Intrapartum Pubic Symphysis Disruption

During pregnancy, high progesterone and relaxin levels produce physiological ligament relaxation on the pelvis. Therefore, moderate pubic symphysis and sacroiliac joints relaxing provide birth canal widening, thereby facilitating vaginal delivery. Sometimes, functional pain or pelvic instability may occur during pregnancy or puerperium, which is defined as symptomatic pelvic girdle relaxation. In rare cases, a pubic symphysis disruption can occur during the labor, causing severe pain and functional limitations. The early recognition of this injury is crucial to prevent complications and improve clinical and functional outcomes. This study reports an acute symphyseal disruption resulting from childbirth in a primiparous patient who underwent open reduction and internal fixation with plate and screws. After a 6 months follow‑up, the patient presented no pain and satisfactory functional recovery.Keywords: Pelvis, Pelvis fracture, Pregnancy, Pubic symphysis, Pubic symphysis diastasi

Performance of Glass Woven Fabric Composites with Admicellar-Coated Thin Elastomeric Interphase

Adequate stress transfer between the inorganic reinforcement and surrounding polymeric matrix is essential for achieving enhanced structural integrity and extended lifetime performance of fiber-reinforced composites. The insertion of an elastomeric interlayer helps increase the stress-transfer capabilities across the fiber/matrix interface and considerably reduces crack initiation phenomena at the fiber ends. In this study, admicellar polymerization is used to modify the fiber/matrix interface in glass woven fabric composites by forming thickness-controlled poly(styrene-co-isoprene) coatings. These admicellar interphases have distinct characteristics (e.g., topology and surface coverage) depending on the surfactant/monomer (S/M) ratios used during the polymerization reaction. Overall, the admicellar coatings have a positive effect on the mechanical response of resin transfer molded (RTM), E-glass/epoxy parts. For instance, ultimate tensile strength (UTS) of composites with admicellar sizings improved 50 to 55% over the control desized samples. Interlaminar shear strength (ILSS) also showed increases ranging from 18 to 38% over the same control group. Interestingly, the flexural properties of these composites proved sensitive to the type of interphase formed for various admicellar polymerization conditions. Higher surface coverage and film connectedness in admicellar polymeric sizings are observed to enhance stress transfer at the interfacial region.Ye

Validation of the Nottingham Hip Fracture Score as a predictor of 30-day mortality after hip surgery

Purpose: To assess whether the Nottingham Hip Fracture Score (NHFS) can predict mortality in the first 30 days after hip surgery. Material and methods: Upon admission, 216 patients were assessed for age, sex, mobility status (bedridden, assisted or unassisted walking), living accommodations (residential or institutionalized), fracture type (intra- or extracapsular), comorbidities (cardiovascular, stroke, respiratory, renal, diabetes), malignant disease, and cognition (Mini-Mental Status Examination). We applied the NHFS, which evaluates seven factors, with scores that range from 0 to 10, as a predictor of 30-day mortality after hip surgery. Results: Survivor scores showed greater variability (CV=0.28) than those of non-survivors (CV=0.20). The receiver operating characteristic curve identified a score of 5.5 as the optimal cutoff point. At this point, the test’s sensitivity and specificity indicate the simultaneous maximum likelihood of 30-day survival or non-survival. Conclusion: The NHFS is a robust predictor of 30-day mortality after hip surgery and an updated equation has been validated for the patients in this sample, which increases its clinical credibility.&nbsp

Medial malleolar fractures: an anatomic survey determining the ideal screw length

Background: Medial malleolar fractures are frequent, and their treatment is familiar to the orthopedic surgeon. Lag screw fixation using partially threaded screws remains the standard treatment method for medial malleolar fractures. However, the literature lacks a defined method for selecting lag screw length, relying more so on the empiric choice of the surgeon. Aim: The aim of this study is to help define the ideal lag screw length for medial melleolar fracture fixation. Materials and Methods: One hundred and sixteen anatomic specimens were included in the study. A transverse cut was performed in the distal third of the tibia, roughly 1 and a half times the distal tibial plafond width from the ankle joint. A coronal cut was then performed using the center of the medial malleolus. Three observers measured the distance between the medial malleolus tip and beginning of the medullary canal in all anatomic specimens. Differences in measurements were statistically compared, level of (P ≤ 0.05). Interclass correlation coefficient (ICC) significance level was set at P < 0.05.Results: Measurement average was 55 mm between the medial malleolus tip and the medullary canal, with a standard deviation of 10 mm. High concordance (ICC: 0.819) was achieved among all pairs of observers (P < 0.01). The systematic difference among measurements was absent, and random distribution around general measurements was observed. Conclusion: The authors recommend a screw length of no more than 45 mm to optimize the location of the screw threads in the best cancellous bone in an effort to obtain the most compression

PATIENFS PERCEPTIONS ON VERBAL COMUNICATION OF TEAM NURSING

Trata-se de um estudo descritivo, com o objetivo de conhecer como o paciente/cliente percebe a comunicação havida no processo de enfermagem. Foram entrevistados pacientes internados em unidade de clínica médica especializada, do hospital campo da pesquisa. A análise das respostas obtidas permitiu extrair as seguintes categorias: “Fazer”, “Não fazer”, “Falar técnico”, “Falar social” e “Falar pouco”. Essas categorias evidenciam que a comunicação enfermeira-paciente é quase inexistente, porém, quando ocorre, está presente nas ações da enfermagem, de forma verbal e não verbal, mas de maneira inadequada, pois não refletem competência interpessoal em comunicação. Não se propicia ao paciente a possibilidade de se expressar sobre o que vivência, pensa ou sente a respeito. É necessário que o pessoal de enfermagem seja alertado e preparado sobre a importância de associar à sua prática o uso consciente da comunicação adequada ou terapêutica, como estilo de vida.Descriptive study which purpose is to know how the patient/client perceives the communication that happens in the nursing process. Interviews have been performed with patients from specialized Clinicai Units of the hospital where this research have been developed. The analysis of their contents allows the extraction of the following categories: “make”, “doesn’t make”, “technical speech”, “social speech”, “a short speech”. These categories reveal that when the nurse-patient communication happens, it takes place in nursing actions, on a verbal and a non verbal manner, but in a inadequate manner, because it doesn’t reflect nursing interpersonal competence in communication. The patient is not allowed to express what he is experiencing, thinking or feeling about it. It is necessary that the nursing team be oriented and prepared about the importance of the association of the conscious use of the adequate OR therapeutic communication in his nursing practice, as a way of living