938 resultados para Single case


Relevância:

60.00% 60.00%

Publicador:

Resumo:

Biasi C., Borelli V., Benedicto H.G., Pereira M.R., Favaron P.O. & Bombonato P.P. 2012. [Comparative analysis between ventricular and sinoatrial node vascularization in cats.] Analise comparativa entre a vascularizacao ventricular e do no sinoatrial em gatos. Pesquisa Veterinaria Brasileira 31(1): 78-82. Setor de Anatomia dos Animais Domesticos e Silvestres, Faculdade de Medicina Veterinaria e Zootecnia, Universidade de Sao Paulo, Av. Prof. Dr. Orlando Marques de Paiva 87, Cidade Universitaria, Sao Paulo, SP 05508-000, Brazil. E-mail: caiobiasi@usp.br The possible existence of interdependence in the blood nutrition of both atrial and ventricular territories has been a subject of concern to cardiologists, mainly related to vascularization of the sinoatrial node and its dependence on just one coronary artery or both, and its relation with the predominance of these vessels in the ventricular vascularization. Therefore, this research aimed evaluated the relation of blood irrigation of the sinoatrial node in relation to the coronary artery predominance in the ventricle vascularization. In doing so, we analyzed 30 hearts of cats without pedigree, males and females, adults of several ages. They were not carrying any heart problems. The hearts were injected by the thoracic aorta with Neoprene Latex 450, stained with red pigment, and then they were dissected. It was found that when there was a prevalence of ventricular vascularization of the left type (63.34%) the sinoatrial node irrigation was predominantly in the dependency of the Ramus proximalis atrii dextri (78.9%) or with less frequency by Ramus proximalis atrii sinister (21.1%). In the ventricular vascularization of the balanced type (33.34%), the pacemaker irrigation was in dependence more often of Ramus proximalis atrii dextri (80%) or with less frequency the nutrition of the sinoatrial node occurred by Ramus proximalis atril sinister (20%). In a single-case, we observed the ventricular vascularization of the right type (3.34%), the pacemaker nutrition was in an exclusive dependence of the Ramus intermedius atril dextri. These results suggest in this species there is no relationship between both the sinoatrial node irrigation and the type of ventricular vascularization, regardless of gender.

Relevância:

60.00% 60.00%

Publicador:

Resumo:

The Ph.D. dissertation analyses the reasons for which political actors (governments, legislatures and political parties) decide consciously to give away a source of power by increasing the political significance of the courts. It focuses on a single case of particular significance: the passage of the Constitutional Reform Act 2005 in the United Kingdom. This Act has deeply changed the governance and the organization of the English judicial system, has provided a much clearer separation of powers and a stronger independence of the judiciary from the executive and the legislative. What’s more, this strengthening of the judicial independence has been decided in a period in which the political role of the English judges was evidently increasing. I argue that the reform can be interpreted as a «paradigm shift» (Hall 1993), that has changed the way in which the judicial power is considered. The most diffused conceptions in the sub-system of the English judicial policies are shifted, and a new paradigm has become dominant. The new paradigm includes: (i) stronger separation of powers, (ii) collective (as well as individual) conception of the independence of the judiciary, (iii) reduction of the political accountability of the judges, (iv) formalization of the guarantees of judicial independence, (v) principle-driven (instead of pragmatic) approach to the reforms, and (vi) transformation of a non-codified constitution in a codified one. Judicialization through political decisions represent an important, but not fully explored, field of research. The literature, in particular, has focused on factors unable to explain the English case: the competitiveness of the party system (Ramseyer 1994), the political uncertainty at the time of constitutional design (Ginsburg 2003), the cultural divisions within the polity (Hirschl 2004), federal institutions and division of powers (Shapiro 2002). All these contributes link the decision to enhance the political relevance of the judges to some kind of diffusion of political power. In the contemporary England, characterized by a relative high concentration of power in the government, the reasons for such a reform should be located elsewhere. I argue that the Constitutional Reform Act 2005 can be interpreted as a result of three different kinds of reasons: (i) the social and demographical transformations of the English judiciary, which have made inefficient most of the precedent mechanism of governance, (ii) the role played by the judges in the policy process and (iii) the cognitive and normative influences originated from the European context, as a consequence of the membership of the United Kingdom to the European Union and the Council of Europe. My thesis is that only a full analysis of all these three aspects can explain the decision to reform the judicial system and the content of the Constitutional Reform Act 2005. Only the cultural influences come from the European legal complex, above all, can explain the paradigm shift previously described.

Relevância:

60.00% 60.00%

Publicador:

Resumo:

La tesi di Matteo Allodi intende analizzare alcune pratiche socio-assistenziali rivolte a minori e famiglie in difficoltà relative a progetti di accoglienza presso alcune strutture residenziali. In particolare, Matteo Allodi si sofferma su progetti di accoglienza elaborati presso alcune Comunità familiari la cui metodologia d’intervento si caratterizza per un orientamento verso un modello di lavoro sociale di tipo sussidiario nell’ottica del recupero dei legami e delle competenze genitoriali. La tesi affronta nella prima parte la dimensione teorica relativa a un approccio progettuale di intervento sociale che, mettendo al centro le relazioni dei soggetti in gioco, possa promuovere la loro attivazione in funzione della realizzazione dell’obiettivo del recupero della genitorialità. Allodi si concentra dal punto di vista teorico sulle modalità di realizzazione di un servizio alla persona guidato dal principio di sussidiarietà, ovvero orientato alla valorizzazione delle capacità riflessive degli attori. Nella seconda, parte Allodi presenta l’indagine condotta in alcune Comunità di tipo familiare di Parma. La strategia iniziale d’indagine è quella del case study. Allodi sceglie di indagare il fenomeno partendo da un’osservazione partecipata di orientamento etnometodologico integrata con interviste agli attori privilegiati. In questa fase si è proceduto a una prima ricerca qualitativa, attraverso la metodologia dello studio di caso, che ha permesso di entrare in contatto con alcune tipologie di strutture residenziali per minori al fine di completare il quadro generale del fenomeno delle Comunità familiari e impostare una prima mappatura esplorativa. La ricerca prosegue con uno studio longitudinale prospettico volto a monitorare e valutare il lavoro di rete della comunità e dei servizi, osservando principalmente la mobilitazione verso l’autonomia e l’empowerment dei soggetti (minori) e delle reti ancorate al soggetto (single case study). Si è voluto comprendere quali modalità relazionali gli attori della rete di coping mettono in gioco in funzione del “cambiamento sociale”.

Relevância:

60.00% 60.00%

Publicador:

Resumo:

Innerhalb der vorliegenden Untersuchung geht es um die Verknüpfung von Medienbildung, homosexueller Sozialität und der Methodik der Biografieanalyse. Ausgangsbasis ist eine sozialkonstruktivistische Sichtweise auf Geschlecht und (Homo-) Sexualität, wobei eine sozio-historische Kontextualisierung von Homosexualität unter Berücksichtigung von Diskriminierung erfolgt. Im Fokus steht der Coming-out-Prozess, der zwischen Zeigen und Verstecken changiert und mittels des Mediums Internet einen Raum findet, indem neue Bestimmungen homosexueller Identitäten und Formen homosexueller Sozialität möglich werden. Kommunikative Aspekte des Internets werden ausführlich expliziert und durch die strukturelle Medienbildungstheorie nach Marotzki (2009) ergänzt, um mögliche verbundene Bildungsprozesse zu beschreiben. Innerhalb dieser Theorie werden vier kritische Reflexionshorizonte (Wissensbezug, Handlungsbezug, Grenzbezug, Biografiebezug) entfaltet und auf die Artikulations- und Präsentationsmöglichkeiten des Internets bezogen. Deutlich wird, dass das Internet Spielräume für Identitäten bietet, denen Potenziale für reale Identitätskonstruktionen inneliegen. Fassbar werden diese Potenziale durch das medienpädagogische Konstrukt der Medienbiografie, sowie Konzepte der erziehungswissenschaftlichen Biografieforschung (Konstrukt Bildung nach Marotzki, 1990a; Konstrukt Sexualbiografie nach Scheuermann, 1999; 1995). Empirisch orientiert sich die Studie an Methodologie und Methodik der Biografieforschung, Grounded Theory (Glaser/Strauss, 1967) und dem narrationsstrukturellen Verfahren nach Schütze (1984, 1983). Konkret wird auf folgende Forschungsfragen referiert: Wie gestalten sich Lern- und Bildungsprozesse für männliche Homosexuelle in digitalen Medienwelten? Welche Möglichkeiten und Gestaltungschancen gibt es für die Repräsentation des (sexuellen) Selbst im Medium Internet? Welche Auswirkungen haben diese virtuellen Prozesse auf die real gelebte Biografie und das Selbst- und Weltverhältnis der einzelnen Homosexuellen? Durch Rekonstruktion von vier Fallbeispielen werden Möglichkeiten des Internets für die Repräsentation und Identitätsgestaltung von männlichen Homosexuellen präsentiert, bei denen die Gestaltbarkeit von Konstruktionen sexueller Identität und die Problematik der Subjekt-Umwelt-Relation deutlich werden. Im weiteren erfolgt ein kontrastierender Vergleich der Einzelfälle (Dimensionen: Familie, Peer Group, sexualbiografische Entwicklung, Medienbildungsprozesse, biografische Fallstruktur), die einer anschließenden Konstruktion von vier idealtypischen Prozessvarianten der sexualbiografischen Identitätsentwicklung zugeführt werden. Vier verschiedene Möglichkeiten des Internets als Präsentationstraum der eigenen Sexualität und Konstruktionen homosexueller Identität lassen sich somit skizzieren (Virtualitätslagerung, Zweckorientierung, reflexive Balancierung, periodische Selbstaktualisierung). Tentative Bildungs- und Identitätsprozesse sind also in der Virtualität des Internets möglich und können rekursiv-zirkulär auf reale Identitätsentwicklungen und reale Zugänge zu spezifischen sozialen Gruppen einwirken.

Relevância:

60.00% 60.00%

Publicador:

Resumo:

La pratica del remix è al giorno d’oggi sempre più diffusa e un numero sempre più vasto di persone ha ora le competenze e gli strumenti tecnologici adeguati per eseguire operazioni un tempo riservate a nicchie ristrette. Tuttavia, nella sua forma audiovisiva, il remix ha ottenuto scarsa attenzione a livello accademico. Questo lavoro esplora la pratica del remix intesa al contempo come declinazione contemporanea di una pratica di lungo corso all’interno della storia della produzione audiovisiva – ovvero il riuso di immagini – sia come forma caratteristica della contemporaneità mediale, atto di appropriazione grassroots dei contenuti mainstream da parte degli utenti. La tesi si articola in due sezioni. Nella prima, l’analisi di tipo teorico e storico-critico è suddivisa in due macro-aree di intervento: da una parte il remix inteso come pratica, atto di appropriazione, gesto di riciclo, decontestualizzazione e risemantizzazione delle immagini mediali che ha attraversato la storia dei media audiovisivi [primo capitolo]. Dall’altra, la remix culture, ovvero il contesto culturale e sociale che informa l’ambiente mediale entro il quale la pratica del remix ha conosciuto, nell’ultimo decennio, la diffusione capillare che lo caratterizza oggi [secondo capitolo]. La seconda, che corrisponde al terzo capitolo, fornisce una dettagliata panoramica su un caso di studio, la pratica del fan vidding. Forma di remix praticata quasi esclusivamente da donne, il vidding consiste nel creare fan video a partire da un montaggio d’immagini tratte da film o serie televisive che utilizza come accompagnamento musicale una canzone. Le vidders, usando specifiche tecniche di montaggio, realizzano delle letture critiche dei prodotti mediali di cui si appropriano, per commentare, criticare o celebrare gli oggetti di loro interesse. Attraverso il vidding il presente lavoro indaga le tattiche di rielaborazione e riscrittura dell’immaginario mediale attraverso il riuso di immagini, con particolare attenzione al remix inteso come pratica di genere.

Relevância:

60.00% 60.00%

Publicador:

Resumo:

Immediate breast reconstruction (IBR) has become an established procedure for women necessitating mastectomy. Traditionally, the nipple-areola complex (NAC) is resected during this procedure. The NAC, in turn, is a principal factor determining aesthetic outcome after breast reconstruction, and due to its particular texture and shape, a natural-looking NAC can barely be reconstructed with other tissues. The aim of this study was to assess the oncological safety as well as morbidity and aesthetic outcome after replantation of the NAC some days after IBR. Retrospective analysis of 85 patients receiving 88 mastectomies and IBR between 1998 and 2007 was conducted. NAC (n=29) or the nipple alone (n=23) were replanted 7 days (median, range 2-10 days) after IBR in 49 patients, provided the subareolar tissue was histologically negative for tumour infiltration. Local recurrence rate was assessed after 49 months (median, range 6-120 months). Aesthetic outcome was evaluated by clinical assessment during routine follow-up at least 12 months after the last intervention. Malignant involvement of the subareolar tissue was found in eight cases (9.1%). Patients qualifying for NAC replantation were in stage 0 in 29%, stage I in 15%, stage IIa in 31%, stage IIb in 17% and stage III in 8%. Total or partial necrosis occurred in 69% and 26% if the entire NAC or only the nipple were replanted, respectively (P<0.01). Depigmentation was seen in 52% and corrective surgery was done in 11 out of 52 NAC or nipple replantations. Local recurrence and isolated regional lymph node metastasis were observed in one single case each. Another 5.8% of the patients showed distant metastases. We conclude that the replantation of the NAC in IBR is oncologically safe, provided the subareolar tissue is free of tumour. However, the long-term aesthetic outcome of NAC replantation is not satisfying, which advocates replanting the nipple alone.

Relevância:

60.00% 60.00%

Publicador:

Resumo:

Background This is the first ever evaluation of narrow band imaging (NBI), an innovative endoscopic imaging procedure, for the visualisation of pleural processes. Methods The pleural cavity was examined in 26 patients with pleural effusions using both white light and narrow band imaging during thoracoscopy under local anaesthesia. Results In the great majority of the patients narrow band imaging depicted the blood vessels more clearly than white light, but failed to reveal any differences in number, shape or size. Only in a single case with pleura thickened by chronic inflammation and metastatic spread of lung cancer did narrow band imaging show vessels that were not detectable under white light. Conclusion It is not yet possible to assess to what extent the evidence provided by NBI is superior to that achieved with white light. Further studies are required, particularly in the early stages of pleural processes.

Relevância:

60.00% 60.00%

Publicador:

Resumo:

OBJECTIVE: To describe the prevalence, main characteristics, and treatment of severe autoimmune cytopenias [autoimmune hemolytic anemia (AIHA), autoimmune thrombocytopenic purpura (AITP)] in patients with chronic hepatitis C virus (HCV) infection. METHODS: Retrospective chart review of patients with chronic HCV infection seen at our institution. Two additional departments contributed eight more patients to assess therapy of HCV-related autoimmune cytopenias. RESULTS: Eight patients (seven AITP, one AIHA) fulfilled the inclusion criteria in our population of 4345 HCV-infected patients. The number of patients with AITP was much greater than would be expected by chance (P<0.0001). Patients with HCV-related AITP were older and demonstrated more immunological markers than a group of 40 controls. Eight additional patients (six AITP, two Evans syndrome) were included. We only assessed the response for AITP patients because of the single case of AIHA. Patients with AITP had a poor response to initial corticosteroids [one complete response (CR), three partial response (PR), and four failures]. Intravenous immunoglobulins led to transient efficacy in three of four patients. In second-line therapy, five of seven patients responded to splenectomy. Rituximab proved effective in increasing platelets in two patients. Of eight patients treated with antiviral therapy (IFN-alpha+/-ribavirin), five responded (three CR, two PR). CONCLUSION: AITP occurs more commonly in patients with chronic HCV infection than would be expected by chance. HCV-positive AITP requires a treatment strategy different from that used in HCV-negative AITP. On the basis of the results from our study and a literature analysis, we propose an algorithm for treatment of severe HCV-related autoimmune cytopenias.

Relevância:

60.00% 60.00%

Publicador:

Resumo:

Oculofaciocardiodental (OFCD) and Lenz microphthalmia syndromes form part of a spectrum of X-linked microphthalmia disorders characterized by ocular, dental, cardiac and skeletal anomalies and mental retardation. The two syndromes are allelic, caused by mutations in the BCL-6 corepressor gene (BCOR). To extend the series of phenotypes associated with pathogenic mutations in BCOR, we sequenced the BCOR gene in patients with (1) OFCD syndrome, (2) putative X-linked ('Lenz') microphthalmia syndrome, (3) isolated ocular defects and (4) laterality phenotypes. We present a new cohort of females with OFCD syndrome and null mutations in BCOR, supporting the hypothesis that BCOR is the sole molecular cause of this syndrome. We identify for the first time mosaic BCOR mutations in two females with OFCD syndrome and one apparently asymptomatic female. We present a female diagnosed with isolated ocular defects and identify minor features of OFCD syndrome, suggesting that OFCD syndrome may be mild and underdiagnosed. We have sequenced a cohort of males diagnosed with putative X-linked microphthalmia and found a mutation, p.P85L, in a single case, suggesting that BCOR mutations are not a major cause of X-linked microphthalmia in males. The absence of BCOR mutations in a panel of patients with non-specific laterality defects suggests that mutations in BCOR are not a major cause of isolated heart and laterality defects. Phenotypic analysis of OFCD and Lenz microphthalmia syndromes shows that in addition to the standard diagnostic criteria of congenital cataract, microphthalmia and radiculomegaly, patients should be examined for skeletal defects, particularly radioulnar synostosis, and cardiac/laterality defects.

Relevância:

60.00% 60.00%

Publicador:

Resumo:

The benefits companies achieve by implementing an ERP system vary considerably. Many companies need to adapt their ERP integration solution in the post-implementation stage. But after the completion of such a usually very complex integration project, benefits do not emerge by all means. A misfit between the organization and the IS, especially the aspect of cross-functional team collaboration, could explain these divergences. Using an initial theoretical framework, we conducted a single case study to explore the team-oriented perceptions in a post-implementation ERP integration project. To analyze the benefits and the influences in greater depth we disentangled the integration benefits into their particular parts (process, system and information quality). Our findings show that post-implementation ERP integration changes are not always perceived as beneficiary by the involved teams and that cross-functional collaboration has an important influence.

Relevância:

60.00% 60.00%

Publicador:

Resumo:

In this article we argue that it is pressing to study the “hybrid media system” at the intersection of online and offl ine communication and its potential for agenda building. The topic is relevant because it is argued that the internet off ers new opportunities of public infl uence for challengers without access to political decision making. Except for single case studies, little is known about the conditions under which these actors succeed. Informed by the research on agenda building we tackle with the mechanisms of online-offline media agenda building and the conditions under which challengers succeed to produce issue spill-over into conventional mass media. We develop a theoretical framework for investigating the linkage between online communication and traditional mass media and discuss how our model translates into empirical research. We conclude that the nature of online networks is critical for spill-over, but also the issue itself and the structure of the political system.

Relevância:

60.00% 60.00%

Publicador:

Resumo:

What's known on the subject? and What does the study add? The EndoSew® prototype was first tested in a porcine model several years ago. The investigators found it both simple to master and reliable, its greatest advantage being a 2.4-fold time saving compared with straight laparoscopic suturing. In addition to that publication, there is a single case report describing the performance of an open EndoSew® suture to close parts (16 cm) of an ileal neobladder. The time for suturing the 16 cm ileum was 25 min, which is in line with our experience. The knowledge on this subject is limited to these two publications. We report on the first consecutive series of ileal conduits performed in humans using the novel prototype sewing device EndoSew®. The study shows that the beginning and the end of the suture process represent the critical procedural steps. It also shows that, overall, the prototype sewing machine has the potential to facilitate the intracorporeal suturing required in reconstructive urology for construction of urinary diversions. Objective To evaluate the feasibility and safety of the novel prototype sewing device EndoSew® in placing an extracorporeal resorbable running suture for ileal conduits. Patients and Methods We conducted a prospective single-centre pilot study of 10 consecutive patients undergoing ileal conduit, in whom the proximal end of the ileal conduit was closed extracorporeally using an EndoSew® running suture. The primary endpoint was the safety of the device and the feasibility of the sewing procedure which was defined as a complete watertight running suture line accomplished by EndoSew® only. Watertightness was assessed using methylene blue intraoperatively and by loopography on postoperative days 7 and 14. Secondary endpoints were the time requirements and complications ≤30 days after surgery. Results A complete EndoSew® running suture was feasible in nine patients; the suture had to be abandoned in one patient because of mechanical failure. In three patients, two additional single freehand stitches were needed to anchor the thread and to seal tiny leaks. Consequently, all suture lines in 6/10 patients were watertight with EndoSew® suturing alone and in 10/10 patients after additional freehand stitches. The median (range) sewing time was 5.5 (3–10) min and the median (range) suture length was 4.5 (2–5.5) cm. There were no suture-related complications. Conclusions The EndoSew® procedure is both feasible and safe. After additional freehand stitches in four patients all sutures were watertight. With further technical refinements, EndoSew® has the potential to facilitate the intracorporeal construction of urinary diversions.

Relevância:

60.00% 60.00%

Publicador:

Resumo:

Introduction: Desmoplastic small round cell tumor (DSRCT) is an uncommon, embryonic-type neoplasm, typically presenting as an abdominal mass in young men. A single case of DSRCT arising in the peripheral nervous system has been reported. Methods: The clinical course, imaging, electrophysiological, intraoperative, histopathological, molecular findings, and postoperative follow-up are reported. Results: A 43-year-old man presented with slowly progressive right brachial plexopathy. Magnetic resonance imaging revealed an enlarged medial cord with heterogeneous contrast enhancement. Histology showed a "small round cell" neoplasm with a polyphenotypic immunoprofile, including epithelial and mesenchymal markers. A pathognomonic fusion of Ewing sarcoma breakpoint region 1 and Wilms tumor 1 genes (EWSR1/WT1) was present. Treatment involved gross total excision and local radiotherapy. Conclusion: Our findings confirm the occurrence of DSRCT as a primary peripheral nerve tumor. Despite its usually very aggressive clinical course, prolonged recurrence-free survival may be reached. Histomorphology and immunoprofile of DSRCT may lead to misdiagnosis as small cell carcinoma. © 2013 Wiley Periodicals, Inc.

Relevância:

60.00% 60.00%

Publicador:

Resumo:

BACKGROUND The aim of the survey was to obtain information on the treatment plan preferences, mechanics and characteristics of temporary anchorage device (TAD) application using a single case presented to orthodontists in Switzerland. METHODS A structured questionnaire to be completed by all study participants with case-specific (treatment plan including mechanics and TAD usage) and general questions (general fixed appliance and TAD usage as well as professional, educational and demographic questions) together with an orthodontic borderline case was utilised. The case was a female adult with dental Class II/2, deep bite and maxillary anterior crowing, who had been treated in childhood with extraction of four premolars and fixed appliance followed by wisdom tooth extraction. RESULTS The response rate was 24.4% (108 out of 443). The majority (96.3%, 104) proposed comprehensive treatment, while 3.7% (4) planned only alignment of maxillary teeth. 8.3% (9) included a surgical approach in their treatment plan. An additional 0.9% (1) combined the surgical approach with Class II mechanics. 75.1% (81) decided on distalization on the maxilla using TADs, 7.4% (8) planned various types of Class II appliances and 3.7% (4) combined distalization using TADs or headgear with Class II appliances and surgery. Palatal implants were the most popular choice (70.6%, 60), followed by mini-screws (22.4%, 19) and mini-plates on the infrazygomatic crests (7.0%, 6). The preferred site of TAD insertion showed more variation in sagittal than in transversal dimension, and the median size of mini-screws used was 10.0-mm long (interquartile range (IQR) 2.3 mm) and 2.0-mm wide (IQR 0.3 mm). CONCLUSIONS Distalization against palatal implants and then distalization against mini-screws were the most popular treatment plans. Preferred site for TAD insertion varied depending on type and size but varied more widely in the sagittal than in the transversal dimension.

Relevância:

60.00% 60.00%

Publicador:

Resumo:

Mutations in MITF lead to a large variety of phenotypes in human, mice and other species. They mostly affect pigmentation and hearing, whereas in mice, they may additionally cause microphthalmia and osteopetrosis. In this study, we report a single case of a Holstein calf with lack of pigmentation and microphthalmia born to healthy parents. Mendelian analysis of high-density SNP genotypes reveals a large number of parentage errors showing missing paternal alleles in the offspring, indicating a deletion encompassing 19 Mb on BTA 22. The genomic deletion affects the paternal allele and includes MITF and 131 other annotated genes. As the calf shows only one copy of the BTA 22 segment, the observed phenotype is probably caused by haploinsufficiency of the genes in that genomic region. Both the observed lack of skin pigmentation and reduced eye size can most likely be explained by a lack of MITF function.