Comparative analysis of proximal humerus fracture management in elderly patients: complications of open reduction and internal fixation by shoulder surgeons and non-shoulder surgeons—a retrospective study

Rui Claro,Bianca Barros,Carlos Ferreira,Ana Ribau,Luis Henrique Barros 대한견주관절학회 2024 대한견주관절의학회지 Vol.27 No.1

Background: Open reduction and internal fixation (ORIF) with a locking plate is a popular surgical treatment for proximal humeral fractures (PHF). This study aimed to assess the occurrence of complications in elderly patients with PHF treated surgically using ORIF with a locking plate and to investigate the potential differences between patients treated by “shoulder surgeons” and “non-shoulder surgeons.” Methods: A retrospective study was conducted using a single-center database to identify patients aged ≥70 years who underwent ORIF for PHF between January 1, 2011, and December 31, 2021. Data on the Neer classification, follow-up, occurrence of avascular necrosis of the humeral head, implant failure, and revision surgery were also collected. Statistical analyses were performed to calculate the overall frequency of complications according to the Neer classification. Results: The rates of implant failure, avascular osteonecrosis, and revision surgery were 15.7%, 4.8%, and 15.7%, respectively. Complications were more common in patients with Neer three- and four-part fractures. Although the difference between surgeries performed by “shoulder surgeons” and “non-shoulder surgeons” did not reach statistical significance, the rate of complications and the need for revision surgery were nearly two-fold higher in the latter group. Conclusions: PHF are highly prevalent in the elderly population. However, the ORIF surgical approach, as demonstrated in this study, is associated with a considerable rate of complications. Surgeries performed by “non-shoulder surgeons” had a higher rate of complications and a more frequent need for revision surgery. Future studies comparing surgical treatments and their respective complication rates are crucial to determine the optimal therapeutic options. Level of evidence: III.

A local-global scheme for tracking crack path in three-dimensional solids

O. L. Manzoli,G.K.S. Claro,J.A. Lopes Jr. 사단법인 한국계산역학회 2013 Computers and Concrete, An International Journal Vol.12 No.3

This paper aims to contribute to the three-dimensional generalization of numerical prediction of crack propagation through the formulation of finite elements with embedded discontinuities. The analysis of crack propagation in two-dimensional problems yields lines of discontinuity that can be tracked in a relatively simple way through the sequential construction of straight line segments oriented according to the direction of failure within each finite element in the solid. In three-dimensional analysis, the construction of the discontinuity path is more complex because it requires the creation of plane surfaces within each element, which must be continuous between the elements. In the method proposed by Chaves (2003) the crack is determined by solving a problem analogous to the heat conduction problem, established from local failure orientations, based on the stress state of the mechanical problem. To minimize the computational effort, in this paper a new strategy is proposed whereby the analysis for tracking the discontinuity path is restricted to the domain formed by some elements near the crack surface that develops along the loading process. The proposed methodology is validated by performing three-dimensional analyses of basic problems of experimental fractures and comparing their results with those reported in the literature.

Mastoid osteoma: A rare incidental finding in an orthodontic patient

Borissova, Ioanna B.,Venturin, Jaqueline S.,Claro-Woodruff, Wanda I.,Shintaku, Werner H. Korean Academy of Oral and Maxillofacial Radiology 2020 Imaging Science in Dentistry Vol.50 No.4

Mastoid osteomas of the temporal bone are rare, benign, and usually asymptomatic tumors. However, depending on their size and extension, mastoid osteomas may cause facial palsy, a sensation of ear fullness, pressure-related pain, hearing loss, recurrent external ear infections, and chronic discharge. The etiology of mastoid osteomas is still unknown, but congenital, infectious, and traumatic factors have been proposed. Surgical treatment may be performed with minimal postoperative morbidity. In this article, the authors report a case of a 48-year-old woman seeking orthodontic treatment with an unusual retroauricular protruding mass, including the diagnostic process and differential diagnosis. This case supports the essential role of cone-beam computed tomography to analyze and identify the lesion as a mastoid osteoma.

Effects of Copper and Selenium Supplementation on Performance and Lipid Metabolism in Confined Brangus Bulls

Netto, Arlindo Saran,Zanetti, Marcus Antonio,Claro, Gustavo Ribeiro Del,de Melo, Mariza Pires,Vilela, Flavio Garcia,Correa, Lisia Bertonha Asian Australasian Association of Animal Productio 2014 Animal Bioscience Vol.27 No.4

Twenty-eight Brangus cattle were used to determine the effect of copper and selenium supplementation on performance, feed efficiency, composition of fatty acids in Longissimus dorsi (LD) muscle, and cholesterol concentration in serum and in LD muscle and enzymes activities, reduced glutathione (GSH) and oxidized glutathione (GSSG). The treatments were: i) Control, without copper (Cu) and selenium (Se) supplementation; ii) Se, 2 mg Se/kg of dry matter such as sodium selenite; iii) Cu, 40 mg Cu/kg of dry matter such as copper sulfate; iv) Se/Cu, 2 mg Se/kg of dry matter such as sodium selenite and 40 mg Cu/kg of dry matter such as copper sulfate. LD muscle fatty acid composition was not influenced by the treatments (p>0.05). The serum concentration of cholesterol was not influenced by the treatments (p>0.05), however, the concentration of cholesterol in LD was lower in cattle supplemented with copper and selenium (p<0.05). Oxidized glutathione and reduced glutathione increased (p<0.05) with Cu, Se and Se/Cu supplementation. The supplementation of copper (40 mg/kg DM) and selenium (2 mg/kg DM) altered the metabolism of lipids in confined Brangus cattle, through a decrease in cholesterol deposition in the LD, possibly by changing the ratio between reduced glutathione/oxidized glutathione. Copper and selenium supplementation improved animal performance and feed efficiency (p<0.05) when compared to the control group, providing advantages in the production system, while also benefiting consumers by reducing cholesterol concentration in the meat.

Opportunity Coefficient for Cluster-Head Selection in LEACH Protocol

Soh, Ben,AlZain, Mohammed,Lozano-Claros, Diego,Adhikari, Basanta International Journal of Computer ScienceNetwork S 2021 International journal of computer science and netw Vol.21 No.1

Routing protocols play a pivotal role in the energy management and lifespan of any Wireless Sensor Network. Lower network lifetime has been one of the biggest concerns in LEACH protocol due to dead nodes. The LEACH protocol suffers from uneven energy distribution problem due to random selection of a cluster head. The cluster head has much greater responsibility compared to other non- cluster head nodes and consumes greater energy for its roles. This results in early dead nodes due to energy lost for the role of cluster- head. This study proposes an approach to balance the energy consumption of the LEACH protocol by using a semi-deterministic opportunity coefficient to select the cluster head. This is calculated in each node with the battery energy level and node ID. Ultimately, based on the opportunity cost, cluster head will be selected and broadcasted for which other nodes with higher opportunity cost will agree. It minimizes the chances of nodes with lower battery level being elected as cluster head. Our simulation experiments demonstrate that cluster heads chosen using our proposed algorithm perform better than those using the legacy LEACH protocol.

Effect of polymerization method and fabrication method on occlusal vertical dimension and occlusal contacts of complete-arch prosthesis

Ana Paula Barbosa Lima,Rafael Pino Vitti,Marina Amaral,Ana Christina Claro Neves,Lais Regiane da Silva Concilio 대한치과보철학회 2018 The Journal of Advanced Prosthodontics Vol.10 No.2

PURPOSE. This study evaluated the dimensional stability of a complete-arch prosthesis processed by conventional method in water bath or microwave energy and polymerized by two different curing cycles. MATERIALS AND METHODS. Forty maxillary complete-arch prostheses were randomly divided into four groups (n = 10): MW1 - acrylic resin cured by one microwave cycle; MW2 - acrylic resin cured by two microwave cycles: WB1 - conventional acrylic resin polymerized using one curing cycle in a water bath; WB2 - conventional acrylic resin polymerized using two curing cycles in a water bath. For evaluation of dimensional stability, occlusal vertical dimension (OVD) and area of contact points were measured in two different measurement times: before and after the polymerization method. A digital caliper was used for OVD measurement. Occlusal contact registration strips were used between maxillary and mandibular dentures to measure the contact points. The images were measured using the software IpWin32, and the differences before and after the polymerization methods were calculated. The data were statistically analyzed using the one-way ANOVA and Tukey test (α = .05). RESULTS. The results demonstrated significant statistical differences for OVD between different measurement times for all groups. MW1 presented the highest OVD values, while WB2 had the lowest OVD values (P<.05). No statistical differences were found for area of contact points among the groups (P=.7150). CONCLUSION. The conventional acrylic resin polymerized using two curing cycles in a water bath led to less difference in OVD of complete-arch prosthesis.

Comparative clinical and radiologic evaluation between patients undergoing standard reversed shoulder arthroplasty or bony increased offset

Tiago Amorim-Barbosa,Ana Ribau,Hélder Fonte,Luís Henrique Barros,Rui Claro 대한견주관절학회 2023 대한견주관절의학회지 Vol.26 No.1

Background: Modifications of the medialized design of Grammont-type reverse shoulder arthroplasty (RSA) using a bony increased offset (BIO-RSA) has shown better clinical results and fewer complications. The aim of this study is to compare the clinical results, complications, and radiological outcomes between patients undergoing standard RSA and BIO-RSA. Methods: A retrospective review was performed of 42 RSA procedures (22 standard RSA and 20 BIO-RSA). With a minimum of one year of follow-up, range of motion (ROM), Constant shoulder score (CSS), visual analog scale (VAS), and subjective shoulder score (SSS) were compared. Radiographs and computed tomography (CT) scan were examined for scapular notching, glenoid and humeral fixation, and graft healing. Results: At a mean follow-up of 27.6 months (range, 12–48 months), a significant difference was found for active-internal rotation (P=0.038) and for passive-external rotation (P=0.013), with better results in BIO-RSA. No other differences were found in ROM, CSS (P=0.884), VAS score, and SSS. Graft healing and viability were verified in all patients with CT scan (n=34). The notching rate was 28% in the standard RSA group and 33% in the BIO-RSA group, but the standard RSA had more severe notching (grade 2) than BIO-RSA (P=0.039). No other significative differences were found in glenoid and humeral fixation. Conclusions: Bone-graft lateralization is associated with better internal and external rotation and with less severe scapular notching compared to the standard RSA. Integration of the bone graft occurs effectively, with no relevant changes observed on radiographic evaluation. Level of evidence: Level III; Retrospective cohort design treatment study

Effects of Dietary Selenium, Sulphur and Copper Levels on Selenium Concentration in the Serum and Liver of Lamb

Netto, Arlindo Saran,Zanetti, Marcus Antonio,Correa, Lisia Bertonha,Del Claro, Gustavo Ribeiro,Salles, Marcia Saladini Vieira,Vilela, Flavio Garcia Asian Australasian Association of Animal Productio 2014 Animal Bioscience Vol.27 No.8

Thirty-two lambs were distributed in eight treatments under $2{\times}2{\times}2$ factorial experiment to compare the effects of two levels of selenium (0.2 to 5 mg/kg dry matter [DM]), sulphur (0.25% and 0.37%) and copper (8 and 25 mg/kg DM) levels on selenium concentration in liver and serum of lambs. A liver biopsy was done on all animals and blood samples were collected from the jugular vein prior to the beginning of the treatments. The blood was sampled every thirty days and the liver was sampled after 90 days, at the slaughter. Increasing differences were noticed during the data collection period for the serum selenium concentration, and it was found to be 0.667 mg/L in animals fed with 5 mg Se/kg DM and normal sulphur and copper concentrations in their diet. However, a three-way interaction and a reduction of selenium concentration to 0.483 mg/L was verified when increasing copper and sulphur concentration levels to 25 ppm and 0.37% respectively. The liver selenium concentration was also high for diets containing higher selenium concentrations, but the antagonist effect with the increased copper and sulphur levels remained, due to interactions between these minerals. Therefore, for regions where selenium is scarce, increasing its concentration in animal diets can be an interesting option. For regions with higher levels of selenium, the antagonistic effect of interaction between these three minerals should be used by increasing copper and sulphur dietary concentrations, thus preventing possible selenium poisoning.

User Preferences Related to Multimedia Elements of a Mobile Application to Prevent Diabetes

Yisel Pinillos-Patiño,Yaneth Herazo-Beltrán,Orlando Rodríguez-Cordero,Amada Escorcia-Bermejo,Enrique Martelo-López,José Armando Vidarte-Claros,José Hoover Vanegas García,Gabriela Y. Cortés Moreno 대한의료정보학회 2020 Healthcare Informatics Research Vol.26 No.4

Objectives: To understand user preferences related to the characteristics of an application that promotes and provides educationon healthy habits to correctly design multimedia elements. Methods: We conducted a comprehensive qualitative studywith a hermeneutical strategy, which gathered information using well-researched questions that were posed to focus groupsconsisting of 32 participants. These participants were asked for opinions related to multimedia elements to display educationalmessages about physical activity and healthy eating in a mobile application. There were three analysis categories ofmultimedia elements: text, visual elements, and audio elements. Results: The majority of the participants, 93.75%, were in thelow socioeconomic stratum; 68.75% are in a civil union with their partner; 53.12% completed or failed to complete secondaryschool, and 68.75% were housewives. Based on the qualitative results, we found that mobile applications become mediatingtools that support the adoption of actions that tend to improve lifestyles and increase knowledge about proper nutrition andphysical activity. Text messages used in mobile applications should promote healthy habits and remind users of their benefits. Images and videos should be accompanied by text and audio to provide greater clarity regarding recommendations of healthyhabits. Conclusions: Technology must provide accessibility and coverage opportunities, while meeting the needs and expectationsof users. It should facilitate primary health intervention through education to transform unhealthy behaviors andgenerate lifestyles that improve the health of the user and their family context.

Screening of BCL-2 associated X protein gene polymorphism associated with scrotal hernia in domesticated swine using polymerase chain reaction-restriction fragment length polymorphism

Manalaysay, Jessica G.,Antonio, Nathaniel D.,Apilado, Ralph Lorenz R.,Bambico, Joseph F.,Mingala, Claro N. Asian Australasian Association of Animal Productio 2017 Animal Bioscience Vol.30 No.2

Objective: This study was conducted to screen scrotal hernia in domesticated swine from selected breeders in the Philippines. This defect is associated with a cytosine to thymine mutation in the BCL-2 associated X protein (BAX) gene of swine. Methods: Genetic screening was done by DNA extraction followed by amplification and digestion using polymerase chain reaction-restriction fragment length polymorphism, amplifying the 416 bp region of the BAX gene that was subjected to digestion using the Ear I enzyme. Sequencing was also conducted to validate the results. Results: Results revealed that out of 538 samples tested, 411 (76.4%) of the samples were found to be normal whereas the remaining were carriers of the mutation in which 80 (14.9%) were heterozygous mutants and 47 (8.7%) were homozygous mutants. Pietrain breed was found to have the highest incidence. Conclusion: Having a scrotal hernia eliminates the chances of using the boar as a breeder stock because the following generations arising from it would most likely exhibit herniation. It is therefore advised to establish a genetic screening method for Scrotal Hernia in the Philippines to eliminate the negative gene from the herd.