Made available in DSpace on 2015-07-22T20:50:03Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-11-25. Added 1 bitstream(s) on 2015-08-11T03:26:32Z : No. of bitstreams: 1 Publico-549%20-%2011769.pdf: 1027011 bytes, checksum: 549288ebc09400ab5c317f529c1f6f07 (MD5) / Objetivo: Estabelecer parâmetros da superfície palmar para localização precisa do limite proximal da polia flexora A1, nos dedos indicador, médio, anular e mínimo, e avaliar o comprimento dessa polia. Métodos: Foram estudados 280 dedos de 70 mãos de 35 cadáveres frescos, mensurando-se inicialmente a distância entre as pregas digitopalmar e interfalangeana proximal (medida A), seguindo-se com a dissecação dos dedos e mensuração da distância entre o limite proximal da polia A1 e a prega digitopalmar (medida B), bem como o comprimento da polia A1 (medida C), em cada dedo. A análise estatística foi feita com a utilização do teste multivariado “T²” de Hotelling e do teste “t” para amostras pareadas. Resultados: Após a análise estatística, foi constatado que não há diferença significante entre as medidas A e B em cada dedo (p-valor > 0,05). Também não se evidenciou diferença significante (p-valor > 0,05) entre as medidas correspondentes para cada dedo de ambas as mãos (AxA), (BxB) e (CxC). Foi observado que o comprimento médio da polia A1 em milímetros no dedo indicador é de 9,83; no médio, de 10,71; no anular, de 9,66, e, no mínimo, de 8,06. Conclusões: A distância entre as pregas digitopalmar e interfalangeana proximal deve ser usada como referência cutânea da superfície palmar para a localização precisa do limite proximal da polia A1 na palma da mão, dando mais segurança na realização de procedimentos cirúrgicos como a liberação percutânea do “dedo em gatilho”. / Purpose: We conducted this study to establish palmar surface parameters to allow for the exact location of the proximal limit of the flexor tendon A1 pulley in the index, middle, ring and little fingers and to evaluate the length of this pulley. Methods: We studied 280 fingers on 70 hands of 35 fresh human cadavers, initially measuring the distance between the digital-palmar and proximal interphalangeal creases (measure A), followed by dissection of the fingers and measurement of the distance between the proximal limit of the A1 pulley and the digital-palmar crease (measure B) and the length of the A1 pulley (measure C). A statistical analysis was carried out using Hotelling’s multivariate T2 test and the paired samples t-test. Results: No statistically significant difference was found between measures A and B in each finger (p > 0.05). The average length of the A1 pulley, in millimeters, was 9.83 in the index finger, 10.71 in the middle finger, 9.66 in the ring finger, and 8.06 in the little finger. Conclusions: The distance between the digital-palmar and proximal interphalangeal creases should be used as a cutaneous reference of the palmar surface for the exact location of the proximal limit of the A1 pulley in the palm of the hand, ensuring greater safety in surgical procedures such as percutaneous release of trigger finger. / TEDE / BV UNIFESP: Teses e dissertações

The object of this work is to chart an educational process of ambulant patients undergoing a planned arm surgery due to carpal tunnel syndrome or trigger finger and creating a functional educational material that leads to a change of knowledge and skills of those patients and that can be used by nurses during their work. The three questions to achieve the objectives were: 1) How does the educational process of the patient look like before arm surgery? 2) How is the patient educated on post-operative regime? 3) How are the educational activities implemented in patients undergoing arm surgery? The research project was aimed to the qualitative investigation. Generally the research survey was structured into two phases, the results are summarized in the practical part. The first phase was focused on observation of professional object and depth semi-structured interviews with patients who underwent an arm surgery were made. This survey was supplemented by direct structured observation of nurses in the process of educational activities. Six nurses were altogether involved in the survey. In the second phase, the educational material based on the obtained results, was made for the nurses to use during their work. This material includes educational cards and maps of care instructions for given diseases. Effectivnes of this material was subsequently verified by more semi-structured interviews with six patiens. The results of the survey showed that in the workplace where the respondents underwent the surgery, the educatinal process was singificantly eliminated and for its realization the nurses did not have satisfactory conditions, especially time and spatil conditions. During the educatinal process the nurses were using monologues teaching methods. Demonstration and practical methods were missing. Nurses were not using teaching aids that can make the educatinal process more effective. The results of this work can elucidate the educational reality in surgeries and focus attention on this sector, often neglected in expert literature.

Made available in DSpace on 2016-06-02T20:19:22Z (GMT). No. of bitstreams: 1 5713.pdf: 2032376 bytes, checksum: 27f33e21a99dcce73a3151b79bdd57d7 (MD5) Previous issue date: 2014-01-10 / Financiadora de Estudos e Projetos / Myofascial pain, represented by points miofascias trigger (MTrPs), has a high prevalence in healthy adults. However, in the case of children, it is not known very well for its occurrence, and even if she is related to dominance and the sensitivity of these individuals before external stimuli, as occurs in pain assessed by pressure pain threshold (PPT). The objectives of this study were to identify the possible presence of MTrPs in typical children featuring their PPTs in the scapular region, and to verify the relationship between the two variables (MTrPs and PPTs). These results were obtained from healthy adults were also compared. Were selected 35 adults (14 men and 21 women; 23, 43 ± 3.42 years; 1.70 ± 0.10 m; 62.90 ± 10.98 kg) and 35 children (15 boys and 20 girls; 9.14 ± 1.68 years; 1.38 ± 0.10 m; 32.41 ± 7.02 kg), with no history of shoulder pathology or cervical spine. All participants underwent investigation with respect to the presence of MTrPs the shoulder musculature and evaluation of the PPT in the regions of neck, shoulder and anterior tibial, by the standards validated in the literature.The X² test was used to compare the distribution of each muscle in latent trigger points (latent TrPs) between groups. After the analysis of normality, parametric tests (test - Student's t for paired and unpaired) and nonparametric (U-Mann Whitney and Wilcoxon tests) were used to compare the amount of PPTs and latent TrPs between groups and sides. Children showed fewer latent TrPs (0.94 ± 1.34) than adults (2.02 ± 2.18). The upper trapezius muscle was more affected by MTrPs reaching 13 adults on the dominant side. The children had lower PPTs compared to healthy adults (P< 0.05). All PPTs correlated with each other in both groups moderately/high. Only adults showed correlations between the amount of latent TrPs and on both sides in total and PPTs. It is concluded that typical children have fewer and smaller latent TrPs and PPTs compared to healthy adults demonstrated to be more sensitive to pain. The pressure sensitive shoulder correlates with the presence of latent TrPs in asymptomatic adults, in other words, children PPTs are associated with increased presence of latent TrPs pattern lacking in children. / A dor miofascial, representada pelos pontos gatilho miofascias (PGMFs), apresenta elevada prevalência em adultos saudáveis. No entanto, no caso das crianças, não se conhece muito bem a sua ocorrência, e nem se ela está relacionada com a dominância e com a sensibilidade desses indivíduos diante de estímulos externos, como ocorre nas dores avaliadas pelo limiar de dor à pressão (LDP). Os objetivos do presente estudo foram: identificar a possível presença de PGMFs em crianças típicas caracterizando seus LDPs na região da cintura escapular, além de verificar a relação entre ambas as variáveis (PGMFs e LDPs). Também foram comparados estes resultados aos obtidos em adultos saudáveis. Foram selecionadas 35 crianças (15 meninos e 20 meninas; 9,14 ±1,68 anos; 1,38 ±0,10 m; 32,41 ±7,02 kg) e 35 adultos (14 homens e 21 mulheres; 23,43 ±3,42 anos; 1,70 ±0,10 m; 62,90 ±10,98 kg) sem histórico de patologias no ombro ou coluna cervical. Todos os participantes foram submetidos à investigação com relação à presença de PGMFs na musculatura do ombro e à avaliação do LDP nas regiões de pescoço, ombro e tibial anterior, segundo os padrões validados na literatura. O teste X² foi usado para comparar a distribuição dos pontos gatilho latentes (PGLs) em cada músculo entre os grupos. Após a análise de normalidade, os testes paramétricos (Teste-t de Student para dados pareados e para não pareados) e não paramétricos (U-Mann-Whitney e Wilcoxon) foram aplicados para comparar os LDPs e a quantidade de PGLs entre grupos e lados. As crianças apresentaram menor quantidade de PGLs (0,94 ±1,34) do que adultos (2,02 ±2,18). O trapézio superior foi o músculo mais afetado por PGMFs atingindo 13 adultos no lado dominante. As crianças apresentaram menor LDP comparado aos adultos saudáveis (P<0,05). Todos os LDPs correlacionaram entre si em ambos os grupos de forma moderada/alta. Somente os adultos apresentaram correlações entre a quantidade de PGLs em ambos os lados e no total e os LDPs. Conclui-se que crianças típicas apresentam menor quantidade de PGLs e menores LDPs comparado aos adultos saudáveis demonstrando serem mais sensíveis à dor e à pressão. A sensibilidade à pressão no ombro se correlaciona com a presença de PGLs em adultos assintomáticos, ou seja, menores LDPs associam-se com maior presença de PGLs, padrão inexistente nas crianças.

Syftet med denna studie är att diskutera konceptet triggervarning och dess betydelse för litteraturundervisningen i den svenska skolan. Detta har gjorts dels genom en kritisk diskursanalys på 17 utvalda svenska artiklar om triggervarning i undervisningen och dels genom en litteraturanalys av Christina Wahldéns debutroman Kort kjol. Resultatet visade på en förskjutning från sakfrågan ”bör triggervarningar användas i undervisningen?” till vems verklighetsuppfattning som är den sanna samt att det till viss del redan triggervarnas i gymnasieskolor runt om i Sverige även om termen triggervarning inte används.

FundaÃÃo de Amparo à Pesquisa do Estado do Cearà / Essa dissertaÃÃo fala de uma experimentaÃÃo em processo, fundamentada em colaboraÃÃo à distÃncia, envolvendo cinco artistas brasileiros que moram fora do Brasil e eu, residente em Fortaleza. O encontro com o texto âExÃlio e criatividadeâ de VilÃm Flusser à o ponto inicial dessa pesquisa. CecÃlia Almeida Salles e Gilbert Simondon, por sua vez, norteiam a escuta do percurso e os atravessamentos ao longo do processo. No trajeto, a partir dos indÃcios e atenta aos disparos, um experimento artÃstico emerge e se desenvolve no trÃnsito da imobilidade para a mobilidade. A experiÃncia à registrada em um diÃrio biogrÃfico e poÃtico compartilhado com os artistas cocriadores, enquanto anfitriÃes do experimento, recebido como hÃspede. Essa escrita (inventÃrio) à construÃda em paralelo, onde de longe, acompanho os deslocamentos. A viagem vai sendo atravessada por distintas passagens e paisagens, no entanto, questÃes como de exÃlio e estrangeiridade dialogam com o processo criativo. De instabilidades em metaestabilidades, inventam-se caminhos performativos pelos quais observo como sÃo afetados pelo gatilho da criaÃÃo. Relaciono os acontecimentos dessa pesquisa Ãs surpresas e transformaÃÃes movidas pelos processos de individuaÃÃo, bem como as percepÃÃes por estes acendidas - a relaÃÃo com o vestuÃrio, por exemplo, à uma delas. / This dissertation speaks about an experimentation in processes, founded on distance collaboration, envolving five brazilian artists living abroad, and I, in Fortaleza. The encounter with VilÃm Flusserâs text âExile and creativityâ was the inicial point of this research. CecÃlia Almeida Salles and Gilbert Simondon, in turn, have guided the hearing of the path and the crossing lines throughout the process. As I follow the route, attentive to the clues and the triggers, an artistic experiment emerges and is developed in the transit from mobility to immobility. The experience was registered in a poetic and biographic diary shared with the co-criators artists, while hosts of the experiment, received as a guest. This writing (inventory) was built in parallel, where, from a distance I followed the shiftings. The journey had been crossed over by diverse landscapes and passages, however, questions about exile and foreingnness dialogued with the creative process. From instabilities by metastabilities, performativives ways have been invented, by wich, I observe how they are affected by the creative impulse. I relate the research events to the transformations and outcomes revealed by the processes of individuation, as well as the perceptions lightened by them â the relation with clothing, for example, is one of them.

Avaliou-se a eficácia do tratamento através da técnica de agulhamento a seco, com injeção de lidocaína a 0,5% e injeção de lidocaína a 1% em pacientes portadores de dor miofascial e na presença de pontos-gatilho em músculos da mastigação. Foram selecionados 26 pacientes e divididos em três grupos: Grupo I: pacientes submetidos a injeção de lidocaína a 0,5%. Grupo II: Pacientes submetidos à injeção de lidocaína a 1%. Grupo III: Pacientes submetidos ao agulhamento a seco. Avaliou-se os pacientes através do limiar de dor a palpação (LDP) e da escala de análise visual de dor (EAV) nos períodos: inicial (antes da infiltração), imediatamente após a infiltração, 24 horas depois, 7, 15, 21 e 30 dias respectivamente. Os resultados foram coletados e analisados através do teste anova a 2 critérios adotando-se nível de significância de 0,05%. Onde houve diferenças estatísticas significantes, aplicou-se o Teste de Tukey. Não houve diferenças estatísticas significantes entre os três grupos quando comparados o LDP entre os grupos, porém houve diferenças significantes quando comparado o LDP ao longo do tempo, sendo que este aumentou significativamente. Em relação à EAV, acharam-se diferenças tanto entre os grupos quanto ao longo do tempo, sendo que o grupo X teve uma diminuição mais rápida do que os outros dois. Porém, ao final, todos os grupos tiveram reduções significantes e sem diferenças entre si. Conclui-se que todos os tratamentos foram eficazes na redução dos sintomas da dor miofascial no tempo avaliado, não havendo diferenças entre os tratamentos. / The purpose of this study was to compare the effectiveness of trigger points injections using lidocaine 0,5%, lidocaine 1% and dry needling without any kind of home-based rehabilitation program. 26 patients with myofascial pain and trigger points in masticatory muscles. They were randomly assigned in three groups and received only one application session. The pressure pain threshold (PPT) was recorded before the injection, ten minutes after, 24 hours later, 7, 15, 21 end 30 days after the treatment. Visual analogue scale (VAS) was used to in all evaluation periods. There were no differences between groups for PPT. but for all groups, the PPT during the time significantly increased when compared the before treatment. VAS showed differences between groups and during the time. VAS was significant lower when compared 30 days to before treatment. Among the groups, 0,5% lidocaine ha the lowest VAS values when compared to the others, but at 30 days there were no differences among them. Despite the differences in VAS and considering there were no differences in PPT increases, we concluded that, in this study, all groups were able to disrupt the mechanisms of trigger point and relieve the myofascial pain symptoms.

De triggers som idag används i Autoliv BKIs laboratorium har till uppgift att synkronisera signalerna vid simulering av krock som en intern kvalitetskontroll av produktionen. De sköter utösning av airbags och start av höghastighetskameror. Då Autoliv har flera modeller av krockkuddar används idag olika triggers och man har därför som önskemål att utveckla ett nytt system som skulle kunna ersätta de nuvarande systemen och som kan användas vid samtliga kvalitetstest. Projektet resulterade i en testad prototyp som inkluderar hårdvara, mjukvara, samt CAD-ritningar till en färdig produkt.

När ett nytt databassystem ska tas fram och införas i en organisation ska funktioner och krav på systemet identifieras och analyseras i en designprocess. Ett krav på ett databassystem kan vara att systemet ska uppvisa en viss prestanda. Designprocessen leder så småningom fram till fysisk design av databasen och dess applikationer. Det kan finnas flera olika lösningar för fysisk design av databasen och dess applikationer som tillgodoser kraven och funktionerna som ska finnas i systemet. Dessa olika lösningsalternativ ger olika prestanda. Detta arbete ger en inblick i att fysisk design av en databas och dess applikationer påverkar prestanda och att det finns strategier för när olika lösningar kan vara lämpliga att använda för prestandaoptimering. Nyckelord: Fysisk design, SQL, index, trigger, lagrad procedur, denormalisering.

The aim of this paper was to summarize the current knowledge of function and regulation of autonomic nervous system (ANS). We wanted to assess possible involvement of ANS in changes of muscle tension. Sympathetic nervous system affects the sensitivity of somatosenzory afferention, thus effecting the function of whole nervous system. Exists evidence about ANS effect on cutaneous afferents activity as well as muscle spindle afferent activity. Sympathetic modulation of proprioceptive information from muscle spindles may influence α motoneuron excitability. ANS may affect muscle tonus regulation. The selective activation of trigger point (TRP) during heightened muscle sympathetic efferent activity (MSNA) was proved. This supports the idea that the sympathetic nervous system can directly contribute on maintaining of the TRP and myofascial pain syndrome. Powered by TCPDF (www.tcpdf.org)

M.Tech. / Purpose: A study to determine the efficacy of Traumeel® gel using phonophoresis in the treatment of a latent trapezius myofascial trigger point, with regards to pain perception, cervical spine range of motion and pressure pain tolerance.Methods: A single-blinded, controlled study design was utilised. Thirty participants who all presented with a latent trapezius myofascial trigger point were randomly divided into two groups of fifteen. Each individual was subjectively and objectively assessed from baseline values prior to receiving treatment. Group A received ultrasound utilising ultrasound gel over the trapezius myofascial trigger point, as the control group. Group B received phonophoresis with Traumeel® gel over the trapezius myofascial trigger point. All participants received two treatments per week, with a total of seven consultations, over the three week study period. The subjective data was obtained utilising a Numerical Pain Rating Scale (NPRS) whilst a hand held Algometer tested pressure pain tolerance and a Cervical Range of Motion Measuring Instrument (CROM) measured cervical spine range of motion. These were utilised to form the objective data. The Data was analysed using non-parametric tests. The two independent treatment groups were assessed for capability at treatments one, four and seven using the Mann-Whitney U-test (non-parametric version of the independent sample T-test). Changes over the three week period were observed and analyzed using the Repeated Measures test or the Friedman Test (Devey, 2010). Results: In this study ultrasound utilising ultrasound gel had a statistically significant impact on the trapezius myofascial trigger point. Statistical analysis of the Traumeel® gel suggests that there was no statistical significance with regards to any of the treatment parameters or variables measured. Subjectively ultrasound gel proved to be statistically and clinically significant in decreasing the participant’s pain perception. There was no statistical improvement but there was a clinical improvement in the Traumeel® gel group.