No description available.

No description available.

Diss. (sammanfattning) Linköping : Univ., 2001. / Härtill 5 uppsatser.

Thesis (M.Sc.)--University of Alberta, 2009. / Title from pdf file main screen (viewed on August 13, 2009). "A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Master of Science, Department of Mechanical Engineering , University of Alberta." Includes bibliographical references.

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OBJECTIVE: CLOVES syndrome (CLO: congenital lipomatous overgrowth, V: vascular anomalies E: epidermal nevi S: spinal anomalies) is a rare, non-heritable sporadic overgrowth disorder with serious morbidity. Previous anecdotal reports indicate that CLOVES patients are at risk for serious thromboembolic events in the perioperative period. The purpose of this study is to systematically determine the adverse events associated with anesthesia and diagnostic or interventional procedures for CLOVES patients, so appropriate assessment of risk can be performed and adequate precautions can be taken in the future to prevent complications. METHODS: We selected our study cohort by gathering patients in the Vascular Anomalies Center (VAC) database with the diagnosis of CLOVES syndrome. Our primary group of interest was patients that were anesthetized at Boston Children's Hospital (BCH) since 2005. All patients having the diagnosis of CLOVES were included. IRB approval was obtained prior to patient selection. Data was collected from BCH electronic medical records. Patient age, gender, ASA level, estimated amount of blood loss (EBL), surgery status, MRI status, complication(s), type of complication if any, and medical history was recorded in a Microsoft Excel document on a password-protected computer. Data analysis was carried out with no statistical analysis beyond simple incidence and prevalence of certain characteristics due to the extremely small patient population. RESULTS: We found that out of the 38 patients in our cohort, 15 (or 39%) suffered from complications during the perioperative period. A total of 23 (or 61%) did not have any complications. Results further showed that pulmonary emboli, respiratory issues, and hypo/hypertension were the most prevalent complications. In addition we found that there was no correlation between substantial EBL and complication occurrence in this cohort. CONCLUSION: In comparison to preliminary studies of Alomari, 2008 and Sapp et al., 2007, we report a lower occurrence of thromboembolic events in CLOVES patients. We hypothesize that this is because patients at BCH were treated aggressively with various prophylactic methods to help minimize the risk of such events. We recommend that early prophylactic anticoagulation methods are applied to future patients. Additionally, we recommend that CLOVES patients be followed by a hematologist and care team that are familiar with the condition throughout their stay at the hospital to reduce the risk of thromboembolic events.

OBJECTIVE: Chronic pain, including persistent postsurgical pain, reduces patients' quality of life, mood, and productivity. It presents a significant economic burden to society, yielding an estimated $600 billion annual cost due to health care and lost work productivity. Moderate to severe chronic pain affects 5% of children and adolescents. The current body of knowledge has demonstrated a consensus opinion that psychological factors and sensory factors are correlated with pain in the adult population. However, more research is necessary to determine what role depression and sensory function play in predicting severity of persistent postsurgical pain in children and adolescents. Thus, the present study seeks to explore how, if at all, post-operative pain and functional disability at 1 month postsurgery is correlated with pre-operative depression and sensory profile. METHODS: Eligible candidates were Adolescent Idiopathic Scoliosis (AIS) patients aged 10-17 who have been recommended to undergo spinal fusion surgery at Boston Children's Hospital (BCH). Fifteen participants were included in this study. Prior to surgery, all participants completed the Children's Depression Inventory: Short Form (CDI:S) via REDCap and underwent Quantitative Sensory Testing (QST) on their palmar thenar eminence (non-surgical site) and their lower back (surgical site). Participants' light touch detection thresholds and sharp prick pain threshold scores were determined using von Frey hairs. Participants' pressure-pain sensation threshold scores were determined using a pressure algometer. Warm and cool detection thresholds and hot and cold pain thresholds were measured using a thermode strapped to the skin. At 1 month postsurgery, participants completed the Functional Disability Inventory (FDI) and reported their pain scores, including their current pain, average and worst pain in the last week, average and worst pain in the last month, and average and worst pain in the last six months. Each presurgical variable was compared with each postsurgical variable using Pearson correlations at a significance level of p < 0.05. Additionally, postsurgical FDI scores were compared with postsurgical pain scores using Pearson correlations. RESULTS: Due to the small sample size (N = 15), the results should be considered preliminary. Preoperative CDI:S scores were not found to be correlated with postoperative pain and functional disability at 1 month postsurgery. Several preoperative QST variables were found to be correlated with postsurgical pain at 1 month. Namely, light touch detection threshold on the hand was negatively correlated with current pain (p < 0.05), average pain in the last week (p < 0.05), worst pain in the last week (p < 0.05), average pain in the last month (p < 0.05), and worst pain in the last month (p < 0.05). Warm detection threshold on the hand was negatively correlated with four different post-operative pain measures taken at one month post-surgery: worst pain in the last week (p < 0.05), worst pain in the last month (p < 0.05), average pain in the last six months (p < 0.05), and worst pain in the last six months (p < 0.05). Finally, heat pain threshold on the hand was negatively correlated with worst pain in the last 6 months at 1 month postsurgery (p < 0.05). Furthermore, postsurgical scores on the FDI were positively correlated with current pain at the 1-month post-surgical time point (p < 0.01), average pain in the last week at the 1-month post-surgical time point (p < 0.05), and worst pain in the last week at the 1-month post-surgical time point (p < 0.05). CONCLUSIONS: This study provides preliminary evidence of a correlation between heat sensitivity and poor postsurgical pain outcomes in the AIS population. Contrary to what was expected, hyposensitivity to light touch was correlated with worse pain outcomes. It is unclear why this is the case, and further research on the somatosensory profiles of pain patients is needed to examine this phenomenon. One of the most important findings in the present study is the correlation between post-operative pain and functional disability. The present study contributes to the small but growing body of knowledge surrounding the correlates of pediatric postsurgical pain. The use of QST provides an objective, quantifiable measure of patients' somatosensory profile. Furthermore, the present study contributes to the expansive research base that has shown the detrimental effects of chronic pain, highlighting the correlation between pain and functional disability in the AIS population following spinal fusion surgery.

O objetivo deste estudo foi verificar a validade da utilização de uma metodologia de avaliação postural baseada na identificação de estruturas anatômicas ósseas por palpação, na utilização de marcadores de superfície e na aquisição de imagens digitais, e a avaliar a validade do software Avaliação Postural a Partir de Imagens Digitais (APPID) na identificação e caracterização da postura da coluna vertebral estática no plano frontal. Foram avaliados 24 indivíduos (16 mulheres e 8 homens) que possuíam requisição médica para realização de exames radiográficos da coluna vertebral e cujas médias foram: idade (31,9 anos ±12,3), massa corporal (58,4 kg ± 9,4) e estatura (1,66 m ± 0,07). Marcadores reflexivos contendo chumbo foram posicionados sobre os processos espinhosos das vértebras C7, T2, T4, T6, T8, T10, T12, L2, L4 e S2, localizadas por palpação em cada indivíduo. Uma imagem radiográfica foi obtida e em seguida uma imagem fotográfica, ambas no plano frontal e em ortostatismo. Por meio da imagem radiográfica foram observados o posicionamento dos marcadores de superfície e a localização das respectivas estruturas ósseas internas e foram realizados dois procedimentos para verificar sua concordância: a avaliação do posicionamento espacial dos marcadores e a distância dos mesmos ao respectivo processo espinhoso. Estatisticamente não existiram indícios na amostra de diferenças significativas (p<0,05) entre os pontos de marcação na coluna vertebral quanto ao posicionamento espacial dos marcadores (c2=13,118; p=0,157), e nem quanto à distância dos marcadores em relação ao nível espinhal (c2=9,366; p=0,404); ou seja, o marcador identificou da mesma forma todas as vértebras estudadas. Para análise da validade do software APPID foram digitalizadas as imagens fotográficas e o laudo fornecido pelo programa foi comparado ao laudo radiográfico, quanto à identificação e caracterização da escoliose e não houve diferença estatisticamente significativa entre as duas formas de avaliação (z=-0,891; p=0,373). Complementando este resultado, as Flechas de Charrière & Roy, fornecidas pelo software APPID, foram correlacionados ao ângulo de Cobb, nas regiões torácica (r=0,75; p< 0,001) e lombar (r=0,76 p=0,007). Os resultados obtidos demonstram que existiu um forte grau de concordância entre os resultados quantitativos fornecidos pelos dois métodos e que esta concordância é estatisticamente significativa. A partir destes resultados pode-se concluir que a metodologia de palpação utilizada neste trabalho para identificação dos processos espinhosos da coluna vertebral permitiu que o software APPID fornecesse resultados válidos quanto à identificação, classificação e mensuração da escoliose idiopática nos indivíduos estudados. Assim, esta metodologia de palpação e marcação dos processos espinhosos, associada ao software APPID, caracteriza uma alternativa válida e simples para avaliação da postura estática no plano frontal. Novos estudos precisam ser realizados para verificar a reprodutibilidade do método. / The aim of this study was to verify the validity of using a postural assessment methodology based on the identification of bony anatomic structures through palpation, using surface markers and in the acquisition of digital images, and to evaluate the validity of the software Postural Assessment From Digital Images (PAFDI) in the identification and characterization of the static spine column in the frontal plan. 24 subjects (16 females and 8 males) that had a medical statement to perform radiography exams in the spine column and whose averages were: age (31.9 years old ±12.3) body mass (58.4kg ± 9.4) and stature (1.66 m ± 0.07) were evaluated. Reflexive markers containing lead were placed on the vertebras C7, T2, T4, T6, T8, T10, T12, L2, L4 and S2, found through palpation in each individual. A radiographic image was obtained and then a photographic image, both in the frontal plan and in orthostatic position. Through the radiographic image it was possible to observe the positioning of the surface markers and the localization of their internal bony structures and two procedures were performed in order to verify its concordance: the evaluation of spatial positioning of the markers and their distance regarding the spine process. Statistically, in the sample, there were not clues of significant differences (p<0,05) between the marking points in the spine column regarding the spatial positioning of the markers (c2=13,118; p=0,157), nor regarding the distance of the markers in relation to the spine level (c2=9,366; p=0,404); that is, the marker identified all the vertebras under study the same way. For the analysis of the validity of the PAFDI software, the photographic images were digitalized and the report supplied by the program was compared to the radiographic report, regarding the identification and characterization of scoliosis, and there was not a statistically significant difference between the two forms of evaluation (z=-0,891; p=0,373). Complementing this result, the Charrière & Roy’s Arrows, supplied by PAFDI software, were correlated to Cobb’s angle, in the thoracic regions (r=0,752; p< 0,001) and lumbar (r=0,760 p=0,007). The results obtained showed that there was a strong degree of concordance between the quantitative results supplied by the two methods and that this concordance is statistically significant. From these results, it can be concluded that the palpation methodology used in this work to identify the spiny processes of the spine column allowed the software PAFDI to give valid results regarding identification, classification and mensuration of idiopathic scoliosis in the individuals under study. Thus, the palpation methodology and the marking of spiny processes, associated to software PAFDI are a simple and valid alternative for the evaluation of the static posture in the frontal plan. New studies must be performed to prove the reliability of the method.

O objetivo deste estudo foi verificar a validade da utilização de uma metodologia de avaliação postural baseada na identificação de estruturas anatômicas ósseas por palpação, na utilização de marcadores de superfície e na aquisição de imagens digitais, e a avaliar a validade do software Avaliação Postural a Partir de Imagens Digitais (APPID) na identificação e caracterização da postura da coluna vertebral estática no plano frontal. Foram avaliados 24 indivíduos (16 mulheres e 8 homens) que possuíam requisição médica para realização de exames radiográficos da coluna vertebral e cujas médias foram: idade (31,9 anos ±12,3), massa corporal (58,4 kg ± 9,4) e estatura (1,66 m ± 0,07). Marcadores reflexivos contendo chumbo foram posicionados sobre os processos espinhosos das vértebras C7, T2, T4, T6, T8, T10, T12, L2, L4 e S2, localizadas por palpação em cada indivíduo. Uma imagem radiográfica foi obtida e em seguida uma imagem fotográfica, ambas no plano frontal e em ortostatismo. Por meio da imagem radiográfica foram observados o posicionamento dos marcadores de superfície e a localização das respectivas estruturas ósseas internas e foram realizados dois procedimentos para verificar sua concordância: a avaliação do posicionamento espacial dos marcadores e a distância dos mesmos ao respectivo processo espinhoso. Estatisticamente não existiram indícios na amostra de diferenças significativas (p<0,05) entre os pontos de marcação na coluna vertebral quanto ao posicionamento espacial dos marcadores (c2=13,118; p=0,157), e nem quanto à distância dos marcadores em relação ao nível espinhal (c2=9,366; p=0,404); ou seja, o marcador identificou da mesma forma todas as vértebras estudadas. Para análise da validade do software APPID foram digitalizadas as imagens fotográficas e o laudo fornecido pelo programa foi comparado ao laudo radiográfico, quanto à identificação e caracterização da escoliose e não houve diferença estatisticamente significativa entre as duas formas de avaliação (z=-0,891; p=0,373). Complementando este resultado, as Flechas de Charrière & Roy, fornecidas pelo software APPID, foram correlacionados ao ângulo de Cobb, nas regiões torácica (r=0,75; p< 0,001) e lombar (r=0,76 p=0,007). Os resultados obtidos demonstram que existiu um forte grau de concordância entre os resultados quantitativos fornecidos pelos dois métodos e que esta concordância é estatisticamente significativa. A partir destes resultados pode-se concluir que a metodologia de palpação utilizada neste trabalho para identificação dos processos espinhosos da coluna vertebral permitiu que o software APPID fornecesse resultados válidos quanto à identificação, classificação e mensuração da escoliose idiopática nos indivíduos estudados. Assim, esta metodologia de palpação e marcação dos processos espinhosos, associada ao software APPID, caracteriza uma alternativa válida e simples para avaliação da postura estática no plano frontal. Novos estudos precisam ser realizados para verificar a reprodutibilidade do método. / The aim of this study was to verify the validity of using a postural assessment methodology based on the identification of bony anatomic structures through palpation, using surface markers and in the acquisition of digital images, and to evaluate the validity of the software Postural Assessment From Digital Images (PAFDI) in the identification and characterization of the static spine column in the frontal plan. 24 subjects (16 females and 8 males) that had a medical statement to perform radiography exams in the spine column and whose averages were: age (31.9 years old ±12.3) body mass (58.4kg ± 9.4) and stature (1.66 m ± 0.07) were evaluated. Reflexive markers containing lead were placed on the vertebras C7, T2, T4, T6, T8, T10, T12, L2, L4 and S2, found through palpation in each individual. A radiographic image was obtained and then a photographic image, both in the frontal plan and in orthostatic position. Through the radiographic image it was possible to observe the positioning of the surface markers and the localization of their internal bony structures and two procedures were performed in order to verify its concordance: the evaluation of spatial positioning of the markers and their distance regarding the spine process. Statistically, in the sample, there were not clues of significant differences (p<0,05) between the marking points in the spine column regarding the spatial positioning of the markers (c2=13,118; p=0,157), nor regarding the distance of the markers in relation to the spine level (c2=9,366; p=0,404); that is, the marker identified all the vertebras under study the same way. For the analysis of the validity of the PAFDI software, the photographic images were digitalized and the report supplied by the program was compared to the radiographic report, regarding the identification and characterization of scoliosis, and there was not a statistically significant difference between the two forms of evaluation (z=-0,891; p=0,373). Complementing this result, the Charrière & Roy’s Arrows, supplied by PAFDI software, were correlated to Cobb’s angle, in the thoracic regions (r=0,752; p< 0,001) and lumbar (r=0,760 p=0,007). The results obtained showed that there was a strong degree of concordance between the quantitative results supplied by the two methods and that this concordance is statistically significant. From these results, it can be concluded that the palpation methodology used in this work to identify the spiny processes of the spine column allowed the software PAFDI to give valid results regarding identification, classification and mensuration of idiopathic scoliosis in the individuals under study. Thus, the palpation methodology and the marking of spiny processes, associated to software PAFDI are a simple and valid alternative for the evaluation of the static posture in the frontal plan. New studies must be performed to prove the reliability of the method.

Submitted by FABIAN RODRIGO CASTRO FORERO null (fabiancastroforero@yahoo.com) on 2016-05-25T17:32:02Z No. of bitstreams: 1 castro_fr_me_ilha.pdf: 5058433 bytes, checksum: bf5b2af2ddbd3137fd6e825d60119c97 (MD5) / Approved for entry into archive by Juliano Benedito Ferreira (julianoferreira@reitoria.unesp.br) on 2016-05-31T13:28:40Z (GMT) No. of bitstreams: 1 castro_fr_me_ilha.pdf: 5058433 bytes, checksum: bf5b2af2ddbd3137fd6e825d60119c97 (MD5) / Made available in DSpace on 2016-05-31T13:28:40Z (GMT). No. of bitstreams: 1 castro_fr_me_ilha.pdf: 5058433 bytes, checksum: bf5b2af2ddbd3137fd6e825d60119c97 (MD5) Previous issue date: 2016-03-30 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / O pé é o órgão base da sustentação do corpo humano que está constantemente submetido a esforços para garantir a estabilidade deste. Analisando-se a distribuição de força na região plantar de indivíduos, pode-se inferir a respeito de patologias nos pés, problemas posturais e de equilíbrio. O estudo da distribuição de força na região plantar é feito com o baropodômetro, um equipamento composto por sistemas de hardware e software. Neste trabalho é apresentado o desenvolvimento de um baropodômetro implementado no Laboratório de Instrumentação e Engenharia Biomédica do Departamento de Engenharia Elétrica, UNESP – Campus Ilha Solteira, constituído por 120 sensores resistivos, tipo Force Sensing Resistor (FSR), dispostos matricialmente em duas plataformas, e por circuitos de aquisição de dados, comunicação e interfaceamento. Com as informações obtidas, por meio do software é possível identificar deformidades na região plantar e locais desta região submetidos a forças elevadas. Foram feitos testes em um grupo de 30 voluntários com diferentes faixas etárias e diferentes graus de escoliose. Inicialmente os voluntários foram divididos em dois grupos, sendo que o grupo G2 (45-78 anos) apresentou valores de estabiliometria maiores quando comparados com o G1 (13-30 anos). De forma similar, foi segmentada a mesma população (N=30) em dois grupos, segundo o grau de escoliose, GrA (0-9°) e GrB (10-32°). O grupo GrB mostrou maiores valores de estabiliometria do que o GrA e foi possível determinar que quanto maior o grau de escoliose menor a dependência das variáveis de estabiliometria com a idade. / The foot is the main support organ of the human body that is constantly subjected to efforts to ensure the stability of the body. Analyzing the distribution of force in the plantar region of individuals, it is possible to infer about feet pathologies, postural and balance problems, among others. The study of foot force distribution is made with the baropodometer, an equipment composed by hardware and software systems. This work describes the baropodometer developed at the Instrumentation and Biomedical Engineering Laboratory at the Department of Electrical Engineering, UNESP – Ilha Solteira, composed of 120 resistive sensors (Force Sensing Resistor - FSR) arranged in matrix on two platforms. Furthermore, acquisition and communication boards and software made in LabVIEW were developed. With the information obtained, with the software it is possible to identify deformities in the plantar region and sites of this region subjected to high forces. Tests in 30 volunteers with different ages and different scoliosis angles were made. Firstly, the volunteers were divided into two groups according to ages. The second group G2 (45-78 years old) had higher stabilometry values than first group G1 (13-30 years old). Secondly, the 30 volunteers were divided in two groups according scoliosis angles, GrA (0-9°) e GrB (10-32°). The GrB group showed higher stabilometry values than the GrA group, and it was possible to determine that the higher the degree of scoliosis the lower the dependency of stabiliometry variables with the age.