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1.
Oper Dent ; 48(4): 351-357, 2023 Jul 01.
Article in English | MEDLINE | ID: mdl-37352465

ABSTRACT

OBJECTIVES: This case report describes the clinical protocols for using injectable flowable resin-based composite veneers without tooth reduction as long-term prototype restorations, followed by conservative feldspathic veneer restorations. CLINICAL CONSIDERATION: The patient's primary concern was to improve her smile. After clinical evaluation, injectable flowable resin composite veneers were recommended as long-term prototypes followed by conservative tooth preparation and ceramic veneers. Flowable composite veneers were created with a transparent silicone index fabricated from a diagnostic wax-up approved by the patient. No tooth reduction was required to place this type of composite veneer. Later, a printed reduction guide was used to provide conservative tooth preparation followed by the cementation of thin feldspathic porcelain veneers under full isolation with a rubber dam. CONCLUSIONS: Injectable flowable resin-based composite veneers can successfully act as long-term esthetic prototypes before ceramic veneers. The outcome of these restorations is very predictable because the diagnostic wax-up anatomy is transferred to the mouth through the transparent silicone index, and they can be placed without tooth reduction. Conservative tooth preparation can be performed on the composite veneers so that minimal tooth structure is removed to maximize the bonding performance of ceramic veneers.


Subject(s)
Dental Porcelain , Dental Veneers , Humans , Female , Dental Porcelain/chemistry , Ceramics , Composite Resins/therapeutic use
2.
Oper Dent ; 46(5): 477-483, 2021 Sep 01.
Article in English | MEDLINE | ID: mdl-34624106

ABSTRACT

OBJECTIVES: The case report describes a minimally invasive, multidisciplinary approach to a single discolored anterior tooth, with internal bleaching using traditional Japanese paper (Washi), a gingivoplasty with a three-dimensional (3D) printed surgical guide, and ultrathin feldspathic porcelain veneers. CLINICAL CONSIDERATION: The patient's primary concern was improving her smile. After clinical evaluation, internal tooth bleaching for the discolored tooth and gingivoplasty with restoration of the maxillary anterior six teeth and first premolars was recommended. The internal tooth whitening was accomplished with sodium perborate mixed with 30% hydrogen peroxide impregnated in Washi and sealed in the root canal with glass ionomer. Once the tooth bleaching was completed, the 3D printed surgical guide was placed in the patient's maxillary anterior region and used to guide soft tissue recontouring. After 6 months, ultrathin feldspathic porcelain veneers were placed. CONCLUSION: Well-planned restorative procedures combining internal tooth bleaching using Washi, gingivoplasty performed with electrosurgery using a 3D printed surgical guide, and ultrathin feldspathic porcelain veneers can achieve the desired results in the esthetic zone and remain successful for 4 years.


Subject(s)
Tooth Bleaching , Tooth Discoloration , Dental Porcelain , Dental Veneers , Esthetics, Dental , Female , Humans , Hydrogen Peroxide/therapeutic use , Tooth Bleaching/methods
3.
World J Surg Oncol ; 18(1): 101, 2020 May 21.
Article in English | MEDLINE | ID: mdl-32438919

ABSTRACT

BACKGROUND: When endometrial carcinoma invades the cervical stroma, overall survival and disease-free survival decrease. However, it is still controversial whether patients in suspected stage II should be treated with radical hysterectomy. The goal of this study is to describe the role of radical hysterectomy in patients with endometrial carcinoma and cervical involvement. METHODS: This was a retrospective cohort study were a total of 239 patients with endometrial carcinoma with cervical involvement from Mexico City's National Cancer Institute were divided according to the type of hysterectomy, and the outcomes were compared using statistical analysis. RESULTS: The 5-year overall survival was 75.76% for the simple hysterectomy group and 89.19% for the radical hysterectomy group, without achieving statistical significance. The 5-year disease-free survival was 72.95% for the simple hysterectomy group and 64.31% for the radical hysterectomy group, without achieving statistical significance. Radicality was associated with longer surgical times, intraoperative complications, and bleeding over 500 ml. CONCLUSIONS: In patients with endometrial carcinoma with cervical involvement, radical hysterectomy does not improve prognosis or alter adjuvant therapy.


Subject(s)
Carcinoma, Endometrioid/therapy , Endometrial Neoplasms/therapy , Hysterectomy/methods , Uterine Cervical Neoplasms/therapy , Blood Loss, Surgical/statistics & numerical data , Carcinoma, Endometrioid/mortality , Carcinoma, Endometrioid/pathology , Cervix Uteri/pathology , Cervix Uteri/surgery , Chemoradiotherapy, Adjuvant/methods , Disease-Free Survival , Endometrial Neoplasms/mortality , Endometrial Neoplasms/pathology , Female , Humans , Hysterectomy/adverse effects , Kaplan-Meier Estimate , Middle Aged , Operative Time , Prognosis , Retrospective Studies , Uterine Cervical Neoplasms/mortality , Uterine Cervical Neoplasms/pathology
4.
J Phys Chem A ; 124(20): 4053-4061, 2020 May 21.
Article in English | MEDLINE | ID: mdl-32338905

ABSTRACT

The accuracy of some density functional (DF) models widely used in material science depends on empirical or free parameters that are commonly tuned using reference physical properties. Grid-search methods are the standard numerical approximations used to find the optimal values of the free parameters, making the computational complexity to scale with the number of points in the grid. In this report, we illustrate that Bayesian optimization (BO), a sample-efficient machine learning algorithm, can calibrate different density functional models, e.g., hybrid exchange-correlation and range-separated density functionals. Using the atomization energies and bond lengths from the Gaussian-1 (G1) and Gaussian-2 (G2) databases, we show that BO optimizes the free parameters of the hybrid exchange-correlation functionals with approximately 55 evaluations of the error function. We also show that selecting exchange-correlation functionals for different physical systems can be done with BO. We jointly optimize and select the form of the exchange-correlation functionals and the free parameters by minimizing the root-mean-square error functions for the G1 and G2 data set atomization energies. The calibrated DF model is more accurate on average than standard DF methods, e.g., PBE0 and B3LYP.

6.
J Econ Entomol ; 109(3): 1015-1019, 2016 May 04.
Article in English | MEDLINE | ID: mdl-27151469

ABSTRACT

Development of alternative strategies for pest control with reduced effect on beneficial organisms is a priority given the increasing global loss of biodiversity. Biological control with entomopathogenic fungi arises as a viable option to control insect pests. However, few studies have focused on the consequences of using these organisms on pollinators other than the honey bee ( Apis mellifera L.) or bumble bees ( Bombus spp). We evaluated the pathogenicity of commercial formulations of three widely used entomopathogenic fungi, Metarhizium anisopliae (Metschnikoff) Sorokin, Beauveria bassiana Vuillemin, and Isaria fumosorosea (Wize), to three species of stingless bees: Tetragonisca angustula Latreille, Scaptotrigona mexicana Guérin-Meneville, and Melipona beecheii Bennett. Bioassays consisted of exposing groups of bees to the recommended field concentration of each fungus using a microspray tower under laboratory conditions. Susceptibility to fungi varied greatly among species . Isaria fumosorosea (strain Ifu-lu 01) and the two formulations of B. bassiana (Bea-TNK and BotanicGard) caused <30.3% mortality in all bee species. Metarhizium anisopliae (Meta-TNK and strain Ma-lu 01) was highly active against T. angustula (94.2% mortality) and moderately active against M. beecheii (53.0% mortality) and S. mexicana (38.9% mortality). Though our laboratory-derived results suggest a moderate to high impact of these entomopathogenic fungi on stingless bees, further field studies are required to support this finding.

7.
Rev. med. vet. zoot ; 62(3): 18-33, sep.-dic. 2015. ilus, tab
Article in Spanish | LILACS-Express | LILACS | ID: lil-779682

ABSTRACT

Cinco razas de ganado bovino (Bos taurus) del trópico alto de Nariño fueron caracterizadas usando once loci microsatélites. Se incluyeron las razas Holstein, Jersey, Normando, Pardo suizo y el ganado Criollo. Las frecuencias alélicas fUeron calculadas y usadas para la caracterización de las razas y el estudio de sus relaciones genéticas. La diversidad genética reflejada en el número de alelos por locus (NPA = 10) y la heterocigosidad observada (Ho = 0,7) fue alta, siendo mayor para la raza Criolla. El AMOVA, evidenció una baja diferenciación genética (FST = 0,0663) para la población total, con una pequeña diferenciación entre Criollo y Holstein (0,006), resultado que fue correspondiente con el análisis de agrupamiento bayesiano, que permitió determinar un grado de absorción del núcleo Criollo del 56% por la raza Holstein. La alta diversidad, supone procesos de adaptación a diferentes ambientes y mezcla de razas, facilitando un continuo flujo genético. Esto puede explicarse por la realización de cruces dirigidos al incremento del volumen de producción teniendo como base la raza Holstein, donde la selección intensiva puede conllevar al detrimento de la pureza del ganado criollo e incidir en su capacidad adaptativa.


Five populations of cattle (Bos taurus) from tropical high of Narino were characterized with 11 loci microsatellites. The breeds included were Holstein, Jersey, Normande, Brown Swiss and Creole. The molecular characterization of breeds and study genetic relationships were made with Alleles frequencies. Genetic diversity as the number of alleles per locus (NPA = 10) and observed heterozygosity (Ho = 0.7) were high, being higher for the Creole breed. Analysis of molecular variance (AMOVA), showed low genetic differentiation (FST = 0.0663) for the total population, with a small difference between Creole and Holstein (0.006). This result was similar to the Bayesian clustering analysis, which identified a percentage of absorption of 56% to Creole by the Holstein breed. The high diversity assumes processes of adaptation to different environments and miscegenation, showing a continuous gene flow. The above can be explain by cross-breeding to increase the production volume on the basis of the Holstein breed. Detrimental impacts, due to the intensive selection, might this have on the creole cattle and has influence in their adaptive capacity.

8.
J Hosp Infect ; 87(1): 63-7, 2014 May.
Article in English | MEDLINE | ID: mdl-24746610

ABSTRACT

It is unknown whether healthcare workers' facial hair harbours nosocomial pathogens. We compared facial bacterial colonization rates among 408 male healthcare workers with and without facial hair. Workers with facial hair were less likely to be colonized with Staphylococcus aureus (41.2% vs 52.6%, P = 0.02) and meticillin-resistant coagulase-negative staphylococci (2.0% vs 7.0%, P = 0.01). Colonization rates with Gram-negative organisms were low for all healthcare workers, and Gram-negative colonization rates did not differ by facial hair type. Overall, colonization is similar in male healthcare workers with and without facial hair; however, certain bacterial species were more prevalent in workers without facial hair.


Subject(s)
Bacterial Infections/microbiology , Biota , Carrier State/microbiology , Hair/microbiology , Health Personnel , Adult , Bacterial Infections/epidemiology , Carrier State/epidemiology , Cross-Sectional Studies , Hospitals , Humans , Male , Middle Aged , Prevalence , Young Adult
9.
Eur J Health Econ ; 15(3): 243-52, 2014 Apr.
Article in English | MEDLINE | ID: mdl-23535984

ABSTRACT

OBJECTIVE: Following intensive care discharge, many patients suffer severe physical and psychological morbidity and a continuing high use of health services. Follow-up programmes have been proposed to improve the outcomes for these patients. We tested the hypothesis that nurse-led intensive care follow-up programmes are cost-effective. METHODS: A pragmatic, multicentre, randomised controlled trial of nurse-led intensive care unit follow-up programmes versus standard care. A cost-utility analysis was conducted after 12 months' follow-up to compare the two interventions. Costs were assessed from the perspective of the UK NHS and outcomes were measured in quality-adjusted life years (QALYs) based upon responses to the EQ-5D administered at baseline, 6 and 12 months. RESULTS: A total of 286 patients were recruited to the trial. Total mean cost was £ 5,789 for standard care and £ 7,577 for the discharge clinic. The adjusted difference in means was £ 2,435 [95 % confidence interval (CI) -297 to 5,566]. Mean QALYs were 0.58 for standard care and 0.60 for the discharge clinic. The adjusted mean difference was -0.003 (95 % CI -0.066 to 0.060). If society were willing to pay £ 20,000 per QALY then there would be a 93 % chance that standard care would be considered most efficient. CONCLUSIONS: A nurse-led intensive care unit (ICU) follow-up programme showed no evidence of being cost-effective at 12 months. Further work should focus on evidence-based development of discharge clinic services and current ICU follow-up programmes should review their practice in light of these results.


Subject(s)
Critical Care/organization & administration , Nurses/organization & administration , Patient Care Management/organization & administration , Continuity of Patient Care/economics , Cost-Benefit Analysis , Critical Care/economics , Health Services/statistics & numerical data , Humans , Nurses/economics , Patient Care Management/economics , Quality of Life , Quality-Adjusted Life Years , State Medicine/economics , United Kingdom
10.
Appl Radiat Isot ; 83 Pt C: 268-71, 2014 Jan.
Article in English | MEDLINE | ID: mdl-23916598

ABSTRACT

We report, the application of the photoacoustic technique for monitoring the photosynthesis evolution in aquatic lirium (Eichhornia Crassipes), before and after it was exposed to ultrasonic irradiations. We obtained the disappearance of the phototobaric contribution in the PA signal measured for the irradiated samples with ultrasound of 17 kHz, and therefore of a possible damage in the centers producing the photosynthesis, due to the irradiation. These results show the utility of the ultrasonic irradiation, as well as, of the photosynthesis monitoring by means of the photoacoustic technique, for the elaboration and establishment of methodologies in the control of this aquatic plant, whose propagation causes many consequences extremely unfavorable for the environment, as well as for the diverse human activities that are developed in the bodies of water in the tropical and sub-tropical regions of the world.


Subject(s)
Acoustics , Eichhornia/physiology , Photochemical Processes , Photosynthesis , Ultrasonics , Eichhornia/radiation effects
11.
Colorectal Dis ; 14(9): e567-72, 2012 Sep.
Article in English | MEDLINE | ID: mdl-22390187

ABSTRACT

AIM: Micropapillary carcinoma (MPC) is regarded as an aggressive variant of adenocarcinoma in any location. The reported proportion of a micropapillary carcinoma component in an entire tumour ranges from 5 to 95% and only one case of pure MPC has been reported. To date, approximately 130 cases of MPC in the colorectum have been reported, but it is likely that this small number is to some extent due to under-reporting because this pattern is not well recognized by the general pathologist. All previous studies have combined colonic and rectal primary tumours and most have only analysed patients with clinical Stages I or II. METHOD: We analysed 15 cases of MPC of the colon alone, diagnosed in our institution, and compared them with 105 conventional carcinomas of the colon. RESULTS: An MPC component was present in 10% of all colonic carcinomas. These tumours presented at a median age of 56 years, and all were of American Joint Committee on Cancer Stages III and IV. Subserosal tissue invasion was present in every case, 60% had more than four positive lymph nodes, 60% were accompanied by poorly differentiated conventional carcinoma, 40% had had an incomplete resection and a third demonstrated lymphovascular invasion. Despite these adverse prognostic factors, tumours containing MPC showed the same survival, stage by stage, as conventional adenocarcinoma in multivariate analysis, although 3-year survival (81.7%vs 87.3%, P=0.035) was worse on univariate analysis. CONCLUSION: The histopathologist should be aware of the possibility of MPC. Three-year survival is worse than in patients with conventional colonic carcinomas in Stage III.


Subject(s)
Adenocarcinoma/pathology , Carcinoma, Papillary/pathology , Colonic Neoplasms/pathology , Adenocarcinoma/mortality , Adenocarcinoma/surgery , Adult , Aged , Aged, 80 and over , Carcinoma, Papillary/mortality , Carcinoma, Papillary/surgery , Colonic Neoplasms/mortality , Colonic Neoplasms/surgery , Female , Humans , Kaplan-Meier Estimate , Lymphatic Metastasis , Male , Middle Aged , Neoplasm Grading , Neoplasm Staging , Prognosis
12.
Orthod Craniofac Res ; 14(2): 63-9, 2011 May.
Article in English | MEDLINE | ID: mdl-21457455

ABSTRACT

OBJECTIVES: To investigate how mandibular and femoral growth is affected when sex hormone- specific receptor antagonist is administered in growing mice. MATERIALS AND METHODS: Forty C57BL/6J mice were used in this experiment. At 5 days of age, the mice received daily injection of estrogen receptor alpha (ERα), beta (ERß), or androgen receptor (AR) antagonists, and their body weight was assessed every 4 days. One, four and eight weeks after the initial injection, radiographs of the mandible and femur were taken and measured. Analyses of variance and pairwise comparisons (Fisher) were performed to examine the differences in values measured among the groups. RESULTS: Mandibular growth was affected by ERß antagonist injection in male mice at 4 and 8 weeks. In female mice, the growth was affected during all the experimental period, when ERß was administered. Moreover, at 8 weeks, mandibular growth was also affected in male and female mice injected with ERα antagonist and in male mice injected with AR antagonist. Femoral growth was affected during all the experimental period in male and female mice injected with ERß antagonist. Moreover, at 8 weeks, the growth was affected in male and female mice injected with ERα antagonist and in male mice injected with AR antagonist. CONCLUSIONS: Growth of the mandible and femur in mice, in part, is induced in response to the stimulation of ERß in chondrocytes before and during early puberty. In late and after puberty, the growth is induced by the stimulation of ERα in male and female mice and that of AR in male mice.


Subject(s)
Femur/growth & development , Gonadal Steroid Hormones/antagonists & inhibitors , Mandible/growth & development , Age Factors , Androgen Receptor Antagonists/pharmacology , Animals , Body Weight , Cephalometry , Epiphyses/diagnostic imaging , Epiphyses/drug effects , Epiphyses/growth & development , Estrogen Receptor alpha/antagonists & inhibitors , Estrogen Receptor beta/antagonists & inhibitors , Female , Femur/diagnostic imaging , Femur/drug effects , Flutamide/pharmacology , Male , Mandible/diagnostic imaging , Mandible/drug effects , Mandibular Condyle/diagnostic imaging , Mandibular Condyle/drug effects , Mandibular Condyle/growth & development , Mice , Mice, Inbred C57BL , Mice, Inbred Strains , Microradiography , Piperidines/pharmacology , Pyrazoles/pharmacology , Pyrimidines/pharmacology , Time Factors
13.
Eur J Orthod ; 33(5): 564-9, 2011 Oct.
Article in English | MEDLINE | ID: mdl-21300724

ABSTRACT

Sex hormones are important for bone growth. However, the mechanism by which sex hormone receptors influence bone growth remains unclear. In orthodontic treatment, there is a need to develop an indicator of bone maturity to accurately predict the beginning and end of growth. This indicator might be developed from the screening of sex hormones. The purpose of this study was to investigate the role of each sex hormone receptor on bone growth in newborn mice. Five-day-old C57BL/6J mice were used in this experiment. Forty mice underwent an orchiectomy (ORX), ovariectomy (OVX), or sham surgery. One week after surgery, the femur and the mandible were resected for immunohistochemical staining. Alternatively, 80 mice were daily injected with antagonist against receptors oestrogen alpha (ERα), beta (ERß), or androgen receptor (AR). One week after the first injection, radiographs of the femur and mandible were taken and then measured. Analysis of variance and pairwise comparisons (Fisher) were performed to examine the differences in values measured among the groups In the sham-operated male and female mice, ERß was found to be more prominent than ERα and AR during all experimental periods. In the ORX and OVX groups, the expressions of all receptors were significantly reduced in comparison with the sham-operated control group throughout the experiment. Moreover, femur and mandibular growth were significantly affected in the group injected with ERß antagonist. The deficiency of any sex hormone leads to reduced bone growth. In particular, a disturbance in ERß produces a greater aberrance in both male and female mice immediately after birth.


Subject(s)
Femur/growth & development , Mandible/growth & development , Osteogenesis/physiology , Receptors, Androgen/physiology , Receptors, Estrogen/physiology , Analysis of Variance , Androgen Receptor Antagonists/pharmacology , Animals , Animals, Newborn , Estrogens/pharmacology , Female , Femur/drug effects , Gonadal Steroid Hormones/physiology , Male , Mandible/drug effects , Mice , Mice, Inbred C57BL , Osteogenesis/drug effects , Receptors, Estrogen/antagonists & inhibitors
14.
Fam Pract ; 26(2): 137-44, 2009 Apr.
Article in English | MEDLINE | ID: mdl-19244470

ABSTRACT

OBJECTIVES: Bell's palsy (BP), which causes facial paralysis, affects 11-40 people per 100 000 per annum in the UK. Its cause is unknown but as many as 30% of patients have continuing facial disfigurement, psychological difficulties and occasionally facial pain. We present an randomised controlled trial (RCT)-based economic evaluation of the early administration of steroids (prednisolone) and/or antivirals (acyclovir) compared to placebo, for treatment of BP. METHODS: The RCT was not powered to detect differences in the cost-effectiveness; therefore, we adopted a decision analytic model approach as a way of gaining precision in our cost-effectiveness comparisons [e.g. prednisolone only (PO) versus acyclovir only versus prednisolone and acyclovir versus placebo, prednisolone versus no prednisolone (NP) and acyclovir versus no acyclovir]. We assumed that trial interventions affect the probability of being cured/not cured but their consequences are independent of the initial therapy. We used the percentage of individuals with a complete recovery (based on House-Brackmann grade = 1) at 9 months and Quality Adjusted Life Years (e.g. derived on responses to the Health Utilities Index III) as measures of effectiveness. Other parameter estimates were obtained from trial data. RESULTS: PO dominated-i.e. was less costly and more effective-all other therapy strategies in the four arms model [77% probability of cost-effective (CE)]. Moreover, Prednisolone dominated NP (77% probability of being CE at 30 000 UK pounds threshold) while no acyclovir dominated aciclovir (85% chance of CE), in the two arms models, respectively. CONCLUSIONS: Treatment of BP with prednisolone is likely to be considered CE while treatment with acyclovir is highly unlikely to be considered CE. Further data on costs and utilities would be useful to confirm findings.


Subject(s)
Acyclovir/administration & dosage , Acyclovir/economics , Anti-Inflammatory Agents/administration & dosage , Anti-Inflammatory Agents/economics , Antiviral Agents/administration & dosage , Antiviral Agents/economics , Bell Palsy/drug therapy , Bell Palsy/economics , Prednisolone/administration & dosage , Prednisolone/economics , Adult , Cost-Benefit Analysis/statistics & numerical data , Decision Trees , Double-Blind Method , Drug Therapy, Combination , Female , Follow-Up Studies , Health Resources/economics , Health Resources/statistics & numerical data , Humans , Male , Middle Aged , State Medicine/economics , Treatment Outcome , United Kingdom , Utilization Review/statistics & numerical data
15.
Colorectal Dis ; 10(9): 859-68, 2008 Nov.
Article in English | MEDLINE | ID: mdl-18624821

ABSTRACT

OBJECTIVE: Colorectal cancer is one of the most common cancers and the standard surgical treatment for this cancer is open resection (OS), but laparoscopic surgery (LS) may be an alternative treatment. In 2000, a Health Technology Assessment (HTA) review found little evidence on costs and cost-effectiveness in comparing the two methods. The evidence base has since expanded and this study systematically reviews the economic evaluations on the subject published since 2000. METHOD: Systematic review of studies reporting costs and outcomes of LS vs OS for colorectal cancer. National Health Service Economic Evaluation Database (NHS EED) methods for abstract writing were followed. Studies were summarized and incremental cost-effectiveness ratios (ICER) for common outcomes were calculated. RESULTS: Five studies met the inclusion criteria. LS generally had higher healthcare costs. Most studies reported longer operational time and shorter length of stay and similar long-term outcomes with LS vs OS. Only one outcome, complications, was common across all studies but results lacked consistency (e.g. in two studies, OS was less costly but more effective; in another study, LS was less costly but more effective; and in the further two studies, LS could potentially be cost effective depending on the decision-makers' willingness to pay for the health gain). CONCLUSION: The evidence on cost-effectiveness is not consistent. LS was generally more costly than OS. However, the effectiveness data used in individual economic evaluation were imprecise and unreliable when compared with data from systematic reviews of effectiveness. Nevertheless, short-term benefits of LS (e.g. shorter recovery) may make LS appear less costly when productivity gains are considered.


Subject(s)
Colorectal Neoplasms/surgery , Digestive System Surgical Procedures/economics , Laparoscopy/economics , Cost-Benefit Analysis , Humans , Randomized Controlled Trials as Topic , Treatment Outcome
16.
Nutr Hosp ; 22(5): 578-83, 2007.
Article in Spanish | MEDLINE | ID: mdl-17970542

ABSTRACT

The present study has as objective to describe behavior of the different components of functionality and muscular mass, in institutionalized older people. Because levels of muscular mass have been associated with reduced levels of force, activity, functionality, depression of the immune function and increase of the morbidity and mortality risk. Were evaluated 152 elderly people older than 60 years old, men and women, of 14 geriatric centers of the Gran Caracas. Anthropometrical variable was measured to value the muscular mass and the body mass index. It was evaluated: hand isometric force, walking time 4.88 m and getting up of a seat. Descriptive statistic was carried out for all the variables, t of Student, Anova and Scheffé. It was observed that 80 years older elderly as well as, women present higher levels of disability, performed motor activities (to walk and to get up of a seat and a impair in physical conditions (lean mass and muscular strength) that interfere with functional status.


Subject(s)
Anthropometry , Muscle Strength , Muscle, Skeletal/anatomy & histology , Aged , Aged, 80 and over , Body Mass Index , Disability Evaluation , Female , Hand Strength , Homes for the Aged , Humans , Male , Middle Aged , Venezuela/epidemiology , Walking
17.
Nutr Hosp ; 20(5): 358-63, 2005.
Article in Spanish | MEDLINE | ID: mdl-16229405

ABSTRACT

Equations to predict height from several body segments have been developed. However, those that use the knee height are limited by the need of an instrument with high cost (anthropometer). Thus, the aim of this study was to develop a prediction equation from the leg length by using a tape measure. Leg length and height was measured in 180 subjects, with ages 30-59 years that attended the Ambulatorio Docente Asistencial of the University Hospital of Caracas, from April to June of 2002. In order to determine the correlation degree of each measurement with height, the existent correlation between height and each one of the studied variables (leg length, sex, age) and between the variables to one each other was calculated by means of the Pearson's correlation coefficient. Linear regression analysis was done to estimate the height in each gender and the results were tested on an independent sample. The generated equations achieved a very good correlation with the real height and the standard error was calculated. Thus, in those subjects in whom assessment of the real height is not possible by conventional means, it is possible to use height prediction equations from simple techniques and equipment accessible to the whole health care staff.


Subject(s)
Body Height , Leg/anatomy & histology , Adult , Age Factors , Female , Humans , Linear Models , Male , Middle Aged , Sex Factors , Weights and Measures
18.
Clin Orthop Relat Res ; (380): 99-107, 2000 Nov.
Article in English | MEDLINE | ID: mdl-11064979

ABSTRACT

The higher costs associated with teaching hospitals have received some attention in the literature. The objective of the current study was to determine the increase in resource consumption associated with resident education in knee arthroplasty surgery. Seventy-four patients who underwent primary total knee arthroplasty in the same hospital were studied (50 private practice and 24 teaching practice). Time in the operating room and medical severity of illness were noted. Hospital charges were used as a measure of resource consumption. In addition, length of stay and in-hospital consultations and complications were observed. Kruskall-Wallis, chi square, and stepwise multiple regression analysis were performed. The mean age of the patients was 68 years. Patients who underwent surgery at the teaching service had higher charges ($30,311 +/- $3,325 versus $23,116 +/- $3,341) and longer times in the operating room (190 +/- 19 minutes versus 145 +/- 29 minutes). These patients also had a trend toward more associated comorbid medical conditions (0.71 versus 0.42). Stepwise multiple regression analysis showed that teaching was the most important predictor of charges and operating room time. The results show a 22% increase in perioperative resource consumption for patients who underwent surgery at a teaching service. The measured increase in cost is significantly lower than what has been reported in other series (82%). At the teaching institution, the anesthesia and orthopaedic surgery residents work together on all cases and perform a significant percent of the procedures under direct supervision. The increased resource consumption observed in a teaching service is most likely attributable to the hands-on approach taken to train residents.


Subject(s)
Arthroplasty, Replacement, Knee , Internship and Residency/economics , Orthopedics/education , Adult , Aged , Aged, 80 and over , Arthroplasty, Replacement, Knee/economics , Comorbidity , Female , Florida , Humans , Male , Middle Aged , Orthopedics/economics , Regression Analysis
19.
J Arthroplasty ; 14(6): 669-71, 1999 Sep.
Article in English | MEDLINE | ID: mdl-10512437

ABSTRACT

Numerous legislative proposals to cut reimbursement to surgeons and hospitals are presently included in U.S. congressional and senate agendas. Perioperative x-ray films in arthroplasty surgery are standard operating procedure. Our objective was to assess the effects of the radiologist reading on the clinical and economic outcome of arthroplasty procedures. One hundred consecutive cases were prospectively studied. The radiologist reading, clinical management, and outcome of each case were carefully reviewed. The amount billed for the radiologist interpretation was noted for each examination. A total of 398 studies in 100 patients were done. Ninety-six preoperative, 110 intraoperative, and 192 postoperative radiographic studies were reviewed. These reports took an average of 1.71 days to be recorded on the chart (SD +/- 2.45). The total radiologic professional fees billed to Medicare in these cases was $11,054. (The radiologist's interpretation was not useful in the clinical management and did not affect the outcome in any case.) Assuming that each surgeon takes 1 x-ray film on every arthroplasty case, the total actual savings to Medicare of not having a radiologist reading these studies could reach $536,000 per year; if 2 intrahospital x-ray studies are performed per procedure (preoperative, intraoperative, or postoperative), the savings are $1.1 million per year. These cost reductions are achieved at no sacrifice to quality of care or outcome. Numerous areas of excessive spending with no improvement in outcome exist in the treatment of Medicare patients. There areas should be identified and eliminated before surgical fees are lowered even further.


Subject(s)
Arthroplasty, Replacement/economics , Outcome Assessment, Health Care/statistics & numerical data , Practice Patterns, Physicians'/economics , Radiography/economics , Aged , Arthroplasty, Replacement/standards , Cost Savings , Florida , Hospital Costs/statistics & numerical data , Humans , Medicare , Preoperative Care/economics , Prospective Studies , Radiography/standards , Radiology/economics , United States
20.
Arch Latinoam Nutr ; 49(4): 344-50, 1999 Dec.
Article in Spanish | MEDLINE | ID: mdl-10883299

ABSTRACT

The frame size improves the interpretation of the body mass in adult and its incorporation is very useful in the assessment of nutritional status. This study compared two of the anthropometric methods used to classify individuals according to frame size: Grant method (height (cm)/wrist circumference (cm)) and Frame index 2 (elbow breadth (mm)/height (cm) x 100) in order to identify coincidence, concordance and divergence between then. Data from two hundred and forty nine apparently healthy individuals, between the ages of 22 and 63, belonging to "Health Project: Administration employees of the Simón Bolívar University" were included. Results showed significant differences between the two methods, not only in the proportion of classified individuals in each frame size category, but also when contrasted the same method using one or another body hemispheres. When studying both methods, the divergence in frame size identification varied between 19% and 55% with a low concordance (k = < or = 0.40). Grant method, compared to Frame index 2 showed a greater association with the variables and indicators of total body mass and body fat; in the other hand, Frame index 2 revealed a lesser correlation with such variables and indicators specially in female (r = 0.17 with fat percentage). These results clearly show the differences that could be created in the frame size identification of an individual of group of individuals if different criteria are used; this could also lead to a wrong anthropometric diagnosis.


Subject(s)
Adipose Tissue , Anthropometry/methods , Body Composition , Adult , Body Height , Body Mass Index , Body Weight , Female , Humans , Male , Middle Aged , Venezuela
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