RESUMO
The high incidence and prevalence of facial trauma makes it important to consider related injuries and possible complications that may arise as a result. Penetrating trauma to the face, although not common, requires a surgeon with knowledge of the anatomy and physiology of the injured area and injury patterns. We present a case of penetrating trauma to the face that was caused by a blunt object (stake) resulting from the felling of a palm tree. We describe the transoral management that was performed and the multidisciplinary support that allowed optimal management of the injury without complications, including functional or aesthetic sequelae.
RESUMO
Irreparable tears of the subscapularis (SS) tendon are difficult to manage and represent a challenge for the surgeon, especially in young and active patients. They are associated with a horizontal imbalance of the shoulder, causing pain and limitation of active internal rotation. Historically, the alternative for these patients has been transfer of the pectoralis major, with all its variations, total or partial, up or under the conjoint tendon. However, this transfer has mechanical disadvantages, especially related to the vector of traction, because it originates in the anterior region of the chest. In 2013, Elhassan and colleagues demonstrated in cadavers the technical feasibility and neurological safety of performing transfers of the latissimus dorsi (LD) to the lesser tuberosity to reconstruct irreparable lesions of the subscapularis. This option, compared with alternatives, has superior biomechanical advantages such as a similar vector of traction, originating from lower and posterior to the thorax, in addition to involving a synergistic muscle in action. In early 2016, Kany and colleagues first published a study of 5 patients undergoing arthroscopic assisted LD to SS transfer, with promising results. Our purpose is to present an arthroscopically assisted latissimus dorsi transfer technique in patients with irreparable subscapularis rupture.
RESUMO
Baked foams made with plantain flour (PF) and sugarcane fiber (SF) were characterized by calorimetric, mechanical, physicochemical and structural techniques in order to assess the results induced by different sugarcane concentrations and fiber size on the structure of baked foams. The addition of SF to the baked samples increased their hydrophobic properties. Thermal conductivity (TC) decreased when the concentration of SF was 10 g and 7.5 g in the baked foams. The density of the biodegradable baked foams (BBFs) decreased with decreasing concentrations of SF, observing an inverse behavior in water vapor permeability (WVP) and solubility properties. The mechanical properties of the baked foams were more influenced by the concentration of SF than by the size of SF, obtained from different sieves. The scanning electron microscopy cross-sectional images of the BBFs showed that the size of SF affected the size and number of the internal cells in the BBFs.
RESUMO
OBJECTIVE: To study the prevalence and the associated factors of work disability (WD) in systemic lupus erythematosus (SLE) patients. METHODS: A sample of 419 SLE patients from an observational cross-sectional multicenter study was included. Sociodemographic features, disease characteristics, comorbidities, quality of life, unhealthy behaviors, and work-related factors were measured in a standardized interview. Work disability was defined by patient self-report of not being able to work because of SLE. To identify variables associated with work disability, two different multivariate regression models using a stepwise backward method were performed. RESULTS: Prevalence of WD due to SLE was 24.3%. Eighty-nine percent were female and 51% were Caucasians. Mean disease duration was 8.9 ± 7.2 years, and median System Lupus International Collaborating Clinics/American College of Rheumatology damage index SLICC-SDI was 1.5 (range 0-17). In stepwise multivariate logistic regression, living below the poverty line (odds ratio [OR] = 4.65), less than 12 years of education (OR = 2.84), Mestizo ethnicity (OR = 1.94) and SLICC-SDI (OR = 1.25) were predictors of WD. A second model was performed including patient-derived measures; in this model sedentary lifestyle (OR = 2.69) and lower emotional health domain score of the Lupus Quality of Life (LupusQoL) questionnaire (OR = 1.03) were found to be associated to WD and a higher score in LupusQoL physical health domain (OR = 0.93) was protective. CONCLUSION: The prevalence of WD in Argentinian SLE patients was 24.3%. WD was associated with ethnic (Mestizo), socioeconomic (poverty) and disease-related factors. Patient-related outcomes such us sedentary lifestyle and poor emotional quality of life were also associated with WD.
Assuntos
Absenteísmo , Avaliação da Deficiência , Indígenas Sul-Americanos , Lúpus Eritematoso Sistêmico/etnologia , Licença Médica , Determinantes Sociais da Saúde , Fatores Socioeconômicos , Adulto , Argentina/epidemiologia , Estudos Transversais , Emoções , Feminino , Nível de Saúde , Humanos , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/psicologia , Lúpus Eritematoso Sistêmico/terapia , Masculino , Saúde Mental , Pessoa de Meia-Idade , Pobreza , Prevalência , Qualidade de Vida , Fatores de Risco , Comportamento Sedentário , Adulto JovemRESUMO
El cáncer de pulmón es la principal causa de muerte por neoplasias malignas en nuestro país, al igual que en todo el mundo. La estadificación actualmente en uso, el TNM, no nos permite identificar a los pacientes que van a presentar nuevamente la enfermedad. El propósito de este trabajo fue investigar factores morfológicos e inmunohistoquímicos en el examen de piezas quirúrgicas de pacientes con carcinoma de células no pequeñas (NSCLC) en estadío I, analizar sus interacciones y evaluar su valor pronóstico para individualizar a los pacientes con riesgo de recurrencia. Se incluyeron 53 pacientes. la sobrevida global fue 52.8 por ciento y el 28 por ciento (15/53) presentó recurrencia. Los carcinomas escamosas (CaE), presentaran con mayor frecuencia recuento mitótico elevado y expresión de MIB-1, bcl-2 y CD44, mientras que los adenocarcinomas (ACa) presentaron más frecuentemente permeación linfática. Encontramos directamente asociadas al tamaño tumoral, la presencia de necrosis y la invasión pleural, al recuento mitótico, la necrosis y la expresión de MIB-1 y p53, y a la expresión de CD44 la de bcl-2, mientras que la diferenciación estuvo inversamente asociada con recuento mitótico, necrosis y expresión de p53 y la de bcl-2 a la permeación linfática. Estos hallazgos ponen en evidencia la estrecha relación entre los mecanismos de proliferación, necrosis, apoptosis, angiogénesis y adhesión celular. El recuento mitótico elevado, la presencia de necrosis y la expresión de MIB-1 y bcl-2 estuvieron significativamente relacionados con menores períodos libres de enfermedad. El análisis multivariado encontró como únicos factores de pronóstico independientes al recuento mitótico y la expresión de MIB-1 y bcl-2. Nuestros resultados sugieren mecanismos de preogresión de los NSCLC que contribuyen a comprender su biología, permitiendo identificar factores tanto morfológicos como inmunohistoquímicos potencialmente valiosos para reconocer pacientes con riesgo de recurrencia.
Assuntos
Masculino , Feminino , Humanos , Antígeno Nuclear de Célula em Proliferação , Carcinoma Pulmonar de Células não Pequenas/patologia , Imuno-Histoquímica/métodos , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/prevenção & controle , Biópsia , Estadiamento de Neoplasias , Prognóstico , SeguimentosRESUMO
El cáncer de pulmón es la principal causa de muerte por neoplasias malignas en nuestro país, al igual que en todo el mundo. La estadificación actualmente en uso, el TNM, no nos permite identificar a los pacientes que van a presentar nuevamente la enfermedad. El propósito de este trabajo fue investigar factores morfológicos e inmunohistoquímicos en el examen de piezas quirúrgicas de pacientes con carcinoma de células no pequeñas (NSCLC) en estadío I, analizar sus interacciones y evaluar su valor pronóstico para individualizar a los pacientes con riesgo de recurrencia. Se incluyeron 53 pacientes. la sobrevida global fue 52.8 por ciento y el 28 por ciento (15/53) presentó recurrencia. Los carcinomas escamosas (CaE), presentaran con mayor frecuencia recuento mitótico elevado y expresión de MIB-1, bcl-2 y CD44, mientras que los adenocarcinomas (ACa) presentaron más frecuentemente permeación linfática. Encontramos directamente asociadas al tamaño tumoral, la presencia de necrosis y la invasión pleural, al recuento mitótico, la necrosis y la expresión de MIB-1 y p53, y a la expresión de CD44 la de bcl-2, mientras que la diferenciación estuvo inversamente asociada con recuento mitótico, necrosis y expresión de p53 y la de bcl-2 a la permeación linfática. Estos hallazgos ponen en evidencia la estrecha relación entre los mecanismos de proliferación, necrosis, apoptosis, angiogénesis y adhesión celular. El recuento mitótico elevado, la presencia de necrosis y la expresión de MIB-1 y bcl-2 estuvieron significativamente relacionados con menores períodos libres de enfermedad. El análisis multivariado encontró como únicos factores de pronóstico independientes al recuento mitótico y la expresión de MIB-1 y bcl-2. Nuestros resultados sugieren mecanismos de preogresión de los NSCLC que contribuyen a comprender su biología, permitiendo identificar factores tanto morfológicos como inmunohistoquímicos potencialmente valiosos para reconocer pacientes con riesgo de recurrencia. (AU)