ABSTRACT
Alveolar capillary dysplasia with misalignment of the pulmonary veins (ACD/MPV) is a rare and lethal interstitial lung disorder, caused by a congenital abnormality affecting the development of the parenchyma and pulmonary vessels. We report the case of a newborn at the end of 40 weeks of pregnancy, who showed no cardiopulmonary anomalies in prenatal control ultrasounds. However, after delivery, pulmonary hypertension and hypoxemic respiratory failure became apparent. She died after 12 days from refractory hemodynamic and respiratory failure despite intensive therapy. A surgical lung biopsy and clinical autopsy were performed, both revealing the same histopathological signs consistent with this disorder. In our case, the findings of digestive and genital malformations, together with the genetic result of the alteration in the FOXF1 gene, led us to conclude the definitive diagnosis of alveolar capillary dysplasia.
Subject(s)
Autopsy , Lung , Persistent Fetal Circulation Syndrome , Pulmonary Alveoli , Humans , Infant, Newborn , Female , Persistent Fetal Circulation Syndrome/pathology , Lung/pathology , Lung/abnormalities , Fatal Outcome , Pulmonary Alveoli/pathology , Pulmonary Alveoli/abnormalities , Biopsy , Pulmonary Veins/abnormalities , Pulmonary Veins/pathology , Forkhead Transcription Factors/genetics , Forkhead Transcription Factors/analysis , Pregnancy , Respiratory Insufficiency/etiology , Hypertension, Pulmonary/etiology , Hypertension, Pulmonary/pathologyABSTRACT
ABSTRACT Objective: To conduct a comparative study of the results obtained in the treatment of adolescent idiopathic scoliosis (AIS) with different types of fixations (traditional, selective and multiple), and to evaluate the correction of angular deformity in the frontal plane by the Cobb and sacral clavicular angle (SCA) methods. Methods: A study of a group of 278 patients with AIS who underwent selective, traditional, and multiple fixation surgeries. Results: Significant corrections of both the Cobb angle and the SCA were observed. Conclusions: In the multiple fixation surgeries there was a 100% correction between the preoperative and postoperative SCA values and a 50% correction in the traditional and selective fixations, a difference considered significant. Regarding the Cobb angle, the three fixations presented corrections between preop and postop with significant differences. Level of evidence III; Retrospective Study.
RESUMO Objetivo: Realizar um estudo comparativo dos resultados obtidos no tratamento da escoliose idiopática do adolescente (EIA) com diferentes tipos de fixação tradicional, seletiva e múltipla e avaliar a correção da deformidade angular no plano frontal pelo método de Cobb e do â ngulo sacro clavicular (ASC). Métodos: Estudo de um grupo de 278 pacientes com EIA operados com fixações seletiva, tradicional e múltipla. Resultados: Observou-se correção significativa tanto do ângulo de Cobb quanto do ASC. Conclusões: Nas cirurgias com fixação múltipla constatou-se, entre pré-operatório (pré-op) e pós-operatório (pós-op), uma correção de 100% do ASC, e com as fixações tradicional e seletiva a correção foi de 50%, diferença que se considerou significativa. Com relação ao ângulo de Cobb as três fixações resultaram em correções entre o pré-op e o pós-op com diferença considerada significativa. Nível de evidência III; Estudo retrospectivo.
RESUMEN Objetivo: Realizar un estudio comparativo de los resultados obtenidos en el tratamiento de la escoliosis idiopática del adolescente (EIA) con diferentes tipos de fijación: tradicional, selectiva y múltiple, y evaluar la corrección de la deformidad angular en el plano frontal mediante el método de Cobb y del ángulo sacro clavicular (ASC). Métodos: Estudio de un grupo de 278 pacientes con EIA operados con fijaciones selectiva, tradicional y múltiple. Resultados: Se observó corrección significativa tanto del ángulo de Cobb como del ASC. Conclusiones: En las cirugías con fijación múltiple se constató, entre preoperatorio (pre-op) y postoperatorio (post-op), una corrección de 100% del ASC, y con las fijaciones tradicional y selectiva la corrección fue de 50%, diferencia que se consideró significativa. Con relación al ángulo de Cobb las tres fijaciones resultaron en correcciones entre pre-op y post-op con diferencia considerada significativa. Nivel de evidencia III; Estudio Retrospectivo.
Subject(s)
Humans , Scoliosis , Spinal Diseases , Spine/abnormalitiesABSTRACT
OBJECTIVES: To compare self-extraction with and without a cervical collar in subjects at low risk of cervical spine injuries. MATERIAL AND METHODS: Simulation study analyzing biomechanical data from inertial sensors to detect misalignment of the cervical spine during self-extraction with and without a cervical collar. RESULTS: Misalignment was a mean (SD) 3.12 (34.62) degrees greater during self-extraction with a Stiffneck collar in place (95% CI, -15.33 to 21.57 degrees; P=.7234) than during extraction without a collar. Misalignment was also greater, by 5.95 (31.76) degrees, with an X-collar in place (95% CI, -10.98 to 22.87; P=.4654) than without a collar. The between-collar comparison of differences showed that misalignment was 2.83 (12.10) degrees greater with the X-collar (95% CI, -3.62 to 9.27 degrees; P=.3650). CONCLUSION: Misalignment of the cervical spinal column is similar during self-extraction with or without a cervical collar in place.
OBJETIVO: Comparar la autoextracción (AE) frente a la AE con collarines en sujetos con bajo riesgo de lesión cervical. METODO: Estudio de simulación mediante análisis biomecánico con sensores inerciales, determinando la desalineación de la columna cervical durante la AE con y sin collarines cervicales. RESULTADOS: El desequilibrio fue 3,12 (DE 34,62) grados mayor con el collarín STIFNECK (SN) (IC al 95% de 15,33 a 21,57; p =0,7234) que con AE y también 5,95 (DE 31,76) grados mayor con collarín X-COLLAR (XC) (IC al 95% de 10,98 a 22,87; p = 0,4654) que con AE. Cuando comparamos la AE con los diferentes tipos de collarines, observamos que con el collarín XC se produjeron 2,83 (DE 12,10) grados de desalineación más que con el collarín SN (IC al 95% de 3,62 a 9,27; p = 0,3650). CONCLUSIONES: La desalineación de la columna cervical mediante la AE es similar a la provocada cuando se aplican collarines cervicales.
Subject(s)
Accidents, Traffic , Cervical Vertebrae/injuries , Neck Injuries/prevention & control , Protective Devices , Restraint, Physical/instrumentation , Spinal Injuries/prevention & control , Adult , Biomechanical Phenomena , Female , Healthy Volunteers , Humans , Male , Middle Aged , Neck Injuries/etiology , Outcome Assessment, Health Care , Risk , Spinal Injuries/etiologyABSTRACT
Spinal misalignments are a common reason for consultation at primary care centers and specialized departments. Misalignment has diverse causes and is influenced by multiple factors: in adolescence, the most frequent misalignment is scoliosis, which is idiopathic in 80% of cases and normally asymptomatic. In adults, the most common cause is degenerative. It is important to know the natural history and to detect factors that might predict progression. The correct diagnosis of spinal deformities requires specific imaging studies. The degree of deformity determines the type of treatment. The aim is to prevent progression of the deformity and to recover the flexibility and balance of the body.