45 resultados para Upper cervical

em Biblioteca Digital da Produção Intelectual da Universidade de São Paulo


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BACKGROUND: There are several techniques for screw insertion in upper cervical spine surgery, and the use of the 3.5-mm screw is usually the standard. However, there is no consensus regarding the feasibility of using these screws in the pediatric population. OBJECTIVE: To determine the measurement of the lamina angle, lamina and pedicle length and thickness, and lateral mass length of the topographic axial view of the axis vertebra of 2- to 10-year-old children to guide the use of surgical screws. METHODS: Seventy-five computed tomography scans from 24- to 120-month-old patients were studied. Measurements were taken in an axial view of C2 and correlated with 2 age groups and both sexes. Statistical analysis was performed with the Student t test. RESULTS: In the 24- to 48-month age group, only 5.5% of the lamina and 8.3% of the pedicles had thicknesses < 3.5 mm. In the 49- to 120-month age group, there were no lamina thickness values < 3.5 mm, and 1.2% of pedicle thicknesses were < 3.5 mm. Both age groups had no lamina and pedicle lengths < 12 mm and no lateral mass lengths > 12 mm. CONCLUSION: In the majority of cases, the use of 3.5-mm lamina and pedicle screws in children is feasible. A base value of 45 degrees for the spinolaminar angle can be adopted as a reference for insertion of screws in the C2 lamina. This information can be particularly useful for decision making during preoperative planning for C1-C2 or craniocervical arthrodesis in children.

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Changes in the Brazilian continental margin`s oceanic productivity and circulation over the last 27,000 years were reconstructed based on sedimentological and microfaunal analyses. Our results suggest that oceanic paleoproductivity and the supply of terrigenous sediments to the Brazilian continental margin were higher during the Last Glacial Maximum (LGM) than during the Holocene. These changes may have been primarily influenced by significant sea level fluctuations that have occurred since the late Pleistocene. During the LGM, the lower sea level, higher productivity and lower sea-surface paleotemperatures may have been the result of the offshore displacement of the main flow of the Brazil Current. However, during the Holocene, the warm waters of the Brazil Current were displaced toward the coast. This displacement contributed to the increase in water temperature and prevented an increase in oceanic productivity. The decrease in terrigenous supply since the LGM could be related to the increase of the extension of the continental shelf and/or drier climatic conditions.

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Deep Chlorophyll Maximum (DCM) modifies the upper ocean heat capture distribution and thus impacts water column temperature and stratification, as well as biogeochemical processes. This energetical role of the DCM is assessed using a 1 m-resolution 1D physical-biogeochemical model of the upper ocean, using climatological forcing conditions of the Guinea Dome (GD). This zone has been chosen among others because a strong and shallow DCM is present all year round. The results show that the DCM warms the seasonal thermocline by +2 degrees C in September/October and causes an increase of heat transfer from below into the mixed layer (ML) by vertical diffusion and entrainment, leading to a ML warming of about 0.3 degrees C in October. In the permanent thermocline, temperature decreases by up to 2 degrees C. The result is a stratification increase of the water column by 0.3 degrees C m(-1) which improves the thermocline realism when compared with observations. At the same time, the heating associated with the DCM is responsible for an increase of nitrate (+300%, 0.024 mu M), chlorophyll (+50%, 0.02 mu g l(-1)) and primary production (+45%: 10 mg C m(-2) day(-1)) in the ML during the entrainment period of October. The considered concentrations are small but this mechanism could be potentially important to give a better explanation of why there is a significant amount of nitrate in the ML. The mechanisms associated with the DCM presence, no matter which temperature or biogeochemical tracers are concerned, are likely to occur in a wide range of tropical or subpolar regions; in these zones a pronounced DCM is present at least episodically at shallow or moderate depths. These results can be generalized to other thermal dome regions where relatively similar physical and biogeochemical structures are encountered. After testing different vertical resolutions (10 m, 5 m, 2.5 m, 1 m and 0.5 m), we show that using at least a 1 to vertical resolution model is mandatory to assess the energetical importance of the DCM.

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Foraminiferal data were obtained from 66 samples of box cores on the southeastern Brazilian upper margin (between 23.8A degrees-25.9A degrees S and 42.8A degrees-46.13A degrees W) to evaluate the benthic foraminiferal fauna distribution and its relation to some selected abiotic parameters. We focused on areas with different primary production regimes on the southern Brazilian margin, which is generally considered as an oligotrophic region. The total density (D), richness (R), mean diversity (H) over bar`, average living depth (ALD(X) ) and percentages of specimens of different microhabitats (epifauna, shallow infauna, intermediate infauna and deep infauna) were analyzed. The dominant species identified were Uvigerina spp., Globocassidulina subglobosa, Bulimina marginata, Adercotryma wrighti, Islandiella norcrossi, Rhizammina spp. and Brizalina sp.. We also established a set of mathematical functions for analyzing the vertical foraminiferal distribution patterns, providing a quantitative tool that allows correlating the microfaunal density distributions with abiotic factors. In general, the cores that fit with pure exponential decaying functions were related to the oligotrophic conditions prevalent on the Brazilian margin and to the flow of the Brazilian Current (BC). Different foraminiferal responses were identified in cores located in higher productivity zones, such as the northern and the southern region of the study area, where high percentages of infauna were encountered in these cores, and the functions used to fit these profiles differ appreciably from a pure exponential function, as a response of the significant living fauna in deeper layers of the sediment. One of the main factors supporting the different foraminiferal assemblage responses may be related to the differences in primary productivity of the water column and, consequently, in the estimated carbon flux to the sea floor. Nevertheless, also bottom water velocities, substrate type and water depth need to be considered.

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Najash rionegrina Apesteguia & Zaher, 2006, a terrestrial fossil snake from the Upper Cretaceous of Argentina, represents the first known snake with a sacrum associated with robust, well-developed hind limbs. Najash rionegrina documents an important gap in the evolutionary development towards limblessness, because its phylogenetic affinities suggest that it is the sister group of all modern snakes, including the limbed Tethyan snakes Pachyrhachis, Haasiophis, and Eupodophis. The latter three limbed marine fossil snakes are shown to be more derived morphologically, because they lack a sacrum, but have articulated lymphapophyses, and their appendicular skeleton is enclosed by the rib cage, as in modern snakes.

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Hemigrommus silimoni is described from the Rio Juruena, upper Rio Tapajos basin, Mato Grosso State, Brazil. The new species is distinguished from all congeners, and in fact from the remaining Characidae, by the autapomorphic presence of an ocellus-like blotch on the caudal-fin dorsal lobe. The high level of fish endemicity In the Rio Juruena (upper Rio Tapajos basin) is discussed.

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Pseudolithoxus kelsorum is described as a new species based on type material from the upper Orinoco in Amazonas State, Venezuela. Pseudolithoxus kelsorum is diagnosed from all other Pseudolithoxus by having dark brown to black base color with eight to 11 (usually nine) light yellow vertical or oblique transversal bands between orbits and caudal fin, bands wide and rarely but sometimes incomplete or contorted as swirls (vs. dark brown to black base color with 18 or more thin, light yellow, frequently contorted transversal bands between orbits and caudal fin in P. tigris; black base color with small white spots in P. anthrax and P. nicoi; and light brown base color with dark brown to black spots in P. dumus). Distributions of P. kelsorum and other Ancistrini taxa support the presence of a zoogeographic filter limiting fish distributions across a reach of the Orinoco River between the Ventuari-Orinoco confluence and the Maipures rapids.

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The purpose was to investigate sociodemographic characteristics of women who underwent a Pap smear test in Manaus, Amazonas, Brazil, and identify the reasons why the women had the test. This exploratory study was performed with 281 women who had taken the Pap smear test within the last five years in Manaus. Most participants were between 18 to 34 years old (54%), had 5 to 11 years of education (54.4%), had a monthly income of less than three minimum wage salaries (84.3%) and were in a stable relationship (72.2%), with an onset of sexual activity between the ages of 15 to 19 years (69.4%). The reasons for their taking the Pap test were personal choice (66.2%), recommendation by a physician (23.5%) and gynecological symptoms (10.3%). Women who received information about the Pap test from health professionals had a greater chance of being tested within the last three years (p=0.008). Women choosing to have the exam (personal choice) are prevalent, and the opportunistic service is provided to younger women, thus not reaching the group at greater risk for cancer. It is necessary to implement active recruitment strategies to reach women in situations of socioeconomic disadvantage.

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The aim of this study was to evaluate the influence of different restorative procedures on the fracture resistance of endodontically treated teeth submitted to intracoronal bleaching. Fifty upper central incisors were distributed into 5 groups: GI - healthy teeth; GII - endodontically treated teeth sealed with Coltosol; GIII - endodontically treated teeth bleached and sealed with Coltosol; GIV - endodontically treated teeth bleached and restored with composite resin; and GV - endodontically treated teeth bleached and restored with a fiberglass post and composite resin. In the bleached specimens, a cervical seal was made prior to bleaching with 38% hydrogen peroxide. The gel was applied on the buccal surface and in the pulp chamber, and was then light-activated for 45 s. This procedure was repeated three times per session for four sessions, and each group was submitted to the restorative procedures described above. The specimens were submitted to fracture resistance testing in a universal testing machine. There were statistically significant differences among the groups (p < 0.05). The mean value found for GIII was the lowest (0.32 kN) and was significantly different from the values found for GI (0.75 kN), GII (0.67 kN), GIV (0.70 kN), and GV (0.72 kN), which were not significantly different from each other (p > 0.05). The restorative procedures using composite resin were found to successfully restore the fracture resistance of endodontically treated and bleached teeth.

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We describe an additional saurischian specimen from the Caturrita Formation (Norian) of the Parana Basin, southern Brazil. This material was collected in the 1950s and remained unstudied due to its fragmentary condition. Detailed comparisons with other saurischians worldwide reveal that some characters of the ilium, including the low ventral projection of the medial wall of the acetabulum and its concave ventral margin, together with the short triangular shape of the pre-acetabular process and its mound-like dorsocaudal edge, resemble those of sauropodomorphs such as Plateosaurus and Riojasaurus. This set of traits suggests that MN 1326-V has affinities with basal Sauropodomorpha, probably closer to plateosaurians than to Saturnalia-like taxa. Previous records of this clade in the Caturrita Formation include Unaysaurus, which has been related to Plateosaurus within Plateosauridae. Alternative schemes suggest that plateosaurids include Plateosaurus plus the Argentinean 'prosauropods' Coloradisaurus and Riojasaurus. Both hypotheses raise biogeographic questions, as a close relationship between faunas from South America and Europe excluding Africa and North America is not supported by geological and biostratigraphical evidence. Additionally, the absence of plateosaurids in other continents suggests that the geographical distribution of this taxon is inconsistent with the geological history of western Pangaea, and this demands further investigations of the phylogeny of sauropodomorphs or improved sampling.

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Background: The complex natural history of human papillomavirus (HPV) infections following a single HPV test can be modeled as competing-risks events (i.e., no-, transient- or persistent infection) in a longitudinal setting. The covariates associated with these compet ng events have not been previously assessed using competing-risks regression models. Objectives: To gain further insights in the outcomes of cervical HPV infections, we used univariate- and multivariate competing-risks regression models to assess the covariaies associated with these competing events. Study Design and Methods: Covariates associated with three competing outcomes (no-, transient- or persistent HR-HPV infection) were analysed in a sub-cohort of 1,865 women prospectively followed-up in the NIS (n = 3,187) and LAMS Study (n = 12,114). Results: In multivariate competing-risks models (with two other outcomes as competing events), permanently HR-HPV negative outcome was significantly predicted only by the clearance of ASCUS+Pap during FU, while three independent covariates predicted transient HR-HPV infections: i) number of recent (< 12 months) sexual partners (risk increased), ii) previous Pap screening history (protective), and history of previous CIN (increased risk). The two most powerful predictors of persistent HR-HPV infections were persistent ASCUS+Pap (risk increased), and previous Pap screening history (protective). In pair-wise comparisons, number of recent sexual partners and previous CIN history increase the probability of transient HR-HPV infection against the HR-HPV negative competing event, while previous Pap screening history is protective. Persistent ASCUS+Pap during FU and no previous Pap screening history are significantly associated with the persistent HR-HPV outcome (compared both with i) always negative, and ii) transient events), whereas multiparity is protective. Conclusions: Different covariates are associated with the three main outcomes of cervical HPV infections. The most significant covariates of each competing events are probably distinct enough to enable constructing of a risk-profile for each main outcome.

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This work develops a computational approach for boundary and initial-value problems by using operational matrices, in order to run an evolutive process in a Hilbert space. Besides, upper bounds for errors in the solutions and in their derivatives can be estimated providing accuracy measures.

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A steady state multi-segmented heat transfer model of the human upper limbs was developed. The main purpose was to evaluate the impact of blood flow through superficial veins and subcutaneous vascular structures in the palm of the hands over the heat transfer between the limbs and the environment. The distinguishing feature of the model is the inclusion of a detailed circulatory network composed of vessels with diameter larger than 1 mm. The model was validated by comparing its results from exposures to a hot, a neutral, and a cold environment to experimental data presented in the literature. (C) 2011 Elsevier Ltd. All rights reserved.