Die distale Radiusfraktur gehört zu den häufigsten Frakturen in Deutschland mit einem Inzidenzanstieg im Alter unter Betonung des weiblichen Geschlechts. Dabei zeigt sich ein zunehmender Trend in Richtung operative Versorgung, allen voran die Versorgung mittels winkelstabiler Plattensysteme. Instabile, distale Radiusfrakturen werden dabei vor geplanter operativer Versorgung im Rahmen der Initialbehandlung üblicherweise geschlossen reponiert und im Gipsverband retiniert. Ziel der vorliegenden monozentrischen, prospektiv randomisierten Studie mit zwei Studiengruppen war es herauszufinden, ob sich das Unterlassen der Reposition vor geplanter Operation nachteilig auf das Schmerzniveau in der präoperativen Phase auswirkt und ob sich durch die Dislokation Nachteile in Bezug auf den Nervus medianus im Sinne eines Traktionsschadens sowie bezüglich des klinisch-radiologischen Ausheilungsergebnisses zeigen. Die Studie zeigte, dass das Schmerzempfinden während der präoperativen Gipsbehandlung unabhängig von einer vorherigen Reposition war. Für den primären Endpunkt an Tag 1 nach der Akutbehandlung konnte statistisch signifikante Nichtunterlegenheit der Gruppe ohne Reposition gegenüber der Gruppe mit Reposition nachgewiesen werden. Gleiches galt für Tag 2, sowohl für die absoluten Schmerzniveaus als auch für die Schmerzlinderung. Das Unterlassen der Reposition hatte zudem keine nachteiligen Effekte auf den Nervus medianus. Gleiches zeigte sich für das klinische und radiologische Ausheilungsergebnis. Für die funktionellen DASH- und Krimmer-Scores konnte ein Jahr postoperativ ebenfalls statistisch signifikante Nichtunterlegenheit der Gruppe ohne Reposition nachgewiesen werden. Diese Erkenntnisse bestätigen die in der Literatur vorhandenen Ergebnisse verschiedener Studien dahingehend, dass das Unterlassen der Reposition keine nachteiligen Effekte auf das postoperative Outcome hat. Einige Studien verdeutlichen zudem, dass es nach Reposition, insbesondere bei Vorliegen gewisser Risiko- und Instabilitätsfaktoren, ohnehin zur sekundären Dislokation kommt, sodass die generelle Notwendigkeit der Reposition vor Gipsanlage sowohl vor einer operativen als auch vor einer konservativen Weiterbehandlung angezweifelt werden muss. / The distal radius fracture is one of the most common fractures in Germany, with an increase in incidence with age and an emphasis on the female sex. There is an increasing trend towards surgical treatment, above all treatments using locking plate systems. Prior to planned surgical treatment, unstable, distal radius fractures are usually reduced in a closed manner as part of the initial treatment and are retained in a plaster cast. The aim of the present monocentric, prospective randomized study with two study groups was to find out whether omitting reduction before planned surgery has a negative effect on the pain level in the preoperative phase and whether the dislocation has disadvantages with regard to the median nerve in terms of traction damage and with regard to the clinical and radiological healing result. The study showed that the sensation of pain during preoperative plaster treatment was independent of previous reduction. For the primary endpoint on day 1 after acute treatment, statistically significant non-inferiority of the group without reduction compared to the group with reduction was demonstrated. The same was true for day 2, both for absolute pain levels and pain relief. The omission of the reduction also had no adverse effects on the median nerve. The same was shown for the clinical and radiological healing results. For the functional DASH and Krimmer scores, statistically significant non-inferiority of the group without reduction was also demonstrated one year postoperatively. These findings confirm the results of various studies in the literature to the effect that omitting reduction has no detrimental effects on the postoperative outcome. Some studies also make it clear that secondary dislocation occurs anyway after reduction, especially in the presence of certain risk and instability factors, so that the general necessity of reduction prior to plaster application must be questioned both before surgical and conservative further treatment.

Made available in DSpace on 2014-06-11T19:35:12Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-07-01Bitstream added on 2014-06-13T18:46:38Z : No. of bitstreams: 1 moraes_jms_dr_botfm.pdf: 700799 bytes, checksum: fc4d9acf6b612dcd147bd547fbffdcbe (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Efeitos das catecolaminas sobre a reposi çãoo vol êmica com solu ção fisiol ógica. Repercuss ão sobre a variabilidade da frequ ência card íaca de coelhos submetidos à hemorragia. Estudo por an álise espectral. Verificar os efeitos de diferentes catecolaminas sobre a expans ão volê mica e sobre o sistema nervoso autonô mico em coelhos submetidos à hemorragia. Foram estudados 24 coelhos, submetidos à hemorragia (25% da volemia), distribu ídos aleatoriamente em quatro grupos experimentais, conforme o tipo de reposi ção vol êmica realizada. Grupo HEMO - reposi ção com o pr óprio sangue com volume igual ao retirado. Grupo SF - reposiçã o com solu çã o fisiol ógica (SF) em volume correspondente a tr ês vezes o volume de sangue retirado. Grupo ISP - reposi ção com SF em volume correspondente a tr ês vezes o volume de sangue retirado, e Isoprenalina na dose de 0,1 g.kg-1.min-1, e Grupo FNL – reposi çã o com SF em volume correspondente a tr ês vezes o volume de sangue retirado, e Fenilefrina na dose de 3,0 g.kg-1.min-1. Durante o experimento, foram monitoradas as seguintes vari áveis: hemató crito (para avalia çã o da retençã o intravascular da soluçã o cristaloide), diurese, press ção venosa central (PVC) e pressão arterial mé dia (PAM). Tamb ém foi feito o registro cont ínuo da onda da press ão arterial donde analisando-se o pico sist ólico aferiu-se a variabilidade da frequ ência card íaca (VFC) nos per íodos correspondentes à: basal, hemorr ágico, infus ção de catecolaminas e controle pó s-reposi ção vol êmica. A reposi çã o com SF associado a catecolaminas α ou β agonistas n ão demonstrou diferen ças no que tange reten ção intravascular comparando-se reposi çã o isolada com SF. A diurese total foi maior no grupo FNL quando comparando-se... / The effect of catecholamines over volemic reposition with saline solution and its effects on the heart rate variability on rabbits subjected to hemorrhage. Research through Spectral Analysis. To check the effects of different catecholamines on the volemic expansion and on the autonomic nervous system of rabbits subjected to hemorrhage. 24 rabbits were studied, subjected to hemorrhage (25% volemia), randomly distributed in four experimental groups, according to the type of volemic reposition done. HEMO Group: Reposition administered with the animal’s own blood, in the same amount of blood taken out. Saline Solution (SS) Group: Reposition with SS, three times the amount of blood withdrawn. Isoprenaline (ISP) Group: Reposition with SS, three times the amount of blood taken out, and Isoprenaline at 0,1 g.kg-1.min-1; and Phenylephrine (PHN) Group: Reposition with SS three times the amount of blood withdrawn, and Phenylephrine at 3,0 g.kg-1.min- 1. During the experiment, the following variables were monitored: hematocrit (to evaluate intravascular retention of the crystalloid solution), diuresis, central venous pressure and medium blood pressure. The blood pressure curve was also checked and by examining the systolic peak, the heart rate variability was verified during these different stages: basal, hemorrhagic, catecholamine infusion and post volemic reposition control. The reposition done with SS mixed in agonist α or β catecholamine did not demonstrate differences in intravascular retention, when comparing to isolated reposition with SS. Total diuresis was bigger in the PHN Group than in the HEMO Group. The Central Venous Pressure was significantly higher in the group where volemic reposition with SS was administered, when comparing it to the group where PHN was used. The HRV research showed that the physiological response of the autonomic nervous system in the PHN group... (Complete abstract click electronic access below)

Orientador: Luiz Antonio Vane / Banca: Eliana Marisa Ganem / Banca: Yara Marcondes Machado Castiglia / Banca: Maria José Carvalho Carmona / Banca: Ismar Lima Cavalcanti / Resumo: Efeitos das catecolaminas sobre a reposi€çãoo vol„êmica com solu€ção fisiolˆógica. Repercussão sobre a variabilidade da frequ„ência cardŠíaca de coelhos submetidos Œ à hemorragia. Estudo por an†álise espectral. Verificar os efeitos de diferentes catecolaminas sobre a expansão volê„mica e sobre o sistema nervoso autonôƒmico em coelhos submetidos Œà hemorragia. Foram estudados 24 coelhos, submetidos Œà hemorragia (25% da volemia), distribuŠídos aleatoriamente em quatro grupos experimentais, conforme o tipo de reposi€ção vol„êmica realizada. Grupo HEMO - reposi€ção com o prˆóprio sangue com volume igual ao retirado. Grupo SF - reposição com solu€ção fisiolˆógica (SF) em volume correspondente a tr„ês vezes o volume de sangue retirado. Grupo ISP - reposi€ção com SF em volume correspondente a tr„ês vezes o volume de sangue retirado, e Isoprenalina na dose de 0,1g.kg-1.min-1, e Grupo FNL - reposi€ção com SF em volume correspondente a tr„ês vezes o volume de sangue retirado, e Fenilefrina na dose de 3,0g.kg-1.min-1. Durante o experimento, foram monitoradas as seguintes vari†áveis: hematóˆcrito (para avalia€ção da retenç、o intravascular da soluç、o cristaloide), diurese, pressção venosa central (PVC) e pressão arterial mé‹dia (PAM). Tamb‹ém foi feito o registro contŠínuo da onda da pressão arterial donde analisando-se o pico sistˆólico aferiu-se a variabilidade da frequ„ência cardŠíaca (VFC) nos perŠíodos correspondentes Œà: basal, hemorr†ágico, infusção de catecolaminas e controle póˆs-reposi€ção vol„êmica. A reposi€ção com SF associado a catecolaminas α ou β agonistas não demonstrou diferen€ças no que tange Œ reten€ção intravascular comparando-se Œreposi€ção isolada com SF. A diurese total foi maior no grupo FNL quando comparando-se... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The effect of catecholamines over volemic reposition with saline solution and its effects on the heart rate variability on rabbits subjected to hemorrhage. Research through Spectral Analysis. To check the effects of different catecholamines on the volemic expansion and on the autonomic nervous system of rabbits subjected to hemorrhage. 24 rabbits were studied, subjected to hemorrhage (25% volemia), randomly distributed in four experimental groups, according to the type of volemic reposition done. HEMO Group: Reposition administered with the animal's own blood, in the same amount of blood taken out. Saline Solution (SS) Group: Reposition with SS, three times the amount of blood withdrawn. Isoprenaline (ISP) Group: Reposition with SS, three times the amount of blood taken out, and Isoprenaline at 0,1g.kg-1.min-1; and Phenylephrine (PHN) Group: Reposition with SS three times the amount of blood withdrawn, and Phenylephrine at 3,0g.kg-1.min- 1. During the experiment, the following variables were monitored: hematocrit (to evaluate intravascular retention of the crystalloid solution), diuresis, central venous pressure and medium blood pressure. The blood pressure curve was also checked and by examining the systolic peak, the heart rate variability was verified during these different stages: basal, hemorrhagic, catecholamine infusion and post volemic reposition control. The reposition done with SS mixed in agonist α or β catecholamine did not demonstrate differences in intravascular retention, when comparing to isolated reposition with SS. Total diuresis was bigger in the PHN Group than in the HEMO Group. The Central Venous Pressure was significantly higher in the group where volemic reposition with SS was administered, when comparing it to the group where PHN was used. The HRV research showed that the physiological response of the autonomic nervous system in the PHN group... (Complete abstract click electronic access below) / Doutor

O objetivo do presente trabalho foi o de estabelecer uma nova característica ao programa de Monte Carlo ESQUEMA, destinado a simular todo o processo de detecção em um sistema de coincidência 4π(β,EC)-γ e possibilitou o conhecimento antecipado do comportamento da atividade aparente da fonte radioativa como função da eficiência do detector 4π. Esta metodologia foi aplicada anteriormente para os casos onde a eficiência é variada pela colocação de absorvedores sobre a fonte radioativa ou variando-se o nível de discriminação eletrônica, com a exclusão completa das contagens abaixo deste nível. No presente trabalho, esta metodologia foi modificada com a inclusão dos eventos não coincidentes abaixo do nível de discriminação eletrônica, adotado para a via beta. Desta forma, a curva de extrapolação passa a ter um comportamento rigorosamente linear e o valor extrapolado corresponde a atividade da fonte radioativa, esperando-se obter uma melhor acurácia no seu valor. Esta alteração é inovadora e particularmente apropriada para ser aplicada ao caso de medidas com o Sistema de Coincidências por Software (SCS), desenvolvido recentemente pelo LMN. O trabalho consiste na modificação de um programa desenvolvido no LMN, denominado ESQUEMA, que leva em conta as características gerais de um esquema de desintegração complexo, incluindo-se os diversos tipos de transição, além das características experimentais do sistema de medidas por coincidência 4π(β,EC)-γ. Estas modificações permitem a obtenção das curvas de extrapolação, aplicando-se o método proposto de Discriminação com Reposição. O software MCNP5 é usado para simular o transporte de radiação. A simulação de Monte Carlo é comparada com valores experimentais para o radionuclídeo padronizados no LMN, o 111In . / The aim of the present work is to establish a new feature to the Monte Carlo code ESQUEMA developed by the Nuclear Metrology Laboratory (LMN), in order to simulate the whole detection process in a 4π(β,EC)-γ system and predict the behavior of radioactive source activity as a function of 4π detector. The methodology was applied previously, when the efficiency is modified by adding absorbers over or under the radioactive source or modifying the electronic discrimination level by excluding all events below this level. In the present work, this methodology applying beta pulse height discrimination has been modified adding to the beta spectrum noncoincident events occurring below the lower level, which are cutted off by the conventional discrimination procedure. In this way, the extrapolation curve is modified obtaining straight line shape and the extrapolated value, corresponding to the radioactive source activity, is expected to achieve better accuracy. This feature is particularly suitable for measurements with the Software Coincidence System (SCS), recently developed at the LMN. The main goal of present work is to modify the software developed by the LMN team, called ESQUEMA where all the characteristics of a complex disintegration scheme are considered, including different kind of transitions and experimental features of 4π(β,EC)-γ detection process. These changes allow to obtain the extrapolated value by the proposed method of Discrimination with Reposition. The software MCNP5 is used to simulate the radiation transport. The Monte Carlo simulation is compared to experimental results obtained for 111In, recently standardized by the LMN using the SCS and conventional extrapolation techniques.

O objetivo do presente trabalho foi o de estabelecer uma nova característica ao programa de Monte Carlo ESQUEMA, destinado a simular todo o processo de detecção em um sistema de coincidência 4π(β,EC)-γ e possibilitou o conhecimento antecipado do comportamento da atividade aparente da fonte radioativa como função da eficiência do detector 4π. Esta metodologia foi aplicada anteriormente para os casos onde a eficiência é variada pela colocação de absorvedores sobre a fonte radioativa ou variando-se o nível de discriminação eletrônica, com a exclusão completa das contagens abaixo deste nível. No presente trabalho, esta metodologia foi modificada com a inclusão dos eventos não coincidentes abaixo do nível de discriminação eletrônica, adotado para a via beta. Desta forma, a curva de extrapolação passa a ter um comportamento rigorosamente linear e o valor extrapolado corresponde a atividade da fonte radioativa, esperando-se obter uma melhor acurácia no seu valor. Esta alteração é inovadora e particularmente apropriada para ser aplicada ao caso de medidas com o Sistema de Coincidências por Software (SCS), desenvolvido recentemente pelo LMN. O trabalho consiste na modificação de um programa desenvolvido no LMN, denominado ESQUEMA, que leva em conta as características gerais de um esquema de desintegração complexo, incluindo-se os diversos tipos de transição, além das características experimentais do sistema de medidas por coincidência 4π(β,EC)-γ. Estas modificações permitem a obtenção das curvas de extrapolação, aplicando-se o método proposto de Discriminação com Reposição. O software MCNP5 é usado para simular o transporte de radiação. A simulação de Monte Carlo é comparada com valores experimentais para o radionuclídeo padronizados no LMN, o 111In . / The aim of the present work is to establish a new feature to the Monte Carlo code ESQUEMA developed by the Nuclear Metrology Laboratory (LMN), in order to simulate the whole detection process in a 4π(β,EC)-γ system and predict the behavior of radioactive source activity as a function of 4π detector. The methodology was applied previously, when the efficiency is modified by adding absorbers over or under the radioactive source or modifying the electronic discrimination level by excluding all events below this level. In the present work, this methodology applying beta pulse height discrimination has been modified adding to the beta spectrum noncoincident events occurring below the lower level, which are cutted off by the conventional discrimination procedure. In this way, the extrapolation curve is modified obtaining straight line shape and the extrapolated value, corresponding to the radioactive source activity, is expected to achieve better accuracy. This feature is particularly suitable for measurements with the Software Coincidence System (SCS), recently developed at the LMN. The main goal of present work is to modify the software developed by the LMN team, called ESQUEMA where all the characteristics of a complex disintegration scheme are considered, including different kind of transitions and experimental features of 4π(β,EC)-γ detection process. These changes allow to obtain the extrapolated value by the proposed method of Discrimination with Reposition. The software MCNP5 is used to simulate the radiation transport. The Monte Carlo simulation is compared to experimental results obtained for 111In, recently standardized by the LMN using the SCS and conventional extrapolation techniques.

The purpose of this study was to observe the joint reposition error and tactile acuity of patients with chronic mild to moderate neck pain and compare those values to healthy controls to further investigate the effect of neck pain on neck function and the need for sensorimotor training in patients with chronic neck pain. In spite of some inconsistencies in the literature and methodology, both the two-point discrimination test and the joint reposition error test can give clinicians valuable, inexpensive and quick objective data that can be used in the diagnostic portion of an examination as well as in designing and assessing change during a rehabilitation program. This study found a significant increase in neck joint reposition error (JRE) in flexion in participants suffering from neck pain when compared to healthy controls. JRE averaged 2.75° ± 1.52° in flexion healthy controls and 4.53° ± 1.74° in flexion in participants with chronic neck pain. Additionally, the dermatome found to be most affected by neck pain was C5. Further research is needed to examine both the effect of proprioceptive training on neck pain and the effectiveness of the two-point discrimination threshold test and the joint reposition error test as diagnostic tools and indicators of progress in the treatment of chronic neck pain.

Aufgrund des demographischen Wandels und der zunehmenden Mobilität im Alter stieg der Anteil der geriatrischen Patientinnen bei den Acetabulumfrakturen in den letzten Jahren rasant an. Die optimale Therapie für geriatrische Acetabulumfrakturen bleibt jedoch weiterhin kontrovers. Vorrangiges Ziel bei der Behandlung älterer Menschen ist die frühzeitige und langfristige Mobilisation. Voraussetzung dafür ist eine primäre Gelenkstabilität. Gering dislozierte Frakturen können als stabil angesehen und zumeist konservativ behandelt werden. Aufgrund der begrenzten Fähigkeit zur Teilbelastung im Alter ist bei konservativer Therapie jedoch mit einer verlängerten Immobilisation und deren Komplikationen zu rechnen. Durch operative Reposition und Fixation der Fraktur kann eine frühzeitige Gelenkstabilität und damit Mobilisation erreicht werden. Dies könnte dazu verleiten, operative Verfahren zu favorisieren. Multimorbidität und verringerte physiologische Reserven schränken die Möglichkeit eines chirurgischen Eingriffs im Alter jedoch ein. Operationen können dabei unterschiedlich invasiv erfolgen. Offen-operative Verfahren erfordern eine hohe Invasivität. Perkutane Verfahren ermöglichen eine primäre Gelenkstabilität bei gleichzeitig geringerer Invasivität, lassen jedoch Einbußen bei der Qualität der Reposition erwarten. Der Vorteil primärer Stabilität ist gegen die potenziellen Komplikationen eines chirurgischen Eingriffs abzuwägen. Ein Vergleich von offen operativer, perkutan operativer und konservativer Behandlung bei geriatrischen, gering dislozierten Acetabulumfrakturen anhand eines Datensatzes ist bislang noch nicht erfolgt. Primäres Ziel dieser Studie war daher, den Einfluss der drei Therapieformen auf die Komplikationsrate und die Qualität der Reposition bei geriatrischen, gering-dislozierten Acetabulumfrakturen anhand eines Datensatzes zu vergleichen. Für diese Arbeit wurden die Daten des prospektiven „Beckenregisters“ der Deutschen Gesellschaft für Orthopädie und Unfallchirurgie zum Thema Acetabulumfrakturen, im Rahmen einer retrospektiven, multizentrischen Registerstudie, zwischen Juli 2008 und März 2018 ausgewertet (n=3432). In die Studie eingeschlossen wurden Patient*innen im Alter von ≥ 60 Jahren, die eine gering dislozierte Acetabulumfraktur mit einem prätherapeutischen Frakturspalt und einer -stufe von maximal 5mm aufwiesen. Ausgeschlossen wurden Patient*innen bei gleichzeitigem Vorliegen einer Beckenringfraktur Typ B/C (Tile Klassifikation) sowie gleichzeitiger Os Sacrum Fraktur, bei bilateralen, periprothetischen oder metastasenbedingten Frakturen, primärer Versorgung mittels Totalendoprothetik oder fehlender Information zur primären Versorgungsart. Die insgesamt 608 verbliebenen Patient*innen wurden, je nach erhaltener Therapie, in drei Gruppen eingeteilt: in die konservative (n=429), offen-operative (n=117) oder perkutan-operative (n=62) Gruppe. Für die statistische Auswertung wurden die Programme Microsoft Excel (Microsoft Corporation, Redmond, USA) und SPSS 24.0 (SPSS Inc., Chicago, IL, USA) verwendet. Nominal skalierte Variablen wurden mittels Pearson Chi-Quadrat-Test analysiert, metrische Variablen mittels Kruskal-Wallis-Test mit Dunn-Bonferroni-Korrektur (3 Gruppen) oder Mann-Whitney-U-Test/ t-Test (2 Gruppen). Das Signifikanzniveau wurde auf p<0,05 festgelegt. Das Durchschnittsalter der Patient*innen zum Zeitpunkt des Traumas lag bei 77,3 Jahren (60-100 Jahre). Konservativ behandelte Patient*innen waren signifikant älter als operativ behandelte Patient*innen. Mehrheitlich betrafen die Frakturen, wie für ältere Menschen typisch, den vorderen Bereich des Acetabulums. Mit 31,4% traten isolierte Vordere-Pfeiler-Frakturen am häufigsten auf, gefolgt von Frakturen des vorderen Pfeilers mit Hemiquerfraktur (20,2%). Die Dauer des Krankenhausaufenthalts betrug bei den konservativ behandelten Patient*innen durchschnittlich 12,9 Tage. Damit erfolgte ihre Entlassung signifikant früher als nach perkutaner (16,8 Tage) und offener Therapie (23,6 Tage). Sowohl die OP-Dauer als auch der intraoperative Blutverlust konnten durch einen minimalinvasiven Eingriff signifikant verringert werden. Bei ca. 11% der Patient*innen traten stationäre Komplikationen auf. Trotz chirurgischen Vorgehens zeigten perkutane Verfahren keine signifikant höhere stationäre Komplikationsrate als konservative Verfahren. Nach offen-operativer Therapie lag die Komplikationsrate jedoch signifikant höher als nach perkutan-operativer oder konservativer Behandlung. Da auch der Krankenhausaufenthalt und somit das Follow-Up nach offener Therapie länger war als nach perkutan/ konservativer Therapie, erfolgte zusätzlich eine partielle Korrelation, um den Effekt der Krankenhausverweildauer auf den Zusammenhang zwischen Therapieform und Komplikationsrate zu analysieren. Nach Adjustierung zeigte sich der Unterschied in der Komplikationsrate nicht mehr signifikant. Ob sich der Krankenhausaufenthalt dabei durch die Komplikationen nach offener Therapie verlängerte, oder die Komplikationen durch den längeren Krankenhausaufenthalt entstanden, konnte durch die Registerdaten nicht abgegrenzt werden. Sowohl perkutane als auch offene Operationen ermöglichten eine signifikante Reduktion von Frakturspalt und Frakturstufe. Interessanterweise zeigten beide operative Therapien bezüglich der Qualität der Reposition vergleichbare Ergebnisse Damit bieten perkutane Methoden beides: die Möglichkeit einer anatomischen Frakturreposition mit primärer Gelenkstabilität bei gleichzeitig geringer Invasivität und niedriger stationärer Komplikationsrate. Eine offen-operative Therapie wiederum bietet vergleichbare Ergebnisse bei der Qualität der Reposition, ist jedoch mit einem verlängerten Krankenhausaufenthalt, höherem Blutverlust und OP-Dauer und einer höheren Rate stationärer Komplikationen assoziiert. Für die konservative Therapie hebt diese Studie die Vorteile einer kurzen Krankenhausverweildauer und einer niedrigen Komplikationsrate hervor. Im Rahmen dieser Studie konnten neue Erkenntnisse bezüglich des Repositionsergebnisses und der Komplikationsrate nach konservativer, perkutan- und offen-operativer Behandlung geriatrischer, gering-dislozierter Acetabulumfrakturen gewonnen werden. Dieses Wissen soll zur Optimierung der Therapieentscheidung bei Acetabulumfrakturen alterstraumatologischer Patient*innen beitragen. Unter Berücksichtigung zukünftiger Forschungsergebnisse sollten diese Ergebnisse bei der Erstellung einheitlicher Behandlungsstrategien Berücksichtigung finden. Insbesondere könnte, entsprechend den Erkenntnissen dieser Studie, eine Ausweitung perkutan-operativer Verfahren bei geriatrischen Acetabulumfrakturen in Erwägung gezogen werden, da sie gleichzeitig primäre Stabilität und eine geringe Invasivität gewährleisten. Aktuell werden perkutane Operationen bei Acetabulumfrakturen im klinischen Alltag noch zurückhaltend angewendet, da sie als komplex und für Chirurg*innen herausfordernd gelten. Gleichzeitig wird gerade im Bereich perkutaner Methoden und insbesondere auch der Visualisierungstechniken viel geforscht, was ihre Anwendung in Zukunft erleichtern kann.

The treatment of labor dismissal has been evolving in the legislation and in the jurisprudence. Whatis the current regulation of this subject? What is the procedure to ask for reparation in the case ofnon justified dismissal? These and other subjects related to this matter have been treated by the Constitutional Court and the Supreme  Court  inthe last binding precedents and in laboral courtrulings, respectively.Within this framework, the author illustrates us regarding the evolution of dismissal’s treatment in the legislation and recent jurisprudential pronouncements. / El tratamiento del despido laboral ha evolucionadotanto en la legislación como en la jurisprudencia. ¿Cuál es la actual regulación de dicha materia?¿Cuáles son las vías procesales para solicitar lasreparaciones en caso de despidos no justificados?Estas y otras cuestiones relacionadas han sido tratadas por el Tribunal Constitucional y la Corte Supremaen sus últimos precedentes vinculantes y plenos jurisdiccionales en materia laboral, respectivamente.En este marco, el autor nos ilustra respecto de la evolución del tratamiento del despido en la legislación y en los pronunciamientos jurisprudenciales recientes.

Made available in DSpace on 2016-01-26T18:56:24Z (GMT). No. of bitstreams: 1 Dissertacao.pdf: 656931 bytes, checksum: 9e652ea425d8ee514d730485376a75bc (MD5) Previous issue date: 2011-11-16 / The Chamomilla recutita (L.) Rauschert is a plant from to the Asteraceae family. It is grown in temperate climates having adequate growing conditions in southern and southeastern Brazil. Its cultivation has increased due to its of their medical use for the extraction of essential oil and fractions of flavonoids for the production of pharmaceuticals and cosmetics. The use of organic fertilizer such as cattle manure and poultry manure, provides higher yields of essential oil and the production of flavonoids. There are few studies related to the agronomic management of medicinal plants, with the need to study the appropriate depths of irrigation and nutrition to obtain a high production and quality. This work aimed to evaluate the effect of irrigation water depths and organic fertilization with cattle and poultry manure on the production and quality of Chamomilla recutita plants. This study was conducted at Unoeste - Campus II in an experimental area. The experimental design was randomized complete block design. The treatments consisted of the irrigation: T0) 0, T1) 150, T2) 100, T3) 75, T4) 50, T5) 25%Etc were calculated using the Class A tank (ECA), associating organic fertilizers used the tanned cattle manure and poultry manure at rates of 0 kg m-2, 3 kg m-2 and 5 kg m-2. Were 36 treatments with four replicates resulting in 144 plots. The measured variables used as parameters on this experiment were: plant height, (two week after seedling transplant and the flowering beginning), fresh and dry weight of plants after harvest, number of capitula, nutrients extraction on the fresh leaves, proline acumlation, content and yield of flavonoids and essecial oil. The statistical analysis was performed using the Scott-Knott test at a probability of 5%. The irrigation water dephts 150% ETc associated with fertilization with chicken manure at a dose 5 kg m-2 promoted the greatest plant growth, production, fresh and dry weight of capitula. The water stress promoted less fresh and dry weight of plant. The water stress caused by the irrigation water dephts of 150% and 0% ETc resulted in a higher concentration of proline in the leaves. The content and yield of flavonoids and essential oil and leaf N content were higher for the irrigation of 150% ETc associated with a dose of 5 kg m-2 of poultry manure. The non-irrigated plants had higher leaf content of macronutrients. / A Chamomilla recutita (L.) Rauschert é uma planta pertencente à família Asteraceae. É cultivada em climas temperados possuindo condições de cultivo adequadas em regiões do sul e sudeste do Brasil. Seu cultivo tem aumentado por ocasião de seu uso medicinal, para extração das frações de óleo essencial e flavonóides para produção de produtos farmacêuticos e cosméticos. A utilização de adubo orgânico, como esterco bovino curtido e esterco de aves, aumenta o rendimento do óleo essencial bem como a produção de flavonóides. Existem poucos estudos relacionados ao manejo agronômico de plantas medicinais, havendo a necessidade do estudo dos níveis adequados de reposição hídrica e nutricional para obtenção de uma produção elevada e de qualidade. O objetivo foi avaliar o efeito da irrigação e da adubação orgânica com esterco bovino curtido e de aves sobre a produção e qualidade da camomila. O presente trabalho foi realizado na Unoeste Campus II,em uma área experimental. O delineamento experimental foi em blocos inteiramente casualizados. Os tratamentos abrangeram as lâminas de irrigação: T0) 0, T1) 150, T2) 100, T3) 75, T4) 50, T5) 25% ETc que foram calculadas utilizando o tanque Classe A (ECA); associando a adubação orgânica utilizado os esterco de curral curtido e esterco de aves nas doses de 0 kg m-2, 3 kg m-2 e 5 kg m-2. Totalizaram 36 tratamentos com quatro repetições resultando em 144 parcelas. As variáveis medidas e utilizadas como parâmetros do experimento foram: altura das plantas (15 dias após o transplante e no início do florescimento), massa fresca e seca de plantas após a colheita, número de capítulos florais, extração de nutrientes pelas folhas, acúmulo de prolina nas folhas frescas, teor e rendimento de flavonóides e de óleo essencial. Após foi realizada análise estatística utilizando o teste de Scott-Knott ao nível de probabilidade de 0,05. A lâmina de irrigação de 150% ETc associada adubação com esterco de aves na dose 5 kg m-2 promoveu maior crescimento das plantas; produção, massa fresca e seca de capítulos florais. O estresse hídrico promoveu menor massa fresca e seca de planta. O estresse hídrico provocado pelas lâminas de 150% e 0%ETc resultaram em maior concentração de prolina nas folhas. O teor e rendimento de flavonóides e óleo essencial, e o teor de nitrogênio foliar foram superior para a lâmina de irrigação de 150% ETc associado a dose de 5 kg m-2 de esterco de ave. As plantas não irrigadas apresentaram maiores teores de macronutrientes foliares.

Made available in DSpace on 2016-07-18T17:51:08Z (GMT). No. of bitstreams: 1 Dissertacao.pdf: 656931 bytes, checksum: 9e652ea425d8ee514d730485376a75bc (MD5) Previous issue date: 2011-11-16 / The Chamomilla recutita (L.) Rauschert is a plant from to the Asteraceae family. It is grown in temperate climates having adequate growing conditions in southern and southeastern Brazil. Its cultivation has increased due to its of their medical use for the extraction of essential oil and fractions of flavonoids for the production of pharmaceuticals and cosmetics. The use of organic fertilizer such as cattle manure and poultry manure, provides higher yields of essential oil and the production of flavonoids. There are few studies related to the agronomic management of medicinal plants, with the need to study the appropriate depths of irrigation and nutrition to obtain a high production and quality. This work aimed to evaluate the effect of irrigation water depths and organic fertilization with cattle and poultry manure on the production and quality of Chamomilla recutita plants. This study was conducted at Unoeste - Campus II in an experimental area. The experimental design was randomized complete block design. The treatments consisted of the irrigation: T0) 0, T1) 150, T2) 100, T3) 75, T4) 50, T5) 25%Etc were calculated using the Class A tank (ECA), associating organic fertilizers used the tanned cattle manure and poultry manure at rates of 0 kg m-2, 3 kg m-2 and 5 kg m-2. Were 36 treatments with four replicates resulting in 144 plots. The measured variables used as parameters on this experiment were: plant height, (two week after seedling transplant and the flowering beginning), fresh and dry weight of plants after harvest, number of capitula, nutrients extraction on the fresh leaves, proline acumlation, content and yield of flavonoids and essecial oil. The statistical analysis was performed using the Scott-Knott test at a probability of 5%. The irrigation water dephts 150% ETc associated with fertilization with chicken manure at a dose 5 kg m-2 promoted the greatest plant growth, production, fresh and dry weight of capitula. The water stress promoted less fresh and dry weight of plant. The water stress caused by the irrigation water dephts of 150% and 0% ETc resulted in a higher concentration of proline in the leaves. The content and yield of flavonoids and essential oil and leaf N content were higher for the irrigation of 150% ETc associated with a dose of 5 kg m-2 of poultry manure. The non-irrigated plants had higher leaf content of macronutrients. / A Chamomilla recutita (L.) Rauschert é uma planta pertencente à família Asteraceae. É cultivada em climas temperados possuindo condições de cultivo adequadas em regiões do sul e sudeste do Brasil. Seu cultivo tem aumentado por ocasião de seu uso medicinal, para extração das frações de óleo essencial e flavonóides para produção de produtos farmacêuticos e cosméticos. A utilização de adubo orgânico, como esterco bovino curtido e esterco de aves, aumenta o rendimento do óleo essencial bem como a produção de flavonóides. Existem poucos estudos relacionados ao manejo agronômico de plantas medicinais, havendo a necessidade do estudo dos níveis adequados de reposição hídrica e nutricional para obtenção de uma produção elevada e de qualidade. O objetivo foi avaliar o efeito da irrigação e da adubação orgânica com esterco bovino curtido e de aves sobre a produção e qualidade da camomila. O presente trabalho foi realizado na Unoeste Campus II,em uma área experimental. O delineamento experimental foi em blocos inteiramente casualizados. Os tratamentos abrangeram as lâminas de irrigação: T0) 0, T1) 150, T2) 100, T3) 75, T4) 50, T5) 25% ETc que foram calculadas utilizando o tanque Classe A (ECA); associando a adubação orgânica utilizado os esterco de curral curtido e esterco de aves nas doses de 0 kg m-2, 3 kg m-2 e 5 kg m-2. Totalizaram 36 tratamentos com quatro repetições resultando em 144 parcelas. As variáveis medidas e utilizadas como parâmetros do experimento foram: altura das plantas (15 dias após o transplante e no início do florescimento), massa fresca e seca de plantas após a colheita, número de capítulos florais, extração de nutrientes pelas folhas, acúmulo de prolina nas folhas frescas, teor e rendimento de flavonóides e de óleo essencial. Após foi realizada análise estatística utilizando o teste de Scott-Knott ao nível de probabilidade de 0,05. A lâmina de irrigação de 150% ETc associada adubação com esterco de aves na dose 5 kg m-2 promoveu maior crescimento das plantas; produção, massa fresca e seca de capítulos florais. O estresse hídrico promoveu menor massa fresca e seca de planta. O estresse hídrico provocado pelas lâminas de 150% e 0%ETc resultaram em maior concentração de prolina nas folhas. O teor e rendimento de flavonóides e óleo essencial, e o teor de nitrogênio foliar foram superior para a lâmina de irrigação de 150% ETc associado a dose de 5 kg m-2 de esterco de ave. As plantas não irrigadas apresentaram maiores teores de macronutrientes foliares.