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    Background: It is a common notion that motion of a femoral component during cementation should be avoided as it may weaken the cement mantle. We created an in vitro model of cemented femoral components and subjected them to varying rotational motion during the cement curing process, to measure the effect on the pullout strength of the stem. Methods: 21 sawbones femurs were separated into four groups. The first group served as control and was cemented in a standard fashion. The remainder of the stems were divided into groups and subjected to angular rotational displacement within the cement mantle during curing . Anteroposterior and lateral radiographs were obtained of each model to evaluate for cement defects. Pullout strength testing was performed. Results: Despite rotational displacement, no cement defects were noted on imaging. The control stems showed an average pullout strength of 3735.79N. The experimental groups showed a trend for lower failure loads but it was not statistically significant (P=0.063). Of the 21 stems tested, three encountered cement mantle failure and associated stem pullout and the remainder failed by peripros-thetic fracture. Conclusion: Despite conventional thinking that rotational displacement during the cementing process leading to disruption of the cement mantle integrity, this was not borne out in our study. This should give surgeons confidence that in the set-ting of unintended rotational displacement of a femoral stem, returning the stem to its original position does not significantly compromise the integrity of the cement mantle or the pullout strength of the femoral implant. Small displacement of the femoral stem with prompt correction during cement curing does not cause evident cement mantle defects or a loss of femoral stem pullout strength.

  • Acute cholecystitis with intraluminal gallbladder bleeding: Case report and literature review

    Background: Hemorrhagic cholecystitis is an infrequent complication of acute cholecystitis associated with high mortality rate. Recognition of this acute abdominal condition is often challenging. Authors present a case of acute intraluminal gallbladder bleeding with a consequential gallbladder wall perforation and hematoperitoneum requiring emergency surgery in a patient on anticoagulant therapy. Case Presentation: An 80-year old woman with atrial fibrillation on warfarin was presented to abdominal surgeon due to acute abdominal pain with hemodynamic instability and active intraluminal gallbladder bleeding on CT-scan. An emergency laparotomy with cholecystectomy was performed. Despite intensive treatment patient died on the third postoperative day. Conclusions: Hemorrhagic cholecystitis is a potentially life-threatening condition. Patients on anticoagulant therapy with clinical signs of acute cholecystitis are more prone to develop bleeding into the gallbladder. Contrast-enhanced CT of the abdomen is the diagnostic modality of choice and cholecystectomy definitive therapy in patients with hemorrhagic cholecystitis.


    Objective: Perform the histomorphometric study of the following regions: areas of perivillous fibrin deposition; thickness of the endothelial layer of the vessels; analysis of Tenney-Parker changes. Analyze the Placental Index (IP). Results: It was seen that the weight of the placentas increased according to the weight of the newborn, however, when the variable PI was analyzed as being decisive for the development of a risk-free pregnancy, it was found that this parameter was not significant between the groups studied. (p


    Objective: The objective of this study was to determine the prevalence of pregnant colonization by group B Streptococcus (GBS) and to verify whether socioeconomic and demographic conditions are risk factors for colonization by this bacterium. Method: This cross-sectional study included the collection of sociodemographic data through a questionnaire and authorization to access the result of the cultivation of vaginal swabs for the investigation of GBS of 50 women treated at the Unified Health System (SUS) in a laboratory in the municipality of Medianeira, PR, between august and september 2020. Results: The population studied showed a 14% prevalence of colonization by GBS, within national and world standards. Among the factors analyzed, the only significant and protective association was living with fewer people in the same house, up to two people, reducing the risk of developing a positive culture for GBS by more than 5 times (5.54) when compared to pregnant women who live with more than 3 people in the same residence (p


    Objective: This review aims to investigate the scientific production aboute the health education in adolescence for the responsible sexual practice. Methods: This is an integrative review, using scientific articles indexed in the Virtual Health Library (VHL). We searched for articles in the databases LILACS, SCIELO and BDENF and the following descriptors were used: Pregnancy in Adolescence; Nurse; Health Education. In the search, 20 articles were found, of which, only 14 met the objective of the study. Inclusion criteria: full text available, original article, publication between 2014 and 2019 available in Portuguese and included in the proposed theme. Results: Adolescent pregnancy is considered a relevant public health problem, due the high prevalence across the country. The profile of pregnant adolescents is between 12 and 19 years, most of them single, low education, mixed race, housewives. The literature shows that early pregnancy impairs the female emancipation, results the school dropout, early entry into the labor market, disqualification, violence, decreased opportunities and also being associated with the spread of IST’s. Due to this situation and the future repercussions, unplanned pregnancy among adolescents requires holistic approaches to promote health and prevention measures. Conclusion: The nurse is essential in the development of preventive and educational skills with adolescents, establishing a strategy aimed at preventing teenage pregnancy, creating groups with purposes in the promotion of health and prevention of IST’s/early pregnancy, with the objective of making young people aware of the importance of active participation in health education actions.

  • Myths and Misconceptions about Communication Disorders: A Survey in North Karnataka region

    Introduction: Communication disorders are highly prevalent in India especially in children. Early identification and treatment can prevent children from falling behind academically, socially, and in other key areas. However, identifying children with communication disorders and providing rehabilitation at an early stage is challenging in Indian scenario. Though 21st century has progressed drastically towards the rehabilitation of various communication disorders effectively, not all the regions in India are accepting the scientific rehabilitation. Due of lack of awareness, ignorance and stigma related to communication disorders, some open prejudices still persist in our country, making it difficult for people with communication disorders to have their condition recognized and to seek rehabilitation. However beforehand it is important to know the origin and degree of the problem so that appropriate remedy can be sought. Hence the present study makes one such effort, to study the extent of myths widely spread over north Karnataka region. Materials and Methods: A questionnaire consisting of 10 questions which focus on myths and misbelieves regarding communication disorders was administered on a total of Six hundred participants in the age range of 18 to 80 years. Results: Results indicted presence of myths in rural population with respect to communication disorders compared to urban population. Compared to younger group older group showed more misconceptions. Conclusion: From the results it can be concluded that further necessary programs needs to be implemented in rural areas and for older age groups of North Karnataka region to create awareness in this regard.

  • Identification Of Parasitic Infections In Food Handlers And The Imminent Risks Of Transmission To School-Aged Children

    Introduction: Most diseases transmitted by food contaminated by protozoa and/or helminths are originated from food improper handling. This fact is related to poor hygiene conditions in the food handling environment or the practices of food handlers. Objective: The aim of this study was to identify parasitic diseases in food handlers, as well as the risk of transmission to school-aged children. Methods: This is a literature review accomplished through researchers in Pubmed, Academic OneFile, SciELO and Google Scholar. The review comprised 40 articles published in the period from 2009 to 2019. In order effect the review, were included in this study literature reviews and original articles, identified in the aforementioned databases and which met the inclusion criteria: having their publication in indexed journals, articles with abstracts and full texts available online, articles published in Portuguese, English or Spanish in the last ten years. Studies whose year of publication was less than 2009 were excluded. Results: Enteroparasitosis are a serious public health problem that affects the world population. This fact is mainly related to the ingestion of contaminated food, having a direct connection with those who handle it. Conclusion: Therefore, food handlers have an important role in the transmissibility of diseases and food security.

  • Brazilian Infectious and Parasitic Diseases Child Mortality between 2014 and 2018

    Objectives: Determinate which children are more likely to die due to infectious and parasitic diseases in order to indicate which groups require more attention from the health system. Methods: Data from the Mortality Information System (SIM) by the Informatics Department of the Unified Health System (DATASUS) regarding deaths from infectious and parasitic diseases were collected. All records by year and region of death and race and sex of children between 0 and 19 years were considered. Results: In the 5 years, 14,659 infant deaths due to infectious and parasitic diseases were recorded in Brazil, an average of 2,931.8 (± 323.8) per year. There is a 19.5% reduction between 2018 and 2014, that is, 5 years. The highest concentration of records is in the Northeast region, close to Southeast, with 33.2% and 32.4% respectively. Children under 1 year old are majority, with 52.1% while 5 to 9 years old are minority, 7.2%. As for sex, there is a small difference, 54.8% of the records are male. Most children are brow, 49.7%, followed by white, with considerably less, 34%. Conclusions: Brown children, under 1 year old and residents of the Northeast or Southeast are, according to statistics, more prone to fatal outcome of infectious and parasitic diseases. From this profile, it can be inferred that race and age are determining factors for child survival. Measures such as guidance to parents during prenatal care on preventing infections and parasites should be instituted, as well as childcare control and child vaccination in primary care.


    Aim: Frontal linear scleroderma, also known as ‘‘en coup de sabre,’’ is a congenital deformity characterized by atrophy and furrowing of the skin of the front parietal area above the level of the eyebrows. In most cases it occurs as a single paramedian line that may be associated with hypoplasia of underlying structures and facial hemiatrophy. In case of a wide lesion many reconstructive strategies have been proposed. The modern approach is aimed at augmentation of the tissue deficiency by using lipostructure and tissue regeneration. Autologous fat transfer (AFT) seems to be an effective strategy to restore the normal volume and contour of the face while providing a source of adipose-derived stem cells (ADSCs) with a multilineage differentiation potential. Methods: In this report, we present a rare case of linear scleroderma en coupe de sabre which was successfully managed with three stages of autologous fat grafting. Conclusion: The proposed uses for ADSCs in tissue repair and regeneration are quite impressive. Recent works on ADSCs would suggest that adult cells may prove to be an equally powerful regenerative tool in treating congenital and acquired maxillofacial disorders. More importantly, physicians, researchers and international associations need to cooperate in informing clinicians about what practices are based on evidence and to encourage support of additional research. There is increasing interest in a possible therapeutic effect of ADSCs from processed lipoaspirate for a wide spectrum of clinical applications in the facial and craniofacial area. AFT can be used in any facial area where soft tissue is lacking or where there is scarring, producing natural and long-lasting results. Mesenchymal stem cells represent a great tool in regenerative medicine. However, more definitive studies are needed to answer specific questions regarding the best technique to be used and the role of ADSCs. Autologous fat grafting provides a safe…

  • Preparing A University Hospital Neonatal Intensive Care Unit for Covid-19 Pandemic and Country Lockdown

    Jordan is one of the earliest countries that took a very strict approach to contain COVID-19 pandemic by declaring a country lock down. Our neonatal intensive care unit is a level three 30 beds unit. The shortage of neonatal nurses, doctors, and of respiratory support devices are the major existing challenges. During COVID-19 pandemic, those two issues were magnified. This paper will shortly discuss the measures taken as a preparedness for COVID-19 Pandemic in our unit. Team development and work schedule: The medical knowledge about COVID-19 was foggy, however; teamwork is the only ev-ident thing. Our team included, the neonatologists, pediatric intensivist, pediatric pul-monologists, in addition to the infectious disease specialist. The team also included three of our senior residents, and the neonatal unit head nurse. To enhance communication, we created a WhatsApp group (Peds COVID -19). Among this group, unidentified Patients’ information, in addition to recent publications and sci-entific opinions, were shared. Meeting with the obstetric department was done to famil-iarize both teams with the measures taken on both sides. The neonatal care is provided by two neonatologists. The in-house care providers are the pediatric residents. Senior residents are well-trained on neonatal resuscitation, endotra-cheal intubation, and umbilical venous catheterization. During COVID-19 lock down, residents were split into separate teams. Neonatal team, the pediatric floor team, and the emergency room team, each team had their sleeping room and lounges. The consultants did rounds daily, the in-house team consisted of two senior residents, and a junior resident. they did a 24-hour shift every four days and are off duty for the next three days. Regarding the nursing staff schedule, their work schedule changed from an 8- hour shift to a 12- hour shifts schedule. The aim was to promote staff well-being, minimize the number of staff who could potentially be exposed…