123 results on '"Robson Luis Oliveira de Amorim"'
Search Results
2. Long-term outcome of traumatic brain injury patients with initial GCS of 3–5
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Rubén David dos Reis Zuniga, Rita de Cássia Almeida Vieira, Davi Jorge Fontoura Solla, Daniel Agustín Godoy, Angelos Kolias, Robson Luis Oliveira de Amorim, Almir Ferreira de Andrade, Manoel Jacobsen Teixeira, and Wellingson Silva Paiva
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Craniocerebral trauma ,Critical care ,Prognosis ,Outcome ,Long-term care ,Glasgow outcome scale ,Surgery ,RD1-811 ,Neurology. Diseases of the nervous system ,RC346-429 - Published
- 2024
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3. Evaluation of Computed Tomography Scoring Systems in the Prediction of Short-Term Mortality in Traumatic Brain Injury Patients from a Low- to Middle-Income Country
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Matheus Rodrigues de Souza, Mayra Aparecida C?rtes, Gustavo Carlos Lucena da Silva, Davi Jorge Fontoura Solla, Eryanne Garcia Marques, Wellithon Luz Oliveira Junior, Caroline Ferreira Fagundes, Manoel Jacobsen Teixeira, Robson Luis Oliveira de Amorim, Andres M. Rubiano, Angelos G. Kolias, and Wellingson Silva Paiva
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CT scoring ,prognostic models ,traumatic brain injury ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
The present study aims to evaluate the accuracy of the prognostic discrimination and prediction of the short-term mortality of the Marshall computed tomography (CT) classification and Rotterdam and Helsinki CT scores in a cohort of TBI patients from a low- to middle-income country. This is a post hoc analysis of a previously conducted prospective cohort study conducted in a university-associated, tertiary-level hospital that serves a population of >12 million in Brazil. Marshall CT class, Rotterdam and Helsinki scores, and their components were evaluated in the prediction of 14-day and in-hospital mortality using Nagelkerk's pseudo-R2 and area under the receiver operating characteristic curve. Multi-variate regression was performed using known outcome predictors (age, Glasgow Coma Scale, pupil response, hypoxia, hypotension, and hemoglobin values) to evaluate the increase in variance explained when adding each of the CT classification systems. Four hundred forty-seven patients were included. Mean age of the patient cohort was 40 (standard deviation, 17.83) years, and 85.5% were male. Marshall CT class was the least accurate model, showing pseudo-R2 values equal to 0.122 for 14-day mortality and 0.057 for in-hospital mortality, whereas Rotterdam CT scores were 0.245 and 0.194 and Helsinki CT scores were 0.264 and 0.229. The AUC confirms the best prediction of the Rotterdam and Helsinki CT scores regarding the Marshall CT class, which presented greater discriminative ability. When associated with known outcome predictors, Marshall CT class and Rotterdam and Helsinki CT scores showed an increase in the explained variance of 2%, 13.4%, and 21.6%, respectively. In this study, Rotterdam and Helsinki scores were more accurate models in predicting short-term mortality. The study denotes a contribution to the process of external validation of the scores and may collaborate with the best risk stratification for patients with this important pathology.
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- 2022
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4. Primary central nervous system tumors in Sergipe, Brazil: descriptive epidemiology between 2010 and 2018
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Bárbara Loiola SANTOS, Arthur Maynart Pereira OLIVEIRA, Hélio Araújo OLIVEIRA, and Robson Luis Oliveira de AMORIM
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Brain Neoplasms ,Epidemiology ,Prevalence ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
ABSTRACT Background: Central nervous system (CNS) tumors are a heterogeneous group with high morbidity and mortality. Objectives: To describe the epidemiology of primary CNS tumors diagnosed in the state of Sergipe from 2010 to 2018. Methods: We evaluated histopathological and immunohistochemical reports on primary CNS tumors diagnosed in Sergipe, Brazil, between 2010 and 2018 and collected data regarding age, sex, location, World Health Organization (WHO) classification and histology. Results: Altogether, 861 primary CNS tumors were found. Tumors in brain locations occurred most frequently (50.8%; n=437). The neoplasms observed were most prevalent in the age range 45‒54 years (20.4%; n=176). Grade I tumors occurred most frequently, corresponding to 38.8% of the cases (n=38) in the age group of 0‒14 years, and 44.6% (n=340) in the population ≥15 years old. Between 0 and 14 years of age, other astrocytic tumors were the most prevalent (29.6%; n=29). In the age group between 15 and 34, gliomas were the most frequent (32.7%; n=54). Meningiomas predominated in the age group of 35 years and above, comprising 47.5% of cases (n=206) in the 35‒74 age group; and 61.2% (n=30) among patients over 75 years old. Conclusion: The epidemiology of primary CNS tumors in Sergipe between 2010 and 2018 is consistent with data in other current studies on the subject. Studies on the epidemiological evolution of these entities in Sergipe are needed.
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- 2021
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5. Brazilian version of the Rivermead Post-Concussion Symptoms Questionnaire
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Marcia Mitie Nagumo, Renata Eloah de Lucena Ferretti-Rebustini, Marcos Alencar Abaide Balbinotti, Daniele Vieira da Silva, Cintya Yukie Hayashi, Wellingson Silva Paiva, Manoel Jacobsen Teixeira, and Robson Luis Oliveira de Amorim
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Brain Injuries, Traumatic ,Post-Concussion Syndrome ,Translating ,Psychometrics ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
ABSTRACT Background: After a traumatic brain injury, post-concussion symptoms are commonly reported by patients. Although common, these symptoms are difficult to diagnose and recognize. To date, no instruments evaluating post-concussion symptoms have been culturally translated or adapted to the Brazilian context. Objective: To culturally adapt the Rivermead Post-Concussion Symptoms Questionnaire for use in Brazilian Portuguese. Methods: Cross-cultural adaptation was done in five steps: translation, synthesis of translations, back-translation, evaluation by two expert committees and two pretests among adults in a target population. Results: The semantic, idiomatic, cultural and experimental aspects of the adaptation were considered adequate. The content validity coefficient of the items regarding language clarity, pratical pertinence, relevance and dimensionality were considered adequate for evaluating the desired latent variable. Both pretests demonstrated that the instrument had satisfactory acceptability. Conclusion: The Brazilian version, named Questionário Rivermead de Sintomas pós Concussionais (RPQ-Br), has been adapted, and is ready for use in the Brazilian context.
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- 2021
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6. Mismatch between midline shift and hematoma thickness as a prognostic factor of mortality in patients sustaining acute subdural hematoma
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Angelos G Kolias, Matheus Rodrigues de Souza, Caroline Ferreira Fagundes, Davi Jorge Fontoura Solla, Gustavo Carlos Lucena da Silva, Rafaela Borin Barreto, Manoel Jacobsen Teixeira, Robson Luis Oliveira de Amorim, Daniel Godoy, and Wellingson Silva Paiva
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Surgery ,RD1-811 ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Background Acute subdural hematoma (ASDH) is a traumatic lesion commonly found secondary to traumatic brain injury. Radiological findings on CT, such as hematoma thickness (HT) and structures midline shift (MLS), have an important prognostic role in this disease. The relationship between HT and MLS has been rarely studied in the literature. Thus, this study aimed to assess the prognostic accuracy of the difference between MLS and HT for acute outcomes in patients with ASDH in a low-income to middle-income country.Methods This was a post-hoc analysis of a prospective cohort study conducted in a university-associated tertiary-level hospital in Brazil. The TRIPOD (Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis) statement guidelines were followed. The difference values between MLS and HT (Zumkeller index, ZI) were divided into three categories (3). Logistic regression analyses were performed to reveal the OR of categorized ZI in predicting primary outcome measures. A Cox regression was also performed and the results were presented through HR. The discriminative ability of three multivariate models including clinical and radiological variables (ZI, Rotterdam score, and Helsinki score) was demonstrated.Results A total of 114 patients were included. Logistic regression demonstrated an OR value equal to 8.12 for the ZI >3 category (OR 8.12, 95% CI 1.16 to 40.01; p=0.01), which proved to be an independent predictor of mortality in the adjusted model for surgical intervention, age, and Glasgow Coma Scale (GCS) score. Cox regression analysis demonstrated that this category was associated with 14-day survival (HR 2.92, 95% CI 1.38 to 6.16; p=0.005). A multivariate analysis performed for three models including age and GCS with categorized ZI or Helsinki or Rotterdam score demonstrated area under the receiver operating characteristic curve values of 0.745, 0.767, and 0.808, respectively.Conclusions The present study highlights the potential usefulness of the difference between MLS and HT as a prognostic variable in patients with ASDH.Level of evidence Level III, epidemiological study.
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- 2021
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7. Lhermitte-Duclos Disease and Cowden Syndrome: A Case Report and Literature Review
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Mylena Miki Lopes Ideta, Mylla Christie Oliveira Paschoalino, Louise Makarem Oliveira, Nelson Brancaccio dos Santos, Marco Rodrigo Valdivia Sanz, and Robson Luis Oliveira de Amorim
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lhermitte-duclos disease ,cowden syndrome ,hamartoma syndrome ,cerebellum ,Medicine ,Surgery ,RD1-811 - Abstract
Lhermitte-Duclos disease (LDD), also known as dysplastic gangliocytoma of the cerebellum, is a rare, usually benign, slow-growing tumor, that commonly affects patients aged 30 to 50 years-old. The manifestations of dysplastic cerebellar gangliocytoma are nonspecific and are related both to the mass effect produced by its growth and to the location of the lesion. Cerebellar symptoms such as ataxia are often present. In 40% of cases, the tumor is associated with Cowden syndrome, which is part of a group of genetic disorders called polypoid hamartoma complex. In this case report, the patient presented expansive lesion in the posterior fossa, compatible with LDD, associated with macrocephaly. These findings are considered major criteria for Cowden syndrome. When together, they confirm the diagnoses. To our knowledge, this is the first report of the association of LDD and Cowden syndrome in Brazil.
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- 2019
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8. Transcranial Direct Current Stimulation for Post-Concussion Syndrome: Study Protocol for a Randomized Crossover Trial
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Robson Luis Oliveira de Amorim, André Russowsky Brunoni, Mirian Akiko Furutani de Oliveira, Ana Luiza Costa Zaninotto, Marcia Mitie Nagumo, Vinícius Monteiro de Paula Guirado, Iuri Santana Neville, Gláucia Rosana Guerra Benute, Mara Cristina Souza de Lucia, Wellingson Silva Paiva, Almir Ferreira de Andrade, and Manoel Jacobsen Teixeira
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brain injuries ,post-concussion syndrome ,transcranial direct current stimulation ,non-invasive brain stimulation ,crossover studies ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
BackgroundMild traumatic brain injury (MTBI) represents 70–80% of all treated brain injuries. A considerable proportion of MTBI patients experience post-concussion symptoms for a prolonged period after MTBI, and these symptoms are diagnosed as persistent post-concussion syndrome (PPCS). PPCS is defined as a range of physical, cognitive, and emotional symptoms. However, memory and executive dysfunction seems to be one of the most debilitating symptoms. Recently, non-invasive brain stimulation has been studied as a potential treatment method for traumatic brain injury (TBI) patients. Therefore, our primary goal is to verify the effects of transcranial direct current stimulation (tDCS) in patients with PPCS who demonstrate cognitive deficits in long-term episodic memory, working memory, and executive function following MTBI.Methods/designThis is a randomized crossover trial of patients with a history of MTBI with cognitive deficits in memory and executive function. Thirty adult patients will be randomized in a crossover manner to receive three weekly sessions of anodal tDCS (2 mA) at left dorsolateral prefrontal cortex, left temporal cortex, and sham stimulation that will be performed at 7-day intervals (washout period). The clinical diagnosis of PPCS will be determined using the Rivermead Post-Concussion Symptoms Questionnaire. Patients who meet the inclusion criteria will be assessed with a neuropsychological evaluation. A new battery of computerized neuropsychological tests will be performed before and immediately after each stimulation. Statistical analysis will be performed to determine trends of cognitive improvement.DiscussionThere is paucity of studies regarding the use of tDCS in TBI patients, and although recent results showed controversial data regarding the effects of tDCS in such patients, we will address specifically patients with PPCS and MTBI and no brain abnormalities on CT scan other than subarachnoid hemorrhage. Moreover, due to the missing information on literature regarding the best brain region to be studied, we will evaluate two different regions to find immediate effects of tDCS on memory and executive dysfunction.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier NCT02292589 (https://register.clinicaltrials.gov).
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- 2017
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9. Calcitonin gene-related peptide and traumatic brain injury
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Saul Almeida da Silva, Almir F de Andrade, Robson Luis Oliveira de Amorim, and Wellingson S Paiva
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Neurology. Diseases of the nervous system ,RC346-429 - Published
- 2019
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10. Continuous ventricular cerebrospinal fluid drainage with intracranial pressure monitoring for management of posttraumatic diffuse brain swelling
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Almir Ferreira de Andrade, Wellingson Silva Paiva, Robson Luis Oliveira de Amorim, Eberval Gadelha Figueiredo, Antonio Nogueira de Almeida, Roger Schmidt Brock, Edson Bor-Seng-Shu, and Manoel Jacobsen Teixeira
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traumatismo craniocerebral ,líquido cefalorraquidiano ,lesão axonal ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
BACKGROUND: Ventricular drainage has played an important role in the management of traumatic brain-injured patients. The aim of the present study was describe outcomes in a series of 57 patients with diffuse brain swelling underwent to intracranial pressure (ICP) monitoring. METHOD: Fifty-eight patients with diffuse posttraumatic brain swelling, were evaluated prospectively. The Glasgow Coma Scale (GCS) scores of patients varied from 4 to 12. Patients groups divided according to GCS and age. Patient neurological assessment was classified as favorable, unfavorable, and death. RESULTS: Mechanisms of injury were vehicle accidents in 72.4% and falls in 15.6%. 54% of patients had GCS scores between 6 and 8. There were no statistical differences, regarding outcome, between groups separated by age. In the adults group (n=47), 44.7% evolved favorably. CONCLUSION: Our results indicate a poor prognosis in patients with brain swelling. We believe that continuous ventricular CSF drainage with ICP monitoring is a simple method as an adjunct in the management of these patients.
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- 2011
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11. Tratamento cirúrgico no acidente vascular cerebral hemorrágico: afinal, o que há de evidências?
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Robson Luis Oliveira de Amorim, Wellingson Silva Paiva, Eberval Gadelha Figueiredo, Marcelo Prudente Espírito Santo, Almir Ferreira de Andrade, and Manoel Jacobsen Teixeira
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acidente vascular cerebral ,hemorragia intracerebral ,Medicine ,Surgery ,RD1-811 - Abstract
Mais da metade dos pacientes com hematoma cerebral espontâneo evolui desfavoravelmente. O controle inadequado da pressão arterial sistêmica é uma das principais causas para esse quadro dramático. Várias pesquisas clínicas visando ao controle da expansão do hematoma têm se mostrado satisfatórias, entretanto pouco houve de avanço no tratamento cirúrgico dessas condições. Há inúmeras variáveis que devem ser avaliadas em um paciente com hematoma intraparenquimatoso espontâneo, e esta revisão visa sistematizar o tratamento cirúrgico baseado em evidências.
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- 2010
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12. Tratamento cirúrgico de emergência no acidente vascular cerebral isquêmico. Afinal, o que há de evidências?
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Robson Luis Oliveira de Amorim, Wellingson Silva Paiva, Eberval Gadelha Figueiredo, Almir Ferreira de Andrade, and Manoel Jacobsen Teixeira
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acidente cerebral vascular, cirurgia ,infarto cerebral, cirurgia ,Medicine ,Surgery ,RD1-811 - Abstract
Contexto: O manuseio dos pacientes com infarto cerebral isquêmico inclui várias abordagens de tratamento. O tratamento cirúrgico é raramente necessário, entretanto os médicos gerais, neurologistas e neurocirurgiões devem estar atentos para essa possibilidade. Objetivo: Esta revisão visa sistematizar o tratamento cirúrgico com base em evidências nos acidentes vasculares isquêmicos. Conclusões: Apesar da crescente pesquisa envolvendo os acidentes vasculares, a taxa de mortalidade após a tentativa de tratamento cirúrgico pouco se tem alterado nas últimas décadas. Questões como quando ou a quem indicar uma craniectomia descompressiva no infarto isquêmico hemisférico são motivos de controvérsias no âmbito neurocirúrgico, e os dados da literatura são pouco esclarecedores.
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- 2009
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13. Cortical stimulation of language fields under local anesthesia: optimizing removal of brain lesions adjacent to speech areas Mapeamento cortical da fala com o paciente acordado: optimização para ressecção de lesões intracranianas localizadas próximas a área da fala
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Robson Luis Oliveira de Amorim, Antônio Nogueira de Almeida, Paulo Henrique Pires de Aguiar, Erich Talamoni Fonoff, Suely Itshak, Daniel Fuentes, and Manoel Jacobsen Teixeira
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mapeamento cortical ,craniotomia acordado ,tumor ,área da fala ,cortical mapping ,awake craniotomy ,speech area ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
OBJECTIVE: The main objective when resecting benign brain lesions is to minimize risk of postoperative neurological deficits. We have assessed the safety and effectiveness of craniotomy under local anesthesia and monitored conscious sedation for the resection of lesions involving eloquent language cortex. METHODS: A retrospective review was performed on a consecutive series of 12 patients who underwent craniotomy under local anesthesia between 2001 and 2004. All patients had lesions close to the speech cortex. All resection was verified by post-operative imaging. Six subjects were male and 6 female, and were aged between 14 and 52 years. RESULTS: Lesions comprised 7 tumour lesions, 3 cavernomas and 1 dermoid cyst. Radiological gross total resection was achieved in 66% of patients while remaining cases had greater than 80% resection. Only one patient had a post-operative permanent deficit, whilst another had a transient post-operative deficit. All patients with uncontrollable epilepsy had good outcomes after surgery. None of our cases subsequently needed to be put under general anesthesia. CONCLUSION: Awake craniotomy with brain mapping is a safe technique and the "gold standard" for resection of lesions involving language areas.OBJETIVO: O presente estudo visa discutir as vantagens e as limitacões do uso da técnica de mapeamento cortical da área da fala com o paciente acordado. MÉTODO: esta é uma revisão retrospectiva dos casos em que foi realizado monitoramento cortical intraoperatório em cirurgias para ressecção de lesões intracranianas localizadas próximas à área da fala. Todos os pacientes foram submetidos a avaliação neuropsicológica no pré e intra-operatório. O grau das ressecções foi verificado através de exames de imagem pós-operatórios. Foram avaliados um total de 12 pacientes. Destes, 6 eram do sexo masculino e 6 do feminino. RESULTADOS: 7 lesões eram tumorais. A ressecção total foi atingida em 66% e ressecção subtotal nos remanescentes. Apenas 1 paciente apresentou déficit motor permanente no pós-operatório e todos os pacientes com quadro prévio de epilepsia refratária obtiveram bom controle das crises no pós-operatório. Em nenhum caso houve necessidade de conversão da anestesia para geral. CONCLUSÃO: O mapeamento funcional intraoperatório na craniotomia com o paciente acordado otimiza a extensão da ressecção da lesão minimizando morbidade permanente. Esta é uma técnica eficaz no manejo de lesões em íntimo contato com o córtex eloqüente, que outrora, seriam designadas inoperáveis.
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- 2008
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14. Horner's syndrome after blunt cervical and chest trauma: case report Síndrome de Horner após trauma cérvico-torácico fechado: relato de caso
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Wellingson Silva Paiva, Robson Luis Oliveira De Amorim, Wagner Malago Tavares, Eduardo Joaquim Lopes Alho, Brasil Ping Jeng, and Eberval Gadelha Figueiredo
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síndrome de Horner ,trauma ,etiologia ,Horner syndrome ,etiology ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Horner‘s syndrome is the triad of miosis, ptosis, and anhidrosis, resulting from disruption of the sympathetic pathways. This article describes an uncommon case of Horner‘s syndrome in a 22-year-old man after blunt trauma to the neck and chest without carotid artery dissection. The patient was brought to the emergency service after motorcycle fall. Neurologic examination revealed a patient presenting the score 15 at Glasgow Coma Scale. The left eyelid was 1-2 mm lower than the right. Carotid Doppler and angiotomography were undertaken and revealed no abnormalities of the carotid artery. CT disclosed a mediastinal hematoma extending to the left apex, compressing the left sympathetic chain. The understanding of this clinical entity may help the surgeon to make a better differential diagnosis in trauma patients in whom prompt diagnosis is critical to stablish the correct treatment.A síndrome de Horner compreende a tríade de miose, ptose e anidrose, resultado de lesão em algum ponto das vias simpáticas. O referido estudo apresenta um caso da referida síndrome em um jovem de 22 anos vitima de queda de moto, com escoriações no tórax e no pescoço, sem dissecção carotídea. Ao exame neurológico, encontrava-se com 15 pontos na Escala de Coma de Glasgow, com miose à esquerda e ptose palpebral ipsilateral. Realizado Doppler de carótidas e angiotomografia dos vasos cérvico-cranianos não sendo evidenciadas anormalidades. A tomografia de tórax mostrou um hematoma no ápice pulmonar esquerdo, comprimindo a cadeia simpática ipsilateral. O conhecimento desta entidade clínica pode ajudar o cirurgião a fazer um diagnóstico diferencial adequado nos pacientes vítimas de traumas, nos quais o diagnóstico correto e eficaz pode ser fundamental para a definição da conduta a ser tomada.
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- 2007
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15. Paracoccidioidomycosis: intralesional therapy Paracoccidioidomicose: terapia intralesional
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Manoel Jacobsen Teixeira, Erich Talamoni Fonoff, Luís dos Ramos Machado, José Paulo Smith Nóbrega, Hugo Sterman-Neto, and Robson Luis Oliveira de Amorim
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Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Published
- 2010
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16. Neurosurgical Emergencies in the Amazon: An Epidemiologic Study of Patients Referred by Air Transport for Neurosurgical Evaluation at a Referral Center in Amazonas
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Paloam Cardoso Nôvo, Sérgio Augusto Barbosa de Farias, Victor do Valle Guttemberg, Victor Rodrigo Félix dos Santos, João Pedro Moreira Guilherme, and Robson Luis Oliveira de Amorim
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Surgery ,Neurology (clinical) - Published
- 2023
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17. Casemix, management, and mortality of patients receiving emergency neurosurgery for traumatic brain injury in the Global Neurotrauma Outcomes Study: a prospective observational cohort study
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David Clark, Alexis Joannides, Amos Olufemi Adeleye, Abdul Hafid Bajamal, Tom Bashford, Hagos Biluts, Karol Budohoski, Ari Ercole, Rocío Fernández-Méndez, Anthony Figaji, Deepak Kumar Gupta, Roger Härtl, Corrado Iaccarino, Tariq Khan, Tsegazeab Laeke, Andrés Rubiano, Hamisi K Shabani, Kachinga Sichizya, Manoj Tewari, Abenezer Tirsit, Myat Thu, Manjul Tripathi, Rikin Trivedi, Bhagavatula Indira Devi, Franco Servadei, David Menon, Angelos Kolias, Peter Hutchinson, Ghayur Abbas, Omar Ibrahim Abdallah, Ahmed Abdel-Lateef, Khalif Abdifatah, Awfa Abdullateef, Ruvini Abeygunaratne, Mostafa Aboellil, Abass Adam, Robert Adams, Amos Adeleye, Augustine Adeolu, Novan Krisno Adji, Nur Afianti, Sudarsan Agarwal, Ifeanyi Kene Aghadi, Paúl Martín Méndez Aguilar, Syeda Rida Ahmad, Daniyal Ahmed, Nafees Ahmed, Haider Aizaz, Yunus Kuntawi Aji, Alex Alamri, Augusto Jacinto Mussindo Alberto, Luis Alcocer Alcocer, Lesly Gonzales Alfaro, Amro Al-Habib, Ahmad Alhourani, Syed Muhammad Rafay Ali, Fahad Alkherayf, Ahmed AlMenabbawy, Aliyah Alshareef, Muhammad Adil s/o Aminullah, Madeha Amjad, Robson Luis Oliveira de Amorim, Sathiaprabhu Anbazhagan, Almir Andrade, Waleed Antar, Theophilus T.K. Anyomih, Salah Aoun, Tedy Apriawan, Daniele Armocida, Paul Arnold, Miguel Arraez, Temesgen Assefa, Andres Asser, S.P. Athiththan, Deepal Attanayake, Maung Maung Aung, Allan Avi, Victor Enrique Antolinez Ayala, Mohammed Azab, Gaousul Azam, Mohd Azharuddin, Olukemi Badejo, Mohamed Badran, Azam Ali Baig, Rehman Ali Baig, Ankur Bajaj, Paul Baker, Renu Bala, Artur Balasa, Ross Balchin, James Balogun, Vin Shen Ban, Bharath Kumar Reddy Bandi, Soham Bandyopadhyay, Matthew Bank, Ernest Barthelemy, Mohammed Talha Bashir, Luciano Silveira Basso, Surajit Basu, Auricelio Batista, Marlies Bauer, Devi Bavishi, Abi Beane, Shmuel Bejell, Anteneh Belachew, Antonio Belli, Amani Belouaer, Najia El Abbadi Bendahane, Okanga Benjamin, Youssef Benslimane, Chaymae Benyaiche, Claudio Bernucci, Luigi Valentino Berra, Arnold Bhebe, Alexios Bimpis, Diana Blanaru, Jean Claude Bonfim, Luis A B Borba, Alp Ozgun Borcek, Erika Borotto, Ahmad Elmabri Mohammad Bouhuwaish, Facundo Bourilhon, Gioia Brachini, Joshua Breedon, Maximilian Broger, Giacoma Maria Floriana Brunetto, Placido Bruzzaniti, Natalia Budohoska, Hira Burhan, Maximiliano Luis Calatroni, Catherine Camargo, Pier Francesco Cappai, Salvatore Massimiliano Cardali, Ana M Castaño-Leon, David Cederberg, Mikel Celaya, Marco Cenzato, Lakshmi Madhavi Challa, Dhanny Charest, Bipin Chaurasia, Rabah Chenna, Iype Cherian, Juliana Henry Ching'o, Tejas Chotai, Ajay Choudhary, Nabeel Choudhary, Florence Choumin, Tomislav Cigic, Juan Ciro, Carlo Conti, Antônio Carlos de Souza Corrêa, Giulia Cossu, Maíra Piani Couto, Aurora Cruz, Divya D'Silva, Giuseppe Antonio D'Aliberti, Lamin Dampha, Roy Thomas Daniel, Andrew Dapaah, Aneela Darbar, Gabriel Dascalu, Happy Amos Dauda, Owain Davies, Andrea Delgado-Babiano, Markus Dengl, Marko Despotovic, Indira Devi, Celeste Dias, Mohamed Dirar, Melina Dissanayake, Hananiah Djimbaye, Simon Dockrell, Ali Dolachee, Julija Dolgopolova, Muge Dolgun, Abdalrouf Dow, Davide Drusiani, Artjom Dugan, Dinh Tuan Duong, Trung Kien Duong, Tomasz Dziedzic, Ali Ebrahim, Nizar El Fatemi, Antonios El El Helou, Rachid El El Maaqili, Brahim El El Mostarchid, Abdessamad El El Ouahabi, Mohammad Elbaroody, Ahmed El-Fiki, Ahmed El-Garci, Nasser M.F. El-Ghandour, Muhammed Elhadi, Vanessa Elleder, Safa Elrais, Mohamed El-shazly, Mohamed Elshenawy, Hesham Elshitany, Omar El-Sobky, Marwa Emhamed, Basil Enicker, Onur Erdogan, Sebastian Ertl, Ignatius Esene, Omar Ocampo Espinosa, Tarig Fadalla, Mohammed Fadelalla, Rodrigo Moreira Faleiro, Nida Fatima, Charbel Fawaz, Assefa Fentaw, Carla Eiriz Fernandez, Ana Ferreira, Francesco Ferri, Tony Figaji, Emerson L B Filho, Loic Fin, Benjamin Fisher, Fitra Fitra, Alexis Palpan Flores, Ioan Stefan Florian, Vincenzo Fontana, Lauren Ford, Daniel Fountain, Jose Maria Roda Frade, Antonio Fratto, Christian Freyschlag, Aranzazu Sánchez Gabin, Clare Gallagher, Mario Ganau, Maria Luisa Gandia-Gonzalez, Andoni Garcia, Borja Hernandez Garcia, Sanjeewa Garusinghe, Biniam Gebreegziabher, Adrian Gelb, Jerome St George, Antonino Francesco Germanò, Ilaria Ghetti, Prajwal Ghimire, Alessandro Giammarusti, Jose Luis Gil, Panagiota Gkolia, Yoseph Godebo, Prakash Rao Gollapudi, Jagos Golubovic, Jeremias Fernando Gomes, Javier Gonzales, William Gormley, Alexander Gots, Giulia Letizia Gribaudi, Dylan Griswold, Paolo Gritti, Ruan Grobler, Rudy Gunawan, Birhanu Hailemichael, Elmehdi Hakkou, Mark Haley, Alhafidz Hamdan, Ali Hammed, Waeel Hamouda, Nurul Ashikin Hamzah, Nyein Latt Han, Sahin Hanalioglu, Rashan Haniffa, Martin Hanko, John Hanrahan, Timothy Hardcastle, Fahd Derkaoui Hassani, Volkmar Heidecke, Eirik Helseth, Miguel Ángel Hernández-Hernández, Zachary Hickman, Le Minh Chau Hoang, Alexa Hollinger, Lenka Horakova, Kismet Hossain-Ibrahim, Boru Hou, Samer Hoz, Janine Hsu, Martin Hunn, Madiha Hussain, Giorgia Iacopino, Mylena Miki Lopes Ideta, Irene Iglesias, Ali Ilunga, Nafiz Imtiaz, Rafiza Islam, Serge Ivashchenko, Karim Izirouel, Mohamed Sobhi Jabal, Soubhi Jabal, John Nute Jabang, Aimun Jamjoom, Irfan Jan, Landing BM Jarju, Saad Javed, Bojan Jelaca, Sukhdeep Singh Jhawar, Ting Ting Jiang, Fernando Jimenez, Jorge Jiris, Ron Jithoo, Walt Johnson, Mathew Joseph, Rameshman Joshi, Eija Junttila, Mubashir Jusabani, Stephen Akau Kache, Satyavara Prasad Kadali, Gabriela F Kalkmann, Usman Kamboh, Hitham Kandel, Ahmet Kamil Karakus, Mengistu Kassa, Ari Katila, Yoko Kato, Martin Keba, Kristy Kehoe, Huseyin Hayri Kertmen, Soha Khafaji, Monty Khajanchi, Mohammed Khan, Muhammad Mukhtar Khan, Sohail Daud Khan, Ahtesham Khizar, Amir Khriesh, Sara Kierońska, Paul Kisanga, Boniface Kivevele, Kacper Koczyk, Anna-Lucia Koerling, Danielle Koffenberger, Kennet Kõiv, Leho Kõiv, Branislav Kolarovszki, Marton König, Dilek Könü-Leblebicioglu, Santhoshi Devi Koppala, Tommi Korhonen, Boguslaw Kostkiewicz, Kacper Kostyra, Srinivas Kotakadira, Arjun Reddy Kotha, Madhu Narayana Rao Kottakki, Nenad Krajcinovic, Michal Krakowiak, Andreas Kramer, Selvamuthukumaran Krishnamoorthy, Ashok Kumar, Pankaj Kumar, Pradhumna Kumar, Nilaksha Kumarasinghe, Gowtham Kuncha, Raja K. Kutty, Ghazwan Lafta, Simon Lammy, Pierfrancesco Lapolla, Jacopo Lardani, Nebojsa Lasica, Giancarlo Lastrucci, Yoann Launey, Laura Lavalle, Tim Lawrence, Albert Lazaro, Vitalii Lebed, Ville Leinonen, Lawrence Lemeri, Leon Levi, Jia Yi Lim, Xiao Yi Lim, Jorge Linares-Torres, Laura Lippa, Lurdes Lisboa, Jinfang Liu, Ziyuan Liu, William B Lo, Jan Lodin, Federico Loi, Daniella Londono, Pedro Antonio Gomez Lopez, Cristina Barceló López, Madeleine De Lotbiniere-Bassett, Rihards Lulens, Facundo Hector Luna, Teemu Luoto, Vijaya Sekhar M.V., Ndyebo Mabovula, Matthew MacAllister, Alcina Americo Macie, Rodolfo Maduri, Moufid Mahfoud, Ashraf Mahmood, Fathia Mahmoud, Dominic Mahoney, Wissam Makhlouf, George Malcolm, Adefolarin Malomo, Toluyemi Malomo, Manoranjitha Kumari Mani, Tomás Gazzinelli Marçal, Jacopo Marchello, Nicolò Marchesini, Franz Marhold, Niklas Marklund, Rubén Martín-Láez, Vickneswaran Mathaneswaran, David José Mato-Mañas, Helen Maye, Aaron Lawson McLean, Catherine McMahon, Saniya Mediratta, Mehreen Mehboob, Alisson Meneses, Nesrine Mentri, Hagos Mersha, Ana Milena Mesa, Cristy Meyer, Christopher Millward, Salomao Amone Mimbir, Andrea Mingoli, Parashruram Mishra, Tejesh Mishra, Basant Misra, Siddharth Mittal, Imran Mohammed, Ioana Moldovan, Masechaba Molefe, Alexis Moles, Preston Moodley, Mario Augusto Narváez Morales, Lucy Morgan, German Del Castillo Morillo, Wahab Moustafa, Nikolaos Moustakis, Salma Mrichi, Satya Shiva Munjal, Abdul-Jalilu Mohammed Muntaka, Denver Naicker, Paulo E H Nakashima, Pratap Kumar Nandigama, Samantha Nash, Ionut Negoi, Valetina Negoita, Samundra Neupane, Manh Hung Nguyen, Fajar Herbowo Niantiarno, Abbi Noble, Mohd Arman Muhamad Nor, Blazej Nowak, Andrei Oancea, Frazer O'Brien, Oghenekevwe Okere, Sandra Olaya, Leandro Oliveira, Louise Makarem Oliveira, Fatma Omar, Okezi Ononeme, René Opšenák, Simone Orlandini, Alrobah Osama, Dorcas Osei-Poku, Haytham Osman, Alvaro Otero, Malte Ottenhausen, Shuli Otzri, Oumaima Outani, Emmanuel Abem Owusu, Kevin Owusu-Agyemang, Ahmad Ozair, Baris Ozoner, Elli Paal, Mauro Sérgio Paiva, Wellingson Paiva, Sharad Pandey, Gastone Pansini, Luigi Pansini, Tobias Pantel, Nikolaos Pantelas, Konstantinos Papadopoulos, Vladimir Papic, Kee Park, Nick Park, Eric Homero Albuquerque Paschoal, Mylla Christie de Oliveira Paschoalino, Rajesh Pathi, Anilkumar Peethambaran, Thiago Andrade Pereira, Irene Panero Perez, Claudio José Piqueras Pérez, Tamilanandh Periyasamy, Stefano Peron, Michael Phillips, Sofía Sotos Picazo, Ertugrul Pinar, Daniel Pinggera, Rory Piper, Pathmanesan Pirakash, Branko Popadic, Jussi P. Posti, Rajmohan Bhanu Prabhakar, Sivanesalingam Pradeepan, Manjunath Prasad, Paola Calvachi Prieto, Ron Prince, Andrea Prontera, Eva Provaznikova, Danilo Quadros, Nezly Jadid Romero Quintero, Mahmood Qureshi, Happiness Rabiel, Gabriel Rada, Sivagnanam Ragavan, Jueria Rahman, Omar Ramadhan, Padma Ramaswamy, Sakina Rashid, Jagath Rathugamage, Tõnu Rätsep, Minna Rauhala, Asif Raza, Naga Raju Reddycherla, Linus Reen, Mohamed Refaat, Luca Regli, Haijun Ren, Antonio Ria, Thales Francisco Ribeiro, Alessandro Ricci, Romana Richterová, Florian Ringel, Faith Robertson, Catarina Mayrink Siqueira Cabral Rocha, Juvenal de Souza Rogério, Adan Anibal Romano, Sally Rothemeyer, Gail Rousseau Gail Rousseau, Ranette Roza, Kevin David Farelo Rueda, Raiza Ruiz, Malin Rundgren, Radoslaw Rzeplinski, Raj S.Chandran, Ramesh Andi Sadayandi, William Sage, André Norbert Josef Sagerer, Mustafa Sakar, Mohcine Salami, Danjuma Sale, Youssuf Saleh, Cristina Sánchez-Viguera, Saning'o Sandila, Ahmet Metin Sanli, Laura Santi, Antonio Santoro, Aieska Kellen Dantas Dos Santos, Samir Cezimbra dos Santos, Borja Sanz, Shabal Sapkota, Gopalakrishnan Sasidharan, Ibrahim Sasillo, Rajeev Satoskar, Ali Caner Sayar, Vignesh Sayee, Florian Scheichel, Felipe Lourenzon Schiavo, Alexander Schupper, Andreas Schwarz, Teresa Scott, Esther Seeberger, Claudionor Nogueira Costa Segundo, Anwar Sadat Seidu, Antonio Selfa, Nazan Has Selmi, Claudiya Selvarajah, Necmiye Şengel, Martin Seule, Luiz Severo, Purva Shah, Muhammad Shahzad, Thobekile Shangase, Mayur Sharma, Ehab Shiban, Emnet Shimber, Temitayo Shokunbi, Kaynat Siddiqui, Emily Sieg, Martin Siegemund, Shahidur Rahman Sikder, Ana Cristina Veiga Silva, Ana Silva, Pedro Alberto Silva, Deepinder Singh, Carly Skadden, Josef Skola, Eirini Skouteli, Pawel Słoniewski, Brandon Smith, Guirish Solanki, Davi Fontoura Solla, Davi Solla, Ozcan Sonmez, Müge Sönmez, Wai Cheong Soon, Roberto Stefini, Martin Nikolaus Stienen, Bogdan Stoica, Matthew Stovell, Maria Natalia Suarez, Alaa Sulaiman, Mazin Suliman, Adi Sulistyanto, Şeniz Sulubulut, Sandra Sungailaite, Madlen Surbeck, Tomasz Szmuda, Graziano Taddei, Abraham Tadele, Ahmed Saleh Ahmed Taher, Riikka Takala, Krishna Murthy Talari, Bih Huei Tan, Leonardo Tariciotti, Murad Tarmohamed, Oumayma Taroua, Emiliano Tatti, Olli Tenovuo, Sami Tetri, Poojan Thakkar, Nqobile Thango, Satish Kumar Thatikonda, Tuomo Thesleff, Claudius Thomé, Owen Thornton, Shelly Timmons, Eva Ercilio Timoteo, Campbell Tingate, Souhil Tliba, Christos Tolias, Emma Toman, Ivan Torres, Luis Torres, Youness Touissi, Musa Touray, Maria Pia Tropeano, Georgios Tsermoulas, Christos Tsitsipanis, Mehmet Erhan Turkoglu, Özhan Merzuk Uçkun, Jamie Ullman, Gheorghe Ungureanu, Sarah Urasa, Obaid Ur-Rehman, Muhammed Uysal, Antonios Vakis, Egils Valeinis, Vaishali Valluru, Debby Vannoy, Pablo Vargas, Phillipos Varotsis, Rahul Varshney, Atul Vats, Damjan Veljanoski, Sara Venturini, Abhijit Verma, Clara Villa, Genaro Villa, Sofia Villar, Erin Villard, Antonio Viruez, Stefanos Voglis, Petar Vulekovic, Saman Wadanamby, Katherine Wagner, Rebecca Walshe, Jan Walter, Marriam Waseem, Tony Whitworth, Ruwani Wijeyekoon, Adam Williams, Mark Wilson, Sein Win, Achmad Wahib Wahju Winarso, Abraão Wagner Pessoa Ximenes, Anurag Yadav, Dipak Yadav, Kamal Makram Yakoub, Ali Yalcinkaya, Guizhong Yan, Eesha Yaqoob, Carlos Yepes, Ayfer Nazmiye Yılmaz, Betelehem Yishak, Farhat Basheer Yousuf, Muhammad Zamzuri Zahari, Hussein Zakaria, Diego Zambonin, Luca Zavatto, Bassel Zebian, Anna Maria Zeitlberger, Furong Zhang, Fengwei Zheng, and Michal Ziga
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casemix ,management ,mortality ,emergency neurosurgery ,traumatic brain injury ,prospective observational cohort study ,Neurology (clinical) - Abstract
© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Traumatic brain injury (TBI) is increasingly recognised as being responsible for a substantial proportion of the global burden of disease. Neurosurgical interventions are an important aspect of care for patients with TBI, but there is little epidemiological data available on this patient population. We aimed to characterise differences in casemix, management, and mortality of patients receiving emergency neurosurgery for TBI across different levels of human development. Methods: We did a prospective observational cohort study of consecutive patients with TBI undergoing emergency neurosurgery, in a convenience sample of hospitals identified by open invitation, through international and regional scientific societies and meetings, individual contacts, and social media. Patients receiving emergency neurosurgery for TBI in each hospital's 30-day study period were all eligible for inclusion, with the exception of patients undergoing insertion of an intracranial pressure monitor only, ventriculostomy placement only, or a procedure for drainage of a chronic subdural haematoma. The primary outcome was mortality at 14 days postoperatively (or last point of observation if the patient was discharged before this time point). Countries were stratified according to their Human Development Index (HDI)—a composite of life expectancy, education, and income measures—into very high HDI, high HDI, medium HDI, and low HDI tiers. Mixed effects logistic regression was used to examine the effect of HDI on mortality while accounting for and quantifying between-hospital and between-country variation. Findings: Our study included 1635 records from 159 hospitals in 57 countries, collected between Nov 1, 2018, and Jan 31, 2020. 328 (20%) records were from countries in the very high HDI tier, 539 (33%) from countries in the high HDI tier, 614 (38%) from countries in the medium HDI tier, and 154 (9%) from countries in the low HDI tier. The median age was 35 years (IQR 24–51), with the oldest patients in the very high HDI tier (median 54 years, IQR 34–69) and the youngest in the low HDI tier (median 28 years, IQR 20–38). The most common procedures were elevation of a depressed skull fracture in the low HDI tier (69 [45%]), evacuation of a supratentorial extradural haematoma in the medium HDI tier (189 [31%]) and high HDI tier (173 [32%]), and evacuation of a supratentorial acute subdural haematoma in the very high HDI tier (155 [47%]). Median time from injury to surgery was 13 h (IQR 6–32). Overall mortality was 18% (299 of 1635). After adjustment for casemix, the odds of mortality were greater in the medium HDI tier (odds ratio [OR] 2·84, 95% CI 1·55–5·2) and high HDI tier (2·26, 1·23–4·15), but not the low HDI tier (1·66, 0·61–4·46), relative to the very high HDI tier. There was significant between-hospital variation in mortality (median OR 2·04, 95% CI 1·17–2·49). Interpretation: Patients receiving emergency neurosurgery for TBI differed considerably in their admission characteristics and management across human development settings. Level of human development was associated with mortality. Substantial opportunities to improve care globally were identified, including reducing delays to surgery. Between-hospital variation in mortality suggests changes at an institutional level could influence outcome and comparative effectiveness research could identify best practices. Funding: National Institute for Health Research Global Health Research Group.
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- 2022
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18. Electromyographic Motor Outcomes in Short- and Long-Term Recovery of Incomplete Spinal Cord Injury Treated with Neuromodulation Techniques
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Daniel Buzaglo Gonçalves, Maria Eduarda de Oliveira, Deborah Araújo Silva, Maria Izabel Andrade dos Santos, Rynele Almeida de Fonseca, Júlio César Claudino dos Santos, Robson Luis Oliveira de Amorim, and Adilson de Oliveira
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- 2022
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19. Sexual Dysfunction After Traumatic Brain Injury: an integrative review
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Márcio Fernando da Silva, Louise Makarem Oliveira, Mylena Miki Lopes Ideta, Mylla Christie de Oliveira Paschoalino, Daniel Buzaglo Gonçalves, Renato Anghinah, Wellingson Silva Paiva, and Robson Luis Oliveira de Amorim
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- 2022
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20. Traumatic Brain Injury (TBI) Caused by a Piece of Wood in the Temporal Region: literature review
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Wesley Lopes da Silva, Moysés Isaac Cohen, Henrique Oliveira Martins, Wellingson Silva Paiva, and Robson Luis Oliveira de Amorim
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- 2022
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21. Primary central nervous system tumors in Sergipe, Brazil: descriptive epidemiology between 2010 and 2018
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Robson Luis Oliveira de Amorim, Hélio Araújo Oliveira, Bárbara Loiola Santos, and Arthur Maynart Pereira Oliveira
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medicine.medical_specialty ,Pediatrics ,Epidemiology ,Central nervous system ,Population ,Neurosciences. Biological psychiatry. Neuropsychiatry ,Neoplasias Encefálicas ,World health ,03 medical and health sciences ,High morbidity ,0302 clinical medicine ,medicine ,Prevalence ,Prevalência ,education ,Epidemiologia ,education.field_of_study ,Heterogeneous group ,business.industry ,Brain Neoplasms ,Histology ,Descriptive epidemiology ,medicine.anatomical_structure ,Neurology ,030220 oncology & carcinogenesis ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,RC321-571 - Abstract
Background: Central nervous system (CNS) tumors are a heterogeneous group with high morbidity and mortality. Objectives: To describe the epidemiology of primary CNS tumors diagnosed in the state of Sergipe from 2010 to 2018. Methods: We evaluated histopathological and immunohistochemical reports on primary CNS tumors diagnosed in Sergipe, Brazil, between 2010 and 2018 and collected data regarding age, sex, location, World Health Organization (WHO) classification and histology. Results: Altogether, 861 primary CNS tumors were found. Tumors in brain locations occurred most frequently (50.8%; n=437). The neoplasms observed were most prevalent in the age range 45‒54 years (20.4%; n=176). Grade I tumors occurred most frequently, corresponding to 38.8% of the cases (n=38) in the age group of 0‒14 years, and 44.6% (n=340) in the population ≥15 years old. Between 0 and 14 years of age, other astrocytic tumors were the most prevalent (29.6%; n=29). In the age group between 15 and 34, gliomas were the most frequent (32.7%; n=54). Meningiomas predominated in the age group of 35 years and above, comprising 47.5% of cases (n=206) in the 35‒74 age group; and 61.2% (n=30) among patients over 75 years old. Conclusion: The epidemiology of primary CNS tumors in Sergipe between 2010 and 2018 is consistent with data in other current studies on the subject. Studies on the epidemiological evolution of these entities in Sergipe are needed. RESUMO Introdução: Os tumores do sistema nervoso central (SNC) são um grupo heterogêneo de entidades que apresenta significativa morbimortalidade. Objetivos: O presente estudo visa à descrição epidemiológica dos tumores primários do SNC com diagnóstico histopatológico no estado de Sergipe, Brasil, entre 2010 e 2018. Métodos: Foram avaliados laudos histopatológicos e imuno-histoquímicos de tumores primários do SNC, diagnosticados entre 2010 e 2018, no estado de Sergipe. Os dados coletados foram descritos de acordo com as variáveis de idade, sexo, localização, classificação da Organização Mundial da Saúde (OMS) e tipo histológico. Resultados: Foram encontrados 861 tumores primários do SNC. A localização cerebral foi a mais frequente (50,8%; n=437). As neoplasias observadas prevaleceram na faixa etária de 45 a 54 anos (20,4%; n=176). Os tumores grau I foram os mais frequentes, correspondendo a 38,8% dos casos (n=38) na faixa etária de 0‒14 anos e 44,6% (n=340) na população a partir de 15 anos de idade. Na faixa etária entre 0‒14 anos, o grupo histológico dos outros tumores astrocíticos foi o mais prevalente (29,6%; n=29). Na população entre 15‒34 anos, os gliomas foram os mais frequentes (32,7%; n=54). Os meningiomas predominaram nas faixas etárias a partir de 35 anos, com 47,5% dos casos (n=206) entre 35‒74 anos; e 61,2% (n=30) nos pacientes acima de 75 anos de idade. Conclusão: A descrição epidemiológica dos tumores primários do SNC em Sergipe, entre 2010 e 2018, é condizente com outros trabalhos atuais sobre o tema. Estudos voltados à evolução epidemiológica dessas entidades em Sergipe são necessários.
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- 2021
22. Brain arteriovenous malformation treatment with transvenous endovascular technique after transarterial technique failure
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Gabriela Campos da Silva Coutinho, Moisés Buzaglo Salles, Robson Luis Oliveira de Amorim, Louise Makarem Oliveira, Vitória Miki Pang Takatani, Maria Izabel Andrade dos Santos, Lucas de Cristo Rojas Cabral, Carlos Michel Albuquerque Peres, Massanobu Takatani, and Daniel Buzaglo Gonçalves
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Splenium ,Arteriovenous malformation ,General Medicine ,medicine.disease ,Corpus callosum ,Therapeutic approach ,Occlusion ,medicine ,Radiology ,Embolization ,Presentation (obstetrics) ,business ,Transarterial technique - Abstract
Arteriovenous malformations (AVMs) are unnatural connections in the vascular system. The treatment strategies are dictated by the angioarchitecture, location and presentation of AVMs. The present study sought to report a case report of a 35-year-old female patient diagnosed with a brain AVM and submitted to a transvenous AVM embolization, located at the corpus callosum's splenium, after a previous transarterial embolization failure. As a therapeutic approach, the patient was submitted to transarterial embolization. However, the procedure was performed too proximally in the arteries, which resulted in the total AVM persistency. The patient was submitted to angiographic control until complete AVM occlusion.
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- 2021
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23. Management of Traumatic Brain Injury at a Medium Complexity Hospital in a Remote Area of Amazonas, 2017–2019
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Maria Clara Paulino Campos, F. A. Reis, Larissa Pessoa de Oliveira, Robson Luis Oliveira de Amorim, and Raphaelly Venzel
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Traumatic brain injury ,Hospitals, Rural ,law.invention ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,law ,Brain Injuries, Traumatic ,Epidemiology ,medicine ,Humans ,Child ,Aged ,business.industry ,Public health ,Incidence (epidemiology) ,Glasgow Coma Scale ,Disease Management ,Infant ,Ecological study ,Remote area ,Middle Aged ,medicine.disease ,Intensive care unit ,Hospitalization ,Cross-Sectional Studies ,Child, Preschool ,030220 oncology & carcinogenesis ,Emergency medicine ,Female ,Surgery ,Neurology (clinical) ,Emergency Service, Hospital ,business ,Brazil ,030217 neurology & neurosurgery - Abstract
Objective To describe the traumatic brain injury (TBI) care in the city of Coari, Amazonas, from 2017–2019. Methods Ecological study based on the analysis of the data obtained by the Epidemiology Service of the Regional Hospital of Coari regarding TBI attendances in the emergency room from January 2017 to October 2019. According to the Glasgow Coma Scale, TBI was classified as mild, moderate, or severe. Other variables analyzed were sex, age, main causes of TBI, hospitalizations at the admission unit, and transfers to another health center and means of transport used. Results One hundred ten admissions were registered: 24 mild TBI, 51 moderate, and 35 severe; higher prevalence among men (70%); and age between 20 and 29 years (29%). The main causes were motorcycle accidents (42.7%), falls (29%), and physical aggression (21%). Some 69% of the patients admitted required to be transferred to another health center, with aerial intensive care unit (ICU) as the most significant means of transport (48.7%). Thirty patients hospitalized at the admission unit progressed with hospital discharge and 4 died. Conclusions The profile of patients affected by TBI in the city of Coari was characterized by male victims of motorcycle accidents with age between 20 and 29 years. The high transfer rates indicates the need for a better neurotrauma assistance. Further investigations and studies associated with regional specificities are essential to recommend changes on the scope of public health and therefore decrease the incidence of TBI.
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- 2021
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24. TRAUMATISMO CRANIOENCEFÁLICO
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Robson Luis Oliveira de Amorim, Daniel Buzaglo Gonçalves, Bruna Guimarães Dutra, and Henrique Martins
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- 2022
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25. Diastematomielia cervical associada a lipoma e hipotrofia de membros superiores: relato de caso e revisão da literatura
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Moysés Isaac Cohen, Daniel Buzaglo Gonçalves, Maria Izabel Andrade dos Santos, Louise Makarem Oliveira, Lucas de Cristo Rojas Cabral, Gabriela Campos da Silva Coutinho, F. A. Reis, Robson Luis Oliveira de Amorim, Henzo Theodoro Fonseca Silva, Rodrigo Viana, Marcos Gabriel do Vale Gomes Falcão, and Stephanie Ramos
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medicine.medical_specialty ,business.industry ,Lipoma ,medicine.disease ,Spinal cord ,Surgery ,Lesion ,Conus medullaris ,medicine.anatomical_structure ,Atrophy ,medicine ,Outpatient clinic ,Intraoperative Period ,medicine.symptom ,business ,Diastematomyelia - Abstract
Diastematomielia é um disrafismo espinhal oculto (HSD), descrito pela primeira vez em 1837 e representa 3,8% de todos os HSD. Poucos casos de diastematomielia cervical foram relatados, uma vez que a localização principal da doença é a coluna torácica baixa, no cone medular. Neste artigo, fizemos uma revisão da literatura e descrevemos um caso raro de diastematomielia cervical associada a lipoma e hipotrofia de membros superiores. Relato do caso: Uma mulher de 48 anos apresentou-se em nosso ambulatório com queixa de atrofia da porção distal do membro superior direito, que evoluiu para o lado contralateral após seis meses. No intraoperatório, a membrana epidural foi aberta, sendo encontrada uma lesão amarelada, reforçando o diagnóstico sugestivo de lipoma. Após a remoção, a medula espinhal dividida tornou-se clara. Discussão: Segundo nossa pesquisa, este é o primeiro caso de lipoma associado a diastematomielia na região cervical. Desde 1985, apenas 23 pacientes adultos foram diagnosticados com exames de imagem e tratados cirurgicamente. É possível dividir os pacientes com malformação da medula espinhal (SCM) em dois grupos. Um grupo de pacientes diagnosticados nos primeiros anos de vida com sintomas remanescentes e outro grupo formado por aqueles diagnosticados na idade adulta. Nosso paciente encontra-se no segundo grupo.
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- 2020
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26. Incremental Prognostic Value of Coagulopathy in Addition to the Crash Score in Traumatic Brain Injury Patients
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Robson Luis Oliveira de Amorim, Wellingson Silva Paiva, Angelos G. Kolias, Almir Ferreira de Andrade, Manoel Jacobsen Teixeira, Davi Jorge Fontoura Solla, and Peter J. Hutchinson
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Adult ,Male ,medicine.medical_specialty ,Critical Care and Intensive Care Medicine ,Logistic regression ,03 medical and health sciences ,Traumatic brain injury ,0302 clinical medicine ,Coagulopathy ,Statistical significance ,Internal medicine ,Brain Injuries, Traumatic ,medicine ,Humans ,Glasgow Coma Scale ,Prospective Studies ,Mortality ,Prospective cohort study ,Retrospective Studies ,Prothrombin time ,Receiver operating characteristic ,medicine.diagnostic_test ,business.industry ,030208 emergency & critical care medicine ,Prognosis ,medicine.disease ,Prognostic score ,Female ,Neurology (clinical) ,business ,Original Work ,030217 neurology & neurosurgery ,Partial thromboplastin time - Abstract
Background/objective Multivariable prognostic scores play an important role for clinical decision-making, information giving to patients/relatives, benchmarking and guiding clinical trial design. Coagulopathy has been implicated on trauma and critical care outcomes, but few studies have evaluated its role on traumatic brain injury (TBI) outcomes. Our objective was to verify the incremental prognostic value of routine coagulopathy parameters in addition to the CRASH-CT score to predict 14-day mortality in TBI patients. Methods This is a prospective cohort of consecutive TBI patients admitted to a tertiary university hospital Trauma intensive care unit (ICU) from March/2012 to January/2015. The prognostic performance of the coagulation parameters platelet count, prothrombin time (international normalized ratio, INR) and activated partial thromboplastin time (aPTT) ratio was assessed through logistic regression adjusted for the original CRASH-CT score. A new model, CRASH-CT-Coag, was created and its calibration (Brier scores and Hosmer–Lemeshow (H–L) test), discrimination [area under the receiver operating characteristic curve (AUC-ROC) and the integrated discrimination improvement (IDI)] and clinical utility (net reclassification index) were compared to the original CRASH-CT score. Results A total 517 patients were included (median age 39 years, 85.1% male, median admission glasgow coma scale 8, neurosurgery on 44.9%). The 14-day mortality observed and predicted by the original CRASH-CT was 22.8% and 26.2%, respectively. Platelet count 3, INR > 1.2 and aPTT ratio > 1.2 were present on 11.3%, 65.0% and 27.2%, respectively, (at least one of these was altered on 70.6%). All three variables maintained statistical significance after adjustment for the CRASH-CT score. The CRASH-CT-Coag score outperformed the original score on calibration (brier scores 0.122 ± 0.216 vs 0.132 ± 0.202, mean difference 0.010, 95% CI 0.005–0.019, p = 0.036, respectively) and discrimination (AUC-ROC 0.854 ± 0.020 vs 0.813 ± 0.024, p = 0.014; IDI 5.0%, 95% CI 1.3–11.0%). Both scores showed the satisfactory H–L test results. The net reclassification index favored the new model. Considering the strata of low ( 30%) risk of death, the CRASH-CT-Coag model yielded a global net correct reclassification of 22.9% (95% CI 3.8–43.4%). Conclusions The addition of early markers of coagulopathy—platelet count, INR and aPTT ratio—to the CRASH-CT score increased its accuracy. Additional studies are required to externally validate this finding and further investigate the coagulopathy role on TBI outcomes.
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- 2020
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27. Evaluation of Head Computed Tomography Assessment of Brain Swelling after Acute Traumatic Brain Injury: A Pilot study
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Marcelo de Lima Oliveira, Francisco Otávio Camargo Pereira, Almir Ferreira de Andrade, Edson Bor-Seng-Shu, Barbara Albuquerque Morais, Wellingson Silva Paiva, Manoel Jacobsen Teixeira, Robson Luis Oliveira de Amorim, and Matheus Fernandes Oliveira
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medicine.medical_specialty ,medicine.diagnostic_test ,Traumatic brain injury ,business.industry ,lcsh:R ,lcsh:Surgery ,lcsh:Medicine ,Computed tomography ,lcsh:RD1-811 ,tomography ,medicine.disease ,Confidence interval ,critical care ,Cohen's kappa ,medicine ,Brain swelling ,brain injurytraumatic ,Surgery ,prognosis ,Neurology (clinical) ,Radiology ,Tomography ,Neurosurgery ,business ,Intracranial pressure - Abstract
Objective To evaluate the interobserver reliability of a new scale created for quantitatively assessing brain swelling in traumatic brain injury (TBI) patients using the computed tomography (CT) findings in three levels. Methods Computed tomography scans of severe head injury patients were randomly selected from a tertiary hospital image database and evaluated by independent groups of neurosurgeons, neurosurgery residents, radiologists, and intensivists from the same hospital. Each specialist assessed the tomographic findings, applying zero to six points in a new scale. The Kappa coefficient was calculated to assess interobserver agreement. Results The highest reliability coefficient was obtained by the neurosurgeons group (0.791; 95% confidence interval [CI]: 0.975–0.607; p Conclusion The proposed scale showed good reliability among neurosurgeons, and moderate overall reliability. This tomographic classification might be useful to better assist severe TBI victims, allowing to identify the worsening or amelioration of brain swelling, which should be further investigated. The scale seems to be feasible, even in low income countries, where the cost of intracranial pressure (ICP) monitoring is higher than that of CTs.
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- 2019
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28. Lhermitte-Duclos Disease and Cowden Syndrome: A Case Report and Literature Review
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Marco Rodrigo Valdivia Sanz, Mylla Christie de Oliveira Paschoalino, Nelson Brancaccio dos Santos, Louise Makarem Oliveira, Mylena Miki Lopes Ideta, and Robson Luis Oliveira de Amorim
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medicine.medical_specialty ,congenital, hereditary, and neonatal diseases and abnormalities ,Lhermitte–Duclos disease ,Ataxia ,cerebellum ,lcsh:Surgery ,lcsh:Medicine ,lhermitte-duclos disease ,Lesion ,medicine ,Hamartoma ,Gangliocytoma ,business.industry ,lcsh:R ,Macrocephaly ,Cowden syndrome ,lcsh:RD1-811 ,medicine.disease ,hamartoma syndrome ,Dermatology ,Dysplastic Cerebellar Gangliocytoma ,Surgery ,Neurology (clinical) ,medicine.symptom ,cowden syndrome ,business - Abstract
Lhermitte-Duclos disease (LDD), also known as dysplastic gangliocytoma of the cerebellum, is a rare, usually benign, slow-growing tumor, that commonly affects patients aged 30 to 50 years-old. The manifestations of dysplastic cerebellar gangliocytoma are nonspecific and are related both to the mass effect produced by its growth and to the location of the lesion. Cerebellar symptoms such as ataxia are often present. In 40% of cases, the tumor is associated with Cowden syndrome, which is part of a group of genetic disorders called polypoid hamartoma complex. In this case report, the patient presented expansive lesion in the posterior fossa, compatible with LDD, associated with macrocephaly. These findings are considered major criteria for Cowden syndrome. When together, they confirm the diagnoses. To our knowledge, this is the first report of the association of LDD and Cowden syndrome in Brazil.
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- 2019
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29. Versão Brasileira do Questionário Rivermead de Sintomas Pós-Concussionais
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Robson Luis Oliveira de Amorim, Cintya Yukie Hayashi, Renata Eloah de Lucena Ferretti-Rebustini, Wellingson Silva Paiva, Daniele Vieira da Silva, Marcia Mitie Nagumo, Marcos Alencar Abaide Balbinotti, and Manoel Jacobsen Teixeira
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Adult ,Cross-Cultural Comparison ,Psychometrics ,Context (language use) ,Neurosciences. Biological psychiatry. Neuropsychiatry ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Tradução ,Brazilian Portuguese ,Lesões Encefálicas Traumáticas ,law ,Surveys and Questionnaires ,Brain Injuries, Traumatic ,medicine ,Content validity ,Humans ,Relevance (information retrieval) ,Translations ,030212 general & internal medicine ,Síndrome Pós-Concussão ,Post-concussion syndrome ,Post-Concussion Syndrome ,Reproducibility of Results ,Rivermead post-concussion symptoms questionnaire ,Translating ,medicine.disease ,language.human_language ,Neurology ,CLARITY ,language ,Neurology (clinical) ,Psychology ,Psicometria ,030217 neurology & neurosurgery ,Brazil ,Clinical psychology ,RC321-571 - Abstract
Background: After a traumatic brain injury, post-concussion symptoms are commonly reported by patients. Although common, these symptoms are difficult to diagnose and recognize. To date, no instruments evaluating post-concussion symptoms have been culturally translated or adapted to the Brazilian context. Objective: To culturally adapt the Rivermead Post-Concussion Symptoms Questionnaire for use in Brazilian Portuguese. Methods: Cross-cultural adaptation was done in five steps: translation, synthesis of translations, back-translation, evaluation by two expert committees and two pretests among adults in a target population. Results: The semantic, idiomatic, cultural and experimental aspects of the adaptation were considered adequate. The content validity coefficient of the items regarding language clarity, pratical pertinence, relevance and dimensionality were considered adequate for evaluating the desired latent variable. Both pretests demonstrated that the instrument had satisfactory acceptability. Conclusion: The Brazilian version, named Questionário Rivermead de Sintomas pós Concussionais (RPQ-Br), has been adapted, and is ready for use in the Brazilian context. RESUMO Introdução: Após um traumatismo cranioencefálico, os sintomas pós-concussionais são comumente relatados pelos pacientes e, embora comuns, são difíceis de serem reconhecidos. Até o momento, não existem instrumentos que tenham sido traduzidos ou adaptados culturalmente para o contexto brasileiro. Objetivo: Adaptação transcultural do Rivermead Post Concussion Symptoms Questionnaire para o português do Brasil. Métodos: O processo de adaptação transcultural foi realizado em cinco etapas: tradução, síntese das traduções, retrotradução, avaliação por dois comitês de especialistas e dois pré-testes com adultos da população-alvo. Resultados: Os aspectos semânticos, idiomáticos, culturais e experimentais foram considerados adequados. Os coeficientes de validade de conteúdo dos itens quanto à clareza da linguagem, pertinência teórica, relevância prática e dimensionalidade foram considerados adequados para avaliar a variável latente desejada. Ambos os pré-testes demonstraram aceitabilidade satisfatória do instrumento. Conclusão: A versão brasileira do Questionário Rivermead de Sintomas pós Concussionais (RPQ-Br) foi traduzida e adaptada com sucesso e está pronta para ser utilizada no contexto brasileiro.
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- 2021
30. Consensus statement from the international consensus meeting on post-traumatic cranioplasty
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F. La Porta, A. Cama, Konstantinos Fountas, Jussi P. Posti, Giuseppe Talamonti, Anna Estraneo, Amos Olufemi Adeleye, Andrew I R Maas, Kee B. Park, P. Palma, Tariq Khan, Mino Zucchelli, Gianluigi Zona, Andres M. Rubiano, E. Viaroli, Vicknes Waran, Robson Luis Oliveira de Amorim, Franco Servadei, Stefano Signoretti, Roberto Stefini, Corrado Iaccarino, I. Hossain, Alessandro Bertuccio, Rita Formisano, Andras Buki, Peter J. Hutchinson, Giuseppe Cinalli, Anthony Figaji, Randall M. Chesnut, Angelo Pompucci, P. De Bonis, Carlo Giussani, V. Sinha, Charalabos Gatos, Dirk Lindner, P. Peretta, Anastasia Tasiou, Angelos G. Kolias, S. K. Sengupta, P. D. Adelson, S. I. Florian, Wellingson Silva Paiva, A. Sinha, Antonino Germanò, P. Kasprzak, Paolo Frassanito, Apollo - University of Cambridge Repository, Kolias, Angelos [0000-0003-3992-0587], Hutchinson, Peter [0000-0002-2796-1835], Iaccarino, C, Kolias, A, Adelson, P, Rubiano, A, Viaroli, E, Buki, A, Cinalli, G, Fountas, K, Khan, T, Signoretti, S, Waran, V, Adeleye, A, Amorim, R, Bertuccio, A, Cama, A, Chesnut, R, De Bonis, P, Estraneo, A, Figaji, A, Florian, S, Formisano, R, Frassanito, P, Gatos, C, Germano, A, Giussani, C, Hossain, I, Kasprzak, P, La Porta, F, Lindner, D, Maas, A, Paiva, W, Palma, P, Park, K, Peretta, P, Pompucci, A, Posti, J, Sengupta, S, Sinha, A, Sinha, V, Stefini, R, Talamonti, G, Tasiou, A, Zona, G, Zucchelli, M, Hutchinson, P, and Servadei, F
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medicine.medical_specialty ,Statement (logic) ,medicine.medical_treatment ,media_common.quotation_subject ,Consensus Development Conferences as Topic ,Neurosurgery ,Decompressive craniectomy ,Brain tumors ,NO ,Cranioplasty ,Voting ,Brain Injuries, Traumatic ,Global health ,medicine ,Humans ,Ratification ,media_common ,Rehabilitation ,business.industry ,Subject (documents) ,Conference Report ,Plastic Surgery Procedures ,Italy ,Review Article - Conference Report ,Family medicine ,hydrocephalu ,Surgery ,hydrocephalus ,Neurology (clinical) ,Human medicine ,business ,Inclusion (education) ,Craniotomy ,Hydrocephalus - Abstract
Background Due to the lack of high-quality evidence which has hindered the development of evidence-based guidelines, there is a need to provide general guidance on cranioplasty (CP) following traumatic brain injury (TBI), as well as identify areas of ongoing uncertainty via a consensus-based approach. Methods The international consensus meeting on post-traumatic CP was held during the International Conference on Recent Advances in Neurotraumatology (ICRAN), in Naples, Italy, in June 2018. This meeting was endorsed by the Neurotrauma Committee of the World Federation of Neurosurgical Societies (WFNS), the NIHR Global Health Research Group on Neurotrauma, and several other neurotrauma organizations. Discussions and voting were organized around 5 pre-specified themes: (1) indications and technique, (2) materials, (3) timing, (4) hydrocephalus, and (5) paediatric CP. Results The participants discussed published evidence on each topic and proposed consensus statements, which were subject to ratification using anonymous real-time voting. Statements required an agreement threshold of more than 70% for inclusion in the final recommendations. Conclusions This document is the first set of practical consensus-based clinical recommendations on post-traumatic CP, focusing on timing, materials, complications, and surgical procedures. Future research directions are also presented.
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- 2021
31. Importance of duration of acute kidney injury after severe trauma: a cohort study
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Angelos G Kolias, Matheus Rodrigues de Souza, Caroline Ferreira Fagundes, Davi Jorge Fontoura Solla, Gustavo Carlos Lucena da Silva, Rafaela Borin Barreto, Manoel Jacobsen Teixeira, Robson Luis Oliveira de Amorim, Daniel Godoy, and Wellingson Silva Paiva
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medicine.medical_specialty ,RD1-811 ,Critical Care and Intensive Care Medicine ,urologic and male genital diseases ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,law ,Medicine ,critical illness ,030212 general & internal medicine ,Stage (cooking) ,Original Research ,RC86-88.9 ,business.industry ,urogenital system ,Incidence (epidemiology) ,Medical record ,Trauma center ,Acute kidney injury ,Medical emergencies. Critical care. Intensive care. First aid ,030208 emergency & critical care medicine ,medicine.disease ,Intensive care unit ,female genital diseases and pregnancy complications ,critical care ,acute kidney injury ,Emergency medicine ,Surgery ,business ,multiple trauma ,Cohort study ,Kidney disease - Abstract
BackgroundAcute kidney injury (AKI) is common after severe trauma. AKI incidence and AKI stage have previously been shown to be associated with poor outcomes after trauma. However, AKI duration may also be important for outcomes after trauma, given that it is associated with long-term morbidity and mortality in general intensive care unit (ICU) and hospitalized patients. We hypothesized that duration of AKI is independently associated with poor outcomes after trauma.MethodsA cohort study was conducted at a single, level 1 trauma center. Patients admitted to the ICU between 2009 and 2018 were included. Data were extracted from the trauma registry and electronic medical records. AKI within 7 days from presentation was defined according to the Kidney Disease Improving Global Outcomes guidelines. Multivariable analyses were performed to assess the association between AKI incidence, AKI stage, and AKI duration with outcomes including prolonged ICU and hospital length of stay, discharge to home, and mortality.ResultsOf 7049 patients included, 72% were male, the median age was 41 years (IQR 27–58), and 10% died. The AKI incidence was 45%, with 69% of these patients presenting with AKI on arrival. The majority (73%) of patients who suffered AKI recovered within 2 days. After adjustment in separate models, AKI incidence, AKI stage and AKI duration were each associated with prolonged hospitalization, an unfavorable discharge disposition, and mortality. AKI stage and duration were not used in the same model due to collinearity.ConclusionsPost-traumatic AKI was common on arrival and frequently short lasting. Duration correlated with highest AKI stage, and both were separately associated with prolonged hospitalization, discharge destination other than home, and mortality on adjusted analyses. Given the high incidence of AKI on arrival, stage or duration may be better targets for future interventions and quality improvement initiatives to improve outcomes after post-traumatic AKI.Level of evidenceIII. Prognostic.
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- 2021
32. Neuroprotection in Brain Injury
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Leonardo C. Welling, Robson Luis Oliveira de Amorim, Eberval Gadelha Figueiredo, and Nícollas Nunes Rabelo
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business.industry ,Excitotoxicity ,Treatment options ,medicine.disease_cause ,Neuroprotection ,Clinical trial ,chemistry.chemical_compound ,Immune system ,chemistry ,medicine ,Neurotransmitter ,business ,Neuroscience ,Oxidative stress - Abstract
Neuroprotection represents an important issue in brain injury (BI) scenarios due to the limited treatment options and the importance of the extent of secondary injury. Neuroprotection in BI targets secondary neuronal injury, a multidimensional molecular cascade that includes excitotoxicity, immune response imbalances, oxidative stress, and apoptotic-like processes. These molecular processes lead to dysfunction of the blood–brain barrier and alterations of neurotransmitter and hormonal systems. The result is an imbalance of the interplay between endogenous defense activity and damage mechanisms. The disappointment over the failure of most randomized clinical trials that failed to find an effective neuroprotective therapy has led to the development of a critical, constructive view of the current understanding of the complexity of secondary injury pathways, how these pathways could be modulated, and how a clinical trial should be designed to detect the multidimensional aspects of BI outcomes.
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- 2021
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33. Improvement in neurological outcome and brain hemodynamics after late cranioplasty
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Corrado Iaccarino, Manoel Jacobsen Teixeira, Edson Bor-Seng-Shu, Almir Ferreira de Andrade, Wellingson Silva Paiva, Sérgio Brasil, Robson Luis Oliveira de Amorim, Gabriel Scarabôtolo Gattás, Fernando Mendes Paschoal Junior, and Arthur Maynart Pereira Oliveira
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Decompressive Craniectomy ,medicine.medical_specialty ,medicine.medical_treatment ,Hemodynamics ,Perfusion scanning ,Decompressive craniectomy ,Cranioplasty ,Cerebral blood flow ,Perfusion imaging ,Transcranial Doppler sonography ,Internal medicine ,medicine.artery ,medicine ,Humans ,Prospective Studies ,Cerebral perfusion pressure ,business.industry ,Skull ,Brain ,Plastic Surgery Procedures ,Transcranial Doppler ,Treatment Outcome ,Cerebrovascular Circulation ,Middle cerebral artery ,Cardiology ,Surgery ,Neurology (clinical) ,business - Abstract
Early cranioplasty has been encouraged after decompressive craniectomy (DC), aiming to reduce consequences of atmospheric pressure over the opened skull. However, this practice may not be often available in low-middle-income countries (LMICs). We evaluated clinical improvement, hemodynamic changes in each hemisphere, and the hemodynamic balance between hemispheres after late cranioplasty in a LMIC, as the institution’s routine resources allowed. Prospective cohort study included patients with bone defects after DC evaluated with perfusion tomography (PCT) and transcranial Doppler (TCD) and performed neurological examinations with prognostic scales (mRS, MMSE, and Barthel Index) before and 6 months after surgery. A final sample of 26 patients was analyzed. Satisfactory improvement of neurological outcome was observed, as well as significant improvement in the mRS (p = 0.005), MMSE (p
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- 2021
34. TRAUMATISMO CRANIOENCEFÁLICO: FATORES PROGNÓSTICOS
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ANDREW GEORG WISCHNESK, ROSANE DIAS DA ROSA, ROBSON LUIS OLIVEIRA DE AMORIM, HENRIQUE OLIVEIRA MARTINS, and João Gabriel Linhares Pulner
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- 2021
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35. Letter to the Editor Regarding 'Optimal Bone Flap Size for Decompressive Craniectomy for Refractory Increased Intracranial Pressure in Traumatic Brain Injury: Taking the Patient's Head Size into Account'
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Daniel Buzaglo Gonçalves, Robson Luis Oliveira de Amorim, Maria Izabel Andrade dos Santos, Wellingson Silva Paiva, and Laura Raquel da Silva Costa
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Head size ,medicine.medical_specialty ,Bone flap ,Decompressive Craniectomy ,Letter to the editor ,Intracranial Pressure ,Traumatic brain injury ,business.industry ,medicine.medical_treatment ,medicine.disease ,Surgical Flaps ,Surgery ,Refractory ,Brain Injuries, Traumatic ,medicine ,Humans ,Decompressive craniectomy ,Neurology (clinical) ,Intracranial Hypertension ,business ,Intracranial pressure - Published
- 2020
36. Safety and costs analysis of early hospital discharge after brain tumour surgery: a pilot study
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Manoel Jacobsen Teixeira, Eduardo Vicentin, Danilo Gomes Quadros, Claudia Marquez Simões, Francisco Ureña, Robson Luis Oliveira de Amorim, Iuri Santana Neville, Wellingson Silva Paiva, Ulysses Ribeiro, Davi Jorge Fontoura Solla, and Mariana F. Lima
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Adult ,Male ,medicine.medical_specialty ,Tumour surgery ,lcsh:Surgery ,Neurological examination ,Pilot Projects ,Logistic regression ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Hospital discharge ,Medicine ,Humans ,ERAS ,Hospital Costs ,Enhanced recovery after surgery ,Early discharge ,Aged ,Retrospective Studies ,Performance status ,medicine.diagnostic_test ,business.industry ,Brain Neoplasms ,Brain tumours ,Postoperative length of stay ,General Medicine ,lcsh:RD1-811 ,Length of Stay ,Middle Aged ,Patient Discharge ,Surgery ,030220 oncology & carcinogenesis ,Female ,Discharge ,business ,030217 neurology & neurosurgery ,Algorithms ,Cohort study ,Research Article - Abstract
Background A daily algorithm for hospital discharge (DAHD) is a key point in the concept of Enhanced Recovery After Surgery (ERAS) protocol. We aimed to evaluate the length of stay (LOS), rate of complications, and hospital costs variances after the introduction of the DAHD compared to the traditional postoperative management of brain tumour patients. Methods This is a cohort study with partial retrospective data collection. All consecutive patients who underwent brain tumour resection in 2017 were analysed. Demographics and procedure-related variables, as well as clinical outcomes, LOS and healthcare costs within 30 days after surgery were compared in patients before/pre-implementation and after/post-implementation the DAHD, which included: stable neurological examination; oral feeding without aspiration risk; pain control with oral medications; no intravenous medications. The algorithm was applied every morning and discharge was considered from day 1 after surgery if criteria was fulfilled. The primary outcome (LOS after surgery) analysis was adjusted for the preoperative performance status on a multivariable logistic regression model. Results A total of 61 patients were studied (pre-implementation 32, post-implementation 29). The baseline demographic characteristics were similar between the groups. After the DAHD implementation, LOS decreased significantly (median 5 versus 3 days; p = 0.001) and the proportion of patients who were discharged on day 1 or 2 after surgery increased (44.8% vs 3.1%; p
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- 2020
37. Prediction of Early TBI Mortality Using a Machine Learning Approach in a LMIC Population
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Marcia Mitie Nagumo, Leandro Costa Miranda, Robson Luis Oliveira de Amorim, Wellingson Silva Paiva, Louise Makarem Oliveira, Luís Marcelo Sá Malbouisson, Almir Ferreira de Andrade, Edson Bor-Seng-Shu, Andres M. Rubiano, André Beer-Furlan, Manoel Jacobsen Teixeira, Marcela Simoes, Angelos G. Kolias, Apollo - University of Cambridge Repository, Kolias, Angelos [0000-0003-3992-0587], and Rubiano, Andrés M. [0000-0001-8931-3254]
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Traumatic brain injury ,Population ,Poison control ,Escala de coma de glasgow ,Machine learning ,computer.software_genre ,lcsh:RC346-429 ,LMICs ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,law ,Injury prevention ,medicine ,Pruebas diagnósticas de rutina ,030212 general & internal medicine ,Mortality ,education ,lcsh:Neurology. Diseases of the nervous system ,Original Research ,education.field_of_study ,business.industry ,traumatic brain injury ,Glasgow Coma Scale ,medicine.disease ,Intensive care unit ,mortality ,machine learning ,Neurology ,Tomografía computarizada espiral ,Cohort ,Observational study ,Neurology (clinical) ,Artificial intelligence ,business ,computer ,prognostic ,030217 neurology & neurosurgery - Abstract
Background: In a time when the incidence of severe traumatic brain injury (TBI) is increasing in low- to middle-income countries (LMICs), it is important to understand the behavior of predictive variables in an LMIC’s population. There are few previous attempts to generate prediction models for TBI outcomes from local data in LMICs. Our study aim is to design and compare a series of predictive models for mortality on a new cohort in TBI patients in Brazil using Machine Learning. Methods: A prospective registry was set in São Paulo, Brazil, enrolling all patients with a diagnosis of TBI that require admission to the intensive care unit. We evaluated the following predictors: gender, age, pupil reactivity at admission, Glasgow Coma Scale (GCS), presence of hypoxia and hypotension, computed tomography findings, trauma severity score, and laboratory results. Results: Overall mortality at 14 days was 22.8%. Models had a high prediction performance, with the best prediction for overall mortality achieved through Naive Bayes (area under the curve = 0.906). The most significant predictors were the GCS at admission and prehospital GCS, age, and pupil reaction. When predicting the length of stay at the intensive care unit, the Conditional Inference Tree model had the best performance (root mean square error = 1.011), with the most important variable across all models being the GCS at scene. Conclusions: Models for early mortality and hospital length of stay using Machine Learning can achieve high performance when based on registry data even in LMICs. These models have the potential to inform treatment decisions and counsel family members. Level of evidence: This observational study provides a level IV evidence on prognosis after TBI.
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- 2020
38. Casuística do Serviço em Implante de Eletrodos de Estimulação Epidural para Dor Crônica Intratável: 8 casos no Amazonas
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F. A. Reis, Renata de Oliveira Galvão, Daniel Buzaglo Gonçalves, Robson Luis Oliveira de Amorim, Maria Izabel Andrade dos Santos, Anelys Feitoza Siqueira, Lucas de Cristo Rojas Cabral, and Layla Calazans Müller
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medicine.anatomical_structure ,business.industry ,Postoperative pain ,Anesthesia ,Chronic pain ,Medicine ,Spinal cord stimulation ,Visual scale ,business ,medicine.disease ,Epidural space - Abstract
Introduction: The spinal cord stimulation has been applied for the treatment of patients with intractable chronic pain through thereduction of the painful state by implantation of electrodes in the posterior epidural space. Objective: This study aims to analyze acase series with intractable chronic pain submitted to the implantation of spinal cord stimulation electrode in the state of Amazonas.Methods: Patients were included if they presented intractable chronic pain, regardless of age or gender, that received the spinal cordstimulation. The Visual Scale Analogue (VAS) was used for the evaluation or in pre and postoperative pain. Results: The sample of thisstudy was 8 patients. The average of pre and postoperative VAS scale was 8.4 and 3.8, respectively. There were no deaths during orafter surgery. Three complications were described. Conclusion: The Spinal Cord Stimulation proved to be effective in the treatment ofintractable chronic pain. However, new researches are essential to the expansion of this treatment.
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- 2020
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39. Hemorragia subaracnóidea traumática
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Wellingson Silva Paiva, Eduardo Joaquim Lopes Alho, Manoel Jacobsen Teixeira, Robson Luis Oliveira de Amorim, Eberval Gadelha Figueiredo, and Almir Ferreira de Andrade
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medicine.medical_specialty ,Poor prognosis ,Subarachnoid hemorrhage ,medicine.anatomical_structure ,business.industry ,General surgery ,Incidence (epidemiology) ,medicine ,MEDLINE ,In patient ,Subarachnoid space ,medicine.disease ,business - Abstract
Introduction: Recent studies have shown association between the presence of blood in subarachnoid space in the first head computed tomography and the prognosis of patients with traumatic brain injury. The importance for the pathophysiology of brain trauma and the large incidence of traumatic subarachnoid hemorrhage led the authors to conduct a review with specificguidelines for classification, diagnosis and treatment. Material and Methods: Review articles listed in MEDLINE/Index Medicus database and LILACS, comprising a period from January 1970 to March 2008, were collected. Results: Thirty seven articles with the greatest impact from a collection of 192 were selected, considering 132 written in English or in Portuguese. Conclusions: Traumatic subarachnoid hemorrhage is a marker of poor prognosis in patients with moderate and severe head trauma and management involves advanced neurointensive care.
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- 2018
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40. Critérios de avaliação neurológica e exames complementares no diagnóstico de morte encefálica
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Leonardo Borges de Barros e Silva, Wellingson Silva Paiva, Eberval Gadelha Figueiredo, Robson Luis Oliveira de Amorim, Almir Ferreira de Andrade, and Manoel Jacobsen Teixeira
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Gynecology ,medicine.medical_specialty ,business.industry ,Clinical diagnosis ,Medicine ,Potential donor ,business - Abstract
O conceito de morte encefálica surgiu concomitantemente com a medicina de transplantes na década de 1960, existindo assim a necessidade de determinação científica e legal de em que momento um paciente pode ser considerado em morte encefálica e, assim, um potencial doador de órgãos e tecidos. O exame clínico deverá avaliar quatro pontos fundamentais que são as bases para a determinação clínica de morte encefálica. Neste artigo, revisamos os conceitos de diagnóstico clínico de morte encefálica e os principais exames complementares confirmatórios.
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- 2018
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41. Traumatic brain injury caused by Brazil-nut fruit in the Amazon: A case series
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Gustavo Lopes de Castro, Marco Antônio Leal Santos, Robson Luis Oliveira de Amorim, Mylena Miki Lopes Ideta, Daniel Buzaglo Gonçalves, Erik Leonardo Jennings Simões, and Louise Makarem Oliveira
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medicine.medical_specialty ,Pediatrics ,Epidemiology ,business.industry ,Traumatic brain injury ,Dura mater ,Glasgow Coma Scale ,Brazil nut tree ,medicine.disease ,Unintentional injury ,food.food ,Hematoma ,medicine.anatomical_structure ,food ,Epidural hematoma ,Skull fracture ,medicine ,Original Article ,Surgery ,Neurology (clinical) ,business ,Amazon ,Brazil nut - Abstract
Background: Traumatic brain injury (TBI) represents one of the leading public health problems and a significant cause of neurological damage. Unintentional causes of TBI are the most frequent. However, fruit falling over the head causing TBI is extremely rare. In the Amazon region, accidents with ouriços, a coconut-like shell fruit, seem relatively common. However, to the best our knowledge, it has never been described in a scientific journal before. Therefore, we aim to evaluate a series of TBI caused by this tropical fruit. Methods: This study is a retrospective review of 7 TBI cases due to the fall of ouriços admitted to two tertiary hospitals in the Amazon region from January 2017 to December 2018. The collected data included: age, Glasgow Coma Scale, skull fracture, venous sinus injury, hematoma, surgical treatment, and outcome. Results: All patients were men, with an average age of 38, ranging from 8 to 77-years-old. Four out of seven had skull fractures. Five patients developed an epidural hematoma, and two of them had an associated subdural hematoma. Dura mater injury was observed in two patients, whereas four patients were operated. There was one related death. Conclusion: This case series is the first to describe an unconventional but potentially fatal cause of TBI in the Amazon: the falling of the Brazil-nut fruit. Most patients were diagnosed with mild TBI. Nevertheless, patients may have cranial fractures and epidural hematomas, leading to death when there’s a delay in medical assistance.
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- 2021
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42. Ultrasonography During Surgery to Approach Cerebral Metastases: Effect on Karnofsky Index Scores and Tumor Volume
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Marcelo de Lima Oliveira, Marcos Roberto de Menezes, Helder Picarelli, Manoel Jacobsen Teixeira, Edson Bor-Seng-Shu, and Robson Luis Oliveira de Amorim
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Male ,Lung Neoplasms ,Neoplasm, Residual ,Skin Neoplasms ,Neurosurgical Procedures ,0302 clinical medicine ,Quality of life ,Odds Ratio ,Melanoma ,Aged, 80 and over ,medicine.diagnostic_test ,Brain Neoplasms ,Sarcoma ,Middle Aged ,Tumor Burden ,Treatment Outcome ,Surgery, Computer-Assisted ,030220 oncology & carcinogenesis ,Colonic Neoplasms ,Adenocarcinoma ,Female ,Metastasectomy ,Adult ,medicine.medical_specialty ,Breast Neoplasms ,Young Adult ,03 medical and health sciences ,Stomach Neoplasms ,medicine ,Humans ,Karnofsky Performance Status ,Aged ,Retrospective Studies ,Surgical team ,Intraoperative Care ,business.industry ,Retrospective cohort study ,Magnetic resonance imaging ,Odds ratio ,medicine.disease ,Echoencephalography ,Surgery ,PROCEDIMENTOS CIRÚRGICOS RECONSTRUTIVOS ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
The goals of treating a cerebral metastasis (CM) are to achieve local control of the disease and to improve patient quality of life. The aim of this study was to analyze the effect of conventional surgery supported by intraoperative ultrasound (IOUS) to approach a CM. To perform this analysis, we determined the postoperative Karnofsky Performance Status Scale (KPS) scores and tumor resection grades.Patients with a CM diagnosis were included in this study. Surgical treatment was either supported or not by IOUS. Pre- and postoperative KPS scores were determined by the oncology team, and cerebral tumor volume was estimated through pre- and postoperative magnetic resonance imaging. The surgical team determined whether it was possible to perform a total CM resection.There were 78 patients treated using surgical management (35 with and 43 without IOUS). In the IOUS group, the postoperative KPS scores were higher (80 vs. 70, respectively; P = 0.045) and the KPS evolution was superior (P = 0.036), especially in the following subgroups: difficulty of tumor resection ranking score4 (P = 0.037), tumor in an eloquent area (P = 0.043), tumor not associated with vessels or nerves (P = 0.007), and solitary lesions (P = 0.038). The residual tumor volume was lower in the IOUS group (9.5% and 1.6 mmIOUS may improve postoperative KPS scores and decrease residual tumor volumes in CM surgeries. These findings should be confirmed in future studies.
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- 2017
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43. Letter to the Editor Regarding 'Traumatic Brain Injury Caused by Missile Wounds in the North of Palestine: A Single Institution's Experience with 520 Consecutive Civilian Patients'
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João Gustavo Rocha Peixoto dos Santos, Wellingson Silva Paiva, Robson Luis Oliveira de Amorim, and João Paulo Souza de Castro
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medicine.medical_specialty ,Letter to the editor ,Traumatic brain injury ,business.industry ,MEDLINE ,Human factors and ergonomics ,Poison control ,medicine.disease ,Suicide prevention ,Occupational safety and health ,Brain Injuries ,Injury prevention ,Emergency medicine ,Brain Injuries, Traumatic ,medicine ,Humans ,Surgery ,Neurology (clinical) ,business - Published
- 2019
44. Mismatch between midline shift and hematoma thickness as a prognostic factor of mortality in patients sustaining acute subdural hematoma
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Manoel Jacobsen Teixeira, Wellingson Silva Paiva, Gustavo Carlos Lucena da Silva, Caroline Ferreira Fagundes, Matheus Rodrigues de Souza, Davi Jorge Fontoura Solla, Angelos G. Kolias, Rafaela Borin Barreto, Robson Luis Oliveira de Amorim, Daniel Agustin Godoy, Kolias, Angelos [0000-0003-3992-0587], and Apollo - University of Cambridge Repository
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medicine.medical_specialty ,Prognostic variable ,RD1-811 ,Critical Care and Intensive Care Medicine ,Logistic regression ,03 medical and health sciences ,traumatic ,0302 clinical medicine ,Hematoma ,Midline shift ,brain injuries ,Internal medicine ,medicine ,030212 general & internal medicine ,Prospective cohort study ,brain edema ,Receiver operating characteristic ,RC86-88.9 ,business.industry ,Proportional hazards model ,Original research ,Glasgow Coma Scale ,Medical emergencies. Critical care. Intensive care. First aid ,medicine.disease ,Surgery ,prognosis ,business ,030217 neurology & neurosurgery - Abstract
BackgroundAcute subdural hematoma (ASDH) is a traumatic lesion commonly found secondary to traumatic brain injury. Radiological findings on CT, such as hematoma thickness (HT) and structures midline shift (MLS), have an important prognostic role in this disease. The relationship between HT and MLS has been rarely studied in the literature. Thus, this study aimed to assess the prognostic accuracy of the difference between MLS and HT for acute outcomes in patients with ASDH in a low-income to middle-income country.MethodsThis was a post-hoc analysis of a prospective cohort study conducted in a university-associated tertiary-level hospital in Brazil. The TRIPOD (Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis) statement guidelines were followed. The difference values between MLS and HT (Zumkeller index, ZI) were divided into three categories (3). Logistic regression analyses were performed to reveal the OR of categorized ZI in predicting primary outcome measures. A Cox regression was also performed and the results were presented through HR. The discriminative ability of three multivariate models including clinical and radiological variables (ZI, Rotterdam score, and Helsinki score) was demonstrated.ResultsA total of 114 patients were included. Logistic regression demonstrated an OR value equal to 8.12 for the ZI >3 category (OR 8.12, 95% CI 1.16 to 40.01; p=0.01), which proved to be an independent predictor of mortality in the adjusted model for surgical intervention, age, and Glasgow Coma Scale (GCS) score. Cox regression analysis demonstrated that this category was associated with 14-day survival (HR 2.92, 95% CI 1.38 to 6.16; p=0.005). A multivariate analysis performed for three models including age and GCS with categorized ZI or Helsinki or Rotterdam score demonstrated area under the receiver operating characteristic curve values of 0.745, 0.767, and 0.808, respectively.ConclusionsThe present study highlights the potential usefulness of the difference between MLS and HT as a prognostic variable in patients with ASDH.Level of evidenceLevel III, epidemiological study.
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- 2021
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45. Evaluation of hematological changes and immune response biomarkers as a prognostic factor in critical patients with COVID-19.
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Liliane Rosa Alves Manaças, Robson Luís Oliveira de Amorim, Alian Aguila, Paloam Cardoso Novo, and Rebeka Caribé Badin
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Medicine ,Science - Abstract
COVID-19 disease has been a challenge for health systems worldwide due to its high transmissibility, morbidity, and mortality. Severe COVID-19 is associated with an imbalance in the immune response, resulting in a cytokine storm and a hyperinflammation state. While hematological parameters correlate with prognosis in COVID patients, their predictive value has not been evaluated specifically among those severely ill. Therefore, we aim to evaluate the role of hematological and immune response biomarkers as a prognostic factor in critically ill patients with COVID-19 admitted to the intensive care unit. From May 2020 to July 2021, a retrospective cohort study was conducted in a reference hospital in Manaus, which belongs to the Brazilian public health system. This study was carried out as single-center research. Clinical and laboratory parameters were analyzed to evaluate the association with mortality. We also evaluated the role of neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein-to-lymphocyte ratio (CLR). We gathered information from medical records, as well as from prescriptions and forms authorizing the use of antimicrobial medications. During the study period, 177 patients were included, with a mean age of 62.58 ± 14.39 years. The overall mortality rate was 61.6%. Age, mechanical ventilation (MV) requirement, leukocytosis, neutrophilia, high c-reactive protein level, NLR, and CLR showed a statistically significant association with mortality in the univariate analysis. In the multivariate logistic regression analysis, only MV (OR 35.687, 95% CI: 11.084-114.898, p< 0.001) and NLR (OR 1.026, 95% CI: 1.003-1.050, p = 0.028) remained statistically associated with the outcome of death (AUC = 0.8096). While the need for mechanical ventilation is a parameter observed throughout the hospital stay, the initial NLR can be a primary risk stratification tool to establish priorities and timely clinical intervention in patients with severe COVID-19 admitted to the ICU.
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- 2024
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46. Current clinical approach to patients with disorders of consciousness
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Wellingson Silva Paiva, Marcia Mitie Nagumo, Robson Luis Oliveira de Amorim, Manoel Jacobsen Teixeira, and Almir Ferreira de Andrade
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medicine.medical_specialty ,Neurology ,Consciousness ,media_common.quotation_subject ,coma ,Disorders of consciousness ,Physical examination ,Antidepressive Agents, Tricyclic ,030204 cardiovascular system & hematology ,emergências ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,emergency medicine ,medicine ,Humans ,Medical history ,030212 general & internal medicine ,Psychiatry ,Intensive care medicine ,Physical Examination ,media_common ,lcsh:R5-920 ,neurologia ,medicine.diagnostic_test ,business.industry ,neurology ,General Medicine ,state of consciousness ,Prognosis ,medicine.disease ,estado de consciência ,Clinical research ,Consciousness Disorders ,Anticonvulsants ,medicine.symptom ,lcsh:Medicine (General) ,business ,Algorithms ,Altered level of consciousness - Abstract
Summary In clinical practice, hospital admission of patients with altered level of consciousness, sleepy or in a non-responsive state is extremely common. This clinical condition requires an effective investigation and early treatment. Performing a focused and objective evaluation is critical, with quality history taking and physical examination capable to locate the lesion and define conducts. Imaging and laboratory exams have played an increasingly important role in supporting clinical research. In this review, the main types of changes in consciousness are discussed as well as the essential points that should be evaluated in the clinical management of these patients. Resumo Abordagem Na prática clínica é extremamente comum a admissão hospitalar de pacientes com nível de consciência alterado, sonolentos ou em estado não responsivo. Essa condição clínica demanda uma investigação eficaz e um tratamento precoce. É fundamental a realização de uma avaliação focada e objetiva, com a realização de anamnese e exame físico de qualidade para localizar a lesão e definir condutas. Exames de imagem e laboratoriais têm desempenhado papéis cada vez mais relevantes no suporte à investigação clínica. Nesta revisão, são discutidos os principais tipos de alterações de consciência e os pontos imprescindíveis que devem ser avaliados na abordagem clínica desses pacientes.
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- 2016
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47. Task-Shifting and Task-Sharing in Neurosurgery: An International Survey of Current Practices in Low- and Middle-Income Countries
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Ali Yalcinkaya, Adil Belhachmi, Amos Olufemi Adeleye, Abigail Javier-Lizan, Rosanda Ilić, Fayez Alelyani, Alvan-Emeka Ukacjukwu, Jannick Brennum, Hugues Brieux Ekouele Mbaki, Rafik Ouchetati, Emmanuel Sunday, Recep Basaran, Jagos Golubovic, Jafri Malin Abdullah, Robson Luis Oliveira de Amorim, Peter J. Hutchinson, Abenezer Tirsit Aklilu, Walid El Gaddafi, Marike L. D. Broekman, Andres M. Rubiano, Yunus Kuntawi Aji, Ken-Keller Kumwenda, Carlos Arias, Magnus Tisel, Goertz Mirenge Dunia, Gail Rosseau, Mirsad Hodzic, Kriengsak Limpastan, Mian Awais, Claire Karekezi, Kee B. Park, B S Liew, Trung Kien Duong, Prabu Rau Sriram, Muhammad Tariq, Saman Wadanamby, Timothy R. Smith, Gabriel Longo, Sunday David Ndubuisi Achebe, Felipe Constanzo, Basant Misra, Ionut Negoi, Satish Babu, Thomas Dakurah, Ghulam Farooq, Stephen Honeybul, Menelas Nkeshimana, Luxwell Jokonya, Igor Lima Maldonado, David Adelson, Hassan Almenshawy, Tariq Khan, Arvind Sukumaran, Vladimir Komar, Hazem Kuheil, Robert J. Dempsey, Osaid Alser, Djula Djilvesi, Armin Gretschel, Danjuma Sale, Amit Agrawal, Sanjay Kumar, Hamisi K. Shabani, Amit Thapa, Nidal Abuhadrous, Michael M. Haglund, Mohamed Kassem, Ignatius N. Esene, Sanjay Behari, Bakr Abo Jarad, Dickson Bandoh, Ahmed Ammar, Severien Muneza, Djvnaba Bah, Ritesh Bhoot, Esayas Adefris, Samuel M. Fetene, Gene Bolles, Paul H. Young, Aliyu Baba Ndajiwo, Eghosa Morgan, Manish Agarwal, Harch Deora, Davendran Kanesen, Khalil Ayadi, Graham Fieggen, Lynne Lourdes N. Lucena, Ivar Mendez, Akira Matsumara, William B. Gormley, Evarsitus Nwaribe, Cohen-Inbar Or, Patrick Kamalo, Mykola Vyval, Faith C. Robertson, Zahid Hussain, Ece Uysal, Mohammed A. Alrawi, Nikolaos Syrmos, Balgopal Karmacharya, Angelos G. Kolias, Ipe Vazheeparambil George, Ana Cristina Veiga Silva, Tsegazeab Laeke, Naci Balak, Irfan Yousaf, Ibrahim E. Efe, Gyang Markus Bot, Atul Vats, M. Elhaj Mahmoud, Jeffrey V. Rosenfeld, Elubabor Buno, Alexandru Tascu, Ulrick Sidney Kanmounye, Ahtesham Khizar, Bipin Chaurasia, and Petra Wahjoepramono
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medicine.medical_specialty ,Referral ,Global health ,lcsh:Surgery ,Psychological intervention ,Global neurosurgery ,Certification ,MOH, Ministry of Health ,lcsh:RC346-429 ,Maintenance of Certification ,LMIC ,Patient safety ,LMIC, Low- and middle-income country ,TS/S, Task-shifting and task-sharing ,medicine ,lcsh:Neurology. Diseases of the nervous system ,Task-sharing ,Capacity ,Descriptive statistics ,business.industry ,lcsh:RD1-811 ,Task-shifting ,Family medicine ,DRC, Democratic Republic of the Congo ,Workforce ,Original Article ,Surgery ,Neurology (clinical) ,business - Abstract
Background: Because nearly 23,000 more neurosurgeons are needed globally to address 5 million essential neurosurgical cases that go untreated each year, there is an increasing interest in task-shifting and task-sharing (TS/S), delegating neurosurgical tasks to nonspecialists, particularly in low- and middle-income countries (LMICs). This global survey aimed to provide a cross-sectional understanding of the prevalence and structure of current neurosurgical TS/S practices in LMICs. Methods: The survey was distributed to a convenience sample of individuals providing neurosurgical care in LMICs with a Web-based survey link via electronic mailing lists of continental societies and various neurosurgical groups, conference announcements, e-mailing lists, and social media platforms. Country-level data were analyzed by descriptive statistics. Results: The survey yielded 127 responses from 47 LMICs; 20 countries (42.6%) reported ongoing TS/S. Most TS/S procedures involved emergency interventions, the top 3 being burr holes, craniotomy for hematoma evacuation, and external ventricular drain. Most (65.0%) believed that their Ministry of Health does not endorse TS/S (24.0% unsure), and only 11% believed that TS/S training was structured. There were few opportunities for TS/S providers to continue medical education (11.6%) or maintenance of certification (9.4%, or receive remuneration (4.2%). Conclusions: TS/S is ongoing in many LMICs without substantial structure or oversight, which is concerning for patient safety. These data invite future clinical outcomes studies to assess effectiveness and discussions on policy recommendations such as standardized curricula, certification protocols, specialist oversight, and referral networks to increase the level of TS/S care and to continue to increase the specialist workforce. Key words: Capacity, Global health, Global neurosurgery, LMIC, Task-sharing, Task-shifting, Workforce
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- 2020
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48. The Evolving Concept of Damage Control in Neurotrauma: Application of Military Protocols in Civilian Settings with Limited Resources
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Rodrigo M. Faleiro, Miguel Maldonado, Claudia Marcela Restrepo, Robson Luis Oliveira de Amorim, Ruy Monteiro, Ahsan Ali Khan, Alvaro R. Soto, Jorge Montenegro, Erick Muñoz, José N. Carreño, Andres M. Rubiano, Jeffrey V. Rosenfeld, Wellingson Silva Paiva, Jorge Paranhos, and Rocco A. Armonda
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Damage control ,Adult ,medicine.medical_specialty ,education ,Medically Underserved Area ,Wounds, Penetrating ,Wounds, Nonpenetrating ,Neurosurgical Procedures ,Patient Positioning ,Surgical Flaps ,03 medical and health sciences ,0302 clinical medicine ,Clinical Protocols ,Brain Injuries, Traumatic ,Medicine ,Humans ,In patient ,Emergency Treatment ,Therapeutic strategy ,Intraoperative Care ,business.industry ,Wound Closure Techniques ,Middle Aged ,medicine.disease ,Military Health ,Damage control surgery ,030220 oncology & carcinogenesis ,Surgery ,Narrative review ,Neurology (clinical) ,Medical emergency ,Neurosurgery ,business ,Tomography, X-Ray Computed ,Limited resources ,Organ Sparing Treatments ,030217 neurology & neurosurgery ,Craniotomy ,Forecasting - Abstract
Objective The aim of the present review was to describe the evolution of the damage control concept in neurotrauma, including the surgical technique and medical postoperative care, from the lessons learned from civilian and military neurosurgeons who have applied the concept regularly in practice at military hospitals and civilian institutions in areas with limited resources. Methods The present narrative review was based on the experience of a group of neurosurgeons who participated in the development of the concept from their practice working in military theaters and low-resources settings with an important burden of blunt and penetrating cranial neurotrauma. Results Damage control surgery in neurotrauma has been described as a sequential therapeutic strategy that supports physiological restoration before anatomical repair in patients with critical injuries. The application of the concept has evolved since the early definitions in 1998. Current strategies have been supported by military neurosurgery experience, and the concept has been applied in civilian settings with limited resources. Conclusion Damage control in neurotrauma is a therapeutic option for severe traumatic brain injury management in austere environments. To apply the concept while using an appropriate approach, lessons must be learned from experienced neurosurgeons who use this technique regularly.
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- 2018
49. Distúrbios de coagulação em doentes com contusão cerebral e associação com prognóstico
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Wellingson Silva Paiva, Andreia Lira de Oliveira, Lucas Messias Ribeiro da Cunha, Robson Luis Oliveira de Amorim, Anny de Souza, Franklin Reis, and Louise Makarem Oliveira
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- 2018
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50. Incremental prognostic value of the activated partial thromboplastin time and creatinine in addition to the CRASH score in traumatic brain injury patients
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Robson Luis Oliveira de Amorim, Davi Jorge Fontoura Solla, Wellingson Silva Paiva, and Manoel Jacobsen Teixeira
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medicine.medical_specialty ,Creatinine ,medicine.diagnostic_test ,business.industry ,Traumatic brain injury ,Crash ,medicine.disease ,chemistry.chemical_compound ,chemistry ,Internal medicine ,Cardiology ,Medicine ,business ,Value (mathematics) ,Partial thromboplastin time - Published
- 2018
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