A internação psiquiátrica compulsória e involuntária: aspectos técnicos e éticos

Pena, José Luis da Cunha

doi:10.11606/t.7.2018.tde-06092017-095338

Cited by 4 publications

(9 citation statements)

References 61 publications

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“…A much higher increase in stress was predicted in the lateral than medial meniscectomy when fluid pressure was not considered [44]. The present results did not support the reported prediction.…”

Section: Discussioncontrasting

confidence: 98%

“…It is not currently clear whether this discrepancy was produced by fluid pressure considered here or large deformation considered in Ref. [44]. Moreover, the discrepancy could have partially been produced by different rotational constraints used.…”

Section: Discussionmentioning

confidence: 88%

“…Controversial results were also seen in the literature regarding the lateral versus medial meniscectomies. For instance, based on a 10-year follow up performed by the French Arthroscopic Society, no significant difference between medial and lateral meniscectomies was found [45], while some other studies reported higher risks for medial [46] or lateral meniscectomies [29,44]. We will further investigate this issue when large deformation is incorporated in our modeling.…”

Section: Discussionmentioning

confidence: 93%

“…In the present study, the knee was constrained in varus-valgus rotation while in Ref. [44] the knee is free in this rotation. Controversial results were also seen in the literature regarding the lateral versus medial meniscectomies.…”

Section: Discussionmentioning

confidence: 94%

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Partial Meniscectomy Changes Fluid Pressurization in Articular Cartilage in Human Knees

Kazemi

Buschmann

et al. 2012

Journal of Biomechanical Engineering

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Partial meniscectomy is believed to change the biomechanics of the knee joint through alterations in the contact of articular cartilages and menisci. Although fluid pressure plays an important role in the load support mechanism of the knee, the fluid pressurization in the cartilages and menisci has been ignored in the finite element studies of the mechanics of meniscectomy. In the present study, a 3D fibril-reinforced poromechanical model of the knee joint was used to explore the fluid flow dependent changes in articular cartilage following partial medial and lateral meniscectomies. Six partial longitudinal meniscectomies were considered under relaxation, simple creep, and combined creep loading conditions. In comparison to the intact knee, partial meniscectomy not only caused a substantial increase in the maximum fluid pressure but also shifted the location of this pressure in the femoral cartilage. Furthermore, these changes were positively correlated to the size of meniscal resection. While in the intact joint, the location of the maximum fluid pressure was dependent on the loading conditions, in the meniscectomized joint the location was predominantly determined by the site of meniscal resection. The partial meniscectomy also reduced the rate of the pressure dissipation, resulting in even larger difference between creep and relaxation times as compared to the case of the intact knee. The knee joint became stiffer after meniscectomy because of higher fluid pressure at knee compression followed by slower pressure dissipation. The present study indicated the role of fluid pressurization in the altered mechanics of meniscectomized knees.

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Section: Discussioncontrasting

confidence: 98%

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 94%

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Partial Meniscectomy Changes Fluid Pressurization in Articular Cartilage in Human Knees

Kazemi

Buschmann

et al. 2012

Journal of Biomechanical Engineering

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“…Recent whole joint FE investigations, such as those of the cervical spine [46,47], the lumbar spine [48,49], the knee [50,51], the sacroiliac joint [52], and the pelvic joint [53] typically model these connective tissues as one-dimensional elastic spring or truss elements in order to reduce computational cost. Three-dimensional, continuum-based material models have been put forth in an attempt to more accurately represent connective tissue anisotropic nonlinear viscoelasticity [54][55][56], However, these continuum formulations require very complicated experimental characterization techniques owing to the relatively large number of required material coefficients and implementation of these anisotropic derivations into whole joint FE model has, to date, been shown to be largely intractable.…”

Section: -4 / Vol 134 November 2012mentioning

confidence: 99%

Experimental Characterization and Finite Element Implementation of Soft Tissue Nonlinear Viscoelasticity

Troyer

Shetye

Puttlitz

2012

Journal of Biomechanical Engineering

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Finite element (FE) models of articular joint structures do not typically implement the fully nonlinear viscoelastic behavior of the soft connective tissue components. Instead, contemporary whole joint FE models usually represent the transient soft tissue behavior with significantly simplified formulations that are computationally tractable. The resultant fidelity of these models is greatly compromised with respect to predictions under temporally varying static and dynamic loading regimes. In addition, models based upon experimentally derived nonlinear viscoelastic coefficients that do not account for the transient behavior during the loading event(s) may further reduce the model's predictive accuracy. The current study provides the derivation and validation of a novel, phenomenological nonlinear viscoelastic formulation (based on the single integral nonlinear superposition formulation) that can be directly inputted into FE algorithms. This formulation and an accompanying experimental characterization technique, which incorporates relaxation manifested during the loading period of stress relaxation experiments, is compared to a previously published characterization method and validated against an independent analytical model. The results demonstrated that the static and dynamic FE approximations are in good agreement with the analytical solution. Additionally, the predictive accuracy of these approximations was observed to be highly dependent upon the experimental characterization technique. It is expected that implementation of the novel, computationally tractable nonlinear viscoelastic formulation and associated experimental characterization technique presented in the current study will greatly improve the predictive accuracy of the individual connective tissue components for whole joint FE simulations subjected to static and dynamic loading regimes.

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Internações compulsórias por processos judiciais para usuários de um Centro de Atenção Psicossocial - álcool e drogas

Taveira¹

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O estudo teve por objetivo avaliar as características sociodemográficos e clínicas de 218 usuários de substâncias psicoativas, em um Centro de Atenção Psicossocial para Álcool e Drogas (CAPS-ad), de Ribeirão Preto, que chegaram por mandado judicial para avaliação médica e internação compulsória. Trata-se de um estudo retrospectivo, baseado em dados secundários do tipo transversal da abordagem quantitativa. O período avaliado se deu entre os anos de 2008 e 2019. Foram avaliadas as informações sociodemográficas, tipos de internações, diagnósticos, tipos de substâncias psicoativas usadas, requerentes no processo judicial e motivações para a abertura do processo judicial. Os resultados demonstraram que os usuários encaminhados por demanda judicial se caracterizam por serem adultos, com média de idade de 30,5 anos, variando entre 15 e 69 anos, do sexo masculino 182 (83,5%), raça/ etnia branca 146 (67,0%), viviam sem um companheiro 177 (81,2%), possuíam baixo nível de escolaridade 146 (66,1%), desempregados 140 (64,2%) e eram residentes de Ribeirão Preto 215 (98,6%). Quanto aos tipos de internações: 126 (58%) foram Internações Compulsórias, 66 (30,3%) internações voluntárias em Comunidades Terapêuticas, 69 (31,7%) internações voluntárias em hospital e 36 (16,6%) internações involuntárias. Considerando que o estudo se deu a partir da análise dos prontuários ao longo de um período de tempo, o mesmo paciente pode ter tido mais de uma internação em qualquer uma das modalidades. Em relação aos tipos de substâncias psicoativas as mais usadas foram: crack 104 (48,4%), cocaína 59 (27,4%), álcool 33 (15,3%) e a maconha 19 (8,8%). Um pouco mais da metade, 113 (54,6%) dos usuários, possuía outro transtorno mental associado ao uso de substâncias, dentre eles, a Esquizofrenia 40 (18,1%) e o Transtorno de Personalidade 25 (11,5%) foram os mais prevalecentes, seguidos de Outros Transtornos Psicóticos 20 (9,2%) e Transtorno Afetivo Bipolar 18 (8,3%). Não apresentaram outro transtorno mental associado ao uso de substâncias 99 (45,4%). O estudo aponta principalmente a dificuldade das famílias dos usuários de álcool ou de outras drogas para lidar com situações de conflito, bem como a necessidade de políticas públicas de saúde que entendam a realidade na qual esses indivíduos estão inseridos.Palavras-chave: Dependência Química. Saúde Mental. Internação involuntária.

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A internação psiquiátrica compulsória e involuntária: aspectos técnicos e éticos

Cited by 4 publications

References 61 publications

Partial Meniscectomy Changes Fluid Pressurization in Articular Cartilage in Human Knees

Partial Meniscectomy Changes Fluid Pressurization in Articular Cartilage in Human Knees

Experimental Characterization and Finite Element Implementation of Soft Tissue Nonlinear Viscoelasticity

Internações compulsórias por processos judiciais para usuários de um Centro de Atenção Psicossocial - álcool e drogas

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