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[PMID]:29206823
[Au] Autor:Sánchez-Chávez FA; Cabrera-Escamilla JA
[Ad] Endereço:Departamento de Cirugía de Columna, Hospital de Traumatología y Ortopedia No 21, Instituto Mexicano del Seguro Social (IMSS), Monterrey, N.L., México.
[Ti] Título:[Thoracic and lumbar fractures in adolescents. An eight-year study].
[Ti] Título:Fracturas torácicas y lumbares en los adolescentes. Estudio de ocho años..
[So] Source:Gac Med Mex;153(6):672-676, 2017 Nov-Dec.
[Is] ISSN:0016-3813
[Cp] País de publicação:Mexico
[La] Idioma:spa
[Ab] Resumo:METHODS: In order to know the characteristics of these lesions in our environment and compare with those the adults, a transversal and descriptive study of adolescents between 12 and 18 years who were hospitalized for thoracic and lumbar fracture in two centers of high level trauma in our country for 8 years was performed. The variables studied were applied statistical analysis descriptive and correlation. RESULTS: They were found significant date by associating the causes of damage with associated lesions (p = 0.006) and the initial neurological damage associated with the final neurological damage (p = 0.000). DISCUSSION: They were registered seven teenagers with 10 fractures firearm, as rare cause of injury. An increase in the frequency of thoracic and lumbar fractures in adolescents with increasing age was found. The thoracic and lumbar fractures in adolescents caused by road accidents are associated with lesions in the chest and abdomen. And when are caused by falls are associated with lower extremity fractures. In addition, 13.5% of cases showed significant changes toward improvement in the initial neurological damage.
[Mh] Termos MeSH primário: Vértebras Lombares/lesões
Fraturas da Coluna Vertebral/epidemiologia
Vértebras Torácicas/lesões
Traumatismos do Sistema Nervoso/epidemiologia
[Mh] Termos MeSH secundário: Acidentes por Quedas/estatística & dados numéricos
Acidentes de Trânsito/estatística & dados numéricos
Adolescente
Distribuição por Idade
Criança
Feminino
Hospitalização
Seres Humanos
Masculino
Fraturas da Coluna Vertebral/etiologia
Traumatismos do Sistema Nervoso/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.24875/GMM.17002809


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[PMID]:29095276
[Au] Autor:Yang M; Li Z; Zhao Y; Zhou F; Zhang Y; Gao J; Yin T; Hu X; Mao Z; Xiao J; Wang L; Liu C; Ma L; Yuan Z; Lv J; Shen H; Hou PC; Kang H
[Ad] Endereço:aDepartment of Critical Care Medicine, Chinese PLA General Hospital, Beijing bDepartment of Orthopedics, Wuhan General Hospital of Guangzhou Command, Guangzhou cDepartment of Critical Care Medicine, Kai Luan General Hospital, Tangshan dDepartment of Critical Care Medicine, The Centre Hospital of Baotou, Baotou eDepartment of Critical Care Medicine, The 251th Hospital of Chinese PLA, Zhangjiakou fDepartment of Critical Care Medicine, The 180th Hospital of Chinese PLA, Quanzhou gDepartment of Critical Care Medicine, People's Hospital Chang Ji Hui Autonomous Prefecture, Xinjiang hDepartment of Critical Care Medicine, Affiliated Hospital of Nan Tong University, Nantong, China iDepartment of Emergency Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
[Ti] Título:Outcome and risk factors associated with extent of central nervous system injury due to exertional heat stroke.
[So] Source:Medicine (Baltimore);96(44):e8417, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:To explore the relationship between the extent of central nervous system (CNS) injury and patient outcomes meanwhile research the potential risk factors associated with neurologic sequelae. In this retrospective cohort study, we analyzed data from 117 consecutive patients (86 survivors, 31 nonsurvivors) with exertional heat stroke (EHS) who had been admitted to intensive care unit (ICU) at 48 Chinese hospitals between April 2003 and July 2015. Extent of CNS injury was dichotomized according to Glasgow coma scale (GCS) score (severe 3-8, not severe 9-15). We then assessed differences in hospital mortality based on the extent of CNS injury by comparing 90-day survival time between the patient groups. Exploring the risk factors of neurologic sequelae. The primary outcomewas the 90-day survival ratewhich differed between the 2 groups (P = .023). The incidence of neurologic sequelae was 24.4%. For its risk factors, duration of recurrent hyperthermia (OR = 1.73, 95% CI: 1.20-2.49, P = .003), duration of CNS injury (OR = 1.39, 95% CI: 1.04-1.85, P = .025), and low GCS in the first 24 hours after admission (OR = 2.39, 95% CI: 1.11-5.15, P = .025) were selected by multivariable logistic regression. Cooling effect was eliminated as a factor (OR = 2641.27, 95% CI 0.40-1.73_107, P = .079). Significant differences in 90-day survival ratewere observed based on the extent of CNS injury in patients with EHS, and incidence was 24.4% for neurologic sequelae. Duration of recurrent hyperthermia, duration of CNS injury, and low GCS score in the first 24 hours following admission may be independent risk factors of neurologic sequelae. Cooling effect should be validated in the further studies.
[Mh] Termos MeSH primário: Golpe de Calor/complicações
Esforço Físico
Traumatismos do Sistema Nervoso/etiologia
[Mh] Termos MeSH secundário: Adulto
Feminino
Febre/etiologia
Escala de Coma de Glasgow
Golpe de Calor/mortalidade
Mortalidade Hospitalar
Seres Humanos
Incidência
Unidades de Terapia Intensiva/estatística & dados numéricos
Modelos Logísticos
Masculino
Análise Multivariada
Estudos Retrospectivos
Fatores de Risco
Fatores de Tempo
Traumatismos do Sistema Nervoso/mortalidade
Adulto Jovem
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171103
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008417


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[PMID]:28906368
[Au] Autor:Wang H; Yu H; Zhou Y; Li C; Liu J; Ou L; Zhao Y; Song G; Han J; Chen Y; Xiang L
[Ad] Endereço:aDepartment of Orthopedics, General Hospital of Shenyang Military Area Command of Chinese PLA bState Key Laboratory of Robotics, Shenyang Institute of Automation, Chinese Academy of Science, Shenyang, Liaoning cState Key Laboratory of Materials Processing and Die & Mould Technology, Huazhong University of Science and Technology, Wuhan, Hubei dDepartment of Orthopedics, Xinqiao Hospital eDepartment of Radiology, Southwest Hospital, The Third Military Medical University, Chongqing 400038, China.
[Ti] Título:Traumatic fractures as a result of falls in children and adolescents: A retrospective observational study.
[So] Source:Medicine (Baltimore);96(37):e7879, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of this study is to investigate the incidence and pattern of traumatic fractures (TFs) as a result of falls in a population of children and adolescents (≤18 years old) in China.This was a cross-sectional study. We retrospectively reviewed 1412 patients who were children and adolescents with TFs as a result of falls admitted to our university-affiliated hospitals in China from 2001 to 2010. Etiologies included high fall (height ≥2) and low fall (height <2 m). The incidence and pattern were summarized with respect to different age groups, year of admission, etiologies, genders, and the neurological function.This study enrolled 1054 males (74.6%) and 358 females (25.4%) aged 10.8 ±â€Š4.7 years. The etiologies were low fall (1059, 75.0%) and high fall (353, 25.0%). There were 2073 fractures in total and 92 patients (6.5%) presented with multiple fractures. The most common fracture sites were upper extremity fractures in 814 patients (57.6%) and lower extremity fractures in 383 patients (27.1%), followed by craniofacial fractures in 233 patients (16.5%). A total of 231 (16.4%) patients suffered a nerve injury. The frequencies of early and late complications/associated injuries were 19.5% (n = 275) and 9.2% (n = 130). The frequencies of emergency admission, nerve injury, spinal fracture, lower extremity fractures, craniofacial fracture, sternum and rib fracture, and early complications/ASOIs were significantly larger in high fall than low fall (all P <.001, respectively). The frequencies of medical insurance rate (P = .042) and upper extremity fractures (P <.001) were significantly larger in low fall than high fall. The frequencies of spinal fracture (P = .039), lower extremity fractures (P = .048), and craniofacial fracture (P = .041) were significantly larger in female than the male patients. The frequency of upper extremity fractures (P <.001) and the mean age (P <.001) was significantly larger in male than female patients. The frequencies of emergency admission, high fall, spinal fracture, and craniofacial fracture were significantly larger in patients with nerve injury than other patients without nerve injury (all P <.001, respectively).Low falls and upper extremity fractures were the most common etiologies and sites, respectively. High fall, spinal fracture and craniofacial fracture were risk factors for nerve injury. Therefore, we should focus on patients who were caused by high fall and presented with spinal and craniofacial fracture to determine the presence of a nerve injury so that we can provide early, timely diagnosis and targeted treatment to children.
[Mh] Termos MeSH primário: Acidentes por Quedas
Fraturas Ósseas/epidemiologia
Fraturas Ósseas/etiologia
[Mh] Termos MeSH secundário: Centros Médicos Acadêmicos
Adolescente
Criança
Pré-Escolar
China/epidemiologia
Estudos Transversais
Feminino
Seres Humanos
Incidência
Masculino
Traumatismo Múltiplo/epidemiologia
Traumatismo Múltiplo/etiologia
Estudos Retrospectivos
Fatores Sexuais
Fatores de Tempo
Traumatismos do Sistema Nervoso/epidemiologia
Traumatismos do Sistema Nervoso/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170915
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007879


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[PMID]:28434268
[Au] Autor:Wang KK; Yang Z; Sarkis G; Torres I; Raghavan V
[Ad] Endereço:a Program for Neurotrauma, Neuroproteomics and Biomarker Research, Chemistry , McKnight Brain Institute, University of Florida , Gainesville , FL , USA.
[Ti] Título:Ubiquitin C-terminal hydrolase-L1 (UCH-L1) as a therapeutic and diagnostic target in neurodegeneration, neurotrauma and neuro-injuries.
[So] Source:Expert Opin Ther Targets;21(6):627-638, 2017 Jun.
[Is] ISSN:1744-7631
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Since its discovery as a major CNS-abundant protein 25 years ago, Ubiquitin C-terminal hydrolase-L1 (UCH-L1) has emerged as an important enzyme in regulating brain protein metabolism, by coupling to the proteasome pathway of protein degradation. Areas covered: UCH-L1 is implicated in both familial and sporadic Parkinson disease and other chronic neurodegenerative diseases. Also, UCH-L1 has been recently emerging as a biofluid-based biomarker for various forms of acute neurotrauma and CNS injury. Expert opinion: The loss of UCH-L1 activity coupled with the gain of proteinopathy function are linked to neurodegeneration such as Parkinsonism and Alzheimer's disease. In addition, certain post-translational modifications of UCH-L1 might promote the conversion of the cytosolic UCH-L1(C) to the membrane-associated UCH-L1(M) form, which seems to play a role in alpha-synucleinopathy formation. Thus, targeting the conversion of UCH-L1(C) to the UCH-L1(M) form might be the key to developing therapies for neurodegenerative diseases linked to UCH-L1. In parallel, UCH-L1 is also emerging as a promising neuron-derived biomarker for traumatic brain injury, ischemic and homographic stroke, pediatric hypoxic-ischemic encephalopathy, spinal cord injury, epileptic seizure and cardiac arrest. This shows that UCH-L1 has strong potential as a robust and universal biomarker target for various forms of CNS injury.
[Mh] Termos MeSH primário: Doenças Neurodegenerativas/fisiopatologia
Traumatismos do Sistema Nervoso/fisiopatologia
Ubiquitina Tiolesterase/metabolismo
[Mh] Termos MeSH secundário: Animais
Biomarcadores/metabolismo
Seres Humanos
Terapia de Alvo Molecular
Doenças Neurodegenerativas/terapia
Processamento de Proteína Pós-Traducional
Traumatismos do Sistema Nervoso/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Biomarkers); EC 3.4.19.12 (Ubiquitin Thiolesterase)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170605
[Lr] Data última revisão:
170605
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170425
[St] Status:MEDLINE
[do] DOI:10.1080/14728222.2017.1321635


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[PMID]:28152303
[Au] Autor:Shin JE; Cho Y
[Ad] Endereço:The Research Institute of Basic Sciences, Seoul National University, Seoul 08826, Korea.
[Ti] Título:Epigenetic Regulation of Axon Regeneration after Neural Injury.
[So] Source:Mol Cells;40(1):10-16, 2017 Jan.
[Is] ISSN:0219-1032
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:When peripheral axons are damaged, neuronal injury signaling pathways induce transcriptional changes that support axon regeneration and consequent functional recovery. The recent development of bioinformatics techniques has allowed for the identification of many of the regeneration-associated genes that are regulated by neural injury, yet it remains unclear how global changes in transcriptome are coordinated. In this article, we review recent studies on the epigenetic mechanisms orchestrating changes in gene expression in response to nerve injury. We highlight the importance of epigenetic mechanisms in discriminating efficient axon regeneration in the peripheral nervous system and very limited axon regrowth in the central nervous system and discuss the therapeutic potential of targeting epigenetic regulators to improve neural recovery.
[Mh] Termos MeSH primário: Axônios/fisiologia
Regeneração Nervosa/fisiologia
[Mh] Termos MeSH secundário: Epigênese Genética
Seres Humanos
Transdução de Sinais
Traumatismos do Sistema Nervoso/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170515
[Lr] Data última revisão:
170515
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170203
[St] Status:MEDLINE
[do] DOI:10.14348/molcells.2017.2311


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[PMID]:28079589
[Au] Autor:Bell JD
[Ad] Endereço:From the Department of Anesthesiology, University of Toronto, Toronto, Ontario, Canada.
[Ti] Título:In Vogue: Ketamine for Neuroprotection in Acute Neurologic Injury.
[So] Source:Anesth Analg;124(4):1237-1243, 2017 Apr.
[Is] ISSN:1526-7598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Neurologic deterioration following acute injury to the central nervous system may be amenable to pharmacologic intervention, although, to date, no such therapy exists. Ketamine is an anesthetic and analgesic emerging as a novel therapy for a number of clinical entities in recent years, including refractory pain, depression, and drug-induced hyperalgesia due to newly discovered mechanisms of action and new application of its known pharmacodynamics. In this focused review, the evidence for ketamine as a neuroprotective agent in stroke, neurotrauma, subarachnoid hemorrhage, and status epilepticus is highlighted, with a focus on its applications for excitotoxicity, neuroinflammation, and neuronal hyperexcitability. Preclinical modeling and clinical applications are discussed.
[Mh] Termos MeSH primário: Analgésicos/uso terapêutico
Ketamina/uso terapêutico
Neuroproteção/efeitos dos fármacos
Fármacos Neuroprotetores/uso terapêutico
Traumatismos do Sistema Nervoso/prevenção & controle
[Mh] Termos MeSH secundário: Analgésicos/farmacologia
Animais
Apoptose/efeitos dos fármacos
Apoptose/fisiologia
Seres Humanos
Ketamina/farmacologia
Neuroproteção/fisiologia
Fármacos Neuroprotetores/farmacologia
Trombose/diagnóstico
Trombose/prevenção & controle
Traumatismos do Sistema Nervoso/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Analgesics); 0 (Neuroprotective Agents); 690G0D6V8H (Ketamine)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170113
[St] Status:MEDLINE
[do] DOI:10.1213/ANE.0000000000001856


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[PMID]:27965076
[Au] Autor:Nevzati E; Berberat J; Soleman J; Coluccia D; Muroi C; Schöpf S; Lukes A; Fischer I; Remonda L; Fandino J; Marbacher S
[Ad] Endereço:Department of Neurosurgery, Kantonsspital Aurau, Aarau, Switzerland. Electronic address: edin.nevzati@gmail.com.
[Ti] Título:Magnetic Resonance Imaging Signal Characteristics of Medishield: Early Postoperative Profile in a Rabbit Interlaminotomy Model.
[So] Source:World Neurosurg;98:704-710.e3, 2017 Feb.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Application of Medishield to the nerve root is common during spinal surgery to create a mechanical barrier from pain mediators and reduce scar formation. However, Medishield's signal characteristics on magnetic resonance imaging (MRI) have not yet been examined. METHODS: Microsurgical interlaminotomy was performed on 2 lower lumbar segments in 17 adult New Zealand white rabbits. After dural exposure, applications of 1 mL (autologous blood clot or Medishield) were randomized for each level. On postoperative days 1 through 3, various MRI sequences in 1.5T were performed including T1-weighted, T2-w, T1-gadolinium-weighted, susceptibility-weighted and turbo inversion recovery magnitude (TIRM) sequence. Signaling characteristics were analyzed by 3 blinded observers. Inter-rater agreement was calculated using Fleiss's kappa coefficient (κ). Positive and negative likelihood ratios in detecting Medishield by MRI were determined. RESULTS: Of 24 MRIs performed, TIRM sequence identified Medishield with the highest likelihood ratio. Medishield's positive likelihood ratio was highest (5.8) on postoperative day 1 with interobserver agreement of 93% (κ = 0.75); these rates declined to 2.5 and 1.4 on postoperative days 2 and 3 with interobserver agreements of 71% (κ = 0.43) and 83% (κ = 0.67), respectively. Medishield adherence was confirmed in each rabbit by histologic examinations. CONCLUSION: Understanding that radiologic detection of Medishield diminished over time as its signal characteristics became less distinguishable from a blood clot is essential in clinical practice. Medishield was detected on postoperative day 1 but not 2 days later after hemodynamic changes had occurred. These results may provide a guide for postoperative findings, such as differential diagnosis of hematoma.
[Mh] Termos MeSH primário: Laminectomia/métodos
Vértebras Lombares/cirurgia
Microcirurgia/métodos
Tratamentos com Preservação do Órgão/métodos
[Mh] Termos MeSH secundário: Animais
Cicatriz/prevenção & controle
Modelos Animais de Doenças
Feminino
Imagem por Ressonância Magnética
Período Pós-Operatório
Coelhos
Traumatismos do Sistema Nervoso/prevenção & controle
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161215
[St] Status:MEDLINE


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[PMID]:27886884
[Au] Autor:Goldstein HE; Anderson RC
[Ad] Endereço:Department of Neurosurgery, Morgan Stanley Children's Hospital, Columbia University, 710 W. 168th Street, New York, NY 10032, USA. Electronic address: heg2117@columbia.edu.
[Ti] Título:Classification and Management of Pediatric Craniocervical Injuries.
[So] Source:Neurosurg Clin N Am;28(1):73-90, 2017 Jan.
[Is] ISSN:1558-1349
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This article addresses the key features, clinical presentation, patterns of injury, indicated workup, and radiographic findings associated with craniocervical injuries in the pediatric population. It discusses nonsurgical and surgical management of pediatric cervical spine trauma, addressing when each is indicated, and the various techniques available to the pediatric neurosurgeon.
[Mh] Termos MeSH primário: Vértebras Cervicais/cirurgia
Traumatismos do Sistema Nervoso/classificação
Traumatismos do Sistema Nervoso/cirurgia
[Mh] Termos MeSH secundário: Vértebras Cervicais/diagnóstico por imagem
Criança
Seres Humanos
Tomografia Computadorizada por Raios X
Traumatismos do Sistema Nervoso/diagnóstico por imagem
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170313
[Lr] Data última revisão:
170313
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161126
[St] Status:MEDLINE


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[PMID]:27050813
[Au] Autor:Tozzi P; Pralong E; Gronchi F; Siniscalchi G
[Ad] Endereço:Department of Cardiovascular Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
[Ti] Título:A New Combined Technique Reducing the Risk of Paraplegia during Thoracoabdominal Aorta Replacement.
[So] Source:Thorac Cardiovasc Surg;65(2):126-129, 2017 Mar.
[Is] ISSN:1439-1902
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Acute spinal cord ischemia during thoracoabdominal aorta replacement is a dreadful complication. Existing tools (motor evoked potential [MEP] and somatosensory evoked potential [SSEP]) do not allow differentiating between central and peripheral paraplegia. Therefore, the surgeon often performs unnecessary reimplantation of intercostal arteries: this is time consuming, and significantly increases bleeding complications. We present a simple technique combining MEP and peripheral compound muscle action potential induced by posterior tibialis nerve stimulation, enabling the surgeon to quickly discriminate between central and peripheral neurologic injury. The surgeon has one more tool to drive in real time the optimal surgical strategy. This strategy guides the decision as to which side branches ought to be reimplanted, thus minimizing the risk of paraplegia.
[Mh] Termos MeSH primário: Aorta Torácica/cirurgia
Aneurisma da Aorta Torácica/cirurgia
Implante de Prótese Vascular/métodos
Potencial Evocado Motor
Monitorização Neurofisiológica Intraoperatória/métodos
Paraplegia/prevenção & controle
Isquemia do Cordão Espinal/prevenção & controle
Traumatismos do Sistema Nervoso/prevenção & controle
[Mh] Termos MeSH secundário: Aorta Torácica/fisiopatologia
Aneurisma da Aorta Torácica/diagnóstico
Aneurisma da Aorta Torácica/fisiopatologia
Prótese Vascular
Implante de Prótese Vascular/efeitos adversos
Implante de Prótese Vascular/instrumentação
Estimulação Elétrica
Seres Humanos
Monitoração Neuromuscular
Paraplegia/diagnóstico
Paraplegia/etiologia
Paraplegia/fisiopatologia
Valor Preditivo dos Testes
Reimplante
Fatores de Risco
Isquemia do Cordão Espinal/diagnóstico
Isquemia do Cordão Espinal/etiologia
Isquemia do Cordão Espinal/fisiopatologia
Artérias Torácicas/cirurgia
Nervo Tibial
Traumatismos do Sistema Nervoso/diagnóstico
Traumatismos do Sistema Nervoso/etiologia
Traumatismos do Sistema Nervoso/fisiopatologia
Resultado do Tratamento
Fluxo de Trabalho
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170718
[Lr] Data última revisão:
170718
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160407
[St] Status:MEDLINE
[do] DOI:10.1055/s-0036-1579700


  10 / 1084 MEDLINE  
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Texto completo SciELO Brasil
[PMID]:28076601
[Au] Autor:Esteves LA; Joaquim AF; Tedeschi H
[Ad] Endereço:Universidade Estadual de Campinas, Campinas, SP, Brazil.
[Ti] Título:Retrospective analysis of a case series of patients with traumatic injuries to the craniocervical junction.
[So] Source:Einstein (Sao Paulo);14(4):528-533, 2016 Oct-Dec.
[Is] ISSN:2317-6385
[Cp] País de publicação:Brazil
[La] Idioma:eng; por
[Ab] Resumo:Objective: To evaluate the correlation between the treatment, the characteristics of the lesions and the clinical outcome of patients with traumatic injuries to the craniocervical junction. Methods: This was a retrospective study of patients treated conservatively or surgically between 2010 and 2013 with complete data sets. Results: We analyzed 37 patients, 73% were men with mean age of 41.7 years. Of these, 32% were submitted to initial surgical treatment and 68% received conservative treatment. Seven (29%) underwent surgery subsequently. In the surgical group, there were seven cases of odontoid type II fractures, two cases of fracture of posterior elements of the axis, one case of C1-C2 dislocation with associated fractured C2, one case of occipitocervical dislocation, and one case of combined C1 and C2 fractures, and facet dislocation. Only one patient had neurological déficit that improved after treatment. Two surgical complications were seen: a liquoric fistula and one surgical wound infection (reaproached). In the group treated conservatively, odontoid fractures (eight cases) and fractures of the posterior elements of C2 (five cases) were more frequent. In two cases, in addition to the injuries of the craniocervical junction, there were fractures in other segments of the spine. None of the patients who underwent conservative treatment presented neurological deterioration. Conclusion: Although injuries of craniocervical junction are relatively rare, they usually involve fractures of the odontoid and the posterior elements of the axis. Our results recommend early surgical treatment for type II odontoid fractures and ligament injuries, the conservative treatment for other injuries. Objetivo: Avaliar a correlação entre o tratamento, as características das lesões e o resultado clínico em pacientes com lesões traumáticas na junção craniocervical. Métodos: Estudo retrospectivo de pacientes maiores de 18 anos tratados de forma conservadora ou cirúrgica, entre 2010 e 2013. Resultados: Foram analisados 37 pacientes, 73% eram do sexo masculino e a média de idade foi de 41,7 anos. Inicialmente 32% dos pacientes foram submetidos a tratamento cirúrgico, e 68% foram submetidos a tratamento conservador. Sete pacientes (29%) do grupo conservador foram submetidos posteriormente à cirurgia. No grupo cirúrgico, houve sete casos de fratura de odontóide tipo II, dois casos de fratura de elementos posteriores do áxis, um caso de luxação C1-C2, um caso de deslocamento occipito-cervical e um caso de fraturas de C1 e C2 e luxação facetária. Um paciente apresentava déficit neurológico, melhorando após o tratamento. Houve duas complicações pós-cirúrgicas, uma fístula liquórica e uma infecção de ferida operatória (reabordada). No grupo conservador, predominaram as fraturas do odontóide (oito) e dos elementos posteriores de C2 (cinco). Em dois casos, havia também fraturas em outros segmentos da coluna. Nenhum dos pacientes deste grupo apresentou deterioração neurológica. Conclusão: As lesões da junção craniocervical são raras, sendo mais frequentes as fraturas do odontóide e dos elementos posteriores do áxis. Nossos resultados recomendam o tratamento cirúrgico precoce para os pacientes com fraturas do odontóide tipo II e lesões ligamentares, e tratamento conservador para os demais pacientes.
[Mh] Termos MeSH primário: Vértebras Cervicais/lesões
Traumatismos do Sistema Nervoso/terapia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Vértebras Cervicais/cirurgia
Tratamento Conservador
Traumatismos Craniocerebrais
Feminino
Seres Humanos
Masculino
Meia-Idade
Osso Occipital/lesões
Complicações Pós-Operatórias/etiologia
Estudos Retrospectivos
Fatores de Risco
Fraturas Cranianas/diagnóstico por imagem
Fraturas da Coluna Vertebral/diagnóstico por imagem
Fraturas da Coluna Vertebral/terapia
Tomografia Computadorizada por Raios X
Traumatismos do Sistema Nervoso/diagnóstico por imagem
Traumatismos do Sistema Nervoso/cirurgia
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170602
[Lr] Data última revisão:
170602
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170112
[St] Status:MEDLINE



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