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1.
Burns ; 50(4): 903-912, 2024 05.
Artigo em Inglês | MEDLINE | ID: mdl-38302393

RESUMO

INTRODUCTION: Nutritional support is essential in burn care. There are few studies investigating the effect of nutrition on burn healing. The purpose of this study was to determine the relationship between perioperative serum prealbumin levels and the probability of autologous skin graft take in burned patients. MATERIALS AND METHODS: A prospective observational study was carried out with burned adults recruited consecutively from April 2019 until September 2021. Serum prealbumin was determined perioperatively. The percentage of graft take was evaluated over the first 5 postoperative dressing changes. Time until full epithelialization (absence of wounds) was also registered. RESULTS: A total of 60 patients were recruited, mostly middle-aged people with moderate flame burns. Serum prealbumin levels and graft take had a weak-moderate, nonlinear, statistically significant correlation. They were also an independent predictor of full epithelialization on the fifth dressing change, together with burn depth. Higher perioperative serum prealbumin levels were significantly associated with a reduction in time until full epithelialization. CONCLUSIONS: Perioperative serum prealbumin levels are significantly correlated with the probability of split-thickness skin autograft take in burned patients and with a reduced time to achieve complete epithelialization. They were an independent predictor of full graft take.


Assuntos
Queimaduras , Pré-Albumina , Transplante de Pele , Cicatrização , Humanos , Queimaduras/cirurgia , Queimaduras/sangue , Queimaduras/metabolismo , Pré-Albumina/metabolismo , Pré-Albumina/análise , Masculino , Feminino , Estudos Prospectivos , Pessoa de Meia-Idade , Transplante de Pele/métodos , Adulto , Cicatrização/fisiologia , Idoso , Sobrevivência de Enxerto , Reepitelização , Transplante Autólogo , Adulto Jovem
3.
Br J Neurosurg ; 33(1): 12-16, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30450999

RESUMO

PURPOSE: Effective treatment of medical conditions relies on proper diagnosis. Clinical trials show the safety and effectiveness of sacroiliac joint (SIJ) fusion in patients with chronic SI joint dysfunction. To what extent is the condition under recognised? OBJECTIVE: To determine whether under recognition of SIJ pain affects healthcare trajectories in Spanish patients with low back pain. METHODS: Retrospective study of characteristics and consequences of 189 patients with persistent SIJ pain seen in an outpatient neurosurgery clinic. RESULTS: Patients with SIJ pain who were denied surgical treatment had a longer pain duration, higher likelihood of prior lumbar fusion, and a high rate (63%) of lumbar fusion within 2 years prior to SIJ pain diagnosis, which, in most cases, provided little benefit. CONCLUSIONS: Lack of knowledge of the role of the SIJ in chronic low back pain probably results in diagnostic confusion and may lead to misdirected treatment.


Assuntos
Artralgia/cirurgia , Dor Lombar/cirurgia , Articulação Sacroilíaca/cirurgia , Fusão Vertebral/estatística & dados numéricos , Dor Crônica/cirurgia , Feminino , Humanos , Região Lombossacral/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
4.
J Neurosurg Sci ; 61(3): 303-315, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27787487

RESUMO

INTRODUCTION: Although spinal infections have always been present recently their incidence has increased, in partly fostered by the advances in medicine (i.e. compromised immunity, chronic diseases, increasingly complex spinal procedures, etc.) and increased life expectancy. EVIDENCE ACQUISITION: Using PubMed for this systematic review, the main spine infections types will be addressed focusing in the minimally invasive surgical techniques that can be used in their treatment. EVIDENCE SYNTHESIS: Spontaneous and iatrogenic pyogenic and non-pyogenic spine infections can be treated in many different ways depending on their extension and location as well as on their causative microorganisms. The indications of percutaneous image-guided, endoscopic and microsurgical treatment techniques will be updated. CONCLUSIONS: In spine infections minimally invasive surgical techniques show a great potential as to be safe, effective, with low surgical morbidity and fast patients' recovery.


Assuntos
Doenças Ósseas Infecciosas/cirurgia , Abscesso Epidural/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Neuroendoscopia/métodos , Procedimentos Neurocirúrgicos/métodos , Doenças da Coluna Vertebral/cirurgia , Humanos
5.
Neurosurg Focus ; 41 Video Suppl 1: 1, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27364423

RESUMO

Chronic pain originating from the sacroiliac joint (SI) can cause severe dysfunction. Although many patients respond to conservative management with NSAIDs, some do need further treatment in the form of SI joint fusion (SIJF). To achieve safe and successful SIJF, intraoperative x-ray fluoroscopy is mandatory to avoid serious damages to nearby vascular and neural structures. Each step of the procedure has to be confirmed by anteroposterior (AP) and lateral projections. With a single-arm x-ray, the arch has to be moved back and forth for the AP and lateral projections, and this lengthens the procedure. To achieve the same results in less time, the authors introduced simultaneous biplanar fluoroscopy with 2 x-ray arches. After the patient is positioned prone with the legs spread apart in the so-called Da Vinci position, one x-ray arch for the lateral projection is placed at a right angle to the patient, and a second x-ray machine is placed with its arch between the legs of the patient. This allows simultaneous AP and lateral x-ray projections and, in the authors' hands, markedly speeds up the procedure. Biplanar fluoroscopy allows excellent AP and lateral projections to be made quickly at any time during the surgical procedure. This is particularly useful in cases of bilateral SI joint fusion if both sides are done at the same time. The video can be found here: https://youtu.be/TX5gz8c765M .


Assuntos
Articulação Sacroilíaca/cirurgia , Fusão Vertebral , Dor Crônica , Fluoroscopia , Humanos , Articulação Sacroilíaca/diagnóstico por imagem , Medula Espinal/cirurgia , Tomografia Computadorizada por Raios X , Raios X
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