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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
101

Análise dos ruídos das articulações temporomandibulares e da atividade eletromiográfica de músculos mastigatórios em crianças submetidas ao tratamento da mordida cruzada posterior funcional / Analysis of the temporomandibular joint noise and the electromyographic activity of masticatory muscles in children submitted to functional posterior crossbite treatment

Pimentel, Diego Jesus Brandariz 28 November 2017 (has links)
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.
102

Efecto de la NIC 16 en la valuación de los activos fijos su impacto financiero en las empresas del sector transporte (de carga) fluvial en la Ciudad de Iquitos en el 2017

Costilla Fernández, Elizabeth Milagros, Valverde Alcoser, Maricarmen Octavia 25 June 2019 (has links)
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
103

Biomechanical Analysis of Stability of Posterior Antiglide Plating in Osteoporotic Pronation Abduction Ankle Fracture Model With Posterior Tibial Fragment

Hartwich, Kathleen, Gomez, Alejandro Lorente, Pyrc, Jaroslaw, Gut, Radosław, Rammelt, Stefan, Grass, René 29 October 2019 (has links)
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.
104

Bayesian Model Checking Methods for Dichotomous Item Response Theory and Testlet Models

Combs, Adam 02 April 2014 (has links)
No description available.
105

The functional locus of emotion effects in visual word processing

Palazova, Marina 11 March 2013 (has links)
Die emotionale Valenz von Wörtern beeinflusst deren kognitive Verarbeitung. Ungeklärt ist, obwohl von zentraler Bedeutung für die Disziplinen der Psycholinguistik und der Neurowissenschaften, die Frage nach dem funktionellen Lokus von Emotionseffekten in der visuellen Wortverarbeitung. In der vorliegenden Dissertation wurde mit Hilfe von Ereignis-korrelierten Potentialen (EKPs) untersucht, ob emotionale Valenz auf lexikalischen oder auf semantischen Wortverarbeitungsstufen wirksam wird. Vorausgegangene Studien weisen auf einen post-lexikalischen Lokus von Emotionseffekten hin, wobei einige wenige heterogene Befunde von sehr frühen Emotionseffekten auch einen lexikalischen Lokus vermuten lassen. In der vorliegenden Arbeit wurden drei emotions-sensitive EKP Komponenten beobachtet, die distinkte zeitliche und räumliche Verteilungen aufwiesen, und daher verschiedene Wortverarbeitungsstufen zu reflektieren scheinen. Die Ergebnisse wurden im Rahmen von allgemeinen Annahmen aktueller Wortverarbeitungs- und semantischer Repräsentationsmodelle diskutiert. Als zentrales Ergebnis kann benannt werden, dass Emotion am stärksten semantische Wortverarbeitungsstufen beeinflusste. Hieraus wurde geschlussfolgert, dass emotionale Valenz einen Teil der Wortbedeutung darstellt. Eine Interaktion mit einem lexikalischen Faktor sowie sehr frühe Emotionseffekte deuten auf einen zusätzlichen Lokus auf lexikalischen oder sogar perzeptuellen Wortverarbeitungsstufen hin. Dies bedeutet, Emotion veränderte die visuelle Wortverarbeitung auf multiplen Stufen, dabei konnten separate emotions-sensitive EKP Komponenten, die unterschiedlichen Randbedingungen unterliegen, mit jeweils einem frühen (pre-)lexikalischen und einem späten semantischen Lokus in der Wortverarbeitung in Verbindung gesetzt werden. Die Befunde stützen Wortverarbeitungsmodelle, die zeitlich flexible und interaktive Wortverarbeitungsstufen annehmen. / Emotional valence of words influences their cognitive processing. The functional locus of emotion effects in the stream of visual word processing is still elusive, although it is an issue of great importance for the disciplines of psycholinguistics and neuroscience. In the present dissertation event-related potentials (ERPs) were applied to examine whether emotional valence influences visual word processing on either lexical or semantic processing stages. Previous studies argued for a post-lexical locus of emotion effects, whereas a lexical locus has been indicated by a few heterogeneous findings of very early emotion effects. Three emotion-related ERP components were observed that showed distinct temporal and topographic distributions, and thus seem to reflect different processing stages in word recognition. Results are discussed within a framework of common assumptions from word recognition and semantic representation models. As a main finding, emotion impacted most strongly semantic processing stages. Thus, emotional valence can be considered to be a part of the meaning of words. However, an interaction of emotion with a lexical factor and very early emotion effects argued for an additional functional locus on lexical, or even on perceptual processing stages in word recognition. In conclusion, emotion impacted visual word processing on multiple stages, whereas distinct emotion-related ERP components, that are subject to different boundary conditions, were associated each with an early (pre-)lexical locus or a late semantic locus. The findings are in line with models of visual word processing that assume time-flexible and interactive processing stages, and point out the need for integration of word recognition models with models of semantic representation.
106

Visuell evozierte Flussgeschwindigkeitänderungen in der A. cerebri posterior bei Normalprobanden und Patienten mit Leitungsverzögerungen im Sehbahnbereich / eine Untersuchung mit der funktionellen transkraniellen Dopplersonographie

Guhr, Susanne 24 July 2002 (has links)
In der vorliegenden Arbeit werden am Beispiel visuell evozierter Flussgeschwindigkeitsänderungen die Anpassung der zerebralen Hämodynamik an Änderungen der Gehirnaktivität untersucht. Dazu wurde das nichtinvasive Verfahren der transkraniellen Dopplersonographie angewendet. Ziele der Arbeit waren das Erstellen von Normwerten der Latenzen und Amplituden visuell evozierter Geschwindigkeitsänderungen an einer Gruppe von Normalprobanden sowie die Prüfung der Sensitivität der zeitlichen Auflösung dieses Verfahrens. Die Untersuchungen wurden an einer Gruppe von 20 Normalprobanden und an einer Gruppe von 16 Patienten, welche eine Leitungsverzögerung im vorderen Sehbahnbereich (nachgewiesen mit den Visuell Evozierten Potentialen anhand der P100) zeigten, vorgenommen. Die Lichtstimulation erfolgte mit einer LED-Blitzbrille und einer Stimulationszeit von jeweils 10 s "on" und "off" mit einer Frequenz von 15 Hz bei konstanter Lichtintensität. In der Kontrollgruppe ermittelten wir einen reaktiven Geschwindigkeitsanstieg von 16 %. Der Anstieg der Flussgeschwindigkeit erfolgte nach 1,4 s bzw. nach 1 s bei Flussantworten, die gleich mit einem Anstieg der Geschwindigkeit begannen. Das initiale Maximum wurde nach 5,6 s erreicht, 2,9 s nach Stimulationsende begann die Geschwindigkeit wieder abzufallen. Außer bei den Latenzwerten bis zum Anstieg ohne vorherigen Abfall der Flussgeschwindigkeit gab es keine signifikanten Unterschiede zwischen den beiden untersuchten Gruppen. Die von uns ermittelten Werte lagen in den Größenordnungen der Ergebnisse anderer Studien mit ähnlichem Versuchsaufbau. Auch die unterschiedlichen Verläufe der Flussantworten wurden bis auf das "initiale undershoot" auch von anderen Autoren beschrieben. Als Erklärung dafür diskutierten wir Aktivierungen anderer Hirnareale und eine Umverteilung des Blutflusses dorthin zu Beginn. Die zeitliche Auflösung der Dopplersonographie ist gut geeignet zeitliche Abläufe der zerebralen Hämodynamik zu untersuchen. Sie ist aber nicht sensitiv genug Leitungsverzögerungen im vorderen Sehbahnbereich zu erfassen. Die Möglichkeiten der Anwendung in der klinischen Routine liegen daher in der Untersuchung von Störungen der neurovaskulären Kopplung. / In this paper we present an investigation about the adaption of the cerebral hemodynamic to changing of the brain activation at the example of visual evoked blood flow response. Therefore we used the transcranial Doppler sonography as a noninvasive method. The aim of the work was to determine normal values of the latencies and amplitudes of visual evoked flow changing and to investigate the sensitivity of the temporal resolution of this method. We examined a group of 20 healthy volunteers and a group of 16 volunteers who had a conduction disturbance in the anterior part of the visual pathway (shown with a prolongation of the latency P100 in the visual evoked potentials). The light stimulation was performed with a LED-goggle and a stimulation time each of 10 s "on" and "off" with a frequency of 15 Hz and constant light intensity. We found a reactive increase of the flow velocity of 16% in the control group. The increase begun after a latency of 1,4 s and 1s respectively in this cases who had an increase of flow velocity at the beginning of the flow response. The initial maximum was reached after 5,6 s. Flow velocity begun to decrease 2,9 s after end of light stimulation. There were no significant differences between both groups except for the latencies with increase of flow velocity at the beginning but without initial decrease. Our values were comparable to the values of other studies with similar experimental conditions. Similar patterns of the flow response were described except of the phenomen of the "initial undershoot". We discussed activation of other areas of the brain and a distribution of blood flow there as an explanation. The time resolution of the functional Doppler sonography is suitable to investigate the time course of the cerebral hemodynamic. But it is not sensitive enough to get conduction disturbances in the anterior part of the visual pathway. The method might be used to investigate disturbances in the neurovascular coupling.
107

Thoracolumbar injuries : short segment posterior instrumentation as standalone treatment - thoracolumbar fractures

Davis, Johan, H. 12 1900 (has links)
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.
108

Factors predicting the long-term renal function in boys presenting with posterior urethral valves at Tygerberg Children's Hospital, South Africa : a ten year study / Prognostic factors in boys with posterior urethral valves

De Wet, Matthys Johannes 04 1900 (has links)
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.
109

Comparación entre los hallazgos clínicos y resonancia magnética nuclear con la artroscopia en pacientes con lesiones de rodilla en el Hospital Militar Central entre los años 2011-2016

Reyes Rupa, Renzo Jeanpaul January 2017 (has links)
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.
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Development of a program for toric intraocular lens calculation considering posterior corneal astigmatism, incision-induced posterior corneal astigmatism, and effective lens position.

Eom, Youngsub, Ryu, Dongok, Kim, Dae Wook, Yang, Seul Ki, Song, Jong Suk, Kim, Sug-Whan, Kim, Hyo Myung 10 1900 (has links)
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.

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