Concomitant trauma of brain and upper cervical spine: lessons in injury patterns and outcomes

Purpose: The literature on concomitant traumatic brain injury (TBI) and traumatic spinal injury is sparse and a few, if any, studies focus on concomitant TBI and associated upper cervical injury. The objective of this study was to fill this gap and to define demographics, patterns of injury, and clinical data of this specific population. Methods: Records of patients admitted at a single trauma centre with the main diagnosis of TBI and concomitant C0-C1-C2 injury (upper cervical spine) were identified and reviewed. Demographics, clinical, and radiological variables were analyzed and compared to those of patients with TBI and: (i) C3-C7 injury (lower cervical spine); (ii) any other part of the spine other than C1-C2 injury (non-upper cervical); (iii) T1-L5 injury (thoracolumbar). Results: 1545 patients were admitted with TBI and an associated C1-C2 injury was found in 22 (1.4%). The mean age was 64 years, and 54.5% were females. Females had a higher rate of concomitant upper cervical injury (p = 0.046 vs non-upper cervical; p = 0.050 vs thoracolumbar). Patients with an upper cervical injury were significantly older (p = 0.034 vs lower cervical; p = 0.030 vs non-upper cervical). Patients older than 55 years old had higher odds of an upper cervical injury when compared to the other groups (OR = 2.75). The main mechanism of trauma was road accidents (RAs) (10/22; 45.5%) All pedestrian injuries occurred in the upper cervical injured group (p = 0.015). ICU length of stay was longer for patients with an upper cervical injury (p = 0.018). Four patients died in the upper cervical injury group (18.2%), and no death occurred in other comparator groups (p = 0.003). Conclusions: The rate of concomitant cranial and upper cervical spine injury was 1.4%. Risk factors were female gender, age ≥ 55, and pedestrians. RAs were the most common mechanism of injury. There was an association between the upper cervical injury group and longer ICU stay as well as higher mortality rates. Increased understanding of the pattern of concomitant craniospinal injury can help guide comprehensive diagnosis, avoid missed injuries, and appropriate treatment

Protocolo para avaliação do estoque de carbono e de nitrogênio do solo em sistemas florestais - Projeto Saltus.

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Monitoramento dos fluxos de gases de efeito estufa de plantio de pinus e mata nativa, Rio Negrinho, SC.

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L'importanza ecologica e fitoalimurgica dei prati ricchi di specie del Trentino

Il cambiamento del sistema foraggero-zootecnico, da estensivo a intensivo, ha determinato la progressiva sostituzione del letame con il liquame. L’uso del liquame come fertilizzante riduce l’oligotrofia del suolo e porta alla banalizzazione delle fitocenosi erbacee. Nell’ambito del progetto Bioagrimont sono state indagate con metodo floristico-vegetazionale e statistico 25 fitocenosi (plots 5m x 5m) prato-pascolive a diversa gestione e quota altimetrica delle valli di Fiemme, di Fassa e Passo di Lavazè. I risultati confermano la correlazione negativa tra ricchezza floristica (S) e apporto di nutrienti (N) ed evidenziano una sensibile perdita del valore naturalistico per i prati del fondovalle. Si dimostra inoltre che le praterie a maggior ricchezza floristica, legate a ridotto o nullo apporto di nutrienti, funzionano da serbatoio di specie potenzialmente utili anche a livello alimentare e officinal