O objetivo deste trabalho foi avaliar a influência da espessura do enxerto e da técnica de dois feixes na estabilidade da reconstrução do ligamento cruzado posterior (LCP) na lesão isolada do mesmo. Para isso foram utilizados nove joelhos de cadáver, onde foram estudadas cinco condições de avaliação: joelho com o LCP e demais ligamentos íntegros (Íntegro), LCP reconstruído com um feixe com enxerto do tendão quadricipital de 10mm de largura (Rec 1), LCP reconstruído com dois feixes com enxerto do tendão quadricipital de 10mm para o feixe ântero-lateral e enxerto duplo do tendão do semitendíneo de sete milímetros de diâmetro para o feixe póstero-medial (Rec 2), LCP reconstruído com um feixe com enxertos do tendão quadricipital de 10mm e do tendão duplo do semitendíneo de sete milímetros (Rec M) e joelho com lesão isolada do LCP (Lesado), sempre nesta ordem. Em cada condição foram avaliados o limite do deslocamento posterior da tíbia (LDPT) e a rigidez ao deslocamento posterior da tíbia ao se aplicar uma força de 134 N em sentido posterior na tíbia. Os ensaios foram realizados em uma máquina eletromecânica com o joelho em extensão, 30, 60 e 90° de flexão. A análise estatística foi realizada com o teste de ANOVA e de comparações múltiplas de Newman-Keuls. Em relação à condição Lesado todas as técnicas de reconstrução (Rec 1, Rec 2 e Rec M) reduziram significativamente o LDPT em todos os ângulos. Em relação à condição Íntegro, o LDPT da técnica Rec 1 foi significativamente maior em todos os ângulos, o LDPT da Rec 2 foi equivalente a 0 e 30° e significativamente maior a 60 e 90° e o LDPT da Rec M foi equivalente a 0, 30 e 60° e significativamente maior a 90°. O LDPT da condição Rec M foi significativamente menor (mais estável) que o da Rec 2 a 60 e 90°. O LDPT das técnicas Rec 2 e Rec M foi significativamente menor que o da condição Rec 1 em todos os ângulos testados. A rigidez de todas as técnicas e em todos os ângulos foi sempre significativamente menor que à do joelho íntegro e equivalente à do lesado. Concluiu-se que na reconstrução do LCP, em sua lesão isolada, o aumento da espessura do enxerto melhora significativamente a estabilidade e que a divisão do enxerto para reconstruir os dois feixes piora a estabilidade da reconstrução a 60 e 90° de flexão do joelho. / The purpose of this study was to evaluate the biomechanical effect of graft thickness and two-bundle technique on posterior cruciate ligament (PCL) reconstruction of nine human cadaveric knees. Five conditions were tested: intact knee, single-bundle reconstruction with a 10mm-quadriceps tendon(Rec 1), two-bundle reconstruction with a 10mm-quadriceps tendon for the anterolateral bundle and a 7-mm doubled semitendinosus tendon for the posteromedial bundle(Rec 2), single-bundle reconstruction with a 10-mm quadriceps tendon plus a 7-mm doubled semitendinosus tendon (Rec M) and PCL-deficient. Posterior tibial translation (PTT) and stiffness to posterior tibial translation were measured in response to a 134-N posterior tibial load at 0, 30, 60 and 90° of knee flexion. All reconstruction techniques reduced posterior tibial translation at all flexion angles when compared with PCL-deficient knees. When compared with the intact knee, PTT of Rec 1 was significantly higher at all angles, PTT of Rec 2 was not significantly different at full extension and 30° of flexion, PTT of Rec M was not significantly different at full extension, 30 and 60° of flexion. Stiffness of all techniques was always significantly lower than the intact knee at all flexion angles. PTT of the Rec 2 and Rec M techniques was always significantly lower (better stability) than the PTT of Rec 1. PTT of Rec M was significantly lower than the PTT of Rec 2 at 60 and 90°. We concluded that graft enlargement improves the reconstruction stability in isolated PCL lesions, whereas the graft division to perform a two-bundle technique worsens this stability at 60 and 90° of knee flexion.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-06-16T18:23:36Z No. of bitstreams: 1 thainarasalgueirodesouza.pdf: 1530638 bytes, checksum: f0b2f7df80129372428b700e7e7b897e (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-07-13T14:26:11Z (GMT) No. of bitstreams: 1 thainarasalgueirodesouza.pdf: 1530638 bytes, checksum: f0b2f7df80129372428b700e7e7b897e (MD5) / Made available in DSpace on 2016-07-13T14:26:11Z (GMT). No. of bitstreams: 1 thainarasalgueirodesouza.pdf: 1530638 bytes, checksum: f0b2f7df80129372428b700e7e7b897e (MD5) Previous issue date: 2014-03-24 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A região posterior da maxila é altamente vascularizada e com diversas estruturas anatômicas importantes. A manipulação dos ossos do crânio durante osteotomias do tipo Le Fort I pode inadvertidamente causar danos aos vasos e nervos da região, além de poder atingir os ápices dos dentes superiores. Assim, o objetivo do presente trabalho foi analisar a variação anatômica da maxila posterior em uma subpopulação brasileira, considerando o gênero, a faixa etária, a simetria bilateral e a relação com os dentes superiores. Foi analisado um total de 200 exames de pacientes da região da Zona da Mata Mineira (Minas Gerais, Brasil), de ambos os gêneros, com faixas etárias variadas (até 30 anos; 31 a 50 anos; 51 a 60 anos e a partir de 61 anos). Foram selecionados cortes sagitais, coronais e axiais, nos quais foram analisadas medidas lineares ósseas (M1 a M8) e medidas dentárias. Os resultados indicaram que tanto as medidas ósseas, com as medidas dentárias apresentaram uma tendência à simetria bilateral. O gênero do paciente influenciou nas medidas ósseas, sendo que os homens apresentaram valores significativamente superiores para as medidas M1, M3, M4 e M7. A faixa etária influenciou mais nas medidas dentárias do que nas medidas ósseas, sendo que indivíduos de maiores faixas etárias apresentaram valores significativamente superiores para todos os dentes avaliados, exceto para os incisivos. Para as medidas ósseas, apenas M3, M6 e M8 foram significativamente superiores para os indivíduos mais jovens. As correlações das medidas ósseas entre si não apresentaram resultados clinicamente relevantes, no entanto, todas as correlações entre as medidas dentárias foram significativas e positivas. Foi observada uma alta frequência de secções radiculares para osteotomias com altura de 3 mm em relação ao assoalho da cavidade nasal, sendo o canino o dente mais frequentemente lesado. Esses principais resultados forneceram informações importantes sobre a anatomia da região posterior da maxila de uma subpopulação brasileira, auxiliando na definição de um protocolo seguro para a realização das osteotomias maxilares. / The posterior maxilla is highly vascularized and with several important anatomical structures. The manipulation of the skull bones during osteotomies Le Fort I may inadvertently cause damage to the vessels and nerves of the region, in addition to reaching the apex of the upper teeth. The objective of this study was to analyze the anatomic variation of the posterior maxilla in a Brazilian subpopulation, considering gender, age, bilateral symmetry and relationship with the upper teeth. It was analyzed a total of 200 examinations of patients in the area of Zona da Mata Minas (Minas Gerais, Brazil), of both genders, with different age groups (up to 30 years; 31-50 years; 51 to 60 years and from 61 years). Sagittal, coronal and axial slices were selected, in which bone linear measurements (M1 to M8) and dental measurements were analyzed. The results indicated that both measures, bone and dental measurements, showed a tendency to bilateral symmetry. The gender of the patient influence on bone measurements, whereas men showed significantly higher values for the M1, M3, M4 and M7 measures. The age group most affected in dental measures than on bone measurements, and individuals of older age groups showed significantly higher values for all evaluated teeth, except for the incisors. For bone measurements, only M3, M6 and M8 were significantly higher than for younger individuals. Correlations between bone measures itself showed no clinically relevant results, however, all correlations between dental measures were significant and positive. A high frequency of root sections for osteotomies was observed with a height of 3 mm above the floor of the nasal cavity, the canine tooth the most frequently injured. These main results provided important information about the anatomy of the posterior maxilla of a Brazilian subpopulation, helping to define a secure protocol for achievement maxillary osteotomies.

O objetivo deste estudo foi analisar os ruídos das articulações temporomandibulares (ATM) e a atividade eletromiográfica (EMG) dos músculos masseteres (MM) e temporais anteriores (TA) nos momentos pré e pós correção da mordida cruzada posterior funcional (MCPF) por meio da expansão rápida da maxila (ERM) com o uso do aparelho ortopédico Haas modificado. A amostra foi composta por 20 crianças (entre 6 e 12 anos de idade, de ambos gêneros) portadoras de MCPF. A eletrovibratografia (EVG) avaliou a presença de ruídos articulares. A eletromiografia (EMG) foi analisada nas situações clínicas de máxima contração voluntária em máxima intercuspidação habitual e mastigação habitual, direita e esquerda nos momentos pré tratamento (T1) e após três meses da finalização da ERM (T2). Os resultados mostraram que: não houve diferença estatística nos ruídos articulares entre o lado afetado e não afetado pela MCPF nos momentos T1 e T2, houve uma melhora do ruído articular com diminuição no pico de amplitude da vibração do lado da MCPF na comparação dos lados não afetados pela MCPF. No teste da EMG a avaliação em repouso e no teste funcional não mostrou diferenças estatisticamente significantes entre lado afetado e não afetado pela MCPF. Houve diferença estatística nas mastigações direita e esquerda tanto para MM como para os TA na mastigação do lado da MCPF sendo que atividade EMG aumentou para estes músculos no T1 do lado não afetado. Na comparação entre o lado afetado e não afetado, os MM e os TA aumentaram sua atividade EMG no T1 na mastigação do lado da MCPF e somente o MM apresentou aumento da atividade EMG na mastigação do lado não afetado pela MCPF. Na comparação entre os lados de MCPF no T1 com T2 e na comparação entre os lados não afetados pela MCPF na avaliação da mastigação de ambos os lados o MM apresentou aumento da atividade EMG nos momentos T1 e T2, com diferenças estatísticas significantes. Em conclusão, o tratamento precoce da ERM diminui a intensidade dos ruídos articulares do lado afetado pela MCPF e gera um equilíbrio nas funções mastigatórias após tratamento ortopédico da MCPF. Estes achados indicam que o tratamento precoce da MCPF favorece a obtenção de condições morfológicas e funcionais adequadas para um melhor desenvolvimento do sistema estomatognático. / The objective of this study was to analyze the temporomandibular joint (TMJ) noise and the electromyographic (EMG) activity of the masseter (MM) and anterior temporal (TA) muscles at the moments before and after correction of functional posterior crossbite (MCPF) by rapid expansion of the maxilla (ERM) with the use of the modified Haas orthopedic device. The sample consisted of 20 children (between 6 and 12 years of age, of both genders) with MCPF. Electrovibratography (EVG) evaluated the presence of joint noises. Electromyography (EMG) was analyzed in the clinical situations of maximum voluntary contraction in maximal habitual intercuspation and habitual chewing, right and left at the pre-treatment (T1) moments and after three months of the completion of ERM (T2). The results showed that: there was no statistical difference in articular noise between the affected and unaffected side of the MCPF at moments T1 and T2, there was an improvement in articular noise with a decrease in the peak of vibration amplitude on the MCPF side in the comparison of the non- affected side of the MCPF. In the EMG test, the evaluation at rest and in the functional test did not show statistically significant differences between the affected and non-affected side of the MCPF. There was a statistically significant difference in right and left chewing for both MM and TA in chewing on the MCPF side and EMG activity increased for these muscles in T1 on the unaffected side. In the comparison between the affected and unaffected side, MM and TA increased their EMG activity in T1 in chewing on the MCPF side and only MM showed increased EMG activity in chewing on the side not affected by MCPF. In the comparison between the MCPF sides in T1 with T2 and in the comparison between the sides not affected by MCPF in the chewing evaluation of both sides, the MM showed an increase in EMG activity at moments T1 and T2, with significant statistical differences. In conclusion, early treatment of MRE reduces the intensity of articular noises on the MCPF affected side and generates a balance in masticatory functions after orthopedic treatment of MCPF. These findings indicate that the early treatment of MCPF favors the achievement of morphological and functional conditions adequate for a better development of the stomatognathic system.

El presente trabajo de investigación “Efecto de la NIC 16 en la valuación de los activos fijos y su impacto financiero en las empresas del sector transporte (de carga) fluvial en la Ciudad de Iquitos en el 2017” se enfoca en determinar el impacto financiero realizar correctamente aplicación de las Normas Internacionales de Información Financiera. Asimismo, se encofará en el análisis del método de revaluación bajo los criterios indicados en la NIC 16. La técnica de investigación utilizada fue cualitativa que consiste en aplicar entrevistas y encuestas a una muestra seleccionada bajo el método no probabilístico, con el fin de conocer y analizar la situación actual de las empresas del sector transporte fluvial con respecto a sus activos fijos. El trabajo de investigación se encuentra dividido en cinco capítulos, como siguen: Capítulo I. Marco Teórico, se definen los conceptos básicos en base a las Normas Internacionales de Información Financiera, así como relacionadas al sector transporte fluvial en la Ciudad de Iquitos. Capítulo II. Plan de investigación, se define el problema, los objetivos e hipótesis para la investigación. Capítulo III. Metodología de la investigación se emplearán los siguientes: investigación exploratoria, descriptiva y explicativa con un enfoque de investigación mixta. Capítulo IV. Desarrollo de la investigación, en este capítulo se mostrarán las encuestas y entrevistas realizadas a una muestra de empresas. Además de desarrollarse un caso práctico en base a la valuación posterior de activos fijos y ver el impacto financiero producido. Capítulo V. Análisis de los resultados, se analizarán las respuestas de las encuestas y entrevistas aplicadas, asimismo se analizará el resultado del caso práctico desarrollado. En el último Capítulo VI, se concluirá en base a las hipótesis planteadas en el Capítulo II. / The present research work "Effect of IAS 16 on the valuation of fixed assets and their financial impact on companies in the fluvial transportation (cargo) sector in the City of Iquitos in 2017" focuses on determining the impact financially by having a correct application of the International Financial Reporting Standards. Likewise, will be focused in the analysis of the revaluation method under the criteria indicated in IAS 16. Qualitative research techniques were used, which consists of applying interviews and surveys to a sample selected under the non-probabilistic method, in order to know and analyze the current situation of companies in the fluvial transport sector respect to its accounting treatment with fixed assets. The research work is divided into five chapters, as follows: Chapter I. Theorical Framework, where is developed to define the basic concepts based on the International Financial Reporting Standards establishes, also definitions in order to describe the fluvial transportation in the City of Iquitos. Chapter II. Research plan, where the problem, the objectives and hypothesis were defined for the investigation. Chapter III. Research methodology, the three types of research; exploratory, descriptive will be used. Chapter IV. Development of the investigation, in this chapter the surveys and interviews made to the sample of companies of fluvial transport will be shown. Likewise, a case of study will be developed. Chapter V. Analysis of the results, the answers obtained in the surveys and interviews applied to the companies will be analyzed. Also we are going to analyze the results of the case of study. In the last Chapter VI, Conclusions, it will be concluded based on the hypotheses set forth in Chapter II on the financial impact with the correct valuation of assets. / Tesis

Background: We performed a biomechanical comparison of 2 methods for operative stabilization of pronation-abduction stage III ankle fractures; group 1: Anterior-posterior lag screws fixing the posterior tibial fragment and lateral fibula plating (LSLFP) versus group 2: locked plate fixation of the posterior tibial fragment and posterior antiglide plate fixation of the fibula (LPFP). Methods: Seven pairs of fresh-frozen osteoligamentous lower leg specimens (2 male, and 5 female donors) were used for the biomechanical testing. Bone mineral density (BMD) of each specimen was assessed by means of dual-energy x-ray absorptiometry. After open transection of the deltoid ligament, an osteotomy model of pronation abduction stage III ankle fracture was created. Specimens were systematically assigned to LSLFP (group 1, left ankles) or LPPFP (group 2, right ankles). After surgery, all specimens were evaluated via CT to verify reduction and fixation. Axial load was then applied onto each specimen using a servohydraulic testing machine starting from 0 N (Zwick/Roell, Ulm, Germany) at a speed of 10 N/s with the foot fixed in a 10 degrees pronation and 15 degrees dorsiflexion position. Construct stiffness, yield, and ultimate strength were measured and dislocation patterns were documented with a high-speed camera. The normal distribution of all data was analyzed using Shapiro-Wilk test. The group comparison was performed using paired Student t test. Statistical significance was assumed at a P value of .05. Results: All specimens had BMD values consistent with osteoporosis. BMD values did not differ between the left and right ankles of the same pair (P = .762). The mean BMD values between feet of men (0.603 g/cm²) and women (0.329 g/cm²) were statistically different (P = .005). The ultimate strength for LSLFP (group 1) with 1139 ± 669 N and LPPFP (group 2) with 2008 ± 943 N was statistically different (P = .036) as well as the yield in LSLFP (group 1) 812 ± 452 N and LPPFD (group 2) 1292 ± 625 N (P = .016). Construct stiffness trended to be higher in group 2 (179 ± 100 kNn) compared to group 1 (127 ± 73 kN/m) but this difference was not statistically significant (P = .120). BMD correlated with bone-construct failure. Conclusion: Fixation of the posterior tibial edge with a posterolateral locking plate resulted in higher biomechanical stability than anterior-posterior lag screw fixation in an osteoporotic pronation-abduction fracture model. Clinical Relevance: The clinical implication of this biomechanical study is that the posterior antiglide plating might be advantageous in patients with osteoporotic pronation abduction stage III ankle fracture.

No description available.

Thesis (MMed (Surgical Sciences. Orthopaedic Surgery))--University of Stellenbosch, 2010. / Objective: This research paper reports on the radiographic outcome of unstable thoracolumbar injuries with short segment posterior instrumentation as standalone treatment; in order to review rate of instrumentation failure and identify possible contributing factors. Background: Short segment posterior instrumentation is the treatment method of choice for unstable thoracolumbar injuries in the Acute Spinal Cord Injury Unit (Groote Schuur Hospital). It is considered adequate treatment in fracture cases with an intact posterior longitudinal ligament, and Gaines score below 7 (Parker JW 2000); as well as fracture dislocations, and seatbelt-type injuries (without loss of bone column - bearing integrity). The available body of literature often states instrumentation failure rates of up to 50% (Alanay A 2001, Tezeren G 2005). The same high level of catastrophic hardware failure is not evident in the unit researched. Methods: Sixty-five consecutive patients undergoing the aforementioned surgery were studied. Patients were divided into two main cohorts, namely the “Fracture group” (n=40) consisting of unstable burst fractures and unstable compression fractures; and the “Dislocation group” (n=25) consisting of fracture dislocations and seatbelt-type injuries. The groups reflect similar goals in surgical treatment for the grouped injuries, with reduction in loss of sagittal profile and maintenance thereof being the main aim in the fracture group, appropriately treated with Schantz pin constructs; and maintenance in position only, the goal in the dislocation group, managed with pedicle screw constructs. Data was reviewed in terms of complications, correction of deformity, and subsequent loss of correction with associated instrumentation failure. Secondly, factors influencing the aforementioned were sought, and stratified in terms of relevance. Results: Average follow up was 278 days for the fracture group and 177 days for the dislocation group (all patients included were deemed to have achieved radiological fusion – if fusion technique was employed). There was an average correction in kyphotic deformity of 10.25 degrees. Subsequent loss in sagittal profile averaged 2 degrees (injured level) and 5 degrees (thoracolumbar region) in the combined fracture and dislocation group. The only factor showing a superior trend in loss of reduction achieved was the absence of bone graft (when non-fusion technique was employed). Instrumentation complications occurred in two cases (bent connection rods in a Schantz pin construct with exaggerated loss in regional sagittal profile, and bent Schantz pins). These complications represent a 3.07% hardware failure in total. None of the failures were considered catastrophic. Conclusion: Short segment posterior instrumentation is a safe and effective option in the treatment of unstable thoracolumbar fractures as a standalone measure.

Thesis (MMed)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: OBJECTIVES The aim of this study was to determine long-term renal function in boys presenting with posterior urethral valves at Tygerberg Children’s Hospital and to determine the prognostic value of certain clinical, biochemical and radiological variables DESIGN Retrospective, descriptive study of boys diagnosed and treated with posterior urethral valves at Tygerberg Children’s Hospital between 2001 and 2011. RESULTS Between 2001 and 2011, 47 cases of posterior urethral valves were diagnosed and treated at our institution. Thirteen patients were excluded from this study. Seven (20,6%) were diagnosed antenatally and 27 (79,4%) presented postnatally. Mean age at presentation was 13,9 months (median 2; range 0-74). The most common postnatal presentation was urinary tract infection (51,9%). Mean follow-up was 54,2 months (median 47,5; range 12-133). A total of 13 boys (38,2%) progressed to chronic renal failure or end-stage renal disease. Initial and nadir serum creatinine, poor corticomedullary differentiation and moderate-severe hydronephrosis were significant predictors of final renal function (p<0,050). Patient age at presentation, type of primary surgical intervention, increased renal echogenicity, bladder wall thickness, the presence of vesicoureteric reflux (no matter what the laterality or severity), severe bladder dysfunction and initial or breakthrough urinary tract infection had no significant impact on future renal function. Receiver operating characteristic curve analysis confirmed that boys with an initial serum creatinine ≥145μmol/L and a nadir serum creatinine ≥62μmol/L were at highest risk to develop chronic renal insufficiency (area under the curve 0,8 and 0,9, respectively). CONCLUSION More than a third of boys (38,2%) developed chronic renal failure or end-stage renal disease at the end of follow-up. Our data confirmed the high prognostic value of initial and nadir serum creatinine. Optimal threshold levels for initial and nadir serum creatinine to predict final renal function were 145μmol/L and 62μmol/L, respectively. Similarly, poor corticomedullary differentiation and moderate-severe hydronephrosis on initial kidney ultrasound were significant indicators of poor renal prognosis. Although all patients with posterior urethral valves should be counselled on potential renal morbidity, children with risk factors warrant closer monitoring. / AFRIKAANSE OPSOMMING: DOELWITTE Die doel van hierdie studie was om langtermyn nierfunksie te bepaal in seuns wat gediagnoseer is met posterior uretrale kleppe by Tygerberg-kinderhospitaal. Die prognostiese waarde van sekere kliniese, biochemiese en radiologiese veranderlikes is ook ondersoek. STUDIE ONTWERP Retrospektiewe, beskrywende studie van seuns wat tussen 2001 en 2011 by Tygerberg-kinderhospitaal gepresenteer het met posterior uretrale kleppe. RESULTATE Tussen 2001 en 2011 is 47 gevalle van posterior uretrale kleppe gediagnoseer en behandel by ons instelling. Dertien pasiënte is uitgesluit van hierdie studie. Sewe (20,6%) is met voorgeboorte sonar gediagnoseer en 27 (79,4%) het ná geboorte gepresenteer. Die gemiddelde ouderdom by diagnose was 13,9 maande (mediaan 2; reeks 0-74 ). Urienweginfeksie was die mees algemene metode waarmee postnatale pasiënte gepresenteer het (51,9%). Die gemiddelde opvolgperiode was 54,2 maande (mediaan 47,5; reeks 12-133). Dertien seuns (38,2%) het chroniese nierversaking of eind-stadium nierversaking ontwikkel. Aanvanklike en nadir serumkreatinien, swak kortiko-medullêre differensiasie en matig-erge hidronefrose was beduidende voorspellers van finale nierfunksie (p<0,050). Pasiënt ouderdom met diagnose, tipe chirurgiese ingryping, verhoogde niereggogenisiteit, blaaswanddikte, vesikoureteriese refluks, blaasdisfunksie en aanvanklike of deurbraak urienweginfeksies het geen beduidende impak op toekomstige nierfunksie gehad nie. Seuns met 'n aanvanklike serumkreatinien ≥145μmol/L en 'n nadir serumkreatinien ≥62μmol/L het die grootste risiko om chroniese nierversaking te ontwikkel, soos bevestig met ‘n ROC-ontleding (AUC 0,8 en 0,9, onderskeidelik). GEVOLGTREKKING Meer as 'n derde van die pasiënte (38,2%) het chroniese nierversaking of eindstadium nierversaking ontwikkel. Ons data bevestig die prognostiese waarde van aanvanklike en nadir serumkreatinienvlakke. Die optimale drempelwaardes vir die aanvanklike en nadir serumkreatinien om finale nierfunksie te voorspel was 145μmol/L en 62μmol/L, onderskeidelik. Swak kortiko-medullêre differensiasie en matig-erge hidronefrose op die aanvanklike niersonar was ook beduidende aanwysers van toekomstige nierfunksie. Alhoewel alle pasiënte met posterior uretrale kleppe berading moet ontvang oor potensiële niermorbiditeit, regverdig seuns met risikofaktore noukeurige monitering.

OBJETIVO: Comparar los hallazgos clínicos y la RMN con la artroscopia para el diagnóstico de las lesiones de rodilla en los pacientes atendidos en el hospital militar central entre 2011-2016. METODOLOGÍA: Estudio retrospectivo, descriptivo y analítico con naturaleza observacional, no experimental. El universo de 1400 pacientes atendidos en el Hospital Militar Central 2011-2016, pasaron por examen clínico (EF), Resonancia Magnética (RMN) y artroscopia en rodilla afectada. Se usaron pruebas de validez diagnostica, sensibilidad (S), especificidad (E), de seguridad diagnostica, valor predictivo positivo (VPP) y negativo (VPN), prueba de X2 y curva ROC. RESULTADOS: RMN tiene (S) 94,9%vs81,6%, (E) 72,6%vs70%, (VPP) 81,2%vs77,2% y (VPN) 91,9%vs75,3% comparado con EF de meniscopatía medial (MM). En el diagnóstico de meniscopatía lateral (ML), RMN tiene (S) 81,2%vs78,1%, (E) 71,5%vs70,1%, (VPP) 77,4%vs75,9% y (VPN) 76%vs72,8% comparado con EF. En lesión de ligamento cruzado anterior (LCA), EF tiene (S) 69,8%vs63,5%, (E) 82%vs78,3%, (VPP) 66,5%vs60% y (VPN) 84,1%vs80,7% comparada con RMN. Y en lesión de ligamento cruzado posterior (LCP), la RMN tiene (S) 91,7%vs83,3% del EF, (E) en el EF 99,3%vs99,1% de la RMN, (VPP) 50%vs47,8% de la RMN y (VPN) equitativo de 99,9% en ambos pruebas. CONCLUSIONES: RMN presenta más (S), (E), (VPP) y (VPN) que en EF, en comparación a los hallazgos artroscópicos para diagnosticar MM, ML y lesión de LCP caso contrario en el LCA donde el EF prevalece sobre la RMN.

Background: To evaluate the toric intraocular lens (IOL) calculation considering posterior corneal astigmatism, incision-induced posterior corneal astigmatism, and effective lens position (ELP). Methods Two thousand samples of corneal parameters with keratometric astigmatism >= 1.0 D were obtained using boot-strap methods. The probability distributions for incision-induced keratometric and posterior corneal astigmatisms, as well as ELP were estimated from the literature review. The predicted residual astigmatism error using method D with an IOL add power calculator (IAPC) was compared with those derived using methods A, B, and C through Monte-Carlo simulation. Method A considered the keratometric astigmatism and incision-induced keratometric astigmatism, method B considered posterior corneal astigmatism in addition to the A method, method C considered incision-induced posterior corneal astigmatism in addition to the B method, and method D considered ELP in addition to the C method. To verify the IAPC used in this study, the predicted toric IOL cylinder power and its axis using the IAPC were compared with ray-tracing simulation results. Results The median magnitude of the predicted residual astigmatism error using method D (0.25 diopters [D]) was smaller than that derived using methods A (0.42 D), B (0.38 D), and C (0.28 D) respectively. Linear regression analysis indicated that the predicted toric IOL cylinder power and its axis had excellent goodness-of-fit between the IAPC and ray-tracing simulation. Conclusions The IAPC is a simple but accurate method for predicting the toric IOL cylinder power and its axis considering posterior corneal astigmatism, incision-induced posterior corneal astigmatism, and ELP.