Made available in DSpace on 2014-06-11T19:23:42Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-02-24Bitstream added on 2014-06-13T19:07:16Z : No. of bitstreams: 1 medeiros_rm_me_jabo.pdf: 4576402 bytes, checksum: 4df7cf376e215b11cedb7a4eaf1dd5b9 (MD5) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / A Ruptura de Ligamento Cruzado Cranial (RLCCr) é a afecção articular que mais acomete os cães. O Avanço da Tuberosidade Tibial (TTA) é uma nova técnica desenvolvida para sua correção. Ela anula a função do ligamento por meio de alteração na biomecânica do joelho. O presente estudo objetivou avaliar, em cães com RLCCr, o uso da técnica de TTA modificada (TTAm) substituindo o espaçador original de titânio por um confeccionado com polímero de mamona fixado com dois parafusos no sentido craniocaudal, dispensando o uso da placa e do “garfo”. Os implantes foram confeccionados nas mesmas medidas e ângulos dos “cages” originais, sendo apenas a porção distal alongada. A técnica de TTAm foi realizada em 35 cães (42 joelhos) com RLCCr. Foram feitas análises da marcha e radiográfica no pré-operatório, pós-operatório imediato e após 30, 60, 90 e 120 dias. Por meio de questionário de avaliação, preenchido pelos proprietários, inferiu-se que todos os proprietários ficaram satisfeitos com a recuperação dos animais. Os animais apresentaram boa evolução radiográfica e obtiveram melhora na marcha e a maioria teve retorno funcional total. O TTAm foi utilizado em cães de tamanhos variados, mostrando-se mais versátil que o TTA convencional, menos invasivo e mais simples de ser realizado / Cranial Cruciate Ligament Rupture (CCLR) is the articular disorder that most affects dogs. The tibial tuberosity advancement (TTA) is a new technique developed to repair the CCLR. It cancels the ligament function through a change in the biomechanics of the knee. This study aimed to evaluate, in dogs with CCLR, the use of the modified TTA technique (TTAm) replacing the original titanium “cage for castor oil polymer fixed by two screws in the craniocaudal direction, eliminating the use of the plate and “fork”. The implants were manufactured on the same measures and angles of the original cages being only the distal elongated. TTAm technique was performed in 35 dogs (42 knees) with CCLR. Analyses of gait and radiographic occurred preoperatively , the immediate postoperative and after 30, 60, 90 and 120 days. An evaluation questionnaire, filled by the owners, inferred that all owners were pleased with the recovery of their animals. The animals had good radiographic outcome and showed improvement in gait, and most had full functional return. The TTAm was used in dogs of many sizes, being more versatile than the conventional TTA, less invasive and simpler to be performed

Made available in DSpace on 2014-06-11T19:23:44Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-10-06Bitstream added on 2014-06-13T19:50:51Z : No. of bitstreams: 1 barros_lp_me_jabo.pdf: 894125 bytes, checksum: 291c2da790713462f8653ad7c1ce412f (MD5) / No presente trabalho comparou-se, experimentalmente, duas técnicas: a estabilização coxofemoral com pino em cavilha ou “toggle pin” e a colocefalectomia. Foram utilizados 16 cães, machos ou fêmeas, distribuidos em dois grupos: o de Pino (GP) e o Colocefalectomia (GC), os quais foram separados em 4 subgrupos: animais com peso superior e, inferior ou igual a 15 kg. Avaliou-se o tempo de cirurgia, o grau de atrofia muscular, a deambulação e a dor, além de presença ou não de alterações radiograficas da articulação. O tempo cirúrgico, devido a maior complexidade da técnica do pino, foi menor no GC. A técnica do GP foi melhor quanto à recuperação do membro, apresentando menor atrofia muscular / On the present assay was compared experimentally between two techniques: hip joint stabilization with toggle pin and hip joint stabilization with head of the femur. Were used 16 dogs, female or male, distributed in 2 groups: the pin group (GP) and head of the femur group (GC), the groups were distributed in 4 subgroups: by weight equal, more or less than 15kg. Evaluating the time of surgery, and the notch of muscle atrophy, wander around the pain and also with the presence or not of alterations on the joint radiograph. The time of surgery is longer in the technique of pin than on the group GC, because the technique of pin had more complexity. So the technical of the group GP was better on the recovery member, which presented less muscle atrophy

Orientador: Márcia Rita Fernandes Machado / Banca: João Guilherme Padilha Filho / Banca: Luís Gustavo Gosuen Gonçalves Dias / Resumo: A Ruptura de Ligamento Cruzado Cranial (RLCCr) é a afecção articular que mais acomete os cães. O Avanço da Tuberosidade Tibial (TTA) é uma nova técnica desenvolvida para sua correção. Ela anula a função do ligamento por meio de alteração na biomecânica do joelho. O presente estudo objetivou avaliar, em cães com RLCCr, o uso da técnica de TTA modificada (TTAm) substituindo o espaçador original de titânio por um confeccionado com polímero de mamona fixado com dois parafusos no sentido craniocaudal, dispensando o uso da placa e do "garfo". Os implantes foram confeccionados nas mesmas medidas e ângulos dos "cages" originais, sendo apenas a porção distal alongada. A técnica de TTAm foi realizada em 35 cães (42 joelhos) com RLCCr. Foram feitas análises da marcha e radiográfica no pré-operatório, pós-operatório imediato e após 30, 60, 90 e 120 dias. Por meio de questionário de avaliação, preenchido pelos proprietários, inferiu-se que todos os proprietários ficaram satisfeitos com a recuperação dos animais. Os animais apresentaram boa evolução radiográfica e obtiveram melhora na marcha e a maioria teve retorno funcional total. O TTAm foi utilizado em cães de tamanhos variados, mostrando-se mais versátil que o TTA convencional, menos invasivo e mais simples de ser realizado / Abstract: Cranial Cruciate Ligament Rupture (CCLR) is the articular disorder that most affects dogs. The tibial tuberosity advancement (TTA) is a new technique developed to repair the CCLR. It cancels the ligament function through a change in the biomechanics of the knee. This study aimed to evaluate, in dogs with CCLR, the use of the modified TTA technique (TTAm) replacing the original titanium "cage" for castor oil polymer fixed by two screws in the craniocaudal direction, eliminating the use of the plate and "fork". The implants were manufactured on the same measures and angles of the original "cages" being only the distal elongated. TTAm technique was performed in 35 dogs (42 knees) with CCLR. Analyses of gait and radiographic occurred preoperatively , the immediate postoperative and after 30, 60, 90 and 120 days. An evaluation questionnaire, filled by the owners, inferred that all owners were pleased with the recovery of their animals. The animals had good radiographic outcome and showed improvement in gait, and most had full functional return. The TTAm was used in dogs of many sizes, being more versatile than the conventional TTA, less invasive and simpler to be performed / Mestre

Neste estudo retrospectivo, controlado, de 94 adolescentes consecutivos com maloclusão de Classe II, divisão 1ª de Angle e retrognatismo mandibular, no surto de crescimento puberal, foram avaliadas as mudanças dentoesqueléticas decorrentes do tratamento com aparelho de Herbst (Grupo A coroas de aço e B splints acrílicos) e de acompanhamento (Grupo C - controle), em um período de 12 meses. As telerradiografias laterais foram obtidas em T1 (inicial) e T2 (no final do período de observação). As variáveis cefalométricas foram analisadas com testes paramétricos. Os resultados mostraram que os dois grupos tratados caracterizaram-se diferencialmente do grupo controle, com restrição do crescimento maxilar e maior crescimento mandibular, o que permitiu melhorar a relação sagital. Da mesma forma, no aspecto dentoalveolar houve melhora da sobressaliência pela retroinclinação dos incisivos superiores e vestibularização dos incisivos inferiores, distalização com controle vertical dos molares superiores e mesialização dos molares inferiores. Os três grupos mostraram semelhança na extrusão dos molares inferiores, na preservação da morfologia mandibular e do padrão facial. O plano oclusal rotacionou no sentido horário nos grupos tratados e anti-horário no grupo controle. Pode-se concluir que no tratamento com dois tipos de aparelho de Herbst da maloclusão de classe II, em adolescentes no pico máximo de crescimento, observaram-se um conjunto de mudanças que melhoraram as relações dentoesqueléticas sagitais, independentemente do crescimento. No aspecto vertical, apesar das pequenas mudanças observadas houve preservação do padrão facial assim como no grupo controle. / This retrospective controlled study enrolled 94 consecutive adolescents during growth spurt with Angle class II division 1 malocclusion and mandibular retrognathism and evaluated skeletal and dental changes resulting from treatment with a Herbst appliance (Group A: steel crowns; Group B: acrylic splints) and compared them with results of a follow-up group (Group C: control) for 12 months. Lateral radiographs were obtained in the beginning of the treatment (T1) and at the end of the observation period (T2). Cephalometric variables were analyzed using parametric tests. The results of the two treatment groups were different from those found for the control group. Maxillary growth was restricted, whereas mandibular growth was greater, which resulted in a better sagittal relation. At the same time, the analysis of dentoalveolar aspects revealed that overjet was reduced due to distal tipping of maxillary incisors and buccal inclination of mandibular incisors, vertical control of maxillary molars and mesial movement of mandibular molars. The three groups had similar extrusion of mandibular molars, preservation of mandibular morphology and facial pattern. The occlusal plane rotated clockwise in the treated groups and counterclockwise in the control group. It can be concluded that the treatment of class II malocclusion in adolescents during growth spurt with two types of Herbst appliance resulted in a set of changes that improved sagittal skeletal and dental relations, regardless of growth. Vertically, facial pattern was preserved in treatment and control groups, despite some small differences.

Background: Axis fractures are a common injury in the elderly population. Treatment is often complicated due to osteoporosis and patient comorbidity. Knowledge of the incidence of these fractures, as well as their treatment, outcome and mortality rate, will improve knowledge and decision-making processes for this fragile group of patients. Objectives: This thesis aims (1) to review the literature on the non-surgical and surgical treatment of odontoid fractures type 2 in the elderly population, (2) to provide an updated overview of axis fracture subtypes, their incidence and their treatment in a cohort in two university cities, (3) to map the incidence of fractures and the treatment of these patients in Sweden, (4) to investigate the effect on mortality of both the surgical and non-surgical treatment of axis fractures and (5) to present the protocol for a randomized controlled trial (RCT) on the treatment of odontoid fractures type 2 in the elderly population. Methods: A systematic review was performed using the MeSH keywords “odontoid AND fracture AND elderly”. The data for the cohort study were extracted from the regional hospital information system. The radiographs were reviewed retrospectively. Data were extracted from the Swedish National Patient Registry (NPR) and the mortality registry for the national registry studies. Finally, the RCT protocol was carried out according to the SPIRIT and CONSORT statements for clinical trial reporting. Results and conclusions: So far, there has been a scarcity of existing evidence on treatment of odontoid fractures type 2 in the elderly population. In this thesis, we found in two university cities an increased incidence, and a trend towards more surgical treatment of type 2 and 3 odontoid fractures 2002-2014. Between 1997 and 2014 in Sweden, there was an increasing incidence of C2 fractures, but the treatment trend went towards more non-surgical treatment. Surgically treated patients had a greater survival rate than non-surgically treated patients. Among those over 88 years of age, surgical treatment lost its effect on survival. In the RCT we will study the function of patients with odontoid fractures type 2 and by comparing non-surgical treatment with posterior C1-C2 fusion, the cost-effectiveness of the treatment options.

M.Tech. / Purpose: The aim of this study was to compare the effects of Chiropractic adjustments to Muscle Energy Technique (MET) with regards to pain, disability and range of motion in the cervical spine. Method: Thirty participants, male or female between the ages of 18 and 55 years, diagnosed with cervical facet syndrome were used in the study. The thirty participants were randomly divided into two groups consisting of fifteen individuals each, ensuring equal male to female and age ratios. Group A received Chiropractic adjustment/s over the restricted joint/s to the cervical spine. Group B received MET to the cervical spine.The trial consisted of seven visits over a treatment period of three weeks, of which the first six visits the participants received treatment and the seventh visit served the purpose of obtaining the final data. The data was gathered on the first, fourth and seventh visits. The data was always gathered before the treatment was performed. Objective data consisted of measuring cervical spine range of motion with a CROM instrument. Subjective data was obtained by using the Numerical Pain Rating Scale (NPRS) and the Vernon-Mior Neck Pain and Disability Index. Results: The results indicated that Group A (Chiropractic adjustments) proved to be the most effective treatment protocol. Although the other treatment protocol, Group B (Muscle Energy Technique), also showed good results. Both subjective and objective results showed that although Group B produced statistically significant results, Group A showed the best results overall. Thus it was noted that in order to achieve a potentially lasting increase in range of motion and a decrease in pain and disability, the treatment protocol used for Group A should be the treatment of choice. Conclusion: It was concluded, based on the results, that Chiropractic adjustments was more effective than MET in the treatment of cervical facet syndrome. This conclusion is based on the results that Chiropractic adjustments was more effective in all the objective and all the subjective measurements. However, this does not rule out MET as a treatment for neck pain, because MET treatment did show improvements in cervical spine ROM and a decrease in pain, although not as efficiently as Chiropractic treatment.

Osteoporosis is a systemic skeletal disease that affects millions of people worldwide. There are many possible etiologies for osteoporosis, including inherent variables like genetics and sex, and lifestyle variables like diet and exercise. Characterized by low bone mass and increased fracture risk, the disease places a burden on both the patients and the healthcare industry. Therefore, it is vital that research determine the mechanisms by which the risk factors affect BMD so that better diagnosis and treatment options may be developed. The purpose of this study was to examine the relationship between various osteoporosis risk factors and biochemical markers of osteogenic cell activity derived from bone-marrow MSCs. It was hypothesized postmenopausal white women, having the greatest risk for osteoporosis, would have elevated hydroxyproline and decreased ALP, indicative of greater bone resorption. Acetabular reamings were collected from 26 patients (15 males and 11 females) undergoing total hip arthroplasty at Boston Medical Center. MSCs from the reamings were plated and underwent osteoinduction into osteoblasts. The cells were then harvested and assayed for various indicators of cell growth and bone cell activity, such as DNA, ALP, and hydroxyproline. Our hypothesis was generally supported in that postmenopausal white women did have less ALP, an indicator of bone deposition, than premenopausal women and postmenopausal African American women. Additional findings and directions for future studies are further discussed in this paper.

INTRODUCTION: The purposes of this study are to determine whether Thiel-embalmed cadavers are an effective educational tool in teaching medical students to perform knee arthrocentesis, to compare the use of Thiel-embalmed cadavers to formalin-embalmed cadavers in arthrocentesis education, and to determine whether the use of Thiel-embalmed cadavers is potentially generalizable to the instruction of other orthopedic procedures. METHODS: Sixty-eight third-year medical students participated in the study. The participants first completed a pre-survey to assess their prior experience with arthrocentesis procedures and Thiel-embalmed cadavers. Participants then attended an instructional session where the knee arthrocentesis procedure was demonstrated on a Thiel-embalmed cadaver. Participants then individually performed the simulated knee arthrocentesis procedure twice: once on a Thiel-embalmed cadaver and once on a formalin-embalmed cadaver. Success of each attempt was determined through the visualization of aspirated joint fluid. Following the laboratory session, each participant completed a post-survey to determine whether the session improved their perceived confidence in performing knee arthrocentesis, if they preferred the use of Thiel-embalmed cadavers or formalin-embalmed cadavers as a teaching tool, and if they believed simulated practice using Thiel-embalmed cadavers would be effective for learning other orthopedic procedural skills. RESULTS: Sixty-eight students participated in the laboratory session and successfully completed both pre- and post-course surveys. 96% of participants reported that they felt confident performing knee arthrocentesis under physician supervision following their participation in the laboratory session (versus 15% of participants in the pre-survey). 96% of participants reported that the Thiel-embalmed cadavers provided a more realistic teaching model than formalin-embalmed cadavers for learning knee arthrocentesis. 100% of participants believed the incorporation of simulated practice using Thiel-embalmed cadavers is an effective method in teaching students to perform knee arthrocentesis. 100% of participants reported that they would participate in future sessions using Thiel-embalmed cadavers to learn and practice other orthopedic procedural techniques. DISCUSSION: This study used a moderate sample size of third-year medical students to provide data regarding the suitability of using Thiel cadavers in arthrocentesis education. Results indicate that Thiel cadavers are effective tools in teaching medical students to perform knee arthrocentesis, that students preferred the Thiel cadavers to the formalin cadavers, and that the use of Thiel cadavers is a safe, engaging, and high-quality teaching modality for demonstrating proper arthrocentesis procedural technique to medical students. Since this study looked specifically at teaching knee arthrocentesis to medical students, it is uncertain whether the benefits of Thiel cadavers are generalizable to the education of other orthopedic procedures and subject groups such as residents, fellows, and practicing physicians. Further studies should be performed to assess whether Thiel cadavers are beneficial in teaching other orthopaedic procedures and if these benefits extend to other subject groups.

As women age and transition into menopause they face a higher risk of developing osteoarthritis leading to total joint replacements. Estrogen is the primary female reproductive hormone. As a woman approaches menopause, estrogen production decreases by 100-fold. Previous research has shown that Estrogen Replacement Therapy (ERT) reduced joint replacements in post-menopausal women. However, there is a lack of research surrounding ERT's effect on chondrocyte proliferation and extracellular matrix production, particularly 3D culture extracellular matrix production. Chondrogenesis is a process of skeletal development resulting in the formation of cartilage. Chondrocytes, derived from mesenchymal progenitors, serve as the fundamental cellular component in the development of articular cartilage, facilitating smooth joint movement. This thesis examines female articular cartilage in both 2D growth assessment and using 3D aggregates with and without arthritis-like inflammatory conditions. Estrogen seems to have minimal effect on growth, metabolic activity, and extracellular matrix production. Healthy and pre-exposed osteoarthritic cartilage donors indicate some variability within the data. Overall, this project allowed us to further elucidate the mechanism of estrogen hormone replacement therapy utilizing healthy and osteoarthritic samples.

No description available.