Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 81
Filter
1.
Healthcare (Basel) ; 12(9)2024 Apr 23.
Article in English | MEDLINE | ID: mdl-38727433

ABSTRACT

The study focused on examining the relationship between well-being and various psychological factors such as loneliness, anxiety, depression, and stress, whilst also considering changes in lifestyle. A total of 108 elderly participants, with an average age of 70.38 years, were enrolled in this quantitative cross-sectional study. The research employed a battery of assessment tools including a Sociodemographic Data Questionnaire, Mini-Mental State Examination, Positive Mental Health Scale, Stress Perception Scale, Geriatric Anxiety Inventory, Geriatric Depression Scale (reduced version), Loneliness Scale, and International Physical Activity Questionnaire. Descriptive analysis was conducted in order to understand the distribution of scores across these variables, followed by the categorization of participants based on the reported alterations in eating and physical activity behaviors. Correlations between variables were assessed using Spearman correlation and an EBIC-LASSO network analysis. The findings indicated a potential detriment to the well-being of elderly individuals practicing social distancing, evidenced by heightened symptoms of loneliness, depression, anxiety, and stress, alongside the reported changes in dietary patterns and physical activity. The study underscores the importance of understanding the pandemic's impact on the well-being of older adults and advocates for longitudinal investigations to delineate the evolving effects of social distancing measures across different phases of the pandemic.

2.
Transl Psychiatry ; 13(1): 358, 2023 Nov 22.
Article in English | MEDLINE | ID: mdl-37993429

ABSTRACT

Exposure to stress can lead to long lasting behavioral and neurobiological consequences, which may enhance the susceptibility for the onset of mental disorders. However, there are significant individual differences in the outcome of stress exposure since only a percentage of exposed individuals may show pathological consequences, whereas others appear to be resilient. In this study, we aimed to characterize the effects of prenatal stress (PNS) exposure in rats at adolescence and to identify subgroup of animals with a differential response to the gestational manipulation. PNS adolescent offspring (regardless of sex) showed impaired emotionality in different pathological domains, such as anhedonia, anxiety, and sociability. However, using cluster analysis of the behavioral data we could identify 70% of PNS-exposed animals as vulnerable (PNS-vul), whereas the remaining 30% were considered resilient (PNS-res). At the molecular level, we found that PNS-res males show a reduced basal activation of the ventral hippocampus whereas other regions, such as amygdala and dorsal hippocampus, show significant PNS-induced changes regardless from vulnerability or resilience. Taken together, our results provide evidence of the variability in the behavioral and neurobiological effects of PNS-exposed offspring at adolescence. While these data may advance our understanding of the association between exposure to stress during gestation and the risk for psychopathology, the investigation of the mechanisms associated to stress vulnerability or resilience may be instrumental to develop novel strategies for therapeutic intervention.


Subject(s)
Prenatal Exposure Delayed Effects , Stress, Psychological , Humans , Male , Pregnancy , Female , Rats , Animals , Adolescent , Anxiety , Anxiety Disorders , Individuality , Anhedonia
3.
J Bras Pneumol ; 49(5): e20230274, 2023.
Article in English, Portuguese | MEDLINE | ID: mdl-37991075

ABSTRACT

OBJECTIVE: To compare lung function between adolescents with and without substance use disorder (SUD). METHODS: This was an observational, cross-sectional exploratory study. The sample consisted of 16 adolescents with SUD and 24 age-matched healthy controls. The adolescents in the clinical group were recruited from a psychiatric inpatient unit for detoxification and rehabilitation; their primary diagnosis was SUD related to marijuana, cocaine, or polysubstance use. Questionnaires and pulmonary function tests were applied for clinical evaluation. RESULTS: We found that FVC, FEV1, and their percentages of the predicted values were significantly lower in the adolescents with SUD than in those without. Those differences remained significant after adjustment for BMI and the effects of high levels of physical activity. The largest effect size (Cohen's d = 1.82) was found for FVC as a percentage of the predicted value (FVC%), which was, on average, 17.95% lower in the SUD group. In addition, the years of regular use of smoked substances (tobacco, marijuana, and crack cocaine) correlated negatively with the FVC%. CONCLUSIONS: This exploratory study is innovative in that it demonstrates the early consequences of smoked substance use for the lung health of adolescents with SUD.


Subject(s)
Substance-Related Disorders , Humans , Adolescent , Cross-Sectional Studies , Lung , Respiratory Physiological Phenomena , Surveys and Questionnaires
4.
J Craniovertebr Junction Spine ; 14(3): 299-305, 2023.
Article in English | MEDLINE | ID: mdl-37860022

ABSTRACT

Placement of pedicle screw in the subaxial cervical spine is a challenging and complex technique but provides significant biomechanical advantages. Despite its potential complications, the role and use of cervical pedicle screw (CPS) are growing. A literature review of the significant articles on applying pedicle screws in the subaxial cervical spine was done (articles between 1994 and 2020). Furthermore, our center´s experience of 15 years related to CPS is also discussed in this study. Transpedicular instrumentation in the subaxial cervical spine requires profound anatomical knowledge and meticulous surgical technique. This technique provides superior biomechanical stability compared to the other cervical fixation techniques. Pull-out strength of CPS is twice as compared to the lateral mass screws. There have been numerous variations in the technique of CPS, varying from open techniques to minimally invasive and the use of biomodels and templates during this procedure. Clinically, CPS can be used in different cervical trauma situations, such as fracture-dislocations, floating lateral mass, and fractures associated with ankylosing spondylitis. Despite the possibility of neurovascular injury due to the proximity of the vertebral artery, spinal cord, and spinal nerves to the cervical pedicles, scientific literature, and our center × s experience show low risk, and this technique can be performed safely. CPS placement is a safe procedure, and it has great potential in the management of cervical spine trauma.

5.
Front Behav Neurosci ; 17: 1059029, 2023.
Article in English | MEDLINE | ID: mdl-36926582

ABSTRACT

Introduction: Skilled walking is influenced by memory, stress, and anxiety. While this is evident in cases of neurological disorders, memory, and anxiety traits may predict skilled walking performance even in normal functioning. Here, we address whether spatial memory and anxiety-like behavior can predict skilled walking performance in mice. Methods: A cohort of 60 adult mice underwent a behavioral assessment including general exploration (open field), anxiety-like behavior (elevated plus maze), working and spatial memory (Y-maze and Barnes maze), and skilled walking performance (ladder walking test). Three groups were established based on their skilled walking performance: superior (SP, percentiles ≥75), regular (RP, percentiles 74-26), and inferior (IP, percentiles ≤25) performers. Results: Animals from the SP and IP groups spent more time in the elevated plus maze closed arms compared to the RP group. With every second spent in the elevated plus maze closed arms, the probability of the animal exhibiting extreme percentiles in the ladder walking test increased by 1.4%. Moreover, animals that spent 219 s (73% of the total time of the test) or more in those arms were 4.67 times more likely to exhibit either higher or lower percentiles of skilled walking performance. Discussion: We discuss and conclude anxiety traits may influence skilled walking performance in facility-reared mice.

6.
Int J Dev Neurosci ; 83(2): 216-223, 2023 Apr.
Article in English | MEDLINE | ID: mdl-36625792

ABSTRACT

Sleep is essential for health: Adequate sleep is essential for healthy development and sleep deprivation results in several consequences. Indeed, sleep deprivation early in life is associated with poor behaviour and cognition, as well as impaired mental and physical health. Preclinical studies have shown that sleep deprivation alters several physiological functions later in life such as the cardiovascular, immune and endocrine systems, resulting in altered oxidative states. Most of the preclinical literature is focused on adult animals, and little is known about oxidative alterations during development, especially in the context of sleep deprivation. Hence, we adapted a classic and well-documented model of sleep deprivation, paradoxical sleep deprivation using multiple platforms, for juvenile rats and explored central and peripheral oxidative parameters, as well as the behavioural consequences of sleep deprivation post-weaning. We showed that 96 h of paradoxical sleep deprivation induced a significant reduction in body weight, decreased sucrose preference-a behaviour suggestive of anhedonia-and increased glucose and decreased cholesterol in the plasma. In the brain, we observed a decrease in reduced glutathione levels in the medial prefrontal cortex and an increase in thiobarbituric acid reactive substance levels in the hypothalamus, indicating oxidative damage in these regions. Taken together, our findings suggest that paradoxical sleep deprivation during development induces anhedonic behaviour and promotes central and peripheral alterations in oxidative parameters.


Subject(s)
Brain , Sleep Deprivation , Rats , Animals , Sleep Deprivation/complications , Weaning , Brain/metabolism , Oxidative Stress , Glutathione/metabolism
7.
Coluna/Columna ; 22(4): e273237, 2023. tab
Article in English | LILACS | ID: biblio-1520798

ABSTRACT

ABSTRACT: Objective: This scientific article describes a retrospective longitudinal study that aimed to compare the outcomes and mechanical complications between patients who underwent the use of either structural allograft (SA) or titanium cage (TC) for vertebral body replacement in the management of tuberculosis in thoracic and lumbar segments. Methods: The sample consisted of 22 cases of vertebral tuberculosis surgically treated, of which 17 cases applied TC containing autograft, and five cases applied SA from a tissue bank. The median age in group A was 32.1, and in group B was 5.2. Results: The results showed no statistical difference in the number of resected vertebrae, the amount of instrumented levels, and the correction of the angular value in coronal and sagittal planes as per Cobb method. Furthermore, there were no cases of subsidence, fracture, or displacement of SA or TC until the last postoperative follow-up. However, in group A, four cases of metal rod fracture, one case of proximal junctional failure, and three cases of operative wound infection were identified, all of which improved after debridement and antibiotic therapy. Conclusion: It was concluded that both SA and TC filled with autologous bone for anterior column support and vertebral body replacement in treating tuberculosis presented similar postoperative correction outcomes with similar rates of postoperative mechanical complications. Future studies with larger samples and longer follow-up periods are necessary to evaluate the occurrence of rod fracture. Level of Evidence III; Retrospective comparative study.


RESUMO: Objetivo: Este artigo científico descreve um estudo longitudinal retrospectivo que teve como objetivo comparar os resultados e as complicações mecânicas entre pacientes que foram submetidos ao uso de aloenxerto estrutural (AE) ou gaiola de titânio (GT) para substituição do corpo vertebral no manejo da tuberculose em segmentos torácico e lombar. Métodos: A amostra foi composta por 22 casos de tuberculose vertebral tratados cirurgicamente, sendo que em 17 casos foram utilizadas GT contendo autoenxerto e em cinco casos foi utilizado AE de banco de tecidos. A mediana da idade do grupo A foi 32,1 e do grupo B foi 5,2. Resultados: Os resultados mostraram que não houve diferença estatística no número de vértebras ressecadas, quantidade de níveis instrumentados e correção do valor angular nos planos coronal e sagital pelo método de Cobb. Além disso, não houve casos de subsidência, quebra ou deslocamento do AE ou GT até o último seguimento pós-operatório. No entanto, no grupo A foram encontrados quatro casos de quebra das hastes metálicas, um caso de falha juncional proximal e três casos de infecção de ferida operatória, que evoluíram bem após desbridamento e antibioticoterapia. Conclusão: Concluiu-se que o AE e a GT preenchida com osso autólogo para o suporte anterior da coluna e substituição de corpos vertebrais no tratamento da tuberculose apresentaram resultados semelhantes na correção pós-operatória, com taxas de complicações mecânicas pós-operatórias semelhantes. Estudos futuros com maior casuística e seguimento são necessários para avaliar a quebra de hastes. Nível de Evidência III; Estudo retrospectivo comparativo.


RESUMEN: Objetivo: Este artículo científico describe un estudio longitudinal retrospectivo cuyo objetivo era comparar los resultados y las complicaciones mecánicas entre los pacientes que se sometieron al uso de aloinjerto estructural (AE) o jaula de titanio (JT) para la sustitución del cuerpo vertebral en el tratamiento de la tuberculosis en los segmentos torácico y lumbar. Métodos: La muestra estuvo compuesta por 22 casos de tuberculosis vertebral tratados quirúrgicamente, de los cuales 17 casos recibieron JT con autoinjerto, y cinco AE de banco de tejidos. La mediana de edad del grupo A fue de 32,1 años, y del grupo B de 5,2 años. Resultados: No hubo diferencia estadística en el número de vértebras extirpadas, la cantidad de niveles instrumentados y la corrección del valor angular en los planos coronal y sagital mediante el método de Cobb. Además, no hubo casos de subsidencia, rotura o desplazamiento del AE o JT hasta el último seguimiento postoperatorio. Sin embargo, en el grupo A se encontraron cuatro casos de rotura de las varillas metálicas, un caso de fallo en la unión proximal, y tres casos de infección de herida operatoria que requirieron desbridamiento y antibioticoterapia. Conclusión: El AE y las JT rellenas de hueso autólogo, para el soporte anterior de columna en sustitución de cuerpos vertebrales por tuberculosis, presentaron resultados similares en la corrección postoperatoria con tasas de complicaciones mecánicas postoperatorias similares. Se necesitan estudios futuros con una mayor casuística y seguimiento para confirmar estas conclusiones. Nivel de Evidencia III; Estudio Retrospectivo Comparativo.


Subject(s)
Humans , Orthopedics , Orthopedic Procedures
8.
J. bras. pneumol ; 49(5): e20230274, 2023. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1521125

ABSTRACT

ABSTRACT Objective: To compare lung function between adolescents with and without substance use disorder (SUD). Methods: This was an observational, cross-sectional exploratory study. The sample consisted of 16 adolescents with SUD and 24 age-matched healthy controls. The adolescents in the clinical group were recruited from a psychiatric inpatient unit for detoxification and rehabilitation; their primary diagnosis was SUD related to marijuana, cocaine, or polysubstance use. Questionnaires and pulmonary function tests were applied for clinical evaluation. Results: We found that FVC, FEV1, and their percentages of the predicted values were significantly lower in the adolescents with SUD than in those without. Those differences remained significant after adjustment for BMI and the effects of high levels of physical activity. The largest effect size (Cohen's d = 1.82) was found for FVC as a percentage of the predicted value (FVC%), which was, on average, 17.95% lower in the SUD group. In addition, the years of regular use of smoked substances (tobacco, marijuana, and crack cocaine) correlated negatively with the FVC%. Conclusions: This exploratory study is innovative in that it demonstrates the early consequences of smoked substance use for the lung health of adolescents with SUD.


RESUMO Objetivo: Comparar a função pulmonar de adolescentes com e sem transtornos relacionados ao uso de substâncias (TUS). Métodos: Trata-se de um estudo exploratório transversal observacional. A amostra foi composta por 16 adolescentes com TUS e 24 controles saudáveis emparelhados pela idade. Os adolescentes do grupo clínico foram recrutados em uma unidade de internação psiquiátrica para desintoxicação e reabilitação; seu diagnóstico primário era o de TUS (maconha, cocaína ou polissubstâncias). Foram aplicados questionários e testes de função pulmonar para a avaliação clínica. Resultados: A CVF, o VEF1 e seus valores em porcentagem do previsto foram significativamente mais baixos nos adolescentes com TUS do que naqueles sem TUS. Essas diferenças permaneceram significativas após os ajustes para levar em conta o IMC e os efeitos de altos níveis de atividade física. O maior tamanho de efeito (d de Cohen = 1,82) foi o observado em relação à CVF em porcentagem do previsto (CVF%), que foi, em média, 17,95% menor no grupo TUS. Além disso, os anos de uso regular de substâncias fumadas (tabaco, maconha e crack) correlacionaram-se negativamente com a CVF%. Conclusões: Este estudo exploratório é inovador na medida em que demonstra as consequências precoces do uso de substâncias fumadas para a saúde pulmonar de adolescentes com TUS.

9.
Rev. enferm. atenção saúde ; 12(2): 202389, Mar.-Jun. 2023.
Article in English, Spanish, Portuguese | BDENF - Nursing | ID: biblio-1444665

ABSTRACT

Objetivo: investigar o conhecimento dos adultos jovens relacionado às Infecções Sexualmente Transmissíveis. Método: Estudo com delineamento descritivo e abordagem qualitativa, realizado na modalidade pesquisa-ação, desenvolvido com 15 estudantes do ensino médio da Educação de Jovens e Adultos de uma Escola Estadual, na cidade de Cajazeiras Paraíba, no alto Sertão Paraibano, no ano de 2019. Os dados foram apurados após aprovação do Comitê de Ética e Pesquisa, e analisados por meio do Discurso do Sujeito Coletivo. Resultados: Com a obtenção dos dados, verificou-se um nível menor de entendimento dos adultos jovens sobre as Infecções Sexualmente Transmissíveis, demonstrando assim uma vulnerabilidade vigente que merece atenção para esta faixa etária, exposta a diversos fatores intrínsecos e extrínsecos. Conclusão: A inclusão da educação em saúde para os adultos jovens apresenta-se como forma de ampliação do conhecimento e direitos legais, para entendimento crucial e necessário referentes à educação sexual e reprodutiva (AU).


Objective: to investigate the knowledge of young adults related to Sexually Transmitted Infections. Method: Study with descriptive design and qualitative approach, carried out in the action-research modality, developed with 15 high school students from Youth and Adult Education of a State School, in the city of Cajazeiras Paraíba, in the high Sertão Paraibano, in the year 2019. Data were obtained after approval by the Ethics and Research Committee, and displacement through the Collective Subject Discourse. Results: With data collection, there was a lower level of understanding among young adults about Sexually Transmitted Infections, thus demonstrating a current vulnerability that deserves attention for this age group, exposed to several intrinsic and extrinsic factors. Conclusion: The inclusion of health education for young adults is a way of expanding knowledge and legal rights, for a crucial and necessary understanding regarding sexual and reproductive education (AU).


Objetivo: Tuvo como objetivo investigar los conocimientos de los adultos jóvenes relacionados con las Infecciones de Transmisión Sexual. Método: Estudio con diseño descriptivo y enfoque cualitativo, realizado en la modalidad de investigación-acción, desarrollado con 15 estudiantes de secundaria de Educación de Jóvenes y Adultos de una Escuela Estatal, en la ciudad de Cajazeiras Paraíba, en el alto Sertão Paraibano, en el año 2019. Los datos se obtuvieron tras la aprobación del Comité de Ética e Investigación, y el desplazamiento por el Discurso del Sujeto Colectivo. Resultados: Con la recolección de datos, se verificó un menor nivel de comprensión de los adultos jóvenes sobre las Infecciones de Transmisión Sexual, demostrando así una vulnerabilidad actual que merece atención para este grupo etario, expuesto a diversos factores intrínsecos y extrínsecos. Conclusión: La inclusión de la educación en salud para jóvenes adultos es una forma de ampliar conocimientos y derechos jurídicos, para una comprensión crucial y necesaria en torno a la educación sexual y reproductiva (AU).


Subject(s)
Humans , Male , Female , Young Adult , Sexually Transmitted Diseases , Sexuality , Young Adult
10.
Coluna/Columna ; 22(1): e265394, 2023. tab, il. color
Article in English | LILACS | ID: biblio-1421315

ABSTRACT

ABSTRACT Objective: Spinal traction by a cranial halo is a method with more than half a century of application, presenting the possibility of gradual correction of deformities while the patient is awake, also improving respiratory and nutritional patterns. This study aimed to evaluate the complications of pins and traction during their use in treating severe spinal deformities. Methods: We evaluated 27 patients undergoing surgical treatment using halo-gravitational traction pre or interoperatively between 2014 and 2020. Inclusion criteria were the presence of severe deformity (>100º) in the coronal and/or sagittal plane and traction for at least seven days. Two subgroups were identified: patients presenting only severe coronal deformity (Group 1) and patients with severe deformity in the sagittal plane accompanied by coronal deformity (Group 2). Clinical and radiological data were analyzed retrospectively, evaluating the variables: age, sex, weight, height, etiological diagnosis, number of pins, traction time, sagittal and coronal Cobb angle before and after traction, and complications related to pins and traction. Results: Age and weight showed a significant correlation with the occurrence of complications related to the pins (p=0.007; p<0.001), as well as the congenital etiology of deformity (p=0.001), and those patients in group 2 (p=0.006). There was no significant correlation between the variables studied and the occurrence of neurological complications. Conclusion: Halo-gravitational traction is an important adjunctive method in treating severe spinal deformities. Despite having a considerable complication rate, there were no serious events. Level of evidence IV; Case series.


Resumo: Objetivo: A tração espinhal por halo craniano é um método com mais de meio século de aplicação, apresentando a possibilidade de correção gradual de deformidades com o paciente desperto, além da melhoria do padrão respiratório e nutricional. Este estudo teve como objetivo avaliar as complicações relacionadas aos pinos e à tração durante o seu uso no tratamento de deformidades graves. Métodos: Foram avaliados 27 pacientes submetidos a tratamento cirúrgico com uso de tração halo-gravitacional pré ou inter-operatória, entre 2014 e 2020. Os critérios de inclusão foram a presença de deformidade grave (>100º) coronal e/ou sagital, e duração mínima de 7 dias de tração. Dois subgrupos foram identificados: pacientes com deformidade grave coronal (Grupo 1) e pacientes com deformidade grave sagital acompanhada de deformidade coronal (Grupo 2). Os dados clínicos e radiológicos foram analisados retrospectivamente, incorporando as variáveis: idade, sexo, peso, altura, diagnóstico etiológico, número de pinos, tempo de tração, ângulo de Cobb sagital e coronal pré e pós tração, complicações relacionadas aos pinos e à tração. Resultados: Idade e peso demonstraram correlação significativa com a ocorrência de complicações relacionadas aos pinos (p=0,007; p<0,001), assim como etiologia congênita (p=0,001), e os pacientes incluídos no grupo 2 (p=0,006). Não houve correlação significativa com a ocorrência de complicações neurológicas. Conclusão: A tração halo-gravitacional é um importante método adjuvante no tratamento de deformidades graves da coluna vertebral. Apesar de ter apresentado taxa de complicações considerável, não ocorreram eventos graves. Nível de evidência IV; Série de casos.


Resumen: Objetivo: La tracción espinal por halo craneal es un método con más de medio siglo de aplicación, presentando la posibilidad de corrección gradual de las curvas con el paciente despierto, mejorando el patrón respiratorio y nutricional. Este estudio evaluó las complicaciones relacionadas con los tornillos y la tracción durante el tratamiento de deformidades espinales graves. Métodos: Se evaluó a 27 pacientes sometidos a cirugía con uso de tracción halo-gravitatoria pre o inter quirúrgica, entre 2014 y 2020. Los criterios de inclusión fueron la presencia de deformidad severa (>100º) en el plano coronal y/o sagital y tiempo mínimo de tracción de 7 días. Dos subgrupos fueron identificados: pacientes con deformidad severa en el plano coronal (Grupo 1), y pacientes con deformidad sagital severa acompañada de deformidad coronal (Grupo 2). Los datos clínicos y radiológicos se analizaron retrospectivamente, evaluando edad, sexo, peso, talla, diagnóstico etiológico, número de tornillos, tiempo de tracción, ángulo de Cobb sagital y coronal pre y post tracción, complicaciones relacionadas con los tornillos y tracción. Resultados: Se demostró que la edad y el peso eran factores significativamente correlacionados con las complicaciones de los tornillos (p=0,007; p<0,001), así como la etiología congénita (p=0,001), y los pacientes incluidos en el grupo 2 (p=0,006). No hubo correlación significativa entre las variables estudiadas y complicaciones neurológicas. Conclusión: La tracción halo-gravitacional es un método adyuvante importante en el tratamiento de deformidades espinales severas. A pesar de haber presentado una tasa de complicaciones considerable, no hubo eventos graves. Nivel de evidencia IV; Series de casos.


Subject(s)
Humans , Scoliosis , Traction
11.
Coluna/Columna ; 22(2): e272598, 2023. tab
Article in English | LILACS | ID: biblio-1439958

ABSTRACT

ABSTRACT Objective: evaluate the correlation between main sacropelvic alignment measurements and pelvic retroversion reduction and assessing Lamartina Square effectiveness in choosing the proximal instrumentation level. Methods: sample comprising 21 patients with high-grade L5 -S1 spondylolisthesis subjected to arthrodesis with instrumentation from January 2004 to December 2016. Patients' demographic data, surgery type, complications, sagittal alignment parameters, Severity Index and Lamartina Square were recorded before surgery and in the last follow-up. Data processed in SPSS 22.0, with different means were calculated through Student's t test, for paired data. Linear correlation analysis was performed based on Spearman's coefficient. P <0.05 was statically significant. Results: there was significant improvement in the slip and Dubousset's lumbosacral kyphosis angles (> 100° in the last postoperative follow-up). There was significant reduction of slip rate ( and in the L4 and L5 Severity Index, which highlighted strong correlation to pelvic tilt, mismatch and slip angle. Severity index also showed strong inverse correlation between Dubousset's lumbosacral kyphosis angle and sacral slope. Conclusion: L5 Severity Index and Lamartina Square are important variables for preoperative planning of patients with high-grade lumbar spondylolisthesis. Level of Evidence IV; Case Series.


Resumo: Objetivo: avaliar a correlação entre as principais medidas do alinhamento sacropélvico com a retroversão pélvica e avaliar a efetividade do Lamartina Square na escolha do nível proximal de intrumentação. Métodos: amostra com 21 pacientes com espondilolistese de alto grau L5-S1, submetidos à artrodese com instrumentação, de 01/2004 a 12/2016. Os dados demográficos dos pacientes, tipos de cirurgias, complicações, parâmetros do alinhamento sagital, Severity Index e Lamartina Square foram registrados antes da cirurgia e no último acompanhamento. Dados processados no SPSS 22.0 com as diferenças das médias calculadas utilizando-se o teste t de Student para dados emparelhados. A análise da correlação linear foi realizada pelo coeficiente de Spearman. Significantes as análises com p < 0,05. Resultados: melhora significativa do ângulo de deslizamento e de cifose lumbosacral de Dubousset´s (> 100° no ultimo seguimento pósoperatório). Redução significativa da porcentagem de deslizamento ( e do severity index em L4 e L5. Este teve uma forte correlação direta com: tilt pélvico, mismatch, ângulo de deslizamento, porcentagem de deslizamento e uma forte inversa com: ângulo de cifose lumbosacral de Dubousset´s e o slope sacral. Conclusão: O Severity Index de L5 e o Lamartina Square devem ser consideradas variáveis importantes no planejamento pré-operatório de pacientes com espondilolistese lombar de alto grau.


Resumen: Objetivo: evaluar la correlación entre las principales medidas de alineación sacropélvica y la reducción de la retroversión pélvica y evaluar la eficacia de Lamartina Square en la elección del nivel de instrumentación proximal. Métodos: muestra compuesta por 21 pacientes con espondilolistesis L5-S1 de alto grado sometidos a artrodesis con instrumentación desde enero de 2004 hasta diciembre de 2016. Se registraron datos demográficos de los pacientes, tipo de cirugía, complicaciones, parámetros de alineación sagital, Índice de Severidad y Cuadrado de Lamartina antes de la cirugía y en el último seguimiento. Los datos procesados en SPSS 22.0, con diferentes medias, se calcularon mediante la prueba t de Student, para datos pareados. Se realizó un análisis de correlación lineal basado en el coeficiente de Spearman. P <0,05 fue estadísticamente significativo. Resultados: hubo mejoría significativa en los ángulos de deslizamiento y cifosis lumbosacra de Dubousset (> 100° en el último control postoperatorio). Hubo una reducción significativa en la tasa de deslizamiento (<50 %) y en el índice de gravedad L4 y L5, que destacó una fuerte correlación con la inclinación pélvica, la falta de coincidencia y el ángulo de deslizamiento. El índice de gravedad también mostró una fuerte correlación inversa entre el ángulo de cifosis lumbosacra de Dubousset y la pendiente sacra. Conclusión: L5 Severity Index y Lamartina Square son variables importantes para la planificación preoperatoria de pacientes con espondilolistesis lumbar de alto grado. Nivel de Evidencia IV; Serie de Casos.


Subject(s)
Humans , Arthrodesis , Spinal Fusion , Surgical Procedures, Operative
12.
J. pediatr. (Rio J.) ; 98(3): 248-255, May-June 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1386091

ABSTRACT

Abstract Objective: To evaluate sleep characteristics of parents and their children during the COVID-19 pandemic and predictors for sleep disturbances. Methods: Cross-sectional web-based study using an online survey made available for dyads of parents and their children during the 7th week of quarantine in southern Brazil. Parents' and adolescents' sleep were characterized using the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale. For children aged 0-3 years parents completed the Brief Infant Sleep Questionnaire, for those aged 4-12 years the Sleep Disturbance Scale for Children. Parents also informed, subjectively, their perception about sleep habits during social distancing. Multiple regression was run to predict sleep disturbances in adults using independent variables: sex, income, education, children age, and children with sleep disturbances. Results: Data from 577 dyads showed sleep alterations in 69,8% of adults, in 58,6% of children aged 0-3 years, 33,9% in the 4-12 years range (with a predominance of disorders of initiating or maintaining sleep), and 56,6% in adolescents. Sex (female) and children with sleep disturbances were significant predictors of a sleep problem in parents (p < 0.005). Subjective perception revealed complaints related to emotional concerns such as anxiety and fear in adults and due to alterations in routine in children and adolescents. Conclusion: The present study's data showed an increased rate of sleep problems among families during quarantine both measured by validated instruments and also based on personal perception.

13.
J Pediatr (Rio J) ; 98(3): 248-255, 2022.
Article in English | MEDLINE | ID: mdl-34480854

ABSTRACT

OBJECTIVE: To evaluate sleep characteristics of parents and their children during the COVID-19 pandemic and predictors for sleep disturbances. METHODS: Cross-sectional web-based study using an online survey made available for dyads of parents and their children during the 7th week of quarantine in southern Brazil. Parents' and adolescents' sleep were characterized using the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale. For children aged 0-3 years parents completed the Brief Infant Sleep Questionnaire, for those aged 4-12 years the Sleep Disturbance Scale for Children. Parents also informed, subjectively, their perception about sleep habits during social distancing. Multiple regression was run to predict sleep disturbances in adults using independent variables: sex, income, education, children age, and children with sleep disturbances. RESULTS: Data from 577 dyads showed sleep alterations in 69,8% of adults, in 58,6% of children aged 0-3 years, 33,9% in the 4-12 years range (with a predominance of disorders of initiating or maintaining sleep), and 56,6% in adolescents. Sex (female) and children with sleep disturbances were significant predictors of a sleep problem in parents (p < 0.005). Subjective perception revealed complaints related to emotional concerns such as anxiety and fear in adults and due to alterations in routine in children and adolescents. CONCLUSION: The present study's data showed an increased rate of sleep problems among families during quarantine both measured by validated instruments and also based on personal perception.


Subject(s)
COVID-19 , Sleep Wake Disorders , Adolescent , Adult , COVID-19/epidemiology , Child , Cross-Sectional Studies , Female , Humans , Pandemics , Parents/psychology , Sleep , Sleep Quality , Sleep Wake Disorders/epidemiology , Surveys and Questionnaires
14.
Int J Dev Neurosci ; 82(2): 180-187, 2022 Apr.
Article in English | MEDLINE | ID: mdl-34734422

ABSTRACT

Inflammatory markers represent important candidates responsible for the altered behavior and physiology observed after stressful experiences. In the maternal brain, the olfactory bulb (OB) is a key constituent of the neural circuit that mediates the reciprocal interaction between mother and infant. This study aimed to investigate the effects of stress during pregnancy on maternal behavior and inflammatory changes in the olfactory bulb of lactating mice. Female Balb/c mice were divided into two groups: control (CT) and restraint stress (RS). Maternal behavior was performed during the first 8 days of life of the offspring. On the 10th day after parturition, corticosterone, gene, and protein expression were assessed. Stress during pregnancy decreased the maternal index at postnatal day 4 and the nuclear factor-κB 1 (NFκB1) gene expression in the OB. Moreover, females from the RS group showed increased interleukin (IL-1ß) protein expression. In contrast, stressed females exhibited a decreased tumor necrosis factor (TNF-α) protein expression in the OB. In conclusion, exposure to stress during pregnancy was able to induce specific postnatal effects on maternal behavior and balance of inflammatory mediators in the OB.


Subject(s)
Olfactory Bulb , Prenatal Exposure Delayed Effects , Animals , Corticosterone/metabolism , Female , Humans , Lactation , Maternal Behavior/physiology , Mice , Mice, Inbred BALB C , Olfactory Bulb/metabolism , Olfactory Bulb/pathology , Pregnancy , Prenatal Exposure Delayed Effects/metabolism , Stress, Psychological
15.
Coluna/Columna ; 21(1): e250508, 2022. tab, graf
Article in English | LILACS | ID: biblio-1364771

ABSTRACT

ABSTRACT Introduction/Objective: The craniovertebral junction (CVJ) requires a detailed evaluation, as the changes in alignment caused by surgery can affect adjacent structures in a secondary way. Examples of these effects are dyspnea or dysphagia after posterior occipitocervical arthrodesis, due to decreased caliber of the oropharynx. These changes can be identified perioperatively by several radiographic parameters that aim to predict possible postoperative respiratory complications. Such complications appear to be related to the narrowest oropharyngeal airway space (nPAS), and may also occur following atlantoaxial (C1-C2) arthrodesis. This work aims to correlate the variation in CVJ alignment parameters before and after C1-C2 arthrodesis with the variation in nPAS. Methods: Patients who underwent posterior C1-C2 arthrodesis between 2011 and 2019 at the National Institute of Traumatology and Orthopedics (INTO) were included in the study, totaling 26 patients. The parameters evaluated included cervical lordosis, C1-C2 angle, slope of C2, Occipito-C2 angle (O-C2), pharyngeal inlet angle (PIA), pharyngeal tilt angle (PTA), occiput and external acoustic meatus to axis angle (O-EAa), cranial transverse motion against C2 angle (C2TA), axial tilt (AT) and the percentage of change in nPAS (%∆nPAS). Results: A correlation was observed between the change in C1-C2 angle, O-C2, PTA, C2TA and the %∆nPAS. Conclusion: The change in cervical alignment and CVJ parameters is correlated with %∆nPAS and should, therefore, be evaluated before and after atlantoaxial fusion as a means of predicting a possible respiratory complication. Level of Evidence: III; Cross sectional study .


RESUMO Introdução/Objetivo: A junção craniovertebral (JCV) deve ter avaliação detalhada já que as alterações de alinhamento ocasionadas pela cirurgia podem acometer estruturas adjacentes de forma secundária. Exemplos desses efeitos são dispneia ou disfagia depois de artrodese occipitocervical posterior, por diminuição no calibre da orofaringe. Essas alterações podem ser identificadas no perioperatório por diversos parâmetros radiográficos que visam predizer possíveis complicações respiratórias pós-operatórias. Tais complicações parecem estar relacionadas com o menor espaço da via orofaríngea (nPAS, narrowest oropharyngeal airway space) e também podem ocorrer depois de artrodese atlantoaxial (C1-C2). Este trabalho tem como objetivo correlacionar a variação dos parâmetros de alinhamento da JCV no pré e pós-operatório de artrodese C1-C2 com a variação do nPAS. Métodos: Foram incluídos no estudo pacientes submetidos à artrodese posterior C1-C2 entre 2011 e 2019 no Instituto Nacional de Traumatologia e Ortopedia (INTO), totalizando 26 indivíduos. Os parâmetros avaliados incluíram lordose cervical, ângulo C1-C2, inclinação de C2, ângulo Occipito-C2 (O-C2), ângulo de entrada da faringe (PIA, pharyngeal inlet angle), ângulo de inclinação da faringe (PTA, pharyngeal tilt angle), ângulo do eixo occipital e meato acústico externo (O-EAa, occiput and external acoustic meatus to axis angle), movimento transversal craniano contra o ângulo C2 (C2TA, cranial transverse motion against C2 angle), inclinação axial (AT, axial tilt) e porcentagem de mudança no nPAS (%∆nPAS) resultado: Foi observada correlação entre a mudança dos ângulos C1-C2, OC2, PTA, C2TA e a %∆nPAS. Conclusão: A alteração do alinhamento cervical e dos parâmetros da JCV está correlacionada com a %∆nPAS e deve, portanto, ser avaliada antes e depois da artrodese atlantoaxial como forma de prever uma possível complicação respiratória. Nível de Evidência III; Estudo transversal .


RESUMEN Introducción/Objetivo: La unión craneocervical debe ser objeto de una evaluación detallada, ya que los cambios de alineación provocados por la cirugía pueden afectar de forma secundaria a las estructuras adyacentes. Ejemplos de estos efectos son la disnea o la disfagia después de la artrodesis occipitocervical posterior debido a la disminución del calibre de la orofaringe. Estos cambios pueden identificarse en el período perioperatorio por varios parámetros radiográficos que pretenden predecir posibles complicaciones respiratorias postoperatorias. Estas complicaciones parecen estar relacionadas con el espacio orofaríngeo más estrecho (nPAS, narrowest oropharyngeal airway space) y también pueden producirse tras la artrodesis atlantoaxial (C1-C2). Este trabajo tiene como objetivo correlacionar la variación de los parámetros de alineación de la unión craneocervical en el período pre y postoperatorio de la artrodesis C1-C2 con la variación del nPAS. Métodos: Se incluyeron en el estudio los pacientes sometidos a artrodesis posterior C1-C2 entre 2011 y 2019 en el Instituto Nacional de Traumatología y Ortopedia (INTO), totalizando 26 individuos. Los parámetros evaluados incluyeron lordosis cervical, ángulo C1-C2, inclinación de C2, ángulo Occipito-C2 (O-C2), ángulo de entrada de la faringe (PIA, pharyngeal inlet angle),, ángulo de inclinación de la faringe (PTA, pharyngeal tilt angle) ), ángulo del eje occipital y el meato acústico externo (O-EAa, occiput and external acoustic meatus to axis angle), movimiento transversal craneal contra el ángulo C2 (C2TA, cranial transverse motion against C2 angle), inclinación axial (AT, axial tilt)) y porcentaje de cambio en el nPAS (%∆nPAS). Resultado: Se observó una correlación entre el cambio de los ángulos C1-C2, O-C2, PTA, C2TA y %∆nPAS. Conclusión: El cambio en la alineación cervical y los parámetros de la unión craneovertebral se correlaciona con el %∆nPAS y por lo tanto, debe evaluarse antes y después de la artrodesis atlantoaxial como forma de predecir una posible complicación respiratoria. Nivel de Evidencia III; Estudio transversal .


Subject(s)
Humans , Orthopedic Procedures , Lordosis
16.
Coluna/Columna ; 21(4): e265776, 2022. tab, il
Article in English | LILACS | ID: biblio-1404413

ABSTRACT

ABSTRACT Objective: Evaluate the surgical indications, epidemiological data, radiographic outcomes, and postoperative complications of 16 cases of aged complex sacral fractures treated using bilateral spinopelvic fixation (PEF) or triangular osteosynthesis (OT) techniques in a case referral service. Traumatology and orthopedics complexes. Methods: A longitudinal study based on a retrospective review of patients' medical records with complex sacral fractures admitted between 2014 and 2020. All patients over 18 years of age whose time of evolution between the trauma and the surgical procedure was greater than or equal to three weeks were included. Results: The mean age was 39.8 years (18 to 71). Anterior pelvic ring injuries represented the most common association, present in 12 (75%) cases. In 8 (50%) cases, there was no neurological injury, 1 (6.2%) individual evolved with paresthesia, 2 (12.5%) with paresis in the lower limbs, and 5 (31.3%) with sphincter dysfunctions. Among the patients with neurological impairment, 4 (50%) evolved with complete improvement, 2 (25%) showed partial improvement, and 2 (25%) cases remained with the deficit. The mean surgical time was 3.6 hours for OT and 4.9 hours for FEP. Postoperative complications occurred in 4 (44.4%) patients who underwent PEF, and there were no postoperative complications in the OT group. Conclusions: The surgical management of these lesions using OT and FEP proved safe and effective. The minimum follow-up was 12 months, and all the individuals analyzed showed good evolution. Level of evidence IV; case series.


RESUMO Objetivo: Avaliar as indicações cirúrgicas, dados epidemiológicos, desfechos radiográficos e complicações pós operatórias de uma série de 16 casos de fraturas complexas envelhecidas do sacro tratadas através das técnicas de fixação espinopélvica bilateral (FEP) ou osteossíntese triangular (OT) em um serviço de referência de casos complexos de traumatologia e ortopedia. Métodos: estudo longitudinal, baseado na revisão retrospectiva de prontuários de pacientes com fraturas complexas do sacro, admitidos entre 2014 e 2020. Foram incluídos todos os pacientes acima de 18 anos cujo tempo de evolução entre o trauma e o procedimento cirúrgico foi maior ou igual a três semanas. Resultados: A média de idade foi de 39,8 anos (18 a 71 anos). As lesões do anel pélvico anterior representaram a associação mais comum, presentes em 12 (75%) casos. Em 8 (50%) casos não ocorreu lesão neurológica, 1 (6,2%) indivíduo evoluiu com parestesia, 2 (12,5%) com paresia nos membros inferiores e 5 (31,3%) com disfunções esfincterianas. Entre os pacientes com comprometimento neurológico, 4 (50%) evoluíram com melhora completa, 2 (25%) apresentaram melhora parcial e 2 (25%) casos permaneceram com o déficit. O tempo médio cirúrgico foi 3,6 horas para OT e 4,9 horas para FEP. Ocorreram complicações pós-operatórias em 4 (44,4%) pacientes que realizaram FEP e não houve complicações pós-operatórias no grupo submetido a OT. Conclusões: O manejo cirúrgico dessas lesões por meio da OT e FEP se mostrou seguro e eficaz. O seguimento mínimo foi de 12 meses e todos os indivíduos analisados apresentaram boa evolução. Nível de evidência IV; série de casos.


RESUMEN Objetivo: Evaluar las indicaciones quirúrgicas, datos epidemiológicos, resultados radiográficos y complicaciones postoperatorias de una serie de 16 casos de fracturas de sacro envejecidas y complejas tratadas mediante las técnicas de fijación espino pélvica bilateral (FEP) u osteosíntesis triangular (OT) en un servicio de referencia de traumatología y ortopedia. Métodos: estudio longitudinal, basado en una revisión retrospectiva de expedientes clínicos de los pacientes con fracturas sacras complejas ingresados entre 2014 y 2020. Se incluyeron en el estudio todos los pacientes mayores de 18 años cuyo tiempo de evolución entre el trauma y el procedimiento quirúrgico fue mayor o igual a tres semanas. Resultados: La edad promedio fue de 39,8 años (18 a 71 años). Las lesiones anteriores del anillo pélvico representaron la asociación más frecuente, presente en 12 (75%) casos. En 8 (50%) casos no hubo lesión neurológica, 1 (6,2%) evolucionó con parestesia, 2 (12,5%) con paresia en miembros inferiores y 5 (31,3%) con disfunción esfinteriana. Entre los pacientes con deterioro neurológico, 4 (50%) evolucionaron con mejoría completa, 2 (25%) mostraron mejoría parcial y 2 (25%) casos permanecieron con déficit. El tiempo quirúrgico promedio fue de 3,6 horas para OT y de 4,9 horas para FEP. Las complicaciones postoperatorias ocurrieron en 4 (44,4%) pacientes que se sometieron a FEP y no hubo complicaciones postoperatorias en el grupo OT. Conclusiones: El manejo quirúrgico de estas lesiones mediante OT y FEP demostró ser seguro y efectivo. El seguimiento mínimo fue de 12 meses y todos los individuos analizados mostraron una buena evolución. Nivel de evidencia IV; Series de casos.


Subject(s)
Humans , Adolescent , Adult , Middle Aged , Aged , Spine , General Surgery
17.
Front Cell Dev Biol ; 9: 653384, 2021.
Article in English | MEDLINE | ID: mdl-34141707

ABSTRACT

Epidemiological studies have shown that environmental insults and maternal stress during pregnancy increase the risk of several psychiatric disorders in the offspring. Converging lines of evidence from humans, as well as from rodent models, suggest that prenatal stress (PNS) interferes with fetal development, ultimately determining changes in brain maturation and function that may lead to the onset of neuropsychiatric disorders. From a molecular standpoint, transcriptional alterations are thought to play a major role in this context and may contribute to the behavioral phenotype by shifting the expression of genes related to excitatory and inhibitory (E/I) transmission balance. Nevertheless, the exact neurophysiological mechanisms underlying the enhanced vulnerability to psychopathology following PNS exposure are not well understood. In the present study, we used a model of maternal stress in rats to investigate the distal effects of PNS on the expression of genes related to glutamatergic and GABAergic neurotransmissions. We inspected two critical brain regions involved in emotion regulation, namely, the prefrontal cortex (PFC) and the amygdala (AMY), which we show to relate with the mild behavioral effects detected in adult rat offspring. We observed that PNS exposure promotes E/I imbalance in the PFC of adult males only, by dysregulating the expression of glutamatergic-related genes. Moreover, such an effect is accompanied by increased expression of the activity-dependent synaptic modulator gene Npas4 specifically in the PFC parvalbumin (PV)-positive interneurons, suggesting an altered regulation of synapse formation promoting higher PV-dependent inhibitory transmission and increased overall circuit inhibition in the PFC of males. In the AMY, PNS more evidently affects the transcription of GABAergic-related genes, shifting the balance toward inhibition. Collectively, our findings suggest that the E/I dysregulation of the PFC-to-AMY transmission may be a long-term signature of PNS and may contribute to increase the risk for mood disorder upon further stress.

18.
Coluna/Columna ; 20(2): 137-143, Apr.-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1249657

ABSTRACT

ABSTRACT Objectives: Exposing the clivus and upper cervical spine should, ideally, provide an adequate surgical field in which the surgeon can safely decompress and stabilize the craniovertebral junction (CVJ). We present a series of four cases with a narrative review of the literature in which Median Labiomandibular Glossotomy was used to treat CVJ disorders, in order to highlight the importance and indications of this access. Methods: We performed a retrospective analysis of patients who underwent MLMG for several pathologies. The group comprised four patients (two men and two women). Five approaches were performed (one revision surgery). Results: The approach was suitable for all cases, clivus was achieved when necessary. Distally, C4 was exposed to obtain satisfactory osteosynthesis. Laterally, we had a good view of the tumor borders and control of the vertebral artery. Complications encountered were a superficial wound infection that was easily healed, a later pharyngeal wound dehiscence and pseudoarthrosis, all in the same patient. There are 3 main anterior surgical techniques for managing lesions of the clivus, foramen magnum or upper cervical vertebrae. We chose Median Labiomadibular Glossotomy (MLMG) as a primary option, which provided a direct view of the clivus, C3 - C4 caudally and a wider surgical field. The main advantages of the MLMG technique include direct access to spinal pathology, an avascular plane through the median pharyngeal raphe, and a wider surgical field in both the transverse and sagittal dimensions. Conclusion: This approach provides excellent exposure of the craniocervical junction and upper cervical spine. Level of evidence IV; Series of cases analyzed retrospectively.


RESUMO Objetivos: A exposição do clivo e da coluna cervical alta deve, de modo ideal, proporcionar um campo cirúrgico adequado, no qual o cirurgião possa descomprimir e estabilizar a junção craniovertebral (JCV) com segurança. Apresentamos uma série de quatro casos, com revisão narrativa da literatura, nos quais a glossotomia labiomandibular mediana foi utilizada para tratamento de afecções da JCV, com o objetivo de destacar a importância e as indicações desse acesso. Métodos: Foi realizada uma análise retrospectiva dos pacientes submetidos a GLMM para diversas patologias. O grupo foi composto por quatro pacientes (dois homens e duas mulheres). Cinco abordagens/procedimentos<??> foram realizados (uma cirurgia de revisão). Resultados: O método/via de acesso/técnica foi adequado para todos os casos e o clivo foi alcançado quando necessário. Distalmente, C4 foi exposta para obter a osteossíntese satisfatória. Lateralmente, obteve-se boa visão das margens tumorais e controle da artéria vertebral. As complicações encontradas foram infecção superficial da ferida, com fácil cicatrização, deiscência tardia da parede posterior da faringe e pseudoartrose, todas no mesmo paciente. Existem três técnicas cirúrgicas principais com acesso anterior para o tratamento de lesões do clivo, forame magno ou vértebras cervicais superiores. Escolhemos a glossotomia labiomadibular mediana (GLMM) como opção primária, que proporcionou uma visão direta do clivo, de C3-C4 caudalmente e campo cirúrgico mais amplo. As principais vantagens da GLMM incluem acesso direto à patologia espinhal, plano avascular através da parte mediana da rafe da faringe e um campo cirúrgico ampliado nas dimensões transversa e sagital. Conclusões: Esta abordagem proporciona excelente exposição da junção craniocervical e da coluna cervical alta. Nível de evidência IV; Série de casos analisados retrospectivamente.


RESUMEN Objetivos: La exposición del clivus y de la columna cervical alta debe, de modo ideal, proporcionar un campo quirúrgico adecuado, en que el cirujano pueda descomprimir y estabilizar de manera segura la unión craneovertebral (UCV). Presentamos una serie de cuatro casos con revisión narrativa de la literatura, en los que se utilizó la glosotomía labiomandibular mediana para el tratamiento de afecciones de la UCV, con el objetivo de destacar la importancia y las indicaciones de ese acceso. Métodos: Se realizó un análisis retrospectivo de los pacientes sometidos a GLMM para diversas patologías. El grupo fue compuesto por cuatro pacientes (dos hombres y dos mujeres). Fueron realizados cinco abordajes/procedimientos (una cirugía de revisión). Resultados: El método/vía de acceso/técnica fue adecuado para todos los casos y el clivus fue alcanzado cuando fue necesario. Distalmente, C4 fue expuesta para obtener la osteosíntesis satisfactoria. Lateralmente, se obtuvo buena visión de los márgenes tumorales y control de la arteria vertebral. Las complicaciones encontradas fueron infección superficial de la herida, con fácil cicatrización, dehiscencia tardía de la pared posterior de la faringe y pseudoartrosis, todas en el mismo paciente. Existen tres técnicas quirúrgicas principales con acceso anterior para el tratamiento de lesiones del clivus, foramen magno o vértebras cervicales superiores. Elegimos la glosotomía labiomandibular mediana (GLMM) como opción primaria, que proporcionó una visión directa del clivus, C3-C4 caudalmente y campo quirúrgico más amplio. Las principales ventajas de la GLMM incluyen acceso directo a la patología espinal, plano avascular a través de la parte mediana del rafe de la faringe y un campo quirúrgico ampliado en las dimensiones transversa y sagital. Conclusiones: Este abordaje proporciona excelente exposición de la unión craneocervical y de la columna cervical alta. Nivel de evidencia IV; Serie de casos analizados retrospectivamente.


Subject(s)
Humans , Trauma, Nervous System , Spine , General Surgery
19.
Neurochem Int ; 147: 105053, 2021 07.
Article in English | MEDLINE | ID: mdl-33961947

ABSTRACT

Maternal stress has been described as an important component in the offspring's cerebral development, altering the susceptibility to diseases in later life. Moreover, the postnatal period is essential for the development and integration of several peripheral and central systems related to the control of homeostasis. Thus, this study aimed to evaluate the effects of prenatal stress on the activation of cortical neurons, by performing experiments both under basal conditions and after KCl-induced depolarization. Female mice were divided in two groups: control and prenatal restraint stress. Cortical neurons from the offspring were obtained at gestational day 18. The effects of prenatal stress and KCl stimulations on cellular mortality, autophagy, gene expression, oxidative stress, and inflammation were evaluated. We found that neurons from PNS mice have decreased necrosis and autophagy after depolarization. Moreover, prenatal stress modulated the HPA axis, as observed by the increased GR and decreased 5HTr1 mRNA expression. The BDNF is an important factor for neuronal function and results demonstrated that KCl-induced depolarization increased the gene expression of BDNF I, BDNF IV, and TRκB. Furthermore, prenatal stress and KCl treatment induced significant alterations in oxidative and inflammatory markers. In conclusion, prenatal stress and stimulation with KCl may influence several markers related to neurodevelopment in cortical neurons from neonate mice, supporting the well-known long-term effects of maternal stress.


Subject(s)
Cell Death/physiology , Hypothalamo-Hypophyseal System/metabolism , Oxidative Stress/physiology , Pituitary-Adrenal System/metabolism , Prenatal Exposure Delayed Effects/metabolism , Animals , Brain-Derived Neurotrophic Factor/metabolism , Cell Death/genetics , Female , Male , Mice, Inbred BALB C , Neurons/metabolism , Pregnancy , Restraint, Physical/methods , Stress, Psychological/metabolism
20.
Behav Brain Res ; 407: 113237, 2021 06 11.
Article in English | MEDLINE | ID: mdl-33798820

ABSTRACT

Hypoxia-ischemia (HI) is a consequence of a lack of oxygen and glucose support to the developing brain, which causes several neurodevelopmental impairments. Environmental enrichment (EE) is considered an option to recover the alterations observed in rodents exposed to HI. The aim of this study was to investigate the impact of early EE on memory, hippocampal volume and brain-derived neurotrophic factor (Bbnf) and glucocorticoid receptor (Nr3c1) gene expression of mice exposed to HI. At P10, pups underwent right carotid artery permanent occlusion followed by 35 min of 8% O2 hypoxic environment. Starting at P11, animals were reared in EE or in standard cage (HI-SC or SHAM-SC) conditions until behavioral testing (P45). SHAM pups did not undergo carotid ligation and hypoxic exposure. Memory performance was assessed in the Y-maze, Novel object recognition, and Barnes maze. Animals were then sacrificed for analysis of hippocampal volume and Bdnf and Nr3c1 gene expression. We observed that animals exposed to HI performed worse in all three tests compared to SHAM animals. Furthermore, HI animals exposed to EE did not differ from SHAM animals in all tasks. Moreover, HI decreased hippocampal volume, while animals reared in early EE were not different compared to SHAM animals. Animals exposed to HI also showed upregulated hippocampal Bdnf expression compared to SHAM animals. We conclude that early EE from P11 to P45 proved to be effective in recovering memory impairments and hippocampal volume loss elicited by HI. Nevertheless, Bdnf expression was not associated with the improvements in memory performance observed in animals exposed to EE after a hypoxic-ischemic event.


Subject(s)
Brain-Derived Neurotrophic Factor/metabolism , Environment , Hippocampus , Hypoxia-Ischemia, Brain/complications , Memory Disorders/etiology , Memory Disorders/rehabilitation , Animals , Animals, Newborn , Disease Models, Animal , Hippocampus/metabolism , Hippocampus/pathology , Hippocampus/physiopathology , Hypoxia-Ischemia, Brain/metabolism , Hypoxia-Ischemia, Brain/pathology , Hypoxia-Ischemia, Brain/physiopathology , Male , Memory Disorders/physiopathology , Mice , Mice, Inbred BALB C
SELECTION OF CITATIONS
SEARCH DETAIL
...