Inspeção, diagnóstico e sugestão de intervenções nos componentes de madeira em edificação de sistema plataforma (light wood frame): estudo de caso no protótipo Stella-UFSC

TCC (graduação) - Universidade Federal de Santa Catarina. Centro Tecnológico. Engenharia Civil.O sistema plataforma é um método construtivo que se utiliza da madeira como elemento principal, usando-a como membro estrutural, ou também na função de revestimento e acabamento. No entanto, a madeira é suscetível ao ataque de organismos xilófagos, e também pode ser danificada por fatores abióticos, como a ação do intemperismo, deterioração química e o desgaste mecânico. Ademais, sua natureza anisotrópica, em conjunto com a influência da ação da variação de umidade, pode originar defeitos nas peças. Nesse contexto, o presente trabalho consiste em um estudo de caso de uma edificação construída a partir do sistema plataforma, o protótipo Stella-UFSC, com o intuito de realizar a inspeção nos componentes de madeira presentes na edificação, constatando e apresentando diferentes manifestações patológicas encontrados nesses elementos. Dentre elas, os problemas mais recorrentes foram nos sidings nas fachadas externas, e nas esquadrias. A partir desse levantamento, foi realizado o diagnóstico correspondente a cada ocorrência, relacionando-o com a revisão bibliográfica estudada. Com base nisso, foram sugeridas medidas de intervenção, para cada caso

Isolated Femoral or Tibial Component Revision in Total Knee Arthroplasty: A Systematic Review

Objective: The purpose of this systematic review is to assess clinical and radiographic outcomes, complications rates, rates and reasons of re-revision of isolated femoral or tibial component revisions, comparing them with total knee revisions. Methods: A review of the published literature was performed using Medline, Embase and Cochrane libraries. The terms "isolate" and "revision" and "knee arthroplasty" or "knee replacement" were together used as MESH terms. Partial knee replacement, non-English literature, case reports and papers published before 2000 were excluded. Results: Out of 911 papers, six papers met the inclusion criteria. Mean MINORS scores achieved quite low values (13.33 and 13.67). No study encompassed revisions for septic loosening or infection. Total revisions performed for instability and wear achieved better clinical outcomes: in the other cases, partial and total revisions showed no differences in clinical outcomes. Both the cohorts showed similar radiographic features. Lesser bleeding and shorter operative times were observed in partial revisions compared to total revisions. The re-revision rates were similar in most of comparative studies: only one study noticed a significant difference in the failure rate between partial (25% at 3 years) and full (7% at 3.5 years) revisions. Conclusions: The poor quality of the studies precluded sound conclusions. Isolated tibial or femoral component revision is an option when the other component is well-fixed and positioned and in absence of chronic periprosthetic infection; nevertheless, it should be carefully evaluated when the reasons for revision are wear or instability

Software-related recalls in computer-assisted hip and knee arthroplasty

Purpose Computer-assisted arthroplasty supports the surgeons in planning, simulating, and performing the replacement procedure, using robotic or navigation technologies. However, the safety of the technology has not been widely ascertained. Food and Drug Administration (FDA) database was interrogated about software-related recalls in computer-assisted arthroplasty, aiming to assess: (1) the incidence, (2) the root causes, and (3) the actions taken due to recalls.Methods The Medical Device Recalls database was investigated about software-related recalls in computer-assisted hip and knee arthroplasty surgery, between 2017 and 2022. The incidence of the software-related recalls, the root causes according to FDA and manufacturers, and the corrective actions taken by firms were determined.Results Eighteen recall numbers could be identified (1.6%), corresponding to 11 recall events. A total of 4634 units were involved. The FDA determined root causes were: software design (66.6%), design change (22.2%), manufacturing deployment (1, 5.6%), and design manufacturing process (5.6%). Among the manufacturers' reasons for recalls, a specific error was declared in 16 cases (88.9%). In seven cases (43.8%), a coding error about lower limb alignment assessment was identified. Seventeen software-related recalls (94.4%) were classified as class 2; only one case was class 3 (5.6%). Return of the device was the main action taken by firms (8, 44.4%), followed by software update (7, 38.9%).Conclusion Software-related recalls in computer-assisted hip and knee arthroplasty were quite uncommon among all the recalls, deemed non-life threatening and usually due to software design errors. The main actions taken by manufacturers were the return of the device or the software update

Prognostic role of nutritional status in elderly patients hospitalized for COVID-19: a monocentric study

BackgroundSymptomatic severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection incidence is higher in the elderly patients. Pre-existing geriatric conditions such as comorbidity and frailty seem related to worse hospital outcomes.AimsTo assess the role of nutritional status as an independent prognostic factor for in-hospital death in elderly patients.MethodsConsecutive elderly patients (age > 65 years) hospitalized for novel coronavirus disease (COVID-19) were enrolled. Demographics, laboratory and comorbidity data were collected. Nutritional status was evaluated using the Geriatric Nutri-tional Risk Index (GNRI). Uni- and multivariate Cox regression analyses to evaluate predictors for in-hospital death were performed.ResultsOne hundred and nine hospitalized elderly patients (54 male) were consecutively enrolled. At univariate analysis, age (HR 1.045 [CI 1.008\u20131.082]), cognitive impairment (HR 1.949 [CI 1.045\u20133.364]), C-reactive protein (HR 1.004 [CI 1.011\u20131.078]), lactate dehydrogenases (HR 1.003 [CI 1.001\u20131.004]) and GNRI moderate\u2013severe risk category (HR 8.571 [CI 1.096\u201367.031]) were risk factors for in-hospital death, while albumin (HR 0.809 [CI 0.822\u20130.964]), PaO2/FiO2 ratio (HR 0.996 [CI 0.993\u20130.999]) and body mass index (HR 0.875 [CI 0.782\u20130.979]) were protective factors. Kaplan\u2013Meier survival curves showed a significative higher survival in patients without GNRI moderate or severe risk category (p = 0.0013).At multivariate analysis, PaO2/FiO2 ratio (HR 0.993 [CI 0.987\u20130.999], p = 0.046) and GNRI moderate\u2013severe risk category (HR 9.285 [1.183\u201372.879], p = 0.034) were independently associated with in-hospital death.ConclusionNutritional status assessed by GNRI is a significative predictor of survival in elderly patients hospitalized for COVID-19. The association between GNRI and PaO2/FiO2 ratio is a good prognostic model these patients

Migraine and cluster headache show impaired neurosteroids patterns

Background: Perturbation of neuronal excitability contributes to migraine. Neurosteroids modulate the activity of γ-aminobutyric acid A and N-methyl-d-aspartate receptors, and might be involved in the pathogenesis of migraine. Here, we measured plasma levels of four neurosteroids, i.e., allopregnanolone, epiallopregnanolone, dehydroepiandrosterone and deydroepiandrosterone sulfate, in patients affected by episodic migraine, chronic migraine, or cluster headache. Methods: Nineteen female patients affected by episodic migraine, 51 female patients affected by chronic migraine, and 18 male patients affected by cluster headache were recruited to the study. Sex- and age-matched healthy control subjects (31 females and 16 males) were also recruited. Patients were clinically characterized by using validated questionnaires. Plasma neurosteroid levels were measured by liquid chromatography-tandem mass spectrometry. Results: We found disease-specific changes in neurosteroid levels in our study groups. For example, allopregnanolone levels were significantly increased in episodic migraine and chronic migraine patients than in control subjects, whereas they were reduced in patients affected by cluster headache. Dehydroepiandrosterone and dehydroepiandrosterone sulfate levels were reduced in patients affected by chronic migraine, but did not change in patients affected by cluster headache. Conclusion: We have shown for the first time that large and disease-specific changes in circulating neurosteroid levels are associated with chronic headache disorders, raising the interesting possibility that fluctuations of neurosteroids at their site of action might shape the natural course of migraine and cluster headache. Whether the observed changes in neurosteroids are genetically determined or rather result from exposure to environmental or intrinsic stressors is unknown. This might also be matter for further investigation because stress is a known triggering factor for headache attacks in both migraineurs and cluster headache patients

Electrophysiological and Neuropsychological Indices of Cognitive Dysfunction in Patients with Chronic Insomnia and Severe Benzodiazepine Use Disorder.

Benzodiazepine (BDZ) misuse is a growing health problem, with 1-2% of patients under BDZ treatment meeting the criteria for use disorder or dependence. Although BDZ addiction potential has been known for decades, much remains unknown its effects on brain functions. The aim of this study was to assess the neuropsychological and neurophysiological profile of a group of chronic insomniacs taking long-term high doses of benzodiazepine. We recruited 17 consecutive patients admitted to our third-level Sleep Medicine Unit for drug discontinuation (7 males, mean age 49.2 ± 11.2 years, mean education 13.7 ± 3.9 years, mean daily diazepam-equivalent BDZ: 238.1 ± 84.5 mg) and 17 gender/age-matched healthy controls (7 males, mean age 46.8 ± 14.1 years, mean education 13.5 ± 4.5 years). We performed a full neuropsychological evaluation of all subjects and recorded their scalp event-related potentials (Mismatch-Passive Oddball-Paradigm and Active Oddball P300 Paradigm). Patients with chronic insomnia and BDZ use disorder showed a profound frontal lobe executive dysfunction with significant impairment in the cognitive flexibility domain, in face of a preserved working, short and long-term memory. In patients, P300 amplitude tended to be smaller, mainly over the frontal regions, compared to controls. BDZ use disorder has a severe cognitive impact on chronic insomnia patients. Long-term high-dose BDZ intake should be carefully evaluated and managed by clinicians in this specific patient population, especially in relation to risky activities

Termometria ao infravermelho na programação da irrigação de feijoeiro

The objective of this work was to determine the critical irrigation time for common bean (Phaseolus vulgaris L. cv. Carioca) using infrared thermometry. Five treatments were analyzed. Canopy temperature differences between plants and a well-watered control about 1, 2, 3, 4, and 5±0.5ºC were tested. Physiological variables and plant growth were analyzed to establish the best time to irrigate. There was a significant linear correlation between the index and stomatal resistance, transpiration rate, and leaf water potential. Although significant linear correlation between the index and mean values of total dry matter, absolute growth rate, and leaf area index was found, no correlation was found with other growth index like relative growth rate, net assimilation rate, and leaf area ratio. Plants irrigated when their canopy temperature was 3±0.5ºC above the control had their relative growth rate mean value increased up to 59.7%, yielding 2,260.2 kg ha-1, with a reduction of 38.0% in the amount of water used. Plants irrigated when their canopy temperature was 4±0.5ºC yielded 1,907.6 kg ha-1, although their relative growth rate mean value was 4.0% below the control. These results show that the best moment to irrigate common bean is when their canopy temperature is between 3ºC and 4±0.5ºC above the control.O objetivo deste trabalho foi determinar o momento crítico para efetuar a irrigação do feijoeiro (Phaseolus vulgaris L. cv. Carioca) utilizando a termometria ao infravermelho. Foram analisados cinco tratamentos. As diferenças entre a temperatura foliar das plantas e a de um controle mantido bem irrigado testadas foram de 1, 2, 3, 4 e 5±0,5ºC. Foram analisadas variáveis fisiológicas e de crescimento para identificar o melhor momento de irrigação. Encontrou-se uma correlação linear significativa entre o índice empregado e a resistência estomática, a taxa transpiratória e o potencial hídrico foliar. Embora tenha-se verificado uma correlação linear significativa entre o índice empregado e os valores médios da matéria seca total, da taxa de crescimento absoluto e do índice de área foliar, não se verificou qualquer correlação significativa com os demais índices de crescimento, como a taxa de crescimento relativo, a taxa assimilatória líquida e a razão de área foliar. As plantas irrigadas a uma temperatura foliar de 3±0,5ºC acima do controle apresentaram um incremento de 59,7% no valor médio da sua taxa de crescimento relativo, produzindo 2.260,2 kg ha-1 de grãos, com uma redução de 38,0% na quantidade de água aplicada. As plantas irrigadas a uma temperatura foliar de 4±0,5ºC acima do controle produziram 1.907,6 kg ha-1 de grãos, contudo o valor médio de sua taxa de crescimento relativo foi de 4,0% inferior ao controle. Estes resultados demonstram que o melhor momento de se irrigar o feijoeiro é quando apresentam temperatura foliar entre 3ºC e 4±0,5ºC acima do controle

Exosomes from Plasma of Neuroblastoma Patients Contain Doublestranded DNA Reflecting the Mutational Status of Parental Tumor Cells

Neuroblastoma (NB) is an aggressive infancy tumor, leading cause of death among preschool age diseases. Here we focused on characterization of exosomal DNA (exo-DNA) isolated from plasma cell-derived exosomes of neuroblastoma patients, and its potential use for detection of somatic mutations present in the parental tumor cells. Exosomes are small extracellular membrane vesicles secreted by most cells, playing an important role in intercellular communications. Using an enzymatic method, we provided evidence for the presence of double-stranded DNA in the NB exosomes. Moreover, by whole exome sequencing, we demonstrated that NB exo-DNA represents the entire exome and that it carries tumor-specific genetic mutations, including those occurring on known oncogenes and tumor suppressor genes in neuroblastoma (ALK, CHD5, SHANK2, PHOX2B, TERT, FGFR1, and BRAF). NB exo-DNA can be useful to identify variants responsible for acquired resistance, such as mutations of ALK, TP53, and RAS/MAPK genes that appear in relapsed patients. The possibility to isolate and to enrich NB derived exosomes from plasma using surface markers, and the quick and easy extraction of exo-DNA, gives this methodology a translational potential in the clinic. Exo-DNA can be an attractive non-invasive biomarker for NB molecular diagnostic, especially when tissue biopsy cannot be easily available

Sleep Complaints, Sleep and Breathing Disorders in Myotonic Dystrophy Type 2

PURPOSE OF REVIEW: To update the current knowledge concerning sleep complaints and breathing disorders in myotonic dystrophy type 2 (DM2) and to better understand if sleep and breathing symptoms may add a further clinical definition of DM2. RECENT FINDINGS: Although DM2 has been poorly evaluated, the most relevant sleep disorders are sleep-disordered breathing (SDB) (37.5-66.7%) and restless legs syndrome (RLS) (50-60%). Excessive daytime somnolence (EDS) is not consistent with SDB, and a large percentage of patients with sleep complaints (58-69%) report pain. In addition, respiratory dysfunctions are reported in 6 to 15% of DM2 patients, albeit few data are available regarding pulmonary restriction, hypoventilation, and non-invasive ventilation (NIV). SDB, RLS, and pain may contribute to sleep fragmentation and EDS in DM2. In addition, few studies report hypoventilation and pulmonary restriction, although there are no studies at all on NIV, except for limited clinical experiences. These findings suggest performing a careful pulmonary examination and NIV when required. Furthermore, sleep studies and respiratory evaluation should be recommended if OSA or respiratory muscle dysfunctions are suspected. A large polysomnographic study should be performed to clarify the link between sleep disorders, pain, and sleep disruption in DM2