Página 1 dos resultados de 18309 itens digitais encontrados em 0.008 segundos

Abdominal compression: A new intraoperative maneuver to detect chyle fistulas during left neck dissections that include level IV

Cernea, Claudio R.; Hojaij, Flavio C.; De Carlucci, Dorival, Jr.; Tavares, Marcos R.; Araujo-Filho, Vergilius J.; Britto e Silva-Filho, Gilberto; Brandao, Lenine G.
Fonte: WILEY-BLACKWELL; HOBOKEN Publicador: WILEY-BLACKWELL; HOBOKEN
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
36.72787%
Background Chyle fistulas may occur after left neck dissections that include level IV, due to injury of the thoracic duct or of 1 of its major branches. Despite being unusual, this complication carries substantial postoperative morbidity and even mortality. So far, no effective intraoperative maneuver has been reported to detect this fistula at the end of a neck dissection. In this cohort study, we sought to describe a simple new maneuver, intraoperative abdominal compression, which can effectively help to identify an open major lymphatic duct on level IV at the end of a neck dissection. Patients and Methods From March 1989 to September 2010, 206 patients underwent neck dissections involving left level IV, and underwent intraoperative abdominal compression. There were 119 men and 87 women, with ages ranging from 18 to 81 years (median, 52 years). One hundred forty-four patients had squamous cell carcinomas, 54 had thyroid carcinomas, 5 had malignant melanomas, and 3 had salivary cancers. Distribution by type of left neck dissection was: selective including levels II, III, and IV (73 cases; 35.4%), selective including levels II, III, IV, and V (55 cases; 26.6%), selective including levels I, II, III, and IV (12 cases; 5.8%), modified radical (47 cases; 22.8%)...

A clinical experience of the supraclavicular flap used to reconstruct head and neck defects in late-stage cancer patients

Alves, Helio R. N.; Ishida, Luis C.; Ishida, Luís Henrique; Besteiro, Julio Morais; Gemperli, Rolf; Faria, Jose C. M.; Ferreira, Marcus Castro
Fonte: ELSEVIER SCI LTD; OXFORD Publicador: ELSEVIER SCI LTD; OXFORD
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
36.690913%
The supraclavicular island flap has been widely used in head and neck reconstruction, providing an alternative to the traditional techniques like regional or free flaps, mainly because of its thin skin island tissue and reliable vascularity. Head and neck patients who require large reconstructions usually present poor clinical and healing conditions. An early experience using this flap for late-stage head and neck tumour treatment is reported. Forty-seven supraclavicular artery flaps were used to treat head and neck oncologic defects after cutaneous, intraoral and pharyngeal tumour resections. Dissection time, complications, donor and reconstructed area outcomes were assessed. The mean time for harvesting the flaps was 50 min by the senior author. All donor sites were closed primarily. Three cases of laryngopharyngectomy reconstruction developed a small controlled (salivary) leak that was resolved with conservative measures. Small or no strictures were detected on radiologic swallowing examinations and all patients regained normal swallowing function. Five patients developed donor site dehiscence. These wounds were treated with regular dressing until healing was complete. There were four distal flap necroses in this series. These necroses were debrided and closed primarily. The supraclavicular flap is pliable for head and neck oncologic reconstruction in late-stage patients. High-risk patients and modified radical neck dissection are not contraindications for its use. The absence of the need to isolate the pedicle offers quick and reliable harvesting. The arc of rotation on the base of the neck provides adequate length for pharyngeal...

Preservação da veia jugular interna em pacientes portadores de carcinoma epidermóide de cabeça e pescoço submetidos a esvaziamento cervical radical; Preservation of the internal jugular vein in patients with epidermoid carcinoma of the head and neck submitted to radical neck dissection

Martins, Everton Pontes
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 30/11/2007 PT
Relevância na Pesquisa
36.75442%
A preservação da veia jugular interna, como modificação do esvaziamento cervical radical, envolve controvérsia no planejamento terapêutico das metástases regionais de pacientes com carcinomas epidermóides de vias aerodigestivas superiores. O objetivo deste estudo foi avaliar a influência da preservação da veia jugular interna na eficácia do tratamento das metástases regionais de casos selecionados de carcinomas epidermóides de cabeça e pescoço, submetidos a esvaziamento cervical radical. Para tanto, analisamos, retrospectivamente, 311 pacientes portadores de carcinomas epidermóides de boca, orofaringe, laringe ou hipofaringe, submetidos a tratamento baseado em cirurgia, que envolveu esvaziamento cervical radical com ou sem preservação da veia jugular interna em pelo menos um dos lados do pescoço, todos com metástases cervicais comprovadas por exame anatomopatológico. Dos 311 esvaziamentos cervicais radicais ipsilaterais ao tumor primário, houve preservação da veia jugular interna em 109 (35%). Recidiva regional ipsilateral ao tumor primário foi detectada em 18 pacientes (5,8%), sendo em 14 (4,5%) inicialmente submetidos a esvaziamento cervical radical sem preservação da veia jugular interna e em 4 (1,3%) tratados com esvaziamento cervical radical com preservação da veia jugular interna. A recidiva regional ipsilateral ao tumor primário não teve relação significativa com a preservação da veia jugular interna (p=0...

Avaliação da funcionalidade do ombro, dor e qualidade de vida em pacientes submetidos a esvaziamento cervical e a resposta ao protocolo de reabilitação fisioterápica; Evaluation of the shoulder function, pain and quality of life in patients undergone neck dissection and results of a physiotherapic rehabilitation protocol

Mozzini, Carolina Barreto
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 31/07/2009 PT
Relevância na Pesquisa
36.75442%
O esvaziamento cervical faz parte do tratamento oncológico de pacientes portadores de neoplasias da cabeça e pescoço, onde o ombro está sob risco de alterações relacionadas ao procedimento. A morbidade pós-operatória está diretamente relacionada com a extensão cirúrgica, na qual podem estar associados deslocamentos de retalhos e ressecções de tecidos e estruturas neuromusculares. Sendo assim, a doença nesta região apresenta potencial suficiente para afetar a função e a qualidade de vida relacionada ao ombro dos pacientes. Altos índices de complicações funcionais são encontrados após o esvaziamento cervical, os quais variam de 18 a 77% nas cirurgias com a preservação do nervo acessório. As seqüelas mais comumente encontradas são a dor, disfunção na amplitude de movimento e força muscular do ombro, déficit funcional e piora da qualidade de vida. Este estudo teve por objetivo avaliar a função do ombro, a dor e a qualidade de vida em pacientes portadores de câncer de cabeça e pescoço submetidos a esvaziamento cervical, bem como avaliar os resultados do protocolo de reabilitação fisioterápica proposto. Foram avaliados prospectivamente 88 pacientes (120 ombros) no pré-operatório, 1º mês e no 3º mês após o procedimento...

Edema na face e pescoço após esvaziamento cervical com ou sem ressecção da veia jugular interna; Facial and neck edema after neck dissection with or without internal jugular vein resection

Mozzini, Carolina Barreto
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 14/10/2011 PT
Relevância na Pesquisa
36.802522%
INTRODUÇÃO: Durante o esvaziamento cervical, além do tecido linfático, algumas estruturas não-linfáticas do pescoço estão sob risco de lesões ou são ressecadas, dentre as quais se encontra a veia jugular interna. Esta é diretamente relacionada com a drenagem venosa e linfática da face e do pescoço e, sua ressecção, pode ocasionar congestão venosa, edema de face e laríngeo, distúrbios visuais e edema cerebral. Há várias técnicas para avaliar o edema, todavia, não há relatos de uma técnica objetiva que possa ser utilizada na região da cervicofacial. Esse estudo teve por objetivo mensurar o edema em pontos específicos localizados na face e no pescoço em indivíduos submetidos a esvaziamento cervical com ou sem ressecção da veia jugular interna. MÉTODOS: Esse estudo utiliza um método objetivo de mensuração do edema na face e no pescoço de indivíduos no pré e no pós-operatório de esvaziamento cervical unilateral ou bilateral com ou sem ressecção da veia jugular interna, por doença maligna na região da cabeça e pescoço e sem tratamento prévio no pescoço, através do medidor da constante dielétrica da pele e da gordura subcutânea em quatro momentos: pré-operatório, 3º, 10º e 30º dia de pós-operatório...

Dor cervical crônica  e postura em trabalhadores de escritório usuários de computador; Chronic neck pain and posture in computer office workers

Bragatto, Marcela Mendes
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 12/02/2015 PT
Relevância na Pesquisa
36.849126%
Introdução: A prevalência de disfunção musculoesquelética entre trabalhadores usuários de computador (TUC) pode variar entre 10 a 62% e os lugares mais acometidos são os membros superiores, pescoço, cabeça e a coluna vertebral. As queixas musculoesqueléticas nesses trabalhadores apresentam etiologia multifatorial e dentre as principais causas é possível citar aspectos posturais e fatores psicossociais. O Maastricht Upper Extremity Questionnaire (MUEQ-Br) é uma das poucas ferramentas existentes na literatura para avaliar aspectos ergonômicos e psicossociais relacionados ao trabalho com uso do computador. A dor cervical é a queixa musculoesquelética mais comum em trabalhadores de escritório usuários de computador. A coexistência entre dor cervical e disfunção temporomandibular (DTM) é comumente citada na literatura. A adoção da postura em anteriorização da cabeça para uso do computador pode estar associada ao aparecimento de sintomas orofaciais e cervicais. A posição sentada é a mais adotada nos ambientes de trabalho especialmente quando este envolve o uso de computador, entretanto, a manutenção dessa posição por tempo prolongado pode acarretar a adoção de posturas inadequadas e intensificar a sobrecarga nas estruturas do sistema musculoesquelético. Desta forma...

Relação de flexão-relaxamento dos músculos cervicais e dor cervical crônica em trabalhadores de escritório usuários de computador; Flexion-relaxation ratio in neck muscles and chronic neck pain in office workers computer users

Pinheiro, Carina Ferreira
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 17/04/2015 PT
Relevância na Pesquisa
36.802522%
A dor cervical é um problema musculoesquelético comum, cuja ocorrência é estimada em torno de 30-50% da população adulta em geral e também muito frequente entre os trabalhadores usuários de computador. A alteração no padrão de atividade muscular dos músculos flexores e extensores é uma das características da dor cervical, que nos usuários de computador parece estar associada à manutenção da postura sentada com anteriorização da cabeça ou flexão cervical. Dois fatores de análise importantes para avaliar déficits na atividade muscular são o fenômeno flexão-relaxamento (FFR) e a relação flexão-relaxamento (RFR). O objetivo principal deste estudo foi avaliar, através da eletromiografia de superfície, a ocorrência do FFR e mensurar a RFR nos músculos extensores da coluna cervical de trabalhadores usuários de computador com e sem dor cervical crônica e de indivíduos saudáveis, não usuários de computador. Foram avaliados 60 indivíduos, 20 usuários de computador com dor cervical crônica (GD), 20 usuários de computador sem dor cervical (GS) e 20 indivíduos saudáveis, não usuários de computador (GC). Os indivíduos responderam o Maastricht Upper Extremity Questionnaire (MUEQ-Br) e o Índice de Incapacidade Relacionada à dor no Pescoço (IIRP)...

Análise histopatológica convencional versus cortes seriados em esvaziamentos cervicais de pacientes com Carcinoma Espinocelular (CEC) de cavidade oral e orofaringe cN0 : mudança de status cervical e correlação com sobrevida = Increasing neck staging with step-serial sectioning of neck dissection specimens for oral end oropharyngeal SCC patients; Increasing neck staging with step-serial sectioning of neck dissection specimens for oral end oropharyngeal SCC patients

Fernando Canola Alliegro
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 21/01/2015 PT
Relevância na Pesquisa
36.74215%
Objetivo. Avaliar a mudança no estadiamento cervical de pacientes com carcinoma espino celular (CEC) de cavidade oral e orofaringe, após alteração na padronização da análise anátomo-patológica dos linfonodos de espécimes cirúrgicos de esvaziamentos cervicais, clinicamente livres de metástases (cN0), com cortes seriados de todos os linfonodos. Materiais e Métodos. Estudo retrospectivo com 21 pacientes previamente classificados como cN0 submetidos a cirurgia para exérese do tumor primário e esvaziamento cervical eletivo. Realizou-se inicialmente a revisão das laminas originais e, posteriormente, cortes seriados com 5 µm de espessura e nova análise das lâminas. Para avaliar o impacto da mudança na sobrevida foi realizada análise de Kaplan-Meier (IC 95%). Resultados. Após a avaliação convencional, 14 pacientes foram classificados como pN0, isto é, patologicamente livres de metástases cervicais, e sete (33%) como pN+, ou seja, patologicamente acometidos. A análise com cortes seriados detectou outros três pacientes com acometimento linfonodal, previamente classificados como pN0 e 1 previamente estadiado como N1 mudou para N2b com 10 pacintes pN+ (48%). Houve aumento de 43% (3/7) no número de pacientes com acometimento linfonodal e 19% de aumento no estadiamento linfonodal após a nova padronização anátomo-patológica...

Mid-Term Results of EVAR in Severe Proximal Aneurysm Neck Angulation.

Oliveira, NFG; Bastos Gonçalves, F; Vries, J; Ultee, K; Hoeks, S; Moll, F; Herwaarden, J; Verhagen, H
Fonte: Elsevier Publicador: Elsevier
Tipo: Artigo de Revista Científica
Publicado em //2015 ENG
Relevância na Pesquisa
36.774414%
OBJECTIVE: To determine if mid-term outcome following endovascular aneurysm repair (EVAR) with the Endurant Stent Graft (Medtronic, Santa Rosa, CA, USA) is influenced by severe proximal neck angulation. METHODS: A retrospective case-control study was performed using data from a prospective multicenter database. All measurements were obtained using dedicated reconstruction software and center-lumen line reconstruction. Patients with neck length >15 mm, infrarenal angle (β) >75°, and/or suprarenal angle (α) >60°, or neck length >10 mm with β >60°, and/or α >45° were compared with a matched control group. Primary endpoint was primary clinical success. Secondary endpoints were freedom from rupture, type 1A endoleak, stent fractures, freedom from neck-related reinterventions, and aneurysm-related adverse events. Morphological neck variation over time was also assessed. RESULTS: Forty-five patients were included in the study group and were compared with a matched control group with 65 patients. Median follow-up time was 49.5 months (range 30.5-58.4). The 4-year primary clinical success estimates were 83% and 80% for the angulated and nonangulated groups (p = .42). Proximal neck angulation did not affect primary clinical success in a multivariate model (hazard ratio 1.56...

Mid-Term Results of EVAR in Severe Proximal Aneurysm Neck Angulation.

Oliveira, NFG; Bastos Gonçalves, F; Vries, J; Ultee, K; Hoeks, S; Moll, F; Herwaarden, J; Verhagen, H
Fonte: Elsevier Publicador: Elsevier
Tipo: Artigo de Revista Científica
Publicado em //2015 ENG
Relevância na Pesquisa
36.774414%
OBJECTIVE: To determine if mid-term outcome following endovascular aneurysm repair (EVAR) with the Endurant Stent Graft (Medtronic, Santa Rosa, CA, USA) is influenced by severe proximal neck angulation. METHODS: A retrospective case-control study was performed using data from a prospective multicenter database. All measurements were obtained using dedicated reconstruction software and center-lumen line reconstruction. Patients with neck length >15 mm, infrarenal angle (β) >75°, and/or suprarenal angle (α) >60°, or neck length >10 mm with β >60°, and/or α >45° were compared with a matched control group. Primary endpoint was primary clinical success. Secondary endpoints were freedom from rupture, type 1A endoleak, stent fractures, freedom from neck-related reinterventions, and aneurysm-related adverse events. Morphological neck variation over time was also assessed. RESULTS: Forty-five patients were included in the study group and were compared with a matched control group with 65 patients. Median follow-up time was 49.5 months (range 30.5-58.4). The 4-year primary clinical success estimates were 83% and 80% for the angulated and nonangulated groups (p = .42). Proximal neck angulation did not affect primary clinical success in a multivariate model (hazard ratio 1.56...

Clinical versus computed tomography evaluation in the diagnosis and management of deep neck infection

Crespo,Agricio Nubiato; Chone,Carlos Takahiro; Fonseca,Adriano Santana; Montenegro,Maria Carolina; Pereira,Rodrigo; Milani,João Altemani
Fonte: Associação Paulista de Medicina - APM Publicador: Associação Paulista de Medicina - APM
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2004 EN
Relevância na Pesquisa
36.765073%
CONTEXT: Deep neck infections have high potential for severe complications and even death, if not properly managed. The difference between clinical and computed tomography findings may demonstrate that clinical evaluation alone underestimates disease extent, which may lead to conservative treatment with worse prognosis. OBJECTIVE: To compare clinical and computed tomography findings from neck spaces affected by deep neck infections and to determine the main clinical and radiological features associated with these. TYPE OF STUDY: Non-randomized retrospective study. SETTING: Department of Otolaryngology and Head and Neck, Universidade Estadual de Campinas. METHODS: Medical charts of 65 patients with deep neck infections were evaluated. Age, gender, clinical complaints, physical findings, computed tomography scan and x-ray imaging, microbiology, treatment and outcome were analyzed. All clinical signs and symptoms were evaluated and stratified in order of frequency. The frequency of neck space involvement in such infections was also assessed from the clinical and tomographic evaluation. All clinical and computed tomography findings were compared with surgical observation. RESULTS: The most frequent clinical findings were neck swelling...

Positive surgical margins at radical prostatectomy: importance of intra-operative bladder neck frozen sections

Nakamura,Kogenta; Kasraeian,Ali; Anai,Satoshi; Pendleton,John; Rosser,Charles J.
Fonte: Sociedade Brasileira de Urologia Publicador: Sociedade Brasileira de Urologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2007 EN
Relevância na Pesquisa
36.74215%
OBJECTIVE: To determine if intraoperative frozen sections of the bladder neck during radical prostatectomy (RP) could decrease the incidence of final positive surgical margins at the bladder neck. MATERIALS AND METHODS: This prospective cohort study included 51 consecutive men who underwent anatomic RP at University of Florida & Shands Jacksonville. All patients had intraoperative frozen section of bladder neck sent for analysis. Preoperative, operative, and postoperative data were collected and analyzed. Main Outcome Measures: Outcome measures were intraoperative bladder neck margin status, final pathologic bladder neck margin status, and postoperative urinary complications. Median follow-up for the 51 patients was 22 months. RESULTS: The final positive surgical margin rate was 20% (10 patients). An additional three patients had positive surgical margins at the bladder neck intraoperatively. These patients then had a wider resection of the affected bladder neck until the frozen sections were negative for cancer or prostatic tissue. Final pathologic evaluation of bladder neck margin was negative for tumor or persistent prostatic tissue in all 51 men. CONCLUSION: With intra-operative frozen sections, we were able to obtain a negligible positive bladder neck margin rate. Surgeons who are still on the learning curve for RP should consider intra-operative frozen section of the bladder neck.

Current State of Neck Dissection in the United States

Seethala, Raja R.
Fonte: Humana Press Inc Publicador: Humana Press Inc
Tipo: Artigo de Revista Científica
Publicado em 07/08/2009 EN
Relevância na Pesquisa
36.74215%
The status of the cervical lymph nodes is the most important prognosticator in head and neck squamous cell carcinoma. The neck dissection is both a therapeutic and staging procedure and has evolved to include various types with standardized level designations (I–VI) for lymph node groups: the radical neck dissection, modified radical neck dissection, the selective neck dissection, and the extended neck dissection. The gross and histologic examination of a neck dissection should provide the critical information (size of metastasis, number of lymph nodes involved) for staging purposes. Additionally, extracapsular spread of lymph node metastasis must be reported because of its significance as an adverse prognosticator. Current dilemmas in nodal disease are the detection of micrometastases, isolated tumor cells, and molecular positivity. The significance of these categories of disease is still unclear, though they may explain a subset of the estimated 10% of the regional recurrences in the neck despite pathologic node negativity by traditional methods of evaluation. Sentinel lymph node biopsy has been recently applied to head and neck squamous cell carcinoma to enhance the management of the clinicoradiographically node negative patients. While still investigational...

Predictive factors for postoperative wound complications after neck dissection

PELLINI, R.; MERCANTE, G.; MARCHESE, C.; TERENZI, V.; SPERDUTI, I.; MANCIOCCO, V.; RUSCITO, P.; CRISTALLI, G.; MARCHESI, P.; PICHI, B.; SPRIANO, G.
Fonte: Pacini Editore SpA Publicador: Pacini Editore SpA
Tipo: Artigo de Revista Científica
Publicado em /02/2013 EN
Relevância na Pesquisa
36.72787%
The objective of this retrospective study was to evaluate risk factors for wound complications after neck dissection. One hundred and nineteen patients were treated with neck dissection for squamous-cell carcinoma of the upper aerodigestive tract at the National Cancer Institute in Rome between 2006 and 2009. Postoperative wound complications were divided into major or minor and were related to different variables to identify risk factors. Postoperative wound complications were found in 20.2% of patients with an individual patient probability for different risk factors ranging from 2% to 34.1%. Preoperative chemoradiation therapy (CRT) and the type of neck dissection were associated with a higher risk of major complications (p ≤ 0.05). Previous CRT and radical neck dissection/modified radical neck dissection are risk factors for major wound complications in patients with head and neck squamous cell carcinoma undergoing neck dissection. Patients requiring neck dissection after CRT should be informed about the increased risk of the procedure, and selective neck dissection, if oncologically appropriate, should be considered to reduce complications.

Gossypiboma of the Neck Mimicking an Isolated Neck Recurrence

Kim, Kyu Jin; Lim, Jae-Yol; Choi, Jeong-Seok; Kim, Young-Mo
Fonte: Korean Society of Otorhinolaryngology-Head and Neck Surgery Publicador: Korean Society of Otorhinolaryngology-Head and Neck Surgery
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
36.71104%
A gossypiboma (also called textiloma or retained surgical sponge) of the neck is rarely reported compared to intraabdominal or intrathoracic gossypibomas and also can be misdiagnosed as metastatic lymph nodes. A patient was referred to our clinic for a supraclavicular neck mass 6 months after thyroidectomy and neck dissection for papillary thyroid carcinoma in another hospital. It was initially considered an isolated neck recurrence, but it was finally diagnosed as gossypiboma by a pathological examination of the surgically-excised specimen. Characteristic findings of computed tomography or positron emission tomography/computed tomography might be helpful to differentiate the gossypiboma from malignant neck mass or other inflammatory conditions. It is essential for clinicians to be aware of this disease entity in differential diagnosis of neck recurrence because a gossypiboma in the neck can be misinterpreted as a malignancy to induce unwarranted radical surgery.

Analysis of selected risk factors for nodal metastases in head and neck cutaneous squamous cell carcinoma

Szewczyk, Mateusz; Pazdrowski, Jakub; Golusiński, Paweł; Dańczak-Pazdrowska, Aleksandra; Marszałek, Sławomir; Golusiński, Wojciech
Fonte: Springer Berlin Heidelberg Publicador: Springer Berlin Heidelberg
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
36.765073%
Cutaneous squamous cell carcinoma (cSCC) accounts for 20 % of all skin malignancies and 20 % of deaths. In contrast to mucosal SCC, treatment results are very good. However, regional metastases are present in 5–20 % of cases, and the prognosis for patients with metastases is 50 % lower. It has been reported that several risk factors are responsible for the head and neck lymph node regional metastasis, such as: poor cell differentiation, local recurrence, immunosuppression, and tumour dimension. Multivariate analysis of metastatic neck lesions in head and neck cSCC. Retrospective analysis of patients treated at our department for head and neck cSCC. The study includes 100 patients: 66 males (66 %) and 34 females (34 %), aged 26–98 years (mean age 74.6). The tumour was evaluated for: sex predilection, local recurrence, stage (according to 7th edition of American Joint Committee on Cancer TNM staging), differentiation, and site. Most patients (79 cases; 79 %) were treated for primary cSCC, while the other 21 patients presented local recurrence of cSCC. Neck metastases were diagnosed in five patients with primary cSCC and in three with recurrent cSCC. No distant metastasis was observed. The most common tumour location was the auricle (29 cases; 29 %). Neck dissection was performed most frequently in patients with lip tumours (17/22 cases; 77 %). Neck metastasis was diagnosed most often in patients with cSCC on the lip (2 patients) and buccal region (2 patients). The most common tumour location in males was the auricle (25/66 cases; 38 %) whereas in females the nasal and buccal regions were the most common locations...

Indices affecting outcome of neglected femoral neck fractures after valgus intertrochanteric osteotomy

Varghese, V.; Ramasamy, B.; Titus, V.; Oommen, A.; Jepegnanam, T.
Fonte: Lippincott Williams & Wilkins Publicador: Lippincott Williams & Wilkins
Tipo: Artigo de Revista Científica
Publicado em //2014 EN
Relevância na Pesquisa
36.71104%
Objectives: To evaluate preoperative neck resorption and postoperative valgus orientation as predictors of union and functional outcome after valgus intertrochanteric osteotomy for treatment of neglected femoral neck fractures and nonunions. Design: Retrospective cohort study. Setting: Tertiary care center. Patients/Participants: Forty consecutive patients with neglected femoral neck fracture and nonunions were treated with valgus intertrochanteric osteotomy, and follow-up was available in 32 patients (average age, 43 years; range, 14–60 years; average nonunion duration, 6 6 7 months; range, 1–36 months). Intervention: Valgus intertrochanteric osteotomy. Main Outcome Measurements: Clinical outcome was assessed with Harris hip score. Plain radiographs were evaluated for union, avascular necrosis, preoperative bone deficiency (neck resorption ratio), and postoperative femoral head fragment alignment (head-shaft angle). Results: Follow-up at 5 6 3 years (range, 2–12 years) after surgery showed union in 29 patients (91%), and Harris hip score was 82 6 13 points (range, 63–100 points). The 3 patients with persistent nonunion at the neck of femur had neck resorption ratio ,0.52. Increased postoperative head-shaft angle was associated with lower follow-up Harris hip score; postoperative valgus alignment .15 degrees compared with the contralateral side was associated with poor functional outcome. The presence of avascular necrosis did not affect the outcome. Conclusions: Valgus intertrochanteric osteotomy resulted in union and satisfactory functional outcome in most patients who had neglected femoral neck fractures and nonunions. Preoperative neck resorption ratio ...

Neck strain in car occupants: the influence of crash-related factors on initial severity

Ryan, G.; Taylor, G.; Moore, V.; Dolinis, J.
Fonte: AUSTRALASIAN MED PUBL CO LTD Publicador: AUSTRALASIAN MED PUBL CO LTD
Tipo: Artigo de Revista Científica
Publicado em //1993 EN
Relevância na Pesquisa
36.71104%
OBJECTIVE: To examine the relationship between the initial severity of neck strain in car occupants and crash-related factors, in particular, crash severity. DESIGN/PARTICIPANTS: Thirty-two individuals with neck strain after a car crash, drawn from physiotherapy and general practices in metropolitan Adelaide, were interviewed about their experience and examined by a manipulative physiotherapist. Crash severity was assessed by measurement of damage to the involved vehicles. MAIN OUTCOME MEASURES: Five measures of neck strain severity were obtained: number of body regions with symptoms, number of positive responses to palpation, cervical range of motion, subject's own rating on an analogue pain scale, and examiner's severity rating. Two measures of crash severity were used: maximum residual deformation, and velocity change of the subject's vehicle. RESULTS: Neck strain was observed in individuals who were involved in crashes of low severity. Maximum residual deformation of the vehicle was negatively associated with the subject's cervical range of motion and positively associated with the other measures of neck strain severity. For rear impacts, both measures of crash severity were associated with measures of neck strain severity. The group of subjects who were aware of the impending collision had a greater range of cervical spine movement and fewer positive responses to palpation than those who were unaware. CONCLUSIONS: Initial severity of neck strain is positively correlated with crash severity. Awareness of the impending collision may have a mitigating effect on injury severity.; G.A. Ryan...

Correlação entre postura da cabeça, intensidade da dor e índice de incapacidade cervical em mulheres com queixa de dor cervical; Correlation between head posture, pain and disability index neck in women with complaints of neck pain

Soares, Juliana Corrêa; Weber, Priscila; Trevisan, Maria Elaine; Trevisan, Claudia Morais; Rossi, Angela Garcia
Fonte: Universidade de São Paulo. Faculdade de Medicina Publicador: Universidade de São Paulo. Faculdade de Medicina
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; Formato: application/pdf
Publicado em 01/03/2012 POR
Relevância na Pesquisa
36.74215%
Neck pain is the most common symptom of cervical dysfunctions often being related to the maintenance of postures. Postural changes of the head are often associated with the occurrence of neck pain with an anterior approach was the most frequent. The purpose was to investigate the correlation between head posture, pain intensity and neck disability index. The study group (SG) was composed of women, aged between 20 and 50 years who complained of neck pain for more than three months, and the control group (CG) for asymptomatic women. Pain intensity was assessed by visual analogue scale (VAS), disability by neck disability index (NDI) and the head posture by the craniovertebral angle (CV). Normality of the data was verified by the Lilliefors test and the comparison between groups by the Student's t-test for independent samples, and the association between variables by Spearman correlation test. Significance level was 5%. The SG had lower average CV for the angle (p=0.02). The CV angle was negatively correlated with the VAS (r=-0.48) and NDI (r=-0.15) suggesting that the smaller the angle, the greater the intensity of neck pain and disability. The NDI and VAS showed a positive correlation (r=0.59). The angle CV in subjects with neck pain was significantly lower than in healthy individuals association with the neck disability index and pain.; A dor cervical é o sintoma mais comum das disfunções cervicais...

Influence of pain on postural control in women with neck pain; Influência da dor no controle postural de mulheres com dor cervical

Soares, Juliana; Universidade Federal de Santa Maria. Programa de Pós-graduação (Mestrado) em Distúrbios da Comunicação Humana. Santa Maria, RS. Brasil.; Weber, Priscila; Universidade Federal de Santa Maria. Programa de Pós-graduação (Mestrado) e
Fonte: Universidade Federal de Santa Catarina. Florianópolis, SC. Brasil Publicador: Universidade Federal de Santa Catarina. Florianópolis, SC. Brasil
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; "Avaliado por Pares",; Descriptive; Avaliado por Pares; Descritivo Formato: application/pdf
Publicado em 30/03/2013 ENG
Relevância na Pesquisa
36.71104%
DOI: http://dx.doi.org/10.5007/1980-0037.2013v15n3p371The objective of this study was to investigate the influence of pain on postural control in women with neck pain and the relationship with possible changes in sensory systems and posture. The neck pain group was composed of women, aged between 20 and 50years, complaining of neck pain for more than three months; the control group was composed of women without complaints of neck pain. For the characterization of the groups, we used anamnesis, neck disability index and Visual Analogue Scale. Postural balance was assessed on force platform. Postural balance with manipulation of the sensory systems was measured by Foam Laser Dynamic Posturography, exposing the individual to six sensory organization tests. Posture was assessed by the Postural Assessment Software. The normality of the variables were verified using Shapiro-Wilk test, Student’s t-test and Mann-Whitney test for comparison between groups, with a significance level of5%. Groups were homogeneous in demographic variables. We observed higher amplitude and displacement velocity of the center of pressure in the neck pain group, showing greater postural balance. There were significant diferences incraniovertebral angle, showing forward head posture in symptomatic women. In dynamics posturography...