Complicações determinadas por placas de cloreto de polivinila (PVC) na estabilização da porção cervical caudal da coluna vertebral de cães Complications determined by polyvinylchloride (PVC) plates in the stabilization of caudal cervical vertebral column of dogs

Em 10 cães com peso médio de 14,6kg, as vértebras cervicais 5 e 6 foram cirurgicamente desestabilizadas através da secção do disco intervertebral e, em seguida, estabilizadas com placas ortopédicas confeccionadas com PVC de 2mm de espessura, para após 180 dias, proceder-se ao estudo histológico do tecido ósseo e conjuntivo circunvizinho. Constatou-se que o PVC causou alterações ósseas que podem ter favorecido o afrouxamento dos parafusos e a falha do implante. O material induziu ainda à formação de granuloma de corpo estranho e a reações inflamatórias locais que podem ter causado degradação do material implantado. Assim, placas de PVC, apesar de proporcionarem estabilidade e alinhamento da coluna vertebral, não satisfazem a maioria das propriedades necessárias a um biomaterial, não sendo recomendadaa a sua utilização em ortopedia veterinária.<br>In ten dogs with an average mean weight of 14,6 kg, the cervical vertebra 5 and 6 were destabilized and fixed with plates of 2mm of thickness. The purpose of this work was to verify the effect of orthopedic PVC plates on the internal stabilization of the caudal cervical spine of dogs by studying the occurrence of alterations in the bone tissue and fibrous tissue adjacent to the plate after 180 days of permanence of the material in the dogs' organism. PVC causes progressive bone alterations, which, in the long term, could promote the loosening of the screws and failure of the implant. It also induces the formation of foreign body granuloma and inflammatory reactions which could cause degradation of the implant. Thus, PVC plates do not satisfy the majority of properties required of a biomaterial, its use not being recommended in veterinary orthopedics

Cost-utility of an eHealth application ‘Oncokompas’ that supports cancer survivors in self-management: results of a randomised controlled trial

Purpose: The eHealth self-management application ‘Oncokompas’ was developed to support cancer survivors in monitoring health-related quality of life (HRQOL) and symptoms, and obtaining personalized feedback and options for supportive care. The aim of this study was to assess the cost-utility of Oncokompas compared with care as usual (CAU) among cancer survivors. Methods: Survivors were randomly allocated to the intervention or control group. Direct (non-)medical, indirect non-medical costs, and HRQOL were measured at 3- and 6-month follow-up, using iMTA Medical Consumption and Productivity Costs and the EuroQol-5D questionnaires. Mean cumulative costs and quality-adjusted life-years (QALYs) were compared between both groups. Results: In total, 625 survivors were randomized into intervention (n = 320) or control group (n = 305). Base case analysis showed that incremental costs from a societal perspective were − €163 (95% CI, − 665 to 326), and incremental QALYs were 0.0017 (95% CI, − 0.0121 to 0.0155) in the intervention group compared with those in the control group. The probability that, c