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Le nombre croissant d'admissions hospitaliairres provoquées par les effets second d'un traitement thérapeutique constitue un problème majeur de santé publique. L'hépatite médicamenteuse, la pathologie iatrogène la plus fréquente pose également un problème d'ordre économique. En effet, l'hépatotoxicité des médicaments constitue la première cause de leur retrait du marché pharmaceutique. La non détection de ce potentiel hépatotoxique, avant commercialisation provient essentiellement du caractère idiosyncratique de ce type d'hépatites médicamenteuscs. Cclles-ci se divisent en deux types : les hépatites médicamenteuses qualifiées de directes et à l'inverse les hépatites médicamenteuses immunoallergiques. Les mécanismes sous-jacents des hépatites médicamenteuses idiosyncratiques sont généralement méconnus et leur comprehension constitue donc à la fois un impératif de santé publique et économique. Mon travail s'est inscrit dans cette optique et a consisté à appréhendcr les premières étapes impliquées dans l'apparition des, hépatites idiosyncratiques et en particulier celle induite par l'acide tiénilique (AT). En effet, ce diurétique, retiré du marché pharmaceutique français en 1992 a été responsable de nombreuses hépatites imrnunoallergiques., Les patients atteints de ces hepatitis induites par l'AT possèdent des anticorps très spécifiques, désignés anti-LKM2, dirigés contre le CYP2C9, le P450 responsible de la métabolisation de l'AT. Les principaux resultants obtenus sont les suivants : nous avons montré que l'activation de l'isomère de l'acide tiénilique par les microsomes hépatiques humains conduit à la formation de sulfoxydes de thiophène. Ces metabolites électrophiles instables, comme ceux de l'AT, réagissent avec les proteins hépatiques avec lesquelles ils forment des adduits covalents. La formation de sulfoxydes de thiophène liée à l'activation de l'AT chez l'homme constitue probablement la première étape impliquée dans les hepatites induites par ce médicament. Nous avons ensuite démontré que la fixation covalente de l'AT après activation par les microsomes hépatiques est très spécifique chez l'homme. En effet le CYP2C9 est la cible principale des metabolites de l'AT. L'alkylation du CYP2C9 par l'AT in vivo chez l'homme pourrait constituer la seconde étape impliquée dans l'hépatite induite par ce medicament. Nous avons ensuite montré que le CYP2C11, l'homologue du CYP2C9 humain, est une cible privilégiée des métabolites de l'AT chez le rat. Nous montrons que cette fixation covalente sur le CYP2C11 est observable à la fois in vitro et in vivo. Nous montrons que les adduits de l'AT chez le rat sont principalement localizes au niveau des hépatocyte centrolobulaires. L'alkylation majoritaire des hépatocytes centrolobulaires chez l'homme pourrait favoriser la présentation d'adduits d'AT aux cellules immunocompétentes sanguines et constituer la troisième étape des hepatitis autoimmunes induites par le medicament. Nous montrons qu'en effet les patients traits avec l'AT possèdent des anticorps capables de reconnaitre l'AT lorsqu'il est lié à des proteins.

The visual system and good ocular motor control play an important role in the effective development of gross motor, sport, fine motor and academic skills (Erhardt et al., 1988:84; Desrocher, 1999:36; Orfield, 2001:114). Various researchers report a link between ocular motor problems and attention–deficit hyperactivity disorder (ADHD) (Cheatum & Hammond, 2000:263; Farrar et al., 2001:441; Gould et al., 2001:633; Armstrong & Munoz, 2003:451; Munoz et al., 2003:510; Borsting et al., 2005:588; Hanisch et al., 2005:671; Mason et al., 2005:1345; Loe et al., 2009:432). A few studies were carried out to analyse the links between ADHD and ocular motor control with regard to matters like visual attention, visual perception and ocular motor control like eye movement outside the normal fixation point, but no studies have been reported on the status of the ocular motor control of South African populations, and the effect of visual–motor intervention on the ocular motor control or visual–motor integration of learners with ADHD. The aim of the study was twofold, namely firstly to determine the ocular motor control functions and status of visual–motor integration of a selected group of 6– tot 8–year–old learners with ADHD in Brakpan, South Africa, while the second aim was to determine whether a visualmotor– based intervention programme can improve the ocular motor control and status of the visual–motor integration of a selected group of 6– to 8–year–old learners with ADHD in Brakpan, South Africa. Statistica for Windows 2010 was used to analyse the data. The Sensory Input Screening measuring instrument and the Quick Neurological Screening Test II (QNST–II) were used to assess the ocular motor control functions (fixation, ocular alignment, visual tracking and convergence–divergence), while the Beery Developmental Test of Visual–Motor Integration (VMI–4de weergawe) was used to determine the status of the learners’ visual–motor integration (VMI), visual perception (VP) and motor coordination (MC). The Disruptive Behaviour Scale, a checklist for ADHD (Bester, 2006), was used as measuring instrument to identify the learners with ADHD. Fifty–six learners (31 boys, 25 girls, with an average age of 7,03 years +0,65) participated in the pre–test and were divided into an ADHD (n=39) and a non–ADHD (n=16) group for aim one. Two–way tables were used to determine the percentage of ocular motor control deficits in the learners with and without ADHD, and an independent t–test was used to analyse the visual–motor integration of these learners. The Pearson Chi–squared test was used to determine the practical significance of differences in VMI and VP (d>0,05). The results of the study reveal that the majority of learners displayed ocular motor control deficits, regardless of whether they were classified with ADHD or not. The biggest percentage of learners fell into Class 2 (moderate deficits), particularly with regard to horizontal (68,57%; 52,63%; w=0,16) and vertical tracking (65,71%; 73,68%), as well as convergence–divergence (80%; 78,95%; w=0,11). However, it appears that ADHD learners experience more serious problems (Class 3) with visual tracking than learners without ADHD (both eyes: 22,86%; compared to 10,53% (w=0,22); right eye: 11,43% compared to 0% (p=0,05; w=0,34); left eye: 14,29% compared to 0% (p=0,02; w=0,38)). Learners with and without ADHD displayed a practically significant difference with respect to visual perception (d=0,37) and motor coordination (d=0,5) compared to learners without ADHD (who achieved better results). For aim 2 the subjects were divided into three groups. A pre–test–post–test design compiled from an availability sample of three groups (intervention group with ADHD (n=20); control group with ADHD (n=10) and control group without ADHD (n=17)) was used for this part of the study. The intervention group participated in a nine–week (3x/week and for 45 minutes) visualmotor– based intervention programme in which the ocular motor control functions section was applied for about 5 minutes per learner. Forty–seven learners (25 boys and 22 girls) with an average age of 6,95 years (+0,69) constituted the experimental group, while a control group with ADHD with an average age of 7,2 years (+0,79) and a control group without ADHD with an average age of 7,12 years (+0,60) did not receive any intervention and just participated in the pre– and post–test opportunity. A two–way cross–tabulation table was used to determine the changes in ocular motor control functions. These results mainly revealed that practically significant changes occurred in all three groups, be it improvement or deterioration in the various classes of ocular motor control. It appears that as far as horizontal and vertical visual tracking is concerned, and with convergence–divergence, more subjects were moved back from Class 3 (serious cases) to Class 1 (no deficits) and 2 (moderate deficits) in particular than in the other two groups that had received no intervention. Independent t–testing was used to analyse intragroup differences in the visual–motor integration subdivisions, while a covariance analysis (ANCOVA) (corrected for pre–test differences) was used to determine adjusted average post–test difference values. These results revealed that the motor coordination of the intervention group improved more than that of the control group with ADHD (p=0,18). This can lead to the conclusion that the intervention programme did have an effect on this specific skill. Abstract The overall indications of the results are that learners with ADHD have a general tendency to achieve poorer results in ocular motor control tests and with skills involving visual–motor integration, visual perception and motor coordination than learners without ADHD. Although only a minor improvement was identified in the experimental group after participation in the intervention programme, it is recommended with regard to motor coordination in particular that a similar programme be compiled for ADHD learners that focuses more specifically on the ocular motor control needs of each learner, and that it be presented on a more individual basis in order to accomplish greater improvement. / Thesis (M.A. (Kinderkinetics))--North-West University, Potchefstroom Campus, 2012.

The visual system and good ocular motor control play an important role in the effective development of gross motor, sport, fine motor and academic skills (Erhardt et al., 1988:84; Desrocher, 1999:36; Orfield, 2001:114). Various researchers report a link between ocular motor problems and attention–deficit hyperactivity disorder (ADHD) (Cheatum & Hammond, 2000:263; Farrar et al., 2001:441; Gould et al., 2001:633; Armstrong & Munoz, 2003:451; Munoz et al., 2003:510; Borsting et al., 2005:588; Hanisch et al., 2005:671; Mason et al., 2005:1345; Loe et al., 2009:432). A few studies were carried out to analyse the links between ADHD and ocular motor control with regard to matters like visual attention, visual perception and ocular motor control like eye movement outside the normal fixation point, but no studies have been reported on the status of the ocular motor control of South African populations, and the effect of visual–motor intervention on the ocular motor control or visual–motor integration of learners with ADHD. The aim of the study was twofold, namely firstly to determine the ocular motor control functions and status of visual–motor integration of a selected group of 6– tot 8–year–old learners with ADHD in Brakpan, South Africa, while the second aim was to determine whether a visualmotor– based intervention programme can improve the ocular motor control and status of the visual–motor integration of a selected group of 6– to 8–year–old learners with ADHD in Brakpan, South Africa. Statistica for Windows 2010 was used to analyse the data. The Sensory Input Screening measuring instrument and the Quick Neurological Screening Test II (QNST–II) were used to assess the ocular motor control functions (fixation, ocular alignment, visual tracking and convergence–divergence), while the Beery Developmental Test of Visual–Motor Integration (VMI–4de weergawe) was used to determine the status of the learners’ visual–motor integration (VMI), visual perception (VP) and motor coordination (MC). The Disruptive Behaviour Scale, a checklist for ADHD (Bester, 2006), was used as measuring instrument to identify the learners with ADHD. Fifty–six learners (31 boys, 25 girls, with an average age of 7,03 years +0,65) participated in the pre–test and were divided into an ADHD (n=39) and a non–ADHD (n=16) group for aim one. Two–way tables were used to determine the percentage of ocular motor control deficits in the learners with and without ADHD, and an independent t–test was used to analyse the visual–motor integration of these learners. The Pearson Chi–squared test was used to determine the practical significance of differences in VMI and VP (d>0,05). The results of the study reveal that the majority of learners displayed ocular motor control deficits, regardless of whether they were classified with ADHD or not. The biggest percentage of learners fell into Class 2 (moderate deficits), particularly with regard to horizontal (68,57%; 52,63%; w=0,16) and vertical tracking (65,71%; 73,68%), as well as convergence–divergence (80%; 78,95%; w=0,11). However, it appears that ADHD learners experience more serious problems (Class 3) with visual tracking than learners without ADHD (both eyes: 22,86%; compared to 10,53% (w=0,22); right eye: 11,43% compared to 0% (p=0,05; w=0,34); left eye: 14,29% compared to 0% (p=0,02; w=0,38)). Learners with and without ADHD displayed a practically significant difference with respect to visual perception (d=0,37) and motor coordination (d=0,5) compared to learners without ADHD (who achieved better results). For aim 2 the subjects were divided into three groups. A pre–test–post–test design compiled from an availability sample of three groups (intervention group with ADHD (n=20); control group with ADHD (n=10) and control group without ADHD (n=17)) was used for this part of the study. The intervention group participated in a nine–week (3x/week and for 45 minutes) visualmotor– based intervention programme in which the ocular motor control functions section was applied for about 5 minutes per learner. Forty–seven learners (25 boys and 22 girls) with an average age of 6,95 years (+0,69) constituted the experimental group, while a control group with ADHD with an average age of 7,2 years (+0,79) and a control group without ADHD with an average age of 7,12 years (+0,60) did not receive any intervention and just participated in the pre– and post–test opportunity. A two–way cross–tabulation table was used to determine the changes in ocular motor control functions. These results mainly revealed that practically significant changes occurred in all three groups, be it improvement or deterioration in the various classes of ocular motor control. It appears that as far as horizontal and vertical visual tracking is concerned, and with convergence–divergence, more subjects were moved back from Class 3 (serious cases) to Class 1 (no deficits) and 2 (moderate deficits) in particular than in the other two groups that had received no intervention. Independent t–testing was used to analyse intragroup differences in the visual–motor integration subdivisions, while a covariance analysis (ANCOVA) (corrected for pre–test differences) was used to determine adjusted average post–test difference values. These results revealed that the motor coordination of the intervention group improved more than that of the control group with ADHD (p=0,18). This can lead to the conclusion that the intervention programme did have an effect on this specific skill. Abstract The overall indications of the results are that learners with ADHD have a general tendency to achieve poorer results in ocular motor control tests and with skills involving visual–motor integration, visual perception and motor coordination than learners without ADHD. Although only a minor improvement was identified in the experimental group after participation in the intervention programme, it is recommended with regard to motor coordination in particular that a similar programme be compiled for ADHD learners that focuses more specifically on the ocular motor control needs of each learner, and that it be presented on a more individual basis in order to accomplish greater improvement. / Thesis (M.A. (Kinderkinetics))--North-West University, Potchefstroom Campus, 2012.

Red alder (Alnus rubra Bong.) is the only tree in British Columbia and the Northwest US to engage in actinorhizal symbiosis to fix atmospheric nitrogen. This study was conducted to explore the plasticity in growth and physiology among 58 17-year-old red alder families in response to variation in climate in two common garden plots, one at Bowser, BC and one at Terrace, BC. Physiological assessments included height and diameter growth, bud flush, water use efficiency as measured by δ13C, cold hardiness as measured by controlled freezing and electrolyte leakage, autumn leaf senescence, and instantaneous and seasonally integrated rates of nitrogen fixation as measured by acetylene reduction and natural abundance δ15N isotope analysis, respectively. Significant differences were identified among families for growth (height and diameter), bud burst stage, leaf senescence, cold hardiness, and bud nitrogen content. No significant differences among families were identified for water use efficiency as measured by δ13C, or for rates of nitrogen fixation as measured by either acetylene reduction or natural abundance δ15N. This study identified possible adaptive differences among red alder genotypes, especially in traits such as bud flush timing, cold hardiness, or nitrogen fixation and their respective contributions to growth. These differences often reflected a tradeoff between growth and the ability to tolerate an extreme environment. Cold hardiness results indicate that red alder families are well adapted to their climate of origin, and may not be able to acclimate sufficiently to a northward assisted migration of genotypes. Nitrogen fixation results demonstrated gaps in our current knowledge of Frankia distribution and impact on the actinorhizal symbiosis in British Columbia. / Graduate

The reading of selected literary texts in this thesis traces the changes from a divinely ordered world of stability (Thomas Mann's Bud<lenbrooks) to surroundings characterized by insecurity (William Faulkner's The Sound and the Fury) to an unstable environment giving rise to largely futile attempts at finding answers to seemingly illogical questions (Thomas Pynchon's The Crying of Lot 49). As a product of the accelerated speed of technological progression and the information revolution in the twentieth century, man is more often than not incapable of adjusting to changed circumstances in a seemingly hostile environment. Indeed, instability and unpredictability are external factors determining the sense of insecurity and uncertainty characterising the 'world' depicted in the literary texts under consideration. For this reason judicious use will be made of philosophical and psychoanalytical concepts, based, amongst others, on Nietzschean and Freudian theories, to explain the disintegration of families, the anguish experienced by individuals or, indeed, the shifting identities informing the portrayal of character in selected literary texts. / Afrikaans and Theory of Literature / D.Litt. et Phil. (Theory of Literature)

Orthognatic surgery deals with congenital and acquired dentoalveolar or skeletal deformities of the face. An unfavourable downward rotation of a mandible and posterior vertical maxillary excess cause an anterior open bite, which is characterized by excessive anterior facial height in the lower third, a gap between the incisors in maximal occlusion and a large mandibular angle. Osteotomy (mainly Le Fort I osteotomy or bilateral sagittal split osteotomy of the mandibular ramus - BSSO), ostectomy or distraction osteogenesis are performed to correct the orthognatic deformities. Osteosynthetic materials based on titanium or bioresorbable materials are used in the form of miniplates with monocortical screws, or bicortical screws are utilized to fix the bony fragments. Stability of the new jaws position is the main criterion for success. Relapse causes a loss of occlusion and consequently functional and aesthetic disorders. Relapse consists of skeletal and dental factors. Skeletal relapse is usually divided into early and long-term relapse. BSSO with counter-clockwise (CCW) rotation of the occlusal plane alone was traditionally considered to be the least stable treatment method. Some authors suggest the use of two miniplates on each side of the osteotomy, but we have not found scientific proof of the...

Made available in DSpace on 2014-07-29T15:16:33Z (GMT). No. of bitstreams: 1 Dissertacao_Daiana_Fernandes.pdf: 425302 bytes, checksum: 7de511c42aac920ca200b0a0f5e3892e (MD5) Previous issue date: 2009-04-30 / The soybeans and beans are of great economic and social importance to Brazil. From the nutritional point of view, they are very demanding in nitrogen and to supply its demand both species are able Biological Nitrogen Fixation (BNF). However, for the BNF, rhizobia require energy supply by the carbohydrates from photosynthesis. For this reason the availability of fotossintato is the biggest limiting factor in BNF. This work had as propose to evaluate the influence of inoculation with rhizobia in two phenological stages of plants under different levels of shading. In this context the inoculation was assessed by the following treatments: two species of legume (Phaseolus vulgaris, L. and Glycine max, L.) inoculated and not inoculated (Fi, Fni, Si and Sni) with specific strains (Rhizobium tropici and Bradyrhizobium japonicum and B. elkanii) in two phenological stages (before, Ep1, and after flowering, Ep2) and subjected to three shadow levels (no shade, 70% and 80% of shade). The experimental design was completely randomized in four replicates on the experiments 1, 2, 3 and 4 conducted in a greenhouse and three replicates for the experiments 5, 6, 7 and 8 in the external environment to a greenhouse. In experiments 1 and 3, both species have continued forming nodules after flowering, the plants of these treatments Fni Ep2, Sni Ep2 and Si Ep2 had the highest average for the number, volume, fresh weight and dry weight of nodules. As the activity of the nodules, the plants of treatments Fi Ep1 and Si Ep1 had the highest number of active nodules compared to treatments Fni Ep2 and Sni Ep2. Assessing the effect of shading in experiments 2 and 4, it was found that bean and soybean plants have behaved differently. The shading of 80% favored the formation of nodules in inoculated bean deferring between treatments of shading, in contrast to the soybean plants that there was no difference (p &#8805; 0.05) among treatments. There was no statistical difference between treatments in the number of active nodes for the beans; the plants of the Sni treatment 80% had the lowest number of active nodules compared to the plants of treatment Si 0%. In experiments 5 and 7 plants of soybeans and reduced the number of nodules after flowering, and as in Experiment 1 and 3 there was a higher number of active nodes during the growing season compared to the reproductive period. The shading applied in bean plants (Experiment 6) was not enough to cause no difference between treatments on the number and activity of nodules; in the experiment with 8 soybean, the shading changed patterns of nodulation and activity of nodules (p &#8805; 0.05). It is this work that the formation and maintenance of activity of the nodules were so distinct in vegetative and reproductive stages, but the shading of 70 and 80% applied was not sufficient to cause significant change in activity of the nodules, suggesting that the reduction the availability of fotossintatos is not the limiting factor in determining the efficiency of N, mainly in the bean / A soja e o feijão são leguminosas de grande importância econômica e social para o Brasil. Do ponto de vista nutricional, são muito exigentes em nitrogênio e para suprir esta demanda ambas às espécies são hábeis em fixá-lo simbioticamente. Mas, para fixar simbioticamente o nitrogênio, os rizóbios necessitam de energia de carboidratos proveniente da fotossíntese. Por esta razão a disponibilidade de fotossintato é o maior fator limitante na Fixação Biológica de Nitrogênio (FBN). Este trabalho se propôs a avaliar a influência da inoculação com rizóbios em dois estádios fenológicos de plantas submetidas a diferentes níveis de sombreamento. Neste contexto foi avaliada a inoculação mediante os seguintes tratamentos: duas espécies de leguminosas (Phaseolus vulgaris, L. e Glycine max, L.) estando elas inoculadas e não inoculadas (Fi, Fni, Si e Sni) com estirpes específicas (Rhizobium tropici e Bradyrhizobium japonicum e B. elkanii) em dois estádios fenológicos (antes, Ep1, e após a floração, Ep2) e submetidas à três níveis de sombreamento (sem sombreamento, 70% e 80% de sombra). O delineamento experimental utilizado foi o inteiramente casualizado com quatro repetições para os experimentos 1, 2, 3 e 4 conduzidos em casa de vegetação e três repetições para os experimentos 5, 6, 7 e 8 conduzidos em ambiente externo a casa de vegetação. Nos experimentos 1 e 3, ambas as espécies continuaram formando nódulos após a floração, nestes as plantas dos tratamentos Fni Ep2, Sni Ep2 e Si Ep2 apresentaram as maiores médias para o número, volume, massa fresca e massa seca de nódulos. Quanto à atividade dos nódulos, as plantas dos tratamentos Fi Ep1 e Si Ep1 apresentaram o maior número de nódulos ativos comparados aos tratamentos Fni Ep2 e Sni Ep2. Avaliando o efeito do sombreamento nos experimentos 2 e 4, observou-se que as plantas de feijão e soja se comportaram de forma diferente. O sombreamento de 80% favoreceu a formação de nódulos no feijoeiro inoculado deferindo entre os tratamentos de sombreamento, ao contrário das plantas de soja que não houve diferença (p &#8805; 0,05) entre os tratamentos. Não houve diferença estatística entre os tratamentos quanto ao número de nódulos ativos para o feijão; as plantas do tratamento Sni 80% obtiveram o menor número de nódulos ativos comparado às plantas do tratamento Si 0%. Nos experimentos 5 e 7 as plantas de feijão e soja reduziram o número de nódulos após a floração, e assim como no experimento 1 e 3, observou-se maior número de nódulos ativos durante o período vegetativo comparado ao período reprodutivo. O sombreamento aplicado nas plantas de feijão (Experimento 6) não foi suficiente para causar nenhuma diferença entre os tratamentos quanto ao número e atividade dos nódulos; no experimento 8 com soja, o sombreamento alterou os padrões de nodulação e atividade dos nódulos (p &#8805; 0,05). Conclui-se neste trabalho, que a formação e manutenção da atividade dos nódulos ocorreram de maneira distinta nos estádios vegetativos e reprodutivos, contudo o sombreamento de 70 e 80% aplicado não foi suficiente para causar alteração notável na atividade dos nódulos, sugerindo que a redução na disponibilidade de fotossintatos não é o fator limitante na eficiência de fixação do N, principalmente no feijoeiro

Made available in DSpace on 2014-07-29T15:29:06Z (GMT). No. of bitstreams: 1 Dissertacao marcelo.pdf: 1119512 bytes, checksum: 984cc3388c7964bc78803aad571255d2 (MD5) Previous issue date: 2009-02-16 / Background: Cervical cancer in Brazil has one of the highest incidence rates. Screening this neoplasia is effective when a cytopathological test stained by Papanicolaou method is performed. However, the quality of cytopathological samples directly influences the screening effectiveness. Eventhough, this method has been criticized due to the high rates of false-negative, due to collection errors, routine scrutiny and the interpretation of cytological changes. Amongst the collection errors, the absence of endocervical cells and bad fixation are highlighted as one of the main concerns. Objectives: to assess the profile of professionals in charge of collecting cytopathological samples as well as verify whether the experience time and the working conditions are associated with sample adequability, verify the main difficulties and easiness reported by the professionals regarding cervical smears collection by using different fixation techniques, verify which fixation technique shows better performance concerning samples adequability and whether the fixation technique influences the detection of precursory injuries; verify the frequency of satisfactory cervical smears, the factors which could partially make samples obscure or make them unsatistactory for the analysis, as well as verify the presence or absence of transformation zone, and whether the presence of these cells is associated with the detection of cervical cancer precursory injuries. Methodology: 19 professionals -doctors and nurses- in charge of collecting cytopathological samples took part in this study. 1,354 cytopathological smears were included in this study, which were divided into three groups, submitted to different fixation techniques and distributed in the following manner: first group: 414 smears fixed with alcohol 95%; second group: 445 fixed with dropping fixation (alcohol 95% + polyethylene glycol) and third group: 495 fixed with spray (alcohol 95% + polyethylene glycol). The cervical material collected was referred to the cytology sector at the Rômulo Rocha Clinical Analyses Center and submitted to scrutiny routine regardless to the fixation technique. The cytopathological outcomes were classified in accordance with Brazilian Nomenclature for Cervical Diagnoses. At the end of the study, a questionnaire was applied to the professionals in which they reported difficulties and easiness concerning the use of different techniques. Data was inserted and processed in the Epi Info 3.3.2 software, and for statistic analysis we used the SAS 9.1.3 software. Outcomes: from the 19 professionals in charge of cytopathological screening 16 (84.2%) are nurses and 3 (15.8%) are doctors. From the 19 professionals in charge of collection, 58% pointed the spray technique as of very easy handling. In the limited smears the most frequent obscuring factor was leukocyte infiltration followed by dissecation, whereas for the unsatisfactory the majority was of dissecation followed by hypocellular material. Conclusions: this study showed that spray fixation technique had the worst performance concerning adequability of sample when compared to alcohol and drops, and that the professionals considered the spray fixation as of easier handling. There was no association between the precursory injuries diagnosis and the fixation technique used. The experience time and the Abstract proper collection environment influenced the quality of cervical material samples and the alcohol 95% fixation technique had the highest rate of difficulty reported, when compared to the drop and spray fixation. We also observed that the transformation zone representation was significant both for the most severe and less severe cervical cancer precursory injuries. / Introdução: O câncer de colo do útero apresenta elevada taxa de incidência no Brasil quando comparado com outras neoplasias. O exame citopatológico, apesar de ser o método de escolha na triagem dessa neoplasia, vem sofrendo críticas devido aos altos índices de resultados falso-negativos, provenientes de erros da coleta, do escrutínio de rotina e da interpretação das alterações citológicas. Dentre os erros da coleta, a ausência de células endocervicais e a má fixação se destacam como os principais problemas. Objetivos: Avaliar o perfil dos profissionais responsáveis pela coleta do exame citopatológico e verificar se o tempo de experiência e as condições de trabalho estão associados com a adequabilidade da amostra. Identificar as principais dificuldades e facilidades relatadas pelos profissionais em relação à coleta dos esfregaços cervicais utilizando diferentes técnicas de fixação. Verificar qual é a técnica de fixação que apresenta melhor desempenho em relação à adequabilidade da amostra e se a técnica de fixação influencia na detecção de lesões precursoras. Verificar a freqüência dos esfregaços cervicais satisfatórios e de fatores que podem obscurecer parcialmente a amostra ou torná-la insatisfatória para análise, bem como, verificar a freqüência dos esfregaços cervicais com representação dos componentes da junção escamo-colunar (JEC), e se a presença desses componentes influencia na detecção de lesões precursoras do câncer do colo do útero. Metodologia: Participaram desse estudo 19 profissionais, dentre estes, médicos e enfermeiros, responsáveis pela coleta dos exames citopatológicos do colo do útero. Foram incluídos nesse estudo 1.354 esfregaços citopatológicos divididos em três grupos, submetidos às diferentes técnicas de fixação e distribuídos da seguinte maneira, o primeiro grupo constituído por 414 esfregaços fixados com álcool a 95%, o segundo grupo por 445 utilizando o fixador em gotas (álcool 95% + polietilenoglicol) e o terceiro grupo por 495 utilizando o fixador em spray (álcool 95% + polietilenoglicol). Após a coleta, os esfregaços foram encaminhados ao Centro de Análises Clínicas Rômulo Rocha e submetido à mesma rotina para análise, independente da técnica de fixação. Os resultados citopatológicos foram classificados de acordo com a Nomenclatura Brasileira para Laudos Cervicais. Após a finalização das coletas, os profissionais responderam um questionário relatando as facilidades e dificuldades frente ao uso das diferentes técnicas de fixação. Os dados foram digitados e processados no programa Epi Info versão 3.3.2 e para os cálculos estatísticos utilizou-se o programa SAS versão 9.1.3. Resultados: Dos 19 profissionais responsáveis pela coleta do exame citopatológico, 84,2% são enfermeiros e 15,8% médicos. Dentre os esfregaços classificados como satisfatórios para análise, a maioria foram coletados por profissionais com mais de cinco anos de experiência, e em ambientes classificados como bom ou ótimo. Dos esfregaços insatisfatórios para análise devido ao dessecamento utilizou-se em, 93,3% deles, a técnica em spray (p= 0,02). Apesar disso, 58% dos profissionais responsáveis pela Resumo coleta cervical apontaram a técnica em spray de muito fácil manuseio. Os fatores obscurecedores mais freqüentes foram dessecamento, infiltrado leucocitário e material hipocelular. Dentre os esfregaços satisfatórios para a análise, 92,7% apresentaram componentes da JEC e a presença destes componentes foi significativa nas lesões mais graves e menos graves (p<0,0001). Conclusões: A técnica de fixação em spray apresentou pior desempenho em relação à adequabilidade da amostra quando comparado com álcool e gotas. Não houve associação entre o diagnóstico de lesões precursoras e a técnica de fixação utilizada. O tempo de experiência e o ambiente de coleta adequado influenciaram na qualidade da amostra do material cervical. A técnica de fixação em álcool 95% teve maior índice de dificuldades relatadas, quando comparada com a fixação em gotas e em spray. A representação da junção escamo-colunar nos esfregaços mostrou-se significativa tanto para o diagnóstico de lesões mais graves quanto as menos graves .

Atualmente, os bons resultados na lesão do ligamento cruzado posterior por avulsão óssea na tíbia associam-se ao tratamento cirúrgico e precoce. A técnica convencional é a fixação com parafuso pela via de acesso posterior do joelho, com abordagem direta das estruturas vasculares e nervosas da região. Neste estudo experimental em 20 joelhos de cadáveres, buscamos apresentar uma alternativa com amarrilho por via artroscópica, comparando-o com a técnica convencional, através da inspeção direta e de testes biomecânicos. Houve falha na fixação de apenas um exemplar de cada método e medidas de deslocamento tibial posterior (p=0,23) e rigidez média (p=0,28) sem diferenças significativas entre as duas técnicas. Concluímos ser o amarrilho artroscópico viável e uma alternativa no tratamento desta lesão. / Nowadays, good results on the management of posterior cruciate ligament bony avulsion of the tibia are associated with early surgical repair. The usual method of treatment is the open posterior approach with screw fixation, wich requires popliteal neurovascular bundle direct manipulation. This study presents a new arthroscopic suture and compares it with the conventional technique, using biomechanical tests and direct inspection in cadaveric specimens (20 knees). On both methods there was a fixation fail in one knee. The analisys of tibial posterior displacement (p=0,23) and stiffness (p=0,20) were similar for the two methods. The Arthroscopic suture presented is an effective reattachment method for this fracture pattern.