Meniscal tears: comparison of the conventional spin-echo and fast spin-echo techniques through image processing

Background: Conventional spin-echo (PD-CSE) and fast spin-echo (PD-FSE) techniques are frequently used to detect meniscal tears. However, the time delay for imaging with PD-CSE has resulted in its replacement with faster techniques, such as proton density fast spin-echo (PD-FSE), which has become a frequent tool at most diagnostic centres. Qualitative analysis shows that the PD-CSE technique is more sensitive, but other authors have not found significant differences between the aforementioned techniques. Therefore, we performed a quantitative analysis in this study that aims to measure differences in the quality of the images obtained with both techniques.Methods: We compared the PD-CSE and PD-FSE techniques by quantitatively analysing the obtained proton density images: the area shown, as well as the brightness and lesion contrast of the obtained image. A set of 100 images from 50 patients thought to contain meniscal tears of the knee were selected. These 100 images were obtained from all individuals using both the PD-CSE and PD-FSE techniques. the images were processed using software developed in Delphi. in addition to these quantifications, three physicians, who are specialists in radiology and capable of analysing magnetic resonance (MR) images of the musculoskeletal system, qualitatively analysed the diagnostic sensitivity of both techniques.Results: On average, samples obtained via the PD-CSE technique contained 22% more pixels in the lesion area. the contrast differed by 28%, and the brightness differed by 31%. the two techniques were correlated using Student's t-test, which showed a statistically significant difference. the specialists detected meniscal tears in 30 of the images obtained via the PD-CSE technique, while only 72% of these cases were detected via the PD-FSE technique.Conclusions: the PD-CSE technique was shown to be superior to PD-FSE for all of the evaluated properties, making its selection preferable.FAEP (Fundacao de Amparo a Ensino e Pesquisa) from Universidade de Mogi das CruzesUniv Mogi das Cruzes, Nucleo Pesquisas Tecnol, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Diagnost Imagem EPM, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Diagnost Imagem EPM, São Paulo, BrazilWeb of Scienc

Teachers' perceptions on inclusion in basic school

Purpose Despite dealing with special educational needs (SEN) students, many teachers feel unprepared for this task. This situation reveals the urgent need for studies in different areas, directed toward the inclusion of students in regular classrooms. Therefore, a diagnosis about the situation of inclusive education and the resources available in schools offering regular teaching becomes of paramount importance. Therefore, the purpose of this paper is to present the results of an investigation that sought information on pedagogical work in inclusive education and in the use of support materials by teachers of basic education in Brazil and Portugal. Design/methodology/approach In order to carry out this investigation, a questionnaire was developed by a partnership between researchers from the Pontifical Catholic University of Sao Paulo, Brazil and the University of Minho, Portugal, and applied to mathematics teachers. The study participants consisted of 197 mathematics teachers, working in primary school, secondary school and young people and adult education. Data collection was carried out through a questionnaire, available online and designed in Google Forms, with 48 questions (both open and closed formats). Findings From the results obtained, there is a clear need not only for promoting initial and further teacher training that takes into consideration the profile of this teacher, but also for promoting the development of support materials (games, software, devices and assistive technology) in a collaborative way, involving users, teachers, engineers in a way to ensure a good usability and adequate adaptability. Thus, the inclusion of SEN students in schools must not take place only with their physical integration, but also must consider their integration at social, emotional and educational levels. Originality/value It is understood that the teacher should receive a solid training in successful inclusion experiences in terms of technological, educational and didactic experiences. Another problem that seems t

Comparison between two thoracotomy closure techniques: postoperative pain and pulmonary function

OBJECTIVE: To compare two thoracotomy closure techniques (pericostal and transcostal suture) in terms of postoperative pain and pulmonary function. METHODS: This was a prospective, randomized, double-blind study carried out in the Department of Thoracic Surgery of the Luzia de Pinho Melo Hospital das Clínicas and at the University of Mogi das Cruzes, both located in the city of Mogi das Cruzes, Brazil. We included 30 patients (18-75 years of age) undergoing posterolateral or anterolateral thoracotomy. The patients were randomized into two groups by the type of thoracotomy closure: pericostal suture (PS; n = 16) and transcostal suture (TS; n = 14). Pain intensity during the immediate and late postoperative periods was assessed by a visual analogic scale and the McGill Pain Questionnaire. Spirometry variables (FEV1, FVC, FEV1/FVC ratio, and PEF) were determined in the preoperative period and on postoperative days 21 and 60. RESULTS: Pain intensity was significantly greater in the PS group than in the TS group. Between the preoperative and postoperative periods, there were decreases in the spirometry variables studied. Those decreases were significant in the PS group but not in the TS group. CONCLUSIONS: The patients in the TS group experienced less immediate and late post-thoracotomy pain than did those in the PS group, as well as showing smaller reductions in the spirometry parameters. Therefore, transcostal suture is recommended over pericostal suture as the thoracotomy closure technique of choice

Value-based Design of Industrial Services: The Impact of Lean Management

Background: Magnetic resonance (MR) techniques used to detect lesions of the ligament complex for articulation of the ankle lack the desired accuracy for the study of the calcaneofibular ligament (CFL). the lack of sensitivity of the conventional techniques is due to variations in the dimensions of the CFL. the best results are obtained when the image plane is oriented parallel to the ligament. This study aims to develop a model that addresses the width, length and angle parameters of the CFL and the orientation of the MR image plane, and thus determine a technique in the oblique transversal plane with the foot in anatomical flexion, that is adequate for the majority of patients.Method: To determine this orientation and adapt it to the majority of people, images of the articulation of the ankle in the 3D isotropic, volumetric, sagittal plane of 100 volunteers were taken using the MR technique. None of the volunteers had a clinical history of ligament lesions, serious pathologies, or surgeries. A measurement of the length, width, and angle of the CFL relative to the sole of the foot was performed using the MR tools. A virtual model was developed that simulated the visualization of the CFL in the oblique transversal image plane from 35 degrees to 45 degrees using the CFL dimensions of 100 volunteers. the comparison of the simulations with the reconstructed images validated the model and permitted the calculation of the agreement and sensitivity of each technique in the detection of the complete CFL.Results: Using the simulator, it was possible to obtain the limit angle for complete CFL visualization as a function of its dimensions for any angle of the oblique transversal image plane of the MR.Conclusion: the results suggest that a single image acquisition technique in the oblique transversal plane at 38 degrees with the foot in anatomical flexion would serve the majority of patients