LESÃO CERVICAL PENETRANTE EM ZONA II

SUMMARY: Several vital structures, of both the aerodigestive and vascular systems, are contained in the cervical regions. Cervical lesions have high complexity and high morbidity and mortality. They are more common in young men inserted in a context of violence. The objective of this study was to demonstrate an injury by firearm with transfixation of the trachea, approached by cervicotomy in which was performed a termino-terminal anastomosis of the affected segment. The patient presented satisfactory clinical and surgical outcomes.    RESUMO: Na região cervical encontra-se estruturas vitais para o sistema aerodigestivo e vascular. Lesões cervicais possuem alta complexidade e elevada morbimortalidade. Acomete mais homens jovens inseridos em contexto de violência. O objetivo deste estudo e demonstrar uma lesão com transfixação da traquéia por arma de fogo, abordada por cervicotomia e realizado anastomose termino-terminal de segmento afetado. Paciente apresentou bom desfecho clínico e cirúrgico

Evaluating the impact of maintenance policies associated to SLA contracts on the dependability of data centers electrical infrastructures

Due to the growth of cloud computing, data center environment has grown in importance and in use. Data centers are responsible for maintaining and processing several critical-value applications. Therefore, data center infrastructures must be evaluated in order to improve the high availability and reliability demanded for such environments. This work adopts Stochastic Petri Nets (SPN) to evaluate the impact of maintenance policies on the data center dependability. The main goal is to analyze maintenance policies, associated to SLA contracts, and to propose improvements. In order to accomplish this, an optimization strategy that uses Euclidean distance is adopted to indicate the most appropriate solution assuming conflicting requirements (e.g., cost and availability). To illustrate the applicability of the proposed models and approach, this work presents case studies comparing different SLA contracts and maintenance policies (preventive and corrective) applied on data center electrical infrastructures

Socio-Environmental and Hematological Profile of Landfill Residents (Sao Jorge Landfill-Sao Paulo, Brazil)

We are experiencing an unprecedented urbanization process that, alongside physical, social and economic developments, has been having a significant impact on a population's health. Due to the increase in pollution, violence and poverty, our modern cities no longer ensure a good quality of life so they become unhealthy environments. This study aims to assess the effect of social, environmental and economic factors on the hematologic profile of residents of Santo Andre's landfill. In particular, we will assess the effect of social, economic, and environmental factors on current and potential disease markers obtained from hematological tests. The research method is the observational type, from a retrospective cohort, and by convenience sampling in Santo Andre in the Greater ABC (municipalities of Santo Andre, Sao Bernardo do Campo and Sao Caetano do Sul, southeast part of the Greater Sao Paulo Metropolitan Area, Brazil). The study determined a socio-environmental profile and the hematologic diseases screening related to a close location to the landfill. The disease manifests itself within a broad spectrum of symptoms that causes changes in blood count parameters. The objective of this work is to show that there is an association between social, environmental and economic factors and a variety of serious disease outcomes that may be detected from blood screening. A causal study of the effect of living near the landfill on these disease outcomes would be a very expensive and time-consuming study. This work we believe is sufficient for public health officials to consider policy and attempt remediation of the effects of living near a landfill.ABC Medical SchoolSchool of Health Technology Coimbra-IPC-Polytechnic Institute of Coimbra-PortugalDepartment of Environmental Health and Public HealthSEMASA-Sanitation and Insurance CentralABC MedSch, Environm Hlth Management Dept, BR-09060650 Santo Andre, SP, BrazilUniv Fed Sao Paulo, Inst Environm Chem & Pharmaceut Sci, Dept Biol Sci, BR-04060650 Diadema, SP, BrazilCoimbra Hlth Sch, EsTesC, Dept Environm Hlth Sci, P-3046854 Coimbra, PortugalBiological Sciences Department, Institute of Environmental, Chemistry and Pharmaceutical Sciences, Universidade Federal de São Paulo (UNIFESP), Diadema 04060-650, SP, BrazilWeb of Scienc

Association between the use of total dental prosthesis (denture) and the type of oral health care service used by toothless elderly individuals

A reabilitação protética foi prevista pela política nacional de saúde bucal em função da alta prevalência de perda de todos os dentes e do baixo uso de prótese dentária entre idosos. Há necessidade de se avaliar o impacto dessa política de reabilitação. Portanto, objetivou-se investigar se o tipo de serviço odontológico utilizado foi um dos fatores associados ao uso de prótese dentária total entre idosos. Trata-se de um estudo transversal conduzido em uma amostra probabilística de idosos (60 anos ou mais) residentes na zona urbana de um município brasileiro de pequeno porte populacional por examinadores calibrados. Realizaram-se análises descritiva, bivariada e múltipla (Regressão logística - odds ratio - OR). Participaram 287 idosos, destes, 186 (64,8%) faziam uso de prótese dentária total. O uso de prótese dentária total foi associado a maiores chances de uso de serviços odontológicos supletivos ou particulares (OR = 4,19; p < 0,001) e a presença de lesão no palato (OR = 7,52; p = 0,002) e, também, a menores chances em idades maiores ou iguais a 73 anos (OR = 0,52; p = 0,023) e entre os com comprometimento na dimensão incapacidade física do OHIP-14 (OR = 0,20; p = 0,002). O uso de prótese dentária total foi associado ao tipo de serviço odontológico entre idosos, sendo maior o uso entre usuários dos serviços supletivos ou particulares24933453356Oral rehabilitation with dental prosthesis was mandated by national oral health policy in Brazil, due to the high prevalence of total teeth loss and low use of dental prosthesis among the elderly. There is a pressing need to assess the impact of this rehabilitation policy. An attempt was therefore made to investigate if the dental service used was one of the factors associated with the use of total dental prosthesis among the elderly. To achieve this, a cross-sectional study using a probabilistic sample of elderly (60 years and above) urban-area residents of a small city was conducted by qualified examiners. Descriptive, bivariate and multiple (logistic regression/odds ratio - OR) analyses were conducted on 287 elderly people, of which 186 (64.8%) used dental prosthesis. The use of total dental prosthesis was associated with a higher probability of being attended by private dental services (OR = 4.19; p < 0.001) and the presence of lesions on the palate (OR = 7.52; p = 0.002). Conversely, it was associated with lower probability in ages greater than or equal to 73 years (OR = 0.52; p = 0.023) and among those with impairment of OHIP-14 (OR = 0.20; p = 0.002) in the physical disability dimension. The use of total dental prosthesis was associated with the type of dental service used by the elderly, it being greater among private service user

A survey of fertility preservation options available to cancer patients around the globe

Purpose: Oncofertility focuses on providing fertility and endocrine-sparing options to patients who undergo life-preserving but gonadotoxic cancer treatment. The resources needed to meet patient demand often are fragmented along disciplinary lines. We quantify assets and gaps in oncofertility care on a global scale. Methods: Survey-based questionnaires were provided to 191 members of the Oncofertility Consortium Global Partners Network, a National Institutes of Health–funded organization. Responses were analyzed to measure trends and regional subtleties about patient oncofertility experiences and to analyze barriers to care at sites that provide oncofertility services. Results: Sixty-three responses were received (response rate, 25%), and 40 were analyzed from oncofertility centers in 28 countries. Thirty of 40 survey results (75%) showed that formal referral processes and psychological care are provided to patients at the majority of sites. Fourteen of 23 respondents (61%) stated that some fertility preservation services are not offered because of cultural and legal barriers. The growth of oncofertility and its capacity to improve the lives of cancer survivors around the globe relies on concentrated efforts to increase awareness, promote collaboration, share best practices, and advocate for research funding. Conclusion: This survey reveals global and regional successes and challenges and provides insight into what is needed to advance the field and make the discussion of fertility preservation and endocrine health a standard component of the cancer treatment plan. As the field of oncofertility continues to develop around the globe, regular assessment of both international and regional barriers to quality care must continue to guide process improvements

Survey of Third-Party Parenting Options Associated With Fertility Preservation Available to Patients With Cancer Around the Globe

Purpose: In the accompanying article, “Analysis of Fertility Preservation Options Available to Patients With Cancer Around the Globe,” we showed that specific fertility preservation services may not be offered at various sites around the world because of cultural and legal barriers. We assessed global and regional experiences as well as the legal status of third-party reproduction and adoption to serve as a comprehensive international data set and resource for groups that wish to begin oncofertility interventions. Methods: We provide data on the legalities of third-party assisted reproductive technologies and other family-building options in the 28 oncofertility-practicing countries surveyed. Results: We found regional and country differences that will be important in the development of tailored resources for physicians and for patient brochures that are sensitive to these local restrictions and cultural norms. Conclusion: Because many patients first consult Web-based materials, the formal assessment of the availability of these options provides members of the global oncofertility community with data to which they might otherwise not have ready access to better serve their patients