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2.
Nat Aging ; 3(9): 1144-1166, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37563227

RESUMO

Aging, often considered a result of random cellular damage, can be accurately estimated using DNA methylation profiles, the foundation of pan-tissue epigenetic clocks. Here, we demonstrate the development of universal pan-mammalian clocks, using 11,754 methylation arrays from our Mammalian Methylation Consortium, which encompass 59 tissue types across 185 mammalian species. These predictive models estimate mammalian tissue age with high accuracy (r > 0.96). Age deviations correlate with human mortality risk, mouse somatotropic axis mutations and caloric restriction. We identified specific cytosines with methylation levels that change with age across numerous species. These sites, highly enriched in polycomb repressive complex 2-binding locations, are near genes implicated in mammalian development, cancer, obesity and longevity. Our findings offer new evidence suggesting that aging is evolutionarily conserved and intertwined with developmental processes across all mammals.


Assuntos
Metilação de DNA , Epigênese Genética , Humanos , Camundongos , Animais , Metilação de DNA/genética , Envelhecimento/genética , Longevidade/genética , Mamíferos/genética
3.
Sci Total Environ ; 902: 166003, 2023 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-37549707

RESUMO

The accumulation of microplastics (MPs) in the environment as well as their presence in foods and humans highlight the urgent need for studies on the effects of these particles on humans. Polylactic acid (PLA) is the most widely used bioplastic in the food industry and medical field. Despite its biodegradability, biocompatibility, and "Generally Recognized As Safe" (GRAS) status, recent animal model studies have shown that PLA MPs can alter the intestinal microbiota; however, to date, no studies have been reported on the possible gut and health consequences of its intake by humans. This work simulates the ingestion of a realistic daily amount of PLA MPs and their pass through the gastrointestinal tract by combining the INFOGEST method and the gastrointestinal simgi® model to evaluate possible effects on the human colonic microbiota composition (16S rRNA gene sequencing analysis) and metabolic functionality (lactic acid and short-chain fatty acids (SCFA) production). Although PLA MPs did not clearly alter the microbial community homeostasis, increased Bifidobacterium levels tended to increase in presence of millimetric PLA particles. Furthermore, shifts detected at the functional level suggest an alteration of microbial metabolism, and a possible biotransformation of PLA by the human microbial colonic community. Raman spectroscopy and field emission scanning electron microscopy (FESEM) characterization revealed morphological changes on the PLA MPs after the gastric phase of the digestion, and the adhesion of organic matter as well as a microbial biofilm, with surface biodegradation, after the intestinal and colonic phases. With this evidence and the emerging use of bioplastics, understanding their impact on humans and potential biodegradation through gastrointestinal digestion and the human microbiota merits critical investigation.


Assuntos
Microbioma Gastrointestinal , Microplásticos , Humanos , Animais , Plásticos , RNA Ribossômico 16S , Poliésteres , Digestão
4.
Pediatr Surg Int ; 39(1): 236, 2023 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-37468717

RESUMO

INTRODUCTION: During "bowel management week," abdominal radiographs are used to monitor the amount and location of stool. A radiologist familiar with the treatment plan can provide an improved interpretation. The goal of this paper is to standardize the radiological reports during a bowel management week. METHODS: We saw 744 patients during bowel management week from May 2016 until March 2023. Diagnosis included: anorectal malformation (397), idiopathic constipation (180), Hirschsprung disease (89), and spina bifida (78). Laxatives were the treatment for 51% of patients, and 49% received enemas. Characteristic radiographs were selected for each treatment group for a proposed reading standardization. RESULTS: When the stool is visualized, it is crucial to report its location. Having a contrast enema helps with the correct interpretation of the colonic anatomy. It is also essential to always compare the amount of stool with the radiograph from the previous day to determine if there is an increase or decrease in stool. Examples of radiographs are shown to guide the use of the preferred proposed terminology. CONCLUSION: Providing information regarding which treatment modality the patient is receiving and stating that a patient is on a bowel management week treatment is crucial for the radiologist to provide adequate interpretation. The radiologist must be familiar with the treatment goals and purpose of the daily radiograph.


Assuntos
Incontinência Fecal , Doença de Hirschsprung , Humanos , Constipação Intestinal/terapia , Laxantes , Intestinos , Enema , Doença de Hirschsprung/terapia , Doença de Hirschsprung/tratamento farmacológico , Incontinência Fecal/terapia
5.
Plant Biol (Stuttg) ; 25(5): 785-792, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37150897

RESUMO

Recent discoveries pointed out the importance of the mutual correlation between timing of environmental stress and plant fitness. However, the internal reshaping of plant growth under daily stress sensing, and their metabolic coordination remain to be investigated. Thus, we studied the connection between time of day, growth and defence to understand how plant fitness is affected by diurnal stress inputs. We examined if simulated herbivory (leaf wounding) in the morning, at midday or the evening differentially influence plant defence state vs growth in three crop species of Brassica: broccoli (Brassica oleraceae), turnip greens (B. rapa) and rapeseed (B. napus). The data revealed that plant's tolerance of wounding stress is diurnally regulated in Brassica crops. Trade-offs between biomass and investment in glucosinolates (GSL) and phenolics were affected by timing of leaf stress. Negative correlations between biomass and induction of defence compounds were found for plants treeated in the morning and evening. However, the correlations were positive for midday treatment. Interestingly, we revealed a new connection between plant growth and changes in aliphatic GSLs and flavonoids in response to wounding. These data suggest that metabolic stress-dependent circadian oscillations in leaf defences could be one mechanism conferring a competitive advantage to plants to anticipate daily environmental variations by synchronizing them with growth. Moreover, this work provides first insights into how secondary metabolites are linked to growth response in a timing-related manner.


Assuntos
Brassica napus , Brassica rapa , Brassica , Biomassa , Brassica napus/metabolismo , Produtos Agrícolas , Folhas de Planta/metabolismo , Glucosinolatos/metabolismo
6.
Rev. cir. (Impr.) ; 75(1)feb. 2023.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1441445

RESUMO

Introducción: El reflujo de enzimas pancreáticas hacia la vía biliar extra-hepática y la vesícula biliar es un fenómeno anormal que tiene un rol en la litogénesis y carcinogénesis. Debido a que la presión de la vía biliar depende entre otros factores, de las presiones del esfínter de Oddi. La disfunción de éste se vería reflejada en presiones elevadas de la vía biliar en pacientes con colelitiasis. Objetivo: El objetivo de este estudio es el de medir las presiones de la vía biliar extra-hepática en pacientes con y sin colelitiasis y relacionarlas con la presencia de reflujo pancreáticobiliar. Material y Método: Se diseñó un estudio pros-pectivo de casos y controles. La muestra está constituida por todos los pacientes operados con gastrectomía total por cáncer gástrico estadios I y II durante 30 meses. La medida de resultado primaria fue establecer diferencias en las presiones de la vía biliar entre pacientes con y sin colelitiasis. Resultados: Las presiones de la vía biliar extra-hepática en pacientes con colelitiasis fueron más elevadas (16,9 mmHg) que en los pacientes sin colelitiasis (3,3 mmHg) (p < 0,0001). Estas presiones se correlacionan con la presencia de amilasa y lipasa en la bilis de la vesícula; se encontraron niveles elevados de enzimas pancreáticas en pacientes con colelitiasis (p < 0,0001). Conclusiones: Las presiones de la vía biliar en pacientes con colelitiasis fueron, significativamente, mayores comparadas con las presiones de la vía biliar en pacientes sin colelitiasis. En los pacientes con colelitiasis, la presión elevada de la vía biliar se asocia a la presencia de reflujo pancreáticobiliar.


Background: The reflux of pancreatic enzymes into the bile duct and the gallbladder is an abnormal phenomenon that plays a role in lithogenesis and carcinogenesis. Because the pressure of the common bile duct depends on the pressures of the sphincter of Oddi, its dysfunction would be reflected in an increase in the pressure of the common bile duct in patients with cholelithiasis. Aim: The objective of this study was to measure the pressures of the common bile duct in patients with and without cholelithiasis and to relate them to the presence of pancreatobiliary reflux. Material and Method: A prospective case-control study was designed. The universe was constituted by all patients undergoing total gastrectomy for gastric cancer stages I and II during 30 months. The primary outcome measure was to establish differences between common bile duct pressures in patients with and without cholelithiasis. Results: Common bile duct pressures in patients with gallstones showed a significant elevation (16.9 mmHg) compared to patients without gallstones (3.3 mm Hg) (p < 0.0001). These pressures correlated with the levels of amylase and lipase in gallbladder bile; higher levels were found in patients with gallstones compared to patients without gallstones (p < 0.0001). Conclusions: Common bile duct pressure in patients with cholelithiasis was significantly higher compared to patients without cholelithiasis leading to pancreatobiliary reflux.

8.
Rev. chil. neuro-psiquiatr ; 60(4): 422-432, dic. 2022. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1423705

RESUMO

El suicidio como problema de salud pública mundial muestra tasas fluctuantes con tendencia a elevarse. Las estrategias en salud pública encaminadas a la reducción del intento y del reintento suicida son la principal alternativa. Objetivo: establecer la incidencia de reintento suicida, oportunidad de atención y adherencia al seguimiento de pacientes atendidos por intento suicida en el servicio de urgencias de un hospital universitario privado. Métodos y participantes: estudio de tipo cohorte prospectiva descriptiva en pacientes ≥18 años con intento suicida de riesgo bajo asignados a tratamiento psiquiátrico ambulatorio y seguido mediante la aplicación WhatsApp durante un año después del egreso. Resultados: la prevalencia de intento suicida de los pacientes que consultaron al servicio de urgencias fue de 0,38%. De 164 pacientes con intento suicida 33 ingresaron al estudio. Tenían una mediana de edad de 23 RI (25-75): 19-33 años, el 87,8% (n: 29) fueron mujeres, 42,4% (n: 22) tenía escolaridad secundaria y 63,6% (n: 21) eran del estrato socioeconómico medio. La incidencia acumulada de reintento suicida fue del 36,3% (n: 12), más frecuente al primer mes. La atención por psiquiatría más temprana fue a las dos semanas del egreso. La adherencia al seguimiento fue del 45,4%. Conclusiones: la incidencia acumulada del reintento suicida fue elevada. La oportunidad de atención y la adherencia al seguimiento fueron bajas. A pesar de los diferentes métodos hasta ahora utilizados, el seguimiento de la conducta suicida sigue siendo difícil. Se necesitan investigaciones que exploren alternativas de intervención de tipo social y comunitario.


Suicide as a global public health issue shows fluctuating rates with a tendency to increase. Public health strategies aimed to reduce suicide attempt and retry are the main alternative. Objective: establish the incidence of suicidal retry, opportunity for care and adherence to treatment in the follow-up of patients treated for suicide attempt in the emergency room of a private University hospital. Methods and participants: a descriptive prospective cohort study in patients ≥18 years of age with a low-risk suicide attempt assigned to outpatient psychiatric treatment and followed up through WhatsApp application for one year after discharge. Results: the prevalence of suicide attempt in patients who consulted the emergency room was 0.38%. Of 164 patients with a suicide attempt, 33 were low risk. With a median age of 23 IR (25-75): 19-33 years, 87.8% (n: 29) were women, 42.4% (n: 22) with secondary school level and 63.6% (n: 21) with middle socioeconomic stratum. 24.2% (n: 8). The accumulate incidence of retry was 36,3% (n: 12), more frequently in the first month. The earlier attention by psychiatry was after two weeks of discharge. The follow-up adherence was of 45,4%. Conclusions: the accumulated incidence for retry was high. The opportunity for outpatient psychiatric care and adherence to follow up were low. Despite the different methods used until now, monitoring suicidal behavior remains difficult. It is necessary research that explore alternatives for community and social intervention.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Tentativa de Suicídio/prevenção & controle , Tentativa de Suicídio/estatística & dados numéricos , Aplicativos Móveis , Escalas de Graduação Psiquiátrica , Incidência , Estudos Prospectivos , Serviço Hospitalar de Emergência , Fatores Sociodemográficos
9.
BMC Health Serv Res ; 22(1): 1218, 2022 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-36180905

RESUMO

INTRODUCTION: Following the COVID-19 directive to cease non-essential services, a rapid shift was made in the delivery of Speech Language Pathology (SLP) dysphagia management in the 3-arm, randomized PRO-ACTIVE trial. To inform future programs, this study explored patients' experiences with telehealth when the planned in-person SLP intervention was moved to a telehealth modality. METHODS: A theory-guided qualitative descriptive approach was used. Willing participants who had received at least one telehealth swallowing therapy session participated in a one-time semi-structured interview. Interview transcripts were subjected to a standard qualitative content/theme analysis. Researchers reviewed all transcripts and used a multi-step analysis process to build a coding framework through consensus discussion. Summaries and key messages were generated for each code. RESULTS: Eleven participants recounted their telehealth experiences and reported feeling satisfied, comfortable and confident with the session(s). They identified that previous experience with teleconferencing, access to optimal technical equipment, clinician skill, and caregiver assistance facilitated their telehealth participation. Participants highlighted that telehealth was beneficial as it reduced commuting time, COVID-19 exposure and fatigue from travel; and also allowed caregiver participation particularly during COVID. In comparing their in-person SLP sessions to telehealth sessions, limitations were also identified, including: lack of previous experience with and/or poor access to technology, and less opportunity for personalization. Participants indicated that use of phone alone was less preferred than an audio/video platform. DISCUSSION: Patients reported that overall, telehealth sessions did not compromise their learning experience when compared to in-person sessions. Patients benefited from use of telehealth in several ways despite some limitations of the use of technology. Patient feedback about telehealth provides an important perspective that may be critical to inform best practices for care delivery.


Assuntos
COVID-19 , Transtornos de Deglutição , Neoplasias de Cabeça e Pescoço , Telemedicina , COVID-19/epidemiologia , Atenção à Saúde , Humanos , Avaliação de Resultados da Assistência ao Paciente
10.
Front Toxicol ; 4: 933300, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36071823

RESUMO

The herbicide atrazine (ATR; 2-chloro-4-ethylamino-6-isopropylamino-s-triazine) is widely used to destroy grasses and broadleaf weeds in crops and some fruits. Studies in rodents have shown that acute, repeated or chronic exposure to ATR is associated with alterations in the nigrostriatal dopaminergic pathway, whereas its effects on GABAergic and glutamatergic pathways have only recently been reported. Sprague-Dawley male rats were exposed daily to 1 or 10 mg ATR/kg of BW for 13 months to evaluate the ATR effects on GABAergic and glutamatergic systems. At the end of the ATR treatment, the levels of mRNA of several genes involved in the production, vesiculation, reuptake, and receptors of GABA and Glu in the striatum (STR), nucleus accumbens (NAcc), prefrontal cortex (PFC), ventral midbrain (vMID) and hippocampus (HIPP) were evaluated by absolute qPCR. For the GABAergic genes, increased expression of GAD67 and Slc32a1 in STR and/or vMID in rats exposed to 1 and/or 10 mg ATR were detected. With regard to the expression of genes involved in the glutamatergic system, Slc17a6 and Grin1 in HIPP of rats exposed to 1 and/or 10 mg ATR, increased as was Gria1 in STR and PFC in the group exposed to 1 mg ATR. In the same fashion, Slc1a3 expression and MGLUR1 increased in STR of rats exposed to 1 and 10 mg ATR groups. The expression of the glutaminases gls (variants 1 and 2) was greater in STR, NAcc, HIPP, and PFC of rats exposed to 1 and/or 10 mg ATR. These findings show that the GABAergic and, especially glutamatergic systems are targets of ATR exposure.

11.
Rev Clin Esp (Barc) ; 2022 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-35843784

RESUMO

BACKGROUND AND AIMS: The aim of this study was to determine the complications of influenza in all adults hospitalized with this disease and, specifically, to analyze the characteristics of post-infection cardiovascular events. METHODS: This work is observational descriptive study of adults hospitalized with influenza during the 2017-2018 and 2018-2019 seasons using the specific registry of a tertiary hospital. The complications analyzed were pneumonia, multiple organ dysfunction syndrome, septic shock, acute respiratory distress syndrome, and cardiac events. RESULTS: A total of 928 adults with influenza required hospitalization and 303 (32.7%) presented with one or more complications. A post-influenza cardiac event occurred in 2.5% of patients; they had a higher probability of ICU admission and higher mortality. Influenza vaccination was a protective factor for cardiac events (OR 0.32; 95%CI 0.13-0.83). CONCLUSIONS: Influenza can lead to important complications in hospitalized patients. The high mortality rate associated with post-infection cardiac events means that preventive measures, including annual influenza vaccination, need to be emphasized.

13.
Heliyon ; 8(4): e09329, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35520622

RESUMO

An analysis of the scientific production of Ecuador is performed by means of the composite indicator computed for Ecuador-based authors as compared to their counterparts of other South American countries. The dataset employed was obtained from the Databricks platform of the ELSEVIER's International Center for Science Research, ICSR. Therefore, this analysis is limited to the metadata of the documents published in journals indexed in SCOPUS. Comparison of the results obtained for two decades: 2001-2010 and 2011-2020 showed that the number of Ecuador-based researchers has significantly increased in different areas of knowledge. Moreover, comparison between the total number of authors that worked in Ecuador at any given year of the 2011-2020 period and the number of authors that are still working in this country up to the date of the data extraction (i.e., June 2021) showed an average of ∼68% of permanency. Analysis of the percentage distribution in terms of range quarters of the composite indicator (i.e., Q4: 0-1.5, Q3: 1.5-3.0, Q2: 3.0-4.5, and Q1: 4.5-6.0) showed that nearly the totality of the Ecuador-based researchers has composite indicators that lay in the Q4 and Q3 ranges for all the scientific fields considered. The latter was observed to be an effect of the scientific impact of South American countries, with larger investments in science and technology in comparison to Ecuador (i.e., Argentina, Brazil, and Chile). Exclusion of this group of countries in the calculation of the composite indicator of Ecuador-based authors resulted in a noticeable increment of scientists with composite indicators within Q2. Finally, our results suggest, in agreement with previous studies, a correlation between the sustained growth of scientific productivity in the decade 2011-2020 with the scientific programs and policies created by the state, where the initiative of scientific culture is shown as a strategy for growth and development.

14.
Vet Anim Sci ; 15: 100237, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35169654

RESUMO

Genetic influence on pork quality exists between breeds and within a breed. The variation is caused by a large set of genes, and pork quality traits have a multifactorial background. Research into the genetics of meat quality found causative mutations associated with marked effects on pig meat value. This study aimed to investigate the segregation of meat quality-related SNPs and compare their diversity and genetics in commercial and Creole pigs from different farms in the North-West of Argentina. A screen for SNPs in RYR1, PRKAG3, CAST, and SOX6 candidate genes and the differentiation of their genotypes by PCR-RFLP was conducted. All genes were characterized by a high level of polymorphism and heterozygosity, and populations showed no differences in the genetic structure for the analyzed SNPs. These results highlighted the role of pig genotypes as a source of basic variability potentially affecting processed meat products and fresh meat.

16.
Acta Ortop Mex ; 35(3): 271-275, 2021.
Artigo em Espanhol | MEDLINE | ID: mdl-34921537

RESUMO

INTRODUCTION: The medial collateral ligament (MCL) is one of the main stabilizers of the knee, but its injury occurs in conjunction with other ligaments. OBJECTIVE: To determine the prevalence of MCL lesions by magnetic resonance imaging, their degrees and associated lesions in our institution. MATERIAL AND METHODS: Retrospective study from January to April 2018 where KNEE MRIs were evaluated where the MCL lesion was presented to evaluate the degree and type of associated injuries. RESULTS: We included 368 studies, prevalence of isolated MCL lesion of 3.07%, grade I and grade II, prevalence of concomitant MCL lesions was 17.66% grade I (75%), grade II (15%) and grade III (3%). Associated injuries were medial meniscus injury (46.15%), anterior cruciate ligament injury (30.7%), isolated bone contusion (18.46%), chodral injuries (37.58%), medial vastus injury (14.51%), patellar medial retinacular injury (14.51%), vastus lateral injury (9.23%), posterior cruciate ligament injury (6.15%), lateral meniscus injury (4.61%), iliotibial band tenosynovitis (4.61%), medial facet avulsion fracture (3.07%), Pes Anserine tenosynovitis (3.07%). CONCLUSION: Prevalence of 17.66% of the MCL injuries in our hospital by magnetic resonance, the first 2 degrees predominate, with a wide spectrum of associated knee injuries.


INTRODUCCIÓN: El ligamento colateral medial (LCM) es uno de los principales estabilizadores de la rodilla, pero su lesión se presenta en conjunto con otras lesiones ligamentarias. OBJETIVO: Determinar la prevalencia de lesiones del LCM por resonancia magnética, sus grados y lesiones asociadas en nuestra institución. MATERIAL Y MÉTODOS: Estudio retrospectivo de Enero a Abril de 2018, se evaluaron resonancias magnéticas de rodilla donde se presentó lesión del LCM para evaluar grado y tipo de lesiones asociadas. RESULTADOS: Se incluyeron 368 estudios, prevalencia de lesión aislada del LCM de 3.07%, una grado I y una grado II, la prevalencia de lesiones de LCM concomitantes fue de 17.66%, grado I (75%), grado II (15%) y grado III (3%). Las lesiones asociadas fueron lesión del menisco medial (46.15%), lesión del ligamento cruzado anterior (30.7%), contusión ósea aislada (18.46%), lesiones condrales (37.58%), lesión de vasto medial (14.51%), lesión del retináculo medial patelar (14.51%), lesión del vasto lateral (9.23%), lesión del ligamento cruzado posterior (6.15%), lesión del menisco lateral (4.61%), tenosinovitis banda iliotibial (4.61%), fractura de avulsión de la faceta medial (3.07%), tenosinovitis de la Pes Anserinus (3.07%). CONCLUSIÓN: Prevalencia de 17.66% de lesiones del LCM en nuestro hospital por resonancia magnética, predominan los dos primeros grados con un espectro amplio de lesiones asociadas de la rodilla.


Assuntos
Ligamentos Colaterais , Imageamento por Ressonância Magnética , Ligamentos Colaterais/diagnóstico por imagem , Humanos , Espectroscopia de Ressonância Magnética , Prevalência , Estudos Retrospectivos
17.
BMC Med Res Methodol ; 21(1): 230, 2021 10 27.
Artigo em Inglês | MEDLINE | ID: mdl-34706652

RESUMO

BACKGROUND: Patient satisfaction or experience with colorectal cancer screening can determine adherence to screening programs. An evaluation of validated patient reported outcome measures (PROMs) for measuring experience or satisfaction with colorectal cancer screening does not exist. Our objective was to identify and critically appraise validated questionnaires for measuring patient satisfaction or experience with colorectal cancer screening. METHODS: We conducted a systematic review following the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology. We conducted searches on MEDLINE, EMBASE, PsychINFO, CINAHL and BiblioPRO and assessed the methodological quality of studies and measurement properties of questionnaires according to the COSMIN guidelines for systematic reviews of PROMs. PROSPERO registration number: CRD42019118527. RESULTS: We included 80 studies that used 75 questionnaires, of which only 5 were validated. Four questionnaires measured satisfaction with endoscopy: two in the context of colorectal cancer screening (for colonoscopy and sigmoidoscopy) and two for non-screening endoscopy. One questionnaire measured satisfaction with bowel preparation. The methodological quality of studies was variable. The questionnaires with evidence for sufficient content validity and internal consistency were: the CSSQP questionnaire, which measures safety and satisfaction with screening colonoscopy, and the Post-Procedure questionnaire which measures satisfaction with non-screening endoscopic procedures. CONCLUSIONS: This systematic review shows that a minority of existing PROMs for measuring patient satisfaction with colorectal cancer screening are validated. We identified two questionnaires with high potential for further use (CSSQP and the Post-Procedure questionnaire).


Assuntos
Neoplasias Colorretais , Satisfação Pessoal , Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer , Humanos , Medidas de Resultados Relatados pelo Paciente , Satisfação do Paciente , Qualidade de Vida , Inquéritos e Questionários
18.
Spine Deform ; 9(5): 1253-1258, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33792837

RESUMO

The association between Chiari 1 malformation and scoliosis is well known in the literature. Prevalence has increased after the advent of magnetic resonance imaging. In children with this association, prophylactic suboccipital decompression prior to scoliosis correction is a common surgical procedure although the rationale for this surgical management and whether not performing it may lead to spinal cord injury has not been clearly elucidated. We conducted a systematic review of the literature with the aim to obtain strong data to support the hypothesis that it is safe to proceed with scoliosis correction without prior prophylactic suboccipital decompression for Chiari 1 in an asymptomatic population. Using the Prisma methodology, we analyzed 3250 studies published between 1972 and 2018. Only four studies met the inclusion criteria. None of the studies had a level of evidence high enough to recommend prophylactic decompression previous to correction of the spinal deformity.


Assuntos
Malformação de Arnold-Chiari , Escoliose , Malformação de Arnold-Chiari/diagnóstico por imagem , Malformação de Arnold-Chiari/cirurgia , Criança , Descompressão Cirúrgica , Humanos , Estudos Retrospectivos , Escoliose/diagnóstico por imagem , Escoliose/cirurgia , Resultado do Tratamento
20.
Neurochirurgie ; 67(2): 165-169, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33130027

RESUMO

BACKGROUND: Double Crush Syndrome (DCS) is a clinical condition that involves multiple compression sites along a single peripheral nerve. The present study aims to describe the epidemiology of DCS and surgical results. METHODS: A retrospective observational analytic study included patients with clinical diagnosis of cervical radiculopathy and carpal tunnel syndrome who underwent surgery between January 2009 and January 2019. General demographic characteristics were noted, and 3 groups were distinguished: spinal surgery, carpal tunnel release, and bimodal decompression (BD); statistical differences were analyzed between them. RESULTS: The sample comprised 32 patients. DCS prevalence was 10.29%. Mean age at presentation was 59.25±10.98 years. There was female predominance (75%). Paresthesia was the main symptom (65.6%). Post-surgical results of BD showed significant improvement in sensory nerve conduction velocity, motor nerve conduction velocity (both P=0.008), and disability on Douleur Neuropathique 4 questions, Neck Disability Index, and Boston Carpal Tunnel Questionnaire (P=0.001, 0.004, 0.008, respectively). CONCLUSIONS: Diagnosis and management of DCS are a challenge. It is necessary to determine the site with maximal compression and risk of complications to decide on treatment. If first-line surgery is adequate, proximal and distal symptomatology can be improved. To maximize success, we recommend BD, according to the present results.


Assuntos
Síndrome do Túnel Carpal/epidemiologia , Síndrome do Túnel Carpal/cirurgia , Síndrome de Esmagamento/epidemiologia , Síndrome de Esmagamento/cirurgia , Radiculopatia/epidemiologia , Radiculopatia/cirurgia , Idoso , Idoso de 80 Anos ou mais , Síndrome do Túnel Carpal/diagnóstico , Síndrome de Esmagamento/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos/métodos , Procedimentos Neurocirúrgicos/tendências , Radiculopatia/diagnóstico , Estudos Retrospectivos , Resultado do Tratamento
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