Relationship between therapeutic alliance and deep abdominal muscle recruitment in nonspecific low back pain sufferers

Chronic low back pain is a difficult condition to be treated. As some patients respond positively to treatment and others do not present any improvements, one can think there are others conditional factors that need to be elucidated. By means of this study, we sought to investigate the association between the occurrence of the formation of a positive relationship between patient and therapist, assessed by the therapeutic alliance inventory, and the adequate recruitment of the deep abdominal muscles, as well as to verify the effect of a protocol intervention based on motor control exercises on levels of pain and disability. The recruitment of the transverse abdominal and internal oblique muscles was examined by ultrasound imaging in 12 subjects with nonspecific chronic low back pain before and after implementation of a protocol for motor control exercises, with subsequent application of the therapeutic alliance inventory questionnaire. No association was found between the level of therapist/patient alliance and muscle recruitment. The proposed protocol was effective in reducing the levels of pain and disability; however, recruitment of transverse abdominal and internal oblique muscles showed no significant changes in the end of the intervention. Based on these findings, we verified that the therapeutic alliance has no association with muscle recruitment in the short term. However, although there were no changes in muscle recruitment after the intervention program, the level of pain and disability was reduced.

Are deep-sea cephalopods really common preys for oceanic seabirds?

Uma análise de dados publicados sobre dietas de aves marinhas oceânicas mostra a predominância de cefalópodes musculares e de distribuição mais superficial nas camadas oceânicas, mas também são importantes as espécies gelatinosas e amoniacais restritas a camadas abaixo dos 300 m da superfície. A princípio, não deveria se esperar que cefalópodes de profundidade fossem considerados presas comuns de aves marinhas oceânicas como reportados por muitos autores. É proposto neste estudo que uma fonte indireta, importante e de fácil obtenção, surgiu com o início das atividades dos barcos atuneiros que operam com espinhel. O hábito de ingerir restos de vísceras de peixes capturados em barcos espinheleiros pode explicar as prováveis conclusões equivocadas de que cefalópodes de profundidade são presas naturais de aves marinhas oceânicas.

Caracterização ultrassonográfica das estruturas flexoras musculotendíneas e ligamentares da porção distal dos membros de novilhas cruzadas

Caracterizaram-se, por meio da ultrassonografia, as estruturas flexoras da porção distal dos membros de bovinos utilizando-se peças anatômicas da porção distal dos membros torácicos e pélvicos, provenientes de 20 novilhas mestiças da raça Nelore, com idades entre 24 e 36 meses. Para análise ultrassonográfica, foram estabelecidas cinco zonas de avaliação no plano transversal, denominadas, respectivamente, de zonas A, B, C, D e E, e duas em plano sagital, F-III e F-IV. Na face flexora, foram avaliados os tendões flexores digitais superficial e profundo, o músculo interósseo, o ligamento acessório do tendão flexor digital profundo e a manica flexoria, quanto à forma, limites, posição, ecogenicidade e mensurações das áreas transversais em cm². Sendo os resultados apresentados na forma descritiva e em tabelas, foi possível a caracterização das estruturas flexoras, identificando e determinando planos ultrassonográficos apropriados para a observação de imagens adequadas destes tecidos, além da obtenção de valores e parâmetros que possam ser utilizados como referência para esta espécie.

A dense GNSS meteorological network for observing deep convection in the Amazon

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Effect of pH of colloidal suspension on crystallization and activation energy of deep levels in SnO2 thin films obtained via sol-gel

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Cubic approximation for the transverse displacement in BEM for elastic plates analysis

This work presents an application for the plate analysis formulation by BEM where 3 boundary equations are used, written for the transverse displacement w and the normal and tangential derivatives partial derivativew/partial derivativen and partial derivativew/partial derivatives. In this extension, the transverse displacement w is approximated by a cubic polynomial and, as a consequence, partial derivativew/partial derivatives has a quadratic approximation. This alternative BEM formulation improves the analysis of thin plates, when compared to the formulation using the linear approximation for the displacements, mainly in the obtaining of the bending moments at the boundary of the plate. The implementation of this proposal to the computational codes is simple. (C) 2004 Published by Elsevier Ltd.

A Comparison of Deep Drawing and Ironing of Metal Alloy Strip Produced conventionally and Non-conventionally via Semi Solid Material Processing

A semi solid thin strip continuous casting process was used to obtain 50%wt Pb/50%wtSn strip by single and twin roll processing at speed of 15 m/min. A 50%wt Pb/50%wtSn plate ingot was also cast for rolling conventionally into strips of 1.4 mm thickness and 45 mm width for comparison with those achieved non-conventionally. This hypoeutectic alloy has a solidification interval and fusion temperature of approximately 31 degrees C and 215 degrees C respectively. The casting alloy temperature was around 280 degrees C as measured by a type K immersion thermocouple prior to pouring into a tundish designed to maintain a constant melt flow on the cooling slope during semi solid material production. A nozzle with a weir ensures that the semi solid material is dragged smoothly by the lower roll, producing strip with minimum contamination of slag/oxide. The temperatures of the cooling slope and the lower roll were also monitored using K type thermocouples. The coiled semi solid strip, which has a thickness of 1.5 mm and 45 mm width, was rolled conventionally in order to obtain 1.2 mm thick strip. The coiled thixorolled strip had a thickness of 1.2 mm and achieved practically the same width as the conventional strips. Blanks of 40 mm diameter were cut from the strips in a mechanical press, ready for deep drawing and ironing for mechanical characterization. All the strips achieved from non-conventional processing had the same mechanical performance as those achieved conventionally. The limiting drawing ratio (LDR) achieved was approximately 2.0 for all strips. Microscopy examination was made in order to observe phase segregation during processing.

Revegetation and Soil Management Effects on Chemical Properties of a Saprolite Resulting from Deep Soil Removal

During the building of a hydroelectrical power plant at Ilha Solteira in the Parana River (Brazil), materials of a highly weathered soil Oxisol were extracted from a depth between 5 and 8 m for engineering works. This resulted in an abandoned depression area. The topsoil was not salvaged and the open pit was not backfilled, and as result vegetation hardly or not at all recovered. on the residual saprolite materials, an experimental field was established to assess different soil rehabilitation treatments. Field experiments were initiated in 1992. After soil tillage, two different crops and three different liming strategies were compared, giving six combinations. In addition, two uncropped control treatments, tilled and no-tilled, were established so that a total of eight treatments were assessed. The experimental design consisted of four randomized experimental blocks, which included a total of 32 plots with a plot area of 100 m(2). This experiment was used to study the effectiveness of the soil-reclamation treatments after a 9-year period. Soil samples were taken at three different depths (0-10, 10-20, and 20-40 cm), and they were analyzed routinely for pH, organic-matter content, and cation exchange capacity (CEC). Revegetation of the abandoned saprolite material increased soil organic-matter content and cation exchange capacity (CEC), and to some extent small differences between treatments were evidenced. Exchangeable calcium (Ca) and magnesium (Mg) recovered faster than organic-matter content. A significant linear relationship was found between organic-matter content and CEC, suggesting continued addition of organic material will further approach the value of these parameters to those levels corresponding to natural soils under "Cerrado" vegetation.

Prophylaxis of deep-vein thrombosis after lower extremity amputation: Comparison of low molecular weight heparin with unfractionated heparin

OBJETIVO: Comparar a eficácia e segurança da profilaxia com heparina de baixo peso molecular (enoxaparina) versus heparina não fracionada (HNF). MÉTODOS: Setenta e cinco pacientes (59 homens e 16 mulheres ), submetidos a amputação maior dos membros inferiores (30 acima do joelho e 45 abaixo do joelho ), foram tratados ao acaso com HNF subcutânea (5,000 IU -2x/dia ) ou enoxaparina subcutânea (40mg/dia ) durante a hospitalização . A profilaxia teve início 12 horas antes da cirurgia ou , em casos emergenciais , no primeiro dia de pós-operatório. RESULTADOS: Os dois grupos de tratamento foram comparáveis em termos de características gerais . A avaliação da TVP foi feita por meio de exame clínico diário e pelo mapeamento dúplex antes e 5-8 dias após a cirurgia . A TVP foi documentada no lado operado em 9,75% dos pacientes tratados com enoxaparina e em 11,76% dos pacientes tratados com HNF (p=0,92) e houve um caso de TVP bilateral em cada grupo . Sangramentos não foram verificados nos 2 grupos . CONCLUSÃO: A enoxaparina e HNF foram igualmente eficientes e seguras para a profilaxia da TVP em pacientes submetidos à amputação de membros inferiores .

Prevalence of deep vein thrombosis and pulmonary embolism in superficial thrombophlebitis of the lower limbs: prospective study of 60 cases

Aim. Superficial thrombophlebitis (ST) ascending the lower limbs is a common disease, which may be associated with deep vein thrombosis (DVT) and pulmonary embolism (PE). The aim of this study was to investigate the prevalence of DVT and PE as complications of ascending ST of the lower limbs in the great saphenous vein (GSV) or SSV (SSV) and probable risk factors.Methods. For this study 60 consecutive patients were enrolled with ascending ST of the GSV or SSV, seen between 2000 and 2003 at a public hospital in Botucatu, SP, Brazil. All patients were assessed clinically, by venous Duplex scanning of the lower limbs to confirm ST and test for DVT, and by means of pulmonary scintigraphy to test for PE.Results. In 13 ST cases (21.67%) there was concomitant DVT and 17 ST patients (28.33%) also had PE. Eleven patients had a clinical status suggestive of DVT, but only in eight of these (61.5%), this clinical diagnosis was confirmed. Fourteen patients had a clinical status suggestive of PE, and this diagnosis was confirmed in six cases (35.30%). ST patients who also had DVT and/or PE were given anticoagulant treatment with heparin and warfarin. None of the variables studied was predictive of DVT or PE (P>0.05). However, the presence of varicose veins reduced the risk of patients having DVT (relative risk=9.09; 95%CI:1.75 - 50.00 and P=0.023).Conclusion. The prevalence rates of PE (28.3%) and DVT (21.6%) were elevated in this sample of ascending ST cases, indicating a need for detailed assessment of patients for signs of these complications, including for therapeutic management decision making. [Int Angiol 2009;28:400-8]

Advances in ultrasound techniques improve early detection of deep vein thrombosis

Aim. This study aimed at assessing the accuracy of ultrasound (US) in the diagnosis of recent deep vein thrombosis (DVT) in an experimental study in dogs.Methods. Design: blinded and randomized experimental study. Twenty dogs were randomly divided in two groups: control group (CG) and thrombosis group (TG). US was performed in the pre- and postoperative period. Phlebography was performed immediately prior to the postoperative US. After the second US, a surgery was performed to detect whether thrombus was present or not. US results were compared to those of phlebography and surgical findings.Results. in all dogs, inferior vena cava (IVC) was compressible. The relations of IVC diameter with the aorta were higher (P<0.005) in TG than in CG. Spectral Doppler in spontaneous breathing, tissue harmonic imaging, power Doppler and B flow showed sensitivity, specificity and accuracy of 1. Phlebography presented sensitivity of 90%, specificity of 80% and accuracy of 85%, when compared to surgical finding.Conclusion. For the diagnosis of recent DVT in the experimental model used, venous compressibility proved to be inefficient. The ratio of WC diameter to aorta, when increased, suggests thrombosis. The use of new US technological advances increases accuracy. Phlebography was less accurate than US.

Cortactin is associated with perineural invasion in the deep invasive front area of laryngeal carcinomas

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Short-term evaluation of the pulpo-dentin complex response to a resin-modified glass-ionomer cement and a bonding agent applied in deep cavities

Objectives. To evaluate the response of the pulpo-dentin complex following application of a resin-modified glass-ionomer cement or an adhesive system in deep cavities performed in human teeth.Methods. Deep class V cavities were prepared on the buccal surface of 26 premolars. In Group I the cavity walls (dentin) and enamel were conditioned with 32% phosphoric acid and the dentin adhesive system One Step (Bisco, Inc., Itasca, IL, USA) was applied. In Groups 2 and 3, before total etching and application of bonding agent, the cavity floor was lined with the resin-modified glass-ionomer cement-Vitrebond (3M ESPE Dental Products Division, St. Paul, MN, USA) or the calcium hydroxide cement-Dycal (control group, Dentsply, Mildford, DE, USA), respectively. The cavities were restored using light-cured Z-100 composite resin (3M ESPE). The teeth were extracted between 5 and 30 days and prepared for microscopic assessment. Serial sections were stained with H/E, Masson's trichrome, and Brown and Brenn techniques.Results. In Group 1, the inflammatory response was more evident than in Groups 2 and 3. Diffusion of dental material components across dentinal tubules was observed only in Group 1, in which the intensity of the pulp response increased as the remaining dentin thickness decreased. Bacteria were evidenced in the lateral walls of two samples (Group 2) which exhibited no inflammatory response or tissue disorganization.Conclusions. Based on the experimental conditions, it was concluded total acid etching followed by application of One Step bonding agent cannot be recommended as adequate procedures. In this clinical condition the cavity walls should be lined with a biocompatible dental material, such as Vitrebond or Dycal. 2003 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Human pulp response after an adhesive system application in deep cavities

Objectives: To evaluate the pulpo-dentin complex response to a dentin adhesive application in deep cavities performed in human teeth.Methods: Deep class V cavities were prepared on the buccal surface of 46 premolars. The remaining dentin of the axial wall received 10% phosphoric acid and dentin adhesive (group DA), or was protected before the acid and dentin adhesive application with calcium hydroxide cement (group CH). Half of the teeth, which received the acid application directly over the axial wall, were contaminated prior to the procedures with dental plaque collected from the patient's own teeth (group DAC). The plaque was placed on the dentin for 5 min and then the cavity was washed. All teeth were restored with a light-cured composite resin. The teeth were extracted after 7, 30 or 60 days and prepared according to normal histologic techniques. Serial sections were stained with WE, Masson's trichrome and Brown & Brenn technique for demonstration of bacteria.Results: the histopathologic evaluation showed that in groups DA and DAC, the inflammatory response was more evident than in group CH. Also, the intensity of the pulp reaction increased as the remaining dentin thickness decreased. There was no statistical difference in the inflammatory response between the groups DA and DAC.Conclusion: Based on the experimental conditions, we concluded that the All Bond 2 adhesive system, when applied on dentin in deep cavities, showed an acceptable biocompatibility. However, the intensity of the pulpo-dentin complex response depends on the remaining dentin thickness. (C) 1999 Elsevier B.V. Ltd. All rights reserved.

Pulp response after application of two resin modified glass ionomer cements (RMGICs) in deep cavities of prepared human teeth

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)