Orientador: Guilherme Monteiro Tosoni / Resumo: As fraturas e reabsorções radiculares dentárias são ocorrências de diagnóstico por vezes complicado, exigindo do Cirurgião-Dentista a realização de exames complementares mais específicos, como a tomografia computadorizada de feixe cônico. Devido à existência de uma gama variável de aparelhos disponíveis no mercado, realizou-se um estudo no qual foi avaliada a capacidade de diagnóstico de cinco modelos (EAGLE 3D® - Dabi Atlante; SCANORA 3D® - Soredex; Orthophos XG 3D® - Sirona Dental; PREXION 3D® - Prexion Dental Inc. e I-CAT® - Imaging Sciences - Kavo) na identificação de fraturas e reabsorções radiculares. Para tanto, foram reproduzidas fraturas e reabsorções radiculares em 60 dentes humanos, obtidos por meio do banco de dentes, que posteriormente foram montados em 12 mandíbulas artificiais e submetidos à aquisição de imagens pelos equipamentos de tomografias computadorizadas de feixe cônico. As imagens DICOM dos exames foram exportadas dos softwares originais dos equipamentos e importadas para dentro do software OnDemand® (Cybermed Inc. USA), onde foram analisadas por 2 radiologistas com experiência na interpretação desse tipo de exame. Foi permitido aos examinadores observarem as imagens nos planos axial, coronal e sagital na busca das fraturas e reabsorções radiculares. Após avaliação das imagens, os resultados obtidos foram agrupados e submetidos à análise estatística para sua validação, utilizando o software GraphPadPrism 6® (San Diego, CA, USA). Os resultados mostraram... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Dental root fractures and resorptions are complicated diagnostic events sometimes, requiring the Dentist to perform more specific complementary exams such as cone beam computed tomography. Due to the existence of a variable range of devices available on the market, a study was carried out analysing the diagnostic capacity of five models (EAGLE 3D® - Dabi Atlante; SCANORA 3D® - Soredex; Orthophos XG 3D® - Sirona Dental; PREXION 3D® - Prexion Dental Inc. and I-CAT® - Imaging Sciences - Kavo) to identify fractures and root resorptions. For this purpose, fractures and root resorption were reproduced in 60 human teeth, obtained through the human tooth bank, which were assembled later in 12 artificial mandibles and submitted to image acquisition by a cone beam computed tomography equipment. The DICOM images of the exams were exported from the original equipment software and imported into OnDemand® software (Cybermed Inc. USA), where they were analyzed by two radiologists with experience in the interpretation of these scans. The examiners were allowed to observe the images in the axial, coronal and sagittal planes in the search for fractures and root resorptions. After evaluation of the images, the results were grouped and submitted to statistical analysis for validation using GraphPadPrism 6® software (San Diego, CA, USA). The results showed that there was a high index of correct answers in the evaluations of both examiners, and also that there were no differences in the diagnostic... (Complete abstract click electronic access below) / Doutor

Orientador: Plauto Christopher Aranha Watanabe / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-27T03:31:42Z (GMT). No. of bitstreams: 1 Alonso_MariaBeatrizCarrazzoneCal_D.pdf: 1019899 bytes, checksum: 6b933c1c5e72bab8ab8d15a411f3eb5a (MD5) Previous issue date: 2015 / Resumo: O objetivo neste estudo foi avaliar e comparar a Densidade Mineral Óssea (DMO), Conteúdo Mineral Ósseo (CMO) e níveis séricos do cálcio, fósforo e magnésio em ratos submetidos à dieta diária de café e refrigerantes à base de cola e guaraná. Para isto foram utilizados 80 ratos (Rattus norvegiau albinus, Wistar), sendo 40 machos e 40 fêmeas, com 60 dias de vida distribuídos em oito grupos de acordo com a dieta. Após 48 dias de administração das substâncias, todos os animais foram sacrificados, coletado o sangue para as análises bioquímicas e dissecados os fêmures esquerdo de cada animal para avaliação da DMO e CMO por meio da densitometria óssea por dupla-absorção de raios X (DXA). Os resultados obtidos foram apresentados como média e erro-padrão da média, submetidos à análise de variância ¿ ANOVA e teste de Tukey com p < 0,05. Os resultados demonstraram que os maiores valores de DMO e CMO foram encontrados nos ratos machos. Redução significativa da DMO e CMO foi observada apenas para o consumo do café nas fêmeas, enquanto que nos machos, nenhuma diferença foi encontrada. Em relação às análises bioquímicas, os ratos machos apresentaram os maiores valores séricos de cálcio, porém sem diferença estatística entre os grupos de dieta. Com referência ao fósforo as fêmeas apresentaram as maiores concentrações séricas do mineral. Para os ratos machos as maiores concentrações de fósforo foram observadas no grupo da cola em relação aos grupos do guaraná e café, porém o mesmo não diferiu do grupo controle. A avaliação do magnésio demonstrou que em ambos os sexos e apenas para o grupo do café houve aumento significativo da concentração plasmática do mineral. Todos os animais apresentaram aumento de peso durante o experimento. Os refrigerantes de cola e guaraná foram as substâncias mais consumidas quando comparadas ao café. Pôde-se concluir que alterações minerais plasmáticas relacionadas ao metabolismo ósseo do cálcio, fósforo e magnésio ocorrem e devem ser avaliadas com cautela na presença de café e refrigerantes à base de cola e guaraná. O café reduziu a DMO e CMO nas fêmeas representando desta maneira um fator de risco à fratura óssea / Abstract: The aim of this study was to determine the effects of the daily intake of coffee, cola and guaraná soft drinks on bone mineral density and blood levels of calcium (Ca), phosphorus (Pi) and magnesium (Mg) in male and female rats. Sixty-days-old Wistar rats were divided into four groups according to the test drink, namely control (water), cola, guaraná and coffee. After 48 days, all animals were sacrificed, had their blood collected for biochemical analyzes and their femora evaluated for bone mineral density (BMD) and bone mineral content (BMC). All animals gained weight during the experiment. Consumption was highest for cola and lowest for coffee. Changes in BMD appeared only in females of the coffee group. As for BMC, males showed higher values across groups, while coffee intake provoked significant BMC reduction in females. Regarding blood biochemistry, males showed higher serum Ca levels across groups. While Pi levels were similar across groups for females, males in the guaraná group showed significantly lower Pi levels. Coffee intake produced a significant increase in Mg levels regardless of gender. Taken together, our data suggest that daily coffee intake can lead to decreased BMD and BMC in female rats, and that habitual consumption of coffee, cola and guaraná soft drinks may induce changes in the levels of blood minerals essentially related to bone metabolism / Doutorado / Radiologia Odontologica / Doutora em Radiologia Odontológica

Includes bibliographical references / Background: Dislocation is one of the most common orthopaedic complications after primary total hip arthroplasty (THA). The reported dislocation rate in elective THR is 5 - 8%. This number increases up to 22% for THA done for neck of femur fractures. Larger femoral head sizes increase the head-neck ratio and range of motion before impingement, therefore reducing the dislocation rate. Due to the reported increase in dislocation for trauma, some surgeons prefer to do a hemi-arthroplasty or open reduction and internal fixation (ORIF). Methods: A retrospective review of all THA done for neck of femur fractures during 2006 - 2012 was undertaken at a large referral hospital. Records were reviewed for patient related and surgical risk factors. We excluded all pathological fractures, extra-capsular fractures and failed ORIF. Results: A total of 96 cases were identified as suitable for analysis. Average age at surgery was 73.2 years (range 30 - 81). Delay to surgery was 5.3 days (range 1 - 63). Average follow up period was 18.3 months (range 3 months - 4.3years). Four patients (4.3%) had a confirmed dislocation. The four patients who had confirmed dislocation had the following characteristics, 28 mm femoral head size, age over 60 years, 2 posterior approaches and 3 females, although not statistically significant. Conclusion: The outcomes of THR in patients with neck of femur fractures can be favourable and provide good long-term prosthesis survival. We report on low dislocation rate post total hip replacement for intra-capsular neck of femur fractures.

No description available.

There are many examples worldwide were fossil magmatic intrusions influence the local water and energy supply. Due to that intrusions can act as a conductor and a reservoir, but also as a barrier for fluids and gases in the ground. The decisive feature between conductor or barrier in an intrusion is its fracture network. Hence it is of paramount importance to characterize an intrusion’s fracture network and thus its permeability. However, other than through boreholes magmatic intrusions are rather inaccessible and very little is known about their influence on aquifers and reservoir rocks in the underground. It is therefore important to increase the knowledge of magmatic intrusion by investigate the intrusions that are accessible for us at ground surface. In this study, photos from a case study about the Sosa dyke have been used to map and characterizes the fractures of the Sosa dyke, which is an accessible vertical magmatic intrusion and a part of the Chachahuén volcano complex in the southwestern parts of Argentina. The photos that were used are taken with an UAV (unmanned aerial vehicle), and to analyze the photos, map the fractures and produce the results, software as Agisoft Metashape, MOVE™ and MATLAB with the toolbox FracPaQ was used. The intrusion has two distinct fracture sets, one that is perpendicular to the intrusion margins and one that stretches parallel with the intrusion. The connectivity of the fractures is low, and since the permeability of the fractures largely depends on the connectivity, it is also low. The fracture set that is perpendicular to the intrusion margin is what’s called cooling fractures, which is created as the magma in the intrusion cools. This causes the magma to contract and break, forming fractures perpendicular to the inward migrating solidification front. The fracture set that is parallel with the intrusion is caused by minerals in the magma flow being affected by friction from the intrusion margins. This causes the minerals in the magma to elongate in the direction of flow along the sides of the dyke, creating foliation, enabling fractures to propagate along. These fracture sets are poorly connected which concludes that the mapped area of the Sosa-dyke has a low permeability. / I hela världen finns det många exempel där stelnade magmatiska intrusioner påverka ett områdes vatten och energiförsörjning, på grund av att intrusioner kan agera som ledare och reservoarer men också som barriärer för vätskor och gaser in marken. Den avgörande faktorn mellan ledare och barriärer i en intrusion är dess spricknätverk. Därför är det viktigt att kartlägga och karakterisera en intrusions spricknätverk och därmed också få en uppfattning om dess permeabilitet. Magmatiska intrusioner är förutom genom borrhål ofta svåråtkomliga, det finns därför väldigt lite information om hur de påverkar akviferer och reservoarer i marken. Det är därför viktigt att öka kunskapen om magmatiska intrusioner genom att undersöka intrusionerna som är tillgängliga vid markytan. I denna studie har bilder från en fallstudie om Sosa Intrusionen använts för att kartera och karakterisera sprickor i Sosa intrusionen. Det är en vertikal magmatisk intrusion som är synlig på markytan, och en del av Chachahuén vulkan komplexet i sydvästra Argentina. Bilderna som användes är tagna med en UAV( unmanned aerial vehicle), och för att analysera bilderna, kartera sprickorna och producera resultaten, användes programmen Agisoft Metashape, MOVE™ och MATLAB med FracPaQ verktyget. Intrusionen har två distinkta sprickgrupper, en som är vinkelrät mot intrusionens kanter och en som går parallellt med kanterna. Konnektivitet mellan sprickorna är låg och eftersom permeabiliteten påverkas av konnektiviteten är den också låg. Sprickgruppen som är vinkelrätt mot intrusionskanten är så kallade kylningssprickor och bildas nät magman i intrusionen svalnar. Det leder till att magman kontraherar och spricker, och bildar sprickor som går inåt mot stelningsgränsen och därmed vinkelrätt mot intrusionskanten. Sprickgruppen som går parallellt med intrusionen bildas av att mineral i magmaströmmen påverkas av friktion från intrusionskanterna. Det gör att mineralen lägger sig och sträcks ut i samma riktning som magmaflödet, vilket när magman stelnar bildar svaghetszoner som sprickor kan fortplanta sig i. Dessa sprickgrupper har låg konnektivitet vilket gör att slutsatsen blir att det karterade området av Sosa intrusionen har låg permeabilitet.

Bakgrund   Höftfrakturer är ett globalt problem och mängden personer som drabbas har ökat sedan 90-talet och antalet drabbade kommer fortsätta öka med en ökande äldre population. Mellan 12–17 procent dör inom det första året efter en höftfraktur varav att alla lider av en högre risk att dö i förtid samt att mängden som återgår till samma funktionsförmåga sedan innan höftfrakturen är inte hög. Något som kan bedöma hur en person upplever sin hälsa är livskvalité. Författarna finner därför att det skulle vara intressant att belysa vad som händer med livskvalitén för den som drabbas av en höftfraktur.  Syfte Syftet med denna studie var att beskriva personers upplevda livskvalité vid höftfraktur. Metod En icke systematisk litteraturstudie har utförts på 17 artiklar, tre med kvalitativ design och 13 med kvantitativ design och en med mixed method. Artiklarna är inhämtade från CINAHL och Pubmed med hjälp av olika sökordskombinationer. Artiklarna kvalitetsgranskades utifrån Sophiahemmet högskolas bedömningsinstrument. En integrerad analys utfördes därefter och artiklarna delades in i tre steg för att identifiera huvudkategorier och underkategorier. Resultat Utifrån resultatartiklarna som bedömde livskvalité utifrån mätinstrument försämrades den upplevda livskvalitén som följd av höftfrakturen. Många upplevde en förbättring av livskvaliteten inom ett år men att den inte blev lika bra som före höftfrakturen. De kvalitativa artiklarna tar upp andra aspekter av att leva efter höftfraktur som “rädslor &amp; oro efter höftfraktur”, “Självständighet och ensamhet efter höftfraktur” och “Förväntningar efter höftfraktur”. Slutsats Majoriteten av de som drabbas av en höftfraktur upplever fortsatt försämrad livskvalité och hälsa en tid efter höftfrakturen inträffat. Det finns ett klart utvecklingsområde för att förbättra omvårdnaden vid en höftfraktur. Fortsatta studier inom ämnet livskvalité, hälsa och höftfraktur bör fokuseras på kvalitativa studier för att utveckla förståelsen för vad patienterna upplevelser och erfarenheter vid höftfraktur. / Background Hip fractures are a global problem and the amount of people suffering from this has increased since the 1990s and the number of people suffering from this condition will continue to increase with an increasing older population. Between 12-17 percent dies within the first year after hip fracture of which everyone affected has a higher risk for premature death. Something that assesses how a person experiences their health was quality of life. The authors of this study therefore find it interesting to see what happens with quality of life during and after hip fracture.  Aim The aim of this study was to describe patients' experienced quality of life during and after study.  Method A non-systematic literature study has been performed on 17 articles, three with a qualitative design, 13 with a quantitative design and one with mixed method. The articles have been obtained from CINAHL and Pubmed with the help of different keyword combinations. The articles have been quality reviewed with the Sophiahemmet högskolas assessment instrument. An integrated analysis has been done in three steps to identify main- and sub-themes.  Results From the result in the articles that assessed quality of life through assessment instruments the perceived quality of life deteriorated due to the hip fracture. Many of the patients perceived an improvement in quality of life within a year but that it did not turn out as well as before the hip fracture. The qualitative studies brought up other aspects of living with hip fracture such as “fears and worries after hip fracture”, “independence and loneliness after hip fracture” and “Expectations after hip fracture”. Conclusions The majority of those who suffer from a hip fracture experience a continued deterioration in quality of life and health some time after the hip fracture has occurred. There was a clear area for ​​development to improve nursing care for patients with a hip fracture. Continued studies in the subject of quality of life, health and hip fracture should focus on qualitative studies to develop an understanding of what patients experience with a hip fracture.

Fracture risk reduction is the main goal of treating osteoporosis, a condition which, in the absence of fragility fractures, is diagnosed by bone densitometry. Bone density, however, although an important factor predicting fracture risk, is not the only one and several other factors modulate the fracture risk such as the patient's age, body mass index, family history, cigarette smoking, medications and the risk of falling: most fractures are preceded by falls. When developing a treatment strategy it is therefore important to take into consideration other factors apart from bone density. Several algorithms and instruments are available for this purpose. The FRAX (Fracture Risk Assessment) tool developed under the aegis of the World Health Organization and the Garvan Fracture Risk Calculator are commonly used to estimate the patient's fracture risk. Both have advantages and limitations. It must be emphasized, however, that treatment decisions are clinical ones.

Fracture risk reduction is the main goal of treating osteoporosis, a condition which, in the absence of fragility fractures, is diagnosed by bone densitometry. Bone density, however, although an important factor predicting fracture risk, is not the only one and several other factors modulate the fracture risk such as the patient's age, body mass index, family history, cigarette smoking, medications and the risk of falling: most fractures are preceded by falls. When developing a treatment strategy it is therefore important to take into consideration other factors apart from bone density. Several algorithms and instruments are available for this purpose. The FRAX (Fracture Risk Assessment) tool developed under the aegis of the World Health Organization and the Garvan Fracture Risk Calculator are commonly used to estimate the patient's fracture risk. Both have advantages and limitations. It must be emphasized, however, that treatment decisions are clinical ones.

There is a need to identify patients with osteopenia who are at high risk of sustaining fractures and who would benefit from treatment, since many patients with osteopenia do not sustain fractures, in 2008, the WHO unveiled the fracture risk-assessment-tool (FRAX®), which calculates the 10-year probability of a patient sustaining a fracture. It is available on the internet free of charge, and represents a major step forward since it takes into account a number of risk factors and allows clinicians to focus on those patients at high risk of sustaining fractures, in whom the benefits of treating a silent disease outweigh the potential adverse effects and cost. In the USA, the National Osteoporosis Foundation has suggested a fracture threshold to recommend treatment. In this article, the various risk factors included in the FRAX tool are briefly reviewed, and the advantages, potential limitations and possible future developments are discussed.

The aims . of this research were twofold, firstly to find out if interferential currents could reduce the healing time for fractures of the tibia and thereby prevent nonunion and secondly to develop a model which could predict nonunion, given the subject characteristics such as race, mechanism of injury, severity of fracture etc. Subjects, males only between the ages of 12 and 86, who had sustained fractures of the tibiae were entered into this double blind clinical trial on admission to the orthopaedic wards at Groote Schuur Hospital (between January 1989 and October 1991). According to strict inclusion and exclusion criteria, a final sample of 227 cases (208 subjects) were entered by block randomisation into three groups; an experimental group (n=41), placebo group (n=35) and control group (n= 151). lnterferential currents were applied to the experimental group via suction electrodes for, 30 minutes per day for 10 days, using a beat frequency of 10 - 25 Hz and a swing mode of 6 ϟ 6. The placebo group had the suction electrodes applied which produce a rhythmical massage effect. Subjects commented on pain relief which resulted in the addition of the control group as a check on the possible effect of suction, the control group received no intervention. The data were analysed firstly, by using the ANOV A with continuous covariates which resulted in a finding of no significant difference in the time taken to union for the three groups. The second statistical analysis using the same data set, were logistic regression models demonstrating risk factors for nonunion within 24, 32 and 40 weeks. These models were then validated, showing sensitivity and specificity for a variety of possible cutoffs. The conclusions reached about the validity of these models were that they could not be used to predict, accurately enough, those cases where surgical intervention would be necessary; however, for low cost non-invasive intervention they may have value.