[Sociodemographic/clinical Characteristics and Outcomes of Patients Admitted to the National Burn Center of Chile].

[Sociodemographic/clinical characteristics and outcomes of patients admitted to the National Burn Center of Chile].

Rev Med Chil. 2013 Feb; 141(2): 181-6
Albornoz CR, Villegas J, Peña V, Whittle S

Background: Approximately 150 subjects per year suffer severe burns in Chile. Aim: To analyze sociodemographic/clinical features and outcomes of severely burned patients. Material and Methods: Retrospective cohort study of 936 patients aged 47 ± 20 years (66% males), admitted to the National Burn Center of Chile between 2006 and 2010. Sociodemographic/clinical and burn variables and outcomes were studied. Results: Mean total percentage of body surface area burned was 27 + 20%. A quarter of the patients had social features that could jeopardize rehabilitation. Fire was the burning agent in 73%, which along with electricity presented greater lethality (p < 0.01). Inhalation injury was diagnosed in 22% of the patients. Twenty eight percent of patients had impaired consciousness at the moment of the accident, leading to larger burns, higher incidence of inhalation injury and greater lethality. Lethality for severe, critical and exceptional survival groups was 8.4,37.7 and 70.4%, respectively. Conclusions: Severely burned patients in Chile are mainly males at working age. Fire is the main agent and 28% had impaired consciousness, which was associated with an increase in the severity of burns. Knowledge of the characteristics and outcomes of the patients is important to implement prevention and treatment strategies adjusted to the national reality. HubMed – rehab

 

Mandibular alveolar reconstruction using three-dimensional planning.

Curr Opin Otolaryngol Head Neck Surg. 2013 May 31;
Moore EJ, Hinni ML, Arce K, Salinas T

PURPOSE OF REVIEW: Resection of malignant disease often results in full-thickness segmental defects of the mandible and loss of dentition. Ideal rehabilitation of the patient requires replacement of the missing segment with vascularized bone that will receive dental implants, and allow osseointegrated prosthetic rehabilitation and restoration of dentition and proper occlusion. Inexact contouring of the bony reconstruction can result in both cosmetic and functional defects that can diminish the future quality of life of the patient. This review summarizes recent advances in preoperative planning and intraoperative techniques that can maximize the success of proper alveolar reconstruction and dental restoration of the patient suffering a segmental maxillary or mandibular defect. RECENT FINDINGS: Preoperative modeling can be achieved with computer software that utilizes patient imaging. From this imaging, anticipated surgical defects can be planned, models can be generated, and intraoperative templates can be produced. These can be used to improve reconstructive plate bending, relative positioning of bone to opposing jaw, contouring of the reconstructive bone, and even placement of osseointegrated implants in a single operative setting. SUMMARY: In patients with complex mandibular defects, the use of computer-assisted three-dimensional planning and modeling can result in time-saving and improved outcomes during maxillary and mandibular reconstruction. HubMed – rehab

 

The Validity and Reliability of Non-invasive Methods for Measuring Kyphosis.

J Spinal Disord Tech. 2013 May 31;
Azadinia F, Kamyab M, Behtash H, Saleh Ganjavian M, Javaheri MR

STUDY DESIGN:: A cross- sectional study. OBJECTIVE:: To examine the inter-rater and intra-rater reliability and validity of tools for measuring thoracic kyphosis, namely the digital inclinometer and the flexicurve. SUMMARY OF BACKGROUND DATA:: Various methods are used to measure kyphosis, each with advantages and disadvantages. Radiography is common, highly reliable and valid, but unsuitable for regular use because of radiation exposure and cost. Other clinical methods allow safe and rapid assessment of spinal curvature. The validity and reliability of some inclinometers have been confirmed; however, there are no data that compares inclinometers and flexicurves with radiography for measuring thoracic kyphosis. METHODS:: We enrolled 105 patients with hyperkyphosis, aged 10-80 years. The Cobb angle was measured radiographically by a spine specialist. Two other examiners, blinded to the Cobb angles, measured thoracic kyphosis using the flexicurve and digital inclinometer. RESULTS:: Comparing the kyphosis angle with the radiographic Cobb angle, as a gold standard, revealed that the digital inclinometer was reasonably valid for patients aged <30 and >50 years while the validity of the flexicurve in both age ranges was poor. On the intra-rater evaluation, the digital inclinometer provided a high reliability in patients aged <30 and >50 years; whereas the flexicurve was also acceptable in this regard. On the other hand on the inter-rater evaluation, the digital inclinometer provided a high reliability in subjects aged <30 and >50 years. The flexicurve provided a poor inter-rater reliability in subjects aged <30 years and an acceptable level in those aged >50 years. CONCLUSIONS:: The digital inclinometer is a valid and reliable instrument for measuring thoracic kyphosis and can be used for regular screening. On the other hand, the flexicurve has poor inter-rater and intra-rater reliability. HubMed – rehab