648 resultados para segmental mastectomy


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Pós-graduação em Anestesiologia - FMB

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Pós-graduação em Ciências da Motricidade - IBRC

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The present study investigated the benefits of tumescent anesthesia with lidocaine in dogs undergoing mastectomy, seeking the patients' comfort and their postoperative recovery. Seven animals, with different weight and breed, who had cancer in the region of mammary chain underwent mastectomy surgery. All animals received the same anesthetic protocol being used as the association between acepromazine and morphine doses of 0.04mg.kg-1 and 0.4mg.kg-1 (IM), respectively. After 15 minutes a catheter was placed in the cephalic vein and induction with propofol 4mg.kg-1 and 0.2mg.kg-1 followed by maintenance with isoflurane anesthesia was done. After instrumentation, we proceeded to the tumescent anesthesia technique with ice-cold solution consisting of Ringer's lactate, lidocaine 2% without epinephrine and adrenaline in a total volume of 15mL.kg-1. The average duration of the procedure was 74±18 minutes. The plasmatic peak of lidocaine was between 30 and 60 minutes after infiltration. The rescue analgesic was performed after approximately seven hours of infiltration. It can be concluded that the tumescent anesthesia with lidocaine should be considered as a constituent of anesthetic and analgesic protocol in dogs undergoing mastectomy surgery providing parameter stability, safety and good quality postoperative recovery.

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A segmental defect of 6mm diameter was performed in the medial metaphyseal region of the tibia of 12 rabbits. For the bone defect reconstruction there was implanted a combination of micro and macro fragments of heterologous fragmented cortical bone matrix preserved in glycerin (98%) and polymethylmethacrylate, both autoclaved. Radiological and macroscopic evaluation was performed at 30, 60, 90 and 120 days. Adhesion in relation to time of the micro and macro composites to the recipient bed was observed in 100% of the cases. This showed that this implant is biologically biocompatible, since it promoted bone defects repair, with no signs of infection, migration and/or rejection. In this way, this implant can be classified as one more option of substitute to fill large bone defects.

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INTRODUCTION: The relationship between the orientation of the segments and the adjustments that can be triggered by shoe lift and insoles in scoliotic patients during maintenance of standing position is unclear. OBJECTIVE: To verify static changes and those associated with unilateral manipulations of shoe lift in the postural orientation in people with idiopathic scoliosis. MATERIALS AND METHODS: Experimental group composed of ten patients with idiopathic scoliosis with double curve (less 10°) and control group with ten participants without scoliosis (aging from 13 to 24 years). Participants were videotaped in upright stance, standing with no, low (1 cm), and high (3 cm) shoe lift, which were placed under right and left shoe. In each condition, the participant maintain upright stance for 15 seconds and reflective markers were affixed on specific anatomical places. Postural angles were obtained: high thoracic; medium thoracic; thoracolumbar; and lumbar, as well segmental angles: shoulder; scapula; pelvis; and knee. RESULTS: In the no shoe lift condition, differences were observed between groups for high and medium thoracic angles and for shoulder. With low and high shoe lift under the right foot, difference was observed between shoe lift heights for high thoracic, for pelvis and knee angles. With low and high shoe lift under the left foot, differences between groups were observed for thoracolumbar angle and between shoe lift heights for pelvis and knee angles. CONCLUSIONS: The shoe lift promotes reorientation in the lower regions of the spine and segments of pelvis and knee. It might be suggested that in the scoliosis with double curves, manipulation in the basis of support changes the alignment of the trunk that might promote structural reorganization and the search of new adjustments among segments in individuals with idiopathic scoliosis.

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

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Autologous fat graft to the breast is a useful tool to correct defects after breast conservative treatment (BCT). Although this procedure gains popularity, little is known about the interaction between the fat graft and the prior oncological environment. Evidences of safety of this procedure in healthy breast and after post-mastectomy reconstruction exist. However, there is paucity of data among patients who underwent BCT which are hypothetically under a higher risk of local recurrence (LR). Fifty-nine patients, with prior BCT, underwent 75 autologous fat graft procedures using the Coleman's technique, between October 2005 and July 2008. Follow-up was made by clinical and radiologic examination at least once, after 6 months of the procedure. Mean age was 50 +/- 8.5 years, and mean follow-up was 34.4 +/- 15.3months. Mean time from oncological surgery to the first fat grafting procedure was 76.6 +/- 30.9months. Most of patients were at initial stage 0 (11.8%), I (33.8%), or IIA (23.7%). Immediate complication was observed in three cases (4%). Only three cases of true LR (4%) associated with the procedure were observed during the follow-up. Abnormal breast images were present in 20% of the postoperative mammograms, and in 8% of the cases, biopsy was warranted. Autologous fat graft is a safe procedure to correct breast defects after BCT, with low postoperative complications. Although it was not associated with increased risk of LR in the group of patients studied, prospective trials are needed to certify that it does not interfere in patient's oncological prognosis.

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Background: Although the effect of symptomatic back pain on functional movement has been investigated, changes to spinal movement patterns in essentially pain-free people with a history of recurrent back pain are largely unreported. Reaching activities, important for everyday and occupational function, often present problems to such people, but have not been considered in this population. The purpose of this study was to compare the amplitude and timing of spinal and hip motions during two, seated reaching activities in people with and without a history of recurrent low back pain (RLBP).Methods: Spinal and hip motions during reaching downward and across the body, in both directions, were tracked using electromagnetic sensors. Analyses were conducted to explore the amplitudes, velocities and timings of 3D segmental movements and to compare controls with subjects with recurrent, but asymptomatic lumbar or lumbosacral pain.Findings: We detected significant differences in the amplitude and timing of movement in the lower thoracic region, with the RLBP group restricting movement and demonstrating compensatory increased motion at the hip. The lumbar region displayed no significant between-group differences. The order in which the spinal segments achieved peak velocity in cross-reaching was reversed in RLBP compared to controls, with lumbar motion leading in controls and lagging in RLBP.Interpretation: Subjects with a history of RLBP show a number of altered kinematic features during reaching activities which are not related to the presence or intensity of pain, but which suggest adaptive changes to movement control. (C) 2013 Elsevier Ltd. All rights reserved.

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Pós-graduação em Medicina Veterinária - FMVZ

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

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

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The test system connection segmental blocks and geogrids at the Department of Civil Engineering, UNESP - Guaratinguetá order to verify the strength of the connection system when subjected to different confining stresses. The present work aims to demonstrate the procedures for carrying out the test as well as the placement of concrete blocks. Were analyzed two ways of placing the blocks in the press. An entire block and two halves in the first layer, named position 12, compared to a different format, two entire blocks in the first layer, named position 21; also geogrids: single and double layer. From the data obtained for the peak strength of 20 tests it was possible to obtain the envelopes break in the connection for single and double layer. In 2011, the size of the concrete block used in the test was lower when compared with previous years. What resulted in significant decreases in the loss of connection in single layer and it was noted that there was no decrease in the strength of connection in the double-layer tests, despite the smaller area of contact between the block and geogrid. It is concluded that, through the analysis of geogrids after running the test, the concrete block is responsible for theforce that allows the movement of the geogrid due to the force from the ground

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Introduction: Loss of muscle strength may represent a burden on everyday tasks significantly compromising the quality of life for mastectomy patients. In addition to the reduced strength of the upper limb, has been shown in mastectomy patients and difficulties in reducing grip. Objectives: To analyze the possible differences in grip strength among women undergoing breast cancer surgery and to compare the body composition. Methods: In the control group (CG n = 46) women participated in the community of FCT / UNESP aged 35 to 70 years without acute orthopedic pathologies. In the experimental group (EG n = 49) participated in women undergoing surgery for breast cancer, without bilateral lymphedema and independent of time and type of surgery. Were evaluated by dynamometer, by Dual Energy X-ray absorptiometry (DEXA) and physical assessment. Results: We observed significant differences in grip strength (p = 0.000), when the group after mastectomy compared with the control group and the radical mastectomy surgery left and quandrandectomia left (p = 0.004). Regarding the presence of lymphedema, statistical difference was observed in the composition of lean mass and trunk fat (p = 0.05). Conclusion: The results of this study suggest that the experimental group are lower grip strength and trunk lean body mass when compared with the control group. The experimental group showed higher values of fat mass when there was presence of lymphedema

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Este trabalho tem por objetivo discutir os erros de pronúncia mais comuns cometidos pelos aprendizes de língua inglesa no nível segmental. Pretendemos ilustrar como isso ocorre dentro da sala de aula de uma escola de idiomas, a Wizard de Araraquara. Neste trabalho apresentaremos dados obtidos ao longo de uma observação contínua de quatro anos em salas de aula, e analisaremos os dados, comparando sempre as duas línguas, o inglês americano e o português brasileiro, tentando entender porque tais equívocos ocorrem e como o professor, através da conscientização dos alunos para a fonética, pode evitá-los e até saná-los. A análise dos dados mostra que não só os alunos têm dificuldades em produzir e compreender sons que são específicos do inglês, mas que professores também não o conseguem em muitos casos, e que muitos desses professores não tem a preparação adequada para ensinar a linguagem oral, e consequentemente, a pronúncia

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During the retaining wall project in soil reinforced with geogrids and face milling system for segmental blocks is essential to determine the maximum connection resistance between the block and the geogrid. Thus, the aim of this study was to analyze the connection resistance based on ASTM D- 6638-01 between the segmental block model MW of Muros Terrae® company with the geogrids model Fortrac® M 35 / 20x20, Fortrac® M 55 / 30x20, Fortrac® M 80 / 30x20 and Fortrac® M 110 / 30x20 of HUESKER Synthetic GmbH using gravel 1 as a filling material. As a result, the resistance curves were obtained for the four models of geogrids and was described how it fracture. An additional investigation was the average gain connection resistance percentage when it is applied to geogrid a second layer instead of a single layer. The average percentage gains in the connection resistance to the geogrids model Fortrac® M 35 / 20x20, Fortrac® M 55 / 30x20, Fortrac® M 80 / 30x20 and Fortrac® M 110 / 30x20 were, respectively, 63.20 %, 63, 47%, 62.23 % and 51.34 %. Finally, we made a comparative analysis of the results of this study with those obtained by Guimarães (2006), Urashima et. al (2008) and Almeida and Toma (2011) to evaluate which combinations offered higher connection resistance