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Objective: To observe the efficacy of warm needling moxibustion plus intra-articular injection of sodium hyaluronate for hip involvement in ankylosing spondylitis (AS). Methods: A total of 60 patients with hip involvement in AS were randomly divided into a control group and an observation group, with 30 cases in each group. The patients in the control group were given an intra-articular injection of sodium hyaluronate, once a week. The patients in the observation group were given additional warm needling moxibustion, once a day, with a 2-day interval after five consecutive days of treatment. After 5 weeks, changes in such indicators as visual analog scale (VAS) score, Harris score, Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), serum cartilage oligomeric matrix protein (COMP), interleukin (IL)-17 were observed, and the efficacy was evaluated. Six months after treatment, Bath ankylosing spondylitis radiology index-hip (BASRI-hip) was evaluated. Results: After treatment, the total effective rate in the observation group was higher than that in the control group (P<0.05). After treatment, the VAS scores in both groups were lower than those before treatment (P<0.05), and the score of the observation group was lower than that of the control group (P<0.05). After treatment, the Harris scores of both groups were higher than those before treatment (P<0.05), and the score of the observation group was higher than that of the control group (P<0.05). Six months after treatment, the BASRI-hip score of the control group was higher than that before treatment (P<0.05), while the score of the observation group was not significantly different from that before treatment (P>0.05) and was lower than that of the control group (P<0.05). After treatment, the scores of BASDAI and BASFI of both groups were lower than those before treatment (P<0.05), and the scores of the observation group were lower than those of the control group (P<0.05). After treatment, the levels of serum COMP and IL-17 of both groups were lower than those before treatment (P<0.05), and the levels of the observation group were lower than those of the control group (P<0.05). Conclusion: The efficacy of warm needling moxibustion plus intra-articular injection of sodium hyaluronate for hip involvement in AS is better than the intra-articular injection of sodium hyaluronate alone. This combined approach can alleviate hip pain, improve hip functions, delay the destruction of the hip, prevent AS development, and reduce the levels of serum COMP and IL-17.
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El ejercicio terapéutico es una modalidad de intervención aplicada por el fisioterapeuta para las limitaciones y alteraciones funcionales que causan restricciones en los roles de los individuos. Objetivo: identificar los efectos del ejercicio terapéutico en pacientes quemados mediante la revi-sión de literatura actualizada disponible. Método: se realizó una revisión de literatura científica de 17 estudios publicados en materia de ejercicio terapéutico en paciente quemado, se revisaron publicaciones en inglés, español y portugués en las bases de datos Pubmed y PEDro, en la biblio-teca virtual Scielo y se integró información de libros en medios impresos y referencias bibliográ-ficas online. Resultados: las intervenciones con ejercicio terapéutico mostraron gran variabilidad, no obstante, los estudios reportan efectos positivos en varios aspectos relacionados con el movi-miento y la mejoría en la funcionalidad Discusión: La evidencia demostró efectos positivos del ejercicio terapéutico en la mejoría funcional y calidad de vida del paciente quemado. La rehabili-tación mediante ejercicio estructurado es una estrategia segura y eficaz para restaurar la función física general en las víctimas de quemaduras
The therapeutic exercise is an intervention modality applied by the physiotherapist for limi-tations and functional alterations that cause restrictions in the roles of individuals. Objective: to identify the effects of the therapeutic exercise in burned patients through reviewing availa-ble updated literature. Method: a literature review of 17 published researches was conducted to determine the effectiveness of therapeutic exercise in burned patients. Publications in English, Spanish and Portuguese were reviewed in the Pubmed and PEDro databases through the Scielo virtual library and integrated. Printed books and online bibliographical references were reviewed aswell. Results: the interventions with a therapeutic exercise showed a great variability, never-theless, the studies report positive effects in different aspects related with the movement and the functionality improvement. Discussion: The evidence showed positive effects of the therapeutic exercise on the functional improvement and quality of life of the burned patient. The rehabilita-tion made through a structured exercise is a reliable and effective strategy to restore the general physical function in burn victims.
Subject(s)
Humans , Burns , Exercise Therapy , Physical Therapy Specialty , Wounds and InjuriesABSTRACT
RESUMEN INTRODUCCIÓN: Los pacientes con trauma craneoencefálico severo pueden tener secuelas neurológicas graves que generan discapacidad de rangos diferentes según la escala de Barthel. La alteración del estado de consciencia es la secuela más grave y es causa de dependencia completa de estos pacientes por la pérdida del autocuidado. La relación entre los hallazgos anormales en las neuroimágenes y los diferentes estados de conciencia ha sido objeto de investigación en los últimos años, con la posibilidad de que existan nuevas opciones con el posproceso de imágenes obtenidas por resonancia magnética nuclear. Este estudio pretende describir las alteraciones en la difusibilidad media haciendo posproceso en la secuencia de DWI en 4 pacientes con trauma craneoencefálico severo y alteración del estado de consciencia, quienes en la fase aguda del trauma fueron estudiados con imágenes convencionales de tomografía y resonancia. MATERIALES Y MÉTODOS: Se describe una serie de 4 casos de pacientes con trauma craneoencefálico severo y alteración del estado de consciencia a quienes se realizó resonancia cerebral simple. Las imágenes fueron sometidas a un posproceso de la secuencia de DWI analizando diferentes regiones por donde transcurren las fibras del sistema reticular activador ascendente (SRAA) (cuerpos restiformes, rafe medio del mesencéfalo, tálamo, regiones subinsulares y lóbulos frontales basales). Igualmente se tomaron valores de difusibilidad en regiones similares, en 5 sujetos sin alteración estructural cerebral tomados como controles. RESULTADOS: Se encontró disminución en la difusibilidad media en las diferentes regiones establecidas en el estudio, que tuvieron diferente localización en cada paciente. Los valores disminuyeron aproximadamente en un 50 % respecto a los del grupo control, observando lesiones en áreas que no fueron identificadas en la interpretación de la imagen cuando fue adquirida durante el trauma. CONCLUSIONES: El posproceso de la secuencia DWI muestra disminución en los valores de difusibilidad media en regiones por donde transcurren las vías del sistema reticular activado ascendente, estos cambios que explican las diferentes alteraciones en el estado de conciencia, no fueron visualizados en las imágenes interpretadas bajo las técnicas convencionales. Se requiere nuevos estudios para establecer las características operativas de la prueba que permitan definir su potencial utilidad dentro de los algoritmos de clasificación inicial de los pacientes con trauma craneoencefálico severo.
SUMMARY INTRODUCTION: Patients with severe traumatic brain injury may have severe neurological sequelae that generate disability of different ranges, according to the Barthel scale. The consciousness impairment is the most serious sequela and is a cause of complete dependence of these patients, due to the loss of self-care. The relationship between abnormal findings in neuroimaging and different states of consciousness has been the subject of research in recent years, with the possibility of new options with the post-processing of magnetic resonance imaging (MRI). This study aims to describe the alterations in the mean diffusivity by post-processing of the diffusion weighted imaging (DWI) sequence in 4 patients with severe traumatic brain injury and impairment of consciousness, who were studied with computed tomography (CT) and MRI in the acute phase of the trauma. MATERIALS AND METHODS: We describe a series of 4 cases of patients with severe traumatic brain injury and impaired consciousness in whom a non-enhanced brain MRI was performed. The DWI sequence images were post-processed, analyzing different regions through which the fibers of the Ascending Reticular Activating System (ARAS) (including restiform bodies, midbrain, thalamus, sub-insular regions and basal frontal lobes) pass. Likewise, diffusivity values were taken in similar regions, in 5 subjects without any structural brain abnormality, who were taken as controls. RESULTS: There was a decrease in mean diffusivity in the different regions established in the study, which had different locations in each patient. Values decreased approximately 50 percent from values in normal patients. After post-processing, some lesions were observed in areas that were not identified in the initial MRI interpretation during the trauma. CONCLUSIONS: The post-processing of the DWI sequence shows a decrease in the mean diffusivity values in regions where the ARAS pathways pass through. These changes explaining the different alterations in consciousness were not visualized in the images interpreted under conventional MRI techniques. New studies are required to establish the operative characteristics of this test, that allow to define its potential utility within the algorithms of initial classification of patients with severe traumatic brain injury.
Subject(s)
Reticular Formation , Diffusion Magnetic Resonance Imaging , Brain Injuries, TraumaticABSTRACT
Alveólise é uma patologia ósseo-gengival caracterizada pela exposição da raiz dentária na cavidade oral, em função da reabsorção da tábua óssea alveolar, comumente relacionada ao traumatismo dentário e/ou cárie dentária. Considerada de baixa ocorrência, geralmente, acomete crianças do sexo masculino entre 4 e 5 anos de idade. O objetivo deste trabalho foi relatar um caso clínico de alveólise em dente decíduo anterior, em uma criança de 6 anos de idade, com história de traumatismo dentário na região anterior da maxila. A lesão foi diagnosticada após exame clínico de rotina. No exame físico intraoral, observou-se a exposição do ápice radicular do dente 61, circundada por tecido levemente edemaciado e eritematoso e presença de ulceração na mucosa labial relacionada ao ápice exposto. O dente envolvido não apresentava cárie, apenas discreta fratura no ângulo incisal. O paciente apresentava uma condição bucal insatisfatória, caracterizada pela presença generalizada de biofilme dental visível e cárie precoce e severa da infância. No exame radiográfico não foi evidenciada reabsorção radicular no dente 61 e se constatou a presença dos incisivos centrais permanentes superiores em condições de normalidade. O diagnóstico foi de alveólise do tipo fenestração apical. O tratamento indicado foi a exodontia do dente afetado. Não houve intercorrência durante o tratamento e o pós-operatório foi satisfatório, considerando a erupção normal do dente sucessor e o restabelecimento das condições ideais de saúde bucal da criança. Concluiuse, portanto, que a alveólise é uma condição de fácil diagnóstico, tratamento simplificado e de bom prognóstico. (AU)
Alveolysis is a bone-gingival pathology characterized by the exposure of the dental root in the oral cavity, due the reabsorption of the alveolar bone, commonly related to dental trauma and/or dental caries. It is a condition of low occurrence, and usually affects male children between 4 and 5-years-old. The aim of this case report was to present a clinical case of alveolysis in a deciduous anterior tooth in a 6-year-old child with a history of dental trauma in the anterior region of the maxilla. The lesion was diagnosed after routine clinical examination. The intraoral examination revealed the radicular apex of the tooth 61, surrounded by slightly edema and erythematous tissue, and ulceration of the labial mucosa related to the exposed apex. The tooth involved had no caries , only slight fracture at the incisal angle. The patient presented an unsatisfactory oral condition, characterized by the presence of visible dental biofilm and severe early childhood caries. The radiographic exam revealed root resorption on tooth 61 and the presence of the maxillary permanent central incisors in conditions of normality. The diagnosis was of alveolysis with apical fenestration. The treatment of choice was the dental extraction of the involved tooth. There was no intercurrence during the treatment and the postoperative was satisfactory, considering the normal eruption of the successor tooth and the restoration of the child's ideal oral health conditions. Thus, it can be concluded that alveolysis is a condition of easy diagnosis, simplified treatment and good prognosis. (AU)
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Se realizó un estudio descriptivo de 35 pacientes intervenidos quirúrgicamente mediante las técnicas convencional y laparoscópica, quienes presentaron lesiones iatrogénicas de las vías biliares, en el Servicio de Cirugía General del Hospital Provincial Docente Clinicoquirúrgico "Saturnino Lora Torres" de Santiago de Cuba, en un período de 8 años (2007-2014), con vistas a caracterizarles según algunas variables de interés y determinar la mortalidad asociada. Entre los resultados preponderantes figuraron el sexo femenino y las edades de 35 a 54 años, las lesiones producidas de la colecistectomía videolaparoscópica electiva por litiasis vesicular, las formas clínicas de presentación el absceso intraabdominal con signos de peritonitis e ictericia, cuyo diagnóstico fue confirmado mediante la ecografía. Asimismo, las lesiones de tipo A y C, según la clasificación de Strasberg, fueron las más reiteradas y el procedimiento técnico reparador más común fue el drenaje y lavado de la cavidad abdominal; 88,6 % de los pacientes egresaron vivos y 4 féminas fallecieron (11,4 %), cuya causa de muerte fue el choque séptico. Pudo concluirse que el momento del diagnóstico de estas lesiones se efectuaba tardíamente, y que a pesar de la complejidad de la reparación quirúrgica, existió baja mortalidad.
A descriptive study of 35 surgically treated patients by means of conventional and laparoscopic techniques who presented iatrogenic injuries of the biliary system, was carried out in the General Surgery Service of "Saturnino Lora Torres" Teaching Clinical Surgical Provincial Hospital in Santiago de Cuba, in a 8 year period (2007-2014), with the aim of characterizing them according to some variables of interest and of determining the associated mortality. Among the predominant results there were the female sex and the ages from 35 to 54 years, the produced lesions of the elective videolaparoscopic cholecystectomy for vesicular lithiasis, the clinical forms of presentation the intraabdominal abscess with peritonitis signs and jaundice, diagnosis confirmed by means of the echography. Also, injuries A and C, according to the classification of Strasberg, were those most reiterated and the most common restorative technical procedure was drainage and washing of the abdominal cavity; 88.6% of the patients were discharged alive and 4 female patients died (11.4%) whose cause of death was the septic shock. It could be concluded that the moment of diagnosis for these lesions took place late, and that in spite of the complexity of the surgical repair, there was low mortality.
Subject(s)
Iatrogenic Disease , Intraoperative Complications , Bile Ducts/surgery , LaparoscopyABSTRACT
Objective To investigate the protective effect and possible mechanism of amentoflavone (AF) on bone marrow cells of mice injured by irradiation. Methods Primary bone marrow cells of male C57BL/6 mice were cultured and randomly divided into 4 groups (normal control, radiation control,AF 2.5μmol/L and 5μmol/L), with 3 samples in each group. After treated with AF for 12 h, the cells were injured by 12 Gy 60Coγirradiation. 6 h and 12 h post-irradiation, apoptosis was evaluated by using Hoechst 33258 stain, cell cycle was determined by flow cytometry while the level of TNF-α was tested by ELISA. Results The cell cycle arrest and apoptosis were not significantly affected by Amentoflavone. Amentoflavone (5 μmol/L)could significantly inhibit the production of TNF-α on cell supernatant of mouse bone marrow cells at 6 h or 12 h after radiation and 2.5 μmol/L Amentoflavone could significantly inhibit the production of TNF-α at 6 h after radiation. Conclusion Taken together, the data suggest that AF may have radioprotection against damage in mice bone marrow by inhibiting the production of TNF-α.
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Objective To investigate the protective effect and possible mechanism of amentoflavone (AF) on bone marrow cells of mice injured by irradiation. Methods Primary bone marrow cells of male C57BL/6 mice were cultured and randomly divided into 4 groups (normal control, radiation control,AF 2.5 μmol/L and 5 μmol/L), with 3 samples in each group. After treated with AF for 12 h, the cells were injured by 12 Gy60Co γ irradiation. 6 h and 12 h post-irradiation, apoptosis was evaluated by using Hoechst 33258 stain, cell cycle was determined by flow cytometry while the level of TNF-α was tested by ELISA. Results The cell cycle arrest and apoptosis were not significantly affected by Amentoflavone. Amentoflavone 5 μmol L) could significantly inhibit the production of TNF- α on cell supernatant of mouse bone marrow cells at 6 h or 12 h after radiation and 2.5 μmol/L Amentoflavone could significantly inhibit the production of TNF- α at 6 h after radiation. Conclusion Taken together, the data suggest that AF may have radioprotection against damage in mice bone marrow by inhibiting the production of TNF-α.
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El objetivo de la presente investigación fue el de evaluar la mortalidad al arribo (DOA) y la presencia de lesiones traumáticas (hematomas y fracturas) en canales de aves de engorde. Se realizó un estudio prospectivo de las lesiones presentes en las canales de 622 lotes (n=248.800 aves) procesados en una planta de sacrificio comercial, durante los meses de junio, julio y agosto de 2011, de acuerdo con los criterios de la inspección sanitaria. La tasa de mortalidad de las aves fue 2.54 %. El 11.8 % (29.335/248.800) de las canales evaluadas presentó algún tipo de lesión. Los hematomas generalizados (32 %), la presencia de aves ahogadas (21.6 %) y los hematomas en las puntas de las alas (18.2 %), fueron las lesiones más frecuentes. Los resultados indican fallas en las prácticas de manejo relacionadas con el bienestar animal en el presacrificio, siendo necesario desarrollar investigaciones para conocer su impacto económico, así como el entrenamiento y la capacitación del personal vinculado en el proceso.
The objective of the present study was to evaluate mortality on arrival (DOA) and the presence of traumatic injures (bruises and fractures) in broilers channels. A prospective study of lesions present in channels of 622 sets (n=248,800 birds) processed in a commercial slaughterhouse was carried out during the months of June, July and August 2011 according to the sanitary inspection criteria. The mortality rate was 2.54 %. Lesions were found in 11.8 % (29.335/248.800) of channels inspected. Generalized bruises (32 %), drowned birds (21.6 %) and bruises on the tips of the wings were the most common injures. The results indicate failure in the handling practices related to animal welfare in pre-slaughter, being necessary to develop research to know their economic impact, as well as training of personnel involved in the process.
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Se realizó un estudio descriptivo y transversal de 137 pacientes con traumatismos de tejidos blandos maxilofaciales por accidentes de ciclos, atendidos en el Servicio de Urgencia de Cirugía Maxilofacial del Hospital Provincial Docente Clinicoquirúrgico "Saturnino Lora Torres" de Santiago de Cuba, desde enero del 2008 hasta diciembre del 2009, con vistas a determinar las características clínicas y terapéuticas de estas lesiones. Entre los resultados más sobresalientes figuraron: la identificación del tipo de lesión, con predominio de las heridas contuso-incisas y contuso-avulsivas, el tercio medio facial como la región dañada con más frecuencia, y una mayor afectación en las unidades estéticas geniana, nasal y labial. Igualmente, 67 pacientes presentaron más de 3 lesiones, primaron como traumatismos asociados los craneales y alrededor de 2 terceras partes de los pacientes recibieron algún procedimiento quirúrgico menor, de los cuales, más de 90,0 % se efectuó bajo anestesia local y régimen ambulatorio.
A descriptive and cross sectional study of 137 patients with traumatisms of the maxillofacial soft tissues due to cycles accidents, assisted in the Emergency Service of Maxillofacial Surgery in "Saturnino Lora Torres" Clinical-Surgical Teaching Provincial Hospital from Santiago de Cuba was carried out from January, 2008 to December, 2009, aimed at determining the clinical and therapeutic characteristics of these lesions. Among the most relevant results there were: the identification of the lesion type, with prevalence of the contused-incisal and contused-avulsive wounds, the middle third as the most frequent injured region, and a greater damage in the genial, nasal and labial aesthetic units. Equally, 67 patients presented more than 3 lesions, the cranial traumatisms prevailed as associated lesions and around two third of the patients received other smaller surgical procedure, of which, more than 90.0% was carried out under local anesthetics and ambulatory surgery.
Subject(s)
Accidents, Traffic , Soft Tissue Injuries , Surgery, Oral , Secondary Care , Emergency Service, HospitalABSTRACT
Introducción: el síndrome de atrapamiento del nervio pudendo se caracteriza por dolor vulvar, perineal, trastornos de la incontinencia fecal y urinaria, disfunción sexual y frecuentemente dolor quemante en el talón; se encuentra también dolor clitoridio. Objetivos: presentar dos casos del síndrome de atrapamiento del nervio pudendo y su tratamiento conservador (infiltrativo). Métodos: se describen dos casos con síndrome de atrapamiento del nervio pudendo, la primera de 36 años y 7 años con dolor y la segunda con 38 años y 8 años con dolor en el hospital "Abel Santamaría Cuadrado", durante los años 2007 y 2008. Resultados: se realizó tratamiento infiltrativo con esteroides en la zona del dolor cada 4-6 sem con cuatro o 6 dosis. Conclusiones: las pacientes tuvieron mejoría clínica del dolor con el tratamiento infiltrativo.
Introduction: this syndrome is characterized by vulvar, perineal pain, fecal and urinary incontinence, sexual dysfunction, burning pain in the heel and costal ridge; clitoridean pain is also found. Objectives: to present two cases suffering from Pudendal Nerve Entrapment Syndrome, applying a conservative treatment (infiltration block). Methods: two cases suffering from Pudendal Nerve Entrapment Syndrome are described in this paper. The first one was 36 years old women with and 7 year-pain and the second one was 38 years old woman with 8 year-pain. Both were treated at Abel Santamaría Cuadrado Teaching General Hospital from 2007 to 2008. Results: infiltration block with steroids in the pain region every 4-6 week per four or 6 doses was performed. Conclusion: the patients showed significant clinical improvement of the pain and symptoms disappeared.
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Objective To review our experience in the diagnosis and surgical management of aberrant right posterior hepatic bile duct injury.Methods Twenty eight patients with aberrant right posterior hepatic bile duct injury treated at the First Affiliated Hospital of Xinjiang Medical University between January 2002 to December 2011 were studied retrospectively.According to the injury type and the time of diagnosis,these patients were divided into three groups.The first group comprised of 10 patients in whom the injury was recognized and repaired at the time of the original surgery.The second group consisted of 10 patients in whom the injured aberrant right posterior hepatic bile duct was diagnosed and treated after operation.The third group comprised of 8 patients who developed an external bile fistula after the aberrant right posterior hepatic bile duct injury.The short and long term complications after surgical repair in the three groups were compared.Results In the first group,1 patient developed an intra-abdominal fluid collection.There was no bile stricture patients in first group.In the second group,1 patient developed bile fistula,2 patients intra-abdominal fluid collections,1 patient wound infection,and 1 patient bile duct stricture.In the third group,2 patients developed bile fistula,1 patient intestinal obstruction,2 patients wound infection,1 patient intra-abdominal hemorrhage,2 patients bile duct stricture and 1 patient an incisional hernia on follow-up.Conclusions Finding and repairing an aberrant right posterior hepatic bile duct injury at the original operation is the best treatment.According to the type and time of diagnosis,different surgical repair methods can be used for the aberrant right posterior hepatic bile duct injury.
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Objective To study application of hematocoelia reinjection in abdominal injury with massive hemorrhage and anemia ,and to estimate the impact of salvaged autotransfusion on blood routine and blood coagulation of patients.Methods In 75 patients with intra-abdominal injury bleeding anemia undergoing autologous hematocoelia reinfusion,compare the anemia index and coagulation indexes before and after surgery to evaluate the therapeutic effect.Results Among 75 cases,1 cases died of brain injury,the other 74 cases were cured.After the second days of review,red blood cell,hemoglobin,hematocrit,platelet were elevated,compared with preoperative,the differences were statistically significant(all P0.05).Conclusion Salvaged autotransfusion can improve anemia prompt-ly without any impact on coagulation function in rescuing abdominal injured patients with massive hemorrhage and a -nemia.The treatment is effective .It has an important application in primary hospital .
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IntroductionThe research was performed with a purpose of assessing the reality of first aid during road accidents in urban and rural areas, knowledge, attitude and practice of the population and risk groups and preparedness of primary care facilities.Materials and Methods30 cases were researched by epidemiologic approach. The observation covered 64 drugstores and shops in urban and rural areas and the action methods were applied to 1068 rural and urban people. ResultsThe percentage of totally-injured pedestrians is 66.7% in 30 cases of 23.3% received first aid. Although the first aid given to 40 percent of accident victims were people who accompanied them, such as drivers and other people, 66.7 percent of those first aids were not performed correctly while there was no the first aid available to the remaining 60%. There was no first aid material in all these cases. 50.7% of the total of 1068 participants involved in the KAP test had no knowledge on first aid, although a quarter of them attended a related training, 69.9% of them have never performed first aid personally, one of every two people had no material for emergency or there was such problem faced that they had no enough knowledge and experience of first aid. There is a first aid corner in 58.3% all drugstores and shops in Ulaanbaatar city and in 30.3% in rural places. Conclusion: As a result of the study, it shows that citizens have no enough KAP on first aid to provide during accidents and injuries: they have no materials for first aid. Training for the first aid is required for citizens. It is necessary make complex sets of first aid materials available in all trade units and to improve their usage commonly.
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O objetivo deste estudo foi avaliar a prevalência de fraturas mandibulares, tratadas no Hospital Municipal São José em Joinville-SC, num período de 18 meses. Foi contabilizado um total de 83 fraturas dos 52 pacientes com fraturas mandibulares. Os resultados mostraram maior frequência das fraturas de mandíbula no gênero masculino (45 casos); a terceira década de vida (21-30 anos) foi a mais afetada, e o acidente automobilístico (22 casos), a etiologia mais comum, seguida de agressão física (19 casos). Quarenta e dois pacientes tiveram fraturas isoladas de mandíbula, e 10 com outras fraturas faciais associadas. Trinta e sete casos foram tratados somente por meio de redução aberta e fixação interna rígida com uso de miniplacas, 15 com bloqueio maxilomandibular. Os tipos de fratura mandibular com maior prevalência foram as fraturas de ângulo mandibular, corpo de mandíbula e sínfise, com 21 casos, 16 casos em região de côndilo, quatro em ramo.
The aim of this study was to evaluate the prevalence of mandibular fractures treated at the São José in Joinville Municipal Hospital over a period of 18 months. A total of 83 fractures in 52 patients with mandibular fractures was recorded. The results showed a greater frequency of fractures of the jaw in males (45 cases); the 21 to 30-yr age group was the most affected; and automobile accidents (22 cases) were the most common cause, followed by physical aggression (19 cases). Forty-two patients had isolated jaw fractures and 10 also had other associated facial fractures. Thirty-seven cases were treated merely by open reduction and rigid internal fixation with the use of miniplates and the other 15 by maxillomandibular fixation. The most prevalent types of jaw fractures were those of the mandibular angle, the mandibular body and symphysis, with 21 cases, 16 in the condylar region and four in the ramus.
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ObjectiveTo compare the short-term efficacy and safety of autologous bone marrow mesenchymal stem cells transplantation on patients with early spinal cord injury by subarachnoid injection and by intravenous injection.MethodsNinety-six patients with early spinal cord injury were hospitalized and treated from November 2006 to March 2010.Thirty-eight cases (subarachnoid transplantation group) got transplantation by subarachnoid injection,32 cases (intravenous transplantation group) got transplantation by intravenous injection,26 cases (control group) were hospitalized in the same period but not transplanted.The motor and sensory functions of all three groups were evaluated according to the score standard developed by American Spinal Injury Association(ASIA) before treatment and at the first,the third,the sixth month after treatment.Meanwhile,routine blood test,coagulation,biochemical items and tumor markers were also examined in follow-up.ResultsThe motor and sensory function of three groups had different degree of recovery at the first month after treatment,and sensory function recovered muchsignificantly,but the comparison among three groups had no statistical significance.The scores of motor function increased in three groups at the third month after treatment,but still had no statistical significance (P＞ 0.05).The scores of sensory function of subarachnoid transplantation group[(130.9 ±41.6) scores] and intravenous transplantation group [ (131.2±22.7 ) scores ] increased obviously,and had significant difference compared with control group [ (109.3±36.4) scores] (P ＜ 0.05),but there were nosignificant difference between subarachnoid transplantation group and intravenous transplantation group (P ＞ 0.05).The scores of sensory and motor function of control group didn't increase obviously at the sixth month after treatment,while the scores of subarachnoid transplantation group and intravenous transplantation group gradually improved and had statistical significance compared with control group(P ＜ 0.05).The scores of sensory function was higher in subarachnoid transplantation group[ (151.6±46.9) scores ] than that in intravenous ransplantation group [(134.6 ±40.7) scores] (P ＜0.05).There were no obvious abnormality in the results of followed-up examination.Conclusions The safety and short-term efficacy of autologous bone marrow mesenchymal stem cells transplantation in treating early spinal cord injury by subarachnoid injection and intravenous injection is certified.The subarachnoid injection is better than intravenous injection,but the long-term efficacy need furter study.
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Objective To evaluate the effects of fasudil on neointima hyperplasia in rat carotid artery balloon-injury model,and explore the potential molecular mechanisms of this effect.Methods Totally 30 male Sprague-Dawley (SD) rats were randomly divided into sham operation group,balloon injury group,2.5 ml/kg fasudil intervention group,5 ml/kg fasudil intervention group,10 ml/kg fasudil intervention group.The intima-to media(I/M) area ratio of neointima was calculated at 14th day after operation; the protein expression of proliferating cell nuclear antigen(PCNA) was measured by immunohistochemical and the integrated optical density (IA) was calculated.As the marker of oxidative stress,the levels of 8-hydroxy-2'-dcoxyguanosine (8OHdG) and malondialdehyde (MDA) were measured by enzyme-linked immunosorbent assay (ELISA).The expressions of phosphorylated and non phosphorylated Ras,mitogen activated protein kinase kinase (MEK1/2) and extracellular signal regulated kinase (ERK1/2) were measured by Western blot.Results The I/M ratios were (0.22 ± 0.01) in sham operation group,(2.71 ± 0.23) in balloon injury group,( 1.72 ±0.24)in 2.5 ml/kg fasudil intervention group,(1.23±0.11)in 5 ml/kg fasudil intervention group,(0.85±0.12)in 10 ml/kg fasudil intervention group.As compared with sham operation group,I/M area ratio was increased in balloon injury group,and three fasudil intervention group inhibited neointima hyperplasia in a dose-dependent manner (all P＜0.01).The IA indexes were(15.11 ±1.42),(53.42±2.30),(45.25±1.62),(22.55±0.88) and(19.61±0.79) in the above five groups,respectively,showing the fasudil inhibited PCNA expression (all P＜0.01).Fasudil also inhibited the levels of 8-OHdG and MDA in a dose-dependent manner [8OHdG:(54.34±4.50)μg/kg,(106.81 ± 6.67)μg/kg,(94.21 ± 3.34) μg/kg,(65.58 ± 5.13) μg/kg,(51.32 ± 2.34) μg/kg; MDA:(19.94 ± 0.65 ) μmol/kg,( 58.83 ± 2.81 ) μmol/kg,(48.94 ± 1.35 ) μmol/kg,(40.62 ± 3.24 )μmol/kg,( 36.85 ± 0.91)μmol/kg (all P＜0.01)].Compared with balloon injury group,the relative expressions of Ras in three fasudil intervention group were 0.49±0.12,0.39±0.13,0.20±0.23 vs.0.62±0.10(P＜0.05 or,P＜0.01); MEK1/2 0.35±0.14,0.29±0.09,0.11±0.12 vs.0.56±0.1(P＜0.05 or,P＜0.01); ERK1/2 0.48±0.15,0.32±0.08,0.12±0.09 vs.0.64±0.13(P＜0.05 or,P＜0.01).The activations of ERK1/2,MEK1/2 and Ras were strongly suppressed in fasudil treated samples on day 14 after balloon injury.Conclusions Blockade of oxidative stress and Ras MEK1/2 ERK1/2 pathway is involved in the fasudil attenuating of balloon injury-induced neointima hyperplasia
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El trauma máxilo facial corresponde a todas las lesiones de origen traumático que afectan al macizo facial, incluyendo tejidos óseos, blandos y las estructuras alveolo dentarias. El trauma en el territorio facial representa uno de los problemas de salud más importantes a nivel mundial, particularmente por su alta prevalencia, diversidad etiológica y alta morbilidad. Reflejándose en importantes alteraciones funcionales y estéticas, que determinan un alto costo social y económico. El diagnóstico y tratamiento del trauma máxilo facial debe realizarse de forma oportuna por un profesional competente, para minimizar las secuelas de esta patología. En el presente artículo se revisan, a modo general, los principales diagnósticos de trauma máxilo facial incluyendo el traumatismo alveolo dentario, con sus respectivos manejos y tratamientos de urgencia.
The maxillo facial trauma corresponds to all injuries of a traumatic origin that affects the facial components, including bones and soft tissues and the alveolo dental structures. The trauma in the facial area represents one of the most important problems of health at a world wide level, particularly for its high prevalence, etiologic diversity and high morbidity. Being reflected as an important functional and aesthetic alteration, that can determine a high social and economic cost. The diagnosis and treatment of the maxillo facial trauma must be realized in an opportune form by a competent professional to diminish the sequels of this patology. In this article they are reviewed, in a general way, the main diagnosis of maxillo facial trauma including alveolar dental traumatism, with its respective handlings and emergency treatments.
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Humans , Tooth Injuries , Facial Injuries/therapy , Maxillofacial Injuries/diagnosis , Jaw Fractures/surgeryABSTRACT
Objective To introduce the treatment of intraarticular calcaneal fractures with poor soft tissue using poking reduction combined with Ilizarov methods. Methods From September 2007 to September 2009,11 patients with the intraarticular calcaneal fractures were treated with poking reduction combined with Ilizarov methods,including 10 males and 1 female at average age of 33.6 years(range,21-50 years).Four patients had the left calcaneal fractures and seven with the right ones.According to Sander classification,there were seven patients with type II fractures,three with type III fractures and one with type IV fracture.The various extents of heel soft tissue injury were emerged in all the patients.Before operation,B(o)hler angle was 0°-12°(average 8°)and Gissane angle 70°-95°(average 80°).According to AO classification of close soft tissue injury,there were three patients with type IC2,six with type IC3,one with type IC5 and one with open soft tissue injury.The collapse of the articular surface was recovered by Steinmann pin which passed through the lateral calcaneal tubercle.The medial and lateral fracture fragments were corrected by using the tensed olive wires.The heighat and width were maintained by using the Ilizarov external fixation. Results The mean duration of follow-up was 13.3 months (range,6-20 months).All fractures were healed after mean duration for 8.1 weeks(range,7-10weeks).The postoperative B(o)hler angle was 20°-45°(average 33°)and Gissane angle 100°-118°(average 107°).According to Maryland Foot Score system,the result of postoperative function was excellent in seven patients,good in three and fair in one,with excellence rate of 91%. Conclusions For the intraarticular calcaneal fractures,the poking reduction combined with Ilizarov method is able to recover and maintain the normal calcaneal height and width and reduce postoperative wound infections and many other complications.specially for Sanders II or III with severe soft tissue injury in the open or closed calcaneal fractures.Master of surgical indications and operating poims can attain satisfactory clinical efficacy.
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Objective To study the protective effect of Nimodipine treatment of brain damage in patients with cerebral hemorrhage.Methods 62 cases of brain damage in patients with cerebral hemorrhage were divided into treatment group and control group,each for 31 cases.The control group were given conventional treatment,and the treatment group were given Nimodipine on the basis of the control group,treatment for 10d.NIHSS,hematoma volume and clinical effective rate were compared.Results After treatment,the NIHSS was lower between two groups,the treatment group decline was more obvious(P ＜ 0.05).The hematoma volume was decreased,the treatment group decrease was more obvious(P ＜0.05).The total effective rate was 51.6％ in the control group,and the total effective rate was 77.4％.There were significantly statistical differences between two groups(P ＜ 0.05).Conclusion Nimodipine had a protective effect for brain damage in patients with cerebral hemorrhage,and could improve the nervous function and decrease hematoma volume,and it was a reliable drug.
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Objective To explore the protective effect of olfactory ensheathing cell(OEC)Schwann cell(SC)-extracellular matrix(ECM)-poly(DL-lactide-co-glycolide acid)(PLGA)bridging complex on peripheral target organ and spinal cord neurons after rat sciatic nerve defect.Methods A 15 mm right sciatic nerve defect model was established in SD rats and repaired with OEC-SC-ECM-PLGA bridging complex that contained OEC,SC,ECM and self-made PLGA conduit.At the same time,the study set OEC-ECM-PLGA group,SC-ECM-PLGA group,ECM-PLGA group,PLGA group and nerve autograft control group.At 1,3,6 and 9 weeks after surgery,the gastrocnemius muscle water weight test and motor end-plate test were performed.At the 9th week after surgery,CM-DiI and horseradish peroxidase(HRP)retrograde tracing were performed.Results The gastrocnemius muscle water weight and number of motor end-plate were decreased in all groups after surgery but gradually increased after three weeks except for ECM-PLGA group and PLGA group.At the 9th week,OEC-SC-ECM-PLGA group showed no statistical differences with nerve autograft group in aspects of gastrocnemius muscle water weight,number of motor end-plate and length of motor end-plate major axis(P ＞ 0.05).At the 9th week,CM-DiI and HRP retrograde tracing found that the number of positive neurons in spinal cord in OEC-SC-ECM-PLGA group showed no statistical differences compared with nerve autograft group(P ＞0.05).Conclusions OEC-SC-ECM-PLGA bridging complex can partially protect peripheral target organ and spinal cord neurons after rat sciatic nerve defect.