scholarly journals Epidemiology of vertebral fractures in pediatric and adolescent patients

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Dominik Saul ◽  
Klaus Dresing
Keyword(s):  
Children And Adolescents ◽  
Vertebral Fractures ◽  
Traffic Accidents ◽  
Clinical Symptoms ◽  
Thoracolumbar Spine ◽  
Fall From Height ◽  
Fractures Of The Spine ◽  
X Ray Computed ◽  
Magnetic Resonance Imaging Mri ◽  
Tentative Diagnosis

Spinal injuries in children and adolescents are rare injuries, but consequences for the growing skeleton can be devastating. Knowledge of accident causes, clinical symptoms and diagnostics should be part of every trauma department treating the sepatients. We retrospectively analyzed patients with radiographically proven vertebral fractures of the spine. After clinical examination and tentative diagnosis the fractures and injuries were proven with conventional X-ray, computed tomography(CT) scans or magnetic resonance imaging (MRI). The study included 890 fractures in 546 patients with an average age of 12.8±6.2 (6.6-19.4) years. Females had anaverage age of 13.7±6.3 (7.4-20.0) years, whereas males were on average 12.0 (6.0-18.0) years old. Fall from height (58%) wasthe main cause of accident and the most common region of fracture was the thoracolumbar spine with a shift towards the thoracic spine the more fractures occurred. Merely 3.7% of all patients required operative treatment. If a vertebral fracture is found in children and adolescents, it is highly recommended to exclude synchronous additional spine fractures in other levels; prevention should concentrate on fall and traffic accidents.

scholarly journals THORACOLUMBAR SPINAL ARTHRODESIS - EPIDEMIOLOGY AND COSTS

2017 ◽  
Vol 16 (1) ◽  
pp. 52-55
Author(s):  
TOBIAS LUDWIG DO NASCIMENTO ◽  
LUIZ PEDRO WILLIMANN ROGÉRIO ◽  
MARCELO MARTINS DOS REIS ◽  
LEANDRO PELEGRINI DE ALMEIDA ◽  
GUILHERME FINGER ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Neurological Deficit ◽  
Traffic Accidents ◽  
Thoracolumbar Spine ◽  
Hospital Costs ◽  
Spine Fracture ◽  
Female Ratio ◽  
Cord Injury ◽  
Fall From Height

ABSTRACT Objective: To describe the epidemiology of patients with thoracolumbar spine fracture submitted to surgery at Hospital Cristo Redentor and the related costs. Methods: Prospective epidemiological study between July 2014 and August 2015 of patients with thoracolumbar spine fracture with indication of surgery. The variables analyzed were sex, age, cost of hospitalization, fractured levels, levels of arthrodesis, surgical site infection, UTI or BCP, spinal cord injury, etiology, length of stay, procedure time, and visual analog scale (VAS) . Results: Thirty-two patients were evaluated in the study period, with a mean age of 38.68 years. Male-female ratio was 4:1 and the most frequent causes were fall from height (46.87%) and traffic accidents (46.87%). The thoracolumbar transition was the most affected (40.62%), with L1 vertebra involved in 23.8% of the time. Neurological deficit was present in 40.62% of patients. Hospital stay had a median of 14 days and patients with neurological deficit were hospitalized for a longer period (p<0.001), with an increase in hospital costs (p= 0.015). The average cost of hospitalization was U$2,874.80. The presence of BCP increased the cost of hospitalization, and patients with spinal cord injury had more BCP (p= 0.014) . Conclusion: Public policies with an emphasis on reducing traffic accidents and falls can help reduce the incidence of these injuries and studies focusing on hospital costs and rehabilitation need to be conducted in Brazil to determinate the burden of spinal trauma and spinal cord injury.

scholarly journals Pathological fractures of the spine in children (review of the literature and clinical and morphological monocenter cohort analysis)

2020 ◽  
Vol 8 (1) ◽  
pp. 5-14
Author(s):  
Vyacheslav I. Zorin ◽  
Alexander Yu. Mushkin ◽  
Tatyana A. Novitskaya
Keyword(s):  
Vertebral Fractures ◽  
Clinical Symptoms ◽  
Cohort Analysis ◽  
Morphological Characteristics ◽  
Morphological Structure ◽  
Spinal Fracture ◽  
Thoracic Vertebrae ◽  
Pathological Fractures ◽  
Fractures Of The Spine ◽  
Mechanical Back Pain

Background. Pathological vertebral fractures are rare and occur in inflammatory, tumor, and dystrophic lesions. Aim. This study aimed to analyze clinical features and morphological structure of pathological fractures of the spine in children. Materials and methods. The authors examined and operated 62 children aged 217 years for pathological vertebral fractures. We investigated the clinical, radiological, and morphological features. Results. The average age of children at the time of hospitalization was 10 years. Lesions of thoracic vertebrae prevailed (78%) with the maximum frequency of occurrence at the apex of physiological kyphosis Th78. In 10 cases, multiple lesions were noted, including the pathology of other parts of the skeleton. In 69% of observations, clinical symptoms were not dominated by mechanical back pain. Palpation pain (34%) and local spinal deformation (27%) were noted. On average, local kyphosis was 24. Eleven patients (18%) manifested a neurological deficiency, of which nine fractures were a consequence of the tumor process. In 16% of observations, the fracture of the vertebra was detected to be an accidental Х-ray finding. Among the radiation manifestations, all cases (12 patients) registered the decrease in the height of the vertebral body in the form of collapse. Destruction was manifested by various options other than blastic. Therapeutic and diagnostic interventions were performed in 56 patients, and in six children, manipulation was limited to trepan biopsy. The pathological fracture was caused by an inflammatory process in 50% of observations and tumors in 42%, of which 31% is malignant. Conclusions. Pathological spinal fracture in children should be considered as a syndrome, which in most cases is based on an inflammatory or tumor process. The high frequency of neoplastic, including malignant processes, requires active invasive diagnosis. Therapeutic tactics are determined by the clinical, radiation, and morphological characteristics of pathology.

MR-derived CT-like Images for the Assessment of Acute Vertebral Fractures and Osseous Degenerative Changes in the Thoracolumbar Spine

2020 ◽  
Author(s):  
Benedikt J. Schwaiger ◽  
Charlotte Schneider ◽  
Sophia Kronthaler ◽  
Christoph Böhm ◽  
Julian Zapf ◽  
...  
Keyword(s):  
Vertebral Fractures ◽  
Thoracolumbar Spine ◽  
Degenerative Changes

Clinical Symptoms of Oncological Diseases at Incurable Children and Adolescents

2016 ◽  
Vol 3 (1) ◽  
pp. 48-53 ◽  
Author(s):  
Yu.A. Punanov ◽  
◽  
S.A. Safonova ◽  
I.G. Venchikova ◽  
S.I. Minchenko ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Clinical Symptoms ◽  
Oncological Diseases

Predicting progression in the late onset frontal lobe syndrome

2018 ◽  
Vol 31 (5) ◽  
pp. 743-748 ◽  
Author(s):  
Flora T. Gossink ◽  
Everard Vijverberg ◽  
Welmoed Krudop ◽  
Philip Scheltens ◽  
Max L. Stek ◽  
...  
Keyword(s):  
Frontal Lobe ◽  
Clinical Symptoms ◽  
Late Onset ◽  
Clinical Syndrome ◽  
Clinical Markers ◽  
Neuropsychological Profile ◽  
Stereotypical Behavior ◽  
Executive Deficits ◽  
Magnetic Resonance Imaging Mri ◽  
Frontal Lobe Syndrome

ABSTRACTA late onset frontal lobe syndrome (LOF) refers to a clinical syndrome with apathy, disinhibition, or stereotypical behavior arising in middle or late adulthood. Diagnostics are challenging, and both clinicians and patients need reliable predictors of progression to improve clinical guidance. In this longitudinal multicenter and genetically screened prospective study, 137 LOF patients with frontal behavior (FBI score≥11) and/or stereotypical behavior (SRI≥10) were included. Progression was defined as institutionalization, death, or progression of frontal or temporal atrophy at magnetic resonance imaging (MRI) after two years of follow up. Absence of progression at MRI in addition to stable or improved Mini Mental State Examination and Frontal Assessment Battery scores after two years was indicative for non-progression. The presence of stereotypy and a neuropsychological profile with executive deficits at baseline were found to be predictive for progression, while a history and family history with psychiatric disorders were predictors for non-progression. The combination of these clinical markers had a predictive value of 80.4% (p < 0.05). In patients presenting with late onset behavioral symptoms, an appraisal of the rate of deterioration can be made by detailed mapping of clinical symptoms. Distinction of progressive discourses from non-progressive or treatable conditions is to be gained.

Clinical Features and Endolymphatic Hydrops in Patients With MRI Evidence of Hydrops

2018 ◽  
Vol 128 (4) ◽  
pp. 286-292 ◽  
Author(s):  
Suming Shi ◽  
Ping Guo ◽  
Wenquan Li ◽  
Wuqing Wang
Keyword(s):  
Diagnostic Criteria ◽  
Clinical Features ◽  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Endolymphatic Hydrops ◽  
Low Frequency ◽  
Clinical Severity ◽  
Mri Findings ◽  
Vestibular Symptoms ◽  
Magnetic Resonance Imaging Mri

Objectives: The purpose of this study was to investigate the correlation between grades of endolymphatic hydrops (ELH) and clinical characteristics and determine the detailed clinical characteristics of Ménière’s disease (MD) patients with evidence of hydrops based on magnetic resonance imaging (MRI). Methods: One hundred ninety-eight MD patients (396 ears) with MRI evidence of hydrops were included. ELH grades were evaluated using the Nakashima grading standard. Correlations between the extent of ELH and clinical features were evaluated. Detailed clinical characteristics were analyzed to assess the clinical diagnostic criteria. Results: Of 198 patients, ELH was observed in 100% of cases on the clinically affected side and 8.6% of cases on the asymptomatic side. In addition, 98.5% of ELH was classified as moderate or significant grade. Low-frequency hearing loss was significantly correlated with the extent of both vestibular and cochlear hydrops, whereas the vertigo attack frequency showed no significant correlation with ELH grades. The disease duration of MD with bilateral ELH was longer than that with unilateral ELH. The clinical characteristics were variant and did not completely fit the proposed diagnostic criteria. Conclusions: MRI findings have relevance to the clinical severity, to a certain extent, but not vestibular symptoms. The proposed diagnostic criteria based on clinical characteristics may be partially effective; analysis of the detailed clinical characteristics of MD was meaningful. Diagnosis of MD based on both MRI and clinical symptoms could facilitate an early diagnosis.

scholarly journals SPECTRUM AND OUTCOME OF BLUNT ABDOMINAL TRAUMA

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Mahesh Kumar Sharma ◽  
Dr. Arun Bhargava
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Traffic Accident ◽  
Traffic Accidents ◽  
Splenic Injury ◽  
Road Traffic ◽  
Age Groups ◽  
Operative Management ◽  
Fall From Height ◽  
Type Of Injury

Background: Blunt abdominal trauma is a leading cause of morbidity and mortality among all age groups. So we evaluate the spectrum and outcome of blunt trauma. Methods: Hospital based prospective study conducted on 100 patients at department of general surgery. Results: Distribution according to type of injury consisted of maximum cases, 84 (84%) of road traffic accidents, 11% cases were of fall from height. Conclusions: Males were pre-dominantly affected. Road traffic accident was the most common cause of injury. Though conservative management is successful in carefully selected patients, operative management remains the main stay of treatment. Keywords: Blunt abdominal trauma, Liver injury, Perforation, Splenic injury

scholarly journals Maxillofacial injuries among Brazilian children and adolescents victims of traffic accidents

2015 ◽  
Vol 63 (1) ◽  
pp. 19-24 ◽  
Author(s):  
Laís Gonzaga de FARIAS ◽  
Rebeca Valeska Soares PEREIRA ◽  
Lorenna Mendes Temóteo BRANDT ◽  
Thaliny Batista Sarmento de OLIVEIRA ◽  
Alidianne Fábia Cabral XAVIER ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Children And Adolescents ◽  
Traffic Accidents ◽  
Young Male ◽  
Cross Sectional Study ◽  
Body Region ◽  
Maxillofacial Injuries ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Test

OBJECTIVE: To analyze the prevalence of morbidity due to traffic accidents in children and adolescents and its relationship with maxillofacial injuries in the city of Campina Grande, Paraíba, Brazil. METHODS: This cross-sectional study analyzed 533 forensic reports of individuals aged 0-19 years, victims of external causes in Campina Grande, Brazil, in 2013. Data were collected through a form containing variables sex, age, day of week, time, type of traffic accident, injured body region, presence of fractures, maxillofacial and oral cavity injuries. The Statistical Package for Social Sciences software (SPSS) was used for data analysis. Prevalence ratios and confidence intervals at 95% were estimated with the chi-square test. RESULTS: There was predominance of males (75.0%) aged 15-19 years (65.0%), with association between sex and occurrence of traffic accidents (p <0.001). The afternoon shift recorded 36.7% of cases of accidents involving motorcyclists (55.0%). In 25.0% of cases, there were injuries on the head and 26.7% on the face. Head and face injuries were observed in 10.0% of patients, while maxillofacial and oral cavity injuries were present in 21.7% and 6.7%, respectively. There was an association between occurrence of accident and face injuries (p = 0.009). CONCLUSION: Traffic accidents affect mostly young male individuals, causing multiple injuries in different body areas, including maxillofacial and oral cavity injuries.

scholarly journals Forced Oscillation Technique for Monitoring the Respiratory Status of Children with Cystic Fibrosis: A Systematic Review

Children ◽  
2021 ◽  
Vol 8 (10) ◽  
pp. 857
Author(s):  
Ioanna Loukou ◽  
Maria Moustaki ◽  
Agni Deligianni ◽  
Olympia Sardeli ◽  
Konstantinos Douros
Keyword(s):  
Cystic Fibrosis ◽  
Lung Function ◽  
Children And Adolescents ◽  
Forced Oscillation ◽  
Clinical Symptoms ◽  
Current Evidence ◽  
Forced Oscillation Technique ◽  
Gold Standard Method ◽  
Respiratory Status ◽  
Alternative Modality

Spirometry is considered the gold standard method for monitoring lung function of patients with cystic fibrosis (CF) but it requires patients’ cooperation and therefore it is not useful for the majority of preschool-aged children. Oscillometry is an alternative modality for lung function monitoring that requires minimal cooperation and can be applied in children as young as 3 years of age. Furthermore, it generates lesser aerosol compared to spirometry, an issue that is of considerable importance in the COVID-19 era. The aim of this review was to present the existing clinical data regarding the application of oscillometry in children and adolescents with CF. The method seems to have acceptable feasibility and repeatability. However, there is conflicting data regarding the correlation of oscillometry values with the clinical symptoms of CF patients either in clinically stable or in exacerbation periods. Furthermore, it is not clear to what extent oscillometry measurements correlate with the spirometry indices. Based on current evidence, spirometry cannot be substituted by oscillometry in the monitoring of the respiratory status of children and adolescents with CF.

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