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1.
Kyobu Geka ; 72(12): 989-992, 2019 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-31701908

RESUMO

Mediastinal enteric cysts are very rare among in adults and usually asymptomatic. A 54-year-old male was referred to our hospital due to an abnormal shadow incidentally found on a chest X-ray at health check. Chest computed tomography scan revealed a cystic mass in the posterior and inferior mediastinum surrounded by diaphragm, inferior vena cava, and esophagus. Based on many reports of thoracoscopic esophagectomy in the prone position in recent years, we chose thoracoscopic resection of the mediastinal tumor in the prone position with artificial pneumothorax. The prone position with artificial pneumothorax provided much better exposure of the operating field and the surgery was performed successfully.


Assuntos
Cisto Mediastínico , Pneumotórax Artificial , Esofagectomia , Humanos , Masculino , Cisto Mediastínico/cirurgia , Pessoa de Meia-Idade , Posicionamento do Paciente , Decúbito Ventral , Toracoscopia
2.
Kyobu Geka ; 72(10): 864-868, 2019 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-31582711

RESUMO

Recently, thoracoscopic esophagectomy has been widely accepted as a minimally invasive surgery and a possible standard procedure for esophageal cancer patients. Furthermore, it has an advantage for meticulous lymph node dissection by providing a magnification view and less blood loss. Mediastinal lymphadenectomy, especially upper mediastinal lymph node dissection, is a key point for esophageal cancer surgery because of its high frequency of metastasis and dissection efficacy. To avoid complications such as recurrent laryngeal nerve palsy, pneumoniae, chylothorax and unexpected injury in mediastinal lymph node dissection, detailed anatomical knowledge and careful procedures are required for surgeon. An appropriate operative procedure or technique will lead to good short- and long-term outcomes for the patients with esophageal cancer.


Assuntos
Neoplasias Esofágicas , Esofagectomia , Humanos , Excisão de Linfonodo , Mediastino , Decúbito Ventral , Estudos Retrospectivos , Toracoscopia
3.
Med. intensiva (Madr., Ed. impr.) ; 43(7): 402-409, oct. 2019. graf, tab
Artigo em Inglês | IBECS | ID: ibc-ET2-3449

RESUMO

Objective: To evaluate the clinical outcomes of patients with severe acute respiratory distress syndrome (ARDS) subjected to prone positioning before extracorporeal membrane oxygenation (ECMO). Design: A retrospective analysis of a multicenter cohort was carried out. Setting: Patients admitted to the Intensive Care Units of 11 hospitals in Korea. Patients: Patients were divided into those who underwent prone positioning before ECMO (n=28) and those who did not (n=34). Interventions: None. Variables of interest: Thirty-day mortality, ECMO weaning failure rate, mechanical ventilation weaning success rate, mechanical ventilation-free days at day 60. Results: The prone group had lower median peak inspiratory pressure and lower median dynamic driving pressure before ECMO. Thirty-day mortality was 21% in the prone group and 41% in the non-prone group (p=0.098). The prone group also showed a lower ECMO weaning failure rate, and a higher mechanical ventilation weaning success rate and more mechanical ventilation-free days at day 60. In the non-prone group, median dynamic compliance marginally decreased shortly after ECMO, but no significant change was observed in the prone group. Conclusions: Prone positioning before ECMO was not associated to increased mortality and tended to exert a protective effect


Objetivo: Evaluar los resultados clínicos de pacientes con síndrome de dificultad respiratoria aguda (SDRA) quienes fueron colocados en decúbito prono previo a la oxigenación con membrana extracorpórea (ECMO). Diseño: Análisis retrospectivo de una cohorte multicéntrico. Escenario: Pacientes admitidos en las unidades de cuidado intensivo de 11 hospitales en Corea. Pacientes: Los pacientes fueron divididos en aquellos que fueron colocados en decúbito prono antes de la ECMO (n=28) y aquellos que no fueron colocados en decúbito prono antes de la ECMO (n=34). Intervenciones: Ninguna. Variables de interés principales: Mortalidad a los 30 días, tasa de fracaso de retirada gradual de la ECMO, tasa de éxito de retirada gradual de la ventilación mecánica, días sin ventilación mecánica a los 60 días. Resultados: El grupo prono tuvo una mediana más baja de la presión inspiratoria máxima y una mediana más baja de la presión de conducción dinámica antes de la ECMO. La mortalidad a los 30 días fue 21% en el grupo prono y 41% en el grupo no prono (P = 0.098). El grupo prono también mostró un valor numérico menor de tasa de fracaso de retirada progresiva de la ECMO, y valores más altos de tasa de éxito de destete de la ventilación mecánica y días sin ventilación mecánica a los 60 días. En el grupo no prono, la mediana del cumplimiento dinámico descendió marginalmente, poco después de ECMO, pero no se observó un cambio significativo en el grupo prono. Conclusiones: La colocación en decúbito prono antes de la ECMO no se asoció con un incremento en mortalidad y tendió a ser de protección


Assuntos
Humanos , Decúbito Ventral/fisiologia , Oxigenação por Membrana Extracorpórea/métodos , Síndrome do Desconforto Respiratório do Adulto/terapia , Posicionamento do Paciente/métodos , Estudos de Coortes , Estudos Retrospectivos , Fatores de Risco , Análise Multivariada , Síndrome do Desconforto Respiratório do Adulto/mortalidade
6.
World Neurosurg ; 131: 38-42, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31369880

RESUMO

BACKGROUND: Venous air embolism (VAE) is a rare but, frequently, fatal complication that can occur during surgery. Several reported studies have shown visible bubbling of air at the surgical site as the first clinical indication of VAE-induced cardiovascular collapse during prone-position spine surgery. However, to the best of our knowledge, video imaging of this phenomenon has not been previously reported. CASE DESCRIPTION: A 41-year-old man had undergone cervical laminoplasty for ossification of the posterior longitudinal ligament and thoracic laminectomy for ossification of the posterior longitudinal ligament and ossification of the ligamentum flavum in the prone position. The entire surgery was recorded with video imaging. Before cardiac arrest due to the massive VAE, visible air bubbling had been observed at the operated site of the thoracic laminectomy, and this phenomenon had been incidentally recorded with the video. The patient recovered with cardiopulmonary resuscitation and intensive treatment against severe acute respiratory distress syndrome due to pulmonary damage. CONCLUSIONS: The present case report offers the first video imaging evidence of intraoperative visible air bubbling as a sign of a massive VAE during prone-position spine surgery. To the best of our knowledge, this is also the first report of intraoperative VAE in a patient with extensive ossification of the spinal ligaments.


Assuntos
Embolia Aérea/complicações , Parada Cardíaca/etiologia , Complicações Intraoperatórias , Ligamento Amarelo/cirurgia , Ossificação do Ligamento Longitudinal Posterior/cirurgia , Decúbito Ventral , Síndrome do Desconforto Respiratório do Adulto/etiologia , Adulto , Reanimação Cardiopulmonar , Vértebras Cervicais/cirurgia , Parada Cardíaca/terapia , Humanos , Masculino , Ossificação Heterotópica/cirurgia , Vértebras Torácicas/cirurgia , Tomografia Computadorizada por Raios X
7.
Crit Care Nurs Q ; 42(4): 371-375, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31449147

RESUMO

Adult respiratory distress syndrome (ARDS) is a clinical entity characterized by hypoxemic respiratory failure in the setting of noncardiogenic pulmonary edema. It is associated with significant morbidity and mortality. Prone positioning is a beneficial strategy in patients with severe ARDS because it improves alveolar recruitment, ventilation/perfusion (V/Q) ratio, and decreases lung strain. The outcome is improved oxygenation, decreased severity of lung injury, and, subsequently, mortality benefit. In this article, we discuss the physiology of prone positioning on chest mechanics and V/Q ratio, the placement and maintenance of patients in the prone position with use of a prone bed and the current literature regarding benefits of prone positioning in patients with ARDS.


Assuntos
Decúbito Ventral/fisiologia , Síndrome do Desconforto Respiratório do Adulto/fisiopatologia , Síndrome do Desconforto Respiratório do Adulto/terapia , Humanos , Hipóxia/etiologia , Alvéolos Pulmonares/fisiologia , Edema Pulmonar/etiologia , Respiração Artificial/efeitos adversos
8.
Int Braz J Urol ; 45(5): 956-964, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31408287

RESUMO

PURPOSE: We aimed to compare the outcomes of supine and prone miniaturized percutaneous nephrolithotomy (m-PNL) in the treatment of lower pole, middle pole and renal pelvic stones. MATERIALS AND METHODS: 54 patients who performed supine m-PNL between January 2017 and March 2018 and 498 patients who performed prone m-PNL between April 2015 and January 2018 were included in the study. Of the 498 patients, 108 matching 1: 2 in terms of age, gender, body mass index, American Association of Anesthesiology score, stone size, stone localization and hydronephrosis according to the supine m-PNL group were selected as prone m-PNL group. The patients with solitary kidney, upper pole stone, urinary system anomaly or skeletal malformation and pediatric patients (<18 years old) were excluded from the study. The success was defined as 'complete stone clearance' and was determined according to the 1st month computed tomography. RESULTS: The operation time and fluoroscopy time in supine m-PNL was significantly shorter than prone m-PNL group (58.1±45.9 vs. 80.1±40.0 min and 3.0±1.7 min vs. 4.9±4.5 min, p=0.025 and p=0.01, respectively). When post-operative complications were compared according to the modified Clavien-Dindo classification, overall and subgroup complication rates were comparable between groups. There was no significant difference between the groups in terms of the success rates (supine m-PNL; 72.2%, prone m-PNL; 71.3%, p=0.902). CONCLUSIONS: Supine m-PNL procedure is more advantageous in terms of operation time and fluoroscopy time in the treatment of lower pole, middle pole and renal pelvic stones.


Assuntos
Cálculos Renais/cirurgia , Nefrolitotomia Percutânea/métodos , Posicionamento do Paciente/métodos , Decúbito Ventral , Decúbito Dorsal , Adulto , Feminino , Fluoroscopia/métodos , Humanos , Cálculos Renais/patologia , Pelve Renal/cirurgia , Masculino , Análise por Pareamento , Pessoa de Meia-Idade , Duração da Cirurgia , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Resultado do Tratamento
9.
J Surg Res ; 243: 469-480, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31377486

RESUMO

BACKGROUND: Abdominoperineal resection (APR) is the primary surgical approach to low rectal cancers. Both prone and lithotomy patient positioning during the perineal dissection are currently acceptable approaches. There is no consensus on whether patient positioning has an impact on operative and oncologic outcomes. The aim of this review was to compare the perioperative and long-term oncologic outcomes between prone and lithotomy patient positioning. MATERIALS AND METHODS: Search of Medline, Embase, Web of Science, CENTRAL, PubMed, and ClinicalTrials.gov databases was performed. Articles were eligible for inclusion if they compared prone and lithotomy positioning for the perineal portion of APR for rectal cancer in one of the primary outcomes. Quality of included studies was assessed using Newcastle-Ottawa Scale and Cochrane Risk of Bias Tool. RESULTS: Nine studies with 888 patients in the prone group and 897 in the lithotomy group were included. Compared with lithotomy position, prone position had a significantly lower perforation rate (risk ratio: 0.50, 95% confidence interval [CI]: 0.32 to 0.79, P = 0.003) and rates of positive circumferential resection margin involvement (risk ratio: 0.66, 95% CI: 0.44 to 1.00, P = 0.05). Prone position also had a significantly shorter operative time than lithotomy position (mean difference: -45.20 min, 95% CI: -63.03 to -27.36, P < 0.00001). Positioning did not affect 5-y overall survival or local and distal recurrence. CONCLUSIONS: Prone positioning may lead to lower rates of perforation and circumferential resection margin involvement in APR. In addition, it may lead to shorter operative time. Larger randomized studies are required to confirm the results of this review and examine the difference in long-term outcomes.


Assuntos
Períneo/cirurgia , Decúbito Ventral , Neoplasias Retais/cirurgia , Humanos , Duração da Cirurgia , Complicações Pós-Operatórias , Decúbito Dorsal
10.
Med Sci Monit ; 25: 5878-5885, 2019 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-31389405

RESUMO

BACKGROUND Advances in percutaneous nephrolithotomy (PCNL) have resulted in smaller devices that cause less trauma and bleeding, while flexible ureterorenoscopy (f-URS) allows access to any calyces. These methods are often used in isolation, but used in combination they may improve treatment of complex renal calculi. This study assessed the effectiveness and complications of f-URS combined with super-mini-PCNL (SMP) to treat complex renal calculi. MATERIAL AND METHODS A retrospective cohort analysis was made of patients with unilateral complex renal stones treated between March 2013 and December 2016. Patients were grouped according to surgical procedure: SMP (SMP Group), f-URS holmium laser lithotripsy (f-URS Group), and combined SMP and f-URS (Combined Group). The postoperative complications and complete stone-free rate were analyzed and compared among the 3 groups. RESULTS A total of 140 patients with complex renal stones were included: 40 patients in the SMP Group, 55 in the f-URS Group, and 45 in the Combined Group. The complete stone-free rate 3 days after the procedure was 77.5% in the SMP Group, 78.2% in the f-URS Group, and 97.8% in the Combined Group (p=0.010). The operation time, intraoperative blood loss, and hospitalization time of the Combined Group were all significantly lower than those in the SMP Group but higher than those in the f-URS Group. The follow-up was 9 months (range, 6-12 months). There were no medium-term complications reported. CONCLUSIONS SMP combined with f-URS holmium laser lithotripsy in the prone position is an effective treatment for complex renal calculi.


Assuntos
Cálculos Renais/cirurgia , Nefrolitotomia Percutânea/métodos , Ureteroscopia/métodos , Adulto , Idoso , Perda Sanguínea Cirúrgica , Estudos de Coortes , Feminino , Humanos , Rim/patologia , Cálculos Renais/terapia , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Complicações Pós-Operatórias , Decúbito Ventral , Estudos Retrospectivos , Resultado do Tratamento
11.
Rev Assoc Med Bras (1992) ; 65(6): 839-844, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31340314

RESUMO

OBJECTIVE: To verify the association between prone position, increased diuresis, and decreased cumulative fluid balance in critically ill pediatric patients who underwent mechanical ventilation (MV) for pulmonary causes and describe adverse events related to the use of the position. METHODS: This is a retrospective observational study. Patients aged between 1 month and 12 years who underwent MV for pulmonary causes, between January 2013 and December 2015, were selected and divided between those who were put on prone position (PG) and those who were not (CG) during the hospitalization at the Pediatric Intensive Care Unit (PICU). Data were analyzed longitudinally from D1 to D4. RESULTS: A total of 77 patients (PG = 37 and CG = 40) were analyzed. The general characteristics of both groups were similar. In the comparison between the groups, there was no increase in diuresis or decrease in cumulative fluid balance in the prone group. In the longitudinal analysis of D1 to D4, we saw that the PG presented higher diuresis (p = 0.034) and a lower cumulative fluid balance (p = 0.001) in D2. Regarding the use of diuretics, there was greater use of furosemide (P <0.001) and spironolactone (P = 0.04) in the PG. There was no increase in adverse events during the use of the prone position. CONCLUSION: The prone position was not associated with increased diuresis or decreased cumulative fluid balance in critically ill pediatric patients who underwent to MV for pulmonary causes.


Assuntos
Diurese/fisiologia , Decúbito Ventral/fisiologia , Respiração Artificial/efeitos adversos , Equilíbrio Hidroeletrolítico/fisiologia , Criança , Pré-Escolar , Estado Terminal , Feminino , Humanos , Lactente , Recém-Nascido , Tempo de Internação/estatística & dados numéricos , Masculino , Respiração Artificial/mortalidade , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
13.
Rozhl Chir ; 98(6): 256-259, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31331183

RESUMO

INTRODUCTION: This case report describes bleeding from an iatrogenic thoracic aortic injury in minimally invasive thoracoscopic esophagectomy. CASE REPORT: A 53-year-old man underwent neoadjuvant radiochemotherapy for adenocarcinoma of the esophagus with positive lymph nodes. PET/CT showed only a partial response after neoadjuvant therapy. Minimally invasive thoracoscopic esophagectomy in the semi-prone position with selective intubation of the left lung was performed. However, massive bleeding from the thoracic aorta during separation of the tumor resulted in conversion from minimally invasive to conventional right thoracotomy. The bleeding was caused by a five millimeter rupture of the thoracic aorta. The thoracic aortic rupture was treated by suture with a gore prosthesis in collaboration with a vascular surgeon. Esophagestomy was not completed due to hypovolemic shock. Hybrid transhiatal esophagectomy was performed on the seventh day after the primary operation. Definitive histological examination showed T3N3M0 adenocarcinoma. CONCLUSION: Esophagectomy for cancer of the esophagus is one of the most difficult operations in general surgery in which surgical bleeding from the surrounding structures cannot be excluded. Aortic hemorrhage is hemodynamically significant in all cases and requires urgent surgical treatment.


Assuntos
Neoplasias Esofágicas , Esofagectomia , Doença Iatrogênica , Neoplasias Esofágicas/cirurgia , Esofagectomia/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Decúbito Ventral , Toracoscopia
14.
J Forensic Leg Med ; 66: 134-137, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31301637

RESUMO

PURPOSE: The purpose of the work is to show and compare three reported cases of Excited Delirium Syndrome, which happened in Warsaw, Poland, from 2013 to 2017. We compared the results of three autopsy and toxicological findings of unexpectedly deceased males and the circumstances of their death, based on the police records. RESULTS: There were no significant findings of chronic diseases or multiple traumas leading us to the clear explanation of cause of death. We noted a rapid cardiopulmonary failure accompanied by drug abuse in all three cases, that happened following a stressful stimulus, evoked by a police restraint in prone position. All patients resembled similar external characteristics and BMI and had used drugs before death. CONCLUSION: A lack of the autopsy findings suggests the Excited Delirium Syndrome as a cause of death. The syndrome may be diagnosed after death, following the definition of exclusion of other somatic causes of death, preceded by symptoms during a stressful event. The syndrome occurs in overweight males, abusing especially stimulants. The physical restraint plays an important role in the initiation of the symptoms. The pathophysiology of the syndrome is poorly understood, but some theories underline dopamine transporters stimulation. To this day, there are no published Excited Delirium guidelines for forensic specialists or pathologists.


Assuntos
Morte Súbita/etiologia , Delírio/diagnóstico , Restrição Física/efeitos adversos , Transtornos Relacionados ao Uso de Substâncias/complicações , Adulto , Índice de Massa Corporal , Humanos , Masculino , Entorpecentes/análise , Obesidade/complicações , Polícia , Prisioneiros , Decúbito Ventral , Detecção do Abuso de Substâncias
15.
Dtsch Med Wochenschr ; 144(14): 978-981, 2019 07.
Artigo em Alemão | MEDLINE | ID: mdl-31311048

RESUMO

The Acute Respiratory Distress Syndrome is still a very severe condition in intensive care patients. Prone positioning is known to improve outcome in patients with moderate to severe ARDS. Therefore proning in these patients is nowadays to be regarded as a standard of care. The risks of proning are reasonably low - if proning is done correctly. Therefore a method of proning in a step-by-step-approach is shown in this article.


Assuntos
Posicionamento do Paciente/métodos , Decúbito Ventral/fisiologia , Respiração Artificial/métodos , Cuidados Críticos/métodos , Humanos , Síndrome do Desconforto Respiratório do Adulto/terapia
16.
Int J Surg ; 68: 142-147, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31276834

RESUMO

BACKGROUND: The diagnosis of anterior cruciate ligament tear can be made by physical examination and magnetic resonance imaging (MRI) in the supine position. In cases where the tear is partially evaluated on MRI, the choice of treatment may vary. The purpose of the study was to investigate the efficiency of MRI at maximum knee flexion in the prone position and to compare the images with findings of the ACL detected during surgery. MATERIALS AND METHODS: Sixty-one patients with partial ACL tears with meniscal and cartilage lesions requiring arthroscopic knee surgery were included in the study between 2017 and 2019. MRI of these patients was prescribed at maximum knee flexion in the prone position. Then, an arthroscopic operation was performed on 61 patients and the findings (intact, partial or total tear of ACL) were recorded. The ACL was evaluated as being intact and partial or total tear. The statistical significance of the efficacy of MRI in the supine position with the knee at maximum flexion in the prone position was compared. RESULTS: It was found that, of 61 patients with suspected partial ACL tears, 25 patients had intact ACLs, 22 patients had partial tears and 14 patients had total ACL tears, through the interpretation of MRIs of the prone position by the radiologist. In the arthroscopic surgery of 61 patients, 20 patients had intact ACLs, 27 patients had a partial tear and 14 patients had a total tear. The MRI results with maximum knee flexion in the prone position were more compatible with the findings of the arthroscopic surgery. CONCLUSIONS: It could be considered that MRI with maximum knee flexion in the prone position may also be guiding in the diagnosis and treatment of patients with partial anterior cruciate ligament rupture.


Assuntos
Lesões do Ligamento Cruzado Anterior/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Adolescente , Adulto , Lesões do Ligamento Cruzado Anterior/cirurgia , Artroscopia , Estudos de Casos e Controles , Feminino , Humanos , Articulação do Joelho/cirurgia , Masculino , Decúbito Ventral , Adulto Jovem
18.
Emerg Med Clin North Am ; 37(3): 431-444, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31262413

RESUMO

Acute hypoxemic respiratory failure (AHRF) is a common challenge in emergency medicine. Patient outcomes depend on interventions performed during preintubation, intubation, and postintubation. The article presents recommendations for evidence-based practice to optimally manage patients with AHRF and the acute respiratory distress syndrome.


Assuntos
Hipóxia/terapia , Respiração Artificial , Insuficiência Respiratória/terapia , Algoritmos , Medicina de Emergência , Oxigenação por Membrana Extracorpórea , Hidratação , Glucocorticoides/uso terapêutico , Humanos , Hipóxia/complicações , Hipóxia/epidemiologia , Bloqueadores Neuromusculares/uso terapêutico , Oxigenoterapia , Decúbito Ventral , Síndrome do Desconforto Respiratório do Adulto/terapia , Insuficiência Respiratória/epidemiologia , Insuficiência Respiratória/etiologia , Volume de Ventilação Pulmonar , Vasodilatadores/uso terapêutico , Lesão Pulmonar Induzida por Ventilação Mecânica/prevenção & controle
19.
World Neurosurg ; 130: e933-e940, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31302276

RESUMO

OBJECTIVE: To assess outcomes in obese patients with chronic obstructive pulmonary disease (COPD) who sustained an osteoporotic vertebral compression fracture (OVCF) treated by percutaneous vertebroplasty (PVP) in the improved prone position and right lateral position. METHODS: Between January 2015 and May 2016, a total of 60 patients were enrolled in this randomized controlled study. Patients in group A were placed in the improved prone position for a bilateral transpedicular technique, and those in group B were placed in the right lateral position for a left transverse process-pedicle approach. Clinical and radiologic outcomes were assessed and compared between the 2 groups during the 12-month follow-up period. RESULTS: All operations were successfully completed without any serious sequelae. The operation time, fluoroscopic time, scores for respiratory condition during the operation, intravertebral cement volume, and incidence of cement leakage were significantly greater in group A compared with group B (P < 0.01). During the follow-up period, all patients in both groups experienced significant improvement in pain relief. Satisfactory functional improvement was obtained at 3 months postoperatively. CONCLUSIONS: Treatment of obese patients with COPD suffering from painful OVCF by PVP in both the improved prone position with a bilateral technique and the right lateral position with a unilateral technique was relatively safe and effective. However, unilateral PVP in the right lateral position was associated with a shorter operation time, limited fluoroscopic time, and minimal cement leakage.


Assuntos
Fraturas por Compressão/cirurgia , Obesidade/cirurgia , Fraturas por Osteoporose/cirurgia , Posicionamento do Paciente/métodos , Doença Pulmonar Obstrutiva Crônica/cirurgia , Fraturas da Coluna Vertebral/cirurgia , Vertebroplastia/métodos , Idoso , Feminino , Seguimentos , Fraturas por Compressão/diagnóstico por imagem , Fraturas por Compressão/epidemiologia , Humanos , Masculino , Obesidade/diagnóstico por imagem , Obesidade/epidemiologia , Fraturas por Osteoporose/diagnóstico por imagem , Fraturas por Osteoporose/epidemiologia , Dor/diagnóstico por imagem , Dor/epidemiologia , Dor/cirurgia , Manejo da Dor/métodos , Decúbito Ventral , Doença Pulmonar Obstrutiva Crônica/diagnóstico por imagem , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Fraturas da Coluna Vertebral/diagnóstico por imagem , Fraturas da Coluna Vertebral/epidemiologia , Resultado do Tratamento
20.
Phys Ther ; 99(6): 807-816, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-31155666

RESUMO

BACKGROUND: Associative learning is the ability to discover a relationship between two or more events. We combined principles of learning and technology to develop a paradigm to assess associative learning in prone. PURPOSE: The purpose of this study was to determine whether 3- to 6-month-old infants can demonstrate: (1) short-term learning of an association between their upper body movements in prone and activation of a toy, and (2) retention of the association learned on day 1, 24 hours later. METHODS: Twenty-eight infants who were 3 to 6 months of age and who were typically developing were tested for 2 consecutive days in an instrumented play gym. Both days of testing had a baseline and 4 acquisition phases (2 minutes each). During the acquisition phase, the toy activated for a maximum of 10 seconds when the infant's head was above a threshold. A criterion was set a priori to distinguish infants as short-term learners and retainers of the association learned on day 1. RESULTS: Of 28 infants, 22 and 14 infants completed all phases of the testing on day 1 and day 2, respectively. Fourteen (50%) of the infants met the criteria for short-term learners. On day 2, there was an analyzable sample of 9 short-term learners. Three of the 12 short-term learners (25%) demonstrated retention on day 2. CONCLUSION: Consistent with prior infant motor learning research, half of the infants demonstrated associative learning in this novel assessment in prone; however, based on study criteria, the infants had limited retention of the association on day 2.


Assuntos
Desenvolvimento Infantil/fisiologia , Aprendizagem/fisiologia , Decúbito Ventral/fisiologia , Desempenho Psicomotor/fisiologia , Feminino , Humanos , Lactente , Masculino , Atividade Motora/fisiologia
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