Preoperative Evaluation For The Use Of Cranial Halo Traction In The Spine Treatment Of Rigid Deformities [avaliação Pré-operatória Visando Ao Uso Do Halo Craniano No Tratamento De Deformidades Rígidas Da Coluna Vertebral]

Objective: to assess the efficacy and safety of using the gravitational cranial halo as a technique for treating rigid deformities in the spinal column and to revisit complications associated to the treatment. Methods: a total often patients with rigid spinal deformities were studied, with the following deformities: kyphosis, scoliosis, kyphoscoliosis and cervical hyperlordosis. The criterion for including a patient was the use of the gravitational cranial halo in a postoperative period and interoperative period for rigid spinal deformities. The patient medical records and their radiographic measurements were studied and compared in a preoperative period, after the installation of the gravitational cranial halo and in the postoperative period. The aspects analyzed were: age, sex, angular value of the main curvature and angular value of the secondary curvature, angular value of the major sagittal curvature, traction protocol and type of procedure. Results: in the frontal plane, an average angle of 89.9° was found in the preoperative period, decreasing to 65° after the installation of the halo and 56.9° in the postoperative period. In the sagittal plane, an angular value of 77.7° was observed, decreasing to 55.4° with the use of the halo and 46.5° in the postoperative period. Conclusion: the conclusion was that the use of cranial halo traction is an efficient method for correcting rigid spinal deformities, taking into account that there was significant correction of the deformities from the preoperative period to the post installation of the halo and the postoperative period, without any neurological lesions or serious complications resulting from the treatment.94417423Seller, K., Haas, S., Raab, P., Krauspe, R., Wild, A., Preoperative Halo-traction in severe paralytic scoliosis (2005) Zeitschrift fur Orthopadie und Ihre Grenzgebiete, 143 (5), pp. 539-543. , DOI 10.1055/s-2005-836750Rinella, A., Lenke, L., Whitaker, C., Kim, Y., Park, S.S., Peelle, M., (2005) Perioperative Halo-gravity Traction in the Treatment of Severe Scoliosis An Kyphosis, 30 (4), pp. 475-482. , Spine (Phila Pa 1976)Stagnara, P., Cranial traction using the Halo of Rancho Los Amigos (1971) Rev Chir Orthop Reparatrice Appar Mot., 57 (4), pp. 287-300Edgar, M.A., Chapman, R.H., Glasgow, M.M.S., Pre-operative correction in adolescent idiopathic scoliosis (1982) Journal of Bone and Joint Surgery - Series B, 64 (5), pp. 530-535Kane, W.J., Moe, J.H., Lai, C.C., Halofemoral pin distraction in the treatment of scoliosis (1967) J Bone Joint Surg Am., 49, pp. 1018-1019Schmidt, A.C., Halo-tibial traction combined with the Milwaukee Brace (1971) Clin Orthop Relat Res., (77), pp. 73-83Campbell, W.C., (1996) Cirurgia Ortopédica de Campbell., , São Paulo: Manole;Perry, J., Nickel, V.L., Total cervicalspine fusion for neck paralysis (1959) J Bone Joint Surg Am., 41 A (1), pp. 37-60Garfin, S.R., Botte, M.J., Waters, R.L., Nickel, V.L., Complications in the use of the halo fixation device (1986) Journal of Bone and Joint Surgery - Series A, 68 (3), pp. 320-325Caird, M.S., Hensinger, R.N., Weiss, N., Farley, F.A., Complications and problems in halo treatment of toddlers: Limited ambulation is recommended (2006) Journal of Pediatric Orthopaedics, 26 (6), pp. 750-752. , DOI 10.1097/01.bpo.0000235395.19042.3f, PII 0124139820061100000011Humbyrd, D.E., Latimer, F.R., Lonstein, J.E., Samberg, L.C., (1981) Brain Abscess As A Complication of Halo Traction, 6 (4), pp. 365-368. , Spine (Phila Pa 1976)Letts, R.M., Palakar, G., Bobecko, W.P., Preoperative skeletal traction in scoliosis (1975) J Bone Joint Surg Am., 57 (5), pp. 616-619Tredwell, S.J., O'Brien, J.P., Apophyseal joint degeneration in the cervical spine following halo-pelvic distraction (1980) Spine (Phila Pa 1976), 5 (6), pp. 497-501O'Brien, J.P., Yau, A.C., Hodgson, A.R., Halo pelvic traction: A technic for severe spinal deformities (1973) Clin Orthop Relat Res., (93), pp. 179-190MacEwen, G.D., Bunnell, W.P., Sriram, K., Acute neurological complications in the treatment of scoliosis. A report of the Scoliosis Research Society (1975) J Bone Joint Surg Am., 57 (3), pp. 404-408Ginsburg, G.M., Basse, G.S., Hypoglossal nerve injury caused by halo-suspension traction (1998) A Case Report., 23 (13), pp. 1490-1493. , Spine (Phila Pa 1976)Nickel, V.L., Perry, J., Garrett, A., Heppenstall, M., The halo. A spinal skeletal traction fixation device (1968) J Bone Joint Surg Am., 50 (7), p. 14009Bonnett, C., Perry, J., Brown, J.C., Greenberg, B.J., Halo-femoral distraction and posterior spine fusion for paralytic scoliosis (1972) J Bone Joint Surg Am., 54, p. 202Salim, F.A., Zielke, K., Osteoporosis and halo traction in scoliosis patients (1982) Zeitschrift fur Orthopadie und Ihre Grenzgebiete, 120 (3), pp. 330-33

Evolução da enfermagem no contexto do hospital-escola: depoimentos de enfermeiros representantes da década de 70 Evolución de la enfermería en el contexto de hospital-escuela: declaraciones de enfermeros de la década de 70 Nursing evolution at university hospitals: declarations of nurses who worked in the 1970s

Este estudo é parte de um projeto mais amplo que visa resgatar aspectos significativos relacionados a revolução da assistência de enfermagem da década de 50 a 90. Este resgate é feito através da técnica de depoimentos orais de enfermeiros em exército e aposentados, no contexto de um hospital-escola do interior paulista. O presidente estudo particulariza os resultados obtidos, referentes a década de 70. Como resultado evidencia-se o esforço empreendido pelos enfermeiros na luta pelo reconhecimento e prestígio da profissão, as transformações intensas e profundas aos novos papéis da enfermeira enquanto líder da equipe e membro da equipe médica.<br>Este estudio es parte de un proyecto más amplio intentando la captación de aspectos significativos relacionados a la evaluación de la asistencia de enfermería en las décadas de 50 a 90. La captación se ha realizado a través de la técnica de declaraciones orales de los enfermeros en ejercicio de la profesión, en el contexto de un hospital-escuela de interior del Estado de São Paulo. El presente estudio particulariza los resultados obtenidos, referentes a la década de 70. Como resultados se evidencian el esfuerzo imprimido por las enfermeras en la lucha por el reconocimiento y prestigio de la profesión. Las transformaciones intensas y profundas relacionadas a los nuevos roles de la enfermera como líder de los trabajadores de enfermería y miembro del grupo de la salud.<br>This study is part of a more extensive project that proposes to recover significant aspects related to nursing care evolution from 1950s. This study is developed through the technique of oral declaration by active and retired registered nurses, in the context of an university-hospital from São Paulo State. The present study emphasizes the outcomes referring to the 1970s. As result becomes evident the undertaken effort by nurses in the struggle for profession's recognition and prestige; intense and deep transformations related to nurse's new roles as leadership of nursing staff and member of medical team