A península na ritidoplastia / The peninsula in rhytidoplasty

Introdução: A ascensão do pé do cabelo é um estigma frequente e desagradável nas ritidoplastias. Para contornar esse problema, criamos a técnica da Península em meados de 1999. Inicialmente utilizada nas faces secundárias, sua indicação foi ampliada, tornando-se imprescindível nos casos primários de implantação alta do cabelo e naqueles pacientes que necessitariam de grande ressecção de pele. Métodos: O total de ritidoplastias realizadas foi de 7356, tendo sido operados 2512 pacientes utilizando a técnica da Península, no período que cursa entre 1999 e 2016, com idade média de 48 anos, sendo 98% dos pacientes do sexo feminino e 2% do sexo masculino. A técnica apresenta três variantes. Resultados: Os pacientes continuaram, posteriormente, em acompanhamento mensal até a alta ao final de 6 meses. Dentre os resultados, surgiram algumas complicações, comuns a qualquer tipo de cirurgia da face. Na grande maioria dos casos, com a utilização da Península, foi possível a realização de uma boa tração cutânea, com maior correção do terço médio, mantendo a linha de implantação capilar. Conclusão: Podemos concluir que a técnica da Península é um recurso único, de fácil reprodução, capaz de reduzir a curva de aprendizado em ritidoplastias, uma vez que permite generosa ressecção de pele sem alteração da implantação capilar, atuando de modo a evitar estigmas pós-cirúrgicos e otimizando a qualidade dos resultados e satisfação por parte dos pacientes, com pequeno ônus cicatricial.

Introduction: High implantation of the hairline by the ear is a frequent, unpleasant stigma in rhytidoplasties. To overcome this problem, we created the Peninsula technique in the mid-1999. Initially used in secondary face liftings, its indication has since been broadened, becoming indispensable in primary cases of high hair implantation and in patients requiring major skin resection. Methods: The total number of rhytidoplasties performed was 7,356, with 2,512 patients operated using the Peninsula technique from 1999 to 2016. Mean age was 48, 98% were females and 2% males. The technique presents three variants. Results: Patients were monitored on a monthly basis until discharge at the end of six months. Among the results, there were some complications, which are usual in any type of facial surgery. In the great majority of cases, with the use of the Peninsula, it was possible to obtain good skin traction, with the greater correction of the mid third, maintaining the capillary implantation line. Conclusion: We can conclude that the Peninsula technique is a unique resource, easily reproducible, capable of reducing the learning curve in rhytidoplasty, as it allows generous skin resection without changing capillary implantation, avoiding post-surgical stigma and optimizing the quality of the results and patient satisfaction, with a little scar burden.

Discapacidad laboral por dolor lumbar: estudio caso control en Santiago de Chile / Work disability for lower back pain: case control study in Santiago

ANTECEDENTES. La discapacidad laboral por dolor lumbar causa ausencia laboral y gastos económicos. Se ha responsabilizado su presencia a condiciones del entorno laboral y a la manipulación manual de cargas (MMC). Se evaluó la asociación entre niveles de exposición laboral a MMC y presencia de discapacidad en trabajadores protegidos por ley laboral en Santiago de Chile. MATERIAL Y MÉTODO. Estudio Caso Control. Exposición y covariables de interés fueron medidas en puesto de trabajo. Los análisis incluyeron Modelos de Regresión Logística Múltiple. RESULTADOS. La exposición a MMC moderada muestra OR: 1,62 (IC95%:0,61-4,33), la exposición a MMC alta y muy alta muestra OR de 2,75 (IC95%:1,08-6,95). DISCUSIÓN. Existe una importante magnitud y gradiente de asociación entre MMC y discapacidad. Variables psicosociales, organizacionales e individuales también explican el fenómeno. Se sugiere rediseñar las estrategias nacionales para prevenir riesgos laborales relacionados con discapacidad por dolor lumbar.

BACKGROUND: Work disability due to low back pain causes lost productivity and economic expense. It has been blamed on the working environment and the manual handling of loads (MHL). The link between levels of work exposure to MHL and the disability of workers protected by labor law was evaluated in Santiago, Chile. MATERIALS AND METHODS: Case-control study. Exposure and study co-variables were measured in the workplace. The analyses included multiple logistic regression models. RESULT AND DISCUSSION: Exposure to moderate MHL shows an OR: 1.62 (95% CI: 0.61-4.33), high and very high exposure to MHL shows an OR of 2.75 (95% CI: 1.08-6.95), controlled by psychosocial, organizational and individual aspects. There is a significant magnitude and gradient of association between MHL and disability. Psychosocial, organizational and individual variables also explain the phenomenon. It is suggested that national strategies be redesigned to prevent the occupational risks related to disability due to low back pain.

30o inclination in handles of plastic boxes can reduce postural and muscular workload during handling

BACKGROUND: The handling of materials, which occurs in the industrial sector, is associated with lesions on the lumbar spine and in the upper limbs. Inserting handles in industrial boxes is a way to reduce work-related risks. Although the position and angle of the handles are significant factors in comfort and safety during handling, these factors have rarely been studied objectively. OBJECTIVE: To compare the handling of a commercial box and prototypes with handles and to evaluate the effects on upper limb posture, muscle electrical activity, and perceived acceptability using different grips while handling materials from different heights. METHOD: Thirty-seven healthy volunteers evaluated the handles of prototypes that allowed for changes in position (top and bottom) and angle (0°, 15°, and 30°). Wrist, elbow, and shoulder movements were evaluated using electrogoniometry and inclinometry. The muscle electrical activity in the wrist extensors, biceps brachii, and the upper portion of the trapezius was measured using a portable electromyographer. The recorded data on muscle movements and electrical activity were synchronized. Subjective evaluations of acceptability were evaluated using a visual analog scale. RESULTS AND CONCLUSIONS: The prototypes with handles at a 30° angle produced the highest acceptability ratings, more neutral wrist positions, lower levels of electromyographic activity for the upper trapezius, and lower elevation angles for the arms. The different measurement methods were complementary in evaluating the upper limbs during handling. .

Valores normales de las alfa-fetoproteínas en embarazadas a las 24 y 28 semanas de gestación

Obtener los valores normales de las alfafetoproteínas en embarazadas a las 24 y 28 semanas de gestación, con el fin de utilizar estos como cifras referenciales en embarazo de riesgo de parto pretérmino. Estudio prospectivo longitudinal, no experimental, en 80 embarazadas atendidas entre enero y noviembre 2005. Se determinaron las alfa-fetoproteínas con la técnica Elisa. El valor medio de las alfa-fetoproteínas a las 24 semanas fue 112 ng/mL y 133 ng/ml a las 28 semanas de gestación, y con rangos de 60 ng/mL en el percentil 10 y 200 ng/ml en el percentil 90 a las 24 semanas, y rangos de 82 ng/mL en el percentil 10 y 230 ng/mL en el percentil 90 a las 28 semanas de gestación. Se dispone de cifras referenciales de alfa-fetoproteínas como parámetro que puede ser utilizado como pronóstico en el embarazo de riesgo de parto pretérmino

To obtain the normal values of alpha-fetoprotein, between 24-28 weeks of pregnancy, to be use as levels of reference in the pregnancies with preterm delivery risk. Longitudinal prospective study, non experimental, in 80 pregnant women attended between January to November 2005. alpha-fetoprotein was determined by the Elisa technic. The alpha-fetoprotein mean values oscilated between 112 ng/mL at 24 weeks and 133 ng/mL at 28 weeks, and in the percentile distribution with ranges of 60 ng/mL in the percentile 10 and 200 ng/mL in the percentile 90 at the 24 weeks. At 28 weeks the range were 82 ng/mL in the percentile 10 and 230 ng/mL in the 90 percentile. We have at one’s disposal alpha-fetoprotein values as a parameter to be used as pronostique in the high risk pregnancy of preterm delivery

An ergonomics intervention program to prevent worker injuries in a metal autoparts factory.

An ergonomics intervention program (EIP) was conducted with male employees working in the pressing and storage sections of a metal autoparts factory in Samut Prakan Province, Thailand. The objectives of this study were to assess the causes of injuries in the pressing and storage sections of that factory, and to improve working conditions by reducing worker injuries from accidents and low back muscular discomfort, using an EIR The study design used a participatory research approach which was quasi-experimental with pretest-posttest evaluations, with a non-equivalent control group. A total of 172 male participants working in Building A were the target group for assessing causes of injury. A retrospective study of official accident information, and questionnaires for general information, health and muscular discomfort, injury frequency rate (IFR), injury severity rate (ISR), medical expenses, and EIP design. Two groups of employees volunteered for the study on muscular back discomfort. The first group of 35 persons volunteered to participate in the EIP (EIP group), and the second 17 persons from Building B did not (non-EIP group). The EIP was composed of 4 major categories: (1) engineering improvement, (2) change in personal protective equipment, (3) environmental improvement, (4) administrative intervention, training, and health education. Low back muscular discomfort was measured through questionnaires on subjective feelings of muscular discomfort, and by surface electromyography (sEMG). Muscle activities were measured by sEMG of the left and right erector spinae and multifidus muscles, and evaluated by multivariate test for dependent samples (paired observation), and multivariate test for two independent samples. After EIP, IFR decreased 65.46%, ISR decreased 41.02%, and medical expenses decreased 42.79%. The low back muscular loads of the EIP group were significantly reduced, with a 95% confidence level (p < 0.05) while those of the non-EIP group were not. Subjective feelings of muscular discomfort, determined by Wilcoxon Signed Ranks test, showed that after applying the EIP to the EIP group, the mean scores for general bodily discomfort and low back muscular discomfort in the EIP group had significantly reduced, while those of the non-EIP group increased, (p < 0.05).

Dureza da dentina após remoção de cárie: avaliação de diferentes métodos / Dentinal hardness after caries removal: evaluation of different methods

O propósito deste estudo foi avaliar a dureza da dentina remanescente de dentes decíduos cariados após a remoção de cárie por três diferentes métodos. Utilizaram-se quinze molares decíduos que apresentavam uma das faces proximais com lesão de cárie de profundidade média. Cada dente foi seccionado longitudinalmente no sentido mesiodistal de forma a ser obter duas cavidades de cárie por dente, totalizando trinta hemi-dentes. Em cada dez hemidentes foi realizada a remoção de cárie por um dos três métodos: método mecânico (broca em baixa rotação), guiado pela dureza à sondagem; método mecânico através do uso de evidenciador de cárie (Caries Detector); método químico-mecânico (Carisolv). Após, as cavidades foram restauradas com sistema adesivo Single-Bond (3M Espe) e resinas compostas Z250 (3M Espe). Cada hemidentes foi preparado para a mensuração da dureza Knoop, mensurada a 150 e 300 mm da junção amelodentinária em três distanciamentos crescentes de 100 em 100 mm da interface restaurada. Os dados foram submetidos à análise de variância e ao teste de Tukey para constraste de média (a = 0,05), verificando-se que a dureza média (KHN) da dentina nos grupos 1 e 2 foi semelhante (p > 0,05) e ambas foram estatisticamente maiores (p < 0.05) que a do Grupo 3. Concluiu-se que a dureza da dentina remanescente após remoção de cárie com o novo método químico mecânico (Carisolv) preservou maior quantidade de estrutura dentária que os dois outros métodos utilizados

Occupational lumbar disc herniation among Thai workers claimed for compensation.

The study was conducted at the Medical Committee Office to the Compensation Fund, from March to August 2000, the documents and medical records of 37 claimants of Thai workers who were diagnosed with occupational lumbar disc herniation were analyzed, 78.4 per cent were male. The most common age was between 26-35 years. About half of the workers had a monthly salary of less than 6,150 baht and had worked for less than 5 years. The most common risk factor was lifting, which accounted for 64.9 per cent and the chance of severity was twice that of other types of work. Ergonomic intervention should be properly implemented.

Métodos de análisis ergonómicos en operaciones de elevación de carga manual: alternativas y comentarios / Ergomonic analysis methods in manual load elevation: alternatives and comments

Se presenta y describe algunos procedimientos destinados a predecir el esfuerzo de columna lumbar duarnte la elevación manual de cargas. Junto a la descripción, se resaltan las características de los métodos, su fundamento, utilidad y limitaciones acorde a las variables que utiliza. En un intento de objetivar o valorar el esfuerzo de columna se describen procedimientos manuales y mencionana otros apoyados en software y métodos video-computacionales pueden ser de gran ayuda para el kinesiológo que trabaja o se inicia en el campo de la ergonomía, dado que puede disponer de información adicional para proyectar su quehacer en esa área

Resistência à remoçäo por traçäo e infiltraçäo marginal de coroas totais fundidas cimentadas em dentes naturais reconstruídos com ionômero de vidro / Tensile strenght and microleakage of full cast crowns cemented on core buildupp reinforced with glass-ionomer

Este trabalho foi realizado com o objetivo de verificar a resistência à remoçäo por traçäo e a infiltraçäo marginal de coroas totais fundidas cimentadas, em dentes reconstruídos com núcleo de preenchimento com duas formulaçöes de cimento de ionômero de vidro, ou seja, Cermet e "mistura milagrosa", em comparaçöes às coroas totais cimentadas em dentes com preparo para coroa dental (sem reconstruçäo). Foram selecionados trinta molares superiores, recém-extraídos, dez dentes para cada condiçäo experimental, os quais foram incluídos em bases plásticas, com resina acrílica ativada quimicamente, até a altura de 1 mm da junçäo cemento-esmalte. Todos os dentes receberam preparo tipo coroa total e, com exceçäo da condiçäo controle (dentes sem reconstruçäo, sofreram o corte da porçäo coronária a 1,5 mm do ângulo cavo-superficial e remoçäo do teto da câmara pulpar. Os dentes foram reconstruídos com cermet e "mistura milagrosa", com auxílio de pinos retidos no conduto radicular. Uma liga do sistema prata/estanho (M3) foi utilizada para obtençäo das coroas totais, as quais foram cimentadas com cimento de ionômero de vidro nos respectivos troquéis, sob a aplicaçäo de uma carga estática de 5 kg. As amostras foram armazenadas em água destilada e mantidas em estufa a 37º ñ 1ºC, durante toda a fase de realizaçäo da pesquisa. Vinte e quatro horas após a cimentaçäo, as amostras foram submetidas a ciclagens térmicas nas temperaturas de 5ºC, 37ºC e 55ºC, por sessenta minutos, durante sete dias. Para a última ciclagem térmica foi utilizado o corante Rhodamina B a 0,1 por cento, em soluçäo aquosa. A seguir, as amostras foram lavadas e deixadas secar em condiçöes ambientais por vinte e quatro horas, para serem levadas à máquina de ensaios universal para os testes de remoçäo por traçäo axial. A avaliaçäo da infiltraçäo marginal foi realizada por três examinadores previamente calibrados, utilizando o método da somatória de escores...