DANIEL RUBIO DE SOUZA

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6
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Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina
IRLM, Hospital das Clínicas, Faculdade de Medicina
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina

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Assunto: Rehabilitation ×

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  • bookPart 0 Citação(ões) na Scopus
    Rehabilitation and wheelchair users after spinal cord injury: An overview
    (2022) RIBERTO, M.; WU, L. J. L.; SOUZA, D. R. de
    Spinal cord injury (SCI) is one of the most complex clinical conditions that occur in humans involving physical aspects such as motor, sensory, and autonomic changes with great emotional, economic, and social implications. Considering the numerous consequences of SCI in human functioning, one must keep clear the objectives for the rehabilitation process, which may comprise motor achievements like gait, wheelchair abilities, transfers, selfcare, sphincter management, sexual and reproductive intentions, as well as social participation in education, leisure, and work. Robotic rehabilitation has proved to be highly efficient rehabilitation resources because of the elevated number of repetitions of movements and enhanced engagement through interactive interfaces. Powered exoskeletons have been used for exercises and socialization when available for nontherapeutic purposes. Numerous actions regarding clinical treatment and prevention of complications should be taken as soon as possible to facilitate clinical management and reduce morbidity and mortality. Among the most usual clinical complications of SCI are pressure ulcers, neurogenic bladder and bowel, spasticity, joint deformities, heterotopic ossification, musculoskeletal and neuropathic pain, pneumonia, and suicides. The SCI clinician must be aware of these problems and act toward their prevention and control. © 2022 Elsevier Inc. All rights reserved.
  • article 13 Citação(ões) na Scopus
    Post-discharge mortality in patients with traumatic spinal cord injury in a Brazilian hospital: a retrospective cohort
    (2019) LEITE, Victor F.; SOUZA, Daniel R. de; IMAMURA, Marta; BATTISTELLA, Linamara R.
    Study design Retrospective cohort. Objective To evaluate the survival outcomes in patients with traumatic spinal cord injury (TSCI). Setting A teaching hospital in Brazil. Methods A total of 434 patients diagnosed with TSCI (2004-2014) were included. Overall survival, standardized mortality ratios (SMR), and causes of death were assessed by Student's t-test, chi(2) test, Kaplan-Meier analysis, and Cox proportional-hazards regression. Results The mean follow-up was 4.8 years (+/- 3.3 years). Individuals with tetraplegia had a median survival of 11 years, with participants in the paraplegia group not reaching median survival. The overall mortality rate was 37 per 1000 person-years. Age-adjusted SMR was 28.8 (95% CI: 22.8-36). There were 77 deaths with 56 defined causes, of which pneumonia was the most frequent (35.7%). Combined infectious etiologies caused 55.3% of deaths. Multivariate analysis revealed higher mortality among individuals with tetraplegia vs. paraplegia in the first 2 years post injury (HR = 8.28, 95% CI: 2.76-24.80), after 2 years post injury (HR = 2.35, 95% CI: 1.31-4.24), and in all years combined (HR = 3.36, 95% CI: 2.04-5.52). Conclusion Mortality among patients with TSCI was 28.8 times higher than in the reference population. In more than half of the cases, the cause of death was linked to infectious diseases. Pneumonia caused two times more deaths in individuals with tetraplegia than in individuals with paraplegia, with a higher impact in the first 2 years post injury. Reported findings indicate the need for a surveillance and prevention program with emphasis on vaccination and respiratory rehabilitation.
  • article 16 Citação(ões) na Scopus
    Evaluation of Sexual Dysfunction in Men With Spinal Cord Injury Using the Male Sexual Quotient
    (2016) MIRANDA, Eduardo P.; GOMES, Cristiano Mendes; BESSA JR., Jose de; ABDO, Carmita Helena Najjar; BELLUCCI, Carlos Henrique Suzuki; CASTRO FILHO, Jose Everton de; CARVALHO, Fabricio Leite de; SOUZA, Daniel Rubio de; BATTISTELLA, Linamara Rizzo; SCAZUFCA, Marcia; BRUSCHINI, Homero; BARROS FILHO, Tarcisio; SROUGI, Miguel.
    Objective: To assess different aspects of sexual function in men with spinal cord injury (SCI) using the Male Sexual Quotient (MSQ), a newly developed tool to assess sexual function and satisfaction. Design: Cross-sectional study. Setting: Tertiary rehabilitation center. Participants: Patients (N=295) older than 18 years (mean age +/- SD, 40.7 +/- 14.5y) with SCI for more than 1 year (median time since SCI, 3.6y; range, 1.6-7.0y) were assessed from February to August 2012. Patients completed the MSQ questionnaire and the Sexual Health Inventory for Men (SHIM). Interventions: Not applicable. Main Outcome Measures: Performance in various domains of sexual function was evaluated using the MSQ and SHIM questionnaires. Results: Erectile function, ejaculation, and orgasm were the most severely affected domains. The median MSQ score was 40 (range, 8-66), and the median SHIM score was 5 (range, 0-16). The diagnostic properties of the 2 instruments were similar in the discrimination of sexually active subjects. The area under the receiver operating characteristic curve was .950 (95% confidence interval [CI], .923.979) for the MSQ and .942 (95% CI, .915.968) for the SHIM. There was a strong correlation between the 2 instruments (r=.826; 95% CI, .802.878). Conclusions: Different domains of sexual function are severely impaired in men with SCI, although their sexual interest remains high. The MSQ and SHIM scores strongly correlate, but the MSQ provides a more comprehensive assessment of sexual dysfunction in male patients with SCI. (C) 2016 by the American Congress of Rehabilitation Medicine
  • article 14 Citação(ões) na Scopus
    Proximal tibia fracture in a patient with incomplete spinal cord injury associated with robotic treadmill training
    (2015) FILIPPO, T. R. M.; CARVALHO, M. C. L. De; CARVALHO, L. B.; SOUZA, D. R. de; IMAMURA, M.; BATTISTELLA, L. R.
    Study design: One case report of proximal tibia fracture in a patient with incomplete spinal cord injury (SCI) associated with robotic treadmill training. Objective: To raise the awareness that bone densitometry may be recommended before starting the robotic treadmill therapy, as well as the active vigilance of symptoms after therapy. Setting: Institute of Physical and Rehabilitation Medicine, Lucy Montoro Institute for Rehabilitation, Hospital das Clinicas, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil. Case report: The patient, female gender, with a fracture of vertebra T12 and arthrodesis from T9 to L1 (American Spinal Injury Association Classification (ASIA-C)). Training on Lokomat consisted of five 30-min weekly sessions, under the supervision of a qualified professional. At the beginning of the 19th session, the patient complained of pain in the anterior region of the left knee. Lokomat and any other body support therapy were discontinued. Magnetic resonance imaging (MRI) evidenced a transverse, oblique, metaphyseal proximal anterior and medial tibial fracture. Conclusion: Fractures are among the chronic complications of a SCI, affecting 34% and many times arising from minimal traumas. Lokomat resembles physiological walking, and more studies show its benefits. Many studies encourage the use of robotic devices for the rehabilitation of lower limbs, but there are still several unanswered questions. However, there are not enough studies to show whether there is a higher risk of fracture incidence in patients with osteopenia or osteoporosis who trained on the Lokomat.