El documento digital no refiere asesor / Describe las alteraciones discales en resonancias magnéticas de columna lumbosacra en postulantes asintomáticos a una empresa productora de sanitarios. Desarrolla un estudio descriptivo, transversal, desde enero del 2013 a noviembre del 2015. Evalúa 559 resonancias magnéticas de columna lumbosacra de postulantes asintomaticos a una empresa productora de sanitarios. Encuentra que la prevalencia de postulantes con lesiones asintomáticas fue de 44.9% (n=251). Del total de postulantes asintomáticos, el 18% tuvo prominencia discal en al menos un nivel, el 20% protrusión discal, el 4% extrusión discal, sin observarse casos de secuestro. Adicionalmente, el 3% presentó hernia intracorporal de Schmorl. Según la regresión de Poisson ajustado, las asociaciones evidenciadas en el modelo crudo se mantuvieron estadísticamente significativas, por cada incremento en 5 años de la edad la posibilidad de presentar lesiones asintomáticas aumenta en 17%, PR=1.17 IC 95% (1.07 a 1.28); mientras que por cada incremento en 5 Kg/m2 de índice de masa corporal, la posibilidad de tener lesiones asintomáticas se incrementa en 15%; PR=1.15 IC 95% (1.00 a 1.33). Del mismo modo, los participantes con educación universitaria tenían 55% mayor posibilidad de tener lesiones asintomáticas comparado con el grupo de participantes con educación secundaria; PR=1.55 IC 95% (1.15 a 2.11). Concluye que en los exámenes de resonancia magnética de columna lumbosacra, hasta cinco de diez personas asintomáticas tendrán alteraciones discales. Debido a esto, las prominencias, protrusiones y hernias intracorpóreas pueden ser una coincidencia. Los resultados de resonancias magnéticas de columna lumbosacra deben ser cuidadosamente analizados, conjuntamente con la evaluación clínica y el criterio médico al momento de tomar una conducta médica. El término "hernia" puede ser demasiado genérico por tener gran relevancia clínica. La clasificación de prominencias, protrusiones, extrusiones y secuestros resulta ser más útil en la tipificación de los hallazgos. / Tesis

Abstract The aim of this study was to analyze angiographic findings and the presence and topography of cerebral ischemic and/or hemorrhagic lesions in cerebral CT or MRI, and to assess the long-term clinical outcome of a series of 136 consecutive cervicocephalic artery dissection (CCAD) patients. Pulsatile tinnitus was evaluated as a symptom of CCAD. Medical records and films were reviewed retrospectively. Irregular stenosis was found in angiography in 50% and occlusion in 33% of the dissected cervicocephalic arteries. Irregular stenosis normalized in 81% and occlusion recanalized in 34%. Other findings, such as pseudoaneurysms, intimal flaps, double lumens, and irregular dilatations were rare and often remained unchanged in follow-up. Pulsatile tinnitus was a presenting symptom in 12% of the CCAD patients, but the majority of patients had concomitant head or neck pain, ischemic brain symptoms, Horner's syndrome, or cranial neuropathies. Of the 131 patients who underwent brain imaging, 73 (56%) had signs of infarction in cerebral CT or MRI. Occlusion of the dissected vessel was accompanied by infarction in 76%, irregular stenosis in 40%, and other findings only rarely. Of the anterior circulation infarctions, 95% (39/41) were territorial, subcortical, or territorial infarctions with fragmentation and could thus be considered embolic. Subarachnoid hemorrhage was found in CT in 5 of the 22 patients (23%) with intracranial dissection. The patient's long-term clinical outcome was assessed using two methods: a classification into categories based on neurological symptoms and defects and the modified Rankin Scale (mRS). Of the 136 CCAD patients, 60% recovered with no or mild disability and 79% scored 0–2 on mRS. In the case of dissection of one or more cervicocephalic arteries without occlusion, the figures were 75% and 89%. In the case of occlusive dissection of one or more arteries, only about 35% of the patients recovered well, having no or mild disability, and 61% scored 0–2 on mRS. No significant differences were seen in recovery after intra- and extracranial dissections. In conclusion: irregular stenosis, which is the most common angiographic finding in CCAD, is associated with brain infarction less frequently than occlusion, and the long-term clinical outcome is good in most cases. Occlusion of the dissected vessel causes more brain infarctions, and only about 35% of the patients recover well, having no or mild disability. More than 10% of CCAD patients have pulsatile tinnitus as a presenting, and sometimes the only symptom.

Determinate the maximum peak of pubertal mandibular growth in a peruvian population through of chronological age and the cervical vertebrae maturation in patients between 8 to16 years of age, who received treatment in the Clinica Dental Docente UPC (Peruvian University of Applied Science), between 2011 - 2013.Materials and Methods: The study was observational, descriptive, cross-sectional, retrospective and used 137 cephalometric digital radiographs obtained from the data base program: SMILE® used in the Dental Clinic of UPC. These digital radiographs were of patients between 8-16 years, who attended the Dental Clinic for dental treatment, and were evaluated with the Method of Vertebral Cervical Maturation proposed by T. Baccetti in 2005. This method analysis the morphological characteristics of the bodies of the second, third and fourth cervical vertebra to determine the peak in mandibular growth. This method classifies six maturational stages, T1-T6. The digital cephalograms were analyzed by two calibrated examiners (Kappa = 0.7). Results: Statistical analysis (Kruskal Wallis, p < 0.05) was conducted to evaluate the relationship between the chronological age and the appearance of the cervical vertebral maturation stage 3 and 4 to determining the peak of pubertal mandibular growth. In girls, the peak of mandibular growth occurred at the age 10.48 and in boys this occurred at the age of 11.21 Conclusions: The peak of pubertal mandibular growth occurred earlier in girls (10.48 years) than in boys (11.21years), having a difference of approximately one year between the two sexes. / Objetivo: Determinar el pico máximo de crecimiento mandibular puberal en una población peruana a través de la edad cronológica y la maduración de las vértebras cervicales en pacientes de entre 8 a 16 años de edad, que recibieron tratamiento en la Clínica Dental Docente Universidad Peruana de Ciencias Aplicadas (UPC), entre 2011 - 2013. Materiales y métodos: El estudio fue de tipo observacional, descriptivo, transversal y retrospectivo donde se trabajó con 137 radiografías digitales cefalométricas de pacientes adolescentes entre 8 a 16 años de edad, obtenidas de la base de datos SMILE de la clínica dental docente UPC. Dichas radiografías fueron evaluadas por el método de maduración cérvico vertebral (MCV) propuesto por Tiziano Baccetti (2005) donde se observa la morfología de la segunda (C2), tercera (C3) y cuarta (C4) vértebra cervical, clasificándolas en 6 estadíos de maduración (T1-T6) de acuerdo a las características morfológicas de cada una. Las radiografías digitales fueron analizadas por 2 examinadores calibrados (KAPPA = 0.7). Resultados: Se realizó el análisis estadístico (Kruskall Wallis, p<0.05) para evaluar la relacione entre la edad cronológica con el estadío de maduración cérvico vertebral 3-4, con la finalidad de determinar el pico máximo de crecimiento mandibular puberal. En las mujeres el pico máximo de crecimiento ocurrió a los 10.48 años de edad y en los hombres ocurrió a los 11.21 años de edad. Conclusiones: El pico máximo de crecimiento mandibular puberal se produce primero en mujeres (10.48) antes que los hombres (11.21), existiendo una diferencia aproximada de un año entre ambos sexos.

Objetivo: Determinar el pico máximo de crecimiento puberal mandibular en una población peruana mediante la edad cronológica y la maduración ósea cérvico vertebral en pacientes entre 8 a 16 años de edad que acuden a la clínica dental docente UPC. Materiales y métodos: El estudio fue de tipo observacional, descriptivo, transversal y retrospectivo donde se trabajó con 137 radiografías digitales cefalométricas de pacientes adolescentes entre 8 a 16 años de edad, obtenidas de la base de datos SMILE de la clínica dental docente UPC. Dichas radiografías fueron evaluadas por el método de maduración cérvico vertebral (MCV) propuesto por Tiziano Baccetti (2005) donde se observa la morfología de la segunda (C2), tercera (C3) y cuarta (C4) vértebra cervical, clasificándolas en 6 estadíos de maduración (T1-T6) de acuerdo a las características morfológicas de cada una. Las radiografías digitales fueron analizadas por 2 examinadores calibrados (KAPPA = 0.7) Resultados: Se realizó el análisis estadístico (Kruskall Wallis, p<0.05) para evaluar la relacione entre la edad cronológica con el estadío de maduración cérvico vertebral 3-4, con la finalidad de determinar el pico máximo de crecimiento mandibular puberal. En las mujeres el pico máximo de crecimiento ocurrió a los 10.48 años de edad y en los hombres ocurrió a los 11.21 años de edad Conclusiones: El pico máximo de crecimiento mandibular puberal se produce primero en mujeres (10.48) antes que los hombres (11.21), existiendo una diferencia aproximada de un año entre ambos sexos. / Objective: The aim of this study was to determinate the peak of mandibular growth by the chronological age and the cervical vertebrae maturation in patients between 8-16 years of age, who received treatment in the clinic of the School of dentistry UPC (Peruvian University of Applied Science), between March 2011 and 2013. Materials and Methods: The study was observational, descriptive, cross-sectional, retrospective and used 137 cephalometric digital radiographs obtained from the data base program: SMILE® used in the Dental Clinic of UPC. These digital radiographs were of patients between 8-16 years, who attended the Dental Clinic for dental treatment, and were evaluated with the Method of Vertebral Cervical Maturation proposed by T. Baccetti in 2005. This method analysis the morphological characteristics of the bodies of the second, third and fourth cervical vertebra to determine the peak in mandibular growth. This method classifies six maturational stages, T1-T6. The digital cephalograms were analyzed by two calibrated examiners (Kappa = 0.7). Results: Statistical analysis (Kruskal Wallis, p < 0.05) was conducted to evaluate the relationship between the chronological age and the appearance of the cervical vertebral maturation stage 3 and 4 to determining the peak of pubertal mandibular growth. In girls, the peak of mandibular growth occurred at the age 10.48 and in boys this occurred at the age of 11.21 Conclusions: The peak of pubertal mandibular growth occurred earlier in girls (10.48 years) than in boys (11.21years), having a difference of approximately one year between the two sexes.

De nombreuses méthodes ont été développées pour estimer l’âge au décès de l’adulte mature. De plus, l’observation de certaines lésions dégénératives amène parfois l’anthropologue à classer un sujet chez les individus âgés, plus spécifiquement lorsqu’elles atteignent la colonne vertébrale. Or si l’ostéoarthrose rachidienne a fait l’objet de nombreux articles en paléopathologie, l’exploitation de l’ensemble des articulations vertébrales au sein d’une méthodologie est quasi inexistante. Ainsi, afin de déterminer le rôle d’une étude paléopathologique dans le vieillissement osseux, nous avons mis au point une méthode originale d’enregistrement des données.Cette méthode, basée sur un découpage topographique du rachis et un système de cotation des lésions arthrosiques, permet d’étudier l’atteinte dégénérative grâce à l’obtention d’un score de sévérité pondéré à l’état de conservation de la vertèbre. Le matériel d’étude est constitué de 750 individus répartis équitablement sur 3 périodes historiques (médiévale, moderne et contemporaine) permettant ainsi d’effectuer une comparaison diachronique des résultats. Les 250 individus constituant l’échantillon contemporain proviennent de collections documentées (Schoten, Belgique ; Bologne, Italie ; Sassari, Sardaigne). L’âge des sujets ostéoarchéologiques a été estimé grâce aux méthodes utilisant la surface auriculaire de l’os coxal (Lovejoy, 1985 et Schmitt, 2005). La même estimation a été faite sur les collections âge/sexe connus afin de déterminer le pourcentage d’erreur commis sur nos échantillons médiéval et moderne. Pour chaque articulation rachidienne nous avons testé statistiquement la relation entre l’âge au décès et les scores de sévérité, ainsi que les dissemblances d’atteinte en fonction du sexe et de la latéralité. Des études qualitatives ont également été entreprises, permettant ainsi d’observer l’expansion des modifications dégénératives en fonction des différentes classes d’âge.Au terme de ce travail de recherche, nous avons constaté l’existence d’une relation entre l’âge et la sévérité des atteintes dégénératives vertébrales. Cependant ce lien est modéré par divers facteurs variant en fonction des articulations et des segments vertébraux. Parmi ces facteurs, nous avons relevé le sexe et la latéralité. Des informations concernant le mode de développement des lésions dégénératives rachidiennes ont également été acquises. Ainsi, nous avons observé que l’OA se développait dans un premier temps de manière progressive le long du rachis, puis, avec l’âge et selon le type d’articulation, les lésions se concentrent sur les mêmes vertèbres (celles étant le plus soumises aux forces biomécaniques). C’est également sur ces mêmes vertèbres que se manifestent les lésions les plus sévères. Ainsi, il semble indispensable, lors d’une étude paléoépidémiologique, d’avoir un nombre minimum de vertèbres et parmi celles-ci les vertèbres les plus sollicitées en pré requis. De plus, nous préconisons lors d’un examen paléopathologique, de considérer plus que la sévérité même de la lésion, le nombre de zone atteintes comme estimateur de l’âge au décès. / Various methods have been developed to estimate age at death of adults and anthropologists sometimes use degenerative vertebral lesions. In paleopathology contrary to vertebral degenerative disease (VDD) that has been extensively studied, the whole vertebral joints have almost never been investigated by standardized methodology that allows approximating the epidemiological performance of various vertebral joints in relation to articular degeneration. In order to better define the paleoepidemiological aspects of bone ageing we have developed a research program based on the recording of degenerative lesions in the vertebral joints.This approach is based on a topographic division of spine and a grading system of degenerative lesions, permits the study VDD using “a severity score” according to the state of vertebral preservation. We studied 750 spines provided equally from three samples (medieval, modern and contemporary) to compare periods. The 250 contemporary spines are from documented collections of Schoten (Belgium), Bologna (Italy) and Sassari (Sardinia). Age estimation was made for each archaeological sample using methods based on the observation of the sacro-iliac joint surface (Lovejoy, 1985 and Schmitt, 2005). The same estimation of age has been made with known sex and age collections in order to calculate error estimates. For each joint of the spine, statistical tests have been made to study relationship between the age at death and “the severity score” and to compare variability between sex and spine laterality. Quantitative studies have also been made to observe degenerative change resulting from advancing age.At the end of this work, we observed the relation between age and the severity of VDD. That link can vary according to joint type, spinal segment and various factors such as sex or laterality. Information concerning the evolution of degenerative lesions has been acquired. VDD appears initially to progressively affect the entire spine and then with aging, degenerative lesions focus on the same vertebrae (those that are the most used biomechanically). Those vertebrae always show the most severe lesions. Thus it is essential for paleoepidemiologic studies to include a minimal number of vertebrae and among them those that are the most used. We also suggest considering the number of affected zones to estimate age at death instead of the lesion severity.

Orientador: Rene Brenzikofer / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Educação Fisica / Made available in DSpace on 2018-07-19T06:10:52Z (GMT). No. of bitstreams: 1 Ortale_RenataLanducci_M.pdf: 1976071 bytes, checksum: 279fd16f5e25de85f875d6b90acfe76d (MD5) Previous issue date: 1993 / Resumo: O propósito deste trabalho é apresentar um método para análise quantitativa e tridimensional da coluna vertebral em posição estática. O método apresentado utiliza registros fotográficos estereoscópicos, medição das imagens em mesa digitalizadora e análise dos dados através de programas computacionais, os quais foram desenvolvidos para agilizar os procedimentos da reconstrução e fornecer resultados quantitativos, sob a forma de gráficos, das curvaturas e das torções geométricas 3D da espinha. A reconstrução 3D dos pontos antõmicos, marcados na pele sobre os processos espinhosos da coluna vertebral, foi desenvolvido por BRENZIKOFER (1991, 1993). A análise matemática em termos de curvatura e torção geométrica 3D dos pontos anatômicos é obtida a partir de um ajuste polinomial por quadrados mínimos. Aplicamos este método em três voluntários, os quais foram submetidos a uma avaliação postural clinica, antes da realização dos experimentos fotográficos. Os pontos anatômicos foram marcados com adesivos autocolantes e contrastantes nos indivíduos na posição ereta e estática, prontos para serem fotografados. Os pontos de interesse, estenderam-se da base do occipital até o processo espinhoso da quarta vértebra lombar, somando um total de vinte pontos. Os resultados obtidos são apresentados sob a forma de seis gráficos, para cada sujeito: dois correspondem ao ajuste polinomial das projeções das curvas da coluna vertebral nos planos sagital e frontal, outros dois às curvaturas bidimensionais nos mesmos planos, um à curvatura 3D e finalmente à torção geométrica 3D. Em todos os gráficos estas variáveis estão representadas em função da coordenada vertical. Através do método ora proposto, detectamos as regiões da coluna onde aparecem as curvaturas e torções geométricas 3D. Também mostramos que o método desenvolvido permite quantificar, com boa sensibilidade, as deformidades da coluna vertebral, como por exemplo: lordoses, cifoses e escolioses. Os resultados obtidos mostraram uma boa correlação com os do diagnóstico clínico / Abstract: This paper aims at presenting a method for quantitative and tridimensional analysis of the spinal column in a static position. The method utilizes stereoscopic photographic registers, image measurement in digitalized table and data analysis using software developed in order to accelerate the reconstruction procedures and supply quantitative results in the format of graphs representing the 3D curvatures and geometrical torsions of the spinal column. The 3D reconstruction of the anatomic points, marked on the skin over the spinous processes, was developed by Brenzikofer (1991, 1993). The mathematical analysis of 3D curvature and torsion of the anatomic points is obtained through an adjustment of the parametric polynomial least square fit. This method was applied to three voluntary subjects who, before having their photographic registers taken, were submitted to a clinical posture evaluation. A total of twenty anatomic points were marked with contrasting adhesive disks. The subjects were in a static and upright position. The points of reference went from the occipital basis until the spinous process of the fourth lumbar vertebra. The results are presented in six graphs for each subject. Two graphs represent the polynomial fit of the projection of the spinal column curves in the sagittaland frontal plane. Two other graphs represent the bidimensional curvatures in the same planes. One graph represents the 3D curvature and the last one represents the geometric 3D torsion. In alI these graphs the variables are represented in function of the vertical coordinate. This method successfully detected in which areas of the spinal column 3D curvatures and geometrical torsions occur. It also enables the user to quantify, with accuracy, spinal column deformities such as, lordosis, kyphosis, and scoliosis. There is a positive correlation between the results of the proposed method and the clinical diagnosis / Mestrado / Mestre em Educação Física

Determina los factores de riesgo asociados a la lumbalgia en trabajadores que realizan labores operativas en la industria del petróleo. Es un estudio observacional y transversal. Se incluyó 115 trabajadores operativos que laboran en una compañía petrolera en Piura, se detectó que 21 trabajadores presentaron lumbalgia. La evaluación de la lumbalgia fue realizada por el médico especialista y verificada por EsSalud mediante el certificado médico. Se aplicó una ficha para la recolección de datos previamente validado. El análisis exploratorio se realizó en SPSS, se calcularon medianas para las variables cuantitativas, chi cuadrado y Odds Ratio para la identificación de los factores de riesgo. El porcentaje de lumbalgia fue 18.3%. Se encontró asociación significativa entre la edad de 50 a 65 años, el esfuerzo físico durante la jornada laboral, las actividades de perforación y la lumbalgia. Concluye que la edad de 50 a 65 años, el esfuerzo físico durante la jornada laboral y las actividades de perforación son factores de riesgo asociados a lumbalgia en trabajadores de la industria de petróleo en Piura. / Tesis

Orientador: Guilherme Antonio Moreira de Barros / Resumo: Segundo a Associação Internacional para o Estudo da Dor (IASP), a dor crônica pós-operatória (DCP) é aquela presente por mais de três meses após a realização de um procedimento cirúrgico. As cirurgias ortopédicas para o tratamento de doenças degenerativas relacionadas ao avanço da idade têm crescido nas últimas décadas, expondo esses indivíduos ao risco de desenvolver a DCP. O objetivo desse estudo foi avaliar a incidência de DCP em pacientes submetidos as cirurgias ortopédicas como a artroplastia total de joelho e quadril, fixação de fratura de fêmur e cirurgias na coluna vertebral. Os fatores de associação para o aparecimento da DCP, assim como sua ocorrência foram estudados. Foram aplicados questionários validados disponíveis na literatura, assim como protocolo de pesquisa desenvolvido pelos pesquisadores. Buscou-se contemplar questões sobre a presença, localização, tipo e intensidade da dor, presença de dor neuropática, identificação de labilidade emocional e catastrofização da dor, uso de medicação para o controle da dor, dentre outros. As entrevistas dos participantes ocorreram em duas etapas, no pré-operatório e pós-operatório, esse último com o seguinte cronograma: 30 dias, três, seis e doze meses após a realização da cirurgia. Os pacientes incluídos no decorrer da pesquisa foram acompanhados durante um ano após a realização da cirurgia, sendo assim, o estudo levou dois anos para ser concluído. Essa pesquisa foi aprovada pelo Comitê de Ética em Pesquisa da instituição... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: According to the International Association for the Study of Pain (IASP), chronic postoperative pain (DCP) is that present for more than three months after the performance of a surgical procedure. Orthopedic surgeries for the treatment of degenerative diseases related to advancing age have grown in recent decades, exposing these individuals to the risk of developing PCD. The aim of this study was to evaluate the incidence of PCD in patients undergoing orthopedic surgeries such as total knee and hip arthroplasty, fixation of the femur fracture and surgeries in the spine. The association factors for the onset of DCP, as well as its occurrence, have been studied. Methods: Validated questionnaires available in the literature were applied, as well as a research protocol developed by the researchers. We sought to contemplate questions about the presence, location, type and intensity of pain, presence of neuropathic pain, identification of emotional lability and pain catastrophization, use of medication for pain control, among others. The participants' interviews took place in two stages, in the preoperative and postoperative periods, the latter with the following schedule: 30 days, three, six and twelve months after the surgery. The patients included in the research were followed up for one year after the surgery, so the study took two years to complete. This research was approved by the institution's Research Ethics Committee. Results: After invitation, analysis of inclusion and ex... (Complete abstract click electronic access below) / Doutor

Publicación a texto completo no autorizada por el autor / El documento digital no refiere asesor / Describe el uso de la punción lumbar en la convulsión febril en pacientes de 6 a 18 meses de edad del Instituto Nacional de Salud del Niño durante el periodo 2008 a 2009. Se realizó un estudio observacional, retrospectivo, transversal, de 65 niños de 6 meses a 18 meses de edad con convulsión febril, en el periodo que correspondió al estudio. Hubo 29 varones (44.6 %), y 36 mujeres (55.4 %). La media de la edad global de los pacientes en estudio fue de 10.6+/- 3.7 meses, siendo la mínima de 6 meses y la máxima de 18 meses. El 63.1 % de los pacientes tuvieron entre 6 a 12 meses. Hubo una mayor frecuencia de convulsión generalizada en el 90.8 % de los casos. En el 84.6 % de los casos duró menos de 15 minutos, y en el 15.4 % duro menos de 15 minutos. Hubo recurrencia de la convulsión en el 58.5%. Hubo una mayor frecuencia de foco respiratorio en el 76.9 %, seguido del foco gastrointestinal (15.4%). El 55.4% de los pacientes tuvieron temperatura menor de 38°C. El 13.8% de los casos tuvieron antecedente familiar de convulsión. Hubo una mayor frecuencia de convulsión febril compleja en el 78.5 % de los casos. El riesgo de meningitis en los pacientes con convulsión febril a los cuales se les realiza punción lumbar es bajo o nulo. Hay mayor frecuencia de convulsión febril en mujeres entre los 6 a 12 meses. No hubo ningún caso de convulsión febril por meningitis aguda. / Trabajo de investigación

Traumatic arteriovenous fistulas of the neck are a relatively uncommon injury, whose ramifications can include immediate or delayed neurological insults, massive bleeding, or death. Angiography and embolization have been increasingly used to manage this complex injury pattern. In this particular case, the patient underwent management of bilateral communicating arteriovenous fistulae using a commercially available plug occlusion device. Epidemiology, with an emphasis on patient management and outcomes, is discussed.