Injuries of the Limbs in Polytrauma: Upper and lower limbs

Extremity injuries are the second most common traumatic injuries after head injuries and account until 80% of all cases of vascular trauma. Peripheral injuries are usually not immediately lethal, whether due to penetrating or blunt injuries; nevertheless, a prompt identification of the injuries is crucial for a correct management. There has been a growing role for both diagnostic and interventional radiology (IR) in all types of trauma affecting different areas of the body, with imaging becoming an integral part of the multidisciplinary approach to modern trauma care. Nowadays, successful revascularization with limb salvage is almost routine, and ischemic limb loss has become the rare exception. Despite success in arterial repair, desirable outcomes with regard to extremity function and disability more often depend on successful identification and treatment of the frequent coexisting injuries to the bone, nerves, and soft tissue. The aim of this chapter is to focalize on injuries of the limbs in polytraumatic patient and to the decision processes associated with the workup and the endovascular interventions (EVIs) of these injuries

Restless Legs Syndrome and Pain Disorders: What’s in common?

Between 10 % and 30 % of the population report chronic pain. More than half of these also have sleep complaints. From considering these data, it can be inferred there is a significant overlapping between these conditions. Restless Legs Syndrome/Willis-Ekbom Disease (RLS/WED) is characterized by complaints of an urge to move frequently associated with dysesthesias. From that perspective, these sensations can also have painful characteristics. By the same token, the presence of comorbid diseases as predicted by a higher prevalence RLS/WED, have many of them with pain as an important complaint. Pain is a multidimensional response involving several levels of expression ranging from somatosensory to emotional. the potential shared mechanisms between RLS/WED and pain may involve sleep deprivation/fragmentation effect, inducing an increase in markers of inflammation and reduction in pain thresholds. These are modulated by several different settings of neurotransmitters with a huge participation of monoaminergic dysfunctional circuits. A thorough comprehension of these mechanisms is of utmost importance for the correct approach and treatment choices.Hosp Israelita Albert Einstein, Dept Neurofisiol Clin, BR-05652900 São Paulo, BrazilUniv Brasilia, Fac Med, BR-70844110 Brasilia, DF, BrazilHosp Israelita Albert Einstein, BR-05652900 São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, Fac Med ABC FMABC, BR-05652900 São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, Fac Med ABC FMABC, BR-05652900 São Paulo, BrazilWeb of Scienc