Orientador: Mario Mantovani / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-11T18:28:45Z (GMT). No. of bitstreams: 1 Uguetto_MichelleKarine_M.pdf: 2245684 bytes, checksum: f80e585c54205749099401755d914d88 (MD5) Previous issue date: 2007 / Resumo: O presente trabalho teve como objetivo, através de um protocolo, avaliar as alterações fonoaudiológicas decorrentes de fraturas zigomático-orbitárias, relacionando-as às disfunções do sistema estomatognático, em relação ao gênero, idade, cor, biomecânica do trauma, tipo de fratura, sinais e sintomas e tratamento cirúrgico definitivo. A amostra foi composta por 40 indivíduos traumatizados com fraturas unilaterais zigomático-orbitárias, sendo 20 pacientes com fraturas de zigoma e 20 de assoalho, que foram submetidos à avaliação fonoaudiológica e seus resultados foram analisados através de exames clínicos de estrutura e funções do sistema estomatognático que compunham o protocolo. O presente estudo demonstrou, segundo a amostra avaliada, que as fraturas zigomático-orbitárias foram mais prevalentes entre adultos jovens, entre 31 a 40 anos, brancos, do sexo masculino, em eventos ligados ao trânsito, sendo o lado esquerdo mais acometido e o tratamento cirúrgico foi mais realizado em detrimento do conservador. As funções de respiração, deglutição e fala apresentaram-se mais alteradas nas fraturas de zigoma, enquanto que as alterações da mímica facial, mastigação estavam mais alteradas nas fraturas de assoalho / Abstract: The aim of this study was to evaluate the phonoaudiologic alterations of the zygomatic orbital fractures, relating this manifestations to stomatognatic system dysfunctions to sex, age, skin, trauma¿s biomechanics, kind of fracture, signals and symptoms and surgical treatment, using a evaluation protocol. The sample was composed for 40 individuals with zygomatic orbital fractures, being 20 patients with zygoma fractures and 20 patients with orbital floor fractures, that had been submitted to the phonoaudiologic evaluation and these results had been analyzed through clinical examinations of structure and functions of the stomatognatic system that composed the protocol. The present study demonstrated that the zygomatic orbital fractures had a higher prevalence in young adults, of white skin ranging from 31 to 40 years; in automobilist accidents, with a higher prevalence in left side of zygomatic orbital complex and the surgical treatment was more carried that the conserving surgery. The functions of stomatognatic system, like respiration, swallow and speech were more damaged in zygoma fractures. The facial movement and mastication functions was more damaged in orbital floor fractures / Mestrado / Pesquisa Experimental / Mestre em Cirurgia

Orientador: Roger William Fernandes Moreira / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-24T16:02:50Z (GMT). No. of bitstreams: 1 Falci_SauloGabrielMoreira_D.pdf: 1799316 bytes, checksum: 1de035c12bc218e5f3759c843bc2025d (MD5) Previous issue date: 2014 / Resumo: O objetivo desse estudo foi comparar por meio de testes mecânicos e fotoelásticos o desempenho dos parafusos canulados cônicos utilizados na fixação de fraturas de sínfise mandibular com outros métodos de fixação. Dez mandíbulas de poliuretano foram utilizadas em cada grupo e fixadas da seguinte maneira: Grupo (PRP), duas miniplacas do sistema 2,0 mm, perpendiculares; Grupo (PLL), uma placa do sistema 2,4 mm e uma miniplaca do sistema 2,0 mm, paralelas; Grupo (PC), dois parafusos canulados cônicos do sistema 2,8 mm. Foram realizados testes de carregamento linear vertical em uma máquina de ensaio universal. O teste de ANOVA One-way e o teste de Tukey foram utilizados para verificar a diferença entre as médias. O teste fotoelástico foi realizado, com o auxílio de um polariscópio plano. Foi usada uma mandíbula de resina fotoelástica para cada grupo de fixação (PRP, PLL e PC). A avaliação dos dados do teste fotoelástico foi qualitativa e descritiva. Os resultados mostraram diferença entre os grupos (PC) e (PRP) nos deslocamentos de 1 mm (p=0,025), 3 mm (p=0,013), 5 mm (p=0,036) e 10 mm (p=0,022). No teste fotoelástico foi observada maior concentração de tensões na região próxima à base mandibular em todos os grupos. No grupo (PRP) e (PLL) foi observada maior concentração de tensões na região da placa mais próxima à base enquanto no grupo (PC) as franjas isocromáticas foram mais dispersas em toda região avaliada. De acordo com os resultados do estudo foi possível concluir que os parafusos canulados cônicos apresentaram um bom desempenho nos testes mecânicos e fotoelásticos, sendo uma opção viável para a fixação das fraturas de sínfise mandibular / Abstract: The aim of this study was to compare by mechanical and photoelastic tests, the performance of the cannulated screws in mandibular symphysis fractures and compare them with other fixations methods. Ten polyurethane mandibles were used in each group and fixed as follows: Group (PRP) 2 2.0-mm perpendicular miniplates; Group (PLL) 1 2.0-mm miniplate and 1 2.4-mm bone plate, parallels; Group (CS) 2 2.8-mm cannulated screws. Vertical linear loading tests were performed in a universal testing machine. Differences among means were analyzed by the One-Way ANOVA and Tukey test. The photoelastic test was carried out using a plane polariscope. One photoelastic mandible resin was used for each fixation group (PRP, PLL and CS). Data evaluation of the photoelastic test was qualitative and descriptive. The results showed differences between (CS) and (PRP) groups in 1 mm (p=0.025), 3 mm (p=0.013), 5 mm (p=0.036) and 10 mm (p=0.022), of displacement. The photoelastic test showed higher stress concentration, in all groups, close to mandibular base. In (PRP) and (PLL) groups, the stress concentration was observed closest to the plate fixed in mandibular basis, while the (CS) group showed more dispersed isochromatic fringes throughout the evaluated region. According to the results of this study, it was concluded that conical cannulated screws performed well in mechanical and photoelastic test, being a viable method for fixation of mandibular symphysis fractures / Doutorado / Cirurgia e Traumatologia Buco-Maxilo-Faciais / Doutor em Clínica Odontológica

No description available.

The derivation of the classical equation for flow through an orifice assumes a fixed orifice area. However, pipe materials exhibit expansion behaviour with increasing pressure, which alters the size of orifices and results in greater leakage rates. The purpose of this investigation was to study the behaviour of round holes and cracks in pipes through theoretical and experimental work. The results of the study include equations derived for increased flow through round holes in pressurized cylindrical shells and pipes. The theoretical models explain the increased flow experienced due to the leak area increasing. The models incorporate material properties, shell geometry and fluid properties for both uni-axially and bi-axially stressed pipe sections. Analytical results are compared with previous finite element investigations. In addition, an experimental study into the effects of pressure on a round hole in a class 6 uPVC pipe was conducted. Conclusions are made relating to the influence of material expansion to increased flow rate through openings in pressurised cylinders. The results compared positively with those of the theoretical equations. Conclusions are made relating to the influence of round hole or crack expansion to an increased flow rate through openings in pressurised pipes. Results include the effects of geometrical and material variables on the expansion of round holes. Better explanation of the increased flow through orifices, documented by practical observations, is presented. Results indicate that round hole area is linearly related to pressure. However, testing on longitudinal cracks resulted in a non-linear relationship between crack area and internal pipe pressure. Results indicate the expansion of round hole area is minimal. Leakage however is greatly affected over extended time periods by even the smallest increase in defect area. Critical pressures before brittle fracture obtained from testing on longitudinal cracks were compared to theoretical formulation. Results show a close relationship between current theory and experimentation. / Prof. K. van Zyl

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in partial fulfillment of the requirements for the degree of Master of Medicine in the branch of Orthopaedic Surgery Johannesburg, 2017 / Background Unstable Thoracolumbar spinal fractures are conventionally treated by open reduction and internal fixation. This involves extensive mobilization of paraspinal muscles, which in turn leads to long-term disability in the form of chronic backache. One of the reasons fractures are stabilized is to prevent kyphotic deformity. Posterior lumbar stabilization done through a minimally invasive technique can achieve the same result as the open technique at the expense of less mobilization of the paraspinal muscles. Aim of the study The aim of the study was to assess the effectiveness of minimally invasive posterior spinal fixation in unstable Thoraco-lumbar fractures in our setting at Charlotte Maxeke Academic Hospital. Objectives To assess the effectiveness of Minimally Invasive Spine Surgery over a short term of minimum of 12 months regarding: Maintaining the correction of fracture kyphosis, Re-operations and Any serious Adverse Events Methodology This was a prospective interventional pilot study. Fractures were classified according to the AO comprehensive system. AO Comprehensive classification fractures A3, B1, B2, C1 and C2 were considered suitable for this technique. Pre-operative, immediate post-operative and one year follow up Cobb’s angles of fracture kyphosis were measured on plain lateral x-rays. Any Serious Adverse Events (SAE) that may have required re-operations were recorded over the minimum of 12 months follow up. Results Twenty patients met the inclusion criteria for this study. Post-operative follow up ranged between 12 and 22 months. There were 14 males and 6 females. The age ranged between 16 years to 54 years with mean of 33.9 years. L1 was the most commonly fractured vertebra. Eleven out of 20 patients sustained fracture of L1, 6 patients had fracture of L2 whereas 3 patients sustained fracture of T12. The AO classification types included one B1, five B2, seven C1 and seven C2 fractures. The pre-operative Cobb’s angle ranged from 7 degrees to 38 degrees with mean of 21.2 degrees. The immediate post-operative Cobb’s angle ranged between zero degrees to 16 degrees with mean of 8.3 degrees. The last follow up Cobb’s angle ranged between zero degrees to 21 degrees with a mean of 10.7 degrees. The loss of correction of fracture kyphosis ranged between zero degrees to 6 degrees with a mean of 2.4 degrees. The post-operative Cobb’s angle was maintained. There was no deterioration of pre-operative neurological status. There was no serious adverse event requiring a re-operation. Conclusion Minimally Invasive Posterior Spinal stabilization for thoracolumbar fractures had an acceptable outcome in our hands in appropriately selected cases. The average loss of correction of 2.4 degrees was in keeping with that found in open technique as well as MIS at other centers. While the number is less, this procedure can be recommended for well selected patients where skills are available. / MT2017

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfillment of the requirements for the degree of Master of Medicine (MMed). Johannesburg 2017 / BACKGROUND: The aim of the study was to assess whether African subjects with fragility fractures were being identified for assessment for osteoporosis on presentation to the orthopaedic department at Chris Hani Baragwanath Academic Hospital (CHBAH) in Soweto. In addition, the recommendation for secondary prevention of disease for these subjects, was also assessed. METHOD: One hundred African subjects over the age of 50 years with fragility fractures were identified in the orthopaedic wards and clinics at CHBAH. These subjects were interviewed with two separate questionnaires addressing risk factors and education regarding osteoporosis, and whether further management was suggested. The first interview was conducted in June and July 2015. After 18 months, a follow up telephonic interview was conducted, in December 2016, with 37 of the original 100 subjects. RESULTS: Of the 100 subjects evaluated, 89 (89%) were asked at least one screening question. The most frequently asked question about risk factors for osteoporosis in the first interview, was regarding previous fractures and was asked of 61 (61%) of the 100 subjects. A further 37 (37%) of all subjects had been given advice regarding appropriate bone strengthening exercises to prevent osteoporosis. Only five subjects (5%) were asked to return for further assessment. The second interview showed that the most frequently asked question was regarding previous fractures in 24 (64.9%) of the 37 subjects and 18 (48.6%) of the 37 subjects had been advised to do bone strengthening exercises. Only two (5.4%) new subjects could confirm receiving a date to return for assessment. CONCLUSION: In this study, orthopaedic surgeons were proven to be inadequately assessing risk factors for osteoporosis and were infrequently referring patients for therapy. Orthopedic surgeons are often the only practitioners to see patients with fragility fractures and thus they have a crucial role in identifying and appropriately referring these patients for further investigations and medical management for osteoporosis. / MT2017

Fractures indicate how an individual has moved through the world. Yet, how an individual navigates their world is also dependent on variables such as age and gender, and the intersection of such variables. This was never more true than during the Roman period, where how one lived was contingent on a number of variables such as class, gender, and age. The current project analyzed data from 1121 individuals to examine whether one’s age, gender, burial treatment and the confluence of these variables related to one’s fractures. To capture the diversity of the Roman Empire, the project examined three large settlements: Winchester, UK; Lisieux Michelet, France; and Barcelona, Spain, as well as two smaller settlements: Godmanchester, UK; and Vagnari, Italy. Temporally, the settlements span from the 1st-8th c. CE, the height of the Roman Empire to the Merovingian period. The results of the current study found that when variables are treated in isolation, there were distinct gendered lifeways at most settlements, with males having more fractures. When the variables are considered together, fractures reflect more complex dynamics of temporal stress, age, and labour within burial communities at the three larger settlements. When settlements were compared to one another, the absence of differences in fracture prevalence between settlements suggest than rather than simple urban/rural divides, settlements are shaped by their economies and lifeways. Further, odds ratios suggest that fracture risk differed for men and women, young and old. The current study represents the first study to examine multiple large and small settlements outside of Roman Britain, as well as the first to consider fractures in relation to burial treatment. By cross cutting variables, this study expands the current understanding of small, complex communities within cemeteries, and contributes to the discussion on the confluence of identities in the Roman and Merovingian periods. / Thesis / Master of Arts (MA)

No description available.

Les individus ayant un diabète de type 1 (DB1) ont un risque de 1,2 à 3 fois plus élevé de présenter une fracture à tout site en comparaison à des individus n'ayant pas le diabète. Pour la fracture de la hanche, ce risque est augmenté de 4 à 7 fois. En général, la densité minérale osseuse (DMO) est abaissée en présence de DB1. Cette baisse légère à modérée de la DMO peut expliquer en partie, mais pas en totalité, l'augmentation disproportionnée du risque de fractures observée en DB1. Il semble ainsi exister, au-delà d'un problème de quantité osseuse, un problème dans la qualité de l'os. Peu d'études à ce jour se sont intéressées particulièrement à la prévalence des fractures vertébrales (FxV) chez des individus ayant un DB1. Une étude transversale a identifié une prévalence de FxV déconcertante de 24 % chez des participants ayant un DB1 âgés en moyenne de seulement 31 ans, en utilisant l'imagerie Vertebral Fracture Assessment (VFA) et en appliquant une méthode morphométrique pour diagnostiquer les FxV. Si une telle prévalence était confirmée à nouveau, de jeunes individus ayant un DB1 pourraient possiblement bénéficier d'un dépistage des FxV afin d'instaurer précocement des mesures pour réduire le risque de subir d'autres fractures. L'étude DenSiFy (Diabetes Spine Fractures) visait à comparer la prévalence des FxV entre des adultes ayant un DB1 et des contrôles n'ayant pas le diabète d'âge, de sexe et d'indice de masse corporelle (IMC) similaires, en utilisant l'imagerie VFA pour identifier les FxV prévalentes et en appliquant la méthode modified Algorithm-Based Qualitative (mABQ) pour les diagnostiquer. Nos résultats ne confirment pas une prévalence accrue de FxV chez des hommes et des femmes ayant un DB1 relativement bien contrôlé. / Individuals with type 1 diabetes (T1D) have a 1.2 to 3-fold increase in fracture risk at any site, and a 4- to 7-fold increase in hip fracture risk relative to those without diabetes. Bone mineral density (BMD) is generally mildly to moderately reduced in individuals with T1D, but this is insufficient to fully explain the high fracture rate observed in this population. Reduced bone quality also appears to play a role in the bone fragility of people with T1D. There is a limited number of studies on the prevalence of vertebral fractures (VFs) in T1D, but available data are concerning. A cross-sectional study reported a prevalence of VFs of 24% among young people with T1D (mean age 31 years old) using Vertebral Fracture Assessment (VFA) and applying a morphometric method for VF diagnosis. If this high prevalence is confirmed, young individuals with T1D could benefit from preventative VF screening to reduce the risk of future fractures. The DenSiFy (Diabetes Spine Fractures) study aimed to compare the prevalence of VFs between adults with T1D and nondiabetic control subjects with a similar age, sex and body mass index (BMI) distribution, using the VFA for identifying prevalent VFs and applying the modified algorithm-based qualitative (mABQ) method to diagnose VFs. Our results do not confirm an increased prevalence of VFs in men and women with relatively well-controlled T1D.

Chow, Dick Ho Kiu. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 93-103). / Abstracts in English and Chinese. / Abstract --- p.ii / Publications --- p.vii / Acknowledgement --- p.viii / Table of Contents --- p.x / List of Figures --- p.xiv / List of Tables --- p.xv / List of Abbreviations --- p.xvii / Chapter 1 --- Introduction --- p.1 / Chapter 1.1 --- Bone and its Cellular Components --- p.1 / Chapter 1.1.1 --- Cellular Components of Bone --- p.1 / Chapter 1.1.2 --- Macroscopic Structure --- p.4 / Chapter 1.1.3 --- Microscopic Structure --- p.4 / Chapter 1.2 --- Fracture Healing --- p.5 / Chapter 1.2.1 --- Inflammation --- p.6 / Chapter 1.2.2 --- Soft Callus Formation --- p.6 / Chapter 1.2.3 --- Hard Callus Formation --- p.7 / Chapter 1.2.4 --- Bone Remodeling --- p.7 / Chapter 1.3 --- Low Magnitude High Frequency Vibration (LMHFV) Stimulation --- p.7 / Chapter 1.3.1 --- Mechanical Stimulation --- p.10 / Chapter 1.3.2 --- Effect of LMHFV on Bone --- p.12 / Chapter 1.4 --- Osteoporosis and Osteoporotic Fractures --- p.16 / Chapter 1.4.1 --- Epidemiology of Osteoporotic Fracture --- p.17 / Chapter 1.4.2 --- Pathophysiology --- p.17 / Chapter 1.4.3 --- Osteoporotic Fracture Healing --- p.20 / Chapter 1.5 --- Bisphosphonate --- p.23 / Chapter 1.5.1 --- Background --- p.23 / Chapter 1.5.2 --- Mechanism of Action --- p.24 / Chapter 1.5.3 --- U sage of Bisphosphonate --- p.25 / Chapter 1.5.4 --- Bisphosphonate Effects on Fracture Healing --- p.27 / Chapter 1.6 --- Hypothesis --- p.27 / Chapter 1.7 --- Study Plan --- p.28 / Chapter 1.7.1 --- Objectives --- p.28 / Chapter 2 --- Method --- p.29 / Chapter 2.1 --- Ovariectomized Rat Femoral Fracture Model --- p.29 / Chapter 2.1.1 --- Ovariectomized Rat Model. --- p.29 / Chapter 2.1.2 --- Closed Femoral Fracture --- p.31 / Chapter 2.2 --- Study Design --- p.32 / Chapter 2.3 --- LMHFV Treatment Protocol --- p.32 / Chapter 2.4 --- Bisphosphonate Treatment Protocol --- p.35 / Chapter 2.4.1 --- Pharmacological Parameters --- p.35 / Chapter 2.4.2 --- Ibandronate Injection Solution Preparation --- p.37 / Chapter 2.4.3 --- Injection --- p.37 / Chapter 2.5 --- Fluorochrome Labeling --- p.38 / Chapter 2.5.1 --- Fluorochrome Preparation --- p.38 / Chapter 2.5.2 --- Injection --- p.38 / Chapter 2.6 --- Assessments --- p.39 / Chapter 2.6.1 --- Radiographic Analysis --- p.39 / Chapter 2.6.2 --- uCT Analysis --- p.40 / Chapter 2.6.3 --- Undecalcified Histology --- p.43 / Chapter 2.6.4 --- ELISA Analysis on Bone Markers --- p.47 / Chapter 2.7 --- Statistical Analysis --- p.50 / Chapter 3 --- Results --- p.51 / Chapter 3.1 --- Radiographic Analysis --- p.52 / Chapter 3.1.1 --- Callus Bridging Rate --- p.52 / Chapter 3.1.2 --- Callus Width and Area --- p.52 / Chapter 3.2 --- uCT Analysis --- p.55 / Chapter 3.3 --- Histomorphometric Analysis --- p.61 / Chapter 3.3.1 --- Bone Mineralization Rate --- p.61 / Chapter 3.4 --- Bone Markers Analysis --- p.64 / Chapter 3.4.1 --- Osteocalcin --- p.64 / Chapter 3.4.2 --- TRAP5b --- p.64 / Chapter 3.4.3 --- Summary --- p.67 / Chapter 4 --- Discussion --- p.69 / Chapter 4.1 --- LMHFV Enhanced Bone Remodeling --- p.69 / Chapter 4.1.1 --- LMHFV Reversed Bis Inhibition on Bone Remodeling --- p.70 / Chapter 4.1.2 --- LMHFV Effect on Osteoclastic Resorption During Bone Re-modeling --- p.71 / Chapter 4.2 --- Enhanced Fracture Healing by LMHFV --- p.72 / Chapter 4.2.1 --- Acceleration of Fracture Healing by LMHFV --- p.72 / Chapter 4.2.2 --- LMHFV Inhibits Osteoclast Activity in the Early Phase of Healing --- p.73 / Chapter 4.2.3 --- LMHFV Stimulates Osteoblast Activity in the Early Phase of Healing --- p.74 / Chapter 4.3 --- Bis Delays Fracture Healing --- p.75 / Chapter 4.4 --- Experimental Design --- p.78 / Chapter 4.4.1 --- Inhibition Study --- p.78 / Chapter 4.4.2 --- Bisphosphonate Injection Protocol --- p.79 / Chapter 4.4.3 --- Individual Analysis of Bone Formation and Resorption . --- p.81 / Chapter 4.5 --- Clinical Implications --- p.84 / Chapter 4.5.1 --- LMHFV Enhanced Remodeling --- p.84 / Chapter 4.5.2 --- Bisphosphonate Delayed Remodeling --- p.85 / Chapter 4.6 --- Limitations --- p.85 / Chapter 4.6.1 --- Measurement of Bone Resorption --- p.85 / Chapter 4.6.2 --- Osteoporotic Fracture Model --- p.86 / Chapter 4.6.3 --- Inhibition of Bone Remodeling --- p.87 / Chapter 4.7 --- Future Studies --- p.88 / Chapter 4.7.1 --- LMHFV Effect on Osteoclast in vitro --- p.88 / Chapter 4.7.2 --- Biomechanics of Fracture Callus --- p.89 / Chapter 4.7.3 --- LMHFV Effect on Leptin- Adrenergic Pathway --- p.89 / Chapter 5 --- Conclusion --- p.91 / Bibliography --- p.93