Oropharyngeal dysphagia in an elderly post-operative hip fracture population : a prospective cohort study

Background: normal ageing processes impact on oropharyngeal swallowing function placing older adults at risk of developing oropharyngeal dysphagia (OD). Anecdotal clinical experience has observed that older patients recovering from hip fracture surgery commonly develop OD post-operatively. Objective: to document the presence of OD following hip fracture surgery, and the factors associated with OD. Methods: one hundred and eighty-one patients with a mean age of 83 years (range: 65–103) admitted to a specialised orthogeriatric unit were assessed for OD post-surgery for hip fracture. Pre-admission, intra-operative and post-operative factors were examined to determine their relationship with the presence of OD. Results: OD was found to be present post-operatively in 34% (n = 61) of the current population. Multivariate logistic regression analyses revealed the presence of pre-existing neurological and respiratory medical co-morbidities, presence of post-operative delirium, age and living in a residential aged care facility prior to hospital admission to be associated with the post-operative OD. Conclusion: these results highlight that OD is present in a large number of the older hip fracture population. Early identification of OD has important implications for the provision of timely dysphagia management that may prevent secondary complications and potentially reduce the hospital length of stay.

The diffusion of Co⠶溩 Zrâ â Tiâ â alloy /|nS. Kumar. -- 260 St Catharines [Ont.] : Dept. of Physics, Brock University,

The diffusion of Co60 in the body centered cubic beta phase of a ZrSOTi SO alloy has been studied at 900°, 1200°, and 1440°C. The results confirm earlier unpublished data obtained by Kidson17 • The temperature dependence of the diffusion coefficient is unusual and suggests that at least two and possibly three mechanisms may be operative Annealing of the specimen in the high B.C.C. region prior to the deposition of the tracer results in a large reduction in the diffusion coefficient. The possible significance of this effect is discussed in terms of rapid transport along dislocation network.

Development and/or change of the notion of permanent object and operative causality: empirical evidence in the first year of life

This study examines the notion of permanent object during the first year of life, taking into account the controversy of two approaches about the nature of change: developmental change and cognitive change. Using a longitudinal/cross-sectional design, tasks adapted of the subscale of permanent object and operative causality of the Uzgiris-Hunt Scale (Uzgiris and Hunt, 1975) (Uzgiris & Hunt, 1975) were presented to 110 infants of 0, 3, 6 and 9 months-old, which reside in three cities of Colombia. The results showed three types of strategies: (a) Not resolution; (b) Exploratory and (c) Resolution, which follow different trajectories in children’s performance. This allows affirming that adaptive conquests of the cognitive development stay together with the variety of strategies. Using strategies reveals adjustments and transformations of action programs that consolidate the notion of permanent object not necessarily with age, but with self-regulatory processes. Empirical evidence contributes to the understanding of the relations between the emergence of novelty in the development and performance variability

The pattern of fall of serum bilirubin after operative relief of obstructive jaundice. A preliminary report

This is the beginning of a prospective study on patients who have obstructive jaundice to see how the serum bilirubin falls after operative relief of the obstruction. Seven of such patients have been studied; four had carcinoma of the head of the pancreas while the other three had choledocholithiasis. The patients with carcinoma had relief of the jaundice through a biliary-enteric anastomosis and those with common bile duct stones had choledochotomy with stone extraction which was completed with insertion of a T-tube. Serial bilirubin estimations were then performed post-operatively to chart the pattern and rate of descent of this in each patient. Our observations suggest that the pattern of fall of serum bilirubin after successful decompression of the extra-hepatic biliary tree exhibit a distinct pattern regardless of the surgical procedure performed for the relief of the obstruction.

Disruption of the 2-methylcitric acid cycle and evaluation of poly-3-hydroxybutyrate-co-3-hydroxyvalerate biosynthesis suggest alternate catabolic pathways of propionate in Burkholderia sacchari

The objective of the present work was to evaluate the relevance of the 2-methylcitric acid cycle (2MCC) to the catabolism of propionate in Burkholderia sacchari. Two B. sacchari mutants unable to grow on propionate were obtained: one disrupted in acnM, and the other in acnM and prpC deleted. An operative 2MCC significantly reduces the bacterial ability to incorporate 3-hydroxyvalerate (3HV) into a biodegradable copolyester accumulated from carbohydrates plus propionate. The efficiency of the mutants in converting propionate to 3HV units (Y(3HV/prp)) increased from 0.09 g.g(-1) to 0.81-0.96 g.g(-1), indicating that acnM and prpC are both essential for growth on propionate. None of the mutations resulted in achievement of the maximum theoretical Y(3HV/prp) (1.35 g.g(-1)). When increasing concentrations of propionate were supplied, decreasing values of Y(3HV/prp) were observed. The results obtained corroborate the hypothesis of the presence of other propionate catabolic pathways in B. sacchari. The 2MCC would be the more operative pathway, but a second pathway, which remains to be elucidated, would assume more importance under propionate concentrations of 1 g.L(-1) or higher. The efficiency in converting propionate to 3HV units can be improved by decreasing the propionate concentrations, owing to the role of the 2MCC.

Lobectomia por carcinoma brônquico : análise das co-morbidades e o seu impacto na morbi-mortalidade pós-operatória

Objetivo: Analisar o impacto das co-morbidades no desempenho pós-operatório de lobectomia por carcinoma brônquico. Pacientes e Métodos: Entre Janeiro de 1998 e Dezembro de 2004, foram estudados retrospectivamente 493 pacientes submetidos à lobectomia por carcinoma brônquico, dentre os quais 305 preencheram os critérios de inclusão. Todos os pacientes foram submetidos à lobectomias com técnica cirúrgica semelhante. Foi realizada análise das co-morbidades de forma a categorizar os pacientes nas escalas de Torrington-Henderson (PORT) e de Charlson, estabelecendo-se assim grupos de risco para complicações e óbito. Resultados: a mortalidade operatória foi 2,9% e o índice de complicações de 44%. O escape aéreo prolongado foi a complicação mais freqüente (20.6%). A análise univariada mostrou que sexo, idade, tabagismo, terapia neoadjuvante e diabetes apresentaram impacto significativo na incidência de complicações. O índice de massa corporal (23,8 ± 4,4), o VEF1 (74,1±24%), bem como a relação VEF1/CVF (0,65 ± 0,1) foram fatores preditivos da ocorrência de complicações. Ambas as escalas de Charlson e PORT foram eficazes na identificação de grupos de risco e na relação com a morbi-mortalidade (p=0,001 e p<0,001). A análise multivariada identificou que o IMC e o índice de Charlson foram os principais determinantes de complicações, enquanto que o escape aéreo prolongado foi o principal fator envolvido na mortalidade (p=0,01). Conclusão: Valores reduzidos de VEF1, VEF1/CVF e IMC baixo, assim como graus 3-4 de Charlson, e 3 de PORT estão associados a maior número de complicações após lobectomias por carcinoma brônquico. Nesta amostra, o escape aéreo persistente esteve fortemente associado à mortalidade.

Fístula oronasal em cão: reparo com flape simples associado a fator proteíco angiogênico purificado do látex de seringueira, veiculado com matriz de esponja de colágeno : estudo experimental

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Co-localização de OPG e RANKL durante o processo de reparo alveolar em ratas ovariectomizadas tratadas com estrógeno ou com raloxifeno

Pós-graduação em Odontologia - FOA

Correlación entre diferentes métodos de evaluación de color en el clareamiento dental. Correlation between different methods for co

The aim of this study was to evaluate the correlation of color change on bleaching tooth through delta E (ΔE) by the spectrophotometer Spectroshade (SS) and digital program Scanwhite (SW). Methods: 25 patient volunteers were recruited from Operative Dentistry at Universidad de Chile Dental School, between 18 to 30 years, with good oral hygiene. Exclusion criteria: Previous experienced tooth bleaching, anterior restorations, cervical lesions, pain dental, pregnant patient, stained teeth, malposition of the teeth and periodontal pathology. The bleaching was made in two sessions with three different bleaching systems which were randomly. The assessment of color change through ΔE was made on the two upper central incisors (N=50) by the SS and SW. The color in the same teeth were measured before (T0) and after (T1) of the bleaching treatment. Data were analyzed using test Spearman correlation coefficient (Rho) with a significant level of 95%. Results: The results showed a positive and significant correlation (0.676), with a statistically significant difference (p<0.05). Conclusion: There is correlation in the measurement of color change on bleaching tooth by SS and SW.

Life Cycle Assessment comparativo tra il processo di co-digestione della frazione organica dei rifiuti solidi urbani e dei fanghi di depurazione disidratati e il sistema di gestione attuale. Il caso di Bagnacavallo (RA)

Waste management is becoming, year after year, always more important both for the costs associated with it and for the ever increasing volumes of waste generated. The discussion on the fate of organic fraction of municipal solid waste (OFMSW) leads everyday to new solutions. Many alternatives are proposed, ranging from incineration to composting passing through anaerobic digestion. “For Biogas” is a collaborative effort, between C.I.R.S.A. and R.E.S. cooperative, whose main goal is to generate “green” energy from both biowaste and sludge anaerobic co-digestion. Specifically, the project include a pilot plant receiving dewatered sludge from both urban and agro-industrial sewage (DS) and the organic fraction of MSW (in 2/1 ratio) which is digested in absence of oxygen to produce biogas and digestate. Biogas is piped to a co-generation system producing power and heat reused in the digestion process itself, making it independent from the national grid. Digestate undergoes a process of mechanical separation giving a liquid fraction, introduced in the treatment plant, and a solid fraction disposed in landfill (in future it will be further processed to obtain compost). This work analyzed and estimated the impacts generated by the pilot plant in its operative phase. Once the model was been characterized, on the basis of the CML2001 methodology, a comparison is made with the present scenario assumed for OFMSW and DS. Actual scenario treats separately the two fractions: the organic one is sent to a composting plant, while sludge is sent to landfill. Results show that the most significant difference between the two scenarios is in the GWP category as the project "For Biogas" is able to generate “zero emission” power and heat. It also generates a smaller volume of waste for disposal. In conclusion, the analysis evaluated the performance of two alternative methods of management of OFMSW and DS, highlighting that "For Biogas" project is to be preferred to the actual scenario.

Effiziente, operative Torbelegung mittels kombinatorischer Auktionen

Das operative Torbelegungsproblem (TBP) z. B. an einem Distributions- oder Cross-dockingzentrum ist ein logistisches Problem, bei dem es gilt, an- und abfahrende Fahrzeuge zeitlich und räumlich so auf die Warenein- und -ausgangstore zu verteilen, dass eine mög-lichst kostengünstige Abfertigung ermöglicht wird. Bisherige Arbeiten, die sich mit dem TBP beschäftigen, lassen Aspekte der Kooperation außer Acht. Dieser Beitrag stellt ein Verfahren vor, durch das der Nachteil einseitig optimaler Torbelegungen überwunden werden kann. Dabei wird auf das Mittel der kombinatorischen Auktionen zurückgegriffen und das TBP als Allokationsproblem modelliert, bei dem Frachtführer um Bündel konsekutiver Einheitszeit-intervalle an den Toren konkurrieren. Mittels eines Vickrey-Clarke-Groves-Mechanismus wird einerseits die Anreizkompatibilität, andererseits die individuelle Rationalität des Auk-tionsverfahrens sichergestellt. Das Verfahren wurde in ILOG OPL Studio 3.6.1 implemen-tiert und die durch Testdaten gewonnenen Ergebnisse zeigen, dass die Laufzeiten gering genug sind, um das Verfahren für die operative (kurzfristige) Planung einzusetzen und so transportlogistische Prozesse für alle Beteiligten wirtschaftlicher zu gestalten.

RADIANCE-A planning software for intra-operative radiation therapy

In the last decades accumulated clinical evidence has proven that intra-operative radiation therapy (IORT) is a very valuable technique. In spite of that, planning technology has not evolved since its conception, being outdated in comparison to current state of the art in other radiotherapy techniques and therefore slowing down the adoption of IORT. RADIANCE is an IORT planning system, CE and FDA certified, developed by a consortium of companies, hospitals and universities to overcome such technological backwardness. RADIANCE provides all basic radiotherapy planning tools which are specifically adapted to IORT. These include, but are not limited to image visualization, contouring, dose calculation algorithms-Pencil Beam (PB) and Monte Carlo (MC), DVH calculation and reporting. Other new tools, such as surgical simulation tools have been developed to deal with specific conditions of the technique. Planning with preoperative images (preplanning) has been evaluated and the validity of the system being proven in terms of documentation, treatment preparation, learning as well as improvement of surgeons/radiation oncologists (ROs) communication process. Preliminary studies on Navigation systems envisage benefits on how the specialist to accurately/safely apply the pre-plan into the treatment, updating the plan as needed. Improvements on the usability of this kind of systems and workflow are needed to make them more practical. Preliminary studies on Intraoperative imaging could provide an improved anatomy for the dose computation, comparing it with the previous pre-plan, although not all devices in the market provide good characteristics to do so. DICOM.RT standard, for radiotherapy information exchange, has been updated to cover IORT particularities and enabling the possibility of dose summation with external radiotherapy. The effect of this planning technology on the global risk of the IORT technique has been assessed and documented as part of a failure mode and effect analysis (FMEA). Having these technological innovations and their clinical evaluation (including risk analysis) we consider that RADIANCE is a very valuable tool to the specialist covering the demands from professional societies (AAPM, ICRU, EURATOM) for current radiotherapy procedures.

Operative surgery of the dog,

Mode of access: Internet.

Postoperative treatment; an epitome of the general management of poet-operative care and treatment of surgical cases as practised by prominent American and European surgeons.

Mode of access: Internet.

A manual of modern surgery: an exposition of the accepted doctrines and approved operative procedures of the present time ..

Mode of access: Internet.