CRIS

Permanent URI for this communityhttps://investigadores.udd.cl/handle/123456789/1

Browse

Search Results

Now showing 1 - 10 of 10

Some of the metrics are blocked by your
consent settings
How I Do It: Evaluating Cardiac Implantable Devices and Noncardiac Mimics on Chest Radiographs
(Radiological Society of North America (RSNA), 2025-05-01)
SILVA FUENTE ALBA, CLAUDIO SERGIO
;
Jared D. Christensen
This article provides a comprehensive review of the radiographic appearances of cardiac implantable electronic devices, other cardiac support apparatuses, and similar-appearing noncardiac devices, emphasizing the importance of accurate identification and evaluation for potential complications.
6
Some of the metrics are blocked by your
consent settings
Variations in management of A3 and A4 cervical spine fractures as designated by the AO Spine Subaxial Injury Classification System
(2022)
Barry Ting Sheen Kweh
;
Jin Wee Tee
;
Sander Muijs
;
F. Cumhur Oner
;
Klaus John Schnake
<jats:sec> <jats:title>OBJECTIVE</jats:title> <jats:p>Optimal management of A3 and A4 cervical spine fractures, as defined by the AO Spine Subaxial Injury Classification System, remains controversial. The objectives of this study were to determine whether significant management variations exist with respect to 1) fracture location across the upper, middle, and lower subaxial cervical spine and 2) geographic region, experience, or specialty.</jats:p> </jats:sec> <jats:sec> <jats:title>METHODS</jats:title> <jats:p>A survey was internationally distributed to 272 AO Spine members across six geographic regions (North America, South America, Europe, Africa, Asia, and the Middle East). Participants’ management of A3 and A4 subaxial cervical fractures across cervical regions was assessed in four clinical scenarios. Key characteristics considered in the vignettes included degree of neurological deficit, pain severity, cervical spine stability, presence of comorbidities, and fitness for surgery. Respondents were also directly asked about their preferences for operative management and misalignment acceptance across the subaxial cervical spine.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>In total, 155 (57.0%) participants completed the survey. Pooled analysis demonstrated that surgeons were more likely to offer operative intervention for both A3 (p < 0.001) and A4 (p < 0.001) fractures located at the cervicothoracic junction compared with fractures at the upper or middle subaxial cervical regions. There were no significant variations in management for junctional incomplete (p = 0.116) or complete (p = 0.342) burst fractures between geographic regions. Surgeons with more than 10 years of experience were more likely to operatively manage A3 (p < 0.001) and A4 (p < 0.001) fractures than their younger counterparts. Neurosurgeons were more likely to offer surgical stabilization of A3 (p < 0.001) and A4 (p < 0.001) fractures than their orthopedic colleagues. Clinicians from both specialties agreed regarding their preference for fixation of lower junctional A3 (p = 0.866) and A4 (p = 0.368) fractures. Overall, surgical fixation was recommended more often for A4 than A3 fractures in all four scenarios (p < 0.001).</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>The subaxial cervical spine should not be considered a single unified entity. Both A3 and A4 fracture subtypes were more likely to be surgically managed at the cervicothoracic junction than the upper or middle subaxial cervical regions. The authors also determined that treatment strategies for A3 and A4 subaxial cervical spine fractures varied significantly, with the latter demonstrating a greater likelihood of operative management. These findings should be reflected in future subaxial cervical spine trauma algorithms.</jats:p> </jats:sec>
17Scopus© Citations 3
Some of the metrics are blocked by your
consent settings
Early Weight-Bearing After Percutaneous Reduction and Screw Fixation for Low-Energy Lisfranc Injury
(2013)
WAGNER HITSCHFFELD, EMILIO
;
Cristian Ortiz
;
Ignacio E. Villalón
;
Andrés Keller
;
Pablo Wagner
<jats:sec><jats:title>Background:</jats:title><jats:p>Anatomic restoration and postoperative rehabilitation of displaced fracture-dislocations of the tarsometatarsal junction of the foot are essential. Our objective was to report percutaneous reduction and screw fixation results in low-energy Lisfranc fracture dislocation injuries that were treated with early weight-bearing and rehabilitation.</jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p>We retrospectively evaluated patients with low-energy Lisfranc injuries who underwent surgery between May 2007 and April 2011. The study reviewed 22 patients (12 men and 10 women) with an average age of 36.2 years (range, 16-50 years) and an average follow-up of 33.2 months (range, 12-50 months). We report the mechanism of trauma; quality of reduction in the postoperative digital radiographs; subjective satisfaction; AOFAS score; time required to return to work, recreational activities, and low-impact sports; and complications. Postoperatively, all of the patients were instructed to be non-weight-bearing for 3 weeks, and the stitches were removed after 2 weeks. At the third postoperative week, the patients were encouraged to bear weight as tolerated.</jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p>Quality of reduction was anatomic or near anatomic in 100% of cases. The subjective satisfaction reported by patients was very good, with complete satisfaction in 20 of them (90.9%). The AOFAS average was 94 points (range, 90-100 points). Average return to work was at 7 weeks (range, 6-9 weeks), recreational activities 7.2 weeks (range, 6-9 weeks), training for low-impact sports 7.6 weeks (range, 7-8 weeks), and symptom-free sport activities 12.4 weeks (range, 11-13 weeks).</jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p>In this selected group of patients with low-energy Lisfranc fracture dislocation, anatomic or near-anatomic reduction can be achieved with percutaneous reduction and screw fixation. Early weight-bearing is possible in these patients, and early return to regular activities and low-impact sport can be expected.</jats:p></jats:sec><jats:sec><jats:title>Level of Evidence:</jats:title><jats:p>Level IV, retrospective case series.</jats:p></jats:sec>
5Scopus© Citations 47
Some of the metrics are blocked by your
consent settings
Arthroskopie nach Trauma des Hüftgelenks
(2011)
CLAUDIO MELLA SCHMIDT
;
JORGE DEL RÍO
;
LARA JIMÉNEZ, JOAQUÍN OSVALDO
;
DANTE RAFAEL PARODI SANHUEZA
;
LUIS EMILIO MOYA CÁDIZ
Scopus© Citations 7 8
Some of the metrics are blocked by your
consent settings
Outcomes of Total Ankle Arthroplasty in Postfracture Ankle Arthritis
(2023)
Jaeyoung Kim
;
Ruben Radkievich
;
Rami Mizher
;
Isabel Shaffrey
;
Martin O’Malley
<jats:sec><jats:title>Background:</jats:title><jats:p> Ankle arthritis that develops after fracture accounts for a significant portion of ankle arthritis necessitating total ankle arthroplasty (TAA). It remains unknown whether TAA in postfracture patients produces equivalent outcomes to those without fracture history. The purpose of this study was to evaluate the medium-term outcomes of TAA in postfracture ankle arthritis compared to those without fracture history. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> This study reviewed 178 ankles from 171 consecutive patients who underwent TAA in our institution between 2007 and 2017 and completed a minimum 5-year follow-up. Four different TAA systems were utilized by 6 surgeons. Based on fracture history, patients were divided into 2 groups: the postfracture group (n = 63; median age 65.7 years; median follow-up 5.9 years) and the nonfracture group (n = 115; median age 64.4 years; median follow-up 6.2 years). Types and rates of complications including revision and reoperation were compared. Minimum 5-year Foot and Ankle Outcome Score (FAOS) and postoperative improvement were investigated. A subgroup analysis was performed to determine whether outcomes differ between intraarticular fracture patients (n = 43) and extraarticular fracture patients (n = 20). </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> Both groups exhibited comparable postoperative improvement and final FAOS scores. The postfracture group had a significantly higher reoperation rate than the nonfracture group (20 of 63, 31.7%, vs 17 of 115, 14.8%; P = .011), with gutter impingement being the most common cause. There were 3 revisions in each group. In the subgroup analysis, we found no evidence of statistical difference between the intraarticular fracture group and the extraarticular fracture group in terms of FAOS scores, revision, and reoperation rates. </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> In this single-center, retrospective comparative study, we found total ankle arthroplasty in patients with a history of fractures around the ankle joint had no evidence of statistical difference in patient-reported outcomes and implant survivorship but led to a higher rate of nonrevision reoperation following surgery. In the much smaller subset of patients with previous fracture, we did not find that those with a history of intraarticular fracture had inferior outcomes after TAA when compared to those with a history of extraarticular fracture. </jats:p></jats:sec><jats:sec><jats:title>Level of Evidence:</jats:title><jats:p> Level III, case-control study. </jats:p></jats:sec>
6Scopus© Citations 2
Some of the metrics are blocked by your
consent settings
Minimally Invasive Surgery for Traumatic Thoracolumbar Fractures: A Cross-Sectional Study of Spine Surgeons
(2023)
Guillermo A. Ricciardi
;
Juan Ignacio Cirillo Totera
;
Juan P. Cabrera
;
Alfredo Guiroy
;
Charles A. Carazzo
7Scopus© Citations 3
Some of the metrics are blocked by your
consent settings
The gain of function <i>SCN1A</i> disorder spectrum: novel epilepsy phenotypes and therapeutic implications
(2022)
Andreas Brunklaus
;
Tobias Brünger
;
Tony Feng
;
Carmen Fons
;
Anni Lehikoinen
<jats:title>Abstract</jats:title> <jats:p>Brain voltage-gated sodium channel NaV1.1 (SCN1A) loss-of-function variants cause the severe epilepsy Dravet syndrome, as well as milder phenotypes associated with genetic epilepsy with febrile seizures plus. Gain of function SCN1A variants are associated with familial hemiplegic migraine type 3. Novel SCN1A-related phenotypes have been described including early infantile developmental and epileptic encephalopathy with movement disorder, and more recently neonatal presentations with arthrogryposis. Here we describe the clinical, genetic and functional evaluation of affected individuals.</jats:p> <jats:p>Thirty-five patients were ascertained via an international collaborative network using a structured clinical questionnaire and from the literature. We performed whole-cell voltage-clamp electrophysiological recordings comparing sodium channels containing wild-type versus variant NaV1.1 subunits. Findings were related to Dravet syndrome and familial hemiplegic migraine type 3 variants.</jats:p> <jats:p>We identified three distinct clinical presentations differing by age at onset and presence of arthrogryposis and/or movement disorder. The most severely affected infants (n = 13) presented with congenital arthrogryposis, neonatal onset epilepsy in the first 3 days of life, tonic seizures and apnoeas, accompanied by a significant movement disorder and profound intellectual disability. Twenty-one patients presented later, between 2 weeks and 3 months of age, with a severe early infantile developmental and epileptic encephalopathy and a movement disorder. One patient presented after 3 months with developmental and epileptic encephalopathy only. Associated SCN1A variants cluster in regions of channel inactivation associated with gain of function, different to Dravet syndrome variants (odds ratio = 17.8; confidence interval = 5.4–69.3; P = 1.3 × 10−7). Functional studies of both epilepsy and familial hemiplegic migraine type 3 variants reveal alterations of gating properties in keeping with neuronal hyperexcitability. While epilepsy variants result in a moderate increase in action current amplitude consistent with mild gain of function, familial hemiplegic migraine type 3 variants induce a larger effect on gating properties, in particular the increase of persistent current, resulting in a large increase of action current amplitude, consistent with stronger gain of function.</jats:p> <jats:p>Clinically, 13 out of 16 (81%) gain of function variants were associated with a reduction in seizures in response to sodium channel blocker treatment (carbamazepine, oxcarbazepine, phenytoin, lamotrigine or lacosamide) without evidence of symptom exacerbation.</jats:p> <jats:p>Our study expands the spectrum of gain of function SCN1A-related epilepsy phenotypes, defines key clinical features, provides novel insights into the underlying disease mechanisms between SCN1A-related epilepsy and familial hemiplegic migraine type 3, and identifies sodium channel blockers as potentially efficacious therapies. Gain of function disease should be considered in early onset epilepsies with a pathogenic SCN1A variant and non-Dravet syndrome phenotype.</jats:p>
Scopus© Citations 45 20
Some of the metrics are blocked by your
consent settings
There is direct relationship between bone bridge length and coracoclavicular fixation resistance to failure: Biomechanical study in a porcine model
(2021)
Alex Vaisman
;
Rodrigo Guiloff
;
GUZMAN ROJAS, RODRIGO ARTURO
;
Francisca Convalía
;
Isidora De la Cruz
2
Some of the metrics are blocked by your
consent settings
Music Therapy for Pain and Anxiety Management in Nasal Bone Fracture Reduction: Randomized Controlled Clinical Trial
(2019)
Alvaro Ortega
;
Felipe Gauna
;
Daniel Munoz
;
Gerardo Oberreuter
;
Hayo A. Breinbauer
<jats:sec><jats:title>Objective</jats:title><jats:p> To evaluate whether listening to music through binaural headphones contributes to the perception of pain and anxiety in patients undergoing closed nasal bone fracture reductions. </jats:p></jats:sec><jats:sec><jats:title>Study Design</jats:title><jats:p> Randomized controlled trial. </jats:p></jats:sec><jats:sec><jats:title>Subjects and Methods</jats:title><jats:p> We recruited patients from San Juan de Dios Hospital with displaced nasal fractures who required a reduction and assigned them to a control group or a music group. For both groups, a protocolized closed reduction of the nasal fracture with local anesthesia was performed. The music group heard music through headphones during the pre-, intra-, and postprocedural periods of the intervention. Physiological variables (blood pressure and heart rate) were measured. An anxiety survey (State-Trait Anxiety Inventory) and the visual analog scale for measuring pain were also applied. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> The music group exhibited significantly lower levels of systolic blood pressure ( P = .0001), anxiety ( P < .0001), and pain ( P = .0004) than the control group. </jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p> Listening to music through headphones—a safe and low-cost intervention—appears to aid in pain and anxiety management associated with procedures that are usually uncomfortable, such as the reduction of nasal bone fractures with local anesthesia. We believe that this effect is achieved by the modulation of pain and anxiety on an emotional-affective dimension at a central level. Given its safety, feasibility, and low cost, music therapy should be considered a complementary treatment for pain and anxiety management for nasal fracture reduction performed with local anesthesia, as well as for other medical procedures of similar pain levels conducted without general anesthesia. </jats:p></jats:sec>
Scopus© Citations 30 7
Some of the metrics are blocked by your
consent settings
SOFT-TISSUE INJURY TO THE FOOT AND ANKLE: LITERATURE REVIEW AND STAGED MANAGEMENT PROTOCOL
(2019)
Alexandre Leme Godoy-Santos
;
Tim Schepers
;
Cristian Ortiz
<jats:p>ABSTRACT Complex trauma of the foot and ankle is characterized by fractures with severe soft tissue damage associated with neurovascular injury and joint involvement. These injuries are frequently present in the polytraumatized patient and are a predictor of unfavorable clinical outcome. In the initial approach to a patient with complex foot and ankle trauma, the decision between amputation and reconstruction is crucial. The various existing classification systems are of limited effectiveness and should serve as tools to assist and support a clinical decision rather than as determinants of conduct. In the emergency department, one of two treatment options must be adopted: early complete treatment or staged treatment. The former consists of definitive fixation and immediate skin coverage, using either primary closure (suturing) or flaps, and is usually reserved for less complex cases. Staged treatment is divided into initial and definitive. The objectives in the first phase are: prevention of the progression of ischemia, necrosis and infection. The principles of definitive treatment are: proximal-to-distal bone reconstruction, anatomic foot alignment, fusions in severe cartilage lesions or gross instabilities, stable internal fixation and adequate skin coverage. Level of evidence III, Systematic review of level III studies.</jats:p>
Scopus© Citations 7 1

CRIS

Browse

Filters

Settings

Sort By

Results per page

Search Results