Tissue hypoxia of the femoral head during orthopaedic treatment of congenital dislocation of the hip

During treatment of cases with congenital dislocation of the hip by closed and open reduction techniques significant tissue hypoxia of the femoral head is revealed by lactate and pyruvate determinations in the regional bone marrow blood before and after various positions attained by adductor myotomy with skeletal traction in children younger than 2 years of age, older than 4 years of age and late postoperatively

Lasers Offer Advantages for Welding Steel Wheel Rims

WOS: 00031432960000

Prediction of late complication of femoral neck fractures by MRI [COCUK FEMUR BOYUN KIRIKLARINDA GEC DONEM KOMPLIKASYONLARININ ERKEN TANISINDA MAGNETIK REZONANS GORUNTULEMENIN YERI]

Femoral neck fractures in children are uncommon injuries and are often associated with excessive incidence of complications, such as avascular necrosis. Precise and early close reduction, surgical fixation, long immobilization, delayed weight bearing and late follow up are mandatory to decrease the amount and severity of complication. Between 1990 and 1992, seven cases with this injury were treated at the Department of Orthopaedics and Traumatology of Ege University Medical School. A prospective study was undertaken to determine the value of MRI in predicting avascular necrosis of the femoral head following femoral neck fractures. MRI was carried out in 7 patients 1 year after first operation. In the MRI Stage I avascular necrosis. All the patients were followed up for at least 1 year. The results indicate that postoperative MRI is useful in children to predict avascular necrosis of femoral head. MRI has been found to be accurate in predicting this complication following femoral neck fractures. It is agreed that MRI have great importance in preparing the medicolegal reports and establishing the prediction of late complication in the follow up of femoral neck fractures of the children

Consumo alimentar de crianças e adolescentes com disfagia decorrente de estenose de esôfago: avaliação com base na pirâmide alimentar brasileira Food consumption by children and adolescent with dysphagia due to esophageal stricture: assessment based on the Brazilian food guide pyramid

OBJETIVO: Avaliar o consumo alimentar de pacientes com disfagia decorrente de estenose de esôfago, comparando a dieta de consistência líquida com a dieta de consistência pastosa e sólida, com base na Pirâmide Alimentar Brasileira. MÉTODOS: Estudo de corte transversal, no qual foram incluídos consecutivamente 31 pacientes com estenose esofágica, sendo 18 (58,0%) cáustica, 7 (22,6%) pós-cirúrgica, 3 (9,7%) péptica e 3 (9,7%) sem causa definida. Empregou-se o recordatório de 24 horas; os alimentos foram transformados em porções em função dos oito grupos de alimentos, conforme recomendado por Philippi. Utilizou-se o teste Kruskal-Wallis e Exato de Fisher, fixando em 5% o nível de rejeição da hipótese de nulidade. RESULTADOS: A idade variou entre 15 e 176 meses (mediana, 56 meses), sendo 28 crianças e três adolescentes, e 18 do sexo masculino. Vinte e nove pacientes (93,5%) apresentavam disfagia, sendo grave em 34,4% (10/29), moderada em 41,3% (12/29), e leve em 24,1% (7/29). O consumo mediano de porções de cereais, leguminosas, e óleos e gorduras foi menor no grupo com dieta líquida (p<0,005), o qual também apresentou maior proporção de pacientes cujo consumo foi abaixo do proposto pela pirâmide alimentar quando comparado ao grupo com dieta pastosa e sólida, com diferença estatisticamente significante (p<0,05). CONCLUSÃO: O suporte nutricional é de extrema importância no tratamento de pacientes com estenose esofágica, principalmente na disfagia grave, cuja dieta deve ser adaptada à consistência líquida, devido ao risco nutricional que se atribui à limitada ingestão alimentar, e para que o tratamento dietético seja precocemente instituído.<br>OBJECTIVE: This study assessed food intake by patients with dysphagia due to esophageal stricture and compared liquid, soft and solid diets based on the Brazilian Food guide pyramid. METHODS: This cross-sectional study consecutively included 31 patients with esophageal stricture, of which 18 (58.0%) were caustic, 7 (22.6%) were postoperative, 3 (9.7%) were peptic and 3 (9.7%) were of unknown etiology. The 24-hour dietary recall was used and the foods were converted into servings according to the eight food groups, as recommended by Philippi. The Kruskal-Wallis and Fisher's Exact Test were used and the significance level was set at 5%. RESULTS: The ages of the patients varied from 15 to 176 months (median: 56 months). There were 28 children and 3 adolescents, of which 28 were males. Twenty-nine patients (93.5%) presented dysphagia, of which 34.4% (10/29) were severe, 41.3% (12/29) were moderate and 24.1% (7/29) were mild. The median intake of grain, legume and fat servings was smaller in the liquid diet group (p<0.005). This group also had a significantly greater proportion of patients whose intakes were below those recommended by the food pyramid (p<0.05). CONCLUSION: Nutritional support is extremely important in the treatment of patients with esophageal stricture, especially those with severe dysphagia. These patients need a liquid diet because of the nutritional risk associated with inadequate food intake, which also allows early introduction of the dietary treatment