Search

Abstract Objective: To outline the epidemiological profile of tibial fractures treated in a tertiary hospital and explore associations between the characteristics of the fractures and the clinical outcome of postoperative complications. Methods: Retrospective cross-sectional study involving adult patients diagnosed with tibial fractures who underwent surgical and/or conservative treatment in a tertiary hospital between January 2019 and December 2021. The variables sex, age, mechanism of injury, type and classification of fracture, associated injuries, personal history, length of hospital stay, surgical treatment, post-surgical complications (infections, loss of synthesis material, surgical wound dehiscence) and death. Results: The sample consisted of 100 individuals, with an average age of 35.8 years, 86% of whom were male, with a higher prevalence of motorcycle accidents. The most common treatment was intramedullary stem, and type C fractures, which are more complex, were more associated with complications. Conclusion: Given the predominance of motorcycle accidents involving young people, there is a need for intervention in accident prevention policies, aiming to reduce the incidence, as well as the morbidity and mortality, of these individuals and, consequently, to reduce costs to the health system. Level of evidence III, Retrospective Study.

Resumo Objetivo desenvolver um processo de intervenção para identificação de crianças em risco para dislexia, baseado no modelo de resposta à intervenção. Especificamente, identificar o perfil de mudança no desempenho pós-intervenção em tarefas de consciência fonológica, memória operacional, acesso lexical, leitura, escrita; e analisar quais funções cognitivas tiveram efeito significativo para discriminação de estudantes em risco para dislexia. Método amostra composta por 30 participantes com dificuldades na leitura e escrita, entre 8 e 11 anos, de escola pública ou particular, estudantes do 3º ao 5º ano. Todos foram submetidos a uma bateria de testes cognitivo-linguísticos, antes e após a realização de 12 sessões de intervenção. Para monitoramento do desempenho foram aplicadas cinco listas de leitura e escrita de palavras/pseudopalavras. Foram realizadas análises, qualitativas e quantitativas, das diferenças de desempenho pré e pós-intervenção; e entre os participantes na pós avaliação, para compreensão de grupos perfil em risco para dislexia vs não-dislexia. Resultados ocorreram mudanças estatisticamente significativas em nomeação automática rápida, compreensão de texto, consciência fonológica, taxa e tipologia de acertos/erros na leitura/escrita e velocidade de leitura. Sendo essas três últimas variáveis as que se mostraram mais discriminativas dos grupos, todas com menos ganhos na pós-intervenção para o grupo com perfil em risco de dislexia. Conclusão a intervenção com foco na estimulação das habilidades fonológicas e ensino explícito das correspondências grafofonêmicas contribuiu para a evolução dos participantes. A abordagem de resposta à intervenção favoreceu a identificação de crianças com perfil em risco para dislexia, as diferenciando de crianças com outras dificuldades de aprendizagem.

Objective: To investigate the performance of 27 children with phenylketonuria (PKU) in tests of Executive Functions (EF) and Social Cognition (SC), and their associations with metabolic control inferred by phenylalanine (Phe) levels. Methods: The PKU group was dichotomized according to baseline Phe-levels into; ''classical PKU''(n = 14), with Phe-levels above 1200 μmol/L (> 20 mg/dL); and ''mild PKU'' (n = 13) with Phe-between 360 and 1200 μmol/L (6–20 mg/dL). The neuropsychological assessment focused on the EF and SC subtests of the NEPSY-II battery and intellectual performance. Children were compared to age-matched healthy participants. Results: Participants with PKU presented significantly lower Intellectual Quotient (IQ) compared to controls (p = 0.001). Regarding EF analysis adjusted by age and IQ, significant differences between groups were observed only in the executive attention subtests (p = 0.029). The SC set of variables was significantly different between groups (p = 0.003), as in the affective recognition task (p < 0.001). In the PKU group, the relative variation of Phe-achieved 32.1 ± 21.0%. Relative Phe-variation was correlated only with measures of Working Memory (p < 0.001), Verbal Fluency (p = 0.004), Inhibitory Control (p = 0.035) and Theory of Mind (p = 0.003). Conclusions: Phonological Verbal Fluency, Working Memory, Inhibitory Control, and Theory of Mind were shown to be most vulnerable when there is non-ideal metabolic control. Variations in the level of Phe-may have a selective negative effect on Executive Functions and Social Cognition, but not on intellectual performance.