PREDICTION OF THE EFFICIENCY OF RECONSTRUCTIVE INTERVENTIONS ON THE MAJOR NERVES OF THE FOREARM, DEPENDING ON THE DEFECT DURATION AND THE FOLLOWING REHABILITATION

2020 ◽  
pp. 77-88
Author(s):  
Дмитрий Валериевич Судаков ◽  
Олег Валериевич Судаков ◽  
Людмила Валентиновна Кретинина ◽  
Наталья Владимировна Якушева ◽  
Артём Николаевич Шевцов
Keyword(s):  
Nervous Tissue ◽  
Clinical Situation ◽  
Economic Importance ◽  
Important Data ◽  
Subsequent Period ◽  
Complete Restoration ◽  
Reconstructive Microsurgery ◽  
The Moment

Статья посвящена построению прогноза эффективности реконструктивных вмешательств на магистральных нервах предплечья в зависимости от протяженности дефекта нервной ткани и особенностей последующего периода реабилитации пациентов. Данная тематика является весьма актуальной, так как с каждым годом во всем мире наблюдается определенный рост случаев травм различного генеза магистральных нервных стволов, которые затем нередко приводят к временной нетрудоспособности и даже инвалидности пациентов. Реконструктивная микрохирургия многие десятилетия пытается решить целый ряд проблем аутотрансплантации нервных стволов и повысить ее общую эффективность. Но из-за определенных проблем связанных с финансированием, некоторые вопросы трансплантологии и реабилитации остаются нерешенными и в настоящий момент. Все это придает представленной работе важное значение не только медицинского, но и социально - экономического плана. Целью работы стала попытка построения прогноза восстановительных операций на нервной ткани, с учетом объема пораженных структур и периода реабилитации. Объектами исследования стало 180 больных, которым по той или иной причине, осуществлялась реконструктивная операция на одном из магистральных нервов предплечья. Все пациенты были разделены на 3 группы по 60 человек, в зависимости от протяженности дефекта магистрального нерва: до 4 см, от 4 до 8 см и от 8 до 12 см. Последующее разделение внутри каждой группы на подгруппы производилось в зависимости от определенного поврежденного нерва (лучевой, локтевой, срединный). В работе изучалось течение раннего послеоперационного воспалительного процесса, с определением бактериальной микрофлоры в ране. Изучались и отдаленные последствия оперативного вмешательства. Своеобразной новизной для данной тематики в целом, стало выявление последующего установления инвалидности пациентов. Кроме того, важные данные были получены и по срокам реабилитации и частичного или полного восстановления утраченных функций по срокам в зависимости от размеров восстанавливаемого дефекта и от наличия или отсутствия необходимой реабилитации. Полученные в работе данные могут представлять интерес не только для врачей хирургов и травматологов, но и для организаторов здравоохранения, позволяя производить прогнозы по выздоровлению пациентов в каждой определенной клинической ситуации The article is devoted to the construction of a forecast of the effectiveness of reconstructive interventions on the main nerves of the forearm, depending on the length of the defect in the nervous tissue and the characteristics of the subsequent period of rehabilitation of patients. This topic is very relevant, since every year all over the world there is a certain increase in cases of injuries of various origins of the main nerve trunks, which then often lead to temporary disability and even disability of patients. For many decades, reconstructive microsurgery has been trying to solve a number of problems of autotransplantation of nerve trunks and improve its overall efficiency. But due to certain problems associated with funding, some issues of transplantation and rehabilitation remain unresolved at the moment. All this gives the presented work important not only medical, but also socio - economic importance. The aim of this work was to attempt to predict restorative operations on the nervous tissue, taking into account the volume of the affected structures and the period of rehabilitation. The objects of the study were 180 patients who, for one reason or another, underwent a reconstructive operation on one of the main nerves of the forearm. All patients were divided into 3 groups of 60 people, depending on the length of the main nerve defect: up to 4 cm, from 4 to 8 cm, and from 8 to 12 cm. Subsequent division within each group into subgroups was performed depending on the specific damaged nerve ( radial, ulnar, median). The work studied the course of the early postoperative inflammatory process, with the determination of bacterial microflora in the wound. The long-term consequences of surgery were also studied. A peculiar novelty for this topic as a whole was the identification of the subsequent establishment of disability in patients. In addition, important data were obtained on the timing of rehabilitation and partial or complete restoration of lost functions in terms of timing, depending on the size of the restored defect and on the presence or absence of the necessary rehabilitation. The data obtained in this work may be of interest not only for surgeons and traumatologists, but also for healthcare organizers, allowing them to make predictions about the recovery of patients in each specific clinical situation

Long-term monitoring of an invasion process: the case of an isolated small wetland on a Mediterranean Island, second stage: toward a complete restoration

Biologia ◽  
2014 ◽  
Vol 69 (8) ◽  
Author(s):  
Bruno Foggi ◽  
Renato Benesperi ◽  
Daniele Viciani ◽  
Michele Giunti ◽  
Lorenzo Lastrucci
Keyword(s):  
Invasion Process ◽  
Second Stage ◽  
Complete Restoration ◽  
Mediterranean Island ◽  
One Year ◽  
The Moment ◽  
Short Time ◽  
Term Monitoring ◽  
Small Wetland

AbstractIn the present article, the results of the first-stage of monitoring, following restoration works on a small Mediterranean wetland (Lake Stagnone, Capraia Island, Tuscan Archipelago), are reported. The recent spread of Typha and Phragmites in the lake changed diversity and composition of the plant communities. Nine years after their first monitoring (2009), a rarefaction of hydrophytes and small helophytes of conservation interest was detected. In 2010, the restoration started with the aim to remove (or at least reduce) the populations of the large, expansive helophytes. In 2012, the first post-actions monitoring were carried out using the same methods as previously, analysing the plant presence/absence and their cover value recorded in the same 15 plots selected in 2000 and 2009. The rise and fall of the populations of the various flora and vegetation types during this invasion process and the following restoration were statistically analysed. One year following the restoration, some recovery (replacement) had occurred of autochthonous hydrophytes and small helophytes. Many of these species are of conservation interest. Some aquatic plants, present on the site until the more or less recent past, were once more recorded. Given the rapid recovery of populations of many autochthonous species, the results are reasonably encouraging, rendering planned reintroductions unnecessary at the moment. On the other hand, because of the short time elapsed since restoration, the current community structure cannot in any way be considered an “equilibrium” one. Continued and regular monitoring is required to allow the reestablishment of the large expansive helophytes populations.

Preparation And elemental analysis of ancient fibers

1987 ◽  
Vol 45 ◽  
pp. 410-411
Author(s):  
Allen Angel ◽  
Kathryn A. Jakes
Keyword(s):  
Cross Sections ◽  
Physical Structure ◽  
Energy Dispersive ◽  
Archaeological Sites ◽  
X Ray ◽  
Long Term Storage ◽  
Backscattered Electron ◽  
Electron Imaging

Fabrics recovered from archaeological sites often are so badly degraded that fiber identification based on physical morphology is difficult. Although diagenetic changes may be viewed as destructive to factors necessary for the discernment of fiber information, changes occurring during any stage of a fiber's lifetime leave a record within the fiber's chemical and physical structure. These alterations may offer valuable clues to understanding the conditions of the fiber's growth, fiber preparation and fabric processing technology and conditions of burial or long term storage (1).Energy dispersive spectrometry has been reported to be suitable for determination of mordant treatment on historic fibers (2,3) and has been used to characterize metal wrapping of combination yarns (4,5). In this study, a technique is developed which provides fractured cross sections of fibers for x-ray analysis and elemental mapping. In addition, backscattered electron imaging (BSI) and energy dispersive x-ray microanalysis (EDS) are utilized to correlate elements to their distribution in fibers.

Traumatic Brain Injury: A Trauma Surgeon's Perspective

2012 ◽  
Vol 22 (3) ◽  
pp. 82-89
Author(s):  
Oscar D. Guillamondegui
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Multidisciplinary Approach ◽  
Trauma Team ◽  
The United States ◽  
Long Term Outcomes ◽  
Term Care ◽  
Injured Brain ◽  
The Moment

Traumatic brain injury (TBI) is a serious epidemic in the United States. It affects patients of all ages, race, and socioeconomic status (SES). The current care of these patients typically manifests after sequelae have been identified after discharge from the hospital, long after the inciting event. The purpose of this article is to introduce the concept of identification and management of the TBI patient from the moment of injury through long-term care as a multidisciplinary approach. By promoting an awareness of the issues that develop around the acutely injured brain and linking them to long-term outcomes, the trauma team can initiate care early to alter the effect on the patient, family, and community. Hopefully, by describing the care afforded at a trauma center and by a multidisciplinary team, we can bring a better understanding to the armamentarium of methods utilized to treat the difficult population of TBI patients.

Klinische Langzeitergebnisse der perkutanen transluminalen Angioplastie bei Patienten mit peripherer arterieller Verschlusskrankheit

VASA ◽  
2002 ◽  
Vol 31 (1) ◽  
pp. 36-42 ◽  
Author(s):  
. Bucek ◽  
Hudak ◽  
Schnürer ◽  
Ahmadi ◽  
Wolfram ◽  
...  
Keyword(s):  
Success Rate ◽  
Clinical Stage ◽  
Ankle Brachial Index ◽  
Clinical Situation ◽  
Clinical Results ◽  
Transluminal Angioplasty ◽  
Term Outcome ◽  
Long Term Outcome

Background: We investigated the long-term clinical results of percutaneous transluminal angioplasty (PTA) in patients with peripheral arterial occlusive disease (PAOD) and the influence of different parameters on the primary success rate, the rate of complications and the long-term outcome. Patients and methods: We reviewed clinical and hemodynamic follow-up data of 166 consecutive patients treated with PTA in 1987 in our department. Results: PTA improved the clinical situation in 79.4% of patients with iliac lesions and in 88.3% of patients with femoro-popliteal lesions. The clinical stage and ankle brachial index (ABI) post-interventional could be improved significantly (each P < 0,001), the same results were observed at the end of follow-up (each P < 0,001). Major complications occurred in 11 patients (6.6%). The rate of primary clinical long-term success for suprainguinal lesions was 55% and 38% after 5 and 10 years (femoro-popliteal 44% and 33%), respectively, the corresponding data for secondary clinical long-term success were 63% and 56% (60% and 55%). Older age (P = 0,017) and lower ABI pre-interventional (P = 0,019) significantly deteriorated primary clinical long-term success for suprainguinal lesions, while no factor could be identified influencing the outcome of femoro-popliteal lesions significantly. Conclusion: Besides an acceptable success rate with a low rate of severe complications, our results demonstrate favourable long-term clinical results of PTA in patients with PAOD.

Improvement Of Curvilinear Diagrams Of Concrete Deformation

2019 ◽  
pp. 99-104
Keyword(s):  
Reinforced Concrete ◽  
Peak Load ◽  
Experimental Studies ◽  
Concrete Structures ◽  
Deformation Model ◽  
Reinforced Concrete Structures ◽  
Significant Difference ◽  
Deformation Diagrams

Problems when calculating reinforced concrete structures based on the concrete deformation under compression diagram, which is presented both in Russian and foreign regulatory documents on the design of concrete and reinforced concrete structures are considered. The correctness of their compliance for all classes of concrete remains very approximate, especially a significant difference occurs when using Euronorm due to the different shape and sizes of the samples. At present, there are no methodical recommendations for determining the ultimate relative deformations of concrete under axial compression and the construction of curvilinear deformation diagrams, which leads to limited experimental data and, as a result, does not make it possible to enter more detailed ultimate strain values into domestic standards. The results of experimental studies to determine the ultimate relative deformations of concrete under compression for different classes of concrete, which allowed to make analytical dependences for the evaluation of the ultimate relative deformations and description of curvilinear deformation diagrams, are presented. The article discusses various options for using the deformation model to assess the stress-strain state of the structure, it is concluded that it is necessary to use not only the finite values of the ultimate deformations, but also their intermediate values. This requires reliable diagrams "s–e” for all classes of concrete. The difficulties of measuring deformations in concrete subjected to peak load, corresponding to the prismatic strength, as well as main cracks that appeared under conditions of long-term step loading are highlighted. Variants of more accurate measurements are proposed. Development and implementation of the new standard GOST "Concretes. Methods for determination of complete diagrams" on the basis of the developed method for obtaining complete diagrams of concrete deformation under compression for the evaluation of ultimate deformability of concrete under compression are necessary.

Perencanaan Strategi TIK Proses Belajar Mengajar di Learning Center

2017 ◽  
Vol 8 (1) ◽  
pp. 22-28
Author(s):  
Sunardi Sunardi ◽  
Dina Fitria Murad
Keyword(s):  
Process Improvement ◽  
Business Strategy ◽  
Educational Institution ◽  
Learning Center ◽  
Language Training ◽  
Short Term ◽  
Participant Satisfaction ◽  
Strategy Planning ◽  
The Moment

BINUS Center is the informal educational institution that organizes IT and language training. Inrecent years the revenue BINUS Center continues to decrease, it is evident from the outlet  BINUS Center decreased from year to year. The purpose of making this research is to make strategy planning Business & ICT, create new models of learning supported by ICT strategy,test and measure the results obtained, and then made some strategic ideas at the moment and will come in the form of short-term priorities, medium and long term. The result is a cost that can be in the efficiency, a more flexible, first-class runs with a minimal number of participants, participant satisfaction, and competitive advantage.  Keywords: business strategy, ICT strategy, business process improvement, priority.

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