June 2018

Introduction: Thyroid cancer is considered the most frequent endocrine neoplasm, the American Association for the Study of the Thyroid (ATA), projected that by 2019 it becomes the third non-fatal cancer in the order of prevalence in women. The thyroid nodule as its most frequent form of presentation, through the use of ultrasound with high spatial resolution, can be captured in 19-67% of healthy individuals. Among the large number of thyroid nodules detected, only 5% -15% are only 5% to 7% of cases. For the differential diagnosis of these thyroid nodules, fine needle aspiration (FNAB) is considered an accurate and cost-effective method for evaluation with a high sensitivity and diagnostic specificity; Associated with this, it has been considered that the elevation of some scabies markers indirectly malignant nodular degeneration. Few studies have evaluated the statistical power in the achievement of ultrasonographic parameters as biochemical in the prediction of the malignant thyroid nodule, which would co-contribute in the clinical act. Objetives: To establish the diagnostic correlation between the serum levels of Thyrotropin and Anti-Tritoglobulin Antibodies and the ultrasound findings that allow the prediction of malignant thyroid nodule development using the BETHESDA and TI-RADS classifications. Material and Method: An observational, cross-sectional, comparative and ambispective study was carried out. Temporary-spatial location of the study: April 2016 to March 2018, Radiology service of the Naval General Hospital of High Specialty. The normal distribution of the TSH values, anti-thyroglobulin antibodies (Anti Anti Tg) and patient age according to the Z value of the Kolmogorov-Smirnov statistic was studied. We use measures of central tendency using the statistical package SPSS version 21.0. Results: Were analyzed 136 cases associated with thyroid nodule, of which 122 (89.7%) were female and 14 (10.3%) male. Age was in the range of 19 to 77 years with an average of 48.7 +/- 14.6 years of standard deviation. Active military were 50.7% of the cases and right holders or military retired 49.3%.According to the histopathological study, 22 cases of thyroid cancer were identified for a prevalence of 16.2% in the sample of clinical suspicion; 63.2% of the cases resulted malignant neoplasia (atypia with undetermined significance, follicular neoplasm and probable thyroid cancer) and only 20.6% were benign.More than half of the thyroid nodules studied were hypoechoic (59.6%), 66.9% had vascularity, 67.9% microcalcifications, 74.3% poorly defined borders, and 48.5% wider than high positive. In 44.9% the location of the nodule was in the isthmus, 45.6% the size ranged between 1 and 2 cm, slightly more than half (52.9%) had TSH> 1.64 mU / L while 65.4% had anti-thyroglobulin antibodies> 40 IU / ml.Comparing malignant versus benign cases according to the gold standard (Bethesda scale) a TSH value> 1.64 mU / L presented 14.7 times [IC95% 4.1-51.9, p = 0.0001] plus risk of malignancy; while those above 0.40 IU / ml of anti-thyroglobulin antibodies have a 1.8-fold increased risk [IC95% 0.8-4.3, p = 0.13] of malignancy.Each Bethesda diagnosis corresponded to an ascending ultrasound score from 1.14 for non-diagnostic sample to 1.81 for probable CA and 1.95 for CA and, at the same time, it is evident that TSH levels increased correlatively and this is because the ultrasound score it is correlative (rho 0.465, p = 0.0001) to the levels of thyrotropin Conclusion: It is concluded that the combination of serum thyrotropin levels with an ultrasound characterization under the TI-RADS system, in right-holders of the Naval Hospital, were highly predictive of nodular malignant thyroid disease, conditioning a feasible diagnostic method for the evaluation of patients carrying thyroid nodule, thus avoiding, getting to perform unnecessary biopsies and surgeries.

A fatigue test program was carried out with the aim to study the effect of the cold working process on the fatigue crack propagation life. Plate specimens of 7475-T7351 aluminium alloy containing a pre-cracked fastener hole with different edge margins have been subjected to cyclic loading of constant amplitude. During a test, the fatigue crack length was monitored using a video-camera system; the results permitted to establish the evolution of the crack along the bore and across the short ligament of the specimen. Three-dimensional finite element simulation of the cold working process has been conducted for establishing the residual stress field around the fastener hole. The residual stress distribution resulting from the process was then combined with the applied stress for calculating the crack propagation life, taking into account the edge margin effect.

The evolution and development of indigenous management theories in Africa have been tremendously affected by Colonialism. This actually accounts for the retarded progress of African management theories and principles. Introduction and infusion of western management literatures and practices have successfully silenced the astonishing management prowess of the pre-colonial Africa. The paper argued for the development of indigenous African management philosophy, which will be rooted in the Africa culture and value system that will bring about the panacea to some unique problems experienced by some African organizations in the continent. It was concluded that the Ubuntu management system that categorically discussed the humaneness, communalism and African patriotism has proven to be a source of comfort and the sterling African culture steeped in hardwork, honesty and team spirit is a starting point for the development of indigenous African management philosophies.

After stroke, hand impairment is very common and its recovery is often incomplete. Early neuroplastic changes may form the basis for restitution of motor function after stroke. Neuroplasticity starts from day one immediately after injury or insult to cortex. Mental practice being one of the principles of motor learning can accelerate neuroplastic changes. Thus to compare the efficacy of mental practice and physical practice over only physical practice on hand function in individuals with stroke, this study was conducted. Methodology: 50 stroke patients divided into two groups i.e. control and experimental. Subjects were screened for inclusion and exclusion criteria. Control group received conventional physiotherapy and experimental group received mental practice and conventional physiotherapy. Outcome measures: nine-hole peg test, voluntary control and motor assessment scale. Outcome measures were evaluated prior to the interventions and after 20 sessions of treatment. Results of the study: Significant difference was observed in both the groups pe and post intervention. The experimental group showed better improvement than conventional group. Conclusion: combination of mental practice and physical practice is more effective than physical practice for improvement of hand function.