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ANALYSIS OF 45,507 SURGICAL TREATMENT OF DISTAL TIBIA AND MALLEOLAR FRACTURES OVER 14 YEARS
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ROSEMBERG, DOV LAGUS

; WOLOSKER, NELSON

; SILVA, MARCELO FIORELLI ALEXANDRINO

; MANN, TANIA SZEJNFELD

; GIORDANO, VINCENZO

; GODOY-SANTOS, ALEXANDRE LEME

Acta Ortopédica Brasileira

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2023, Volume 31 N. 2 elocation e263885

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT The distal leg joint fractures are among the most common fractures in humans across all age groups, and 50% of them require surgical treatment. Few studies discuss the epidemiology and costs of this fracture in the global and national literature. Objective: To evaluate the annual incidence and reimbursement value of distal leg joint fractures requiring surgical treatment from 2008 to 2021. Methods: A retrospective study was conducted to analyze the complex structured data of high volume and high variability (Big Data), publicly available on the TabNet platform (DATASUS), via software with artificial intelligence. Data from 2008 to 2021 on surgical treatment for malleolar fracture, distal tibia fracture, and isolated fibula fracture were analyzed. Results: From 2008 to 2021, there was an average incidence of 28.8 fractures/105 inhabitants per year, representing 14.62% of all fractures. The total amount paid for hospitalizations due to these fractures was R$ 34,218,014.62 over these 14 years. Conclusion: The incidence of distal leg joint fractures follows the pattern of those recorded in other countries. The adjustment of reimbursement over the years was lower than the accumulated inflation. Level of Evidence II, Economic and Decision Analyses - Developing an Economic or Decision Model.

RESUMO As fraturas articulares distais da perna estão entre as fraturas mais comuns do ser humano ao longo de todas as faixas etárias, e 50% delas necessitam de tratamento cirúrgico. Existem poucos trabalhos discutindo a epidemiologia e os custos dessa fratura na literatura mundial e, principalmente, na nacional. Objetivo: Avaliar a incidência anual e o valor de reembolso das fraturas distais da perna com indicação para tratamento cirúrgico entre os anos de 2008 e 2021. Métodos: Estudo retrospectivo para analisar os dados complexos estruturados de alto volume e alta variabilidade (Big Data), disponibilizados publicamente na plataforma TabNet (Datasus), através de um software com inteligência artificial. Foram analisados os dados de 2008 a 2021 do tratamento cirúrgico de fratura maleolar, fratura distal da tíbia e fratura isolada da fíbula. Resultados: Entre 2008 e 2021, houve incidência média de 28,8 fraturas/105 habitantes-ano, representando 14,62% de todas as fraturas. O valor total pago pelas internações dessas fraturas foi de R$ 34.218.014,62 ao longo desses 14 anos. Conclusão: A incidência das fraturas articulares distais da perna acompanha o padrão daqueles registrados em outros países. O reajuste do repasse ao longo dos anos foi inferior à inflação acumulada. Nível de Evidência II, Análises Econômicas e de Decisão - Desenvolvimento de Modelo Econômico ou de Decisão.

https://doi.org/10.1590/1413-785220233102e263885

Epidemiological Analysis of 12 Years of Open Thoracoabdominal Aortic Aneurysm Repair in the Brazilian Public Health System
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Anacleto, Alexandre Maierá

; Morales, Marcia Maria

; Teivelis, Marcelo Passos

; Silva, Marcelo Fiorelli Alexandrino da

; Portugal, Maria Fernanda Cassino

; Szlejf, Claudia

; Amaro Junior, Edson

; Wolosker, Nelson

Brazilian Journal of Cardiovascular Surgery

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oct 2022, Volume 37 N. 5 Pages 622 - 627

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction: Although endovascular correction is a promising perspective, the gold-standard treatment for thoracoabdominal aortic aneurisms and type-B dissections with visceral involvement remains open surgery, particularly due to its well-established long-term durability. This study aims to describe and evaluate public data from patients treated for thoracoabdominal aortic aneurism in the Brazilian public health system in a 12-year interval. Methods: Data from procedures performed between 2008 and 2019 were extracted from the national public database (Departamento de Informática do Sistema Único de Saúde, or DATASUS) using web scraping techniques. Procedures were evaluated regarding the yearly frequency of elective or urgency surgeries, in-hospital mortality, and governmental costs. All tests were done with a level of significance P<0.05. Results: A total of 812 procedures were analyzed. Of all surgeries, 67.98% were elective cases. There were 328 in-hospital deaths (mortality of 40.39%). In-hospital mortality was lower in elective procedures (26.92%) than in urgency procedures (46.74%) (P=0.008). Total governmental expenditure was $3.127.051,56 — an average of $3.774,22 for elective surgery and $3.791,93 for emergency surgery (P=0.999). Conclusion: The proportion of urgency procedures is higher than that recommended by international literature. Mortality was higher for urgent admissions, although governmental costs were equal for elective and urgent procedures; specialized referral centers should be considered by health policy makers.

https://doi.org/10.21470/1678-9741-2021-0291

Epidemiological analysis of 556 procedures of open thoracoabdominal aortic aneurysm repair in the Public Health System in the largest Brazilian city
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Anacleto, Alexandre Maierá

; Morales, Marcia Maria

; Teivelis, Marcelo Passos

; Silva, Marcelo Fiorelli Alexandrino da

; Portugal, Maria Fernanda Cassino

; Stabellini, Nickolas

; Szlejf, Claudia

; Amaro Junior, Edson

; Wolosker, Nelson

einstein (São Paulo)

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2022, Volume 20 elocation eAO6724

Abstract: En | Text: En | PDF: En

ABSTRACT Objective Despite the development of endovascular procedures, open repair remains the gold standard for the treatment of aortic thoracoabdominal aneurysms and some type B dissections, with well-established good outcomes and long-term durability at high-volume centers. The present study described and analyzed public data from patients treated in the public system in a 12-year interval, in a city where more than 5 million inhabitants depend on the Public Health System. Methods Public data from procedures performed between 2008 and 2019 were extracted using web scraping techniques. The variables available in the database include sex, age, elective or emergency hospital admission, number of surgeries, in-hospital mortality, length of stay, and information on reimbursement values. Results A total of 556 procedures were analyzed. Of these, 60.79% patients were men, and 41.18% were 65 years of age or older. Approximately 60% had a residential address registered in the municipality. Of all surgeries, 65.83% were elective cases. There were 178 in-hospital deaths (mortality of 32%). In the elective context, there were 98 deaths 26.78% versus 80 deaths (42.10%) in the emergency context (p=0.174). Mortality was lower in the hospitals that performed more surgeries. A total of USD 3,038,753.92 was paid, an average of USD 5,406.95 for elective surgery and USD 5,074.76 for emergency surgery (p=0.536). Conclusion Mortality was no different between groups, and hospitals with higher volume presented more favorable outcomes. Specialized referral centers should be considered by health policy makers.

https://doi.org/10.31744/einstein_journal/2022ao6724

Anxiety and depression scores in patients subjected to aortic and iliac aneurysm repair procedures
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Mendes, Cynthia de Almeida

; Wolosker, Nelson

; Fioranelli, Alexandre

; Mello, Ricardo Abreu Feijó de

; Portugal, Maria Fernanda Cassino

; Silva, Marcelo Fiorelli Alexandrino da

; Caffaro, Roberto Augusto

; Pinheiro, Lucas Lembrança

; Teivelis, Marcelo Passos

Revista da Associação Médica Brasileira

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jun 2021, Volume 67 N. 5 Pages 747 - 752

Abstract: En | Text: En | PDF: En

SUMMARY OBJECTIVE: This study examines the changes in anxiety and depression scores of 84 patients subjected to aortic or iliac aneurysm correction with no previous psychiatric history. METHODS: Patients were referred to the evaluation using the Beck Anxiety and Depression Inventories no more than 3 days before surgery (i.e., preoperative [Pre-Op]), 30 days after revascularization (i.e., Early postoperative [PO]), and at least 6 months after revascularization (i.e., Late PO). RESULTS: Mean anxiety scores declined from baseline at both the Early (mean difference: 2.75, p<0.001) and Late PO (mean difference: 2.74, p=0.001). The depression levels showed no significant variation in either evaluation (Early PO; mean difference: −0.84, p>0.05, Late PO: 0.87, p=0.05). A more severe degree of anxiety at baseline was related to better anxiety results both in the Early PO (p=0.041) and Late PO (p=0.008). An endovascular technique was related to the improvement in depression symptoms in the Early PO (p=0.01) but the worsening of the symptoms in the Late PO (p=0.033). CONCLUSIONS: Patients subjected to aortoiliac aneurysm corrections have a higher incidence of anxiety and depressive symptoms. Anxiety symptoms, but not the depressive ones, improved considerably following the successful treatment. The formal psychiatric evaluation may be beneficial for patients with less improvement in the symptom.

https://doi.org/10.1590/1806-9282.20210187 66 downloads

Endovascular correction of isolated descending thoracic aortic disease: a descriptive analysis of 1,344 procedures over 10 years in the public health system of São Paulo
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Portugal, Maria Fernanda Cassino

; Teivelis, Marcelo Passos

; Silva, Marcelo Fiorelli Alexandrino da

; Stabellini, Nickolas

; Fioranelli, Alexandre

; Szlejf, Claudia

; Amaro Junior, Edson

; Wolosker, Nelson

Clinics

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2021, Volume 76 elocation e2332

Abstract: En | Text: En | PDF: En

OBJECTIVES: In Brazil, descending thoracic aorta disease (TAD), including aneurysms and dissection, are preferentially managed by endovascular treatment (TEVAR) due to the feasibility and good results of this technique. In this study, we analyzed endovascular treatment of isolated TAD (ITAD) in the public health system over a 10-year period in São Paulo, a municipality in Brazil in which more than 5 million inhabitants depend on the governmental health system. METHODS: Public data from procedures performed between 2008 and 2019 were extracted using web scraping techniques. The following types of data were analyzed: demographic data, operative technique, elective or urgent status, number of surgeries, in-hospital mortality, length of hospital stay, mean length of stay in the intensive care unit, and reimbursement values paid by the government. Trauma cases and congenital diseases were excluded. RESULTS: A total of 1,344 procedures were analyzed; most patients were male and aged ≥65 years. Most individuals had a residential address registered in the city. Approximately one-third of all surgeries were urgent cases. There were 128 in-hospital deaths (9.52%), and in-hospital mortality was lower for elective than for urgent surgeries (7.29% vs. 14.31%, p=0.031). A total of R$ 24.766.008,61 was paid; an average of R$ 17.222,98 per elective procedure and R$ 18.558,68 per urgent procedure. Urgent procedures were significantly more expensive than elective surgeries (p=0.029). CONCLUSION: Over a 10-year period, the total cost of ITAD interventions was R$ 24.766.008,61, which was paid from the governmental system. Elective procedures were associated with lower mortality and lower investment from the health system when compared to those performed in an urgent scenario.

https://doi.org/10.6061/clinics/2021/e2332 439 downloads

Epidemiological Analysis of 5,595 Procedures of Endovascular Correction of Isolated Descending Thoracic Aortic Disease Over 12 Years in the Public Health System in Brazil
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Portugal, Maria Fernanda Cassino

; Teivelis, Marcelo Passos

; Silva, Marcelo Fiorelli Alexandrino da

; Fioranelli, Alexandre

; Szlejf, Claudia

; Amaro-Júnior, Edson

; Wolosker, Nelson

Clinics

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2021, Volume 76 elocation e2890

Abstract: En | Text: En | PDF: En

OBJECTIVES: In Brazil, descending thoracic aorta disease, including aneurysms and dissections, is managed preferentially by endovascular treatment, owing to its feasibility and good results. In this study, we analyzed endovascular treatment of isolated descending thoracic aortic disease cases in the Brazilian public health system over a 12-year period. METHODS: Public data from procedures performed from 2008 to 2019 were extracted using web scraping techniques to assess procedure type frequency (elective or urgency), mortality, and governmental costs. RESULTS: A total of 5,595 procedures were analyzed, the vast majority of which were urgent procedures (61.82% vs. 38.18%). In-hospital mortality was lower for elective than for urgent surgeries (4.96 vs.10.32% p=0.008). An average of R$16,845.86 and R$20,012.04 was paid per elective and emergency procedure, respectively, with no statistical difference (p=0.095). CONCLUSION: Elective procedures were associated with lower mortality than urgent procedures. There was no statistically significant difference between elective and urgent procedures regarding costs.

https://doi.org/10.6061/clinics/2021/e2890 201 downloads

Transaxillary single-port subtotal parathyroidectomy: feasibility study in cadavers
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Marsillac, Alexandre Elmães de

; Fiorelli, Rossano Kepler Alvim

; Phillips, Henrique Neubarth

; Novellino, Pietro

; Oliveira, André Lacerda

; Zorron, Ricardo Paiva A. Scheiba

Revista do Colégio Brasileiro de Cirurgiões

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apr 2017, Volume 44 N. 2 Pages 125 - 130

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: testar a técnica minimamente invasiva de paratireoidectomia subtotal transaxilar single-port em cadáveres não formalizados para avaliar sua viabilidade e reprodução. Método: foram realizadas dez paratireoidectomias subtotais por via transaxilar através de acesso por TriPort em cadáveres. A técnica realizada consistiu em acesso pela fossa axilar, criando-se um túnel subcutâneo até a região cervical anterior, para manuseio da glândula tireoide e dissecção e ressecção das paratireoides. Resultados: todas as cirurgias foram realizadas com sucesso. O tempo médio de cirurgia foi 65 minutos (57-79 min), com identificação, sem dificuldades, de todas as estruturas anatômicas. Não houve necessidade de incisões complementares na região cervical. Conclusão: a técnica de paratireoidectomia subtotal transaxilar single-port foi viável e reprodutível, sugerindo uma alternativa para a cirurgia cervical minimamente invasiva.

ABSTRACT Objective : to test the minimally invasive technique of single-port transaxillary subtotal parathyroidectomy in non-formalized cadavers to evaluate its viability and reproduction. Method : we performed ten subtotal parathyroidectomies through a transaxillary TriPort access in cadavers. The technique consisted of access through the axillary fossa, creating a subcutaneous tunnel to the anterior cervical region, for handling of the thyroid gland and dissection and resection of the parathyroid glands. Results : all surgeries were successful. The mean time of surgery was 65 minutes (57-79 min), with uncomplicated identification of all anatomical structures. There was no need for complementary incisions in the cervical region. Conclusion : the transaxillary single-port subtotal parathyroidectomy technique was feasible and reproducible, suggesting an alternative for minimally invasive cervical surgery.

https://doi.org/10.1590/0100-69912017002003 1104 downloads

Multisensory and closed kinetic chain exercises on the functional capacity and balance in elderly women: blinded randomized clinical trial
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Ferreira, Luiz Gustavo Padovini

; Genebra, Caio Vitor dos Santos

; Maciel, Nicoly Machado

; Arca, Eduardo Aguilar

; Fiorelli, Alexandre

; Vitta, Alberto De

Fisioterapia em Movimento

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2017, Volume 30 Suppl. 1 Pages 259 - 266

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Introdução: O processo de envelhecimento provoca perdas que levam à diminuição do equilíbrio, da velocidade da marcha e capacidade funcional e, portanto, há necessidade de protocolos específicos para trabalhar preventivamente essas variáveis, que contribuirão para a diminuição na freqüência de quedas nesta população. Objetivo: verificar o efeito de um programa de exercícios multissensoriais e de cadeia cinética fechada sobre a capacidade funcional e o equilíbrio em idosas. Métodos: Tratou-se de um ensaio clínico randomizado mascarado (cego). Participaram 32 idosas de Centro de Convivência da Secretaria de Bem-estar social de Bauru, distribuídas em dois grupos: controle (GC = n15) e experimental (GE = 17) avaliadas em dois momentos: inicial (M1 = antes da intervenção) e final (M2 = após intervenção), por meio da capacidade funcional (Timed Up and Go - TUG e velocidade de marcha - TC10) e o equilíbrio pela Escala de Equilíbrio de Berg (EEB). O programa de exercícios multissensoriais e de cadeia cinética fechada foi aplicado uma vez por semana, por uma hora, durante 10 semanas. Resultados: Em relação à comparação entre os momentos M1 e M2 do GE após a intervenção, houve um aumento significativo da capacidade funcional (p = 0,00006), velocidade da marcha (p = 0,0008) e do equilíbrio (p = 0,0006). Conclusão: O programa de treinamento multissensorial e de cadeia cinética fechada sinalizou efeito favorável na melhora do equilíbrio e do desempenho funcional de idosas.

Abstract Introduction: The aging process causes losses that lead to decreased balance, gait speed and functional capacity and, therefore, there is a need of specific protocols to work preventively these variables, which will contribute to the decrease in the frequency of falls in this population. Objective: Verify the effect of a program of multisensory and closed kinetic chain exercises on the functional capacity and balance in elderly women. Methods: Randomized clinical trial masked (blind). Subjects were 32 elderly women from the Centro de Convivência of the Bauru Department of Social Welfare (Secretaria de Bem-Estar Social de Bauru) distributed in two groups: control (CG = 15) and experimental (EG = 17). Interventions: The program of multisensory and closed kinetic chain exercises was applied during an hour, once a week, for 12 weeks. Main measures: Functional capacity was measured by Timed Up and Go (TUG) and the 10-meter walking test (TC10) and their balance by the Berg Balance Scale (BBS). Results: Regarding the comparison between the moments M1 and M2 of the EG after the intervention, there was a statistically significant increase in the functional capability (p = 0.00006), walking speed (p = 0.0008) and balance (p = 0.0006). Conclusion: The multisensory and closed kinetic chain-training program indicated a beneficial effect in the improvement of the elderly women balance and functional performance.

https://doi.org/10.1590/1980-5918.030.s01.ao25 2393 downloads

The effects of a global postural exercise program on temporomandibular disorder
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Fiorelli, Alexandre

; Arca, Eduardo Aguilar

; Fiorelli, Carolina Menezes

; Rodrigues, Alitéia Aparecida Souza

; Furcin, Ana Carla

; Vitta, Alberto De

; Waisberg, Cesar Becalel

; Trize, Débora de Melo

; Weckwerth, Paulo Henrique

Motriz: Revista de Educação Física

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dec 2016, Volume 22 N. 4 Pages 272 - 276

Abstract: En | Text: En | PDF: En

Abstract Changes in the suboccipital muscles and the hamstrings may interfere with head posture and the biomechanics of the temporomandibular joint, both of which contribute to the severity of temporomandibular disorders (TMD). The objective of this investigation was to evaluate the effects of a global postural exercise program (GPEP) on pain intensity and mouth-opening range of motion (ROM) in women with TMD. The participants were comprised of 30 women with TMD who were divided into two groups: an experimental group (EG) and a control group (CG). A pressure algometer was used for pain assessment and a paquimeter was used to measure ROM. The duration of the GPEP was six weeks. In the EG, there was a reduction in pain intensity and an increase in mouth-opening ROM compared to the CG. Therefore, we concluded that the GPEP was effective in relieving pain in all of the evaluated muscles and regions, and in increasing mouth-opening ROM in women with TMD.

https://doi.org/10.1590/s1980-6574201600040009 1690 downloads

10.

LOW BACK PAIN IN SCHOOLCHILDREN: A CROSS-SECTIONAL STUDY IN A WESTERN CITY OF SÃO PAULO STATE, BRAZIL
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Fernandes, Júlio Alberto Agante

; Genebra, Caio Vitor dos Santos

; Maciel, Nicoly Machado

; Fiorelli, Alexandre

; Conti, Marta Helena Souza de

; De Vitta, Alberto

Acta Ortopédica Brasileira

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oct 2015, Volume 23 N. 5 Pages 235 - 238

Abstract: En | Text: En | PDF: En

Objective:To determine the prevalence of low back pain in children and its relationship with gender, age, exercise practice and sedentary activities (time on TV and on computer and/or video game).Methods:We conducted a cross-sectional study with a sample of 1,461 students, being 754 males and 707 females enrolled in the 5th to 8thgrades of all five local elementary schools of urban Ourinhos, SP, Brasil, aged 10-14 years old, from whom sociodemographic data, time spent on sedentary activities such as TV and computer and/or video game were collected. We conducted a descriptive, bivariate and multivariate binary logistic regression.Results:The results showed that the prevalence of low back pain in the sample was 18.5%, being 15.5% in boys and 21.6% in girls. Low back pain was associated to the female gender, age range between 12-14 years and the habit of watching TV more than three times a week and over 3 hours per day.Conclusion:The students analyzed showed high prevalence of low back pain related to gender, age and habit of watching TV. Appropriate interventions should be implemented to reduce the occurrences of back pain in schoolchildren.Level of Evidence III, Cross Sectioning.

https://doi.org/10.1590/1413-785220152305148842 2089 downloads

11.

Neck/shoulders pain and its relation to the use of tv/computer/videogame and physical activity in school students from Bauru
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De Vitta, Alberto

; Trize, Débora de Melo

; Fiorelli, Alexandre

; Carnaz, Letícia

; De Conti, Marta Helena Souza

; Simeão, Sandra Fiorelli de Almeida Penteado

Fisioterapia em Movimento

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mar 2014, Volume 27 N. 1 Pages 111 - 118

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Objetivo O objetivo foi verificar a prevalência de dor musculoesquelética na região cervical/ombros em escolares e sua relação com o nível de atividade física e atividades sedentárias (tempo na TV e computador e/ou videogame). Materiais e métodos Realizou-se um estudo transversal com uma amostra de 524 escolares (278 meninos e 246 meninas) matriculados nas 5ª a 8ª séries de todas as cinco escolas municipais de ensino fundamental urbanas do município de Bauru (SP), na faixa etária entre 10 e 14 anos, de quem foram coletados dados sociodemograficos, atividades sedentárias – tempo na TV e computador e/ou videogame – e nível de atividade física, por meio do questionário de atividade física para crianças (PAQ-C). Resultados Os resultados mostraram que as prevalências de dor localizada na região cervical/ombros foi de 30,1% para meninos e meninas. Verificou-se também que há predomínio da manifestação dos sintomas referido na cervical/ombros, nos meninos, em relação à frequência e quantidade de horas que assistem TV ao dia e horas no computador; enquanto que nas meninas a associação foi com a frequência e quantidade de horas que assistem TV ao dia. Conclusões Pode-se concluir que a dor cervical/ombros é comum em escolares e que a compreensão das relações entre as variáveis possibilita elementos valiosos de medidas visando à manutenção, melhora e promoção do bem-estar dos estudantes.

Objective The objective was to determine the prevalence of musculoskeletal pain in the neck/shoulders of school children and its relationship with the level of physical activity and sedentary activities (time spent on TV and computer and/or video game). Materials and methods We conducted a cross-sectional study with a sample of 524 5th to 8th grade students (278 boys and 246 girls), enrolled in all five urban elementary schools in the municipality of Bauru (SP), aged between 10 and 14 years old. Sociodemographic data, sedentary activities – time spent on TV and computer and/or videogame - and level of physical activity - was collected through a Physical Activity Questionnaire for Children (PAQ-C). Results The results showed that the prevalence of localized pain in the neck/shoulders was of 30.1% for boys and girls. It was also found that there is a predominance of onset of pain reported in neck/shoulders in boys related to the frequency and amount of hours a day watching TV and hours on the computer, whereas in girls the association was with frequency and amount of hours they watch TV daily. Conclusions It can be concluded that the pain in the neck/shoulders are common in children and that understanding the relationship between variables enables valuable elements of measures aimed at maintaining, improving and promoting the welfare of students.

https://doi.org/10.1590/0103-5150.027.001.AO12 3953 downloads

12.

Interrupções e distrações na sala de cirurgia do trauma: entendendo a ameaça do erro humano
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Pereira, Bruno Monteiro Tavares

; Pereira, Alexandre Monteiro Tavares

; Correia, Clarissa dos Santos

; Marttos Jr, Antonio Carlos

; Fiorelli, Rossano Kepler Alvim

; Fraga, Gustavo Pereira

Revista do Colégio Brasileiro de Cirurgiões

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oct 2011, Volume 38 N. 5 Pages 292 - 298

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

OBJETIVO: Compreender o fator humano como ameaça à segurança do paciente vítima de trauma no centro cirúrgico, traduzindo para a sala de operação algumas regras importantes já aplicadas no campo da aviação. MÉTODOS: A amostra incluiu 50 casos de cirurgia de trauma coletados prospectivamente por observadores em plantões de 12 horas, ,durante seis meses, em um centro de trauma nível I nos Estados Unidos da América. Informações quanto ao tipo de trauma, escore de gravidade e mortalidade foram coletadas, assim como, determinantes de distrações/interrupções e o volume de ruídos na sala de cirurgia durante o ato cirúrgico. RESULTADOS: Ocorreram, em média, 60 interrupções ou distrações durante o ato cirúrgico, na maioria das vezes desencadeado pelo movimento de pessoas na sala. Em pacientes mais graves (ISS > 45), submetidos ao controle de danos, a incidência de distrações foi ainda maior. A média de ruídos na sala de cirurgia do trauma foi muito elevada, com barulho próximo ao de um secador de cabelos. CONCLUSÃO: Interrupções e distrações são frequentes e devem ser estudadas pelo cirurgião do trauma a fim de desenvolver estratégias de prevenção e linhas de defesa para minimizá-las e reduzir seus efeitos.

OBJECTIVE: To understand the human factor as a threat to the security of trauma patients in the operating room, bringing to the operating room some important rules already applied in the field of aviation. METHODS: The sample included 50 cases of surgical trauma patients prospectively collected by observers in shifts of 12 hours, for six months in a Level I trauma center in the United States of America. Information regarding the type of trauma, severity score and mortality were collected, as well as determinants of distractions / interruptions and the volume of noise in the operating room during surgery. RESULTS: There was an average of 60 interruptions or distractions during surgery, most often triggered by the movement of people in the room. In more severe patients (ISS> 45), subjected to damage control, the incidence of distractions was even greater. The average noise in the trauma surgery room was very high, close to the noise of a hair dryer. CONCLUSION: Interruptions and distractions are frequent and should be studied by the trauma surgeon to develop prevention strategies and lines of defense to minimize them and reduce their effects.

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13.

II Diretriz Brasileira de Transplante Cardíaco
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Bacal, Fernando

; Souza Neto, João David de

; Fiorelli, Alfredo Inácio

; Mejia, Juan

; Marcondes-Braga, Fabiana Goulart

; Mangini, Sandrigo

; Oliveira Jr, José de Lima

; Almeida, Dirceu Rodrigues de

; Azeka, Estela

; Dinkhuysen, Jarbas Jakson

; Moreira, Maria da Consolação Vieira

; Rossi Neto, João Manoel

; Bestetti, Reinaldo Bulgarelli

; Fernandes, Juliana Rolim

; Cruz, Fátima das Dores

; Ferreira, Lucinei Paz

; Costa, Helenice Moreira da

; Pereira, Ana Augusta Maria

; Panajotopoulos, Nicolas

; Benvenuti, Luiz Alberto

; Moura, Lídia Zytynski

; Vasconcelos, Glauber Gean

; Branco, João Nelson Rodrigues

; Gelape, Claudio Leo

; Uchoa, Ricardo Barreira

; Ayub-Ferreira, Silvia Moreira

; Camargo, Luis Fernando Aranha

; Colafranceschi, Alexandre Siciliano

; Bordignon, Solange

; Cipullo, Reginaldo

; Horowitz, Estela Suzana Kleiman

; Branco, Klébia Castelo

; Jatene, Marcelo

; Veiga, Sergio Lopes

; Marcelino, Cesar Augusto Guimarães

; Teixeira Filho, Guaracy Fernandes

; Vila, José Henrique

; Montera, Marcelo Westerlund

Arquivos Brasileiros de Cardiologia

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2010, Volume 94 N. 1 Pages e16 - e76

Abstract: Pt | Text: Pt | PDF: Pt

103007 downloads Cited 7 times in SciELO

14.

Dor torácica por compressão atrial direita por timolipoma
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Ramos Filho, José

; Melo, Ricardo F.

; Macedo, Marcelo de

; Fiorelli, Luiz Antônio

; Costa, Alexandre

; Isolatto, Roberto B.

Arquivos Brasileiros de Cardiologia

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may 2004, Volume 82 N. 5 Pages 481 - 483

Abstract: Pt | Text: Pt | PDF: Pt

5572 downloads

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