Orientadores: Helder Tedeschi, Andrei Fernandes Joaquim / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-27T03:41:44Z (GMT). No. of bitstreams: 1 Cruz_HalissonYoshinari_M.pdf: 548904 bytes, checksum: f83210d67f0f8e7df7a28e330c894fb3 (MD5) Previous issue date: 2015 / Resumo: Introdução: O SLICS (Subaxial Cervical Spine Injury Classification System) foi proposto para auxílio na tomada de decisão do traumatismo da coluna cervical sub-axial, contudo poucos trabalhos avaliaram sua segurança e eficácia. Método: comparar coorte histórica de pacientes tratados com base na preferência do cirurgião com pacientes tratados baseando-se no escore obtido com a aplicação do sistema. Foram incluidos pacientes com lesão traumática aguda de C3-7 com exames radiológicos e dados clínicos completos. O status neurológico foi avaliado através do ASIA Impairment Scale (AIS). Resultados: entre 2009-10, 12 pacientes foram incluídos (seguimento médio de 24,5 meses). Na admissão hospitalar 5 pacientes (41,6%) apresentavam AIS E, 1 (8,3%) AIS D, 1 (8,3%) AIS C, 1 (8,3%) AIS B e 4 (33.3%) AIS A. Dois de sete pacientes com déficit incompleto melhoraram durante o seguimento clínico. O SLICS escore variou de 2 a 9 pontos (média de 5.5 e mediana de 5.75), onde dois pacientes tinham escore menor do que 4. Entre 2011-13, 28 pacientes foram incluídos (média de 6,1 meses), com média de idade de 41,5 anos. Na admissão hospitalar 12 pacientes (42,9%) apresentavam AIS E, 4 (14,3%) AIS D, 5 (17,9%) AIS C, 2 (7,15%) AIS B e 5 (17,9%) AIS A. Seis pacientes entre os 11 com déficit incompleto apresentaram melhora. O escore de SLICS variou de 4 a 9 pontos, com média e mediana de 6. Conclusões: observamos que após a aplicação do sistema, houve uma diminuição de indicação cirúrgica nos pacientes com lesões mais estáveis ou menos graves, sem que se detectasse piora neurológica em ambos os grupos. Isso sugere que o SLICS pode ser útil para auxiliar a diferenciação das lesões mais instáveis que acometem a coluna cervical sub-axial que requeiram tratamento cirúrgico / Abstract: Introduction: The SLICS (Subaxial Cervical Spine Injury Classification System) was proposed to help in the decision-making process of surgical treatment of sub-axial cervical spine trauma, eventhough the literature assessing its safety and efficacy is scarce. Methods: we compared a cohort series of patients treated based on surgeon¿s preference with patients treated based on the SLICS. We have only included patients with acute spinal trauma from C3-7 that had complete clinical and radiological data. Results: between 2009-10, 12 patients were included (mean 24.5 months of follow-up). The preoperative AIS was: 5 patients (41.6%) were AIS E, 1 (8.3%) AIS D, 1 (8.3%) AIS C, 1 (8.3%) AIS B and 4 (33.3%) AIS A. Two out of seven patients had neurological improvement during follow-up. The SLICS score ranged from 2 to 9 points (mean of 5.5 and median of 5.75 points) with two patients with less than 4 points. From 2011-13, 28 patients were included with a SLICS (mean of 6.1 months of follow-up). The preoperative AIS was: 12 patients (42.9%) with AIS E, 4 (14.3%) AIS D, 5 (17.9%) AIS C, 2 (7.15%) AIS B and 5 (17.9%) AIS A. Six patients out of 11 had some neurological improvement. The SLICS score ranged from 4 to 9 points (mean and median of 6). There was no neurological deterioration in any group. Conclusions: after using the SLICS there was a decrease in the number of patients with less severe injuries that were treated surgically, with no reflection on neurological outcome. This suggests that the SLICS can be helpful in differentiating mild from severe injuries, potentially improving the results of treatment / Mestrado / Neurologia / Mestre em Ciências Médicas

External cause injuries are defined as intentionally or unintentionally harm or injury to a person, which may be caused by trauma, poisoning, assault, accidents, etc., being fatal (fatal injury) or not leading to death (non-fatal injury). External injuries have been considered a global health problem for two decades. This work aims to determine criminal patterns using data mining techniques to a sample of patients from Mumbai city in India.

Running has been a popular sport because of convenience and health benefits. Fatigue among recreational runners may alter running mechanics, thereby increasing the risk for injury. The purpose of this study was to evaluate changes in lower extremity biomechanics throughout a 3.1 mile (5K) run. Ten male and ten female participants wore reflective markers to capture contralateral pelvic drop, knee adduction, knee abduction, and hip adduction. Participants ran 3.1 miles (5K) on a treadmill at a self-determined pace. A two-way, repeated measures ANOVA was conducted to capture the within-subject data across time and between-subject comparing differences in gender. Females had significantly greater contralateral pelvic drop but it did not change over time. Knee abduction angles significantly declined over the five observations. Gender differences and effects of distance can alter the biomechanics in recreational runners. More research is needed to identify predisposing factors to the development of chronic running injuries. / North Dakota State University. Department of Health, Nutrition, and Exercise Sciences

Schoolboy rugby injuries are a cause for concern in medical and non-medical circles, but few scientific investigations into their nature and frequency have been undertaken. The majority of reported rugby injury surveys are retrospective, have considered only specific injuries, or have reported only those seen at one location. Also, most studies have not distinguished minor injuries from major injuries. A pilot study conducted at one school in Cape Town during the 1982 rugby season, showed clear patterns of injury related to the age of players, their level of competition, playing position, the stage of the rugby season and the phase of play at the time of injury (Nathan et al. 198 3) . The studies as reported in this thesis were designed as a comprehensive follow-up study. The research methods and definition were similar but a much larger sample was studied and new areas not covered by the pilot study were introduced. During two 18-week seasons, in which approximately 4 700 players from 26 high schools played 6766 rugby matches, 905 players were prevented from participating in rugby for at least one week due to injury. The incidence and nature of injuries occurring to these players were followed in a prospective study and results were analysed for: (i) overall number and incidence of injured players; (ii) age-group and playing level; (iii) time of the season; (iv) phase of play; (v) playing position; (vi) type of injury; (vii) anatomical site; (viii) specific diagnoses; (ix) match vs practice injuries; (x) number of days off rugby; and (xi) medical treatment. The use of correspondence as a survey method resulted in 40 to 50% of injuries not being reported over the two-year period of the study. It appeared that the most accurate method of data collection was direct personal contact between the researcher and the injured player.

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Medicine Johannesburg, 2018. / The knee is indispensable in everyday life and injuries to it can be debilitating with significant loss of earnings incurred. Clinical diagnosis may not always be made with certainty and Magnetic Resonance Imaging (MRI) helps further elucidate intra-articular injuries. MRI reporting has its shortcomings and may provide spurious results according to the interpretor’s level of experience. This study aims to test the diagnostic reliability of MRI done in a teaching hospital for the evaluation of anterior cruciate ligament and meniscal injuries using arthroscopy as the baseline for comparison. Due to the long waiting times to have surgery we also determined if there was a change in the reliability of an MRI result as time elapsed. A retrospective review of records of patients who had knee arthroscopies at Chris Hani Baragwanath Academic Hospital (Johannesburg, South Africa) from May 2009 to May 2015 was done. Adults (16 − 60 years) with one major episode of trauma to the knee and had MRI done prior to surgery at the above institution were included. Arthroscopy was performed by 2 senior surgeons or by residents under their direct supervision. Arthroscopic findings of anterior cruciate ligament (ACL) and medial (MM) or lateral meniscal (LM) injuries were compared to MRI findings. Data was analysed by STATA version 13.1 to determine injury demographics, sensitivity, specificity and diagnostic accuracy of MRI. The effect of time interval from MRI to surgery on the diagnostic accuracy was determined. A total of 72 patients (74 knees) qualified for review. The median age was 35 years (IQR 26 − 43) with a significant difference between males and females (28 vs 41 years, p = 0.0019). Leading causes of injury were traffic accidents (32.4%), falls (27.0%) and sports injuries (17.6%). Median interval from MRI to surgery was 71.5 days (IQR 29 − 143). The sensitivity of MRI for ACL, MM and LM injuries was (63.6%, 58.8% and 52.6%), specificity (92.7%, 86.0% and 80.0%) and diagnostic accuracy (79.7%, 79.7% and 73.0%) respectively. The patients were divided into subgroups of early (< 6 weeks), intermediate (6 − 16 weeks) and late intervention (> 16 weeks) post-MRI. There were marked differences in the diagnostic accuracy in the three groups for the ACL (70.8% vs 92.6% vs 73.9%) and LM (62.5% vs 81.5% vs 73.9%). This was unremarkable for the MM (75.0% vs 81.5% vs 82.6%). MRI findings correlate well with arthroscopic findings making it a reliable preoperative screening tool for ACL and meniscal injuries. However its diagnostic accuracy appears to change with time. It is apparent that the diagnostic accuracy is higher between 6 − 16 weeks post MRI. A bigger cohort would help determine an ideal waiting time interval without significant depreciation in diagnostic accuracy. / LG2018

ABSTRACT Trauma in South Africa has been described as a “malignant epidemic” (Muckart DJ, 1991)5. Trauma is most acute in Sub-Saharan Africa, where deaths from trauma is higher than in any other region of the world where the risk of death from injury is greatest, especially for men aged 15-29 years (Murray CJL, in Bowley etal, 2002)5.The recognition of concurrent life threatening injuries is critical, given that patients with facial fractures seldom die in the absence of airway problems, massive bleeding, aspiration of blood into the lungs and massive head injury30. There are several reports in the literature regarding multisystem trauma and facial fractures. Head injuries are commonly associated with facial fractures, and facial fractures can be markers for brain injury16 .This study is aimed to identify the prevalence of head injuries associated with maxillofacial trauma in the Johannesburg General Hospital, Gauteng, South Africa. The data was collected from 1st January 2003 to 30th June 2003. A total of 196 patients with maxillofacial injuries were treated and 176 were included in the study. The data was analyzed using SASTM for WindowsTM. From the results it was found that of the 176 patients the majority were males comprising 88.07% of the study. Based on the GCS scores alone it was shown that 38.06% patients suffered head injuries. After reviewing patient records, it was found that of the whole sample only 31.25% of patients suffered true head injuries based on CT scan and neurosurgery findings. It was also shown that the most frequent mechanism of injury with headinjuries was gunshot wounds at 52.72% and the most common maxillofacial injury associated with head injury was panfacial fractures at 23.63%. In this study we also reviewed the outcome of the patients based on mortality rates. A total of 24 patients (13.63%) died from associated injuries. Of these patients 2 (1.13%) died from associated injuries due to polytrauma and 22 (12.5%) died due to severe head injury. We found that severe maxillofacial injuries involving the midfacial region such as panfacial fractures, zygomatic complex fractures and Le Fort fractures are frequently seen in patients with significant head injury. This should alert trauma unit personnel during assessment of patients to the fact that if a patient presents with significant midfacial trauma, one might expect that an underlying head injury is present. It is important to make note, that of the associated injuries present with maxillofacial trauma, involvement of the central nervous system including concussion, is the most frequent.

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Thesis (Ed.D.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / Abstract: Recovering from a sport injury can be physically and emotionally challenging for an adolescent athlete. Previous research indicates elevated levels of anxiety, stress, and depression following sport injuries. Providing effective social support following a sport injury has been found to influence an athletes' ability to cope with the experience of being injured and assist in rehabilitation adherence. The aim of the present investigation was to examine emotional disturbance following a sport injury in the adolescent population and determine the effects of social support provided by e-mentoring. The first phase of the research involved a descriptive data analysis to assess emotional disturbance of adolescent athletes ( n =9) sustaining an injury preventing sport participation for six weeks or greater. The Center of Epidemiological Studies on Depression (CES-D) and The Incredibly Short Profile of Mood States (IS-POMS) were administered and analyzed for elevated symptoms of emotional disturbance. The second phase of the research was an examination of social support provided by an e-mentor, a college age athlete with prior experience of a similar injury. Randomly selected participants ( n =4) were assigned an e-mentor for a six week rehabilitation phase of recovery. Three specific questions involving e-mentoring as social support were evaluated: (1) Do injured athletes demonstrate an increased positive awareness of injury rehabilitation and understanding of the injury with e-mentoring? Analysis of e-mentoring conversations indicated the adolescent injured athletes developed a greater awareness of their injury, the rehabilitation process, and the ability to share the physical experience. (2) Does e-mentoring influence emotional disturbance following a sport injury? Not all injured participants suffered emotional disturbance indicated through descriptive data analysis. However, examination of e-mentoring conversations indicated emotional support was provided from the e-mentor relationships. (3) Can the e-mentoring process provide a social support validating the injury and offer a positive experience? This investigation indicates e-mentoring provided physical, emotional and psychological support during a six week rehabilitation phase of an injury. Each injured athlete's interpretation and follow-up responses from the study suggest e-mentoring was a positive social support. Results from this research will raise awareness of emotional disturbance by an adolescent athlete following an injury and the manner in which social support can influence injury knowledge and rehabilitation adherence. The implications of e-mentoring suggest positive social support from an e-mentor can influence the physical, emotional and psychological well-being of an injured athlete affecting emotional recovery following a sport injury. / 2031-01-02

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