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Dissertations / Theses on the topic 'Bone rehabilitation'
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Mikkelsen, Christina. "Rehabilitation following bone-patellar tendon-bone graft ACL reconstruction /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-913-0/.
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Hariri, Firdaus. "Alveolar distraction osteogenesis for dental implant rehabilitation inreconstructed jaws." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B44661514.
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Eager, Katrise Mary. "Rehabilitation of unilateral profound sensorineural hearing loss with a bone anchored hearing aid." University of Western Australia. School of Surgery, 2010. http://theses.library.uwa.edu.au/adt-WU2010.0061.
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The long-term outcomes of subjects fitted with a bone anchored hearing aid (BAHA) for a unilateral profound sensorineural hearing loss (UPSHL) are still evolving. Previous studies have focused on the comparison between shortterm outcomes obtained with hard-wired contralateral routing of signal (CROS) hearing aids and those obtained with BAHA devices. Published results on subjects who have worn their BAHA devices for UPSHL for more than twelve months are limited. This study explored the long-term outcomes of adults fitted with a BAHA for UPSHL. The aims were firstly to examine subjects' pre-operative and postoperative speech perception in quiet and noise, as well as administer two standardised questionnaires, the Abbreviated Profile of Hearing Benefit (APHAB) and the Glasgow Hearing Aid Benefit Profile (GHABP). The second aim was to evaluate the responses of implanted subjects following the preoperative test protocols using a supplementary questionnaire, the Single Sided Deafness Questionnaire (SSDQ). The third aim was to monitor the subjects' implant or repair issues. In addition, questionnaire results were compared to subjects who underwent pre-operative assessment but were not implanted. All subjects had a UPSHL resulting from various aetiologies including vestibular schwannoma or other skull base tumour removal, viral infections, cochlear trauma, idiopathic sudden hearing loss, and Meniere's disease. There was a significant difference between the implanted groups' pre- and post-operative outcomes measures, indicating a treatment effect from the fitting of the BAHA device. No significant changes were found with the non-implanted groups' longterm outcome measures in regards to their perceived hearing difficulties. No significant correlations were found between outcome measures and gender, age of fitting, length of deafness, or ear affected for either group.
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Milliken, Laura Ann 1970. "Bone mineral density, bone remodeling, insulin-like growth factors, hormone replacement therapy, and exercise training in postmenopausal women." Diss., The University of Arizona, 1998. http://hdl.handle.net/10150/282746.
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Osteoporosis is a condition of reduced bone mineral density (BMD) resulting in an increased susceptibility to bone fractures. The purpose of this study was to determine the effects of 12 months of weight bearing and resistance exercise on BMD, bone formation, measured by serum osteocalcin (OC) and bone resorption, measured by urinary excretion of deoxypyridinoline crosslinks (Dpd), in 2 groups of postmenopausal women who were either taking or not taking hormone replacement therapy (HRT). Secondary aims were to characterize the changes in insulin-like growth factors-l and -2 (IGF-l and -2) and IGF binding protein 3 (IGFBP3) in response to exercise training, and to determine the contribution of these growth factors in predicting changes in bone mineral density in the 2 populations of postmenopausal women. Women who were three to ten years postmenopausal and aged 40-65 years were included in the study. Women in HRT and no HRT groups were randomized into the exercise intervention resulting in four groups: (1) women not taking HRT, not exercising; (2) women taking HRT, not exercising; (3) women exercising, not taking HRT; and (4) women exercising, taking HRT. The number of subjects per group after one year was 27, 21, 25, and 16, respectively. Exercise training and HRT increase BMD similarly at most BMD sites whereas the combination of exercise and HRT produced increases in BMD greater than either treatment alone. Bone remodeling was surpressed in the groups taking HRT regardless of exercise status. The bone remodeling response to exercise training in women not taking HRT was not significantly different from those not exercising but the direction of change suggests an elevation in bone remodeling in response to exercise training. Exercise training does not stimulate a change in IGF-1, IGF-2, IGF-1:IGF-2, and IGFBP3. Markers of bone remodeling and IGF-1 are significant predictors of BMD changes but the overall amount of variation in BMD changes accounted for is low. Exercise and HRT status were significant predictors of changes in BMD even after accounting for variation due to bone remodeling indicating that bone changes are regulated by factors not addressed in this study.
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Dashottar, Amitabh. "Posterior Shoulder Tightness Measurements: Differentiating Capsule, Muscle and Bone." The Ohio State University, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=osu1337880690.
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Thomas, George George. "Extraction of Follow up Parameters of Bone Density Microwave Sensor from Post Craniotomy and Lower Extremity Trauma Rehabilitation Measurements." Thesis, Uppsala universitet, Institutionen för informationsteknologi, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-348887.
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Longitudinal microwave based sensor systems facilitates frequent follow ups in scenarios where healing information is largely missing. An example is neonatalcraniotomy where Computerized Tomography (CT) information is available mostly before surgery and up to three years after that. In such case, frequent CT’s cannot betaken due to multitude of reasons ranging from dosage concerns to sheer cost. In this context, the use of a follow-up modality could substantially improve the quality of life. Bone Density Measurement Analysis (BDAS) and Complex Fracture Orthopaedic Rehabilitation (COMFORT) are two such projects dealing with collecting vital information that will help in addressing the unknown physiological changes. Compliant to ethical approvals 200 low extremity trauma patients from Holland and23 craniosynostosis patients from Sweden, were enrolled in clinical trials for theCOMFORT and BDAS projects respectively. For COMFORT study, itself, it involves200 (patients) x 3 (low extremity locations) x 5 (Repetition) x 9 (time points) =27000 data sets. Similarly, the BDAS projects deals with 966 data sets. Microwave Sensors measure how the signal reflected from target area for a given set offrequency (1GHz to 3GHz). As can be seen, there is a big volume of data that is prone to error during repeated measurements and useful information in terms ofmutual variability between test subjects, targets, time points etc. In this study the follow-up parameters to monitor the physiological changes are identified and are extracted from the large volume of raw data. This is done by delimiting the initial data between 2.3 GHz to 2.6 GHz. It was seen from simulation, error estimation and previous works that the above-mentioned frequency range contains the needed information. Then the delimited data is averaged for its magnitude and phase with respect to frequency. An algorithm for finding the minimum value of the averaged delimited data (resonance) is implemented for the dB magnitude and compared withrespect to time points. A sub function is created to derive the polar coordinates(absolute magnitude, phase in radiance) and the Cartesian coordinates (in thecomplex plane). A preliminary analysis was performed on the processed data and some basic postulations were made. This work segregates the follow up parameters from raw data which can be used in future in depth analysis of clinical outcomes.
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Cooke, Barbara Jane. "Bad to the bone? : the effects of dog training programs on factors related to desistance." Thesis, University of Cambridge, 2014. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.708348.
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Alibakhshi, Esmaeil. "Femoral bone mineral density and rectus femoris phenotype as sarcopenia indicators after a pulmonary rehabilitation protocol in patients with chronic respiratory disease." Doctoral thesis, Universitat de Barcelona, 2019. http://hdl.handle.net/10803/668651.
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INTRODUCTION: Patients with chronic respiratory disease (CRDs) have a disorder in muscle structure and function, but their function increases with physical progress and decreases the risk of general and muscular weakness. CRDs patients with muscle weakness also have higher mortality rates than patients without muscle weakness and they are more likely to develop sarcopenia and the incidence of pathogens. The Main objective of the present study was to evaluate the indicators of Sarcopenia in chronic respiratory patients with a greater focus on musculoskeletal structure and function and quality of life in these patients, which can highest affect their mortality.
METHODS: We randomly selected patients (N=38) with mean age of 72±1.0 years old men and women elderly with chronic respiratory diseases such as asthma, COPD, bronshiectasis and obesity with dyspnea score ≥ 2 in Medical Research Council (MRC) index. All patients after receiving research information and signing informed consent they have gone on performed assessments of pre and post rehabilitation protocol in spirometry for lung function, hand-grip dynamometer, quadriceps strength grading test, body mass index (BMI), skeletal muscle Index (SMI), 6-minute walking test (6-MWT) and quality of life questionnaire SF-36 in rehabilitation and pulmonology departments at the Health Parc Sant Joan de Deu. Then, they have done femor bone mineral density (FBMD) and ultrasound on rectus femoris in mid-tight cross sectional area (RFMTCSA) on quadriceps muscle at the electro-diagnosis department. They have had a 4-month long term a pulmonary rehabilitation protocol, which included: Exercise tests- incremental and constant, 12 weeks, 3 times a week, duration of each session was 1h :15 min. Breathing techniques, respiratory muscle training and self-management, (ATS-ERS guidelines, 2013-2016).
RESULTS: After the rehabilitation protocol, significant changes in BMI were seen in all patients, pre rehabilitation, BMI= 30±1.06 kg/m2 and post rehabilitation, BMI=29±1.00 kg/m2. In the analysis of Pearson’s correlation r =0.607 between T-scores and Z-score in Femur Bone Mineral Density (FBMD) and Rectus femoris Mid-Tight Cross Sectional Area (RFMTCSA) in pre-rehabilitation, there is a little bit significant correlation between the variables (P<0.00). But, in the analysis of the Pearson’s correlation r =0.910 in post-rehabilitation between T-score and Z-scores in FBMD and RFMTCSA, there have a high significant correlation between variables than pre-rehabilitation on P<0.00.
DISCUSSION: When we compared femur bone, rectus femoris muscle parameters and quality of life as indicators diagnosis of sarcopenia in chronic respiratory patients, we observed that in rectus femoris muscle ultrasound as the most effective foot muscle in detecting sarcopenia was the determination of the parameters of RFMTCSA and Circumference muscle, and we found significant change in the test of DEXA scan in T-score some more than Z-score. Also, we observed that T-score and Z-score in femur bone and RFMTCSA had a high significant correlation after the pulmonary rehabilitation protocol. I conclude that it is not necessary to investigate all factors in order to accurately determine the severity of sarcopenia in patients with chronic respiratory disease, and if specialists are considering rectus femoris ultrasound and femoral DEXA as the main intervention of sarcopenic in chronic respiratory patients, they can follow the latest situation health and mortality of them should be more accurately diagnosed.
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Barbosa, Adelton Aparecido Andrade. "Densidade mineral óssea e propriedades mecânicas de fêmur de ratos submetidos à hipocinesia dos membros pélvicos e a diferentes programas de reabilitação." Universidade Federal de Viçosa, 2009. http://locus.ufv.br/handle/123456789/2214.
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Previous issue date: 2009-05-15During the absence of load on the skeleton, and even short periods of reduced physical activity, may arise bone weakening. Thus, common medical treatments for diseases muscle-equeléticas involving immobilization through temporary splints, traction or rest forced the risk of fractures increase. Physical activity is studied, both to prevent damage and to promote recovery of bone structure. Therefore, the objective of this research was evaluated by bone densitometry and mechanical testing, the influence of hypocinesia and subsequent activity on a treadmill or free movement in femurs of rats. Sixty-four Wistar rats were used. The animals were created until the age of sixty-five days for the beginning of the procedures experimental. They were divided into eight groups, being three control and five experimental. The animals in group 6 (G6), were created until completeting 93 days of age and served as a control for G1, which was to suspend the animal by the tail for 28 days. In G7, the animals were created until 121 days and were for the control groups, G2 (suspended and trained on a treadmill for 4 weeks) and G4 (suspended and released for 4 weeks. Already in the G8, the animals were created until 149 days and were for the control groups, G3 (suspended and trained on a treadmill for 8 weeks) and G5 (suspended and released for 8 weeks). We analyzed the content and bone mineral density of the left femur by bone densitometry. Another analysis related to mechanical properties of the middle third of the femur (maximum force necessary to break and stiffness). The suspension by the tail caused a decrease in bone mineral density, maximum strength and rigidity of the femur of animals. The training on a treadmill and free activity after suspension promoted the recovery of bone mineral content, density, increased bone stiffness and strength required to produce fracture in a similar way and over time.
Durante a ausência de carga no esqueleto, e mesmo em curtos períodos de atividade física diminuída, pode ocorrer enfraquecimento ósseo. Assim, tratamentos médicos comuns para doenças músculo-equeléticas que envolvam imobilização temporária por meio de talas, repouso forçado ou tração aumentam o risco de fraturas. A atividade física é a medida mais estudada, tanto para evitar danos quanto para promover recuperação da estrutura óssea. Portanto, o objetivo deste estudo foi avaliar, por meio da densitometria óssea e do ensaio mecânico, a influência da hipocinesia e posterior atividade de corrida em esteira ou movimentação livre na caixa em fêmur de ratos. Foram utilizados sessenta e quatro ratos Wistar com sessenta e cinco dias de idade e massa corporal média de 316,11 gramas. Eles foram separados aleatoriamente em oito grupos, sendo três controles e cinco experimentais. Os animais do grupo 6 (G6), foram criados até completarem 93 dias de idade e serviram de controle para G1, composto por ratos suspensos pela cauda por 28 dias. No G7, os animais foram criados até 121 dias e foram controle para os grupos, G2 (suspenso e treinado em esteira por 4 semanas) e G4 (suspenso e liberado por 4 semanas). No G8, os animais foram criados até 149 dias e foram controle para os grupos, G3 (suspenso e treinado em esteira por 8 semanas) e G5 (suspenso e liberado por 8 semanas). Foram analisados o conteúdo e a densidade mineral óssea do fêmur esquerdo por meio de densitometria óssea. Foram analisadas as propriedades mecânicas do terço médio do fêmur (força máxima de ruptura e rigidez). A suspensão pela cauda provocou a diminuição na densidade mineral óssea, na força máxima admitida e na rigidez do fêmur dos animais. O treinamento em esteira e a atividade livre na caixa após a suspensão promoveram recuperação do conteúdo mineral ósseo e da densidade mineral óssea e aumentou a rigidez óssea e a força necessária para produzir fratura de forma semelhante e ao longo do tempo.
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Carlman, Maria, and Carina Engqvist. "Hur skall patienter med metastaser till skelettet förhålla sig till fysisk aktivitet? : en litteraturstudie." Thesis, Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-5122.
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Background : Many cancer patients who get bone metastases live longer thanks to the successful research and development of medicines during recent years. Many studies show general health benefits from physical activity. For patients with bone metastases the possibility of physical activity perhaps should limit? Nurses at oncological units are often in lifelong contact with this group of patients. It´s therefore important to have knowledge about the bone metastases and how it influence the patient´s possibility of performing physical activity in order to support and encourage the patient to safely physical activity. Aim : To describe the patient´s possibility of physical activity with metastases to the bone. Method : A literature study. Results : The extension of the bone metastases shall be verified through X-ray. Based on the result estimation should be done regarding the risks for fractures. Few metastases allow the patient to perform more physical activity. No study showed that physical activity according to carefully elaborated exercise programmes will be of any risk for patients with bone metastases. Conclusions : The conclusion of this study was that research within nursing of the chosen problem is limited. The nurse is the one who often meets this group of patients in treatment and it is important that he/she has adequate knowledge about the individual patients’ possibilities to perform physical activity. Even if the result was not that big there is still a consensus among the articles included. Nevertheless this area seems to be fairly unexplored and more studies are needed to strengthen the evidence.
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Pereira, Izabella Patta 1986. "Análise fotoelástica das tensões induzidas em prótese total inferior reembasada com materiais permanentes resiliente e rígido." [s.n.], 2012. http://repositorio.unicamp.br/jspui/handle/REPOSIP/288547.
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Orientador: Rafael Leonardo Xediek ConsaniDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: O objetivo neste estudo experimental in vitro foi avaliar o comportamento das tensões induzidas nas estruturas de suporte de prótese total, por meio da análise fotoelástica nas seguintes condições: Grupo 1- prótese total convencional, Grupo 2- prótese total convencional reembasada com material rígido permanente à base de resina acrílica e Grupo 3- prótese total convencional reembasada com material resiliente permanente à base de silicone. Para este experimento foram confeccionadas três próteses totais inferiores e uma prótese total superior, possibilitando que os testes fotoelásticos fossem conduzidos com as próteses em posição de máxima intercuspidação habitual. Foram feitos carregamentos axiais no modelo fotoelástico mandibular com cargas de 10, 20 e 30 kgf /cm! em cada corpo-deprova. O Grupo 1 apresentou tensões em toda extensão do rebordo, com maior ênfase na região anterior e lateral esquerda e menor tensão na lateral direita. Na região lateral esquerda, o Grupo 2 apresentou tensões similares ao Grupo 1 nas regiões de pré-molares e trígono retromolar. O Grupo 3 exibiu diminuição das ordens de franja e distribuição homogênea de tensões induzidas. Concluiu-se que prótese total convencional e a prótese total convencional reembasada com material à base de resina acrílica geraram tensões pontuais, podendo acarretar maior reabsorção do tecido ósseo. Já o material reembasador à base de silicone proporcionou distribuição mais homogênea das tensões induzidas pela prótese
Abstract: The aim of this experimental in vitro study was to evaluate the behavior of the stresses induced in the supporting structures of denture through the photoelastic method in the following conditions: Group 1- conventional denture, Group 2- conventional denture relined with hard chairside reline resin and Group 3- conventional denture relined with resilient material silicone-based. For this experiment were made three lower dentures and a maxillary one. The photoelastic tests were conducted with the prosthesis in position of maximum intercuspation. Loads were made in axial position. The mandibular photoelastic model was loaded with 10, 20 and 30 kgf/cm! in each specimen. The Group 1 showed stresses all along the model, with greater emphasis on the anterior and left lateral and less strain on the right side. In the left lateral surface, Group 2 showed similar as Group 1, with stresses in the region of premolar and retromolar trigone. The Group 3 exhibited decreased of fringe orders and homogeneous distribution of induced stresses. It was concluded that the first and the second groups generated punctual tensions, which may cause increased bone resorption. The relining material based on silicone provided more homogeneous distribution of the stresses induced by the prosthesis
Mestrado
Protese Dental
Mestre em Clínica Odontológica
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Willig, R. (Reeta). "Hip fracture—aspects of background factors and outcome." Doctoral thesis, University of Oulu, 2006. http://urn.fi/urn:isbn:9514279808.
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Abstract
There are no definitive laboratory tests for osteoporosis, and little is known of their age-related variation. Furthermore, the knowledge of factors contributing to the occurrence of hip fracture, the most important complication of osteoporosis, during the fall is insufficient. Hip fracture is known to impair the function of elderly patients considerably at short term, but here is only limited information of the potential permanence of this impairment. The goal of treatment is to restore the patient's pre-fracture lifestyle. In this respect, intensive rehabilitation has been recommended and applied in many institutions. However, the number of critical reports on this topic is limited, and the results are heterogeneous.
An assessment of the effects of age on some commonly used parameters of bone metabolism in females was performed on 238 healthy Caucasian women aged 40–86 years. It was observed that the markers of bone formation, alkaline phosphatase and osteocalcin, and the marker of bone resorption, tartrate-resistant acid phosphatase (TRACP) as well as parathyroid hormone (PTH), phosphorus and creatinine increased with age, whereas 25-hydroxyvitamin D [25(OH)D] and oestradiol decreased. All these parameters except calcium showed a significant age relation.
An evaluation of the factors contributing to the occurrence of hip fracture during a fall on the hip was performed by comparing 123 hip fracture patients to 132 persons who had experienced a fall that caused a visible soft tissue injury in the hip or gluteal region without a fracture. The hip fracture patients more commonly than the fallers were women, lived in long-term institutional care, had had previous stroke with hemiparesis, had Parkinsonism, used neuroleptics, were dependent in ADL and had lower body mass indexes. According to the logistic regression model, institutional residence, low body mass index and a history of stroke with hemiplegic status differed between the fracture cases and controls.
The long-term effects (mean follow-up 7 years) of trochanteric hip fracture on outcome were studied by comparing 200 consecutive patients (mean age 77 years) and age- and sex-matched controls representing the average population from the same area. Mortality increased gradually, being 4.5% above the control level at one month and 9% at six years after the fracture. 48% the surviving patients and 90% of the surviving controls were still living in their own homes or service apartments ,whereas 48% of the patients and 5% of the controls were instutionalized. The ambulatory capacity of the patients was significantly worse than controls. The patients managed their ADL activities significantly less well, required more home help and had fewer social contacts and outdoor hobbies than the controls.
An assessment of the effect of intensive rehabilitation on the coping of hip fracture patients was done in a prospective randomised study on 154 patients, half of whom were treated postoperatively in a rehabilitation clinic and the other half at health care centre hospitals. Seven of the 70 survival patients of the rehabilitation group 5 of the 71 respective controls were institutionalized at one year. No difference was either observed in the walking ability or ADL functions between the groups.
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Cardoso, Luiz de Camargo 1958. "Dispositivo customizado produzido por manufatura aditiva para reabilitação oral em pacientes com regiões de atrofia óssea em áreas desdentadas extensas : Custom device produced by additive manufacturing for oral rehabilitation in patients with bone atrophy in regions of large edentulous areas." [s.n.], 2014. http://repositorio.unicamp.br/jspui/handle/REPOSIP/265923.
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Orientador: Cecília Amélia de Carvalho ZavagliaDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Mecânica
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Resumo: A necessidade de reabilitação oral gera o desenvolvimento de inúmeras pesquisas com o intuito de inovações nesta área. O aumento da expectativa de vida, a busca pelo conforto e saúde são fatores primordiais para os aprimoramentos dos novos dispositivos de reabilitação oral. A atual pesquisa trata do desenvolvimento de um dispositivo de titânio intra-oral visando a reabilitação oral em pacientes com regiões ósseas atróficas. Para tanto foram realizados: a obtenção e tratamento da tomografia de um caso adequado; a criação do modelo virtual da mandíbula e do dispositivo; a confecção destes pelo processo de manufatura aditiva; ensaios de flexão e estudos in vitro do material Os valores de resistência à flexão do material foram superiores ao da região mandibular de um humano saudável. A análise do resultado do ensaio de citotoxicidade do titânio Ti-6Al-4V evidencia as características deste de ser um biomaterial. A análise dos resultados dos ensaios, mecânicos e do estudo in vitro, viabiliza a aplicação da liga de titânio Ti-6Al-4V no desenvolvimento deste dispositivo para reabilitação oral. O dispositivo se adapta perfeitamente ao protótipo da mandíbula, permitindo que posteriormente se torne justaposto ao osso e seja fixada a parte protética. Desse modo, o dispositivo desenvolvido possui características adequadas para se tornar uma opção factível para pacientes com regiões orais atróficas posteriores
Abstract: Research and new techniques are a real needed for a better treatment in oral rehabilitation. The increase of life expectancy leads to a search for comfort and health, Are fundamental for the development of devices that may provide an increase in life quality. The scope of this research is the development of a titanium device for intra-oral use that may allow oral rehabilitation in patients with atrophic and extended areas of bone lost. This research aims the device development which will give oral rehabilitation solution to cases where absences of vertical bone quantity does not allow the placement of traditional implants. In this study, were made the gathering and processing of the tomography of an appropriate case, the manufacture of the device by the virtual model and by additive manufacturing, the mechanical flexural test and cytotoxicity study where performed. The results presented show viability for the application that was studied. The flexural strength of the biomaterial was higher than the mandible region of a healthy human and the choice of the materials (titanium Ti - 6Al -4V) did not show any characteristic of cytotoxicity. The developed device is suitable as a prototype of the mandible, allowing subsequent juxtaposition to the bone and be is fixed in the prosthetic part. Thus, the developed device has suitable characteristics to become a feasible option for patients with atrophic oral posterior regions
Mestrado
Materiais e Processos de Fabricação
Mestre em Engenharia Mecânica
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Hoch, Johanna M. "SERUM CARTILAGE OLIGOMERIC MATRIX PROTEIN: A BIOMARKER FOR ACUTE ARTICULAR CARTILAGE DAMAGE." UKnowledge, 2012. http://uknowledge.uky.edu/rehabsci_etds/3.
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Bone bruise lesions (BBL) are documented on MRIs diagnosing acute knee ligament injury (AKLI). Recent evidence has indicated that a majority of patients that sustain an AKLI, especially anterior cruciate ligament (ACL) knee injury, will develop post-traumatic osteoarthritis (PTOA) 10-20 years following injury. It has been proposed that the initial damage sustained to the articular cartilage overlying BBL causes a cascade of events that may result in PTOA.
Researchers have proposed a modification to treatment protocols for more severe BBL, or have stressed the need for the development of protective therapies to protect the articular cartilage. However, there are limited tools available to evaluate the clinical outcome of articular cartilage overlying BBL. Furthermore, damage to the cartilage overlying BBL may be different according to differing BBL severities. Therefore, the use of a cartilage degradation biomarker, serum cartilage oligomeric matrix protein (sCOMP) and the use of a BBL severity classification system may be useful to determine if differences exist between patients with and without BBL, and with differing BBL severities.
The purpose of this dissertation was to investigate the utility of sCOMP as a biomarker for acute articular cartilage damage. The purposes of these studies were to determine the inter and intraday reliability of this marker, to document sCOMP longitudinally in collegiate athletes and following AKLI, and to determine if differences in sCOMP and self-reported pain and function exist for patients with and without BBL, and differing BBL following AKLI.
The results of these studies indicated sCOMP measures had strong inter and intraday reliability. Additionally, exercise does seem to influence sCOMP levels; however, these elevations may not be clinically meaningful. Furthermore, sCOMP levels were not different between patients with BBL and without, and between differing BBL severities. The results of these studies support the use of a BBL severity classification for future research studies in order to further elucidate the outcomes of these lesions.
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Brito, Christina May Moran de. "Perfil de risco de perda óssea em pacientes hemiplégicos crônicos." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/5/5166/tde-25092009-150918/.
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INTRODUÇÃO: A perda óssea acelerada é uma das reconhecidas complicações da hemiplegia pós-acidente vascular encefálico (AVE), mas pouco se sabe sobre o ritmo de perda na fase crônica e seus determinantes. O objetivo deste estudo foi avaliar a evolução tardia da densidade mineral óssea (DMO) em pacientes hemiplégicos crônicos, bem como identificar possíveis fatores associados. MÉTODOS: Foi realizado um estudo longitudinal envolvendo pacientes ambulatoriais com hemiplegia há mais de 12 meses. Pacientes com doenças e outras condições associadas à perda óssea foram excluídos. Avaliações clínica e densitométrica foram realizadas no início e após aproximadamente 16 meses, e foram analisados fatores de risco para perda óssea. RESULTADOS: Cinquenta e sete pacientes foram estudados, sendo 40 do sexo masculino, com média de 59,3 anos e tempo médio de hemiplegia de 33,4 meses. Ao comparar os hemicorpos acometido e não acometido, foi observada perda óssea mais acentuada em antebraço acometido (p=0,001), mas não em fêmur acometido. Foi observada perda óssea significativa em 56% dos pacientes em antebraço e 22,6% em fêmur, no lado acometido. Maior tempo de AVE foi protetor para a perda óssea em antebraço (OR = 0,96, IC 95%: 0,92 0,99; p=0,015), e o uso de anticoagulantes e/ou anticonvulsivantes (OR = 5,83, IC 95%:1,25 27,3; p=0,025) e espasticidade moderada/intensa (OR = 8,29, IC 95%:1,10 62,4; p=0,040) foram determinantes para perda óssea em fêmur. CONCLUSÕES: O presente estudo evidenciou que a perda óssea é comum e frequente em antebraço acometido em pacientes com hemiplegia crônica, com tendência à estabilização da perda com o passar do tempo. Espasticidade mais intensa e uso de anticoagulantes e/ou anticonvulsivantes foram associados à perda óssea em fêmur. Estes achados indicam que pacientes hemiplégicos crônicos devem ser monitorados e tratados para perda óssea, com atenção para os determinantes identificados, e que o membro superior acometido deve ser incluído na avaliação da DMOINTRODUCTION: Accelerated bone loss is a well-known early complication of hemiplegia. However, less is known about chronicphase bone loss and its determinants. The objective of this study was to evaluate long-term changes in bone mineral density (BMD) in chronic hemiplegic patients, and investigate possible related factors. METHODS: A longitudinal study involving chronic stroke-related hemiplegic patients was conducted. Clinical and densitometric evaluations were performed at baseline and after approximately 16 months, and risk factors for bone loss were analyzed. RESULTS: Fiftyseven patients were studied (40 males) with a mean of 59.3 years and with mean time since hemiplegia of 33.4 months. Decrease in BMD was more pronounced in affected forearms compared to the nonaffected forearms (p=0.001). No difference was found between affected and non-affected femurs. Bone loss was observed in 56% of the affected forearms and 22.6% of the affected femurs. Longer time since stroke was protective for bone loss in the forearm (OR = 0.96, 95% CI: 0.92 0.99; p=0.015), and the use of anticoagulation/antiepileptic drugs (OR = 5.83, 95% CI: 1.25 27.3; p=0.025) and moderate/severe spasticity (OR = 8.29, 95% CI: 1.10 62.4; p=0.040) were associated to bone loss in the femur. CONCLUSIONS: Bone loss is common and more frequent in the affected forearm in chronic hemiplegic patients with tendency to stabilize over time. Greater spasticity and use of anticoagulation and/or antiepileptic drugs were proved to be associated with bone loss at the femur. Our findings indicate that chronic hemiplegic patients should be monitored and treated for bone loss, with attention to the identified determinants, and that the upper paretic limb should be included in BMD evaluation
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Moraes, Paulo Hemerson de 1982. "Rehabilitation of fully edentulous maxilla = retrospective survival analysis of dental implants in native x autogenous bone and proposed technique for bone reconstruction with rhBMP-2 = Reabilitações de maxilas totalmente edêntulas: análise retrospectiva de sobrevida de implantes dentários em osso nativo x enxerto autógeno e proposta de técnica para reconstrução óssea com rhBMP-2." [s.n.], 2013. http://repositorio.unicamp.br/jspui/handle/REPOSIP/289417.
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Orientador: José Ricardo de Albergaria BarbosaTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: Em maxilas severamente absorvidas, como tratamento de reabilitação, podem ser utilizados os implantes dentais osseointegráveis convencionais. Todavia, nestas situações, estão presentes obstáculos para a instalação dos implantes como: quantidade insuficiente e qualidade inadequada do osso encontrado na maxila. Nestas situações, são necessárias cirurgias reconstrutivas para restabelecer as dimensões do rebordo avelolar em espessura e altura possibilitando assim a instalação adequada destes implantes. Geralmente, essas reconstruções utilizam osso autógeno retirado de algum sitio doador do paciente, como a calota craniana, costela e crista do ilíaco. Alternativamente, com os avanços da engenharia tecidual, a rhBMP-2 (recombinant human bone morphogenethic protein-2) surgiu eliminando a necessidade de qualquer remoção de sítio doador como também qualquer outro biomaterial nas reconstruções ósseas dos maxilares deixando o procedimento com menor morbidade e maior aceitabilidade dos pacientes. Desta forma, a presente pesquisa apresenta 2 estudos descritos nos capítulos a seguir. CAPÍTULO 1: O objetivo deste estudo foi avaliar a sobrevida de implantes instalados em osso nativo de maxilas como também nas reconstruídas com osso autógeno. Foi obtido um acompanhamento de 8-10 anos com pacientes de ambos os grupos reabilitados com próteses fixas sobre implantes dentais. O sucesso dos implantes em maxilas reconstruídas com ósso autogeno não apresentaram diferenças estatísticas à implantes inseridos em maxilas com osso nativo. CAPÍTULO 2: O objetivo deste estudo foi apresentar uma nova técnica de reconstrução óssea de maxila utilizando rhBMP-2 objetivando previsibilidade e melhores resultados no aumento do volume ósseo necessário. A técnica sugerida ofereceu bons resultados no volume ósseo a ser obtido nas reconstruções ósseas de maxila com rhBMP-2.
Abstract: In maxillary severely absorbed as rehabilitation treatment, can be used conventional dental implants. However, these situations are present obstacles to the installation of the implants as insufficient and inadequate quality of bone found in the jaw , as well as the expansion of the maxillary sinus pneumatization . In these situations, it is necessary reconstructive surgery to restore the dimensions of thickness and height on rim thus allowing proper installation of these implants. Generally, these reconstructions using autogenous bone taken from a donor site from the patient , such as calota craneal , rib and the iliac crest . Alternatively, with advances in tissue engineering, rhBMP-2 (recombinant human bone morphogenethic protein-2) appeared eliminating the need to remove any donor site as well as any other biomaterial in the maxila bone reconstruction procedure with leaving the lower morbidity and higher patient acceptability. Given the above, this research presents two studies described in the following chapters. CHAPTER 1: The objective of this study was to evaluate the survival of implants placed in native bone in the maxilla as well as in maxilla reconstructed with autogenous bone. We obtained a follow-up of 8-10 years with both groups of patients rehabilitated with fixed prostheses on dental implants. The survival of implants in maxilla was reconstructed with autogenous bone implants inserted into the lower maxilla with native bone. CHAPTER II: The objective of this study was to present a new technique for reconstruction of maxilla bone using rhBMP-2 seeking precision in increased bone volume needed. The suggested technique offered precision in bone volume to be obtained in the maxilla bone reconstruction with rhBMP-2.
Doutorado
Cirurgia e Traumatologia Buco-Maxilo-Faciais
Doutor em Clínica Odontológica
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Lombardi, Raymond M. "Bone density as a source of error measuring body composition with the BOD POD and iDXA in female runners." The Ohio State University, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=osu1325172432.
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Soares, Jorge Manuel Martins Terra. "Reconstrução do ligamento cruzado anterior: revisão sistemática - osso-tendão-osso versus ísquiotibiais." Bachelor's thesis, [s.n.], 2014. http://hdl.handle.net/10284/4435.
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Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciado em FisioterapiaObjetivo: Esta revisão tem por objetivo saber como os diferentes enxertos influenciam na recuperação pós ligamentoplastia do ligamento cruzado anterior (LCA), na manutenção do nível de atividade desportiva e score funcional ao longo do tempo. Metodologia: Foi efetuada uma pesquisa computorizada nas bases de dados B-on, EBSCO, Medline, PEdro e Pubmed para identificar estudos clínicos randomizados que, após reconstrução ligamentar do LCA, comparassem os efeitos ao fim de pelo menos dois anos dos enxertos do tendão rotuliano e semitendinoso/gracilis, com publicações entre 2004 e 2014. Resultados: Nesta revisão foram incluídos 5 estudos clínicos randomizados envolvendo 344 indivíduos com a classificação metodológica de 9 em 10 na escala de PEDro, que compararam os diferentes enxertos com programas de reabilitação e instrumentos de avaliação. Conclusão: Constatou-se que a reconstrução anatómica artroscópica do LCA com enxertos de osso-tendão-osso (OTO) em comparação com semitendinoso e gracílis (ST-G) são ambas técnicas seguras e efetivas. Ambos enxertos mostrarem resultados bastantes similares em termos de avaliação subjetiva quantificada com diferentes escalas.
Objective: This review aims to find out how the different grafts influence the recovery after ligamento plasty of anterior cruciate ligament, in maintaining the level of sporting activity and functional score over the time. Methodology: computerized search was performed in the databases B -on, EBSCO, Medline, Pubmed and PEdro to identify randomized clinical trials that made the comparison the effects at least two years after ACL reconstructing of the patellar tendon and semitendinosus / gracilis grafts, , with publications between 2004 and 2014 . Results: this review include 5 randomized clinical trials involving 344 individuals with methodological classification of 9 in 10 in the PEDro scale. that compared the different grafts with rehabilitation programs and instruments evaluation. Conclusion: It was found that arthroscopic anatomic ACL reconstruction with grafts bone-tendon-bone (OTO) compared with semitendinosus / gracilis (ST-G) are both safe and effective techniques. Both grafts show quite similar results in terms of subjective assessment quantified with different scales.
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Silveira, Douglas Severo. "Avaliação bioquímica e densitométrica dos efeitos do ultra-som terapêutico de 1 mhz, na dose de 0,5 OU 1 W/cm2, sobre o tecido ósseo de cães." Universidade Federal de Santa Maria, 2007. http://repositorio.ufsm.br/handle/1/4139.
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Tendineous injuries on distal extremity of members are among the most frequent alterations of the locomotor system in both human and animal clinic-surgical routine and frequently adjuvant therapies are needed for the complete return of the physiological functions. The Therapeutic Ultrasound (TUS) is the most commonly used mode of treating tendineous injuries in rehabilitation clinics. However, due to the lack or the disagreements on specific studies about its effects on bone tissues, the use of TUS on distal regions of members, rich in bone protuberances and areas without muscular covering, always worries the professionals of the medical area. With the intention of clarifying the effects of TUS on bone tissue, 18 dogs were separated randomly into 3 groups, in which they received continuous ultrasonic treatment of 1 MHz for 5 minutes during 20 days on the cranium-distally region of the radio and ulna. According to the pre-determined groups, the frequency of TUS applied was of 0.5 or 1 W/cm2. The serum levels of total proteins, albumin, total calcium, ionic calcium, phosphates, alkaline phosphatase and bone alkaline phosphatase, were measured before the beginning of the therapy and after days 4, 7, 11, 14 and 20 of the treatment. The treated regions were also radiographed for analysis of bone densitometry in radiographic images before the therapy and at the end of the treatment. The laboratory exams detected normal serum levels for the main items researched, excepted for albumin which was inferior to the reference values. The statistic analysis of the results obtained show that the TUS caused alteration on the mineral bone metabolism and on the activity of the osteoblasts, especially on the first 7 days of the application, but did not alter the mineral bone density, no matter what dose was used (0.5 or 1 W/cm2). One can conclude that for the parameters in the experiment, TUS in regions of bone protuberances or deprived of muscular covering can be applied with safety.As lesões tendíneas nas extremidades distais dos membros, estão entre as mais freqüentes alterações do aparelho locomotor da rotina clínico-cirúrgica humana e animal e, não raro, necessitam de terapias adjuvantes para seu completo retorno às funções fisiológicas. O ultra-som terapêutico (UST) é a modalidade mais utilizada nas clínicas de reabilitação para tratar lesões tendíneas, mas devido à falta ou a divergências de estudos específicos sobre seus efeitos no tecido ósseo, sua utilização sobre as regiões distais dos membros, ricas em protuberâncias ósseas e áreas desprovidas de cobertura muscular, sempre preocuparam os profissionais da área médica. No intuito de esclarecer os efeitos do UST sobre o tecido ósseo, 18 cães foram divididos aleatoriamente em três grupos, onde receberam tratamento ultra-sônico contínuo, de 1MHz, durante 5 minutos diários, por um período de 20 dias sobre a região crânio-distal do rádio e ulna. De acordo com os grupos prédeterminados, a freqüência do UST aplicada foi de 0,5 ou 1 W/cm2. Foram mensurados os níveis séricos de proteínas totais, albumina, cálcio total, cálcio iônico, fósforo, fosfatase alcalina e fosfatase alcalina óssea no momento anterior ao começo da terapia e após 4, 7, 11, 14 e 20 dias de tratamento. Também foram radiografadas as regiões tratadas, para análise de densitometria óssea em imagens radiográficas, antes da terapia e ao final do tratamento. Os exames laboratoriais detectaram níveis séricos normais para os principais itens pesquisados, apenas a albumina foi inferior aos valores de referência. As análises estatísticas dos resultados obtidos evidenciaram que o UST causou alterações no metabolismo mineral ósseo e na atividade dos osteoblastos, principalmente nos primeiros 7 dias de aplicação, porém não alteraram a densidade mineral óssea, não importando a dose utilizada (0,5 ou 1 W/cm2). Conclui-se que dentro dos parâmetros utilizados no experimento, a utilização do UST em regiões ósseas protuberantes ou desprovidas de cobertura muscular pode ser feita com segurança.
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Li, Che Tin Raymond. "The stability of EMG median frequency under different muscle contraction conditions and following anterior cruciate ligament injury." Queensland University of Technology, 2004. http://eprints.qut.edu.au/15968/.
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Musculoskeletal injuries are commonly associated with muscle atrophy as a function of immobilization or change of normal function. For example, injuries to the anterior cruciate ligament (ACL) which may involve ligament reconstruction, results in the "quadriceps avoidance" gait which leads to atrophy of the knee extensormuscles. In these situations it is not clear whether or not the atrophy is associated with loss of specific muscle fibre types with accompanying functional deficits. Such knowledge would be helpful in implementing exercise regimes designed to compensate for loss of particular fibre types. It is believed that isokinetic exercise performed at speeds below 180° per second strengthens type I muscle fibres, and type II fibres at fast speeds. However, there is no evidence to indicate the specific muscle fibre response to different rates of muscle contraction. Identification of muscle fibre type is most directly determined by biopsy technique but is too invasive for a routine measurement. Electromyography median frequency has been used as a non-invasive measure to infer muscle fibre composition in various studies. However, the reliability and accuracy of this technique has been questioned and improvement is necessary. This research was designed to provide a more accurate and reliable protocol for the determination of EMG median frequency which may be used, after validation against more direct biopsy techniques, as a routine method for inferring muscle fibre composition. The investigation also explored the muscular response as measured by EMG median frequency to varying speeds of muscle contraction, fatiguing exercise and atrophy following ACL reconstruction. The ultimate aim of this research was to improve the reliability of the determination of EMG median frequency to enhance its application as a predictor of muscle fibre composition. This provides information which may improve ACL rehabilitation programs designed to restore and prevent specific muscle fibre types loss that have not previously been targeted by current rehabilitation programs. This research was conducted in three studies. Study one determined the stability of the EMG median frequency bilaterally for the quadriceps and hamstrings muscles and identified the mode of contraction associated with the greatest reliability. The strength and EMG median frequency of the vastus lateralis, medial hamstrings and vastus medialis of 55 subjects was determined across 5 speeds from 0° to 240° per second using a Kin-Com isokinetic dynamometer and an EMG data acquisition system. Isometric contraction was found to have the least bilateral discrepancy (4.01% ±3.06) and between trials standard deviation (4.50) in the vastus lateralis, medial hamstrings and vastus medialis. Study two investigated the EMG median frequency changes in the vastus lateralis which occur immediately following different speeds of isokinetic exercise to the point of fatigue in normal subjects. Thirty-four subjects participated in the study, and performed a 90-second period of isokinetic exercise to activate the knee extensors at either 30° or 300° per second. EMG median frequency of the vastus lateralis was determined before, immediately after and 7 minutes after the fatiguing exercise. The percentage drop in EMG median frequency of the vastus medialis was gnificantly (p<0.05) greater after slow speed (27.9%) than fast speed (20.25%) exercise, while no significant difference was found for the percentage drop in extension torque. Full recovery was found 7 minutes after the fatiguing exercise. By reference to previous research showing a relationship between EMG median frequency and muscle fibre type, an increase in activation of type I muscle fibres with slow speed exercise and an increase in type II muscle fibres with fast speed exercise was observed. Study three identified the changes in EMG median frequency following ACL reconstruction and evaluated the bilateral differences in EMG median frequency of the knee muscles. The relationships between EMG median frequency and the measures of knee functional ability, knee muscle strength, age and time since surgery were also investigated. Twelve subjects who had undergone ACL reconstruction using a semitendinosus and gracilis graft 6 to 12 months earlier, participated in the study. EMG median frequency was determined from an 8-second isometric contraction and knee functional ability was assessed using the Cincinnati Rating Scale. Bilateral EMG median frequency shifts were inconsistent among subjects. On the basis of previous research which indicated a relationship between EMG median frequency and fibre type, no consistent pattern of muscular fibre type atrophy subsequent to ACL reconstruction occurred within 6 to 12 months (ranged from -43 to 57 Hz). Additionally, no significant correlations were found between the EMG median frequency and the knee functional score and knee extension and flexion torques, age, time since operation and the bilateral differences in EMG median frequency. The results of this investigation will serve to improve the reliability of EMG median frequency across a range of conditions in which it has been evaluated. Further research is needed to confirm the relationship between EMG median frequency and direct observations of muscle fibre composition to improve the predictive value of this measure. Following this validation it will be possible to evaluate the bilateral EMG median frequency shift to infer the type of muscle fibre atrophy, and use this measure in determining the efficacy of specific rehabilitation programs. In conclusion * An 8-second isometric contraction is recommended for determining EMG median frequency. * EMG median frequency of a muscle decreases significantly more after slow fatiguing exercise than after fast speed fatiguing exercise. * There was no generalised bilateral EMG median frequency shift found in a group of subjects 6 to 12 months following semitendinosus and gracilis graft ACL reconstruction. * The results of this study will serve to improve the reliability of procedures used to determine EMG median frequency under a range of different contractile conditions. The EMG median frequency changes in response to these conditions require further validations with muscle biopsy in future.
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Daissè, Gilda. "Interfacial bond behavior of steel-FRCM composites applied to a masonry substrate." Master's thesis, Alma Mater Studiorum - Università di Bologna, 2017.
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In the last decades the theme of structural rehabilitation has acquired great importance and the adoption of composite materials in civil engineering applications has been a turning point in this field. The cement-based matrix of FRCM composites presents many advantages for their application to historical buildings. This dissertation presents a study of the influence of composite bonded length and width on the load response and failure mode. Two types of mortar matrix and two different steel densities were employed. The classical push pull configuration is adopted where fibers are pulled while the masonry block is restrained. Based on the experimental results and through a fracture mechanics approach, the cohesive material laws for mode II was obtained. For the completeness of the work, the characterization of each material involved in the single-lap shear test has been achieved.
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Bittencourt, Aline Gomes. "Referências anatômicas ao giro basal da cóclea no assoalho da fossa craniana média para o implante coclear." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/5/5143/tde-05082014-151655/.
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Introdução: A técnica clássica para o implante coclear é realizada por meio de mastoidectomia seguida de timpanotomia posterior. O acesso pela fossa craniana média provou ser uma alternativa valiosa, embora seja usada para o implante coclear, ainda sem normatização. Objetivo: Descrever um novo acesso pela fossa craniana média que expõe o giro basal da cóclea para o implante coclear. Métodos: Estudo anatômico de ossos temporais. Foram dissecados 50 ossos temporais. A cocleostomia foi realizada mediante um acesso via fossa craniana média, na porção mais superficial do giro basal da cóclea, usando o plano meatal e seio petroso superior como as principais referências anatômicas. Foi determinada a distância entre os pontos de referência, o ângulo entre o plano meatal e a cocleostomia, e a distância entre esta estrutura e a janela redonda. Foi realizada tomografia computadorizada em 5 dos ossos temporais utilizados neste estudo. Resultados: Em todos os 50 ossos temporais, apenas a porção mais superficial do giro basal da cóclea foi aberta e tanto as escalas timpânica como a vestibular foram visualizadas. As distâncias médias ± DP, menores e maiores, entre a cocleostomia e o plano meatal foram estimadas em 2,48±0,88mm e 3,11±0,86mm, respectivamente. A distância média da cocleostomia até a janela redonda foi de 8,38±1,96mm, e daquela até o seio petroso superior 9,19±1,59mm. As distâncias médias, menores e maiores, entre a cocleostomia e o eixo longo do plano meatal a partir da sua porção mais proximal foram estimadas em 6,63±1,38mm e 8,2±1,43mm, respectivamente. O valor médio do ângulo entre a cocleostomia e o plano meatal foi igual a 22,54±7,400. As tomografias computadorizadas demonstraram a inserção do feixe de eletrodos por meio do giro basal da cóclea até o seu ápice em todas as peças submetidas a este exame. Conclusão: A técnica proposta para identificar o giro basal da cóclea é simples e confiável. Igualmente, permite a visualização da escala timpânica e a inserção do feixe de eletrodos do implante coclear através desta câmaraIntroduction: The classic technique for cochlear implantation uses mastoidectomy followed by posterior tympanotomy. The middle cranial fossa approach has proved to be a valuable alternative for cochlear implantation, although the standardization of this technique is still needed. Objectives: To describe a novel approach through the middle cranial fossa for exposing the cochlear basal turn for cochlear implantation. Materials And Methods: Anatomical temporal bone study. Fifty temporal bones were dissected. A cochleostomy was performed via a middle fossa approach on the most superficial part of the cochlear basal turn, using the meatal plane and superior petrous sinus as the main landmarks. The distance between the landmarks, the angle between the cochleostomy and the meatal plane, and the distance between this structure and the round window were measured. A computed tomography was performed on 5 of the studied temporal bones. Results: In all 50 temporal bones, only the superficial portion of the cochlear basal turn was uncovered. The cochlear exposure allowed both the scala tympani and vestibule to be exposed. The mean ± SD minor and major distances between the cochleostomy and the meatal plane were estimated to be 2.48±0.88mm and 3.11±0.86mm, respectively. The mean distance from the cochleostomy to the round window was 8.38±1.96mm, and that to the superior petrosal sinus was 9.19±1.59mm. The mean minor and major distances between the cochleostomy and the long axis of the meatal plane from its most proximal portion were estimated to be 6.63±1.38mm and 8.29±1.43mm, respectively. The mean angle between the cochleostomy and the meatal plane was 22.54±7.400. The computed tomography of all 5 temporal bones demonstrated the insertion of the implant array from the cochlear basal turn towards its apex. Conclusion: The proposed technique for identifying the cochlear basal turn is simple and trustworthy. Additionally, it enables visualization of the scala tympani, facilitating the insertion of the cochlear implant array through this chamber
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Deneno, Bianca Pratelezzi. "Resultado funcional em crianças e adolescentes submetidos a hemipelvectomia interna tipo II com ou sem reconstrução do anel pelvico." [s.n.], 2007. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312076.
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Orientador: Silvia Regina BrandaliseDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: Os tumores ósseos malignos perfazem 7% dos tumores em pacientes menores de 20 anos de idade, sendo 10 a 15% deles, localizados em pelve. Com o advento da poliquimioterapia, radioterapia e novas técnicas cirúrgicas, a taxa de sobrevida livre de doença, em cinco anos, das crianças e adolescentes acometidos por tumor ósseo não metastático, está ao redor de 70%. Atualmente, pode ser observado o impacto dos efeitos estéticos e funcionais decorrentes do tratamento, e sua interferência na qualidade de vida desses indivíduos. O objetivo do presente estudo foi avaliar retrospectivamente, os resultados funcionais em crianças e adolescentes portadores de tumores pélvicos, submetidos à hemipelvectomia interna tipo II, com ou sem reconstrução do anel pélvico. Foram avaliados 31 pacientes portadores de tumor pélvico, tratados no Centro Boldrini e no Hospital A.C. Camargo, entre 1994 e 2005. O resultado funcional foi baseado no Sistema de Avaliação Funcional, padronizado por Enneking et al (1993). Os critérios analisados foram: dor, função, aceitação emocional, necessidade de suporte, capacidade de deambulação e marcha. Dos 31 casos seguidos, 12 (38,7%) fizeram a reconstrução do anel pélvico com enxerto de fíbula e 19 (61,3%) não a fizeram. A média de idade dos pacientes foi de 11,4 anos (4-17,8 anos). A média de seguimento para os 31 casos foi de 41 meses. O resultado funcional final obtido aos 12 meses do pós-operatório, foi excelente em 17,4 % dos pacientes (todos com reconstrução do anel pélvico), bom em 60,9% dos pacientes, regular em 17,4% e ruim em 4,3%. A média do escore foi melhor no grupo de pacientes com a reconstrução com autoenxerto de fíbula, comparativamente ao grupo de pacientes que não tiveram esta reconstrução, sendo significativa a diferença entre os grupos (p=0,008)
Abstract: Seven percent of all malignant tumors in patients less than 20 years old are bone tumors, being 10 to 15% of them localized in pelvis. The overall survival of these non metastatic patients, with polichemoterapy, radiation and new surgery approach is 70% in 5 years. Nowadays, the impact of esthetical and functional effects due to treatment interfere in their quality of life. The objective of this study was to assess, retrospectively, the functional results in children and adolescents with pelvic tumors, who underwent type II internal hemipelvectomy, with or without reconstruction of the pelvic ring. Thirty-one patients with pelvic tumor were treated at Boldrini¿s Hospital and A.C. Camargo Hospital during the period of 1994 and 2005. The functional result was evaluated based on the System for the Functional Evaluation, standardized by Enneking et al (1993). The analyzed criteria were: pain, function, emotional acceptance, need to support, walking ability and gait. Out of the 31 cases analyzed, 12 (38,7%) underwent reconstruction of the pelvic ring with fibular graft and 19 (61,3%) did not have reconstruction. The mean age of the patients was 11. 4 years (4 - 17,8 years). The mean of follow-up for the 31 cases was 41 months. The functional result, obtained 12 months after the surgery, was excellent in 17,4 % of the patients (all of them with pelvic ring reconstruction), good in 60,9% of the patients, regular in 17,4% and poor in 4,3%. The mean of score was better in the group of patients who underwent reconstruction with fibular autograft, comparatively to the group of patients who did not have pelvic ring reconstruction. The global functional result showed significant difference among the groups with and without reconstruction of the pelvic ring (p = 0,008)
Mestrado
Saude da Criança e do Adolescente
Mestre em Saude da Criança e do Adolescente
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Lesser, Juan Carlos Cisneros. "Avaliação do trauma intracoclear causado pela inserção do feixe de eletrodos do implante coclear via fossa média em ossos temporais." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/5/5143/tde-03052017-152606/.
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Introdução: O acesso pela via da fossa craniana média para colocação do implante coclear provou ser uma alternativa valiosa em pacientes com otite média crônica e cavidades de mastoidectomia instáveis, cócleas parcialmente ossificadas e em alguns casos de displasia do ouvido interno. Até hoje não existem pesquisas que descrevam se a inserção do feixe de eletrodos pela via da fossa média pode ser feita com um mínimo de traumatismo intracoclear, comparável ao observado nas inserções pela janela redonda. Objetivo: Avaliar o trauma intracoclear com dois modelos distintos de implante quando o feixe de eletrodos é inserido por cocleostomia na fossa craniana média em ossos temporais. Método: 20 ossos temporais retirados antes de 24 horas pós-óbito, foram implantados através do local da cocleostomia no giro basal da cóclea identificado no assoalho da fossa cerebral média. Dez peças receberam um implante reto e dez um pré-curvado, e foram fixadas em resina epóxi. Foi realizada tomografia computadorizada para determinar a colocação adequada do feixe eletrodos, profundidade de inserção e a distância entre a janela redonda e a cocleostomia. Por último, as peças foram polidas em série, tingidas e visualizadas por estereomicroscópio para avaliar a posição do feixe e trauma intracoclear. Resultados: A tomografia mostrou um posicionamento intracoclear do feixe de eletrodos nas 20 peças. No grupo dos implantes retos a média de eletrodos inserido foi 12,3 (10 a 14) e dos pré-curvados 15,1 (14 a 16) com uma diferença significativa (U=78, p=0,0001). A mediana de profundidade de inserção foi maior para o eletrodo pré-curvado (14,5mm) que para o reto (12,5mm) com diferenças estatisticamente significativas (U = 66, p = 0,021). Só uma das 20 inserções foi atraumática e 70% tiveram graus de trauma altos (grau 3 ou 4). Não foram observadas diferenças significativas do grau de trauma entre os dois tipos de feixes nem quando as inserções foram no sentido da janela redonda, comparado com o sentido do giro médio. Conclusões: A técnica cirúrgica utilizada permitiu a inserção do feixe de eletrodos na cóclea em todas as peças, porém sem garantir uma inserção na escala timpânica e com alto risco de trauma nas microestruturas da cócleaIntroduction: In recent years, a middle fossa approach has been described for the insertion of cochlear implants, and it proved to be a reliable alternative for implantation in patients with chronic supurative otitis media, unstable mastoid cavities with recurrent otorrhea, partially ossified cochlea and in some cases of inner ear dysplasia. Until now, no research has been done to describe if this approach allows for anatomic preservation and non-traumatic insertions comparable to those through the round window. Objective: To evaluate cochlear trauma when the cochlear implant electrode is inserted through a middle fossa approach by means of histologic and imaging studies in temporal bones. Methods: 20 temporal bones retrieved before 24 hours after death were implanted through a middle cranial fossa cochleostomy in the basal turn of the cochlea. Ten received a straight electrode and 10 a perimodiolar electrode. After reducing the bone size with preservation of the inner ear structures, the temporal bones were fixed, dehydrated and embedded in an epoxy resin. CT scans were performed to determine if an adequate direction of insertion was attained, the depth of insertion and the distance between the cochleostomy and the round window. At last, the samples were polished by micro-grinding technique and microscopically visualized to evaluate intracochlear trauma. Results: The CT-scan showed an adequate intracoclear position of the electrode in all the samples. In the straight electrode group the average number of inserted electrodes was 12.3 (10 to 14) against 15.1 (14- 16) for the perimodiolar (U=78, p=0.0001). The median depth of insertion was significantly larger for the perimodiolar electrode group (14.4mm vs. 12.5mm U=66, p = 0.021). Only one atraumatic insertion was achieved and 70% of the samples had important trauma (grades 3 and 4). No differences were identified for the trauma grades between the two groups of electrodes. Also, there were no differences in trauma if the cochlear implants were inserted in the direction of the basal turn of the cochlea or in the direction of the middle and apical turns. Conclusions: The surgical technique that was used allowed for a proper intracochlear insertion of the electrodes in all 20 temporal bones but it does not guarantee a correct scala tympani position and carries high trauma risk for the intracochlear microstructures
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Kam, Weng Yuen. "Selective Weakening and Post-Tensioning for the Seismic Retrofit of Non-Ductile RC Frames." Thesis, University of Canterbury. Department of Civil and Natural Resources Engineering, 2010. http://hdl.handle.net/10092/5237.
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This research introduces and develops a counter-intuitive seismic retrofit strategy, referred to as “Selective Weakening” (SW), for pre-1970s reinforced concrete (RC) frames with a particular emphasis on the upgrading of exterior beam-column joints. By focusing on increasing the displacement and ductility capacities of the beam-column joints, simple retrofit interventions such as selective weakening of the beam and external post-tensioning of the joint can change the local inelastic mechanism and result in improved global lateral and energy dissipation capacities.
The thesis first presents an extensive review of the seismic vulnerability and assessment of pre-1970s RC frames. Following a review of the concepts of performance-based seismic retrofit and existing seismic retrofit solutions, a thorough conceptual development of the SW retrofit strategy and techniques is presented. A “local-to-global” design procedure for the design of SW retrofit is proposed. Based on the evaluation of the hierarchy of strength at a subassembly level, a capacity-design retrofit outcome can be achieved using various combinations of levels of beam-weakening and joint post-tensioning. Analytical tools for the assessment and design of the SW-retrofitted beam-column joints are developed and compared with the test results.
Nine 2/3-scaled exterior joint subassemblies were tested under quasi-static cyclic loading to demonstrate the feasibility and effectiveness of SW retrofit for non-ductile unreinforced beam-column connections. Parameters considered in the tests included the presence of column lap-splice, slab and transverse beams, levels of post-tensioning forces and location of beam weakening. Extensive instrumentation and a rigorous testing regime allowed for a detailed experimental insight into the seismic behaviour of these as-built and retrofitted joints. Experimental-analytical comparisons highlighted some limitations of existing seismic assessment procedures and helped in developing and validating the SW retrofit design expressions. Interesting insights into the bond behaviour of the plain-round bars, joint shear cracking and post-tensioned joints were made based on the experimental results.
To complement the experimental investigation, refined fracture-mechanic finite-element (FE) modelling of the beam-column joint subassemblies and non-linear dynamic time-history analyses of RC frames were carried out. Both the experimental and numerical results have shown the potential of SW retrofit to be a simple and structurally efficient structural rehabilitation strategy for non-ductile RC frames.
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Bahillo, Varela José. "Sustitutos de Amalgama para la obtención de un composite que nos permita obturar las cavidades de manera rápida y sencilla." Doctoral thesis, Universitat Internacional de Catalunya, 2015. http://hdl.handle.net/10803/315650.
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La Odontología conservadora ha dado varios cambios sustanciales, el ultimo se llama
"odontología adhesiva". Los avances en la tecnología adhesiva han simplificado los
procedimientos dentales, ofreciendo un resultado más estético a los pacientes y un tratamiento
más conservador a los clínicos.
Estás mejoras en la adhesion, el aumento de la demanda de la sociedad hacia
restauraciones más estéticas o restauraciones libres de metal, junto con el interés de
profesionales dentales por materiales del color del diente, hizo que el uso de la amalgama y
otros metales utilizados en boca cada vez más controvertido, a pesar de la ausencia de pruebas
científicas definitivas .
El objetivo de esta tesis se centró en analizar el desarrollo de la odontología adhesiva;
se evaluó la adaptación marginal, analizando cuantitativamente mediante microscopía
electrónica la cantidad de márgenes continuos y no continuos en restauraciones de clase V
empleando un adhesivo de grabado total con diferencias en la aplicación del ácido
ortofosfórico. Cualitativamente mediante el OCT, se analizó la posible propagación de las
grietas o márgenes no continuos. Se evaluó también la adaptación marginal de un composite
de polimerización dual como un sustituto de amalgama con diferencias en el grabado de ácido
ortofosfórico en esmalte y diferentes modos de polimerización química y dual, con el objetivo
de obtener la restauración de cavidades de una forma rápida y sencilla. Por último se
describió el paso a paso de una rehabilitación adhesiva de composite en un paciente joven con
un enfoque mínimamente invasivo, restaurando la salud, la función biomecánica y la
apariencia estética.
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Arquez, Ana Paula. "Aplicação de laminado de polímero reforçado com fibras de carbono (PRFC) inserido em substrato de microconcreto com fibras de aço para reforço à flexão de vigas de concreto armado." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/18/18134/tde-29062010-114146/.
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O reforço de elementos estruturais de concreto armado com uso de polímeros reforçados com fibras de carbono (PRFC) está cada vez mais conhecido, seguro e acessível. Em todo o mundo, a aplicação do PRFC vem sendo estudada sob diversas técnicas. Características como elevada resistência à tração e à corrosão, baixo peso, facilidade e rapidez de aplicação são os principais fatores para essa disseminação. Em particular, a técnica aqui estudada é conhecida como Near Surface Mounted (NSM), que consiste na inserção de laminados de PRFC em entalhes realizados no concreto de cobrimento de elementos de concreto armado. Com dupla área de aderência, ela vem a suprir uma deficiência comum no reforço colado externamente, que é o seu destacamento prematuro. Como nas demais técnicas de reforço à flexão, o material é colado na região do concreto tracionado. Sabe-se que, na prática da intervenção, essa região frequentemente encontra-se danificada por razões diversas, como fissuração causada por ações externas, corrosão da armadura e deterioração do concreto, o que exige a sua prévia reparação. Considerando que a boa qualidade desse reparo é imprescindível à eficiência do reforço, propõe-se uma inovação técnica pela reconstituição da face tracionada da viga com um compósito cimentício de alto desempenho, que sirva como substrato para aplicação do PRFC e elemento de transferência de esforços à estrutura a ser reforçada. Produzido à base de cimento Portland, fibras e microfibras de aço, o compósito tem também potencial para retardar a abertura de fissuras e aumentar a rigidez da viga, melhorando o aproveitamento do reforço. Com apoio da mecânica do fraturamento, foi possível encontrar as taxas de fibras e microfibras de aço a serem adicionadas a uma matriz cimentícia especialmente desenvolvida. Foram realizados ensaios de aderência para estudar o processo de transferência de tensões cisalhantes do laminado para o compósito na zona de ancoragem da viga. Uma vez conhecido o comportamento do sistema, foram ensaiadas vigas de concreto armado de tamanho representativo de estruturas reais, em três diferentes versões de ancoragem do laminado, sendo duas delas com uso do compósito cimentício. Comprovou-se a eficiência da inovação proposta, constatando-se o aumento da rigidez e da capacidade de carga da viga reforçada, com excelente aproveitamento do laminado. Além disso, as fibras e microfibras diminuíram a abertura das fissuras em estágios mais avançados de carregamento, sem que se observasse fissuras horizontais próxima ao reforço, que poderiam indicar destacamento iminente do laminado de PRFC.Strengthening of reinforced concrete elements with carbon fiber reinforced polymer (CFRP) is increasingly well known, safe and accessible. The application of CFRP has been studied worldwide using various techniques. Features like high tensile strength, corrosion resistance, lightweightness and easy and speedy application are the main factors for dissemination. In particular, the technique here analyzed is known as Near Surface Mounted (NSM), which involves inserting CFRP strips into grooves made on the concrete cover of reinforced concrete elements. With double bonding area, this technique avoids the premature peeling-off that usually takes place in externally bonded CFRP reinforcement. As in others flexural strengthening techniques, the material is bonded in the concrete tension region. It is known in strengthening practice that this region usually requires prior repair. Often it shows up damaged by several reasons such as cracking caused by external actions, reinforcement corrosion and deterioration of the concrete. Whereas the good quality of this repair is essential to strengthening efficiency, an innovative technique is proposed. A high-performance cementitious composite is used as a transition layer for insertion of CFRP strips. The composite is made of Portland cement, steel fibers and microfibers of steel. It also has the potential to delay crack opening and to increase the beam stiffness. Based on fracture mechanics, it was possible to find suitable volume fractions of steel fibers and microfibers to be added to the cementitious matrix. Bonding tests were performed to analyze the shear stress transferring from the CFRP laminate to the beam anchorage zone. Once known the system behavior, real size reinforced concrete beams were tested in three different versions of the anchorage conditions, two of them with use of cementitious composites. The efficiency of the proposed innovation was proved by confirming increased stiffness and load capacity of the strengthened beam. In addition, fibers and microfibers allowed the decrease of the crack opening in later loading steps. No horizontal cracks near to the reinforcement were noticed, which means that CFRP laminate peeling-off was not likely to occur.
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JAPIASSÚ, Pammila. "Estudo do mecanismo de aderência de azulejos e argamassas de cal em revestimentos históricos." Universidade Federal de Goiás, 2011. http://repositorio.bc.ufg.br/tede/handle/tde/1339.
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Previous issue date: 2011-05-16The historical glazed tiles facades are an important luso-brazilian cultural expression that must be conserved and preserved. The bonding loss of glazed tiles to laying mortars is one of the most critical pathologic manifestations of this kind of coating. However, despite this importance, there‟s still a lack of studies about the bonding mechanism between this historical components. Accordingly, this dissertation proposed to perform an experimental and exploratory research, which the main objective is to give some contribution to the understanding of the ancient tile‟s bonding mechanism to the aerial lime-based mortar of historical buildings facade. For this, were analyzed samples of facade historical ceramic coating, between the late XIX and early XX century, of Ovar‟s buildings, in Portugal. In order to reproduce the historical bonding mechanism, were also analyzed ceramic coating applied in laboratory studying mortars of rehabilitation. In the first stage, were analyzed the ceramic coating and the mortars historic of three cases, as well was performed the interface‟s study between this two materials. In the second stage, were produced ceramic coatings in laboratory using tiles (similar to the historical ones) and four types of mortars of rehabilitation, composed by aerial lime, metakaolin and sand, varying the content of pozolana in 0%, 5%, 10% e 15%, replacement of lime in volume. In this stage, were characterized the tile, the raw materials of the mortar, and mortar in the fresh and hardened. Finally, yet was studied the interface between the glazed tile and the mortar of rehabilitation, in order to compare this one to the historical one. It was observed in the analysis of the historical ceramic coatings that the values of bond strength and of extension of bond were more related to the agregates granulometry than to the binder/aggregate of the laying mortars. In the case of the ceramic coatings molded in laboratory, it was found the influence of the metakaolin content in the rehabilitation mortars in bond strength. It was also observed a possible influence of the shape of the tile‟s back surface in the bonding of ceramic coatings. By the analysis in the SEM was identified the morphology of the products of carbonation and possible pozzolanic reactions in the studied mortars, that contributing to the increased bond strength of these materials.
Os azulejos históricos em fachada são uma importante expressão cultural luso-brasileira, que deve ser conservada e preservada. A perda de aderência dos azulejos à argamassa de assentamento é uma das manifestações patológicas mais graves desse tipo de revestimento. No entanto, apesar dessa importância, ainda existe uma carência de estudos sobre o mecanismo de aderência entre esses componentes históricos. Nesse sentido, essa dissertação se propôs a realizar uma pesquisa exploratória e experimental, cujo objetivo principal é dar contribuição ao entendimento do mecanismo de aderência dos azulejos antigos à argamassa à base de cal aérea de fachada de edificações históricas. Para tanto, foram analisadas amostras de revestimentos cerâmicos históricos de fachada, entre o final século XIX e início do século XX, de edificações de Ovar, em Portugal. No intuito de reproduzir o mecanismo de aderência histórico, foram analisados também revestimentos cerâmicos aplicados em laboratório estudando argamassas de reabilitação. Na primeira etapa, foram caracterizados os azulejos e as argamassas históricas de três casos, bem como realizado o estudo interface entre esses dois materiais. Na segunda etapa, foram produzidos revestimentos cerâmicos em laboratório utilizando azulejos (similares aos históricos) e quatro tipos de argamassas de reabilitação, compostas por cal aérea, metacaulim e areia, variando o teor de pozolana em 0%, 5%, 10% e 15%, de substituição da cal em volume. Nesta etapa, foram caracterizados o azulejo, as matérias-primas da argamassa, assim como argamassa no estado fresco e endurecido. Por fim, ainda foi estudada a interface entre o azulejo e a argamassa de reabilitação, visando compará-la com a histórica. Observou-se na análise dos revestimentos cerâmicos históricos que os valores de resistência de aderência e de extensão de aderência estavam mais relacionados à granulometria dos agregados do que à relação aglomerante/agregado das argamassas de assentamento. No caso dos revestimentos cerâmicos moldados em laboratório, constatou-se a influência do teor de metacaulim nas argamassas reabilitação na resistência de aderência. Foi observada também uma possível influência da muratura do tardoz do azulejo na aderência dos revestimentos cerâmicos. Pelas análises no MEV foi identificada a morfologia de produtos de carbonatação e de possíveis reações pozolânicas nas argamassas estudadas, que contribuem para o aumento da resistência de aderência dessas.
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esquillo, mariusse chars, and 馬俐歐. "IMPLANT REHABILITATION OF SEVERELY ATROPHIED MAXILLARY ALVEOLAR RIDGE AFTER LATERAL TRAP DOOR WINDOW SINUS LIFT TECHNIQUE WITHOUT BONE GRAFT." Thesis, 2009. http://ndltd.ncl.edu.tw/handle/28324109143988538148.
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碩士國立陽明大學
臨床牙醫學研究所
98
Bone quantity and quality play an important role in the rehabilitation of edentulous ridges. Anatomic considerations such as in early loss of maxillary posterior teeth leads to rapid resorption of bone in the alveolar process below the maxillary sinus. In order to compensate for the loss bone, augmentation of the maxillary sinus floor is required using sinus lift procedure. The classic procedure for the augmentation entails the preparation of a trap door to elevate the Schneiderian membrane in the lateral sinus wall. While autogenous bone has long been considered the gold standard grafting material because of its osteoinductive and osteoconductive properties, alternative materials have, in general, no osteoinductive potential but are considered to provide a scaffold for optimal bone growth. More so, autogenous bone grafting presents a major disadvantage in requiring a second surgical site with associated morbidity. Recent cases of immediate implant placement in maxillary alveolar ridge after performing sinus lift without bone graft challenges the utility of conventional approach involving placement of filling materials into the sinus space created during the sinus lift procedure. It is conceivable that that formation of new bone in the maxillary sinus does not require the presence of various grafts as scaffolds, rather, the maintenance of space for blood clot formation followed by the resorption and deposition of bone cells derived from the sinus periosteum or peripheral cancellous marrow in the maxilla is proposed to explain the appearance of new bone in the maxillary sinus. This study aims to review the survival of implant cases which underwent the implant placement after sinus lift without bone graft performed at Taipei Veterans General Hospital – Department of Oral & Maxillofacial Surgery.
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Cheng, Chia-Chun, and 鄭家囷. "Effects of omega-3 polyunsaturated fatty acids and exercise rehabilitation on bone health in patients with chronic obstructive pulmonary disease." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/67103877246580215810.
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碩士中山醫學大學
營養學系碩士班
101
Systemic inflammation and osteoporosis are common complications in patients with COPD (chronic obstructive pulmonary disease). The level of physical activity and quality of life could be significantly affected in severe cases. Several inflammation markers (CRP, IL-1, IL-6, IL-11 and TNF-α) have been known to enhance osteoclastic activity and bone resorption, and to inhibit bone formation on the other hand, and thus increase the risk for osteoporosis and fractures in these patients. The results of earlier studies show that omega-3 polyunsaturated fatty acids of fish oil may inhibit local inflammation, and reduce the heart rate and overall oxygen consumption when performing steady-state submaximal exercise. In addition, intervention with pulmonary rehabilitation and physical activity may be able to slow down the deterioration of lung function and improve the quality of life in COPD patients. The current study was carried out to investigate the effects of omega-3 polyunsaturated fatty acids and exercise rehabilitation on bone health status and inflammatory response in COPD patients of GOLD II to IV. Thirty subjects with COPD were recruited from the outpatient clinic of chest medicine in Chung Shan Medical University Hospital, Taichung. Daily dose of fish oil supplementation was 957 mg of EPA plus 638 mg of DHA. The duration of intervention was 6 months. All subjects were asked to record the items and length of time of their daily home-based pulmonary rehabilitation and physical activity during the intervention. Data were collected at baseline and at the third and sixth month post-intervention, including the medical history, anthropometric measurements, blood samples, questionnaire and assessment of activity capacity, and lung function measurements as well. Bone mass were measured by dual-energy X-ray absorptiometry at baseline and at the sixth month post-intervention. Venous blood samples were analyzed for serum levels of markers for bone resorption (cross-linked carboxy-terminal telopeptide of type I collagen, ICTP) and bone formation (osteocalcin, OST), as well as inflammation markers, including IL-6 (interleukin-6) and Hs-CRP (high sensitivity C-reactive protein). The results showed that the mean bone mineral density at lumbar spine and femoral neck, and inflammation markers 6 months post-intervention did not significantly differ from baseline. However, there appeared to be trends toward an increase in the result of activity capacity (six-minute walking distance) and improvement in lung function measurements, and a downward trend in St George’s Respiratory Questionnaire (SGRQ) scores was also observed. At six months post-intervention, there were also trends observed for an elevation in serum level of OST, and a decrease in serum ICTP, although not statistically significant. In conclusion, supplementation of fish oil and intervention with pulmonary rehabilitation may slow down the rate of bone loss and the deterioration of lung function, and may improve activity capacity and quality of life in patients with COPD. Whether the effects sustain or if a longer period of time for intervention is necessary to observe significant effects need to be further studied.
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"Substitution of cranialcruciate ligament in dogs with homolog bone tendon segment conserved in 98% glycerin and submitted to different rehabilitation procedures." Tese, Biblioteca Digital de Teses e Dissertações da UFSM, 2006. http://coralx.ufsm.br/tede/tde_busca/arquivo.php?codArquivo=423.
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Stock, Vera. "Bewertung des Langzeiterfolgs der kaufunktionellen Rehabilitation mit implantatgetragenem Zahnersatz in Kombination mit autogenem Knochentransfer anhand unterschiedlicher statistischer Verfahren." Doctoral thesis, 2010. http://hdl.handle.net/11858/00-1735-0000-0006-AF7D-8.
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Su, Ching-cheng, and 蘇清正. "Periodontal-Prosthetic Case Reports-Represented by a case of immediate implant placement to gain the height of the alveolar bone after the extraction of the teeth and the rehabilitation of full mouth." Thesis, 2004. http://ndltd.ncl.edu.tw/handle/02356699854437372481.
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碩士高雄醫學大學
牙醫學研究所碩士在職專班
92
The severely destroyed alveolar bone of the chronic severe periodontal teeth will atrophy even more quickly after the extraction of the teeth.This phenomenon often causes the difficulty of later prosthetics.Even if bone grafting and tissue grafting have been conducted many times at the same area,it is also hard to increase even half of the original height of alveolar bone .In order not to let patients suffer the pain from the operations and to improve the effectiveness of the operation,immediate implant placement into the socket after the extraction of the teeth to gain the height of alveolar bone is very important. The objective of the case report was to evaluate the preservation of the height of the alveolar bone after the extraction of the teeth with the chronic severe periodontal disease.The results of this report support the conclusion that periodontal infected site may be not a contraindication for immediate implant and even for severe peridontal teeth if appropriate administration of periodontal infection has performed before implant placement,as describe by Novaes Jr. and Novaes coworkers,such as antibiotic administration,meticulous cleaning,and alveolar debridement before surgery.In addition,primary flap closure is also desirable when placing immediate implants,and avoid exposure of the implant must be considered.
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Обожина, Д. А., and D. A. Obozhina. "Программа физической реабилитации женщин с остеопорозом в период постменопаузы : магистерская диссертация." Master's thesis, 2015. http://hdl.handle.net/10995/36203.
Full textAbstract:
Профилактика остеопороза является актуальной задачей, решение которой способно значительно улучшить показатели продолжительности и качества жизни. Проблема состоит в поиске путей повышения минеральной костной массы у женщин на начальной стадии остеопороза в период постменопаузы.
Цель исследования – Нормализовать состав тела женщины в постменопаузе.
В соответствии с целью была выдвинута гипотеза: предполагается, что в ходе систематической, целенаправленной работы посредством комплексного использования идеомоторных упражнений, комплекса физических упражнений, массажа и правильного питания положительно повлияет на увеличение минеральной костной массы у женщин в период менопаузы.Prevention of osteoporosis is a very important task and is aimed to improve indices of life-span and quality of life. The main issue is to search the pathways of increasing mineral bone mass in female population at early stage of osteoporosis in menopause. The objective of the study was to normalize body composition of women in postmenopause. It was suspected that implementation of complex systematic task-orientic work with the use of ideomotor exercise, set of physical exercise, massage and nutrition will benefit for increase of bone mineral mass in postmenopausal women.
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Teixeira, Ana Rita Cardoso. "Reabilitação oral cirúrgica: aumento ósseo vertical da maxila - limitações éticas." Master's thesis, 2017. http://hdl.handle.net/10284/6377.
Full textAbstract:
Introdução: Frequentemente após extrações ou pneumatização do seio maxilar, é frequente a perda de rebordo alveolar devido à sua reabsorção ficando assim impossibilitados de realizar uma correta reabilitação (Monje et al. 2013).
Materiais e métodos: Foi realizada uma pesquisa bibliográfica na base de dados b-on (biblioteca do conhecimento), no repositório institucional da Universidade Fernando Pessoa e biblioteca Ricardo Reis.
Das 57 referências bibliográficas pesquisadas, incluindo livros, artigos, revistas cuja recolha foi feita entre Janeiro 2017 e Maio 2017, tiveram como limite temporal 2005-2017 no idioma inglês. Destas foram selecionadas 12 sendo que foram aplicados como critérios de exclusão o limite temporal e a pertinência/enquadramento da informação recolhida.
Discussão: Nos casos de atrofia severa da maxila o osso autólogo é o que proporciona maior capacidade osteoindutiva e osteogénica (Schmitt et al., 2012).
Da pesquisa realizada, os enxertos ósseos inlay demonstraram ser a opção de maior sucesso; quando utilizados conjuntamente com a colocação de implantes.
Conclusões: Existem as mais diversas opções de tratamento para os aumentos ósseos verticais e horizontais, destacando as técnicas de enxerto: Onlay, Inlay (sinus lift).
O gold standard a nível de materiais, preconizado por toda a literatura trata-se de enxerto autólogo, idealmente osso intramembranoso.
Em todos os casos a escolha do material deve ser feita pelos doentes e a escolha da técnica deve ser feita pelo profissional atendendo às características físicas do caso clínico e dos diversos materiais a usar (Park et al., 2009 e Wauf, 2002).Introduction: Maxillary bone resorption following tooth extraction or due to pneumatization of maxillary sinus often results in inadequate residual ridges for ideal implant placement (Monje et al. 2013). Materials and Methods: A research bibliography was made at b-on data base, Universidade Fernando Pessoa-institutional repository and Ricardo Reis library. From 57 references researched including books and articles from 2005 – 2017 in English were selected 12. The criteria used to select the chosen resources was based on timeline frame and content relevance. Discussion: In cases with severe resorption of maxillary alveolar ridge, the autogenous bone is the one that provides the best osteoinductive and osteogenic capacities (Schmitt et al., 2012). From the gathered research, the inlay bone graft showed the most success from the other options, while simultaneously using implants. Conclusions: There is a large diversity of options for the treatment of vertical and horizontal bone increase, especially when using inlay/onlay grafting techniques. The gold standard of materials, as proclaimed throughout all the scientific arcticles is the autologous graft. In all cases the material choice should be made by the patient, while the technique applied should be chosen by the professional according to the characteristics of the clinical case and the various materials available (Park et al., 2009 e Wauf, 2002).
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Vale, Soraia Magalhães. "Prótese obturadora palatina." Master's thesis, 2016. http://hdl.handle.net/10284/5589.
Full textAbstract:
Nos pacientes com defeitos ósseos palatinos congénitos ou adquiridos, quando a possibilidade de reconstrução cirúrgica não existe, poderá ter de se utilizar uma prótese obturadora palatina, com vista ao restabelecimento das funções do sistema estomatognático, tais como, a fonética, deglutição e mastigação. Contudo, esta necessidade não é só funcional mas também estética e psicológica, com vista a melhorar a qualidade de vida dos pacientes.
As próteses obturadoras palatinas têm vindo a desenvolver há alguns séculos, com o aprimoramento das técnicas de confecção e materiais dentários que auxiliam na elaboração, cada vez mais eficientes, principalmente no que se refere a sua adaptação.
Neste trabalho realizou-se uma revisão narrativa da literatura sobre próteses obturas palatinas utilizando as palavras-chave: maxillary birth bony defects; maxillary acquired bony defects; obturator prosthesis; prosthetic rehabilitation in maxillary defects; inflatable hollow obturator; prosthodontic rehabilitation of maxillary defects.
Os objectivos deste trabalho foi o de conhecer os diferentes tipos de próteses obturadoras palatinas utilizadas na reabilitação de pacientes com defeitos ósseos palatinos, bem como, as suas indicações, contra-indicações, os cuidados de utilização e o protocolo clínico e laboratorial de confecção.
As próteses obturadoras palatinas são assim uma solução possível na reabilitação funcional de um número grande de pacientes com defeitos ósseos palatinos, no entanto, o seu sucesso está dependente do correcto planeamento e da execução clínica e laboratorial cuidadosa.In patients with congenital palatal bone defects or acquired, when the possibility of surgical reconstruction does not exist, you may have to use a palatal obturator prosthesis with a view to restoration of the stomatognathic system functions, such as phonetics, swallowing and chewing. However, this need is not only aesthetic but also functional and psychological, to improve the quality of life of patients. The palatine obturator prostheses have been developing for several centuries, with the improvement of production techniques and dental materials that assist in the preparation, more efficient, especially as regards its adaptation. In this work is a narrative review of the literature on prosthetic palatal obturator using the keywords: maxillary birth bony defects; maxillary acquired bony defects; obturator prosthesis; prosthetic rehabilitation in maxillary defects; inflatable hollow obturator; prosthodontic rehabilitation of maxillary defects. The objectives of this study was to know the different types of palatal obturator prosthesis used in the rehabilitation of patients with palatal bone defects, as well as its indications, contraindications, use care and clinical and laboratory protocol execution. The prosthetic palatine obturator are thus a possible solution in the functional restoration of a large number of patients with palatine bone defects, however, its success is dependent on careful planning and proper clinical and laboratory performance.
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Elhuni, Hesham. "Evaluation of Different Techniques for Repair of Shear-span Corrosion-Damaged RC Beams." Thesis, 2013. http://hdl.handle.net/10012/7440.
Full textAbstract:
Deterioration of reinforced concrete structures due to reinforcement corrosion is a serious problem that faces concrete infrastructure worldwide. Effect of the rebar corrosion in the shear span on the structural behaviour is not fully addressed in the published literature. This study examined the effects of corrosion of the longitudinal reinforcement in the shear span on the structural behaviour of RC beams and the effectiveness of three rehabilitation schemes on the structural performance of such beams. The experimental program consisted of testing fifteen medium-scale reinforced concrete beams (150mm wide x 350mm deep x 2400mm long) under static load. Test variables included: span to depth ratio, the degree of corrosion and the anchorage end condition and repair schemes. Two span to depth (a/d) ratios were considered: a/d=3.4 with one-point loading and a/d=2.4 with two-point loading. Two anchorage end-conditions were used: bonded or un-bonded reinforcement in the an-chorage zone. Four degrees of corrosion were chosen to simulate minor (2.5% to 5% mass loss), medium (7.5% mass loss), and severe (15% mass loss) degrees of corrosion. Corrosion was induced in the longitudinal reinforcement in the shear-span using accelerated corrosion techniques based on Faradays’ law. Three different repair scenarios were applied. The first scenario included removing the deteriorated concrete, cleaning the corroded steel and patching with a new self-compacting concrete. The second scenario included U-wrapping the beams cross-section using Glass fiber reinforced cement-based composite (GFRCM), and Carbon fiber reinforced cement-based composite (CFRCM) without removing the deteriorated concrete. The third scenario included patch repair and confinement by wrapping with GFRCM or CFRCM. Following corrosion and repair, all specimens were loaded statically to failure. Test results showed no major effect of shear-span corrosion on the flexural behaviour for the beams with end anchorage whereas a noticeable effect on the flexural behaviour was observed for beams with no end anchorage regions. The corrosion degree and the shear span to depth ratio affected the mode of failure for the specimens with no end anchorages. The type of repair significantly affected the overall behaviour of the corroded specimens. An analytical model was proposed and used to predict the load-deflection response of the tested specimens. The program calculated the mid-span deflection for a given load as an integration of the deflection of a series of elements, with the deflection being based on the elongation of the steel reinforcement in each element. A modified bond stress-slip model was incorporated into the calculations to account for the change in bond strength caused by the corrosion and/or confinement that are provided by repairs. The predicted results were in reasonable agreement with the experimental results.
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(9166931), Kerri E. Rodriguez. "The Effects of Service Dogs on Individuals with Physical Disabilities and Mental Disorders: A Multimethod Examination." Thesis, 2020.
Find full textAbstract:
An increasing number of individuals with physical disabilities or mental disorders are incorporating specially trained service dogs as an assistance aid to improve functionality. In addition to the tasks that service dogs are rained for, studies also suggest that service dogs may benefit psychosocial health and wellbeing. However, current knowledge on these potential benefits is limited by methodological weaknesses without multi-method assessment. There remains a need for empirical and replicable quantification the psychosocial outcomes of service dog assistance and companionship.
The objective of Chapters 1-3 was to summarize, evaluate, and quantify the effects of service dogs on psychosocial health among individuals with physical disabilities. Chapter 1 conducted a systematic literature review of N=24 articles describing the effects of guide, hearing, mobility, and medical service dogs on standardized measures of psychosocial functioning. Chapters 2 and 3 conducted an empirical investigation using quantitative and qualitative methods to quantify the psychosocial effects of mobility and medical service dogs among N=154 individuals with physical disabilities. Results identified specific psychological, social, and emotional benefits that are associated with having an assistance dog or service dog among diverse populations with physical disabilities or chronic conditions.
The objective of Chapters 4-6 was to quantify the role of psychiatric service dogs for post-9/11 military veterans with PTSD. Chapter 4 quantified the perceived importance, frequency of use, and therapeutic value of service dog behaviors for N=216 military veterans with PTSD. Chapters 5 and 6 then quantified the effects that PTSD service dogs on psychosocial outcomes and physiological indicators of functioning, respectively, among a sample of N=141 military veterans with PTSD. Results identified therapeutic components, tangible psychosocial benefits, and potential physiological mechanisms of psychiatric service dogs for military veterans with PTSD.
Overall, this research combined quantitative, qualitative, and physiological measurement to describe outcomes of service dog pairings in two different at-risk populations. Results provide non-causational evidence of psychosocial benefits from service dogs for individuals with physical disabilities or mental disorders. Findings provide a basis for further large-scale research to disentangle active components of the assistance dog-human partnership and identify potential mediating variables of effects.