Assuntos
Infecções Comunitárias Adquiridas , Staphylococcus aureus Resistente à Meticilina , Infecções Estafilocócicas , Infecções Cutâneas Estafilocócicas , Antibacterianos/uso terapêutico , Infecções Comunitárias Adquiridas/tratamento farmacológico , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/prevenção & controle , Humanos , Distanciamento Físico , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/prevenção & controle , Infecções Cutâneas Estafilocócicas/epidemiologia , Infecções Cutâneas Estafilocócicas/prevenção & controle , Staphylococcus aureusRESUMO
OBJECTIVES: To assess the accuracy of patient-specific instruments (PSIs) versus standard manual technique and the precision of computer-assisted planning and PSI-guided osteotomies in pelvic tumour resection. METHODS: CT scans were obtained from five female cadaveric pelvises. Five osteotomies were designed using Mimics software: sacroiliac, biplanar supra-acetabular, two parallel iliopubic and ischial. For cases of the left hemipelvis, PSIs were designed to guide standard oscillating saw osteotomies and later manufactured using 3D printing. Osteotomies were performed using the standard manual technique in cases of the right hemipelvis. Post-resection CT scans were quantitatively analysed. Student's t-test and Mann-Whitney U test were used. RESULTS: Compared with the manual technique, PSI-guided osteotomies improved accuracy by a mean 9.6 mm (p < 0.008) in the sacroiliac osteotomies, 6.2 mm (p < 0.008) and 5.8 mm (p < 0.032) in the biplanar supra-acetabular, 3 mm (p < 0.016) in the ischial and 2.2 mm (p < 0.032) and 2.6 mm (p < 0.008) in the parallel iliopubic osteotomies, with a mean linear deviation of 4.9 mm (p < 0.001) for all osteotomies. Of the manual osteotomies, 53% (n = 16) had a linear deviation > 5 mm and 27% (n = 8) were > 10 mm. In the PSI cases, deviations were 10% (n = 3) and 0 % (n = 0), respectively. For angular deviation from pre-operative plans, we observed a mean improvement of 7.06° (p < 0.001) in pitch and 2.94° (p < 0.001) in roll, comparing PSI and the standard manual technique. CONCLUSION: In an experimental study, computer-assisted planning and PSIs improved accuracy in pelvic tumour resections, bringing osteotomy results closer to the parameters set in pre-operative planning, as compared with standard manual techniques.Cite this article: A. Sallent, M. Vicente, M. M. Reverté, A. Lopez, A. Rodríguez-Baeza, M. Pérez-Domínguez, R. Velez. How 3D patient-specific instruments improve accuracy of pelvic bone tumour resection in a cadaveric study. Bone Joint Res 2017;6:577-583. DOI: 10.1302/2046-3758.610.BJR-2017-0094.R1.
RESUMO
Introducción: el proceso de duelo se puede complicar y prolongar en el tiempo, dando lugar a un duelo patológico o complicado, generando un sufrimiento añadido a la pérdida de un ser querido. Es necesario contar con instrumentos de evaluación que nos permitan diferenciar las reacciones normales de las que no lo son, para poder intervenir y facilitar el ajuste a la pérdida de los deudos. Objetivo: adaptar al castellano el Inventory of Complicated Grief -Inventario de Duelo Complicado- (IDC), cuestionario que permite diagnosticar el duelo patológico. Material y método: se realizó una adaptación transcultural del IDC, y se estimaron las propiedades psicométricas del instrumento mediante el análisis de la fiabilidad (consistencia interna y estabilidad en el tiempo), la validez factorial (análisis factorial tipo rotación varimax) y la validez convergente(correlación del IDC con las escalas de Beck de ansiedad y depresión y con el Inventario de experiencias en duelo) en una muestra de 87 deudos. Resultados: el análisis de consistencia interna mostró un alfa de Cronbach del IDC adaptado al castellano de 0,88, y una fiablidad test-retest de 0,81. Del análisis factorial del IDC adaptado al castellano resultaron 3 factores que explicaron el 50,2% de la varianza del IDC total, y la correlación del IDC con la escala de ansiedad fue 0,24 y 0,43 con la de depresión. ElIDC presenta correlaciones positivas con 9 subescalas del Inventario de duelo complicado que oscilan entre 0,21 y 0,31. Conclusiones: los resultados obtenidos muestran que el IDC adaptado al castellano presenta adecuadas propiedades psicométricas, similares a la versión original. El IDC es un instrumento sencillo que permitirá distinguirlas reacciones normales de duelo de las complicadas, lo que facilitará, en gran medida, la planificación de las intervenciones en los deudos en proceso de duelo (AU)
Introduction: the grieving process can become complicated and prolonged over time, leading to pathological or complicated mourning, and generating suffering added to the loss of a loved one. There is a need for assessment tools allowing to differentiate between normal reactions and maladaptive symptoms in order to intervene and facilitate adjustment to loss. Objective: the aim of this study was to develop a Spanish version of the Inventory of Complicated Grief, and to explore its psychometric properties. Material and method: we conducted a cross-cultural adaptation ofIDC, and studied the psychometric properties of the instrument by analyzing its reliability (internal consistency and stability over time), factorial validity (factor analysis varimax rotation rate), and convergent validity(correlation of IDC with Beck scales for anxiety and depression, and theGrief Experiences Inventory) in a sample of 87 conjugally bereaved relatives. Results: the analysis of the adapted IDC showed an internal consistency of 0.88 Cronbach alpha, and a test-retest reliability of 0.81. A factorial analysis of the adapted IDC provided 3 factors that explained 50.2% of the total variance of IDC. The correlation of IDC with the level of anxiety was 0.24, and 0.43 with depression. IDC presents positive correlations with 9 subscales of the Grief Experience Inventory, ranging from 0.21 to 0.31. Conclusions: data show that the Spanish adaptation has good psychometric properties, similar to the original version. IDC, as validated and adapted into Spanish, is a useful tool for the identification and follow-up of symptoms of complicated grief, and allows to schedule interventions to facilitate adaptation to loss (AU)
Assuntos
Humanos , Pesar , Transtorno Depressivo/diagnóstico , Psicometria/instrumentação , Reprodutibilidade dos TestesRESUMO
BACKGROUND: Pain and suffering are not synonymous terms. The concept of suffering is wider than just physical pain. People can suffer for multiple causes, pain among them, but it is not the only reason since <