bluuebunny/crossref_metadata_2025 huggingface dataset:
NG2-Glia Transiently Overcome Their Homeostatic Network and Contribute to Wound Closure After Brain Injury
Authors: von Streitberg Axel , Jäkel Sarah , Eugenin von Bernhardi Jaime , Straube Christoph , Buggenthin Felix , Marr Carsten , Dimou Leda
Published: April 2021

In the adult brain, NG2-glia represent a cell population that responds to injury. To further investigate if, how and why NG2-glia are recruited to the injury site, we analyzed in detail the long-term reaction of NG2-glia after a lesion by time-lapse two-photon in vivo microscopy. Live imaging over several weeks of GFP-labeled NG2-glia in the stab wounded cerebral cortex revealed their fast and heterogeneous reaction, including proliferation, migration, polarization, hypertrophy, or a mixed response, while a small subset of cells remained unresponsive. At the peak of the reaction, 2–4 days after the injury, NG2-glia accumulated around and within the lesion core, overcoming the homeostatic control of their density, which normalized back to physiological conditions only 4 weeks after the insult. Genetic ablation of proliferating NG2-glia demonstrated that this accumulation contributed beneficially to wound closure. Thus, NG2-glia show a fast response to traumatic brain injury (TBI) and participate in tissue repair.
Rural life in the art of Palekh lacquer miniature
Authors: Zanegina A.B. , Smolenskaya V.K. , Leventseva E.N.
Published: April 2021

The article offers the analysis of the art of Palekh lacquer miniature, a phenomenon unique in the nature of the material, in the strength of the images, and in the methods of creating an artistic object that turns into a jewel and in which the epic beginning peculiar to folklore is strongly expressed. The specific examples of rural life, glorifying the beauty of working on land are presented in this type of art. In addition, the authors underline the necessity to preserve the identity of traditional crafts that are closely related to peasant life.
Classification of the territory of Middle Volga based on soil and ecological zoning
Authors: Chursin A.I. , Bibaeva R.A. , Antropov D.V. , Semenova Y.K.
Published: April 2021

The article considers the territory classification of the Middle Volga region on the basis of soil-ecological zoning. Looking at the map of erosion processes, we can see widespread erosion in the region. The high level of agro-landscape and ecological zoning make it possible to improve the validity, clarify the targeting and increase the adaptability of feed production technologies and their extrapolation, as well as to ensure stability, optimization and protection of agro-landscapes, and the effectiveness of rational nature management. The article offers a map of the territory classification of the Middle Volga region corresponding to the current state of soil cover, erosion processes and the structure of agricultural land.
Registration of security zones of power grid facilities
Authors: Olesova M.M. , Ivanova I.P.
Published: April 2021

The article deals with the registration issues of security zones of power lines and power distribution points as objects of power system. The procedure for drawing up a map (plan) of an electric grid facility has been studied and distributed in stages.
Geoecological assessment of territories on which gas condensate field facilities were liquidated
Authors: Seratirova V.V. , Pilnik Y.N.
Published: April 2021

A typical section of the tundra zone of the Far North is considered here as an object of research. Such territories slowly recover after technogenic development. Therefore, an urgent task is an assessment of the environment in the zone of the gas condensate field facilities. Carrying out such assessment before the start of reclamation makes it possible to realize the company's compliance with environmental requirements in the process of production activities, assess the tendency of environmental pollution and determine the main problems of environmental restoration.
The estimation of geoecological processes affecting depletion of water resources in the Republic of Bashkortostan
Authors: Nafikova E.V. , Dorosh I.V. , Alexandrov D.V.
Published: April 2021

The geoecological processes affecting depletion of water resources of the Republic of Bashkortostan are reflected in this paper. The zoning maps and diagrams of Bashkortostan were compiled by average annual levels of precipitation, amount of watercourses, types of land use, and types of soils. The risks of water depletion in the Republic of Bashkortostan were calculated on the basis of spatial and attribution data. On the basis of the integration of this data, the authors created the zoning map of Bashkortostan reflecting quantitative water depletion.
Complications after sciatic nerve defect repair in rats
Authors: Marin Andrei , Marin Georgiana Gabriela , Giuglea Carmen
Published: April 2021

Experimental microsurgery is a provocative field with great rewards. Nerve microsurgery is particularly challenging because the results of the operation can only be tardily observed. During this time frame, multiple complications can appear to the laboratory rats, which can influence the final results.

For this reason, when experimenting with Wistar rats, one must be familiarized with the possible complications in order to know the suitable solutions for all the issues. Lack of information and henceforth lack of action might result in compromising the final data.
Endodermal cyst of the cranio-cervical junction
Authors: Ivan Bogdanović , Rosanda Ilić , Mihajlo Milićević , Vuk Aleksić , Filip Milosavljević , Aleksandar Miljković , Vuk Šćepanović , Aleksandar Stanimirović , Žarko Nedeljković , Marko Todorović , Miloš Joković , Danica Grujičić
Published: April 2021

We report an extremely rare case of an endodermal cyst of the cranio-cervical junction located dorsally to the brainstem and upper cervical spine in a 27-year-old female presented with occipital headache, vertigo and pain in both shoulders. Neurological examination showed neck stiffness with bilateral XIth nerve palsy. Magnetic resonance imaging revealed a cystic lesion at the cranio-cervical junction and slight compression of the brain stem. The lesion was totally removed through the posterior approach. The histological diagnosis was endodermal cyst. To our knowledge, the only one such case has been reported in the literature.
Safety of metoclopramide in traumatic brain injury patients
Authors: Al Jaadi Said , Al Kindi Yahya , Al-Saadi Tariq
Published: April 2021

Background: One in every three related-injury deaths in United State are linked directly to traumatic brain injury (TBI), for which it is considered as a leading cause of death. Traumatic brain injury took place due to severe head assault to a hard object, with headache and vomiting being amongst the most common presenting symptoms. Metoclopramide is an old antiemetic agent that has been used widely for nausea and vomiting in TBI patients.
Aim: A systematic review of the literature to investigate the safety of metoclopramide in treating traumatic brain injury patients.
Methods: A literature review was conducted in 6 databases, we determine the pertinence of a study to the inclusion criteria by assessing the title, keywords, and abstracts. Five studies were found to be relevant. Data were extracted using multiple variables that were formulated incongruent with the study aim and then further analyzed.
Results: The collective sample size was 93 patients with an average of age 38.5 years. 51.6 % were male and 48.6% were females. Most patients received 10 mg metoclopramide IV with a percentage of 77.4%. While only 22.5% received 20 mg IV metoclopramide. Seventy-one patients received metoclopramide alone and 22 received combination therapy.  Headache was the most common reported side effect (46.2 %), followed by anxiety and drowsiness with (39.7%) and (27.9 %); respectively. Fatigue reported in (24.7%), while dystonia was the least common and developed only in 5.3%.
Conclusion: Metoclopramide is a common medication used to treat TBI patients in the emergency department. However, the review demonstrated that the central nervous system (CNS) side effect is excepted. Alternative options with lower CNS side effects may be better tried.
Pre-hospital care: demography, current profile and future trends
Authors: Verma Sateesh Chandra , Sachan Abhijeet Singh , Singh Surjeet , Sachan Prakrati
Published: April 2021

Introduction. Traumatic brain injury (TBI) is a major public health problem throughout the world. It is one of the leading causes of mortality and disability as a consequence results in a great financial burden on societies. Damage to the brain following trauma does not occur only at the moment of injury but also develops over a period of hours to days with the further secondary insult of the brain.
Methods. This was a prospective study done between April 2017 to March 2019. A total of 2134 patients were enrolled for this study with a collection of data in a formatted proforma. All the patients of trauma with clinical or radiological evidence of head injury coming to the trauma centre were included.
Results. In our study patient, mortality was 6.79% in patients receiving pre-hospital care compared to 12.03% in patients not receiving adequate pre-hospital care. 29.42% were in the age group of 21–30 years. RTA (overall 64.45%) was the most common mode of injury in the age group 21–30 years with 81.36% cases. Mortality in first emergency care provider by ambulance paramedics was 5.69% and member of the public was 10.10%. 
Conclusion. It was observed that mortality was higher in patients not receiving adequate pre-hospital care. Early resuscitation facilities at the site of the accident have to be introduced and improved with the execution of rapid transportation to trauma care centres.
Brain radionecrosis after radiation therapy for atypical meningioma
Authors: Abdulla Ebtesam , Luther Harleen , Shah Tejal , Chandran Nisha
Published: April 2021

Introduction. Atypical Meningioma (AM) is at high risk of local failure. The role of radiation therapy (XRT) as an adjuvant to surgical resection is incompletely defined. The most deleterious consequence of brain-directed XRT is radiation necrosis. Brain radionecrosis (BRN) after AM has been rarely reported. The relevant literature is reviewed, highlighting its diagnostic challenges.
Case Presentation. We report a 25-year-old male with a BRN after adjuvant XRT for AM, which has been misdiagnosed as a recurrent neoplastic lesion upon magnetic resonance spectroscopy (MRS) examination. Surgery and histopathological description were made and yielded a definitive diagnosis of BRN. The patient was treated by dexamethasone with concomitant hyperbaric oxygen therapy (HBO2). The patient showed a further progression of the disease. Therefore, he was elected to receive bevacizumab. However, the patient finally died for refractory brain edema.
Conclusion. BRN is a relatively rare instance after XRT for AM. There is no single modality that can reliably distinguish BRN from tumour recurrence.  Therefore, reaching an early prompt treatment decision is challenging.
Traumatic isolated intracerebellar haematoma without any supratentorial lesion
Authors: Pintu Sachin Kumar Jain , Tarun Kumar Gupta , Jaiswal Gaurav , Lohar Vishnu Kumar , Patel Prateek
Published: April 2021

Purpose. Pure isolated cerebellar haematoma of traumatic aetiology, without associated posterior fossa sub- or epidural haematomas and without supratentorial bleed is a rare entity. We conducted this retrospective study to analyze the management strategy of isolated traumatic intracerebellar haematoma without supratentorial lesion in our institute.
Methods. We retrospectively reviewed records of more than 15000 head injury patients in our department of neurosurgery between January 2014 and November 2019. In this isolated intracerebellar hematoma patients are  60. Patients were divided into two groups assessed by the GCS score at the time of presentation – Group A (GCS>13) Group B (GCS lesser than or equal to 13). Group A  treated conservatively and  B  surgically. Group A subdivided according to the size of hematoma into1st  (>3cm ) and 2nd  (<3 cm ). Group B subdivided according to GCS into 1st ( <8 ) and 2nd ( 8-13).
Results. Most Group B, subgroup 1st ( GCS<8)  patients found to be associated with poorer outcome ( 60 %) and subgroup 2nd  ( GCS 8-13) had only 10 %. Group A subgroup 1st ( > 3 cm hematoma) has associated with poor outcome ( 28.57%)  and Subgroup 2nd  ( < 3 cm ) has  4.34% . GCS score at the time of admission, hematoma size, hematoma location, the timing of surgery were important factors for outcome.
Conclusion. We concluded that hematoma size is > 3 cm and GCS > 8 patient should operate within 12 hr. Patient of GCS < 8  results of surgery are poor( 60%.) .If the size of hematoma < 3 cm, lateral hematoma and GCS >13 should be treated conservatively.  The factors which may be associated with the poor outcome are Low GCS score at the time of admission(<8), the large size of hematoma (>3cm), median location and delay time of surgery(>12hr).
Dorsolumbar angiolipoma
Authors: Gupta Surendra Kumar , Chhabra Anuj , Prajapati Hanuman Kumar , Ahmad Faran
Published: April 2021

A 55-year-old female was presented with complaints of tingling sensations of the bilateral lower limb with spastic paraplegia for last one year. Her pre-operative contrast MRI study of Dorsolumbar Spine was suggestive of extradural angiolipoma. She underwent D11, D12 and L1 Laminectomy and a mildly vascular yellowish globular extradural mass was found which was excised completely and dural decompression was achieved. Post-operatively, the patient’s neurologic symptoms improved.
Conclusion: Spinal angiolipoma is considered a rare benign entity which emulates malignancy. It should be included as a differential diagnosis of the spinal epidural tumour with fat component and a high degree of vascularisation. surgical removal of this epidural tumour through a proper and comprehensive approach provides complete and permanent recovery.
Comparative analysis of anterior third ventricle approaches
Authors: Singh Deepak Kumar , Yadav Kuldeep , Kumar Rakesh , Singh Arun Kumar , Chand Vipin Kumar
Published: April 2021

Background. Third ventricle tumors are uncommon and account for only 0.6 - 0.9% of all the brain tumors7. In 1921, Dandy was the first neurosurgeon who successfully removed a colloid cyst from the third ventricle through a posterior transcallosal approach. Despite their unfavourable locations, these tumours can be removed successfully by proper knowledge of anatomical landmarks and by choosing the appropriate approach.
Methods. We performed a retrospective analysis of all patients (17 patients) who underwent surgery for anterior third ventricular masses between March 2018 to March 2020 in the Dr Ram Manohar Lohia Institute of Medical Science Lucknow, Uttar Pradesh.
Results: The most common symptom in our cases was headache, which was present in all (100%) patients, nausea/vomiting in 7 (41%), history of recurrent episodes of drop attacks in 4 (23%), h/o seizure in 2 (11.7%), visual disturbance in 1 (5.4%), memory disturbance in 1 (5.4%) and urinary incontinence in 1 (5.4%) patient. 6 patients were operated with transcallosal-transforaminal approach, 1 patient was operated with transcallosal interforniceal approach, 3 patients were operated with transcortical-transforaminal approach, 1 patient was operated with subfrontal translamina terminalis approach, 1 patient was operated with transcallosal-transchoroidal approach, 5 patients were operated with endoscopically. Gross total excision was achieved in 15 (88%) patients while in 2 (11.7%) patients subtotal resection was done due to their adherence to choroid plexus and optic chiasm. The most common post-operative complication was endocrine dysfunction in the form of diabetes insipidus.
Conclusions. Anterior Third ventricular tumours are mostly benign and best treatment modality is surgical resection. When we analyzed the results of various approaches, we found that despite their unfavourable location, the results were satisfactory for different tumours of different location in the anterior third ventricle, when treated with the carefully planned microsurgical or endoscopic approach with proper knowledge of anatomical landmarks.
Spontaneous spinal hematoma
Authors: Mandaka Parambil Rajeev , Sasi Premkumar , Vadakkam Muriyil Pavithran , Valiyaveetil Jose Byjo , Mohan Akhil
Published: April 2021

Background. Spontaneous spinal hematoma (SSH) is a rare condition that can result in severe functional disability and even death. But early detection and prompt intervention can substantially reduce the morbidity. We present a series of seven operated cases of SSH.
Methods. All operated cases of SSH between 2017 and 2019 were studied. The demographic and clinical features, risk factors and imaging features were analyzed. The functional outcome at discharge and 6 months were assessed.
Results. Seven operated cases of SSH with mean age 35(SD-20.9) were studied. Six cases were spontaneous spinal extradural hematomas (SSEDH) and one case was spontaneous spinal subdural hematoma (SSSDH). The most common site was cervicothoracic. Risk factors associated with SSH were thrombocytopenia, pregnancy, and necrotising pancreatitis. Two patients had preoperative Frankel’s grade A-B, three had grade C and two had D. The mean interval between the onset of symptoms and surgery was 4.7days.
The functional outcome was dependent on the pre-operative functional status of the patient. Patients with SSEDH and thrombocytopenia had a poor outcome.
Conclusion. SSH even though spontaneous may be associated with risk factors. The presence of thrombocytopenia and preoperative functional status predicted outcome. This is the only single institution case series to report thrombocytopenia as a factor predicting poor outcome.
Surgical options for traumatic fractures of the thoracic and lumbar spine
Authors: Mohamed Elhawary E. , Aljboor Ghaith S. , Buzantian P. Armand
Published: April 2021

Background context. Thoracolumbar fractures represent a large number of spine injuries in adults. Such fractures are a result of traumatic accidents with high-energy impacts, such as falls from height or following motor vehicle accidents, often resulting in some degree of neurological deficit.
Purpose. To report a total of 20 cases of thoracolumbar fractures in young adults with various neurological manifestations. The majority had indications for transpedicular fixation.   
Study Design. Series of 20 cases and review of the literature. 
Patient Sample. A series of 20 patients with a history of falling from a height or after motor vehicle accidents (RTA) with complicated fractures at the level of the thoracolumbar vertebrae which present with neurological deficits. 
Methods. We report here on a total of 20 patients with a history of falls from height or following RTA. Patients presented to the hospital complaining of back and abdominal pain. Fractures at the thoracolumbar vertebral level were confirmed with imaging studies revealing post-traumatic spinal deformities. All cases were initially considered for conservative medical treatment. However, unstable complicated cases with bone fragment migration as well as spinal canal compression were deemed candidates for surgical intervention via posterior spinal fusion with transpedicular screw fixation.
Written informed consent was gathered from all patients. Detailed history, clinical examination, as well as X-ray, computed tomography and magnetic resonance imaging of the dorsolumbar spine were obtained in all cases. Neurological status was assessed using the Frankel grading for spinal cord injury. 
Results. The patients tolerated the operations without complications and remained in stable postoperative condition.  
Conclusion. Surgical treatments via transpedicular fixation are extremely efficient for treating unstable and complicated thoracolumbar spinal fractures. Nevertheless, conservative medical treatment is still of high value and should be considered as the first treatment option, especially in stable cases. The patients who underwent surgery showed excellent outcomes and improvement of neurological deficits. The surgical procedure preferred in the present study was the posterior spinal fusion with pedicle screw fixation.
Intradural migration of bullet in vertebra corpus after meningitis
Authors: Gündüz Halil İbrahim , Kandemir Turan
Published: April 2021

In a gunshot injury, the spinal cord of the thoracic region is usually the most affected and damaged part of the body. In most cases, the bullet cannot be removed without causing more damage to the injury. Over time, the bullet tends to travel in different areas of the body. Moreover, cases on bullet movements in the spinal canal were reported in the literature. In this study, we reviewed the diagnosis and treatment of a 27-year-old male patient with a bullet detected in his vertebra corpus, which is caused by a gunshot injury. During the follow-up period, an intradural migration of the bullet from the vertebra corpus was observed. Furthermore, we performed surgery to prevent any future neural damage. In this study, we focused on a case with a gunshot injury, presenting an intradural migration of a bullet from the vertebra corpus after meningitis.
Global neurosurgery, Bangladesh and COVID-19 era
Authors: Khan Robert Ahmed , Rahman Moshiur , Agrawal Amit , Garcia-Ballestas Ezequiel , Moscote-Salazar Luis Rafael
Published: April 2021

Background. COVID-19 has become an alarming pandemic for our earth. It has created panic not only in China but also in developing countries like Bangladesh. Bangladesh has adequate confinements to constrain the spread of the infection and in this circumstance, overall healthcare workers including neurosurgeons are confronting a ton of difficulties. The purpose of this paper is to depict the proficiency of Global neurosurgery in this COVID-19 time.
Method. Global neurosurgery offers the chance of fusing the best proof-based guidelines of care. This paper demonstrated that, in low to middle-income countries, Global medical procedure has been received to address the issues of residents who lack critical surgical care.
Results. Inappropriate and insufficient asset allotment has been a significant obstacle for the health system for decently giving security to the patients. The fundamental training process has been genuinely hampered in the current circumstance. Worldwide health activities have set to an alternate centre and Global neurosurgery as an assurance is slowed down.
Conclusion. This paper recommended that Global neurosurgical activities need to come forward and increase the workforce to emphasize surgical service.
On thin ice
Authors: Florian Ioan Alexandru , Timis Teodora Larisa , Beni Lehel , Serban Larisa , Florian Ioan Stefan , Bălașa Adrian , Berindan-Neagoe Ioana
Published: April 2021

Introduction. Brain vascular malformations (BVMs) are congenital lesions with evolutive properties that possess a considerable chance of causing intracranial haemorrhage. The most common types are arteriovenous malformations (AVMs), aberrant entanglements of deformed vessels that shunt blood from the arteries directly into the veins, and cavernous malformations (CMs), being mulberry-shaped sinusoid spaces filled with blood. The rate of hemorrhagic stroke varies between these two types of lesions, being the most common form of symptomatic presentation for AVMs, but a much rarer occurrence for CMs. The purpose of our pilot study was to test whether the incidence of intracranial haemorrhage from BVMs varies between seasons, as well as examining a possible causality for this event.

Material and methods. We performed a retrospective analysis on the cases of ruptured BVMs of the brain operated by the senior surgeon in our department between January 2008 and December 2019. We then divided the patients according to the type of lesion and gender, based on the month of the year when their pathologies caused the hemorrhagic stroke. We performed Pearson’s chi-square test to verify the relationship between season and rate of rupture of AVMs and CMs, individual month and rate of rupture, season and gender, and individual month and gender.

Results. There were 87 ruptured vascular malformations, out of which 71 were AVMs and 16 were CMs. There were 51 males (40 AVMs, 11 CMs) and 36 females (31 AVMs, 5 CMs). The majority of hemorrhagic strokes occurred in the months of July (10 AVVMs, 2 CMs) and December (10 AVMs, 1 CM). We obtained a statistically significant correlation between the summer season and presentation with ruptured cavernous malformation, as well as the male sex and presentation with a ruptured AVM in December, whereas the female sex presented a correlation with ruptured AVMs in the month of March. We also obtained a correlation between the male sex and presenting with a ruptured vascular malformation of any kind in December, as well as the female gender and hemorrhagic stroke from any vascular malformation in the months of January and August.

Conclusion. Despite promising statistical results, the relatively low number of cases may not be applicable to a larger patient population. It seems probable that meteorological conditions, especially extreme temperatures, might act as an additional risk factor for hemorrhagic stroke from vascular malformations, however, these findings should be corroborated with supplementary case series from other centres or a large prospective trial.
Odontogen frontoparial epidural and subdural empyema complicated with frontal intracerebral abscess and Covid
Authors: Balasa D. , Tunas A. , Stan A.V.
Published: April 2021

Introduction: Cerebral infections (frontoparietal extradural and subdural empyema) following a dental abscess and multiple sinusitis is a rare and potentially devastating entity even in the era of modern diagnosis and treatment.

Case presentation: We present a patient with parietal epidural and subdural empyema and intracerebral frontal abscess, sinusitis and dental abscess, chronic consumer of alcohol and with neglected diabetes mellitus. He was initially diagnosed with encapsulated hematoma and sinusitis. The pus obtained at the intervention was certified by our laboratory as sterile with the consequent difficulty in antibiotic treatment and who induced a longer antibiotic treatment, a second surgical intervention for an encapsulated frontal abscess, a longer hospitalisation and favoured contamination with Covid 19. Despite these, the patient had a finally good evolution.

Conclusions: A frontoparietal extradural and subdural empyema and an intracerebral frontal abscess produced by a dental abscess and sinusitis is a rare and potentially lethal complication. The multidisciplinary approach between radiologist, neurosurgeon, otolaryngologist, dentist, microbiologists is mandatory for a proper diagnosis and treatment of these pathologies.
The impact and causes of negative cortical mapping in primary motor area tumours
Authors: Coșman Mihaela , Iliescu Bogdan Florin , Sava Anca , Dumitrecu Gabriela Florența , Poeata Ion
Published: April 2021

Introduction: Intraoperative neurophysiological monitoring is the golden standard for lesions located in eloquent areas of the brain. On the one hand, positive mapping offers a view of the relationship between the anatomo-functional cortical organisation of the patient and the lesion, facilitating the choice of the cerebrotomy entry point and the resection until the functional borders are found. On the other hand, negative mapping does not offer certainty that the absence of the motor response, from the operative field, is the real feedback or is the result of the false-negative response. In such a situation, a differentiation between those two must be done.

Materials and methods: We evaluated the results of direct cortical stimulation of lesion located in or near the primary motor area, which were diagnosticated with contrast-enhancement head MRI and admitted to the Third Department of Neurosurgery, "Prof. Dr N. Oblu” Emergency Clinical Hospital, Iasi, Romania, between January 2014 and July 2018. Special attention was given especially to the negative mapping cases, regarding the histological type, imagistic localisation, symptoms and neurological outcome immediate postoperative, at 6 months and one-year follow-up.

Results: From all 66 patients meeting the inclusion and exclusion criteria in 9,09% (6 cases) we did not obtain any motor response after direct cortical stimulation. The imagistic localisations of those cases were: 3 – Rolandic, 2 – pre-Rolandic and one retro-Rolandic. Tumors histological types were: glioblastoma, anaplastic astrocytoma, oligoastrocytoma and oligodendroglioma each one case and two cases of fibrillary astrocytoma. The intensity range was between 6 – 18mA, the mode – 12mA and the median – 10mA. Postoperatively the neurological condition of 3 patients worsened (4,54% from all the cases), while 3 had a favourable evolution with symptom remission. At 6monts and one-year follow-up in one case (1,51%), we observed no improvement in contrast with the other two, where dysfunction remission was highlighted.

Conclusion: The possible technical, surgical and anesthesiologic causes of false-negative motor response must be eliminated to be able to differentiate from the real absence of the functional area from the operative field. In the first scenario, the resection may be associated with permanent postoperative neurologic deficit and major life quality alteration while in the second one the patient presents no motor dysfunction after surgery and the resection may be extensive with multiple oncological benefits.
rCBV and ADC based grading of gliomas with glimpse into radiogenomics
Authors: Rohilla Seema , Deodurg Ambresh R. , Kanakavvanavar Pritviraj S. , Singh Ishwar , Gupta Veena , Dhaulakhandi Dhara B.
Published: April 2021

Purpose. The present study was carried out to study the role of relative cerebral blood volume (rCBV), apparent diffusion coefficient (ADC) and MR spectroscopy in grading gliomas to help the surgeon plan the approach and extent of surgery as well as judge the need for any adjuvant radio/chemotherapy.

Methods. 65 patients with glioma were prospectively studied with MRI. Basic MR sequences (T1W, T2W, T2W/FLAIR) were followed by diffusion-weighted (DW) imaging with b value of 1000 (minimum ADC values used for analysis). Then the patients were administered Gadobenate Dimeglumine/ Meglumine Gadoterate in a dose of 0.1mmol/kg at a rate of 4ml/sec after which 20ml of saline was flushed at a rate of 4ml/sec and  T2*W/FFE dynamic images were acquired; dynamics showing maximum fall in the intensity were used for creating rCBV and rCBF maps and calculating rCBV. Single voxel spectroscopy (SVC) was done using the PRESS sequence with intermediate TE of 144ms. NAA/Cr, Cho/Cr, Cho/NAA, Cho+Cr/NAA and NAA/Crn ratios (NAA from the tumour, Crn from the normal side) were calculated.

Results. Grade I gliomas showed minimum ADC>0.84x10-3mm2/s and maximum rCBV<1.9ml/100gm, grade II gliomas showed min ADC 0.75-0.84x10-3mm2/s and max rCBV of 1.9-2.6ml/100gm, grade III had min ADC of 0.70-0.75x10-3mm2/s and max rCBV of 2.7-3.0ml/100gm, while grade IV tumors showed min ADC<0.70x10-3mm2/s and max rCBV>3.0ml/100gm. rCBV values were better than ADC values in differentiating grade I from II and grade II from III. The ADC values were better than rCBV values in differentiating grade III from grade IV.

Conclusions. Both minimum ADC and maximum rCBV within the tumour were significant but these parameters within peritumoral oedema were not significant in grading gliomas. Though lipid and lactate (especially lipid) peaks were found more frequently in higher-grade tumours, various spectroscopy parameters were not significant in grading gliomas. Preoperative grading of gliomas with the help of advanced MR parameters like ADC and rCBV can help the surgeon plan the approach and extent of surgery as well as judge the need for any adjuvant radio/chemotherapy. Advancing radio-genomic and radiomic technologies can supplement the current radiologic methods of diagnosis and prognosis.
Volumetric threshold of pituitary macroadenoma as a predictor to visual impairment
Authors: Elsherbini Mohamed , Saad Mahmoud , Deniwar Mohamed
Published: April 2021

Purpose: In this study, we aimed at correlating the curve of visual impairment against pituitary macroadenoma size.

Method: In this study, we retrospectively analyzed the visual correlation between the volume and dimensions of pituitary adenoma and the degree of visual impairment on patients’ examination. 35 patients with no history of eye or refraction disorder were included in the study. Spearman correlation test was used to validate the correlation.

Results: 57 % of pituitary macroadenoma patients suffer from visual impairment, even if not the primary presentation. Macroadenomas greater than 5 cm³ in volume and/or 2 cm height are more likely to cause various degrees of visual impairment, this correlation is not linear beyond these values.

Conclusion: Visual impairment due to pituitary adenomas is more frequent than the presentation, the threshold volume is 5 cm³ and height is 2 cm, bigger adenomas behaviour is more multifactorial than the only size.
Primary multiple cerebral hydatid disease in a young patient with surgically-treated intracerebral haemorrhage
Authors: Hafedh Anwar N. , Aktham Awfa A. , Al-Sharshahi Zahraa F. , Al-Jorani Ahmed Ibrahim , Albairamani Sama , Alsubaihawi Zahraa A. , Al-Khafaji Aktham O. , Hoz Samer S.
Published: April 2021

Introduction:  Cerebral hydatid disease (CHD) is rare and the multiple-cystic variety is even rarer. In this paper, we report a case of multiple CHD and explore a possible link with a preceding spontaneous intracerebral haemorrhage (ICH).  

Case presentation: A 27-year old gentleman with a history of surgically-evacuated, spontaneous ICH presented with severe headache, left-sided weakness - Medical Research Council (MRC) grade II - and recurrent tonic-clonic seizures, while on a full dose of anti-epileptic medication. Brain magnetic resonance imaging (MRI) scans showed multiple intra-axial cystic lesions in the right hemisphere. The cysts were removed intact using Dowling’s technique through a large temporoparietal craniotomy. The surgery went uneventful and the patient recovered as expected. Post-operatively, a prophylactic course of albendazole (200 mg) was prescribed. On his one-year follow-up visit, the patient was symptom-free and his weakness had improved (left upper limb: MRC grade IV and full power of the left lower limb). The computed tomography (CT) scan showed no new findings.  

Conclusion: Primary cerebral hydatid disease is rare and the multiple-cyst variety is even rare. In this case, a peculiar association with a surgically-treated ICH was explored with possible theories to suggest future research directions.
Retrospective study on early outcomes of carotid stenting
Authors: Sharma Saurabh , Singh Prashant Raj , Goyal Ram Kumar , Sharma Raghavendra Kumar , Yamada Yashuhiro , Kato Yoko
Published: April 2021

Objective: This study is conducted to evaluate the early events after Carotid artery stenting (CAS) among our patients in a single institute.
Methods: This study was conducted on 40 patients. These patients underwent stenting of extracranial carotid arteries. Stenting was performed on symptomatic patients with carotid artery stenosis of more than 50 per cent of asymptomatic patients with more than 70 per cent carotid artery stenosis on Doppler ultrasonography. Follow up period for this study was of one month. 
Results: 40 patients who underwent CAS between August 2018 and June 2019 were included in the study. Self-expandable hybrid stents were implanted in all patients and pre or poststent-dilatation was performed if required after implantation. None of the patients suffered from a stroke, myocardial infarction or death due to CAS during their hospital stay. Only one patient had a minor stroke during follow up, which was managed conservatively. No transient ischemic attack (TIA), myocardial infarction or death during the follow-up period. Re-stenosis was not observed in the follow-up carotid Doppler ultrasonography; flow rates were within normal limits.
Conclusions: Carotid stenting is a safe alternative to CEA (carotid endarterectomy) in the treatment of carotid stenosis regardless of age. CAS with cerebral protection can be performed safely in patients who are at high surgical risk, with low perioperative morbidity and mortality. The durability of the procedure must be determined with a longer follow-up. Further high-quality RCTs are required to address other shortcomings and controversies.
Safety of surgical management of accessory sinus pericranii in infants
Authors: Elsherbini Mohamed M. , Badr Hatem , Khalil Amr Farid
Published: April 2021

Purpose: to better understand the pathological process of sinus pericranii and the safety of the surgical intervention.

Methods: patients’ archive review of patients who underwent surgical management for sinus pericranii with a confirmed diagnosis and with follow up period greater than 6 months.

Results: 6 infants were included; all underwent disconnection surgically with good outcome in all cases.

Conclusion: disconnection surgery for sinus pericranii is a safe procedure with a good prognosis.
El respeto a los animales como tema transversal en valores para educación inicial
Authors: Prince Torres Ángel Carmelo
Published: April 2021

Los infantes durante los primeros años de sus vidas están en el momento ideal para cimentar las bases de su sistema de creencias, en consonancia con los objetivos sociales. Este trabajo tuvo como propósito desarrollar la importancia de la noción sobre respeto hacia los animales como tema transversal desde la educación inicial, de manera que se potencie en los niños un sistema de valores fundado en la empatía. El esquema investigativo utilizado fue documental con enfoque cualitativo y método hermenéutico. Con la información recabada se determinó que episodios de maltrato animal ocurren alrededor del mundo, y la educación es un instrumento que puede reconducir ese fenómeno porque los niños en el proceso de aprendizaje están prestos a construir conocimientos. Se concluyó que es importante que el niño dentro de educación inicial tenga nociones sobre las vidas de los animales, y esto ayudará a que desarrolle sensibilidad hacia la naturaleza.
Importancia de la asignatura cátedra Integradora en el desarrollo de los estudiantes de Profesionalización de la UNAE
Authors: Castillo Pinos Karina Maribel , Rodríguez Carrión Juan Alejandro , Luengo Molero Dilida Anayra
Published: April 2021

La asignatura de Cátedra Integradora se ha constituido en una herramienta implementada para ayudar a los estudiantes universitarios a desarrollar investigaciones y proyectos que les permitirá vincularse con su profesión durante el proceso académico de titulación. Por lo tanto, se consideró pertinente establecer desde una perspectiva teórica la importancia de la asignatura de Cátedra Integradora en el desarrollo de los estudiantes de Profesionalización de la UNAE. En este sentido, la limitada disponibilidad de material informativo sobre la relevancia de esta asignatura en la UNAE puso en evidencia la necesidad de llevar a cabo la presente investigación; en cuyo caso, se desarrolló a partir de un estudio de carácter explicativo y descriptivo considerando como población a los estudiantes de la carrera de Profesionalización y docentes de la asignatura para el levantamiento de la información.
Una mirada gerontológica hacia la política social y educación permanente en latinoamérica
Authors: Ortiz-Hernández Arantxa , Rodríguez-Díaz Melina
Published: April 2021

La educación permanente es una propuesta innovadora que aspira la inclusión y optimización de los recursos internos de las personas en su aprendizaje. Su presencia en las convenciones internacionales como un derecho señala la adopción de ella para la elaboración de políticas sociales enfocadas a la población mayor de México y en Latinoamérica. El objetivo de este estudio fue la búsqueda y comparación de los parámetros de los programas enfocados a la educación permanente. La búsqueda de información fue por medio de la revisión diferentes documentos oficiales de instituciones públicas de México y y otros países latinoamericanos. A pesar de que actualmente existen planes y programas que acatan este requerimiento, se desconoce su estado de implementación y los resultados que verdaderamente tiene en la población de adultos. Es necesaria la participación colectiva de instituciones públicas y privadas para un desarrollo educativo de calidad en las personas adultas mayores.
Requerimientos de la gestión de la calidad en las empresas venezolanas de fluidos de perforación
Authors: González Antepaz Oscar Miguel
Published: April 2021

La presente investigación tuvo como objetivo analizar los requerimientos de la gestión de la calidad en las empresas venezolanas de fluidos de perforación. La metodología fue de tipo descriptivo, con un diseño no experimental, de campo, transeccional. La población quedó conformada por las siete (7) empresas que prestan servicios de fluidos de perforación en la Costa Oriental del Lago, siendo los informantes un total de 14 personas. La información se recolectó a través de un cuestionario contentivo de 12 ítems, con escala de frecuencias. Para procesar los resultados se recurrió al método de la estadística descriptiva, en específico la media aritmética (X ?) o promedio. Se concluye, si bien las empresas en estudio cuentan en términos generales con un alto cumplimiento en cuanto a la manera como la organización asume responsabilidad, y procede al establecimiento de responsabilidades con una buena planificación estratégica.
Proceso de gestión del conocimiento. Experiencia en la industria petrolera venezolana
Authors: Urribarri Estrada Norbellys Coromoto
Published: April 2021

El propósito de la investigación fue describir el proceso de gestión del conocimiento en las gerencias de operaciones acuáticas de la industria petrolera en el estado Zulia. El tipo de investigación fue descriptiva, de campo, transeccional no experimental. La población estuvo conformada por 46 sujetos entre líderes, gerentes y supervisores. Se utilizó la encuesta, mediante un cuestionario, validado por el juicio de expertos. La confiabilidad se determinó mediante el Coeficiente de Alpha Cronbach, cuyo valor fue 0,95 (muy alta confiabilidad). Se aplicó la estadística descriptiva, con base en la media y la desviación estándar. Los resultados obtenidos revelaron que los componentes del proceso de la gestión del conocimiento están medianamente presentes en las gerencias estudiadas, siendo determinantes en el cumplimiento de los objetivos organizacionales; estableciendo la importancia de elaborar un diagnóstico interno a fin de establecer una valoración en base a las carencias y oportunidades de la organización.
Tipos de mantenimiento aplicados en la industria petrolera venezolana de la Región Occidente
Authors: Paredes Renny
Published: April 2021

El estudio forma parte de una investigación de mayor alcance, cuyo objetivo general fue analizar la gestión de mantenimiento a taladros y gabarras en las divisiones de la industria petrolera venezolana en la región occidente. Este avance tuvo como propósito determinar los tipos de mantenimiento que se aplican en las mencionadas divisiones. La investigación fue descriptiva, con diseño no experimental, de campo y transeccional. Participaron cuatro divisiones, cuyas unidades informantes fueron los gerentes, líderes y supervisores. La técnica aplicada fue la encuesta y el instrumento un cuestionario, conformado por 12 ítems; validado por el juicio de expertos, con una confiabilidad muy alta de 0.89 según el método Alfa Cronbach. El análisis de los datos se realizó con estadística descriptiva, con base en la media aritmética. Se concluye que, estos tipos de mantenimiento: correctivo, preventivo, predictivo y proactivo arribaron a baja aplicación.
A review of mass concentrations of Bramblings Fringilla montifringilla: implications for assessment of large numbers of birds
Authors: Svensson Tomas
Published: April 2021

Mass concentrations of birds, or the lack thereof, is a phenomenon of great ecological and domestic significance. Apart from being and indicator of, e.g., food availability, ecological change, and population size, it is also a source of conflict between humans and birds. By attracting the attention of the public—either as a spectacular phenomenon or as an unwelcome pest—they also form the public perception of birds and their abundance. In the context of the mass concentration of Bramblings Fringilla montifringilla in Sweden during the winter 2019–2020, this work reviews the literature on this striking phenomenon. I found that winter roosts amount to about one million birds per hectare of roost area, but the variation between reports is significant. There is support for roosts of up to around 15 million Bramblings, but much larger numbers are frequently cited in the literature. I discuss difficulties related to the assessment of mass concentrations, and argue that reports of very large numbers should always be carefully scrutinized.
Kan Kültürlerinden İzole Edilen Nonfermentatif Gram Negatif Bakterilerin Çeşitli Antibiyotiklere Direnç Durumları
Authors: TANRIVERDİ ÇAYCI Yeliz , KARACAN Gülşah , GÜR VURAL Demet , BİLGİN Kemal , BIRINCI Asuman
Published: April 2021

Amaç:Bu çalışmadaki amacımız, hastanemizde çeşitli kliniklerde tedavi görmekte olan hastaların kan kültürlerinden izole edilen nonfermentatif gram negatif bakterileri tanımlamak, antimikrobiyal direnç profillerini incelemektir.
Yöntem:Tıbbi Mikrobiyoloji laboratuvarına Haziran 2016 – Haziran 2019 tarihleri arasında gönderilen kan kültürleri retrospektif olarak değerlendirildi. Kan kültürleri otomatize sistem ile BacT/Alert (BioMerieux, Fransa) çalışıldı. Üreyen mikroorganizmaların tanımlanması Vitek MS (BioMérieux, Fransa) ile antibiyotik duyarlılıkları Mueller- Hinton (BioMérieux, Fransa) agarda disk difüzyon yöntemi ve VITEK 2 (BioMerieux, Fransa) otomatize sistemle belirlenmiştir.Antibiyotik duyarlılık oranları EUCAST (European Committee on Antimicrobial Susceptibility Testing) kriterlerine göre değerlendirilmiştir.
Bulgular: Laboratuvarımızda3 yıllık sürede kan kültürlerinden 668 nonfermentatif bakteri izole edildi.İzole edilen mikroorganizmaların 299’u (%45) Acinetobacter spp. ve bunların 270 tanesi Acinetobacter baumanniiolarak tespit edildi. 189’ u (%28) Pseudomonas spp. ve bunların 164 tanesi Pseudomonas aeruginosa olarak tespit edildi.42’ sini (%6)Stenotrophomonas maltophilia, geriye kalan 138’ ini (%21) diğer nonfermentatif bakteriler oluşturmaktadır. Acinetobacter spp. en yüksekdirenç oranlarılevofloksasin ve siprofloksasin için %76 olarak saptanmıştır. Pseudomonas spp. en yüksek direnç oranları piperasilin için %32 olarak saptanmıştır. Stenotrophomonas maltophilia’ ların hepsi trimetoprim/ sülfometoksazol’ e duyarlı saptanmıştır.

Sonuç:Hastanemizde elde ettiğimiz kan kültürlerindeki nonfermentatif bakterilerin antibiyotik direnç sonuçları, gelecek yıllarda oluşacak antimikrobiyal direnç paternlerine ışık tutması bakımından önem taşımaktadır.Kan dolaşımı enfeksiyonu etkenlerinin ve duyarlılık testlerinin devamlı olarak takip edilerek etkin tedavi protokollerinin uygulanması gerekmektedir.