Bone turnover markers for early detection of fracture healing disturbances: A review of the scientific literature

Imaging techniques are the standard method for assessment of fracture healing processes. However, these methods are perhaps not entirely reliable for early detection of complications, the most frequent of these being delayed union and non-union. A prompt diagnosis of such disorders could prevent prolonged patient distress and disability. Efforts should be directed towards the development of new technologies for improving accuracy in diagnosing complications following bone fractures. The variation in the levels of bone turnover markers (BTMs) have been assessed with regard to there ability to predict impaired fracture healing at an early stage, nevertheless the conclusions of some studies are not consensual. In this article the authors have revised the potential of BTMs as early predictors of prognosis in adult patients presenting traumatic bone fractures but who did not suffer from osteopenia or postmenopausal osteoporosis. The available information from the different studies performed in this field was systematized in order to highlight the most promising BTMs for the assessment of fracture healing outcome.

A influência dos blogues de beleza no processo de tomada de decisão das consumidoras

Dissertação de mestrado em Marketing e Estratégia

Os novos desafios do direito tributário: em particular, a tributação do jogo online

Dissertação de mestrado em Direito Tributário e Fiscal

Psychometric properties of assessment instruments for autism spectrum disorder: a systematic review of Brazilian studies

Objective To systematically review the scientific literature on the psychometric properties of international instruments for the assessment of autism spectrum disorder (ASD) in the Brazilian population. Methods A search of bibliographic references was conducted in six electronic databases: PsycINFO, PubMed, IndexPsi, Lilacs, Capes (theses and dissertations) and SciELO. The studies were selected by two independent researchers. Results The procedure identified 11 studies of the Brazilian population that encompassed six ASD assessment tools. Given the information provided, the adaptation of the M-CHAT, a screening instrument, was the best conducted. All steps of the adaptation process were described and the changes made to the final version of the instrument were presented, which was not addressed in other studies. In terms of reliability, all of the instruments that assessed internal consistency showed adequate values. In addition, the ADI-R and the CARS adaptations also satisfactorily contemplated inter-rater reliability and test-retest indices, respectively. Finally, all studies aiming to validate instruments showed evidence of validity and sensitivity, and specificity values above 0.90 were observed in the ASQ, ADI-R and ABC. Conclusion Considering both the psychometric aspects and the copyright information, the screening instrument that currently appears to be best indicated for clinical and research use is the M-CHAT. It was also noticed that there are still no specific ASD diagnostic tools available for use in Brazil. This lack of diagnostic instruments consists in a critical situation for the improvement of clinical practice and the development of research in this area.

Body Mass Index: A Scientific Evidence-Based Inquiry

OBJECTVE: To objectively and critically assess body mass index and to propose alternatives for relating body weight and height that are evidence-based and that eliminate or reduce the limitations of the body mass index. METHODS: To analyze the relations involving weight and height, we used 2 databases as follows: 1) children and adolescents from Brazil, the United States, and Switzerland; and 2) 538 university students. We performed mathematical simulations with height data ranging from 115 to 190 cm and weight data ranging from 25 to 105 kg. We selected 3 methods to analyze the relation of weight and height as follows: body mass index - weight (kg)/height (m²); reciprocal of the ponderal index - height (cm)/weight1/3 (kg); and ectomorphy. Using the normal range from 20 to 25 kg/m² for the body mass index in the reference height of 170 cm, we identified the corresponding ranges of 41 to 44 cm/kg1/3 for the reciprocal of the ponderal index, and of 1.45 to 3.60 for ectomorphy. RESULTS: The mathematical simulations showed a strong association among the 3 methods with an absolute concordance to a height of 170 cm, but with a tendency towards discrepancy in the normal ranges, which had already been observed for the heights of 165 and 175 cm. This made the direct convertibility between the indices unfeasible. The reciprocal of the ponderal index and ectomorphy with their cut points comprised a larger age range in children and adolescents and a wider and more central range in the university students, both for the reported (current) and desired weights. CONCLUSION: The reciprocal of the ponderal index and ectomorphy are stronger and are more mathematically logical than body mass index; in addition, they may be applied with the same cut points for normal from the age of 5 ½ years on.

The illustrated dictionary of gardening :a practical and scientific encyclopædia of horticulture for gardeners and botanists /edited by George Nicholson ; assisted by J.W.H. Trail ... and J. Garrett ...

v. 1

The illustrated dictionary of gardening :a practical and scientific encyclopædia of horticulture for gardeners and botanists /edited by George Nicholson ; assisted by J.W.H. Trail ... and J. Garrett ...

v. 2

The illustrated dictionary of gardening :a practical and scientific encyclopædia of horticulture for gardeners and botanists /edited by George Nicholson ; assisted by J.W.H. Trail ... and J. Garrett ...

v. 3

The illustrated dictionary of gardening :a practical and scientific encyclopædia of horticulture for gardeners and botanists /edited by George Nicholson ; assisted by J.W.H. Trail ... and J. Garrett ...

v. 4

The illustrated dictionary of gardening :a practical and scientific encyclopædia of horticulture for gardeners and botanists /edited by George Nicholson ; assisted by J.W.H. Trail ... and J. Garrett ...

v. 5

The illustrated dictionary of gardening :a practical and scientific encyclopædia of horticulture for gardeners and botanists /edited by George Nicholson ; assisted by J.W.H. Trail ... and J. Garrett ...

v. 6

The illustrated dictionary of gardening :a practical and scientific encyclopædia of horticulture for gardeners and botanists /edited by George Nicholson ; assisted by J.W.H. Trail ... and J. Garrett ...

v. 7

The illustrated dictionary of gardening :a practical and scientific encyclopædia of horticulture for gardeners and botanists /edited by George Nicholson ; assisted by J.W.H. Trail ... and J. Garrett ...

v. 8

The illustrated dictionary of gardening :a practical and scientific encyclopædia of horticulture for gardeners and botanists /edited by George Nicholson ; assisted by J.W.H. Trail ... and J. Garrett ...

v. 9

Report on the scientific results of the voyage of H.M.S. Challenger during the years 1873-76 under the command of Captain George S. Nares ... and the late Captain Frank Tourle Thomson, R.N.

Botany v.2=pt.4 (1886)