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PURPOSE: The aim of our retrospective study is to analyze how spinopelvic dissociations (SPDs) were treated in a single center trying to better understand how to improve surgical and non-surgical options. METHODS: Twenty patients of a single center surgically treated for SPDs between 2013 and 2021 were retrospectively included in this study. Three surgical techniques have been used: modified triangular stabilization, triangular stabilization and double iliac screws stabilization. Follow-up was assessed for up to 11.6 ± 9.9 months through ODI, MRS, NRS, IIEF or FSFI, a CT scan and whole spine X-ray examination. RESULTS: Twenty patients were admitted to our ER for traumatic spinopelvic dissociation. Surgical treatment for spinopelvic dissociation has been performed on average 11.5 ± 6.7 days after the trauma event. Eighteen fractures were C3 type and two C2 types. Neurological examination showed nerve root injury (N2) in 5 patients, incomplete spinal cord injury (N3) in 4 patients and cauda equina syndrome in two patients (N4). In case of neurologic deficits, routinary nerve decompression was performed. Three different surgical techniques have been used: 8 triangular fixations (Group 1), 6 modified triangular stabilization (Group 2) and 6 double iliac screws triangular fixation (Group 3). CONCLUSION: In patients with post-traumatic neurological deficit, decompression surgery and fracture reduction seem to be associated with clinical improvement; however, sexual disorders seem to be less responsive to the treatment. Some open stabilization techniques, such as the double iliac screw, could help in restoring the sagittal balance in case of severe deformities.
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Fraturas Ósseas , Fraturas da Coluna Vertebral , Humanos , Estudos Retrospectivos , Fraturas da Coluna Vertebral/diagnóstico por imagem , Fraturas da Coluna Vertebral/cirurgia , Fraturas da Coluna Vertebral/complicações , Fixação Interna de Fraturas/métodos , Sacro/cirurgia , Fraturas Ósseas/complicações , Resultado do TratamentoRESUMO
Milk is an important food of the daily diet. Many countries include it in their dietary recommendations due to its content in several important nutrients that exert beneficial effects on human health. Human milk is a newborn's first food and plays an important role in the growth, development, and future health of every individual. Cow milk is the type of milk most consumed in the world. However, its relatively high content of saturated fats raises concerns about potential adverse effects on human health, although epidemiological studies have disproved this association. Indeed, dairy consumption appear to be linked to a lower risk of mortality and major cardiovascular disease events. In the last few years many researchers have begun to focus their attention on both the production and quality of cow milk as well as the analysis of milk from other animal species to evaluate their effect on human health. The need to investigate the composition and metabolic effects of milk from other animal species arises from the adverse reactions of individuals in several groups to certain components of cow milk. It has emerged that donkey milk compared with that of other animal species, is the nearest to human milk and an excellent substitute for it. Milk from various animal species shows substantial differences in nutritional composition and distinct metabolic effects. In this review, we discussed the main compositional features and metabolic effects of 3 types of milk: human, cow, and donkey milk.
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Equidae , Leite , Feminino , Humanos , Bovinos , Animais , Leite Humano , Dieta , Nutrientes , AlérgenosRESUMO
BACKGROUND: Despite literature's evidence about COVID-19 vaccines' safety, concerns have arisen regarding adverse events, including the possible impact on fertility, accentuated by misinformation and anti-vaccine campaigns. The present study aims to answer the question: Is there any impact of COVID-19 vaccines on the fertility of men and women of reproductive age? METHODS: PubMed, Scopus, Web of Science, Cochrane and Embase databases were searched for eligible studies until June 8th, 2022. The search was restricted to articles regarding humans, published in any languages, without additional restrictions. Studies' quality was assessed by the Newcastle-Ottawa and the Before and After Quality Assessment scales for cohort and pre-post studies, respectively. Random-effect meta-analyses were performed for parameters considered in ≥ 2 studies, calculating means, p-values and 95 % Confidence Intervals (CIs). RESULTS: Out of 1406 studies screened, 29 were included in the systematic review. These studies, conducted in Israel (34.5 %), USA (24.1 %), Russia (20.7 %) China (10.3 %), Italy (3.5 %), North America (3.5%) and Turkey (3.5 %) were of poor (34.5 %), moderate (58.6 %) and good (6.9 %) quality. Meta-analyses were performed for pre- and post-vaccination sperm progressive motility (44 %, 95 % CI 42 %-62 % vs 43 %, 95 % CI 31 %-59 % p = 0.07) and concentration (50.6 mln/ml, 95 % CI 35.1-72.8 vs 55.4 mln/ml, 95 % CI 37.4-82.2p = 0.12). Biochemical (0.51, 95 % CI 0.40-0.66 vs 0.60, 95 % CI 0.53-0.68p = 0.45) and clinical (0.45, 95 % CI 0.37-0.54 vs 0.47, 95 % CI 0.40-0.55 p = 0.31) pregnancy rate did not differ among vaccinated and not vaccinated groups. Subgroup meta-analyses based on the type of vaccine showed no significant difference: between vaccinated with mRNA vaccines and non-vaccinated regarding biochemical pregnancy rates; pre- and post-vaccination with Gam-COVID-Vac regarding testosterone, FSH and LH levels; pre- and post-vaccination with BNT162b2 vaccines regarding sperm volumes. CONCLUSION: Based on the studies published so far, there is no scientific proof of any association between COVID-19 vaccines and fertility impairment in men or women.
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Vacinas contra COVID-19 , COVID-19 , Vacina BNT162 , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , Feminino , Fertilidade , Hormônio Foliculoestimulante , Humanos , Masculino , Gravidez , Sêmen , TestosteronaRESUMO
BACKGROUND: The ultrasound biomicroscopy (UBM) technique generates high-resolution echographic images using acoustic frequencies between 20 and 200 MHz. In dermatology, it enables non-invasive visualization of cutaneous structures. In this sense, several studies are being conducted for the measurement of cutaneous tumor sizes and for the evaluation of their response to therapeutic procedures. The present work was conducted to analyze the ability of UBM to identify diverse histological structures associated with cutaneous carcinomas ex vivo regarding the evaluation of the technique as a diagnostic tool that could, eventually, improve the patient's healthcare protocol. METHODS: Ex vivo human tissue samples, corresponding to basal cell carcinoma and squamous cell carcinoma cases, were studied. The ultrasonic system operated with a center frequency of 45MHz and the histological structures were identified by comparison with the light microscopy images. RESULTS: The histological components present in the tumors were identified by variations in the echogenicity level for several of the studied cases and particular characteristics were observed for the different tumor types. CONCLUSION: The possibility of differentiating the histological components associated with cutaneous carcinomas indicates the potential use of UBM for diagnostic applications. However, a larger number of specimens must be studied.
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Doença de Bowen/diagnóstico por imagem , Carcinoma Basocelular/diagnóstico por imagem , Carcinoma de Células Escamosas/diagnóstico por imagem , Dermoscopia/métodos , Neoplasias Cutâneas/diagnóstico por imagem , Ultrassonografia/métodos , Biópsia , Doença de Bowen/patologia , Carcinoma Basocelular/patologia , Carcinoma de Células Escamosas/patologia , Dermoscopia/instrumentação , Humanos , Técnicas In Vitro , Neoplasias Cutâneas/patologia , Ultrassonografia/instrumentaçãoRESUMO
Neurofibromatosis type-1 (NF1) is a common neurogenetic disorder and an important cause of intellectual disability. Brain-behaviour associations can be examined in vivo using morphometric magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) to study brain structure. Here, we studied structural and behavioural phenotypes in heterozygous Nf1 mice (Nf1(+/-) ) using T2-weighted imaging MRI and DTI, with a focus on social recognition deficits. We found that Nf1(+/-) mice have larger volumes than wild-type (WT) mice in regions of interest involved in social cognition, the prefrontal cortex (PFC) and the caudate-putamen (CPu). Higher diffusivity was found across a distributed network of cortical and subcortical brain regions, within and beyond these regions. Significant differences were observed for the social recognition test. Most importantly, significant structure-function correlations were identified concerning social recognition performance and PFC volumes in Nf1(+/-) mice. Analyses of spatial learning corroborated the previously known deficits in the mutant mice, as corroborated by platform crossings, training quadrant time and average proximity measures. Moreover, linear discriminant analysis of spatial performance identified 2 separate sub-groups in Nf1(+/-) mice. A significant correlation between quadrant time and CPu volumes was found specifically for the sub-group of Nf1(+/-) mice with lower spatial learning performance, suggesting additional evidence for reorganization of this region. We found strong evidence that social and spatial cognition deficits can be associated with PFC/CPu structural changes and reorganization in NF1.
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Encéfalo/fisiopatologia , Neurofibromatose 1/fisiopatologia , Animais , Comportamento Animal/fisiologia , Encéfalo/diagnóstico por imagem , Cognição/fisiologia , Transtornos Cognitivos/diagnóstico por imagem , Transtornos Cognitivos/fisiopatologia , Imagem de Tensor de Difusão , Modelos Animais de Doenças , Feminino , Imageamento por Ressonância Magnética , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Neurofibromatose 1/diagnóstico por imagem , Fenótipo , Córtex Pré-Frontal/diagnóstico por imagem , Córtex Pré-Frontal/fisiopatologia , Comportamento Social , Transtornos do Comportamento Social/fisiopatologia , Relação Estrutura-AtividadeRESUMO
Despite the potential benefits of using prescription claims databases for pharmacoepidemiological research, little work has been reported on the nature of available information or its accuracy. The purpose of this study was to describe information contained within the prescription claims database in Québec, and to assess the accuracy of drug information that might be used to monitor drug exposure and physician prescribing. The comprehensiveness of the prescriptions claims database was assessed by examining 1,917,214 records of dispensed prescriptions for a regionally stratified random sample of 65,349 Québec elderly in 1990. We found that values in key fields (individual identifiers, drug, quantity, date dispensed and duration) were missing or out of range in 0-0.4% of records. The accuracy of data were examined in 723 prescriptions filled by 306 elderly patients attending one internal medicine clinic. Of these prescriptions, 83% were filled by the patient and correctly identified the patient and drug and in 89% of these 599 records, the prescribing physician was correctly identified. The quantity and duration of the prescriptions were accurate in 69.1% and 72.1% of records, respectively. We conclude that the prescription claims database in Québec may represent one of the most accurate means of determining drugs dispensed to individuals. There may be limitations in using this database for dosing information.
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Prescrições de Medicamentos/estatística & dados numéricos , Uso de Medicamentos/estatística & dados numéricos , Sistemas de Informação/estatística & dados numéricos , Farmacoepidemiologia , Quebeque/epidemiologia , Sensibilidade e EspecificidadeRESUMO
The psychoflexed hand is a rare clinical condition characterized by fixed finger contractures undetermined by organic etiology, often associated with a psychiatric pathology. We report a series of 20 patients (nine males and 11 females, mean aged 56.2 years). We have introduced a new classification of the various possible patterns of finger deformities: 1) Type 1: prevalent flexion contracture at the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints of the last two or three fingers; the thumb and the index are not affected; 2) type 2: prevalent flexion contracture at the PIP and distal interphalangeal (DIP) joints of the last two or three fingers; 3) type 3: flexion contracture of all the long fingers; 4) type 4: flexion contracture of all the fingers of the hand, including the thumb (clenched fist syndrome); 5) type 5: isolated flexus-adductus thumb (the long fingers are not affected); 6) type 6: flexion of digits associated with flexion contractures of other joints of the upper extremity. The treatment was conservative in 14 patients with recent deformities and surgical in six patients. Both forms of treatment were followed by a rigorous rehabilitation program, mostly based on home self-rehabilitation. The correction of the deformities was obtained in all cases and maintained over time.
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Contratura/cirurgia , Dedos/cirurgia , Deformidades Adquiridas da Mão/classificação , Deformidades Adquiridas da Mão/cirurgia , Articulação Metacarpofalângica/cirurgia , Transtornos Psicofisiológicos/complicações , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Contratura/patologia , Transtornos Autoinduzidos/complicações , Feminino , Dedos/patologia , Deformidades Adquiridas da Mão/diagnóstico , Deformidades Adquiridas da Mão/psicologia , Deformidades Adquiridas da Mão/reabilitação , Humanos , Masculino , Articulação Metacarpofalângica/patologia , Pessoa de Meia-Idade , Procedimentos Ortopédicos/métodos , Psicoterapia , Amplitude de Movimento Articular , Procedimentos de Cirurgia Plástica/métodos , Resultado do TratamentoRESUMO
PRIMARY OBJECTIVE: The primary objective of this study was to understand how intrinsic and extrinsic factors influence productive involvement over time. RESEARCH DESIGN: Given this relatively unexplored area of study, an interpretive research paradigm was incorporated using the grounded theory methodology. METHODS AND PROCEDURES: Six participants were recruited based on inclusion criteria. They had been living with a brain injury for an average of 14 years. The primary method of data collection was semi-structured interviews, which was supplemented by programme reports to enhance methodological triangulation. RESULTS: The results revealed that factors influencing involvement in productive activities over time were conceptually linked to learning about one's capacity. These factors involved: an opportunity to try, support and feedback from others, experimenting, and participants' appraisals of themselves. CONCLUSIONS: Recommendations for clinical practice include incorporating the postulates of the social cognitive theory in rehabilitation and moving from a deficits approach towards a strengths model of practice.
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Lesões Encefálicas/reabilitação , Adaptação Psicológica , Adulto , Idoso , Lesões Encefálicas/psicologia , Retroalimentação Psicológica , Feminino , Humanos , Entrevistas como Assunto , Masculino , Motivação , Reabilitação Vocacional/psicologia , Autoimagem , Identificação Social , Apoio Social , Voluntários/psicologiaRESUMO
The in vivo histological and ultrastructural analysis of periprosthetic tissue collected at time of revision surgery for failure of a 28 mm yttria-tetragonal zirconium oxide polycrystal (YTZP) ball head, 2 years after implantation is reported. Histologic analysis showed Zirconia particles, rounded to polygonal ranging from 2m to more than 10m intra or extra cellular in a stroma without vessels with few giant cells. Scanning electron microscopy (SEM) and energy dispersive X-ray analysis (EDAX) showed the different shape from rounded to polygonal of Zirconia. SEM analysis of the internal part of Zirconia ball head showed the presence of different fracture lines especially in the internal surface (Hip International 2002; 4: 388-93).
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The Medical Office for the Twenty First Century (MOXXI) is a research project testing the potential benefits of an electronic prescription and drug management system for primary care physicians. This system includes a dynamic electronic pad for prescription entry with fields for treatment indications; a drug profiler with a graphic representation of the list of prescription medications purchased in the last year; a refill compliance calculator; dates of emergency room visits and hospital admissions; cost of drugs dispensed; and an alert system that detects interactions among drugs, treatment duplications, and contraindications with certain allergies or specific diseases. One concern expressed by physicians that could influence uptake and acceptability is the increased time that may be required to use the system. User abilities are a factor in this process, as well as user interface, user training and system speed.