Incidence and causes of lower-limb amputations in the city of Ribeirão Preto from 1985 to 2008: evaluation of the medical records from 3,274 cases

Barbosa, Bruna Maria Bueno; Monteiro, Rosane Aparecida; Sparano, Lucas Françolin; Bareiro, Rodolfo; Passos, Afonso Dinis Costa; Engel, Edgard Eduard

doi:10.1590/1980-5497201600020009

Cited by 10 publications

(9 citation statements)

References 7 publications

(8 reference statements)

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“…With increases in traffic accidents, malignant diseases and natural disasters, the number of lower-limb amputees (LLAs) is increasing ( Barbosa et al, 2016 ). LLAs have difficulties in motor control and coordination, especially in the early stages following amputation because of the major structural asymmetry arising from the amputation ( Molina Rueda et al, 2013 ).…”

Section: Introductionmentioning

confidence: 99%

Brain Functional Connectivity Plasticity Within and Beyond the Sensorimotor Network in Lower-Limb Amputees

Zhang

Wang

et al. 2018

Front. Hum. Neurosci.

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Cerebral neuroplasticity after amputation has been elucidated by functional neuroimaging. However, little is known concerning how brain network-level functional reorganization of the sensorimotor system evolves following lower-limb amputation. We studied 32 unilateral lower-limb amputees (LLAs) and 32 matched healthy controls (HCs) using resting-state functional magnetic resonance imaging (rs-fMRI). A regions of interest (ROI)-wise connectivity analysis was performed with ROIs in eight brain regions in the sensorimotor network to investigate intra-network changes, and seed-based whole-brain functional connectivity (FC) with a seed in the contralateral primary sensorimotor cortex (S1M1) was used to study the FC reorganization between the sensorimotor region (S1M1) and other parts of the brain in the LLAs. The ROI-wise connectivity analysis showed that the LLAs had decreased FC, mainly between the subcortical nuclei and the contralateral S1M1 (p < 0.05, FDR corrected). Seed-based whole-brain FC analysis revealed that brain regions with decreased FC with the contralateral S1M1 extended beyond the sensorimotor network to the prefrontal and visual cortices (p < 0.05, FDR corrected). Moreover, correlation analysis showed that decreased FC between the subcortical and the cortical regions in the sensorimotor network progressively increased in relation to the time since amputation. These findings indicated a cascade of cortical reorganization at a more extensive network level following lower-limb amputation, and also showed promise for the development of a possible neurobiological marker of changes in FC related to motor function recovery in LLAs.

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Section: Introductionmentioning

confidence: 99%

Brain Functional Connectivity Plasticity Within and Beyond the Sensorimotor Network in Lower-Limb Amputees

Zhang

Wang

et al. 2018

Front. Hum. Neurosci.

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“…Em 2013 inaugurou seu núcleo administrativo dos APH's e começou a utilizar um gerenciador eletrônico para auxiliar o controle dos dados das chamadas de socorro, esta organização justifica o notório desenvolvimento em recursos para atendimento de urgências e emergências desta região na América Latina (7) . Mesmo com esta estrutura, a demanda social desta região ainda é maior que a disponibilidade da assistência e evidenciam-se elevadas taxas de mortalidade e mobilidade relacionadas a ocorrências clínicas e traumáticas (7) (8) .…”

Section: Introductionunclassified

Justiça distributiva no mapeamento inicial dos atendimentos pré-hospitalares de um país em desenvolvimento

Montandon¹,

Oliveira²,

Pedroso³

et al. 2021

Arch. Health

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A cidade de Ribeirão Preto no interior do Estado de São Paulo no Brasil tem a mais de 20 anos atendimento pré-hospitalar de urgência pública e gratuita, mesmo assim os recursos disponíveis ainda são insuficientes para atender adequadamente a demanda da população. Por isso é necessário analisar se existe justiça distributiva, aos moldes aristotélicos, no geoprocessamento destes atendimentos, com a finalidade de avaliar o principio da equidade ao acesso neste serviço de saúde. Método: estudo transversal, incluindo 41.389 ocorrências de urgência pré-hospitalar de 2014, cujas variáveis permitiram a construção de um mapa para avaliar a distribuição espacial dos atendimentos no município. Resultado: Houve predomínio de atendimentos clínicos do tipo cardiológicos, maior número de atendimentos nos menores distritos urbanos e equivalência de socorro diante da variável sexo. A analise do mapeamento comprova aglomeração dos atendimentos nas regiões centrais. Conclusão: Os arranjos espaciais dos atendimentos estão aglomerados na região central da cidade, portanto não evidenciou-se justiça distributiva pelo ponto de vista aristotélico.

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“…With increases in traffic accidents, natural disasters, diabetes, and malignant tumors, the number of amputees is increasing 1 . Phantom limb pain (PLP) is one of the most common symptoms experienced by amputees, with an incidence of 29% to 80% 2,3 .…”

Section: Introductionmentioning

confidence: 99%

Altered Cortical Reorganization and Brain Functional Connectivity in Phantom Limb Pain: A Functional MRI Study

et al. 2020

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Objectives Functional neuroimaging studies have shown that amputees have altered cortical reorganization and functional connectivity (FC). This study aimed to investigate whether patients with phantom limb pain (PLP) and PLP‐free lower limb amputees exhibit changes in corresponding primary cortical motor area/somatosensory cortex (M1/S1) cortical reorganization and supplementary motor area (SMA) network FC. The association between functional magnetic resonance imaging (fMRI) changes and clinical parameters is also explored. Methods A total of 10 PLP patients were matched with 10 PLP‐free amputees and 10 healthy controls (HCs). Before undergoing fMRI, all participants completed questionnaires evaluating pain, anxiety, depression, and health‐related quality of life. Task‐related activation and regions of interest (ROI)‐wise connectivity analysis were applied to differentiate the brain regions of amputees from those of HCs. Linear correlation analysis was used to evaluate the correlation between altered FC and clinical manifestations. Results As compared with HCs, PLP patients showed increased cortical activation in M1/S1 when moving the intact foot, imagining phantom big toe movement, or having the corresponding thumb stimulated. The increased FC in the SMA network included the SMA‐caudate nucleus, SMA‐bilateral insula, and SMA‐anterior cingulate cortex. Furthermore, results of the linear correlation analysis demonstrated that this increased FC was positively correlated with VAS scores, negatively correlated with Medical Outcomes Study 36‐item Short‐Form (SF‐36) scores, and not correlated with anxiety or depression scores. Conclusions Phantom limb pain in lower limb amputees is associated with M1/S1 cortical reorganization and altered SMA network FC in different areas of the brain, which could help to support our understanding of the central mechanism of PLP.

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Incidence and causes of lower-limb amputations in the city of Ribeirão Preto from 1985 to 2008: evaluation of the medical records from 3,274 cases

Cited by 10 publications

References 7 publications

Brain Functional Connectivity Plasticity Within and Beyond the Sensorimotor Network in Lower-Limb Amputees

Brain Functional Connectivity Plasticity Within and Beyond the Sensorimotor Network in Lower-Limb Amputees

Justiça distributiva no mapeamento inicial dos atendimentos pré-hospitalares de um país em desenvolvimento

Altered Cortical Reorganization and Brain Functional Connectivity in Phantom Limb Pain: A Functional MRI Study

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