Tratamento da tuberculose da coluna vertebral: conservador ou cirúrgico?

Medeiros, Rodrigo Serikawa de; Abdo, Rodrigo Calil Teles; Paula, Fabiano Cortesi de; Narazaki, Douglas Kenji; Correia, Leonardo dos Santos; Araújo, Marcelo Poderoso de; Cristante, Alexandre Fogaça; Iutaka, Alexandre Sadao; Marcon, Raphael Martus; Oliveira, Reginaldo Perilo; Filho, Tarcísio Eloy Pessoa de Barros

doi:10.1590/s1413-78522007000300001

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…Patients requiring surgery were hospitalized for longer periods than those in the group receiving only antituberculostatic treatment (Medeiros et al, 2007;Wang et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Clinical–epidemiological profile of confirmed cases of osteoarticular tuberculosis

Panico¹,

Oliveira²,

Carvalho³

et al. 2023

J. Bone Joint Infect.

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Abstract. Introduction: tuberculosis (TB) remains a major cause of morbidity and mortality worldwide. The incidence of TB has increased since the 1980s. Given the increasing prevalence of TB worldwide, osteoarticular TB (OATB) is a significant health problem. Methods: retrospective study of a case series of hospitalized patients with confirmed OATB by culture or histopathological examination who were seen at a reference orthopedic hospital in São Paulo, Brazil, from 2014 to 2019. Results: thirty patients with confirmed bone and joint TB were seen from 2014 to 2019. The main sites of OATB were the spine (83.3 %) and the appendicular skeleton (26.7 %). Indication of surgical treatment was significantly related to the need for hospitalization (p=0.009) and the increased length of hospital stay (p=0.005). Presence of sequelae at the end of treatment was correlated with the presence of motor deficit at the time of OATB diagnosis (p=0.035) as well as with initial presence of functional limitation (p=0.025) and with high value of C-reactive protein at the end of treatment (p=0.037). Conclusions: the delay in the onset of clinical and laboratory signs of cases of osteoarticular infections hinders the early diagnosis and treatment of the disease, resulting in major complications sometimes requiring surgical treatment and consequently leading to a prolonged hospital stay, evidence of high inflammatory activities, and the presence of neurological deficits.

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“…Patients requiring surgery were hospitalized for longer periods than those in the group receiving only antituberculostatic treatment (Medeiros et al, 2007;Wang et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Clinical–epidemiological profile of confirmed cases of osteoarticular tuberculosis

Panico¹,

Oliveira²,

Carvalho³

et al. 2023

J. Bone Joint Infect.

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“…[9][10][11][16][17][18][19][20][21][22] The difficulties in conducting trials on surgical interventions are well known and cannot be denied. However, once it is decided to conduct a randomized clinical trial, the sample size calculation, selection and description of the randomization and blinding of the researcher/evaluator and, whenever possible, of the patients, are required in order to provide evidence that can be safely incorporated into clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Designs of studies published in two Brazilian journals of orthopedics and sports medicine, recently indexed in the ISI Web of Science

Riera

2009

Sao Paulo Med. J.

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CONTEXT AND OBJECTIVE: The methodology and relevance of articles are among the keystones for promoting their citation and increasing journals' impact factors. Study designs appropriate for answering the questions and adequate sample sizes have the aim of reducing the risk of bias. This study evaluated the articles published in two Brazilian journals of orthopedics and sports medicine that were recently indexed in the ISI Web of Science, regarding study design, sample size calculation, randomization and blinding. DESIGN AND SETTING:Descriptive study at Brazilian Cochrane Center. METHODS:Through a manual search, all original manuscripts published in 2007 in Acta Ortopédica Brasileira and Revista Brasileira de Medicina do Esporte were selected and evaluated.RESULTS: All the 60 articles published in Acta Ortopédica Brasileira and the 87 articles in Revista Brasileira de Medicina do Esporte were included and evaluated. The commonest design in Acta Ortopédica Brasileira was experimental studies (n = 19) and in Revista Brasileira de Medicina do Esporte, update or review articles (n =14). Sample calculations were seen in a minority of the articles. None of the eight clinical trials published presented sample calculations or adequate randomization processes. Three were described as blinded, but none described the measures taken to prevent disclosure of the allocation concealment.CONCLUSIONS: Publication of studies of good methodological quality other than review and experimental studies should be strongly encouraged among Brazilian journals, with the aim of increasing their citation and therefore their impact factor. RESUMO CONTEXTO E OBJETIVO:A qualidade metodológica e a pertinência dos artigos estão entre algumas das peças fundamentais para promover sua citação e aumentar o fator de impacto da revista. Um desenho de estudo apropriado para responder às perguntas e uma amostra de tamanho adequado visam reduzir o risco de viés. Este estudo avaliou os artigos publicados em duas revistas brasileiras das áreas de ortopedia e medicina esportiva recentemente indexadas no ISI Web of Science, com relação a desenho do estudo, cálculo do tamanho amostral, aleatorização e mascaramento. TIPO DE ESTUDO E LOCAL: Estudo descritivo no Centro Cochrane do Brasil.MÉTODOS: Por meio de pesquisa manual, foram selecionados e avaliados todos os manuscritos originais publicados em 2007 na Acta Ortopédica Brasileira e Revista Brasileira de Medicina do Esporte. RESULTADOS:Todos os 60 artigos publicados na Acta Ortopédica Brasileira e os 87 artigos da Revista Brasileira de Medicina do Esporte foram incluídos e avaliados. O desenho mais comum na Acta Ortopédica Brasileira foi de estudo experimental (n = 19) e na Revista Brasileira de Medicina do Esporte, de atualização ou revisão (n = 14). O cálculo da amostra foi observado em uma minoria dos artigos. Nenhum dos oito ensaios clínicos publicados apresentou o cálculo do tamanho da amostra, nem o processo de aleatorização adequado. Três foram descritos como cegos, no entanto, nenhum descreveu a...

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Spinal Tuberculosis: Current Concepts

Rajasekaran

Soundararajan

Shetty

et al. 2018

Global Spine Journal

198

217

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Study Design:Review article.Objectives:A review of literature on the epidemiology, diagnosis, and management of spinal tuberculosis (TB).Methods:A systematic computerized literature search was performed using Cochrane Database of Systematic Reviews, EMBASE, and PubMed. Studies published over the past 10 years were analyzed. The searches were performed using Medical Subject Headings terms, and the subheadings used were “spinal tuberculosis,” “diagnosis,” “epidemiology,” “etiology,” “management,” “surgery,” and “therapy.”Results:Tissue diagnosis remains the only foolproof investigation to confirm diagnosis. Magnetic resonance imaging and Gene Xpert help in early detection and treatment of spinal TB. Uncomplicated spinal TB has good response to appropriately dosed multimodal ambulant chemotherapy. Surgery is warranted only in cases of neurological complications, incapacitating deformity, and instability.Conclusions:The incidence of atypical clinicoradiological presentations of spinal TB is on the rise. Improper dosing, inadequate duration of treatment, and inappropriate selection of candidates for chemotherapy has not only resulted in the resurgence of TB but also led to the most dreadful consequence of multidrug resistant strains. In addition, global migration phenomenon has resulted in worldwide spread of spinal TB. The current consensus is to diagnose and treat spinal TB early, prevent complications, promote early mobilization, and restore the patient to his or her earlier functional status.

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Tratamento da tuberculose da coluna vertebral: conservador ou cirúrgico?

Cited by 3 publications

References 10 publications

Clinical–epidemiological profile of confirmed cases of osteoarticular tuberculosis

Clinical–epidemiological profile of confirmed cases of osteoarticular tuberculosis

Designs of studies published in two Brazilian journals of orthopedics and sports medicine, recently indexed in the ISI Web of Science

Spinal Tuberculosis: Current Concepts

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