Comparação dos aspectos funcionais da deglutição e indicadores clínicos em pacientes com traumatismo cranioencefálico em UTI

Ferrucci, Juliana Lopes; Sassi, Fernanda Chiarion; Medeiros, Gisele Chagas de; Andrade, Cláudia Regina Furquim de

doi:10.1590/2317-1782/20182017278

Cited by 5 publications

(3 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…(79) On the other hand, TBI can be responsible for swallowing deficiency and may also cause lung infections. (80) Infections, and more specifically pneumonia and urinary tract infections, have been reported in the literature as risk factors of NHO development after SCI (14,16) and TBI. (3,4) We also identified a higher incidence of urinary tract infections in patients who developed NHO.…”

Section: Discussionmentioning

confidence: 99%

Bacterial Lipopolysaccharides Exacerbate Neurogenic Heterotopic Ossification Development

Salga,

Samuel,

Tseng

et al. 2023

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

Neurogenic heterotopic ossifications (NHO) are heterotopic bones that develop in periarticular muscles after severe central nervous system (CNS) injuries. Several retrospective studies have shown that NHO prevalence is higher in patients who suffer concomitant infections. However, it is unclear whether these infections directly contribute to NHO development or reflect the immunodepression observed in patients with CNS injury. Using our mouse model of NHO induced by spinal cord injury (SCI) between vertebrae T11 to T13, we demonstrate that lipopolysaccharides (LPS) from gram‐negative bacteria exacerbate NHO development in a toll‐like receptor‐4 (TLR4)‐dependent manner, signaling through the TIR‐domain‐containing adapter‐inducing interferon‐β (TRIF/TICAM1) adaptor rather than the myeloid differentiation primary response‐88 (MYD88) adaptor. We find that T11 to T13 SCI did not significantly alter intestinal integrity nor cause intestinal bacteria translocation or endotoxemia, suggesting that NHO development is not driven by endotoxins from the gut in this model of SCI‐induced NHO. Relevant to the human pathology, LPS increased expression of osteoblast markers in cultures of human fibro‐adipogenic progenitors isolated from muscles surrounding NHO biopsies. In a case–control retrospective study in patients with traumatic brain injuries, infections with gram‐negative Pseudomonas species were significantly associated with NHO development. Together these data suggest a functional association between gram‐negative bacterial infections and NHO development and highlights infection management as a key consideration to avoid NHO development in patients. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).

show abstract

Section: Discussionmentioning

confidence: 99%

Bacterial Lipopolysaccharides Exacerbate Neurogenic Heterotopic Ossification Development

Salga,

Samuel,

Tseng

et al. 2023

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

show abstract

“…Dysphagia is a common symptom in traumatic brain injury (TBI), with a prevalence varying between 37 and 78% (1,2). It is associated with pneumonia, malnutrition, dehydration, and increased morbidity and mortality (3).…”

Section: Introductionmentioning

confidence: 99%

Neurogenic Dysphagia in Subdural Hematoma

et al. 2022

View full text Add to dashboard Cite

IntroductionDysphagia is a common and severe symptom of traumatic brain injury (TBI) affecting up to 78% of patients. It is associated with pneumonia, increased morbidity, and mortality. Although subdural hematoma (SDH) accounts for over 50% of TBI, the occurrence of dysphagia in this subtype has not been investigated yet.MethodsAll patients with SDH admitted to the author's institution between the years 2007 and 2020 were included in the study. Patients with SDH and clinical suspicion for dysphagia received a clinical swallowing assessment by a speech and language pathologist (SLP). Furthermore, the severity of dysphagia was rated according to swallowing disorder scale. Functional outcome was evaluated by the Glasgow outcome scale (GOS).ResultsOut of 545 patients with SDH, 71 patients had dysphagia (13%). The prevalence of dysphagia was significantly lower in the surgical arm compared to the conservative arm (11.8 vs. 21.8%; OR 0.23; p = 0.02). Independent predictors for dysphagia were GCS <13 at admission (OR 4.17; p < 0.001), cardiovascular disease (OR 2.29; p = 0.002), and pneumonia (OR 2.88; p = 0.002), whereas the operation was a protective factor (OR 0.2; p < 0.001). In a subgroup analysis, right-sided SDH was an additional predictor for dysphagia (OR 2.7; p < 0.001). Overall, patients with dysphagia improved significantly under the SLP treatment from the initial diagnosis to hospital discharge (p < 0.01). However, a subgroup of patients with the most severe grade of dysphagia showed no significant improvement. Patients with dysphagia had significantly worse outcomes (GOS 1–3) compared to those without dysphagia (48.8 vs. 26.4%; p < 0.001).ConclusionDysphagia is a frequent symptom in SDH, and the early identification of dysphagia is crucial regarding the initiation of treatment and functional outcome. Surgery is effective in preventing dysphagia and should be considered in high-risked patients.

show abstract

“…Outro prejuízo às pesquisas está nos países emergentes que possuem poucos estudos epidemiológicos sobre o alcance e impacto do TCE. Estatísticas sobre TCE no Brasil são raras e abordam regiões específica(FERRUCCI, et al, 2019).Segundo o Ministério da Saúde(2015), uma das causas de maior prevalência na mortalidade e morbidade em todo o mundo é o TCE, tendo um grande impacto na qualidade de vida dos pacientes. Apesar de ocorrer em questão de segundos, seus efeitos permanecem por longos períodos sobre a pessoa, sua família e a sociedade.…”

unclassified

Tratamento cirurgico de traumatismo cranioencefálico com afundamento no Brasil nos anos de 2014 a 2018

Oliveira

Spaziani

Frota

et al. 2020

BJHR

View full text Add to dashboard Cite

Comparação dos aspectos funcionais da deglutição e indicadores clínicos em pacientes com traumatismo cranioencefálico em UTI

Cited by 5 publications

References 28 publications

Bacterial Lipopolysaccharides Exacerbate Neurogenic Heterotopic Ossification Development

Bacterial Lipopolysaccharides Exacerbate Neurogenic Heterotopic Ossification Development

Neurogenic Dysphagia in Subdural Hematoma

Tratamento cirurgico de traumatismo cranioencefálico com afundamento no Brasil nos anos de 2014 a 2018

Contact Info

Product

Resources

About