Retrospective study of sports-related maxillofacial fractures in a Brazilian trauma care center

Aim: Maxillofacial fractures occur frequently in the general population, and sports-related fractures represent some of these cases. However, few studies have been carried out in Brazilian populations aimed at sports-related maxillofacial fractures. This study assessed the demographic and fracture characteristics of patients with sports-related maxillofacial fractures who were seen at a Brazilian trauma care center. Methods: Medical records of patients with a history of sports-related maxillofacial fractures treated between January 2018 and December 2019 were retrospectively evaluated. Personal data, fracture characteristics, sport type, treatment performed and need for hospitalization were collected. The data were subjected to statistical analyses with likelihood ratio test using the Statistical Package for Social Sciences (SPSS) 25.0 (p ≤ 0.050). Results: Forty cases (4.96% of the total) of facial fractures were included. The mean age was 24.9 (± 9.8) years, with a predominance of males (92.5%). The use of protective equipment was rare. The most frequently involved sport modality was soccer (47.5%), followed by cycling (27.5%). The most frequent fracture location was nose (45%), followed by mandible (25%) and zygomatic complex (17.5%). Soccer was responsible for most nose fractures (61.1%), while cycling caused the majority of mandibular fractures (60%). Conservative treatment predominated (60%). There was only a significant difference between fracture location and the need for hospitalization (p = 0.021). Conclusion: Patients with sportsrelated maxillofacial fractures were typically young adult males, the injury was more often located in the nose and mandible and related to soccer or cycling. The use of protective equipment must be reinforced.

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Isolated Tympanic Plate Fracture Frequency and Its Relationship to Mandibular Trauma

Canadian Association of Radiologists Journal ◽

10.1016/j.carj.2014.02.004 ◽

2014 ◽

Vol 65 (4) ◽

pp. 360-365 ◽

Cited By ~ 4

Author(s):

Canan Altay ◽

Nezahat Erdoğan ◽

Ozan Batkı ◽

Erdem Eren ◽

Sedat Altay ◽

...

Keyword(s):

Ct Images ◽

Maxillofacial Trauma ◽

Mandibular Fractures ◽

Condylar Process ◽

Plate Fracture ◽

Maxillofacial Fractures ◽

Significant Difference ◽

Mandible Fractures ◽

The Right ◽

Communications System

PurposeThis study evaluated the prevalence of isolated tympanic fractures and their correlation with mandibular fractures by using maxillofacial computed tomography (CT).Materials and MethodsWe retrospectively evaluated the maxillofacial CT of 1590 patients who presented to our emergency department with maxillofacial trauma between December 2010 and December 2012. Maxillofacial CT was used as the criterion standard for evaluating patients with maxillofacial fractures. The CT images were evaluated by using an electronic picture archiving and communications system and interpreted independently by 2 radiologists.ResultsThe maxillofacial CT images revealed mandibular fractures in 167 of the patients and isolated tympanic plate fractures in 35 of these 167 patients. Four patients (11%) had a bilateral tympanic plate fracture, and 31 patients (89%) had unilateral tympanic plate fracture. Of all the tympanic plate fractures, 19 (54%) were on the right side and 16 (46%) were on the left side ( P > .05). In our results, a significant correlation between the presence of a right-sided tympanic plate fracture and fracture of the ipsilateral condylar process was found ( P = .036). However, a statistically significant difference between the presence of a tympanic plate fracture and other mandible fractures, additional soft-tissue findings, or the number of fractures was not determined ( P > .05). Sex had no impact on the presence of tympanic plate fracture ( P > .05).ConclusionThe frequency of isolated tympanic plate fractures in maxillofacial trauma is low, but it is an important anatomic location. Condyle fractures are significantly associated with isolated tympanic plate fractures. The presence of these injuries should raise suspicion of a concomitant isolated tympanic plate fracture.

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Challenge and management outcome of panfacial fractures in Sohag University hospital, Egypt

International Surgery Journal ◽

10.18203/2349-2902.isj20175881 ◽

2017 ◽

Vol 5 (1) ◽

pp. 126 ◽

Cited By ~ 1

Author(s):

Tarek Elsayed Ftohy Abdelrahman ◽

Ahmed Abdelmaaboud ◽

Ahmed Hamody

Keyword(s):

Internal Fixation ◽

Open Reduction ◽

Road Traffic ◽

Mouth Opening ◽

University Hospital ◽

Mandibular Fractures ◽

Trauma Patients ◽

Adult Males ◽

Maxillofacial Fractures ◽

Panfacial Fractures

Background: panfacial fractures resembles a therapeutic challenge to maxillofacial surgeons This study was carried out to determine the etiology, injury characteristics and management outcome of pan facial fractures at Sohag university hospital.Methods: A retrospective hospital based study of panfacial fractures patients was carried out at Sohag university hospital from January 2010 to December 2016. Data was collected and analyzed using SPPS.Results: 200 Panfacial Trauma Patients were analysed. Males to females by a ratio of 24:1. Their ages ranged from 13 to 63 years with a mean of 30±12 years Most injuries were due to road traffic accidents (78%), and by falling from height in 12%. Mandibular fractures were the most common type of injuries. Open reduction and internal fixation by using plates and screws was the commonest surgical technique, used in 97.8% of cases. The most common complications were limited mouth opening, malocclusion. The mean duration of hospital stay was 11.13±2.23 days.Conclusions: Road traffic accident (RTC) was the most common cause of panfacial injuries in our locality and the young adult males were the most commonly affected victims. The majority of maxillofacial fractures were treated by open reduction and internal fixation.

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Comparative Morbidity Profile of Elective vs Therapeutic Neck Dissection

Otolaryngology ◽

10.1177/01945998211008915 ◽

2021 ◽

pp. 019459982110089

Author(s):

Quinn Dunlap ◽

James Reed Gardner ◽

Amanda Ederle ◽

Deanne King ◽

Maya Merriweather ◽

...

Keyword(s):

Neck Dissection ◽

Surgical Complications ◽

Chart Review ◽

Care Center ◽

Tertiary Care ◽

Retrospective Chart Review ◽

Neck Surgery ◽

Continuous Variables ◽

Significant Difference ◽

History Of

Objective Neck dissection (ND) is one of the most commonly performed procedures in head and neck surgery. We sought to compare the morbidity of elective ND (END) versus therapeutic ND (TND). Study Design Retrospective chart review. Setting Academic tertiary care center. Methods Retrospective chart review of 373 NDs performed from January 2015 to December 2018. Patients with radical ND or inadequate chart documentation were excluded. Demographics, clinicopathologic data, complications, and sacrificed structures during ND were retrieved. Statistical analysis was performed with χ2 and analysis of variance for comparison of categorical and continuous variables, respectively, with statistical alpha set a 0.05. Results Patients examined consisted of 224 males (60%) with a mean age of 60 years. TND accounted for 79% (n = 296) as compared with 21% (n = 77) for END. Other than a significantly higher history of radiation (37% vs 7%, P < .001) and endocrine pathology (34% vs 2.6%, P < .001) in the TND group, no significant differences in demographics were found between the therapeutic and elective groups. A significantly higher rate of structure sacrifice and extranodal extension within the TND group was noted to hold in overall and subgroup comparisons. No significant difference in rate of surgical complications was appreciated between groups in overall or subgroup analysis. Conclusion While the significantly higher rate of structure sacrifice among the TND population represents an increased morbidity profile in these patients, no significant difference was found in the rate of surgical complications between groups. The significant difference seen between groups regarding history of radiation and endocrine pathology likely represents selection bias.

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Prehospital Intubations Are Associated with Elevated Endotracheal Tube Cuff Pressures: A Cross-Sectional Study Characterizing ETT Cuff Pressures at a Tertiary Care Emergency Department

Prehospital and Disaster Medicine ◽

10.1017/s1049023x21000297 ◽

2021 ◽

pp. 1-4

Author(s):

Ruo S. Chen ◽

Laurel O’Connor ◽

Matthew R. Rebesco ◽

Kara L. LaBarge ◽

Edgar J. Remotti ◽

...

Keyword(s):

Endotracheal Tube ◽

Cuff Pressure ◽

Care Center ◽

Tertiary Care ◽

Cross Sectional Study ◽

Endotracheal Tube Cuff ◽

Cross Sectional ◽

Tube Cuff ◽

Respiratory Therapists ◽

Significant Difference

Abstract Introduction: Emergency Medical Services (EMS) providers are trained to place endotracheal tubes (ETTs) in the prehospital setting when indicated. Endotracheal tube cuffs are traditionally inflated with 10cc of air to provide adequate seal against the tracheal lumen. There is literature suggesting that many ETTs are inflated well beyond the accepted safe pressures of 20-30cmH2O, leading to potential complications including ischemia, necrosis, scarring, and stenosis of the tracheal wall. Currently, EMS providers do not routinely check ETT cuff pressures. It was hypothesized that the average ETT cuff pressure of patients arriving at the study site who were intubated by EMS exceeds the safe pressure range of 20-30cmH2O. Objectives: While ETT cuff inflation is necessary to close the respiratory system, thus preventing air leaks and aspiration, there is evidence to suggest that over-inflated ETT cuffs can cause long-term complications. The purpose of this study is to characterize the cuff pressures of ETTs placed by EMS providers. Methods: This project was a single center, prospective observational study. Endotracheal tube cuff pressures were measured and recorded for adult patients intubated by EMS providers prior to arrival at a large, urban, tertiary care center over a nine-month period. All data were collected by respiratory therapists utilizing a cuff pressure measurement device which had a detectable range of 0-100cmH2O and was designed as a syringe. Results including basic patient demographics, cuff pressure, tube size, and EMS service were recorded. Results: In total, 45 measurements from six EMS services were included with ETT sizes ranging from 6.5-8.0mm. Mean patient age was 52.2 years (67.7% male). Mean cuff pressure was 81.8cmH2O with a range of 15 to 100 and a median of 100. The mode was 100cmH2O; 40 out of 45 (88.9%) cuff pressures were above 30cmH2O. Linear regression showed no correlation between age and ETT cuff pressure or between ETT size and cuff pressure. Two-tailed T tests did not show a significant difference in the mean cuff pressure between female versus male patients. Conclusion: An overwhelming majority of prehospital intubations are associated with elevated cuff pressures, and cuff pressure monitoring education is indicated to address this phenomenon.

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Evaluation of the Anxiety Level of Mothers of Children with Epilepsy during the COVID-19 Pandemic Period

European Neurology ◽

10.1159/000514826 ◽

2021 ◽

pp. 1-8

Author(s):

Halil Celik ◽

Sadettin Burak Acikel ◽

Fatih Mehmet Akif Ozdemir ◽

Erhan Aksoy ◽

Ulkuhan Oztoprak ◽

...

Keyword(s):

Neurological Disease ◽

Chronic Conditions ◽

Care Center ◽

Tertiary Care ◽

Anxiety Level ◽

Childhood And Adolescence ◽

Routine Examination ◽

Significant Difference ◽

Anxiety Levels

Background and Aim: Although anyone can be affected by the COVID-19 pandemic, it may cause additional concern for people with chronic conditions. Epilepsy is the most common neurological disease in childhood and adolescence. The aim of this study was to determine anxiety levels among the mothers of children under follow-up for epilepsy in our clinic during the COVID-19 pandemic. Methods: The study group consisted of the mothers of epilepsy patients who were under follow-up in the pediatric neurology outpatient clinic of the tertiary care center and were scheduled for a routine examination during the COVID-19 pandemic. The mothers’ anxiety levels according to the Beck Anxiety Inventory and their opinions about COVID-19 in relation to their child were assessed and compared based on whether the mother/patient attended their appointments in person and whether the child had frequent or infrequent seizures. Results: There was no statistically significant difference in anxiety level between the mothers of 64 children with epilepsy who attended their appointment during the pandemic and those of the mothers of 52 who did not attend their appointment. However, the mothers of children with frequent seizures had significantly higher anxiety levels. Conclusion: Anxiety level of mothers whose children have frequent seizures was significantly higher compared to mothers whose children have infrequent seizures. It is important to be aware about this point and using telemedicine approach in suitable population and postpone routine outpatient follow-up appointments as much as possible.

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Tailor-Made Psychosocial Intervention for the Caregivers in Emergency and Trauma Care Center

Journal of Neurosciences in Rural Practice ◽

10.1055/s-0041-1722815 ◽

2021 ◽

Vol 12 (02) ◽

pp. 290-294

Author(s):

T.R. Kanmani ◽

Birudu Raju ◽

Subhas Konar ◽

Dhaval Shukla ◽

Raghavendra Kukkehalli

Keyword(s):

Trauma Care ◽

Psychosocial Intervention ◽

Care Center ◽

Psychosocial Problems ◽

Psychosocial Interventions ◽

Survey Method ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Study Objective ◽

The Impact

Abstract Introduction The caregiver’s psychosocial problems are unnoticed in the emergency and trauma care center. Therefore, the study objective was to understand the impact of psychoeducation and psychosocial intervention on traumatic brain injury (TBI) caregivers during hospitalization. Methodology The study adopted a descriptive research design. Sixty-three (n = 63) consented caregivers were recruited by using a cross-sectional survey method. Two separate checklists were used to collect the psychosocial problems in emergency and trauma care as well as to know the satisfaction levels of caregivers after the intervention. R free 3.0.1 software was used to calculate the frequency and percentage. Results The caregiver’s mean age was 39 years (39.46 ± 16.22). The majority of the caregivers were males (45; 71.4%) working as daily wagers (42; 66.7%). Caregivers experienced psychosocial problems, that is, depression, anxiety, stress, unable to handle crisis, grief, lack of coping skills (57; 90.5%), emotional distress (57; 90.5%), financial constraints (45; 71.1%), and need for referral services (45; 71.1%). Tailor-made psychosocial interventions were provided to the caregivers. Conclusion To conclude, there is a greater need to provide psychosocial intervention and train the caregivers to provide care for TBI survivors during hospitalization. There is a need to develop the uniform standard operating procedure for medical and psychiatric social workers in providing psychosocial care in emergency and trauma care setting.

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Miniplate 1.5 fixation for the repair of mandibular osteotomies in cats

Acta Cirurgica Brasileira ◽

10.1590/s0102-86502011000100007 ◽

2011 ◽

Vol 26 (1) ◽

pp. 31-37 ◽

Cited By ~ 3

Author(s):

Adelina Maria da Silva ◽

Wilson Machado de Souza ◽

Patrícia de Athayde Barnabé ◽

Marion Burkhardt de Koivisto ◽

Nair Trevizan Machado de Souza

Keyword(s):

Radiolucent Line ◽

The Body ◽

Bone Union ◽

Dental Occlusion ◽

Mandibular Fractures ◽

Significant Difference ◽

Osteotomy Line ◽

Group 2 ◽

Adult Cats ◽

Group 1

Purpose: To evaluate the application of the maxillofacial miniplate 1.5 in the repair of unilateral mandibular osteotomies in cats. Methods: Twelve adult cats were divided into two groups. In group 1 (n=6), the osteotomy was performed in the body of the mandible, behind the 1st molar. In group 2 (n=6), the osteotomy was performed between the 4th premolar and 1st molar. The osteotomy was fixed with a titanium miniplate 1.5. Oral alimentation was reinitiated 24 hours after surgery. Cats were euthanized at 12 weeks postoperative. Results: Radiographs taken 1 week after surgery showed a radiolucent line. The osteotomy line was not more visible on the radiographs taken at 12 weeks postoperative. Macroscopic examination confirmed alignment and bone union of operated hemimandibles. Histological examination showed formation of woven bone within the osteotomy line. The percentage of bone tissue at these areas was measured by the histometry. There was no statistically significant difference between the values of group 1(75.07 ± 5.99) and group 2 (74.76 ± 8.54) (Mann-Whitney's test p= 0.469). Conclusion: We concluded that the use of miniplate 1.5 for the fixation of mandibular osteotomy in cats provided the main goals in the treatment of mandibular fractures: bone union, normal dental occlusion and immediate return to oral alimentation.

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Usefulness of the Non-Contact Tonometry in Out-Patient Screening

Asian Journal of Ophthalmology ◽

10.35119/asjoo.v15i2.232 ◽

2016 ◽

Vol 15 (2) ◽

Author(s):

Satheesh Solomon T Selvin ◽

Chris Elsa Samson Jacob ◽

Thomas Kuriakose

Keyword(s):

Central Corneal Thickness ◽

Care Center ◽

Corneal Thickness ◽

Tertiary Care ◽

Cross Sectional Study ◽

Applanation Tonometry ◽

Cross Sectional ◽

Significant Difference ◽

Iop Measurement ◽

The Mean

Purpose: Goldmann applanation tonometry (GAT) is considered the gold standard for Intraocular Pressure (IOP) measurement. It has the disadvantages of being a contact device, need for a slit-lamp, non-portability and need of a skilled examiner. Many hospitals are using a Non Contact Tonometry (NCT) as a screening device to save clinician time, however the usefulness is not proved in terms of reliability. This study was aimed to determine the usefulness of the Air-puff tonometer (TONOREF NIDEK II, NIDEK CO., LTD., JAPAN) over a GAT in a tertiary care center. Design: Cross-sectional Study Methods: This was a cross-sectional, non interventional observational study conducted on 224 eyes (right eye) from 224 patients. All patients underwent the IOP measurement with both methods and a central corneal thickness (CCT) measured. The data was analyzed using SPSS 20.0 software. Results: The mean age of the patients was 40.3±11.29 years. There was a statistically significant difference (p<0.001) between the mean NCT and GAT readings which persisted even after correction for central corneal thickness. The correlation between NCT and GAT using Pearson’s correlation coefficient was strong irrespective of the corrections for their corneal thickness (r = 0.751 and 0.718 for uncorrected and corrected values respectively). The correlation of the individual clinicians for the readings varied from moderate to strong. The ROC curve showed the best sensitivity and specificity to occur at around 13 to 14 mmHg. Conclusion: NCT seems to overestimate the IOP at low ranges as compared to the GAT and underestimate at higher ranges. The crossover of the values is seen between 12 to 13 mmHg. The clinician should do an individualized analysis of his/her GAT measurements to the readings of the NCT machine at the clinic to obtain clinician specific nomogram.

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Patterns of Maxillofacial Fractures in Road Traffic Crashes in an Indian Rural Tertiary Center

Panamerican Journal of Trauma, Critical Care & Emergency Surgery ◽

10.5005/jp-journals-10030-1088 ◽

2014 ◽

Vol 3 (2) ◽

pp. 53-58

Author(s):

A Sagayaraj ◽

Rijo M Jayaraju ◽

Mallika P Reddy ◽

KR Harshitha ◽

Priyanka Majety

Keyword(s):

Road Traffic ◽

Bone Fractures ◽

Nasal Bone ◽

Road Traffic Crash ◽

Mandibular Fractures ◽

Traffic Crashes ◽

Large Variability ◽

Road Traffic Crashes ◽

Maxillofacial Fractures ◽

Tertiary Center

ABSTRACT Background and objectives Road traffic crashes are reported to be the leading cause of maxillofacial fractures in developing countries. The large variability in reported incidence and etiology is due to a variety of contributing factors, including environmental, cultural and socioeconomic factors. The study aims at describing the patterns of maxillofacial fractures in road traffic crashes by clinical and radiological methods and to study the complications associated with these fractures. Materials and methods The study included 100 road traffic crash patients with maxillofacial injuries. Patients were evaluated for any maxillofacial fracture by clinical assessment and, radiologically, using plain radiographs and computed tomography scan. Results Midfacial skeleton was more prone to fractures. Isolated fractures of the maxilla was the commonest (58%) followed by nasal bone fractures (43%). Among the complex fractures, Le Fort type II was the commonest. Mandibular fractures were seen in 33% of the patients, parasymphysis being the commonest site. Majority of the patients had associated soft tissue injuries. The incidence of complications associated with maxillofacial fractures was 11%, malocclusion being the commonest. Conclusion Maxillofacial fractures are commoner in the mobile population in the most productive age group, more so in two wheeler riders causing significant morbidity and mortality. Midface region is more prone to fractures and is most of the time associated with complications. How to cite this article Jayaraju RM, Sagayaraj A, Reddy MP, Harshitha KR, Majety P. Patterns of Maxillofacial Fractures in Road Traffic Crashes in an Indian Rural Tertiary Center. Panam J Trauma Crit Care Emerg Surg 2014;3(2):53-58.

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Personal and environmental characteristics associated with coordination development disorder

Journal of Physical Education ◽

10.4025/jphyseduc.v32i1.3266 ◽

1989 ◽

Author(s):

Viviane Aparecida Pereira dos Santos ◽

◽

Luciana Ferreira ◽

Vânia de Fátima Mathias de Souza ◽

José Luiz Lopes Vieira

Keyword(s):

Cognitive Development ◽

Motor Development ◽

Developmental Coordination Disorder ◽

Classroom Teacher ◽

Care Center ◽

Personal Characteristics ◽

Early Years ◽

Measurement Instruments ◽

Environmental Characteristics ◽

Significant Difference

Identify the associtation among personal and environmental characteristics on the motor development of children with probable developmental coordination disorder (DCD). The participants were 42 parents, 32 teachers and 42 preschoolers’ (3.4±0.5years). As measurement instruments: The Movement Assessment Battery for Children 2 (MABC2), the Columbia Mental Maturity test (EMMC), the Questionnaire of the Brazilian Association of Research Companies (ABEP), the Strengths and Difficulties Questionnaire (SDQ), the Swanson Nolan and Pelham IV Scale (SNAP-IV), Structured Questionnaire for parents on motor, academic, emotional and behavioral skills and Early Years Movement Skills Checklist were used. For data analysis, the Shapiro Wilk test and Binary Logistic Regression were used, adopting p <0.05. Results shown statistically significant difference for the personal characteristics associated with children with persistence DCD: 1) birth weight, age to sit, cognitive development, language problems and conduct problems; 2) For home characteristics: quality of the home environment and the parents' stable union were taken into account; 3) For day care center, the education of the classroom teacher was considered. In conclusion, children who were born with greater weight, who had higher cognitive development, live with parents in a stable relationship and who have a specialized classroom teacher were less likely to persist in DCD.

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