Advanced Imaging for Robotic Bronchoscopy: A Review.

Recent advances in navigational platforms have led bronchoscopists to make major strides in diagnostic interventions for pulmonary parenchymal lesions. Over the last decade, multiple platforms including electromagnetic navigation and robotic bronchoscopy have allowed bronchoscopists to safely navigate farther into the lung parenchyma with increased stability and accuracy. Limitations persist, even with these newer technologies, in achieving a similar or higher diagnostic yield when compared to the transthoracic computed tomography (CT) guided needle approach. One of the major limitations to this effect is due to CT-to-body divergence. Real-time feedback that better defines the tool-lesion relationship is vital and can be obtained with additional imaging using radial endobronchial ultrasound, C-arm based tomosynthesis, cone-beam CT (fixed or mobile), and O-arm CT. Herein, we describe the role of this adjunct imaging with robotic bronchoscopy for diagnostic purposes, describe potential strategies to counteract the CT-to-body divergence phenomenon, and address the potential role of advanced imaging for lung tumor ablation.

Os efeitos do stretching global ativo em bailarinas clássicas / The effects of global active stretching on classical ballet dancers

INTRODUÇÃO: O Stretching Global Ativo (SGA) pode ser uma boa estratégia para a melhora da postura e qualidade de vida e para a redução da dor. Ele atua com alongamentos de cadeias musculares podendo proporcionar melhora da prática do balé sem grandes estresses físicos. OBJETIVO: Verificar os efeitos do SGA na postura, dor e qualidade de vida de bailarinas clássicas. MATERIAIS E MÉTODOS: Foi um ensaio clínico randomizado no período de novembro de 2020 a outubro de 2021. Constituiu-se de 20 bailarinas (idade entre 12 e 22 anos), sem lesões ortopédicas ou em recuperação, e sem tratamento fisioterapêutico. Estas foram divididas em dois grupos. O grupo controle em que não houve nenhuma intervenção e o grupo SGA, o qual realizou três posturas durante 15 minutos para cada, duas vezes por semana, totalizando 10 sessões. Avaliouse por meio do Questionário de Qualidade de Vida do Atleta, Questionário Nórdico Musculoesquelético e pelo Software para Avaliação Postural, empregando os testes t (independência), teste t (pareado), teste G (contingência) e o Qui-quadrado. RESULTADOS: Não houve diferença estatística na qualidade de vida e dor, porém no grupo controle houve aumento da extensão do corpo (0,003) e dorsiflexão do tornozelo (0,01); e no grupo SGA, houve aumento do valgo de joelho esquerdo (0,05), redução da rotação interna da cabeça do fêmur (0,01) e extensão do joelho esquerdo. CONCLUSÃO: Houve efeitos do SGA apenas na postura das bailarinas, fato não encontrado na dor e qualidade de vida das mesmas. Registro Brasileiro de Ensaios Clínicos (ReBEC) de protocolo RBR-10wckkk7.

INTRODUCTION: Global Active Stretching (GAS) can be a good strategy for improving posture and quality of life, as well as reducing pain. It works by stretching muscle chains and can improve ballet practice without major physical stress. OBJECTIVE: To verify the effects of GAS on posture, pain and quality of life of classical ballet dancers. MATERIALS AND METHODS: It was a randomized clinical trial from November 2020 to October 2021, consisting of 20 dancers (aged between 12 and 22 years), without orthopedic or recovering lesions, and without physical therapy treatment. They were divided into two groups. The control group, in which there was no intervention and the SGA group, which performed three postures twice a week for 15 minutes each, for total of 10 sessions. The Athlete's Quality of Life Questionnaire, The Nordic Musculoskeletal Questionnaire, and the Postural Assessment Software were evaluated using the t tests (independence), the t test (paired), the G test (contingency) and the Chi-square. RESULTS: There was no statistical difference in quality of life and pain, but in the control group there was an increase in body extension (0.003) and ankle dorsiflexion (0.01); and in the SGA group, there was an increase in left knee valgus (0.05), reduction of internal rotation of the femoral head (0.01) and left knee extension. CONCLUSION: There SGA affected only on posture of the dancers, but not their pain and quality of life. Brazilian Registry of Clinical Trials (ReBEC) protocol RBR-10wckkk7.

Factores predisponentes para la enfermedad quística ovárica bovina y su efecto en la eficiencia reproductiva / Factors predisposing to bovine ovarian cystic disease and its effect on reproductive efficiency / Fatores de pré-disposição à doença cística ovárica bovina e seu efeito na eficiência reprodutiva

Resumen En el ganado lechero los quistes ováricos son anomalías habituales. Se caracterizan por presentar anestro, celos irregulares, aumento de intervalos reproductivos e infertilidad. Su origen es aún desconocido. Es importante estudiar su patogenia y posible vinculación a ciertos factores predisponentes en su presentación. El objetivo de este trabajo fue determinar ecográficamente la prevalencia y tipo de quistes ováricos. Se estudiaron 93 vacas que pertenecían a 23 ganaderías de la Hoya de Loja. Las formaciones quísticas se identificaron y clasificaron según el perfil ecográfico de 24 días, con 6 exploraciones cada 4 días. Las edades de los animales fluctuaron entre 2 y 12 años, con condición corporal > 2. Para el análisis de datos se utilizó el PROC REG en el programa estadístico SPSS Statistics 21. Se determinó un incremento de 256,4 días abiertos en animales con quistes ováricos versus 114,8 días abiertos en las vacas sanas control. La prevalencia de quistes ováricos fue de 32 %, distribuidos en 21 % de quistes foliculares y 11 % de luteínicos. Además, se evidenció correlación entre presencia de quistes con condición corporal < 3 (23 %), presencia de metritis (9 %) y utilización de productos hormonales (10 %). La manifestación clínica de los quistes ováricos se expresó con síntomas de anestro de vacas con quistes luteínicos (90 %), y la presencia de celos irregulares en vacas con quistes foliculares (40 %). En conclusión, los quistes ováricos son causa directa del incremento de los periodos parto-celo, parto-concepción y del intervalo entre partos en vacas lecheras en posparto.

Abstract Ovarian cysts are common anomalies in dairy cattle. They are characterized by presenting with anestrus, irregular estrus, increased reproductive intervals, and infertility. Their origin is still unknown, thus it is important to study their pathogenesis and possible relation to certain factors predisposing to their onset. The objective of this study was to determine by ultrasound the prevalence and types of ovarian cysts. 93 cows belonging to 23 farms in the Hoya de Loja were studied. Cystic formations were identified and classified according to ultrasound profile during 24 days, with 6 scans every 4 days. The age of the animals varied from 2 to 12 years, with body condition > 2. For data analysis, PROC REG was used in the SPSS Statistics 21 statistical program. An increase of 256.4 open days was evidenced in cows with ovarian cysts, versus 114.8 open days in healthy control animals. The prevalence of ovarian cysts was 32%, distributed in follicular cysts (21%) and luteal cysts (11%). In addition, there was a correlation between the presence of cysts and body condition < 3 (23%), presence of metritis (9%), and the use of hormonal products (10%). Ovarian cysts were clinically manifested through symptoms of anestrus in cows with luteal cysts (90%) and the presence of irregular estrus in cows with follicular cysts (40%). In conclusion, ovarian cysts are a direct cause of increased periods of delivery-estrus and delivery-conception, as well as increased intervals between deliveries in postpartum dairy cows.

Resumo No gado leiteiro os cistos ováricos são anomalias habituais. Se caracterizam por apresentar anestro, cios irregulares, aumento de intervalos reprodutivos e infertilidade. Sua origem ainda é desconhecida. É importante estudar sua patogenia e possível vinculação a certos fatores de pré-disposição em sua apresentação. O objetivo deste trabalho foi determinar eco graficamente a prevalência e tipo de cistos ováricos. Foram analisadas 93 vacas que pertenciam a 23 rebanhos de gado de La Hoya de Loja. As formações císticas se identificaram e classificaram segundo o perfil ecográfico de 24 dias, com 6 explorações cada 4 dias. As idades dos animais variaram entre 2 e 12 anos, com condição corporal > 2. Para a análise de dados se utilizou o PROC REG no programa estatístico SPSS Statistics 21. Determinou-se um aumento de 256,4 dias abertos em animais com cistos ováricos versus 114,8 dias abertos nas vacas saudáveis controladas. A prevalência de cistos ováricos foi de 32 %, distribuídos em 21 % de cistos foliculares e 11 % de cistos lúteos. Além do mais, evidenciou-se correlação entre presença de cistos com condição corporal < 3 (23 %), presença de metrite (9 %) e utilização de produtos hormonais (10 %). A manifestação clínica dos cistos ováricos se expressou com sintomas de anestro de vacas com cistos lúteos (90 %), e a presença de cios irregulares em vacas com cistos foliculares (40 %). Em conclusão, os cistos ováricos são causa direta do aumento dos períodos parto-cio, parto-concepção e do intervalo entre partos em vacas leiteiras em pós-parto.

Exploring Innovation Capabilities of Hospital CIOs: An Empirical Assessment.

Hospital CIOs play a central role in the adoption of innovative health IT. Until now, it remained unclear which particular conditions constitute their capability to innovate in terms of intrapersonal as well as organisational factors. An inventory of 20 items was developed to capture these conditions and examined by analysing data obtained from 164 German hospital CIOs. Principal component analysis resulted in three internally consistent components that constitute large portions of the CIOs innovation capability: organisational innovation culture, entrepreneurship personality and openness towards users. Results were used to build composite indicators that allow further evaluations.

Does the choice of mobile C-arms lead to a reduction of the intraoperative radiation dose?

INTRODUCTION: Mobile C-arm imaging is commonly used in operating rooms worldwide. Especially in orthopaedic surgery, intraoperative C-arms are used on a daily basis. Because of new minimally-invasive surgical procedures a development in intraoperative imaging is required. The purpose of this article is investigate if the choice of mobile C-arms with flat panel detector technology (Siemens Cios Alpha and Ziehm Vision RFD) influences image quality and dose using standard, commercially available test devices. MATERIALS AND METHODS: For a total of four clinical application settings, two zoom formats, and all dose levels provided, the transmission dose was measured and representative images were recorded for each test device. The data was scored by four observers to assess low contrast and spatial resolution performance. The results were converted to a relative image quality figure allowing for a direct image quality and dose comparison of the two systems. RESULTS: For one test device, the Cios Alpha system achieved equivalent (within the inter-observer standard error) or better low contrast resolution scores at significantly lower dose levels, while the results of the other test device suggested that both systems achieved similar image quality at the same dose. The Cios Alpha system achieved equivalent or better spatial resolution at significantly lower dose for all application settings except for Cardiac, where a comparable spatial resolution was achieved at the same dose. CONCLUSION: The correct choice of a mobile C-arm is very important, because it can lead to a reduction of the intraoperative radiation dose without negative effects on image quality. This can be a big advantage to reduce intraoperative radiation not only for the patient but also for the entire OR-team.

Composição, princípios ativos e indicações clínicas dos dentifrícios: uma revisão da literatura entre 1989 e 2011 / Composition, active ingredients and clinical indications of dentifrices: a literature review between1989 and 2011

Apesar do controle mecânico ser tido como o melhor método para remoção do biofilme das superfícies dentárias, a utilização de agentes antimicrobianos presentes em soluções para bochechos e em dentifrícios é, muitas vezes, requerida. O presente estudo teve como objetivo revisar a literatura acerca da composição dos dentifrícios atuais, seus princípios ativos e suas indicações clínicas. Para tanto, revisou-se a literatura compreendida entre o período de 1989 a 2011, utilizando-se a combinação das seguintes palavras-chaves: dentifrícios, composição química e flúor, nas línguas inglesa e portuguesa, nas bases de dados Pubmed, BVS, Bireme, SciELO e Portal da Capes. Foram incluídos também livros-texto de referência. Observou-se que os dentifrícios são utilizados para levar várias substâncias à cavidade bucal, objetivando a redução da cárie, das doenças gengivais e periodontais, do cálculo dentário, da hipersensibilidade dentinária e da halitose. Atualmente, os dentifrícios são compostos por: sistemas abrasivos, detergentes, flavorizantes, solventes, umectantes, aglutinantes, edulcorantes, conservantes e princípio ativo. A variedade de substâncias presentes nos dentifrícios é muito grande, sendo essa uma das razões para a grande dificuldade em identificar o dentifrício mais apropriado para cada situação clínica. No intuito de facilitar a aquisição desses produtos, é de suma importância que a composição química e a sua indicação sejam informadas adequadamente.

Although mechanical control is considered the best method to remove dental surfaces biofilm, the use of antimicrobial agents contained in mouthwashes and toothpaste is required. This study aimed to review the literature about the current composition of dentifrices, their active ingredients and clinical indications. Thus the literature between 1989 and 2011 was reviewed, using the following keyword combinations: dentifrice, chemical composition and fluoride, in English and Portuguese languages, in Pubmed, BVS, Bireme, SciELO, and Portal Capes databases. It was also included reference textbooks. It was observed that dentifrices are used to carry out a lot of substances to oral cavity, aiming to reduce caries, gingival and periodontal diseases, dental calculus, dentin hypersensitivity and also halitosis. Nowadays, dentifrices are composed of: abrasive systems, detergents, flavorings, solvents, humectants, binders, sweeteners, preservatives and active ingredient.The variety of substances found in dentifrices is huge, and this is one of the reasons that makes harder to identify the most appropriate dentifrice for each clinical situation. In order to facilitate the acquisition of these products, is quite important that the chemical composition and its indication are informed properly.