Category: Trauma; Ankle Introduction/Purpose: Ankle fractures are one of the most operated injuries in orthopedic practice. The decision upon the best management is based on the displacement of the bone fragments and the presence of associated lesions (osseous and/or soft tissues). The therapeutic decision is classically established upon plain radiographs, which might be temerarious due to the usual difficulty in analyzing those exams. In recent years, some authors have advocated that computed tomography could be used as an assistant instrument on the decision-making. Our study aims to demonstrate the superiority of the association between both methods on diagnosis, therapeutic decision, and surgical plan for these injuries. Methods: Patients diagnosed with an ankle fracture, between 2011 and 2016, and assessed with CT and X-ray were included in our investigation. Seven examiners with different degrees of experience analyzed the exams, determined the injuries, chose how they would treat, and the defined surgical strategy when applicable. This was done, at first, only with radiographs and after with the combination of CT and radiographs. The data were statistically compared. Results: Fifty-three patients were included. The medial malleolus fractures characteristics (posteromedial fragment and anterior colliculus), the presence of posterior malleolus fracture and its characteristics (displacement, bone fragment greater than 25%, posteromedial or posterolateral segment), syndesmosis injury, and the absence of deltoid ligament lesion were more noticeable from the combination of CT and radiography. Concerning surgical treatment, the prone position, the posterolateral surgical approach (rather than anterolateral) on lateral malleolus osteosynthesis, the decision to surgically treat the posterior malleolus fracture (through posterolateral approach with posterolateral plate), the option to include the syndesmosis approach in the treatment, and not to include deltoid ligament repair were more noticeable from the combination of CT and radiography, among all groups of expertise, with high inter-observer reliability. Conclusion: The usual radiographs may fail to demonstrate subtle lesions, as posterior malleolus fractures and syndesmotic injuries. The tomographic evaluation increases the precision of diagnosis and improves the quality of information that the surgeon receives, providing data that can positively affect patient care.
O queijo do tipo colonial é caracterizado por ser um produto semigordo, média umidade, maturação curta e de massa semimole. Ainda muito produzido de forma artesanal em regiões ao Sul do Brasil, devido ao clima propício para agropecuária nos meses mais frios. Para que sua produção seja de boa qualidade e seguro para o consumo é necessário controle de qualidade durante todo seu processamento, distribuição e comercialização, começando pela matéria prima (leite) e seu processamento até transformação em queijo. Podendo ocorrer contaminação durante estes processos que leva ao surgimento de Doenças Transmitidas por Alimentos (DTA) ao consumidor. Sendo assim o objetivo deste estudo foi avaliar a qualidade sanitária de queijos colonial comercializados em feiras livres (sem Cadastro Nacional de Pessoa Física) e do comércio varejista (com Cadastro Nacional de Pessoa Física) na cidade de Pelotas-RS. Para isto todas as amostras foram avaliadas quanto a sua adequação sanitária definida pela RDC 12/2001-ANVISA por meio verificação de presença de Salmonella spp., da análise de Coliformes a 45ºC e de Staphylococcus coagulase positiva. De modo geral 83,3% dos queijos com certificação vendidos no comércio varejista estavam seguros para o consumo, e apenas 16,6% dos queijos vendidos em feiras livres sem certificação. A partir de tais resultados verifica-se a necessidade de conscientização dos pequenos produtores, qualificação dos mesmos e vislumbra-se a certificação dos queijos coloniais a fim de revalorizar sua identidade e cultura artesanal. Programas de qualidade e revalorização do produto devem ser incentivados e postos em prática, agregando valor econômico, social e cultural a região produtora.
Underlying factors influencing street food vendors' implementation of food safety behavioursFactores subyacentes que influyen en la implementación de comportamientos de seguridad de los alimentos por parte de los vendedores ambulantes de alimentos
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