cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.6992381.v1
title: Tracheobronchial injuries in chest trauma: a 17-year experience

description: ABSTRACT Objective: to discuss the clinical and therapeutic aspects of tracheobronchial lesions in victims of thoracic trauma. Methods: we analyzed the medical records of patients with tracheobronchial lesions treated at the São Paulo Holy Home from April 1991 to June 2008. We established patients' severity through physiological (RTS) and anatomical trauma indices (ISS, PTTI). We used TRISS (Trauma Revised Injury Severity Score) to evaluate the probability of survival. Results: nine patients had tracheobronchial lesions, all males, aged between 17 and 38 years. The mean values of the trauma indices were: RTS - 6.8; ISS - 38; PTTI - 20.0; and TRISS - 0.78. Regarding the clinical picture, six patients displayed only emphysema of the thoracic wall or the mediastinum and three presented with hemodynamic or respiratory instability. The time interval from patient admission to diagnosis ranged from one hour to three days. Cervicotomy was performed in two patients and thoracotomy, in seven (77.7%), being bilateral in one case. Length of hospitalization ranged from nine to 60 days, mean of 21. Complications appeared in four patients (44%) and mortality was nil. Conclusion: tracheobronchial tree trauma is rare, it can evolve with few symptoms, which makes immediate diagnosis difficult, and presents a high rate of complications, although with low mortality.
DOI: 10.6084/m9.figshare.6992039
title: Robotic Transversus Abdominis Release (TAR): is it possible to offer minimally invasive surgery for abdominal wall complex defects?

description: ABSTRACT We describe the preliminary national experience and the early results of the use of robotic surgery to perform the posterior separation of abdominal wall components by the Transversus Abdominis Release (TAR) technique for the correction of complex defects of the abdominal wall. We performed the procedures between 04/2/2015 and 06/15/2015 and the follow-up time was up to six months, with a minimum of two months. The mean surgical time was five hours and 40 minutes. Two patients required laparoscopic re-intervention, since one developed hernia by peritoneal migration of the mesh and one had mesh extrusion. The procedure proved to be technically feasible, with a still long surgical time. Considering the potential advantages of robotic surgery and those related to TAR and the results obtained when these two techniques are associated, we conclude that they seem to be a good option for the correction of complex abdominal wall defects.
DOI: 10.6084/m9.figshare.6992039.v1
title: Robotic Transversus Abdominis Release (TAR): is it possible to offer minimally invasive surgery for abdominal wall complex defects?

description: ABSTRACT We describe the preliminary national experience and the early results of the use of robotic surgery to perform the posterior separation of abdominal wall components by the Transversus Abdominis Release (TAR) technique for the correction of complex defects of the abdominal wall. We performed the procedures between 04/2/2015 and 06/15/2015 and the follow-up time was up to six months, with a minimum of two months. The mean surgical time was five hours and 40 minutes. Two patients required laparoscopic re-intervention, since one developed hernia by peritoneal migration of the mesh and one had mesh extrusion. The procedure proved to be technically feasible, with a still long surgical time. Considering the potential advantages of robotic surgery and those related to TAR and the results obtained when these two techniques are associated, we conclude that they seem to be a good option for the correction of complex abdominal wall defects.
DOI: 10.6084/m9.figshare.19959457.v1
title: Mortality predictors in patients with pelvic fractures from blunt trauma

description: ABSTRACT Objective: to analyze the association of mortality with sociodemographic and clinical variables, as well as lesions and complication in patients with pelvic trauma due to blunt trauma. Methods: we conducted a retrospective, observational study with five-year trauma record data. Death was considered as the main stratification variable for the analyzes. We used the Student t test to compare means, the Chi-Square or Fisher exact test for proportions, and the Wilcoxon-Mann Whitney test for medians. We analyzed the independent factors using a logistic regression model with penalized likelihood, based on the Wald tests, the Akaike Information Criterion (AIC) and the Schwarz Bayesian Information Criterion (BIC). Results: of the 28 patients with blunt trauma fracture, 23 (82.1%) were men; 16 (57.1%) were, in average, 38.8 years old (±17.3). There were 98 lesions or fractures in the 28 patients. As for severity, seven people had Injury Severity Score higher than 24 (25%). The mean hospital stay was 26.8 days (±22.4). Fifteen patients (53.6%) had ICU admission. Mortality was 21.4%. The analysis showed that age 50 years or more and presence of coagulopathy were factors independently associated with death. Conclusion: pelvic fractures can have high mortality. In this study, mortality was higher than that described in the literature. Age above 50 years and the presence of coagulopathy are risk factors in this population.
DOI: 10.6084/m9.figshare.19959457
title: Mortality predictors in patients with pelvic fractures from blunt trauma

description: ABSTRACT Objective: to analyze the association of mortality with sociodemographic and clinical variables, as well as lesions and complication in patients with pelvic trauma due to blunt trauma. Methods: we conducted a retrospective, observational study with five-year trauma record data. Death was considered as the main stratification variable for the analyzes. We used the Student t test to compare means, the Chi-Square or Fisher exact test for proportions, and the Wilcoxon-Mann Whitney test for medians. We analyzed the independent factors using a logistic regression model with penalized likelihood, based on the Wald tests, the Akaike Information Criterion (AIC) and the Schwarz Bayesian Information Criterion (BIC). Results: of the 28 patients with blunt trauma fracture, 23 (82.1%) were men; 16 (57.1%) were, in average, 38.8 years old (±17.3). There were 98 lesions or fractures in the 28 patients. As for severity, seven people had Injury Severity Score higher than 24 (25%). The mean hospital stay was 26.8 days (±22.4). Fifteen patients (53.6%) had ICU admission. Mortality was 21.4%. The analysis showed that age 50 years or more and presence of coagulopathy were factors independently associated with death. Conclusion: pelvic fractures can have high mortality. In this study, mortality was higher than that described in the literature. Age above 50 years and the presence of coagulopathy are risk factors in this population.
DOI: 10.6084/m9.figshare.19959458
title: Evaluation of sepsis treatment with enteral glutamine in rats

description: ABSTRACT Objective: to analyze the influence of glutamine on morphological and histological changes observed in the ileum, lung, kidney and liver of Wistar rats subjected to sepsis. Methods: we induced sepsis by cecal ligature and puncture. We divided the animals in two groups: group A, control, with five animals, and group B, experience, with ten animals that received enteral glutamine two days before sepsis induction. We used histological analysis to rank the injury according to a score dependent on the injury severity and the affected organ. The sum of values assigned to each animal resulted in a final grade. We assessed the villi in the ileum, microgoticular steatosis in the liver, interstitial pneumonitis in the lungs, and vacuolation of the proximal convoluted tubules in the kidneys. Results: cell lysis and destruction of the villi of the ileum were more intense in the control group when compared with animals receiving glutamine. In the kidney, we found more pronounced vacuolization in the proximal convoluted tubules in the control group compared with animals receiving glutamine. Both microgoticular steatosis and interstitial pneumonitis were similar between groups. Conclusion: administration of enteral glutamine prior to sepsis preserved the histological structure.
DOI: 10.6084/m9.figshare.19959458.v1
title: Evaluation of sepsis treatment with enteral glutamine in rats

description: ABSTRACT Objective: to analyze the influence of glutamine on morphological and histological changes observed in the ileum, lung, kidney and liver of Wistar rats subjected to sepsis. Methods: we induced sepsis by cecal ligature and puncture. We divided the animals in two groups: group A, control, with five animals, and group B, experience, with ten animals that received enteral glutamine two days before sepsis induction. We used histological analysis to rank the injury according to a score dependent on the injury severity and the affected organ. The sum of values assigned to each animal resulted in a final grade. We assessed the villi in the ileum, microgoticular steatosis in the liver, interstitial pneumonitis in the lungs, and vacuolation of the proximal convoluted tubules in the kidneys. Results: cell lysis and destruction of the villi of the ileum were more intense in the control group when compared with animals receiving glutamine. In the kidney, we found more pronounced vacuolization in the proximal convoluted tubules in the control group compared with animals receiving glutamine. Both microgoticular steatosis and interstitial pneumonitis were similar between groups. Conclusion: administration of enteral glutamine prior to sepsis preserved the histological structure.
DOI: 10.6084/m9.figshare.19959469.v1
title: Predictors of mortality in patients submitted to nephrectomy for non-metastatic renal cell carcinoma at a referral center in Northeastern Brazil

description: ABSTRACT Objective: to identify predictors of mortality in patients submitted to nephrectomy for non-metastatic renal cancer. Methods: we conducted a retrospective cohort study based on the records of patients with renal cancer submitted to radical or partial nephrectomy at the Ceará Cancer Institute. Results: we studied 117 patients, with mean and median age of 59.14 and 59 years, respectively. The male gender was slightly predominant. The right kidney was most frequently affected (64%). The most common histopathological diagnosis was clear-cell carcinoma (77%). Stage pT1 and Fuhrman grade II were predominant. The only predictive variables of overall survival were pathological stage (pT) and lymph node involvement. Conclusion: pathological stage (pT) and lymph node involvement are important prognostic factors in patients undergoing nephrectomy for non-metastatic renal cancer.
DOI: 10.6084/m9.figshare.19959470
title: Perioperative care in bariatric surgery in the context of the ACERTO project: reality versus surgeons assumptions in a Cuiabá hospital

description: ABSTRACT Objective: to assess the level of knowledge among bariatric surgeons, about the recommendations of the ACERTO Project, correlating their assumptions on their perioperative prescriptions and the reality, according to the patients charts. Method: we conducted a prospective, longitudinal, observational study comparing the assumptions of bariatric surgeons obtained through responses on a specific questionnaire with the reality found in clinical data from the hospital records. We analyzed the following variables: preoperative fasting, early postoperative feeding, intravenous hydration, perioperative antibiotic prophylaxis, use of abdominal drains, type of analgesia, and prophylaxis of nausea and vomiting. We confronted the responses of seven surgeons with data from 200 records of patients undergoing gastroplasty for morbid obesity. Results: all interviewed surgeons knew the ACERTO Project. Five (72%) responded that they followed the protocol thoroughly. The median time of preoperative fasting found in the records was higher than the reported by the surgeons (p&lt;0.05). Early postoperative feeding was prescribed for 96.5% of cases. The median volume of intravenous fluids prescribed in the first 24 hours was 4000ml, which was consistent with the interviews. There were no differences between the response in the questionnaire and the findings in the hospital records in relation to antibiotic prophylaxis, use of catheters and drains, analgesia and prophylaxis of nausea and vomiting. Conclusion: the ACERTO Project was well practiced among the surveyed surgeons. There was a good correlation between their assumptions and the reality in perioperative care of patients undergoing bariatric surgery. However, there was a significant difference in preoperative fasting time.
DOI: 10.6084/m9.figshare.19959470.v1
title: Perioperative care in bariatric surgery in the context of the ACERTO project: reality versus surgeons assumptions in a Cuiabá hospital

description: ABSTRACT Objective: to assess the level of knowledge among bariatric surgeons, about the recommendations of the ACERTO Project, correlating their assumptions on their perioperative prescriptions and the reality, according to the patients charts. Method: we conducted a prospective, longitudinal, observational study comparing the assumptions of bariatric surgeons obtained through responses on a specific questionnaire with the reality found in clinical data from the hospital records. We analyzed the following variables: preoperative fasting, early postoperative feeding, intravenous hydration, perioperative antibiotic prophylaxis, use of abdominal drains, type of analgesia, and prophylaxis of nausea and vomiting. We confronted the responses of seven surgeons with data from 200 records of patients undergoing gastroplasty for morbid obesity. Results: all interviewed surgeons knew the ACERTO Project. Five (72%) responded that they followed the protocol thoroughly. The median time of preoperative fasting found in the records was higher than the reported by the surgeons (p&lt;0.05). Early postoperative feeding was prescribed for 96.5% of cases. The median volume of intravenous fluids prescribed in the first 24 hours was 4000ml, which was consistent with the interviews. There were no differences between the response in the questionnaire and the findings in the hospital records in relation to antibiotic prophylaxis, use of catheters and drains, analgesia and prophylaxis of nausea and vomiting. Conclusion: the ACERTO Project was well practiced among the surveyed surgeons. There was a good correlation between their assumptions and the reality in perioperative care of patients undergoing bariatric surgery. However, there was a significant difference in preoperative fasting time.
DOI: 10.6084/m9.figshare.19959469
title: Predictors of mortality in patients submitted to nephrectomy for non-metastatic renal cell carcinoma at a referral center in Northeastern Brazil

description: ABSTRACT Objective: to identify predictors of mortality in patients submitted to nephrectomy for non-metastatic renal cancer. Methods: we conducted a retrospective cohort study based on the records of patients with renal cancer submitted to radical or partial nephrectomy at the Ceará Cancer Institute. Results: we studied 117 patients, with mean and median age of 59.14 and 59 years, respectively. The male gender was slightly predominant. The right kidney was most frequently affected (64%). The most common histopathological diagnosis was clear-cell carcinoma (77%). Stage pT1 and Fuhrman grade II were predominant. The only predictive variables of overall survival were pathological stage (pT) and lymph node involvement. Conclusion: pathological stage (pT) and lymph node involvement are important prognostic factors in patients undergoing nephrectomy for non-metastatic renal cancer.
DOI: 10.6084/m9.figshare.19959472
title: Extracranial carotid stenosis: evidence based review

description: ABSTRACT Extracranial cerebrovascular disease is one of the most important causes of death and disability worldwide and its treatment is based on clinical and surgical strategies, the latter being performed by conventional or endovascular techniques. The management of stenosis of the carotid bifurcation is mainly aimed at preventing stroke and has been the subject of extensive investigation. The role of clinical treatment has been re-emphasized, but carotid endarterectomy remains the first-line treatment for symptomatic patients with 50% to 99% stenosis and for asymptomatic patients with 60% to 99% stenosis. Stent angioplasty is reserved for symptomatic patients with stenosis of 50% to 99% and at high risk for open surgery due to anatomical or clinical reasons. Currently, the endovascular procedure is not recommended for asymptomatic patients who are able to undergo conventional surgical treatment. Brazil presents a trend similar to that of other countries in North America and Europe, keeping endarterectomy as the main indication for the treatment of carotid stenosis and reserving the endovascular procedure for cases in which there are contraindications for the first intervention. However, we must improve our results by reducing complications, notably the overall mortality rate.
DOI: 10.6084/m9.figshare.19959472.v1
title: Extracranial carotid stenosis: evidence based review

description: ABSTRACT Extracranial cerebrovascular disease is one of the most important causes of death and disability worldwide and its treatment is based on clinical and surgical strategies, the latter being performed by conventional or endovascular techniques. The management of stenosis of the carotid bifurcation is mainly aimed at preventing stroke and has been the subject of extensive investigation. The role of clinical treatment has been re-emphasized, but carotid endarterectomy remains the first-line treatment for symptomatic patients with 50% to 99% stenosis and for asymptomatic patients with 60% to 99% stenosis. Stent angioplasty is reserved for symptomatic patients with stenosis of 50% to 99% and at high risk for open surgery due to anatomical or clinical reasons. Currently, the endovascular procedure is not recommended for asymptomatic patients who are able to undergo conventional surgical treatment. Brazil presents a trend similar to that of other countries in North America and Europe, keeping endarterectomy as the main indication for the treatment of carotid stenosis and reserving the endovascular procedure for cases in which there are contraindications for the first intervention. However, we must improve our results by reducing complications, notably the overall mortality rate.
DOI: 10.6084/m9.figshare.6991484
title: Trauma mechanism predicts the frequency and the severity of injuries in blunt trauma patients

description: ABSTRACT Objective: to study the correlation of trauma mechanism with frequency and severity of injuries in blunt trauma patients. Methods: retrospective analysis of trauma registry in a 15-month period was carried out. Trauma mechanism was classified into six types: occupants of four-wheeled vehicles involved in road traffic accidents (AUTO), pedestrians struck by road vehicles (PED), motorcyclists involved in road traffic accidents (MOTO), falls from height (FALL), physical assault with blunt instruments (ASSA) and falls on same level (FSL). Injuries with AIS&gt;2 were considered severe. One-way ANOVA, Students t and Chi-square tests were used for statistical analysis, considering p&lt;0.05 significant. Results: trauma mechanism was classified by group for 3639 cases, comprising 337 (9.3%) AUTO, 855 (23.5%) PED, 924 (25.4%) MOTO, 455 (12.5%) FALL, 424 (11.7%) ASSA and 644 (17.7%) FSL. There was significant difference among groups when comparing the Revised Trauma Score (RTS), the Injury Severity Score (ISS) and the Abbreviated Injury Scale (AIS) of the head, thorax, abdomen and extremities (p&lt;0.001). Severe injuries in the head and in the extremities were more frequent in PED patients (p&lt;0.001). Severe injuries to the chest were more frequent in AUTO (p&lt;0.001). Abdominal injuries were less frequent in FSL (p=0.004). Complex fractures of the pelvis and spine were more frequent in FALL (p&lt;0.001). Lethality was greater in PED, followed by FALL and AUTO (p&lt;0.001). Conclusion: trauma mechanism analysis predicted frequency and severity of injuries in blunt trauma patients.
DOI: 10.6084/m9.figshare.6991484.v1
title: Trauma mechanism predicts the frequency and the severity of injuries in blunt trauma patients

description: ABSTRACT Objective: to study the correlation of trauma mechanism with frequency and severity of injuries in blunt trauma patients. Methods: retrospective analysis of trauma registry in a 15-month period was carried out. Trauma mechanism was classified into six types: occupants of four-wheeled vehicles involved in road traffic accidents (AUTO), pedestrians struck by road vehicles (PED), motorcyclists involved in road traffic accidents (MOTO), falls from height (FALL), physical assault with blunt instruments (ASSA) and falls on same level (FSL). Injuries with AIS&gt;2 were considered severe. One-way ANOVA, Students t and Chi-square tests were used for statistical analysis, considering p&lt;0.05 significant. Results: trauma mechanism was classified by group for 3639 cases, comprising 337 (9.3%) AUTO, 855 (23.5%) PED, 924 (25.4%) MOTO, 455 (12.5%) FALL, 424 (11.7%) ASSA and 644 (17.7%) FSL. There was significant difference among groups when comparing the Revised Trauma Score (RTS), the Injury Severity Score (ISS) and the Abbreviated Injury Scale (AIS) of the head, thorax, abdomen and extremities (p&lt;0.001). Severe injuries in the head and in the extremities were more frequent in PED patients (p&lt;0.001). Severe injuries to the chest were more frequent in AUTO (p&lt;0.001). Abdominal injuries were less frequent in FSL (p=0.004). Complex fractures of the pelvis and spine were more frequent in FALL (p&lt;0.001). Lethality was greater in PED, followed by FALL and AUTO (p&lt;0.001). Conclusion: trauma mechanism analysis predicted frequency and severity of injuries in blunt trauma patients.
DOI: 10.6084/m9.figshare.6992090
title: What is the ideal working length for bridge plating osteosynthesis of a femoral shaft fracture? A multinational online survey evaluation

description: ABSTRACT Objective: to evaluate how orthopedic surgeons in Latin America define the working length for distinct patterns of femoral shaft fracture. Methods: a survey was developed presenting different options of working length in four femoral fracture patterns. The survey was submitted to the participants using Google Forms tool. The association between professional characteristics and medical management options according to each type of fracture was analyzed by Chi-square test, with 5% significance level. Results: seven hundred and seven professionals from all Latin America answered the survey. The majority prefered a smaller working length for all situations presented in the study. There was a significant association between the main interest area and the medical preference for the management in fracture types AO 32-B3 and 32-C2 (p&lt;0.05). Other professional characteristics had no significant association at the level of 5%. Conclusion: most of the study participants preferred constructions with smaller working length, representing approximately one-third of the total length of the plate, regardless of fracture pattern. There was a significant association between the main interest area (orthopedic trauma) and medical management options for fracture type AO 32-B3 and 32-C2. This can be attributed in part to the fact that these two types of fractures are considered, in the view of the authors, intermediate patterns in terms of strain. This study reinforces the importance of understanding the concept of working length, showing that its calculation remains more based on the surgeons' experience than grounded by strong biomechanical concepts governing the fracture healing process.