Innovative Infrastructures for Sustainable Mobility in Urban Areas: Protective Asphalt to Prevent Vulnerable Road Users Injuries.

Nell’elaborato viene studiato il fenomeno dell’incidentalità singola delle utenze deboli sulla strada (perdita di controllo, scivolamento ecc..ecc..), con particolare enfasi nell’analizzare le conseguenze traumatiche dovute all’impatto con la superficie stradale. Una nuova tecnologia viene sviluppata per rendere le pavimentazioni di piste ciclabili, marciapiedi e zone pedonali con capacità di assorbimento degli impatti, prevenendo, o riducendo drasticamente, la probabilità e entità di eventi traumatici a seguito di una caduta. Attraverso una stesa di prova avvenuta ad Imola (BO), si sono analizzate e risolte le problematiche dovute alle discrepanze riscontrate fra “costruzione” in laboratorio e costruzione nella realtà urbana. La nuova tecnologia, infatti, è stata studiata come “construction-friendly”, permettendo alle società di costruzione e pavimentazione di stendere il nuovo manto protettivo con strumenti e macchinari tradizionali. Infine l’asfalto modificato è stato testato nei laboratori svedesi del KTH – Royal Institute of Technology per provarne l’efficacia in termini di assorbimento degli impatti. Nel “Drop Impact Test”, test specifico per l’approvazione dei caschi protettivi da bicicletta, l’asfalto modificato ha performato ben al di sotto della soglia di approvazione dei caschi da ciclista, e si colloca in un range di valore di accelerazione lineare perfino al di sotto della soglia di “Low Risk of Injuries”. La nuova tecnologia, inoltre, fa utilizzo di gomma granulata riciclata da pneumatici fuori uso. Tale dettaglio conferisce maggiore sostenibilità al progetto: oltre all’utilizzo di legante a freddo, che diminuisce le emissioni di CO2, e di incentivare l’utilizzo della mobilità dolce attraverso una più sicura rete infrastrutturale, l’utilizzo di gomma riciclata dà nuova vita al materiale che altrimenti andrebbe in discarica e prolunga, così, la vita utile del materiale.

Responsabilidades da equipe na saúde ocular

Este infográfico faz parte do curso de Oftalmologia na Atenção Básica à Saúde (2016) e tem como objetivo informar aos profissionais médicos da Saúde da Família ou da Unidade de Atenção Básica, sobre as responsabilidades da equipe na saúde ocular.

Procedimento de irrigação ocular

Este infográfico faz parte do curso de Oftalmologia na Atenção Básica à Saúde (2016) e tem como objetivo apresentar o procedimento para a realização de uma irrigação ocular.

Cuidados gerais na abordagem do trauma ocular

Este infográfico faz parte do curso de Oftalmologia na Atenção Básica à Saúde (2016) e tem como objetivo apresentar os cuidados gerais para realizar uma abordagem em caso de trauma ocular.

Curativo ocular não compressivo

Este vídeo integra o curso Oftalmologia na Atenção Básica à Saúde (2016). Apresenta as indicações e demonstra a técnica de oclusão ocular com curativo simples e com curativo não compressivo.

Irrigação ocular

Este vídeo integra o curso Oftalmologia na Atenção Básica à Saúde (2016) que tem o objetivo de ampliar a capacidade de resolução clínico-oftalmológica na Atenção Básica à saúde. O vídeo apresenta a técnica de irrigação ocular.

Acidentes por trauma ocular entre trabalhadores rurais

O presente trabalho tem como objetivo uma revisão da literatura sobre os acidentes com trauma ocular ocorrido em trabalhadores rurais, retatando, por meio de revisão de literatura, como são preveníveis estes tipos de acidente.

Trauma ocular

Esta webaula contempla as principais informações sobre o trauma ocular: Avaliação, tratamento e prognósticos.

Hepatic Involvement In Paediatric Patients With Paracoccidioidomycosis: A Histological Study.

Paracoccidioidomycosis is a systemic mycosis that is endemic to certain countries in Latin America. This study aimed to describe the histological features of liver involvement in patients with paracoccidioidomycosis aged <16 years of age who were treated between 1980 and 2010, with a diagnosis that was confirmed by detection of the fungus by pathological examination. Liver tissue was obtained from one necropsy and 12 biopsies. Throughout 2007, biopsies were taken from patients with persistent jaundice or portal hypertension, after which biopsies became indicated due to elevated aminotransferase and low albumin levels. Using haematoxylin and eosin (H&E), Masson's trichrome and immunohistochemical (CK7 and CK19) staining, we noted degenerative alterations in bile duct cells and inflammatory injury to the bile ducts in 10 biopsies. Using immunohistochemistry for CK7 and CK19, we observed ductal proliferation in all 12 samples. Bile duct injuries by inflammatory cells might explain the predominant increase in canalicular enzymes; immunohistochemistry is more sensitive in demonstrating ductular reactions and might show changes that are not apparent on H&E staining.

Low-density Lipoprotein Cholesterol And Radiotherapy-induced Carotid Atherosclerosis In Subjects With Head And Neck Cancer.

Radiotherapy (RT) is a risk factor for accelerated carotid artery atherosclerotic disease in subjects with head and neck cancer. However, the risk factors of RT-induced carotid artery remodeling are not established. This study aimed to investigate the effects of RT on carotid and popliteal arteries in subjects with head and neck cancer and to evaluate the relationship between baseline clinical and laboratory features and the progression of RT-induced atherosclerosis. Eleven men (age = 57.9 ± 6.2years) with head and neck cancer who underwent cervical bilateral irradiation were prospectively examined by clinical and laboratory analysis and by carotid and popliteal ultrasound before and after treatment (mean interval between the end of RT and the post-RT assessment = 181 ± 47 days). No studied subject used hypocholesterolemic medications. Significant increases in carotid intima-media thickness (IMT) (0.95 ± 0.08 vs. 0.87 ± 0.05 mm; p < 0.0001) and carotid IMT/diameter ratio (0.138 ± 0.013 vs. 0.129 ± 0.014; p = 0.001) were observed after RT, while no changes in popliteal structural features were detected. In addition, baseline low-density lipoprotein cholesterol levels showed a direct correlation with RT-induced carotid IMT change (r = 0.66; p = 0.027), while no other studied variable exhibited a significant relationship with carotid IMT change. These results indicate that RT-induced atherosclerosis is limited to the irradiated area and also suggest that it may be predicted by low-density lipoprotein cholesterol levels in subjects with head and neck cancer.

Cervical Spine Involvement In Rheumatoid Arthritis--a Systematic Review.

Rheumatoid arthritis (RA) is a systemic chronic inflammatory disorder that can compromise the cervical spine in up to 80% of the cases. The most common radiological presentations of cervical involvement are atlantoaxial subluxation (AAS), cranial settling and subaxial subluxation (SAS). We performed a systematic review in the PubMed Database of articles published later 2005 to evaluate the prevalence, progression and risk factors for cervical spine involvement in RA patients. Articles were classified according to their level of evidence. Our literature review reported a wide range in the prevalence of cervical spine disease, probably explained by the different studied populations and disease characteristics. Uncontrolled RA is probably the main risk factor for developing a spinal instability. Adequate treatment with DMARD and BA can prevent development of cervical instabilities but did not avoid progression of a pre-existing injury. MRI is the best radiological method for diagnosis cervical spine involvement. AAS is the most common form of RA. Long term radiological follow-up is necessary to diagnosis patients with late instabilities and monitoring progression of diagnosed injuries.

Management Of Severe Thoracic Impalement Trauma Against Two-wheeled Horse Carriage: A Case Report And Literature Review.

Thoracic injuries in general are of great importance due to their high incidence and high mortality. Thoracic impalement injuries are rare but severe due to the combination of cause, effect and result. This study's primary objective is to report the case of a young man who was impaled by a two-wheeled horse carriage shaft while crashing his motorcycle in a rural zone. An EMT-B ferry was called at the crash scene and a conscious patient was found, sustaining a severe impalement injury to the left hemithorax, suspended over the floor by the axial skeleton with the carriage shaft coming across his left chest. As a secondary objective, a literature review of thoracic impalement injuries is performed. Cases of thoracic impalement injury require unique and individualized care based on injury severity and affected organs. Reported protocols for managing impalement injuries are entirely anecdotal, with no uniformity on impaled patient's approach and management. In penetrating trauma, it is essential not to remove the impaled object, so that possible vascular lesions remain buffered by the object, avoiding major bleeding and exsanguination haemorrhage. Severed impaled thoracic patients should be transferred to a specialist centre for trauma care, as these lesions typically require complex multidisciplinary treatment. High-energy thoracic impalement injuries are rare and hold a high mortality rate, due to the complexity of trauma and associated injuries such as thoracic wall and lung lesions. Modern medicine still seems limited in cases of such seriousness, not always with satisfactory results.

Influence Of Cyclosporine On The Occurrence Of Nephrotoxicity After Allogeneic Hematopoietic Stem Cell Transplantation: A Systematic Review.

Cyclosporine, a drug used in immunosuppression protocols for hematopoietic stem cell transplantation that has a narrow therapeutic index, may cause various adverse reactions, including nephrotoxicity. This has a direct clinical impact on the patient. This study aims to summarize available evidence in the scientific literature on the use of cyclosporine in respect to its risk factor for the development of nephrotoxicity in patients submitted to hematopoietic stem cell transplantation. A systematic review was made with the following electronic databases: PubMed, Web of Science, Embase, Scopus, CINAHL, LILACS, SciELO and Cochrane BVS. The keywords used were: bone marrow transplantation OR stem cell transplantation OR grafting, bone marrow AND cyclosporine OR cyclosporin OR risk factors AND acute kidney injury OR acute kidney injuries OR acute renal failure OR acute renal failures OR nephrotoxicity. The level of scientific evidence of the studies was classified according to the Oxford Centre for Evidence Based Medicine. The final sample was composed of 19 studies, most of which (89.5%) had an observational design, evidence level 2B and pointed to an incidence of nephrotoxicity above 30%. The available evidence, considered as good quality and appropriate for the analyzed event, indicates that cyclosporine represents a risk factor for the occurrence of nephrotoxicity, particularly when combined with amphotericin B or aminoglycosides, agents commonly used in hematopoietic stem cell transplantation recipients.

Applications Of Visual Evoked Potentials And Fourier-domain Optical Coherence Tomography In Parkinson's Disease: A Controlled Study.

The goal of this cross-sectional observational study was to quantify the pattern-shift visual evoked potentials (VEP) and the thickness as well as the volume of retinal layers using optical coherence tomography (OCT) across a cohort of Parkinson's disease (PD) patients and age-matched controls. Forty-three PD patients and 38 controls were enrolled. All participants underwent a detailed neurological and ophthalmologic evaluation. Idiopathic PD cases were included. Cases with glaucoma or increased intra-ocular pressure were excluded. Patients were assessed by VEP and high-resolution Fourier-domain OCT, which quantified the inner and outer thicknesses of the retinal layers. VEP latencies and the thicknesses of the retinal layers were the main outcome measures. The mean age, with standard deviation (SD), of the PD patients and controls were 63.1 (7.5) and 62.4 (7.2) years, respectively. The patients were predominantly in the initial Hoehn-Yahr (HY) disease stages (34.8% in stage 1 or 1.5, and 55.8 % in stage 2). The VEP latencies and the thicknesses as well as the volumes of the retinal inner and outer layers of the groups were similar. A negative correlation between the retinal thickness and the age was noted in both groups. The thickness of the retinal nerve fibre layer (RNFL) was 102.7 μm in PD patients vs. 104.2 μm in controls. The thicknesses of retinal layers, VEP, and RNFL of PD patients were similar to those of the controls. Despite the use of a representative cohort of PD patients and high-resolution OCT in this study, further studies are required to establish the validity of using OCT and VEP measurements as the anatomic and functional biomarkers for the evaluation of retinal and visual pathways in PD patients.