973 resultados para pediatric orthopedic surgery


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

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We assessed the effect of the topical application of epsilon-aminocaproic antifibrinolytic acid (EACA) on the pericardium of patients submitted to coronary artery bypass graft (CABG) without the use of cardiopulmonary bypass (CPB). This is a prospective, randomized, and double-blind study. We evaluated 26 patients with chronic coronary heart disease indicated for CABG without CPB (EACA and placebo groups). The analysis of the postoperative hematological results showed no difference between groups in hemoglobin and hematocrit. There was no difference between the groups regarding the postoperative bleeding through the drains in the first 24 hours, 48 hours, and accumulated loss until removal of drains. The use of EACA in patients undergoing CABG without CPB presented no difference in the reduction of the amount of bleeding and the need for blood transfusions.

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Background: Rheumatic diseases in children are associated with significant morbidity and poor health-related quality of life (HRQOL). There is no health-related quality of life (HRQOL) scale available specifically for children with less common rheumatic diseases. These diseases share several features with systemic lupus erythematosus (SLE) such as their chronic episodic nature, multi-systemic involvement, and the need for immunosuppressive medications. HRQOL scale developed for pediatric SLE will likely be applicable to children with systemic inflammatory diseases.Findings: We adapted Simple Measure of Impact of Lupus Erythematosus in Youngsters (SMILEY (c)) to Simple Measure of Impact of Illness in Youngsters (SMILY (c)-Illness) and had it reviewed by pediatric rheumatologists for its appropriateness and cultural suitability. We tested SMILY (c)-Illness in patients with inflammatory rheumatic diseases and then translated it into 28 languages. Nineteen children (79% female, n= 15) and 17 parents participated. The mean age was 12 +/- 4 years, with median disease duration of 21 months (1-172 months). We translated SMILY (c)-Illness into the following 28 languages: Danish, Dutch, French (France), English (UK), German (Germany), German (Austria), German (Switzerland), Hebrew, Italian, Portuguese (Brazil), Slovene, Spanish (USA and Puerto Rico), Spanish (Spain), Spanish (Argentina), Spanish (Mexico), Spanish (Venezuela), Turkish, Afrikaans, Arabic (Saudi Arabia), Arabic (Egypt), Czech, Greek, Hindi, Hungarian, Japanese, Romanian, Serbian and Xhosa.Conclusion: SMILY (c)-Illness is a brief, easy to administer and score HRQOL scale for children with systemic rheumatic diseases. It is suitable for use across different age groups and literacy levels. SMILY (c)-Illness with its available translations may be used as useful adjuncts to clinical practice and research.

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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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With the advent of high frequency transducers, the use of ocular ultrasound has become widely used because it provides definitions of major ocular structures. This diagnostic tool is useful in the evaluation of ophthalmic injuries, and also used for qualitative and quantitative evaluation of intraocular and orbital lesions. It is a noninvasive, safe and fast, easy to use and can be performed in an awake animal. The ocular ultrasonography is indicated in cases of ocular opacity, when the ophthalmic examination cannot be done, and in eyes with ocular trauma or suspected orbital disease. Ultrasound biomicroscopy (UBM) is a diagnostic tool with high cost and sedation or general anesthesia is necessary, but has the advantage of evaluating structures poorly defined or visualized in the anterior segment of the eye. Therefore, this paper aims to show the importance of ocular ultrasonography and UBM to veterinary practitioners, and to demonstrate its advantages and indications in ophthalmic routine.

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The present work aims to study the microstructure and mechanical properties of titanium alloys, widely used in the manufacture of orthopedic implants in order to compare a new manufacturing technology of implants, rapid prototyping in metals with conventional manufacturing processes. Rapid prototyping is being used in many areas of human knowledge to assist in the study and often in the manufacture of components for their own use. Nowadays with the advancement of software and equipment such as computed tomography and magnetic resonance imaging, we can reproduce any part of the human body in three-dimensional images with great perfection and it is used in the reproduction of implants, scaffolds, material aid and preparation in surgery. This work aims to do: A comparison between the microstructure of the alloy in the two manufacturing processes (prototyping and conventional), showing the grain size, the nature, form, quantity, and distribution of various ingredients or certain inclusions and study of mechanical properties of titanium in both cases.

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Aims mid background: We studied, retrospectively, 33 cases of adrenal tumors of children at the Pediatric Endocrinology Unit, Children's Institute, Sao Paulo State University Medical School, from 1975 to 1993. Ail patients had at least 2 years of follow-up with a few exceptions. Methods: Clinical follow-up data were correlated with histopathologic review, laboratory data and cell kinetic evaluation (based on detection of proliferating cell nuclear antigens). Results: With one exception, all the patients had presented signs of androgen production and had high levels of dehydro-epiandrosterone-sulfate. Tumor weight evaluation represented a good parameter of neoplasm evolution: of 19 cases weighing less than 250 g, 17 had no evidence of disease after surgery, and 2 had an unfavorable prognosis. Of 14 cases weighing more than 250 g, only 1 had no evidence of disease and 13 had an unfavorable evolution. Conclusions: Proliferating cell nuclear antigen (PCNA) was not helpful to evaluate adrenal neoplasm evolution: our study did not show any correlation between PCNA score and prognosis.

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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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Hypothermia is a common phenomenon in the perioperative period, and it affects 60 to 90% of patients submitted to anesthetic-surgical procedures. In order to minimize its incidence, warming methods are used. Such methods can be passive, such as orthopedic cotton, sheets and blankets, or active, such as warm-air blankets and thermal mattresses. In this scenario, the present study aimed at comparing two warming methods used in the intraoperative period. Patients submitted to abdominal surgery in the specialties of gynecology and gastric surgery from August to September 2010 were included in the study. After randomization, they were divided into two groups: one using a thermal blanket (group I) and one using orthopedic cotton (group II). At last, 9 patients were included. The variables for each question were considered according to occurrence frequency. Comparison between groups was performed by Student’s t test. With the purpose to analyze whether there was an association, the chi-square test or Fisher’s Exact test was used. Whenever it was applicable for multiple comparisons, Tukey’s test was utilized; p values < 0.05 were considered to be statistically significant for analysis. The sample comprised 6 males and 3 females submitted to gynecological and gastric surgeries. Their mean age was 48 years for group I and 46.2 years for group II. A predominance of general anesthesia was observed. The time of permanence in the operating room ranged from 80 to 360 minutes. With regard to warming parenteral solutions, the procedure was performed on 5 patients, and infusion of warm solution into the abdominal cavity was performed on 50% of the sample. Concerning the warming method used, 5 patients used a thermal blanket. In view of the results presented, it was not possible to conclude which warming method should be used due to sample size

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Several body fluids have been evaluated as new sources for cancer biomarker discovery. In this context, salivary and serum proteomics seem promising diagnostic and predictive tools for head and neck diseases. In the present study, we performed a proteomic analysis of saliva and serum from patients presenting head and neck squamous cell carcinoma (HNSCC) and compared the results before and after therapy. In saliva of cancer patients, we observed an altered protein profile, including over-expression of PLUNC and zinc-alpha-2-glycoprotein. Both proteins may contribute to control tumor growth and, therefore, represent targets for new analysis. We also detected serotransferrin and a modified transthyretin form with altered levels in serum from patients. Comparing preoperative and postreatment samples, the results showed that the protein profile after treatment reverted to a pattern closer to those observed for controls. These results add information on the role of secreted proteins in the cancer process and emphasize the potential of saliva and serum analysis for diagnosis and monitoring of HNSCC.

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Pós-graduação em Engenharia Mecânica - FEG

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Enamel microabrasion is a non-invasive method that removes intrinsic and superficial defects from teeth aimed to improve dental esthetic with minimal loss of dental tissue. This case presentation describes the attempt for teeth color correction utilizing that conservative technique in a young girl whose upper central incisor presented an opaque white stain. Scanning electron microscopy (SEM) was conducted in order to illustrate the glasslike luster and a smooth texture of microabraded enamel surface. The correct diagnosis of defect is a difficult task, when consider this conservative approach.