A newmethod to analyze the subjective visual vertical in patients with bilateral vestibular dysfunction

OBJECTIVE: The aim of this study was to assess the subjective visual vertical in patients with bilateral vestibular dysfunction and to propose a new method to analyze subjective visual vertical data in these patients. METHODS: Static subjective visual vertical tests were performed in 40 subjects split into two groups. Group A consisted of 20 healthy volunteers, and Group B consisted of 20 patients with bilateral vestibular dysfunction. Each patient performed six measurements of the subjective visual vertical test, and the mean values were calculated and analyzed. RESULTS: Analyses of the numerical values of subjective visual vertical deviations (the conventional method of analysis) showed that the mean deviation was 0.326±1.13º in Group A and 0.301±1.87º in Group B. However, by analyzing the absolute values of the subjective visual vertical (the new method of analysis proposed), the mean deviation became 1.35±0.48º in Group A and 2.152±0.93º in Group B. The difference in subjective visual vertical deviations between groups was statistically significant (p

Software for subjective visual vertical assessment: an observational cross-sectional study

Spatial orientation in relation to the gravitational axis is significantly important for the maintenance of the posture, gait and for most of the human's motor activities. The subjective visual vertical exam evaluates the individual's perception of vertical orientation. Objectives: The aims of this study were (1) to develop a virtual system to evaluate the subjective visual vertical exam, (2) to provide a simple tool to clinical practice and (3) to assess the subjective visual vertical values of h ealthy subjects using the new software. Study Design: observational cross-sectional study. Methods: Thirty healthy volunteers performed the subjective visual vertical exam in both static and dynamic conditions. The exam consisted in adjusting a virtual line in the vertical position using the computer mouse. For the static condition, the virtual line was projected in a white background. For the dynamic condition, black circles rotated in clockwise or counterclockwise directions. Six measurements were taken and the mean deviations in relation to the real vertical calculated. Results: The mean values of subjective visual vertical measurements were: static -0.372 degrees; +/- 1.21; dynamic clockwise 1.53 degrees +/- 1.80 and dynamic counterclockwise -1.11 degrees +/- 2.46. Conclusion: This software showed to be practical and accurate to be used in clinical routines.FAPESP (Fundacao de Apoio a Pesquisa do Estado de Sao Paulo)Fundacao de Apoio a Pesquisa do Estado de Sao Paulo (FAPESP)CAPES (Coordenacao de Aperfeicoamento de Pessoal de nivel Superior)Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)CNPq (Centro Nacional de Pesquisa)CNPq (Centro Nacional de Pesquisa

Influence of obesity and handgrip strength in the static postural balance of active older women

O objetivo deste estudo foi investigar a influência da obesidade e da força de preensão palmar (FPP) no equilíbrio postural estático de idosas ativas nas condições de olhos abertos e fechados. Participaram 31 idosas (16 eutróficas e 15 obesas). A idade média e o Índice de Massa Corpórea (IMC) das eutróficas foram, respectivamente, 68,3±2,7 anos e 23,4±1,6kg/m², e das obesas 69,1±2,7 anos e 33,5±3kg/m². A FPP foi avaliada usando um dinamômetro (JAMAR). O equilíbrio postural estático foi avaliado usando um sistema tridimensional nas condições de olhos abertos (OA) e fechados (OF), durante 90 segundos cada condição. A FPP das idosas eutróficas foi 25,1±4,6kgf e das obesas foi 24,8±5,2kgf, não havendo diferenças significativas. No equilíbrio postural, foram observadas diferenças significativas entre os grupos apenas no deslocamento máximo a-p com AO (p=0,04) e OF (p<0,01), com as idosas obesas apresentando menor deslocamento a-p em relação às eutróficas. Não houve correlação entre o deslocamento máximo a-p com IMC e a FPP. No presente estudo FPP não influenciou o equilíbrio postural estático, enquanto a obesidade foi fator determinante de menor deslocamento ântero-posterior de idosas ativas

Profilaxia tromboembólica farmacológica e por compressão pneumática intermitente em 563 casos consecutivos de abdominoplastia

Job file for the creation/design of stained glass from either the Charles J. Connick Studio (1912-1945) or the Charles J. Connick Associates studio (1945-1986). The job file contains a job number, location information, date of completion, size, contact information, price, and a description of the project. This particular job file contains information on a job located at: Framingham, Massachusetts. Grace Congregational Church

Profilaxia tromboembólica farmacológica e por compressão pneumática intermitente em 563 casos consecutivos de abdominoplastia Pharmacologic and intermittent pneumatic compression thromboembolic prophylaxis in 563 consecutives abdominoplasty cases

INTRODUÇÃO: A abdominoplastia é uma das cirurgias estéticas mais realizadas e, como qualquer outro ato cirúrgico, está sujeita a inúmeras complicações, entre as quais os fenômenos tromboembólicos. O objetivo deste estudo foi analisar a incidência de complicações em uma série consecutiva de abdominoplastias, fatores de risco e a eficácia de dois protocolos de prevenção para tromboembolia. MÉTODO: Estudo retrospectivo de 563 abdominoplastias, isoladas ou não, realizadas entre março de 2008 e abril de 2011, que receberam dois protocolos de profilaxia de tromboembolismo diferentes: o farmacológico, com emprego de enoxaparina (357 pacientes), e o mecânico, com compressão pneumática intermitente (206 pacientes). RESULTADOS: Dentre os 563 pacientes, 4 (0,7%) eram do sexo masculino (0,7%) e 559 (99,3%), do sexo feminino. Foram submetidos a abdominoplastia isolada 201 (35,7%) pacientes, enquanto 362 (64,3%) foram submetidos a abdominoplastia associada a algum outro procedimento. Os grupos com profilaxia farmacológica e mecânica tinham fatores de risco e características demográficas e clínicas semelhantes. A incidência de complicações no grupo farmacológico em relação ao grupo mecânico foi de: hematoma, 5,6% e 10,7%; infecção, 2,2% e 2,4%; deiscência, 3,1% e 1,9%; seroma, 2,2% e 2,4%; e trombose venosa profunda/tromboembolia pulmonar, 0,6% e 0,5%. Nenhuma complicação apresentou diferença estatística significante entre os grupos. CONCLUSÕES: A taxa de complicações em 563 casos consecutivos de abdominoplastia foi semelhante à da literatura. A eficácia da profilaxia tromboembólica em abdominoplastia é a mesma observada com a utilização de métodos farmacológicos e mecânicos isoladamente.BACKGROUND: Abdominoplasty is a common cosmetic surgery and is subject to the same complications as any surgical procedure, including thromboembolic phenomena. The aim of this study was to assess the incidence of complications in consecutive abdominoplasties performed over a 3-year period, to identify risk factors for the complications, and to compare the efficacy of two protocols for prevention of thromboembolism. METHODS: A retrospective study was conducted of 563 patients who underwent isolated abdominoplasty or abdominoplasty combined with additional cosmetic surgeries between March 2008 and April 2011. All patients received thromboembolism prophylaxis using either pharmacological (enoxaparin; 357 patients) or mechanical (intermittent pneumatic compression, IPC; 206 patients) protocols. RESULTS: Of the 563 patients studied, 4 (0.7%) were male (0.7%) and 559 (99.3%) were female. The patients underwent isolated abdominoplasty (201; 35.7%) or abdominoplasty combined with other procedures (362; 64.3%). The patient groups receiving pharmacological and mechanical prophylaxis presented similar demographic and clinical characteristics and had similar risk factors for thromboembolic events. The incidence of complications in the patient groups undergoing pharmacological versus mechanical prophylaxis were: hematoma (5.6% vs. 10.7%), infection (2.2% vs. 2.4%), dehiscence (3.1% vs. 1.9%), seroma (2.2% vs. 2.4%), and deep vein thrombosis/pulmonary embolism (0.6% vs. 0.5%). There were no statistically significant differences in the incidence of complications between the two groups. CONCLUSION: The incidence of complications in 563 consecutive cases of abdominoplasty was similar to that reported in the literature. The pharmacological and mechanical protocols for thromboembolic prophylaxis in abdominoplasty were equally effective

Neuroimaging in stroke and non-stroke pusher patients

Pusher behavior (PB) is a disorder of postural control affecting patients with encephalic lesions. This study has aimed to identify the brain substrates that are critical for the occurrence of PB, to analyze the influence of the midline shift (MS) and hemorrhagic stroke volume (HSV) on the severity and prognosis of the PB. We identified 31 pusher patients of a neurological unit, mean age 67.4±11.89, 61.3% male. Additional neurological and functional examinations were assessed. Neuroimaging workup included measurement of the MS, the HSV in patients with hemorrhagic stroke, the analysis of the vascular territory, etiology and side of the lesion. Lesions in the parietal region (p=0.041) and thalamus (p=0.001) were significantly more frequent in PB patients. Neither the MS nor the HSV were correlated with the PB severity or recovery time

Análise do equilíbrio postural estático utilizando um sistema eletromagnético tridimensional Analysis of static postural balance using a 3d electromagnetic system

A detecção precoce de distúrbios posturais é fundamental para a promoção de intervenções adequadas para pacientes com desequilíbrios. OBJETIVO: Este é um estudo piloto que descreve uma nova ferramenta para avaliação do equilíbrio postural estático. FORMA DE ESTUDO: Coorte contemporânea com corte transversal. MATERIAL E MÉTODO: Foram avaliados 25 voluntários (15 mulheres e 10 homens). Idade média de 25,8±4,2anos, peso 63,9±13,1Kg, estatura 1,68±0,08m e índice de massa corporal 22,3±3,3kg/m2. A posturografia foi realizada por meio da análise de oscilação postural utilizando um equipamento eletromagnético com um sensor fixado sobre o processo espinhoso da 1ª vértebra torácica. Os testes foram realizados com os sujeitos na posição ortostática durante 90 segundos, para as condições de olhos abertos (OA) e fechados (OF) em superfície estável e instável. RESULTADOS: Quando analisada a influência da superfície (estável x instável) para o equilíbrio postural na condição OA, foram observadas diferenças significativas nos parâmetros de trajetória médio-lateral (m-l) (p=0.004) e total (p=0.014) e de velocidade m-l (p=0.004) e total (p=0.014). Na condição OF, foram observadas diferenças significativas em todos os parâmetros estudados (pEarly detection of postural disorders is essential for timely interventions in patients with imbalance. AIM: A pilot study describing a new tool for evaluating static postural balance. STUDY DESIGN: A cross-sectional study of a contemporary series. MATERIAL AND METHOD: Twenty-five volunteers (15 women and 10 men) were evaluated. The mean age was 25.8 ± 4.2 years, the mean weight was 63.9 ± 13.1Kg, the mean height was 1.68 ± 0.08 m and the body mass index was 22.3±3.3kg/m2. Posturography was done by analysing postural sway with an electromagnetic system; a sensor was attached to the skin over the spinous process of the first thoracic vertebra. Tests were carried out with the subjects in the orthostatic position for 90 seconds, with eyes opened(EO) and closed(EC) on stable and unstable surfaces. RESULTS: When the influence of the surface was analyzed (stable x unstable) in the EO condition, there were significant differences in the middle-lateral parameters (m-l) (p=0.004) and total path (p=0.01), and in the m-l (p=0.004) and total (p=0.014) speed. In the EC condition, there were significant differences in all parameters (p<0.001). The influence of the vision was observed in all parameters only on unstable surfaces (p<0.05). CONCLUSION: The new tool was efficient for analysing postural sway

A newmethod to analyze the subjective visual vertical in patients with bilateral vestibular dysfunction

OBJECTIVE: The aim of this study was to assess the subjective visual vertical in patients with bilateral vestibular dysfunction and to propose a new method to analyze subjective visual vertical data in these patients. METHODS: Static subjective visual vertical tests were performed in 40 subjects split into two groups. Group A consisted of 20 healthy volunteers, and Group B consisted of 20 patients with bilateral vestibular dysfunction. Each patient performed six measurements of the subjective visual vertical test, and the mean values were calculated and analyzed. RESULTS: Analyses of the numerical values of subjective visual vertical deviations (the conventional method of analysis) showed that the mean deviation was 0.326±1.13º in Group A and 0.301±1.87º in Group B. However, by analyzing the absolute values of the subjective visual vertical (the new method of analysis proposed), the mean deviation became 1.35±0.48º in Group A and 2.152±0.93º in Group B. The difference in subjective visual vertical deviations between groups was statistically significant (p,<0.05) only when the absolute values and the range of deviations were considered. CONCLUSION: An analysis of the absolute values of the subjective visual vertical more accurately reflected the visual vertical misperception in patients with bilateral vestibular dysfunction