Introduction Obstructive sleep apnea (OSA) is a prevalent and underdiagnosed clinical condition, characterized by the presence of repetitive airway collapse during sleep, resulting in oxyhemoglobin desaturation and sleep fragmentation. Among the most frequent reports of patients with OSA, is morning headache or chronic daily headache, which in 2004 received its own classification in the International Classification of Headache Disorders (ICHD-2) as sleep apnea headache. Objective The present review aims to evaluate the available scientific literature on the association between OSA and headache after classification, totaling a period of 18 years. Results In 8 included studies, 1,637 patients were analyzed, observing a bilateral and frequent association between the two pathologies. Conclusion However, there is still no consensus on the mechanism behind this relationship, and the results of studies are divergent.
Chest tube insertion is one of the most performed surgical procedures in medical practice, being performed in Brazil by both general practitioners and experienced surgeons. This study aimed to report an experience with the application of an animal model to simulate chest drainage, as well as review the scientific literature available on the subject. In our experience, pork rib pieces were used to simulate the human rib cage, where medical students trained the procedure with the help of a thoracic surgeon. The porcine model used proved to be satisfactory, allowing the study of anatomical correlations and surgical technique among the students. In our review, we found 5 other experiences reported, 3 in a synthetic anatomical model, 1 in a porcine model and 1 comparative study between a synthetic model and a cadaver model. All models proved to be efficient for training students, but they present differences in terms of cost and durability, with the synthetic model being the most cost-effective alternative.
This article proposes to carry out an integrative literature review on the different types of chest wall fixation after traumatic fracture and on the indications for such a procedure. There is still no clear consensus on when fixation should be performed or not, since the conservative approach is still widely used and has its advantages and disadvantages, as does the surgical procedure. This study was based on a bibliographic search on the PubMed platform from January to February 2022, using the strategy: (Rib cage) AND (Osteosynthesis) OR (Fracture Fixation, Internal) NOT (Spine) NOT (Cardiovascular Surgical Procedures), resulting in 22 articles, of which 7 were chosen. Most of the selected articles were of a retrospective nature, and also, all of them referred to an approach with early surgical intervention. Early fixation showed pain relief, shorter hospitalization and intubation time, reduced physical limitations, and better range of thoracic motion. Although no consensus was found on all indications, the literature analyzed points to the superiority of surgical fixation of the costal arches in the prevention and reduction of secondary outcomes, such as chest pain and length of hospital stay and mechanical ventilation in patients with respiratory complications is evident,corroborating the indication of this procedure for this group.
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