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Atherosclerosis was found in humans who lived thousands years ago. Paleopathologist Marc Armand Ruffer (1859-1917) identified atherosclerotic plaques in the aorta as well as in several large arteries of numerous Egyptian mummies, noting that atherosclerosis was a widespread disease in antiquity. Russian researchers tried to induce experimental atherosclerosis in an animal model, feeding laboratory animals with pure cholesterol. They demonstrated that cholesterol alone caused atherosclerotic lesions in the artery wall. Many studies have shown that blood cholesterol levels are largely determined by the amount of fat in the diet. The Study of the Seven Countries was the first epidemiological evidence that linked the increase in cholesterol to cardiovascular events. In the genetic approach, one of the first indications that coronary artery disease was related to cholesterol came from anecdotal case reports of children with xanthomas (large deposits of lipids just under the skin or attached to tendon sheaths, on the back of the hands or ankles), who had sudden death or myocardial infarction before the age of 10 years. The first cases of homozygous familial hypercholesterolemia were described. The 2019 European Guideline, for example, considers for high-risk patients, a target LDL-c < 70 mg/dl and a reduction > 50% compared to baseline; for very high risk, a target LDL-c < 55 mg/dl and a reduction > 50% compared to baseline; and for patients with acute coronary syndrome, within a two-year period, a target LDL< 40 mg/dl. In order to achieve these more aggressive goals, the combination of drugs is necessary, especially in patients with eligibility criteria for the new lipid-lowering drugs, based on molecular biology techniques, in addition to an adequate clinical judgment.

O objetivo deste estudo foi compreender como ocorre a participação do gerente de nível médio na gestão estratégica da inovação à luz da estratégia como prática. De forma a alcançar tal objetivo foi aplicadaa metodologia qualitativa por meio de estudo de caso efetuadoem uma empresa de base tecnológica. As técnicas utilizadas para a coleta de dados foram entrevistas semiestruturadas, análise documental e observação direta. Para analisarosdados adotou-se a técnica pattern matching. A contribuição deste artigo está na conexão entre três pilares teóricos que conduzem o estudo: o papel do middle manager; gestão da inovação e a ponto de vistada estratégia como prática. Os resultados revelam que a gestão da inovação ocorre por meio das práticas, práxis e praticantes em que o middle manager tem papel fundamental por atuar como, sintetizador da informação, defensor de alternativas, facilitador da adaptação e implementador da estratégia da inovação conforme tipologia de Floyd e Wooldridge (1992).

Abstract Objective To evaluate the results of the treatment of 31 giant-cell tumors of the tendon sheath of the hand cared for between 2006 and 2015. Methods A group of patients for the present retrospective evaluation was defined, covering the period between February 2006 and November 2015, in which 31 records of patients who underwent surgery due to cell tumor of the tendon sheath of the fingers were studied and evaluated. The recommended treatment was complete excision of the tumor with preservation of the adjacent structures. The diagnosis was confirmed by pathological examination. The progress of the treatment after surgery was evaluated, especially regarding the rate of tumor recurrence. Results Taking all 31 patients into consideration, there was a predominance of the female gender and white ethnicity. Most of these patients were aged between 30 and 50 years. The most affected side was the left one, and most tumors were in the flexor face. There was a predominance of the radial fingers, along with their distal end. A total of 27 patients are being followed up at regular intervals at an outpatient clinic, and three cases of tumor recurrence have been identified. Conclusion An appropriate surgical technique is essential in order to prevent GCTTS recurrences. The results obtained in this research are in agreement with the literature.

Em um cenário em constante transição, um dos desafios vividos, atualmente, no âmbito educacional, é o que envolve o planejamento e a construção de modelos de design instrucional compatíveis às emergentes necessidades de aprendizagem do aluno em qualquer nível de formação, seja básico, seja superior. Assim, com o intuito de experimentar um ambiente em que se tem a implementação de princípios da educação híbrida, este artigo tem por objetivo apresentar um estudo de caso em que se planejou e aplicou uma proposta de design instrucional, com ênfase na utilização de inovações e aplicações tecnológicas como apoio a aulas presenciais, para a disciplina de Comunicação e Expressão em um curso superior tecnológico público.

ABSTRACT Recent anatomical and biomechanical studies on the anterolateral ligament (ALL) of the knee have shown that this structure has an important function in relation to joint stability, especially when associated with anterior cruciate ligament (ACL) injury. However, the criteria for its reconstruction have not yet been fully established and the surgical techniques that have been described present variations regarding anatomical points and fixation materials. This study presents a reproducible technique for ALL and ACL reconstruction using hamstring tendons, in which three interference screws are used for fixation.

The association of tiletamine with zolazepam (T/Z) is commonly used in dissociative anesthesia in household pets. This combination induces short-duration somatic analgesia, loss of voluntary movements and myorelaxation caused by the benzodiazepin, with stimulation of the ardiovascular system and maintenance of protective reflexes. Due to the large use of this association in elective neutering of felines and its anesthetic properties, we chose to monitorize and identify electrocardiographic (ECG) and clinical changes during the anesthetic procedure, with and without oxygen supplementation. For this study, 20 female felines were recruited. All animals were young adults, healthy, no specific breed. The subjects underwent clinical, laboratorial and electrocardiographic evaluations prior to anesthesia. Tramadol hydrochloride was given as Preanesthetic medication followed by anesthesia with T/Z. The felines were randomly assigned to either Group 1 (n=10), in which subjects received oxygen supplementation through mask during the anesthetic procedure, or Group 2 (n=10), in which subjects were not supplemented with oxygen. Heart and respiratory rates, systolic blood pressure, rectal temperature and pulse oxymetry were monitored in all subjects from both groups. We also obtained recordings of the ECG tracing and derivations for each animal which were posteriorly evaluated and interpreted. The results showed significant differences between the groups in respiratory rate (G1 = 26,8 +/- 2,1 and G2= 38,5+/- 3,2) and pulse oxymetry (G1= 97,3 +/- 2,4% and G2 = 91,2 +/- 1,1%). We also observed on the ECG recordings development of periods of intermittent right branch blockage and S-T elevation in both groups. We therefore concluded that the ECG recordings were identical in both groups despite oxygenotherapy; however, we observed an improvement in the clinical parameters in animals who received oxygen supplementation via mask.

OBJETIVO: O objetivo do estudo foi avaliar o efeito, nas propriedades mecânicas, do arranjo de reparo com material de sutura, no tendão calcâneo de rato, na ausência de processo de cicatrização. MÉTODO: Foram utilizados 12 ratos machos da linhagem Wistar. Os animais foram submetidos à colocação de ponto de sutura tipo Kessler modificado no tendão calcâneo. Os sacrifícios foram realizados nos períodos imediato e com seis semanas de pós-operatório. As propriedades mecânicas estudadas foram: carga máxima, tensão na carga máxima e módulo de elasticidade. O tendão contralateral foi usado como controle. RESULTADOS: A análise estatística indicou que, em relação aos períodos estudados, os valores das propriedades mecânicas não apresentaram diferenças significativas. Em relação ao controle, isto é, tendão contralateral sem sutura, os resultados demonstram que, com seis semanas de pós-operatório, houve queda dos valores do módulo de elasticidade, enquanto a carga máxima e a tensão na carga máxima não apresentaram variações significativas. CONCLUSÃO: A colocação de material de sutura em tendão extrassinovial não lesado provocou queda do módulo de elasticidade, porém não interferiu na carga máxima e na tensão na carga máxima após seis semanas de pós-operatório.OBJECTIVE: The aim of this study was to evaluate the effects on the mechanical properties of rats' calcaneus tendons, of repair arrangements using suture material in the absence of any healing process. METHOD: Twelve male Wistar rats were used. They were subjected to placement of a modified Kessler suture stitch in the calcaneus tendon. The sacrifices were performed immediately after and six weeks after the operation. The mechanical properties studied were maximum load, tension in the maximum load and module of elasticity. The contralateral tendon was used as a control. RESULTS: The statistical analysis showed that for the times studied, the values for mechanical properties did not present any significant differences. In relation to the control, i.e. the contralateral tendon without a suture, the results demonstrated that, six weeks after the operation, the values for the modulus of elasticity were lower, whereas there were no significant variations in maximum load or tension at maximum load. CONCLUSION: Placement of suture material on an extrasynovial tendon without lesions decreased the modulus of elasticity, but it did not interfere with the maximum load or tension at maximum load, six weeks after the operation.

Estudou-se a presença de anticorpos para o vírus da influenza aviária, subtipos H1N1 e H3N2, por meio da técnica de inibição da hemaglutinação no plasma de 225 aves da Fundação RIO-ZOO, do Bwana Park e de pequenas criações do Estado do Rio de Janeiro. Entre as aves estudadas 60 (26,6%) foram soropositivas, sendo 22 (9,8%) para o subtipo H1N1, 28 (12,4%) para o subtipo H3N2 e 10 (4,4%) para os dois subtipos. Esses resultados indicam a ocorrência dos subtipos do vírus da influenza aviária investigados no Rio de Janeiro e apontam para o risco potencial de sua transmissão para a avicultura industrial e para pessoas.

Purpose: This study evaluated the effect of severe magnesium (Mg) dietary deficiency on systemic bone density and biomechanical resistance of bone tissue to the removal torque of osseointegrated implants. Materials and Methods: The sample consisted of 45 rats; each received a titanium implant in their tibial metaphysis. After 60 days, the animals were divided into three groups (n = 15) according to their dietary Mg: the control group received the recommended content of Mg, group Mgl received a 75% reduction in dietary Mg content, and group Mg2 was fed a diet with a 90% reduction in Mg content. Animals were sacrificed 150 days after implant placement. Serum concentrations of Mg were measured and the effect of Mg deficiency on systemic bone density was evaluated by densitometry of the lumbar vertebrae and femur. Biomechanical characteristics were measured by resistance of the bone tissue to removal of the implants. Results: Lower Mg serum concentrations were found for the Mgl and Mg2 groups; however, densitometric analysis and torque evaluations showed a statistically significant difference only in the Mg2 group (P < .05). There was a statistically significant difference in removal torque between the Mg2 group and the control group. Conclusions: This study showed that a severe deficiency of Mg decreased the systemic bone density and removal torque of osseointegrated implants. [ABSTRACT FROM AUTHOR]

Estudo das alterações observadas nas tomografias computadorizadas (TCs) de 16 casos de neurocisticercose, com hipertensão intracraniana por hidrocefalia. Todos os casos foram submetidos a radiografias simples do crânio e 12, à ventriculografia com Dimer-X. Nas radiografias simples foram observados sinais de hipertensão intracraniana em 7, calcificações em um, e d foram normais. A TC mostrou parênquima cerebral normal em 9 casos e nos 7 restantes áreas hipodensas arredondadas de tamanho variado, com ou sem retenção de contraste na periferia, e/ou calcificações esparsas no parenquima. Hidrocefalia foi a única alteração observada no sistema ventricular nos casos em que o exame foi realizado previamente à derivação do LCR. As ventriculografias foram analisadas em trabalho anterior e permitiram localizar e determinar as características da obstrução e a presença de massas ocupando espaço dentro dos ventrículos. A comparação das ventriculografias e TCs realizadas na mesma época evidenciou que a primeira fornece melhores informações sobre o sistema ventricular mas, por outro lado, a tomografia fornece informações adicionais sobre o parênquima cerebral. A TC e a ventriculografia são exames que se completam na avaliação e no diagnóstico destes pacientes.

O caso descrito refere-se a paciente do sexo feminino, com 22 anos, com história de dois episódios de crise convulsiva lateralizada à direita, hemiparesia direita e disfasia. O exame neurológico mostrou ainda edema de papila bilateral. A tomografia computadorizada (TC) do crânio mostrou um cisto de 70x77 mm, ocupando a região fronto-parieto-temporal esquerda, ocasionando grande desvio da linha média, além de outras lesões menores, semelhantes, esparsas no parênquima. Com o diagnóstico de neurocisticercose foi submetida a craniotomia, sendo removidos o cisto maior (cisticerco racemoso) e pequeno cisticerco cortical (10x10 mm) para exame. Teve alta 13 dias após a cirurgia, com regressão completa do quadro neurológico, exceto o edema de papila (regressão parcial). Um mês após foi submetida a tratamento com praziquantel (50 mg/kg/dia durante 20 dias). O exame de LCR foi normal antes deste tratamento e, durante ele, apresentou reação celular eosinofílica, com positivação da reação de fixação de complemento para a cisticercose, ambas transitórias. A TC prévia ao tratamento mostrou várias áreas hipodensas de 10 a 40 mm, esparsas no parênquima, inclusive na área operada- A TC realizada três meses após mostrou diminuição do número de cistos do parênquima, persistindo apenas uma área hipodensa de 20 mm no local operado e dilatação do corno frontal do ven-trículo do mesmo lado. A evolução clínica foi excelente e o exame neurológico foi normal 3 meses depois.

ABSTRACT Objective: This study aims at analyzing retrospectively the clinical-functional and radiographic results of surgical treatment of the terrible elbow triad, with at least 12 months of postoperative follow-up evaluating elbow function. Methods: A group of patients for retrospective analysis from 2004 to 2015 was defined, in which 12 patients were studied. They underwent surgery due to fracture of the radial head, coronoid fracture, and elbow dislocation; they were evaluated by the Disabilities of the Arm, Shoulder and Hand (DASH) score, the degree of patient satisfaction, the degree of trauma energy, radiographic images, range of motion, and complications. Results: There was a higher incidence of Regan and Morrey type II coronoid process fractures; in relation to the injuries, nine patients had deinsertion of the brachialis. Half of the patients suffered a fall from their own height as the mechanism of trauma. The extent of elbow flexion and extension averaged 126.6 and 24.1 degrees, respectively; the averages for pronation and supination were 64.1 and 62.0 degrees, respectively. All patients presented muscle strength of grade IV or V. The mean DASH score was 14.3, the mean pain score was 2.5, and a majority of the patients were satisfied with the treatment. Conclusion: Despite the total loss of range of motion of the elbow, especially in extension, the treatment was satisfactory for most patients.

PURPOSE: We compared corneal and total higher order wavefront aberrations in 25 pseudophakic eyes implanted with five different types of intraocular lenses to obtain an objective evaluation of the optical quality of these pseudophakic eyes. Five IOLs per type were studied. METHODS: Implanted lenses were the Pharmacia Tecnis Z9000 with negative spherical aberration, Pharmacia 911 Edge, Alcon Acrysof SA60AT and MA60BM, and Allergan Sensar AR40e. Eyes were examined using the Topcon KR-9000PW topographer/aberrometer, which obtains simultaneous coaxial measurements of corneal and ocular aberrations, and displays the calculated Point Spread Function (PSF) and Modulation Transfer Function (MTF). RESULTS: Corneal spherical aberration was positive in all tested eyes. For a 4-mm optical zone, ocular spherical aberration was 0.0054 ± 0.0172 µm root-mean-square (RMS) in eyes implanted with the Tecnis lens, and was 0.0562 to 0.0974 ±m RMS in eyes implanted with the four other conventional IOLs. A myopic refractive shift with mydriasis of -0.08 D occurred with the Tecnis IOL; it was -0.57 to -0.90 D with the conventional IOLs. Coma did not show a substantial reduction with any of the IOLs. Total wavefront aberrations showed nonsignificant reduction with the Tecnis lens. The PSF and the MTF also showed nonsignificant improvements over conventional IOLs. CONCLUSIONS: The optical quality of pseudophakic eyes can be measured in vivo by aberrometers. Different IOLs resulted in measurably different outcomes. In this preliminary study, compensation of the spherical aberration observed with the Tecnis lens confirmed the theoretical predictions associated with this lens and resulted in no myopic shift in refraction with mydriasis. [ABSTRACT FROM AUTHOR]

Phakomatous choristoma is a rare adnexal congenital tumor of lenticular anlage. The authors performed a standard orbital tomography of the orbits for the evaluation of a mass that was palpable in the left lower eyelid of a 3-month-old boy. Hematoxylin-eosin, special stainings and immunohistochemistry were performed on the excised mass. The histopathological and immunohistochemical findings confirmed the diagnosis of phakomatous choristoma. The CT scans showed that the mass was located in the orbit. Even though phakomatous choristoma is usually reported as a lower eyelid lesion, the orbital localization offers a better explanation for the chronological embryonic origin of this rare pediatric tumor. [ABSTRACT FROM AUTHOR]