Arthrogryposis is a term used to describe the presence of multiple joint contractures that are present at birth. Reports that describe the experience of a rehabilitation program for adult patients with arthrogryposis are rare. We describe the treatment of an adult patient who had not received previous surgery or rehabilitation. At home, she walked on her knees and elsewhere used a wheelchair. She was submitted to surgery and Ilizarov external fixator to correct the deformities, followed by intensive rehabilitation to permit upright standing and walking with assistive devices. After 4 mos, the patient was able to walk average distances in different types of terrain with a reciprocating walker and Canadian crutches. This report aims to emphasize the good result of interdisciplinary care of a previously untreated adult patient with arthrogryposis.
O objetivo do estudo é descrever os fatores de risco para meningite bacteriana em recém-nascidos e analisar a prevalência destes fatores, considerando-se a presença ou não de baixo peso ao nascimento. Foram analisados 50 recém-nascidos com meningite bacteriana, excluindo-se aqueles com meningomielocele ou infecção congênita. Na análise estatística utilizou-se o teste exato de Fisher, considerando-se significantes os valores de p < 0,05. O estudo mostrou que a prematuridade, o baixo peso ao nascimento, e a presença de doenças infecciosas pré-existentes no recém-nascido ou na mãe estiveram fatores de risco importantes para meningite. Entre os recém-nascidos de baixo peso, os procedimentos invasivos, especialmente a intubação traqueal, o catéter venoso central e o uso prévio de antibióticos estiveram associados significativamente à ocorrência de meningite. Estes resultados indicam que a melhora na assistência pré-natal e no controle das infecções hospitalares constituem medidas de grande importância na diminuição da incidência de meningite bacteriana neonatal.
Objective: To provide a retrospective analysis of pediatric patients with Spinal Cord Injury (SCI), who were admitted for treatment and rehabilitation in a reference Brazilian medical center during the past 6 years. Methods: This retrospective analysis included 106 patients 16 years of age or younger who were admitted with SCI in our Rehabilitation Medical Center between April 2002 and June 2008. The patients admitted were analyzed according to their gender, age, origin region, cause and level of injury and clinical complications. Results/Conclusions: The frequency corresponded to 5.4% of the total of SCI cases studied. The 106 patients reviewed included 67 boys (63.2%) and the mean age of 8.6 years. In all, 50.9% of the SCI have traumatic etiology. The most frequent causes were gunshot 42.6%, traffic accident 38.9%, diving 9.3% and fall 3.7%. The nontraumatic etiologies corresponded to 49.1% of the total patients. Overall, tumor (36.5%) and infection (19.2%) were the most frequent cause of spinal injuries. The average time between SCI event and arrival at the rehabilitation medical center was 27 months. The majority of patients were paraplegic (76.4%). In the first assessment 64.2% patients showed clinical complications, such as orthopedic deformity (69.1%), pressure ulcers (35.3%), spasticity (8.8%), obesity (2.9%). Pediatric SCI is a rare but devastating condition affecting the patient, patient's family and society. An understanding of the etiology and the frequency of pediatric SCI can improve prevention and treatment.
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