Hospital de Santa Maria
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Predictors of echocardiographic response to cardiac resynchronization therapy: A systematic review with Meta-Analysis
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Intravertebral expandable implants in thoracolumbar vertebral compression fractures
Full text linkCurrent scientific evidence enhances the importance of the anatomic restauration of vertebral bodies with compression fractures aiming, as with other human body joints, to obtain a biomechanic and functional spine as close as the one prior to the fracture as possible. We consider that anatomic reduction of these fractures is only completely possible using intravertebral expandable implants, restoring vertebral endplate morphology, and enabling a more adequate intervertebral disc healing. This enables avoiding disc and osteodegenerative changes to that vertebral segment and its adjacent levels, as well as the anterior overload of adjacent vertebral bodies in older adults - a consequence of post-traumatic vertebral flattening - thus minimizing the risk of adjacent vertebral fractures. The ability of vertebral body fracture reduction and height maintenance over time and its percutaneous transpedicular application make the intra-vertebral expandable implants a very attractive option for treating these fractures. The authors show the direct and indirect reduction concepts of vertebral fractures, review the biomechanics, characteristics and indications of intravertebral expandable implants and present a suggestion for updating the algorithm for the surgical treatment of vertebral compression fractures which includes the use of intravertebral expandable implants. Level of Evidence V, Expert Opinion.info:eu-repo/semantics/publishedVersio
AB0747 MATERNAL AND FETAL OUTCOMES IN PREGNANT WOMEN WITH JUVENILE IDIOPATHIC ARTHRITIS: A SYSTEMATIC LITERATURE REVIEW
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Personality, cognitive emotion regulation and insomnia
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Lesões Cervicais no Mergulho
Full text linkAs lesões da coluna cervical associadas a atividades aquáticas, tais como o mergulho, ocorrem principalmente em indivíduos jovens e saudáveis. As lesões mais comuns são as fraturas e luxações das vértebras cervicais, habitualmente de C5, C6 e C7, podendo estar associadas a lesão da medula espinhal, mais frequentemente no nível C5 e C6. São causa primária de tetraplegia associada a atividades recreativas, caracterizando-se por dependência funcional grave com condicionantes familiares e socioeconómicas importantes. A antecipação do risco e a prática prudente do mergulho, associados a campanhas de sensibilização para as potenciais consequências, devem estar na linha da frente na prevenção da ocorrência destas lesões.info:eu-repo/semantics/publishedVersio
A fundamental distinction in early neural processing of implicit social interpretation in schizophrenia and bipolar disorder
Full text linkBackground: Social cognition impairment is a key phenomenon in serious mental disorders such as schizophrenia (SCZ) and bipolar disorder (BPD). Although genetic and neurobiological studies have suggested common neural correlates, here we hypothesized that a fundamental dissociation of social processing occurs at an early level in these conditions.
Methods: Based on the hypothesis that key structures in the social brain, namely the temporoparietal junction, should present distinctive features in SCZ and BPD during low-level social judgment, we conducted a case-control study in SCZ (n = 20) and BPD (n = 20) patients and controls (n = 20), using task-based fMRI during a Theory of Mind (ToM) visual paradigm leading to interpretation of social meaning based on simple geometric figures.
Results: We found opposite neural responses in two core ToM regions: SCZ patients showed social content-related deactivation (relative to controls and BPD) of the right supramarginal gyrus, while the opposite pattern was found in BPD; reverse patterns, relative to controls and SCZ, were found in the left posterior superior temporal gyrus, a region involved in inferring other's intentions. Receiver-operating-characteristic curve analysis showed 88% accuracy in discriminating the two clinical groups based on these neural responses.
Conclusions: These contrasting activation patterns of the temporoparietal junction in SCZ and BPD represent mechanistic differences of social cognitive dysfunction that may be explored as biomarkers or therapeutic targets.info:eu-repo/semantics/publishedVersio
Clinical performance of monolithic CAD/CAM tooth-supported zirconia restorations: systematic review and meta-analysis
Full text linkPurpose: The purpose of this systematic review was to evaluate the survival rate, biological complications, technical complications, and clinical behavior of single crowns supported by teeth made up in monolithic zirconia with CAD/CAM technology.
Study selection: An extensive electronic search was conducted through Medline/PubMed, Embase, and Cochrane Library databases. Additional manual search was performed on the references of included articles to identify relevant publications. Two reviewers independently performed the selection and electronic and manual search.
Results: From nine articles included, there was a total of 594 participants and 1657 single-tooth restorations with a mean exposure time of 1.07 years, and follow-up period between 0.3 and 2.1 years. All studies showed a moderate level of quality, with a consequent moderate possibility of associated bias, using the Newcastle-Ottawa Scale (NOS), with survival rate (SR) ranging between 91% to 100%. Bleeding on probing (BOP) were reported with an average value of 29.12%. Marginal integrity showed high success rate values for the observation periods, except for one that included patients with bruxism which obtained a SR of 31.60%. Failures and/or fractures, mostly total and requiring replacement, were observed in three studies. Linear regression showed that there was no statistical correlation between survival rate and type of cementation and the average years of follow-up (p=0.730 e p=0.454). There was high heterogeneity between studies (I2 = 93.74% and Q = 79.672).
Conclusions: Within the limitation of this study, monolithic zirconia might be considered as a possible option for restoring single crowns, especially in the posterior zone.info:eu-repo/semantics/publishedVersio
Surgical Treatment of Multiple Osteoporotic Fractures of the Dorsolumbar Spine: Case Report
Full text linkOsteoporotic vertebral fractures are a common type of fracture and affect a significant number of subjects with osteoporosis. Despite the high fracture risk, the concomitant occurrence of vertebral fractures at non-contiguous levels is very rare. We report the case of a patient with three burst dorsolumbar spine fractures at non-contiguous levels who was treated with percutaneous kyphoplasty and transpedicular posterior fixation. Six months after the surgery, the patient walks autonomously and without pain; in addition, there is no radiological evidence of fracture reduction loss.info:eu-repo/semantics/publishedVersio
Sequelas da COVID-19 Evidência Atual
Full text linkA epidemia de Coronavirus Disease 2019 disseminou-se pelo mundo em poucos meses,
levando à sua designação de pandemia. Múltiplas medidas de saúde pública foram
implementadas nos países afetados para conter e mitigar a disseminação da doença. A
necessidade de distanciamento físico leva a que esta pandemia tenha um impacto importante na sociedade e particularmente no desporto, provocando cancelamento e adiamento
de treinos, competições e eventos. No entanto, o início da pandemia data já de 2019,
com preocupações globais, não só na fase aguda da doença com as suas consequências
imediatas, mas também com as eventuais sequelas a médio e a longo prazo e o risco de
cronicidade de alguns sintomas, em particular na população jovem. Neste artigo revemos
a limitada evidência científica atual acerca da relevância clínica das sequelas da COVID-19,
em particular do foro respiratório e cardíaco, e finalizamos com recomendações de avaliação das sequelas em atletas e com indicações para regresso seguro à prática desportiva.info:eu-repo/semantics/publishedVersio