Posterior surgical approach procedures for cervical myelopathy

This is the protocol for a review and there is no abstract. The objectives are as follows: The main objective of this review is to assess the effects of laminectomy and fusion versus laminoplasty for multilevel cervical stenosis with myelopathy, on treatment outcomes such as pain, quality of life, functional and neurological improvement, and complication rates. © 2015 The Cochrane Collaboration

Vissim 8, uso y aplicación en una intersección urbana; avenida Pablo Ricchieri, Bernardo O'Higgins y Celso Barrios

Práctica Supervisada (IC)--FCEFN-UNC, 2007Analiza la intersección de las Av. O'Higgins, Av. Pablo Ricchieri y Celso Barrios, simulando las propuestas de mejoras utilizando software de micro simulación de tránsito como soporte en la toma de decisió

A identificação do leitor LGBTQIA+ com a literatura de João Gilberto Noll

Trabalho de Conclusão de Curso (graduação)—Universidade de Brasília, Instituto de Letras, Departamento de Teoria Literária e Literaturas, 2020.A pesquisa sobre a identificação do leitor LGBTQIA+ com a literatura em que essa minoria está representada visa entender como o texto consegue desenvolver uma ressignificação da realidade por meio da ficcionalização e representar uma visão remodela e, portanto, positiva dessa realidade. A Teoria da Recepção, representada por Wolfgang Iser, fornece os meios de análise da transposição da realidade ao texto pelo mecanismo literário. Para analisar a interpretação e a relação leitor-texto, os comentários de leitores disponibilizados na internet permitem entender a potencialidade do texto nas representações de realidades que são estigmatizadas pela sociedade. Diante disso, comparamos as recepções do autor João Gilberto Noll com as de autores populares que publicam suas obras na internet. Apesar das recepções gerarem resultados diferentes, percebe-se serem duas leituras que permitem compreender a literatura LGBTQIA+ como um espaço de ressignificação dessa minoria. De acordo com os trabalhos de Michele Petit, podemos entender que a literatura LGBTQIA+ pode ser entendida como um refúgio para o leitor em crise

Guanacos en la playa

El presente artículo reporta el análisis de un conjunto faunístico recuperado en la costa marina del partido de Mar Chiquita. La mayoría de los especímenes fueron identificados como Lama guanicoe. La cuantificación, morfometría, re-ensamble anatómico y trazas tafonómicas sugieren que la mayoría o la totalidad del conjunto se originó en una única carcasa depositada naturalmente. Los restos óseos fueron recuperados durante el relevamiento realizado con motivo de un rescate arqueológico en el sector costero marino, en mayo de 2016. Los resultados de su análisis contribuyen a la discusión sobre la biogeografía de Lama guanicoe y su eventual disponibilidad como recurso para las poblaciones prehispánicas de la Provincia de Buenos Aires durante el Holoceno tardío.This paper reports the analysis of a faunal assemblagefrom the marine coast of the Mar Chiquita party. Bone specimens were identified mainly as Lama guanicoe. Quantification, morphometry, anatomical refitting and taphonomic traces point to a single naturally deposited carcass as the sole or the main source of faunal remains. This assemblage was recovered during a survey carried out on the occasion of an archaeological rescue in the marine coastal sector, in May 2016. The reported data contribute to the discussion on the biogeography of L. guanicoe and its potential availability as a resource for pre-Hispanic populations throughout the province of Buenos Aires during late Holocene.Fil: Aldazabal, Veronica Beatriz. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Instituto Multidisciplinario de Historia y Ciencias Humanas; ArgentinaFil: Belloti, Carlos. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Instituto Multidisciplinario de Historia y Ciencias Humanas; Argentin

Efeito do tempo de armazenagem e dos cimentos na resistencia a remoção por tração de coroas totais metalicas

Orientador : Lourenço Correr SobrinhoTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaAbstract: The purpose of this study was to evaluate the effect of storage time (24 hours and 6 month) in the tensile strength of complete cast crowns luted with 3 kinds of dental cements. Ninety bovin incisors were embedded in epoxic resin. The coronal portions of the teeth were prepared to receive complete crowns using a 4103 diamond bur under refrigeration with 100 of tapering and right shoulder. Ninety crowns were cast with nickel-chromium (Verabond 2) melted by gas-oxygen torch. After the crowns were cleaned and blasted with aluminum oxide (50 _m) and they were separated in three groups of thirty specimens each one. Afterwards thirty crowns were luted with zinc phosphate cement (SSWhite), Thirty luted with resin­ modified glass ionomer cement (Fuji Plus) and thirty with resin cement (Rely X). The crowns were luted onto the tooth with static load of 9 kg for 10 minutes. After ali specimens were stored in distilled water 370 C, where 15 specimens for each cement were storage for 24 hours and 15 for 6 months. Afterwards the storage time, the specimens were submitled to the tension tests on Instron machine with a speed of 1mmlmin. The results were analyzed by ANOVA and Tukey's test (p<0.05) and showed that the crowns luted with resin cement showed higher values tension strength in the storage time of the 24 hours and 6 months in relation of the glass ionomer cement and zinc phosphate (p<0.05). The values of the tension strength of the 6 months storage was higher than 24 hours for the resin cement and glass ionomer cement. No statistic difference was found for the zinc phosphate cementResumo: O propósito deste estudo foi avaliar o efeito do tempo de armazenagem (24 horas e 6 meses) na resistência à remoção por tração de coroas totais metálicas fixadas com 3 tipos de cimento dental. Noventa incisivos bovinos foram fixados pelas raízes em resina epóxica. As porções coronárias foram preparadas para receber coroas totais completas, usando pontas diamantadas n° 4103 com paredes axiais com expulsividade de 10° e término cervical em ombro reto. Noventa coroas totais foram fundidas com a liga de níquel-cromo (Verabond 2). Após a limpeza e jateamento com óxido de alumínio (50 /lm) as coroas foram separadas em 3 grupos de 30 amostras. Em seguida, trinta coroas foram fixadas com cimento de fosfato de zinco (55 White), 30 com cimento de ionõmero de vidro modificado por resina (Fuji Plus) e 30 com cimento resinoso (Rely X). As coroas foram fixadas com auxílio de prensa pneumática, com carga estática de 9 kg por 1O minutos. Após, todos os corpos-de-prova foram armazenados em água destilada numa estufa a 37° C, sendo que 15 corpos-de-prova para cada agente de fixação foram armazenados por 24 horas e 15 por 6 meses. Após os períodos de armazenagem, os corpos-de-prova foram submetidos ao ensaio de resistência à remoção por tração numa máquina de ensaio universal Instron à velocidade de 1 mmlminuto. Os resultados foram submetidos à análise de variância e às médias ao teste de Tukey (p<0,05) e mostraram que as coroas fixadas com o cimento resinoso apresentou valores de resistência à remoção por tração superiores nos tempos de armazenagem de 24 horas e 6 meses em relação ao cimento de ionõmero de vidro e fosfato de zinco (p<0,05). Os valores de resistência à remoção por tração no tempo de armazenagem de 6 meses foram superiores ao de 24 horas para os cimentos resinoso e ionõmero de vidro. Nenhuma diferença estatística foi observada para o cimento de fosfato de zincoDoutoradoDoutor em Materiais Dentário

Efetividade da injeção intrarticular de lidocaína na redução das luxações anteriores do ombro: ensaio clínico randomizado

CONTEXT AND OBJECTIVE: Shoulder dislocation is the most common dislocation among the large joints. The aim here was to compare the effectiveness of reduction of acute anterior shoulder dislocation with or without articular anesthesia. DESIGN AND SETTING: Prospective randomized trial conducted in Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP) (EPM-UNIFESP). METHODS: From March 2008 to December 2009, 42 patients with shoulder dislocation were recruited. Reductions using traction-countertraction for acute anterior shoulder dislocation with and without lidocaine articular anesthesia were compared. As the primary outcome, pain was assessed through application of a visual analogue scale before reduction, and one and five minutes after the reduction maneuver was performed. Complications were also assessed. RESULTS: Forty-two patients were included: 20 in the group without analgesia (control group) and 22 in the group that received intra-articular lidocaine injection. The group that received intra-articular lidocaine had a statistically greater decrease in pain over time than shown by the control group, both in the first minute (respectively: mean 2.1 (0 to 5.0), standard deviation, SD 1.3, versus mean 4.9 (2.0 to 7.0, SD 1.5; P < 0.001) and the fifth minute (respectively: mean 1.0; 0 to 3.0; SD = 1.0 versus mean 4.0; 1.0 to 6.0; SD = 1.4; P < 0.001). There was one failure in the control group. There were no other complications in either group. CONCLUSION: Reduction of anterior shoulder dislocation using intra-articular lidocaine injection is effective, since it is safe and diminishes the pain. CLINICAL TRIAL REGISTRATION: ISRCTN27127703.CONTEXTO E OBJETIVO: A luxação do ombro é a mais frequente luxação das grandes articulações. O objetivo foi comparar a efetividade da redução da luxação anterior aguda do ombro, com ou sem anestesia articular. TIPO DE ESTUDO E LOCAL: Ensaio clínico randomizado desenvolvido na Escola Paulista de Medicina - Universidade Federal de São Paulo (UNIFESP) (EPM-UNIFESP). MÉTODOS: De março de 2008 a dezembro de 2009 foram recrutados 42 pacientes com luxação anterior do ombro agudas. Foi comparada a redução de tração e contra-tração com e sem anestesia intra-articular com lidocaína. Como desfecho primário, a dor foi avaliada por meio da escala visual analógica antes da redução e um e cinco minutos após a redução do ombro. Complicações também foram avaliadas. RESULTADOS: Foram incluídos 42 pacientes: 20 no grupo sem anestesia (grupo controle) e 22 no grupo que recebeu injeção intra-articular de lidocaína. O grupo que recebeu lidocaína intra-articular teve estatisticamente menos dor no primeiro (média = 2,1; 0 a 5,0, desvio padrão, DP, de 1,3, versus média = 4,9; 2,0 a 7,0; DP = 1,5; respectivamente; P < 0,001) e no quinto minutos (média = 1,0; 0 a 3,0; DP = 1,0 versus 4,0; 1,0 a 6,0; DP = 1,4; respectivamente; P < 0,001) após a redução em comparação ao grupo controle. Houve uma falha no grupo controle. Não houve complicações adicionais em ambos os grupos. CONCLUSÃO: A redução da luxação do ombro com o uso de lidocaína intra-articular é efetiva, pois é segura e proporciona menos dor. REGISTRO DE ENSAIO CLÍNICO: ISRCTN27127703Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Department of Orthopedics and TraumatologyUNIFESP, EPM, Department of Orthopedics and TraumatologySciEL

Treatment of reducible unstable fractures of the distal radius in adults: a randomised controlled trial of De Palma percutaneous pinning versus bridging external fixation

Background: At present, there is no conclusive evidence regarding the best treatment method for reducible unstable fractures of the distal radius. This study compared the effectiveness of two methods used in surgical treatment of such fractures: percutaneous pinning and external fixation.Methods: We randomly allocated 100 patients into two groups treated surgically with modified de Palma percutaneous pinning and bridging external fixation. Independent but not blinded evaluators administered the DASH quality-of-life questionnaire at postoperative months 6 and 24, performed functional assessment of pain, range of motion, and palm grip strength, and radiographic examinations (volar and radial angle, and height of the radius) before the operation, immediately afterwards, and at 6 and 24 months postoperative. Modified de Palma percutaneous pinning patients used an above-elbow cast whereas external fixation group had unrestricted elbow motion after surgery. Patients who for any reason demonstrated treatment failure or required additional interventions were followed up and their results were included in the group into which these patients had initially been randomised according to the intention-to-treat principle. A significance level of 5% (alpha = 0.05). was used for all statistical tests, such that tests presenting a p-value less than 0.05 were considered statistically significant.Results: Ninety one (58.8 mean age and 66 participants were female) were included in the final assessment at 24 months. the DASH questionnaire evaluation showed a statistically significant result favouring the de Palma group (mean difference = -7.1 p = 0.044) after six months, but this was not maintained at 24 months. There were no statistically differences between the groups with respect to palm grip strength. Analysis of the range-of-motion limitation index (uninjured side minus affected side motion of) showed a statistical difference (mean difference = 2.4 p = 0.043) favoring the external fixator group with regard to the supination movement 6 months after the operation; however, this was not maintained at 24 months. the final results of the radiographic evaluation were similar for the two groups. Overall, five patients developed complications: two with de Palma pinning and three with external fixation.Conclusion: There was a small statistically significant difference favouring the de Palma method in early functional at 6 months according to the DASH questionnaire, and for supination movement favouring the fixator group. However, both were not clinical relevant. By 24 months the groups were similar for all outcome

Treatment of reducible unstable fractures of the distal radius: randomized clinical study comparing the locked volar plate and external fixator methods: study protocol

Background: Various treatments are available for reducible unstable fractures of the distal radius, such as closed reduction combined with fixation by external fixator (EF), and rigid internal fixation using a locked volar plate (VP). Although there are studies comparing these methods, there is no conclusive evidence indicating which treatment is best. the hypothesis of this study is that surgical treatment with a VP is more effective than EF from the standpoint of functional outcome (patient-reported).Methods/Design: the study is randomized clinical trial with parallel groups and a blinded evaluator and involves the surgical interventions EF and VP. Patients will be randomly assigned (assignment ratio 1: 1) using sealed opaque envelopes. This trial will include consecutive adult patients with an acute (up to 15 days) displaced, unstable fracture of the distal end of the radius of type A2, A3, C1, C2 or C3 by the Arbeitsgemeinschaft fur Osteosynthesefragen-Association for the Study of Internal Fixation classification and type II or type III by the IDEAL(32) classification, without previous surgical treatments of the wrist. the surgical intervention assigned will be performed by three surgical specialists familiar with the techniques described. Evaluations will be performed at 2, and 8 weeks, 3, 6 and 12 months, with the primary outcomes being measured by the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and measurement of pain (Visual Analog Pain Scale and digital algometer). Secondary outcomes will include radiographic parameters, objective functional evaluation (goniometry and dynamometry), and the rate of complications and method failure according to the intention-to-treat principle. Final postoperative evaluations (6 and 12 months) will be performed by independent blinded evaluators. for the Student's t-test, a difference of 10 points in the DASH score, with a 95% confidence interval, a statistical power of 80%, and 20% sampling error results in 36 patients per group.Discussion: Results from this study protocol will improve the current evidence regarding to the surgical treatment these fractures.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Universidade Federal de São Paulo, UNIFESP EPM, Dept Orthoped & Traumatol, Hand Arm & Shoulder Surg Unit, São Paulo, BrazilHand Arm & Shoulder Surg Unit, São Paulo, BrazilUniversidade Federal de São Paulo, UNIFESP EPM, Dept Orthoped & Traumatol, Hand Arm & Shoulder Surg Unit, São Paulo, BrazilFAPESP: FAPESP - 2012/00806-2- annex 3Web of Scienc