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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
531

Epidemiologia das fraturas mandibulares e avaliação mecânica de métodos de fixação de fraturas de ângulo em mandíbulas de poliuretano / Epidemiology of mandibular fractures and mechanical evaluation of fixation methods of angle fractures in polyuretane mandibles

Muñante Cardenas, Jose Luis 25 August 2018 (has links)
Orientador: Luis Augusto Passeri / Texto em português e inglês / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-25T07:56:16Z (GMT). No. of bitstreams: 1 MunanteCardenas_JoseLuis_D.pdf: 3765952 bytes, checksum: 97597698c84a612dd3f881f11b254a15 (MD5) Previous issue date: 2014 / Resumo: Este estudo teve como objetivo avaliar as características epidemiológicas de casos envolvendo fraturas mandibulares e o comportamento mecânico de quatro diferentes métodos de fixação de fraturas de ângulo mandibular. Foi realizado um levantamento epidemiológico sobre os casos de fraturas de mandíbula tratados pela Área de Cirurgia Plástica do Hospital das Clínicas da Universidade Estadual de Campinas (Unicamp). Foram analisados os prontuários de 119 pacientes tratados entre janeiro de 2006 e dezembro de 2011. As fraturas identificadas afetaram principalmente pacientes jovens do gênero masculino. Os acidentes de trânsito causaram o maior número de fraturas, sendo os acidentes de motocicleta a causa mais comum. As regiões mandibulares mais envolvidas foram a parassínfise e o ângulo. O tratamento cirúrgico foi aplicado na grande maioria dos casos. Complicações ocorreram em 36 pacientes (30,2%). As complicações no ângulo mandibular representaram 27% dos casos. A gravidade do trauma e a pouca colaboração dos pacientes foram fatores que contribuíram para o desenvolvimento de complicações pós-operatórias. Para a avaliação mecânica foram utilizadas quarenta réplicas de mandíbulas confeccionadas em poliuretano. As amostras foram divididas em quatro grupos com diferentes métodos de fixação: uma miniplaca, duas miniplacas dispostas paralelamente, uma miniplaca grade de 4 furos e uma miniplaca grade de 8 furos, todos do sistema de 2,0mm. Os grupos foram submetidos ao teste mecânico em uma máquina de ensaio universal, Instron 4411 (Instron Corp, Norwood, MA), recebendo uma carga vertical linear na região do incisivo e do primeiro molar. A técnica de duas placas paralelas apresentou resistência estatisticamente maior que todos os outros métodos de fixação. Entretanto, as placas grade de 4 furos não apresentaram diferença estatisticamente significante em relação ao grupo de uma miniplaca. As placas grade de 8 furos apresentaram os menores valores de resistência. Desta forma, a técnica de duas placas apresentou melhor comportamento mecânico para a fixação de fraturas de ângulo mandibular / Abstract: The objectives of this study were evaluate the epidemiological characteristics of cases involving mandibular fractures and to evaluate the mechanical behavior of four different methods of fixation of fractures of the mandibular angle. An epidemiological survey on cases of mandibular fractures treated by the Department of Plastic Surgery, at the Clinical Hospital of University of Campinas, was performed. The medical records of 119 patients treated between January 2006 and December 2011 were analyzed. The fractures mainly affected young male patients. Road traffic accidents caused the largest number of fractures, being the motorcycle accidents the most common cause. The most affected regions were the mandibular angle and parasymphysis. Surgical treatment was applied in most cases. Complications occurred in 36 patients (30.2 %). Complications in mandibular angle accounted for 27 % of cases. The severity of the trauma and uncooperative patients were factors that contributed to the development of postoperative complications. To the mechanical evaluation, forty mandible replicas made of polyurethane were used. The samples were divided into four groups with different fixation methods: one miniplate, two parallel miniplates, a 3D miniplates with 4 holes and a 3D miniplate with 8 holes, all of them of a 2.0mm system. Each group was subjected to linear vertical loading at the incisal and molar region by an Instron 4411 mechanical testing unit (Instron Corp, Norwood, MA). The technique of two parallel miniplates showed statistically greater resistance than all other fixation methods. No statistically significant difference was observed in 3D miniplates with 4 holes in relation to the group of one miniplate. The 3DPP group showed lower values of strength. Thus, the technique of two miniplates showed better mechanical behavior for the fixation of the mandibular angle fractures / Doutorado / Fisiopatologia Cirúrgica / Doutor em Ciências
532

Avaliação mecânica in vitro e análise fractográfica de duas marcas comerciais nacionais de sistema de fixação 2,0mm com travamento de parafusos em fraturas simuladas de corpo mandibular / Mechanical and fractographic analysis of two national brands of 2.0mm locking fixation systems in simulated mandibular body fracture

Correia Medeiros, Raquel, 1986- 23 August 2018 (has links)
Orientador: Roger William Fernandes Moreira / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-23T02:59:43Z (GMT). No. of bitstreams: 1 CorreiaMedeiros_Raquel_M.pdf: 1506622 bytes, checksum: 7e7760f3ed374300679a2cb781f5ca71 (MD5) Previous issue date: 2013 / Resumo: Este trabalho teve como objetivo de avaliar comparativamente a resistência de duas marcas de sistema de fixação de 2,0 mm com sistema de travamento de parafusos em hemimandíbulas de alumínio com fratura simulada de corpo mandibular. E também, realizar a análise fractográfica das placas utilizadas no estudo acima, através de Microscopia Eletrônica de Varredura (MEV). Quatro hemimandíbulas em alumínio com seccionamento linear simulando uma fratura de corpo mandibular foram utilizadas como substrato, fixadas de acordo com duas técnicas de fixação de duas marcas nacionais Tóride® (Tóride Indústria e Comércio Ltda. - Mogi Mirim, São Paulo - Brasil) e Traumec® (Traumec - Tecnologia e Implantes Ortopédicos Imp. e Exp. Ltda.- Rio Claro, São Paulo- Brasil) e divididas em dois grupos. O grupo I foi fixado com uma placa de quatros furos, com quatro parafusos de 6 mm na zona de tensão e uma placa de 4 furos, com 4 parafusos de 10 mm na zona de compressão e o grupo II foi fixado com uma placa de 4 furos com 4 parafusos de 6 mm na zona neutra. Para cada grupo foram utilizadas cinco amostras de cada marca comercial. As hemimandíbulas foram submetidas a testes de carregamento linear vertical por uma unidade de testes mecânicos Instron 4411(Instron Corp, Norwood, MA) para registro da carga de pico e da carga nos deslocamentos de 3 mm, 5 mm e 7 mm. As médias e o desvio padrão foram avaliados aplicando-se a Análise de Variância em nível de significância de 5%. Após os testes mecânicos, não houve diferença estatisticamente significante entre as marcas, tanto no grupo I quanto no grupo II, em relação às cargas suportadas no deslocamento de 3 mm e 5mm, nem entre as cargas de pico, havendo diferença apenas no deslocamento de 7 mm. De uma maneira geral, as placas Tóride® suportaram uma carga maior nos dois grupos. A superfície de fratura analisada no MEV apontou para uma fratura do tipo dúctil, normalmente encontrada em corpos de ensaio de tração de materiais dúcteis, como o titânio. Não foram observados em nenhuma superfície de fratura quaisquer indícios de falha por alteração na estrutura ou na composição do material / Abstract: This study aimed to comparatively evaluate the resistance of two brands of rigid fixation system with 2,0 mm locking system in hemimandibles of aluminum with simulated fracture of the mandibular body. Also, perform fractographic analysis of the same, by Scanning Electron Microscopy (SEM). Four hemimandible of aluminum with a sectioning linear simulating fracture of mandibular body were used as substrate and fixed according to two techniques for two national brands Tóride® (Tóride Indústria e Comércio Ltda. - Mogi Mirim, São Paulo - Brazil) and Traumec® (Traumec - Orthopedic Implants and Technology Imp. e Exp Ltda. - Rio Claro, São Paulo, Brazil). The techniques were: two 4- hole locking miniplate applied at the superior and inferior borders and one 4-hole locking miniplate applied in neutral zone. The samples was subjected to linear vertical loading in the canine region in an mechanical testing unit Instron 4411 (Instron Corporation, Norwood, MA) and the peak load and load displacement in 3 mm, 5 mm and 7 mm were recorded. Averages and standard deviations were evaluated by applying the analysis of variance at a significance level of 5%.After mechanical testing, there was no statistically significant difference between the brands, both in group I and group II, in relation to the load supported in the displacement of 3 mm and 5 mm, or between peak loads. The only difference between the brands, for both groups, was the load in the displacement of 7 mm. In general, the plates Toride supported a greater load in both groups. The fracture surface examined under SEM indicated a ductile fracture, usually found in bodies testing of ductile materials such as titanium. Were not observed, in any fracture surface, any evidence of failure by altering the structure or composition of the material / Mestrado / Cirurgia e Traumatologia Buco-Maxilo-Faciais / Mestra em Clínica Odontológica
533

Avaliação do escore TLICS em trauma de coluna torácica e lombar / Evaluation of the TLICS score thoracolumbar spine trauma

Cavalcante, Rodrigo Alves de Carvalho, 1979- 19 August 2018 (has links)
Orientador: Yvens Barbosa Fernandes / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-19T18:49:05Z (GMT). No. of bitstreams: 1 Cavalcante_RodrigoAlvesdeCarvalho_M.pdf: 47962870 bytes, checksum: 30187744bcc8d761f23631f51a4d472c (MD5) Previous issue date: 2012 / Resumo: Fraturas da coluna tóraco-lombar tem alta prevalência em todo mundo e, portanto, exige dos cirurgiões de coluna uma constante tomada de condutas no sentido de propor a melhor forma de tratamento para os doentes acometidos com essas fraturas. A melhor forma de tratar as mesmas seria então tentar agrupá-las, classificá-las e a definir a presença ou não de instabilidade, definindo uma conduta de tratamento clínico ou cirúrgico. Dentre os vários sistemas de classificações existentes para classificar essas fraturas, os mais utilizados na atualidade são o Thoracolumbar Injury Classification System (TLICS) escore e sistema de Classificação da ArbeitgemeinschaftOsteosynthesefragen (AO). Nesse estudo foi utilizado o escore TLICS recentemente publicado para avaliar retrospectivamente 49 doentes tratados cirurgicamente entre 2003 a 2009 no Hospital das Clínicas da Unicamp e no Hospital Dr. Mário Gatti em Campinas-SP, por fraturas em coluna tóraco-lombar. O TLICS recomendou tratamento em 47 de 49 pacientes operados (96%), sendo identificada correlação estatística significante do mesmo, com o sistema de classificação AO (p= 0.0088), com status neurológico( p=0.001) e a correlação da classificação AO com status neurológico( p=0.041), utilizando o teste de Fischer. Os resultados do presente estudo permitem concluir que esse escore é acurado para predizer a conduta cirúrgica no tratamento dessas lesões / Abstract: Fractures of the thoracic and lumbar spine have a high prevalence worldwide, therefore, requires the spine surgeons conduct a continuous decision to propose the best treatment for patients affected with these fractures. The best way to treat the same would then try to group and classify them and after that define its stability or instability, a defining conduct of clinical or surgical treatment. Among the various classification systems exist to classify these fracture, the most frequently used are TLICS score and Arbeitgemeinschaft fur Osteosynthesefragen (AO) classification system. We used the recently published TLICS score to evaluate retrospectively 49 patients treated surgically between 2003 to 2009 at the Hospital of UNICAMP and Dr. Mário Gatti Hospital in Campinas-SP, for fractures at the thoracolumbar spine. The TLICS score recommended treatment in 47 of 49 operated patients (96%), being identified a significance statistical analysis correlation between the same with the AO classification system (p=0.0088), the TLICS score and neurological status (p=0.001) and the AO classification system and neurological status (p=0.041); therefore, the results presented in this article show be accurate to predict the surgical treatment of these lesions / Mestrado / Neurologia / Mestre em Ciências Médicas
534

Relações experimentais entre tensão e propriedades de fratura em meios sintéticos anisotrópicos / Experimental relations between stress and fracture properties on synthetic anisotropic media

Marcondes, Paulo Eduardo Pasquini 21 August 2018 (has links)
Orientador: Joerg Dietrich Wilhelm Schleicher / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Mecânica e Instituto de Geociências / Made available in DSpace on 2018-08-21T13:15:48Z (GMT). No. of bitstreams: 1 Marcondes_PauloEduardoPasquini_M.pdf: 15230137 bytes, checksum: 6a3ec19ac833d41b7e0e630fdfdcd247 (MD5) Previous issue date: 2012 / Resumo: Nos reservatórios de hidrocarbonetos, a caracterização das falhas e fraturas é de extrema importância devido a seu papel ora como barreiras ao fluxo, ora canais condutores. Os efeitos da anisotropia causada por fraturas alinhadas têm sido objeto de muitos trabalhos e experimentos de modelagem sísmica. No entanto, devido a complexidade exibida por meios fraturados anisotrópicos, a caracterização desse tipo de meio nem sempre é possível. Nestas condições, através da adoção de modelos e geometrias simplificados, bem como da adequada escolha dos parâmetros é que a modelagem física da propagação de ondas sísmicas através de meios fraturados permite estimar a influência destas características das fraturas de forma mais confiável. Modelamos fraturas preenchidas por material de baixa resistência ao cisalhamento usando inclusões de neoprene, que possui esta característica. Foram efetuadas medidas de transmissão acústica de ondas P e S em um modelo de referência sem inclusões e em outro modelo com inclusões discóides de neoprene. Os dados ultrassônicos foram adquiridos usando transdutores de ondas P com frequência central de 120 kHz e de ondas S com 90 kHz. Estudamos o comportamento destes dois meios anisotrópicos sob compressão uniaxial. Também estudamos o efeito destas inclusões sobre os parâmetros anisotrópicos de um meio cujo arcabouço já apresentava comportamento anisotrópico polar. Ambos os modelos foram submetidos a compressão uniaxial com tensões de 3 até 15,8 MPa. O completo fechamento das fraturas ocorre ao nível de tensão de 14,6 MPa. Nossa análise aponta a existência de diferentes regimes para o comportamento das inclusões, observados tanto no parâmetro densidade de fraturas quanto sob sua razão de aspecto. Estes resultados sugerem uma dependência da razão de aspecto para baixos níveis de tensão uniaxial diferente do que se tem reportado na literatura. Outros resultados obtidos dizem respeito à caracterização dos meios anisotrópicos devido ao fraturamento a partir dos coeficientes elásticos derivados a partir das velocidades sísmicas. Apesar de não exaustivos, nossos resultados mostram que abordagens experimentais simples podem fornecer conhecimento valioso do comportamento de rochas fraturadas aos níveis de tensão existentes nos reservatórios / Abstract: Fault and fracture characterization is very important for hydrocarbon reservoirs, due to it being either a flow barrier or conduit. Elastic anisotropy due to aligned cracks has been the subject of many seismic physical modeling experiments. However, due to the complexity exhibited by fractured anisotropic media, fully characterizing these kind of media is not always possible. Under these conditions, the adoption of simplified models and geometries as well as adequate parameter choices permits characterizing these media using physical seismic modeling in a reliable way. We modeled fractures with a low shear modulus filling using neoprene rubber discs as inclusions, because of neoprene's low shear modulus. We carried out pulse transmission measurements of P- and S-wave velocities in a reference model without inclusions and in a model with penny-shaped neoprene inclusions. The reference model is an anisotropic matrix that consists of stacked plexiglass plates. Rubber discs were used as inclusions in that anisotropic matrix leading to secondary anisotropy, this is our second model. We recorded ultrasonic seismic data using P-wave transducers with central frequency 120 kHz and S-wave transducers with 90 kHz. We compressed the physical models using pressures ranging from 3 to 15.8MPa. Full crack closure occurs at stress 14.6MPa normal to model faces. Our analysis indicates different regimens for the behavior of the inclusions when observed via its crack densities and aspect ratios. These results suggest a different dependence of the crack aspect ratio on uniaxial stress at the low state of stress than usually described in the literature. Other results point that it might be possible to characterize a fractured medium though its elastic coefficients. Though our results are not extensive, they show that simple experimental approaches might provide valuable insight into the behavior of cracked rocks at reservoir stress levels / Mestrado / Reservatórios e Gestão / Mestre em Ciências e Engenharia de Petróleo
535

Estudo das lesões ligamentares e condrais nas fraturas articulares da extremidade distal do rádio: avaliação artroscópica / Studies of the ligament and chondral injuries in articular fractures of the distal end of the radius: arthroscopic evaluation

Marcelo Araf 25 March 2008 (has links)
As fraturas da extremidade distal do rádio são muito comuns em nosso meio, sendo a mais freqüente do punho. Inúmeras pesquisas já foram realizadas sobre o tema e é conhecida a importância da redução anatômica das fraturas intra-articulares; porém, a causa de insucesso no seu tratamento pode ser a associação de outras lesões, envolvendo partes moles e cartilagem. O objetivo foi realizar uma avaliação artroscópica para analisar a incidência das lesões ligamentares e condrais associadas às fraturas intraarticulares da extremidade distal do rádio, correlacionado-a com classificação AO/ASIF. Trinta pacientes, com idade entre 20 a 50 anos, portadores de fratura fechada dos grupos B e C da classificação AO/ASIF foram selecionados. Todos eles foram submetidos à artroscopia do punho, para abordar as lesões intra-articulares e para redução e osteossíntese da fratura. Observou-se uma alta incidência de lesões intra-articulares, sendo que 76,7% deles apresentavam lesão do complexo da fibrocartilagem triangular, 36,6% do ligamento intrínseco escafo-semilunar, 6,6% do ligamento intrínseco semilunar-piramidal e 33,3% com lesão da cartilagem articular maior que três milímetros. Pacientes portadores de fraturas tipo C da classificação AO/ASIF apresentam uma incidência maior de lesões ligamentares associadas. Não houve relação entre a presença de lesão cartilaginosa e a classificação AO/ASIF das fraturas nesta casuística. / Fractures of the distal end of the radius are very frequent in our country and the most common is that of the wrist. Much research was carried out on the subject and the importance of the anatomical reduction of intra-articular fractures is well known, however the cause of unsuccessful treatment may be the association of other injuries involving soft tissues and cartilage. The purpose here was to perform an arthroscopic evaluation to analyze the incidence of ligament and chondral injuries associated to intra-articular fractures of the distal end of the radius, for correlation with the AO/ASIF classification. Thirty patients ranging from 20 to 50 years of age, bearers of closed fractures of groups B and C of the AO/ASIF classification were selected. They were submitted to wrist arthroscopy to treat the intra-articular injuries for fracture reduction and osteosynthesis. A high incidence of intraarticular injuries was noted, 76.7% of them presenting injury of the triangular fibrocartilage complex, 36.6% of the intrinsic scapholunate ligament, 6.6% of the intrinsic lunotriquetral ligament and 33.3% of an injury of the articular cartilage larger than three millimeters. Patients bearers of a type C fracture in the AO/ASIF classification present with a higher incidence of associated ligament injuries. No relation between presence of cartilage injury and AO/ASIF Classification was found in this casuistry.
536

Ecoulements en milieux fracturés : vers une intégration des approches discrètes et continues.

Delorme, Matthieu 02 April 2015 (has links) (PDF)
Simuler les réservoirs souterrains permet d’optimiser la production d’hydrocarbures. Les réservoirs naturellement ou hydrauliquement fracturés détiennent une part importante des réserves et exhibent un degré élevé d’hétérogénéité : les fractures, difficiles à détecter, impactent fortement la production via des réseaux préférentiels d’écoulement. Une modélisation précise de ces forts contrastes permettrait d’optimiser l’exploitation des ressources tout en maîtrisant mieux les risques environnementaux. L’enjeu est de prédire les processus d’écoulement multi échelles par un modèle simplement paramétrable. Une stratégie de simulations, qui améliore la fiabilité et les temps de calculs est mise au point dans cette thèse. Elle permet de simuler numériquement ou analytiquement la complexité d’un réservoir fracturé à grande échelle. Ces techniques dont l’intérêt est démontré sur un réservoir de roche mère trouvent des applications en géothermie ou dans la gestion des ressources en eau.
537

Comparison of an intra-oral approach using a contra-angle hand piece with the transbuccal technique for mandibular angle fracture repair

De Waal, Andre Stephanus January 2010 (has links)
Magister Chirurgiae Dentium - MChD / Purpose: To compare the intra-oral approach using a contra-angled hand piece with the standard transbuccal approach in the treatment of mandibular angle fractures. Patients and Methods: Thirty patients with isolated fractures of the mandibular angle were treated by open reduction and internal fixation using one three-dimensional “strut” or “geometric” Synthes® angle plate. Patients were selected randomly for placement of two-millimeter self-threading screws, either through the standard transbuccal technique or with an intra-oral approach using a contra-angle hand piece. None of the patients were placed into post-surgical maxillomandibular fixation (MMF). Swelling and pain were measured pre-operatively and again twenty-four hours after surgery. The actual cutting time from first incision to placement of last suture was documented, as well as the perception of difficulty of the specific case by a single operating surgeon. Results: No statistically significant difference in perception of pain was experienced between the two groups of patients during the first twenty-four hours after surgery. There was also no statistically relevant difference in cutting time between the two placement techniques. A small statistically relevant difference (p-value = 0.089) was found in the amount of swelling post-operatively between the two groups, with more swelling in the control group. Conclusion: The use of a contra-angle hand piece to place screws in the compression band area in a mandible angle fracture is an acceptable alternative to the transbuccal approach. / South Africa
538

Aspects of dental cone-beam computed tomography in children and young people

Hidalgo Rivas, Jose Alejandro January 2014 (has links)
Cone-beam computed tomography (CBCT) has become increasingly popular in dentistry. It is usually associated with radiation doses that are lower than those seen with conventional computed tomography (CT) but greater than those seen with dental radiography. Because exposure to ionising radiation is associated with risks, the radiation protection principles of justification and optimisation should be applied. These are especially important in children and young people due to their greater risk of developing stochastic effects. Justification requires a balancing of the radiation risk with the potential benefits and the latter is dependent on diagnostic efficacy. There has been a proliferation of articles published on dental CBCT and there is a need to review this systematically so that diagnostic efficacy can be judged. In terms of optimisation, radiation dose reduction can be achieved in various ways, but the use of barrier materials to protect younger patients in CBCT has not been adequately tested. Reduction in exposure parameters in CBCT will lower doses but at the expense of a loss of image quality. While some efforts have been made to relate radiation exposure and image quality in CBCT, there is a need to develop low-dose CBCT protocols specifically for children and young people. The first aim of this thesis was to survey current uses of CBCT in children and young people in three United Kingdom dental hospitals. The second aim was to determine the efficacy of thyroid shielding in a child phantom testing several different designs, materials and thickness of thyroid shields. The third aim was to evaluate the evidence on diagnostic efficacy of dental CBCT for root fractures in permanent, non-endodontically treated, anterior teeth by conducting a systematic review. The fourth aim was to evaluate objective and subjective image quality in a laboratory study to determine a low-dose CBCT protocol which maintains adequate diagnostic image quality for a clinical indication in children. Finally, the aim was to evaluate this low-dose protocol in terms of image quality in real clinical situations. A high adherence to the European guidelines No 172 on radiation protection in dental CBCT was found amongst the surveyed hospitals. Thyroid shielding was found to be effective in dose reduction when performing a large field of view CBCT scan in a child phantom, but design influenced efficacy. The systematic review showed that research articles investigating CBCT diagnostic accuracy for vertical and horizontal root fractures had deficiencies in methodology, while only one study was identified addressing higher levels of diagnostic efficacy. A low-dose imaging protocol was identified in a laboratory study, which has been shown to be an effective tool in dose reduction providing an adequate diagnostic image quality and reducing radiation doses considerably for clinical indications in the anterior maxilla in children and young people.
539

An investigation of immature rib fractures resultant from both CPR and abusive scenarios

Johnson, Mark Richard January 2014 (has links)
The presence of rib fractures in deceased infants is generally considered to be highly specific of non-accidental injury, with some pathologists considering them to be evidence of abuse. Although rib fractures may occur during resuscitative efforts in adults, the general consensus is that such injuries are exceptional in infants owing to inherent plasticity within the thoracic region. The recommendation for cardiopulmonary resuscitation (CPR) of infants since the year 2000 has been for the use of the “two-thumb” technique. However, there has been limited biomechanical investigation to what injuries may occur subsequent to this specific form of CPR. The overall aim of this thesis was to determine if two-thumb CPR can cause similar rib injuries to those seen in abusive squeezing cases. In particular, whether or not this CPR technique allows for over excessive levering of the posterior rib over the transverse process of the spine. To this end, physical experimentation simulating both two-thumb CPR and abusive squeezing was performed on an immature swine model of the infant thorax. The results of these tests did not show any significant difference in the force required to compress the thorax by one third its original anterior-posterior diameter in the two scenarios. One third being the recommended depth for CPR compressions. Fractures resultant from the testing were assessed with radiography and computed tomography, techniques commonly used by post-mortem pathologists. The type and nature of the injuries observed were remarkably similar in both scenarios. Rib injuries were primarily seen in the anterior part of the thoracic cage in both CPR and abusive specimens. The specific site of rib fracture was typically close to or within the costochondral joints. There was however an apparent absence of posterior rib fractures in the abusively tested cohort. This is in part due to the slight difference in profile of the neck and head areas within the ribs of the surrogate model. This acts to reduce the mechanical advantage offered by levering over the transverse processes of the spine. This study has shown anterior fractures of the ribs result from two-thumb CPR, challenging the long held belief that CPR cannot produce rib fractures. X-ray CT offered a significant improvement on the ability to detect costochondral junction injuries. This would offer further support to the routine use of X-ray CT in post-mortem examinations of infants where the cause of death is unknown. This has the potential to offer differential interpretation to the cause of rib injuries, especially in cases of sudden unexpected deaths in infancy, where otherwise child abuse may be diagnosed.
540

Acoustic velocity structure of the carboneras fault zone, SE Spain

Taylor, Rochelle Louise January 2013 (has links)
The Carboneras fault zone (CFZ, Almería Province, SE Spain) is a major NE-SW trending tectonic lineament that marks part of the diffuse plate boundary between Iberia and Africa. Developed within a basement terrain dominated by mica schist, the fault system comprises two main strands within a complex zone up to 1 km wide. Between these two strands is a braided network of left-lateral strike-slip, phyllosilicate-rich fault gouge bands, ranging between 1 and 20 m in thickness, passively exhumed from up to 3 km depth. The excellent exposure in a semi-arid environment, the wide range of rock types and fault structures represented and the practicality of carrying out in-situ geophysical studies makes this fault zone particularly well suited to verifying and interpreting the results of in-situ seismic investigations. Integration of elements of field study, laboratory analysis and modelling has aided interpretation of the internal structure of the fault zone. Ultrasonic measurements were made using standard equipment over confining and pore pressure ranges appropriate to the upper 10 km of the continental crust. Seismic velocities have also been approximated from modal analysis and mineral phase elastic properties and adjusted for the effects of porosity. In-situ seismic investigations recorded P-wave velocities 40-60% lower than those measured in the laboratory under corresponding pressures and at ambient temperatures for hard rock samples. Fault gouge velocities measured in the laboratory, however, are comparable to those measured in the field because, unlike the host rocks, fault gouges are only pervasively micro-fractured and lack the populations of long cracks (larger than the sample size) that cause slowing of the velocities measured in the field. By modelling the effect of fractures on seismic velocity (by superimposing upon the laboratory seismic data the effects of crack damage) the gap between field- and laboratory-scale seismic investigations has been bridged. Densities of macroscopic cracks were assessed by measuring outcrop lengths on planar rock exposures. Assuming crack length follows a power law relation to frequency, this fixes a portion of the power spectrum, which is then extrapolated to cover the likely full range of crack sizes. The equations of Budiansky and O'Connell (1976), linking crack density to elastic moduli, were used to calculate modified acoustic velocities, and the effects of the wide range of crack sizes were incorporated by breaking the distribution down into small sub-populations of limited range of crack density. Finally, the effect of overburden pressure causing progressively smaller cracks to close was incorporated to predict velocity versus depth of burial (i.e. pressure). Determination of rock physical properties from laboratory analysis and sections constructed from geological mapping provides a representation of velocity from selected parts of the Carboneras fault zone. First break tomography images show particularly well the location of steeply-inclined fault cores, and these correlate generally well with geological mapping and laboratory velocity measurements corrected for the effect of cracks. The decoration of the fault zone with intrusive igneous material is well correlated with the results of geological observations. Comparisons made between the field (seismic) inversion model and laboratory forward velocity model in El Saltador valley show the laboratory and field velocity measurements made within the fault zone can be reconciled by accounting for the effects of crack damage in field data.

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