959 resultados para DIRECT LATERAL APPROACH
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Este estudo de caso de metodologia mista foi conduzido com foco na migração brasileira para a Guiana como uma estratégia de sobrevivência. O estudo examinou, descreveu e analisou o processo da migração e da adaptação, e os impactos socioeconômicos e ambientais físicos e as preocupações associadas com as atividades de sobrevivência destes migrantes na Guiana. Foram utilizados questionários, entrevistas, documentários, arquivos e observações (direta e participante) com o objetivo de obter um entendimento profundo do fenômeno em questão. O estudo confirma que através de um forte sistema de rede, os brasileiros de classes socioeconômicas e culturais mais baixas são capazes de adotar a migração como estratégia de sobrevivência, à medida que eles migram através de uma rota por passos (step-wise) prédefinida para a Guiana. Este sistema de rede permite aos migrantes responderem prontamente às novas atividades de sobrevivência tanto interna como internacionalmente. Na Guiana, a mineração e a prostituição são identificadas como as principais atividades de sobrevivência que tem gerado conseqüências socioeconômicas tanto positivas quanto negativas e impactos ambientais negativos.
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Implementações dos métodos de migração diferença finita e Fourier (FFD) usam fatoração direcional para acelerar a performance e economizar custo computacional. Entretanto essa técnica introduz anisotropia numérica que podem erroneamente posicionar os refletores em mergulho ao longo das direções em que o não foi aplicado a fatoração no operador de migração. Implementamos a migração FFD 3D, sem usar a técnica do fatoração direcional, no domínio da frequência usando aproximação de Padé complexa. Essa aproximação elimina a anisotropia numérica ao preço de maior custo computacional buscando a solução do campo de onda para um sistema linear de banda larga. Experimentos numéricos, tanto no modelo homogêneo e heterogêneo, mostram que a técnica da fatoração direcional produz notáveis erros de posicionamento dos refletores em meios com forte variação lateral de velocidade. Comparamos a performance de resolução do algoritmo de FFD usando o método iterativo gradiente biconjugado estabilizado (BICGSTAB) e o multifrontal massively parallel direct solver (MUMPS). Mostrando que a aproximação de Padé complexa é um eficiente precondicionador para o BICGSTAB, reduzindo o número de iterações em relação a aproximação de Padé real. O método iterativo BICGSTAB é mais eficiente que o método direto MUMPS, quando usamos apenas um termo da expansão de Padé complexa. Para maior ângulo de abertura do operador, mais termos da série são requeridos no operador de migração, e neste caso, a performance do método direto é mais eficiente. A validação do algoritmo e as propriedades da evolução computacional foram avaliadas para a resposta ao impulso do modelo de sal SEG/EAGE.
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A superfície oclusal excessivamente desgastada pode resultar em desarmonia oclusal e prejuízo à estética e função. Como abordagem terapêutica, coroas unitárias convencionais têm sido propostas, porém este tipo de tratamento é complexo, altamente invasivo e caro. Este relato de caso descreve os resultados clínicos de um tratamento alternativo minimamente invasivo baseado em restaurações adesivas diretas retidas por pinos. Uma paciente de 64 anos apresentando dentição severamente desgastada, problemas mastigatórios relacionados às ausências dentárias e hipersensibilidade dental generalizada foi encaminhada para tratamento. O adequado plano de tratamento baseado no enceramento diagnóstico foi utilizado para guiar a reconstrução dos dentes anteriores superiores com resina composta direta sobre pinos dentinários auto-rosqueáveis. Como os dentes inferiores remanescentes eram extremamente desgastados, uma sobre-dentadura dento-suportada foi instalada. Uma placa estabilizadora também foi utilizada de modo a proteger as restaurações. Este tratamento constitui uma alternativa mais acessível de reabilitação de boca total com resultados estéticos e funcionais positivos após 1,5 anos de acompanhamento.
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Vascular access is the major risk factor for bacteremia, hospitalization, and mortality among hemodialysis (HD) patients. The type of vascular access most associated with bloodstream infection is central venous catheter (CVC). The incidence of catheter-related bacteremia ranges between 0.6 and 6.5 episodes per 1000 catheter days and increases linearly with the duration of catheter use. Given the high prevalence of CVC use and its direct association with catheter-related bacteremia, which adversely impacts morbidity and mortality rates and costs among HD patients, several prevention measures aimed at reducing the rates of CVC-related infections have been proposed and implemented. As a result, a large number of clinical trials, systematic reviews, and meta-analyses have been conducted in order to assess the effectiveness, clinical applicability, and long-term adverse effects of such measures. In the following article, prophylactic measures against CVC-related infections in HD patients and their possible advantages and limitations will be discussed, and the more recent literature on clinical experience with prophylactic antimicrobial lock therapy in HD CVCs will be reviewed.
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Aim: This case report describe a resin layering restorative technique based on biomimetic concept to improve esthetics in a patient with dental defects that affected both enamel and dentin in anterior teeth. Background: Severe structural defect in anterior teeth compromises esthetics and it is a high challenge to become the defect imperceptible after the restoration. Case description: A clinical sequence of applying different composite resin layers allowed the reproduction of the interaction between hard dental tissues and the restorative material. Conclusion: This technique achieved a satisfactory final esthetic outcome, preserving sound teeth structure and at same time, improved the quality of life of the young patient. Clinical significance: The utilization of the biomimetic concept to increase a disharmonic smile with dental defects is based in a conservative approach, which reached a satisfactory and esthetic outcome.
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Background This multicentre study aimed to investigate long-term radiographic and functional results following the treatment of condylar fractures using an angulated screwdriver system and open rigid internal fixation with an intraoral surgical approach. Methods Twenty-nine patients with a total of 32 condylar fractures were evaluated. The patients were investigated prospectively based on the following variables: age, sex, aetiology, side, location and classification of the fracture, degree of displacement, associated fractures, surgical approach, oral health status, type of osteosynthesis plate, duration of surgery, mouth-opening, complications, and duration of follow-up. Results The fractures were classified as subcondylar (n = 25) or condylar neck (n = 7). Mean patient age was 36.38 ± 16.60 years. The median duration of postoperative follow-up was 24.39 ± 13.94 months. No joint noise, weakness of the facial nerve, joint pain, or muscle pain was observed. An additional retromandibular approach was necessary to enable the treatment of one subcondylar fracture with medial displacement. Conclusion Subcondylar or condylar neck fractures with medial or lateral displacement can be treated using an intraoral approach with satisfactory results with the advantages of the absence of visible scarring, the avoidance of facial nerve injury, and the ability to obtain rapid access to the fracture.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Background: This multicentre study aimed to investigate long-term radiographic and functional results following the treatment of condylar fractures using an angulated screwdriver system and open rigid internal fixation with an intraoral surgical approach.Methods: Twenty-nine patients with a total of 32 condylar fractures were evaluated. The patients were investigated prospectively based on the following variables: age, sex, aetiology, side, location and classification of the fracture, degree of displacement, associated fractures, surgical approach, oral health status, type of osteosynthesis plate, duration of surgery, mouth-opening, complications, and duration of follow-up.Results: The fractures were classified as subcondylar (n = 25) or condylar neck (n = 7). Mean patient age was 36.38 +/- 16.60 years. The median duration of postoperative follow-up was 24.39 +/- 13.94 months. No joint noise, weakness of the facial nerve, joint pain, or muscle pain was observed. An additional retromandibular approach was necessary to enable the treatment of one subcondylar fracture with medial displacement.Conclusion: Subcondylar or condylar neck fractures with medial or lateral displacement can be treated using an intraoral approach with satisfactory results with the advantages of the absence of visible scarring, the avoidance of facial nerve injury, and the ability to obtain rapid access to the fracture. (C) 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
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Surgery on the head and neck region may be complicated by vascular trauma, caused by direct injury on the vascular wall. Lesions of the arteries are more dangerous than the venous one. The traumatic lesion may cause laceration of the artery wall, spasm, dissection, arteriovenous fistula, occlusion or pseudoaneurysm. We present a case of a child with a giant ICA pseudoaneurysm after tonsillectomy, manifested by pulsing mass and respiratory distress, which was treated by endovascular approach, occluding the lesion and the proximal artery with Histoacryl. We reinforce that the endovascular approach is the better way to treat most of the traumatic vascular lesions.
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Gastroesophageal reflux disease (GERD) is a gastrointestinal disorder in which stomach acids are chronically regurgitated into the esophagus and oral cavity. Continual exposure of the teeth to these acids can cause severe tooth wear. Dentists are often the first healthcare professionals to diagnose dental erosion in patients with GERD. This article presents a case report of a 27-year-old male smoker with tooth wear and dentin sensitivity caused by GERD associated with bruxism. After diagnosis, a multidisciplinary treatment plan was established. The initial treatment approach consisted of medical follow-up with counseling on dietary and smoking habits, as well as management of the gastric disorders with medication. GERD management and the dental treatment performed for the eroded dentition are described, including diagnosis, treatment planning, and restorative therapy.
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Case Report. An 8-year-old girl with amelogenesis imperfecta (AI) reported unsatisfactory aesthetics, difficulty in mastication, and dental hypersensitivity. The intraoral examination observed mixed dentition, malocclusion in anteroposterior relationships, anterior open bite, and dental asymmetry. A hypoplastic form of AI was diagnosed in the permanent dentition. A multidisciplinary planning was performed and divided into preventive, orthopedic, and rehabilitation stages. Initially, preventive treatment was implemented, with fluoride varnish applications, in order to protect the fragile enamel and reduce the dental sensitivity. In the second stage, the patient received an interceptive orthopedic treatment to improve cross-relationship of the arches during six months. Finally, the rehabilitation treatment was executed to establish the vertical dimension. In the posterior teeth, indirect composite resin crowns were performed with minimally invasive dental preparation. Direct composite resin restorations were used to improve the appearance of anterior teeth. Follow-Up. The follow-up was carried out after 3, 6, 12, and 18 months. After 18 months of follow-up, The restoration of integrity, oral hygiene, and patient satisfaction were observed . Conclusion. Successful reduction of the dental hypersensitivity and improvement of the aesthetic and functional aspects as well as quality of life were observed.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
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The objective of this paper is to present a benefit-cost ranking of 127 civil transport aircraft; this ranking was determined considering a new data envelopment analysis (DEA) approach, called triple index, which combines three assessment methods: 1) standard frontier, 2) inverted index; 3) cross-multiplicative index. The analysis used the following inputs: a) market price; b) direct operating costs; and as outputs: a) payload, b) cruise speed; c) maximum rate of climb with a single engine. To ensure the homogeneity of the units, the aircrafts were divided according to the propulsion system (jet and turboprop) and size (regional, narrow-body and wide-body); they were also evaluated according to different ranges in order to identify the aircraft with the best cost-benefit relationship for each option.
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Early diagenetic chert, infrequently exploited in Phanerozoic micropaleontology, was examined for organic-walled microfossils in petrographic thin sections of silicified dolostones from diverse levels and localities of the Assistencia Formation (Permian, Parana Basin) in the state of Sao Paulo, Brazil. In contrast to previous palynological studies of this formation, the use of thin sections allowed direct observation in three dimensions of common palynomorphs, as well as benthic microbial mats preserved in situ in various stages of their life cycles and degradation. As in palynological residues from the more wellknown shale of this formation, the chert contains wind-dispersed pollen grains and phytoclasts derived from terrestrial sources and planktonic cryptarchs (unornamented coccoidal unicellular or colonial palynomorphs). However, only in the chert is it possible to see much more delicate microfossils, such as abundant cyanobacteria of the in situ benthic microbiota as well as chlorophycean microalgae of the microphytoplankton. Post-depositional processes affecting the formation have destroyed all but the most resistant organic remains in the other lithologies, such that only rare, degraded pollen grains are seen in the unsilicified dolostone of the formation, and in the shale the vast majority of microfossils have been compacted to flattened disks. On the other hand, early silicification not only preserved organic remains at an incipient stage of decomposition but also impeded significant further degradation due to compaction, recrystallization, and oxidation. Thus, the petrographic study of such chert can complement traditional palynological investigations in Phanerozoic rocks by furnishing hitherto unavailable information, especially with regard to benthic organic microfossils and fragile organic-walled phytoplankton normally absent from organic residues. (C) 2011 Elsevier Ltd. All rights reserved.