Is there a good agreement between MRI readers for Thaunat's classification in arthroscopically-proven meniscal ramp lesions?

OBJECTIVE: To describe and evaluate the reproducibility by MRI of an arthroscopically-based classification for meniscal ramp lesions. We hypothesize that MRI would present good interobserver and intraobserver reliability to evaluate meniscal ramp lesions. MATERIALS AND METHODS: Twenty MRI of the knee with arthroscopically-proven meniscal ramp lesions were independently assessed by two skilled musculoskeletal radiologists and a third-year radiology resident. Reading was performed in a randomized and anonymous manner, in two steps, with a minimum of 1-month interval between each. Cohen's kappa coefficient statistic was used to analyze intra and interobserver reading agreement. Associate findings were also categorized. RESULTS: From 20 subjects, 17 were male, with mean age of 35 years. MRI reading showed type IV ramp lesion as most prevalent with eight cases (37%), followed by type V - four (21%), type I - four (20%), type III - three, (16%) and type II - one (6%). Regarding ramp lesion types, intraobserver agreement was substantial for both skilled readers (Kappa = 0.72), and moderate for the less experienced reader (Kappa = 0.51); interobserver agreement was moderate. Results between most experienced readers were also analyzed in two categories: stable (types I and II) and unstable (types III, IV and V), also resulting in moderate agreement (Kappa = 0.54). Intraobserver agreement was substantial for both readers (Kappa = 0.68). The most common associate findings were joint effusion (85%), posteromedial capsular structures injury (60%), and medial meniscus extrusion (60%). CONCLUSION: The arthroscopy classification for meniscal ramp lesions stability adapted for MRI has good reproducibility when applied by trained musculoskeletal radiologists.

Educação profissional cidadã: ampliando a concepção dos cuidadores(as) de idosos(as) acerca do processo de envelhecimento para além das práticas de cuidado / Professional public education: extending the concept of elderly caregivers about the aging process in addition to the practices of care

Cuidar de pessoas idosas é uma atividade complexa, envolvendo não apenas conhecimentos teórico-práticos, mas também os ligados às dimensões éticas, psicológicas e socioculturais. O objetivo desse trabalho é destacar alguns aspectos mais relevantes do perfil do(a) Cuidador(a) de pessoas idosas e problematizar o trabalho realizado por este profissional, ampliando o valor de suas práticas, tendo como ponto de partida os resultados obtidos com o desenvolvimento do projeto de pesquisa “Melhoria da Qualidade do Trabalho realizado pelo(a) Cuidador(a) de Idosos(as) da Cidade de Juazeiro e do Crato, no Ceará”, Brasil.

Caring for the elderly is a complex activity involves not only theoretical knowledge and practical, but ethical, psychological and sociocultural. The aim of this paper is to present relevant aspects of the profile caregiver of elderly and their work, taking as its starting point the development of the project “Quality Improvement of the Work performed by Caretaker Elderly of Cities Juazeiro and Crato in Ceará”, Brazil.

Educação Profissional Cidadã: ampliando a concepção dos cuidadores(as) de idosos(as) acerca do processo de envelhecimento para além das práticas de cuidado / Professional Public Education: extending the concept of elderly caregivers about the aging process in addition to the practices of care

Cuidar de pessoas idosas é uma atividade complexa, envolvendo não apenas conhecimentos teórico-práticos, mas também os ligados às dimensões éticas, psicológicas e socioculturais. O objetivo desse trabalho é destacar alguns aspectos mais relevantes do perfil do(a) Cuidador(a) de pessoas idosas e problematizar o trabalho realizado por este profissional, ampliando o valor de suas práticas, tendo como ponto de partida os resultados obtidos com o desenvolvimento do projeto de pesquisa “Melhoria da Qualidade do Trabalho realizado pelo(a) Cuidador(a) de Idosos(as) da Cidade de Juazeiro e do Crato, no Ceará”, Brasil.(AU)

Caring for the elderly is a complex activity involves not only theoretical knowledge and practical, but ethical, psychological and sociocultural. The aim of this paper is to present relevant aspects of the profile caregiver of elderly and their work, taking as its starting point the development of the project “Quality Improvement of the Work performed by Caretaker Elderly of Cities Juazeiro and Crato in Ceará”, Brazil.(AU)