Lateral window technique: a focus review

The posterior alveolar bone region of the maxilla has, in more than 40% of the cases, a height inferior to 4 mm, thus making rehabilitation with implants a clinical challenge. This focus literature review was carried out through an exhaustive literature search in PubMed, ScienceDirect, LILACS, Web of Science, Scielo and Cochrane Library. The aim was to illustrate and analyse various factors that should be accounted for while applying the maxillary sinus elevation technique. The lateral osteotomy technique is carefully described including its indications, complications, contraindications, as well as, different factors to take into account, such as the use of electric piezo, graft materials, membranes and the expected success rates.publishe

A new model for pharmacies? Insights from a quantitative study regarding the public's perceptions

Background: Worldwide community pharmacies are shifting their role in the healthcare system from simple medication dispensers to health care providers. High levels of satisfaction with pharmacy services were found in previous studies. This study has two main goals. The primary goal is to describe the levels of satisfaction and knowledge regarding pharmacy services in Portugal. The secondary goal is to explore the perceptions and the utilisation of pharmacy services by the Portuguese. This statement includes exploring the impact of a set of variables on both perceptions and uses of pharmacies in regard to services that are currently offered as well as to new services that may be provided in the future. Methods: A face-to-face survey of closed-ended questions was applied to a nationwide representative sample of the Portuguese population in September 2015. The sample was weighted based on population distribution across regions, habitat, age and gender. Data analysis comprises descriptive statistics and Multiple Correspondence Analysis to explore different typologies of respondent's orientation toward community pharmacy. Results: A total of 1114 interviews comprised the study. Of the respondents, 36% used the pharmacy as a first resource when seeking to treat a minor ailment, and 54% reported that they use the pharmacy as a first resource when seeking answers about medicines. Of those who visited their pharmacy at least once in the previous year, 94% were either globally satisfied or very satisfied. The level of acknowledgement of pharmacy services' was also high among the Portuguese. Of the participants, 29% considered there could be more services available in pharmacies that are currently provided by other health care facilities. The construction of a typology of orientations towards community pharmacy practice resulted in three outcome groups: "Motivated" (63%), those with a connection to a pharmacy; "Settled" (23%), mainly those who had a pharmacy nearby; and "Demobilised" (14%), those who are weakly tied to a pharmacy. Conclusions: The vast majority of the Portuguese population has a strong positive attitude towards their community pharmacy, as expressed by the high levels of satisfaction with, and positive evaluation of, the pharmacy's services.info:eu-repo/semantics/publishedVersio

Os estudantes e a leitura

info:eu-repo/semantics/publishedVersio

O contributo da origem e das práticas silvícolas na sustentabilidade dos montados de sobro

Considerando que, num contexto global de exigência crescente das sociedades e de implementação de políticas de gestão sustentável dos recursos naturais, cabe às entidades e agentes ligados ao sector participar de uma forma activa numa adequada aplicação e inovação das práticas existentes, os autores pretendem dar um contributo para o melhoramento dos montados de sobro e para a obtenção de um maior rendimento em cortiça. Nesse sentido entendem que os esforços desenvolvidos para a identificação de populações de sobreiro mais adaptadas devem ser completados com a aplicação de práticas silvícolas que conduzam a um maior rendimento em cortiça. Assim, foram implementados cortes de formação nas primeiras idades em ensaios genéticos de sobreiro existentes no nosso País, pertencentes a uma rede internacional, que cobrem no seu conjunto toda a área de distribuição da espécie, com o objectivo de obter fustes direitos e cilíndricos em pelo menos 3 a 4 m do tronco, contribuindo de uma forma efectiva e directa para uma maior valorização da prancha de cortiça e consequentemente proporcionar uma mais-valia no rendimento do proprietário florestal. A variação observada quer ao nível das populações quer das descendências nestes ensaios é indicativo que não é indiferente a escolha da população a utilizar nas acções de repovoamento, assim como na implementação de um programa de melhoramento, apontando também para a necessidade de seleccionar os indivíduos dentro das populações. A experiência adquirida relativamente à poda de formação aconselha que esta operação seja efectuada num período de crescimento activo das plantas para garantir uma cicatrização rápida dos tecidos e uma menor rebentação nas zonas dos cortes

O contributo da origem e das práticas silvícolas na sustentabilidade dos montados de sobro

Considerando que, num contexto global de exigência crescente das sociedades e de implementação de políticas de gestão sustentável dos recursos naturais, cabe às entidades e agentes ligados ao sector participar de uma forma activa numa adequada aplicação e inovação das práticas existentes, os autores pretendem dar um contributo para o melhoramento dos montados de sobro e para a obtenção de um maior rendimento em cortiça. Nesse sentido entendem que os esforços desenvolvidos para a identificação de populações de sobreiro mais adaptadas devem ser completados com a aplicação de práticas silvícolas que conduzam a um maior rendimento em cortiça. Assim, foram implementados cortes de formação nas primeiras idades em ensaios genéticos de sobreiro existentes no nosso País, pertencentes a uma rede internacional, que cobrem no seu conjunto toda a área de distribuição da espécie, com o objectivo de obter fustes direitos e cilíndricos em pelo menos 3 a 4 m do tronco, contribuindo de uma forma efectiva e directa para uma maior valorização da prancha de cortiça e consequentemente proporcionar uma mais-valia no rendimento do proprietário florestal. A variação observada quer ao nível das populações quer das descendências nestes ensaios é indicativo que não é indiferente a escolha da população a utilizar nas acções de repovoamento, assim como na implementação de um programa de melhoramento, apontando também para a necessidade de seleccionar os indivíduos dentro das populações. A experiência adquirida relativamente à poda de formação aconselha que esta operação seja efectuada num período de crescimento activo das plantas para garantir uma cicatrização rápida dos tecidos e uma menor rebentação nas zonas dos cortes

Pectus Excavatum postsurgical outcome based on preoperative soft body dynamics simulation

Pectus excavatum is the most common congenital deformity of the anterior chest wall, in which an abnormal formation of the rib cage gives the chest a caved-in or sunken appearance. Today, the surgical correction of this deformity is carried out in children and adults through Nuss technic, which consists in the placement of a prosthetic bar under the sternum and over the ribs. Alth ough this technique has been shown to be safe and reliable, not all patients have achieved adequate cosmetic outcome. This often leads to psyc hological problems and social stress, before and after the surgical correction. This paper targets this particular problem by presenting a method to predict the patient surgical outcome based on pre-surgical imagiologic information and chest skin dynamic modulation. The proposed approach uses the patient pre-surgical thoracic CT scan and anatomical-surg ical references to perform a 3D segmentation of the left ribs, right ribs, sternum and skin. The technique encompasses three steps: a) approximation of the cartilages, between the ribs and the sternum, trough b-spline interpolation; b) a volu metric mass spring model that connects two layers - inner skin layer based on the outer pleura contour and the outer su rface skin; and c) displacement of the sternum according to the prosthetic bar position. A dynamic model of the skin around the chest wall region was generated, capable of simulating the effect of the movement of the prosthetic bar along the sternum. The results were compared and validated with patient postsurgical skin surface acquired with Polhemus FastSCAN system.Fundação para a Ciência e Tecnologi

Thoracic wall reconstruction using ultrasound images to model/bend the thoracic prosthesis for correction of pectus excavatum

Pectus excavatum is the most common congenital deformity of the anterior thoracic wall. The surgical correction of such deformity, using Nuss procedure, consists in the placement of a personalized convex prosthesis into sub-sternal position to correct the deformity. The aim of this work is the CT-scan substitution by ultrasound imaging for the pre-operative diagnosis and pre-modeling of the prosthesis, in order to avoid patient radiation exposure. To accomplish this, ultrasound images are acquired along an axial plane, followed by a rigid registration method to obtain the spatial transformation between subsequent images. These images are overlapped to reconstruct an axial plane equivalent to a CT-slice. A phantom was used to conduct preliminary experiments and the achieved results were compared with the corresponding CT-data, showing that the proposed methodology can be capable to create a valid approximation of the anterior thoracic wall, which can be used to model/bend the prosthesis.Fundação para a Ciencia e Tecnologia (FCT

Variations of the soft tissue thicknesses external to the ribs in pectus excavatum patients

BACKGROUND: Surgical repair of pectus excavatum (PE) has become more popular due to improvements in the minimally invasive Nuss procedure. The pre-surgical assessment of PE patients requires Computerized Tomography (CT), as the malformation characteristics vary from patient to patient. OBJECTIVE: This work aims to characterize soft tissue thickness (STT) external to the ribs among PE patients. It also presents a comparative analysis between the anterior chest wall surface before and after surgical correction. METHODS: Through surrounding tissue segmentation in CT data, STT values were calculated at different lines along the thoracic wall, with a reference point in the intersection of coronal and median planes. The comparative analysis between the two 3D anterior chest surfaces sets a surgical correction influence area (SCIA) and a volume of interest (VOI) based on image processing algorithms, 3D surface algorithms, and registration methods. RESULTS: There are always variations between left and right side STTs (2.54 ± 2.05 mm and 2.95 ± 2.97 mm for female and male patients, respectively). STTs are dependent on age, sex, and body mass index of each patient. On female patients, breast tissue induces additional errors in bar manual conception. The distances starting at the deformity's largest depression point at the SCIA are similar in all directions. Some diverging measures and outliers were found, being difficult to find similar characteristics between them, especially in asymmetric patients. CONCLUSION: The Nuss procedure metal bar must be modeled according to each patient's special characteristics. The studied relationships between STT and chest surface could represent a step forward to eliminate the CT scan from PE pre-surgical evaluation.This work was supported by "Fundacao para a Ciencia e a Tecnologia" (FCT), Portugal, through the R&D project referenced PTDC/SAU-BEB/103368/2008 and the fellowships referenced SFRH/BD/74276/2010, SFRH/BD/68270/2010 and SFRH/BPD/46851/2008

L’origine du matériel de reproduction et les pratiques sylvicoles: outils pour la durabilité des subéraies

Dans le contexte actuel de l’exigence croissante de la société et de l’implémentation des politiques de gestion durable des ressources naturelles et face aux risques des changements climatiques, il incombe aux entités et agents liés au secteur une participation active à l’application adéquate et à l'innovation des pratiques forestières. Les auteurs prétendent apporter une contribution à l'amélioration des forêts de chênes liège afin d’améliorer leur rendement en liège. Dans ce contexte, les efforts développés pour identifier les populations de chêne-liège les plus adaptées devraient être complétés par l'application des pratiques sylvicoles qui permettront l’augmentation de ce rendement. Des tailles de formation ont été réalisées sur des jeunes essais génétiques de chêne liège âgés de 11 ans, installés au Portugal (nombre de sujets, date tailles, etc). L'objectif principal de ces tailles est d’obtenir un fût rectiligne d'au moins 3 à 4 m afin de valoriser les planches de liège et par conséquent fournir une valeur ajoutée aux revenus du propriétaire forestier. Les variations observées, que ce soit au niveau des populations (donner ces variations) ou au niveau des descendances (donner ces variations) révèlent l’importance du choix des populations à utiliser dans le reboisement et dans les programmes d'amélioration génétique. Cela met en évidence la nécessité de sélectionner les individus au sein des populations. Donner plus de résultats chiffrés au résuméPTDC/AGR-AAM/104364/200

An unusual case of an isolated capitellar fracture of the right elbow in a child: a case report

<p>Abstract</p> <p>Introduction</p> <p>Although elbow fractures have a high incidence in the pediatric population, fractures of the capitellum are almost exclusively observed in individuals older than 12 years of age. Due to their rarity in children, reports with large numbers of cases are lacking in the literature and the surgical treatment options are poorly defined.</p> <p>Case presentation</p> <p>We present the case of an 11-year-old Portuguese girl with a displaced fracture of the capitellum of the right elbow, a typical Hahn-Steinthal or Type 1 fracture, which was followed for one year. The treatment and outcome of this fracture are described. Our patient underwent an open reduction and internal fixation with two cannulated screws. There were no complications and normal elbow function was recovered.</p> <p>Conclusion</p> <p>The authors believe that cannulated screw fixation is a reliable method of treatment for Type 1 capitellar fracture in children because it enables good interfragmentary compression, early mobilization, faster functional elbow recovery and implant removal is rarely necessary.</p