scholarly journals Upper limb anatomy and preoperative mapping

2021 ◽  
pp. 112972982110468
Author(s):  
Joaquim Vallespin ◽  
Mario Meola ◽  
Jose Ibeas

Vascular access is absolutely essential for haemodialysis due to its relationship with quality of dialysis and associated morbidity. Therefore, it must be monitored and continuously surveilled from the moment it is created to prevent failure in maturation and thrombosis. Multidisciplinary collaboration is necessary when the main aim is to achieve the adequate vascular access flow with the fewest possible complications. The starting point, and probably the main one, is vascular access planning. This planning requires both a deep understanding of the anatomy of the upper limb and enough skill to examine it by Doppler ultrasound. The aim of this article is to review the anatomical and haemodynamical concepts of the arterial and venous vascular tree and explain how to perform ultrasound mapping, optimising the technical resources provided by this tool. Likewise, adequate access creation criteria that minimise the risk of failure and associated complications will be discussed.

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Hironobu Machida ◽  
Takeshi Sugahara ◽  
Izumi Hirasawa

AbstractEven if a liquid is cooled below its melting point, the liquid state can be maintained under certain conditions. This state is called supercooling. Spraying fine particles of dry ice or silver iodide induces a phase change from supercooled droplets to ice grains. However, the mechanism by which crystallization seeds diminish supercooling is not well understood. Here, we captured the moment when a cluster, which is the smallest structural unit of a crystal, envelops a silver nanoparticle. As a result of observing the structure of a supercooled aqueous solution of a clathrate hydrate, we found that silver nanoparticles accelerate the formation of clusters, whereas the noble metals palladium, gold and iridium likewise form nanoparticles but do not promote crystallization. Our discoveries elucidate the mechanism of heterogeneous nucleation during a phase change in clathrate hydrates. We anticipate our discovery to be the starting point for the control of supercooling, a technique that can be applied to enhance the production efficiency and quality of manufactured products.


Ultrasound ◽  
2019 ◽  
Vol 27 (4) ◽  
pp. 225-232
Author(s):  
Ana S Germano ◽  
António P Gomes ◽  
Rita Martins ◽  
Marta Sousa ◽  
Vitor Nunes

Introduction Doppler ultrasound is recommended by international societies for preoperative vascular mapping in vascular access surgery. Literature is scarce regarding data on Doppler ultrasound-associated errors. Objectives Our aim was to evaluate Doppler ultrasound precision for upper limb vascular mapping. Methods Fifty-two adult healthy volunteers were evaluated for superficial vein diameter, brachial artery flow and diameter in the lower third of non-dominant arm by a dedicated vascular access radiologist blinded for the identification of the participants. Each participant was scheduled for three evaluations one week apart. Friedman test and multivariate analysis of variance for repeated measures were used. Results There were no statistical differences within subjects across the three weeks except for brachial artery flow in participants who had basilic vein as the dominant vein. Discussion Repeated anatomical and haemodynamic parameters measured by Doppler ultrasound performed by an experienced medical sonographer, according to our protocol, did not show statistical differences within subjects, independently of age, gender and body mass index.


2012 ◽  
pp. 66-80
Author(s):  
Michał Mrozowicki

Michel Butor, born in 1926, one of the leaders of the French New Novel movement, has written only four novels between 1954 and 1960. The most famous of them is La Modification (Second thoughts), published in 1957. The author of the paper analyzes two other Butor’s novels: L’Emploi du temps (Passing time) – 1956, and Degrés (Degrees) – 1960. The theme of absence is crucial in both of them. In the former, the novel, presented as the diary of Jacques Revel, a young Frenchman spending a year in Bleston (a fictitious English city vaguely similar to Manchester), describes the narrator’s struggle to survive in a double – spatial and temporal – labyrinth. The first of them, formed by Bleston’s streets, squares and parks, is symbolized by the City plan. During his one year sojourn in the city, using its plan, Revel learns patiently how to move in its different districts, and in its strange labyrinth – strange because devoid any centre – that at the end stops annoying him. The other, the temporal one, symbolized by the diary itself, the labyrinth of the human memory, discovered by the narrator rather lately, somewhere in the middle of the year passed in Bleston, becomes, by contrast, more and more dense and complex, which is reflected by an increasinly complex narration used to describe the past. However, at the moment Revel is leaving the city, he is still unable to recall and to describe the events of the 29th of February 1952. This gap, this absence, symbolizes his defeat as the narrator, and, in the same time, the human memory’s limits. In Degrees temporal and spatial structures are also very important. This time round, however, the problems of the narration itself, become predominant. Considered from this point of view, the novel announces Gerard Genette’s work Narrative Discourse and his theoretical discussion of two narratological categories: narrative voice and narrative mode. Having transgressed his narrative competences, Pierre Vernier, the narrator of the first and the second parts of the novel, who, taking as a starting point, a complete account of one hour at school, tries to describe the whole world and various aspects of the human civilization for the benefit of his nephew, Pierre Eller, must fail and disappear, as the narrator, from the third part, which is narrated by another narrator, less audacious and more credible.


Author(s):  
Ella Polozova ◽  
Vsevolod Skvortsov ◽  
Olga Radaykina ◽  
Mariya Narvatkina ◽  
Anastasiya Seskina ◽  
...  

The widespread prevalence of comorbid pathology determines the relevance of this problem. Comorbid pathology due to the interaction of diseases, drug pathomorphism, age characteristics of the patient, significantly changes clinical picture and course of the main nosology, affects severity of complications and their nature, significantly affects quality of life and prognosis of patients. Diagnosis and treatment of many diseases is complicated in the conditions of comorbidity. The article presents a clinical case of a comorbid patient with arterial hypertension from the moment of exposure to risk factors and ending with the formation of many concomitant diseases, as an example of trans-nosological comorbidity.


1997 ◽  
Vol 36 (2-3) ◽  
pp. 361-367 ◽  
Author(s):  
Eleftheria Papachristou ◽  
Costas T. Lafazanis

A great number of cheese dairies and dairy industries in Greece are disposing their wastes, mainly cheese whey, either on land or in surface receivers, in large quantities creating a major environmental problem. A typical agricultural and pastoral provincial town of 70,000 inhabitants, Trikala, became the starting point of this research. A co-treatment of the urban sewage and the dairy wastes in the municipal treatment plant was recommended. The successful application of the above statement is based primarily on the pretreatment of the cheese dairies wastes. So far for cheese whey the recovery of the lactose serum in the contemporary central unit applying membrane technology has been suggested. As far as the wastewaters of the washing and refrigeration are concerned a pretreatment is required for the defatting in a grease trap, the grating, the adjustment of pH and the equalisation in an appropriate tank. Finally, this research has also focussed on the importance of membrane technology in improving the quality of milk and cheese production.


2019 ◽  
Vol 5 (1) ◽  
pp. 35-42
Author(s):  
Erma Yenis

Abstractlearning process  good teaching  can create a situation that allows children to learn, so that is the starting point of the success of teaching. The low quality of education depends on the management of the teaching and learning process which can be interpreted as being less effective in the teaching and learning process, the causes: (1) Low learning activities, (2) Inadequate facilities and infrastructure. The case in Solok City Middle School, the low level of student learning activities allegedly influenced the low student learning outcomes. Based on observations on class VIII A which included the superior class had not yet achieved the desired completeness, the class with the least completeness was class VIII B which was 33.33% with KKM 65 criteria. Seeing this reality, teachers were required to motivate students and foster enthusiasm student learning. Therefore, to foster students' enthusiasm for learning, the author tries to apply student learning activities through discussion methods in small groups.Keywords: Learning, discussion AbstrakProses belajar mengajar yang baik dapat menciptakan situasi yang mmemungkinkan anak belajar, sehingga merupakan titik awal keberhasilan pengajaran. Rendahnya mutu pendidikan tergantung pada pengelolaan proses belajar mengajar yang dapat diartikan kurang efektifnya proses belajar mengajar, penyebabnya: (1) Rendahnya aktifitas belajar,  (2) Sarana dan prasarana yang belum memadai. Kasus pada SMP Negeri % Kota Solok rendahnya aktifitas belajar siswa diduga berpengaruh terhadap rendahnya hasil belajar siswa. Berdasarkan pengamatanpada  kelas VIII A yang termasuk kelas unggul belum mencapai ketuntasan yang di inginkan, sedangkan kelas yang paling sedikit ketuntasannya adalah kelas VIII B yaitu sebanyak 33,33 % dengan kriterian KKM 65. Melihat kenyataan tersebut, guru dituntut untuk dapat memotivasi siswa dan menumbuhkan semangat belajar siswa. Karena itu, untuk menumbuhkan semangat belajar siswa, penulis mencoba untuk menerapkan aktivitas belajar siswa melalui metode diskusi dalam kelompok kecil. Kata kunci: Pembelajaran, diskusi


Author(s):  
Richard Mayne ◽  
Neil Heron

Tingling, pain and numbness in the hand can be a major cause of morbidity for many people. Adequate hand and wrist function are required for a huge variety of daily tasks, therefore disorders of the hand and wrist can have significant detrimental effects on the quality of life for affected individuals. With any upper limb issue, it is important to consider hand dominance, occupation and pastimes of the affected person. This article focuses on the optimal diagnosis and management of carpal and cubital tunnel syndromes from a primary care perspective.


2021 ◽  
Vol 10 (7) ◽  
pp. 1478
Author(s):  
Alexandra Voinescu ◽  
Jie Sui ◽  
Danaë Stanton Fraser

Neurological disorders are a leading cause of death and disability worldwide. Can virtual reality (VR) based intervention, a novel technology-driven change of paradigm in rehabilitation, reduce impairments, activity limitations, and participation restrictions? This question is directly addressed here for the first time using an umbrella review that assessed the effectiveness and quality of evidence of VR interventions in the physical and cognitive rehabilitation of patients with stroke, traumatic brain injury and cerebral palsy, identified factors that can enhance rehabilitation outcomes and addressed safety concerns. Forty-one meta-analyses were included. The data synthesis found mostly low- or very low-quality evidence that supports the effectiveness of VR interventions. Only a limited number of comparisons were rated as having moderate and high quality of evidence, but overall, results highlight potential benefits of VR for improving the ambulation function of children with cerebral palsy, mobility, balance, upper limb function, and body structure/function and activity of people with stroke, and upper limb function of people with acquired brain injury. Customization of VR systems is one important factor linked with improved outcomes. Most studies do not address safety concerns, as only nine reviews reported adverse effects. The results provide critical recommendations for the design and implementation of future VR programs, trials and systematic reviews, including the need for high quality randomized controlled trials to test principles and mechanisms, in primary studies and in meta-analyses, in order to formulate evidence-based guidelines for designing VR-based rehabilitation interventions.


2021 ◽  
Vol 53 (5) ◽  
pp. 515-522
Author(s):  
P Raynham

Electric light in buildings may provide some health benefits; however, for most people these benefits are likely to be small. It is possible for electric lighting to cause health problems, if there is too little light or there is glare, but for the most part there is good guidance available and these problems can be avoided. The quality of the lit environment can have a psychological impact and this may in turn impact well-being. A starting point for this is perceived adequacy of illumination. Related lighting metrics are examined and a hypothetical explanation is suggested.


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