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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.
171

QUALIFICATION OF LOW DOSE HYDRATE INHIBITORS (LDHIS): FIELD CASES STUDIES DEMONSTRATE THE GOOD REPRODUCIBILITY OF THE RESULTS OBTAINED FROM FLOW LOOPS

Peytavy, Jean-Louis, Glénat, Philippe, Bourg, Patrick 07 1900 (has links)
Replacement of the traditional thermodynamic hydrate inhibitors (methanol and glycols) in multiphase applications is highly desirable for Health, Safety & Environment (HSE) considerations and for investment costs savings. Low Dose Hydrate Inhibitors (LDHI) are good candidates to achieve this objective and their interest is growing in the E&P industry. There are two types of LDHI: the Kinetic Hydrate Inhibitors (KHI) and the Anti-Agglomerants (AA) also called dispersant additives. The main challenge with LDHIs is that they require the unprocessed effluents to be produced inside the hydrate stability zone. It is then of the utmost importance to select, qualify and implement properly LDHIs, so that their field deployment is performed with success. But due to the very stochastic nature of the nucleation step, the hydrate crystallisation process leads to very large discrepancies between performances results carried out at lab or pilot scales. In order to overcome this difficulty, we have developed an in-house special protocol which is implemented prior to each qualification tests series. This in-house 15 years old protocol consists in conducting each tests series with a fluids system having previously formed hydrates in a first step but followed by a dissociation step at moderate temperature for a few hours. This paper presents results selected from several field cases studies and obtained from our 80 bara and 165 bara flow loops. They show the very good reproducibility obtained with and without LDHIs. In the case of KHI, where the stochastic nature of the nucleation step is very critical, the results show that the deviation on the “hold time” for a given subcooling is less than 15%. (Revised version of ICGH paper 5499_1)
172

Extracting FMRI Brain Patterns Significantly Related to Behavior via Individual Preprocessing Pipeline Optimization

Spring, Robyn 26 November 2012 (has links)
Background: Functional magnetic resonance imaging (fMRI) can require extensive preprocessing to minimize noise and maximize signal. There is evidence suggesting that fixed-subject preprocessing pipelines, the current standard in fMRI preprocessing, are suboptimal compared to individual-subject pipelines. Aim: We sought to test if individual-subject preprocessing pipeline optimization, compared to fixed, resulted in stronger and more reliable brain-patterns in episodic recognition. Methodology: 27 young healthy controls were scanned via fMRI while performing forced-choice episodic recognition. Several sets of fMRI preprocessing pipelines were tested and optimized in a fixed and individual-subject manner, using methods outlined by Churchill et al. (2011). Results: Individual-subject pipeline optimization, compared to fixed, significantly increased reproducibility, significantly increased the detection of positively and negatively activated voxels, and resulted in a brain-pattern with significant correlation to a task behavioral measure. Conclusions: Individual-subject pipeline optimization, compared to fixed, led to stronger and more reliable brain-patterns that are significantly correlated with behavior.
173

Extracting FMRI Brain Patterns Significantly Related to Behavior via Individual Preprocessing Pipeline Optimization

Spring, Robyn 26 November 2012 (has links)
Background: Functional magnetic resonance imaging (fMRI) can require extensive preprocessing to minimize noise and maximize signal. There is evidence suggesting that fixed-subject preprocessing pipelines, the current standard in fMRI preprocessing, are suboptimal compared to individual-subject pipelines. Aim: We sought to test if individual-subject preprocessing pipeline optimization, compared to fixed, resulted in stronger and more reliable brain-patterns in episodic recognition. Methodology: 27 young healthy controls were scanned via fMRI while performing forced-choice episodic recognition. Several sets of fMRI preprocessing pipelines were tested and optimized in a fixed and individual-subject manner, using methods outlined by Churchill et al. (2011). Results: Individual-subject pipeline optimization, compared to fixed, significantly increased reproducibility, significantly increased the detection of positively and negatively activated voxels, and resulted in a brain-pattern with significant correlation to a task behavioral measure. Conclusions: Individual-subject pipeline optimization, compared to fixed, led to stronger and more reliable brain-patterns that are significantly correlated with behavior.
174

Hand function in children and in persons with neurological disorders : aspects of movement control and evaluation of measurements

Svensson, Elisabeth January 2009 (has links)
Hand function is of great importance in the many daily activities that require well-coordinated hand and arm movements. Measurement of hand function is an essential element in the rehabilitation process, in order to facilitate medical diagnosis and determine developmental stages, functional levels, and the efficacy of treatment interventions. Basic requirements for any measurement used in clinics are that they are easy to use, relevant to the function being assessed, and valid and reliable. When scrutinizing the literature on hand function, important gaps were found with regard to measurement. For example, the reliability of grip strength with the Grippit in children has yet to be determined, and there are few evaluations of hand function measurements in Charcot-Marie-Tooth disease (CMT). Furthermore, laboratory measurements of hand function, which have the potential to provide more detailed information and insight into hand control, such as the role of the cerebellum in reactive grip control – have not been fully explored. The overall aim of the thesis was to achieve more knowledge on hand function; on the evaluation of measurements in different target populations; and on movement control of the hand. In the first study, the aim was to evaluate the test-retest reliability of the peak and sustained grip strength with Grippit in a sample of healthy children (n=58, 6-, 10- and 14-y-olds). This was followed by two studies examining hand function in an adult sample (n=20) diagnosed with CMT. The test-retest reliability of grip and pinch strength using Grippit, sensation with the Shape Texture Identification test (STI) and dexterity with the Box and Block Test (BBT) and Nine-Hole Peg test (NHP) were studied. The impact of the disease on daily life, measured with the Disability of the Arm, Shoulder and Hand questionnaire (DASH), and correlations between disability and various aspects of hand function, were also explored in this condition. The aim of the fourth study was to examine grip force response to unpredictable loadings of an object held in a pinch grip in subjects (n=9, 22-48 yrs) who had been diagnosed with a cerebellar lesion, compared with a healthy control group (n=11). The first study showed that test-retest reliability was good for both peak and sustained grip strength in healthy children. The mean and best of three trials were equally reliable, but differences in reliability were detected within different age groups. For example, the peak grip strength, best of three trials, was more reliable for the 6-y-olds (intraclass correlation coefficient (ICC)=0.96, standard error of measurement in percentage (SEM%)=6.3) and 14-y-olds (ICC=0.96, SEM%=5.2) compared with the 10-y-olds (ICC=0.78, SEM%=12.5). In the second study, evaluating measurements of hand function in subjects with CMT, grip strength proved to be reliable (ICC=0.99, coefficient of repeatability (CR)=26.7 N, coefficient of variation (CV)=6.6 %), but pinch strength was less reliable. The reliability was also good for the BBT (ICC=0.95, CR=11.5 blocks/min, CV=8.4%) and the NHP (ICC=0.99, CR=4.3 s, CV=3.9 %). However, a bias towards higher values was noted on the second test occasion with the BBT. The reliability of the STI test (kappa=0.87) was also very good in subjects with CMT. A limitation in this latter test was noted in terms of its ability to describe subjects either performing very well or very poorly. The results of the third study showed that hand function in CMT was reduced (p<0.001) to about 60% of that in healthy controls in each of the separate outcome measures, as well as by a constructed summary index of hand function. The median DASH score was 38.8 (range 0-66.7) and was clearly related to hand function (r=0.64-0.83). The results of the final study in subjects with cerebellar lesions showed that the ipsilateral hand had delayed and more variable response latencies e.g. 278±166 ms for loads delivered at 2 N/s, compared with healthy subjects (HS) 80±53 ms (p=0.005). The cerebellar subjects also used a higher pre-load grip force with the ipsilateral hand (1.6±0.8 N) than the HS (1.3±0.6 N (p=0.017)). Even the contralateral hand in subjects with unilateral cerebellar stroke showed a delayed onset of the grip response. In conclusion: Grip strength assessment in children with Grippit results in good reliability for peak and sustained grip strength, although the 10-y-olds were less reliable. In CMT the tested instruments can all be used to evaluate hand function, but certain factors, such as the number of trials used should be taken into consideration. The CMT subjects’ hand function was reduced and correlated with their self-experienced disability. However, clinicians should be aware that patients might score lower than expected on DASH, possibly due to a long process of adaptation. Cerebellar lesions can impair the reactive grip control in both the ipsilateral and the contralateral hand. These investigations have thus, as intended increased the knowledge of hand function. The studies have evaluated some measurements in different samples, which will help clinicians testing hand function.
175

Pressure sores : risk assessment and prevention /

Lindgren, Margareta, January 2003 (has links) (PDF)
Diss. (sammanfattning) Linköping : Univ., 2003. / Härtill 4 uppsatser.
176

Avaliação da reprodutibilidade dos parâmetros de adequação da hemodiálise crônica / Evaluation of reproducibility of adequacy Parameters in chronic hemodialysis

Manente, Marislei January 2002 (has links)
Justificativa: Doses inadequadas de diálise estão associadas a maior morbidade e mortalidade em pacientes com uremia terminal em tratamento hemodialítico. Atualmente os métodos mais utilizados para medir a adequação da hemodiálise baseiam-se no cálculo da depuração fracional de uréia (Kt/V) e da taxa de redução da uréia (URR). Nesse estudo avaliou-se a reprodutibilidade do Kt/V e da URR e analisou-se o número aceitável de medidas mensais destes parâmetros para determinar de forma fidedigna a adequação da hemodiálise. Métodos: Avaliamos 43 pacientes clinicamente estáveis, em cinco sessões de hemodiálise (sessões 1 a 5), durante três semanas. Três diálises consecutivas na primeira semana (sessões 1, 2, 3) e duas sessões de meio de semana, nas duas semanas subseqüentes (sessões 4 e 5). Resultados: Não houve diferença entre a média dos Kt/Vs obtidos em diálises seqüenciais (1, 2 e 3) comparada a média dos Kt/Vs obtidos em diálises no meio da semana (2, 4 e 5). O mesmo aconteceu com a URR e com os coeficientes de variação do Kt/V e da URR. Também não encontramos diferença entre uma medida mensal (Kt/V 2) e três medidas mensais (média dos Kt/Vs 2, 4 e 5). O mesmo ocorreu com a URR. A diferença entre o Kt/V 2 e a média dos Kt/Vs 2, 4 e 5 foi de – 0,02 unidades e entre a URR 2 em relação a média das URRs 2, 4 e 5 foi de – 0,5%. Além disso, se fizermos apenas uma medida mensal (Kt/V 2) 80% dos pacientes estarão a uma distância de no máximo 0,16 unidades abaixo da média dos Kt/Vs 2, 4 e 5 e no máximo 0,12 unidades acima. Em relação a URR 80% dos pacientes estarão a uma distância de no máximo 4,37% abaixo da média das URRs 2, 4 e 5 e no máximo 3,37% acima. O grau de concordância entre o Kt/V 2 e a média dos Kt/Vs 2, 4 e 5 é bom para pontos de corte do Kt/V igual ou superior a 1,3. No caso da URR a concordância é boa para pontos de corte acima de 65%. Conclusão: Concluímos que nesta população de pacientes clinicamente estáveis os parâmetros de adequação da hemodiálise mostraram-se reprodutíveis não havendo necessidade de aumentar o número de medidas mensais da quantidade de diálise ofertada. / Background: Inadequate doses of dialysis are associated with higher morbidity and mortality rates for end-stage renal disease (ESRD) patients undergoing hemodialysis treatment. Most methods aimed at measuring dialysis adequacy use the calculation of fractional clearance of urea (Kt/V) and urea reduction ratio (URR). This study evaluates the reproducibility of Kt/V and URR and analyzes the acceptable number of monthly measurements of these parameters to determine hemodialysis adequacy. Methods: We evaluated 43 clinically stable patients in five hemodialysis sessions (1 to 5) along three weeks. Three consecutive sessions were carried out in the first week (1, 2, 3), while the two other studied sessions were carried out in the middle of the week at weekly intervals (4, 5). Results: There was no difference between mean Kt/V in sessions 1, 2, and 3 and in sessions 2, 4, and 5. The same was observed for URR and the coefficients of variation for Kt/V and URR. Either differences were found between one monthly measurement (2) or three monthly measurements (mean of 2, 4, and 5) for Kt/V and URR. The difference between Kt/V 2 and the arithmetic mean of Kt/Vs 2, 4, and 5 was – 0.02 units, and between URR 2 and the mean of URRs 2, 4, and 5 was – 0.5%. When only one monthly measurement (Kt/V 2) was considered, 80% of the patients presented ≤0.16 unit below or ≤0.12 above the mean of Kt/Vs 2, 4, and 5. For URR, 80% of patients presented ≤4.73% below or ≤3.37% above the arithmetic mean of URRs 2, 4, and 5. The degree of agreement between Kt/V 2 and the mean of Kt/Vs 2, 4 and 5 is good for Kt/Vs of 1.3 or higher. URR agreements are good for URR of 65% or higher. Conclusion: In this population, hemodialysis adequacy parameters were reproducible, and an increase in the number of monthly measurements seems not to be necessary.
177

Avaliação da qualidade de vida em cardiopatia isquêmica : validação de instrumentos para uma população brasileira

Franzen, Elenara January 2005 (has links)
Objetivos: validar versões em português do Short Form Health Survey (SF-36) e do Seattle Angina Questionnaire (SAQ) para avaliação de qualidade de vida em pacientes brasileiros com cardiopatia isquêmica. Métodos: estudo transversal com instrumentos traduzidos e aplicados em dois grupos: em 200 pacientes ambulatoriais com cardiopatia isquêmica estável em dois momentos, com intervalo de 14 dias; e em 50 pacientes antes e 30 dias após a angioplastia. Classe funcional foi avaliada pelo Specific Activity Scale. Testes de correlação intraclasse, Cronbach α e Wilcoxon foram utilizados. Resultados: os participantes dos dois grupos apresentaram características clínicodemográficas semelhantes, sendo a taxa de resposta de 78% e 76% no reteste. Reprodutibilidade dos instrumentos (coeficiente α de Cronbach) variou de 0,70 a 0,90 e 0,62 a 0,79 para os domínios do SF-36 e do SAQ, respectivamente. Estabilidade dos instrumentos em 14 dias (coeficiente de correlação intraclasse) foi >0,68 e >0,49 para os domínios do SF-36 e SAQ. No quesito responsividade, o SF-36 demonstrou melhora nos domínios capacidade funcional (10,5), dor (16,5), vitalidade (13,5), aspecto social (10,1) e saúde mental (9,8); e no SAQ, nos domínios estabilidade (41,1) e freqüência (27,3) da angina e percepção da doença (12,0). Os domínios do SF-36 e do SAQ, exceto um, foram consistentemente relacionados à classe funcional. Conclusão: as versões traduzidas dos instrumentos mostraram desempenho adequado sem diferenças entre si, sugerindo serem reprodutíveis, responsivas e válidas para a avaliação da qualidade de vida em pacientes com cardiopatia isquêmica no Brasil. / Objectives: To validate Portuguese-language versions of the Short Form Health Survey (SF-36) and of the Seattle Angina Questionnaire (SAQ), for the evaluation of quality of life in Brazilian patients with ischemic heart disease. Methods: Cross-sectional study using instruments translated and applied to two groups: 200 outpatients with stable ischemic cardiomyopathy at two points in time- 14-day interval; and 50 patients pre and 30 days post angioplasty. Functional class was evaluated by the Specific Activity Scale. Intra-class correlation, Cronbach’s alpha and Wilcoxon tests were used. Results: The participants in both groups presented similar clinical-demographic characteristics, and the rate of response in the retest was 78% and 76%. Reproducibility of the instruments (Cronbach alpha coefficient) varied from 0.70 to 0.90 and 0.62 to 0.79 for the SF-36 and SAQ domains, respectively. Stability of instruments in 14 days (intraclass correlation coefficient) was ≥0.68 and ≥0.49 for the SF-36 and SAQ domains. For the responsiveness item, SF-36 showed improvement in the domains physical functioning (10.5), bodily pain (16.5), vitality (13.5), social functioning (10.1) and mental health (9.8); and in SAQ in those concerning stability (41.1) and frequency (27.3) of angina and disease perception (12.0). The SF-36 and SAQ domains except one were consistently related to functional class. Conclusion: The translated versions of the instruments showed an adequate performance without differences amongst them, suggesting that they are reproducible, responsive and valid to evaluate quality of life in ischemic heart disease patients in Brazil.
178

Reprodutibilidade e comparação de diferentes métodos de avaliação de restaurações de resina composta em dentes posteriores

Podestá Rodriguez, Karina January 2007 (has links)
O objetivo deste estudo foi comparar diferentes métodos de avaliação de restaurações de resina composta em dentes posteriores, assim como avaliar a concordância intra-examinador. Cento e trinta e seis restaurações oclusais de resina composta foram avaliadas por um examinador treinado usando os critérios modificados do USPHS para avaliar quatro características das restaurações: integridade marginal, forma anatômica, descoloração marginal e textura superficial. Três métodos diferentes foram estudados: clínico, fotográfico e modelos. A reprodutibilidade intra-examinador foi medida através do teste de Kappa e a comparação de métodos através dos testes não-paramétricos de Fischer e Wilcoxon. Os resultados mostraram que os valores de concordância intra-examinador foram melhores na avaliação de integridade marginal e forma anatômica através de modelos, e os valores foram similares entre a avaliação clínica e fotográfica para integridade marginal e descoloração marginal. A textura superficial apresentou os valores mais baixos de concordância intra-examinador para todos os métodos examinados. O método direto foi significantemente diferente que os métodos indiretos para todas as características avaliadas (p< 0,05). Entretanto, quando os métodos foram avaliados segundo a aceitabilidade clínica considerada pelo USPHS, os métodos não foram diferentes. Os métodos fotográfico e modelos detectaram defeitos que não foram percebidos pelo método clínico na avaliação da integridade marginal e da forma anatômica. As avaliações através de fotografias e modelos foram semelhantes em todas as características avaliadas com exceção da textura superficial (p< 0,05). Todos os métodos mostraram ser inadequados para a avaliação de textura superficial. Houve diferenças significativas entre o método direto e os métodos indiretos. Os métodos indiretos permitiram realizar observações mais detalhadas e críticas. Entretanto, o método clínico mostrou ter capacidade para diferenciar entre restaurações clinicamente aceitáveis e não-aceitáveis. / The aim of this study was to compare different methods for evaluating composite resin restorations in posterior teeth and to evaluate the reproducibility of each method by determining the intraexaminer agreement. One hundred and thirty six occlusal composite resin restorations were evaluated by a trained examiner using modified USPHS criteria to assess four restoration characteristics: marginal integrity, anatomic form, marginal discoloration and surface texture. Three different methods were studied: clinical, photographic and dental cast models. Kappa statistics was used to determine reproducibility and non-parametric Friedman and Wilcoxon tests to compare the methods. The results showed that the best intraexaminer agreement values were obtained for dental cast models evaluations for marginal integrity and anatomic form and were similar between photographic and clinical evaluations for marginal integrity and marginal discoloration. Surface texture showed the lowest degree of intraexaminer agreement with all the methods tested. Direct clinical method and the two indirect methods were significantly different for all the characteristics assessed (p< 0.05). However, when they were evaluated according to USPHS clinical acceptability, the methods did not differ. Photographs and dental cast models methods detected defects that the direct clinical method could not distinguish for marginal integrity and anatomic form. Photographs and dental cast models evaluations were similar for all the characteristics assessed, except for surface texture (p< 0.05). All the methods showed that they are not adequate to evaluate surface texture. There were significant differences between the direct clinical method and the indirect methods for all the composite resin restorations characteristics assessed. The indirect methods allowed more detailed and critical observations. However, the direct clinical method was able to distinguish between clinical acceptable and unacceptable restorations.
179

From cellular variability to shape reproducibility : mechanics and morphogenesis of Arabidopsis thaliana sepal / De la variabilité cellulaire à la reproductibilité des organes : étude de la mécanique de la morphogenèse du sépale d'Arabidopsis thaliana

Dumond, Mathilde 15 September 2017 (has links)
Les organismes produisent des organes de formes similaires, malgré une forte variabilité intrinsèque. La régulation de la forme des organes a été largement étudiée, cependant la robustesse des formes est encore mal comprise. Une plante telle qu’Arabidopsis possède de nombreux sépales, notre système modèle car il est possible d’étudier leur variabilité. Comme les cellules végétales contrôlent leur croissance à travers les propriétés mécaniques de leur paroi, ma thèse vise à étudier le lien entre mécanique cellulaire et robustesse des formes.J’ai d’abord cherché à comprendre si la forme des organes est influencée par la réaction cellulaire aux contraintes mécaniques induites par la croissance. J’ai validé cette hypothèse grâce un modèle mécanique, et fait des prédictions de la forme des sépales qui ont été confirmées expérimentalement par un collaborateur.D’autre part, j’ai mesuré les propriétés mécaniques de la paroi qui se révèlent spatialement hétérogènes. L’ajout de cette hétérogénéité dans le modèle conduit à des organes de forme variable. J’ai obtenu des formes robustes en ajoutant de la variabilité temporelle, et j’ai montré que, contre-intuitivement, le niveau de variabilité spatiale est anti-corrélé avec la robustesse des formes.Ces prédictions ont été testés en étudiant un mutant présentant des formes de sépales variables. J’ai en particulier montré que les propriétés mécaniques de ce mutant étaient moins variables spatialement que le sauvage. Ainsi, ma thèse a permis de mieux comprendre la régulation de la robustesse de forme des organes, en particulier en montrant que la variabilité des propriétés mécaniques peut conduire à une robustesse des formes. / Developmental robustness is the ability to produce similar phenotypes despite intrinsic variability.Regulation of organ shape has been widely studied, but regulation of organ shape reproducibility is yet to be elucidated.A. thaliana sepals, flower external organs, can be used to study such robustness : each plant produces more than 60 flowers, allowing variability measurement.Plant cells modulate their surrounding cell wall stiffness and anisotropy to control growth, thus my PhD aims at elucidating the role of cell wall mechanics on organ shape robustness.Cells sense their physical environment and accordingly adjust their cell wall mechanics: we studied whether the strength of this feedback influenced organ shapes. Using a model, I showed that a strong feedback lead to the formation of a pointy sepal tip; this prediction was experimentally validated by a PhD student of the team.Measurements of the cell wall mechanical properties using atomic force microscopy (AFM) showed that they were highly spatially variable. When this variability was added in the model, the organ shapes were variable. To get reproducible shapes, I increased the temporal variability of the mechanics: it smoothed the spatial variability over time. Likewise, decreasing spatial variability reduced organ shape robustness. These theoretical results suggest that spatial and temporal variability influence shape robustness.To experimentally test these results, our collaborators identified a mutant displaying less robust sepal shapes. Using AFM, I showed that the spatial variability was reduced in the mutant, confirming that mechanical spatial variability influenced shape robustness.
180

Alterações torácicas musculoesqueléticas no primeiro ano de vida em crianças nascidas prematuras: fatores associados e importância da fotogrametria para o seu diagnóstico / Thoracic musculoskeletal alterations in the fisrt year of life in infant born premature: factors associated and the importance of photogrammetry for its diagnose

Vieira, Josy Davidson Okida [UNIFESP] 29 April 2009 (has links) (PDF)
Made available in DSpace on 2015-07-22T20:49:19Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-04-29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Objetivo: Determinar a frequência e os fatores associados às alterações torácicas musculoesqueléticas em crianças nascidas prematuras e analisar a acurácia e a reprodutibilidade da fotogrametria para detectar tais alterações. Método: Estudo transversal com crianças no primeiro ano de vida, nascidas de fevereiro/2007 a dezembro/2008, idade gestacional <37 semanas, peso ao nascer <2000g e acompanhadas no Ambulatório de Prematuros da Universidade Federal de São Paulo (UNIFESP). Excluíram-se: malformações, doenças neuromusculares e cromossômicas, hemorragia peri-intraventricular grau III/IV e/ou leucomalácia periventricular. Utilizou-se o exame físico para determinar frequência e fatores associados às alterações torácicas e como padrão de referência para análise de acurácia, por curva ROC, do ângulo manúbrio/acrômio/trapézio e da medida da retração costal para detectar, respectivamente, elevação de ombros e retração costal em duas fotografias analisadas em computador. Projeto aprovado pelo Comitê de Ética da UNIFESP, com assinatura do Termo de Consentimento. Resultados: Das 121 crianças com idade gestacional: 31,1+2,8 semanas e peso ao nascer: 1400+338g, 66,9% apresentaram alterações torácicas. À regressão logística, os fatores associados às alterações torácicas foram: idade corrigida (dias): OR: 1,018 (IC95%: 1,004- 1,1019) e dias de oxigenoterapia: OR: 1,096 (IC95%: 1,031-1,164). O ângulo manúbrio/acrômio/trapézio apresentou: acurácia: 0,793, sensibilidade: 71,4%, especificidade: 78,4%, coeficiente de correlação intra e interclasse (CCI): 0,922 e 0,947. A medida de retração costal mostrou: acurácia: 0,895, sensibilidade: 96,6%, especificidade: 75,9%, CCI: 0,841 e 0,838. Conclusões: As alterações torácicas foram freqüentes e se associaram à maior idade corrigida e maior tempo de oxigenoterapia. A fotogrametria apresentou excelente reprodutibilidade e boa acurácia / Objective: To determine the frequency and factors associated with thoracic musculoskeletal alterations in infants born premature and to analyze the accuracy and the reproducibility of photogrammetry to detect these alterations. Methods: Cross sectional study with infants in the first year of life, born from February/2007 to December/2008, with gestational age <37 weeks, birth weight <2000g and followed at the Premature Clinic of the Federal University of São Paulo. Major malformation, intraventricular hemorrhage grade III/IV and/or periventricular leucomalacia were excluded. Physical exam was used as a reference standard to determine the frequency and factors associated with thoracic alterations and for accuracy analysis, by ROC curve. Photographs were analyzed by a computer program to detect shoulder elevation and thoracic retraction by the measurement of manubrium/acromion process/trapezius angle and the greatest thoracic retraction depth. The study was approved by the Ethical Committee of the Institution and parents/guardians signed terms of informed consent. Results: Of 121 studied infants (gestational age: 31.1+2.8 weeks, birth weight: 1400+338g), 81 (66.9%) presented thoracic alterations. By logistic regression, factors associated with thoracic alterations were: days of corrected age (OR=1.018, CI95%: 1.004-1.019) and days on oxygen therapy (OR=1.096, CI 95%: 1.031-1.164). Compared to physical exam, the manubrium/acromion process/trapezius angle presented: accuracy: 0.793, sensitivity: 71.4%, specificity: 78.4%, intraclass and interclass correlation coefficient (ICC): 0.922 and 0.947. The greatest thoracic retraction depth showed: accuracy: 0.895, sensitivity: 96.6%, specificity: 75.9%, (ICC): 0.841 and 0.838. Conclusions: The frequency of thoracic alterations was high and associated with higher corrected age and longer oxygen therapy. The photogrammetry provided an objective, accurate and reliable test to detect thoracic alterations in preterm infants. / TEDE

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