914 resultados para Ressecção anterior do recto


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Purpose: To describe the evolution of retinal thickness in eyes affected with acute anterior uveitis (AAU) in the course of follow-up and to assess its correlation with severity of inflammatory activity in the anterior chamber. Methods: Design: Prospective, cohort study Setting: Institutional study Patient population: 72 eyes (affected and fellow eyes) of 36 patients Observation procedure: Patients were followed daily until beginning of resolution of inflammatory activity and weekly thereafter. Optical coherence tomography and laser flare photometry were performed at each visit. Treatment consisted of topical corticosteroids Main outcome measures: Retinal thickness of affected eyes, difference in retinal thickness between affected and fellow eyes and their evolution in time, association between maximal retinal thickness and initial laser flare photometry. Results: Difference in retinal thickness between affected and fellow eyes became significant on average seven days from baseline and remained so through-out follow-up (p<0.001). There was a steep increase in retinal thickness of affected eyes followed by a progressive decrease after reaching a peak value. Maximal difference in retinal thickness between affected and fellow eyes was observed between 17 and 25 days from baseline and exhibited a strong, positive correlation with initial laser flare photometry values (p=0.015). Conclusions: Retinal thickness in eyes affected with AAU presents a steep increase over 3 to 4 weeks and then gradually decreases. Severity of inflammation at baseline predicts the amount of retinal thickening in affected eyes. A characteristic pattern of temporal response of retinal anatomy to inflammatory stimuli seems to arise.

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The interfilament spacing of the anterior byssus retractor muscle from Mytilus edulis was studied as the muscle was extended. It was found that variations in this spacing were very small and consistent with the hypothesis that the interfilament spacing was independent of the extension of the muscle. It was observed that the interfilament spacing was dependent on the osmolarity of the bathing medium. In concentrated solutions of the artificial seawater, the interfilament spacing decreased; while in dilute solutions of artificial seawater, it was observed that the interfilament spacing was increasing. X-ray diffraction patterns were obtained from fresh, and glutaraldehyde fixed, specimens of insect flight muscle from Sarcophaga bullata. There patterns were in general agreement with previous X-ray diffraction studies of insect flight muscle. A reflexion G at 93A was observed and interpreted as arising from diffraction in the mitochondria. Specimens of dried insect flight muscle produced a diffraction pattern consisting of arc and ring reflexions. This was interpreted as suggesting an ordered arrangement of cristae, in the mitochondria from these muscles.

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With repeated activity, force production, rate of force production, and relaxation time are impaired. These are characteristics ofa fatigued muscle (Vandenboom, 2004). However, brief bouts of near maximal to maximal activity results in the increased ability of the muscle to generate force, termed post activation potentiation (P AP)(V andervoort et aI., 1983). The purpose of the present study was to characterize motor unit firing rate (MUFR) in the unfatigued, potentiated tibialis anterior (TA). Using a quadrifilar needle electrode, MUFR was measured during a 5s 50% MVC in which the TA was either potentiated or unpotentiated; monopolar electrodes measured surface parameters. A lOs MVC was used to potentiate the muscle. Firing rate decreased significantly from 20.15±2.9Opps to 18.27±2.99pps, while mean power frequency decreased significantly from 60. 13±7.75 Hz to 53.62±8.56 Hz. No change in root mean square (RMS) was observed. Therefore, in the present study, MUFR decreases in response to a potentiated TA.

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This document could not have been completed without the hard work of a number of individuals. First and foremost, my supervisor, Dr. David Gabriel deserves the utmost recognition for the immense effort and time spent guiding the production of this document through the various stages of completion. Also, aiding in the data collection, technical support, and general thought processing were Lab Technician Greig Inglis and fellow members of the Electromyographic Kinesiology Laboratory Jon Howard, Sean Lenhardt, Lara Robbins, and Corrine Davies-Schinkel. The input of Drs. Ted Clancy, Phil Sullivan and external examiner Dr. Anita Christie, all members ofthe assessment committee, was incredibly important and vital to the completion of this work. Their expertise provided a strong source of knowledge and went to ensure that this project was completed at exemplary level. There were a number of other individuals who were an immense help in getting this project off the ground and completed. The donation of their time and efforts was very generous and much needed in order to fulfill the requirements needed for completion of this study. Finally, I cannot exclude the contributions of my family throughout this project especially that of my parents whose support never wavers.

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Tesis ( Maestría en Ciencias Odontológicas con Especialidad en Ortodoncia) U.A.N.L.

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Desarrollo y redacción de una guía basada en la mejor evidencia disponible sobre el diagnóstico y manejo de la ruptura aguda del ligamento cruzado anterior (LCA) para asistir a la toma de decisiones para controlar la variabilidad en los procesos clínicos de diagnóstico y manejo de dicha patología. Se definió el grupo de desarrollo de la guía (GDG) y de acuerdo con la metodología desarrollada en el Centro de Estudios del Hospital según convocatoria del Ministerio de Salud, se cumplieron las siguientes etapas : Priorización, definición de foco y alcance, formulación de las preguntas clínicas relevantes al estado del arte y puntos de controversia actual en el tema a tratar (Metodología PECOT), revisión sistemática de la literatura, síntesis de la evidencia, evaluación y graduación de acuerdo con la metodología "GRADE" y las platillas propuestas por SIGN. Por consenso se definieron las recomendaciones de acuerdo con la metodología GRADE. Se presenta una Guía de Práctica Clínica (GPC), que responde las preguntas: enfoque de hemartrosis, indicaciones quirúrgicas, terapia física preoperatoria, profilaxis antitrombótica, tipo de injerto, anestésicos intrarticulares, lesiones asociadas, posición del túnel femoral, reconstrucción de uno contra dos haces. De acuerdo con la evidencia encontrada se formulan doce recomendaciones ajustadas al nivel de evidencia. La presente GPC corresponde a un piloto de una metodología para desarrollo de GPC aprobabda para uso a nivel nacional y al primer producto sobre este tema en la literatura encontrada.

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El prolapso del piso pélvico es una entidad frecuente, especialmente en pacientes postmenopáusicas y en su gran mayoría requiere tratamiento quirúrgico. En este estudio comparamos la aparición de complicaciones postoperatorias tempranas entre la colporrafia anterior con técnica clásica (TC) versus la colporrafia anterior con técnica de sitio especifico (CSE). Se realizó un estudio observacional analítico, retrospectivo, de dos cohortes de pacientes que requirieron colporrafia anterior entre agosto de 2009 hasta junio de 2012. Las características de cada grupo fueron homogéneas y comparables. El desenlace de mayor frecuencia fue dehiscencia de la línea de sutura, sin embargo, no se encontraron diferencias estadísticamente significativas entre las dos técnicas. La aparición de reprolapso temprano y el diagnóstico de abscesos o hematomas presentaron frecuencias que carecen de diferencia significativa. No hubo complicaciones tempranas graves tales como sangrado intraoperatoria mayor o lesiones vesicouretrales. Los resultados sugieren que las dos técnicas tienen una incidencia baja de complicaciones postoperatorias tempranas y por lo tanto parecen ser seguros dentro del manejo quirúrgico del prolapso del componente anterior del piso pélvico.