Reviewing the prognostic factors in myelomeningocele
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2019 |
| Outros Autores: | , , , , , , , , , |
| Tipo de documento: | Artigo |
| Idioma: | eng |
| Título da fonte: | Repositório Institucional da FIOCRUZ (ARCA) |
| Texto Completo: | https://www.arca.fiocruz.br/handle/icict/44072 |
Resumo: | Departamento de Cirurgia Pediátrica. Divisão de Neurocirurgia Pediátrica. |
| id |
CRUZ_f84acc6a0d8463d3514289d6d97b5423 |
|---|---|
| oai_identifier_str |
oai:www.arca.fiocruz.br:icict/44072 |
| network_acronym_str |
CRUZ |
| network_name_str |
Repositório Institucional da FIOCRUZ (ARCA) |
| repository_id_str |
2135 |
| spelling |
Cervante, Tatiana ProtzenkoBellas, AntônioPousa, Marcelo SampaioProtzenko, MichelleFontes, Juliana MarinSilveira, Anne Margareth de LimaSá, Cynthia AmaralPereira, José PauloSalomão, Renato ManganelliSalomão, José Francisco ManganelliGomes Junior, Saint Clair dos Santos2020-10-19T19:35:43Z2020-10-19T19:35:43Z2019CERVANTE, Tatiana Protzenko et al. Reviewing the prognostic factors in myelomeningocele. Neurosurg Focus, v. 47, n. 4, p. 1-7, Oct. 2019.1092-0684https://www.arca.fiocruz.br/handle/icict/4407210.3171/2019.7.FOCUS19462engAmerican Association of Neurological SurgeonsReviewing the prognostic factors in myelomeningoceleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleDepartamento de Cirurgia Pediátrica. Divisão de Neurocirurgia Pediátrica.Departamento de Cirurgia Pediátrica. Divisão de Neurocirurgia Pediátrica.Unidade de Pesquisa Clínica.Unidade de Pesquisa Clínica.Departamento de Urodinâmica Pediátrica e Micção Disfuncional.Departamento de Cirurgia Pediatrica. Divisão de Neurocirurgia Pediátrica.Departamento de Medicina Fetal e Neonatologia..Universidade Federal do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Departamento de Cirurgia Pediatrica. Divisão de Neurocirurgia Pediátrica. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Departamento de Pesquisa Clínica. Rio de Janeiro, RJ, Brasil.Objective: The goal of this study was to analyze the factors that have an impact on morbidity and mortality in patients with myelomeningocele (MMC). Methods: A retrospective cohort study was conducted to analyze factors associated with MMC that influence the morbidity and mortality of the disease. Data were collected from medical records of children who underwent the primary repair of MMC at the Fernandes Figueira Institute-Oswaldo Cruz Foundation (IFF-Fiocruz) between January 1995 and January 2015, with a minimum follow-up of 1 year. The following variables were analyzed: demographic characteristics (gestational age, sex, and birth weight); clinical features (head circumference at birth, anatomical and functional levels of MMC, hydrocephalus, symptomatic Chiari malformation type II, neurogenic bladder, and urinary tract infection [UTI]); and surgical details such as timing of repair of MMC, age at first shunt placement, shunt surgery modality (elective or emergency), concurrent surgery (correction of MMC and shunt insertion in the same surgical procedure), incidence and cause of shunt dysfunction, use of external ventricular drain, transfontanelle puncture, surgical wound complications prior to shunting, and endoscopic treatment of hydrocephalus. Results: A total of 231 patients with MMC were included in the analysis. Patients were followed for periods ranging from 1 to 20 years, with a mean of 6.9 years. The frequency of shunt placement was observed mainly among patients with MMC at the highest spinal levels (p < 0.01). The main causes of morbidity and mortality in patients with MMC were shunt failures, diagnosed in 91 of 193 cases (47.2%) of hydrocephalus, and repeated UTIs, in 129 of 231 cases (55.8%) of MMC; these were the main causes of hospitalization and death. Head circumference ≥ 38 cm at birth was found to be a significant risk factor for shunt revision (p < 0.001; 95% CI 1.092-1.354). Also, the lumbar functional level of MMC was associated with less revision than upper levels (p < 0.014; 95% CI 0.143-0.805). There was a significant association between recurrent UTI and thoracic functional level. Conclusions: Macrocephaly at birth and higher levels of the defect have an impact on worse outcome and, therefore, are a challenge to the daily practice of pediatric neurosurgery.MyelomeningoceleChiari malformation type IIHydrocephalusSpinal dysraphismCerebrospinal fluid shuntinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txttext/plain1748https://www.arca.fiocruz.br/bitstream/icict/44072/1/license.txt8a4605be74aa9ea9d79846c1fba20a33MD51ORIGINALtatiana_protzenko_et_all.pdfapplication/pdf1777467https://www.arca.fiocruz.br/bitstream/icict/44072/2/tatiana_protzenko_et_all.pdfb1dea2c60443f4ecc14806f1f200f584MD52TEXTtatiana_protzenko_et_all.pdf.txttatiana_protzenko_et_all.pdf.txtExtracted texttext/plain37985https://www.arca.fiocruz.br/bitstream/icict/44072/3/tatiana_protzenko_et_all.pdf.txt330780ab68b51a9b5f83c427ff65b257MD53icict/440722020-10-20 02:14:57.7oai:www.arca.fiocruz.br:icict/44072Tk9URTogUExBQ0UgWU9VUiBPV04gTElDRU5TRSBIRVJFClRoaXMgc2FtcGxlIGxpY2Vuc2UgaXMgcHJvdmlkZWQgZm9yIGluZm9ybWF0aW9uYWwgcHVycG9zZXMgb25seS4KCk5PTi1FWENMVVNJVkUgRElTVFJJQlVUSU9OIExJQ0VOU0UKCkJ5IHNpZ25pbmcgYW5kIHN1Ym1pdHRpbmcgdGhpcyBsaWNlbnNlLCB5b3UgKHRoZSBhdXRob3Iocykgb3IgY29weXJpZ2h0Cm93bmVyKSBncmFudHMgdG8gRFNwYWNlIFVuaXZlcnNpdHkgKERTVSkgdGhlIG5vbi1leGNsdXNpdmUgcmlnaHQgdG8gcmVwcm9kdWNlLAp0cmFuc2xhdGUgKGFzIGRlZmluZWQgYmVsb3cpLCBhbmQvb3IgZGlzdHJpYnV0ZSB5b3VyIHN1Ym1pc3Npb24gKGluY2x1ZGluZwp0aGUgYWJzdHJhY3QpIHdvcmxkd2lkZSBpbiBwcmludCBhbmQgZWxlY3Ryb25pYyBmb3JtYXQgYW5kIGluIGFueSBtZWRpdW0sCmluY2x1ZGluZyBidXQgbm90IGxpbWl0ZWQgdG8gYXVkaW8gb3IgdmlkZW8uCgpZb3UgYWdyZWUgdGhhdCBEU1UgbWF5LCB3aXRob3V0IGNoYW5naW5nIHRoZSBjb250ZW50LCB0cmFuc2xhdGUgdGhlCnN1Ym1pc3Npb24gdG8gYW55IG1lZGl1bSBvciBmb3JtYXQgZm9yIHRoZSBwdXJwb3NlIG9mIHByZXNlcnZhdGlvbi4KCllvdSBhbHNvIGFncmVlIHRoYXQgRFNVIG1heSBrZWVwIG1vcmUgdGhhbiBvbmUgY29weSBvZiB0aGlzIHN1Ym1pc3Npb24gZm9yCnB1cnBvc2VzIG9mIHNlY3VyaXR5LCBiYWNrLXVwIGFuZCBwcmVzZXJ2YXRpb24uCgpZb3UgcmVwcmVzZW50IHRoYXQgdGhlIHN1Ym1pc3Npb24gaXMgeW91ciBvcmlnaW5hbCB3b3JrLCBhbmQgdGhhdCB5b3UgaGF2ZQp0aGUgcmlnaHQgdG8gZ3JhbnQgdGhlIHJpZ2h0cyBjb250YWluZWQgaW4gdGhpcyBsaWNlbnNlLiBZb3UgYWxzbyByZXByZXNlbnQKdGhhdCB5b3VyIHN1Ym1pc3Npb24gZG9lcyBub3QsIHRvIHRoZSBiZXN0IG9mIHlvdXIga25vd2xlZGdlLCBpbmZyaW5nZSB1cG9uCmFueW9uZSdzIGNvcHlyaWdodC4KCklmIHRoZSBzdWJtaXNzaW9uIGNvbnRhaW5zIG1hdGVyaWFsIGZvciB3aGljaCB5b3UgZG8gbm90IGhvbGQgY29weXJpZ2h0LAp5b3UgcmVwcmVzZW50IHRoYXQgeW91IGhhdmUgb2J0YWluZWQgdGhlIHVucmVzdHJpY3RlZCBwZXJtaXNzaW9uIG9mIHRoZQpjb3B5cmlnaHQgb3duZXIgdG8gZ3JhbnQgRFNVIHRoZSByaWdodHMgcmVxdWlyZWQgYnkgdGhpcyBsaWNlbnNlLCBhbmQgdGhhdApzdWNoIHRoaXJkLXBhcnR5IG93bmVkIG1hdGVyaWFsIGlzIGNsZWFybHkgaWRlbnRpZmllZCBhbmQgYWNrbm93bGVkZ2VkCndpdGhpbiB0aGUgdGV4dCBvciBjb250ZW50IG9mIHRoZSBzdWJtaXNzaW9uLgoKSUYgVEhFIFNVQk1JU1NJT04gSVMgQkFTRUQgVVBPTiBXT1JLIFRIQVQgSEFTIEJFRU4gU1BPTlNPUkVEIE9SIFNVUFBPUlRFRApCWSBBTiBBR0VOQ1kgT1IgT1JHQU5JWkFUSU9OIE9USEVSIFRIQU4gRFNVLCBZT1UgUkVQUkVTRU5UIFRIQVQgWU9VIEhBVkUKRlVMRklMTEVEIEFOWSBSSUdIVCBPRiBSRVZJRVcgT1IgT1RIRVIgT0JMSUdBVElPTlMgUkVRVUlSRUQgQlkgU1VDSApDT05UUkFDVCBPUiBBR1JFRU1FTlQuCgpEU1Ugd2lsbCBjbGVhcmx5IGlkZW50aWZ5IHlvdXIgbmFtZShzKSBhcyB0aGUgYXV0aG9yKHMpIG9yIG93bmVyKHMpIG9mIHRoZQpzdWJtaXNzaW9uLCBhbmQgd2lsbCBub3QgbWFrZSBhbnkgYWx0ZXJhdGlvbiwgb3RoZXIgdGhhbiBhcyBhbGxvd2VkIGJ5IHRoaXMKbGljZW5zZSwgdG8geW91ciBzdWJtaXNzaW9uLgo=Repositório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352020-10-20T05:14:57Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)false |
| dc.title.pt_BR.fl_str_mv |
Reviewing the prognostic factors in myelomeningocele |
| title |
Reviewing the prognostic factors in myelomeningocele |
| spellingShingle |
Reviewing the prognostic factors in myelomeningocele Cervante, Tatiana Protzenko Myelomeningocele Chiari malformation type II Hydrocephalus Spinal dysraphism Cerebrospinal fluid shunt |
| title_short |
Reviewing the prognostic factors in myelomeningocele |
| title_full |
Reviewing the prognostic factors in myelomeningocele |
| title_fullStr |
Reviewing the prognostic factors in myelomeningocele |
| title_full_unstemmed |
Reviewing the prognostic factors in myelomeningocele |
| title_sort |
Reviewing the prognostic factors in myelomeningocele |
| author |
Cervante, Tatiana Protzenko |
| author_facet |
Cervante, Tatiana Protzenko Bellas, Antônio Pousa, Marcelo Sampaio Protzenko, Michelle Fontes, Juliana Marin Silveira, Anne Margareth de Lima Sá, Cynthia Amaral Pereira, José Paulo Salomão, Renato Manganelli Salomão, José Francisco Manganelli Gomes Junior, Saint Clair dos Santos |
| author_role |
author |
| author2 |
Bellas, Antônio Pousa, Marcelo Sampaio Protzenko, Michelle Fontes, Juliana Marin Silveira, Anne Margareth de Lima Sá, Cynthia Amaral Pereira, José Paulo Salomão, Renato Manganelli Salomão, José Francisco Manganelli Gomes Junior, Saint Clair dos Santos |
| author2_role |
author author author author author author author author author author |
| dc.contributor.author.fl_str_mv |
Cervante, Tatiana Protzenko Bellas, Antônio Pousa, Marcelo Sampaio Protzenko, Michelle Fontes, Juliana Marin Silveira, Anne Margareth de Lima Sá, Cynthia Amaral Pereira, José Paulo Salomão, Renato Manganelli Salomão, José Francisco Manganelli Gomes Junior, Saint Clair dos Santos |
| dc.subject.en.pt_BR.fl_str_mv |
Myelomeningocele Chiari malformation type II Hydrocephalus Spinal dysraphism Cerebrospinal fluid shunt |
| topic |
Myelomeningocele Chiari malformation type II Hydrocephalus Spinal dysraphism Cerebrospinal fluid shunt |
| description |
Departamento de Cirurgia Pediátrica. Divisão de Neurocirurgia Pediátrica. |
| publishDate |
2019 |
| dc.date.issued.fl_str_mv |
2019 |
| dc.date.accessioned.fl_str_mv |
2020-10-19T19:35:43Z |
| dc.date.available.fl_str_mv |
2020-10-19T19:35:43Z |
| dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
| dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
| format |
article |
| status_str |
publishedVersion |
| dc.identifier.citation.fl_str_mv |
CERVANTE, Tatiana Protzenko et al. Reviewing the prognostic factors in myelomeningocele. Neurosurg Focus, v. 47, n. 4, p. 1-7, Oct. 2019. |
| dc.identifier.uri.fl_str_mv |
https://www.arca.fiocruz.br/handle/icict/44072 |
| dc.identifier.issn.pt_BR.fl_str_mv |
1092-0684 |
| dc.identifier.doi.none.fl_str_mv |
10.3171/2019.7.FOCUS19462 |
| identifier_str_mv |
CERVANTE, Tatiana Protzenko et al. Reviewing the prognostic factors in myelomeningocele. Neurosurg Focus, v. 47, n. 4, p. 1-7, Oct. 2019. 1092-0684 10.3171/2019.7.FOCUS19462 |
| url |
https://www.arca.fiocruz.br/handle/icict/44072 |
| dc.language.iso.fl_str_mv |
eng |
| language |
eng |
| dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
| eu_rights_str_mv |
openAccess |
| dc.publisher.none.fl_str_mv |
American Association of Neurological Surgeons |
| publisher.none.fl_str_mv |
American Association of Neurological Surgeons |
| dc.source.none.fl_str_mv |
reponame:Repositório Institucional da FIOCRUZ (ARCA) instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ |
| instname_str |
Fundação Oswaldo Cruz (FIOCRUZ) |
| instacron_str |
FIOCRUZ |
| institution |
FIOCRUZ |
| reponame_str |
Repositório Institucional da FIOCRUZ (ARCA) |
| collection |
Repositório Institucional da FIOCRUZ (ARCA) |
| bitstream.url.fl_str_mv |
https://www.arca.fiocruz.br/bitstream/icict/44072/1/license.txt https://www.arca.fiocruz.br/bitstream/icict/44072/2/tatiana_protzenko_et_all.pdf https://www.arca.fiocruz.br/bitstream/icict/44072/3/tatiana_protzenko_et_all.pdf.txt |
| bitstream.checksum.fl_str_mv |
8a4605be74aa9ea9d79846c1fba20a33 b1dea2c60443f4ecc14806f1f200f584 330780ab68b51a9b5f83c427ff65b257 |
| bitstream.checksumAlgorithm.fl_str_mv |
MD5 MD5 MD5 |
| repository.name.fl_str_mv |
Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ) |
| repository.mail.fl_str_mv |
repositorio.arca@fiocruz.br |
| _version_ |
1794075614017224704 |