Habilitación de funciones frontales básicas en cardiópatas congénitos a través de LEGO® Education / Basic frontal functions qualification in congenital heart disease with LEGO® Education

Las cardiopatías congénitas se consideran una de las anomalías que alteran la irrigación y el intercambio de oxigenación adecuado a las principales venas y arterias. Esto puede generar consecuencias en el desarrollo neurológico que se puede traducir en retraso psicomotor, déficits de aprendizaje, dificultades académicas y problemas de integración social. Para mejorar los trastornos cognitivos, se propone la habilitación cognitiva basada en los principios de mecánica y robótica de LEGO® Education. El objetivo de este estudio fue medir el efecto de un programa de intervención, basado en el uso de ensamblado y programación robótica con LEGO® Education, sobre las funciones frontales básicas como primera aproximación a un modelo propuesto en pacientes cardiópatas congénitos que han sido sometidos a cirugía cardiovascular. Se trató de un estudio de serie de casos, en el que finalizaron el tratamiento una niña y dos niños con cardiopatías congénitas con RACHS 2 y 3. Se aplicaron sub-escalas BANFE-2 y el cuestionario neuropsicológico de daño frontal antes y después del tratamiento; así como una escala para medir el nivel de ejecución por intervención, durante las ocho sesiones. Los resultados muestran en la escala BANFE2, cambios en las medias de las funciones frontales básicas, de daño leve-moderado y normal a normal alto, principalmente en memoria de trabajo y fluidez verbal. En esta primera aproximación, el método LEGO® Education mostró ser una buena herramienta para la habilitación neuropsicológica de estos pacientes.

Congenital heart diseases are considered to be an anomaly which alter the irrigation and the adequate exchange of oxygenation to the main veins and arteries. They can have neurodevelopmental consequences that could translate into psychomotor retardation, learning deficits, academic difficulties, and social integration problems. Cognitive empowerment based on the mechanics and robotics principles of LEGO® Education is proposed to improve cognitive disorders. In this study, the objective was to measure the effect of an intervention program, based on the use of assembly and robotic programming with LEGO® Education, upon basic frontal functions as a first approach to a proposed model in congenital heart disease patients who have undergone cardiovascular surgery. This was a case-series study, in which a girl and two boys with congenital heart disease with RACHS 2 and 3, completed the treatment. BANFE-2 subscales and the neuropsychological questionnaire of frontal damage were applied before and after the treatment; as well as a scale to measure the level of performance per intervention, through all the eight sessions. The BANFE-2 scale showed changes in the means of frontal functions, from mild-moderate damage and normal to high normal, mainly in working memory and verbal fluency. In this first approach, LEGO® Education method proved to be a useful tool for the neuropsychological empowerment of these patients.

Resección laparoendoscópica de tumor de la unión gastroesofágica / Laparoendoscopic resection of a tumor of the gastroesophageal junction

RESUMEN La resección gástrica atípica ha demostrado ser beneficiosa para tumores submucosos. La técnica pre senta mayor riesgo cuando estos se desarrollan próximos a la unión esófago-gástrica (UEG). Para esta limitación se propuso la resección intragástrica mediante una técnica mixta combinando laparoscopia y endoscopia. En nuestro medio no existen publicaciones al respecto. Se trata de una mujer de 42 años, con lesión subepitelial-subcardial de 2 cm, evaluada mediante videoendoscopia alta (VEDA), compa tible con tumor del estroma gastrointestinal (GIST) evaluado mediante ecoendoscopia. La lesión fue resecada mediante abordaje combinado laparoendoscópico. Bajo visión laparoscópica se introdujeron en cavidad abdominal trocares con balón, y bajo visión endoscópica intragástrica se introdujeron estos en el estómago y se fijó la pared gástrica a la pared abdominal insuflando dichos balones. Posterior mente se realizó la resección de la lesión con sutura mecánica. El abordaje combinado es seguro y eficaz, simple en manos entrenadas, pero constituye una opción reproducible en casos seleccionados.

ABSTRACT Atypical gastric resection has proved to be beneficial to treat submucosal tumors. The technique is more difficult when these tumors develop next to the gastroesophageal junction (GEJ). Intragastric resection combining endoscopic and laparoscopic approach was proposed to solve this limitation. There are no publications about this technique in our environment. A 42-year-old female patients with a 2-mm subepithelial tumor below the cardia evaluated by upper gastrointestinal (UGI) videoendoscopy and endoscopic ultrasound suggestive of a gastrointestinal stroma tumor (GIST) underwent resection using the combined laparo-endoscopic approach. Under laparoscopic guidance, balloon-tipped trocars were introduced in the abdominal cavity and then into the stomach using endoscopic view. The balloons were inflated to fix the gastirc wall to the abdominal wall. The lesion was resected using mechanical stapler. The combined approach is safe and efficient, and simple to perform for trained professionals, constituting a reproducible option in selected cases.

Fisiología respiratoria mecánica de la respiración / Mechanics breathing

El trabajo respiratorio se ejerce en una estructura cerrada donde se encuentran los pulmones, estos son sometidos a cambios de presiones determinados por la musculatura pulmonar en las diferentes fases del ciclo respiratorio, lo que generará gradientes y permite la entrada y salida de aire. Se suman a ello el calibre de las vías aéreas, el tipo de flujo, las características de las vías aéreas y del surfactante pulmonar, que determinan un menor o mayor trabajo respiratorio según la condición fisiológica.

The work of breathing is exerted in a closed structure where the lungs are located. These are subjected to pressure changes determined by the pulmonary musculature in the different phases of the respiratory cycle, which will generate gradients and allow the entry and exit of air. In addition to the aforesaid, airway calibre, type of flow, airway characteristics and pulmonary surfactant determine less or more work of breathing depending on the physiological condition.

Tratamiento de la coledocolitiasis mediante CPRE e instrumentación a través de un tubo en T / Treatment of choledocholithiasis by ERCP, and instrumentation through a T-tube

Resumen El tratamiento de la coledocolitiasis ha evolucionado de forma significativa desde que Robert Abbe realizó la primera coledocotomía y la exploración de las vías biliares en Nueva York, en 1889. La colangiopancreatografía retrógrada endoscópica (CPRE), que inicialmente fue un método diagnóstico, ahora solo tiene validez como método terapéutico. En la actualidad, los principales métodos diagnósticos son la colangioresonancia magnética (CRM) y la ultrasonografía endoscópica (USE). El tratamiento de la coledocolitiasis pasó de la técnica quirúrgica abierta -en la que, de forma rutinaria, se realizaba la coledocorrafia sobre un tubo de Kehr o tubo en T- a la endoscópica, mediante el uso de la CPRE, la esfinteroplastia y la instrumentación con balones y canastilla. Hoy en día se dispone de técnicas adicionales como la litotricia mecánica (LM) o extracorpórea, la dilatación con balón (DB) de gran tamaño y el Spyglass ® . La técnica laparoscópica se usa desde hace varios años, en diversas partes del mundo, para el tratamiento de la coledocolitiasis. Estudios recientes proponen incluso el cierre primario del colédoco o la coledocoduodenostomía, con lo cual no sería necesaria la utilización del tubo en T. Pero en muchos otros sitios, y por diversas razones, se continúa usando la exploración quirúrgica abierta y el tubo en T, que representa una importante opción en el tratamiento de algunos pacientes. Caso clínico: paciente masculino de 88 años, con coledocolitiasis recidivante, cálculo gigante de difícil manejo endoscópico y sepsis de origen biliar, que requirió drenaje quirúrgico abierto de urgencias. Se realizó una coledocotomía, y se dejó el tubo en T. Posteriormente, se efectuó un tratamiento exitoso conjunto, mediante instrumentación por el tubo en T, por parte de cirugía general, y CPRE, por gastroenterología.

Abstract The treatment of choledocholithiasis has evolved significantly since Robert Abbé performed the first bile duct exploration via choledochotomy in New York in 1889. Endoscopic retrograde cholangiopancreatography (ERCP), which was initially used for diagnosis, is now only valid as a therapeutic tool. Currently, the main diagnostic methods are magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasound (EUS). The treatment of choledocholithiasis moved from the open surgery in which biliary stenting was routinely performed on a Kehr tube or T-tube, to the endoscopic technique using ERCP, sphincteroplasty and instrumentation with balloons and baskets. Additional techniques are now available such as mechanical or extra-corporeal lithotripsy, endoscopic papillary large balloon dilation and SpyGlass cholangioscopy. The laparoscopic technique has been used for several years in different parts of the world for the treatment of choledocholithiasis. Recent studies even propose performing the primary closure of the bile duct or choledochoduodenostomy, so that the T-tube is not necessary. However, in many other places, and for a variety of reasons, open exploratory surgery and the T-tube continue to be used, being an important option in the treatment of some patients. Case presentation: 88-year-old male patient with recurrent choledocholithiasis and a giant gallstone that was difficult to treat endoscopically, with sepsis of biliary origin, which required open surgical drainage at the emergency room. Choledocotomy was performed, and a T-tube was inserted at the site. Subsequently, a successful joint treatment was performed by the General Surgery Service and the Gastroenterology Service, using T-tube instrumentation and ERCP, respectively.

Pre-germination treatments of Paricá (Schizolobium amazonicum) seeds / Tratamentos pré-germinativos de sementes de Paricá (Schizolobium amazonicum)

Paricá seeds have dormancy and, even after mechanical scarification, these seeds show slow and uneven germination. Pre-germination treatments can be used to increase seed germination performance. Thus, the aimed to evaluate the physiological potential and initial growth of paricá seeds after pre-germination treatments, using different substances as plant regulators and nutrients, in addition to mechanical scarification. The experimental design was completely randomized, in a 2x7 factorial scheme, consisting of the following pre-germination treatments: mechanical scarification (10% and 50% of the seed coat) and seed pre-soaking [control-water, KNO3 0.2%,Ca(NO3)2 0.2%, gibberellin 0.02%, cytokinin 0.02%, and mixture of gibberellin + cytokinin (1:1)] besides a control group without pre-soaking, with four replicates. The study evaluated germination and emergence rates, germination and emergence speed indices, collar diameter, plant height, seedling dry mass, hypocotyl and seedling length, and electrical conductivity. It was observed that pre-soaking the seeds in gibberellin after mechanical scarification at 50% as a pre-germination treatment resulted in seeds with higher vigor expression and greater initial seedling growth.

Sementes de paricá apresentam dormência e após superada pela escarificação mecânica, as sementes apresentam germinação lenta e desuniforme. Tratamentos pré-germinativos podem ser utilizados para incrementar a performance de germinação de sementes. Assim, o objetivo foi avaliar o potencial fisiológico de sementes, crescimento inicial de Paricá após tratamentos pré-germinativos, utilizando diferentes substâncias como reguladores vegetais e nutrientes, além da intensidade da escarificação mecânica. O delineamento experimental empregado foi o inteiramente casualizado, em esquema fatorial 2x7, constituído pelos tratamentos pré-germinativos: escarificação mecânica (10% e 50% do tegumento) e pré-embebição das sementes [controle- água, KNO3 0,2%,Ca(NO3)2 0,2%, giberelina 0,02%, citocinina 0,02%, e a mistura da solução de giberelina + citocinina (1:1)] além de um grupo controle sem pré-embebição, com quatro repetições. Avaliou-se a porcentagem de germinação e emergência, índice de velocidade de germinação e emergência, diâmetro, altura e fitomassa seca de plantas, comprimento de plântulas e hipocótilo e condutividade elétrica. A pré-embebição das sementes com giberelina após escarificação mecânica de 50% como tratamento pré-germinativo é recomendado para obtenção de sementes com maior expressão de vigor e crescimento inicial de plântulas.

Fundamentos teóricos de la mecánica corporal en la movilización de pacientes en el ámbito de enfermería / Theoretical foundations of body mechanics in the mobilization of patients in the field of nursing

Existe un conglomerado importante de fundamento teórico que en su discurso sustenta la importancia de la mecánica corporal en la medicina, por ser una actividad completa; su correcta aplicación garantiza una buena salud. Objetivo: Describir los fundamentos teóricos de la mecánica corporal en la movilización de pacientes en el ámbito de la enfermería. Metodología: Documental, descriptiva. Resultados: Diversos estudios demuestran que las lesiones musculo-esqueléticas en el personal de enfermería, en un porcentaje alto se deben a la aplicación inadecuada de la mecánica corporal durante la movilización de pacientes. La bibliografía consultada revela: en el ámbito de la enfermería se refleja desconocimiento en el tema de la mecánica corporal en la movilización de pacientes, antes, durante o después de la ejecución de procedimientos, lo cual es causante de lesiones musculo-esqueléticas en el personal de enfermería. Recomendación: Es un deber para el personal de enfermería aplicar la mecánica corporal en todas las acciones que realiza en la práctica consigo mismo y también con el paciente, aprovechando al máximo la energía que brinda, el bienestar que ofrece a ambos y la prevención que trae consigo ante posibles lesiones músculo-esqueléticas(AU)

There is an important conglomerate of theoretical foundation, which in its speech supports the importance of body mechanics in medicine as a complete activity; because its correct application guarantees good health. Objective: Describe the theoretical foundations of body mechanics in the mobilization of patients in the field of Nursing. Methodology: Documentary, descriptive. Several studies show that musculoskeletal injuries in nursing staff, in a high percentage, are due to improper application of body mechanics during patient mobilization. Conclusion: The bibliography consulted reveals that in the nursing field the subject of body mechanics in the mobilization of patients, before, during or after the execution of procedures is unknown, which is the cause of musculoskeletal injuries in nursing staff. Recommendation: It is a duty for the nursing staff to apply body mechanics in all the actions they perform in practice with themselves and also with the patient, taking full advantage of the energy it provides, the well-being it offers to both and the prevention it brings before possible musculoskeletal injuries(AU)

Determinants of occupational health hazards among roadside automobile mechanics in Sokoto Metropolis, Nigeria

Roadside automobile mechanics are in the course of their work exposed to several hazards that put them at risk of severe debilitating health challenges. This group of workers, however, is reported not to know much about such hazards and to have little or no training on workplace safety. Aim: The study aimed to identify the determinants of occupational health hazards among roadside automobile mechanics in Sokoto Metropolis. Methodology: This was a descriptive, cross-sectional study, and using a two-stage sampling technique, a total of 205 roadside mechanics were recruited for the study. A semi-structured interviewer-administered questionnaire was used, and the data were imputed into and analyzed using IBM SPSS. Results: The mean age of the respondents was 31.10 ± 10.19 years, and over one-third of them (38.1%) were general vehicle repairers. Majority of the respondents had good knowledge of and attitude toward workplace hazards. However, a good proportion (91.0%) of the mechanics felt that their occupation was a risky one and 80.1% ate and 86.1% drank while working. Type of training and job description were the predictors of knowledge of workplace hazards. Job description was the only predictor of attitude. Burns, bruises, headache/dizziness, and cuts were the most reported work-related illnesses and injuries. Conclusion: Although most of the auto-mechanics were aware and had good knowledge of workplace hazards, they did not adhere to safety practices in the workplace, mostly due to nonavailability of protective apparels. There is, therefore, need for continuous health education under the platform of the auto-mechanics association so that they can voluntarily adopt safety practices in their workplace

Terapia Eléctrica Funcional en el Manejo de la Disfagia / Functional Electrical therapy in the management of Dysphagia

La participación del Fonoaudiólogo en la rehabilitación neuromuscular orofacial y musculatura implicada en la mecánica deglutoria, se ha complementado con el uso de la terapia eléctrica funcional; esta carece de evidencia científica que respalde su efectividad en los procesos de recuperación funcional. Objetivo: Realizar una revisión documental sobre el uso de la terapia eléctrica funcional en el manejo de la disfagia, con el fin de crear un soporte teórico que respalde los procesos de intervención en fonoaudiología. Metodología: La revisión de la literatura se realizó en las bases de datos de Proquest, EBSCO, Scielo, Redalyc y Medic Latina. Fueron revisados artículos entre el 2008 y 2018. Para la selección de los artículos se utilizó el diagrama de flujo PRISMA (Preferred Reporting Hems for Systematic Reviews and Meta analyses). Resultados: Se revisaron 2980 artículos para exclusión por título, quedando 66 artículos en la primera depuración, de los cuales 21 fueron descartados por no cumplir con ningún criterio propuesto, 10 por repetición y 12 por no permitir el acceso al documento. Finalmente fueron considerados 23 artículos y 5 fuentes de consulta física para realizar el respectivo análisis. Conclusiones: Existe escasa evidencia científica que respalde la intervención fonoaudiológica en la disfagia con electroterapia.

The participation of the speech therapist within the orofacial neuromuscular rehabilitation and the musculature involved in swallowing mechanics, has been complemented with the use of functional electrical therapy, which has lacked scientific evidence that supports its effectiveness in faster recovery processes in terms of functionality. Objective: To carry out a documentary review of information related to the use of functional electric therapy on the management of dysphagia, to create a theoretical support that supports the processes of speech therapy intervention. Methodology: The review of the literature was carried out in the databases of Proquest, EBSCO, Scielo, Redalyc and Medic Latina. Articles were reviewed between 2008 and 2018. For the selection of the articles the PRISMA flow chart (Preferred Reporting Hems for Systematic Reviews and Meta analyzes) was used. Results: 2980 articles were reviewed for exclusion by title, leaving 66 articles in the first debugging, of which 21 were discarded for not complying with any proposed criteria, 10 for repetition and 12 for not allowing access to the document. Finally, 23 articles and 5 sources of physical consultation were considered to perform the respective analysis. Conclusions: There is little scientific evidence to support the speech therapy intervention in dysphagia with electrotherapy.

Necessidades humanas básicas de pessoas em hemodiálise sob à luz da teoria de Wanda Horta / Basic human need in persons in hemodialysis in the light of Wanda Horta's theory

To know, be aware of, the Basic Human Needs of chronic renal patients on hemodialysis, according to Wanda Horta's Theory. Methods: exploratory and descriptive research of qualitative approach, conducted from interviews with 10 patients followed in a hemodialysis clinic located in a city in the interior of Bahia, Brazil. Data were categorized according to Bardin's Content Analysis technique and discussed from the perspective of Wanda Horta's Basic Human Needs Theory. Results: Three categories emerged themes that highlight the basic human needs affected in the lives of patients with chronic renal failure and on hemodialysis treatment, highlighting: Nutrition and hydration changes; Changes in sleep and rest ; and Deprivation of freedom, leisure and sociability. Final considerations: there was a predominance of psychobiological needs, namely: hydration, nutrition, locomotion, sleep, rest and body mechanics. As for psychosocial NHB, it was possible to observe those related to recreation, leisure, freedom, participation, gregarious, of self-esteem and self-realization. No NHB affections regarding the psycho-spiritual domain emerged.

Conhecer as Necessidades Humanas Básicas de pacientes renais crônicos em hemodiálise, conforme a Teoria de Wanda Horta. Métodos:pesquisa exploratória e descritiva de abordagem qualitativa, realizada a partir de entrevistas com 10 pacientes acompanhados em uma clínica de hemodiálise localizada em uma cidade do interior da Bahia, Brasil. Os dados foram categorizados de acordo com a técnica de Análise de Conteúdo de Bardin e discutidos sob a ótica da Teoria das Necessidades Humanas Básicas de Wanda Horta. Resultados: emergiram três categorias temáticas que evidenciam as necessidades humanas básicas afetadas na vida dos pacientes com insuficiência renal crônica e em tratamento com hemodiálise, destacando-se: Mudanças nutricionais e de hidratação; Alterações no sono e repouso; e Privação da liberdade, lazer e sociabilidade. Considerações finais: observou-se o predomínio das necessidades psicobiológicas, a saber: hidratação, nutrição, locomoção, sono, repouso e mecânica corporal. Quanto às NHB psicossociais, foi possível observar aquelas relacionadas à recreação, lazer, liberdade, participação, gregária, de autoestima e autorrealização. Não emergiram NHB afetas quanto ao domínio psicoespiritual.

Tensões residuais térmicas em porcelanas sobre zircônia e sua potencial influência no risco de lascamento / Thermal residual stress on porcelain veneer with zirconia framework and its potential influence on chipping risk

Parte I. A discrepância positiva, recomendada para as coroas protéticas em metalocerâmica, tem sido apontada como um dos fatores que pode contribuir para a maior taxa de lascamento ("chipping") nas porcelanas sobre a infraestrutura de zircônia Y-TZP. Objetivo: Comparar a distribuição das tensões residuais, in silico, em peças de duas camadas, uma de porcelana feldspáticas sinterizada sobre a outra, de material de infraestrutura, com discrepância de valores de coeficiente de expansão térmica linear (CETL) entre elas. Métodos: Espécimes de formato de barra plana e coroa com espessuras de 0,7 mm de infraestrutura e 1,5 mm de porcelana de cobertura foram investigadas por meio da análise elástica de elementos finitos. Oito condições de discrepância ("mismatch") de CETL foram simuladas, através da combinação de dois tipos de materiais de infraestrutura (zircônia e metal) e seis porcelanas de cobertura (distintas por valores de CETL). Além das combinações dos sistemas metal-porcelana e zircônia-porcelana recomendadas pelo fabricante, foram apresentados modelos com valores de mismatch similares (1 ppm/°C) com diferentes materiais de infraestrutura (metal ou zircônia) e modelos de infraestrutura de zircônia com porcelanas compatíveis ao metal também foram testadas. O protocolo de resfriamento após a sinterização adotado foi o protocolo denominado resfriamento lento, com taxa de 32ºC/min, entre 600 °C e a temperatura ambiente. Além disso, a natureza multidirecional das tensões residuais em barras e coroas foi apresentada para que fosse possível explorar as contradições aparentes entre os diferentes estudos. Foram analisadas as tensões principais máxima (?1) e mínima (?3), assim como as componentes paralelas a interface (?pi) ao longo eixo dos espécimes. Resultados: Espécimes barras e coroas geraram diferentes padrões de distribuições de tensões. Quando analisadas as combinações recomendadas pelo fabricante, tensões residuais em modelos de zircônia foram, significantemente, maiores aos modelos com infraestrutura metálica. Quando combinadas as infraestruturas de zircônia com as porcelanas indicadas para metal, os valores de tensões residuais foram ainda maiores. Tensões residuais não foram diferentes entre os modelos de infraestrutura em metal e em zircônia quando as discrepâncias de CETL foram similares (1 ppm/°C). Significância: Algumas conclusões obtidas com os espécimes planos não podem ser extrapoladas para as situações clínicas porque o formato dos espécimes influencia fortemente nos padrões de tensões residuais. Uma vez que discrepância positiva gera tensões de compressão circunferencial e tensões de tração radial e uma vez que as coroas com infraestrutura em zircônia tendem a ser mais vulneráveis para o lascamento ("chipping"), um estado livre de tensão de tração a partir da discrepância zero poderia ser mais vantajosa. Parte II. Objetivo: Verificar os padrões das tensões residuais em espécimes com formato de coroa utilizando dois tipos de métodos: Método de Indentação Vickers (MIV) e Análises em Elementos Finitos (AEF). Métodos: Infraestruturas anatômicas estilizadas e axissimétrica de zircônia e metal (n=20) foram recobertas com as respectivas porcelanas recomendadas (VM9/Y-TZP ou VM13/NiCrMo). As porcelanas foram sinterizadas de acordo com as instruções do fabricante, seguidas dos protocolos de resfriamento lento ou rápido. As coroas foram seccionadas longitudinalmente em duas metades. Para cada seção plana polida, sete indentações foram realizadas, distantes 0,375 mm da interface porcelana/infraestrutura. As regiões de medição foram rotuladas de acordo com o perfil do plano de corte: A - interface convexa da porcelana na área cervical, B - porcelana linear, paralela à parede axial da preparação do dente, C - interface côncava da porcelana, no ângulo oclusal e D - porcelana linear, paralela à parede oclusal. O indentador Vickers foi posicionado de forma a permitir o cálculo da tensão residual em duas orientações específicas: paralela e perpendicular à interface porcelana - infraestrutura. Os valores de tensão residual coletados foram submetidos a ANOVA e ao teste de Tukey. Os modelos de elementos finitos foram desenvolvidos de acordo com o teste experimental, exceto para a secção longitudinal. Resultados: Tensões residuais paralelas à interface, medidas por MIV, mostraram prevalência de compressão em coroas com infraestrutura em zircônia, e prevalência de tensões de tração em infraestrutura em metal, para ambos os protocolos de resfriamento. Os valores de tensões na região A foram similares aos das regiões B e inferiores aos das regiões C e D. Em relação à orientação perpendicular à interface, a tensão de tração nas coroas de infraestrutura metálica não foi influenciada nem pelo protocolo de resfriamento, nem pela região de medição. Contudo, para as coroas com infraestrutura em zircônia, as tensões de tração perpendicular foram maiores quando foi usado o protocolo de resfriamento lento. O padrão de tensões em MIV não ficou de acordo com os resultados encontrados em AEF. Este resultado não confirmou a influência das tensões residuais térmicas no lascamento das porcelanas de recobrimento nas coroas de zircônia.

Embolización venosa transcatéter de várices gástricas con coils / Transcatheter venous coil embolization of gastric varices

Resumen Los espirales de embolización (coils o microcoils) son los agentes más comúnmente usados, con un éxito técnico reportado en aproximadamente el 81-100 % de los casos. Los espirales o coils se encuentran disponibles en una amplia variedad de configuraciones y tamaños, lo que permite acomodarse a vasos de distintos calibres; además, por su buena radiopacidad, tienen la ventaja de ser liberados con precisión. Los espirales o coils son el análogo de una ligadura arterial quirúrgica, debido a que producen una oclusión mecánica por su posicionamiento en el lumen vascular, lo que disminuye el flujo sanguíneo, y sus fibras sintéticas tienen un efecto trombogénico adicional. Caso: presentamos cuatro casos del Hospital Universitario Fundación Santa Fe de pacientes con várices gástricas tratadas satisfactoriamente con embolización transcatéter con coils, los cuales tuvieron un buen resultado técnico; además presentamos una revisión de la literatura.

Abstract Coils and microcoils, the most commonly used embolization agents, have reported technical success rates ranging from 81% to 100% of cases. The spirals or coils are available in a wide variety of configurations and sizes which fit into vessels of different calibers. They have good radiopacity allowing for accurate release. Coils are the analogue of a surgical arterial ligation, because they produce mechanical occlusion due to their positioning in the vascular lumen. This decreases blood flow while their synthetic fibers have an additional thrombogenic effect. Case: We present four cases of coil embolization treatment of gastric varicose veins at our institution. All procedures were successful and had good technical results. We also present a review of the literature.

Estudio de propiedades moleculares del glifosato usando métodos químico-cuánticos computacionales / Study of molecular properties of glyphosate using chemical-quantum computational methods

En este trabajo de investigación se realizó un estudio computacional del glifosato calculando detalladamente las propiedades moleculares del mismo. Se logró a través de este trabajo la caracterización del herbicida glifosato, presentado valores de longitudes de enlace y ángulos así como de propiedades químicas de interés en estudios QSAR, de energías y de bioactividad obtenidos por métodos mecano cuánticos utilizando la mecánica molecular, semiempirico y ab initio. Se analizaron los resultados obtenidos al comparar los datos experimentales del glifosato con los obtenidos computacionalmente demostrando una buena correlación. La estructura del glifosato fue trazada usando la interfaz de Hyperchem; esta fue sometida a cálculos de optimización geométrica inicialmente de Mecánica Molecular para obtener la estructura más estable, posteriormente todas las estructuras fueron analizadas mediante el método semiempirico PM3 para obtener valores más confiables de energía y geometría. Para el método ab initio se usó la base 3-21G. La minimización de la energía de las estructuras se desarrolló por el método Fletcher-Reeves de gradiente conjugado hasta un valor de gradiente RMS (root-mean-square) menor a 0,100 Kcal/(A°mol) o un máximo de 500 ciclos de iteración, el límite de convergencia SCF empleado fue de 0,001 Kcal/mol. Las propiedades moleculares necesarias en QSAR (Relaciones estructura actividad) y la predicción de bioactividad se realizó en el software quimio informático Molinspiration. El ordenamiento de los datos numéricos, las gráficas, regresiones y el ANOVA se realizaron en Excel 2015. Los valores encontrados de longitud de enlace resultan muy satisfactorios, se encontró que el estadístico F (0,1574) es menor al valor crítico (2,479) y la P es mayor a 0,05, aceptándose la hipótesis nula, la desviación media absoluta resultó 0,27Å. La regresión dió coeficientes r2 de 0,89-0,86 y 0,76 para el método semiempirico, mecánica molecular y ab initio respectivamente.Para los ángulos, los valores encontrados también son satisfactorios, el estadístico F (0,226 ) valor crítico (2,43) y la P es mayor a 0,05, desviación media absoluta encontrada fue de 5,02 grados.

In this research work a computational study of glyphosate was carried out, calculating in detail the molecular properties of it. Through this work, the characterization of the glyphosate herbicide was achieved, presenting values of link lengths and angles as well as chemical properties of interest in QSAR studies, of energies and bioactivity obtained by quantum mechano methods using molecular, semi-empirical and ab-mechanical mechanics. Initio the results obtained were analyzed by comparing the experimental data of glyphosate with those obtained computationally demonstrating a good correlation. The structure of glyphosate was plotted using the Hyperchem interface; this was subjected to geometric optimization calculations initially of Molecular Mechanics to obtain the most stable structure, subsequently all structures were analyzed using the PM3 semi-empirical method to obtain more reliable energy and geometry values. For the ab initio method, the 3-21G base was used. The energy minimization of the structures was developed by the Fletcher-Reeves method of conjugate gradient up to a RMS (root-mean-square) gradient value less than 0,100 Kcal / (A°mol) or a maximum of 500 iteration cycles , the SCF convergence limit used was 0,001 Kcal / mol. The molecular properties required in QSAR (Activity structure relationships) and bioactivity prediction were performed in the Molinspiration computer chemo software. The ordering of the numerical data, the graphs, regressions and the ANOVA were performed in Excel 2015. The values found for link length are very satisfactory, it was found that the F statistic (0,1574) is less than the critical value (2,479) and the P is greater than 0.05, accepting the null hypothesis, the absolute mean deviation was 0.27Å. The regression gave r2 coefficients of 0,89-0,86 and 0,76 for the semi-empirical method, molecular mechanics and ab initio respectively. For the angles, the values found are also satisfactory, the statistical F (0,226) critical value (2,43) and P is greater than 0,05, absolute mean deviation found was 5,02 degrees.

Máquina e realidade: cibernética, autopoiese e produção de subjetividade em félix guattari / Máquina y realidad: cibernética, autopoiesis y producción de subjetividad en félix guattari / Machine and reality: cybernetics, autopoiesis and production of subjectivity in félix guattari

RESUMO O presente artigo tem como objetivo abordar o conceito de máquina e a consequente apropriação do mesmo nas discussões sobre a subjetividade. É um estudo teórico na interface entre psicologia, filosofia, física e biologia. Nesse sentido, ele se inicia apresentando que, na modernidade, a analogia à máquina foi estendida à compreensão do universo como sendo um relógio preciso e geometricamente previsível em seu funcionar. E se, até o século XVIII, a vida, o corpo e o cosmos foram significados, pela ciência emergente, como uma máquina mecânica (de movimento calculável em sua previsibilidade), no século XIX estes passaram igualmente a serem compreendidos como uma máquina térmica, com seus desdobramentos na física da termodinâmica e na cibernética. No final do século XX, a partir dos trabalhos dos biólogos Francisco Varela e Humberto Maturana, o conceito de máquina autopoiética ganhou relevância nos estudos sobre a vida e sobre a cognição, sendo este apropriado por Félix Guattari no desenvolvimento de seu conceito de produção de subjetividade e suas problematizações em torno dos processos de subjetivação. Assim, o conceito de máquina saiu das limitações de uma leitura mecânica e termodinâmica da realidade, para uma abordagem existencial, processual e inventiva da subjetividade.

RESUMEN El presente artículo tiene como objetivo abordar el concepto de máquina y la consiguiente apropiación del mismo en las discusiones sobre la subjetividad. Es un estudio teórico en la interfaz entre Psicología, Filosofía, Física y Biología. En ese sentido, se inicia presentando que, en la modernidad, la analogía a la máquina se extendió a la comprensión del universo como un reloj preciso y geométricamente previsible en su funcionamiento. Y si, hasta el siglo XVIII, la vida, el cuerpo y el cosmos fueron significados, por la ciencia emergente, como una máquina mecánica (de movimiento calculable en su previsibilidad), en el siglo XIX estos pasaron igualmente a ser comprendidos como una máquina térmica, con sus desdoblamientos en la física de la termodinámica y en la cibernética. A finales del siglo XX, a partir de losestudios de los biólogos Francisco Varela y Humberto Maturana, el concepto de máquina autopoiética ganó relevancia en los estudios sobre la vida y sobre la cognición, siendo éste apropiado por Félix Guattari en el desarrollo de su concepto de producción de subjetividad y sus problemasen torno a los procesos de subjetivación. Así, el concepto de máquina salió de las limitaciones de una lectura mecánica y termodinámica de la realidad, hacia un enfoque existencial, procesal e inventivo de la subjetividad.

ABSTRACT This article aims to address the concept of machine and its consequent appropriation in the discussions on subjectivity. It is a theoretical study at the interface among Psychology, Philosophy, Physics and Biology. In this sense, it starts showing that in the modernity, the analogy to the machine was extended to the understanding of the universe as a precise and geometrically predictable functioning clock. And if, until the eighteenth century, life, body and cosmos were signified by the emerging science as a mechanical machine (of calculable motion in its predictability), in the nineteenth century they also came to be understood as a thermal machine, with its developments in the thermodynamics physics and cybernetics. In the late twentieth century, the concept of autopoietic machine gained relevance in the studies of life and cognition, based on the works of the biologists Francisco Varela and Humberto Maturana, which is appropriated by Félix Guattari for the development of his concept of the production of subjectivity and its problematizations around the subjectivation processes. Thus, the concept of machine has gone beyond the limitations of a mechanical and thermodynamics reading of reality, to an existential, procedural and inventive approach of the subjectivity.

Is Hyperabduction Arm Position in Early Cocking Phase Really Dangerous for Baseball Pitchers? / 대한스포츠의학회지

PURPOSE: Certain pitching mechanics is thought to lead pitchers in danger of surgical risk and decrease performance. The objective of this study is to analyze the effect of shoulder hyperabduction position during early cocking phase in association with surgical risk and performance in professional baseball players.METHODS: From 2009 to 2013, total of 93 candidates reached minimum inning qualification. After exclusion criteria (overlapped players, foreign players, age over 31 years, proceed to other league and retirement), 19 players were analyzed with slow-motion pitching video for hyperabduction of the shoulder and hyperpronation of forearm in cocking-phase. Also players were analyzed with innings pitched, earned run average (ERA), walks and hits divided by innings pitched (WHIP) and surgical history with database offered by official Korean Baseball Organization website.RESULTS: Out of total 19 players, nine players had hyperabduction arm movement and 10 players did not. Group with hyperabduction had average age of 24.3 years old, average inning/ERA/WHIP for 5 years were 55 innings/yr, 6.52 ERA/yr and 1.33 WHIP/yr, respectively, and seven players (77%) had surgeries eventually. Group without hyperabduction arm movement had average age of 25.4 years old; average inning, ERA/WHIP for 5 years were 127 1/3 innings/yr, 4.84 ERA/yr, and 1.32 WHIP/yr, respectively and five players (50%) went for surgeries. Player performance (ERA, p=0.66; WHIP, p=0.14) was not statistically influenced by the certain arm position at cocking phase but average inning pitched was statistically affected (p<0.01).CONCLUSION: Hyperabduction of shoulder in early cocking phase of throwing motion does not lead to decrease in performance (ERA, WHIP) but will result in tremendous decline of average IP. Also, risk of surgery is not associated to hyperabduction motion of the shoulder.

Comparison of Biomechanical Properties of Dura Mater Substitutes and Cranial Human Dura Mater : An In Vitro Study

OBJECTIVE: The aim of this study was to investigate the biomechanical differences between human dura mater and dura mater substitutes to optimize biomimetic materials.METHODS: Four groups were investigated. Group I used cranial dura mater (n=10), group II used Gore-Tex® Expanded Cardiovascular Patch (W.L. Gore & Associates Inc., Flagstaff, AZ, USA) (n=6), group III used Durepair® (Medtronic Inc., Goleta, CA, USA) (n=6), and group IV used Tutopatch® (Tutogen Medical GmbH, Neunkirchen am Brand, Germany) (n=6). We used an axial compression machine to measure maximum tensile strength.RESULTS: The mean tensile strengths were 7.01±0.77 MPa for group I, 22.03±0.60 MPa for group II, 19.59±0.65 MPa for group III, and 3.51±0.63 MPa for group IV. The materials in groups II and III were stronger than those in group I. However, the materials in group IV were weaker than those in group I.CONCLUSION: An important dura mater graft property is biomechanical similarity to cranial human dura mater. This biomechanical study contributed to the future development of artificial dura mater substitutes with biomechanical properties similar to those of human dura mater.

Computational analysis of the electromechanical performance of mitral valve cerclage annuloplasty using a patient-specific ventricular model

We aimed to propose a novel computational approach to predict the electromechanical performance of pre- and post-mitral valve cerclage annuloplasty (MVCA). Furthermore, we tested a virtual estimation method to optimize the left ventricular basement tightening scheme using a pre-MVCA computer model. The present model combines the three-dimensional (3D) electromechanics of the ventricles with the vascular hemodynamics implemented in a lumped parameter model. 3D models of pre- and post-MVCA were reconstructed from the computed tomography (CT) images of two patients and simulated by solving the electromechanical-governing equations with the finite element method. Computed results indicate that reduction of the dilated heart chambers volume (reverse remodeling) appears to be dependent on ventricular stress distribution. Reduced ventricular stresses in the basement after MVCA treatment were observed in the patients who showed reverse remodeling of heart during follow up over 6 months. In the case who failed to show reverse remodeling after MVCA, more virtual tightening of the ventricular basement diameter than the actual model can induce stress unloading, aiding in heart recovery. The simulation result that virtual tightening of the ventricular basement resulted in a marked increase of myocardial stress unloading provides in silico evidence for a functional impact of MVCA treatment on cardiac mechanics and post-operative heart recovery. This technique contributes to establishing a pre-operative virtual rehearsal procedure before MVCA treatment by using patient-specific cardiac electromechanical modeling of pre-MVCA.

Comparison of Biomechanical Properties of Dura Mater Substitutes and Cranial Human Dura Mater : An In Vitro Study

OBJECTIVE: The aim of this study was to investigate the biomechanical differences between human dura mater and dura mater substitutes to optimize biomimetic materials. METHODS: Four groups were investigated. Group I used cranial dura mater (n=10), group II used Gore-Tex® Expanded Cardiovascular Patch (W.L. Gore & Associates Inc., Flagstaff, AZ, USA) (n=6), group III used Durepair® (Medtronic Inc., Goleta, CA, USA) (n=6), and group IV used Tutopatch® (Tutogen Medical GmbH, Neunkirchen am Brand, Germany) (n=6). We used an axial compression machine to measure maximum tensile strength. RESULTS: The mean tensile strengths were 7.01±0.77 MPa for group I, 22.03±0.60 MPa for group II, 19.59±0.65 MPa for group III, and 3.51±0.63 MPa for group IV. The materials in groups II and III were stronger than those in group I. However, the materials in group IV were weaker than those in group I. CONCLUSION: An important dura mater graft property is biomechanical similarity to cranial human dura mater. This biomechanical study contributed to the future development of artificial dura mater substitutes with biomechanical properties similar to those of human dura mater.

Intrastromal Corneal Foreign Body – Case Series and Discussion on the Physics of Injury

@#Traumatic injury to the eye can occur due to various causes, most of which are avoidable. Here we report three cases of intrastromal corneal foreign bodies (FB) which required surgical removal. Most corneal FBs are removed easily at the slit lamp, however, these cases required surgical intervention due to the mechanism of which the FB penetrated into the stroma. Although the mechanism of injury was similar, with all three cases occurring at high velocity, we observed that the entry and level of penetration differed in each case. In the first case, the corneal FB penetrated the cornea and was embedded in the anterior stroma, whereas in the second case, the FB was embedded in the posterior stroma, but with an intact endothelium. In the third case, the FB caused a full thickness, self-sealed laceration wound but remained embedded in the stroma. Through further evaluation, we noted that several factors contribute towards the severity of the injury, namely, anatomy of the cornea, area affected, shape, size, mass and velocity of the object. We speak in depth about the mechanism of injury and physics associated with these injuries and why the penetration differed in each case.

Respiratory Responses during Exercise in Self-contained Breathing Apparatus among Firefighters and Nonfirefighters

BACKGROUND: Firefighters are required to use self-contained breathing apparatus (SCBA), which impairs ventilatory mechanics. We hypothesized that firefighters have elevated arterial CO₂ when using SCBA. METHODS: Firefighters and controls performed a maximal exercise test on a cycle ergometer and two graded exercise tests (GXTs) at 25%, 50%, and 70% of their maximal aerobic power, once with a SCBA facemask and once with protective clothing and full SCBA. RESULTS: Respiratory rate increased more in controls than firefighters. Heart rate increased as a function of oxygen consumption (V.(O₂)) more in controls than firefighters. End-tidal CO₂ (ETCO₂) during the GXTs was not affected by work rate in either group for either condition but was higher in firefighters at all work rates in both GXTs. SCBA increased ETCO₂ in controls but not firefighters. CONCLUSIONS: The present study showed that when compared to controls, firefighters’ hypoventilate during a maximal test and GXT. The hypoventilation resulted in increased ETCO₂, and presumably increased arterial CO₂, during exertion. It is proposed that firefighters have altered CO₂ sensitivity due to voluntary hypoventilation during training and work. Confirmation of low CO₂ sensitivity and the consequence of this on performance and long-term health remain to be determined.

Cranial cruciate ligament structure in relation to the tibial plateau slope and intercondylar notch width in dogs

Cranial cruciate ligament (CCL) rupture is one of the most common orthopedic conditions in dogs. The pathogenesis of CCL rupture is not fully described and remains to be elucidated fully. Several hypotheses have been proposed to explain the etiology of these changes. The objective of this study was to investigate structural changes in the CCL in relation to the tibial plateau angle (TPA) and the intercondylar notch (ICN) width in dogs. Fifty-five skeletally mature dogs were included in this study. ICN width and TPA measurements were obtained from intact CCL stifles. Samples of the CCL, caudal cruciate ligament (CaCL), and femoral head ligament (FHL) were harvested and stained for routine histological and immunohistochemical analysis. Microscopic changes in the ligaments were observed and were found to correlate with the TPA and ICN width values. The degree of structural changes within the CCL was observed to correlate with an increasing TPA and a narrowing ICN width. Changes in the CCL are likely to be caused by excessive forces acting through the ligament in stifles with a high TPA. Chondroid metaplasia of the CCL is an adaptation to abnormal mechanics within the stifle joint caused by altered bone morphology.