Avaliação tomográfica dos pedículos vertebrais no tratamento cirúrgico dos pacientes com escoliose idiopática do adolescente

OBJETIVO: Determinar através de cortes tomográficos e reconstrução tridimensional a incidência de mal posicionamento de parafusos em pacientes submetidos ao tratamento cirúrgico da Escoliose idiopática do adolescente. MÉTODOS: Foram analisados exames tomográficos de 8 pacientes, tratados cirurgicamente no Hospital de Base de São José do Rio Preto-SP, realizada instrumentação posterior partindo de T2 /T4 a L4/L5 totalizando 164 parafusos. RESULTADOS: 32,9% (n=54) apresentavam posicionamento com risco potencial,ou seja desvio acima de 2 milímetros, sendo 20,1% (n=33) com invasão lateral, 9,1% (n=15) com invasão medial, 3,6 %(n=6) com invasão anterior. Dos parafusos que ofereciam risco potencial a relação com aspecto da curva foi de 46% (n=25) na concavidade, 35% (n=19) na convexidade e 19% (n=10) em vértebras adjacentes a curva. CONCLUSÃO: Os limites de penetração aceitáveis, assim como os métodos de mensuração ainda não foram padronizados, a técnica free hand' mostrou-se segura, apesar da violação dos pedículos. A tomografia computadorizada pré-operatória, auxilia no planejamento cirúrgico e na redução das complicações.

Campesinato, resistência e emancipação: o modelo agroecológico adotado pelo MST no Estado do Paraná

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Treatment and complications of orbito-zygomatic fractures

The aim of the present study was to analyze the etiology, type and treatment employed in the orbito-zygomatic fractures (OZ). Also, postoperative complications are described and correlated with the type of treatment used. Fifty patients with OZ fractures were evaluated. Orbital fractures in which the zygomatic bone was not involved were excluded. Epidemiologic data and characteristics of treatment such as the type of material used for osteosynthesis, number of anatomical sites on which rigid internal fixation (RIF) was applied, surgical approaches and associated complications were recorded. The main causes of trauma were motorcycle and bicycle accidents, constituting 52% of the sample. The osteosynthesis system used was the 2.0 mm, except in four patients in whom the 1.5mm system was used for fixation at the infra-orbital rim. A total of 18% of the patients required reconstruction of the internal orbit and in all cases titanium mesh was used. 46% of the patients received RIF in three anatomical sites, most in the fronto-zygomatic suture, infra-orbital rim and zygomatic-maxillary buttress. The most frequent complication was paresthesia of the infra-orbital nerve (34 patients, 68%). Other findings were also discussed with the intent of better understanding the treatment of the OZ fractures.

Contribuições de Anhaia Mello ao urbanismo paulistano: de Ebenezer Howard à escola de Chicago

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Osseointegração de implantes instalados sem estabilidade primária: o papel dos materiais à base de fibrina e fosfato de cálcio

When implants are installed immediately after tooth extraction may occur anchoring primary decreased, delay or failure of osseointegration process. This occurs because of the large interface between the surrounding walls of the socket and the surface of the implant. For reconstruction, replacement or filling of bone defects the solution can be obtained with the use of autogenous, heterogenous or allogeneic bone grafts. However, these grafts suffer certain drawbacks, particularly a high rate of donor site morbidity, limited amounts of available bone, and the additional operative time required for harvest. For these reasons, intensive efforts have been directed toward developing alternative substances for to either augment or substitute. In this paper, we will examine some of the commonly used materials : fibrin and calcium phosphate.

Particularities in the technique of calvaria graft

Calvaria grafts provide good bone quantity for the reconstruction of the atrophic maxilla, and have lower morbidity and resorption rates when compared to iliac crest. The aim of this paper is to present the technique for obtaining a graft of the skull. Initially, the depth of the osteotomy is determined by a manually conducted bur, which establishes the limits of the structures of the skull (outer table, diploe and inner table), making the removal of bone blocks easier and safer. Thus, osteotomies of the blocks are made with greater security, avoiding the complications inherent to surgical technique. The case that will be presented it is from a male patient of 65 years who refused to submit to the iliac crest graft, opting for the calvaria, despite being bald, that is a contraindication for this treatment modality. A delicate suture associated with placement of titanium mesh to maintain the conformation of the patient's skull in the region of the bone defect, created after removal of the graft, provided a good cosmetic result at the donor site. The use of titanium mesh for re-anatomization of bone defects created in the grafts is well indicated for bald patients.

El papel de la institución en el escoger, acoger y acompañar al profesor universitario

Objective. To analyze the role of the institution in choosing, receiving and chaperone professors. Methodology. Qualitative study, which body analysis was composed of 32 participations in a thematic forum of a group of nine health professionals. Results. After professor hiring it is necessary to receive and chaperone him. Professors with longer time in the institution represent a more important role in the admission of the new professor. Chaperone process is an opportunity to change and redefine the rules, and should be supported by permanent evaluation. The university as a legitimate learning scenario, production and knowledge reconstitution, should accompany changes of contemporary science and support the interdisciplinary demands in the new knowledge construction. Conclusion. It is fundamental the role of the university receiving and chaperoning teachers from joining. As well university should favor the growth of the professor, not only by supporting the challenges of their pedagogic activity, but mainly through the respect of autonomy.