-01

The aim of this article is to report the MRI features of bilateral parotid haemangiomas of infancy and highlight the diagnostic and prognostic value of MRI especially with regard to those lesions that may cause respiratory compromise. Retrospective review of MRI scans in six infants with bilateral parotid haemangiomas. The bilateral haemangiomas were symmetrical in all but one patient. On T1-weighted images the masses were isointense to muscle and on T2 they were hyperintense with numerous small vessels giving a septated appearance. There was vivid enhancement with gadolinium in all cases. In three patients, deep bilateral extensions were demonstrated involving the parapharyngeal spaces resulting in respiratory compromise which required tracheostomy. Bilateral parotid haemangiomas are rare, but when present may have deep extensions, which can result in respiratory compromise requiring tracheostomy. (orig.)

Bilateral electric energy contracts: return and risk

Energy Technology Data Exchange (ETDEWEB)

Gunn, Laura K.; Silva, Elisa B.; Correia, Paulo B. [State University of Campinas (UNICAMP), SP (Brazil). College of Mechanical Engineering

2009-07-01

In Brazil electricity is traded through three segments: the spot market that balances offer and demand, with prices calculated by a cost-based computational model; the regulated market , where prices are settled in public auctions, and the free market for bilateral contracts. As spot and regulated market prices are public information, a seller is able to calculate his opportunity price to trade a bilateral contract in the free market by using the non-arbitrage principle. Thus, the seller searches the price of a bilateral contract in the free market that balances his/her revenues with the value expected in case it were negotiated in the regulated and the spot market. Besides the expected revenue, the seller may also consider the CVaR to measure the risk of her/his bilateral contract in the free market. So this paper develops a binomial lattice approach to price bilateral contracts in the free market, considering the seller's opportunity of negotiations in both regulated and spot markets, and measuring the contract risk directly. (author)

Diseño de sistema de gestión de la comunicación interna a la medida organizacional

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Norge Lauzao-Serrano

2012-01-01

evaluación y control de los procesos comunicativos en la organización, capaz de permitir la existencia de un sistema de comunicación coherente y armónico, contribuyendo a una mayor integración interna, fortaleciendo su cultura e identidad.

Bilateral Traumatic Globe Luxation with Optic Nerve Transection

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Levent Tok

2014-12-01

Full Text Available Purpose: The purpose of this study was to document clinical findings and management of a patient with bilateral globe luxation and optic nerve transection. Materials and Methods: A 25-year-old female patient was admitted to the emergency department with bilateral traumatic globe luxation following a motor vehicle accident. Results: Visual acuity testing showed no light perception. The right pupil was dilated and bilaterally did not react to light. The globes were bilaterally intact. A computed tomography scan revealed Le Fort type II fractures, bilateral optic nerve transection and disruption of all extraocular muscles. The globes of the patient were bilaterally reduced into the orbit. However, the patient developed phthisis bulbi in the right eye at month 3. Conclusion: Globe luxation presents a dramatic clinical picture, and may lead to the development of severe complications due to the concomitance of complete optic nerve dissection and multiple traumas. Even if the luxated globe is repositioned into the orbit, there is still an increased risk of the development of phthisis due to ischemia.

Bilateral Traumatic Globe Luxation with Optic Nerve Transection

Science.gov (United States)

Tok, Levent; Tok, Ozlem Yalcin; Argun, Tugba Cakmak; Yilmaz, Omer; Gunes, Alime; Unlu, Elif Nisa; Sezer, Sezgin; Ibisoglu, Seda; Argun, Mehmet

2014-01-01

Purpose The purpose of this study was to document clinical findings and management of a patient with bilateral globe luxation and optic nerve transection. Materials and Methods A 25-year-old female patient was admitted to the emergency department with bilateral traumatic globe luxation following a motor vehicle accident. Results Visual acuity testing showed no light perception. The right pupil was dilated and bilaterally did not react to light. The globes were bilaterally intact. A computed tomography scan revealed Le Fort type II fractures, bilateral optic nerve transection and disruption of all extraocular muscles. The globes of the patient were bilaterally reduced into the orbit. However, the patient developed phthisis bulbi in the right eye at month 3. Conclusion Globe luxation presents a dramatic clinical picture, and may lead to the development of severe complications due to the concomitance of complete optic nerve dissection and multiple traumas. Even if the luxated globe is repositioned into the orbit, there is still an increased risk of the development of phthisis due to ischemia. PMID:25606034

Entidades clínicas cardiovasculares asociadas al consumo de cocaína por vía nasal en una población peruana

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Luis Razzeto-Ríos

2008-06-01

Full Text Available Objetivos: Conocer la frecuencia de entidades clínicas cardiovasculares asociadas al empleo de cocaína por vía nasal en consumidores peruanos. Diseño: Estudio prospectivo, descriptivo, tipo serie de casos. Lugar: Hospital Edgardo Rebagliati Martins, EsSalud, hospital docente, y Clínica San Felipe. Participantes: Pacientes atendidos entre los años 1991 y 2006. Principales medidas de resultados: Síntomas y entidades clínicas asociadas al consumo de cocaína vía nasal. Resultados: En los 63 pacientes evaluados, la mediana de edad fue 35 años, 53 (84% eran de sexo masculino, 86% afirmó haber ingerido cocaína previamente. Los síntomas aparecieron antes de las 2 horas en 78% de los pacientes y 81% presentó trastornos del electrocardiograma. Los síntomas reportados fueron dolor torácico (59%, palpitaciones (27%, convulsiones (5%, hipertermia (3% y cefalea (6%. Las entidades clínicas asociadas fueron: síndromes coronarios agudos (49%, arritmia ventricular (25%, infarto agudo de miocardio (10%, crisis hipertensiva (5% y muerte súbita (11%. Durante el seguimiento, la reincidencia en el consumo se produjo en 76%, siendo esta predominantemente en los primeros 6 meses (63%. Conclusiones: El empleo de cocaína intranasal se asocia a importantes entidades clínicas cardiovasculares, la mayoría de ellas graves. Se aconseja la evaluación de los pacientes en emergencia, incluyendo una anamnesis completa dirigida a la evaluación del consumo de sustancias ilícitas.

Bilateral adrenal masses: a single-centre experience

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Nilesh Lomte

2016-05-01

Full Text Available Background Bilateral adrenal masses may have aetiologies like hyperplasia and infiltrative lesions, besides tumours. Hyperplastic and infiltrative lesions may have coexisting hypocortisolism. Bilateral tumours are likely to have hereditary/syndromic associations. The data on clinical profile of bilateral adrenal masses are limited. Aims To analyse clinical, biochemical and radiological features, and management outcomes in patients with bilateral adrenal masses. Methods Retrospective analysis of 70 patients with bilateral adrenal masses presenting to a single tertiary care endocrine centre from western India (2002–2015. Results The most common aetiology was pheochromocytoma (40%, followed by tuberculosis (27.1%, primary adrenal lymphoma (PAL (10%, metastases (5.7%, non-functioning adenomas (4.3%, primary bilateral macronodular adrenal hyperplasia (4.3%, and others (8.6%. Age at presentation was less in patients with pheochromocytoma (33 years and tuberculosis (41 years compared with PAL (48 years and metastases (61 years (P<0.001. The presenting symptoms for pheochromocytoma were hyperadrenergic spells (54% and abdominal pain (29%, whereas tuberculosis presented with adrenal insufficiency (AI (95%. The presenting symptoms for PAL were AI (57% and abdominal pain (43%, whereas all cases of metastasis had abdominal pain. Mean size of adrenal masses was the largest in lymphoma (5.5cm followed by pheochromocytoma (4.8cm, metastasis (4cm and tuberculosis (2.1cm (P<0.001. Biochemically, most patients with pheochromocytoma (92.8% had catecholamine excess. Hypocortisolism was common in tuberculosis (100% and PAL (71.4% and absent with metastases (P<0.001. Conclusion In evaluation of bilateral adrenal masses, age at presentation, presenting symptoms, lesion size, and biochemical features are helpful in delineating varied underlying aetiologies.

Bilateral adrenal masses: a single-centre experience

Science.gov (United States)

Bandgar, Tushar; Khare, Shruti; Jadhav, Swati; Lila, Anurag; Goroshi, Manjunath; Kasaliwal, Rajeev; Khadilkar, Kranti; Shah, Nalini S

2016-01-01

Background Bilateral adrenal masses may have aetiologies like hyperplasia and infiltrative lesions, besides tumours. Hyperplastic and infiltrative lesions may have coexisting hypocortisolism. Bilateral tumours are likely to have hereditary/syndromic associations. The data on clinical profile of bilateral adrenal masses are limited. Aims To analyse clinical, biochemical and radiological features, and management outcomes in patients with bilateral adrenal masses. Methods Retrospective analysis of 70 patients with bilateral adrenal masses presenting to a single tertiary care endocrine centre from western India (2002–2015). Results The most common aetiology was pheochromocytoma (40%), followed by tuberculosis (27.1%), primary adrenal lymphoma (PAL) (10%), metastases (5.7%), non-functioning adenomas (4.3%), primary bilateral macronodular adrenal hyperplasia (4.3%), and others (8.6%). Age at presentation was less in patients with pheochromocytoma (33 years) and tuberculosis (41 years) compared with PAL (48 years) and metastases (61 years) (P<0.001). The presenting symptoms for pheochromocytoma were hyperadrenergic spells (54%) and abdominal pain (29%), whereas tuberculosis presented with adrenal insufficiency (AI) (95%). The presenting symptoms for PAL were AI (57%) and abdominal pain (43%), whereas all cases of metastasis had abdominal pain. Mean size of adrenal masses was the largest in lymphoma (5.5cm) followed by pheochromocytoma (4.8cm), metastasis (4cm) and tuberculosis (2.1cm) (P<0.001). Biochemically, most patients with pheochromocytoma (92.8%) had catecholamine excess. Hypocortisolism was common in tuberculosis (100%) and PAL (71.4%) and absent with metastases (P<0.001). Conclusion In evaluation of bilateral adrenal masses, age at presentation, presenting symptoms, lesion size, and biochemical features are helpful in delineating varied underlying aetiologies. PMID:27037294

Bilateral Ovarian Fibrothecoma Associated with Ascites, Bilateral Pleural Effusion, and Marked Elevated Serum CA-125

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Védi André Serges Loué

2013-01-01

Full Text Available Background. The risk of ovarian cancer is increased in the association of ovarian tumor, ascites, and hydrothorax with the significant elevated tumor marker CA-125. However, this association can be observed in a rare clinical and benign pathological entity, that is Demons-Meigs’ syndrome. Objective. To describe a rare case of Demons-Meigs' syndrome observed in our department. Methods. A black African woman of 35 years old, seventh gravida and fourth parous, underwent a total abdominal hysterectomy with bilateral salpingoophorectomy for large bilateral ovarian masses associated with significant ascites, bilateral pleural effusion, and particular highly elevated tumor marker CA-125 (1835 UI/mL in a pronounced general alteration condition. Results. The postoperative course was uneventful characterized by a complete remission of hydrothorax and ascites with normal level of CA-125 three months after tumor excision. Histology of both masses revealed a bilateral ovarian fibrothecoma, a benign tumor of the ovary, thus confirming the diagnosis of Demons-Meigs’ syndrome. Conclusion. The Demons-Meigs syndrome, although it strongly mimics the clinical picture of malignant metastatic ovarian cancer, remains a disease with benign prognosis after surgical tumor resection. This is a rare condition that must be known and recognized by practitioners to avoid unnecessary practices.

Bilateral Tubal Pregnancy without Known Risk Factor

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Hyacinthe Zamané

2017-01-01

Full Text Available Spontaneous bilateral ectopic gestation is very rare. The authors report a case diagnosed and taken care of at Yalgado Ouedraogo Teaching Hospital, Ouagadougou. It was a 30-year-old patient with no known pathological history. She had presented at the obstetric emergencies with a state of hypovolemic shock by haemoperitoneum with digestive disorders, pelvic pain, vaginal bleeding, and a mention of delayed menstruation. The ultrasound coupled with the urinary immunological pregnancy test confirmed the diagnosis of ruptured ectopic pregnancy and a bilateral form was suspected. A laparotomy in emergency confirmed the diagnosis of bilateral ectopic gestation with a right ampullary unruptured pregnancy and a left isthmic ruptured gestation. A bilateral salpingectomy was performed and counseling was made for the use of medical help of procreation in case of future need of pregnancy.

[Bilateral torticollis].

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Kustos, T; Magdics, M

1993-12-19

Bilateral torticollis is a very rare form of a well known deformity i.e. muscular torticollis. This malformation might present a differential diagnostic problem both for orthopaedic surgeons and ophthalmologists, as well as, for neurologists. In agreement with the literature, the role of an injury during labour or defective embriogenesis is suggested to play a part.

Bilateral optic neuropathy in acute cr yptococcal meningitis

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Qi Zhe Ngoo

2016-11-01

Full Text Available We reported a case of cryptococcal meningitis presenting with bilateral optic neuropathy in an immunocompetent patient. A 64-year-old Malay gentleman with no medical comorbidities presented with acute bilateral blurring of vision for a week, which was associated with generalised throbbing headache and low grade fever. He also had somnolence and altered consciousness. Visual acuity in both eyes was no perception of light with poor pupillary reflexes. Extraocular muscle movements were normal. Anterior segments were unremarkable bilaterally. Fundoscopy revealed bilateral optic disc swelling. CT scan of the brain showed multifocal infarct, but no meningeal enhancement or mass. Cerebrospinal fluid opening pressure was normal, while its culture grew Cryptococcus neoformans. A diagnosis of cryptococcal meningitis with bilateral optic neuropathy was made. Patient was treated with a six-week course of intravenous fluconazole and started concomitantly on a fortnight's course of intravenous amphotericin B. After that, his general condition improved, but there was still no improvement in his visual acuity. On reviewing at two months post-initiation of treatment, fundi showed bilateral optic atrophy. Bilateral optic neuropathy secondary to cryptococcal meningitis was rare. The prognosis was guarded due to the sequelae of optic atrophy. Anti-fungal medication alone may not be sufficient to manage this condition. However, evidence for other treatment modalities is still lacking and further clinical studies are required.

Neglected simultaneous bilateral femoral neck fractures secondary to narcotic drug abuse treated by bilateral one-staged hemiarthroplasty: a case report

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Vahedi Ehsan

2010-06-01

Full Text Available Abstract Simultaneous bilateral femoral neck fractures are extremely rare and associated with various conditions. Up to now Most cases had correlations with major trauma, repetitive minor trauma, seizure, parathyroid or renal dysfunction, anti-epileptic medications, seizure, etc. A 28-year-old addict man referred to us with a 10-year history of narcotic drug abuse and history of 8 months bilateral groin pain. He admitted with displaced bilateral femoral neck fracture. Because of long duration of this condition and osteonecrosis revealed on bone scan, one-staged bilateral hip hemiarthroplasty was done. A good function was noted after surgery to 4-month follow up. Up to now, have not be founded in the literature that a case of bilateral femoral neck fracture associated with narcotic drug abuse. Because of negative effects of opium or smoking on bone tissues, a simple bone pain should aware us about the risk of stress or fatigue fracture.

El endometrio como glándula de secreción interna sinergia utero-ovarica

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Manuel Aristizábal Z.

1946-11-01

Full Text Available Antiguamente durante la era anatómica de la ginecología, pudiéramos decir que toda mujer sin útero había resuelto su problema, basados en la formula hipocrática: "las matrices son la causa de todas las enfermedades de las mujeres". Más tarde al ingresar la ginecología en el periodo que pudiéramos llamar funcional, y al ponerse en evidencia las secreciones internas del ovario, los conceptos se modificaron aclarando esta antigua concepción.

Simultaneous Bilateral Transient Osteoporosis of the Hip without Pregnancy

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Yasuaki Okada

2016-01-01

Full Text Available Transient osteoporosis of the hip (TOH is a rare disorder characterized by acute severe coxalgia and temporary osteopenia in the proximal femur. Although most cases were unilateral or staged bilateral TOH, some authors reported that the pregnant patients simultaneously had TOH in their bilateral hips. However, there has been no report of simultaneous bilateral TOH in the patient without pregnancy. A 25-year-old Japanese woman without pregnancy had acute simultaneous bilateral hip pain. Plain X-ray of the bilateral hips did not show a periarticular osteopenia. However, magnetic resonance image obtained one week after the onset demonstrated increased T2-weighted signal intensity and decreased T1-weighted signal intensity in the bilateral femoral heads. She was treated conservatively, and follow-up magnetic resonance image at seven weeks after the onset returned to normal bone marrow signal intensity. Her bilateral coxalgia subsided gradually. At one year after the onset, she had no sign of symptomatic flair. Our experience with this case indicates that recognizing the possibility of simultaneous bilateral TOH is important unless the patient is pregnant, and magnetic resonance image is predictable test to make a diagnosis of TOH, even in the absence of abnormal finding on plain X-ray.

Estudo sobre a influência de variáveis meteorológicas em internações hospitalares em Maceió-AL, durante o período 1998 a 2006

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Daniel dos Santos

2014-09-01

Full Text Available Foram utilizados dados de insolação, pressão atmosférica, velocidade do vento, temperatura do ar, umidade relativa do ar e precipitação pluviométrica de valores médios mensais do período de 1998 a 2006, de Maceió, objetivando identificar a influência destas variáveis meteorológicas nas internações hospitalares por asma, leptospirose, insuficiência cardíaca, esquistossomose e bronquite aguda. Determinaram-se os coeficientes de internações mensais em hospitais públicos de Maceió, relacionando-os com as variáveis estudadas no período estudado. Calculou-se o coeficiente de correlação de Pearson (r e coeficiente de determinação (r² das variáveis meteorológicas, para saber, o máximo que estes explicam as internações estudadas. O resultado sugere que houve influência das variáveis meteorológicas nos casos de internações por asma, com r² (% de 0% a 9%, bronquite o r² foi de 29% a 55%, para esquistossomose 15% a 45%, insuficiência cardíaca 0% a 11% e leptospirose 14% a 79% .

Pressão interna e refração molar dos sistemas dimetilsulfóxido + tiofeno, dimetilsulfóxido + piridina a 298,15K

OpenAIRE

AZNAREZ, Silvia Beatriz; POSTIGO, Miguel Ángelo; MARTINS, Adair

1999-01-01

Pressão interna, volume livre, refração molar e propriedades termodinâmicas de excesso de misturas líquidas binárias de dimetil sulfóxido + tiofeno e dimetil sulfóxido + piridina a 298.15K foram calculadas a partir de medidas experimentais de densidades, tensão superficial e índice de refração. A relação entre a pressão interna, volume molar de excesso, refração molar, e a interação molecular dos sistemas binários é examinada. Internal pressure, free volume, molar refraction and excess mol...

Bilateral Wilms' tumor

International Nuclear Information System (INIS)

Malcolm, A.W.; Jaffe, N.; Folkman, M.J.; Cassady, J.R.

1980-01-01

Twenty children with bilateral Wilms' tumor were presented to the Children's Hospital Medical Center and Children's Cancer Research Foundation, Sidney Farber Cancer Institute, and Joint Center for Radiation Therapy (CHMC-CCRF, SFCI, JCRT) from January 1, 1956 to December 31, 1976. Of these 20, 16 had simultaneous and 4 had metachronous disease on presentation. All patients were treated with surgery, radiation and chemotherapy. Of the 16 patients with simultaneous disease, 10 (63%) are alive and free of disease 12+ to 175+ months post diagnosis and treatment, with median follow-up of 121 months. There were no long-term survivors in the metachronous group; all were dead of disease within 21 months from initial presentation of original tumor. With these data we relate prognosis to extent of disease and discuss a general approach to the management of bilateral Wilms' tumor

La incidencia delictual para la seguridad interna y el rol del Ministerio Público.

OpenAIRE

Villacís, María Cristina

1999-01-01

La seguridad interna es la garantía proporcionada a la nación, para que esta pueda promover la búsqueda de sus objetivos, a pesar de las divergencias de cualquier índole –externo o interno- o de naturaleza –política, económica, sicosocial o militar –o de forma violenta: subversión, corrupción, tráfico de influencias, infiltración ideológica, dominio económico o disgregación social. Una parte de esta seguridad está asignada al Ministerio Público, al tener dentro de sus funciones, la defensa...

Internações e complicações apresentadas por idosos em hospital de referência em doenças infecciosas.

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Gabriella Xavier Barbalho Mesquita

2015-01-01

Full Text Available Justificativa e Objetivos: A mortalidade por doenças infecciosas vem declinando, entretanto, permanece como um desafio para a Saúde Pública Nacional, devido à persistência de níveis elevados de doenças associadas à pobreza e exclusão social. Deste modo, o objetivo do estudo é identificar as causas de internação dos idosos e as complicações apresentadas em hospital de infectologia do Rio Grande do Norte, Brasil e avaliar o custo financeiro das internações. Métodos: Estudo seccional realizado com idosos internados no Hospital Giselda Trigueiro do ano 2005 a 2010, por meio da análise de prontuários. As variáveis dependentes foram: “consequência da internação” e “custo financeiro”. Foram realizados teste qui-quadrado determinar a associação entre as variáveis e a análise do efeito independente das variáveis intervenientes sobre o desfecho foi realizada através da regressão logística múltipla. Resultados: A idade média foi 72,4 anos e predominaram homens. Diagnósticos prevalentes: Infecção pulmonar não tuberculosa; Infecções de pele e partes moles e Tuberculose pulmonar e extrapulmonar. Na análise múltipla com a variável “consequência da internação”, foram significativas: ventilação mecânica, sonda nasogástrica e entérica, hemorragia digestiva alta e insuficiência renal aguda. Para “custo financeiro”, as variáveis infecção pulmonar não tuberculosa, tuberculose pulmonar e extrapulmonar, sonda vesical de demora e ventilação mecânica permaneceram significativas. Conclusões: O predomínio de infecções respiratórias aponta para a necessidade de medidas preventivas que devem ocorrer no nível da atenção primária à saúde e consequentemente reduzindo a demanda pela atenção especializada. DESCRITORES: Idoso; Hospitalização; Saúde do Idoso; Custos hospitalares; Doenças transmissíveis.

Simultaneous bilateral patellar tendon rupture ?

OpenAIRE

Moura, Diogo Lino; Marques, Jos? Pedro; Lucas, Francisco Manuel; Fonseca, Fernando Pereira

2016-01-01

Bilateral patellar tendon rupture is a rare entity, often associated with systemic diseases and patellar tendinopathy. The authors report a rare case of a 34-year-old man with simultaneous bilateral rupture of the patellar tendon caused by minor trauma. The patient is a retired basketball player with no past complaints of chronic knee pain and a history of steroid use. Surgical management consisted in primary end-to-end tendon repair protected temporarily with cerclage wiring, followed by a s...

Maxillary arch width in unoperated adult bilateral cleft lip and alveolus and complete bilateral cleft lip and palate.

NARCIS (Netherlands)

Latief, B.S.; Lekkas, C.; Kuijpers, M.A.R.

2010-01-01

OBJECTIVES: To study maxillary arch width in adult patients with bilateral cleft lip and alveolus (BCLA) or with complete bilateral cleft lip and palate (BCLP), who have not had any surgery. SETTING AND SAMPLING POPULATION: Eighteen patients with BCLA, 13 patients with BCLP, and 24 controls from

Bilateral ovarian tumour in a young girl | Govindarajan | African ...

African Journals Online (AJOL)

Bilateral ovarian tumour in a girl presents the dilemma of conservative versus aggressive approach towards these tumours. When faced with suspicious tumour and complete replacement of the ovaries bilaterally, bilateral oophorectomy is a viable option, though the certain possibility of infertility and lifelong hormonal ...

Bilateral elastofibroma dorsi: A case report

OpenAIRE

Molini, L.; Ciortan, E.; Bianchi, S.

2010-01-01

Elastofibroma dorsi is a rare pseudotumoral lesion located in the periscapular region. Ultrasound can be used to evaluate its dimensions, margins, and internal structure. In the presence of bilateralism, diagnosis can be made on the basis of clinical and sonographic findings. The authors present a case of bilateral elastofibroma dorsi in which the clinical and ultrasound diagnosis was confirmed by magnetic resonance imaging.

Unusual Presentation of Recurrent Pyogenic Bilateral Psoas Abscess Causing Bilateral Pulmonary Embolism by Iliac Vein Compression

OpenAIRE

Ijaz, Mohsin; Sakam, Sailaja; Ashraf, Umair; Marquez, Jose Gomez

2015-01-01

Patient: Male, 47 Final Diagnosis: Bilateral psoas abscess • acute lower extremity deep vein thrombosis • bilateral pulmonary embolism Symptoms: Progressive left leg swelling • productive cough with whitish sputum • right flank pain Medication: Antibiotics and anticoagulation Clinical Procedure: CT-guided percutaneous drain placement Specialty: Internal Medicine/Critical Care Objective: Unusual presentation Background: Psoas abscesses are a known cause of back pain, but they have not been rep...

Bilateral acute iris transillumination: Case report

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Cumali Degirmenci

2016-04-01

Full Text Available Bilateral acute iris transillumination (BAIT is a recently defined disease characterized with bilateral acute, severe pigment dispersion of iris and pupil sphincter paralysis. The etiopathogenesis of the disease is unknown, but antibiotics such as moxifloxacin, clarithromycin, viral infections, and fumigation therapies were considered as probable etiologic factors. A 33-year-old female was referred to our clinic for acute iridocyclitis refractory to azathioprine, colchicum and corticosteroid treatments. Ophthalmic examination revealed bilateral pigment dispersion, significant iris transillumination, heavy pigment deposition in iridocorneal angle, and elevated intraocular pressure. Upon systemic evaluation she was found to have bacterial urinary tract infection. BAIT is an important cause of pigment dispersion and clinicians must be vigilant for this condition to avoid unnecessary diagnostic tests and treatment.

Migración interna indígena desde el Istmo veracruzano: nuevas articulaciones regionales

OpenAIRE

Velázquez-Hernández, Emilia

2013-01-01

El objetivo de este trabajo es analizar las nuevas articulaciones regionales que se crean a través de las migraciones internas. Para ello, se toma como estudio de caso las migraciones que desde mediados de la década de 1990 se realizan desde el Istmo veracruzano hacia la frontera norte de México y los campos de agricultura intensiva de Sinaloa. Se muestra que, a través de la migración laboral de trabajadores nahuas y popolucas de la Sierra de Santa Marta, regiones antes inconexas se articulan...

MOTORES DE COMBUSTIÓN INTERNA (MCI) OPERANDO CON MEZCLAS DE ETANOL GASOLINA: REVISIÓN

OpenAIRE

Alexander García Mariaca; Edwin Darío Cendales Ladino; Andrés Felipe Eslava Sarmiento

2016-01-01

En este artículo se presenta una revisión bibliográfica acerca del uso de etanol como combustible en motores de combustión interna de encendido provocado (MCI-EP). Este empieza por una breve descripción de las diversas formas de producción y principales productores en el mundo de etanol, para posteriormente profundizar en el desempeño, combustión y las emisiones en MCIEP al operar con diferentes mezclas de etanol y gasolina convencional. Los resultados obtenidos por los diferentes autores de ...

MOTORES DE COMBUSTIÓN INTERNA (MCI) OPERANDO CON MEZCLAS DE ETANOL GASOLINA: REVISIÓN

OpenAIRE

Garcia Mariaca, Alexander; Cendales Ladino, Edwin Darío; Eslava Sarmiento, Andrés Felipe

2016-01-01

En este artículo se presenta una revisión bibliográfica acerca del uso de etanol como combustible en motores de combustión interna de encendido provocado (MCI-EP). Este empieza por una breve descripción de las diversas formas de producción y principales productores en el mundo de etanol, para posteriormente profundizar en el desempeño, combustión y las emisiones en MCI-EP al operar con diferentes mezclas de etanol y gasolina convencional. Los resultados obtenidos por los diferentes autores de...

Infectious mononucleosis presenting as bilateral acute dacryocystitis.

Science.gov (United States)

Atkinson, P L; Ansons, A M; Patterson, A

1990-01-01

A case of infectious mononucleosis presenting as bilateral acute dacryocystitis in a 7-year-old girl is reported. Acute dacryocystitis is uncommon in this age group, and an underlying systemic illness should be suspected particularly when it is bilateral. Images PMID:2275940

Similarity in Bilateral Isolated Internal Orbital Fractures.

Science.gov (United States)

Chen, Hung-Chang; Cox, Jacob T; Sanyal, Abanti; Mahoney, Nicholas R

2018-04-13

In evaluating patients sustaining bilateral isolated internal orbital fractures, the authors have observed both similar fracture locations and also similar expansion of orbital volumes. In this study, we aim to investigate if there is a propensity for the 2 orbits to fracture in symmetrically similar patterns when sustaining similar trauma. A retrospective chart review was performed studying all cases at our institution of bilateral isolated internal orbital fractures involving the medial wall and/or the floor at the time of presentation. The similarity of the bilateral fracture locations was evaluated using the Fisher's exact test. The bilateral expanded orbital volumes were analyzed using the Wilcoxon signed-rank test to assess for orbital volume similarity. Twenty-four patients with bilateral internal orbital fractures were analyzed for fracture location similarity. Seventeen patients (70.8%) had 100% concordance in the orbital subregion fractured, and the association between the right and the left orbital fracture subregion locations was statistically significant (P < 0.0001). Fifteen patients were analyzed for orbital volume similarity. The average orbital cavity volume was 31.2 ± 3.8 cm on the right and 32.0 ± 3.7 cm on the left. There was a statistically significant difference between right and left orbital cavity volumes (P = 0.0026). The data from this study suggest that an individual who suffers isolated bilateral internal orbital fractures has a statistically significant similarity in the location of their orbital fractures. However, there does not appear to be statistically significant similarity in the expansion of the orbital volumes in these patients.

Modelo matemático de tipo valor medio de un motor de combustión interna y estimación de estados usando técnicas Bayesianas

OpenAIRE

Hernández Lordui, Mónica Patricia

2013-01-01

En el presente trabajo se obtiene el modelo matemático orientado al control de un motor de combustión interna de ignición por chispa. El modelo aplica ecuaciones de primeros principios con no-linealidades y parámetros desconocidos. Las ecuaciones aplicadas al modelo están explicadas mediante relaciones termodinámicas conocidas en la literatura como \\Mean Value Engine Modelling" (MVEM). La MVEM describe un modelo matemático orientado al control para las máquinas de combustión interna de ignici...

Características epidemiológicas de la neumonía intrahospitalaria en un servicio de medicina interna del Hospital Guillermo Almenara Irigoyen de Lima, Perú

OpenAIRE

León-Chahua, César; Hospital Nacional Guillermo Almenara Irigoyen-EsSalud, Lima.; Oscanoa-Espinoza, Teodoro; Hospital Nacional Guillermo Almenara Irigoyen-EsSalud, Lima.; Chávez-Gutiérrez, Cynthia; Facultad de Medicina, Universidad San Martín de Porres, Lima.; Chávez-Gutiérrez, José; Facultad de Medicina, Universidad San Martín de Porres, Lima.

2016-01-01

Objetivo: Determinar las características epidemiológicas de los pacientes con neumonía intrahospitalaria (NIH) en un servicio de medicina interna.Material y métodos: Estudio descriptivo, retrospectivo; llevado a cabo en el servicio de medicina interna Nº 5 del Hospital Nacional Guillermo Almenara Irigoyen (HNGAI) durante el año 2015. Se revisaron las historias clínicas de pacientes mayores de 15 años con el diagnóstico de egreso de NIH que cumplieron los criterios de selección.Resultados: Se ...

O efeito do status de sobrevivência sobre gastos com internações hospitalares públicas no Brasil em uma perspectiva temporal

Directory of Open Access Journals (Sweden)

Cristina Guimarães Rodrigues

2012-09-01

Full Text Available As projeções de gastos com saúde apontam para um crescimento considerável das despesas em decorrência do envelhecimento populacional. No entanto, estudos mostram que os gastos se concentram no fim da vida e, dessa forma, projeções que não levam em conta variáveis de proximidade à morte tendem a superestimar as projeções. O objetivo deste trabalho é analisar a magnitude dos gastos com internações públicas no Brasil por status de sobrevivência, e identificar se existe uma relação entre despesas com internações para indivíduos próximos à morte e idade à morte. O banco de dados empregado é oriundo do Sistema de Informações Hospitalares do DATASUS - SIH/DATASUS - para o período de 1995 a 2007 no Brasil. Foi analisada a evolução dos gastos totais e a tendência dos gastos por grupo etário para aqueles pacientes que tiveram como motivo de saída do hospital a alta (sobreviventes ou o óbito (pacientes terminais. A fim de analisar o efeito do status de sobrevivência sobre os gastos com internações no futuro, simulamos projeções de gastos em 2050, desagregados entre gastos de sobreviventes e gastos relacionados à morte. Os resultados mostram que o padrão de gastos por status de sobrevivência no Brasil é crescente por grupo etário para o grupo de sobreviventes, e decrescente para os indivíduos que faleceram. Também se verificou que a razão de gastos mortos/sobreviventes diminui com a idade. A simulação da projeção de gastos com internações para 2050 mostra que quando se considera apenas o perfil etário dos gastos médios em 2007, há um crescimento de mais de 380% nos gastos com internações em 2050 quando comparado a 2007, mas quando os gastos são projetados segundo o status de sobrevivência, o crescimento não passa de 70%. Projeção retrospectiva para 2007 mostra que o efeito do envelhecimento é menor quando o efeito da proximidade à morte é levado em consideração. Os resultados parecem

Bilateral locked facets in the thoracic spine

NARCIS (Netherlands)

M.H.A. Willems; Braakman, R. (Reinder); B. van Linge (Bert)

1984-01-01

textabstractTwo cases of traumatic bilateral locked facets in the thoracic spine are reported. Both patients had only minor neurological signs. They both made a full neurological recovery after surgical reduction of the locked facets. Bilateral locked facets are very uncommon in the thoracic spine.

Fibromuscular Dysplasia Presenting with Bilateral Renal Infarction

International Nuclear Information System (INIS)

Doody, O.; Adam, W. R.; Foley, P. T.; Lyon, S. M.

2009-01-01

Fibromuscular dysplasia (FMD) describes a group of conditions which cause nonatheromatous arterial stenoses, most commonly of the renal and carotid arteries, typically in young women. We report a rare case of bilateral segmental renal infarction secondary to FMD in a young male patient. His initial presentation with loin pain and pyrexia resulted in a delay in the definitive diagnosis of FMD. He was successfully treated with bilateral balloon angioplasty. The delayed diagnosis in this patient until the condition had progressed to bilateral renal infarcts highlights the need for prompt investigation and diagnosis of suspected cases of FMD.

Recurrent Bilateral Breast Abscesses after Sternotomy

Directory of Open Access Journals (Sweden)

Hamza Cinar

2012-01-01

Full Text Available Median sternotomy is the most commonly used incision in cardiothoracic procedures. Development of breast abscess after sternotomy is a very rare situation. We present a case of sternal wound infection with recurrent bilateral breast abscess after sternotomy. Our case is the first and only case in the literature due to the presence of sternal wound infection with recurrent bilateral breast abscess after sternotomy.

Bilateral agreements

International Nuclear Information System (INIS)

Anon.

2004-01-01

The bilateral agreements concern Brazil with United States relative to the co operation in nuclear energy, Germany with Russian Federation relative to the elimination and disposal of nuclear weapons; The multilateral agreements concerns the signature of the Protocols to amend the Paris and Brussels Conventions, the multilateral nuclear environmental programme in the Russian Federation, the status of Conventions in the field of nuclear energy. (N.C.)

A importância da auditoria interna para uma gestão eficiente e eficaz em instituições hospitalares do setor público

OpenAIRE

Duarte, Mariana da Silva

2017-01-01

Versão final (Esta versão contém as críticas e sugestões dos elementos do júri) Na evolução das organizações as instituições hospitalares estão sujeitas a várias pressões, quer internas quer externas, pelo que são cada vez mais necessárias as atividades de auditoria interna de suporte à gestão que permitam atingir os seus objetivos. Uma vez que o serviço hospitalar se insere num ”mundo” complexo e de enorme dificuldade no que se refere à aquisição de um serviço de excelência...

Bilateral Simultaneous Macular Infarction with Spontaneous Visual ...

African Journals Online (AJOL)

To report the rare and dramatic event of bilateral macular infarction in a sickle cell hemoglobinopathy (SS genotype) patient, resulting in bilateral severe reduction in visual acuity. Without any intervention, the patient's vision gradually improved over the follow‑up period. Central visual field defects however persisted.

Noise reduction with complex bilateral filter.

Science.gov (United States)

Matsumoto, Mitsuharu

2017-12-01

This study introduces a noise reduction technique that uses a complex bilateral filter. A bilateral filter is a nonlinear filter originally developed for images that can reduce noise while preserving edge information. It is an attractive filter and has been used in many applications in image processing. When it is applied to an acoustical signal, small-amplitude noise is reduced while the speech signal is preserved. However, a bilateral filter cannot handle noise with relatively large amplitudes owing to its innate characteristics. In this study, the noisy signal is transformed into the time-frequency domain and the filter is improved to handle complex spectra. The high-amplitude noise is reduced in the time-frequency domain via the proposed filter. The features and the potential of the proposed filter are also confirmed through experiments.

Prognosis of synchronous bilateral breast cancer

DEFF Research Database (Denmark)

Holm, Marianne; Tjønneland, Anne; Balslev, Eva

2014-01-01

Currently, no consistent evidence-based guidelines for the management of synchronous bilateral breast cancer (SBBC) exist and it is uncertain how presenting with SBBC affects patients' prognosis. We conducted a review of studies analyzing the association between SBBC and prognosis. The studies...... that reported adjusted effect measures were included in meta-analyses of effect of bilaterality on breast cancer mortality. From 57 initially identified records 17 studies from 11 different countries including 8,050 SBBC patients were included. The quality of the studies varied but was generally low with small...... sample sizes, and lack of consistent, detailed histo-pathological information. When doing meta-analysis on the subgroup of studies that provided adjusted effect estimates on breast cancer mortality (nine studies including 3,631 SBBC cases), we found that bilaterality in itself had a negative impact...

Bilateral Medial Medullary Infarction with Nondominant Vertebral Artery Occlusion.

Science.gov (United States)

Zhang, Lei; Zhang, Gui-lian; Du, Ju-mei; Ma, Zhu-lin

2015-09-01

Bilateral medial medullary infarction (MMI) is a rare stroke subtype. Here, we report a case with bilateral MMI caused by nondominant vertebral artery occlusion confirmed by brain digital subtraction angiography and magnetic resonance imaging basi-parallel-anatomical-scanning. We highlight that anterior spinal arteries could originate from a unilateral vertebral artery (VA). Radiologists and neurologists should pay attention to the nondominant VA as bilateral MMI may be induced by occlusion of nondominant VA that supplies the bilateral anteromedial territories of the medulla. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

EXERTIONAL RHABDOMYOLYSIS OF THE BILATERAL ADDUCTOR MAGNUS

Directory of Open Access Journals (Sweden)

Tolga Saka

2007-12-01

Full Text Available We present a case study of a person (63 year-old man, who has been using statins for 18 years, with rhabdomyolysis of the bilateral adductor muscles associated with strenuous and prolonged eccentric exercises (hiking in a hot environment. Clinical examination showed predominantly on the right side muscle swelling and palpational pain of the bilateral adductor muscle groups and bilateral tibial edema. His serum creatine kinase (CK level was 12218 IU/L. T2-weighted magnetic resonance (MR images showed a high signal intensity in the bilateral adductor muscles of the hip. The patient did not develop complications and returned to his previous performance level in 30 days following adequate hydration and resting of the affected muscles. Strenuous eccentric exercise should be avoided during the course of statin use and clinicians should be aware of present observations when considering the significance of acute CK elevations in patients on statin treatment

Bilateral nasolabial cysts associated with recurrent dacryocystitis.

Science.gov (United States)

Kyrmizakis, Dionysios E; Lachanas, Vassilios A; Benakis, Antonios A; Velegrakis, George A; Aslanides, Ioannis M

2005-05-01

Nasolabial cysts are rare, nonodontogenic, soft-tissue, developmental cysts occurring inferior to the nasal alar region. They are thought to arise from remnants of the nasolacrimal ducts and they are frequently asymptomatic. We report a rare case of bilateral nasolabial cysts accompanied by bilateral chronic dacryocystitis. A 48-year-old woman suffering from bilateral chronic dacryocystitis was referred to our department for endonasal dacryocystorhinostomy. She had undergone external dacryocystorhinostomy on the left side a few years earlier. Physical examination and computed tomography scan revealed nasolabial cysts bilaterally inferior to the nasal alar region. The cysts were removed via a sublabial approach and endoscopic dacryocystorhinostomy was performed on the right side. Ten months after surgery, the patient was asymptomatic. There may be a correlation, due to embryological reasons, between the presence of nasolabial cysts and the presence of chronic dacryocystitis. Both can be corrected surgically, under the same anaesthesia, without visible scar formation.

Internações por complicações obstétricas na gestação e desfechos maternos e perinatais, em uma coorte de gestantes no Sistema Único de Saúde no Município de São Paulo, Brasil

Directory of Open Access Journals (Sweden)

Barbara Laisa Alves Moura

2018-02-01

Full Text Available A morbidade materna, a mortalidade neonatal e a mortalidade fetal são importantes indicadores da saúde materna infantil. O estudo tem por objetivo descrever desfechos maternos e perinatais (baixo peso ao nascer, prematuridade, óbito fetal e neonatal, internações pós-parto e readmissão dos recém-nascidos de uma coorte de gestantes cujos partos foram financiados pelo Sistema Único de Saúde (SUS no Município de São Paulo, Brasil, no segundo semestre de 2012. Foi obtida uma coorte retrospectiva de 55.404 gestantes com vinculação (determinística e probabilística das informações do Sistema de Informações Hospitalares do SUS (SIH/SUS, Sistema de Informações sobre Nascidos Vivos (SINASC, Sistema de Informações sobre Mortalidade (SIM e Cadastro Nacional de Estabelecimentos de Saúde (CNES. Internações por complicações obstétricas da gestação ocorreram em 4,3% das gestantes. Diagnósticos mais frequentes foram: infecções, doenças hipertensivas e diabetes. As internações prévias ao parto foram mais frequentes nas gestantes a partir de 35 anos, de gestações múltiplas e com baixa escolaridade. As internações das gestantes no pós-parto foram 3 vezes maior e a mortalidade materna 9 vezes maior entre as gestantes com internação prévia por complicações obstétricas. Os desfechos perinatais (mortalidade fetal e neonatal, prematuridade e baixo peso ao nascer foram 2 vezes mais frequentes entre os conceptos de gestantes com internação prévia que aquelas sem internação. Comportamento semelhante foi encontrado com relação à internação dos recém-nascidos logo após o parto e na readmissão hospitalar. Desfechos maternos e perinatais negativos foram mais frequentes em gestantes com internação prévia ao parto.

The behavioral implications of the bilateral gamma process

Science.gov (United States)

Xie, Haibin; Wang, Shouyang; Lu, Zudi

2018-06-01

Bilateral gamma process is widely used in risk management and asset pricing. However the behavioral implications of this process remain unknown. This paper investigates this problem for the first time within the framework of Tauchen and Pitts (1983). With the assumption that there are two types of traders in the market, the optimistic and the pessimistic, we find the bilateral gamma process can be derived from Walrasian equilibrium. This finding establishes the microstructure foundations for the bilateral gamma process.

[Atypical etiology of rhinorrhea: spontaneous bilateral temporal encephalocele].

Science.gov (United States)

Lorente Muñoz, Asís; Lisbona Alquézar, María Pilar; González Martínez, Luis; Sevil Navarro, Jorge; Llorente Arenas, Eva María

2012-01-01

Spontaneous herniation of brain parenchyma through a dural and osseous defect in the temporal bone is a rare entity and a bilateral form is even more infrequent. It usually presents as an intermittent but persistent otorrhea. Manifestation as nose cerebrospinal fluid (CSF) leak is very uncommon. Our objective is presenting this unusual case report of a spontaneous bilateral encephalocele with a bilateral tegmen tympani defect. Copyright © 2010 Elsevier España, S.L. All rights reserved.

Bilateral cerebellar activation in unilaterally challenged essential tremor

Directory of Open Access Journals (Sweden)

Marja Broersma

2016-01-01

Conclusions: Our results expand on previous findings of bilateral cerebellar involvement in ET. We have identified specific areas in the bilateral somatomotor regions of the cerebellum: lobules V, VI and VIII.

Bilateral calcaneal epiphysiolysis in a dog.

Science.gov (United States)

Font, J; Pèlach, M; Font, C; Cairo, J

2013-01-01

A case of bilateral calcaneal epiphysiolysis in a six-month-old female Dobermann Pinscher is described in this report. The absence of a traumatic event and the clinical, radiographic and histopathological abnormalities led us to the diagnosis of simultaneous bilateral epiphysiolysis of the calcaneus. A tension band and a type II transarticular external fixator were placed. The clinical signs were resolved only temporarily because of the gravity of the bone changes.

Bilateral Ramsay Hunt syndrome in a diabetic patient

Directory of Open Access Journals (Sweden)

Goyal Amit

2004-12-01

Full Text Available Abstract Background Herpes zoster oticus accounts for about 10% cases of facial palsy, which is usually unilateral and complete and full recovery occurs in only about 20% of untreated patients. Bilateral herpes zoster oticus can sometime occur in immunocompromised patients, though incidence is very rare. Case presentation Diabetic male, 57 year old presented to us with bilateral facial palsy due to herpes zoster oticus. Patient was having bilateral mild to moderate sensorineural hearing loss. Patient was treated with appropriate metabolic control, anti-inflammatory drugs and intravenous acyclovir. Due to uncontrolled diabetes, glucocorticoids were not used in this patient. Significant improvement in hearing status and facial nerve functions were seen in this patient. Conclusions Herpes zoster causes severe infections in diabetic patients and can be a cause of bilateral facial palsy and bilateral Ramsay Hunt syndrome. Herpes zoster in diabetic patients should be treated with appropriate metabolic control, NSAIDS and intravenous acyclovir, which we feel should be started at the earliest. Glucocorticoids should be avoided in diabetic patients.

Vasculitis asociadas a anticuerpos anti-citoplasma de neutrófilos: Clínica y tratamiento

Directory of Open Access Journals (Sweden)

María Virginia Paolini

2013-04-01

Full Text Available Las vasculitis asociadas a anticuerpos anti-citoplasma de neutrófilos (ANCA comprenden a un grupo de enfermedades caracterizadas por la inflamación de la pared de pequeños vasos. Analizamos las características epidemiológicas y clínicas en una serie de 47 pacientes: 23 (49% granulomatosis de Wegener (GW, 15 (32% poliangeítis microscópica (PAM y nueve (19% vasculitis limitada al riñón (VLR. La edad media al inicio de los síntomas fue de 50.7 ± 14.9 años. La manifestación clínica más frecuente fue el compromiso renal en 41 (87% pacientes, seguido por el pulmonar en 26 (55% y el otorrinolaringológico en 17 (36%. En 26 (55% se asoció compromiso renal y pulmonar. La forma clínica más frecuente fue la generalizada en 23 (49%, seguida por la grave en 18 (38%. El 89% presentaron determinaciones de ANCA positivas. Cuatro (8% no recibieron tratamiento inmunosupresor de inicio. De los 43 que recibieron tratamiento de inicio, 29 (67% tuvieron remisión completa, con un tiempo de remisión promedio de 35.3 meses. Once (26% presentaron recaídas, diez (91% recaídas mayores y uno (9% menor. Doce (28% fallecieron, siete en forma temprana y cinco durante la evolución de la enfermedad. Quince (31% evolucionaron a insuficiencia renal crónica. Los 26 pacientes en seguimiento tuvieron respuesta al tratamiento y 20 (77% de ellos estaban en remisión al finalizar el estudio. Las vasculitis asociadas a ANCA continúan siendo enfermedades de alta morbilidad y mortalidad, a pesar de las mejorías logradas con los tratamientos inmunosupresores.

Bilateral Giant Retinal Tear and Sequential Vitrectomy.

Science.gov (United States)

Mustapha, Mushawiahti; Roufail Franzco, Edward

2017-01-01

To describe the excellent outcome of surgery for bilateral giant retinal tears (GRTs) with better options of endotamponade. This is a case report of a 62-year-old man who presented with bilateral GRTs and associated retinal detachment. The tear in the right eye was supero-temporal and silicone oil was used as an endotamponade. The tear in the left eye was infero-temporal and perfluorocarbon liquid was used as an endotamponade. The outcome at 6 months after surgery was excellent with visual acuities of 6/6 in both eyes. Improved availability of endotamponade agents allows repair of bilateral GRTs to be done at the same time, with good surgical outcomes.

Simultaneous bilateral cataract surgery: economic analysis; Helsinki Simultaneous Bilateral Cataract Surgery Study Report 2.

Science.gov (United States)

Leivo, Tiina; Sarikkola, Anna-Ulrika; Uusitalo, Risto J; Hellstedt, Timo; Ess, Sirje-Linda; Kivelä, Tero

2011-06-01

To present an economic-analysis comparison of simultaneous and sequential bilateral cataract surgery. Helsinki University Eye Hospital, Helsinki, Finland. Economic analysis. Effects were estimated from data in a study in which patients were randomized to have bilateral cataract surgery on the same day (study group) or sequentially (control group). The main clinical outcomes were corrected distance visual acuity, refraction, complications, Visual Function Index-7 (VF-7) scores, and patient-rated satisfaction with vision. Health-care costs of surgeries and preoperative and postoperative visits were estimated, including the cost of staff, equipment, material, floor space, overhead, and complications. The data were obtained from staff measurements, questionnaires, internal hospital records, and accountancy. Non-health-care costs of travel, home care, and time were estimated based on questionnaires from a random subset of patients. The main economic outcome measures were cost per VF-7 score unit change and cost per patient in simultaneous versus sequential surgery. The study comprised 520 patients (241 patients included non-health-care and time cost analyses). Surgical outcomes and patient satisfaction were similar in both groups. Simultaneous cataract surgery saved 449 Euros (€) per patient in health-care costs and €739 when travel and paid home-care costs were included. The savings added up to €849 per patient when the cost of lost working time was included. Compared with sequential bilateral cataract surgery, simultaneous bilateral cataract surgery provided comparable clinical outcomes with substantial savings in health-care and non-health-care-related costs. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

La conformación de una frontera interna en las riberas del Tesechoacán

OpenAIRE

Hoffmann , Odile; Palma , Rafael

2009-01-01

El capítulo trata de visualizar la lenta construcción regional en el Sur veracruzano, subrayando aquellos procesos históricos que intervienen en la configuración del municipio de Playa Vicente hasta llegar a su singular geografía actual. La diferenciación intra-regional fue un motor muy importante para los variados pulsos de colonización, esfuerzos que terminaron por incidir en las distinciones internas que hoy privan en el municipio: distinciones entre espacios poblados de otros despoblados,...

Auditoria interna de sistema de gestão ambiental: estudo de caso no Verdegreen Hotel

OpenAIRE

Adriano Lucena da Silva; Isaiane Vieira de Melo; Diego Rodrigues de Lucena

2017-01-01

Esta pesquisa analisa as contribuições e os desafios associados às auditorias internas no Verdegreen Hotel, empreendimento hoteleiro de grande destaque na cidade de João Pessoa-PB, selecionado como unidade de estudo por dispor de um Sistema de Gestão Ambiental (SGA) ISO 14001 implantado e certificado. Este estudo trata de uma pesquisa descritiva, baseada em um estudo de caso qualitativo. As técnicas utilizadas na metodologia foram: levantamento bibliográfico sobre as normas ISO que abordam as...

Bilateral tumors of the upper urothelium

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Đokić Milan

2006-01-01

Full Text Available Introduction: The incidence of tumors of the upper urothelium is high in our country, apart from their relation to specific regions (BEN and PBEN and their frequent bilateralism. Bilateral forms are present in significant percentage and are followed, in most cases, by renal failure, which speaks in favor of conservative surgery, if possible. Objective: The aim of the study was to present epidemiological, pathoanatomical and clinical characteristics of bilateral tumors of the upper urothelium and evaluate the Results of their treatment. Method: Our retrospective study analyzed 12 patients with bilateral tumors of the upper urothelium who were treated in the period from 1992 to 1996, according to their epidemiological, clinical, pathoanatomical and pathohistological characteristics, type of surgical treatment and relevant success. Results: In the observed period, bilateral tumors of the upper urothelium were found in 8.2% of our patients. In the group of 12 patients, 5 females and 7 males, 11 cases were from the region of Balkan Endemic Nephropathy (BEN. Renal failure was recorded in high percentage (66%. Radical surgical treatment - total nephroureterectomy was performed in 9 kidney units, and conservative operation in 15 units. Relapse significantly depended on tumor stage and grade, not on type of surgical treatment in the majority of cases. Five-year survival was 58.33%; major cause of death was associated with further evolution of tumor, recurrence and tumor dissemination, respectively, while renal failure complications were the cause of death in one case. Conclusion: The success of treatment mainly depends on tumor stage and grade and not on type of surgical Method in conservative treatment, but renal failure and its complications are an important risk factor in these patients.

Pathogenesis and prognosis of bilateral thalamic infarction

International Nuclear Information System (INIS)

Nakase, Taizen; Ogura, Naoko; Maeda, Tetsuya; Yamazaki, Takashi; Kameda, Tomoaki; Sato, Yuichi; Nagata, Ken

2008-01-01

Only a few reports have discussed the detailed clinical symptoms and pathogenesis of bilateral thalamic infarction. The thalamus is composed of different functional nuclei and supplied by vessels containing several variations from the main arteries, leading to difficulty in the precise evaluation of bilateral thalamic infarction. In the present study, we assessed the prognosis of bilateral thalamic infarction based on the distribution of stroke lesions. From among the consecutive ischemic stroke patients admitted to hospital between April 2001 and March 2005, cases of acute bilateral thalamic infarction were selected for this study (n=9; 65.1±13.6 y.o.). The stroke lesions and vascular abnormalities were investigated by magnetic resonance imaging and magnetic resonance angiography on admission. Outcome was evaluated from the modified Rankin scale (mRS) at discharge. Good outcome patients (mRS 0-2; n=5) showed memory disturbance, cognitive impairment and hypersomnia. On the other hand, quadriplegia, oculomotor disturbance and bulbar palsy were observed in the poor outcome patients (mRS≥4; n=4). The critical features of a poor outcome were the age at onset (72.0±15.3 vs. 58.2±11.9 y.o.), inclusion of brainstem lesions and total occlusion of the basilar artery. In conclusion, older age at onset and/or basilar artery occlusion may be critical factors for predicting a poor outcome in bilateral thalamic infarction cases. (author)

Danish Exports and Danish Bilateral Aid

DEFF Research Database (Denmark)

Hansen, Henrik; Rand, John

higher in the 1980s compared to in particular the most recent decade. This may be related to factors such as untying of aid in the same period. The econometric analysis has two important limitations. First of all, the model can only give information about marginal changes in aid. As a decision to give...... and trade policies. The main result of the study is that Danish bilateral aid has a positive and statistically significant impact on Danish exports to the recipient countries. Bilateral development assistance may affect exports through several channels. Three of the main channels are direct aid tying......; increasing recipient income where higher income leads to higher imports, and decreased trade costs, say due to improved information about cultural and administrative customs and practices. Thus, as for preferential trade arrangements, bilateral aid has two potential economic effects; trade creation working...

Bilateral movements increase sustained extensor force in the paretic arm.

Science.gov (United States)

Kang, Nyeonju; Cauraugh, James H

2018-04-01

Muscle weakness in the extensors poststroke is a common motor impairment. Unfortunately, research is unclear on whether bilateral movements increase extensor force production in the paretic arm. This study investigated sustained force production while stroke individuals maximally extended their wrist and fingers on their paretic arm. Specifically, we determined isometric force production in three conditions: (a) unilateral paretic arm, (b) unilateral nonparetic arm, and (c) bilateral (both arms executing the same movement simultaneously). Seventeen chronic stroke patients produced isometric sustained force by executing wrist and fingers extension in unilateral and bilateral contraction conditions. Mean force, force variability (coefficient of variation), and signal-to-noise ratio were calculated for each contraction condition. Analysis of two-way (Arm × Type of Condition: 2 × 2; Paretic or Nonparetic Arm × Unilateral or Bilateral Conditions) within-subjects ANOVAs revealed that the bilateral condition increased sustained force in the paretic arm, but reduced sustained force in the nonparetic arm. Further, although the paretic arm exhibited more force variability and less signal-to-noise ratio than the nonparetic arm during a unilateral condition, there were no differences when participants simultaneously executed isometric contractions with both arms. Our unique findings indicate that bilateral contractions transiently increased extensor force in the paretic arm. Implications for Rehabilitation Bilateral movements increased isometric wrsit extensor force in paretic arms and redcued force in nonparetic arms versus unilateral movements. Both paretic and nonparetic arms produced similar force variability and signal-to-noise ratio during bilateral movements. Increased sustained force in the paretic arm during the bilateral condition indicates that rehabilitation protocols based on bilateral movements may be beneficial for functional recovery.

Coexistence of bilateral first and second branchial arch anomalies

Science.gov (United States)

Thakur, J S; Shekar, Vidya; Saluja, Manika; Mohindroo, N K

2013-01-01

Branchial arch anomalies are one of the most common congenital anomalies that are usually unilateral and bilateral presentation is rare. The simultaneous presence of bilateral second branchial arch anomalies along with bilateral first arch anomalies is extremely rare, with only three such cases reported in the literature. We present two non-syndromic cases of coexisting bilateral first and second arch anomalies. Developmental anomalies of the branchial apparatus account for 17% of all paediatric cervical masses and are the most common type of congenital cervical mass. They usually present in the paediatric age group. About 96–97% of these anomalies are unilateral. Bilateral presentation is seen in 2–3% having a strong familial association. Congenital syndromes also have been associated with first and second branchial arch anomalies. Thorough clinical examination and investigations should be done to rule out these syndromes. PMID:23580675

Internação domiciliar: o perfil dos pacientes assistidos pelo Programa HU em Casa Home care: profile of patients attended by a home care program

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Daniella Reis Barbosa Martelli

2011-01-01

Full Text Available Internação domiciliar é uma modalidade de atendimento à saúde que está se transformando em uma alternativa importante para minimizar alguns dos principais problemas inerentes aos sistemas de saúde vigentes, especialmente os da rede pública. O objetivo do estudo foi descrever o perfil sociodemográfico e clínico da população assistida pelo Programa de Internação Domiciliar (PID HU em Casa do Hospital Universitário Clemente de Faria da Universidade Estadual de Montes Claros. O estudo foi descritivo e retrospectivo por meio da análise de prontuários, realizada de maio de 2005 a maio de 2008. Foram analisados 137 pacientes, sendo 75 do gênero feminino (54,7% e 62 do masculino (45,3%. O grupo de 61 a 80 anos foi mais prevalente (37,2% e 73% dos pacientes residiam em bairros periféricos do município de Montes Claros-MG. Dos agravos mais comuns na primeira internação, a pneumonia foi prevalente, 22 casos (16,1%. A maioria dos pacientes foi encaminhada ao PID pela clinica médica (84,7%, com intervalo de maior prevalência de duas a três internações (42,4%. Do total de pacientes, 120 (87,6% permaneceram internados por 16 a 30 dias e 51,8% não necessitaram passar novamente pelo PID para uma segunda internação. Com relação à resolutividade clínica, 130 (94,9% tiveram alta clínica, no PID, na primeira internação. O PID mostrou-se ser um programa de alta resolutividade, atendendo mais ao público idoso feminino, de baixa renda e com períodos de internação relativamente curtos.The home care is a modality of health care which is becoming an important alternative to minimize some of mainly relevant problems of world health, especially the public health network. This paper aimed to describe the socio-demographic and clinical population assisted by the Home Care Program HU em Casa, of the University Hospital Clemente de Faria, Universidade Estadual de Montes Claros. It is a descriptive and retrospective study analyzing

Associations of unilateral whisker and olfactory signals induce synapse formation and memory cell recruitment in bilateral barrel cortices: cellular mechanism for unilateral training toward bilateral memory

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Zilong Gao

2016-12-01

Full Text Available Somatosensory signals and operative skills learned by unilateral limbs can be retrieved bilaterally. In terms of cellular mechanism underlying this unilateral learning toward bilateral memory, we hypothesized that associative memory cells in bilateral cortices and synapse innervations between them were produced. In the examination of this hypothesis, we have observed that paired unilateral whisker and odor stimulations led to odorant-induced whisker motions in bilateral sides, which were attenuated by inhibiting the activity of barrel cortices. In the mice that showed bilateral cross-modal responses, the neurons in both sides of barrel cortices became to encode this new odor signal alongside the innate whisker signal. Axon projections and synapse formations from the barrel cortex, which was co-activated with the piriform cortex, toward its contralateral barrel cortex were upregulated. Glutamatergic synaptic transmission in bilateral barrel cortices was upregulated and GABAergic synaptic transmission was downregulated. The associative activations of the sensory cortices facilitate new axon projection, glutamatergic synapse formation and GABAergic synapse downregulation, which drive the neurons to be recruited as associative memory cells in the bilateral cortices. Our data reveals the productions of associative memory cells and synapse innervations in bilateral sensory cortices for unilateral training toward bilateral memory.

Spontaneous Unruptured Bilateral Tubal Pregnancy: A Case Report

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Nayereh Ghomian

2015-11-01

Full Text Available Bilateral spontaneous tubal ectopic pregnancy is the rarest form of extra uterine pregnancy. The diagnosis is usually made intraoperatively and levels of serum BHCG and ultrasound has not been useful in the diagnosis of bilateral tubal ectopic pregnancy. A 33-year-old woman with 8 weeks amenorrhea and sever lower abdominal pain was admitted. A transvaginal pelvic ultrasound revealed left adnexal mass and massive fluid collection in the pelvis and abdomen. The serum BHCG was 5,700 mIU/ml and in laparotomy bilateral unruptured tubal pregnancy was noted. Left salpingectomy and right salpingostomy were performed. The diagnosis of bilateral spontaneous tubal ectopic pregnancy is usually made intraoperatively. Both tubes at the time of surgery should be closely examined in order to prevent maternal morbidity and mortality.

Delayed-onset bilateral abducens paresis after head trauma

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Pravin Salunke

2012-01-01

Full Text Available Bilateral sixth nerve paresis following closed head injury, though rare, is a known entity. However, delayed-onset post-traumatic bilateral abducens paresis is extremely rare. We present two cases. The first patient had onset of bilateral abducens paresis 2 weeks after closed head injury and the second patient after 3 days. The cause in the former was detected to be chronic subdural hematoma and in the latter is speculated to be edema/ischemia due to injury to soft tissue structures housing these nerves. The delayed onset of bilateral abducens paresis following head injury may vary according to the cause. There may be another mechanism of injury apart from direct trauma. Though rare, it needs to be evaluated and may have a treatable cause like elevated intracranial pressure.

Diffusion MR Imaging of Postoperative Bilateral Acute Ischemic Optic Neuropathy

International Nuclear Information System (INIS)

Park, Ju Young; Lee, In Ho; Song, Chang June; Hwang, Hee Youn

2012-01-01

A 57-year-old woman experienced bilateral acute ischemic optic neuropathy after spine surgery. Routine MR imaging sequence, T2-weighted image, showed subtle high signal intensity on bilateral optic nerves. A contrast-enhanced T1 weighted image showed enhancement along the bilateral optic nerve sheath. Moreover, diffusion-weighted image (DWI) and an apparent diffusion coefficient map showed markedly restricted diffusion on bilateral optic nerves. Although MR findings of T2-weighted and contrast enhanced T1-weighted images may be nonspecific, the DWI finding of cytotoxic edema of bilateral optic nerves will be helpful for the diagnosis of acute ischemic optic neuropathy after spine surgery.

Diffusion MR Imaging of Postoperative Bilateral Acute Ischemic Optic Neuropathy

Energy Technology Data Exchange (ETDEWEB)

Park, Ju Young; Lee, In Ho; Song, Chang June [Chungnam National University Hospital, Daejeon (Korea, Republic of); Hwang, Hee Youn [Eulji University Hospital, Daejeon(Korea, Republic of)

2012-03-15

A 57-year-old woman experienced bilateral acute ischemic optic neuropathy after spine surgery. Routine MR imaging sequence, T2-weighted image, showed subtle high signal intensity on bilateral optic nerves. A contrast-enhanced T1 weighted image showed enhancement along the bilateral optic nerve sheath. Moreover, diffusion-weighted image (DWI) and an apparent diffusion coefficient map showed markedly restricted diffusion on bilateral optic nerves. Although MR findings of T2-weighted and contrast enhanced T1-weighted images may be nonspecific, the DWI finding of cytotoxic edema of bilateral optic nerves will be helpful for the diagnosis of acute ischemic optic neuropathy after spine surgery.

Bilateral anophthalmia with septo-optic dysplasia

OpenAIRE

Jana, Manisha; Sharma, Sanjay

2010-01-01

Bilateral anophthalmia is a rare entity and association with septo-optic dysplasia is an even rare condition. The condition is characterized by absent eyeballs in the presence of eyelids, conjunctiva or lacrimal apparatus. Though anophthalmia can be diagnosed clinically, imaging plays a crucial role in delineating the associated anomalies. In addition, often clinical anophthalmia may prove to be severe microphthalmia on imaging. We describe the imaging findings in an infant with bilateral ano...

Bilateral spontaneous adrenal haemorrhage complicating acute pancreatitis

International Nuclear Information System (INIS)

Pianta, M.; Varma, D. K.

2007-01-01

Bilateral adrenal haemorrhage is an event that mandates prompt diagnosis and treatment to prevent primary adrenocortical insufficiency and potential death. Presentation can be non-specific and incidentally diagnosed with imaging alone, primarily CT. We present a case of acute pancreatitis with spontaneous bilateral adrenal haemorrhage and briefly discuss imaging and treatment implications

Simultaneous bilateral patellar tendon rupture.

Science.gov (United States)

Moura, Diogo Lino; Marques, José Pedro; Lucas, Francisco Manuel; Fonseca, Fernando Pereira

2017-01-01

Bilateral patellar tendon rupture is a rare entity, often associated with systemic diseases and patellar tendinopathy. The authors report a rare case of a 34-year-old man with simultaneous bilateral rupture of the patellar tendon caused by minor trauma. The patient is a retired basketball player with no past complaints of chronic knee pain and a history of steroid use. Surgical management consisted in primary end-to-end tendon repair protected temporarily with cerclage wiring, followed by a short immobilization period and intensive rehabilitation program. Five months after surgery, the patient was able to fully participate in sport activities.

Migración interna indígena desde el Istmo veracruzano: nuevas articulaciones regionales

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Emilia Velázquez Hernández

2013-07-01

Full Text Available El objetivo de este trabajo es analizar las nuevas articulaciones regionales que se crean a través de las migraciones internas. Para ello, se toma como estudio de caso las migraciones que desde mediados de la década de 1990 se realizan desde el Istmo veracruzano hacia la frontera norte de México y los campos de agricultura intensiva de Sinaloa. Se muestra que, a través de la migración laboral de trabajadores nahuas y popolucas de la Sierra de Santa Marta, regiones antes inconexas se articulan actualmente de manera desigual.

UN ANÁLISIS ESPACIAL DE LAS MIGRACIONES INTERNAS EN COLOMBIA (2000-2005

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ADRIANA CAROLINA SILVA ARIAS

2009-01-01

Full Text Available El objetivo de este documento es realizar un análisis espacial acerca de la dinámica de las migraciones internas recientes en Colombia; en específico durante el periodo del 2000-2005 con base en información censal. Así, se identifica mediante un modelo gravitacional que los flujos migratorios inter-departamentales en Colombia se dirigieron hacia los departamentos más poblados, con mayores ingresos y con tradición migratoria. En adición, se encuentra que durante este mismo periodo Guaviare fue el departamento donde se presentó una mayor probabilidad de emigrar y hacia las zonas vecinas; por otro lado, Antioquia fue el departamento donde se presentó menor probabilidad de emigrar.

Dacrioadenite bilateral causada pelo vírus Epstein-Barr: relato de caso Epstein-Barr virus bilateral dacryoadenitis: case report

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Bernardo Kaplan Moscovici

2009-12-01

Full Text Available Os autores apresentam um caso raro de dacrioadenite aguda bilateral associada à mononucleose. Paciente do sexo feminino, 27 anos, tinha aumento agudo da glândula lacrimal, bilateral, com sinais flogísticos. As alterações tomográficas e laboratoriais confirmaram o diagnóstico e o tratamento com esteróide sistêmico foi introduzido, com resolução completa dos sinais e sintomas. COMENTÁRIOS: A dacrioadenite é uma apresentação incomum da mononucleose infecciosa e pode minimizar outras manifestações desta doença. O diagnóstico de mononucleose deve ser considerado em casos de dacrioadenite aguda bilateral. Os esteróides sistêmicos contribuem para a resolução do quadro inflamatório.The authors present a rare case of acute bilateral dacryoadenitis in association with infectious mononucleosis. A 27 year-old woman had acute bilateral lacrimal gland enlargement with inflammatory signs. The CT scan findings and laboratorial investigations confirmed the diagnosis of infectious mononucleosis. The systemic treatment with intravenous steroids was initiated leading to complete remission of the signs and symptoms. COMMENTS: Dacryoadenitis is an uncommon manifestation of infectious mononucleosis and may minimize other signs of the disease. Mononucleosis has to be considered in acute dacryoadenitis cases. Systemic steroids contribute to the fast regression of inflammatory condition.

Sarcoidosis Presenting as Bilateral Vocal Fold Immobility.

Science.gov (United States)

Hintze, Justin M; Gnagi, Sharon H; Lott, David G

2018-05-01

Bilateral true vocal fold paralysis is rarely attributable to inflammatory diseases. Sarcoidosis is a rare but important etiology of bilateral true vocal fold paralysis by compressive lymphadenopathy, granulomatous infiltration, and neural involvement. We describe the first reported case of sarcoidosis presenting as bilateral vocal fold immobility caused by direct fixation by granulomatous infiltration severe enough to necessitate tracheostomy insertion. In addition, we discuss the presentation, the pathophysiology, and the treatment of this disease with a review of the literature of previously reported cases of sarcoidosis-related vocal fold immobility. Sarcoidosis should therefore be an important consideration for the otolaryngologist's differential diagnosis of true vocal fold immobility. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Bilateral chronic subdural hematoma

DEFF Research Database (Denmark)

Andersen-Ranberg, Nina Christine; Rom Poulsen, Frantz; Bergholt, Bo

2017-01-01

OBJECTIVE Bilateral chronic subdural hematoma (bCSDH) is a common neurosurgical condition frequently associated with the need for retreatment. The reason for the high rate of retreatment has not been thoroughly investigated. Thus, the authors focused on determining which independent predictors...... are associated with the retreatment of bCSDH with a focus on surgical laterality. METHODS In a national database of CSDHs (Danish Chronic Subdural Hematoma Study) the authors retrospectively identified all bCSDHs treated in the 4 Danish neurosurgical departments over the 3-year period from 2010 to 2012...... that a separated hematoma density and the absence of postoperative drainage were independent predictors of retreatment. CONCLUSIONS In bCSDHs bilateral surgical intervention significantly lowers the risk of retreatment compared with unilateral intervention and should be considered when choosing a surgical...

Evaluación del funcionamiento de motores de combustión interna trabajando con biodiesel.

OpenAIRE

R. Piloto Rodríguez; R. Sierens; S. Verhelst; N. Ferrer Frontela

2008-01-01

En el presente trabajo se determinó la característica exterior de velocidad para dos motores de combustión interna trabajando con combustible biodiesel procedente de varias fuentes naturales y se comparó con la característica exterior de velocidad de los motores originalmente trabajando con combustible diesel. Los motores fueron evaluados con variaciones de carga y velocidad. En uno de los motores ensayados fue determinada la presión en el interior de la cámara de combustión con el objetivo d...

A Case of Synchronous Bilateral Upper Urinary System Urothelial Carcinoma

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Ibrahim Buldu

2014-12-01

Full Text Available Synchronous bilateral upper urinary tract urothelial cancer (UTUC is a very rare form of urothelial cancer. In patients with high-risk unilateral UTUC, radical nephroureterectomy (RNU is the gold standard treatment. However, there is no consensus on the treatment for synchronous bilateral UTUC. Evaluation of the patient and the tumor is recommended. Bilateral nephron-sparing surgery (NSS was performed on a 53-year-old patient who presented with high-risk synchronous bilateral UTUC, and the outcome was reported.

Psychiatric and social outcome after deep brain stimulation for advanced Parkinson's disease

NARCIS (Netherlands)

Boel, J.A.; Odekerken, V.J.J.; Geurtsen, G.J.; Schmand, B.A.; Cath, D.C.; Figee, M.; van den Munckhof, P.; de Haan, R.J.; Schuurman, P.R.; de Bie, R.M.A.

BACKGROUND: The aim of this study was to assess psychiatric and social outcome 12 months after bilateral deep brain stimulation (DBS) of the globus pallidus pars interna (GPi) and subthalamic nucleus (STN) for advanced Parkinson's disease (PD). METHODS: We randomly assigned patients to receive GPi

Psychiatric and social outcome after deep brain stimulation for advanced Parkinson's disease

NARCIS (Netherlands)

Boel, Judith A; Odekerken, Vincent J J; Geurtsen, Gert J; Schmand, Ben A; Cath, Danielle C; Figee, Martijn; van den Munckhof, Pepijn; de Haan, Rob J; Schuurman, P Richard; de Bie, Rob M A

2016-01-01

BACKGROUND: The aim of this study was to assess psychiatric and social outcome 12 months after bilateral deep brain stimulation (DBS) of the globus pallidus pars interna (GPi) and subthalamic nucleus (STN) for advanced Parkinson's disease (PD). METHODS: We randomly assigned patients to receive GPi

IgG4-Related Disease of Bilateral Temporal Bones.

Science.gov (United States)

Li, Lilun; Ward, Bryan; Cocks, Margaret; Kheradmand, Amir; Francis, Howard W

2017-03-01

IgG4-related disease (IgG4-RD) is an idiopathic inflammatory condition that causes pseudotumor formation in single or multiple organs, including those of the head and neck. Temporal bone involvement is rare, with only 3 cases of unilateral temporal bone IgG4-RD described in the literature. We report the first known case of IgG4-RD of bilateral temporal bones and describe its clinical presentation, diagnosis, and treatment. The patient was a 52-year-old man with latent tuberculosis (TB) who presented with a 10-year history of bilateral profound hearing loss and vestibular dysfunction. Computed tomography and magnetic resonance imaging demonstrated bilateral labyrinthine destruction with invasion of the posterior fossa. Immunoglobulin level testing showed elevated total serum IgG levels with normal IgG4 levels. Bilateral mastoidectomies were performed, with biopsy samples demonstrating IgG4 staining with IgG4-positive plasma cells up to 40/HPF (high power field) on the right and 20/HPF on the left, consistent with bilateral IgG4-RD. IgG4-RD of bilateral temporal bones presents with chronic and progressive bilateral hearing loss and vestibular dysfunction. Clinical presentation and radiologic findings are nonspecific, and definitive diagnosis must be made with histopathology and immunostaining. Corticosteroids are therapeutic, but surgical resection may be necessary for temporal bone IgG4-RD to improve long-term remission.

Outcome of bilateral ureteroscopic retrieval of stones in a single session

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Majid Mushtaque

2012-01-01

Conclusion: Bilateral same-session ureteroscopy is a safe and effective procedure in the management of bilateral ureteral stones. The results are comparable to unilateral or staged bilateral procedures.

Essure insert expulsion after 3-month hysterosalpingogram confirmation of bilateral tubal occlusion and bilateral correct placement: case report.

Science.gov (United States)

Garcia, Amy L; Lewis, Rae M; Sloan, Anita Lee

2013-01-01

Essure hysteroscopic sterilization is an effective permanent contraception option for women, with a 99.83% effectiveness rate. To date, more than 600,000 Essure procedures have been performed worldwide. This case report describes bilateral Essure insert placement, after which the left insert was subsequently expelled after hysterosalpingogram (HSG)-confirmed correct bilateral insert placement and bilateral tubal occlusion. Although insert expulsion has been reported before a 3-month post-procedure HSG, this is the first published report of expulsion after a confirmatory 3-month post-procedure HSG. Because there now exists documentation of Essure insert expulsion after a 3-month confirmatory HSG, physicians and patients should be informed of this rare occurrence. Further investigation into the causes of such an event is warranted. Copyright © 2013 AAGL. Published by Elsevier Inc. All rights reserved.

Simultaneous bilateral patellar tendon rupture

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Diogo Lino Moura

Full Text Available ABSTRACT Bilateral patellar tendon rupture is a rare entity, often associated with systemic diseases and patellar tendinopathy. The authors report a rare case of a 34-year-old man with simultaneous bilateral rupture of the patellar tendon caused by minor trauma. The patient is a retired basketball player with no past complaints of chronic knee pain and a history of steroid use. Surgical management consisted in primary end-to-end tendon repair protected temporarily with cerclage wiring, followed by a short immobilization period and intensive rehabilitation program. Five months after surgery, the patient was able to fully participate in sport activities.

Bilateral anophthalmia with septo-optic dysplasia

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Manisha Jana

2010-01-01

Full Text Available Bilateral anophthalmia is a rare entity and association with septo-optic dysplasia is an even rare condition. The condition is characterized by absent eyeballs in the presence of eyelids, conjunctiva or lacrimal apparatus. Though anophthalmia can be diagnosed clinically, imaging plays a crucial role in delineating the associated anomalies. In addition, often clinical anophthalmia may prove to be severe microphthalmia on imaging. We describe the imaging findings in an infant with bilateral anophthalmia and septo-optic dysplasia.

Fatores associados às internações hospitalares no Brasil Analysis of hospital admissions associated factors in Brazil

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Mônica Silva Monteiro de Castro

2002-01-01

Full Text Available O objetivo foi identificar fatores associados às admissões hospitalares no Brasil, analisando se essa utilização é eqüitativa e identificando características associadas aos grandes usuários. A PNAD/1998 foi analisada, utilizando regressão logística e regressão logística multinomial, com pesos normalizados e técnicas estatísticas para correção do efeito de desenho. O modelo teórico utilizado foi o Comportamental de Andersen. No modelo ajustado por necessidade de saúde e fatores capacitantes, pessoas com menor renda apresentaram maior chance de se internar; o contrário ocorreu no modelo ajustado somente por necessidade de saúde. Todas as variáveis de necessidade mostraram-se menos relacionadas ao uso nas pessoas com duas internações, em comparação com aquelas com mais do que duas internações. Não houve associação entre variáveis sociais e ocorrência de duas internações, mas essa associação ocorreu para três ou mais internações. A redução das desigualdades sociais nos aspectos que "capacitam" ao uso de admissões hospitalares reduziria as desigualdades neste uso. Um sistema de saúde que ofereça um "serviço de uso regular", além de baixo ou nenhum pagamento no ato do consumo, seriam medidas de impacto positivo na eqüidade do consumo de serviços hospitalares no Brasil.The objective was to identify hospital admission associated factors in Brazil, analyzing if that utilization is equitable and identifying which characteristics are associated with heavy users. We analyzed data from the 1998 National Household Survey, using logistic regression and multinomial logistic regression, with normalized weights and statistical techniques to correct for design effect. We used Andersen's Behavioral Model as the theoretical model for this analysis. In model adjusted for health needs and enabling factors, people with smaller income had more chance of being admitted to hospital; and in model adjusted only for health

Congenital bilateral neuroblastoma (stage IV-S): case report

International Nuclear Information System (INIS)

Lee, Jeong Hee; Lee, Hee Jung; Woo, Seong Ku; Lee, Sang Rak; Kim, Heung Sik

2002-01-01

Congenital neonatal neuroblastoma is not uncommon but bilateral adrenal neuroblastoma is rare, accounting for about ten percent of neuroblastomas in children. We report the US the MR findings of a stage IV-S congenital bilateral neuroblastoma occurring in a one-day-old neonate

A case of bilateral vocal fold mucosal bridges, bilateral trans-vocal fold type III sulci vocales, and an intracordal polyp.

Science.gov (United States)

Tan, Melin; Pitman, Michael J

2011-07-01

We present a patient with a novel finding of bilateral mucosal bridges, bilateral type III trans-vocal fold sulci vocales, and a vocal fold polyp. Although sulci and mucosal bridges occur in the vocal folds, it is rare to find multiples of these lesions in a single patient, and it is even more uncommon when they occur in conjunction with a vocal fold polyp. To our knowledge, this is the first description of a vocal fold polyp in combination with multiple vocal fold bridges and multiple type III sulci vocales in a single patient. To describe and visually present the diagnosis and treatment of a patient with an intracordal polyp, bilateral mucosal bridges, as well as bilateral type III trans-vocal fold sulci vocales. Presentation of a set of high definition intraoperative photos displaying the extent of the vocal fold lesions and the resection of the intracordal polyp. This patient presented with only 6 months of significant dysphonia. It was felt that the recent change in voice was because of the polyp and not the bridges or sulci vocales. Considering the patient's presentation and the possible morbidity of resection of mucosal bridges and sulci, only the polyp was excised. Postoperatively, the patient's voice returned to his acceptable mild baseline dysphonia, and the benefit has persisted 6 months postoperatively. The combination of bilateral mucosal bridges, bilateral type III sulcus vocalis, and an intracordal polyp in one patient is rare if not novel. Treatment of the polyp alone returned the patient's voice to his lifelong baseline of mild dysphonia. Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Fibrovascular tissue in bilateral juxtafoveal telangiectasis.

Science.gov (United States)

Park, D; Schatz, H; McDonald, H R; Johnson, R N

1996-09-01

To study the natural history and retinal findings associated with the intraretinal and subretinal fibrovascular tissues that develop in the late phases of bilateral juxtafoveal telangiectasis. The records of 10 patients (11 eyes) with bilateral juxtafoveal telangiectasis who developed these fibrovascular tissues were examined. Throughout the follow-up period (average 44 months), only 2 eyes (18%) lost 2 or more lines of vision; the final visual acuities were similar for the eyes both with and without fibrovascular tissues. Sixty-four percent of fibrovascular tissues showed little to no growth. Eyes with fibrovascular tissue commonly had retinal pigment epithelial hyperplasia (72%), draining retinal venules (82%), and retinal vascular distortion (64%). Fibrovascular tissues of bilateral juxtafoveal telangiectasis have little proliferative potential and minimal effects on visual acuity. Nevertheless, these fibrovascular tissues do remodel over time, leading to retinal vascular distortion. Given these benign findings, the role of laser photocoagulation treatment of these tissues is questionable.

Multilateral and bilateral agreements

International Nuclear Information System (INIS)

Koponen, H.

1993-01-01

Finland has made both multilateral and bilateral agreements on the exchange of information related to radiation safety. The first arrangements for international agreements and exchange of information were made after the Chernobyl accident. In 1987, Finland joined the convention on early notification of a nuclear power accident coordinated by International Atomic Energy Agency. The convention is applied to accidents that cause of may cause emissions of radioactive substances that might affect the radiation safety of another country. Besides the convention on early notification, some other individual agreements have also been made. These include the International Nuclear Event Scale (INES) system and power companies own information exchange systems. Finland has conducted bilateral agreements with the Nordic countries and the Soviet Union on the notification of accidents and exchange of nuclear power plant information. Today, Russia answers for the Soviet Union's contractual obligations. (orig.)

Fast-track surgery for bilateral total knee replacement

DEFF Research Database (Denmark)

Husted, H; Troelsen, A; Otte, K S

2011-01-01

Bilateral simultaneous total knee replacement (TKR) has been considered by some to be associated with increased morbidity and mortality. Our study analysed the outcome of 150 consecutive, but selected, bilateral simultaneous TKRs and compared them with that of 271 unilateral TKRs in a standardised...

Simultaneous bilateral anterior cruciate ligament reconstruction: Cost comparison and functional results

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Matjaž Sajovic

2014-04-01

Full Text Available Background: The ideal treatment for patients presenting with bilateral anterior cruciate ligament (ACL deficiency remains controversial. The purpose was to evaluate cost and mid-term functional results after one-stage bilateral ACL reconstruction using either hamstring or patella tendon autograft.Methods: We compared the mid-term outcome of 7 patients (14 knees who had one-stage bilateral ACL reconstruction with that of a matched group of patients who had unilateral reconstruction (21 patients.Results: The median duration of hospital stay was 4 nights (range 3 to 5 for the bilateral group and 2 nights (range, 1 to 4 for the control group. The duration of rehabilitation process in patients from the control group with unilateral ACL reconstruction was one week shorter (9 versus 8 weeks. In the bilateral group, the median Lysholm score was 96 (range 85–100 and in the control group, the median score was 93 (range 81–100. The median time to return to full-time work and to full sports was 9 weeks and 7 months for the simultaneous bilateral group and 8 weeks and 6 months for the unilateral group. Six patients (86 % in the bilateral group and 17 patients (81 % in the control group were still performing at their pre-injury level of activity. The Health Insurance Institute of Slovenia saves EUR 2,925 when we perform simultaneous bilateral ACL reconstruction instead of two stage ACL reconstruction.Conclusions: Mid-term clinical results suggested that simultaneous bilateral ACL reconstruction using either hamstring or patella tendon autograft is clinically effective. For patients presenting with symptomatic bilateral ACL deficient knees, one stage bilateral ACL reconstruction is reproducible, cost effective, and does not compromise functional results.

Laparoscopic Partial Adrenalectomy for Bilateral Cortisol-secreting Adenomas

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Jeffrey P. Domino

2007-04-01

Full Text Available Bilateral cortisol-secreting adenomas are a rare cause of Cushing's syndrome. We report a case of a 35-year-old woman who presented with ACTH-independent Cushing's syndrome and bilateral adrenal adenomas. Adrenal venous sampling confirmed both adenomas to be hyper-secreting cortisol. She underwent bilateral laparoscopic adrenalectomy; total right and partial left adrenalectomies. At 2-year follow-up, she is maintained on low-dose fludrocortisone and hydrocortisone, and without recurrence of hypercorticolism. Laparoscopic partial adrenalectomy is a feasible option for this rare condition; however, long-term follow-up is needed to determine her total independence from steroid usage.

Obesidad. Caracterización clínica y comorbilidades asociadas: efectividad de una intervención grupal vs individual

OpenAIRE

Piñera Tamés, Marbella J.

2014-01-01

La obesidad es un grave problema sociosanitario por el importante consumo de recursos económicos necesarios para su tratamiento, debido no solo, a su elevada y creciente prevalencia, sino también por la importante comorbilidad asociada, que abarca desde alteraciones clínicas, metabólicas, hormonales, respiratorias, neoplasias, ortopédicas y hasta psicológicas. Debido a su etiología multifactorial, resultado de la interacción entre el genotipo y el entorno, factores psicológicos, sociales y c...

Severe Bilateral Breast Mucinous Carcinoma with Bilateral Lungs and Cutaneous Metastasis: A Case Report and Literature Review

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Rong Pu

2018-01-01

Full Text Available The case of a female who had severe, rare, terminal breast mucinous carcinoma (BMC and failed to receive surgery and chemotherapy was reported. The patient was diagnosed with pure BMC (ER++, PR++, CerbB-2−, and Ki-67 10% accompanied with bilateral lungs, bilateral chest walls with skin ulcer (D = 14 cm, lymph nodes of bilateral armpits, and right supraclavicular metastases. ECOG (Eastern Cooperative Oncology Group and NRS (Numeric Rating Scale pain scores were 4 and 6, respectively. Because the patient refused traditional chemotherapy and radiotherapy on religious grounds, an herbal medicine containing Panax ginseng, Agrimonia pilosa, and white flower Patrinia herb was administered; extensive nursing for tumor debridement was also provided. Quality of Life (QOL improved and pain reduced. Tumor-bearing survival time was prolonged. The present case dictates that herbal extract medicines and supportive treatment can be helpful for uncommon severe BMC as an appropriate alternative treatment.

Psychiatric and social outcome after deep brain stimulation for advanced Parkinson's disease

NARCIS (Netherlands)

Boel, Judith A.; Odekerken, Vincent J. J.; Geurtsen, Gert J.; Schmand, Ben A.; Cath, Danielle C.; Figee, Martijn; van den Munckhof, Pepijn; de Haan, Rob J.; Schuurman, P. Richard; de Bie, Rob M. A.; van Dijk, J. Marc C.; Staal, Michael

BackgroundThe aim of this study was to assess psychiatric and social outcome 12 months after bilateral deep brain stimulation (DBS) of the globus pallidus pars interna (GPi) and subthalamic nucleus (STN) for advanced Parkinson's disease (PD). MethodsWe randomly assigned patients to receive GPi DBS

Bilateral cerebellopontine arachnoid cyst: A rare entity.

Science.gov (United States)

Sharma, Anand; Sharma, Achal; Mittal, Radhey S; Gandhi, Ashok

2015-01-01

Bilateral cerebellopontine angle (CPA) arachnoid cysts (ACs) are very rare: only one case is reported in literature. Pathogenesis of those cysts is unknown; they are thought to be congenital. The presenting symptoms of CPA AC are frequently nonspecific or otological. The management of ACs of the CPA is controversial. We are reporting two cases of bilateral CPA AC with their pathophysiology and review of literature.

Bilateral teleoperation for force sensorless 1-dof robots

NARCIS (Netherlands)

Lichiardopol, S.; Wouw, van de N.; Nijmeijer, H.; Filipe, J.; Cetto, J.A.; Ferrier, J.-L.

2010-01-01

It is well known that for bilateral teleoperation, force feedback information is needed. In this paper, we propose a control approach for bilateral teleoperation with uncertainties in the model of the slave robot and which does not use force sensors for haptic feedback. The controller design is

Neuropatía Endémica Crónica Asociada con Virus Humano Linfotrófico

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Jaime G. Gómez

1990-04-01

Full Text Available

Diagnóstico y Tratamiento de la Neuropatía Endémica Crónica Asociada con Virus Humano Linfotrófico de Células T, Tipo I (HTLV-l

El propósito del presente artículo es haccr una breve revisión del estado actual de la Neuropatía endémica crónica asociada con el Virus Humano Linfotrópico de Celulas T-tipo L conocido por la sigla inglesa HTLV-I y presentar el primer caso tratado con éxito. logrando posiblemente la curación de la enfermedad.

La Neuropatía endémica asociada con el Virus Humano Linfotrópico de Celulas T-tipo 1, (NEC-HTL V-1 es una enfermedad lentamente progresiva caracterizada por debilidad de las extremidades inferiores, trastornos de los esfínteres, alteraciones subjetivas de la sensibilidad, asociadas con la presencia de anticuerpos contra el HTL V-I en la sangre y en el líquido cefalorraquídeo.

La enfermedad fue descrita por primera vez hace casi cien años en Jamaica por Strachnan (1897, Cruishank publicó en 1956 el cuadro patológico en el cual se encuentra degeneración de las vías piramidales, desmielinización, proliferación capilar con acúmulos de linfocitos alrededor de los vasos sanguineos. Maní y col informaron una enfermedad similar en el Sur de la India (1969. En 1981 Zaninovich encontró una zona endémica en la costa del Pacífico de Colombia y gracias a su interes consiguió apoyo de la Organización Mundial de la Salud y del Instituto Nacional de Salud de los Estados Unidos para adelantar los estudios sobre esta endemia.

En 1985 Gessain y col hallaron por primera vez en Martinfca anticuerpos contra el HTL V-1 en una alta proporción de pacientes con la enfermedad que denominaron Paraparesia Espástica Tropical.

El Virus Humano Linfotrópico de Celulas T o HTL V-1, pertenece a la familia de los Retrovirus, caracterizados por poseer una enzima denominada Transcriptasa Invertida (“Reverse Transcriptase”. Fue descubierto por Gallo

Diagnóstico situacional de las internas del establecimiento penitenciario de Concepción

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Carlos Soria Parra

2012-06-01

Full Text Available El sistema penitenciario en el país está a cargo del Instituto Nacional Penitenciario (INPE, que administra un total de 66 establecimientos, organizados en ocho Oficinas Regionales (OR. De acuerdo con el artículo 139 la Constitución Política, este organismo público descentralizado del Ministerio de Justicia y Derechos Humanos tiene, como ente rector del sistema penitenciario nacional, la responsabilidad de hacer que los internos ocupen establecimientos adecuados (inciso 21 y que alcancen la reeducación, rehabilitación y reincorporación a la sociedad (inciso 22. Ambas responsabilidades, sin embargo, son claramente incumplidas. Las cárceles padecen hoy de sobrepoblación y hacinamiento sorprendentes, y es más, de condiciones adecuadas para impulsar seriamente el complejo proceso de reeducación, rehabilitación y reincorporación. Lo peor es que la sobrepoblación ya se hace incontrolable. El último año, de junio del 2011 a junio del 2012, la población de internos, según informe del INPE, llegó a 58 019, y alcanzó un asombroso crecimiento de 19,4%, es decir, 9 433 presos más. Las razones de todo este problema, sin duda, son tan diversas, que inclusive van más allá de las decisiones del propio organismo. Es conocido que esta situación es dramática en las cárceles de Lima y Callao, pero no deja de ser preocupante en el interior del país. Los autores - la mayoría - estando desempeñandonos en la Policía Nacional del Perú y siendo a la vez estudiantes de Derecho, quisimos conocer esta realidad en las cárceles en Huancayo, conformantes de la Oficina Regional Centro, y por está razón se comprometió en apoyar a las internas a través de un proceso de asesoría legal, previo estudio sobre la situación del Establecimiento Penitenciario de Mujeres de Concepción, una de la ocho cárceles de mujeres existentes en el país y la única en la zona centro. Su capacidad de albergue es para 55 internas. Está ubicada en la provincia

Bilateral nanophthalmos and pigmentary retinal dystrophy--an unusual syndrome.

Science.gov (United States)

Proença, Helena; Castanheira-Dinis, A; Monteiro-Grillo, M

2006-09-01

To report the clinical picture of the rare association of nanophthalmos and pigmentary retinal dystrophy and its cataract surgery outcome. We report a case of a 60-year-old female who presented with bilateral slowly progressive visual loss. The patient presented with bilateral light perception visual acuity, exotropia, brunescent cataract hindering fundus examination and hypodontia. Ultrasonography revealed bilateral nanophthalmos. A visual-evoked potential was also performed preoperatively. Cataract surgery with +40D IOL implantation was uneventful. Postoperative fundus examination revealed pigmentary retinal dystrophy, confirmed by electrophysiologic tests. Glycosaminoglycan urinary excretion was normal. Congenital bilateral nanophthalmos may rarely be associated with pigmentary retinal dystrophy. We suggest thorough preoperative evaluation in nanophthalmic eyes for the exclusion of significant features concerning visual prognosis.

Synchronous bilateral male breast cancer: a case report.

Science.gov (United States)

Sun, Woo-Young; Lee, Ki-Hyeong; Lee, Ho-Chang; Ryu, Dong-Hee; Park, Jin-Woo; Yun, Hyo-Young; Song, Young-Jin

2012-06-01

Synchronous bilateral breast cancer is extremely rare in men and has not, up to date, been reported in Korea. A 54-year-old man presented with a palpable mass in the right breast. The right nipple was retracted and bilateral axillary accessory breasts and nipples were present. On physical examination, a 2 cm-sized mass was palpated directly under the right nipple, and, with squeezing, bloody discharge developed in a single duct of the left nipple. There was no palpable mass in the left breast, and axillary lymph nodes were not palpable. Physical examination of external genitalia revealed a unilateral undescended testis on the left side. Synchronous bilateral breast cancer was diagnosed using mammography, ultrasonography, and core-needle biopsy. Histopathological examination revealed invasive ductal carcinoma in the right breast and ductal carcinoma in situ in the left breast. Bilateral total mastectomy, sentinel lymph node biopsy, and excision of accessory breasts in the axilla were performed.

Bilateral patellar tuberculosis masquerading as infected infrapatellar bursitis.

Science.gov (United States)

Sreenivasan, Ravi; Haq, Rehan Ul

2017-04-01

A 30-year-old woman presented to our outpatient department with complaints of pain and swelling in bilateral infrapatellar regions and a discharging sinus in the right knee over the duration of one year. Radiographs showed lytic regions in bilateral patellae. Samples sent from material curetted from sinus yielded no organism but histopathology reported granulomatous inflammation. Following a fresh magnetic resonance imaging (MRI) scan that revealed the infrapatellar pad of fat communicating with the patellar lesions, an exploration and evacuation was done. Material sent revealed epithelioid cell granulomas with caseous necrosis consistent with tuberculosis (TB). The patient was put on first line anti-tubercular treatment (ATT) and has responded favourably with healing of sinus and patellar lesions. Bilateral infrapatellar bursitis is not rare. However patellar TB as a cause for OMIT is not a common diagnosis. A bilateral patellar involvement has not been reported in literature to the best of our knowledge.

Impacto de sesiones formativas sobre medios de prevención de neumonía asociada a ventilación mecánica en la Unidad de Críticos del Hospital Clínico San Carlos

OpenAIRE

Torres González, Juan Ignacio

2015-01-01

La neumonía asociada a la ventilación mecánica (NAVM) es la principal infección nosocomial en las Unidades de Cuidados Intensivos. Esta complicación conlleva un aumento de la mortalidad, de los días de estancia y de los costes hospitalarios. El principal mecanismo fisiopatológico es la aspiración repetitiva de secreciones colonizadas de la orofaringe a la vía aérea inferior asociada a procedimientos y productos sanitarios invasivos. Se han estudiado múltiples medidas preventivas publicadas en...

Bilateral Supernumerary Kidney: A Very Rare Presentation

International Nuclear Information System (INIS)

Keskin, Suat; Batur, Abdussamet; Keskin, Zeynep; Koc, Abdulkadir; Firat Ozcan, Irfan

2014-01-01

To our knowledge, bilateral supernumerary kidney is a very rare renal abnormality and there are five cases presented in the literature. It is difficult to diagnose supernumerary kidney and clinicians have not detected most cases preoperatively. Laboratory and imaging studies were acquired and carefully examined. The normal laboratory tests were found. Emergency ultrasonography was performed and they revealed no signs of parenchymal abnormality in both kidneys. Serial imaging study including enhanced computed tomography (CT) was performed. An imaging study identified bilateral supernumerary kidney with expanded collecting systems. On each side, significant rotation anomaly was found. In addition, there were two different renal arteries originating from the aorta. This report presents radiological determinations of supernumerary kidney bilaterally in a young man. We think that CT commonly appears to be enough for the diagnosis of supernumerary kidneys

Infecciones asociadas a catéteres en niños tratados con hemodiálisis Catheter-related infections in hemodyalisis-treated children

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Diana Patricia Durán Casal

2007-06-01

Full Text Available Se estudiaron los expedientes clínicos de los 22 pacientes incluidos en el plan de enfermos crónicos del Servicio de Hemodiálisis de nuestro hospital en el 2005. Diez de estos pacientes tenían como acceso vascular temporal para hemodiálisis un catéter venoso central percutáneo (45,5 % y en ellos se registraron 26 procesos infecciosos relacionados con el cateterismo −algunos de ellos presentaron más de un episodio de infección relacionado con el catéter. Los catéteres utilizados fueron colocados por vía percutánea en las venas subclavia, femoral y yugular interna. Los catéteres insertados en la vena femoral presentaron el mayor número de complicaciones infecciosas. El hemocultivo fue positivo para el mismo germen en 14 casos del total de pacientes infectados, lo que evidenció que 53,8 % de los pacientes desarrollaron una infección asociada al uso del catéter. Los gérmenes que predominaron fueron los grampositivos (53,7 %, representados mayoritariamente por el estafilococo coagulasa-negativo. Las sepsis sistémicas predominaron en el estudio y todos los pacientes desarrollaron manifestaciones clínicas. En nuestro servicio la tasa estimada de sepsis por catéter para hemodiálisis fue de 18,1 %.The medical histories of the 22 patients from the chronically-ill patient program of Hemodyalisis Service at our hospital were studied in 2005. Ten of them had a central percutaneous venous catheter as a temporary vascular access for hemodyalisis (45,5%, but they also suffered 26 catheter-related infectious processes, some of them even more than one episode of infection. The used catheters were percutaneously placed in subclavian, femoral and internal jugular veins. Those catheters inserted into the femoral vein exhibited the highest number of infectious complications. Hemoculture was positive to the same germ in 14 cases of the total number of infected patients, which proved that 53,8% of patients developed catheter-related infection

Bilateral cerebral hemispheric infarction associated with sildenafil citrate (Viagra) use.

Science.gov (United States)

Kim, K-K; Kim, D G; Ku, Y H; Lee, Y J; Kim, W-C; Kim, O J; Kim, H S

2008-03-01

Sildenafil citrate (Viagra) is one of the frequently prescribed drugs for men with erectile dysfunction. We describe a 52-year-old man with bilateral middle cerebral artery (MCA) territory infarction after sildenafil use. He ingested 100 mg of sildenafil and about 1 h later, he complained of chest discomfort, palpitation and dizziness followed by mental obtundation, global aphasia and left hemiparesis. Brain magnetic resonance imaging documented acute bilateral hemispheric infarction, and cerebral angiography showed occluded bilateral MCA. Despite significant bilateral MCA stenosis and cerebral infarction, systemic hypotension persisted for a day. We presume that cerebral infarction was caused by cardioembolism with sildenafil use.

Características asociadas al subregistro de muerte en niños del estado de Guerrero, México

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TOMÉ PATRICIA

1997-01-01

Full Text Available Objetivo. Estimar la frecuencia de subregistro de muerte en niños en localidades rurales e identificar las características asociadas. Material y métodos. El estudio se realizó en tres etapas: en la primera se formaron tres estratos de localidades según el número de habitantes; de cada estrato se eligió, de manera aleatoria, un número representativo de localidades que fueron censadas para identificar las defunciones ocurridas entre junio de 1993 y julio de 1994. En la segunda etapa se realizó autopsia verbal con las madres de los niños fallecidos para identificar la causa de muerte e investigar las variables de estudio. Por último, se identificó el registro de muerte a través de los certificados de defunción. Resultados. Se identificó una frecuencia de subregistro de 68.9%; en las localidades menores de 500 habitantes fue de 73.2%, y en las mayores, de 60.5%. Como características asociadas al subregistro se identificaron: carecer de certificado de defunción y de registro de nacimiento; edad menor de un mes; desconocimiento del concepto y funciones del registro civil; distancia al registro civil y acceso al médico mayor de 30 minutos, y localidad menor de 1 000 habitantes. Conclusiones. Se propone una modificación en la organización actual del procedimiento de registro de muerte, así como el establecimiento del certificado de nacimiento propuesto por el Sistema Nacional de Salud.

Homogeneous bilateral block shifts

Indian Academy of Sciences (India)

Douglas class were classified in [3]; they are unilateral block shifts of arbitrary block size (i.e. dim H(n) can be anything). However, no examples of irreducible homogeneous bilateral block shifts of block size larger than 1 were known until now.

US findings of bilateral primary breast cancer: Retrospective study

International Nuclear Information System (INIS)

Lou Li; Cong Xinli; Yu Guofang; Li Jichang; Ma Yuxiang

2007-01-01

Background: For women with breast cancer, the contralateral breast is at high risk. The bilateral cancers may be synchronous or metachronous. If the bilateral breast cancers have similar ultrasonography (US) appearances, the US findings of the first breast cancer (index cancer) might lead to early detection of the contralateral cancer. The purpose of this study was to identify the US characteristics of bilateral breast cancer and to determine whether bilateral breast cancers have similar US appearances and whether the US findings for one breast cancer might be predictive of the contralateral breast cancer. Methods: We retrospectively reviewed the US manifestations of 58 patients with surgically proven bilateral primary breast cancer and compared the contralateral cancer with the index cancer by evaluation the margin, shape, inside echoes, posterior attenuation, calcification and color flow signals of 58 lesion pairs to investigate whether the bilateral breast cancers have similar US appearances. Results: Bilateral primary breast cancers were more located in upper outer quadrant, frequently spiculation, taller than wide shape, with irregular margin, heterogeneous internal echo and acoustic shadowing, containing microcalcification and abundant color flow signals. The most common US appearances were taller than wide shape (75.0%, 87/116), irregular margins (79.3%, 92/116) and heterogeneous internal echo (86.2%, 100/116). Of the total 58 lesion pairs, 18 (31.0%) pairs had similar US characteristics, whereas 40 (69.0%) pairs had different US characteristics. Conclusions: US signs of the index cancer do not indicate the most likely appearance of the second cancer in the contralateral breast. Evaluation of the contralateral cancer should be performed without regard for the US findings for the index cancer

Las migraciones internas de los latinoamericanos en España: del boom a la crisis económica

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Fernando GIL-ALONSO

2012-01-01

Full Text Available Las migraciones internas de la población de nacionalidad extranjera en España se caracterizan por su elevada intensidad, redistribuyendo a la población en el territorio. El objetivo de este artículo es el estudio del colectivo latinoamericano, que con más de 1,7 millones de personas se configuran como una de las comunidades extranjeras más importantes. Mientras sus principales características socio-demográficas han sido ampliamente investigadas -la feminización de los flujos migratorios y del stock de residentes, o su especialización laboral en los servicios-, sus pautas migratorias internas son menos conocidas. El primer objetivo del artículo es analizar la intensidad y las direcciones predominantes de su movilidad en el interior de España, tanto de larga distancia (interprovinciales como de corto radio (intraprovinciales, especial atención en los flujos de suburbanización en Madrid y Barcelona. El segundo objetivo es conocer el impacto de la crisis económica sobre dicha movilidad. Para ello se utilizarán los datos de la Estadística de Variaciones Residenciales junto a los del Padrón continuo.

A Consultoria Interna de Recursos Humanos como Prática Catalisadora da Gestão do Conhecimento Organizacional

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Dante Marciano Girardi

2009-09-01

Full Text Available http://dx.doi.org/10.5007/2175-8077.2009v11n25p151   Este artigo objetiva analisar a contribuição da Consultoria Interna de Recursos Humanos para a Gestão do Conhecimento nas indústrias catarinenses de grande porte. Os procedimentos metodológicos seguiram a linha qualitativa, por meio da pesquisa descritiva e aplicada. Foram entrevistadas sete das maiores empresas catarinenses em número de funcionários. Utilizou-se análise documental e de conteúdo. Quanto aos resultados, a consultoria interna auxilia principalmente nas etapas de socialização e externalização do conhecimento. Além disso, se implementada na sua totalidade e dada autonomia ao consultor interno, permite uma maior interação nos níveis individual, grupal e organizacional descritos por Sabbag (2007. Assim, pode-se perceber que as empresas que possuem maior grau de autonomia, bem como maior nível de implementação são aquelas que os processos são mais compartilhados, socializados e internalizados pelos funcionários. Dessa forma, pode-se afirmar que, nas empresas analisadas, o desenvolvimento dos processos de CIRH catalisa os resultados da Gestão do Conhecimento nas mesmas.

The unpredictable outcomes of bilateral simultaneous fractures of ...

African Journals Online (AJOL)

Bilateral simultaneous fractures of Neck of Femur (NOF) are rare. They result amongst others from trauma, metabolic disease, electro-convulsion and simple falls. We report two cases of 40-year-old and 74-year-old females who presented with bilateral simultaneous fractures of NOF post simple falls. Both patients had ...

Stabilization of Bilateral Progressive Rheumatoid Corneal Melt with Infliximab

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Sheelah F. Antao

2012-01-01

Results. A patient with rheumatoid arthritis presented with bilateral PUK following a 2-month history of ocular discomfort and redness. His systemic prednisolone (PDN and methotrexate (MTX were increased and, despite an initial favorable response, bilateral recurrent corneal perforations ensued. Both eyes underwent cyanoacrylate glue repair, amniotic membrane transplantation (AMT, and penetrating keratoplasty (PKP. Recurrence of the disease and bilateral perforations of the second PKP in both eyes prompted administration of intravenous infliximab immediately after the fourth PKP. The disease activity rapidly settled in both eyes, and at eighteen-month followup, after 12 infliximab infusions, the PUK remains quiescent with no further graft thinning or perforation. Conclusion. Infliximab can be used to arrest the progression of severe bilateral rheumatoid PUK in cases that are refractory to conventional treatment.

Cryptogenic organising pneumonia presenting with bilateral hilar and mediastinal lymphadenopathy.

Science.gov (United States)

Kahraman, Hasan; Tokur, Mahmut; Sayar, Hamide; Inci, Mehmet Fatih

2013-06-10

Cryptogenic organising pneumonia is not considered in the differential diagnosis of bilateral hilar and mediastinal lymphadenopathy. We submitted a patient presenting with bilateral hilar and mediastinal lymphadenopathy. We suspected diagnosis of sarcoidosis, but the patient was diagnosed as cryptogenic organising pneumonia with the histological result. This is the second case report of cryptogenic organising pneumonia presenting with bilateral hilar and mediastinal lymphadenopathy.

Encefalitis autoinmunitaria asociada a anticuerpos contra el receptor N-metil-D-aspartato: presentación de dos casos

OpenAIRE

José Bustos; Yasmin Sánchez; Jhon Medina; Rommy Olivieri; Julián Mojica; Johan Ortiz

2017-01-01

La encefalitis asociada a anticuerpos contra receptores N-metil-D-aspartato es un síndrome neurológico que se presenta más comúnmente en mujeres jóvenes y frecuentemente se asocia al teratoma de ovario. Se caracteriza por un cuadro clínico agudo con síntomas generales inespecíficos que evoluciona hacia deterioro neurológico, psicosis y convulsiones; en su etapa más avanzada, se asocia con movimientos anormales y disautonomía. Se reportan dos casos en mujeres de 23 y 12 años. Dada su baja i...

Luxatio erecta bilateral: um relato de caso Bilateral luxatio erecta, a case report

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César Augusto Xavier Acosta

2012-02-01

Full Text Available O deslocamento inferior do ombro (luxatio erecta é uma lesão rara, acometendo aproximadamente 0,5% dos deslocamentos dessa articulação. A grande maioria desses casos ocorre unilateralmente. Em setembro de 2004, um homem de 43 anos chegou ao pronto-socorro do Hospital Universitário de Santa Maria (HUSM com queixa de dor bilateral no ombro e incapacidade de abaixar os braços, em consequência de uma queda com os braços abduzidos, enquanto desempenhava sua atividade laboral. Após o exame físico e radiológico constatou- se que o indivíduo apresentava uma luxação inferior bilateral dos ombros. O paciente foi então encaminhado ao bloco cirúrgico onde foi realizada redução incruenta das luxações sob anestesia através da técnica de tração e contra-tração. No dia seguinte recebeu alta com imobilização tipo Velpeau mantendo os ombros totalmente aduzidos e rotados internamente, com orientação de manter a imobilização por três semanas. Foi orientado também a realizar fisioterapia.Inferior shoulder dislocation (luxactio erecta is a rare lesion affecting approximately 0.5% of dislocations of this joint. The vast majority of these cases occur unilaterally. In September 2004, a 43 year old man was brought to the emergency room of the University Hospital of Santa Maria (HUSM complaining of bilateral shoulder pain and inability to lower the arms, as a result of a fall with the arms abducted, while carrying out work activities. After physical examination and radiological exams, it was found that the patient had a bilateral inferior shoulder dislocation. He was referred to the surgical ward and after intravenous sedation, both shoulders were reduced by closed reduction using the traction-countertraction maneuver. The patient was discharged the day after the reduction. Both arms were immobilized with a velpeau sling in total adduction and intrarotation, with instructions to maintain immobilization for three weeks. The patient was

Bilateral Herpes Simplex Uveitis: Review of the Literature and Own Reports‏.

Science.gov (United States)

de-la-Torre, Alejandra; Valdes-Camacho, Juanita; Foster, C Stephen

2017-08-01

Herpes simplex-associated uveitis is usually considered a unilateral eye disease, and rarely included in the differential diagnosis whenever there is bilateral involvement. We report three cases of bilateral herpetic anterior uveitis. We evaluated three patients who presented with clinical manifestations of bilateral uveitis suggestive of viral origin. We found intraocular hypertension, cells in the anterior chamber, paralytic mydriasis, iris atrophy with transillumination defects, and variable anterior vitreous cellularity. According to the clinical findings, supported with herpes-specific antibody titers and aqueous humor PCR results in two of them, they were diagnosed with bilateral anterior herpetic uveitis. Our patients were initially misdiagnosed as having non-infectious uveitis and were treated with immunomodulatory medications, which could have favored the extension of infection bilaterally. Although uncommon, bilateral herpetic uveitis should always be considered in the differential diagnoses, when patients present with hypertensive uveitis in both eyes.

Validación del Handwashing Assessment Inventory en un hospital universitario de Bogotá

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Licet Villamizar Gómez

2014-12-01

Full Text Available El lavado de manos evita infecciones asociadas al cuidado; es necesaria una escala que mida la motivación y su cumplimiento. Objetivo: Validar el Handwashing Assessment Inventory (HAI en enfermeras del Hospital de San José, Bogotá, Colombia. Métodos: Luego de la adaptación transcultural, se realizó el análisis factorial (AF. Para la validez concurrente se comparó el HAI con la escala Acttitudes Regarding Guidelines Practices (ARGP. Se evaluó consistencia interna (CI, confiabilidad prueba reprueba (CPR y sensibilidad al cambio. Resultados: Se presentó una adecuada equivalencia lingüística. El AF indicó ocho dominios, similares a la escala original. La correlación entre escalas (ARGP-HAI fue menor a 0,30. La CI indicó alfa de Cronbach de 0,82. La CPR presentó valores menores de 0,30. El ANOVA de medidas repetidas no presentó diferencias en siete dominios. Conclusión: La validación del HAI presenta satisfactoria equivalencia transcultural. La consistencia interna es adecuada; pero la confiabilidad es baja.

Synchronous, bilateral tonsillar carcinomas

DEFF Research Database (Denmark)

Nami Saber, Camelia; Grønhøj, Christian; Jensen, David Hebbelstrup

2017-01-01

INTRODUCTION: The incidence of oropharyngeal squamous cell carcinoma (OPSCC) is increasing, but data on the incidence of synchronous, bilateral tonsillar squamous cell carcinomas (BiTSCCs) is sparse. In this study, we report the incidence and tumour characteristics of BiTSCCs in a population-base...

Manual de buenas prácticas de comunicación interna en la Biblioteca Universitaria (BUA)

OpenAIRE

Biblioteca Universitaria

2017-01-01

Todo cuanto hace la biblioteca es comunicación, voluntaria o involuntariamente. La comunicación no es una actividad opcional. La biblioteca comunica sí o sí, lo sepa o no, lo quiera o no, consciente o inconscientemente… (adaptación al campo de la biblioteca de las palabras de Daniel Scheisohn). Con estas premisas comenzamos este Manual de buenas prácticas de comunicación interna en la BUA, con el objetivo de orientar, de una manera sencilla y práctica, hacia las herramientas, técnicas y canal...

Bilateral acoustic neuromas.

Science.gov (United States)

Anand, V T; Byrnes, D P; Walby, A P; Kerr, A G

1993-10-01

This article reviews 12 patients with bilateral acoustic neuromas. The sex incidence was equal and the mean age at diagnosis was 26.2 years. The family history was positive in nine of the patients. Five patients have had incomplete surgical removal of acoustic neuromas on both sides. Two of them are completely deaf and the other three have severe sensorineural hearing loss in one ear and no hearing in the other ear. In five patients the tumour on one side has been operated on and the other side is being observed with at least short-term preservation of good hearing. The remaining two patients died of intra-cranial complications, one of them post-operatively. Four patients developed facial palsy immediately following surgery and one developed facial weakness 6 months after surgery. Guidelines are discussed for the care of these patients including the timing of surgery and alternative treatment options (observation, radio-surgery and chemotherapy). This is essentially a group of young individuals who have had multiple operations for bilateral acoustic tumours and associated manifestations and for whom the disease and the sequelae of treatment can be tragic.

Simultaneous bilateral contracture of the infraspinatus muscle.

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Franch, J; Bertran, J; Remolins, G; Fontecha, P; Díaz-Bertrana, M C; Durall, I

2009-01-01

A case of bilateral fibrotic contracture of the infraspinatus muscles in a five-year-old Belgian Shepherd dog is described. The dog was presented with progressive forelimb lameness with postural and gait abnormalities three months after an episode of overexertion. When walking, the lower part of both forelimbs swung in a lateral arc causing a circumduction movement and in the standing position, the dog showed elbow adduction with external rotation of the distal part of both front limbs. Orthopaedic examination revealed bilateral atrophy of both infraspinatus and supraspinatus muscles and restriction in the range of motion of both shoulders, especially when attempting abduction and flexion. No specific findings were observed in the shoulder or elbow radiographs but hyperechogenic areas were evident in the ultrasonographic examination of both infraspinatus muscles. A diagnosis of fibrotic contracture of both infraspinatus muscles was established and bilateral tenectomy of the insertion tendons of the infraspinatus muscles was performed. Complete recovery of the animal was achieved after the surgery, which was confirmed in a long-term follow-up (10 months). In conclusion, physical examination and ultrasonography allowed a proper diagnosis of the condition, and tenectomy of the infraspinatus muscles resulted in a complete recovery of the patient even with bilateral involvement.

Gerenciando equipes de design interna e externa no processo de desenvolvimento de produtos: caso de duas empresas calçadistas do sul do Brasil.

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Andréa Capra

2012-12-01

Full Text Available Esse artigo trata da inserção do design no processo de desenvolvimento de produtos em duas empresas da indústria calçadista da região do Vale do Paranhana, no Rio Grande do Sul. Essas empresas podem trabalhar com diferentes tipos de equipes, interna, externa ou mista e, entender as vantagens e desvantagens de cada tipo de equipe é fundamental ao determinar a melhor opção para a empresa. Porém, pouco tem-se estudado buscando essa relação entre equipes de design e desenvolvimento de produtos. Nesse sentido, o objetivo do estudo foi analisar o gerenciamento de equipes de design, interna e externa, no processo de desenvolvimento de produtos de empresas da indústria calçadista. Para isso, um estudo de caso foi realizado através da análise do caso de uma empresa que trabalhava com os dois tipos de equipes. Com a realização desta pesquisa, foi possível estudar a forma de atuação e gerenciamento das equipes interna e externa de design no processo de desenvolvimento de produtos. Os resultados indicam que diferenças nas formas de atuação e gerenciamento de cada equipe estão relacionados com a autonomia decisória conferida para equipe no início do desenvolvimento de novos projetos.

High Performance, Three-Dimensional Bilateral Filtering

International Nuclear Information System (INIS)

Bethel, E. Wes

2008-01-01

Image smoothing is a fundamental operation in computer vision and image processing. This work has two main thrusts: (1) implementation of a bilateral filter suitable for use in smoothing, or denoising, 3D volumetric data; (2) implementation of the 3D bilateral filter in three different parallelization models, along with parallel performance studies on two modern HPC architectures. Our bilateral filter formulation is based upon the work of Tomasi [11], but extended to 3D for use on volumetric data. Our three parallel implementations use POSIX threads, the Message Passing Interface (MPI), and Unified Parallel C (UPC), a Partitioned Global Address Space (PGAS) language. Our parallel performance studies, which were conducted on a Cray XT4 supercomputer and aquad-socket, quad-core Opteron workstation, show our algorithm to have near-perfect scalability up to 120 processors. Parallel algorithms, such as the one we present here, will have an increasingly important role for use in production visual analysis systems as the underlying computational platforms transition from single- to multi-core architectures in the future.

High Performance, Three-Dimensional Bilateral Filtering

Energy Technology Data Exchange (ETDEWEB)

Bethel, E. Wes

2008-06-05

Image smoothing is a fundamental operation in computer vision and image processing. This work has two main thrusts: (1) implementation of a bilateral filter suitable for use in smoothing, or denoising, 3D volumetric data; (2) implementation of the 3D bilateral filter in three different parallelization models, along with parallel performance studies on two modern HPC architectures. Our bilateral filter formulation is based upon the work of Tomasi [11], but extended to 3D for use on volumetric data. Our three parallel implementations use POSIX threads, the Message Passing Interface (MPI), and Unified Parallel C (UPC), a Partitioned Global Address Space (PGAS) language. Our parallel performance studies, which were conducted on a Cray XT4 supercomputer and aquad-socket, quad-core Opteron workstation, show our algorithm to have near-perfect scalability up to 120 processors. Parallel algorithms, such as the one we present here, will have an increasingly important role for use in production visual analysis systems as the underlying computational platforms transition from single- to multi-core architectures in the future.

Bilateral Supernumerary Kidney: A Very Rare Presentation

Science.gov (United States)

Keskin, Suat; Batur, Abdussamet; Keskin, Zeynep; Koc, Abdulkadir; Firat Ozcan, Irfan

2014-01-01

To our knowledge, bilateral supernumerary kidney is a very rare renal abnormality and there are five cases presented in the literature. It is difficult to diagnose supernumerary kidney and clinicians have not detected most cases preoperatively. Laboratory and imaging studies were acquired and carefully examined. The normal laboratory tests were found. Emergency ultrasonography was performed and they revealed no signs of parenchymal abnormality in both kidneys. Serial imaging study including enhanced computed tomography (CT) was performed. An imaging study identified bilateral supernumerary kidney with expanded collecting systems. On each side, significant rotation anomaly was found. In addition, there were two different renal arteries originating from the aorta. This report presents radiological determinations of supernumerary kidney bilaterally in a young man. We think that CT commonly appears to be enough for the diagnosis of supernumerary kidneys. PMID:25780543

Bilateral ureteropelvic junction obstruction presenting with hypertension and cerebral vascular accident.

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Tourchi, Ali; Kajbafzadeh, Abdolmohammad; Nejat, Farideh; Golmohammadi, Abolfazl; Alizadeh, Farshid; Mahboobi, Amir Hassan

2010-11-01

Cerebrovascular accident and renal hypertension secondary to ureteropelvic junction obstruction (UPJO) are extremely rare. A 6-year-old girl presented with intracranial hemorrhage because of hypertension secondary to the bilateral UPJO. This was successfully treated with craniotomy and subsequent percutaneous nephrostomy placement and bilateral pyeloplasty. Brain computerized tomography revealed right-sided intracranial hemorrhage, and renal ultrasonography confirmed bilateral severe hydronephrosis. Craniotomy with evacuation of intracerebral hematoma and bilateral nephrostomy under ultrasound guidance were performed. One week later, she underwent bilateral pyeloplasty in 2 stages. The patient has been well with normalized renal function and is completely cured of her hypertension in long-term follow-up. Copyright © 2010 Elsevier Inc. All rights reserved.

Psychiatric and social outcome after deep brain stimulation for advanced Parkinson's disease

NARCIS (Netherlands)

Boel, Judith A.; Odekerken, Vincent J. J.; Geurtsen, Gert J.; Schmand, Ben A.; Cath, Danielle C.; Figee, Martijn; van den Munckhof, Pepijn; de Haan, Rob J.; Schuurman, P. Richard; de Bie, Rob M. A.; van Laar, Teus; van Dijk, J. Marc C.; Mosch, Arne; Hoffmann, Carel F. E.; Nijssen, Peter C. G.; Beute, Guus N.; van Vugt, Jeroen P. P.; Lenders, Mathieu W. P. M.; Contarino, M. Fiorella; Bour, Lo J.

2016-01-01

The aim of this study was to assess psychiatric and social outcome 12 months after bilateral deep brain stimulation (DBS) of the globus pallidus pars interna (GPi) and subthalamic nucleus (STN) for advanced Parkinson's disease (PD). We randomly assigned patients to receive GPi DBS (n = 65) or STN

Bilateral Tubal Gestation Associated with Schistosomiasis in an African Woman

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K. H. Odubamowo

2014-01-01

Full Text Available Background. The incidence of tubal ectopic gestation caused by schistosomiasis induced tubal pathology is undocumented in this environment, which may be due to rarity of this pathology. Bilateral tubal gestation is common in patients that have undergone in vitro fertilization. We report a hitherto undocumented case of spontaneous bilateral ectopic gestation following tubal schistosomiasis. Case Report. Mrs. OB was a 32-year-old G4P3+0 (3 alive woman who complained of abdominal pain and bleeding per vaginam of 4 and 2 days’ duration respectively following 8 weeks of amenorrhea. A clinical impression of ruptured ectopic gestation was confirmed by ultrasound scanning. She had bilateral salpingectomy with histology of specimens showing bilateral ectopic gestation with Schistosoma haematobium induced salpingitis (findings of Schistosoma haematobium ova noted on slide. Conclusion. Schistosoma induced salpingitis is a rare but possible cause of bilateral tubal gestation.

Bilateral and unilateral ECT: effects on verbal and nonverbal memory.

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Squire, S R; Slater, P C

1978-11-01

The memory loss associated with bilateral and nondominant unilateral ECT was assessed with verbal memory tests known to be sensitive to left temporal lobe dysfunction and with nonverbal memory tests known to be sensitive to right temporal lobe dysfunction. Bilateral ECT markedly impaired delayed retention of verbal and nonverbal material. Right unilateral ECT impaired delayed retention of nonverbal material without measurably affecting retention of verbal material. Nonverbal memory was affected less by right unilateral ECT than by bilateral ECT. These findings, taken together with a consideration of the clinical efficacy of the two types of treatment, make what appears to be a conclusive case for unilateral over bilateral ECT.

Parálisis diafragmática bilateral. Presentación de un caso Bilateral diaphragmatic paralysis

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Jorge Carnot Pereira

2012-04-01

Full Text Available La parálisis diafragmática bilateral es una entidad muy infrecuente en la clínica, debido a diferentes entidades con capacidad de lesionar el nervio frénico. El compromiso respiratorio que produce requiere cuidado especializado. Este es el primer caso reportado en nuestra literatura a consecuencia de hernias cervicales múltiples. Se presenta un caso de un paciente de 43 años, con antecedentes de salud, exatleta de alto rendimiento, que ingresó en nuestro servicio, con disnea de 5 meses de evolución, que aumentó progresivamente en intensidad hasta mantenerlo en ortopnea constante, fue estudiado exhaustivamente hasta llegar a diagnostico definido y derivarlo al servicio de Neurocirugía para su solución definitiva. La importancia del tema que se presenta es que se describe una presentación rara de parálisis diafragmática bilateral, a consecuencia de hernias discales cervicales múltiples.Bilateral diaphragmatic paralysis is a rare condition in clinical practice due to different entities that can damage phrenic nerve. The resulting respiratory compromise requires medical special care. This is the first case reported in our medical literature caused by multiple cervical hernias. A 43 year-old patient having health history, high performance ex-athlete, admitted in the service with 5-month evolution of dyspnea which progressively increased in intensity up to maintain him in permanent orthopnea, thorough studies were conducted to the definite diagnosis and he was transferred to Neurosurgery Service to a definite solution. A rare presentation of a bilateral diaphragmatic paralysis resulting from multiple cervical hernias gives importance to the topic.

Delayed diagnosis of homocystinuria presenting as bilateral congenital lens subluxation

OpenAIRE

Jelić-Vuković Marija; Matić Suzana; Barać Josip; Novinščak Tomislav; Belovari Mirna; Barić Hrvoje

2017-01-01

Introduction. Homocystinuria is an autosomal recessively inherited defect leading to hyperhomocysteinemia and associated with ocular manifestations, mainly myopia and ectopia lentis. Case outline. A 26-year-old male with secondary glaucoma due to bilateral lens subluxation was admitted to the Department of vitreoretinal surgery. Horizontal nystagmus, bilateral lens subluxation, and bilateral amblyopia were first discovered at the age of three years. Preoperative laboratory workup revealed ele...

Biomechanics of unilateral and bilateral sacroiliac joint stabilization: laboratory investigation.

Science.gov (United States)

Lindsey, Derek P; Parrish, Robin; Gundanna, Mukund; Leasure, Jeremi; Yerby, Scott A; Kondrashov, Dimitriy

2018-03-01

OBJECTIVE Bilateral symptoms have been reported in 8%-35% of patients with sacroiliac (SI) joint dysfunction. Stabilization of a single SI joint may significantly alter the stresses on the contralateral SI joint. If the contralateral SI joint stresses are significantly increased, degeneration may occur; alternatively, if the stresses are significantly reduced, bilateral stabilization may be unnecessary for patients with bilateral symptoms. The biomechanical effects of 1) unilateral stabilization on the contralateral SI joint and 2) bilateral stabilization on both SI joints are currently unknown. The objectives of this study were to characterize bilateral SI joint range of motion (ROM) and evaluate and compare the biomechanical effects of unilateral and bilateral implant placement for SI joint fusion. METHODS A lumbopelvic model (L5-pelvis) was used to test the ROM of both SI joints in 8 cadavers. A single-leg stance setup was used to load the lumbar spine and measure the ROM of each SI joint in flexion-extension, lateral bending, and axial rotation. Both joints were tested 1) while intact, 2) after unilateral stabilization, and 3) after bilateral stabilization. Stabilization consisted of lateral transiliac placement of 3 triangular titanium plasma-sprayed (TPS) implants. RESULTS Intact testing showed that during single-leg stance the contralateral SI joint had less ROM in flexion-extension (27%), lateral bending (32%), and axial rotation (69%) than the loaded joint. Unilateral stabilization resulted in significant reduction of flexion-extension ROM (46%) on the treated side; no significant ROM changes were observed for the nontreated side. Bilateral stabilization resulted in significant reduction of flexion-extension ROM of the primary (45%) and secondary (75%) SI joints. CONCLUSIONS This study demonstrated that during single-leg loading the ROMs for the stance (loaded) and swing (unloaded) SI joints are significantly different. Unilateral stabilization for SI

Hardware Implementation of a Bilateral Subtraction Filter

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Huertas, Andres; Watson, Robert; Villalpando, Carlos; Goldberg, Steven

2009-01-01

A bilateral subtraction filter has been implemented as a hardware module in the form of a field-programmable gate array (FPGA). In general, a bilateral subtraction filter is a key subsystem of a high-quality stereoscopic machine vision system that utilizes images that are large and/or dense. Bilateral subtraction filters have been implemented in software on general-purpose computers, but the processing speeds attainable in this way even on computers containing the fastest processors are insufficient for real-time applications. The present FPGA bilateral subtraction filter is intended to accelerate processing to real-time speed and to be a prototype of a link in a stereoscopic-machine- vision processing chain, now under development, that would process large and/or dense images in real time and would be implemented in an FPGA. In terms that are necessarily oversimplified for the sake of brevity, a bilateral subtraction filter is a smoothing, edge-preserving filter for suppressing low-frequency noise. The filter operation amounts to replacing the value for each pixel with a weighted average of the values of that pixel and the neighboring pixels in a predefined neighborhood or window (e.g., a 9 9 window). The filter weights depend partly on pixel values and partly on the window size. The present FPGA implementation of a bilateral subtraction filter utilizes a 9 9 window. This implementation was designed to take advantage of the ability to do many of the component computations in parallel pipelines to enable processing of image data at the rate at which they are generated. The filter can be considered to be divided into the following parts (see figure): a) An image pixel pipeline with a 9 9- pixel window generator, b) An array of processing elements; c) An adder tree; d) A smoothing-and-delaying unit; and e) A subtraction unit. After each 9 9 window is created, the affected pixel data are fed to the processing elements. Each processing element is fed the pixel value for

Bilateral Rhegmatogenous Retinal Detachment during External Beam Radiotherapy

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Takako Hidaka

2016-06-01

Full Text Available Herein, we report a case of nontraumatic bilateral rhegmatogenous retinal detachment (RRD during external beam radiotherapy for nonocular tumor, presented as an observational case study in conjunction with a review of the relevant literature. A 65-year-old male was referred to our hospital due to bilateral RRD. He underwent a biopsy for a tumor of the left frontal lobe 4 months prior to presentation, and the tumor had been diagnosed as primary central nerve system B-cell type lymphoma. He received chemotherapy and external beam radiotherapy for 1 month. There were no traumatic episodes. Bilateral retinal detachment occurred during a series of radiotherapies. Simultaneous nontraumatic bilateral retinal detachment is rare. The effects of radiotherapy on ocular functionality, particularly in cases involving retinal adhesion and vitreous contraction, may include RRD. Thus, it is necessary to closely monitor the eyes of patients undergoing radiotherapy, particularly those undergoing surgery for retinal detachment and those with a history of photocoagulation for retinal tears, a relevant family history, or risk factors known to be associated with RRD.

Bilateral Moyamoya Disease in a 2-Year-Old Pakistani Male Treated with Bilateral Encephaloduroarteriosynangiosis: A Positive Outcome

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Shahvaiz Magsi

2016-01-01

Full Text Available Background. We present a rare case of bilateral moyamoya disease presenting as multiple strokes and neurological deficits, treated with the neurosurgical procedure, encephaloduroarteriosynangiosis (EDAS, in a 2-year-old male Pakistani minor. A positive outcome was achieved and the patient recovered fully. Case Summary. Our patient presented with a history of seizures and multiple episodes of hemiparesis (on and off weakness at the age of 2 years. He had a delayed speech development and could not speak more than a few words. He had a slight slurring of speech too. He was diagnosed with bilateral moyamoya disease on Computed Tomography Angiography (CTA. Bilateral EDAS was done in the same year, after which his symptoms improved and patient had moderate functional recovery. Conclusion. A rare disease, moyamoya has been left unexplored in Pakistan; physicians and surgeons when dealing with cases in the pediatric population presenting with symptoms of stroke, signs of generalized weakness, and seizures should consider moyamoya disease as a possibility. Furthermore, this case demonstrates the effectiveness of EDAS procedure for the treatment of moyamoya disease.

Bilateral pulmonary infiltrates in association with disseminated actinomycosis.

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Dontfraid, F; Ramphal, R

1994-07-01

The most common infectious cause of bilateral upper-lobe pulmonary disease is tuberculosis. However, we recently encountered a patient with bilateral apical infiltrates and multiple soft-tissue abscesses caused by Actinomyces odontolyticus. Other findings included fever, weight loss, and leukocytosis, and the patient's only known source of immunosuppression was a long history of alcoholism. There was no history of diabetes, steroid use, or other chronic underlying disease. The diagnosis was made by culture of drainage fluid from one abscess. Therapy with intravenous penicillin G led to rapid clinical improvement and reduction in the infiltrates. To our knowledge, the presentation of pulmonary infection, with bilateral apical infiltrates due to A. odontolyticus has not been previously reported in the medical literature.

Parámetros y factores asociados a la dilución interna en yacimientos cubanos de níquel y cobalto

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Lázaro Fernández-Martínez

2015-12-01

Full Text Available El propósito de este trabajo fue establecer, en los yacimientos cubanos de níquel y cobalto, los elementos que condicionan e identifican las intercalaciones de baja ley, generadoras de dilución interna, para su posterior separación durante el laboreo minero. La observación y la interpretación de datos geológicos y geoquímicos de pozos y frentes de explotación permitieron diferenciar, según su naturaleza geológica o minera, los distintos elementos que engloban los parámetros y factores vinculados con la dilución interna. Son los parámetros y factores geoquímicos del componente geológico los que mejor caracterizan las intercalaciones a partir de muestras de perforación, mientras que el control de campo es, dentro del componente minero, el que mejor permite identificar (y separar las intercalaciones inmediatamente antes del ingreso de las menas al proceso industrial, en virtud del potencial selectivo de la tecnología minera y de los equipos de arranque actuales.

Obstáculos del aprendizaje de respiración celular asociada al metabolismo de carbohidratos en estudiantes de nivel universitario

OpenAIRE

Garófalo, Judith

2009-01-01

El objetivo del trabajo fue identificar posibles obstáculos en el procesamiento de la información asociada al metabolismo de los carbohidratos y la respiración celular, en estudiantes de segundo año de Ciencias Biológicas de la Universidad de Buenos Aires, mediante una metodología consistente en Entrevistas Concurrentes y Entrevistas Recurrentes.Mostramos que la mayoría de los errores de los estudiantes provienen de visiones parciales y descontextualizadas de los procesos bioquímicos estudiad...

Phacoemulsification of bilateral cataracts in two pet rabbits | Gomes ...

African Journals Online (AJOL)

Two 3 year-old, healthy, client-owned Lop rabbits presented with bilateral cataracts. After performing a physical examination, bloodwork, ocular ultrasonography and electroretinography, both animals were deemed good surgical candidates for phacoemulsification. Bilateral cataract surgery was performed and both rabbits ...

Bilateral spontaneous pneumothorax with pulmonary metastases of synovial sarcoma

International Nuclear Information System (INIS)

Matushita, J.P.K.; Azevedo, C.M. de

1989-01-01

The association of bilateral spontaneous pneumothorax with pulmonary tumor is uncommon and with pulmonary metastases is rare. The clinical and radiological features of bilateral spontaneous pneumothorax from a synovial sarcoma in a 14 years old boy are described. (author) [pt

Bilateral nasolabial cysts - case report and review of literature

International Nuclear Information System (INIS)

Patil, Aruna R; Singh, Abhinav Pratap; Nandikoor, Shrivalli; Meganathan, Prabhu

2016-01-01

Nasolabial cyst is a non-odontogenic, extraosseous, soft tissue cyst, commonly unilateral, located in the nasolabial fold. Bilateral nasolabial cysts are of rare occurrence. This case report describes the multimodality imaging appearance of bilateral nasolabial cysts with a review of literature

UNITED STATES/GERMAN TECHNICAL BILATERAL AGREEMENT: PAST, PRESENT & FUTURE

Science.gov (United States)

The U.S. Environmental Protection Agency (EPA) and the German Federal Ministry of Education and Research (BMBF) entered into a Bilateral Agreement in 1990 to study each country's efforts in developing and demonstrating remedial technologies. The bilateral agreement is being impl...

Pros and cons of immediately sequential bilateral cataract surgery (ISBCS).

Science.gov (United States)

Grzybowski, Andrzej; Wasinska-Borowiec, Weronika; Claoué, Charles

2016-01-01

Immediately sequential bilateral cataract surgery (ISBCS) is currently a "hot topic" in ophthalmology. There are well-documented advantages in terms of quicker visual rehabilitation and reduced costs. The risk of bilateral simultaneous endophthalmitis and bilateral blindness is now recognized to be minuscule with the advent of intracameral antibiotics and modern management of endophthalmitis. Refractive surprises are rare for normal eyes and with the use of optical biometry. Where a general anesthetic is indicated for cataract surgery, the risk of death from a second anesthetic is much higher than the risk of blindness. A widely recognized protocol from the International Society of Bilateral Cataract Surgeons needs to be adhered to if surgeons wish to start practicing ISBCS.

Bilateral papillary renal cell carcinoma

International Nuclear Information System (INIS)

Gossios, K.; Vazakas, P.; Argyropoulou, M.; Stefanaki, S.; Stavropoulos, N.E.

2001-01-01

Papillary renal cell carcinoma is a subgroup of malignant renal epithelial neoplasms. We report the clinical and imaging findings of a case with multifocal and bilateral renal cell carcinoma which are nonspecific. (orig.)

Análisis de consistencia interna mediante Alfa de Cronbach: un programa basado en gráficos dinámicos

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Rubén Ledesma

Full Text Available En este trabajo se presenta una herramienta informática original que permite realizar análisis de consistencia interna (modelo Alfa de Cronbach utilizando métodos gráficos dinámicos. Se trata de un módulo basado en la filosofía del Análisis Exploratorio de Datos y en métodos de visualización estadística, diseñado para asistir al analista en el proceso de construcción de pruebas psicológicas. La herramienta permite analizar la consistencia interna de la prueba, las propiedades de los ítems que la componen, los patrones de respuesta de los sujetos a los ítems, y el efecto de la eliminación de los ítems y del incremento en la longitud de la prueba sobre su fiabilidad. En comparación con otros programas existentes, el beneficio del módulo es la incorporación de gráficos estadísticos dinámicos como complemento a la presentación de resultados convencionales en formato texto.

Tromboembolia pulmonar asociada al síndrome de la vena cava superior de origen trombótico

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Ana Madeleine Barrera-López

2017-07-01

Full Text Available Se describe el caso de un paciente masculino de 32 años de edad, quien consulta al servicio de urgencias con historia clínica del síndrome de la vena cava superior, en el estudio de la angiotomografía pulmonar, se demuestra embolismo pulmonar izquierdo, trombosis de la vena yugular interna derecha y confluente yugulo subclavio. No hay evidencia de asociación con neoplasia, infecciones o enfermedades del tejido conectivo, siendo el único factor de riesgo asociado para la trombosis, hiperviscocidad (tríada de virchow por poliglobulia.

Anoftalmia bilateral como defeito congênito isolado: uma abordagem etiológica e psicossocial

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Diego Davi Corso

2011-08-01

Full Text Available A anoftalmia é uma condição oftalmológica rara, caracterizada pela ausência de um ou ambos os olhos, de etiologia não elucidada, podendo ser congênita, adquirida ou associada a outras síndromes sistêmicas. Quanto à etiologia, já foram descritas na literatura aberrações cromossômicas, mutações genéticas e fatores ambientais como responsáveis pelo surgimento da anomalia. Não existe consenso sobre a real incidência da anoftalmia, devido à escassez em dados oficiais, principalmente no Brasil. Neste estudo relata-se um caso de uma paciente do sexo feminino que apresenta anoftalmia bilateral congênita, sem outras anormalidades. Foram utilizados dados compilados do prontuário médico hospitalar, exames laboratoriais e de imagem realizados durante a internação, bem como exames solicitados no acompanhamento clínico pós-alta e um questionário aplicado aos responsáveis legais pela paciente. Os fatores genéticos e não genéticos envolvidos no desenvolvimento de anomalias, assim como as complicações estéticas e psicossociais advindas da anoftalmia foram discutidos. Conclui-se que o fator idade pode estar relacionado ao aparecimento da anoftalmia e que a maior divulgação desta rara anomalia congênita propiciará aos profissionais da saúde, especialmente aos oftalmologistas, conhecimentos adicionais para lidar com os aspectos físicos, humanísticos e sociais envolvidos no atendimento do paciente e de seus familiares, minimizando a gravidade e abrangência dos seus efeitos.

Bilateral cheiloschisis in bovine - A case report

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Saulo Andrade Caldas

2014-01-01

Full Text Available ABSTRACT. Caldas S.A., Nogueira V.A., Lima A.E.S., Aragão A.P., d’Avila M.S., Santos A.M., Miranda I.C., Costa S.Z.R. & Peixoto T.C. [Bilateral cheiloschisis in bovine - A case report.] Queilosquise bilateral em bovino - Relato de caso. Revista Brasileira de Medicina Veterinária, 36(1:55-59, 2014. Departamento de Medicina e Cirurgia Veterinária, Instituto de Veterinária, Universidade Federal Rural do Rio de Janeiro, BR 465 Km 7, Seropédica RJ 23890-000, Brasil. E-mail: saulocaldas@hotmail.com A case of bilateral queilosquise in a cattle two years old was reported. Clinically, there was cachexia, difficulty in grasping food and water intake. The clinical examination revealed that the nasal orifices were discontinuous with the upper lip, which allowed communication between the nostrils and mouth in its rostral portion, crowding of incisors (tweezers, as well as exposure of medium and the 2nd corner and of the tongue. In this case, the bilateral queilosquise was the result of flaws in fusion of the maxillary process and the medial nasal process and its surroundings, probably due to mineral deficiencies of pregnant cow. This pathogenesis was suggested by excluding other possible causes, the knowledge of the existence of mineral deficiencies in the region where the event occurred and bad nutritional status of pregnant female.

Unilateral versus bilateral stent insertion for malignant hilar biliary obstruction.

Science.gov (United States)

Chang, Gang; Xia, Feng-Fei; Li, Hong-Fu; Niu, Su; Xu, Yuan-Shun

2017-11-01

To determine the clinical efficiency and long-term outcomes between unilateral and bilateral stent insertion in patients with malignant hilar biliary obstruction. From August 2012 to February 2016, 63 consecutive patients with malignant hilar biliary obstruction were treated with unilateral or bilateral stent insertion at our center. The bilateral stents were inserted using the side-by-side technique. The clinical efficiency and long-term outcomes were compared between the two groups. Unilateral and bilateral stent insertions were successfully performed in 31 of 33 and 27 of 30 patients, respectively (P = 0.912). No procedure-related complication occurred. Clinical success was achieved in 29 of 31 patients in the unilateral stent group and in 26 of 27 patients in the bilateral stent group (P = 0.637). During the follow-up, re-obstruction of stent occurred in five patients in the unilateral stent group and in three patients in the bilateral stent group (P = 0.58). The significant differences were not observed in the stent patency time (368 vs. 387 days, P = 0.685) and survival (200 vs. 198 days, P = 0.751) between two groups. Based on the univariate and multivariate analyses, the independent risk factors for decreasing the survival time included higher Eastern Cooperative Oncology Group performance status (P = 0.018), higher alanine aminotransferase level (P = 0.009), and absence of anticancer treatment after stent insertion (P = 0.002). Compared to bilateral stent insertion for malignant hilar biliary obstruction, unilateral stent insertion can provide comparable clinical efficiency and long-term outcomes.

Immediate Sequential Bilateral Cataract Surgery

DEFF Research Database (Denmark)

Kessel, Line; Andresen, Jens; Erngaard, Ditte

2015-01-01

The aim of the present systematic review was to examine the benefits and harms associated with immediate sequential bilateral cataract surgery (ISBCS) with specific emphasis on the rate of complications, postoperative anisometropia, and subjective visual function in order to formulate evidence......-based national Danish guidelines for cataract surgery. A systematic literature review in PubMed, Embase, and Cochrane central databases identified three randomized controlled trials that compared outcome in patients randomized to ISBCS or bilateral cataract surgery on two different dates. Meta-analyses were...... performed using the Cochrane Review Manager software. The quality of the evidence was assessed using the GRADE method (Grading of Recommendation, Assessment, Development, and Evaluation). We did not find any difference in the risk of complications or visual outcome in patients randomized to ISBCS or surgery...

International bilateral and multilateral arrangements in energy technologies

International Nuclear Information System (INIS)

1978-07-01

This document, the second report in the series, outlines current DOE international commitments under bilateral and multilateral arrangements, as of January 1, 1978. Included are bilateral agreements for cooperation in the civil uses of atomic energy with countries and international organizations, bilateral and multilateral technical exchanges in all energy technology areas, and multilateral agreements under the auspices of the International Energy Agency (IEA). In addition to outlining the terms, scope, and status of these agreements, this document describes DOE's participation in the work of the major international energy organizations. IEA, the International Atomic Energy Agency (IAEA), and the Nuclear Energy Agency (NEA). Future reports will update the status of ongoing cooperative projects and provide information on new energy R and D activities

Prolapso de gordura orbitária bilateral associado a pterígio: relato de caso Bilateral orbital fat prolapse associated with pterygium: case report

Directory of Open Access Journals (Sweden)

Vanderson Glerian Dias

2006-06-01

Full Text Available O prolapso de gordura orbitária é entidade benigna incomum que pode causar defeitos estéticos. Os autores apresentam uma paciente de 63 anos com prolapso de gordura orbitária temporal bilateral associado a pterígio medial bilateral, ressaltando aspectos clínicos e cirúrgicos. Discute-se a importância do diagnóstico clínico e de imagem, além da comprovação histopatológica da lesão.Orbital fat prolapse is an uncommon benign entity that can cause esthetic defects. The authors present a 63-year-old patient with bilateral temporal orbital fat prolapse associated with a bilateral nasal pterygium. Clinical and surgical features are described. The clinical, imaging and histopathological diagnoses are discussed.

Relatório de estágio: auditoria interna e controlo de gestão

OpenAIRE

Pinho, Marisa Ferreira Alves de

2014-01-01

O presente relatório resulta do estágio curricular realizado na Divisão Municipal de Auditoria Interna, Planeamento e Sistemas de Informação do Município de Oliveira de Azeméis (MOA), no âmbito do Mestrado Contabilidade e Administração Pública e propõe-se divulgar as atividades desenvolvidas ao longo do estágio bem como a propor um método para integração da Failure Mode and Effects Analysis (FMEA) no Plano Global de Gestão dos Riscos Organizacionais (PGGRO), aplicado à Divisão Municipal de Em...

Cutaneous metastasis of bilateral renal cell carcinoma.

Science.gov (United States)

Abbasi, Fariba; Alizadeh, Mansur; Noroozinia, Farahnaz; Moradi, Amin

2013-01-01

Renal cell carcinoma (RCC) is a malignant lethal tumour with high potential of metastasis. However, metastasis from RCC to the skin is much less common. It is virtually a sign of poor prognosis. We represent a 42 years old man with bilateral RCC of clear cell type followed by metastasis to the scalp one month later. In this case the relatively young age of the patient, bilaterality of RCC and occurance of skin metastasis in the absence of recurrent kidney tumour are interesting.

BILATERAL CHOROIDAL EXCAVATION IN JUVENILE LOCALIZED SCLERODERMA.

Science.gov (United States)

Franklin, Mackenzie L; Day, Shelley

2018-01-01

To describe a case of bilateral choroidal excavation in a patient with juvenile localized scleroderma. Case report. An asymptomatic 12-year-old boy with localized scleroderma presented for examination and was found to have bilateral areas of choroidal excavation temporal to the fovea. Previous reports of ocular complications of localized scleroderma have primarily described adnexal and anterior segment changes. This is the second report of choroidal changes in a patient with localized scleroderma, and the first in a pediatric patient.

Selección interna: el control de la filogenia por la ontogenia en una perspectiva variacional

Directory of Open Access Journals (Sweden)

Gustavo Caponi

2009-11-01

Full Text Available La idea de selección interna, propuesta originalmente por Lancelot Whyte, no sólo sirve para entender el papel causal que los constreñimientos del desarrollo tienen en evolución; sino que además puede hacernos comprender de qué modo esos factores organísmicos o internos, cuya importancia la Biología Evolucionaria del Desarrollo hoy quiere rescatar, son pasibles de ser considerados desde una perspectiva variacional o seleccional compatible, pero no asimilable, a la Teoría de la Selección Natural. Así, considerado como un concepto autónomo y diferente al de selección natural, el concepto de selección interna puede permitirnos comprender de qué modo eso que Wallace Arthur llama developmental bias constituye una causa, efectiva y positiva, de transformaciones evolutivas irreversibles y acumulables.The idea of internal selection, originally proposed by Lancelot Whyte, not only helps to understand the causal role that the developmental constraints have in evoltion, but it can also show how these organismic or internal factors, which relevancy the Evolutionary Developmental Biology remarks today, can be considered from a variational or selectional perspective that is compatible with, but not reducible to, Natural Selection Theory. Thus, being considered as a concept autonomous and different from natural selection, the concept of internal selection can allow us to understand how that phenomenon that Wallace Arthur calls developmental bias constitutes an effective and positive cause of irreversible and cumulative evolutionary changes.

Diagnóstico del estado situacional de la comunicación interna en Amanco-Costa Rica

Directory of Open Access Journals (Sweden)

Paola Rojas Lobo

2009-06-01

Full Text Available El presente articulo resume el trabajo de graduacion titulado "Diagnostico del estado situacional de los procesos de comunicacion interna generados por el Departamento de Recursos Humanos de Amanco Costa Rica, durante el II semestre del 2006 y primer semestre del 2007" para optar por el grado de Master en comunicacion con enfasis en mercadeo. Este trabajo busca demostrar como la comunicacion interna en una organizacion permite generar un compromiso en los colaboradores con las labores de la empresa, ayuda a tomar decisiones congruentes, consolida las politicas y la identidad de la organizacion, integra al personal, delimita roles laborales, satisface las necesidades de los clientes internos y los motiva, mejora la calidad de vida de los colaboradores, genera una buena sinergia de trabajo, descentraliza funciones, maximiza el aprovechamiento de oportunidades, reduce los conflictos, mejora la comunicacion entre departamentos, mejora las adaptaciones al cambio, genera un sentido de pertenencia y aumenta la productividad de los procesos y del recurso humano. Para efectuar el diagnostico, se elaboro una serie de variables las cuales fueron convalidadas a traves de los mapeos y diagramas de los procesos comunicacionales de la empresa; ademas, se ejecuto un periodo de observacion estructurado donde se recaudo la mayor cantidad de informacion por medio de la revision de documentos, reuniones, entrevistas, convivencia y el analisis de procesos y macroprocesos. Igualmente, se efectuo entrevistas a profundidad estructuradas a personas claves, quienes se designaron por el mapeo, liderazgo y por sus roles laborales; asi como, una encuesta.

Análise das internações por doenças respiratórias em Tangará da Serra - Amazônia Brasileira Analysis of hospitalizations for respiratory diseases in Tangará da Serra, Brazil

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Antonia Maria Rosa

2008-08-01

Full Text Available OBJETIVO: Analisar as internações hospitalares por doenças respiratórias em menores de 15 anos de idade em uma área com elevados níveis de poluição ambiental. MÉTODOS: Estudo transversal da morbidade hospitalar por doenças respiratórias de residentes no município de Tangará da Serra (MT na Amazônia brasileira, no período de 2000 a 2005, através de dados de internações hospitalares do Sistema Único de Saúde brasileiro e de estimativas populacionais do Instituto Brasileiro de Geografia e Estatística. RESULTADOS: Em 2005, a taxa de internações por doenças respiratórias em menores de 15 anos foi de 70,1/1.000 crianças na microrregião de Tangará da Serra. Entre 2000 a 2005 ocorreram, no município de Tangará da Serra, 12.777 internações de crianças, das quais 8.142 (63,7% por doenças respiratórias. No período da seca (maio a outubro houve 10% mais internações por doenças respiratórias que no período da chuva (novembro a abril. As principais causas de internação foram: pneumonias (90,7% e insuficiência respiratória (8,5%. Em menores de 5 anos de idade, as internações por pneumonia foram mais de 4 vezes o esperado para o município. Os menores de 12 meses de idade foram mais frequentemente internados, com incremento médio de 32,4 internações por 1.000 crianças a cada ano. CONCLUSÕES: Tangará da Serra tem apresentado elevado número de internações por doenças respiratórias, portanto, é coerente considerá-lo como área prioritária para investigação e monitoramento dos fatores de risco ambientais para tais doenças.OBJECTIVE: To analyze hospitalizations for respiratory diseases among children under 15 years of age in an area with high levels of environmental pollution. METHODS: A cross-sectional study of hospitalizations due to respiratory diseases of patients residing in the city of Tangará da Serra, located in the state of Mato Grosso (Brazilian Amazon region, from 2000 to 2005. Data on

Eficacia y seguridad de la terapia tópica con capsaicina 0,075% versus mentol 1%, en el tratamiento del prurito de la foliculitis eosinofílica asociada al virus de la inmunodeficiencia adquirida

Directory of Open Access Journals (Sweden)

Carlos Galarza

2007-09-01

Full Text Available Objetivo: Determinar la eficacia y seguridad de la terapia tópica con capsaicina 0,075% versus mentol 1% en el tratamiento del prurito de la foliculitis eosinofílica asociada al virus de la inmunodeficiencia adquirida (VIH. Diseño: Estudio clínico aleatorizado y doble ciego. Lugar: Servicios de Enfermedades Infecciosas y Tropicales (SEIT y Dermatología, Hospital Nacional Dos de Mayo, Lima, Perú. Participantes: Pacientes con foliculitis eosinofílica asociada al VIH. Intervenciones: La muestra estuvo constituida por 40 pacientes con foliculitis eosinofílica asociada al VIH, quienes fueron distribuidos mediante muestreo aleatorio sistemático en dos grupos: el grupo 1 conformado por 20 pacientes que recibieron la terapia 1; y el grupo 2, conformado por 20 pacientes que recibieron la terapia 2. Los pacientes recibieron tratamiento con capsaicina al 0,075% y mentol 1%; la aplicación se realizó en el área afectada, cada 6 horas, durante 45 días. Se implementó un sistema de visitas (domiciliarias u hospitalarias, se evaluó la eficacia en la reducción del prurito (escala de Likert y se registró los eventos. Principales medidas de resultados: Respuesta clínica a la administración de capsaicina y mentol. Resultados: La respuesta fue buena en 90% de los pacientes que recibieron capsaicina 0,075%, en comparación con 40% en el grupo que recibió mentol al 1% (p = 0,001, con OR = 0,074 (IC 95 %: 0,013 - 0,411. La eficacia de las terapias tópicas fue modificada por el recuento de linfocitos CD4 (p 0,05. Conclusiones: La terapia tópica con capsaicina es eficaz y segura en el tratamiento del prurito, en la foliculitis eosinofílica asociada al VIH.

Consistência interna da versão em português do Mini-Inventário de Fobia Social (Mini-SPIN Internal consistency of the Portuguese version of the Mini-Social Phobia Inventory (Mini-SPIN

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Gustavo J. Fonseca D'El Rey

2007-01-01

Full Text Available CONTEXTO: A fobia social é um grave transtorno de ansiedade que traz incapacitação e sofrimento. OBJETIVOS: Investigar a consistência interna da versão em português do Mini-Inventário de Fobia Social (Mini-SPIN. MÉTODOS: Foi realizado um estudo da consistência interna do Mini-SPIN em uma amostra de 206 estudantes universitários da cidade de São Paulo, SP. RESULTADOS: A consistência interna do instrumento, analisada pelo coeficiente alfa de Cronbach, foi de 0,81. CONCLUSÕES: Esses achados permitiram concluir que a versão em português do Mini-SPIN exibiu resultados de boa consistência interna, semelhantes aos da versão original em inglês.BACKGROUND: Social phobia is a severe anxiety disorder that brings disability and distress. OBJECTIVES: To investigate the internal consistency of the Portuguese version of the Mini-Social Phobia Inventory (Mini-SPIN. METHODS: We conducted a study of internal consistency of the Mini-SPIN in a sample of 206 college students of the city of São Paulo, SP. RESULTS: The internal consistency of the instrument, analyzed by Cronbach's alpha coefficient, was 0.81. CONCLUSIONS: These findings suggest that the Portuguese version of the Mini-SPIN has a good internal consistency, similar to those obtained with the original English version.

A case misdiagnosed as bilateral abducens palsy

International Nuclear Information System (INIS)

Takeda, Naoya; Kuwamura, Keiichi; Shirataki, Kunio; Tamaki, Norihiko; Matsumoto, Satoshi

1984-01-01

A 66-year-old male was admitted to our neurosurgical floor because of double vision and gait disturbance. Neurological examinations revealed bilateral 6th nerve palsy with both eyes pointing toward the midline. Initially, using a tentative diagnosis of intracranial mass lesions, especially localized at the base of the skull, computerized tomography of the head, cerebral angiography, orbital venography, and metrizamide CT cisternography were performed; the findings were normal. An orbital CT scan showed an enlargement of the bilateral medial rectus muscles, and the thyroid functions of T 3 and T 4 and the T 3 uptake were all elevated, which was compatible with the diagnosis of Graves' disease. The limitations of both eyeballs were considered to be due not to the 6th nerve palsy, but to the hypertrophy of the bilateral medial rectus muscles. We neurosurgeons should recall Graves' disease as well as intracranial lesions, cerebrovascular disease, and post-traumatic sequelae when examining a patient who presents limitations of external ocular movement. (author)

Bilateral clear cell sarcoma of the kidney

International Nuclear Information System (INIS)

Zekri, W.; Yehia, D.; Alfaar, A.S.; Elshafie, M.M.; Younes, A.A.; Zaghloul, M.S.; El-Kinaai, N.; Taha, H.; Refaat, A.; Zekri, W.; Elshafie, M.M.; Zaghloul, M.S.; Taha, H.; Refaat, A.; Younes, A.A.; Alfaar, A.S.; Yehia, D.

2015-01-01

Clear cell sarcoma of the kidney (CCSK) accounts for 2-5% of all pediatric renal malignancies, and is known for its propensity to metastasize to bone and other sites. We are reporting two cases with bilateral CCSK that were diagnosed at our institution. One patient initially presented with bilateral renal masses, as well as pulmonary, hepatic and bone metastasis; while other present only with bilateral masses with no evident distant metastasis. Both patients received aggressive neo-adjuvant chemotherapy to decrease tumor size. One patient completed his designated treatment and initially showed complete remission (CR); eventually suffering from relapse. The other patient’s tumor progressed during the course of chemotherapy. Both cases manifested brain dissemination at the time of relapse or progression. This emphasizes the importance of staging stratification in CCSK. This also illustrates CCSK’s ability to metastasize to bone and other sites including the brain (a primary relapse site in our cases)

Post appendectomy acalculus bilateral ureteric obstruction: A rare entity in children

Directory of Open Access Journals (Sweden)

Vipul Gupta

2013-01-01

Full Text Available Bilateral acalculus ureteric obstruction is described as rare sequelae of acute appendicitis in two paediatric patients aged 6 and 11 years presented with features of anuria. Imaging and endoscopic evaluation confirmed bilateral ureteric obstruction secondary to bladder wall oedema as an inflammatory reaction to appendix. Both cases recovered following bilateral ureteric stenting and are doing well.

Trauma torácico: importância da antibioticoterapia sobre o tempo de internação

Directory of Open Access Journals (Sweden)

Fontelles Mauro José

2001-01-01

Full Text Available No que tange a comprovada eficácia da drenagem pleural fechada, grande controvérsia ainda persiste em relação ao uso associado da antibioticoterapia. Os autores estudaram 167 pacientes, com trauma isolado do tórax, com objetivo de avaliar a importância do uso do antibiótico sobre o tempo de internação pós-drenagem pleural fechada. Dois grupos de pacientes foram incluídos num estudo longitudinal e prospectivo de acompanhamento de coortes. O grupo controle incluiu 104 pacientes sem uso da antibioticoterapia; no grupo experimental, 63 pacientes receberam a cefalotina sódica no pós-operatório (500 mg IV - 6/6 h. Entre os pacientes estudados, 12 (7.2% apresentavam trauma fechado; 98 (58.6%, ferimento por arma branca; 41 (24.6% ferida por projétil de arma de fogo e, 16 (9.6% lesões por outros agentes vulnerantes. Entre os pacientes do grupo controle o tempo médio de permanência hospitalar foi de 5.7± 3.2 dias e, no grupo com antibiótico, 5.7± 2.9 dias. Os resultados mostraram que nos pacientes que não receberam antibiótico e evoluíram com algum tipo de complicação pleuropulmonar, o tempo de internação foi, em média, 3.2 dias maior que nos demais.

Aneurisma de artéria ilíaca interna roto: relato de caso Ruptured internal iliac artery aneurysm: case report

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Cristina Toledo Afonso

2009-03-01

Full Text Available Aneurismas isolados da artéria ilíaca interna são raros, acometem 0,1% da população e correspondem a 1% dos aneurismas aorto-ilíacos. Na maioria das vezes, os pacientes são assintomáticos, mas podem apresentar dor abdominal, massa pulsátil no hipogástrio ou na fossa ilíaca, sintomas compressivos urinários, gastrointestinais ou neurológicos. Podem ocasionar quadro de abdome agudo, principalmente quando há ruptura. O diagnóstico precoce dos aneurismas isolados de artéria ilíaca interna é incomum, sendo identificados quando mais volumosos ou rotos, o que aumenta significativamente sua morbimortalidade e torna seu prognóstico mais reservado. Dessa forma, representam um desafio terapêutico. A ligadura cirúrgica tem sido o tratamento mais comum, entretanto a cirurgia endovascular tem mostrado bons resultados, inclusive nos aneurismas rotos. É relatado caso de aneurisma de artéria ilíaca interna isolado roto diagnosticado durante laparotomia para abordagem de abdome agudo.Isolated internal iliac artery aneurysms are rare. They affect 0.1% of the population, and account for 1% of aortoiliac aneurysms. Patients are mostly asymptomatic, yet they can have abdominal pain, pulsatile mass in the hypogastrium or iliac fossa, or urinary, gastrointestinal or neurological compressive symptoms. Such aneurysms are likely to course with an acute abdomen, especially when ruptured. Early diagnosis of isolated internal iliac artery aneurysms is difficult, as they are more easily detected when larger or ruptured, which significantly raises their morbidity and mortality rate and determines a poor prognosis. Therefore, they are a therapeutic challenge. Surgical ligation has been the most common treatment; however, the endovascular approach has presented good outcomes, even in the event of ruptured aneurysms. A case of ruptured isolated iliac artery aneurysm diagnosed during a laparotomy (acute abdomen approach is reported.

Bilateral leukocoria in a patient with homozygous protein C deficiency

International Nuclear Information System (INIS)

Khan, Nasrat M.; Al-Dohayan, Noura D.; Al-Batiniji, Fatima S.

2007-01-01

We describe a bilateral leukocoria and neonatal purpura fulminans in a male infant, born at full term after an unremarkable pregnancy to a healthy consanguineous married couple. Multiple hemorrhagic skin bullae were found at birth on various parts of the body with bilateral leukocoria, organized vitreous hemorrhage, retinal detachment, and intracranial hemorrhage with undetectable levels of protein C activity. We report a clinical case of homozygous protein-C deficiency with severe purpura fulminans and bilateral leukocoria. (author)

Long-term functional outcome of bilateral spontaneous and simultaneous Achilles tendon ruptures.

LENUS (Irish Health Repository)

Ellanti, Prasad

2012-10-01

Bilateral simultaneous ruptures are rare comprising less than 1% of all Achilles tendon ruptures. Risk factors for bilateral ruptures include chronic diseases and medications such as corticosteroids and fluoroquinolones. There is little in the literature on the long-term functional outcome of bilateral Achilles tendon ruptures. This article present a series of 3 cases of simultaneous and spontaneous bilateral Achilles tendon ruptures with a minimum of 5-year follow up suggesting a good functional outcome.

Bilateral Periventricular Nodular Heterotopia

OpenAIRE

J Gordon Millichap

1998-01-01

Two unrelated boys, ages 8 and 5 years, with a syndrome of bilateral periventricular nodular heterotopia (BPNH), regional cortical dysplasia, mild mental retardation, and frontonasal malformation (FNM) are reported from the Instituto di Neuropsychiatria Infantile, University of Pisa, Italy, and the Institute of Human Genetics, University of Minnesota Medical School, Minneapolis, MN.

Bilateral teleoperation for linear force sensorless 3D robots

NARCIS (Netherlands)

Lichiardopol, S.; Wouw, van de N.; Nijmeijer, H.; Andrade Cetto, J.; Ferrier, J.; Filipe, J.

2011-01-01

It is well known that for bilateral teleoperation, force feedback information is needed. In this paper, we propose a control approach for bilateral teleoperation with uncertainties in the model of the slave robot and which does not use force sensors for haptic feedback. The controller design is

Simultaneous Bilateral Bell's palsy in a Nigerian man | Owolabi ...

African Journals Online (AJOL)

Bilateral Bellfs palsy occurring simultaneously is exceedingly rare. We report a case of a 27.year.old Nigerian man with bilateral Bellfs palsy, that occurred simultaneously, who had remarkable response to steroid and physiotherapy. We emphasized the importance of considering Bellfs palsy and the various differential ...

La lipocalina asociada con la gelatinasa de neutrófilos como factor temprano de predicción de la función retardada del injerto renal

Directory of Open Access Journals (Sweden)

John Fredy Nieto-Ríos

2016-06-01

Conclusión. Los niveles de lipocalina urinaria asociada a la gelatinasa de neutrófilos a las 48 horas del trasplante renal predijeron la función retardada, incluida la necesidad de diálisis, pero no fueron superiores a los de la creatinina sérica para la detección temprana.

Planejamento das atividades de auditoria interna nas universidades federais brasileiras: apresentação do embasamento normativo = Planning of the internal audit activities in Brazilian federal universities: presentation of the normative bases

Directory of Open Access Journals (Sweden)

Orion Augusto Platt Neto

2008-07-01

Full Text Available Este artigo apresenta um enfoque normativo sobre o planejamento anual que deve serrealizado nas unidades de auditoria interna, componentes da estrutura administrativadas universidades federais brasileiras. Deste modo, o objetivo do artigo é apresentar asnormas relativas à elaboração e ao acompanhamento da execução do plano anual deatividades de auditoria interna, que devem ser seguidas pelas universidades federais.Trata-se de umapesquisa aplicada, de natureza qualitativa e de caráter exploratório. O âmbito da pesquisaé restrito às instituições dedicadas ao ensino superior, componentes da administraçãoindireta na esfera federal brasileira. Foi utilizada a análise documental da legislação brasileira sobre controle e auditoria interna na administração pública. A pesquisa queembasou o artigo justifica-se, entre outros motivos, como contribuição à literatura daárea, que sofre escassez quanto às referências direcionadas para a auditoria interna nasuniversidades. Como resultados, foram apresentadas as bases normativas mais recentesque regulam as o planejamento das atividades de auditoria interna nas universidadesfederais, bem como a elaboração do Plano Anual de Atividades da Auditoria Interna (PAINT.As ações de auditoria interna nas universidades federais têm sua base normativa derivadada Constituição Federal de 1988, que, nos artigos 70 e 74, trata do sistema de controleinterno do Poder Executivo Federal. A partir disso, o Decreto Presidencial nº 3.591/00definiu atribuições à Controladoria-Geral da União (CGU e à Secretaria Federal de Controle Interno (SFC para a edição de instruções normativas sobre controle e auditoria interna.This paper presents a normative approach about the annual planning that must becarried through by internal audit units that compose the administrative structure of theBrazilian federal universities. This way, the objective of the paper is to present thespecific rules related to the

Bilateral parotitis as the initial presentation of childhood sarcoidosis.

Science.gov (United States)

Banks, Gretchen C; Kirse, Daniel J; Anthony, Evelyn; Bergman, Simon; Shetty, Avinash K

2013-01-01

The differential diagnosis of bilateral parotid gland enlargement in children includes infectious, inflammatory, and neoplastic disorders. We present the case of a 13-year-old male who presented with a 5-week history of bilateral parotid swelling. On exam, both parotid glands were nontender, smooth, and diffusely enlarged. He had slightly elevated inflammatory markers, but other lab results were normal. A neck CT revealed symmetric enlargement of the parotid, submandibular, and sublingual glands. A chest CT revealed scattered peripheral pulmonary nodules and bilateral hilar adenopathy. A parotid gland biopsy showed multiple noncaseating granulomas with multinucleated giant cells surrounded by lymphocytes, consistent with the diagnosis of sarcoidosis. Special stains for acid-fast and fungal organisms were negative. Using this illustrative case, we discuss the differential diagnosis of bilateral salivary gland enlargement in children and review the etiology, diagnosis, clinical manifestations, and treatment of pediatric sarcoidosis. Copyright © 2013 Elsevier Inc. All rights reserved.

Delayed diagnosis of homocystinuria presenting as bilateral congenital lens subluxation

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Jelić-Vuković Marija

2017-01-01

Full Text Available Introduction. Homocystinuria is an autosomal recessively inherited defect leading to hyperhomocysteinemia and associated with ocular manifestations, mainly myopia and ectopia lentis. Case outline. A 26-year-old male with secondary glaucoma due to bilateral lens subluxation was admitted to the Department of vitreoretinal surgery. Horizontal nystagmus, bilateral lens subluxation, and bilateral amblyopia were first discovered at the age of three years. Preoperative laboratory workup revealed elevated levels of homocysteine. Bilateral pars plana lensectomy and vitrectomy followed by a sulcus fixation of the intraocular lens (ALCON MA60 Acrysof IOL were performed. The patient was prescribed folic acid, methionine, and pyridoxine, and was urged to maintain a methionine-low diet. After a bilateral lensectomy and sulcus fixation of the intraocular lens and a methionine restriction therapy combined with vitamin B6, B9, and B12 supplementation, his condition improved greatly. Conclusion. In this report of a rare case we emphasize the importance of examining differential diagnoses of lens subluxation, since early intervention can prevent serious complications.

Bilateral Hallux Valgus: A Utility Outcome Score Assessment.

Science.gov (United States)

Makhdom, Asim M; Sinno, Hani; Aldebeyan, Sultan; Cota, Adam; Hamdy, Reggie Charles; Alzahrani, Mohammad; Janelle, Chantal

2016-01-01

Hallux valgus is the most common forefoot problem in adults. Although it can cause considerable disability and affect the quality of life of those affected, many patients seek medical attention because of cosmetic concerns. Our aim was to objectively measure the perceived health burden of living with bilateral hallux valgus. Previously validated utility outcome measures, including the visual analog scale, time trade-off, and standard gamble tests, were used to quantify the health burden for single-eye blindness, double-eye blindness, and bilateral hallux valgus in 103 healthy subjects using an online survey. The Student t test and linear regression analysis were used for statistical analysis. The mean visual analog scale, time trade-off, and standard gamble scores for bilateral hallux valgus were 0.86 ± 1.6, 0.95 ± 0.5, and 0.95 ± 0.14, respectively. These were significantly greater than the utility scores for single-eye and double-eye blindness (p hallux valgus. In conclusion, we have objectively demonstrated the effect of living with bilateral hallux valgus deformities. Our sample population reported being willing to undergo a procedure with a 5% mortality rate and sacrifice 1.8 years of life to attain perfect health and avoid the bilateral hallux valgus health state. Our findings will guide us in counseling our patients and understanding how they perceive their foot deformity. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Binaural Speech Understanding With Bilateral Cochlear Implants in Reverberation.

Science.gov (United States)

Kokkinakis, Kostas

2018-03-08

The purpose of this study was to investigate whether bilateral cochlear implant (CI) listeners who are fitted with clinical processors are able to benefit from binaural advantages under reverberant conditions. Another aim of this contribution was to determine whether the magnitude of each binaural advantage observed inside a highly reverberant environment differs significantly from the magnitude measured in a near-anechoic environment. Ten adults with postlingual deafness who are bilateral CI users fitted with either Nucleus 5 or Nucleus 6 clinical sound processors (Cochlear Corporation) participated in this study. Speech reception thresholds were measured in sound field and 2 different reverberation conditions (0.06 and 0.6 s) as a function of the listening condition (left, right, both) and the noise spatial location (left, front, right). The presence of the binaural effects of head-shadow, squelch, summation, and spatial release from masking in the 2 different reverberation conditions tested was determined using nonparametric statistical analysis. In the bilateral population tested, when the ambient reverberation time was equal to 0.6 s, results indicated strong positive effects of head-shadow and a weaker spatial release from masking advantage, whereas binaural squelch and summation contributed no statistically significant benefit to bilateral performance under this acoustic condition. These findings are consistent with those of previous studies, which have demonstrated that head-shadow yields the most pronounced advantage in noise. The finding that spatial release from masking produced little to almost no benefit in bilateral listeners is consistent with the hypothesis that additive reverberation degrades spatial cues and negatively affects binaural performance. The magnitude of 4 different binaural advantages was measured on the same group of bilateral CI subjects fitted with clinical processors in 2 different reverberation conditions. The results of this work

A case of simultaneous bilateral spontaneous pneumothorax after the Nuss procedure.

Science.gov (United States)

Matsuoka, Shunichiro; Miyazawa, Masahisa; Kashimoto, Kentaro; Kobayashi, Hiroaki; Mitsui, Fumihiko; Tsunoda, Hajime; Kunitomo, Kazuyoshi; Chisuwa, Hisanao; Haba, Yoshiaki

2016-06-01

We present a case of simultaneous bilateral spontaneous pneumothorax caused by a pleuro-pleural communication formed from Nuss procedure for pectus excavatum. A 17-year-old man with a history of Nuss operation complained chest pain and dyspnea. A chest roentgenogram demonstrated a tiny bilateral pneumothorax and two metallic bars inserted at the Nuss procedure. Computed tomography revealed furthermore a bulla in the apex of the left lung. The bilateral pneumothorax critically deteriorated after 4 days from onset and urgent bilateral chest drainages were performed. Nevertheless the drainages the full expansion of both lungs was not obtained and air leakage only from left side was continued. A video-assisted left bullectomy was performed 9 days after the tube insertion. The two bars penetrating anterior mediastinal pleura were thought to be a cause of the simultaneous bilateral spontaneous pneumothorax.

Prolapsed bilateral ureteroceles leading to intermittent outflow obstruction.

LENUS (Irish Health Repository)

Stunell, H

2012-02-01

A ureterocele refers to a cystic dilatation of the distal ureter. It may be unilateral or bilateral and may be associated with a duplex system in some cases. We present an unusual case where a young patient was found to have large bilateral ureteroceles which prolapsed into the urethra, causing intermittent incontinence and obstruction. We discuss the case and review the literature concerning this rare anomaly.

Amyad's hernia while reparing the bilateral inguinal hernia

OpenAIRE

Arif Aslaner; Tuğrul Çakır; Umut Rıza Gündüz; Burhan Mayir; Nurullah Bülbüller

2015-01-01

Amyand's hernia is the term used for inguinal hernia containing appendix. It is a rare condition and found in 1% of inguinal hernia repairs. Here we report a case of Amyand's hernia in a 61 years old male who was diagnosed with bilateral inguinal hernia. He underwent surgery and bilateral inguinal hernia repair with prosthetic meshes and without appendectomy. The patient was discharged uneventfully. 

A Case of Bilateral Pigment Dispersion Syndrome Following Many Years of Uninterrupted Treatment With Atropine 1% for Bilateral Congenital Cataracts.

Science.gov (United States)

Gizzi, Corrado; Mohamed-Noriega, Jibran; Murdoch, Ian

2017-10-01

Describe an unusual case of bilateral pigment dispersion syndrome (PDS) following years of uninterrupted treatment with atropine 1% for bilateral congenital cataracts, speculate on potential mechanisms leading to this condition. This is a case report. A 45-year-old white patient on long-term treatment with atropine 1% ointment since his infancy for bilateral congenital cataracts developed PDS with secondary ocular hypertension. The patient showed all the hallmarks of PDS with secondary ocular hypertension. An anterior segment Swept-Source optical coherence tomography was obtained to review the iris profile. The patient showed good pressure response to topical prostaglandin therapy. This is the second case report of PDS in a patient with chronic use of topical atropine. The proposed mechanisms for pigment dispersion are discussed and the possibility raised of dispersion being a potential side effect of the drug.

Modelo experimental estável de aneurisma sacular em artéria carótida de suínos utilizando veia jugular interna

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Severino Lourenço da Silva Júnior

Full Text Available OBJETIVO: Desenvolver um modelo experimental estável de aneurisma sacular em carótida de suínos utilizando veia jugular interna. MÉTODOS: Em 12 suínos sadios, com peso variando entre 25 e 50kg, cinco machos e sete fêmeas, foi confeccionado aneurisma na artéria carótida comum direita. Após arteriotomia elíptica, foi realizada anastomose terminolateral com coto distal de veia jugular interna. O volume do aneurisma era calculado de maneira que o valor não excedesse em 27 vezes o valor da área da arteriotomia. Após seis dias, era realizada angiografia e análise microscópica do aneurisma para avaliar perviedade e trombose parcial ou total. RESULTADOS: Houve ganho de peso significante dos suínos no intervalo de tempo entre a confecção do aneurisma e a angiografia (p = 0,04. Foi observada perviedade aneurismática em dez suínos (83%. Ocorreram infecções de feridas operatórias em dois animais (16,6%, ambas com início de aparecimento em três dias após a confecção do aneurisma. Análise histológica dos aneurismas mostrou trombos ocluindo parcialmente a luz em nove suínos (75%. Nesses animais, observou-se que, em média, 9% da luz aneurismática estava preenchida por trombos. CONCLUSÃO: Pôde ser desenvolvido um modelo experimental estável de aneurisma sacular em carótida de suínos utilizando veia jugular interna.

Bilateral Free Flap Breast Reconstruction Outcomes: Do Abdominal Scars Affect Bilateral Flaps?

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Dmytro Unukovych, MD, PhD

2017-09-01

Conclusion:. Surgical outcomes of bilateral reconstructions in patients with abdominal scars are generally comparable with ones in patients without prior surgery; however, some problems have been identified. These procedures might have some intraoperative considerations and often require increased operative times. Apart from the traditional preoperative computed tomography angiography, intraoperative imaging (e.g., fluorescence angiography may be advocated in patients with abdominal scars.

Bilateral femoral head dysplasia and osteochondritis. Multiple epiphyseal dysplasia tarda, spondylo-epiphyseal dysplasia tarda, and bilateral Legg-Perthes disease

Energy Technology Data Exchange (ETDEWEB)

Andersen, P.E. Jr.; Schantz, K.; Bollerslev, J.; Justesen, P.

Multiple epiphyseal dysplasia tarda (MEDT) and spondylo-epiphyseal dysplasisa tarda (SEDT) are genetically transmitted conditions affecting the hips, which may resemble bilateral Legg-Perthes disease (LPD). Misdiagnoses are not uncommon, with serious implications for treatment, prognosis and genetic counseling. An epidemiologic study of MEDT and SEDT in a well-defined population of 453 921 persons in Denmark was performed. A population prevalence of 0.7 per 100 000 inhabitants with SEDT and 4.0 per 100 000 inhabitants with MEDT was found. Distinguishing features between MEDT, SEDT and bilateral LPD based on radiologic findings in the hips, other joints, and spine were ascertained. Bilateral LPD is always asymmetric, exhibits patches of increased density in the epiphyses and often metaphyseal cyst-like changes. No spinal lesion or affection of other joints is present, and the acetabula are normal. In MEDT and SEDT the capital femoral epiphyses are symmetrically flattened, fragmented and uniformly slightly sclerotic. Generalised platyspondyly is a constant finding in SEDT.

Una sorprendente victoria: Menem y su red de apoyo en las elecciones internas del peronismo de 1988

OpenAIRE

Joaquín Baeza Belda

2010-01-01

1989 supuso para Argentina la llegada a la presidencia del justicialista Carlos Menem y el inicio de un sorprendente giro, dados los antecedentes de su partido, hacia políticas neoliberales. Como paso previo, sin embargo, Menem debió vencer en unas elecciones internas en las que partía, en principio, en clara desventaja ante el favorito Antonio Cafiero, gobernador de la provincia de Buenos Aires y líder de la llamada Renovación peronista. La sorprendente victoria de Menem en 1988 ha sido expl...

Trauma torácico: importância da antibioticoterapia sobre o tempo de internação

OpenAIRE

Fontelles, Mauro José; Mantovani, Mario

2001-01-01

No que tange a comprovada eficácia da drenagem pleural fechada, grande controvérsia ainda persiste em relação ao uso associado da antibioticoterapia. Os autores estudaram 167 pacientes, com trauma isolado do tórax, com objetivo de avaliar a importância do uso do antibiótico sobre o tempo de internação pós-drenagem pleural fechada. Dois grupos de pacientes foram incluídos num estudo longitudinal e prospectivo de acompanhamento de coortes. O grupo controle incluiu 104 pacientes sem uso da antib...

Condiciones motivacionales internas según los estilos de liderazgo del gerente, los directores, los coordinadores y los socios: el caso de una empresa de ingeniería e innovación (Medellín, Antioquia)

OpenAIRE

Hoyos Hoyos, José Froilán

2016-01-01

En esta investigación se indagó por las condiciones motivacionales internas definidas en un cuestionario psicométrico (logro, poder, afiliación, autorrealización, reconocimiento), según el estilo de liderazgo encontrado -- Se trata de condiciones motivacionales personales de índole interna y de carácter afectivo que permiten al individuo derivar sentimientos de agrado o desagrado de experiencias con eventos externos específicos o personas; como consecuencia de estos sentimientos, pueden gener...

Feocromocitoma bilateral: la importancia de los estudios de diagnóstico por imagen Bilateral pheochromocytoma: the importance of imaging studies

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Igor I Bonnet

2011-10-01

Full Text Available Se presenta un caso clínico poco frecuente de feocromocitoma bilateral, en el cual los estudios de diagnóstico por imagen, tanto de información estructural como funcional, constituyeron una fuente fundamental para su detección y seguimiento.We report a rare case of bilateral pheochromocytoma, in which imaging studies, both of structural and functional information, were a major source for its detection and follow-up.

[On the origin, course and influx-vessels of the V. basalis and the V. cerebri interna (author's transl)].

Science.gov (United States)

Lang, J; Köth, R; Reiss, G

1981-01-01

Origin, course and influx-vessels of the basal vein are investigated on 100 brains. An anterior formation of the basal vein (textbook) was found in 41%, a posterior formation in 34%. The different possibilities of drainage are examined procentually at the different types. Course and number of the different variations of the influx-vessels are taken into account: Vv. thalamostriata inferiores, gyri olfactorii, ventricularis inferior, peduncularis, cerebri interna, thalamostriata superioris, (terminalis), septi pellucidi anterior, septi pellucidi posterior, atrii medialis, atrii lateralis, nuclei caudati.

Efficacy of breast conservation therapy in early stage bilateral breast cancer

International Nuclear Information System (INIS)

Lee, Misa M.; Chen, Luci M.; Heimann, Ruth; Powers, Claire; Weichselbaum, Ralph R.

1996-01-01

PURPOSE: To evaluate outcome of patients with bilateral breast cancer as compared to unilateral breast cancer treated with breast conservation therapy. This is a complex issue, however, we address this by comparing (1) synchronous bilateral breast cancer patients, (2) metachronous bilateral breast cancer patients from the time of diagnosis of the second breast primary, and (3) unilateral breast cancer patients. The authors recognize that there are inherent biases in these comparisons. MATERIALS AND METHODS: A total of 60 bilateral patients and 1080 unilateral patients treated with breast conservation therapy from 1977-1994 were analyzed for outcome. Of the 60 bilateral patients, 44 were metachronous bilateral breast cancer patients (MBBC) and 16 were synchronous breast cancer patients (SBBC). Patients with bilateral breast cancer had local-regional disease with the following tumor stages: DCIS=8%, T1=80%, T2=12%, pathologic N0=90%, pathologic N+=10%. Unilateral patients had the following tumor stages: DCIS=10%, T1=66%, T2=20%, T3=1.2%, Tx=2%, pathological N0=80%, pathological N+=19%, and NX=1%. The majority of patients received lumpectomy and axillary node dissection followed by radiation therapy. The median size of the lesions were 1.4cm and 1.5cm for bilateral and unilateral patients, respectively. Median total dose to the primary tumor was 60Gy for both unilateral and bilateral patients. Of the 44 metachronous bilateral breast cancer patients, 14 patients received breast conservation for both the first and second lesions while 30 patients had breast conservation for only the second metachronous breast lesion. Thus 58 lesions in the 44 patients were treated with breast conservation therapy in the patients with metachronous bilateral breast cancer. Of the synchronous bilateral breast cancer patients, 13 out of 16 patients had breast conserving therapy for both breasts, and 3 patients received mastectomy for the second synchronous breast tumor. The median follow

Blunt bilateral diaphragmatic rupture—A right side can be easily missed

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Maria Michailidou

2015-12-01

Full Text Available Blunt diaphragmatic rupture (BDR is uncommon with a reported incidence range of 1%–2%. The true incidence is not known. Bilateral BDR is particularly rare. We presented a case of bilateral BDR and we think that the incidence is under-recognised thanks to an easily missed and difficult to diagnose right sided injury. Keywords: Blunt, Diaphragm, Bilateral, Injury

Introduction of a Case of Bilateral Pheochromocytoma Tumor

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M Zare

2009-01-01

Full Text Available Summary: Pheochromocytoma is an adrenal tumor characterized by symptoms of hypertension, headache, increased sweating, and tachycardia .In one third of patients, the tumor is discovered incidentally during radiological evaluation of the abdomen. In this article a case of bilateral pheochromocytoma is reported. The patient, a twelve years old boy, referred with complaints of headache, flushing, palpitation and blurring of vision. He had a blood pressure of 200/120 mmHg and after investigation, coarctation of aorta was excluded. On abdominal ultrasound, bilateral adrenal mass was diagnosed, followed by serial measurements of urinary vanillyl mandellic acid (VMA which was found to be elevated. Meta- Iodio benzyl glunidin (MIBG scan showed increased uptake in both adrenals. Patient underwent laparotomy and bilateral adrenalectomy with the diagnosis of pheochromocytoma. Pathologic report confirmed the diagnosis

Bilateral Olecranon Tophaceous Gout Bursitis

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Güzelali Özdemir

2017-01-01

Full Text Available In this case, we present a patient with the diagnosis of bilateral olecranon tophaceous gout. After the surgical treatment, there was no limitation of range of motion or wound problem at 6th month control.

Tratamiento conservador en pacientes con retinoblastoma bilateral

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Juan C. Suárez

2008-11-01

Full Text Available OBJETIVO: comparar el tratamiento convencional del retinoblastoma bilateral, usado hasta hace algunos años, consistente en radioterapia o enucleación bilateral, con el tratamiento conservador actual que incluye termoterapia transpupilar (TTT o TTT/quimioterapia al menos en un ojo, en niños con diagnóstico de retinoblastoma bilateral. DISEÑO: estudio retrospectivo descriptivo. MUESTRA: 20 pacientes con diagnóstico de retinoblastoma bilateral que consultaron al Hospital Universitario San Vicente de Paúl, de Medellín, Colombia, entre 1997 y 2007. MÉTODO: se hizo enucleación del ojo con el tumor de mayor tamaño. En el otro ojo se hizo tratamiento con TTT, con el láser diodo (810 nm, spot amplio, solo o combinado con otras terapias. RESULTADOS: se dividió a los pacientes en dos grupos: 16 pacientes (32 ojos en el grupo 1 tratados conservadoramente y 4 pacientes (8 ojos en el grupo 2 con tratamiento convencional. El rango de edad fue de 1-72 meses en el grupo 1 y de 1-12 meses en el grupo 2. El tiempo de seguimiento fue de 7-67 meses para el grupo 1 y de 13-73 meses para el grupo 2. En el grupo 1 se hizo enucleación de 16 ojos (50%, radioterapia externa de uno (3,1%, quimioterapia más termoterapia de 5 (15,6% y quimioterapia más termoterapia más crioterapia de 10 (31,3%. En todos los pacientes se logró preservar al menos un ojo. En el grupo 2, se enuclearon 7 ojos (87,5% y se hizo radioterapia externa más enucleación en un paciente (12.5%. Además, todos los pacientes recibieron quimioterapia. CONCLUSIÓN: la terapia conservadora actual consistente en tratamiento local (termoterapia, crioterapia o braquiterapia y quimiorreducción permite preservar al menos un ojo y en algunos casos de los dos, muchas veces con buena agudeza visual, en niños con retinoblastoma bilateral; se evitan así la enucleación bilateral y la radioterapia externa usada en el tratamiento convencional con todos sus efectos secundarios. La enucleación contin

Bilateral breast cancer : mammographic and clinical findings

International Nuclear Information System (INIS)

Kim, Eun Kyung; Oh, Ki Keun; Jun, Hwang Yoon; Lee, Byung Chan; Lee, Kyong Sik; Lee, Yong Hee

1997-01-01

To evaluate the mammographic and clinical features of bilateral breast cancer. We retrospectively reviewed clinical records(n=23) and mammograms (n=15) of 23 patients with bilateral breast cancer. Patients' age, location of the tumor and pathologic staging were determined from clinical records. Mammographic features were classified as spiculated mass, nonspiculated mass, mass with microcalcification, microcalcification only, asymmetric density, and normal. Of the 23 cases of bilateral breast cancer, 8(34.8%) were synchronous and 15(65.2%) were metachronous. Age at diagnosis of cancer in the first breast was between 27 and 59(mean 43) years ; there was no statistically significant difference in mean age between patients with synchronous and metachronous cancer. The mean interval between the diagnosis of each lesion of the metachronous pairs was 9.1 years. In 11 of 23 cases(48%), tumors were locaated in the same quadrant, and in the other 12 cases(52%), they were in different quadrant. At mammography, five of 15 metachronous cancers(33%) were similar in appearance and 10 pairs(67%) were different. In 4 of 23 cases(17%), cancer in the first breast was at stage 0 and stage 1, and in 13 of 23(57%), cancer in the second breast was at this same stage. In bilateral breast cancer, the two breasts frequently show different mammographic features. Cancer of the second breast was at an early stage; this suggest that regular examination and mammography are important and can allow early detection of contralateral breast cancer

MODEL OF TEACHING PROFESSION SPECIFIC BILATERAL TRANSLATION

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Yana Fabrychna

2017-03-01

Full Text Available The article deals with the author’s interpretation of the process of teaching profession specific bilateral translation to student teacher of English in the Master’s program. The goal of the model of teaching profession specific bilateral translation development is to determine the logical sequence of educational activities of the teacher as the organizer of the educational process and students as its members. English and Ukrainian texts on methods of foreign languages and cultures teaching are defined as the object of study. Learning activities aimed at the development of student teachers of English profession specific competence in bilateral translation and Translation Proficiency Language Portfolio for Student Teachers of English are suggested as teaching tools. The realization of the model of teaching profession specific bilateral translation to student teachers of English in the Master’s program is suggested within the module topics of the academic discipline «Practice of English as the first foreign language»: Globalization; Localization; Education; Work; The role of new communication technologies in personal and professional development. We believe that the amount of time needed for efficient functioning of the model is 48 academic hours, which was determined by calculating the total number of academic hours allotted for the academic discipline «Practice of English as the first foreign language» in Ukrainian universities. Peculiarities of the model realization as well as learning goals and content of class activities and home self-study work of students are outlined.

A 72-year-old patient with bilateral Maisonneuve fractures

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Thomas Dienstknecht

2012-07-01

Full Text Available Maisonneuve fractures result from a disruption of the medial ankle structures and a proximal fibular fracture. Patient complaints can be misleading and there is a significant rate of delayed diagnosed injuries. We present a case of bilateral Maisonneuve fractures after a fall due to a syncopal collapse. A precise clinical examination led to this rare diagnosis. The injuries were treated with syndesmotic screw fixation, removal of hardware followed after 6 weeks. The patient was asymptomatic at threemonths follow up. Patients with bilateral injuries undergoing standard surgical treatment can gain full recovery, but high suspicion in clinical examination is needed to detect this uncommon bilateral injury.

Anton's Syndrome due to Bilateral Ischemic Occipital Lobe Strokes.

Science.gov (United States)

Zukić, Sanela; Sinanović, Osman; Zonić, Lejla; Hodžić, Renata; Mujagić, Svjetlana; Smajlović, Edina

2014-01-01

We present a case of a patient with Anton's syndrome (i.e., visual anosognosia with confabulations), who developed bilateral occipital lobe infarct. Bilateral occipital brain damage results in blindness, and patients start to confabulate to fill in the missing sensory input. In addition, the patient occasionally becomes agitated and talks to himself, which indicates that, besides Anton's syndrome, he might have had Charles Bonnet syndrome, characterized by both visual loss and hallucinations. Anton syndrome, is not so frequent condition and is most commonly caused by ischemic stroke. In this particular case, the patient had successive bilateral occipital ischemia as a result of massive stenoses of head and neck arteries.

Bilateral fusion of permanent mandibular incisors: A case report

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Saxena A

2008-05-01

Full Text Available This case report showing a classical presentation of bilateral fusion of permanent mandibular incisors in a child patient for dental attention. Fusion defined as the merger of two adjacent tooth germs producing one tooth. These teeth may be fused by enamel, dentin, or both. The fused crown is broader than non fused adjacent teeth and thus resembles gemination. However, tooth counting reveals decreased numbers. Fused teeth are rare in the permanent dentition. The incisors are reported to be fused in primary and permanent dentition, but bilateral fusion is a rare occurrence. Hence the case report of bilateral fusion in an 11-year-old boy is presented.

Condiciones de monitoreo para sistema de control de motores de combustión interna

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Elio Rafael Hidalgo-Batista

2016-01-01

Full Text Available En el presente trabajo se presentan las insuficiencias existentes en el sistema de control de los motores de combustión interna pertenecientes a los grupos electrógenos, estas insuficiencias se determinaron luego de un análisis realizado al surgimiento de las fallas y a este sistema. Para la mejora del mismo se da a conocer un procedimiento que permite el seguimiento y procesamiento de las condiciones de monitoreo de estos equipos, el uso de este procedimiento ha permitido: definir los patrones de fallo de las tres variables (de ocho que se estudian que con mayor probabilidad se relacionan con el surgimiento de los fallos, mejorar el método comparativo y dos insuficiencias del sistema de control.

Coherencia interna y sincretismo teórico en la fundamentación constitucional mexicana

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Luis Eusebio Alberto Avendaño González

2014-10-01

Full Text Available En la teoría jurídica actual el ámbito constitucional es la plataforma para la garantía de los derechos y las libertades; sin embargo, la Constitución mexicana prevé supuestos que son excluyentes entre sí. Esta circunstancia implica prescribir en el nivel constitucional un derecho y, a su vez, un no derecho, lo que por consecuencia crea un sincretismo metodológico. Este texto, además de denunciar tal contradicción, defiende la premisa de que la Constitución requiere de coherencia interna. Dicha idea toma como base el principio de igualdad y la interpretación judicial, para adecuar la coherencia teórica y normativa de la carta constitucional.

Fundamento molecular de la esteatosis hepática asociada a la obesidad Molecular basis of obesity-related hepatic steatosis

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X. Buqué

2008-09-01

Full Text Available La enfermedad del hígado graso no alcohólico es una enfermedad inflamatoria hepática de carácter crónico de gran relevancia en la actualidad por su fuerte asociación con enfermedades de incidencia creciente como la obesidad y la diabetes mellitus tipo 2. En este trabajo se recoge buena parte del conocimiento existente sobre los mecanismos moleculares implicados en el establecimiento de la esteatosis hepática, el primer estadio de la enfermedad, y en su progreso a esteatohepatitis. Se ha prestado una atención especial al hígado graso asociado a la obesidad, clínica y experimental. En este caso, se valora la rata fa/fa, un modelo animal de obesidad con rasgos fenotípicos similares a los de la obesidad humana, incluyendo la resistencia a la insulina y la dislipemia. La esteatosis hepática se revela como una situación compleja, eminentemente metabólica, en la que se simultanean procesos metabólicos aparentemente contradictorios, así como estrés oxidativo, estrés de retículo endoplasmático, disfunción mitocondrial y descenso en la expresión de genes de supervivencia. En buena medida, en su base se sitúan señales extrahepáticas, como las producidas en una situación de resistencia periférica a la insulina asociada a un aumento de la masa adiposa y de ácidos grasos libres sistémicos, e internas, causantes de un desajuste de las funciones glucostática y lipidostática del hígado y de una mayor vulnerabilidad a otras agresiones.Non-alcoholic fatty liver disease is a chronic inflammation liver condition that is currently highly relevant because of its strong association with increasingly incident diseases such as obesity and type-2 diabetes mellitus. The primary purpose of this paper is to discuss the best part of current knowledge on the molecular mechanisms involved in hepatic steatosis development, the condition's initial stage, and on progression to steatohepatitis. Special attention has been paid to clinical and

Nelson′s syndrome presenting as bilateral oculomotor palsy

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Abhay Gundgurthi

2013-01-01

Full Text Available Nelson′s syndrome refers to a clinical spectrum arising from progressive enlargement of pituitary adenoma and elevated adrenocorticotrophic hormone after total bilateral adrenalectomy for Cushing′s disease comprising of hyperpigmentation, visual field defects which can be life threatening. We report here a 50-year male presenting with rapid onset of Nelson′s syndrome with an unusual finding of bilateral oculomotor palsy mistakenly treated as ocular myasthenia.

Amyad's hernia while reparing the bilateral inguinal hernia

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Arif Aslaner

2015-01-01

Full Text Available Amyand's hernia is the term used for inguinal hernia containing appendix. It is a rare condition and found in 1% of inguinal hernia repairs. Here we report a case of Amyand's hernia in a 61 years old male who was diagnosed with bilateral inguinal hernia. He underwent surgery and bilateral inguinal hernia repair with prosthetic meshes and without appendectomy. The patient was discharged uneventfully. 

Bilateral double level tibial lengthening in dwarfism.

Science.gov (United States)

Burghardt, Rolf D; Yoshino, Koichi; Kashiwagi, Naoya; Yoshino, Shigeo; Bhave, Anil; Paley, Dror; Herzenberg, John E

2015-12-01

Outcome assessment after double level tibial lengthening in patients with dwarfism. Fourteen patients with dwarfism were analyzed after bilateral simultaneous double level tibial lengthening. Average age was 15.1 years. Average lengthening was 13.5 cm. The two levels were lengthened by an average of 7.5 cm proximally and 6.0 cm distally. Concomitant deformities were also addressed during lengthening. External fixation treatment time averaged 8.8 months. Healing index averaged 0.7 months/cm. Bilateral tibial lengthening for dwarfism is difficult, but the results are usually quite gratifying.

Bilateral meandering pulmonary veins

Energy Technology Data Exchange (ETDEWEB)

Thupili, Chakradhar R.; Udayasankar, Unni [Pediatric Imaging, Imaging Institute Cleveland Clinic, Cleveland, OH (United States); Renapurkar, Rahul [Imaging Institute Cleveland Clinic, Thoracic Imaging, L10, Cleveland, OH (United States)

2015-06-15

Meandering pulmonary veins is a rare clinical entity that can be mistaken for more complex congenital syndromes such as hypogenetic lung syndrome. We report imaging findings in a rare incidentally detected case of bilateral meandering pulmonary veins. We briefly discuss the role of imaging in diagnosing this condition, with particular emphasis on contrast-enhanced CT. (orig.)

Bilateral iatrogenic maxillary fractures after dental treatment in two aged horses

OpenAIRE

Widmer, A; Fürst, A; Bettschart-Wolfensberger, R; Makara, M; Geyer, H; Kummer, M

2010-01-01

This clinical report describes two horses with bilateral maxillary fractures following dental treatment. The fractures occurred during dental treatment by a veterinarian, and both had rostral, transverse, and complete bilateral maxillary fractures with instability and minimal displacement. The fractures were repaired using bilateral intraoral wiring with the patients under general anesthesia. The postoperative period was without complications and the fractures healed as expected. Maxillary fr...

Bilateral Elastofibroma Dorsi: A Case Report

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Burçin Çelik

2010-09-01

Full Text Available Elastofibroma dorsi is a rare, slow-growing soſt tissue tumor of the chest wall. The tumor typically located under the lower pole of the scapula. A 57-year-old woman who had retiredas a teacher, presented with a 1-year history of pain on the back and with a 3-month history of swelling located under the leſt scapula. Computed tomography and magnetic resonance imaging showed bilateral, solid soſt tissue tumors under the scapula. She underwent total resection of the tumor on the leſt side. Tumor was diagnosed histopathologically as elastofibroma. Elastofibroma dorsi can be undetermined because of its localization. Radiological examination is important especially on diagnosis of bilateral localization.

Bilateral cerebrovascular accidents in incontinentia pigmenti.

Science.gov (United States)

Fiorillo, Loretta; Sinclair, D Barry; O'Byrne, Mary L; Krol, Alfons L

2003-07-01

Incontinentia Pigmenti is an X-linked dominant neurocutaneous disorder with central nervous system manifestations in 30% of cases, including seizures and mental retardation. Ischemic or hemorrhagic cerebrovascular accidents have been reported rarely in incontinentia pigmenti. Chart review and literature search was performed following identification of the index case. We describe a patient with incontinentia pigmenti who developed bilateral cerebrovascular accidents in the neonatal period, with resultant severe neurologic sequelae. This is the second reported case of bilateral cerebrovascular accidents in a patient with incontinentia pigmenti. This finding may be secondary to cerebrovascular anomalies, similar to those observed in the retina. Recognition of cerebrovascular accidents as a complication of incontinentia pigmenti will hopefully lead to earlier recognition and treatment.

Luxação lateral bilateral isolada do cotovelo Elbow bilateral lateral dislocation

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Leandro José Reckers

2006-01-01

Full Text Available Os autores apresentam um caso de luxação lateral bilateral isolada de cotovelo em uma paciente do sexo feminino de 48 anos. Optou-se pelo tratamento conservador através de redução fechada sob anestesia geral. Ambos os cotovelos foram imobilizados com gesso axilo-palmar e mantidos a 90º de flexão por três semanas, quando se iniciou a reabilitação. No seguimento de dezoito meses observou-se boa estabilidade e recuperação do arco de movimento de ambos os cotovelos.The authors present an isolated case of bilateral lateral dislocation of the elbow joint in a 48-year old female patient. The conservative treatment was chosen, through closed reduction under general anesthesia. Both elbows were placed in an axillopalmar splint cast and held at a 90 degree angle of flexion for three weeks when rehabilitation began. In the eighteen-month follow-up period, good stability as well as the recovery of the range of motion was observed in both elbows

Simultaneous bilateral distal biceps tendon repair: case report

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Thiago Medeiros Storti

Full Text Available ABSTRACT Simultaneous bilateral rupture of the distal biceps tendon is a rare clinical entity, seldom reported in the literature and with unclear therapeutic setting. The authors report the case of a 39-year-old white man who suffered a simultaneous bilateral rupture while working out. When weightlifting with elbows at 90° of flexion, he suddenly felt pain on the anterior aspect of the arms, coming for evaluation after two days. He presented bulging contour of the biceps muscle belly and ecchymosis in the antecubital fossa, extending distally to the medial aspect of the forearm, as well as a marked decrease of supination strength and pain in active elbow flexion. MRI confirmed the rupture with retraction of the distal biceps bilaterally. The authors opted for performing the tendon repairs simultaneously through the double incision technique and fixation to the bicipital tuberosity with anchors. The patient progressed quite well, with full return to labor and sports activities, being satisfied with the result after two years of surgery. In the literature search, few reports of simultaneous bilateral rupture of the distal biceps were retrieved, with only one treated in the acute phase of injury. Therefore, the authors consider this procedure to be a good option to solve this complex condition.

Simultaneous bilateral distal biceps tendon repair: case report.

Science.gov (United States)

Storti, Thiago Medeiros; Paniago, Alexandre Firmino; Faria, Rafael Salomon Silva

2017-01-01

Simultaneous bilateral rupture of the distal biceps tendon is a rare clinical entity, seldom reported in the literature and with unclear therapeutic setting. The authors report the case of a 39-year-old white man who suffered a simultaneous bilateral rupture while working out. When weightlifting with elbows at 90° of flexion, he suddenly felt pain on the anterior aspect of the arms, coming for evaluation after two days. He presented bulging contour of the biceps muscle belly and ecchymosis in the antecubital fossa, extending distally to the medial aspect of the forearm, as well as a marked decrease of supination strength and pain in active elbow flexion. MRI confirmed the rupture with retraction of the distal biceps bilaterally. The authors opted for performing the tendon repairs simultaneously through the double incision technique and fixation to the bicipital tuberosity with anchors. The patient progressed quite well, with full return to labor and sports activities, being satisfied with the result after two years of surgery. In the literature search, few reports of simultaneous bilateral rupture of the distal biceps were retrieved, with only one treated in the acute phase of injury. Therefore, the authors consider this procedure to be a good option to solve this complex condition.

An accelerometry-based methodology for assessment of real-world bilateral upper extremity activity.

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Ryan R Bailey

Full Text Available The use of both upper extremities (UE is necessary for the completion of many everyday tasks. Few clinical assessments measure the abilities of the UEs to work together; rather, they assess unilateral function and compare it between affected and unaffected UEs. Furthermore, clinical assessments are unable to measure function that occurs in the real-world, outside the clinic. This study examines the validity of an innovative approach to assess real-world bilateral UE activity using accelerometry.Seventy-four neurologically intact adults completed ten tasks (donning/doffing shoes, grooming, stacking boxes, cutting playdough, folding towels, writing, unilateral sorting, bilateral sorting, unilateral typing, and bilateral typing while wearing accelerometers on both wrists. Two variables, the Bilateral Magnitude and Magnitude Ratio, were derived from accelerometry data to distinguish between high- and low-intensity tasks, and between bilateral and unilateral tasks. Estimated energy expenditure and time spent in simultaneous UE activity for each task were also calculated.The Bilateral Magnitude distinguished between high- and low-intensity tasks, and the Magnitude Ratio distinguished between unilateral and bilateral UE tasks. The Bilateral Magnitude was strongly correlated with estimated energy expenditure (ρ = 0.74, p<0.02, and the Magnitude Ratio was strongly correlated with time spent in simultaneous UE activity (ρ = 0.93, p<0.01 across tasks.These results demonstrate face validity and construct validity of this methodology to quantify bilateral UE activity during the performance of everyday tasks performed in a laboratory setting, and can now be used to assess bilateral UE activity in real-world environments.

Variability of gait, bilateral coordination, and asymmetry in women with fibromyalgia.

Science.gov (United States)

Heredia-Jimenez, J; Orantes-Gonzalez, E; Soto-Hermoso, V M

2016-03-01

To analyze how fibromyalgia affected the variability, asymmetry, and bilateral coordination of gait walking at comfortable and fast speeds. 65 fibromyalgia (FM) patients and 50 healthy women were analyzed. Gait analysis was performed using an instrumented walkway (GAITRite system). Average walking speed, coefficient of variation (CV) of stride length, swing time, and step width data were obtained and bilateral coordination and gait asymmetry were analyzed. FM patients presented significantly lower speeds than the healthy group. FM patients obtained significantly higher values of CV_StrideLength (p=0.04; pGait asymmetry only showed significant differences in the fast condition. FM patients walked more slowly and presented a greater variability of gait and worse bilateral coordination than healthy subjects. Gait asymmetry only showed differences in the fast condition. The variability and the bilateral coordination were particularly affected by FM in women. Therefore, variability and bilateral coordination of gait could be analyzed to complement the gait evaluation of FM patients. Copyright © 2016 Elsevier B.V. All rights reserved.

Congenital bilateral perisylvian syndrome with pituitary hypoplasia and ectopic neurohypophysis

Energy Technology Data Exchange (ETDEWEB)

Yekeler, Ensar; Genchellac, Hakan; Dursun, Memduh; Acunas, Gulden [Istanbul Faculty of Medicine, Department of Radiology, Istanbul (Turkey); Ozmen, Meral [Istanbul Faculty of Medicine, Department of Paediatric Neurology, Istanbul (Turkey)

2004-11-01

Congenital bilateral perisylvian syndrome (CBPS) is a congenital neurological syndrome characterized by pseudobulbar palsy, cognitive deficits and bilateral perisylvian abnormalities observed on imaging. The described abnormality in CBPS is polymicrogyria located in the frontal, parietal, and/or occipital lobes. A few syndromes or abnormalities associated with this syndrome have been documented. Pituitary abnormalities are rare disorders. Association of CBPS with pituitary abnormalities has not been reported previously. In this case, a combination of bilateral perisylvian polymicrogyria with pituitary hypoplasia and ectopic neurohypophysis, caused by a possible single common insult, is presented. (orig.)

Congenital bilateral perisylvian syndrome with pituitary hypoplasia and ectopic neurohypophysis

International Nuclear Information System (INIS)

Yekeler, Ensar; Genchellac, Hakan; Dursun, Memduh; Acunas, Gulden; Ozmen, Meral

2004-01-01

Congenital bilateral perisylvian syndrome (CBPS) is a congenital neurological syndrome characterized by pseudobulbar palsy, cognitive deficits and bilateral perisylvian abnormalities observed on imaging. The described abnormality in CBPS is polymicrogyria located in the frontal, parietal, and/or occipital lobes. A few syndromes or abnormalities associated with this syndrome have been documented. Pituitary abnormalities are rare disorders. Association of CBPS with pituitary abnormalities has not been reported previously. In this case, a combination of bilateral perisylvian polymicrogyria with pituitary hypoplasia and ectopic neurohypophysis, caused by a possible single common insult, is presented. (orig.)

Manicômio em circuito: os percursos dos jovens e a internação psiquiátrica The psychiatric hospital circuit: the trajectories of yong people prior to psychiatric hospitalization

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Andrea Cristina Coelho Scisleski

2008-02-01

Full Text Available Este artigo analisa a internação psiquiátrica de jovens, tomando-a não a partir de uma perspectiva psicopatológica individual, mas de uma dimensão subjetivo-social com base nos percursos desses jovens até a internação. O estudo foi realizado no Centro Integrado de Atenção Psicossocial para crianças e adolescentes do Hospital Psiquiátrico São Pedro, na cidade de Porto Alegre, Rio Grande do Sul, Brasil, por meio de oficinas com os jovens que estavam em atendimento na internação deste serviço. Percebeu-se uma recorrência que marca o percurso desses jovens e expressa um determinado modo de funcionamento da rede de atenção até a internação, acarretando na produção de um certo perfil desses jovens: pobreza sócio-econômica, baixa escolaridade e uso de drogas. Outro aspecto importante é o papel da ordem judicial nos encaminhamentos à internação, que obedece tanto a uma lógica de punição aos jovens e aos serviços, como também, paradoxalmente, constitui-se numa estratégia de acesso aos serviços de saúde.This article analyzes psychiatric hospitalization of young patients from a contemporary social-subjective (rather than a psychopathological perspective, following the trajectory of these youth prior to their admission. The study was conducted at the Center for Comprehensive Psychosocial Care for Children and Adolescents, São Pedro Psychiatric Hospital, in the city of Porto Alegre, Rio Grande do Sul State, Brazil. Recurrent traits in the trajectory of these youth expressed how the health care network functioned with them prior to their hospitalization, with a consistent pattern of socioeconomic deprivation, low schooling, and drug use. Another key aspect was the role of the court system in referring them for hospitalization, adhering to a kind of logic that punished both the youth and the services and paradoxically formed a strategy for access to health services.

Bilateral primary adrenocortical carcinoma complicated by Addisonian crisis: case report

International Nuclear Information System (INIS)

Foster, M.; Nolan, R.L.; Hong, H.H.

2001-01-01

Primary adrenal carcinoma is a rare malignancy. Primary adrenal insufficiency (i.e. Addison's disease) is a rare complication of bilateral infiltration. We report a case of primary bilateral adrenal carcinoma complicated by an episode of primary adrenal insufficiency. (author)

Security cost allocation under combined bilateral-pool market dispatch

International Nuclear Information System (INIS)

Abdullah, M.P.; Hassan, M.Y.; Hussin, F.

2008-01-01

Most electricity markets around the world are a combination of bilateral and pool markets, such as NordPool and NYPOOL. In these models, market participants bid into the pool and also make bilateral contracts with each other. This paper addressed the issue of congestion management and security cost allocation in a power pool market model. The basic idea of security cost allocation is to divide the incurred security cost due to congestion relief into pool and bilateral market based on their flow contribution to the congested line. A newly proposed security cost allocation strategy of the combined bilateral-pool market was also presented along with case studies using IEEE-14 bus system that tested the proposed method. Using the proposed method, it was shown that security costs are allocated to market participants at different prices which reflect the load contribution to the security problem. This solves the problem of the uniform security cost allocation in a pure pool market system having uniform pricing, and provides a proper security signal to market participants. 11 refs., 3 tabs., 4 figs

Caracterización de comunidades microbianas asociadas a depósitos de minerales secundarios en tubos de lava y minas de agua

OpenAIRE

García-Sánchez, A. M.

2016-01-01

La presente tesis doctoral representa un trabajo multidisciplinar, donde confluyen diversas especialidades biológicas, geoquímicas y mineralógicas, mediante la realización de un estudio geomicrobiológico exhaustivo de los ambientes de estudio. Los objetivos específicos planteados son los siguientes: 1. Conocer la diversidad de comunidades microbianas subterráneas asociadas a depósitos de minerales secundarios recogidos en minas de agua excavadas en granito y tubos de lava de diferentes ...

Bilateral acute retinal necrosis-A case report

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Prasad Palimar

1992-01-01

Full Text Available A 42 year old man presented with acute bilateral uveitis and necrotizing retinitis. Systemic investigations including test for AIDS and CMV retinitis were negative. Despite oral Acyclovir, both eyes progressed rapidly to retinal detachment with loss of vision. Early recognition is necessary to diagnose the bilateral acute retinal necrosis syndrome and initiate treatment. Bilateral acute retinal necrosis (BARN is a term first coined by Young and Bird in 1978 although the syndrome had been originally described by Urayama et al as an unilateral condition. This syndrome is characterized by the triad of acute confluent peripheral necrotizing retinitis, moderate to severe vasculitis and vitritis in an otherwise healthy individual. Rhegmatogenous retinal detachment occurs within two to three months of the onset of the disease and the second eye is involved in 36% of patients, usually within 6 weeks. We herein report a patient who presented with simultaneous BARN leading to retinal detachment in a matter of days. Also, to our knowledge this is the first report of this condition in India.

Multilateral, regional and bilateral energy trade governance

Energy Technology Data Exchange (ETDEWEB)

Leal-Arcas, Rafael; Grasso, Costantino; Rios, Juan Alemany (Queen Mary Univ. of London (United Kingdom))

2014-12-01

The current international energy trade governance system is fragmented and multi-layered. Streamlining it for greater legal cohesiveness and international political and economic cooperation would promote global energy security. The current article explores three levels of energy trade governance: multilateral, regional and bilateral. Most energy-rich countries are part of the multilateral trading system, which is institutionalized by the World Trade Organization (WTO). The article analyzes the multilateral energy trade governance system by focusing on the WTO and energy transportation issues. Regionally, the article focuses on five major regional agreements and their energy-related aspects and examines the various causes that explain the proliferation of regional trade agreements, their compatibility with WTO law, and then provides several examples of regional energy trade governance throughout the world. When it comes to bilateral energy trade governance, this article only addresses the European Union’s (EU) bilateral energy trade relations. The article explores ways in which gaps could be filled and overlaps eliminated whilst remaining true to the high-level normative framework, concentrating on those measures that would enhance EU energy security.

Transsynaptic neuronal degeneration of optic nerves associated with bilateral occipital lesions

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Sachdev Mahipal

1990-01-01

Full Text Available A case is reported of a 9-year old male who presented with abnormal behaviour and progressive diminution of vision. Pupils were middilated in both eyes but the pupillary reflexes were preserved. Fundus examination revealed a bilateral optic atrophy and radiological investigations showed a bilateral occipital calcification. We hereby document a case of retrograde transsynaptic neuronal degeneration of the visual system secondary to bilateral occipital lesions. Transsynapptic neuronal degeneration of optic nerves consequent to occipital lobe lesions is a rare phenomenon. Experimentally occipital lobe ablation in non-human primates has been shown to result in optic atrophy. Herein, we document a case of retrograde transsynaptic neuronal degeneration of the visual system secondary to bilateral occipital lesions.

ESPECIES DE DRYOPHTHORINAE (COLEOPTERA: CURCULIONIDAE ASOCIADAS A PLÁTANO Y BANANO (Musa spp. EN COLOMBIA

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JOSE RUBIO-GOMEZ

2009-05-01

Full Text Available RESUMEN Se presenta una sinopsis de los escarabajos de la subfamilia Dryophthorinae (Coleoptera: Curculionidae asociados a cultivos de plátano y banano en Colombia. Adicionalmente se ofrecen claves ilustradas para las especies del país. Se registran seis especies asociadas a dichos cultivos: Cosmopolites sordidus (Germar, 1824, Metamasius hemipterus (Linnaeus, 1758, Metamasius hebetatus (Gyllenhal, 1838, Metamasius submaculatus Champion, 1910, Rhyncophorus palmarum (Linnaeus, 1758 y Polytus mellerborgii (Boheman, 1838. Palabras clave: picudos, plátano, banano, Polytus, Colombia. ABSTRACT This synopsis is about beetle’s subfamily Dryophthorinae (Coleoptera: Curculionidae associated to plantain and banana crops. Additionally keys illustrated for the species of the country are offered. Six species associated to these cultures are registered: Cosmopolites sordidus (Germar, 1824, Metamasius hemipterus (Linnaeus, 1758, Metamasius hebetatus (Gyllenhal, 1838, Metamasius submaculatus Champion, 1910, Rhyncophorus palmarum (Linnaeus, 1758 y Polytus mellerborgii (Boheman, 1838. Key words: weevils, plantain, banana, Polytus, Colombia.

Quantitative assessment of paretic limb dexterity and interlimb coordination during bilateral arm rehabilitation training.

Science.gov (United States)

Xu, Chang; Li, Siyi; Wang, Kui; Hou, Zengguang; Yu, Ningbo

2017-07-01

In neuro-rehabilitation after stroke, the conventional constrained induced movement therapy (CIMT) has been well-accepted. Existing bilateral trainings are mostly on mirrored symmetrical motion. However, complementary bilateral movements are dominantly involved in activities of daily living (ADLs), and functional bilateral therapies may bring better skill transfer from trainings to daily life. Neurophysiological evidence is also growing. In this work, we firstly introduce our bilateral arm training system realized with a haptic interface and a motion sensor, as well as the tasks that have been designed to train both the manipulation function of the paretic arm and coordination of bilateral upper limbs. Then, we propose quantitative measures for functional assessment of complementary bilateral training performance, including kinematic behavior indices, smoothness, submovement and bimanual coordination. After that, we describe the experiments with healthy subjects and the results with respect to these quantitative measures. Feasibility and sensitivity of the proposed indices were evaluated through comparison of unilateral and bilateral training outcomes. The proposed bilateral training system and tasks, as well as the quantitative measures, have been demonstrated effective for training and assessment of unilateral and bilateral arm functions.

La influencia de la comunicación interna asertiva en el fortalecimiento de valores organizacionales de confianza en la empresa ANDICONS Constructora Andina Cía. Ltda. Sede Quito para el último trimestre del 2016

OpenAIRE

Moreno Clavijo, Eduardo Xavier

2017-01-01

La tesis se orienta a una investigación experiencial, sobre la influencia de la comunicación interna asertiva en los valores organizacionales de confianza, por medio de la metodología andragógica aprender haciendo, para demostrar la validez de ambas variables. El primer capítulo contiene una visión integral de la comunicación interna, la interpretación del marco teórico con base en conceptos e ideas de varios autores (Echeverría, Armengol, Castanyer, Del Pozo, Fernández, Frigoli, entre otros)...

CARACTERÍSTICAS DE LA CIRCULACIÓN TROPOSFÉRICA ASOCIADA A LAS VARIACIONES INTERANUALES DEL CAUDAL DEL RÍO TECKA – GUALJAINA, ARGENTINA

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Mariana P. Torrero

2016-06-01

Full Text Available La cuenca del río Tecka – Gualjaina se localiza al Noroeste de la provincia de Chubut, Argentina y desarrolla una superficie de 5.318 km2. El trabajo explora los forzantes del sistema atmósfera-océano asociados a la variabilidad interanual del caudal para la temporada de máximo caudal (de junio a noviembre, que representa el 80% del total anual, y de mínimo caudal (de diciembre a mayo. El balance hídrico de la cuenca arrojó condiciones de aridez, por lo que el comportamiento temporal del caudal depende del de la precipitación. En el registro disponible 1956-2013 la serie de máximo caudal presentó tendencia negativa, con un cambio de régimen en las anomalías de caudal a comienzos de los 80, pasando de un predominio positivo antes a otro negativo después. La serie de mínimo caudal mostró ser más estacionaria, sin tendencia significativa. Los ciclos dominantes en ambas series temporales sólo se observaron en la alta frecuencia interanual ( 2 años y 4-5 años. Las teleconexiones y forzantes asociados a las series de caudal se analizaron para el período 1979-2013 mediante el reanálisis del ERA-Interim. Las variaciones interanuales del caudal máximo estuvieron asociadas a teleconexión troposférica de baja frecuencia (interanual simétrica respecto del Ecuador, posiblemente asociada a variaciones en la convección tropical entre aproximadamente 10oN-10oS y 150oE-180oE, inducidas por variaciones de temperatura superficial del mar en el Pacífico occidental ecuatorial (entre 180oO-150oO. La teleconexión afectó la posición e intensidad de las corrientes en chorro subtropical y polar, alterando la trayectoria de sistemas baroclínicos invernales que precipitan en la región. Las variaciones interanuales del mínimo caudal estuvieron asociadas a una variabilidad de altas latitudes simétricamente anular, modulada por un tren de onda 3 en latitudes medias sobre el Pacífico Sur y el Atlántico Sur. Estas características pudieron

Fisiopatogenia y diagnóstico de la ventriculitis asociada a drenaje ventricular externo. Análisis de la formación de biopelículas bacterianas sobre el drenaje ventricular externo. Utilidad del sTREM-1 en el diagnóstico de la ventriculitis asociada a drenaje ventricular externo.

OpenAIRE

Gordón Sahuquillo, Mónica

2015-01-01

[spa] INTRODUCCIÓN: La ventriculitis asociada a drenaje ventricular externo (DVE) es una grave complicación relacionada con el uso de estos dispositivos. La formación de biopelícula sobre la superficie del DVE es un factor etiopatogénico importante pero nunca ha sido estudiado de forma sistemática. Por otra parte, establecer el diagnóstico de ventriculitis puede resultar complicado en el paciente crítico. Biomarcadores de infección como la forma soluble del triggering receptor expresse...

Seizure semiology identifies patients with bilateral temporal lobe epilepsy.

Science.gov (United States)

Loesch, Anna Mira; Feddersen, Berend; Tezer, F Irsel; Hartl, Elisabeth; Rémi, Jan; Vollmar, Christian; Noachtar, Soheyl

2015-01-01

Laterality in temporal lobe epilepsy is usually defined by EEG and imaging results. We investigated whether the analysis of seizure semiology including lateralizing seizure phenomena identifies bilateral independent temporal lobe seizure onset. We investigated the seizure semiology in 17 patients in whom invasive EEG-video-monitoring documented bilateral temporal seizure onset. The results were compared to 20 left and 20 right consecutive temporal lobe epilepsy (TLE) patients who were seizure free after anterior temporal lobe resection. The seizure semiology was analyzed using the semiological seizure classification with particular emphasis on the sequence of seizure phenomena over time and lateralizing seizure phenomena. Statistical analysis included chi-square test or Fisher's exact test. Bitemporal lobe epilepsy patients had more frequently different seizure semiology (100% vs. 40%; p<0.001) and significantly more often lateralizing seizure phenomena pointing to bilateral seizure onset compared to patients with unilateral TLE (67% vs. 11%; p<0.001). The sensitivity of identical vs. different seizure semiology for the identification of bilateral TLE was high (100%) with a specificity of 60%. Lateralizing seizure phenomena had a low sensitivity (59%) but a high specificity (89%). The combination of lateralizing seizure phenomena and different seizure semiology showed a high specificity (94%) but a low sensitivity (59%). The analysis of seizure semiology including lateralizing seizure phenomena adds important clinical information to identify patients with bilateral TLE. Copyright © 2014 Elsevier B.V. All rights reserved.

Prenatal natural history of isolated fetal mild bilateral pyelectasis

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Gustavo de Paula Pereira

Full Text Available OBJECTIVE: To analyze the prenatal outcomes in a cohort of fetuses with mild bilateral pyelectasis and determine whether performing serial ultrasounds is a good follow-up strategy. METHODS: A prospective longitudinal study was conducted on 62 fetuses with mild bilateral pyelectasis. Fetal mild bilateral pyelectasis was considered when the renal pelvis measured (in millimeters ≥5.0 to 10.0, ≥7.0 to 10.0, and ≥10.0 to 15 at ≤23 weeks 6 days, 24 to 31 weeks 6 days, and ≥32 weeks, respectively, with no uretero-calyceal dilatation. Ultrasounds were performed every 3 weeks to assess whether the mild bilateral pyelectasis regressed, remained unchanged (Group 1 or progressed (Group 2. RESULTS: Group 1 consisted of 53 fetuses (85.4%, and progression was observed in 9 cases (Group 2, 14.6%. The initial renal pelvis diameter was significantly larger in fetuses with progression (p=0.028. Statistically significant differences in the renal pelvis diameter were also found at weeks 31 and 35 for both kidneys (p<0.05. The cases requiring intrauterine procedures or early delivery were not observed. CONCLUSION: Fetal mild bilateral pyelectasis with no calyceal dilatation is a benign condition that can be managed in the postnatal period. The initial renal pelvis diameter and the diameter in week 31 or 35 were valuable parameters for identifying cases that would eventually need specific postnatal procedures.

Bilateral congenital absence of the long head of the biceps tendon

Energy Technology Data Exchange (ETDEWEB)

Koplas, Monica C. [Cleveland Clinic, Imaging Institute/HB6, Cleveland, OH (United States); Winalski, Carl S. [Cleveland Clinic, Imaging Institute/A21, Cleveland, OH (United States); Ulmer, William H. [Orthopedic and Spine Specialists, York, PA (United States); Recht, Michael [NYU Langone Medical Center, Department of Radiology, New York, NY (United States)

2009-07-15

Absence of the long head of the biceps tendon is a rare anomaly particularly when it occurs bilaterally. We present the magnetic resonance and arthroscopy findings in a patient with bilateral congenital absence of the long head of the biceps who presented with bilateral shoulder pain. Identification of a shallow or absent intertubercular groove may aid in differentiating congenital absence of the long head of the biceps from a traumatic tendon rupture. (orig.)

Closed cervical spine trauma associated with bilateral vertebral artery injuries

NARCIS (Netherlands)

Kloen, P.; Patterson, J. D.; Wintman, B. I.; Ozuna, R. M.; Brick, G. W.

1999-01-01

Bilateral vertebral artery injuries in closed cervical spine injuries are uncommon, but early recognition and treatment are important to prevent neurological deterioration. A case of bilateral vertebral injuries in a 35-year-old motor vehicle accident victim is presented, and the current literature

Traumatic bilateral basal ganglia hematoma: A report of two cases

OpenAIRE

Bhargava, Pranshu; Grewal, Sarvpreet Singh; Gupta, Bharat; Jain, Vikas; Sobti, Harman

2012-01-01

Traumatic Basal ganglia hemorrhage is relatively uncommon. Bilateral basal ganglia hematoma after trauma is extremely rare and is limited to case reports. We report two cases of traumatic bilateral basal ganglia hemorrhage, and review the literature in brief. Both cases were managed conservatively.

Surgical management for early-stage bilateral breast cancer patients in China.

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Jia-jian Chen

Full Text Available The aim of this study was to investigate the current surgical management strategy for bilateral breast cancer (BBC patients and to assess the changes in this strategy in China.This is a retrospective review of all patients with early-stage BBC who underwent surgical treatment at the Fudan University Shanghai Cancer Center between June 2007 and June 2014.A total of 15,337 patients with primary breast cancer were identified. Of these patients, 218 (1.5% suffered from synchronous bilateral breast cancer (sBBC, and 296 (2.0% suffered from metachronous bilateral breast cancer (mBBC. Patients with a lobular carcinoma component, those with estrogen receptor-positive cancer, and those with an accompanying sclerosing adenosis in the affected breast tended to develop BBC. The rates of bilateral mastectomy, breast conserving therapy, reconstruction, and combined surgeries were 86.2%, 6.4%, 3.7%, and 3.7%, respectively, for patients with sBBC and 81.1%, 4.4%, 3.0%, and 11.5%, respectively, for patients with mBBC. The interval between bilateral cancers, age at first diagnosis of breast cancer, histopathological type, and stage have significant impacts on the choice of surgery for patients with BBC.Bilateral mastectomy was the dominant surgical management for patients with BBC in China, despite the increased application of breast reconstruction surgery observed in recent years. Bilateral prosthetic breast reconstruction was the ideal choice for patients with sBBC. Chinese surgeons should take responsibility for patient education and inform their patients about their surgical options.

Spontaneous Bilateral Meningoencephalocoeles of the Temporal Bones

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Oliver Rose

2013-01-01

Full Text Available Spontaneous tegmen tympani defects are rare with even rarer bilateral cases. The symptoms are nonspecific; hence, a high index of suspicion is required to prevent serious intracranial complications. We present a case of spontaneous bilateral tegmen tympani defects with associated meningoencephalocoeles in a 54-year-old male who presented with the signs and symptoms of severe meningitis. After careful workup which included a lumbar puncture, CT and MRI scans, both defects were repaired using a middle fossa approach. The patient made an uneventful recovery with complete cessation of otorrhoea and improvement in his hearing.

Glomerulonefritis aguda post-infecciosa asociada a neumonía neumocócica Acute post infectious glomerulonephritis associated to pneumococcal pneumonia

OpenAIRE

S. Fernández de Miguel; E. de Goicoechea Manzanares; M. Gaboli; J.M. Sánchez Granados; V. Murga Herrera

2009-01-01

Presentamos un niño de 6 años con insuficiencia renal aguda secundaria a glomerulonefritis asociada a neumonía neumocócica. El paciente presentó en primer lugar un síndrome nefrítico con hematuria, proteinuria, oliguria, edemas y deterioro de la función renal, siendo diagnosticado a continuación de neumonía con derrame pleural. La función renal se normalizó tras 72 horas, persistiendo una hipertensión arterial que precisó tratamiento en la fase aguda. El cuadro se resolvió sin secue...

Bilateral metachronous periosteal tibial amyloid tumors

International Nuclear Information System (INIS)

Murata, H.; Kusuzaki, Katsuyuki; Hashiguchi, S.; Ueda, Hidetaka; Hirasawa, Yasusuke

2000-01-01

Localized primary periosteal amyloid tumors are extremely rare. A case of bilateral tibial amyloid tumor is presented. A 62-year-old woman initially presented with a painful mass in the anterior aspect of the right leg. There was no evidence of underlying systemic disease, including chronic infection or malignancy. Based on the results of resistance with Congo red staining to treatment with potassium permanganate and positivity for kappa light chain, we classified this particular case as AL-type amyloidosis. The patient noticed a swelling in the opposite leg 2 years later. The second tumor was also an AL-type amyloidoma. Amyloid tumors are generally solitary. This is the first case of bilateral periosteal amyloid tumors of the AL-type occurring in the tibiae. (orig.)

Bilateral inguinal hernia repair: laparoscopic or open approach?

Science.gov (United States)

Feliu, X; Clavería, R; Besora, P; Camps, J; Fernández-Sallent, E; Viñas, X; Abad, J M

2011-02-01

The aim of this study was to investigate outcomes in the treatment of bilateral inguinal hernia, comparing the laparoscopic totally extraperitoneal (TEP) and open tension-free mesh repair (LICHT) approaches. We performed a prospective controlled non randomized clinical study in 128 patients with bilateral inguinal hernia over a period of 3 years. LICHT was used in 106 cases (53 patients) while TEP was employed in 150 cases (75 patients). The main outcome measurements were: recurrence rate, operating time, hospital stay and postoperative complications. There were three recurrences (2.3%): two in the LICHT group (3.8%) and one (1.3%) in the TEP group P = NS. The TEP procedure was faster than LICHT repair (48.8 ± 10.8 vs. 70.4 ± 11.2 min) P approach is an effective option for the treatment of bilateral inguinal hernia when performed by experienced surgeons.

BILATERAL HYDRONEPHROSIS IN A SUGAR GLIDER (PETAURUS BREVICEPS).

Science.gov (United States)

Cusack, Lara; Schnellbacher, Rodney; Howerth, Elizabeth W; Jiménez, David A; Mayer, Joerg; Divers, Stephen

2016-09-01

An adult, intact male sugar glider ( Petaurus breviceps ) presented for acute caudal abdominal swelling. Treatment by the referring veterinarian included aspiration of urine from the swelling. On physical examination, mild depression, pale mucus membranes, and caudal abdominal swelling were noted. Focused ultrasonographic assessment revealed a fluid-filled caudal abdominal structure and subjective bladder wall thickening. The following day, the sugar glider was severely depressed. Hematology results included hypoglycemia, hyperkalemia, hyponatremia, and azotemia. Ultrasonography revealed bilateral hydronephrosis and hydroureter. Despite supportive care, the animal died. Postmortem examination confirmed bilateral ureteral dilation, renal petechial hemorrhage, and dilation of the right renal pelvis. Submucosal edema, hemorrhage, and lymphoplasmacytic infiltration of the urinary bladder, ureters, and renal pelvises were noted. Hyperplasia of the urinary bladder and ureteral epithelium, coupled with inflammation, may have caused functional obstruction leading to bilateral hydronephrosis and hydroureter. This is the first reported case of hydronephrosis in a marsupial.

Constipation following bilateral of internal iliac artery aneurysms

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S Morita

2012-09-01

Full Text Available A 72-year-old man presented with constipation. He was hypertensive and suffered from chronic constipation. On arrival, the patient was fully conscious, and his vital signs were stable. He requested an enema because this treatment had proved effective in the past. On physical examination, a hard palpable mass was detected in the lower abdomen. Computed tomography was performed with contrast media. It revealed an abdominal aortic aneurysm (AAA and bilateral internal iliac artery aneurysms (IIAAs; the latter obstructing the sigmoid colon. We believe that this obstruction was the cause of constipation. The patient underwent Y-graft replacement for the treatment of the AAA and bilateral IIAAs. The surgery was successful, and constipation has not recurred since. As constipation is the most common digestive disorder in the general population, all physicians should be aware that chronic constipation can be caused by bilateral IIAAs.

Uso inadecuado de antimicrobianos en pacientes con insuficiencia cardiaca descompensada

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Milena Duque Vizcaíno

Full Text Available Introducción: en la práctica clínica, el número de pacientes que ingresa por insuficiencia cardiaca descompensada y recibe tratamiento antimicrobiano, supera la prevalencia descrita de infecciones (15,3 % como causa de descompensación. Objetivo: determinar el uso inadecuado de antimicrobianos en pacientes con insuficiencia cardiaca. Métodos: estudio descriptivo, transversal y retrospectivo en 184 pacientes que ingresaron con diagnóstico de insuficiencia cardiaca en el Servicio de Medicina Interna del Hospital Docente Clinicoquirúrgico "Joaquín Albarrán", entre enero de 2010 y diciembre de 2011. Se consideró inadecuada la utilización de antimicrobianos, en caso de ausencia de infección asociada a la insuficiencia cardiaca. Resultados: hubo un predominio de infección asociada a insuficiencia cardiaca de 40,8 % y se prescribió antimicrobianos al 69 % de estos pacientes. La prevalencia global de utilización inadecuada de antimicrobianos en la población estudiada fue del 32,6 %. Conclusiones: los resultados indican que existe la necesidad de mejorar la prescripción de antimicrobianos en pacientes con insuficiencia cardiaca.

Bilateral adrenalectomy for Cushing's syndrome: Pros and cons

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O P Prajapati

2015-01-01

Full Text Available Aim: To assess the outcome of patients undergoing bilateral adrenalectomy for Cushing's syndrome (CS. Methods: All patients who underwent bilateral adrenalectomy for CS at the Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences hospital between 1991 and 2013 were included. Medical records were reviewed to obtain patient characteristics and follow-up data. Results: Twenty-seven patients were studied. Mean age was 28.74 ± 12.95 years (range 9–60, male:female ratio was 1.7:1. About half that is, 48.19% were of Cushing's disease (failed trans-sphenoidal surgery [TSS], 37.04% were of ectopic CS (ECS, and 14.81% were of CS due to bilateral adrenal pathology. Median follow-up period was 80.5 months. Before surgery, 74.1% patients had body mass index > which after surgery declined to <25 in 75% of them. Hypertension was present in 85.2% and after surgery resolved in 40%. Diabetes mellitus was present in 44.4% and after surgery resolved in 33% of them. Hirsutism and proximal muscle weakness were present in 55.6% and 70.4% patients, respectively, and after surgery improved markedly in all patients. Adrenal crisis developed in 36.3% and Nelson's syndrome in 41.7% patients during follow-up. Three patients died in perioperative period while three succumbed to the disease during follow-up. Two patients developed recurrence of endogenous cortisol production during the follow-up period. Conclusions: Bilateral adrenalectomy is a valid treatment option for palliating severe symptoms in Pituitary Cushing's with failed TSS and unlocalized ECS but the procedure is curative for CS due to bilateral adrenal disease. Overall morbidity and mortality is higher than other endocrine operations. Co-morbidities tend to be more severe and are a risk factor for mortality during the time patient survives.

Double Trouble: A Rare Case of Bilateral Upper Pole Ureteropelvic Junction Obstruction

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Craig A. Peters

2014-09-01

Full Text Available A 16-year-old girl presented with bilateral back pain caused by bilateral upper pole ureteropelvic junction obstructions; an extremely rare phenomenon. Bilateral robotically assisted upper pole pyeloplasties were preformed at the same setting with an excellent clinical response. Although rare, upper pole ureteropelvic junction obstruction is a defined entity that urologists should be aware of.

Alternativas metodológicas para perfeccionar la adquisición de habilidades en residentes de Medicina Interna

OpenAIRE

Pérez Bada, Elvys; Pérez de Alejo Rodríguez, Marta; Lima León, Carlos Eddy; Bello Medina, Bienvenido; Cabrera Bermúdez, Yamila

2013-01-01

Se realizó una investigación de desarrollo con enfoque cualitativo en el Hospital Universitario "Arnaldo Milián Castro" de Villa Clara en el período comprendido entre septiembre del 2008 hasta julio del 2010, con el propósito de diseñar varias acciones metodológicas para perfeccionar la adquisición de habilidades del residente de Medicina Interna que se forma en esta institución. El proceso indagatorio fue concebido en tres etapas: diagnóstico, diseño de las acciones metodológicas y valoració...

Bilateral optical nerve atrophy secondary to lateral occipital lobe infarction.

Science.gov (United States)

Mao, Junfeng; Wei, Shihui

2013-06-01

To report a phenomenon of optical nerve atrophy secondary to lateral occipital lobe infarction. Two successive patients with unilateral occipital lobe infarction who experienced bilateral optical nerve atrophy during the follow-up underwent cranial imaging, fundus photography, and campimetry. Each patient was diagnosed with occipital lobe infarction by cranial MRI. During the follow-up, a bilateral optic atrophy was revealed, and campimetry showed a right homonymous hemianopia of both eyes with concomitant macular division. Bilateral optic atrophy was related to occipital lobe infarction, and a possible explanation for the atrophy was transneuronal degeneration caused by occipital lobe infarction.

Haptic Manipulation of Deformable Objects in Hybrid Bilateral Teleoperation System

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Juan Manuel Ibarra-Zannatha

2007-01-01

Full Text Available The aim of this work is the integration of a virtual environment containing a deformable object, manipulated by an open kinematical chain virtual slave robot, to a bilateral teleoperation scheme based on a real haptic device. The virtual environment of this hybrid bilateral teleoperation system combines collision detection algorithms, dynamical, kinematical and geometrical models with a position–position and/or force–position bilateral control algorithm, to produce on the operator side the reflected forces corresponding to the virtual mechanical interactions, through a haptic device. Contact teleoperation task over the virtual environment with a flexible object is implemented and analysed.

Effects of Bilateralism and the MFN Clause on International Trade

DEFF Research Database (Denmark)

Lampe, Markus

2009-01-01

manufactured goods. Gravity model estimates show that specific liberalizations increased exports of corresponding items, but not overall trade. Exporters from countries whose governments used bilateralism strategically to bring down partner tariffs benefitted most. Hence, the network in form and outcome......This study contributes to a revised picture of nineteenth-century bilateralism. Employing a new disaggregated data set, it argues that bilateral treaties did not implement general free trade, but instead reduced tariffs unevenly through commodity-specific preferences, especially favoring...... is more properly identified with reciprocal liberalization practiced by the French than with British free-trade ideology....

Hacia una critica interna de la teoría del intercambio desigual de Emmanuel

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Garay S. Luis Jorge

1980-12-01

Full Text Available El presente ensayo constituye apenas una versión parcial y preliminar de un trabajo más extenso que el autor está desarrollando sobre la teoría del intercambio desigual de Emmanuel. Entendido así el carácter de éste, su objetivo se limita únicamente a estudiar los principales supuestos, inconsistencias y vicios teóricos y metodológicos implícitos en
el "traslado" particular que Emmanuel realiza del esquema de precios de Marx al plano del comercio internacional. En otras palabras, el análisis aquí incluido corresponde más a lo que en la literatura se denomina una crítica interna que a una crítica externa de la teoría de intercamhio desigual de Emmanuel.

Adenocarcinoma of the ethmoid following radiotherapy for bilateral retinoblastoma

Energy Technology Data Exchange (ETDEWEB)

Rowe, L.D.; Lane, R.; Snow, J.B. Jr.

1980-01-01

Adenocarcinoma of the ethmoid sinus is rare, representing only 4 to 8% of malignancies of the paranasal sinuses. An extraordinary case of papillary adenocarcinoma of the ethmoid sinus arising 30 years following high-dose radiotherapy for bilateral retinoblastoma is presented. Second fatal mesenchymal and epithelial primaries have been described in 8.5% of patients with bilateral retinoblastomas previously treated with radiotherapy; however, papillary adenocarcinoma arising within the paranasal sinuses has not been reported. Aggressive treatment including partial maxillectomy, radical pansinusectomy, radical neck dissection followed by regional radiotherapy and systemic chemotherapy failed to prevent the development of fatal hepatic metastases. The high incidence of second fatal primary neoplasms in patients with bilateral retinoblastomas receiving radiation suggests an innate susceptibility that may add to the risk of radiotherapy.

Adenocarcinoma of the ethmoid following radiotherapy for bilateral retinoblastoma

International Nuclear Information System (INIS)

Rowe, L.D.; Lane, R.; Snow, J.B. Jr.

1980-01-01

Adenocarcinoma of the ethmoid sinus is rare, representing only 4 to 8% of malignancies of the paranasal sinuses. An extraordinary case of papillary adenocarcinoma of the ethmoid sinus arising 30 years following high-dose radiotherapy for bilateral retinoblastoma is presented. Second fatal mesenchymal and epithelial primaries have been described in 8.5% of patients with bilateral retinoblastomas previously treated with radiotherapy; however, papillary adenocarcinoma arising within the paranasal sinuses has not been reported. Aggressive treatment including partial maxillectomy, radical pansinusectomy, radical neck dissection followed by regional radiotherapy and systemic chemotherapy failed to prevent the development of fatal hepatic metastases. The high incidence of second fatal primary neoplasms in patients with bilateral retinoblastomas receiving radiation suggests an innate susceptibility that may add to the risk of radiotherapy

Una sorprendente victoria: Menem y su red de apoyo en las elecciones internas del peronismo de 1988

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Joaquín Baeza Belda

2010-11-01

Full Text Available 1989 supuso para Argentina la llegada a la presidencia del justicialista Carlos Menem y el inicio de un sorprendente giro, dados los antecedentes de su partido, hacia políticas neoliberales. Como paso previo, sin embargo, Menem debió vencer en unas elecciones internas en las que partía, en principio, en clara desventaja ante el favorito Antonio Cafiero, gobernador de la provincia de Buenos Aires y líder de la llamada Renovación peronista. La sorprendente victoria de Menem en 1988 ha sido explicada comúnmente como fruto de la reacción de la sociedad a la clase política, en el contexto de crisis que atravesaba el país, o bien como producto de los límites e insuficiencias de la línea cafierista. Sin desconocer estos enfoques, en este texto abordamos el problema desde la perspectiva interna del peronismo y del propio Menem, describiendo su labor de acumulación y reestructuración de los sectores más ortodoxos del partido, apartados por el avance de la Renovación. El estudio de estas elecciones internas sirve así para explorar las continuidades y rupturas de la Argentina que abre un nuevo ciclo en 1989.Palabras clave: Argentina, peronismo, Menem, Renovación, elecciones, 1988___________________________ABSTRACT:1989 marked the arrival to the Argentinian presidency of the PJ Carlos Menem and the beginning of a surprising twist, considering the history of his party, towards neoliberal policies. As a preliminary step, however, Menem had to overcome in a primary election, in which he was disadvantaged compared to the favorite Antonio Cafiero, Governor of Province of Buenos Aires and leader of the so called “Peronist Renovation”. Menem's stunning victory in 1988 has been commonly explained as the result of society's reaction to the political class, in the context of crisis of the country, or as a result of the limits and shortcomings of the Cafiero’s political line. Without ignoring these approaches, in this paper we approach the

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

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Silvio Romero de Barros Marques

2006-03-01

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

Patrones y flujos de la migración interna en la gran área metropolitana de Costa Rica, en el período 1995-2000

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Molina-Varela, Wendy

2009-01-01

Full Text Available Los más recientes cambios en los patrones de migración interna en varios países de Latinoamérica, apuntan a los crecientes flujos de migración intrametropolitana desde los centros urbanos hacia la periferia, asociados a procesos de urbanización residencial de zonas rurales cercanas a la zona metropolitana. Este artículo analiza este fenómeno para Costa Rica, estimando los patrones de migración interna dentro del Gran Área Metropolitana (GAM, y tratando de determinar algunos factores de atracción y expulsión que posiblemente explican estos patrones, utilizando un modelo de Poisson para discriminar entre algunas variables seleccionadas en un modelo de regresión multivariable. Los resultados confirman algunas tendencias observadas para otras áreas metropolitanas de América Latina, y da algunas explicaciones al caso específico de la GAM.

Bilateral simultaneous traumatic upper arm compartment syndromes associated with anabolic steroids.

Science.gov (United States)

Erturan, Gurhan; Davies, Nev; Williams, Huw; Deo, Sunny

2013-01-01

Acute compartment syndrome, a surgical emergency, is defined as increased pressure in an osseofascial space. The resulting reduction of capillary perfusion to that compartment requires prompt fasciotomy. Treatment delay has a poor prognosis, and is associated with muscle and nerve ischemia, resultant infarction, and late-onset contractures. We report a case of traumatic bilateral upper limb acute compartment syndrome associated with anabolic steroids, requiring bilateral emergency fasciotomies. A 25-year-old male bodybuilder taking anabolic steroids, with no past medical history, presented to the Emergency Department 25 min after a road traffic accident. Secondary survey confirmed injuries to both upper limbs with no distal neurovascular deficit. Plain radiographs demonstrated bilateral metaphyseal fractures of the distal humeri. Within 2 h of the accident, the patient developed clinical features that were consistent with bilateral upper arm compartment syndrome. Bilateral fasciotomies of both anterior and posterior compartments were performed, confirming clinical suspicion. We suggest consideration of a history of anabolic steroid use when evaluating patients with extremity trauma. Copyright © 2013 Elsevier Inc. All rights reserved.

Temporal lobe developmental malformations and epilepsy: dual pathology and bilateral hippocampal abnormalities.

Science.gov (United States)

Ho, S S; Kuzniecky, R I; Gilliam, F; Faught, E; Morawetz, R

1998-03-01

Temporal lobe developmental malformations (TLDM) with focal cortical dysplasia and balloon cells may coexist with mesial temporal sclerosis. The true incidence of this dual pathology is unknown. Our aim was to assess the frequency of amygdala (AM)-hippocampal abnormality in a homogeneous population with this specific developmental malformation. MRI-based volumetry of the AM and hippocampal formation (HF) in 30 patients with unilateral TLDM and intractable partial epilepsy was performed. A volume normalization process defined a normal range of HF and AM volumes in control subjects, and enabled the detection of bilateral volume loss. Normalized volumes detected HF atrophy in 26 patients (nine unilateral and 17 bilateral) and AM atrophy in 18 patients (three unilateral and 15 bilateral). Visual analysis detected unilateral HF abnormality in 21 patients and bilateral abnormality in two. When compared with a group of patients with temporal lobe epilepsy and pure hippocampal sclerosis (N = 92), where volumetry revealed bilateral HF atrophy in 18%, a significant difference in the frequency of bilateral HF atrophy was found (p Dual pathology is frequent in patients with TLDM (87%), and the AM-HF abnormality is often bilateral (57%). Our data suggest that more widespread and potentially epileptogenic lesions coexist with visibly detectable unilateral TLDM. This has implications for the selection of patients for temporal lobe surgery and may influence surgical strategies.

Linear accelerator-based stereotactic radiosurgery for bilateral vestibular schwannomas in patients with neurofibromatosis type 2

NARCIS (Netherlands)

Meijer, Otto W. M.; Vandertop, W. Peter; Lagerwaard, Frank J.; Slotman, Ben J.

2008-01-01

OBJECTIVE: Patients with neurofibromatosis Type 2 (NF2) patients typically have bilateral vestibular schwannomas (VS) and are at risk for developing bilateral deafness, bilateral trigeminal, and bilateral facial nerve function loss. Previous reports suggested that treatment outcomes in these

Bilateral adrenal hemorrhage and primary antiphospholipid antibody syndrome

International Nuclear Information System (INIS)

Garcia de Iturrospe, C.; Quilez, I.J.; Echevarria, J.J.

1996-01-01

Bilateral adrenal hemorrhage is an uncommon entity that is difficult to diagnose given the ambiquity of the clinical signs. Computerized tomography plays a major role in the diagnosis, disclosing enlarged adrenal glands presenting the hyperdense aspect that characterizes this disorders. We present a case of bilateral adrenal hemoorrhage in a patient diagnosed as having primary antiphospholipid antibody syndrome, which is a less common cause of adrenal hemorrhage than those classically reported, such as anticoagulant therapy, sepsis, shock and abdominal injury. (Author) 8 refs

Bilateral tension pneumothorax resulting from a bicycle-to-bicycle collision.

Science.gov (United States)

Edwin, Frank; Sereboe, Lawrence; Tettey, Mark Mawutor; Aniteye, Ernest; Bankah, Patrick; Frimpong-Boateng, Kwabena

2009-01-01

Bilateral tension pneumothorax occurring as a result of recreational activity is exceedingly rare. A 10-year-old boy with no previous respiratory symptoms was involved in a bicycle-to-bicycle collision during play. He was the only one hurt. A few hours later, he was rushed to the general casualty unit of the emergency department of our institution with respiratory distress, diminished bilateral chest excursions and diminished breath sounds. The correct diagnosis was made after a chest radiograph was obtained in the course of resuscitation at the casualty unit. Pleural space needle decompression was suggestive of tension only on the right. Bilateral tube thoracostomies provided effective relief. He was discharged from hospital after a week in excellent health. This case illustrates the need for children to have safety instruction to reduce the risks of recreational bicycling. Chest radiography may be needed to establish the diagnosis of bilateral tension pneumothorax. Needle thoracostomy decompression is not always effective.

Bilateral experimental neck pain reorganize axioscapular muscle coordination and pain sensitivity.

Science.gov (United States)

Christensen, S W; Hirata, R P; Graven-Nielsen, T

2017-04-01

Neck pain is a large clinical problem where reorganized trunk and axioscapular muscle activities have been hypothesised contributing to pain persistence and pain hypersensitivity. This study investigated the effects of bilateral experimental neck pain on trunk and axioscapular muscle function and pain sensitivity. In 25 healthy volunteers, bilateral experimental neck pain was induced in the splenius capitis muscles by hypertonic saline injections. Isotonic saline was used as control. In sitting, subjects performed slow, fast and slow-resisted unilateral arm movements before, during and after injections. Electromyography (EMG) was recorded from eight shoulder and trunk muscles bilaterally. Pressure pain thresholds (PPTs) were assessed bilaterally at the neck, head and arm. Data were normalized to the before-measures. Compared with control and post measurements, experimental neck pain caused (1) decreased EMG activity of the ipsilateral upper trapezius muscles during all but slow-resisted down movements (p neck pain reorganized axioscapular and trunk muscle activity together with local hyperalgesia and widespread hypoalgesia indicating that acute neck pain immediately affects trunk and axioscapular function which may affect both assessment and treatment. Bilateral clinical neck pain alters axioscapular muscle coordination but only effects of unilateral experimental neck pain has been investigated. Bilateral experimental neck pain causes task-dependent reorganized axioscapular and trunk muscle activity in addition to widespread decrease in pressure pain sensitivity. © 2016 European Pain Federation - EFIC®.

Avaliação da morfologia interna de sementes de Acca sellowiana O. Berg por meio de análise de imagens

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Vanessa Neumann Silva

2013-12-01

Full Text Available Acca sellowiana O. (Berg Burret é uma fruteira nativa da região Sul do Brasil e do Uruguai, que apresenta grande potencial de uso na recuperação de áreas degradadas. O objetivo deste trabalho foi avaliar a morfologia interna de sementes de Acca sellowiana O. Berg por meio da análise de imagens de raios X e relacionar os resultados com a germinação das sementes. Sementes de Acca sellowiana O. Berg, representadas por três lotes, foram analisadas pelo teste de raios X e, posteriormente, conduzidas ao teste de germinação, com avaliação aos 44 dias após a semeadura. As imagens de raios X foram analisadas com o software ImageJ. A análise das imagens radiográficas de sementes de Acca sellowiana permite a mensuração das áreas internas livres, assim como a determinação da relação entre estas e a germinação. Danos internos detectados por meio de raios X afetam a germinação das sementes.

Bilateral topographic symmetry patterns across Aphrodite Terra, Venus

International Nuclear Information System (INIS)

Crumpler, L.S.; Head, J.W.

1988-01-01

Western Aphrodite Terra, Venus, is characterized by a series of parallel linear structural discontinuities 2000--4000 km in length and 100--200 km wide, which strike at high angles to the general topographic trend of the Aphrodite Terra highlands. The broad chracteristics of the cross-strike discontinuities (CSDs) are similar to both strike-slip fault zones and terrestrial oceanic fracture zones. In an effort to distinguish between these two hypotheses, topographic profiles were taken across Aphrodite Terra to test for bilateral symmetry of the type associated with thermal boundary layer topography at divergent plate boundaries on Earth. In addition to a broad bilateral symmetry at a range of angles across Aphrodite Terra, detailed bilateral symmetry is observed within domains between linear discontinuities in directions generally parallel to the strike of the discontinuities. In addition, within a domain the centers of symmetry of several profiles define a linear rise crest that is oriented normal to the bounding CSDs and terminates against them

[Bilateral traumatic patella fracture: a case report].

Science.gov (United States)

Cırpar, Meriç; Türker, Mehmet; Aslan, Arif; Yalçınozan, Mehmet

2011-08-01

Patellar fractures are uncommon injuries and account for approximately 1% of all fractures. In this article, a 35-year-old male patient who sustained a collision deceleration accident with bilateral comminuted transverse patellar fractures is presented. For this patient, open reduction and internal fixation with tension band technique, using two Kirschner wires and cerclage wire was applied for both fractures. At the first postoperative day, isometric quadriceps and active range of motion exercises were begun and the patient was allowed to walk full weight bearing with two crutches while both extremities were immobilized in a hinged brace allowing maximum 30 degrees of flexion. At postoperative fourth week brace immobilization was terminated. However, the patient was advised to use crutches for two weeks more to prevent any complications that may arise during walking because of the bilaterally of the injury. At six weeks solid union was achieved. During the last visit at postoperative second year, the patient had no complaints and the range of motion was full. In this paper a case of bilateral patella fractures is presented as a consequence of a dashboard injury, and the pathomechanical and therapeutical aspects of such an injury is discussed.

A Digital Image Denoising Algorithm Based on Gaussian Filtering and Bilateral Filtering

Directory of Open Access Journals (Sweden)

Piao Weiying

2018-01-01

Full Text Available Bilateral filtering has been applied in the area of digital image processing widely, but in the high gradient region of the image, bilateral filtering may generate staircase effect. Bilateral filtering can be regarded as one particular form of local mode filtering, according to above analysis, an mixed image de-noising algorithm is proposed based on Gaussian filter and bilateral filtering. First of all, it uses Gaussian filter to filtrate the noise image and get the reference image, then to take both the reference image and noise image as the input for range kernel function of bilateral filter. The reference image can provide the image’s low frequency information, and noise image can provide image’s high frequency information. Through the competitive experiment on both the method in this paper and traditional bilateral filtering, the experimental result showed that the mixed de-noising algorithm can effectively overcome staircase effect, and the filtrated image was more smooth, its textural features was also more close to the original image, and it can achieve higher PSNR value, but the amount of calculation of above two algorithms are basically the same.

Bilateral Diabetic Papillopathy and Metabolic Control

DEFF Research Database (Denmark)

Ostri, Christoffer; Lund-Andersen, Henrik; Sander, Birgit

2010-01-01

OBJECTIVE: The pathogenesis of diabetic papillopathy largely is unknown, but case reports suggest that it may follow rapidly improved metabolic control. The present study was designed to investigate this hypothesis. DESIGN: Retrospective case-control study. PARTICIPANTS: Two thousand sixty......-six patients with type 1 diabetes. METHODS: Review of clinical, photographic, and clinical chemistry records from a large diabetology and ophthalmology unit between 2001 and 2008. MAIN OUTCOME MEASURES: Simultaneous, bilateral diabetic papillopathy. RESULTS: The mean follow-up was 4.9 years. During 10 020...... patient-years of observation, bilateral diabetic papillopathy developed in 5 patients. During the year preceding this incident, all 5 patients had experienced a decrease in glycosylated hemoglobin A(1c) (HbA(1C)) at a maximum rate of -2.5 (mean) percentage points per quarter year, which was significantly...

Sweden-Lithuania bilateral cooperation in nuclear safety

International Nuclear Information System (INIS)

Nistad, J.H.; Vaisnys, P.

1996-01-01

This cooperation started in early 1992 shortly after Lithuania became a newly independent republic. The results from the bilateral co-operation in the field of nuclear safety are very fruitful and promising. The work is progressing in a very efficient and cost-effective way. The pace of progress is to a great extent governed by the resources the Lithuanian partners can allocate. The Swedish Government has up to now allocated more than 200 MSEK (>30 MUSD) for this bilateral cooperation in nuclear safety enhancement. This paper gives an overview of the main content and achievements of the Swedish-Lithuanian cooperation. 1 tab, 2 diagrams

Consistencia interna del cuestionario autoadministrado de la Entrevista Clínica Estructurada para Trastornos del Eje II del DSM-IV*

OpenAIRE

Campo-Arias, Adalberto; Díaz-Martínez, Luis Alfonso; Barros-Bermúdez, Jaider Alfonso

2008-01-01

Introducción: Es infrecuente identificar posibles casos de trastornos de personalidad en la población general, debido a la carencia de instrumentos autoadministrados con buena validez y confiabilidad. Hasta la fecha no se ha explorado la confiabilidad del cuestionario autoadministrado de la Entrevista Clínica Estructurada para Diagnósticos del eje II (SDID-II) del DSM-IV en la población colombiana. Objetivo: Determinar la consistencia interna de las subescalas del cuestionario autoadministrad...

Monte Carlo simulation based reliability evaluation in a multi-bilateral contracts market

International Nuclear Information System (INIS)

Goel, L.; Viswanath, P.A.; Wang, P.

2004-01-01

This paper presents a time sequential Monte Carlo simulation technique to evaluate customer load point reliability in multi-bilateral contracts market. The effects of bilateral transactions, reserve agreements, and the priority commitments of generating companies on customer load point reliability have been investigated. A generating company with bilateral contracts is modelled as an equivalent time varying multi-state generation (ETMG). A procedure to determine load point reliability based on ETMG has been developed. The developed procedure is applied to a reliability test system to illustrate the technique. Representing each bilateral contract by an ETMG provides flexibility in determining the reliability at various customer load points. (authors)

Control system design concepts for improving bilateral characteristics of master-slave manipulators

International Nuclear Information System (INIS)

Hewitt, J.E.; Siva, K.V.

1986-01-01

The paper concerns control system design concepts for improving bilateral characteristics of master-slave manipulators. In particular, the article concentrates on the identification of the remote manipulative process itself from studying direct manipulation with hand tools. Bilateral servo loop systems in operator controlled manipular systems are discussed, as well as Bond Graph modelling techniques. The performance of different kinds of bilateral servos are compared. (U.K.)

Catastrophic Antiphospholipid Syndrome Presenting as Bilateral Central Retinal Artery Occlusions

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Steven S. Saraf

2015-01-01

Full Text Available A previously healthy 22-year-old African American woman presented with bilateral vision loss associated with headache. Her ocular examination was significant for bilateral retinal arterial “boxcarring,” retinal whitening, retinal hemorrhages, and cherry red spots. She was diagnosed with bilateral central retinal artery occlusions and was hospitalized due to concomitant diagnosis of stroke and hypercoagulable state. She was also found to be in heart failure and kidney failure. Rheumatology was consulted and she was diagnosed with catastrophic antiphospholipid syndrome in association with systemic lupus erythematosus. Approximately 7 months after presentation, the patient’s vision improved and remained stable at 20/200 and 20/80.

Bilateral Bell palsy as a presenting sign of preeclampsia.

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Vogell, Alison; Boelig, Rupsa C; Skora, Joanna; Baxter, Jason K

2014-08-01

Bell palsy is a facial nerve neuropathy that is a rare disorder but occurs at higher frequency in pregnancy. Almost 30% of cases are associated with preeclampsia or gestational hypertension. Bilateral Bell palsy occurs in only 0.3%-2.0% of cases of facial paralysis, has a poorer prognosis for recovery, and may be associated with a systemic disorder. We describe a case of a 24-year-old primigravid woman with a twin gestation at 35 weeks diagnosed initially with bilateral facial palsy and subsequently with preeclampsia. She then developed partial hemolysis, elevated liver enzymes, and low platelet count syndrome, prompting the diagnosis of severe preeclampsia, and was delivered. Bilateral facial palsy is a rare entity in pregnancy that may be the first sign of preeclampsia and suggests increased severity of disease, warranting close monitoring.

Generalized approach to bilateral control for EMG driven exoskeleton

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Gradetsky Valery

2017-01-01

Full Text Available The paper discusses a generalized approach to bilateral control for EMG driven exoskeleton systems. In this paper we consider a semi-automatic mechatronic system that is controlled via human muscle activity (EMG level. The problem is to understand how the movement of the exoskeleton effects on the control. The considered system can be described in terms of bilateral control. This means the existence of force feedback from the object via the exoskeleton links and drives to operator. The simulation of the considered model was held on the MATLAB Simulink. The mathematical model of the bilateral system with exoskeleton and operator was developed. Transient functions for different dynamic parameters were obtained. It was shown that force feedback is essential for the R&D of such systems.

Pregnancy-associated purpura fulminans (PF Púrpura fulminans asociada al embarazo

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Gisela de la Rosa Echavez

2005-03-01

Full Text Available

PF is a serious cutaneous purpuric disease, associated with an intravascular disseminated coagulation syndrome. Among its known causes, besides those of thrombophilia, are viral and bacterial infections, mostly Neisseria meningitidis. During pregnancy there are alterations in the hemostatic mechanism. However, by themselves, they have not been shown to lead to PF. The case of a 22-year-old woman who developed PF during pregnancy, presumably due to her Escherichia coli urinary tract infection, is presented including clinical, paraclinical, therapeutic and surgical aspects. She recovered but suffered amputation of the distant phalanges of three toes in the left foot 

Synchronous bilateral testicular seminoma. Presentation of a clinical case and review of the literature

International Nuclear Information System (INIS)

Roldán, G.; Musé, I.

2004-01-01

Introduction: The patients with testicular germ cell tumors (TGT) present in the contralateral tumor development in approximately 3% of the cases. A small subset presenting with synchronous bilateral tumors (TBS). Case report: Patient is a 41-year study of infertility in who have performed bilateral testicular biopsies. Using ultrasound bilateral testicular nodules were diagnosed predominantly right. It performs a bilateral orchiectomy evidencing bilateral pure classic seminoma (T1 and T4). Staging the regional nodal involvement and distance rule and visceral with normal tumor markers. Receive adjuvant radiotherapy (3060 cGy) including inguinal lymph node chains, and pelvic and lumbo-aortic remaining free of disease at 33 months after surgery. Discussion: 85% of all bilateral TGT metachronous are presented as 15% synchronously. TBS represent less than 1% of the most representative series. In most cases they are seminomas and have been associated with infertility and history Family suggestive of genetic predisposition. Bilateral orchiectomy is local treatment of choice and subsequent planned strategy is according the loco-regional extension stressing the importance of hormone replacement and psychological support. Conclusions: In patients with a family history suggestive or infertile should be evaluated for TBS, especially if it carries a seminoma. the bilateral orchiectomy is local treatment of choice. We found no evidence seminomatous TBS have a worse prognosis compared with patients with unilateral or bilateral metachronous tumors of similar size lesional

Bilateral Dentigerous Cyst: An Unusual Case Report and Review of Literature

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Shweta Tikekar

2010-01-01

Full Text Available Dentigerous cysts are the most common developmental cysts of the jaws, most frequently associated with impacted mandibular third molar teeth. Bilateral dentigerous cysts are rare and occur typically in association with a developmental syndrome. The reported occurrence of bilateral dentigerous cysts in the absence of a syndrome is rare and, to date, only 17 cases have been described. The following is a report of a case of unusual bilateral nonsyndromic dentigerous cysts associated with developing mandibular second premolars and a review of literature.

Multimodality approach in the diagnosis and management of bilateral giant juvenile breast fibroadenoma.

Science.gov (United States)

Rafeek, Noora; Rangasami, Rajeswaran; Dhanraj, Kamakshi; Joseph, Santhosh

2016-10-06

Juvenile giant fibroadenoma is a very rare breast disease affecting young girls of premenarche and adolescent ages. It is a benign fibroepithelial tumour characterised by stromal and epithelial proliferation that causes rapidly growing breast mass. Bilateral symmetrical involvement is extremely rare. In this article, we describe this entity in a girl aged 13 years who presented with bilateral gigantically enlarged breasts. Ultrasonography and MRI showed large, multilobulated masses involving both breasts entirely. Endovascular embolisation of bilateral internal mammary arteries and lateral thoracic arteries supplying the masses was performed prior to surgery to reduce their vascularity. The patient subsequently underwent excision of bilateral breast masses and reduction mammoplasty. Histopathologically, bilateral breast masses were confirmed to be juvenile fibroadenomas. 2016 BMJ Publishing Group Ltd.

Bilateral Video-Assisted Thoracoscopic Surgery Resection for Multiple Mediastinal Myelolipoma: Report of a Case

Science.gov (United States)

Kohno, Tadasu; Mun, Mingyon; Yoshiya, Tomoharu

2014-01-01

Myelolipoma in the mediastinum is an extremely rare entity. In this report, we present the case of a 79-year-old asymptomatic man who had three bilateral paravertebral mediastinal tumors. The three tumors were resected simultaneously using bilateral three-port video-assisted thoracoscopic surgery (VATS). There has been no evidence of recurrence within four years after the operation. Multiple bilateral mediastinal myelolipomas are extremely rare. There are no reports in the English literature of multiple bilateral thoracic myelolipomas that were resected simultaneously using bilateral VATS. We also present characteristic features of myelolipomas, which are helpful for diagnosis. PMID:24782978

Inventario de la entomofauna asociada al cultivo de pitahaya amarilla (Selenicereus megalanthus Haw. en Briceño (Boyacá

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Héctor Iván Patiño-Tiria

2015-04-01

Full Text Available Boyacá es uno de los departamentos con mayor producción de pitahaya amarilla en el país. Los estudios realizados sobre este cultivo son muy pocos, y el conocimiento de la entomofauna asociada a él es un punto de partida para realizar nuevas investigaciones que permitan identificar la entomofauna asociada a este cultivo en el municipio de Briceño (Boyacá. El desarrollo de esta investigación se llevó a cabo en plantaciones de pitahaya en tres fincas del municipio de Briceño (Boyacá. Se realizaron muestreos empleando métodos activos, como captura manual directa, uso de red y aspirador entomológico, y métodos pasivos, como trampas con atrayentes y trampas  de caída. Los insectos colectados se sometieron a cámara letal y luego se montaron en alfileres para su posterior identificación con ayuda del estereoscopio y claves taxonómicas. En las tres fincas se identificaron un total de 9 órdenes y 58 familias, y los órdenes Hymenóptera y Díptera se reportaron con la mayor cantidad de individuos benéficos. En la finca San Pablo se observó la mayor cantidad de insectos; también fue la única en donde se evidenció la presencia de la plaga más limitante para este cultivo, que es Dasiops saltans (mosca del botón floral. La cantidad de familias presentes en los muestreos se ve influenciada más por el manejo agronómico implementado en cada finca que por las variables climatológicas, como temperatura, humedad relativa y precipitación.

Qualidade da atenção básica mediante internações evitáveis no Sul do Brasil Quality of primary care as measured by preventable hospitalizations in the South of Brazil

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Juvenal Soares Dias-da-Costa

2008-07-01

Full Text Available Realizou-se estudo para avaliar mediante taxa de internações hospitalares evitáveis a qualidade dos cuidados oferecidos pela rede básica de saúde em Pelotas, Rio Grande do Sul, Brasil, no período entre 1995 a 2004. Foram consideradas como internações evitáveis: diabetes mellitus, insuficiência cardíaca, hipertensão arterial sistêmica, doença pulmonar obstrutiva crônica e doenças imunopreveníveis (poliomielite, difteria, tétano, coqueluche, sarampo. Foram incluídos homens e mulheres de 20 a 59 anos. Os percentuais entre as mulheres foram superiores aos encontrados nos homens. Foi observada uma diminuição dos percentuais de internações tanto nos homens como nas mulheres no decorrer do período. Mesmo após a padronização direta revelou-se que as taxas de internação de Pelotas foram inferiores às do Rio Grande do Sul. Os custos das hospitalizações evitáveis acompanharam a queda observada nas taxas de internações. Aparentemente, a diminuição verificada nas taxas de internações evitáveis pode estar relacionada à qualificação dos serviços de atenção básica. Contudo, os resultados podem ser conseqüências do financiamento do sistema de saúde. Os valores de pagamento desses procedimentos são baixos e podem estar direcionando os hospitais a uma diminuição da oferta de leitos.This study assessed the quality of primary care in Pelotas, Rio Grande do Sul, Brazil, through preventable hospitalization rates (1995-2004. Preventable hospitalizations were defined as those related to the following diseases: diabetes mellitus, congestive heart failure, hypertension, chronic obstructive pulmonary disease, and vaccine-preventable diseases (polio, diphtheria, tetanus, whooping cough, and measles. Men and women from 20 to 59 years of age were included in the study. The proportion of preventable causes among hospital admissions was higher for women than for men. From 1995 to 2004 there was a decrease in preventable

Binaural Pitch Fusion in Bilateral Cochlear Implant Users.

Science.gov (United States)

Reiss, Lina A J; Fowler, Jennifer R; Hartling, Curtis L; Oh, Yonghee

Binaural pitch fusion is the fusion of stimuli that evoke different pitches between the ears into a single auditory image. Individuals who use hearing aids or bimodal cochlear implants (CIs) experience abnormally broad binaural pitch fusion, such that sounds differing in pitch by as much as 3-4 octaves are fused across ears, leading to spectral averaging and speech perception interference. The goal of this study was to determine if adult bilateral CI users also experience broad binaural pitch fusion. Stimuli were pulse trains delivered to individual electrodes. Fusion ranges were measured using simultaneous, dichotic presentation of reference and comparison stimuli in opposite ears, and varying the comparison stimulus to find the range that fused with the reference stimulus. Bilateral CI listeners had binaural pitch fusion ranges varying from 0 to 12 mm (average 6.1 ± 3.9 mm), where 12 mm indicates fusion over all electrodes in the array. No significant correlations of fusion range were observed with any subject factors related to age, hearing loss history, or hearing device history, or with any electrode factors including interaural electrode pitch mismatch, pitch match bandwidth, or within-ear electrode discrimination abilities. Bilateral CI listeners have abnormally broad fusion, similar to hearing aid and bimodal CI listeners. This broad fusion may explain the variability of binaural benefits for speech perception in quiet and in noise in bilateral CI users.

Immediately sequential bilateral cataract surgery: advantages and disadvantages.

Science.gov (United States)

Singh, Ranjodh; Dohlman, Thomas H; Sun, Grace

2017-01-01

The number of cataract surgeries performed globally will continue to rise to meet the needs of an aging population. This increased demand will require healthcare systems and providers to find new surgical efficiencies while maintaining excellent surgical outcomes. Immediately sequential bilateral cataract surgery (ISBCS) has been proposed as a solution and is increasingly being performed worldwide. The purpose of this review is to discuss the advantages and disadvantages of ISBCS. When appropriate patient selection occurs and guidelines are followed, ISBCS is comparable with delayed sequential bilateral cataract surgery in long-term patient satisfaction, visual acuity and complication rates. In addition, the risk of bilateral postoperative endophthalmitis and concerns of poorer refractive outcomes have not been supported by the literature. ISBCS is cost-effective for the patient, healthcare payors and society, but current reimbursement models in many countries create significant financial barriers for facilities and surgeons. As demand for cataract surgery rises worldwide, ISBCS will become increasingly important as an alternative to delayed sequential bilateral cataract surgery. Advantages include potentially decreased wait times for surgery, patient convenience and cost savings for healthcare payors. Although they are comparable in visual acuity and complication rates, hurdles that prevent wide adoption include liability concerns as ISBCS is not an established standard of care, economic constraints for facilities and surgeons and inability to fine-tune intraocular lens selection in the second eye. Given these considerations, an open discussion regarding the advantages and disadvantages of ISBCS is important for appropriate patient selection.

False Computed Tomography Findings in Bilateral Choanal Atresia

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Elsheikh, Ezzeddin

2016-01-01

Full Text Available Introduction Choanal atresia (CA is a challenging surgical problem defined as a failure in the development of communication between the nasal cavity and nasopharynx. Objective The objective of this study is to describe computed tomography (CT findings in cases with bilateral choanal atresia. Methods The study involved performing axial and coronal non-contrast CT scanning with 2–3 mm sections on14 neonates that had bilateral CA. We used fiberoptic nasal endoscopy to confirm the diagnosis. We evaluated coronal CT to study the skull base area in such neonates. Results This study included 14 neonates with bilateral CA; with mean age of 7 ± 3.5 days. Mixed atretic plates were found in 12 (85.7% cases while two (14.3% had pure bony atresia. Isolated CA was detected in 9 cases (64.3% and 5 (35.7% cases had associated anomalies. Coronal CT showed soft tissue density in the nasal cavity that appeared to extend through an apparent defect in the nasal roof (cribriform plate, falsely diagnosed by radiologists as associated encephalocele. At the time of surgical repair, all patients showed thick tenacious mucous secretions in both nasal cavities and revealed no encephalocele. Nasal roof remained intact in all cases. Conclusion The thick secretion of bilateral CA could give a false encephalocele appearance on the CT. It is highly recommended to perform proper suction of the nasal cavity of suspected CA cases just before CT scanning.

Genetics of Unilateral and Bilateral Age-Related Macular Degeneration Severity Stages.

Science.gov (United States)

Schick, Tina; Altay, Lebriz; Viehweger, Eva; Hoyng, Carel B; den Hollander, Anneke I; Felsch, Moritz; Fauser, Sascha

2016-01-01

Age-related macular degeneration (AMD) is a common disease causing visual impairment and blindness. Various gene variants are strongly associated with late stage AMD, but little is known about the genetics of early forms of the disease. This study evaluated associations of genetic factors and different AMD stages depending on unilateral and bilateral disease severity. In this case-control study, participants were assigned to nine AMD severity stages based on the characteristics of each eye. 18 single nucleotide polymorphisms (SNPs) were genotyped and attempted to correlate with AMD severity stages by uni- and multivariate logistic regression analyses and trend analyses. Area under the receiver operating characteristic curves (AUC) were calculated. Of 3444 individuals 1673 were controls, 379 had early AMD, 333 had intermediate AMD and 989 showed late AMD stages. With increasing severity of disease and bilateralism more SNPs with significant associations were found. Odds ratios, especially for the main risk polymorphisms in ARMS2 (rs10490924) and CFH (rs1061170), gained with increasing disease severity and bilateralism (exemplarily: rs1061170: unilateral early AMD: OR = 1.18; bilateral early AMD: OR = 1.20; unilateral intermediate AMD: OR = 1.28; bilateral intermediate AMD: OR = 1.39, unilateral geographic atrophy (GA): OR = 1.50; bilateral GA: OR = 1.71). Trend analyses showed pstages was lowest for unilateral early AMD (AUC = 0.629) and showed higher values in more severely and bilaterally affected individuals being highest for late AMD with GA in one eye and neovascular AMD in the other eye (AUC = 0.957). The association of known genetic risk factors with AMD became stronger with increasing disease severity, which also led to an increasing discriminative ability of AMD cases and controls. Genetic predisposition was also associated with the disease severity of the fellow-eye, highlighting the importance of both eyes in AMD patients.

Effects of virtual reality-based bilateral upper-extremity training on brain activity in post-stroke patients.

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Lee, Su-Hyun; Kim, Yu-Mi; Lee, Byoung-Hee

2015-07-01

[Purpose] This study investigated the therapeutic effects of virtual reality-based bilateral upper-extremity training on brain activity in patients with stroke. [Subjects and Methods] Eighteen chronic stroke patients were divided into two groups: the virtual reality-based bilateral upper-extremity training group (n = 10) and the bilateral upper-limb training group (n = 8). The virtual reality-based bilateral upper-extremity training group performed bilateral upper-extremity exercises in a virtual reality environment, while the bilateral upper-limb training group performed only bilateral upper-extremity exercise. All training was conducted 30 minutes per day, three times per week for six weeks, followed by brain activity evaluation. [Results] Electroencephalography showed significant increases in concentration in the frontopolar 2 and frontal 4 areas, and significant increases in brain activity in the frontopolar 1 and frontal 3 areas in the virtual reality-based bilateral upper-extremity training group. [Conclusion] Virtual reality-based bilateral upper-extremity training can improve the brain activity of stroke patients. Thus, virtual reality-based bilateral upper-extremity training is feasible and beneficial for improving brain activation in stroke patients.

Bilateral Necrotizing Fasciitis of the Foot Associated with Group B Streptococcus

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Keitaro Fukuda

2016-09-01

Full Text Available Necrotizing fasciitis (NF is a severe bacterial infection involving fascia and subcutaneous tissue. It generally affects upper or lower extremities unilaterally, and there are few reports of bilateral-extremity NF. Here, we report a case of a 43-year-old male with type 1 diabetes who had NF on the left foot and subsequently developed NF on the other foot 1 week later. The patient survived with antimicrobial therapy and bilateral below-knee amputation. As group B streptococcus (GBS was isolated by blood culture and culture of excised tissues of both feet, bilateral GBS NF of the foot was diagnosed. GBS is a rare causative pathogen in NF; however, there have been two case reports of bilateral GBS NF of an extremity in which NF appeared on the opposite extremity 1 week after the primary site infection, as in our case. GBS was isolated from cultures of blood and excised tissues of both extremities in both cases. Together, these observations suggest that GBS has a potential to cause secondary NF at remote sites by hematogenous dissemination with approximately 1 week delay and thereby lead to bilateral NF.

Estruturas de governança interna e a capacidade de inovação em pequenas firmas brasileiras de torrefação e moagem de café

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Gabriela Feresin Jardim

2013-06-01

Full Text Available Na pesquisa relatada neste artigo são investigadas quais as combinações de estruturas de governança interna (mercado, burocrática e comunitária que possibilitam mais capacidade de inovação de produto nas pequenas firmas. Neste estudo, inspirado nos trabalhos de Grandori e Furnari (2008; 2010, tem-se como hipótese que a capacidade de inovação ocorre de modo mais consistente nas firmas que adotam uma estrutura de governança interna multimodal. Essa hipótese foi testada por meio de um survey com 80 indústrias brasileiras de torrefação e moagem de café(1. Para encontrar as combinações de estruturas, foi utilizada a análise comparativa qualitativa (QCA no software fs/QCA versão 2.0 (RAGIN, 2008. Como resultado, verificou-se que a estrutura de governança interna multimodal - que combina práticas de incentivos monetários, burocráticas e comunitárias - apresentou resultados mais consistentes para a inovação das pequenas firmas de torrefação. Esses resultados, ao permitirem identificar os requisitos organizacionais que produzem mais possibilidades de inovação, podem ajudar a traçar ações de políticas públicas e privadas para as empresas brasileiras, de modo a melhorar sua taxa de inovação e a competitividade em seus mercados.

Monoartritis gotosa de muñeca asociada a necrosis del semilunar: a propósito de un caso clínico

OpenAIRE

Olmedo García, N.; Mackenney Carrasco, Enrique

1994-01-01

Se presenta un caso de monoartritis de muñeca asociada a imágenes radiológicas de necrosis avascular del semilunar que, tras biopsia de la sinovial, se diagnostica de artritis gotosa. Esta asociación es rara. La alteración metabólica que se produce en la gota da lugar a una sinovitis, que provoca un aumento de presión intraarticular. Esta hiperpresión en el carpo podría determinar una necrosis isquémica del semilunar, pero con una evolución diferente a la enfermedad de Kienböck...

Fractures of the bilateral distal radius and scaphoid: a case report

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Ozkan Korhan

2008-03-01

Full Text Available Abstract Introduction Bilateral fractures of the distal radius and scaphoid are extremely rare injuries. Case presentation A patient with bilateral comminuted, displaced distal fractures of the radius and bilateral fractures of the scaphoid was treated via internal fixation of the scaphoid fractures with Herbert screws and internal fixation of the distal radius fractures with locked volar plating. Conclusion Rigid internal fixation of distal radius and scaphoid fractures is mandatory to start early active rehabilitation of the wrist without the need for wrist immobilization with a plaster or external skeletal fixation.

Bilateral s-shaped kidneys: A rare congenital malformation

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Nikhil Ranjan

2015-01-01

Full Text Available A bilateral S-shaped kidney is a rare anomaly in which both the kidneys are in their normal position, in contrast to the commonly reported S-shaped fusion anomaly, in which the contralateral kidney crosses the midline to fuse with opposite kidney leaving the ipsilateral renal fossa empty. Here we present the diagnosis and management of a case of bilateral S-shaped renal anomaly with associated left pelviureteric junction obstruction and nonfunctioning kidney and right renal stones. Left kidney was managed by open nephrectomy and right kidney by PNL.

Bilateral impacted femoral neck fracture in a renal disease patient ...

African Journals Online (AJOL)

Spontaneous bilateral femoral neck facture in a renal disease patient is not common. We report a case of 47-year-old female patient with chronic renal failure and on regular hemodialysis for the past 5 years who sustained bilateral impacted femoral neck fracture without history of trauma and injury and refused any surgical ...

A rare case of bilateral aspergillus endophthalmitis

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Saurabh Gupta

2015-12-01

Full Text Available Aspergillus endophthalmitis is a devastating inflammatory condition of the intraocular cavities that may result in irreparable loss of vision and rapid destruction of the eye. Almost all cases in the literature have shown an identified source causing aspergillus endophthalmitis as a result of direct extension of disease. We present a rare case of bilateral aspergillus endophthalmitis. A 72-year-old woman with a history of diabetes mellitus, congenital Hirschsprung disease, and recent culture-positive candida pyelonephritis with hydronephrosis status post-surgical stent placement presented with difficulty opening her eyes. She complained of decreased vision (20/200 with pain and redness in both eyes – right worse then left. Examination demonstrated multiple white fungal balls in both retinas consistent with bilateral fungal endophthalmitis. Bilateral vitreous taps for cultures and staining were performed. Patient was given intravitreal injections of amphotericin B, vancomycin, ceftazidime, and started on oral fluconazole. Patient was scheduled for vitrectomy to decrease organism burden and to remove loculated areas of infection that would not respond to systemic antifungal agents. Four weeks after initial presentation, the fungal cultures revealed mold growth consistent with aspergillus. Patient was subsequently started on voriconazole and fluconazole was discontinued due to poor efficacy against aspergillus. Further workup was conducted to evaluate for the source of infection and seeding. Transthoracic cardiogram was unremarkable for any vegetation or valvular abnormalities. MRI of the orbits and sinuses did not reveal any mass lesions or bony destruction. CT of the chest was unremarkable for infection. Aspergillus endophthalmitis may occur because of one of these several mechanisms: hematogenous dissemination, direct inoculation by trauma, and contamination during surgery. Our patient's cause of bilateral endophthalmitis was through an

United Kingdom national paediatric bilateral cochlear implant audit: preliminary results.

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Cullington, Helen; Bele, Devyanee; Brinton, Julie; Lutman, Mark

2013-11-01

Prior to 2009, United Kingdom (UK) public funding was mainly only available for children to receive unilateral cochlear implants. In 2009, the National Institute for Health and Care Excellence published guidance for cochlear implantation following their review. According to these guidelines, all suitable children are eligible to have simultaneous bilateral cochlear implants or a sequential bilateral cochlear implant if they had received the first before the guidelines were published. Fifteen UK cochlear implant centres formed a consortium to carry out a multi-centre audit. The audit involves collecting data from simultaneously and sequentially implanted children at four intervals: before bilateral cochlear implants or before the sequential implant, 1, 2, and 3 years after bilateral implants. The measures include localization, speech recognition in quiet and background noise, speech production, listening, vocabulary, parental perception, quality of life, and surgical data including complications. The audit has now passed the 2-year point, and data have been received on 850 children. This article provides a first view of some data received up until March 2012.

A case of adrenal Cushing's syndrome with bilateral adrenal masses.

Science.gov (United States)

Guo, Ya-Wun; Hwu, Chii-Min; Won, Justin Ging-Shing; Chu, Chia-Huei; Lin, Liang-Yu

2016-01-01

A functional lesion in corticotrophin (ACTH)-independent Cushing's syndrome is difficult to distinguish from lesions of bilateral adrenal masses. Methods for distinguishing these lesions include adrenal venous sampling and (131)I-6β-iodomethyl-19-norcholesterol ((131)I-NP-59) scintigraphy. We present a case of a 29-year-old Han Chinese female patient with a history of hypercholesterolaemia and polycystic ovary syndrome. She presented with a 6month history of an 8kg body weight gain and gradual rounding of the face. Serial examinations revealed loss of circadian rhythm of cortisol, elevated urinary free-cortisol level and undetectable ACTH level (Cushing's syndrome presenting with bilateral adrenal masses. The clinical presentation of Cushing' syndrome includes symptoms and signs of fat redistribution and protein-wasting features.The diagnosis of patients with ACTH-independent Cushing's syndrome with bilateral adrenal masses is challenging for localisation of the lesion.Both adrenal venous sampling and (131)I-NP-59 scintigraphy are good methods to use in these patients with Cushing's syndrome presenting with bilateral adrenal masses.

Bilateral akillesseneruptur efter behandling med ciprofloxacin

DEFF Research Database (Denmark)

Attarzadeh, Amir Pasha; Ryge, Camilla

2013-01-01

We report a case of spontaneous non-traumatic bilateral rupture of the Achilles tendons following ciprofloxacin treatment. A 54-year-old man presented with spontaneous Achilles tendon rupture on the left side, tendinitis and partial tear on the right side following few days of treatment with cipr......We report a case of spontaneous non-traumatic bilateral rupture of the Achilles tendons following ciprofloxacin treatment. A 54-year-old man presented with spontaneous Achilles tendon rupture on the left side, tendinitis and partial tear on the right side following few days of treatment...... with ciprofloxacin 500 mg twice daily and long-term treatment with prednisolon 10 mg once daily. This rare side effect caused by concurrent treatment with steroids and ciprofloxacin should be kept in mind. Any signs of tendinitis following this treatment should arouse the physicians' suspicion towards ciprofloxacin....

Projeção da mortalidade e internações hospitalares na rede pública de saúde atribuíveis à poluição atmosférica no Estado de São Paulo entre 2012 e 2030

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Cristina Guimarães Rodrigues

2015-12-01

Full Text Available No Brasil, os padrões nacionais de qualidade do ar são da década de 1990, desatualizados em relação aos internacionais, o que dificulta um controle eficaz dos níveis de poluição e contribui para a continuidade de mortes e internações. A fim de quantificar o montante de desfechos desfavoráveis de saúde em decorrência da concentração de material particulado no Estado de São Paulo, esse trabalho tem como objetivo realizar projeções de mortes, internações e gastos com internações públicas atribuíveis à poluição atmosférica, para o período de 2012 a 2030. Para isso foram considerados distintos cenários de poluição por material particulado fino (MP2,5, tomando-se como referência o ano-base 2011. Os resultados mostram que, mantendo o mesmo nível de poluição observado em 2011, haverá um total de mais de 246 mil óbitos por todas as causas entre 2012 e 2030, cerca de 953 mil internações hospitalares públicas e um gasto público estimado em internações de mais de R$ 1,6 bilhão. A magnitude dos resultados aponta para a necessidade de implementação de medidas mais rigorosas para o controle da poluição do ar, formas alternativas de energia limpa de transporte, entre outras ações, como forma de reduzir os danos à saúde da população e os gastos governamentais.

Bilateral aneurysmal bone cyst of the mandible: A case report

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Gopal HK Sharma

2015-01-01

Full Text Available An aneurysmal bone cyst (ABC, usually considered a reactive lesion of bone rather than a cyst or true neoplasm, is believed to represent an exaggerated, localized, proliferative response of vascular tissue in bone. The case described here is of a 40-year-old female patient presenting with gradually increasing bilateral mandibular swelling of more than 1 year duration. The radiographic and cone beam computed tomography (CBCT images showed bilateral, multilocular expansile radiolucent lesions in the mandible in the premolar-molar region. On considering the blood aspirate obtained and the histopathologic findings, the patient was diagnosed with bilateral aneurysmal bone cysts in the mandible, with probable pre-existing bone lesion.

Anton’s Syndrome due to Bilateral Ischemic Occipital Lobe Strokes

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Sanela Zukić

2014-01-01

Full Text Available We present a case of a patient with Anton’s syndrome (i.e., visual anosognosia with confabulations, who developed bilateral occipital lobe infarct. Bilateral occipital brain damage results in blindness, and patients start to confabulate to fill in the missing sensory input. In addition, the patient occasionally becomes agitated and talks to himself, which indicates that, besides Anton’s syndrome, he might have had Charles Bonnet syndrome, characterized by both visual loss and hallucinations. Anton syndrome, is not so frequent condition and is most commonly caused by ischemic stroke. In this particular case, the patient had successive bilateral occipital ischemia as a result of massive stenoses of head and neck arteries.

Escala de Actitudes hacia Lesbianas y Hombres Homosexuales en México 1. Estructura factorial y consistencia interna

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José Moral de la Rubia

2011-01-01

Full Text Available Este estudio tiene como objetivos calcular la consistencia interna de la escala de Actitudes hacia Lesbianas y Hombres Homosexuales (ATLG y sus factores, determinar la estructura factorial y comprobar su invarianza entre hombres y mujeres. Se levantó una muestra incidental de 356 estudiantes. Los 20 ítems fueron consistentes (¿ = .94. Se definió un factor de actitud hacia las lesbianas (.91 y dos factores de rechazo abierto (.85 y sutil (.78 hacia los hombres homosexuales. Esta estructura de tres factores correlacionados tuvo un ajuste adecuado a los datos y resultó estable entre hombres y mujeres. Se recomienda su uso en México.

Nicolás Ruiz: la lucha contra el Estado y la restricción interna de derechos

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Inés Castro Apreza

2007-05-01

Full Text Available Desde una perspectiva histórica, en este artículo se analiza el desarrollo político-electoral de Nicolás Ruiz, un municipio de los Valles Centrales de Chiapas; se pone el énfasis en el período que comienza en 1994, cuando sus habitantes cambian de opción política. Se muestra que es un caso paradigmático de una población mayoritaria con reivindicaciones frente al gobierno local y el Estado nacional, al tiempo que la asamblea de comuneros impone restricciones internas que limitan o anulan los derechos comunales y los derechos políticos de sus habitantes.

Acerca de “Mapeo político de la discriminación y homofobia asociadas con la epidemia de VIH en México”

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Andrea Carolina Ochoa-Fernández

2017-01-01

Full Text Available Hemos leído con gran interés el artículo titulado “Mapeo político de la discriminación y homofobia asociadas con la epidemia de VIH en México”. Ante la situación actual planteada en México,presumimos que en otros países de Latinoamérica la realidad no es muy diferente debido a las características similares a nivel cultural y social...

Symptomatic bilateral xanthogranuloma of the choroid plexus

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Selin Tural Emon

2017-01-01

Full Text Available Xanthogranulomas (XGRs of the choroid plexus are rare, asymptomatic, and benign lesions usually found incidentally. Here, we present a case of a 47-year-old male with bilateral XGR of the choroid plexus with periventricular edema and discuss our case in relation to a review of existing literature pertaining to the radiology of XGRs. To the best of our knowledge, this is the first reported case of bilateral trigonal XGR causing brain edema without ventricular dilatation. Despite the fact that they can cause hydrocephalus, XGRs are silent and benign lesions. Although the etiopathology of XGRs remains poorly understood, enhanced imaging analyses may provide additional information regarding edema and focal white matter signal changes.

Bilateral calf chronic compartment syndrome in an elderly male: a case report.

LENUS (Irish Health Repository)

Siau, Keith

2009-01-01

Leg pain is a common presentation to the outpatient department. Bilateral calf chronic compartment syndrome is a rare cause of bilateral calf pain. Although this condition has been well documented in young athletes, it has rarely been reported in the elderly. We present the case of a 68-year-old male bodybuilder with bilateral calf chronic compartment syndrome, describe the presentation and evaluation of the condition, and provide a review of the literature herewith.

Bilateral renal artery variation

OpenAIRE

Üçerler, Hülya; Üzüm, Yusuf; İkiz, Z. Aslı Aktan

2014-01-01

Each kidney is supplied by a single renal artery, although renal artery variations are common. Variations of the renal arteryhave become important with the increasing number of renal transplantations. Numerous studies describe variations in renalartery anatomy. Especially the left renal artery is among the most critical arterial variations, because it is the referred side forresecting the donor kidney. During routine dissection in a formalin fixed male cadaver, we have found a bilateral renal...

Ascites, a New Cause for Bilateral Hydronephrosis: Case Report

Science.gov (United States)

Jain, Deepika; Dorairajan, Smrita; Misra, Madhukar

2009-01-01

Bilateral hydronephrosis secondary to urinary obstruction leads to a buildup of back pressure in the urinary tract and may lead to impairment of renal function. We present a case of a 57-year-old male with a history of alcoholic liver cirrhosis, who presented with tense ascites and acute renal failure. Bilateral hydronephrosis was seen on abdominal ultrasound. Multiple large-volume paracenteses resulted in resolution of hydronephrosis and prompt improvement in renal function. PMID:19802498