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Abstract: Marcucci (1985) proposed a chi square goodness of fit statistic based generalized p-chart for multinomial process monitoring. A chi square distribution quantile was considered as a control chart limit. A weighted chi square goodness of fit statistic-based control chart is proposed for multinomial process monitoring in this paper, where more important weights are advocated to poor quality categories. The statistic distribution is approximated by a well-known linear combination of chi squares distribution. The approximation is assessed through a simulation, an extreme percentile of the approximated distribution is used as an upper control chart limit and a comparison is carried out with a chi square goodness of fit statistic-based control chart. The average run length is used as a benchmark and the comparison is performed using simulations considering two process shifts scenarios. Under some restrictions, the weighted statistic-based control chart allows an earlier detection of process shift in case of deterioration and postpones out of control signals in case of improvement. This benefit is clearer when the process is improved by a decrease in the poor quality probability category and an increase in the best quality category probability.

Abstract: Interpreting an out-of-control signal is a crucial step in monitoring categorical processes. For the Chi-Square Control Chart (CSCC), an out-of control situation does not specify if it was a process deterioration or a process improvement. For this reason, a weighted chi-square statistical control chart WSCC is proposed with different weighting categories in order to enable an accelerated disclosure of a control situation after a shift due to a deterioration of quality and on the other hand, decelerate an out of control situation after a shift due to a quality improvement. Furthermore, in comparison with Marcucci’s method, the new procedure provides an accurate and easier way to interpret several signals. In other words, the WSCC allows a faster detection of an out-of control situation in the case of a quality deterioration, however, an out-of control situation is not quickly detected in the case of a quality improvement. Indeed, comparative studies have been performed to find the best control chart for each combination. Concluding remarks with comments and recommendations are given based on Average Run Length (ARL) and standard deviation run length (SDRL).

ABSTRACT Forty male Naemi lambs were used to evaluate the effect of total mixed rations (TMR) alone or in combination with supplementation of alfalfa hay offered at different schedules on growth, carcass characteristics, and meat quality. Lambs at the age of three months, with an average weight of 28.85±1.09 kg, were randomly selected and distributed into four different feeding systems, 10 lambs each, as follows: TMR diet (control); TMR plus 100 g alfalfa hay; TMR plus 200 g alfalfa hay every two days; and TMR plus 300 g alfalfa hay every three days. The TMR and fresh drinking water were offered ad libitum. Lambs in the treated groups (with alfalfa hay) had significantly higher body weight, body weight change, dry matter intake, and feed conversion ratio compared with the control. Similarly, slaughter weight, carcass weight (hot and cold), and internal organs weight significantly increased in the treated groups, except for dressing weight percentage, which improved only in the treatment with TMR plus 300 g alfalfa hay. By contrast, mesentery fat, back fat, and body wall fat decreased in treated groups. Meat quality characteristics indicated that cooking loss and pH values did not differ between the control and treated groups; however, meat colour (lightness, yellowness, and redness) and pH (1 and 24 h) improved in post-slaughter treated groups. Furthermore, no difference was found in texture profile analysis (hardness, springiness, cohesiveness, and chewiness), although the shear force decreased significantly in treated groups. Addition of alfalfa hay offered at the present plan may not only improve the growth and carcass characteristics, but also enhance the meat quality of Naemi lambs. From the labour and economic point of view, TMR plus 300 g alfalfa hay every three days may be adopted while taking into account the management decision.

Background: The cosmetic treatment of varicose veins is the main activity of most vascular surgeons in Brazil. In order to obtain satisfactory cosmetic results, careful planning of varicose vein operations is necessary. Objective: Marking (or "mapping") the varicose veins with indelible ink is an essential step in planning cosmetic surgeries for lower limb varicose veins. In the present study, the role of transcutaneous phleboscopy (TcPh) in planning varicose vein operations is evaluated. Methods: A series of 100 consecutive patients, all female, were evaluated with TcPH as part of their varicose vein operations planning. A total of 171 limbs with varicose veins (71 bilateral and 29 unilateral) were evaluated. The process of marking the varicose veins followed the same protocol in all cases. Firstly, the varicose veins were marked by inspection and palpation, with the patient standing, using an indelible black ink pen. Secondly, with the patients resting in supine and prone positions, the varicose veins detected with TcPh were marked again with red or blue ink. The marks made by the two methods were then compared. Results: In 41 patients, for a total of 80 limbs (46.8%), the marks were altered after use of TcPh. Reasons for such changes were: 1) identification of other varicose veins; 2) identification of reticular veins draining complex telangiectasias; and 3) changes in the position of the marks placed with the patient standing. Conclusions: TcPh has altered the planning of varicose vein surgeries in 46.8% of all limbs evaluated, especially when the patients had complex telangiectasias, associated with reticular varicose veins.Contexto: O tratamento estético de varizes é a principal atividade da maioria dos cirurgiões vasculares do Brasil. Para se obter resultados estéticos satisfatórios, é necessário um planejamento adequado da cirurgia de varizes. Objetivo: A marcação (ou "mapeamento") das varizes com tinta indelével é uma etapa essencial do planejamento das cirurgias de varizes dos membros inferiores com finalidade estética. Neste estudo, é avaliado o papel da fleboscopia por transiluminação na marcação pré-operatória de varizes. Métodos: Uma série de 100 pacientes consecutivas, todas do sexo feminino, foram avaliadas através de fleboscopia por transiluminação, como parte do planejamento de suas operações de varizes. Do total de 171 membros com varizes, 71 pacientes tinham varizes bilaterais e 29 tinham varizes unilaterais. Em todos os casos, a marcação das varizes a serem operadas seguiu o mesmo protocolo. Na primeira etapa, as varizes foram marcadas de forma tradicional, por inspeção e palpação, com as pacientes de pé, usando canetas de tinta indelével de cor preta. Na segunda etapa, as pacientes assumiram a posição de decúbito e as varizes foram re-marcadas, com o auxílio da fleboscopia por transiluminação, com tinta de cor vermelha ou azul. Em seguida, foram comparadas as marcações pelos dois métodos. Resultados: Em 41 pacientes, totalizando 80 membros (46,8%), foram alteradas as marcações depois da fleboscopia por transiluminação. Os motivos para as alterações foram: 1) identificação de novos trajetos varicosos; 2) identificação de veias de drenagem de telangiectasias complexas; e 3) mudanças no trajeto de varizes marcadas da forma tradicional. Conclusões: A fleboscopia por transiluminação alterou o planejamento da cirurgia de varizes em 46,8% dos membros avaliados, especialmente quando as pacientes tinham telangiectasias complexas associadas a varizes reticulares.

Os aneurismas venosos são entidades raras, porém com potencialidade de causar complicações tromboembólicas. Na maioria das vezes, são encontrados incidentalmente, como achados de exame físico ou de imagem. Os aneurismas sintomáticos de veia poplítea são obrigatoriamente tratados por reparo cirúrgico, devido ao alto risco de recorrência de embolia pulmonar. A técnica mais utilizada é a aneurismectomia tangencial com venorrafia lateral. Na impossibilidade de se empregar essa técnica, faz-se a ressecção com reconstrução venosa. Os autores relatam o caso de uma paciente com aneurisma de veia poplítea, cujo diâmetro era de 47 mm, submetido a aneurismectomia tangencial e venorrafia lateral, com sucesso.Venous aneurysms are considered to be a rare disease; however they can be a potential cause for the development of thromboembolism. They are mostly detected by physical examination or imaging exams. Symptomatic aneurysms of the popliteal vein must be surgically treated, due to high risk of recurrent pulmonary embolism. The most widely used procedure is tangential aneurysmectomy and lateral venorrhaphy. If not possible, the aneurysm should be removed and a venous reconstruction should be performed. The authors report a case of a patient with a popliteal vein aneurysm measuring 47 mm in diameter. Tangential aneurysmectomy and lateral venorrhaphy were successfully used for treatment.

Este trabalho descreve um caso de pseudo-aneurisma da artéria tibial posterior devido ao uso de fixador externo para tratamento de fratura dos ossos da perna (técnica de Ilizarov), bem como as técnicas utilizadas para seu tratamento. A compressão guiada por ultra-som e a injeção de trombina guiada por ultra-som foram realizadas, sem sucesso. O tratamento definitivo do pseudo-aneurisma e reconstrução arterial foi conseguido através do tratamento cirúrgico clássico, usando enxerto interposto de veia safena magna homóloga invertida. As indicações, vantagens e desvantagens das técnicas de tratamento não invasivo (compressão guiada por ultra-som e injeção de trombina guiada por ultra-som) e as possíveis causas de sua incapacidade na obliteração do pseudo-aneurisma são discutidas. Também foi realizada a revisão de casos de pseudo-aneurisma da artéria tibial posterior na literatura médica, encontrando-se apenas um caso semelhante, entre 24 publicados.We describe a case of pseudoaneurysm in the posterior tibial artery following treatment for tibial and fibula fractures using external fixation (Ilizarov technique), as well as the techniques used for its treatment. Ultrasound-guided compression and ultrasound-guided thrombin injection were unsuccessfully performed. Definite treatment of pseudoaneurysm and arterial reconstruction was achieved through the traditional surgical treatment, using interposed graft of inverted homologous great saphenous vein. Indications, advantages and disadvantages of noninvasive treatment techniques (ultrasound-guided compression and ultrasound-guided thrombin injection) and the possible causes of their inability in obliterating the pseudoaneurysm are discussed. A literature review of pseudoaneurysms of the posterior tibial artery was also carried out, resulting in only one similar case out of 24 published cases.