Estudo comparativo da artrodese posterolateral e PLIF no tratamento da espondilolistesis degenerativa grau I ou II ? análise de 124 casos

Objetivo: Posterior Lumbar Interbody Fusion (PLIF) ou artrodese posterolateral (APL) são técnicas cirúrgicas válidas na espondilolistese degenerativa. Alterações biomecânicas no nível adjacente à artrodese aceleram alterações degenerativas. Na literatura discute-se o tratamento adequado. Este estudo comparativo avalia clínica, taxa de fusão, complicações, alterações degenerativas e instabilidade no nível adjacente. Material e Métodos: Retrospectivamente foram analisadas espondilolisteses degenerativas grau I e II de Meyerding tratadas com PLIF ou APL de Janeiro 2000 a Dezembro 2010 num total de 124 doentes, 45 PLIF e 79 APL. Recorreu-se à escala visual analógica (VAS), Oswestry Disability Index (ODI) e Short Form-36 (SF-36). No PLIF foi determinada artrodese por estabelecimento de pontes ósseas estáveis. A instabilidade na APL foi definida quando osteolise adjacente aos parafusos, deslizamento ou angulação no nível da fusão. Resultados: O follow-up foi 4.5±2.7 e 3.9±2.6 anos (1-11 anos) no PLIF e APL, respectivamente. Ocorreu fusão em 93.3% no PLIF e 74.7% na APL (p=0.008). O PLIF apresenta superioridade no VAS pós-operatório (p=0.01) e variação geral (p=0.002). O ODI pós-operatório no PLIF foi menor (p<0.001) e 2.2% permanecem com disfunção severa comparativamente com 19% na APL. O PLIF é superior em escalas do SF-36: Função Física (p=0.034), Limitação Emocional (p=0.037), Função Social (p=0.05) e Saúde Geral (p=0.02). A taxa de complicações foi 4.4% no PLIF e 12.6% na APL (p=0.2). Ambas as técnicas desenvolveram doença do disco adjacente. Conclusões: Em ambos os grupos verifica-se melhoria da qualidade de vida, no entanto, a médio prazo o PLIF mostra superioridade. Instabilidade pré-operatória pode ser indicativa da eleição de PLIF

How much does it cost to implement a community-based walking football programme for patients with type 2 diabetes?

ObjectivesThe current study analysed the implementation costs of a community-based walking football exercise programme for patients with type 2 diabetes.MethodsThe direct costs of a community-based walking football programme for middle-aged and older male patients with type 2 diabetes, designed and tested in Porto (Portugal), were calculated from the payer's perspective. One season of this programme consists of three sessions per week (60 min per session) for nine months (October to June). Cost calculations were based on two groups of 20 patients and included the sports infrastructure and equipment, human resources, pre-exercise clinical evaluation, medical equipment, technical training and other consumable costs. An economic depreciation of 1 year using the linear method for sports and electronic materials was considered. Cost analysis dated December 2021 and is expressed in international dollars ($).ResultsThis programme was estimated to have a total implementation cost of$22 923.07; $2547.01/month;$573.08/patient; $106.13/session;$63.68/patient/month and $5.31/patient/session.ConclusionA community-based walking football programme for patients with type 2 diabetes is affordable and can be scaled up by local communities to promote physical activity and manage type 2 diabetes with the involvement of multiple stakeholders such as the football clubs, municipalities and primary healthcare units.This work was supported by the Portuguese Foundation for Science and Technology within the scope of projects UIDB/04750/2020 and LA/P/0064/2020. AB is supported by the Portuguese Foundation for Science and Technology [grant number SFRH/BD/136702/2018]

Numerical simulation of strongly nonlinear and dispersive waves using a Green-Naghdi model

We investigate here the ability of a Green-Naghdi model to reproduce strongly nonlinear and dispersive wave propagation. We test in particular the behavior of the new hybrid finite-volume and finite-difference splitting approach recently developed by the authors and collaborators on the challenging benchmark of waves propagating over a submerged bar. Such a configuration requires a model with very good dispersive properties, because of the high-order harmonics generated by topography-induced nonlinear interactions. We thus depart from the aforementioned work and choose to use a new Green-Naghdi system with improved frequency dispersion characteristics. The absence of dry areas also allows us to improve the treatment of the hyperbolic part of the equations. This leads to very satisfying results for the demanding benchmarks under consideration

Transcript of The Dory Derby Accident

This story is an excerpt from a longer interview that was collected as part of the Launching through the Surf: The Dory Fleet of Pacific City project. In this story, Don Grotjohn recounts an accident that occurred during a Dory Derby competition

Strategies for cancer treatment based on photonic nanomedicine

Traditional cancer treatments, such as surgery, radiotherapy, and chemotherapy, are still the most effective clinical practice options. However, these treatments may display moderate to severe side effects caused by their low temporal or spatial resolution. In this sense, photonic nanomedicine therapies have been arising as an alternative to traditional cancer treatments since they display more control of temporal and spatial resolution, thereby yielding fewer side effects. In this work, we reviewed the challenge of current cancer treatments, using the PubMed and Web of Science database, focusing on the advances of three prominent therapies approached by photonic nanomedicine: (i) photothermal therapy; (ii) photodynamic therapy; (iii) photoresponsive drug delivery systems. These photonic nanomedicines act on the cancer cells through different mechanisms, such as hyperthermic effect and delivery of chemotherapeutics and species that cause oxidative stress. Furthermore, we covered the recent advances in materials science applied in photonic nanomedicine, highlighting the main classes of materials used in each therapy, their applications in the context of cancer treatment, as well as their advantages, limitations, and future perspectives. Finally, although some photonic nanomedicines are undergoing clinical trials, their effectiveness in cancer treatment have already been highlighted by pre-clinical studies

Internet-based medical education: a realist review of what works, for whom and in what circumstances

http://creativecommons.org/licenses/by/2.0

Phosphonium-based ionic liquids as grease additives in rolling bearing tests

Two phosphonium-derived ionic liquids: trihexyltetradecylphosphonium bis(2-ethylhexyl)phosphate (IL1) and trihexyltetradecylphosphonium tricyanomethanide (IL2) were used as additives in lithium complex- (G1) and anhydrous calcium-based (G2) greases at 5 wt%. Friction torque and wear tests were performed using a modified four-ball machine for testing rolling bearings in order to determine the friction and wear reducing properties of these grease samples in a real component. The IL2 improved the friction reduction performance of both greases, especially G1. Both ILs improved the antiwear behaviour of grease G2. Grease G2 showed higher oxidation and thermal ageing levels than G1, but the addition of the ILs, IL2 in particular, improved this issue

Interrelationship between TP53 gene deletion, protein expression and chromosome 17 aneusomy in gastric adenocarcinoma

Background: This study evaluates the existence of numerical alterations of chromosome 17 and TP53 gene deletion in gastric adenocarcinoma. the p53 protein expression was also evaluated, as well as, possible associations with clinicopathological characteristics.Methods: Dual-color fluorescence in situ hybridization and immunostaining were performed in twenty gastric cancer samples of individuals from Northern Brazil.Results: Deletion of TP53 was found in all samples. TP53 was inactivated mainly by single allelic deletion, varying to 7-39% of cells/case. Aneusomy of chromosome 17 was observed in 85% of cases. Chromosome 17 monosomy and gain were both observed in about half of cases. Cells with gain of chromosome 17 frequently presented TP53 deletion. the frequency of cells with two chr17 and one TP53 signals observed was higher in diffuse than in intestinal-type GC. Immunoreactivity of p53 was found only in intestinal-type samples. the frequency of cells with two chr17 and two TP53 signals found was higher in samples with positive p53 expression than in negative cases in intestinal-type GC.Conclusion: We suggest that TP53 deletion and chromosome 17 aneusomy is a common event in GC and other TP53 alterations, as mutation, may be implicated in the distinct carcinogenesis process of diffuse and intestinal types.Financiadora de Estudos e Projetos (FINEP CT-INFRA/FADESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Fed Univ Para, Inst Biol Sci, Humans Cytogenet Lab, BR-66075900 Belem, Para, BrazilUniv Fed Piaui, Dept Biol, Campus Minist Reis Velloso Parnaiba, Teresina, PI, BrazilUniversidade Federal de São Paulo, Dept Morphol, Div Genet, São Paulo, BrazilUniv Fed Ceara, Sch Med, Dept Pathol, Mol Genet Lab, Fortaleza, Ceara, BrazilFed Univ Para, Joao de Barros Barreto Univ Hosp, BR-66075900 Belem, Para, BrazilUniversidade Federal de São Paulo, Dept Morphol, Div Genet, São Paulo, BrazilFinanciadora de Estudos e Projetos (FINEP CT-INFRA/FADESP): 0927-03. RRBWeb of Scienc